The Influence of Michal Kalecki on Joan Robinson’s Approach to Economics

Joan Robinson and Michal Kalecki were two of the intellectual giants of twentieth century economics, whose contributions over a significant range of issues have had major impacts on economics. This paper examines the significant communications between them, concentrating on the major cross influences which were apparent from the first time that they met. It focuses on Kalecki’s influence on Joan Robinson in a number of areas. In particular, there was much communication between them about developments in Keynesian theory, where Joan Robinson was influenced by Kalecki’s Marxian approach. Further areas of influence included the role and determination of investment and innovation, the nature of price setting in capitalist economies, and methodological issues associated with the nature of economic theory, particularly with respect to economic cycles and trends.History of Economic Thought since 1925; Current Heterodox Approaches; Economic Methodology

Predicting Clinical Deteriorations using Wearable Sensors

Introduction Acutely-ill hospitalised patients are at risk of clinical deteriorations such as cardiac arrest, admission to intensive care, or unexpected death. Currently, patients are manually assessed every 4-6 hours to determine the likelihood of subsequent deterioration. However, this is limited to intermittent assessments, delaying time-sensitive interventions. Wearable sensors, combined with an alerting system, could provide continuous automated assessments of the likelihood of deteriorations. To be suitable for hospital use, wearable sensors must be unobtrusive and provide reliable measurements of key vital signs including breathing rate (BR), a key predictor of deteriorations. The aims of this work were: (i) to develop a technique for monitoring BR unobtrusively using wearable sensors, and (ii) to assess whether wearable sensors provide reliable predictions of deteriorations when using this technique. Monitoring breathing rate (BR) unobtrusively Current methods for monitoring BR using wearable sensors are obtrusive. An alternative approach is to estimate BR from electrocardiogram or pulse oximeter signals, which are already acquired by wearable sensors to monitor heart rate and blood oxygen levels. Both signals are subtly modulated by breathing, providing opportunity to use them to monitor BR. I assessed the performance of previously proposed signal processing techniques for estimating BR from these signals in both healthy and hospitalised subjects. Although some techniques were precise enough for use with healthy subjects in the laboratory, they were imprecise when used with hospital patients. Therefore, I developed a novel technique, combining the strengths of time- and frequency-domain techniques. Its performance was assessed on data from 264 subjects. In hospital patients, the technique provided highly precise BRs 86% of the time, which exceeds the performance of manual observation, the current clinical standard. Assessing the reliability of wearable sensors for predicting deteriorations I implemented methods for rejecting unreliable sensor data, and for fusing continuous multiparametric data, to predict deteriorations. These were used alongside the novel technique for monitoring BR to predict deteriorations using wearable sensors. The system was assessed in a clinical trial of 184 hospital patients, conducted in collaboration with clinicians. The reliability of the system was assessed by comparing its predictions against documented deteriorations. Its predictive value was similar to that of the routine manual assessments (AUROCs of 0.78 vs 0.79). Crucially it provided continuous assessment, potentially providing predictions of deteriorations hours earlier than routine practice. Conclusion This work has demonstrated the potential for wearable sensors to reliably and unobtrusively predict deteriorations, when coupled with a novel technique for monitoring BR. This could improve patient outcomes, and reduce costs. Further work should investigate which patients would benefit most from this technology, and whether it could reduce clinical workload. In the future the technology could potentially be used with consumer wearables to improve patient safety in the community, where clinical expertise is less readily available.This poster was displayed at the STEM for Britain event, held in the Houses of Parliament (London, UK) on 12th March 2018

Respiratory rate monitoring to detect deteriorations using wearable sensors

This poster provides an overview of the work described in: P. H. Charlton, "Continuous respiratory rate monitoring to detect clinical deteriorations using wearable sensors," Ph.D. Thesis, King’s College London, 2017.This poster was first presented at the Bioengenuity Keynotes Conference, held on Monday 6th March at the University of Oxford

Clinical Applications of Attractor Reconstruction Analysis

This poster was presented at the Science and Engineering Impact Showcase, King's College London, 4th April 2017

Langmuir Turbulence under Hurricane Gustav (2008)

Extreme winds and complex wave fields drive upper-ocean turbulence in tropical cyclone conditions. Motivated by Lagrangian float observations of bulk vertical velocity variance (VVV) under Hurricane Gustav (2008), upper-ocean turbulence is investigated based on large-eddy simulation (LES) of the wave-averaged Navier–Stokes equations. To realistically capture wind- and wave-driven Langmuir turbulence (LT), the LES model imposes the Stokes drift vector from spectral wave simulations; both the LES and wave model are forced by the NOAA Hurricane Research Division (HRD) surface wind analysis product. Results strongly suggest that without LT effects simulated VVV underestimates the observed VVV. LT increases the VVV, indicating that it plays a significant role in upper-ocean turbulence dynamics. Consistent with observations, the LES predicts a suppression of VVV near the hurricane eye due to wind-wave misalignment. However, this decrease is weaker and of shorter duration than that observed, potentially due to large-scale horizontal advection not present in the LES. Both observations and simulations are consistent with a highly variable upper ocean turbulence field beneath tropical cyclone cores. Bulk VVV, a TKE budget analysis, and anisotropy coefficient (ratio of horizontal to vertical velocity variances) profiles all indicate that LT is suppressed to levels closer to that of shear turbulence (ST) due to misaligned wind and wave fields. VVV approximately scales with the directional surface layer Langmuir number. Such a scaling provides guidance for the development of an upper-ocean boundary layer parameterization that explicitly depends on sea state

A Novel Paramyxovirus?

In public databases, we identified sequences reported as human genes expressed in kidney mesangial cells. The similarity of these genes to paramyxovirus matrix, fusion, and phosphoprotein genes suggests that they are derived from a novel paramyxovirus. These genes are sufficiently unique to suggest the existence of a novel paramyxovirus genus

Glucocorticoids in elite sport: current status, controversies and innovative management strategies-a narrative review

The use of systemic glucocorticoids (GCs), as well as local injections, continues to be a controversial issue in the sport/anti-doping community. There is widespread and legitimate use of GCs for numerous health conditions, yet there are concerns about side effects and the possibility of enhanced athletic performance in limited settings. This is compounded by the uncertainty regarding the prevalence of GC use, mechanisms underlying physiological effects and complex pharmacokinetics of different formulations. While WADA continues to promote research in this complex area, some international sporting federations, major event organisers and professional sports leagues have introduced innovative rules such as needle policies, mandatory rest periods and precompetition guidelines to promote judicious use of GCs, focusing on athlete health and supervision of medical personnel. These complementary sport-specific rules are helping to ensure the appropriate use of GCs in athletes where overuse is a particular concern. Where systemic GCs are medically necessary, Therapeutic Use Exemptions (TUEs) may be granted after careful evaluation by TUE Committees based on specific and strict criteria. Continued vigilance and cooperation between physicians, scientists and anti-doping organisations is essential to ensure that GC use in sport respects not only principles of fairness and adherence to the rules but also promotes athlete health and well-being. The purpose of this narrative review is to summarise the use and management of GCs in sport illustrating several innovative programmes by sport leagues and federations

Insight into the relationship between the cell culture model, cell trafficking and siRNA silencing efficiency

Despite research efforts, cell uptake processes determining siRNA silencing efficiency remain unclear. Here, we examine the relationship between in vitro cell culture models, cellular trafficking and siRNA silencing efficiency to provide a mechanistic insight on siRNA delivery system design. Model siRNA-polyplexes, based on chitosan as a ‘classical’ condensing agent, were applied to a panel of lung epithelial cell lines, H1299, A549 and Calu-3 and cell internalization levels, trafficking pathways and gene silencing assessed on exposure to pharmacological inhibitors. The data reveal striking differences in the internalization behaviour and gene silencing efficiency in the tested cell lines, despite their common lung epithelial origins. The model system’s silencing was lower where clathrin internalization pathway predominated in Calu-3, relative to silencing in H1299 cells where a non-clathrin internalization appears dominant. Increased silencing on endosomal disruption was apparent in Calu-3 cells, but absent when cellular internalization was not predominantly clathrin-mediated in A549 cells. This highlights that identifying cell trafficking pathways before incorporation of functional components to siRNA delivery systems (e.g. endosomolytic compounds) is crucial. The study hence stresses the importance of selection of appropriate cell culture model, relevant to in vivo target, to assess the gene silencing efficiency and decide which functionalities the ‘stratified siRNA silencing vector’ requires