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The COVID-19 pandemic changed the clinical research landscape in America. The most urgent challenge has been to rapidly review protocols submitted by investigators that were designed to learn more about or intervene in COVID-19. International Review Board (IRB) offices developed plans to rapidly review protocols related to the COVID-19 pandemic. An online survey was conducted with the IRB Directors at Clinical and Translational Science Awards (CTSA) institutions as well as two focus groups. Across the CTSA institutions, 66% reviewed COVID-19 protocols across all their IRB committees, 22% assigned protocols to just one committee, and 10% created a new committee for COVID-19 protocols. Fifty-two percent reported COVID-19 protocols were reviewed much faster, 41% somewhat faster, and 7% at the same speed as other protocols. Three percent reported that the COVID-19 protocols were reviewed with much better quality, 32% reported slightly better quality, and 65% reported the reviews were of the same quality as similar protocols before the COVID-19 pandemic. IRBs were able to respond to the emergent demand for reviewing COVID-19 protocols. Most of the increased review capacity was due to extra effort by IRB staff and members and not changes that will be easily implemented across all research going forward.
Climate change is one of the biggest challenges facing the world. Scientific research points out that it is predominately driven by human activity. There are three different types of risks that arise from this change. These have been broadly grouped into physical, transition and liability risks. These risks can impact general insurers to different degrees, depending on their business areas and investment strategies. These may pose different strategic, investment, market, operational and reputational risks. This paper provides General Insurance Practitioners with an overview of different aspects of insurance operations that may be affected by climate change. It highlights the impact of these risks on pricing and underwriting, reserving, reinsurance, catastrophe modelling, investment, risk management and capital management processes.
While many studies have evaluated consumer demand for local foods, fewer studies have focused on the mechanism that has created the positive willingness-to-pay for local foods. This article compares the role of geographic distance and attachment value in consumer preferences for locally produced hard cider. Consumer valuations are estimated via a “branded” discrete choice experiment where the respondents chose between an in-state hard cider, an out-of-state hard cider, and a no buy option. Our measure of travel distance is based on the optimal driving route between each consumer's GPS location and the locations of the cideries while our attachment value measure is based on social capital theory. This allows us to analyze individual-specific travel distance heterogeneity in consumer choice as it relates to attachment value. Based on a latent class logit model estimated from a discrete choice experiment with 441 participants, we show that attachment value is higher for a cider produced within the state than for a cider produced outside the state. Furthermore, we show that increases in attachment value increase demand for locally produced hard cider more than an equal increase in attachment value for non-locally produced hard cider. Our findings are consistent with “local” preferences based on geopolitical boundaries (e.g., the state of Michigan) and not distance. (JEL Classifications: B55, M3, Q13, C83)
Originally published in 1994, this was the first volume to look in depth at the way the brain responds to trauma and subsequently integrates and influences behavioural, metabolic, neurohumoral, cardiovascular and immune functions. At the time, the role of the brain in the control and integration of the responses to injury and infection was becoming increasingly clear. It had been established that some of these responses, such as fever and neuroendocrine changes, responded to the direct influence of the central nervous system. These, and other advances, provided fresh insights into this area and formed a basis for the more effective understanding and clinical management of trauma patients. In this volume, the authors, all international authorities in their fields, discuss data from experimental and clinical studies and considered the implications of these findings for the treatment of the trauma patient.
The buckling coefficient for a conventional shear web, reinforced by a series of equally-spaced transverse stiffeners, is practically independent of the flexural rigidity of the stiffeners provided this exceeds a certain critical value. The stiffeners then provide conditions close to simple-support (if they are of negligible torsional stiffness). For stiffeners of less than this critical rigidity, reduced buckling coefficients are plotted in Ref. 1, in terms of a stiffness parameter μ related to the second moment of area of the stiffeners. Reference 1 also shows that the critical value μc referred to above increases rapidly with reducing stiffener pitch, leading in some cases to impractically large stiffeners.
Edited by
Fiona Jenkins, Australian National University, Canberra,Mark Nolan, Australian National University, Canberra,Kim Rubenstein, Australian National University, Canberra
Children in care often have poor outcomes. There is a lack of evaluative research into intervention options.
Aims
To examine the efficacy of Multidimensional Treatment Foster Care for Adolescents (MTFC-A) compared with usual care for young people at risk in foster care in England.
Method
A two-arm single (assessor) blinded randomised controlled trial (RCT) embedded within an observational quasi-experimental case–control study involving 219 young people aged 11–16 years (trial registration: ISRCTN 68038570). The primary outcome was the Child Global Assessment Scale (CGAS). Secondary outcomes were ratings of educational attendance, achievement and rate of offending.
Results
The MTFC-A group showed a non-significant improvement in CGAS outcome in both the randomised cohort (n = 34, adjusted mean difference 1.3, 95% CI −7.1 to 9.7, P = 0.75) and in the trimmed observational cohort (n = 185, adjusted mean difference 0.95, 95% CI −2.38 to 4.29, P = 0.57). No significant effects were seen in secondary outcomes. There was a possible differential effect of the intervention according to antisocial behaviour.
Conclusions
There was no evidence that the use of MTFC-A resulted in better outcomes than usual care. The intervention may be more beneficial for young people with antisocial behaviour but less beneficial than usual treatment for those without.
Phenolic acids are secondary plant metabolites that may have protective effects against oxidative stress, inflammation and cancer in experimental studies. To date, limited data exist on the quantitative intake of phenolic acids. We estimated the intake of phenolic acids and their food sources and associated lifestyle factors in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Phenolic acid intakes were estimated for 36 037 subjects aged 35–74 years and recruited between 1992 and 2000 in ten European countries using a standardised 24 h recall software (EPIC-Soft), and their food sources were identified. Dietary data were linked to the Phenol-Explorer database, which contains data on forty-five aglycones of phenolic acids in 452 foods. The total phenolic acid intake was highest in Aarhus, Denmark (1265·5 and 980·7 mg/d in men and women, respectively), while the intake was lowest in Greece (213·2 and 158·6 mg/d in men and women, respectively). The hydroxycinnamic acid subclass was the main contributor to the total phenolic acid intake, accounting for 84·6–95·3 % of intake depending on the region. Hydroxybenzoic acids accounted for 4·6–14·4 %, hydroxyphenylacetic acids 0·1–0·8 % and hydroxyphenylpropanoic acids ≤ 0·1 % for all regions. An increasing south–north gradient of consumption was also found. Coffee was the main food source of phenolic acids and accounted for 55·3–80·7 % of the total phenolic acid intake, followed by fruits, vegetables and nuts. A high heterogeneity in phenolic acid intake was observed across the European countries in the EPIC cohort, which will allow further exploration of the associations with the risk of diseases.
Visual artists of acknowledged creativity but not students with divergent thinking showed allusive (loose) thinking on an Object Sorting Test. It was concluded that high but not low level creativity in some fields may be associated with a predisposition to schizophrenia.
Immune responses of 4 inbred lines of chickens, that differ in resistance to Eimeria maxima and E. tenella, were examined. Significant differences were found in in vitro proliferation of peripheral blood lymphocytes to E. maxima sporozoite antigen, the more resistant lines C and 72 having higher responses than the more susceptible line 151. These differences existed pre-infection and were enhanced following both primary and a second infection. The proportions of lymphocyte subsets in the peripheral blood following primary infection also differed between lines, with significantly higher percentages of CD8 + and TCR1 + lymphocytes circulating in the more resistant birds. In contrast, there were few differences between lines in either resistance or in in vitro proliferation of peripheral blood lymphocytes to E. tenella sporozoite antigen either pre-infection or following a primary infection. However, after a second infection when there were significant differences in resistance between lines, as measured by oocyst excretion, there were also significant differences in lymphoproliferation with the more resistant lines 151 and 62 having higher responses than the more susceptible line C. Thus for E. maxima there is a direct relationship between resistance to infection and lymphoproliferation in response to parasite antigen. This implies that differences in cellular immunity may account for differences in resistance between lines, and since these specific responses are enhanced by infection they may also reflect important immune mechanisms. For the rather less immunogenic E. tenella, the correlation between resistance and lymphoproliferation is not so clear. However, where there were significant differences between lines, i.e. after a second infection, the direct relationship between resistance and lymphoproliferation was upheld.
Two lines of guinea-pigs, whose susceptibilities to infection with the parasitic nematode Trichostrongylus colubriformis differ significantly, have been established. This difference is probably based on genetically determined differences between the ability of members of each line to bring about immune expulsion. of the parasite.