Developing a service user informed intervention to improve participation and ability to perform daily activities in primary Sjögren’s syndrome: a mixed-methods study protocol

Introduction: A significant proportion of patients with primary Sjögren’s syndrome (PSS) is functionally impaired and experience difficulties participating in various aspects of everyday life. There is currently no evidence of efficacy for non-pharmacological interventions aimed specifically at supporting the patients with PSS to improve their participation and ability to perform daily activities. This paper describes a research protocol for a mixed-methods study to develop an intervention to improve these outcomes. The protocol follows the Medical Research Council framework for complex interventions. Methods and analysis: We will use group concept mapping with the patients, adults who live with them and healthcare professionals to identify factors which prevent people with PSS from participating in daily life and performing daily activities. The factors will be prioritised by participants for importance and feasibility and will inform an intervention to be delivered within a National Health Service (NHS) setting. Evidence-based intervention techniques will be identified for the prioritised factors and combined into a deliverable intervention package. Key stakeholders will comment on the intervention content and mode of delivery through focus groups, and the data will be used to refine the intervention. The acceptability and feasibility of the refined intervention will be evaluated in a future study. Ethics and dissemination: The study has been approved by an NHS Research Ethics Committee, REC Reference: 13/NI/0190. The findings of this study will be disseminated in peer-reviewed journals and through presentation at national and international conferences. Trial registration number: UKCRN Study ID: 15939

INTEGRAL observations of TeV plerions

Amongst the sources seen in very high gamma-rays several are associated with Pulsar Wind Nebulae (``TeV plerions''). The study of hard X-ray/soft gamma-ray emission is providing an important insight into the energetic particle population present in these objects. The unpulsed emission from pulsar/pulsar wind nebula systems in the energy range accessible to the INTEGRAL satellite is mainly synchrotron emission from energetic and fast cooling electrons close to their acceleration site. Our analyses of public INTEGRAL data of known TeV plerions detected by ground based Cherenkov telescopes indicate a deeper link between these TeV plerions and INTEGRAL detected pulsar wind nebulae. The newly discovered TeV plerion in the northern wing of the Kookaburra region (G313.3+0.6 powered by the middle aged PSR J1420-6048) is found to have a previously unknown INTEGRAL counterpart which is besides the Vela pulsar the only middle aged pulsar detected with INTEGRAL. We do not find an INTEGRAL counterpart of the TeV plerion associated with the X-ray PWN ``Rabbit'' G313.3+0.1 which is possibly powered by a young pulsar.Comment: 4 pages, 6 figures, proceedings of conference "The Multi-Messenger Approach to High-Energy Gamma-ray Sources" Barcelona/Spain (2006

Modelling the unfolding pathway of biomolecules: theoretical approach and experimental prospect

We analyse the unfolding pathway of biomolecules comprising several independent modules in pulling experiments. In a recently proposed model, a critical velocity $v_{c}$ has been predicted, such that for pulling speeds $v>v_{c}$ it is the module at the pulled end that opens first, whereas for $v<v_{c}$ it is the weakest. Here, we introduce a variant of the model that is closer to the experimental setup, and discuss the robustness of the emergence of the critical velocity and of its dependence on the model parameters. We also propose a possible experiment to test the theoretical predictions of the model, which seems feasible with state-of-art molecular engineering techniques.Comment: Accepted contribution for the Springer Book "Coupled Mathematical Models for Physical and Biological Nanoscale Systems and Their Applications" (proceedings of the BIRS CMM16 Workshop held in Banff, Canada, August 2016), 16 pages, 6 figure

Integrating evolution into ecological modelling: accommodating phenotypic changes in agent based models.

PMCID: PMC3733718This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.Evolutionary change is a characteristic of living organisms and forms one of the ways in which species adapt to changed conditions. However, most ecological models do not incorporate this ubiquitous phenomenon. We have developed a model that takes a 'phenotypic gambit' approach and focuses on changes in the frequency of phenotypes (which differ in timing of breeding and fecundity) within a population, using, as an example, seasonal breeding. Fitness per phenotype calculated as the individual's contribution to population growth on an annual basis coincide with the population dynamics per phenotype. Simplified model variants were explored to examine whether the complexity included in the model is justified. Outputs from the spatially implicit model underestimated the number of individuals across all phenotypes. When no phenotype transitions are included (i.e. offspring always inherit their parent's phenotype) numbers of all individuals are always underestimated. We conclude that by using a phenotypic gambit approach evolutionary dynamics can be incorporated into individual based models, and that all that is required is an understanding of the probability of offspring inheriting the parental phenotype

Accurate first-principle equation of state for the One-Component Plasma

Accurate "first-principle" expressions for the excess free energy $F_{ex}$ and internal energy $U_{ex}$ of the classical one-component plasma (OCP) are obtained. We use the Hubbard-Schofield transformation that maps the OCP Hamiltonian onto the Ising-like Hamiltonian, with coefficients expressed in terms of equilibrium correlation functions of a reference system. We use the ideal gas as a reference system for which all the correlation functions are known. Explicit calculations are performed with the high-order terms in the Ising-like Hamiltonian omitted. For small values of the plasma parameter $\Gamma$ the Debye-Huckel result for $F_{ex}$ and $U_{ex}$ is recovered. For large $\Gamma$ these depend linearly on $\Gamma$ in accordance with the Monte Carlo findings for the OCP. The MC data for the internal energy are reproduced fairly well by the obtained analytical expression.Comment: 15 pages, 2 figures, to appear in Contrib. Plasma Phys., v.38 N4, (1998

Negative phenotypic and genetic associations between copulation duration and longevity in male seed beetles

Reproduction can be costly and is predicted to trade-off against other characters. However, while these trade-offs are well documented for females, there has been less focus on aspects of male reproduction. Furthermore, those studies that have looked at males typically only investigate phenotypic associations, with the underlying genetics often ignored. Here, we report on phenotypic and genetic trade-offs in male reproductive effort in the seed beetle, Callosobruchus maculatus. We find that the duration of a male's first copulation is negatively associated with subsequent male survival, phenotypically and genetically. Our results are consistent with life-history theory and suggest that like females, males trade-off reproductive effort against longevity

A primary care, multi-disciplinary disease management program for opioid-treated patients with chronic non-cancer pain and a high burden of psychiatric comorbidity

BACKGROUND: Chronic non-cancer pain is a common problem that is often accompanied by psychiatric comorbidity and disability. The effectiveness of a multi-disciplinary pain management program was tested in a 3 month before and after trial. METHODS: Providers in an academic general medicine clinic referred patients with chronic non-cancer pain for participation in a program that combined the skills of internists, clinical pharmacists, and a psychiatrist. Patients were either receiving opioids or being considered for opioid therapy. The intervention consisted of structured clinical assessments, monthly follow-up, pain contracts, medication titration, and psychiatric consultation. Pain, mood, and function were assessed at baseline and 3 months using the Brief Pain Inventory (BPI), the Center for Epidemiological Studies-Depression Scale scale (CESD) and the Pain Disability Index (PDI). Patients were monitored for substance misuse. RESULTS: Eighty-five patients were enrolled. Mean age was 51 years, 60% were male, 78% were Caucasian, and 93% were receiving opioids. Baseline average pain was 6.5 on an 11 point scale. The average CESD score was 24.0, and the mean PDI score was 47.0. Sixty-three patients (73%) completed 3 month follow-up. Fifteen withdrew from the program after identification of substance misuse. Among those completing 3 month follow-up, the average pain score improved to 5.5 (p = 0.003). The mean PDI score improved to 39.3 (p < 0.001). Mean CESD score was reduced to 18.0 (p < 0.001), and the proportion of depressed patients fell from 79% to 54% (p = 0.003). Substance misuse was identified in 27 patients (32%). CONCLUSIONS: A primary care disease management program improved pain, depression, and disability scores over three months in a cohort of opioid-treated patients with chronic non-cancer pain. Substance misuse and depression were common, and many patients who had substance misuse identified left the program when they were no longer prescribed opioids. Effective care of patients with chronic pain should include rigorous assessment and treatment of these comorbid disorders and intensive efforts to insure follow up

Surface Chemistry of Perfluoropolyethers and Hydrogenated Analogs: Are Studies of Model Compounds Useful?

We have studied adsorption, desorption, and decomposition of ethers on Ru(001), an atomically-smooth metal surface. We have compared diethers with monoethers, and fluorinated ethers with hydrogenated ethers. The number of ether linkages does not strongly influence adsorption bond strength, nor the extent of decomposition. Fluorination does weaken the adsorption bond strength and prevents decomposition. These studies suggest that the surface properties of monomeric ethers can be used to predict properties of oligomeric, and perhaps even polymeric, ethers

Alcohol dependence: international policy implications for prison populations

BACKGROUND: In light of the emphasis on drug abuse, this study explored the relative prevalence of substance use disorders among United Kingdom (UK) prison inmates in the context of findings from a general inmate population in the United States (US). The lead author of the report conducted a structured diagnostic interview with 155 new admissions to one of two prisons in the UK using the CAAPE (Comprehensive Addiction And Psychological Evaluation), a structured diagnostic interview, to ensure consistent assessments. The US sample consisted of 6,881 male inmates in a state prison system evaluated with an automated version of the SUDDS-IV (Substance Use Disorder Diagnostic Schedule-IV) interview. RESULTS: Alcohol dependence emerged as the most prevalent substance use disorder in both UK prisons and in the US sample. Relative frequencies of abuse and dependence for alcohol and other drugs revealed that dependence on a given substance was more prevalent than abuse ad defined by the current diagnostic criteria. CONCLUSION: Despite the emphasis on drugs in correctional populations, alcohol dependence appears to be the most prominent substance use disorder among the incarcerated in both the US and UK and must be considered in developing treatment programs and policy priorities

Enhanced strange baryon production in Au+Au collisions compared to p+p at sqrts = 200 GeV

We report on the observed differences in production rates of strange and multi-strange baryons in Au+Au collisions at sqrts = 200 GeV compared to pp interactions at the same energy. The strange baryon yields in Au+Au collisions, then scaled down by the number of participating nucleons, are enhanced relative to those measured in pp reactions. The enhancement observed increases with the strangeness content of the baryon, and increases for all strange baryons with collision centrality. The enhancement is qualitatively similar to that observed at lower collision energy sqrts =17.3 GeV. The previous observations are for the bulk production, while at intermediate pT, 1 < pT< 4 GeV/c, the strange baryons even exceed binary scaling from pp yields.Comment: 7 pages, 4 figures. Printed in PR