Recent study has shown that some estrogen metabolites are capable of producing genome instability [ 41]. A recent study has shown significant malnutrition among Palestinian children, diplomats familiar with its results said. A recent study has shown that it has having a limited. A recent study has found that within the past few years, many doctors had elected early retirement rather than face the threats of lawsuits and the rising costs of. A new study led by researchers at the Earth-Life Science Institute of Tokyo Tech provides new answers to this question. Microbial Latest Health Headlines.
a study In recent
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I'll try it now. Hide Show timer Statistics. A recent study has found that within the past few years, many doctors had elected early retirement rather than face the threats of lawsuits and the rising costs of malpractice insurance. A had elected early retirement rather than face B had elected early retirement instead of facing C have elected retiring early instead of facing D have elected to retire early rather than facing E have elected to retire early rather than face Official Guide for GMAT Verbal Review, 2nd Edition, Practice Question Question No.: OG Verbal Review 2, SC 39 Verb form; Parallelism For action that started in the past and continues into the present, it is correct to use the present perfect tense: When a choice is presented using the rather than construction- the doctors ha'ue chosen x rather than y -the x and the y must be parallel.
In this case, the doctors have chosen to retire rather than to understood face. To does not need to be repeated in order to maintain parallelism because it is understood. A Had elected shows an action completed in the past; early retirement is not parallel to face.
B Had elected shows an action completed in the past; retirement and facing are not parallel. C Have elected must be followed by an infinitive to retire. D Facing and to retire early are not parallel. In this sentence, have elected shows action continuing into the present; to retire and to understood face are parallel. The correct answer is E. Originally posted by redferrocene on Oct 25, 5: Last edited by Bunuel on Dec 20, 9: Most Helpful Expert Reply.
To avoid shift of tense, one has to maintain present perfect in the subordinate clause also. Among C, D and E, C is out because of using instead of. In D, to retire ….. E is the best choice. To retire, an infinitive, matches face, elliptically meaning to face. Most Helpful Community Reply. E is better because it is using present perfect tense. The passage is in the present tense so talking about an event that happened prior to another event in the present and could be still ongoing , we use present perfect.
Read on about present and past perfect and verb tenses in general: Here's an attempt at an explanation In the sentence given, there isn't really a sequence of events, it's a stating a recent study. Here's an example of where had will make sense, The doctors had retired before the lawyers sued them for malpractice.
In this sentence, had is used to indicate that an event occured before another event. First the doctors retired, then the lawyers sued them. You cannot elect early retirement, but you can elect to retire early. Only D and E are possible choices. E is the best for parallellism because "elected to retire" is parallel to "face". Here I am talking about usage of verbs to maintain the parallelism. If you use "to" before "face" then it looks like the doctors have elected to face something.
Those sentences are least parallel. I have found this material when looking for instead of vs rather than: The phrase rather than consists of an adverb and a conjunction and often means "and not," as in I decided to skip lunch rather than eat in the cafeteria again. I would stay here and eat flies sooner than go with them. Rather than can also be used with nouns as a compound preposition meaning "instead of": I bought a mountain bike rather than a ten-speed.
But some people object to this use, insisting that than should be used only as a conjunction. They therefore object to constructions in which rather than is followed by a gerund, as in Rather than buying a new car, I kept my old one.
In some cases, however, rather than can only be followed by a gerund and not by a bare infinitive. If the main verb of the sentence has a form that does not allow parallel treatment of the verb following rather than, you cannot use a bare infinitive, and you must use a gerund.
This is often the case when the main verb is in a past tense or has a participle. Thus, you must say The results of the study, rather than ending not end or ended the controversy, only added to it. If the main verb was in the present tense add , you could use the bare infinitive end.
Curiously, when the rather than construction follows the main verb, it can use other verb forms besides the bare infinitive. Thus you can say The results of the study added to the controversy rather than ended it. The overriding concern in all of this should be to avoid faulty parallels, as in sentences like Rather than buy a new car, I have kept my old one and Rather than take a cab, she is going on foot.
In patients with hypertension, elite performers had a significant reduction in risk-adjusted all-cause mortality compared with high performers adjusted HR, 0. In all other comorbid subgroups, there was no statistical difference in survival between elite and high performers.
The adjusted mortality risk of reduced performance on ETT was comparable to, if not greater than, traditional clinical risk factors eg, CAD, smoking. Importantly, there was no upper limit of benefit of increased aerobic fitness.
In subgroup analysis, the survival benefit of elite vs high performers was present in older adults and those with hypertension. These findings emphasize the importance of aerobic fitness in overall health, including the magnitude of benefit of increased CRF in relation to traditional clinical risk factors and the incremental survival advantage of extremely high fitness.
Previous studies 1 - 6 have consistently demonstrated a reduction in mortality associated with higher levels of aerobic fitness. The present study reinforces these findings with data from a large cohort of patients referred for ETT. Even after adjustment for baseline clinical characteristics, the magnitude of benefit of increased aerobic fitness remains particularly striking. In addition, the adjusted mortality risk of reduced performance was comparable to, if not significantly greater than, traditional clinical risk factors, such as CAD, diabetes, and smoking Figure 2 C.
This finding remains true even when comparing adjacent performance groups; the reduction in mortality risk was seen in a dose-effect manner with any increment in CRF. These findings not only reinforce the large collective body of evidence correlating aerobic fitness with numerous health benefits but also illustrate the importance of aerobic fitness as a powerful, modifiable indicator of long-term mortality.
There continues to be uncertainty regarding the relative benefit or potential risk of extreme levels of exercise and fitness. Significant attention has been paid to better understand the long-term cardiovascular effects of extreme exercise. It remains unclear whether these associations are signals of true pathologic findings or rather benign features of cardiovascular adaptation.
The present study is the first, to our knowledge, to specifically evaluate the association between extremely high CRF and long-term mortality. We found that elite performers undergoing ETT had a significant association with reduction in all-cause mortality when compared with any other performance group. Overall, increases in CRF were associated with a reduction in all-cause mortality at any level, without evidence of a plateau effect or U-shaped association Figure 2 A.
There does not appear to be an upper limit of aerobic fitness above which a survival benefit is no longer observed. These results are in concordance with previous observational studies 35 - 38 of highly active cohorts and other large, longitudinal studies 4 , 6 of CRF and mortality but are notably discrepant from population-based studies 24 - 26 of physical activity and exercise.
This difference may reflect the objective measurement of physical fitness in the present study, as opposed to self-reported activity levels, which have been a major limitation of prior studies. Regardless of these discrepancies, in patients referred for ETT, it is evident that higher CRF, even to extreme levels, is associated with improved survival.
Elite performance was significantly associated with improved survival in these groups compared with high performers. An age-associated benefit of CRF has been demonstrated previously in older adults, 1 though without specific attention to extremely high levels of fitness. Older patients may also derive additional benefits outside those traditionally ascribed to CRF, including reductions in overall frailty and maintenance of physical independence. Furthermore, this finding may reflect unique selection factors present in older patients who are able to continue with such high levels of activity.
Clinically, this age-related association is significant because it emphasizes the importance of continued physical activity in older adults and the benefits of extremely high levels of fitness in elderly people. The benefit of elite performance in patients with hypertension is consistent with previous data showing CRF to be the strongest factor associated with survival in these patients, more so than any other clinical risk factors. The relative benefit of extremely high fitness may be attenuated in patients with known CAD or certain cardiac risk factors.
No statistically significant difference was found in all-cause mortality between elite and high performers with established CAD, hyperlipidemia, or diabetes.
The number of elite performers with these comorbidities was comparatively small and may have limited the statistical power to detect an associated mortality difference. Overall, higher CRF was associated with improved survival in these subgroups eFigure 7 in the Supplement. The rates of cardiac and noncardiac comorbidities except hyperlipidemia were significantly lower in elite performers compared with all other performance groups.
There was also no evidence to suggest relative harm associated with extreme levels of fitness in these subsets of patients. Collectively, these data demonstrate improved survival associated with increased CRF in patients with known CAD or certain cardiac comorbidities, without evidence of relative harm at extreme levels of fitness. A significant increase was found in unadjusted mortality in patients referred for ETT for other or non-CAD indications.
The most common indication in this subgroup was evaluation of valvular disease, which has been a practice at our institution since the s. The observed reduction in survival in this group may be driven by unique clinical factors and mortality risk among patients with severe valvular disease. The primary limitation of the study reflects its retrospective nature, in that the association between CRF and mortality does not prove causation. The degree to which high CRF preselects patients with lower mortality vs causes a reduction in mortality is not discernible from our study.
These limitations apply to other studies of aerobic fitness and long-term outcomes and are unlikely to be overcome because of the infeasibility of a large-scale, randomized study. Given these inherent limitations, our study demonstrates that patients who can exercise to an extreme level live longest, acknowledging that there may be many measured and unmeasured factors that contribute to this association. We also recognize that the study population ie, those referred for ETT may not reflect the general population distribution of estimated functional capacity for the purpose of identifying elite performers.
Recent proposals have suggested similar age-specific methods for CRF standardization. Cutoff values for elite performers were consistent with historic normative data, 41 and measured CRF of elite performers was comparable to published age- and sex-matched cohorts of endurance athletes 42 - However, this study reinforces the clinical utility of using ETT to better understand and determine patient prognosis.
Even measured at a single time point, performance on ETT is remarkably correlated with long-term survival. Increased CRF was associated with reduced long-term mortality with no observed upper limit of benefit.
The adjusted mortality risk of reduced CRF was greater than or equal to traditional clinical risk factors, such as cardiovascular disease, diabetes, and smoking. Dr Mandsager had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.
Acquisition, analysis, or interpretation of data: Mandsager, Harb, Cremer, Nissen, Jaber. Critical revision of the manuscript for important intellectual content: Conflict of Interest Disclosures: Home Issues Specialties For Authors. Patient Survival by Performance Group. Classification of Cardiorespiratory Fitness by Age and Sex a.
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Not exercising worse for your health than smoking, diabetes and heart disease, study reveals
The answer is D, but the reasoning seems a bit shaky to me. It seems that, with answer D, the test writers are trying to weaken the stimulus by. The new Global Initiative for Chronic Obstructive Lung Disease (GOLD) ABCD classification is not better at predicting all-cause and respiratory mortality. A massive new study says there's a single, highly surprising factor that predicts whether men will describe themselves as "happy" (and rank.