'Everything's fine, so why does it happen?' A qualitative investigation of patients' perceptions of noncardiac chest pain

Aims and objectives. To examine patients’ perceptions and experiences of noncardiac chest pain, within the framework of the common sense model. Background. Patients with noncardiac chest pain have good physical prognosis, but frequently suffer prolonged pain and psychological distress. The common sense model may provide a good framework for examining outcomes in patients with noncardiac chest pain. Design. Qualitative thematic analysis with semi-structured interviews. Methods. In 2010, participants recruited from an emergency department (N = 7) with persistent noncardiac chest pain and distress were interviewed using a semistructured schedule, and data were analysed using thematic analysis. Results. Seven themes were identified; six of which mapped onto core dimensions of the common sense model (identity, cause, timeline, consequences, personal control, treatment control). Contrary to previous research on medically unexplained symptoms, most participants perceived psychological factors to play a causal role in their chest pain. Participants’ perceptions largely mapped onto the common sense model, although there was a lack of coherence across dimensions, particularly with regard to cause. Conclusion. Patients with noncardiac chest pain lack understanding with regard to their condition and may be accepting of psychological causes of their pain. Relevance to clinical practice. Brief psychological interventions aimed at improving understanding of the causes of noncardiac chest pain and providing techniques for managing pain and stress may be useful for patients with noncardiac chest pain

THE EFFECT OF WIND DIRECTION ON FLOW PAST SOUTH GEORGIA

A series of simulations of idealized flows past South Georgia are conducted in order to investigate how the wind direction affects the airflow around a real mesoscale mountain. Our experiments build on the work of Petersen et al. (2003) who investigated the impact of upstream wind direction on flow around an idealized mountain designed to be a similar size to Greenland. However, our experiments differ from Petersen’s experiments in two key ways. Firstly, we use real, complex multi-scale orography rather than idealized, smooth orography. Secondly, our mountain is much smaller. Results indicate that the flow features are sensitive to the wind direction, with the flow most effectively blocked when the incident flow at a slight angle to the major axis of the orography. In contrast to Petersen’s experiments around symmetrical idealized orography the flow features are also sensitive to a 180° rotation of the orography. However, the magnitude of the surface pressure force is relatively insensitive to this, varying by less than 10% when the orography is rotated by 180° from any initial orientation

Three-spined sticklebacks show dimension-specific preferences for shelter

Funding Information: We are grateful to the Association for the Study of Animal Behaviour (ASAB) for funding this work through an ASAB research grant to N.A.R.J. Thank you also to the University of St Andrews Research internship Scheme (StARIS) which provided funding for G.G.Shelter is an important resource, serving as protection from rivals, predators and environmental stressors. The physical dimensions of a potential shelter are an important factor that can affect decisions about potential shelter options. Animals must select a shelter that they can fit into and use as a refuge, but beyond that, do they show fine-scale preferences based on shelter dimensions? This question has been actively studied for species whose shelter use is closely connected to their life cycles, such as obligate shell dwellers and nest-inhabiting species. However, preferences and decision making for temporary shelters has received less attention. We tested whether three-spined sticklebacks, Gasterosteus aculeatus, a common laboratory model, exhibit preferences in shelter use (actively entering and spending time within a shelter) between shelters with different dimensions. We used PVC tubes of different dimensions as shelters and conducted a simultaneous choice assay where individual fish were presented with each of three tubes available for use as shelter. The fish showed a clear preference, using larger diameter shelters more frequently than either of the other two options. There was no difference in the number of nonsheltering visits fish made or time to enter a shelter across tube sizes, which suggests an active selection by the fish rather than passive bias. There was no difference in duration of time spent within a shelter, suggesting that despite these preferences, actual benefit derived by the fish may be decoupled from the shelter dimensions. Our results offer opportunities for future research that addresses longer term questions in both behavioural ecology and welfare. What drives the preference for larger diameter tubes, and are there are long-term benefits to shelter with preferred dimensions? Certainly, our results suggest that housing sticklebacks with larger diameter shelters may be a simple and convenient means to improve welfare.Publisher PDFPeer reviewe

Effect of HIV infection and antiretroviral therapy on hepatitis B virus (HBV)-specific T cell responses in patients who have resolved HBV infection

Coinfection with hepatitis B virus (HBV) is a common occurrence in human immunodeficiency virus (HIV)–positive patients and an increasing cause of morbidity and mortality. The CD8+ T cell response is critical for long-term control of HBV in patients resolving acute infection. Here, we examine the effect of HIV on HBV-specific CD8+ T cell responses in patients who have resolved HBV infection. A cross-sectional study showed a reduction in HBV-specific CD8+ T cell responses in HIV-positive, HBV-immune patients, compared with those in HIV-negative, HBV-immune patients. A longitudinal study of a subgroup of patients examined whether this attrition could be reversed by effective antiretroviral therapy. The introduction of highly active antiretroviral therapy (HAART) resulted in reconstitution of some HBV-specific CD4+ and CD8+ T cell responses, in association with restoration of CD4+ T cell counts. These data provide a mechanism to account for the observed impairment of control of HBV infection in the setting of HIV infection and support the ability of HAART to reconstitute functionally active T cell responses

Physical enrichment research for captive fish : time to focus on the DETAILS

Funding: Fisheries Society of the British Isles (GB) (Grant Number(s): PhD Studentship).Growing research effort has shown that physical enrichment (PE) can improve fish welfare and research validity. However, the inclusion of PE does not always result in positive effects and conflicting findings have highlighted the many nuances involved. Effects are known to depend on species and life stage tested, but effects may also vary with differences in the specific items used as enrichment between and within studies. Reporting fine-scale characteristics of items used as enrichment in studies may help to reveal these factors. We conducted a survey of PE-focused studies published in the last 5 years to examine the current state of methodological reporting. The survey results suggest that some aspects of enrichment are not adequately detailed. For example, the amount and dimensions of objects used as enrichment were frequently omitted. Similarly, the ecological relevance, or other justification, for enrichment items was frequently not made explicit. Focusing on ecologically relevant aspects of PE and increasing the level of detail reported in studies may benefit future work and we propose a framework with the acronym DETAILS ( D imensions, E cological rationale, T iming of enrichment, A mount, I nputs, L ighting and S ocial environment). We outline the potential importance of each of the elements of this framework with the hope it may aid in the level of reporting and standardization across studies, ultimately aiding the search for more beneficial types of PE and the development of our understanding and ability to improve the welfare of captive fish and promote more biologically relevant behaviour.Publisher PDFPeer reviewe

Analysis of the Radiative Heat Transfer in Chains of Nanoparticles

The transfer of heat through radiation plays a crucial role in the thermalization of nanoscale objects thanks to the involvement of evanescent waves. As nanotechnology becomes a prominent area of research and development, the understanding of this phenomenon is becoming more and more crucial. In this work, we investigate the thermalization of linear chains of SiC nanospheres. To that end, we develop an analytical method that allows us to calculate the radiative heat exchange between the particles through the analysis of the normal modes of the system and their corresponding decay rates. Using this approach we analyze the time evolution of the temperature distribution of different structure

Coats-like Vasculopathy in Inherited Retinal Disease: Prevalence, Characteristics, Genetics, and Management.

To describe the largest, most phenotypically and genetically diverse cohort of patients with inherited retinal disease (IRD)-related Coats-like vasculopathy (CLV). Multicenter retrospective cohort study. A total of 67 patients with IRD-related CLV. Review of clinical notes, ophthalmic imaging, and molecular diagnosis from 2 international centers. Visual function, retinal imaging, management, and response to treatment were evaluated and correlated. The prevalence of IRD-related CLV was 0.5%; 54% of patients had isolated retinitis pigmentosa (RP), 21% had early-onset severe retinal dystrophy, and less frequent presentations were syndromic RP, sector RP, cone-rod dystrophy, achromatopsia, PAX6-related dystrophy, and X-linked retinoschisis. The overall age of patients at CLV diagnosis was 30.7 ± 16.9 years (1-83). Twenty-one patients (31%) had unilateral CLV, and the most common retinal features were telangiectasia, exudates, and exudative retinal detachment (ERD) affecting the inferior and temporal retina. Macular edema/schisis was observed in 26% of the eyes, and ERD was observed in 63% of the eyes. Fifty-four patients (81%) had genetic testing, 40 of whom were molecularly solved. Sixty-six eyes (58%) were observed, 17 eyes (15%) were treated with a single modality, and 30 eyes (27%) had a combined approach. Thirty-five eyes (31%) were "good responders," 42 eyes (37%) were "poor responders," 22 eyes (19%) had low vision at baseline and were only observed, and 12 eyes (11%) did not have longitudinal assessment. Twenty-one observed eyes (62%) responded well versus 14 (33%) treated eyes. Final best-corrected visual acuity was significantly worse than baseline (P = 0.002); 40 patients (60%) lost 15 ETDRS letters or more over follow-up in 1 or both eyes, and 21 patients (31%) progressed to more advanced stages of visual impairment. Inherited retinal disease-related CLV is rare, sporadic, and mostly bilateral; there is no gender predominance, and it can occur in diverse types of IRD at any point of the disease, with a mean onset in the fourth decade of life. Patients with IRD-related CLV who have decreased initial visual acuity, ERD, CLV changes affecting 2 or more retinal quadrants, and CRB1-retinopathy may be at higher risk of a poor prognosis. Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article