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Individual Management Plan Outcome Score (IMP-OS):Psychometric Evaluation of an Adult Aural Rehabilitation Idiographic Patient-Reported Outcome Measure for Use in Audiology
Get PDFBackground/ObjectiveIdiographic patient-reported outcome measures (I-PROMs) have been shown to be an engaging and meaningful way of collecting therapeutic outcomes in healthcare, but no such tool currently exists in adult aural rehabilitation. This paper describes a new I-PROM, the Individual Management Plan Outcome Score (IMP-OS) that was developed in a North Wales audiology service and aims to assess its psychometric properties.MethodsIMP-OS was compared to two existing condition-specific patient reported outcome measures (PROMs) for convergent validation, and a generic health-related quality of life PROM for divergent validation. Test–retest reliability was also assessed, and normative data were derived, leading to the creation of clinical interpretation recommendations. Convergent, divergent validation and normative data were based on sample A (59 adults) and for test–retest, sample B (15 adults).ResultsIMP-OS was significantly correlated with some condition-specific PROMs, but not with the generic PROM. It had a moderate-excellent test–retest reliability. Normative data showed that scores below 50 would suggest further clinical intervention is warranted, and should guide further therapeutic discussions with the patient.ConclusionsIMP-OS is the first I-PROM in audiology to be psychometrically verified using international best-practice. It has been shown to reflect aspects of hearing-related outcomes that are important to patients and can be easily integrated into current clinical practice thus helping guide patient-centred care
Corporate discourse
No full textThis chapter explores the linguistic landscape of corporate communication, summarizing key concepts and themes from current research. Linguists have approached corporate discourse from various theoretical and methodological perspectives, including pragmatics, discourse analysis, and cognitive linguistics. These approaches have been applied to different genres of corporate discourse, from advertising and financial reports to crisis messaging and customer service interactions. This body of research reveals how companies tailor their language to different contexts and audiences, influencing consumer decisions as well as broader societal structures and ideologies
Perceptions and Experiences of Co-Produced Positive Behaviour Support Training in Community-Based Services and Organisations for Children With Intellectual Disabilities and Behaviours That Challenge:A Qualitative Multiple Case Study Design
Get PDFBackgroundChildren with intellectual disabilities can display behaviours that challenge, often associated with poor outcomes. Despite national policy commitment to co-production, little evidence is available on how such services deliver co-produced activity.MethodsQualitative data were collected from three services that reported co-producing Positive Behaviour Support introductory workshops. Participants' experiences and perceptions of these workshops were described through individual semi-structured interviews conducted with staff and family carers (n = 24) and analysed using a Framework approach.ResultsTwo main themes were represented in the initial framework. Positives of Co-production included the advantages of obtaining and combining theoretical and practical knowledge, including personal and professional development for those delivering the intervention. Challenges to Implementation included the time and effort required to build a collaborative way of working, barriers to organisational support and family carers' history with services.ConclusionsSupport, funding and resources need to be made available and protected to make co-production activities meaningfu
NEO:No-Optimization Test-Time Adaptation through Latent Re-Centering
Get PDFTest-Time Adaptation (TTA) methods are often computationally expensive, require a large amount of data for effective adaptation, or are brittle to hyperparameters. Based on a theoretical foundation of the geometry of the latent space, we are able to significantly improve the alignment between source and distribution-shifted samples by re-centering target data embeddings at the origin. This insight motivates NEO -- a hyperparameter-free fully TTA method, that adds no significant compute compared to vanilla inference. NEO is able to improve the classification accuracy of ViT-Base on ImageNet-C from 55.6% to 59.2% after adapting on just one batch of 64 samples. When adapting on 512 samples NEO beats all 7 TTA methods we compare against on ImageNet-C, ImageNet-R and ImageNet-S and beats 6/7 on CIFAR-10-C, while using the least amount of compute. NEO performs well on model calibration metrics and additionally is able to adapt from 1 class to improve accuracy on 999 other classes in ImageNet-C. On Raspberry Pi and Jetson Orin Nano devices, NEO reduces inference time by 63% and memory usage by 9% compared to baselines. Our results based on 3 ViT architectures and 4 datasets show that NEO can be used efficiently and effectively for TTA
‘Felt Sense of Anomaly’-type transdiagnostic dissociative experiences in adolescents:endorsed phenomenology and plausible mechanisms
No full textObjective: Research indicates dissociative experiences are prevalent in adolescents. However, the exact phenomenology and underlying mechanisms of dissociation in adolescence have yet to be clarified. The current study explores the presentation of, and possible psychological factors maintaining, dissociation in this population.Method: Two online self-report surveys captured data from 3076 adolescents aged 13 to 18 years. Participants completed the Černis Felt Sense of Anomaly (ČEFSA) scale of felt sense of anomaly-type dissociation, alongside measures of mechanisms chosen to test the relevance of a cognitive-behavioural model of dissociation in adults (cognitive appraisals, alexithymia, healthy affect regulation, and affect intolerance in the form of expressive suppression). N=409 completed the ČEFSA scale at a second timepoint, one month later, enabling exploration of proposed maintenance factors.Results: Most (91.87%) adolescents endorsed at least one ČEFSA item. The mean number of endorsed items was 13.00 (SD = 9.67). The most endorsed factors of the ČEFSA were Altered Sense of Agency (82.96%), Anomalous experience of the Self (76.76%), and Altered Sense of Connection (73.76%).Mediation analysis indicated that affect intolerance (expressive suppression) mediated the relationship between Time One and Time Two dissociation scores: greater suppression was associated with greater dissociation one month later. No other tested variables showed statistically significant mediation.Conclusions: Adolescents are likely to experience dissociation as detachment and disconnection, particularly relating to their selfhood and external world (i.e., depersonalisation and derealisation). This study suggests that the key element of a recent cognitive-behavioural model of dissociative experiences in adults – that affect intolerance perpetuates dissociation – may also be applicable in adolescence
Agreement testing of AMSTAR-PF, a tool for quality appraisal of systematic reviews of prognostic factor studies
Get PDFObjectives: To test the agreement and usability of a novel quality appraisal tool: A MeaSurement Tool to Assess systematic Reviews of Prognostic Factor studies (AMSTAR-PF). Design: Observational study. Participants: 14 appraisers of varied experience levels and backgrounds, including undergraduate, master’s and PhD students, postgraduate researchers, research fellows and clinicians. Study procedure: Eight systematic reviews were rated by all reviewers using AMSTAR-PF. Outcome measures: Planned measures included intrapair and inter-pair agreement using Cohen’s and Fleiss’ kappa, time of use and time to reach consensus. Interrater agreement was an added measure, and Gwet’s agreement coefficient was calculated and presented due to its greater stability across agreement levels. The percentage of intrapair agreements identical or one category apart was also presented. Results: Interrater agreement averaged 0.59 (range 0.21–0.90), inter-pair agreement 0.61 (range 0.24–0.91) and intrapair agreement 0.75 (range 0.45–0.95) across the domains, with agreement for the overall rating 0.46 (95% CI 0.30 to 0.62) for interrater agreement, 0.46 (95% CI 0.17 to 0.74) for inter-pair agreement and 0.68 (range of averages 0.22–1.00) for intrapair agreement. The majority (60.7%) of intrapair ratings were identical, with 94.6% of final ratings either identical or only one category different for the overall appraisal. The time taken to appraise a study with AMSTAR-PF improved with use and averaged around 34 min after the first two appraisals. Conclusions: Despite some variance in agreement for different domains and between different appraisers, the testing results suggest that AMSTAR-PF has clear utility for appraising the quality of systematic reviews of prognostic factor studies
The Myth of Male Vulnerability:Exploring Sex Differences in Physiological Risk for Drowsy Driving
No full textAn upstream secondary DNA motif within the <i>IL3 </i>insulator CTCF binding site is required for enhancer-blocking insulator activity
Get PDFCCCTC-binding Factor (CTCF) is the only known vertebrate protein that functions to organise the genome into distinct functional chromatin domains. A subset of CTCF sites also provide insulator activity and barrier activity to block inappropriate enhancer-promoter communication and spreading of histone modifications and non-coding transcription into loci where it is unwarranted. Paradoxically, other CTCF sites mediate enhancer and promoter communication, partly by supporting DNA loop extrusion within chromatin domains. Despite intensive study and abundant data, it remains poorly understood how CTCF directs these different functions. In this study we provide new data and mine published data that show that CTCF utilises zinc fingers 9–11 and an upstream DNA binding consensus sequence resembling CAGCTGTTCC to mediate high affinity binding and enhancer-blocking insulator activity. A single high affinity CTCF binding site from the IL3 locus is able block IL3 promoter activation by an upstream enhancer. Mutation of a CTGCAGCTTT sequence upstream of the CTCF core motif abolishes insulator activity. We propose that CTCF is able to confer insulator and barrier activity upon a specific subset of CTCF sites that contain the upstream DNA consensus binding motif, thereby allowing CTCF to function differently in different contexts
Pyrolysis of Cellulose with Gallium/HZSM-5 Catalysts via Py/GC-MS
Get PDFCellulose has received significant attention, given its high demand for the transition to sustainable fuels and renewable energy, addressing the environmental challenges of fossil fuels. Fast pyrolysis is a process that can transform cellulose into bio-oil. Although the bio-oils produced contain considerable amounts of oxygen and water, they are highly corrosive and highly viscous, which limits their utility as biofuels. Pyrolysis bio-oils require upgrading to remove oxygen and corrosive components, thereby enhancing their stability for use as biofuels and their environmental sustainability. This study investigates the catalytic pyrolysis of cellulose without a catalyst and with Ga/HZSM-5 catalysts with various gallium loadings (0.3, 3 and 9 wt%) and bulk Ga2O3 catalysts using pyrolysis/gas chromatography–mass spectrometry (Py/GC-MS). The catalytic influence of different gallium loadings on HZSM-5 in cellulose pyrolysis reactions is discussed using a range of characterisation techniques, including ICP, XRD, N2 porosimetry, DRIFTS, and TPRS. The main production of oxygenated compounds (furan, sugar, ketone and phenol) and hydrocarbon products, including total aromatic and monocyclic and polycyclic aromatics, as well as benzene, toluene, xylene (BTX) and naphthalene compounds, using a family of Ga-doped HZSM-5 catalysts for cellulose pyrolysis is investigated for making sustainable cellulose-derived fuel. Ga(3)/HZSM-5 formed the highest amount of aromatics, displaying that aromatic yield depends on the Brønsted-to-Lewis acid balance (2.3 ratio) and total acidity (1.03 mmol·g−1), rather than on gallium loading alone.</p
Hyodeoxycholic acid attenuates atherosclerosis by antagonizing FXR and modulating the PD-1/mTORC1 signaling axis
Get PDFAccumulating evidence suggested that bile acids play a significant role in modulating metabolic and inflammatory diseases. In this study, we investigated the roles of the farnesoid X receptor (FXR) and its endogenous antagonist hyodeoxycholic acid (HDCA) in the development of atherosclerosis (AS). We found that serum HDCA was significantly reduced in patients with AS, and systemic HDCA therapy attenuated plaque burden in vivo. Adoptive transfer of HDCA-treated Foxp3+ Tregs into ApoE-deficient recipients reduced lesion growth, whereas FXR-deficient Tregs failed to confer benefit. HDCA enhanced Treg migration and accumulation within plaques and reprogrammed Treg metabolism by antagonizing FXR and modulating PD-1/mTORC1 signaling. This shift relieved CPT1a-driven fatty acid oxidation bias, increased glycolysis and ATP production, and improved migratory capacity and effector function. We further identify ZNF671 as a transcriptional inhibitor of Treg migration that is mitigated by HDCA-dependent metabolic switching. Collectively, HDCA reduced FXR-mediated metabolic constraints while activating glycolytic and migratory programs in Tregs, thereby improving lipid handling and immune regulation within the plaque microenvironment. These findings position the HDCA-FXR-PD-1/mTORC1 axis as a novel immunometabolic target for AS.</p
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