4,830 research outputs found

    Longitudinal evaluation of cognitive functioning in young children with type 1 diabetes over 18 months

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    OBJECTIVE: Decrements in cognitive function may already be evident in young children with type 1 diabetes (T1D). Here we report prospectively acquired cognitive results over 18 months in a large cohort of young children with and without T1D. METHODS: 144 children with T1D (mean HbA1c: 7.9%) and 70 age-matched healthy controls (mean age both groups 8.5 years; median diabetes duration 3.9 yrs; mean age of onset 4.1 yrs) underwent neuropsychological testing at baseline and after 18-months of follow-up. We hypothesized that group differences observed at baseline would be more pronounced after 18 months, particularly in those T1D patients with greatest exposure to glycemic extremes. RESULTS: Cognitive domain scores did not differ between groups at the 18 month testing session and did not change differently between groups over the follow-up period. However, within the T1D group, a history of diabetic ketoacidosis (DKA) was correlated with lower Verbal IQ and greater hyperglycemia exposure (HbA1c area under the curve) was inversely correlated to executive functions test performance. In addition, those with a history of both types of exposure performed most poorly on measures of executive function. CONCLUSIONS: The subtle cognitive differences between T1D children and nondiabetic controls observed at baseline were not observed 18 months later. Within the T1D group, as at baseline, relationships between cognition (VIQ and executive functions) and glycemic variables (chronic hyperglycemia and DKA history) were evident. Continued longitudinal study of this T1D cohort and their carefully matched healthy comparison group is planned

    Stem Cell Transplantation As A Dynamical System: Are Clinical Outcomes Deterministic?

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    Outcomes in stem cell transplantation (SCT) are modeled using probability theory. However the clinical course following SCT appears to demonstrate many characteristics of dynamical systems, especially when outcomes are considered in the context of immune reconstitution. Dynamical systems tend to evolve over time according to mathematically determined rules. Characteristically, the future states of the system are predicated on the states preceding them, and there is sensitivity to initial conditions. In SCT, the interaction between donor T cells and the recipient may be considered as such a system in which, graft source, conditioning and early immunosuppression profoundly influence immune reconstitution over time. This eventually determines clinical outcomes, either the emergence of tolerance or the development of graft versus host disease. In this paper parallels between SCT and dynamical systems are explored and a conceptual framework for developing mathematical models to understand disparate transplant outcomes is proposed.Comment: 23 pages, 4 figures. Updated version with additional data, 2 new figures and editorial revisions. New authors adde

    Physical Activity and Sedentary Behavior of Cancer Survivors and Non-Cancer Individuals: Results from a National Survey

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    Increasing physical activity and decreasing sedentary behavior are associated with a higher quality of life and lower mortality rates for cancer survivors, a growing population group. Studies detailing the behavior of cancer survivors are limited. Therefore, we investigated physical activity and sedentary behavior of cancer survivors using data from the National Health and Nutrition Examination Survey (NHANES) 2007–2010. Participants were those who provided physical activity and sedentary behavior data. Those who were pregnant,old, or10,472 non-cancer participants. After adjustment for age, race, gender, education status, body mass index, and smoking status, cancer survivors (n = 10,472) reported significantly longer duration of sedentary behavior (OR = 1.42, 95% CI (1.12, 1.80) for 8 or more hours, p-value for trend = 0.09), compared to non-cancer participants (n = 741). They also reported non-significant increases in maximum intensity, duration, frequency, and energy expenditure, whereas they reported significant increases in moderate intensity (OR = 1.26, 95% CI (1.01, 1.57)), moderate frequency (1–4 times/week) (OR = 1.32, 95% CI (1.00, 1.74)), and moderate energy expenditure (4018.5–7623.5 kcal) (OR = 1.30, 95% CI (1.00, 1.71)) of physical activity, compared to non-cancer participants. These patterns are similar for breast and prostate cancer survivors, with prostate cancer survivors more likely to engage in physical activity for more than one hour per day (OR = 1.98, 95% CI (1.05, 3.71)). Our findings suggest that cancer survivors tend to have more physical activity, but they are also more likely to engage in sedentary behavior

    Self-reported health and cardiovascular reactions to psychological stress in a large community sample: Cross-sectional and prospective associations

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    Exaggerated cardiovascular reactions to acute psychological stress have been implicated in a number of adverse health outcomes. This study examined, in a large community sample, the cross-sectional and prospective associations between reactivity and self-reported health. Blood pressure and heart rate were measured at rest and in response to an arithmetic stress task. Self-reported health was assessed concurrently and five years later. In cross-sectional analyses, those with excellent/good self-reported health exhibited larger cardiovascular reactions than those with fair/poor subjective health. In prospective analyses, participants who had larger cardiovascular reactions to stress were more likely to report excellent/good health five years later, taking into account their reported health status at the earlier assessment. The findings suggest that greater cardiovascular reactivity may not always be associated with negative health outcomes

    Russia and the post-2014 international legal order: revisionism and realpolitik

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    Russia’s annexation of Crimea and intervention in eastern Ukraine are viewed by Western governments as a flagrant affront to the ideal of a rule-governed international order. This order depends fundamentally on rules governing the use of force. The wider clash of legal and normative positions over Russia’s neighbourhood between Moscow and Western states has now become acute. It is polarised by Russia’s breach in the post-Cold War territorial settlement, its violation of the basic prohibition against states reverting to wars of territory or the use of force to expand their territorial sphere. This prohibition is the bedrock of the architecture of the modern international law system, which has enabled a more developed system of rules to develop

    Russia's case for war against Ukraine: legal claims, political rhetoric and instrumentality in a fracturing international order

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    In seeking to justify its war of aggression against Ukraine, Russia has presented a wide variety of legal, quasi-legal, and normative claims, alongside political rhetoric and transparent revanchism. Drawing on a qualitative content analysis of Russian speeches and texts concerning the war, this article deconstructs Russia’s legal and political arguments and analyzes their rhetorical character as well as their intended audiences. It also assesses the instrumentality of Putin’s irredentist claims on “historic Russian regions” in Ukraine. The article concludes that this abuse of legal and normative discourse to justify not only a full-scale invasion but also territorial annexation is a central threat to core global rules and norms

    Russia, Ukraine and state survival through neutrality

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    During the Cold War neutrality and a ‘non-bloc’ status were used by certain European states to escape great power rivalries. But these foreign and security policy strategies declined in significance and have received little scholarly attention since the early 1990s. This article argues that in a period of renewed confrontation between Russia and western powers, significant insights may be derived from a critical review of the past experiences of neutral and non-bloc states. These help scholars and practitioners assess the contemporary options of states in vulnerable locations which choose or are compelled to survive outside alliances. This article probes the critical case of Ukraine as a sovereign but potentially neutral state. Relevant criteria for neutrality are drawn from short interpretive case-studies of Austria and Finland during the Cold War, as well as Moldova and Finland in post-Cold War years. Soviet and Russian policy prioritized the strategic denial of these states to NATO, while forms of armed neutrality helped sustain conventional deterrence against Russian coercion. If Moscow reigns in its ambitions for the political subjugation of Ukraine and accepts its statehood, such thinking may form part of an eventual security policy settlement beyond the current war

    Relationship between latent and rebound viruses in a clinical trial of anti-HIV-1 antibody 3BNC117.

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    A clinical trial was performed to evaluate 3BNC117, a potent anti-HIV-1 antibody, in infected individuals during suppressive antiretroviral therapy and subsequent analytical treatment interruption (ATI). The circulating reservoir was evaluated by quantitative and qualitative viral outgrowth assay (Q2VOA) at entry and after 6 mo. There were no significant quantitative changes in the size of the reservoir before ATI, and the composition of circulating reservoir clones varied in a manner that did not correlate with 3BNC117 sensitivity. 3BNC117 binding site amino acid variants found in rebound viruses preexisted in the latent reservoir. However, only 3 of 217 rebound viruses were identical to 868 latent viruses isolated by Q2VOA and near full-length sequencing. Instead, 63% of the rebound viruses appeared to be recombinants, even in individuals with 3BNC117-resistant reservoir viruses. In conclusion, viruses emerging during ATI in individuals treated with 3BNC117 are not the dominant species found in the circulating latent reservoir, but frequently appear to represent recombinants of latent viruses

    Are Messages of R-parity Violating Supersymmetry Hidden within Top Quark Signals ?

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    In an R-parity nonconserving supersymmetric theory, the lighter stop can dominantly decay into bμb\mu and bτb\tau if R-parity breaking has to explain the neutrino mass and mixing pattern suggested by the data on atmospheric muon neutrinos. This should give rise to dilepton+dijetdilepton+dijet and singlelepton+jetssingle-lepton+jets, signals resembling those of the top quark at the Fermilab Tevatron. One can thus constrain the stop parameter space using the current top search data, and similarly look for the first signals of supersymmetry at the upgraded runs of the Tevatron.Comment: 13 pages, RevTeX, 2 PS figures, uses epsfig.sty, few comments and references added, version to appear in Phys. Rev. Let
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