From the Ground Up: Strengthening Health Systems at District Level (Introduction)

This supplement introduces the African Health Initiative (AHI), a research program comprised of five unique district health system-strengthening activities in Ghana, Mozambique, Rwanda, Tanzania, and Zambia that beganin 2009. This supplement should be of interest to all engaged in improving delivery of district primary health care -- whether ministries of health, service providers, funders, or those who evaluate complex interventions. The five AHI projects, known as Population Health Implementation and Training (PHIT) Partnerships, are funded by the Doris Duke Charitable Foundation (DDCF) with a common goal: to produce significant, measureable health improvements in a defined geographic area over a five to seven year grant period.With the partnerships in their fourth year of funding, it is now possible to capture lessons learned in project design and implementation. Evaluation of the African Health Initiative's impact on population health, including mortality, however, mustawait the conclusion of the grant period

Massless Metric Preheating

Can super-Hubble metric perturbations be amplified exponentially during preheating ? Yes. An analytical existence proof is provided by exploiting the conformal properties of massless inflationary models. The traditional conserved quantity \zeta is non-conserved in many regions of parameter space. We include backreaction through the homogeneous parts of the inflaton and preheating fields and discuss the role of initial conditions on the post-preheating power-spectrum. Maximum field variances are strongly underestimated if metric perturbations are ignored. We illustrate this in the case of strong self-interaction of the decay products. Without metric perturbations, preheating in this case is very inefficient. However, metric perturbations increase the maximum field variances and give alternative channels for the resonance to proceed. This implies that metric perturbations can have a large impact on calculations of relic abundances of particles produced during preheating.Comment: 8 pages, 4 colour figures. Version to appear in Phys. Rev. D. Contains substantial new analysis of the ranges of parameter space for which large changes to the inflation-produced power spectrum are expecte

The Relationship between the UniProt Knowledgebase (UniProtKB) and the IntAct Molecular Interaction Databases

IntAct provides a freely available, open source database system and analysis tools for protein interaction data. All interactions are derived from literature curation or direct user submission and all experimental information relating to binary protein-protein
interactions is entered into the IntAct database by curators, via a web-based editor. Interaction information is added to the SUBUNIT comment and the RP line of the relevant publication within the UniProtKB entry. There may be a single INTERACTION comment present within a UniProtKB entry, which conveys information relevant to binary protein-protein interactions. This is automatically derived from the IntAct database and is updated on a triweekly basis. Interactions can be derived by any appropriate experimental method but must be confirmed by a second interaction if resulting from a single yeast2hybrid experiment. For large-scale experiments, interactions are considered if a high confidence score is assigned by the authors. The INTERACTION line contains a direct link to IntAct that provides detailed information for the experimental support. These lines are not changed manually and any discrepancy is reported to IntAct for updates. There is also a database crossreference line within the UniProtKB entry i.e.: DR IntAct _UniProtKB AC, which directs the user to additional interaction data for that molecule. 
UniProt is supported by grants from the National Institutes of Health, European Commission, Swiss Federal Government and PATRIC BRC.
IntAct is funded by the European Commission under FELICS, contract number 021902 (RII3) within the Research Infrastructure Action of the FP6 "Structuring the European Research Area" Programme

Volume Based Feeding Versus Rate Based Feeding in the Critically Ill: A UK Study

Background Underfeeding in intensive care patients on enteral nutrition is commonplace and multifactorial. This can be exacerbated by interruptions caused by routine fasting for procedures and investigations. Our study aims to demonstrate that a volume based feeding protocol can overcome the barriers of underfeeding and safely increase energy and protein delivery in UK intensive care patients, potentially improving clinical outcomes. Methods In this single centre cohort study, data were collected from adult mechanically ventilated patients. We compared the standard care of rate based feeding, from an International Nutrition Survey (2014/15) to the new intervention of volume based feeding, in a mixed medical and surgical intensive care unit. The primary outcomes were the proportion of energy and protein daily targets delivered. Secondary outcomes compared the effects on gastrointestinal tolerance, glycaemic control, mortality, mechanical ventilation days, length of stay in intensive care unit and hospital. Results From a total of 82 patients (rate based feeding = 27, volume based feeding = 55), volume based feeding patients received significantly more prescribed energy (52% versus 81%; p < 0.001) and protein (40% versus 74%; p < 0.001). There was no significant difference in gastrointestinal symptoms such as gastric residual volumes (p = 0.62), glycaemic control (p = 0.94) or insulin usage (p = 0.75). Although there was an improvement in energy and protein delivery, there were no differences in mechanical ventilation days (p = 0.12), mortality (p = 0.06), length of stay in intensive care unit (p = 0.93) and hospital (p = 0.72) between the groups. Conclusion Compared to rate based feeding, volume based feeding significantly improved energy and protein provision with no adverse effects on glycaemic control or gastrointestinal tolerance, clinical outcomes were not affected

A new twist to preheating

Metric perturbations typically strengthen field resonances during preheating. In contrast we present a model in which the super-Hubble field resonances are completely {\em suppressed} when metric perturbations are included. The model is the nonminimal Fakir-Unruh scenario which is exactly solvable in the long-wavelength limit when metric perturbations are included, but exhibits exponential growth of super-Hubble modes in their absence. This gravitationally enhanced integrability is exceptional, both for its rarity and for the power with which it illustrates the importance of including metric perturbations in consistent studies of preheating. We conjecture a no-go result - there exists no {\em single-field} model with growth of cosmologically-relevant metric perturbations during preheating.Comment: 6 pages, 3 figures, Version to appear in Physical Review

Static post-Newtonian equivalence of GR and gravity with a dynamical preferred frame

A generally covariant extension of general relativity (GR) in which a dynamical unit timelike vector field is coupled to the metric is studied in the asymptotic weak field limit of spherically symmetric static solutions. The two post-Newtonian parameters known as the Eddington-Robertson-Schiff parameters are found to be identical to those in the case of pure GR, except for some non-generic values of the coefficients in the Lagrangian.Comment: 13 pages; v.2: minor editing, signs corrected, version to appear in PRD; v. 3: signs corrected in eqn (3

Controllability of structural brain networks.

Cognitive function is driven by dynamic interactions between large-scale neural circuits or networks, enabling behaviour. However, fundamental principles constraining these dynamic network processes have remained elusive. Here we use tools from control and network theories to offer a mechanistic explanation for how the brain moves between cognitive states drawn from the network organization of white matter microstructure. Our results suggest that densely connected areas, particularly in the default mode system, facilitate the movement of the brain to many easily reachable states. Weakly connected areas, particularly in cognitive control systems, facilitate the movement of the brain to difficult-to-reach states. Areas located on the boundary between network communities, particularly in attentional control systems, facilitate the integration or segregation of diverse cognitive systems. Our results suggest that structural network differences between cognitive circuits dictate their distinct roles in controlling trajectories of brain network function

A cross-sectional survey of cardiovascular health and lifestyle habits of hospital staff in the UK: Do we look after ourselves?

Background: A high prevalence of stress-related disorders is well known among healthcare professionals. We set out to assess the prevalence of cardiovascular risk factors and compliance with national dietary and physical activity recommendations in NHS staff in the UK with comparison between clinical and non-clinical staff, and national surveys. Design: A multi-centre cross-sectional study. Methods: A web-based questionnaire was developed to include anonymised data on demographics, job role, cardiovascular risk factors and diseases, dietary habits, physical activity and barriers towards healthy lifestyle. This was distributed to staff in four NHS hospitals via emails. Results: A total of 1158 staff completed the survey (response rate 13%) with equal distribution between the clinical and non-clinical groups. Most staff were aged 26–60 years and 79% were women. Half of the staff were either overweight or obese (51%) with no difference between the groups (P = 0.176), but there was a lower prevalence of cardiovascular risk factors compared to the general population. The survey revealed a low compliance (17%) with the recommended intake of five-a-day portions of fruit and vegetables, and that of moderate or vigorous physical activity (56%), with no difference between the clinical and non-clinical staff (P = 0.6). However, more clinical staff were exceeding the alcohol recommendations (P = 0.02). Lack of fitness facilities and managerial support, coupled with long working hours, were the main reported barriers to a healthy lifestyle. Conclusions: In this survey of UK NHS staff, half were found to be overweight or obese with a lower prevalence of cardiovascular risk factors compared to the general population. There was a low compliance with the five-a-day fruit and vegetables recommendation and physical activity guidelines, with no difference between the clinical and non-clinical staff