922017 research outputs found
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Denosumab and risk of community-acquired pneumonia: A population-based cohort study
No full textContext: Recent meta-analyses of randomized controlled trials raised concerns that denosumab might increase the risk of infection. However, data of denosumab on the risk of community-acquired pneumonia is sparse. Objective: To examine the risk of community-acquired pneumonia in subjects receiving denosumab compared to those receiving alendronate.Design: We conducted a propensity score-matched cohort study with a UK primary care database (IQVIA Medical Research Database). We examined the relation of denosumab to community-acquired pneumonia using a Cox proportional hazard model.Participants: The study subjects were osteoporotic patients >45 years who were initiators of denosumab or alendronate from August 1, 2010, to September 17, 2020.Outcome Measures: Community-acquired pneumonia.Results: Patients treated with denosumab (n=933) were compared with those treated with alendronate (n=4,652). In the matched population, the mean (SD) age was 77 (11) years, 89% were women, and about half of the study population had a history of major osteoporotic fracture. Over five years follow-up, the incidence of community-acquired pneumonia per 1000 person-years was 72.0 (95% confidence interval [CI] 60.1, 85.7) in the denosumab group and 75.1 (95%CI 69.4, 81.2) in the alendronate group. The hazard of community-acquired pneumonia was similar between denosumab and alendronate users (hazard ratio [HR] 0.96; 95% 0.79, 1.16). The results remain consistent in a series of sensitivity analyses, with HR ranging from 0.82 (95% CI 0.65, 1.04) to 0.99 (95% CI 0.81, 1.21).Conclusion: Denosumab does not significantly increase the susceptibility of community-acquired pneumonia and could possibly be safely used for the management of osteoporosis. <br/
How is the NHS Low-Calorie Diet Programme expected to produce behavioural change to support diabetes remission: An examination of underpinning theory
No full textBackground: In 2020, the National Health Service Low-Calorie Diet Programme (NHS-LCD) was launched, piloting a Total Diet Replacement intervention with behaviour change support for people living with Type 2 Diabetes and excess weight. Four independent service providers were commissioned to design and deliver theoretically grounded programmes in localities across England. Aims: To (1) develop a logic model detailing how the NHS-LCD programme is expected to produce changes in health behaviour, and (2) analyse and evaluate the use of behaviour change theory in providers’ NHS-LCD Programme designs. Methods: A documentary review was conducted. Information was extracted from the NHS-LCD service specification documents on how the programme expected to produce outcomes. The Theory Coding Scheme was used to analyse theory use in providers’ programme designs documents. Results: The NHS-LCD logic model included techniques aimed at enhancing positive outcome expectations of programme participation and beliefs about social approval of behaviour change to facilitate programme uptake and behaviour change intentions. This was followed by techniques aimed at shaping knowledge and enhancing the ability of participants to self-regulate their health behaviours, alongside a supportive social environment and person-centred approach. Application and type of behaviour change theory within providers’ programme designs varied: One provider explicitly linked theory to programme content; two providers linked 63% and 70% of intervention techniques to theory; and there was limited underpinning theory identified in the programme design documents for one of the providers. Conclusions: The nature and extent of theory use underpinning the NHS-LCD varied greatly amongst service providers, with some but not all intervention techniques explicitly linked to theory. How this relates to outcomes across providers should be evaluated. It is recommended that explicit theory use in programme design and evidence of its implementation becomes a requirement of future NHS commissioning processes.<br/
A Laser-Atom Interaction Simulator derived from Quantum Electrodynamics
No full textA laser-atom interaction simulator derived from quantum electrodynamics (LASED) is presented, which has been developed in the python programming language. LASED allows a user to calculate the time evolution of a laser-excited atomic system. The model allows for any laser polarization, a Gaussian laser beam profile, a rotation of the reference frame chosen to define the states, and an averaging over the Doppler profile of an atomic beam. Examples of simulations using LASED are presented for excitation of calcium from the 41S0 state to the 41P1 state, for excitation from the helium 31D2 state excited by electron impact to the 101P1 state, and for laser excitation of caesium via the D2 line
Cascade adsorptive separation of light hydrocarbons by commercial zeolites
No full textAdsorptive separation of light hydrocarbons by porous solids provides an energy-efficient alternative to state-of-the-art cryogenic distillation. However, an optimal balance between the cost, performance and stability of the sorbent material is yet to be achieved for industrial applications. Here, we report the efficient separation of C2 and C3 hydrocarbons by a faujasite zeolite (Na-X, Si/Al=1.23). A tandem configuration of two fixed-beds packed with Na-X affords complete dynamic separation of the ternary mixture of C2H2/C2H4/C2H6 (1/49.5/49.5; v/v/v) under ambient conditions. Pressure-swing desorption on the latter fixed-bed gives ethylene (>99.50%, 1.80 mmol g-1) and ethane (>99.99%, 1.41 mmol g-1). In situ synchrotron X-ray powder diffraction revealed the binding sites for C2H2 and C2H4 in Na-X. This study highlights the potential application of commercial zeolites for challenging industrial separations
Trends and projections in sexually transmitted infections in people aged 45 and older in England: analysis of national surveillance data
No full textAimsWe describe the epidemiology of sexually transmitted infections (STIs) and HIV in people aged ≥45 years in England and provide future projections about the burden of STIs in this age group.MethodsAnalysis of national surveillance data in England from 2014 to 2019 for chlamydia, gonorrhoea, herpes, syphilis, anogenital warts and HIV. Time trends were assessed by Poisson regression and reported using incidence rate ratios (IRR). Two scenarios were modelled to predict the number of new STI diagnoses and associated costs in 2040.Results In 2019, there were 37,692 new STI diagnoses in people ≥45 years in England. Between 2014-2019 there was a significant increase in the rate of new STI diagnoses in men (IRR 1.05, p=0.05) and those aged 45-64 (IRR 1.04, p= 0.05). Absolute numbers of new STI diagnosis in men who have sex with men increased by 76% between 2014 and 2019 (IRR 1.15, p<0.001). In adults aged ≥50 the number of episodes of care for HIV increased over time (age 50-64 IRR 1.10; 65+ IRR 1.13; p<0.001). The modelled scenarios predicted an increase in STI diagnoses and costs in older people by 2040.ConclusionsSTI rates in England are increasing in people aged ≥45 years. The population is ageing and older people will contribute an increasing burden to STI costs if this trend continues. The reasons for this trend are not fully understood and further longitudinal epidemiological research is needed. Sexual health promotion campaigns and healthcare interventions targeted at older people should be prioritised.<br/
Heart rate variability biofeedback in Long COVID (HEARTLOC)
No full textIntroduction: Long COVID (LC) refers to symptoms persisting 12 weeks after SARS-COV-2 infection. It affects over 50 million people worldwide, causing varied symptoms including fatigue, breathlessness and palpitations Many of these symptoms can be linked to autonomic nervous system dysregulation (dysautonomia). This proof-of-concept study tests feasibility, and estimates efficacy, of a heart rate variability biofeedback (HRV-B) intervention using a standardised diaphragmatic breathing technique in LC patients.Methods and Analysis: 30 adult LC patients with symptoms of palpitations or dizziness and abnormal NASA Lean Test (NLT) are recruited from a UK COVID-19 rehabilitation service. They undertake an active 4-week HRV-B intervention using a chest strap linked to a HRV phone application while undertaking the breathing technique for 10-min twice daily. Quantitative data including HRV are gathered during the study period using Fitbit, the modified COVID-19 Yorkshire Rehabilitation Scale (C19-YRSm), Composite Autonomic Symptom Score (COMPASS 31), World Health Organisation Disability Assessment Schedule (WHODAS 2.0) and EQ-5D-5L health related quality of life measure. Quantitative data will be analysed using standard statistical tests.Results: This study is ongoing; we have preliminary data for 3 completed participants. They demonstrated mean improvement of 3.7 points (from 16.7 pre-intervention to 13 post-intervention) on C19-YRS symptom severity scale, 1.3 (from 5.3 to 4.0) on C19-YRS functional scale, and 0.6 (from 4.7 to 5.3) on C19-YRS overall health score. Average autonomic score improved by 9.6 (from 47.0 to 37.4). Mean WHODAS score improvement was 4.3 (from 28.5 to 24.2) There was improvement in HRV score and reduction in resting heart rate. Further data will be presented at conference.Conclusion: These preliminary data demonstrate that HRV-B can improve LC symptoms, autonomic symptoms, reduce disability and improve HRV
Photocatalytic biomass reforming: what role will the technology play in future energy systems
No full textPhotocatalytic biomass reforming has emerged as an area of significant interest within the last decade. The number of papers published in the literature has been steadily increasing with keywords such as ‘hydrogen’ and ‘visible’ becoming prominent research topics. There are likely two primary drivers behind this, the first of which is biomass represents a more sustainable photocatalytic feedstock for reforming to value-added products and energy. The second is the transition towards achieving net zero emission targets, which has increased focus on the development of technologies that could play a role in future energy systems. Therefore, this review provides a perspective on not only the current state of the art of research but also a future outlook on the potential roadmap for photocatalysis biomass reforming. Producing energy via photocatalytic biomass reforming is very desirable due to the ambient operating conditions and potential to utilise renewable energy (e.g. solar) with a wide variety of biomass resources. As both interest and development within this field continues to grow, however, there are challenges being identified that are paramount to further advancement. In reviewing both the literature and trajectory of the field, research priorities can be identified and utilised to facilitate fundamental research alongside whole systems evaluation. Moreover, this would underpin the enhancement of photocatalytic technology with a view towards improving the Technology Readiness Level and promoting engagement between academic and industry
Energy Efficiency Optimization for PSOAM Mode-Groups based MIMO-NOMA Systems
No full textPlane spiral orbital angular momentum (PSOAM) mode-groups (MGs) and multiple-input multiple-output nonorthogonal multiple access (MIMO-NOMA) serve as two emerging techniques for achieving high spectral efficiency (SE) in the next-generation networks. In this paper, a PSOAM MGs based multi-user MIMO-NOMA system is studied, where the base station transmits data to users by utilizing the generated PSOAM beams. For such scenario, the interference between users in different PSOAM mode groups can be avoided, which leads to a significant performance enhancement. We aim to maximize the energy efficiency (EE) of the system subject to the constraints of the total transmission power and the minimum data rate. This designed optimization problem is non-convex owing to the interference among users, and hence is quite difficult to tackle directly. To solve this issue, we develop a dual layer resource allocation algorithm where the bisection method is exploited in the outer layer to obtain the optimal EE and a resource distributed iterative algorithm is exploited in the inner layer to optimize the transmit power. Besides, an alternative resource allocation algorithm with Deep Belief Networks (DBN) is proposed to cope with the requirement for low computational complexity. Simulation results verify the theoretical findings and demonstrate the proposed algorithms on the PSOAM MGs based MIMO-NOMA system can obtain a better performance comparing to the conventional MIMO-NOMA system in terms of EE
Definition, diagnosis, and clinical management of nonobstructive kidney dysplasia: A consensus statement by the ERKNet working group on Kidney Malformations
No full textKidney dysplasia is one of the most frequent causes of chronic kidney failure in children. While dysplasia is a histological diagnosis, the term “kidney dysplasia” is frequently used in daily clinical life without histopathological confirmation. Clinical parameters of kidney dysplasia have not been clearly defined, leading to imprecise communication amongst healthcare professional and with patients. This lack of consensus hampers precise disease understanding and the development of specific therapies. Based on a structured literature search, we here suggest a common basis for clinical, imaging, genetic, pathological, and basic science aspects of non-obstructive kidney dysplasia associated with functional kidney impairment.We propose to accept hallmark sonographic findings as surrogate parameters defining a clinical diagnosis of dysplastic kidneys. We suggest differentiated clinical follow-up plans for children with kidney dysplasia and summarize established monogenic causes for non-obstructive kidney dysplasia. Finally, we point out and discuss research gaps in the field
Control flow graph, formal verification and constraint programming techniques
No full textFormal program verification is a generally undecidable problem. Bounded Model Checking (BMC) is one method that can achieve decidability by searching for violations of properties of a program up to a bound k. BMC reduces the program verification problem to the classic NP-complete Boolean Satisfiability (SAT). However, it can still lead to an exponential state-space exploration due to the program’s large and possibly unbounded loops. In this case, there might be many execution paths to traverse through a program during its symbolic execution. Therefore, the control flow or computation during the program’s execution, mainly in symbolic execution, can be represented as a directed graph named Control Flow Graph (CFG). In this work, we present the properties of the CFG and discuss the application of constraint programming techniques to reduce variable domains as a preprocessing step or during the BMC process for verifying software systems. We also describe how constraint programming can be exploited to prove the (partial) correctness of the program via proof by induction built on top of BMC