From peripheral region to escalator region in Europe: young Baltic graduates in London

This paper examines recent migration from three little-studied European Union (EU) countries, the Baltic states, focusing on early-career graduates who move to London. It looks at how these young migrants explain the reasons for their move, their work and living experiences in London, and their plans for the future, based on 78 interviews with individual migrants. A key objective of this paper is to rejuvenate the core–periphery structural framework through the theoretical lens of London as an ‘escalator’ region for career development. We add a necessary nuance on how the time dimension is crucial in understanding how an escalator region functions – both in terms of macro-events such as EU enlargement or economic crisis, and for life-course events such as career advancement or family formation. Our findings indicate that these educated young adults from the EU’s north-eastern periphery migrate for a combination of economic, career, lifestyle and personal-development reasons. They are ambivalent about their futures and when, and whether, they will return-migrate

BHPR research: qualitative1. Complex reasoning determines patients' perception of outcome following foot surgery in rheumatoid arhtritis

Background: Foot surgery is common in patients with RA but research into surgical outcomes is limited and conceptually flawed as current outcome measures lack face validity: to date no one has asked patients what is important to them. This study aimed to determine which factors are important to patients when evaluating the success of foot surgery in RA Methods: Semi structured interviews of RA patients who had undergone foot surgery were conducted and transcribed verbatim. Thematic analysis of interviews was conducted to explore issues that were important to patients. Results: 11 RA patients (9 ♂, mean age 59, dis dur = 22yrs, mean of 3 yrs post op) with mixed experiences of foot surgery were interviewed. Patients interpreted outcome in respect to a multitude of factors, frequently positive change in one aspect contrasted with negative opinions about another. Overall, four major themes emerged. Function: Functional ability & participation in valued activities were very important to patients. Walking ability was a key concern but patients interpreted levels of activity in light of other aspects of their disease, reflecting on change in functional ability more than overall level. Positive feelings of improved mobility were often moderated by negative self perception ("I mean, I still walk like a waddling duck”). Appearance: Appearance was important to almost all patients but perhaps the most complex theme of all. Physical appearance, foot shape, and footwear were closely interlinked, yet patients saw these as distinct separate concepts. Patients need to legitimize these feelings was clear and they frequently entered into a defensive repertoire ("it's not cosmetic surgery; it's something that's more important than that, you know?”). Clinician opinion: Surgeons' post operative evaluation of the procedure was very influential. The impact of this appraisal continued to affect patients' lasting impression irrespective of how the outcome compared to their initial goals ("when he'd done it ... he said that hasn't worked as good as he'd wanted to ... but the pain has gone”). Pain: Whilst pain was important to almost all patients, it appeared to be less important than the other themes. Pain was predominately raised when it influenced other themes, such as function; many still felt the need to legitimize their foot pain in order for health professionals to take it seriously ("in the end I went to my GP because it had happened a few times and I went to an orthopaedic surgeon who was quite dismissive of it, it was like what are you complaining about”). Conclusions: Patients interpret the outcome of foot surgery using a multitude of interrelated factors, particularly functional ability, appearance and surgeons' appraisal of the procedure. While pain was often noted, this appeared less important than other factors in the overall outcome of the surgery. Future research into foot surgery should incorporate the complexity of how patients determine their outcome Disclosure statement: All authors have declared no conflicts of interes

Increased production of IL-4 and IL-12p40 from bronchoalveolar lavage cells are biomarkers of Mycobacterium tuberculosis in the sputum

BACKGROUND: Tuberculosis (TB) causes 1.45 million deaths annually world wide, the majority of which occur in the developing world. Active TB disease represents immune failure to control latent infection from airborne spread. Acid-fast bacillus (AFB) seen on sputum smear is a biomarker for contagiousness. METHODS: We enrolled 73 tuberculosis patients with extensive infiltrates into a research study using bronchoalveolar lavage (BAL) to sample lung immune cells and assay BAL cell cytokine production. All patients had sputum culture demonstrating Mycobacterium tuberculosis and 59/73 (81%) had AFB identified by microscopy of the sputum. Compared with smear negative patients, smear positive patients at presentation had a higher proportion with smoking history, a higher proportion with temperature >38.5 0 C, higher BAL cells/ml, lower percent lymphocytes in BAL, higher IL-4 and IL-12p40 in BAL cell supernatants. There was no correlation between AFB smear and other BAL or serum cytokines. Increasing IL-4 was associated with BAL PMN and negatively associated with BAL lymphocytes. Each 10-fold increase in BAL IL-4 and IL-12p40 increased the odds of AFB smear positivity by 7.4 and 2.2-fold, respectively, in a multi-variable logistic model. CONCLUSION: Increasing IL-4 and IL-12p40 production by BAL cells are biomarkers for AFB in sputum of patients who present with radiographically advanced TB. They likely reflect less effective immune control of pathways for controlling TB, leading to patients with increased infectiousness

Students` perceptions of study modes

This paper reports on a survey of how Australian undergraduate students perceive the benefits of broad study modes: face-to-face classes, web-based study, and print-based study. Two benefit types were identified through factor analysis: engagement and functionality. Respondents rated face-to-face classes highest on engagement and print-based study highest on functionality. However, they distinguished only marginally between the engagement and functionality benefits of print-based and web-based study. Two variables associated with differences in students\u27 perceptions of study modes were attendance mode and student tenure. The findings raise questions about the learning and marketing rationales for offering web-based delivery of educational programmes at the expense of both the traditional face-to-face experience and the traditional &ldquo;distance&rdquo; experience in Australia using print materials. <br /

Adaptive Evolution of the Lactose Utilization Network in Experimentally Evolved Populations of Escherichia coli

Adaptation to novel environments is often associated with changes in gene regulation. Nevertheless, few studies have been able both to identify the genetic basis of changes in regulation and to demonstrate why these changes are beneficial. To this end, we have focused on understanding both how and why the lactose utilization network has evolved in replicate populations of Escherichia coli. We found that lac operon regulation became strikingly variable, including changes in the mode of environmental response (bimodal, graded, and constitutive), sensitivity to inducer concentration, and maximum expression level. In addition, some classes of regulatory change were enriched in specific selective environments. Sequencing of evolved clones, combined with reconstruction of individual mutations in the ancestral background, identified mutations within the lac operon that recapitulate many of the evolved regulatory changes. These mutations conferred fitness benefits in environments containing lactose, indicating that the regulatory changes are adaptive. The same mutations conferred different fitness effects when present in an evolved clone, indicating that interactions between the lac operon and other evolved mutations also contribute to fitness. Similarly, changes in lac regulation not explained by lac operon mutations also point to important interactions with other evolved mutations. Together these results underline how dynamic regulatory interactions can be, in this case evolving through mutations both within and external to the canonical lactose utilization network

Tropical field stations yield high conservation return on investment

Conservation funding is currently limited; cost‐effective conservation solutions are essential. We suggest that the thousands of field stations worldwide can play key roles at the frontline of biodiversity conservation and have high intrinsic value. We assessed field stations’ conservation return on investment and explored the impact of COVID‐19. We surveyed leaders of field stations across tropical regions that host primate research; 157 field stations in 56 countries responded. Respondents reported improved habitat quality and reduced hunting rates at over 80% of field stations and lower operational costs per km 2 than protected areas, yet half of those surveyed have less funding now than in 2019. Spatial analyses support field station presence as reducing deforestation. These “earth observatories” provide a high return on investment; we advocate for increased support of field station programs and for governments to support their vital conservation efforts by investing accordingly

Visually Sealed and Digitally Signed Documents

One of the primary flaws with current digital signature technology is that a digital signature does not "feel" or resemble a traditional seal or personal signature to the human observer; lacking a sense of visualisation and changing each time it is applied. This paper reviews the historical value of seals in Eastern and Western cultures to provide a basis to enhance global acceptability of existing digital signatures. The functionality of traditional seals is investigated in broad terms, encompassing newly established applications to accommodate digital signature technology, and traditional seal principles. Traditional seal certificates are employed to prevent the fraudulent use of the seal and serve to bind a particular identity with a particular seal in some Eastern countries, for instance, Taiwan, Japan and Korea. This usage is analogous to the purpose of current digital certificates. This proposal develops the concept of integrating a seal certificate into an overall digital certificate. Verification of a document by visualisation is done by affixing a visual seal within a document and then digitally signing the document. Incorporating the seal images into digital certificates ensures the integrity of the seal images applied to digital signatures. This paper defines new private extensions to the X.509 v3 certificate structure and explains the new digital signing and verifying process. The purpose of this proposed solution is to fulfil the cultural gap between traditional seals and digital signatures through the integration of culturally relevant built-in features for increasing the acceptability of digital signatures in global e-commerce, while maintaining the security features of current digital signature schemes