Research priorities for the management of major trauma: an international priority setting partnership with the James Lind Alliance

Objective The objective of this study is to determine research priorities for the management of major trauma, representing the shared priorities of patients, their families, carers and healthcare professionals. Design/setting An international research priority-setting partnership. Participants People who have experienced major trauma, their carers and relatives, and healthcare professionals involved in treating patients after major trauma. The scope included chest, abdominal and pelvic injuries as well as major bleeding, multiple injuries and those that threaten life or limb. Methods A multiphase priority-setting exercise was conducted in partnership with the James Lind Alliance over 24 months (November 2021–October 2023). An international survey asked respondents to submit their research uncertainties which were then combined into several indicative questions. The existing evidence was searched to ensure that the questions had not already been sufficiently answered. A second international survey asked respondents to prioritise the research questions. A final shortlist of 19 questions was taken to a stakeholder workshop, where consensus was reached on the top 10 priorities. Results A total of 1572 uncertainties, submitted by 417 respondents (including 132 patients and carers), were received during the initial survey. These were refined into 53 unique indicative questions, of which all 53 were judged to be true uncertainties after reviewing the existing evidence. 373 people (including 115 patients and carers) responded to the interim prioritisation survey and 19 questions were taken to a final consensus workshop between patients, carers and healthcare professionals. At the final workshop, a consensus was reached for the ranking of the top 10 questions. Conclusions The top 10 research priorities for major trauma include patient-centred questions regarding pain relief and prehospital management, multidisciplinary working, novel technologies, rehabilitation and holistic support. These shared priorities will now be used to guide funders and teams wishing to research major trauma around the globe

UCIP: User controlled internet protocol

Internet protocols have developed significantly over the last 50 years but have reached a point where the further improvements in performance, resilience, security and privacy cannot be achieved by simple incremental changes. This paper proposes a new IP protocol that puts the user's end host at the centre of major algorithmic decisions. It consist of three new mechanisms: a private source routing establishment protocol that allows inter-domain traffic routes to be decided by the user and kept private from the providers whilst allowing for anonymous connections where two node can communicate without knowing the identity/address of the other end point; a mechanism to control reception of packets that mitigates denial-of-service attacks and a new directory system that puts the end user at the core of the decisions enabling anycast and mobility with a pub-sub mechanism with fine grain capabilities for describe resources. These changes allow end nodes to have a much tighter control of how they send and receive their traffic and provide a paradigm shift for the Internet ecosystem

Location Dependent Dirichlet Processes

Dirichlet processes (DP) are widely applied in Bayesian nonparametric modeling. However, in their basic form they do not directly integrate dependency information among data arising from space and time. In this paper, we propose location dependent Dirichlet processes (LDDP) which incorporate nonparametric Gaussian processes in the DP modeling framework to model such dependencies. We develop the LDDP in the context of mixture modeling, and develop a mean field variational inference algorithm for this mixture model. The effectiveness of the proposed modeling framework is shown on an image segmentation task

Exponential Qubit Reduction in Optimization for Financial Transaction Settlement

We extend the qubit-efficient encoding presented in [Tan et al., Quantum 5, 454 (2021)] and apply it to instances of the financial transaction settlement problem constructed from data provided by a regulated financial exchange. Our methods are directly applicable to any QUBO problem with linear inequality constraints. Our extension of previously proposed methods consists of a simplification in varying the number of qubits used to encode correlations as well as a new class of variational circuits which incorporate symmetries, thereby reducing sampling overhead, improving numerical stability and recovering the expression of the cost objective as a Hermitian observable. We also propose optimality-preserving methods to reduce variance in real-world data and substitute continuous slack variables. We benchmark our methods against standard QAOA for problems consisting of 16 transactions and obtain competitive results. Our newly proposed variational ansatz performs best overall. We demonstrate tackling problems with 128 transactions on real quantum hardware, exceeding previous results bounded by NISQ hardware by almost two orders of magnitude.Comment: 16 pages, 8 figure

Using Markov Models and Statistics to Learn, Extract, Fuse, and Detect Patterns in Raw Data

Many systems are partially stochastic in nature. We have derived data driven approaches for extracting stochastic state machines (Markov models) directly from observed data. This chapter provides an overview of our approach with numerous practical applications. We have used this approach for inferring shipping patterns, exploiting computer system side-channel information, and detecting botnet activities. For contrast, we include a related data-driven statistical inferencing approach that detects and localizes radiation sources.Comment: Accepted by 2017 International Symposium on Sensor Networks, Systems and Securit

Patient experiences of receiving arthroscopic surgery or personalised hip therapy for femoroacetabular impingement in the context of the UK fashion study:a qualitative study

UK FASHIoN was a multicentre randomised controlled trial comparing hip arthroscopic surgery (HA) with personalised hip therapy (PHT, physiotherapist-led conservative care), for patients with hip pain attributed to femoroacetabular impingement (FAI) syndrome. Our aim was to describe the treatment and trial participation experiences of patients, to contextualise the trial results and offer further information to assist treatment decision-making in FAI. We conducted in-depth semi-structured telephone interviews with a purposive sample of trial participants from each of the trial arms. They were interviewed after they received treatment and completed their first year of trial participation. Thematic analysis and constant comparison analytical approaches were used to identify themes of patient treatment experiences during the trial. Forty trial participants were interviewed in this qualitative study. Their baseline characteristics were similar to those in the main trial sample. On average, their hip-related quality of life (iHOT-33 scores) at 12 months follow-up were lower than average for all trial participants, indicating poorer hip-related quality of life as a consequence of theoretical sampling. Patient experiences occurred in five patient groups: those who felt their symptoms improved with hip arthroscopy, or with personal hip therapy, patients who felt their hip symptoms did not change with PHT but did not want HA, patients who decided to change from PHT to HA and a group who experienced serious complications after HA. Interviewees mostly described a trouble-free, enriching and altruistic trial participation experience, although most participants expected more clinical follow-up at the end of the trial. Both HA and PHT were experienced as beneficial by participants in the trial. Treatment success appeared to depend partly on patients' prior own expectations as well as their outcomes, and future research is needed to explore this further. Findings from this study can be combined with the primary results to inform future FAI patients

Post-acute Brain Injury Urinary Signature: A New Resource for Molecular Diagnostics

Heterogeneity within brain injury presents a challenge to the development of informative molecular diagnostics. Recent studies show progress particularly in cerebrospinal fluid with biomarker assays targeting one or a few structural proteins. Protein-based assays in peripheral fluids, however, have been more challenging to develop in part due to restricted and intermittent barrier access. Further, a greater number of molecular variables may be required to inform on patient status given the multifactorial nature of brain injury. Presented is an alternative approach profiling peripheral fluid for a class of small metabolic by-products rendered by ongoing brain pathobiology. Urine specimens were collected for head trauma subjects upon admission to acute brain injury rehabilitation and nontraumatized matched controls. An innovative data-independent mass spectrometry approach was employed for reproducible molecular quantification across osmolarity-normalized samples. The postacute human traumatic brain injury urinary signature encompassed 2,476 discriminant variables reproducibly measured in specimens for subject classification. Multiple sub-profiles were then discerned in correlation with injury severity per Glasgow Comma Scale and behavioral and neurocognitive function per Patient Competency Rating Scale and Frontal Systems Behavioral Scale. Identified peptide constituents were enriched for outgrowth and guidance, extracellular matrix and post-synaptic density proteins, which were reflective of ongoing post-acute neuroplastic processes demonstrating pathobiological relevance. Taken together, these findings support further development of diagnostics based on brain injury urinary signatures using either combinatorial quantitative models or patternrecognition methods. Particularly, these findings espouse assay development to address unmet diagnostic and theragnostic needs in brain injury rehabilitative medicine

Lower entropy bounds and particle number fluctuations in a Fermi sea

We demonstrate, in an elementary manner, that given a partition of the single particle Hilbert space into orthogonal subspaces, a Fermi sea may be factored into pairs of entangled modes, similar to a BCS state. We derive expressions for the entropy and for the particle number fluctuations of a subspace of a fermi sea, at zero and finite temperatures, and relate these by a lower bound on the entropy. As an application we investigate analytically and numerically these quantities for electrons in the lowest Landau level of a quantum Hall sample.Comment: shorter version, typos fixe