656 research outputs found

    Understanding Barriers to the Realization of Human Rights Among Older Women With Mental Health Conditions

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    There is increasing emphasis in research and at the level of international human rights bodies such as the United Nations on the gendered contours of age-based disadvantage and discrimination, and the cumulative effects of gender inequalities over the life-course on outcomes in later life. However, to date, the role of mental health in shaping the age/gender nexus in the realization of human rights has received little attention. In response, this paper aims to 1) elucidate the economic, social and cultural disadvantages and discrimination faced by older women living with mental health conditions; and 2) identify opportunities to protect their human rights. It concludes that older women face inequalities and disadvantages at the intersections of age, gender, and mental health and wellbeing that compromise their capacity to age well, illuminating the urgent need for a UN Convention on the Human Rights of Older Persons that considers the role of mental health in shaping the realization of human rights among older people. (Am J Geriatr Psychiatry 2021; 29:1009-1014

    Machine learning for risk prediction of oesophago-gastric cancer in primary care: comparison with existing risk-assessment tools

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    Oesophago-gastric cancer is difficult to diagnose in the early stages given its typical non-specific initial manifestation. We hypothesise that machine learning can improve upon the diagnostic performance of current primary care risk-assessment tools by using advanced analytical techniques to exploit the wealth of evidence available in the electronic health record. We used a primary care electronic health record dataset derived from the UK General Practice Research Database (7471 cases; 32,877 controls) and developed five probabilistic machine learning classifiers: Support Vector Machine, Random Forest, Logistic Regression, Naïve Bayes, and Extreme Gradient Boosted Decision Trees. Features included basic demographics, symptoms, and lab test results. The Logistic Regression, Support Vector Machine, and Extreme Gradient Boosted Decision Tree models achieved the highest performance in terms of accuracy and AUROC (0.89 accuracy, 0.87 AUROC), outperforming a current UK oesophago-gastric cancer risk-assessment tool (ogRAT). Machine learning also identified more cancer patients than the ogRAT: 11.0% more with little to no effect on false positives, or up to 25.0% more with a slight increase in false positives (for Logistic Regression, results threshold-dependent). Feature contribution estimates and individual prediction explanations indicated clinical relevance. We conclude that machine learning could improve primary care cancer risk-assessment tools, potentially helping clinicians to identify additional cancer cases earlier. This could, in turn, improve survival outcomes

    An optimal gap theorem

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    By solving the Cauchy problem for the Hodge-Laplace heat equation for dd-closed, positive (1,1)(1, 1)-forms, we prove an optimal gap theorem for K\"ahler manifolds with nonnegative bisectional curvature which asserts that the manifold is flat if the average of the scalar curvature over balls of radius rr centered at any fixed point oo is a function of o(r2)o(r^{-2}). Furthermore via a relative monotonicity estimate we obtain a stronger statement, namely a `positive mass' type result, asserting that if (M,g)(M, g) is not flat, then lim infrr2Vo(r)Bo(r)S(y)dμ(y)>0\liminf_{r\to \infty} \frac{r^2}{V_o(r)}\int_{B_o(r)}\mathcal{S}(y)\, d\mu(y)>0 for any oMo\in M

    Anti-tumour necrosis factor agent and liver injury : literature review, recommendations for management

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    Abnormalities in liver function tests, including transient and self-limiting hypertransaminasemia, cholestatic disease and hepatitis, can develop during treatment with anti-tumour-necrosis-factor (TNF) therapy. The optimal management of liver injury related to anti-TNF therapy is still a matter of debate. Although some authors recommend discontinuing treatment in case of both a rise of alanine aminotransferase more than 5 times the upper limit of normal, or the occurrence of jaundice, there are no standard guidelines for the management of anti-TNF-related liver injury. Bibliographical searches were performed in PubMed, using the following key words: inflammatory bowel disease (IBD); TNF inhibitors; hypertransaminasemia; drug-related liver injury; infliximab. According to published data, elevation of transaminases in patients with IBD treated with anti-TNF is a common finding, but resolution appears to be the usual outcome. Anti-TNF agents seem to be safe with a low risk of causing severe drug-related liver injury. According to our centre experience, we found that hypertransaminasemia was a common, mainly self-limiting finding in our IBD cohort and was not correlated to infliximab treatment on both univariate and multivariate analyses. An algorithm for the management of liver impairment occurring during anti-TNF treatment is also proposed and this highlights the need of a multidisciplinary approach and suggests liver biopsy as a key-point in the management decision in case of severe rise of transaminases. However, hepatic injury is generally self-limiting and drug withdrawal seems to be an exception

    Origin and Evolution of Saturn's Ring System

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    The origin and long-term evolution of Saturn's rings is still an unsolved problem in modern planetary science. In this chapter we review the current state of our knowledge on this long-standing question for the main rings (A, Cassini Division, B, C), the F Ring, and the diffuse rings (E and G). During the Voyager era, models of evolutionary processes affecting the rings on long time scales (erosion, viscous spreading, accretion, ballistic transport, etc.) had suggested that Saturn's rings are not older than 100 My. In addition, Saturn's large system of diffuse rings has been thought to be the result of material loss from one or more of Saturn's satellites. In the Cassini era, high spatial and spectral resolution data have allowed progress to be made on some of these questions. Discoveries such as the ''propellers'' in the A ring, the shape of ring-embedded moonlets, the clumps in the F Ring, and Enceladus' plume provide new constraints on evolutionary processes in Saturn's rings. At the same time, advances in numerical simulations over the last 20 years have opened the way to realistic models of the rings's fine scale structure, and progress in our understanding of the formation of the Solar System provides a better-defined historical context in which to understand ring formation. All these elements have important implications for the origin and long-term evolution of Saturn's rings. They strengthen the idea that Saturn's rings are very dynamical and rapidly evolving, while new arguments suggest that the rings could be older than previously believed, provided that they are regularly renewed. Key evolutionary processes, timescales and possible scenarios for the rings's origin are reviewed in the light of tComment: Chapter 17 of the book ''Saturn After Cassini-Huygens'' Saturn from Cassini-Huygens, Dougherty, M.K.; Esposito, L.W.; Krimigis, S.M. (Ed.) (2009) 537-57

    Search for lepton-flavor violation at HERA

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    A search for lepton-flavor-violating interactions epμXe p \to \mu X and epτXe p\to \tau X has been performed with the ZEUS detector using the entire HERA I data sample, corresponding to an integrated luminosity of 130 pb^{-1}. The data were taken at center-of-mass energies, s\sqrt{s}, of 300 and 318 GeV. No evidence of lepton-flavor violation was found, and constraints were derived on leptoquarks (LQs) that could mediate such interactions. For LQ masses below s\sqrt{s}, limits were set on λeq1βq\lambda_{eq_1} \sqrt{\beta_{\ell q}}, where λeq1\lambda_{eq_1} is the coupling of the LQ to an electron and a first-generation quark q1q_1, and βq\beta_{\ell q} is the branching ratio of the LQ to the final-state lepton \ell (μ\mu or τ\tau) and a quark qq. For LQ masses much larger than s\sqrt{s}, limits were set on the four-fermion interaction term λeqαλqβ/MLQ2\lambda_{e q_\alpha} \lambda_{\ell q_\beta} / M_{\mathrm{LQ}}^2 for LQs that couple to an electron and a quark qαq_\alpha and to a lepton \ell and a quark qβq_\beta, where α\alpha and β\beta are quark generation indices. Some of the limits are also applicable to lepton-flavor-violating processes mediated by squarks in RR-Parity-violating supersymmetric models. In some cases, especially when a higher-generation quark is involved and for the process epτXe p\to \tau X , the ZEUS limits are the most stringent to date.Comment: 37 pages, 10 figures, Accepted by EPJC. References and 1 figure (Fig. 6) adde
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