Levels of State and Trait Anxiety in Patients Referred to Ophthalmology by Primary Care Clinicians: A Cross Sectional Study

Purpose There is a high level of over-referral from primary eye care leading to significant numbers of people without ocular pathology (false positives) being referred to secondary eye care. The present study used a psychometric instrument to determine whether there is a psychological burden on patients due to referral to secondary eye care, and used Rasch analysis to convert the data from an ordinal to an interval scale. Design Cross sectional study. Participants and Controls 322 participants and 80 control participants. Methods State (i.e. current) and trait (i.e. propensity to) anxiety were measured in a group of patients referred to a hospital eye department in the UK and in a control group who have had a sight test but were not referred. Response category analysis plus infit and outfit Rasch statistics and person separation indices were used to determine the usefulness of individual items and the response categories. Principal components analysis was used to determine dimensionality. Main Outcome Measure Levels of state and trait anxiety measured using the State-Trait Anxiety Inventory. Results State anxiety scores were significantly higher in the patients referred to secondary eye care than the controls (p0.1). Rasch analysis highlighted that the questionnaire results needed to be split into “anxiety-absent” and “anxiety-present” items for both state and trait anxiety, but both subscales showed the same profile of results between patients and controls. Conclusions State anxiety was shown to be higher in patients referred to secondary eye care than the controls, and at similar levels to people with moderate to high perceived susceptibility to breast cancer. This suggests that referral from primary to secondary eye care can result in a significant psychological burden on some patients

Hibernation in pygmy lorises (Nycticebus pygmaeus)–what does it mean?

Torpor use in primates appeared to be restricted to African species and was only recently discovered in a species from Asia, the pygmy loris (Nycticebus pygmaeus). This finding has considerable implications for our perception of torpor in this mammal group and demonstrates that torpor is probably more widespread in mammals than commonly thought. This article summarizes the current knowledge on the use of torpor in the pygmy loris and places it into the context of ongoing research on this topic

Proposal to Search for Heavy Neutral Leptons at the SPS

A new fixed-target experiment at the CERN SPS accelerator is proposed that will use decays of charm mesons to search for Heavy Neutral Leptons (HNLs), which are right-handed partners of the Standard Model neutrinos. The existence of such particles is strongly motivated by theory, as they can simultaneously explain the baryon asymmetry of the Universe, account for the pattern of neutrino masses and oscillations and provide a Dark Matter candidate. Cosmological constraints on the properties of HNLs now indicate that the majority of the interesting parameter space for such particles was beyond the reach of the previous searches at the PS191, BEBC, CHARM, CCFR and NuTeV experiments. For HNLs with mass below 2 GeV, the proposed experiment will improve on the sensitivity of previous searches by four orders of magnitude and will cover a major fraction of the parameter space favoured by theoretical models. The experiment requires a 400 GeV proton beam from the SPS with a total of 2x10^20 protons on target, achievable within five years of data taking. The proposed detector will reconstruct exclusive HNL decays and measure the HNL mass. The apparatus is based on existing technologies and consists of a target, a hadron absorber, a muon shield, a decay volume and two magnetic spectrometers, each of which has a 0.5 Tm magnet, a calorimeter and a muon detector. The detector has a total length of about 100 m with a 5 m diameter. The complete experimental set-up could be accommodated in CERN's North Area. The discovery of a HNL would have a great impact on our understanding of nature and open a new area for future research

Case series on granulosa cell tumour in cattle with practical hints on diagnostics and outcome

Granulosa cell tumours are the most common neoplasm of the bovine ovary and present with a wide range of clinical signs. This case series comprises five case reports of ovarian granulosa cell tumours in cattle. The affected animals had different breeds (Red Holstein, Eringer, Swiss Braunvieh, crossbred beef) and ranged in age from 1 year 4 months to 20 years 11 months. The diversity of the cases gives an overview of the diagnostic possibilities as well as the possible treatments and outcomes of the disease. Anti-mullerian hormone (AMH) was measured in one of the affected animals, and was extremely elevated (>150 pmoL/L) compared to reported normal values (<3 pmoL/L). Three animals underwent standing laparotomy with unilateral ovariectomy, and the remaining two animals were slaughtered. One of the cases confirms the previously published reports that malignancy or metastasis is possible in cattle. Another case indicates that successful surgical treatment with subsequent resumption of reproduction is possible. In summary, the initial tentative diagnosis of GCT is made by ultrasound-assisted rectal examination of the genital tract or ovaries and can subsequently be supported by evaluation of AMH levels. The decision to proceed with treatment should be made without delay, as surgical removal of the altered ovary with subsequent resumption of reproductive activity and cessation of undesirable behaviour is possible

Effects of oxidized low density lipoprotein, lipid mediators and statins on vascular cell interactions

The integrin heterodimer CD11b/CD18 (alpha M beta 2, Mac-1, CR3) expressed on monocytes or polymorphonuclear leukocytes (PMN) is a receptor for iC3b, fibrinogen, heparin, and for intercellular adhesion molecule (ICAM)-1 on endothelium, crucially contributing to vascular cell interactions in inflammation and atherosclerosis. In this report, we summarize our findings on the effects of lipid mediators and lipid-lowering drugs. Exposure of endothelial cells to oxidized low density lipoprotein (oxLDL) induces upregulation of ICAM-1 and increases adhesion of monocytic cells expressing Mac-1. Inhibition experiments show that monocytes use distinct ligands, i.e. ICAM-1 and heparan sulfate proteoglycans for adhesion to oxLDL-treated endothelium. An albumin-transferable oxLDL activity is inhibited by the antioxidant pyrrolidine dithiocarbamate (PDTC), while 8-epi-prostaglandin F2 alpha (8-epi-PGF2 alpha) or lysophosphatidylcholine had no effect, implicating yet unidentified radicals. Sequential adhesive! and signaling events lead to the firm adhesion of rolling PMN on activated and adherent platelets, which may occupy areas of endothelial denudation. Shear resistant arrest of PMN on thrombin-stimulated platelets in flow conditions requires distinct regions of Mac-1, involving its interactions with fibrinogen bound to platelet alpha llb beta 3, and with other platelet ligands. Both arrest and adhesion strengthening under flow are stimulated by platelet-activating factor and leukotriene B4, but not by the chemokine receptor CXCR2. We tested whether Mac-1-dependent monocyte adhesiveness is affected by inhibitors of hydroxy-methylglutaryl-Coenzyme A reductase (statins) which improve morbidity and survival of patients with coronary heart disease. As compared to controls, adhesion of isolated monocytes to endothelium ex vivo was increased in patients with hypercholesterolemia. Treatment with statins decreased total and low density lipoprotein (LDL) cholesterol plasma levels, surface expression of Mac-1, and resulted in a dramatic reduction of Mac,mediated monocyte adhesion to endothelium. The inhibition of monocyte adhesion was reversed by mevalonate but not LDL in vitro,indicating that isoprenoid precursors are crucial for adhesiveness of Mac-1. Such effects may crucially contribute to the clinical benefit of statins, independent of cholesterol-lowering, and may represent a paradigm for novel, anti-inflammatory mechanisms of action by this class of drugs

Volumetrie der Schilddrüsenlappen mittels Real-time-Sonographie

Im direkten Vergleich mit der durch Submersion ermittelten wahren Schilddrüsengröße wurde bei Leichen mit einem Real-time-Gerät ein Verfahren zur Volumenbestimmung durch sonographische Messungen erarbeitet. Länge mal Breite mal Dicke des Schilddrüsenlappens, multipliziert mit dem Faktor π/6, entsprechen einem Rotationsellipsoid, während sich bei Multiplikation mit dem optimierten Korrekturfaktor f = 0,479 das bestmögliche rechnerische Volumen des Lappens ergibt. Die Richtigkeit dieser Bestimmung ist definitionsgemäß 100 %; der. durchschnittliche Fehler der Methode beträgt 16 %. Die Messungen sind einfach durchzuführen und verlangen keinerlei Zusatzeinrichtungen für Planimetrie oder Rechneroperationen. Die Volumetrie der Schilddrüse ist vor allem zur Therapiebeurteilung und zur Berechnung der Dosis bei einer Radiojodtherapie erforderlich.Thyroid volume as measured by real-time ultrasound in cadavers was compared with direct measurements obtained by submersion. Length × width × thickness of the thyroid lobe multiplied by factor π/6, correspond to a rotation ellipsoid, while the best calculated volume of the lobe is obtained by multiplying with the optimised correction factor f = 0.479. The correctness of this calculation is, by definition, 100 %; average error of the method is 16 %. The measurements are easy to do and require no additional equipment for planimetry or calculations. Volumetric analysis of the thyroid gland is especially necessary in assessing results of treatment and for measuring dosage in connection with radioiodine therapy

Effect of quantum confinement on exciton-phonon interactions

We investigate the homogeneous linewidth of localized type-I excitons in type-II GaAs/AlAs superlattices. These localizing centers represent the intermediate case between quasi-two-dimensional (Q2D) and quasi-zero-dimensional localizations. The temperature dependence of the homogeneous linewidth is obtained with high precision from micro-photoluminescence spectra. We confirm the reduced interaction of the excitons with their environment with decreasing dimensionality except for the coupling to LO-phonons. The low-temperature limit for the linewidth of these localized excitons is five times smaller than that of Q2D excitons. The coefficient of exciton-acoustic-phonon interaction is 5 ~ 6 times smaller than that of Q2D excitons. An enhancement of the average exciton-LO-phonon interaction by localization is found in our sample. But this interaction is very sensitive to the detailed structure of the localizing centers.Comment: 6 pages, 4 figure

Paternal Diet Defines Offspring Chromatin State and Intergenerational Obesity

The global rise in obesity has revitalized a search for genetic and epigenetic factors underlying the disease. We present a Drosophila model of paternal-diet-induced intergenerational metabolic reprogramming (IGMR) and identify genes required for its encoding in offspring. Intriguingly, we find that as little as 2 days of dietary intervention in fathers elicits obesity in offspring. Paternal sugar acts as a physiological suppressor of variegation, desilencing chromatin-state-defined domains in both mature sperm and in offspring embryos. We identify requirements for H3K9/K27me3-dependent reprogramming of metabolic genes in two distinct germline and zygotic windows. Critically, we find evidence that a similar system may regulate obesity susceptibility and phenotype variation in mice and humans. The findings provide insight into the mechanisms underlying intergenerational metabolic reprogramming and carry profound implications for our understanding of phenotypic variation and evolution