Sum-Rate and Power Scaling of Massive MIMO Systems with Channel Aging

This paper investigates the achievable sum-rate of massive multiple-input multiple-output (MIMO) systems in the presence of channel aging. For the uplink, by assuming that the base station (BS) deploys maximum ratio combining (MRC) or zero-forcing (ZF) receivers, we present tight closed-form lower bounds on the achievable sum-rate for both receivers with aged channel state information (CSI). In addition, the benefit of implementing channel prediction methods on the sum-rate is examined, and closed-form sum rate lower bounds are derived. Moreover, the impact of channel aging and channel prediction on the power scaling law is characterized. Extension to the downlink scenario and multi-cell scenario are also considered. It is found that, for a system with/without channel prediction, the transmit power of each user can be scaled down at most by 1= p M (where M is the number of BS antennas), which indicates that aged CSI does not degrade the power scaling law, and channel prediction does not enhance the power scaling law; instead, these phenomena affect the achievable sum-rate by degrading or enhancing the effective signal to interference and noise ratio, respectively.

Plasma levels of intermedin (adrenomedullin-2) in healthy human volunteers and patients with heart failure

Intermedin/adrenomedullin-2 (IMD) is a member of the adrenomedullin/CGRP peptide family. Less is known about the distribution of IMD than for other family members within the mammalian cardiovascular system, particularly in humans. The aim was to evaluate plasma IMD levels in healthy subjects and patients with chronic heart failure. IMD and its precursor fragments, preproIMD25–56 and preproIMD57–92, were measured by radioimmunoassay in 75 healthy subjects and levels of IMD were also compared to those of adrenomedullin (AM) and mid-region proadrenomedullin45–92 (MRproAM45–92) in 19 patients with systolic heart failure (LVEF < 45%). In healthy subjects, plasma levels (mean + SE) of IMD (6.3 + 0.6 pg ml−1) were lower than, but correlated with those of AM (25.8 + 1.8 pg ml−1; r = 0.49, p < 0.001). Plasma preproIMD25–56 (39.6 + 3.1 pg ml−1), preproIMD57–92 (25.9 + 3.8 pg ml−1) and MRproAM45–92 (200.2 + 6.7 pg ml−1) were greater than their respective bioactive peptides. IMD levels correlated positively with BMI but not age, and were elevated in heart failure (9.8 + 1.3 pg ml−1, p < 0.05), similarly to MRproAM45–92 (329.5 + 41.9 pg ml−1, p < 0.001) and AM (56.8 + 10.9 pg ml−1, p < 0.01). IMD levels were greater in heart failure patients with concomitant renal impairment (11.3 + 1.8 pg ml−1) than those without (6.5 + 1.0 pg ml−1; p < 0.05). IMD and AM were greater in patients receiving submaximal compared with maximal heart failure drug therapy and were decreased after 6 months of cardiac resynchronization therapy. In conclusion, IMD is present in the plasma of healthy subjects less abundantly than AM, but is similarly correlated weakly with BMI. IMD levels are elevated in heart failure, especially with concomitant renal impairment, and tend to be reduced by high intensity drug or pacing therapy.

Retinal pigment epithelial cell multinucleation in the aging eye - a mechanism to repair damage and maintain homoeostasis

Retinal pigment epithelial (RPE) cells are central to retinal health and homoeostasis. Dysfunction or death of RPE cells underlies many age-related retinal degenerative disorders particularly age-related macular degeneration. During aging RPE cells decline in number, suggesting an age-dependent cell loss. RPE cells are considered to be postmitotic, and how they repair damage during aging remains poorly defined. We show that RPE cells increase in size and become multinucleate during aging in C57BL/6J mice. Multinucleation appeared not to be due to cell fusion, but to incomplete cell division, that is failure of cytokinesis. Interestingly, the phagocytic activity of multinucleate RPE cells was not different from that of mononuclear RPE cells. Furthermore, exposure of RPE cells in vitro to photoreceptor outer segment (POS), particularly oxidized POS, dose-dependently promoted multinucleation and suppressed cell proliferation. Both failure of cytokinesis and suppression of proliferation required contact with POS. Exposure to POS also induced reactive oxygen species and DNA oxidation in RPE cells. We propose that RPE cells have the potential to proliferate in vivo and to repair defects in the monolayer. We further propose that the conventionally accepted 'postmitotic' status of RPE cells is due to a modified form of contact inhibition mediated by POS and that RPE cells are released from this state when contact with POS is lost. This is seen in long-standing rhegmatogenous retinal detachment as overtly proliferating RPE cells (proliferative vitreoretinopathy) and more subtly as multinucleation during normal aging. Age-related oxidative stress may promote failure of cytokinesis and multinucleation in RPE cells.

Promoting healthy dietary behaviour through personalised nutrition: technology push or technology pull?

The notion of educating the public through generic healthy eating messages has pervaded dietary health promotion efforts over the years and continues to do so through various media, despite little evidence for any enduring impact upon eating behaviour. There is growing evidence, however, that tailored interventions such as those that could be delivered online can be effective in bringing about healthy dietary behaviour change. The present paper brings together evidence from qualitative and quantitative studies that have considered the public perspective of genomics, nutrigenomics and personalised nutrition, including those conducted as part of the EU-funded Food4Me project. Such studies have consistently indicated that although the public hold positive views about nutrigenomics and personalised nutrition, they have reservations about the service providers' ability to ensure the secure handling of health data. Technological innovation has driven the concept of personalised nutrition forward and now a further technological leap is required to ensure the privacy of online service delivery systems and to protect data gathered in the process of designing personalised nutrition therapies.

Biomarker responses to folic acid intervention in healthy adults: a meta-analysis of randomized controlled trials

BACKGROUND: The task of revising dietary folate recommendations for optimal health is complicated by a lack of data quantifying the biomarker response that reliably reflects a given folate intake.

OBJECTIVE: We conducted a dose-response meta-analysis in healthy adults to quantify the typical response of recognized folate biomarkers to a change in folic acid intake.

DESIGN: Electronic and bibliographic searches identified 19 randomized controlled trials that supplemented with folic acid and measured folate biomarkers before and after the intervention in apparently healthy adults aged ≥18 y. For each biomarker response, the regression coefficient (β) for individual studies and the overall pooled β were calculated by using random-effects meta-analysis.

RESULTS: Folate biomarkers (serum/plasma and red blood cell folate) increased in response to folic acid in a dose-response manner only up to an intake of 400 μg/d. Calculation of the overall pooled β for studies in the range of 50 to 400 μg/d indicated that a doubling of folic acid intake resulted in an increase in serum/plasma folate by 63% (71% for microbiological assay; 61% for nonmicrobiological assay) and red blood cell folate by 31% (irrespective of whether microbiological or other assay was used). Studies that used the microbiological assay indicated lower heterogeneity compared with studies using nonmicrobiological assays for determining serum/plasma (I(2) = 13.5% compared with I(2) = 77.2%) and red blood cell (I(2) = 45.9% compared with I(2) = 70.2%) folate.

CONCLUSIONS: Studies administering >400 μg folic acid/d show no dose-response relation and thus will not yield meaningful results for consideration when generating dietary folate recommendations. The calculated folate biomarker response to a given folic acid intake may be more robust with the use of a microbiological assay rather than alternative methods for blood folate measurement.

Community dynamics and the lower airway microbiota in stable chronic obstructive pulmonary disease, smokers and healthy non-smokers

RATIONALE: The role bacteria play in the progression of COPD has increasingly been highlighted in recent years. However, the microbial community complexity in the lower airways of patients with COPD is poorly characterised.

OBJECTIVES: To compare the lower airway microbiota in patients with COPD, smokers and non-smokers.

METHODS: Bronchial wash samples from adults with COPD (n=18), smokers with no airways disease (n=8) and healthy individuals (n=11) were analysed by extended-culture and culture-independent Illumina MiSeq sequencing. We determined aerobic and anaerobic microbiota load and evaluated differences in bacteria associated with the three cohorts. Culture-independent analysis was used to determine differences in microbiota between comparison groups including taxonomic richness, diversity, relative abundance, 'core' microbiota and co-occurrence.

MEASUREMENT AND MAIN RESULTS: Extended-culture showed no difference in total load of aerobic and anaerobic bacteria between the three cohorts. Culture-independent analysis revealed that the prevalence of members of Pseudomonas spp. was greater in the lower airways of patients with COPD; however, the majority of the sequence reads for this taxa were attributed to three patients. Furthermore, members of Bacteroidetes, such as Prevotella spp., were observed to be greater in the 'healthy' comparison groups. Community diversity (α and β) was significantly less in COPD compared with healthy groups. Co-occurrence of bacterial taxa and the observation of a putative 'core' community within the lower airways were also observed.

CONCLUSIONS: Microbial community composition in the lower airways of patients with COPD is significantly different to that found in smokers and non-smokers, indicating that a component of the disease is associated with changes in microbiological status.

Medication regimen complexity in institutionalized elderly people in an aging society

Background Complex medication regimens may adversely affect compliance and treatment outcomes. Complexity can be assessed with the medication regimen complexity index (MRCI), which has proved to be a valid, reliable tool, with potential uses in both practice and research. Objective To use the MRCI to assess medication regimen complexity in institutionalized elderly people. Setting Five nursing homes in mainland Portugal. Methods A descriptive, cross-sectional study of institutionalized elderly people (n = 415) was performed from March to June 2009, including all inpatients aged 65 and over taking at least one medication per day. Main outcome measure Medication regimen complexity index. Results The mean age of the sample was 83.9 years (±6.6 years), and 60.2 % were women. The elderly patients were taking a large number of drugs, with 76.6 % taking more than five medications per day. The average medication regimen complexity was 18.2 (±SD = 9.6), and was higher in the females (p < 0.001). The most decisive factors contributing to the complexity were the number of drugs and dosage frequency. In regimens with the same number of medications, schedule was the most relevant factor in the final score (r = 0.922), followed by pharmaceutical forms (r = 0.768) and additional instructions (r = 0.742). Conclusion Medication regimen complexity proved to be high. There is certainly potential for the pharmacist’s intervention to reduce it as part as the medication review routine in all the patients.

Mindful Living in Older Age: a Pilot Study of a Brief, Community-Based, Positive Aging Intervention

Although mindfulness-based interventions have been successfully used with older adults, there have been few interventions that, (a) are created specifically for older adults, (b) are delivered in the community, and (c) aim to promote ‘successful aging’ (rather than just treating dysfunction/disorder). To this end, the current study piloted a brief ‘positive aging’ intervention, comprising two 150 minute sessions, with six female older adults living in the community. Data were gathered through focus groups that were interwoven throughout the intervention. Using thematic analysis, four main themes were identified: (a) aging as a mixed blessing; (b) understanding mindfulness; (c) the challenges of mindfulness; and (d) the benefits of mindfulness. Overall, the intervention was successful in introducing participants to mindfulness and potentially forming the basis of a longer term practice. However, the study also highlighted important points on the challenges of practising mindfulness, in relation to which the paper makes recommendations pertaining to the teaching of mindfulness with older adults.

Processos de cuidar em enfermagem:idosos com hipertenção arterial

Tese de doutoramento, Enfermagem, Universidade de Lisboa, com a participação da Escola Superior de Enfermagem, 2014

Envelhecimento ativo e o recurso à medicina tradicional chinesa : entre a responsabilidade individual e os fatores sociais determinantes da saúde

Tese de doutoramento, Antropologia (Antropologia da Saúde), Universidade de Lisboa, Instituto de Ciências Sociais, 2015

Klebsiella pneumoniae subsp. pneumoniae–bacteriophage combination from the caecal effluent of a healthy woman

A recent study characterizing bacteriophage populations within human caecal effluent demonstrated the presence of numerous Podoviridae, Siphoviridae and Myoviridae within this material (Hoyles et al., 2014, Res Microbiol 165, 803–812). Further to this work, anaerobic bacteria were isolated on fastidious anaerobe agar from the caecal effluent of a healthy 31-year-old woman. Ten colonies were selected at random, streaked to purity and screened against the remaining caecal effluent (filter-sterilized, 0.45 μm pore size) in an attempt to isolate lytic bacteriophages. Bacteriophages within the effluent [2×105 ± 2.65×103 (n=3) pfu/ml] were active against five of the isolates, all identified by 16S rRNA gene sequence analysis as Klebsiella pneumoniae. One of the five isolates, L4-FAA5, was characterized further and found to be K. pneumoniae subsp. pneumoniae capsule type K2 rmpA+, and was used to propagate a bacteriophage (which we named KLPN1) to purity. Bacteriophage KLPN1 was a member of the Siphoviridae with a rosette-like tail tip and exhibited depolymerase activity, demonstrated by the formation of plaque-surrounding haloes that increased in size over the course of incubation. When screened against a panel of 21 clinical strains representing unknown K. pneumoniae subsp. pneumoniae capsule types and types K1, K2, K5, K20, K54 and K57, KLPN1 infected only K2 strains, but did not exhibit depolymerase activity against these. Whole-genome sequence analysis of KLPN1 showed the bacteriophage to have a genome of 49,037 bp (50.53 GC mol%) comprising 73 predicted ORFs, of which 22 encoded genes associated with structure, host recognition, packaging, DNA replication and cell lysis. The host recognition-associated gene was a potential depolymerase. This is the first report of the isolation of a bacterium–bacteriophage combination from the human caecum, and only the third member of the Siphoviridae known to infect K. pneumoniae subsp. pneumoniae.

Klebsiella pneumoniae subsp. pneumoniae–bacteriophage combination from the caecal effluent of a healthy woman

A sample of caecal effluent was obtained from a female patient who had undergone a routine colonoscopic examination. Bacteria were isolated anaerobically from the sample, and screened against the remaining filtered caecal effluent in an attempt to isolate bacteriophages (phages). A lytic phage, named KLPN1, was isolated on a strain identified as Klebsiella pneumoniae subsp. pneumoniae (capsular type K2, rmpA+). This Siphoviridae phage presents a rosette-like tail tip and exhibits depolymerase activity, as demonstrated by the formation of plaque-surrounding haloes that increased in size over the course of incubation. When screened against a panel of clinical isolates of K. pneumoniae subsp. pneumoniae, phage KLPN1 was shown to infect and lyse capsular type K2 strains, though it did not exhibit depolymerase activity on such hosts. The genome of KLPN1 was determined to be 49,037 bp (50.53 %GC) in length, encompassing 73 predicted ORFs, of which 23 represented genes associated with structure, host recognition, packaging, DNA replication and cell lysis. On the basis of sequence analyses, phages KLPN1 (GenBank: KR262148) and 1513 (a member of the family Siphoviridae, GenBank: KP658157) were found to be two new members of the genus “Kp36likevirus”.

Relationship between post-awakening salivary cortisol and melatonin secretion in healthy participants

We report the relationship between patterns of post-awakening salivary melatonin and cortisol secretion in healthy participants (n=51; mean age 21.6 ±5.0 years). Saliva samples were collected within the domestic setting, at 0-, 15-, 30-, and 45-min post-awakening on 2 consecutive typical weekdays. Analyses were undertaken on data with electronically verified sample timing accuracy (55-min delay between awakening and the start of saliva sampling). Melatonin secretion declined linearly by an average of 29% within the first 45-min post-awakening. In contrast, there was a marked 112% surge in cortisol, characteristic of the cortisol awakening response. No day differences in melatonin or cortisol secretion were observed but melatonin concentrations were lower with later awakening. Despite contrasting post-awakening changes in these hormones, there was a lack of relationship between overall levels or patterns of melatonin and cortisol during this period.