Does the built environment influence location- and trip-based sedentary behaviors? Evidence from a GPS-based activity space approach of neighborhood effects on older adults

OBJECTIVE

Evidence on the influence of built environments on sedentary behaviors remains unclear and is often contradictory. The main limitations encompass the use of self-reported proxies of sedentary time (ST), the scarce consideration of the plurality of sedentary behaviors, and environmental exposures limited to the residential neighborhood. We investigated the relationships between GPS-based activity space measures of environmental exposures and accelerometer-based ST measured in total, at the place of residence, at all locations, and during trips.

METHODS

This study is part of the CURHA project, based on 471 older adults residing in Luxembourg, who wore a GPS receiver and a tri-axial accelerometer during 7 days. Daily ST was computed in total, at the residence, at all locations and during trips. Environmental exposures included exposure to green spaces, walking, biking, and motorized transportation infrastructures. Associations between environments and ST were examined using linear and negative binomial mixed models, adjusted for demographics, self-rated health, residential self-selection, weather conditions and wear time.

RESULTS

Participants accumulated, on average, 8 h and 14 min of ST per day excluding sleep time. ST spent at locations accounted for 83 % of the total ST. ST spent at the residence accounted for 87 % of the location-based ST and 71 % of the total ST. Trip-based ST represents 13 % of total ST, and 4 % remained unclassified. Higher street connectivity was negatively associated with total ST, while the density of parking areas correlated positively with total and location-based ST. Stronger associations were observed for sedentary bouts (uninterrupted ST over 20 and 30 min).

CONCLUSION

Improving street connectivity and controlling the construction of new parking, while avoiding the spatial segregation of populations with limited access to public transport, may contribute to limit ST. Such urban planning interventions may be especially efficient in limiting the harmful uninterrupted bouts of ST among older adults.

Bottle Fermented Sparkling Wine: Cork or Crown Closures During the Second Fermentation?

Bottle-fermented sparkling wine producers are continuously striving to increase quality and produceniche products. One production tool that could be used is a cork closure instead of a crown cap closureduring the second fermentation and maturation on yeast lees. Anecdotal evidence suggests that thisleads to stylistic differences in the wine. Six pairs of South African bottle-fermented sparkling wines(Méthode Cap Classique), closed by either a cork or crown cap, were investigated. Analyses includedbottle pressure, infrared spectroscopy, phenolic acids, sensory attributes and CO2 kinetics. Generally,there were differences between the cork-closed and crown-capped wines. Cork-closed wines tended tohave lower pressure compared to crown-capped wines, albeit still well within legal requirements. Otherdifferences were evident in the infrared spectral data and in the polyphenol profile of the analysed wines.Levels of gallic, caftaric, caffeic and p-coumaric acids could be used collectively as marker compounds todifferentiate between cork-closed and crown-capped wines. The effect of the cork was also evident in thesensory attributes and CO2 kinetics. Cork-closed wines were judged to have smaller bubbles and a longeraftertaste. It was also shown that the cork-closed wines tended to lose CO2 from the glass slower after beingpoured than their crown-capped counterparts. The data tentatively support the anecdotal evidence thatcork can be used during the second fermentation and maturation on the yeast lees to change the style ofbottle-fermented sparkling wine.

Ästhetische Behandlungen mit Fillern und das Management von Nebenwirkungen

Medizinisch-ästhetische Behandlungen sind für die tägliche dermatologische Praxis von zunehmender Bedeutung. Als zentraler Bestandteil eines multimodalen Therapiekonzeptes sind dermale und Volumenfiller aus der modernen ästhetischen Therapie nicht mehr wegzudenken. Wegweisende Erkenntnisse zum Alterungsprozess des Gesichtes und zur Sicherheit und Spezifika der verschiedenen Typen von Füllstoffen der vergangenen Jahre bieten heute differenzierte Anwendungsmöglichkeiten von Volumenaugmentation bis hin zu Hydratation oder Kollageninduktion. Gleichsam sind aber auch der Markt an verfügbaren Injektionsprodukten und die verschiedenen Indikationen und Injektionstechniken nahezu unüberschaubar. Schließlich werden wir in der Praxis immer wieder mit Komplikationen nach unsachgemäßer Anwendung oder den Langzeitkomplikationen von in Deutschland längst nicht mehr verfügbaren Füllstoffen konfrontiert und auch bei regelhafter Injektion sind Nebenwirkungen nicht ausgeschlossen. Die vorliegende Arbeit soll einen Überblick über die am Markt verfügbaren aber auch relevanten historischen bzw. obsoleten Filler und ferner über mögliche Komplikationen und deren Management geben. Ferner finden sich persönliche Bewertungen zu besonderen Indikationen bzw. Injektionstechniken.

Spot the phish by checking the pruned URL

Purpose

Phishing is still a very popular and effective security threat, and it takes, on average, more than a day to detect new phish websites. Protection by purely technical means is hampered by this vulnerability window. During this window, users need to act to protect themselves. To support users in doing so, the paper aims to propose to first make users aware of the need to consult the address bar. Moreover, the authors propose to prune URL displayed in the address bar. The authors report on an evaluation of this proposal.

Design/methodology/approach

The paper opted for an online study with 411 participants, judging 16 websites – all with authentic design: half with legitimate and half with phish URLs. The authors applied four popular widely used types of URL manipulation techniques. The authors conducted a within-subject and between-subject study with participants randomly assigned to one of two groups (domain highlighting or pruning). The authors then tested both proposals using a repeated-measures multivariate analysis of variance.

Findings

The analysis shows a significant improvement in terms of phish detection after providing the hint to check the address bar. Furthermore, the analysis shows a significant improvement in terms of phish detection after the hint to check the address bar for uninitiated participants in the pruning group, as compared to those in the highlighting group.

Research limitations/implications

Because of the chosen research approach, the research results may lack generalisability. Therefore, researchers are encouraged to test the proposed propositions further.

Practical implications

This paper confirms the efficacy of URL pruning and of prompting users to consult the address bar for phish detection.

Originality/value

This paper introduces a classification for URL manipulation techniques used by phishers. We also provide evidence that drawing people’s attention to the address bar makes them more likely to spot phish websites, but does not impair their ability to identify authentic websites.

Weight loss prior to bariatric surgery: an updated review of the literature

BACKGROUND AND AIMS

Prior to bariatric surgery, a preoperative weight-reducing regimen is usually adhered to in most centers. The clinical effects of such a regimen are yet to be determined.

MATERIAL AND METHODS

We reviewed the current literature by searching in PubMed for publications reporting clinical effects resulting from a preoperative weight loss regimen prior to bariatric surgery published from January 1, 1995 to April 30, 2014.

RESULTS

In total, we identified 23 original publications and 2 review articles which met all inclusion criteria. These were included and fully analyzed with regard to effects of preoperative weight loss. In general, for parameters such as operating time and intraoperative complications including blood loss and recovery, inconsistent data were reported. Most studies included low number of patients and with heterogenic designs, and the results could not form the base for recommendations. However, for outcomes such as postoperative complications and weight development over time, data from large-scale studies and randomized controlled trials suggest beneficial effects following adherence to weight loss prior to bariatric surgery.

CONCLUSION

Although a large amount of data in the current literature on the effects of weight loss prior to bariatric surgery are inconsistent for many outcome parameters, recently published results regarding effects on postoperative complications and weight development over time strongly suggest that such a regimen should be recommended. Whether a certain degree of weight loss should be mandatory before being accepted for bariatric surgery is, however, still controversial.

Improved physiological properties of gravity-enforced reassembled rat and human pancreatic pseudo-islets

Previously we demonstrated the superiority of small islets vs large islets in terms of function and survival after transplantation, and we generated reaggregated rat islets (pseudo-islets) of standardized small dimensions by the hanging-drop culture method (HDCM). The aim of this study was to generate human pseudo-islets by HDCM and to evaluate and compare the physiological properties of rat and human pseudo-islets. Isolated rat and human islets were dissociated into single cells and incubated for 6-14 days by HDCM. Newly formed pseudo-islets were analysed for dimensions, morphology, glucose-stimulated insulin secretion (GSIS) and total insulin content. The morphology of reaggregated human islets was similar to that of native islets, while rat pseudo-islets had a reduced content of α and δ cells. GSIS of small rat and human pseudo-islets (250 cells) was increased up to 4.0-fold (p < 0.01) and 2.5-fold (p < 0.001), respectively, when compared to their native counterparts. Human pseudo-islets showed a more pronounced first-phase insulin secretion as compared to intact islets. GSIS was inversely correlated to islet size, and small islets (250 cells) contained up to six-fold more insulin/cell than large islets (1500 cells). Tissue loss with this new technology could be reduced to 49.2 ± 1.5% in rat islets, as compared to the starting amount. With HDCM, pseudo-islets of standardized size with similar cellular composition and improved biological function can be generated, which compensates for tissue loss during production. Transplantation of small pseudo-islets may represent an attractive strategy to improve graft survival and function, due to better oxygen and nutrient supply during the phase of revascularization. Copyright © 2014 John Wiley & Sons, Ltd.

Juggling revisited - a voxel-based morphometry study with expert jugglers

Juggling is a highly interesting tool to investigate neuroplasticity associated with motor-learning. Several brain-imaging studies have reported changes in regional brain morphology in visual association cortices in individuals learning how to juggle a three-ball cascade. However, to our knowledge there are no studies that investigated expert jugglers, looking for specific features in regional brain morphology related to this highly specialized skill. Using T1-weighted images and voxel-based morphometry we investigated in a cross-sectional study design 16 expert jugglers, able to juggle at least five balls and an age- and gender-matched group of non-jugglers. We hypothesized that expert jugglers would show higher gray matter density in regions involved in visual motion perception and eye-hand coordination. Images were pre-processed and analyzed using SPM8. Age was included in the analyses as covariate of no interest. As compared to controls jugglers displayed several clusters of higher, regional gray matter density in the occipital and parietal lobes including the secondary visual cortex, the hMT+/V5 area bilaterally and the intraparietal sulcus bilaterally. Within the jugglers group we also found a correlation between performance and regional gray matter density in the right hMT+/V5 area. Our study provides evidence that expert jugglers show increased gray matter density in brain regions involved in visual motion perception and eye-hand coordination, i.e. brain areas that have previously been shown to undergo dynamic changes in terms of gray matter increases in subjects learning a basic three-ball cascade. The extent to which transient increases in beginners and the differences in experts and non-experts are based on the same neurobiological correlates remains to be fully elucidated.

Usefulness of Austroads' fitness-to-drive guidelines: lessons from the Gillett case

Regina v Gillett deals with a man who did not disclose his epilepsy when seeking a drivers licence. Subsequently, he had a seizure while driving, causing an accident in which three people died. He was found guilty but appealed. During the trial to decide whether Gillett was guilty of dangerous driving occasioning death, the judge decided that the Austroads fitness-to-drive guidelines were extraneous to legal consideration of the acceptable risk to be attached to chronic medical conditions. Although the appeal was unsuccessful with respect to guilt and sentencing, it did reinstate the relevance of the Austroads guidelines when evaluating suitable risk with respect to potentially dangerous drivers. We suggest that even greater protection can be afforded to the community if a clearly enunciated warning, outlining a driver's responsibilities, were to appear on each drivers license.

Late-term abortion: what can be learned from Royal Women's Hospital v Medical Practitioners Board of Victoria?

In 2001, the Medical Practitioners Board of Victoria received a complaint from an Australian Government Senator regarding a late-term abortion carried out in February 2000 at the Royal Women's Hospital, Melbourne. Five years later, the complaint of professional misconduct was finally dismissed by the Board as being frivolous and vexatious. The action highlights a number of deficiencies in the way medical practitioner boards deal with complaints against medical practitioners; in particular, the Board's lack of discretion to deal with complaints lacking substance. Early mediation of the dispute between the Royal Women's Hospital and the Medical Practitioners Board could have avoided a great deal of suffering and expense. As a result of this case, it is likely that the Victorian Medical Practitioners Board will be given additional powers in the future to deal with complaints without merit.

What can we learn from the Hwang and Sudbø affairs?

The recent publication, in prestigious scientific journals, of two major studies that were subsequently shown to contain fabricated data may compel reviewers and editors to adopt a more rigorous policy in accepting articles for publication. The current manner of peer reviewing research articles provides no assurance that the proffered work is not the result of fraud. The present guidelines for contributors in large team investigations may need to be updated to avoid giving credit to co-authors who may have made little, if any, contribution to the work.

Nutrient balances for improving the use-efficiency of non-renewable resources: experiences from Switzerland and Southeast Asia

Simple nutrient balances can be a valuable tool to assess and visualize whether farming systems are in equilibrium or not with respect to nutrient inputs and outputs. Thus, they can raise awareness about environmental risks of agricultural production, and especially intensive livestock production. They are also a valuable tool for policy development and implementation processes. In this paper, we discuss how a nutrient-balance approach can help to improve the awareness of different stakeholders about the ecological impacts of agriculture and the efficient use of nutrients. While the example from Switzerland demonstrates the potential ecological benefits of compulsory nutrient balancing, the examples from Asia demonstrate how a combination of nutrient balancing and geographic information system (GIS) was used to identify hot-spots with respect to insufficient and excessive P input, and we will discuss a nutrient-balance method developed to improve nutrient management in the rapidly growing intensive livestock-production sector.

Validation and use of the MM-PBSA approach for drug discovery

The MM-PBSA approach has become a popular method for calculating binding affinities of biomolecular complexes. Published application examples focus on small test sets and few proteins and, hence, are of limited relevance in assessing the general validity of this method. To further characterize MM-PBSA, we report on a more extensive study involving a large number of ligands and eight different proteins. Our results show that applying the MM-PBSA energy function to a single, relaxed complex structure is an adequate and sometimes more accurate approach than the standard free energy averaging over molecular dynamics snapshots. The use of MM-PBSA on a single structure is shown to be valuable (a) as a postdocking filter in further enriching virtual screening results, (b) as a helpful tool to prioritize de novo design solutions, and (c) for distinguishing between good and weak binders (DeltapIC(50) > or = 2-3), but rarely to reproduce smaller free energy differences.

[Nasal polyps and osteolyses]

A 38-year-old man presented with a 2-month history of progressive leg pain. An x-ray film of both tibial bones showed multiple osteolysis. At the same time, nasal polyps were present. A biopsy of the tibial bone remained unclear. A carcinoma was not found. A biopsy of the nasal polyps revealed a Rosai-Dorfman-Destombes disease.

Structural, Kinetic, and Thermodynamic Analysis of the Binding of the 40 kDa PEG−Interferon-α2aand Its Individual Positional Isomers to the Extracellular Domain of the Receptor IFNAR2

Type-I Interferons exert antiviral and antiproliferative activities through the binding to a common cell surface receptor comprising two subunits, IFNAR1 and IFNAR2. Human recombinant Interferon-alpha(2a) (IFNalpha(2a)) is a potent drug (Roferon-A) used to treat various cancers and viral diseases including Hepatitis B/C infections. To significantly improve the pharmacological properties of the drug, a pegylated form of IFNalpha(2a) was developed (PEGASYS). This 40 kDa PEG-conjugated IFNalpha(2a) ((40)PEG-IFNalpha(2a)) is obtained by the covalent binding of one 40 kDa branched PEG-polymer to a lysine side-chain of IFNalpha(2a). Here, we report the detailed structural, kinetic, and thermodynamic analysis of the binding to the extracellular domain of the receptor IFNAR2 of (40)PEG-IFNalpha(2a) and its isolated positional isomers modified at K31, K134, K131, K121, K164, and K70, respectively, in comparison with unmodified IFNalpha(2a). Our binding studies, using the surface plasmon resonance technique, show that the pegylation does not abolish the binding to the receptor, but significantly reduces the affinity mainly due to a change of the association rate. The results are supported by modeling and simulation of the binding, using Self-Avoiding-Walk calculations for the polymer conformations. A correlation between the structural parameters and the kinetic and thermodynamic parameters of the binding of the positional isomers could be established. For the Isomer-K31 and -K164, the PEG-polymer attachment point is located in proximity to the binding interface, and the isomers display affinity in the range 150-520 nM in an enthalpy-driven binding process. In contrast for the Isomer-K134, -K131, -K121, and -K70, the PEG-polymer is attached remotely from the binding interface, and the isomers exhibit a higher affinity (32-76 nM) in an entropy-driven binding process. This study constitutes an essential collection of knowledge on which the interaction of (40)PEG-IFNalpha(2a) and its positional isomers with its cellular receptors can be better understood.

[Diabetes]

In 2004, a new insulin analogue was launched, Detemir insulin (Levemir). Detemir insulin is a long acting insulin and has a lower within-subject variability in comparison with other insulins. The recently published results of the CARDS study (atorvastatin treatment) also emphasize the need for a more aggressive attitude toward cardiovascular risk in diabetics even if LDL-cholesterol values are not particularly elevated. We will end this short review discussing the future of the inhibitor of GLP-1 degradation which in addition to a modest hypoglycaemic effect seems to be able to prevent apoptosis of insulin producing beta cells.

Failed sterilisations and the unwanted child: a new medicolegal minefield?

A recent High Court decision has held that parents are entitled, in addition to the usual costs arising from a failed sterilisation, to the reasonable costs of raising a healthy child.

Novel dihydrofolate reductase inhibitors. Structure-based versus diversity-based library design and high-throughput synthesis and screening

Novel 2,4-diaminopyrimidines bearing N,N-disubstituted aminomethyl residues at the 5-position were designed as dihydrofolate reductase (DHFR) inhibitors. These compounds were obtained by treatment of 1-[(2,4-diamino-5-pyrimidinyl)methyl]pyridinium bromide with secondary amines in a polar solvent and in the presence of triethylamine at room temperature. The procedure was found to be very efficient and suitable for application in high-throughput synthesis. In addition, we found that high-throughput screening for enzymatic and in vitro antibacterial activity could be performed on crude reaction mixtures, thus avoiding any purification step. Over 1200 proprietary secondary amines were selected for high-throughput synthesis, based on structural and diversity-related criteria, and the resulting products were submitted to high-throughput screening. A greater number of hits, and significantly more active compounds, were obtained through structure-based library design than through diversity-based library design. Different classes of inhibitors of DHFR were identified in this way, including compounds derived from di-, tri-, and tetracyclic amines. In general, these products showed high activity against the enzymes derived from both TMP-sensitive and TMP-resistant Streptococcus pneumoniae. Some compounds possessed appreciable selectivity for the bacterial over the human enzyme, whereas other compounds were not at all selective. In most cases, active enzyme inhibitors also displayed antibacterial activity.

Routine experimental system for defining conditions used in photodynamic therapy and fluorescence photodetection of (non-) neoplastic epithelia

A common method to induce enhanced short-term endogenous porphyrin synthesis and accumulation in cell is the topical, systemic application of 5-aminolevulinic acid or one of its derivatives. This circumvents the intravenous administration of photosensitizers normally used for photodynamic therapy (PDT) of fluorescence photodetection. However, in the majority of potential medical indications, optimal conditions with respect to the porphyrin precursor or its pharmaceutical formulation have not yet been found. Due to ethical restrictions and animal right directives, the number of available test objects is limited. Hence, definition and use of nonanimal test methods are needed. Tissue and organ cultures are a promising approach in replacing cost intensive animal models in early stages of drug development. In this paper, we present a tissue culture, which can among others be used routinely to answer specific questions emerging in the field of photodynamic therapy and fluorescence photodetection. This technique uses mucosae excised from sheep paranasal sinuses or pig bladder, which is cultured under controlled conditions. It allows quasiquantitative testing of different protoporphyrin IX precursors with respect to dose-response curves and pharmacokinetics, as well as the evaluation of different incubation conditions and/or different drug formulations. Furthermore, this approach, when combined with the use of electron microscopy and fluorescence-based methods, can be used to quantitatively determine the therapeutic outcome following protoporphyrin IX-mediated PDT.

Cardiovascular parameters telemetrically measured during pregnancy, parturition, and lactation in a common marmoset (Callithrix jacchus)

Here we present the first report of heart rate, blood pressure, and locomotive activity of a female common marmoset (Callithrix jacchus) that was moving freely in its home cage during gestation, parturition, and lactation. We collected the data by using a miniaturized telemetry and data-acquisition system (Data Sciences, St. Paul, MN) that had been adapted for marmosets (1). The parameters were recorded continually from 12 days before to 15 days after parturition. Parturition lasted about 3.5 h, during which marked changes in heart rate, systolic blood pressure, and diastolic blood pressure occurred. To obtain control values, we again measured these parameters for 13 days during a "physiologically neutral" phase (4 months after parturition), when the female was neither pregnant nor lactating. Heart rate was 200% higher, systolic blood pressure was 25% higher, and diastolic blood pressure was 75% higher during parturition than during the neutral phase.

Retention of Teflon particles in hamster lungs: a stereological study

The significance of aerosols in medicine is increased when the distribution of inhaled aerosols in the different respiratory tract compartments and their interaction with lung structures are known. The aim of this study was to investigate the retention of the hydrophobic Teflon spheres used in human beings so as to analyze their regional distribution and to study their interaction with lung structures at the deposition site. Six intubated and anesthetized Syrian Golden hamsters inhaled aerosols of Teflon particles with an aerodynamic diameter of 5.5 microns by continuous negative-pressure ventilation adjusted to slow breathing. Lungs were fixed by intravascular perfusion within 21 minutes after inhalation was started, and tissue samples were taken and processed for light and electron microscopy. The stereological (fractionator) analysis revealed that particle retention was the greatest in alveoli (72.4%), less in intrapulmonary conducting airways (22.9%), and the least in extrapulmonary mainstem bronchi (0.3%) and trachea (4.4%). Particles were found submerged in the aqueous lining layer and in close vicinity to epithelial cells. In intrapulmonary conducting airways, 21.5% of Teflon particles had been phagocytized by macrophages. This study with highly hydrophobic Teflon particles clearly demonstrates that for spheres of this size, surface tension and line tension forces rather than the particles' surface free energy are decisive for the displacement of particles into the aqueous phase by surfactant. It was this displacement that enabled subsequent interaction with macrophages. Refined knowledge of particle retention may help us to better understand the biological response to inhaled particles.

Metabolic effects of temocapril in hypertensive patients with diabetes mellitus type 2

Compared with other angiotensin-converting enzyme (ACE) inhibitors, the elimination of temocapril is less dependent on renal function. To investigate the metabolic and antihypertensive effects of temocapril in diabetic hypertensives, 30 patients with diabetes mellitus type 2 and mild to moderate hypertension [diastolic blood pressure (BP) 90-115 mm Hg] and without azotemia (plasma creatinine < 180 microM) were evaluated in a prospective randomized double-blind placebo-controlled study. After a 4-week placebo run-in, they received temocapril, 20 mg daily (n = 19), or placebo (n = 11) for 6 weeks. Insulin sensitivity index (SI), determined by the Minimal Model method of Bergman, serum lipoproteins, plasma renin activity, fibrinogen, and microalbuminuria were assessed at the end of the placebo run-in phase and the double-blind treatment phases. Temocapril but not placebo administration produced a significant decrease in supine BP (152/92+/-5/3 vs. 162/98+/-5/2 mm Hg; p < 0.01) and increase in plasma renin (p < 0.05). Variation of SI during temocapril treatment did not reach statistical significance (0.95+/-0.2 before vs. 1.44+/-0.4 x 10(-4)/min/mU/L after treatment). During administration of temocapril or placebo, no significant changes in fasting plasma glucose, insulin, and serum levels of total triglycerides, cholesterol, lipoprotein cholesterol fractions, or fibrinogen were observed. Microalbuminuria decreased significantly on temocapril treatment (49+/-10 vs. 79+/-17 mg/24 h; p < 0.01) but not on placebo. These findings demonstrate that in hypertensive patients with diabetes mellitus type 2, short-term treatment with temocapril is neutral to insulin sensitivity, lipoprotein metabolism, and fibrinogen, and significantly reduces microalbuminuria.

Confidentiality and the courts

There is a general belief that, once in the witness box, doctors are compelled to reveal confidential information about their patients if asked by counsel. Where no issue of public interest is involved, a medical witness should ask the court to rule in its inherent discretion that the information sought is confidential and privileged.