Identifying risk factors and protective factors for venous leg ulcer recurrence using a theoretical approach : a longitudinal study

Background The high recurrence rate of chronic venous leg ulcers has a significant impact on an individual’s quality of life and healthcare costs. Objectives This study aimed to identify risk and protective factors for recurrence of venous leg ulcers using a theoretical approach by applying a framework of self and family management of chronic conditions to underpin the study. Design Secondary analysis of combined data collected from three previous prospective longitudinal studies. Setting The contributing studies’ participants were recruited from two metropolitan hospital outpatient wound clinics and three community-based wound clinics. Participants Data were available on a sample of 250 adults, with a leg ulcer of primarily venous aetiology, who were followed after ulcer healing for a median follow-up time of 17 months after healing (range: 3 to 36 months). Methods Data from the three studies were combined. The original participant data were collected through medical records and self-reported questionnaires upon healing and every 3 months thereafter. A Cox proportion-hazards regression analysis was undertaken to determine the influential factors on leg ulcer recurrence based on the proposed conceptual framework. Results The median time to recurrence was 42 weeks (95% CI 31.9–52.0), with an incidence of 22% (54 of 250 participants) recurrence within three months of healing, 39% (91 of 235 participants) for those who were followed for six months, 57% (111 of 193) by 12 months, 73% (53 of 72) by two years and 78% (41 of 52) of those who were followed up for three years. A Cox proportional-hazards regression model revealed that the risk factors for recurrence included a history of deep vein thrombosis (HR 1.7, 95% CI 1.07–2.67, p=0.024), history of multiple previous leg ulcers (HR 4.4, 95% CI 1.84–10.5, p=0.001), and longer duration (in weeks) of previous ulcer (HR 1.01, 95% CI 1.003–1.01, p<0.001); while the protective factors were elevating legs for at least 30 minutes per day (HR 0.33, 95% CI 0.19–0.56, p<0.001), higher levels of self-efficacy (HR 0.95, 95% CI 0.92–0.99, p=0.016), and walking around for at least three hours/day (HR 0.66, 95% CI 0.44–0.98, p=0.040). Conclusions Results from this study provide a comprehensive examination of risk and protective factors associated with leg ulcer recurrence based on the chronic disease self and family management framework. These results in turn provide essential steps towards developing and testing interventions to promote optimal prevention strategies for venous leg ulcer recurrence.

Leadership to support quality improvement in Vietnamese higher education

The impetus for the study reported in this paper is the Higher Education (HE) reform agenda outlined by the Vietnamese Ministry of Education and Training (MOET). The paper reports on phase one of a mixed method research; a quantitative approach using the Multifactor Leadership Questionnaire (MLQ) to investigate the Vietnamese HE leaders’ leadership styles. The MLQ survey was administered to approximately 190 senior managers in State HE institutions in Mekong Delta region in Vietnam (nine of colleges). The psychometrics of the MLQ for the Vietnamese sample confirmed the reliability and validity of the instrument with a Cronbach’s alpha of 0.779. A CFA was conducted and all factor structures were stable and consistent. The demographic variables were used to analyse patterns of leadership behaviours by the different sub-groups. The findings suggest that leaders who have different educational background and different gender in Mekong Delta region, Vietnam do not differ significantly in their perceptions about leadership factors.

The implicit structure of positive characteristics

The implicit structure of positive character traits was examined in two studies of 190 and 100 undergraduates. Participants judged the pairwise covariation or semantic similarity of 42 positive characteristics using a sorting or a rating task. Characteristics were drawn from a new classification of strengths and virtues, the Five-Factor Model, and a taxonomy of values. Participants showed consistent patterns of perceived association among the characteristics across the study conditions. Multidimensional scaling yielded three consistent dimensions underlying these judgments (“warmth vs. self-control,” “vivacity vs. decency,” and “wisdom vs. power”). Cluster analyses yielded six consistent groupings—“self-control,” “love,” “wisdom,” “drive,” “vivacity,” and “collaboration”—that corresponded only moderately to the virtue classification. All three taxonomies were systematically related to this implicit structure, but none captured it satisfactorily on its own. Revisions to positive psychology’s classification of strengths are proposed.

Genetic characterisation and structural analysis of the O-specific polysaccharide of Yersinia pseudotuberculosis serotype O:1c

Many, but not all, of the current 21 serotypes of Yersinia pseudotuberculosis have been investigated with regard to the chemical structures of their O-specific polysaccharide (OPS) and the genetic basis of their biosynthesis. Completion of the genetics and structures of the remaining serotypes will enhance our understanding of the emerging relationship between genetics and structures within this species. Here, we present a structural and genetic analysis of the Y. pseudotuberculosis serotype O:1c OPS. Our results showed that this OPS has the same backbone as Y. pseudotuberculosis O:2b, but with a 3,6-dideoxy-D-ribo-hexofuranose (paratofuranose, Parf) side-branch instead of a 3,6-dideoxy-D-xylo-hexopyranose (abequopyranose, Abep). The 3'-end of the gene cluster is the same as for O:2b and has the genes for synthesis of the backbone and for processing the completed repeat unit. The 5'-end of the cluster consists of the same genes as O:1b for synthesis of Parf and a related gene for its transfer to the repeating unit backbone.

Obstacle detection for a mining vehicle using a 2D laser

This paper discusses a number of key issues for the development of robust obstacle detection systems for autonomous mining vehicles. Strategies for obstacle detection are described and an overview of the state-of-the-art in obstacle detection for outdoor autonomous vehicles using lasers is presented, with their applicability to the mining environment noted. The development of an obstacle detection system for a mining vehicle is then detailed. This system uses a 2D laser scanner as the prime sensor and combines dead-reckoning data with laser data to create local terrain maps. The slope of the terrain maps is then used to detect potential obstacles.

Environmental contributions to childhood cancers

Recent increases in incidence of childhood cancers cannot be explained by genetic factors. Identifying the environmental risk factors that may explain increases in cancer incidence is an important step to reduce the overall burden of disease. The risk factors for which the most evidence exists include ionising radiation, ultraviolet radiation and chemicals such as benzene and pesticides, biological agents as well as parental smoking and parental substance use. Regarding the link between exposure to non-ionising radiation and development of cancer, the evidence was limited. Maternal vitamin supplementation may reduce the risk of cancer in offspring. Environmental exposures encountered during development and early childhood may be even more important contributors to the risk of cancer than exposures in adulthood and the early developmental period presents an important opportunity for cancer prevention.

A practical guide to terminology for kimberlite facies: A systematic progression from descriptive to genetic, including a pocket guide

Kimberlite terminology remains problematic because both descriptive and genetic terms are mixed together in most existing terminology schemes. In addition, many terms used in existing kimberlite terminology schemes are not used in mainstream volcanology, even though kimberlite bodies are commonly the remains of kimberlite volcanic vents and edifices. We build on our own recently published approach to kimberlite facies terminology, involving a systematic progression from descriptive to genetic. The scheme can be used for both coherent kimberlite (i.e. kimberlite that was emplaced without undergoing any fragmentation processes and therefore preserving coherent igneous textures) and fragmental kimberlites. The approach involves documentation of components, textures and assessing the degree and effects of alteration on both components and original emplacement textures. This allows a purely descriptive composite component, textural and compositional petrological rock or deposit name to be constructed first, free of any biases about emplacement setting and processes. Then important facies features such as depositional structures, contact relationships and setting are assessed, leading to a composite descriptive and genetic name for the facies or rock unit that summarises key descriptive characteristics, emplacement processes and setting. Flow charts summarising the key steps in developing a progressive descriptive to genetic terminology are provided for both coherent and fragmental facies/deposits/rock units. These can be copied and used in the field, or in conjunction with field (e.g. drill core observations) and petrographic data. Because the approach depends heavily on field scale observations, characteristics and process interpretations, only the first descriptive part is appropriate where only petrographic observations are being made. Where field scale observations are available the progression from developing descriptive to interpretative terminology can be used, especially where some petrographic data also becomes available.

Regulating ride-sharing in the peer economy

The rise of the peer economy poses complex new regulatory challenges for policy-makers. The peer economy, typified by services like Uber and AirBnB, promises substantial productivity gains through the more efficient use of existing resources and a marked reduction in regulatory overheads. These services are rapidly disrupting existing established markets, but the regulatory trade-offs they present are difficult to evaluate. In this paper, we examine the peer economy through the context of ride-sharing and the ongoing struggle over regulatory legitimacy between the taxi industry and new entrants Uber and Lyft. We first sketch the outlines of ride-sharing as a complex regulatory problem, showing how questions of efficiency are necessarily bound up in questions about levels of service, controls over pricing, and different approaches to setting, upholding, and enforcing standards. We outline the need for data-driven policy to understand the way that algorithmic systems work and what effects these might have in the medium to long term on measures of service quality, safety, labour relations, and equality. Finally, we discuss how the competition for legitimacy is not primarily being fought on utilitarian grounds, but is instead carried out within the context of a heated ideological battle between different conceptions of the role of the state and private firms as regulators. We ultimately argue that the key to understanding these regulatory challenges is to develop better conceptual models of the governance of complex systems by private actors and the available methods the state has of influencing their actions. These struggles are not, as is often thought, struggles between regulated and unregulated systems. The key to understanding these regulatory challenges is to better understand the important regulatory work carried out by powerful, centralised private firms – both the incumbents of existing markets and the disruptive network operators in the peer-economy.

A multi-criteria analysis approach for ranking and selection of microorganisms for the production of oils for biodiesel production

Oleaginous microorganisms have potential to be used to produce oils as alternative feedstock for biodiesel production. Microalgae (Chlorella protothecoides and Chlorella zofingiensis), yeasts (Cryptococcus albidus and Rhodotorula mucilaginosa), and fungi (Aspergillus oryzae and Mucor plumbeus) were investigated for their ability to produce oil from glucose, xylose and glycerol. Multi-criteria analysis (MCA) using analytic hierarchy process (AHP) and preference ranking organization method for the enrichment of evaluations (PROMETHEE) with graphical analysis for interactive aid (GAIA), was used to rank and select the preferred microorganisms for oil production for biodiesel application. This was based on a number of criteria viz., oil concentration, content, production rate and yield, substrate consumption rate, fatty acids composition, biomass harvesting and nutrient costs. PROMETHEE selected A. oryzae, M. plumbeus and R. mucilaginosa as the most prospective species for oil production. However, further analysis by GAIA Webs identified A. oryzae and M. plumbeus as the best performing microorganisms.

Is there a higher genetic load of susceptibility loci in familial ankylosing spondylitis?

Objective Several genetic risk variants for ankylosing spondylitis (AS) have been identified in genome-wide association studies. Our objective was to examine whether familial AS cases have a higher genetic load of these susceptibility variants. Methods Overall, 502 AS patients were examined, consisting of 312 patients who had first-degree relatives (FDRs) with AS (familial) and 190 patients who had no FDRs with AS or spondylarthritis (sporadic). All patients and affected FDRs fulfilled the modified New York criteria for AS. The patients were recruited from 2 US cohorts (the North American Spondylitis Consortium and the Prospective Study of Outcomes in Ankylosing Spondylitis) and from the UK-Oxford cohort. The frequencies of AS susceptibility loci in IL-23R, IL1R2, ANTXR2, ERAP-1, 2 intergenic regions on chromosomes 2p15 and 21q22, and HLA-B27 status as determined by the tag single-nucleotide polymorphism (SNP) rs4349859 were compared between familial and sporadic cases of AS. Association between SNPs and multiplex status was assessed by logistic regression controlling for sibship size. Results HLA-B27 was significantly more prevalent in familial than sporadic cases of AS (odds ratio 4.44 [95% confidence interval 2.06, 9.55], P = 0.0001). Furthermore, the AS risk allele at chromosome 21q22 intergenic region showed a trend toward higher frequency in the multiplex cases (P = 0.08). The frequency of the other AS risk variants did not differ significantly between familial and sporadic cases, either individually or combined. Conclusion HLA-B27 is more prevalent in familial than sporadic cases of AS, demonstrating higher familial aggregation of AS in patients with HLA-B27 positivity. The frequency of the recently described non-major histocompatibility complex susceptibility loci is not markedly different between the sporadic and familial cases of AS.

Heterologous promoter recognition leading to high-level expression of cloned foreign genes in Bombyx mori cell lines and larvae

The baculovirus expression system using the Autographa californica nuclear polyhedrosis virus (AcNPV) has been extensively utilized for high-level expression of cloned foreign genes, driven by the strong viral promoters of polyhedrin (polh) and p10 encoding genes. A parallel system using Bombyx mori nuclear polyhedrosis virus (BmNPV) is much less exploited because the choice and variety of BmNPV-based transfer vectors are limited. Using a transient expression assay, we have demonstrated here that the heterologous promoters of the very late genes polh and p10 from AcNPV function as efficiently in BmN cells as the BmNPV promoters. The location of the cloned foreign gene with respect to the promoter sequences was critical for achieving the highest levels of expression, following the order +35 > +1 > -3 > -8 nucleotides (nt) with respect to the polh or p10 start codons. We have successfully generated recombinant BmNPV harboring AcNPV promoters by homeologous recombination between AcNPV-based transfer vectors and BmNPV genomic DNA. Infection of BmN cell lines with recombinant BmNPV showed a temporal expression pattern, reaching very high levels in 60-72 h post infection. The recombinant BmNPV harboring the firefly luciferase-encoding gene under the control of AcNPV polh or p10 promoters, on infection of the silkworm larvae led to the synthesis of large quantities of luciferase. Such larvae emanated significant luminiscence instantaneously on administration of the substrate luciferin resulting in 'glowing silkworms'. The virus-infected larvae continued to glow for several hours and revealed the most abundant distribution of virus in the fat bodies. In larval expression also, the highest levels were achieved when the reporter gene was located at +35 nt of the polh.

Is that all there is? The limitations of global/local, PISA, and the dilemma of transnational curriculum research

Sob o rótulo da globalização, as ciências humanas e sociais têm sido forçadas a rever seu pensamento para encontrar novas maneiras de falar sobre as situações de mudança ao nosso redor e para reorientar-se conceitualmente em um aparente ‘mundo sem fronteiras’. Este artigo analisa algumas dessas formas, sugerindo que a pesquisa em currículo transnacional como tarefa, como talvez inclusiva de algo para além dos estudos curriculares como subárea, tem preocupações, pontos de entrada e horizontes de promulgação amplos, inconstantes, imprevisíveis, que levantam uma série de questões e considerações éticas que exigem maior compromisso nos espaços em que as fronteiras percebidas forem transgredidas no ato da investigação. Usando os relatórios sobre os resultados do PISA como disparador intelectual, este artigo discute quatro questões que surgem no ato investigativo em currículo transnacional: a comparação como princípio de produção de conhecimento; as estratégias de agrupamento onto-teo-filosóficas e a delimitação da ética; o retorno do sujeito centrado, humanista, racional e as críticas a esse sujeito inspirado no Iluminismo; as questões relativas à causalidade, ou seja, como os processos de atribuição são forjados e que tipos de ‘legitimação via procedimento’ operam na crítica social. Em vez de sugerir uma nova ordem, este artigo busca um questionamento mais profundo dos repetitivos pressupostos ocidentalistas.

Mechanism of coupling periodate-oxidized nucleosides to proteins

This paper describes a mechanism of coupling periodate-oxidized nucleosides to proteins. Each of the dialdehyde groups of a periodate-oxidized nucleoside is shown to couple to lysine residues on different protein molecules through Schiff bases, thereby cross-linking different protein molecules, forming a polymer. This is in contrast to the previous model in which nucleosides were suggested to couple to proteins through a morpholine structure. The cross-linked structure of the nucleoside-antigen, significantly different when compared to the native protein, may affect the specificity and the efficiency of antibody production.

Basic Needs and Much More With One Kilowatt Per Capita

Conventional thinkin g holds that increased energy consumption is a prerequisite for economic and social development. This belief, together With the prospect of dwindling global petroleum supplies and the high costs of expanding energy supply generally, lead many to believe that it is not feasible to improve living standards substantially in the developing countries. But by shifting to high-quality energy carriers and by exploiting cost-effective opportunities for more efficient energy use, it would be possible to satisfy basic human needs and to provide considerable further improvements in living standards without significantly increasing per-capita energy use above the present level.