On the nucleotide distribution in bacterial DNA sequences

It is probable that the distributional structure of DNA sequences arises from the accumulation of many successive stochastic events such as nucleotide deletions, insertions, substitutions and elongations [1, 2, 3, 4, 5, 6, 7]. Although the existence of long-range correlations in non-coding portions of DNA sequences is well established [8, 9, 10, 11], first order Markov chains might well capture aspects of their nucleotide distributions [12]. Here we propose a hidden Markov model based on a coupling of an urn process with a Markov chain to approximate the distributional structure of primitive DNA sequences. Then, by supposing that a bacterial DNA sequence can be derived from uniformly distributed mutations of some primitive DNA, we use the model to explain and predict some distributional properties of bacterial DNA sequences. The distributional properties intrinsic to the model were compared to statistical estimates from 1049 bacterial DNA sequences. In particular, the proposed model provides another possible theoretical explanation for Chargaff’s second parity rule for short oligonucleotides [13, 14]

Pizarro-Ortega v. Cervantes-Lopez, 133 Nev. Adv. Op. 37 (June 22, 2017)

The court held that future medical expenses are a category of damages to which NRCP 16.1(a)(1)(C)’s computation requirement applies, and that a plaintiff is not absolved of complying with NRCP 16.1(a)(1)(C) simply because the plaintiff’s treating physician has indicated in medical records that future medical care is necessary

Work stress and well-being : a longitudinal study of the job demands-resources model in Australian Clergy

Background: Work stress and well-being continue to be a major concern warranting research and intervention. The Job Demands-Resources (JDR) model has been supported as a model of clergy well-being in Australian Salvation Army clergy by Cotton (2006). This research aims to examine the JDR model among clergy in other denominations, with general and occupation-specific demands and job (and personal) resources. In addition to other health and work outcomes, work-related depression was investigated. This research also sought to contribute to job redesign through an evaluation of a pilot work stress intervention focussed on individual job redesign. Method: A longitudinal web-based survey of 283 respondents at Time 1 and 64 of these respondents at Time 2 was conducted with NSW/ACT clergy in four denominations. The first survey measured job demands, burnout, health, depression, and resources, work engagement, self-rated performance and resignation intention. The second survey focussed on the health impairment pathway of the JDR model retaining job demands, burnout, health, and depression as well as resources from the first survey. Results: Time 1 The results at Time 1 provided cross-sectional support for the JDR model for clergy. The health impairment pathway, and the motivational enhancement pathway were supported. Job resources, particularly co-worker support buffered the effect of job demands on burnout, depression and health. Work home interference had a broader role than as a job demand, as it mediated the relationship between job demands and health, as well as the relationship between burnout and health. The relationship between depression and burnout was explored with cynicism particularly prominent in its relationship with the depression scale and mediation of the effect of job demands for this occupational sample. Results: Time 2 The longitudinal results showed correlational evidence for the hypotheses of the health impairment pathway for depression, and some support for the buffering of the effect of job demands on depression by job resources from Time 1 to Time 2. However, despite these findings analysis of the JDR model through structural equation modelling and ordinal logistic regression did not find evidence to support the health impairment pathway and associated hypotheses of the JDR model longitudinally. Conclusion The JDR model provides a valuable way of understanding clergy well-being, as this research found support across several denominations for both pathways as well as some support for the buffering by resources of the effect of demands on burnout, depression and health. The inclusion of clergy-specific demands and resources improved the applicability of the model. There was cross-sectional support for the application of the JDR model in work-related depression. Research recommendations include longitudinal research of the role of work home interference, use of all burnout scales in research on depression, further consideration of the match hypotheses, and use of collaborative research approaches with denominations. Limitations A major limitation of this research is the small number of respondents at Time 2 that reduced the capacity to undertake effective longitudinal analysis. The response rate was also low which impacts on the capacity to make research and practical recommendations

Why we can't help working when ill: the perverse causes of presenteeism in the UK, with a focus on prison officers and academics

The term ‘presenteeism’ refers to situations where employees continue to attend work while they are sick. In this report we look at why absenteeism policies can encourage presenteeism and how presenteeism presents in two working populations: UK prison officers and UK academics

Hospital expenditure at the end-of-life: what are the impacts of health status and health risks?

Background: It is important for health policy and expenditure projections to understand the relationship between age, death and expenditure on health care (HC). Research has shown that older age groups incur lower hospital costs than previously anticipated and that remaining time to death (TTD) was a much stronger indicator for expenditure than age. How health behaviour or risk factors impact on HC utilisation and costs at the end of life is relatively unknown. Smoking and Body Mass Index (BMI) have featured most prominently and mixed findings exist as to the exact nature of this association.<p></p> Methods: This paper considers the relationship between TTD, age and expenditure for inpatient care in the last 12 quarters of life; and introduces measures of health status and risks. A longitudinal dataset covering 35 years is utilised, including baseline survey data linked to hospital and death records. The effect of age, TTD and health indicators on expenditure for inpatient care is estimated using a two-part model.<p></p> Results: As individuals approach death costs increase. This effect is highly significant (p<0.01) from the last until the 8th quarter before death and influenced by age. Statistically significant effects on costs were found for: smoking status, systolic blood pressure and lung function (FEV1). On average, smokers incurred lower quarterly costs in their last 12 quarters of life than non-smokers (~7%). Participants’ BMI at baseline did show a negative association with probability of HC utilisation however this effect disappeared when costs were estimated.<p></p> Conclusions: Health risk measures obtained at baseline provide a good indication of individuals’ probability of needing medical attention later in life and incurring costs, despite the small size of the effect. Utilising a linked dataset, where such measures are available can add substantially to our ability to explain the relationship between TTD and costs.<p></p&gt

Cardiopulmonary exercise testing for predicting early outcomes after major cancer resection: A systematic review

Background: Postoperative complications after major surgery are thought to be associated with reduced fitness. Surgical cancer patients are often malnourished, cachexic and subject to neoadjuvant chemotherapy resulting in low preoperative fitness levels. This review examined the associations between aerobic fitness, as determined objectively by preoperative cardiopulmonary exercise testing (CPEX), and short-term morbidity after cancer surgery. Methods: A literature search using databases of PubMed, Medline, Embase, Cumulative Index to Nursing and Allied Health Literature (CINAHL) and the Cochrane Library for studies that examined associations between preoperative CPEX variables and postoperative complications following surgery for the ten commonest cancers. Results: A total of 21 observational studies were identified with 4957 patients that underwent CPEX testing prior to lung, colorectal, liver, oesophagogastric, bladder and pancreas resections. The median sample size was 105 patients (range 64 - 1684). No studies were found for breast or brain cancers or lymphoma. In lung cancer patients undergoing thoracotomy, a VO2peak ≤ 15ml/kg/min was associated with an increased risk of respiratory complications and death. None of the studies in other cancer types had adequate sample sizes to report on mortality. CPEX testing had mostly poor to average discriminatory accuracy to predict postoperative morbidity in other cancer resection surgeries. Findings across studies were inconsistent, and detection and selective reporting biases were likely to be significant. Conclusion: The utility of CPEX testing prior to cancer surgery is questionable and currently should not be used as a discriminatory tool, except in patients undergoing lung cancer resection by thoracotomy. Larger studies with more robust methodologies are currently required to determine the utility of CPEX

Does physical activity protect against the development of gastroesophageal reflux disease, Barrett’s oesophagus and oesophageal adenocarcinoma?:A review of the literature with a meta-analysis

Physical activity affects the functioning of the gastrointestinal system through both local and systemic effects and may play an important role in reducing the risk of esophageal adenocarcinoma. This review assesses the biological mechanisms and epidemiological evidence for the relationship between physical activity and the development of esophageal adenocarcinoma and its precursor diseases: gastroesophageal reflux disease (GORD) and Barrett's esophagus. A search of PubMed, Medline, Embase, and CINAHL was conducted from their inceptions to 25th March 2017 for analytical studies that examined associations between recreational and/or occupational levels of physical activity and the risk of GORD, Barrett's esophagus, and esophageal adenocarcinoma. Where appropriate, a meta-analysis of effects was undertaken. Seven studies were included (2 cohort, 5 case control). For GORD, there were three case-control studies with 10 200 cases among 78 034 participants, with a pooled estimated OR of 0.67 (95% CI 0.57–0.78) for high versus low levels of recreational physical activity. In Barrett's esophagus, there was a single case-control study, which reported no association, OR 1.19 (95% CI 0.82–1.73). For esophageal adenocarcinoma, there were three studies (two prospective cohort, one case control) with 666 cases among 910 376 participants. The largest cohort study reported an inverse association for high versus low levels of recreational physical activity, RR 0.68, 95% CI 0.48–0.96. The remaining two studies reported no associations with either occupational or combined recreational and occupational activity. Heterogeneity in the measurement of exposure (recreational, occupational, and both) made a pooled estimate for esophageal adenocarcinoma inappropriate. Although limited, there is some evidence that higher levels of recreational physical activity may reduce the risk of both GORD and esophageal adenocarcinoma, but further large cohort studies examining the type, intensity and duration of activities that may be beneficial are needed