Why are patients with anca-associated vasculitis fatigued?

Objective: To assess the severity and predictors of fatigue in ANCA-associated vasculitis (AAV), and the contribution of peripheral and central mechanisms. Methods: Fatigue, anxiety/depression, sleep quality and pain were measured in 152 patients with AAV, 68 patients with CKD, andTl healthy conffols. Muscle mass, strength and endurance, cardio-respiratory fitness, perception of exertion, high-sensitivity C-reactive protein (hsCRP), and dehydroepiandrosterone (DHEA) were measured in 48 patients with AAV and 4l healthy controls. Results: Fatigue in AAV was more severe than in CKD 1p:g.gl3) or controls (p<0.001), and correlated with anxiety/depression, sleep quality and pain (all p<0.001). There was no difference in muscle mass (p:0.979) or strength (p=0.315) between AAV and conhols, but muscle endurance time was shorter in AAV (p=0.006), with greater muscle reserve (p=0.038) indicating central activation failure. Perception of exertion (p=0.006) and cardio-respiratory fitness (p:0.029) were worse in AAV than controls. Only perception of exertion independently predicted AAV fatigue (p:0.01). Sleep disturbance predicted altered perception of exertion (p:0.017). hsCRP was higher (p0.01 1) and DHEAS levels were lower (p<0.001) in AAV than controls, but neither predicted fatigue. Conclusion: Fatigue in AAV is more severe than in CKD or health, is due to central mechanisms, and may be amenable to intervention

The addition of the cytochrome B562 export sequence to the sperm whale myoglobin gene inhibits expression in Escherichia coli

Thesis (B.S.) in Biochemistry--University of Illinois at Urbana-Champaign, 1989.Includes bibliographical references (leaf 23)Microfiche of typescript. [Urbana, Ill.]: Photographic Services, University of Illinois, U of I Library, [1990]. 1 microfiche (29 frames): negative.s 1990 ilu n

What Happens After a Shark Incident? Behavioral Changes Among Australian Beachgoers

Sharks (Selachimorpha) have an important ecological function and are both valued and feared by people around the world. Shark bite incidents present a high consequence risk in terms of human health and safety. In Australia, shark interactions with humans are most frequently recorded for the white shark (Carcharodon carcharias), bull shark (Carcharhinus leucas), and tiger shark (Galeocerdo cuvier). Human anxiety of encountering sharks may be elevated relative to the actual level of risk due to intensive media coverage, which typically emphasizes a narrative of highly abundant animals actively targeting human water users. This narrative is not supported by scientific evidence. Public perceptions of shark incidents can strongly influence shark management efforts. To help management, we set out to understand how people change their behavior in response to shark incidents and why some behaviors do or do not change. In October 2019, we used 4 participatory workshops, attended by 60 people, and a visual communication approach to study the socioecological context of beachgoer behavior to sharks in a high shark incident region around Ballina and Byron Bay in New South Wales, Australia. Of all recorded comments captured at the workshops (174), 91% mentioned changes in behavior following the reported incidents, and 9% indicated no behavior change. The behavior changes generally did not result in less beach use but in different types of use. When beachgoers visited the beach and used the ocean, they implicitly asked themselves the following questions in selecting activities and behaviors: (1) how much risk do I think is present, (2) how much risk am I willing to accept, and (3) how much do I trust the information and advice available to me to mitigate these risks? We found that families, teenagers, and experienced beachgoers (such as surfers) used different socioecological information on which to base their risk assessments and that these groups had different risk profiles. Despite these variations, a common finding across beachgoers was a strong desire to improve the quality of publicly available and locally relevant information on risk factors. Using the graphic visualization of our findings for communication purposes can help beachgoers contextualize their own risk perception and learn from how others have changed their reported behavior. Sharing of behavior change information and risk reduction strategies can help target public investment in mitigation measures and may encourage further risk reduction strategies and policies to be implemented

Sequential burkholderia cenocepacia isolates from siblings with cystic fibrosis show increased lung cell attachment

No abstract availabl

Quality of life measurement in community-based aged care : understanding variation between clients and between care service providers

Background: Measuring person-centred outcomes and using this information to improve service delivery is a challenge for many care providers. We aimed to identify predictors of QoL among older adults receiving community-based aged care services and examine variation across different community care service outlets. Methods: A retrospective sample of 1141 Australians aged ≥60 years receiving community-based care services from a large service provider within 19 service outlets. Clients’ QoL was captured using the ICEpop CAPability Index. QoL scores and predictors of QoL (i.e. sociodemographic, social participation and service use) were extracted from clients’ electronic records and examined using multivariable regression. Funnel plots were used to examine variation in risk-adjusted QoL scores across service outlets. Results: Mean age was 81.5 years (SD = 8) and 75.5% were women. Clients had a mean QoL score of 0.81 (range 0– 1, SD = 0.15). After accounting for other factors, being older (p < 0.01), having lower-level care needs (p < 0.01), receiving services which met needs for assistance with activities of daily living (p < 0.01), and having higher levels of social participation (p < 0.001) were associated with higher QoL scores. Of the 19 service outlets, 21% (n = 4) had lower mean risk-adjusted QoL scores than expected (< 95% control limits) and 16% (n = 3) had higher mean scores than expected. Conclusion: Using QoL as an indicator to compare care quality may be feasible, with appropriate risk adjustment. Implementing QoL tools allows providers to measure and monitor their performance and service outcomes, as well as identify clients with poor quality of life who may need extra support

Effects of eddy vorticity forcing on the mean state of the Kuroshio Extension

Author Posting. © American Meteorological Society, 2015. This article is posted here by permission of American Meteorological Society for personal use, not for redistribution. The definitive version was published in Journal of Physical Oceanography 45 (2015): 1356–1375, doi:10.1175/JPO-D-13-0259.1.Eddy–mean flow interactions along the Kuroshio Extension (KE) jet are investigated using a vorticity budget of a high-resolution ocean model simulation, averaged over a 13-yr period. The simulation explicitly resolves mesoscale eddies in the KE and is forced with air–sea fluxes representing the years 1995–2007. A mean-eddy decomposition in a jet-following coordinate system removes the variability of the jet path from the eddy components of velocity; thus, eddy kinetic energy in the jet reference frame is substantially lower than in geographic coordinates and exhibits a cross-jet asymmetry that is consistent with the baroclinic instability criterion of the long-term mean field. The vorticity budget is computed in both geographic (i.e., Eulerian) and jet reference frames; the jet frame budget reveals several patterns of eddy forcing that are largely attributed to varicose modes of variability. Eddies tend to diffuse the relative vorticity minima/maxima that flank the jet, removing momentum from the fast-moving jet core and reinforcing the quasi-permanent meridional meanders in the mean jet. A pattern associated with the vertical stretching of relative vorticity in eddies indicates a deceleration (acceleration) of the jet coincident with northward (southward) quasi-permanent meanders. Eddy relative vorticity advection outside of the eastward jet core is balanced mostly by vertical stretching of the mean flow, which through baroclinic adjustment helps to drive the flanking recirculation gyres. The jet frame vorticity budget presents a well-defined picture of eddy activity, illustrating along-jet variations in eddy–mean flow interaction that may have implications for the jet’s dynamics and cross-frontal tracer fluxes.A. S. Delman (ASD) and J. L. McClean (JLM) were supported by NSF Grant OCE-0850463 and Office of Science (BER), U.S. Department of Energy, Grant DE-FG02-05ER64119. ASD and J. Sprintall were also supported by a NASA Earth and Space Science Fellowship (NESSF), Grant NNX13AM93H. JLM was also supported by U.S. DOE Office of Science grant entitled “Ultra-High Resolution Global Climate Simulation” via a Los Alamos National Laboratory subcontract. S. R. Jayne was supported by NSF Grant OCE-0849808. Computational resources for the model run were provided by NSF Resource Grants TG-OCE110013 and TG-OCE130010.2015-11-0

An empirical model approach for assessing soil organic carbon stock changes following biomass crop establishment in Britain

Land-use change (LUC) is a major influence on soil organic carbon (SOC) stocks and the global carbon cycle. LUC from conventional agricultural to biomass crops has increased in Britain but there is limited understanding of the effects on SOC stocks. Results from paired plot studies investigating site-specific effects document both increasing and decreasing SOC stocks over time. Such variation demonstrates the sensitivity of SOC to many factors including environmental conditions. Using a chronosequence of 93 biomass crop sites in England and Wales, mainly of 1–14 y age, empirical models were developed of SOC trajectory following LUC from arable and grassland to short rotation coppice (SRC) willow and Miscanthus production. SOC stocks were calculated for each site using a fixed sampling depth of 30 cm and changes were estimated by comparing with typical pre-conversion SOC stocks. Most LUCs had no demonstrable net effect on SOC stocks. An estimated net SOC loss of 45.2 ± 24.1 tonnes per hectare (±95% confidence intervals) occurred after 14 y following LUC from grassland to SRC willow. Soil texture and climate data for each site were included in multivariable models to assess the influence of different environmental conditions on SOC trajectory. In most cases the addition of explanatory variables improved the model fit. These models may provide some preliminary estimates of more region-specific changes in SOC following LUC. However, the model fit did not improve sufficiently as to provide a basis for adopting a more targeted LUC strategy for lignocellulosic biomass crop production

Simvastatin is associated with superior lipid and glycaemic control to atorvastatin and reduced levels of incident Type 2 diabetes, in men and women, in the UK Biobank

INTRODUCTION: Cardiovascular disease (CVD) is the leading cause of mortality in people with Type 2 diabetes mellitus (T2DM). Statins reduce low‐density lipoproteins and positively affect CVD outcomes. Statin type and dose have differential effects on glycaemia and risk of incident T2DM; however, the impact of gender, and of individual drugs within the statin class, remains unclear. AIM: To compare effects of simvastatin and atorvastatin on lipid and glycaemic control in men and women with and without T2DM, and their association with incident T2DM. METHODS: The effect of simvastatin and atorvastatin on lipid and glycaemic control was assessed in the T2DM DiaStrat cohort. Prescribed medications, gender, age, BMI, diabetes duration, blood lipid profile and HbA1c were extracted from Electronic Care Record, and compared in men and women prescribed simvastatin and atorvastatin. Analyses were replicated in the UKBiobank in those with and without T2DM. The association of simvastatin and atorvastatin with incident T2DM was also investigated in the UKBiobank. Cohorts where matched for age, BMI and diabetes duration in men and women, in the UKBioBank analysis, where possible. RESULTS: Simvastatin was associated with better LDL (1.6 ± 0.6 vs 2.1 ± 0.9 mmol/L, p < .01) and total cholesterol (3.6 ± 0.7 vs 4.2 ± 1.0 mmol/L, p < .05), and glycaemic control (62 ± 17 vs 67 ± 19 mmol/mol, p < .059) than atorvastatin specifically in women in the DiaStrat cohort. In the UKBiobank, both men and women prescribed simvastatin had better LDL (Women: 2.6 ± 0.6 vs 2.6 ± 0.7 mmol/L, p < .05; Men: 2.4 ± 0.6 vs 2.4 ± 0.6, p < .01) and glycaemic control (Women:54 ± 14 vs 56 ± 15mmol/mol, p < .05; Men, 54 ± 14 vs 55 ± 15 mmol/mol, p < .01) than those prescribed atorvastatin. Simvastatin was also associated with reduced risk of incident T2DM in both men and women (p < .0001) in the UKBiobank. CONCLUSIONS: Simvastatin is associated with superior lipid and glycaemic control to atorvastatin in those with and without T2DM, and with fewer incident T2DM cases. Given the importance of lipid and glycaemic control in preventing secondary complications of T2DM, these findings may help inform prescribing practices