922017 research outputs found
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Latent class trajectory modelling: impact of changes in model specification
No full textLatent class trajectory models (LCTMs) are often used to identify subgroups of patients that are clinically meaningful in terms of longitudinal exposure and out¬come, e.g. drug response patterns. These models are increasingly applied in medicine and epidemiology. However, in many published studies, it is not clear whether the chosen models, where subgroups of patients are identified, represent real heterogeneity in the population, or whether any associations with clinically meaningful characteristics are accidental. In particular, we note an apparent over-reliance on lowest AIC or BIC values. While these are objective measures of goodness of fit, that can help identify the optimal number of subgroups, they are not sufficient on their own to fully evaluate a given trajectory model. Here we demonstrate how longitudinal latent class models can substantially change by making small modification in model specification, and the potential impact of this on the relationship to clinical outcomes. We show that the predicted trajectory patterns and outcome probabilities differ when pre-specified cubic versus linear shapes are tested on the same data. However, both could be interpreted to be the “correct” model. We emphasise that LCTMs, as all unsupervised approaches, are hypotheses generating, and should not be directly implemented in clinical practice without significant testing and validation
Should Developing Countries Ban Dual Practice by physicians? An Analysis Under Mixed Hospital Competition*
No full textDual practice, where physicians work both in public and private hospitals, is a widely observed phenomenon, particularly in developing countries. This paper studies a multi-stage game where hospitals compete for physicians as well as patients and, the effort provided by physicians endogenously depends on the competitive setting in which hospitals operate. Specifically, we examine the impact of allowing dual practice on hospital payoffs, physician effort and patients and societal welfare. We find that dual practice introduced in a setting that resembles the characteristics of the health care system of a developing country can be in general socially desirable, since it softens the competition for physician’s exclusive effort (reducing hospital costs) while also increasing the level of their medical effort.<br/
Effect of Temperature on the Preferential Intergranular Oxidation Susceptibility of Thermally-Treated Alloy 600
No full textThermally-treated Alloy 600 coupons were tested in pressurized water reactor simulated primary water at 320 °C and in high-pressure superheated steam at 400 °C to study the effect of a “semi-continuous” network of intergranular carbides on the stress corrosion cracking “precursors events”: preferential intergranular oxidation (PIO) and diffusion-induced grain boundary migration (DIGM). The intergranular carbides were partially consumed due to the environmental exposure, whereby the Cr released from the carbides contributed to the formation of the external oxide layer that limited both PIO and DIGM. The results were compared with previous studies in which similar coupons were exposed to H2-steam
Picturing Displaced Persons (DPs), Exhibiting French Prestige? Photographs of humanitarian aid for European DPs in French-occupied Germany, c. 1945-1952
No full textThis article explores how photography documenting humanitarian aid for European DPs in French-occupied Germany was mobilised to enhance France’s image in Allied occupied Germany, against the backdrop of increasing anxieties about its international standing. It draws on a selection of images found in the archives of the United Nations Relief and Rehabilitation Administration [UNRRA] and the French occupation zone at La Courneuve, which sat between the ‘official’ and the ‘private’. In doing so, this article calls for a recognition of the role of amateur and relief workers photographers in sustaining post-war visual discourses of internationalism and national-self fashioning. Although largely overlooked today, these images play a role in wider debates about what it meant to be ‘French’ in the aftermath of the Nazi occupation. In particular, relief workers and amateur photographers built on and reproduced aspects of the widely disseminated narrative about the universalism of resistance that was being circulated in metropolitan France and Britain at the same time to disrupt conventional images of the French zone as a refuge for French wartime collaborators. Ultimately, this article argues that this hitherto neglected aspect of humanitarian imagery offers fresh insights into the contribution of relief workers and amateur photographers to French post-war diplomatic and occupation strategies
Evaluating and Updating a Design Space for Augmented Reality Television
No full textAs Augmented Reality Television (ARTV) transitions out of the feasibility phase, it is crucial to understand the impact of designdecisions on the viewers’ ARTV experiences. In a previous study, six ARTV design dimensions were identified by relying on insightsfrom existing prototypes. However, the set of possible dimensions is likely to be broader. Building on top of previous work, wecreate an ARTV design space and present it in a textual cheat sheet. We subsequently evaluate the cheat sheet in a between-subjectstudy (𝑛 = 10), with participants with wide-ranging expertise. We identified six new dimensions (genre, broadcast mode, audiencedemographics, cartoonish vs. photoreal representation, modality, and privacy), and a new aspect (360◦) for the display dimension. Inlight of our observations, we provide an updated ARTV design space and observe that asking participants to write ARTV scenarioscan be an effective method for harvesting novel design dimensions
Recall of exposure in UK farmers and pesticide applicators:trends with follow-up time
No full textBACKGROUND: Occupational epidemiological studies on pesticide use commonly rely on self-reported questionnaire or interview data to assess exposure. Insight into recall accuracy is important, as misclassification of exposures due to imperfect recall can bias risk estimates.METHODS: We assessed the ability of workers in three UK cohorts (Prospective Investigation of Pesticide Applicators' Health [PIPAH], Pesticide Users' Health Study [PUHS], and Study of Health in Agricultural Work [SHAW]) to remember their working history related to pesticide exposure over time periods ranging from 3 to 14 years prior. During 2019-2020, cohort participants were re-surveyed using a similar questionnaire to that used previously. We compared recall of responses at follow-up to those reported at baseline related to crops/areas of work, use of personal protective equipment (PPE) items, hygiene habits, frequency of pesticide use, and application method. To assess the extent of recall, we used sensitivity, specificity, the percentage of overall agreement, and area under the curve (AUC) values. We also examined the presence of over or underestimation of recalled years, and days and hours per year, of working with pesticides using geometric mean ratios (GMR) and regression analysis to investigate any trends based on demographic characteristics.RESULTS: There were 643 individuals who completed both the baseline and follow-up surveys in the three cohorts with response rates ranging from 17 to 46%. There was a strong correlation (rho = 0.77) between the baseline and recalled years working with pesticides, though higher values were reported at follow-up (GMR = 1.18 [95% confidence interval: 1.07-1.30]) with no consistent differences by demographic characteristics. There was stronger agreement in the recalled days compared to hours per year in two of the cohorts. Recall for a number of exposure determinants across short and longer periods entailed overall agreement of >70%, though with some differences: for example, sensitivity for long-term recall of crops was poor (<43% in PUHS), whereas short-term recall of hygiene practices was good (AUC range = 0.65-1.00 in PIPAH).CONCLUSION: Results indicate that recall ability may deteriorate over a longer period. Although low-response rates may require these findings to be interpreted with caution, recall for a number of exposure determinants appeared reliable, such as crops and hygiene practices within 3 years, as well as days per year working with pesticides.</p
The Magnetic Field in the Milky Way Filamentary Bone G47
No full textStar formation primarily occurs in laments where magnetic fields are expected to be dynamicallyimportant. The largest and densest laments trace spiral structure within galaxies. Over a dozen ofthese dense (∼10 4 cm-3) and long (>10 pc) laments have been found within the Milky Way, and they are often referred to as 'bones." Until now, none of these bones have had their magnetic field resolved and mapped in their entirety. We introduce the SOFIA legacy project FIELDMAPS which has begun mapping ∼10 of these Milky Way bones using the HAWC+ instrument at 214 μm and 18:002 resolution. Here we present a first result from this survey on the ∼60 pc long bone G47. Contrary to some studies of dense laments in the Galactic plane, we find that the magnetic field is often not perpendicular to the spine (i.e., the center-line of the bone). Fields tend to be perpendicular in the densest areas of active star formation and more parallel or random in other areas. The average field is neither parallel or perpendicular to the Galactic plane nor the bone. The magnetic field strengths along the spine typically vary from ∼20 to ∼100 μG. Magnetic fields tend to be strong enough to suppress collapse along much of the bone, but for areas that are most active in star formation, the fields are notably less able to resist gravitational collapse.<br/
Glucose Treatment Targets in Pregnancy - A Review of Evidence and Guidelines
No full textBackgroundMaternal diabetes mellitus during pregnancy is associated with an increased risk of pregnancy complications for both the mother and the fetus. One of the most prevalent complications is pathological fetal growth, and particularly infants are born large for gestational age (LGA), which leads to problematic deliveries, including the need for caesarean section, instrumental delivery and further perinatal complications. Glucose monitoring during pregnancy is essential for ensuring appropriate glycaemic control and to reduce these associated risks. The current methods of glucose monitoring include measuring glycosylated haemoglobin (HbA1c), self-monitoring of capillary blood glucose (SMBG), and more recently, continuous glucose monitoring (CGM). Observational studies and randomised controlled trials (RCTs) have assessed the appropriate glycaemic targets for HbA1c, SMBG, and CGM in relation to pregnancy outcomes. ObjectiveIn this review we identify current international guidelines on glycaemic targets and review the supporting evidence. MethodWe performed an extensive literature search on glycaemic targets in pregnancies affected by diabetes and we researched international guidelines from recognised societies.Results and ConclusionThe majority of studies used to define the glucose targets associated with the best pregnancy outcomes, across all modalities, were in women with type 1 diabetes. There were limited studies in women with type 2 diabetes and gestational diabetes. We therefore suggest that further research needs to be conducted on glucose targets and clinical outcomes specifically in these populations where CGM technology offers the greatest potential for monitoring glucose and improving pregnancy outcomes.<br/
Direct propylene epoxidation with molecular oxygen over cobalt-containing zeolites
No full textDirect propylene epoxidation with molecular oxygen is a dream reaction with 100 % atom economy, but the aerobic epoxidation is challenging due to the undesired over-oxidation and isomerization of epoxide product. Herein, we report the construction of uniform cobalt ions confined in faujasite zeolite, namely Co@Y, which exhibits unprecedented catalytic performance in the aerobic epoxidation of propylene. Propylene conversion of 24.6 % is achieved at propylene oxide selectivity of 57 % at 773 K, giving a state-of-the-art propylene oxide production rate of 4.7 mmol/gcat/h. The catalytic performance of Co@Y is very stable and no activity loss can be observed for over 200 h. Spectroscopic analyses reveal the details of molecular oxygen activation on isolated cobalt ions followed by interaction with propylene to produce epoxide, in which the Co2+-Coδ+-Co2+ (2<δ<3) redox cycle is involved. The reaction pathway of propylene oxide and byproduct acrolein formation from propylene epoxidation is investigated by density functional theory calculations, and the unique catalytic performance of Co@Y is interpreted. This work presents an explicit example of constructing specific transition metal ions within zeolite matrix toward selective catalytic oxidations.<br/
Autistic Girls and Emotionally Based School Avoidance: Supportive factors for successful re-engagement in mainstream high school
No full textSchool can be challenging for autistic girls who are at risk of internalised anxiety which can ultimately lead to school avoidance. Low attendance is acknowledged as negatively impacting on educational attainment and exacerbating mental health difficulties. Semi-structured interviews were conducted with three autistic girls aged 13-15 years from different high schools, their parent(s) and key adult. Thematic analysis identified the first phase of re-engagement is developing a trusting student-key adult relationship. This provides the foundation for social and emotional intervention. Challenges were also acknowledged and possible improvements reflected upon. These results will aid educators and researchers aiming to support the successful inclusion of autistic girls at risk of experiencing emotionally based school avoidance in mainstream high schools