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Prehospital Extremity Fracture Management in Low and Middle‐Income Countries: A Scoping Review of Lay First Responders and Traditional Bonesetters
Get PDFPurpose: Low‐ and middle‐income countries (LMICs) experience the highest rates of injury‐related deaths globally, exacerbated by a lack of robust emergency medical services (EMS). Though fractures contribute substantially to global injury, little is known about prehospital management of extremity fractures in LMICs. Methods: This review included literature published between January 2000 and January 2024. Inclusion criteria pertained to prehospital settings, defined as care rendered prior to hospital presentation, including care provided by lay first responders (LFRs), professional EMS personnel, and traditional bonesetters (TBS). Multiple authors used the Newcastle‐Ottawa scale to assess texts meeting inclusion criteria, extracting relevant details for analysis. Results: Of 1251 articles identified, 25 met inclusion criteria. Studies spanned 9 countries across 4 continents, with 14 articles studying care by TBS, 9 by LFRs, and 2 by other prehospital providers. LFR training courses report a combined weighted average pre‐/post‐course difference of 29.16 percentage points. A total of 67% of included studies report adverse outcomes associated with TBS‐managed fractures in the prehospital setting. TBS care is often sought prior to hospital presentation due to sociocultural beliefs, accessibility, and cheaper costs. Few training courses for TBS have been performed, though one course reports a 20.4% increase in fracture management knowledge. Conclusion: In certain resource‐limited settings, TBS provide most initial fracture management, which may adversely impact outcomes. Knowledge transfer has been demonstrated during prehospital fracture management courses for LFRs and TBS. Early evidence suggests TBS training and integration into healthcare systems may reduce complication rates, improving long‐term outcomes
Artificial intelligence, digital social networks, and climate emotions
Get PDFEmotions relate to climate change action in various ways. Here we elaborate on how the expansion of digital social networks and advances in artificial intelligence, ranging from recommender systems to generative AI, may affect the way people perceive and engage emotionally on climate change. We develop a simple framework that links individual and collective emotions, AI, and climate action, and suggest three critical areas in need of further investigation
Identification of plasma proteomic markers underlying polygenic risk of type 2 diabetes and related comorbidities
Get PDFGenomics can provide insight into the etiology of type 2 diabetes and its comorbidities, but assigning functionality to non-coding variants remains challenging. Polygenic scores, which aggregate variant effects, can uncover mechanisms when paired with molecular data. Here, we test polygenic scores for type 2 diabetes and cardiometabolic comorbidities for associations with 2,922 circulating proteins in the UK Biobank. The genome-wide type 2 diabetes polygenic score associates with 617 proteins, of which 75% also associate with another cardiometabolic score. Partitioned type 2 diabetes scores, which capture distinct disease biology, associate with 342 proteins (20% unique). In this work, we identify key pathways (e.g., complement cascade), potential therapeutic targets (e.g., FAM3D in type 2 diabetes), and biomarkers of diabetic comorbidities (e.g., EFEMP1 and IGFBP2) through causal inference, pathway enrichment, and Cox regression of clinical trial outcomes. Our results are available via an interactive portal (https://public.cgr.astrazeneca.com/t2d-pgs/v1/)
Reducing transmission in multiple settings is required to eliminate the risk of major Ebola outbreaks: a mathematical modelling study
Get PDFThe Ebola virus (EV) persists in animal populations, with zoonotic transmission to humans occurring every few months or years. When zoonotic transmission arises, it is important to understand which interventions are most effective at preventing a major outbreak driven by human-to-human transmission. Here, we analyse a mathematical model of EV transmission and calculate the probability of a major outbreak starting from a single introduced case. We consider community, funeral and healthcare facility transmission and conduct sensitivity analyses to explore the effects of non-pharmaceutical interventions (NPIs) that influence these transmission routes. We find that, if the index case is treated in the community, then the elimination of transmission at funerals reduces the probability of a major outbreak substantially (from 0.410 to 0.066 under our baseline model parametrization). However, eliminating the risk of major outbreaks entirely requires combinations of measures that limit transmission in different settings, such as community engagement to promote safe burial practices and implementation of barrier nursing in healthcare facilities. In addition to generating insights into the drivers of Ebola outbreaks, this research provides a modelling framework for assessing the effectiveness of interventions at mitigating outbreaks of other infectious diseases with transmission in multiple settings
High-performance automated abstract screening with large language model ensembles
Get PDFObjective
Abstract screening is a labor-intensive component of systematic review involving repetitive application of inclusion and exclusion criteria on a large volume of studies. We aimed to validate large language models (LLMs) used to automate abstract screening.
Materials and Methods
LLMs (GPT-3.5 Turbo, GPT-4 Turbo, GPT-4o, Llama 3 70B, Gemini 1.5 Pro, and Claude Sonnet 3.5) were trialed across 23 Cochrane Library systematic reviews to evaluate their accuracy in zero-shot binary classification for abstract screening. Initial evaluation on a balanced development dataset (n = 800) identified optimal prompting strategies, and the best performing LLM-prompt combinations were then validated on a comprehensive dataset of replicated search results (n = 119 695).
Results
On the development dataset, LLMs exhibited superior performance to human researchers in terms of sensitivity (LLMmax = 1.000, humanmax = 0.775), precision (LLMmax = 0.927, humanmax = 0.911), and balanced accuracy (LLMmax = 0.904, humanmax = 0.865). When evaluated on the comprehensive dataset, the best performing LLM-prompt combinations exhibited consistent sensitivity (range 0.756-1.000) but diminished precision (range 0.004-0.096) due to class imbalance. In addition, 66 LLM-human and LLM-LLM ensembles exhibited perfect sensitivity with a maximal precision of 0.458 with the development dataset, decreasing to 0.1450 over the comprehensive dataset; but conferring workload reductions ranging between 37.55% and 99.11%.
Discussion
Automated abstract screening can reduce the screening workload in systematic review while maintaining quality. Performance variation between reviews highlights the importance of domain-specific validation before autonomous deployment. LLM-human ensembles can achieve similar benefits while maintaining human oversight over all records.
Conclusion
LLMs may reduce the human labor cost of systematic review with maintained or improved accuracy, thereby increasing the efficiency and quality of evidence synthesis
Differential cross-section measurements of Higgs boson production in the H → τ + τ − decay channel in pp collisions at s = 13 TeV with the ATLAS detector
Get PDFDifferential measurements of Higgs boson production in the τ-lepton-pair decay channel are presented in the gluon fusion, vector-boson fusion (VBF), VH and tt¯H associated production modes, with particular focus on the VBF production mode. The data used to perform the measurements correspond to 140 fb−1 of proton-proton collisions collected by the ATLAS experiment at the LHC. Two methods are used to perform the measurements: the Simplified Template Cross-Section (STXS) approach and an Unfolded Fiducial Differential measurement considering only the VBF phase space. For the STXS measurement, events are categorized by their production mode and kinematic properties such as the Higgs boson’s transverse momentum (pTH), the number of jets produced in association with the Higgs boson, or the invariant mass of the two leading jets (mjj). For the VBF production mode, the ratio of the measured cross-section to the Standard Model prediction for mjj > 1.5 TeV and pTH > 200 GeV (pTH < 200 GeV) is 1.29−0.34+0.39 (0.12−0.33+0.34). This is the first VBF measurement for the higher-pTH criteria, and the most precise for the lower-pTH criteria. The fiducial cross-section measurements, which only consider the kinematic properties of the event, are performed as functions of variables characterizing the VBF topology, such as the signed ∆ϕjj between the two leading jets. The measurements have a precision of 30%–50% and agree well with the Standard Model predictions. These results are interpreted in the SMEFT framework, and place the strongest constraints to date on the CP-odd Wilson coefficient cHW~
Soft robot localization using distributed miniaturized time-of-flight sensors
Get PDFThanks to their compliance and adaptability, soft robots can be deployed to perform tasks in constrained or complex environments. In these scenarios, spatial awareness of the surroundings and the ability to localize the robot within the environment represent key aspects. While state-of-the-art localization techniques are well-explored in autonomous vehicles and walking robots, they rely on data retrieved with lidar or depth sensors which are bulky and thus difficult to integrate into small soft robots. Recent developments in miniaturized Time of Flight (ToF) sensors show promise as a small and lightweight alternative to bulky sensors. These sensors can be potentially distributed on the soft robot body, providing multi-point depth data of the surroundings. However, the small spatial resolution and the noisy measurements pose a challenge to the success of state-of-the-art localization algorithms, which are generally applied to much denser and more reliable measurements.
In this paper, we enforce distributed VL53L5CX ToF sensors, mount them on the tip of a soft robot, and investigate their usage for self-localization tasks. Experimental results show that the soft robot can effectively be localized with respect to a known map, with an error comparable to the uncertainty on the measures provided by the miniaturized ToF sensors
Analogical being: the phenomenological side of the analogia entis: The other phenomenologist: Erich Przywara and his analogical phenomenology
No full textThe debate about the analogy of being (analogia entis) is not a niche twentieth-century theological debate. Contrary to the mainstream reading, this theological controversy of the 1930s was also a debate with phenomenology. It is the objective of this project to bring to light this phenomenological side of the analogia entis.
Focusing on the figure of Erich Przywara, this dissertation moves beyond the over-studied Barth-Przywara debate and investigates Przywara’s engagement with three of the foremost phenomenologists of his time—Husserl, Scheler, and Heidegger. Through this, it not only underscores the existence of a phenomenological dimension within the broader debate about the analogy of being, but also shows that what was really at stake was the relationship between phenomenology and analogy.
Przywara does not reject phenomenology but highlights its perceived vulnerabilities and complements them with an analogical metaphysics. He believes that no single finite principle— be it the transcendental ego, values, or being—is able to describe created reality adequately. An analogical structure is necessary. In his view, being is constituted by various relationships, or analogies. It cannot be reduced to one single principle. Rather, the different relationships present within the immanent sphere, and uncovered through phenomenology, lead towards an ultimate transcendent relationship with the divine mystery. Together they form a cruciform structure of relationships. Przywara is, therefore, combining the phenomenological and metaphysical languages to make a philosophical and theological argument.
This project provides both an historical investigation of Przywara’s pioneering engagement with phenomenology and also a systematic exploration of the innovative way in which he integrates theology and metaphysics with phenomenology. This is why Przywara’s unique voice remains relevant today, in contemporary theology, as this still grapples with the way to articulate the relationship between these three disciplines
Chern-Simons induced thermal friction on axion domain walls
Get PDFWe study the dynamics and interactions of the solitonic domain walls that occur in realistic axion electrodynamics models including the Chern-Simons interaction, aϵμνλσFμνFλσ, between an axion a(x) of mass ma, and a massless U(1) gauge field, e.g. EM, interacting with strength α = e2/4π with charged matter, e.g. electron-positron pairs. In particular, in the presence of a U(1) gauge-and-matter relativistic thermal plasma we study the friction experienced by the walls due to the Chern-Simons term. Utilizing the linear response method we include the collective effects of the plasma, as opposed to purely particle scattering across the wall (as is done in previous treatments) which is valid only in the thin wall regime that is rarely applicable in realistic cases. We show that the friction depends on the Lorentz-γ-factor-dependent inverse thickness of the wall in the plasma frame, ℓ−1 ~ γma, compared to the three different plasma scales, the temperature T, the Debye mass mD ~ αT, and the damping rate Γ ~ α2T, and elucidate the underlying physical intuition for this behavior. (For friction in the thin-wall-limit we correct previous expressions in the literature.) We further consider the effects of long-range coherent magnetic fields that are possibly present in the early universe and compare their effect with that of thermal magnetic fields. We comment on the changes to our results that likely apply in the thermal deconfined phase of a non-Abelian gauge theory. Finally, we briefly discuss the possible early universe consequences of our results for domain wall motion and network decay, stochastic gravitational wave production from domain wall networks, and possible primordial black hole production from domain wall collapse, though a more complete discussion of these topics is reserved for a companion paper
Assessing the restorative effects of campus greeness on student depression: a comparative study across three distinct university campus type in Macau
Get PDFThis study addresses the growing mental health challenges among university students, with a particular focus on depression, by examining the role of campus greenness in mitigating its effects. In contrast to the majority of studies that concentrate on campus environments in Western countries, this research uniquely investigates how variations in campus density and form within the Chinese context influence the role of campus greenness in mitigating depression among university students. By analyzing three distinct types of university campuses in Macau, the study also reflects on the broader implications for campuses across China. A comprehensive model is then employed to assess the effects of perceived greenness, frequency of use, and ease of access on depression, identifying both mediation and moderation effects through the application of PLS-SEM. The results demonstrate that perceived greenness exerts the most significant influence in high-density campuses, while frequency of use and convenience of access play a greater role in larger, lower-density campuses. Mediation analysis shows that perceived greenness partially mediates the relationship between green space usage and depression, particularly in smaller, high-density campuses. Additionally, moderation analysis indicates that frequency of use amplifies the restorative effects of higher perceived greenness, especially in medium and large campuses. These findings advance current theories in environmental psychology and campus planning by underscoring the contextual intricacies of green space benefits. The outcomes are expected to inform future campus design and urban planning, emphasizing the importance of green spaces in fostering environments that support student well-being