Accuracy of telephone triage for predicting adverse outcomes in suspected COVID-19 : an observational cohort study linking NHS 111 telephone triage, primary and secondary healthcare and mortality records.

Objectives Settings in identifying need for emergency care amongst those with suspected COVID-19 infection and identify factors which affect triage accuracy. Approach An observational cohort study of adults who contacted the NHS 111 telephone triage service provided by Yorkshire Ambulance Service between March and June 2020 with symptoms indicating possible COVID-19 infection. Patient-level data encompassing  triage call, primary care, hospital care and death registration records relating to 40,261 adults were linked. The accuracy of triage outcome (self-care/non-urgent assessment versus ambulance/urgent assessment) was assessed for death or organ support 30 days from first contact. Multivariable logistic regression was used to identify factors associated with risk of false negative or false positive triage. Results Callers had a 3% (1,200/40,261) risk of serious adverse outcomes. Telephone triage recommended self-care or non-urgent assessment for 60% (24,335/40,261), with a 1.3% (310/24,335) risk of adverse outcomes 30 days from first contact. Telephone triage had 74.2% sensitivity (95% CI: 71.6 to 76.6%) and 61.5% specificity (61% to 62%) for the primary outcome. Analysis suggested respiratory comorbidities may be over-appreciated and diabetes under-appreciated as predictors of deterioration. Repeat contact with triage service appears to be an important under-recognised predictor of deterioration. Conclusion Patients advised to self-care or receive non-urgent clinical assessment had a small but non-negligible risk of serious clinical deterioration. Repeat contact with telephone services needs recognition as an important predictor of subsequent adverse outcomes

Agricultural practices and plant economy of the West Bank / Palestine from the Bronze Age to the Ottoman period : carpological and ethno-archaeobotanical studies

L'étude des restes végétaux issus de sites archéologiques différents, tant sur le plan chronologique que géographique, localisés en Cisjordanie : Tell Jenin, Bustan Abdo, Sébastiyé, Khirbet BirZeit, Tell Kiela, Khirbet al-Mafjar « moulin » et Qasser Hisham, nous a permis de comprendre la relation entre les sociétés locales et la végétation environnante, mais également de mettre en évidence les principales cultures agricoles et leurs activités associées. En raison de certains obstacles, essentiellement techniques, rencontrés au cours de nos recherches archéologiques, et particulièrement pour localiser deséchantillons dans les contextes archéologiques, nous avons élaboré une méthode d’étude afin de préciser les résultats tirés de l'analyse de ces échantillons. La documentation et l’étude de certaines activités et procédés agricoles en Cisjordanie, tels que la production de frikeh (grain de blé laiteux non mûr, grillé au feu), la production badoudia (c'est une méthode d'extraction traditionnelle de l'huile d'olive). Et le four à pain traditionnel (Tabun), et aussi les connaissances tirées de l'histoire orale et d'entretiens effectués au sujet des anciennes méthodes agricoles, nous ont offert des indications essentielles et une base comparative solide afin de comprendre les méthodes agricoles et la transformation des aliments dans la région au cours des siècles. Cette thèse constitue la première étape de notre projet d'étude archéobotanique des sites palestiniens. La comparaison de nos résultats avec les travaux archéobotaniques effectués auparavant, mais aussi les méthodes de culture itinérante, les sélections de cultures et certaines méthodes de traitement des aliments sont une preuve de la continuité culturelle en Palestine. On a pu aussi mettre au jour des variations entraînées par les conditions climatiques, l'influence des sociétés limitrophes et les nouvelles cultures apparues ou importées dans la région. Ce travail se poursuivra afin d'étoffer notre corpus archéobotanique et d'approfondir nos connaissances quant aux relations entre l'homme et son milieu.By studying ancient plant remains, from many archaeological sites in the West Bank / Palestine, Tell Jenin in Jenin, Bustan Abdo, Samaria near Nablus, Khirbet BirZeit near BirZeit, Tell Kiela near Hebron, Khirbet al-Mafjar "water mill” and Qasser Hisham in Jericho, although these archaeological sites are differentiated by their contexts, their chronological sequences and their geographical location, we were provided a good idea of the relationship between the local society and its surrounding vegetation, in addition to the main agricultural crops and its associated activities. Due to some obstacles, mainly the technical once during the archaeological work, we found that after the analysis of these samples, we needed another type of study method to clarify the results of these samples. Documenting and studying some agricultural activities and process in the West Bank, such as frikeh (unripe, milky roasted wheat grain kernels) production, badoudia production (one of the primitive olive oil extraction methods in Palestine), and tabun oven, in addition to the oral history of the ancient agricultural methods, give a very good indication and a sort of analogy very important to understand the agricultural methods and food processing in the region during the time. This thesis is the first step of a future work in Archaeobotany in the Palestinian region ; meanwhile we compared our results in general with the ancient archaeobotanical work that had been done before. The agricultural methods, crops selections and some food processing methods are an evidence of the cultural continuity in Palestine, with some kind of interactions depending on the climatic conditions, effects of neighbor’s societies, and the new crops that appeared in or were imported to the region. For this reason, our work will continue after this thesis by documenting more and more traditional agricultural and food processing methods, in addition to the archaeobotanical remains analysis belonging to new archaeological sites projects ; as a trying to have more evidence that support our idea of agricultural method continuity during scale of time

Vi måste vara engagerade tillsammans : En kvalitativ studie om praktikgemenskaper inom bankväsendet

Bankerna i Sverige har en betydande funktion för svensk tillväxt och välfärd. Ettvälfungerande banksystem är en grundpelare för det samhälle vi känner till idag. Bankerförser oss med tjänster och produkter för att vi ska ha möjlighet att spara och låna. Kunskapoch kompetens blir färskvaror eftersom vi lever i ett samhälle i konstant förändring. Kravetpå kompetens ökar konstant, inte minst för privatrådgivare som har en viktig funktion förhela den svenska befolkningens privatekonomi.Mot denna bakgrund har vi lagt fokus på att skapa en förståelse för privatrådgivares villkorför lärande, i avsikt att få syn på hur de aktualiserar kunskap och kompetens för att kunnamöta både kunders och omvärldens krav. Studien behandlar privatrådgivares lärande påarbetsplatsen vid två av Sveriges största banker. Syftet med studien är att få kunskap om ochförståelse för hur praktikgemenskaper, med fokus på praktik och gemenskap, bidrar tilllärande för privatrådgivare. Vi har intresserat oss för frågor som berör privatrådgivareserfarenhetsutbyte på arbetsplatsen. Studien resultat visar att privatrådgivares praktiker avserexempelvis samspel mellan kollegor, gemensamma veckomöten och workshops. Rådgivarnasgemenskaper kännetecknas av ett ömsesidigt engagemang kring gemensamt uppsatta mål.Studiens resultat visar även att den praktikgemenskap som framträder av privatrådgivaresbeskrivningar kännetecknas av en gemensam förståelse kring arbetsrelaterade ändamål. Dettabidrar till ett systematiskt samspel mellan privatrådgivarna och deras kollegor och är såledesen ständigt pågående lärprocess där erfarenheter utbyts.Studien har en teoretisk utgångspunkt i Wengers (1998) teori om praktikgemenskaper. Vidgenomförandet användes kvalitativa semistrukturerade intervjuer av sex privatrådgivare somarbetar på två storbanker i Sverige

Supplementary Figure 4 from Immune Modulation of Innate and Adaptive Responses Restores Immune Surveillance and Establishes Antitumor Immunologic Memory

A. TKO mouse ovarian cancer cells were treated with increasing concentrations of CARG-2020 or VLV-GFP and effect on cell growth and cell death is quantified in real time using Cytation5/Biospa by measuring mCherry confluence and CelltoxTM fluorescence; B. Representative fluorescence images showing PBS Control and CARG-2020-treated cultures. red, mCherry; green, CelltoxTM; C. Human ovarian cancer cells, clone OCSC1-F2 and the hTERT-immortalized human endometrial stromal cells were treated with increasing concentrations of CARG-2020 for 72h and cell death was quantified using CelltoxTM fluorescence. Note that CARG-2020 induces cell death only in cancer cells and not in normal cells.</p

Supplementary Figure 2 from Immune Modulation of Innate and Adaptive Responses Restores Immune Surveillance and Establishes Antitumor Immunologic Memory

Diagram showing major immune phenotypes in each phase of ovarian tumor progression.</p

Supplementary Figure 1 from Immune Modulation of Innate and Adaptive Responses Restores Immune Surveillance and Establishes Antitumor Immunologic Memory

Flow cytometry gating strategy CD8 T cells, Macrophages and MDSC.</p

Supplementary Table S2 from Immune Modulation of Innate and Adaptive Responses Restores Immune Surveillance and Establishes Antitumor Immunologic Memory

Primers used for qPCR reactions</p

Supplementary Table S1 from Immune Modulation of Innate and Adaptive Responses Restores Immune Surveillance and Establishes Antitumor Immunologic Memory

Primers used to clone CARG-2020, VLV-12 and VLV-GFP</p

Supplementary Figure 5 from Immune Modulation of Innate and Adaptive Responses Restores Immune Surveillance and Establishes Antitumor Immunologic Memory

A. Cytolytic effect of VLV-GFP in cancer cells is mediated by the induction of pro-apoptotic genes. Treatment of cancer cells with VLV-GFP is associated with a significant increase on TRAIL and FAS mRNA expression. *=p>0.005; **= p>0.001 B. In vivo induction of pro-apoptotic genes. Mice bearing mCherry-TKO tumors were treated 2X with VLV-GFP. The expression of TRAIL and FAS was determined 24h after the last treatment. Note the significant increase on TRAIL and FAS mRNA expression following VLV-GFP treatment. ***= p>0.0001</p

Supplementary Figure 7 from Immune Modulation of Innate and Adaptive Responses Restores Immune Surveillance and Establishes Antitumor Immunologic Memory

A. Mean tumor burden over time of nude mice bearing OCSC1-F2 human ovarian tumors. mCherry fluorescent ROI was used to provide a measure of tumor burden. Data are presented as mean ± SEM. Treatments began on day 6 and continued through to day 12. B. Survival analysis using Kaplan-Meier.  </p