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For rare blood groups the recruitment of donor relatives, for example siblings, is expected to be effective, since the probability of a similar rare blood group is likely. However, the likelihood differs between blood groups and is not commonly available. This paper provides a unified mathematical formulation to calculate such likelihoods. From a mathematical and probabilistic point of view, it is shown that these likelihoods can be obtained from the computation of a stationary genotype distribution. This, in turn, can be brought down to a system of quadratic stochastic operators. A generic mathematical approach is presented which directly leads to a stationary genotype distribution for arbitrary blood groups. The approach enables an exact computation for the effectiveness of recruiting next of kin for blood donorship. Next to an illustration of computations for ‘standard’ ABO and Rhesus-D blood groups, it is particularly illustrated for the extended Rhesus blood group system. Also other applications requiring next of kin blood group associations can be solved directly by using the unified mathematical formulation.
We previously found that guar gum (GG) and chickpea flour (CPF) added to flatbread wheat flour lowered postprandial blood glucose (PPG) and insulin responses dose dependently. However, rates of glucose influx cannot be determined from PPG, which integrates rates of influx, tissue disposal and hepatic glucose production. The objective was to quantify rates of glucose influx and related fluxes as contributors to changes in PPG with GG and CPF additions to wheat-based flatbreads. In a randomised cross-over design, twelve healthy males consumed each of three different 13C-enriched meals: control flatbreads (C), or C incorporating 15 % CPF with either 2 % (GG2) or 4 % (GG4) GG. A dual isotope technique was used to determine the time to reach 50 % absorption of exogenous glucose (T50 %abs, primary objective), rate of appearance of exogenous glucose (RaE), rate of appearance of total glucose (RaT), endogenous glucose production (EGP) and rate of disappearance of total glucose (RdT). Additional exploratory outcomes included PPG, insulin, glucose-dependent insulinotropic peptide and glucagon-like peptide 1, which were additionally measured over 4 h. Compared with C, GG2 and GG4 had no significant effect on T50 %abs. However, GG4 significantly reduced 4-h AUC values for RaE, RaT, RdT and EGP, by 11, 14, 14 and 64 %, respectively, whereas GG2 showed minor effects. Effect sizes over 2 and 4 h were similar except for significantly greater reduction in EGP for GG4 at 2 h. In conclusion, a soluble fibre mix added to flatbreads only slightly reduced rates of glucose influx, but more substantially affected rates of postprandial disposal and hepatic glucose production.
Developmental origins of health and disease (DOHaD) is the study of how the early life environment can impact the risk of chronic diseases from childhood to adulthood and the mechanisms involved. Epigenetic modifications such as DNA methylation, histone modifications and non-coding RNAs are involved in mediating how early life environment impacts later health. This review is a summary of the Epigenetics and DOHaD workshop held at the 2016 DOHaD Society of Australia and New Zealand Conference. Our extensive knowledge of how the early life environment impacts later risk for chronic disease would not have been possible without animal models. In this review we highlight some animal model examples that demonstrate how an adverse early life exposure results in epigenetic and gene expression changes that may contribute to increased risk of chronic disease later in life. Type 2 diabetes and cardiovascular disease are chronic diseases with an increasing incidence due to the increased number of children and adults that are obese. Epigenetic changes such as DNA methylation have been shown to be associated with metabolic health measures and potentially predict future metabolic health status. Although more difficult to elucidate in humans, recent studies suggest that DNA methylation may be one of the epigenetic mechanisms that mediates the effects of early life exposures on later life risk of obesity and obesity related diseases. Finally, we discuss the role of the microbiome and how it is a new player in developmental programming and mediating early life exposures on later risk of chronic disease.
The preference of older people when it comes to ageing in place may be modified by levels of frailty. The aim of this research is to characterise the relationship between frailty and ageing in place, and to identify differences in neighbourhood characteristics supporting ageing in place missed by frail and non-frail older people. A concurrent nested mixed-methods approach was used. For quantitative evaluation, a sample of 945 independently living older adults residing in four districts of Rotterdam were asked to complete a questionnaire in 2013 (response rate = 62%; N = 558). In addition, 32 interviews were conducted with frail and non-frail older people. Results showed that gender, age and especially frailty were related to missed neighbourhood characteristics. People displayed awareness of their increasing frailty and often acknowledged that it increased the need for neighbourhood characteristics enabling them to age in place. We can conclude that dependence on neighbourhoods varies with frailty status. This relationship is dynamic; with frailty, older people become more dependent on their neighbourhood. However, expectations regarding neighbourhood characteristics seem to dissipate with advanced age and increasing frailty.
Due to demographic changes and a widely supported policy of ageing in place, the number of community-dwelling older people will increase immensely. Thus, supportive neighbourhoods enabling older people to age in place successfully are required. Using Q-methodology, we examined older people's perceptions of the comparative importance of neighbourhood characteristics for ageing in place. Based on the World Health Organization's Global Age-friendly Cities guide, we developed 26 statements about physical and social neighbourhood characteristics. Thirty-two older people in Rotterdam, half of whom were frail, rank-ordered these statements. Q-factor analysis revealed three distinct viewpoints each among frail and non-frail older people. Comparisons within and between groups are discussed. Although both frail and non-frail older people strongly desired a neighbourhood enabling them to age in place, they have divergent views on such a neighbourhood. Older people's dependence on the neighbourhood seems to be dynamic, affected by changing social and physical conditions and levels of frailty.
Weather patterns in northern European regions have changed noticeably over the past several decades, featuring warmer, wetter weather with more extreme events. The climate is projected to continue on this trajectory for the foreseeable future, even under the most modest warming scenarios. Such changes will have a significant impact on livestock farming, both directly through effects on the animals themselves, and indirectly through changing exposure to pests and pathogens. Adaptation options aimed at taking advantage of new opportunities and/or minimising the risks of negative impacts will, in themselves, have implications for animal health and welfare. In this review, we consider the potential consequences of future intensification of animal production, challenges associated with indoor and outdoor rearing of animals and aspects of animal transportation as key examples. We investigate the direct and indirect effects of climate change on the epidemiology of important livestock pathogens, with a particular focus on parasitic infections, and the likely animal health consequences associated with selected adaptation options. Finally, we attempt to identify key gaps in our knowledge and suggest future research priorities.
Description of a female patient with diagnosed Kjer's disease and sensorineural hearing loss, who specifically complained of a progressive inability to understand speech in noisy situations.
A 30-year-old, Caucasian woman with Kjer's disease.
Audiological assessment showed low-frequency sensorineural hearing loss and a disproportionate deterioration in speech discrimination. This inconsistency gave rise to suspicion of possible aggravation. Follow-up testing showed that brainstem responses were absent, while clear otoacoustic emissions and cochlear microphonics were present. Hearing aids were fitted but no improvement was shown.
This case shows a combination of auditory neuropathy and Kjer's optic neuropathy. It also illustrates that the combination of unexplained hearing loss and apparently inconsistent audiometric outcomes may be associated with auditory neuropathy. Such unexpected hearing evaluation outcomes may be due to other neurological conditions, such as Kjer's disease.
Highly compact dual-mode semiconductor laser sources get
more and more attention in different application fields such as radar,
security and personal communication systems. When the two generated
wavelengths are detected within the same photodetector, an electrical signal
which frequency is the difference between the frequencies of the two optical
modes will be issued. We report on an integrated semiconductor device which
is composed of two in-line DFB sections that are using the same optical
waveguide structure. The so generated dual-mode spectrum can be adjusted
first, by the difference in the grating parameters of each DFB section and
second, by their respective driving current. We will report on the
characterisation of such a device focusing on tunability and linewidth
aspects that are of prime importance in above mentioned applications.
Although norovirus infection is generally known to be a mild disease, there is some evidence for severe outcome. An outbreak in a Dutch psychiatric institution, originating from pilgrims returning from Lourdes (France), provided an opportunity for performing a retrospective cohort study in order to identify risk factors for norovirus disease and excess mortality. Relative risks (RR) including 95% confidence intervals (CI) showed that attending the pilgrimage (RR 2·0, 95% CI 1·4–3·0) and age >70 (RR 1·7, 95% CI 1·2–2·2) were risk factors for symptomatic infection. In a subset of patients, for whom more detailed information was available, the use of statins was associated with norovirus disease when adjusted for underlying condition (adjusted odds ratio 3·9, 95% CI 1·2–13·0). Mortality was higher in cases infected during the pilgrimage compared to other residents (RR 20·9, 95% CI 4·7–93·8). Norovirus disease can lead to severe outcome. The newly identified risk of statins for contracting norovirus disease may have considerable consequences for the Western world and needs prospective confirmation.
In the UK, recent mean temperatures have consistently increased by between 1°C and 4°C compared to the 30-year monthly averages. Furthermore, all available predictive models for the UK indicate that the climate is likely to change further and feature more extreme weather events and a trend towards wetter, milder winters and hotter, drier summers. These changes will alter the prevalence of endemic diseases spatially and/or temporally and impact on animal health and welfare. Most notable among these endemic parasites are the helminths, which have been shown to be very strongly influenced by both the short-term weather and climate through effects on their free-living larval stages on pasture. In this review, we examine recent trends in prevalence and epidemiology of key helminth species and consider whether these could be climate-related. We identify likely effects of temperature and rainfall on the free-living stages and some key parasite traits likely to determine parasite abundance under changed climatic conditions. We find clear evidence that climate change, especially elevated temperature, has already changed the overall abundance, seasonality and spatial spread of endemic helminths in the UK. We explore some confounders and alternative explanations for the observed patterns. Finally, we explore the implications of these findings for policy makers and the livestock industry and make some recommendations for future research priorities.
The study of the potential impacts of climate change on animal health and welfare is in its infancy and urgently needs to gather momentum. This presentation aims to provide a general overview of the current state of affairs, drawing on available information from a Scottish perspective. There is a now a broad consensus amongst scientists that the global climate is changing. All available predictions would indicate that, over the next decade, the weather in the UK will feature greater extremes of climatic conditions, with a general trend towards drier, warmer summers and milder, wetter winters. These changes will obviously impact on the health and welfare of farmed animals, both directly and indirectly. For example, we may anticipate having to protect animals from heat stress and dehydration or provide adequate shelter in more adverse weather conditions. Similarly, there may be indirect effects on livestock through availability of feed supply or a change in forage available for grazing, for example. However, where a changing climate is likely to have most impact is in the transmission and epidemiology of livestock disease. There has been much publicity surrounding the incursion of “exotic” diseases such as Bluetongue and West Nile virus and the spread of vector-borne disease such as Lyme disease and tick-borne encephalitis. However, endemic diseases have been largely ignored. Endemic infectious organisms likely to be strongly influenced by changes in the weather are the parasitic helminths, the causative agents of such diseases as parasitic gastroenteritis (PGE) and liver fluke disease. The larval stages of these parasites develop and survive at pasture and, in some cases, in an intermediate host for a considerable amount of time before being ingested by a host. If climate change alters the ability of some of these larval stages to over-winter on pasture, or survive arrested within the host, the epidemiology of these parasites may be altered accordingly and unexpected, ‘unseasonal’, clinical disease may be witnessed.
Limited information exists on the relationship between specific chronic somatic conditions and care for co-morbid depression in primary care settings. Therefore, the present prospective, general practice-based study examined this relationship.
Longitudinal data on morbidity, prescribing and referrals concerning 991 patients newly diagnosed with depression by their general practitioner (GP) were analysed. The influence of a broad range of 13 specific chronic somatic conditions on the initiation of any depression care, as well as the prescription of continuous antidepressant therapy for 180 days, was examined. Multilevel logistic regression analysis was used to control for history of depression, psychiatric co-morbidity, sociodemographics and interpractice variation.
Multilevel analysis showed that patients with pre-existing ischaemic heart disease (72.1%) or cardiac arrhythmia (59.3%) were significantly less likely to have any depression care being initiated by their GP than patients without chronic somatic morbidity (88.0%). No other specific condition had a significant influence on GP initiation of any care for depression. Among the patients being prescribed antidepressant treatment by their GP, none of the conditions was significantly associated with being prescribed continuous treatment for 180 days.
Our study indicates that patients with ischaemic heart disease or cardiac arrhythmia have a lower likelihood of GP initiation of any care for depression after being newly diagnosed with depression by their GP. This finding points to the importance of developing interventions aimed at supporting GPs in the adequate management of co-morbid depression in heart disease patients to reduce the negative effects of this co-morbidity.
X-ray diffraction with hard X-rays (E = 70 keV) was used to investigate the grain nucleation and grain growth during solidification of a grain refined Al-0.3Ti-0.02B (wt.%) alloy. The investigations showed for the first time the nucleation profile during solidification and how nucleation rate increases with cooling rate. The results indicate that the nucleation process is complete for solid fraction below 30 %, irrespective of the cooling rate. This is explained in terms of the release of latent heat during solidification. The growth of individual aluminium grains during solidification is experimentally observed and compared to model predictions for the diffusion limited grain growth. The experimental results are only in agreement with the theory in the first stage of the transformation. The difference between the experiment and the theory is discussed qualitatively.
We have investigated Coplanar Waveguide (CPW) elements on AlN for use in future AlGaN/GaN based power amplifiers. This technology becomes crucial if a via-hole technology is not available. Lines, discontinuities, metal-insulator-metal (MIM) capacitors and resistors were measured and modelled. These elements are embedded between two adaptors for RF probing. A technique was developed to de-embed the adaptors from the overall measurement and hence correctly determine the properties of the element itself. Measurements on elements containing multiple ports with right angles can best be carried out using standard calibration techniques followed by carefully reorienting the probes. It is shown that for accurate design of matching networks operating at 10 GHz each element has to be carefully modelled. The method presented in this paper can be a useful contribution tackling some of the problems related to the design of these networks.
Ohmic contacts and Schottky contacts were made on an undoped AlGaN/GaN FET structure. Despite the high Al content (33%), we were still able to obtain a contact resistance of 0.3 ωmm. Pulsed measurements showed the large effect of self-heating even for circular contacts with a radius of 50 μm. The behavior ofthe Ni/Au Schottky contacts is according to the charge control model; the reverse current and capacitanceonly scale with the area of the diode. Tests with polygon type diodes showed no dependence of the reverse current on the number of polygon corners. The reverse current decreased when the devices were aged at 400°C for 30 hrs. Coplanar Waveguide discontinuities were realized on AlN substrates. A scalable lumped element model was derived from measurements for T-junctions, transmission lines, bends and crosses.