High-sensitivity cardiac troponin concentrations at presentation in patients with ST-segment elevation myocardial infarction

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Correlating tephras and cryptotephras using glass compositional analyses and numerical and statistical methods:Review and evaluation

We define tephras and cryptotephras and their components (mainly ash-sized particles of glass ± crystals in distal deposits) and summarize the basis of tephrochronology as a chronostratigraphic correlational and dating tool for palaeoenvironmental, geological, and archaeological research. We then document and appraise recent advances in analytical methods used to determine the major, minor, and trace elements of individual glass shards from tephra or cryptotephra deposits to aid their correlation and application. Protocols developed recently for the electron probe microanalysis of major elements in individual glass shards help to improve data quality and standardize reporting procedures. A narrow electron beam (diameter ~3-5 μm) can now be used to analyze smaller glass shards than previously attainable. Reliable analyses of ‘microshards’ (defined here as glass shards <32 µm in diameter) using narrow beams are useful for fine-grained samples from distal or ultra-distal geographic locations, and for vesicular or microlite-rich glass shards or small melt inclusions. Caveats apply, however, in the microprobe analysis of very small microshards (<=~5 µm in diameter), where particle geometry becomes important, and of microlite-rich glass shards where the potential problem of secondary fluorescence across phase boundaries needs to be recognised. Trace element analyses of individual glass shards using laser ablation inductively coupled plasma-mass spectrometry (LA-ICP-MS), with crater diameters of 20 μm and 10 μm, are now effectively routine, giving detection limits well below 1 ppm. Smaller ablation craters (<10 μm) can be subject to significant element fractionation during analysis, but the systematic relationship of such fractionation with glass composition suggests that analyses for some elements at these resolutions may be quantifiable. In undertaking analyses, either by microprobe or LA-ICP-MS, reference material data acquired using the same procedure, and preferably from the same analytical session, should be presented alongside new analytical data. In part 2 of the review, we describe, critically assess, and recommend ways in which tephras or cryptotephras can be correlated (in conjunction with other information) using numerical or statistical analyses of compositional data. Statistical methods provide a less subjective means of dealing with analytical data pertaining to tephra components (usually glass or crystals/phenocrysts) than heuristic alternatives. They enable a better understanding of relationships among the data from multiple viewpoints to be developed and help quantify the degree of uncertainty in establishing correlations. In common with other scientific hypothesis testing, it is easier to infer using such analysis that two or more tephras are different rather than the same. Adding stratigraphic, chronological, spatial, or palaeoenvironmental data (i.e. multiple criteria) is usually necessary and allows for more robust correlations to be made. A two-stage approach is useful, the first focussed on differences in the mean composition of samples, or their range, which can be visualised graphically via scatterplot matrices or bivariate plots coupled with the use of statistical tools such as distance measures, similarity coefficients, hierarchical cluster analysis (informed by distance measures or similarity or cophenetic coefficients), and principal components analysis (PCA). Some statistical methods (cluster analysis, discriminant analysis) are referred to as ‘machine learning’ in the computing literature. The second stage examines sample variance and the degree of compositional similarity so that sample equivalence or otherwise can be established on a statistical basis. This stage may involve discriminant function analysis (DFA), support vector machines (SVMs), canonical variates analysis (CVA), and ANOVA or MANOVA (or its two-sample special case, the Hotelling two-sample T² test). Randomization tests can be used where distributional assumptions such as multivariate normality underlying parametric tests are doubtful. Compositional data may be transformed and scaled before being subjected to multivariate statistical procedures including calculation of distance matrices, hierarchical cluster analysis, and PCA. Such transformations may make the assumption of multivariate normality more appropriate. A sequential procedure using Mahalanobis distance and the Hotelling two-sample T² test is illustrated using glass major element data from trachytic to phonolitic Kenyan tephras. All these methods require a broad range of high-quality compositional data which can be used to compare ‘unknowns’ with reference (training) sets that are sufficiently complete to account for all possible correlatives, including tephras with heterogeneous glasses that contain multiple compositional groups. Currently, incomplete databases are tending to limit correlation efficacy. The development of an open, online global database to facilitate progress towards integrated, high-quality tephrostratigraphic frameworks for different regions is encouraged

Laying the Foundation for Policy: Measuring Local Prevalence for Autism Spectrum Disorder

Claims have been made that families with children living with autism spectrum disorders (ASD) have been migrating to Alberta because of higher funding available for ASD supports compared to other provinces. The legitimacy of these claims, along with many others about the adequacy or inadequacy of funding for supporting persons living with ASD, has not been evaluated because we simply don’t know how many people in Alberta are living with ASD. Typically in Canada, ASD prevalence is reported in national figures, based on international estimates. Canadian prevalence estimates for ASD are needed. With no national surveillance system in place, national estimates are difficult to determine. In addition, such broad measurements are problematic as they may not adequately inform the service delivery needs for specific jurisdictions. A new study shows that 1,711, or 1 in 94, school age children in the Calgary region have an ASD diagnosis. As this number matches what is often reported for the national prevalence of ASD, it suggests that Alberta’s relatively higher ASD funding is not inducing in-migration of families seeking better support. The data also show that the prevalence is higher in elementary-grade children, with a diagnosis in one of every 86 children. In the senior grades, there are significantly fewer students with ASD diagnoses, specifically within the Calgary Board of Education. There is no evident reason for diagnoses to seemingly dematerialize in the older grades. These students could be dropping out or choosing home-schooling in greater numbers. Possibly there has been an increase in prevalence. These prevalence estimates help to inform the demand for special-needs services within the local school system. In addition, there is growing concern that upon graduation there is a “support cliff” resulting from a less systematized, less generous support system available for adults with neurodevelopmental disability. Families that need support for ASD face enough challenges; it is critical for policy-makers to be aware of the extent of the situation in their own jurisdiction so as to develop the right kinds of supports for these families

A New Task for Philosophy of Science

We philosophers of science have before us an important new task that we need urgently to take up. It is to convince the scientific community to adopt and implement a new philosophy of science that does better justice to the deeply problematic basic intellectual aims of science than that which we have at present. Problematic aims evolve with evolving knowledge, that part of philosophy of science concerned with aims and methods thus becoming an integral part of science itself. The outcome of putting this new philosophy into scientific practice would be a new kind of science, both more intellectually rigorous, and one that does better justice to the best interests of humanity

Pre-treatment tumour perfusion parameters and initial RECIST response do not predict long-term survival outcomes for patients with head and neck squamous cell carcinoma treated with induction chemotherapy

<p>Tumour plasma perfusion (F_p) in relation to overall survival (a), disease specific survival (b) and locoregional control (c). Nodal plasma perfusion in relation to survival (d) disease specific survival (e) and locoregional control (f).</p

Modelling chemistry in the nocturnal boundary layer above tropical rainforest and a generalised effective nocturnal ozone deposition velocity for sub-ppbv NOx conditions

Measurements of atmospheric composition have been made over a remote rainforest landscape. A box model has previously been demonstrated to model the observed daytime chemistry well. However the box model is unable to explain the nocturnal measurements of relatively high [NO] and [O3], but relatively low observed [NO2]. It is shown that a one-dimensional (1-D) column model with simple O3 -NOx chemistry and a simple representation of vertical transport is able to explain the observed nocturnal concentrations and predict the likely vertical profiles of these species in the nocturnal boundary layer (NBL). Concentrations of tracers carried over from the end of the night can affect the atmospheric chemistry of the following day. To ascertain the anomaly introduced by using the box model to represent the NBL, vertically-averaged NBL concentrations at the end of the night are compared between the 1-D model and the box model. It is found that, under low to medium [NOx] conditions (NOx <1 ppbv), a simple parametrisation can be used to modify the box model deposition velocity of ozone, in order to achieve good agreement between the box and 1-D models for these end-of-night concentrations of NOx and O3. This parametrisation would could also be used in global climate-chemistry models with limited vertical resolution near the surface. Box-model results for the following day differ significantly if this effective nocturnal deposition velocity for ozone is implemented; for instance, there is a 9% increase in the following day’s peak ozone concentration. However under medium to high [NOx] conditions (NOx > 1 ppbv), the effect on the chemistry due to the vertical distribution of the species means no box model can adequately represent chemistry in the NBL without modifying reaction rate constants

Human gut Bacteroidetes can utilize yeast mannan through a selfish mechanism

Yeasts, which have been a component of the human diet for at least 7000 years, possess an elaborate cell wall α-mannan. The influence of yeast mannan on the ecology of the human microbiota is unknown. Here we show that yeast α-mannan is a viable food source for Bacteroides thetaiotaomicron (Bt), a dominant member of the microbiota. Detailed biochemical analysis and targeted gene disruption studies support a model whereby limited cleavage of α-mannan on the surface generates large oligosaccharides that are subsequently depolymerized to mannose by the action of periplasmic enzymes. Co-culturing studies showed that metabolism of yeast mannan by Bt presents a ‘selfish’ model for the catabolism of this recalcitrant polysaccharide. This report shows how a cohort of highly successful members of the microbiota has evolved to consume sterically-restricted yeast glycans, an adaptation that may reflect the incorporation of eukaryotic microorganisms into the human diet

Assessing the effectiveness of artificial intelligence (AI) in prioritising CT head interpretation: study protocol for a stepped-wedge cluster randomised trial (ACCEPT-AI)

Introduction: Diagnostic imaging is vital in emergency departments (EDs). Accessibility and reporting impacts ED workflow and patient care. With radiology workforce shortages, reporting capacity is limited, leading to image interpretation delays. Turnaround times for image reporting are an ED bottleneck. Artificial intelligence (AI) algorithms can improve productivity, efficiency and accuracy in diagnostic radiology, contingent on their clinical efficacy. This includes positively impacting patient care and improving clinical workflow. The ACCEPT-AI study will evaluate Qure.ai’s qER software in identifying and prioritising patients with critical findings from AI analysis of non-contrast head CT (NCCT) scans. Methods and analysis: This is a multicentre trial, spanning four diverse sites, over 13 months. It will include all individuals above the age of 18 years who present to the ED, referred for an NCCT. The project will be divided into three consecutive phases (pre-implementation, implementation and post-implementation of the qER solution) in a stepped-wedge design to control for adoption bias and adjust for time-based changes in the background patient characteristics. Pre-implementation involves baseline data for standard care to support the primary and secondary outcomes. The implementation phase includes staff training and qER solution threshold adjustments in detecting target abnormalities adjusted, if necessary. The post-implementation phase will introduce a notification (prioritised flag) in the radiology information system. The radiologist can choose to agree with the qER findings or ignore it according to their clinical judgement before writing and signing off the report. Non-qER processed scans will be handled as per standard care. Ethics and dissemination: The study will be conducted in accordance with the principles of Good Clinical Practice. The protocol was approved by the Research Ethics Committee of East Midlands (Leicester Central), in May 2023 (REC (Research Ethics Committee) 23/EM/0108). Results will be published in peer-reviewed journals and disseminated in scientific findings (ClinicalTrials.gov: NCT06027411) Trial registration number: NCT06027411