A 7-year follow-up of sacral anterior root stimulation for bladder control in patients with a spinal cord injury: quality of life and users' experiences\ud

Study design: Cross-sectional descriptive study.\ud \ud Objectives: To assess long-term effects and quality of life (QoL) of using sacral anterior root stimulation (SARS) in spinal cord injured patients.\ud \ud Setting: Neurosurgical and Urological Departments of a large teaching hospital and a large rehabilitation centre in the Netherlands.\ud \ud Methods: In all, 42 patients with complete spinal cord injury (SCI) implanted between 1987 and 2000 were included. A questionnaire was constructed to determine complications, technical failures and personal experiences of the patients. The Qualiveen questionnaire was used and the outcome was compared with data obtained from a reference group of 400 SCI patients with neurogenic bladder problems not using the bladder controller. The Qualiveen questionnaire measures disease-specific aspects in four domains with respect to limitations, constraints, fears and feelings and general QoL aspects, suitable for use in SCI patients with urinary disorders.\ud \ud Results: The results of 37 patients are presented. Our results with the bladder controller with respect to medical and technical complications and infection rates are similar to the results presented by others. From users' experiences, the most important advantages reported were a decreased infection rate (68%), improved social life (54%) and continence (54%). Comparison of the obtained results of our patient group with the Qualiveen questionnaire with a reference group not using the bladder controller indicates that the specific impact of urinary disorders in the four domains on QoL is reduced and that general QoL is improved.\ud \ud Conclusion: SARS is effective and safe for neurogenic bladder management in patients with complete SCI. Users' experiences are positive. Furthermore, this therapy seems to reduce the effects of urinary-disorder-specific QoL aspects, and to increase the QoL in general\u

Absorption of pyrimidines, purines, and nucleosides by Co, Ni, Cu and Fe /III-montmorillonite /clay-organic studies XIII/

Absorption of pyrimidines, purines, and nucleosides by copper, nickel, cobalt, and iron montmorillonit

Absorption of pyrimidines, purines and nucleosides by Li, Na, Mg, and Ca montmorillonite /clay organic studies 12/

Absorption of purines, pyrimidines, and nucleoside in aqueous solution by montmorillionite occurring as cation exchange reactio

Those Four-Spotted Bugs... Friend or Foe?

The four-spotted fungus beetle is a sort of dual-charactered insect.This beetle is both destructive and a genreal nuisance. But on the other hand, it kills corn larvae

Contrasting Observed Atmospheric Responses to Tropical Sea Surface Temperature Warming Patterns

AM was funded by a NERC doctoral training partnership grant (NE/L002558/1). This study was funded as part of NERC's support of the National Center for Earth Observation: HB and PIP were supported by grant number NE/R016518/1.Equilibrium climate sensitivity (ECS) is a theoretical concept which describes the change in global mean surface temperature that results from a sustained doubling of atmospheric CO2. Current ECS estimates range from ∼1.8 to 5.6 K, reflecting uncertainties in climate feedbacks. The sensitivity of the lower (1,000–700 hPa) and upper (500–200 hPa) troposphere to changes in spatial patterns of tropical sea surface temperature (SST) have been proposed by recent model studies as key feedbacks controlling climate sensitivity. We examine empirical evidence for these proposed mechanisms using 14 years of satellite data. We examine the response of temperature and humidity profiles, clouds, and top‐of‐the‐atmosphere radiation to relative warming in tropical ocean regions when there is either strong convection or subsidence. We find warmer SSTs in regions of strong subsidence are coincident with a decrease in lower tropospheric stability (−0.9 ± 0.4 KK−1) and low cloud cover (∼−6% K−1). This leads to a warming associated with the weakening in the shortwave cooling effect of clouds (4.2 ± 1.9 Wm−2K−1), broadly consistent with model calculations. In contrast, warmer SSTs in regions of strong convection are coincident with an increase in upper tropospheric humidity (3.2 ± 1.5% K−1). In this scenario, the dominant effect is the enhancement of the warming longwave cloud radiative effect (3.8 ± 3.0 Wm−2K−1) from an increase in high cloud cover (∼7% K−1), though changes in the net (longwave and shortwave) effect are not statistically significant (p < 0.003). Our observational evidence supports the existence of mechanisms linking contrasting atmospheric responses to patterns in SST, mechanisms which have been linked to climate sensitivity.Publisher PDFPeer reviewe

Blockchain vehicles for efficient Medical Record management

The lack of interoperability in Britain’s medical records systems precludes the realisation of benefits generated by increased spending elsewhere in healthcare. Growing concerns regarding the security of online medical data following breaches, and regarding regulations governing data ownership, mandate strict parameters in the development of efficient methods to administrate medical records. Furthermore, consideration must be placed on the rise of connected devices, which vastly increase the amount of data that can be collected in order to improve a patient’s long-term health outcomes. Increasing numbers of healthcare systems are developing Blockchain-based systems to manage medical data. A Blockchain is a decentralised, continuously growing online ledger of records, validated by members of the network. Traditionally used to manage cryptocurrency records, distributed ledger technology can be applied to various aspects of healthcare. In this manuscript, we focus on how Electronic Medical Records in particular can be managed by Blockchain, and how the introduction of this novel technology can create a more efficient and interoperable infrastructure to manage records that leads to improved healthcare outcomes, while maintaining patient data ownership and without compromising privacy or security of sensitive data

Developing coaches for mathematical resilience: level 2

The construct ‘Mathematical Resilience’ [1] has been developed to describe a positive stance towards mathematics that enables learners to develop approaches to mathematical learning which allow them to overcome the barriers and setbacks that are frequently part of learning mathematics for many people. A resilient stance towards mathematics can be engineered by a strategic and explicit focus on the culture of learning mathematics within both formal and informal learning environments. As part of that cultural engineering, we have developed the notion of coaches specifically to support emergent resilience. The work described here is focused on developing coaches who can work beside learners, helping them to conjecture and use resilient learning ideas when facing difficulties in mathematics. Coaches develop a culture of ‘can do’ mathematics which works to counter the prevalent culture of mathematics helplessness and mathematics anxiety in the general population when faced with mathematical ideas. The coaches are not required to know the answer but rather to know ways that might yield an understanding of the mathematical ideas involved and thus lead to an answer. Our previous paper described the outcomes of the level 1 course, in which participants became skilled at peer-coaching. This paper discusses the outcomes of a second pilot course (Sept to Nov 2013) designed to develop ‘coaches for mathematical resilience’ at level 2, equipped to work with learners under the direction of a mathematics tutor outside the course. The 10 participants at Level 2, who regularly work with apprentices, both young and more mature, in a work-based environment continued with part 2 of the programme because of the positive outcomes from level 1. In the Level 1 course, they had worked to develop their knowledge of how to overcome deep seated antipathy to mathematics in themselves and in those with whom they work. The data confirms that once an individual has begun to develop their own personal mathematical resilience, worked through their own anxieties and negative stance towards mathematics in a safe and collaborative environment, they can then successfully coach learners to develop as resilient learners of mathematics. They become able to help those learners to find or develop the resources and skills to overcome their own barriers to learning mathematics and to manage any anxiety that may be engendered. Importantly, when the coach learns not to take any responsibility for the mathematics, but rather to focus on the learning skills and well-being of the learner, t learner outcomes are improved

Preliminary evidence for genetic overlap between body mass index and striatal reward response

The reward-processing network is implicated in the aetiology of obesity. Several lines of evidence suggest obesitylinked genetic risk loci (such as DRD2 and FTO) may influence individual variation in body mass index (BMI) through neuropsychological processes reflected in alterations in activation of the striatum during reward processing. However, no study has tested the broader hypotheses that (a) the relationship between BMI and reward-related brain activation (measured through the blood oxygenation-dependent (BOLD) signal) may be observed in a large population study and (b) the overall genetic architecture of these phenotypes overlap, an assumption critical for the progression of imaging genetic studies in obesity research. Using data from the Human Connectome Project (N = 1055 healthy, young individuals: average BMI = 26.4), we first establish a phenotypic relationship between BMI and ventral striatal (VS) BOLD during the processing of rewarding (monetary) stimuli (β = 0.44, P = 0.013), accounting for potential confounds. BMI and VS BOLD were both significantly influenced by additive genetic factors (H2r = 0.57; 0.12, respectively). Further decomposition of this variance suggested that the relationship was driven by shared genetic (ρg = 0.47, P = 0.011), but not environmental (ρE = −0.07, P = 0.29) factors. To validate the assumption of genetic pleiotropy between BMI and VS BOLD, we further show that polygenic risk for higher BMI is also associated with increased VS BOLD response to appetitive stimuli (calorically high food images), in an independent sample (N = 81; PFWE−ROI o 0.005). Together, these observations suggest that the genetic factors link risk to obesity to alterations within key nodes of the brain's reward circuity. These observations provide a basis for future work exploring the mechanistic role of genetic loci that confer risk for obesity using the imaging genetics approach

Insights into the diurnal cycle of global Earth outgoing radiation using a numerical weather prediction model

A globally complete, high temporal resolution and multiple-variable approach is employed to analyse the diurnal cycle of Earth’s outgoing energy flows. This is made possible via the use of Met Office model output for September 2010 that is assessed alongside regional satellite observations throughout. Principal component analysis applied to the longwave component of modelled outgoing radiation reveals dominant diurnal patterns related to land surface heating and convective cloud development, respectively explaining 68.5 and 16.0% of the variance at the global scale. The total variance explained by these first two patterns is markedly less than previous regional estimates from observations, and this analysis suggests that around half of the difference relates to the lack of global coverage in the observations. The first pattern is strongly and simultaneously coupled to the land surface temperature diurnal variations. The second pattern is strongly coupled to the cloud water content and height diurnal variations, but lags the cloud variations by several hours. We suggest that the mechanism con- trolling the delay is a moistening of the upper troposphere due to the evaporation of anvil cloud. The shortwave component of modelled outgoing radiation, analysed in terms of albedo, exhibits a very dominant pattern explaining 88.4 % of the variance that is related to the angle of incoming solar radiation, and a second pattern explaining 6.7 % of the variance that is related to compensating effects from convective cloud development and marine stratocumulus cloud dissipation. Similar patterns are found in regional satellite observations, but with slightly different timings due to known model biases. The first pattern is controlled by changes in surface and cloud albedo, and Rayleigh and aerosol scattering. The second pattern is strongly coupled to the diurnal variations in both cloud water content and height in convective regions but only cloud water content in marine stratocumulus regions, with substantially shorter lag times compared with the longwave counterpart. This indicates that the shortwave radiation response to diurnal cloud development and dissipation is more rapid, which is found to be robust in the regional satellite observations. These global, diurnal radiation patterns and their coupling with other geophysical variables demonstrate the process-level understanding that can be gained using this approach and highlight a need for global, diurnal observing systems for Earth outgoing radiation in the future