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Background\ud Phonetic transcription is recognized in regulatory standards as an essential skill for Speech and Language Therapists (SLTs) in the assessment, diagnosis and management of clients with speech difficulties. Previous research has identified that approaches to phonetic transcription vary, and that SLTs often lack confidence in transcribing. However, SLTs’ views and working practices have not been investigated in detail, particularly in terms of whole service approaches and following the recent increase in telehealth.\ud \ud Aims\ud To investigate SLTs’ views about phonetic transcription, their working practices at both individual and service levels, and the factors that influence these.\ud \ud Methods & Procedures\ud A total of 19 SLTs from the UK were recruited to online focus groups via social media and local networks. Participants discussed their views of, and practices in, phonetic transcription. Themes were identified using reflexive thematic analysis.\ud \ud Outcomes & Results\ud Three broad themes were generated division and unity; one small part of a big job; and fit for purpose. SLTs were uniformly proud of their ability to phonetically transcribe and viewed this as a unique skill, but clear differences existed between different groups of SLTs in their views and practices. Investing in phonetic transcription was not always a priority for SLTs or services, and although many felt under-confident in their skills they considered these to be adequate for the populations they usually encounter. SLTs make an early judgement about possible therapy targets, which influences the level of detail used in their phonetic transcription. Practical barriers are often not addressed at service level, and assessment via telehealth poses some specific challenges.\ud \ud Conclusions & Implications\ud SLTs and services would benefit from increased investment in phonetic transcription in terms of time, opportunities for continuing professional development (CPD) and initiatives such as electronic patient records (EPRs) which support the use of phonetic symbols. Identifying target sounds at an early stage raises questions about the implications of disregarding other features of speech, and the selection of appropriate intervention approaches. Further research is needed to analyse actual rather than reported practices, and to consider the relationship between phonetic transcription and intervention approaches. Future studies could also identify precise CPD requirements and evaluate the effectiveness of CPD.\ud \ud \ud What this paper adds\ud \ud What is already known on the subject\ud Previous research has demonstrated that SLTs often lack confidence in phonetic transcription and that practices are varied, with relatively little use of narrow transcription. SLTs are interested in opportunities to maintain and develop transcription skills but do not often undertake CPD for transcription.\ud \ud What this paper adds to existing knowledge\ud By using focus groups as a forum for discussions, this study provides a rich and detailed insight into SLTs’ views about clinical transcription and their working practices, with previously unreported details about the reasons for these practices in a clinical context and at a service-wide level.\ud \ud What are the potential or actual clinical implications of this work?\ud Transcription is often de-prioritized in non-specialist contexts, with practical barriers and a lack of clear and consistent protocols at a whole-service level. There is an opportunity for service managers to address the systemic difficulties in using transcription effectively by raising the profile and value of transcription amongst clinicians, and promoting CPD opportunities, using the findings of this study as a rationale for funding this. Together, these recommendations have the potential to improve client outcomes through more accurate assessment and diagnosis, and hence more appropriate intervention.

Aims Routinely collected patient-reported outcome measures (PROMs) have been useful to quantify and quality-assess provision of total hip arthroplasty (THA) and total knee arthroplasty (TKA) in the UK for the past decade. This study aimed to explore whether the outcome following primary THA and TKA had improved over the past seven years. Methods Secondary data analysis of 277,430 primary THAs and 308,007 primary TKAs from the NHS PROMs programme was undertaken. Outcome measures were: postoperative Oxford Hip/Knee Score (OHS/OKS); proportion of patients achieving a clinically important improvement in joint function (responders); quality of life; patient satisfaction; perceived success; and complication rates. Outcome measures were compared based on year of surgery using multiple linear and logistic regression models. Results For primary THA, multiple linear regression modelling found that more recent year of surgery was associated with higher postoperative OHS (unstandardized coefficient (B) 0.15 points (95% confidence interval (CI) 0.14 to 0.17); p < 0.001) and higher EuroQol five-dimension index (EQ-5D) utility (B 0.002 (95% CI 0.001 to 0.002); p < 0.001). The odds of being a responder (odds ratio (OR) 1.02 (95% CI 1.02 to 1.03); p < 0.001) and patient satisfaction (OR 1.02 (95% CI 1.01 to 1.03); p < 0.001) increased with year of surgery, while the odds of any complication reduced (OR 0.97 (95% CI 0.97 to 0.98); p < 0.001). No trend was found for perceived success (p = 0.555). For primary TKA, multiple linear regression modelling found that more recent year of surgery was associated with higher postoperative OKS (B 0.21 points (95% CI 0.19 to 0.22); p < 0.001) and higher EQ-5D utility (B 0.002 (95% CI 0.002 to 0.003); p < 0.001). The odds of being a responder (OR 1.04 (95% CI 1.03 to 1.04); p < 0.001), perceived success (OR 1.02 (95% CI 1.01 to 1.02); p < 0.001), and patient satisfaction (OR 1.02 (95% CI 1.01 to 1.02); p < 0.001) all increased with year of surgery, while the odds of any complication reduced (OR 0.97 (95% CI 0.97 to 0.97); p < 0.001). Conclusion Nearly all patient-reported outcomes following primary THA/TKA improved by a small amount over the past seven years. Due to the high proportion of patients achieving good outcomes, PROMs following THA and TKA may need to focus on better discrimination of patients achieving high scores to be able to continue to measure improvement in outcomes. Cite this article: Bone Joint J 2022;104-B(6):687–695.

International audience; No abstract available

Nonalcoholic fatty liver disease (NALFD) is now a leading cause of chronic liver disease worldwide, in part, as a consequence of rapidly rising levels of obesity and metabolic syndrome and is a major risk factor for cirrhosis, hepatocellular carcinoma, and liver-related mortality. From NAFLD stems a myriad of clinical challenges related to both diagnosis and management. A growing body of evidence suggests an intricate linkage between the gut microbiome and the pathogenesis of NAFLD. We highlight how our current knowledge of the gut-liver axis in NAFLD may be leveraged to develop gut microbiome-based personalized approaches for disease management, including its use as a non-invasive biomarker for diagnosis and staging, as a target for therapeutic modulation, and as a marker of drug response. We will also discuss current limitations of these microbiome-based approaches. Ultimately, a better understanding of microbiota-host interactions in NAFLD will inform the development of novel preventative strategies and precise therapeutic targets.

Microbial communities along mucosal surfaces throughout the digestive tract are hypothesized as risk factors for impaired glucose regulation and the development of clinical cardiometabolic disease. We investigated whether baseline measures of subgingival microbiota predicted fasting plasma glucose (FPG) longitudinally. The Oral Infections, Glucose Intolerance and Insulin Resistance Study (ORIGINS) enrolled 230 diabetes-free adults (77% female) aged 20 to 55 y (mean ± SD, 34 ± 10 y) from whom baseline subgingival plaque and longitudinal FPG were measured. DNA was extracted from subgingival plaque, and V3 to V4 regions of the 16S rRNA gene were sequenced. FPG was measured at baseline and again at 2 y; glucose change was defined as follow-up minus baseline. Multivariable linear models regressed 2-y glucose change onto baseline measures of community diversity and abundances of 369 individual taxa. A microbial dysbiosis index (MDI) summarizing top individual taxa associated with glucose change was calculated and used in regression models. Models were adjusted for age, sex, race/ethnicity, education, smoking status, body mass index, and baseline glucose levels. Statistical significance was based on the false discovery rate (FDR

© 2018 The Authors, some rights reserved. Environmental microbial communities are stratified by chemical gradients that shape the structure and function of these systems. Similar chemical gradients exist in the human body, but how they influence these microbial systems is more poorly understood. Understanding these effects can be particularly important for dysbiotic shifts in microbiome structure that are often associated with disease. We show that pH and oxygen strongly partition the microbial community from a diseased human lung into two mutually exclusive communities of pathogens and anaerobes. Antimicrobial treatment disrupted this chemical partitioning, causing complex death, survival, and resistance outcomes that were highly dependent on the individual microorganism and on community stratification. These effects were mathematically modeled, enabling a predictive understanding of this complex polymicrobial system. Harnessing the power of these chemical gradients could be a drug-free method of shaping microbial communities in the human body from undesirable dysbiotic states.

© 2018 National Academy of Sciences. All rights reserved. Soil microbes that colonize plant roots and are responsive to differences in plant genotype remain to be ascertained for agronomically important crops. From a very large-scale longitudinal field study of 27 maize inbred lines planted in three fields, with partial replication 5 y later, we identify root-associated microbiota exhibiting reproducible associations with plant genotype. Analysis of 4,866 samples identified 143 operational taxonomic units (OTUs) whose variation in relative abundances across the samples was significantly regulated by plant genotype, and included five of seven core OTUs present in all samples. Plant genetic effects were significant amid the large effects of plant age on the rhizosphere microbiome, regardless of the specific community of each field, and despite microbiome responses to climate events. Seasonal patterns showed that the plant root microbiome is locally seeded, changes with plant growth, and responds to weather events. However, against this background of variation, specific taxa responded to differences in host genotype. If shown to have beneficial functions, microbes may be considered candidate traits for selective breeding.

Richard A. Knight, Carol Chen-Scarabelli, Zhaokan Yuan, Roy B. McCauley, J. Di Rezze, Gabriele M. Scarabelli, Paul A. Townsend, David Latchman, Louis Saravolatz, Giuseppe Faggian, Alessandro Mazzucco, Hardial S. Chowdrey, Anastasis Stephanou, Tiziano M. Scarabelli First published: 22 February 2008 FEBS Letters, Volume 582, Issue 6, Pages 984-990 DOI: 10.1016/j.febslet.2008.02.035 The above article from FEBS Letters, published online on February 22, 2008 in Wiley Online Library (http://wileyonlinelibrary.com), has been withdrawn by agreement between the authors, the Journal Managing Editor Felix Wieland, and John WileySons Ltd., on behalf of the Federation of European Biochemical Societies. The retraction has been agreed following an initial investigation from the University College London that found clear signs of manipulation in Figures 1, 3, and 5. A subsequent investigation by the journal's Editorial Office with the assistance of an image integrity analyst corroborated these findings.

The HOMEChem (House Observations of Microbial and Environmental Chemistry) is a collaborative indoor air chemistry field study to be performed in June 2018 at the UTest House, a manufactured research house located in the University of Texas at Austin's research campus. The HOMEChem experiment investigates the effects of building occupants and their activities, such as cooking and cleaning, on the chemistry of the gas phase, particle phase, and surfaces in a simulated home environment. Specifically, this study focuses on the presence of organic species, chemical oxidants, and reactive nitrogen species indoors compared to outdoor levels. This study incorporates state-of the art atmospheric chemistry instrumentation from multiple research groups to build a shared dataset from those measurements.

© 2015 The Australian Psychological Society Background: Competency-based training and assessment is considered the best practice internationally in postgraduate clinical psychology education. In Australia, there are still some ways to go as programmes begin to integrate competency-based pedagogical models into clinical training and assessment. Further understanding of the strengths and challenges of these models will be useful to educators interested in developing a competency-based approach. Methods: A structured literature review was carried out using the databases PsychInfo, PubMed, and PsychArticles. Keywords were: competency, and “training” or “assessment” or “model” or “clinical” or “psychology” or “medicine” or “allied health.” Articles had to be written in the English language and published in peer-reviewed journals. Relevant book chapters and web references from professional accreditation bodies were also assessed for inclusion. A total of 54 references were utilised in the review. Results: The review supports the relevance of competency-based learning and teaching. It draws on seminal benchmarking work from the international literature and considers the strengths and limitations of competency-based approaches to clinical health training and assessment. The review provides support for the ongoing progression towards competency-based training models in Australian postgraduate clinical psychology. Conclusions: Competency-based training and assessment methods offer educators sophisticated mechanisms for ensuring that clinical psychology graduates are prepared to meet the demands of professional practice and public accountability. Further efforts at integrating competency-based training models into Australian postgraduate curriculum, and associated research into the outcomes, are necessary to ensure a pedagogical culture of best practice in this country.

BackgroundIL-17A and IL-17F are pro-inflammatory cytokines which induce the expression of several cytokines, chemokines and matrix metalloproteinases (MMPs) in target cells. IL-17 cytokines have recently attracted huge interest due to their pathogenic role in diseases such as arthritis and inflammatory bowel disease although a role for IL-17 cytokines in myocardial infarction (MI) has not previously been described.MethodsIn vivo MI was performed by coronary artery occlusion in the absence or presence of a neutralizing IL-17 antibody for blocking IL-17 actions in vivo. IL-17 signaling was also assessed in isolated primary cardiomyocytes by Western blot, mRNA expression and immunostaining.ResultsExpression of IL-17A, IL-17F and the IL-17 receptor (IL-17RA) were all increased following MI. Expression of several IL-17 target genes, including Cxcl1, Cxcl2, IL-1β, iNOS and IL-6 was also upregulated following MI. In addition, IL-17A promoted the expression of Cxcl1 and IL-6 in isolated cardiomyocytes in a MAPK and PI(3)K-dependent manner. IL-17A and ischaemia/reperfusion (I/R) injury were found to have an additive effect on Cxcl1 expression, suggesting that IL-17 may enhance myocardial neutrophil recruitment during MI. Moreover, protein levels of both IL-17R and IL-17A were enhanced following in vivo MI. Finally, blocking IL-17 signaling in vivo reduced the levels of apoptotic cell death markers following in vivo MI.ConclusionsThese data imply that the expression of IL-17 cytokines and their receptor are elevated during myocardial I/R injury and may play a fundamental role in post infarct inflammatory and apoptotic responses.

Transition from description to causality and engineering

Background: The aim of the study was to determine the safety profile, pharmacokinetics and potential drug interactions of the angiogenesis inhibitor ABT-510 combined with gemcitabine-cisplatin chemotherapy in patients with solid tumors.Patients and methods: Patients with advanced solid tumors received gemcitabine 1250 mg/m(2) intravenously (i.v.) on days 1 and 8 and cisplatin 80 mg/m(2) on day 1 of a 3-week cycle in combination with ABT-510. ABT-510 was administered subcutaneously twice daily at doses of 50 mg or 100 mg. Plasma samples for pharmacokinetics were obtained on days 1 (gemcitabine, cisplatin as single agents), 15 (ABT-510 as single agent) and 22 (gemcitabine, cisplatin and ABT-510 as combination).Results: Thirteen patients received ABT-510 as either 50 mg b.i.d. (seven patients) or 100 mg b.i.d. (six patients) in combination with gemcitabine-cisplatin. The most common reported adverse events reflected the known toxicity profile induced by gemcitabine-cisplatin without ABT-510. One episode of hemoptysis occurred in a patient with non-small-cell lung cancer (NSCLC) after 13 days of treatment. No clinically significant pharmacokinetic interactions between ABT-510, gemcitabine and platinum were observed. Three partial responses were observed in 12 evaluable patients (one head and neck cancer, one melanoma and one NSCLC).Conclusions: Combining ABT-510 at doses of 50 mg and 100 mg with gemcitabine-cisplatin is feasible. Pharmacokinetic interactions were not observed and adding ABT-510 does not appear to increase toxicity.

Although all plant and animal species harbor microbial symbionts, we know surprisingly little about the specificity of microbial communities to their hosts. Few studies have compared the microbiomes of different species of animals, and fewer still have examined animals in the wild. We sampled four pond habitats in Colorado, USA, where multiple amphibian species were present. In total, 32 amphibian individuals were sampled from three different species including northern leopard frogs (Lithobates pipiens), western chorus frogs (Pseudacris triseriata) and tiger salamanders (Ambystoma tigrinum). We compared the diversity and composition of the bacterial communities on the skin of the collected individuals via barcoded pyrosequencing of the 16S rRNA gene. Dominant bacterial phyla included Acidobacteria, Actinobacteria, Bacteriodetes, Cyanobacteria, Firmicutes and Proteobacteria. In total, we found members of 18 bacterial phyla, comparable to the taxonomic diversity typically found on human skin. Levels of bacterial diversity varied strongly across species: L. pipiens had the highest diversity; A. tigrinum the lowest. Host species was a highly significant predictor of bacterial community similarity, and co-habitation within the same pond was not significant, highlighting that the skin-associated bacterial communities do not simply reflect those bacterial communities found in their surrounding environments. Innate species differences thus appear to regulate the structure of skin bacterial communities on amphibians. In light of recent discoveries that some bacteria on amphibian skin have antifungal activity, our finding suggests that host-specific bacteria may have a role in the species-specific resistance to fungal pathogens. © 2012 International Society for Microbial Ecology All rights reserved.

Here we describe, the longest microbial time-series analyzed to date using high-resolution 16S rRNA tag pyrosequencing of samples taken monthly over 6 years at a temperate marine coastal site off Plymouth, UK. Data treatment effected the estimation of community richness over a 6-year period, whereby 8794 operational taxonomic units (OTUs) were identified using single-linkage preclustering and 21 130 OTUs were identified by denoising the data. The Alphaproteobacteria were the most abundant Class, and the most frequently recorded OTUs were members of the Rickettsiales (SAR 11) and Rhodobacteriales. This near-surface ocean bacterial community showed strong repeatable seasonal patterns, which were defined by winter peaks in diversity across all years. Environmental variables explained far more variation in seasonally predictable bacteria than did data on protists or metazoan biomass. Change in day length alone explains >65% of the variance in community diversity. The results suggested that seasonal changes in environmental variables are more important than trophic interactions. Interestingly, microbial association network analysis showed that correlations in abundance were stronger within bacterial taxa rather than between bacteria and eukaryotes, or between bacteria and environmental variables. © 2012 International Society for Microbial Ecology All rights reserved.

High-throughput sequencing methods enable characterization of microbial communities in a wide range of environments on an unprecedented scale. However, insight into microbial community composition is limited by our ability to detect patterns in this flood of sequences. Here we compare the performance of 51 analysis techniques using real and simulated bacterial 16S rRNA pyrosequencing datasets containing either clustered samples or samples arrayed across environmental gradients. We found that many diversity patterns were evident with severely undersampled communities and that methods varied widely in their ability to detect gradients and clusters. Chi-squared distances and Pearson correlation distances performed especially well for detecting gradients, whereas Gower and Canberra distances performed especially well for detecting clusters. These results also provide a basis for understanding tradeoffs between number of samples and depth of coverage, tradeoffs that are important to consider when designing studies to characterize microbial communities. © 2010 Nature America, Inc. All rights reserved.

Purpose Lenalidomide has shown significant antimyeloma activity in clinical studies. Oral melphalan, prednisone, and thalidomide have been regarded as the standard of care in elderly multiple myeloma patients. We assessed dosing, efficacy, and safety of melphalan, prednisone, and lenalidomide (MPR) in newly diagnosed elderly myeloma patients. Patients and Methods Oral melphalan was administered in doses ranging from 0.18 to 0.25 mg/kg on days 1 to 4, prednisone at a 2-mg/kg dose on days 1 to 4, and lenalidomide at doses ranging from 5 to 10 mg on days 1 to 21, every 28 days for nine cycles, followed by maintenance therapy with lenalidomide alone. Aspirin was given as a prophylaxis for thrombosis. Results Fifty-four patients were enrolled and evaluated after completing the assigned treatment schedule. The maximum tolerated dose was defined as 0.18 mg/kg melphalan and 10 mg lenalidomide. With these doses, 81% of patients achieved at least a partial response, 47.6% achieved a very good partial response, and 23.8% achieved a complete immunofixation-negative response. In all patients, 1-year event-free and overall survival rates were 92% and 100%, respectively. At the maximum tolerated dose, grade 3 adverse events included neutropenia (38.1%), thrombocytopenia (14.2%), febrile neutropenia (9.5%), vasculitis (9.5%), and thromboembolism (4.8%); grade 4 adverse events were neutropenia (14.2%) and thrombocytopenia (9.5%). Conclusion Oral MPR therapy is a promising first-line treatment for elderly myeloma patients. Hematologic adverse events were frequent but manageable. A low incidence of nonhematologic adverse events was noted. Aspirin appears to provide adequate antithrombosis prophylaxis.

The high velocity oxy-fuel (HVOF) combustion spray technique has been shown previously to be an excellent solution for depositing crystalline matrix nano-reinforced polymer coatings. Dense polymer coatings can be produced by controlling both the particle dwell time in the HVOF jet and through substrate thermal management. In composite materials, it is often desirable to incorporate the maximum amount of reinforcing material into the polymer matrix to achieve optimum mechanical properties. The experiments described here were performed to determine the maximum amount of different scales of silica particles that could be incorporated into a nylon 11 matrix and the time required to do so. Ashing results indicated a maximum amount of silica that can be incorporated. Also, the maximum level of silica incorporation occurs in a shorter time than previously believed. Microscopy, however, indicated that other physical changes continued to occur within the powders when ball milling was allowed to continue beyond this time.

The high velocity oxy-fuel [HVOF] combustion spray technique has previously been shown to be an excellent solution for depositing crystalline matrix nano-reinforced polymer coatings. Dense polymer coatings can be produced by controlling both the particle dwell time in the HVOF jet and through substrate thermal management. Use of an amorphous matrix material, polycarbonate, will enable the role of matrix crystallinity on the structure and properties of thermally sprayed polymer matrix nanocomposite coatings to be separated from effects resulting from the reinforcing phase. An amorphous, commercial polycarbonate powder with a broad particle size distribution and irregular particle morphology has been successfully deposited by HVOF spraying using hydrogen as fuel gas. Polycarbonate matrix coatings up to 18 mils thick with zero to 10 vol. % loadings of nano-sized hydrophobic and hydrophilic silica, and carbon-black have been sprayed onto Al substrates. Results from optical microscopy. X-ray diffraction, scratch, density, microhardness and dilute-solution viscometry measurements will be presented. These indicate that incorporation of the nanosized filers improved the scratch resistance and microhardness of the coatings by 50 % and 23 %, respectively, relative to sprayed pure polymer. Some degradation of the polymer matrix was also detected, with molecular weight being reduced from 17,000 in the feedstock to ~5,000 in the sprayed deposits. The influence of variations in process parameters such as fuel:oxygen ratio, total gas flow, spray distance, nozzle length, total travel distance, and spray distance/nozzle length ratio on coating structure will also be addressed. The threshold loading of silica in the polycarbonate matrix for which dense coatings can be obtained has also been determined.

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The high velocity oxy-fuel (HVOF) combustion spray technique has previously been shown to be an excellent solution for depositing crystalline matrix nano-reinforced polymer coatings. The use of multiple scales of reinforcement is expected to improve the load transfer from the larger reinforcing particles to the matrix through the mediation of the smaller particles. The initial step in developing multi-scale coatings is studying the effects of reinforcement size on distribution and properties. Nylon 11 coatings filled with silica particulates of 7 nm, 20 nm, 10µm and 100µm have been produced using the high velocity oxy-fuel (HVOF) combustion spray process. The physical properties and microstructure have been evaluated as a function of the reinforcement size. Nylon 11 was co-milled with the fillers to a 10% volume fraction. The filler was agglomerated at the splat boundaries in the final coating microstructures. All filled coatings had significant changes in x-ray pattern relative to pure nylon 11 coatings, indicative of both increased crystallinity and changes in crystal structure. Coatings containing the smallest reinforcements exhibited improvements of 40 % in scratch and 84 % in wear resistance above those containing the largest reinforcement particles in coatings with nominal 10 vol. % of hydrophobic silica. This increase appeared to be primarily due to filler addition and increased matrix crystallinity.

Let f be a unimodal map of the interval with critical point c. If the orbit of c is not dense then most points in lim{[0,1],f} have neighborhoods that are homeomorphic with the product of a Cantor set and an open arc. The points without this property are called inhomogeneities, and the set, I, of inhomogeneities is equal to lim {{\omega}(c),f| {\omega}(c) }. In this paper we consider the relationship between the limit complexity of {\omega}(c) and the limit complexity of I. We show that if {\omega}(c) is more complicated than a finite collection of convergent sequences then I can have arbitrarily high limit complexity. We give a complete description of the limit complexity of I for any possible {\omega}(c).

The collection of fecal material and developments in sequencing technologies have enabled standardised and non-invasive gut microbiome profiling. Microbiome composition from several large cohorts have been cross-sectionally linked to various lifestyle factors and diseases. In spite of these advances, prospective associations between microbiome composition and health have remained uncharacterised due to the lack of sufficiently large and representative population cohorts with comprehensive follow-up data. Here, we analyse the long-term association between gut microbiome variation and mortality in a well-phenotyped and representative population cohort from Finland (n = 7211). We report robust taxonomic and functional microbiome signatures related to the Enterobacteriaceae family that are associated with mortality risk during a 15-year follow-up. Our results extend previous cross-sectional studies, and help to establish the basis for examining long-term associations between human gut microbiome composition, incident outcomes, and general health status.