The effect of the Talking Diabetes consulting skills intervention on glycaemic control and quality of life in children with type 1 diabetes: cluster randomised controlled trial (DEPICTED study)

Objective To evaluate the effectiveness on glycaemic control of a training programme in consultation skills for paediatric diabetes teams

A new search for distant radio galaxies in the Southern hemisphere -- III. Optical spectroscopy and analysis of the MRCR--SUMSS sample

We have compiled a sample of 234 ultra-steep-spectrum(USS)-selected radio sources in order to find high-redshift radio galaxies (HzRGs). The sample is in the southern sky at -40 deg < DEC < -30 deg which is the overlap region of the 408-MHz Revised Molonglo Reference Catalogue, 843-MHz Sydney University Molonglo Sky Survey (the MRCR--SUMSS sample) and the 1400-MHz NRAO VLA Sky Survey. This is the third in a series of papers on the MRCR--SUMSS sample. Here we present optical spectra from the ANU 2.3-m telescope, ESO New Technology Telescope and ESO Very Large Telescope for 52 of the identifications from Bryant et al. (2009, Paper II), yielding redshifts for 36 galaxies, 13 of which have z>2. We analyse the K-z distribution and compare 4-arcsec-aperture magnitudes with 64-kpc aperture magnitudes in several surveys from the literature; the MRCR--SUMSS sample is found to be consistent with models for 10^{11}-10^{12} solar mass galaxies. Dispersions about the fits in the K-z plot support passive evolution of radio galaxy hosts since z>3. By comparing USS-selected samples in the literature, we find that the resultant median redshift of the samples shown is not dependent on the flux density distribution or selection frequency of each sample. In addition, our finding that the majority of the radio spectral energy distributions remain straight over a wide frequency range suggests that a k-correction is not responsible for the success of USS-selection in identifying high redshift radio galaxies and therefore the steep radio spectra may be intrinsic to the source or a product of the environment. Two galaxies have been found to have both compact radio structures and strong self-absorption in the Ly-alpha line, suggesting they are surrounded by a dense medium...abridged.Comment: Accepted for MNRAS. 25 page

Abnormal clot microstructure formed in blood containing HIT-like antibodies

IntroductionThrombosis is a severe and frequent complication of heparin-induced thrombocytopenia (HIT). However, there is currently no knowledge of the effects of HIT-like antibodies on the resulting microstructure of the formed clot, despite such information being linked to thrombotic events. We evaluate the effect of the addition of pathogenic HIT-like antibodies to blood on the resulting microstructure of the formed clot.Materials and methodsPathogenic HIT-like antibodies (KKO) and control antibodies (RTO) were added to samples of whole blood containing Unfractionated Heparin and Platelet Factor 4. The formed clot microstructure was investigated by rheological measurements (fractal dimension; df) and scanning electron microscopy (SEM), and platelet activation was measured by flow cytometry.Results and conclusionsOur results revealed striking effects of KKO on clot microstructure. A significant difference in df was found between samples containing KKO (df = 1.80) versus RTO (df = 1.74; p < 0.0001). This increase in df was often associated with an increase in activated platelets. SEM images of the clots formed with KKO showed a network consisting of a highly branched and compact arrangement of thin fibrin fibres, typically found in thrombotic disease. This is the first study to identify significant changes in clot microstructure formed in blood containing HIT-like antibodies. These observed alterations in clot microstructure can be potentially exploited as a much-needed biomarker for the detection, management and monitoring of HIT-associated thrombosis

Laterality and Flight: Concurrent Tests of Side-Bias and Optimality in Flying Tree Swallows

Behavioural side-bias occurs in many vertebrates, including birds as a result of hemispheric specialization and can be advantageous by improving response times to sudden stimuli and efficiency in multi-tasking. However, behavioural side-bias can lead to morphological asymmetries resulting in reduced performance for specific activities. For flying animals, wing asymmetry is particularly costly and it is unclear if behavioural side-biases will be expressed in flight; the benefits of quick response time afforded by side-biases must be balanced against the costs of less efficient flight due to the morphological asymmetry side-biases may incur. Thus, competing constraints could lead to context-dependent expression or suppression of side-bias in flight. In repeated flight trials through an outdoor tunnel with obstacles, tree swallows (Tachycineta bicolor) preferred larger openings, but we did not detect either individual or population-level side-biases. Thus, while observed behavioural side-biases during substrate-foraging and copulation are common in birds, we did not see such side-bias expressed in obstacle avoidance behaviour in flight. This finding highlights the importance of behavioural context for investigations of side-bias and hemispheric laterality and suggests both proximate and ultimate trade-offs between species-specific cognitive ecology and flight biomechanics

Increasing capacity for the treatment of common musculoskeletal problems: A non-inferiority RCT and economic analysis of corticosteroid injection for shoulder pain comparing a physiotherapist and orthopaedic surgeon

Background Role substitution is a strategy employed to assist health services manage the growing demand for musculoskeletal care. Corticosteroid injection is a common treatment in this population but the efficacy of its prescription and delivery by physiotherapists has not been established against orthopaedic standards. This paper investigates whether corticosteroid injection given by a physiotherapist for shoulder pain is as clinically and cost effective as that from an orthopaedic surgeon. Methods A double blind non-inferiority randomized controlled trial was conducted in an Australian public hospital orthopaedic outpatient service, from January 2013 to June 2014. Adults with a General Practitioner referral to Orthopaedics for shoulder pain received subacromial corticosteroid and local anaesthetic injection prescribed and delivered independently by a physiotherapist or a consultant orthopaedic surgeon. The main outcome measure was total Shoulder Pain and Disability Index (SPADI) score at baseline, six and 12 weeks, applying a non-inferiority margin of 15 points. Secondary outcomes tested for superiority included pain, shoulder movement, perceived improvement, adverse events, satisfaction, quality of life and costs. Results 278 participants were independently assessed by the physiotherapist and the orthopaedic surgeon, with 64 randomised (physiotherapist 33, orthopaedic surgeon 31). There were no significant differences in baseline characteristics between groups. Non-inferiority of injection by the physiotherapist was declared from total SPADI scores at 6 and 12 weeks (upper limit of the 95% one-sided confidence interval 13.34 and 7.17 at 6 and 12 weeks, respectively). There were no statistically significant differences between groups on any outcome measures at 6 or 12 weeks. From the perspective of the health funder, the physiotherapist was less expensive. Conclusions Corticosteroid injection for shoulder pain, provided by a suitably qualified physiotherapist is at least as clinically effective, and less expensive, compared with similar care delivered by an orthopaedic surgeon. Policy makers and service providers should consider implementing this model of care

Serum Amyloid A Stimulates Vascular and Renal Dysfunction in Apolipoprotein E-Deficient Mice Fed a Normal Chow Diet

Elevated serum amyloid A (SAA) levels may promote endothelial dysfunction, which is linked to cardiovascular and renal pathologies. We investigated the effect of SAA on vascular and renal function in apolipoprotein E-deficient (ApoE−/−) mice. Male ApoE−/− mice received vehicle (control), low-level lipopolysaccharide (LPS), or recombinant human SAA by i.p. injection every third day for 2 weeks. Heart, aorta and kidney were harvested between 3 days and 18 weeks after treatment. SAA administration increased vascular cell adhesion molecule (VCAM)-1 expression and circulating monocyte chemotactic protein (MCP)-1 and decreased aortic cyclic guanosine monophosphate (cGMP), consistent with SAA inhibiting nitric oxide bioactivity. In addition, binding of labeled leukocytes to excised aorta increased as monitored using an ex vivo leukocyte adhesion assay. Renal injury was evident 4 weeks after commencement of SAA treatment, manifesting as increased plasma urea, urinary protein, oxidized lipids, urinary kidney injury molecule (KIM)-1 and multiple cytokines and chemokines in kidney tissue, relative to controls. Phosphorylation of nuclear-factor-kappa-beta (NFκB-p-P65), tissue factor (TF), and macrophage recruitment increased in kidneys from ApoE−/− mice 4 weeks after SAA treatment, confirming that SAA elicited a pro-inflammatory and pro-thrombotic phenotype. These data indicate that SAA impairs endothelial and renal function in ApoE−/− mice in the absence of a high-fat diet

WISE x SuperCOSMOS photometric redshift catalog: 20 million galaxies over 3pi steradians

We cross-match the two currently largest all-sky photometric catalogs, mid-infrared WISE and SuperCOSMOS scans of UKST/POSS-II photographic plates, to obtain a new galaxy sample that covers 3pi steradians. In order to characterize and purify the extragalactic dataset, we use external GAMA and SDSS spectroscopic information to define quasar and star loci in multicolor space, aiding the removal of contamination from our extended-source catalog. After appropriate data cleaning we obtain a deep wide-angle galaxy sample that is approximately 95% pure and 90% complete at high Galactic latitudes. The catalog contains close to 20 million galaxies over almost 70% of the sky, outside the Zone of Avoidance and other confused regions, with a mean surface density of over 650 sources per square degree. Using multiwavelength information from two optical and two mid-IR photometric bands, we derive photometric redshifts for all the galaxies in the catalog, using the ANNz framework trained on the final GAMA-II spectroscopic data. Our sample has a median redshift of z_{med} = 0.2 but with a broad dN/dz reaching up to z>0.4. The photometric redshifts have a mean bias of |delta_z|~10^{-3}, normalized scatter of sigma_z = 0.033 and less than 3% outliers beyond 3sigma_z. Comparison with external datasets shows no significant variation of photo-z quality with sky position. Together with the overall statistics, we also provide a more detailed analysis of photometric redshift accuracy as a function of magnitudes and colors. The final catalog is appropriate for `all-sky' 3D cosmology to unprecedented depths, in particular through cross-correlations with other large-area surveys. It should also be useful for source pre-selection and identification in forthcoming surveys such as TAIPAN or WALLABY