JURNAL AGROTEKNOLOGI
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Shielding working-memory representations from temporally predictable external interference
No full textProtecting working-memory content from distracting external sensory inputs and intervening tasks is an ubiquitous demand in daily life. Here, we ask whether and how temporal expectations about external events can help mitigate effects of such interference during working-memory retention. We manipulated the temporal predictability of interfering items that occurred during the retention period of a visual working-memory task and report that temporal expectations reduce the detrimental influence of external interference on subsequent memory performance. Moreover, to determine if the protective effects of temporal expectations rely on distractor suppression or involve shielding of internal representations, we compared effects after irrelevant distractors that could be ignored vs. interrupters that required a response. Whereas distractor suppression may be sufficient to confer protection from predictable distractors, any benefits after interruption are likely to involve memory shielding. We found similar benefits of temporal expectations after both types of interference. We conclude that temporal expectations may play an important role in safeguarding behaviour based on working memory – acting through mechanisms that include the shielding of internal content from external interference
Can European electric utilities manage asset impairments arising from net zero carbon targets?
No full textThis paper develops a framework to assess the ability of electric utilities to sustain the forced impairment of carbon emitting power plants and applies it to the European market. We present a new method to measure asset impairment, for both the company and the industry, based on a database of power plants. We develop a novel framework to analyse a utility's ability to transition by investing in green technology assets through the impact on its credit rating metrics. Finally, we apply our framework to European utilities under scenarios set out by the European Commission to limit global warming by imposing net zero carbon emissions constraints on companies. We conclude that most European utilities have the financial capacity to meet the requirements of net zero carbon emissions under the scenarios with timely action. However, a delay of as little as five years could cause serious financial problems across the sector
A perspective: use of machine learning models to predict the risk of multimorbidity
No full textMachine Learning (ML) is a common Artificial Intelligence (AI) method. The use of ML offers the opportunity to develop better data mining techniques in order to analyse complex clinical interactions with a large number of variables. ML models should provide “real-time” clinical support reducing clinical risk to patients with model-agnostic interpretation to deduce a more specific clinical decision. Whilst ML algorithms have been used as the relatively “new kid on the block” in healthcare practice, they have shown promising results in predicting disease outcomes or risks in a variety of diseases such as depressive disorder, Type 2 diabetes mellitus, postoperative complications and cardiovascular diseases. However, patients suffering from a chronic condition are likely to have more than one condition requiring simultaneous attention and care. Therefore, a risk assessment model developed using ML methods, in theory, would be suitable to evaluate multimorbid populations. While there are many AI/ML algorithms and methods to build such a risk assessment tool, an optimal ‘fit-for-purpose’ model is chosen by comparing and contrasting across many possible alternatives. Furthermore, given the high-stake decisions associated with health, it is also important that the model is interpretable and explainable by the clinicians who are purported to use such a model as their decision support system. In this paper, we provide a perspective on the current landscape of multimorbidity treatment, potential benefit of employing AI/ML to enhance holistic care of multimorbid patients, and associated challenges, concerns that need to be addressed as we make progress in this direction
The electoral connection revisited: introduction to the special issue
No full textIntroduction to a symposium: ‘The electoral connection revisited: personal vote-seeking efforts
CD8 co-receptor enhances T-cell activation without any effect on initial attachment
No full textThe scanning of surrounding tissues by T lymphocytes to detect cognate antigens requires high speed, sensitivity and specificity. T-cell receptor (TCR) co-receptors such as CD8 increase detection performance, but the exact mechanism remains incompletely understood. Here, we used a laminar flow chamber to measure at the single molecule level the kinetics of bond formation and rupture between TCR- transfected CD8+ and CD8- Jurkat cells and surfaces coated with five peptide-exposing major histocompatibility antigens (pMHCs) of varying activating power. We also used interference reflection microscopy to image the spreading of these cells dropped on pMHC-exposing surfaces. CD8 did not influence the TCR-pMHC interaction during the first few seconds following cell surface encounter, but it promoted the subsequent spreading responses, suggesting that CD8 was involved in early activation rather than binding. Further, the rate and extent of spreading, but not the lag between contact and spreading initiation, depended on the pMHC. Elucidating T-lymphocyte detection strategy may help unravel underlying signaling networks
Modelling non-linear age-period-cohort effects and covariates, with an application to English obesity 2001–2014
No full textWe develop an age-period-cohort model for repeated cross-section data with individual covariates, which identifies the non-linear effects of age, period and cohort. This is done for both continuous and binary dependent variables. The age, period and cohort effects in the model are represented by a parametrization with freely varying parameters that separates the identified non-linear effects and the unidentifiable linear effects. We develop a test of the parametrization against a more general ‘time-saturated’ model. The method is applied to analyse the obesity epidemic in England using survey data. The main non-linear effects we find in English obesity data are age-related among women and cohort-related among men
Risk factors associated with mechanical ventilation, autonomic nervous dysfunction and physical outcome in Vietnamese adults with tetanus
No full textBackground: Tetanus remains common in many low- and middle-income countries, but as critical care services improve, mortality from tetanus is improving. Nevertheless, patients develop severe syndromes associated with autonomic nervous system disturbance (ANSD) and the requirement for mechanical ventilation (MV). Understanding factors associated with worse outcome in such settings is important to direct interventions. In this study, we investigate risk factors for disease severity and long-term physical outcome in adults with tetanus admitted to a Vietnamese intensive care unit.
Methods: Clinical and demographic variables were collected prospectively from 180 adults with tetanus. Physical function component scores (PCS), calculated from Short Form Health Survey (SF-36), were assessed in 79 patients at hospital discharge, 3 and 6 months post discharge.
Results: Age, temperature, heart rate, lower peripheral oxygen saturation (SpO2) and shorter time from first symptom to admission were associated with MV (OR 1.03 [ 95% confidence interval (CI) 1.00, 1.05], p = 0.04; OR 2.10 [95% CI 1.03, 4.60], p = 0.04; OR 1.04 [ 95% CI 1.01, 1.07], p = 0.02); OR 0.80 [95% CI 0.66, 0.94], p = 0.02 and OR 0.65 [95% CI 0.52, 0.79, p
Heart rate, SpO2 and time from first symptom to admission were associated with ANSD (OR 1.03 [95% CI 1.01, 1.06], p
Median [interquartile range] PCS at hospital discharge, 3 and 6 months were 32.37 [24.95–41.57, 53.0 [41.6–56.3] and 54.8 [51.6–57.3], respectively. Age, female sex, admission systolic blood pressure, admission SpO2, MV, ANSD, midazolam requirement, hospital-acquired infection, pressure ulcer and duration of ICU and hospital stay were associated with reduced 0.25 quantile PCS at 6 months after hospital discharge.
Conclusions: MV and ANSD may be suitable endpoints for future research. Risk factors for reduced physical function at 3 months and 6 months post discharge suggest that modifiable features during hospital management are important determinants of long-term outcome
The role of locum GPs in antibiotic prescribing and stewardship: a mixed-methods study
No full textBackground: Most antibiotics are prescribed in primary care. Locum or sessional general practitioners (locums) are perceived as contributing to higher prescribing and may face barriers to engaging with antimicrobial stewardship (AMS). Aim: To identify how locums’ antibiotic prescribing compares to other general practice prescribers, and how they perceive their role in antibiotic prescribing and AMS. Design and Setting: A mixed-methods study in primary care. Methods: Data on antibiotic prescribing, diagnoses, and patient and prescriber characteristics were extracted from The Health Improvement Network database. A mixed-effects logistic model was used to compare locums’ and other prescribers’ antibiotic prescribing for conditions which do not usually benefit from antibiotics. Nineteen semi-structured telephone interviews were conducted with locums in England and analysed thematically. Results: Locums accounted for 11% of consultations analysed. They prescribed antibiotics more often than other GPs and nurse prescribers for cough, sore throat, asthma exacerbations and acute bronchitis. The percentage of patients receiving antibiotics for these conditions was 4% higher (on absolute scale) when consulting with locums compared to other GPs. Four themes capture the perceived influences on prescribing antibiotics and AMS: (1) Antibiotic prescribing as a complex but individual issue; (2) Nature and patterns of locum work; (3) Relationships between practices and locums; (4) Professional isolation. Conclusions: Locums contribute to higher antibiotic prescribing compared to their peers. They experience challenges but also opportunities for contributing to AMS, which should be better addressed. With an increasing proportion of locums, they have an important role in antibiotic optimisation and AMS
Income, consumer preferences, and the future of livestock-derived food demand
No full textIn recent decades there has been a sustained and substantial shift in human diets across the globe towards including more livestock-derived foods. Continuing debates scrutinize how these dietary shifts affect human health, the natural environment, and livelihoods. However, amidst these debates there remain unanswered questions about how demand for livestock-derived foods may evolve over the upcoming decades for a range of scenarios for key drivers of change including human population, income, and consumer preferences. Future trends in human population and income in our scenarios were sourced from three of the shared socioeconomic pathways. We used scenario-based modeling to show that average protein demand for red meat (beef, sheep, goats, and pork), poultry, dairy milk, and eggs across the globe would increase by 14% per person and 38% in total between the year 2020 and the year 2050 if trends in income and population continue along a mid-range trajectory. The fastest per person rates of increase were 49% in South Asia and 55% in sub-Saharan Africa. We show that per person demand for red meat in high-income countries would decline by 2.8% if income elasticities of demand (a partial proxy for consumer preferences, based on the responsiveness of demand to income changes) in high-income countries decline by 100% by 2050 under a mid-range trajectory for per person income growth, compared to their current trajectory. Prices are an important driver of demand, and our results demonstrate that the result of a decline in red meat demand in high-income countries is strongly related to rising red meat prices, as projected by our scenario-based modeling. If the decline in the income elasticity of demand occurred in all countries rather than only in high-income countries, then per person red meat demand in high-income countries would actually increase in 2050 by 8.9% because the income elasticity-driven decline in global demand reduces prices, and the effect of lower prices outweighs the effect of a decline in the income elasticity of demand. Our results demonstrate the importance of interactions between income, prices, and the income elasticity of demand in projecting future demand for livestock-derived foods. We complement the existing literature on food systems and global change by providing quantitative evidence about the possible space for the future demand of livestock-derived foods, which has important implications for human health and the natural environment
The potential of artificial intelligence to detect lymphovascular invasion in testicular cancer
No full textTesticular cancer is the most common cancer in men aged from 15 to 34 years. Lymphovascular invasion refers to the presence of tumours within endothelial-lined lymphatic or vascular channels, and has been shown to have prognostic significance in testicular germ cell tumours. In non-seminomatous tumours, lymphovascular invasion is the most powerful prognostic factor for stage 1 disease. For the pathologist, searching multiple slides for lymphovascular invasion can be highly time-consuming. The aim of this retrospective study was to develop and assess an artificial intelligence algorithm that can identify areas suspicious for lymphovascular invasion in histological digital whole slide images. Areas of possible lymphovascular invasion were annotated in a total of 184 whole slide images of haematoxylin and eosin (H&E) stained tissue from 19 patients with testicular germ cell tumours, including a mixture of seminoma and non-seminomatous cases. Following consensus review by specialist uropathologists, we trained a deep learning classifier for automatic segmentation of areas suspicious for lymphovascular invasion. The classifier identified 34 areas within a validation set of 118 whole slide images from 10 patients, each of which was reviewed by three expert pathologists to form a majority consensus. The precision was 0.68 for areas which were considered to be appropriate to flag, and 0.56 for areas considered to be definite lymphovascular invasion. An artificial intelligence tool which highlights areas of possible lymphovascular invasion to reporting pathologists, who then make a final judgement on its presence or absence, has been demonstrated as feasible in this proof-of-concept study. Further development is required before clinical deployment