What are safe sleeping arrangements for infants?

Non-supine sleep position and parental tobacco use are known risk factors for sudden infant death syndrome (SIDS). Recent studies show that co-sleeping (bed sharing) slightly increases the overall risk of SIDS (strength of recommendation [SOR]: B) and is greatest for infants less than 11 weeks old (SOR: B). The relationship between bed sharing and SIDS is strongest for infants whose parents use tobacco (SOR: B). Infants who sleep in a room separate from their caregivers or on a couch or an armchair are at increased risk for SIDS (SOR: B). Using bedding accessories such as duvets or pillows may increase an infant's risk of SIDS (SOR: B)

The literary, personal, and scio-political background of William Plomer's Turbott Wolfe

This dissertation examines William Plomer's first novel, Turbott Wolfe (1925), within its socio-political and literary context, and also explores the crucial relationship between the author's life and his work. Turbott Wolfe at one level represents Plomer's complex responses to and interpretation of the South African milieu during the early 1920s. During this decade, the foundations of modem Apartheid were being consolidated, and African Nationalism emerged as a powerful challenge to the South African state. Turbott Wolfe is informed by these political developments, and the milieu and events portrayed in the novel vividly express the author's feelings about and attitudes towards the society he finds himself in. Since its publication, ZiZ&stsJBal&a has suffered considerable critical neglect The superficiality of much of the existing criticism about the novel must be challenged, since Turbott Wolfe is not only of tremendous intrinsic literary merit, but also provides valuable insights into the socio-political environment and historical moment in which Plotter wrote. Thus one of the novel's main concerns is the all informing "colour question", which dominated political debate in the 1920s. Plomer's appr< -• "colour question" is unorthodox,« rajor question confronting the reader is how this unusual novel cane to be written. An examination of earlier fiction reveals that Turbott Wolfe is both influenced b; and a reaction against existing literary traditions, while the major themes show in what way and to what extent the novel is engaged with contemporary sociopolitical issues. The key to this crucial question, however, lies in a detailed exploration of the author's personal history. Turbott Wolfe emerges as an important work within the development of South African literature, a novel which encapsulates some of the complexity and diversity of contemporary South Africa, as perceived by its youthful author

The Effects of Strategy Instruction in Reading Informational Text on Reading Level and Motivation of Fifth Grade Students

The purpose of this nonequivalent control-group design study was to determine if students had an increase in reading level and motivation to read when more informational text and instruction was added into the curriculum. The independent variables were the reading curriculum, with Success for All (SFA) used with the control group and SFA with additional instruction in informational text used with the study group. The dependent variables were reading level and levels of motivation determined by the Scholastic Reading Inventory (SRI) and the Elementary Reading Attitude Survey (ERAS) measured after eight weeks of instruction and again three months post-study. The research questions sought to determine if there was a two population case significance test of means difference in reading level and motivational gains between the group that received traditional reading instruction and the group that received additional instruction in reading informational text. The study also sought to determine if the academic reading and recreational reading gains differed between two instructional groups. Finally, the study also looked at immediate and three month post-study reading level gains. The sample included approximately sixty fifth graders from a mid-sized elementary school in the mid-west. Reading levels were measured with the Scholastic Reading Inventory (SRI), a quantitative assessment that is both valid and reliable, and attitude gains were measured with the Elementary Reading Attitude Survey (ERAS), also valid and reliable. After Levene’s tests were run, ANCOVA was used to compare means. Results showed that students in the study group scored significantly higher on the academic, recreational, and total score of the ERAS post-study but did not score significantly better on the SRI, neither eight weeks post-study nor three months post-study

Toward a Psycholinguistic Model of Irony Comprehension

This dissertation examines how listeners reach pragmatic interpretations of irony in real-time. Over four experiments I addressed limitations of prior work by using fine-grained measures of time course, providing strong contexts to support ironic interpretations, and accounting for factors known to be important for other linguistic phenomena (e.g., frequency). Experiment 1 used a visual world eye-tracking paradigm to understand how comprehenders use context and frequency information to interpret irony. While there was an overall delay for ironic utterances compared to literal ones, the speed of interpretation was modulated by frequency. Participants interpreted frequent ironic criticisms (e.g., “fabulous chef” about a bad chef) more quickly than infrequent ironic compliments (e.g., “terrible chef” about a good chef). In Experiment 2A, I tested whether comprehending irony (i.e., drawing a pragmatic inference) differs from merely computing the opposite of an utterance. The results showed that frequency of interpretation (criticisms vs. compliments) did not influence processing speed or overall interpretations for opposites. Thus, processing irony involves more than simply evaluating the truth-value condition of an utterance (e.g., pragmatic inferences about the speaker’s intentions). This was corroborated by Experiment 2B, which showed that understanding irony involves drawing conclusions about speakers in a way that understanding opposites does not. Opposite speakers were considered weirder and more confusing than ironic speakers. Given the delay in reaching ironic interpretations (Exp. 1), Experiments 3 and 4 examined the cognitive mechanics that contribute to inhibiting a literal interpretation of an utterance and/or promoting an ironic one. Experiment 3 tested whether comprehending irony engages cognitive control to resolve among competing representations (literal vs. ironic). Results showed that hearing an ironic utterance engaged cognitive control, which then facilitated performance on a subsequent high-conflict Stroop trial. Thus, comprehenders experience conflict between the literal and ironic interpretations. In Experiment 4, however, irony interpretation was not facilitated by prior cognitive control engagement. This may reflect experimental limitations or late-arriving conflict. I end by presenting a model wherein access to the literal and ironic interpretations generates conflict that is resolved by cognitive control. In addition, frequency modulates cue strength and generates delays for infrequent ironic compliments

Production of a SARS-CoV-2 Spike Protein Vaccine Using the Baculovirus Expression Vector System

Various COVID-19 vaccines are currently in development, as the COVID-19 pandemic has created an unmet need for protection against the SARS-CoV-2 virus. While there are many different types of vaccines, we focused on developing one that would be safe, affordable, and quickly available for emergency use. A vaccine synthesized using recombinant proteins utilizes a reliable and well-studied technological platform, avoids the safety risks inherent to viral vectors, and provides a cost-effective, scalable method of production of antigen used to induce an immune response. Other vaccines on the market notably include Pfizer’s and Moderna’s mRNA based vaccines. Although these are widely used, there is still a large demand for an inexpensive yet safe and effective vaccine. Herein, we propose the production of 500 million doses of a recombinant spike protein-based COVID-19 vaccine in a quick time frame and cost-effective manner, using the baculovirus expression vector system (BEVS). Our upstream process involves a three-stage cellular scale-up from shake flasks to WAVE bioreactors to perfusion to production bioreactors, as well as an additional two-stage viral amplification from flasks to WAVE bioreactors. Our downstream process involves a six-stage protein recovery with depth filtration, his-tag chromatography, viral inactivation, ion-exchange chromatography, viral filtration, and diafiltration. We will be partnering with a contract manufacturing organization (CMO) for this project, as we do not have the time to quickly build a plant to get these vaccines out for emergency use. This arrangement makes this process highly profitable. Selling each dose for $16 yields net earnings near$2 billion and an extremely high IRR due to the lack of permanent and fixed costs other than our rental fee. The IRR for the CMO is estimated to be at least 16% with the NPV of the plant at $855,000 and an ROI of 18%

Feasibility study for a community based intervention for adults with severe chronic fatigue syndrome/ME

Background: Chronic Fatigue Syndrome/ME (CFS/ME) is characterised by debilitating fatigue with many bedbound patients. The study aims were: to determine whether a new intervention could be successfully delivered; to collect quantitative outcome data to guide the design of future studies; to explore qualitatively the experience of patients, carers and clinicians. Methods: Mixed-methods feasibility study with qualitative and quantitative evaluation. Participants: 12 UK patients who were housebound with severe CFS/ME. Intervention: Based on recovery skills identified through a 2.5 year Patient and Public Involvement development process involving individuals with first-hand experience of recovery from CFS/ME, as well as current patients and clinicians. The resulting one year intervention, delivered by a multi-disciplinary team, included domiciliary therapy visits and optional peer support group. Quantitative outcome measures: Patient-reported and therapist-reported outcome measures (including fatigue, physical function, anxiety, depression and other variables) and electronic activity measurement. Results: The study recruited and engaged twelve participants with no serious adverse events or dropouts. At end of intervention, 5/12 participants had improved in fatigue, physical function. Group mean scores improved overall for fatigue (Chalder fatigue scale), physical function (activity and physical function scale) and anxiety. Qualitative interviews suggested that the intervention was acceptable to patients, whilst also highlighting suggestions for improvement. Participants will be followed up for a further year to find out if improvements are sustained. Conclusion: This is the largest study ever conducted in severe CFS/ME and shows significant recovery suggesting further studies are indicated. Treatment is uniquely based on a patient inspired intervention

Ancient dental calculus reveals oral microbiome shifts associated with lifestyle and disease in Great Britain

We thank C. Stringer and R. Kruszynski of the Natural History Museum, London; S. Schiffels; D. Sayer; Oxford Archaeology East; M. Farrell of the Royal College of Surgeons of England; J. Pearson of the Inverness Museum; and all of the museums for access to samples. We also thank the Museum of London for allowing us to collect and destructively analyse archaeological dental calculus samples from their collections from London, particularly J. Bekvalac and R. Redfern. We would also like to acknowledge J. VanderBerg at EnDev Geographic for producing the map used in Fig. 1. A.C., C.A. and L.W. thank the Australian Research Council for research funding (DP110105038) and Laureate (FL140100260). The work was also supported by an Australian Research Council Future Fellowship Award to L.S.W. (FT180100407). This material is also based on work supported by the National Science Foundation Graduate Research Fellowship Program awarded to A.S.G. under Grant No. DGE1255832. Any opinions, findings, and conclusions or recommendations expressed in this material are those of the authors and do not necessarily reflect the views of the National Science Foundation.Peer reviewedPostprintPostprintPostprin

Implementing personalized medicine in diabetic kidney disease:Stakeholders' perspectives

The promise of personalized medicine to deliver "the right treatments at the right time to the right person" is the next frontier in healthcare. However, to implement personalized medicine in chronic diseases such as diabetes mellitus and diabetic kidney disease (DKD), a number of different aspects need to be taken into account. Better risk stratification and more precise options for treatment need to be developed and included in clinical practice guidelines. A patient's unique psychological, social and environmental situation also drive disease progression and outcomes. Appraising the cost effectiveness of precision medicines is necessary, not just as the cost of new therapies, but also the cost of diagnosis with novel methodologies and averted complications. As the prevalence of DKD grows worldwide to epidemic proportions, challenges such as global disparities in resources, access to healthcare and prevalence need to be addressed. This review considers these issues to achieve the short and longer-term goals of implementing personalized medicine in clinical practice

Evaluation of an Artificial Intelligence Coronary Artery Calcium Scoring Model from Computed Tomography

OBJECTIVES: Coronary artery calcium (CAC) scores derived from computed tomography (CT) scans are used for cardiovascular risk stratification. Artificial intelligence (AI) can assist in CAC quantification and potentially reduce the time required for human analysis. This study aimed to develop and evaluate a fully automated model that identifies and quantifies CAC. METHODS: Fully convolutional neural networks for automated CAC scoring were developed and trained on 2439 cardiac CT scans and validated using 771 scans. The model was tested on an independent set of 1849 cardiac CT scans. Agatston CAC scores were further categorised into five risk categories (0, 1–10, 11–100, 101–400, and > 400). Automated scores were compared to the manual reference standard (level 3 expert readers). RESULTS: Of 1849 scans used for model testing (mean age 55.7 ± 10.5 years, 49% males), the automated model detected the presence of CAC in 867 (47%) scans compared with 815 (44%) by human readers (p = 0.09). CAC scores from the model correlated very strongly with the manual score (Spearman’s r = 0.90, 95% confidence interval [CI] 0.89–0.91, p < 0.001 and intraclass correlation coefficient = 0.98, 95% CI 0.98–0.99, p < 0.001). The model classified 1646 (89%) into the same risk category as human observers. The Bland–Altman analysis demonstrated little difference (1.69, 95% limits of agreement: −41.22, 44.60) and there was almost excellent agreement (Cohen’s κ = 0.90, 95% CI 0.88–0.91, p < 0.001). Model analysis time was 13.1 ± 3.2 s/scan. CONCLUSIONS: This artificial intelligence–based fully automated CAC scoring model shows high accuracy and low analysis times. Its potential to optimise clinical workflow efficiency and patient outcomes requires evaluation. KEY POINTS: • Coronary artery calcium (CAC) scores are traditionally assessed using cardiac computed tomography and require manual input by human operators to identify calcified lesions. • A novel artificial intelligence (AI)–based model for fully automated CAC scoring was developed and tested on an independent dataset of computed tomography scans, showing very high levels of correlation and agreement with manual measurements as a reference standard. • AI has the potential to assist in the identification and quantification of CAC, thereby reducing the time required for human analysis. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00330-022-09028-3