897 research outputs found

    Evaluating an online support package delivered within a disability unemployment service: study protocol for a randomised controlled feasibility study

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    Background Mental health problems such as anxiety and depression are known to be higher in those who are unemployed. Cognitive behavioural therapy (CBT) is a recognised support for people with such problems and can improve the ability of people to get back to work.<p></p> Methods/design Participants with symptoms of low mood will be recruited from the disability employment service, Remploy. Participants will receive either immediate or delayed access to an online CBT-based life skills intervention, the “Living Life” package. The primary end point will be at 3 months when the delayed group will be offered the intervention. This feasibility study will test the trial design and assess recruitment, retention, acceptability and adherence, as well as providing efficacy data.<p></p> Discussion The study will inform the design and sample size for a future full randomised controlled trial (RCT) which will be carried out to determine the effectiveness of the online package in improving mood and employment status.<p></p&gt

    A randomized trial of deferred stenting versus immediate stenting to prevent no- or slow-reflow in acute ST-segment elevation myocardial infarction (DEFER-STEMI)

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    Objectives: The aim of this study was to assess whether deferred stenting might reduce no-reflow and salvage myocardium in primary percutaneous coronary intervention (PCI) for ST-segment elevation myocardial infarction (STEMI). Background: No-reflow is associated with adverse outcomes in STEMI. Methods: This was a prospective, single-center, randomized, controlled, proof-of-concept trial in reperfused STEMI patients with ≄1 risk factors for no-reflow. Randomization was to deferred stenting with an intention-to-stent 4 to 16 h later or conventional treatment with immediate stenting. The primary outcome was the incidence of no-/slow-reflow (Thrombolysis In Myocardial Infarction ≀2). Cardiac magnetic resonance imaging was performed 2 days and 6 months after myocardial infarction. Myocardial salvage was the final infarct size indexed to the initial area at risk. Results: Of 411 STEMI patients (March 11, 2012 to November 21, 2012), 101 patients (mean age, 60 years; 69% male) were randomized (52 to the deferred stenting group, 49 to the immediate stenting). The median (interquartile range [IQR]) time to the second procedure in the deferred stenting group was 9 h (IQR: 6 to 12 h). Fewer patients in the deferred stenting group had no-/slow-reflow (14 [29%] vs. 3 [6%]; p = 0.006), no reflow (7 [14%] vs. 1 [2%]; p = 0.052) and intraprocedural thrombotic events (16 [33%] vs. 5 [10%]; p = 0.010). Thrombolysis In Myocardial Infarction coronary flow grades at the end of PCI were higher in the deferred stenting group (p = 0.018). Recurrent STEMI occurred in 2 patients in the deferred stenting group before the second procedure. Myocardial salvage index at 6 months was greater in the deferred stenting group (68 [IQR: 54% to 82%] vs. 56 [IQR: 31% to 72%]; p = 0.031]. Conclusions: In high-risk STEMI patients, deferred stenting in primary PCI reduced no-reflow and increased myocardial salvage

    A single nucleotide mutation in Nppc is associated with a long bone abnormality in lbab mice

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    BACKGROUND: The long bone abnormality (lbab) mouse is a new autosomal recessive mutant characterized by overall smaller body size with proportionate dwarfing of all organs and shorter long bones. Previous linkage analysis has located the lbab mutation on chromosome 1 between the markers D1Mit9 and D1Mit488. RESULTS: A genome-based positional approach was used to identify a mutation associated with lbab disease. A total of 122 genes and expressed sequence tags at the lbab region were screened for possible mutation by using genomic DNA from lbabl/lbab, lbab/+, and +/+ B6 mice and high throughput temperature gradient capillary electrophoresis. A sequence difference was identified in one of the amplicons of gene Nppc between lbab/lbab and +/+ mice. One-step reverse transcriptase polymerase chain reaction was performed to validate the difference of Nppc in different types of mice at the mRNA level. The mutation of Nppc was unique in lbab/lbab mice among multiple mouse inbred strains. The mutation of Nppc is co-segregated with lbab disease in 200 progenies produced from heterozygous lbab/+ parents. CONCLUSION: A single nucleotide mutation of Nppc is associated with dwarfism in lbab/lbab mice. Current genome information and technology allow us to efficiently identify single nucleotide mutations from roughly mapped disease loci. The lbab mouse is a useful model for hereditary human achondroplasia

    Examples of the Impact of Collaboration in Creative and Technological Practices

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    Over recent years, the creative industries have continued to flourish, especially in the UK, where its economic growth and impact has bucked trends of national decline. One of the most identifiable characteristics of the creative industries is the range and diversity of people who work in the field. As such, it includes employees from many disciplines working in collaboration to achieve organizational goals. It is this creative collaboration, with a rich level of technological support in the background, which is the focus of discussion. This article describes an analysis of collaborative practices, followed by the formation of a model that attempts to capture and explain the relationship between the key features. This model is then applied as a lens to a small case study of 63 technology–related employees' perceptions of their employer in three successful companies who were in the top 5 of the 2017 Fortune 500 list, with the intention of determining how well their experiences map to the model. It was found that the six characteristics of the model were evident in each of the three organizations studied, but that one feature, organizational support, seemed to be more prevalent than the others. Consideration, via a second case study, is then given to creative multidisciplinary work, specifically in the field of crowd–accelerated development and the factors that surround it, leading us to devise a set of recommendations as to how future successful creative collaborations might be assessed and valued, along with a discussion of questions that have been identified for additional research and exploration. This is an extended version of a paper published at the Cyberworlds 2015 international conference

    Atom-economic access to cationic magnesium complexes

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    Cationic alkaline-earth complexes attract interest for their enhanced Lewis acidity and reactivity compared with their neutral counterparts. Synthetic protocols to these complexes generally utilize expensive specialized reagents in reactions generating multiple by-products. We have studied a simple ligand transfer approach to these complexes using (NacNac)MgR and ER3 (NacNac = ÎČ-diketiminate anion; E = group 13 element; R = aryl/amido anion) which demonstrates high atom economy, opening up the ability to target these species in a more sustainable manner. The success of this methodology is dependent on the identity of the group 13 element with the heavier elements facilitating faster ligand exchange. Furthermore, while this reaction is successful with aromatic ligands such as phenyl and pyrrolyl, the secondary amide piperidide (pip) fails to transfer, which we attribute to the stronger 3-centre-4-electron dimerization interaction of Al2(pip)6

    Digital Silicon Photomultipliers with OR/XOR Pulse Combining Techniques

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    A recently proposed XOR-based digital silicon photomultiplier (dSiPM) is compared against the OR-based counterpart. We show experimental data from a set of single-photon avalanche diode (SPAD) pixel arrays in 130-nm CMOS process with selectable OR tree and XOR tree for direct comparison. We demonstrate how XOR-based dSiPMs solve the limitation caused by monostable circuits and reach higher maximum count rates compared with optimized OR-based dSiPMs. The increased throughput of the SPAD array allows higher sampling rates for the digitization of the light signal enhancing dynamic range and linearity

    Analysis of Photon Detection Efficiency and Dynamic Range in SPAD based Visible Light Receivers

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    We investigate the photon detection efficiency (PDE) and the dynamic range for digital silicon photomultipliers (dSiPMs) over a selection of design parameters: dSiPM unit cell dead time, PDE, unit cell area and fill factor, number of cells, and total dSiPM active area. Two receiver scaling scenarios are con-sidered: varying the number of cells for 1) a fixed unit cell area or 2) a fixed total dSiPM area. Theoretical and simulated results are confirmed with experimental data from a selection of dSiPMs realised on a test chip in130-nm CMOS process

    A Simulation Model for Digital Silicon Photomultipliers

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    We propose a simulator model to estimate the performance of digital Silicon Photomultipliers (dSiPM) based on Single Photon Avalanche Diodes (SPADs) in terms of detection rate of photons incident on the sensor. The work provides guidelines for efficient array structure depending on: the number of SPADs, fill factor, area of both SPADs and array. A comparison of the main techniques present in the literature to digitally combine multiple outputs into single channel is included with simulated results showing promising higher detection rates for XOR-based dSiPMs. Mathematical expressions are derived to estimate dSiPM parameters such as maximum detection rate and detector dead time as functions of the mentioned design parameters

    Looking after bubba for all our mob: Aboriginal and Torres Strait Islander community experiences and perceptions of stillbirth

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    The stillbirth rate among Aboriginal and Torres Strait Islander women and communities in Australia is around double that of non-Indigenous women. While the development of effective prevention strategies during pregnancy and improving care following stillbirth for women and families in communities has become a national priority, there has been limited progress in stillbirth disparities. With community permission, this study aimed to gain a better understanding of community experiences, perceptions, and priorities around stillbirth. We undertook an Indigenous researcher-led, qualitative study, with community consultations guided by a cultural protection protocol and within an unstructured research framework. A total of 18 communities were consulted face-to-face through yarning interviews, focus groups and workshops. This included 54 community member and 159 health professional participants across remote, regional, and urban areas of Queensland, Western Australia, Victoria, South Australia, and Northern Territory. Thematic analysis of consultation data identified common themes across five focus/priority areas to address stillbirth: Stillbirth or Sorry Business Baby care needs to be family-centered; using Indigenous “ways of knowing, being, and doing” to ensure cultural safety; application of Birthing on Country principles to maternal and perinatal care; and yarning approaches to improve communication and learning or education. The results underscore the critical need to co-design evidence-based, culturally appropriate, and community-acceptable resources to help reduce existing disparities in stillbirth rates
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