Study protocol for a multicentre longitudinal mixed methods study to explore the Outcomes of ChildrEn and fAmilies in the first year after paediatric Intensive Care: the OCEANIC study.

INTRODUCTION: Annually in the UK, 20 000 children become very ill or injured and need specialist care within a paediatric intensive care unit (PICU). Most children survive. However, some children and their families may experience problems after they have left the PICU including physical, functional and/or emotional problems. It is unknown which children and families experience such problems, when these occur or what causes them. The aim of this mixed-method longitudinal cohort study is to understand the physical, functional, emotional and social impact of children surviving PICU (aged: 1 month-17 years), their parents and siblings, during the first year after a PICU admission. METHODS AND ANALYSIS: A quantitative study involving 300 child survivors of PICU; 300 parents; and 150-300 siblings will collect data (using self-completion questionnaires) at baseline, PICU discharge, 1, 3, 6 and 12 months post-PICU discharge. Questionnaires will comprise validated and reliable instruments. Demographic data, PICU admission and treatment data, health-related quality of life, functional status, strengths and difficulties behaviour and post-traumatic stress symptoms will be collected from the child. Parent and sibling data will be collected on the impact of paediatric health conditions on the family's functioning capabilities, levels of anxiety and social impact of the child's PICU admission. Data will be analysed using descriptive and inferential statistics. Concurrently, an embedded qualitative study involving semistructured interviews with 24 enrolled families at 3 months and 9 months post-PICU discharge will be undertaken. Framework analysis will be used to analyse the qualitative data. ETHICS AND DISSEMINATION: The study has received ethical approval from the National Health Services Research Ethics Committee (Ref: 19/WM/0290) and full governance clearance. This will be the first UK study to comprehensively investigate physical, functional, emotional and social consequences of PICU survival in the first-year postdischarge.Clinical Trials Registration Number: ISRCTN28072812 [Pre-results]

ForestHash: Semantic Hashing With Shallow Random Forests and Tiny Convolutional Networks

Hash codes are efficient data representations for coping with the ever growing amounts of data. In this paper, we introduce a random forest semantic hashing scheme that embeds tiny convolutional neural networks (CNN) into shallow random forests, with near-optimal information-theoretic code aggregation among trees. We start with a simple hashing scheme, where random trees in a forest act as hashing functions by setting `1' for the visited tree leaf, and `0' for the rest. We show that traditional random forests fail to generate hashes that preserve the underlying similarity between the trees, rendering the random forests approach to hashing challenging. To address this, we propose to first randomly group arriving classes at each tree split node into two groups, obtaining a significantly simplified two-class classification problem, which can be handled using a light-weight CNN weak learner. Such random class grouping scheme enables code uniqueness by enforcing each class to share its code with different classes in different trees. A non-conventional low-rank loss is further adopted for the CNN weak learners to encourage code consistency by minimizing intra-class variations and maximizing inter-class distance for the two random class groups. Finally, we introduce an information-theoretic approach for aggregating codes of individual trees into a single hash code, producing a near-optimal unique hash for each class. The proposed approach significantly outperforms state-of-the-art hashing methods for image retrieval tasks on large-scale public datasets, while performing at the level of other state-of-the-art image classification techniques while utilizing a more compact and efficient scalable representation. This work proposes a principled and robust procedure to train and deploy in parallel an ensemble of light-weight CNNs, instead of simply going deeper.Comment: Accepted to ECCV 201

Real-time selective sequencing using nanopore technology

The Oxford Nanopore Technologies MinION sequencer enables the selection of specific DNA molecules for sequencing by reversing the driving voltage across individual nanopores. To directly select molecules for sequencing, we used dynamic time warping to match reads to reference sequences. We demonstrate our open-source Read Until software in real-time selective sequencing of regions within small genomes, individual amplicon enrichment and normalization of an amplicon set

Fractal analysis of right ventricular trabeculae in pulmonary hypertension

Purpose: To measure right ventricular (RV) trabecular complexity by its fractal dimension (FD) in healthy subjects and patients with pulmonary hypertension (PH) and assess its relationship to hemodynamic and functional parameters, and future cardiovascular events. Materials and methods: This retrospective study used data acquired from May 2004 to October 2013 for 256 patients with newly-diagnosed PH that underwent cardiac magnetic resonance (CMR) imaging, right heart catheterization and six-minute walk distance testing with a median follow-up of 4.0 years. 256 healthy controls underwent CMR only. Biventricular FD, volumes and function were assessed on short-axis cine images. Reproducibility was assessed by intraclass correlation coefficient, correlation between variables was assessed by Pearson’s correlation test, and mortality prediction compared by univariable and multivariable Cox regression analysis. Results: RV-FD reproducibility had an intraclass correlation coefficient of 0.97 (95% confidence interval [CI]: 0.96, 0.98). RV-FD was higher in PH patients than healthy subjects (median 1.310, inter-quartile range [IQR] 1.281-1.341 vs 1.264, 1.242-1.295, P <.001) with the greatest difference near the apex. RV-FD was associated with pulmonary vascular resistance (r=0.30, P <.001). In univariable Cox regression analysis, RV-FD was a significant predictor of death (hazards ratio [HR]: 1.256, CI: 1.011, 1.560, P =.04), but in a multivariable analysis did not predict survival independently of conventional parameters of RV remodeling (HR: 1.179, CI: 0.871, 1.596, P =0.29). Conclusion: Fractal analysis of RV trabecular complexity is a highly reproducible measure of remodeling in PH associated with afterload, although the gain in survival prediction over traditional markers is not significant

Family composition and age at menarche: findings from the international Health Behaviour in School-Aged Children Study

This research was funded by The University of St Andrews and NHS Health Scotland.Background Early menarche has been associated with father absence, stepfather presence and adverse health consequences in later life. This article assesses the association of different family compositions with the age at menarche. Pathways are explored which may explain any association between family characteristics and pubertal timing. Methods Cross-sectional, international data on the age at menarche, family structure and covariates (age, psychosomatic complaints, media consumption, physical activity) were collected from the 2009–2010 Health Behaviour in School-aged Children (HBSC) survey. The sample focuses on 15-year old girls comprising 36,175 individuals across 40 countries in Europe and North America (N = 21,075 for age at menarche). The study examined the association of different family characteristics with age at menarche. Regression and path analyses were applied incorporating multilevel techniques to adjust for the nested nature of data within countries. Results Living with mother (Cohen’s d = .12), father (d = .08), brothers (d = .04) and sisters (d = .06) are independently associated with later age at menarche. Living in a foster home (d = −.16), with ‘someone else’ (d = −.11), stepmother (d = −.10) or stepfather (d = −.06) was associated with earlier menarche. Path models show that up to 89% of these effects can be explained through lifestyle and psychological variables. Conclusions Earlier menarche is reported amongst those with living conditions other than a family consisting of two biological parents. This can partly be explained by girls’ higher Body Mass Index in these families which is a biological determinant of early menarche. Lower physical activity and elevated psychosomatic complaints were also more often found in girls in these family environments.Publisher PDFPeer reviewe

Intermediate Mass Black Holes in Accreting Binaries: Formation, Evolution and Observational Appearance

We study the origin of the ultraluminous X-ray source M82-X1 in the nearby starburst galaxy M82. This X-ray source is of particular interest as it is currently the best candidate intermediate mass black hole; it is associated with a 54mHz quasi periodic oscillations with a relatively low (~1keV) black-body temperature. We perform detailed binary evolution calculations of 2--15Msun stars which transfer mass to a 100--2000Msun black hole and present an empirical model for the X-ray characteristics expected for such binaries. Based on the binary evolution calculations and the assumption in our simulations we conclude that the most likely candidate for the bright X-ray source M82-X1 is a 10-15Msun star near the end of its main-sequence or slightly evolved, which transfers mass to a ~1000Msun black hole. We expect the system to be in the high/soft state. In that case the binary will not be visible as a source of gravitational wave radiation, but other transient X-ray binaries with lower mass donors way be rather bright sources of gravitational wave radiation.Comment: in press: 2004, MNRAS volume 481 (erratum added

Commercial hospitality in destination experiences: McDonald's and tourists' consumption of space

This paper examines the multiple roles that globalised, branded spaces of hospitality can play in tourists' experiences in destinations. It is argued that previous studies have not considered adequately how such commercial hospitality services and spaces interact with and influence tourists' experiences of places. Drawing on a netnographic analysis of online discussions of McDonald's, this study explores how tourists perceive these hospitality venues, and how they use them to engage with foreign destinations and negotiate the ‘work of tourism’. The data show how tourists (re)construct their identities through reflections on consuming McDonald's. The data also demonstrate that tourists critically evaluate discourses of authenticity and the (in)authenticity of consuming McDonald's. The paper concludes by discussing the implications for the marketing and management of McDonald's and similar branded commercial hospitality venues, the marketing and management of destinations, and it outlines avenues for further research

Assessing respiratory contributions to f0 declination in German across varying speech tasks and respiratory demands

International audienceMany past studies have sought to determine the factors that affect f0 declination, and the physiological underpinnings of the phenomenon. This study assessed the relation between respiration and f0 declination by means of simultaneous acoustic and respiratory recordings from read and spontaneous speech from speakers of German. Within the respective Intonational Phrase unit, we analysed the effect of the number of syllables and voiceless obstruents. Both factors could influence the slope of either f0 declination or rib cage movement. If respiration and f0 declination are related physiologically, their relationship might also be modulated by either one or both factors. Our results show consistently for both speech tasks that the slope of the rib cage movement is not related with f0 declination when length and consonant content vary. Furthermore f0 slopes are generally shallower in spontaneous than in read speech. Finally, although a higher number of voiceless obstruents yielded a greater rib cage compression, it did not affect f0 declination. These results suggest that although f0 declination occurs in many languages, it might not have a purely physiological origin in breathing, but rather reflects cognitive processing which allows speakers to look ahead when planning their utterances

A multiproxy (micro-XRF, pollen, chironomid and stable isotope) lake sediment record for the Lateglacial to Holocene transition from Thomastown Bog, Ireland

A multiproxy Lateglacial environmental record is presented for a ca. 3.5-m lacustrine sequence retrieved from a small basin (ca. 2 km2) at Thomastown Bog in County Meath, Ireland. Sediment chemistry, pollen, chironomid and stable isotope data provide a detailed picture of catchment and lake system changes from the end of the last glacial (GS-2a) to the early Holocene that correspond closely to existing local and regional models of climate change. Concomitant adjustments in independent proxy records are matched to the NGRIP oxygen isotope curve giving 12 event-episodes ranging from major climatic shifts to lower amplitude, centennial- to sub-centennial-scale adjustments, including a previously unreported regressive period of landscape instability during the north-west European ‘Rammelbeek Phase’. The study emphasizes the potential of palaeoenvironmental reconstruction from sediment chemistry where the sediment mixing system reflects autochthonous versus allochthonous inputs. The investigation also indicates problems of interpreting isotope data derived from bulk marl due to possible lag effects controlling the delivery of soil and groundwater and multiple sources of HCO3– (aq.). These research findings have implications for core site selection and for studies attempting to use stable isotopes for correlation purposes