Four layer bandage compared with short stretch bandage for venous leg ulcers: systematic review and meta-analysis of randomised controlled trials with data from individual patients

<p><b>Objective:</b> To compare the effectiveness of two types of compression treatment (four layer bandage and short stretch bandage) in people with venous leg ulceration.</p> <p><b>Design:</b> Systematic review and meta-analysis of patient level data.</p> <p><b>Data:</b> sources Electronic databases (the Cochrane Central Register of Controlled Trials, the Cochrane Wounds Group Specialised Register, Medline, Embase, CINAHL, and National Research Register) and reference lists of retrieved articles searched to identify relevant trials and primary investigators. Primary investigators of eligible trials were invited to contribute raw data for re-analysis.</p> <p><b>Review:</b> methods Randomised controlled trials of four layer bandage compared with short stretch bandage in people with venous leg ulceration were eligible for inclusion. The primary outcome for the meta-analysis was time to healing. Cox proportional hazards models were run to compare the methods in terms of time to healing with adjustment for independent predictors of healing. Secondary outcomes included incidence and number of adverse events per patient.</p> <p><b>Results:</b> Seven eligible trials were identified (887 patients), and patient level data were retrieved for five (797 patients, 90% of known randomised patients). The four layer bandage was associated with significantly shorter time to healing: hazard ratio (95% confidence interval) from multifactorial model based on five trials was 1.31 (1.09 to 1.58), P=0.005. Larger ulcer area at baseline, more chronic ulceration, and previous ulceration were all independent predictors of delayed healing. Data from two trials showed no evidence of a difference in adverse event profiles between the two bandage types.</p> <p><b>Conclusions:</b> Venous leg ulcers in patients treated with four layer bandages heal faster, on average, than those of people treated with the short stretch bandage. Benefits were consistent across patients with differing prognostic profiles.</p&gt

Investigation of the collapse of the skewness and kurtosis exhibited in atmospheric dispersion data

This paper studies the collapse of the estimators for skewness and kurtosis of concentration onto a near universal curve. This phenomenon is observed for data taken from atmospheric dispersion experiments under a variety of different conditions. By means of careful investigation of the high concentration tails, modelled by means of the generalized Pareto distribution, and the fundamental physics of the problem, a set of envelope curves encompassing the data will be established. The implications of these results for modelling the probability density function of concentration are discussed

Comments on the properties and uses of atmospheric dispersion datasets

Great recent improvements in the quality and quantity of atmospheric dispersion datasets have highlighted the crucial importance of concentration fluctuations. However, this has inevitably been accompanied by the realisation that estimating the properties of concentration fluctuations accurately involves new, difficult, but interesting, research problems. Some of these problems are discussed and illustrated. The paper concludes with some recommendations about how research funding agencies (such as governments, regulatory authorities and industry) should change their present strategy in response to new knowledge

Is attending a mental process?

The nature of attention has been the topic of a lively research programme in psychology for over a century. But there is widespread agreement that none of the theories on offer manage to fully capture the nature of attention. Recently, philosophers have become interested in the debate again after a prolonged period of neglect. This paper contributes to the project of explaining the nature of attention. It starts off by critically examining Christopher Mole’s prominent “adverbial” account of attention, which traces the failure of extant psychological theories to their assumption that attending is a kind of process. It then defends an alternative, process-based view of the metaphysics of attention, on which attention is understood as an activity and not, as psychologists seem to implicitly assume, an accomplishment. The entrenched distinction between accomplishments and activities is shown to shed new light on the metaphysics of attention. It also provides a novel diagnosis of the empirical state of play

The nutritional care of people living with dementia at home: A scoping review.

There are an increasing number of people with dementia living in their own home for longer, often supported by a family member. The symptoms of dementia can affect an individual's nutritional status, which can lead to a reduced quality of life for the person with dementia and their family members. A scoping review was conducted from July 2016 until September 2016, using a recognised framework, to explore what is currently known, and identify any gaps in the research regarding the nutritional care of people living with dementia at home. This included any interventions that may have been trialled or implemented, and the views of those living with dementia, carers and clinicians. Six electronic databases were searched from inception to July 2016. A review team was involved in screening and data extraction for selected articles. Published qualitative and quantitative studies were included that explored the nutritional care of people living with dementia at home. Methods included data extraction and conventional content analysis. Stakeholders were involved in the development of final categories. Following screening, 61 studies reported in 63 articles were included. Most studies were cross-sectional (n = 24), cohort (n = 15) or qualitative (n = 9). Only three were randomised controlled trials. Three overarching categories represented the results: Timely identification of nutritional risk and subsequent regular monitoring of nutritional status, multi-component tailored interventions and the influence of the care-giving dyad on nutritional status. Many studies identify people living at home with dementia as a vulnerable group prone to malnutrition; however, a lack of interventions exists to address the increased risk. There is a lack of research exploring the role of home care providers and healthcare professionals in the provision of nutritional care. Further research is required to explore how the emotional aspect of the care-giving dyad influences nutritional care

Two Ising-like magnetic excitations in a single-layer cuprate superconductor

There exists increasing evidence that the phase diagram of the high-transition temperature (Tc) cuprate superconductors is controlled by a quantum critical point. One distinct theoretical proposal is that, with decreasing hole-carrier concentration, a transition occurs to an ordered state with two circulating orbital currents per CuO2 square. Below the 'pseudogap' temperature T* (T* > Tc), the theory predicts a discrete order parameter and two weakly-dispersive magnetic excitations in structurally simple compounds that should be measurable by neutron scattering. Indeed, novel magnetic order and one such excitation were recently observed. Here, we demonstrate for tetragonal HgBa2CuO4+d the existence of a second excitation with local character, consistent with the theory. The excitations mix with conventional antiferromagnetic fluctuations, which points toward a unifying picture of magnetism in the cuprates that will likely require a multi-band description.Comment: Including supplementary informatio

Integrin beta 1 coordinates survival and morphogenesis of the embryonic lineage upon implantation and pluripotency transition

At implantation, the embryo establishes contacts with the maternal endometrium. This stage is associated with a high incidence of preclinical pregnancy losses. While the maternal factors underlying uterine receptivity have been investigated, the signals required by the embryo for successful peri-implantation development remain elusive. To explore these, we studied integrin beta 1 signaling, as embryos deficient for this receptor degenerate at implantation. We demonstrate that the coordinated action of pro-survival signals and localized actomyosin suppression via integrin beta 1 permits the development of the embryo beyond implantation. Failure of either process leads to developmental arrest and apoptosis. Pharmacological stimulation through fibroblast growth factor 2 (FGF2) and insulin-like growth factor 1 (IGF1), coupled with ROCK-mediated actomyosin inhibition, rescues the deficiency of integrin beta 1, promoting progression to post-implantation stages. Mutual exclusion between integrin beta 1 and actomyosin seems to be conserved in the human embryo, suggesting the possibility that these mechanisms could also underlie the transition of the human epiblast from pre- to post-implantation

Drivers use active gaze to monitor waypoints during automated driving

Peer reviewe