RESUMEN
Loop ileostomy is a common surgical procedure to allow downstream tissue healing, with the aim of re-joining the bowel approximately 12 months later. The reversal procedure is associated with a substantial morbidity up to 40%. Our previous research demonstrated that defunctioned ileum becomes atrophied, with extensive microbial dysbiosis. This study sought to investigate the potential influence of delaying ileostomy reversal surgery upon both clinical and pathological outcomes. Post-operative clinical data was recorded, including routine blood test results, duration of hospital stay, length of time with stoma and incidence of post-operative complications. We measured ileal fibrosis and atrophy and assessed whether these, or dysbiosis, were impacted by the length of time a stoma was in place, or were linked to clinical outcomes. Associations between clinical data were investigated using scatterplot matrix analysis and t-tests. We found no differences in time between ileostomy formation and reversal in patients experiencing complications vs. individuals with no complications. Furthermore, there were no correlations between days with stoma and pathological measures, such as atrophy or fibrosis, and no ongoing increases in collagen production at the time of reversal surgery. This data suggests that the length of time a stoma is in place does not impact on the likelihood of complications. The incidence of complications is associated with increased loss of microbiota in the defunctioned ileum, but importantly, the decrease in bacteria is not linked to time with stoma. Microbiota diversity in the functional and defunctioned limb correlated within an individual, and was not significantly different between those who experienced complications following surgery vs. those that didn't. Microbiota diversity was also not significantly impacted through delay (>365 days) in stoma reversal. We propose that methods to restore intestinal microbiota numbers, and not necessarily their composition, prior to reversal should be explored to improve the clinical outcomes of ileostomy reversal surgery.
Asunto(s)
Microbioma Gastrointestinal , Estomas Quirúrgicos , Humanos , Ileostomía/efectos adversos , Disbiosis/etiología , Intestinos/cirugía , Estomas Quirúrgicos/efectos adversosRESUMEN
AIMS: Aerobic exercise is well recognised as an effective treatment for people with type 2 diabetes but the optimal amount of aerobic exercise to improve glycaemic control remains to be determined. Thus, the aim of this meta-analysis and meta-regression was to assess the impact of volume and intensity of aerobic exercise on glycaemic control. METHODS: Medline, Cochrane, Embase, and Web of Science databases were searched up until 15 December 2020 for the terms "aerobic exercise AND glycaemic control", "type 2 diabetes AND exercise", and "exercise AND glycaemic control AND Type 2 diabetes AND randomised control trial". We included (i) randomised control trials of ≥ 12 weeks, (ii) trials where participants had type 2 diabetes and were aged 18 or over, and (iii) the trial reported HbA1c concentrations pre- and post-intervention. Two reviewers selected studies and extracted data. Data are reported as standardised mean difference (SMD) and publication bias was assessed using funnel plots. RESULTS: A total of 5364 original titles were identified. Sixteen studies were included in the meta-analysis. Aerobic exercise reduced HbA1c versus control (SMD = 0.56 (95% CI 0.3-0.82), p < 0.001). There were also significant reductions in BMI (SMD = 0.76 (95% CI 0.25-1.27), p < 0.05). There was no dose-response relationship between improvement in HbA1c and the intensity and volume of the intervention (p > 0.05). CONCLUSIONS: Twelve-week or longer aerobic exercise programmes improve glycaemic control and BMI in adults with type 2 diabetes. Longer or more intense interventions appear to confer no additional benefit on HbA1c.
Asunto(s)
Diabetes Mellitus Tipo 2 , Adulto , Diabetes Mellitus Tipo 2/terapia , Ejercicio Físico , Hemoglobina Glucada , HumanosRESUMEN
Life expectancy in the UK has increased since the 19th century. As of 2019, there are just under 12 million people in the UK aged 65 or over, with close to a quarter living by themselves. Thus, many families and carers are looking for new ways to improve the health and care of older people. Passive sensors such as infra-red motion and plug sensors have had success as a noninvasive way to help the older people. These provide a series of categorical sensor events throughout the day. Modeling this categorical dataset can help to understand and predict behavior. This article proposes a method to model the probability a sensor will trigger throughout the day for a household whilst accounting for the prior data and other sensors within the home. We present our results on a dataset from Howz, a company helping people to passively identify changes in their behavior over time.
Asunto(s)
Tecnología , Anciano , HumanosRESUMEN
Long-term change and shorter-term variability in the atmospheric deposition of pollutants and marine salts can have major effects on the biogeochemistry and ecology of soils and surface water ecosystems. In the 1980s, at the time of peak acid deposition in the UK, deposition loads were highly dependent on prevailing weather types, and it was postulated that future pollution recovery trajectories would be partly dependent on any climate change-driven shifts in weather systems. Following three decades of substantial acidic emission reductions, we used monitoring data collected between 1992 and 2015 from four UK Environmental Change Network (ECN) sites in contrasting parts of Great Britain to examine the trends in precipitation chemistry in relation to prevailing weather conditions. Weather systems were classified on the basis of Lamb weather type (LWT) groupings, while emissions inventories and clustering of air mass trajectories were used to interpret the observed patterns. Concentrations of ions showed clear differences between cyclonic-westerly-dominated periods and others, reflecting higher marine and lower anthropogenic contributions in Atlantic air masses. Westerlies were associated with higher rainfall, higher sea salt concentrations, and lower pollutant concentrations at all sites, while air mass paths exerted additional controls. Westerlies therefore have continued to favour higher sea salt fluxes, whereas emission reductions are increasingly leading to positive correlations between westerlies and pollutant fluxes. Our results also suggest a shift from the influence of anthropogenic emissions to natural emissions (e.g., sea salt) and climate forcing as they are transported under relatively cleaner conditions to the UK. Westerlies have been relatively frequent over the ECN monitoring period, but longer-term cyclicity in these weather types suggests that current contributions to precipitation may not be sustained over coming years.
Asunto(s)
Contaminantes Atmosféricos , Contaminación del Aire , Contaminantes Ambientales , Contaminantes Atmosféricos/análisis , Contaminación del Aire/análisis , Animales , Ecosistema , Monitoreo del Ambiente/métodos , Femenino , Embarazo , Ovinos , Tiempo (Meteorología)RESUMEN
Social interactions are known to be an essential component of infant development. For this reason, exploring functional neural activity while infants are engaged in social interactions will enable a better understanding of the infant social brain. This in turn, will enable the beginning of disentangling the neural basis of social and non-social interactions as well as the influence that maternal engagement has on infant brain function. Maternal sensitivity serves as a model for socio-emotional development during infancy, which poses the question: do interactions between parents and their offspring present altered electrophysiological responses in comparison to the general population if said parents are at risk of mental health disorders? The current research aimed to observe the oscillatory activity of 6-month-old infants during spontaneous free-play interactions with their mother. A 5-minute unconstrained free-play session was recorded between infant-mother dyads with EEG recordings taken from the 6-month-old infants (n = 64). During the recording, social and non-social behaviours were coded and EEG assessed with these epochs. Results showed an increase in oscillatory activity both when an infant played independently or interacted with their mother and oscillatory power was greatest in the alpha and theta bands. In the present 6-month-old cohort, no hemispheric power differences were observed as oscillatory power in the corresponding neural regions (i.e. left and right temporal regions) appeared to mirror each other. Instead, temporal estimates were larger and different from all other regions, whilst the frontal and parietal regions bihemispherically displayed similar estimates, which were larger than those observed centrally, but smaller than those displayed in the temporal locations. The interactions observed between the behavioural events and frequency bands demonstrated a significant reduction in power comparative to the power observed in the gamma band during the baseline event. The present research sought to explore the obstacle of artificial play paradigms for neuroscience research, whereby researchers question how much these paradigms relate to reality. The present manuscript will discuss the strengths and limitations of taking an unconstrained free-play approach.
Asunto(s)
Encéfalo , Electroencefalografía , Desarrollo Infantil , Femenino , Humanos , Lactante , MadresRESUMEN
BACKGROUND: Gallstone related pathology (GRP) accounts for a significant proportion of general surgery admissions. The aim of this study is to investigate if seasonal variation for GRP admissions exist in England allowing improved resource allocation and planning. METHODS: This multicentre retrospective cohort study included only emergency adult (≥18 years old) admissions to acute secondary care with ICD-10 codes associated with gallstones between 01/01/2010 to 31/12/2019 in England using Hospital Episode Statistics data. Seasons were defined according to United Kingdom Met Office. RESULTS: A total of 396 879 GRP related admissions were recorded during the specified period, accounting for 1.44% of all emergency admissions. Our study suggests a significant seasonal peak in Summer (n = 102 620) based cumulative admissions per season and a linear regression model (p < 0.001), followed by Autumn (n = 102 267), then Spring (n = 97 807) and finally Winter (n = 94 185). Spectral analysis confirmed there is seasonality in the emergency GRP admissions every 12 months. A forecasting model was shown to be reliable; all observed admissions for 2019 were within the 95% prediction intervals for each month for the proportion of emergency GRP admissions. CONCLUSION: Resource allocation towards the Summer months to target seasonal peaks in GRP should be considered.
Asunto(s)
Cálculos Biliares , Adolescente , Adulto , Inglaterra/epidemiología , Cálculos Biliares/epidemiología , Cálculos Biliares/cirugía , Hospitalización , Humanos , Estudios Retrospectivos , Estaciones del AñoRESUMEN
Previous research has revealed that people from different genetic, racial, biological, and/or cultural backgrounds may display fundamental differences in eye-tracking behavior. These differences may have a cognitive origin or they may be at a lower level within the neurophysiology of the oculomotor network, or they may be related to environment factors. In this paper we investigated one of the physiological aspects of eye movements known as post-saccadic oscillations and we show that this type of eye movement is very different between two different populations. We compared the post-saccadic oscillations recorded by a video-based eye tracker between two groups of participants: European-born and Chinese-born British students. We recorded eye movements from a group of 42 Caucasians defined as White British or White Europeans and 52 Chinese-born participants all with ages ranging from 18 to 36 during a prosaccade task. The post-saccadic oscillations were extracted from the gaze data which was compared between the two groups in terms of their first overshoot and undershoot. The results revealed that the shape of the post-saccadic oscillations varied significantly between the two groups which may indicate a difference in a multitude of genetic, cultural, physiologic, anatomical or environmental factors. We further show that the differences in the post-saccadic oscillations could influence the oculomotor characteristics such as saccade duration. We conclude that genetic, racial, biological, and/or cultural differences can affect the morphology of the eye movement data recorded and should be considered when studying eye movements and oculomotor fixation and saccadic behaviors.
Asunto(s)
Movimientos Sacádicos , Universidades , Adolescente , Adulto , China , Femenino , Humanos , Masculino , Población Blanca , Adulto JovenRESUMEN
Changepoint analysis (also known as segmentation analysis) aims to analyze an ordered, one-dimensional vector in order to find locations where some characteristic of the data changes. Many models and algorithms have been studied under this theme, including models for changes in mean and/or variance, changes in linear regression parameters, etc. This work is interested in an algorithm for the segmentation of long duration acoustic signals; the segmentation is based on the change of the root-mean-square power of the signal. It investigates a Bayesian model with two possible parameterizations and proposes a binary algorithm in two versions using non-informative or informative priors. These algorithms are tested in the segmentation of annotated acoustic signals from the Alcatrazes marine preservation park in Brazil.
Asunto(s)
Acústica , Modelos Teóricos , Sonido , Teorema de Bayes , Océanos y MaresRESUMEN
Background: There is increasing evidence that people in the early stages of Alzheimer's disease (AD) have subtle impairments in cognitive inhibition that can be detected by using relatively simple eye-tracking paradigms, but these subtle impairments are often missed by traditional cognitive assessments. People with mild cognitive impairment (MCI) are at an increased likelihood of dementia due to AD. No study has yet investigated and contrasted the MCI subtypes in relation to eye movement performance. Methods: In this work we explore whether eye-tracking impairments can distinguish between patients with the amnesic and the non-amnesic variants of MCI. Participants were 68 people with dementia due to AD, 42 had a diagnosis of aMCI, and 47 had a diagnosis of naMCI, and 92 age-matched cognitively healthy controls. Results: The findings revealed that eye-tracking can distinguish between the two forms of MCI. Conclusions: The work provides further support for eye-tracking as a useful diagnostic biomarker in the assessment of dementia.
Asunto(s)
Enfermedad de Alzheimer/fisiopatología , Disfunción Cognitiva/fisiopatología , Movimientos Sacádicos/fisiología , Anciano , Anciano de 80 o más Años , Enfermedad de Alzheimer/diagnóstico , Enfermedad de Alzheimer/psicología , Amnesia/diagnóstico , Amnesia/fisiopatología , Amnesia/psicología , Estudios de Casos y Controles , Disfunción Cognitiva/diagnóstico , Disfunción Cognitiva/psicología , Progresión de la Enfermedad , Medidas del Movimiento Ocular/estadística & datos numéricos , Femenino , Humanos , Masculino , Persona de Mediana EdadRESUMEN
Spatial researchers have been arguing over the optimum cognitive strategy for spatial problem-solving for several decades. The current article aims to shift this debate from strategy dichotomies to strategy flexibility-a cognitive process, which although alluded to in spatial research, presents practical methodological challenges to empirical testing. In the current study, participants' eye movements were tracked during a mental rotation task (MRT) using the Tobii ×60 eye-tracker. Results of a latent profile analysis, combining different eye movement parameters, indicated two distinct eye-patterns-fixating and switching patterns. The switching eye-pattern was associated with high mental rotation performance. There were no sex differences in eye-patterns. To investigate strategy flexibility, we used a novel application of the changepoint detection algorithm on eye movement data. Strategy flexibility significantly predicted mental rotation performance. Male participants demonstrated higher strategy flexibility than did female participants. Our findings highlight the importance of strategy flexibility in spatial thinking and have implications for designing spatial training techniques. The novel approaches to analyzing eye movement data in the current paper can be extended to research beyond the spatial domain. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
Asunto(s)
Movimientos Oculares/fisiología , Orientación/fisiología , Solución de Problemas/fisiología , Percepción Espacial/fisiología , Adolescente , Adulto , Algoritmos , Atención/fisiología , Femenino , Lateralidad Funcional/fisiología , Humanos , Masculino , Estimulación Luminosa , Psicofísica , Rotación , Caracteres Sexuales , Adulto JovenRESUMEN
Recent research have shown that the eye movement data measured by an eye tracker does not necessarily reflect the exact rotations of the eyeball. For example, post-saccadic eye movements may be more reflecting the relative movements between the pupil and the iris rather than the eyeball oscillations. Since, accurate measurement of eye movements is important in many studies, it is crucial to identify different factors that influence the dynamics of the eye movements measured by an eye tracker. Previous studies have shown that deformation of the internal structure of the iris and size of the pupil directly affect the amplitude of the post-saccadic oscillations that are measured by video-based eye trackers that are pupil-based. In this paper, we look at the effect of aging on post-saccadic oscillations. We recorded eye movements from a group of 43 young and 22 older participants during an abstract and a more natural viewing task. The recording was conducted with a video-based eye tracker using the pupil center and corneal reflection. We anticipated that changes in the muscle strength as an effect of aging might affect, directly or indirectly, the post-saccadic oscillations. Results showed that the size of the post-saccadic oscillations were significantly larger for our older group. The results suggests that aging has to be considered as an important factor when studying the post-saccadic eye movements.
Asunto(s)
Envejecimiento/fisiología , Movimientos Sacádicos/fisiología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Medidas del Movimiento Ocular/instrumentación , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pupila/fisiología , Adulto JovenRESUMEN
Time series within fields such as finance and economics are often modelled using long memory processes. Alternative studies on the same data can suggest that series may actually contain a 'changepoint' (a point within the time series where the data generating process has changed). These models have been shown to have elements of similarity, such as within their spectrum. Without prior knowledge this leads to an ambiguity between these two models, meaning it is difficult to assess which model is most appropriate. We demonstrate that considering this problem in a time-varying environment using the time-varying spectrum removes this ambiguity. Using the wavelet spectrum, we then use a classification approach to determine the most appropriate model (long memory or changepoint). Simulation results are presented across a number of models followed by an application to stock cross-correlations and US inflation. The results indicate that the proposed classification outperforms an existing hypothesis testing approach on a number of models and performs comparatively across others.