Primary Care Endometrial Sampling for Abnormal Uterine Bleeding: A Pilot Study

Background Most cases of abnormal uterine bleeding (AUB) could potentially be managed in primary care but lack of access to endometrial sampling leads to avoidable referrals to hospital to rule out endometrial hyperplasia and cancer. Aims To design and evaluate a pilot service for primary care endometrial sampling (PCES). Design Retrospective analysis of data from two service evaluations. Setting General practices and the gynaecology department in a large city in the United Kingdom. Methods 1) To design the new service we identified all the endometrial samples taken in the city’s gynaecology department in 2012/13 and estimated the proportion of these with AUB that would be suitable for PCES. 2) To evaluate the new PCES service we analysed data from the first year of activity. Results 1) 1894 endometrial samples were taken in hospital in 2012/13. An estimated 424 (22.4%) of these were from patients with AUB who fitted the criteria for PCES. 2) In the first year of the PCES service 108 samples were taken by GPs. Initial management of these patients was exclusively in primary care in 97.2% (104/108), most patients were treated with Mirena IUS (79/109; 73.1%) and there were no cases of hyperplasia or cancer. Conclusions Most pre-menopausal patients with AUB could potentially be managed in primary care without referral to hospital if ES was made available to appropriately trained and supported GPs. However, this study was limited by it’s retrospective non-interventional design and more research is required to demonstrate safety and cost-effectiveness. Key Message Points Primary care is a crucial part of the care pathway for patients with abnormal uterine bleeding. In the first instance, the majority of patients with AUB can be managed exclusively in primary care without referral to hospital. Primary care management of AUB may be cost effective but an economic model of the care pathway is required to make accurate comparisons between primary care and secondary care

The use of chemoprophylaxis in East African Zebu village cattle exposed to trypanosomiasis in Muhaka, Kenya

A study conducted to assess the efficacy of chemoprophylaxis for the improvement of the health and productivity of East African Zebu village cattle exposed to trypanosomiasis. Examines the cost-effectiveness of the treatment. Includes data on calf pre-weaning health and weight traits, weight traits of calves from 12-18 months of age, calf post-weaning health and weight traits, and breeding cow health and production traits - for the non-prophylactic and prophylactic groups

Coulomb blockade of strongly coupled quantum dots studied via bosonization of a channel with a finite barrier

A pair of quantum dots, coupled through a point contact, can exhibit Coulomb blockade effects that reflect an oscillatory term in the dots' total energy whose value depends on whether the total number of electrons on the dots is even or odd. The effective energy associated with this even-odd alternation is reduced, relative to the bare Coulomb blockade energy for uncoupled dots, by a factor (1-f) that decreases as the interdot coupling is increased. When the transmission coefficient for interdot electronic motion is independent of energy and the same for all channels within the point contact (which are assumed uncoupled), the factor (1-f) takes on a universal value determined solely by the number of channels and the dimensionless conductance g of each individual channel. This paper studies corrections to the universal value of (1-f) that result when the transmission coefficent varies over energy scales of the size of the bare Coulomb blockade energy. We consider a model in which the point contact is described by a single orbital channel containing a parabolic barrier potential, and we calculate the leading correction to (1-f) for one-channel (spin-split) and two-channel (spin-degenerate) point contacts in the limit where the single orbital channel is almost completely open. By generalizing a previously used bosonization technique, we find that, for a given value of the dimensionless conductance g, the value of (1-f) is increased relative to its value for a zero-thickness barrier, but the absolute value of the increase is small in the region where our calculations apply.Comment: 13 pages, 3 Postscript figure

Liver, horseradish and bananas: a diet of enzymes for voltammetry

In this paper we will report on recent work that we have carried out involving enzymes such as glutamate dehydrogenase (from liver), peroxidase (from horseradish) and tyrosinase (from banana)

Recent developments in monitoring and modelling airborne pollen, a review

Public awareness of the rising importance of allergies and other respiratory diseases has led to increased scientific effort to accurately and rapidly monitor and predict pollen, fungal spores and other bioaerosols in our atmosphere. An important driving force for the increased social and scientific concern is the realisation that climate change will increasingly have an impact on worldwide bioaerosol distributions and subsequent human health. In this review we examine new developments in monitoring of atmospheric pollen as well as observation and source-orientated modelling techniques. The results of a Scopus® search for scientific publications conducted with the terms ‘Pollen allergy’ and ‘Pollen forecast’ included in the title, abstract or keywords show that the number of such articles published has increased year on year. The 12 most important allergenic pollen taxa in Europe as defined by COST Action ES0603 were ranked in terms of the most ‘popular’ for model-based forecasting and for forecasting method used. Betula, Poaceae and Ambrosia are the most forecast taxa. Traditional regression and phenological models (including temperature sum and chilling models) are the most used modelling methods, but it is notable that there are a large number of new modelling techniques being explored. In particular, it appears that Machine Learning techniques have become more popular and led to better results than more traditional observation-orientated models such as regression and time-series analyses

Contribution of Color Information in Visual Saliency Model for Videos

International audienceMuch research has been concerned with the contribution of the low level features of a visual scene to the deployment of visual attention. Bottom-up saliency models have been developed to predict the location of gaze according to these features. So far, color besides to brightness, contrast and motion is considered as one of the primary features in computing bottom-up saliency. However, its contribution in guiding eye movements when viewing natural scenes has been debated. We investigated the contribution of color information in a bottom-up visual saliency model. The model efficiency was tested using the experimental data obtained on 45 observers who were eye tracked while freely exploring a large data set of color and grayscale videos. The two datasets of recorded eye positions, for grayscale and color videos, were compared with a luminance-based saliency model. We incorporated chrominance information to the model. Results show that color information improves the performance of the saliency model in predicting eye positions

Calibration of the Gamma-RAy Polarimeter Experiment (GRAPE) at a Polarized Hard X-Ray Beam

The Gamma-RAy Polarimeter Experiment (GRAPE) is a concept for an astronomical hard X-ray Compton polarimeter operating in the 50 - 500 keV energy band. The instrument has been optimized for wide-field polarization measurements of transient outbursts from energetic astrophysical objects such as gamma-ray bursts and solar flares. The GRAPE instrument is composed of identical modules, each of which consists of an array of scintillator elements read out by a multi-anode photomultiplier tube (MAPMT). Incident photons Compton scatter in plastic scintillator elements and are subsequently absorbed in inorganic scintillator elements; a net polarization signal is revealed by a characteristic asymmetry in the azimuthal scattering angles. We have constructed a prototype GRAPE module containing a single CsI(Na) calorimeter element, at the center of the MAPMT, surrounded by 60 plastic elements. The prototype has been combined with custom readout electronics and software to create a complete "engineering model" of the GRAPE instrument. This engineering model has been calibrated using a nearly 100% polarized hard X-ray beam at the Advanced Photon Source at Argonne National Laboratory. We find modulation factors of 0.46 +/- 0.06 and 0.48 +/- 0.03 at 69.5 keV and 129.5 keV, respectively, in good agreement with Monte Carlo simulations. In this paper we present details of the beam test, data analysis, and simulations, and discuss the implications of our results for the further development of the GRAPE concept.Comment: 35 pages, 14 figures, accepted for publication in NIM-

Coreceptor Usage by HIV-1 and HIV-2 Primary Isolates: The Relevance of CCR8 Chemokine Receptor as an Alternative Coreceptor

The human immunodeficiency virus replication cycle begins by sequential interactions between viral envelope glycoproteins with CD4 molecule and a member of the seven-transmembrane, G-protein-coupled, receptors' family (coreceptor). In this report we focused on the contribution of CCR8 as alternative coreceptor for HIV-1 and HIV-2 isolates. We found that this coreceptor was efficiently used not only by HIV-2 but particularly by HIV-1 isolates. We demonstrate that CXCR4 usage, either alone or together with CCR5 and/or CCR8, was more frequently observed in HIV-1 than in HIV-2 isolates. Directly related to this is the finding that the non-usage of CXCR4 is significantly more common in HIV-2 isolates; both features could be associated with the slower disease progression generally observed in HIV-2 infected patients. The ability of some viral isolates to use alternative coreceptors besides CCR5 and CXCR4 could further impact on the efficacy of entry inhibitor therapy and possibly also in HIV pathogenesis