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Accurate and efficient valuation of property is of utmost importance in a variety of settings, such as when securing mortgage finance to purchase a property, or where residential property taxes are set as a percentage of a property's resale value. Internationally, resale based property taxes are most common due to ease of implementation and the difficulty of establishing site values. In an Irish context, property valuations are currently based on comparison to recently sold neighbouring properties, however, this approach is limited by low property turnover. National property taxes based on property value, as opposed to site value, also act as a disincentive to improvement works due to the ensuing increased tax burden. In this article we develop a spatial hedonic regression model to separate the spatial and non-spatial contributions of property features to resale value. We mitigate the issue of low property turnover through geographic correlation, borrowing information across multiple property types and finishes. We investigate the impact of address mislabelling on predictive performance, where vendors erroneously supply a more affluent postcode, and evaluate the contribution of improvement works to increased values. Our flexible geo-spatial model outperforms all competitors across a number of different evaluation metrics, including the accuracy of both price prediction and associated uncertainty intervals. While our models are applied in an Irish context, the ability to accurately value properties in markets with low property turnover and to quantify the value contributions of specific property features has widespread application. The ability to separate spatial and non-spatial contributions to a property's value also provides an avenue to site-value based property taxes.
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Lyme disease (LD) is the most common tick-borne illness in Europe. Population-based studies in European children are few. This study aimed to assess the incidence, clinical presentation, treatment and outcome of serologically confirmed paediatric LD in the Republic of Ireland over a 5-year period. A retrospective review of records from accredited laboratories performing Borrelia burgdorferi serological testing was undertaken. Proformas were distributed to clinicians of children and adolescents with positive Lyme serology. Data were requested regarding clinical presentation, treatment and outcome. Updated NICE guidelines were used to classify clinical cases. Serology testing for B. burgdorferi was performed on 2908 samples. Sixty-three (2.2%) children were two-tier positive, generating a crude annual incidence rate of 1.15/100,000. Proformas were returned for 55 (87%) and 47 met clinical and laboratory criteria for LD. Twenty-seven (57%) presented with non-focal symptoms (erythema migrans and/or influenza-like symptoms), and 20 (43%) with focal symptoms (cranial nerve involvement, 11; CNS involvement, 8; arthritis, 1). Median age at presentation was 8.2 (2.5-17.9) years. Seventeen (36%) acquired LD overseas. Twenty-five (83%) of the remaining 30 children acquired infection in the West/Northwest of Ireland. Full resolution of symptoms was reported in 97% of those with available data. Serologically confirmed LD in children is relatively rare in the Republic of Ireland. Ninety-eight percent of children tested were seronegative. Of the seropositive cases, 40% could have been diagnosed based on clinical findings alone. Neurological presentations (40%) were common. Full resolution of symptoms occurred in almost all (97%) where data were available.
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Antibacterianos/uso terapêutico , Doença de Lyme/epidemiologia , Doença de Lyme/microbiologia , Adolescente , Anticorpos Antibacterianos/sangue , Borrelia/imunologia , Criança , Pré-Escolar , Estudos de Coortes , Feminino , Humanos , Imunoglobulina G/sangue , Imunoglobulina M/sangue , Irlanda , Doença de Lyme/tratamento farmacológico , Masculino , Estudos RetrospectivosRESUMO
A number of analyses, meta-analyses, and assessments, including those performed by the Intergovernmental Panel on Climate Change, the National Oceanic and Atmospheric Administration, the National Renewable Energy Laboratory, and the International Energy Agency, have concluded that deployment of a diverse portfolio of clean energy technologies makes a transition to a low-carbon-emission energy system both more feasible and less costly than other pathways. In contrast, Jacobson et al. [Jacobson MZ, Delucchi MA, Cameron MA, Frew BA (2015) Proc Natl Acad Sci USA 112(49):15060-15065] argue that it is feasible to provide "low-cost solutions to the grid reliability problem with 100% penetration of WWS [wind, water and solar power] across all energy sectors in the continental United States between 2050 and 2055", with only electricity and hydrogen as energy carriers. In this paper, we evaluate that study and find significant shortcomings in the analysis. In particular, we point out that this work used invalid modeling tools, contained modeling errors, and made implausible and inadequately supported assumptions. Policy makers should treat with caution any visions of a rapid, reliable, and low-cost transition to entire energy systems that relies almost exclusively on wind, solar, and hydroelectric power.
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Financiamento Governamental , Suspensão de Tratamento , Deficiência de alfa 1-Antitripsina/tratamento farmacológico , alfa 1-Antitripsina/uso terapêutico , Custo Compartilhado de Seguro , Indústria Farmacêutica , Política de Saúde , Humanos , Irlanda , Doença Pulmonar Obstrutiva Crônica/etiologia , alfa 1-Antitripsina/economia , Deficiência de alfa 1-Antitripsina/complicações , Deficiência de alfa 1-Antitripsina/mortalidadeRESUMO
The adsorbed layer conformation and lubricity of 35, 100, and 300 kDa PEO adsorbed to ionic liquid (IL)-silica interfaces from 0.01 wt % solutions have been investigated using colloid probe atomic force microscopy. The ILs used were propylammonium nitrate (PAN) and 1-butyl-3-methylimidazolium tetrafluoroborate ([BMIM][BF4]), which are protic and aprotic ILs, respectively. Normal force curves reveal steric interactions consistent with adsorbed polymer layers which are best fit using the mushroom model. Friction measurements show that the adsorbed polymer layer markedly reduces friction compared to surfaces sliding in the pure ILs and that lubricity increases with polymer length. When polymer is adsorbed to the sliding surfaces, friction is controlled by the creation and disruption of intermolecular interactions between entangled chains and the dragging of polymer chains through the interpenetration region. These experiments show that added polymer can reduce friction while maintaining the useful properties of ILs as lubricants.
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Colloid probe friction force microscopy (FFM) has been used to study the lubricity of propylammonium nitrate (PAN) mixed with n-alkanols confined between sliding silica and mica surfaces. Mixtures of PAN with butanol, hexanol, octanol and dodecanol were investigated for various n-alkanol volume fractions to elucidate the effect of n-alkanol hydrocarbon chain length and concentration on shear forces. For all n-alkanols friction decreases with n-alkanol vol%. The trends in friction reduction with n-alkanol vol% do not correlate with changes in the bulk phase viscosity or the near surface nanostructure, and colloid probe atomic force microscope (AFM) fluid dynamic measurements showed that none of the mixtures shear thin. Thus, the reduction in friction is attributed to the n-alkanol disrupting solvophobic interactions between boundary layer propylammonium ions adsorbed to the mica and near surface liquid layers. The lowest friction is obtained for pure dodecanol, which is attributed to the dodecanol forming a robust boundary layer. Friction for the other pure n-alkanols is higher because the lateral attractions between adsorbed n-alkanols are too weak to facilitate the formation of a strong boundary layer, commensurate with the decreased hydrocarbon chain length.
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The effect of ionic liquid (IL) molecular structure on nanoscale friction has been investigated using colloidal probe Friction Force Microscopy (FFM). The ILs studied were ethylammonium formate (EAF), ethylammonium nitrate (EAN), propylammonium formate (PAF), propylammonium nitrate (PAN), dimethylethylammonium formate (DMEAF), and ethanolammonium nitrate (EtAN). ILs were confined between a silica colloid probe and a mica surface, and the friction force was measured as a function of normal load for sliding velocities between 10 and 40 µm s(-1). At low normal forces, multiple IL layers are found between the probe and the surface, but at higher force, in the boundary layer regime, a single ion layer separates the probe and the surface. In the boundary layer regime energy is dissipated by two main pathways. Firstly, the ionic liquid near the surface, with the exception of the boundary layer, is expelled from the advancing contact made by the probe on the surface. This disruption in the interactions between the boundary layer and the near surface multilayers, leads to energy dissipation and depends on the strength of the attraction between the boundary and near surface layers. The second pathway is via rotations and twists of ions in the boundary layer, primarily associated with the cation terminal methyl group. The friction coefficient did not vary over the limited range of sliding speeds investigated.
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In Ireland, the interferon-gamma (IFN-γ) assay is routinely used as an ancillary test interpreted in parallel with the single intradermal comparative tuberculin test (SICTT) to maximize the detection of bovine tuberculosis (bTB) infected animals. Up until 2018, a positive test result was recorded in the IFN-γ ELISA assay following whole blood stimulation with purified protein derivative (PPD)-bovine (B), PPD-avian (A) and nil sample (N), using the interpretation criteria, B-N > 50 optical density units (OD), B > 100 and B-A > 0. Following a review of available data, the threshold of the B-A component changed to B-A > 80. As predicting the impact of changing the cut-off thresholds for the IFN-γ test de novo is challenging, the aims of this study were to follow animals that initially tested negative using the new IFN-γ assay interpretation criteria and investigate their future risk of disclosure with bTB, with a focus on animals that otherwise would have been removed when using the older interpretation criteria (0 < B-A ≤ 80). Enrolled animals (n = 28,669 cattle from 527 herds) were followed up for two years (2019-2021), or to point of bTB detection or death. At the end of follow-up, 1151 (4.0%) of enrolled animals were bTB cases. The majority of these cases were diagnosed using SICTT (80.5%). The cumulative number of positive animals that would have been removed if the old cut-off (0 < B-A ≤ 80) was used amounted to 1680 cattle (5.9% of the enrolled cohort). Of these, 127 (7.5%) were diagnosed with bTB during follow-up. In contrast, 1024 of the 1151 cattle which subsequently tested positive during the study period following a negative IFN-γ test would not have been identified with the old or new IFN-γ cut-off criteria. Survival analysis showed that animals that would have been removed under the old interpretation criteria were at increased risk of a positive diagnosis with bTB during follow-up compared to other test negative animals. A newly developed risk prediction model (using a Cox proportional hazard model) showed that age, animal number of SICTT tests, number of inconclusive SICTT tests, B-A (IFN-γ assay), B-N (IFN-γ assay), animals from store herds and the percentage of the rest of the herd that were positive during the breakdown were statistically significantly associated with bTB detection. However, inclusion of the IFN-γ OD variables did not show added value in terms of prediction performance of the model.
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Mycobacterium bovis , Tuberculose Bovina , Animais , Bovinos , Interferon gama , Irlanda/epidemiologia , Mycobacterium bovis/fisiologia , Tuberculina , Teste Tuberculínico/veterinária , Tuberculose Bovina/diagnóstico , Tuberculose Bovina/epidemiologiaRESUMO
We propose to embed time series in a latent space where pairwise Euclidean distances (EDs) between samples are equal to pairwise dissimilarities in the original space, for a given dissimilarity measure. To this end, we use auto-encoder (AE) and encoder-only neural networks to learn elastic dissimilarity measures, e.g., dynamic time warping (DTW), that are central to time series classification (Bagnall et al., 2017). The learned representations are used in the context of one-class classification (Mauceri et al., 2020) on the datasets of UCR/UEA archive (Dau et al., 2019). Using a 1-nearest neighbor (1NN) classifier, we show that learned representations allow classification performance that is close to that of raw data, but in a space of substantially lower dimensionality. This implies substantial and compelling savings in terms of computational and storage requirements for nearest neighbor time series classification.
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Right ventricular (RV) dysfunction and resultant acute right heart failure (ARHF) is a rapidly growing field of interest, driven by increasing appreciation of its contribution to heart failure morbidity and mortality. Understanding of ARHF pathophysiology has advanced dramatically over recent years and can be broadly described as RV dysfunction related to acute changes in RV afterload, contractility, preload, or left ventricular dysfunction. There are several diagnostic clinical signs and symptoms as well as imaging and hemodynamic assessments that can provide insight into the degree of RV dysfunction. Medical management is tailored to the different causative pathologies, and in cases of severe or end-stage dysfunction, mechanical circulatory support can be utilized. In this review, we describe the pathophysiology of ARHF, how its diagnosis is established by clinical signs and symptoms and imaging findings, and provide an overview of treatment options, both medical and mechanical.
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The lubricating properties of an ionic liquid on gold surfaces can be controlled through application of an electric potential to the sliding contact. A nanotribology approach has been used to study the frictional behavior of 1-butyl-1-methylpyrrolidinium tris(pentaï¬uoroethyl) triï¬uorophosphate ([Py(1,4)]FAP) confined between silica colloid probes or sharp silica tips and a Au(111) substrate using atomic force microscopy. Friction forces vary with potential because the composition of a confined ion layer between the two surfaces changes from cation-enriched (at negative potentials) to anion-enriched (at positive potentials). This offers a new approach to tuning frictional forces reversibly at the molecular level without changing the substrates, employing a self-replenishing boundary lubricant of low vapor pressure.
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Despite training and field experience that the location and spread between conducted electrical weapon (CEW) probes is important in establishing incapacitation, there have been no human studies which have systematically examined the relationships between probe spread and incapacitation. We have investigated this relationship with the TASER(®) X26. We have also developed and validated methodologies for prospective assessment of the effectiveness of CEWs in the incapacitation of highly motivated human subjects. Subjects (n = 30) had probes placed on the front or back with randomly varied spreads in accordance with recommended targeting zones. Subjects were motivated to complete the task of disabling the device or a dummy officer suspended ten feet away during the exposure while using a training knife. Subjects were rated on their progress toward goal success and on the extent of any incapacitation using two separate observer scoring panels: one consisting of experts in physiology and X26 technology, and another of veteran peace officers. Incapacitation by all measures was found to be a function of spread; generally increasing in effectiveness up to spreads between 9 and 12 in. There were notable differences between front and back exposures, with front exposures not leading to full incapacitation of the upper extremities regardless of probe spread. This is the first published study on a quantitative methodology for directly assessing the effectiveness of CEWs in human incapacitation. We have also validated and quantified for the first time in human subjects that establishing a minimal spread between X26 probes correlates to the extent of device effectiveness.
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Estimulação Elétrica/instrumentação , Imobilização , Aplicação da Lei , Adulto , Desenho de Equipamento , Humanos , Pessoa de Meia-Idade , Contração Muscular , Estudos Prospectivos , Adulto JovemRESUMO
Dynamic loading is a shared feature of tendon tissue homeostasis and pathology. Tendon cells have the inherent ability to sense mechanical loads that initiate molecular-level mechanotransduction pathways. While mature tendons require physiological mechanical loading in order to maintain and fine tune their extracellular matrix architecture, pathological loading initiates an inflammatory-mediated tissue repair pathway that may ultimately result in extracellular matrix dysregulation and tendon degeneration. The exact loading and inflammatory mechanisms involved in tendon healing and pathology is unclear although a precise understanding is imperative to improving therapeutic outcomes of tendon pathologies. Thus, various model systems have been designed to help elucidate the underlying mechanisms of tendon mechanobiology via mimicry of the in vivo tendon architecture and biomechanics. Recent development of model systems has focused on identifying mechanoresponses to various mechanical loading platforms. Less effort has been placed on identifying inflammatory pathways involved in tendon pathology etiology, though inflammation has been implicated in the onset of such chronic injuries. The focus of this work is to highlight the latest discoveries in tendon mechanobiology platforms and specifically identify the gaps for future work. An interdisciplinary approach is necessary to reveal the complex molecular interplay that leads to tendon pathologies and will ultimately identify potential regenerative therapeutic targets.
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A prototype main-ion CHarge Exchange Recombination Spectroscopy (mCHERS) diagnostic is providing measurements of the main-ion (hydrogen or deuterium) temperature and velocity in the C-2W field reversed configuration plasma using charge exchange Balmer-alpha emission at five different radial locations with 500 Hz frequency and a per-pixel velocity resolution of 15 km/s. Measurement along the entire plasma radius of C-2W is enabled by a diagnostic neutral beam (DNB) that passes through the center of plasma, unlike the larger diameter heating neutral beams that have impact parameters of 20 cm. DNB provides high time resolution via beam modulation and spatial resolution via its small cross section. The goals of the current mCHERS upgrade are to double the number of spatial channels, improve the per-pixel velocity resolution by three times, and increase the measurement frequency to match the maximum modulation frequency of the diagnostic neutral beam (â¼10 kHz). To accomplish these goals, a new astigmatism-free Isoplane spectrometer has been commissioned. Progress and results from the newly upgraded mCHERS system are detailed.
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BACKGROUND: Textbook depictions of the mitral valve (MV) often illustrate it as composed of a single nonscalloped anterior leaflet, with the posterior leaflet having three symmetric and evenly spaced scallops. However, common variations in this anatomy have been noted in autopsy series for decades. Improved cardiac imaging with three-dimensional transesophageal echocardiography (TEE) now affords the ability to detect variations in scallop anatomy in vivo. The aims of this study were to catalog variations in mitral anatomy and to examine for association with mitral regurgitation in patients referred for clinical three-dimensional TEE. METHODS: Three-dimensional transesophageal echocardiographic images of the MV from 107 subjects were reviewed for MV variations. Three-dimensional analysis software was used to characterize mitral leaflet anatomy and assess the relative sizes of posterior leaflet scallops. RESULTS: Variations from the classic MV configuration were seen in 58.9%. Symmetric variations in the posterior leaflet (dominant P2 scallop, accessory P2 scallop, absent P2 scallop, and dichotomous P2 scallop) were seen in 33.6% of the study group. Asymmetric variants in the posterior leaflet (fused P1 and P2, fused P2 and P3, commissural scallop, accessory scallops, dichotomous P1 or P3, and dominant P2 or P3) were seen in 24.3%. Indentations or folds in the anterior leaflet were noted in 5.6%. Leaflet variations were not associated with patient demographics, indication for TEE, mitral regurgitation, mitral annular dimensions, or Carpentier class. CONCLUSIONS: Mitral leaflet morphologic variants were well characterized using three-dimensional TEE. Variants are common and were present with a frequency consistent with autopsy series. Mitral scallop variations were not associated with mitral regurgitation.
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Ecocardiografia Tridimensional , Insuficiência da Valva Mitral , Prolapso da Valva Mitral , Pectinidae , Animais , Ecocardiografia Transesofagiana , Humanos , Valva Mitral/diagnóstico por imagem , Insuficiência da Valva Mitral/diagnóstico por imagemRESUMO
The medical literature on the effect of electronic control devices (ECD) on muscle injury is sparse. In this paper, we examine pooled data from five human studies that used creatine kinase (CK) as a marker for muscle injury. CK was measured in five separate studies involving four TASER ECDs with different exposure durations and number of circuits or contact points. Device type, exposure duration, number of circuits or contact points, and CK values at baseline and 24 h after exposure were pooled from these previous studies. Data were analyzed to determine the correlation of CK to duration of exposure, number of contact points, and distance between the probes. The pooled results contained 163 subjects. Seven were withdrawn due to incomplete data, leaving 156 subjects for analysis (median age 36, range 19-67, 93.6% male). 121 (77.6%) subjects had 2 contacts points, 10 (6.4%) had 3 contact points, 18 (11.5%) had 4 contact points, and 7 (4.5%) had 6 contact points. 81 (51.9%) subjects had a 5-s exposure, 64 (41.0%) a 10-s exposure, and, 11 (7.1%) a 30-s exposure. Median baseline CK (145 U/l, IQR 104-217, range 12-1956) did not differ between groups (P = 0.213 for number of contact points, 0.124 for duration). For the number of contacts, the median change in CK for 2 points of contact was 32 (IQR -1 to 1513, range -205 to 1821), for 3 was 1456 (IQR 634-1868, range 101-25452), for 4 was 887 (IQR 285-7481, range -1054 to 7481), and for 6 was 846 (IQR 57-1149, range -8 to 2309), (P < 0.001). For duration, the median change in CK for 5 s was 26.5 (IQR -8 to 109, range -1054 to 2309), for 10 s was 303 (IQR 34.5-1073, range -205 to 25452), and for 30 s was 47 (IQR 23-82, range -140 to 364), (P < 0.001). There was a relationship between the number of points of contact and the change in CK (P < 0.001) but not a relationship between the duration and the change in CK (P = 0.496). The median spread between the probe pairs for our pooled data was 40 cm, with a range from 18 to 70 cm (n = 76). The correlation between the change in CK and spread between the probe pairs was 0.16 at baseline (P = 0.18), and 0.24 at 24 h (P = 0.04) by Spearman's rank correlation. ECD exposure can cause a modest increase in CK. Although we cannot draw conclusions about the individual devices included in this analysis, our findings indicated that multiple contact points or exposures may result in a larger increase in CK, but the duration of the exposure does not appear to have a significant effect on CK. There is a correlation between the distance between the probes and the change in CK.
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Lesões por Armas de Eletrochoque/enzimologia , Creatina Quinase/sangue , Eletrônica/instrumentação , Músculo Esquelético/enzimologia , Músculo Esquelético/lesões , Armas , Adulto , Idoso , Biomarcadores/sangue , Lesões por Armas de Eletrochoque/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Rabdomiólise/epidemiologia , Fatores de RiscoRESUMO
Several studies of neurocognitive differences between selected samples of nonimpact and impact patients experiencing mild traumatic brain injury (mTBI) in a single motor vehicle accident have been conducted. The results suggested comparable and essentially normal brain-related cognitive skills for these clinical groups, but with notable exceptions for nonimpact individuals involving tactile- and visual-spatial perceptual and memory deficiencies. These findings raised the possibility that some nonimpact patients were experiencing dysfunction of post-central cerebral regions due to neck injury that was interfering with vertebral artery function. Neck injury was presented in this study as a hypothetical correlate of vertebral artery dysfunction. The hypothesis that neck injury was more likely for this sample of nonimpact mTBI patients was tested by comparing frequencies of neck injury complaints and diagnostic conclusions of neck injury, and agreement between these variables, for nonimpact and impact patients. While frequency differences for neck injury complaints and diagnostic conclusions did not quite achieve statistical significance, concordance between these variables was significantly higher for nonimpact individuals. Agreement between neck injury complaints and diagnostic conclusions was significantly more likely for nonimpact patients, supporting the possibility of a notable relationship between nonimpact mTBI and neck injury in motor vehicle collisions.
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Concussão Encefálica , Lesões do Pescoço , Acidentes de Trânsito , Concussão Encefálica/complicações , Concussão Encefálica/diagnóstico , Concussão Encefálica/epidemiologia , Humanos , Veículos Automotores , Testes NeuropsicológicosRESUMO
BACKGROUND: The failure of some high-income countries to retain their medical graduates is one driver of doctor immigration from low- and middle-income countries. Ireland, which attracts many international medical graduates, implemented a doctor retention strategy from early 2015. This study measures junior doctors' migration intentions, the reasons they leave and likelihood of them returning. The aim is to identify the characteristics and patterns of doctors who plan to emigrate to inform targeted measures to retain these doctors. METHODS: A national sample of 1148 junior hospital doctors completed an online survey in early 2018, eliciting their experiences of training and working conditions. Respondents were asked to choose between the following career options: remain in Ireland, go and return, go and stay away, or quit medicine. Bivariate analyses and a two-stage multivariable analysis were used to model the factors associated with these outcomes. RESULTS: 45% of respondents planned to remain in Ireland, 35% leave but return later, 17% leave and not return; and 3% to quit medicine. An intention to go abroad versus remain in Ireland was independently associated (P<.05) with the doctor being under 30 years (odds ratio [OR]=1.09 per year under 30), a non-European Union (EU) national (OR=1.54), a trainee (OR=1.50), and with hospital specialization, especially in Anesthesiology (OR=5.09). Respondents were more likely to remain if they had experienced improvements in supervision and training costs. Intention to go abroad and not return versus go and return was independently associated (P<.05) with: age over 30 years (OR=1.16 per year over 30); being a non-EU (OR=9.85) or non-Irish EU (OR=3.42) national; having trained through a graduate entry pathway (OR=2.17), specializing in Psychiatry (OR=4.76) and reporting that mentoring had become worse (OR=5.85). CONCLUSION: Ireland's doctor retention strategy has not addressed the root causes of poor training and working experiences in Irish hospitals. It needs a more diversified retention strategy that addresses under-staffing, facilitates circular migration by younger trainees who choose to train abroad, identifies and addresses specialty-specific factors, and builds mentoring linkages between trainees and senior specialists.