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Iron deficiency has been associated with heart failure severity and mortality in children and adults. Intravenous iron therapy has been associated with improved outcomes for adults with heart failure. However, little is known about its impact and safety in children. We performed a single-centre review of all intravenous iron sucrose infusions prescribed to hospitalised patients ≤ 21 years of age with a primary cardiac diagnosis from 2020 to 2022. Ninety-one children (median age 6 years, weight 18 kg) received 339 iron sucrose infusions with a median dose of 6.5 mg/kg [5.1 mg/kg, 7.0 mg/kg]. At initial infusion, the majority (n = 63, 69%) had CHD, 70 patients (77%) were being managed by the advanced cardiac therapy team for heart failure, 13 (14%) were listed for heart transplant, 32 (35%) were on at least one vasoactive infusion, and 5 (6%) were supported with a ventricular assist device. Twenty infusions (6%) were associated with 27 possible infusion-related adverse events in 15 patients. There were no episodes of anaphylaxis or life-threatening adverse events. The most common adverse events were hypotension (n = 12), fever (n = 5), tachycardia (n = 3), and nausea/vomiting (n = 3). Eight of 20 infusion-related adverse events required intervention, and two infusions were associated with escalation in a patient’s level of care. Following intravenous iron repletion, patients’ serum iron, serum ferritin, transferrin saturation, and haemoglobin increased (p < 0.05 for all). In children hospitalised with cardiac disease, intravenous iron sucrose repletion is safe and may improve haemoglobin and iron parameters, including transferrin saturation and ferritin levels.
This report investigates excess frame count during radiotherapy sessions using Elekta Versa HD systems with X-ray Volume Imaging (XVI) technology at Singleton Hospital. The hospital has 4 clinical linear accelerators (linacs) with XVI, which were analysed to identity variations in the number of excess frames between machines and imaging protocols. Such deviations could affect imaging dose accuracy, patient safety, and system efficiency.
Method:
XVI log files were gathered from each linac over an 18-month period using data backups. A Python script was created to read and link all the required data in a simple format to generate histograms and tables.
Results:
The excessive frames resulted in increased radiation doses. Although individual doses were negligible, the highest excess dose for a single patient was 0.7 mSv in 1 fraction, leading to a total dose of 3.4 mSv instead of the expected 2.7 mSv scans which is equivalent to 3 months of background radiation extra. The study revealed that 1.7 % of all imaging sessions were affected (417 imaging fractions). It was identified that the ‘Fast’ Breast imaging protocols were more likely to generate excess frames, likely to be due to the increased gantry speed.
Conclusion:
Despite the small individual doses, the findings raise concerns about system performance and patient safety for imaging, emphasising the need for further investigation to ensure optimal treatment accuracy and compliance with the Ionising Radiation (Medical Exposure) (Amendment) 2024), Regulation 11 and 12.
Evaluate how a foundation-supported fellowship employs early health-technology assessment (eHTA) to guide the development and positioning of emerging health innovations.
Methods
We reviewed all eHTA reports conducted under the Fellowship from 2018 to 2021 (n = 10), extracting technology class, development stage, economic modeling, and recommendations. In 2023, we conducted thirty-minute structured video interviews with developers of each technology (eleven invitees, ten responses). The interview comprised Likert questions on perceived usefulness and intention to update the model in later stages, and six open-ended questions on perceived advantages, implementation barriers, and downstream actions. Likert data were summarized descriptively; open-ended responses were summarized and discussed within the research team until consensus on key themes.
Results
The eHTA subject technologies were four diagnostics, three therapeutics, two predictive algorithms, and one curative device, all preclinical. Analyses used six Markov or decision-tree frameworks, four hybrid models or simulations, and six value-based-pricing scenarios. Five technologies were potentially cost-effective, three conditionally cost-effective, one unlikely to be cost-effective without stronger evidence, and one cost-effective yet unlikely to break even. Eight developers rated eHTA “useful” or “very useful”; three had already leveraged results in grant or investor materials and two planned to do so when more data emerged. Reported barriers included evidence gaps, funding constraints, and misalignment with pharmaceutical partners on codevelopment strategies; two projects were discontinued.
Conclusions
eHTA supplies developers with early economic insight, but its guidance is most reliable when interpreted alongside budget impact, feasibility, regulatory, and adoption considerations.
The moderating roles of friendship and contextual variables on associations between social withdrawal and peer exclusion and growth curves of depressed affect were studied with a three-wave multilevel longitudinal design. Participants were 313 boys and girls aged 10–12 from Canada (n = 139), mostly of European and North African descent, and Colombia (n = 174), mostly mestizo, afrocolombian, and European descent. Depressed affect, peer exclusion, social withdrawal and friendship were assessed with peer-reports, and collectivism and individualism with self-reports. Group-level scores included gender, place and means of social withdrawal, peer exclusion, friendship, collectivism and individualism for each child’s same-gender classroom peer-group. Results indicated that being friended weakened associations between peer exclusion and social withdrawal and depressed affect. The strength of this effect varied across peer-group contexts.
Psychotic disorders are severe mental health conditions frequently associated with long-term disability, reduced quality of life and premature mortality. Early Intervention in Psychosis (EIP) services aim to provide timely, comprehensive packages of care for people with psychotic disorders. However, it is not clear which components of EIP services contribute most to the improved outcomes they achieve.
Aims
We aimed to identify associations between specific components of EIP care and clinically significant outcomes for individuals treated for early psychosis in England.
Method
This national retrospective cohort study of 14 874 EIP individuals examined associations between 12 components of EIP care and outcomes over a 3-year follow-up period, by linking data from the National Clinical Audit of Psychosis (NCAP) to routine health outcome data held by NHS England. The primary outcome was time to relapse, defined as psychiatric inpatient admission or referral to a crisis resolution (home treatment) team. Secondary outcomes included duration of admissions, detention under the Mental Health Act, emergency department and general hospital attendances and mortality. We conducted multilevel regression analyses incorporating demographic and service-level covariates.
Results
Smaller care coordinator case-loads and the use of clozapine for eligible people were associated with reduced relapse risk. Physical health interventions were associated with reductions in mortality risk. Other components, such as cognitive–behavioural therapy for psychosis (CBTp), showed associations with improvements in secondary outcomes.
Conclusions
Smaller case-loads should be prioritised and protected in EIP service design and delivery. Initiatives to improve the uptake of clozapine should be integrated into EIP care. Other components, such as CBTp and physical health interventions, may have specific benefits for those eligible. These findings highlight impactful components of care and should guide resource allocation to optimise EIP service delivery.
Vascular rings represent a heterogeneous set of aberrant great vessel anatomic configurations which can cause respiratory symptoms or dysphagia due to tracheal or oesophageal compression. These symptoms can be subtle and may present at varied ages. More recently, many have been identified in patients without symptoms, including fetal echocardiogram, resulting in a conundrum for practitioners when attempting to determine who will benefit from surgical correction. Here, we provide a review of vascular rings and a guide to the practitioner on when to consider additional imaging or referral. Additionally, we discuss the changing landscape regarding asymptomatic patients and fetal echocardiogram.
Bovine trichomoniasis is a venereal disease that causes significant losses in the US beef industry. The USDA Animal and Plant Health Inspection Service views bovine trichomoniasis as endemic and delegates control to state agencies and producers. Disease management’s positive externalities are not reflected in a producer’s profit maximization problem, leading to potentially suboptimal levels of control. Our objective was to assess the economic impacts of 50% and 100% reductions of herd-level bovine trichomoniasis prevalence. The cumulative present value of net welfare increased by $388.856 and $193.222 million under the 100% and 50% scenarios, respectively. Feeder cattle producers and retail beef consumers benefit most from enhanced control.
Channel coding lies at the heart of digital communication and data storage. Fully updated, including a new chapter on polar codes, this detailed introduction describes the core theory of channel coding, decoding algorithms, implementation details, and performance analyses. This new edition includes over 50 new end-of-chapter problems and new figures and worked examples throughout. The authors emphasize the practical approach and present clear information on modern channel codes, including turbo and low-density parity-check (LDPC) codes, detailed coverage of BCH codes, Reed-Solomon codes, convolutional codes, finite geometry codes, product codes as well as polar codes for error correction and detection, providing a one-stop resource for classical and modern coding techniques. Assuming no prior knowledge in the field of channel coding, the opening chapters begin with basic theory to introduce newcomers to the subject. Later chapters then extend to advanced topics such as code ensemble performance analyses and algebraic code design.
We aimed to determine whether benchmarking antimicrobial use (AU) to antimicrobial resistance (AR) using select AU/AR ratios is more informative than AU metrics in isolation.
Design:
We retrospectively measured AU (antimicrobial therapy days per 1,000 days present) and AU/AR ratios (specific antimicrobial therapy days per corresponding AR event) in two hospitals during 2020 through 2022. We then had antimicrobial stewardship committee members evaluate each AU and corresponding AU/AR value and indicate whether they believed it represented potential overuse, appropriate use, or potential underuse of the antimicrobials, or whether they could not provide an assessment.
Setting:
Two acute-care hospitals.
Patients:
Hospitalized patients.
Results:
In semi-annual facility-wide analyses, echinocandins had a median AU/AR ratio of 658.5 therapy days per fluconazole-resistant Candida event in Hospital A, IV vancomycin had a median AU/AR ratio of 114.9 and 108.2 therapy days per methicillin-resistant Staphylococcus aureus event in Hospital A and B, respectively, and linezolid had a median AU/AR ratio of 33.8 and 88.0 therapy days per vancomycin-resistant Enterococcus event in Hospital A and B, respectively. When AU and AU/AR values were evaluated by stewardship committees, more respondents were able to assess antimicrobial use based on AU/AR values compared to AU values. Based on AU/AR ratios, most respondents identified potential overuse of echinocandins and IV vancomycin in Hospital A, and potential overuse of linezolid and IV vancomycin in Hospital B.
Conclusion:
Select AU/AR ratios provided informative metrics to antimicrobial stewardship personnel, which can be used to motivate audits of antimicrobial administration to determine appropriateness.
Foliar-applied postemergence applications of glufosinate are often applied to glufosinate-resistant crops to provide nonselective weed control without significant crop injury. Rainfall, air temperature, solar radiation, and relative humidity near the time of application have been reported to affect glufosinate efficacy. However, previous research may have not captured the full range of weather variability to which glufosinate may be exposed before or following application. Additionally, climate models suggest more extreme weather will become the norm, further expanding the weather range to which glufosinate can be exposed. The objective of this research was to quantify the probability of successful weed control (efficacy ≥85%) with glufosinate applied to some key weed species across a broad range of weather conditions. A database of >10,000 North American herbicide evaluation trials was used in this study. The database was filtered to include treatments with a single postemergence application of glufosinate applied to waterhemp [Amaranthus tuberculatus (Moq.) Sauer], morningglory species (Ipomoea spp.), and/or giant foxtail (Setaria faberi Herrm.) <15 cm in height. These species were chosen because they are well represented in the database and listed as common and troublesome weed species in both corn (Zea mays L.) and soybean [Glycine max (L.) Merr.] (Van Wychen 2020, 2022). Individual random forest models were created. Low rainfall (≤20 mm) over the 5 d before glufosinate application was detrimental to the probability of successful control of A. tuberculatus and S. faberi. Lower relative humidity (≤70%) and solar radiation (≤23 MJ m−1 d−1) on the day of application reduced the probability of successful weed control in most cases. Additionally, the probability of successful control decreased for all species when average air temperature over the first 5 d after application was ≤25 C. As climate continues to change and become more variable, the risk of unacceptable control of several common species with glufosinate is likely to increase.
Previous economic evidence about interventions for schizophrenia is outdated, non-transparent and/or limited to a specific clinical context.
Aims
We developed a de novo discrete event simulation (DES) model for estimating the cost-effectiveness of interventions in schizophrenia in the UK.
Method
The DES model was developed based on the structure of previous models, populated with demographic, clinical and cost data from the UK, and antipsychotics' effects from recent network meta-analyses. We simulated treatment pathways for patients with first-episode schizophrenia including events such as relapse, remission, treatment discontinuation, cardiovascular disease and death and estimated costs (2020£) taking the National Health Service perspective and quality-adjusted life years (QALYs) over ten years. Using the model, we ranked ten first-line antipsychotics based on their QALYs and cost-effectiveness.
Results
Amisulpride was associated with the highest QALYs, followed by risperidone long-acting injection (LAI), aripiprazole-LAI (6.121, 6.084, 6.070, respectively) and others (5.947–6.058). The most cost-effective antipsychotics were amisulpride, olanzapine and risperidone-LAI, with total probability of rankings of 1, ≤2, ≤3, that is, 95%, 89%, 80%, respectively; meanwhile, the least cost-effective were cariprazine, lurasidone and quetiapine, with total probability of rankings of 10, ≥9, ≥8, that is, 96%, 92%, 81%, respectively. Results were robust across sensitivity analyses and influenced primarily by relapse relevant parameters.
Conclusions
Our findings suggest amisulpride (or risperidone-LAI where oral treatment is inappropriate) as the best overall first-line option based on QALYs and cost-effectiveness. Our ranking may be used to guide decision-making between antipsychotics. Our model is open source and could be applied to the other settings.
Channel coding lies at the heart of digital communication and data storage. Fully updated to include current innovations in the field, including a new chapter on polar codes, this detailed introduction describes the core theory of channel coding, decoding algorithms, implementation details, and performance analyses. This edition includes over 50 new end-of-chapter problems to challenge students and numerous new figures and examples throughout.
The authors emphasize a practical approach and clearly present information on modern channel codes, including polar, turbo, and low-density parity-check (LDPC) codes, as well as detailed coverage of BCH codes, Reed–Solomon codes, convolutional codes, finite geometry codes, and product codes for error correction, providing a one-stop resource for both classical and modern coding techniques.
Assuming no prior knowledge in the field of channel coding, the opening chapters begin with basic theory to introduce newcomers to the subject. Later chapters then begin with classical codes, continue with modern codes, and extend to advanced topics such as code ensemble performance analyses and algebraic LDPC code design.
300 varied and stimulating end-of-chapter problems test and enhance learning, making this an essential resource for students and practitioners alike.
Provides a one-stop resource for both classical and modern coding techniques.
Starts with the basic theory before moving on to advanced topics, making it perfect for newcomers to the field of channel coding.
180 worked examples guide students through the practical application of the theory.
Channel coding lies at the heart of digital communication and data storage. Fully updated to include current innovations in the field, including a new chapter on polar codes, this detailed introduction describes the core theory of channel coding, decoding algorithms, implementation details, and performance analyses. This edition includes over 50 new end-of-chapter problems to challenge students and numerous new figures and examples throughout.
The authors emphasize a practical approach and clearly present information on modern channel codes, including polar, turbo, and low-density parity-check (LDPC) codes, as well as detailed coverage of BCH codes, Reed–Solomon codes, convolutional codes, finite geometry codes, and product codes for error correction, providing a one-stop resource for both classical and modern coding techniques.
Assuming no prior knowledge in the field of channel coding, the opening chapters begin with basic theory to introduce newcomers to the subject. Later chapters then begin with classical codes, continue with modern codes, and extend to advanced topics such as code ensemble performance analyses and algebraic LDPC code design.
300 varied and stimulating end-of-chapter problems test and enhance learning, making this an essential resource for students and practitioners alike.
Provides a one-stop resource for both classical and modern coding techniques.
Starts with the basic theory before moving on to advanced topics, making it perfect for newcomers to the field of channel coding.
180 worked examples guide students through the practical application of the theory.
Channel coding lies at the heart of digital communication and data storage. Fully updated to include current innovations in the field, including a new chapter on polar codes, this detailed introduction describes the core theory of channel coding, decoding algorithms, implementation details, and performance analyses. This edition includes over 50 new end-of-chapter problems to challenge students and numerous new figures and examples throughout.
The authors emphasize a practical approach and clearly present information on modern channel codes, including polar, turbo, and low-density parity-check (LDPC) codes, as well as detailed coverage of BCH codes, Reed–Solomon codes, convolutional codes, finite geometry codes, and product codes for error correction, providing a one-stop resource for both classical and modern coding techniques.
Assuming no prior knowledge in the field of channel coding, the opening chapters begin with basic theory to introduce newcomers to the subject. Later chapters then begin with classical codes, continue with modern codes, and extend to advanced topics such as code ensemble performance analyses and algebraic LDPC code design.
300 varied and stimulating end-of-chapter problems test and enhance learning, making this an essential resource for students and practitioners alike.
Provides a one-stop resource for both classical and modern coding techniques.
Starts with the basic theory before moving on to advanced topics, making it perfect for newcomers to the field of channel coding.
180 worked examples guide students through the practical application of the theory.
Channel coding lies at the heart of digital communication and data storage. Fully updated to include current innovations in the field, including a new chapter on polar codes, this detailed introduction describes the core theory of channel coding, decoding algorithms, implementation details, and performance analyses. This edition includes over 50 new end-of-chapter problems to challenge students and numerous new figures and examples throughout.
The authors emphasize a practical approach and clearly present information on modern channel codes, including polar, turbo, and low-density parity-check (LDPC) codes, as well as detailed coverage of BCH codes, Reed–Solomon codes, convolutional codes, finite geometry codes, and product codes for error correction, providing a one-stop resource for both classical and modern coding techniques.
Assuming no prior knowledge in the field of channel coding, the opening chapters begin with basic theory to introduce newcomers to the subject. Later chapters then begin with classical codes, continue with modern codes, and extend to advanced topics such as code ensemble performance analyses and algebraic LDPC code design.
300 varied and stimulating end-of-chapter problems test and enhance learning, making this an essential resource for students and practitioners alike.
Provides a one-stop resource for both classical and modern coding techniques.
Starts with the basic theory before moving on to advanced topics, making it perfect for newcomers to the field of channel coding.
180 worked examples guide students through the practical application of the theory.
Channel coding lies at the heart of digital communication and data storage. Fully updated to include current innovations in the field, including a new chapter on polar codes, this detailed introduction describes the core theory of channel coding, decoding algorithms, implementation details, and performance analyses. This edition includes over 50 new end-of-chapter problems to challenge students and numerous new figures and examples throughout.
The authors emphasize a practical approach and clearly present information on modern channel codes, including polar, turbo, and low-density parity-check (LDPC) codes, as well as detailed coverage of BCH codes, Reed–Solomon codes, convolutional codes, finite geometry codes, and product codes for error correction, providing a one-stop resource for both classical and modern coding techniques.
Assuming no prior knowledge in the field of channel coding, the opening chapters begin with basic theory to introduce newcomers to the subject. Later chapters then begin with classical codes, continue with modern codes, and extend to advanced topics such as code ensemble performance analyses and algebraic LDPC code design.
300 varied and stimulating end-of-chapter problems test and enhance learning, making this an essential resource for students and practitioners alike.
Provides a one-stop resource for both classical and modern coding techniques.
Starts with the basic theory before moving on to advanced topics, making it perfect for newcomers to the field of channel coding.
180 worked examples guide students through the practical application of the theory.
Channel coding lies at the heart of digital communication and data storage. Fully updated to include current innovations in the field, including a new chapter on polar codes, this detailed introduction describes the core theory of channel coding, decoding algorithms, implementation details, and performance analyses. This edition includes over 50 new end-of-chapter problems to challenge students and numerous new figures and examples throughout.
The authors emphasize a practical approach and clearly present information on modern channel codes, including polar, turbo, and low-density parity-check (LDPC) codes, as well as detailed coverage of BCH codes, Reed–Solomon codes, convolutional codes, finite geometry codes, and product codes for error correction, providing a one-stop resource for both classical and modern coding techniques.
Assuming no prior knowledge in the field of channel coding, the opening chapters begin with basic theory to introduce newcomers to the subject. Later chapters then begin with classical codes, continue with modern codes, and extend to advanced topics such as code ensemble performance analyses and algebraic LDPC code design.
300 varied and stimulating end-of-chapter problems test and enhance learning, making this an essential resource for students and practitioners alike.
Provides a one-stop resource for both classical and modern coding techniques.
Starts with the basic theory before moving on to advanced topics, making it perfect for newcomers to the field of channel coding.
180 worked examples guide students through the practical application of the theory.
Channel coding lies at the heart of digital communication and data storage. Fully updated to include current innovations in the field, including a new chapter on polar codes, this detailed introduction describes the core theory of channel coding, decoding algorithms, implementation details, and performance analyses. This edition includes over 50 new end-of-chapter problems to challenge students and numerous new figures and examples throughout.
The authors emphasize a practical approach and clearly present information on modern channel codes, including polar, turbo, and low-density parity-check (LDPC) codes, as well as detailed coverage of BCH codes, Reed–Solomon codes, convolutional codes, finite geometry codes, and product codes for error correction, providing a one-stop resource for both classical and modern coding techniques.
Assuming no prior knowledge in the field of channel coding, the opening chapters begin with basic theory to introduce newcomers to the subject. Later chapters then begin with classical codes, continue with modern codes, and extend to advanced topics such as code ensemble performance analyses and algebraic LDPC code design.
300 varied and stimulating end-of-chapter problems test and enhance learning, making this an essential resource for students and practitioners alike.
Provides a one-stop resource for both classical and modern coding techniques.
Starts with the basic theory before moving on to advanced topics, making it perfect for newcomers to the field of channel coding.
180 worked examples guide students through the practical application of the theory.