224 research outputs found
Global dynamics of a vibro-impacting linear oscillator
International audienceThe steady state, vibro-impacting responses of one dimensional, harmonically excited, linear oscillators are studied by using a modern dynamical systems approach allied with numerical simulation. The steady state motions are attracting sets in the system phase space and capture initial conditions in their domains of attraction. Unlike the free, harmonically excited oscillator, the phase space of a vibro-impacting system may be inhabited by many attracting sets. For example, there are sub-harmonic, multi-impact, periodic orbits and chaotic, steady state responses. In order to build a qualitative understanding of vibro-impact response, an attempt is made to build generic topological models of their phase spaces for physically significant parameter ranges. Use is made of the Poincaré section or stroboscopic mapping technique, essentially following an initial impact forwards or backwards in time to subsequent or previous impacts using a computer. The qualitative understanding gained from the analysis and simulations is discussed in an engineering context
Cohomology theory of the kenematical groups
A number of applications of S. Eilenberg and S. Maclane's cohomology theory of groups to the kinematical groups of physics are presented. Within this field, we apply the theory of group exten sions by Abelian and non-Abelian kernels to the study of the algebraic structures of the Galilei, Static and Carroll groups, and introduce to physics the mathematical concepts of group enlargements and prolongations. The global algebraic structures of the kinematical groups are analysed in depth using these tools and a generalisation of kinematical groups is attempted. The use of the methods of homological algebra in classical mechanics is discussed from the new view point of Lagrangian mechanics introduced by Lévy-Leblond. In this direction two advances are made. Homological algebra is introduced to the study of Hamilton's principle and then a reformulation of Levy-Leblond's free Lagrangian mechanics is obtained. Whilst the above author concentrates on a certain second cohomology group, we see that it is a first cohomology group which is more relevant to this approach. The group theoretic discussion of non-inertial motions is initiated using the theory of the loop prolongations of a group Q by a group K, where a loop is a 'non-associative group'. Our preliminary results enable us to give a cohomological description of constant Newtonian acceleration
Management of Patients Following Endoscopic Retrograde Cholangiopancreatography for Choledocholithiasis
The CD4+ T cell methylome contributes to a distinct CD4+ T cell transcriptional signature in Mycobacterium bovis-infected cattle
peer-reviewedWe hypothesised that epigenetic regulation of CD4+ T lymphocytes contributes to a shift toward a dysfunctional T cell phenotype which may impact on their ability to clear mycobacterial infection. Combined RNA-seq transcriptomic profiling and Reduced Representation Bisulfite Sequencing identified 193 significantly differentially expressed genes and 760 differentially methylated regions (DMRs), between CD4+ T cells from M. bovis infected and healthy cattle. 196 DMRs were located within 10 kb of annotated genes, including GATA3 and RORC, both of which encode transcription factors that promote TH2 and TH17 T helper cell subsets respectively. Gene-specific DNA methylation and gene expression levels for the TNFRSF4 and Interferon-γ genes were significantly negatively correlated suggesting a regulatory relationship. Pathway analysis of DMRs identified enrichment of genes involved in the anti-proliferative TGF-β signaling pathway and TGFB1 expression was significantly increased in peripheral blood leukocytes from TB-infected cattle. This first analysis of the bovine CD4+ T cell methylome suggests that DNA methylation directly contributes to a distinct gene expression signature in CD4+ T cells from cattle infected with M. bovis. Specific methylation changes proximal to key inflammatory gene loci may be critical to the emergence of a non-protective CD4+ T cell response during mycobacterial infection in cattle
Flexible Commissioning: A prevention and access focused approach in Yorkshire and the Humber
No abstract available
Erratum to: ‘Integrated analysis of the local and systemic changes preceding the development of post-partum cytological endometritis’
ErratumErratum to: ‘Integrated analysis of the local and systemic changes preceding the development of post-partum cytological endometritis’ -http://hdl.handle.net/11019/90
Moderate-intensity aerobic and resistance exercise is safe and favorably influences body composition in patients with quiescent Inflammatory Bowel Disease: a randomized controlled cross-over trial
peer-reviewedBackground
Overweight and metabolic problems now add to the burden of illness in patients with Inflammatory Bowel Disease. We aimed to determine if a program of aerobic and resistance exercise could safely achieve body composition changes in patients with Inflammatory Bowel Disease.
Methods
A randomized, cross-over trial of eight weeks combined aerobic and resistance training on body composition assessed by Dual Energy X-ray Absorptiometry was performed. Patients in clinical remission and physically inactive with a mean age of 25 ± 6.5 years and Body Mass Index of 28.9 ± 3.8 were recruited from a dedicated Inflammatory Bowel Disease clinic. Serum cytokines were quantified, and microbiota assessed using metagenomic sequencing.
Results
Improved physical fitness was demonstrated in the exercise group by increases in median estimated VO2max (Baseline: 43.41mls/kg/min; post-intervention: 46.01mls/kg/min; p = 0.03). Improvement in body composition was achieved by the intervention group (n = 13) with a median decrease of 2.1% body fat compared with a non-exercising group (n = 7) (0.1% increase; p = 0.022). Lean tissue mass increased by a median of 1.59 kg and fat mass decreased by a median of 1.52 kg in the exercising group. No patients experienced a deterioration in disease activity scores during the exercise intervention. No clinically significant alterations in the α- and β-diversity of gut microbiota and associated metabolic pathways were evident.
Conclusions
Moderate-intensity combined aerobic and resistance training is safe in physically unfit patients with quiescent Inflammatory Bowel Disease and can quickly achieve favourable body compositional changes without adverse effects.
Trial registration
The study was registered at ClinicalTrials.gov; Trial number:
NCT02463916
Retroperitoneal Compared to Transperitoneal Approach for Open Abdominal Aortic Aneurysm Repair Is Associated with Reduced Systemic Inflammation and Postoperative Morbidity
Background  In the United Kingdom, the most common surgical approach for repair of open abdominal aortic aneurysms (AAAs) is transperitoneal (TP). However, retroperitoneal (RP) approach is favored in those with more complex vascular anatomy often requiring a cross-clamp on the aorta superior to the renal arteries. This study compared these approaches in patients matched on all major demographic, comorbid, anatomic, and physiological variables. Methods  Fifty-seven patients (TP: n  = 24; RP: n  = 33) unsuitable for endovascular aneurysm repair underwent preoperative cardiopulmonary exercise testing prior to open AAA repair. The surgical approach undertaken was dictated by individual surgeon preference. Postoperative mortality, complications, and length of hospital stay (LoS) were recorded. Patients were further stratified according to infrarenal (IR) or suprarenal/supraceliac (SR/SC) surgical clamping. Systemic inflammation (C-reactive protein) and renal function (serum creatinine and estimated glomerular filtration rate) were recorded. Results  Twenty-three (96%) of TP patients only required an IR clamp compared with 12 (36%) in the RP group. Postoperative systemic inflammation was lower in RP patients ( p  = 0.002 vs. TP) and fewer reported pulmonary/gastrointestinal complications whereas renal impairment was more marked in those receiving SR/SC clamps ( p  < 0.001 vs. IR clamp). RP patients were defined by lower LoS ( p  = 0.001), while mid-/long-term mortality was low/comparable with TP, resulting in considerable cost savings. Conclusion  Despite the demands of more complicated vascular anatomy, the clinical and economic benefits highlighted by these findings justify the more routine adoption of the RP approach for complex AAA repair
Laboratory practice is central to earlier myeloma diagnosis:Utilizing a primary care diagnostic tool and laboratory guidelines integrated into haematology services
Treatment advances have greatly improved survival, but myeloma is among the worst of all cancers for delayed diagnosis, causing serious morbidities and early deaths. This delay is largely because the symptom profile of myeloma has very low specificity, and in primary care, myeloma is rare. However, initiating the journey to diagnosis simply requires considering myeloma and sending blood to test for monoclonal immunoglobulin. Laboratory tests reliably detect monoclonal immunoglobulin, which is present in 99% of myeloma cases, so why do health care systems have such a problem with delayed diagnosis? The Myeloma UK early diagnosis programme has brought together diverse expertise to investigate this problem, and this article was prepared by the programme's working group for laboratory best practice. It reviews evidence for test requesting, analysis and reporting, for which there is large variation in practice across the United Kingdom. It presents a ‘GP Myeloma diagnostic tool’ and how it can be integrated into laboratory practice alongside a laboratory best practice tool. It proposes improved requesting and integration with haematology services for reporting and interpretation. Here the laboratory has a central role in creating efficient and cost-effective pathways for appropriate and timely bone marrow examination for myeloma diagnosis.<br/
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