Application of Correspondence Analysis to Graphically Investigate Associations Between Foods and Eating Locations.

This paper presents the application of correspondence analysis (CA) for investigating associations using confidence regions (CRs) with a focus on facilitating mining the data and hypothesis generation. We study the relationship between locations and "less-healthy" food consumption by UK teenagers. CA allows for a quick visual inspection of the various association structures that exist between the categories of cross-classified variables in large datasets derived with varying study designs. The hypotheses generated by the visual display can then be independently tested using suitable regression models. CA makes use of readily available software tools and of robust statistical tests amenable to interpretation

Application of correspondence analysis to graphically investigate associations between foods and eating locations

This paper presents the application of correspondence analysis (CA) for investigating associations using confidence regions (CRs) with a focus on facilitating mining the data and hypothesis generation. We study the relationship between locations and “less-healthy” food consumption by UK teenagers. CA allows for a quick visual inspection of the various association structures that exist between the categories of cross-classified variables in large datasets derived with varying study designs. The hypotheses generated by the visual display can then be independently tested using suitable regression models. CA makes use of readily available software tools and of robust statistical tests amenable to interpretation

Plate-impact loading of cellular structures formed by selective laser melting

Studies of the shock loading of porous material have the potential to improve our understanding of factors such as density, crush strength and pore size on energy absorbing capability. Porous components were manufactured using Selective Laser Melting (SLM) in which layers of metal powder are fused together to create a structure specified by an electronic file. Samples have been manufactured in which a lattice is formed by an array of intersecting rods angled at 45 degrees to the surface of a 6 mm thick x ~100 mm diameter disc. The cell size is 1 mm3 and the density is 44.6% of solid. A 100 mm gas gun has been used to impact the porous samples onto solid stainless steel plates. Het-V laser interferometry was used to measure the velocity vs. time profile of the transmitted shock. The experimental results were compared with three dimensional computer predictions. It was found that the simulations reproduced the main features of the experimental record but tended to underestimate the measured velocities, suggesting that the codes were not calculating the energy absorbed by the lattice correctly. Additional calculations were performed with the aim of building a picture of the processes of energy absorption in cellular materials whose structure is varied systematically. These supporting studies suggest a possible explanation for the observed computational/experimental discrepancies. © 2012 British Crown

Shock interactions, turbulence, and the origin of the stellar mass spectrum

Supersonic turbulence is an essential element in understanding how structure within interstellar gas is created and shaped. In the context of star formation, many computational studies show that the mass spectrum of density and velocity fluctuations within dense clouds, as well as the distribution of their angular momenta, trace their origin to the statistical and physical properties of gas that is lashed with shock waves. In this article, we review the observations, simulations, and theories of how turbulent-like processes can account for structures we see in molecular clouds. We then compare traditional ideas of supersonic turbulence with a simpler physical model involving the effects of multiple shock waves and their interaction in the interstellar medium. Planar intersecting shock waves produce dense filaments, and generate vortex sheets that are essential to create the broad range of density and velocity structure in clouds. As an example, the lower mass behaviour of the stellar initial mass function can be traced to the tendency of a collection of shock waves to build-up a log-normal density distribution (or column density). Vorticity - which is essential to produce velocity structure over a very broad range of length scales in shocked clouds - can also be generated by the passage of curved shocks or intersecting planar shocks through such media. Two major additional physical forces affect the structure of star forming gas - gravity and feedback processes from young stars. Both of these can produce power-law tails at the high mass end of the IMF.Comment: 20 pages, 5 figures, to appear in theme issue "Turbulent Mixing" of the Philosophical Transactions of the Royal Society A, Snezhana I. Abarzhi, Serge Gauthier, and Katepalli R. Sreenivasan (Guest Editors), accepted for publicatio

Evidence-based management approaches for patients with severe chronic obstructive pulmonary disease (COPD): A practice review

Background: Patients with chronic obstructive pulmonary disease (COPD) face limited treatment options and inadequate access to palliative care. Aim: To provide a pragmatic overview of clinical guidelines and produce evidence-based recommendations for severe COPD. Interventions for which there is inconsistent evidence to support their use and areas requiring further research were identified. Design: Practice review of guidelines supported by scoping review methodology to examine the evidence reporting the use of guideline-recommended interventions. Data sources: An electronic search was undertaken in MEDLINE, EMBASE, PsycINFO, CINAHL and The Cochrane Database of Systematic Reviews, complemented by web searching for guidelines and publications providing primary evidence (July 2021). Guidelines published within the last 5 years and evidence in the last 10 years were included. Results: Severe COPD should be managed using a multidisciplinary approach with a holistic assessment. For stable patients, long-acting beta-agonist/long-acting muscarinic antagonist and pulmonary rehabilitation are recommended. Low dose opioids, self-management, handheld fan and nutritional support may provide small benefits, whereas routine corticosteroids should be avoided. For COPD exacerbations, systematic corticosteroids, non-invasive ventilation and exacerbation action plans are recommended. Short-acting inhaled beta-agonists and antibiotics may be considered but pulmonary rehabilitation should be avoided during hospitalisation. Long term oxygen therapy is only recommended for patients with chronic severe hypoxaemia. Short-acting anticholinergic inhalers, nebulised opioids, oral theophylline or telehealth are not recommended. Conclusions: Recommended interventions by guidelines are not always supported by high-quality evidence. Further research is required on efficacy and safety of inhaled corticosteroids, antidepressants, benzodiazepines, mucolytics, relaxation and breathing exercises

Conceptualising effective symptom management in palliative care: a novel model derived from qualitative data

Background Pain, breathlessness and fatigue are some of the most challenging symptoms to manage in patients with advanced disease. Specialist palliative care leads to better symptom management, but factors contributing to successful symptom management in this context have not been explored. Our aim was to understand what facilitates effective symptom management in specialist palliative care within UK hospices and investigate what barriers are experienced. Methods This was a grounded theory study using qualitative semi-structured focus groups and interviews. Participants were recruited from multidisciplinary specialist palliative care teams (doctors, nurses, healthcare assistants, physiotherapists, occupational therapists, complementary therapists, social workers and chaplains) working in inpatient, outpatient and community services provided by five hospices in the United Kingdom. Results We present a novel qualitative data-derived model of effective symptom management in specialist palliative care. We describe a co-ordinated, multi-faceted, sequential approach involving a process of engagement, partnership, decision-making, and delivery. Interventions to manage symptoms are less effective in psychologically distressed patients. Our data highlights that families of patients have a key role in determining effectiveness of symptom management interventions A holistic approach by a co-ordinated, multi-disciplinary team, including support to recognise and minimise psychological distress might facilitate more effective symptom management. Barriers to symptom management include team discordance and lack of understanding about symptom management by patient and families. Conclusions Shared decision-making between patients and professionals and co-ordination of care by a multi-disciplinary team are key components of effective symptom management. Actions to address psychological distress and evaluate the understanding and expectations of patients and their families would enable more effective symptom management. A more effective multi-disciplinary approach would be facilitated by discussion within teams about role competencies and boundaries

Non-pharmacological interventions to manage psychological distress in patients living with cancer: a systematic review

BACKGROUND: Psychological distress is common in patients with cancer; interfering with physical and psychological wellbeing, and hindering management of physical symptoms. Our aim was to systematically review published evidence on non-pharmacological interventions for cancer-related psychological distress, at all stages of the disease. METHODS: We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The review was registered on PROSPERO (CRD42022311729). Searches were made using eight online databases to identify studies meeting our inclusion criteria. Data were collected on outcome measures, modes of delivery, resources and evidence of efficacy. A meta-analysis was planned if data allowed. Quality was assessed using the Mixed Methods Appraisal Tool (MMAT). RESULTS: Fifty-nine studies with 17,628 participants were included. One third of studies included mindfulness, talking or group therapies. Half of all studies reported statistically significant improvements in distress. Statistically significant intervention effects on distress were most prevalent for mindfulness techniques. Four of these mindfulness studies had moderate effect sizes (d = -0.71[95% CI: -1.04, -0.37] p < 0.001) (d = -0.60 [95% CI: -3.44, -0.89] p < 0.001) (d = -0.77 [CI: -0.146, -1.954] p < 0.01) (d = -0.69 [CI: -0.18, -1.19] p = 0.008) and one had a large effect size (d = -1.03 [95% CI: -1.51, -0.54] p < 0.001). Heterogeneity of studies precluded meta-analysis. Study quality was variable and some had a high risk of bias. CONCLUSIONS: The majority of studies using a mindfulness intervention in this review are efficacious at alleviating distress. Mindfulness-including brief, self-administered interventions-merits further investigation, using adequately powered, high-quality studies. SYSTEMATIC REVIEW REGISTRATION: This systematic review is registered on PROSPERO, number CRD42022311729

Practice review: Evidence-based and effective management of fatigue in patients with advanced cancer

Background: Fatigue affects most patients living with advanced cancer and is a symptom that healthcare professionals can find difficult to manage. Aim: To provide healthcare professionals with a pragmatic overview of approaches to management of fatigue in patients with advanced cancer that are commonly recommended by guidelines and to evaluate evidence underpinning them. Design: Scoping review methodology was used to determine the strength of evidence supporting use of interventions recommended in management of fatigue in patients with advanced cancer. Data sources: National or international guidelines were examined if they described the management of fatigue in adult cancer patients and were written within the last 6 years (2015–2021) in English. The Cochrane Database of Systematic Reviews (January 2011–December 2021) was searched for ‘cancer’ AND ‘fatigue’ in title, abstract or keywords. A PubMed search was also made. Results: Evidence indicates physical exercise interventions are effective and patients may benefit from energy conservation tactics. Evidence does not support use of psychostimulants such as methylphenidate. Limited data were found on efficacy of corticosteroids, psychological interventions, nutritional intervention, sleep optimization or complementary therapies for management of fatigue in advanced cancer. Conclusion: We recommend regular assessment, review and acknowledgement of the impact of fatigue. Exercise and energy conservation should be considered. Pharmacological interventions are not endorsed as a routine approach. Many interventions currently recommended by guidelines are not supported by a robust evidence base and further research on their efficacy is required

Targeted knock-down of miR21 primary transcripts using snoMEN vectors induces apoptosis in human cancer cell lines

We have previously reported an antisense technology, 'snoMEN vectors', for targeted knock-down of protein coding mRNAs using human snoRNAs manipulated to contain short regions of sequence complementarity with the mRNA target. Here we characterise the use of snoMEN vectors to target the knock-down of micro RNA primary transcripts. We document the specific knock-down of miR21 in HeLa cells using plasmid vectors expressing miR21-targeted snoMEN RNAs and show this induces apoptosis. Knock-down is dependent on the presence of complementary sequences in the snoMEN vector and the induction of apoptosis can be suppressed by over-expression of miR21. Furthermore, we have also developed lentiviral vectors for delivery of snoMEN RNAs and show this increases the efficiency of vector transduction in many human cell lines that are difficult to transfect with plasmid vectors. Transduction of lentiviral vectors expressing snoMEN targeted to pri-miR21 induces apoptosis in human lung adenocarcinoma cells, which express high levels of miR21, but not in human primary cells. We show that snoMEN-mediated suppression of miRNA expression is prevented by siRNA knock-down of Ago2, but not by knock-down of Ago1 or Upf1. snoMEN RNAs colocalise with Ago2 in cell nuclei and nucleoli and can be co-immunoprecipitated from nuclear extracts by antibodies specific for Ago2

Optimisation of the Schizosaccharomyces pombe urg1 expression system

The ability to study protein function in vivo often relies on systems that regulate the presence and absence of the protein of interest. Two limitations for previously described transcriptional control systems that are used to regulate protein expression in fission yeast are: the time taken for inducing conditions to initiate transcription and the ability to achieve very low basal transcription in the "OFF-state". In previous work, we described a Cre recombination-mediated system that allows the rapid and efficient regulation of any gene of interest by the urg1 promoter, which has a dynamic range of approximately 75-fold and which is induced within 30-60 minutes of uracil addition. In this report we describe easy-to-use and versatile modules that can be exploited to significantly tune down P urg1 "OFF-levels" while maintaining an equivalent dynamic range. We also provide plasmids and tools for combining P urg1 transcriptional control with the auxin degron tag to help maintain a null-like phenotype. We demonstrate the utility of this system by improved regulation of HO-dependent site-specific DSB formation, by the regulation Rtf1-dependent replication fork arrest and by controlling Rhp18(Rad18)-dependent post replication repair