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OBJECTIVES/GOALS: Our study explores the dose-related effects of THC on cardiovascular measures, self-reported effects, balance, and cognitive function among older adults. We also evaluate the acceptability and feasibility of study procedures, to inform future study designs employing this population. METHODS/STUDY POPULATION: Using a within-subject, double-blind, placebo-controlled design and standard behavioral pharmacology methods, reasonably healthy male and female adults aged 55-70 years undergo an eligibility screening, followed by a mock session and 3 experimental sessions (>7 days apart). During experimental sessions, participants are administered cannabis-infused brownies with varying THC doses. Prior to and at multiple intervals post- consumption, subjects complete assessments including self reports and observer ratings, psychomotor and cognitive performance measures, and vital signs. Follow-up interviews regarding the experience will be conducted one day after each session. RESULTS/ANTICIPATED RESULTS: We anticipate our results to mirror those of previously reported studies conducted in adults under 45 years old in that a dose-response relationship exists for subjective drug effects and vital signs with the caveat that this relationship may be exacerbated in our population. We additionally anticipate findings that indicate THC impairs balance and coordination, potentially increasing the risk of falls and accidents among this population, and cognitive function, affecting attention, memory, and executive functions. Feedback provided during the follow-up interviews will help refine procedures for future studies, ensuring that the methodology is acceptable and feasible for this population. DISCUSSION/SIGNIFICANCE: Prior work demonstrates the safety and efficacy of THC in conditions common among older adults, however, no conclusive data regarding tolerability and safety in this population exists. The presented work is vital groundwork for future research on THC as a potential therapeutic for older adults.
Globally, human house types are diverse, varying in shape, size, roof type, building materials, arrangement, decoration and many other features. Here we offer the first rigorous, global evaluation of the factors that influence the construction of traditional (vernacular) houses. We apply macroecological approaches to analyse data describing house features from 1900 to 1950 across 1000 societies. Geographic, social and linguistic descriptors for each society were used to test the extent to which key architectural features may be explained by the biophysical environment, social traits, house features of neighbouring societies or cultural history. We find strong evidence that some aspects of the climate shape house architecture, including floor height, wall material and roof shape. Other features, particularly ground plan, appear to also be influenced by social attributes of societies, such as whether a society is nomadic, polygynous or politically complex. Additional variation in all house features was predicted both by the practices of neighouring societies and by a society's language family. Collectively, the findings from our analyses suggest those conditions under which traditional houses offer solutions to architects seeking to reimagine houses in light of warmer, wetter or more variable climates.
The Paleozoic represents a key time interval in the origins and early diversification of chondrichthyans (cartilaginous fishes), but their diversity and macroevolution are largely obscured by heterogenous spatial and temporal sampling. The predominantly cartilaginous skeletons of chondrichthyans pose an additional limitation on their preservation potential and hence on the quality of their fossil record. Here, we use a newly compiled genus-level dataset and the application of sampling standardization methods to analyze global total-chondrichthyan diversity dynamics through time from their first appearance in the Ordovician through to the end of the Permian. Subsampled estimates of chondrichthyan genus richness were initially low in the Ordovician and Silurian but increased substantially in the Early Devonian. Richness reached its maximum in the middle Carboniferous before dropping across the Carboniferous/Permian boundary and gradually decreasing throughout the Permian. Sampling is higher in both the Devonian and Carboniferous compared with the Silurian and most of the Permian stages. Shark-like scales from the Ordovician are too limited to allow for some of the subsampling techniques. Our results detect two Paleozoic radiations in chondrichthyan diversity: the first in the earliest Devonian, led by acanthodians (stem-group chondrichthyans), which then decline rapidly by the Late Devonian, and the second in the earliest Carboniferous, led by holocephalans, which increase greatly in richness across the Devonian/Carboniferous boundary. Dispersal of chondrichthyans, specifically holocephalans, into deeper-water environments may reflect a niche expansion following the faunal displacement in the aftermath of the Hangenberg extinction event at the end of the Devonian.
With contributions from an international team of experts, this collection provides a much-needed international, comparative approach to mental capacity law.
Automatic dialog systems have become a mainstream part of online customer service. Many such systems are built, maintained, and improved by customer service specialists, rather than dialog systems engineers and computer programmers. As conversations between people and machines become commonplace, it is critical to understand what is working, what is not, and what actions can be taken to reduce the frequency of inappropriate system responses. These analyses and recommendations need to be presented in terms that directly reflect the user experience rather than the internal dialog processing.
This paper introduces and explains the use of Actionable Conversational Quality Indicators (ACQIs), which are used both to recognize parts of dialogs that can be improved and to recommend how to improve them. This combines benefits of previous approaches, some of which have focused on producing dialog quality scoring while others have sought to categorize the types of errors the dialog system is making. We demonstrate the effectiveness of using ACQIs on LivePerson internal dialog systems used in commercial customer service applications and on the publicly available LEGOv2 conversational dataset. We report on the annotation and analysis of conversational datasets showing which ACQIs are important to fix in various situations.
The annotated datasets are then used to build a predictive model which uses a turn-based vector embedding of the message texts and achieves a 79% weighted average f1-measure at the task of finding the correct ACQI for a given conversation. We predict that if such a model worked perfectly, the range of potential improvement actions a bot-builder must consider at each turn could be reduced by an average of 81%.
Adrenal gland-induced hypertension, also known as secondary hypertension, is a medical condition caused by an underlying adrenal pathology, most typically adrenocortical adenomas. Current clinical practices involve pharmacotherapy or surgical resection to treat adrenal gland diseases that cause hypertension. However, due to the limitations of these treatment options, microwave ablation (MWA) has emerged as a promising minimally invasive alternative. An accurate understanding of the dielectric properties of adrenal glands would support the further development and optimization of MWA technology for treating adrenal tumors. Only a few studies have examined the dielectric properties of both human and animal adrenal glands, and the sample sizes of these studies have been relatively small. Therefore, further dielectric data of human and animal adrenal glands are warranted. This paper presents the ex vivo dielectric properties of the ovine adrenal glands (medulla and cortex) and summarizes the published literature on dielectric data of adrenal glands from porcine, bovine, ovine, and human samples in the microwave frequency range to analyze the consistency and reliability of the reported data. The dielectric properties of the ovine adrenal glands (N = 8) were measured using an open-ended coaxial probe measurement technique at frequencies ranging from 0.5 to 8.5 GHz. This study also investigated the temperature-dependent dielectric properties of the ovine adrenal medulla ranging from 37 to 64°C at frequencies ranging from 0.5 to 8.5 GHz. The dielectric properties of the ovine adrenal medulla measured in this study were found to be consistent with the literature. Moreover, the review suggests that variations exist in the dielectric properties of the adrenal medulla and cortex among species. The study also found that the dielectric properties of the adrenal medulla decrease with increasing temperature, similar to other tissues for which temperature-dependent dielectric data have been reported. This summary of dielectric data of adrenal glands and the temperature-dependent dielectric properties of the ovine adrenal medulla will accelerate the development of MWA technologies for hypertension treatment.
Background: To estimate hand hygiene compliance using electronic hand hygiene monitoring, the number of hand hygiene opportunities (HHOs) per period must be known in a given setting. Data on the number of HHOs in a neonatal ICU (NICU) are limited. We measured HHOs per hour and identified factors that may influence the number of HHOs per hour to calibrate compliance estimates for electronic hand hygiene monitoring. Methods: The study was conducted in 2 large NICUs in Ontario, Canada (72 and 42 beds, respectively). We centrally trained observers to identify HHOs using the Ontario-based “Four Moments of Hand Hygiene,” which is similar to combining moments 4 and 5 of the WHO “Five Moments of Hand Hygiene.” To apply the moments of hand hygiene to the NICU setting, the following modifications were made: moment 1 was entering the incubator or contact with anything within the ‘baby space’ directly around the incubator, and moment 4 was when hands exited the incubator and, as such, the ‘baby space.’ Using a standardized tool, the investigators conducted direct observation of HHOs during randomized observation periods from July 1, 2022, to January 9, 2023. In addition to HHOs, data on covariables potentially associated with the frequency of HHOs were collected: time and day of the week, acuity, additional precautions, corrected gestational age, and private versus multibed room or open pod. Results: We audited HHOs for 146 hours including 26 at site A and 120 at site B. Overall, 804 HHOs (69.2%) occurred during weekdays and 739 (63.6%) occurred during day shifts from 7:00 a.m. to7:00 p.m. The most frequent moments of hand hygiene were moment 1 (47.8%, before contact) and moment 4 (36.8%, after contact). The average numbers of HHOs were 7.8 per hour overall, 7.6 per hour on weekdays, 7.7 per hour on weekends, 8.8 per hour on day shifts, and 6.8 per hour on night shifts. The breakdown of HHOs by profession was 92.8% nurses, 0.6% physicians, 4.5% allied health, and 2.1% for others. Discussion: The rate of HHOs in NICU varied over a 24-hour period and was similar between 2 different NICUs. Evenings and weekends had considerably fewer average HHOs, and peaks were observed following nursing shift changes. The rate of HHOs may be influenced by other factors including unit design, patient acuity, and use of transmission-based precautions. Further analysis using a Poisson regression model will help to explore these factors and to calibrate electronic monitoring for this population.
A survey was conducted among Canadian tertiary neonatal intensive care units. Of the 27 sites who responded, 9 did not have any form of antimicrobial stewardship, and 11 used vancomycin for empirical coverage in late-onset-sepsis evaluations. We detected significant variations in the diagnostic criteria for urinary tract infection and ventilator-associated pneumonia.
Since the start of the 21st century, policy developments and legal practice have increasingly sought to express and implement changes that recognise the equality and rights of persons with mental impairments, including persons with learning disabilities and mental disorders. A great deal of academic scholarship, legal commentary and policy recommendations have focused attention on internal analyses of specific jurisdictions – for example, academic and practice-based discussions of mental capacity law in England and Wales have flourished in the time leading up to and since the instantiation of the Mental Capacity Act 2005 (MCA). Equally, much scholarship has focused on the changing human rights landscape since the advent of the United Nations Convention on the Rights of Persons with Disabilities (CRPD), with particular attention on the meaning of its requirements and jurisdiction-specific adherence to human rights aspirations. Dialogue between these jurisdiction-specific and human rights analyses has become increasingly common. Less common – but no less important – is an international comparative perspective across different legal approaches to mental capacity law, to encourage learning and critical reflection based on a closer analysis of how different jurisdictions grapple with common issues and imperatives around assuring the empowerment and participation in decision-making by, with and for individuals with impairments.
The purpose of this edited collection is to advance this much-needed international comparative contribution to mental capacity law. Our particular focus in the volume is to spur on a comparative-oriented conversation around substantive commonalities and divergences in normative orientation and practical application embedded in different legal frameworks. Regarding normative orientation, we are particularly keen to critically identify how values and assumptions are built into laws (formally or by convention) about persons and personal decision-making, and what this is taken to mean for the roles of law, institutions, and legal and other professionals. Crucially, we are interested against that to understand what those laws mean for the place and voice of persons whose decisions are governed by such laws. Therefore, in practical application we are not only interested in the letter of different laws, but also how they function; including what they miss, or whether and how they may be inequitable in their application or generate outcomes that are opposed to their (apparent) rationales.
This volume has taken an international approach to learning about, and critically exploring, how legal systems may, or may fail to, assure the (meaningful) participation in decision-making by, with and for individuals who are subject to mental capacity laws (P). Equally, the contributors have explained how laws bring individuals’ values into personal decisionmaking, or present barriers to this, and how values beyond the person's may also feature in such decisions. We invited contributions based on a single template of contextual and law-focused questions across the book's authors, and yet we see significant distinctions in both the practical and the socioethical situations among the respective jurisdictions that the book examines. These are, unsurprisingly, in part explicable by reference to sociocultural, demographic, historical and institutional (including professional hegemonic) distinctions between the different places that the book looks at. They are also a consequence of the distinct critical perspectives and orientations across the book's authorship. And they are explicable given distinct legal framings and assumptions, which prove significant even among the common law systems and their shared traditions that form the focus of the majority of the contributions.
We may begin to collect our own reflections in this concluding chapter by noting that the book's inquiry is pitched as being about mental capacity law. Even among those jurisdictions who share their legal heritage with systems that have expressly enacted ‘mental (in)capacity’ laws, this already presents its own distinct vocabulary, as we see in Stavert's chapter (Chapter 3) on the AWIA in Scotland; likewise the language of guardianship, as discussions of Australia (Chapter 8), the US (Chapter 6) and Hong Kong (Chapter 10) indicate. Accordingly, part of the comparative exercise is in understanding the substance and practical import of technical language when making observations and evaluations. ‘P’ will have been a designation that is alien to readers in many legal systems, and even within legal systems that use the term this designation is not well known outside the realms of mental capacity law. The lack of explicit reference to guardianship laws in the book's title may seem surprising.
Iconicity in language is receiving increased attention from many fields, but our understanding of iconicity is only as good as the measures we use to quantify it. We collected iconicity measures for 304 Japanese words from English-speaking participants, using rating and guessing tasks. The words included ideophones (structurally marked depictive words) along with regular lexical items from similar semantic domains (e.g., fuwafuwa ‘fluffy’, jawarakai ‘soft’). The two measures correlated, speaking to their validity. However, ideophones received consistently higher iconicity ratings than other items, even when guessed at the same accuracies, suggesting the rating task is more sensitive to cues like structural markedness that frame words as iconic. These cues did not always guide participants to the meanings of ideophones in the guessing task, but they did make them more confident in their guesses, even when they were wrong. Consistently poor guessing results reflect the role different experiences play in shaping construals of iconicity. Using multiple measures in tandem allows us to explore the interplay between iconicity and these external factors. To facilitate this, we introduce a reproducible workflow for creating rating and guessing tasks from standardised wordlists, while also making improvements to the robustness, sensitivity and discriminability of previous approaches.
In this final chapter, we offer some comparative analysis and tentative concluding comments. We begin with an examination of different aspects of the law and practice of advance directives (ADs) in these jurisdictions, identifying similarities and trends. With this summary of the various connections between these jurisdictions, we then offer some broader reflections on two key features common to Asian jurisdictions, the role of religion and the role of the family. We conclude with a critical examination of this emerging picture of ADs in Asia, arguing that these insights suggest that distinctive patterns of “generative accommodation” are observable as a way of aligning international consensus with localised traditions and expectations in a more nuanced account of the meeting ground between the East and the West.