555 research outputs found
Intermittent control models of human standing: similarities and differences
Two architectures of intermittent control are compared and contrasted in the context of the single inverted pendulum model often used for describing standing in humans. The architectures are similar insofar as they use periods of open-loop control punctuated by switching events when crossing a switching surface to keep the system state trajectories close to trajectories leading to equilibrium. The architectures differ in two significant ways. Firstly, in one case, the open-loop control trajectory is generated by a system-matched hold, and in the other case, the open-loop control signal is zero. Secondly, prediction is used in one case but not the other. The former difference is examined in this paper. The zero control alternative leads to periodic oscillations associated with limit cycles; whereas the system-matched control alternative gives trajectories (including homoclinic orbits) which contain the equilibrium point and do not have oscillatory behaviour. Despite this difference in behaviour, it is further shown that behaviour can appear similar when either the system is perturbed by additive noise or the system-matched trajectory generation is perturbed. The purpose of the research is to come to a common approach for understanding the theoretical properties of the two alternatives with the twin aims of choosing which provides the best explanation of current experimental data (which may not, by itself, distinguish beween the two alternatives) and suggesting future experiments to distinguish between the two alternatives
Factor H autoantibody is associated with atypical hemolytic uremic syndrome in children in the United Kingdom and Ireland
Factor H autoantibodies can impair complement
regulation, resulting in atypical hemolytic uremic
syndrome, predominantly in childhood. There are no trials
investigating treatment, and clinical practice is only
informed by retrospective cohort analysis. Here we
examined 175 children presenting with atypical hemolytic
uremic syndrome in the United Kingdom and Ireland for
factor H autoantibodies that included 17 children with
titers above the international standard. Of the 17, seven
had a concomitant rare genetic variant in a gene encoding
a complement pathway component or regulator. Two
children received supportive treatment; both developed
established renal failure. Plasma exchange was associated
with a poor rate of renal recovery in seven of 11 treated. Six
patients treated with eculizumab recovered renal function.
Contrary to global practice, immunosuppressive therapy to
prevent relapse in plasma exchange–treated patients was
not adopted due to concerns over treatment-associated
complications. Without immunosuppression, the relapse
rate was high (five of seven). However, reintroduction of
treatment resulted in recovery of renal function. All
patients treated with eculizumab achieved sustained
remission. Five patients received renal transplants without
specific factor H autoantibody–targeted treatment with
recurrence in one who also had a functionally significant CFI mutation. Thus, our current practice is to initiate
eculizumab therapy for treatment of factor H
autoantibody–mediated atypical hemolytic uremic
syndrome rather than plasma exchange with or without
immunosuppression. Based on this retrospective analysis
we see no suggestion of inferior treatment, albeit the
strength of our conclusions is limited by the small sample siz
Factors affecting aseptic loosening of 4750 total hip arthroplasties: multivariate survival analysis
White privilege, empathy and alterity in higher education : Teaching about race and racism in the sociology of PE and sport
In this chapter we provide a reflexive account on personal experiences teaching in HE in order to consider the extent to which our status as white HE practitioners reinforces and/or undermines white privilege in HE. As lecturers teaching within the discipline of sociology in physical education (PE) and sport contexts, we question whether our delivery of lectures on race and racism effectively challenges racialised discourses and encourages social action within our field. Despite the fact that the undergraduate programmes we work on incorporate lectures on race and ethnicity as a crucial part of the curriculum, these sessions have rarely been delivered by black and minority ethnic (BME) academics. We therefore consider whether our practice can provide a critical pedagogic voice, or if it simply provides a platform for white academics to unconsciously reinforce the institutional whiteness of HE. In particular, we reflect upon the possibility for white academics to empathise with the racialised social experiences of BME students in our cohorts, and the potential risk that our practice simply offers tokenistic discussion of race which reinforce the current forms of inequality and white privilege, whilst violating the alterity of our students
Patient-reported outcome measures for cancer caregivers: a systematic review
Purpose
Informal caregivers provide invaluable help and support to people with cancer. As treatments extend survival and the potential burdens on carers increase, there is a need to assess the impact of the role. This systematic review identified instruments that measure the impact of caregiving, evaluated their psychometric performance specifically in cancer and appraised the content.
Methods
A 2-stage search strategy was employed to: 1. identify instruments that measure the impact of caregiving, 2. run individual searches on each measure to identify publications evaluating psychometric performance in the target population. Searches were conducted in Medline, Embase, CINAHL and Psychinfo and restricted to English for instrument used and article language. Psychometric performance was evaluated for content and construct validity, internal consistency, test-retest reliability, precision, responsiveness and acceptability. Individual scale items were extracted and systematically categorised into conceptual domains.
Results
10 papers were included reporting on the psychometric properties of 8 measures. Although construct validity and internal consistency were most frequently evaluated, no study comprehensively evaluated all relevant properties. Few studies met our inclusion criteria so it was not possible to consider the psychometric performance of the measures across a group of studies. Content analysis resulted in 16 domains with 5 overarching themes: lifestyle disruption; wellbeing; health of the caregiver; managing the situation and relationships.
Conclusions
Few measures of caregiver impact have been subject to psychometric evaluation in cancer caregivers. Those that have do not capture well changes in roles and responsibilities within the family and career, indicating the need for a new instrument
Higher education delays and shortens cognitive impairment. A multistate life table analysis of the US Health and Retirement Study
Improved health may extend or shorten the duration of cognitive impairment by postponing incidence or death. We assess the duration of cognitive impairment in the US Health and Retirement Study (1992–2004) by self reported BMI, smoking and levels of education in men and women and three ethnic groups. We define multistate life tables by the transition rates to cognitive impairment, recovery and death and estimate Cox proportional hazard ratios for the studied determinants. 95% confidence intervals are obtained by bootstrapping. 55 year old white men and women expect to live 25.4 and 30.0 years, of which 1.7 [95% confidence intervals 1.5; 1.9] years and 2.7 [2.4; 2.9] years with cognitive impairment. Both black men and women live 3.7 [2.9; 4.5] years longer with cognitive impairment than whites, Hispanic men and women 3.2 [1.9; 4.6] and 5.8 [4.2; 7.5] years. BMI makes no difference. Smoking decreases the duration of cognitive impairment with 0.8 [0.4; 1.3] years by high mortality. Highly educated men and women live longer, but 1.6 years [1.1; 2.2] and 1.9 years [1.6; 2.6] shorter with cognitive impairment than lowly educated men and women. The effect of education is more pronounced among ethnic minorities. Higher life expectancy goes together with a longer period of cognitive impairment, but not for higher levels of education: that extends life in good cognitive health but shortens the period of cognitive impairment. The increased duration of cognitive impairment in minority ethnic groups needs further study, also in Europe
REST mediates resolution of HIF-dependent gene expression in prolonged hypoxia
The hypoxia-inducible factor (HIF) is a key regulator of the cellular response to hypoxia which promotes oxygen delivery and metabolic adaptation to oxygen deprivation. However, the degree and duration of HIF-1α expression in hypoxia must be carefully balanced within cells in order to avoid unwanted side effects associated with excessive activity. The expression of HIF-1α mRNA is suppressed in prolonged hypoxia, suggesting that the control of HIF1A gene transcription is tightly regulated by negative feedback mechanisms. Little is known about the resolution of the HIF-1α protein response and the suppression of HIF-1α mRNA in prolonged hypoxia. Here, we demonstrate that the Repressor Element 1-Silencing Transcription factor (REST) binds to the HIF-1α promoter in a hypoxia-dependent manner. Knockdown of REST using RNAi increases the expression of HIF-1α mRNA, protein and transcriptional activity. Furthermore REST knockdown increases glucose consumption and lactate production in a HIF-1α- (but not HIF-2α-) dependent manner. Finally, REST promotes the resolution of HIF-1α protein expression in prolonged hypoxia. In conclusion, we hypothesize that REST represses transcription of HIF-1α in prolonged hypoxia, thus contributing to the resolution of the HIF-1α response
Biodiversity in urban gardens: assessing the accuracy of citizen science data on garden hedgehogs
Urban gardens provide a rich habitat for species that are declining in rural areas. However, collecting data in gardens can be logistically-challenging, time-consuming and intrusive to residents. This study examines the potential of citizen scientists to record hedgehog sightings and collect habitat data within their own gardens using an online questionnaire. Focussing on a charismatic species meant that the number of responses was high (516 responses were obtained in 6 weeks, with a ~ 50:50% split between gardens
with and without hedgehog sightings). While many factors commonly thought to influence hedgehog
presence (e.g. compost heaps) were present in many hedgehog-frequented gardens, they were not discriminatory as they were also found in gardens where hedgehogs were not seen. Respondents were most likely to have seen hedgehogs in their garden if they had also seen hedgehogs elsewhere in their neighbourhood. However, primary fieldwork using hedgehog ‘footprint tunnels’ showed that hedgehogs were found to be just as prevalent in gardens in which hedgehogs had previously been reported as gardens where they had not been reported. Combining these results indicates that hedgehogs may be more common in urban and semi-urban gardens than previously believed, and that casual volunteer records of hedgehogs may be influenced more by the observer than by habitat preferences of the animal. When verified, volunteer records can provide useful information, but care is needed in interpreting these data
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