Evidence for Octupole Correlations in Multiple Chiral Doublet Bands.

Two pairs of positive-and negative-parity doublet bands together with eight strong electric dipole transitions linking their yrast positive- and negative-parity bands have been identified in ^{78}Br. They are interpreted as multiple chiral doublet bands with octupole correlations, which is supported by the microscopic multidimensionally-constrained covariant density functional theory and triaxial particle rotor model calculations. This observation reports the first example of chiral geometry in octupole soft nuclei.

Association between common variation at the FTO locus and changes in body mass index from infancy to late childhood: the complex nature of genetic association through growth and development.

An age-dependent association between variation at the FTO locus and BMI in children has been suggested. We meta-analyzed associations between the FTO locus (rs9939609) and BMI in samples, aged from early infancy to 13 years, from 8 cohorts of European ancestry. We found a positive association between additional minor (A) alleles and BMI from 5.5 years onwards, but an inverse association below age 2.5 years. Modelling median BMI curves for each genotype using the LMS method, we found that carriers of minor alleles showed lower BMI in infancy, earlier adiposity rebound (AR), and higher BMI later in childhood. Differences by allele were consistent with two independent processes: earlier AR equivalent to accelerating developmental age by 2.37% (95% CI 1.87, 2.87, p = 10(-20)) per A allele and a positive age by genotype interaction such that BMI increased faster with age (p = 10(-23)). We also fitted a linear mixed effects model to relate genotype to the BMI curve inflection points adiposity peak (AP) in infancy and AR. Carriage of two minor alleles at rs9939609 was associated with lower BMI at AP (-0.40% (95% CI: -0.74, -0.06), p = 0.02), higher BMI at AR (0.93% (95% CI: 0.22, 1.64), p = 0.01), and earlier AR (-4.72% (-5.81, -3.63), p = 10(-17)), supporting cross-sectional results. Overall, we confirm the expected association between variation at rs9939609 and BMI in childhood, but only after an inverse association between the same variant and BMI in infancy. Patterns are consistent with a shift on the developmental scale, which is reflected in association with the timing of AR rather than just a global increase in BMI. Results provide important information about longitudinal gene effects and about the role of FTO in adiposity. The associated shifts in developmental timing have clinical importance with respect to known relationships between AR and both later-life BMI and metabolic disease risk.

Lifestyle and demographic correlates of poor mental health in early adolescence.

AIM: To determine the constellation of lifestyle and demographic factors that are associated with poor mental health in an adolescent population. METHODS: The Raine Study 14-year follow-up involved primary care givers and their adolescent children (n= 1860). The Child Behaviour Checklist (CBCL) was used to assess adolescent mental health. We examined diet, socio-demographic data, family functioning, physical activity, screen use and risk-taking behaviours with mental health outcomes using linear regression. RESULTS: Adolescents with higher intakes of meat and meat alternatives and 'extras' foods had poorer mental health status. Adverse socio-economic conditions, higher hours of screen use and ever partaking in the health risk behaviours of smoking and early sexual activity were significantly associated with increasing CBCL scores, indicative of poorer functioning. CONCLUSIONS: By identifying the lifestyle and demographic factors that accompany poorer mental health in early adolescence, we are able to better understand the context of mental health problems as they occur within an adolescent population.

Nonzero quadrupole moments of candidate tetrahedral bands.

Negative-parity bands in the vicinity of 156Gd and 160Yb have been suggested as candidates for the rotation of tetrahedral nuclei. We report the observation of the odd and even-spin members of the lowest energy negative-parity bands in 160Yb and 154Gd. The properties of these bands are similar to the proposed tetrahedral band of 156Gd and its even-spin partner. Band-mixing calculations are performed and absolute and relative quadrupole moments deduced for 160Yb and 154Gd. The values are inconsistent with zero, as required for tetrahedral shape, and the bands are interpreted as octupole vibrational bands. The failure to observe the in-band E2 transitions of the bands at low spins can be understood using the measured B(E1) and B(E2) values.

Impact of the 2017 American Heart Association and American College of Cardiology hypertension guideline in aged individuals.

OBJECTIVES: The AHA/ACC-2017 hypertension guideline recommends an age-independent target blood pressure (BP) of less than 130/80 mmHg. In an elderly cohort without established cardiovascular disease (CVD) at baseline, we determined the impact of this guideline on the prevalence of hypertension and associated CVD risk. METHODS: Nineteen thousand, one hundred and fourteen participants aged at least 65 years from the ASPirin in Reducing Events in the Elderly (ASPREE) study were grouped by baseline BP: 'pre-2017 hypertensive' (BP ≥140/90 mmHg and/or on antihypertensive drugs); 'reclassified hypertensive' (normotensive by pre-2017 guidelines; hypertensive by AHA/ACC-2017 guideline), and 'normotensive' (BP <130 and <80 mmHg). For each group, we evaluated CVD risk factors, predicted 10-year CVD risk using the Atherosclerotic Cardiovascular Disease (ASCVD) risk equation, and reported observed CVD event rates during a median 4.7-year follow-up. RESULTS: Overall, 74.4% (14 213/19 114) were 'pre-2017 hypertensive'; an additional 12.3% (2354/19 114) were 'reclassified hypertensive' by the AHA/ACC-2017 guideline. Of those 'reclassified hypertensive', the majority (94.5%) met criteria for antihypertensive treatment although 29% had no other traditional CVD risk factors other than age. Further, a relatively lower mean 10-year predicted CVD risk (18% versus 26%, P < 0.001) and lower CVD rates (8.9 versus 12.1/1000 person-years, P = 0.01) were observed in 'reclassified hypertensive' compared with 'pre-2017 hypertensive'. Compared with 'normotensive', a hazard ratio (95% confidence interval) for CVD events of 1.60 (1.26-2.02) for 'pre-2017 hypertensive' and 1.26 (0.93-1.71) for 'reclassified hypertensive' was observed. CONCLUSION: Applying current CVD risk calculators in the elderly 'reclassified hypertensive', as a result of shifting the BP threshold lower, increases eligibility for antihypertensive treatment but documented CVD rates remain lower than hypertensive patients defined by pre2017 BP thresholds.

Long-term follow-up of participants in a health promotion program for treated hypertensives (ADAPT).

BACKGROUND AND AIMS: Improvements in a lifestyle modification program for hypertensives were maintained 1 year later. Longer follow-up in such studies is limited; we therefore re-assessed participants after an additional 2 years in which there was no contact with program facilitators. METHODS AND RESULTS: Participants randomised to usual care (N=118) or a 4-month lifestyle program (N=123) were previously assessed after 4 months and 1 year. After a further 2 years, diet, alcohol intake, physical activity, weight, waist girth, ambulatory blood pressure (BP), blood lipids, glucose and insulin were measured (usual care N=64; program N=76). Statistically significant net changes, relative to usual care, included blood cholesterol (-0.2 mmol/L, 95% CI 0.1-0.4); physical activity (53 min/week, 95% CI 15-91); dietary saturated fat (-1.9% energy, 95% CI -0.1 to -3.8); fish (3.2 serves/month, 95% CI 0.7-5.7); vegetables (9.1 serves/month, 95% CI 3.2-15.1); and sweet foods (-6.2 serves/month, 95% CI -1.1 to -11.3). Between-group changes in weight (-0.7 kg, 95% CI -1.8-0.4), BP (systolic 1.4 mmHg, 95% CI -0.7-3.5)/diastolic 1.0 mmHg, 95% CI -0.3-2.4) and Framingham risk (usual care: men 12.1%, women 3.7%; program: men 12.2%; women 3.5%) did not differ significantly. CONCLUSION: Continued reinforcement with long-term follow-up is needed in lifestyle modification programs.

A lifestyle program for treated hypertensives improved health-related behaviors and cardiovascular risk factors, a randomized controlled trial.

OBJECTIVE: To assess effects of a cognitively based program on health-related behaviors and cardiovascular risk factors in overweight drug-treated hypertensives. STUDY DESIGN AND SETTING: In a clinical trials center, volunteers, recruited by advertisement, were randomized to usual care (N=118) or to a 4-month program (N=123) incorporating weight loss; a low-sodium diet, high in fruit, vegetables, and fish; and increased physical activity. Diet, physical activity, weight, blood lipids, glucose, and insulin were measured at 4 and 16 months. RESULTS: Ninety-eight usual care and 106 program participants completed the 4-month assessment; 90 and 102, respectively, completed follow-up. Using intention-to-treat analysis, relative to usual care, net changes with the program at 4 months were as follows: dietary fat (-2.6% energy; P<0.001); sodium (-290mg/d; P=0.004); energy (-313mJ/d; P=0.005); fish (+2.1 serves/wk; P<0.001); vegetables (+3.0 serves/wk; P<0.001); physical activity (+37min/wk; P=0.004); weight (-2.8kg; P<0.001); waist girth (-3.1cm; P<0.001); total cholesterol (-0.2mmol/L; P=0.017); and triacylglycerols (-0.12mmol/L; P=0.002). One year later, net changes included dietary fat (-2.2% energy; P<0.001); sodium (-150mg/d; P=0.029); fish (+2.0 serves/wk; P<0.001); vegetables (+4.3 serves/wk; P<0.001); weight (-2.5kg; P=0.001); waist girth (-3.1cm; P<0.001); high-density lipoprotein cholesterol (+0.03mmol/L; P=0.031). CONCLUSION: Improvements in behaviors and risk factors, several maintained long term, suggest the potential for long-term benefits in hypertensives.

The presence of a Ca2+ bridge within the gamma chain of human fibrinogen.

The presence of Ca2+ increased the mobility of fragment D, and the gamma chain from fibrinogen on polyacrylamide gel electrophoresis in the presence of sodium dodecyl sulphate, suggesting that a Ca2+ was associated with these fibrinogen derivatives. The mobilities of the constituent chains from fragment D produced under various conditions, indicate that Ca2+ bound to fibrinogen form an intrachain bridge towards the C-terminus of each gamma chain.

Urinary 20-hydroxyeicosatetraenoic acid is associated with endothelial dysfunction in humans.

BACKGROUND: 20-hydroxyeicosatetraenoic acid (20-HETE) is a cytochrome P450 (omega-hydroxylase) metabolite of arachidonic acid with vasoconstrictor activity that may be involved in the pathogenesis of hypertension. In humans, there are few data relating 20-HETE to vascular pathophysiology. This study aimed to determine whether urinary 20-HETE excretion is related to blood pressure or vascular endothelial function in humans. METHODS AND RESULTS: Sixty-six subjects (37 males, 29 females), including 29 with untreated hypertension, had urinary 20-HETE excretion measured by gas chromatography/mass spectrometry. There was no significant difference for 20-HETE excretion between hypertensive and normotensive subjects. 20-HETE excretion was positively related to body mass index and sodium excretion. There was a significant inverse association between urinary 20-HETE and endothelium-dependent vasodilation measured by flow-mediated dilation of the brachial artery (P=0.006). There was no association with vasodilator responses to nitroglycerin. In multiple regression analysis, 20-HETE remained an independent predictor of endothelium-dependent vasodilation after adjustment for age, body mass index, and blood pressure. When gender was included in the model, the relationship between 20-HETE and flow-mediated dilation was attenuated. Separate analysis by gender revealed that in women, hypertensive subjects had significantly higher 20-HETE excretion than normotensive subjects, but this was not seen in men. In women, 20-HETE was positively related to diastolic and systolic blood pressure. In men, 20-HETE was positively related to body mass index. CONCLUSIONS: This is the first demonstration of an association between 20-HETE excretion and in vivo vascular function in humans. Given the negative modulatory role of nitric oxide on omega-hydroxylase, the present results suggest a potentially important role for 20-HETE in human vascular physiology.

Effects of a lifestyle programme on ambulatory blood pressure and drug dosage in treated hypertensive patients: a randomized controlled trial.

OBJECTIVE: To assess effects of multifactorial lifestyle modification on antihypertensive drug needs in treated hypertensive individuals. DESIGN: Randomized controlled trial. SETTING: Research studies unit. PARTICIPANTS: Overweight hypertensive patients, receiving one or two antihypertensive drugs, were recruited by advertising, and allocated randomly to a usual care group (controls; n = 118) or a lifestyle modification group (programme group; n = 123). INTERVENTION: A 4-month programme of weight loss, a low-sodium 'Dietary Approaches to Stop Hypertension'-type diet with added fish, physical activity and moderation of alcohol intake. After 4 months, if mean 24-h ambulatory blood pressure (ABP) was less than 135/85 mmHg, antihypertensive drugs were withdrawn over 4 weeks and long-term home blood pressure monitoring was begun. MAIN OUTCOME MEASURES: Antihypertensive drug requirements, ABP, weight, waist girth at 4 months and 1-year follow-up. RESULTS: Ninety control group and 102 programme group participants completed the study. Mean 24-h ABP changed after 4 months by -1.0/-0.3 +/- 0.5/0.4 mmHg in controls and -4.1/-2.1 +/- 0.7/0.5 mmHg with the lifestyle programme (P < 0.01). At follow-up, changes in the two groups were not significantly different (4.1/1.3 +/- 1.1/1.0 mmHg in controls; 2.5/-0.1 +/- 1.1/0.8 mmHg in the programme group; P = 0.73). At 4 months, drug withdrawal differed significantly between the groups (P = 0.038) in men (control 44%; programme 66%) but not in women (65 and 64%, respectively; P = 0.964). At follow-up, sex-related differences were not significant, and 41% in the control group and 43% in the programme group maintained drug-withdrawal status. With the programme, net weight loss was 3.3 kg (P < 0.001) at 4 months and 3.0 kg (P < 0.001) at follow-up; respective net decreases in waist girth were 3.3 cm (P < 0.001) and 3.5 cm (P < 0.001). CONCLUSIONS: A 4-month multifactorial lifestyle modification in patients with treated hypertension reduced blood pressure in the short-term. Decreased central obesity persisted 1 year later and could reduce overall cardiovascular risk.

Patterns of flow and conduction during early ventricular arrhythmias following coronary arterial occlusion in the dog.

The early ventricular arrhythmias of acute myocardial ischaemia arise against a background of rapid alterations in regional myocardial blood flow and electrophysiological properties. The relation between patterns of flow and epicardial activation has been examined in eight open chest anaesthetised dogs at time of onset of these arrhythmias following a proximal occlusion of the left anterior descending coronary artery. Data were derived from 80 epicardial and endocardial sites within a 4 X 5 cm area of left ventricular free wall and processed utilising a three-dimensional computer plotting program. Mean flow within the ischaemic zone was reduced to 0.27 and 0.24 cm3 x g-1 x min-1 in epicardium and endocardium respectively. Marked epicardial activation delays and fragmentation of conduction were observed confined to areas of flow less than 0.3 cm3 x g-1 x min-1. 74% of endocardial and 71% of epicardial tissue samples within the ischaemic zone derived from this area and analysis of flow distribution between adjacent samples demonstrated spatial heterogeneity of flow. It is suggested that local spatial variability in flow within the central ischaemic region may be a prerequisite for abnormal fractionation of conduction leading to re-entrant excitation at the time of onset of early ventricular arrhythmias.

Slow release dietary carbohydrate improves second meal tolerance.

Breakfasts of lentils or wholemeal bread of identical carbohydrate content were taken by seven healthy volunteers. The lentils produced a significant 71% (p less than 0.001) reduction in the blood glucose area and flattened the plasma insulin and gastric inhibitory polypeptide responses by comparison with the bread. In addition, the lentil breakfast was followed by a significantly flatter blood glucose response to the standard bread lunch which followed 4 h later (by 38%, p less than 0.01). The blood glucose pattern was mimicked by feeding the bread breakfast slowly over the 4 h before lunch. Giving a bread breakfast containing a quarter of the carbohydrate reduced the breakfast glucose profile but resulted in a significantly impaired blood glucose response to lunch (168% of control, p less than 0.01). These results, together with breath hydrogen studies, performed on a separate group of four volunteers, indicate that the flattened response to lentils is not due to carbohydrate malabsorption. Slow release or "lente" carbohydrate foods such as lentils may form a useful part of the diets of those with impaired carbohydrate tolerance.

Pathophysiologic studies in human rabies.

Six patients with proved rabies were studied with a combination of clinical, physiologic and pathologic technics. Three were given a type of intensive care but died with evidence of respiratory failure. Although circulatory failure did not develop in any of the six patients, three had supraventricular arrhythmias: interstitial myocarditis was found in one of these and rabies virus was isolated from the myocardium of another. Inspiratory muscle spasm was the dominant clinical feature in all cases. This occurred as part of the hydrophobic response and followed stimulation of the upper respiratory tract and skin. Hydrophobia may represent an exaggerated respiratory tract irritant reflex with associated arousal. Later in the course of the disease, various patterns of periodic and ataxic breathing were observed. Widespread brain stem encephalitis was discovered at autopsy, with particular involvement of the neighborhood of the nucleus ambiguous in two of three patients examined. In one patient cerebral metabolism was grossly abnormal, with greatly reduced cerebral oxygen consumption suggesting irreversible brain damage. Respiratory and circulatory disturbances may well be immediate causes of death in patients with rabies, but the present studies reemphasize the severity of the encephalitis which remains the ultimate barrier to survival. In the developing countries in which rabies is still a major problem and in which the cost precludes intensive care, the clinical management of rabies can aim only to reduce suffering by heavy sedation.

Mechanisms of phase 1a and 1b early ventricular arrhythmias during acute myocardial ischemia in the dog.

Two phases of ventricular arrhythmia occur within the first 30 minutes of experimental myocardial ischemia. Possible differences in their mechanisms of pathogenesis were investigated in anesthetized dogs by detailed mapping of patterns of epicardial activation and regional myocardial blood flow during phase 1a and phase 1b early ventricular arrhythmias induced by high ligation of the left anterior descending coronary artery. Data were derived from 80 sites in a 4 by 5 cm area of left ventricular anterior free wall and displayed using computer graphics. Regional myocardial blood flow and the relation of regional flow to epicardial delay did not differ significantly during the 2 phases of arrhythmia in central ischemic or nonischemic areas, although epicardial flow in border region segments was increased during phase 1b. Significantly greater mean epicardial delays and spatial heterogeneity of epicardial delay (assessed by intersite variance within the ischemic area) occurred during phase 1a arrhythmias. Serial studies show striking increases in spatial heterogeneity of delays during phase 1a, but not during phase 1b, relating to temporal dispersion of a phenomenon of transient prolongation of activation delay at individual electrode sites. These data are consistent with the concept that phase 1a and 1b arrhythmias arise through different electrophysiologic mechanisms independent of flow-dependent effects.

Accuracy of blood pressure measurement and anthropometry among volunteer observers in a large community survey.

The Busselton Survey is a population survey that is held about every three years. In 1994-1995 a re-survey was held of all past participants and 8,502 attended. Financial constraints precluded employing staff for data collection for blood pressure and anthropometry, these therefore were collected by unpaid lay volunteers. Quality control by a health professional was critical to the assessment and maintenance of accuracy in these measurements. For blood pressure three readings were taken simultaneously by a quality control person and the volunteer using a dual stethoscope. Duplicate anthropometric measurements were taken by a criterion anthropometrist and the volunteer. Inter and intra-observer technical errors of measurement (TEM) were calculated. Sixty-two volunteers were trained to take BP measurements; of these, 38 collected data, and 63 were trained in anthropometry; of these, 30 were suitable as measurers. Training was conducted on a group and individual basis by the quality assurance person for the study both in the Perth metropolitan area and rural Busselton. The TEM for SBP was 1.6 mm Hg (SD 1.0 mm Hg) and 1.5 mm Hg (SD 0.8) for DBP. For skin-folds intra-observer TEM ranged from 0.6 mm to 1.0 mm. Between-observer TEM ranged from 2.1 mm to 5.4 mm. For limb and waist circumferences, intra-observer TEM ranged from 0.3 cm to 1.6 cm. Between-observer TEM for circumferences ranged from 0.5 cm to 1.9 cm. Unpaid volunteer measurers can, if carefully trained and supervised, provide acceptable blood pressure data and anthropometry in large population surveys.

Physical activity and nutrition programs for couples: a randomized controlled trial.

Diet and physical activity habits may deteriorate after cohabitation, leading to weight gain and increased risk of lifestyle diseases. We carried out a 4-month, randomized controlled trial of a diet and physical activity program for couples with a 1-year follow-up, comparing two methods of delivery. The program used six modules, which, after an initial group session, were mailed to the low-level intervention group. In the high-level intervention group, half of the modules were mailed, and the others were delivered at interactive group sessions. A control group received no intervention. Postintervention and at follow-up, physical fitness improved in the high-level group, saturated fat intake decreased in both intervention groups, and low-density lipoprotein cholesterol fell in the high-level group. Fewer participants in the high-level group became overweight or obese. Health promotion for couples can improve health behaviors and potentially lower the risk of lifestyle diseases in participants and their future families.

The independent and combined effects of 16 weeks of vigorous exercise and energy restriction on body mass and composition in free-living overweight men--a randomized controlled trial.

This study assessed the effects of 16 weeks of energy restriction and vigorous exercise on body mass and body composition. Sixty sedentary men, mean body mass (mean +/- SD) 96.3 (13.9) kg and mean age 42.4 (5.0) years, were randomly assigned to either continue their normal energy intake or restrict energy intake by 4,186 to 6,279 kJ. d(-1). Each group was further randomized to a control light exercise program, or a vigorous exercise program for 3 half-hour sessions per week. Vigorous exercise improved maximum oxygen consumption (Vo(2max)) by approximately 24% (0.56 [95% confidence interval, 0.47 to 0.65) L. min(-1), P <.001) with no significant changes in body mass, body composition, or fat distribution. With energy restriction there was a significant reduction in body mass of 10.1 (8.0 to 12.2) kg, lean body mass (LBM) of 2.4 (1.5 to 3.3) kg, fat mass (FM) of 7.7 (5.9 to 9.6) kg, waist to hip ratio (WHR) of 0.03 (0.01 to 0.04), and the sum of 6 skinfolds of 26.9 (15.4 to 38.4) mm (P <.001). Combining vigorous exercise with energy restriction resulted in no further changes in measures of body composition. We conclude that in sedentary free-living overweight men, 16 weeks of energy restriction, but not vigorous intensity exercise, results in substantial reductions in body mass, LBM, and FM. Furthermore, vigorous intensity exercise when combined with energy restriction did not modify or enhance the changes in body fat distribution or body composition seen with energy restriction alone. The independent effects of exercise to induce changes in body mass and composition in the longer term in free-living overweight subjects on an energy-restricted diet deserve further study.

Identification of pathogenic Leishmania promastigotes by DNA: DNA hybridization with kinetoplast DNA cloned into E. coli plasmids.

We report the characterization of Leishmania (L. infantum, L. donovani, and L. major) kinetoplast DNA (kDNA) by the use of restriction endonuclease digestion patterns and Southern hybridizations. Overall, the sizes and fragment patterns of MspI restriction endonuclease-produced DNA fragments vary from species to species. However, kDNA isolates from different species and strains cross-reacted to a great extent in Southern hybridization experiments. Only kDNA isolated from L. infantum and L. major had little homology during hybridization reactions. To prepare DNA probes that would differentiate between species of Leishmania, minicircle kDNA was digested with restriction enzymes and ligated to an E. coli plasmid. Several plasmids were isolated that specifically detect in hybridization experiments as few as 5 X 10(3) L. donovani or L. infantum promastigotes lysed on nitrocellulose filters.

The influence of calcium ions on the conformation of fibrinogen fragment D: the use of chemical cross-linking agents.

Fibrinogen fragment D prepared in the presence of calcium ions (fragment D[Ca++]) shows qualitatively similar cross-linking patterns with dimethyl suberimidate, dimethyl adipimidate and tetranitromethane. Fragment D prepared in the presence of EDTA (fragment D[EDTA]) gives a consistently different pattern with these reagents. In the case of fragment D[EDTA] there is much more intermolecular cross-linking suggesting that the loss of the C-terminus of the gamma-chain remnant results in fragment D adopting a more open conformation. Neither the addition of 2M urea nor EDTA to fragment D[Ca++] alters its cross-linking pattern suggesting that the proposed conformational change follows cleavage of a plasmin susceptible bond which is normally protected by the presence of calcium ions.