A Qualitative Analysis Of Multi-Level Barriers To Hiv Testing Among Women In Lebanon

The Middle East and North Africa (MENA) is a region of concern in regards to the global HIV epidemic. In 2015, a call to action was released through the American University of Beirut urging an expansion of research and policy regarding women and HIV in the MENA region. Through individual, semi-structured interviews with sexual healthcare providers and NGO staff, we sought to understand barriers to HIV testing among women in Lebanon. Using purposive and snowball sampling strategies, key informants were recruited from neighborhoods in greater Beirut (N=21; 12 physicians, 9 NGO staff). Data were analyzed utilizing a Grounded Theory inductive framework. Findings identified barriers to HIV testing among women at each level of an adapted social-ecological model (i.e., social-cultural-level barriers, policy-level barriers, interpersonal healthcare provider-level barriers, and intrapersonal-level barriers). Findings can be utilized to inform HIV-related sexual health interventions for women in Lebanon at multiple levels

Dickkopf-3 is upregulated in osteoarthritis and has a chondroprotective role

Objective Dickkopf-3 (Dkk3) is a non-canonical member of the Dkk family of Wnt antagonists and its upregulation has been reported in microarray analysis of cartilage from mouse models of osteoarthritis (OA). In this study we assessed Dkk3 expression in human OA cartilage to ascertain its potential role in chondrocyte signaling and cartilage maintenance. Methods Dkk3 expression was analysed in human adult OA cartilage and synovial tissues and during chondrogenesis of ATDC5 and human mesenchymal stem cells. The role of Dkk3 in cartilage maintenance was analysed by incubation of bovine and human cartilage explants with interleukin-1 (IL1) and oncostatin-M (OSM). Dkk3 expression was measured in cartilage following murine hip avulsion. Whether Dkk3 influenced Wnt, TGF and activin cell signaling was assessed in primary human chondrocytes and SW1353 chondrosarcoma cells using RT-qPCR and luminescence assays. Results Increased gene and protein levels of Dkk3 were detected in human OA cartilage, synovial tissue and synovial fluid. DKK3 expression was decreased during chondrogenesis of both ATDC5 cells and humans MSCs. Dkk3 inhibited IL1 and OSM-mediated proteoglycan loss from human and bovine cartilage explants and collagen loss from bovine cartilage explans. Cartilage DKK3 expression was decreased following hip avulsion injury. TGF signaling was enhanced by Dkk3 and Wnt3a and activin signaling were inhibited. Conclusions We provide evidence that Dkk3 is upregulated in OA and may have a protective effect on cartilage integrity by preventing proteoglycan loss and helping to restore OA-relevant signaling pathway activity. Targeting Dkk3 may be a novel approach in the treatment of OA

Data resource profile: the Scottish Social Care Survey (SCS) and the Scottish Care Home Census (SCHC)

Introduction: Linked health care datasets have been used effectively in Scotland for some time. Use of social care data has been much more limited, partly because responsibility for these services is distributed across multiple local authorities. However, there are substantial interactions between health and social care (also known internationally as long-term care) services, and keen policy interest in better understanding these. We introduce two social care resources that can now be linked to health datasets at a population level across Scotland to study these interdependencies. These data emerge from the Scottish Government’s centralised collation of data from mandatory returns provided by local authorities and care homes. Methods: Deterministic and Probabilistic methods were used to match the Social Care Survey (SCS) and Scottish Care Home Census (SCHC) to the Community Health Index (CHI) number via the National Records of Scotland (NRS) Research Indexing Spine. Results: For the years 2010/11 to 2015/16, an overall match rate of 91.2% was achieved for the SCS to CHI from 31 of Scotland’s 32 local authority areas. This rate varied from 76.7% to 98.5% for local authority areas. A match rate of 89.8% to CHI was achieved for the SCHC in years 2012/13 to 2015/16 but only 52.5% for the years 2010/11 to 2011/12. Conclusion: Indexing of the SCS and SCHC to CHI offers a new and rich resource of data for health and social care research

Modifications to the representation of subgrid mixing in kilometre‐scale versions of the Unified Model

A mixed subgrid scheme for scalars and momentum fluxes in cloud‐resolving models which includes an extra subgrid vertical flux, referred to as “the Leonard term”, that accounts for the tilting of horizontal flux into the vertical by horizontal gradients in vertical velocity was proposed by Moeng. Here we describe the implementation of the Leonard term in the current subgrid mixing scheme used in kilometre‐scale versions of the Met Office's Unified Model. We present results that show that including this extra term in the Met Office's 1.5 km grid length UK model reduces the domain‐average precipitation by reducing the number of grid points with rainfall rates greater than 4 mm/hr‐1, which are over‐represented by the model. Increasing the magnitude of the Leonard terms further decreases the occurrence of the heaviest rainfall rates

Weathering fluxes and sediment provenance on the SW Scottish shelf during the last deglaciation

The reconstruction of past ice sheet dynamics can shed a light on long-term ice stream activity, and in turn provide constraints on the response of modern ice sheets to climate change. The Hebrides Ice Stream (HIS) flowed across part of the western Scottish shelf to the shelf-break during the last glacial cycle and drained a large portion of the northern sector of the British Irish-Ice Sheet. To investigate the deglacial dynamics of the HIS following the Last Glacial Maximum, lead (Pb) isotope records were extracted from the FeMn oxyhydroxide and detrital fractions of recovered laminated glacimarine mud sequences to monitor the changing activity of HIS during its retreat. These provide timing and some source information of glacially weathered inputs to the marine environment. The FeMn oxyhydroxide fraction in the samples is dominated by allochthonous particles (pre-formed) and shows a marked decrease from radiogenic (≤ 20.05 206Pb/204Pb) at ~ 21 cal ka BP to less radiogenic Pb isotope compositions (~ 19.48) towards the Windermere Interstadial (15.4–13 ka). This decrease represents a reduction in the flux of subglacially-derived radiogenic Pb to the continental shelf is interpreted as being associated with the break-up of the ice-stream in western Scotland around that time. The Pb, Sr and Nd isotopic signatures of the detrital fraction indicate a preponderance of Moine-sourced fine sediments (originated from the NW Highlands) in the core locations from ~ 21 to 15 cal ka BP (Dimlington Stadial - Windermere Interstadial), most likely dictated by the orientation of ice flow, tidal and oceanic current directions and sediment delivery. In contrast, ice rafted debris in a ~ 21 cal ka BP old basal diamicton contains volcanic-derived material, suggesting different provenance for different grain sizes. The FeMn oxyhydroxide 208Pb/204Pb ratio shows an unusual inversion relative to the other Pb isotope ratios, and is attributed to the introduction of secondary weathering phases from a source with contrasting 208Pb/204Pb but similar 206Pb/204Pb and 207Pb/204Pb. In the detrital fraction, the inversions are constrained to periodic spikes, which may indicate an increased contribution from a high Th/U source, potentially the neighbouring Archaean amphibolitic Lewisian basement in the Outer Hebrides. This study demonstrates how geochemical investigation on continental shelves can be used to constrain the timing, activity and flow sources of palaeo-ice streams

Sulforaphane represses matrix-degrading proteases and protects cartilage from destruction in vitro and in vivo:Sulforaphane is protective in the articular Joint

Sulforaphane (SFN) has been reported to regulate signaling pathways relevant to chronic diseases. The aim of this study was to investigate the impact of SFN treatment on signaling pathways in chondrocytes and to determine whether sulforaphane could block cartilage destruction in osteoarthritis

Altered sense of humor in dementia.

Sense of humor is potentially relevant to social functioning in dementias, but has been little studied in these diseases. We designed a semi-structured informant questionnaire to assess humor behavior and preferences in patients with behavioral variant frontotemporal dementia (bvFTD; n = 15), semantic dementia (SD; n = 7), progressive nonfluent aphasia (PNFA; n = 10), and Alzheimer's disease (AD; n = 16) versus healthy age-matched individuals (n = 21). Altered (including frankly inappropriate) humor responses were significantly more frequent in bvFTD and SD (all patients) than PNFA or AD (around 40% of patients). All patient groups liked satirical and absurdist comedy significantly less than did healthy controls. This pattern was reported premorbidly for satirical comedy in bvFTD, PNFA, and AD. Liking for slapstick comedy did not differ between groups. Altered sense of humor is particularly salient in bvFTD and SD, but also frequent in AD and PNFA. Humor may be a sensitive probe of social cognitive impairment in dementia, with diagnostic, biomarker and social implications

Laparoscopic supracervical hysterectomy versus endometrial ablation for women with heavy menstrual bleeding (HEALTH) : a parallel-group, open-label, randomised controlled trial

UK National Institute for Health Research Health Technology Assessment Programme. Acknowledgments We thank the women who participated in the HEALTH study. We also thank Angela Hyde (Vice Chair of the Royal College of Obstetricians and Gynaecologists Women's Network until September, 2015, and co-applicant on the original grant application until October, 2016) for her contribution to the design of the participant facing documents and participation in trial meetings from the perspective of a patient, Jonathan Cook (statistician and co-applicant on the original grant application until April, 2014) for his contributions to the study design, Rebecca Bruce for her secretarial support and data management, members of the project management group for their ongoing advice and support of the trial, plus the independent members of the trial steering committee (Henry Kitchener [Chair], Patrick Chien, Barbara Farrell, and Isobel Montgomery) and data monitoring committee (Jane Norman [Chair], Peter O'Donovan, and Andy Vail), and the staff at the recruitment sites who facilitated recruitment, treatment, and follow-up of trial participants. The project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment Programme (project number 12/35/23). The Health Services Research Unit and the Health Economics Research Unit are funded by the Chief Scientist Office of the Scottish Government Health and Social Care Directorates. The views expressed herein are those of the authors and not necessarily those of the NIHR or the UK Department of Health and Social Care.Peer reviewedPublisher PD

The DYMECS project: a statistical approach for the evaluation of convective storms in high-resolution NWP models

A new frontier in weather forecasting is emerging by operational forecast models now being run at convection-permitting resolutions at many national weather services. However, this is not a panacea; significant systematic errors remain in the character of convective storms and rainfall distributions. The DYMECS project (Dynamical and Microphysical Evolution of Convective Storms) is taking a fundamentally new approach to evaluate and improve such models: rather than relying on a limited number of cases, which may not be representative, we have gathered a large database of 3D storm structures on 40 convective days using the Chilbolton radar in southern England. We have related these structures to storm life-cycles derived by tracking features in the rainfall from the UK radar network, and compared them statistically to storm structures in the Met Office model, which we ran at horizontal grid length between 1.5 km and 100 m, including simulations with different subgrid mixing length. We also evaluated the scale and intensity of convective updrafts using a new radar technique. We find that the horizontal size of simulated convective storms and the updrafts within them is much too large at 1.5-km resolution, such that the convective mass flux of individual updrafts can be too large by an order of magnitude. The scale of precipitation cores and updrafts decreases steadily with decreasing grid lengths, as does the typical storm lifetime. The 200-m grid-length simulation with standard mixing length performs best over all diagnostics, although a greater mixing length improves the representation of deep convective storms