COUPLES AND WEIGHT LOSS SURGERY: EXPERIENCING SUCCESS

Bariatric surgery, also known as weight loss surgery (WLS) is an intervention for individuals who are suffering from obesity and weight-related health complications which often accompany being 100 pounds or more overweight (Smith et al., 2011). Even though bariatric surgery has been shown to be a life-saving and life-enhancing operation, efforts to seek out surgery options, qualify and prepare for the procedure, recover from surgery, and then adapt new routines to support surgery are challenging not only for the patient, but also for the people with whom the patient spends the most time—their romantic partners (Applegate & Friedman, 2008; Bylund, Benzein, & Carina, 2013; Moore & Cooper, 2016; Sarwer, Dilks, & West-Smith, 2011). This dissertation was a means to explore relational, food, and WLS success experiences that take place within couples when at least one person has had bariatric surgery. Comparisons between life before, during, and after WLS were discussed with focused attention given to relationship dynamics and daily food routines (Bocchieri, Meana, & Fisher, 2002). The couple’s definition of WLS success and the means by which they have been successful were launching points for more in-depth conversation. Data was generated through 2 interviews per couple (n = 11) with patients who met selection criteria for the study—committed long-term relationship and of the same residence for at least the past 5 years with at least 1 person having been successful with WLS. Success was defined by the WLS patient, however they had to be at least 2 years post-WLS, the critical time period where postoperative weight regain has been shown to occur, in order to participate (Magro et al., 2008; Ogden, Avenell, & Ellis, 2011; Pories et al., 2016). A thematic analysis with multiple rounds of coding was conducted after data saturation was met and couples indicated their agreeableness with results through a short, follow-up survey which also functioned as a form of member-checking. Overall, couples’ relationship dynamics were characterized as secure and WLS gave them another way to give support, engage in teamwork, and ultimately become closer. Patients and spouses explained that they loved each other unconditionally, no matter what the patient weighed, and this had been the reality for their entire relationship. Thus, security was the theme for relationship dynamics with support, teamwork, and closer as subthemes. Spouses expressed their desire to help the WLS patient when it came to being open to change and then making necessary modifications in habits and lifestyle. The commitment to change happened before WLS and a mind-shift happened after WLS that enabled both people to adjust their thinking, consistently evaluate their routines, and continue to change their behaviors. As a result, commit and mind-shift were the themes and subsequent changes (diet, exercise, and mindsets) were the subthemes. A secure relationship and commitment to making “better choices” assisted the patient in experiencing WLS success and this meant that their spouse experienced success, too; “it’s our success together.” The theme for WLS success was follow-through and subthemes were results, comfort, happy, and freedom. Hope was also a by-product of success and it was the grand-theme of this study

Posttransplant lymphoproliferative disorders in neuronal xenotransplanted macaques

Posttransplant lymphoproliferative disorders (PTLDs) are a heterogeneous group of lymphoid proliferations that occur in the setting of depressed T-cell function due to immunosuppressive therapy used following solid organ transplantation, hematopoietic stem cell transplantation, and also xenotransplantation. In the present study, 28 immunosuppressed parkinsonian Macaca fascicularis were intracerebrally injected with wild-type or CTLA4-Ig transgenic porcine xenografts to identify a suitable strategy to enable long-term cell survival, maturation, and differentiation. Nine of 28 (32%) immunosuppressed primates developed masses compatible with PTLD, located mainly in the gastrointestinal tract and/or nasal cavity. The masses were classified as monomorphic PTLD according to the World Health Organization classification. Immunohistochemistry and polymerase chain reaction (PCR) analyses revealed that the PTLDs were associated with macaca lymphocryptovirus as confirmed by double-labeling immunohistochemistry for CD20 and Epstein-Barr nuclear antigen 2 (EBNA-2), where the viral protein was located within the CD20+ neoplastic B cells. In sera from 3 distinct phases of the experimental life of the primates, testing by quantitative PCR revealed a progression of the viral load that paralleled the PTLD progression and no evidence of zoonotic transmission of porcine lymphotropic herpesvirus through xenoneuronal grafts. These data suggest that monitoring the variation of macaca lymphocryptovirus DNA in primates could be used as a possible early diagnostic tool for PTLD progression, allowing preemptive treatment such as immunosuppression therapy reduction

Modal quantum theory

We present a discrete model theory similar in structure to ordinary quantum mechanics, but based on a finite field instead of complex amplitudes. The interpretation of this theory involves only the "modal" concepts of possibility and necessity rather than quantitative probability measures. Despite its simplicity, our model theory includes entangled states and has versions of both Bell's theorem and the no cloning theorem.Comment: Presented at the 7th Workshop on Quantum Physics and Logic, Oxford University (29-30 May 2010). Revised 1 Aug 2011 in response to referee comment

Indeterminate-length quantum coding

The quantum analogues of classical variable-length codes are indeterminate-length quantum codes, in which codewords may exist in superpositions of different lengths. This paper explores some of their properties. The length observable for such codes is governed by a quantum version of the Kraft-McMillan inequality. Indeterminate-length quantum codes also provide an alternate approach to quantum data compression.Comment: 32 page

Comparative Genome-Wide Screening Identifies a Conserved Doxorubicin Repair Network That Is Diploid Specific in Saccharomyces cerevisiae

The chemotherapeutic doxorubicin (DOX) induces DNA double-strand break (DSB) damage. In order to identify conserved genes that mediate DOX resistance, we screened the Saccharomyces cerevisiae diploid deletion collection and identified 376 deletion strains in which exposure to DOX was lethal or severely reduced growth fitness. This diploid screen identified 5-fold more DOX resistance genes than a comparable screen using the isogenic haploid derivative. Since DSB damage is repaired primarily by homologous recombination in yeast, and haploid cells lack an available DNA homolog in G1 and early S phase, this suggests that our diploid screen may have detected the loss of repair functions in G1 or early S phase prior to complete DNA replication. To test this, we compared the relative DOX sensitivity of 30 diploid deletion mutants identified under our screening conditions to their isogenic haploid counterpart, most of which (n = 26) were not detected in the haploid screen. For six mutants (bem1Δ, ctf4Δ, ctk1Δ, hfi1Δ,nup133Δ, tho2Δ) DOX-induced lethality was absent or greatly reduced in the haploid as compared to the isogenic diploid derivative. Moreover, unlike WT, all six diploid mutants displayed severe G1/S phase cell cycle progression defects when exposed to DOX and some were significantly enhanced (ctk1Δ and hfi1Δ) or deficient (tho2Δ) for recombination. Using these and other “THO2-like” hypo-recombinogenic, diploid-specific DOX sensitive mutants (mft1Δ, thp1Δ, thp2Δ) we utilized known genetic/proteomic interactions to construct an interactive functional genomic network which predicted additional DOX resistance genes not detected in the primary screen. Most (76%) of the DOX resistance genes detected in this diploid yeast screen are evolutionarily conserved suggesting the human orthologs are candidates for mediating DOX resistance by impacting on checkpoint and recombination functions in G1 and/or early S phases

Frequent Infection of Neurons by SV40 Virus in SIV-Infected Macaque Monkeys with Progressive Multifocal Leukoencephalopathy and Meningoencephalitis

Simian virus 40 (SV40), family Polyomaviridae, in immunocompromised macaques can cause fatal demyelinating central nervous system disease analogous to progressive multifocal leukoencephalopathy caused by John Cunningham (JC) virus in immunocompromised humans. Recently, we have demonstrated that JC virus can infect cerebellar granule cell neurons and cortical pyramidal neurons in immunosuppressed people. To examine whether SV40 neuronal infection occurs spontaneously in immunosuppressed macaques, we analyzed archival brain specimens from 20 simian immunodeficiency virus–infected rhesus with AIDS and 1 cynomolgus post-transplant selected with SV40 brain infection from archival records from 1991 to 2012. In addition to white matter SV40 distribution in classic demyelinating progressive multifocal leukoencephalopathy, some of the 21 monkeys exhibited meningeal, subpial neocortical, and periventricular virus. This distribution pattern corresponded to broader viral tropism with neuronal infection in 14 (66.7%) of 21 cases. In all 14 cases, identified neurons were positive for early SV40 transcript large T antigen, but only 4 of the 14 cases exhibited late viral transcript viral protein 1–positive neurons. SV40-infected neurons were detected in frontal, parietal, occipital, and temporal cortices, hippocampus, thalamus, and brain stem. These observations confirm that spontaneous SV40 neuronal infection occurs in immunosuppressed macaques, which parallels JC virus–neuronal infection in immunosuppressed patients. Neuronal infection may be an important aspect of both SV40 and JC virus neuropathogenesis in their respective hosts

Classical information deficit and monotonicity on local operations

We investigate classical information deficit: a candidate for measure of classical correlations emerging from thermodynamical approach initiated in [Phys. Rev. Lett 89, 180402]. It is defined as a difference between amount of information that can be concentrated by use of LOCC and the information contained in subsystems. We show nonintuitive fact, that one way version of this quantity can increase under local operation, hence it does not possess property required for a good measure of classical correlations. Recently it was shown by Igor Devetak, that regularised version of this quantity is monotonic under LO. In this context, our result implies that regularization plays a role of "monotoniser".Comment: 6 pages, revte

Parenting ‘gifted and talented’ children in urban areas: Parents' voices

This is the author's accepted manuscript. The final published article is available from the link below. Copyright © 2014 by SAGE Publications.International evidence demonstrates the importance of engaging parents in the education of their ‘high-potential’ children, yet limited research has focused on the involvement of parents from differing economic strata/backgrounds. The current study explored the dilemmas of parenting academically high-ability children from economically deprived urban areas in the UK. Data were gathered from a sample of parents whose children attended a university-based sustained intervention programme for designated ‘gifted’ pupils aged 12–16. Parental perceptions were sought in relation to (a) the usefulness/impact of the intervention programme, (b) parents’ aspirations for their children growing up in economically deprived urban areas and (c) parents’ views on the support provided by the extended family, peer groups and the wider community. The findings have significant implications for both policy and practice and, more specifically, for engaging parents in intervention programmes offered by universities and schools to children in order to increase their access to higher education and for enhancing their life chances

Registrar wellness in Botswana: Measuring burnout and identifying ways to improve wellness

Background. Burnout during registrar training is high, especially in resource-limited settings where stressors are intensified. Burnout leads to decreased quality of life for doctors, poor job and patient satisfaction, and difficulty retaining doctors.Objectives. Primary: to measure burnout among registrars working at Princess Marina Hospital in Gaborone, Botswana. Secondary: to determine factors contributing to burnout and identify potential wellness interventions.Methods. The validated Maslach Burnout Inventory was used to measure the degree of emotional exhaustion, depersonalisation and personal accomplishment. Work-related difficulties and potential wellness interventions were explored through multiple-choice and open-ended questions.Results. Of 40 eligible registrars, 20 (50%) completed the survey. High levels of burnout were reported for emotional exhaustion in 65% (13/20), depersonalisation in 45% (9/20), and personal accomplishment in 35% (7/20) of registrars. A high degree of burnout was reported by 75% (15/20) of registrars in one or more domains. In the previous 7 days, registrars worked an average of 77 hours, took 1.5 overnight calls, slept 5.7 hours per night, and 53% (10/19) had ≥1 of their patients die. Five (25%) registrars considered leaving Botswana to work in another country, which correlated with those with the highest degree of burnout. The most common frustrations included insufficient salary and limited medical resources. Suggested interventions included improved mentorship and wellness lectures.Conclusions. There is a high degree of burnout, especially emotional exhaustion, among registrars. Encouragingly, most registrars have a desire to work in Botswana after training. Future research on improving registrar wellness in low-resource settings is urgently needed