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Longitudinal Immunoprofiling of the CD8 + T-Cell Response in SARS-CoV-2 mRNA Vaccinees and COVID-19 Patients
Get PDFBackground: SARS-CoV-2 was the causing agent of the COVID-19 pandemic, which resulted in millions of deaths worldwide and massive economic losses. Although there are already several vaccines licensed, as novel variants develop, understanding the immune response induced by vaccination and natural infection is key for the development of future vaccines. Methods: In this study, we have used flow cytometry and next-generation sequencing to assess the longitudinal CD8+ T-cell response against natural infection and vaccination in convalescent and vaccinated individuals, from early activation to immune memory establishment. Moreover, we have characterized the T-cell receptor clonality and diversity at different stages post-infection and post-vaccination. Results: We have found no significant differences in CD8+ T-cell activation during the first three weeks post-infection compared to the first three weeks after first vaccination. Conversely, natural infection resulted in sustained high levels of T-cell activation at four weeks post-infection, a point in which we observed a decline in T-cell activation post-vaccination despite boosting with a second vaccination shot. Moreover, additional vaccination did not result in enhanced T-cell activation. Of note, we have observed variations in the memory subset structure at every stage of disease and vaccination. Overall, both infection and immunization induced a highly diverse T-cell receptor repertoire, which was observed both between study groups and between patients inside a given group. Conclusions: These data contribute to expand our knowledge about the immune response to SARS-CoV-2 infection and vaccination and call for additional strategies to enhance T-cell responses by booster immunization
Layered motion fusion: lifting motion segmentation to 3D in egocentric videos
Get PDFComputer vision is largely based on 2D techniques, with 3D vision still relegated to a relatively narrow subset of applications. However, by building on recent advances in 3D models such as neural radiance fields, some authors have shown that 3D techniques can at last improve outputs extracted from independent 2D views, by fusing them into 3D and denoising them. This is particularly helpful in egocentric videos, where the camera motion is significant, but only under the assumption that the scene itself is static. In fact, as shown in the recent analysis conducted by EPIC Fields, 3D techniques are ineffective when it comes to studying dynamic phenomena, and, in particular, when segmenting moving objects. In this paper, we look into this issue in more detail. First, we propose to improve dynamic segmentation in 3D by fusing motion segmentation predictions from a 2D-based model into layered radiance fields (Layered Motion Fusion). However, the high complexity of long, dynamic videos makes it challenging to capture the underlying geometric structure, and, as a result, hinders the fusion of motion cues into the (incomplete) scene geometry. We address this issue through test-time refinement, which helps the model to focus on specific frames, thereby reducing the data complexity. This results in a synergy between motion fusion and the refinement, and in turn leads to segmentation predictions of the 3D model that surpass the 2D baseline by a large margin. This demonstrates that 3D techniques can enhance 2D analysis even for dynamic phenomena in a challenging and realistic setting
ADHD, school performance, and economic outcomes
No full textThis review of the literature on Attention Deficit Hyperactivity Disorder (ADHD) focuses on its long-term effects on educational and economic outcomes, the impact of pharmacological treatments, and broader societal costs. It offers a critical perspective, complementing existing health science reviews by: (a) including studies from the economics literature that employ quasi-experimental methods; (b) critically comparing the estimation strategies adopted in past studies; and (c) emphasizing unresolved econometric challenges.
The review key findings are summarized as follows: (a) The quasi-experimental evidence based on sibling fixed effect estimation and genetic variation confirms that ADHD negatively impacts educational and economic outcomes. Notably, separating the effects of inattention and hyperactivity reveals that inattention drives adverse educational outcomes, while hyperactivity does not. (b) When evaluating the effect of medications on long-term outcomes, the lack of long-term random control trial studies requires addressing the challenge of non-random selection into ADHD treatment. A novel, promising estimation approach to address this selection issue is using pharmacoepidemiological studies that exploit administrative data and quasi-random variation in prescription rates across health providers. While this is possibly the most convincing estimation approach, it captures the causal effect of medications only for marginally treated patients who tend to be individuals with milder ADHD symptoms. The findings from these studies could be generalized to the full population only if there are no heterogeneous effects of the treatment and, in particular, if the effect of medications is identical across patients with different levels of symptoms. Adopting the marginal treatment effect framework is a potential methodological solution for future research. (c) Evidence indicates that children with milder ADHD symptoms are more likely to have a marginal diagnosis if they are the youngest in their school grade and if they live in countries or areas with higher rates of ADHD diagnoses. As a result, a cautious interpretation is required when comparing the estimated effects of pharmacological treatment across different countries or children with different propensity to be diagnosed. (d) The total economic burden of ADHD is substantial and multifaceted, extending beyond healthcare to include education costs, lost productivity, and justice system expenses, with significant spillover effects on families, peers, and society. Capturing all these costs is econometrically challenging and data-demanding, and there is a need for more robust empirical evidence and more findings for developing countries. Focusing on developed countries, recent studies estimate the annual per-person cost of ADHD at 244 to 18,751 US dollars (2019 constant dollars)
Ethical mediation: navigating research ethics and frictions in overseas fieldwork
Get PDFThis paper problematises the application of UK-based research ethics policy for overseas fieldwork. It draws on our own fieldwork experiences as researchers holding double affiliations. On the one hand, we are affiliated with two UK universities, on the other, our overseas fieldwork sites are in our home country, Jordan. Insider researchers face multiple frictions as they navigate between ethics requirements by their institutions and their participants' culture. We argue that in the researchers' pursuit to uphold institutional policies of their universities while respecting the socio-cultural sensibilities of their participants at overseas fieldwork sites, they engage in mediative acts. Thus, we put forth the concept of ethical mediation to describe these acts of mediation that researchers engage in. We discuss the concept through two topics that cause friction and prompt mediation: researchers’ positionality and informed consent. This paper examines our field experiences in conducting 80 semi-structured interviews, including a structured 53-page ethics diary. The data examination follows two approaches: a prospective approach that focuses on ethics processes from the onset of fieldwork preparation, and a retrospective approach that assesses ethical aspects after the conclusion of the research project. We conclude by reflecting on the role of ethics training. We also suggest measures for improving institutional ethics processes to support researchers as they engage in ethical mediation during overseas fieldwork
Recyclable Li‐Metal Battery Electrolytes via In Situ Cyclic Carbonate Polymerization
Get PDFEnabling recycling and improving performance are key challenges for next‐generation electrolytes for rechargeable batteries. Here, an equilibrium polymerization: trimethylene carbonate (TMC) ring‐opening polymerization, in the presence of lithium difluoro(oxalato)borate salt, is utilized to form an electrolyte in situ during coin cell fabrication for lithium batteries. This process creates a semi‐solid poly(trimethylene carbonate) electrolyte with high ambient ionic conductivity (0.52 mS cm−1), thermal stability (Td, 5% = 160 °C), and oxidative stability up to 4.7 V. Using this electrolyte with commercial lithium iron phosphate cathodes, results in 97% capacity retention after 350 cycles at 2C, achieving theoretical capacities of 170 mAh g−1 at 0.1C. The cells retain excellent performance at high current densities (86 mAh g−1 at 4C). Post‐use, the polymer can be separated from the salt and selectively recycled to pure starting monomer (TMC) through a solid‐state chemical recycling process. The recycled monomer, when repolymerized to reform the polycarbonate electrolyte, yields cells with performance identical to the original. The exploitation of polymerization‐depolymerization equilibria offers a useful strategy for enhancing battery performance, ensuring effective material recycling, and advancing a circular economy
Corinna and the shield of Athena
No full textThis article analyses an underappreciated testimonium for Corinna’s literary corpus to reconsider how female poetic production fits within the wider poetic tradition of archaic and classical Greece: namely, Antipater of Thessalonica’s report that Corinna ‘sang of the impetuous shield of Athena’ (AP 9.26.5–6 = 667 PMG). After locating Corinna in a fourth-century context, the article proceeds in three stages: first, it focusses on Antipater’s epigram and argues that Antipater is responding to the distinctive poetry of the different female authors he lists (including Sappho’s hair-centric poetics); this strengthens the likelihood that the ‘shield of Athena’ was indeed the subject of one of Corinna’s poems. Second, it considers the possible nature of a poem that treated ‘Athena’s shield’, exploring how Corinna’s poem might have foregrounded Athena and Medusa as distinctive emblems of female power, set against the masculine shield ecphrases of the epic tradition. This strategy would complement Corinna’s practice elsewhere in her extant fragments, where she attentively reworks the male epic tradition from a female perspective. Finally, it considers the possible narrative context of a poem featuring Athena’s shield, exploring connections with the known titles of Corinna’s poetry, as well as possible links with the importance of shields to Boeotian identity, with the cult of Athena Itonia at Coroneia and with the myth of the petrified priestess Iodama
Fast Degradation of Solid Electrolyte in Initial Cycling Processes, Tracked in 3D by Synchrotron X‑ray Computed Tomography
Get PDFSolid-state lithium batteries are developing rapidly as a promising next-generation battery, while challenges still persist in understanding their degradation processes during cycling due to the difficulties in characterization. In this study, the 3D morphological evolution of the Li3PS4 solid electrolyte was tracked during electrochemical cycles (plating and stripping) until short circuit by utilizing in situ synchrotron X-ray computed tomography with sufficient spatial and temporal resolution. During the degradation process, cracks in the electrolyte alternately generated from the two electrode/electrolyte interfaces and propagated until shorting. The lithium dendrites filled in the electrolyte cracks but had a greatly reduced filling ratio after the first plating stage; therefore, the cell could continue working for some time after the solid electrolyte was fully fractured by cracks. The compression of the two lithium electrodes mainly occurred in initial cycles where a ca. 4–7 μm reduction in thickness was observed. The mechanical force and electric potential fields were modeled to visualize their redistributions in different stages of cycling. The release of strain energy after the first penetration and thereafter the subsequent driving forces are discussed. These results reveal a fast degradation of solid electrolyte in the initial cycles, providing insights for further modifications and improvements in solid-state batteries
Accelerators for improved health among adolescent mothers in South Africa: HIV and violence prevention, sexual reproductive health and education success
Get PDFBackground: 30% of girls in Africa are mothers, facing high risk for negative health and educational outcomes. We aimed to identify services with the potential to reduce multiple simultaneous risks for adolescent mothers, described by the UN as ‘development accelerators’. Methods: Adolescent mothers (n=1044) from South Africa completed questionnaires between 2017/2019 and 2020/2023, assessing mental health, HIV risks, violence victimisation, education access and hypothesised ‘accelerators’. We used multivariable random effects regression models, adjusting for covariates. Predicted probabilities (marginal effects) were estimated to determine how each identified accelerator, and their combinations, influence the probability of each outcome, offering improved interpretability into the impact of the accelerators. Results: Three ‘accelerators’ showed protective associations against multiple risks: Food security was associated with reductions in age disparate/transactional sex (OR 0.56, 95% CI (0.42, 0.74)); no contraception use (OR 0.42, 95% CI (0.29, 0.60)); no school enrolment or work engagement (OR 0.46, 95% CI (0.32, 0.67)) and low self-efficacy (OR 0.62, 95% CI (0.46, 0.83)). Non-violent parenting was associated with reductions in suicidality (OR 0.20, 95% CI (0.10, 0.39)); mental health distress (OR 0.44, 95% CI (0.31, 0.64)); transactional/age disparate sex (OR 0.62, 95% CI (0.45, 0.87)); intimate partner violence (OR 0.27, 95% CI (0.14, 0.52)); and sexual violence (OR 0.21, 95% CI (0.10, 0.44)). Respectful clinics were associated with reductions in mental health distress (OR 0.65, 95% CI (0.46, 0.92)); low self-efficacy (OR 0.43, 95% CI (0.33, 0.58)) and condomless sex (OR 0.46, 95% CI (0.35, 0.61). When all three accelerators—compared with none—were provided, risks were greatly lowered. For example, suicidality from 13% to 2%; intimate partner violence from 22% to 5% and sexual violence from 11% to 1%. Conclusions: This real-world, longitudinal cohort design study identifies services with accelerator impacts that protect adolescent mothers against multiple risks. These can be realised through improved reach of existing services to include adolescent mothers: economic support including government cash transfers, parenting programmes and adolescent-responsive healthcare
Prevalence and types of errors in the electronic health record: protocol for a mixed systematic review
Get PDFIntroduction: In countries with access to the electronic health record (EHR), both patients and healthcare professionals have reported finding errors in the EHR, so-called EHRrors. These can range from simple typos to more serious cases of missing or incorrect health information. Despite their potential detrimental effect, the evidence on EHRrors has not been systematically analysed. It is unknown how common EHRrors are or how they impact patients and healthcare professionals. Methods and analysis: A mixed systematic review will be carried out to address the research gap. We will search PubMed, Web of Science and CINAHL for studies published since 2000, which report original research data on patient-identified and healthcare professional-identified EHRrors. We will analyse (1) the prevalence of EHRrors, (2) the types of EHRrors and (3) their impact on care. Quantitative and qualitative findings will be synthesised following the Joanna Briggs Institute Framework for Mixed Systematic Reviews. Identified studies will be critically appraised for meta-biases and risk of bias in individual studies. The confidence in the emerging evidence will be further assessed through the Grading of Recommendations Assessment, Development and Evaluation approach. Findings will be contextualised and interpreted involving an international team of patient representatives and practising healthcare professionals. Ethics and dissemination: The study will not involve collection or analysis of individual patient data; thus, ethical approval is not required. Results will be published in a peer-reviewed publication and further disseminated through scientific events and educational materials. PROSPERO registration number: CRD42024622849
Impact and outcomes of the Emerging Leaders Programme: a mixed-methods evaluation of a leadership development programme for healthcare professionals
Get PDFBackground: The significance of effective medical leadership in enhancing healthcare outcomes has been widely acknowledged. This study evaluates the Emerging Leaders Programme, a multidisciplinary leadership development initiative for healthcare professionals at a UK Hospital Trust. Methods: The evaluation spanned three cohorts (2017–2019) and a total of 54 participants, employing mixed methods to assess participant reactions, learning, behaviour changes and organisational impact. Quantitative pre-/post-measures included the Primary Colours Questionnaire (PCQ), Medical Leadership Competency Framework Questionnaire (MLCFQ) and Brief Resilience Scale (BRS), while qualitative data were gathered via free-text comments and long-term follow-up interviews. Results: The programme had high satisfaction ratings, with particularly positive feedback relating to the multidisciplinary cohort and experiential learning via Quality Improvement projects. Findings indicated improvements in participants’ leadership skills, knowledge, confidence and job satisfaction. Organisational outcomes included increased organisational interest in quality improvement and individual career progression. Conclusion: The results highlight the value of a structured leadership programme in developing healthcare leaders and driving organisational improvements, with long-term effects. Recommendations for future programmes include multidisciplinary involvement, experiential learning, inspiring speakers and embedded mixed-methods evaluation