jimnoneill/paper-to-field-training huggingface dataset:
Developing competencies for end of life care in care homes

Introduction End of life care is provided by generalists, often in the care home sector. Inadequate training and support can lead to suboptimal end of life care in care homes. The development of measureable competencies supported by education is essential to improve care delivery. This relies on working together as hospice competencies are not directly transferrable to the care home environment. Aim To improve end of life care in care homes in a sustainable way through the development of core competencies supported by education. Method This pilot project involved hospice staff working collaboratively with four local care homes. Year one developed a competency framework within each individual home informed by focus groups. Year two analysed competencies and identified key issues for inclusion in a 5-day training programme, tailored to address these issues in the broader context of palliative care. 15 care home staff attended the course, feeding back learning in their respective homes. The impact of the course on end of life care delivery was considered. Year three incorporated the competencies into existing staff appraisal systems. Senior care home staff were trained to assess competence, promoting sustainability of the competency work. Results Engaging care home staff in the development of competencies and identification of educational need is essential to ensure a tailored, relevant programme. Effective measurement of competence is achieved through appropriate assessment linked to staff appraisal. Opportunities for sharing learning throughout the process should be identified at an early stage. Discussion and conclusions Developing a competency framework demonstrates an ongoing commitment to the development of staff and ultimately care home services, when supported by a tailored package of education. Working together is fundamental to success.

Topic: Palliative Care and End-of-Life Issues
Subfield: Public Health, Environmental and Occupational Health
Field: Medicine
Domain: Health Sciences
Genetic Diversity of Plum Curculio (Coleoptera: Curculionidae) Among Geographical Populations in the Eastern United States

Abstract This study investigated the genetic diversity among plum curculio, Conotrachelus nenuphar (Herbst), populations from 11 different geographic locations by using partial sequences of mitochondrial cytochrome oxidase I (mtCOI) gene. Polymerase chain reaction (PCR) products were 863 bp. In total, 23 unique haplotypes were identified from 50 tested samples. Haplotypes G (n = 5), L (n = 12), and T (n = 13) made up 60% of the 50 samples. Two distinct major clades were found in the phylogenetic analyses. Northern and southern clades were strongly supported (100/83 (MP/ML) and 100/62, respectively) by bootstraps. The mid-southern subclade within the southern clade was also moderately supported by bootstraps (73/57, MP/ML). The results of analyses of molecular variance (AMOVA) are consistent with phylogenetic analysis. The results suggested that the northern and the southern clades correspond with northern strain and southern strain of plum curculio. The three-group model of AMOVA test may suggest that there is a transitional group existing between northern and southern groups. In this study, the mtCOI sequence was highly informative as a molecular marker in that it could distinguish C. nenuphar from northern and southern geographic locations in the eastern United States.

Topic: Insect Pest Control Strategies
Subfield: Plant Science
Field: Agricultural and Biological Sciences
Domain: Life Sciences
77P BRCA mutations may induce immune-resistance in breast cancer patients treated with IO-only approach: A retrospective analysis

Immunotherapy (IO) has been recently introduced in triple-negative breast cancer (TNBC) therapeutic algorithm, however no predictive biomarkers beyond PDL-1 expression demonstrated utility in clinical practice. BRCA mutations account for 15-20% of TNBC, with a positive association with platinum response and an inflammatory background on tumor tissue. Preclinical evidences demonstrated a lack of T-cell activation in BRCA-mutant (BRCAm) tumors due to an HLA machinery defects, but no subgroup effects were observed in IO pivotal trials evaluating chemotherapy-IO combinations. We retrospectively evaluated the effect of germline BRCA mutations in consecutive BC patients underwent any-line IO-only treatment in phase I/II trials at Fondazione IRCCS Istituto Nazionale dei Tumori in Milan. Only mutations evaluated as pathogenic after genetic counselling were considered. IO treatment included PD(L)1, LAG3 and ICOS inhibitors, single agents or in combination. Statistical analysis were performed with RStudio software v2022.07.0. Of 39 pts treated with IO from June 2016 to September 2022, 22 had available germline BRCA status. 4 pts exhibited mutations in BRCA1 gene, 1 in BRCA2. All pts had triple-negative histology, except one (HR+). Median number of previous treatment lines for metastatic disease was 2 (1-8), without significant difference among BRCA groups (p=0.872). None of the other clinical features evaluated significantly differ among BRCA groups. 18 (81.8%) patients received platinum compound as therapy for metastatic disease, while 4 (18.2) received a PARP inhibitor. BRCAm pts demonstrated a significantly shorted PFS compared to wild-type (1.7 vs 3.6 months; HR 4.12, CI 95% 1.32-12.89, p=0.015), whereas a non-significant trend toward a worse OS was observed in BRCAm pts (77.1 vs 42.0 months; HR 2.31, CI 95% 0.65-8.24, p=0.199). A numerically higher primary resistance rate was also observed in BRCAm pts (80% vs 50%). In our small retrospective cohort, the presence of a pathogenic mutation in BRCA1/2 genes resulted in reduced benefit to IO-alone approach. If confirmed in a wider and prospective cohort, these results could guide the decision on first-line treatment of BRCAm TNBC.

Topic: Cancer Genomics and Diagnostics
Subfield: Cancer Research
Field: Biochemistry, Genetics and Molecular Biology
Domain: Life Sciences
Position sensing in restricted environments in automated manufacturing

This thesis describes a successful attempt to identify angular movement of leather components, when transported from one operation to another, by a conveyor system. The automated manufacturing process of skiving leather components was utilised for this research. Skiving is the localised thinning of the leather components to enable the joining of these without forming thick and unsightly joints. This process had been automated, but its performance could be enhanced by combining an additional sensing system. The research work was directed towards integrating a relatively small and low-cost form of sensing system onto a dynamic matrix skiving machine. Two key areas of the research were the identification of suitable sensor technology and the investigation of the environment within which they operate. The sensors form a vital and necessary part of any type of identification process and are used to acquire relevant data. The thesis describes a variety of sensor technologies and their suitability for use in restrictive environments. These environmental restrictions of the skiving process and the component material influence the choice of sensor. Following the study of sensor technologies, the second phase was aimed at implementing an automatic position sensing system. Therefore the main specification of the system was to detect the leather components, and their orientation prior to, and following transportation through the process. The final part of this work presents the results obtained from the introduction of the sensing arrays. It also identifies areas that may be investigated further to improve the system, concerning the particular restricted environment utilised in this research.

Topic: Industrial Vision Systems and Defect Detection
Subfield: Industrial and Manufacturing Engineering
Field: Engineering
Domain: Physical Sciences
Visualization of Flow and Forces in Swimming

水泳，特に泳速度を競う競泳は，物理的に見て非常に複雑な現象である，泳者身体の多くの部分は水中，一部は空中であり，泳者は多自由度の三次元運動を行い，水中の流れは高レイノルズ数の乱流となる，よって力学的な研究対象としては大変チャレンジングであり，逆に言えば研究しがいのある対象である．筆者は20年近く競泳を対象として研究を行っており，本稿では可視化の観点からその取り組みのいくつかを紹介する．まず流れの可視化として数値流体力学的研究の状況について概観し，実験的研究として筆者らの研究グループによる流れの可視化の取り組みについて紹介する．次に競泳中に泳者に作用する流体力（水からの力）の可視化として，筆者らによる水泳のシミュレーションモデルによる取り組みについて紹介する．最後にこの分野の今後の展開について期待も交えて述べる．

Topic: Sports Performance and Training
Subfield: Orthopedics and Sports Medicine
Field: Medicine
Domain: Health Sciences
New Phototubes and Photomultipliers Resistive against High Magnetic Fields

The energy of particles in recent high energy physics experiments has been increasing, so that detector apparatus is inevitably placed in high magnetic field environment. Therefore new photodetectors are required which, unlike conventional photomultipliers, are inherently insensitive to high magnetic fields. We have developed four types of new photodetector for the use in high magnetic fields: a one-atm. xenon filled phototube, a rectangular vacuum photodiode, a one-stage photomultiplier and a photomultiplier with fine-mesh dynodes. Each of them is specially designed on the basis of the analysis of the behavior of electrons in electromagnetic fields and is capable of stable operation in magnetic fields as high as several kilogauss or more.

Topic: Particle Detector Development and Performance
Subfield: Nuclear and High Energy Physics
Field: Physics and Astronomy
Domain: Physical Sciences
(P.) Johnstone The Byzantine tradition in church embroidery. London: A. Tiranti. 1967. Pp. x + 144. 121 plates (incl. 1 in colour). 10 text figures. £2 10<i>s</i>.

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Topic: Historical and Religious Studies of Rome
Subfield: History
Field: Arts and Humanities
Domain: Social Sciences
Embedding Sexual and Reproductive Health and Rights in a Transformational Development Framework: Lessons Learned from the MDG Targets and Indicators

This paper explores the intended and unintended consequences of the selection of MDG 5 as a global goal, together with its respective targets and indicators, and places what happened to MDG 5, and sexual and reproductive health and rights more broadly, into the context of the development model that was encoded in the MDGs. Over the last decade, as the MDGs increasingly took centre stage in development and their use evolved, they were inappropriately converted from global goals into national planning targets. This conversion was particularly detrimental in the case of MDG 5. It not only created a narrowing in terms of policies and programming, but also had an enormous impact on the discourse of development itself, reshaping the field in terms of the organization and dissemination of knowledge, and underscoring that the process of setting targets and indicators is far from neutral but encodes normative values. Looking forward, it is not adequate to propose an MDG framework based on the same structure. Sexual and reproductive health and rights must be placed back into the global discourse, using development to empower women and marginalized populations, and to address structural inequalities that are fundamental to sustained social change. The new development framework should include a strong narrative of social transformation in which fit-for-purpose targets and indicators play a role, but do not overtake or restrict the broader aims of advancing social, political, and gender justice.

Topic: Human Rights and Development
Subfield: Sociology and Political Science
Field: Social Sciences
Domain: Social Sciences
RS-DPO: A Hybrid Rejection Sampling and Direct Preference Optimization Method for Alignment of Large Language Models

Reinforcement learning from human feedback (RLHF) has been extensively employed to align large language models with user intent. However, proximal policy optimization (PPO) based RLHF is occasionally unstable requiring significant hyperparameter finetuning, and computationally expensive to maximize the estimated reward during alignment. Recently, direct preference optimization (DPO) is proposed to address those challenges. However, DPO relies on contrastive responses generated from human annotator and alternative LLM, instead of the policy model, limiting the effectiveness of the RLHF. In this paper, we addresses both challenges by systematically combining rejection sampling (RS) and DPO. Our proposed method, RS-DPO, initiates with the development of a supervised fine-tuned policy model (SFT). A varied set of k responses per prompt are sampled directly from the SFT model. RS-DPO identifies pairs of contrastive samples based on their reward distribution. Finally, we apply DPO with the contrastive samples to align the model to human preference. Our experiments indicate that our proposed method effectively fine-tunes LLMs with limited resource environments, leading to improved alignment with user intent. Furthermore, it outperforms existing methods, including RS, PPO, and DPO.

Topic: Natural Language Processing Techniques
Subfield: Artificial Intelligence
Field: Computer Science
Domain: Physical Sciences
Unintended consequences of discrimination litigation caps

Abstract On July 14, 1992, the U.S. Equal Employment Opportunity Commission (EEOC) implemented a policy that caps punitive damage payouts from discrimination litigation at different employee counts allowing for a “difference‐in‐discontinuities” design. I find that these kink points incentivize firms to restrict their number of employees, which reduces their maximum discrimination litigation exposure to between 40% and 60% of their yearly median revenues. In turn, firm growth decreases for firms below these EEOC thresholds after the implementation of the policy. These firms reduce financing and are not motivated to decrease growth by relative changes in cash flows from discrimination risk exposure.

Topic: Discrimination and Equality Law
Subfield: Law
Field: Social Sciences
Domain: Social Sciences
Prognostic Value of Mandard and Dworak Tumor Regression Grading in Rectal Cancer: Study of a Single Tertiary Center

Goal . To evaluate the prognostic value of Mandard and Dworak grading systems regarding neoadjuvant chemoradiotherapy (CRT) response on rectal cancer. Materials and Methods . We queried our center’s database for patients with colo rectal cancer with locally advanced rectal cancer (LARC) who received neoadjuvant CRT followed by total mesorectum excision (TME) between 2003 and 2011. After excluding 18 patients from the initial query the remaining 139 were reassessed for disease recurrence and survival; the specimens’ slides were reviewed and classified according to two tumor regression grading (TRG) systems: Mandard and Dworak. Based on these TRG scores, two patient groups were created: patients with good response versus patients with bad response (Mandard TRG1+2 versus Mandard TRG3+4+5 and Dworak TRG4+3 versus Dworak TRG2+1+0). Overall survival (OS), disease-free survival (DFS), and disease recurrence were then evaluated. Results . Mean age was 64.2 years and median follow up was 56 months. No significant survival difference was found when comparing patients with Dworak TRG 4+3 versus Dworak TRG2+1+0 (<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M1"><mml:mi>P</mml:mi><mml:mo>=</mml:mo><mml:mo>0.</mml:mo><mml:mn>10</mml:mn></mml:math>). Mandard TRG1+2 presented with significantly better OS and DFS than Mandard TRG3+4+5 (OS <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M2"><mml:mi>P</mml:mi><mml:mo>=</mml:mo><mml:mo>0.</mml:mo><mml:mn>013</mml:mn></mml:math>; DFS <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M3"><mml:mi>P</mml:mi><mml:mo>=</mml:mo><mml:mo>0.</mml:mo><mml:mn>007</mml:mn></mml:math>). Conclusions . Mandard system provides higher accuracy over Dworak system in predicting rectal cancer prognosis when neoadjuvant CRT is applied for tumor regression.

Topic: Colorectal Cancer Surgical Treatments
Subfield: Oncology
Field: Medicine
Domain: Health Sciences
CCDC 230770: Experimental Crystal Structure Determination

An entry from the Cambridge Structural Database, the world’s repository for small molecule crystal structures. The entry contains experimental data from a crystal diffraction study. The deposited dataset for this entry is freely available from the CCDC and typically includes 3D coordinates, cell parameters, space group, experimental conditions and quality measures.

Topic: Crystallization and Solubility Studies
Subfield: Materials Chemistry
Field: Materials Science
Domain: Physical Sciences
Associations Between Residential Segregation and Incident Hypertension: The Multi‐Ethnic Study of Atherosclerosis

Background Residential segregation, a geospatial manifestation of structural racism, is a fundamental driver of racial and ethnic health inequities, and longitudinal studies examining segregation’s influence on cardiovascular health are limited. This study investigates the impact of segregation on hypertension in a multiracial and multiethnic cohort and explores whether neighborhood environment modifies this association. Methods and Results Leveraging data from a diverse cohort of adults recruited from 6 sites in the United States with 2 decades of follow‐up, we used race‐ and ethnicity‐stratified Cox models to examine the association between time‐varying segregation with incident hypertension in 1937 adults free of hypertension at baseline. Participants were categorized as residing in segregated and nonsegregated neighborhoods using a spatial‐weighted measure. We used a robust covariance matrix estimator to account for clustering within neighborhoods and assessed effect measure modification by neighborhood social or physical environment. Over an average follow‐up of 7.35 years, 65.5% non‐Hispanic Black, 48.1% Chinese, and 53.7% Hispanic participants developed hypertension. Net of confounders, Black and Hispanic residents in segregated neighborhoods were more likely to develop hypertension relative to residents in nonsegregated neighborhoods (Black residents: hazard ratio [HR], 1.33; 95% CI, 1.09–1.62; Hispanic residents: HR, 1.33; 95% CI, 1.04–1.70). Results were similar but not significant among Chinese residents (HR, 1.20; 95% CI, 0.83–1.73). Among Black residents, neighborhood social environment significantly modified this association such that better social environment was associated with less pronounced impact of segregation on hypertension. Conclusions This study underscores the importance of continued investigations of groups affected by the health consequences of racial residential segregation while taking contextual neighborhood factors, such as social environment, into account.

Topic: Health disparities and outcomes
Subfield: Health
Field: Social Sciences
Domain: Social Sciences
Identifying Glaucoma in Primary Care Offices

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA Ophthalmology HomeNew OnlineCurrent IssueFor Authors Podcast Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA Ophthalmology journal

Topic: Glaucoma and retinal disorders
Subfield: Ophthalmology
Field: Medicine
Domain: Health Sciences
Dynamic of excretion and immune response of experimentally infected pigs with monophasic varient of Salmontella typhimurium serovar 1,4[5], 12:i:-

In recent years Salmonella enterica serovar Typhimurium 1,4[5],12:i:- (mono-phasic variant of S. Typhimurium or vmST) was focused as a major zoonotic problem because produce human gastroenteritis outbreaks in many countries. Human disease caused by this serovar is considered as emergent in European Union countries and actually is ranked as the third most reported serotype after S. Enteritidis and S. Typhimurium (EFSA, 2016; Fernandes et al., 2016).

Topic: Salmonella and Campylobacter epidemiology
Subfield: Food Science
Field: Agricultural and Biological Sciences
Domain: Life Sciences
Superfluidity of heated Fermi systems in the static fluctuation approximation

Superfluidity properties of heated finite Fermi systems are studied in the static fluctuation approximation, which is an original method. This method relies on a single and controlled approximation, which permits taking correctly into account quasiparticle correlations and thereby going beyond the independent-quasiparticle model. A closed self-consistent set of equations for calculating correlation functions at finite temperature is obtained for a finite Fermi system described by the Bardeen–Cooper–Schrieffer Hamiltonian. An equation for the energy gap is found with allowance for fluctuation effects. It is shown that the phase transition to the supefluid state is smeared upon the inclusion of fluctuations.

Topic: Quantum, superfluid, helium dynamics
Subfield: Atomic and Molecular Physics, and Optics
Field: Physics and Astronomy
Domain: Physical Sciences
Evaluation of the Technical Value of Powertrain Systems to Enable Safe Performance-based Flight Guidance for Urban Air Mobility

Urban Air Mobility (UAM) has emerged as a promising solution to address the challenges of traditional transportation at urban level. This paper focuses on the powertrain systems of UAM vehicles, which play a critical role in ensuring safe and reliable flight operations. The study evaluates the performance implications of different powertrain systems for UAM multirotors and their relevance to safe performance-based flight guidance. Six different powertrain architectures are analyzed for three use cases (Airport Shuttle, Intra-City, and Mega-City), which results in 18 different variations of use case and powertrain architecture combinations. Key performance indicators are used to assess the technical value of each use case - powertrain architecture combination. The findings highlight the importance of power and energy demand, weight, but also reliability in powertrain design. Power, efficiency, range, endurance, redundancy, and integration are identified as crucial factors for successful UAM operations. The study result show that a hybrid parallel powertrain architecture, which combines 20% battery power and 80% fossil fuel-derived power, demonstrates the highest technical value for all three covered use cases. The study contributes to the ongoing efforts in UAM research and development, paving the way for the realization of UAM's full potential as a sustainable mode of transportation in urban environments.

Topic: Advanced Aircraft Design and Technologies
Subfield: Global and Planetary Change
Field: Environmental Science
Domain: Physical Sciences