Impact of the Covid-19 Pandemic on ALS Care in the UK

The Covid-19 pandemic has impacted healthcare. Our aim was to identify how amyotrophic lateral sclerosis (ALS) care in the UK has been affected by the pandemic by exploring the experiences of people living with ALS (plwALS), healthcare professionals (HCPs) working with plwALS, and ALS care centers. Three surveys were carried out to explore the experiences of plwALS, HCPs and ALS care centers during the pandemic. Quantitative data were analyzed using descriptive and inferential statistics and triangulated with the qualitative data which were analyzed thematically. Responses from 53 plwALS, 73 HCPs and 23 ALS care centers were analyzed. Five main themes were identified: keeping safe, losses, negative emotions, delivering care and alternative care delivery in a pandemic. PlwALS and HCPs felt that care was sub-optimal as a result of the pandemic. Changes to care included longer waiting times and face-to-face appointments being canceled or replaced by virtual consultations. While benefits of virtual consultations were reported, concerns were raised about incomplete clinical assessments and the disruption of provision of testing and interventions. ALS care has changed as a result of the pandemic. Patients have had a lack of face-to-face contact with HCPs and have experienced delays to investigations and treatments. PlwALS and HCPs were concerned about the impact of this change, but the long-term implications remain unclear. We propose recommendations for HCPs caring for plwALS, that will promote continuity of evidenced based care in the context of a pandemic

Automatic quantification of lymphocyte vacuolization in peripheral blood smears of patients with Batten's disease (CLN3 disease)

Quantifying lymphocyte vacuolization in peripheral blood smears (PBSs) serves as a measure for disease severity in CLN3 disease—a lysosomal storage disorder of childhood-onset. However, thus far quantification methods are based on labor-intensive manual assessment of PBSs. As machine learning techniques like convolutional neural networks (CNNs) have been deployed quite successfully in detecting pathological features in PBSs, we explored whether these techniques could be utilized to automate quantification of lymphocyte vacuolization. Here, we present and validate a deep learning pipeline that automates quantification of lymphocyte vacuolization. By using two CNNs in succession, trained for cytoplasm-segmentation and vacuolization-detection, respectively, we obtained an excellent correlation with manual quantification of lymphocyte vacuolization (r = 0.98, n = 40). These results show that CNNs can be utilized to automate the otherwise cumbersome task of manually quantifying lymphocyte vacuolization, thereby aiding prompt clinical decisions in relation to CLN3 disease, and potentially beyond

The G0 Experiment: Apparatus for Parity-Violating Electron Scattering Measurements at Forward and Backward Angles

In the G0 experiment, performed at Jefferson Lab, the parity-violating elastic scattering of electrons from protons and quasi-elastic scattering from deuterons is measured in order to determine the neutral weak currents of the nucleon. Asymmetries as small as 1 part per million in the scattering of a polarized electron beam are determined using a dedicated apparatus. It consists of specialized beam-monitoring and control systems, a cryogenic hydrogen (or deuterium) target, and a superconducting, toroidal magnetic spectrometer equipped with plastic scintillation and aerogel Cerenkov detectors, as well as fast readout electronics for the measurement of individual events. The overall design and performance of this experimental system is discussed.Comment: Submitted to Nuclear Instruments and Method

Measuring Servitization Progress and Outcome:The Case of ‘Advanced Services’

The purpose of this paper is to establish a framework for assessing the progress and outcome of a manufacturer’s transformation towards becoming a provider of ‘advanced services’ – a complex bundling of products and services, whereby manufacturers offer capabilities and outcomes instead of products alone. ‘Advanced services’ represent the most complex offering in the current servitization trend among manufacturers. However, current performance measures lack the breadth and focus to assess progress or outcomes, and so support research and practice of organisational transformation efforts required. To address this gap the paper investigates how a manufacturer’s efforts to become an ‘advanced services’ provider can be comprehensively measured, and develops a framework for assessing the transformation journey towards becoming an ‘advanced services’ provider. The research method is based on (1) a systematic literature review process to create a comprehensive set of service-related performance measures that are available to assess a manufacturer’s servitization efforts, followed by (2) an engagement with an expert panel to synthesise the identified measures and create a set of ‘advanced services’ performance measures. The proposed framework is presented as a scorecard that can be used in practice to assess the progress and outcome of a manufacturer’s transformation towards becoming a provider of ‘advanced services’

Seismic risk assessment for developing countries : Pakistan as a case study

Modern Earthquake Risk Assessment (ERA) methods usually require seismo-tectonic information for Probabilistic Seismic Hazard Assessment (PSHA) that may not be readily available in developing countries. To bypass this drawback, this paper presents a practical event-based PSHA method that uses instrumental seismicity, available historical seismicity, as well as limited information on geology and tectonic setting. Historical seismicity is integrated with instrumental seismicity to determine the long-term hazard. The tectonic setting is included by assigning seismic source zones associated with known major faults. Monte Carlo simulations are used to generate earthquake catalogues with randomized key hazard parameters. A case study region in Pakistan is selected to demonstrate the effectiveness of the method. The results indicate that the proposed method produces seismic hazard maps consistent with previous studies, thus being suitable for generating such maps in regions where limited data are available. The PSHA procedure is developed as an integral part of an ERA framework named EQRAM. The framework is also used to determine seismic risk in terms of annual losses for the study region

A Bronze Age Round Barrow Cemetery, Pit Alignments, Iron Age Burials, Iron Age Copper Working, and Later Activity at Four Crosses, Llandysilio, Powys.

Excavation undertaken at the Upper Severn valley round barrow cemetery at Four Crosses, Llandysilio between 2004 and 2006 has increased the known barrows and ring-ditches to some 26 monuments, and revealed additional burials. Based on limited dating evidence, and the data from earlier excavations, the majority of the barrows are thought to be constructed in the Bronze Age. The barrows are part of a larger linear cemetery and the landscape setting and wider significance of this linear barrow cemetery are explored within this report. Dating suggests two barrows were later, Iron Age additions. The excavation also investigated Iron Age and undated pit alignments, Middle Iron Age copper working and a small Romano-British inhumation cemetery and field systems. Much of this evidence reflects the continuing importance of the site for ritual and funerary activity