202 research outputs found
On the front line: integrated habitat mapping for olive ridley sea turtles in the southeast Atlantic
notes:types: JOURThis study demonstrates that it is imperative that marine conservation policy recognizes the spatial extent of highly migratory species with expansive ranges. It also highlights that deficiencies exist in current knowledge of bycatch, both in gear specificity and in catch per unit effort. With integration of vessel monitoring system (VMS) data and those on fisheries catch, knowledge and understanding of bycatch may be improved, and this will ultimately facilitate development of appropriate management strategies and long-term sustainability of fisheries and their supporting ecosystems
A Preliminary Study on Robot-Assisted Ankle Rehabilitation for the Treatment of Drop Foot
This paper involves the use of a compliant ankle rehabilitation robot (CARR) for the treatment of drop foot. The robot has a bio-inspired design by employing four Festo Fluidic muscles (FFMs) that mimic skeletal muscles actuating three rotational degrees of freedom (DOFs). A trajectory tracking controller was developed in joint task space to track the predefined trajectory of the end effector. This controller was achieved by controlling individual FFM length based on inverse kinematics. Three patients with drop foot participated in a preliminary study to evaluate the potential of the CARR for clinical applications. Ankle stretching exercises along ankle dorsiflexion and plantarflexion (DP) were delivered for treating drop foot. All patients gave positive feedback in using this ankle robot for the treatment of drop foot, although some limitations exist. The proposed controller showed satisfactory accuracy in trajectory tracking, with all root mean square deviation (RMSD) values no greater than 0.0335 rad and normalized root mean square deviation (NRMSD) values less than 6.7%. These preliminary findings support the potentials of the CARR for clinical applications. Future work will investigate the effectiveness of the robot for treating drop foot on a large sample of subjects
Understanding the effects of a decentralized budget on physicians' compliance with guidelines for statin prescription – a multilevel methodological approach
<p>Abstract</p> <p>Background</p> <p>Official guidelines that promote evidence-based and cost-effective prescribing are of main relevance for obvious reasons. However, to what extent these guidelines are followed and their conditioning factors at different levels of the health care system are still insufficiently known.</p> <p>In January 2004, a decentralized drug budget was implemented in the county of Scania, Sweden. Focusing on lipid-lowering drugs (i.e., statins), we evaluated the effect of this intervention across a 25-month period. We expected that increased local economic responsibility would promote prescribing of recommended statins.</p> <p>Methods</p> <p>We performed two separate multilevel regression analyses; on 110 827 individual prescriptions issued at 136 <it>publicly</it>-administered health care centres (HCCs) nested within 14 administrative areas (HCAs), and on 72 012 individual prescriptions issued by 115 <it>privately</it>-administered HCCs. Temporal trends in the prevalence of prescription of recommended statins were investigated by random slope analysis. Differences (i.e., variance) between HCCs and between HCAs were expressed by median odds ratio (MOR).</p> <p>Results</p> <p>After the implementation of the decentralized drug budget, adherence to guidelines increased continuously. At the end of the observation period, however, practice variation remained high. Prescription of recommended statins presented a high degree of clustering within both publicly (i.e., MOR<sub>HCC </sub>= 2.18 and MOR<sub>HCA </sub>= 1.31 respectively) and privately administered facilities (MOR<sub>HCC </sub>= 3.47).</p> <p>Conclusion</p> <p>A decentralized drug budget seems to promote adherence to guidelines for statin prescription. However, the high practice differences at the end of the observation period may reflect inefficient therapeutic traditions, and indicates that rational statin prescription could be further improved.</p
Does home oxygen therapy (HOT) in addition to standard care reduce disease severity and improve symptoms in people with chronic heart failure? A randomised trial of home oxygen therapy for patients with chronic heart failure
Background: Home oxygen therapy (HOT) is commonly used for patients with severe chronic heart failure(CHF) who have intractable breathlessness. There is no trial evidence to support its use.Objectives: To detect whether or not there was a quality-of-life benefit from HOT given as long-termoxygen therapy (LTOT) for at least 15 hours per day in the home, including overnight hours, comparedwith best medical therapy (BMT) in patients with severely symptomatic CHF.Design: A pragmatic, two-arm, randomised controlled trial recruiting patients with severe CHF. It includeda linked qualitative substudy to assess the views of patients using home oxygen, and a free-standingsubstudy to assess the haemodynamic effects of acute oxygen administration.Setting: Heart failure outpatient clinics in hospital or the community, in a range of urban andrural settings.Participants: Patients had to have heart failure from any aetiology, New York Heart Association (NYHA)class III/IV symptoms, at least moderate left ventricular systolic dysfunction, and be receiving maximallytolerated medical management. Patients were excluded if they had had a cardiac resynchronisation therapydevice implanted within the past 3 months, chronic obstructive pulmonary disease fulfilling the criteria forLTOT or malignant disease that would impair survival or were using a device or medication that wouldimpede their ability to use LTOT.Interventions: Patients received BMT and were randomised (unblinded) to open-label LTOT, prescribed for15 hours per day including overnight hours, or no oxygen therapy.Main outcome measures: The primary end point was quality of life as measured by the Minnesota Livingwith Heart Failure (MLwHF) questionnaire score at 6 months. Secondary outcomes included assessing theeffect of LTOT on patient symptoms and disease severity, and assessing its acceptability to patientsand carers.Results: Between April 2012 and February 2014, 114 patients were randomised to receive either LTOT orBMT. The mean age was 72.3 years [standard deviation (SD) 11.3 years] and 70% were male. Ischaemicheart disease was the cause of heart failure in 84%; 95% were in NYHA class III; the mean left ventricularejection fraction was 27.8%; and the median N-terminal pro-B-type natriuretic hormone was 2203 ng/l.The primary analysis used a covariance pattern mixed model which included patients only if they provided datafor all baseline covariates adjusted for in the model and outcome data for at least one post-randomisationtime point (n = 102: intervention, n = 51; control, n = 51). There was no difference in the MLwHF questionnairescore at 6 months between the two arms [at baseline the mean score was 54.0 (SD 18.4) for LTOT and54.0 (SD 17.9) for BMT; at 6 months the mean score was 48.1 (SD 18.5) for LTOT and 49.0 (SD 20.2) forBMT; adjusted mean difference –0.10, 95% confidence interval (CI) –6.88 to 6.69; p = 0.98]. At 3 months,the adjusted mean MLwHF questionnaire score was lower in the LTOT group (–5.47, 95% CI –10.54 to–0.41; p = 0.03) and breathlessness scores improved, although the effect did not persist to 6 months.There was no effect of LTOT on any secondary measure. There was a greater number of deaths in the BMTarm (n = 12 vs. n = 6). Adherence was poor, with only 11% of patients reporting using the oxygenas prescribed.Conclusions: Although the study was significantly underpowered, HOT prescribed for 15 hours per dayand subsequently used for a mean of 5.4 hours per day has no impact on quality of life as measured bythe MLwHF questionnaire score at 6 months. Suggestions for future research include (1) a trial of patientswith severe heart failure randomised to have emergency oxygen supply in the house, supplied by cylindersrather than an oxygen concentrator, powered to detect a reduction in admissions to hospital, and (2) astudy of bed-bound patients with heart failure who are in the last few weeks of life, powered to detectchanges in symptom severity.Trial registration: Current Controlled Trials ISRCTN60260702.Funding: This project was funded by the NIHR Health Technology Assessment programme and will bepublished in full in Health Technology Assessment; Vol. 19, No. 75. See the NIHR Journals Library websitefor further project information
Scientific publishing and the reading of science in nineteenth-century Britain: a historiographical survey and guide to sources
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It is now generally accepted that both the conception and practices of natural enquiry in the Western tradition underwent a series of profound developments in the late eighteenth and early nineteenth century—developments which have been variously characterized as a ‘second scientific revolution’ and, much more tellingly, as the ‘invention of science’. As several authors have argued, moreover, a crucial aspect of this change consisted in the distinctive audience relations of the new sciences. While eighteenth-century natural philosophy was distinguished by an audience relation in which, as William Whewell put it, ‘a large and popular circle of spectators and amateurs [felt] themselves nearly upon a level, in the value of their trials and speculations, with more profound thinkers’, the science which was invented in the late eighteenth and early nineteenth century was, as Simon Schaffer has argued, marked by the ‘emergence of disciplined, trained cadres of research scientists’ clearly distinguished from a wider, exoteric public. Similarly, Jan Golinski argues that the ‘emergence of new instrumentation and a more consolidated social structure for the specialist community’ for early nineteenth-century chemistry was intimately connected with the transformation in the role of its public audience to a condition of relative passivity. These moves were underpinned by crucial epistemological and rhetorical shifts—from a logic of discovery, theoretically open to all, to a more restrictive notion of discovery as the preserve of scientific ‘genius’, and from an open-ended philosophy of ‘experience’ to a far more restrictive notion of disciplined ‘expertise’. Both of these moves were intended to do boundary work, restricting the community active in creating and validating scientific knowledge, and producing a passive public
Large expert-curated database for benchmarking document similarity detection in biomedical literature search
Document recommendation systems for locating relevant literature have mostly relied on methods developed a decade ago. This is largely due to the lack of a large offline gold-standard benchmark of relevant documents that cover a variety of research fields such that newly developed literature search techniques can be compared, improved and translated into practice. To overcome this bottleneck, we have established the RElevant LIterature SearcH consortium consisting of more than 1500 scientists from 84 countries, who have collectively annotated the relevance of over 180 000 PubMed-listed articles with regard to their respective seed (input) article/s. The majority of annotations were contributed by highly experienced, original authors of the seed articles. The collected data cover 76% of all unique PubMed Medical Subject Headings descriptors. No systematic biases were observed across different experience levels, research fields or time spent on annotations. More importantly, annotations of the same document pairs contributed by different scientists were highly concordant. We further show that the three representative baseline methods used to generate recommended articles for evaluation (Okapi Best Matching 25, Term Frequency–Inverse Document Frequency and PubMed Related Articles) had similar overall performances. Additionally, we found that these methods each tend to produce distinct collections of recommended articles, suggesting that a hybrid method may be required to completely capture all relevant articles. The established database server located at https://relishdb.ict.griffith.edu.au is freely available for the downloading of annotation data and the blind testing of new methods. We expect that this benchmark will be useful for stimulating the development of new powerful techniques for title and title/abstract-based search engines for relevant articles in biomedical research
A novel formulation of inhaled sodium cromoglicate (PA101) in idiopathic pulmonary fibrosis and chronic cough: a randomised, double-blind, proof-of-concept, phase 2 trial
Background Cough can be a debilitating symptom of idiopathic pulmonary fibrosis (IPF) and is difficult to treat. PA101 is a novel formulation of sodium cromoglicate delivered via a high-efficiency eFlow nebuliser that achieves significantly higher drug deposition in the lung compared with the existing formulations. We aimed to test the efficacy and safety of inhaled PA101 in patients with IPF and chronic cough and, to explore the antitussive mechanism of PA101, patients with chronic idiopathic cough (CIC) were also studied. Methods This pilot, proof-of-concept study consisted of a randomised, double-blind, placebo-controlled trial in patients with IPF and chronic cough and a parallel study of similar design in patients with CIC. Participants with IPF and chronic cough recruited from seven centres in the UK and the Netherlands were randomly assigned (1:1, using a computer-generated randomisation schedule) by site staff to receive PA101 (40 mg) or matching placebo three times a day via oral inhalation for 2 weeks, followed by a 2 week washout, and then crossed over to the other arm. Study participants, investigators, study staff, and the sponsor were masked to group assignment until all participants had completed the study. The primary efficacy endpoint was change from baseline in objective daytime cough frequency (from 24 h acoustic recording, Leicester Cough Monitor). The primary efficacy analysis included all participants who received at least one dose of study drug and had at least one post-baseline efficacy measurement. Safety analysis included all those who took at least one dose of study drug. In the second cohort, participants with CIC were randomly assigned in a study across four centres with similar design and endpoints. The study was registered with ClinicalTrials.gov (NCT02412020) and the EU Clinical Trials Register (EudraCT Number 2014-004025-40) and both cohorts are closed to new participants. Findings Between Feb 13, 2015, and Feb 2, 2016, 24 participants with IPF were randomly assigned to treatment groups. 28 participants with CIC were enrolled during the same period and 27 received study treatment. In patients with IPF, PA101 reduced daytime cough frequency by 31·1% at day 14 compared with placebo; daytime cough frequency decreased from a mean 55 (SD 55) coughs per h at baseline to 39 (29) coughs per h at day 14 following treatment with PA101, versus 51 (37) coughs per h at baseline to 52 (40) cough per h following placebo treatment (ratio of least-squares [LS] means 0·67, 95% CI 0·48–0·94, p=0·0241). By contrast, no treatment benefit for PA101 was observed in the CIC cohort; mean reduction of daytime cough frequency at day 14 for PA101 adjusted for placebo was 6·2% (ratio of LS means 1·27, 0·78–2·06, p=0·31). PA101 was well tolerated in both cohorts. The incidence of adverse events was similar between PA101 and placebo treatments, most adverse events were mild in severity, and no severe adverse events or serious adverse events were reported. Interpretation This study suggests that the mechanism of cough in IPF might be disease specific. Inhaled PA101 could be a treatment option for chronic cough in patients with IPF and warrants further investigation
Determinants of recovery from post-COVID-19 dyspnoea: analysis of UK prospective cohorts of hospitalised COVID-19 patients and community-based controls
Background The risk factors for recovery from COVID-19 dyspnoea are poorly understood. We investigated determinants of recovery from dyspnoea in adults with COVID-19 and compared these to determinants of recovery from non-COVID-19 dyspnoea. Methods We used data from two prospective cohort studies: PHOSP-COVID (patients hospitalised between March 2020 and April 2021 with COVID-19) and COVIDENCE UK (community cohort studied over the same time period). PHOSP-COVID data were collected during hospitalisation and at 5-month and 1-year follow-up visits. COVIDENCE UK data were obtained through baseline and monthly online questionnaires. Dyspnoea was measured in both cohorts with the Medical Research Council Dyspnoea Scale. We used multivariable logistic regression to identify determinants associated with a reduction in dyspnoea between 5-month and 1-year follow-up. Findings We included 990 PHOSP-COVID and 3309 COVIDENCE UK participants. We observed higher odds of improvement between 5-month and 1-year follow-up among PHOSP-COVID participants who were younger (odds ratio 1.02 per year, 95% CI 1.01–1.03), male (1.54, 1.16–2.04), neither obese nor severely obese (1.82, 1.06–3.13 and 4.19, 2.14–8.19, respectively), had no pre-existing anxiety or depression (1.56, 1.09–2.22) or cardiovascular disease (1.33, 1.00–1.79), and shorter hospital admission (1.01 per day, 1.00–1.02). Similar associations were found in those recovering from non-COVID-19 dyspnoea, excluding age (and length of hospital admission). Interpretation Factors associated with dyspnoea recovery at 1-year post-discharge among patients hospitalised with COVID-19 were similar to those among community controls without COVID-19. Funding PHOSP-COVID is supported by a grant from the MRC-UK Research and Innovation and the Department of Health and Social Care through the National Institute for Health Research (NIHR) rapid response panel to tackle COVID-19. The views expressed in the publication are those of the author(s) and not necessarily those of the National Health Service (NHS), the NIHR or the Department of Health and Social Care. COVIDENCE UK is supported by the UK Research and Innovation, the National Institute for Health Research, and Barts Charity. The views expressed are those of the authors and not necessarily those of the funders
Large expert-curated database for benchmarking document similarity detection in biomedical literature search
Document recommendation systems for locating relevant literature have mostly relied on methods developed a decade ago. This is largely due to the lack of a large offline gold-standard benchmark of relevant documents that cover a variety of research fields such that newly developed literature search techniques can be compared, improved and translated into practice. To overcome this bottleneck, we have established the RElevant LIterature SearcH consortium consisting of more than 1500 scientists from 84 countries, who have collectively annotated the relevance of over 180 000 PubMed-listed articles with regard to their respective seed (input) article/s. The majority of annotations were contributed by highly experienced, original authors of the seed articles. The collected data cover 76% of all unique PubMed Medical Subject Headings descriptors. No systematic biases were observed across different experience levels, research fields or time spent on annotations. More importantly, annotations of the same document pairs contributed by different scientists were highly concordant. We further show that the three representative baseline methods used to generate recommended articles for evaluation (Okapi Best Matching 25, Term Frequency-Inverse Document Frequency and PubMed Related Articles) had similar overall performances. Additionally, we found that these methods each tend to produce distinct collections of recommended articles, suggesting that a hybrid method may be required to completely capture all relevant articles. The established database server located at https://relishdb.ict.griffith.edu.au is freely available for the downloading of annotation data and the blind testing of new methods. We expect that this benchmark will be useful for stimulating the development of new powerful techniques for title and title/abstract-based search engines for relevant articles in biomedical research.Peer reviewe
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