Soft landings on a bumpy runway

Our case study of the 1995 economic slowdown reveals that part of the widespread deterioration in economic indicators was predictable in light of 1994 monetary policy actions. But it was also partly unanticipated due to a modest adverse supply shock in the first quarter of 1995.Monetary policy - United States ; Monetary policy ; Recessions

Professionals' diagnostic and prognostic communication practices in cancer, and the mediating effect of illness perceptions on quality of life in brain tumour patients

The portfolio has three parts. Part one is a systematic literature review, in which the empirical literature relating to general disclosure practices of clinicians regarding the diagnosis and prognosis of cancer is reviewed. Part two is an empirical paper, which explores the potential mediating effect of illness perceptions on the relationship between diagnosis communication and quality-of-life in people with a brain tumour. Part three comprises the appendices.Background: Oncology patients have expressed the wish to be informed of diagnostic and prognostic information in an open and timely manner. The positive outcomes of having these discussions has been researched, both in relation to patients and their caregivers. Investigations of clinicians’ personal opinions about disclosure have revealed the majority believe patients should be told their diagnosis. However, historically it has not always been the case that clinicians disclose this information in practice. Procedure: A systematic literature search was conducted, and the relevant data was extracted and presented using a narrative synthesis approach. Participants: 3479 qualified clinicians with a range of specialities working with oncology patients were included in this review. Findings: This review suggests clinicians do not consistently disclose diagnosis and prognosis to cancer patients, which stands in conflict with patient preferences and service guidelines. There is an apparent difference between clinicians’ opinion and their clinical practice, with more clinicians believing the diagnosis and prognosis should be disclosed in comparison to their reported practice. A vast array of factors contributed to clinicians’ disclosure practices, but due to a high level of inconsistency, general disclosure practices cannot be attributed to any consistent clinician, personal, or patient factors alone. Conclusions: Not all clinicians report they routinely disclose diagnostic and prognostic information to patients, and there are a number of factors they consider when making this decision. More should be done within services to increase disclosure rates to bring this in line with patient preferences and current guidelines

Chapter A drone’s eye view: A preliminary assessment of the efficiency of drones in mapping shallow-water benthic assemblages

The study assesses consumer drone efficiency for surveying shallow-water benthic cover. We hypothesised that using a drone would reduce duration, and manpower requirements, while increasing accuracy, relative to manual surveys. Results obtained during this study clearly indicated that automated drone surveys were faster and more accurate than manual survey methods under most circumstances. This result has important implications for the scientific and economic aspects of the process and would have a multiplicative effect in monitoring programs that require regular surveys

Anti-vascular endothelial growth factor for diabetic macular oedema.

BACKGROUND: Diabetic macular oedema (DMO) is a common complication of diabetic retinopathy. Although grid or focal laser photocoagulation has been shown to reduce the risk of visual loss in DMO, or clinically significant macular oedema (CSMO), vision is rarely improved. Antiangiogenic therapy with anti-vascular endothelial growth factor (anti-VEGF) modalities is used to try to improve vision in people with DMO. OBJECTIVES: To investigate the effects in preserving and improving vision and acceptability, including the safety, compliance with therapy and quality of life, of antiangiogenic therapy with anti-VEGF modalities for the treatment of DMO. SEARCH METHODS: We searched CENTRAL (which contains the Cochrane Eyes and Vision Group Trials Register) (2014, Issue 3), Ovid MEDLINE, Ovid MEDLINE In-Process and Other Non-Indexed Citations, Ovid MEDLINE Daily, Ovid OLDMEDLINE (January 1946 to April 2014), EMBASE (January 1980 to April 2014), Latin American and Caribbean Health Sciences Literature Database (LILACS) (January 1982 to April 2014), the metaRegister of Controlled Trials (mRCT) (www.controlled-trials.com), ClinicalTrials.gov (www.clinicaltrials.gov) and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en). We did not use any date or language restrictions in the electronic searches for trials. We last searched the electronic databases on 28 April 2014. SELECTION CRITERIA: We included randomised controlled trials (RCTs) comparing any antiangiogenic drugs with an anti-VEGF mechanism of action versus another treatment, sham treatment or no treatment in people with DMO. DATA COLLECTION AND ANALYSIS: We used standard methodological procedures expected by The Cochrane Collaboration. The risk ratios (RR) for visual loss and visual gain of three or more lines of logMAR visual acuity were estimated at one year of follow-up (plus or minus six months) after treatment initiation. MAIN RESULTS: Eighteen studies provided data on four comparisons of interest in this review. Participants in the trials had central DMO and moderate vision loss.Compared with grid laser photocoagulation, people treated with antiangiogenic therapy were more likely to gain 3 or more lines of vision at one year (RR 3.6, 95% confidence interval (CI) 2.7 to 4.8, 10 studies, 1333 cases, high quality evidence) and less likely to lose 3 or more lines of vision (RR 0.11, 95% CI 0.05 to 0.24, 7 studies, 1086 cases, high quality evidence). In meta-analyses, no significant subgroup difference was demonstrated between bevacizumab, ranibizumab and aflibercept for the two primary outcomes, but there was little power to detect a difference. The quality of the evidence was judged to be high, because the effect was large, precisely measured and did not vary across studies, although some studies were at high or unclear risk of bias for one or more domains. Regarding absolute benefit, we estimated that 8 out of 100 participants with DMO may gain 3 or more lines of visual acuity using photocoagulation whereas 28 would do so with antiangiogenic therapy, meaning that 100 participants need to be treated with antiangiogenic therapy to allow 20 more people (95% CI 13 to 29) to markedly improve their vision after one year. People treated with anti-VEGF on average had 1.6 lines better vision (95% CI 1.4 to 1.8) after one year compared to laser photocoagulation (9 studies, 1292 cases, high quality evidence). To achieve this result, seven to nine injections were delivered in the first year and three or four in the second, in larger studies adopting either as needed regimens with monthly monitoring or fixed regimens.In other analyses antiangiogenic therapy was more effective than sham (3 studies on 497 analysed participants, high quality evidence) and ranibizumab associated with laser was more effective than laser alone (4 studies on 919 participants, high quality evidence).Ocular severe adverse events, such as endophthalmitis, were rare in the included studies. Meta-analyses conducted for all antiangiogenic drugs compared with either sham or photocoagulation did not show a significant difference regarding serious systemic adverse events (15 studies, 441 events in 2985 participants, RR 0.98, 95% CI 0.83 to 1.17), arterial thromboembolic events (14 studies, 129 events in 3034 participants, RR 0.89, 95% CI 0.63 to 1.25) and overall mortality (63 events in 3562 participants, RR 0.88, 95% CI 0.52 to 1.47). We judged the quality of the evidence on adverse effects as moderate due to partial reporting of safety data and the exclusion of participants with previous cardiovascular events in some studies. AUTHORS' CONCLUSIONS: There is high quality evidence that antiangiogenic drugs provide a benefit compared to current therapeutic options for DMO, that is grid laser photocoagulation, in clinical trial populations at one or two years. Future research should investigate differences between drugs, effectiveness under real-world monitoring and treatment conditions, and safety in high-risk populations, particularly regarding cardiovascular risk

Uniqueness Results for Second Order Bellman-Isaacs Equations under Quadratic Growth Assumptions and Applications

In this paper, we prove a comparison result between semicontinuous viscosity sub and supersolutions growing at most quadratically of second-order degenerate parabolic Hamilton-Jacobi-Bellman and Isaacs equations. As an application, we characterize the value function of a finite horizon stochastic control problem with unbounded controls as the unique viscosity solution of the corresponding dynamic programming equation

early nutritional programming and progeny performance is reproductive success already set at birth

Compelling evidence indicates that the environment encountered dur-ing fetal life exerts a profound influence on development, physiological function, and risk of disease in adult mammals (Barker, 2007; Langley-Evans and McMullen, 2010). Development is a plastic process, wherein a range of different phenotypes can be expressed from a given genotype. The developing conceptuses respond to conditions in the environment during sensitive periods of cellular proliferation, differentiation, and maturation, resulting in structural and functional changes in cells, tissues, and organ systems. These changes may have short- and/or long-term consequences for health and disease susceptibility. Hence, the term "programming" has been adopted to describe the process whereby a stimulus or an insult at a critical and sensitive period of fetal or perinatal life has permanent effects on the structure, physiology, and metabolism of different organs and sys-tems. Despite many studies investigating the associations between mater-nal environment during fetal development and the onset of cardiovascular disease, obesity, and diabetes in offspring as adults (McMillen and Robin-son, 2005), few studies have investigated the impact of maternal environ-ment on the reproductive potential of offspring. This paper reviews the existing literature on the effects of prenatal and perinatal nutrition on the development and function of the reproductive system in female and male domestic mammals, with particular emphasis on cattle and sheep

Surface grafting of electrospun fibers using ATRP and RAFT for the control of biointerfacial interactions

BACKGROUND The ability to present signalling molecules within a low fouling 3D environment that mimics the extracellular matrix is an important goal for a range of biomedical applications, both in vitro and in vivo. Cell responses can be triggered by non-specific protein interactions occurring on the surface of a biomaterial, which is an undesirable process when studying specific receptor-ligand interactions. It is therefore useful to present specific ligands of interest to cell surface receptors in a 3D environment that minimizes non-specific interactions with biomolecules, such as proteins. METHOD In this study, surface-initiated atom transfer radical polymerization (SI-ATRP) of poly(ethylene glycol)-based monomers was carried out from the surface of electrospun fibers composed of a styrene/vinylbenzyl chloride copolymer. Surface initiated radical addition-fragmentation chain transfer (SI-RAFT) polymerisation was also carried out to generate bottle brush copolymer coatings consisting of poly(acrylic acid) and poly(acrylamide). These were grown from surface trithiocarbonate groups generated from the chloromethyl styrene moieties existing in the original synthesised polymer. XPS was used to characterise the surface composition of the fibers after grafting and after coupling with fluorine functional XPS labels. RESULTS Bottle brush type coatings were able to be produced by ATRP which consisted of poly(ethylene glycol) methacrylate and a terminal alkyne-functionalised monomer. The ATRP coatings showed reduced non-specific protein adsorption, as a result of effective PEG incorporation and pendant alkynes groups existing as part of the brushes allowed for further conjugation of via azide-alkyne Huisgen 1,3-dipolar cycloaddition. In the case of RAFT, carboxylic acid moieties were effectively coupled to an amine label via amide bond formation. In each case XPS analysis demonstrated that covalent immobilisation had effectively taken place. CONCLUSION Overall, the studies presented an effective platform for the preparation of 3D scaffolds which contain effective conjugation sites for attachment of specific bioactive signals of interest, as well as actively reducing non-specific protein interactions.This research was supported by the Cooperative Research Centre for Polymers (CRCP)

Feasibility Study of the Application of the LOICZ Budget to the Mediterranean Sea

The Mediterranean Sea is an important regional EU sea and often used to assess the impacts of global change on the environment, due to its practically enclosed character. As most of the northern part is bordered by the EU, it is also of interest in the evaluation of the environmental and economic impact of the implementation of the EU Water Framework Directive and related environmental legislation. For this purpose, the feasibility to carry out a budget approach, developed in LOICZ (Land Ocean Interactions in the Coastal Zone) project has been analyzed. The activities carried out allow to conclude that all budget components can be reliably estimated and such budget correctly set up. In particular: - estimates for precipitation and evaporation of the Mediterranean Sea can be obtained from ECMWF; other sources for estimates of such variables are available, and in a further implementation of this work a comparison between estimate sets will be carried out; - estimates of annual flow and nutrient output to the Mediterranean Sea as required by the LOICZ budget can be obtained via the setting up of the AVGWLF model, with reasonable operating expense (time and effort) and with acceptable assumptions made for information/data not available for some or all of the regions, especially in the Asian and North African part of the Mediterranean; - exchanges through the Gibraltar and Dardanelles Straits can also be reliably estimated, based on previous studies. It is recognized that the estimates of all budget components, as illustrated in the paragraphs above, can be improved. It is foreseen that some of these improvements will be obtained already in the actual implementation of the LOICZ budget.JRC.H.5-Rural, water and ecosystem resource