The role of fluctuating soundscapes in shaping the emotional geographies of individuals living with Ménière’s disease

This is the author accepted manuscript. The final version is available from Taylor & Francis via the DOI in this record.The potential for everyday soundscapes to evoke diverse emotions amongst different cultural and acoustic communities is increasingly recognised within the literature. However, few studies have examined how these soundscapes can shift with the onset and progression of specific hearing impairments. This paper explores such shifts, drawing on a series of in-depth narrative interviews conducted in the south west of England with individuals diagnosed with Ménière’s disease; a long-term progressive vestibular disorder characterised by episodes of vertigo, tinnitus, sensorineural hearing loss and, for some people, hyperacusis (high sensitivity to sudden irregular sounds). Located in the subfield of ‘emotional geographies’, the paper discusses how participants were forced to connect with and attune to previously unremarkable aspects of their everyday soundscapes in ways that were both emotionally and socially challenging. Four aspects of participants’ embodied, emotional soundscapes are critically explored: hearing life in ‘2D’; corporeal and environmental ‘sonic intruders’; corporeal sound ‘symbols’; and seeking to regain a semblance of control through soundscape (re)-negotiations. Such insights are important to inform conscious acoustic design efforts that respect the ‘ears and voice’ of people living with varying levels of auditory sensitivity, rather than urban and community planning policies that continue to prioritise vision and transit.This work was supported by the Ménière’s Society with further follow-on funding provided by PenCLAHRC (no grant numbers given)

Using structural information to change the phosphotransfer specificity of a two-component chemotaxis signalling complex.

addresses: Oxford Centre for Integrative Systems Biology, Department of Biochemistry, University of Oxford, Oxford, United Kingdom.notes: PMCID: PMC2817712types: Journal Article; Research Support, Non-U.S. Gov'tCopyright: © 2010 Bell et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.Two-component signal transduction pathways comprising histidine protein kinases (HPKs) and their response regulators (RRs) are widely used to control bacterial responses to environmental challenges. Some bacteria have over 150 different two-component pathways, and the specificity of the phosphotransfer reactions within these systems is tightly controlled to prevent unwanted crosstalk. One of the best understood two-component signalling pathways is the chemotaxis pathway. Here, we present the 1.40 A crystal structure of the histidine-containing phosphotransfer domain of the chemotaxis HPK, CheA(3), in complex with its cognate RR, CheY(6). A methionine finger on CheY(6) that nestles in a hydrophobic pocket in CheA(3) was shown to be important for the interaction and was found to only occur in the cognate RRs of CheA(3), CheY(6), and CheB(2). Site-directed mutagenesis of this methionine in combination with two adjacent residues abolished binding, as shown by surface plasmon resonance studies, and phosphotransfer from CheA(3)-P to CheY(6). Introduction of this methionine and an adjacent alanine residue into a range of noncognate CheYs, dramatically changed their specificity, allowing protein interaction and rapid phosphotransfer from CheA(3)-P. The structure presented here has allowed us to identify specificity determinants for the CheA-CheY interaction and subsequently to successfully reengineer phosphotransfer signalling. In summary, our results provide valuable insight into how cells mediate specificity in one of the most abundant signalling pathways in biology, two-component signal transduction

Impact of a COPD Discharge Care Bundle on Readmissions following Admission with Acute Exacerbation: Interrupted Time Series Analysis.

We evaluated the impact of a COPD discharge care bundle on readmission rates following hospitalisation with an acute exacerbation.Interrupted time series analysis, comparing readmission rates for COPD exacerbations at nine trusts that introduced the bundle, to two comparison groups; (1) other NHS trusts in London and (2) all other NHS trusts in England. Care bundles were implemented at different times for different NHS trusts, ranging from October 2009 to April 2011.Nine NHS acute trusts in the London, England.Patients aged 45 years and older admitted to an NHS acute hospital in England for acute exacerbation of COPD. Data come from Hospital Episode Statistics, April 2002 to March 2012.Annual trend readmission rates (and in total bed days) within 7, 28 and 90 days, before and after implementation.In hospitals introducing the bundle readmission rates were rising before implementation and falling afterwards (e.g. readmissions within 28 days +2.13% per annum (pa) pre and -5.32% pa post (p for difference in trends = 0.012)). Following implementation, readmission rates within 7 and 28 day were falling faster than among other trusts in London, although this was not statistically significant (e.g. readmissions within 28 days -4.6% pa vs. -3.2% pa, p = 0.44). Comparisons with a national control group were similar.The COPD discharge care bundle appeared to be associated with a reduction in readmission rate among hospitals using it. The significance of this is unclear because of changes to background trends in London and nationally

Evidence of a high incidence of subclinically affected calves in a herd of cattle with fatal cases of Bovine Neonatal Pancytopenia (BNP).

BACKGROUND: Bovine Neonatal Pancytopenia (BNP) is a disease of calves characterised by bone marrow trilineage hypoplasia, mediated by ingestion of alloantibodies in colostrum. Suspected subclinical forms of BNP have been reported, suggesting that observed clinical cases may not represent the full extent of the disease. However to date there are no objective data available on the incidence of subclinical disease or its temporal distribution. This study aimed to 1) ascertain whether subclinical BNP occurs and, if so, to determine the incidence on an affected farm and 2) determine whether there is evidence of temporal clustering of BNP cases on this farm. To achieve these aims, haematological screening of calves born on the farm during one calving season was carried out, utilising blood samples collected at defined ages. These data were then analysed in comparison to data from both known BNP-free control animals and histopathologically confirmed BNP cases. An ordinal logistic regression model was used to create a composite haematology score to predict the probabilities of calves being normal, based on their haematology measurements at 10–14 days old. RESULTS: This study revealed that 15% (21 of 139) of the clinically normal calves on this farm had profoundly abnormal haematology (<5% chance of being normal) and could be defined as affected by subclinical BNP. Together with clinical BNP cases, this gave the study farm a BNP incidence of 18%. Calves with BNP were found to be distributed throughout the calving period, with no clustering, and no significant differences in the date of birth of cases or subclinical cases were found compared to the rest of the calves. This study did not find any evidence of increased mortality or increased time from birth to sale in subclinical BNP calves but, as the study only involved a single farm and adverse effects may be determined by other inter-current diseases it remains possible that subclinical BNP has a detrimental impact on the health and productivity of calves under certain circumstances. CONCLUSIONS: Subclinical BNP was found to occur at a high incidence in a herd of cattle with fatal cases of BNP

Derivation and validation of a simple, accurate and robust prediction rule for risk of mortality in patients with Clostridium difficile infection.

Published onlineJournal ArticleResearch Support, Non-U.S. Gov'tBACKGROUND: Clostridium difficile infection poses a significant healthcare burden. However, the derivation of a simple, evidence based prediction rule to assist patient management has not yet been described. METHOD: Univariate, multivariate and decision tree procedures were used to deduce a prediction rule from over 186 variables; retrospectively collated from clinical data for 213 patients. The resulting prediction rule was validated on independent data from a cohort of 158 patients described by Bhangu et al. (Colorectal Disease, 12(3):241-246, 2010). RESULTS: Serum albumin levels (g/L) (P = 0.001), respiratory rate (resps /min) (P = 0.002), C-reactive protein (mg/L) (P = 0.034) and white cell count (mcL) (P = 0.049) were predictors of all-cause mortality. Threshold levels of serum albumin ≤ 24.5 g/L, C- reactive protein >228 mg/L, respiratory rate >17 resps/min and white cell count >12 × 10(3) mcL were associated with an increased risk of all-cause mortality. A simple four variable prediction rule was devised based on these threshold levels and when tested on the initial data, yield an area under the curve score of 0.754 (P < 0.001) using receiver operating characteristics. The prediction rule was then evaluated using independent data, and yield an area under the curve score of 0.653 (P = 0.001). CONCLUSIONS: Four easily measurable clinical variables can be used to assess the risk of mortality of patients with Clostridium difficile infection and remains robust with respect to independent data.This work was funded by University of Exeter, Systems Biology Initiative, a small grants fund from the RD&E NHS Trust and The National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care (CLAHRC) for the South West Peninsula (PenCLAHRC). This article presents independent research funded by the National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care (CLAHRC) for the South West Peninsula. The views expressed in this publication are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health in England

Free randomness can be amplified

Are there fundamentally random processes in nature? Theoretical predictions, confirmed experimentally, such as the violation of Bell inequalities, point to an affirmative answer. However, these results are based on the assumption that measurement settings can be chosen freely at random, so assume the existence of perfectly free random processes from the outset. Here we consider a scenario in which this assumption is weakened and show that partially free random bits can be amplified to make arbitrarily free ones. More precisely, given a source of random bits whose correlation with other variables is below a certain threshold, we propose a procedure for generating fresh random bits that are virtually uncorrelated with all other variables. We also conjecture that such procedures exist for any non-trivial threshold. Our result is based solely on the no-signalling principle, which is necessary for the existence of free randomness.Comment: 5+7 pages, 2 figures. Updated to match published versio

Experiencing nature with sight impairment: seeking freedom from ableism

This is the author accepted manuscript. The final version is available from SAGE Publications via the DOI in this record.Data Accessibility: Due to ethical concerns of maintaining participant confidentiality, the research data supporting this publication are not publicly available.The idea of nature as freedom has long captured the human imagination, particularly since the Romantic era when notions of escapism were underpinned by the idealisation and externalisation of nature. The drive for freedom persists in the findings of much contemporary research examining the contribution of nature to human health and wellbeing. Yet, this work tells us little about how cultural narratives of freedom play out in the lives of people living with impairment and disability, or the constraining ableist assumptions that often underpin popular discourses of nature. This paper aims to address this, drawing on the findings of an in-­‐depth qualitative study exploring how 31 people with varying forms and severities of sight impairment, living in rural and urban areas of England, describe their experiences with(in) diverse types of nature through the life course. Moving beyond the ‘wilderness ideal’ and sensationalised ‘supercrip’ stories that reproduce ableist ideas of bodies without limitation, this paper foregrounds the richly textured ways in which participants experienced feelings of freedom with nonhuman nature. These freedoms are characterised as social, mobile and exploratory. In doing so, it seeks to make room for a range of nature experiences, folding social justice into the growing momentum to connect people with nature in the name of health and wellbeing.Economic and Social Research Council (ESRC

Limit Cycles in Four Dimensions

We present an example of a limit cycle, i.e., a recurrent flow-line of the beta-function vector field, in a unitary four-dimensional gauge theory. We thus prove that beta functions of four-dimensional gauge theories do not produce gradient flows. The limit cycle is established in perturbation theory with a three-loop calculation which we describe in detail.Comment: 12 pages, 1 figure. Significant revision of the interpretation of our result. Improved description of three-loop calculatio

Built-in and induced polarization across LaAlO3_3/SrTiO3_3 heterojunctions

Ionic crystals terminated at oppositely charged polar surfaces are inherently unstable and expected to undergo surface reconstructions to maintain electrostatic stability. Essentially, an electric field that arises between oppositely charged atomic planes gives rise to a built-in potential that diverges with thickness. In ultra thin film form however the polar crystals are expected to remain stable without necessitating surface reconstructions, yet the built-in potential has eluded observation. Here we present evidence of a built-in potential across polar \lao ~thin films grown on \sto ~substrates, a system well known for the electron gas that forms at the interface. By performing electron tunneling measurements between the electron gas and a metallic gate on \lao ~we measure a built-in electric field across \lao ~of 93 meV/\AA. Additionally, capacitance measurements reveal the presence of an induced dipole moment near the interface in \sto, illuminating a unique property of \sto ~substrates. We forsee use of the ionic built-in potential as an additional tuning parameter in both existing and novel device architectures, especially as atomic control of oxide interfaces gains widespread momentum.Comment: 6 pages, 4 figures. Submitted to Nature physics on May 1st, 201

True Neutrality as a New Type of Flavour

A classification of leptonic currents with respect to C-operation requires the separation of elementary particles into the two classes of vector C-even and axial-vector C-odd character. Their nature has been created so that to each type of lepton corresponds a kind of neutrino. Such pairs are united in families of a different C-parity. Unlike the neutrino of a vector type, any C-noninvariant Dirac neutrino must have his Majorana neutrino. They constitute the purely neutrino families. We discuss the nature of a corresponding mechanism responsible for the availability in all types of axial-vector particles of a kind of flavour which distinguishes each of them from others by a true charge characterized by a quantum number conserved at the interactions between the C-odd fermion and the field of emission of the corresponding types of gauge bosons. This regularity expresses the unidenticality of truly neutral neutrino and antineutrino, confirming that an internal symmetry of a C-noninvariant particle is described by an axial-vector space. Thereby, a true flavour together with the earlier known lepton flavour predicts the existence of leptonic strings and their birth in single and double beta decays as a unity of flavour and gauge symmetry laws. Such a unified principle explains the availability of a flavour symmetrical mode of neutrino oscillations.Comment: 19 pages, LaTex, Published version in IJT