Gout, which is commonly associated with hyperuricemia, affects
0.2% of the population. Hyperuricemia has a heterogeneous etiology
that may be due to either over production and/or reduced renal
...clearance, of urate. In order to identify the mechanisms underlying
reduced excretion of urate, we undertook positional cloning studies of
familial juvenile hyperuricaemic nephropathy (FJHN), which is an
autosomal dominant disorder characterized by hyperuricaemia, a low
fractional renal excretion of urate, and chronic renal failure that is
associated with interstitial fibrosis. The FJHN locus has been
previously localized to a 22 centiMorgan interval flanked
centromerically by D16S401 and telomerically by D16S3069, on chromosome
16p11-p13. This interval contains over 120 genes and we selected 13
renal expressed sequences to search for mutations in 5 unrelated FJHN
families that contained 21 affected and 24 unaffected members. This
revealed 5 heterozygous missense mutations (Cys77Tyr, Cys126Arg,
Asn128Ser, Cys255Tyr and Cys300Gly) that altered evolutionary conserved
residues in the gene encoding UROMODULIN. UROMODULIN, which is an 85
Kda glycoprotein, has roles in renal stone formation, the
modulation of immune responses, and urothelial cytoprotection. The
results of our studies, which have identified the gene causing FJHN,
now indicate a further, novel role for UROMODULIN in urate
metabolism.
In this study, we analyze 44 terrestrial gamma‐ray flashes (TGFs) detected by the Fermi Gamma‐ray Burst Monitor (GBM) occurring in 2014–2016 in conjunction with data from the U.S. National Lightning ...Detection Network (NLDN). We examine the characteristics of magnetic field waveforms measured by NLDN sensors for 61 pulses that occurred within 5 ms of the start‐time of the TGF photon flux. For 21 (out of 44) TGFs, the associated NLDN pulse occurred almost simultaneously with (that is, within 200 μs of) the TGF. One TGF had two NLDN pulses within 200 μs. The median absolute time interval between the beginning of these near‐simultaneous pulses and the TGF flux start‐time is 50 μs. We speculate that these RF pulses are signatures of either TGF‐associated relativistic electron avalanches or currents traveling in conducting paths “preconditioned” by TGF‐associated electron beams. Compared to pulses that were not simultaneous with TGFs (but within 5 ms of one), simultaneous pulses had higher median absolute peak current (26 kA versus 11 kA), longer median threshold‐to‐peak rise time (14 μs versus 2.8 μs), and longer median peak‐to‐zero time (15 μs versus 5.5 μs). A majority (77%) of our simultaneous RF pulses had NLDN‐estimated peak currents less than 50 kA indicating that TGF emissions can be associated with moderate‐peak‐amplitude processes. The lightning flash associated with one of the TGFs in our data set was observed by a Lightning Mapping Array, which reported a relatively high‐power source at an altitude of 25 km occurring 101 μs after the GBM‐reported TGF discovery‐bin start‐time.
Key Points
TGF‐associated RF pulses have a wide range of NLDN‐estimated peak currents, which are proportional to their magnetic field peak amplitudes
Median rise time and peak‐to‐zero time for TGF‐simultaneous RF pulses were significantly longer than those for nonsimultaneous pulses
A TGF that was associated with relatively high‐power VHF radiation is described in detail
Context: Endometrium of fertile women expresses progesterone-regulated Mucin 1 (MUC1) that carries selectin ligands recognized by the human blastocyst. Altered MUC1 expression at the time of ...implantation may contribute to endometrial infertility.
Objective: The aim was to assess the expression of MUC1 in the endometrium from polycystic ovary syndrome (PCOS), endometriosis, and fertile women in comparison with other hormone-regulated proteins hydroxysteroid dehydrogenase (HSD) 1, HSD2, estrogen receptor (ER) and progesterone receptor (PR).
Design and Patients: Endometrial samples were obtained from 33 fertile patients, 26 ovulatory PCOS patients, 15 anovulatory PCOS patients, and 25 endometriosis patients.
Main Outcome Measure: Immunohistochemistry assessed the expression of MUC1 subunits ER, PR, HSD1, and HSD2 in endometrial epithelium. Endometrial MUC1 expression was quantified by immunoblots and RT-PCR. HSD1 and HSD2 expression was assayed by RT-PCR.
Results: MUC1ND expression was significantly higher in ovulatory PCOS than in fertile and anovulatory PCOS patients, even after progesterone stimulation. MUC1ND and -CD expression was lower in anovulatory PCOS than in fertile patients. Only MUC1CD expression was lower in endometriosis patients. Endometrial ER expression was significantly higher in PCOS and endometriosis patients, whereas PR expression was significantly higher in PCOS than in fertile patients. The expression of HSD1 was significantly higher in anovulatory PCOS than in fertile patients. Expression of HSD2 was significantly higher in PCOS patients and lower in endometriosis patients.
Conclusion: Expression of MUC1 subunits in the infertile endometrium is significantly different from fertile and appears to be a component of altered gene expression that potentially contributes to endometrial insufficiency.
MUC1 subunit expression in the infertile endometrium is significantly different from that in the fertile and is a component of altered gene expression that contributes to endometrial insufficiency.
The Fermi Gamma‐ray Burst Monitor (GBM) has detected terrestrial gamma‐ray flash (TGF) pulses and TGF pairs with separations from submilliseconds to several minutes. Enhancements in the TGF rate ...are reobserved on successive orbits. We report on the distribution of TGF pulse separations observed with Fermi GBM. Additionally, a detailed analysis is performed on TGFs that have temporal associations within 3.5 ms with radio atmospheric signals (sferics) from the World Wide Lightning Location Network or the Earth Networks Total Lightning Network. Sferics are typically associated with lightning discharges, but the relativistic runaway electron avalanche process, according to models, should also produce radio emissions. The separations times between TGFs show a gap from 10 ms to 1 s that we interpret as showing differing origins for the separations below 10 ms and those above 1 s. Analysis of paired TGFs with separation time ≥1 s reveals 51 pairs with a sferic association with both members. The majority of these pairs have members originating from separate cells in thunderstorm systems, but 10 pairs have geolocations consistent with originating from the same cell. The minimum separation time of pairs from the same cell is 10 s, with an average separation time of 56 s. This leads to implications on TGF generation models and the recharge time of the large‐scale electric field at the source of the production of the TGF. This separation time would result in a constraint on the recharge time of the large‐scale electric field before an additional TGF can be produced.
Key Points
A gap in separation time of TGF emissions distinguishes two differing origins
Ten TGF pairs have origins consistent with the same thunderstorm cell
The minimum separation time between multiple TGFs from the same cell is 10 s
Aim The aim of the present study was to review the current literature on oppressed group behaviours in nursing, with emphasis on interventions to change the behaviours, and on instruments that have ...been developed to measure it.
Background Oppressed group behaviours have been described in nurses for over two decades and their presence has been related to decreased nurse self‐advocacy, and other negative aspects of the nursing workplace.
Evaluation Systematic review of the literature on oppressed group behaviour in nursing.
Key issues Oppressed group behaviours are frequently found in nurses. Interventions have been created and tested to decrease oppressed group behaviours.
Conclusion Oppressed group behaviours are frequently found in nurses. Interventions exist that can decrease oppressed group behaviours and the decrease is related to increased work force performance, satisfaction and retention of nurses in the workplace.
Implications for nurse managers Nurse Managers can improve the workplace by measuring oppressed group behaviours and utilizing interventions to break the cycle of oppression in the workplace culture. Utilizing these innovations improve the workplace culture for nursing.
We present an event that was detected by Fermi Gamma‐ray Burst Monitor on 4 February 2014 as the spacecraft was flying over Madagascar. We interpret the three pulses during this event (herein known ...as 140204581) as the following: the first pulse as a terrestrial gamma‐ray flash, the second as a 2 ms long terrestrial electron beam (TEB) 0.5 ms after the terrestrial gamma‐ray flash, and the last pulse as the TEB mirror pulse 90 ms after the TEB. The nature of these events were confirmed using both the World Wide Lightning Location Network and the Earth Networks Total Lightning Network, which detected the same simultaneous sferic underneath the spacecraft and in the magnetic footprint. Several models were fit to the data, and results show that the vertical narrow beam model was found to be inconsistent with the data.
Key Points
Fermi GBM observed an event in both gamma‐rays from a TGF and charged particles from a (TEB)
Simulations show observations of the event are consistent with an origin identified by radio networks
The best fit positron fraction for the TEB is about 10%
Objective. This paper presents the development of the Warwick Patient Experiences Framework (WaPEF) and describes how it informed the development of the NICE Guidance and Quality Standard, 'Patient ...experience in adult NHS services: improving the experience of care for people using adult NHS services'. Design. The WaPEF was developed using a thematic qualitative overview that utilized a systematic review approach. Search strategies were developed, inclusion and exclusion criteria developed and data extracted from papers. Results. The WaPEF identifies seven key generic themes that are important to a high-quality patient experience: patient as active participant, responsiveness of services, an individualized approach, lived experience, continuity of care and relationships, communication, information and support. Conclusions. The WaPEF is the first patient experiences framework with an explicit link to an underpinning patient evidence base, linking themes and sub-themes with specific references. The WaPEF informed the structure and content of the NICE Patient Experiences Guidance. The guidance, published in February 2012, will form a key part of the NHS Outcomes Framework in the UK for the future evaluation of health and social care. The proposed framework could be adapted to other country contexts and settings.
Anti-Americanism has been the subject of much commentary but little serious research. In response, Peter J. Katzenstein and Robert O. Keohane have assembled a distinguished group of experts, ...including historians, polling-data analysts, political scientists, anthropologists, and sociologists, to explore anti-Americanism in depth, using both qualitative and quantitative methods. The result is a book that probes deeply a central aspect of world politics that is frequently noted yet rarely understood.
Katzenstein and Keohane identify several quite different anti-Americanisms-liberal, social, sovereign-nationalist, and radical. Some forms of anti-Americanism respond merely to what the United States does, and could change when U.S. policies change. Other forms are reactions to what the United States is, and involve greater bias and distrust. The complexity of anti-Americanism, they argue, reflects the cultural and political complexities of American society. The analysis in this book leads to a surprising discovery: there are as many ways to be anti-American as there are ways to be American.
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