Assessment of Insulin Resistance and Metabolic Syndrome in Drug Naive Patients of Bipolar Disorder

The levels of fasting glucose, fasting insulin, insulin resistance (IR) and the prevalence of metabolic syndrome (MS) in a sample population of bipolar disorder (BPD) patients who were newly diagnosed and psychotropically naïve were assessed and compared with an age, sex and racially matched control population. 55 BPD-I patients (15–65 years) who were non-diabetic, nonpregnant, and drug naïve for a period of at least 6 months were included in the study. Diagnosis was made using the structured clinical interview for DSM-IV axis I disorders (SCID IV). IR was assessed using homeostasis model of insulin resistance (HOMA-IR); MS was defined according to National Cholesterol Education Program-Adult Treatment Panel III (NCEP-ATP III). Data were compared with 25 healthy controls. BPD patients had significantly higher mean levels of fasting plasma insulin (13.2 ± 9.2 vs. 4.68 ± 3.1 μIU/ml, p < 0.05), postprandial plasma insulin (27.2 ± 14.5 vs. 18.1 ± 9.3 μIU/ml, p < 0.05) and a higher value of HOMA-IR (3.16 ± 2.2 vs. 1.19 ± 0.8, p < 0.05) when compared to the controls. A significantly higher proportion of patients of BPD compared to controls were manifesting levels of fasting plasma glucose, serum triglyceride and blood pressure higher than the cut off while waist circumference and serum HDL cholesterol failed to show any significant difference in the proportion. There was a significantly higher proportion of prevalence of IR between BPD cases and controls (26/55 vs. 2/25, z value 9.97, p < 0.05) while there was no significant difference in proportion of prevalence of MS between these two groups. Within BPD patients, logistic regression analysis showed that age, sex or current mood status (depressed/manic) were not significantly predictive of presence or absence of MS or increased IR.     

Life at university with Asperger syndrome: a comparison of student and staff perspectives

Although increasing numbers of students with disabilities are accessing higher education, there is relatively little information about the needs of students with Asperger syndrome (AS). Crucially, students themselves have rarely been included in research examining their needs or the supports they might find helpful. Three focus groups, one with students with AS and two with staff were conducted to explore the challenges, barriers and supports to students' successful progress through one university in the UK. Thematic analysis revealed some key differences between staff and student perspectives, particularly with regard to impact of sensory sensitivities and daily life difficulties on academic progress. Students and staff also held differing views about what is helpful, relating to disclosure of diagnosis and the value of formal social supports. The study highlights the importance of developing services beyond traditional academic supports that students with AS themselves feel are valuable.     

Floor Covering Options for “Sick Buildings”

Abstract

Ever since the library at Humboldt State University had been renovated in the early ′70s, staff had been complaining about the air quality in the building, which was blamed for all sorts of ailments, from nausea, to skin and eye irritation, to severe allergies. The library administration finally pushed for a solution to the problems and hired an environmental firm to investigate the air quality. At the same time, recognizing that old carpets also have been found to contribute to indoor pollution, the administration commissioned a selected group from all sections of the library and from Plant Operations, to undertake a study and recommend new floor covering options for all areas of the building. The group studied resilient materials, hard floors, and wood floors exhaustively and came up with detailed recommendations about the different types to be used in different areas. As soon as funding became available, most public and stack areas were covered with a carpetlike new generation, low emission, self-adhesive, closed-cell vinyl backed nylon floor covering, with no ill side effects to date. The success of this project is in great part due to the fact that staff for the task force was drawn from all departments and from outside the library and from the fact that the administration accepted the recommendations and followed up on most of them in good faith.     

环孢素A联合CAG方案治疗MDS转化的急性白血病疗效观察

目的探讨环孢素A（CsA）联合CAG方案治疗骨髓增生异常综合征（MDS）转化的急性白血病的疗效和不良反应。方法对16例MDS/AML患者实施CsA联合CAG方案诱导治疗,1个疗程后评估疗效,无效者退出,有效者继续接受下个疗程治疗。随访分析14例患者生存期,评判CsA联合CAG方案的长期疗效。结果 16例MDS/AML患者,1疗程后4例达CR（25.0%）,6例达PR（37.5%）,4例NR（25.0%）;2疗程CR 43.8%,总有效率62.5%。7例大于≥60岁的老年患者中,2疗程1例达CR（14.3%）,2例达PR（28.6%）,2例NR（28.6%）,2例早期死亡,有效率42.9%。随访14例患者中位生存时间11月,1年、2年的生存率分别为50.0%,21.4%。临床不良反应主要为骨髓抑制,其中中性粒细胞〈0.5×109/L发生率87.5%,PLT〈20×109/L发生率81.3%。结论 CsA联合CAG方案治疗MDS/AML安全有效,疗效较为满意。     

Learning mathematics in mainstream secondary schools: experiences of students with Down’s syndrome

The key questions are: is it true that persons with Down’s syndrome can study mathematics only at a very elementary level? Might it be possible that their difficulties are mainly restricted to some fields, such as numeracy and mental computation, but do not encompass the entire domain of mathematics? Is the use of a calculator recommended? Is non-elementary mathematics accessible at most for the brightest students with Down’s syndrome? Our experience with about 30 students with Down’s syndrome, attending Italian mainstream secondary schools, is that these students can solve mathematical problems, using simple algebraic equations, though they may have very poor numeracy skills and need to use the calculator even with the simplest computations. Moreover, a familiarity with more advanced topics, as algebraic computation and analytic geometry, can help to raise their self-esteem and improve their numeracy too. Surprisingly, these students can learn and apply mathematical procedures in a variety of other different contexts. For instance, Francesca, an Italian student attending a secondary mainstream school, with a mild impairment in numeracy and relatively good linguistic skills, started with algebra and then learned to solve problems in the areas of nutritional science and of business administration. In the same way, Martina, a student in a mainstream secondary school with severe linguistic and numerical impairments, learned to work with Cartesian coordinates and formulas in analytic geometry. She began connecting points on a Cartesian plane, given their coordinates, and colouring in the shapes, such as flowers and animals, that they define. Applying the two points distance formula and verifying the result, she learned to measure the distance of two points with a ruler and to understand the concept of ‘millimetres’. The role of the inclusion in mainstream Italian schools of every disabled student, regardless the severity of the disability, has been crucial for these results.     

Educating children and young people with fetal alcohol spectrum disorders: constructing personalised pathways to learning

This paper reports findings from a study about young people’s preferences for social interaction with similar and different others, in terms of a tension between social inclusion and homophily – the concept that similarity breeds connection. The issue was explored empirically using moral dilemmas scenarios to conduct in-depth semi-structured interviews with young people with Asperger syndrome, visual impairment and without disabilities. The data indicates that homophily and inclusion can come into a tension with an ethical dimension, since they represent, respectively, a personal preference to be among similar others and the moral imperative of including all people. The paper argues that this tension is constructive as it can challenge our understanding of what the ethical obligation to inclusion entails, and what treating the students respectfully means. Respect is often seen as an attempt to avoid the humiliation that any kind of recognition of difference can bring, and has tended to be translated into a demand for inclusion for all. However, the recognition of difference is an acknowledgement of young people’s right to make their own decisions, and can be reflected in provision and translated into educational and life opportunities; as such, it is also an expression of respect. Negotiating a way between the two understandings through dialogue can ensure that inclusion would be a shared value.     

Expression of MMP-9 in hepatic sinusoidal obstruction syndrome induced by Gynura segetum

Background and objective:Hepatic sinusoidal obstruction syndrome(HSOS) is characterized by painful hepatomegaly,ascites,increased body weight,and jaundice.Gynura segetum(Compositae),a plant widely used in Chinese traditional medicine,often leads to the development of HSOS.However,the mechanism is unclear.The aim was to study the role of matrix metalloproteinase-9(MMP-9) in the onset of HSOS induced by Gynura segetum.Methods:Twenty-five male Sprague-Dawley rats were randomly divided into two groups.Twenty were exposed to 600 mg/kg daily Gynura segetum extract solution for three weeks;five control rats were exposed to tap water alone.Liver sections were evaluated by light microscopy with a modified scoring system.Routine transmission electron microscopy(TEM) methods were used to evaluate the ultrastructual features of fixed liver tissue,and blood samples were collected to determine liver enzyme concentrations.MMP-9 expression was assessed by both immunohistochemical staining and enzyme-linked immunosorbent assay(ELISA) methods.Results:A stable and reproducible rat model of HSOS was achieved by long-term exposure to Gynura segetum extract.The treated rats presented clinical symptoms and the histopathological manifestation of HSOS,including abnormal liver enzyme concentrations(alanine aminotransferase(ALT):(84.8±13.62) vs.(167.0±72.63) U/L,P<0.05;aspartate aminotransferase(AST):(27.6±6.31) vs.(232.8±108.58) U/L,P<0.05).Hematoxylin and eosin(H&E) staining and TEM together revealed deposition of red blood cells,the damage and destruction of hepatic sinusoidal endothelial cells,collapse of hepatic sinusoids,hemorrhage of subendothelial cells,atrophy and destruction of hepatocytes,etc.Compared with controls,the expression of MMP-9 in the blood sample,the lung and liver tissues of HSOS rats was increased.Conclusions:MMP-9 may have an important role in early pathological changes of HSOS,and thus the onset of the disease.     

Physiological and metabolic responses of wheelchair athletes in different racing classes to prolonged exercise

The aims of this study were to examine and compare selected physiological and metabolic responses of wheelchair athletes in two paraplegic racing classes [T3: n?=?8 (lesion levels T1–T7; paraplegics); T4: n?=?9 (lesion levels below T7; paraplegics)] to prolonged exercise. In addition, we describe the responses of three tetraplegic athletes [T2: n?=?3 (lesion levels C6/C7: tetraplegics)]. Twenty athletes completed 90?min of exercise at 75% [Vdot]O_2peak on a motorized treadmill adapted for wheelchairs. The mean (±s) heart rates of the T3 and T4 racing classes were 165±2 and 172±6 beats?·?min^?1, respectively. For the T4 racing class, heart rate gradually increased during the test (P?<0.05), whereas for the T3 racing class, heart rate reached a plateau after an initial increase. The mean heart rate of the tetraplegics was 114±3 beats?·?min^?1. The T3 and T4 classes exhibited similar respiratory exchange ratios, plasma lactate and glucose concentrations throughout the test. For both the T3 and T4 racing class, free fatty acid, glycerol, ammonia, urea and potassium concentrations had increased from resting values by the end of the test (P?<0.05). In conclusion, the results of this study suggest that endurance-trained wheelchair athletes are able to maintain velocities equivalent to the same relative exercise intensity (75% [Vdot]O_2peak) for prolonged periods irrespective of lesion level.     

Changes in transverse relaxation time of quadriceps femoris muscles after active recovery exercises with different intensities

Abstract

The purpose of this study was to examine the changes in the metabolic state of quadriceps femoris muscles using transverse relaxation time (T2), measured by muscle functional magnetic resonance (MR) imaging, after inactive or active recovery exercises with different intensities following high-intensity knee-extension exercise. Eight healthy men performed recovery sessions with four different conditions for 20 min after high-intensity knee-extension exercise on separate days. During the recovery session, the participants conducted a light cycle exercise for 20 min using a cycle (50%, 70% and 100% of the lactate threshold (LT), respectively: active recovery), and inactive recovery. The MR images of quadriceps femoris muscles were taken before the trial and after the recovery session every 30 min for 120 min. The percentage changes in T2 for the rectus femoris and vastus medialis muscles after the recovery session in 50%LT and 70%LT were significantly lower than those in either inactive recovery or 100%LT. There were no significant differences in those for vastus lateralis and vastus intermedius muscles among the four trials. The percentage changes in T2 of rectus femoris and vastus medialis muscles after the recovery session in 50%LT and 70%LT decreased to the values before the trial faster than those in either inactive recovery or 100%LT. Those of vastus lateralis and vastus intermedius muscles after the recovery session in 50%LT and 70%LT decreased to the values before the trial faster than those in 100%LT. Although the changes in T2 after active recovery exercises were not uniform in exercised muscles, the results of this study suggest that active recovery exercise with the intensities below LT are more effective to recover the metabolic state of quadriceps femoris muscles after intense exercise than with either intensity at LT or inactive recovery.     

Determinants of “optimal” cadence during cycling

Abstract

Cadence is one of the only variables cyclists can adjust to manage their performance and fatigue during an event. Not surprisingly, cadence has received a great deal of attention from the scientific community in an effort to identify the cadence that optimizes power output while minimizing the fatigue that is incurred. The literature appears to present conflicting results with little consensus as regards the optimal pedalling cadence. This is in large part due to the inconsistent definition of the term “optimal” cadence, which has been used to describe energetic cost, muscular stress, and perception of effort. The issue is further confounded by the workload-dependent nature of the “optimal” cadence – that is, at higher power outputs, the optimized cadence is different from that at lower power outputs. Although the optimal cadence is different for energetic, muscular, and perceptual definitions, the curves that describe the effect of changes in cadence on these variables consistently exhibit a J-shaped response. This suggests that there is an underlying principle that is common to each of the definitions. Indeed, it would appear that the response of both the cardio-respiratory system (energetic cost) and the muscular system (muscular stress) is determined by the types of muscle motor units that are recruited during the exercise. Furthermore, although part of the response may be due to the inherent differences in the characteristics between the different motor units, the absolute contraction velocity relative to fibre type optimum may be of greater significance. Even when the power output is increased, the shape of the response curves to changes in cadence remains constant, although the nadir of the curve does shift to the right for increasing power outputs. We propose that the point at which the energetic vs. power and the muscular stress vs. power curves intercept is defined by the cadence at which the perceived effort is minimized (i.e. the preferred cadence). However, cadence fluctuations occur under field conditions that are unrelated to physiological factors and, therefore, the ability to identify an “optimal” cadence is limited to the laboratory environment and specific field conditions.