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Energy deficit is common during prolonged periods of strenuous physical activity and limited sleep, but the extent to which appetite suppression contributes is unclear. The aim of this randomized crossover study was to determine the effects of energy balance on appetite and physiologic mediators of appetite during a 72-hr period of high physical activity energy expenditure (PAEE, ˜2300kcal/d) and limited sleep designed to simulate military operations (SUSOPS). Ten men consumed an energy-balanced diet while sedentary for 1d (REST) followed by energy balanced (BAL) and energy deficient (DEF) controlled diets during SUSOPS. Appetite ratings, gastric emptying time (GET), and appetite-mediating hormone concentrations were measured. Energy balance was positive during BAL (18±20%) and negative during DEF (-43±9%). Relative to REST, hunger, desire to eat and prospective consumption ratings were all higher during DEF (26±40%, 56±71%, 28±34%, respectively), and lower during BAL (-55±25%, -52±27%, -54±21%, respectively; Pcondition<0.05). Fullness ratings did not differ from REST during DEF, but were 65±61% higher during BAL (Pcondition<0.05). Regression analyses predicted hunger and prospective consumption would be reduced and fullness increased if energy balance were maintained during SUSOPS, and energy deficits of ≥25% would be required to elicit increases in appetite. Between-condition differences in GET and appetite-mediating hormones identified slowed gastric emptying, increased anorexigenic hormone concentrations, and decreased fasting acylated ghrelin concentrations as potential mechanisms of appetite suppression. Findings suggest that physiologic responses that suppress appetite may deter energy balance from being achieved during prolonged periods of strenuous activity and limited sleep.
Zn is an essential nutrient for humans; however, a sensitive biomarker to assess Zn status has not been identified. The objective of this study was to determine the reliability and sensitivity of Zn transporter and metallothionein (MT) genes in peripheral blood mononuclear cells (PBMCs) to Zn exposure ex vivo and to habitual Zn intake in human subjects. In study 1, human PBMCs were cultured for 24 h with 0–50 µm ZnSO4 with or without 5 µm N,N,N′,N′-tetrakis(2-pyridylmethyl)ethylenediamine (TPEN), and mRNA expression of SLC30A1-10, SLC39A1-14, MT1 subtypes (A, B, E, F, G, H, L, M and X), MT2A, MT3 and MT4 mRNA was determined. In study 2, fifty-four healthy male and female volunteers (31·9 (sd 13·8) years, BMI 25·7 (sd 2·9) kg/m2) completed a FFQ, blood was collected, PBMCs were isolated and mRNA expression of selected Zn transporters and MT isoforms was determined. Study 1: MT1E, MT1F, MT1G, MT1H, MT1L, MT1M, MT1X, MT2A and SLC30A1 increased with increasing concentrations of Zn and declined with the addition of TPEN. Study 2: Average daily Zn intake was 16·0 (sd 5·3) mg/d (range: 9–31 mg/d), and plasma Zn concentrations were 15·5 (SD 2·8) μmol/l (range 11–23 μmol/l). PBMC MT2A was positively correlated with dietary Zn intake (r 0·306, P = 0·03) and total Zn intake (r 0·382, P < 0·01), whereas plasma Zn was not (P > 0·05 for both). Findings suggest that MT2A mRNA in PBMCs reflects dietary Zn intake in healthy adults and may be a component in determining Zn status.
Consumption of certain berries appears to slow postprandial glucose absorption, attributable to polyphenols, which may benefit exercise and cognition, reduce appetite and/or oxidative stress. This randomised, crossover, placebo-controlled study determined whether polyphenol-rich fruits added to carbohydrate-based foods produce a dose-dependent moderation of postprandial glycaemic, glucoregulatory hormone, appetite and ex vivo oxidative stress responses. Twenty participants (eighteen males/two females; 24 (sd 5) years; BMI: 27 (sd 3) kg/m2) consumed one of five cereal bars (approximately 88 % carbohydrate) containing no fruit ingredients (reference), freeze-dried black raspberries (10 or 20 % total weight; LOW-Rasp and HIGH-Rasp, respectively) and cranberry extract (0·5 or 1 % total weight; LOW-Cran and HIGH-Cran), on trials separated by ≥5 d. Postprandial peak/nadir from baseline (Δmax) and incremental postprandial AUC over 60 and 180 min for glucose and other biochemistries were measured to examine the dose-dependent effects. Glucose AUC0–180 min trended towards being higher (43 %) after HIGH-Rasp v. LOW-Rasp (P=0·06), with no glucose differences between the raspberry and reference bars. Relative to reference, HIGH-Rasp resulted in a 17 % lower Δmax insulin, 3 % lower C-peptide (AUC0–60 min and 3 % lower glucose-dependent insulinotropic polypeptide (AUC0–180 min) P<0·05. No treatment effects were observed for the cranberry bars regarding glucose and glucoregulatory hormones, nor were there any treatment effects for either berry type regarding ex vivo oxidation, appetite-mediating hormones or appetite. Fortification with freeze-dried black raspberries (approximately 25 g, containing 1·2 g of polyphenols) seems to slightly improve the glucoregulatory hormone and glycaemic responses to a high-carbohydrate food item in young adults but did not affect appetite or oxidative stress responses at doses or with methods studied herein.
Astrophysics Telescope for Large Area Spectroscopy Probe is a concept for a National Aeronautics and Space Administration probe-class space mission that will achieve ground-breaking science in the fields of galaxy evolution, cosmology, Milky Way, and the Solar System. It is the follow-up space mission to Wide Field Infrared Survey Telescope (WFIRST), boosting its scientific return by obtaining deep 1–4 μm slit spectroscopy for ∼70% of all galaxies imaged by the ∼2 000 deg2 WFIRST High Latitude Survey at z > 0.5. Astrophysics Telescope for Large Area Spectroscopy will measure accurate and precise redshifts for ∼200 M galaxies out to z < 7, and deliver spectra that enable a wide range of diagnostic studies of the physical properties of galaxies over most of cosmic history. Astrophysics Telescope for Large Area Spectroscopy Probe and WFIRST together will produce a 3D map of the Universe over 2 000 deg2, the definitive data sets for studying galaxy evolution, probing dark matter, dark energy and modifications of General Relativity, and quantifying the 3D structure and stellar content of the Milky Way. Astrophysics Telescope for Large Area Spectroscopy Probe science spans four broad categories: (1) Revolutionising galaxy evolution studies by tracing the relation between galaxies and dark matter from galaxy groups to cosmic voids and filaments, from the epoch of reionisation through the peak era of galaxy assembly; (2) Opening a new window into the dark Universe by weighing the dark matter filaments using 3D weak lensing with spectroscopic redshifts, and obtaining definitive measurements of dark energy and modification of General Relativity using galaxy clustering; (3) Probing the Milky Way’s dust-enshrouded regions, reaching the far side of our Galaxy; and (4) Exploring the formation history of the outer Solar System by characterising Kuiper Belt Objects. Astrophysics Telescope for Large Area Spectroscopy Probe is a 1.5 m telescope with a field of view of 0.4 deg2, and uses digital micro-mirror devices as slit selectors. It has a spectroscopic resolution of R = 1 000, and a wavelength range of 1–4 μm. The lack of slit spectroscopy from space over a wide field of view is the obvious gap in current and planned future space missions; Astrophysics Telescope for Large Area Spectroscopy fills this big gap with an unprecedented spectroscopic capability based on digital micro-mirror devices (with an estimated spectroscopic multiplex factor greater than 5 000). Astrophysics Telescope for Large Area Spectroscopy is designed to fit within the National Aeronautics and Space Administration probe-class space mission cost envelope; it has a single instrument, a telescope aperture that allows for a lighter launch vehicle, and mature technology (we have identified a path for digital micro-mirror devices to reach Technology Readiness Level 6 within 2 yr). Astrophysics Telescope for Large Area Spectroscopy Probe will lead to transformative science over the entire range of astrophysics: from galaxy evolution to the dark Universe, from Solar System objects to the dusty regions of the Milky Way.
The primary focus of this paper is to offer guidance on the analysis of time streams of effects that a project may have so that they can be discounted appropriately. This requires a framework that identifies the common parameters that need to be assessed, whether conducting cost-effectiveness or benefit-cost analysis. The quantification and conversion of the time streams of different effects into their equivalent health, health care cost or consumption effects avoids embedding multiple arguments in discounting policies. This helps to identify where parameters are likely to differ in particular contexts, what type of evidence would be relevant, what is currently known and how this evidence might be strengthened. The current evidence available to support the assessment of the key parameters is discussed and possible estimates and default assumptions are suggested. Reporting the results in an extensive way is recommended. This makes the assessments required explicit so the impact of alternative assumptions can be explored and analysis updated as better estimates evolve. Some projects will have effects across different countries where some or all of these parameters will differ. Therefore, the net present value of a project will be the sum of the country specific net present values rather than the sum of effects across countries discounted at some common rate.
Climate Change Adaptation Strategies and Sustainability of Philippine Agriculture
Majah-Leah V. Ravago, Research Faculty at the Department of Economics, Ateneo de Manila University, and previously Assistant Professor at the School of Economics, University of the Philippines, Diliman.,
James A. Roumasset, Professor (emeritus) at the Department of Economics, University of Hawaii, USA.,
Karl Robert L. Jandoc, Assistant Professor at the School of Economics, University of the Philippines, Diliman.
The Philippines is inherently vulnerable to adverse natural events of extreme intensity purely based on its geographic location.1 The warm western Pacific waters, normally around 28°C, contribute to the formation of typhoons, 18–20 of which reach the Philippines each year on average. Cagayan Valley (Region 2), Central Luzon (Region 3), and the Cordillera Administrative Region (CAR) are particularly vulnerable, averaging about seven to nine typhoons per year (Figure 8.1). Flooding occurs in a number of regions, the Western Visayas registering the highest incidence. The Philippines also rests on the Pacific “Ring of Fire”, where most of the earth's volcanic eruptions and earthquakes occur. Geophysical events, such as earthquakes and tsunamis, occur with regularity, albeit at long intervals. The Bicol Region, home of the active Mayon Volcano, experienced the greatest number of volcanic eruptions during 1991–2006. Earthquakes of moderate and high magnitude occur most frequently in the Central Visayas and Bicol regions (Figure 8.1).
Climate projections for the Philippines are similar to those in many other parts of the world (Chapters 2 and 4, this volume). Using the Intergovernmental Panel on Climate Change (IPCC) for the “A1B scenario” most relevant to the Philippines, Cinco et al. (2013) projected that mean yearly temperatures will rise between 1.9°C and 2.2°C by 2050, over baseline levels of between 25.5°C and 27.6°C (derived as averages of minimum and maximum temperatures for the 1971–2000 period). Increasing rainfall concentration and mean rainfall levels indicate that the wet seasons of June–August and September–November will become wetter in Luzon and Visayas towards 2050, yet higher rainfall concentrations combined with higher temperatures are likely to increase moisture stress in the dry season. In particular, it is expected that the frequency of damaging storms will increase. Although disputed by some (Cruz et al. 2007), evidence also suggests that the frequency of droughts will increase (Miyan 2015). One implication of these changes is that farmers’ experience of the frequency, duration, strength, and timing of rainfall and the frequency of droughts will be less reliable than previously; hence, the accuracy of their subjective decision-making processes will decline, causing their level of risk to rise. Past experience will become — and is already becoming — less useful as a predictor of future experience. The bottom line is that risk and uncertainty facing farmers are increasing.
We reviewed all patients who were supported with extracorporeal membrane oxygenation and/or ventricular assist device at our institution in order to describe diagnostic characteristics and assess mortality.
A retrospective cohort study was performed including all patients supported with extracorporeal membrane oxygenation and/or ventricular assist device from our first case (8 October, 1998) through 25 July, 2016. The primary outcome of interest was mortality, which was modelled by the Kaplan–Meier method.
A total of 223 patients underwent 241 extracorporeal membrane oxygenation runs. Median support time was 4.0 days, ranging from 0.04 to 55.8 days, with a mean of 6.4±7.0 days. Mean (±SD) age at initiation was 727.4 days (±146.9 days). Indications for extracorporeal membrane oxygenation were stratified by primary indication: cardiac extracorporeal membrane oxygenation (n=175; 72.6%) or respiratory extracorporeal membrane oxygenation (n=66; 27.4%). The most frequent diagnosis for cardiac extracorporeal membrane oxygenation patients was hypoplastic left heart syndrome or hypoplastic left heart syndrome-related malformation (n=55 patients with HLHS who underwent 64 extracorporeal membrane oxygenation runs). For respiratory extracorporeal membrane oxygenation, the most frequent diagnosis was congenital diaphragmatic hernia (n=22). A total of 24 patients underwent 26 ventricular assist device runs. Median support time was 7 days, ranging from 0 to 75 days, with a mean of 15.3±18.8 days. Mean age at initiation of ventricular assist device was 2530.8±660.2 days (6.93±1.81 years). Cardiomyopathy/myocarditis was the most frequent indication for ventricular assist device placement (n=14; 53.8%). Survival to discharge was 42.2% for extracorporeal membrane oxygenation patients and 54.2% for ventricular assist device patients. Kaplan–Meier 1-year survival was as follows: all patients, 41.0%; extracorporeal membrane oxygenation patients, 41.0%; and ventricular assist device patients, 43.2%. Kaplan–Meier 5-year survival was as follows: all patients, 39.7%; extracorporeal membrane oxygenation patients, 39.7%; and ventricular assist device patients, 43.2%.
This single-institutional 18-year review documents the differential probability of survival for various sub-groups of patients who require support with extracorporeal membrane oxygenation or ventricular assist device. The indication for mechanical circulatory support, underlying diagnosis, age, and setting in which cannulation occurs may affect survival after extracorporeal membrane oxygenation and ventricular assist device. The Kaplan–Meier analyses in this study demonstrate that patients who survive to hospital discharge have an excellent chance of longer-term survival.
This chapter deals with promoting the common good through better energy, resource and environmental policies as well as improved management of natural disaster risks, including climate change. Increasing gross domestic product (GDP) will be insufficient to meet the aspirations of the Philippine people for higher levels of living, inasmuch as GDP does not measure welfare. Largely because of the omission of these elements, we begin with a discussion of green accounting — the method of extending national income accounting to include the degradation of the environment and the depletion of natural resources.
As we discuss in the second part, comprehensive national income accounting can be further extended to include natural disasters and other shocks to the ecological–economic system. Even policy distortions can be accounted for by including them as constraints to the system. Thus, environmental resource conservation, disaster preparedness and policy reform all become potential sources of welfare growth. The later section deals with the mission of sustainable development, particularly how the Sustainable Development Goals (SDGs) relate to the mission of improving the welfare of Filipinos.
Increasing Levels of Living in the Face of Environmental Degradation and Resource Depletion
Stewardship of natural resources and the environment should not be treated as a separate objective from management of the economy (World Commission on Environment and Development 1987). The fundamental premise of sustainable income and green accounting, which have a long history in the Philippines and other countries, is that nature and the economy are part of the same system (the environomy) as shown in Figure 6.1. And one system requires one unifying measure of performance.
To convert the most common indicator of the size of an economy, GDP, into a measure of national well-being, several adjustments must be made. It is well known that GDP overestimates public welfare by failing to deduct depreciation — that portion of investment that simply replaces capital which has worn out or become obsolete. Deducting capital depreciation from GDP yields net domestic product (NDP). And since income is a better measure of welfare than production, we need to subtract the income earned in the Philippines by foreigners, add income earned by Philippine citizens abroad, and add remittances to the Philippines by non-citizens.
The neurobiological understanding of mood, and by extension mood disorders, remains elusive despite decades of research implicating several neuromodulator systems. This review considers a new approach based on existing theories of functional brain organisation. The free energy principle (a.k.a. active inference), and its instantiation in the Bayesian brain, offers a complete and simple formulation of mood. It has been proposed that emotions reflect the precision of – or certainty about – the predicted sensorimotor/interoceptive consequences of action. By extending this reasoning, in a hierarchical setting, we suggest mood states act as (hyper) priors over uncertainty (i.e. emotions). Here, we consider the same computational pathology in the proprioceptive and interoceptive (behavioural and autonomic) domain in order to furnish an explanation for mood disorders. This formulation reconciles several strands of research at multiple levels of enquiry.
The association of 6.7 GHz class II methanol (CH3OH) masers with ATLASGAL/ ALMA 0.9 mm massive dense cores is presented in this work from a statistical viewpoint. 42 of the 112 cores (37.5%) detected with the Atacama Compact Array (ACA) excite 6.7 GHz CH3OH masers. ACA cores have offsets 0\rlap.″17 to 4\rlap.″79 from the methanol multibeam survey (MMB), with a median of 2.″19. Approximately 90% of the MMB-associated cores are of masses > 40 M⊙. Because all the cores show evidence of outflow activity, and only a fraction of the cores excited CH3OH masers, we suggest that outflows precede the emergence of maser emission. This first ALMA survey of massive dense cores combined with the MMB survey along with other maser specie surveys is a promising tool to trace the evolutionary sequence of high-mass stars.
Courage. Endurance. Mateship. Sacrifice. These values, engraved in stone at the Isurava war memorial, have become synonymous with the Australian experience during the Kokoda campaign of 1942. The story of Kokoda and of the fighting in Papua has been told and retold in books, films and documentaries, but these popular narratives rarely explore beyond this one campaign. Kokoda: Beyond the Legend critically assesses not only the campaigns in Papua and their context in the wider lengthy Pacific war, but also the actions of senior Australian, American and Japanese military leaders. Moving beyond the legend, this book addresses the central question of why Kokoda holds such a significant place in Australian military history. In this book, Karl James brings together eminent military scholars to reassess the principal battles from both Allied and Japanese perspectives, providing readers with a more complete understanding of one of the major turning points in the Second World War.