How will EMU affect Cohesion?

The new policy environment of EMU affects economic, political, and social cohesion in different ways: the policy mix and menu will be reconfigured; it will provide for more macroeconomic stability in cohesion countries; economic competition will intensify and change patterns of specialisation; and comparison of living standards will become easier which puts pressure on policymakers to reduce inequalities. This article assesses the significance of these effects and their likely consequences in the short, medium and long run. Then the salient cohesion issues regarding Eastern enlargement are discussed. Finally, policy conclusions are drawn, mindful of the considerable uncertainties that warrant further research.cohesion, EMU, regional development, macroeconomic stability, enlargement

European investment bank: the UK will miss it when it is gone

European Investment Bank loans have been present in every important sector of the UK economy. The UK will miss that gold-plated source of project finance when it is gone, write Brian Unwin and Iain Begg

Effect of Aging on the Reversibility of Pu(IV) Sorption to Goethite

Designing safe remediation and disposal strategies for plutonium (Pu) requires understanding the sorption affinity of Pu for soil minerals. Sorption of Pu(IV) was examined with respect to aging for a goethite system using batch sorption experiments. Sorption of Pu(IV) to iron oxides has been observed to be strong, rapid, and possibly irreversible or hysteretic. These observations may be explained by aging, a surface chemical process happening after initial sorption which causes a change in contaminant surface speciation over time. Measurements of Pu(IV) sorption are often complicated by oxidative leaching of Pu(IV) as Pu(V). Desferrioxamine B (DFOB) is a complexant capable of competing with the proposed strong surface complexes. Additionally, DFOB minimizes oxidative leaching by forming strong Pu(IV)-DFOB complexes, thereby stabilizing Pu(IV) as the dominant aqueous oxidation state. Pu(IV) was reacted in suspensions of 0.1g/L goethite and 10mM NaCl spanning pH 4–7 for various lengths of time (1,6,15,34 and 116 days). Supernatant was replaced with a 1.7µM DFOB solution and, after 34 more days, analyzed for aqueous Pu by liquid scintillation counting. Modeling sorption curves in FITEQL yielded logK values which increased from 0.078 to 0.953 over 116 days, indicating Pu(IV) sorption onto goethite becomes less reversible with aging

EFFECTS OF STATIC STRETCHING ON MAXIMAL ISOKINETIC TORQUE

The effects of 20 seconds of agonist (AGO), antagonist (ANT) or no (NO) pre-exercise stretch on concentric (CON) and eccentric (ECC) maximal isokinetic torque produced at the knee were examined. Twelve male semi-pro rugby players performed dominant isokinetic knee extension following the specified stretch protocol. One-way Repeated Measures ANOVA revealed AGO to be significantly less (p < 0.05) than the other protocols for both CON (270 28 Nm) and ECC (309 42 Nm) torque. There was no difference between the ANT or NO for either CON (303 35 Nm and 304 38 Nm, respectively) or ECC (341 40 Nm and 33644 Nm). The results support the theory that pre-exercise agonist stretching may lead to performance decrements in maximal concentric torque production

Inter- and intra-observer reliability and agreement of O2Pulse inflection during cardiopulmonary exercise testing: a comparison of subjective and novel objective methodology.

Cardiopulmonary exercise testing (CPET) is the 'gold standard' method for evaluating functional capacity, with oxygen pulse (O2Pulse) inflections serving as a potential indicator of myocardial ischaemia. However, the reliability and agreement of identifying these inflections have not been thoroughly investigated. This study aimed to assess the inter- and intra-observer reliability and agreement of a subjective quantification method for identifying O2Pulse inflections during CPET, and to propose a more robust and objective novel algorithm as an alternative methodology. A retrospective analysis was conducted using baseline data from the HIIT or MISS UK trial. The O2Pulse curves were visually inspected by two independent examiners, and compared against an objective algorithm. Fleiss' Kappa was used to determine the reliability of agreement between the three groups of observations. The results showed almost perfect agreement between the algorithm and both examiners, with a Fleiss' Kappa statistic of 0.89. The algorithm also demonstrated excellent inter-rater reliability (ICC) when compared to both examiners (0.92-0.98). However, a significant level (P ≤0.05) of systematic bias was observed in Bland-Altman analysis for comparisons involving the novice examiner. In conclusion, this study provides evidence for the reliability of both subjective and novel objective methods for identifying inflections in O2Pulse during CPET. These findings suggest that further research into the clinical significance of O2Pulse inflections is warranted, and that the adoption of a novel objective means of quantification may be preferable to ensure equality of outcome for patients

The broad-spectrum antimicrobial potential of [Mn(CO)4(S2CNMe(CH2CO2H))], a water-soluble CO-releasing molecule (CORM-401): intracellular accumulation, transcriptomic and statistical analyses, and membrane Polarization

Aims: Carbon monoxide (CO)-releasing molecules (CORMs) are candidates for animal and antimicrobial therapeutics. We aimed to probe the antimicrobial potential of a novel manganese CORM. Results: [Mn(CO)4S2CNMe(CH2CO2H)], CORM-401, inhibits growth of Escherichia coli and several antibiotic-resistant clinical pathogens. CORM-401 releases CO that binds oxidases in vivo, but is an ineffective respiratory inhibitor. Extensive CORM accumulation (assayed as intracellular manganese) accompanies antimicrobial activity. CORM-401 stimulates respiration, polarizes the cytoplasmic membrane in an uncoupler-like manner, and elicits loss of intracellular potassium and zinc. Transcriptomics and mathematical modeling of transcription factor activities reveal a multifaceted response characterized by elevated expression of genes encoding potassium uptake, efflux pumps, and envelope stress responses. Regulators implicated in stress responses (CpxR), respiration (Arc, Fnr), methionine biosynthesis (MetJ), and iron homeostasis (Fur) are significantly disturbed. Although CORM-401 reduces bacterial growth in combination with cefotaxime and trimethoprim, fractional inhibition studies reveal no interaction. Innovation: We present the most detailed microbiological analysis yet of a CORM that is not a ruthenium carbonyl. We demonstrate CO-independent striking effects on the bacterial membrane and global transcriptomic responses. Conclusions: CORM-401, contrary to our expectations of a CO delivery vehicle, does not inhibit respiration. It accumulates in the cytoplasm, acts like an uncoupler in disrupting cytoplasmic ion balance, and triggers multiple effects, including osmotic stress and futile respiration

CDKN2A Germline Mutations in Individuals with Cutaneous Malignant Melanoma

Cyclin-dependent kinase inhibitor type 2A (CDKN2A) has been identified as a major melanoma susceptibility gene based on the presence of germline mutations in high-risk melanoma families. In this study, we sought to identify and characterize the spectrum of CDKN2A mutations affecting p16 inhibitor of cyclin-dependent kinase type 4 (INK4a) in individuals with melanoma using a population-based study design. DNA samples from 1189 individuals with incident multiple primary melanoma (MPM) and 2424 with incident single primary melanoma unselected for family history of melanoma were available for screening of CDKN2A (p16INK4a) mutations. Variants were classified for functional impact based on intragenic position, existing functional data, sequence, and structural analysis. The impact of individual mutations and functional groupings was assessed by comparing frequencies in cases of MPM versus cases with a single first primary melanoma, and by comparing the reported incidence rates in first-degree relatives. Our results show that mutations occur infrequently in these high-risk groups, and that they occur mainly in exons 1alpha and 2. Rare coding variants with putative functional impact are observed to increase substantially the risk of melanoma. With the exception of the variant in position -34 of CDKN2A of known functional consequence, the remaining rare variants in the non-coding region have no apparent impact on risk

Diabetes Mellitus Increases the Risk of Active Tuberculosis: A Systematic Review of 13 Observational Studies

In a systematic review and meta-analysis including more than 17,000 tuberculosis cases, Christie Jeon and Megan Murray find that diabetes mellitus is associated with an approximately 3-fold increased risk of tuberculosis

Outcomes of Operatively Treated Acute Knee Dislocations

Knee dislocation is a complex and rare injury often presenting in the context of high velocity trauma. The aim of this study is to establish the subjective outcomes of surgically treated knee dislocations. A total of 20 knees dislocations treated by open repair were reviewed. Their progress and outcomes were assessed by using a modified Lysholm score questionnaire. Data was obtained on patient demographics, details of injury, investigation, treatment, rehabilitation, 24 months objective outcome and subjective outcomes. Six patients had a vascular deficit and six had neurological deficits. The median range of motion was 0°-100°. Patients with an initially lower pre-injury level of function were able to return an activity level comparable to their pre-injury status. 22% of competitive athletes retuned to competitive sports. 38% of patients undertaking heavy activity returned to comparable pre-injury level of activity and 67% of patients undertaking moderate level of activity before injury returned to a comparable level after repair. 68% regularly had problems running, 70% problem squatting, 40% swelling and 42% problem with stairs. Most patients however did not have locking of the knee or problems with knees giving way. Patients pain scores decreased over time to an acceptable level. Despite the severity of the injury, majority of patients achieved a satisfactory outcome, although none of the patients reached the same level of function as before the injury. 80% of the patients were satisfied with their outcome. All dissatisfied patients suffered postoperative complications

High-intensity interval training versus moderate-intensity steady-state training in UK cardiac rehabilitation programmes (HIIT or MISS UK): study protocol for a multicentre randomised controlled trial and economic evaluation

Introduction: Current international guidelines for cardiac rehabilitation (CR) advocate moderate-intensity exercise training (MISS, moderate-intensity steady state). This recommendation predates significant advances in medical therapy for coronary heart disease (CHD) and may not be the most appropriate strategy for the ‘modern’ patient with CHD. High-intensity interval training (HIIT) appears to be a safe and effective alternative, resulting in greater improvements in peak oxygen uptake (VO2 peak). To date, HIIT trials have predominantly been proof-of-concept studies in the laboratory setting and conducted outside the UK. The purpose of this multicentre randomised controlled trial is to compare the effects of HIIT and MISS training in patients with CHD attending UK CR programmes. Methods and analysis: This pragmatic study will randomly allocate 510 patients with CHD to 8 weeks of twice weekly HIIT or MISS training at 3 centres in the UK. HIIT will consist of 10 high-intensity (85–90% peak power output (PPO)) and 10 low-intensity (20–25% PPO) intervals, each lasting 1 min. MISS training will follow usual care recommendations, adhering to currently accepted UK guidelines (ie, >20 min continuous exercise at 40–70% heart rate reserve). Outcome measures will be assessed at baseline, 8 weeks and 12 months. The primary outcome for the trial will be change in VO2 peak as determined by maximal cardiopulmonary exercise testing. Secondary measures will assess physiological, psychosocial and economic outcomes. Ethics and dissemination: The study protocol V.1.0, dated 1 February 2016, was approved by the NHS Health Research Authority, East Midlands— Leicester South Research Ethics Committee (16/EM/ 0079). Recruitment will start in August 2016 and will be completed in June 2018. Results will be published in peer-reviewed journals, presented at national and international scientific meetings and are expected to inform future national guidelines for exercise training in UK CR. Trial registration number: NCT02784873; pre-results