695915 research outputs found
Sort by
Excess deaths from COVID-19 and other causes by region, neighbourhood deprivation level and place of death during the first 30 weeks of the pandemic in England and Wales
No full textBackgroundExcess deaths during the COVID-19 pandemic compared with those expected from historical trends have been unequally distributed, both geographically and socioeconomically. Not all excess deaths have been directly related to COVID-19 infection. We investigated geographical and socioeconomic patterns in excess deaths for major groups of underlying causes during the pandemic. MethodsWeekly mortality data from 27/12/2014 to 2/10/2020 for England and Wales were obtained from the Office of National Statistics. Negative binomial regressions were used to model death counts based on pre-pandemic trends for deaths caused directly by COVID-19 (and other respiratory causes) and those caused indirectly by it (cardiovascular disease or diabetes, cancers, and all other indirect causes) over the first 30 weeks of the pandemic (7/3/2020 –2/10/2020).FindingsThere were 62,321 (95% CI: 58,849 to 65,793) excess deaths in England and Wales in the first 30 weeks of the pandemic. Of these, 46,221 (95% CI: 45,439 to 47,003) were attributable to respiratory causes, including COVID-19, and 16,100 (95% CI: 13,410 to 18,790) to other causes. Rates of all-cause excess mortality ranged from 78 per 100,000 in the South West of England and in Wales to 130 per 100,000 in the West Midlands; and from 93 per 100,000 in the most affluent fifth of areas to 124 per 100,000 in the most deprived. The most deprived areas had the highest rates of death attributable to COVID-19 and other indirect deaths, but there was no socioeconomic gradient for excess deaths from cardiovascular disease/diabetes and cancer.InterpretationDuring the first 30 weeks of the COVID-19 pandemic there was significant geographic and socioeconomic variation in excess deaths for respiratory causes, but not for cardiovascular disease, diabetes and cancer. Pandemic recovery plans, including vaccination programmes, should take account of individual characteristics including health, socioeconomic status and place of residence.<br/
ERS Clinical Practice Guidelines on Treatment of Sarcoidosis
No full textBackground: The major reasons to treat sarcoidosis are to lower the morbidity and mortality risk or to improve quality of life (QoL). The indication for treatment varies depending on which manifestation is the cause of symptoms: lungs, heart, brain, skin, or other manifestations. While glucocorticoids (GC) remain the first choice for initial treatment of symptomatic disease, prolonged use is associated with significant toxicity. GC-sparing alternatives are available. The presented treatment guideline aims to provide guidance to physicians treating the very heterogenous sarcoidosis manifestations.Materials and methods A European Respiratory Society Task Force (TF) committee composed of clinicians, methodologists, and patients with experience in sarcoidosis developed recommendations based on the GRADE (Grading of Recommendations, Assessment, Development and Evaluations) methodology. The committee developed eight PICO (Patients, Intervention, Comparison, Outcomes) questions and these were used to make specific evidence-based recommendations.Results The TF committee delivered twelve recommendations for seven PICOs. These included treatment of pulmonary, cutaneous, cardiac, and neurologic disease as well as fatigue. One PICO question regarding small fiber neuropathy had insufficient evidence to support a recommendation. In addition to the recommendations, the committee provided information on how they use alternative treatments, when there was insufficient evidence to support a recommendation.Conclusions There are many treatments available to treat sarcoidosis. Given the diverse nature of the disease, treatment decisions require an assessment of organ involvement, risk for significant morbidity, and impact on QoL of the disease and treatment
Towards a Tuwün Wariache? Place-making and creative acts of traversing in the Mapuche city
No full textThis article addresses experiences of belonging and place-making of indigenousMapuche youths in Santiago, Chile. Moving from a collaborative ethnography, it elaborates on the emplacement of the tuwün (place of origin) – usually linked to ancestral territories – within the city, and the meanings this shift entails. Furthering knowledge on indigenous spatiality by addressing migration, the analysis focuses on the ambivalent ways in which memory, affect andpower relations are embedded in urban materialities, and are negotiated through ‘acts of traversing’. The significant relationship between persons and places is conceived as mediated by movement, expanding on the creative possibilities of routing. Moreover, drawing on practice based methods, the article argues for a shared engagement with research participants in order to gain a deeper understanding of the ways in which place and self-making in contexts of migration encompass both rupture and creative re-appropriation, contributing to current debates on displacement and the sense of place
Stochastic Rounding: Algorithms and Hardware Accelerator
No full textAlgorithms and a hardware accelerator for performing stochastic rounding (SR) are presented. The main goal is to augment the ARM M4F based multi-core processor SpiNNaker2 with a more flexible rounding functionality than is available in the ARM processor itself. The motivation of adding such functionality in hardware is based on our previous results showing improvements in numerical accuracy of ODE solvers in fixed-point arithmetic with SR, compared to standard round to nearest or bit truncation rounding modes. Performing SR purely in software can be expensive due to requirement of multiple masking and shifting instructions, and an addition operation per each rounding. Also, saturation of values is included since it usually follows rounding, which is common in fixed-point arithmetic due to a narrow dynamic range. The main intended use of the accelerator is to round fixed-point multiplier outputs, which are returned unrounded by the ARM processor in a wider fixed-point format than the arguments. The proposed accelerator is not specific to SpiNNaker, and is a generally applicable rounding unit provided a pseudo-random number generator is available that can supply random bits to it. Additionally, to the best of our knowledge, this is the first exploration of a rounding accelerator with a programmable bit position and multiple data type support
An exploratory case study: Children’s comparative play access in English and Welsh classrooms
No full textThe United Nations Convention on the Rights of the Child (1989) stipulates children’s right to play, and its later-published General Comment No. 17 (2013) also emphasises the importance of play as a medium for learning. This comparative case study explored children’s experiences of accessing play through curriculum delivery in two United Kingdom (UK) countries, England and Wales, where curricula place comparative emphasis on play. The study used structured classroom observations of sixteen five- to seven-year-olds and interviews with two teachers. Both participating teachers valued play and child-led learning for children’s enjoyment and engagement, and reflected on the experiences and beliefs impacting on their teaching practice. Implications are discussed in relation to individual, contextual and systemic features that may facilitate or inhibit children’s access to play within the curriculum. The study calls for further research on the implementation and impact of recent Welsh policy and curricular legislation on children’s opportunities for play and play-based learning in school, and what could be learnt from this in terms of pedagogy and playfulness in an English or other context
Lock-down, Slow-down:Impact of COVID-19 Lockdown on Physical Activity using data from Cardiac Devices
No full textIn response to the COVID-19 pandemic, the UK was placed under strict lockdown measures on March 23rd 2020. The aim of this study was to quantify the effects on physical activity levels utilising data from the prospective Triage-HF Plus study. This represents a cohort of adult patients with implanted cardiac devices capable of measuring activity by embedded accelerometery via a remote monitoring platform. Activity data were available for the 4 weeks pre- and post- implementation of ‘stay at home’ lockdown measures in the form of ‘minutes active per day’ (mins/day). Data were analysed for 311 patients (77.2% male, mean age 68.8, frailty 55.9%. 92.2% established heart failure diagnosis, of these 51.2% NYHA II), with co—morbidities representative of a real-world cohort.Post- lockdown, a significant reduction in median physical activity equating to 20.8 active mins/day was seen. The reduction was uniform with a slightly more pronounced drop in PA for females, but no statistically significant difference with respect to age, BMI, frailty or device type. Activity dropped in the immediate 2-week period post lockdown, but steadily returned thereafter. Median activity week 4 weeks post lockdown remained significantly lower than 4 weeks pre-lockdown (p = <0.001).In a population of predominantly heart failure patients with cardiac devices, activity reduced by approximately 20 minutes active per day in the immediate aftermath of strict COVID-19 lockdown measures
Experiences of barriers to self-monitoring and medication-management among Indian patients with type 2 diabetes, their primary family-members and physicians
No full textObjectives: This study explored the subjective accounts of the main barriers to self-monitoring of blood-glucose (SMBG) and medication-management among Indian patients with type 2 diabetes (T2DM), their primary family-members (PFMs) and physicians. Methods: Using convenience sampling, patients with T2DM, their PFMs, and physicians, residing in a South Indian capital city, were recruited for semi-structured, audio-recorded interviews. Thematic analysis was used to analyze the data. Results: Fifty patients (female=14; mean age=42.5 years) and their PFMs (female=38; mean age=39 years), and 25 physicians (female=4; mean age=49.8 years) were recruited. Three superordinate themes were identified: (i) complex medication-regimen: confusion, forgetting and reduced motivation, (ii) family recommendations of alternative therapies due to the social pressures of avoiding stigma, intrusiveness and being misrepresented for injecting insulin, and (iii) an expensive illness: choosing to spend money on only medication. Discussion: Implications of the findings highlight the need to (i) train physicians in communication and empathy skills, (ii) empower patients to communicate their barriers to physicians through triadic communication models and question-prompt lists, (iii) educate communities on the benefits of insulin for managing T2DM to reduce stigma, and (iv) equip communities with information about health insurance to address the financial toll of T2DM management
Generating Three-dimensional Drape Model Based on Projection and Mesh Deformation
No full textIn order to generate the three-dimensional (3D) mesh of draped fabric based on a two-dimensional (2D) fabric projection, the 3D point cloud of draped fabric was scanned via a self-built 3D scanning device followed by triangulation. The 3D boundary of fabric drape model and the two-dimensional contour of the projection of the fabric drape model were extracted respectively. Two neural networks were constructed to bridge the 2D fabric drape projection and the 3D boundary of draped fabric. With the trained neural networks, the 3D boundary of draped fabric could be inferred by merely referring a 2D projection of draped fabric. Six reference triangular meshes with different triangle density were generated. Driven by two mesh deformation methods, Laplacian deformation and Poisson deformation, the reference mesh was deformed into 3D mesh similar to scanned fabric drape models (meshes). The result shows that the generated models have a high agreement with the scanned meshes. In addition, the Laplacian deformation outperforms Poisson deformation in generating 3D fabric drape models
Addition of Ge to Cr-Ta-Si Laves phase-based alloys
No full textThe Cr-Cr2Ta system is of interest as a potential candidate for structural applications at temperatures that exceed those that can be tolerated by nickel-based superalloys. However, the oxidation resistance of alloys based on this system is currently insufficient. Previous work on the Cr-Cr3Si system suggests that Ge additions may also improve the oxidation resistance of alloys based on the Cr-Cr2Ta system. To ascertain whether such additions may be appropriate, the effect of Ge additions on the microstructure and mechanical properties of a Cr-10Ta-7Si alloy was investigated. The Laves phase in this system was unexpectedly found to decompose into a lamellar structure comprising a Cr solid solution and a cubic phase with an Fd-3m structure. The addition of Ge promotes this decomposition, as well as the formation of the A15 Cr3(Si,Ge) phase, at the expense of the Cr solid solution. The formation of the A15 phase increases the hardness of the alloy but has a detrimental effect on its ductility
Advantages of NOMA for Multi-User BackCom Networks
No full textAmbient backscatter communication (BackCom) is faced with the challenge that a single BackCom device can occupy multiple orthogonal resource blocks unintentionally. As a result, in order to avoid co-channel interference, a conventional approach is to serve multiple BackCom devices in different time slots, which reduces both spectral efficiency and connectivity. This letter demonstrates that the use of non-orthogonal multiple access (NOMA) can efficiently improve the system throughput and support massive connectivity in ambient BackCom networks. In particular, two transceiver design approaches are developed in the letter to realize different tradeoffs between system performance and complexity