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Evaluating the Implications of a Coronary Artery Calcium Score of Zero (CAC = 0) in Modern Risk Prediction: Is Zero Truly Zero?
Get PDFCoronary artery calcium (CAC) scoring is a well-validated screening tool used to calculate the amount of calcified plaque deposited in coronary arteries from a computed tomography (CT) scan. It stratifies patients by risk to predict their future probability of cardiovascular disease and helps establish the ideal preventive therapies. Considering these factors, the purpose of this narrative review is to evaluate the latest research on the effectiveness of CAC scoring, explore the various limitations and challenges faced in utilizing this tool, and discuss alternative investigations commonly used to supplement it for risk stratification. To achieve this, a narrative review was conducted by searching recent literature through databases such as PubMed, Cochrane, and Google Scholar. Identified literature included large population cohort studies and systematic reviews from the last five years, focusing on CAC scoring, cardiovascular risk prediction, ethnicity, artificial intelligence (AI) integration, and secondary prevention. The literature identified generally shows that the validity of CAC scoring is strongly debated due to its variable efficacy in symptomatic versus asymptomatic patients and in the context of ethnic variations, with many studies having supported the validity of this scoring tool, but others challenging its ability to prognosticate cardiovascular disease due to the presence of these external factors, which could lead to an inaccurate representation of the score. As a result, a major recommendation has been to combine the calculated score with pre-existing patient risk factors when making clinical judgments to guide prompt, individualized primary and secondary preventive care. Studies have shown that patients with varying ethnic backgrounds and also those who are symptomatic for stable cardiovascular disease have confounding risk factors that can lead to a false representation of their score and could potentially be at a higher than predicted risk of major cardiovascular events even with a score of zero. In conclusion, the use of CAC scoring remains a valuable prognostic tool for predicting a patient’s cardiovascular prognosis; however, its interpretation must consider correlation with clinical, biochemical, and demographic contexts to optimize decision-making. The literature has also identified the potential for improving the precision and effectiveness of major adverse cardiovascular event (MACE) prediction using traditional scoring methods by incorporating AI, including automated scoring tools and calcium-omics models, into CAC scoring
Convergence Vs Homogeneity: Exploring Hong Kong’s Identity in Transition
Get PDFThis article explores the multiple drivers behind Hong Kong’s identity transition through the lens of the disappearing neon signs. Its cultural and political significances are analyzed through the theoretical frameworks of identity politics, decolonization, and nationalism. The simultaneous forces of decolonization and mainlandization largely accounts for the intricate politicalization of many issues in Hong Kong, including its iconic neon signs, whose connotations has gone through several transitions: from being historical (Western influence), to economic (as a prosperous entrepot and shopping paradise), cultural (unique hybrid of glocalization), technological (becoming outdated in energy efficiency) and even political (fading away after the strengthened regulation in 2010), especially when its early development was a result of bottom-up participation at a grassroots level, while their removal came from a top-down approach through government regulations. The study design incorporates both quantitative and qualitative methods by combining survey results with interviews and policy paper analysis to explore the multiple drivers and the perceived effects on Hong Kong’s identity. This then informs discussions of how to maintain Hong Kong’s position as a space for convergence while developing some new features of in-betweenness
Game Intelligence in Rugby Union: What do coaches think it is? An exploratory qualitative survey design
Get PDFGame Intelligence (GI) is promoted by coaches, pundits and commentators as a key element underpinning high level performance in sport. There is however a limited amount of research in GI in sport, and less in Rugby Union (RU). The purpose of this study, therefore, was to explore rugby coaches’ understanding of GI, to establish its key components and to propose a working definition for GI in Rugby Union. Rugby Union coaches (n= 175) completed an online survey which contained a combination of open and closed questions. Participants were asked for their views about GI, with Reflexive Thematic Analysis (RTA) used to interpret their qualitative responses. Consequently, twelve sub-themes and four major themes were constructed that described the various facets of GI in Rugby Union, these being: situational awareness, effective decision-making, knowledge and understanding, and the ability to influence the game. Data also identifies that the development of player GI is seen as a joint responsibility between player and coach. This study is original in that it explores coaches’ understanding of GI, then proposes a conceptual model for GI, and further, offers a definition for GI in Rugby Union. It is hoped that this will aid further discussion and research into this crucial but under-developed area of coach education
Forelimb muscle activity during level and progressive incline and decline walking in dogs and implications for rehabilitation
Get PDFIntroduction – Shoulder pathologies are a common reason for presentation to veterinary sports medicine and rehabilitation practices. Currently there are no standardized rehabilitation protocols for shoulder injuries but controlled walking, either on flat ground or on inclines/declines, is recommended in nearly every recovery rehabilitation program. The objective of this study was to evaluate the peak and average muscle activity of commonly targeted forelimb muscle groups using fine-wire and surface electromyography (EMG) during treadmill walking at five treadmill positions. Our hypothesis was that the forelimb muscle activity would be significantly higher during decline walking than level walking and significantly lower during incline walking.
Methods - Fine-wire and surface EMG of the supraspinatus, deltoideus, biceps brachii and lateral head of the triceps brachii muscles were performed during treadmill walking at 0%, 5% incline, 10% incline, 5% decline, and 10% decline. The average and peak muscle enveloped EMG signals for 10 gait cycles were compared between the treadmill positions.
Results - Significant main effects were seen during decline walking for average supraspinatus muscle activity (p<0.001), and both average and peak deltoideus muscle activity (p=0.021, p<0.001) respectively. There were no significant differences for peak or average lateral triceps brachii or biceps brachii activity between treadmill positions.
Conclusion - Decline walking significantly increases muscle activity in the supraspinatus and deltoideus muscles of dogs. This study provides new insights regarding the muscle activity of the thoracic limbs in dogs during various treadmill positions at the walk. The impact of incremental treadmill positions on the average supraspinatus EMG activity, along with increases in the average and peak EMG activity of the deltoideus muscle during decline walking should be considered when developing a therapeutic exercise plan in canine patients with shoulder injuries
Can Cross-Layer Intrusion Detection Secure Agriculture 4.0 Systems?
No full textAgriculture 4.0 leverages the Internet of Things (IoT), advanced communication technologies, and artificial intelligence (AI) to improve agriculture efficiency, optimize resource utilization, and promote sustainable crop production. IoT devices continuously monitor environmental conditions and transmit data to enable real-time decision-making in agricultural operations. However, the increased connectivity also expands the attack surface, exposing critical agricultural infrastructures to diverse cyber threats. Current intrusion detection systems (IDSs) primarily focus on detecting external attacks at isolated layers, often neglecting challenges related to data integrity, such as silent data corruption, sensor inconsistencies, and cross-layer anomalies. In this paper, we review existing IDS approaches and emphasize the need for a comprehensive system design methodology that addresses these challenges across all layers of Agriculture 4.0 systems. We propose DIVA-IDS, a cross-layer framework that integrates data integrity validation and anomaly detection to provide robust security for agricultural IoT environments. The framework aims to ensure reliable and secure data transmission, supporting the coexistence of various agricultural applications with differing security priorities
Bridging the gap: how business education shapes employability in architecture engineering students in Jordan
No full textThis study explores the impact of business skills education on architecture engineering students at a Jordanian university, with a focus on how such education shapes students’ understanding of human capital, value creation, and employability. Grounded in human capital theory, this study investigates how entrepreneurial competencies contribute to students’ perceived value in the labour market. Using a case study design, we compare students who participated in the Marsam 006 business programme with those who did not. Survey data were collected to assess whether exposure to business-focussed learning enhanced entrepreneurial competencies, including self-awareness, problem-solving, and strategic thinking
Spent Nuclear Fuel—Waste to Resource, Part 1: Effects of Post-Reactor Cooling Time and Novel Partitioning Strategies in Advanced Reprocessing on Highly Active Waste Volumes in Gen III(+) UOx Fuel Systems
Get PDFSome of nuclear power’s primary detractors are the unique environmental challenges and impacts of radioactive wastes generated during fuel cycle operations. Key benefits of spent fuel reprocessing (SFR) are reductions in primary high active waste (HAW) masses, volumes, and lengths of radiotoxicity at the expense of secondary waste generation and high capital and operational costs. By employing advanced waste management and resource recovery concepts in SFR beyond the existing standard PUREX process, such as minor actinide and fission product partitioning, these challenges could be mitigated, alongside further reductions in HAW volumes, masses, and duration of radiotoxicity. This work assesses various current and proposed SFR and fuel cycle options as base cases, with further options for fission product partitioning of the high heat radionuclides (HHRs), rare earths, and platinum group metals investigated. A focus on primary waste outputs and the additional energy that could be generated by the reprocessing of high-burnup PWR fuel from Gen III(+) reactors using a simple fuel cycle model is used; the effects of 5- and 10-year spent fuel cooling times before reprocessing are explored. We demonstrate that longer cooling times are preferable in all cases except where short-lived isotope recovery may be desired, and that the partitioning of high-heat fission products (Cs and Sr) could allow for the reclassification of traditional raffinates to intermediate level waste. Highly active waste volume reductions approaching 50% vs. PUREX raffinate could be achieved in single-target partitioning of the inactive and low-activity rare earth elements, and the need for geological disposal could potentially be mitigated completely if HHRs are separated and utilised
The solidarity of rights and responsibilities
No full textThis is the concluding chapter of the book. Prior to this chapter, there has been an examination of human rights, including their natural rights’ foundations, as well as the responsibilities and duties arising from rights. There has been an analysis of critical legal theory, as well as an analysis of a multitude of criticisms of rights from a range of critical perspectives, such as Marxism, critical legal studies, feminism and critical race theory. However, the aim of this book is to present a defence of human rights, so it has been incumbent to ‘rehabilitate’ rights within the tradition of critical legal theory. Following a rehabilitation of rights, this chapter grounds freedoms within the spirit of a political community of rights-holders and duty-bearers. But some political communities have been far from progressive eg. Stalinist Russia, Nazi Germany, Apartheid South Africa. Indeed, philosophically, the political communities of, say, Thomas Hobbes, Carl Schmitt, Jeremy Bentham etc hardly attached much weight to individual rights either. A possible compromise between the rights of the individual and the rights of the collective resides in, say, Alan Gewirth. Gewirth is particularly interesting because he wrote a book called The Community of Rights, in 1996. But is Gewirth maybe too focused on individual autonomy? That said, his ideas have caught the attention of critical scholars. Perhaps, to navigate ourselves out of this liberal ‘impasse’, we simply adopt ‘solidarity’ as the rallying call? Solidarity has influenced the writing of (in the author’s opinion) Jean-Jacques Rousseau and Emile Durkheim and surely describes the type of progressive, political community of rights-holders and duty-bearers which the author wants to convey. And, more importantly, following the writings of Roberto Unger, the choice of solidarity is directly compatible with critical legal theory. This is the final conclusion of the book