Comparing motor-­vehicle crash risk of EU and US vehicles

This study examined the hypotheses that vehicles meeting EU safety standards perform similarly to US-­‐regulated vehicles in the US driving environment, and vice versa. The analyses used three statistical approaches to “triangulate” evidence regarding differences in crash and injury risk. Separate analyses assessed crash avoidance technologies, including headlamps and mirrors. The results suggest that when controlling for differences in environment and exposure, vehicles meeting EU standards offer reduced risk of serious injury in frontal/side crashes and have driver-­‐side mirrors that reduce risk in lane-­‐change crashes better, while vehicles meeting US standards provide a lower risk of injury in rollovers and have headlamps that make pedestrians more conspicuous.Alliance of Automobile Manufacturershttp://deepblue.lib.umich.edu/bitstream/2027.42/112977/1/103199.pd

Character evolution and missing (morphological) data across Asteridae

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/143691/1/ajb21050-sup-0007-AppendixS7.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/143691/2/ajb21050_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/143691/3/ajb21050-sup-0019-AppendixS19.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/143691/4/ajb21050-sup-0013-AppendixS13.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/143691/5/ajb21050-sup-0014-AppendixS14.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/143691/6/ajb21050-sup-0012-AppendixS12.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/143691/7/ajb21050-sup-0009-AppendixS9.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/143691/8/ajb21050-sup-0018-AppendixS18.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/143691/9/ajb21050.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/143691/10/ajb21050-sup-0004-AppendixS4.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/143691/11/ajb21050-sup-0008-AppendixS8.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/143691/12/ajb21050-sup-0005-AppendixS5.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/143691/13/ajb21050-sup-0017-AppendixS17.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/143691/14/ajb21050-sup-0006-AppendixS6.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/143691/15/ajb21050-sup-0011-AppendixS11.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/143691/16/ajb21050-sup-0016-AppendixS16.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/143691/17/ajb21050-sup-0015-AppendixS15.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/143691/18/ajb21050-sup-0010-AppendixS10.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/143691/19/ajb21050-sup-0003-AppendixS3.pd

Comparing motor-vehicle crash risk of EU and US vehicles

Objective: This study examined the hypotheses that passenger vehicles meeting European Union (EU) safety standards have similar crashworthiness to United States (US) -regulated vehicles in the US driving environment, and vice versa. Methods: The first step involved identifying appropriate databases of US and EU crashes that include in-depth crash information, such as estimation of crash severity using Delta-V and injury outcome based on medical records. The next step was to harmonize variable definitions and sampling criteria so that the EU data could be combined and compared to the US data using the same or equivalent parameters. Logistic regression models of the risk of a Maximum injury according to the Abbreviated Injury Scale of 3 or greater, or fatality (MAIS3+F) in EU-regulated and US-regulated vehicles were constructed. The injury risk predictions of the EU model and the US model were each applied to both the US and EU standard crash populations. Frontal, near-side, and far-side crashes were analyzed together (termed “front/side crashes”) and a separate model was developed for rollover crashes. Results: For the front/side model applied to the US standard population, the mean estimated risk for the US-vehicle model is 0.035 (sd = 0.012), and the mean estimated risk for the EU-vehicle model is 0.023 (sd = 0.016). When applied to the EU front/side population, the US model predicted a 0.065 risk (sd = 0.027), and the EU model predicted a 0.052 risk (sd = 0.025). For the rollover model applied to the US standard population, the US model predicted a risk of 0.071 (sd = 0.024), and the EU model predicted 0.128 risk (sd = 0.057). When applied to the EU rollover standard population, the US model predicted a 0.067 risk (sd = 0.024), and the EU model predicted 0.103 risk (sd = 0.040). Conclusions: The results based on these methods indicate that EU vehicles most likely have a lower risk of MAIS3+F injury in front/side impacts, while US vehicles most likely have a lower risk of MAIS3+F injury in llroovers. These results should be interpreted with an understanding of the uncertainty of the estimates, the study limitations, and our recommendations for further study detailed in the report

Predictive modelling of a novel anti-adhesion therapy to combat bacterial colonisation of burn wounds

As the development of new classes of antibiotics slows, bacterial resistance to existing antibiotics is becoming an increasing problem. A potential solution is to develop treatment strategies with an alternative mode of action. We consider one such strategy: anti-adhesion therapy. Whereas antibiotics act directly upon bacteria, either killing them or inhibiting their growth, anti-adhesion therapy impedes the binding of bacteria to host cells. This prevents bacteria from deploying their arsenal of virulence mechanisms, while simultaneously rendering them more susceptible to natural and artificial clearance. In this paper, we consider a particular form of anti-adhesion therapy, involving biomimetic multivalent adhesion molecule 7 coupled polystyrene microbeads, which competitively inhibit the binding of bacteria to host cells. We develop a mathematical model, formulated as a system of ordinary differential equations, to describe inhibitor treatment of a Pseudomonas aeruginosa burn wound infection in the rat. Benchmarking our model against in vivo data from an ongoing experimental programme, we use the model to explain bacteria population dynamics and to predict the efficacy of a range of treatment strategies, with the aim of improving treatment outcome. The model consists of two physical compartments: the host cells and the exudate. It is found that, when effective in reducing the bacterial burden, inhibitor treatment operates both by preventing bacteria from binding to the host cells and by reducing the flux of daughter cells from the host cells into the exudate. Our model predicts that inhibitor treatment cannot eliminate the bacterial burden when used in isolation; however, when combined with regular or continuous debridement of the exudate, elimination is theoretically possible. Lastly, we present ways to improve therapeutic efficacy, as predicted by our mathematical model

Development of carpels and ovules in Dialypetalanthus fuscescens Kuhlm. (Rubiaceae): an enigmatic taxon

ABSTRACT Dialypetalanthus is a monospecific genus that occurs in the Amazon Basin of Brazil, Bolivia and Peru and occupies a controversial position among the Rubiaceae. We continue this taxonomic discussion with the overall aim of clarifying the systematic position of D. fuscescens within the Rubiaceae. To accomplish this, we analyzed the ontogeny of its gynoecium, in particular the floral meristem, as well as the development of the carpels and cauline placentation. Gynosporogenesis and the differentiation of the carpellary septa and ovules were also described. Dialypetalanthus fuscescens was classified according to evolutionary diagrams found in the literature. The following characteristics were observed in D. fuscescens: 1) permanence of the floral meristem in the central basal part of the early flower bud; 2) dual origin of carpellary septum; 3) trizonate ovular primordia with only one fertile gynospore per ovule; and 4) cellular proliferation in the chalazal region. Embryological results confirm the classification of D. fuscescens in the subfamily Ixoroideae. These results are distinct from any others previously proposed in the evolutionary diagram. Therefore, we conclude that this study has presented evidence strongly suggesting that Dialypetalanthus possesses new morphological-type of ovule we refer to as the Dialypetalanthus-type

How do patient reported outcome measures (PROMs) support clinician-patient communication and patient care? A realist synthesis

Background: In this paper, we report the findings of a realist synthesis that aimed to understand how and in what circumstances patient reported outcome measures (PROMs) support patient-clinician communication and subsequent care processes and outcomes in clinical care. We tested two overarching programme theories: (1) PROMs completion prompts a process of self-reflection and supports patients to raise issues with clinicians and (2) PROMs scores raise clinicians’ awareness of patients’ problems and prompts discussion and action. We examined how the structure of the PROM and care context shaped the ways in which PROMs support clinician-patient communication and subsequent care processes. Results: PROMs completion prompts patients to reflect on their health and gives them permission to raise issues with clinicians. However, clinicians found standardised PROMs completion during patient assessments sometimes constrained rather than supported communication. In response, clinicians adapted their use of PROMs to render them compatible with the ongoing management of patient relationships. Individualised PROMs supported dialogue by enabling the patient to tell their story. In oncology, PROMs completion outside of the consultation enabled clinicians to identify problematic symptoms when the PROM acted as a substitute rather than addition to the clinical encounter and when the PROM focused on symptoms and side effects, rather than health related quality of life (HRQoL). Patients did not always feel it was appropriate to discuss emotional, functional or HRQoL issues with doctors and doctors did not perceive this was within their remit. Conclusions: This paper makes two important contributions to the literature. First, our findings show that PROMs completion is not a neutral act of information retrieval but can change how patients think about their condition. Second, our findings reveal that the ways in which clinicians use PROMs is shaped by their relationships with patients and professional roles and boundaries. Future research should examine how PROMs completion and feedback shapes and is influenced by the process of building relationships with patients, rather than just their impact on information exchange and decision making