2,211 research outputs found
Eurasian Arctic greening reveals teleconnections and the potential for novel ecosystems
Arctic warming has been linked to observed increases in tundra shrub cover and growth in recent decades on the basis of significant relationships between deciduous shrub growth/biomass and temperature. These vegetation trends have been linked to Arctic sea ice decline and thus to the sea ice/albedo feedback known as Arctic amplification. However, the interactions between climate, sea ice and tundra vegetation remain poorly understood. Here we reveal a 50- year growth response over a >100,000 km2 area to a rise in summer temperature for alder (Alnus) and willow (Salix), the most abundant shrub genera respectively at and north of the continental treeline. We demonstrate that whereas plant productivity is related to sea ice in late spring, the growing season peak responds to persistent synoptic-scale air masses over West Siberia associated with Fennoscandian weather systems through the Rossby wave train. Substrate is important for biomass accumulation, yet a strong correlation between growth and temperature encompasses all observed soil types. Vegetation is especially responsive to temperature in early summer. These results have significant implications for modelling present and future Low Arctic vegetation responses to climate change, and emphasize the potential for structurally novel ecosystems to emerge fromwithin the tundra zone.Vertaisarviointia edeltävä käsikirjoitu
Evolution of design considerations in complex craniofacial reconstruction using patient-specific implants
Previously published evidence has established major clinical benefits from using Computer Aided Design (CAD), Computer Aided Manufacturing (CAM), and Additive Manufacturing (AM) to produce patient-specific devices. These include cutting guides, drilling guides, positioning guides, and implants. However, custom devices produced using these methods are still not in routine use – particularly by the UK National Health Service (NHS). Oft-cited reasons for this slow uptake include: a higher up-front cost than conventionally-fabricated devices, material-choice uncertainty, and a lack of long-term follow-up due to their relatively recent introduction. This paper identifies a further gap in current knowledge – that of design rules, or key specification considerations for complex CAD/CAM/AM devices. This research begins to address the gap by combining a detailed review of the literature with first-hand experience of interdisciplinary collaboration on five craniofacial patient case-studies.
In each patient case, bony lesions in the orbito-temporal region were segmented, excised, and reconstructed in the virtual environment. Three cases translated these digital plans into theatre via polymer surgical guides. Four cases utilised AM to fabricate titanium implants. One implant was machined from PolyEther Ether Ketone (PEEK). From the literature, articles with relevant abstracts were analysed to extract design considerations. 19 frequently-recurring design considerations were extracted from previous publications. 9 new design considerations were extracted from the case studies – on the basis of subjective clinical evaluation. These were synthesised to produce a design considerations framework to assist clinicians with prescribing and design engineers with modelling. Promising avenues for further research are proposed
Index Theorem and Overlap Formalism with Naive and Minimally Doubled Fermions
We present a theoretical foundation for the Index theorem in naive and
minimally doubled lattice fermions by studying the spectral flow of a Hermitean
version of Dirac operators. We utilize the point splitting method to implement
flavored mass terms, which play an important role in constructing proper
Hermitean operators. We show the spectral flow correctly detects the index of
the would-be zero modes which is determined by gauge field topology. Using the
flavored mass terms, we present new types of overlap fermions from the naive
fermion kernels, with a number of flavors that depends on the choice of the
mass terms. We succeed to obtain a single-flavor naive overlap fermion which
maintains hypercubic symmetry.Comment: 27 pages, 17 figures; references added, version accepted in JHE
Use of the Oxford Handicap Scale at hospital discharge to predict Glasgow Outcome Scale at 6 months in patients with traumatic brain injury
BACKGROUND: Traumatic brain injury (TBI) is an important cause of acquired disability. In evaluating the effectiveness of clinical interventions for TBI it is important to measure disability accurately. The Glasgow Outcome Scale (GOS) is the most widely used outcome measure in randomised controlled trials (RCTs) in TBI patients. However GOS measurement is generally collected at 6 months after discharge when loss to follow up could have occurred. The objectives of this study were to evaluate the association and predictive validity between a simple disability scale at hospital discharge, the Oxford Handicap Scale (OHS), and the GOS at 6 months among TBI patients. METHODS: The study was a secondary analysis of a randomised clinical trial among TBI patients (MRC CRASH Trial). A Spearman correlation was estimated to evaluate the association between the OHS and GOS. The validity of different dichotomies of the OHS for predicting GOS at 6 months was assessed by calculating sensitivity, specificity and the C statistic. Uni and multivariate logistic regression models were fitted including OHS as explanatory variable. For each model we analysed its discrimination and calibration. RESULTS: We found that the OHS is highly correlated with GOS at 6 months (spearman correlation 0.75) with evidence of a linear relationship between the two scales. The OHS dichotomy that separates patients with severe dependency or death showed the greatest discrimination (C statistic: 84.3). Among survivors at hospital discharge the OHS showed a very good discrimination (C statistic 0.78) and excellent calibration when used to predict GOS outcome at 6 months. CONCLUSION: We have shown that the OHS, a simple disability scale available at hospital discharge can predict disability accurately, according to the GOS, at 6 months. OHS could be used to improve the design and analysis of clinical trials in TBI patients and may also provide a valuable clinical tool for physicians to improve communication with patients and relatives when assessing a patient's prognosis at hospital discharge
On the Generalizability of Experimental Results
The age-old question of the generalizability of the results of experiments that are conducted in artificial laboratory settings to more realistic inferential and decision making situations is considered in this paper. Conservatism in probability revision provides an example of a result that 1) has received wide attention, including attention in terms of implications for real-world decision making, on the basis of experiments conducted in artificial settings and 2) is now apparently thought by many to be highly situational and not at all a ubiquitous phenomenon, in which case its implications for real-world decision making are not as extensive as originally claimed. In this paper we consider the questions of generalizations from the laboratory to the real world in some detail, both within the context of the experiments regarding conservatism and within a more general context. In addition, we discuss some of the difficulties inherent in experimentation in realistic settings, suggest possible procedures for avoiding or at least alleviating such difficulties, and make a plea for more realistic experiments
Gut γδ T cells as guardians, disruptors and instigators of cancer
Colorectal cancer is the third most common cancer worldwide with nearly 2 million cases per year. Immune cells and inflammation are a critical component of colorectal cancer progression, and they are used as reliable prognostic indicators of patient outcome. With the growing appreciation for immunology in colorectal cancer, interest is growing on the role γδ T cells have to play, as they represent one of the most prominent immune cell populations in gut tissue. This group of cells consists of both resident populations—γδ intraepithelial lymphocytes (γδ IELs)—and transient populations that each has unique functions. The homeostatic role of these γδ T cell subsets is to maintain barrier integrity and prevent microorganisms from breaching the mucosal layer, which is accomplished through crosstalk with enterocytes and other immune cells. Recent years have seen a surge in discoveries regarding the regulation of γδ IELs in the intestine and the colon with particular new insights into the butyrophilin family. In this review, we discuss the development, specialities, and functions of γδ T cell subsets during cancer progression. We discuss how these cells may be used to predict patient outcome, as well as how to exploit their behavior for cancer immunotherapy
The Calcitonin and Glucocorticoids Combination: Mechanistic Insights into Their Class-Effect Synergy in Experimental Arthritis
PMCID: PMC3564948This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited
Empowerment or Engagement? Digital Health Technologies for Mental Healthcare
We argue that while digital health technologies (e.g. artificial intelligence, smartphones, and virtual reality) present significant opportunities for improving the delivery of healthcare, key concepts that are used to evaluate and understand their impact can obscure significant ethical issues related to patient engagement and experience. Specifically, we focus on the concept of empowerment and ask whether it is adequate for addressing some significant ethical concerns that relate to digital health technologies for mental healthcare. We frame these concerns using five key ethical principles for AI ethics (i.e. autonomy, beneficence, non-maleficence, justice, and explicability), which have their roots in the bioethical literature, in order to critically evaluate the role that digital health technologies will have in the future of digital healthcare
Interfaces: The Next NDE Challenge
Nondestructive evaluation, as practiced in the 1960’s, attempted to detect (but was often unable to characterize) the existence of defects in engineering structures. Qualitative criteria were used in the assessment of defect significance and the determination of accept/reject decisions. Advances in elasto-plastic fracture mechanics during the 1970’s focused attention upon the defect size and orientation- if these could be measured, then fracture mechanics was capable of quantitative structural integrity evaluation. The papers presented in this conference series during the 1980’s trace the considerable advances of quantitative nondestructive evaluation in satisfying this measurement need. Nowadays, for monolithic materials with well defined fracture toughness, the overconservative rejection criteria of the past are beginning to be replaced by “retirement for cause” concepts
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