29 research outputs found
Re-Focusing - Building a Future for Entrepreneurial Education & Learning
The field of entrepreneurship has struggled with fundamental
questions concerning the subject’s nature and purpose. To whom and to
what means are educational and training agendas ultimately directed?
Such questions have become of central importance to policy makers,
practitioners and academics alike. There are suggestions that university
business schools should engage more critically with the lived experiences
of practising entrepreneurs through alternative pedagogical approaches
and methods, seeking to account for and highlighting the social, political
and moral aspects of entrepreneurial practice. In the UK, where funding in
higher education has become increasingly dependent on student fees,
there are renewed pressures to educate students for entrepreneurial
practice as opposed to educating them about the nature and effects of
entrepreneurship. Government and EU policies are calling on business
schools to develop and enhance entrepreneurial growth and skill sets, to
make their education and training programmes more proactive in
providing innovative educational practices which help and facilitate life
experiences and experiential learning. This paper makes the case for
critical frameworks to be applied so that complex social processes
become a source of learning for educators and entrepreneurs and so that
innovative pedagogical approaches can be developed in terms both of
context (curriculum design) and process (delivery methods)
The Cholecystectomy As A Day Case (CAAD) Score: A Validated Score of Preoperative Predictors of Successful Day-Case Cholecystectomy Using the CholeS Data Set
Background
Day-case surgery is associated with significant patient and cost benefits. However, only 43% of cholecystectomy patients are discharged home the same day. One hypothesis is day-case cholecystectomy rates, defined as patients discharged the same day as their operation, may be improved by better assessment of patients using standard preoperative variables.
Methods
Data were extracted from a prospectively collected data set of cholecystectomy patients from 166 UK and Irish hospitals (CholeS). Cholecystectomies performed as elective procedures were divided into main (75%) and validation (25%) data sets. Preoperative predictors were identified, and a risk score of failed day case was devised using multivariate logistic regression. Receiver operating curve analysis was used to validate the score in the validation data set.
Results
Of the 7426 elective cholecystectomies performed, 49% of these were discharged home the same day. Same-day discharge following cholecystectomy was less likely with older patients (OR 0.18, 95% CI 0.15–0.23), higher ASA scores (OR 0.19, 95% CI 0.15–0.23), complicated cholelithiasis (OR 0.38, 95% CI 0.31 to 0.48), male gender (OR 0.66, 95% CI 0.58–0.74), previous acute gallstone-related admissions (OR 0.54, 95% CI 0.48–0.60) and preoperative endoscopic intervention (OR 0.40, 95% CI 0.34–0.47). The CAAD score was developed using these variables. When applied to the validation subgroup, a CAAD score of ≤5 was associated with 80.8% successful day-case cholecystectomy compared with 19.2% associated with a CAAD score >5 (p < 0.001).
Conclusions
The CAAD score which utilises data readily available from clinic letters and electronic sources can predict same-day discharges following cholecystectomy
SARS-CoV-2-specific nasal IgA wanes 9 months after hospitalisation with COVID-19 and is not induced by subsequent vaccination
BACKGROUND: Most studies of immunity to SARS-CoV-2 focus on circulating antibody, giving limited insights into mucosal defences that prevent viral replication and onward transmission. We studied nasal and plasma antibody responses one year after hospitalisation for COVID-19, including a period when SARS-CoV-2 vaccination was introduced. METHODS: In this follow up study, plasma and nasosorption samples were prospectively collected from 446 adults hospitalised for COVID-19 between February 2020 and March 2021 via the ISARIC4C and PHOSP-COVID consortia. IgA and IgG responses to NP and S of ancestral SARS-CoV-2, Delta and Omicron (BA.1) variants were measured by electrochemiluminescence and compared with plasma neutralisation data. FINDINGS: Strong and consistent nasal anti-NP and anti-S IgA responses were demonstrated, which remained elevated for nine months (p < 0.0001). Nasal and plasma anti-S IgG remained elevated for at least 12 months (p < 0.0001) with plasma neutralising titres that were raised against all variants compared to controls (p < 0.0001). Of 323 with complete data, 307 were vaccinated between 6 and 12 months; coinciding with rises in nasal and plasma IgA and IgG anti-S titres for all SARS-CoV-2 variants, although the change in nasal IgA was minimal (1.46-fold change after 10 months, p = 0.011) and the median remained below the positive threshold determined by pre-pandemic controls. Samples 12 months after admission showed no association between nasal IgA and plasma IgG anti-S responses (R = 0.05, p = 0.18), indicating that nasal IgA responses are distinct from those in plasma and minimally boosted by vaccination. INTERPRETATION: The decline in nasal IgA responses 9 months after infection and minimal impact of subsequent vaccination may explain the lack of long-lasting nasal defence against reinfection and the limited effects of vaccination on transmission. These findings highlight the need to develop vaccines that enhance nasal immunity. FUNDING: This study has been supported by ISARIC4C and PHOSP-COVID consortia. ISARIC4C is supported by grants from the National Institute for Health and Care Research and the Medical Research Council. Liverpool Experimental Cancer Medicine Centre provided infrastructure support for this research. The PHOSP-COVD study is jointly funded by UK Research and Innovation and National Institute of Health and Care Research. The funders were not involved in the study design, interpretation of data or the writing of this manuscript
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COHERENT AND INCOHERENT PROCESSES IN PROJECTILE FRAGMENTATION
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MOLECULAR RESONANCES AND THE PRODUCTION OF FAST auPARTICLES IN THE REACTION OF 160 WITH 12,13C NUCLEI
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MOLECULAR RESONANCES AND THE PRODUCTION OF FAST auPARTICLES IN THE REACTION OF 160 WITH 12,13C NUCLEI
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MOLECULAR RESONANCES AND THE PRODUCTION OF FAST auPARTICLES IN THE REACTION OF 160 WITH 12,13C NUCLEI
A search was made for a resonant, final-state interaction between carbon ions produced in the reactions {sup 12}C + {sup 16}O {yields} a + {sup 12}C + {sup 12}C and {sup 13}C + {sup 16}O {yields} {alpha} + {sup 12}C + {sup 13}C at E{sub lab} = 140 MeV. However, the {alpha}-{sup 12}C coincidence spectra for both {sup 12}C and {sup 13}C targets were instead found to be dominated by the excitation and subsequent {alpha} decay of states in the projectile