Rehabilitation interventions to modify physical frailty in adults before lung transplantation: A systematic review protocol

Introduction: Lung transplantation is the gold standard treatment for end-stage lung disease for a small group of patients meeting strict acceptance criteria after optimal medical management has failed. Physical frailty is prevalent in lung transplant candidates and has been linked to worse outcomes both on the waiting list and postoperatively. Exercise has been proven to be beneficial in optimising exercise capacity and quality of life in lung transplant candidates but its impact on physical frailty is unknown. This review aims to assess the effectiveness of exercise interventions in modifying physical frailty for adults awaiting lung transplantation. Methods and Analysis: This protocol was prospectively registered on the PROSPERO database. We will search four databases plus trials registries to identify primary studies of adult candidates for lung transplantation undertaking exercise interventions and assessing outcomes pertaining to physical frailty. Studies must include at least ten participants. Article screening will be performed by two researchers independently at each stage. Extraction will be performed by one reviewer and checked by a second. The risk of bias in studies will be assessed by two independent reviewers using tools appropriate for the research design of each study; where appropriate we will use Cochrane risk of bias 2 or ROBINS-I. At each stage of the review process discrepancies will be resolved through consensus or consultation with a third reviewer. Meta-analyses of frailty outcomes, will be performed if possible and appropriate as will pre-specified subgroup and sensitivity analyses. Where we are unable to perform meta-analysis we will conduct narrative synthesis following SWiM guidance. The review will be reported using the PRISMA Checklist.Ethics and Dissemination: No ethical issues are predicted due to the nature of this study. Dissemination will occur via conference abstracts, professional networks, peer reviewed journals and patient support groups. Registration Details: PROSPERO registration number CRD42022363730

Emergence of a spin microemulsion in spin-orbit coupled Bose-Einstein condensates

We report the first observation of a ``spin microemulsion''-- a phase with undulating spin domains resembling classical bicontinuous oil-water-surfactant emulsions -- in two-dimensional systems of spinor Bose-Einstein condensates with isotropic Rashba spin-orbit coupling. Using field-theoretic numerical simulations, we investigated the melting of a low-temperature stripe phase with supersolid character and find that the stripes lose their superfluidity at elevated temperature and undergo a Kosterlitz--Thouless-like transition into a spin microemulsion. Momentum distribution calculations highlight a thermally broadened occupation of the Rashba circle of low-energy states with macroscopic and isotropic occupation around the ring. We provide a finite-temperature phase diagram that positions the emulsion as an intermediate, structured isotropic phase with residual quantum character before transitioning at higher temperature into a structureless normal fluid.Comment: Main text: 6 pages, 5 figures. Supplementary Material: 5 pages, 5 figure

Ambivalence and transnational intergenerational solidarity: the perspective of highly educated Portuguese women emigrant daughters

peer reviewedExisting literature has highlighted solidarity across generations as a crucial mechanism for transfers and maintaining cohesion within families. However, researching solidarity across generations among transnational families is still an underexplored area, especially from the viewpoint of highly skilled female migrants. This study explored the way highly educated Portuguese adult daughters, living transnationally, perceive the existing solidarity ties with their parents, in times of transition, such as during the process of migration. By using a cluster analysis approach to explore the statistical associations between ambivalence and intergenerational solidarity dimensions, this study provides insight into the migrant solidarity types incorporating the role of ambivalence in forging a typology of transnational intergenerational relationships. The sample comprised 248 daughters who volunteered to provide information in an online survey. Participants gave their full consent to partake in this study, and this study was approved by the ethical committee of the authors’ institution. Measures of intergenerational solidarity dimensions, perceived ambivalence, sociocultural adaptation, acculturation, and social well-being in the destination country were included in the survey. Model-based cluster analysis resulted in three clusters: low ambivalence with strong cohesion, autonomous with affection and low ambivalence, and ambivalent functional ties with low affection. These clusters differed significantly in terms of intergenerational solidarity dimensions, perceived ambivalence, and in several other measures addressed. Perceived high parent-daughter ambivalent ties were associated with high levels of functional contacts and financial exchange. That pattern was also associated with lower levels of affection and consensus, being most frequently found in older daughters, mostly when single, economically inactive, or unemployed. Low perceived ambivalent parent-daughter ties were the most frequently found (around 80%), with two different types of intergenerational relationships being revealed, namely the low ambivalence with strong cohesion type and the autonomous with affection and low ambivalence type. Half (50%) of the daughters that perceived low parent-daughter ambivalent ties have associated the highest intergenerational solidarity, being, in general, better adapted to the migration context and slightly younger on average. The other half, less well acculturated, living abroad for longer, in countries with stronger welfare state systems and less reliance on families as providers of care, are more associated with an autonomous relationship type with low solidarity, but high affection. These results suggest that there might be a spillover effect: those who fare well in the country of migration, have better relations with their families at home—either being very interdependent or very independent, but always with good affective quality and low ambivalence.3. Good health and well-bein

(2S)-2-[(2S*,5R*,6R*)-5,6-Dimeth­oxy-5,6-dimethyl-1,4-dioxan-2-yl]-1-[(S)-1,1-dimethyl­ethylsulfon­yl]aziridine

The reaction of a sulfur ylide with a chiral non-racemic sulfinyl imine afforded the desired aziridine in excellent yield and subsequent oxidation of the sulfinyl moiety dissolved in anhydrous dichloro­methane using a 75% aqueous solution of 3-chloro­per­oxy­benzoic acid afforded the title compound, C14H27NO6S. The configuration of the newly formed stereogenic center at the point of attachment of the 1,4-dioxane ring to the aziridine ring is S. The configurations of the pre-existing sites 2-, 5-, and 6-positions of the 1,4-dioxane ring prior to reaction of sulfinyl imine with the sulfur ylide are S, R, and R, respectively. The C—N bond lengths of the aziridine are 1.478 (2) and 1.486 (2) Å

Young children’s impressionable use of teleology: the influence of question wording and questioned topic on teleological explanations for natural phenomena

There is a significant body of research on children's preconceptions concerning scientific concepts and the impact this has upon their science education. One active issue concerns the extent to which young children's explanations for the existence of natural kinds rely on a teleological rationale: for example, rain is for watering the grass, or tigers’ stripes are for camouflage. It has been argued that this teleological tendency hampers children's ability to learn about causality in the natural world. This paper investigates two factors (question wording and topic) which it is argued have led to a misestimation of children's teleological tendencies within the area natural phenomena: i.e., those that are time-constrained, natural events or process such as snow, clouds or night. Sixty-six (5- to 8-years-old) children took part in a repeated-measures experiment, answering both open- and leading-questions across 10 topics of natural phenomena. The findings indicate that children's teleological reasoning may have been overestimated as open question forms significantly reduced their tendency to answer teleologically. Moreover, the concept of teleology is more nuanced than often suggested. Consequently, young children may be more able to learn about causal explanations for the existence of natural phenomena than the literature implies

Sunny windy Sundays

Rapid expansion of wind and solar capacity in Great Britain presents challenges for managing electricity systems. One concern is the reduction in system inertia during periods where renewables provide a high proportion of demand which has led to some networks imposing system nonsynchronous penetration limits. However, given the lack of operational data, the relationship between renewable generation and demand for the full range of meteorological conditions experienced in Great Britain is poorly understood. This study uses reanalysis datasets to determine the proportion of demand from renewable generation on an hourly resolution for a 36-year period. The days with highest penetration of renewables tend to be sunny, windy weekend days between May and September, when there is a significant contribution of both wind and solar generation and demand is suppressed due to human behaviour. Based on the current distribution of wind and solar capacity, there is very little curtailment for all system non-synchronous penetration limits considered. However, as installed capacity of renewables grows the volume of generation curtailed also increases with a disproportionate volume occurring at weekends. The total volume of curtailment is highly dependent on ratio of wind and solar capacity, with the current blend close to the optimum level

Carbohydrate-derived iminium salt organocatalysts for the asymmetric epoxidation of alkenes

A new family of carbohydrate-based dihydroisoquinolinium salts has been prepared and tested for potential as asymmetric catalysts for the epoxidation of unfunctionalized alkene substrates, providing up to 57% ee in the product epoxides

Sexual health of ethnic minority MSM in Britain (MESH project): design and methods

Background: Men who have sex with men (MSM) remain the group most at risk of acquiring HIV infection in Britain. HIV prevalence appears to vary widely between MSM from different ethnic minority groups in this country for reasons that are not fully understood. The aim of the MESH project was to examine in detail the sexual health of ethnic minority MSM living in Britain. Methods/Design: The main objectives of the MESH project were to explore among ethnic minority MSM living in Britain: (i) sexual risk behaviour and HIV prevalence; (ii) their experience of stigma and discrimination; (iii) disclosure of sexuality; (iv) use of, and satisfaction with sexual health services; (v) the extent to which sexual health services (for treatment and prevention) are aware of the needs of ethnic minority MSM. The research was conducted between 2006 and 2008 in four national samples: (i) ethnic minority MSM living in Britain; (ii) a comparison group of white British MSM living in Britain; (iii) NHS sexual health clinic staff in 15 British towns and cities with significant ethnic minority communities and; (iv) sexual health promotion/HIV prevention service providers. We also recruited men from two “key migrant” groups living in Britain: MSM born in Central or Eastern Europe and MSM born in Central or South America. Internet-based quantitative and qualitative research methods were used. Ethnic minority MSM were recruited through advertisements on websites, in community venues, via informal networks and in sexual health clinics. White and “key migrant” MSM were recruited mostly through Gaydar, one of the most popular dating sites used by gay men in Britain. MSM who agreed to take part completed a questionnaire online. Ethnic minority MSM who completed the online questionnaire were asked if they would be willing to take part in an online qualitative interview using email. Service providers were identified through the British Association of Sexual Health and HIV (BASHH) and the Terrence Higgins Trust (THT) CHAPS partnerships. Staff who agreed to take part were asked to complete a questionnaire online. The online survey was completed by 1241 ethnic minority MSM, 416 men born in South and Central America or Central and Eastern Europe, and 13,717 white British MSM; 67 ethnic minority MSM took part in the online qualitative interview. In addition 364 people working in sexual health clinics and 124 health promotion workers from around Britain completed an online questionnaire. Discussion: The findings from this study will improve our understanding of the sexual health and needs of ethnic minority MSM in Britain

Monitoring and evaluation of breast cancer screening programmes : Selecting candidate performance indicators

In the scope of the European Commission Initiative on Breast Cancer (ECIBC) the Monitoring and Evaluation (M&E) subgroup was tasked to identify breast cancer screening programme (BCSP) performance indicators, including their acceptable and desirable levels, which are associated with breast cancer (BC) mortality. This paper documents the methodology used for the indicator selection. The indicators were identified through a multi-stage process. First, a scoping review was conducted to identify existing performance indicators. Second, building on existing frameworks for making well-informed health care choices, a specific conceptual framework was developed to guide the indicator selection. Third, two group exercises including a rating and ranking survey were conducted for indicator selection using pre-determined criteria, such as: relevance, measurability, accurateness, ethics and understandability. The selected indicators were mapped onto a BC screening pathway developed by the M&E subgroup to illustrate the steps of BC screening common to all EU countries. A total of 96 indicators were identified from an initial list of 1325 indicators. After removing redundant and irrelevant indicators and adding those missing, 39 candidate indicators underwent the rating and ranking exercise. Based on the results, the M&E subgroup selected 13 indicators: screening coverage, participation rate, recall rate, breast cancer detection rate, invasive breast cancer detection rate, cancers > 20 mm, cancers ≤10 mm, lymph node status, interval cancer rate, episode sensitivity, time interval between screening and first treatment, benign open surgical biopsy rate, and mastectomy rate. This systematic approach led to the identification of 13 BCSP candidate performance indicators to be further evaluated for their association with BC mortality