ULearn: personalized medical learning on the web for patient empowerment

Health literacy constitutes an important step towards patient empowerment and the Web is presently the biggest repository of medical information and, thus, the biggest medical resource to be used in the learning process. However, at present, web medical information is mainly accessed through generic search engines that do not take into account the user specific needs and starting knowledge and so they are not able to support learning activities tailored to the specific user requirements. This work presents “ULearn” a meta engine that supports access, understanding and learning on the Web in the medical domain based on specific user requirements and knowledge levels towards what we call “balanced learning”. Balanced learning allows users to perform learning activities based on specific user requirements (understanding, deepening, widening and exploring) towards his/her empowerment. We have designed and developed ULearn to suggest search keywords correlated to the different user requirements and we have carried out some preliminary experiments to evaluate the effectiveness of the provided information

Clinical trial of a low-cost external fixator for global surgery use

PURPOSE: A low-cost modular external fixator for the lower limb has been developed for global surgery use. The purpose of this study is to assess outcome measures in the first clinical use of the device. METHODS: A prospective cohort study was conducted with patients recruited in two trauma hospitals. Initial clinical procedure data were collected, and patients were followed up every two weeks until 12 weeks or definitive fixation. Follow-up assessed infection, stability, and radiographic outcomes. In addition, patient-reported outcomes and surgeons' feedback on device usability were collected by questionnaires. RESULTS: The external fixator was used on 17 patients. Ten were mono-lateral, five were joint spanning, and two were delta configuration. One patient had a pin site infection at 12-week follow-up. All were stable when tested mechanically and using radiographic assessment, and 53% were converted to definitive fixation. CONCLUSION: The low-cost external fixator developed is appropriate for use in global surgery trauma centres with good clinical outcomes. PROSPECTIVE TRIAL REGISTRATION NUMBER AND DATE: SLCTR/2021/025 (06 Sep 2021)

Empirical Evidence on the Use of Credit Scoring for Predicting Insurance Losses with Psycho-social and Biochemical Explanations

An important development in personal lines of insurance in the United States is the use of credit history data for insurance risk classification to predict losses. This research presents the results of collaboration with industry conducted by a university at the request of its state legislature. The purpose was to see the viability and validity of the use of credit scoring to predict insurance losses given its controversial nature and criticism as redundant of other predictive variables currently used. Working with industry and government, this study analyzed more than 175,000 policyholders’ information for the relationship between credit score and claims. Credit scores were significantly related to incurred losses, evidencing both statistical and practical significance. We investigate whether the revealed relationship between credit score and incurred losses was explainable by overlap with existing underwriting variables or whether the credit score adds new information about losses not contained in existing underwriting variables. The results show that credit scores contain significant information not already incorporated into other traditional rating variables (e.g., age, sex, driving history). We discuss how sensation seeking and self-control theory provide a partial explanation of why credit scoring works (the psycho-social perspective). This article also presents an overview of biological and chemical correlates of risk taking that helps explain why knowing risk-taking behavior in one realm (e.g., risky financial behavior and poor credit history) transits to predicting risk-taking behavior in other realms (e.g., automobile insurance incurred losses). Additional research is needed to advance new nontraditional loss prediction variables from social media consumer information to using information provided by technological advances. The evolving and dynamic nature of the insurance marketplace makes it imperative that professionals continue to evolve predictive variables and for academics to assist with understanding the whys of the relationships through theory development.IC2 Institut

Shear strength of reinforced concrete dapped-end beams using mechanism analysis.

yesA mechanism analysis based on the upper-bound theorem of concrete plasticity is developed to predict the critical failure plane and corresponding shear capacity of reinforced concrete dapped-end beams. Failure modes observed in physical tests of reinforced concrete dapped-end beams are idealised as an assemblage of two moving blocks separated by a failure surface of displacement discontinuity. The developed mechanism analysis rationally represents the effect of different parameters on failure modes; as a result, the predicted shear capacity is in good agreement with test results. On the other hand, empirical equations specified in the Precast/Prestressed Concrete Institute design method and strutand-tie model based on ACI 318-05 highly underestimate test results. The shear capacity of dapped-end beams predicted by the mechanism analysis and strut-and-tie model decreases with the increase of shear span-to-full beam depth ratio when failure occurs along diagonal cracks originating at the bottom corner of the full-depth beam, although the shear span-to-full beam depth ratio is ignored in the Precast/Prestressed Concrete Institute design method

Outcome and Predictors for Mortality in Patients with Cardiogenic Shock:A Dutch Nationwide Registry-Based Study of 75,407 Patients with Acute Coronary Syndrome Treated by PCI

It is important to gain more insight into the cardiogenic shock (CS) population, as currently, little is known on how to improve outcomes. Therefore, we assessed clinical outcome in acute coronary syndrome (ACS) patients treated by percutaneous coronary intervention (PCI) with and without CS at admission. Furthermore, the incidence of CS and predictors for mortality in CS patients were evaluated. The Netherlands Heart Registration (NHR) is a nationwide registry on all cardiac interventions. We used NHR data of ACS patients treated with PCI between 2015 and 2019. Among 75,407 ACS patients treated with PCI, 3028 patients (4.1%) were identified with CS, respectively 4.3%, 3.9%, 3.5%, and 4.3% per year. Factors associated with mortality in CS were age (HR 1.02, 95%CI 1.02-1.03), eGFR (HR 0.98, 95%CI 0.98-0.99), diabetes mellitus (DM) (HR 1.25, 95%CI 1.08-1.45), multivessel disease (HR 1.22, 95%CI 1.06-1.39), prior myocardial infarction (MI) (HR 1.24, 95%CI 1.06-1.45), and out-of-hospital cardiac arrest (OHCA) (HR 1.71, 95%CI 1.50-1.94). In conclusion, in this Dutch nationwide registry-based study of ACS patients treated by PCI, the incidence of CS was 4.1% over the 4-year study period. Predictors for mortality in CS were higher age, renal insufficiency, presence of DM, multivessel disease, prior MI, and OHCA

IEEE 1355-Based Architecture for an ATM Switch: A Case for Onboard Switching and Processing

The recent evolution of the communication scenario has profound implications for the role of communication satellites within the communication infrastructure. Indeed, it raises the possibility that the satellite be viewed not merely as a repeater but rather as a network node in its own right in a hopefully integrated space/terrestrial network. We draw attention to the new IEEE 1355 Standard for Heterogeneous Inter-Connect as a possible platform to support several onboard processing functions, including onboard communications and onboard ATM switching. The IEEE 1355 is a new serial bus standard which enables high- performance, scalable, modular, parallel systems to be constructed with low system integration cost. This IEEE 1355- based approach can satisfy many of the requirements of onboard communications and onboard ATM switching, e.g., size, flexibility, reliability, fault-tolerance, and high communication processing speeds. This is made possible by using the highly integrated 1355 chipsets and performing protocol processing with multiple transputers in parallel. The IEEE 1355 approach also allows for easy expandability owing to its inherent design modularity

Assessment of a diverse panel of transmitted/founder HIV-1 infectious molecular clones in a luciferase based CD8 T-cell mediated viral inhibition assay

Introduction: Immunological protection against human immunodeficiency virus-1 (HIV-1) infection is likely to require both humoral and cell-mediated immune responses, the latter involving cytotoxic CD8 T-cells. Characterisation of CD8 T-cell mediated direct anti-viral activity would provide understanding of potential correlates of immune protection and identification of critical epitopes associated with HIV-1 control. Methods: The present report describes a functional viral inhibition assay (VIA) to assess CD8 T-cell-mediated inhibition of replication of a large and diverse panel of 45 HIV-1 infectious molecular clones (IMC) engineered with a Renilla reniformis luciferase reporter gene (LucR), referred to as IMC-LucR. HIV-1 IMC replication in CD4 T-cells and CD8 T-cell mediated inhibition was characterised in both ART naive subjects living with HIV-1 covering a broad human leukocyte antigen (HLA) distribution and compared with uninfected subjects. Results & discussion: CD4 and CD8 T-cell lines were established from subjects vaccinated with a candidate HIV-1 vaccine and provided standard positive controls for both assay quality control and facilitating training and technology transfer. The assay was successfully established across 3 clinical research centres in Kenya, Uganda and the United Kingdom and shown to be reproducible. This IMC-LucR VIA enables characterisation of functional CD8 T-cell responses providing a tool for rational T-cell immunogen design of HIV-1 vaccine candidates and evaluation of vaccine-induced T-cell responses in HIV-1 clinical trials

Italy's Communist Party and People's China (50s-early 60s)

In the ’50s and early ’60s the Italian Communist Party (ICP) was one of the main actors involved in informal and unconventional diplomacy between Italy and the People’s Republic of China (PRC). In the absence of diplomatic relations between the two countries, the presence in Italy of the largest Communist party in Western Europe undoubtedly acted as an important channel for unofficial Sino-Italian exchanges. This paper tries to trace the development of ICP-CCP relations focusing in particular on the Italian Communists’ views and analysis of the CCP’s historical experience. It also would like to show that ICP leaders generally viewed the CCP’s revolutionary in a positive way, an evaluation which largely stemmed from the ICP’s own national experience and its search for a more autonomous international role