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The idea that engineers are graduating without the necessary communication skills, specifically written communication, is not new. In the past 25 years, changes have been made both in accreditation requirements and in engineering program curriculums to work to improve students’ writing skills and make their writing better align with the needs of industry, and research is emerging that considers industry standards and how those standards can be applied to the classroom. One challenge is that the characteristics of quality writing are not always the same for the industry and the classroom, which can create problems for new graduates entering the workforce. This article looks at how effective writing is defined by both academics and professional engineers. Drawing on a study by Cunningham & Stewart (2012), which researched the criteria professional engineers consider essential in effective writing, this article provides the results of a survey of instructors of introductory professional and technical writing classes. The survey was designed to determine the characteristics the instructors use when grading writing assignments. The results are then compared to the characteristics of quality writing as identified by the engineers. In addition, the article reviews assessment rubrics to identify criteria used when evaluating writing and compares these criteria to the qualities of effective writing as determined by the Analytic Writing Continuum, part of the National Writing Project. After determining gaps between industry and academics, the article considers ways to bridge those gaps, including working with professional engineers to obtain sample documents, increasing reading and evaluation of engineering documents in professional and technical writing classes, and using interdisciplinary approaches to course design and instruction.

Background Ending the global tuberculosis (TB) epidemic requires a focus on treating individuals with latent TB infection (LTBI) to prevent future cases. Promising trials of shorter regimens have shown them to be effective as preventative TB treatment, however there is a paucity of data on self-administered treatment completion rates. This pilot trial assessed treatment completion, adherence, safety and the feasibility of treating LTBI in the UK using a weekly rifapentine and isoniazid regimen versus daily rifampicin and isoniazid, both self-administered for 12 weeks. Methods An open label, randomised, multi-site pilot trial was conducted in London, UK, between March 2015 and January 2017. Adults between 16 and 65 years with LTBI at two TB clinics who were eligible for and agreed to preventative therapy were consented and randomised 1:1 to receive either a weekly combination of rifapentine/isoniazid (‘intervention’) or a daily combination of rifampicin/isoniazid (‘standard’), with both regimens taken for twelve weeks; treatment was self-administered in both arms. The primary outcome, completion of treatment, was self-reported, defined as taking more than 90% of prescribed doses and corroborated by pill counts and urine testing. Adverse events were recorded. Results Fifty-two patients were successfully enrolled. In the intervention arm 21 of 27 patients completed treatment (77.8, 95% confidence interval [CI] 57.7–91.4), compared with 19 of 25 (76.0%, CI 54.9–90.6) in the standard of care arm. There was a similar adverse effect profile between the two arms. Conclusion In this pilot trial, treatment completion was comparable between the weekly rifapentine/isoniazid and the daily rifampicin/isoniazid regimens. Additionally, the adverse event profile was similar between the two arms. We conclude that it is safe and feasible to undertake a fully powered trial to determine whether self-administered weekly treatment is superior/non-inferior compared to current treatment. Trial registration The trial was funded by the NIHR, UK and registered with ISRCTN (26/02/2013-No.04379941).

IntroductionThe successful scale-up of a latent tuberculosis (TB) infection testing and treatment programme is essential to achieve TB elimination. However, poor adherence compromises its therapeutic effectiveness. Novel rifapentine-based regimens and treatment support based on behavioural science theory may improve treatment adherence and completion.Methods and analysisA pragmatic multicentre, open-label, randomised controlled trial assessing the effect of novel short-course rifapentine-based regimens for TB prevention and additional theory-based treatment support on treatment adherence against standard-of-care. Participants aged between 16 and 65 who are eligible to start TB preventive therapy will be recruited in England. 920 participants will be randomised to one of six arms with allocation ratio of 5:5:6:6:6:6: daily isoniazid +rifampicin for 3 months (3HR), routine treatment support (control); 3HR, additional treatment support; weekly isoniazid +rifapentine for 3 months (3HP), routine treatment support; weekly 3HP, additional treatment support ; daily isoniazid +rifapentine for 1 month (1HP), routine treatment support; daily 1HP, additional treatment support. Additional treatment support comprises reminders using an electronic pillbox, a short animation, and leaflets based on the perceptions and practicalities approach. The primary outcome is adequate treatment adherence, defined as taking ≥90% of allocated doses within the pre-specified treatment period, measured by electronic pillboxes. Secondary outcomes include safety and TB incidence within 12 months. We will conduct process evaluation of the trial interventions and assess intervention acceptability and fidelity and mechanisms for effect and estimate the cost-effectiveness of novel regimens. The protocol was developed with patient and public involvement, which will continue throughout the trial.Ethics and disseminationEthics approval has been obtained from The National Health Service Health Research Authority (20/LO/1097). All participants will be required to provide written informed consent. We will share the results in peer-reviewed journals.Trial registration numberEudraCT 2020-004444-29.

We sought to identify the influence of shoulder arthroplasty (SA) type (primary anatomic, primary reverse, revision) and indication (fracture, arthritis) on the risk of postoperative packed red blood cell transfusion (pRBCT) and intravenous fluid bolus (IVFB).Patients who underwent SA from 2013 through 2016 at our institution were categorized into four groups: primary anatomic (pTSA; N = 298), primary reverse (pRTSA; N = 292), revision (RevSA; N = 133), and shoulder arthroplasty for fracture (SAF; N = 58). Basic demographics, intraoperative metrics, preoperative lab values, and postoperative interventions (pRBCT and IVFB) were retrieved from electronic records.There were 781 SAs, of which 176 cases involved at least one postoperative intervention: pRBCT (6.3%) or IVFB (18.8%). Compared to pTSA, the odds of pRBCT in pRTSA, revSA, and SAF were: 3.0 (95% CI 0.9-10.0), 3.4 (95% CI 0.9-2.7), and 8.6 (95% CI 2.2-32.9), respectively. Independent risk factors for pRBCT included increasing age (p = 0.003), underweight body mass index (p = 0.019), Charlson Comorbidity Index ≥ 3 (p = 0.002), inpatient discharge to higher level of care (p = 0.011), estimated blood loss (p = 0.003), and preoperative hemoglobin (p ≤ 0.001). Also, compared to pTSA, the odds for IVFB in pRTSA, revSA, and SAF were: 2.8 (95% CI 1.7-4.6), 2.2 (95% CI 1.2-4.0), and 4.7 (95% CI 2.2-9.9), respectively. Other independent risk factors for IVFB included female sex (0.002), CCI ≥ 3 (p = 0.017), and operative time (p = 0.047).Shoulder arthroplasty for fracture is an independent risk factor for higher risk of postoperative pRBCT and IVFB.

Background: The rate of mortality in surgical procedures involving the lumbar spine has historically been low, and as a result, there has been difficulty providing accurate quantitative mortality rates to patients in the preoperative planning phase. Awareness of these mortality rates is essential in reducing postoperative complications and improving outcomes. Additionally, mortality rates can be influenced by procedure type and patient profile, including demographics and comorbidities. The purpose of this study is to assess rates and risk factors associated with mortality in surgical procedures involving the lumbar spine using a large national database. Methods: The Nationwide Inpatient Sample database was reviewed from 2003 to 2012. A total of 803,949 patients age 18 years or older were identified by ICD-9CM procedure codes for spinal fusion or decompression of the lumbar spine. Mortality was stratified based on type of procedure (simple or complex fusion, decompression), patient demographics and comorbidities, and in-hospital complications. Binary logistic regression was used to identify the risk of death while controlling for comorbidities, race, sex, and procedure performed. Significance was defined as P Results: Mortality for all patients requiring surgery of the lumbar spine was 0.13%. Mortality based on procedure type was 0.105% for simple fusions, 0.321% for complex fusions, and 0.081% for decompression only. Increased mortality was observed demographically in patients who were male (odds ratio [OR]: 1.75; 95% confidence interval [CI]: 1.51–2.03), black (OR: 1.40; CI: 1.10–1.79), ages 65–74 (OR: 1.46; CI: 1.25–1.70), and age 75+ (OR: 2.70; CI: 2.30–3.17). Comorbidities associated with the greatest increase in mortality were mild (OR: 10.04; CI: 7.76–13.01) and severe (OR: 26.47; CI: 16.03–43.70) liver disease and congestive heart failure (OR: 4.57; CI: 3.77–5.53). The complications with the highest mortality rates were shock (OR: 20.67; CI: 13.89–30.56) and pulmonary embolism (OR: 20.15; CI: 14.01–29.00). Conclusions: From 2003 to 2012, the overall mortality rate in 803,949 lumbar spine surgery patients was 0.13%. Risk factors that were significantly associated with increased mortality rates were male gender, black race, and ages 65–74 and 75+. Comorbidities associated with an increased mortality rate were mild and severe liver disease and congestive heart failure. Inpatient complications with the highest mortality rates were shock and pulmonary embolism. These findings can be helpful to surgeons providing preoperative counseling for patients considering elective lumbar procedures and for allocating resources to treat and prevent perioperative complications leading to mortality. Level of Evidence: 3.

IntroductionThe predictive utility for incident tuberculosis (TB) of the purified protein derivative tuberculin skin test and region of difference 1 (RD1)-based interferon-gamma release assays (IGRA) is comparable; and either is recommended to test for latent TB infection (LTBI). Despite associated high costs of IGRA, sites participating in LTBI screening in many high-income settings pragmatically favour IGRA due to its higher specificity and simpler logistics. A new RD1-based skin test, C-Tb, could offer an acceptable and as accurate, cheaper alternative to IGRA. Evaluating the impact of C-Tb on process and patient-related outcomes would provide important information to help guide its use in LTBI testing strategies.Methods and analysisThis is a pragmatic multicentre, open-label, non-inferiority, randomised controlled trial. The trial will assess the initiation of LTBI treatment following a positive result of the randomised test as the primary outcome. Participants will be randomised to receive the C-Tb test (intervention) or IGRA (usual care, control) for initiation of treatment. We will enrol 1530 participants in England aged≥16 years who are eligible for LTBI testing and treatment according to UK guidance. In the C-Tb arm, skin induration will be assessed 2–3 days after intradermal injection and measured in millimetres of induration. Results of IGRA will be obtained in line with standard practice. Behavioural studies will explore people’s experiences, perspectives and preferences of LTBI testing and treatment. Economic analysis will estimate cost-effectiveness of changes to the diagnostic algorithm for LTBI. The protocol was developed with Patient and Public Involvement (PPI), which will continue throughout the trial.Ethics and disseminationEthics approval has been obtained from The NHS Health Research Authority (269485). We will share results of the trial in peer-reviewed journals and conferences.Trial registration numberEudraCT 2019-002592-34; ISRCTN17936038.

Background Peer support can enable patient engagement with healthcare services, particularly for marginalised populations. In this randomised controlled trial, the efficacy of a peer support intervention at promoting successful engagement with clinical services for chronic hepatitis C was assessed. Methods In London, UK, potential participants were approached through outreach services for problematic drug use and homelessness. Individuals positive for hepatitis C virus (HCV) after confirmatory testing were randomised using an online service to the intervention (peer support) or standard of care. The primary outcome of interest was successful engagement with clinical hepatitis services. The study was non-blinded. Absolute differences were calculated using a generalised linear model and the results compared to logistic regression. Results Three hundred sixty-four individuals consented to participate. One hundred one had chronic hepatitis C and were randomised, 63 to receive the intervention (peer support). A successful outcome was achieved by 23 individuals in this arm (36.5%) and seven (18.4%) receiving the standard of care, giving an absolute increase of 18.1% (95% confidence interval 1.0–35.2%, p value = 0.04). This was mirrored in the logistic regression (odds ratio 2.55 (0.97–6.70), p = 0.06). No serious adverse events were reported. Conclusions Peer support can improve the engagement of patients with chronic HCV with healthcare services. Trial registration ISRCTN24707359. Registered 19th October 2012. Electronic supplementary material The online version of this article (10.1186/s12916-019-1300-2) contains supplementary material, which is available to authorized users.

The present title work under the name of "The analysis of the impact of the implementation of International Financial Reporting Standards for SMEs in the textile sector of Ecuador" is responsible for analyzing the impact derived from the change of an accounting standard to a new one that It requires a lot of work and effort on the part of the people in the accounting department and those related to it. The companies with a greater number in Ecuador correspond to SMEs, being these entrepreneurial businesses of short trajectory with a view to grow in the long term, tend to have administrative and financial problems due to lack of investment in trained personnel working in the areas more vulnerable. The textile activity is developed throughout Ecuador, for this study the companies that are located within the city of Guayaquil are considered………. El presente trabajo de titulación llamado “El análisis del impacto de la implementación de las Normas Internacionales de Información Financiera para PYMES del sector textil del Ecuador” se encarga de analizar el impacto derivado tras el cambio de una norma contable a una nueva. Las empresas con un mayor número en el Ecuador corresponden a las PYMES, siendo estos negocios de emprendimiento de corta trayectoria con miras a crecer en el largo plazo, tienden a tener problemas administrativos y financieros por falta de inversión en personal capacitado que trabaje en las áreas más vulnerables. La actividad textil se desarrolla en todo el Ecuador, para este estudio se consideran las compañías que se encuentran dentro de la ciudad de Guayaquil…………

PurposeThis paper aims to examine whether the health education and health promotion literature is inclusive of people with physical mobility impairments. The English government Department of Health statistics indicate that the number of people living with physical mobility impairments is increasing and this is largely a result of chronic illness survival. The current UK Government has set targets to reduce inequalities that disproportionally affect those with disabilities. In light of the above points, it was expected that this interest would be reflected by a growing health promotion literature.Design/methodology/approachIn order to achieve an overview of health promotion offered for those with physical mobility impairments, a literature review was conducted. The literature was systematically reviewed using keywords and inclusion criteria. The range of published literature searched included research journals, health promotion texts, health and disability policy documents, as well as web sites offered on the internet.FindingsThere is a dearth in the information and development of health promotion for those with physical mobility impairments. Health policy documents offer little that is specifically focused for this group of people in particular. The majority of the relevant literature comes from the USA. Two theoretical positions are offered in the literature: one argues that those with physical impairments require a medical model approach to support individual's adjustment to society; and the other argues that emphasis should be placed on social change to accommodate those with physical impairments. While there are a range of initiatives in legislation and policy that utilise the social model position, the lack of UK health promotion interventions and the small number of US studies for improving the health of those with physical mobility impairments tends to encourage the medical model approach.Research limitations/implicationsThis review focuses particularly on health promotion for those with physical mobility impairments. Although not exhaustive, it highlights the need for further research into effective development of health promotion for those with physical mobility impairments in the UK.Practical implicationsFar more needs to be done to promote the health of those with physical mobility impairments. Both the medical model and social change approaches are required to deliver health promotion for this segment of the population.Originality/valueThere are no other reviews of the literature with a focus on physical mobility impairment and health promotion. This paper considers an often‐neglected group of people and identifies a need for effective health promotion information and resources.

Des femmes et de l’écriture. Le Bassin méditerranéen rend compte du colloque organisé sur ce thème par Carmen Boustani (Université libanaise de Beyrouth) et Edmond Jouve (Sorbonne, Paris 5), colloque qui s’est tenu du 26 au 29 aout 2004, dans le cadre des Rencontres internationales francophones du Quercy. Les participants y ont interrogé la spécificité des écrivaines du bassin de la Méditerranée, orientale et occidentale, à travers deux questions principales : l’écriture féminine, d’une part,...

In order to maintain transit systems, information about them is needed. This article provides information regarding the absence of correlation between transit use, population density, and accessibility. To this end, mobile application data is used. The data is from an application called Transit App that enables easy navigation within transit systems. In North America, the transportation mode share of the automobile is very high. One consequence of the North American population’s high automobile dependency is high auto travel demand on roads. Concurrently, the ability to build additional infrastructure is limited and, in some cases, impossible. As a result, traffic congestion levels have increased significantly, particularly in the past decade. (Schrank, Eisele, and Lomax 2012). Traffic congestion negatively affects transportation efficiency and also creates negative environmental externalities. As Vukan Vuchic stated in Transportation for Livable Cities: “Unrestricted individual behaviour collides with socially optimal behavior” (1999). One solution to the problem of traffic congestion is to increase the mode share of public transportation. But what can induce urban North American populations to trade their automobiles in favor of public transit? What are the qualities a public transit system must have for a significant proportion of the population to frequent it? One of the ways to approach this question is to investigate where people do and do not use it. In this article, public transit in all 19 boroughs of Montreal is considered. Population density is compared to transit use to determine whether transit use is homogenous in all Montreal boroughs. The results are then discussed within the context of other public transit research. The results will hopefully disambiguate some of the factors that influence public transit use in Montreal. This knowledge may facilitate the creation of coherent goals and purposes for public transit in general and the Société de Transport de Montréal in particular.

BETWEEN ANCIENT AND MODERN. NOVELS AND THE IMAGE OF THE ALGERIAN WOMAN The subject here will be the liberation of the Algerian woman, which is a recurrent theme in novels from the Maghreb, such as those of Machrek. Through her work and sustained by her faith, the Algerian woman is emancipating herself from social injustice. New literary representations are evidence of a freedom to live, which has been obtained through protest and resistance, and is being taken up by militant literature., ENTRE L'ANCIEN ET LE MODERNE. IMAGES ROMANESQUES DE L'ALGÉRIENNE Il s'agira ici de la libération de la femme algérienne, thème récurrent des romans du Maghreb comme ceux du Machrek. La femme algérienne s'affranchit de l'injustice sociale au prix de son travail et soutenue par sa foi. De nouvelles représentations littéraires témoignent de sa liberté de vivre, acquise par la protestation, le refus et assumée par l'écriture militante., ENTRE LO ANTIGUO Y LO MODERNO. IMAGENES NOVELESCAS DE LA MUJER ARGELINA Se tratará aquí de la liberación de la mujer argelina, tema recurrente en la novela del Magreb соmо en la del Masrek. La mujer argelina se libera de la injusticia social a través de su trabajo y sostenida por su fe. Nuevas representaciones literarias testimonian de su libertad, de sus deseos de contestación y de rechazo, todo ello asumido gracias a una escritura militante., Francis-Saad Marie. Entre l'ancien et le moderne. Images romanesques de l'Algérienne. In: Mots, n°57, décembre 1998. Algérie en crise entre violence et identité, sous la direction de Lamria Chetouani et Maurice Tournier. pp. 39-48.

Plasminogen activator inhibitor type 1 (PAI-1), the primary physiologic inhibitor of plasminogen activation, is associated with the adhesive glycoprotein vitronectin (Vn) in plasma and the extracellular matrix. In this study we examined the binding of different conformational forms of PAI-1 to both native and urea-purified vitronectin using a solid-phase binding assay. These results demonstrate that active PAI-1 binds to urea-purified Vn with approximately 6-fold higher affinity than to native Vn. In contrast, inactive forms of PAI-1 (latent, elastase-cleaved, synthetic reactive center loop peptide-annealed, or complexed to plasminogen activators) display greatly reduced affinities for both forms of adsorbed Vn, with relative affinities reduced by more than 2 orders of magnitude. Structurally, these inactive conformations all differ from active PAI-1 by insertion of an additional strand into beta-sheet A, suggesting that it is the rearrangement of sheet A that results in reduced Vn affinity. This is supported by the observation that PAI-1 associated with beta-anhydrotrypsin, which does not undergo rearrangement of beta-sheet A, shows no such decrease in affinity, whereas PAI-1 complexed to beta-trypsin, which does undergo sheet A rearrangement, displays reduced affinity for Vn similar to PAI-1.plasminogen activator complexes. Together these data demonstrate that the interaction between PAI-1 and Vn depends on the conformational state of both proteins and suggest that the Vn binding site on PAI-1 is sensitive to structural changes associated with loss of inhibitory activity.

Magíster en Física Maestría

A mutant recombinant plasminogen activator inhibitor 1 (PAI-1) was created (Ser-338 → Cys) in which cysteine was placed at the P9 position of the reactive center loop. Labeling this mutant with N,N′-dimethyl-N(acetyl)-N′-(7-nitrobenz-2-oxa-1,3-diazol-4-yl) ethylene diamine (NBD) provided a molecule with a fluorescent probe at that position. The NBD-labeled mutant was almost as reactive as wild type but was considerably more stable. Complex formation with tissue or urokinase type plasminogen activator (tPA or uPA), and cleavage between P3 and P4 with a catalytic concentration of elastase, all resulted in identical 13-nm blue shifts of the peak fluorescence emission wavelength and 6.2-fold fluorescence enhancements. Formation of latent PAI showed the same 13-nm spectral shift with a 6.7-fold fluorescence emission increase, indicating that the NBD probe is in a slightly more hydophobic milieu. These changes can be attributed to insertion of the reactive center loop into the β sheet A of the inhibitor in a manner that exposes the NBD probe to a more hydrophobic milieu. The rate of loop insertion due to tPA complexation was followed using stopped flow fluorimetry. This rate showed a hyperbolic dependence on tPA concentration, with a half-saturation concentration of 0.96 μM and a maximum rate constant of 3.4 s−1. These results demonstrate experimentally that complexation with proteases is presumably associated with loop insertion. The identical fluorescence changes obtained with tPA•PAI-1 and uPA•PAI-1 complexes and elastase-cleaved PAI-1 strongly suggest that in the stable protease-PAI-1 complex the reactive center loop is cleaved and inserted into β sheet A and that this process is central to the inhibition mechanism.

The mechanism by which high molecular weight kininogen (H-kininogen) potentiates the heparin-accelerated inhibition of plasma kallikrein by antithrombin [Olson, S. T., Sheffer, R., & Francis, A. M. (1993) Biochemistry (preceding paper in this issue)] was investigated at I = 0.15, pH 7.4, 25 degrees C. Single-chain, two-chain, and light-chain, but not heavy-chain, forms of H-kininogen were similarly effective in potentiating the heparin-accelerated antithrombin-kallikrein reaction, indicating that the light-chain region of the protein was responsible for promoting kallikrein inactivation and that cleavage of H-kininogen did not significantly affect this promoting activity. H-kininogen potentiation increased in a saturable manner with increasing kininogen concentration, reflecting a KD (23 +/- 8 nM) similar to that previously measured for H-kininogen binding to kallikrein by equilibrium methods. Both H-kininogen-stimulated and unstimulated heparin rate enhancements initially increased with increasing heparin concentration in a manner corresponding to the saturation of antithrombin with heparin (KD = 10-30 nM). However, at higher heparin concentrations, the stimulated but not the unstimulated heparin rate enhancement decreased in parallel with the saturation of a protein-heparin interaction with a KD (0.4 +/- 0.2 microM) comparable to that directly measured for the H-kininogen-heparin interaction (2.0 +/- 0.2 microM). These results implied that H-kininogen stimulation required the formation of a quaternary complex in which antithrombin and H-kininogen-kallikrein complex were bound to the same heparin chain. In keeping with this interpretation, a synthetic heparin pentasaccharide representing the antithrombin binding sequence accelerated the antithrombin-kallikrein reaction to an extent similar to that of full-length heparin chains containing this sequence, but the pentasaccharide acceleration was not stimulated by H-kininogen. The importance of H-kininogen-kallikrein complex binding to heparin for kininogen stimulation was further indicated from the marked salt dependence of the second-order rate constant for the association of H-kininogen-kallikrein complex but not free kallikrein with antithrombin-heparin complex, under conditions where saturation of the two binary complexes was maintained. Kinetic analyses of antithrombin-kallikrein reactions as a function of the inhibitor concentration indicated that the KD for an initial antithrombin-kallikrein encounter complex was decreased 20-fold by heparin binding to antithrombin and an additional 200-fold by H-kininogen also binding to kallikrein. By contrast, rate constants for the conversion of the encounter complex to a stable complex were comparable for all reactions.(ABSTRACT TRUNCATED AT 400 WORDS)

Purpose To demonstrate the efficacy of the UVAR XTS Photopheresis System and evaluate health-related quality of life in patients with early-stage mycosis fungoides (MF). Patients and Methods Extracorporeal photopheresis was administered 2 days every 4 weeks for 6 months. Patients with partial responses by skin weighted assessment continued for 6 months; nonresponders added oral bexarotene and/or interferon α. Health-related quality of life was assessed at baseline and every 3 months with 3 validated tools. Results Nineteen patients with early-stage MF (7 men, 12 women; 16 white, 3 African Americans) with median age of 63.5 years (range, 46-85 years) participated. Their stages were IA (n = 3), IB (n = 14), and IIA (n = 2). The overall response rate for extracorporeal photopheresis (ECP) alone, was 42% (8/19; including 7 partial response, 1 complete response), with a median of 12 ECP sessions (range, 3-32) given over a median of 12 months (3-32 months) and with an overall duration of response of 6.5 months (range, 1-48 months). Seven patients with stable disease at 3 months received additional bexarotene (3/5; 1 complete response) or bexarotene plus interferon α (1/2), and 4 (57%) of 7 responded. Treatment-related adverse effects were limited to those expected with interferon (fatigue, nausea, vomiting, and diarrhea), or with hypertriglyceridemia and bexarotene. Trends in health-related quality of life indicated an improvement in emotional scores over time. Conclusions ECP is effective for patients with early-stage MF alone or in combination with biologic response modifiers with low toxicity and improved quality of life.

Francis-Saad Marie. Naguib Mahfouz. Du fils du pays à l'homme universel . In: Revue du monde musulman et de la Méditerranée, n°59-60, 1991. Des ethnies aux nations en Asie centrale, sous la direction de Olivier Roy . pp. 241-252.

L’étude de M. Nasr a eu pour objet d’extraire et de déterminer les traits caractéristiques de l’image des Arabes et de l’Islam, dans les manuels de lecture, d’histoire, de géographie et d’instruction civique, publiés par quatre éditeurs – Hachette, Nathan, Magnard et Bordas – pour l’enseignement primaire et secondaire en France. La recherche a porté essentiellement sur des manuels utilisés durant l’année 1986, où l’auteure explore les principales dimensions de l’image des Arabes et de l’Islam...

The bottom line A 27 year old white woman born in the United Kingdom presented with diarrhoea and rectal bleeding. A diagnosis of Crohn’s disease was made after urgent flexible sigmoidoscopy and she was treated with high dose intravenous corticosteroid. She relapsed on conversion to oral drugs and was start on infliximab, a tumour necrosis factor α (TNF-α) inhibitor. Biological drugs that target components of the immune system, such as TNF-α antagonists, interleukin 1 receptor antagonists, and interleukin 6 receptor antagonists, are licensed for the treatment of immune mediated inflammatory conditions such as rheumatoid arthritis and Crohn’s disease. These agents suppress the host immune response, so are associated with increased risk of opportunistic infections including viral infections (odds ratio 1.91, 95% confidence interval 1.02 to 3.58), such as herpes simplex virus and varicella zoster virus, and mycobacterial infections (3.73, 1.72 to 8.13), although risk varies with different agents.1 In about 95% of people infected with Mycobacterium tuberculosis the infection is controlled by the immune system. This results in a state of “latent tuberculosis infection,” with no features of active disease.2 However 5% of those with latent tuberculosis later develop reactivation of tuberculosis and active disease.2 TNF-α antagonists can cause such reactivation of latent infection and active disease.3 People with reactivation have a significantly higher risk of disseminated tuberculosis, and deaths have been recorded.3 Crucially, screening …

Reform of state education in England, which began seriously with the Education Act of 1870, and continued with the Education Act of 1902 failed to give the reform movement the secular system and equality of access and provision it desired for all students. The system was far from the democratic entity that enfranchised citizens deserved. After the First World War, the reform movement’s advance toward full educational democracy gained impetus, culminating in the Education Act of 1944, which some believed had solved most of the educational problems perceived by the reformers. Yet in the 1980’s, scholars like Kevin Jefferys and Brian Simon concluded that this 1944 Act was conservative, and that it failed to give the reform movement much of what it had advocated. To examine the reform movement from 1905 to 1944 and to consider the Jefferys/Simon challenge, I focus on R.H. Tawney, one of the great social democrats and educational reform leaders of the time. By examining his whole career including his Workers’ Educational Association work, his First World War experiences, his contributions to the Church of England, government, and the Labour Party as well as his academic life, I believe that a thematic approach enables me to probe and link the various aspects of his life and educational crusade in greater depth. At the heart of his integrated life was his unshakeable belief in equal rights for all and his conviction that educational provision was the essential foundation for achieving this. Of great assistance were the Tawney papers, among them the Tawney/Vyvyan collection, released to the public at the London School of Economics in 2005. Drawing on these and a myriad of Tawney books, articles and reviews as well as the vast literature written about him and the context in which he operated, I argue that for decades Tawney led the educational reform movement that reached its climax in 1944, a measure that, unfortunately for Tawney and his fellow reformers, did not meet all their objectives. In the end, their reform efforts failed to produce a 1944 Education Act that was a major step forward for English children. Although there was limited progress towards educational equality, the system of privilege, successfully deflecting the efforts of Tawney and the reform lobby, continued to dominate the state school system. Keywords: educational reform in England, equality of educational provision, Christian Socialism, the integrated life, Workers’ Educational Association

Last August we introduced our readers to scotopic sensitivity syndrome, a suggested cause of dyslexia. It will be recalled that the treatment of this condition involved wearing coloured lenses or using a coloured perspex sheet to cover the page. The authors of that article found the evidence for the effectiveness of this technique far from conclusive and they urged further research. This article describes a small-scale investigation into the same area. The Dex frame, which incorporates coloured filters, has been put to the test. At the end of a trial period the authors conclude that only a very small percentage of pupils is likely to benefit from this approach. The matter is unlikely to simply rest here if only because the debate has unearthed a whole range of visual difficulties hitherto neglected.

The effects of previously characterized interactions of high molecular weight kininogen (H-kininogen) with plasma kallikrein and with heparin on the regulation of kallikrein by the heparin-activated inhibitor, antithrombin, were investigated. H-kininogen, at levels sufficient to fully complex kallikrein, greatly potentiated the acceleration of antithrombin inhibition of kallikrein produced by heparin with high affinity for antithrombin. At I = 0.15, pH 7.4, 25 degrees C, kininogen thus maximally increased the heparin enhancement of the second-order rate constant for the antithrombin-kallikrein reaction from 13-fold (1.6 x 10(2) M-1 s-1 to 2.1 x 10(3) M-1 s-1) to 1200-fold (1.9 x 10(5) M-1 s-1). In contrast, H-kininogen had no effect on the antithrombin-kallikrein reaction in the absence of heparin, nor did the protein enhance the rate constants of 1.7 x 10(4) and 3.4 x 10(4) M-1 s-1 for kallikrein reactions with its primary plasma inhibitors C1-inhibitor and alpha 2-macroglobulin, respectively, in the absence or presence of heparin. Consistent with these results, SDS gel electrophoresis of the 125I-labeled kallikrein-inhibitor complexes formed in a mixture of these kallikrein inhibitors at their relative plasma concentrations indicated that antithrombin effectively competed with C1-inhibitor and alpha 2-macroglobulin for kallikrein, accounting for 54% of the total kallikrein complexes, only when both heparin and H-kininogen were present. Similarly, the presence of therapeutic levels of heparin (approximately 1 unit/mL) in normal, factor XII-deficient, and prekallikrein-deficient plasmas enhanced the rate of inactivation of added kallikrein by 2.3-fold and significantly altered the partitioning of radiolabeled kallikrein from predominantly C1-inhibitor and alpha 2-macroglobulin complexes (86-92%) to mostly antithrombin complexes (50-53%). Experiments in antithrombin-deficient and H-kininogen-deficient plasmas confirmed that the enhanced kallikrein inactivation rate and predominant formation of antithrombin-kallikrein complexes in heparinized plasma were dependent on antithrombin and H-kininogen. The contribution of antithrombin to kallikrein inhibition in plasma remained significant (approximately 40-70%) at optimal concentrations of unfractionated or size- and antithrombin affinity-fractionated heparin, in the presence of plasma levels of calcium and zinc ions, at 37 degrees C, and with minimal plasma dilution. These results suggest that antithrombin and H-kininogen may play important roles in the regulation of kallikrein activity in the presence of heparin or heparin-like glycosaminoglycans.

A device called the Des Frame has recently been marketed as an aid for children with specific learning difficulties. Using a test of reading speed and a test of reading accuracy we have attempted to evaluate the device. Two groups of children with learning difficulties were used, one having sole use of the device and being allowed to carry it with them and a second group who only used the device when attending for remedial tuition and assessment. The results show that no significant improvement occurred in reading performance of the groups with learning difficulties using the Dex Frame as compared with a control group. The teachers of the groups did, however, feel that on an individual basis some children (< 10%) expressed that they felt more comfortable using the device.

Behavioural patterns used in mobbing predators by the cooperatively breeding Florida scrub jay, Aphelocoma c. coerulescens , are described from films, field observations and field experiments. The roles of individual group members and the ontogeny of mobbing by fledglings were investigated experimentally by releasing a 1·6-m snake in the presence of jays. Jays used at least nine action patterns and one variable vocalization in mobbing. Male breeders mobbed most intensely, female breeders and helpers mobbed with lesser and approximately equal intensity, and fledglings mobbed the least. Fledglings began mobbing by 47 days post-hatch and gradually acquired adult-like mobbing behaviour by 3 months of age. Coordinated flying ability may be necessary before fledglings begin to mob. Mobbing fledglings were often ignored by adults that had not yet seen the predator. A comparison of the mobbing of the Florida scrub jay with other congeners indicates that several aspects of mobbing behaviour may be related to the social system of the birds.

Background HCV infection disproportionately affects underserved populations such as homeless individuals, people who inject drugs and prison populations. Peer advocacy can enable active engagement with healthcare services and increase the likelihood of favourable treatment outcomes. Objectives This observational study aims to assess the burden of disease in these underserved populations and describe the role of peer support in linking these individuals to specialist treatment services. Methods Services were identified if they had a high proportion of individuals with risk factors for HCV, such as injecting drug use or homelessness. Individuals were screened for HCV using point-of-care tests and a portable FibroScan. All positive cases received peer support for linkage to specialist care. Information was gathered on risk factors, demographics and follow-up information regarding linkage to care and treatment outcomes. Results A total of 461 individuals were screened, of which 197 (42.7%) were chronically infected with HCV. Referral was made to secondary care for 176 (89.3%) and all received peer support, with 104 (52.8%) individuals engaged with treatment centres. Of these, 89 (85.6%) started treatment and 76 (85.4%) had a favourable outcome. Factors associated with not being approved for treatment were recent homelessness, younger age and current crack cocaine injecting. Conclusions Highly trained peer support workers working as part of a specialist outreach clinical team help to identify a high proportion of individuals exposed to HCV, achieve high rates of engagement with treatment services and maintain high rates of treatment success amongst a population with complex needs.

Plasminogen activator inhibitor-1 (PAI-1), the primary inhibitor of tissue-type plasminogen activator (t-PA) and urokinase plasminogen activator, is an important regulator of the blood fibrinolytic system. Elevated plasma levels of PAI-1 are associated with thrombosis, and high levels of PAI-1 within platelet-rich clots contribute to their resistance to lysis by t-PA. Consequently, strategies aimed at inhibition of PAI-1 may prove clinically useful. This study was designed to test the hypothesis that a 14-amino acid peptide, corresponding to the PAI-1 reactive center loop (residues 333-346), can rapidly inhibit PAI-1 function. PAI-1 (0.7 microM) was incubated with peptide (55 microM) at 37 degrees C. At timed intervals, residual PAI-1 activity was determined by addition of reaction mixture samples to t-PA and chromogenic substrate. The T1/2 of PAI-1 activity in the presence of peptide was 4 +/- 3 min compared to a control T1/2 of 98 +/- 18 min. The peptide also inhibited complex formation between PAI-1 and t-PA as demonstrated by SDS-PAGE analysis. However, the capacity of the peptide to inhibit PAI-1 bound to vitronectin, a plasma protein that stabilizes PAI-1 activity, was markedly attenuated. Finally, the peptide significantly enhanced in vitro lysis of platelet-rich clots and platelet-poor clots containing recombinant PAI-1. These results indicate that a 14-amino acid peptide can rapidly inactivate PAI-1 and accelerate fibrinolysis in vitro. These studies also demonstrate that PAI-1 function can be directly attenuated in a physiologic setting and suggest a novel approach for augmenting fibrinolysis in vivo.

Reform of state education in England, which began seriously with the Education Act of 1870, and continued with the Education Act of 1902 failed to give the reform movement the secular system and equality of access and provision it desired for all students. The system was far from the democratic entity that enfranchised citizens deserved. After the First World War, the reform movement's advance toward full educational democracy gained impetus, culminating in the Education Act of 1944, which some believed had solved most of the educational problems perceived by the reformers. Yet in the 1980's, scholars like Kevin Jefferys and Brian Simon concluded that this 1944 Act was conservative, and that it failed to give the reform movement much of what it had advocated. To examine the reform movement from 1905 to 1944 and to consider the Jefferys/Simon challenge, I focus on R.H. Tawney, one of the great social democrats and educational reform leaders of the time. By examining his whole career including his Workers' Educational Association work, his First World War experiences, his contributions to the Church of England, government, and the Labour Party as well as his academic life, I believe that a thematic approach enables me to probe and link the various aspects of his life and educational crusade in greater depth. At the heart of his integrated life was his unshakeable belief in equal rights for all and his conviction that educational provision was the essential foundation for achieving this. Of great assistance were the Tawney papers, among them the Tawney/Vyvyan collection, released to the public at the London School of Economics in 2005. Drawing on these and a myriad of Tawney books, articles and reviews as well as the vast literature written about him and the context in which he operated, I argue that for decades Tawney led the educational reform movement that reached its climax in 1944, a measure that, unfortunately for Tawney and his fellow reformers, did not meet all