Association of Cystic Medial Necrosis of the Aorta and Undiagnosed Thyroiditis [Scripta Medica]

We have recently seen two patients with cystic medial necrosis of the aorta. The first patient died of a dissecting aneurysm of the thoracic aorta. At autopsy, classical Hashimoto’s thyroiditis was discovered. The second patient died of a rupture of the ascending aorta. At autopsy, chronic thyroiditis was seen with multiple large germinal center and diffuse fibrosis. Neither patient was clinically suspected of thyroid dysfunction although the second patient had had a partial thyroidectomy in the remote past

Proalgebraic crossed modules of quasirational presentations

We introduce the concept of quasirational relation modules for discrete and pro-$p$ presentations of discrete and pro-$p$ groups and show that aspherical presentations and their subpresentations are quasirational. In the pro-$p$-case quasirationality of pro-$p$-groups with a single defining relation holds. For every quasirational (pro-$p$)relation module we construct the so called $p$-adic rationalization, which is a pro-fd-module $\overline{R}\widehat{\otimes}\mathbb{Q}_p= \varprojlim R/[R,R\mathcal{M}_n]\otimes\mathbb{Q}_p$. We provide the isomorphisms $\overline{R^{\wedge}_w}(\mathbb{Q}_p)=\overline{R}\widehat{\otimes}\mathbb{Q}_p$ and $\overline{R_u}(\mathbb{Q}_p)=\mathcal{O}(G_u)^*$, where $R^{\wedge}_w$ and $R^{\wedge}_u$ stands for continuous prounipotent completions and corresponding prounipotent presentations correspondingly. We show how $\overline{R^{\wedge}_{w}}$ embeds into a sequence of abelian prounipotent groups. This sequence arises naturally from a certain prounipotent crossed module, the latter bring concrete examples of proalgebraic homotopy types. The old-standing open problem of Serre, slightly corrected by Gildenhuys, in its modern form states that pro-$p$-groups with a single defining relation are aspherical. Our results give a positive feedback to the question of Serre.Comment: This is a corrected version of the paper which appeared in the Extended Abstracts Spring 2015, Interactions between Representation Theory, Algebraic Topology and Commutative Algebra, Research Perspectives CRM Barcelona, Vol.5, 201

The Role of Transformational Leadership in the Collaborative Development of a Full Inclusion Program: An Action Research Study

ABSTRACT This dissertation is a critical action research study on full inclusion for students with learning disabilities. The study describes how full inclusion for 16 students with learning disabilities in three regular classes was implemented in an Illinois elementary school over a one year period. The purpose of this study is to describe how transformational leadership, collaborative decision-making and action research helped in the development of full inclusion. Action research was the method used to 1) observe and collect data about the project, 2) to analyze what was happening, and 3) help guide the inclusion teaching team in taking actions to improve the program for the students. Both qualitative and quantitative data was used in the study. Collaborative decision-making by the teaching team resulted in the design and implementation of the full inclusion project. We were able to integrate the students in regular classes through team teaching, instructional grouping and cooperative learning. The project showed that planning time and additional personnel were needed to educate this many students adequately. Teacher perceptions of inclusion were that socialization of the students with learning disabilities with their typical peers improved as a result of being in the same classes, while individual academic growth was less than expected. The study concluded that transformational leadership and collaborative decision-making by teachers were essential to the development of full inclusion. Full Inclusion of learning disabilities students in regular education classes was possible because of the philosophical commitment of the principal and teachers and their thoughtful dedication to the task

DNN approach to speaker diarisation using speaker channels

Speaker diarisation addresses the question of 'who speaks when' in audio recordings, and has been studied extensively in the context of tasks such as broadcast news, meetings, etc. Performing diarisation on individual headset microphone (IHM) channels is sometimes assumed to easily give the desired output of speaker labelled segments with timing information. However, it is shown that given imperfect data, such as speaker channels with heavy crosstalk and overlapping speech, this is not the case. Deep neural networks (DNNs) can be trained on features derived from the concatenation of speaker channel features to detect which is the correct channel for each frame. Crosstalk features can be calculated and DNNs trained with or without overlapping speech to combat problematic data. A simple frame decision metric of counting occurrences is investigated as well as adding a bias against selecting nonspeech for a frame. Finally, two different scoring setups are applied to both datasets. The stricter SHEF setup finds diarisation error rates (DER) of 9.2% on TBL and 23.2% on RT07 while the NIST setup achieves 5.7% and 15.1% respectively

DNN-based speaker clustering for speaker diarisation

Speaker diarisation, the task of answering "who spoke when?", is often considered to consist of three independent stages: speech activity detection, speaker segmentation and speaker clustering. These represent the separation of speech and nonspeech, the splitting into speaker homogeneous speech segments, followed by grouping together those which belong to the same speaker. This paper is concerned with speaker clustering, which is typically performed by bottom-up clustering using the Bayesian information criterion (BIC). We present a novel semi-supervised method of speaker clustering based on a deep neural network (DNN) model. A speaker separation DNN trained on independent data is used to iteratively relabel the test data set. This is achieved by reconfiguration of the output layer, combined with fine tuning in each iteration. A stopping criterion involving posteriors as confidence scores is investigated. Results are shown on a meeting task (RT07) for single distant microphones and compared with standard diarisation approaches. The new method achieves a diarisation error rate (DER) of 14.8%, compared to a baseline of 19.9%

The abelianization of the Johnson kernel

We prove that the first complex homology of the Johnson subgroup of the Torelli group Tg is a non-trivial, unipotent Tg-module for all g ≥ 4 and give an explicit presentation of it as a Sym H 1(Tg,C)-module when g ≥ 6. We do this by proving that, for a finitely generated group G satisfying an assumption close to formality, the triviality of the restricted characteristic variety implies that the first homology of its Johnson kernel is a nilpotent module over the corresponding Laurent polynomial ring, isomorphic to the infinitesimal Alexander invariant of the associated graded Lie algebra of G. In this setup, we also obtain a precise nilpotence test. © European Mathematical Society 2014

Evidence-based planning and costing palliative care services for children : novel multi-method epidemiological and economic exemplar

Background: Children’s palliative care is a relatively new clinical specialty. Its nature is multi-dimensional and its delivery necessarily multi-professional. Numerous diverse public and not-for-profit organisations typically provide services and support. Because services are not centrally coordinated, they are provided in a manner that is inconsistent and incoherent. Since the first children’s hospice opened in 1982, the epidemiology of life-limiting conditions has changed with more children living longer, and many requiring transfer to adult services. Very little is known about the number of children living within any given geographical locality, costs of care, or experiences of children with ongoing palliative care needs and their families. We integrated evidence, and undertook and used novel methodological epidemiological work to develop the first evidence-based and costed commissioning exemplar. Methods: Multi-method epidemiological and economic exemplar from a health and not-for-profit organisation perspective, to estimate numbers of children under 19 years with life-limiting conditions, cost current services, determine child/parent care preferences, and cost choice of end-of-life care at home. Results: The exemplar locality (North Wales) had important gaps in service provision and the clinical network. The estimated annual total cost of current children’s palliative care was about £5.5 million; average annual care cost per child was £22,771 using 2007 prevalence estimates and £2,437- £11,045 using new 2012/13 population-based prevalence estimates. Using population-based prevalence, we estimate 2271 children with a life-limiting condition in the general exemplar population and around 501 children per year with ongoing palliative care needs in contact with hospital services. Around 24 children with a wide range of life-limiting conditions require end-of-life care per year. Choice of end-of-life care at home was requested, which is not currently universally available. We estimated a minimum (based on 1 week of end-of-life care) additional cost of £336,000 per year to provide end-of-life support at home. Were end-of-life care to span 4 weeks, the total annual additional costs increases to £536,500 (2010/11 prices). Conclusions: Findings make a significant contribution to population-based needs assessment and commissioning methodology in children’s palliative care. Further work is needed to determine with greater precision which children in the total population require access to services and when. Half of children who died 2002-7 did not have conditions that met the globally used children's palliative care condition categories, which need revision in light of findings

Spatial patterns in timing of the diurnal temperature cycle

This paper investigates the structural difference in timing of the diurnal temperature cycle (DTC) over land resulting from choice of measuring device or model framework. It is shown that the timing can be reliably estimated from temporally sparse observations acquired from a constellation of low Earth-orbiting satellites given record lengths of at least three months. Based on a year of data, the spatial patterns of mean DTC timing are compared between temperature estimates from microwave Ka-band, geostationary thermal infrared (TIR), and numerical weather prediction model output from the Global Modeling and Assimilation Office (GMAO). It is found that the spatial patterns can be explained by vegetation effects, sensing depth differences and more speculatively the orientation of orographic relief features. In absolute terms, the GMAO model puts the peak of the DTC on average at 12:50 local solar time, 23 min before TIR with a peak temperature at 13:13 (both averaged over Africa and Europe). Since TIR is the shallowest observation of the land surface, this small difference represents a structural error that possibly affects the model's ability to assimilate observations that are closely tied to the DTC. The equivalent average timing for Ka-band is 13:44, which is influenced by the effect of increased sensing depth in desert areas. For non-desert areas, the Ka-band observations lag the TIR observations by only 15 min, which is in agreement with their respective theoretical sensing depth. The results of this comparison provide insights into the structural differences between temperature measurements and models, and can be used as a first step to account for these differences in a coherent way

Siblings of children with life-limiting conditions: psychological adjustment and sibling relationships

BACKGROUND: This study explored psychological adjustment and sibling relationships of siblings of children with life‐limiting conditions (LLCs), expanding on previous research by defining LLCs using a systematic classification of these conditions. METHODS: Thirty‐nine siblings participated, aged 3–16 years. Parents completed measures of siblings' emotional and behavioural difficulties, quality of life, sibling relationships and impact on families and siblings. Sibling and family adjustment and relationships were compared with population norms, where available, and to a matched comparison group of siblings of children with autistic spectrum disorder (ASD), as a comparable ‘high risk’ group. RESULTS: LLC siblings presented significantly higher levels of emotional and behavioural difficulties, and lower quality of life than population norms. Their difficulties were at levels comparable to siblings of children with ASD. A wider impact on the family was confirmed. Family socio‐economic position, time since diagnosis, employment and accessing hospice care were factors associated with better psychological adjustment. CONCLUSIONS: Using a systematic classification of LLCs, the study supported earlier findings of increased levels of psychological difficulties in siblings of children with a LLC. The evidence is (i) highlighting the need to provide support to these siblings and their families, and (ii) that intervention approaches could be drawn from the ASD field