Uptake of systematic reviews and meta-analyses based on individual participant data in clinical practice guidelines: descriptive study.

To establish the extent to which systematic reviews and meta-analyses of individual participant data (IPD) are being used to inform the recommendations included in published clinical guidelines

Tunnel valleys of the central and northern North Sea (56°N to 62°N): Distribution and characteristics

© 2020 Elsevier B.V. The analysis of buried tunnel valleys in the North Sea can provide information about the past configuration and dynamics of the Scandinavian and British ice sheets and the processes by which sediment and meltwater were transported at the ice-sheet base. However, little is presently known about the distribution and characteristics of tunnel valleys in the Norwegian sector of the North Sea. Here we use an extensive database of 3D seismic and high-resolution magnetic data to map >2200 tunnel valleys in the Norwegian and British sectors of the North Sea between 56°N and 62°N. With the exception of the deep Norwegian Channel, in which evidence for tunnel valleys is absent, the geological setting of the North Sea is interpreted to have been conducive to tunnel-valley formation and preservation because of its poorly consolidated substrate and shallow water depths. The highest density of tunnel valleys is located in the central part of the North Sea where Quaternary sediments are thickest. The extreme length of some of the tunnel valleys, which are up to 155 km long, supports theories that tunnel valleys form in stages rather than catastrophically. Detailed analysis of the orientation of tunnel valleys and their relative age relationships within four representative subareas shows that tunnel-valley orientation varies significantly across the central and northern North Sea and between different generations of valleys. This suggests that the pattern of subglacial meltwater drainage in the central and northern North Sea was different between each deglacial event in which tunnel valleys were formed

Basal melting of Ross Ice Shelf from solar heat absorption in an ice-front polynya

Ice-ocean interactions at the base of Antarctic ice shelves are rarely observed, yet have a profound influence on ice sheet evolution and stability. Ice sheet models are highly sensitive to assumed ice shelf basal melt rates; however, there are few direct observations of basal melting or the oceanographic processes that drive this, and consequently our understanding of these interactions remains limited. Here we use new in-situ observations from the Ross Ice Shelf to examine the oceanographic processes that drive basal ablation of the world’s largest ice shelf. We show that basal melt rates beneath a thin and structurally important part of the shelf are an order of magnitude higher than the shelf-wide average. This melting is strongly influenced by a seasonal inflow of solar-heated surface water from the adjacent Ross Sea Polynya that downwells into the ice shelf cavity, nearly tripling basal melt rates during summer. Melting driven by this frequently overlooked process is expected to increase with predicted surface warming. We infer that solar heat absorbed in ice front polynyas can make an important contribution to the present-day mass balance of ice shelves, and potentially impact their future stability.Rutherford Foundation and Antarctica New Zealan

RADAR-base: Epilepsy Case Study

The traditional hospital set-up is not appropriate for long-term epilepsy seizure detection in naturalistic ambulatory settings. To explore the feasibility of seizure detection in such a setting, an in-hospital study was conducted to evaluate three wearable devices and a data collection platform for ambulatory seizure detection. The platform collects and processes data for study administrators, clinicians and data scientists, who use it to create models to detect seizures. For that purpose, all data collected from the wearable devices is additionally synchronized with the hospital EEG and video, with gold-standard seizure labels provided by trained clinicians. Data collected by wearable devices shows potential for seizure detection in out-of-hospital based and ambulatory settings

Elliptic logarithms, diophantine approximation and the Birch and Swinnerton-Dyer conjecture

Most, if not all, unconditional results towards the abc-conjecture rely ultimately on classical Baker's method. In this article, we turn our attention to its elliptic analogue. Using the elliptic Baker's method, we have recently obtained a new upper bound for the height of the S-integral points on an elliptic curve. This bound depends on some parameters related to the Mordell-Weil group of the curve. We deduce here a bound relying on the conjecture of Birch and Swinnerton-Dyer, involving classical, more manageable quantities. We then study which abc-type inequality over number fields could be derived from this elliptic approach.Comment: 20 pages. Some changes, the most important being on Conjecture 3.2, three references added ([Mas75], [MB90] and [Yu94]) and one reference updated [BS12]. Accepted in Bull. Brazil. Mat. So

Identification and Characterisation of a Novel Pathogenic Mutation in the Human Lipodystrophy Gene AGPAT2 : C48R: A Novel Mutation in AGPAT2.

Loss-of-function mutations in AGPAT2, encoding 1-acylglycerol-3-phosphate-O-acyltransferase 2 (AGPAT2), produce congenital generalised lipodystrophy (CGL). We screened the AGPAT2 gene in two siblings who presented with pseudoacromegaly, diabetes and severe dyslipidaemia and identified a novel mutation in AGPAT2 causing a single amino acid substitution, p.Cys48Arg. We subsequently investigated the molecular pathogenic mechanism linking both this mutation and the previously reported p.Leu228Pro mutation to clinical disease. Wild-type and mutant AGPAT2 were expressed in control and AGPAT2-deficient preadipocyte cell lines. mRNA and protein expression was determined, and the ability of each AGPAT2 species to rescue adipocyte differentiation in AGPAT2-deficient cells was assessed. Protein levels of both p.Cys48Arg and p.Leu228Pro AGPAT2 were significantly reduced compared with that of wild-type AGPAT2 despite equivalent mRNA levels. Stable expression of wild-type AGPAT2 partially rescued adipogenesis in AGPAT2 deficient preadipocytes, whereas stable expression of p.Cys48Arg or p.Leu228Pro AGPAT2 did not. In conclusion, unusually severe dyslipidaemia and pseudoacromegaloid overgrowth in patients with diabetes should alert physicians to the possibility of lipodystrophy. Both the previously unreported pathogenic p.Cys48Arg mutation in AGPAT2, and the known p.Leu228Pro mutation result in decreased AGPAT2 protein expression in developing adipocytes. It is most likely that the CGL seen in homozygous carriers of these mutations is largely accounted for by loss of protein expression

Lower Bounds for Heights in Relative Galois Extensions

The goal of this paper is to obtain lower bounds on the height of an algebraic number in a relative setting, extending previous work of Amoroso and Masser. Specifically, in our first theorem we obtain an effective bound for the height of an algebraic number $\alpha$ when the base field $\mathbb{K}$ is a number field and $\mathbb{K}(\alpha)/\mathbb{K}$ is Galois. Our second result establishes an explicit height bound for any non-zero element $\alpha$ which is not a root of unity in a Galois extension $\mathbb{F}/\mathbb{K}$, depending on the degree of $\mathbb{K}/\mathbb{Q}$ and the number of conjugates of $\alpha$ which are multiplicatively independent over $\mathbb{K}$. As a consequence, we obtain a height bound for such $\alpha$ that is independent of the multiplicative independence condition

Identification of hip fracture patients from radiographs using Fourier analysis of the trabecular structure: a cross-sectional study

Peer reviewedPublisher PD

Comparison of marker types and map assumptions using Markov chain Monte Carlo-based linkage analysis of COGA data

We performed multipoint linkage analysis of the electrophysiological trait ECB21 on chromosome 4 in the full pedigrees provided by the Collaborative Study on the Genetics of Alcoholism (COGA). Three Markov chain Monte Carlo (MCMC)-based approaches were applied to the provided and re-estimated genetic maps and to five different marker panels consisting of microsatellite (STRP) and/or SNP markers at various densities. We found evidence of linkage near the GABRB1 STRP using all methods, maps, and marker panels. Difficulties encountered with SNP panels included convergence problems and demanding computations

Foot health education for people with rheumatoid arthritis : the practitioner's perspective

Background: Patient education is considered to be a key role for podiatrists in the management of patients with rheumatoid arthritis (RA). Patient education has undoubtedly led to improved clinical outcomes, however no attempts have been made to optimise its content or delivery to maximise benefits within the context of the foot affected by rheumatoid arthritis. The aim of this study was to identify the nature and content of podiatrists' foot health education for people with RA. Any potential barriers to its provision were also explored. Methods: A focus group was conducted. The audio dialogue was recorded digitally, transcribed verbatim and analysed using a structured, thematic approach. The full transcription was verified by the focus group as an accurate account of what was said. The thematic analysis framework was verified by members of the research team to ensure validity of the data. Results: Twelve members (all female) of the north west Podiatry Clinical Effectiveness Group for Rheumatology participated. Six overarching themes emerged: (i) the essence of patient education; (ii) the content; (iii) patient-centred approach to content and timing; (iv) barriers to provision; (v) the therapeutic relationship; and (vi) tools of the trade. Conclusion: The study identified aspects of patient education that this group of podiatrists consider most important in relation to its: content, timing, delivery and barriers to its provision. General disease and foot health information in relation to RA together with a potential prognosis for foot health, the role of the podiatrist in management of foot health, and appropriate self-management strategies were considered to be key aspects of content, delivered according to the needs of the individual. Barriers to foot health education provision, including financial constraints and difficulties in establishing effective therapeutic relationships, were viewed as factors that strongly influenced foot health education provision. These data will contribute to the development of a patient-centred, negotiated approach to the provision of foot health education for people with RA