The Clinicians’ Skills, Capability, and Organisational Research Readiness (SCORR) Tool

A research-active healthcare workforce contributes to improved quality of care. Clinicians may be unaware that they are applying early research skills during their everyday practice. Greater understanding of their level of research attainment may improve their awareness and confidence in their research skills. This article describes the development of the Clinicians Skills, Capability, and Organisational Research Readiness (SCORR) Tool, a simple innovation that assesses and captures research skills and attainment at 1) clinician, and 2) organisational level. The SCORR Tool was initially developed to assess levels of research attainment and to promote discussion during annual appraisals for podiatrists working across secondary and community care in a northern region of England. The levels (1 to 5) of attainment recognise UK Health and Care Professions Council (HCPC) registration requirements for chiropodists/podiatrists (Standards 12 to 14). Following testing and feedback, research levels were adapted (Levels 0 to 5) to accommodate all healthcare professionals (with the exception of doctors and dentists). The SCORR Tool may be used individually by clinicians, or in collaboration with their manager, to better understand the level of research attainment and to prompt discussion to increase research activity. It may also be used across a workforce (e.g. during an appraisal) to understand the organisational research readiness. The SCORR Tool requires additional testing and evaluation to validate it as a tool for use across a variety of organisational environments

Double polarization experiments at intermediate energy

At modern electron accelerators with highly polarized, intense, high duty factor beams double polarization coincidence experiments became feasible with good statistical accuracy. The strong potential towards the precise determination of small nucleon structure quantities is illustrated by two recent examples from MAMI. The measurement of $G_E^n$ in the quasifree reaction $D(\vec e, e'\vec n)p$ lead to a new parametrization of $G_E^n$ which is significantly above the previously preferred one from elastic $e-D$ scattering. A $p(\vec e, e'\vec p)\pi^0$ experiment at the energy of the $\Delta$ resonance yields preliminary results for the longitudinal quadrupole mixing. Both experimental errors and model uncertainties are complementary to unpolarized measurements.Comment: 8 pages, 6 figures, plenary talk given at PANIC'9

Design of a Digital Triaxial Force Sensor for Plantar Load Measurements

Measurement of load information on the plantar (lower) surface of the foot can provide valuable insights to help identify pathologies like diabetic foot ulcers. Studies have shown that both plantar pressure and shear stress play an important role in foot disorders, especially ulcer formation. However, in this context shear stress is much less studied in comparison with pressure distribution, mainly due to the lack of reliable measurement technologies. In this paper, we propose a triaxial force sensor for measuring plantar loading. The sensor consists of an array of sensing coils combined with an elastomeric spacer and a conductive target. Under loading, the sensor demonstrates differential variations in inductance which are digitized by built-in conditioning circuitry and decoupled. A 3D finite element (FE) model was developed for the system as a design tool. This was validated experimentally and demonstrated a high agreement to the results. In experimental evaluation with multiaxial loading the sensor showed precise operation over the operating range (RMSE: 0.05 N for shear (-1.5 N - 1.5 N) and 0.70 N for normal force (0-13 N) measurements). The FE model was then used to investigate the effect of undesirable tilting of the target. The results indicated that it is important to minimize the tilting of the target for robust operation in real-world scenarios

Evaluating the use of a novel low-cost measurement insole to characterise plantar foot strain during gait loading regimes

Introduction: Under plantar loading regimes, it is accepted that both pressure and shear strain biomechanically contribute to formation and deterioration of diabetic foot ulceration (DFU). Plantar foot strain characteristics in the at-risk diabetic foot are little researched due to lack of measurement devices. Plantar pressure comparatively, is widely quantified and used in the characterisation of diabetic foot ulceration risk, with a range of clinically implemented pressure measurement devices on the market. With the development of novel strain quantification methods in its infancy, feasibility testing and validation of these measurement devices for use is required. Initial studies centre on normal walking speed, reflecting common activities of daily living, but evaluating response to differing gait loading regimes is needed to support the use of such technologies for potential clinical translation. This study evaluates the effects of speed and inclination on stance time, strain location and strain response using a low-cost novel strain measurement insole. Methods: The STrain Analysis and Mapping of the Plantar Aspect (STAMPS) insole has been developed, and feasibility tested under self-selected normal walking speeds to characterise plantar foot strain, with testing beyond this limited regime required. A treadmill was implemented to standardise speed and inclination for a range of daily plantar loading conditions. A small cohort, comprising of five non-diabetic participants, were examined at slow (0.75 m/s), normal (1.25 m/s) and brisk (2 m/s) walking speeds and normal speed at inclination (10% gradient). Results: Plantar strain active regions were seen to increase with increasing speed across all participants. With inclination, it was seen that strain active regions reduce in the hindfoot and show a tendency to forefoot with discretionary changes to strain seen. Stance time decreases with increasing speed, as expected, with reduced stance time with inclination. Discussion: Comparison of the strain response and stance time should be considered when evaluating foot biomechanics in diabetic populations to assess strain time interval effects. This study supports the evaluation of the STAMPS insole to successfully track strain changes under differing plantar loading conditions and warrants further investigation of healthy and diabetic cohorts to assess the implications for use as a risk assessment tool for DFU

Near real-time input to a propagation model for nowcasting of HF communications with aircraft on polar routes

There is a need for improved techniques for nowcasting and forecasting (over several hours) HF propagation at northerly latitudes to support airlines operating over the increasingly popular trans-polar routes. In this paper the assimilation of real-time measurements into a propagation model developed by the authors is described, including ionosonde measurements and Total Electron Content (TEC) measurements to define the main parameters of the ionosphere. The effects of D-region absorption in the polar cap and auroral regions are integrated with the model through satellite measurements of the flux of energetic solar protons (>1 MeV) and the X-ray flux in the 0.1-0.8 nm band, and ground-based magnetometer measurements which form the Kp and Dst indices of geomagnetic activity. The model incorporates various features (e.g. convecting patches of enhanced plasma density) of the polar ionosphere that are, in particular, responsible for off-great circle propagation and lead to propagation at times and frequencies not expected from on-great circle propagation alone. The model development is supported by the collection of HF propagation measurements over several paths within the polar cap, crossing the auroral oval, and along the mid-latitude trough

Twelve-month prevalence of haemarthrosis and joint disease using the Haemophilia Joint Health score: evaluation of the UK National Haemophilia Database and Haemtrack patient reported data: an observational study

Objectives: To report the 12-month prevalence of joint bleeds from the National Haemophilia Database (NHD) and Haemtrack, a patient-reported online treatment diary and concurrent joint disease status using the haemophilia joint health score (HJHS) at individual joint level, in children and adults with severe haemophilia A and B (HA/HB) without a current inhibitor. Design: A 2018 retrospective database study of NHD from which 2238 cases were identified, 463 patients had fully itemised HJHS of whom 273 were compliant in recording treatment using Haemtrack. Setting: England, Wales and Scotland, UK. Participants: Children (<18 years) and adults (≥18 years) with severe HA and HB (factor VIII/factor IX, <0.01 iu/mL) without a current inhibitor. Primary and secondary outcomes: Prevalence of joint haemarthrosis and concurrent joint health measured using the HJHS. Results: The median (IQR) age of children was 10 (6-13) and adults 40 (29-50) years. Haemarthrosis prevalence in HA/HB children was 33% and 47%, respectively, and 60% and 42%, respectively, in adults. The most common site of haemarthrosis in children was the knee in HA and ankle in HB. In adults, the incidence of haemarthrosis at the ankles and elbows was equal. The median total HJHS in HA/HB children was 0 and in adults with HA/HB, were 18 and 11, respectively. In adults with HA/HB, the median ankle HJHS of 4.0 was higher than the median HJHS of 1.0 for both the knee and elbow. Conclusion: Despite therapeutic advances, only two-thirds of children and one-third of adults were bleed-free, even in a UK cohort selected for high compliance with prophylaxis. The median HJHS of zero in children suggests joint health is relatively unaffected during childhood. In adults, bleed rates were highest in ankles and elbows, but the ankles led to substantially worse joint health scores

The human insulin receptor mRNA contains a functional internal ribosome entry segment.

Regulation of mRNA translation is an important mechanism determining the level of expression of proteins in eukaryotic cells. Translation is most commonly initiated by cap-dependent scanning, but many eukaryotic mRNAs contain internal ribosome entry segments (IRESs), providing an alternative means of initiation capable of independent regulation. Here, we show by using dicistronic luciferase reporter vectors that the 5'-UTR of the mRNA encoding human insulin receptor (hIR) contains a functional IRES. RNAi-mediated knockdown showed that the protein PTB was required for maximum IRES activity. Electrophoretic mobility shift assays confirmed that PTB1, PTB2 and nPTB, but not unr or PTB4, bound to hIR mRNA, and deletion mapping implicated a CCU motif 448 nt upstream of the initiator AUG in PTB binding. The IR-IRES was functional in a number of cell lines, and most active in cells of neuronal origin, as assessed by luciferase reporter assays. The IRES was more active in confluent than sub-confluent cells, but activity did not change during differentiation of 3T3-L1 fibroblasts to adipocytes. IRES activity was stimulated by insulin in sub-confluent cells. The IRES may function to maintain expression of IR protein in tissues such as the brain where mRNA translation by cap-dependent scanning is less effective

Developments in HF Propagation Predictions to Support Communications with Aircraft on Trans-polar Routes

Commercial airlines began operations over polar routes in 1999 with a small number of proving flights. By 2014 the number had increased to in excess of 12,000 flights per year, and further increases are expected. For safe operations, the aircraft have to be able to communicate with air traffic control centres at all times. This is achieved by VHF links whilst within range of the widespread network of ground stations, and by HF radio in remote areas such as the Polar regions, the North Atlantic and Pacific where VHF ground infrastructure does not exist. Furthermore, the Russian side of the pole only has HF capability. This has created a demand for improved HF nowcasting and forecasting procedures to support the polar operations, which are the subject of this paper

Gomesin peptides prevent proliferation and lead to the cell death of devil facial tumour disease cells.

The Tasmanian devil faces extinction due to devil facial tumour disease (DFTD), a highly transmittable clonal form of cancer without available treatment. In this study, we report the cell-autonomous antiproliferative and cytotoxic activities exhibited by the spider peptide gomesin (AgGom) and gomesin-like homologue (HiGom) in DFTD cells. Mechanistically, both peptides caused a significant reduction at G0/G1 phase, in correlation with an augmented expression of the cell cycle inhibitory proteins p53, p27, p21, necrosis, exacerbated generation of reactive oxygen species and diminished mitochondrial membrane potential, all hallmarks of cellular stress. The screening of a novel panel of AgGom-analogues revealed that, unlike changes in the hydrophobicity and electrostatic surface, the cytotoxic potential of the gomesin analogues in DFTD cells lies on specific arginine substitutions in the eight and nine positions and alanine replacement in three, five and 12 positions. In conclusion, the evidence supports gomesin as a potential antiproliferative compound against DFTD disease