Acceptability and Feasibility of Examining Physical Activity in Young Children with Type 1 Diabetes

Physical activity is important but may be difficult to evaluate in young children (YC) with Type 1 diabetes (T1D) because of parents' fears of hypoglycemia, difficulties engaging YC in physical activity, and use of assessment devices. This study aimed to explore the acceptability and feasibility of an in-lab exercise session for YC with T1D. Ten YC ages 3 through7 years with T1D participated in a 20-minute exercise session while wearing blinded continuous glucose monitors and accelerometers. High acceptability was found for participation in the exercise session; high feasibility and acceptability were reported for the assessments. Although most children completed the session, it did not produce moderate to vigorous physical activity. YC were found to spend most of their day sedentary, and they had frequent blood glucose excursions. Findings support the feasibility of conducting a more extensive examination of the relationship among blood glucose levels and physical activity in YC with T1D.     

夹竹桃花脂溶性成分提取工艺优化及其生物活性分析

目的 研究夹竹桃花脂溶性成分的提取工艺、组成成分及生物活性。方法 利用Box-Behnken响应面法优化提取工艺，GC-MS分析组成成分，滤纸片扩散法和二倍连续梯度稀释法分析抑菌活性，并测定抗氧化活性。结果 最佳提取工艺为索氏提取4 h，连续提取4次，料液比1∶ 15，得率9.16%，比优化前提高了13.09%。脂溶性成分含有烷烃类、醛类和酯类等30种化合物，具有还原能力和清除DPPH自由基、羟自由基、超氧自由基的能力，对枯草芽孢杆菌、金黄色葡萄球菌、大肠埃希菌和铜绿假单胞菌的最小抑菌浓度分别为1.22，1.72，0.75，1.96 g·L^–1，最小杀菌浓度分别为2.34，2.84，1.88，3.32 g·L^–1。结论 脂溶性成分最佳提取工艺得率为9.16%，以烷烃类、醛类、酯类为主，具有一定的抗氧化和抑菌活性，可为夹竹桃资源的开发利用提供参考。     

Lifestyle interventions targeting changes in body weight and composition among youth with an intellectual disability: A systematic review

Over the past three decades, the potential effects of lifestyle interventions targeting changes in body weight and composition (weight, body mass index, fat mass, waist circumference) among adults with an intellectual disability (ID) have been examined in various systematic reviews. Nevertheless, since the middle of the 1980s, the potential effects of these interventions for youth with an ID remain an open question. The purpose of this article is to review the effects of lifestyle interventions targeting changes in body weight and composition among youth with an ID. This review will focus on changes in body weight and composition, healthy lifestyle, and secondary health conditions. A systematic review of English- and French-language studies, published between 1981 and 2013, was performed on Academic Search Complete, PsycARTICLES, Medline and Scopus. The nine studies included in this review focused mainly on: a sample with a wide age range (e.g., 7–22 years); males; overweight-obese youth having a mild-to-moderate ID with Down or Prader-Willi syndrome; physical activity interventions; cohort pre- and post-test designs with/without a control group; and changes in body weight and composition. Taken together, results from these studies suggest successful changes in weight, body mass index and fat mass. However, intervention effects on healthy lifestyle and secondary health conditions are scarce and inconclusive. Given the weaknesses of the reviewed studies, the present findings should be considered preliminary and indicative of the need for future research.     

Fair Play Game: a group contingency strategy to increase students' active behaviours in physical education

A dependent group contingency strategy called Fair Play Game was applied to promote increase in number of steps during physical education classes for sixth-grade students. Results from a multiple baseline design across three classes showed that the mean number of steps for baseline vs. intervention were: Class 1: 43 vs. 64 steps/minute; Class 2: 49 vs. 81 steps/minute; Class 3: 50 vs. 87 steps/minute. Visual inspection of the graphs showed that Class 1 had an upward trend of number of steps (baseline vs. intervention) without a change in level. Classes 2 and 3 demonstrated clearer change in level of number of steps between these two phases. Social validity data showed that students increased their engagement in class and Fair Play Game is a feasible and acceptable strategy. Therefore, it can be concluded that Fair Play Game appeared to be associated with students' increase in active behaviours in physical education lessons.     

Persistent Enhancement on Contrast-Enhanced Ultrasound Studies of Severe Crohn's Disease: Stuck Bubbles?

A small population of patients with severe Crohn's disease (CD) exhibit atypical lack of intensity decline on intestinal contrast-enhanced ultrasound. From a retrospective CD cohort examined with contrast-enhanced ultrasound, 104 patients were identified. Twenty study patients with severe active disease exhibited high peak enhancement (>23 dB) and minimal decline. From the same cohort, 84 control patients also exhibited high peak enhancement >23dB, but with typical intensity decline. Patient outcomes were assessed. Time–intensity curve analysis revealed a significantly higher (p < 0.0001) area under the curve (44.7 ± 1.5 dB·s), washout time and intensities at 60s and 120s in the study population compared with controls (40.0 ± 1.1 dB·s). Study patients had a worse overall outcome with surgery in 30% versus 10% (p?=?0.027) during follow-up. Heightened enhancement with lack of decline on contrast-enhanced ultrasound suggests microbubbles are stuck within the inflamed bowel wall for an extended period. This observation occurs in patients with severe disease and a bad outcome.     

Preserving the efficacy of front-line fluoroquinolones through selective use to optimise clinical outcomes

As antibiotic resistance is increasing worldwide, it is important to prescribe fluoroquinolone (FQ) antibiotics appropriately for a given infection to preserve class efficacy. Clinical studies reveal good efficacy and tolerability of the currently approved FQs (ciprofloxacin, levofloxacin and moxifloxacin) in a wide range of community- and hospital-acquired infections. However, certain features supporting their clinical efficacy suggest a rationale for inclusion of moxifloxacin and ciprofloxacin with complementary clinical benefit on a formulary rather than levofloxacin alone; it may also be more cost-effective. Ciprofloxacin has advantages over levofloxacin in the treatment of Gram-negative infections, whilst moxifloxacin has certain efficacy and ease of use advantages over levofloxacin in respiratory tract infections. To preserve the potential of FQs and to minimise the risk of resistance selection, agents with the highest in vitro activity and supportive pharmacokinetic/pharmacodynamic profiles should be used first-line, as appropriate for local guidelines and prescribing information.     

What is an active regimen in carcinoma of unknown primary sites? Analysis of correlation between activity endpoints reported in phase II trials. Correlation of activity endpoints in phase II trials

BackgroundThe choice of the activity endpoint is crucial when designing phase II screening trials. This choice is usually guided by convention, but the level of evidence for picking-up one of them is limited.MethodsWe have analysed the phase II trials in carcinoma of unknown primary patients (CUP; 48 strata). We calculated the Pearson correlation coefficient using weighted linear regression to measure the degree of association between the different available activity endpoints (Best objective response – BORR, best tumour control rate – BTCR, 3- and 6-month progression-free rates, 3- and 6-month PFR and median progression-free survival). We also explored the correlation between these endpoints and OS.ResultsAll activity endpoints were strongly correlated in CUP studies; all of these endpoints were strongly correlated with OS. The median BORR across the studies was 30%. Positive trials defined by BORR ≥ 30% were associated with statistically longer PFS (4.8 versus 3.7 months, P = 0.013) and OS (10.0 versus 8.0, P = 0.0007).DiscussionIn phase II studies with CUP patients, BORR and the threshold of BORR > 30% for defining promising drug appears adequate.