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Medicine & Health
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(2021) Lim, MaeThesisConcern about falling is a common and serious health concern for older people. However, older people's participation in proven interventions for reducing concern about falling remains low. Health literacy could be influential to older people’s long-term participation in health programs for concern about falling. This thesis aimed to understand the relationship between health literacy and concern about falling in community-living older people. Six studies were conducted: (i) proposed a multicomponent theoretical model on health literacy and concern about falling; (ii) conducted a systematic review and meta-analysis exploring the relationship between health literacy and physical activity; (iii) developed and validated the Falls Health Literacy Scale (FHLS), a health literacy instrument specific to falls; (iv) developed cut-points for the 30-item and 10-item Iconographical Falls Efficacy Scales (IconFES) and evaluated their construct and predictive validity to falls and reduced physical activity; (v) assessed the effectiveness of a six-week online cognitive behavioural therapy (CBT) program for reducing concern about falling; (vi) explored how health literacy affects adherence to a home-based exercise program. The main findings were: (i) health literacy is closely related to many determinants of concern about falling and greater efforts are needed to clarify the impact of health literacy on intervention adherence and decision-making of older people with concern about falling; (ii) older people with inadequate health literacy are less likely to engage in physical activity on ≥5 days per week than those with adequate health literacy; (iii) the FHLS is sensitive to levels of fall-related health literacy, with good validity in an older population; (iv) the developed IconFES cut-points were sensitive to variables associated with concern about falling and predicted fall incidence and physical activity restriction after one year; (v) online CBT is a feasible treatment method for older people, and a targeted program with a well-integrated psychoeducation module on concern about falling seems warranted to boost the therapeutic effects; (vi) education, history of falls, anxiety and neuroticism moderate the relationship between health literacy and adherence of older people to a home-based exercise program. The thesis findings elucidate key aspects of the relationship between health literacy and concern about falling in older people.
(2022) Das, AbhijitThesisThe homeostatic regulation of amino acid concentrations is crucial for optimal brain function and development. Different amino acid transporters at cell membranes work together to facilitate the movement of amino acids into and out of the brain. Despite countless in vitro and in vivo research on these amino acids' activities, many fundamental concerns about their metabolic function in different brain areas and pathophysiological conditions remain unanswered. In the framework of this thesis, the effects of exogenous administration of several non-essential amino acids and the participation of their specific transporters in brain metabolism were investigated in Guinea pig cortical brain slices and mouse brain tissues using a targeted neuropharmacological and metabolomic strategy. Alterations in brain metabolism were analyzed using 1H and 13C nuclear magnetic resonance spectroscopy to evaluate changes in metabolite pools and 13C-enriched substrates. All the amino acid transporters mentioned in this study were addressed by the existing solute carrier (SLC) gene nomenclature system for amino acid transporters. The effect of exogenous L-aspartate, L-ornithine, and their salt, L-aspartate-L-ornithine (LOLA), on brain metabolism was investigated with or without an intact blood-brain barrier (BBB). The results indicated that neither L-aspartate, L-ornithine, nor LOLA, affected brain metabolism with an intact BBB. In cortical tissue slices L-aspartate increased brain metabolism concentration-dependently, L-ornithine significantly slowed it at higher concentrations (100 μmol/L), and the effects of LOLA was largely dependent on the balance of its two constituent amino acids. D-aspartate, another isoform of aspartate, produced a range of metabolic impacts, particularly on glutamatergic and GABAergic systems, with varying concentrations. In principal component analysis, the effects of D-aspartate were clearly distinguished from those of L-aspartate, indicating a metabolic pattern distinct from that of excitatory mechanisms. L-Proline administration significantly inhibited brain metabolism in Guinea pig cortical tissue slices, indicating a GABA-like effect; however, it was not a significant metabolic substrate. While it was actively taken up by cells in a concentration-dependent manner but was not completely metabolized. The metabolic pattern revealed that L-proline's effects clustered with 3-aminopropyl(methyl)phosphinic acid (SKF 97541), GABA, 1,5,6-tetrahydropyridin-4-yl)methylphosphinic acid (TPMPA) and (5,6-dihydro-5-methyl-6-oxo-4H-imidazo[1,5-a]thieno[2,3-f][1,4]diazepine-3-carboxylic acid) 1,1-dimethylethyl ester (RO194603) at lower concentrations (10 μmol/L) and with vigabatrin and RO194603 at higher concentrations (100 μmol/L); indicating that proline may act as a GABAB receptor agonist or GABAArho antagonist. Deletion of SLC6A17/NTT4 (neurotransmitter transporter 4) gene significantly impaired glutamate-glutamine cycle, reduced incorporation of 13C into Krebs cycle intermediates, and increased incorporation into lactate in the brain of mice lacking the gene. NTT4 knockout also altered several important metabolites in glutamatergic neurones, implying that it is a crucial transporter for maintaining brain amino acid homeostasis. Investigation of glutamine transport in cerebellum demonstrated that system A dominates glutamine transport in the cerebellum, with contributions from system N, which is inhibited by histidine and 2-(Methylamino)-2-methylpropionic acid (MeAIB) exerting the most metabolic influence. Inhibition of systems A and L by L-γ-Glutamyl-p-nitroanilide (GPNA) and 2-amino-4-bis(aryloxybenzyl)aminobutanoic acid (AABA) did not influence glutamine transport due to their low affinity for the transporters. Inhibition of systems L and B0 by 2-Aminobicyclo[2.2.1]heptane-2-carboxylic acid (BCH) showed little effect on fluxes from [1-13C]D-glucose but increased the flux of [1,2-13C]acetate into Glu C4,5 and Gln C4,5. Effects of cycloleucine were comparable to BCH but less powerful. This study provided new insight into the role of several non-essential amino acids in brain metabolism and also showed how brain metabolism is regulated in different brain regions.
(2022) Cao, JunThesisThis thesis focuses on the development and applications of magnetic resonance electrical properties tomography (MREPT), which is an emerging imaging modality to noninvasively obtain the electrical properties of tissues, such as conductivity and permittivity. Chapter 2 describes the general information about human research ethics, MRI scanner, MR sequence and the method of phase-based MREPT implemented in this thesis. Chapter 3 examines the repeatability of phase-based MREPT in the brain conductivity measurement using balanced fast field echo (bFFE) and turbo spin echo (TSE) sequences, and investigate the effects of compressed SENSE, whole-head B_1 shimming and video watching during scan on the measurement precision. Chapter 4 investigates the conductivity signal in response to short-duration visual stimulus, compares the signal and functional activation pathway with that of BOLD, and tests the consistency of functional conductivity imaging (funCI) with visual stimulation across participants. Chapter 5 extends the use of functional conductivity imaging to somatosensory stimulation and trigeminal nerve stimulation to evaluate the consistency of functional conductivity activation across different types of stimuli. In addition, visual adaptation experiment is performed to test if the repetition suppression effect can be observed using funCI. Chapter 6 explores if resting state conductivity networks can be reliably constructed using resting state funCI, evaluates the consistency of persistent homology architectures, and compares the links between nodes in the whole brain. Chapter 7 investigates the feasibility of prostate conductivity imaging using MREPT, and distinctive features in the conductivity distribution between healthy participants and participants with suspected abnormalities.
Metabolic and behavioural effects of cafeteria diet-induced maternal obesity on rat offspring: Impact of postweaning diet(2023) Seyed Tajaddini, AynazThesisMuch evidence indicates that maternal obesity programs a range of complications in offspring, highlighting the need to identify beneficial interventions. The present thesis examined if the programmed effects of maternal obesity on offspring are exacerbated by exposure to a high-fat, high-sugar ‘Cafeteria’ (Caf) diet and investigated the effects of a healthy diet intervention in adulthood. The first study examined whether a diet switch intervention could reverse the adverse effects of an unhealthy postweaning diet in male and female rat offspring born to dams fed standard chow or a high-fat, high-sugar, Caf diet. Weanling offspring from Caf dams were smaller and lighter, yet had more retroperitoneal (RP) fat, particularly in males. Maternal obesity enhanced the impact of postweaning Caf exposure on adult (14-week-old) body weight, RP fat, liver mass and plasma leptin in males but not females. Maternal Caf diet significantly increased relative expression of ACACA and Fasn in male and female weanling liver, whereas PPARα was increased in males from Caf dams. Hepatic CPT-1 expression was reduced in adult males from Caf fed dams. The results underline the sex-specific detrimental effects of maternal obesity on offspring; maternal obesity exacerbated the obesogenic phenotype produced by postweaning Caf diet in male, but not female offspring. A subset of rats from this first cohort were maintained on their postweaning diets until 22 weeks of age, when postweaning Caf groups were switched to chow for a further 5 weeks. Switching from Caf to chow in adulthood suppressed energy intake below groups maintained on chow. Consequently, body weight and adiposity fell in switched groups, but remained significantly higher than chow-fed controls. The diet switch improved a deficit in place recognition memory observed in Caf-fed groups, with no significant change over time in chow-fed groups. Importantly, the effects of the switch did not differ between offspring born to chow or Caf-fed dams. Thus, in these older adult offspring a healthy dietary intervention led to benefits regardless of prior exposure to maternal obesity. To complement these data, our second study investigated if the programming effects of maternal obesity were aggravated by offspring exposure to a Caf diet when introduced in adulthood. Male and female offspring from lean and obese dams were weaned onto chow until 9 weeks of age; siblings were then either continued on chow or switched to Caf diet for 5 weeks. Offspring from Caf dams were smaller than those from chow dams at birth, and exhibited greater adiposity, plasma glucose and leptin levels at weaning in both sexes. Offspring of Caf dams exhibited elevated liver triglyceride content at weaning but no significant changes in the liver antioxidant enzymes GPx, SOD, and CAT. The switch to Caf diet elevated body weight and fat mass, with more pronounced effects in females than males. As in our first study, adult males (14 week old) from Caf-fed dams exhibited increased body weight, adiposity, and plasma insulin and leptin levels relative to offspring from chow dams. In female offspring, only RP fat mass and plasma insulin were increased by maternal obesity. Moreover, there were behavioural effect of maternal obesity (reduced anxiety-like behaviour) on offspring. Thus, the effects of maternal Caf diet exposure were absent until a cafeteria diet challenge in adulthood, indicating that Caf diet-induced maternal obesity programs a latent vulnerability to obesogenic diet exposure in offspring, particularly in males. Further studies are needed to investigate the beneficial effects of reprogramming strategies such as healthy diet intervention in offspring, which are likely to be influenced by the duration, timing and mode of intervention.