Developmental and evolutionary origins of the pharyngeal apparatus

The vertebrate pharyngeal apparatus, serving the dual functions of feeding and respiration, has its embryonic origin in a series of bulges found on the lateral surface of the head, the pharyngeal arches. Developmental studies have been able to discern how these structures are constructed and this has opened the way for an analysis of how the pharyngeal apparatus was assembled and modified during evolution. For many years, the role of the neural crest in organizing pharyngeal development was emphasized and, as this was believed to be a uniquely vertebrate cell type, it was suggested that the development of the pharyngeal apparatus of vertebrates was distinct from that of other chordates. However, it has now been established that a key event in vertebrate pharyngeal development is the outpocketing of the endoderm to form the pharyngeal pouches. Significantly, outpocketing of the pharyngeal endoderm is a basal deuterostome character and the regulatory network that mediates this process is conserved. Thus, the framework around which the vertebrate pharyngeal apparatus is built is ancient. The pharyngeal arches of vertebrates are, however, more complex and this can be ascribed to these structures being populated by neural crest cells, which form the skeletal support of the pharynx, and mesoderm, which will give rise to the musculature and the arch arteries. Within the vertebrates, as development progresses beyond the phylotypic stage, the pharyngeal apparatus has also been extensively remodelled and this has seemingly involved radical alterations to the developmental programme. Recent studies, however, have shown that these alterations were not as dramatic as previously believed. Thus, while the evolution of amniotes was believed to have involved the loss of gills and their covering, the operculum, it is now apparent that neither of these structures was completely lost. Rather, the gills were transformed into the parathyroid glands and the operculum still exists as an embryonic entity and is still required for the internalization of the posterior pharyngeal arches. Thus, the key steps in our phylogenetic history are laid out during the development of our pharyngeal apparatus

The National Singing Programme for primary schools in England: an initial baseline study

The ‘Sing Up’ National Singing Programme for Primary schools in England was launched in November 2007 under the UK Government’s ‘Music Manifesto’. ‘Sing Up’ is a four-year programme whose overall aim is to raise the status of singing and increase opportunities for children throughout the country to enjoy singing as part of their everyday lives, in and out of school. As part of the Programme’s research evaluation, a key focus has been to build an initial picture of singing in Primary schools across England. This information could then be used as a ‘baseline’ by which the programme’s subsequent impact could be judged, including ‘before’ and ‘after’ measures of schools that receive particular ‘Sing Up’ input. This paper reports an overview of key outcomes of first five months of baseline profiling (October, 2007 to February 2008), embracing analyses of the singing behaviours of 3,472 children in 76 Primary schools. These findings are complimented by additional analyses of children’s views on singing in and out of school; and the self-efficacy of their class teachers’ (n=90), both as singers and as teachers of singing

Prospectivity Mapping for Epithermal Deposits of Western Milos Using a Fuzzy Multi Criteria Evaluation Approach Parameterized by Airborne Hyperspectral Remote Sensing Data

A Mineral prospectivity mapping (MPM) approach using a GIS-based weighted linear combination implementation of a Multi-Criteria Evaluation approach utilising a fuzzy Analytical Hierarchy Process to elucidate expert knowledge has been implemented to analyse the spatial distribution of epithermal deposits on the Island of Milos, Greece and model their association with exploration evidence data with the aim of providing insights into the controls on ore deposition. An integrated field and Digital Airborne Imaging Spectrometer (DAIS) hyperspectral and thermal multispectral airborne remote sensing dataset supported by field mapping and laboratory analyses, has been utilised to resolve hydrothermal alteration and parameterise the MPM. This study has highlighted the intimate spatial relationship between topographic highs and locations with high grade silicified alteration at a number of locations. The ability of high spatial resolution multispectral Thermal InfraRed (TIR) remote sensing imagery, integrated with topographic data, to resolve these silicified topographic highs provides an additional tool in the exploration of epithermal deposits. The spatial relationships between silicified lithocaps, high-grade altered rocks, faulting and topographic highs were utilised in the development of the MPM model. A close association between the modelled results and the hydrothermal alteration mapped in the field supports the accuracy of this MPM approach.Funded by Natural Environment Research Council (NERC) GA/09f/139-RMS E355

Exposure to secondhand smoke in cars and e-cigarette use among 10-11 year old children in Wales: CHETS Wales 2 key findings report

No abstract available

Foot health education for people with rheumatoid arthritis : the practitioner's perspective

Background: Patient education is considered to be a key role for podiatrists in the management of patients with rheumatoid arthritis (RA). Patient education has undoubtedly led to improved clinical outcomes, however no attempts have been made to optimise its content or delivery to maximise benefits within the context of the foot affected by rheumatoid arthritis. The aim of this study was to identify the nature and content of podiatrists' foot health education for people with RA. Any potential barriers to its provision were also explored. Methods: A focus group was conducted. The audio dialogue was recorded digitally, transcribed verbatim and analysed using a structured, thematic approach. The full transcription was verified by the focus group as an accurate account of what was said. The thematic analysis framework was verified by members of the research team to ensure validity of the data. Results: Twelve members (all female) of the north west Podiatry Clinical Effectiveness Group for Rheumatology participated. Six overarching themes emerged: (i) the essence of patient education; (ii) the content; (iii) patient-centred approach to content and timing; (iv) barriers to provision; (v) the therapeutic relationship; and (vi) tools of the trade. Conclusion: The study identified aspects of patient education that this group of podiatrists consider most important in relation to its: content, timing, delivery and barriers to its provision. General disease and foot health information in relation to RA together with a potential prognosis for foot health, the role of the podiatrist in management of foot health, and appropriate self-management strategies were considered to be key aspects of content, delivered according to the needs of the individual. Barriers to foot health education provision, including financial constraints and difficulties in establishing effective therapeutic relationships, were viewed as factors that strongly influenced foot health education provision. These data will contribute to the development of a patient-centred, negotiated approach to the provision of foot health education for people with RA

“Patch them up and send them home”: perceptions of nurses and physiotherapists in their role with end-stage COPD

Background: People with severe Chronic Obstructive Pulmonary Disease (COPD) have a high symptom burden and experience repeated hospital admissions as their disease progresses. End of life is typically difficult to predict, and although palliative care initiatives are developing within COPD, active treatment often continues up to death. There is a lack of literature in the field concerning the impact this has on staff delivering care, and their role in decision-making within this patient group. Aims: To explore the role of staff in caring and treatment decision-making for those with acute severe COPD and the multi-disciplinary team relationships influencing care. Methods: This exploratory, qualitative study consisted of 4 interviews and 1 focus group with nurses and physiotherapists who care for patients with severe COPD in the acute hospital setting. A grounded theory approach to analysis was aided by the software NVivo. Results: Advocacy and support to patients and families were cited as important aspects of their role, but effectiveness is hampered by pressure on beds and the general approach of “patch them up and send them home”. Advocacy was described in terms of information-giving and communication, and staff opinions were consulted in some treatment decisions, but that this depended on the hierarchy of the medical team: “…it comes down to which consultant is in charge that day”. Levels of decision-making involvement and advocacy were related to knowing the patient and professional experience, but were significantly limited by time and other pressures. Conclusions: Participants described frustration regarding the lack of palliative care decision-making in end-stage COPD, but nurses and physiotherapists are developing their roles in advocacy for this patient group. A second phase of data collection is investigating the nature of advocacy in this group further

An automated fitting procedure and software for dose-response curves with multiphasic features.

In cancer pharmacology (and many other areas), most dose-response curves are satisfactorily described by a classical Hill equation (i.e. 4 parameters logistical). Nevertheless, there are instances where the marked presence of more than one point of inflection, or the presence of combined agonist and antagonist effects, prevents straight-forward modelling of the data via a standard Hill equation. Here we propose a modified model and automated fitting procedure to describe dose-response curves with multiphasic features. The resulting general model enables interpreting each phase of the dose-response as an independent dose-dependent process. We developed an algorithm which automatically generates and ranks dose-response models with varying degrees of multiphasic features. The algorithm was implemented in new freely available Dr Fit software (sourceforge.net/projects/drfit/). We show how our approach is successful in describing dose-response curves with multiphasic features. Additionally, we analysed a large cancer cell viability screen involving 11650 dose-response curves. Based on our algorithm, we found that 28% of cases were better described by a multiphasic model than by the Hill model. We thus provide a robust approach to fit dose-response curves with various degrees of complexity, which, together with the provided software implementation, should enable a wide audience to easily process their own data.This work was funded by Cancer Research UK grant C14303/A17197.This is the final version of the article. It first appeared from NPG via http://dx.doi.org/10.1038/srep1470

Goals-of-Care & End-of-Life Quality in Relapsed High-Risk Leukemia: Silent Conversations

BACKGROUND: The distorted association of “end of life (EOL)” with “goals of care (GOC)” has “silenced” crucial goals discussions in patients with relapsed high-risk leukemia, which raises concerns for the provision of care that is inconsistent with patient’s values and preferences. AIM: The two main goals of this study were to quantify hematologists rate of participation in a GOC pathway initiative during two separate months, then explore their definition and barriers to having/documenting GOC discussions. DESIGN: Mixed-methods, explanatory sequential design (follow-up explanations variant). SAMPLE: Quan: Hematology inpatient admissions during the months of October 2020 and January 2021. Qual: Eighteen leukemia hematologists from one dedicated cancer in the United States. RESULTS: During the two months, an average of 36% of admissions met criteria for GOC pathway initiation, 19% of those had an appropriate initiation order, of which 15.5% had a properly documented and billed GOC discussion. Nine hematologists responded to the SurveyMonkey with two questions. All nine included clinical situation and communication in their definition/components of GOC discussions. Time required and prognostic uncertainty were the two most mentioned barriers