The influence of prior training on GPs’ attitudes to sickness absence certification post-fit note.

AimTo investigate the attitudes to health and work of general practitioners (GPs) with training in occupational medicine (OM) compared with non-OM trained GPs, since the introduction of the fit note.BackgroundChanges to the UK sickness certification system since 2010 and the introduction of the fit note required GPs to change their focus to what patients can do, rather than what they cannot do in relation to work. In an effort to reduce the UK sickness absence burden, GPs completion of the fit note should help to keep people in work, or assist patients to return to work as quickly as possible after a period of absence.MethodsQuestionnaire data were collected via the 7th National General Practitioner Worklife Survey.FindingsResults indicate that responses from GPs who had undertaken training in OM, and GPs having received some form of work and health training in the 12-month period before the study were associated with significantly more positive attitudes to patients’ returning to work and to the fit note. This study reveals evidence of a difference between trained and non-trained GPs in their attitude to the fit note, and to work and health generally. Further work investigating the effect of specific training in OM on the management and recognition of ill-health by GPs is recommended.</jats:sec

Hormonal contraceptive methods and risk of HIV acquisition in women : a systematic review of epidemiological evidence

Peer reviewedPublisher PD

An X-ray review of MS1054-0321: hot or not?

XMM-Newton observations are presented for the z=0.83 cluster of galaxies MS1054-0321, the highest redshift cluster in the Einstein Extended Medium Sensitivity Survey (EMSS). The temperature inferred by the XMM-Newton data, T=7.2 (+0.7, -0.6) keV, is much lower than the temperature previously reported from ASCA data, T=12.3 (+3.1, -2.2) keV (Donahue et al. 1998), and a little lower than the Chandra temperature, T=10.4(+1.7, -1.5) keV, determined by Jeltema et al. 2001. The discrepancy between the newly derived temperature and the previously derived temperatures is discussed in detail. If one allows the column density to be a free parameter, then the best fit temperature becomes T=8.6 (+1.2, -1.1) keV, and the best fit column density becomes N_(H)=1.33 (+0.15 -0.14) x 10^20 atoms/cm^2. The iron line is well detected in the XMM-Newton spectrum with a value for the abundance of Z=0.33 (+0.19 -0.18) Zsol, in very good agreement with previous determinations. The derived XMM X-ray luminosity for the overall cluster in the 2-10 keV energy band is L_X=(3.81 +/- 0.19) x 10^44 h^-2 erg s^-1 while the bolometric luminosity is L_BOL=(8.05+/-0.40) x 10^44 h^-2 erg s^-1. The XMM-Newton data confirm the substructure in the cluster X-ray morphology already seen by ROSAT and in much more detail by Chandra. The central weak lensing clump is coincident with the main cluster component and has a temperature T=8.1 (+1.3, -1.2) keV. The western weak lensing clump coincides with the western X-ray component which is much cooler with a temperature T=5.6 (+0.8, -0.6)$ keV. Given the newly determined temperature, MS1054-0321 is no longer amongst the hottest clusters known.Comment: To appear in the A&A main Journal, 13 pages including 3 postscript figures and 4 tables. Figs. 1, 4, 5 and 7 are too large and are not given here. The whole paper as pdf file is posted at http://www.ira.cnr.it/~gioia/PUB/publications.htm

Efficacy of beveled tip aspiration catheter in mechanical thrombectomy for acute ischemic stroke

BACKGROUND: Direct aspiration thrombectomy techniques use large bore aspiration catheters for mechanical thrombectomy. Several aspiration catheters are now available. We report a bench top exploration of a novel beveled tip catheter and our experience in treating large vessel occlusions (LVOs) using next-generation aspiration catheters. METHODS: A retrospective analysis from a prospectively maintained database comparing the bevel shaped tip aspiration catheter versus non-beveled tip catheters was performed. Patient demographics, periprocedural metrics, and discharge and 90-day modified Rankin Scale (mRS) scores were collected. Patients were divided into two groups based on which aspiration catheter was used. RESULTS: Our data showed no significant difference in age, gender, IV tissue plasminogen activator administration, admission NIH Stroke Scale score, baseline mRS, or LVO location between the beveled tip and flat tip groups. With the beveled tip, Thrombolysis in Cerebral Infarction (TICI) 2C or better recanalization was more frequent overall (93.2% vs 74.2%, p=0.017), stent retriever usage was lower (9.1% vs 29%, p=0.024), and patients had lower mRS on discharge (median 3 vs 4, p \u3c 0.001) and at 90 days (median 2 vs 4, p=0.008). CONCLUSION: Patients who underwent mechanical thrombectomy with the beveled tip catheter had a higher proportion of TICI 2C or better and had a significantly lower mRS score on discharge and at 90 days

Detection of X-rays from the jet-driving Symbiotic Star MWC 560

We report the detection of X-ray emission from the jet-driving symbiotic star MWC 560. We observed MWC 560 with XMM-Newton for 36 ks. We fitted the spectra from the EPIC pn, MOS1 and MOS2 instruments with XSPEC and examined the light curves with the package XRONOS. The spectrum can be fitted with a highly absorbed hard X-ray component from an optically-thin hot plasma, a Gaussian emission line with an energy of 6.1 keV and a less absorbed soft thermal component. The best fit is obtained with a model in which the hot component is produced by optically thin thermal emission from an isobaric cooling flow with a maximum temperature of 61 keV, which might be created inside an optically-thin boundary layer on the surface of the accreting with dwarf. The derived parameters of the hard component detected in MWC 560 are in good agreement with similar objects as CH Cyg, SS7317, RT Cru and T CrB, which all form a new sub-class of symbiotic stars emitting hard X-rays. Our previous numerical simulations of the jet in MWC 560 showed that it should produce detectable soft X-ray emission. We infer a temperature of 0.17 keV for the observed soft component, i.e. less than expected from our models. The total soft X-ray flux (i.e. at < 3 keV) is more than a factor 100 less than predicted for the propagating jet soon after its birth (<0.3 yr), but consistent with the value expected due its decrease with age. The ROSAT upper limit is also consistent with such a decrease. We find aperiodic or quasi-periodic variability on timescales of minutes and hours, but no periodic rapid variability. All results are consistent with an accreting white dwarf powering the X-ray emission and the existence of an optically-thin boundary layer around it.Comment: 8 pages, 5 figure, accepted for publication in A &

Impact of temperature and mode polarization on the acoustic phonon range in complex crystalline phases: A case study on intermetallic clathrates

The low and weakly temperature-varying lattice thermal conductivity, κL (T), in crystals with a complex unit cell such as type-I clathrates is assumed to originate from a reduced momentum and energy space available for propagative lattice vibrations, which is caused by the occurrence of low-energy optical phonon modes. In the context of ab initio self-consistent phonon (SCP) theory, it has been shown that the cubic and quartic anharmonic interactions result in a temperature-induced energy renormalization of these low-lying optical branches which contributes to the anomalous behavior of κL (T) in structurally ordered type-I clathrates [T. Tadano and S. Tsuneyuki, Phys. Rev. Lett. 120, 105901 (2018)]. By means of inelastic neutron scattering, we provide evidence for this energy renormalization in temperature, which has been resolved for transversely and longitudinally polarized phonons in the single crystal type-I clathrate Ba7.81Ge40.67Au5.33. By mapping the neutron intensity in the momentum space, we demonstrate the coherent character of the low-lying optical phonons. The overall phonon spectrum and dynamical structure factors are satisfactorily reproduced by ab initio harmonic calculations using density functional theory with the meta-GGA SCAN functional and a fully ordered structure. However, a polarization-dependent cutoff energy with opposing temperature shifts for longitudinal and transverse acoustic dispersions is experimentally observed which is not reproduced by the simulations. Anharmonicity affects the energies of the low-lying optical phonons in the transverse polarization, which compares quantitatively well with available results from SCP theory, whereas differences are observed for the longitudinal polarizatio

The stellar association around Gamma Velorum and its relationship with Vela OB2

We present the results of a photometric BVI survey of 0.9 square degrees around the Wolf-Rayet binary gamma^2 Vel and its early-type companion gamma^1 Vel. Several hundred PMS stars are identified and the youth of a subset of these is confirmed by the presence of lithium, H-alpha emission and X-ray activity. We show that the PMS stars are kinematically coherent and spatially concentrated around gamma Vel. The PMS stars have similar proper motions to gamma Vel, to main-sequence stars around gammaVel and to early-type stars of the wider Vela OB2 association of which gamma^2 Vel is the brightest member. The ratio of main-sequence stars to low-mass (0.1-0.6 Msun) PMS stars is consistent with a Kroupa mass function. Main-sequence fitting to stars around gamma Vel gives a distance modulus of 7.76+/-0.07 mag, consistent with a similarly-determined distance for Vela OB2 and with interferometric distances to gamma^2 Vel. High-mass stellar models indicate an age of 3-4 Myr for gamma^2 Vel, but the low-mass PMS stars have ages of ~10 Myr according to low-mass evolutionary models and 5-10 Myr by empirically placing them in an age sequence with other clusters based on colour-magnitude diagrams and lithium depletion. We conclude that the low-mass PMS stars form a genuine association with gamma Vel and that this is a subcluster within the larger Vela OB2 association. We speculate that gamma^2 Vel formed after the low-mass stars, expelling gas, terminating star formation and unbinding the association. The velocity dispersion of the PMS stars is too low for this star forming event to have produced all the stars in Vela OB2. Instead, star formation must have started at several sites within a molecular cloud, either sequentially or, simultaneously after some triggering event [abridged].Comment: Accepted for publication in MNRA

Two Rare Magnetic Cataclysmic Variables with Extreme Cyclotron Features Identified in the Sloan Digital Sky Survey

Two newly identified magnetic cataclysmic variables discovered in the Sloan Digital Sky Survey (SDSS), SDSSJ155331.12+551614.5 and SDSSJ132411.57+032050.5, have spectra showing highly prominent, narrow, strongly polarized cyclotron humps with amplitudes that vary on orbital periods of 4.39 and 2.6 hrs, respectively. In the former, the spacing of the humps indicates the 3rd and 4th harmonics in a magnetic field of ~60 MG. The narrowness of the cyclotron features and the lack of strong emission lines imply very low temperature plasmas and very low accretion rates, so that the accreting area is heated by particle collisions rather than accretion shocks. The detection of rare systems like these exemplifies the ability of the SDSS to find the lowest accretion rate close binaries.Comment: Accepted for publication in the Astrophysical Journal, vol. 583, February 1, 2003; slight revisions and additions in response to referee's comments; 17 pages, 6 figures, AASTeX v4.

Polyphenol-rich sorghum brans alter colon microbiota and impact species diversity and species richness after multiple bouts of dextran sodium sulfate-induced colitis

The microbiota affects host health, and dysbiosis is involved in colitis. Sorghum bran influences butyrate concentrations during dextran sodium sulfate (DSS) colitis, suggesting microbiota changes. We aimed to characterize the microbiota during colitis, and ascertain if polyphenol-rich sorghum bran diets mitigate these effects. Rats (n = 80) were fed diets containing 6% fiber from cellulose, or Black (3-deoxyanthocyanins), Sumac (condensed tannins), or Hi Tannin black (both) sorghum bran. Inflammation was induced three times using 3% DSS for 48 h (40 rats, 2 week separation), and the microbiota characterized by pyrosequencing. The Firmicutes/Bacteroidetes ratio was higher in Cellulose DSS rats. Colonic injury negatively correlated with Firmicutes, Actinobacteria, Lactobacillales and Lactobacillus, and positively correlated with Unknown/Unclassified. Post DSS#2, richness was significantly lower in Sumac and Hi Tannin black. Post DSS#3 Bacteroidales, Bacteroides, Clostridiales, Lactobacillales and Lactobacillus were reduced, with no Clostridium identified. Diet significantly affected Bacteroidales, Bacteroides, Clostridiales and Lactobacillus post DSS#2 and #3. Post DSS#3 diet significantly affected all genus, including Bacteroides and Lactobacillus, and diversity and richness increased. Sumac and Hi Tannin black DSS had significantly higher richness compared to controls. Thus, these sorghum brans may protect against alterations observed during colitis including reduced microbial diversity and richness, and dysbiosis of Firmicutes/Bacteroidetes

Discovery of mating in the major African livestock pathogen Trypanosoma congolense

The protozoan parasite, Trypanosoma congolense, is one of the most economically important pathogens of livestock in Africa and, through its impact on cattle health and productivity, has a significant effect on human health and well being. Despite the importance of this parasite our knowledge of some of the fundamental biological processes is limited. For example, it is unknown whether mating takes place. In this paper we have taken a population genetics based approach to address this question. The availability of genome sequence of the parasite allowed us to identify polymorphic microsatellite markers, which were used to genotype T. congolense isolates from livestock in a discrete geographical area of The Gambia. The data showed a high level of diversity with a large number of distinct genotypes, but a deficit in heterozygotes. Further analysis identified cryptic genetic subdivision into four sub-populations. In one of these, parasite genotypic diversity could only be explained by the occurrence of frequent mating in T. congolense. These data are completely inconsistent with previous suggestions that the parasite expands asexually in the absence of mating. The discovery of mating in this species of trypanosome has significant consequences for the spread of critical traits, such as drug resistance, as well as for fundamental aspects of the biology and epidemiology of this neglected but economically important pathogen