bluuebunny/crossref_metadata_2025 huggingface dataset:
Surface Proteins on Gram-Positive Bacteria
Authors: Fischetti Vincent A.
Published: August 2019

Surface proteins are critical for the survival of gram-positive bacteria both in the environment and to establish an infection. Depending on the organism, their surface proteins are evolutionarily tailored to interact with specific ligands on their target surface, be it inanimate or animate. Most surface molecules on these organisms are covalently anchored to the peptidoglycan through an LPxTG motif found at the C-terminus. These surface molecules are generally modular with multiple binding or enzymatic domains designed for a specific survival function. For example, some molecules will bind serum proteins like fibronectin or fibrinogen in one domain and have a separate function in another domain. In addition, enzymes such as those responsible for the production of ATP may be generally found on some bacterial surfaces, but when or how they are used in the life of these bacteria is currently unknown. While surface proteins are required for pathogenicity but not viability, targeting the expression of these molecules on the bacterial surface would prevent infection but not death of the organism. Given that the number of different surface proteins could be in the range of two to three dozen, each with two or three separate functional domains (with hundreds to thousands of each protein on a given organism), exemplifies the complexity that exists on the bacterial surface. Because of their number, we could not adequately describe the characteristics of all surface proteins in this chapter. However, since the streptococcal M protein was one of the first gram-positive surface protein to be completely sequenced, and perhaps one of the best studied, we will use M protein as a model for surface proteins in general, pointing out differences with other surface molecules when necessary.
SecA-Mediated Protein Translocation through the SecYEG Channel
Authors: Komarudin Amalina Ghaisani , Driessen Arnold J. M.
Published: August 2019

In bacteria, the Sec translocase mediates the translocation of proteins into and across the cytoplasmic membrane. It consists of a protein conducting channel SecYEG, the ATP-dependent motor SecA, and the accessory SecDF complex. Here we discuss the function and structure of the Sec translocase.
Shaping of intraplate mountain patterns: The Cantabrian orocline legacy in Alpine Iberia
Authors: Fernández-Lozano J. , Gutiérrez-Alonso G. , Willingshofer E. , Sokoutis D. , de Vicente G. , Cloetingh S.
Published: August 2019

The present-day topography in Iberia is related to geodynamic processes dealing with lithospheric-scale deformation. However, little attention has been paid to the role of inherited crustal- or lithospheric-scale structures involved in the recent observed large-scale topographic patterns. Whereas the analysis of brittle structures focuses on the evolution of Mesozoic sedimentary basins and their subsequent response to tectonic inversion, their contribution to mountain building has been underestimated. Large numbers of structures, from ductile to brittle, which affected the whole lithosphere, were developed during the evolution of the Cantabrian orocline (ca. 310–300 Ma). The contribution of these Paleozoic post-Variscan structures, together with lithospheric mantle evolution and replacement during orocline development in the Mesozoic and Cenozoic geological evolution of Iberia, remains unexplored. To explore the role of these inherited structures on the final configuration of topography during N-S Pyrenean shortening, we carried out a series of analogue experiments complemented by surface velocity field analyses. Our experiments indicate that strain was concentrated along preexisting crustal- to lithospheric-scale discontinuities, and they show several reactivation events marked by differences in the velocity vector field. Differences in fault displacement were also observed in the models depending upon preexisting fault trends. The obtained results may explain the different amount of displacement observed during the reactivation of some of the post-orocline structures in Iberia during the Cenozoic, indicating the key role of unveiled structures, which probably have accommodated most of the Alpine shortening.
Recent trends in energy and nutrient content of take-home food and beverage purchases in Great Britain: an analysis of 225 million food and beverage purchases over 6 years
Authors: Berger Nicolas , Cummins Steven , Smith Richard D , Cornelsen Laura
Published: August 2019

Introduction

In recent years, there has been an increased focus on developing a coherent obesity policy in the UK, which has led to various national policy initiatives aimed at improving population diet. We sought to determine whether there have been concurrent changes in trends in the nutrient content of take-home food and beverage purchases within this policy environment.

Methods

We used 2012–2017 data from the UK Kantar Fast-Moving Consumer Goods (FMCG) panel, a nationally representative panel study of food and beverages bought by British households and brought into the home (n≈32 000 per year). Households used hand-held barcode scanners to report over 225 million product-level purchases of food and beverages, for which nutritional information was obtained. We estimated daily per capita purchases of energy and nutrients from 32 healthier and less healthy food groups defined using the nutrient profiling model used by the UK Department of Health.

Results

From 2012 to 2017, daily purchases of energy from food and beverages taken home decreased by 35.4 kcal (95% CI 25.5 to 45.2) per capita. This is explained by moderate decreases in the purchase of products with high contents in carbohydrate (−13.1 g (−14.4 to –11.8)) and sugar (−4.4 g (−5.1 to –3.7)), despite small increases in protein (1.7 g (1.4 to 2.1)) and saturated fat (0.4 g (0.2 to 0.6)). Food and beverage purchases exceeded daily reference intake values in fat (on average +6%), saturated fat (+43%), sugar (+16%) and protein (+28%) across all years. Although substitutions between individual food groups were large in energy and nutrients purchased, the heterogeneity of these patterns resulted in modest overall changes.

Conclusion

There have been small declines in the purchase of less healthy food products, which translated to a small reduction of total energy and sugar purchases taken home. However, the rate of change needs to be accelerated in order to substantially reduce the health risks of poor diets, suggesting that more radical policies may be needed to attain larger population effects.
Understanding the lived experiences of severe postnatal psychiatric illnesses in English speaking South Asian women, living in the UK: a qualitative study protocol
Authors: Sihre Harpreet Kaur , Gill Paramjit , Lindenmeyer Antje , McGuiness Mary , Berrisford Giles , Jankovic Jelena , Patel Minaxi , Lewin Jona , Fazil Qulsom
Published: August 2019

Introduction

The South Asian population is the UK’s largest and fastest growing minority ethnic group. There is evidence to suggest the lay understanding of postnatal psychiatric illnesses of this group may fall outside the purview of Western biomedical perspectives. Alternative explanations include psychosocial, cultural and spiritual factors. Approaching psychiatric illnesses through a social perspective includes gaining insight to the patient’s subjective experiences and understandings via qualitative inquiry. The objectives of this qualitative study are to explore South Asian women’s narrative of living with a severe postnatal psychiatric illness and experiences of Perinatal Mental Health Services, care and support.

Methods and analysis

Data collection is ongoing and will continue until 31 December 2018. Participants will be identified and recruited from Perinatal Mental Health Services in Birmingham and London. Eligible participants will be English speaking South Asian females aged 18 years or above with the capacity to give written informed consent. Participants are clinically diagnosed with a severe postnatal psychiatric illness. This qualitative study uses individual in-depth face-to-face interviews that aim to last 1 hour. Interviews will be audio recorded with participants’ permission. Interview audio recordings will be transcribed verbatim and analysed using interpretative phenomenological analysis (IPA). The primary goal of IPA is for the researcher to closely study and interpret how individuals make sense of their life experiences in a particular context by drawing on the fundamental principles of phenomenology, hermeneutics and idiography.

Ethics and dissemination

The University of Birmingham, the South Birmingham Research Ethics Committee and the Health Research Authority have approved this study (approvals date: 18-12-2017 ref: 17/WM/0350). Local capability and capacity have been confirmed from Trust Research and Development departments. The researchers plan to publish the results from this study in journals and present findings at academic conferences.
Subjective experiences of cognitive decline and receiving a diagnosis of dementia: qualitative interviews with people recently diagnosed in memory clinics in the UK
Authors: Xanthopoulou Penny , McCabe Rose
Published: August 2019

Objectives

To explore people’s experiences of cognitive decline and receiving a diagnosis of dementia.

Design

61 semistructured interviews within 2 weeks of diagnosis. Audio recordings were transcribed, line-by-line coded using NVIVO V.11 and analysed using thematic analysis.

Setting

9 memory clinics (UK).

Participants

People with mild/moderate dementia.

Results

Most participants were diagnosed with Alzheimer’s disease (56% female, mean age 81 years). 104 codes were grouped into 22 categories, feeding into 9 subthemes and 4 overarching themes: (1) dissonance, threat to identity and visibility of dementia: dementia was associated with a progressive loss of competence, culminating in being an idiot, crazy and losing the plot. The stigma of dementia led people to hide their diagnosis from others, even close family members. However, decreasing competence in everyday tasks was becoming increasingly visible in family and wider social networks. (2) Vulnerability and being in limbo: people were frustrated by the impact of dementia on their lives and felt vulnerable. Moreover, people were disturbed by not knowing how much and when they would deteriorate further. (3) Loss of control and agency: loneliness, increasing dependence and becoming a burden foreshadowed increasing diminished personal agency. (4) Maintaining agency and self-worth: some people focused on what they could do and the benefits of diagnosis. This involved accepting the diagnosis, adapting to changes by using coping strategies and accepting support from others. This helped people to maintain personal agency and self-worth.

Conclusion

While personal acceptance of dementia is challenging, people are additionally troubled about disclosing their diagnosis to others. Limited time in diagnostic appointments and limited postdiagnostic support leave few opportunities to address the emotional impact of a dementia diagnosis. There may be opportunities for healthcare professionals to discuss with patients the benefits of staying positive, implementing coping strategies and accepting support to live well with dementia.
Lost cost savings to the NHS in England due to the delayed entry of multiple generic low-dose transdermal buprenorphine: a case scenario analysis
Authors: Chapman Stephen Robert , Aladul Mohammed Ibrahim , Fitzpatrick Raymond William
Published: August 2019

Objective

Originator pharmaceutical companies prolonging the patent of a medicine prevents rivals’ entry to the market and competition. As the entry of generic alternatives usually results in price reduction, any delay in their entry potentially deprives the National Health Service (NHS) of much-needed savings. This study estimates the potential cost savings lost to the NHS as a result of delayed entry of generic low-dose buprenorphine (LDTB) patches in England.

Design

Two case scenarios were modelled to determine the savings from the entry of generic LDTB Butec only between February and August 2016 and the potential savings which could have been achieved if all generic LDTB patches had entered the market at the same time.

Setting

The volume of utilisation of branded and generic LDTB in UK primary care was derived from the NHS business services authority website for prescriptions dispensed between February 2015 and January 2018.

Main outcome measures

Cost savings associated with the entry of generic LDTB.

Results

The cumulative cost savings from the introduction of Butec alone was £0.7 ($0.92) million. The model predicted that if all generic buprenorphine entered the market at the same time with Butec, they could have been achieved a £1.2 ($1.57) million saving. This means that approximately £0.5 ($0.65) million savings was lost to the NHS over the 6-month time period.

Conclusions

The entry of Butec was associated with cost savings. We estimated that more cost savings could have been achieved if other generic LDTB patches had entered the market at the same time to drive competition between rivals. Patent protection strategies which delayed the entry of multiple generics were responsible for the reduced cost savings to the NHS in England.
Screening Of Pulmonary Hypertension in Methamphetamine Abusers (SOPHMA): rationale and design of a multicentre, cross-sectional study
Authors: Cheng Yangyang , Tung Chi-Kwong , Chung Albert Kar Kin , Liu Wan-Wan , Huang Duo , Chan Pak Hei , Lam Ming , Chan Wai-Chi , Siu Chung-Wah , Hai Jo Jo
Published: August 2019

Introduction

Methamphetamine misuse is classified as a ‘likely’ risk factor for pulmonary arterial hypertension (PAH). Nevertheless, the actual prevalence of and a screening strategy for PAH in methamphetamine users have not been established. We plan to study the prevalence of PAH and identify its independent risk factors among methamphetamine users.

Methods and analysis

The Screening Of Pulmonary Hypertension in Methamphetamine Abusers (SOPHMA) study will be a multicentre, cross-sectional screening study that will involve substance abuse clinics, hospitals and rehabilitation facilities in Hong Kong that cater to more than 20 methamphetamine users. A total of 400 patients who (1) are ≥18 years at enrolment; (2) report methamphetamine use in the last 2 years; (3) are diagnosed with methamphetamine use disorder; and (4) voluntarily agree to participate by providing written informed consent will be included. Patients will undergo standard echocardiography-based PAH screening procedures recommended for those with systemic sclerosis. Right heart catheterisation will be offered to participants with intermediate or high echocardiographic probability of PAH. For participants with a low echocardiographic probability of PAH, rescreening will be performed within 1 year. The primary measure will be the prevalence of PAH in methamphetamine users. The secondary measures will be the risk factors and a prediction model for PAH in methamphetamine users.

Ethics and dissemination

The SOPHMA study has been approved by the institutional review board. The findings of this study will provide the necessary evidence to establish universal guidelines for screening of PAH in methamphetamine users. Our results will be disseminated through immediate feedback to study participants, press release to the general public, as well as presentation in medical conferences and publications in peer-reviewed journals to healthcare providers and academia worldwide.
Digital and online symptom checkers and health assessment/triage services for urgent health problems: systematic review
Authors: Chambers Duncan , Cantrell Anna J , Johnson Maxine , Preston Louise , Baxter Susan K , Booth Andrew , Turner Janette
Published: August 2019

Objectives

In England, the NHS111 service provides assessment and triage by telephone for urgent health problems. A digital version of this service has recently been introduced. We aimed to systematically review the evidence on digital and online symptom checkers and similar services.

Design

Systematic review.

Data sources

We searched Medline, Embase, the Cochrane Library, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Health Management Information Consortium, Web of Science and ACM Digital Library up to April 2018, supplemented by phrase searches for known symptom checkers and citation searching of key studies.

Eligibility criteria

Studies of any design that evaluated a digital or online symptom checker or health assessment service for people seeking advice about an urgent health problem.

Data extraction and synthesis

Data extraction and quality assessment (using the Cochrane Collaboration version of QUADAS for diagnostic accuracy studies and the National Heart, Lung and Blood Institute tool for observational studies) were done by one reviewer with a sample checked for accuracy and consistency. We performed a narrative synthesis of the included studies structured around pre-defined research questions and key outcomes.

Results

We included 29 publications (27 studies). Evidence on patient safety was weak. Diagnostic accuracy varied between different systems but was generally low. Algorithm-based triage tended to be more risk averse than that of health professionals. There was very limited evidence on patients’ compliance with online triage advice. Study participants generally expressed high levels of satisfaction, although in mainly uncontrolled studies. Younger and more highly educated people were more likely to use these services.

Conclusions

The English ‘digital 111’ service has been implemented against a background of uncertainty around the likely impact on important outcomes. The health system may need to respond to short-term changes and/or shifts in demand. The popularity of online and digital services with younger and more educated people has implications for health equity.

PROSPERO registration number

CRD42018093564.
Effect of promoting current local research activities on large monitors on the population’s interest in health-related research: a randomised controlled trial
Authors: Gunnarsson Ronny , Cullen Paul , Heal Clare , Banks Jennifer
Published: August 2019

Objective

The objectives of this study were threefold: to estimate people’s interest in health-related research, to understand to what extent people appreciate being actively informed about current local health-related research and to investigate whether their interest can be influenced by advertising local current health-related research using large TV monitors.

Design

Randomised controlled trial using a stepped wedge design.

Setting

The emergency department waiting room at two public hospitals in northern Queensland, Australia.

Participants

Waiting patients and their accompanying friends and relatives in the emergency department waiting room not requiring immediate medical attention.

Interventions

A TV monitor advertising local current health-related research.

Main outcome measures

OR for the effect of intervention on changing the interest in health-related research compared with a control group while adjusting for gender, age and socioeconomic standard.

Results

The intervention significantly increased the short-term interest in health-related research with an OR of 1.3 (1.1–1.7, p=0.0063). We also noted that being female and being older was correlated to a higher interest in health-related research

Conclusions

This study found that proactive information significantly increased the general populations’ interest in health-related research. There are reasonable set up costs involved but the costs for maintaining the system were very low. Hence, it seems reasonable that research-active organisations should give much higher priority to this type of activity.

Trial registration number

ACTRN12617001085369
Design and protocol of a comprehensive multicentre biobank for abdominal aortic aneurysms
Authors: Jalalzadeh Hamid , Indrakusuma Reza , Blankensteijn Jan D. , Wisselink Willem , Yeung Kak K , Lindeman Jan H N , Hamming Jaap F , Koelemay Mark J W , Legemate Dink A , Balm Ron
Published: August 2019

Introduction

The pathophysiology and natural course of abdominal aortic aneurysms (AAAs) are insufficiently understood. In order to improve our understanding, it is imperative to carry out longitudinal research that combines biomarkers with clinical and imaging data measured over multiple time points. Therefore, a multicentre biobank, databank and imagebank has been established in the Netherlands: the ‘Pearl Abdominal Aortic Aneurysm’ (AAA bank).

Methods and analysis

The AAA bank is a prospective multicentre observational biobank, databank and imagebank of patients with an AAA. It is embedded within the framework of the Parelsnoer Institute, which facilitates uniform biobanking in all university medical centres (UMCs) in the Netherlands. The AAA bank has been initiated by the two UMCs of Amsterdam UMC and by Leiden University Medical Center. Participants will be followed during AAA follow-up. Clinical data are collected every patient contact. Three types of biomaterials are collected at baseline and during follow-up: blood (including DNA and RNA), urine and AAA tissue if open surgical repair is performed. Imaging data that are obtained as part of clinical care are stored in the imagebank. All data and biomaterials are processed and stored in a standardised manner. AAA growth will be based on multiple measurements and will be analysed with a repeated measures analysis. Potential associations between AAA growth and risk factors that are also measured on multiple time points can be assessed with multivariable mixed-effects models, while potential associations between AAA rupture and risk factors can be tested with a conditional dynamic prediction model with landmarking or with joint models in which linear mixed-effects models are combined with Cox regression.

Ethics and dissemination

The AAA bank is approved by the Medical Ethics Board of the Amsterdam UMC (University of Amsterdam).

Trial registration number

NCT03320408.
Stratification of inflammatory bowel disease outpatients by disease activity and risk of complications to guide out-of-hospital monitoring: a patient-centred quality improvement project
Authors: Fofaria Rishi K , Barber Susan , Adeleke Yewande , Woodcock Tom , Kamperidis Nikolaos , Mohamed Alaa , Misra Ravi , Shah Ajit , Bailey-Fee Susan , Bluston Howard , Robinson Denise , Tyrrell Tracey , Arebi Naila
Published: August 2019

Background

Inflammatory bowel disease (IBD) is a chronic relapsing-remitting condition affecting 600 000 people in the UK. Traditionally, patients attend outpatient clinics for monitoring regardless of their symptoms or risk of developing complications. This can lead to a mismatch between need and access: patients in remission given elective appointments displace those in need of urgent specialist attention. Novel initiatives implemented in the UK to improve outpatient monitoring have often required a well-maintained patient registry, empowered patients and significant information technology support.

Design and strategy

In this large-scale quality improvement project at St Mark’s Hospital, a tertiary centre for IBD, we stratified over 1000 patients attending three non-complex IBD clinics over 12 months according to disease activity and risk profile. The aim was to offer a choice and subsequently transfer 50% of eligible patients to specialist nurse-led telephone clinics and demonstrate non-inferior satisfaction levels to existing outpatient follow-up. We also sought to ensure there was timely access to a newly established rapid access clinic for patients requiring urgent specialist attention.

A core project team consisting of healthcare professionals, patients and quality improvement scientists met regularly. The team tested and scaled up interventions using ‘Plan-Do-Study-Act’ cycles within the ‘Model for Improvement’ framework and analysed data continuously using statistical process charts.

Results

Over 12 months, the average number of eligible patients transferred to telephone clinics rose from 17.6% (42/239) using a questionnaire method to 59.3% (73/123) using active discussion in clinic. Patient satisfaction scores remained high and non-inferior to baseline scores in face-to-face clinics. The median waiting time to be seen in the rapid access clinic was 6.5 days.

Conclusion

This is the first published study to report on the successful stratification of patients with IBD based on disease activity and risk of complications to create a more responsive, sustainable and patient-centred model for IBD monitoring.
Exploring stakeholder perceptions around implementation of the Operating Room Black Box for patient safety research: a qualitative study using the theoretical domains framework
Authors: Etherington Cole , Usama Aya , Patey Andrea M , Trudel Chantal , Przybylak-Brouillard Antoine , Presseau Justin , Grimshaw Jeremy M , Boet Sylvain
Published: August 2019

Background

Systematically observing clinical performance in the operating room (OR) to support patient safety initiatives faces numerous logistical and methodological challenges. These may be solved by new audio-video recording technologies like the OR Black Box, which is a tool similar to black boxes in aviation. This study aimed to identify barriers and enablers that may influence patients’, clinicians’ and senior leadership team members’ support of the OR Black Box in order to guide its future implementation.

Methods

Patients, clinicians and senior leadership team members were recruited to participate in semistructured interviews informed by the theoretical domains framework (TDF) to identify factors relevant to planning OR Black Box implementation. Deidentified interview transcripts were analysed in duplicate following a TDF coding structure.

Results

Data saturation was achieved at 15 patients, 17 clinicians and 9 senior leadership team members. Seven domains were relevant for patients, nine for clinicians and four for senior leadership. Knowledge and Beliefs about consequences were barriers and enablers for all three groups. Memory, attention and decision processes and Social influences were enablers for both clinicians and senior leadership. Environmental context and resources, Emotion and Behavioural regulation were found to be barriers and enablers for both clinicians and patients. Social/professional role and identity and Reinforcement were enablers for patients only and Optimism and Intentions were barriers and enablers to clinicians.

Conclusions

While most stakeholders were supportive of the OR Black Box, we identified many key areas that need to be addressed during its implementation. It is critical to ensure all stakeholders have adequate and accurate information about the OR Black Box system and research goals, and that the OR Black Box is positioned as a patient safety initiative for learning from and improving practice.
Addressing inequities in child health and development: towards social justice
Authors: Spencer Nick , Raman Shanti , O'Hare Bernadette , Tamburlini Giorgio
Published: August 2019

Inequities have a profound impact on the health and development of children globally. While inequities are greatest in the world’s poorest countries, even in rich nations poorer children have poorer health and developmental outcomes. From birth through childhood to adolescence, morbidity, mortality, growth and development are socially determined, resulting in the most disadvantaged having the highest risk of poor health outcomes. Inequities in childhood impact across the life course. We consider four categories of actions to promote equity: strengthening individuals, strengthening communities, improving living and working conditions, and promoting healthy macropolicies. Inequitiescanbe reduced but action to reduce inequities requires political will. The International Society for Social Paediatrics and Child Health (ISSOP) calls on governments, policy makers, paediatricians and professionals working with children and their organisations to act to reduce child health inequity as a priority. ISSOP recommends the following: governments act to reduce child poverty; ensure rights of all children to healthcare, education and welfare are protected; basic health determinants such as adequate nutrition, clean water and sanitation are available to all children. Paediatric and child health organisations ensure that their members are informed of the impact of inequities on children’s well-being and across the life course; include child health inequities in curricula for professionals in training; publish policy statements relevant to their country on child health inequities; advocate for evidence-based pro-equity interventions using a child rights perspective; advocate for affordable, accessible and quality healthcare for all children; promote research to monitor inequity as well as results of interventions in their child populations. Paediatricians and child health professionals be aware of the impact of social determinants of health on children under their care; ensure their clinical services are accessible and acceptable to all children and families within the constraints of their country’s health services; engage in advocacy at community and national level.
On legal age change
Authors: Simkulet William
Published: August 2019

Joona Räsänen argues some people have a right to change their legal age to prevent age discrimination. He proposes two prerequisites—the person feels his age differs from his legal age, and that person’s biological age differs from his chronological age. I argue we can achieve the same protections from ageism through restricting access to one’s birth date. I review several moral reasons in favour of changing one’s legal age, concluding the enterprise is folly.
Surgical trainees’ experience of pregnancy, maternity and paternity leave: a cross-sectional study
Authors: Mohan Helen , Ali Oroog , Gokani Vimal , McGoldrick Ciara , Smitham Peter , Fitzgerald J Edward F , Harries Rhiannon
Published: August 2019

Background

Internationally, supporting surgical trainees during pregnancy, maternity and paternity leave is essential for trainee well-being and for retention of high-calibre surgeons, regardless of their parental status. This study sought to determine the current experience of surgical trainees regarding pregnancy, maternity and paternity leave.

Methods

A cross-sectional anonymised electronic voluntary survey of all surgical trainees working in the UK and Ireland was distributed via the Association of Surgeons in Training and the British Orthopaedic Trainees’ Association.

Results

There were 876 complete responses, of whom 61.4% (n=555) were female. 46.5% (258/555) had been pregnant during surgical training. The majority (51.9%, n=134/258) stopped night on-call shifts by 30 weeks’ gestation. The most common reason for this was concerns related to tiredness and maternal health. 41% did not have rest facilities available on night shifts. 27.1% (n=70/258) of trainees did not feel supported by their department during pregnancy, and 17.1% (n=50/258) found the process of arranging maternity leave difficult or very difficult. 61% (n=118/193) of trainees felt they had returned to their normal level of working within 6 months of returning to work after maternity leave, while a significant minority took longer. 25% (n=33/135) of trainees found arranging paternity leave difficult or very difficult, and the most common source of information regarding paternity leave was other trainees.

Conclusion

Over a quarter of surgical trainees felt unsupported by their department during pregnancy, while a quarter of male trainees experience difficulty in arranging paternity leave. Efforts must be made to ensure support is available in pregnancy and maternity/paternity leave.
Analysis of sand – woven geotextile interface shear behavior using discrete element method (DEM)
Authors: Feng Shi-Jin , Chen Jie-Ni , Chen Hong-Xin , Liu Xin , Zhao T. , Zhou Annan
Published: August 2019

The interaction between soil and geotextile is essential for the performance of reinforced soil. This study reveals the microscopic mechanism of interface shear between sand and geotextile based on the discrete element method (DEM). The surface characteristics of geotextile are simulated by overlapped particles. The micromechanical parameters of sand, geotextile, and interface are calibrated effectively using laboratory test results. Three types of shear tests on the sand–geotextile interface are simulated; namely, interface direct shear test (IDST), double-sided interface shear test (D_IST), and interface direct shear test with periodic boundary (PBST). For IDST, the results show that the thickness of shear band is 2.4∼3.0 times the average particle diameter (D50); the contact force, percentage of sliding contact, and contact normal anisotropy inside the shear band are larger than those outside the shear band, whereas the coordination number is smaller inside the shear band. The mechanical response of D_IST is similar to that of IDST. However, D_IST has a shear band thickness of 3.0D50, and greater coordination number, percentage of sliding contact, and contact normal anisotropy. The results of PBST indicate that the peak stress and the shear band no longer appear without boundary constraint and the contact distribution is uniform.
Thermal relativity, modified Hawking radiation, and the generalized uncertainty principle
Authors: Castro Perelman Carlos
Published: August 2019

After a brief review of the thermal relativistic corrections to the Schwarzschild black hole entropy, it is shown how the Stefan–Boltzman law furnishes large modifications to the evaporation times of Planck-size mini-black holes, and which might furnish important clues to the nature of dark matter and dark energy since one of the novel consequences of thermal relativity is that black holes do not completely evaporate but leave a Planck size remnant. Equating the expression for the modified entropy (due to thermal relativity corrections) with Wald’s entropy should, in principle, determine the functional form of the modified gravitational Lagrangian [Formula: see text]. We proceed to derive the generalized uncertainty relation which corresponds to the effective temperature [Formula: see text] associated with thermal relativity and given in terms of the Hawking ([Formula: see text]) and Planck ([Formula: see text]) temperature, respectively. Such modified uncertainty relation agrees with the one provided by string theory up to first order in the expansion in powers of [Formula: see text]. Both lead to a minimal length (Planck size) uncertainty. Finally, an explicit analytical expression is found for the modifications to the purely thermal spectrum of Hawking radiation which could cast some light into the resolution of the black hole information paradox.
Electrochemical properties and catalytic reactivity of cobalt complexes with redox-active meso-substituted porphycene ligands
Authors: Koide Taro , Zhou Zihan , Xu Ning , Yano Yoshio , Ono Toshikazu , Luo Zhongli , Shimakoshi Hisashi , Hisaeda Yoshio
Published: August 2019

The cobalt complexes of meso-aryl substituted porphycenes were synthesized and characterized. The reduction potentials of the complexes were shifted to the positive side depending on the strength of the electron-withdrawing properties of the meso-substituents, while the optical properties, such as the absorption spectra of these complexes, were similar. This suggests that the energy levels of the molecular orbitals of the complexes were changed by the meso-substituents while the gaps of the orbitals were not significantly changed. The one-electron reduction of the complex did not afford the Co(I) species, but the ligand-reduced radical anion, which was characterized by electrospectrochemistry. The generated ligand-reduced species reacted with alkyl halides to form the Co(III)-alkyl complex. As a result, the reduction potential of the electrolytic reaction could be directly controlled by the substituents of the porphycene. The catalytic reaction with trichloromethylbenzene was also performed and it was found that the ratio of the obtained products was changed by the reduction potentials of the catalyst, [Formula: see text]. the cobalt porphycenes.
Supramolecular block copolymers incorporating chiral and achiral chromophores for the bottom-up assembly of nanomaterials
Authors: Riba-Moliner Marta , Oliveras-González Cristina , Amabilino David B. , González-Campo Arántzazu
Published: August 2019

The coordination of the chiral metalloporphyrin ([5,10,15,20-[4-([Formula: see text]-2-[Formula: see text]-octadecylamidoethyloxiphenyl]porphyrin] zinc (II)) and an achiral homologue to an amphiphilic block copolymer of poly(styrene-[Formula: see text]-4-vinyl pyridine) (PS-[Formula: see text]-P4VP) have been studied in solution and as cast material. The resulting chiral dye-polymer hybrid material has been accomplished via axial coordination between the zinc (II) metal ion in the core of the porphyrin ring and the pyridyl units of the block-copolymer in a non-coordinative solvent. The supramolecular organization and possible chirality transfer to the hybrid material have been studied in solution by UV-visible absorption spectroscopy, fluorescence spectroscopy, Nuclear Magnetic Resonance and Circular Dichroism. The morphology of the chiral and achiral doped polymers has been studied in solid state by Transmission Electron Microscopy and Atomic Force Microscopy. We show that the nanostructures formed depend greatly upon the nature of the side-chains on the porphyrins, where a chiral group leads to a very homogeneous phase-separated material, perhaps indicating that chiral side groups are useful for the preparation of this type of supramolecular hybrid.
High-efficient energy saving processing of big data of communication under mobile cloud computing
Authors: Liu Yazhen , Fan Pengfei , Zhu Jiyang , Wen Liping , Fan Xiongfei
Published: August 2019

From 21st century, it is hard for traditional storage and algorithm to provide service with high quality because of big data of communication which grows rapidly. Thus, cloud computing technology with relatively low cost of hardware facilities is created. However, to guarantee the quality of service in the situation of the rapid growth of data volume, the energy consumption cost of cloud computing begins to exceed the hardware cost. In order to solve the problems mentioned above, this study briefly introduced the virtual machine and its energy consumption model in the mobile cloud environment, introduced the basic principle of the virtual machine migration strategy based on the artificial bee colony algorithm and then simulated the performance of processing strategy to big data of communication based on artificial bee colony algorithm in mobile cloud computing environment by CloudSim3.0 software, which was compared with the performance of two algorithms, resource management (RM) and genetic algorithm (GA). The results showed that the power consumption of the migration strategy based on the artificial bee colony algorithm was lower than the other two strategies, and there were fewer failed virtual machines under the same number of requests, which meant that the service quality was higher.
Alcohol-induced microtubule acetylation leads to the accumulation of large, immobile lipid droplets
Authors: Groebner Jennifer L. , Girón-Bravo Marlene T. , Rothberg Mia L. , Adhikari Raghabendra , Tuma Dean J. , Tuma Pamela L.
Published: August 2019

Although steatosis (fatty liver) is a clinically well-described early stage of alcoholic liver disease, surprisingly little is known about how it promotes hepatotoxicity. We have shown that ethanol consumption leads to microtubule hyperacetylation that can explain ethanol-induced defects in protein trafficking. Because almost all steps of the lipid droplet life cycle are microtubule dependent and because microtubule acetylation promotes adipogenesis, we examined droplet dynamics in ethanol-treated cells. In WIF-B cells treated with ethanol and/or oleic acid (a fatty acid associated with the “Western” diet), we found that ethanol dramatically increased lipid droplet numbers and led to the formation of large, peripherally located droplets. Enhanced droplet formation required alcohol dehydrogenase-mediated ethanol metabolism, and peripheral droplet distributions required intact microtubules. We also determined that ethanol-induced microtubule acetylation led to impaired droplet degradation. Live-cell imaging revealed that droplet motility was microtubule dependent and that droplets were virtually stationary in ethanol-treated cells. To determine more directly whether microtubule hyperacetylation could explain impaired droplet motility, we overexpressed the tubulin-specific acetyltransferase αTAT1 to promote microtubule acetylation in the absence of alcohol. Droplet motility was impaired in αTAT1-expressing cells but to a lesser extent than in ethanol-treated cells. However, in both cases, the large immotile droplets (but not small motile ones) colocalized with dynein and dynactin (but not kinesin), implying that altered droplet-motor microtubule interactions may explain altered dynamics. These studies further suggest that modulating cellular acetylation is a potential strategy for treating alcoholic liver disease.

NEW & NOTEWORTHY Chronic alcohol consumption with the “Western diet” enhances the development of fatty liver and leads to impaired droplet motility, which may have serious deletrious effects on hepatocyte function.
Asynchronous action potential discharge in human muscle sympathetic nerve activity
Authors: Klassen Stephen A. , Moir M. Erin , Limberg Jacqueline K. , Baker Sarah E. , Nicholson Wayne T. , Curry Timothy B. , Joyner Michael J. , Shoemaker J. Kevin
Published: August 2019

What strategies are employed by the sympathetic system to communicate with the circulation? Muscle sympathetic nerve activity (MSNA) occurs in bursts of synchronous action potential (AP) discharge, yet whether between-burst asynchronous AP firing exists remains unknown. Using multiunit microneurography and a continuous wavelet transform to isolate APs, we studied AP synchronicity within human MSNA. Asynchronous APs were defined as those which occurred between bursts. Experiment 1 quantified AP synchronicity in eight individuals at baseline (BSL), −10 mmHg lower body negative pressure (LBNP), −40 mmHg LBNP, and end-expiratory apnea (APN). At BSL, 33 ± 12% of total AP activity was asynchronous. Asynchronous discharge was unchanged from BSL (67 ± 37 AP/min) to −10 mmHg LBNP (69 ± 33 AP/min), −40 mmHg LBNP (83 ± 68 AP/min), or APN (62 ± 39 AP/min). Across all conditions, asynchronous AP probability and frequency decreased with increasing AP size. Experiment 2 examined the impact of the ganglia on AP synchronicity by using nicotinic blockade (trimethaphan). The largest asynchronous APs were derecruited from BSL (11 ± 4 asynchronous AP clusters) to the last minute of the trimethaphan infusion with visible bursts (7 ± 2 asynchronous AP clusters). However, the 6 ± 2 smallest asynchronous AP clusters could not be blocked by trimethaphan and persisted to fire 100 ± 0% asynchronously without forming bursts. Nonnicotinic ganglionic mechanisms affect some, but not all, asynchronous activity. The fundamental behavior of human MSNA contains between-burst asynchronous AP discharge, which accounts for a considerable amount of BSL activity.

NEW & NOTEWORTHY Historically, sympathetic nerve activity destined for the blood vessels supplying skeletal muscle (MSNA) has been characterized by spontaneous bursts formed by synchronous action potential (AP) discharge. However, this study found a considerable amount (~30% during baseline) of sympathetic AP discharge to fire asynchronously between bursts of human MSNA. Trimethaphan infusion revealed that nonnicotinic ganglionic mechanisms contribute to some, but not all, asynchronous discharge. Asynchronous sympathetic AP discharge represents a fundamental behavior of MSNA.
ESTHER VAN GOBSECK E LÚCIA: PERCURSOS DE DUAS CORTESÃS
Authors: Oliveira Regina Cibelle de
Published: August 2019

Este artigo se propõe a fazer uma comparação entre dois romances oitocentistas: Splendeurs et misères des courtisanes, do escritor francês Honoré de Balzac, e Lucíola, do brasileiro José de Alencar. Do ponto de vista do assunto, os dois se aproximam por narrarem histórias sobre o amor de cortesãs, que se apaixonam e, depois de muito sofrer por amor, têm a morte como destino. No entanto, se observarmos as ações dos narradores, das personagens e mesmo das cortesãs, percebemos que se manifestam de forma diferente nos dois romances. Examinaremos assim como a profissão de cortesã é tratada nas duas obras, a partir dos discursos dos narradores, das cortesãs e das personagens no que diz respeito a essa profissão, e abordaremos alguns motivos dessas distinções.
Risk Factors for Unruptured Intracranial Aneurysms and Subarachnoid Hemorrhage in a Prospective Population-Based Study
Authors: Müller Tomm B. , Vik Anne , Romundstad Pål R. , Sandvei Marie Søfteland
Published: August 2019

Background and Purpose—

We wanted to evaluate potential risk factors for unruptured intracranial aneurysms (UIAs) and aneurysmal subarachnoid hemorrhage (aSAH) in a large, prospective study of the general population with risk factors collected before the detection of UIA or aSAH.

Methods—

All residents ≥20 years were invited to the HUNT (The Nord-Trøndelag Health Study). In this study, 89 951 participants were included. The study included standardized measurements of blood pressure and self-administered questionnaires. Cases of UIA and aSAH from 1999 to 2014 were identified using hospital records and the Norwegian Cause of Death Register. Hazard ratios with CIs were estimated using Cox regression analysis.

Results—

The detection rate of UIA was 8.2 per 100 000 person-years (97 patients). Current smoking (hazard ratio, 4.1; 95% CI, 2.4–7.1) and female sex (hazard ratio, 2.8; 95% CI, 1.7–4.5) were associated with markedly increased risk of UIA, but we found no association with systolic blood pressure (
P
for trend 0.62). The incidence of aSAH was 9.9 per 100 000 person-years (117 patients). The most important risk factors for aSAH were current smoking, female sex and increasing blood pressure (
P
for trend 0.006 for systolic blood pressure).

Conclusions—

In contrast to previous studies on risk factors of UIA, we found no association with systolic blood pressure. However, there was a strong association between systolic blood pressure and aSAH in the same population. Current smoking and female sex were associated with both diseases.
No Word is an Island—A Transformation Weighting Model for Semantic Composition
Authors: Dima Corina , de Kok Daniël , Witte Neele , Hinrichs Erhard
Published: August 2019

Composition models of distributional semantics are used to construct phrase representations from the representations of their words. Composition models are typically situated on two ends of a spectrum. They either have a small number of parameters but compose all phrases in the same way, or they perform word-specific compositions at the cost of a far larger number of parameters. In this paper we propose transformation weighting (TransWeight), a composition model that consistently outperforms existing models on nominal compounds, adjective-noun phrases, and adverb-adjective phrases in English, German, and Dutch. TransWeight drastically reduces the number of parameters needed compared with the best model in the literature by composing similar words in the same way.