Organ failure, outcomes and deprivation status among critically ill cirrhosis patients — a one-year cohort study

No abstract available

School characteristics and children's mental health: A linked survey-administrative data study

Mental health difficulties are childhood-onset with lifelong health, social and economic consequences. Children spend a large amount of time in schools, making schools an important context for mental health prevention and support. We examine how school composition and school climate, controlling for individual child-level characteristics, are associated with children's mental health difficulties (emotional and behavioural difficulties). Data from 23,215 children from 648 primary schools in England were analysed to examine the associations of school composition (size, gender, socioeconomic and ethnicity) and school climate with mental health (emotional symptoms, behavioural symptoms and above clinical cut-off scores) adjusting for individual child socio-demographic characteristics. We find that between 3% and 4.5% of the variation in children's mental health outcomes could be attributed to schools. Of this, small proportions were explained by school composition (1.4 to 3.8%) and larger proportions were explained by school climate (29.5 to 48.8%). Lower school socio-economic status was associated with higher behavioural symptoms (coef = 0.02 [95%CI: 0.01–0.04]) and slightly raised odds of high mental health difficulties (OR = 1.05, 95% CI: 1.01,1.09). More positive school climate was associated with lower emotional (coef = −0.09 [95%CI:-0.11,-0.08]) and behavioural (coef = −0.13 [95% CI,-0.15:-0.11]) symptoms and lower odds of mental health difficulties (OR = 0.78, 95%CI:0.74,0.81). Some associations between school factors and mental health were moderated by child sex and SES. School composition factors were weakly associated with children's mental health, whereas school climate explained a larger amount of between-school variation and appears a good target for universal prevention of mental health difficulties in children

Modeling Focused Ultrasound Exposure for the Optimal Control of Thermal Dose Distribution

Preclinical studies indicate that focused ultrasound at exposure conditions close to the threshold for thermal damage can increase drug delivery at the focal region. Although these results are promising, the optimal control of temperature still remains a challenge. To address this issue, computer-simulated ultrasound treatments have been performed. When the treatments are delivered without taking into account the cooling effect exerted by the blood flow, the resulting thermal dose is highly variable with regions of thermal damage, regions of underdosage close to the vessels, and areas in between these two extremes. When the power deposition is adjusted so that the peak thermal dose remains close to the threshold for thermal damage, the thermal dose is more uniformly distributed but under-dosage is still visible around the thermally significant vessels. The results of these simulations suggest that, for focused ultrasound, as for other delivery methods, the only way to control temperature is to adjust the average energy deposition to compensate for the presence of thermally significant vessels in the target area. By doing this, we have shown that it is possible to reduce the temperature heterogeneity observed in focused ultrasound thermal treatments

Signalment risk factors for cutaneous and renal glomerular vasculopathy (Alabama rot) in dogs in the UK

Seasonal outbreaks of cutaneous and renal glomerular vasculopathy (CRGV) have been reported annually in UK dogs since 2012, yet the aetiology of the disease remains unknown. The objectives of this study were to explore whether any breeds had an increased or decreased risk of being diagnosed with CRGV, and to report on age and sex distributions of CRGV cases occurring in the UK. Multivariable logistic regression was used to compare 101 dogs diagnosed with CRGV between November 2012 and May 2017 with a denominator population of 446,453 dogs from the VetCompass database. Two Kennel Club breed groups—hounds (odds ratio (OR) 10.68) and gun dogs (OR 9.69)—had the highest risk of being diagnosed with CRGV compared with terriers, while toy dogs were absent from among CRGV cases. Females were more likely to be diagnosed with CRGV (OR 1.51) as were neutered dogs (OR 3.36). As well as helping veterinarians develop an index of suspicion for the disease, better understanding of the signalment risk factors may assist in the development of causal models for CRGV and help identify the aetiology of the disease

Canine dystocia in 50 UK first-opinion emergency-care veterinary practices: prevalence and risk factors

Dystocia can represent a major welfare issue for dogs of certain breeds and morphologies. First-opinion emergency-care veterinary caseloads represent a useful data resource for epidemiological research because dystocia can often result in emergency veterinary care. The study analysed a merged database of clinical records from 50 first-opinion emergency-care veterinary practices participating in the VetCompass Programme. Multivariable logistic regression modelling was used for risk factors analysis. There were 701 dystocia cases recorded among 18,758 entire female dogs, resulting in a dystocia prevalence of 3.7 per cent (95 per cent CI 3.5–4.0 per cent). Breeds with the highest odds of dystocia compared with crossbred bitches were French Bulldog (OR: 15.9, 95 per cent CI 9.3 to 27.2, P<0.001), Boston Terrier (OR: 12.9, 95 per cent CI 5.6 to 29.3, P<0.001), Chihuahua (OR: 10.4, 95 per cent CI 7.0 to 15.7, P<0.001) and Pug (OR: 11.3, 95 per cent CI 7.1 to 17.9, P<0.001). Bitches aged between 3.0 and 5.9 years had 3.1 (95 per cent CI 2.6 to 3.7, P<0.001) times the odds of dystocia compared with bitches aged under 3.0years. Certain breeds, including some brachycephalic and toy breeds, appeared at high risk of dystocia. Opportunities to improve this situation are discussed

Bacterial Cholangitis, Cholecystitis, or both in Dogs

BACKGROUND: Bacterial cholangitis and cholecystitis are rarely reported, poorly characterized diseases in the dog. OBJECTIVES: To characterize the clinical features of these conditions. ANIMALS: Twenty‐seven client‐owned dogs with bacterial cholangitis, cholecystitis, or both. METHODS: Multicenter, retrospective cases series of dogs with bacterial cholangitis, cholecystitis, or both, presenting January 2000 to June 2011 to 4 Veterinary Schools in Ireland/United Kingdom. Interrogation of hospital databases identified all cases with the inclusion criteria; histopathologically confirmed cholangitis or cholecystitis and bile culture/cytology results supporting a bacterial etiology. RESULTS: Twenty‐seven dogs met the inclusion criteria with approximately 460 hepatitis cases documented over the same study period. Typical clinical pathology findings were increases in liver enzyme activities (25/26), hyperbilirubinemia (20/26), and an inflammatory leukogram (21/24). Ultrasound findings, although nonspecific, aided decision‐making in 25/26 cases. The most frequent hepatobiliary bacterial isolates were Escherichia coli (n = 17; 16 cases), Enterococcus spp. (n = 8; 6 cases), and Clostridium spp. (n = 5; 5 cases). Antimicrobial resistance was an important feature of aerobic isolates; 10/16 E. coli isolates resistant to 3 or more antimicrobial classes. Biliary tract rupture complicated nearly one third of cases, associated with significant mortality (4/8). Discharged dogs had a guarded to fair prognosis; 17/18 alive at 2 months, although 5/10 re‐evaluated had persistent liver enzyme elevation 2–12 months later. CONCLUSION AND CLINICAL SIGNIFICANCE: Bacterial cholangitis and cholecystitis occur more frequently than suggested by current literature and should be considered in dogs presenting with jaundice and fever, abdominal pain, or an inflammatory leukogram or with ultrasonographic evidence of gallbladder abnormalities

Development Of VHF (240-270 MHz) Antennas For SoOp (Signal Of Opportunity) Receiver For 6u Cubesat Platforms

The main goal of this research is to design, fabricate, and test deployable VHF antennas for 6U Cubesat platforms to enable validation of root zone soil moisture (RZSM) estimation algorithms for signal of opportunity (SoOp) remote sensing over the 240-270 MHz frequency band. The proposed work provides a strong foundation for establishing a technology development path for maturing a truly global direct surface soil moisture (SM) and RZSM measurement system (Figure 1) over a variety of land covers with limited density restrictions. In SoOp methodology, signals transmitted by already existing transmitters (known as transmitters of opportunity, in this case the Military Satellite Communication (MilSatCom) System's UHF Follow-On program) are utilized to measure properties of reflecting targets by recording reflected signals using a simple passive microwave receiver

A geometric Newton method for Oja's vector field

Newton's method for solving the matrix equation $F(X)\equiv AX-XX^TAX=0$ runs up against the fact that its zeros are not isolated. This is due to a symmetry of $F$ by the action of the orthogonal group. We show how differential-geometric techniques can be exploited to remove this symmetry and obtain a ``geometric'' Newton algorithm that finds the zeros of $F$. The geometric Newton method does not suffer from the degeneracy issue that stands in the way of the original Newton method

A Stochastic Sequential Quadratic Optimization Algorithm for Nonlinear Equality Constrained Optimization with Rank-Deficient Jacobians

A sequential quadratic optimization algorithm is proposed for solving smooth nonlinear equality constrained optimization problems in which the objective function is defined by an expectation of a stochastic function. The algorithmic structure of the proposed method is based on a step decomposition strategy that is known in the literature to be widely effective in practice, wherein each search direction is computed as the sum of a normal step (toward linearized feasibility) and a tangential step (toward objective decrease in the null space of the constraint Jacobian). However, the proposed method is unique from others in the literature in that it both allows the use of stochastic objective gradient estimates and possesses convergence guarantees even in the setting in which the constraint Jacobians may be rank deficient. The results of numerical experiments demonstrate that the algorithm offers superior performance when compared to popular alternatives