Equivalent Rise Research Articles

Impact of non-invasive post-mortem micro-CT imaging on a fetal autopsy service: a single centre retrospective study

To evaluate the impact of a new, less-invasive micro-computed tomography (CT) service on autopsy service provision. We recorded parental consent, type of autopsy performed, autopsy reporting times and time taken for the body to be released from the mortuary. A retrospective, single-centre case series was conducted for all perinatal deaths since the introduction of our micro-CT service in 2016, with a detailed review of records extracted from 2019 and 2021. Fetal demographics (gestational age, weight), type of autopsy conducted, and the time taken from receiving the bodyto releasing the body and issuing a final report were recorded. Micro-CT imaging uptake increased to over two hundred cases/year by 2021. Overall, invasive autopsies reduced from (45.8%, 196/428; 2019) to (32.1%, 125/390; 2021) with an equivalent rise in less-invasive autopsy from 54.2% (232/428;2019) to 67.9% (265/390;2019). Offering a micro-CT service resulted in an increase in consent to imaging-based autopsies from (76.9%, 329/428;2019) to (87.2%, 340/390;2021). Micro-CT has become the most commonpost-mortem imaging performed in our institution at 54.4% (212/251;2021), although the body preparation time from the tissue staining required has increased the time to provide an autopsy report to 17 days and release of the body to 18 days. Our study shows that introducing a micro-CT post-mortem imaging service was associated with reduced use of conventional invasive procedures, despite a slight increase in turnaround times. Understanding these factors and continued improvements in micro-CT service delivery will help make this accessible to a wider population in the future.

Associations between adverse childhood experiences and trust in health and other information from public services, professionals and wider sources: national cross sectional survey

IntroductionTrust in health and other systems can affect uptake of public health advice and engagement with health services. Individuals who had adverse childhood experiences (ACEs) are more likely to experience...

Two-Lane Highway Capacity Estimation Based on Geometric Features

Abstract The majority of roads in most countries are two-lane highways. These lanes quickly reach their capacity and must be upgraded on a regular basis. To do so, we must first determine the capacity of the street. The primary objective of this study was to determine the effect of carriageway width, the radius of the horizontal curve, and gradients on Passenger Car Unit (PCU) values as well as on capacity of two-lane undivided Highways, and more importantly, to develop a multiple linear regression model to determine the capacity of the highway when all of these factors are present, which has not been previously reported. Green shield’s model was used to estimate the capacity of each element for all thirty-six sections using flow and speed data. Different models were built using regression analysis to estimate capacity independently, and the combined model was developed as a result. It has been noted that with proportionate increases in carriageway width and radius of the curve, there is an equivalent rise in PCU values and highway capacity, providing improved comfort and safety to road users. It was also discovered that when the value of the gradient increases cause increase in PCU values but the highway capacity decreases, thereby increasing the vehicle operating cost. Where all of these characteristics are present simultaneously in a section, the resulting multiple linear regression model was proven to be appropriate. It is believed to be valuable to practitioners as well as in the development or revision of Indian highway capacity manuals.

Hardware Efficient Massive MIMO Systems with Optimal Antenna Selection.

An increase in the number of transmit antennas (M) poses an equivalent rise in the number of Radio Frequency (RF) chains associated with each antenna element, particularly in digital beamforming. The chain exhibits a substantial amount of power consumption accordingly. Hence, to alleviate such problems, one of the potential solutions is to reduce the number of RFs or to minimize their power consumption. In this paper, low-resolution Digital to Analogue Conversion (DAC) and transmit antenna selection at the downlink are evaluated to favour reducing the total power consumption and achieving energy efficiency in mMIMO with reasonable complexity. Antenna selection and low-resolution DAC techniques are proposed to leverage massive MIMO systems in free space and Close In (CI) path-loss models. The simulation results show that the power consumption decreases with antenna selection and low-resolution DAC. Then, the system achieves more energy efficiency than without low-resolution of DAC and full array utilization.

Soft computing models for forecasting day-ahead energy consumption

The massive increase in automation, innovative technologies and standard of living has witnessed an equivalent rise in energy consumption. The depletion of conventional energy sources and the challenges faced in harnessing the non-conventional sources have reinforced the necessity for optimized energy consumption. Forecasting energy consumption will serve as a great tool for meticulous planning, judicious usage and outage prevention. In this paper, time series forecasting models have been used to forecast day-ahead energy consumption. Soft computing approaches have been employed for building single step and multiple step forecasting using five different datasets. The performance of the models has been evaluated using appropriate performance criteria.

Metformin in pregnancy: a re-examination of its safety.

Metformin in pregnancy: a re-examination of its safety.

THE LABOR MARKET FOR A MINING ENGINEER: A SURVEY OF FORMALLY HIRED EMPLOYEES IN BRAZIL

The number of Mining Engineering courses has increased in Brazil since 2004, resulting in a significant rise in the number of graduates. However, such growth was not followed by an equivalent rise in the number of applications for professional registration as a Mining Engineer with the Regional Engineering Councils, which might indicate a shortage of professional opportunities in the marketplace. This paper addresses the current labor market scenario for mining engineers in Brazil, taking sources of formal employment data as a basis: the Labor Ministry’s CAGED and RAIS employee data systems. It was found that there has been a significant asymmetry between the number of graduates and the number of mining engineers formally registered in the country in recent years. Moreover, the number of mining engineers’ dismissals exceeds the hiring figures as of 2012, in contrast with the previous expansion forecasts in this industry, elaborated in 2010 and 2014, based on which new Mining Engineering courses had been opened.

An Assessment of the International and Domestic Tourists Behavior in Australia

Tourism contributes to regional development and generates income for destinations. However, in many cases, the growth of tourist numbers does not necessarily result in an equivalent rise in economic contribution. The search for quality tourists over the quantity of tourists is certainly an important goal of regional development managers, but the efforts required to implement such an approach, especially the detailed documentation of tourist behavior while visiting the region, pose a challenge for most. This is perhaps why the analysis of quality vs quantity of tourists has been limited. This study focuses on the Great Ocean Road Region in Australia; an area that is experiencing increased visitor numbers but is not seeing commensurate economic growth. A fine-grained analysis of the international and domestic tourists is employed to determine behavior-based tourist quality, including the measurement of their traveling behavior, overnight visitation pattern, expenditure, and regional dispersal. Data was collected from 311 domestic tourists and 562 international tourists. Descriptive statistical methods were used in analyzing data. Results indicate that the domestic tourists were of a higher quality than the international tourists; they stayed longer, spent more, and were more widespread across the region than the international tourists. Hence, high-quality tourists can be a valuable resource and should be a priority for regional tourism development.

Improved Selected Mapping Technique for Reduction of PAPR in OFDM Systems

High peak to average power ratio (PAPR) is a limiting factor towards the performance of an OFDM system. Selected Mapping (SLM) is a popular peak to average power ratio (PAPR) reduction scheme used with the OFDM systems. In this technique, U set of candidate sequences are generated that leads to improvement in the PAPR reduction ability of the OFDM systems. The major concern of the conventional SLM is that as the number of candidates is increased, there is a proportional rise in the inverse fast Fourier transforms (IFFT) computations of the systems. In our article we have proposed a scheme in which we increase the number of candidate sequence as (U+U2/4) that leads to improved PAPR performance of the OFDM systems without any equivalent rise in the IFFT computations. It has been demonstrated that both the simulation and analytical results are well-approximated in our proposed schemes. We also estimate the threshold value of PAPR at a fixed value of complementary cumulative distribution function (CCDF) for different number of subcarriers and candidate sequences. Results demonstrate that our proposed scheme outperforms in terms of PAPR reduction ability of the OFDM signal and obtains effective PAPR threshold values with negligible loss in BER performance of the system.

Uncoupling of cerebral blood flow and brain oxygen saturation under non-pulsatile flow conditions

Introduction Non-pulsatile blood flow has been associated with altered microcirculatory perfusion. Soon after loss of pulsatility a marked heterogenous flow profile in the very small vessels ensues that is coupled with impaired oxygen extraction [1]. We investigated if changes in cerebral blood flow during non-pulsatile perfusion would affect brain tissue oxygenation assessed by near-infrared spectroscopy. Methods After approval by the local ethics committee thirty-two patients were included in this trial. They were studied during general anaesthesia, and stable hemodynamic conditions. Cerebral blood flow velocity in the middle cerebral artery was measured during non-pulsatile flow in the course of cardiac surgery on total extracorporeal bypass and again postoperatively on the intensive care unit during pulsatile flow. We modified cerebral blood flow by changing arterial partial pressures of carbon dioxide between 30, 40 and 50 mmHg. This was conducted either by a change of sweep gas flow at the heart lung machine or by changing respiratory rate at the respirator. In addition to flow measurements patients' regional brain oxygenation was determined. Relative changes in blood flow velocity were plotted against relative changes in regional brain saturation for both flow conditions and compared using Pearson's correlation. A p-value Results Absolute cerebral blood flow velocity was slightly higher during non-pulsatile flow when serum hemoglobin was diluted. Relative changes in cerebral blood flow velocity and regional brain oxygenation were tightly coupled independent of the flow condition. R-values for non-pulsatile and pulsatile blood flow were 0.724 and 0.796, respectively. However, during non-pulsatile flow the slope of the regression line was less steep as compared with pulsatile flow (P Discussion Despite greater cerebral perfusion during hypercapnia and non-pulsatile flow there was no equivalent rise in cerebral oxygenation. Assuming similar cerebral oxygen delivery this finding could be explained by impaired brain oxygen extraction in the high flow range while partial pressure of carbon dioxide was elevated. In contrast, during hypocapnia, when cerebral blood flow was decreased to a greater extent as during pulsatile flow, the concomitant desaturation was less pronounced. Both findings are in line with shunting on the microcirculatory level, whereby hyperperfused vessels coexist with vessels lacking adequate flow. These findings substantiate that loss of pulsatility seems to negatively affect nutritive tissue perfusion. Raised neurological morbidity in patients supported with non-pulsatile extracorporeal cardiac assist devices could potentially be attributable to the observed perfusion deficit [2].

Physical fitness contributes to cardio-respiratory synchronization.

Cardio-respiratory synchronization is a phenomenon of particular interest- especially at a 1:1 ratio- and may give greater insight into the underlying mechanisms of cardio-respiratory communication. Synchronization of this ratio is hypothesised to occur when breathing rate exceeds heart rate, which is the premise of this research. A novel experimental design focused on guiding elevated respiration to induce the entrainment of heart rate, and produce an equivalent rise in value. Application of instantaneous phase for identification and analysis of synchronization allowed for a reliable method of measuring the interaction between these stochastic processes. We have identified 1:1 phase synchronization in all volunteers measured. Longer synchronization episodes were observed reliably in athletic individuals, corroborating previous research for spontaneous breathing. This observation suggests that cardio-respiratory synchronization at all respiration rates is associated with a common underlying communication mechanism. Furthermore, it presents cardio-respiratory synchronization as a potential future measurement of fitness and autonomic health.

Age Dependency Ratios and GDP Growth in Developing Countries

What is the relationship, if any, between age dependency ratios (ADRs) and macroeconomic growth in low-income countries versus emerging economies? This paper probes the hypotheses that (1) ADRs and GDP growth are inversely correlated at both stages of development and (2) an equivalent rise in ADR is associated with a greater change in GDP growth in low-income countries than in emerging economies. The approach to testing the corresponding null hypotheses is to conduct linear fixed-effects regression analyses with AR(1) disturbances using annual World Bank and United Nations data on 38 low-income countries and 63 emerging economies over the 24-year period from 1994 to 2017. Model 1 is a simple bivariate regression of GDP growth against ADR by group; Model 2 adds population growth, unemployment, human capital (represented by Human Development Index scores), and technology (reflected in gross fixed capital formation) as control variables. The ADR coefficients have greater statistical significance in low-income countries than in emerging economies, but the differences themselves are more likely to be statistically significant in Model 2 than in Model 1, and tests of the null hypotheses produce mixed results. The paper closes with a comment on the implications for fiscal policy in low-income countries.

Diagnosing Disorders of Consciousness

The definition of consciousness has long been debated in a scientific and philosophical context due to its ambiguous nature. Recent developments in the concept of consciousness have contributed to a better understanding of associated Disorders of Consciousness (DOC). However, there has not been an equivalent rise in the accuracy of diagnostic measures for DOC. About half of the patients with DOC are incorrectly diagnosed due to significant reliance on subjective and inaccurate behavioural scales. Consequently, the misrepresentation of a patient’s present residual consciousness severely affects the treatment and rehabilitation measures that they receive. These inaccurate diagnoses ultimately influence the patient’s chance of survival. Thus, it is necessary to critique the current methods of evaluating consciousness. Neurophysiological scales are explored as a possible alternative method of evaluating consciousness, which is characterized by high sensitivity and objectivity. An understanding of the advantages and disadvantages of different consciousness-evaluating techniques can aid in the advocacy of their widespread use for DOC patients.

Postoperative imaging of the aorta.

Considerable progress has been made in the management of diseases of the thoracic and abdominal aorta over the past decades, ranging from advances in open repair to the advent of minimally invasive endovascular techniques. Along with this comes an equivalent rise in imaging necessity for these patients, both in preoperative planning and postoperative surveillance. With the growing complexity and diversity of vascular procedures and techniques, it is essential to have a solid understanding of the imaging features and postoperative complications of these procedures to avoid imaging pitfalls. This review is an attempt to define the normal postoperative appearance and important complications of various open and endovascular surgical techniques of the thoracic and abdominal aorta.

Human capital and FDI: How does corruption affect the relationship?

Can corruption affect the relationship between human capital and FDI for a host country? This paper explores the interactive impact of corruption and human capital on FDI. In particular, we investigate whether countries with higher or lower corruption levels benefit differently in terms of FDI inflow following an equal improvement in the level of human capital. Employing an extensive panel data and robust identification strategies, our results suggest that if the corruption score of a highly corrupt country becomes comparable to that of a low corruption country, FDI inflow will rise by almost 40 percent for an equivalent rise in human capital stock. The results remain robust for various measures of human capital.

Deterioration of Groundwater in Beirut Due to Seawater Intrusion

All of Lebanon’s aquifers, without exception, are afflicted with some form of contamination, be it from untreated raw sewage, pesticides or fertilizers, but at the forefront there is seawater intrusion, and nowhere it is more pronounced than in Beirut, the capital. Extensive sampling of Beirut’s groundwater in recent years has revealed alarming values of Total Dissolved Solids (TDS) in the thousands of milligrams per litre, in an increasing number of wells. This irreversible deterioration of groundwater quality is forcing citizens to install costly desalination equipment, importing questionable water by private tankers or abandoning their wells altogether. Initial groundwater sampling began in 2004. In what was possibly Lebanon’s worst drought in decades, another campaign to sample Beirut’s groundwater was undertaken in the summer of 2014 which still continues to date. Acute water shortages in recent years coupled with recurrent periods of drought, have rendered Total Dissolved Solids (TDS) of many sampled wells in Beirut, equivalent to that of seawater (~37,500 mg/L). Fundamental in combating the impact of seawater intrusion however is an understanding of the Ghyben-Herzberg principle which warns that for every meter of groundwater drop above sea level there is an equivalent rise of 40 meters of the saline-fresh water interface, demonstrating just how sensitive over-pumping is in coastal aquifers. With an understanding of the principle dynamics behind the phenomena of seawater intrusion, myriad methods may then be employed to combat this encroachment in coastal aquifers. Restricting or even preventing altogether withdrawals from Beirut’s coastal aquifers may however be the only viable option left.

Non-Pharmacological Approaches to the Prevention and Treatment of Alzheimer's Disease with Respect to the Rising Treatment Costs.

Alzheimer's disease is a serious degenerative disease which is mainly typical of the developed countries. The prevalence percentage in Africa is only 2.6 %, whereas in America it is 6.5 % and in Western Europe 7.2 %. Overall, this disease affects 44 million people worldwide. With respect to the demographic development, a number of people suffering from Alzheimer's disease is expected in future. The key issue is not only the discovery of an effective medication, but also the early diagnosis, prevention and care about people with AD, as well as the provision of an equivalent rise of places in health and social institutions. Since the treatment of Alzheimer's disease (AD) imposes a severe economic and social burden, the main purpose of this study is to analyze and compare available non-pharmacological approaches to the prevention and treatment of patients with AD with special focus on their cognitive competences. In addition, the analysis also concentrates on the costs of pharmacological care in individual countries all over world. This is done by using Drummond's methodological approaches to direct and indirect costs. The analysis of non-pharmacological approaches is conducted on the basis of literature review of both clinical and review studies relevant for the research issue in the acknowledged databases and a comparison and evaluation of their findings.

Identifying the Flypaper Effect in the Presence of Spatial Dependence: Evidence from Education inChina's Counties

AbstractIn the context ofChina without a median voter system, this study examines whether the “flypaper effect,” an unconditional lump‐sum grant from the upper governments to the county governments increases spending in a greater proportion than an equivalent rise in local income, holds true inChina. UsingChina's county‐level education data during 2007, the models have been estimated using a spatial econometric technique that accounts for spatial interaction behavior on public education expenditure across local governments. We find that, in the presence of spatial interdependence, there is no evidence of a “flypaper effect” when different spatial weighting schemes and the endogeneity problem of education grants are accounted for. Rather, the “anti‐flypaper effect” is found. Important policy implications are drawn forChina's fiscal decentralization reform.

The Greenland Ice Sheet at the peak of warming during the previous Interglacial

The Last Interglacial (LIG or the Eemian) between ca. 130 and 115 kyr BP is probably the best analogue for future climate warming for which increasingly better proxy data are becoming available. The volume of the Greenland Ice Sheet (GrIS) during this period is of particular interest to better assess how much and how fast sea-level can rise in a future Earth undergoing gradual climatic warming. Sea-level during the LIG is inferred to have been up to 9 meter higher than today, but contribution of the GrIS into this rise remains unclear. Various ice-sheet modeling studies have come up with a very broad range of the LIG volume loss by the GrIS to between 60 cm and 6 m of equivalent sea-level rise. This wide range is explained by the sensitivity of GrIS models to the imposed climatic conditions and to poor knowledge of the LIG climate itself in terms of the magnitude and precise timing of the maximum warming, as well as in terms of spatial and annual patterns. To partially circumvent these uncertainties we made use of the newest temperature record over the Central Greenland reconstructed from the isotopic composition of the recently obtained NEEM ice core containing undisturbed LIG segment to build the climatic forcing of the model. The NEEM record unequivocally indicates times of the start and of the end of the LIG warming in Greenland as well as the duration of the warmest time period within the Eemian. Using a three-dimensional thermomechanical ice-sheet model, we produced an ensemble of possible LIG configurations by varying only four key parameters for temperature, precipitation rate, surface melting magnitude and melting pattern within realistic bounds. The outcome of a series of the numerical experiments is a variety of glaciologically consistent GrIS geometries corresponding to a wide range of possible «climates». To constrain the ensemble of GrIS geometries, we used data inferred from 5 Greenland ice cores such as the presence or absence of LIG ice, borehole temperature and isotopic composition. Lagrangian backtracing of particles was used to calculate non-climatic biases in isotopic records introduced by horizontal advection, systematic latitudinal contrast and local elevation changes. Comparison of model-generated ice-core characteristics with the observed data enabled to narrow down the ensemble to a bound on the GrIS contribution to the LIG sea-level rise of between 1.3 and 2.9 m with the best choice of 1.8–2.2 m. This conclusion in general supports the point of view about the modest GrIS contribution to global sea level rise during the LIG.

Impedance changes in chronically implanted and stimulated cochlear implant electrodes

ObjectivesElectrode impedance increases following implantation and undergoes transitory reduction with onset of electrical stimulation. The studies in this paper measured the changes in access resistance and polarization impedance in vivo before and following electrical stimulation, and recorded the time course of these changes.DesignImpedance measures recorded in (a) four cats following 6 months of cochlear implant use, and (b) three cochlear implant recipients with 1.5–5 years cochlear implant experience.ResultsBoth the experimental and clinical data exhibited a reduction in electrode impedance, 20 and 5% respectively, within 15–30 minutes of stimulation onset. The majority of these changes occurred through reduction in polarization impedance. Cessation of stimulation was followed by an equivalent rise in impedance measures within 6–12 hours.ConclusionsStimulus-induced reductions in impedance exhibit a rapid onset and are evident in both chronic in vivo models tested, even several years after implantation. Given the impedance changes were dominated by the polarization component, these findings suggest that the electrical stimulation altered the electrode surface rather than the bulk tissue and fluid in the cochlea.