The relevance of perspectivism to the task of modularisation in ontology development

An ontology development methodology seeks to provide developers with established principles, processes, practices, methods and activities for developing ontologies (Gasevic et al., 2009). Diverse methodologies have been published for the development of ontologies, and have evolved, based on the diverse experiences of researchers and practitioners, and the development teams who surveyed the benefits and shortcomings of the available methodologies in order to determine the applicability of methodologies to particular contexts. An evaluation of existing ontology development methodologies has identified that the concept formulation process is not well defined, or based on rigorous processes (Castro et al., 2006; Winters &amp; Tolk, 2009). In order for the validity of the social realism of the actors in a social setting to be captured, the perspectives of each actor needs to be acknowledged and incorporated into the concept formulation process / framework. This paper demonstrates how consideration of perspectivism leads to a meaningful modularisation of the resultant ontology.<br /

Providing for Perspectives: The Role of Discourse Analysis in Ontology Concept Formulation and Development

Concept formulation and ontology development are problematic to achieve in complex social settings. Previously, we have proposed and illustrated a method to develop an ontology based on grounded theory, whereby the ontology is linked to the social processes involved. Further, distinct actors in the social setting assume perspectives that are often fundamentally different from each other. We have previously argued that perspectivism is a cogent theoretical explanation for the different emergent ontologies. However, a rigorous method for analysing the text, in order to identify these perspectives has been needed. In this paper we propose the identification of perspectives by using discourse analysis to bridge between term identification and clarification of perspectives. We have found that discourse analysis provides the structure and rigour required to establish the presence of perspectives, and that actors use metaphors and the genre of historical stories to bridge between, or link with, other perspectives. It is likely that identifying perspectives and the role of language in linking them will produce ontological modularity that is true to the social setting

Illustrating The Process Of Ontology Concept Formulation In A Multi-Perspective Social Setting

Developing an ontology for use in a social process requires conceptualisation of the domain, and the influence of skills and perspectives of actors in the processes to be considered. It is essential that methodologies have a rigorous concept formulation process that ensures abstraction from the domain narration and also disambiguates the terms in the narration. However, the abstraction needs to be a parsimonious representation of a community’s collaborative terminology and concept pluralism. This paper presents a method of ontological concept formulation, using an approach based on a rigorous grounded theory method, and illustrates the process using a fragment from a case study. We have found that the method has assisted in clarifying terms emerging from the text and in grounding the conceptual understanding of natural language fragments, by interpreting concepts at the phrase level with the support of a reference lexicon, and using a basis of perspectivism. The identification of semantic relationships between concepts is conducted within the multiple adopted perspectives and permits a pluralistic approach to ontological formulatio

Can we accurately forecast non-elective bed occupancy and admissions in the NHS?:A time-series MSARIMA analysis of longitudinal data from an NHS Trust

OBJECTIVES: The main objective of the study was to develop more accurate and precise short-term forecasting models for admissions and bed occupancy for an NHS Trust located in Bristol, England. Subforecasts for the medical and surgical specialties, and for different lengths of stay were realised DESIGN: Autoregressive integrated moving average models were specified on a training dataset of daily count data, then tested on a 6-week forecast horizon. Explanatory variables were included in the models: day of the week, holiday days, lagged temperature and precipitation. SETTING: A secondary care hospital in an NHS Trust in South West England. PARTICIPANTS: Hospital admissions between September 2016 and March 2020, comprising 1291 days. PRIMARY AND SECONDARY OUTCOME MEASURES: The accuracy of the forecasts was assessed through standard measures, as well as compared with the actual data using accuracy thresholds of 10% and 20% of the mean number of admissions or occupied beds. RESULTS: The overall Autoregressive Integrated Moving Average (ARIMA) admissions forecast was compared with the Trust’s forecast, and found to be more accurate, namely, being closer to the actual value 95.6% of the time. Furthermore, it was more precise than the Trust’s. The subforecasts, as well as those for bed occupancy, tended to be less accurate compared with the overall forecasts. All of the explanatory variables improved the forecasts. CONCLUSIONS: ARIMA models can forecast non-elective admissions in an NHS Trust accurately on a 6-week horizon, which is an improvement on the current predictive modelling in the Trust. These models can be readily applied to other contexts, improving patient flow

Adventures with Animals Big and Small

The purpose of this project is to produce a short collection of out-of-print children’s stories that would be suitable for first grade level readers. Stories selected for the collection fit the theme of being seasonally themed and include animals as main protagonists. Under the guidance of Dr. Tara Penry, the class searched children’s magazines from the late 1800’s and early 1900’s to find stories that would be relevant and interesting to today’s elementary schoolers

Evaluating the impact of the IPOP (Improving Personal and Organisational Performance) programme: An introductory leadership and management development module for social work managers

A host of recent UK social work publications have highlighted the critical importance of leadership and management development for social work managers. The lack of specialist leadership and management development is evidenced by the General Social Care Council’s figures on the uptake of post-qualifying leadership and management programmes. There is a limited amount of published research on the impact of this type of professional learning as most studies focus on programme delivery rather than on their impact on practice. Hence, this paper will report on an evaluation of the practice related impact of an introductory leadership and management programme, using data from pre-and post-programme questionnaires (n=75), follow up telephone interviews at 3-months (n=24) and an initial analysis of submitted assignments (n=32). Those data are drawn from consenting social work managers across 5 widespread local authorities in England. The programme, Improving Personal and Organisational Performance, is taught over 4-days in two, 2-day blocks and focuses on three areas of development: self-leadership, communication and resilience as a leader. A third-party testimony process, alongside assignment submission, ensures the involvement of, and validation from, the employer. The findings of the evaluation indicate positive, statistically significant evidence of initial programme impact on managers and longitudinal examples of actual programme impact on managers, their teams, organisations and services. The implications of these findings will be considered in relation to the new Professional Capabilities Framework

Phylogenetic ctDNA analysis depicts early-stage lung cancer evolution.

The early detection of relapse following primary surgery for non-small-cell lung cancer and the characterization of emerging subclones, which seed metastatic sites, might offer new therapeutic approaches for limiting tumour recurrence. The ability to track the evolutionary dynamics of early-stage lung cancer non-invasively in circulating tumour DNA (ctDNA) has not yet been demonstrated. Here we use a tumour-specific phylogenetic approach to profile the ctDNA of the first 100 TRACERx (Tracking Non-Small-Cell Lung Cancer Evolution Through Therapy (Rx)) study participants, including one patient who was also recruited to the PEACE (Posthumous Evaluation of Advanced Cancer Environment) post-mortem study. We identify independent predictors of ctDNA release and analyse the tumour-volume detection limit. Through blinded profiling of postoperative plasma, we observe evidence of adjuvant chemotherapy resistance and identify patients who are very likely to experience recurrence of their lung cancer. Finally, we show that phylogenetic ctDNA profiling tracks the subclonal nature of lung cancer relapse and metastasis, providing a new approach for ctDNA-driven therapeutic studies

Effect of Hydrocortisone on Mortality and Organ Support in Patients With Severe COVID-19: The REMAP-CAP COVID-19 Corticosteroid Domain Randomized Clinical Trial.

Importance: Evidence regarding corticosteroid use for severe coronavirus disease 2019 (COVID-19) is limited. Objective: To determine whether hydrocortisone improves outcome for patients with severe COVID-19. Design, Setting, and Participants: An ongoing adaptive platform trial testing multiple interventions within multiple therapeutic domains, for example, antiviral agents, corticosteroids, or immunoglobulin. Between March 9 and June 17, 2020, 614 adult patients with suspected or confirmed COVID-19 were enrolled and randomized within at least 1 domain following admission to an intensive care unit (ICU) for respiratory or cardiovascular organ support at 121 sites in 8 countries. Of these, 403 were randomized to open-label interventions within the corticosteroid domain. The domain was halted after results from another trial were released. Follow-up ended August 12, 2020. Interventions: The corticosteroid domain randomized participants to a fixed 7-day course of intravenous hydrocortisone (50 mg or 100 mg every 6 hours) (n = 143), a shock-dependent course (50 mg every 6 hours when shock was clinically evident) (n = 152), or no hydrocortisone (n = 108). Main Outcomes and Measures: The primary end point was organ support-free days (days alive and free of ICU-based respiratory or cardiovascular support) within 21 days, where patients who died were assigned -1 day. The primary analysis was a bayesian cumulative logistic model that included all patients enrolled with severe COVID-19, adjusting for age, sex, site, region, time, assignment to interventions within other domains, and domain and intervention eligibility. Superiority was defined as the posterior probability of an odds ratio greater than 1 (threshold for trial conclusion of superiority >99%). Results: After excluding 19 participants who withdrew consent, there were 384 patients (mean age, 60 years; 29% female) randomized to the fixed-dose (n = 137), shock-dependent (n = 146), and no (n = 101) hydrocortisone groups; 379 (99%) completed the study and were included in the analysis. The mean age for the 3 groups ranged between 59.5 and 60.4 years; most patients were male (range, 70.6%-71.5%); mean body mass index ranged between 29.7 and 30.9; and patients receiving mechanical ventilation ranged between 50.0% and 63.5%. For the fixed-dose, shock-dependent, and no hydrocortisone groups, respectively, the median organ support-free days were 0 (IQR, -1 to 15), 0 (IQR, -1 to 13), and 0 (-1 to 11) days (composed of 30%, 26%, and 33% mortality rates and 11.5, 9.5, and 6 median organ support-free days among survivors). The median adjusted odds ratio and bayesian probability of superiority were 1.43 (95% credible interval, 0.91-2.27) and 93% for fixed-dose hydrocortisone, respectively, and were 1.22 (95% credible interval, 0.76-1.94) and 80% for shock-dependent hydrocortisone compared with no hydrocortisone. Serious adverse events were reported in 4 (3%), 5 (3%), and 1 (1%) patients in the fixed-dose, shock-dependent, and no hydrocortisone groups, respectively. Conclusions and Relevance: Among patients with severe COVID-19, treatment with a 7-day fixed-dose course of hydrocortisone or shock-dependent dosing of hydrocortisone, compared with no hydrocortisone, resulted in 93% and 80% probabilities of superiority with regard to the odds of improvement in organ support-free days within 21 days. However, the trial was stopped early and no treatment strategy met prespecified criteria for statistical superiority, precluding definitive conclusions. Trial Registration: ClinicalTrials.gov Identifier: NCT02735707

Safety and efficacy of the ChAdOx1 nCoV-19 vaccine (AZD1222) against SARS-CoV-2: an interim analysis of four randomised controlled trials in Brazil, South Africa, and the UK.

BACKGROUND: A safe and efficacious vaccine against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), if deployed with high coverage, could contribute to the control of the COVID-19 pandemic. We evaluated the safety and efficacy of the ChAdOx1 nCoV-19 vaccine in a pooled interim analysis of four trials. METHODS: This analysis includes data from four ongoing blinded, randomised, controlled trials done across the UK, Brazil, and South Africa. Participants aged 18 years and older were randomly assigned (1:1) to ChAdOx1 nCoV-19 vaccine or control (meningococcal group A, C, W, and Y conjugate vaccine or saline). Participants in the ChAdOx1 nCoV-19 group received two doses containing 5 × 1010 viral particles (standard dose; SD/SD cohort); a subset in the UK trial received a half dose as their first dose (low dose) and a standard dose as their second dose (LD/SD cohort). The primary efficacy analysis included symptomatic COVID-19 in seronegative participants with a nucleic acid amplification test-positive swab more than 14 days after a second dose of vaccine. Participants were analysed according to treatment received, with data cutoff on Nov 4, 2020. Vaccine efficacy was calculated as 1 - relative risk derived from a robust Poisson regression model adjusted for age. Studies are registered at ISRCTN89951424 and ClinicalTrials.gov, NCT04324606, NCT04400838, and NCT04444674. FINDINGS: Between April 23 and Nov 4, 2020, 23 848 participants were enrolled and 11 636 participants (7548 in the UK, 4088 in Brazil) were included in the interim primary efficacy analysis. In participants who received two standard doses, vaccine efficacy was 62·1% (95% CI 41·0-75·7; 27 [0·6%] of 4440 in the ChAdOx1 nCoV-19 group vs71 [1·6%] of 4455 in the control group) and in participants who received a low dose followed by a standard dose, efficacy was 90·0% (67·4-97·0; three [0·2%] of 1367 vs 30 [2·2%] of 1374; pinteraction=0·010). Overall vaccine efficacy across both groups was 70·4% (95·8% CI 54·8-80·6; 30 [0·5%] of 5807 vs 101 [1·7%] of 5829). From 21 days after the first dose, there were ten cases hospitalised for COVID-19, all in the control arm; two were classified as severe COVID-19, including one death. There were 74 341 person-months of safety follow-up (median 3·4 months, IQR 1·3-4·8): 175 severe adverse events occurred in 168 participants, 84 events in the ChAdOx1 nCoV-19 group and 91 in the control group. Three events were classified as possibly related to a vaccine: one in the ChAdOx1 nCoV-19 group, one in the control group, and one in a participant who remains masked to group allocation. INTERPRETATION: ChAdOx1 nCoV-19 has an acceptable safety profile and has been found to be efficacious against symptomatic COVID-19 in this interim analysis of ongoing clinical trials. FUNDING: UK Research and Innovation, National Institutes for Health Research (NIHR), Coalition for Epidemic Preparedness Innovations, Bill & Melinda Gates Foundation, Lemann Foundation, Rede D'Or, Brava and Telles Foundation, NIHR Oxford Biomedical Research Centre, Thames Valley and South Midland's NIHR Clinical Research Network, and AstraZeneca