Effectiveness, Feasibility, and Acceptability of Dynamic Elastomeric Fabric Orthoses (DEFO) for Managing Pain, Functional Capacity, and Quality of Life during Prenatal and Postnatal Care: A Systematic Review

Conservative interventions for addressing prenatal and postnatal ailments have been described in the research literature. Research results indicated that maternity support belts assist with reducing pain and other symptoms in these phases; however, compliance in wearing maternity support belts is poor. To combat poor compliance, commercial manufacturers designed dynamic elastomeric fabric orthoses (DEFO)/compression garments that target prenatal and postnatal ailments. This systematic review aimed to identify, critically appraise, and synthesize key findings on the effectiveness, the feasibility, and the acceptability of using DEFO to manage ailments during pre-natal and postnatal phases of care. Electronic databases were systematically searched to identify relevant studies, resulting in 17 studies that met the eligibility criteria. There were variations in DEFO descriptors, including hosiery, support belts, abdominal binders and more, making it difficult to compare findings from the research articles regarding value of DEFO during prenatal and/or postnatal phases. A meta-synthesis of empirical research findings suggests wearing DEFOs during pregnancy has a significant desirable effect for managing pain and improving functional capacity. Further research is required to investigate the use of DEFOs for managing pain in the postnatal period and improving quality life during prenatal and postnatal care

Radio Emission from the Composite Supernova Remnant G326.3-1.8 (MSH15-56)

High resolution radio observations of the composite supernova remnant (SNR) G326.3-1.8 or MSH 15-56 with the Australia Telescope Compact Array show details of both the shell and the bright plerion which is offset about 1/3 of the distance from the center of the SNR to the shell. The shell appears to be composed of thin filaments, typical of older shell SNRs. The central part of the elongated plerion is composed of a bundle of parallel ridges which bulge out at the ends and form a distinct ring structure on the northwestern end. The magnetic field with a strength of order 45 microGauss, is directed along the axis of the ridges but circles around the northwestern ring. This plerion is large and bright in the radio but is not detected in x-ray or optical wavelengths. There is, however, a faint hard x-ray feature closer to the shell outside the plerion. Perhaps if the supernova explosion left a rapidly moving magnetar with large energy input but initially rapid decay of both relativistic particles and magnetic field, the observed differences with wavelength could be explained.Comment: 15 pages, 10 figures, accepted by Ap

Integrating remote sensing datasets into ecological modelling: a Bayesian approach

Process-based models have been used to simulate 3-dimensional complexities of forest ecosystems and their temporal changes, but their extensive data requirement and complex parameterisation have often limited their use for practical management applications. Increasingly, information retrieved using remote sensing techniques can help in model parameterisation and data collection by providing spatially and temporally resolved forest information. In this paper, we illustrate the potential of Bayesian calibration for integrating such data sources to simulate forest production. As an example, we use the 3-PG model combined with hyperspectral, LiDAR, SAR and field-based data to simulate the growth of UK Corsican pine stands. Hyperspectral, LiDAR and SAR data are used to estimate LAI dynamics, tree height and above ground biomass, respectively, while the Bayesian calibration provides estimates of uncertainties to model parameters and outputs. The Bayesian calibration contrasts with goodness-of-fit approaches, which do not provide uncertainties to parameters and model outputs. Parameters and the data used in the calibration process are presented in the form of probability distributions, reflecting our degree of certainty about them. After the calibration, the distributions are updated. To approximate posterior distributions (of outputs and parameters), a Markov Chain Monte Carlo sampling approach is used (25 000 steps). A sensitivity analysis is also conducted between parameters and outputs. Overall, the results illustrate the potential of a Bayesian framework for truly integrative work, both in the consideration of field-based and remotely sensed datasets available and in estimating parameter and model output uncertainties

The ASCA Spectrum of the Vela Pulsar Jet

ROSAT observations of the Vela pulsar and its surroundings revealed a collimated X-ray feature almost 45' in length (Markwardt & Ogelman 1995), interpreted as the signature ``cocoon'' of a one-sided jet from the Vela pulsar. We report on a new ASCA observation of the Vela pulsar jet at its head, the point where the jet is believed to interact with the supernova remnant. The head is clearly detected, and its X-ray spectrum is remarkably similar to the surrounding supernova remnant spectrum, extending to X-ray energies of at least 7 keV. A ROSAT+ASCA spectrum can be fit by two-component emission models but not standard one-component models. The lower energy component is thermal and has a temperature of 0.29+/-0.03 keV (1 sigma); the higher energy component can be fit by either a thermal component of temperature ~4 keV or a power law with photon index ~2.0. Compared to the ROSAT-only results, the mechanical properties of the jet and its cocoon do not change much. If the observed spectrum is that of a hot jet cocoon, then the speed of the jet is at least 800 km s^-1, depending on the angle of inclination. The mechanical power driving the jet is >10^36 erg s^-1, and the mass flow rate at the head is > 10^-6 M_sun yr^-1. We conclude that the jet must be entraining material all along its length in order to generate such a large mass flow rate. We also explore the possibility that the cocoon emission is synchrotron radiation instead of thermal.Comment: 12 pages, LaTeX in AAS v4.0 preprint style, two PS figures, accepted for publication in the ApJ Letter

Time to publication for NIHR HTA programme-funded research: a cohort study

ObjectiveTo assess the time to publication of primary research and evidence syntheses funded by the National Institute for Health Research (NIHR) Health Technology Assessment (HTA) Programme published as a monograph in Health Technology Assessment and as a journal article in the wider biomedical literature.Study designRetrospective cohort study.SettingPrimary research and evidence synthesis projects funded by the HTA Programme were included in the cohort if they were registered in the NIHR research programmes database and was planned to submit the draft final report for publication in Health Technology Assessment on or before 9 December 2011.Main outcome measuresThe median time to publication and publication at 30?months in Health Technology Assessment and in an external journal were determined by searching the NIHR research programmes database and HTA Programme website.ResultsOf 458 included projects, 184 (40.2%) were primary research projects and 274 (59.8%) were evidence syntheses. A total of 155 primary research projects had a completion date; the median time to publication was 23?months (26.5 and 35.5?months to publish a monograph and to publish in an external journal, respectively) and 69% were published within 30?months. The median time to publication of HTA-funded trials (n=126) was 24?months and 67.5% were published within 30?months. Among the evidence syntheses with a protocol online date (n=223), the median time to publication was 25.5?months (28?months to publication as a monograph), but only 44.4% of evidence synthesis projects were published in an external journal. 65% of evidence synthesis studies had been published within 30.0?months.ConclusionsResearch funded by the HTA Programme publishes promptly. The importance of Health Technology Assessment was highlighted as the median time to publication was 9?months shorter for a monograph than an external journal article

The clinical relevance and newsworthiness of NIHR HTA-funded research: a cohort study

ObjectiveTo assess the clinical relevance and newsworthiness of the UK National Institute for Health Research (NIHR) Health Technology Assessment (HTA) Programme funded reports.Study designRetrospective cohort study.SettingThe cohort included 311 NIHR HTA Programme funded reports publishing in HTA in the period 1 January 2007–31 December 2012. The McMaster Online Rating of Evidence (MORE) system independently identified the clinical relevance and newsworthiness of NIHR HTA publications and non-NIHR HTA publications. The MORE system involves over 4000 physicians rating publications on a scale of relevance (the extent to which articles are relevant to practice) and a scale of newsworthiness (the extent to which articles contain news or something clinicians are unlikely to know).Main outcome measuresThe proportion of reports published in HTA meeting MORE inclusion criteria and mean average relevance and newsworthiness ratings were calculated and compared with publications from the same studies publishing outside HTA and non-NIHR HTA funded publications.Results286/311 (92.0%) of NIHR HTA reports were assessed by MORE, of which 192 (67.1%) passed MORE criteria. The average clinical relevance rating for NIHR HTA reports was 5.48, statistically higher than the 5.32 rating for non-NIHR HTA publications (mean difference=0.16, 95% CI 0.04 to 0.29, p=0.01). Average newsworthiness ratings were similar between NIHR HTA reports and non-NIHR HTA publications (4.75 and 4.70, respectively; mean difference=0.05, 95% CI ?0.18 to 0.07, p=0.402). NIHR HTA-funded original research reports were statistically higher for newsworthiness than reviews (5.05 compared with 4.64) (mean difference=0.41, 95% CI 0.18 to 0.64, p=0.001).ConclusionsFunding research of clinical relevance is important in maximising the value of research investment. The NIHR HTA Programme is successful in funding projects that generate outputs of clinical relevance

The A2A adenosine receptor: its role in suppressing vascular inflammation and its regulation by phosphorylation

Endothelial inflammation leading to vascular dysfunction is a major contributor to the development of atherosclerosis. The release of adenosine at sites of inflammation represents an endogenous mechanism for limiting excessive inflammation and tissue damage. The majority of the anti-inflammatory effects of adenosine are mediated by signalling through the A2AAR and activation of the A2AAR has been shown to be protective in numerous models of inflammatory disease. Little is known about the molecular mechanisms behind these effects. However, in vitro studies using cultured endothelial cells indicate that signalling through the A2AAR can suppress activation of the NF kappa B and JAK/STAT proinflammatory signalling pathways. NF kappa B appears to be primed for activation in atherosclerosis-prone regions of the aorta indicating that suppression of NF kappa B signalling may protect against the development of atherosclerosis. In this study, the role of the A2AAR in regulating NF kappa B and JAK/STAT signalling pathway activation in the aorta was studied using A2AAR-deficient mice subjected to an LPS-induced model of septic shock. In response to LPS treatment, these mice displayed markedly elevated plasma levels of the pro-inflammatory cytokines TNF-alpha, IL-6, IL-1 beta and GMCSF compared to wild-type mice. Consistent with this finding, heightened activation of the NF kappa B and JAK/STAT pathways was detected in aortic protein samples from A2AAR-deficient mice as demonstrated by increased levels of the phosphorylated forms of I kappa B alpha and STAT1. However, expression of the NF kappa B and STAT1-regulated genes ICAM-1, VCAM-1 and TAP-1 was unaffected indicating the involvement of compensatory negative feedback mechanisms. These findings confirm a role for the A2AAR in regulation of pro-inflammatory signalling in the aorta. Further analysis of mechanisms which mediate this response may reveal new targets for therapeutic intervention to suppress inflammation in inflammatory disorders such as atherosclerosis. While the wide range of anti-inflammatory and tissue-protective responses elicited by the A2AAR have been well documented, the molecular regulation of the A2AAR has been less well studied. The presence of several serine and threonine residues in the extended C-terminal tail of the A2AAR suggests that it may be regulated by phosphorylation events occurring in this region. Indeed, the canine A2AAR is phosphorylated in response to PKC activation. Interestingly, several proteins have recently been identified as being able to interact with the C-terminal tail of the A2AAR. However, how these interactions are regulated is not known. One of the aims of this study was to characterise phosphorylation of the human A2AAR and to determine whether this could provide a means for regulating the binding of C-terminal interacting proteins. This was examined using human umbilical vein endothelial cells infected with recombinant adenovirus encoding the human A2AAR. It was found that phosphorylation of the human A2AAR could be induced in HUVECs by treatment with PMA or by stimulation of endogenous histamine H1 receptors. This was due to activation of PKC, as phosphorylation was inhibited by the PKC inhibitor GF109203X and by depletion of PKC following chronic treatment with PMA. Treatment of cells with the calcium-chelating agent BAPTA/AM did not inhibit PMA-induced phosphorylation indicating that a calcium-insensitive isoform of PKC was responsible. Meanwhile an siRNA-mediated gene silencing approach confirmed that PKC epsilon was not responsible indicating the involvement of either PKC delta or PKC theta. Previously reported interactions between the A2AAR and TRAX and 14-3-3 tau were confirmed in vitro by GST pull-down assay. Binding of 14-3-3 tau to the A2AAR appeared to be unaffected by treatment of HUVECs with PMA. However, A2AAR complex formation with TRAX was significantly reduced in samples from PMA-stimulated cells. These findings indicate that PKC-mediated phosphorylation may represent a means of regulating which proteins can interact with the C-terminal tail of the A2AAR. This may allow the A2AAR to initiate distinct signalling pathways depending on the cellular context in order to achieve the appropriate response