Effects of Sex and Gender on Adaptation to Space: Musculoskeletal Health

There is considerable variability among individuals in musculoskeletal response to long-duration spaceflight. The specific origin of the individual variability is unknown but is almost certainly influenced by the details of other mission conditions such as individual differences in exercise countermeasures, particularly intensity of exercise, dietary intake, medication use, stress, sleep, psychological profiles, and actual mission task demands. In addition to variations in mission conditions, genetic differences may account for some aspect of individual variability. Generally, this individual variability exceeds the variability between sexes that adds to the complexity of understanding sex differences alone. Research specifically related to sex differences of the musculoskeletal system during unloading is presented and discussed

Doping Effects on the Performance of Paired Metal Catalysts for the Hydrogen Evolution Reaction

Metal heteroatoms dispersed in nitrogen-doped graphene display promising catalytic activity for fuel cell reactions such as the hydrogen evolution reaction (HER). Here we explore the effects of dopant concentration on the synergistic catalytic behaviour of a paired metal atom active site comprised of Co and Pt atoms. The metals are coordinated to six atoms in a vacancy of N-doped graphene. We find that HER activity is enhanced with increasing N concentration, where the free energy of hydrogen atom adsorption ranges from 0.23 to -0.42 eV as the doping changes from a single N atom doped in the pore, to fully doped coordination sites. The results indicated that the effect of N is to make the Co atom more active towards H adsorption and presents a means through which transition metals can be modified to make more effective and sustainable fuel cell catalysts

The effects of cash transfers and vouchers on the use and quality of maternity care services: a systematic review

Background Cash transfers and vouchers are forms of 'demand-side financing' that have been widely used to promote maternal and newborn health in low- and middle-income countries during the last 15 years. Methods This systematic review consolidates evidence from seven published systematic reviews on the effects of different types of cash transfers and vouchers on the use and quality of maternity care services, and updates the systematic searches to June 2015 using the Joanna Briggs Institute approach for systematic reviewing. The review protocol for this update was registered with PROSPERO (CRD42015020637). Results Data from 51 studies (15 more than previous reviews) and 22 cash transfer and voucher programmes suggest that approaches tied to service use (either via payment conditionalities or vouchers for selected services) can increase use of antenatal care, use of a skilled attendant at birth and in the case of vouchers, postnatal care too. The strongest evidence of positive effect was for conditional cash transfers and uptake of antenatal care, and for vouchers for maternity care services and birth with a skilled birth attendant. However, effects appear to be shaped by a complex set of social and healthcare system barriers and facilitators. Studies have typically focused on an initial programme period, usually two or three years after initiation, and many lack a counterfactual comparison with supply-side investment. There are few studies to indicate that programmes have led to improvements in quality of maternity care or maternal and newborn health outcomes. Conclusion Future research should use multiple intervention arms to compare cost-effectiveness with similar investment in public services, and should look beyond short- to medium-term service utilisation by examining programme costs, longer-term effects on service utilisation and health outcomes, and the equity of those effects

Pengurangan Waste Pada Proses Produksi Botol X Menggunakan Metode Lean Sigma

Waste merupakan semua aktivitas kerja yang tidak memberikan nilai tambah dalam proses pembuatan produk sehingga harus segera direduksi atau dihilangkan dari proses produksi. Penelitian ini bertujuan untuk mengidentifikasi jenis-jenis waste yang terjadi dalam proses produksi, menganalisis faktor-faktor penyebab waste, serta memberikan usulan rekomendasi perbaikan untuk meminimasi waste. Metode yang digunakan dalam penelitian ini adalah lean Sigma, yaitu perpaduan antara metode lean manufacturing dan six Sigma yang bertujuan untuk mengidentifikasi dan meminimasi waste, memperbaiki proses, serta meningkatkan kualitas dari proses produksi. Penelitian ini dilakukan sebagai upaya continuous improvement untuk perbaikan proses dalam langkah kerja six Sigma (DMAIC). Dari tujuh kategori waste, teridentifikasi empat jenis waste dalam proses produksi botol X, yaitu defect, overproduction, waiting, dan inventories. Rekomendasi perbaikan yang diusulkan dalam penelitian ini ini didasarkan dari hasil identifikasi CTQ waste yang telah dianalisis menggunakan fishbone diagram dan pemilihan prioritas rekomendasi menggunakan FMEA. Hasil rekomendasi dari penelitian ini adalah mengenai peningkatan kedisiplinan operator maupun pihak manajemen

Epithelial cell-directed efferocytosis in the post-partum mammary gland is necessary for tissue homeostasis and future lactation

<p>Abstract</p> <p>Background</p> <p>Mammary glands harbor a profound burden of apoptotic cells (ACs) during post-lactational involution, but little is known regarding mechanisms by which ACs are cleared from the mammary gland, or consequences if this process is interrupted. We investigated AC clearance, also termed efferocytosis, during post-lactational remodeling, using mice deficient for MerTK, Axl, and Tyro3, three related receptor tyrosine kinases (RTKs) regulating macrophage-mediated efferocytosis in monocytes. MerTK expression, apoptosis and the accumulation of apoptotic debris were examined in histological sections of MerTK-deficient, Axl/Tyro3-deficient, and wild-type mammary glands harvested at specific time points during lactation and synchronized involution. The ability of primary mammary epithelial cells (MECs) to engulf ACs was assessed in culture. Transplant of MerTK-deficient mammary epithelium into cleared WT mammary fat pads was used to assess the contribution of WT mammary macrophages to post-lactational efferocytosis.</p> <p>Results</p> <p>ACs induced MerTK expression in MECs, resulting in elevated MerTK levels at the earliest stages of involution. Loss of MerTK resulted in AC accumulation in post-lactational MerTK-deficient mammary glands, but not in Axl and Tyro3-deficient mammary glands. Increased vascularization, fibrosis, and epithelial hyperproliferation were observed in MerTK-deficient mammary glands through at least 60 days post-weaning, due to failed efferocytosis after lactation, but did not manifest in nulliparous mice. WT host-derived macrophages failed to rescue efferocytosis in transplanted MerTK-deficient mammary epithelium.</p> <p>Conclusion</p> <p>Efferocytosis by MECs through MerTK is crucial for mammary gland homeostasis and function during the post-lactational period. Efferocytosis by MECs thus limits pathologic consequences associated with the apoptotic load following lactation.</p

Evaluating the catalytic efficiency of paired, single-atom catalysts for the oxygen reduction reaction

Paired, single-atom catalysts have been shown to demonstrate synergistic effects computationally and experimentally which enable them to outperform the benchmark catalyst, Pt/C, for electrochemical reactions. We explore the limit of these catalysts by screening different transition metal atoms (M = Co, Pt, Fe, Ni) in nitrogen-doped graphene for their ability to catalyze the oxygen reduction reaction (ORR). We employ density functional theory methods to explore the electronic factors affecting catalytic activity in an effort to rationalize trends in the performance of materials which are promising candidates for the next generation of electrocatalysts. It is found that CoPt@N8V4, composed of paired Co and Pt in a nitrogen-doped four-atom vacancy in graphene (N8V4), performs ideally for the ORR with an overpotential (η) of 0.30 V, followed closely by Co and Ni (η = 0.35 V) and paired Co (η = 0.37 V). The origin of activity is suggested to be the changing reduction potential of the active Co atom via the local distortion of the pore by the spectating metal partner. We utilize the ORR scaling relations and plot catalytic activity on a volcano plot, which we correlate with the degree of antibonding interactions with the O atom in the OH intermediate of the ORR. We establish that the local tuning of paired catalysts allows for the reactivity of metal atoms to be specifically modified for desirable reactivity

Direct Observations of the Ionizing Star in the UC HII Region G29.96-0.02: A Strong Constraint on the Stellar Birth Line for Massive Stars

We have observed the ultracompact HII region G29.96-0.02 in the near infrared J, H, and K bands and in the Br-gamma line. By comparison with radio observations, we determine that the extinction to the nebula is AK = 2.14 with a 3 sigma uncertainty of 0.25. We identify the ionizing star and determine its intrinsic K magnitude. The star does not have an infrared excess and so appears to be no longer accreting. The K magnitude and the bolometric luminosity allow us to place limits on the location of the ionizing star in the HR diagram. The 3 sigma upper limit on the effective temperature of the ionizing star is 42500 K. We favor a luminosity appropriate for star with a mass in excess of about 60 solar masses. The limit on the temperature and luminosity exclude stars on the ZAMS and stars within 10^6 yr of the ZAMS. Since the age of the UC HII region is estimated to be only about 10^5 yr, we suggest that this is direct evidence that the stellar birth line for massive stars at twice solar metallicity must be significantly redder than the ZAMS.Comment: 42 pages; LaTex; 11 Postscript figures; accepted for publication in Ap

Citrullinated and Malondialdehyde-Acetaldehyde Modified Fibrinogen Activates Macrophages and Promotes an Aggressive Synovial Fibroblast Phenotype in Patients with Rheumatoid Arthritis

Objective: Post-translational protein modifications with malondialdehyde-acetaldehyde (MAA) and citrulline (CIT) are implicated in the pathogenesis of rheumatoidarthritis (RA). Although precise mechanisms have not been elucidated, macrophage-fibroblast interactions have been proposed to play a central role in the development and progression of RA. The purpose of our study was to evaluate the downstream effects of macrophage released soluble mediators, following stimulation with fibrinogen (FIB) modified antigens, on human fibroblast-like synoviocytes (HFLS). Methods: PMA-treated U-937 monocytes (Mϕ) and macrophage-differentiated peripheral blood mononuclear cells (MP) were stimulated with FIB, FIB-MAA, FIB-CIT, or FIB-MAA-CIT. HFLS-RA cells were stimulated directly with FIB antigens or with supernatants (SN) from macrophages (Mϕ-SN or MP-SN) stimulated with FIB antigens. Genes associated with an aggressive HFLS phenotype, extracellular matrix proteins, and activated signaling pathways were evaluated. Results: HFLS-RA cells treated with Mϕ-SNFIB-CIT and Mϕ-SNFIB-MAA-CIT demonstrated significant increases in mRNA expression of genes associated with an aggressive phenotype at 24-h as compared to direct stimulation with the same antigens. Similar results were obtained using MP-SN. Cellular morphology was altered and protein expression of vimentin (p\u3c0.0001 vs. Mϕ-SNFIB) and type II collagen (p\u3c0.0001) were significantly increased in HFLS-RA cells treated with any of the Mϕ-SN generated following stimulation with modified antigens. Phosphorylation of JNK, Erk1/2, and Akt were increased most substantially in HFLS-RA treated with Mϕ-SNFIB-MAA-CIT (p\u3c0.05 vs Mϕ-SNFIB). These and other data suggested the presence of PDGF-BB in Mϕ-SN. Mϕ-SNFIB-MAA-CIT contained the highest concentration of PDGF-BB (p\u3c0.0001 vs. Mϕ-SNFIB) followed by Mϕ-SNFIB-CIT then Mϕ-SNFIB-MAA. HFLS-RA cells treated with PDGF-BB showed similar cellular morphology to the Mϕ-SN generated following stimulation with modified FIB, as well as the increased expression of vimentin, type II collagen, and the phosphorylation of JNK, Erk1/2 and Akt signaling molecules. Conclusion: Together, these findings support the hypothesis that in response to MAA-modified and/or citrullinated fibrinogen,macrophages release soluble factors including PDGF-BB that induce fibroblast activation and promote an aggressive fibroblast phenotype. These cellular responses were most robust following macrophage activation with dually modified fibrinogen, compared to single modification alone, providing novel insights into the combined role of multiple post-translational protein modifications in the development of RA

A case study evaluation of implementation of a care pathway to support normal birth in one English birth centre: anticipated benefits and unintended consequences

Background: The policy drive for the UK National Health Service (NHS) has focused on the need for high quality services informed by evidence of best practice. The introduction of care pathways and protocols to standardise care and support implementation of evidence into practice has taken place across the NHS with limited evaluation of their impact. A multi-site case study evaluation was undertaken to assess the impact of use of care pathways and protocols on clinicians, service users and service delivery. One of the five sites was a midwifery-led Birth Centre, where an adapted version of the All Wales Clinical Pathway for Normal Birth had been implemented. Methods: The overarching framework was realistic evaluation. A case study design enabled the capture of data on use of the pathway in the clinical setting, use of multiple methods of data collection and opportunity to study and understand the experiences of clinicians and service users whose care was informed by the pathway. Women attending the Birth Centre were recruited at their 36 week antenatal visit. Episodes of care during labour were observed, following which the woman and the midwife who cared for her were interviewed about use of the pathway. Interviews were also held with other key stakeholders from the study site. Qualitative data were content analysed. Results: Observations were undertaken of four women during labour. Eighteen interviews were conducted with clinicians and women, including the women whose care was observed and the midwives who cared for them, senior midwifery managers and obstetricians. The implementation of the pathway resulted in a number of anticipated benefits, including increased midwifery confidence in skills to support normal birth and promotion of team working. There were also unintended consequences, including concerns about a lack of documentation of labour care and negative impact on working relationships with obstetric and other midwifery colleagues. Women were unaware their care was informed by a care pathway. Conclusion: Care pathways are complex interventions which generate a number of consequences for practice. Those considering introduction of pathways need to ensure all relevant stakeholders are engaged with this and develop robust evaluation strategies to accompany implementation

An Open System for Social Computation

Part of the power of social computation comes from using the collective intelligence of humans to tame the aggregate uncertainty of (otherwise) low veracity data obtained from human and automated sources. We have witnessed a surge in development of social computing systems but, ironically, there have been few attempts to generalise across this activity so that creation of the underlying mechanisms themselves can be made more social. We describe a method for achieving this by standardising patterns of social computation via lightweight formal specifications (we call these social artifacts) that can be connected to existing internet architectures via a single model of computation. Upon this framework we build a mechanism for extracting provenance meta-data across social computations