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Clinical standards in angina and non-obstructive coronary arteries: a clinician and patient consensus document
Get PDFPatients with angina and non-obstructive coronary arteries (ANOCA) or myocardial ischaemia with non-obstructive coronary arteries (INOCA) comprise a relatively large subgroup within those with ischaemic heart disease.
Advances in the understanding of disease mechanisms, diagnostic tests and multidisciplinary care are improving awareness of the needs of affected individuals. However, practice variations and suboptimal management promulgate the health burden and increase health care resource consumption.
Clinical standards represent a limited number of quality statements that describe the care patients should be offered by health professionals and providers for a specific clinical condition or defined clinical pathway in line with current best evidence. Clinical standards should address implementation of this evidence along with education of patients and healthcare professionals, multidisciplinary care networks, and research.
In this consensus statement, we highlight contemporary evidence and stakeholder views, including clinicians and patients, to provide an international perspective for developing clinical standards for services involving ANOCA/INOCA patients. A clinical service for ANOCA/INOCA should “consider the whole patient” and provide a multidisciplinary, patient-centred service
The contradictions of legitimation strategies and the welfaring of education
Get PDFThis paper explores the interplay between legitimation crises and welfare state contradictions, as well as the extent to which these can be witnessed in the UK education field. The paper argues that these ideas, developed in the 1970s in a changing global context that was placing severe pressure on welfare states, still have resonance in the twenty-first century. While welfare state regimes may have undergone some restructuring in the twenty-first century, they are still tasked with the job of responding to crises and upheavals in the economic sector. The manner in which they respond, however, has changed, which has moved education into a more central role as a tool of legitimation. The shift from a mediated to a delegated welfare state apparatus has resulted in ever greater welfaring of education policy, to such an extent that contradictions can be identified in modern efforts to stave off crises of legitimation at the political level
Silicon/hard carbon composites synthesized from phenolic resin as anode materials for lithium-ion batteries
Get PDFSilicon could revolutionize the performance of lithium-ion batteries (LIBs) due to its formidable theoretical gravimetric capacity, approximately ten times that of graphite. However, huge volume expansion during charge/discharge processes and poor electronic conductivity inhibited its commercialization. To address the problems, new carbon-silicon core-shell microparticles have emerged for prospective anodes in LIBs. In this study, we develop a core-shell structure by using hard carbon derived from phenolic resin as the core and nano silicon/pitch coating as the shell to the resulting HC@Si-P composite anode. A composition-optimized 20 wt.% pitch coated-Si/HC composite anode delivers superior cycling stability over 200 cycles under 1 A/g current density, showing a 398 mAh/g capacity. At 5.0 A/g current density during charge and discharge processes, the reversible capacity reaches 215 mAh/g. Upon reducing the current density to 0.1 A/g, the capacity remains high at 537 mAh/g. Impedance testing shows that after pitch coating, the RSEI impedance decreases and the diffusion coefficient of HC@Si-P increases. Moreover, the facile and scalable preparation technique is encouraging for the potential practical application of silicon-based anode materials of this type in the upcoming generation of LIBs
Novel risk factors associated with fatal musculoskeletal injury in Thoroughbreds in North American racing (2009-2023)
Get PDFBackground:
The Equine Injury Database (EID) is a census-level record of Thoroughbred racing in North America, currently recording 95.6% of all race starts in 2023, along with partial training and veterinary histories of each horse.
Objectives:
To identify horse-, race- and track-level risk factors associated with race-related fatal musculoskeletal injury (MSI) of Thoroughbred racehorses in North America.
Study Design:
Retrospective cohort study.
Methods:
The study cohort included all race starts made by horses born after 31 December 2006, at tracks that fully report to the EID and consisted of 3,851,659 race starts made by 250,840 Thoroughbred racehorses (median [IQR] starts per horse 11 [5–22]) at 115 racetracks in the USA and Canada between 2009 and 2023, inclusive. Ninety-seven potential risk factors were investigated using univariable and multivariable logistic regression modelling.
Results:
Exactly 5733 fatal MSIs were recorded, an incidence of 1.49 fatal MSIs per 1000 starts. Twenty risk factors had statistically significant associations with increased or decreased odds of fatal MSI. Previously unidentified risk factors included claiming race-related variables and void claim rules (VCR). Horses racing as claimers were at increased odds compared with those who were not (odds ratio 1.31, 95% confidence interval 1.19–1.45, p < 0.001 for the lowest claim prices). Starts in races with the strictest VCR were at reduced odds compared with starts in races with no VCR (OR 0.76 [0.67–0.85], p < 0.001).
Main Limitations:
Availability of new data sources increased substantially during the 15-year time period of the study, meaning some new risk factors are limited in scope compared with others.
Conclusions:
Thoughtful integration of new data sources with race-level data can lead to new insights into risk factors for deleterious outcomes affecting racehorses. Results can inform ongoing efforts to mitigate the risk of fatal MSI, through direct regulatory intervention and through building a risk profile based on individual history and track-level factors
Exercise electrocardiography stress testing in suspected angina and non-obstructive coronary arteries
Get PDFNo abstract available
Document Quality Scoring for Web Crawling
No full textThe internet contains large amounts of low-quality content, yet users expect web search engines to deliver high-quality, relevant results. The abundant presence of low-quality pages can negatively impact retrieval and crawling processes by wasting resources on these documents. Therefore, search engines can greatly benefit from techniques that leverage efficient quality estimation methods to mitigate these negative impacts. Quality scoring methods for web pages are useful for many processes typical for web search systems, including static index pruning, index tiering, and crawling. Building on work by Chang et al. [1], who proposed using neural estimators of semantic quality for static index pruning, we extend their approach and apply their neural quality scorers to assess the semantic quality of web pages in crawling prioritisation tasks. In our experimental analysis, we found that prioritising semantically high-quality pages over low-quality ones can improve downstream search effectiveness. Our software contribution consists of a Docker container that computes an effective quality score for a given web page, allowing the quality scorer to be easily included and used in other components of web search systems
Identifying critical control points for colostrum contamination in first milking colostrum from Scottish dairy herds
Get PDFExcessive bacterial contamination (≥100,000 colony forming units [CFU]/ml total bacteria count (TBC) and ≥ 10,000 CFU/ml total coliform count [TCC]) reduces the quality of colostrum and subsequent absorption of IgG across neonatal enterocytes, leading to failure to transfer of passive immunity (FTPI). Furthermore, the presence of pathogenic bacteria can cause disease in their own right. The objectives of the study were to identify critical control points and farm risk factors to minimise colostrum contamination from Scottish dairy herds. Eleven farms in Dumfries and Galloway, Scotland, were enrolled and first milking colostrum was sampled at sequential control points throughout the harvest, storage and feeding process. Farmers also completed a questionnaire at enrolment detailing colostrum management practices to identify risk factors for high bacterial contamination. Samples then underwent testing to estimate TBC, TCC and Brix % (measure of total solids estimating IgG concentration). Samples collected directly from cows’ teats had a lower median TBC (4000 CFU/ml, IQR = 15,000 CFU/ml) and TCC (1850, CFU/ml, IQR = 3775 CFU/ml) than those collected from storage buckets (median TBC = 101,000 CFU/ml, IQR = 930,000 CFU/ml and median TCC = 12,000, IQR = 108,000 CFU/ml) and feeding equipment (median TBC = 410,000 CFU/ml, IQR 3230,000 CFU/ml; median TCC = 40,000, IQR = 375,000 CFU/ml). Linear regression models revealed higher bacterial contamination was associated with a larger number of buckets used between harvest and storage of colostrum; smaller size of containers used to store colostrum, method of colostrum storage (freezing), and method of teat cleaning (wet wipe). Mean teat, storage bucket and feeder Brix (%) values were 23.1 %, 22 % and 23.1 % respectively. A one-way repeated ANOVA showed no difference in Brix % between source type (F = 2(3168), p = 0.1). Brix % was negatively associated with increasing time from calving to colostrum harvest
Fostering Critical Thinking in STEM Education for Underserved Communities with a Low-Cost 3D-Printed Microscope
Get PDFSTEM education is often challenging for high school students in underserved communities, emphasizing the need to foster critical thinking for deeper understanding and practical application of concepts. This study presents a cost-effective, 3D-printed microscope designed to enhance STEM learning in resource-limited settings. Developed using additive manufacturing, the customizable microscope integrates with a Project-Based Learning (PBL) framework, utilizing structured rubrics to assess critical thinking and scientific knowledge. Field tests in underprivileged schools in Pakistan demonstrated significant improvements in students' data analysis, problem-solving, and experimental skills. This affordable optical tool showcases the transformative potential of photonics in advancing STEM education for underserved communities
Forms of death and the death of form in contemporary Black fiction
No full textIn this article, I explore how death has become one of the determinant logics of contemporary Black fiction as authors attempt to anticipate the insatiable desire of white audiences to witness Black people dying. At the same time, however, I look at how a certain subset of contemporary Black authors anticipate that market demand and undercut the very processes of reifying their work. Looking at work by Monica Brashears, Percival Everett, and Jason Mott, I explore how all three authors use satire (and, more specifically, a satire of mourning) as a way of both drawing attention to and exceeding the implied interpretive and formal framework of a white literary marketplace
“How do I start strong?”: exploring the subjective well-being, beliefs, and lifestyles of first-year university students in the UK
Get PDFMental well-being is an integral part of university students’ overall well-being, and has been a matter of increasing concern in the UK. The main purpose of this study was to examine the subjective well-being of first-year university students in the UK by investigating the impact of their beliefs and lifestyles on their overall well-being, as well as the factors contributing to such changes. A total of 197 participants, including domestic and international students with ages ranging from 18 to 24, completed a survey assessing subjective well-being, beliefs, lifestyles, and demographic information. Thirty-one of the participants took part in the follow-up interviews. The findings revealed diverse experiences among students, including variations in well-being, belief systems, and lifestyles. Key findings of the research include all three categories of subjective well-being (i.e., emotional, social, and physical well-being) were positively correlated with both philosophical and religious beliefs, and negatively correlated with inactive community engagement. This study also revealed that personal beliefs and lifestyles had an important impact on these changes. This paper discusses the implications of these findings for university support services, and offers insights into the challenges and experiences of first-year students
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