An integrated model of care for neurological infections: the first six years of referrals to a specialist service at a university teaching hospital in Northwest England

Background A specialist neurological infectious disease service has been run jointly by the departments of infectious disease and neurology at the Royal Liverpool University Hospital since 2005. We sought to describe the referral case mix and outcomes of the first six years of referrals to the service. Methods Retrospective service review. Results Of 242 adults referred to the service, 231 (95 %) were inpatients. Neurological infections were confirmed in 155 (64 %), indicating a high degree of selection before referral. Viral meningitis (35 cases), bacterial meningitis (33) and encephalitis (22) accounted for 38 % of referrals and 61 % of confirmed neurological infections. Although an infrequent diagnosis (n = 19), neurological TB caused the longest admission (median 23, range 5 – 119 days). A proven or probable microbiological diagnosis was found in 100/155 cases (64.5 %). For the whole cohort, altered sensorium, older age and longer hospital stay were associated with poor outcome (death or neurological disability); viral meningitis was associated with good outcome. In multivariate analysis altered sensorium remained significantly associated with poor outcome, adjusted odds ratio 3.04 (95 % confidence interval 1.28 – 7.22, p = 0.01). Conclusions A service of this type provides important specialist care and a focus for training and clinical research on complex neurological infections

Paraphrastic Reformulations in Spoken Corpora

International audienceOur work addresses the automatic detection of paraphrastic reformulation in French spoken corpora. The proposed approach is syn-tagmatic. It is based on specific markers and the specificities of the spoken language. Manual multi-dimensional annotation performed by two annotators provides fine-grained reference data. An automatic method is proposed in order to decide whether sentences contain or not paraphras-tic relations. The obtained results show up to 66.4% precision. Analysis of the manual annotations indicates that few paraphrastic segments show morphological modifications (inflection, derivation or compounding) and that the syntactic equivalence between the segments is seldom respected, as these usually belong to different syntactic categories

1862-05-30 R. Beeching requests an enlistment certificate for D.K. Lovell of Company F

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Business models in rail infrastructure: explaining innovation

Policy decisions about the UK railway industry often draw on models and frameworks that treat technology and organisational processes as static and unchanging. As a result, policy makers often have limited understanding of how changes in policy will influence organisational knowledge, learning and the allocation of risk that subsequently affects innovation and system development. This paper applies a business model lens, focused on the mechanisms firms use to create and capture value, to connect policy decisions to subsequent changes in the organisation and industrial structure of the UK railway sector. By analysing innovation-related activity across several different governance structures, the paper highlights how policy impacts in network-based infrastructure sectors are mediated by business strategy, sometimes leading to unintended outcomes. The findings suggest that policy to improve the performance should focus upon coordination rather than just ownership. The application of a business model approach to complement existing economic and policy models in system analysis for policy decisions is advocated

Rabies and the pandemic: Lessons for One Health

This article examines the impact of coronavirus disease 2019 (COVID-19) on dog-mediated rabies, a neglected tropical disease that remains endemic in >65 countries. A globally agreed strategy for rabies elimination is underpinned by a One Health approach, coordinating human and animal health sectors and engaging communities. We present data on the scale and nature of COVID-19 disruption to rabies control programmes and the wider learning for One Health implementation. We argue that the global shift in health priorities caused by the pandemic, and consequent side-lining of animal health, will have broader ramifications for One Health implementation and preparedness for future emergent zoonoses

An evaluation of CT radiation doses within the Yorkshire Lung Screening Trial

YesObjectives; To evaluate radiation doses for all low-dose CT scans performed during the first year of a lung screening trial. Methods; For all lung screening scans that were performed using a CT protocol that delivered image quality meeting the RSNA QIBA criteria, , radiation dose metrics, participant height, weight, gender and age were recorded. Values of CTDIvol and DLP were evaluated as a function of weight in order to assess the performance of the scan protocol across the participant cohort. Calculated effective doses were used to establish the additional lifetime attributable cancer risks arising from trial scans. Results; Median values of CTDIvol, DLP and effective dose (IQR) from the 3521 scans were 1.1mGy (0.70), 42.4mGycm (24.9) and 1.15mSv (0.67), whilst for 60-80kg participants the values were 1.0mGy (0.30), 35.8mGycm (11.4) and 0.97mSv (0.31). A statistically significant correlation between CTDIvol and weight was identified for males (r=0.9123, p<0.001) and females (r=0.9052, p<0.001), however the effect of gender on CTDIvol was not statistically significant (p=0.2328) despite notable differences existing at the extremes of the weight range. The additional lifetime attributable cancer risks from a single scan were in the range 0.001-0.006%. Conclusions; Low radiation doses can be achieved across a typical lung screening cohort using scan protocols that have been shown to deliver high levels of image quality. The observed dose levels may be considered as typical values for lung screening scans on similar types of scanner for an equivalent participant cohort. Advances in Knowledge; Presentation of typical radiation dose levels for CT lung screening examinations in a large UK trial. Effective radiation doses can be of the order of 1mSv for standard sized participants. Lifetime attributable cancer risks resulting from a single LDCT scan did not exceed 0.006%.The Yorkshire Lung Screening Trial is funded by Yorkshire Cancer Research (award reference L403)

Developing employability in higher education music

The development of employability in higher music education concerns students, musicians, educators, administrators and funding bodies, and yet employability is both impossible to measure and poorly defined. This paper sets the context for a set of short papers that explore employability from the perspective of music. Because many of the issues they raise have relevance across the creative industries, this paper discusses research that positions them within this broader context. The paper highlights the need for both the functional (how-to) aspects of employability and those that are cognitive: development of students' cognitive dispositions and their capacity to engage as professionals. As such, the paper argues that employability requires collaborative action on three fronts: enhancement of the ways in which employment outcomes are defined and measured; initiatives that engage students in career- and life-relevant activities; and advocacy work that re-aligns stakeholder perceptions of graduate work and employability itself

Mundane objects in the city: Laundry practices and the making and remaking of public/private sociality and space in London and New York

The paper considers how shifting laundry practices and technologies associated with dirty washing have over time summoned different spaces, socialities and socio-spatial assemblages in the city, enrolling different actors and multiple publics and constituting different associations, networks and relations in its wake as it travels from the home and back again. It argues that rather than being an inert object of unpleasant matter, whose encounter with humans has been largely restricted to certain categories of person for its transformation to re-use, and thus passed unnoticed, the paper explores how laundry practices have figured in producing and reproducing gendered (and classed) relations of labour, and enacting multiple socio-spatial, and gendered, relations and assemblages in the city, which have largely gone unnoticed in accounts of everyday urban life