The impact of approaches in improving male partner involvement in the prevention of mother-to-child transmission of HIV on the uptake of maternal antiretroviral therapy among HIV-seropositive pregnant women in sub-Saharan Africa: a systematic review and meta-analysis.

Objectives: To identify the approaches that are used in improving on male partner involvement in the prevention of mother-to-child transmission (PMTCT) of HIV and their impact on the uptake maternal antiretroviral therapy (ART) in sub-Saharan Africa (SSA). Setting: This was a systematic review and meta-analysis of published studies carried out in SSA at all levels of healthcare (primary, secondary, tertiary and community). Participants: The participants of the studies included were HIV-positive pregnant women and breastfeeding mothers with their male partners. Studies were included if they were conducted in SSA and mentioned an approach used in improving male partner involvement with data on the impact on the uptake of maternal ART uptake. Outcomes: In the protocol, maternal ART uptake, infant prophylaxis, safe infant feeding options, condom use and family planning were envisaged. However, only maternal ART has been reported here due to limitations on the word count. Results: From an initial 2316 non-duplicate articles, 17 articles were included in the systematic review and meta-analysis. In the combined model, the ORs for complex community interventions, enhanced psychosocial interventions, verbal encouragement and invitation letters were 4.22 (95% CI 2.27 to 7.77), 2.29 (95% CI 1.42 to 7.69), 2.39 (95% CI 1.26 to 4.53) and 1.21 (95% CI 0.89 to 1.63), respectively, whereas in the model using adjusted ORs, enhanced psychosocial interventions had a higher effect than any other intervention. The heterogeneity was moderate using adjusted ORs. Conclusion: Enhanced psychosocial interventions and complex community interventions increase male partner involvement and the uptake of PMTCT services more than any other intervention. Invitation letters had no effect. More randomised trials and observational studies (that have adjusted for potential confounders) are needed in the future. PROSPERO registration number: 42016032673

Comparing distance education and conventional education: Observations from a comparative study of post‐registration nurses

This retrospective study presents a comparison of assessment results achieved by distance‐learning students and classroom‐based students undertaking the same module in a degree course. The purpose of the comparison is to provide some objective measurement of the quality of distance education in relation to conventional classroom‐based education. The authors have selected three groups of students, who have all undertaken the same module in the B. Sc Health Studies degree programme offered by the University of Paisley. One group (in Paisley) undertook their studies by means of conventional classroom‐based education, the second (in Hong Kong) by supported distance learning with face‐to‐face contact in the form of tutorials, and the third (in a geographically dispersed group in the United Kingdom and other countries) by supported distance learning with no face‐to‐face contact. The results obtained by these three groups of students were analysed. Because of the differences in the size of the groups, the Kruskal‐ Wallis 1‐ Way Anova test was applied to validate the face value findings. The authors include findings from the literature comparing distance education with conventional education and from cross‐cultural studies to present their data in context. Analysis of the assessment results showed that students from all three groups were successful in their studies, but the students studying by distance learning obtained significantly higher end‐of‐module results than their classroom‐based colleagues. This latter finding reflects the conclusion that other investigators have reached In their discussion the authors identify educational, cultural and personal factors that may help to explain their findings. A limitation in the study is that it concerns only one module in the degree programme. The research now moves on to comparing students who have undertaken the whole degree programme by the means describe

Impact of approaches in improving male partner involvement in the prevention of mother-to-child transmission (PMTCT) of HIV on the uptake of PMTCT services in sub-Saharan Africa: a protocol of a systematic review and meta-analysis

Introduction: Several studies have reported approaches used in improving the delivery of prevention of mother-to-child transmission (PMTCT) of HIV services through the involvement of male partners, but evidence from a systematic review is limited. We aim at determining the impact of male partner involvement on PMTCT in sub-Saharan Africa. Methods and analysis: This will be a systematic review of published literature. Interventional and observational studies on male involvement in PMTCT carried out in sub-Saharan Africa will be included irrespective of the year and language of publication. OVID Medline, Embase, PschINFO, and Cochrane database of controlled trials will be searched. After manual searching of articles, authors shall be contacted for further information. 2 authors (NFT and CJ) will independently screen potential articles for eligibility using defined inclusion and exclusion criteria. Critical Appraisal Skills Programme (CASP) tools, Jadad scale and the STROBE checklist will be used for critical appraisal, and the 2 authors will independently assess the quality of articles. Authors will independently extract data from studies using a pre-established data collection form, and any discrepancies will be sorted by a third author (TRK). Outcomes will be analysed using STATA V.12.0. The random effect model will be used to produce forest plots. The heterogeneity χ2 statistics and I2 will be used to assess for heterogeneity. Publication bias will be assessed using funnel plots. This protocol is reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols (PRISMA-P) 2015 guidelines. Ethics and dissemination: No ethical approval since included studies will be published studies that had already obtained ethical approvals. The findings will guide HIV programmes on the best approaches towards involving male partners in PMTCT with a view to improving PMTCT services in sub-Saharan Africa

A Systematic Review of the Health Impacts of Mass Earth Movements (Landslides)

Background. Mass ground movements (commonly referred to as ‘landslides’) are common natural hazards that can have significant economic, social and health impacts. They occur as single events, or as clusters, and are often part of ‘disaster’ chains, occurring secondary to, or acting as the precursor of other disaster events. Whilst there is a large body of literature on the engineering and geological aspects of landslides, the mortality and morbidity caused by landslides is less well documented. As far as we are aware, this is the first systematic review to examine the health impacts of landslides. Methods. The MEDLINE, EMBASE, CINAHL, SCOPUS databases and the Cochrane library were systematically searched to identify articles which considered the health impacts of landslides. Case studies, case series, primary research and systematic reviews were included. News reports, editorials and non-systematic reviews were excluded. Only articles in English were considered. The references of retrieved papers were searched to identify additional articles. Findings. 913 abstracts were reviewed and 143 full text articles selected for review. A total of 27 papers reporting research studies were included in the review (25 from initial search, 1 from review of references and 1 from personal correspondence). We found a limited number of studies on the physical health consequences of landslides. Only one study provided detail of the causes of mortality and morbidity in relation a landslide event. Landslides cause significant mental health impacts, in particular the prevalence of PTSD may be higher after landslides than other types of disaster, though these studies tend to be older with only 3 papers published in the last 5 years, with 2 being published 20 years ago, and diagnostic criteria have changed since they were produced. Discussion. We were disappointed at the small number of relevant studies, and the generally poor documentation of the health impacts of landslides. Mental health impacts were better documented, though some of the studies are now quite old. Further research on the health impacts of landslides needs to be undertaken to support those responding to landslide disasters and to aid disaster risk mitigation advocacy

Comparative evaluation of delamination in carbon fiber reinforced composites (CFRPs) utilizing various common non-destructive inspection techniques

Non-destructive Inspection (NDI) is routinely used to diagnose and monitor defects in composite parts, which could impact composite lifespan and performance. There are a variety of methods to conduct NDT in composites, the most popular being ultrasonic c-scan, shearography (thermal and vacuum excitation), and pulsed thermography testing. This study evaluates these NDT methods by testing on a set of CFRP laminates fabricated through a vacuum infusion process with artificially programmed defects. Firstly, these methods are evaluated based upon their detection capability- i.e., can each find the programmed defect in a standard inspection procedure. Secondly, how well do the scans predict the defect area? This is done utilizing a computed tomography scanning (CT-Scan) of the same laminates to create a benchmark to reference for the other three NDT methods. Finally, these methods are compared and contrasted. This study finds that ultrasonic c-scans and pulsed thermography share near-identical detection capabilities in the range of depths analyzed. Shearography, utilizing thermal excitation, could not detect any of the programmed delaminations, while partial vacuum shearography was only able to detect a limited selection of the largest sized defects. Under CT scans, the programmed defects were found to have inconsistencies, error correction was performed and relationships for ultrasonic scanning and thermography were able to be ascertained. Ultrasonic scans show consistent levels of error past near surface defects and thermography sees increased error in area detection as defect depth increases

The phosphorylation of ribosomal proteins in baby hamster kidney fibroblasts

This thesis describes studies directed towards understanding the function of the phosphorylation of a particular ribosomal protein - S6 - in eukaryotic cells. Two experimental approaches to determine the extent of phosphorylation of ribosomal protein S6 were adopted. One involved labelling the cells with radioactive orthophosphate and quantitatively estimating the extent of phosphorylation of the ribosomes by measuring the radioactivity incorporated into the protein and the specific radioactivity of the presumed precursor, ATP, The other involved qualitative estimation of the phosphorylation by analysing the ribosomal proteins in a system of gel electrophoresis in which the phosphorylated derivatives of the protein are resolved from the unphosphorylated protein. This latter method had the advantage that it could be applied when it was not possible to label certain subcellular fractions of ribosomes with (32P)-orthophosphate. It had previously been found that the phosphorylation of ribosomal protein S6 was greater in pre-confluent hamster fibroblasts than in confluent fibroblasts. Part of this thesis describes attempts to determine whether this was due to there being a greater proportion of highly phosphorylated newly-synthesised ribosomes in the pre-confluent cells, as might have been expected if the function of the phosphorylation was in the nucleus. The extent of phosphorylation of ribosomal protein S6 in nucleoli was first examined electrophoretically after labelling the cells with (35S)-methionine, isolating the nucleoli and extracting their protein. However this approach was unsuccessful because of insufficient incorporation of radioactivity into the nucleolar ribosomal proteins. When nucleoli were incubated in vitro with (32P)-ATP, histones became labelled with showing that protein kinase activity was present. However no radioactivity could be detected in ribosomal protein S6, so that the extent (if any) of its phosphorylation could not be determined in this way. The extent of phosphorylation of ribosomal protein S6 was also investigated in 'native' ribosomal subunits, as they include ribosomal subunits which have newly entered the cytoplasm from the nucleus. Proteins from 'native' ribosomal subunits were again analysed by two-dimensional gel electrophoresis. The results here were complicated by the presence of non-ribosomal proteins, but seemed to indicate that ribosomal protein S6 was in a low state of phosphorylation in 'native' 40S subunits. This conclusion was finally confirmed when the extent of phosphozylation of ribosomal protein S6 was compared in newly-synthesised and older cytoplasmic ribosomes. These two populations of ribosomes were identified by differentially labelling the cells with (35S)-methionine, either for 20 minutes before harvesting (newly-synthesised ribosomes), or with a 3 hour pulse of (35S)-methionine followed by a 'chase' with non-radioactive methionine for 2 days before harvesting (2-day old ribosomes). Electrophoretic analysis clearly showed that both newly-synthesised and 2-day old ribosomes had ribosomal protein S6 in a low state of phosphorylation. These results demonstrated that newly- synthesised ribosomes were no more phosphorylated than older ribosomes, in contrast to the original hypothesis. This therefore suggested that the proposal that the function of the phosphorylation was in the nucleus was incorrect. The remainder of the work described in this thesis was concerned with the phosphorylation of ribosomal proteins in cells infected with, or transfoimed by viruses. It had been reported that in cells infected with several different viruses the (35P)-labelling of ribosomal protein S6 increased, although no change in the position of electrophoretic migration of the protein was detected. The work described here clearly demonstrates that in cells infected with pseudorabies virus there is an increase of between 350% and 750% in the extent of phosphorylation of ribosomal protein S6, as estimated by both of the methods mentioned above. (Abstract shortened by ProQuest.)

Activation of MAPK signalling results in resistance to saracatinib (AZD0530) in ovarian cancer

SRC tyrosine kinase is frequently overexpressed and activated in late-stage, poor prognosis ovarian tumours, and preclinical studies have supported the use of targeted SRC inhibitors in the treatment of this disease. The SAPPROC trial investigated the addition of the SRC inhibitor saracatinib (AZD0530) to weekly paclitaxel for the treatment of platinum resistant ovarian cancer; however, this drug combination did not provide any benefit to progression free survival (PFS) of women with platinum resistant disease. In this study we aimed to identify mechanisms of resistance to SRC inhibitors in ovarian cancer cells. Using two complementary strategies; a targeted tumour suppressor gene siRNA screen, and a phospho-receptor tyrosine kinase array, we demonstrate that activation of MAPK signalling, via a reduction in NF1 (neurofibromin) expression or overexpression of HER2 and the insulin receptor, can drive resistance to AZD0530. Knockdown of NF1 in two ovarian cancer cell lines resulted in resistance to AZD0530, and was accompanied with activated MEK and ERK signalling. We also show that silencing of HER2 and the insulin receptor can partially resensitize AZD0530 resistant cells, which was associated with decreased phosphorylation of MEK and ERK. Furthermore, we demonstrate a synergistic effect of combining SRC and MEK inhibitors in both AZD0530 sensitive and resistant cells, and that MEK inhibition is sufficient to completely resensitize AZD0530 resistant cells. This work provides a preclinical rationale for the combination of SRC and MEK inhibitors in the treatment of ovarian cancer, and also highlights the need for biomarker driven patient selection for clinical trials

Images in cardiovascular medicine : multiphoton microscopy for three-dimensional imaging of lymphocyte recruitment into apolipoprotein-E-deficient mouse carotid artery

Two recent elegant studies have shown that in apolipoprotein-E– deficient mice, the lamina adventitia is a major site of arterial wall inflammation associated with lymphocyte infiltration into atherosclerotic arteries and with formation of adventitial lymphoid-like tissues.1,2 These results suggest that lymphocyte responses in the lamina adventitia may play a crucial role in atherosclerosis development.1,

Towards the 3D Web with Open Simulator

Continuing advances and reduced costs in computational power, graphics processors and network bandwidth have led to 3D immersive multi-user virtual worlds becoming increasingly accessible while offering an improved and engaging Quality of Experience. At the same time the functionality of the World Wide Web continues to expand alongside the computing infrastructure it runs on and pages can now routinely accommodate many forms of interactive multimedia components as standard features - streaming video for example. Inevitably there is an emerging expectation that the Web will expand further to incorporate immersive 3D environments. This is exciting because humans are well adapted to operating in 3D environments and it is challenging because existing software and skill sets are focused around competencies in 2D Web applications. Open Simulator (OpenSim) is a freely available open source tool-kit that empowers users to create and deploy their own 3D environments in the same way that anyone can create and deploy a Web site. Its characteristics can be seen as a set of references as to how the 3D Web could be instantiated. This paper describes experiments carried out with OpenSim to better understand network and system issues, and presents experience in using OpenSim to develop and deliver applications for education and cultural heritage. Evaluation is based upon observations of these applications in use and measurements of systems both in the lab and in the wild.Postprin

Energy and material flows of megacities

Understanding the drivers of energy and material flows of cities is important for addressing global environmental challenges. Accessing, sharing, and managing energy and material resources is particularly critical for megacities, which face enormous social stresses because of their sheer size and complexity. Here we quantify the energy and material flows through the world’s 27 megacities with populations greater than 10 million people as of 2010. Collectively the resource flows through megacities are largely consistent with scaling laws established in the emerging science of cities. Correlations are established for electricity consumption,heating and industrial fuel use, ground transportation energy use, water consumption, waste generation, and steel production in terms of heating-degree-days, urban form, economic activity, and population growth. The results help identify megacities exhibiting high and low levels of consumption and those making efficient use of resources. The correlation between per capita electricity use and urbanized area per capita is shown to bea consequence of gross building floor area per capita, which is found to increase for lower-density cities. Many of the megacities are growing rapidly in population but are growing even faster in terms of gross domestic product (GDP) and energy use. In the decade from 2001–2011, electricity use and ground transportation fuel use in megacities grew at approximately half the rate of GDP growthPostprint (published version