Shared intentions and the advance of cumulative culture in hunter-gatherers

It has been hypothesized that the evolution of modern human cognition was catalyzed by the development of jointly intentional modes of behaviour. From an early age (1-2 years), human infants outperform apes at tasks that involve collaborative activity. Specifically, human infants excel at joint action motivated by reasoning of the form "we will do X" (shared intentions), as opposed to reasoning of the form "I will do X [because he is doing X]" (individual intentions). The mechanism behind the evolution of shared intentionality is unknown. Here we formally model the evolution of jointly intentional action and show under what conditions it is likely to have emerged in humans. Modelling the interaction of hunter-gatherers as a coordination game, we find that when the benefits from adopting new technologies or norms are low but positive, the sharing of intentions does not evolve, despite being a mutualistic behaviour that directly benefits all participants. When the benefits from adopting new technologies or norms are high, such as may be the case during a period of rapid environmental change, shared intentionality evolves and rapidly becomes dominant in the population. Our results shed new light on the evolution of collaborative behaviours.Comment: 6 pages, 4 figures, 1 table, Supplementary Information not include

Identifying Promising Candidate Radiotherapy Protocols via GPU-GA in-silico

Around half of all cancer patients, world-wide, will receive some form of radiotherapy (RT) as part of their treatment. And yet, despite the rapid advance of high-throughput screening to identify successful chemotherapy drug candidates, there is no current analogue for RT protocol screening or discovery at any scale. Here we introduce and demonstrate the application of a high-throughput/high-fidelity coupled tumour-irradiation simulation approach, we call "GPU-GA", and apply it to human breast cancer analogue - EMT6/Ro spheroids. By analysing over 9.5 million candidate protocols, GPU-GA yields significant gains in tumour suppression versus prior state-of-the-art high-fidelity/-low-throughput computational search under two clinically relevant benchmarks. By extending the search space to hypofractionated areas (> 2 Gy/day) yet within total dose limits, further tumour suppression of up to 33.7% compared to state-of-the-art is obtained. GPU-GA could be applied to any cell line with sufficient empirical data, and to many clinically relevant RT considerations

Human RIF1 and protein phosphatase 1 stimulate DNA replication origin licensing but suppress origin activation

We thank David Stead at the Aberdeen Proteomics Service for help in mass spectrometry interpretation, and Raif Yücel and his team at the University of Aberdeen Iain Fraser Cytometry Centre for assistance with flow cytometry. We thank Robert Alver and Julian Blow at University of Dundee for advice on the use of tautomycetin. Peter Cherepanov of the Francis Crick Institute gifted XL413. Daniel Durocher of Lunenfeld-Tanenbaum Research Institute gifted DNA constructs. Work by ADD and SH was supported by Cancer Research UK Grant A13356, Cancer Research UK Programme Award A19059, and BBSRC grant (BB/K006304/1). AIL was supported by Wellcome Trust Awards (108058/Z/15/Z & 105024/Z/14/Z). This work was also supported by JSPS KAKENHI Grant # 16H04739, 25116004 to CO and 16J04327 to YO.Peer reviewedPublisher PD

Equity impact of minimum unit pricing of alcohol on household health and finances among rich and poor drinkers in South Africa

INTRODUCTION: South Africa experiences significant levels of alcohol-related harm. Recent research suggests minimum unit pricing (MUP) for alcohol would be an effective policy, but high levels of income inequality raise concerns about equity impacts. This paper quantifies the equity impact of MUP on household health and finances in rich and poor drinkers in South Africa. METHODS: We draw from extended cost-effectiveness analysis (ECEA) methods and an epidemiological policy appraisal model of MUP for South Africa to simulate the equity impact of a ZAR 10 MUP over a 20-year time horizon. We estimate the impact across wealth quintiles on: (i) alcohol consumption and expenditures; (ii) mortality; (iii) government healthcare cost savings; (iv) reductions in cases of catastrophic health expenditures (CHE) and household savings linked to reduced health-related workplace absence. RESULTS: We estimate MUP would reduce consumption more among the poorest than the richest drinkers. Expenditure would increase by ZAR 353 000 million (1 US$=13.2 ZAR), the poorest contributing 13% and the richest 28% of the increase, although this remains regressive compared with mean income. Of the 22 600 deaths averted, 56% accrue to the bottom two quintiles; government healthcare cost savings would be substantial (ZAR 3.9 billion). Cases of CHE averted would be 564 700, 46% among the poorest two quintiles. Indirect cost savings amount to ZAR 51.1 billion. CONCLUSIONS: A MUP policy in South Africa has the potential to reduce harm and health inequality. Fiscal policies for population health require structured policy appraisal, accounting for the totality of effects using mathematical models in association with ECEA methodology

A BEME systematic review of the effects of interprofessional education : BEME Guide No. 39

BACKGROUND: Interprofessional education (IPE) aims to bring together different professionals to learn with, from, and about one another in order to collaborate more effectively in the delivery of safe, high-quality care for patients/clients. Given its potential for improving collaboration and care delivery, there have been repeated calls for the wider-scale implementation of IPE across education and clinical settings. Increasingly, a range of IPE initiatives are being implemented and evaluated which are adding to the growth of evidence for this form of education. AIM: The overall aim of this review is to update a previous BEME review published in 2007. In doing so, this update sought to synthesize the evolving nature of the IPE evidence. METHODS: Medline, CINAHL, BEI, and ASSIA were searched from May 2005 to June 2014. Also, journal hand searches were undertaken. All potential abstracts and papers were screened by pairs of reviewers to determine inclusion. All included papers were assessed for methodological quality and those deemed as "high quality" were included. The presage-process-product (3P) model and a modified Kirkpatrick model were employed to analyze and synthesize the included studies. RESULTS: Twenty-five new IPE studies were included in this update. These studies were added to the 21 studies from the previous review to form a complete data set of 46 high-quality IPE studies. In relation to the 3P model, overall the updated review found that most of the presage and process factors identified from the previous review were further supported in the newer studies. In regard to the products (outcomes) reported, the results from this review continue to show far more positive than neutral or mixed outcomes reported in the included studies. Based on the modified Kirkpatrick model, the included studies suggest that learners respond well to IPE, their attitudes and perceptions of one another improve, and they report increases in collaborative knowledge and skills. There is more limited, but growing, evidence related to changes in behavior, organizational practice, and benefits to patients/clients. CONCLUSIONS: This updated review found that key context (presage) and process factors reported in the previous review continue to have resonance on the delivery of IPE. In addition, the newer studies have provided further evidence for the effects on IPE related to a number of different outcomes. Based on these conclusions, a series of key implications for the development of IPE are offered

Impact of centralising acute stroke services in English metropolitan areas on mortality and length of hospital stay: difference-in-differences analysis

Objective: To investigate whether centralisation of acute stroke services in two metropolitan areas of England was associated with changes in mortality and length of hospital stay. Design: Analysis of difference-in-differences between regions with patient level data from the hospital episode statistics database linked to mortality data supplied by the Office for National Statistics. Setting: Acute stroke services in Greater Manchester and London, England. Participants: 258 915 patients with stroke living in urban areas and admitted to hospital in January 2008 to March 2012. Interventions “Hub and spoke” model for acute stroke care. In London hyperacute care was provided to all patients with stroke. In Greater Manchester hyperacute care was provided to patients presenting within four hours of developing symptoms of stroke. Main outcome measures Mortality from any cause and at any place at 3, 30, and 90 days after hospital admission; length of hospital stay. Results: In London there was a significant decline in risk adjusted mortality at 3, 30, and 90 days after admission. At 90 days the absolute reduction was −1.1% (95% confidence interval −2.1 to −0.1; relative reduction 5%), indicating 168 fewer deaths (95% confidence interval 19 to 316) during the 21 month period after reconfiguration in London. In both areas there was a significant decline in risk adjusted length of hospital stay: −2.0 days in Greater Manchester (95% confidence interval −2.8 to −1.2; 9%) and −1.4 days in London (−2.3 to −0.5; 7%). Reductions in mortality and length of hospital stay were largely seen among patients with ischaemic stroke. Conclusions: A centralised model of acute stroke care, in which hyperacute care is provided to all patients with stroke across an entire metropolitan area, can reduce mortality and length of hospital stay

Bench-to-bedside review: The evaluation of complex interventions in critical care

Complex interventions, such as the introduction of medical emergency teams or an early goal-directed therapy protocol, are developed from a number of components that may act both independently and inter-dependently. There is an emerging body of literature advocating the use of integrated complex interventions to optimise the treatment of critically ill patients. As with any other treatment, complex interventions should undergo careful evaluation prior to widespread introduction into clinical practice. During the development of an international collaboration of researchers investigating protocol-based approaches to the resuscitation of patients with severe sepsis, we examined the specific issues related to the evaluation of complex interventions. This review outlines some of these issues. The issues specific to trials of complex interventions that require particular attention include determining an appropriate study population and defining current treatments and outcomes in that population, defining the study intervention and the treatment to be used in the control group, and deploying the intervention in a standardised manner. The context in which the research takes place, including existing staffing levels and existing protocols and procedures, is crucial. We also discuss specific details of trial execution, in particular randomization, blinded outcome adjudication and analysis of the results, which are key to avoiding bias in the design and interpretation of such trials

Observational Constraints on the Modified Gravity Model (MOG) Proposed by Moffat: Using the Magellanic System

A simple model for the dynamics of the Magellanic Stream (MS), in the framework of modified gravity models is investigated. We assume that the galaxy is made up of baryonic matter out of context of dark matter scenario. The model we used here is named Modified Gravity (MOG) proposed by Moffat (2005). In order to examine the compatibility of the overall properties of the MS under the MOG theory, the observational radial velocity profile of the MS is compared with the numerical results using the $\chi^2$ fit method. In order to obtain the best model parameters, a maximum likelihood analysis is performed. We also compare the results of this model with the Cold Dark Matter (CDM) halo model and the other alternative gravity model that proposed by Bekenstein (2004), so called TeVeS. We show that by selecting the appropriate values for the free parameters, the MOG theory seems to be plausible to explain the dynamics of the MS as well as the CDM and the TeVeS models.Comment: 14 pages, 3 Figures, accepted in Int. J. Theor. Phy