Cumulative Effects of Neonatal Hyperoxia on Murine Alveolar Structure and Function

Background Bronchopulmonary dysplasia (BPD) results from alveolar simplification and abnormal development of alveolar and capillary structure. Survivors of BPD display persistent deficits in airflow and membrane and vascular components of alveolar gas diffusion. Despite being the defining feature of BPD, various neonatal hyperoxia models of BPD have not routinely assessed pulmonary gas diffusion. Methods To simulate the most commonly-utilized neonatal hyperoxia models, we exposed neonatal mice to room air or ≥90% hyperoxia during key stages of distal lung development: through the first 4 (saccular), 7 (early alveolar), or 14 (bulk alveolar) postnatal days, followed by a period of recovery in room air until 8 weeks of age when alveolar septation is essentially complete. We systematically assessed and correlated the effects of neonatal hyperoxia on the degree of alveolar–capillary structural and functional impairment. We hypothesized that the degree of alveolar–capillary simplification would correlate strongly with worsening diffusion impairment. Results Neonatal hyperoxia exposure, of any duration, resulted in alveolar simplification and impaired pulmonary gas diffusion. Mean Linear Intercept increased in proportion to the length of hyperoxia exposure while alveolar and total lung volume increased markedly only with prolonged exposure. Surprisingly, despite having a similar effect on alveolar surface area, only prolonged hyperoxia for 14 days resulted in reduced pulmonary microvascular volume. Estimates of alveolar and capillary structure, in general, correlated poorly with assessment of gas diffusion. Conclusion Our results help define the physiological and structural consequences of commonly-employed neonatal hyperoxia models of BPD and informtheir clinical utility

Telephone administered cognitive behaviour therapy for treatment of obsessive compulsive disorder: randomised controlled non-inferiority trial

This is a freely-available open access publication. Please cite the published version which is available via the DOI link in this record.To compare the effectiveness of cognitive behaviour therapy delivered by telephone with the same therapy given face to face in the treatment of obsessive compulsive disorder.NHS Executive North West (Research and Development Fund

Análisis de la rotación de personal: estudio de caso

La rotación de personal en la organización es representativa y están ligados a procesos administrativos implícitos en la búsqueda de nuevos talentos, generando costos intangibles relacionados con la capacitación, formación de los colaboradores, adaptación, adiestramiento, la calidad y servicio hacia el cliente. La investigación consistió en la elaboración de un estudio enfocado a identificar las principales variables causantes de la rotación de personal, para conocer la relación que existe entre cada una de las dimensiones que obtuvieran la media baja, del personal de trabajo en una empresa de seguridad privada. Con el fin de proponer mejoras que permitan tener un control interno. Se seleccionó una empresa del sector servicios, específicamente en la rama económica de comercialización de productos de seguridad y la prestación de equipo e instrumentos para el monitoreo de seguridad de instalaciones particulares, que presenta problemas con su capital humano, haciendo evidente una grave rotación de personal, que impacta directamente sobre la productividad y rentabilidad de las compañías. La investigación por su naturaleza tendrá un enfoque mixto cuantitativo/cualitativo, el cual permitirá la recolección y el análisis de datos, así como su integración para posteriormente analizarla mediante la aplicación de instrumentos de recopilación de información. Se encontró una inclinación negativa en la motivación de los trabajadores y reconocimiento del personal

Association between rheumatoid arthritis disease activity, progression of functional limitation and long-term risk of orthopaedic surgery : Combined analysis of two prospective cohorts supports EULAR treat to target DAS thresholds

Objectives: To examine the association between disease activity in early rheumatoid arthritis (RA), functional limitation and long-term orthopaedic episodes. Methods: Health Assessment Questionnaire (HAQ) disability scores were collected from two longitudinal early RA inception cohorts in routine care; Early Rheumatoid Arthritis Study and Early Rheumatoid Arthritis Network from 1986 to 2012. The incidence of major and intermediate orthopaedic surgical episodes over 25 years was collected from national data sets. Disease activity was categorised by mean disease activity score (DAS28) annually between years 1 and 5; remission (RDAS≤2.6), low (LDAS>2.6-3.2), low-moderate (LMDAS≥3.2-4.19), high-moderate (HMDAS 4.2-5.1) and high (HDAS>5.1). Results: Data from 2045 patients were analysed. Patients in RDAS showed no HAQ progression over 5 years, whereas there was a significant relationship between rising DAS28 category and HAQ at 1 year, and the rate of HAQ progression between years 1 and 5. During 27 986 person-years follow-up, 392 intermediate and 591 major surgeries were observed. Compared with the RDAS category, there was a significantly increased cumulative incidence of intermediate surgery in HDAS (OR 2.59 CI 1.49 to 4.52) and HMDAS (OR 1.8 CI 1.05 to 3.11) categories, and for major surgery in HDAS (OR 2.48 CI 1.5 to 4.11), HMDAS (OR 2.16 CI 1.32 to 3.52) and LMDAS (OR 2.07 CI 1.28 to 3.33) categories. There was no significant difference in HAQ progression or orthopaedic episodes between RDAS and LDAS categories. Conclusions: There is an association between disease activity and both poor function and long-term orthopaedic episodes. This illustrates the far from benign consequences of persistent moderate disease activity, and supports European League Against Rheumatism treat to target recommendations to secure low disease activity or remission in all patients.Peer reviewedFinal Published versio

Stomatal optimisation based on xylem hydraulics (SOX) improves land surface model simulation of vegetation responses to climate

This is the final version. Available on open access via the DOI in this record•Land surface models (LSMs) typically use empirical functions to represent vegetation responses to soil drought. These functions largely neglect recent advances in plant ecophysiology that link xylem hydraulic functioning with stomatal responses to climate. •We developed an analytical stomatal optimisation model based on xylem hydraulics (SOX) to predict plant responses to drought. Coupling SOX to the Joint UK Land Environment Simulator (JULES) LSM, we conducted a global evaluation of SOX against leaf- and ecosystem-level observations. •SOX simulates leaf stomatal conductance responses to climate for woody plants more accurately and parsimoniously than the existing JULES stomatal conductance model. An ecosystem-level evaluation at 70 eddy flux sites shows that SOX decreases the sensitivity of gross primary productivity (GPP) to soil moisture, which improves the model agreement with observations and increases the predicted annual GPP by 30% in relation to JULES. SOX decreases JULES root mean squared error in GPP by up to 45 % in evergreen tropical forests, and can simulate realistic patterns of canopy water potential and soil water dynamics at the studied sites. •SOX provides a parsimonious way to incorporate recent advances in plant hydraulics and optimality theory into LSMs, and an alternative to empirical stress factors.Newton Fund through the Met Office Climate Science for Service Partnership Brazil (CSSP Brazil)Natural Environment Research Council (NERC

How can the First ISLSCP Field Experiment contribute to present-day efforts to evaluate water stress in JULESv5.0?

The First International Satellite Land Surface Climatology Project (ISLSCP) Field Experiment (FIFE), Kansas, US, 1987–1989, made important contributions to the understanding of energy and CO2 exchanges between the land surface and the atmosphere, which heavily influenced the development of numerical land-surface modelling. Now, 30 years on, we demonstrate how the wealth of data collected during FIFE and its subsequent in-depth analysis in the literature continue to be a valuable resource for the current generation of land-surface models. To illustrate, we use the FIFE dataset to evaluate the representation of water stress on tallgrass prairie vegetation in the Joint UK Land Environment Simulator (JULES) and highlight areas for future development. We show that, while JULES is able to simulate a decrease in net carbon assimilation and evapotranspiration during a dry spell, the shape of the diurnal cycle is not well captured. Evaluating the model parameters and results against this dataset provides a case study on the assumptions in calibrating “unstressed” vegetation parameters and thresholds for water stress. In particular, the responses to low water availability and high temperatures are calibrated separately. We also illustrate the effect of inherent uncertainties in key observables, such as leaf area index, soil moisture and soil properties. Given these valuable lessons, simulations for this site will be a key addition to a compilation of simulations covering a wide range of vegetation types and climate regimes, which will be used to improve the way that water stress is represented within JULES