Impact of Kidney Function on Effects of the Dietary Approaches to Stop Hypertension (Dash) Diet.

OBJECTIVES: Although the Dietary Approaches to Stop Hypertension (DASH) diet lowers blood pressure in adults with hypertension, how kidney function impacts this effect is not known. We evaluated whether Estimated Glomerular Filtration Rate (eGFR) modifies the effect of the DASH diet on blood pressure, markers of mineral metabolism, and markers of kidney function. METHODS: Secondary analysis of the DASH-Sodium trial, a multicenter, randomized, controlled human feeding study that evaluated the blood pressure lowering effect of the DASH diet at three levels of sodium intake. Data from 92 participants with pre-hypertension or stage 1 hypertension during the 3450 mg /day sodium diet assignment contributed to this analysis. Stored frozen plasma and urine specimens were used to measure kidney related laboratory outcomes. RESULTS: Effects of the DASH diet on blood pressure, phosphorus, intact parathyroid hormone, creatinine, and albuminuria were not modified by baseline eGFR (mean 84.5 ± 18.0 ml/min/1.73 m(2), range 44.1 to 138.6 ml/min/1.73 m(2)) or the presence of chronic kidney disease (N=13%). CONCLUSIONS: The impact of the DASH diet on blood pressure, markers of mineral metabolism, and markers of kidney function does not appear to be modified by eGFR in this small subset of DASH-Sodium trial participants with relatively preserved kidney function. Whether greater reduction in eGFR modifies the effects of DASH on kidney related measures is yet to be determined. A larger study in individuals with more advanced kidney disease is needed to establish the efficacy and safety of the DASH diet in this patient population.

Adaptive intervention design in mobile health: Intervention design and development in the Cell Phone Intervention for You trial.

BACKGROUND/AIMS: The obesity epidemic has spread to young adults, and obesity is a significant risk factor for cardiovascular disease. The prominence and increasing functionality of mobile phones may provide an opportunity to deliver longitudinal and scalable weight management interventions in young adults. The aim of this article is to describe the design and development of the intervention tested in the Cell Phone Intervention for You study and to highlight the importance of adaptive intervention design that made it possible. The Cell Phone Intervention for You study was a National Heart, Lung, and Blood Institute-sponsored, controlled, 24-month randomized clinical trial comparing two active interventions to a usual-care control group. Participants were 365 overweight or obese (body mass index≥25 kg/m2) young adults. METHODS: Both active interventions were designed based on social cognitive theory and incorporated techniques for behavioral self-management and motivational enhancement. Initial intervention development occurred during a 1-year formative phase utilizing focus groups and iterative, participatory design. During the intervention testing, adaptive intervention design, where an intervention is updated or extended throughout a trial while assuring the delivery of exactly the same intervention to each cohort, was employed. The adaptive intervention design strategy distributed technical work and allowed introduction of novel components in phases intended to help promote and sustain participant engagement. Adaptive intervention design was made possible by exploiting the mobile phone's remote data capabilities so that adoption of particular application components could be continuously monitored and components subsequently added or updated remotely. RESULTS: The cell phone intervention was delivered almost entirely via cell phone and was always-present, proactive, and interactive-providing passive and active reminders, frequent opportunities for knowledge dissemination, and multiple tools for self-tracking and receiving tailored feedback. The intervention changed over 2 years to promote and sustain engagement. The personal coaching intervention, alternatively, was primarily personal coaching with trained coaches based on a proven intervention, enhanced with a mobile application, but where all interactions with the technology were participant-initiated. CONCLUSION: The complexity and length of the technology-based randomized clinical trial created challenges in engagement and technology adaptation, which were generally discovered using novel remote monitoring technology and addressed using the adaptive intervention design. Investigators should plan to develop tools and procedures that explicitly support continuous remote monitoring of interventions to support adaptive intervention design in long-term, technology-based studies, as well as developing the interventions themselves.

The Physarum polycephalum Genome Reveals Extensive Use of Prokaryotic Two-Component and Metazoan-Type Tyrosine Kinase Signaling.

Physarum polycephalum is a well-studied microbial eukaryote with unique experimental attributes relative to other experimental model organisms. It has a sophisticated life cycle with several distinct stages including amoebal, flagellated, and plasmodial cells. It is unusual in switching between open and closed mitosis according to specific life-cycle stages. Here we present the analysis of the genome of this enigmatic and important model organism and compare it with closely related species. The genome is littered with simple and complex repeats and the coding regions are frequently interrupted by introns with a mean size of 100 bases. Complemented with extensive transcriptome data, we define approximately 31,000 gene loci, providing unexpected insights into early eukaryote evolution. We describe extensive use of histidine kinase-based two-component systems and tyrosine kinase signaling, the presence of bacterial and plant type photoreceptors (phytochromes, cryptochrome, and phototropin) and of plant-type pentatricopeptide repeat proteins, as well as metabolic pathways, and a cell cycle control system typically found in more complex eukaryotes. Our analysis characterizes P. polycephalum as a prototypical eukaryote with features attributed to the last common ancestor of Amorphea, that is, the Amoebozoa and Opisthokonts. Specifically, the presence of tyrosine kinases in Acanthamoeba and Physarum as representatives of two distantly related subdivisions of Amoebozoa argues against the later emergence of tyrosine kinase signaling in the opisthokont lineage and also against the acquisition by horizontal gene transfer.

Proxemics: The World is a Deaf Machine

A multi-channel sound installation involving fixed loudspeakers and multiple mp3 players, commissioned by the Sainsbury Centre of Visual Arts, Norwich as a response to the sculpture of Ian Tyson and the architecture of Denys Lasdun.

Relación entre la innovación de las empresas y el comportamiento del consumidor en el lanzamiento de nuevos productos en la industria de bebidas no alcohólicas

Como consumidores todas las personas toman decisiones de compra todos los días. Respondiendo a esto, la mayoría de empresas investigan esas decisiones para conocer qué, cómo, cuánto, dónde, cuándo y por qué compran los consumidores en el momento en que lo hacen. Cuando se logra descubrir estos factores, nace el interés por parte de las compañías de agregar características a los productos ofrecidos o lanzar nuevos productos al mercado con el fin de responder a esas necesidades descubiertas en las investigaciones. En el mercado de bebidas no alcohólicas, durante los últimos dos años, se ha presentado en los consumidores una mayor preferencia hacia productos más saludables y a tener exigencias mayores en las presentaciones y cualidades de las bebidas. En las empresas del sector, por otro lado, la tendencia es a encontrar una mayor amplitud y profundidad de las líneas de productos ofrecidos en el mercado en cuestión. Dado que el comportamiento de los consumidores y las acciones correspondientes de las empresas están estrechamente vinculados, se hace necesario estudiar y establecer la relación que existe entre estos factores que se han evidenciado en el mercado de bebidas no alcohólicas, con el fin de entender la nueva dinámica del sector y aportar sugerencias que podrían representar oportunidades para el crecimiento del mismo.

Proceso de Internacionalización y aproximación a la logística de servicios: TELMEX COLOMBIA

Telmex es una organización que inicia su operación como empresa estatal mexicana con bajos niveles de eficiencia, posterior a su privatización tomó un nuevo rumbo en sus procesos internos, llevándola a generar modelos de negocio diferenciados y enfocados a la prestación de servicios de telecomunicación a la vanguardia. A partir de la búsqueda de nuevos horizontes la compañía logra tener presencia en la mayoría de los países del continente americano operando bajo la marca de “Telmex Internacional”, y a su vez, con sus respectivas subsidiarias en cada uno de los diferentes países, con el objetivo de satisfacer las necesidades locales con mayor efectividad. Con el apoyo de los diferentes acercamientos teóricos se busca identificar los patrones que le permitieron a Telmex llegar a posicionarse como una compañía líder en el sector de las telecomunicaciones en Latinoamérica y específicamente en Colombia, manteniéndose en un mercado competitivo mediante la oferta de servicios de empaquetamiento ajustados a las necesidades de los clientes.

Patient and public involvement in healthcare quality improvement: how organizations can help patients and professionals to collaborate

Citizens across the world are increasingly called upon to participate in healthcare improvement. It is often unclear how this can be made to work in practice. This 4- year ethnography of a UK healthcare improvement initiative showed that patients used elements of organizational culture as resources to help them collaborate with healthcare professionals. The four elements were: (1) organizational emphasis on nonhierarchical, multidisciplinary collaboration; (2) organizational staff ability to model desired behaviours of recognition and respect; (3) commitment to rapid action, including quick translation of research into practice; and (4) the constant data collection and reflection process facilitated by improvement methods.

When enough is not enough: information overload and metacognitive decisions to stop studying information

People are often exposed to more information than they can actually remember. Despite this frequent form of information overload, little is known about how much information people choose to remember. Using a novel “stop” paradigm, the current research examined whether and how people choose to stop receiving new—possibly overwhelming—information with the intent to maximize memory performance. Participants were presented with a long list of items and were rewarded for the number of correctly remembered words in a following free recall test. Critically, participants in a stop condition were provided with the option to stop the presentation of the remaining words at any time during the list, whereas participants in a control condition were presented with all items. Across five experiments, we found that participants tended to stop the presentation of the items to maximize the number of recalled items, but this decision ironically led to decreased memory performance relative to the control group. This pattern was consistent even after controlling for possible confounding factors (e.g., task demands). The results indicated a general, false belief that we can remember a larger number of items if we restrict the quantity of learning materials. These findings suggest people have an incomplete understanding of how we remember excessive amounts of information.

I owe you: age-related similarities and differences in associative memory for gains and losses

Older adults often experience associative memory impairments but can sometimes remember important information. The current experiments investigate potential age-related similarities and differences associate memory for gains and losses. Younger and older participants were presented with faces and associated dollar amounts, which indicated how much money the person “owed” the participant, and were later given a cued recall test for the dollar amount. Experiment 1 examined face-dollar amount pairs while Experiment 2 included negative dollar amounts to examine both gains and losses. While younger adults recalled more information relative to older adults, both groups were more accurate in recalling the correct value associated with high value faces compared to lower value faces and remembered gist-information about the values. However, negative values (losses) did not have a strong impact on recall among older adults versus younger adults, illustrating important associative memory differences between younger and older adults.

Metacognition and proofreading: the roles of aging, motivation, and interest

Objectives: The current study examined younger and older adults’ error detection accuracy, prediction calibration, and postdiction calibration on a proofreading task, to determine if age-related difference would be present in this type of common error detection task. Method: Participants were given text passages, and were first asked to predict the percentage of errors they would detect in the passage. They then read the passage and circled errors (which varied in complexity and locality), and made postdictions regarding their performance, before repeating this with another passage and answering a comprehension test of both passages. Results: There were no age-related differences in error detection accuracy, text comprehension, or metacognitive calibration, though participants in both age groups were overconfident overall in their metacognitive judgments. Both groups gave similar ratings of motivation to complete the task. The older adults rated the passages as more interesting than younger adults did, although this level of interest did not appear to influence error-detection performance. Discussion: The age equivalence in both proofreading ability and calibration suggests that the ability to proofread text passages and the associated metacognitive monitoring used in judging one’s own performance are maintained in aging. These age-related similarities persisted when younger adults completed the proofreading tasks on a computer screen, rather than with paper and pencil. The findings provide novel insights regarding the influence that cognitive aging may have on metacognitive accuracy and text processing in an everyday task.

An Agent-Based Approach to Real-Time Patient Identification for Clinical Trials

Patient recruitment for clinical trials is expensive and has been a significant challenge, with many trials not achieving their recruitment goals. One method that shows promise for improving recruitment is the use of interactive prompts that inform practitioners of patient eligibility for clinical trials during consultation. This paper presents the ePCRN-IDEA recruitment system, which utilises an agent-based infrastructure to enable real-time recruitment of patients. In essence, whenever patients enter a clinic, the system compares their details against eligibility criteria, which define the requirements of active clinical trials. If a patient is found to be eligible, a prompt is raised to notify the user. In this way, it becomes possible for recruitment to take place quickly in a cost effective manner, whilst maintaining patient trust through the involvement of their own health care practitioner.