208 research outputs found
Recommended from our members
Real Time Video Microscopy for the Fused Deposition Method
Fused deposition is a layered manufacturing technology, which is being investigated for
fabrication of functional parts. Defects and voids in the build process affect the quality andlevel
of accuracy of components. These occur due to several factors, such as the.toolpath contours in a
layer, material(s) deposited, and the environmental/conditions. For a functional part to be
constructed, a perfect green part is critical. To further understand this process, a visualization of
the deposition is needed. Therefore, we have developed a real-time. video microscopy system.
The hardware has been constructed and mounted on theexistingliquifier.·Real time deposition·of
layered manufacturing is being recorded. Three materials being investigated are: PZT, silicon
nitride, and wax. The contrast in wax layering is not as strong, which·makes•• visual observation
extremely hard. However, interaction between the roads of PZT and silicone nitride parts has
been successfully quantified. Using the current set. up and software, the raod width and height
have been quantified.Mechanical Engineerin
Severity of Pain is not associated with Urgency of Diagnosis in ED Patients with Abdominal Pain
Background
Abdominal Pain is the most common cause of visits to US Emergency Departments (EDs) and the causes range from urgent to non-urgent diagnoses. Distinguishing urgent versus non-urgent causes of abdominal pain is done through the use of clinical exam, lab studies and diagnostic imaging such as CT scans. There are no validated clinical decision rules to assist physicians in discriminating urgent from non-urgent causes of abdominal pain or which patient needs a CT scan. There is controversy regarding the use of CT scans for patients with abdominal pain due to the increased cost, radiation exposure and length of stay.
Objective
The objective of this study is to compare the demographics, pain score and CT utilization for patients with urgent versus non-urgent causes of abdominal pain.
Methods
At an academic ED, a convenience sample of patients with abdominal pain was prospectively enrolled by research assistants during the ED visit. Research assistants abstracted treatment information from the electronic medical record for the ED and hospitalization if applicable. Finally, enrollees were telephoned 2 weeks after the index ED visit to ascertain symptom resolution and treatment outcomes. Following establishment of final diagnosis, patients were classified as having an urgent or non-urgent diagnosis based upon published peer-reviewed criteria. Risk differences in pain severity, CT scan utilization and demographics were compared to urgency of diagnosis and a paired t-test was used to estimate differences in initial clinical characteristics.
Results
In a model of 725 patients, 144 had urgent diagnoses and 561 had non-urgent diagnoses. There was no distinction in insurance type, income level, mean age or pain score in the two groups. Ct scan utilization was higher in patients with urgent diagnoses (42.4% versus 16.4%.)
Conclusion
20.4% of patients had an urgent diagnosis for the abdominal pain. There was no difference in the pain score for patients with urgent versus non-urgent diagnosis. While work-up bias is a potential limitation, CT scan utilization was higher in patients with an urgent diagnosis suggesting appropriate clinical judgement. Future studies will need to look at ways to target the testing to more high-risk patients who present with undifferentiated abdominal pain
Integrated enhanced cognitive behavioural (I-CBTE) therapy significantly improves effectiveness of inpatient treatment of anorexia nervosa in real life settings
BACKGROUND: Inpatient treatment of anorexia nervosa can be lifesaving but is associated with high rates of relapse and poor outcomes. To address this, the Oxford service has adapted the enhanced cognitive behavioural treatment (CBTE) model, first developed for inpatients in Italy to a UK national health service (NHS) setting. In this study, we compared the outcomes from treatment as usual (TAU), integrated CBTE (I-CBTE), and alternative treatment models in routine UK clinical practice. METHODS: This is a longitudinal cohort study, using routinely collected data between 2017 and 2020 involving all adults with anorexia nervosa admitted to specialist units from a large geographical area in England covering a total population of 3.5 million. We compared TAU with (1) I-CBTE (13 weeks inpatient CBTE, restoration to a healthy weight, combined with 7 weeks day treatment followed by 20 weeks of outpatient CBTE; (2) standalone inpatient CBTE (due to insufficient resources since the pandemic; and (3) 6-8 weeks admission with partial weight restoration as crisis management. Primary outcome measures (min. 1 year after discharge from hospital) were defined as: (1) good outcome: Body Mass Index (BMI) > 19.5 and no abnormal eating or compensatory behaviours; (2) poor outcome: BMI < 19.5 and/or ongoing eating disorder behaviours; (3) readmission; or (4) deceased. Secondary outcomes were BMI on discharge, and length of stay. RESULTS: 212 patients were admitted to 15 specialist units in the UK depending on bed availability. The mean age was 28.9 (18-60) years, mean admission BMI was 14.1 (10-18.3), 80% were voluntary. At minimum 1-year follow up after discharge, 70% of patients receiving I-CBTE and 29% standalone inpatient CBTE maintained good outcomes, in contrast with < 5% TAU and crisis management admission. Readmission rates of I-CBTE were 14.3% vs ~ 50% (χ2 < 0.0001) in the other groups. The main predictors of good outcome were reaching healthy BMI by discharge, I-CBTE and voluntary status. Age, psychiatric comorbidity and length of stay did not predict outcomes. BMI on discharge and length of stay were significantly better in the CBTE groups than in TAU. CONCLUSIONS: Our main finding is that in a real-life setting, I-CBTE has superior short- and minimum 1 year outcomes as compared with alternative inpatient treatment models. Dissemination of I-CBTE across the care pathway has the potential to transform outcomes of inpatient treatment for this high-risk patient population and reduce personal and societal costs
CD40mAb adjuvant induces a rapid antibody response that may be beneficial in post-exposure prophylaxis
Active vaccination can be effective as a post-exposure prophylaxis, but the rapidity of the immune response induced, relative to the incubation time of the pathogen, is critical. We show here that CD40mAb conjugated to antigen induces a more rapid specific antibody response than currently used immunological adjuvants, alum and monophosphoryl lipid A™
Obesity and dental caries in childhood : trends in prevalence and socioeconomic inequalities - a multicohort population-wide data linkage study
Objectives To quantify levels of coexisting obesity and caries experience in children in Scotland, and any associated socioeconomic inequalities over the years 2011/2012–2017/2018. Design A multicohort population-wide data linkage study. Setting Local authority primary schools in Scotland. Patients 335 361 primary 1 (approximately 5 years old) schoolchildren in Scotland between 2011/2012 and 2017/2018. Main outcome measures Prevalence and inequalities in coexisting caries and obesity. Results The prevalence of coexisting obesity and caries experience was 3.4% (n=11 494 of 335 361) and did not change over the 7 years. Children living in the 20% most deprived areas had more than sixfold greater odds of coexisting obesity and caries experience than children from the 20% least deprived areas (adjusted OR=6.63 (95% CI=6.16 to 7.14; p<0.001)). There was a large persistent socioeconomic gradient across the Scottish Index of Multiple Deprivation groups, with the Slope and Relative Indices of Inequality remaining unchanged over the 7 cohort years. Conclusions Despite improvements in oral health in children in Scotland, the prevalence of coexisting obesity and caries experience has remained static, with large persistent inequalities. These conditions are likely to signal increased risk of chronic conditions including multimorbidity in adulthood and therefore early identification of children most at risk and timely intervention tackling common risk factors should be developed and evaluated
Obesity and dental caries in childhood: trends in prevalence and socio-economic inequalities: a multi-cohort population-wide data linkage study
Objectives: To quantify levels of coexisting obesity and caries experience in children in Scotland, and any associated socioeconomic inequalities over the years 2011/2012–2017/2018.
Design: A multicohort population-wide data linkage study.
Setting: Local authority primary schools in Scotland.
Patients: 335 361 primary 1 (approximately 5 years old) schoolchildren in Scotland between 2011/2012 and 2017/2018.
Main outcome measures: Prevalence and inequalities in coexisting caries and obesity.
Results: The prevalence of coexisting obesity and caries experience was 3.4% (n=11 494 of 335 361) and did not change over the 7 years. Children living in the 20% most deprived areas had more than sixfold greater odds of coexisting obesity and caries experience than children from the 20% least deprived areas (adjusted OR=6.63 (95% CI=6.16 to 7.14; p<0.001)). There was a large persistent socioeconomic gradient across the Scottish Index of Multiple Deprivation groups, with the Slope and Relative Indices of Inequality remaining unchanged over the 7 cohort years.
Conclusions: Despite improvements in oral health in children in Scotland, the prevalence of coexisting obesity and caries experience has remained static, with large persistent inequalities. These conditions are likely to signal increased risk of chronic conditions including multimorbidity in adulthood and therefore early identification of children most at risk and timely intervention tackling common risk factors should be developed and evaluated
circRNAs expressed in human peripheral blood are associated with human aging phenotypes, cellular senescence and mouse lifespan.
Circular RNAs (circRNAs) are an emerging class of non-coding RNA molecules that are thought to regulate gene expression and human disease. Despite the observation that circRNAs are known to accumulate in older organisms and have been reported in cellular senescence, their role in aging remains relatively unexplored. Here, we have assessed circRNA expression in aging human blood and followed up age-associated circRNA in relation to human aging phenotypes, mammalian longevity as measured by mouse median strain lifespan and cellular senescence in four different primary human cell types. We found that circRNAs circDEF6, circEP300, circFOXO3 and circFNDC3B demonstrate associations with parental longevity or hand grip strength in 306 subjects from the InCHIANTI study of aging, and furthermore, circFOXO3 and circEP300 also demonstrate differential expression in one or more human senescent cell types. Finally, four circRNAs tested showed evidence of conservation in mouse. Expression levels of one of these, circPlekhm1, was nominally associated with lifespan. These data suggest that circRNA may represent a novel class of regulatory RNA involved in the determination of aging phenotypes, which may show future promise as both biomarkers and future therapeutic targets for age-related disease
EOSCpilot Ethics: Supporting Document to D3.3 Draft Policy Recommendations
This paper discusses how an ethical dimension can best be included within the policies, structures and services of the developing European Open Science Cloud (EOSC).
Although the inclusion of ethical principles and policies are seen as of fundamental importance to the EOSC, it is difficult to anticipate all the ethical issues that may emerge as the scientific, technical, social and political landscape evolves. It is therefore seen as crucially important to have governance mechanisms in place that can ensure ethical issues are appropriately dealt with in the future, however and whenever they are presented, as well as identifying and proposing responses to current issues.
An analysis of ethical issues relating to organisational conduct and policies, research conduct, research decision making, the use of data, especially sensitive personal data, and the interaction between science and society, serves to underline the complexity and diversity of potential issues
- …