1,072 research outputs found
The rad18 Gene of Schizosaccharomyces pombe Defines a New Subgroup of the SMC Superfamily Involved in DNA Repair
The rad18 mutant of Schizosaccharomyces pombe is very sensitive to killing by both UV and ¿ radiation. We have cloned and sequenced the rad18 gene and isolated and sequenced its homolog from Saccharomyces cerevisiae, designated RHC18. The predicted Rad18 protein has all the structural properties characteristic of the SMC family of proteins, suggesting a motor function- the first implicated in DNA repair. Gene deletion shows that both rad18 and RHC18 are essential for proliferation. Genetic and biochemical analyses suggest that the product of the rad18 gene acts in a DNA repair pathway for removal of UV-induced DNA damage that is distinct from classical nucleotide excision repair. This second repair pathway involves the products of the rhp51 gene (the homolog of the RAD51 gene of S. cerevisiae) and the rad2 gene
Patients' knowledge, attitudes, behaviour and health care experiences on the prevention, detection, management and control of hypertension in Colombia: a qualitative study.
Hypertension is a leading cause of premature death worldwide and the most important modifiable risk factor for cardiovascular disease. Effective screening programs, communication with patients, regular monitoring, and adherence to treatment are essential to successful management but may be challenging in health systems facing resource constraints. This qualitative study explored patients' knowledge, attitudes, behaviour and health care seeking experiences in relation to detection, treatment and control of hypertension in Colombia. We conducted in-depth interviews and focus group discussions with 26 individuals with hypertension and 4 family members in two regions. Few participants were aware of ways to prevent high blood pressure. Once diagnosed, most reported taking medication but had little information about their condition and had a poor understanding of their treatment regime. The desire for good communication and a trusting relationship with the doctor emerged as key themes in promoting adherence to medication and regular attendance at medical appointments. Barriers to accessing treatment included co-payments for medication; costs of transport to health care facilities; unavailability of drugs; and poor access to specialist care. Some patients overcame these barriers with support from social networks, family members and neighbours. However, those who lacked such support, experienced loneliness and struggled to access health care services. The health insurance scheme was frequently described as administratively confusing and those accessing the state subsidized system believed that the treatment was inferior to that provided under the compulsory contributory system. Measures that should be addressed to improve hypertension management in Colombia include better communication between health care professionals and patients, measures to improve understanding of the importance of adherence to treatment, reduction of co-payments and transport costs, and easier access to care, especially in rural areas
The 74MHz System on the Very Large Array
The Naval Research Laboratory and the National Radio Astronomy Observatory
completed implementation of a low frequency capability on the VLA at 73.8 MHz
in 1998. This frequency band offers unprecedented sensitivity (~25 mJy/beam)
and resolution (~25 arcsec) for low-frequency observations. We review the
hardware, the calibration and imaging strategies, comparing them to those at
higher frequencies, including aspects of interference excision and wide-field
imaging. Ionospheric phase fluctuations pose the major difficulty in
calibrating the array. Over restricted fields of view or at times of extremely
quiescent ionospheric ``weather'', an angle-invariant calibration strategy can
be used. In this approach a single phase correction is devised for each
antenna, typically via self-calibration. Over larger fields of view or at times
of more normal ionospheric ``weather'' when the ionospheric isoplanatic patch
size is smaller than the field of view, we adopt a field-based strategy in
which the phase correction depends upon location within the field of view. This
second calibration strategy was implemented by modeling the ionosphere above
the array using Zernike polynomials. Images of 3C sources of moderate strength
are provided as examples of routine, angle-invariant calibration and imaging.
Flux density measurements indicate that the 74 MHz flux scale at the VLA is
stable to a few percent, and tied to the Baars et al. value of Cygnus A at the
5 percent level. We also present an example of a wide-field image, devoid of
bright objects and containing hundreds of weaker sources, constructed from the
field-based calibration. We close with a summary of lessons the 74 MHz system
offers as a model for new and developing low-frequency telescopes. (Abridged)Comment: 73 pages, 46 jpeg figures, to appear in ApJ
Understanding the modifiable health systems barriers to hypertension management in Malaysia: a multi-method health systems appraisal approach.
BACKGROUND: The growing burden of non-communicable diseases in middle-income countries demands models of care that are appropriate to local contexts and acceptable to patients in order to be effective. We describe a multi-method health system appraisal to inform the design of an intervention that will be used in a cluster randomized controlled trial to improve hypertension control in Malaysia. METHODS: A health systems appraisal was undertaken in the capital, Kuala Lumpur, and poorer-resourced rural sites in Peninsular Malaysia and Sabah. Building on two systematic reviews of barriers to hypertension control, a conceptual framework was developed that guided analysis of survey data, documentary review and semi-structured interviews with key informants, health professionals and patients. The analysis followed the patients as they move through the health system, exploring the main modifiable system-level barriers to effective hypertension management, and seeking to explain obstacles to improved access and health outcomes. RESULTS: The study highlighted the need for the proposed intervention to take account of how Malaysian patients seek treatment in both the public and private sectors, and from western and various traditional practitioners, with many patients choosing to seek care across different services. Patients typically choose private care if they can afford to, while others attend heavily subsidised public clinics. Public hypertension clinics are often overwhelmed by numbers of patients attending, so health workers have little time to engage effectively with patients. Treatment adherence is poor, with a widespread belief, stemming from concepts of traditional medicine, that hypertension is a transient disturbance rather than a permanent asymptomatic condition. Drug supplies can be erratic in rural areas. Hypertension awareness and education material are limited, and what exist are poorly developed and ineffective. CONCLUSION: Despite having a relatively well funded health system offering good access to care, Malaysia's health system still has significant barriers to effective hypertension management. DISCUSSION: The study uncovered major patient-related barriers to the detection and control of hypertension which will have an impact on the design and implementation of any hypertension intervention. Appropriate models of care must take account of the patient modifiable health systems barriers if they are to have any realistic chance of success; these findings are relevant to many countries seeking to effectively control hypertension despite resource constraints
Analysing age structure, residency and relatedness uncovers social network structure in aggregations of young birds
Animal sociality arises from the cumulative effects of both individual social decisions and environmental factors. While juveniles' social interactions with parents prior to independence shape later life sociality, in most bird and mammal species at least one sex undergoes an early life dispersal before first-year reproduction. The social associations from this period could also have implications for later life yet are rarely characterized. Here, we derived predictions from available examples of juvenile groups in the literature (mobile ‘flocks’, spatially stable ‘gangs’ or adult-associated ‘crèches’) and then used three cohorts of juvenile hihi, Notiomystis cincta, a threatened New Zealand passerine, to demonstrate how multistate modelling and social network analysis approaches can be used to characterize group type based on residency, movement, relatedness and social associations. At sites where hihi congregated, we found that juveniles were resighted at a higher frequency than adults and associated predominantly with unrelated juveniles rather than siblings or parents. Movement between group sites occurred, but associations developed predominantly within the sites. We suggest therefore that juvenile hihi social structure is most similar to a ‘gang’, a group structure in which juveniles congregate without adults at predictable sites. Such gangs have previously only been described formally in ravens, Corvus corax. By combining spatial and social network analyses, our study demonstrates how social group structures can be described and therefore facilitate broader comparisons and discussion about the form and function of juvenile groups across taxa
Low doses of ionising radiation:definitions and contexts
The term ‘low dose’ is applied to different levels of dose depending on the circumstances of exposure, with the potential for confusion unless the reasoning is clear. The United Nations Scientific Committee on the Effects of Ionising Radiation has defined low absorbed doses of ionising radiation as below about 100 mGy, and low dose rates as below 0.1 mGy min−1 (6 mGy h−1). These values relate to the interpretation of scientific evidence from epidemiological and biological studies. The International Commission on Radiological Protection has used similar values of 100 mSv and 5 mSv h−1 and applied this categorisation directly to the specific situation of patients undergoing diagnostic procedures: doses below 100 mSv were referred to as ‘low’ and doses below 10 mSv as ‘very low’. Consideration of other exposure situations suggest that the same terms can be used for exposures received by emergency workers. However, for workers and members of the public in planned exposure situations, it is suggested that the term ‘low dose’ applies to doses below 10 mSv and 1 mSv, respectively—that is, below the dose limits. In each case, dose is being used as a surrogate for risk—risks at low doses are uncertain and estimates may change, but order of magnitude considerations are sufficient in most cases. Doses of < 100 mSv, < 10 mSv and < 1 mSv correspond to life-time cancer risk estimates of the order of < 10−2, < 10−3 and < 10−4, respectively.</p
International longitudinal registry of patients with atrial fibrillation and treated with rivaroxaban: RIVaroxaban Evaluation in Real life setting (RIVER)
Background
Real-world data on non-vitamin K oral anticoagulants (NOACs) are essential in determining whether evidence from randomised controlled clinical trials translate into meaningful clinical benefits for patients in everyday practice. RIVER (RIVaroxaban Evaluation in Real life setting) is an ongoing international, prospective registry of patients with newly diagnosed non-valvular atrial fibrillation (NVAF) and at least one investigator-determined risk factor for stroke who received rivaroxaban as an initial treatment for the prevention of thromboembolic stroke. The aim of this paper is to describe the design of the RIVER registry and baseline characteristics of patients with newly diagnosed NVAF who received rivaroxaban as an initial treatment.
Methods and results
Between January 2014 and June 2017, RIVER investigators recruited 5072 patients at 309 centres in 17 countries. The aim was to enroll consecutive patients at sites where rivaroxaban was already routinely prescribed for stroke prevention. Each patient is being followed up prospectively for a minimum of 2-years. The registry will capture data on the rate and nature of all thromboembolic events (stroke / systemic embolism), bleeding complications, all-cause mortality and other major cardiovascular events as they occur. Data quality is assured through a combination of remote electronic monitoring and onsite monitoring (including source data verification in 10% of cases). Patients were mostly enrolled by cardiologists (n = 3776, 74.6%), by internal medicine specialists 14.2% (n = 718) and by primary care/general practice physicians 8.2% (n = 417). The mean (SD) age of the population was 69.5 (11.0) years, 44.3% were women. Mean (SD) CHADS2 score was 1.9 (1.2) and CHA2DS2-VASc scores was 3.2 (1.6). Almost all patients (98.5%) were prescribed with once daily dose of rivaroxaban, most commonly 20 mg (76.5%) and 15 mg (20.0%) as their initial treatment; 17.9% of patients received concomitant antiplatelet therapy. Most patients enrolled in RIVER met the recommended threshold for AC therapy (86.6% for 2012 ESC Guidelines, and 79.8% of patients according to 2016 ESC Guidelines).
Conclusions
The RIVER prospective registry will expand our knowledge of how rivaroxaban is prescribed in everyday practice and whether evidence from clinical trials can be translated to the broader cross-section of patients in the real world
Onset of the aerobic nitrogen cycle during the Great Oxidation Event
The rise of oxygen on the early Earth (about 2.4 billion years ago)1 caused a reorganization of marine nutrient cycles2, 3, including that of nitrogen, which is important for controlling global primary productivity. However, current geochemical records4 lack the temporal resolution to address the nature and timing of the biogeochemical response to oxygenation directly. Here we couple records of ocean redox chemistry with nitrogen isotope (15N/14N) values from approximately 2.31-billion-year-old shales5 of the Rooihoogte and Timeball Hill formations in South Africa, deposited during the early stages of the first rise in atmospheric oxygen on the Earth (the Great Oxidation Event)6. Our data fill a gap of about 400 million years in the temporal 15N/14N record4 and provide evidence for the emergence of a pervasive aerobic marine nitrogen cycle. The interpretation of our nitrogen isotope data in the context of iron speciation and carbon isotope data suggests biogeochemical cycling across a dynamic redox boundary, with primary productivity fuelled by chemoautotrophic production and a nitrogen cycle dominated by nitrogen loss processes using newly available marine oxidants. This chemostratigraphic trend constrains the onset of widespread nitrate availability associated with ocean oxygenation. The rise of marine nitrate could have allowed for the rapid diversification and proliferation of nitrate-using cyanobacteria and, potentially, eukaryotic phytoplankton
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