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Altered functional connectivity of the hippocampus in cortico-subcortical networks in early-stage and emerging psychosis
Get PDFBackground: Deficits in the hippocampus are a consistent finding in schizophrenia and have also been demonstrated in earlystage psychosis. Moreover, alterations in hippocampal anatomy and connectivity have been implicated in aberrant functional interactions in subcortical and cortical networks. However, the nature and extent of these alterations and their association with frontal and subcortical regions remain unclear. Methods: To address these questions, we analysed resting state fMRI functional connectivity and graph properties in n = 93 individuals at clinical high-risk for psychosis (CHR-P), n = 26 patients with first-episode psychosis (FEP), n = 31 individuals with affective disorders and substance abuse as well as n = 58 healthy controls. We used novel denoising techniques and individually optimised functional connectivity matrices, which were compared across clinical groups. Finally, the centrality of the hippocampus as well as network segregation and integration were assessed using graph-based analysis.
Results: Both the FEP and CHR-P groups were characterised by reduced functional connectivity between the hippocampus and inferior frontal cortex albeit the differences in CHR-P individuals did not survive corrections for multiple comparisons. Compared to CHR-P, FEP show lower centrality of the hippocampus but increased network segregation. Conclusions: Our findings show lower connectivity between the hippocampus and frontal cortex in early-stage psychosis, with FEP patients showing stronger decreases in connectivity compared to CHR-Ps. Furthermore, network-based analyses highlight reduced centrality in FEPs compared to CHR-Ps, indicating reduced influence on the wider network. Thus, altered connectivity along the hippocampal-frontal axis could be a potential marker of illness stage in early-stage psychosis
A protocol for a pilot randomised controlled trial of a Tailored Intervention for people with moderate-to-severe Chronic Obstructive Pulmonary Disease and Co-morbidities delivered by Pharmacists and Consultant respiratory Physicians (TICC-PCP) in Scotland
Get PDFBackground:
Symptomatic chronic obstructive pulmonary disease (COPD) is a global health problem associated with a number of co-morbidities, disproportionately affecting people who are poor. Sub-optimal management of symptomatic COPD and co-morbidities negatively impacts quality of life, ability to work and survival. Previous trials of healthcare professional-led complex interventions have targeted COPD management, but not also simultaneously targeted the treatment of co-morbidities. Recommendations for complex intervention testing include feasibility studies followed by pilot randomised controlled trials (RCTs), including economic and parallel process evaluations. Following a feasibility study, a Tailored, home-based Intervention for people with COPD and Co-morbidities by generalist prescribing Pharmacists collaborating with Consultant respiratory Physicians (TICC PCP) is undergoing pilot testing. The pilot study aims to recruit at least 70% of invited participants within 4 months; deliver TICC PCP to at least 70% of participants in the intervention arm; retain at least 80% of participants (excluding those who died or developed incapacity before the end of the study) until 21-month data collection; and collect at least 90% of in person data at each study time point. In addition, findings from the economic and process evaluations along with information obtained on the proposed quantitative efficacy outcomes inform on the sample size required for a subsequent definitive RCT will help inform on future research.
Methods:
We describe methods for a multicentre pilot RCT, with parallel economic and qualitative process evaluations of TICC PCP. Set in Glasgow and Edinburgh (Scotland), we plan to recruit 100 people with symptomatic COPD and conduct home-based assessments at baseline and at subsequent three monthly follow up visits over a period of 21 months. Independent researchers will collect extensive health and social care data at recruitment (baseline) before participants are randomised (stratified by site and number of respiratory hospitalisations in the past 12 months), to TICC PCP in addition to usual care (UC), or UC alone. Collected data will include objective and subjective measures of health, healthcare utilisation (including prescribing), home circumstances, health related quality of life, healthcare resource use and intervention costs. Follow up data will be collected three monthly for 21 months. The intervention, delivered by NHS Pharmacists visiting participants at home monthly for 6 months, then every 2 months for the next 6 months, involves clinical assessment and intervention at home including prescribing for COPD and co-morbidities. Pharmacists will also assess and help participants to address wider health needs, e.g. appointment attendance and home equipment. Pharmacists will collaborate mainly with consultant respiratory physicians, and General Practitioners.
Discussion:
A holistic, 1 year long, individualised home-based intervention for people with symptomatic COPD and co-morbidities may help address unmet health needs. We will utilise the information obtained from this pilot study, including: the recruitment and retention rates; the sample size required to detect a minimal clinically important difference in the proposed efficacy outcomes of interest; the economic analyses; and process evaluation, to determine whether we should progress to a definitive RCT with parallel process and economic evaluation
Andrew Hass, Mattias Martinson and Laurens ten Kate, The Music of Theology: Language, Space, Silence
Get PDFNo abstract available
A precision image-guided model of stereotactic ablative radiotherapy for hepatocellular carcinoma
Get PDFLiver tumours, both primary and metastatic, are diseases of unmet clinical need. Hepatocellular carcinoma (HCC), the most common primary liver tumour, like many other cancers, can be treated by stereotactic ablative radiotherapy (SABR), reducing off-target effects of radiation on local anatomical structures. However, integrating all the necessary components for stereotactic irradiation of HCC in murine models has not yet been reported. Here, we provide the development and detailed characterisation of a murine SABR model combining magnetic resonance imaging- and computed tomography (CT)-guided delineation of the tumour, together with CT-guided liver tumour radiotherapy. The model enables accurate delivery of clinically relevant doses of radiotherapy with good tolerability and on-target tumour responses in models with otherwise universally progressive disease. The development of this preclinical modelling platform paves the way for its integration into multimodal therapeutic and mechanistic testing in preclinical murine models of metastatic and primary liver tumours, including HCC
Internationalisation and moral economies in healthcare: NHS exporting and the English patient
Get PDFBackground:
Contemporary conditions require detailed study of internationalisation. This article offers a novel perspective on processes of internationalisation in healthcare, adapting an approach from higher education studies and enhancing it with insights from sociological scholarship on moral economies. The article asks how institutions and individuals respond to the globalising healthcare environment, and what this reveals about normative questions that govern healthcare provisioning in national contexts. This is pursued using qualitative data from a study on international commercial services in the English National Health Service (NHS).
Results:
The findings of the research demonstrate how the UK government has sought to build political consensus around specific (commodified) forms of internationalisation in a context of fiscal austerity and xenophobia surrounding the provision of public services. The English NHS has been politically re-imagined as world-leading and of interest as an export industry. Study findings show this stance is premised normatively on processes of subsidy between two apparently distinct spheres – from international (private) to national (public) – but that in practice the distinction is hazy and subsidy at times indirect, routed to individual staff members or to commercial teams. The ascendancy of this as a prevailing, politically legitimate form of internationalisation for the English NHS contrasts sharply with non-commodified alternatives decried as ‘health tourism’.
Conclusions:
The internationalisation framework presented in this article offers a platform for future research that can shed light on the contexts, visions, policies and contestations the emerge as healthcare institutions respond to processes of globalisation. It will be important to avoid uncritical approaches to research and policy by examining not just what forms of internationalisation find favour, and their basis in geographical and racialised hierarchies, but also how approaches to healthcare internationalisation impact inequalities within and between nations
Do you know your neighborhood? Integrating street view images and multi-task learning for fine-grained multi-class neighborhood wealthiness perception prediction
No full textThe assessment of urban wealthiness is fundamental to effective urban planning and development. However, conventional methodologies often rely on aggregated datasets, such as census data, with a coarse-grained resolution at the census tract level, impeding accurate evaluation of wealthiness in individual neighborhoods and failing to capture spatial heterogeneity. This study proposes a novel approach to predict urban wealthiness at a point-scale spatial resolution by utilizing geo-tagged street view images as input for deep learning models, thereby simulating human perception of urban built environments. Using the Place Pulse 2.0 dataset, which contains over 1.2 million pairwise comparisons of 110,988 street view images from 56 cities worldwide for different urban environment perception factors (e.g., safety and wealthiness), we developed deep learning models based on the Swin Transformer and Multi-gate Mixture-of-Experts (MMOE), a multi-task learning architecture. These models extract and integrate visual features of surrounding elements, including buildings, parks, and vehicles, to classify the wealthiness of specific geo-locations into three categories: Impoverished, Middle, and Affluent. To enhance model training and ground truth data, we modified and enhanced the TrueSkill Rating System, used for scoring neighborhoods via pairwise street view image comparisons, by considering temporal decay and spatial autocorrelation factors. These modifications improved the normality of wealthiness score distribution, reducing the standard deviation from 5.385 to 4.302 and skewness from −0.055 to −0.024. Consequently, model performance improved consistently, with accuracy increases observed in Swin Transformer (63 % to 68 %), ViT (54 % to 58 %), and ResNet50 (51 % to 56 %). In addition, proposed MMOE model demonstrates a significant improvement in the differentiation and classification of wealth categories within a three-class classification system (Impoverished, Middle, Affluent). It achieves an overall accuracy of 82 %, outperforming baseline models, Swin Transformer, ViT, and ResNet50, by 14 %, 24 %, and 26 % respectively. Additionally, we compared our model's predictions with average household income data at the census block group level to elucidate its strengths and limitations. Experimental results demonstrated the efficacy of using geo-tagged street view images for predicting urban wealthiness across diverse geographic and environmental contexts. Our findings also highlight the importance of integrating both quantitative and qualitative evaluations in the prediction of urban environmental factors. By synthesizing human perceptions with advanced deep learning techniques, our approach offers a nuanced understanding of urban wealthiness, providing valuable insights for urban planning and development strategies
Bespoke SDRadar platform for Animal Welfare
Get PDF—Lameness in dairy cattle is a major challenge in
precision livestock farming, impacting productivity and incurring
losses of $75–500 per animal annually. Conventional gait assessment methods lack consistency and objectivity, while existing
sensor- and vision-based technologies often require controlled
environments and frequent maintenance. This paper presents a
1 GHz bandwidth FMCW Software-Defined Radar (SDRadar)
system for non-contact animal monitoring. The system enables
real-time vital signs monitoring in stationary cattle and gait
analysis in walking animals. Lameness is detected by analysing
micro-Doppler signatures associated with limb motion, offering a
robust, environmentally resilient alternative to vision-based methods. Experimental validation demonstrates the radar’s capability
to operate under typical farm conditions, supporting reliable,
scalable deployment for automated animal welfare monitoring
The law of averages: the use and abuse of statistics in UK music streaming debates
Get PDFIn the UK, three legislative recommendations have been made to improve recording artists’ remuneration from streaming: equitable remuneration, rights reversion, and contract adjustment. As proposed, each measure would witness the recording artists’ share of revenue increase at the expense of the recording companies’ share. This article addresses the recording industry’s attempt to thwart these recommendations on the grounds that average royalty rates have improved. First, it looks at evidence relating to royalty rates and finds that the increase is less marked than has been presented. Second, it argues that improvement to average royalties does not provide a legitimate means for rejecting these proposals
Heat Stress Dichotomy: Long-term Adaptation and Acute Shock in London Domestic Environments
Get PDFClimate change is driving rising temperatures and more frequent extreme weather, challenging countries like the UK with historically mild summers. This study uses sensor data to analyze indoor thermal comfort in London homes during a record-hot summer. Findings reveal frequent discomfort, brief heat spikes, and links between indoor temperatures, socioeconomic factors, and housing conditions. The research provides insights to improve thermal resilience in homes
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