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In this video, you'll uncover the single biggest mistake eCommerce businesses make when trying to improve their conversion rates—and why it's costing them serious revenue. You'll learn how to interpret performance data correctly before making any website changes, why industry benchmarks can be misleading, and the key differences in conversion expectations based on product type. Most importantly, you'll get a proven framework to diagnose and fix conversion issues with data-driven confidence. This is not theory—it's battle-tested insight from scaling stores to millions per month.

JAMA. 2013;309(12):1241-1250Background Case reports as early as the 1950s suggested chelation of lead might reduce angina. The popularity of chelation accelerated around the turn of the century. Small underpowered trials of chelation were inconclusive. Mainstream medicine considered chelation unproven and potentially hazardous.Cardiology Trial's Substack is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber.Chelation with disodium EDTA binds divalent and some trivalent cations, including calcium, magnesium, lead, cadmium, zinc, iron, aluminum, and copper, which facilitates their urinary excretion. High dose vitamins are often co-administered with chelation.The NIH-funded Trial to Assess Chelation Therapy (TACT) trial was conducted to respond to the public health problem posed by EDTA chelation therapy: namely, that large numbers of patients could be exposed to undefined risks for unproven benefits. TACT was a double-blind placebo-controlled 2x2 factorial randomized trial enrolling 1708 patients to test chelation therapy.Patients Eligibility for TACT required patients be older than 50 years, have a creatinine of < 2 mg/dl, and have survived a previous myocardial infarction. Exclusion criteria included platelet count less than 100 000/μL, abnormal liver function, BP > 160/100 mm Hg, past intolerance to the chelation or vitamin components, chelation therapy within 5 years, coronary or carotid revascularization planned or having taken place within 6 months, cigarette smoking within 3 months, active heart failure or heart failure hospitalization within 6 months, or inability to tolerate 500-mL infusions weekly. Enrollment began in 2003 and follow-up continued until 2011. There were 134 sites; 60% of which were established chelation centers.Baseline Characteristics The median age of patients was 65 years, 18% were women and the median body mass index was 30. More than 90% of patients had had either percutaneous coronary intervention or coronary bypass surgery. Approximately 31% of patients had diabetes. Use of guideline directed medications was typical of a well-treated population of post-MI patients. Procedures The active 10-component chelation solution consisted of up to 3 g of disodium EDTA; 7 g of ascorbic acid; 2 g of magnesium chloride; 100 mg of procaine; 2500 U of unfractionated heparin; 2 mEq of potassium chloride; 840 mg of sodium bicarbonate; 250 mg of pantothenic acid; 100 mg of thiamine; 100 mg of pyridoxine; and sterile water to make up 500 mL of solution. The identical-appearing placebo solution consisted of 500 mL of normal saline and 1.2% dextrose (2.5 g total).The chelation or placebo infusions were administered through a peripheral intravenous line, weekly for the first 30 infusions, followed by an additional 10 infusions 2 to 8 weeks apart. Patient also received an oral vitamin-mineral regimen vs an oral placebo. In this review, we focus on the intention-to-treat comparison of EDTA chelation vs placebo.Endpoints The primary endpoint was a composite of death, reinfarction, stroke, coronary revascularization, or hospitalization for angina.TACT trialists had planned to enroll 2300 patients over three years with a follow-up of one year. Enrollment was slow, and with permission from the data safety monitoring board (DSMB) enrollment was decreased to 1700 patients and follow-up was extended. The resultant power was 85% to detect a 25% reduction in the primary endpoint assuming a 2.5% per year event rate in the placebo arm.Over the course of the trial, the DSMB requested 11 interim analyses of the data. Because of the increased monitoring, the level of statistical significance required for the primary endpoint was enhanced to a P value of less than 0.036.Results After a median follow-up of 55 months, a primary end point occurred in 222 (26%) of the chelation group and 261 (30%) of the placebo group (hazard ratio [HR]: 0.82 [95% CI: 0.69-0.99]; p= .035). There was no effect on total mortality (10% vs 11%, HR: 0.93, 95% CI: 0.70-1.25; p= 0.64). Myocardial infarction and coronary revascularization favored chelation (6% vs 8% and 15% vs 18%, respectively), however this did not reach statistical significance for either endpoints.Subgroup analysis revealed a potentially important heterogenous treatment effect. In patients with diabetes (about a third of patients) there was an approximate 40% reduction in the primary endpoint (HR: 0.61, 95% CI: 0.45-0.83; p= 0.002).There were no significant differences in adverse effects between the two groups.The trialists did sensitivity analyses centering on patients who withdrew from the trial or were lost to follow-up. The comparison of the 2 groups remained significant even if the percentage of events among withdrawn/lost patients in the active group was 25% higher than in the placebo group.Conclusions The results of the TACT trial surprised the cardiology community. Prior beliefs were pessimistic because heavy metals was not a proven causal factor in atherosclerosis. What's more, the majority of patients were enrolled from non-traditional medical centers.Yet the effect size was both clinically important and statistically significant. The effect size in the diabetes subgroup, which was pre-specified, was even larger and more robust statistically than the general results. In fact, there was essentially no signal of benefit from chelation in non-diabetic patients. If this was confirmed, it would be a major finding both therapeutically and scientifically, as it would have discovered heavy metal exposure as an important cause of atherosclerosis.The Journal of the American Medical Association published the manuscript along with an explanatory letter from the editors, and an accompanying editorial from Dr. Steve Nissen, which challenged the internal validity of the trial.The results of TACT did not lead to widespread adoption of chelation, but it did lead primary investigator Gervasio Lamas to seek (and obtain) funding for a TACT 2 trial to study chelation in patients with diabetes. Experts often refer to subgroup findings as “hypothesis-generating” and so it was with the TACT 1 and TACT 2 trials.Cardiology Trial's Substack is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber. Get full access to Cardiology Trial's Substack at cardiologytrials.substack.com/subscribe

Watch and read this hereIn this episode you're going to find out what happens at the intersection where science meets the pavement – the quest for ultimate running performance. We'll dissect the importance of power and speed in your resistance/weight training. I'll answer the question for runners; where does power, speed, strength, muscle endurance, and hypertrophy fit in to an already crowded training plan? Especially for distance runners?! I'll even tell my own story of how I switched gears in my training and embraced the fusion of lifting with speed and power. It wasn't just a change in routine – it was a transformation in philosophy.This episode isn't just about challenging how your muscles move; it's about challenging your mindset.By the end of this, you'll not only rethink your 1% better training habits approach but you'll also… (yes get ready for the laundry list)Become more resilient so you have less niggling injuriesGenerally more bounceDevelop that extra gear in your runningBecome more efficient so your easy runs are close to the same speed as your more intense sessionsDevelop your secret weapon at the end of races — speed reserve (more on that later)And overall take your training to the next level.Yes, that's a big promise so let's see if I can deliver.Timestamps[00:01:15] - The Benefits of Resistance Training for Runners[00:03:13] - Speed Strength vs. Strength Speed Explained[00:04:16] - The Role of Power in Distance Running[00:04:47] - My Resistance Training Revelation[00:05:19] - Introducing the Experts at Axis Performance Labs[00:07:34] - What This Episode Is Not About[00:10:11] - Defining Power and Speed in Athletic Performance[00:11:03] - Why Speed Reserve is your secret weapon[00:11:36] - Differentiating Between Power, Speed, Strength, and Hypertrophy[00:12:29] - Why an Objective Sports Professional is Crucial[00:13:53] - My First Assessment and Baseline Testing[00:16:09] - The Training Plan in Action and Progression[00:17:01] - Reassessment and Results After 10 Weeks[00:18:31] - The Future of My Training and Its Impact on Running[00:22:49] - The 2 reasons why runners don't like to do resistance training[00:26:33] - Why Axis does the type of testing for power, force and strength[00:30:21] - Why Axis choose this specific training plan for meLinks & LearningsThe difference between speed strength and strength speedTesting tools: GymAware & Vald Performance ForceDecksHuberman Labs Guest Series with Dr. Andy GalpinNCBI Study on strength training and runningAxis Performance Labs in SydneyDLake on Instagram Hosted on Acast. See acast.com/privacy for more information.

Dive into a case study with hosts James Breese and Josh Kennedy as they unravel Jeroen Westra's transformative journey from being an overweight CrossFit box owner to shedding 20 kilograms. Through data-driven decisions and tailored approaches, discover how Jeroen overcame crippling back pain and mental struggles. This episode offers insights into the power of assessment, data visualization, and personalized fitness strategies. Take advantage of this inspiring story of resilience and transformation.Timeline Summary:[00:01:22] Highlighting the Importance of Assessments.[00:01:48] Exploring the Role of Data in Analysis.[00:02:13] Diving into Jeroen's Mental Struggles.[00:02:33] Showcasing Jeroen's Visual Improvements.[00:03:32] Breaking Down the Athletic Pyramid Concept.[00:06:17] Introduction to The Traffic Light System.[00:16:56] Unveiling Jeroen's Results After the Final Phase.[00:20:31] Mention of The 60-minute Test.Key Takeaways:The Importance of Assessment: Before starting any program, it's essential to assess to avoid guessing. The focus isn't just on the external transformation but also on the data analysis to make informed decisions.The Power of Consistency and Visualization: By visualizing data, individuals and coaches can quickly identify areas of strength and weakness, making it easier to tailor training programs and track progress over time.The Athletic Performance Pyramid: A structured approach to holistic fitness, categorizing athleticism into 10 components across three layers. Mental Resilience and Capacity: The process of using data-driven approaches not only improved his physical health but also bolstered his mental resilience, showcasing the interconnectedness of physical and mental health.Tailored Approach Over Generic Solutions: Instead of applying a one-size-fits-all solution, the use of data and the Athletic Performance Pyramid allowed for a program specifically designed for your client's needs.Websites and Links Mentioned:Strength MattersUltimate Training SystemThe Strength Matters BlogQuotes:"A lot of people focus on the external transformation, the visual effects of the transformation. But what we want to show with you guys behind the scenes is the data analysis that we use to make better and more informed decisions." - James Breese"Data without visualisation is useless, in our opinion." - James Breese"We're looking for the gaps in their training to make them improve and focus on what they need to be doing, not what they think they need to be doing." - James BreeseShow Your Support: Rate and Review Us!If you enjoyed today's episode, please consider giving us a 5-star rating and a review on Apple Podcasts or wherever you listen to podcasts. Your support helps us reach more people and bring you even more quality content. Click the link below to rate and review us now! Rate and Review us on Apple Podcasts FREE DownloadsTo learn more about Strength Matters and our high-performance training system, download your FREE copy of The Strength Matters System of Athletic Development. Get it at - www.strengthmatters.com/system

BUFFALO, NY- October 11, 2023 – A new research paper was published in Aging (listed by MEDLINE/PubMed as "Aging (Albany NY)" and "Aging-US" by Web of Science) Volume 15, Issue 18, entitled, “Pathways explaining racial/ethnic and socio-economic disparities in dementia incidence: the UK Biobank study.” Pathways explaining racial/ethnic disparities in dementia risk are under-evaluated. In their new study, researchers May A. Beydoun, Hind A. Beydoun, Marie T. Fanelli-Kuczmarski, Jordan Weiss, Michael F. Georgescu, Osorio Meirelles, Donald M. Lyall, Michele K. Evans, and Alan B. Zonderman from the National Institute on Aging, Fort Belvoir Community Hospital, Stanford University, and the University of Glasgow examined those disparities and their related pathways among UK Biobank study respondents (50–74 y, N = 323,483; 3.6% non-White minorities) using a series of Cox proportional hazards and generalized structural equations models (GSEM). “The present study examines pathways that might explain racial, ethnic, and socio-economic disparities in AD or all-cause dementia in a large cohort study, the UK Biobank. Our study used several methodologies, including structural equation modeling coupled with survival analysis techniques to examine complex mediating effects between race, ethnicity, socioeconomic status, and dementia or AD [Alzheimer's disease] risk in a sex-specific manner focusing on lifestyle, biological and cognitive pathways. It is also an attempt at replicating a previous study conducted among US older adults [24].” Results: After ≤15 years, 5,491 all-cause dementia cases were diagnosed. Racial minority status (RACE_ETHN, Non-White vs. White) increased dementia risk by 24% (HR = 1.24, 95% CI: 1.07–1.45, P = 0.005), an association attenuated by socio-economic status (SES), (HR = 1.12, 95% CI: 0.96–1.31). Total race-dementia effect was mediated through both SES and Life's Essential 8 lifestyle sub-score (LE8LIFESTYLE), combining diet, smoking, physical activity, and sleep factors. SES was inversely related to dementia risk (HR = 0.69, 95% CI: 0.67, 0.72, P < 0.001). Pathways explaining excess dementia risk among racial minorities included ‘RACE_ETHN(−) → SES(−) → DEMENTIA', ‘RACE_ETHN(−) → SES(−) → Poor cognitive performance, COGN(+) → DEMENTIA' and ‘RACE_ETHN(−) → SES(+) → LE8LIFESTYLE(−) → DEMENTIA'. “Pending future interventions, lifestyle factors including diet, smoking, physical activity, and sleep are crucial for reducing racial and socio-economic disparities in dementia.” DOI - https://doi.org/10.18632/aging.205058 Corresponding author - May A. Beydoun - baydounm@mail.nih.gov Subscribe for free publication alerts from Aging - https://www.aging-us.com/subscribe-to-toc-alerts Keywords - aging, dementia, Alzheimer's disease, health disparities, socio-economic status, structural equations modeling About Aging-US Launched in 2009, Aging-US publishes papers of general interest and biological significance in all fields of aging research and age-related diseases, including cancer—and now, with a special focus on COVID-19 vulnerability as an age-dependent syndrome. Topics in Aging-US go beyond traditional gerontology, including, but not limited to, cellular and molecular biology, human age-related diseases, pathology in model organisms, signal transduction pathways (e.g., p53, sirtuins, and PI-3K/AKT/mTOR, among others), and approaches to modulating these signaling pathways. Please visit our website at https://www.Aging-US.com​​ and connect with us: SoundCloud - https://soundcloud.com/Aging-Us Facebook - https://www.facebook.com/AgingUS/ X - https://twitter.com/AgingJrnl Instagram - https://www.instagram.com/agingjrnl/ YouTube - https://www.youtube.com/@AgingJournal LinkedIn - https://www.linkedin.com/company/aging/ Pinterest - https://www.pinterest.com/AgingUS/ Media Contact 18009220957 MEDIA@IMPACTJOURNALS.COM

Link to bioRxiv paper: http://biorxiv.org/cgi/content/short/2023.06.28.546718v1?rss=1 Authors: Schmitt, A., Kim, C., Rampp, S., Buchfelder, M., Mueller-Voggel, N. Abstract: Background: Tinnitus is the subjective perception of a sound without a physical sound source. Neuronal activity in various brain areas contribute to its generation. Research has highlighted somatosensory processes associated with tinnitus. We here investigate if differences in tinnitus perception mediated by the somatosensory system are reflected in brain oscillations. Methods: 24 tinnitus patients performed relaxing versus straining exercises with their jaw. After each condition, participants brain activity was measured with Magnetoencephalography and participants rated tinnitus loudness and annoyance on visual analogue scales. Brain activity was contrasted for the strained versus relaxed state on sensor level using a cluster-based permutation test. Derived significant clusters were localized using a beamformer approach. Additionally, for every patient and condition a mean loudness and pleasantness score was determined and differences between conditions tested using students t-tests. Results: After completion of straining compared to relaxing exercises participants experienced their tinnitus as louder and more annoying (p less than .05). Tinnitus worsening was accompanied by a significant increase of gamma power (32-46 Hz) showing up mainly in right secondary auditory cortex, and a significant decrease of alpha power (7-14 Hz) peaking in left and right sensorimotor cortex after completion of the straining versus relaxing exercises. Discussion: We here show that tinnitus perception can be reduced by preceding relaxing exercises with the jaw. Tinnitus improvement is accompanied by reduced auditory gamma power and increased sensorimotor alpha power. These results point to a functional role of the cortical sensorimotor system in maintaining tinnitus. Copy rights belong to original authors. Visit the link for more info Podcast created by Paper Player, LLC

Listen to our new YouTube For Realtors Season 3 of WALK AND TALK #5- I have so many things going through my head every day about YouTube for Realtors that I just want to get it all out! I get asked so many questions everyday and coach so many agents. It's time to answer all of those in depth, on my way to the gym, inside my studio, and in the most recent one-on-one interview with your favorite agents!In todays episode I do a deep dive in RESULTS After 100 YouTube Shorts - Why the NEW Podcast Tab is CRUSHING SHORTS!Long wait is over! Here's the link for my most awaited e-book ("The Billion Dollar Channel Method"), here's your chance to download the pdf file:   https://s3.amazonaws.com/kajabi-storefronts-production/file-uploads/sites/2147548848/themes/2153681303/downloads/c05412d-1f83-dda-1ae-8d4ec3a11e6_The_Billion_Dollar_Channel_Method.pdfGet your very own digital whiteboard from vibe. Use my referral link below for a $150 off!https://vibe.refr.cc/channeljunkiesWant to see over 500 free videos teaching you YouTube for Real Estate? Go here: https://www.youtube.com/channel/UCVALMF99nztSJEJ7lehzEOQTo learn more about our courses and trainings schedule call here: https://calendly.com/channeljunkiessalesWant to partner with us at eXp and get all our training and coaching free? Tell me more here: https://forms.gle/UrVcNtnSYCR6H1Vd9Or email info@jacksonwilkey.com and say you came from the podcast!Did you like this episode? We would love to hear your thoughts you can leave a comment here: https://g.page/r/CZHHK0K6nUEwEAg/reviewAnd let us know what you're thinking. 

Clinical Tests Reveal that Black Cumin Seed (Nigella Sativa) May Treat Hypothyroidism Tabriz University, April 13, 2022 Consuming a few grams of powdered Nigella sativa (NS), more commonly known as black cumin seeds, may improve the autoimmune thyroid condition known as Hashimoto's thyroiditis, according to a study published in the journal BMC Complementary and Alternative Medicine. Hashimoto's thyroiditis is the most common form of thyroid gland inflammation. It is also the most common thyroid disorder in the U.S. In fact, the disease affects 14 million people in the country alone. Data also showed that the condition will affect about five percent of the U.S. population. Hashimoto's thyroiditis was 15 times more prevalent in women compared with men. Women aged between 30 to 60 years had the highest prevalence of the condition. The study also revealed that patients who took the black seed supplement exhibited marked reductions in serum concentrations of thyroid stimulating hormone and anti-thyroid peroxidase antibodies at eight weeks of intervention. In addition, patients in the intervention group showed a notable decline in serum vascular endothelial growth factor levels. Researchers also highlighted a significant increase in triiodothyronine concentration in patients who received powdered black seeds. However, the experts did not observe a similar effect in patients who took a placebo pill. (NEXT) Following a Mediterranean-style diet during pregnancy may reduce the risk of preeclampsia Johns Hopkins University, April 20, 2022 Following a Mediterranean-style diet during pregnancy was associated with a reduced risk of developing preeclampsia, and Black women appeared to have the greatest reduction of risk, according to new research published today in the Journal of the American Heart Association. Preeclampsia, a condition during pregnancy characterized by severe high blood pressure and liver or kidney damage, is a major cause of complications and death for the mother and her unborn child. Preeclampsia also increases a woman's risk of heart diseases, such as high blood pressure, heart attack, stroke or heart failure, by more than two times later in life. Women with preeclampsia have a higher risk of preterm delivery (giving birth before 37 weeks gestation) or low birth weight babies, and children born to mothers with preeclampsia are also at higher risk of developing high blood pressure and heart disease. Researchers created a Mediterranean-style diet score based on participants' responses to food frequency interviews and questionnaires, which were conducted within three days of giving birth. The analysis found: Women who had any form of diabetes before pregnancy and pre-pregnancy obesity were twice as likely to develop preeclampsia compared to women without those conditions. The risk of preeclampsia was more than 20% lower among the women who followed a Mediterranean-style diet during pregnancy. Black women who had the lowest Mediterranean-style diet scores had the highest risk (78%) for preeclampsia compared to all other non-Black women who more closely adhered to the Mediterranean-style diet. (NEXT) Individuals with type 2 diabetes should exercise after dinner University of Missouri, April 18, 2022 Exercise is a popular prescription for individuals suffering from the symptoms of Type 2 diabetes, but little research has explored whether these individuals receive more benefits from working out before or after dinner. Now, researchers at the University of Missouri have found that individuals with Type 2 diabetes can lower their risks of cardiovascular diseases more effectively by exercising after a meal. "This study shows that it is not just the intensity or duration of exercising that is important but also the timing of when it occurs," said Jill Kanaley, professor in the MU Department of Nutrition and Exercise Physiology. "Results from this study show that resistance exercise has its most powerful effect on reducing glucose and fat levels in one's blood when performed after dinner." Kanaley and her colleagues studied a group of obese individuals with Type 2 diabetes. On one occasion, participants performed resistance exercises before eating dinner. During another visit, participants exercised 45 minutes after eating dinner. Participants performed resistance exercises such as leg curls, seated calf raises and abdominal crunches. Compared to levels on a non-exercise day, Kanaley found that the participants who exercised before dinner were able to only reduce the sugar levels in their blood; however, participants who exercised after dinner were able to reduce both sugar and fat levels. Participants consumed a moderate carbohydrate dinner on the evenings of the study. (NEXT) Dietary supplementation with açaí pulps improves cognition attenuates inflammatory signaling in BV-2 microglial cells Tufts University, April 18, 2022 Objectives: The present study was carried out to determine if lyophilized açaí fruit pulp (genus, Euterpe), rich in polyphenols and other bioactive antioxidant and anti-inflammatory phytochemicals, is efficacious in reversing age-related cognitive deficits in aged rats. Methods: The diets of 19-month-old Fischer 344 rats were supplemented for 8 weeks with 2% Euterpe oleracea (EO), Euterpe precatoria (EP), or a control diet. Rats were tested in the Morris water maze and then blood serum from the rats was used to assess inflammatory responses of BV-2 microglial cells. Results: After 8 weeks of dietary supplementation with 2% EO or EP, rats demonstrated improved working memory in the Morris water maze, relative to controls; however, only the EO diet improved reference memory. BV-2 microglial cells treated with blood serum collected from EO-fed rats produced less nitric oxide (NO) than control-fed rats. Serum from both EO- and EP-fed rats reduced tumor necrosis factor-alpha (TNF-α). There is a relationship between performance in the water maze and the production of NO and TNF-α by serum-treated BV-2 cells, such that serum from rats with better performance was more protective against inflammatory signaling.   (SUPERFOOD) Peppers (capsicum): Native American folk medicine, which has so many features we can still learn from, gave a prominent place in its pharmacology to peppers of the capsicum family, which includes bell and chili peppers. Recent work suggests that the nutrient capsaicin, found in these peppers, is a natural analgesic and a neuro-inflammatory blocker that relieves aches and pains to joints and muscles. This is one reason why Native American medicine prescribed a topical application of pepper to painful areas of the body. Capsaicin is particularly deserving of mention in this book because recent, promising research in Canada has explored the uses of capsaicin in the treatment of Type I diabetes. Other work has noted it can benefit sufferers from prostate cancer and leukemia. Some scientists have noted that this much studied nutrient found in peppers helps with weight loss, stimulation of insulin-producing cells, and prevention of LDL cholesterol oxidation. Another benefit recently uncovered is that the nutrient protects from stomach ulcerations and induces apoptosis (cancer cell death) in lung cancer. Setting aside the value of capsaicin, peppers can also be prized because they are rich in the antioxidant vitamins A as well as in vitamins B1, B6, E, and K. They are also high in potassium, magnesium, and iron. Yellow peppers are rich in lutein and zeaxanthin, which protect from eye disease and blindness. Videos: 1. American Who Lived 8 Years in Ukraine Speaks Out on Russia War (Start @ 0:41) 4. Kim Iversen: Noam Chomsky BLASTED By Liberals For Anti-War Stance, EXPOSING The New Pro-War Left 5. How the U.S. Media Betrayed Afghanistan (16:47 long)    

10 Years of increased physical activity (exercise) AFTER MIDLIFE can reduce mortality rate by 32% Publication: British Medical Journal Subjects: 2205 50 yr-olds in 1970-73 What: Re-examined at age 60, 70, 77, and 82 Results: After an increase in physical activity, subjects could not be distinguished [on the basis of differences in cardiovascular risk factor profile] from those who had always had high activity. The value of increasing activity rates was similar to that associated with stopping smoking compared to continued smoking. Message: It's never too late! Prove-It-to-Me-Girl? Source:   Byberg L, Melhus H, Gedeborg R, et al. Total mortality after changes in leisure time physical activity in 50 year old men: 35 year follow-up of population based cohort. BMJ. 2009;338:b688. Published 2009 Mar 5. doi:10.1136/bmj.b688 Exercise fountain of youth? It depends. Yes, Exercise can turn back the clock. And then there are some details you can't ignore. A 2019 study in Aging offers proof you've got to eat to win. I've shared numerous studies here, blogs, and podcasts (link in bio) about ability to reverse 179 genes associated with aging, reverse mortality rate as you age, and so much more with an “it's never too late message.” Yet, there's this little detail. Lifting weights (properly to muscle fatigue), is ONE STEP. You must have the presence of adequate protein to carry out the mission of younger, stronger, leaner. A comparison of low protein after resistance training vs high protein after training found that without high protein, there was no “reverse aging” effect in the muscle. “Regeneration of muscle occurs only with high protein availability after resistance exercise.” For older adults, the amount of protein required to hit the “high protein” threshold, increases. That little bit of cottage cheese or yogurt after, although yes, have protein in them: it's not HIGH ENOUGH alone. [And remember, dairy may increase inflammation instead of halting it – the goal of the protein- and sabotage your results] Source: Yang C, Jiao Y, Wei B, et al. Aged cells in human skeletal muscle after resistance exercise [published correction appears in Aging (Albany NY). 2019 Sep 24;11(18):8035]. Aging (Albany NY). 2018;10(6):1356-1365. doi:10.18632/aging.101472 Resources: Flipping50 Insiders

Link to bioRxiv paper: http://biorxiv.org/cgi/content/short/2020.08.09.243394v1?rss=1 Authors: Tahir, W., Kura, S., Zhu, J., Cheng, X., Damseh, R., Tadesse, F., Seibel, A., Lee, B. S., Lesage, F., Sakadzic, S., Boas, D. A., Tian, L. Abstract: Segmentation of blood vessels from two-photon microscopy (2PM) angiograms of brains has important applications in hemodynamic analysis and disease diagnosis. Here we develop a generalizable deep-learning technique for accurate 2PM vascular segmentation of sizable regions in mouse brains acquired from multiple 2PM setups. In addition, the technique is computationally efficient, making it ideal for large-scale neurovascular analysis. Introduction: Vascular segmentation from 2PM angiograms is usually an important first step in hemodynamic modeling of brain vasculature. Existing state-of-the-art segmentation methods based on deep learning either lack the ability to generalize to data from various imaging systems, or are computationally infeasible for large-scale angiograms. In this work, we present a method which improves upon both these limitations by being generalizable to various imaging systems, and also being able to segment very large-scale angiograms. Methods: We employ a computationally efficient deep learning framework based on a semi-supervised learning strategy, whose effectiveness we demonstrate on experimentally acquired in-vivo angiograms from mouse brains of dimensions up to 808x808x702 micrometers. Results: After training on data from only one 2PM microscope, we perform vascular segmentation on data from another microscope without any network tuning. Our method demonstrates 10x faster computation in terms of voxels-segmented-persecond and 3x larger depth compared to the state-of-the-art. Conclusion: Our work provides a generalizable and computationally efficient anatomical modeling framework for the brain vasculature, which consists of deeplearning based vascular segmentation followed by graphing. It paves the way for future modeling and analysis of hemodynamic response at much greater scales that were inaccessible before. Copy rights belong to original authors. Visit the link for more info

Abstract [Purpose] To demonstrate the reduction of symptoms related to Parkinson's disease by improvement in posture. [Participant and Methods] A 59-year-old male patient presented with a prior diagnosis of Parkinson's. Symptoms included a resting right hand tremor, intermittent 'freezing episodes' with gait, mild ataxia with shuffling on toes and bradykinesia assisted with a cane, as well as low back pain and right knee pain. Radiography revealed gross postural and spine deformity. The patient received Chiropractic BioPhysics care including mirror image exercises, spinal traction, spinal adjustments as well as gait rehabilitation. [Results] After 38 treatments over 5 months, the patient had significant improvements in posture alignment as well as gait, balance, hand tremors, low back and knee pains and SF-36 values. A 21 month follow-up revealed the patient had remained essentially well and the initial postural improvements were maintained. [Conclusion] This case demonstrates improvement of various symptoms in a patient with Parkinson's disease. Since poor posture is a long known clinical manifestation of this disorder, it is proposed that the improvement of posture in these patients may lead to improved outcomes. X-ray use in the diagnosis and management in those with spine deformity is safe and not carcinogenic. Keywords: Adult spinal deformity; Parkinson's disease; Posture rehabilitation. Full paper: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6382490/

Abstract [Purpose] To demonstrate the reduction of symptoms related to Parkinson's disease by improvement in posture. [Participant and Methods] A 59-year-old male patient presented with a prior diagnosis of Parkinson's. Symptoms included a resting right hand tremor, intermittent 'freezing episodes' with gait, mild ataxia with shuffling on toes and bradykinesia assisted with a cane, as well as low back pain and right knee pain. Radiography revealed gross postural and spine deformity. The patient received Chiropractic BioPhysics care including mirror image exercises, spinal traction, spinal adjustments as well as gait rehabilitation. [Results] After 38 treatments over 5 months, the patient had significant improvements in posture alignment as well as gait, balance, hand tremors, low back and knee pains and SF-36 values. A 21 month follow-up revealed the patient had remained essentially well and the initial postural improvements were maintained. [Conclusion] This case demonstrates improvement of various symptoms in a patient with Parkinson's disease. Since poor posture is a long known clinical manifestation of this disorder, it is proposed that the improvement of posture in these patients may lead to improved outcomes. X-ray use in the diagnosis and management in those with spine deformity is safe and not carcinogenic. Keywords: Adult spinal deformity; Parkinson’s disease; Posture rehabilitation. Full paper: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6382490/

Background: Positive psychology indicators like well-being and life satisfaction may play a pivotal role in pain-related outcomes. In this study, we aimed to examine the prospective associations of positive well-being and life satisfaction with pain severity. Methods and Subjects: This longitudinal study, with a follow-up of 2 years, included 9361 participants (4266 males, 5095 females; mean age: 52.5 years; SD: 17.5) without and with chronic pain (CP) at baseline. All analyses were stratified by the two sub-cohorts—participants without CP (sub-cohort 1) and participants with CP (sub-cohort 2) at baseline. The predictive associations, assessed using ordinal regression in a Generalized Linear Model, were adjusted for baseline potential confounders and reported as odds ratios (ORs) with corresponding 95% confidence intervals (CIs). Results: After adjustments, in sub-cohort 1 positive well-being at baseline was associated with lower severe pain at follow-up compared to participants with severe distress (OR: 0.64; 95% CI 0.49–0.84; p 

Why Feast And Famine Might Not Be Working ****definition of a diet “working:” ability to lose weight and then maintain that weight loss. So in this instance will people be able to lose weight using this theory AND then maintain it. The quick and dirty if you don’t have time: To quote Dr. Jason Fung’s website, “Eating is a celebration of life. Any diet that does not acknowledge this fact is doomed to failure.” These two sentence he argues support his theory, I would actually argue are the downfall of his theory. My rebuttal would be any diet that does not acknowledge the potential for food addiction, binge eating disorder, and or hedonic obesity is "doomed for failure” to use the above quote. A.) Food “Addiction” The thing is for people who been exposed to “adiposity” maintaining the sense of food as a reward is quite often dangerous. This sort of mentality can maladaptively accidentally place food up on some pedestal, when really food should “just be food.” Especially with those out there who know, but may not want to admit that food, and more likely carbs, are addictive. Currently, we have not technically “proven” food is addictive in humans, but we are finding it more and more true in mice. Unfortunately we may never be able to actually prove it in humans, as the dirty truth is we can’t do trials on humans as we can on tiny little animals, who take up a small amount of space, eat a relatively small amount of food, who then can be sacrificed to an autopsy at the end of the the study. So we likely are going to more just go on, and lean towards an educated guess that food, especially hyper caloric carbohydrate food is addictive. And if you still can’t get yourself to say it, if you are a, “but how can food be addictive, we need it to live,” at the very minimum you could maybe admit that some food has addictive qualities. The question is will you really be able to fast the next day, I mean really? With food still be around everywhere, will you be able to? It may not just be in your house, but it still is likely within about 5 mixtures of your house. Will you be able to just cold turkey say no to food, especially after you just showered you brain with all kinds of “feel” good hormones released from being exposed to those “celebration foods” you just feasted on?  Some might say yes, I can totally do it. Others, I am betting if you think about it, really sit and be honest with yourself, the answer is likely going to be “no.” One thing I love to point out is to think to yourself, “will one night’s sleep change me as a person.” Will sleeping with this belly full of food really stop me from eating tomorrow?” Haven’t I gone to bed with a full belly in the past? Did I wake up the next morning not hungry? Or have I ever noticed the more I eat the more I become hungry? Interesting studies I will interject here: Basically, in this study obese and non obese participants where allowed to eat at a buffet, no meal before. Then they came back to the same buffet, on another day, but this time they were all given a chocolate shake to drink before the buffet. The non obese people ate less, the obese people ate more! [Finding study link…my bookmarks where erased!!!! :( ] Others: Brain Cogn. 2016 Dec;110:53-63. doi: 10.1016/j.bandc.2015.08.006. Epub 2015 Oct 1. Eating with our eyes: From visual hunger to digital satiation. Spence C1, Okajima K2, Cheok AD3, Petit O4, Michel C5. “In the fasting state, obese individuals demonstrated increased neural activation in those areas that are known to be associated with the anticipation of reward.” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1864961/   Effects of binge eating on satiation, satiety, and energy intake of overweight children “Results: After the overnight fast, children in the binge-eating group consumed more energy [x (±SD): 1748 ± 581 compared with 1309 ± 595 kcal; P = 0.04] and exhibited a shorter satiety duration (194 ± 84 compared wit...

When you are in the thick of things it can be hard to stay on track and focus on priorities. Unexpected challenges can make it especially difficult to cross items off your to-do list. In this episode of Today’s Business Leaders Lisa of Impactive Strategies and Gabe of Business Marketing Engine explain how to merge work emergencies, or fires, into your day. Establishing Priorities You know what your prioritizes are and how to go about accomplishing everything. If not, check out our first episode to learn about the magic of 168. Aligning tasks and goals allows you to determine your priorities. Using A.W.E. to Prioritize A.W.E. is an acronym that stands for Awareness, Work and Evaluation. In episode two Lisa outlined how to use A.W.E. to end distractions. This principle can be applied to urgent and unexpected tasks that take you away from your to-do list. Being aware of priorities and creating a plan to take on these tasks ensures you accomplish what you set out to do. Implementing structure keeps your priorities top of mind and focused. Distraction vs. Emergency All too often people will be faced with a distraction, but they will misidentify it as an emergency, or a fire. Distractions can take many forms from email to phone calls and other tasks that appear urgent. To further complicate matters sometimes urgent tasks are thrust into your day that demand immediate attention. In order to keep your day on track and remain productive it is necessary to be able to identify whether or not a so-called fire is really an emergency. Defining a Fire Start to figure out the real fires by identifying whether the issue is your responsibility. You may not need to create a resolution for a fire just because someone came to you with the issue. Ultimately, if the alleged fire will not result in an extreme loss of money or present a health and safety issue it is not a true fire. The matter may still be urgent and need attention, but it may not require immediate focus from you. Evaluating the Results After completing a project take the time to step back and look at how much time you invested. Reviewing your work after the fact and focusing on how much time you spent will make it easier to estimate your time going forward. The more accurately you can gauge time the better you will become at allocating your time. Using A.W.E. to Manage Your Time Manage your time to avoid being sucked into something you think is a fire. When presented with a possible fire use A.W.E. to determine how to proceed and ensure you continue to move forward in a productive manner. Next time Lisa and Gabe will discuss what happens when you want to do everything, but time is limited.

Bitte beachten Sie auch immer den aktuellen "Haftungsausschluss (Disclaimer) und allgemeiner Hinweis zu medizinischen Themen" auf https://paleolowcarb.de/haftungsausschluss/ #geNUSS[explosion] von [næhr:sinn] - das low carb knusper nuss müsli [næhr:sinn] geNUSS[explosion] ist ein hochwertiges low-carb* Müsli und besteht zu 100% aus natürlichen Zutaten. Es ist gut als Frühstück und Snack und hat nur 13,7g verwertbaren Kohlenhydraten auf 100g. Es ist getreidefrei und sojafrei. Perfekt für den Start in den Tag. Wir verarbeiten nur hochwertigste, nährstoffreiche Zutaten, die dich länger satt machen und nachhaltig mit Energie versorgen. Wir nutzen ballaststoffreiche Kokosnuss, Erdmandel und heimische Nüsse. Mehr darüber erfährst du auf lowcarbmüsli.at oder auf Amazon.de In Folge #096 Wie viel Veränderung kann man in nur 4 Tagen erreichen? Sehr viel, schaut man sich die Studie von Sportwissenschaftler und Paleo-Experte Jens Freese an. Er hat im Rahmen seiner Doktorarbeit 28 Teilnehmer, für 4 Tage in die Natur geschickt und sie nach paleolithischem Vorbild leben lassen. Die Ergebnisse waren beeindruckend. Signifikante Veränderungen in wichtigen Gesundheitsparametern wie Blutzucker, Insulin, Körperfett und Blutfettwerten. Jens Freese erzählt in diesem Interview mehr über die Studie selbst, den Ablauf, die Ergebnisse und welche Herausforderungen die Durchführung einer solchen Studie mit sich bringt. Das Video der aktuellen Folge direkt auf Youtube öffnen Und nicht vergessen: Wenn du uns auf Youtube siehst, und wenn du es noch nicht getan hast, dann abonniere unseren Kanal „Evolution Radio Show“ Wenn du das Podcast hörst, dann findest du die Links für Apple iTunes und Android hier auf unserer Homepage Kurze Zusammenfassung Jens Freese ist Sportwissenschaftler und Psychoneuroimmunologe und zählt zu den führenden Experten des Paleo Lifestyle im deutschsprachigen Raum. Der Kölner kann auf eine über 15-jährigen Lehrtätigkeit als wissenschaftlicher Leiter der Deutschen Trainer Akademie zurückblicken, in der er mehr als 6000 Trainer in diversen Fitness- und Gesundheitsbereichen ausgebildet hat. Neben all dem, setzt er sich auch leidenschaftlich für wissenschaftliche Fragestellungen ein. Er war Mitglied einer Forschungsgruppe an der Universität Essen-Duisburg, die den Einfluss von Sport auf die Prävention von Alzheimer untersucht hat. Mit seiner aktuellen Forschungsgruppe, am Institut für Natursport und Ökologie der Deutschen Sporthochschule Köln, untersucht er die Auswirkungen einer steinzeitlich-orientierten Lebensweise auf die Prävention moderner Zivilisationserkrankungen. Jens Freese hat auch die Marke "Paleo Leben" gegründet und bietet dort eine Ausbildung zum Paleo-Coach an. Paleo Leben - Ausbildung zum Paleo-Coach http://www.paleo-leben.de/ Journal of Evolution and Health To Restore Health, “Do we Have to Go Back to the Future?” The Impact of a 4-Day Paleolithic Lifestyle Change on Human Metabolism – a Pilot Study ##Abstract On their way from the Stone Age via the Agricultural Revolution to current high-tech conditions, humans lost their primal foraging behavior. Today, energy expenditure is not necessary anymore for gathering nor hunting, and metabolic diseases are epidemically arising wherever our original Paleolithic lifestyle is turning into a modern sedentary lifestyle. In this pilot study, we followed through the concept that a radical change towards a Paleolithic hunter-gatherer lifestyle could serve as therapy against any metaflammatory disease, even in the short term. Thirteen healthy adult volunteers were transferred to the DELUX National Park (Germany and Luxembourg) for four days and three nights, where Stone Age conditions where mimicked. Thirty-eight biochemical and bioelectrical parameters were measured from participants before and after this relocation. Body weight (-3,9%), body fat (-7,5%), body mass index (-3,8%), visceral fat area (-14,4%) and metaflammation-related parameters (fasting glucose = -18,2%; fasting insulin = -50,1%; HOMA = -57,8%) decreased significantly. C-reactive protein, as the main indicator for low-grade inflammation, increased up to an average of 169,6 %. Our data show that returning to our Paleolithic roots may have positive effects on risk factors commonly associated with metabolic disorders, such as obesity and type 2 diabetes. These findings may lead the way to further research to answer the question whether the already existing metabolic conditions and/or autoimmune and neuroinflammatory diseases could be influenced by a Paleolithic lifestyle Back to the Future. Metabolic Effects of a 4-Day Outdoor Trip Under Simulated Paleolithic Conditions – New Insights from The Eifel Study ##Abstract Background: The observation that the emergence of common Western diseases takes place with much greater prevalence as societies migrate from natural-living cultures to modernized societies, has been well documented. For approximately 84,000 generations humans lived under hunter-gatherer conditions but recently endured dramatic change from our native lifestyle with the occurrence of the agricultural, industrial, and digital revolutions. The massive technological advancement that occurred within a relatively recent timeframe enabled humans to live in manner that is remarkably different than our pre-agricultural past. Consequently, the shift from a natural to a modern lifestyle likely promotes a gene-environment mismatch which causes metabolic dysregulation which causes disease. Methods: Using a within-participant design, we examined whether, compared to baseline, changes in lifestyle towards a more Paleolithic-style pattern, for a four-day and four-night period related to changes in a variety of metabolic parameters. Two groups of 14 volunteers were isolated for a period of four days and four nights in the natural park Südeifel on the borders between Germany and Luxembourg. Participants lived outdoors without tents. The daily hiking performance was 16.4 km (≈ 24963 steps/day) and the daily activity time 5.49 h/day by a mean caloric intake of 1747 kcal/day. Results: After four days of simulated Paleolithic conditions, body weight (-2.9%), body mass index (-2.7%), body fat (-10.4%), visceral fat (-13.6%) and waist-hip-ratio (-2.2%) significantly decreased, while muscle mass significantly increased (+2,3%). Additionally, fasting glucose (-6.5%), basal insulin (-44.4%), homeostasis model assessment-index (-49.3%) and fatty liver index (-41%) significantly dropped. In contrast, C-reactive protein, significantly increased (+67.1%). Conclusion: Our study indicates that a short nature trip, where modern humans adjust their behavioral patterns to simulate a more Paleolithic-like condition, could serve as an effective strategy to help prevent or improve modern metabolic disease. Particularly, the major findings of an expeditious reduction of homeostasis model assessment-index and fatty liver index scores in only four days reveal the potential for meaningful benefits with such an intervention, even when compared to the effects of longer-term, singleintervention studies such as dietary or fitness programs on similar metabolic parameters. Webseiten Jens Freese | (auf Facebook folgen) Paleo Low Carb - JULIAS BLOG | (auf Facebook folgen) Superhumanoid - PAWELS BLOG Super | (auf Facebook folgen)

Background: Solid-organ transplantations (SOT) are usually life-saving high-tech medical procedures. The transplantation itself and the intensive care unit stay could be traumatic stressors triggering posttraumatic stress symptoms (PTSS). Our retrospective follow-up study aimed to explore preoperative risk factors of PTSS in a cohort of SOT recipients, and we investigated how PTSS are associated with health-related quality of life (HRQOL) and life satisfaction. Methods: 126 SOT recipients were enrolled in this investigation. Psychiatric examination of all SOT candidates based on the Transplant Evaluation Rating Scale was carried out before SOT, and after SOT, recipients completed the PTSS-10, the SF-36 and the FLZ. Results: After the surgical intervention 19 (15.1%) SOT recipients had clinical significant PTSS. Preoperative risk factors for developing postoperative PTSS were: 1.) preexisting psychiatric morbidity, 2.) history of retransplantation, 3.) chronic benzodiazepine consumption, 4.) age, and 5.) type of transplantation. SOT-related PTSS were associated with maximal decrements in HRQOL and life satisfaction. The following HRQOL and life satisfaction domains were affected: Physical Functioning, Role Physical, Pain, General Health, Vitality, Social Functioning, Role Emotional, Mental Health, Occupation/Work and Character/Own Skills. Conclusion: SOT recipients may face a major risk of transplantation-and treatment-related PTSS and the development of impairments to HRQOL and life satisfaction.

Background: No data are available about the sports activity of patients with bone-conserving short-stem hip implants. Hypothesis: Patients can return to a good level of sports activity after implantation of a short-stem hip implant. Study Design: Case series; Level of evidence, 4. Methods: The sports activity level of 68 patients (76 hips) after short-stem hip arthroplasty was assessed for a minimum of 2 years after implantation. In addition to the clinical examination, a detailed evaluation of the patients’ sports pattern was obtained. Furthermore, the results were analyzed with regard to gender (female and male) and age (55 years). Results: After a mean of 2.7 years, patients showed a Harris Hip Score (HHS) of 93.6, a Western Ontario and McMaster Universities Arthritis Index (WOMAC) score of 9.5, and a University of California, Los Angeles (UCLA) activity score of 7.6, with each individual participating on average in 3.5 different disciplines after surgery compared with 3.9 before surgery. High-impact activities decreased significantly postoperatively, whereas low-impact activities increased significantly. The duration of the sports activities remained stable, while the frequency actually increased. In contrast, men participated preoperatively in more sports than women (4.3 men vs 3.3 women). However, because of a pronounced decrease in high-impact activities by men, both genders participated in an equal number of sports postoperatively (3.5 men vs 3.5 women). Finally, 45% (n = 31) reported at least one activity that they missed. Most of them were disciplines with an intermediate- or high-impact level. Conclusion: Patients with a short-stem hip implant can return to a good level of activity postoperatively. Participation in sports almost reached similar levels as preoperatively but with a shift from high- to low-impact activities. This seems desirable from a surgeon’s point of view but should also be communicated to the patient before hip replacement

Background: Isocyanates are some of the leading occupational causes of respiratory disorders, predominantly asthma. Adequate exposure monitoring may recognize risk factors and help to prevent the onset or aggravation of these aliments. Though, the biomonitoring appears to be most suitable for exposure assessment, the sampling time is critical, however. In order to settle the optimal time point for the sample collection in a practical biomonitoring approach, we aimed to measure the elimination of isocyanate urine metabolites. Methods: A simple biomonitoring method enabling detection of all major diamine metabolites, from mono-, poly- and diisocyanates in one analytical step, has been established. Urine samples from 121 patients undergoing inhalative challenge tests with diisocyanates for diagnostic reasons were separated by gas chromatography and analyzed with mass spectrometry (GC-MS) at various time points (0-24 h) after the onset of exposure. Results: After controlled exposures to different concentrations of diisocyanates (496 +/- 102 ppb-min or 1560 +/- 420 ppb-min) the elimination kinetics (of respective isocyanate diamine metabolites) revealed differences between aliphatic and aromatic isocyanates (the latter exhibiting a slower elimination) and a dose-response relationship. No significant differences were observed, however, when the elimination time patterns for individual isocyanates were compared, in respect of either low or high exposure or in relation to the presence or absence of prior immunological sensitization. Conclusions: The detection of isocyanate metabolites in hydrolyzed urine with the help of gas chromatography combined with mass spectrometric detection system appears to be the most suitable, reliable and sensitive method to monitor possible isocyanate uptake by an individual. Additionally, the information on elimination kinetic patterns must be factored into estimates of isocyanate uptake before it is possible for biomonitoring to provide realistic assessments of isocyanate exposure. The pathophysiological elimination of 1,6-hexamethylene diamine, 2,4-diamine toluene, 2,6-diamine toluene, 1,5-naphthalene diamine, 4,4'-diphenylmethane diamine and isophorone diamines (as respective metabolites of: 1,6-hexamethylene diisocyanate, 2,4-toluene diisocyanate and 2,6 toluene diisocyanate, 1,5-naphthalene diisocyanate, 4,4'-diphenylmethane diisocyanate and isophorone diisocyanates) differs between individual isocyanates' diamines.

Background: Blood gas analysis (BGA), including measurement of ionized calcium, is performed routinely in patients with end stage renal disease on renal replacement therapy, especially when using citrate for regional anticoagulation. After installation of a new blood gas analyzer (RAPIDpoint (R) 405; BGA), we observed lower ionized calcium concentrations in a few patients without signs of hypocalcemia, whereas calcium concentrations were normal using a standard laboratory method. Pseudohypocalcemia was of limited duration and correlated with the short-term intake of sodium perchlorate monohydrate (Irenat (R)). Methods: We prepared dilution series from whole blood samples and stock solutions of calcium and perchlorate with different concentrations of ionized calcium and perchlorate. Measurement of ionized calcium concentrations was performed using two different blood gas analyzers (RAPIDpoint (R) 405; BGA and Roche AVL 9180; standard laboratory method). Results: After addition of different amounts of perchlorate, significant lower ionized calcium concentrations were measured with BGA compared to the standard laboratory method using either preparations from whole blood samples or stock solutions. The addition of potassium or methylene blue known to complex perchlorate had no effect on the concentrations of ionized calcium measured with BGA. Using different mathematical methods, a calculation of the "real" ionized calcium concentration from the value measured with BGA was not possible. Conclusions: Based on our experiments, we confirm the hypothesis that perchlorate can influence the measurement of ionized calcium by BGA. As the effect depends on the ion selective electrode that is used, it is advisable to test the blood gas analyzer with calcium and perchlorate solutions.

Objective: Recent findings support the crucial role of microcirculatory disturbance and ischemia for hearing impairment especially after noise-induced hearing loss (NIHL). The aim of this study was to establish an animal model for in vivo analysis of cochlear microcirculation and hearing function after a loud noise to allow precise measurements of both parameters in vivo. Study Design: Randomized controlled trial. Setting: Animal study. Subjects and Methods: After assessment of normacusis (0 minutes) using evoked auditory brainstem responses (ABRs), noise (106-dB sound pressure level [SPL]) was applied to both ears in 6 guinea pigs for 30 minutes while unexposed animals served as controls. In vivo fluorescence microscopy of the stria vascularis capillaries was performed after surgical exposure of 1 cochlea. ABR measurements were derived from the contralateral ear. Results: After noise exposure, red blood cell velocity was reduced significantly by 24.3% (120 minutes) and further decreased to 44.5% at the end of the observation (210 minutes) in contrast to stable control measurements. Vessel diameters were not affected in both groups. A gradual decrease of segmental blood flow became significant (38.1%) after 150 minutes compared with controls. Hearing thresholds shifted significantly from 20.0 ± 5.5 dB SPL (0 minutes) to 32.5 ± 4.2dB SPL (60 minutes) only in animals exposed to loud noise. Conclusion: With regard to novel treatments targeting the stria vascularis in NIHL, this standardized model allows us to analyze in detail cochlear microcirculation and hearing function in vivo.

Background: Evidence for protection of preterm born infants from invasive pneumococcal disease (IPD) by 7-valent pneumococcal conjugate vaccination (PCV7) is relatively sparse. Data from randomized trials is based on relatively small numbers of preterm born children. Methods: We report data from active prospective surveillance of IPD in children in Germany. The cohorts of preterm born children in 2000 and 2007 and the respective whole birth cohorts are compared regarding occurrence of IPD. Results: After introduction of PCV7 we observed a reduction in the rate of IPD in preterm born infants comparing the 2000 and 2007 birth cohort. The rate of IPD among the whole birth cohorts was reduced from 15.0 to 8.5 notifications per 100,000 (P < .001). The impact among the preterm birth cohort was comparable: A reduction in notification rate from 26.1 to 16.7 per 100,000 comparing the 2000 with the 2007 preterm birth cohort (P = .39). Preterm born infants with IPD were either unvaccinated or vaccinated delayed or incomplete. Conclusions: This adds to evidence that PCV7 also protects preterm born infants effectively from IPD. Preterm born infants should receive pneumococcal vaccination according to their chronological age.

Background: Coliform bacteria are the most common etiologic agents in severe mastitis of cows. Escherichia coli infections are mostly restricted to a single udder quarter whereas neighboring quarters stay clinically inapparent, implicating the presence of a systemic defense reaction. To address its underlying mechanism, we performed a transcriptome study of mammary tissue from udder quarters inoculated with E. coli (6 h and 24 h post infection), from neighboring quarters of the same animals, and from untreated control animals. Results: After 6 h 13 probe sets of differentially expressed genes (DEG) were detected in infected quarters versus control animals. Eighteen hours later 2154 and 476 DEG were found in infected and in neighboring quarters vs. control animals. Cluster analysis revealed DEG found only in infected quarters (local response) and DEG detected in both infected and neighboring quarters (systemic response). The first group includes genes mainly involved in immune response and inflammation, while the systemic reaction comprises antigen processing and presentation, cytokines, protein degradation and apoptosis. Enhanced expression of antimicrobial genes (S100A8, S100A9, S100A12, CXCL2, GNLY), acute phase genes (LBP, SAA3, CP, BF, C6, C4BPA, IF), and indicators of oxidative stress (GPX3, MT1A, MT2A, SOD2) point to an active defense reaction in infected and neighboring healthy quarters. Its early onset is indicated by increased transcription of NFIL3 at 6 h. NFIL3 is a predicted regulator of many genes of the systemic response at 24 h. The significance of our transcriptome study was evidenced by some recent findings with candidate gene based approaches. Conclusions: The discovery and holistic analysis of an extensive systemic reaction in the mammary gland significantly expands the knowledge of host-pathogen interactions in mastitis which may be relevant for the development of novel therapies and for genetic selection towards mastitis resistance.

Objectives: To provide valid clinical data of early in-hospital deaths with presumed acute myocardial infarction (AMI) who are often not included in clinical trials or registries. Methods: From August 2004 to August 2006 all patients (age 25-84 years) dying within 24 h after hospitalization in a large tertiary care academic teaching hospital were screened regarding an underlying cardiovascular cause of death. Results: After validation, 79 out of 1,352 patients remained with a final diagnosis of AMI. Sixty-six percent of these experienced prehospital cardiac arrest or shock. In 37% no resuscitation attempts were performed in-hospital, the most common reason being multimorbidity. Only 23% could be transferred to coronary angiography for revascularisation attempts. An independent panel of clinicians judged that only in one patient would another management strategy have been promising. Of interest, 33% of the deceased patients had typical or atypical chest pain the days before the lethal event. Conclusion: A large percentage of AMI patients who died soon after hospitalization were in critical circulatory state directly before hospitalization. In 37%, in-hospital resuscitation attempts were omitted for understandable reasons. Options for improvement in acute care in the investigated setting were not found. However, in one third of the cases earlier preventive measures might have been reasonable. Copyright (C) 2010 S. Karger AG, Basel

Background: The comprehensive International Classification of Functioning, Disability and Health (ICF) Core Set for rheumatoid arthritis (RA) is a selection of 96 categories from the ICF, representing relevant aspects in the functioning of patients with RA. Objectives: To study the responsiveness of the ICF Core Set for RA in rheumatological practice. Methods: A total of 46 patients with RA (72% women, mean (SD) age 53.6 (12.6) years, disease duration 6.3 (8.0) years) were interviewed at baseline and again after 6 months treatment with a disease-modifying antirheumatic drug (DMARD), applying the ICF Core Set for RA with qualifiers for problems on a modified three-point scale (no problem, mild/moderate, severe/complete). Patient-reported outcomes included Modified Health Assessment Questionnaire (MHAQ) and Short-Form 36 (SF-36) health survey, and disease activity was calculated. Responsiveness was measured as change in qualifiers in ICF categories, and was also compared with change in patient-reported outcomes. Results: After 6 months of DMARD treatment, improvement by at least one qualifier was seen in 20% of patients (averaged across all ICF categories), 71% experienced no change and 9% experienced worsening symptoms. Findings were similar across the different aspects of functioning. Mainly moderate effect sizes were seen for 6-month changes in the ICF Core Set for RA, especially in patients with improved health status, with similar effect size for disease activity. The components in the ICF Core Set for RA were only weakly associated with patient-reported outcomes and disease activity. Conclusions: The ICF Core Set for RA demonstrated moderate responsiveness in this real-life setting of patients where minor changes occurred during treatment with DMARDs.

Background/Aims: Combination therapy with interferon-alpha (IFN-alpha) plus ribavirin is more efficacious than IFN-alpha monotherapy in previously untreated patients with chronic hepatitis C and patients with IFN-alpha relapse. Only limited data are available in IFN-alpha non-responders. In a multicenter trial we therefore evaluated the efficacy of combination therapy in IFN-alpha-resistant chronic hepatitis C. Methods: Eighty-two patients (mean age 46.8 years, 54 males, 28 females) with chronic hepatitis C were treated with IFN-alpha-2a (3 x 6 MIU/week) and ribavirin (14 mg/kg daily) for 12 weeks. Thereafter, treatment was continued only in virological responders (undetectable serum HCV RNA at week 12) with an IFN-alpha dose of 3 x 3 MIU/week and without ribavirin for a further 9 months. The primary study endpoint was an undetectable HCV RNA by RT-PCR at the end of the 24-week follow-up period. Results: After 12 weeks of combination therapy, an initial virological response was observed in 29 of 82 (35.4%) patients. Due to a high breakthrough rate after IFN-a dose reduction and ribavirin discontinuation, an end-of-treatment response was only achieved in 12 of 82 (14.6%) patients. After the follow-up period, a sustained virological response was observed in 8 of 82 (9.8%) patients. Infection with HCV genotype 3 was the only pretreatment parameter, which could predict a sustained response (HCV-1, 5%; HCV-3, 57.1%; p < 0.001). Conclusions: Despite a high initial response rate of 35.4%, sustained viral clearance was achieved only in 9.8% of the retreated primary IFN-alpha non-responders. Higher IFN-alpha induction and maintenance dose, as well as prolonged ribavirin treatment may possibly increase the virological response rates in non-responders, particularly in those infected by HCV-1.