How pharmaceutical and diagnostic stakeholders construct policy solutions to a public health ‘crisis’: an analysis of submissions to a United Kingdom House of Commons inquiry into antimicrobial resistance

© 2022 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. This is an Open Access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License (http:// creativecommons.org/licenses/by-nc-nd/4.0/).Antimicrobial resistance (AMR) is often characterised as a ‘crisis’, requiring action by public, private, and third-sector stakeholders to achieve strategic change. Crisis narratives are powerful and may be co-opted to privilege solutions promoted by influential groups. In relation to AMR, this applies particularly to the pharmaceutical and medical diagnostics industries. Given the associated risk of inefficient use of public funds, critical attention must be paid to how the promoted ‘solutions’ to the AMR crisis are constructed, and their symbolic and material effects on health policy. We conducted a critical discourse analysis (CDA) of the seventy-one written submissions to the UK House of Commons Health and Social Care Committee’s 2018 inquiry into AMR. Two researchers collaboratively coded the findings and categorised the submissions. We applied the Policy Dystopia Model to further analyse the proposed solutions and ascertain the discursive and instrumental arguments in the industry submissions to the Committee. We found that industry submissions deployed economic and governance discursive strategies, articulating three main ‘market paradoxical’ arguments: (i) interference but non-interference; (ii) power but powerlessness; and (iii) for-profit but not-for-profit. The industry submissions also drew upon instrumental strategies including: coalition management, information management, and direct involvement and influence in policymaking. Our analysis suggests that commercial interests deploy crisis narratives to advocate for solutions involving market deregulation and industry subsidies. Thus, the solutions presented to the Committee were heavily shaped by a technocratic-industrial complex. This contributes to influencing what is seen as possible and acceptable in the global AMR policy landscape.Peer reviewedFinal Published versio

Analytic pricing of American put options

American options are the most commonly traded financial derivatives in the market. Pricing these options fairly, so as to avoid arbitrage, is of paramount importance. Closed form solutions for American put options cannot be utilised in practice and so numerical techniques are employed. This thesis looks at the work done by other researchers to find an analytic solution to the American put option pricing problem and suggests a practical method, that uses Monte Carlo simulation, to approximate the American put option price. The theory behind option pricing is first discussed using a discrete model. Once the concepts of arbitrage-free pricing and hedging have been dealt with, this model is extended to a continuous-time setting. Martingale theory is introduced to put the option pricing theory in a more formal framework. The construction of a hedging portfolio is discussed in detail and it is shown how financial derivatives are priced according to a unique riskneutral probability measure. Black-Scholes model is discussed and utilised to find closed form solutions to European style options. American options are discussed in detail and it is shown that under certain conditions, American style options can be solved according to closed form solutions. Various numerical techniques are presented to approximate the true American put option price. Chief among these methods is the Richardson extrapolation on a sequence of Bermudan options method that was developed by Geske and Johnson. This model is extended to a Repeated-Richardson extrapolation technique. Finally, a Monte Carlo simulation is used to approximate Bermudan put options. These values are then extrapolated to approximate the price of an American put option. The use of extrapolation techniques was hampered by the presence of non-uniform convergence of the Bermudan put option sequence. When convergence was uniform, the approximations were accurate up to a few cents difference

Assessing Peer Leader Skill Acquisition and Group Dynamics in a First-Year Calculus Course

Peer-led team learning (PLTL), specifically the model known as ‘Workshops’, has been shown to contribute positively and significantly to student success in STEM courses across subjects (Gosser et al., 2001). Our research adds to the SOTL literature describing the effectiveness of Workshops by reporting on the changes in student leaders. We examine the level to which leaders acquired new skills in effective teaching and describe the pedagogical interactions in the groups they led as a result of the combination of training and experience facilitating first-year Calculus Workshop sections. This was a semester-long study on twenty-two Workshop leaders for two multi-section, introductory calculus courses at a small research university. Our method is a novel overlay of two metrics that allows, with some forethought, a robust analysis of Workshop leader outcomes that would complement any assessment of PLTL implementation faculty might choose to undertake

Deficiency of the bone mineralization inhibitor NPP1 protects against obesity and diabetes

The emergence of bone as an endocrine regulator has prompted a re-evaluation of the role of bone mineralization factors in the development of metabolic disease. Ectonucleotide pyrophosphatase/phosphodiesterase-1 (NPP1) controls bone mineralization through the generation of pyrophosphate, and levels of NPP1 are elevated both in dermal fibroblast cultures and muscle of individuals with insulin resistance. We investigated the metabolic phenotype associated with impaired bone metabolism in mice lacking the gene that encodes NPP1 (Enpp1−/− mice). Enpp1−/− mice exhibited mildly improved glucose homeostasis on a normal diet but showed a pronounced resistance to obesity and insulin resistance in response to chronic high-fat feeding. Enpp1−/− mice had increased levels of the insulin-sensitizing bone-derived hormone osteocalcin but unchanged insulin signalling within osteoblasts. A fuller understanding of the pathways of NPP1 could inform the development of novel therapeutic strategies for treating insulin resistance

Seasonal variability of sediment controls of nitrogen cycling in an agricultural stream

Agricultural streams receive large inputs of nutrients, such as nitrate (NO3−) and ammonium (NH4+), which impact water quality and stream health. Streambed sediments are hotspots of biogeochemical reactivity, characterised by high rates of nutrient attenuation and denitrification. High concentrations of nitrous oxide (N2O) previously observed in stream sediments point to incomplete denitrification, with sediments acting as a potentially significant source of global N2O. We investigated the effect of sediment type and seasonal variation on denitrification and N2O production in the streambed of an agricultural UK stream. Denitrification was strongly controlled by sediment type, with sand-dominated sediments exhibiting potential rates of denitrification almost 10 times higher than those observed in gravel-dominated sediments (0.026 ± 0.004 N2O–N μg g−1 h−1 for sand-dominated and 0.003 ± 0.003 N2O–N μg g−1 h−1 for gravel-dominated). In-situ measurements supported this finding, with higher concentrations of NO3−, nitrite (NO2−) and N2O observed in the porewaters of gravel-dominated sediments. Denitrification varied substantially between seasons, with denitrification increasing from winter to autumn. Our results indicate highest NO3− reduction occurred in sand-dominated sediments whilst highest N2O concentrations occurred in gravel-dominated sediments. This suggests that finer-grained streambeds could play an important role in removing excess nitrogen from agricultural catchments without producing excess N2O

Machine learning and domain adaptation to monitor yoghurt fermentation using ultrasonic measurements

In manufacturing environments, real-time monitoring of yoghurt fermentation is required to maintain an optimal production schedule, ensure product quality, and prevent the growth of pathogenic bacteria. Ultrasonic sensors combined with machine learning models offer the potential for non-invasive process monitoring. However, methods are required to ensure the models are robust to changing ultrasonic measurement distributions as a result of changing process conditions. As it is unknown when these changes in distribution will occur, domain adaptation methods are needed that can be applied to newly acquired data in real-time. In this work, yoghurt fermentation processes are monitored using non-invasive ultrasonic sensors. Furthermore, a transmission based method is compared to an industrially-relevant non-transmission method which does not require the sound wave to travel through the fermenting yoghurt. Three machine learning algorithms were investigated including fully-connected neural networks, fully-connected neural networks with long short-term memory layers, and convolutional neural networks with long short-term memory layers. Three real-time domain adaptation strategies were also evaluated, namely; feature alignment, prediction alignment, and feature removal. The most accurate method (mean squared error of 0.008 to predict pH during fermentation) was non-transmission based and used convolutional neural networks with long short-term memory layers, and a combination of all three domain adaption methods

The Passive Journalist: How sources dominate the local news

This study explores which sources are “making” local news and whether these sources are simply indicating the type of news that appears, or are shaping newspaper coverage. It provides an empirical record of the extent to which sources are able to dominate news coverage from which future trends in local journalism can be measured. The type and number of sources used in 2979 sampled news stories in four West Yorkshire papers, representing the three main proprietors of local newspapers in the United Kingdom, were recorded for one month and revealed the relatively narrow range of routine sources; 76 per cent of articles cited only a single source. The analysis indicates that journalists are relying less on their readers for news, and that stories of little consequence are being elevated to significant positions, or are filling news pages at the expense of more important stories. Additionally, the reliance on a single source means that alternative views and perspectives relevant to the readership are being overlooked. Journalists are becoming more passive, mere processors of one-sided information or bland copy dictated by sources. These trends indicate poor journalistic standards and may be exacerbating declining local newspaper sales

Coronary CT Angiography and 5-Year Risk of Myocardial Infarction.

BACKGROUND: Although coronary computed tomographic angiography (CTA) improves diagnostic certainty in the assessment of patients with stable chest pain, its effect on 5-year clinical outcomes is unknown. METHODS: In an open-label, multicenter, parallel-group trial, we randomly assigned 4146 patients with stable chest pain who had been referred to a cardiology clinic for evaluation to standard care plus CTA (2073 patients) or to standard care alone (2073 patients). Investigations, treatments, and clinical outcomes were assessed over 3 to 7 years of follow-up. The primary end point was death from coronary heart disease or nonfatal myocardial infarction at 5 years. RESULTS: The median duration of follow-up was 4.8 years, which yielded 20,254 patient-years of follow-up. The 5-year rate of the primary end point was lower in the CTA group than in the standard-care group (2.3% [48 patients] vs. 3.9% [81 patients]; hazard ratio, 0.59; 95% confidence interval [CI], 0.41 to 0.84; P=0.004). Although the rates of invasive coronary angiography and coronary revascularization were higher in the CTA group than in the standard-care group in the first few months of follow-up, overall rates were similar at 5 years: invasive coronary angiography was performed in 491 patients in the CTA group and in 502 patients in the standard-care group (hazard ratio, 1.00; 95% CI, 0.88 to 1.13), and coronary revascularization was performed in 279 patients in the CTA group and in 267 in the standard-care group (hazard ratio, 1.07; 95% CI, 0.91 to 1.27). However, more preventive therapies were initiated in patients in the CTA group (odds ratio, 1.40; 95% CI, 1.19 to 1.65), as were more antianginal therapies (odds ratio, 1.27; 95% CI, 1.05 to 1.54). There were no significant between-group differences in the rates of cardiovascular or noncardiovascular deaths or deaths from any cause. CONCLUSIONS: In this trial, the use of CTA in addition to standard care in patients with stable chest pain resulted in a significantly lower rate of death from coronary heart disease or nonfatal myocardial infarction at 5 years than standard care alone, without resulting in a significantly higher rate of coronary angiography or coronary revascularization. (Funded by the Scottish Government Chief Scientist Office and others; SCOT-HEART ClinicalTrials.gov number, NCT01149590 .)

Whale-Fall Ecosystems: Recent Insights into Ecology, Paleoecology, and Evolution

Abstract Whale falls produce remarkable organic-and sulfide-rich habitat islands at the seafloor. The past decade has seen a dramatic increase in studies of modern and fossil whale remains, yielding exciting new insights into whale-fall ecosystems. Giant body sizes and especially high bone-lipid content allow great-whale carcasses to support a sequence of heterotrophic and chemosynthetic microbial assemblages in the energy-poor deep sea. Deep-sea metazoan communities at whale falls pass through a series of overlapping successional stages that vary with carcass size, water depth, and environmental conditions. These metazoan communities contain many new species and evolutionary novelties, including bone-eating worms and snails and a diversity of grazers on sulfur bacteria. Molecular and paleoecological studies suggest that whale falls have served as hot spots of adaptive radiation for a specialized fauna; they have also provided evolutionary stepping stones for vent and seep mussels and could have facilitated speciation in other vent/seep taxa