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This work evaluated the suitability of MR derived sequences for use in online adaptive RT workflows on a 1.5 Tesla (T) MR-Linear Accelerator (MR Linac).Non-patient volunteers were recruited to an ethics approved MR Linac imaging study. Participants attended 1-3 imaging sessions in which a combination of DIXON, 2D and 3D volumetric T1 and T2 weighted images were acquired axially, with volunteers positioned using immobilisation devices typical for radiotherapy to the anatomical region being scanned. Images from each session were appraised by three independent reviewers to determine optimal sequences over six anatomical regions: head and neck, female and male pelvis, thorax (lung), thorax (breast/chest wall) and abdomen. Site specific anatomical structures were graded by the perceived ability to accurately contour a typical organ at risk. Each structure was independently graded on a 4-point Likert scale as 'Very Clear', 'Clear', 'Unclear' or 'Not visible' by observers, consisting of radiographers (therapeutic and diagnostic) and clinicians.From July 2019 to September 2019, 18 non-patient volunteers underwent 24 imaging sessions in the following anatomical regions: head and neck (n=3), male pelvis (n=4), female pelvis (n=5), lung/oesophagus (n=5) abdomen (n=4) and chest wall/breast (n=3). T2 sequences were the most preferred for perceived ability to contour anatomy in both male and female pelvis. For all other sites T1 weighted DIXON sequences were most favourable.This study has determined the preferential sequence selection for organ visualisation, as a pre-requisite to our institution adopting MR-guided radiotherapy for a more diverse range of disease sites.

It is well known that one of the main impacts caused by land cover change is the process of forest fragmentation. Connecting the remaining fragments is always an exercise for technicians and academics, and even corridors of remaining vegetation usually present places of forest discontinuity, lacking connection strategies for the corridor to gain a real function. In this paper, we applied a model structured to identify priority locals to implement connectors. We used a GIS package and a digital, georeferenced satellite image. We complemented the project by surveying a database through a drone-based field survey. The integration of data revealed that for our studied area (Sorocaba, SP Brazil) 42.5% need assisted restoration. The mapping also revealed the existence of 25 forest fragments larger than 50 ha, arranged chiefly in one single corridor but disconnected from each other. Hence, through the application of the model, we could localize nine strategic locations in distances as short as possible among the fragments, feasible to implement a connector with the economy of resources and expect satisfactory performance in ecological terms. The database generated by the drone-based survey helped us to assert

At the time of writing, although siRNA therapeutics are approved for human use, no official regulatory guidance specific to this modality is available. In the absence of guidance, preclinical development for siRNA followed a hybrid of the small molecule and biologics guidance documents. However, siRNA differs significantly from small molecules and protein-based biologics in its physicochemical, absorption, distribution, metabolism and excretion properties, and its mechanism of action. Consequently, certain reports typically included in filing packages for small molecule or biologics may benefit from adaption, or even omission, from an siRNA filing. In this white paper, members of the ‘siRNA working group’ in the IQ Consortium compile a list of reports included in approved siRNA filing packages and discuss the relevance of two in vitro reports—the plasma protein binding evaluation and the drug–drug interaction risk assessment—to support siRNA regulatory filings. Publicly available siRNA approval packages and the literature were systematically reviewed to examine the role of siRNA plasma protein binding and drug–drug interactions in understanding pharmacokinetic/pharmacodynamic relationships, safety and translation. The findings are summarized into two decision trees to help guide industry decide when in vitro siRNA plasma protein binding and drug–drug interaction studies are warranted.

Campylobacter spp. are the most common bacterial cause of foodborne illness in the UK, with chicken considered to be the most important vehicle of transmission for this organism. It is estimated there are 500,000 cases of campylobacteriosis in the UK annually, with Campylobacter jejuni (C. jejuni) and Campylobacter coli (C. coli) accounting for approximately 91% and 8 % of infections, respectively. Although severe infection in humans is uncommon, treatment is seldom needed for human infection but usually involves the administration of a macrolide (e.g., azithromycin) or a fluoroquinolone (e.g., ciprofloxacin). An increased rate of resistance in Campylobacter in chicken to such antimicrobials could limit effective treatment options for human infections and it is therefore important to monitor changes in rates of resistance over time. In this report we analysed trends in antimicrobial resistance (AMR) in C. jejuni and C. coli isolated from chicken in the UK. The chicken samples were from chicken reared for meat (ie. broiler chicken as opposed to layer chicken (ie. egg-laying chicken)) and included chicken sampled at slaughterhouses as well as from retail stores in the UK. Datasets included AMR results from retail surveys of Campylobacter spp. on chicken sampled in the UK from various projects in the time period from 2001 to 2020. In the retail surveys, samples were obtained from stores including major and minor retail stores throughout the UK (in proportion to the population size of each nation) and Campylobacter spp. testing was performed using standard methods with the majority of isolates obtained from direct culture on standard media (mCCDA). Data from national scale surveys of broiler chicken, sampling caecal contents and carcase neckskins at slaughterhouses, undertaken by APHA in 2007/2008, and between 2012 and 2018 were also included in the study. In the APHA-led surveys, Campylobacter were isolated using standard culture methods (culture onto mCCDA) and antimicrobial susceptibility testing was performed by a standard microbroth dilution method to determine the minimum inhibitory concentration (MIC) of isolates. Care was taken when comparing data from different studies as there had been changes to the threshold used to determine if an isolate was susceptible or resistant to an antimicrobial in a small number of scenarios. Harmonised thresholds (using epidemiological cut-off (ECOFF) values) were employed to assess AMR with appropriate adjustments made where required to allow meaningful comparisons of resistance prevalence over time. Data from additional isolates where resistance to antimicrobials were predicted from genome sequence data were also considered.

Objectives Accurate image registration is vital in cervical cancer where changes in both planning target volume (PTV) and organs at risk (OARs) can make decisions regarding image registration complicated. This work aims to determine the impact of a dedicated educational tool compared with experience gained in MR-guided radiotherapy (MRgRT). Methods 10 therapeutic radiographers acted as observers and were split into two groups based on previous experience with MRgRT and Monaco treatment planning system. Three CBCT-CT, three MR-CT and two MR-MR registrations were completed per patient by each observer. Observers recorded translations, time to complete image registration and confidence. Data were collected in two phases; prior to and following the introduction of a cervix registration guide. Results No statistically significant differences were noted between imaging modalities. Each group was assessed independently pre- and post-education, no statistically significant differences were noted in either CBCT-CT or MR-CT imaging. Group 1 MR-MR imaging showed a statistically significant reduction in interobserver variability (p=0.04), in Group 2, the result was not statistically significant (p=0.06). Statistically significant increases in confidence were seen in all three modalities (p≤0.05). Conclusions At The Christie NHS Foundation Trust, radiographers consistently registered images across three different imaging modalities regardless of their previous experience. The implementation of an image registration guide had limited impact on inter- and intraobserver variability. Radiographers’ confidence showed statistically significant improvements following the use of the registration manual. Advances in knowledge This work helps evaluate training methods for novel roles that are developing in MRgRT.

Purpose This study compared MRI to CBCT for the identification and registration of lymph nodes (LN) in patients with locally advanced (LA)-NSCLC, to assess the suitability of targeting LNs in future MR-image guided radiotherapy (MRgRT) workflows. Method Radiotherapy radiographers carried out Visual Grading Analysis (VGA) assessment of image quality, LN registration and graded their confidence in registration for each of the 24 LNs on CBCT and two MR sequences, MR1 (T2w Turbo Spin Echo) and MR2 (T1w DIXON water only image). Results Pre-registration image quality assessment revealed MR1 and MR2 as significantly superior to CBCT in terms of image quality (p ≤ 0.01). No significant differences were noted in interobserver variability for LN registration between CBCT, MR1 and MR2. Observers were more confident in their MR registrations compared to their CBCT based LN registrations (p ≤ 0.02). Summary Interobserver setup correction variability was not found to be significantly different between CBCT and MR. Image quality and registration confidence were found to be superior for MRI sequences. This is a promising step towards MR-guided radiotherapy for the treatment of LA-NSCLC.

Introduction Magnetic resonance–guided adaptive radiotherapy (MRgART) has the potential to improve treatment processes and outcomes for a variety of tumour sites; however, it requires significant clinical resources. Magnetic resonance linear accelerator (MR-linac) treatments require a daily multidisciplinary presence for delivery. To facilitate sustainable MRgART models, agreed protocols facilitating therapeutic radiographer (RTT)-led delivery must be developed to establish a service similar to conventional image-guided radiotherapy (IGRT). This work provides a clinical perspective on the implementation of a protocol-driven ‘clinician-lite’ MRgART workflow at one institution. Methods To identify knowledge, skills, and competence required at each step in the MRgART workflow, an interdisciplinary informal survey and needs assessment were undertaken to identify additional or enhanced skills required for MRgART, over and above those required for conventional cone-beam computed tomography–based IGRT. The MRgART pathway was critically evaluated by relevant professionals to encourage multidisciplinary input and discussion, allowing an iterative development of the RTT-led workflow. Starting with the simplest online adaptation strategy, consisting of a virtual couch shift and online replanning, clear guidelines were established for the delivery of radical prostate radiotherapy with a reduction in staff numbers present. Results The MRgART-specific skills identified included MRI safety and screening, MR image acquisition, MRI-based anatomy, multimodality image interpretation and registration, and treatment plan evaluation. These skills were developed in RTTs via tutorials, workshops, focussed self-directed reading, teaching of colleagues, and end-to-end workflow testing. After initial treatments and discussions, roles and responsibilities of the three professional groups (clinicians, RTTs, and physicists) have evolved to achieve a ‘clinician-lite’ workflow for simple radical prostate treatments. Discussion Through applying a definitive framework and establishing agreed threshold and action levels for action within anticipated treatment scenarios similar to those in cone-beam computed tomography–based IGRT, we have implemented a ‘clinician-lite’ workflow for simple adaptive treatments on the MR-linac. The responsibility for online plan evaluation and approval now rests with physicists and RTTs to streamline MRgART. Early evaluation of the framework after treatment of 10 patients has required minimal online clinician input (1.5% of 200 fractions delivered). Conclusion A ‘clinician-lite’ prostate treatment workflow has been successfully introduced on the MR-linac at our institution and will serve as a model for other tumour sites, using more complex adaptive strategies. Early indications are that this framework has the potential to improve patient throughput and efficiency. Further identification and validation of roles and responsibilities such as online contouring, and more interactive online planning, will facilitate RTTs to fully lead in the online workflow as adaptive radiotherapy becomes ever more complex.

Commercial shrimpers frequently encounter marine debris in their nets, resulting in economic impacts. Currently, no information existed on the spatial and temporal distribution of marine debris that shrimpers encounter and the subsequent economic impact on commercial shrimping. Twenty commercial shrimpers participated in a comprehensive data collection program (July 2020 through December 2020) within the north-central Gulf of Mexico, USA to characterize the quantity and impacts of marine debris. Derelict crab traps were an overwhelming issue for shrimpers. The type of fishing gear used influenced the type of marine debris encountered and the subsequent economic impacts. Surveyed shrimpers encountered marine debris on 19 % of tows and lost an average of 18.21 min, 7.88 kg of catch, and $6.37 in gear damage per tow with encounters, resulting in average annual losses of $6601 per shrimper. The results of this study show that marine debris encounters can have a large impact on the commercial shrimping industry.

Human infection with Shiga toxin-producing Escherichia coli (STEC) causes an estimated 2.8 million cases of acute illness worldwide each year. Serogroup O157 is the most commonly diagnosed STEC in humans, but cases linked to non-O157 STEC serogroups have increased recently due to increased surveillance and improvements to detection methods. Cattle are an important reservoir for STEC O157 and the same may be true for non-O157 STEC; therefore, reducing the occurrence of these pathogens in cattle could mitigate human infection risk. A systematized literature review of articles published within the Scopus database since 2010 (employing a partially systematic approach) was therefore conducted followed by qualitative synthesis of evidence to provide a structured overview of potential risk factors for non-O157 STEC in primary cattle production. Overall, few relevant studies were identified (n = 22), highlighting that more studies are needed. Consistently significant associations were only identified with respect to cattle age (broadly higher rate of isolation from young animals compared to adults) and season of sampling (generally increased isolation of non-O157 STEC in summer). However, wide variation in study designs, including notable differences in laboratory detection methods, means drawing more general conclusions is currently not possible based on the results of this review. However, it is likely that the development of more sensitive methods for non-O157 STEC detection in potential livestock reservoirs and increased standardization across statistically sound epidemiological investigations are required to identify pertinent risk factors.

Sotorasib is a first-in-class, targeted covalent inhibitor of Kirsten rat sarcoma viral oncogene homolog (KRAS)

Introduction/Background Magnetic Resonance Imaging (MRI) is used in radiotherapy planning, and increasingly in on-treatment guidance. The potential for the MR environment to be hazardous, without stringent safe working practices, is real. Guidance suggests all workers in MRI undergo annual safety training. To facilitate a tangible MR safety program, an electronic learning module was created and evaluated. Methods An existing presentation, normally delivered face-to-face, was modified and questions added to test knowledge. The module was delivered and feedback collected, together with answers to the questions, over three phases to ensure deliverability, clarity, and robustness. These comprised an initial pilot phase for non-MR personnel, an evaluation phase for staff renewing annual MR safety training, and finally for new therapeutic radiographer graduates, a test-retest methodology. Results Seven participants took part in the initial pilot phase, followed by thirty-one in the evaluation phase. Participants included radiographers (therapeutic and diagnostic), play specialists, clinical oncologists and anaesthetists, physicists and nursing staff. Within the evaluation group, 74.2% achieved a score >80%. Incorrect responses were principally related to questions regarding expected levels of responsibility and working practices, rather than the physics of high magnetic field strengths. The test-retest phase (n = 5) followed. Mean scores prior to learning were 59%, improving to 79% following learning, with the weakest sections mirroring those highlighted within the evaluation phase. Discussion Transferring MR safety training into an electronic format has provided a standardised, tangible tool that provides evidence of compliance with recommended guidance. Conclusions This work illustrates the transition of MR safety learning for radiotherapy staff from passive presentation, to an interactive teaching methodology. The e-learning module has now been implemented within the department.

At the Fermilab Tevatron proton-antiproton ($p\bar{p}$) collider, high-mass electron-neutrino ($e\nu$) pairs are produced predominantly in the process $p \bar{p} \rightarrow W(\rightarrow e\nu) + X$. The asymmetry of the electron and positron yield as a function of their pseudorapidity constrain the slope of the ratio of the $u$- to $d$-quark parton distributions versus the fraction of the proton momentum carried by the quarks. This paper reports on the measurement of the electron-charge asymmetry using the full data set recorded by the Collider Detector at Fermilab in 2001--2011 and corresponding to 9.1~fb$^{-1}$ of integrated luminosity. The measurement significantly improves the precision of the Tevatron constraints on the parton-distribution functions of the proton. Numerical tables of the measurement are provided., Comment: 27 pages, 25 figures. To be published in PRD

In this chapter, the authors argue that the notion of fracturing the legal skeleton, as put forward by Justice Brennan in Mabo, is incorrect. In fact, they demonstrate that the legal skeleton has been practising yoga for some time, as several notions of ‘shared’ or ‘internal’ sovereignty already exist in this country. Furthermore, the authors believe it is the very denial of Indigenous sovereignty that is unsettling the nation, and that this unsettling will continue whilst it remains a contentious issue. Despite the semantic discussion around definitions of sovereignty, Larissa Behrendt argues that Indigenous sovereignty does not pose a threat to the nation state of Australia, 'but it does question the legitimacy of that authority'. All of the models expressing Indigenous sovereignty which the authors prioritise the conclusion of a treaty or treaties with the Commonwealth government as an essential hallmark of 'internal' sovereignty.

Data Science applications represent a growing fraction of the scientific computing workload, many of them written in Python. The goal of this paper is to compare two popular parallel programming models, namely MPI and Apache Spark for Python based Data Science applications. The paper presents communication and file I/O microbenchmarks to evaluate the MPI support for Python applications, and uses two applications use-cases from Natural Language Processing to compare the performance of the MPI and the Spark versions. Our results indicate that the MPI version shows better scalability and performance than the PySpark version of the code. On the other hand, the MPI applications are significantly larger than their PySpark counterparts, and took significantly longer to develop due to the necessity to implement some of the built-in functionality provided by Spark.

Opioids and benzodiazepines are commonly used to provide analgesia and sedation for critically ill children with cardiac disease. These medications have been associated with adverse effects including delirium, dependence, withdrawal, bowel dysfunction, and potential neurodevelopmental abnormalities. Our objective was to implement a risk-stratified opioid and benzodiazepine weaning protocol to reduce the exposure to opioids and benzodiazepines in pediatric patients with cardiac disease.A prospective pre- and postinterventional study.Critically ill patients less than or equal to 21 years old with acquired or congenital cardiac disease exposed to greater than or equal to 7 days of scheduled opioids ± scheduled benzodiazepines between January 2013 and February 2015.A 24-bed pediatric cardiac ICU and 21-bed cardiovascular acute ward of an urban stand-alone children's hospital.We implemented an evidence-based opioid and benzodiazepine weaning protocol using educational and quality improvement methodology.One-hundred nineteen critically ill children met the inclusion criteria (64 post intervention, 55 pre intervention). Demographics and risk factors did not differ between groups. Patients in the postintervention period had shorter duration of opioids (19.0 vs 30.0 d; p0.01) and duration of benzodiazepines (5.3 vs 22.7 d; p0.01). Despite the shorter duration of wean, there was a decrease in withdrawal occurrence (% Withdrawal Assessment Tool score ≥ 4, 4.9% vs 14.1%; p0.01). There was an 8-day reduction in hospital length of stay (34 vs 42 d; p0.01). There was a decrease in clonidine use (14% vs 32%; p = 0.02) and no change in dexmedetomidine exposure (59% vs 75%; p = 0.08) in the postintervention period.We implemented a risk-stratified opioid and benzodiazepine weaning protocol for critically ill cardiac children that resulted in reduction in opioid and benzodiazepine duration and dose exposure, a decrease in symptoms of withdrawal, and a reduction in hospital length of stay.

The success of hand surgery relies heavily on post-operative therapy. The ability to identify barriers to patient adherence with therapy may therefore allow for improvement in therapeutic and surgical decisions and results. The purpose of this study was to identify significant barriers to adherence with hand therapy following surgery for distal radius fracture. A questionnaire addressing demographic, social, psychological, occupational and medical factors was administered to 20 subjects undergoing surgery for distal radius fracture. Adherence was evaluated by the therapist and by the number of missed sessions. There were 9 males and 11 females. Average age was 46.2 (19–88). The therapists’ evaluation of adherence and number of missed appointments were significantly correlated (R2 = 0.86, p

Objectives: The aim of this study was to assess the consistency of therapy radiographers performing image registration using cone beam computed tomography (CBCT)-CT, magnetic resonance (MR)-CT, and MR-MR image guidance for cervix cancer radiotherapy and to assess that MR-based image guidance is not inferior to CBCT standard practice. Methods: 10 patients receiving cervix radiation therapy underwent daily CBCT guidance and magnetic resonance (MR) imaging weekly during treatment. Offline registration of each MR image, and corresponding CBCT, to planning CT was performed by five radiographers. MR images were also registered to the earliest MR interobserver variation was assessed using modified Bland–Altman analysis with clinically acceptable 95% limits of agreement (LoA) defined as ±5.0 mm. Results: 30 CBCT-CT, 30 MR-CT and 20 MR–MR registrations were performed by each observer. Registration variations between CBCT-CT and MR-CT were minor and both strategies resulted in 95% LoA over the clinical threshold in the anteroposterior direction (CBCT-CT ±5.8 mm, MR-CT ±5.4 mm). MR–MR registrations achieved a significantly improved 95% LoA in the anteroposterior direction (±4.3 mm). All strategies demonstrated similar results in lateral and longitudinal directions. Conclusion: The magnitude of interobserver variations between CBCT-CT and MR-CT were similar, confirming that MR-CT radiotherapy workflows are comparable to CBCT-CT image-guided radiotherapy. Our results suggest MR–MR radiotherapy workflows may be a superior registration strategy. Advances in knowledge: This is the first publication quantifying interobserver registration of multimodality image registration strategies for cervix radical radiotherapy patients.

Breast cancer is the predominant form of cancer among females, with one in eight women likely to develop this disease in their lifetime. The protein INPP4B is a tumour suppressor that is lost in a subset of breast cancers, leading to increased tumour growth. However, the findings in this thesis show that INPP4B levels are increased in a different subset of breast cancers with poorer prognosis. Paradoxically, INPP4B overexpression was found to promote tumour growth via a previously uncharacterised signalling mechanism. These findings could lead to the development of novel therapeutic strategies for breast cancers.

Highlights • Fast (2 min) 4D CBCT can be simulated accurately from long (4 min) scans. • Registration was accurate for 96.6% of simulated 2 min scans. • Acquired 2 min scan registration was accurate in 6/8 patients. • 2 min 4D CBCT produces sufficient image quality for IGRT in lung cancer patients., Purpose Image guided radiotherapy (IGRT) based on respiration correlated cone-beam CT (4D-CBCT) provides accurate tumour localisation in lung cancer patients by taking into account respiratory motion when deriving setup correction. However, 4D-CBCT scan times are typically longer than for acquisition of 3D-CBCT scans, e.g. 4 min. This work aims to quantitatively evaluate the effect of reduced scan times on 4D-CBCT image quality and registration accuracy in lung cancer patients. Methods and materials Scan times down to 1 min were simulated by retaining only projection images corresponding to every second, third or fourth respiratory cycle in forty-four 4D-CBCTs from 15 lung cancer patients. In addition twenty 2-minute scans were acquired for 12 lung cancer patients. Image quality was quantified by assessing registration accuracy in the shorter scan times, comparing to the 4-minute scan registration result where available as reference. Results Use of 2-minute scans had little impact on registration accuracy or ability to detect tumour motion: automatic registration accuracy was within 2 mm in 6/8 scans analysed with 2-minute acquisitions, and 96.6% of registration discrepancies were within 2 mm for the simulated scans. When the scan time simulated was below 2 min, automatic registration results still agreed within 2 mm for 84.7% of scans, however visual image quality was considerably degraded. Conclusion A 4D-CBCT acquisition time of 2 min produces scans of sufficient image quality for IGRT in most lung cancer patients, as demonstrated quantitatively by assessing the impact on automatic registration accuracy in simulated and real acquisitions.

Background Of the many genetic mutations known to increase the risk of autism spectrum disorder, a large proportion cluster upon synaptic proteins. One such family of presynaptic proteins are the neurexins (NRXN), and recent genetic and mouse evidence has suggested a causative role for NRXN2 in generating altered social behaviours. Autism has been conceptualised as a disorder of atypical connectivity, yet how single-gene mutations affect such connectivity remains under-explored. To attempt to address this, we have developed a quantitative analysis of microstructure and structural connectivity leveraging diffusion tensor MRI (DTI) with high-resolution 3D imaging in optically cleared (CLARITY) brain tissue in the same mouse, applied here to the Nrxn2α knockout (KO) model. Methods Fixed brains of Nrxn2α KO mice underwent DTI using 9.4 T MRI, and diffusion properties of socially relevant brain regions were quantified. The same tissue was then subjected to CLARITY to immunolabel axons and cell bodies, which were also quantified. Results DTI revealed increases in fractional anisotropy in the amygdala (including the basolateral nuclei), the anterior cingulate cortex, the orbitofrontal cortex and the hippocampus. Axial diffusivity of the anterior cingulate cortex and orbitofrontal cortex was significantly increased in Nrxn2α KO mice, as were tracts between the amygdala and the orbitofrontal cortex. Using CLARITY, we find significantly altered axonal orientation in the amygdala, orbitofrontal cortex and the anterior cingulate cortex, which was unrelated to cell density. Conclusions Our findings demonstrate that deleting a single neurexin gene (Nrxn2α) induces atypical structural connectivity within socially relevant brain regions. More generally, our combined within-subject DTI and CLARITY approach presents a new, more sensitive method of revealing hitherto undetectable differences in the autistic brain. Electronic supplementary material The online version of this article (10.1186/s13229-019-0261-9) contains supplementary material, which is available to authorized users.

Purpose– The purpose of this paper is to investigate delay factors within private housing construction in Northern Ireland. Delays are inherent throughout the construction industry and create major difficulties in terms of project performance and client satisfaction. Whilst a voluminous body of international literature has investigated pertinent delay factors within construction projects, there is a relative paucity of research which offers a more delineated exploration of delay factors affecting private housing development schemes, particularly in the UK context.Design/methodology/approach– This study applies questionnaire survey research to examine the relative importance of 75 delay attribute factors for housing construction projects in Northern Ireland. The approach applies both a relative rank and principal component analysis to distil the key factors impinging upon the delay process in housing construction.Findings– The key finding from this research is that delays within the housing construction sector in Northern Ireland can be attributed to deficiencies in site management, ineffective communication strategies and a lack of coordination between key stakeholders involved in the construction process.Originality/value– The study adds to the existing knowledge base and provides stakeholders with information on factors, which, if properly risk assessed and understood, can improve housing construction performance. The findings are of relevance to construction industry practitioners, policy makers and researchers with lessons learned serving as a basis for future policy development as well as affording an information platform for improving the efficiency and expediency of housing provision internationally.

"100 copies printed by the Merrymount Press. "A check list of editions of Jewitt's captivity, with bibliographical descriptions of the more important": pp [87]-91."-- Strathern, G. M., & Edwards, M. H. (1970). Navigations, traffiques & discoveries, 1774-1848: A guide to publications relating to the area now British Columbia. Victoria, BC: University of Victoria, p. 143

Purpose Opioids are important in the care of critically ill children. However, their use is associated with complications including delirium, dependence, withdrawal, and bowel dysfunction. Our aim was to implement a risk-stratified opioid weaning protocol to reduce the duration of opioids without increasing the incidence of withdrawal. Methods A pre- and post-interventional prospective study was undertaken in a large children's hospital pediatric ICU where we implemented a risk-stratified opioid weaning protocol. Patients were included if exposed to ≥ 7 days of scheduled opioids. The primary outcome was duration of opioids and secondary outcome was hospital LOS. Results One hundred seven critically ill children met the inclusion criteria (68 pre-, 39 post-intervention). Demographics, risk factors, and confounders did not differ between groups. Patients in the post-intervention group had shorter duration of opioids (17 vs. 22.5 days, p = 0.01) and opioid wean (12 vs. 18 days, p = 0.01). Despite the shorter duration of opioid wean, there was no increase in withdrawal incidence. There was no difference in the LOS (29 vs. 33 days, p = 0.06). Conclusions We implemented a risk-stratified opioid weaning protocol for critically ill children that resulted in reduction in opioid exposure without an increase in withdrawal. There was no difference in the LOS.

We describe a hand therapy protocol aimed at unloading the wrist and increasing blood supply to the wrist, specifically to the lunate. The protocol was used in a series of patients with clinical radial wrist pain, dysfunction and changes on wrist imaging studies. The patients were not candidates for surgical treatment. Application of the therapy protocol improved objective and subjective parameters such as pain and motion, and may provide a viable treatment option for patients with lunate overload or early Kienbock's disease that are not candidates for surgery.

The design of 0.67 THz/200 kW pulsed gyrotron for detecting concealed radioactive materials is presented. The coil with liquid nitrogen cooling and solenoid power supply was successfully tested.

Disrupted-in-Schizophrenia 1 (DISC1) is a risk factor for schizophrenia and affective disorders. The full-length DISC1 protein consists of an N-terminal 'head' domain and a C-terminal tail domain that contains several predicted coiled-coils, structural motifs involved in protein-protein interactions. To probe the in vivo effects of missense mutation of DISC1's C-terminal tail, we tested mice carrying mutation D453G within a predicted α-helical coiled-coil region. We report that, relative to wild-type littermates, female DISC1(D453G) mice exhibited novelty-induced hyperlocomotion, an anxiogenic profile in the elevated plus-maze and open field tests, and reduced social exploration of unfamiliar mice. Male DISC1(D453G) mice displayed a deficit in passive avoidance, while neither males nor females exhibited any impairment in startle reactivity or prepulse inhibition. Whole brain homogenates showed normal levels of DISC1 protein, but decreased binding of DISC1 to GSK3β, decreased phospho-inhibition of GSK3β at serine 9, and decreased levels of β-catenin in DISC1(D453G) mice of either sex. Interrupted GSK3β signaling may thus be part of the mechanism underlying the behavioral phenotype associated with D453G, in common with the previously described N-terminal domain mutations Q31L and L100P in mice, and the schizophrenia risk-conferring variant R264Q in humans.

Estuaries are valuable ecosystems that are easily affected by human activities within the watershed. One determinant of water quality for in an estuary is the presence of suspended sediments. The use of satellite sensors to remotely sense visible and near-infrared reflectance allows for suspended particulate matter (SPM) and suspended particulate inorganic matter (SPIM) concentrations to be monitored on a repetitive synoptic scale. Previously presented algorithms for relating remote sensing reflectance (Rrs) and SPM/SPIM concentrations were evaluated for the Weeks Bay estuary in Alabama. Additionally, numerous potential SPM/SPIM concentration retrieval algorithms using the Landsat-8 satellite were determined through regression analysis, as well as through the consideration of the inherent optical properties of the water body. The most robust empirical algorithm produced an RMSE of 12.50% and utilized the band combination of Ln(Band4)/Ln(Band3), while the most robust semi-analytical algorithm produced an RMSE of 16.34% and utilized the band combination of Band4/Band3.

The ability to predict the crystal structure of a material, given its constituent atoms, is one of the most fundamental problems in materials research. There exist a number of empirical methods which make predictions by clustering existing experimental data, generally using a few simple physical parameters. Although Pettifor maps are perhaps the best known and most successful of these empirical methods, the implementation and assessment of Pettifor maps has not been formalized. Here we propose well-defined algorithms for transforming data from a standard materials crystal structure database into a Pettifor map, using the map to predict the crystal structure for a new system, and assessing the predictive accuracy of the map. We introduce the idea of a candidate crystal structure list, demonstrating that by predicting more than one candidate for a new system the utility of the maps can be enhanced. We assess the accuracy of the maps by testing predictive accuracy using a cross-validation technique on all AB and A3B compounds in the CRYSTMET database. We show that for a new unknown alloy with a stable structure at the stoichiometry of the Pettifor map, a candidate list of five structures will contain the correct crystal structure for the alloy 86% of the time. The algorithms presented here can be used to automate Pettifor maps in materials crystal structure databases, making it possible for users to construct, apply and assess entirely new Pettifor maps quickly and easily.