Chronic pain is highly prevalent worldwide and represents a significant socioeconomic and public health burden. Several aspects of chronic pain, for example back pain and a severity-related phenotype ...'chronic pain grade', have been shown previously to be complex heritable traits with a polygenic component. Additional pain-related phenotypes capturing aspects of an individual's overall sensitivity to experiencing and reporting chronic pain have also been suggested as a focus for investigation. We made use of a measure of the number of sites of chronic pain in individuals within the UK general population. This measure, termed Multisite Chronic Pain (MCP), is a complex trait and its genetic architecture has not previously been investigated. To address this, we carried out a large-scale genome-wide association study (GWAS) of MCP in ~380,000 UK Biobank participants. Our findings were consistent with MCP having a significant polygenic component, with a Single Nucleotide Polymorphism (SNP) heritability of 10.2%. In total 76 independent lead SNPs at 39 risk loci were associated with MCP. Additional gene-level association analyses identified neurogenesis, synaptic plasticity, nervous system development, cell-cycle progression and apoptosis genes as enriched for genetic association with MCP. Genetic correlations were observed between MCP and a range of psychiatric, autoimmune and anthropometric traits, including major depressive disorder (MDD), asthma and Body Mass Index (BMI). Furthermore, in Mendelian randomisation (MR) analyses a causal effect of MCP on MDD was observed. Additionally, a polygenic risk score (PRS) for MCP was found to significantly predict chronic widespread pain (pain all over the body), indicating the existence of genetic variants contributing to both of these pain phenotypes. Overall, our findings support the proposition that chronic pain involves a strong nervous system component with implications for our understanding of the physiology of chronic pain. These discoveries may also inform the future development of novel treatment approaches.
We have conducted a Galactic plane survey of methanol masers at 6668 MHz using a seven-beam receiver on the Parkes telescope. Here we present results from the first part, which provides sensitive ...unbiased coverage of a large region around the Galactic Centre. Details are given for 183 methanol maser sites in the longitude range 345° through the Galactic Centre to 6°. Within 6° of the Galactic Centre, we found 88 maser sites, of which more than half (48) are new discoveries. The masers are confined to a narrow Galactic latitude range, indicative of many sources at the Galactic Centre distance and beyond, and confined to a thin disc population; there is no high-latitude population that might be ascribed to the Galactic bulge. Within 2° of the Galactic Centre the maser velocities all lie between −60 and +77 km s−1, a range much smaller than the 540 km s−1 range observed in CO. Elsewhere, the maser with highest positive velocity (+107 km s−1) occurs, surprisingly, near longitude 355° and is probably attributable to the Galactic bar. The maser with the most negative velocity (−127 km s−1) is near longitude 346°, within the longitude–velocity locus of the near side of the ‘3-kpc arm’. It has the most extreme velocity of a clear population of masers associated with the near and far sides of the 3-kpc arm. Closer to the Galactic Centre the maser space density is generally low, except within 0.25 kpc of the Galactic Centre itself, the ‘Galactic Centre zone’, where it is 50 times higher, which is hinted at by the longitude distribution, and confirmed by the unusual velocities.
The 6-GHz multibeam maser survey – I. Techniques Green, J. A.; Caswell, J. L.; Fuller, G. A. ...
Monthly notices of the Royal Astronomical Society,
January 2009, Letnik:
392, Številka:
2
Journal Article
Recenzirano
Odprti dostop
A new seven-beam 6–7 GHz receiver has been built to survey the Galaxy and the Magellanic Clouds for newly forming high-mass stars that are pinpointed by strong methanol maser emission at 6668 MHz. ...The receiver was jointly constructed by Jodrell Bank Observatory (JBO) and the Australia Telescope National Facility (ATNF) and allows simultaneous coverage at 6668 and 6035 MHz. It was successfully commissioned at Parkes in 2006 January and is now being used to conduct the Parkes–Jodrell multibeam maser survey of the Milky Way. This will be the first systematic survey of the entire Galactic plane for masers of not only 6668-MHz methanol, but also 6035-MHz excited-state hydroxyl. The survey is two orders of magnitude faster than most previous systematic surveys and has an rms noise level of ∼0.17 Jy. This paper describes the observational strategy, techniques and reduction procedures of the Galactic and Magellanic Cloud surveys, together with deeper, pointed, follow-up observations and complementary observations with other instruments. It also includes an estimate of the survey detection efficiency. The 111 d of observations with the Parkes telescope have so far yielded >800 methanol sources, of which ∼350 are new discoveries. The whole project will provide the first comprehensive Galaxy-wide catalogue of 6668-MHz and 6035-MHz masers.
Transient ischemic attack (TIA) patients are at high risk of recurrent vascular events; timely management can reduce that risk by 70%. The Protocol-guided Rapid Evaluation of Veterans Experiencing ...New Transient Neurological Symptoms (PREVENT) developed, implemented, and evaluated a TIA quality improvement (QI) intervention aligned with Learning Healthcare System principles.
This stepped-wedge trial developed, implemented and evaluated a provider-facing, multi-component intervention to improve TIA care at six facilities. The unit of analysis was the medical center. The intervention was developed based on benchmarking data, staff interviews, literature, and electronic quality measures and included: performance data, clinical protocols, professional education, electronic health record tools, and QI support. The effectiveness outcome was the without-fail rate: the proportion of patients who receive all processes of care for which they are eligible among seven processes. The implementation outcomes were the number of implementation activities completed and final team organization level. The intervention effects on the without-fail rate were analyzed using generalized mixed-effects models with multilevel hierarchical random effects. Mixed methods were used to assess implementation, user satisfaction, and sustainability.
PREVENT advanced three aspects of a Learning Healthcare System. Learning from Data: teams examined and interacted with their performance data to explore hypotheses, plan QI activities, and evaluate change over time. Learning from Each Other: Teams participated in monthly virtual collaborative calls. Sharing Best Practices: Teams shared tools and best practices. The approach used to design and implement PREVENT may be generalizable to other clinical conditions where time-sensitive care spans clinical settings and medical disciplines.
clinicaltrials.gov: NCT02769338 May 11, 2016.
Aim
Many women do not attend recommended glucose testing following a pregnancy affected by gestational diabetes (GDM). We aimed to synthesize the literature regarding the views and experiences of ...women with a history of GDM on postpartum glucose testing, focusing on barriers and facilitators to attendance.
Methods
We systematically identified qualitative studies that examine women's experiences following GDM relating to glucose testing (diabetes screening) or experience of interventions to promote uptake of testing. We conducted a thematic synthesis to develop descriptive and then analytical themes, then developed recommendations to increase uptake based on the findings. We evaluated the quality of each study and the confidence that we had in the recommendations using published checklists.
Results
We included 16 articles after screening 23 160 citations and 129 full texts. We identified four themes of influences relating to the healthcare system and personal factors that affected both ability and motivation to attend: relationship with health care, logistics of appointments and tests, family‐related practicalities and concern about diabetes. We developed 10 recommendations addressing diabetes risk information and education, and changes to healthcare systems to promote increased attendance at screening in this population, most with high or moderate confidence.
Conclusions
We have identified a need to improve women's understanding about Type 2 diabetes and GDM, and to adjust healthcare provision during and after pregnancy to decrease barriers and increase motivation for testing. Encouraging higher uptake by incorporating these recommendations into practice will enable earlier management of diabetes and improve long‐term outcomes.
What's new?
There is a need to increase the number of women attending glucose testing after gestational diabetes. Higher attendance will enable earlier diagnosis and management of diabetes and improve long‐term outcomes.
This is the first qualitative review focusing on barriers and facilitators to screening attendance.
We found that factors could affect either mothers’ motivation or opportunity to attend.
Some influences related to the healthcare system (relationship with health care and logistics of the appointment and test), whereas others were personal (concern about diabetes and family‐related practicalities).
We developed 10 recommendations to increase screening attendance based on the barriers and facilitators identified.
A decrease in dopamine D2 receptor (D2R) binding in the striatum is one of the most common findings in disorders that involve a dysregulation of motivation, including obesity, addiction and attention ...deficit hyperactivity disorder. As disruption of D2R signaling in the ventral striatum--including the nucleus accumbens (NAc)--impairs motivation, we sought to determine whether potentiating postsynaptic D2R-dependent signaling in the NAc would improve motivation. In this study, we used a viral vector strategy to overexpress postsynaptic D2Rs in either the NAc or the dorsal striatum. We investigated the effects of D2R overexpression on instrumental learning, willingness to work, use of reward value representations and modulation of motivation by reward associated cues. Overexpression of postsynaptic D2R in the NAc selectively increased motivation without altering consummatory behavior, the representation of the value of the reinforcer, or the capacity to use reward associated cues in flexible ways. In contrast, D2R overexpression in the dorsal striatum did not alter performance on any of the tasks. Thus, consistent with numerous studies showing that reduced D2R signaling impairs motivated behavior, our data show that postsynaptic D2R overexpression in the NAc specifically increases an animal's willingness to expend effort to obtain a goal. Taken together, these results provide insight into the potential impact of future therapeutic strategies that enhance D2R signaling in the NAc.
In the quantum version of a Trojan-horse attack, photons are injected into the optical modules of a quantum key distribution system in an attempt to read information direct from the encoding devices. ...To stop the Trojan photons, the use of passive optical components has been suggested. However, to date, there is no quantitative bound that specifies such components in relation to the security of the system. Here, we turn the Trojan-horse attack into an information leakage problem. This allows us to quantify the system security and relate it to the specification of the optical elements. The analysis is supported by the experimental characterization, within the operation regime, of reflectivity and transmission of the optical components most relevant to security.
Water scarcity is a rapidly growing concern around the globe, but little is known about how it has developed over time. This study provides a first assessment of continuous sub-national trajectories ...of blue water consumption, renewable freshwater availability, and water scarcity for the entire 20
century. Water scarcity is analysed using the fundamental concepts of shortage (impacts due to low availability per capita) and stress (impacts due to high consumption relative to availability) which indicate difficulties in satisfying the needs of a population and overuse of resources respectively. While water consumption increased fourfold within the study period, the population under water scarcity increased from 0.24 billion (14% of global population) in the 1900s to 3.8 billion (58%) in the 2000s. Nearly all sub-national trajectories show an increasing trend in water scarcity. The concept of scarcity trajectory archetypes and shapes is introduced to characterize the historical development of water scarcity and suggest measures for alleviating water scarcity and increasing sustainability. Linking the scarcity trajectories to other datasets may help further deepen understanding of how trajectories relate to historical and future drivers, and hence help tackle these evolving challenges.
ABSTRACT
Near IR spectroscopic reverberation of Active Galactic Nuclei (AGN) potentially allows the infrared (IR) broad line region (BLR) to be reverberated alongside the disc and dust continua, ...while the spectra can also reveal details of dust astro-chemistry. Here, we describe results of a short pilot study (17 near-IR spectra over a 183 d period) for Mrk 509. The spectra give a luminosity-weighted dust radius of 〈Rd,lum〉 = 186 ± 4 light-days for blackbody (large grain dust), consistent with previous (photometric) reverberation campaigns, whereas carbon and silicate dust give much larger radii. We develop a method of calibrating spectral data in objects where the narrow lines are extended beyond the slit width. We demonstrate this by showing our resultant photometric band light curves are consistent with previous results, with a hot dust lag at >40 d in the K band, clearly different from the accretion disc response at <20 d in the z band. We place this limit of 40 d by demonstrating clearly that the modest variability that we do detect in the H and K band does not reverberate on time-scales of less than 40 d. We also extract the Pa β line light curve, and find a lag which is consistent with the optical BLR H β line of ∼70–90 d. This is important as direct imaging of the near-IR BLR is now possible in a few objects, so we need to understand its relation to the better studied optical BLR.
Aims
After gestational diabetes, many women exhibit behaviours that increase their risk of developing Type 2 diabetes. We aimed to systematically synthesize the literature that focuses on the views ...of women with a history of gestational diabetes on reducing their risk of developing diabetes postpartum through lifestyle and behaviour changes.
Methods
We identified qualitative studies that examined the views of women with a history of gestational diabetes towards healthy eating and physical activity, Type 2 diabetes risk management or their experience of a diabetes prevention programme, and conducted a thematic synthesis to develop descriptive and then analytical themes. We also evaluated the quality of each study and the confidence that we had in our findings.
Results
We included 21 articles after screening 23 160 citations and 129 full texts. We identified six themes of interacting influences on postpartum behaviour: role as mother and priorities; social support; demands of life; personal preferences and experiences; risk perception and information; and finances and resources (plus preferred format of interventions). These factors inhibited many women from addressing their own health, while they motivated others to persevere. We also developed 20 recommendations, most with high or moderate confidence, for effective promotion of healthy lifestyles in this population.
Conclusions
Many factors hinder healthy lifestyles after gestational diabetes, yet how women interpret them can motivate or prevent changes that reduce diabetes risk. As our recommendations emphasize, women's experiences and needs should be considered when designing strategies to promote healthier lifestyles in this population.
What's new?
After having had gestational diabetes, many women do not adopt healthy lifestyles that would reduce their risk of developing Type 2 diabetes.
We found, in summary, that women identified themselves primarily as mothers who prioritized their family above themselves, and needed resources, time, energy, information and support to encourage healthy diets and levels of activity.
Based on these findings, we developed 20 recommendations for effectively promoting healthy lifestyle in this population. These recommendations highlight the need for interventions to be centred on women's needs and experiences.
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