Can Deep Water Exercise Training Improve Arterial Stiffness in Women with Metabolic Syndrome?

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Influence of gas pressure on high-order harmonic generation of Ar and Ne

We study the effect of gas pressure on the generation of high-order harmonics where harmonics due to individual atoms are calculated using the recently developed quantitative rescattering theory, and the propagation of the laser and harmonics in the medium is calculated by solving the Maxwell's wave equation. We illustrate that the simulated spectra are very sensitive to the laser focusing conditions at high laser intensity and high pressure since the fundamental laser field is severely reshaped during the propagation. By comparing the simulated results with several experiments we show that the pressure dependence can be qualitatively explained. The lack of quantitative agreement is tentatively attributed to the failure of the complete knowledge of the experimental conditions.Comment: 7 figure

Perspectives of vaccinators on the factors affecting uptake of meningococcal ACWY vaccine amongst school leavers in London.

OBJECTIVES: Uptake of meningococcal ACWY (Men ACWY) vaccine amongst school leavers is suboptimal in London (9.9% compared to 17.4% nationally in 2015/16). This study explores service delivery barriers and elicits insights from general practice staff on their interaction with this cohort. The purpose was to inform the National Health Service England (London) public health commissioning team's strategy to improve Men ACWY vaccination uptake in London. STUDY DESIGN: Qualitative semi-structured interviews study. METHODS: Purposive sampling of practice nurses from three general practices from each of the three London clinical commissioning group areas (Barnet, Camden and Newham) with the largest numbers of 18-20 year old registered patients. Participants were recruited through their practice managers. A thematic analysis approach was used. RESULTS: A total of ten interviews were conducted between June and August 2017. Five themes were identified: (1) Nurses unsupported by practice systems; (2) difficulty getting school leavers into the practice; (3) confused messaging; (4) reliance on parental responsibility for health; and (5) perception of complacency amongst adolescents. CONCLUSION: Little is known about the service factors that impede uptake of adolescent vaccinations. This exploratory study suggests that existing programmatic mechanisms for delivering the Men ACWY catch-up programme were not adequate. The number of adolescent vaccinations offered has increased in the UK in the last five years and is likely to continue. Although the findings need to be further extrapolated in quantitative research, general practice staff need more systematic guidance on their role and how they can support vaccine decision-making in later adolescence

Creating connections - the development of a mobile-health monitoring system for heart failure:Qualitative findings from a usability cohort study

Objective There is significant interest in the role of digital health technology in enabling optimal monitoring of heart failure patients. To harness this potential, it is vital to account for users’ capacity and preferences in the development of technological solutions. We adopted an iterative approach focussed on learning from users’ interactions with a mobile-health monitoring system.Methods We used a participatory mixed methods research approach to develop and evaluate a mobile-health monitoring system. Fifty-eight heart failure patients were recruited from three health care settings in the UK and provided with Internet-enabled tablet computers that were wirelessly linked to sensor devices for blood pressure, heart rate and weight monitoring. One to two home visits were conducted with a subgroup of 29 participants to evaluate the usability of the system over a median follow-up period of six months. The thematic analysis of observational data and 45 interviews was informed by the domestication of technology theory.Results Our findings indicate that digital health technologies need to create and extend connections with health professionals, be incorporated into users’ daily routines, and be personalised according to users’ technological competencies and interest in assuming a proactive or more passive role in monitoring their condition.Conclusions Users' patterns of engagement with health technology changes over time and varies according to their need and capacity to use the technology. Incorporating diverse user experiences in the development and maintenance of mobile-health systems is likely to increase the extent of successful uptake and impacts on outcomes for patients and providers.%U http://dhj.sagepub.com/content/spdhj/2/2055207616671461.full.pd

Monocyte-lymphocyte cross-communication via soluble CD163 directly links innate immune system activation and adaptive immune system suppression following ischemic stroke

CD163 is a scavenger receptor expressed on innate immune cell populations which can be shed from the plasma membrane via the metalloprotease ADAM17 to generate a soluble peptide with lympho-inhibitory properties. The purpose of this study was to investigate CD163 as a possible effector of stroke-induced adaptive immune system suppression. Liquid biopsies were collected from ischemic stroke patients (n = 39), neurologically asymptomatic controls (n = 20), and stroke mimics (n = 20) within 24 hours of symptom onset. Peripheral blood ADAM17 activity and soluble CD163 levels were elevated in stroke patients relative to non-stroke control groups, and negatively associated with post-stroke lymphocyte counts. Subsequent in vitro experiments suggested that this stroke-induced elevation in circulating soluble CD163 likely originates from activated monocytic cells, as serum from stroke patients stimulated ADAM17-dependant CD163 shedding from healthy donor-derived monocytes. Additional in vitro experiments demonstrated that stroke-induced elevations in circulating soluble CD163 can elicit direct suppressive effects on the adaptive immune system, as serum from stroke patients inhibited the proliferation of healthy donor-derived lymphocytes, an effect which was attenuated following serum CD163 depletion. Collectively, these observations provide novel evidence that the innate immune system employs protective mechanisms aimed at mitigating the risk of post-stroke autoimmune complications driven by adaptive immune system overactivation, and that CD163 is key mediator of this phenomenon

Medium propagation effects in high harmonic generation of Ar and N2_{2}

We report theoretical calculations of high harmonic generation (HHG) by intense infrared lasers in atomic and molecular targets taking into account the macroscopic propagation of both fundamental and harmonic fields. On the examples of Ar and N$_2$, we demonstrate that these {\it ab initio} calculations are capable of accurately reproducing available experimental results with isotropic and aligned target media. We further present detailed analysis of HHG intensity and phase, under various experimental conditions, in particular, as the wavelength of the driving laser changes. Most importantly, our results strongly support the factorization of HHG at the macroscopic level into a product of a returning electron wave packet and the photorecombination transition dipole, under typical experimental conditions. This implies that the single-atom/molecule structure information can be retrieved from experimentally measured HHG spectra

Machine-Learning Approach Identifies a Pattern of Gene Expression in Peripheral Blood that can Accurately Detect Ischaemic Stroke

Early and accurate diagnosis of stroke improves the probability of positive outcome. The objective of this study was to identify a pattern of gene expression in peripheral blood that could potentially be optimised to expedite the diagnosis of acute ischaemic stroke (AIS). A discovery cohort was recruited consisting of 39 AIS patients and 24 neurologically asymptomatic controls. Peripheral blood was sampled at emergency department admission, and genome-wide expression profiling was performed via microarray. A machine-learning technique known as genetic algorithm k-nearest neighbours (GA/kNN) was then used to identify a pattern of gene expression that could optimally discriminate between groups. This pattern of expression was then assessed via qRT-PCR in an independent validation cohort, where it was evaluated for its ability to discriminate between an additional 39 AIS patients and 30 neurologically asymptomatic controls, as well as 20 acute stroke mimics. GA/kNN identified 10 genes (ANTXR2, STK3, PDK4, CD163, MAL, GRAP, ID3, CTSZ, KIF1B and PLXDC2) whose coordinate pattern of expression was able to identify 98.4% of discovery cohort subjects correctly (97.4% sensitive, 100% specific). In the validation cohort, the expression levels of the same 10 genes were able to identify 95.6% of subjects correctly when comparing AIS patients to asymptomatic controls (92.3% sensitive, 100% specific), and 94.9% of subjects correctly when comparing AIS patients with stroke mimics (97.4% sensitive, 90.0% specific). The transcriptional pattern identified in this study shows strong diagnostic potential, and warrants further evaluation to determine its true clinical efficacy

Determination of total x-ray absorption coefficient using non-resonant x-ray emission

An alternative measure of x-ray absorption spectroscopy (XAS) called inverse partial fluorescence yield (IPFY) has recently been developed that is both bulk sensitive and free of saturation effects. Here we show that the angle dependence of IPFY can provide a measure directly proportional to the total x-ray absorption coefficient, µ(E). In contrast, fluorescence yield (FY) and electron yield (EY) spectra are offset and/or distorted from µ(E) by an unknown and difficult to measure amount. Moreover, our measurement can determine µ(E) in absolute units with no free parameters by scaling to µ(E) at the non-resonant emission energy. We demonstrate this technique with measurements on NiO and NdGaO3. Determining µ(E) across edge-steps enables the use of XAS as a non-destructive measure of material composition. In NdGaO3, we also demonstrate the utility of IPFY for insulating samples, where neither EY or FY provide reliable spectra due to sample charging and self-absorption effects, respectively