A Diagnostic System Using Broad Categories With Clinicaly Relevant Specifiers: Lessons for ICD-10

A diagnostic system for ICD-11 is proposed which commences with broad reorganization and simplification of the current categories and the use of clinically relevant specifiers. Such changes have implications for the positioning of diagnostic groups and lead to a range of possibilities for improving terminology and the juxtaposition of individual conditions. The development of ICD-11 provides the first opportunity in almost two decades to improve the validity and reliability of the international classification system. Widespread change in broad categories and criteria cannot be justified by research that has emerged since the last revision. It would also be disruptive to clinical practice and might devalue past research work. However, the case for reorganization of the categories is stronger and has recently been made by an eminent international group of researchers (Andrews et al., 2009). A simpler, interlinked diagnostic system is proposed here which is likely to have fewer categories than its predecessor. There are major advantages of such a system for clinical practice and research and it could also produce much needed simplification for primary care (Gask et al., 2008) and the developing world (Wig, 1990; Kohn et al., 2004).

Risk reducing mastectomy: outcomes in 10 European centres

Background: Increasingly women at high risk of breast cancer are opting for risk reducing surgery. The aim of this study was to assess the effectiveness of this approach in women at high risk in both carriers and non-carriers of BRCA1/2.

A GREM1 gene variant associates with diabetic nephropathy

Gremlin, a cell growth and differentiation factor, promotes the development of diabetic nephropathy in animal models, but whether GREM1 gene variants associate with diabetic nephropathy is unknown. We comprehensively screened the 5' upstream region (including the predicted promoter), all exons, intron-exon boundaries, complete untranslated regions, and the 3' region downstream of the GREM1 gene. We identified 31 unique variants, including 24 with a minor allele frequency exceeding 5%, and 9 haplotype-tagging single nucleotide polymorphisms (htSNPs). We selected one additional variant that we predicted to alter transcription factor binding. We genotyped 709 individuals with type 1 diabetes of whom 267 had nephropathy (cases) and 442 had no evidence of kidney disease (controls). Three individual SNPs significantly associated with nephropathy at the 5% level, and two remained significant after adjustment for multiple testing. Subsequently, we genotyped a replicate population comprising 597 cases and 502 controls: this population supported an association with one of the SNPs (rs1129456; P = 0.0003). Combined analysis, adjusted for recruitment center (n = 8), suggested that the T allele conferred greater odds of nephropathy (OR 1.69; 95% CI 1.36 to 2.11). In summary, the GREM1 variant rs1129456 associates with diabetic nephropathy, perhaps explaining some of the genetic susceptibility to this condition.

Observation of K-Shell Soft X Ray Emission of Nitrogen Irradiated by XUV-Free Electron Laser FLASH at Intensities Greater than 10(16) W/cm(2)

In the past few years, the development of light sources of the 4(th) generation, namely XUV/X-ray Free Electron Lasers provides to the scientific community outstanding tools to investigate matter under extreme conditions never obtained in laboratories so far. As theory is at its infancy, the analysis of matter via the self-emission of the target is of central importance. The characterization of such dense matter is possible if photons can escape the medium. As the absorption of K-shell X-ray transitions is minimal, it plays a key role in this study. We report here the first successful observation of K-shell emission of Nitrogen at 430 eV using an XUV-Free Electron Laser to irradiate solid Boron Nitride targets under exceptional conditions: photon energy of 92 eV, pulse duration of similar to 20 fs, micro focusing leading to intensities larger than 10(16) W/cm(2). Using a Bragg crystal of THM coupled to a CCD, we resolved K-shell line emission from different charge states. We demonstrate that the spectroscopic data allow characterization of electron heating processes when X-ray radiation is interacting with solid matter. As energy transport is non-trivial because the light source is monochromatic, these results have an important impact on the theory. (C) 2011 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim

Development and characterization of 10 polymorphic microsatellite loci for the blue shark, Prionace glauca, and their cross shark-species amplification.

Ten polymorphic nuclear microsatellite loci were developed from a microsatellite enriched genomic library of the blue shark, Prionace glauca. The utility of these markers for genetic studies of this globally distributed, heavily exploited, oceanic predator was assessed by screening 120 specimens sampled from six locations throughout the species’ range. Both moderately and highly polymorphic marker loci were identified. Three to 35 alleles were found to be segregating per locus (mean 10.1) with observed heterozygosities ranging from 24 to 91%. Evaluation of the cross-species amplification of these markers across 18 additional shark species indicates that these microsatellites are potentially useful for genetic studies of other species of conservation concern.

Conditions for efficient and stable ion acceleration by moderate circularly polarized laser pulses at intensities of 10(20) W/cm(2)

Conditions for efficient and stable ion radiation pressure acceleration (RPA) from thin foils by circularly polarized laser pulses at moderate intensities are theoretically and numerically investigated. It is found that the unavoidable decompression of the co-moving electron layer in Light-Sail RPA leads to a change of the local electrostatic field from a

Volumetric properties and enthalpies of solution of alcohols CkH2k+1OH (k = 1, 2, 6) in 1-methyl-3-alkylimidazolium bis(trifluoromethylsulfonyl)imide {[C1CnIm][NTf2] n = 2, 4, 6, 8, 10} ionic liquids

We present a study on the effect of the alkyl chain length of the imidazolium ring in 1-alkyl-3-methylimidazolium bis(trifluoromethylsulfonyl)imide ionic liquids, [C1CnIm][NTf2] (n = 2 to 10), on the mixing properties of (ionic liquid + alcohol) mixtures (enthalpy and volume). We have measured small excess molar volumes with highly asymmetric curves as a function of mole fraction composition (S-shape) with more negative values in the alcohol-rich regions. The excess molar volumes increase with the increase of the alkyl-chain length of the imidazolium cation of the ionic liquid. The values of the partial molar excess enthalpy and the enthalpy of mixing are positive and, for the case of methanol, do not vary monotonously with the length of the alkyl side-chain of the cation on the ionic liquid – increasing from n = 2 to 6 and then decreasing from n = 8. This non-monotonous variation is explained by a more favourable interaction of methanol with the cation head group of the ionic liquid for alkyl chains longer than eight carbon atoms. It is also observed that the mixing is less favourable for the smaller alcohols, the enthalpy of mixing decreasing to less positive values as the alkyl chain of the alcohol increases. Based on the data from this work and on the knowledge of the vapour pressure of {[C1CnIm][NTf2] + alcohol} binary mixtures at T = 298 K reported in the literature, the excess Gibbs free energy, excess enthalpy and excess entropy could be then calculated and it was observed that these mixtures behave like the ones constituted by a non-associating and a non-polar component, with its solution behaviour being determined by the enthalpy.

UNISTEP (University Students Exercise and Physical Activity) Study: A Pilot Study of the Effects of Accumulating 10,000 Steps on Health and Fitness Among University Students.

BACKGROUND: Recent public health initiatives have promoted accumulating 10,000 steps per day. Little previous research has evaluated its effects in young adults. The aim of this study was to determine the effects of taking 10,000 steps per day on fitness and cardiovascular risk factors in sedentary university students. METHODS: Healthy, sedentary students (mean age 21.16 ± SD 6.17) were randomly allocated to take 10,000 steps per day or to a control group who maintained their habitual activity. Members of the 10,000 step group wore a pedometer and reported daily step count in a diary. Outcome measurements (20-meter multistage shuttle run, BMI, and blood pressure) were measured before and after 6 weeks. RESULTS: There were no significant differences between the groups at baseline. After 6 weeks, the 10,000 steps group were taking significantly more steps (8824.1 ± SD 5379.3 vs. 12635.9 ± SD 6851.3; P = .03).No changes were observed in fitness, or BMI (P > .05). Significant reductions in blood pressure (P = .04) in the 10,000 step group. CONCLUSIONS: A daily target of 10,000 steps may be an appropriate intervention in sedentary university students to increase their physical activity levels. The positive health benefits of simple everyday physical activity should be promoted among health professionals.

Human Rights in the Courts of Northern Ireland 2009-10

This article surveys and comments on the decisions issued on human rights points by courts in Northern Ireland during the legal year 2009-2010.