Pulmonary arterial hypertension: the burden of disease and impact on quality of life.

Pulmonary arterial hypertension (PAH) is a debilitating disease that pervades all aspects of a patients daily life. It is also increasingly acknowledged that the burden of PAH extends to older patients and carers. Until recently, the adverse effect of disease symptoms on the physical, emotional and social factors governing patient health-related quality of life (HRQoL) remained largely unrecognised. With a shift in therapeutic objectives to longer term improvements and HRQoL benefits, clinical trials now frequently include HRQoL measures as study end-points. Most HRQoL instruments used in patients with PAH are generic or non-disease-specific questionnaires and therefore may not accurately capture PAH disease burden. New PAH-specific HRQoL instruments currently undergoing validation include emPHasis-10 and Pulmonary Arterial Hypertension-Symptoms and Impact (PAH-SYMPACT; Actelion Pharmaceuticals Ltd, Allschwil, Switzerland). Using various HRQoL measures, pharmacological therapies have been shown to improve HRQoL in patients with PAH. Patients also derive HRQoL benefits from nonpharmacological strategies, which include the emotional support provided by multidisciplinary care and support groups that is fundamental to patient wellbeing. Looking to the future, validated PAH-specific HRQoL instruments together with dedicated guidelines and procedures are essential to support the translation of HRQoL scores to the clinic, thus enabling a holistic treatment approach to the management of patients with PAH

Supporting safe motherhood : a review of financial trends : summary

An estimated 500,000 women, 99 percent of them from the developing world, die each year from pregnancy-related causes. About three quarters of these deaths are the direct result of obstetrical complications -- hemorrhage, infection, toxemia, obstructed labor, and abortion (under primitive and illegal conditions). An estimated equivalent number of infants do not survive their mother's death. For surviving mothers, the consequences of pregnancy have a severe impact on health and family economics. The strategy for safe motherhood is based on two approaches. First, the encouragement of activities that indirectly improve maternal health. These include education, policies to improve women's rights and working conditions, health care and nutrition, transportation and communication systems, water and sanitation facilities, and increases in family income and food production. The second approach targets activities to reduce maternal deaths. These activities include reducing unwanted pregnancies through the provision of family planning services, and through national policies that recognize the importance of this issue. A second objective is to reduce the risks of pregnancy through providing community-based family planning and prenatal services to identify high-risk cases'adequate referral services for the complications of pregnancy, and communication and transport systems to support patient referral procedures.Health Monitoring&Evaluation,Health Systems Development&Reform,Gender and Health,Early Child and Children's Health,Agricultural Knowledge&Information Systems

Cozymase. A study of purification methods

Cozymase is one of the essential components of the complex enzyme mixture which effects alcoholic fermentation in the absence of living cells. The separation of the mixture into zymase and cozymase was first accomplished by Harden and Young [1] by means of ultrafiltration through a gelatin-impregnated Chamberland filter candle. The residue and filtrate as thus prepared possessed, separately, no fermentative action, but when mixed were found to produce a rapid fermentation. The active constituent of the residue was named zymase, while that constituent of the filtrate responsible for the reactivation of the residue was named cozymase. We studied the purification produced in our material by a variety of reagents. In the investigation we have repeated much of the work done by von Euler and Myrbäk [2], and several differences have been found, which appear difficult to explain solely upon the basis of the lower initial purity of our material. As certain of the experiments show distinct promise, we hope to be able to extend the work upon a material of considerably higher original purity, such as was employed by von Euler and Myrbäk

Control of germ-band retraction in Drosophila by the zinc-finger protein HINDSIGHT

Drosophila embryos lacking hindsight gene function have a normal body plan and undergo normal germ-band extension. However, they fail to retract their germ bands. hindsight encodes a large nuclear protein of 1920 amino acids that contains fourteen C2H2-type zinc fingers, and glutamine-rich and proline-rich domains, suggesting that it functions as a transcription factor. Initial embryonic expression of hindsight RNA and protein occurs in the endoderm (midgut) and extraembryonic membrane (amnioserosa) prior to germ-band extension and continues in these tissues beyond the completion of germ-band retraction. Expression also occurs in the developing tracheal system, central and peripheral nervous systems, and the ureter of the Malpighian tubules. Strikingly, hindsight is not expressed in the epidermal ectoderm which is the tissue that undergoes the cell shape changes and movements during germ-band retraction. The embryonic midgut can be eliminated without affecting germ-band retraction. However, elimination of the amnioserosa results in the failure of germ-band retraction, implicating amnioserosal expression of hindsight as crucial for this process. Ubiquitous expression of hindsight in the early embryo rescues germ-band retraction without producing dominant gainof-function defects, suggesting that hindsight’s role in germ-band retraction is permissive rather than instructive. Previous analyses have shown that hindsight is required for maintenance of the differentiated amnioserosa (Frank, L. C. and Rushlow, C. (1996) Development 122, 1343-1352). Two classes of models are consistent with the present data. First, hindsight’s function in germ-band retraction may be limited to maintenance of the amnioserosa which then plays a physical role in the retraction process through contact with cells of the epidermal ectoderm. Second, hindsight might function both to maintain the amnioserosa and to regulate chemical signaling from the amnioserosa to the epidermal ectoderm, thus coordinating the cell shape changes and movements that drive germ-band retraction

Standardization and the production of justice in summary criminal courts: a post human analysis

Since the 1980s, successive governments have become increasingly distrustful of professional judgment in those services which remain funded by the state, including the criminal justice system. Against this background, governments sought to increase efficiency in summary criminal courts. One way that this seems to have occurred is via the use of standardized forms in case progression. During 2013, Welsh conducted empirical research in which the reliance placed on standardized case management forms became apparent. We argue, drawing on post-humanist vocabularies to inform our analytic framework, that such documents may have shifted the temporality of summary criminal justice, which has the (perhaps unintended) consequence of (further) marginalizing defendant participation and limiting the types of legal issue that are litigated. These documents and processes, therefore, participate in the development of a particularized, and temporally situated, form of ‘justice’

From urban to national heat island: The effect of anthropogenic heat output on climate change in high population industrial countries

The project presented here sought to determine whether changes in anthropogenic thermal emission can have a measurable effect on temperature at the national level, taking Japan and Great Britain as type examples. Using energy consumption as a proxy for thermal emission, strong correlations (mean r2 = 0.90 and 0.89, respectively) are found between national equivalent heat output (HO) and temperature above background levels Δt averaged over 5‐ to 8‐yr periods between 1965 and 2013, as opposed to weaker correlations for CMIP5 model temperatures above background levels Δmt (mean r2 = 0.52 and 0.10). It is clear that the fluctuations in Δt are better explained by energy consumption than by present climate models, and that energy consumption can contribute to climate change at the national level on these timescales

Persistence in the Voter model: continuum reaction-diffusion approach

We investigate the persistence probability in the Voter model for dimensions d\geq 2. This is achieved by mapping the Voter model onto a continuum reaction-diffusion system. Using path integral methods, we compute the persistence probability r(q,t), where q is the number of ``opinions'' in the original Voter model. We find r(q,t)\sim exp[-f_2(q)(ln t)^2] in d=2; r(q,t)\sim exp[-f_d(q)t^{(d-2)/2}] for 2<d<4; r(q,t)\sim exp[-f_4(q)t/ln t] in d=4; and r(q,t)\sim exp[-f_d(q)t] for d>4. The results of our analysis are checked by Monte Carlo simulations.Comment: 10 pages, 3 figures, Latex, submitted to J. Phys. A (letters

Integrated structure electromagnetic optimization of large space antenna reflectors

The requirements for extremely precise and powerful large space antenna reflectors have motivated the development of a procedure for shape control of the reflector surface. A mathematical optimization procedure has been developed which improves antenna performance while minimizing necessary shape correction effort. In contrast to previous work which proposed controlling the rms distortion error of the surface thereby indirectly improving antenna performance, the current work includes electromagnetic (EM) performance calculations as an integral of the control procedure. The application of the procedure to a radiometer design with a tetrahedral truss backup structure demonstrates the potential for significant improvement. The results indicate the benefit of including EM performance calculations in procedures for shape control of large space antenna reflectors

Some interactions among driver, vehicle, and roadway variables in normal driving

Effects of road and vehicle conditions, visual warning signs, direction of turns, night time, and skill on automobile driver performance are studied in several experiments. Considered criteria are variability in speed and acceleration