Sds22 regulates aurora B activity and microtubule-kinetochore interactions at mitosis

Sds22 defines protein phosphatase 1 location and function at kinetochores and subsequent activity of aurora B in mitosis

Improving the effectiveness and efficiency of outpatient services: a scoping review of interventions at the primary-secondary care interface.

Objectives Variation in patterns of referral from primary care can lead to inappropriate overuse or underuse of specialist resources. Our aim was to review the literature on strategies involving primary care that are designed to improve the effectiveness and efficiency of outpatient services. Methods A scoping review to update a review published in 2006. We conducted a systematic literature search and qualitative evidence synthesis of studies across five intervention domains: transfer of services from hospital to primary care; relocation of hospital services to primary care; joint working between primary care practitioners and specialists; interventions to change the referral behaviour of primary care practitioners and interventions to change patient behaviour. Results The 183 studies published since 2005, taken with the findings of the previous review, suggest that transfer of services from secondary to primary care and strategies aimed at changing referral behaviour of primary care clinicians can be effective in reducing outpatient referrals and in increasing the appropriateness of referrals. Availability of specialist advice to primary care practitioners by email or phone and use of store-and-forward telemedicine also show potential for reducing outpatient referrals and hence reducing costs. There was little evidence of a beneficial effect of relocation of specialists to primary care, or joint primary/secondary care management of patients on outpatient referrals. Across all intervention categories there was little evidence available on cost-effectiveness. Conclusions There are a number of promising interventions which may improve the effectiveness and efficiency of outpatient services, including making it easier for primary care clinicians and specialists to discuss patients by email or phone. There remain substantial gaps in the evidence, particularly on cost-effectiveness, and new interventions should continue to be evaluated as they are implemented more widely. A move for specialists to work in the community is unlikely to be cost-effective without enhancing primary care clinicians' skills through education or joint consultations with complex patients.This project was funded by the National Institute for Health Research Health Services and Delivery Research programme (project number 12/135/02).This is the final version of the article. It first appeared from SAGE via http://dx.doi.org/10.1177/1355819616648982

Kinetochore alignment within the metaphase plate is regulated by centromere stiffness and microtubule depolymerases

During mitosis in most eukaryotic cells, chromosomes align and form a metaphase plate halfway between the spindle poles, about which they exhibit oscillatory movement. These movements are accompanied by changes in the distance between sister kinetochores, commonly referred to as breathing. We developed a live cell imaging assay combined with computational image analysis to quantify the properties and dynamics of sister kinetochores in three dimensions. We show that baseline oscillation and breathing speeds in late prometaphase and metaphase are set by microtubule depolymerases, whereas oscillation and breathing periods depend on the stiffness of the mechanical linkage between sisters. Metaphase plates become thinner as cells progress toward anaphase as a result of reduced oscillation speed at a relatively constant oscillation period. The progressive slowdown of oscillation speed and its coupling to plate thickness depend nonlinearly on the stiffness of the mechanical linkage between sisters. We propose that metaphase plate formation and thinning require tight control of the state of the mechanical linkage between sisters mediated by centromeric chromatin and cohesion

Feasibility and outcomes of Fibreoptic Endoscopic Evaluation of Swallowing following prophylactic swallowing rehabilitation in head and neck cancer

Objectives Investigate the feasibility and outcomes of fibreoptic endoscopic evaluation of swallowing (FEES) following a programme of prophylactic swallowing exercises in head and neck cancer (HNC) patients treated with radiotherapy. Design Prospective, single cohort, feasibility study. Setting Three head and neck cancer centres in Scotland. Participants Pre‐radiotherapy HNC patients who consented to participate in a prophylactic swallowing intervention. Outcome measures FEES recruitment and retention rates, assessment acceptability and compliance, qualitative process evaluation. Results Higher rates of recruitment and retention were achieved in centres where FEES equipment was available on site. Travel and anticipated discomfort were barriers to recruitment. Data completion was high for all rating scales, with goo d reliability. Following radiotherapy, swallowing safety significantly deteriorated for liquid boluses (p=0.005‐0.03); pharyngeal residue increased for liquid and semi‐solid boluses. Pharyngo‐laryngeal oedema was present pre‐treatment and significantly increased post‐radiotherapy (p=0.001). Patients generally reported positive experience of FEES for their own learning and establishing a baseline. Conclusions FEES is an acceptable method of assessing patients for a prophylactic swallowing intervention and offers some additional information missing from VF. Barriers have been identified and should be taken into account in order to maximise recruitment for future trials

Observation of Target Electron Momentum Effects in Single-Arm M\o ller Polarimetry

In 1992, L.G. Levchuk noted that the asymmetries measured in M\o ller scattering polarimeters could be significantly affected by the intrinsic momenta of the target electrons. This effect is largest in devices with very small acceptance or very high resolution in laboratory scattering angle. We use a high resolution polarimeter in the linac of the polarized SLAC Linear Collider to study this effect. We observe that the inclusion of the effect alters the measured beam polarization by -14% of itself and produces a result that is consistent with measurements from a Compton polarimeter. Additionally, the inclusion of the effect is necessary to correctly simulate the observed shape of the two-body elastic scattering peak.Comment: 29 pages, uuencoded gzip-compressed postscript (351 kb). Uncompressed postscript file (898 kb) available to DECNET users as SLC::USER_DISK_SLC1:[MORRIS]levpre.p

Community Hospitals in Selected High Income Countries: A Scoping Review of Approaches and Models.

BACKGROUND: There is no single definition of a community hospital in the UK, despite its long history. We sought to understand the nature and scope of service provision in community hospitals, within the UK and other high-income countries. METHODS: We undertook a scoping review of literature on community hospitals published from 2005 to 2014. Data were extracted on features of the hospital model and the services provided, with results presented as a narrative synthesis. RESULTS: 75 studies were included from ten countries. Community hospitals provide a wide range of services, with wide diversity of provision appearing to reflect local needs. Community hospitals are staffed by a mixture of general practitioners (GPs), nurses, allied health professionals and healthcare assistants. We found many examples of collaborative working arrangements between community hospitals and other health care organisations, including colocation of services, shared workforce with primary care and close collaboration with acute specialists. CONCLUSIONS: Community hospitals are able to provide a diverse range of services, responding to geographical and health system contexts. Their collaborative nature may be particularly important in the design of future models of care delivery, where emphasis is placed on integration of care with a key focus on patient-centred care.This project was funded by the National Institute for Health Research Health Services and Delivery Research programme (project number 12/177/14)

EXACT2: the semantics of biomedical protocols

© 2014 Soldatova et al.; licensee BioMed Central. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.This article has been made available through the Brunel Open Access Publishing Fund.Background: The reliability and reproducibility of experimental procedures is a cornerstone of scientific practice. There is a pressing technological need for the better representation of biomedical protocols to enable other agents (human or machine) to better reproduce results. A framework that ensures that all information required for the replication of experimental protocols is essential to achieve reproducibility. Methods: We have developed the ontology EXACT2 (EXperimental ACTions) that is designed to capture the full semantics of biomedical protocols required for their reproducibility. To construct EXACT2 we manually inspected hundreds of published and commercial biomedical protocols from several areas of biomedicine. After establishing a clear pattern for extracting the required information we utilized text-mining tools to translate the protocols into a machine amenable format. We have verified the utility of EXACT2 through the successful processing of previously ‘unseen’ (not used for the construction of EXACT2) protocols. Results: The paper reports on a fundamentally new version EXACT2 that supports the semantically-defined representation of biomedical protocols. The ability of EXACT2 to capture the semantics of biomedical procedures was verified through a text mining use case. In this EXACT2 is used as a reference model for text mining tools to identify terms pertinent to experimental actions, and their properties, in biomedical protocols expressed in natural language. An EXACT2-based framework for the translation of biomedical protocols to a machine amenable format is proposed. Conclusions: The EXACT2 ontology is sufficient to record, in a machine processable form, the essential information about biomedical protocols. EXACT2 defines explicit semantics of experimental actions, and can be used by various computer applications. It can serve as a reference model for for the translation of biomedical protocols in natural language into a semantically-defined format.This work has been partially funded by the Brunel University BRIEF award and a grant from Occams Resources

Incremental Cost of Conducting Population-Based Prevalence Surveys for a Neglected Tropical Disease: The Example of Trachoma in 8 National Programs

The costs of conducting population-based prevalence surveys for neglected tropical diseases such as trachoma are often cited as a reason that program managers do not conduct baseline or impact assessments when guidelines suggest they are warranted. The authors conducted a review of actual costs incurred during the implementation of 165 district level surveys in 8 national trachoma control programs to identify the median and mean costs per district and per cluster. In addition, the costs of the principal activities that are the most expensive were measured. The data show that field work is the most expensive activity for a prevalence survey, with personnel (per diems, allowances and accommodation) and transport costs driving the total cost of the survey. These findings can be used by program managers to budget for population-based prevalence surveys that are recommended for baseline and evaluation surveys, and periodic uptake surveys for neglected tropical diseases such as trachoma

Determining the Impact of Heatwaves on Emergency Ambulance Calls in Queensland: A Retrospective Population-Based Study

Heatwaves are a significant and growing threat to the health and well-being of the residents of Queensland, Australia. This threat is increasing due to climate change. Excess heat increases the demand for health services, including ambulance calls, and the purpose of this study was to explore this impact across Queensland. A state-wide retrospective analysis of heatwaves and emergency ‘Triple Zero’ (000) calls to Queensland Ambulance (QAS) from 2010–2019 was undertaken. Call data from the QAS and heatwave data from the Bureau of Meteorology were analysed using a case-crossover approach at the postcode level. Ambulance calls increased by 12.68% during heatwaves. The effect was greatest during low-severity heatwaves (22.16%), followed by severe (14.32%) and extreme heatwaves (1.16%). The impact varied by rurality, with those living in very remote areas and major cities most impacted, along with those of low and middle socioeconomic status during low and severe intensity heat events. Lag effects post-heatwave continued for at least 10 days. Heatwaves significantly increase ambulance call centre workload, so ambulance services must actively prepare resources and personnel to address increases in heatwave frequency, duration, and severity. Communities must be informed of the risks of heatwaves at all severities, particularly low severity, and the sustained risks in the days following a heat event