Search

We study unsupervised learning in a probabilistic generative model for occlusion. The model uses two types of latent variables: one indicates which objects are present in the image, and the other how they are ordered in depth. This depth order then determines how the positions and appearances of the objects present, specified in the model parameters, combine to form the image. We show that the object parameters can be learned from an unlabeled set of images in which objects occlude one another. Exact maximum-likelihood learning is intractable. Tractable approximations can be derived, however, by applying a truncated variational approach to Expectation Maximization (EM). In numerical experiments it is shown that these approximations recover the underlying set of object parameters including data noise and sparsity. Experiments on a novel version of the bars test using colored bars, and experiments on more realistic data, show that the algorithm performs well in extracting the generating components. The studied approach demonstrates that the multiple-causes generative approach can be generalized to extract occluding components, which links research on occlusion to the field of sparse coding approaches. [ABSTRACT FROM AUTHOR]

Aims To determine whether thiazolidinedione use is associated with a risk of bladder cancer. Methods We searched MEDLINE and EMBASE in June 2012 (with Pub Med update to July 2013) and conducted meta-analysis on the overall risks of bladder cancer with pioglitazone or rosiglitazone and the risk with different categories of cumulative dose or duration of drug use. Results We screened 230 citations and included 18 studies, comprising five randomized controlled trials ( RCTs) and 13 observational studies. Meta-analysis showed a significantly higher overall risk of bladder cancer with pioglitazone in RCTs [7878 participants; odds ratio ( OR) 2.51, 95% confidence interval ( CI) 1.09-5.80] and observational studies (>2.6 million patients; OR for 'ever' users vs. non-users 1.21, 95% CI 1.09-1.35). Subgroup analysis of observational studies by cumulative dose showed the risk of bladder cancer to be greatest with >28.0 g of pioglitazone ( OR 1.64, 95% CI 1.28-2.12). A significantly increased risk was found with both 12-24 months ( OR 1.41, 95% CI 1.16-1.71) and >24 months ( OR 1.51, 95% CI 1.26-1.81) cumulative durations of pioglitazone exposure. No significant risk was seen with rosiglitazone in RCTs ( OR 0.84, 95% CI 0.35-2.04) or 'ever' users vs. non-users in observational studies ( OR 1.03, 95% CI 0.94-1.12); the evidence for any relationship between bladder cancer risk and rosiglitazone cumulative duration is limited and inconsistent. Direct comparison of pioglitazone to rosiglitazone 'ever' users yielded an OR of 1.25 (95% CI 0.91-1.72). Conclusions A modest but clinically significant increase in the risk of bladder cancer with pioglitazone was found, which appears to be related to cumulative dose and duration of exposure. We recommend that prescribers limit pioglitazone use to shorter durations. [ABSTRACT FROM AUTHOR]

Background Duodenal perforation is an uncommon complication of endoscopic retrograde cholangio-pancreatography (ERCP) and a rare complication of upper gastrointestinal endoscopy. Most are minor perforations that settle with conservative management. A few perforations however result in life-threatening retroperitoneal necrosis and require surgical intervention. There is a relative paucity of references specifically describing the surgical interventions required for this eventuality. Methods Five cases of iatrogenic duodenal perforation were ascertained between 2002 and 2007 at Cairns Base Hospital. Clinical features were analyzed and compared, with reference to a review of ERCP at that institution for the years 2005/2006. Results One patient recovered with conservative management. Of the other four, one died after initial laparotomy. The other three survived, undergoing multiple procedures and long inpatient stays. Conclusions Iatrogenic duodenal perforation with retroperitoneal necrosis is an uncommon complication of endoscopy, but when it does occur it is potentially life-threatening. Early recognition may lead to a better outcome through earlier intervention, although a protracted course with multiple procedures should be anticipated. A number of surgical techniques may need to be employed according to the individual circumstances of the case. [ABSTRACT FROM AUTHOR]

The limit order book of an exchange represents an information store of market participants’ future aims and for many traders the information held in this store is of interest. However, information loss occurs between orders being entered into the exchange and limit order book data being sent out. We present an online algorithm which carries out Bayesian inference to replace information lost at the level of the exchange server and apply our proof of concept algorithm to real historical data from some of the world’s most liquid futures contracts as traded on CME GLOBEX, EUREX and NYSE Liffe exchanges. [ABSTRACT FROM PUBLISHER]

Abstract: Multi-product biopharmaceutical facilities need flexible process configurations that can adapt to products with diverse characteristics and impurity loads so as to avoid bottlenecks and delays, whilst meeting final product specifications and cost targets. In order to aid the design of such facilities, this work presents a meta-heuristic optimisation approach using genetic algorithms where different levels of decision are addressed (facility, product sequence and unit operation) and multiple process and business criteria are used to evaluate each alternative generated. This is applied to a case study on the production of therapeutic monoclonal antibodies (mAbs), with a focus on the optimal purification sequences and chromatography column sizing strategies to cope with different facility configurations of upstream and downstream trains and different product impurity loads. The industrial case study provides novel insights that allow the identification of the most cost-effective purification sequences and column sizing strategies that meet demand and purity targets for each product in the facility. Emphasis is placed also on providing methods to visualise the trade-offs in the set of optimal solutions with similar cost values so as to enhance the decision making process. [Copyright &y& Elsevier]

Wind data at time scales from 10 min to 1 h are an important input for modeling the performance of wind farms and their impact on many countries' national electricity systems. Planners need long-term realistic (i.e., meteorologically spatially and temporally consistent) wind-farm data for projects studying how best to integrate wind power into the national electricity grid. In New Zealand, wind data recorded at wind farms are confidential for commercial reasons, however, and publicly available wind data records are for sites that are often not representative of or are distant from wind farms. In general, too, the public sites are at much lower terrain elevations than hilltop wind farms and have anemometers located at 10 m above the ground, which is much lower than turbine hub height. In addition, when available, the mast records from wind-farm sites are only for a short period. In this paper, the authors describe a novel and practical method to create a multiyear 10-min synthetic wind speed time series for 15 wind-farm sites throughout the country for the New Zealand Electricity Commission. The Electricity Commission (known as the Electricity Authority since 1 October 2010) is the agency that has regulatory oversight of the electricity industry and that provides advice to central government. The dataset was constructed in such a way as to preserve meteorological realism both spatially and temporally and also to respect the commercial secrecy of the wind data provided by power-generation companies. [ABSTRACT FROM AUTHOR]

This paper provides new estimates of changing patterns of serial cohabitation, using data from the 1995 and 2002 National Survey of Family Growth. Serial cohabitation is defined as having multiple premarital cohabiting relationships. Analyses indicate that rates of serial cohabitation increased by nearly 40 percent over the late 1990s and early 2000s, and rates were especially high among young adults and recent marriage cohorts. A large majority of women – 75 percent – nevertheless lived only with men they eventually married. Although rates of serial cohabitation are higher among never-married women than ever-married women, there is little indication that single women – even older single women – have embraced serial cohabitation as an alternative to marriage or even as an intensive kind of dating. The results show that serial cohabitation is heavily concentrated among disadvantaged populations (e.g., women who grew up in single parent families). Early sexual activity and teen childbearing are especially important “risk” factors for serial cohabitation in the never-married population. There is little evidence, however, that recent shifts in the sociodemographic risk profile of the US population have been responsible for observed increases in single-instance or serial cohabitation. Increases in serial cohabitation have been broadly experienced across population groups in America. [Copyright &y& Elsevier]

Adult specimens of the West Indian basketstar Astrophyton muricatum lack spines on basal branches of the arms. This character has been used in a number of taxonomic treatments to distinguish several genera of basketstars from others that bear arm spines on basal branches. Examination of a growth series revealed that juvenile A. muricatum bear arm spines on basal regions and lose them progressively farther out on the arm over time. At all sizes, spines on more basal spine-bearing branches lose the morphology that is typical of most spine-bearing segments. Individual spines seem to be resorbed from the imperforate claw-like tip to the bulbous perforated base. Spine bosses on spineless segments lose the characteristic morphology that supports the attachment and operation of spines. Of four possible hypotheses to explain the absence of spines from basal arm segments, we reject the hypothesis that juveniles fail to form spines on those segments. Data predominately support the hypothesis that basal spines are eventually resorbed, but the hypothesis that spines are released by histolysis at some point in life does not conflict with the evidence on spine loss. There is no evidence that spines are abraded and not regenerated. A taxonomic key to basketstars of the West Indian Province is provided that does not rely on presence or absence of arm spines. [ABSTRACT FROM AUTHOR]

Abstract: Pagurus maclaughlinae is the most common hermit in the Indian River Lagoon System. Wide variations in lagoonal salinity make it likely that P. maclaughlinae is euryhaline and that other hermit species in the area are more stenohaline, at least in some stages of their life histories. In a study of salinity tolerance, crabs were held unfed at salinities of 5–50 (25 control) for up to 30days. Based on survivorship curves, P. maclaughlinae tolerated acute exposure to salinities of 10–45 for up to 18days, and survivorship up to 30days at 20–45 equaled or exceeded survivorship of the control. In a study of acclimation, the osmotic pressure of hemolymph was measured after crabs were held in the laboratory for 12, 48, and 96h acutely exposed to salinities of 10–45. Paired t-tests revealed that the crabs weakly hyperregulated their hemolymph at 45–154mOsmol above the external medium at all salinities and sampling times, and the osmotic differential of their hemolymph was fully acclimated by 96h. In a third study, acclimatization of hemolymph was studied on crabs at four field sites that differed in their recent salinity histories. Field-collected crabs weakly regulated their hemolymph 72–84mOsmol above the external medium at all sites sampled. Performance did not differ by site. The range of salinity tolerance and acclimation of hemolymph of P. maclaughlinae partly explain their wide distribution, and the consistent osmotic differential of its hemolymph indicates that the osmoregulatory ability of this small-bodied species is conserved in populations throughout the lagoon. Although some other larger-bodied hermit species in the region are euryhaline as adults, their tendency to hyperregulate strongly at low salinities possibly adds an energetic burden that, along with their less euryhaline long-lived larvae, might exclude them from the lagoon. Salinity tolerance of larval P. maclaughlinae has yet to be studied. [Copyright &y& Elsevier]

The article presents a study which documents the epibiotic taxa of the eastern surf chiton, Ceratozona squalida, to support future experimental studies on the relationship between C. squalida and its epibionts. It states that the study has collected and performed field studies along the rocky supratidal and high intertidal at the House of Refuge and Coral Cove Park on the east coast of Florida. Based on the study, the red alga Polysiphonia howei has dominated the algal turf.

The article offers information on a 2007 study conducted by the Steven Institute of Technology on new reference curriculum for masters degrees in software engineering. The study was sponsored by the U.S. Department of Defense and surveyed 28 university programs. A coalition composed of people from academia, industry, and government was formed. Findings revealed that less than 40 percent of programs has introductory software engineering course. Other findings were 85 percent cover software testing while 20 percent cover software tools and methods.

The visual system must learn to infer the presence of objects and features in the world from the images it encounters, and as such it must, either implicitly or explicitly, model the way these elements interact to create the image. Do the response properties of cells in the mammalian visual system reflect this constraint? To address this question, we constructed a probabilistic model in which the identity and attributes of simple visual elements were represented explicitly and learnt the parameters of this model from unparsed, natural video sequences. After learning, the behaviour and grouping of variables in the probabilistic model corresponded closely to functional and anatomical properties of simple and complex cells in the primary visual cortex (V1). In particular, feature identity variables were activated in a way that resembled the activity of complex cells, while feature attribute variables responded much like simple cells. Furthermore, the grouping of the attributes within the model closely parallelled the reported anatomical grouping of simple cells in cat V1. Thus, this generative model makes explicit an interpretation of complex and simple cells as elements in the segmentation of a visual scene into basic independent features, along with a parametrisation of their moment-by-moment appearances. We speculate that such a segmentation may form the initial stage of a hierarchical system that progressively separates the identity and appearance of more articulated visual elements, culminating in view-invariant object recognition. [ABSTRACT FROM AUTHOR]

This paper investigates the theoretical basis for estimating vocal-tract length (VTL) from the formant frequencies of vowel sounds. A statistical inference model was developed to characterize the relationship between vowel type and VTL, on the one hand, and formant frequency and vocal cavity size, on the other. The model was applied to two well known developmental studies of formant frequency. The results show that VTL is the major source of variability after vowel type and that the contribution due to other factors like developmental changes in oral-pharyngeal ratio is small relative to the residual measurement noise. The results suggest that speakers adjust the shape of the vocal tract as they grow to maintain a specific pattern of formant frequencies for individual vowels. This formant-pattern hypothesis motivates development of a statistical-inference model for estimating VTL from formant-frequency data. The technique is illustrated using a third developmental study of formant frequencies. The VTLs of the speakers are estimated and used to provide a more accurate description of the complicated relationship between VTL and glottal pulse rate as children mature into adults. [ABSTRACT FROM AUTHOR]

Philanthropic studies has made impressive gains in recent decades in terms of its research achievements and its curriculum and program offerings. That success creates the pressure for it to develop its standing as a discipline or as an interdisciplinary field that operates with the responsibilities of a discipline. This article outlines the process that Indiana University-Purdue University lndianapolis (IUPUI) philanthropic studies faculty undertook to create a rationale for their work and suggests that the work offers a model for any faculty group facing deep and important changes in their contexts. Articulating the values and parameters of a field, as indicated by what the philanthropic studies faculty at IUPUI have done, needs to be pursued with increasing regularity as the conditions of faculty work continue to change and respond to new pressures on the academic community. [ABSTRACT FROM AUTHOR]

The brain extracts useful features from a maelstrom of sensory information, and a fundamental goal of theoretical neuroscience is to work out how it does so. One proposed feature extraction strategy is motivated by the observation that the meaning of sensory data, such as the identity of a moving visual object, is often more persistent than the activation of any single sensory receptor. This notion is embodied in the slow feature analysis (SFA) algorithm, which uses ‘slowness’ as a heuristic by which to extract semantic information from multidimensional time series. Here, we develop a probabilistic interpretation of this algorithm, showing that inference and learning in the limiting case of a suitable probabilistic model yield exactly the results of SFA. Similar equivalences have proved useful in interpreting and extending comparable algorithms such as independent component analysis. For SFA, we use the equivalent probabilistic model as a conceptual springboard with which to motivate several novel extensions to the algorithm. [ABSTRACT FROM AUTHOR]

Abstract: Previous studies have shown that individual TCRs are able to effectively recognize multiple peptide/MHC complexes that have varying degrees of structural diversity. These TCR cross-reactivities have usually been demonstrated by using peptides that have different amino acid sequences. To further examine the extent to which TCRs can accommodate structurally diverse ligands, we analyzed human TCR cross-reactivity to eight structurally distinct haptens that are coupled to the HLA-A2-binding Tax peptide with a lysine substitution at position 5 (Tax-5K, LLFG[K-hapten]PVYV). The results demonstrate that 71% percent of the haptenated-peptide-induced CTL lines could cross-react on at least one other hapten. We compared the effects of HLA-A2 mutants with substitutions at known TCR contact sites for recognition by hapten-cross-reactive CTL. Recognition of the A2 mutants was remarkably similar whether they were presenting the immunizing or the cross-reactive peptide, indicating that similar amino acid contacts are made by the TCR during recognition of both complexes. Thus, hapten cross-reactivity is apparently accomplished without major adjustments to the interaction between the TCR and the surface of the HLA-A2 molecule. Collectively, these results suggest that TCRs possess the molecular flexibility to accommodate very structurally diverse ligands while retaining conserved interactions with the surface of the MHC molecule. [Copyright &y& Elsevier]

Introduction: There are very little clinical and pathological data on colorectal cancer among Indigenous people in Australia. Methods: A retrospective study on Indigenous patients treated for colorectal cancer at the Townsville and Cairns Base Hospitals from 1999 to 2004 was carried out in order to better characterise this disease in the Indigenous population. Results: There were 25 patients (12 M, 13 F) with a median age of 57.3 years. The majority (56%) of the tumours were left-sided, being in the sigmoid colon, rectosigmoid junction and rectum. Of the patients, 60% had American Joint Committee on Cancer (AJCC) staging system Stage I and II disease at presentation. There was a relatively high proportion of poorly differentiated adenocarcinomas (40%). Six patients died of the disease. The median follow-up was 20.5 months (range 2−51). Conclusions: Comparisons were made with available data on colorectal cancer in the general Australian population. The limitations and deficiencies of the study, as well as problems of data collection on Indigenous people were discussed. [ABSTRACT FROM AUTHOR]

This article presents information related to management challenges to implementing agile processes in traditional development organizations. In March 2004, the University of Southern California Center for Software Engineering Affiliates Annual Research Review held the fourth in a series of annual workshops to identify as many of these barriers as possible and to discuss whether or not they represented real conflicts with traditional engineering. Larger organizations must pay specific alienation to identifying how to synchronize teams. Some organizations have experienced success with medium-sized teams-of-teams, but multiple 15-minute daily meetings can become untenable. Finding enough competent team leaders who possess the necessary mix of technical, people, and agility skills can also prove difficult. Working with different life cycles is also difficult. Agile processes focus on immediately delivering functionality, while traditional methods focus on optimizing development over a longer period. The traditional longer life cycle require adjustments to the agile processes. For example, the documentation traditional methods require for training and support isn't a be natural output of agile methods. INSETS: Categories of Barriers to Agile Processes.;The Nonproblems..

Daily rainfall totals are a key input for hydrological models that are designed to simulate water and pollutant flow through both soil and waterways. Within New Zealand there are large areas and many river catchments where no long-term rainfall observations exist. A method for estimating daily rainfall over the whole of New Zealand on a 5-km grid is described and tested over a period from January 1985 to April 2002. Improvement over a spatial interpolation method was gained by scaling high-elevation rainfall estimates using simulated mesoscale model rainfall surfaces that are generated for short periods in 1994 and 1996. This method is judged to produce reasonable and useful estimates of daily rainfall. [ABSTRACT FROM AUTHOR]

Presents a risk-based approach for structuring projects to incorporate both agile and plan-driven methods in software developments. Use of risk analysis and a unified process framework to tailor risk-based processes into an overall development strategy; Characteristics of agile and plan-driven methods; Involvement of major business losses during system failures.

Wind speeds over a 6-month period from 21 surface stations, 3 upper-wind stations, and 2 different models are compared. Similar data are used for three different topographic regions of New Zealand broadly classed as having low, moderate, and high terrain. Mesoscale model winds are obtained in the three regions over 300 km by 300 km squares. The dataset is at 40-km grid spacing but some 20-km winds are also used. Correlation coefficients among the surface wind speeds decrease more quickly with separation the more mountainous the terrain. Correlation coefficients of observed surface speeds are lower than for model winds but composites of the observed station winds in each region have similar spatial variations to the model winds. An extrapolation technique for estimating the quality of model wind speed fields is inferred. [ABSTRACT FROM AUTHOR]

Probes factors influencing volcanic ash dispersal from the 1995 and 1996 eruptions of Mount Ruapehu, New Zealand. Airline companies' use of data on volcanic ash dispersal for rerouting of aircraft; Presentation of results of numerical simulations using the Regional Atmospheric Modeling System and Hybrid particle and Concentration and Transport Model.

SummaryWe and colleagues have suggested that deletions of mitochondrial DNA may be useful as a biomarker of ultraviolet radiation exposure in skin. In this study using a southwestern approach involving monoclonal antibodies against thymine dimers we provide direct evidence for the presence of ultraviolet-induced damage in mitochondrial DNA purified from any nuclear DNA contamination. Previous studies have been limited, as they have focused on the frequency of a single mitochondrial DNA deletion. Therefore we have addressed the question of the spectrum of mitochondrial DNA deletions in skin and whether this can be used as an index of overall DNA damage. We have used a long polymerase chain reaction technique to determine the mitochondrial DNA deletion spectrum of almost the entire mitochondrial genome in 71 split skin samples in relation to sun exposure. There was a significant increase in the number of deletions with increasing ultraviolet exposure in the epidermis (Kruskal–Wallis test, p = 0.0015) but not the dermis (p = 0.6376). The findings in the epidermis are not confounded by any age-dependent increases in mitochondrial DNA deletions also detected by the long polymerase chain reaction technique. The large spectrum of deletions identified in our study highlights the ubiquitous nature and the high mutational load of mitochondrial DNA associated with ultraviolet exposure and chronologic aging. Compared with the detection of single deletions using competitive polymerase chain reaction, we show that long polymerase chain reaction is a sensitive technique and may therefore provide a more comprehensive, although not quantitative, index of overall mitochondrial DNA damage in skin. [ABSTRACT FROM AUTHOR]

Aims: To update our previously reported systematic review and meta‐analysis of observational studies on cardiovascular drug exposure and COVID‐19 clinical outcomes by focusing on newly published randomized controlled trials (RCTs). Methods: More than 500 databases were searched between 1 November 2020 and 2 October 2021 to identify RCTs that were published after our baseline review. One reviewer extracted data with other reviewers verifying the extracted data for accuracy and completeness. Results: After screening 22 414 records, we included 24 and 21 RCTs in the qualitative and quantitative syntheses, respectively. The most investigated drug classes were angiotensin‐converting enzyme inhibitors (ACEIs)/angiotensin receptor blocker (ARBs) and anticoagulants, investigated by 10 and 11 studies respectively. In meta‐analyses, ACEI/ARBs did not affect hospitalization length (mean difference −0.42, 95% confidence interval [CI] −1.83; 0.98 d, n = 1183), COVID‐19 severity (risk ratio/RR 0.90, 95% CI 0.71; 1.15, n = 1661) or mortality (risk ratio [RR] 0.92, 95% CI 0.58; 1.47, n = 1646). Therapeutic anticoagulation also had no effect (hospitalization length mean difference −0.29, 95% CI −1.13 to 0.56 d, n = 1449; severity RR 0.86, 95% CI 0.70; 1.04, n = 2696; and, mortality RR 0.93, 95% CI 0.77; 1.13, n = 5689). Other investigated drug classes were antiplatelets (aspirin, 2 trials), antithrombotics (sulodexide, 1 trial), calcium channel blockers (amlodipine, 1 trial) and lipid‐modifying drugs (atorvastatin, 1 trial). Conclusion: Moderate‐ to high‐certainty RCT evidence suggests that cardiovascular drugs such as ACEIs/ARBs are not associated with poor COVID‐19 outcomes, and should therefore not be discontinued. These cardiovascular drugs should also not be initiated to treat or prevent COVID‐19 unless they are needed for an underlying currently approved therapeutic indication. [ABSTRACT FROM AUTHOR]

A letter to editor is presented in response to the article "The effectiveness of BCG vaccination in preventing Mycobacterium tuberculosis infection and disease in Greenland" by S. W. Michelsen, B. Soborg and colleagues in the 2014 issue.

A letter to the editor is presented in response to the article "Predicting survival in malignant pleural effusion: development and validation of the LENT prognostic score" by A.O. Clive et al published in the year 2014.

A microstructural characterisation and computational modelling framework for simulating the coupled thermal-mechanical cycles with two different initial parent microstructures, and their impact upon the emerging microstructure features including β grain size and phase volume fractions during electron beam welding (EBW) of Ti-6Al-4 V (Ti64) alloy is presented. Ti64 plates (measuring 5.5 mm in thickness) with different thermal processing have been electron beam welded using differing process parameter sets. These experimental welds have been fully characterised to provide information on the effect that a prior heat treatment has upon the microstructural evolution caused by the EB welding. Microstructure characterisation was investigated using both light microscopy and scanning electron microscopy. The results from this microstructure characterisation have been used to identity physically-based parameters required for microstructure predictions. [ABSTRACT FROM AUTHOR]

• This study uniquely investigates ex cult-members' experiences of a creative therapy workshop. • Flow states were measured in creative therapy activities and explored with participants. • Multimodal arts within a pluralistic therapeutic framework enabled Flow and goal attainment. • Therapeutic arts can support individuals surviving, transcending and healing from cultic abuse. • Research recruitment and novel methods can trigger ex-cult members' suspicion and resistance. Creative arts can play an important role for cult survivors in surviving, transcending and healing from their past realities. Flow – an empowering state of mind-body integration and skilful, intuitive action while engaged in a challenging yet enjoyable task (Csikszentmihalyi, 1997) – may be an important mechanism in arts therapies and may be especially impactful as an experience for cult survivors. Research reporting on arts therapies for cult survivors, Flow in cult survivors and Flow in arts therapies is currently severely lacking. This study reports on a multimodal creative psychological therapy, Arts for the Blues, piloted as a workshop with a small group of cult survivors. Results obtained from three participants show that they experienced Flow in their creative activities and increased attainment in a self-selected personal goal. Interviews with two participants reveal important considerations for working with cult survivors, the healing power of the arts, the attainment of Flow states in the process, and the impact of the Arts for the Blues approach. This study is the first of its kind to trial art therapies with ex cult-members, or to document participants' views on Flow states during an arts therapy approach. Although limited by a small sample size, further research is warranted. [ABSTRACT FROM AUTHOR]

Purpose: Therapeutic drug monitoring (TDM) is widely recognised as a key attribute of clinical pharmacologists; yet, the extent to which physicians undertaking postgraduate training in clinical pharmacology (hereafter trainees) are involved in TDM is poorly characterised. Our own experience suggests wide variation in trainee exposure to TDM. Method: We performed a Europe-wide cross-sectional internet-based survey of trainees to determine the nature and extent of trainee involvement in TDM. Results: There were 43 responses from eight countries analysed. Of the 21 respondents from the UK, all were also training in general internal medicine (GIM), while all of the respondents who were solely training in clinical pharmacology were from outside the UK. Overall, 86.0% of respondents reported access to drug monitoring for clinical care at their affiliated institution, of which 81.0% were personally involved in TDM in some capacity. On average, trainees reported that drug monitoring was available for 16 of the 33 (48%) of the drug/drug classes surveyed. UK-based respondents were involved in requesting drug-level investigations and interpreting the results for patients under their care in 76.2% and 85.7% of cases, respectively, while non-UK respondents supported other healthcare professionals to interpret results in 45.4% of cases. Trainees felt TDM training was generally either insufficient or very inadequate. Conclusion: While access to TDM is relatively available at institutions where trainees are based, the role of trainees is variable and affected by a variety of factors including country and training programme. Universally, trainees feel they need more education in TDM. [ABSTRACT FROM AUTHOR]

Argues that the use of Islam as the paradigm for black racial separatism and identity has an impact on nationalist and Islamic movements in the United States. Conviction that Islam was preferable to Christianity; Important analytical pole of black nationalism.

Presents several correspondence on medicine. Development of preoperative radiotherapy in rectal cancer; Techniques in removing ingrown toenails; Efficacy of propanol in treating hypertension.

Presents three interrelated analytical perspectives for the study of the Islam identity in the context of African American history. Resistance in the pre-twentieth century Islam; Construction of identity in the context of early-twentieth century Islam; Commodification of identity in contemporary Islam.

Analyzes the Ahmadiyya mission in the U.S. in the 1920s with reference to the impact on Afro-American religious consciousness. Foundations of the Ahmadiyya movement in the U.S.; Factors to an adverse relationship between the Ahmadiyya movement and the American media; Efforts of Mufti Muhammad Sadiq for mission expansion in the U.S.

Most of the prescribing and dispensing of medicines happens in primary care. Pharmacogenomics (PGx) is the study and clinical application of the role of genetic variation on drug response. Mounting evidence suggests PGx can improve the safety and/or efficacy of several medications commonly prescribed in primary care. However, implementation of PGx has generally been limited to a relatively few academic hospital centres, with little adoption in primary care. Despite this, many primary healthcare providers are optimistic about the role of PGx in their future practice. The increasing prevalence of direct-to-consumer genetic testing and primary care PGx studies herald the plausible gradual introduction of PGx into primary care and highlight the changes needed for optimal translation. In this article, the potential utility of PGx in primary care will be explored and on-going barriers to implementation discussed. The evidence base of several drug-gene pairs relevant to primary care will be outlined with a focus on antidepressants, codeine and tramadol, statins, clopidogrel, warfarin, metoprolol and allopurinol. This review is intended to provide both a general introduction to PGx with a more in-depth overview of elements relevant to primary care. [ABSTRACT FROM AUTHOR]

Objective: To understand the experiences of vulnerable clients who used telehealth during the Coronavirus pandemic. Design: The study employed a qualitative enquiry, utilising semi‐structured interviews lasting 30‐60 minutes with a thematic analysis approach to explore factors influencing client experience with telehealth. Setting: A wide range of locations across Tasmania, Australia. Participants: Twelve participants who were considered to be vulnerable on a number of domains, including: health and human wellbeing factors, social risk factors, functional limitations, and individual behavioural factors. Interventions: The provision of telehealth consultations to vulnerable clients. Main outcome measures: Four global themes were discovered: i) Telehealth saves time, money and energy; ii) User friendly technology facilitates care; iii) Rapport and confidentiality helps clients to feel safe; and iv) Fit for purpose telehealth provides a quality service. Results: The discovered themes entailed the major finding that most participants were satisfied with the overall quality of the telehealth service they received and the convenience of this service. Concerns were raised regarding the limitations around social interaction, physical examination, and access to fit‐for‐purpose telehealth devices. Conclusion: This research with vulnerable clients, from Tasmania, supports the evidence that the utilisation of telehealth allows more convenient access to care. To optimise the service, however, concerns regarding the desire for social interaction, appropriate physical examination, and access to fit‐for‐purpose telehealth devices will need to be addressed. [ABSTRACT FROM AUTHOR]

The article discusses the commitment of Indiana University-Purdue University Indianapolis in Indiana to its faculty work. The university has devoted sustained attention to faculty work in the past twenty years. Its commitment has led to four general initiatives, including formal and informal conversations about faculty work, significant resources invested in faculty development, a readiness to reconfigure faculty appointments to match faculty work with university missions and aspirations, and efforts to restore a sense of cohesion as an academic community.

Statins are a cornerstone in the pharmacological prevention of cardiovascular disease. Although generally well tolerated, a small subset of patients experience statin-related myotoxicity (SRM). SRM is heterogeneous in presentation; phenotypes include the relatively more common myalgias, infrequent myopathies, and rare rhabdomyolysis. Very rarely, statins induce an anti-HMGCR positive immune-mediated necrotizing myopathy. Diagnosing SRM in clinical practice can be challenging, particularly for mild SRM that is frequently due to alternative aetiologies and the nocebo effect. Nevertheless, SRM can directly harm patients and lead to statin discontinuation/non-adherence, which increases the risk of cardiovascular events. Several factors increase systemic statin exposure and predispose to SRM, including advanced age, concomitant medications, and the nonsynonymous variant, rs4149056, in SLCO1B1, which encodes the hepatic sinusoidal transporter, OATP1B1. Increased exposure of skeletal muscle to statins increases the risk of mitochondrial dysfunction, calcium signalling disruption, reduced prenylation, atrogin-1 mediated atrophy and pro-apoptotic signalling. Rare variants in several metabolic myopathy genes including CACNA1S, CPT2, LPIN1, PYGM and RYR1 increase myopathy/rhabdomyolysis risk following statin exposure. The immune system is implicated in both conventional statin intolerance/myotoxicity via LILRB5 rs12975366, and a strong association exists between HLA-DRB1*11:01 and anti-HMGCR positive myopathy. Epigenetic factors (miR-499-5p, miR-145) have also been implicated in statin myotoxicity. SRM remains a challenge to the safe and effective use of statins, although consensus strategies to manage SRM have been proposed. Further research is required, including stringent phenotyping of mild SRM through N-of-1 trials coupled to systems pharmacology omics- approaches to identify novel risk factors and provide mechanistic insight. [ABSTRACT FROM AUTHOR]

Sea cucumbers (holothuroids) lack the only known echinoderm immune organ, the axial organ. Holothuroids of the families Synaptidae and Chiridotidae have coelomic organs, known as ciliary urns, that gather and excrete waste and, therefore, might function in immunity. Although ciliary urns are widely reported and illustrated in the literature, the process and histology of urn development remain unknown. Development and structure of ciliary urns were examined in Synaptula hydriformis using scanning electron, brightfield, and scanning laser confocal microscopy. Mature urns occurred on all three mesenteries in 10‐tentacled young and later growth stages, and developing urns were found in post‐pentactulae, 10‐tentacled young, and released juveniles. Developing urns were circular clusters of ciliated collar cells protruding from the mesentery. The cells increased in number to form the sessile cushion stage with a shallow lumen. The subsequent spoon‐shaped stage had a stalk and a deepened lumen with an extensive ciliary field where coelomocytes began to accumulate. Mature urns had a thin stalk and cornucopia‐shaped body with an abluminal epithelium of squamous cells and an adluminal epithelium of densely packed ciliated collar cells. Cell boundaries of the rim of mature urns and of the stalk and body of developing urns were outlined on one or both sides by microvilli and an elevated cell membrane. Ciliary urns resembling the cushion‐stage urns of S. hydriformis have been described in the sea star Archaster typicus. If urns in these groups are homologous, it is likely that cushion urns are plesiomorphic and that they are present and have been overlooked in other echinoderms. [ABSTRACT FROM AUTHOR]

Considers frequently encountered hazards in the search for best practices. Insufficient supplies; Determining actual benefits of a program; Identification of source of best practice; Appropriateness to type of environment.

Background Methods Results Conclusion Prompt diagnosis of choledocholithiasis is crucial for reducing disease severity, preventing complications and minimizing length of stay. Magnetic resonance cholangiopancreatography (MRCP) is commonly used to evaluate patients with suspected choledocholithiasis but is expensive and may delay definitive intervention. To optimize patient care and resource utilization, we have developed five machine learning models that predict a patients' risk of choledocholithiasis based on clinical presentation and pre‐MRCP investigation results.Inpatients admitted to the Royal Hobart Hospital from 2018 to 2023 with a suspicion of choledocholithiasis were included. Exclusion criteria included prior hepatobiliary surgery, known hepatobiliary disease, or incomplete records. Variables related to clinical presentation, laboratory testing, and sonographic or CT imaging were collected. Four machine learning techniques were employed: logistic regression, XGBoost, random forest, and K‐nearest neighbours. The three best performing models were combined to create an ensemble model. Model performance was compared against the American Society for Gastrointestinal Endoscopy (ASGE) choledocholithiasis risk stratification guidelines.Of the 222 patients included, 113 (50.9%) had choledocholithiasis. The most successful models were the random forest (accuracy: 0.79, AUROC: 0.83) and ensemble (accuracy and AUROC: 0.81). Every model outperformed the ASGE guidelines. Key variables influencing the models' predictions included common bile duct diameter, lipase, imaging evidence of cholelithiasis, and liver function tests.Machine learning models can accurately assess a patient's risk of choledocholithiasis and could assist in identifying patients who could forgo an MRCP and proceed directly to intervention. Ongoing validation on prospective data is necessary to refine their accuracy and clinical utility. [ABSTRACT FROM AUTHOR]