The Impact of Local Demographics on Retail Centre Health in England and Wales

Spatial Interaction Models are a widely accepted means of linking retail centres to their local customer catchments. However, without real consumer data to validate the findings, such models remain as mere estimations based on geographic population and store data. Using a spatial interaction model which accounts for both the residential and local workplace populations, the following study seeks to evaluate the extent of which demographic characteristics of estimated retail catchments are an effective predictor of retail health for retail centres in England and Wales. Overall, this case study explores the value of demographics from estimated centre catchments to retail planners

Subarachnoid haemorrhage guidelines and clinical practice: a cross-sectional study of emergency department consultants' and neurospecialists' views and risk tolerances

OBJECTIVES: To establish if emergency medicine and neuroscience specialist consultants have different risk tolerances for investigation of suspected spontaneous subarachnoid haemorrhage (SAH), and to establish if their risk-benefit appraisals concur with current guidelines. SETTING: 4 major neuroscience centres in London. PARTICIPANTS: 58 consultants in emergency medicine and neuroscience specialities (neurology, neurosurgery and neuroradiology) participated in an anonymous survey. PRIMARY AND SECONDARY OUTCOME MEASURES: The primary outcome measure was the highest stated acceptable risk of missing SAH in the neurologically intact patient presenting with sudden onset headache. Secondary outcome measures included agreement with guideline recommendations, risk/benefit appraisal and required performance of diagnostic tests, including lumbar puncture. RESULTS: Emergency department clinicians accepted almost 3 times the risk of a missed SAH diagnosis compared with the neuroscience specialists (2.8% vs 1.1%; p=0.02), were more likely to accept a higher risk of missed diagnosis for the benefit of a non-invasive test (p=0.04) and were more likely to disagree with current published guidelines stipulating the need for LP in all CT-negative cases (p=0.001). CONCLUSIONS: Divergence from recognised procedures for SAH investigation is often criticised and attributed to a lack of knowledge of guidelines. This study indicates that divergence from guidelines may be explained by alternative risk-benefit appraisals made by doctors with their patients. Guideline recommendations may gain wider acceptance if they accommodate the requirements of the doctors and patients using them. Further study of clinical risk tolerance may help explain patterns of diagnostic test use and other variations in healthcare delivery

Mesothelial cells in tissue repair and fibrosis

Mesothelial cells are fundamental to the maintenance of serosal integrity and homeostasis and play a critical role in normal serosal repair following injury. However, when normal repair mechanisms breakdown, mesothelial cells take on a profibrotic role, secreting inflammatory, and profibrotic mediators, differentiating and migrating into the injured tissues where they contribute to fibrogenesis. The development of new molecular and cell tracking techniques has made it possible to examine the origin of fibrotic cells within damaged tissues and to elucidate the roles they play in inflammation and fibrosis. In addition to secreting proinflammatory mediators and contributing to both coagulation and fibrinolysis, mesothelial cells undergo mesothelial-to-mesenchymal transition, a process analogous to epithelial-to-mesenchymal transition, and become fibrogenic cells. Fibrogenic mesothelial cells have now been identified in tissues where they have not previously been thought to occur, such as within the parenchyma of the fibrotic lung. These findings show a direct role for mesothelial cells in fibrogenesis and open therapeutic strategies to prevent or reverse the fibrotic process

SAMM: A Spontaneous Micro-Facial Movement Dataset

Micro-facial expressions are spontaneous, involuntary movements of the face when a person experiences an emotion but attempts to hide their facial expression, most likely in a high-stakes environment. Recently, research in this field has grown in popularity, however publicly available datasets of micro-expressions have limitations due to the difficulty of naturally inducing spontaneous micro-expressions. Other issues include lighting, low resolution and low participant diversity. We present a newly developed spontaneous micro-facial movement dataset with diverse participants and coded using the Facial Action Coding System. The experimental protocol addresses the limitations of previous datasets, including eliciting emotional responses from stimuli tailored to each participant. Dataset evaluation was completed by running preliminary experiments to classify micro-movements from non-movements. Results were obtained using a selection of spatio-temporal descriptors and machine learning. We further evaluate the dataset on emerging methods of feature difference analysis and propose an Adaptive Baseline Threshold that uses individualised neutral expression to improve the performance of micro-movement detection. In contrast to machine learning approaches, we outperform the state of the art with a recall of 0.91. The outcomes show the dataset can become a new standard for micro-movement data, with future work expanding on data representation and analysis

Micro-Facial Movements: An Investigation on Spatio-Temporal Descriptors

This paper aims to investigate whether micro-facial movement sequences can be distinguished from neutral face sequences. As a micro-facial movement tends to be very quick and subtle, classifying when a movement occurs compared to the face without movement can be a challenging computer vision problem. Using local binary patterns on three orthogonal planes and Gaussian derivatives, local features, when interpreted by machine learning algorithms, can accurately describe when a movement and non-movement occurs. This method can then be applied to help aid humans in detecting when the small movements occur. This also differs from current literature as most only concentrate in emotional expression recognition. Using the CASME II dataset, the results from the investigation of different descriptors have shown a higher accuracy compared to state-of-the-art methods

Sprinting with an amputation: Some race-based lower-limb step observations.

BACKGROUND: T44 sprinting with an amputation is still in a state of relative infancy. Future scope for athletic training and prosthetic limb development may be assisted with a better understanding of information derived from T44 athletes when under race-based conditions. OBJECTIVES: To investigate the behaviour of step count and step frequency when under competitive conditions. STUDY DESIGN: The study comprises two elements: (1) a video-based analysis of race-based limb-to-limb symmetry and (2) a video-based analysis of race-based step count. METHODS: Video analysis of several major events from 1996-2012 are assessed for step count and step limb-to-limb symmetry characteristics. RESULTS: The video analysis highlights limb-to-limb imbalances greater than those indicated in the previous literature. A low step count is determined to be desirable for success in the 100-m event. CONCLUSION: Future analysis of athletes with a lower-limb amputation would be worthwhile when placed under race-based conditions as the limb-to-limb behaviour is more exaggerated than those seen in typical studies held within a laboratory setting. The within-event behaviour of step counts requires further investigation to establish where these take place or whether it is a cumulative step length issue. CLINICAL RELEVANCE: This article increases the understanding of the race-based behaviour of amputee athletes and provides more information to contribute to any discussions on the performance of lower-limb prostheses

How can we optimise inhaled beta2 agonist dose as ‘reliever’ medicine for wheezy pre-school children? Study protocol for a randomised controlled trial

Background: Asthma is a common problem in children and, if inadequately controlled, may seriously diminish their quality of life. Inhaled short-acting beta2 agonists such as salbutamol are usually prescribed as ‘reliever’ medication to help control day-to-day symptoms such as wheeze. As with many medications currently prescribed for younger children (defined as those aged 2 years 6 months to 6 years 11 months), there has been no pre-licensing age-specific pharmacological testing; consequently, the doses currently prescribed (200–1000 μg) may be ineffective or likely to induce unnecessary side effects. We plan to use the interrupter technique to measure airway resistance in this age group, allowing us for the first time to correlate inhaled salbutamol dose with changes in clinical response. We will measure urinary salbutamol levels 30 min after dosing as an estimate of salbutamol doses in the lungs, and also look for genetic polymorphisms linked to poor responses to inhaled salbutamol. Methods: This is a phase IV, randomised, controlled, observer-blinded, single-centre trial with four parallel groups (based on a sparse sampling approach) and a primary endpoint of the immediate bronchodilator response to salbutamol so that we can determine the most appropriate dose for an individual younger child. Simple randomisation will be used with a 1:1:1:1 allocation. Discussion: The proposed research will exploit simple, non-invasive and inexpensive tests that can mostly be performed in an outpatient setting in order to help develop the evidence for the correct dose of salbutamol in younger children with recurrent wheeze who have been prescribed salbutamol by their doctor. Trial registration: EudraCT2014-001978-33, ISRCTN15513131. Registered on 8 April 2015

Ten commandments for the future of ageing research in the UK: a vision for action

Increases in longevity resulting from improvements in health care and living conditions together with a decrease in fertility rates have contributed to a shift towards an aged population profile. For the first time the UK has more people over age 60 than below 16 years of age. The increase in longevity has not been accompanied by an increase in disease-free life expectancy and research into ageing is required to improve the health and quality of life of older people. However, as the House of Lords reported, ageing research in the UK is not adequately structured and a clear vision and plan are urgently required. Hence, with the aim of setting a common vision for action in ageing research in the UK, a 'Spark Workshop' was organised. International experts from different disciplines related to ageing research gathered to share their perspectives and to evaluate the present status of ageing research in the UK. A detailed assessment of potential improvements was conducted and the prospective secondary gains were considered, which were subsequently distilled into a list of 'ten commandments'. We believe that these commandments, if followed, will help to bring about the necessary implementation of an action plan for ageing research in the UK, commensurate with the scale of the challenge, which is to transform the manifold opportunities of increased longevity into actual delivery of a society living not only for longer, but also healthier, wealthier and happier

Football and Health: Getting Strategic

Community foundations and charities operating within professional football clubs are being championed as a vehicle to deliver on the Public Health agenda. This personal commentary from the authors offers insight into the context of football for health drawing on the relevant research literature and their experiences working within the football industry in England. The football and health examples highlight under-resourced and under-evaluated interventions, whilst highlighting the importance of partnership working. The authors hope to support those in football and health in getting strategic through their interventions, evaluations and partnerships, in order to capitalize the potential of football in supporting the objectives of Public Health England

PPARα and PPARγ activation is associated with pleural mesothelioma invasion but therapeutic inhibition is ineffective

Mesothelioma is a cancer that typically originates in the pleura of the lungs. It rapidly invades the surrounding tissues, causing pain and shortness of breath. We compared cell lines injected either subcutaneously or intrapleurally and found that only the latter resulted in invasive and rapid growth. Pleural tumors displayed a transcriptional signature consistent with increased activity of nuclear receptors PPARα and PPARγ and with an increased abundance of endogenous PPAR-activating ligands. We found that chemical probe GW6471 is a potent, dual PPARα/γ antagonist with anti-invasive and anti-proliferative activity in vitro. However, administration of GW6471 at doses that provided sustained plasma exposure levels sufficient for inhibition of PPARα/γ transcriptional activity did not result in significant anti-mesothelioma activity in mice. Lastly, we demonstrate that the in vitro anti-tumor effect of GW6471 is off-target. We conclude that dual PPARα/γ antagonism alone is not a viable treatment modality for mesothelioma