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Lung health in the Terai region of Nepal
Get PDFBackground: Chronic respiratory disease burden in Nepal is high, although data from the Terai (lowlands) is limited. Methods: Through a community outreach programme in Mechinagar, 3398 adults (mean age 49.6years, 59% female) were recruited to complete spirometry and questionnaires to determine prevalences of airflow obstruction, breathlessness (MRC dyspnoea score ≥3) and self-reported chronic lung disease. Multivariate logistic regression examined associated demographic and lifestyle factors. Results: Prevalences of airflow obstruction (15%) and breathlessness (13%) exceeded self-reported chronic lung disease (8%). Age (odds ratio = 1.06, 95% confidence interval = 1.05-1.07), body mass index (BMI) per 1kg/m2 (0.90, 0.88-0.93), physical inactivity (1.95, 1.07-3.84) and no formal education (1.46, 1.14-1.88) were associated with airflow obstruction. Smoking was only associated with airflow obstruction in females (1.90, 1.22-2.94) and adults ≥40 years (1.40, 1.05-1.86). Age (1.04, 1.03-1.05), airflow obstruction (2.43, 1.85-3.18), and male sex (0.63, 0.49-0.80) were associated with breathlessness. Only in females was breathlessness associated with BMI (1.08, 1.05-1.12) and mixed biomass use (2.65, 1.39-4.85). In men, labour/farming/agriculture work (3.30, 1.12-14.20) or unemployment (4.39, 1.43-19.30) was associated with breathlessness. Conclusion: There is likely underdiagnosis of chronic lung disease in the Terai. Addressing smoking, educational disparities, physical inactivity and environmental pollutant exposure are public health priorities to improve respiratory health in the region
Delivering an exploratory near-peer teaching pilot in general practice: a qualitative study of the experiences of GP speciality trainees and medical students
Get PDFBackgroundSignificant challenges exist for ensuring adequate clinical placement capacity for medical students within healthcare. Innovative solutions are needed to address these. Near-peer teaching (NPT) may provide educational benefits which extend to both the learners and the peer tutors involved. We designed and implemented a pilot scheme whereby General Practice Speciality Trainees (GPSTs) in the United Kingdom supervised first year graduate entry medical students across six visits to general practice.ObjectivesTo explore the experiences of the GPSTs and the medical students within the pilot study to gain insight into their perceptions of NPT and its delivery within this scheme.MethodsA qualitative design using focus groups was chosen to explore the participant’s experiences. The focus groups took a semi-structured format based around questions designed to answer the research aims. Seven out of seven (100%) GPSTs and six out of seven (86%) medical students that participated in the pilot scheme took part in focus groups.ResultsData analysis generated three main themes: near-peer supervision benefits GPSTs and students, reciprocal relationships are significant to the educational experience and the organisation of the project and placements is key to success.ConclusionsThe experiences of GPSTs and medical students were positive, highlighting particular benefit of a longitudinally developed near-peer relationship. If similar findings were replicated on a larger scale and across institutions, this would add confidence for the role of GPSTs in teaching medical students during clinical placements, which could in turn improve training capacity
A novel method to quantify gas–particle interactions in fluidized beds using 3D-printed fluidization structures
Get PDFGas–particle interactions are fundamental to fluidized bed theory and computational fluid dynamics (CFD) simulations, yet hindered by inherent structural instability. This study pioneers a novel method using high-fidelity 3D printing to manufacture stable fluidization structures (uniform, clusters, bubbles) with controlled solids holdup (εs, 0–0.65), particle diameter (dp, 40–2000 μm), and geometries. Intrinsic pressure drops are measured via a custom experimental system, enabling drag coefficient quantification through energy balance. Validation against fixed beds (high εs) and liquid-particle systems (medium/low εs) confirms 118×), advance fluidization theories, and enable precise CFD optimization of fluidized beds
Chromosome 8q21.11 Deletion Syndrome
No full textChromosome 8q21.11 deletion syndrome is an uncommon genetic disorder involving intellectual disability (ID), corneal opacities described as Peters anomaly (Happ et al. 2016), and typical facial dysmorphic features. According to Palomeras et al. (2011), the first large cohort comprised eight patients, and the 8q21.11–q21.3 submicroscopic deletions represented a clinically recognizable entity. Despite the variety of phenotypes among patients, common features were noted, including facial dysmorphism, developmental delay, hypotonia, developmental ocular abnormality, and behavioral problems. Aside from the typical features, other systemic defects may include sensorineural hearing loss, cleft palate, congenital cardiac abnormalities, and brain abnormalities (Palomares et al. 2011)
High-temperature viscoelastic-viscoplastic deformation of 316 stainless steel
Get PDFIrreversible viscous behaviour is often assumed to occur only after yielding, yet experiments show measurable irreversibility within the nominally elastic regime. In this work, we experimentally demonstrate multi-timescale viscoelastic relaxation in 316 SS between 500 and 700 and show that this behaviour cannot be represented by conventional unified viscoplastic models alone. A thermodynamically based viscoelastic–viscoplastic model is calibrated using stress relaxation, cyclic, and anisothermal waveforms, achieving R2 > 0.87 and RMSE < 28MPa for all isothermal conditions while maintaining reasonable accuracy under anisothermal cycling (R2=0.72, RMSE =43.41MPa). The model captures both recoverable and permanent time-dependent deformation across temperatures, providing improved predictive capability for components subjected to dwell periods and flexible power plant cycling. These results highlight the need to incorporate viscoelasticity into high temperature constitutive models for austenitic steels
Beyond standardisation, subjects and syllabi: How primary schools organise for arts richness in an era of curriculum reform
Get PDFAs England embarks on its first comprehensive curriculum review in fifteen years, this paper offers critical insights from schools that sustained arts-rich provision despite a policy landscape hostile to creative subjects. Drawing on data from the Researching Arts-rich Primary Schools (RAPS) project—a mixed-methods study of 76 arts-rich primary schools in England—we analyse how these schools organise themselves to maintain robust arts provision. Using an organisational practices framework encompassing spatial, temporal, cultural, structural, communication and social practices, we show that arts-richness is not simply about what schools teach, but also about how they organise time, space, relationships and resources. Our analysis demonstrates that successful arts provision requires reimagining the school as a ‘design’ that constantly adapts familiar organisational elements. These findings have implications for the current curriculum review in England and for international readers grappling with similar tensions between standardisation and arts education. The paper concludes that any curriculum reform must attend to organisational conditions, not merely curriculum content, if arts education is to be genuinely accessible to all children
Menopause, Female Sex Hormones, Skeletal Muscle Mass and Muscle Protein Turnover in Humans
Get PDFSarcopenia describes the loss of muscle mass and function with age. The increase in prevalence of sarcopenia in women appears to coincide with the onset of menopause, which is characterized by large changes to the hormonal milieu such as decreased oestrogen and progesterone concentrations. Although the timing of menopause and sarcopenia may coincide, there is a lack of high-quality evidence demonstrating a link between the two. This narrative review aims to assess evidence for the effects of menopause on muscle mass and muscle protein turnover. Longitudinal (n = 4/5) and cross-sectional (n = 7/11) studies demonstrate a reduction in lean or muscle mass across the menopausal transition with −2.5% and −5.7% reductions in perimenopausal and postmenopausal women, respectively, compared to premenopausal women. Most of this evidence (n = 10/11) is taken through assessment of lean body mass via dual-energy x-ray absorptiometry (DXA), which may underestimate changes in muscle mass. Assessment on changes to muscle protein turnover is largely limited to short-term measures of muscle protein synthesis (MPS), which may be elevated in older women versus younger women (n = 3/7) or age-matched males (n = 4/5). MPS responses to anabolic stimuli, such as resistance exercise (n = 3/4) or protein ingestion (n = 3/6), may be blunted in older women. Evidence assessing muscle protein breakdown (MPB) is lacking; however, evidence from animal and cell models demonstrates the role of estradiol in suppressing MPB, which may contribute to an increase in MPB following menopause. Advancements in understanding the role of the menopausal transition in the regulation of muscle mass, and subsequent effectiveness of interventions such as exercise or exogenous hormone provision will enable healthy ageing and sarcopenia prevention in older women
Lipid droplets in felid kidneys: prevalence and composition by lipidomics
Get PDFIntroduction: An accepted and common phenotypic curiosity of Felidae is the presence of intracytoplasmic lipid droplets in renal proximal tubule epithelial cells (RPTEC), also frequently observed in urine (lipuria). Both outcomes are currently considered, and taught, as incidental – without obvious pathophysiological consequence. This contrasts markedly with clinical (human) medicine, where lipid vacuoles in RPTEC are usually associated with metabolic or chronic disease, such as chronic kidney disease (CKD). Despite domestic felids having a high incidence of CKD with advancing age, no study has fully characterized feline RPTEC lipid droplets in the context of CKD.Methods: In this study, we first characterized the incidence of RPTEC lipid in domestic cats (with/without CKD or chronic interstitial nephritis) versus domestic dogs and Scottish Wildcats, across a wide age range, using a number of lipidomic approaches (chromatography, fatty acid characterization, mass spectrometry).Results: Felids (domestic and wildcat) consistently had greater renal lipid content than dogs at all ages studied. Intracytoplasmic lipid extraction revealed a panoply of novel lipids found only in domestic cats: lipids were primarily modified (i.e., less polar) ether-soluble triacylglycerols, including mono-alkyl-diacylglycerols (MADAGs) and other likely, branched-chain fatty acids.Discussion: We suggest that the common presence of such rare lipid species in tubular lipid droplets in domestic cats reflects an aspect of felid biology that parallels age-related disease prevalence, in particular, being associated with the aetiopathogenesis of chronic renal interstitial nephritis (CIN) – a hallmark of CKD in felids
Structural Characterisation of Disordered Porous Materials Using Gas Sorption and Complementary Techniques
Get PDFWhile advanced imaging techniques and ordered porous materials like MOFs have gained prominence, gas sorption remains the indispensable tool for characterizing the multiscale heterogeneity of industrially important disordered solids, such as catalysts and shales. This review examines recent developments in gas sorption methodologies specifically tailored for rigid, disordered porous media. We discuss experimental advances, including the choice of adsorbate and the utility of the overcondensation method for probing macroporosity and ensuring saturation. Furthermore, we critically evaluate theoretical approaches for determining pore size distributions (PSDs), contrasting classical methods with Density Functional Theory (DFT) and Grand Canonical Monte Carlo (GCMC) simulations. Special emphasis is placed on the impact of pore-to-pore cooperative effects, such as advanced condensation, cavitation, and pore-blocking, on the interpretation of sorption isotherms. We highlight how complementary techniques, including integrated mercury porosime-try, NMR, and computerized X-ray tomography (CXT), are essential for deconvolving these complex network effects and validating void space descriptors. We conclude that, while "brute force" molecular simulations on image-based reconstructions are progressing, "minimalist" pore network models, which incorporate cooperative mechanisms, currently offer the most empirically adequate approach. Ultimately, gas sorption remains unique in its ability to statistically characterize void spaces from Angstroms to millimeters in a single experiment
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