The implementation of standards of care in Europe: State of the art

AbstractThe care and condition of people with cystic fibrosis (CF) in 34 European countries is reported using data obtained from publications, registries and professionals providing CF patient care. Care and outcomes differ markedly between countries. Although the 2005 European standards of patient care publication was widely known, in many countries there were no specialized CF centres. In only a minority of countries was funding considered adequate and in some countries costs covered by patients compromised care. Only 15 countries had a national CF patient registry. Neonatal screening was routine in only 10 countries, but this included 59% of European infants. The initiatives of EuroCareCF Workpackage 1 to form networks for professionals working with CF patients are described. Suggestions for the future include at least one adequately staffed CF Centre in each country, improved funding, neonatal screening, national patient registries and the formation of national CF parent and patient organisations

On a Conjecture of Foulkes

AbstractSuppose that Ω={1,2,…,ab} for some non-negative integers a and b. Denote by P(a,b) the set of unordered partitions of Ω into a parts of cardinality b. In this paper we study the decomposition of the permutation module CP(a,b) where C is the field of complex numbers. In particular, we show that CP(3,b) is isomorphic to a submodule of CP(b,3) for b≥3. This settles the next unproven case of a conjecture of Foulkes

The association of working alliance, outcome expectation, adherence and self-efficacy with clinical outcomes for Achilles tendinopathy: A feasibility cohort study (the MAP study)

Introduction: This study evaluated the feasibility of a large longitudinal cohort study utilizing an online platform to investigate the association and predictive relationship of working alliance, outcome expectations, adherence and self-efficacy with outcome in Achilles tendinopathy. The objectives were: (1) to determine the recruitment and retention rate and (2) to carry out preliminary data analysis of the selected variables and clinical outcomes. Methods: A multi-centred, longitudinal feasibility cohort study was used. Eligible participants were directed to a bespoke online platform hosting study information and the outcome measures in the form of an online questionnaire. Responses from the online questionnaire were collected on three occasions: at baseline, at 6 and at 12 weeks following completion of the first questionnaire. Feasibility outcomes (recruitment and retention rates) were described using descriptive statistics. Results: The website recorded a total 55 views. These 55 views resulted in 24 participants consenting to join the study. The questionnaire at baseline was started 63 times and completed on 60 separate occasions resulting in a 95% conversion rate. Retainment for completion of the questionnaire for a second time was 83.3% and for the third time was 66.6%. All questionnaires were completed fully yielding a missing data indicator of 0%. Conclusions: Feasibility studies ask the question ‘can this be done’? Based on the data from recruitment and rates and exploratory correlation analysis a future study can be done; this previously untested online platform appears feasible, but changes could be useful before proceeding to a much larger study

Innovative Multispectral Optoacoustic Tomography Strategies for Evaluating Different Aspects of Renal Function

Kidney disease carries significant morbidity, mortality, and cost while its prevalence is rising. Preclinical work utilising different kidney injury models to evaluate novel therapies is a valuable step in the transition of treatments from lab to clinic. An accurate measurement of kidney function is important in this setting to make appropriate conclusions about the efficacy of a therapy. Measuring kidney function by dynamic contrast enhanced (DCE) imaging offers the distinct benefit of separately measuring left and right kidney function which can differ even in health. Additionally, measuring both kidneys in a unilateral injury model offers the advantage of an internal control. This thesis aims to assess whether near-infrared (NIR) dyes and their clearance in multispectral optoacoustic tomography (MSOT) can be used to measure the renal excretory functions of glomerular filtration and tubular secretion in health and a surgical model of ischaemia reperfusion injury (IRI). The dyes ABZWCY-HPβCD (glomerular filtration marker) and STAR FLUOR 770 Acid (potential tubular secretion marker) are examined for this purpose. We explore the best metrics of quantifying renal injury in DCE MSOT and whether the application of mathematical models could allow the measurement glomerular filtration rate (GFR) or tubular secretion rate (TSR) in a single kidney. Finally, the MSOT clearance kinetics of these dyes are compared to more standard measures of renal health: sinistrin clearance, histology, and dimercaptosuccinic acid (DMSA) uptake. ABZWCY-HPβCD, STAR FLUOR 770 Acid, and the renal clearance of the two dyes can be detected by MSOT in C57BL/6 albino mice. However, light fluence impairs the accurate absolute quantification of these dyes at the depth of the aorta. ABZWCY-HPβCD shows significantly different MSOT renal kinetics from the current standard MSOT renal contrast agent, IRDye 800CW. In combination with a modified Patlak-Rutland model, ABZWCY-HPβCD can be used to calculate a single kidney GFR. This method showed a greater correlation with GFR measured by sinistrin clearance than MSOT model-free measures. STAR FLUOR 770 Acid has shown significant protein binding and evidence of biliary clearance both in MSOT and fluorescence imaging. However, it is partially cleared by the kidneys and spectrally unchanged following this. DCE MSOT measured STAR FLUOR 770 Acid clearance does not correlate with split renal function measured by the tubular uptake of DMSA. STAR FLUOR 770 Acid clearance shows recovery 3 weeks after IRI, while DMSA uptake and histology show ongoing tubular injury. The results indicate that DCE MSOT is a fast, safe, flexible, and approachable imaging modality for evaluating different renal excretory functions. Further, the NIR dye ABZWCY-HPβCD appears suitable for measuring single kidney GFR in MSOT. STAR FLUOR 770 Acid requires further assessment as a tubular secretion marker. Improvements and validation of fluence correction algorithms will facilitate absolute quantification in MSOT that will further its ability to determine renal clearance rates

On (almost) extreme components in Kronecker products of characters of the symmetric groups

Using a recursion formula due to Dvir, we obtain information on maximal and almost maximal components in Kronecker products of characters of the symmetric groups. This is applied to confirm a conjecture made by Bessenrodt and Kleshchev in 1999, which classifies all such Kronecker products with only three or four components.Comment: 38 pages, new theorems added, and paper now focused on maximal and almost maximal components in Kronecker product

Irreducible projective representations of the alternating group which remain irreducible in characteristic 2

For any finite group G it is an interesting question to ask which ordinary irreducible representations of G remain irreducible in a given characteristic p. We answer this question for p=2 when G is the proper double cover of the alternating group. As a key ingredient in the proof, we prove a formula for the decomposition numbers in Rouquier blocks of double covers of symmetric groups, in terms of Schur P-functions

Irreducible projective representations of the symmetric group which remain irreducible in characteristic 2

For any finite group $G$ and any prime $p$ one can ask which ordinary irreducible representations remain irreducible in characteristic $p$. We answer this question for $p=2$ when $G$ is a proper double cover of the symmetric group. Our techniques involve constructing part of the decomposition matrix for a Rouquier block of a double cover, restricting to subgroups using the Brundan--Kleshchev modular branching rules and comparing the dimensions of irreducible representations via the bar-length formula

Association of psychological variables and outcome in tendinopathy: a systematic review

Objective Fear, anxiety, depression, distress and catastrophisation are all factors known to affect pain and disability levels. To date, the association of such psychological factors has yet to be established in tendinopathy. Therefore, the purpose of this paper was to determine if psychological variables are associated with tendinopathy and whether any such variables may be associated with pain and disability outcomes in conservative management of tendinopathy. Design A systematic review was undertaken and included studies were appraised for risk of bias using the Newcastle-Ottawa Scale. Owing to heterogeneity of studies, a qualitative synthesis was undertaken. Data sources An electronic search of MEDLINE, CiNAHL, SPORTDiscus, PsycINFO, EMBASE and PsycARTICLES was undertaken from their inception to April 2016. Eligibility criteria for selecting studies Any study design that incorporated psychological measures and clinical outcomes using participants with tendinopathy. Results Ten articles describing nine studies and 1108 participants were included. Conflicting evidence exists regarding the association of anxiety, depression and lateral epicondylalgia (LE). Strong evidence suggests LE is not associated with kinesiophobia. Moderate evidence links catastrophisation and distress with LE. Moderate evidence suggests distress is not associated with rotator cuff tendinopathy, but kinesiophobia and catastrophisation are. Limited evidence suggests patellar tendinopathy is not associated with anxiety or depression and kinesiophobia may be linked with suboptimal outcomes in Achilles tendinopathy. Summary/conclusions Tendinopathy requires an individualised approach to management. Clinicians should consider using validated screening tools for the presence of psychological variables as a part of their holistic management

Principal forms X^2 + nY^2 representing many integers

In 1966, Shanks and Schmid investigated the asymptotic behavior of the number of positive integers less than or equal to x which are represented by the quadratic form X^2+nY^2. Based on some numerical computations, they observed that the constant occurring in the main term appears to be the largest for n=2. In this paper, we prove that in fact this constant is unbounded as n runs through positive integers with a fixed number of prime divisors.Comment: 10 pages, title has been changed, Sections 2 and 3 are new, to appear in Abh. Math. Sem. Univ. Hambur