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This letter presents a new optimum interference mitigating combining (OIMC) scheme for the code-division multiple-access downlink RAKE receiver. The OIMC scheme optimizes the RAKE weights and maximizes the signal-to-interference-plus-noise ratio (SINR) at the RAKE combiner output. Unlike other interference mitigation schemes, the new scheme does not need to estimate the interference or data correlation matrix (and its inverse) of the received signal to render a reliable and low complexity receiver. The OIMC scheme mitigates interference by inversely proportionately weighting the finger output by its associated interference power, while simultaneously mitigating multipath fading. The interference power is found to be directly related to the finger's associated multipath channel gain, rendering the OIMC scheme with the same order of complexity as a maximal ratio combining (MRC) scheme. Under realistic channel conditions, simulation results show that the proposed OIMC scheme always outperforms MRC with a gain of up to more than 1 dB. [ABSTRACT FROM PUBLISHER]

Background: Altered plasma fatty acid (FA) profile and desaturase activities have been associated with several metabolic disease, including MetS. However, their relations have rarely been studied among general population, and no study have included the FA profile in plasma phospholipids (PL) and triglycerides (TG) separately. We investigated the relationship of the FA profile and desaturase activities in plasma PL and TG with MetS, and investigated if there were new characteristics of altered FA profile that could be related to MetS status in a general population. Methods: Baseline characteristic data from 850 participants (Male: 50.2%) aged 38-68 years who were recruited in the Lifelines Cohort study in the Netherlands were obtained. Individual FA profile was determined in fasting plasma PL and TG, and desaturase activities were estimated from product/precursor ratios. MetS was defined according to International Diabetes Federation in 2006. Logistic regression and odds ratios (OR) were used to examine these relations with the prevalence of MetS, and possible moderation effect of gender in these relation was also investigated. Results: There was 102 people (12%) who had MetS. After adjustment for several confounders, higher tertiles of PL C18:3 n-6, C18:0, C20:3 n-6, Δ6 desaturase (D6D), and TG C14:0, C16:0, C20:0 were associated with an increasing prevalence of MetS, while higher tertiles of PL C18:1 n-7, C24:1 n-9, C20:0, C24:0, Δ5 desaturase (D5D), stearoyl-CoA desaturase (SCD-18), and TG C24:0, C18:2 n-6, C20:4 n-6, C24:1 n-9, C20:5 n-3, C22:5 n-3, C22:6 n-3, D5D were inversely associated with MetS. Meanwhile, men seemed to be more vulnerable to MetS when having an altered or unfavorable FA profile in both plasma PL and TG. Conclusions: It is important to increase w-3 and w-6 essential fatty acids intake and decrease saturated fatty acids intake, and monitoring the D5D, D6D, and SCD-18 desaturases as additional fatty acids biomarkers is of equal importance. Key messages: • This study have added the evidence that an altered fatty acids profile was associated with metabolic syndrome (MetS) in a general population. • The altered fatty acids profile that was associated with metabolic syndrome differed in plasma PL and TG, which requires further study. [ABSTRACT FROM AUTHOR]

Deals with bacterial vaginosis' (BV) connection with preterm delivery. Factors that predict preterm delivery; Unreliability of predicting preterm delivery based on BV; Symptoms exhibited by women with abnormal bacterial flora due to BV.

Background: Posterior fossa decompression is carried out to improve passage of cerebrospinal fluid (CSF) in patients with symptomatic Chiari 1 malformations (CM1), but the extent and means of decompression remains controversial. Dural opening with subsequent duraplasty may contribute to clinical outcome, but may also increase complication risk. The aim of this systematic review and meta-analysis is to assess the effects of durotomy with subsequent duraplasty on clinical outcome in surgical treatment of adults with CM1., Data Sources and Study Eligibility Criteria: We systematically searched MEDLINE, Embase and CENTRAL, and screened references in relevant articles and in UpToDate. Publications with previously untreated adults (>15 years) with CM1 with or without associated syringomyelia, treated in the period 1990-2013 were eligible., Interventions: Posterior fossa decompression with duraplasty (PFDD group) was compared to posterior fossa decompression with bony decompression alone (PFD group)., Results: The search retrieved 233 articles. After the review we included 12 articles, but only 4 articles included posterior fossa decompression with both techniques. Only 2 out of 12 studies were prospective. The odds ratio (OR) for reoperation was 0.15 (95% CI 0.05-0.49) in the PFDD group compared to PFD (p=0.002). The OR of clinical failure at follow-up was 1.06 (95% CI 0.52-2.14) for PFDD compared to PFD (p=0.88). There was also no difference in syringomyelia improvement between techniques (p=0.60). The OR for CSF-related complications were 6.12 (95% CI 0.37-101.83) for PFDD compared to PFD (p=0.21)., Conclusion: This systematic review of observational studies reveals higher reoperation rates after bony decompression alone, but clinical improvement was not higher after primary decompression with duraplasty. There are so far no high-quality studies that offer guidance in the choice of decompressive technique in adult CM1 patients. We think that a randomized controlled trial on this topic is both needed and feasible., (Copyright © 2014 Elsevier B.V. All rights reserved.)

Cancer treatment and its side effects may cause muscle wasting. Physical exercise has the potential to increase muscle mass and strength and to improve physical function in cancer patients undergoing treatment. A systematic review was conducted to study the effect of physical exercise (aerobic, resistance or a combination of both) on muscle mass and strength in cancer patients with different type and stage of cancer disease. Electronic searches were performed up to January 11th 2012, identifying 16 randomised controlled trials for final data synthesis. The studies demonstrated that aerobic and resistance exercise improves upper and lower body muscle strength more than usual care. Few studies have assessed the effect of exercise on muscle mass. Most studies were performed in patients with early stage breast or prostate cancer. Evidence on the effect of physical exercise on muscle strength and mass in cancer patients with advanced disease is lacking. More exercise studies in patients with advanced cancer and at risk of cancer cachexia are warranted., (Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.)

While effective general practitioner (GP)-patient communication is required for the provision of good palliative care, barriers and facilitators for this communication are largely unknown. We aimed to identify barriers and facilitators for GP-patient communication in palliative care. In a systematic review seven computerized databases were searched to find empirical studies on GP-patient communication in palliative care. Fifteen qualitative studies and seven quantitative questionnaire studies were included. The main perceived barriers were GPs' lack of availability, and patients' and GPs' ambivalence to discuss 'bad prognosis'. Main perceived facilitators were GPs being available, initiating discussion about several end-of-life issues and anticipating various scenarios. Lack of availability and failure to discuss former mistakes appear to be blind spots of GPs. GPs should be more forthcoming to initiate discussions with palliative care patients about prognosis and end-of-life issues. Empirical studies are needed to investigate the effectiveness of the perceived barriers and facilitators.

Objective: To systematically review the effectiveness of workplace interventions for reducing sitting., Methods: Studies published up to April 2009 were identified by literature searches in multiple databases. Studies were included if they were interventions to increase energy expenditure (increase physical activity or decrease sitting); were conducted in a workplace setting; and specifically measured sitting as a primary or secondary outcome. Two independent reviewers assessed methodological quality of the included studies, and data on study design, sample, measures of sitting, intervention and results were extracted., Results: Six studies met the inclusion criteria (five randomised trials and one pre-post study). The primary aim of all six was to increase physical activity; all had reducing sitting as a secondary aim. All used self-report measures of sitting; one specifically assessed occupational sitting time; the others used measures of general sitting. No studies showed that sitting decreased significantly in the intervention group, compared with a control or comparison group., Conclusion: Currently, there is a dearth of evidence on the effectiveness of workplace interventions for reducing sitting. In light of the growing body of evidence that prolonged sitting is negatively associated with health, this highlights a gap in the scientific literature that needs to be addressed., (Copyright © 2010 Elsevier Inc. All rights reserved.)

Context: Emerging evidence suggests that sedentary behavior (i.e., time spent sitting) may be negatively associated with health. The aim of this study was to systematically review the evidence on associations between occupational sitting and health risks., Evidence Acquisition: Studies were identified in March-April 2009 by literature searches in PubMed, PsycINFO, CENTRAL, CINAHL, EMBASE, and PEDro, with subsequent related-article searches in PubMed and citation searches in Web of Science. Identified studies were categorized by health outcome. Two independent reviewers assessed methodologic quality using a 15-item quality rating list (score range 0-15 points, higher score indicating better quality). Data on study design, study population, measures of occupational sitting, health risks, analyses, and results were extracted., Evidence Synthesis: 43 papers met the inclusion criteria (21% cross-sectional, 14% case-control, 65% prospective); they examined the associations between occupational sitting and BMI (n=12); cancer (n=17); cardiovascular disease (CVD, n=8); diabetes mellitus (DM, n=4); and mortality (n=6). The median study-quality score was 12 points. Half the cross-sectional studies showed a positive association between occupational sitting and BMI, but prospective studies failed to confirm a causal relationship. There was some case-control evidence for a positive association between occupational sitting and cancer; however, this was generally not supported by prospective studies. The majority of prospective studies found that occupational sitting was associated with a higher risk of DM and mortality., Conclusions: Limited evidence was found to support a positive relationship between occupational sitting and health risks. The heterogeneity of study designs, measures, and findings makes it difficult to draw definitive conclusions at this time., (Copyright © 2010 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.)

AIM.: To study the relationship between abnormal vaginal flora (AVF) in the first trimester as a risk factor for shortening cervix length (CL) at second and third trimester, and to assess the combination of these factors in predicting preterm delivery. METHODS.: 1026 unselected low risk women seen before 16 weeks of pregnancy underwent sampling of vaginal fluid for wet mount microscopy at a central laboratory blinded to clinical data. Disappearance of lactobacilli and bacterial vaginosis (BV) were scored according to standardized definitions. Specific cultures were performed for M hominis, U urealyticum, aerobic vaginitis (AV) and vaginal colonization with Candida. CL was measured by transvaginal ultrasound at 10-14, 20-24 and at 30-34 weeks, and gestational age at delivery was recorded. RESULTS.: Short cervix (CL below the lower quartile) at 10-14 weeks is related to a lower CL at 20-24 and 30-34 weeks of gestation (p=0.01, p=0.005 respectively). Short cervix at 20-24 weeks, but not at 10-14 weeks, was predictive for preterm birth. In patients with M. hominis and/or with severe AV at 10-14 weeks, the cervix appeared shorter at 20-24 and at 30-34 weeks than in other women. Increased risk for preterm birth in women with a shorter cervix at 10-14 weeks and AVF could not be proved by this study. DISCUSSION.: Presence of AV or M. hominis is associated with a shorter cervix at 20-24 and 30-34 weeks. Although a short cervix at 10-14 weeks increases the likelihood of having a short cervix later in pregnancy, it was not a prerequisite for AVF to be associated with preterm delivery. Therefore, in the pathogenesis of preterm birth, certain types of AVF may be involved directly in the process of cervical shortening, rather than being exposed to the intrauterine cavity more readily by a short cervix in the early stages of pregnancy. Copyright (c) 2010 ISUOG. Published by John Wiley & Sons, Ltd.

Introduction: Abnormal vaginal flora (AVF) before 14 gestational weeks is a risk factor for preterm birth (PTB). The presence of aerobic microorganisms and an inflammatory response in the vagina may also be important risk factors., Aim: The primary aim of the study was to investigate the differential influences of AVF, full and partial bacterial vaginosis, and aerobic vaginitis in the first trimester on PTB rate. The secondary aim was to elucidate why treatment with metronidazole has not been found to be beneficial in previous studies., Setting: Unselected women with low-risk pregnancies attending the prenatal unit of the Heilig Hart General Hospital in Tienen, Belgium, were included in the study., Materials and Methods: At the first prenatal visit, 1026 women were invited to undergo sampling of the vaginal fluid for wet mount microscopy and culture, of whom 759 were fully evaluable. Abnormal vaginal flora (AVF; disappearance of lactobacilli), bacterial vaginosis (BV), aerobic vaginitis (AV), increased inflammation (more than ten leucocytes per epithelial cell) and vaginal colonisation with Candida (CV) were scored according to standardised definitions. Partial BV was defined as patchy streaks of BV flora or sporadic clue cells mixed with other flora, and full BV as a granular anaerobic-type flora or more than 20% clue cells. Vaginal fluid was cultured for aerobic bacteria, Mycoplasma hominis and Ureaplasma urealyticum. Outcome was recorded as miscarriage