MELD score measured day 10 after orthotopic liver transplantation predicts death and re-transplantation within the first year

OBJECTIVE: The impact of early allograft dysfunction on the outcome after liver transplantation is yet to be established. We explored the independent predictive value of the Model for End-Stage Liver Disease (MELD) score measured in the post-transplant period on the risk of mortality or re-transplantation. MATERIAL AND METHODS: Retrospective cohort study on adults undergoing orthotopic deceased donor liver transplantation from 2004 to 2014. The MELD score was determined prior to transplantation and daily until 21 days after. The risk of mortality or re-transplantation within the first year was assessed according to quartiles of MELD using unadjusted and adjusted stepwise Cox regression analysis. RESULTS: We included 374 consecutive liver transplant recipients of whom 60 patients died or were re-transplanted. The pre-transplant MELD score was comparable between patients with good and poor outcome, but from day 1 the MELD score significantly diversified and was higher in the poor outcome group (MELD score quartile 4 versus quartile 1-3 at day 10: HR 5.1, 95% CI: 2.8-9.0). This association remained after adjustment for non-identical blood type, autoimmune liver disease and hepatocellular carcinoma (adjusted HR 5.3, 95% CI: 2.9-9.5 for MELD scores at day 10). The post-transplant MELD score was not associated with pre-transplant MELD score or the Eurotransplant donor risk index. CONCLUSION: Early determination of the MELD score as an indicator of early allograft dysfunction after liver transplantation was a strong independent predictor of mortality or re-transplantation and was not influenced by the quality of the donor, or preoperative recipient risk factors

Ionised gas kinematics in bipolar H II regions

Stellar feedback plays a fundamental role in shaping the evolution of galaxies. Here we explore the use of ionised gas kinematics in young, bipolar H II regions as a probe of early feedback in these star-forming environments. We have undertaken a multiwavelength study of a young, bipolar H II region in the Galactic disc, G$316.81-0.06$, which lies at the centre of a massive ($\sim10^3$ M$_{\odot}$) infrared-dark cloud filament. It is still accreting molecular gas as well as driving a $\sim 0.2$ pc ionised gas outflow perpendicular to the filament. Intriguingly, we observe a large velocity gradient ($47.81 \pm 3.21$ km s$^{-1}$ pc$^{-1}$) across the ionised gas in a direction perpendicular to the outflow. This kinematic signature of the ionised gas shows a reasonable correspondence with the simulations of young H II regions. Based on a qualitative comparison between our observations and these simulations, we put forward a possible explanation for the velocity gradients observed in G$316.81-0.06$. If the velocity gradient perpendicular to the outflow is caused by rotation of the ionised gas, then we infer that this rotation is a direct result of the initial net angular momentum in the natal molecular cloud. If this explanation is correct, this kinematic signature should be common in other young (bipolar) H II regions. We suggest that further quantitative analysis of the ionised gas kinematics of young H II regions, combined with additional simulations, should improve our understanding of feedback at these early stages

Broadband III-V on silicon hybrid superluminescent LEDs by quantum well intermixing and multiple die bonding

Combining quantum well intermixing and multiple die bonding a broadband superluminescent III-V on silicon LED was realized. Balancing four LEDs with different band gaps resulted in 292nm 3dB bandwidth and an on-chip power of -8dBm

Towards an analytical framework of science communication models

This chapter reviews the discussion in science communication circles of models for public communication of science and technology (PCST). It questions the claim that there has been a large-scale shift from a ‘deficit model’ of communication to a ‘dialogue model’, and it demonstrates the survival of the deficit model along with the ambiguities of that model. Similar discussions in related fields of communication, including the critique of dialogue, are briefly sketched. Outlining the complex circumstances governing approaches to PCST, the author argues that communications models often perceived to be opposed can, in fact, coexist when the choices are made explicit. To aid this process, the author proposes an analytical framework of communication models based on deficit, dialogue and participation, including variations on each

What a difference a term makes:the effect of educational attainment on marital outcomes in the UK

Abstract In the past, students in England and Wales born within the first 5 monthsof the academic year could leave school one term earlier than those born later inthe year. Focusing on women, those who were required to stay on an extra termmore frequently hold some academic qualification. Using having been required tostay on as an exogenous factor affecting academic attainment, we find that holding alow-level academic qualification has no effect on the probability of being currentlymarried for women aged 25 or above, but increases the probability of the husbandholding some academic qualification and being economically active.33 Halama

A weak characterization of slow variables in stochastic dynamical systems

We present a novel characterization of slow variables for continuous Markov processes that provably preserve the slow timescales. These slow variables are known as reaction coordinates in molecular dynamical applications, where they play a key role in system analysis and coarse graining. The defining characteristics of these slow variables is that they parametrize a so-called transition manifold, a low-dimensional manifold in a certain density function space that emerges with progressive equilibration of the system's fast variables. The existence of said manifold was previously predicted for certain classes of metastable and slow-fast systems. However, in the original work, the existence of the manifold hinges on the pointwise convergence of the system's transition density functions towards it. We show in this work that a convergence in average with respect to the system's stationary measure is sufficient to yield reaction coordinates with the same key qualities. This allows one to accurately predict the timescale preservation in systems where the old theory is not applicable or would give overly pessimistic results. Moreover, the new characterization is still constructive, in that it allows for the algorithmic identification of a good slow variable. The improved characterization, the error prediction and the variable construction are demonstrated by a small metastable system

Exploring the psychological attributes underpinning elite sports coaching.

The influential role of the coach in athlete performance and development has long been acknowledged, and coaches are now considered ‘performers’, just like their athletes. The purpose of the present study was to explore the psychological attributes elite coaches perceived to underpin their ability to coach most effectively and factors perceived to influence attribute development. Qualitative research methods were implemented where 12 elite coaches (eight male, four female) participated in semi-structured interviews. Inductive thematic analysis generated nine higher order themes related to psychological attributes: (a) attitude, (b) confidence, (c) resilience, (d) focus, (e) drive for personal development, (f) being athlete-centred, (g) emotional awareness, (h) emotional understanding, and (i) emotional management. In addition, three higher order themes were generated related to factors perceived to influence attribute development: (a) education, (b) experience, and (c) conscious self-improvement. Findings indicated that several attributes perceived to be essential to coaching effectiveness related to the emotional nature of coaching, where coaches’ abilities to identify, understand, and manage emotions in both themselves and others had many positive effects

'Moving life stories tell us just why politics matters’: personal narratives in tabloid anti-austerity campaigns

This article examines the use of personal narratives in two tabloid newspaper campaigns against a controversial welfare reform popularly known as the ‘bedroom tax’. It aims firstly to evaluate whether the personal narratives operate as political testimony to challenge government accounts of welfare reform and dominant stereotypes of benefits claimants, and secondly to assess the potential for and limits to progressive advocacy in popular journalism. The study uses content analysis of 473 articles over the course of a year in the Daily Mirror and Sunday People newspapers, and qualitative analysis of a sub-set of 113 articles to analyse the extent to which the campaign articles extrapolated from the personal to the general, and the role of ‘victim-witnesses’ in articulating their own subjectivity and political agency. The analysis indicates that both newspapers allowed affected individuals to express their own subjectivity to challenge stereotypes, but it was civil society organisations and opinion columnists who most explicitly extrapolated from the personal to the political. Collectively organised benefits claimants were rarely quoted, and there was some evidence of ventriloquization of the editorial voice in the political criticisms of victim-witnesses. However, a campaigning columnist in the Mirror more actively empowered some of those affected to speak directly to politicians. This indicates the value of campaigning journalism when it is truly engaged in solidarity with those affected, rather than instrumentalising victim-witnesses to further the newspapers’ campaign goals