From Collapse to Freezing in Random Heteropolymers

We consider a two-letter self-avoiding (square) lattice heteropolymer model of N_H (out ofN) attracting sites. At zero temperature, permanent links are formed leading to collapse structures for any fraction rho_H=N_H/N. The average chain size scales as R = N^{1/d}F(rho_H) (d is space dimension). As rho_H --> 0, F(rho_H) ~ rho_H^z with z={1/d-nu}=-1/4 for d=2. Moreover, for 0 < rho_H < 1, entropy approaches zero as N --> infty (being finite for a homopolymer). An abrupt decrease in entropy occurs at the phase boundary between the swollen (R ~ N^nu) and collapsed region. Scaling arguments predict different regimes depending on the ensemble of crosslinks. Some implications to the protein folding problem are discussed.Comment: 4 pages, Revtex, figs upon request. New interpretation and emphasis. Submitted to Europhys.Let

No Evidence of a Drug-Drug Interaction Between Letermovir (MK-8228) and Mycophenolate Mofetil

Introduction: Letermovir (MK-8228) is a potent, oncedaily inhibitor of the cytomegalovirus (CMV) terminase complex that is being developed for the prophylaxis of CMV infection in transplant patients. This study evaluated the pharmacokinetic interactions, safety, and tolerability of letermovir when coadministered in healthy subjects with mycophenolate mofetil (MMF), which is the morpholinoethyl ester prodrug of mycophenolic acid (MPA). Methods: This was an open-label trial in 14 healthy female subjects that explored the pharmacokinetic parameters of a single 1 g oral dose of MMF administered alone on Day 1 and coadministered on Day 12 with 480 mg oral once-daily letermovir given on Day 5 and from Day 8 continued through Day 16. Letermovir PK was assessed at single dose (Day 5) and at steady state on Day 12 (with MMF) and Day 16 (alone following MMF washout). Results: Coadministration of 480 mg qd letermovir at steady state with a single dose of 1 g of MMF had no effect on the pharmacokinetics of MPA. The MPA AUC0-inf and Cmax geometric mean ratios (GMRs) [90% confidence interval] for the comparison (MMF with letermovir/ MMF alone) were 1.08 [0.96, 1.21] and 0.96 [0.81, 1.13], respectively. Coadministration of a single dose of 1 g MMF with 480 mg qd letermovir at steady state had no clinically meaningful effect on the pharmacokinetics of letermovir, with AUC0-24 and Cmax GMR of 1.18 [1.04, 1.32] and 1.11 [0.93, 1.34], respectively. The letermovir geometric mean accumulation ratio (Day 16/Day 5) and 95% CI were 1.13 [0.90, 1.42] for AUC0-24 and 1.01 [ 0.79, 1.28] f or Cmax, indicating that accumulation of letermovir when administered as daily doses is minimal. All related AEs were reported as mild in severity and resolved. Conclusions: Multiple-dose administration of 480 mg letermovir daily with a single dose of 1 g MMF was generally well tolerated by the healthy subjects in this study. Coadministration of letermovir and MMF had no clinically meaningful effect on the PK of letermovir or MPA. Letermovir and MMF may be coadministered without dose adjustment

Combined cognitive and vocational interventions after mild to moderate traumatic brain injury: study protocol for a randomized controlled trial

Background A considerable proportion of patients with mild to moderate traumatic brain injury (TBI) experience long-lasting somatic, cognitive, and emotional symptoms that may hamper their capacity to return to work (RTW). Although several studies have described medical, psychological, and work-related factors that predict RTW after TBI, well-controlled intervention studies regarding RTW are scarce. Furthermore, there has traditionally been weak collaboration among health-related rehabilitation services, the labor and welfare sector, and workplaces. Methods/design This study protocol describes an innovative randomized controlled trial in which we will explore the effect of combining manualized cognitive rehabilitation (Compensatory Cognitive Training [CCT]) and supported employment (SE) on RTW and related outcomes for patients with mild to moderate TBI in real-life competitive work settings. The study will be carried out in the southeastern region of Norway and thereby be performed within the Norwegian welfare system. Patients aged 18–60 years with mild to moderate TBI who are employed in a minimum 50% position at the time of injury and sick-listed 50% or more for postconcussive symptoms 2 months postinjury will be included in the study. A comprehensive assessment of neurocognitive function, self-reported symptoms, emotional distress, coping style, and quality of life will be performed at baseline, immediately after CCT (3 months after inclusion), following the end of SE (6 months after inclusion), and 12 months following study inclusion. The primary outcome measures are the proportion of participants who have returned to work at 12-month follow-up and length of time until RTW, in addition to work stability as well as work productivity over the first year following the intervention. Secondary outcomes include changes in self-reported symptoms, emotional and cognitive function, and quality of life. Additionally, a qualitative RTW process evaluation focused on organizational challenges at the workplace will be performed. Discussion The proposed study will combine cognitive and vocational rehabilitation and explore the efficacy of increased cross-sectoral collaboration between specialized health care services and the labor and welfare system. If the intervention proves effective, the project will describe the cost-effectiveness and utility of the program and thereby provide important information for policy makers. In addition, knowledge about the RTW process for persons with TBI and their workplaces will be provided. Trial registration ClinicalTrials.gov, NCT03092713. Registered on 10 March 2017

Explicitly modelling microtopography in permafrost landscapes in a land surface model (JULES vn5.4_microtopography)

Microtopography can be a key driver of heterogeneity in the ground thermal and hydrological regime of permafrost landscapes. In turn, this heterogeneity can influence plant communities, methane fluxes, and the initiation of abrupt thaw processes. Here we have implemented a two-tile representation of microtopography in JULES (the Joint UK Land Environment Simulator), where tiles are representative of repeating patterns of elevation difference. Tiles are coupled by lateral flows of water, heat, and redistribution of snow, and a surface water store is added to represent ponding. Simulations are performed of two Siberian polygon sites, (Samoylov and Kytalyk) and two Scandinavian palsa sites (Stordalen and Iškoras). The model represents the observed differences between greater snow depth in hollows vs. raised areas well. The model also improves soil moisture for hollows vs. the non-tiled configuration (“standard JULES”) though the raised tile remains drier than observed. The modelled differences in snow depths and soil moisture between tiles result in the lower tile soil temperatures being warmer for palsa sites, as in reality. However, when comparing the soil temperatures for July at 20 cm depth, the difference in temperature between tiles, or “temperature splitting”, is smaller than observed (3.2 vs. 5.5 ∘C). Polygons display small (0.2 ∘C) to zero temperature splitting, in agreement with observations. Consequently, methane fluxes are near identical (+0 % to 9 %) to those for standard JULES for polygons, although they can be greater than standard JULES for palsa sites (+10 % to 49 %). Through a sensitivity analysis we quantify the relative importance of model processes with respect to soil moisture and temperatures, identifying which parameters result in the greatest uncertainty in modelled temperature. Varying the palsa elevation between 0.5 and 3 m has little effect on modelled soil temperatures, showing that using only two tiles can still be a valid representation of sites with a range of palsa elevations. Mire saturation is heavily dependent on landscape-scale drainage. Lateral conductive fluxes, while small, reduce the temperature splitting by ∼ 1 ∘C and correspond to the order of observed lateral degradation rates in peat plateau regions, indicating possible application in an area-based thaw model

Exercise therapy and cognitive behavioural therapy to improve fatigue, daily activity performance and quality of life in Postpoliomyelitis Syndrome: the protocol of the FACTS-2-PPS trial

Contains fulltext : 88661.pdf (publisher's version ) (Open Access)BACKGROUND: Postpoliomyelitis Syndrome (PPS) is a complex of late onset neuromuscular symptoms with new or increased muscle weakness and muscle fatigability as key symptoms. Main clinical complaints are severe fatigue, deterioration in functional abilities and health related quality of life. Rehabilitation management is the mainstay of treatment. Two different therapeutic interventions may be prescribed (1) exercise therapy or (2) cognitive behavioural therapy (CBT). However, the evidence on the effectiveness of both interventions is limited. The primary aim of the FACTS-2-PPS trial is to study the efficacy of exercise therapy and CBT for reducing fatigue and improving activities and quality of life in patients with PPS. Additionally, the working mechanisms, patients' and therapists' expectations of and experiences with both interventions and cost-effectiveness will be evaluated. METHODS/DESIGN: A multi-centre, single-blinded, randomized controlled trial will be conducted. A sample of 81 severely fatigued patients with PPS will be recruited from 3 different university hospitals and their affiliate rehabilitation centres. Patients will be randomized to one of three groups i.e. (1) exercise therapy + usual care, (2) CBT + usual care, (3) usual care. At baseline, immediately post-intervention and at 3- and 6-months follow-up, fatigue, activities, quality of life and secondary outcomes will be assessed. Costs will be based on a cost questionnaire, and statistical analyses on GEE (generalized estimated equations). Analysis will also consider mechanisms of change during therapy. A responsive evaluation will be conducted to monitor the implementation process and to investigate the perspectives of patients and therapists on both interventions. DISCUSSION: A major strength of the FACTS-2-PPS study is the use of a mixed methods design in which a responsive and economic evaluation runs parallel to the trial. The results of this study will generate new evidence for the rehabilitation treatment of persons with PPS. TRIAL REGISTRATION: Dutch Trial Register NTR1371

Sights and insights: Vocational outdoor students’ learning

Outdoor leader and adventure sport education in the United Kingdom has been characterized by an over-emphasis on technical skills at the expense of equally important, but often marginalized intra- and inter-personal skills necessary for contemporary outdoor employment. This study examined the lived experience of vocational outdoor students in order, firstly, to identify what was learned about the workplace through using reflective practice and, secondly, what was learned about reflective practice through this experience. The study used a purposive sample of students (n=15) who were invited to maintain reflective journals during summer work experience, and this was followed up with semi-structured interviews. Manual Interpretative Phenomenological Analysis (IPA) revealed that in the workplace setting students used reflective practice to understand and develop technical proficiency, support awareness of the value of theory, and acted as a platform to express emergent concepts of ‘professionalism’. Lessons about reflective practice emphasized its value in social settings, acknowledging different ways of reflection, and understanding and managing professional life beyond graduation

Children, civilianhood, and humanitarian securitization

In this paper, the influence of the construction of children as civilians over the processes of securitization in the US intervention in Somalia is examined. This is done through an analysis of the US print news media coverage of that event. The study employs two key theoretical frameworks: the first is the social understanding of civilianhood; and the second is the Copenhagen School’s theory of securitization. The work concludes that a failure to unpack the value of referent objects of security diminishes the insights that securitization theory can offer. The grammar of securitizing moves cannot be fully comprehended in instances of militarized humanitarian interventions, in particular, without this kind of analysis. Children as suffering civilians draw considerable attention from the world’s media and thus an investigation of their role in securitization can be highly informative