START REACTS Clinical Trial : Physiotherapy Manual

In the START REACTS Trial, participants are referred to physiotherapy after having the surgical intervention. This manual provides information and background to the clinical trial to physiotherapists who will be treating trial participants. It has been written to ensure the post-operative physiotherapy is consistent across the trial population

Development of a single-session physiotherapy and self-management intervention for the treatment of primary traumatic anterior shoulder dislocation for the ‘Acute Rehabilitation following Traumatic anterior shoulder dISlocAtioN (ARTISAN)’ multi centre RCT

Objective Optimum physiotherapy management for people with a conservatively managed primary traumatic anterior shoulder dislocation is not known. The purpose of the ARTISAN trial is to compare the clinical and cost-effectiveness of a course of usual care physiotherapy with a single session of physiotherapy and self-management, the ARTISAN intervention. ARTISAN is a UK multi-centre, two-arm, parallel group, randomised controlled trial with 1:1 treatment allocation. Design The intervention was developed following the Medical Research Council framework for developing and evaluating complex interventions and will be reported in line with the template for intervention description and replication checklist (TIDieR) and the Consensus on Exercise Reporting Template (CERT). It was informed by published research, national clinical guidelines, current clinical practice and patient and public involvement. Results The ARTISAN intervention comprises education (Phase 1), progressive exercise (Phase 2 and Phase 3) and an optional return to sport component (Phase 4). Behaviour change strategies are embedded throughout intervention. The single session of physiotherapy is delivered by a chartered physiotherapist, within the first six weeks of injury, in an NHS outpatient setting. At the end of the initial session, paper-based booklets and/or a patient website with the same content are provided to participants to aid self-management and progression though the four phases of the trial intervention. Conclusion The ARTISAN intervention was successfully implemented throughout the internal pilot and is suitable for testing in the subsequent definitive RCT ARTISAN trial

Optical BVI Imaging and HI Synthesis Observations of the Dwarf Irregular Galaxy ESO 364-G 029

As part of an effort to enlarge the number of well-studied Magellanic-type galaxies, we obtained broadband optical imaging and neutral hydrogen radio synthesis observations of the dwarf irregular galaxy ESO 364-G 029. The optical morphology characteristically shows a bar-like main body with a one-sided spiral arm, an approximately exponential light distribution, and offset photometric and kinematic centers. The HI distribution is mildly asymmetric and, although slightly offset from the photometric center, roughly follows the optical brightness distribution, extending to over 1.2 Holmberg radii (where mu_B = 26.5 mag/arcsec^2). In particular, the highest HI column densities closely follow the bar, one-arm spiral, and a third optical extension. The rotation is solid-body in the inner parts but flattens outside of the optical extent. The total HI flux F_HI = 23.1 pm 1.2 Jy km/s, yielding a total HI mass M_HI= (6.4 pm 1.7) x 10^8 Msun (for a distance D = 10.8 pm 1.4 Mpc) and a total HI mass-to-blue-luminosity ratio M_HI/L_B = (0.96 pm 0.14) Msun / Lsun,B (distance independent). The HI data suggest a very complex small-scale HI structure, with evidence of large shells and/or holes, but deeper observations are required for a detailed study. Follow-up observations are also desirable for a proper comparison with the Large Magellanic Cloud, where despite an optical morphology very similar to ESO 364-G 029 the HI bears little resemblance to the optical.Comment: 10 pages, 11 figures, accepted by A&

Speech Communication

Contains research objectives and summary of research on four research projects.National Institutes of Health (Grant 5 RO1 NS04332-14)National Institutes of Health (Grant 5 T32 NS07040-02)National Institutes of Health (Fellowship 1 F22 NS00796-01)National Institutes of Health (Grant 1 ROI NS13028-01)National Institutes of Health (Grant 5 T3Z NS07040-02)National Institutes of Health (Fellowship 1 F22 MH58258-02)U. S. Army- Maryland Procurement Office (Contract MDA904-76-C-0331

The Impact of Global Warming and Anoxia on Marine Benthic Community Dynamics: an Example from the Toarcian (Early Jurassic)

The Pliensbachian-Toarcian (Early Jurassic) fossil record is an archive of natural data of benthic community response to global warming and marine long-term hypoxia and anoxia. In the early Toarcian mean temperatures increased by the same order of magnitude as that predicted for the near future; laminated, organic-rich, black shales were deposited in many shallow water epicontinental basins; and a biotic crisis occurred in the marine realm, with the extinction of approximately 5% of families and 26% of genera. High-resolution quantitative abundance data of benthic invertebrates were collected from the Cleveland Basin (North Yorkshire, UK), and analysed with multivariate statistical methods to detect how the fauna responded to environmental changes during the early Toarcian. Twelve biofacies were identified. Their changes through time closely resemble the pattern of faunal degradation and recovery observed in modern habitats affected by anoxia. All four successional stages of community structure recorded in modern studies are recognised in the fossil data (i.e. Stage III: climax; II: transitional; I: pioneer; 0: highly disturbed). Two main faunal turnover events occurred: (i) at the onset of anoxia, with the extinction of most benthic species and the survival of a few adapted to thrive in low-oxygen conditions (Stages I to 0) and (ii) in the recovery, when newly evolved species colonized the re-oxygenated soft sediments and the path of recovery did not retrace of pattern of ecological degradation (Stages I to II). The ordination of samples coupled with sedimentological and palaeotemperature proxy data indicate that the onset of anoxia and the extinction horizon coincide with both a rise in temperature and sea level. Our study of how faunal associations co-vary with long and short term sea level and temperature changes has implications for predicting the long-term effects of “dead zones” in modern oceans

Speech Communication

Contains reports on three research projects.National Institutes of Health (Grant 2 ROI NS04332)National Institutes of Health (Training Grant 5 T32 NS07040)C. J. LeBel FellowshipsNational Institutes of Health (Grant 5 RO1 NS13028)National Science Foundation (Grant BNS76-80278)National Science Foundation (Grant BNS77-26871

Biosynthetic Gene Cluster for the Cladoniamides, Bis-Indoles with a Rearranged Scaffold

The cladoniamides are bis-indole alkaloids isolated from Streptomyces uncialis, a lichen-associated actinomycete strain. The cladoniamides have an unusual, indenotryptoline structure rarely observed among bis-indole alkaloids. I report here the isolation, sequencing, and annotation of the cladoniamide biosynthetic gene cluster and compare it to the recently published gene cluster for BE-54017, a closely related indenotryptoline natural product. The cladoniamide gene cluster differs from the BE-54017 gene cluster in gene organization and in the absence of one N-methyltransferase gene but otherwise contains close homologs to all genes in the BE-54017 cluster. Both gene clusters encode enzymes needed for the construction of an indolocarbazole core, as well as flavin-dependent enzymes putatively involved in generating the indenotryptoline scaffold from an indolocarbazole. These two bis-indolic gene clusters exemplify the diversity of biosynthetic routes that begin from the oxidative dimerization of two molecules of l-tryptophan, highlight enzymes for further study, and provide new opportunities for combinatorial engineering

Speech Communication

Contains reports on two research projects.National Institutes of Health (Grant 2 ROl1 NS04332)National Institutes of Health (Training Grant 5 T32 NS07040)C.J. LeBel FellowshipsNational Science Foundation (Grant BNS77-26871