Characterisation of Death Receptor 3 dependent aortic changes during inflammatory arthritis

Murine collagen‐induced arthritis (mCIA) is characterized by decreased vascular constriction responses and increased MMP‐9. Here, we describe additional histological alterations within the aorta and surrounding perivascular adipose tissue (PVAT), study the role of PVAT in constriction response, and investigate the potential involvement of death receptor 3 (DR3). mCIA was induced in wild‐type (WT) and DR3−/− mice with nonimmunized, age‐matched controls. Vascular function was determined in isolated aortic rings ±PVAT, using isometric tension myography, in response to cumulative serotonin concentrations. Cellular expression of F4/80 (macrophages), Ly6G (neutrophils), DR3, and MMP‐9 was determined using immunohistochemistry. In WTs, arthritis‐induced vascular dysfunction was associated with increased F4/80+ macrophages and increased DR3 expression in the aorta and PVAT. MMP‐9 was also up‐regulated in PVAT, but did not correlate with alterations of PVAT intact constriction. DR3−/− mice inherently showed increased leukocyte numbers and MMP‐9 expression in the PVAT, but retained the same nonarthritic constriction response as DR3WT mice ±PVAT. Arthritic DR3−/− mice had a worsened constriction response than DR3WT and showed an influx of neutrophils to the aorta and PVAT. Macrophage numbers were also up‐regulated in DR3−/− PVAT. Despite this influx, PVAT intact DR3−/− constriction responses were restored to the same level as DR3WT. Impaired vascular constriction in inflammatory arthritis occurs independently of total MMP‐9 levels, but correlates with macrophage and neutrophil ingress. Ablating DR3 worsens the associated vasculature dysfunction, however, DR3−/− PVAT is able to protect the aorta against aberrant vasoconstriction caused in this model

Ultra-brief non-expert-delivered defusion and acceptance exercises for food cravings: A partial replication study

Food cravings are a common barrier to losing weight. This article presents a randomised comparison of non-expert group-delivered ultra-brief defusion and acceptance interventions against a distraction control. A total of 63 participants were asked to carry a bag of chocolates for a week while trying to resist the temptation to eat them. A behavioural rebound measure was administered. Each intervention out-performed control in respect of consumption, but not cravings. These techniques may have a place in the clinical management of food cravings. We provide tentative evidence that the mechanism of action is through decreased reactivity to cravings, not through reduced frequency of cravings

From victims to actors:the role of children and young people in flood recovery and resilience

Following a series of recent devastating storms across England with large numbers of homes and businesses evacuated, and despite widespread consensus that further severe flooding is expected, a large section of the population continues to be excluded from developments in flood risk management. We argue that the absence of children and young people from assessments of both the effects of flooding and ways in which it can be mitigated, undermines the effectiveness and legitimacy of policy making. Drawing on in-depth participative research with two groups of flood-affected children and young people we show the range of ways in which they are affected by flooding, some ways they can be better supported, and then how their valuable experience can help shape positive change in policy and practice before, during and after floods. Children developed Flood Manifestos for Change in a direct challenge to their omission from flood governance. The Manifestos and the steps children took to advocate for them can be seen as acts of citizenship, highlighting the capacities of children and young people as flood actors, rather than flood victims

Treatment outcomes from the largest antiretroviral treatment program in Myanmar (Burma): a cohort analysis of retention after scale-up.

Article approval pendingAntiretroviral treatment (ART) coverage in Myanmar is well below average. This study describes retention and baseline predictors of prognosis from the largest ART program in the country

Exacerbated inflammatory arthritis in response to hyperactive gp130 signalling is independent of IL-17A

Objective Interleukin (IL)-17A producing CD4 T-cells (TH-17 cells) are implicated in rheumatoid arthritis (RA). IL-6/STAT3 signalling drives TH-17 cell differentiation, and hyperactive gp130/STAT3 signalling in the gp130F/F mouse promotes exacerbated pathology. Conversely, STAT1-activating cytokines (eg, IL-27, IFN-γ) inhibit TH-17 commitment. Here, we evaluate the impact of STAT1 ablation on TH-17 cells during experimental arthritis and relate this to IL-17A-associated pathology. Methods Antigen-induced arthritis (AIA) was established in wild type (WT), gp130F/F mice displaying hyperactive gp130-mediated STAT signalling and the compound mutants gp130F/F:Stat1−/− and gp130F/F: Il17a−/− mice. Joint pathology and associated peripheral TH-17 responses were compared. Results Augmented gp130/STAT3 signalling enhanced TH-17 commitment in vitro and exacerbated joint pathology. Ablation of STAT1 in gp130F/F mice (gp130F/F: Stat1−/− ) promoted the hyperexpansion of TH-17 cells in vitro and in vivo during AIA. Despite this heightened peripheral TH-17 cell response, disease severity and the number of joint-infiltrating T-cells were comparable with that of WT mice. Thus, gp130-mediated STAT1 activity within the inflamed synovium controls T-cell trafficking and retention. To determine the contribution of IL-17A, we generated gp130F/F:IL-17a−/− mice. Here, loss of IL-17A had no impact on arthritis severity. Conclusions Exacerbated gp130/STAT-driven disease in AIA is associated with an increase in joint infiltrating T-cells but synovial pathology is IL-17A independent

岡山とギザにおける太陽エネルギーの所要量と推定

Egypt as a developed country still has no electricity in many villages but at the same time has enough natural energy such as solar energy. Solar radiation data is not always available in many areas of the world and they have to be estimated using some sort of empirical model. The results of this prediction are compared for the measured data of two different countries: Japan (Okayama City) and Egypt (Giza City). The comparison shows an acceptable level of prediction between both of them. On a June day, actual accumulated insolation through one day was 18.88 MJ/m2 in Okayama and 22.79 MJ/m2 in Giza. On the other hand on a January day, actual accumulated insolation through one day was 4.93 MJ/m2 in Okayama and 5.49 MJ/m2 in Giza. We can see also that in January the worst solar month, solar water heaters still provide 35.25% of the energy for Okayama and 40.37% for Giza, That was because in Okayama the number of sunny days was only 6 but there were 19 in Giza.太陽エネルギーを農業に有効利用する目的で、岡山とエジプト・ギザを観測地点として、獲得できるエネルギーの量を観測し、2地点での比較を行った。岡山とギザでは緯度が、34°39'と30°02'と異なるために集めることができる太陽エネルギーの量に差が生じ、その量はギザの方が多くなり農業への有効利用の可能性が大である

Effecting change in primary care management of respiratory conditions : a global scoping exercise and literature review of educational interventions to inform the IPCRG's E-Quality initiative

This discussion paper describes a scoping exercise and literature review commissioned by the International Primary Care Respiratory Group (IPCRG) to inform their E-Quality programme which seeks to support small-scale educational projects to improve respiratory management in primary care. Our narrative review synthesises information from three sources: publications concerning the global context and health systems development; a literature search of Medline, CINAHL and Cochrane databases; and a series of eight interviews conducted with members of the IPCRG faculty. Educational interventions sit within complex healthcare, economic, and policy contexts. It is essential that any development project considers the local circumstances in terms of economic resources, political circumstances, organisation and administrative capacities, as well as the specific quality issue to be addressed. There is limited evidence (in terms of changed clinician behaviour and/or improved health outcomes) regarding the merits of different educational and quality improvement approaches. Features of educational interventions that were most likely to show some evidence of effectiveness included being carefully designed, multifaceted, engaged health professionals in their learning, provided ongoing support, were sensitive to local circumstances, and delivered in combination with other quality improvement strategies. To be effective, educational interventions must consider the complex healthcare systems within which they operate. The criteria for the IPCRG E-Quality awards thus require applicants not only to describe their proposed educational initiative but also to consider the practical and local barriers to successful implementation, and to propose a robust evaluation in terms of changed clinician behaviour or improved health outcomes.The IPCRG commissioned this work as part of the IPCRG e-Quality initiative. HP is supported by a Primary Care Research Career Award from the Chief Scientist's Office of the Scottish Government