Convergence towards an asymptotic shape in first-passage percolation on cone-like subgraphs of the integer lattice

In first-passage percolation on the integer lattice, the Shape Theorem provides precise conditions for convergence of the set of sites reachable within a given time from the origin, once rescaled, to a compact and convex limiting shape. Here, we address convergence towards an asymptotic shape for cone-like subgraphs of the $\Z^d$ lattice, where $d\ge2$. In particular, we identify the asymptotic shapes associated to these graphs as restrictions of the asymptotic shape of the lattice. Apart from providing necessary and sufficient conditions for $L^p$- and almost sure convergence towards this shape, we investigate also stronger notions such as complete convergence and stability with respect to a dynamically evolving environment.Comment: 23 pages. Together with arXiv:1305.6260, this version replaces the old. The main results have been strengthened and an earlier error in the statement corrected. To appear in J. Theoret. Proba

End-user involvement in a systematic review of quantitative and qualitative research of non-pharmacological interventions for attention deficit hyperactivity disorder delivered in school settings: reflections on the impacts and challenges.

JOURNAL ARTICLEBACKGROUND: The benefits of end-user involvement in health-care research are widely recognized by research agencies. There are few published evaluations of end-user involvement in systematic reviews. OBJECTIVES: (i) Describe end-user involvement in a complex mixed-methods systematic review of ADHD in schools, (ii) reflect on the impact of end-user involvement, (iii) highlight challenges and benefits experienced and (iv) provide suggestions to inform future involvement. METHODS: End-users were involved in all stages of the project, both as authors and as members of an advisory group. In addition, several events were held with groups of relevant end-users during the project. RESULTS: End-user input (i) guided the direction of the research, (ii) contributed to a typology of interventions and outcomes, (iii) contributed to the direction of data analysis and (iv) contributed to the robustness of the syntheses by demonstrating the alignment of interim findings with lived experiences. Challenges included (i) managing expectations, (ii) managing the intensity of emotion, (iii) ensuring that involvement was fruitful for all not just the researcher, (iv) our capacity to communicate and manage the process and (v) engendering a sense of involvement amongst end-users. CONCLUSIONS: End-user involvement was an important aspect of this project. To minimize challenges in future projects, a recognition by the project management team and the funding provider that end-user involvement even in evidence synthesis projects is resource intensive is essential to allow appropriate allocation of time and resources for meaningful engagement.NIHR HTA programmeNIHRExeter NHS Foundation Trus

ParaMED Home: A protocol for a randomised controlled trial of paramedic assessment and referral to access medical care at home

<p>Abstract</p> <p>Background</p> <p>In Australia approximately 25% of Emergency Department (ED) attendances are via ambulance. ED overcrowding in Australia, as in many countries, is common. Measures to reduce overcrowding include the provision of enhanced timely primary care in the community for appropriate low risk injury and illness. Therefore paramedic assessment and referral to a community home hospital service, in preference to transfer to ED, may confer clinical and cost benefit.</p> <p>Methods/Design</p> <p>A randomised controlled trial. Consenting adult patients that call an ambulance and are assessed by paramedics as having an eligible low risk problem will be randomised to referral to ED via ambulance transfer or referral to a rapid response service that will assess and treat the patient in their own residence. The primary outcome measure is requirement for unplanned medical attention (in or out of hospital) in the first 48 hours. Secondary outcomes will include a number of other clinical endpoints. A cost effectiveness analysis will be conducted.</p> <p>Discussion</p> <p>If this trial demonstrates clinical non-inferiority and cost savings associated with the primary assessment service, it will provide one means to safely address ED overcrowding.</p> <p>Trial Registration</p> <p>Australian and New Zealand Clinical Trials Registry Number <a href="http://www.anzctr.org.au/trial_view.aspx?ID=335818">12610001064099</a></p

Methods for Analyzing the Role of DNA Methylation and Chromatin Structure in Regulating T Lymphocyte Gene Expression

Chromatin structure, determined in part by DNA methylation, is established during differentiation and prevents expression of genes unnecessary for the function of a given cell type. We reported that DNA methylation and chromatin structure contributes to lymphoid-specific ITGAL (CD11a) and PRF1 (perforin) expression. We used bisulfite sequencing to compare methylation patterns in the ITGAL promoter and 5' flanking region of T cells and fibroblasts, and in the PRF1 promoter and upstream enhancer of CD4+ and CD8+ T cells with fibroblasts. The effects of methylation on promoter function were tested using regional methylation of reporter constructs, and confirmed by DNA methyltransferase inhibition. The relationship between DNA methylation and chromatin structure was analyzed by DNaseI hypersensitivity. Herein we described the methods and results in greater detail

Democratic Teacher Education Practices

[Living reference work entry] This entry provides an insight into the turbulent and recently disappointing events in the history of Design and Technology (D&T) teacher education in England over the last 150 years. It is a complex journey that needs to include a review of the generic history of teacher education in England, the differing educational needs of children, the changing role of D&T as a school curriculum subject, the requirements for an appropriately trained workforce to meet the economic needs of the country, and how various government educational initiatives and interventions (Gillard 2018) have affected how teachers in general and D&T teachers in particular have been and still are trained today. All these factors are inseparably intertwined. Therefore, this entry discusses them all together in chronological date order

Multi-domain clinical natural language processing with MedCAT: The Medical Concept Annotation Toolkit

Electronic health records (EHR) contain large volumes of unstructured text, requiring the application of information extraction (IE) technologies to enable clinical analysis. We present the open source Medical Concept Annotation Toolkit (MedCAT) that provides: (a) a novel self-supervised machine learning algorithm for extracting concepts using any concept vocabulary including UMLS/SNOMED-CT; (b) a feature-rich annotation interface for customizing and training IE models; and (c) integrations to the broader CogStack ecosystem for vendor-agnostic health system deployment. We show improved performance in extracting UMLS concepts from open datasets (F1:0.448-0.738 vs 0.429-0.650). Further real-world validation demonstrates SNOMED-CT extraction at 3 large London hospitals with self-supervised training over ∼8.8B words from ∼17M clinical records and further fine-tuning with ∼6K clinician annotated examples. We show strong transferability (F1 > 0.94) between hospitals, datasets and concept types indicating cross-domain EHR-agnostic utility for accelerated clinical and research use cases

Spatial Ecology of Sub-Adult Green Turtles in Coastal Waters of the Turks and Caicos Islands: Implications for Conservation Management

This is the final version. Available on open access from frontiers Media via the DOI in this recordData Availability Statement: Raw data will not be made available due to the sensitivity of endangered species location information. Requests to access the datasets should be directed to the corresponding author. All other data used for analyses are presented in the manuscript. Requests to access the datasets should be directed to [email protected] turtles are of conservation concern throughout their range, with past population declines largely due to exploitation through both legal and illegal take, and incidental capture in fisheries. Whilst much research effort has been focused on nesting beaches and elaborating migratory corridors, these species spend the vast majority of their lifecycle in foraging grounds, which are, in some species, quite discrete. To understand and manage these populations, empirical data are needed on distribution, space-use, and habitats to best inform design of protective measures. Here we describe space-use, occupancy, and wide-ranging movements derived from conventional flipper tagging and satellite tracking of sub-adult green turtles (Chelonia mydas) within the coastal waters of the Turks and Caicos Islands (TCI; 2011–2017). 623 turtles were fitted with flipper tags, with 69 subsequently recaptured, five of which in international waters. Sixteen individual turtles of between 63 and 81 cm curved carapace length were satellite tracked for a mean 226 days (range: 38–496). Data revealed extended periods of occupancy in the shallow coastal waters within a RAMSAR protected area. Satellite tracking and flipper tagging showed wide-ranging movements, with flipper tag recaptures occurring in waters off Nicaragua (n = 4), and Venezuela (n = 1). Also, four of 16 satellite tracked turtles exhibiting directed movements away (displaced >450 km) from TCI waters traveling through nine geo-political zones within the Caribbean-Atlantic basin, as well as on the High Seas. One turtle traveled to the Central American coast before settling on inshore habitat in Colombia’s waters for 162 days before transmission ceased, indicating ontogenetic dispersal to a distant foraging habitat. These data highlight connectivity throughout the region, displaying key linkages between countries that have previously only been linked by genetic evidence. This study also provides evidence of the importance of the Turks and Caicos Islands marine protected area network and importance of effective management of the sea turtle fishery for regional green turtle populations.Anne and Simon NotleyBlavatnik FamilyWiese FamilyGerrity FamilyKeith AndersonKenneth De Regt and Alison OversethPatrick and Linda FlockhartStephen Meringoff and Kim CharltonBig Blue UnlimitedAmanyara ResortPeople’s Trust for Endangered SpeciesPrincess YachtsNational Marine Aquarium, Plymouth, UKNatural Environment Research Council (NERC

Four priority areas to advance invasion science in the face of rapid environmental change

Unprecedented rates of introduction and spread of non-native species pose burgeoning challenges to biodiversity, natural resource management, regional economies, and human health. Current biosecurity efforts are failing to keep pace with globalization, revealing critical gaps in our understanding and response to invasions. Here, we identify four priority areas to advance invasion science in the face of rapid global environmental change. First, invasion science should strive to develop a more comprehensive framework for predicting how the behavior, abundance, and interspecific interactions of non-native species vary in relation to conditions in receiving environments and how these factors govern the ecological impacts of invasion. A second priority is to understand the potential synergistic effects of multiple co-occurring stressors— particularly involving climate change—on the establishment and impact of non-native species. Climate adaptation and mitigation strategies will need to consider the possible consequences of promoting non-native species, and appropriate management responses to non-native species will need to be developed. The third priority is to address the taxonomic impediment. The ability to detect and evaluate invasion risks is compromised by a growing deficit in taxonomic expertise, which cannot be adequately compensated by new molecular technologies alone. Management of biosecurity risks will become increasingly challenging unless academia, industry, and governments train and employ new personnel in taxonomy and systematics. Fourth, we recommend that internationally cooperative biosecurity strategies consider the bridgehead effects of global dispersal networks, in which organisms tend to invade new regions from locations where they have already established. Cooperation among countries to eradicate or control species established in bridgehead regions should yield greater benefit than independent attempts by individual countries to exclude these species from arriving and establishing