361 research outputs found

    Landfast ice controls on turbulence in Antarctic coastal seas

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    Knowledge of the ocean surface layer beneath Antarctic landfast ice is sparse. In this article surface layer turbulent and fine structure are quantified with and without landfast ice in the same West Antarctic Peninsula location. Landfast ice reduced turbulence levels locally to an order of magnitude less than ice-free values, and near-inertial energy and sub-inertial tidal energy levels to less than half their ice-free values. Vertical turbulent heat and nutrient fluxes were, respectively, 6 and 10 times greater than previously estimated. Under-ice tidal energy dissipation over the entire Antarctic continental shelf due to seasonal landfast ice cover is estimated at 788 MW. The total rate of wind-generated turbulence in the surface ocean is greatly reduced by the presence of seasonal landfast ice to an average of 14% of the ice-free value, but with large sectoral variations. Counter-intuitively, however, tides and wind contribute approximately equally to the turbulent kinetic energy budget of the upper ocean between the Antarctic coastline and the maximal landfast ice extent, with large sectoral variations, attributed to geographic variations in the strength of the barotropic tide

    Extending the diabetic retinopathy screening interval beyond 1 year : systematic review

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    To determine whether the recommended screening interval for diabetic retinopathy (DR) in the UK can safely be extended beyond 1 year. Systematic review of clinical and cost-effectiveness studies. Nine databases were searched with no date restrictions. Randomised controlled trials (RCTs), cohort studies, prognostic or economic modelling studies which described the incidence and progression of DR in populations with type 1 diabetes mellitus or type 2 diabetes mellitus of either sex and of any age reporting incidence and progression of DR in relation to screening interval (vs annual screening interval) and/or prognostic factors were included. Narrative synthesis was undertaken. 14 013 papers were identified, of which 11 observational studies, 5 risk stratification modelling studies and 9 economic studies were included. Data were available for 262 541 patients of whom at least 228 649 (87%) had type 2 diabetes. There were no RCTs. Studies concluded that there is little difference between clinical outcomes from screening 1 yearly or 2 yearly in low-risk patients. However there was high loss to follow-up (13–31%), heterogeneity in definitions of low risk and variation in screening and grading protocols for prior retinopathy results. Observational and economic modelling studies in low-risk patients show little difference in clinical outcomes between 1-year and 2-year screening intervals. The lack of experimental research designs and heterogeneity in definition of low risk considerably limits the reliability and validity of this conclusion. Cost-effectiveness findings were mixed. There is insufficient evidence to recommend a move to extend the screening interval beyond 1 year

    Increased risk of type 3c diabetes mellitus after acute pancreatitis warrants a personalised approach including diabetes screening

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    BACKGROUND: Acute pancreatitis (AP) is a frequent cause of hospitalization with long-term health consequences, including type 3c diabetes mellitus (DM). The incidence and risk factors for new-onset morbidities after AP need to be clarified to inform a personalized medicine approach. METHODS: Using a longitudinal electronic healthcare record-linkage analysis, all patients admitted to hospital in Scotland with a first episode of AP between 1 April 2009 and 31 March 2012 and followed for a minimum of 5 years after their index AP admission were identified. All new-onset morbidity with specific focus on type 3c DM were analysed and, using time-split multiple regression. RESULTS: A total of 2047 patients were included. AP requiring critical care was followed by 2 years of heightened risk (HR 5.24) of developing type 3c DM, increased risk of new-onset cardiac disease (HR 1.61), and renal disease (HR 2.96). The additional risk conferred by critical care AP had a negative interaction with time, whereas additional risk associated with male sex and a non-gallstone aetiology was long lasting. CONCLUSION: Based on these findings, a personalized approach to include type 3c DM screening for a minimum of 2 years for individuals who required critical care when hospitalized with AP is recommended

    Agreement between gastrointestinal panel testing and standard microbiology methods for detecting pathogens in suspected infectious gastroenteritis : test evaluation and meta-analysis in the absence of a reference standard

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    Objective: Multiplex gastrointestinal pathogen panel (GPP) tests simultaneously identify bacterial, viral and parasitic pathogens from the stool samples of patients with suspected infectious gastroenteritis presenting in hospital or the community. We undertook a systematic review to compare the accuracy of GPP tests with standard microbiology techniques. Review methods: Searches in Medline, Embase, Web of Science and the Cochrane library were undertaken from inception to January 2016. Eligible studies compared GPP tests with standard microbiology techniques in patients with suspected gastroenteritis. Quality assessment of included studies used tailored QUADAS-2. In the absence of a reference standard we analysed test performance taking GPP tests and standard microbiology techniques in turn as the benchmark test, using random effects meta-analysis of proportions. Results: No study provided an adequate reference standard with which to compare the test accuracy of GPP and conventional tests. Ten studies informed a meta-analysis of positive and negative agreement. Positive agreement across all pathogens was 0.93 (95% CI 0.90 to 0.96) when conventional methods were the benchmark and 0.68 (95% CI: 0.58 to 0.77) when GPP provided the benchmark. Negative agreement was high in both instances due to the high proportion of negative cases. GPP testing produced a greater number of pathogen-positive findings than conventional testing. It is unclear whether these additional ‘positives’ are clinically important. Conclusions: GPP testing has the potential to simplify testing and accelerate reporting when compared to conventional microbiology methods. However the impact of GPP testing upon the management, treatment and outcome of patients is poorly understood and further studies are needed to evaluate the health economic impact of GPP testing compared with standard methods

    Health facility utilisation changes during the introduction of community case management of malaria in South Western Uganda: An interrupted time series approach.

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    This dataset contains all visits made to health facilities in Bwambara Sub-county, South Western Uganda as part of a cluster randomised trial. The anonymised dataset includes basic demographic details of the visit and the diagnosis made

    How do pilot and feasibility studies inform randomised placebo-controlled trials in surgery? : A systematic review

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    © Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY. Published by BMJ.Peer reviewedPublisher PD

    Embedding transparency in artificial intelligence machine learning models: managerial implications on predicting and explaining employee turnover

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    Employee turnover (ET) is a major issue faced by firms in all business sectors. Artificial intelligence (AI) machine learning (ML) prediction models can help to classify the likelihood of employees voluntarily departing from employment using historical employee datasets. However, output responses generated by these AI-based ML models lack transparency and interpretability, making it difficult for HR managers to understand the rationale behind the AI predictions. If managers do not understand how and why responses are generated by AI models based on the input datasets, it is unlikely to augment data-driven decision-making and bring value to the organisations. The main purpose of this article is to demonstrate the capability of Local Interpretable Model-Agnostic Explanations (LIME) technique to intuitively explain the ET predictions generated by AI-based ML models for a given employee dataset to HR managers. From a theoretical perspective, we contribute to the International Human Resource Management literature by presenting a conceptual review of AI algorithmic transparency and then discussing its significance to sustain competitive advantage by using the principles of resource-based view theory. We also offer a transparent AI implementation framework using LIME which will provide a useful guide for HR managers to increase the explainability of the AI-based ML models, and therefore mitigate trust issues in data-driven decision-making
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