Hearing the voices of older adult patients: processes and findings to inform health services research

Background Clinical academic research and service improvement is planned using Patient and Public Involvement and Engagement (PPIE) but older PPIE participants are consulted less often due to the perception that they are vulnerable or hard to engage. Objectives To consult frail older adults about a recently adopted service, discharge to assess (D2A), and to prioritise services improvements and research topics associated with the design and delivery of discharge from hospital. To use successive PPIE processes to enable a permanent PPIE panel to be established. Participants Following guidance from an established hospital PPI panel 27 older adult participants were recruited. Participants from Black, Asian and Minority Ethnic (BAME) communities, affluent and non-affluent areas and varied social circumstances were included. Methods Focus groups and individual interviews were conducted in participants own homes or nearby social venues. Results Priorities for discharge included remaining independent despite often feeling lonely at home; to remain in hospital if needed; and for services to ensure effective communication with families. The main research priority identified was facilitating independence, whilst establishing a permanent PPIE panel involving older adults was viewed favourably. Conclusions Taking a structured approach to PPIE enabled varied older peoples’ voices to express their priorities and concerns into early discharge from hospital, as well as enabling the development of health services research into hospital discharge planning and management. Older people as participants identified research priorities after reflecting on their experiences. Listening and reflection enabled researchers to develop a new “Community PPIE Elders Panel” to create an enduring PPIE infrastructure for frail older housebound people to engage in research design, development and dissemination

Altered synaptic properties during integration of adult-born hippocampal neurons following a seizure insult

Pathological conditions affect several stages of neurogenesis in the adult brain, including proliferation, survival, cell fate, migration, and functional integration. Here we explored how a pathological environment modulates the heterogeneous afferent synaptic input that shapes the functional properties of newly formed neurons. We analyzed the expression of adhesion molecules and other synaptic proteins on adult-born hippocampal neurons formed after electrically-induced partial status epilepticus (pSE). New cells were labeled with a GFP-retroviral vector one week after pSE. One and three weeks thereafter, synaptic proteins were present on dendritic spines and shafts, but without differences between pSE and control group. In contrast, at six weeks, we found fewer dendritic spines and decreased expression of the scaffolding protein PSD-95 on spines, without changes in expression of the adhesion molecules N-cadherin or neuroligin-1, primarily located at excitatory synapses. Moreover, we detected an increased expression of the inhibitory scaffolding protein gephyrin in newborn but not mature neurons after SE. However, this increase was not accompanied by a difference in GABA expression, and there was even a region-specific decrease in the adhesion molecule neuroligin-2 expression, both in newborn and mature neurons. Neuroligin-2 clusters co-localized with presynaptic cholecystokinin terminals, which were also reduced. The expression of neuroligin-4 and glycine receptor was unchanged. Increased postsynaptic clustering of gephyrin, without an accompanying increase in GABAergic input or neuroligin-2 and -4 expression, the latter important for clustering of GABAA and glycine receptors, respectively, could imply an increased but altered inhibitory connectivity specific for newborn neurons. The changes were transient and expression of both gephyrin and NL-2 was normalized 3 months post-SE. Our findings indicate that seizure-induced brain pathology alters the sub-cellular expression of synaptic adhesion molecules and scaffolding proteins related to particularly inhibitory but also excitatory synapses, which may yield functional consequences for the integration of adult-born neurons

Seasonality and the effects of weather on Campylobacter infections

Background Campylobacteriosis is a major public health concern. The weather factors that influence spatial and seasonal distributions are not fully understood. Methods To investigate the impacts of temperature and rainfall on Campylobacter infections in England and Wales, cases of Campylobacter were linked to local temperature and rainfall at laboratory postcodes in the 30 days before the specimen date. Methods for investigation included a comparative conditional incidence, wavelet, clustering, and time series analyses. Results The increase of Campylobacter infections in the late spring was significantly linked to temperature two weeks before, with an increase in conditional incidence of 0.175 cases per 100,000 per week for weeks 17 to 24; the relationship to temperature was not linear. Generalized structural time series model revealed that changes in temperature accounted for 33.3% of the expected cases of Campylobacteriosis, with an indication of the direction and relevant temperature range. Wavelet analysis showed a strong annual cycle with additional harmonics at four and six months. Cluster analysis showed three clusters of seasonality with geographic similarities representing metropolitan, rural, and other areas. Conclusions The association of Campylobacteriosis with temperature is likely to be indirect. High-resolution spatial temporal linkage of weather parameters and cases is important in improving weather associations with infectious diseases. The primary driver of Campylobacter incidence remains to be determined; other avenues, such as insect contamination of chicken flocks through poor biosecurity should be explored

Improved Linear Cryptanalysis of SOSEMANUK

Abstract. The SOSEMANUK stream cipher is one of the finalists of the eSTREAM project. In this paper, we improve the linear cryptanalysis of SOSEMANUK presented in Asiacrypt 2008. We apply the generalized linear masking technique to SOSEMANUK and derive many linear approximations holding with the correlations of up to 2 −25.5. We show that the data complexity of the linear attack on SOSEMANUK can be reduced by a factor of 2 10 if multiple linear approximations are used. Since SOSEMANUK claims 128-bit security, our attack would not be a real threat on the security of SOSEMANUK. Keywords: Stream Ciphers, Linear Cryptanalysis, SOSEMANUK, SOBER-128.

Stockpile surveillance: Past and future

The US nuclear weapon stockpile is entering a different era. Continuous introduction of new weapons into the stockpile, a large production capacity, and underground nuclear testing played important roles in how the nuclear weapons stockpile was managed in the past. These are no longer elements of the nuclear weapons program. Adjustments need to be made to compensate for the loss of these elements. The history of the stockpile indicates that problems have been found in both nuclear and nonnuclear components through a variety of methods including the Stockpile Evaluation Program, stockpile management activities, underground nuclear tests, and research activities. Changes have been made to the stockpile when necessary to assure safety, performance, and reliability. There have been problems found in each of the weapon types expected to be in the stockpile in the year 2000. It is reasonable to expect problems will continue to arise in the stockpile as it ages beyond the original design expectations

Synopsis of Cathode #4 Activation

The purpose of this report is to describe the activation of the fourth cathode installed in the DARHT-II Injector. Appendices have been used so that an extensive amount of data could be included without danger of obscuring important information contained in the body of the report. The cathode was a 612 M type cathode purchased from Spectra-Mat. Section II describes the handling and installation of the cathode. Section III is a narrative of the activation based on information located in the Control Room Log Book supplemented with time plots of pertinent operating parameters. Activation of the cathode was performed in accordance with the procedure listed in Appendix A. The following sections provide more details on the total pressure and constituent partial pressures in the vacuum vessel, cathode heater power/filament current, and cathode temperature