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Ring lasers are commonly used as gyroscopes for aircraft navigation and attitude control. The largest ring lasers are sensitive enough that they can be used for high resolution inertial rotation sensing of the Earth in order to detect tiny perturbations to the Earth's rotation caused by earthquakes or global mass transport. This book describes the latest advances in the development of large ring lasers for applications in geodesy and geophysics using the most sensitive and stable devices available. Chapters cover our current knowledge of the physics of the laser gyroscope, how to acquire and analyse data from ring lasers, and what the potential applications are in the geosciences. It is a valuable reference for those working with ring lasers or using the data for applications in geodesy and geophysics; as well as researchers in laser physics, photonics and navigation.
Numerous studies have shown that arthroscopic partial meniscectomy (APM) is not (cost-) effective in patients with symptoms attributed to a degenerative meniscus tear. We aimed to assess the budget impact of reducing APM in routine clinical practice in this population.
Materials and methods
A patient-level state transition model was developed to simulate patients recently diagnosed with a degenerative meniscus tear. Three strategies were compared: “current guideline” (i.e., postpone surgery to at least 3 months after diagnosis), “APM at any time” (i.e., APM available directly after diagnosis), and “nonsurgical” (i.e., APM no longer performed). Total societal costs over 5 years were calculated to determine the budget impact. Probabilistic and deterministic sensitivity analyses were conducted to address uncertainty.
The average cost per patient over 5 years were EUR 5,077, EUR 4,577, and EUR 4,218, for the “APM at any time,” “current guideline,” and “nonsurgical” strategy, respectively. Removing APM from the treatment mix (i.e., 30,000 patients per year) in the Netherlands, resulted in a reduction in health care expenditures of EUR 54 million (95 percent confidence interval [CI] EUR 38 million–EUR 70 million) compared to the “current guideline strategy” and EUR 129 million (95 percent CI EUR 102 million–EUR 156 million) compared to the “APM at any time” strategy. Sensitivity analyses showed that uncertainty did not alter our conclusions.
Substantial costs can be saved when APM is no longer performed to treat symptoms attributed to degenerative meniscus tears in the Netherlands. It is therefore recommended to further reduce the use of APM to treat degenerative meniscus tears.
Animal rescue shelters provide temporary housing for thousands of stray and abandoned dogs every year. Many of these animals fail to find new homes and are forced to spend long periods of time in kennels. This study examined the influence of the length of time spent in a rescue shelter (<1 month, 2-12 months, 1-5 years, >5 years) on the behaviour of 97 dogs. The dogs ‘ position in their kennels (front, back), their activity (moving, standing, sitting, resting, sleeping), and their vocalisation (barking, quiet, other) were recorded over a 4 h period at 10 min intervals. The dogs’ behaviour was significantly related to the length of time the animals had spent in the rescue shelter. Dogs housed in the shelter for over five years spent more of their time at the back of their kennels, more time resting, and less time barking than dogs housed in the shelter for shorter periods of time. The age of the dog could not account for the significant results found, suggesting that environmental factors were responsible for the change in the dogs’ behaviour. The findings suggest that lengthy periods of time spent in a captive environment may encourage dogs to behave in a manner that is generally considered unattractive by potential buyers. This may decrease the chances of such dogs being adopted, resulting in longer periods of time spent in the kennel environment and the possible development of further undesirable behaviours.
This study explored the influence of five types of visual stimulation on the behaviour of 50 dogs housed in a rescue shelter. These conditions were: one control condition (no visual stimulation) and four experimental conditions (blank television screen, and moving televised images of conspecifics, interspecifics [ie unfamiliar animal species] and humans). The dogs were exposed to each condition for 4 h per day for five days, with an intervening period of two days between conditions. The dogs' behaviour was recorded on days 1, 3 and 5 during each condition. Dogs spent relatively little of the total observation time looking at the television monitors (10.8%). They spent significantly more of their time looking at the moving images of conspecifics, interspecifics and humans than at the blank screen, although their interest in all experimental conditions declined over time. Dogs spent more time at the front of their enclosures during all of the experimental conditions than during the control condition. Images of conspecifics were more likely to attract the dogs to the front of their kennels than the blank screen. The conspecific and human conditions of visual stimulation attracted slightly more attention from the dogs than the interspecific condition, although not significantly. All of the experimental conditions encouraged significantly less vocalisation and movement than the control condition. Overall, the findings suggest that the behaviour of kennelled dogs is influenced by visual stimulation in the form of television programmes. Such animals, however, may not benefit from this type of enrichment to the same degree as species with more well-developed visual systems. The addition of other types of enrichment strategy for dogs housed in rescue shelters is advocated.
This study explored the influence of five toys (squeaky ball, non-squeaky ball, Nylabone chew, tug rope and Boomer ball) on the behaviour of 32 adult dogs housed in a rescue shelter. The dogs were exposed to each toy separately for six days, with an intervening period of one day between toys. The dogs' location in their kennels (front or back), activity (moving, standing, sitting or resting) and vocalisation (barking, quiet or other) were recorded over 4 h at 10 min intervals on Days 1, 3 and 5 during a control condition (no toy present) and during five experimental (toy) conditions. Whether or not the dogs were observed playing with the toys during the experimental conditions was also recorded. The dogs spent relatively little (<8%) of the overall observation time playing with the toys. The toys elicited varying degrees of interest, with dogs showing a preference for the Nylabone chew over the other toys. The dogs' interest in the toys waned over time, but the speed of habituation to the Nylabone chew was slower than to any of the other toys. The dogs' activity was significantly related to toy condition: dogs spent more time moving and less time standing during the Nylabone chew, squeaky ball and non-squeaky ball conditions than during any of the other conditions. It is suggested that the welfare of kennelled dogs may be slightly enhanced by the addition of suitable toys to their kennels. It is advised, however, that toys are rotated to encourage exploration and reduce habituation. The provision of other forms of environmental enrichment is also recommended.
Blindfolding is routinely used to aid the handling and loading of horses that are difficult to control. Fifteen relatively well-behaved horses of varying ages and disciplines were used to investigate the effects of blinkering and blindfolding on behaviour and heart rate in three situations: whilst stabled, when being led in a ménage, and during loading onto a lorry. Heart rate increased in all three situations when a blindfold was used, and when animals were handled by the least experienced of three handlers. The effects of blinkering on heart rate and behaviour were small compared with blindfolding. Overall, blindfolding appeared to make the horses more nervous and difficult to handle. However, the study does not discount the practical application that blindfolding may have for improving welfare and safety when handling certain individual horses. This work forms the basis for further studies involving animals less accustomed or disposed to being handled.
This study explored the effect of auditory stimulation on the behaviour and welfare of four zoo-housed, female Asian elephants (Elephas maximus). All animals were exposed, in an ABA design, to two conditions of auditory stimulation: a ‘control’ (no auditory stimulation), and an ‘experimental’ condition, during which the animals were presented with a commercially-available CD of classical music. Each condition lasted for five days, with an interim period of two days between each condition (Study 1). The elephants’ behaviour was recorded every minute for four hours a day for the full five days of each condition using instantaneous scan-sampling. The procedure was repeated four months later (Study 2), for a shorter period of time (one day per condition, again using an ABA design) to assess whether the results are generalisable. Analysis of both studies revealed that the elephants spent significantly less of their time stereotyping during the experimental conditions than the control. None of the other behaviours recorded were influenced significantly by auditory stimulation. Overall, the findings from this study suggest that auditory stimulation, in the form of classical music, may be a useful method of reducing stereotypic behaviour in zoo-housed Asian elephants, although more long-term work with a larger number of animals is needed before firm conclusions can be drawn.
This study explored the influence of five types of auditory stimulation (human conversation, classical music, heavy metal music, pop music, and a control) on the behaviour of 50 dogs housed in a rescue shelter. The dogs were exposed to each type of auditory stimulation for 4 h, with an intervening period of one day between conditions. The dogs ‘ position in their kennels (front, back), their activity (moving, standing, sitting, resting, sleeping), and their vocalisation (barking, quiet, other) were recorded over 4 h at 10 min intervals during each condition of auditory stimulation. The dogs’ activity and vocalisation were significantly related to auditory stimulation. Dogs spent more time resting and less time standing when classical music was played than when any of the other stimuli were played. Exposure to heavy metal music encouraged dogs to spend significantly more of their time barking than did other types of auditory stimulation. Classical music resulted in dogs spending significantly more of their time quiet than did other types of auditory stimulation. It is suggested that the welfare of sheltered dogs may be enhanced through exposure to appropriate forms of auditory stimulation. Classical music appears particularly beneficial, resulting in activities suggestive of relaxation and behaviours that are considered desirable by potential buyers. This form of music may also appeal to visitors, resulting in enhanced perceptions of the rescue shelter's environment and an increased desire to adopt a dog from such a source.
Visitors to zoos can be a potential source of stress to captive-housed primates, resulting in increased abnormal behaviour and intra-group aggression. Finding a way to screen primates from human visitors may be one method of decreasing stress and enhancing animal welfare. For this study, the behaviour of six zoo-housed gorillas was studied for one month during standard housing conditions (control condition) and for a further month following the installation of a camouflage net barrier to the viewing area of the exhibit (barrier condition). Visitors’ (n = 200) perceptions of the animals and the exhibit were also recorded during each condition. The net barrier had a significant effect on some components of the gorillas’ behaviour. The gorillas exhibited significantly lower levels of conspecific-directed aggression and stereotypic behaviours during the barrier than the control condition. The net barrier also had a slight effect on visitors’ perceptions both of the animals and of their exhibit. The gorillas were considered to look more exciting and less aggressive during the barrier than the control condition. The exhibit was also considered to be more appropriate for visitors following the introduction of the camouflage netting. Overall, the addition of a screen such as camouflage netting could be considered a positive change, resulting in a reduction in those behaviours typically induced by large groups of visitors and an improvement in public perceptions of the animals and their environment.
Every year sees an increase in the number of dogs admitted to rescue shelters. However well these dogs are cared for in the shelter it cannot be ignored that being in such a situation is stressful, and the time spent in the shelter may change the dogs’ behaviour which may in turn influence their chances of being bought from the shelter. This research examined the behaviour of stray and unwanted dogs on their first, third and fifth days in an Ulster Society for the Prevention of Cruelty to Animals (USPCA) shelter. A questionnaire was also distributed to members of the public to determine how popular the USPCA was as a place from where to purchase a dog, and what factors about a dog's physical characteristics, behaviour and environment influenced potential buyers. Results revealed no significant difference between the behaviour of stray and unwanted dogs although the public viewed stray dogs as much less desirable than unwanted dogs. Time in the shelter had no adverse effects on the dogs’ behaviour. Indeed those changes which did occur during captivity, dogs being more relaxed in the presence of people and eating food more quickly, may be considered as positive changes. The USPCA was viewed as a popular place from which to buy a dog. Of factors influencing the public's choice, the dog's environment and behaviour appeared more important than its physical characteristics. The presence of a toy in the dog's cage greatly increased the public's preference for the dog, although the toy was ignored by the dog. The welfare implications of sheltering dogs are discussed.
HIV and severe wasting are associated with post-discharge mortality and hospital readmission among children with complicated severe acute malnutrition (SAM); however, the reasons remain unclear. We assessed body composition at hospital discharge, stratified by HIV and oedema status, in a cohort of children with complicated SAM in three hospitals in Zambia and Zimbabwe. We measured skinfold thicknesses and bioelectrical impedance analysis (BIA) to investigate whether fat and lean mass were independent predictors of time to death or readmission. Cox proportional hazards models were used to estimate the association between death/readmission and discharge body composition. Mixed effects models were fitted to compare longitudinal changes in body composition over one year. At discharge, 284 and 546 children had complete BIA and skinfold measurements, respectively. Low discharge lean and peripheral fat mass were independently associated with death/hospital readmission. Each unit z-score increase in impedance index and triceps skinfolds was associated with 48% (aHR 0.52, 95%CI 0.30,0.90) and 17% (aHR 0.83, 95%CI 0.71, 0.96) lower hazard of death/readmission respectively. HIV-positive versus HIV-negative children had lower gains in sum of skinfolds (mean difference -1.49, 95%CI -2.01, -0.97) and impedance index z-scores (-0.13, 95%CI -0.24, -0.01) over 52 weeks. Children with non-oedematous versus oedematous SAM had lower mean changes in sum of skinfolds (-1.47, 95%CI -1.97, -0.97) and impedance index z-scores (-0.23, 95%CI -0.36, -0.09). Risk stratification to identify children at risk for mortality or readmission, and interventions to increase lean and peripheral fat mass, should be considered in the post-discharge care of these children.
Patients treated with immunotherapy are divided into two subgroups: (i) long-term survivors (LTS) and (ii) moderate survivors. Nevertheless, clinical trials (RCTs) report only average treatment effects such as hazard rate (HRs). Health economic-models often only input average treatment effects, even though it has been shown that accounting for the LTS subgroup is crucial for accurate projection of long-term survival under immunotherapy. We investigated the incorporation of a statistical mixture cure model (MCM) in a health-economic model for lung cancer as a way to account for LTS while incorporating reported average RCT-based treatment effects.
We developed a microsimulation model describing disease progression under three treatment lines in advanced lung cancer using Dutch real-world data of chemotherapies treated patients. Here we focus on first-line treatment, for which we used gompertz distribution to simulate time-to-progression. To simulate the impact of immunotherapy, we adjusted base-model assuming MCM for first-line treatment, where the LTS subgroup was not at risk to progress, but instead die from background mortality. The subgroup of moderate survivors on the other hand are at risk to progress with adjusted progression-free HR (PF-HR). We simulated the model with size of LTS (prop_LTS) ranging from 14-34 percent (keynote-001 five-year overall survival [OS], 95% confidence interval) while fixing average RCT PF-HR at 0.5. Model predictions under the different prop_LTS were compared to real-world Dutch OS as well as the long-term RCT five-year OS.
With respect to observed short-term survival outcomes, model predictions were insensitive to assumptions regarding the size of the LTS subgroup. However, to match the five-year RCT OS rate reported (32%), the prop_LTS had to be equal to 34 percent. Under this latter setting for the prop_LTS, the progression HR in the subgroup of moderate survivors was calibrated to be 1.1.
The use of a mixture cure model improves long-term model-based projections with the implicit assumption that moderate survivors have little or no treatment benefit.
With advances in care, an increasing number of individuals with single-ventricle CHD are surviving into adulthood. Partners of individuals with chronic illness have unique experiences and challenges. The goal of this pilot qualitative research study was to explore the lived experiences of partners of individuals with single-ventricle CHD.
Partners of patients ≥18 years with single-ventricle CHD were recruited and participated in Experience Group sessions and 1:1 interviews. Experience Group sessions are lightly moderated groups that bring together individuals with similar circumstances to discuss their lived experiences, centreing them as the experts. Formal inductive qualitative coding was performed to identify salient themes.
Six partners of patients participated. Of these, four were males and four were married; all were partners of someone of the opposite sex. Themes identified included uncertainty about their partners’ future health and mortality, becoming a lay CHD specialist, balancing multiple roles, and providing positivity and optimism. Over time, they took on a role as advocates for their partners and as repositories of medical history to help navigate the health system. Despite the uncertainties, participants described championing positivity and optimism for the future.
In this first-of-its-kind pilot study, partners of individuals with single-ventricle CHD expressed unique challenges and experiences in their lives. There is a tacit need to design strategies to help partners cope with those challenges. Further larger-scale research is required to better understand the experiences of this unique population.
The most provocative legacy of surrealism in Latin America in the period following World War II can arguably be found in the work of women artists and writers. The postwar feminine surrealisms examined in this chapter responded to the encroachment of capitalism in daily life and the gradual, if incomplete, loosening of normative categories of sex and gender. Taking up historical surrealism’s focus on eros as an incomplete promise, they expanded into alternative configurations of sex, desire, and family life, while simultaneously emphasizing persistent, if updated, forms of gendered violence. This chapter analyzes experimental writers and visual artists from Brazil, Argentina, and Uruguay from the mid-1940s to the mid-1960s – Grete Stern, Maria Martins, Marosa Di Giorgio, and Alejandra Pizarnik. It concludes by noting the legacies of their erotic surrealisms for contemporary art and literature.
A resurgence of research investigating the administration of psychedelic compounds alongside psychotherapy suggests that this treatment is a promising intervention for anxiety, depression, and existential distress in people with cancer. However, psychedelic treatment that induces a mind-altering experience potentially poses barriers to vulnerable cancer patients, and health-care practitioners may have concerns about referring their patients to trials investigating this approach. The aim of the current study was to investigate the perceptions of cancer health-care practitioners based in New Zealand and the USA related to psychedelic-assisted therapy.
This study utilized a cross-sectional survey of cancer health-care practitioners in New Zealand and the USA via convenience sampling to identify their perceptions about the concept of conducting psychedelic-assisted therapy with cancer patients.
Participants perceived that (1) psychedelic-assisted therapy has the potential to provide benefit for cancer patients, (2) research in this area across a variety of domains is important, (3) work should consider spiritual and indigenous perspectives of health, and (4) there was willingness to refer patients to trials in this area, especially patients with advanced disease who were no longer going through curative treatment. Participants in the USA had greater awareness of psychedelics than the New Zealand sample; however, New Zealand participants more strongly believed that spiritual/indigenous factors should be considered in psychedelic-assisted therapy.
Significance of results
Cancer health-care practitioners in our sample considered research investigating the potential for psychedelic-assisted therapies to be important and may be more open to studies that start in palliative and end-of-life contexts.
There is growing evidence that childhood malnutrition is associated with non-communicable diseases (NCD) in adulthood and that body composition mediates some of this association. This review aims to determine if childhood body composition can be used to predict later-life cardiometabolic NCD and which measures of body composition predicts future NCD.
Electronic databases were searched for articles where: children aged under 5 years had body composition measured; cardiometabolic health outcomes were measured a minimum of 10 years later.
The databases Embase, Medline and Global Health were searched through July 2020.
Children aged under 5 years with a follow-up of minimum 10 years.
Twenty-nine studies met the inclusion criteria. Though a poor proxy measure of body composition, body mass index (BMI) was commonly reported (n 28, 97 %). 25 % of these studies included an additional measure (ponderal index or skinfold thickness). Few studies adjusted for current body size (n 11, 39 %).
Many studies reported that low infant BMI and high childhood BMI were associated with an increased risk of NCD-related outcomes in later life but no conclusions can be made about the exact timing of child malnutrition and consequent impact on NCD. Because studies focussed on BMI rather than direct measures of body composition, nothing can be said about which measures of body composition in childhood are most useful. Future research on child nutrition and long-term outcomes is urgently needed and should include validated body composition assessments as well as standard anthropometric and BMI measurements.
The thirty-four-year reign of President Porfirio Díaz (1876–1910) is generally acknowledged to have been the period of Mexico's great economic transformation. In reality, Mexico was unable to avoid the accelerated change that overtook it during the last quarter of the nineteenth century, as proliferating patterns of trade, which accompanied the burgeoning industrial development of the United States and Western Europe, tied Mexico ever more closely to the global economy. An international economic division of labor was negotiated between foreign industrialists and entrepreneurs—who urgently needed primary products, markets for goods, and opportunities for investment, and national and regional elites—who welcomed infrastructural improvements, modern machinery, an array of consumer goods, and the increasing availability of foreign capital.
Hypoplastic Left Heart Syndrome accounts for a significant proportion of CHD morbidity and mortality, despite improvements in care and improved survival. This study evaluates number of, reasons for, and trends in discharges of patients with hypoplastic left heart syndrome over 11 years in Texas.
The Texas Inpatient Discharge Dataset Public Use File captures almost all discharges in Texas and was reviewed from 2009 to 2019. Discharges of patients ≥5 years of age and diagnosis codes for Hypoplastic Left Heart Syndrome were included. The admitting and principle diagnoses were categorised and all discharges were evaluated for procedures performed. Descriptive and univariate statistical analyses were performed.
A total of 1024 discharges were identified with a 16.9% annual increase over the study period. Median length of stay was 4 [IQR: 2–8] and there were 17 (1.7%) in-hospital mortalities with no differences across age groups. Seven (17.1%) discharges of patients 25+ years were uninsured, higher than other age groups (p < 0.001). The most common admitting diagnosis was CHD and 224 (21.9%) of discharges included a procedure, including 23 heart transplants. Discharges occurred from 67 different hospitals with 4 (6.0%) representing 71.4% of all discharges.
Discharges of Hypoplastic Left Heart Syndrome have increased rapidly, particularly in the older age groups and were spread over a large number of hospitals. Further work is needed to understand the interplay between Hypoplastic Left Heart Syndrome and other conditions and care experiences that occur within the general population, which will become more common as this population ages and grows.