Use of novel serum markers in clinical follow-up of Sertoli-Leydig cell turnours

Background: Sertoli-Leyclig cell tumours of the ovary account for only 0.2% of malignant ovarian tumours. Two-thirds of all patients become apparent due to the tumour's hormone production. Methods: A 41-year-old patient (gravida 4, para 4) presented with dyspnoea, enlarged abdominal girth and melaena. Diagnostic imaging was suspicious for an ovarian cancer. The standard tumour marker for ovarian cancer (CA 125) was elevated to 984 U/mL. Results: Surgical exploration of the abdomen revealed a mouldering tumour of both adnexes extending to the level of the navel. Frozen sections showed an undifferentiated carcinoma of unknown origin. Radical surgery was performed. The final histological report described a malignant sex-cord stroma tumour, a Sertoli-Leydig cell tumour, emanating from both ovaries. Analysis of preoperative blood serum showed elevated levels of CYFRA 21-1 (10.4 ng/mL), neuron-specific enolase (36.2 ng/mL), oestradiol (485 pg/mL) and CA-125 (984 U/mL). Adjuvant chemotherapy and regional hyperthermia were performed due to the malignant potential and incomplete resection of the tumour. Conclusions: Undifferentiated Sertoli-Leyclig cell tumours show a poor clinical course. As only two-thirds of patients with this rare disease present with elevated hormone levels, new markers deserve further investigation to offer more specific, individualised tumour monitoring

Determination of the strange nucleon form factors

The strange contribution to the electric and magnetic form factors of the nucleon is determined at a range of discrete values of $Q^2$ up to $1.4$ GeV$^2$. This is done by combining recent lattice QCD results for the electromagnetic form factors of the octet baryons with experimental determinations of those quantities. The most precise result is a small negative value for the strange magnetic moment: $G_M^s(Q^2=0) = -0.07\pm0.03\,\mu_N$. At larger values of $Q^2$ both the electric and magnetic form factors are consistent with zero to within $2$-sigma

Charge Symmetry Violation in the Electromagnetic Form Factors of the Proton

Experimental tests of QCD through its predictions for the strange-quark content of the proton have been drastically restricted by our lack of knowledge of the violation of charge symmetry (CSV). We find unexpectedly tiny CSV in the proton's electromagnetic form factors by performing the first extraction of these quantities based on an analysis of lattice QCD data. The resulting values are an order of magnitude smaller than current bounds on proton strangeness from parity violating electron-proton scattering experiments. This result paves the way for a new generation of experimental measurements of the proton's strange form factors to challenge the predictions of QCD

Survey of ultrasound practice amongst podiatrists in the UK

Background: Ultrasound in podiatry practice encompasses musculoskeletal ultrasound imaging, vascular hand-held Doppler ultrasound and therapeutic ultrasound. Sonography practice is not regulated by the Health and Care Professions Council (HCPC), with no requirement to hold a formal qualification. The College of Podiatry does not currently define ultrasound training and competencies. This study aimed to determine the current use of ultrasound, training received and mentorship received and/or provided by podiatrists using ultrasound. Methods: A quantitative study utilising a cross-sectional, on-line, single-event survey was undertaken within the UK. Results: Completed surveys were received from 284 podiatrists; 173 (70%) use ultrasound as part of their general practice, 139 (49%) for musculoskeletal problems, 131 (46%) for vascular assessment and 39 (14%) to support their surgical practice. Almost a quarter (n=62) worked for more than one organisation; 202 (71%) were employed by the NHS and/or private sector (n=118, 41%). Nearly all (93%) respondents report using a hand-held vascular Doppler in their daily practice; 216 (82%) to support decisions regarding treatment options, 102 (39%) to provide diagnostic reports for other health professionals, and 34 (13%) to guide nerve blocks. Ultrasound imaging was used by 104 (37%) respondents primarily to aid clinical decision making (n=81) and guide interventions (steroid injections n=67; nerve blocks n=39). Ninety-three percent stated they use ultrasound imaging to treat their own patients, while others scan at the request of other podiatrists (n=28) or health professionals (n=18). Few use ultrasound imaging for research (n=7) or education (n=2). Only 32 (11%) respondents (n=20 private sector) use therapeutic ultrasound to treat patients presenting with musculoskeletal complaints, namely tendon pathologies. Few respondents (18%) had completed formal post-graduate CASE (Consortium for the Accreditation of Sonographic Education) accredited ultrasound courses. Forty (14%) respondents receive ultrasound mentorship; the majority from fellow podiatrists (n=17) or medical colleagues (n=15). Over half (n=127) who do not have ultrasound mentorship indicated they would like a mentor predominantly for ultrasound imaging. Fifty-five (19%) report they currently provide ultrasound mentorship for others. Conclusions: Understanding the scope of ultrasound practice, the training undertaken and the requirements for mentorship will underpin the development of competencies and recommendations defined by the College of Podiatry to support professional development and ensure safe practice.</p

Optimization of Air Entrained Grout Enriched Roller Compacted Concrete for Improving Freeze-Thaw Resistance of Hydraulic Structures

Roller compacted concrete (RCC) is frequently used to construct gravity dams, stepped spillways, and to armor earthen embankments for passing extreme floods. Early experience on RCC dam applications in the 1980s showed a tendency for seepage to develop along the lift lines. Therefore, RCC dam designers started including an upstream facing system as a watertight barrier. An alternative facing material that has been used extensively overseas and is starting to gain more widespread acceptance in the United States is Grout Enriched RCC (GERCC). The grout enriched method of face construction has been shown to be less expensive than other facing options, particularly on larger dam projects. However, in the United States, the use of GERCC technology has been fairly limited, primarily due to concern over the material’s freeze-thaw resistance. Achieving cost-effective GERCC air entrainment and consolidation can significantly advance the competitiveness of RCC versus other alternatives. The objective of this project is to develop a grout formulation and construction technique that allows the production of air entrained GERCC. The study includes four phases to systemically achieve this objective: (1) optimizing grout formulation including type and dosage of chemical admixtures, (2) evaluation of small scale laboratory samples of RCC and grout combined in a mixer, (3) evaluation of large scale laboratory samples of RCC and grout combined simulating field construction techniques, and (4) conducting a field trial. The results of Phases 1 and 2 (presented herein) show that when the grout and RCC are combined in a mixer, good freeze-thaw resistance can be achieved. Phases 3 and 4 are currently underway. Through additional research, the project team’s goal is to advance the use of GERCC and promote more cost effective and technically viable construction of gravity dams, stepped spillways, armored earthen embankments and other hydraulic structures in climates subject to freeze-thaw cycles

Chart Adequacy: Workshop and GEBCO Training

In July, 2015 the first NOAA Chart Adequacy Workshop was held in Silver Spring, Maryland, USA. Following a three-day workshop (14th to 16th July, 2015), four Nippon Foundation GEBCO students stayed at NOAA for an additional 10-day training at Office of Coast Survey’s Marine Chart Division. The key objective of the NOAA Chart Adequacy Workshop was to demonstrate techniques to evaluate the suitability of nautical chart products using chart quality information and publicly-available information. The attendees were cartographers, hydrographers and potential chart producers from hydrographic offices and government agencies around the world. The nations of the participants in the workshop included: Indonesia, Israel, Japan, Kenya, Malaysia, Philippines, South Korea, Sri Lanka, United Kingdom, United States and Venezuela. Through instructor presentations and GIS laboratory exercises (provided by Dr. Shachak Pe’eri and Lt Anthony Klemm), the participants generated the key layers that are involved in the NOAA procedure. A vessel traffic layer was generated by classification of navigational routes using Automatic Identification Systems (AIS) information. A bathymetric difference layer was generated by identifying areas that showed significant bathymetric changes identified by comparing Satellite-Derived Bathymetry (SDB) or other surveys of opportunity, with the existing chart. A hydrographic characteristics layer was generated by classification of chart quality information. Chart data (including the smooth sheet sounding sets) for the procedure were provided in a vector format with the appropriate metadata according to IHO S-57. Raster Navigational Charts were also used as a background and as a reference for the Bathymetric Difference layer

Communication with young people in paediatric and adult endocrine consultations: an intervention development and feasibility study

Background: Communication is complex in endocrine care, particularly during transition from paediatric to adult services. The aims of this study were to examine the feasibility of interventions to support young people to interact with clinicians. Methods: Development and evaluation of a complex intervention in 2 phases: Pre-intervention observational study; Intervention feasibility study. Purposive sample of recordings of 62 consultations with 58 young people aged 11-25 years with long-term endocrine conditions in two paediatric and two adult endocrine clinics. Proportion of time talked during consultations, number and direction of questions asked; Paediatric Consultation Assessment Tool (PCAT); OPTION shared decision making tool; Medical Information Satisfaction Scale (MISS- 21). Young people were invited to use one or more of: a prompt sheet to help them influence consultation agendas and raise questions; a summary sheet to record key information; and the www.explain.me.uk website. Results: Nearly two thirds of young people (63%) chose to use at least one communication intervention. Higher ratings for two PCAT items (95% CI 0.0 to 1.1 and 0.1 to 1.7) suggest interventions can support consultation skills. A higher proportion of accompanying persons (83%) than young people (64%) directed questions to clinicians. The proportion of young people asking questions was higher (84%) in the intervention phase than in the observation phase (71%). Conclusions: Interventions were acceptable and feasible. The Intervention phase was associated with YP asking more questions, which implies that the availability of interventions could promote interactivity

Health research improves healthcare: now we have the evidence and the chance to help the WHO spread such benefits globally

There has been a dramatic increase in the body of evidence demonstrating the benefits that come from health research. In 2014, the funding bodies for higher education in the UK conducted an assessment of research using an approach termed the Research Excellence Framework (REF). As one element of the REF, universities and medical schools in the UK submitted 1,621 case studies claiming to show the impact of their health and other life sciences research conducted over the last 20 years. The recently published results show many case studies were judged positively as providing examples of the wide range and extensive nature of the benefits from such research, including the development of new treatments and screening programmes that resulted in considerable reductions in mortality and morbidity. Analysis of specific case studies yet again illustrates the international dimension of progress in health research; however, as has also long been argued, not all populations fully share the benefits. In recognition of this, in May 2013 the World Health Assembly requested the World Health Organization (WHO) to establish a Global Observatory on Health Research and Development (R&D) as part of a strategic work-plan to promote innovation, build capacity, improve access, and mobilise resources to address diseases that disproportionately affect the world’s poorest countries. As editors of Health Research Policy and Systems (HARPS), we are delighted that our journal has been invited to help inform the establishment of the WHO Global Observatory through a Call for Papers covering a range of topics relevant to the Observatory, including topics on which HARPS has published articles over the last few months, such as approaches to assessing research results, measuring expenditure data with a focus on R&D, and landscape analyses of platforms for implementing R&D. Topics related to research capacity building may also be considered. The task of establishing a Global Observatory on Health R&D to achieve the specified objectives will not be easy; nevertheless, this Call for Papers is well timed – it comes just at the point where the evidence of the benefits from health research has been considerably strengthened

Real Time Hand Movement Trajectory Tracking for Enhancing Dementia Screening in Ageing Deaf Signers of British Sign Language

Real time hand movement trajectory tracking based on machine learning approaches may assist the early identification of dementia in ageing Deaf individuals who are users of British Sign Language (BSL), since there are few clinicians with appropriate communication skills, and a shortage of sign language interpreters. Unlike other computer vision systems used in dementia stage assessment such as RGB-D video with the aid of depth camera, activities of daily living (ADL) monitored by information and communication technologies (ICT) facilities, or X-Ray, computed tomography (CT), and magnetic resonance imaging (MRI) images fed to machine learning algorithms, the system developed here focuses on analysing the sign language space envelope(sign trajectories/depth/speed) and facial expression of deaf individuals, using normal 2D videos. In this work, we are interested in providing a more accurate segmentation of objects of interest in relation to the background, so that accurate real-time hand trajectories (path of the trajectory and speed) can be achieved. The paper presents and evaluates two types of hand movement trajectory models. In the first model, the hand sign trajectory is tracked by implementing skin colour segmentation. In the second model, the hand sign trajectory is tracked using Part Afinity Fields based on the OpenPose Skeleton Model [1, 2]. Comparisons of results between the two different models demonstrate that the second model provides enhanced improvements in terms of tracking accuracy and robustness of tracking. The pattern differences in facial and trajectory motion data achieved from the presented models will be beneficial not only for screening of deaf individuals for dementia, but also for assessment of other acquired neurological impairments associated with motor changes, for example, stroke and Parkinsons disease