94 research outputs found

    Investigating the Impact of Entry Qualifications on Student Performance in Computing Programmes at Undergraduate Level

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    Context: This thesis investigates the impact of prior A-level study on students taking degree programmes within the Computing discipline. The focus of this work investigates opportunities to providing more-personalised learning which is based on students’ existing knowledge, for example, by providing additional learning support to those students who had studied a particular topic at A-level. Although other studies have been carried out in this area, these studies have typically focused on outcomes across multiple programmes. Due to the variation of content taught, the researchers carrying out these prior studies have been unable to draw conclusions at the level of specific assignments. Aim: The aim of this work is to investigate the impact of A-level subject selection on the performance of those studying Computing programmes at Durham University. Method: This thesis is a detailed study, tracking Durham students, from entry until the completion of year two, over a particular three year period. This three year period of study was selected as, during these three years, Durham’s entry qualifications and course content remained largely unchanged. Hence, the unintended impact of entry qualification and content change were not factors that needed to be taken into consideration. A statistical analysis framework has been developed to investigate the impact which choosing specific A-levels has on student performance. Particularly, this work considers the impact on student performance, in course work (to the level of specific assignments) and examinations, of Maths, Computing, ICT, and Physics A-levels. The research compares the outcomes for students who have these qualifications against those who have not. Specific combinations of these A-levels are also considered. Results: The results highlight some benefits in year one for students studying specific qualifications: largely Maths. However, the most significant result of this work is that, at the end of year two, any differences are insignificant. Therefore, while students with specific A-levels may gain benefits initially, at the point these student enter the final year of their programme, these differences no longer impact of their ability to study. The curriculum within Durham, therefore, already appears to address the needs of students, specifically by covering knowledge, or promoting individual study, of all topics necessary for successful progression. This research has, thereby, revalidated and added to the current body of knowledge in this research area. While this work has identified students without specific A-levels are not adversely affected, what it points to is that some students with A-levels, for instance, in Computing, perceive their early University education to repeat much of their A-level work. So, although this study was not able to recommend personalisation of learning in support of those who have not studied specific A-levels, this work does highlight that, perhaps, personalised learning for those who have taken specific A-level may be necessary. Conclusions: The outcomes of this research have clear and important consequences for Higher Education Admission Policies for the Computing discipline. As an outcome, it would seem that the requirements placed by many institutions on entrants to have specific A-level is unnecessarily restrictive and may be preventing many students entering a discipline in which they would, otherwise, have been successful

    Opportunities and perspectives for utilisation of co-products in the meat industry

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    peer-reviewedMeat co-products are the non-meat components arising from meat processing/fabrication and are generated in large quantities on a daily basis. Co-products are considered as low added-value products, and in general it is difficult for industries to divert efforts into increasing their value. While many of these products can be edible those not used for human consumption or pet food is usually processed to be used as animal feed, fertilizer or fuel. However, to a large extent meat co-products are an excellent source of high nutritive value protein, minerals and vitamins and hence may be better diverted to contribute to alleviate the increasing global demand for protein. In this review the current uses, legislation and potential techniques for meat co-products processing are reviewed with the aim of showing a route to improve meat industry sustainability, profitability and better usage of available resources

    Adjunctive Medication Management and Contingency Management to enhance adherence to acamprosate for alcohol dependence: the ADAM trial RCT

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    BackgroundAcamprosate is an effective and cost-effective medication for alcohol relapse prevention but poor adherence can limit its full benefit. Effective interventions to support adherence to acamprosate are therefore needed.ObjectivesTo determine the effectiveness of Medication Management, with and without Contingency Management, compared to Standard Support alone in enhancing adherence to acamprosate and the impact of adherence to acamprosate on abstinence and reduced alcohol consumption.DesignMulticentre, three-arm, parallel-group, randomised controlled clinical trial.SettingSpecialist alcohol treatment services in five regions of England (South East London, Central and North West London, Wessex, Yorkshire and Humber and West Midlands).ParticipantsAdults (aged 18 years or more), an International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, diagnosis of alcohol dependence, abstinent from alcohol at baseline assessment, in receipt of a prescription for acamprosate.Interventions(1) Standard Support, (2) Standard Support with adjunctive Medication Management provided by pharmacists via a clinical contact centre (12 sessions over 6 months), (3) Standard Support with adjunctive Medication Management plus Contingency Management that consisted of vouchers (up to £120) to reinforce participation in Medication Management. Consenting participants were randomised in a 2 : 1 : 1 ratio to one of the three groups using a stratified random permuted block method using a remote system. Participants and researchers were not blind to treatment allocation.Main outcome measuresPrimary outcome: self-reported percentage of medication taken in the previous 28 days at 6 months post randomisation. Economic outcome: EuroQol-5 Dimensions, a five-level version, used to calculate quality-adjusted life-years, with costs estimated using the Adult Service Use Schedule.ResultsOf the 1459 potential participants approached, 1019 (70%) were assessed and 739 (73 consented to participate in the study, 372 (50%) were allocated to Standard Support, 182 (25%) to Standard Support with Medication Management and 185 (25%) to Standard Support and Medication Management with Contingency Management. Data were available for 518 (70%) of participants at 6-month follow-up, 255 (68.5%) allocated to Standard Support, 122 (67.0%) to Standard Support and Medication Management and 141 (76.2%) to Standard Support and Medication Management with Contingency Management. The mean difference of per cent adherence to acamprosate was higher for those who received Standard Support and Medication Management with Contingency Management (10.6%, 95% confidence interval 19.6% to 1.6%) compared to Standard Support alone, at the primary end point (6-month follow-up). There was no significant difference in per cent days adherent when comparing Standard Support and Medication Management with Standard Support alone 3.1% (95% confidence interval 12.8% to −6.5%) or comparing Standard Support and Medication Management with Standard Support and Medication Management with Contingency Management 7.9% (95% confidence interval 18.7% to −2.8%). The primary economic analysis at 6 months found that Standard Support and Medication Management with Contingency Management was cost-effective compared to Standard Support alone, achieving small gains in quality-adjusted life-years at a lower cost per participant. Cost-effectiveness was not observed for adjunctive Medication Management compared to Standard Support alone. There were no serious adverse events related to the trial interventions reported.LimitationsThe trial’s primary outcome measure changed substantially due to data collection difficulties and therefore relied on a measure of self-reported adherence. A lower than anticipated follow-up rate at 12 months may have lowered the statistical power to detect differences in the secondary analyses, although the primary analysis was not impacted.ConclusionsMedication Management enhanced with Contingency Management is beneficial to patients for supporting them to take acamprosate

    Adjunctive Medication Management and Contingency Management to enhance adherence to acamprosate for alcohol dependence: the ADAM trial RCT

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    BACKGROUND: Acamprosate is an effective and cost-effective medication for alcohol relapse prevention but poor adherence can limit its full benefit. Effective interventions to support adherence to acamprosate are therefore needed. OBJECTIVES: To determine the effectiveness of Medication Management, with and without Contingency Management, compared to Standard Support alone in enhancing adherence to acamprosate and the impact of adherence to acamprosate on abstinence and reduced alcohol consumption. DESIGN: Multicentre, three-arm, parallel-group, randomised controlled clinical trial. SETTING: Specialist alcohol treatment services in five regions of England (South East London, Central and North West London, Wessex, Yorkshire and Humber and West Midlands). PARTICIPANTS: Adults (aged 18 years or more), an International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, diagnosis of alcohol dependence, abstinent from alcohol at baseline assessment, in receipt of a prescription for acamprosate. INTERVENTIONS: (1) Standard Support, (2) Standard Support with adjunctive Medication Management provided by pharmacists via a clinical contact centre (12 sessions over 6 months), (3) Standard Support with adjunctive Medication Management plus Contingency Management that consisted of vouchers (up to ÂŁ120) to reinforce participation in Medication Management. Consenting participants were randomised in a 2 : 1 : 1 ratio to one of the three groups using a stratified random permuted block method using a remote system. Participants and researchers were not blind to treatment allocation. MAIN OUTCOME MEASURES: Primary outcome: self-reported percentage of medication taken in the previous 28 days at 6 months post randomisation. Economic outcome: EuroQol-5 Dimensions, a five-level version, used to calculate quality-adjusted life-years, with costs estimated using the Adult Service Use Schedule. RESULTS: Of the 1459 potential participants approached, 1019 (70%) were assessed and 739 (73 consented to participate in the study, 372 (50%) were allocated to Standard Support, 182 (25%) to Standard Support with Medication Management and 185 (25%) to Standard Support and Medication Management with Contingency Management. Data were available for 518 (70%) of participants at 6-month follow-up, 255 (68.5%) allocated to Standard Support, 122 (67.0%) to Standard Support and Medication Management and 141 (76.2%) to Standard Support and Medication Management with Contingency Management. The mean difference of per cent adherence to acamprosate was higher for those who received Standard Support and Medication Management with Contingency Management (10.6%, 95% confidence interval 19.6% to 1.6%) compared to Standard Support alone, at the primary end point (6-month follow-up). There was no significant difference in per cent days adherent when comparing Standard Support and Medication Management with Standard Support alone 3.1% (95% confidence interval 12.8% to -6.5%) or comparing Standard Support and Medication Management with Standard Support and Medication Management with Contingency Management 7.9% (95% confidence interval 18.7% to -2.8%). The primary economic analysis at 6 months found that Standard Support and Medication Management with Contingency Management was cost-effective compared to Standard Support alone, achieving small gains in quality-adjusted life-years at a lower cost per participant. Cost-effectiveness was not observed for adjunctive Medication Management compared to Standard Support alone. There were no serious adverse events related to the trial interventions reported. LIMITATIONS: The trial's primary outcome measure changed substantially due to data collection difficulties and therefore relied on a measure of self-reported adherence. A lower than anticipated follow-up rate at 12 months may have lowered the statistical power to detect differences in the secondary analyses, although the primary analysis was not impacted. CONCLUSIONS: Medication Management enhanced with Contingency Management is beneficial to patients for supporting them to take acamprosate. FUTURE WORK: Given our findings in relation to Contingency Management enhancing Medication Management adherence, future trials should be developed to explore its effectiveness and cost-effectiveness with other alcohol interventions where there is evidence of poor adherence. TRIAL REGISTRATION: This trial is registered as ISRCTN17083622 https://doi.org/10.1186/ISRCTN17083622. FUNDING: This project was funded by the National Institute for Health and Care Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 27, No. 22. See the NIHR Journals Library website for further project information

    L'Ă©quipe-projet HeKA

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    This article describe the Inria, Inserm, Univ. de Paris project team HeKA.International audienceHeKA est une Ă©quipe-projet de recherche commune Ă  Inria, l’Inserm et l’UniversitĂ© de Paris. Plus prĂ©cisĂ©ment, HeKA, dĂ©pend du Centre de Recherche des Cordeliers et du Centre Inria de Paris. En plus de deux chercheurs Inria et Inserm, HeKA est composĂ© de chercheurs hospitalo-universitaires de l’AP-HP associĂ©s Ă  des services de l’HĂŽpital EuropĂ©en Georges Pompidou, l’HĂŽpital Necker et de l’Institut Imagine. Les thĂšmes de recherche de l’équipe sont l’informatique mĂ©dicale, les biostatistiques et les mathĂ©matiques appliquĂ©es pour l’aide Ă  la dĂ©cision clinique. Le terme HeKA est Ă  la fois une rĂ©fĂ©rence Ă  la divitĂ© Ă©gyptienne de la mĂ©decine et un acronyme pour Health data- and model- driven Knowledge Acquisition.L’équipe HeKA fait suite Ă  l’équipe 22 (Information Sciences to support Personalized Medicine) dirigĂ©e par Anita Burgun au Centre de Recherche des Corderliers (Inserm, UniversitĂ© de Paris). La responsable de HeKA est Sarah Zohar, elle est secondĂ©e par Adrien Coulet

    Intended and unintended consequences of the implementation of minimum unit pricing of alcohol in Scotland: a natural experiment

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    Background: Scotland was the first country to implement minimum unit pricing for alcohol nationally. Minimum unit pricing aims to reduce alcohol-related harms and to narrow health inequalities. Minimum unit pricing sets a minimum retail price based on alcohol content, targeting products preferentially consumed by high-risk drinkers. This study comprised three components. Objectives: This study comprised three components assessing alcohol consumption and alcohol-related attendances in emergency departments, investigating potential unintended effects of minimum unit pricing on alcohol source and drug use, and exploring changes in public attitudes, experiences and norms towards minimum unit pricing and alcohol use. Design: We conducted a natural experiment study using repeated cross-sectional surveys comparing Scotland (intervention) and North England (control) areas. This involved comparing changes in Scotland following the introduction of minimum unit pricing with changes seen in the north of England over the same period. Difference-in-difference analyses compared intervention and control areas. Focus groups with young people and heavy drinkers, and interviews with professional stakeholders before and after minimum unit pricing implementation in Scotland allowed exploration of attitudes, experiences and behaviours, stakeholder perceptions and potential mechanisms of effect. Setting: Four emergency departments in Scotland and North England (component 1), six sexual health clinics in Scotland and North England (component 2), and focus groups and interviews in Scotland (component 3). Participants: Research nurses interviewed 23,455 adults in emergency departments, and 15,218 participants self-completed questionnaires in sexual health clinics. We interviewed 30 stakeholders and 105 individuals participated in focus groups. Intervention: Minimum unit pricing sets a minimum retail price based on alcohol content, targeting products preferentially consumed by high-risk drinkers. Results: The odds ratio for an alcohol-related emergency department attendance following minimum unit pricing was 1.14 (95% confidence interval 0.90 to 1.44; p = 0.272). In absolute terms, we estimated that minimum unit pricing was associated with 258 more alcohol-related emergency department visits (95% confidence interval –191 to 707) across Scotland than would have been the case had minimum unit pricing not been implemented. The odds ratio for illicit drug consumption following minimum unit pricing was 1.04 (95% confidence interval 0.88 to 1.24; p = 0.612). Concerns about harms, including crime and the use of other sources of alcohol, were generally not realised. Stakeholders and the public generally did not perceive price increases or changed consumption. A lack of understanding of the policy may have caused concerns about harms to dependent drinkers among participants from more deprived areas. Limitations: The short interval between policy announcement and implementation left limited time for pre-intervention data collection. Conclusions: Within the emergency departments, there was no evidence of a beneficial impact of minimum unit pricing. Implementation appeared to have been successful and there was no evidence of substitution from alcohol consumption to other drugs. Drinkers and stakeholders largely reported not noticing any change in price or consumption. The lack of effect observed in these settings in the short term, and the problem-free implementation, suggests that the price per unit set (£0.50) was acceptable, but may be too low. Our evaluation, which itself contains multiple components, is part of a wider programme co-ordinated by Public Health Scotland and the results should be understood in this wider context. Future work: Repeated evaluation of similar policies in different contexts with varying prices would enable a fuller picture of the relationship between price and impacts.Additional co-authors: Oarabile Molaodi, Michele Open, Chris Patterson, Samantha Perry, Thomas Phillips, Gabriel Schembri, Janet Wilson, Chris Yap, Lyndal Bond, and Alastair H Leylan

    Human SNP links differential outcomes in inflammatory and infectious disease to a FOXO3-regulated pathway

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    The clinical course and eventual outcome, or prognosis, of complex diseases varies enormously between affected individuals. This variability critically determines the impact a disease has on a patient’s life but is very poorly understood. Here, we exploit existing genome-wide association study data to gain insight into the role of genetics in prognosis. We identify a noncoding polymorphism in FOXO3A (rs12212067: T > G) at which the minor (G) allele, despite not being associated with disease susceptibility, is associated with a milder course of Crohn’s disease and rheumatoid arthritis and with increased risk of severe malaria. Minor allele carriage is shown to limit inflammatory responses in monocytes via a FOXO3-driven pathway, which through TGFÎČ1 reduces production of proinflammatory cytokines, including TNFα, and increases production of anti-inflammatory cytokines, including IL-10. Thus, we uncover a shared genetic contribution to prognosis in distinct diseases that operates via a FOXO3-driven pathway modulating inflammatory responses. PAPERCLIP

    Pan-cancer Alterations of the MYC Oncogene and Its Proximal Network across the Cancer Genome Atlas

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    Although theMYConcogene has been implicated incancer, a systematic assessment of alterations ofMYC, related transcription factors, and co-regulatoryproteins, forming the proximal MYC network (PMN),across human cancers is lacking. Using computa-tional approaches, we define genomic and proteo-mic features associated with MYC and the PMNacross the 33 cancers of The Cancer Genome Atlas.Pan-cancer, 28% of all samples had at least one ofthe MYC paralogs amplified. In contrast, the MYCantagonists MGA and MNT were the most frequentlymutated or deleted members, proposing a roleas tumor suppressors.MYCalterations were mutu-ally exclusive withPIK3CA,PTEN,APC,orBRAFalterations, suggesting that MYC is a distinct onco-genic driver. Expression analysis revealed MYC-associated pathways in tumor subtypes, such asimmune response and growth factor signaling; chro-matin, translation, and DNA replication/repair wereconserved pan-cancer. This analysis reveals insightsinto MYC biology and is a reference for biomarkersand therapeutics for cancers with alterations ofMYC or the PMN

    Pan-Cancer Analysis of lncRNA Regulation Supports Their Targeting of Cancer Genes in Each Tumor Context

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    Long noncoding RNAs (lncRNAs) are commonly dys-regulated in tumors, but only a handful are known toplay pathophysiological roles in cancer. We inferredlncRNAs that dysregulate cancer pathways, onco-genes, and tumor suppressors (cancer genes) bymodeling their effects on the activity of transcriptionfactors, RNA-binding proteins, and microRNAs in5,185 TCGA tumors and 1,019 ENCODE assays.Our predictions included hundreds of candidateonco- and tumor-suppressor lncRNAs (cancerlncRNAs) whose somatic alterations account for thedysregulation of dozens of cancer genes and path-ways in each of 14 tumor contexts. To demonstrateproof of concept, we showed that perturbations tar-geting OIP5-AS1 (an inferred tumor suppressor) andTUG1 and WT1-AS (inferred onco-lncRNAs) dysre-gulated cancer genes and altered proliferation ofbreast and gynecologic cancer cells. Our analysis in-dicates that, although most lncRNAs are dysregu-lated in a tumor-specific manner, some, includingOIP5-AS1, TUG1, NEAT1, MEG3, and TSIX, synergis-tically dysregulate cancer pathways in multiple tumorcontexts

    Genomic, Pathway Network, and Immunologic Features Distinguishing Squamous Carcinomas

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    This integrated, multiplatform PanCancer Atlas study co-mapped and identified distinguishing molecular features of squamous cell carcinomas (SCCs) from five sites associated with smokin
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