Health impact modelling of active travel visions for England and Wales using an Integrated Transport and Health Impact Modelling Tool (ITHIM).

BACKGROUND: Achieving health benefits while reducing greenhouse gas emissions from transport offers a potential policy win-win; the magnitude of potential benefits, however, is likely to vary. This study uses an Integrated Transport and Health Impact Modelling tool (ITHIM) to evaluate the health and environmental impacts of high walking and cycling transport scenarios for English and Welsh urban areas outside London. METHODS: Three scenarios with increased walking and cycling and lower car use were generated based upon the Visions 2030 Walking and Cycling project. Changes to carbon dioxide emissions were estimated by environmental modelling. Health impact assessment modelling was used to estimate changes in Disability Adjusted Life Years (DALYs) resulting from changes in exposure to air pollution, road traffic injury risk, and physical activity. We compare the findings of the model with results generated using the World Health Organization's Health Economic Assessment of Transport (HEAT) tools. RESULTS: This study found considerable reductions in disease burden under all three scenarios, with the largest health benefits attributed to reductions in ischemic heart disease. The pathways that produced the largest benefits were, in order, physical activity, road traffic injuries, and air pollution. The choice of dose response relationship for physical activity had a large impact on the size of the benefits. Modelling the impact on all-cause mortality rather than through individual diseases suggested larger benefits. Using the best available evidence we found fewer road traffic injuries for all scenarios compared with baseline but alternative assumptions suggested potential increases. CONCLUSIONS: Methods to estimate the health impacts from transport related physical activity and injury risk are in their infancy; this study has demonstrated an integration of transport and health impact modelling approaches. The findings add to the case for a move from car transport to walking and cycling, and have implications for empirical and modelling research

Management and outcomes of extreme preterm birth

Extreme preterm birth, defined as birth before 28 weeks’ gestational age (box 1),1 affects about two to five in every 1000 pregnancies, and varies slightly by country and by definitions used. Severe maternal morbidity, including sepsis and peripartum haemorrhage, affects around a quarter of mothers delivering at these gestations.2 For the babies, survival and morbidity rates vary, particularly by gestational age at delivery but also according to other risk factors (birth weight and sex, for example) and by country.34 In this update, we focus on high income countries and provide a broad overview of extreme preterm birth epidemiology, recent changes, and best practices in obstetric and neonatal management, including new treatments such as antenatal magnesium sulphate or changes in delivery management such as delayed cord clamping and placental transfusion. We cover short and long term medical, psychological, and experiential consequences for individuals born extremely preterm, their mothers and families, as well as preventive measures that may reduce the incidence of extreme preterm birth

Femtosecond x-ray diffraction from an aerosolized beam of protein nanocrystals

We demonstrate near-atomic-resolution Bragg diffraction from aerosolized single granulovirus crystals using an x-ray free-electron laser. The form of the aerosol injector is nearly identical to conventional liquid-microjet nozzles, but the x-ray-scattering background is reduced by several orders of magnitude by the use of helium carrier gas rather than liquid. This approach provides a route to study the weak diffuse or lattice-transform signal arising from small crystals. The high speed of the particles is particularly well suited to upcoming MHz-repetition-rate x-ray free-electron lasers

Nonlinear Schr\"odinger equations from prequantum classical statistical field theory

We derive some important features of the standard quantum mechanics from a certain classical-like model -- prequantum classical statistical field theory, PCSFT. In this approach correspondence between classical and quantum quantities is established through asymptotic expansions. PCSFT induces not only linear Schr\"odinger's equation, but also its {\it nonlinear generalizations.} This coupling with ``nonlinear wave mechanics'' is used to evaluate the small parameter of PCSFT.Comment: Links to theory of nonlinear Schrodinger equation; new model of physical space: Infinite-Dimensional Physical Spac

Maternity service reconfigurations for intrapartum and postnatal midwifery staffing shortages: modelling of low-risk births in England

Introduction: Choice of birth setting is important and it is valuable to know how reconfiguring available settings may affect midwifery staffing needs. COVID-19-related health system pressures have meant restriction of community births. We aimed to model the potential of service reconfigurations to offset midwifery staffing shortages. Methods: We adapted the Birthrate Plus method to develop a tool that models the effects on intrapartum and postnatal midwifery staffing requirements of changing service configurations for low-risk births. We tested our tool on two hypothetical model trusts with different baseline configurations of hospital and community low-risk birth services, representing those most common in England, and applied it to scenarios with midwifery staffing shortages of 15%, 25% and 35%. In scenarios with midwifery staffing shortages above 15%, we modelled restricting community births in line with professional guidance on COVID-19 service reconfiguration. For shortages of 15%, we modelled expanding community births per the target of the Maternity Transformation programme. Results: Expanding community births with 15% shortages required 0.0 and 0.1 whole-time equivalent more midwives in our respective trusts compared with baseline, representing 0% and 0.1% of overall staffing requirements net of shortages. Restricting home births with 25% shortages reduced midwifery staffing need by 0.1 midwives (–0.1% of staffing) and 0.3 midwives (–0.3%). Suspending community births with 35% shortages meant changes of –0.3 midwives (–0.3%) and –0.5 midwives (–0.5%) in the two trusts. Sensitivity analysis showed that our results were robust even under extreme assumptions. Conclusion: Our model found that reconfiguring maternity services in response to shortages has a negligible effect on intrapartum and postnatal midwifery staffing needs. Given this, with lower degrees of shortage, managers can consider increasing community birth options where there is demand. In situations of severe shortage, reconfiguration cannot recoup the shortage and managers must decide how to modify service arrangements

Detector Simulation Challenges for Future Accelerator Experiments

Detector simulation is a key component for studies on prospective future high-energy colliders, the design, optimization, testing and operation of particle physics experiments, and the analysis of the data collected to perform physics measurements. This review starts from the current state of the art technology applied to detector simulation in high-energy physics and elaborates on the evolution of software tools developed to address the challenges posed by future accelerator programs beyond the HL-LHC era, into the 2030–2050 period. New accelerator, detector, and computing technologies set the stage for an exercise in how detector simulation will serve the needs of the high-energy physics programs of the mid 21st century, and its potential impact on other research domains

Cidofovir for the Treatment of Recurrent Respiratory Papillomatosis: A Review of the Literature

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/90089/1/phco.2005.25.7.977.pd

Som-Based Class Discovery Exploring the ICA-Reduced Features of Microarray Expression Profiles

Gene expression datasets are large and complex, having many variables and unknown internal structure. We apply independent component analysis (ICA) to derive a less redundant representation of the expression data. The decomposition produces components with minimal statistical dependence and reveals biologically relevant information. Consequently, to the transformed data, we apply cluster analysis (an important and popular analysis tool for obtaining an initial understanding of the data, usually employed for class discovery). The proposed self-organizing map (SOM)-based clustering algorithm automatically determines the number of ‘natural’ subgroups of the data, being aided at this task by the available prior knowledge of the functional categories of genes. An entropy criterion allows each gene to be assigned to multiple classes, which is closer to the biological representation. These features, however, are not achieved at the cost of the simplicity of the algorithm, since the map grows on a simple grid structure and the learning algorithm remains equal to Kohonen’s one

Institutional adjustment and change at the firm level: A varieties of capitalism perspective

This paper contributes to a better understanding of global corporate and industrial change at the firm level. Our focus is on convergence vs. divergence of national institutional systems. Data are drawn from a survey of German and UK firms. Our results for adaptation behavior of British subsidiaries in Germany suggest that at the firm level the primacy of national institutions and institutional complementarity as determinants of the organizational behavior of MNEs may be overstated. Nonetheless, evidence that German MNEs in Britain seek to choose strategic choices for which there is institutional support in the host country suggests that complementarity is functional enough to incite adjustment even in the absence of strong formal pressure. The evidence that both German and British firms seem to prefer practices characteristic of liberal market economies may pose a problem for institutional stability in Germany and generates implications for the likely pathways of institutional change