Health effects of reduced occupational sedentary behaviour in type 2 diabetes using a mobile health intervention: a study protocol for a 12-month randomized controlled trial-the ROSEBUD study.

BACKGROUND: Short-term trials conducted in adults with type 2 diabetes mellitus (T2DM) showed that reducing sedentary behaviour by performing regular short bouts of light-intensity physical activity enhances health. Moreover, support for reducing sedentary behaviour may be provided at a low cost via mobile health technology (mHealth). There are a wide range of mHealth solutions available including SMS text message reminders and activity trackers that monitor the physical activity level and notify the user of prolonged sitting periods. The aim of this study is to evaluate the effects of a mHealth intervention on sedentary behaviour and physical activity and the associated changes in health in adults with T2DM. METHODS: A dual-arm, 12-month, randomized controlled trial (RCT) will be conducted within a nationwide Swedish collaboration for diabetes research in primary health care. Individuals with T2DM (n = 142) and mainly sedentary work will be recruited across primary health care centres in five regions in Sweden. Participants will be randomized (1:1) into two groups. A mHealth intervention group who will receive an activity tracker wristband (Garmin Vivofit4), regular SMS text message reminders, and counselling with a diabetes specialist nurse, or a comparator group who will receive counselling with a diabetes specialist nurse only. The primary outcomes are device-measured total sitting time and total number of steps (activPAL3). The secondary outcomes are fatigue, health-related quality of life and musculoskeletal problems (self-reported questionnaires), number of sick leave days (diaries), diabetes medications (clinical record review) and cardiometabolic biomarkers including waist circumference, mean blood pressure, HbA1c, HDL-cholesterol and triglycerides. DISCUSSION: Successful interventions to increase physical activity among those with T2DM have been costly and long-term effectiveness remains uncertain. The use of mHealth technologies such as activity trackers and SMS text reminders may increase awareness of prolonged sedentary behaviour and encourage increase in regular physical activity. mHealth may, therefore, provide a valuable and novel tool to improve health outcomes and clinical management in those with T2DM. This 12-month RCT will evaluate longer-term effects of a mHealth intervention suitable for real-world primary health care settings. TRIAL REGISTRATION: ClinicalTrials.gov NCT04219800 . Registered on 7 January 2020.

The risk of venous thromboembolism and physical activity level, especially high level: a systematic review.

Venous thromboembolism (VTE) is the third most common cause of cardiovascular disease. Connection between high level of physical activity (PA) and the onset of VTE is unknown. We searched the literature on the possible association between PA level, especially high levels, and the risk of VTE. A systematic review was carried out to identify relevant articles on the relation between PA level and VTE. The initial search was conducted together with the Karolinska Institutet University Library in February 2018, with follow-up searches after that. In total, 4383 records were found and then screened for exclusion of duplicates and articles outside the area of interest. In total, 16 articles with data on 3 or more levels of PA were included. Of these, 12 were cohort and 4 were case-control studies. Totally 13 studies aimed at investigating VTE cases primarily, while three studies had other primary outcomes. Of the 16 studies, five found a U-shaped association between PA level and VTE risk, although non-significant in three of them. Two articles described an association between a more intense physical activity and a higher risk of VTE, which was significant in one. Nine studies found associations between increasing PA levels and a decreasing VTE risk. Available literature provides diverging results as to the association between high levels of PA and the risk of venous thromboembolism, but with several studies showing an association. Further research is warranted to clarify the relationship between high level PA and VTE.

Genomic determinants of chronic myelomonocytic leukemia.

The biology, clinical phenotype and progression rate of chronic myelomonocytic leukemia (CMML) are highly variable due to diverse initiating and secondary clonal genetic events. To determine the effects of molecular features including clonal hierarchy in CMML, we studied whole-exome and targeted next-generation sequencing data from 150 patients with robust clinical and molecular annotation assessed cross-sectionally and at serial time points of disease evolution. To identify molecular lesions unique to CMML, we compared it to the related myeloid neoplasms (N=586), including juvenile myelomonocytic leukemia, myelodysplastic syndromes (MDS) and primary monocytic acute myeloid leukemia and discerned distinct molecular profiles despite similar pathomorphological features. Within CMML, mutations in certain pathways correlated with clinical classification, for example, proliferative vs dysplastic features. While most CMML patients (59%) had ancestral (dominant/co-dominant) mutations involving TET2, SRSF2 or ASXL1 genes, secondary subclonal hierarchy correlated with clinical phenotypes or outcomes. For example, progression was associated with acquisition of new expanding clones carrying biallelic TET2 mutations or RAS family, or spliceosomal gene mutations. In contrast, dysplastic features correlated with mutations usually encountered in MDS (for example, SF3B1 and U2AF1). Classification of CMML based on hierarchies of ancestral and subclonal mutational events may correlate strongly with clinical features and prognosis.

Modified visual field test for ptosis surgery (Leicester Peripheral Field Test).

INTRODUCTION: There is lack of consensus among Primary Health Care Trusts (PCTs) and health insurers on how to reimburse ptosis surgery and upper lid blepharoplasty, as these procedures can be regarded as cosmetic. Standardised photographs are expensive and difficult to achieve, whilst the routine 24-2 visual field lacks the range to detect visually significant superior field defects.AimTo introduce a modified visual field designed to assess the functional disability associated with ptosis and dermatochalasis and to demonstrate the effectiveness of surgery in improving the visual field. METHODS: Patients who had surgery for ptosis or dermatochalasis between January 2006 and December 2009 were prospectively invited to perform a modified visual field test pre- and post-operatively. RESULTS: In total, 97 patients amounting to 194 eyes were included in the study. Ninety five eyes had aponeurotic repair with or without blepharoplasty and 77 eyes had blepharoplasty alone. This modified test has a sensitivity of 98.8% of detecting ptosis. For patients who underwent ptosis surgery with or without blepharoplasty, 84.2% recorded an improvement in points seen with the test and 81% recorded an improvement in visual field height. For those who had blepharoplasty alone, 90.9% recorded an improvement in points seen in the modified visual field test and 80.6% had improvement in visual field height. CONCLUSION: Our modified visual field assessment is a quick and easy way to assess patient disability associated with ptosis and dermatochalasis. Surgery improves the demonstrated defect, confirming that ptosis and dermatochalasis can be considered a functional rather than cosmetic issue.

Recovery of process water from spent emulsions generated in copper cable factory.

Treatment of waste emulsions generated in the cable factory from copper wire drawing was investigated using the integrated membrane processes: ultrafiltration (UF) and nanofiltration (NF). The application of UF tubular membranes (MWCO 100 kDa) resulted in 98% retention of oil and lubricants, whereas the degree of passage of copper ions (the major component of effluents from cable factory) was 99%. The average permeate flux amounted to 45 l/m(2) h for the transmembrane pressure of 3.5 bar during the UF pretreatment of waste emulsions. The Silt Density Index (SDI) values of UF permeates were appropriate for the application of spiral wound membranes in the NF process. The complete removal of oil and lubricants was achieved in NF process and the content of TOC was reduced by more than 90%. The rejection of copper ions in the NF process was 90% and 98% for NF270 and NF90 membranes (FILMTEC), respectively. The quality of NF permeates allows a direct reuse of treated water for the preparation of fresh emulsion.

Azo dyes decomposition on new nitrogen-modified anatase TiO2 with high adsorptivity.

New vis active photocatalyst was obtained by the modification of commercial anatase TiO2 (Police, Poland) in pressure reactor in an ammonia water atmosphere at 100 degrees C for 4h. The photocatalytic activity of new material was tested during three azo dyes decomposition: monoazo (Reactive Read), diazo (Reactive Black) and poliazodye (Direct Green). Obtained photocatalyst had new bands at 1430-1440 cm(-1) attributed to the bending vibrations of NH(4)(+) and at 1535 cm(-1) associated with NH(2) groups or NO(2) and NO. UV-vis/DR spectra of photocatalyst had also insignificant decrease in visible region. Fluorescence technique was used for studying the amount of hydroxyl radicals produced on TiO2 surface during visible light irradiation. The hydroxyl radicals produced react with coumarin present in the solution to form 7-hydroxycoumarin which has fluorescent capacity. Photocatalytic activity of modified TiO2 was compared with commercial titanium dioxide P25 (Degussa, Germany). The photocatalytic activity of TiO2/N was higher than that of unmodified material and P25 under visible light irradiation. The ability for dye adsorption (Reactive Red) on photocatalyst surface was also tested. Unmodified TiO2 and P25 has isotherm of adsorption by Freundlich model, and nitrogen-modified TiO2 by Langmuir model. The presence of nitrogen at the surface of TiO2 significantly increased adsorption capacity of TiO2 as well as OH radicals formation under visible radiation.

Photodecomposition of dyes on Fe-C-TiO(2) photocatalysts under UV radiation supported by photo-Fenton process.

Fe-C-TiO(2) photocatalysts were prepared by mechanical mixing of commercial anatase TiO(2) precursor with FeC(2)O(4) and heating at 500-800 degrees C under argon flow. These photocatalysts were tested for dyes decomposition: Methylene Blue (MB), Reactive Black (RB) and Acid Red (AR). The preliminary adsorption of dyes on the photocatalysts surface was performed. Modification of anatase by FeC(2)O(4) caused reducing of zeta potential of the photocatalyst surface from +12 to -7mV and decreasing of their adsorption ability towards RB and AR, which were negatively charged, -46.8 and -39.7, respectively. Therefore, unmodified TiO(2) showed the highest degree of RB and AR decompositions in the combination of dyes adsorption and UV irradiation. Methylene Blue, which had zeta potential of +4.3 in the aqueous solution was poorly adsorbed on all the tested photocatalysts and also slowly decomposed under UV irradiation. The high rate of dyes decomposition was noted on Fe-C-TiO(2) photocatalysts under UV irradiation with addition of H(2)O(2). It was observed, that at lower temperatures of heat treatment such as 500 degrees C higher content of carbon is remained in the sample, blocking the built in of iron into the TiO(2) lattice. This iron is reactive in the photo-Fenton process resulting in high production of OH radicals and also high activity of the photocatalyst. At higher temperatures of heat treatment, less active FeTiO(3) phase is formed, therefore Fe-C-TiO(2) sample prepared at 800 degrees C showed low photocatalytic activity for dyes decomposition. Fe-C-TiO(2) photocatalysts are active under visible light irradiation, however, the efficiency of a dye decomposition is lower than under UV light. In a dark Fenton process there is observed an insignificant generation of OH radicals and very little decomposition of a dye, what suggests the powerful of photo-Fenton process in the dyes decomposition.

Nutritional value and physiological effects of soya-free diets fed to rats during growth and reproduction.

The objective of the study was to assess the effects of substitution milk and egg for soya products in breeding diets for rats, with concomitant decrease of the dietary protein level and supplementation with amino acids. Soya-containing (S) and two soya-free (NS and NSA) diets were evaluated as protein and energy sources, and their effects on reproductive performance during two cycles, and on the quality of the offspring were assessed. Organ weights were registered in females and blood parameters were determined in males. In the offspring males from S and NS groups, plasma LH, testosterone and prolactin levels were measured on the 22nd and the 60th day of life. The S diet contained more protein of smaller concentration of methionine and cystine and lower biological value than both NS and NSA diets and promoted similar post-weaning growth rate, similar body weight changes of dams during gestation and lactation and slightly lower mating efficiency. Within each reproductive cycle, the number and individual and total body weight of newborn and weanling pups did not differ but in two cycles mean number of neonates per litter and mean litter weight were significantly lower on S than on NSA diet. Plasma concentration of hormones did not differ in 22-day-old offspring males while in the older ones LH and prolactin levels were higher in animals fed on S than on NS diet. It is concluded that replacing soya protein by milk and egg protein with concomitant lowering dietary protein level and amino acid supplementation does not impair the growth rate and tends to improve reproductive performance. Feeding soya-free vs. soya-containing diets differentiates hormonal status of young males.

New TiO2/C sol-gel electrodes for photoelectrocatalytic degradation of sodium oxalate.

This paper reports the preparation of carbon doped TiO2 electrodes by a modification of a sol-gel route. The electrodes have been characterized by measuring their photocurrent, as a function of applied potential. Their photoelectrocatalytic activity, relative to similar sol-gel electrodes without carbon, has been assessed by measuring the decomposition of a 10 mM sodium oxalate solution. Measurements have been made on electrodes prepared with 2%, 5% and 10% of active carbon. The highest photocurrents and the highest photoelectrocatalytic activity were both obtained with electrodes prepared by heating, at 600 degrees C, electrodes prepared with 5% of active carbon. All the electrodes showed evidence of enhanced photocatalytic activity at 1.2 V. Five percent addition of C double the measured rates of photodegradation, even though, in these preliminary studies, no attempt has been made to optimize the type of carbon or the details of the electrode preparation.

Comparison of the life-time of P25 and A11 TiO2 in a labyrinth flow photoreactor.

A series of experiments for the comparison of activity and life-time of anatase titanium dioxide, Tytanpol All (Chemical Factory "Police", Poland) with Degussa P25 (Germany) was conducted in a labyrinth flow reactor with an immobilized catalyst bed. Phenol, with relatively high concentration up to 100 mg dm(-3), was chosen as a model organic compound. Photocatalytic materials were characterized by determination of: phenol decomposition degree, reaction rate constant, band gap energy, FTIR spectra and phase composition. The pureanatase Tytanpol All shows comparable activity as Degussa P25. However, the life-time of P25 Degussa at high phenol concentration was lower compared to that of anatase A11 because of the carbon deposit formation on P25 surface. The catalytic activity of rutile phase in P25 in the reaction of carbon deposits formation is postulated.

Modification of carbon-coated TiO2 by iron to increase adsorptivity and photoactivity for phenol.

Carbon-coated TiO(2) modified by iron, were prepared from TiO(2) of anatase structure and PET modified by FeC(2)O(4). Catalysts were prepared by mixing powders of TiO(2) and modified PET and heating at different temperatures, from 400 to 800 degrees C under flow of Ar gas. High adsorption of phenol was observed on the catalyst heated at 400 degrees C, confirmed by FT-IR analysis. On this catalyst, fast rate of phenol decomposition was achieved by addition of small amount of H(2)O(2) to the reaction mixture. Phenol decomposition proceeded mainly through the direct oxidation of phenol species adsorbed on the catalyst surface due to the photo-Fenton reaction. Iron-modified carbon-coated TiO(2) catalysts heated at 500-800 degrees C showed almost no phenol adsorption or oxidation.

Purification of oily wastewater by hybrid UF/MD.

Investigations on the treatment of oily wastewater by a combination of ultrafiltration (UF) and membrane distillation (MD) as a final purification method have been performed. A tubular UF module equipped with polyvinylidene fluoride (PVDF) membranes and a capillary MD module with polypropylene membranes were tested using a typical bilge water collected from a harbour without pretreatment. The permeate obtained from the UF process generally contains less than 5 ppm of oil. A further purification of the UF permeate by membrane distillation results in a complete removal of oil from wastewater and a very high reduction of the total organic carbon (99.5%) and total dissolved solids (99.9%).

[New perspectives in color ultrasound in breast diagnosis]. / Neue Perspektiven des Farb-Ultraschalls in der Mamma-Diagnostik.

In recent years, ultrasound has become established as part of the diagnostic evaluation of breast tumours. Not replacing, but complementing mammography, ultrasonic investigations increasingly represent a sensitive means of early diagnosis. Thermography, on the other hand, has proved of relatively little value and doesn't play a significant role today. Lately, Colour Doppler sonography has been used for differentiating tumour-associated blood supply patterns--however, sensitivity and specificity were not as high as initially expected. Colour spectrum analysis of local findings in comparison to the remaining glandular tissue, however, seems to be a promising method in the differentiation of ultrasound findings of uncertain tumour status. A fibroadenoma shows no significantly different colour density as compared to surrounding tissue. In carcinoma, on the other hand, one regularly finds a hyperintensive zone with sharp margins. In 70 patients, who had breast tumours, we attempted the differentiation of benign and malignant findings with the help of colour spectrum analysis. Postoperatively, these results were validated by histology. With the exception of one mesenchymal tumour, the Doppler diagnosis was identical to the histopathological findings.

[Laparoscopic treatment of ovarian tumors in menopausal women]. / Traitement coelioscopique des tumeurs de l'ovaire chez la femme ménopausée.

OBJECTIVE: The authors report their experiences in the laparoscopical therapy of ovarian tumours with 94 postmenopausal women. STUDY DESIGN: The patients were treated in the Department of Gynecology at Göppingen Medical Center from March 1, 1992 until December 31, 1993. Tumour marker CA 125 was not within normal limits (< 35 U/ml) in all patients. Preoperatively all findings were verified by ultrasound examination. In some cases, cysts were single-chambered, smooth-bounded or without endovegetations. Choice therapy has been bilateral adnectomy without opening the ovarian cyst and without trauma to the ovary capsula. Adnectomy was performed by bipolar coagulation and sharp preparation. In every case the specimen was positioned intact in a "Lap-Sac" and then removed via second puncture. In case of ultrasonographic or laparoscopic-macroscopic conspicuous findings an obligatory fast microscopic random sample was performed. RESULTS: In one case the microscopic test sample revealed carcinoma of the ovary--the operation was terminated by standard laparotomy. No other cases showed signs of malignancy. There were no peri- or postoperative complications. The average operation lasted 35 min (20-80 min), all operations were performed without significant blood-loss. Usually the patients were discharged at the 4th to 6th postoperative day. CONCLUSION: This operation-technique guaranteed "oncological aseptic" results at any time of operation. Therefore you can waive the standard laparotomy for the benefit of laparoscopy in many elderly patients even with suspicious findings.

[Histocompatibility antigens (HLA) in children with lipoid nephrosis]. / Antygeny zgodnosci tkankowej (HLA) w nerczycy lipidowej u dzieci.

Actual knowledge on the HLA relationship with the primary glomerulopathies, with particular reference to steroid - sensitive nephrosis of childhood, is surveyed. Occurrence of HLA B-8 and B-35 in this nephropathy has been investigated. The studies involved 47 patients aged between 3 and 15 years and 117 healthy children from Lower Silesian region. It has been showed, that HLA B-8 is present more frequently in sick children, than in healthy controls. The situation is reverse in case of HLA B-35 antigen. However, the difference is statistically insignificant. A probability of the lipid nephrosis sensitivity to corticosteroids can not be predicted on the base of the presence of these HLA antigens.

[Ileus caused by right sided paraduodenal hernia]. / Niedroznosc przewodu pokarmowego spowodowana przepuklina okolodwunastnicza prawostronna.

A case is presented of an ileus caused by right-sided paraduodenal hernia. The result of surgical treatment was successful.