Structure of myelin P2 protein from equine spinal cord

Equine P2 protein has been isolated from horse spinal cord and its structure determined to 2.1 Å. Since equine myelin is a viable alternative to bovine tissue for large-scale preparations, characterization of the proteins from equine spinal cord myelin has been initiated. There is an unusually high amount of P2 protein in equine CNS myelin compared with other species. The structure was determined by molecular replacement and subsequently refined to an R value of 0.187 (<sub>free</sub> = 0.233). The structure contains a molecule of the detergent LDAO and HEPES buffer in the binding cavity and is otherwise analogous to other cellular retinol-binding proteins

Early warning signals in plant disease outbreaks

Infectious disease outbreaks in plants threaten ecosystems, agricultural crops and food trade. Currently, several fungal diseases are affecting forests worldwide, posing a major risk to tree species, habitats and consequently ecosystem decay. Prediction and control of disease spread are difficult, mainly due to the complexity of the interaction between individual components involved. In this work, we introduce a lattice-based epidemic model coupled with a stochastic process that mimics, in a very simplified way, the interaction between the hosts and pathogen. We studied the disease spread by measuring the propagation velocity of the pathogen on the susceptible hosts. Our quantitative results indicate the occurrence of a critical transition between two stable phases: local confinement and an extended epiphytotic outbreak that depends on the density of the susceptible individuals. Quantitative predictions of epiphytotics are performed using the framework early-warning indicators for impending regime shifts, widely applied on dynamical systems. These signals forecast successfully the outcome of the critical shift between the two stable phases before the system enters the epiphytotic regime. Our study demonstrates that early-warning indicators could be useful for the prediction of forest disease epidemics through mathematical and computational models suited to more specific pathogen–host-environmental interactions. Our results may also be useful to identify a suitable planting density to slow down disease spread and in the future, design highly resilient forests

A meta-ethnography of shared decision-making in mental health care from the perspective of staff and service users

Background Human rights, recovery, and value-based approaches are integral to strategic changes and development in mental health care. Successfully integrating such person-centred values in mental health services requires a paradigm shift from traditional biomedical models of care to a more human rights-based approach. An important aspect of this is shared decision making (SDM) between mental health staff and service users. Whilst it is widely acknowledged SDM leads to improved outcomes, there are barriers and challenges to implementing this approach effectively in clinical practice. Objectives This systematic review aimed to assess existing empirical research exploring mental health service users and/or staff’s attitudes towards and experiences of SDM in adult mental health care settings. Methods The review and protocol were registered on PROSPERO (CRD42023369472). Systematic searches were run on four databases. Search terms pertained to studies reporting on mental health staff or service users’ experiences of SDM in adult mental health care. Initial searches yielded 721 results. Included studies were analysed using a meta-ethnographic approach. Results Thirteen articles were included. Data were synthesised using meta ethnographic synthesis, which produced four higher order themes with related subthemes; the role of service user ownership, the influence of fluctuating capacity, the importance of therapeutic alliance and changing clinicians’ behaviours and attitudes. Implications Both staff and service users found SDM to be an important factor in delivering high quality, effective mental health care. Despite this, participants had very little experience of implementing SDM in practice due to several personal, professional, and organisational challenges. This suggests that differences exist between what services strive towards achieving, and the experience of those implementing this in practice. These findings suggest that further research needs to be conducted to fully understand the barriers of implementing SDM in mental health services with training delivered to staff and service users about SDM

Dimensional errors in LIGA-produced metal structures due to thermal expansion and swelling of PMMA.

Numerical methods are used to examine dimensional errors in metal structures microfabricated by the LIGA process. These errors result from elastic displacements of the PMMA mold during electrodeposition and arise from thermal expansion of the PMMA when electroforming is performed at elevated temperatures and from PMMA swelling due to absorption of water from aqueous electrolytes. Both numerical solutions and simple analytical approximations describing PMMA displacements for idealized linear and axisymmetric geometries are presented and discussed. We find that such displacements result in tapered metal structures having sidewall slopes up to 14 {micro}m per millimeter of height for linear structures bounded by large areas of PMMA. Tapers for curved structures are of similar magnitude, but these structures are additionally skewed from the vertical. Potential remedies for reducing dimensional errors are also discussed. Here we find that auxiliary moat-like features patterned into the PMMA surrounding mold cavities can reduce taper by an order of magnitude or more. Such moats dramatically reduce tapers for all structures, but increase skew for curved structures when the radius of curvature is comparable to the structure height

Exploring the impact of care home environments and culture on supporting residents to “wander” safely

Background Up to 60% of people with dementia living in care homes will ‘wander’ at some point, which has typically been seen by staff as a problematic behaviour. A range of non-pharmacological interventions have been tested to either support or prevent wandering. However, even recent innovative practice continues to maintain a focus on reducing or preventing wandering. This study aimed to identify, for the first time, care home staff perspectives on home level factors that facilitate or hinder them supporting residents to wander safely. Methods Semi-structured qualitative interviews were conducted with 19 care home staff, working in the North of England. Framework analysis was used to analyse the data. Results A range of environmental considerations were identified by staff. Care home design influenced how residents were able to move safely around, and inclusion of points of interest encouraged walking to different locations, such as a garden. Staff worried about managing access to other residents’ rooms by people who wander. Within the care home culture, prioritising safe staffing levels, training and awareness, involving external healthcare professionals where required and mentorship from experienced staff members, all contributed towards safe wandering. Staff support for positive risk-taking within the care home was key to promote person-centred care, alongside careful oversight and management of relationships between residents. Conclusions We identified a range of cultural and environmental factors that contribute towards safe wandering. A positive approach to risk-taking by staff is required to support residents to engage in wandering as an enjoyable activity, whilst acknowledging that there are inherent risks associated with this

Development of a novel patient reported outcome measure for health-related quality of life in amyotrophic lateral sclerosis (PROQuALS): study protocol

Background Patient reported outcome measures (PROMs) can be used to assess the impact of health conditions upon an individual’s health-related quality of life (HRQoL). Whilst PROMs have been used to quantify the HRQoL impact of amyotrophic lateral sclerosis (ALS), existing instruments may not fully capture what matters to people living with ALS (plwALS) or be appropriate to be used directly to inform the cost-effectiveness of new treatments. This highlights a need for a new condition-specific PROM that can both capture what’s important to plwALS and be used in economic evaluation. This study has two key aims: 1) to produce a novel PROM for measuring HRQoL in plwALS (PROQuALS). 2) to value a set of items from the novel PROM to generate an associated preference-weighted measure (PWM) that will enable utility values to be generated. Methods A mixed-methods study design will be conducted across three stages. Stage 1 involves concept elicitation and the generation of draft PROM content from a robust and comprehensive systematic review of HRQoL in ALS, with input from plwALS. Stage 2 consists of cognitive debriefing of the draft PROM content to ascertain its content validity (Stage 2a), followed by a psychometric survey (Stage 2b) to assess statistical performance. Evidence from Stage 2 will be used to make decisions on the final content and format of the novel PROM. Stage 3 will involve valuation and econometric modeling using health economics methods to generate preference weights, so a PWM derived from the novel PROM can be used in the cost-effectiveness analyses of treatments. Patient and clinical advisory groups will have critical, collaborative input throughout the project. Discussion The novel PROM will be designed to comprehensively assess important aspects of HRQoL to plwALS and to quantify HRQoL in terms of subjective impact. The PROQuALS measure will be available for use in research and healthcare settings. The associated PWM component will extend and enable the use of PROQuALS in cost-effective analyses of new treatments for ALS. Trial registration Not applicable

Commutative C∗C^*-algebras of Toeplitz operators on complex projective spaces

We prove the existence of commutative $C^*$-algebras of Toeplitz operators on every weighted Bergman space over the complex projective space $\mathbb{P}^n(\mathbb{C})$. The symbols that define our algebras are those that depend only on the radial part of the homogeneous coordinates. The algebras presented have an associated pair of Lagrangian foliations with distinguished geometric properties and are closely related to the geometry of $\mathbb{P}^n(\mathbb{C})$

Antimicrobials: a global alliance for optimizing their rational use in intra-abdominal infections (agora)

Intra-abdominal infections (IAI) are an important cause of morbidity and are frequently associated with poor prognosis, particularly in high-risk patients. The cornerstones in the management of complicated IAIs are timely effective source control with app1133132sem informaçãosem informaçã

Field-Induced Magnetic Ordering in the Quantum Spin System KCuCl3_3

KCuCl$_3$ is a three-dimensional coupled spin-dimer system and has a singlet ground state with an excitation gap ${\Delta}/k_{\rm B}=31$ K. High-field magnetization measurements for KCuCl$_3$ have been performed in static magnetic fields of up to 30 T and in pulsed magnetic fields of up to 60 T. The entire magnetization curve including the saturation region was obtained at $T=1.3$ K. From the analysis of the magnetization curve, it was found that the exchange parameters determined from the dispersion relations of the magnetic excitations should be reduced, which suggests the importance of the renormalization effect in the magnetic excitations. The field-induced magnetic ordering accompanied by the cusplike minimum of the magnetization was observed as in the isomorphous compound TlCuCl$_3$. The phase boundary was almost independent of the field direction, and is represented by the power law. These results are consistent with the magnon Bose-Einstein condensation picture for field-induced magnetic ordering.Comment: 9 pages, 7 figures, 9 eps files, revtex styl

Radiotherapy exposure directly damages the uterus and causes pregnancy loss

Female cancer survivors are significantly more likely to experience infertility than the general population. It is well established that chemotherapy and radiotherapy can damage the ovary and compromise fertility, yet the ability of cancer treatments to induce uterine damage, and the underlying mechanisms, have been understudied. Here, we show that in mice total-body γ-irradiation (TBI) induced extensive DNA damage and apoptosis in uterine cells. We then transferred healthy donor embryos into ovariectomized adolescent female mice that were previously exposed to TBI to study the impacts of radiotherapy on the uterus independent from effects to ovarian endocrine function. Following TBI, embryo attachment and implantation were unaffected, but fetal resorption was evident at midgestation in 100% of dams, suggesting failed placental development. Consistent with this hypothesis, TBI impaired the decidual response in mice and primary human endometrial stromal cells. TBI also caused uterine artery endothelial dysfunction, likely preventing adequate blood vessel remodeling in early pregnancy. Notably, when pro-apoptotic protein Puma-deficient (Puma-/-) mice were exposed to TBI, apoptosis within the uterus was prevented, and decidualization, vascular function, and pregnancy were restored, identifying PUMA-mediated apoptosis as a key mechanism. Collectively, these data show that TBI damages the uterus and compromises pregnancy success, suggesting that optimal fertility preservation during radiotherapy may require protection of both the ovaries and uterus. In this regard, inhibition of PUMA may represent a potential fertility preservation strategy.</p