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Development and validation of a non-remission risk prediction model in First Episode Psychosis: An analysis of two longitudinal studies
- Samuel Leighton, Pavan Mallikarjun, Rajeev Krishnadas, Jonathan Cavanagh, Simon Rogers, Rachel Upthegrove, Max Birchwood, Stephen Marwaha, Ewout Steyerberg, Georgios Gkoutos, Matthew Broome, Peter Liddle, Linda Everard, Swaran Singh, Nicholas Freemantle, David Fowler, Peter Jones, Vimal Sharma, Robin Murray, Til Wykes, Richard Drake, Iain Buchan, Shon Lewis
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- Journal:
- BJPsych Open / Volume 7 / Issue S1 / June 2021
- Published online by Cambridge University Press:
- 18 June 2021, p. S36
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Aims
Psychosis is a major mental illness with first onset in young adults. The prognosis is poor in around half of the people affected, and difficult to predict. The few tools available to predict prognosis have major weaknesses which limit their use in clinical practice. We aimed to develop and validate a risk prediction model of symptom non-remission in first-episode psychosis.
MethodOur development cohort consisted of 1027 patients with first-episode psychosis recruited between 2005 to 2010 from 14 early intervention services across the National Health Service in England. Our validation cohort consisted of 399 patients with first-episode psychosis recruited between 2006 to 2009 from a further 11 English early intervention services. The one-year non-remission rate was 52% and 54% in the development and validation cohorts, respectively. Multivariable logistic regression was used to develop a risk prediction model for non-remission, which was externally validated.
ResultThe prediction model showed good discrimination (C-statistic of 0.74 (0.72, 0.76) and adequate calibration with intercept alpha of 0.13 (0.03, 0.23) and slope beta of 0.99 (0.87, 1.12). Our model improved the net-benefit by 16% at a risk threshold of 50%, equivalent to 16 more detected non-remitted first-episode psychosis individuals per 100 without incorrectly classifying remitted cases.
ConclusionOnce prospectively validated, our first episode psychosis prediction model could help identify patients at increased risk of non-remission at initial clinical contact.
Why care about integrated care? Part 2. Integrated care systems: an irresistible force changing mental health services
- Derek K. Tracy, Frank Holloway, Kara Hanson, Nikita Kanani, Matthew Trainer, Iain Dimond, Adrian James, Sridevi Kalidindi, Sukhwinder S. Shergill
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- Journal:
- BJPsych Advances / Volume 29 / Issue 1 / January 2023
- Published online by Cambridge University Press:
- 17 February 2020, pp. 19-30
- Print publication:
- January 2023
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Part 1 of this three-part series on integrated care discussed the drivers for change in healthcare delivery in England set out in the NHS Long Term Plan. This second part explores the evolution of mental health services within the wider National Health Service (NHS), and describes important relevant legislation and policy over the past decade, leading up to the 2019 Long Term Plan. We explain the implications of this, including the detail of emerging structures such as integrated care systems (ICSs) and primary care networks (PCNs), and conclude with challenges facing these novel systems. Part 3 will address the practical local implementation of integrated care.
Near-Infrared Stellar Populations in the metal-poor, Dwarf irregular Galaxies Sextans A and Leo A
- Olivia C. Jones, Matthew T. Maclay, Martha L. Boyer, Margaret Meixner, Iain McDonald
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- Journal:
- Proceedings of the International Astronomical Union / Volume 14 / Issue S343 / August 2018
- Published online by Cambridge University Press:
- 30 December 2019, pp. 429-430
- Print publication:
- August 2018
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We present JHK observations of the metal-poor $$(\left[ {{\rm{Fe}}/{\rm{H}}} \right] < - 1.40)$$ dwarf-irregular galaxies, Leo A and Sextans A, obtained with the WIYN High-resolution Infrared Camera. Their near-IR stellar populations are characterized by using a combination of color-magnitude diagrams and by identifying long-period variable (LPV) stars. We detected red giant and asymptotic giant branch (AGB) stars, consistent with membership of the galaxy’s intermediate-age populations (2-8 Gyr old). We identify 32 dusty evolved stars in Leo A and 101 dusty stars in Sextans A, confirming that metal-poor stars can form substantial amounts of dust. We also find tentative evidence for oxygen-rich dust formation at low metallicity, contradicting previous models that suggest oxygen-rich dust production is inhibited in metal-poor environments. The majority of this dust is produced by a few very dusty evolved stars.
An annually resolved bristlecone pine carbon isotope chronology for the last millennium
- Roderick J. Bale, Iain Robertson, Matthew W. Salzer, Neil J. Loader, Steven W. Leavitt, Mary Gagen, Thomas P. Harlan, Danny McCarroll
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- Journal:
- Quaternary Research / Volume 76 / Issue 1 / July 2011
- Published online by Cambridge University Press:
- 20 January 2017, pp. 22-29
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We present the first near millennium-length, annually resolved stable isotope record from bristlecone pines (Pinus longaeva, D.K Bailey). The carbon isotope ratios from the cellulose of seven trees from the White Mountains of California, corrected for anthropogenic changes in atmospheric chemistry, are used to reconstruct growing season (June through August) precipitation back to AD 1085. Extremely negative isotope results are strongly correlated with proposed severest El Niño events over the last 500 yr, and similar values in the first half of the millennium are used to reconstruct a further 13 strong El Niño events, concentrated in the 12th Century and the mid 13th and 14th Centuries. Ring-width chronologies from adjacent sites in the White Mountains demonstrate a high degree of decadal covariance with the δ13C series, although there are several periods of notable divergence.
Nonlinear self-excited thermoacoustic oscillations of a ducted premixed flame: bifurcations and routes to chaos
- Karthik Kashinath, Iain C. Waugh, Matthew P. Juniper
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- Journal:
- Journal of Fluid Mechanics / Volume 761 / 25 December 2014
- Published online by Cambridge University Press:
- 25 November 2014, pp. 399-430
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Thermoacoustic systems can oscillate self-excitedly, and often non-periodically, owing to coupling between unsteady heat release and acoustic waves. We study a slot-stabilized two-dimensional premixed flame in a duct via numerical simulations of a $G$-equation flame coupled with duct acoustics. We examine the bifurcations and routes to chaos for three control parameters: (i) the flame position in the duct, (ii) the length of the duct and (iii) the mean flow velocity. We observe period-1, period-2, quasi-periodic and chaotic oscillations. For certain parameter ranges, more than one stable state exists, so mode switching is possible. At intermediate times, the system is attracted to and repelled from unstable states, which are also identified. Two routes to chaos are established for this system: the period-doubling route and the Ruelle–Takens–Newhouse route. These are corroborated by analyses of the power spectra of the acoustic velocity. Instantaneous flame images reveal that the wrinkles on the flame surface and pinch-off of flame pockets are regular for periodic oscillations, while they are irregular and have multiple time and length scales for quasi-periodic and aperiodic oscillations. This study complements recent experiments by providing a reduced-order model of a system with approximately 5000 degrees of freedom that captures much of the elaborate nonlinear behaviour of ducted premixed flames observed in the laboratory.
Matrix-free continuation of limit cycles and their bifurcations for a ducted premixed flame
- Iain C. Waugh, K. Kashinath, Matthew P. Juniper
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- Journal:
- Journal of Fluid Mechanics / Volume 759 / 25 November 2014
- Published online by Cambridge University Press:
- 17 October 2014, pp. 1-27
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Many experimental studies have demonstrated that ducted premixed flames exhibit stable limit cycles in some regions of parameter space. Recent experiments have also shown that these (period-1) limit cycles subsequently bifurcate to period-$2^{n}$, quasiperiodic, multiperiodic or chaotic behaviour. These secondary bifurcations cannot be found computationally using most existing frequency domain methods, because these methods assume that the velocity and pressure signals are harmonic. In an earlier study we have shown that matrix-free continuation methods can efficiently calculate the limit cycles of large thermoacoustic systems. This paper demonstrates that these continuation methods can also efficiently calculate the bifurcations from the limit cycles. Furthermore, once these bifurcations are found, it is then possible to isolate the coupled flame–acoustic motion that causes the qualitative change in behaviour. This information is vital for techniques that use selective damping to move bifurcations to more favourable locations in the parameter space. The matrix-free methods are demonstrated on a model of a ducted axisymmetric premixed flame, using a kinematic $G$-equation solver. The methods find limit cycles and period-2 limit cycles, and fold, period-doubling and Neimark–Sacker bifurcations as a function of the location of the flame in the duct, and the aspect ratio of the steady flame.
Contributors
- Edited by Mark A. Wrathall, University of California, Riverside
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- The Cambridge Companion to Heidegger's <I>Being and Time</I>
- Published online:
- 05 August 2013
- Print publication:
- 31 July 2013, pp xi-xiv
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- By Alaa A. Abd-Elsayed, Basem Abdelmalak, Kalil G. Abdullah, Maged Argalious, Rafi Avitsian, Maria Bauer, Edward C. Benzel, Dani S. Bidros, William Bingaman, Jay B. Brodsky, David Brown, Patrick M. Callahan, Juan P. Cata, Chakorn Chansakul, Jianguo Cheng, Jeffrey G. Clark, Peter J. Davis, Stacie Deiner, Xiao Di, Karen B. Domino, D. John Doyle, Zeyd Ebrahim, Ehab Farag, Gordon Finlayson, Elizabeth A. M. Frost, Matthew Grosso, David P. Gurd, Rodolfo Hakim, Robert Helfand, Iain H. Kalfas, Rami Karroum, Michael Kelly, Stephen J. Kimatian, Christian Koopman, Ajit A. Krishnaney, Andrea Kurz, Lorri A. Lee, Brian P. Lemkuil, James K. C. Liu, Sara P. Lozano, Daniel Lubelski, Mark Luciano, Ramez Malaty, Mariel R. Manlapaz, Edward M. Manno, Virgilio Matheus, Robert F. McLain, Nagy Mekhail, Doksu Moon, Loran Soliman Mounir, Raghu Mudumbai, Thomas E. Mroz, Dileep R. Nair, Julie Niezgoda, R. Douglas Orr, Piyush M. Patel, Jason E. Pope, Manuel Saavedra, Kenneth J. Saliba, Richard Schlenk, John Seif, John H. Shin, Jeffrey Silverstein, Dmitri Souzdalnitski, Michael Steinmetz, Tunga Suresh, John E. Tetzlaff, Sherif Zaky
- Edited by Ehab Farag
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- Anesthesia for Spine Surgery
- Published online:
- 05 June 2012
- Print publication:
- 17 May 2012, pp ix-xii
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- By Virginie Attina, Pierre Badin, Gérard Bailly, Denis Beautemps, Atef Ben Youssef, Lynne Bernstein, Jonas Beskow, Christoph Bregler, N. Michael Brooke, Vicki Bruce, Denis Burnham, Ruth Campbell, Marie-Agnès Cathiard, Rashid Clark, Michael M. Cohen, Tony Ezzat, Gadi Geiger, Rafaël Laboissière, Karen Lander, Hélène Loevenbrück, Juergen Luettin, MairÉad MacSweeney, Dominic W. Massaro, Iain Matthews, Kevin Munhall, Chalapathy Neti, Pascal Perrier, Tomaso A. Poggio, Gerasimos Potamianos, Robert E. Remez, Lionel Revéret, Christophe Savariaux, Jean-Luc Schwartz, Simon D. Scott, Kaoru Sekiyama, Malcom Slaney, Marija Tabain, Eric Vatikiotis-Bateson, Anne Vilain
- Edited by Gérard Bailly, Université de Grenoble, Pascal Perrier, Université de Grenoble, Eric Vatikiotis-Bateson, University of British Columbia, Vancouver
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- Audiovisual Speech Processing
- Published online:
- 05 May 2012
- Print publication:
- 26 April 2012, pp xviii-xxxii
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Safety of antipsychotics in people with intellectual disability
- Valeria Frighi, Matthew T. Stephenson, Alireza Morovat, Iain E. Jolley, Marialena Trivella, Christina A. Dudley, Ezhil Anand, Sarah J. White, Christina V. Hammond, Rena A. Hockney, Beryl Barrow, Rehana Shakir, Guy M. Goodwin
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- Journal:
- The British Journal of Psychiatry / Volume 199 / Issue 4 / October 2011
- Published online by Cambridge University Press:
- 02 January 2018, pp. 289-295
- Print publication:
- October 2011
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Background
Despite frequent use, little is known about the metabolic and endocrine side-effects of antipsychotics in individuals with intellectual disability.
AimsTo compare indices of obesity, glucose, lipids and prolactin between antipsychotic-treated and antipsychotic-naive individuals with intellectual disability and also between participants with intellectual disability and controls from the general population.
MethodObservational study comparing 138 antipsychotic-treated and 64 antipsychotic-naive participants with intellectual disability in one National Health Service trust with general population controls.
ResultsAntipsychotic treatment comprised: risperidone 48%, olanzapine 18%, thioxanthenes 10%, other 24%; monotherapy 95% of participants; mean treatment duration 8 years; median daily chlorpromazine equivalent dose 108mg (range 16–667). Metabolic indices were the same or more favourable in the intellectual disability group than the general population control group but overweight/obesity and type 2 diabetes were more prevalent in the women in the intellectual disability group than the control group. Metabolic indices were similar, statistically or clinically, between the antipsychotic-treated and the antipsychotic-naive groups but there was a non-significant trend towards a higher rate of type 2 diabetes in the antipsychotic group. A total of 100% and 70% of participants on amisulpride/sulpiride and risperidone respectively had hyperprolactinaemia, with secondary hypogonadism in 77% and 4% of affected women and men.
ConclusionsAntipsychotics, on average, did not increase metabolic risk, although the existence of a susceptible subgroup at risk of diabetes cannot be excluded. Some antipsychotics induced hyperprolactinaemic hypogonadism, requiring active management. However, our findings suggest that antipsychotics at the low doses routinely prescribed for people with intellectual disability are generally safe in relation to metabolic adverse effects, even if efficacy remains poorly defined.
Contributors
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- By Rose Teteki Abbey, K. C. Abraham, David Tuesday Adamo, LeRoy H. Aden, Efrain Agosto, Victor Aguilan, Gillian T. W. Ahlgren, Charanjit Kaur AjitSingh, Dorothy B E A Akoto, Giuseppe Alberigo, Daniel E. Albrecht, Ruth Albrecht, Daniel O. Aleshire, Urs Altermatt, Anand Amaladass, Michael Amaladoss, James N. Amanze, Lesley G. Anderson, Thomas C. Anderson, Victor Anderson, Hope S. Antone, María Pilar Aquino, Paula Arai, Victorio Araya Guillén, S. Wesley Ariarajah, Ellen T. Armour, Brett Gregory Armstrong, Atsuhiro Asano, Naim Stifan Ateek, Mahmoud Ayoub, John Alembillah Azumah, Mercedes L. García Bachmann, Irena Backus, J. Wayne Baker, Mieke Bal, Lewis V. Baldwin, William Barbieri, António Barbosa da Silva, David Basinger, Bolaji Olukemi Bateye, Oswald Bayer, Daniel H. Bays, Rosalie Beck, Nancy Elizabeth Bedford, Guy-Thomas Bedouelle, Chorbishop Seely Beggiani, Wolfgang Behringer, Christopher M. Bellitto, Byard Bennett, Harold V. Bennett, Teresa Berger, Miguel A. Bernad, Henley Bernard, Alan E. Bernstein, Jon L. Berquist, Johannes Beutler, Ana María Bidegain, Matthew P. Binkewicz, Jennifer Bird, Joseph Blenkinsopp, Dmytro Bondarenko, Paulo Bonfatti, Riet en Pim Bons-Storm, Jessica A. Boon, Marcus J. Borg, Mark Bosco, Peter C. Bouteneff, François Bovon, William D. Bowman, Paul S. Boyer, David Brakke, Richard E. Brantley, Marcus Braybrooke, Ian Breward, Ênio José da Costa Brito, Jewel Spears Brooker, Johannes Brosseder, Nicholas Canfield Read Brown, Robert F. Brown, Pamela K. Brubaker, Walter Brueggemann, Bishop Colin O. Buchanan, Stanley M. Burgess, Amy Nelson Burnett, J. Patout Burns, David B. Burrell, David Buttrick, James P. Byrd, Lavinia Byrne, Gerado Caetano, Marcos Caldas, Alkiviadis Calivas, William J. Callahan, Salvatore Calomino, Euan K. Cameron, William S. Campbell, Marcelo Ayres Camurça, Daniel F. Caner, Paul E. Capetz, Carlos F. Cardoza-Orlandi, Patrick W. Carey, Barbara Carvill, Hal Cauthron, Subhadra Mitra Channa, Mark D. Chapman, James H. Charlesworth, Kenneth R. Chase, Chen Zemin, Luciano Chianeque, Philip Chia Phin Yin, Francisca H. Chimhanda, Daniel Chiquete, John T. Chirban, Soobin Choi, Robert Choquette, Mita Choudhury, Gerald Christianson, John Chryssavgis, Sejong Chun, Esther Chung-Kim, Charles M. A. Clark, Elizabeth A. Clark, Sathianathan Clarke, Fred Cloud, John B. Cobb, W. Owen Cole, John A Coleman, John J. Collins, Sylvia Collins-Mayo, Paul K. Conkin, Beth A. Conklin, Sean Connolly, Demetrios J. Constantelos, Michael A. Conway, Paula M. Cooey, Austin Cooper, Michael L. Cooper-White, Pamela Cooper-White, L. William Countryman, Sérgio Coutinho, Pamela Couture, Shannon Craigo-Snell, James L. Crenshaw, David Crowner, Humberto Horacio Cucchetti, Lawrence S. Cunningham, Elizabeth Mason Currier, Emmanuel Cutrone, Mary L. Daniel, David D. Daniels, Robert Darden, Rolf Darge, Isaiah Dau, Jeffry C. Davis, Jane Dawson, Valentin Dedji, John W. de Gruchy, Paul DeHart, Wendy J. Deichmann Edwards, Miguel A. De La Torre, George E. Demacopoulos, Thomas de Mayo, Leah DeVun, Beatriz de Vasconcellos Dias, Dennis C. Dickerson, John M. Dillon, Luis Miguel Donatello, Igor Dorfmann-Lazarev, Susanna Drake, Jonathan A. Draper, N. Dreher Martin, Otto Dreydoppel, Angelyn Dries, A. J. Droge, Francis X. D'Sa, Marilyn Dunn, Nicole Wilkinson Duran, Rifaat Ebied, Mark J. Edwards, William H. Edwards, Leonard H. Ehrlich, Nancy L. Eiesland, Martin Elbel, J. Harold Ellens, Stephen Ellingson, Marvin M. Ellison, Robert Ellsberg, Jean Bethke Elshtain, Eldon Jay Epp, Peter C. Erb, Tassilo Erhardt, Maria Erling, Noel Leo Erskine, Gillian R. Evans, Virginia Fabella, Michael A. Fahey, Edward Farley, Margaret A. Farley, Wendy Farley, Robert Fastiggi, Seena Fazel, Duncan S. Ferguson, Helwar Figueroa, Paul Corby Finney, Kyriaki Karidoyanes FitzGerald, Thomas E. FitzGerald, John R. Fitzmier, Marie Therese Flanagan, Sabina Flanagan, Claude Flipo, Ronald B. Flowers, Carole Fontaine, David Ford, Mary Ford, Stephanie A. Ford, Jim Forest, William Franke, Robert M. Franklin, Ruth Franzén, Edward H. Friedman, Samuel Frouisou, Lorelei F. Fuchs, Jojo M. Fung, Inger Furseth, Richard R. Gaillardetz, Brandon Gallaher, China Galland, Mark Galli, Ismael García, Tharscisse Gatwa, Jean-Marie Gaudeul, Luis María Gavilanes del Castillo, Pavel L. Gavrilyuk, Volney P. Gay, Metropolitan Athanasios Geevargis, Kondothra M. George, Mary Gerhart, Simon Gikandi, Maurice Gilbert, Michael J. Gillgannon, Verónica Giménez Beliveau, Terryl Givens, Beth Glazier-McDonald, Philip Gleason, Menghun Goh, Brian Golding, Bishop Hilario M. Gomez, Michelle A. Gonzalez, Donald K. Gorrell, Roy Gottfried, Tamara Grdzelidze, Joel B. Green, Niels Henrik Gregersen, Cristina Grenholm, Herbert Griffiths, Eric W. Gritsch, Erich S. Gruen, Christoffer H. Grundmann, Paul H. Gundani, Jon P. Gunnemann, Petre Guran, Vidar L. Haanes, Jeremiah M. Hackett, Getatchew Haile, Douglas John Hall, Nicholas Hammond, Daphne Hampson, Jehu J. Hanciles, Barry Hankins, Jennifer Haraguchi, Stanley S. Harakas, Anthony John Harding, Conrad L. Harkins, J. William Harmless, Marjory Harper, Amir Harrak, Joel F. Harrington, Mark W. Harris, Susan Ashbrook Harvey, Van A. Harvey, R. Chris Hassel, Jione Havea, Daniel Hawk, Diana L. Hayes, Leslie Hayes, Priscilla Hayner, S. Mark Heim, Simo Heininen, Richard P. Heitzenrater, Eila Helander, David Hempton, Scott H. Hendrix, Jan-Olav Henriksen, Gina Hens-Piazza, Carter Heyward, Nicholas J. Higham, David Hilliard, Norman A. Hjelm, Peter C. Hodgson, Arthur Holder, M. Jan Holton, Dwight N. Hopkins, Ronnie Po-chia Hsia, Po-Ho Huang, James Hudnut-Beumler, Jennifer S. Hughes, Leonard M. Hummel, Mary E. Hunt, Laennec Hurbon, Mark Hutchinson, Susan E. Hylen, Mary Beth Ingham, H. Larry Ingle, Dale T. Irvin, Jon Isaak, Paul John Isaak, Ada María Isasi-Díaz, Hans Raun Iversen, Margaret C. Jacob, Arthur James, Maria Jansdotter-Samuelsson, David Jasper, Werner G. Jeanrond, Renée Jeffery, David Lyle Jeffrey, Theodore W. Jennings, David H. Jensen, Robin Margaret Jensen, David Jobling, Dale A. Johnson, Elizabeth A. Johnson, Maxwell E. Johnson, Sarah Johnson, Mark D. Johnston, F. Stanley Jones, James William Jones, John R. Jones, Alissa Jones Nelson, Inge Jonsson, Jan Joosten, Elizabeth Judd, Mulambya Peggy Kabonde, Robert Kaggwa, Sylvester Kahakwa, Isaac Kalimi, Ogbu U. Kalu, Eunice Kamaara, Wayne C. Kannaday, Musimbi Kanyoro, Veli-Matti Kärkkäinen, Frank Kaufmann, Léon Nguapitshi Kayongo, Richard Kearney, Alice A. Keefe, Ralph Keen, Catherine Keller, Anthony J. Kelly, Karen Kennelly, Kathi Lynn Kern, Fergus Kerr, Edward Kessler, George Kilcourse, Heup Young Kim, Kim Sung-Hae, Kim Yong-Bock, Kim Yung Suk, Richard King, Thomas M. King, Robert M. Kingdon, Ross Kinsler, Hans G. Kippenberg, Cheryl A. Kirk-Duggan, Clifton Kirkpatrick, Leonid Kishkovsky, Nadieszda Kizenko, Jeffrey Klaiber, Hans-Josef Klauck, Sidney Knight, Samuel Kobia, Robert Kolb, Karla Ann Koll, Heikki Kotila, Donald Kraybill, Philip D. W. Krey, Yves Krumenacker, Jeffrey Kah-Jin Kuan, Simanga R. Kumalo, Peter Kuzmic, Simon Shui-Man Kwan, Kwok Pui-lan, André LaCocque, Stephen E. Lahey, John Tsz Pang Lai, Emiel Lamberts, Armando Lampe, Craig Lampe, Beverly J. Lanzetta, Eve LaPlante, Lizette Larson-Miller, Ariel Bybee Laughton, Leonard Lawlor, Bentley Layton, Robin A. Leaver, Karen Lebacqz, Archie Chi Chung Lee, Marilyn J. Legge, Hervé LeGrand, D. L. LeMahieu, Raymond Lemieux, Bill J. Leonard, Ellen M. Leonard, Outi Leppä, Jean Lesaulnier, Nantawan Boonprasat Lewis, Henrietta Leyser, Alexei Lidov, Bernard Lightman, Paul Chang-Ha Lim, Carter Lindberg, Mark R. Lindsay, James R. Linville, James C. Livingston, Ann Loades, David Loades, Jean-Claude Loba-Mkole, Lo Lung Kwong, Wati Longchar, Eleazar López, David W. Lotz, Andrew Louth, Robin W. Lovin, William Luis, Frank D. Macchia, Diarmaid N. J. MacCulloch, Kirk R. MacGregor, Marjory A. MacLean, Donald MacLeod, Tomas S. Maddela, Inge Mager, Laurenti Magesa, David G. Maillu, Fortunato Mallimaci, Philip Mamalakis, Kä Mana, Ukachukwu Chris Manus, Herbert Robinson Marbury, Reuel Norman Marigza, Jacqueline Mariña, Antti Marjanen, Luiz C. L. Marques, Madipoane Masenya (ngwan'a Mphahlele), Caleb J. D. Maskell, Steve Mason, Thomas Massaro, Fernando Matamoros Ponce, András Máté-Tóth, Odair Pedroso Mateus, Dinis Matsolo, Fumitaka Matsuoka, John D'Arcy May, Yelena Mazour-Matusevich, Theodore Mbazumutima, John S. McClure, Christian McConnell, Lee Martin McDonald, Gary B. McGee, Thomas McGowan, Alister E. McGrath, Richard J. McGregor, John A. McGuckin, Maud Burnett McInerney, Elsie Anne McKee, Mary B. McKinley, James F. McMillan, Ernan McMullin, Kathleen E. McVey, M. Douglas Meeks, Monica Jyotsna Melanchthon, Ilie Melniciuc-Puica, Everett Mendoza, Raymond A. Mentzer, William W. Menzies, Ina Merdjanova, Franziska Metzger, Constant J. Mews, Marvin Meyer, Carol Meyers, Vasile Mihoc, Gunner Bjerg Mikkelsen, Maria Inêz de Castro Millen, Clyde Lee Miller, Bonnie J. Miller-McLemore, Alexander Mirkovic, Paul Misner, Nozomu Miyahira, R. W. L. Moberly, Gerald Moede, Aloo Osotsi Mojola, Sunanda Mongia, Rebeca Montemayor, James Moore, Roger E. Moore, Craig E. Morrison O.Carm, Jeffry H. Morrison, Keith Morrison, Wilson J. Moses, Tefetso Henry Mothibe, Mokgethi Motlhabi, Fulata Moyo, Henry Mugabe, Jesse Ndwiga Kanyua Mugambi, Peggy Mulambya-Kabonde, Robert Bruce Mullin, Pamela Mullins Reaves, Saskia Murk Jansen, Heleen L. Murre-Van den Berg, Augustine Musopole, Isaac M. T. Mwase, Philomena Mwaura, Cecilia Nahnfeldt, Anne Nasimiyu Wasike, Carmiña Navia Velasco, Thulani Ndlazi, Alexander Negrov, James B. Nelson, David G. Newcombe, Carol Newsom, Helen J. Nicholson, George W. E. Nickelsburg, Tatyana Nikolskaya, Damayanthi M. A. Niles, Bertil Nilsson, Nyambura Njoroge, Fidelis Nkomazana, Mary Beth Norton, Christian Nottmeier, Sonene Nyawo, Anthère Nzabatsinda, Edward T. Oakes, Gerald O'Collins, Daniel O'Connell, David W. Odell-Scott, Mercy Amba Oduyoye, Kathleen O'Grady, Oyeronke Olajubu, Thomas O'Loughlin, Dennis T. Olson, J. Steven O'Malley, Cephas N. Omenyo, Muriel Orevillo-Montenegro, César Augusto Ornellas Ramos, Agbonkhianmeghe E. Orobator, Kenan B. Osborne, Carolyn Osiek, Javier Otaola Montagne, Douglas F. Ottati, Anna May Say Pa, Irina Paert, Jerry G. Pankhurst, Aristotle Papanikolaou, Samuele F. Pardini, Stefano Parenti, Peter Paris, Sung Bae Park, Cristián G. Parker, Raquel Pastor, Joseph Pathrapankal, Daniel Patte, W. Brown Patterson, Clive Pearson, Keith F. Pecklers, Nancy Cardoso Pereira, David Horace Perkins, Pheme Perkins, Edward N. Peters, Rebecca Todd Peters, Bishop Yeznik Petrossian, Raymond Pfister, Peter C. Phan, Isabel Apawo Phiri, William S. F. Pickering, Derrick G. Pitard, William Elvis Plata, Zlatko Plese, John Plummer, James Newton Poling, Ronald Popivchak, Andrew Porter, Ute Possekel, James M. Powell, Enos Das Pradhan, Devadasan Premnath, Jaime Adrían Prieto Valladares, Anne Primavesi, Randall Prior, María Alicia Puente Lutteroth, Eduardo Guzmão Quadros, Albert Rabil, Laurent William Ramambason, Apolonio M. Ranche, Vololona Randriamanantena Andriamitandrina, Lawrence R. Rast, Paul L. Redditt, Adele Reinhartz, Rolf Rendtorff, Pål Repstad, James N. Rhodes, John K. Riches, Joerg Rieger, Sharon H. Ringe, Sandra Rios, Tyler Roberts, David M. Robinson, James M. Robinson, Joanne Maguire Robinson, Richard A. H. Robinson, Roy R. Robson, Jack B. Rogers, Maria Roginska, Sidney Rooy, Rev. Garnett Roper, Maria José Fontelas Rosado-Nunes, Andrew C. Ross, Stefan Rossbach, François Rossier, John D. Roth, John K. Roth, Phillip Rothwell, Richard E. Rubenstein, Rosemary Radford Ruether, Markku Ruotsila, John E. Rybolt, Risto Saarinen, John Saillant, Juan Sanchez, Wagner Lopes Sanchez, Hugo N. Santos, Gerhard Sauter, Gloria L. Schaab, Sandra M. Schneiders, Quentin J. Schultze, Fernando F. Segovia, Turid Karlsen Seim, Carsten Selch Jensen, Alan P. F. Sell, Frank C. Senn, Kent Davis Sensenig, Damían Setton, Bal Krishna Sharma, Carolyn J. Sharp, Thomas Sheehan, N. Gerald Shenk, Christian Sheppard, Charles Sherlock, Tabona Shoko, Walter B. Shurden, Marguerite Shuster, B. Mark Sietsema, Batara Sihombing, Neil Silberman, Clodomiro Siller, Samuel Silva-Gotay, Heikki Silvet, John K. Simmons, Hagith Sivan, James C. Skedros, Abraham Smith, Ashley A. Smith, Ted A. Smith, Daud Soesilo, Pia Søltoft, Choan-Seng (C. S.) Song, Kathryn Spink, Bryan Spinks, Eric O. Springsted, Nicolas Standaert, Brian Stanley, Glen H. Stassen, Karel Steenbrink, Stephen J. Stein, Andrea Sterk, Gregory E. Sterling, Columba Stewart, Jacques Stewart, Robert B. 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- Edited by Daniel Patte, Vanderbilt University, Tennessee
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- Book:
- The Cambridge Dictionary of Christianity
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- 05 August 2012
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- 20 September 2010, pp xi-xliv
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Physiological parameters governing the action of pancreatic lipase
- Iain A. Brownlee, Deborah J. Forster, Matthew D. Wilcox, Peter W. Dettmar, Chris J. Seal, Jeff P. Pearson
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- Journal:
- Nutrition Research Reviews / Volume 23 / Issue 1 / June 2010
- Published online by Cambridge University Press:
- 01 March 2010, pp. 146-154
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The most widely used pharmacological therapies for obesity and weight management are based on inhibition of gastrointestinal lipases, resulting in a reduced energy yield of ingested foods by reducing dietary lipid absorption. Colipase-dependent pancreatic lipase is believed to be the major gastrointestinal enzyme involved in catalysis of lipid ester bonds. There is scant literature on the action of pancreatic lipase under the range of physiological conditions that occur within the human small intestine, and the literature that does exist is often contradictory. Due to the importance of pancreatic lipase activity to nutrition and weight management, the present review aims to assess the current body of knowledge with regards to the physiology behind the action of this unique gastrointestinal enzyme system. Existing data would suggest that pancreatic lipase activity is affected by intestinal pH, the presence of colipase and bile salts, but not by the physiological range of Ca ion concentration (as is commonly assumed). The control of secretion of pancreatic lipase and its associated factors appears to be driven by gastrointestinal luminal content, particularly the presence of acid or digested proteins and fats in the duodenal lumen. Secretion of colipase, bile acids and pancreatic lipase is driven by cholecystokinin and secretin release.