The place of popular music in Scotland’s cultural policy

n the last two decades the status of popular music as both a cultural activity and creative industry has changed significantly in Scottish and UK cultural policy. The change is in line with a broader shift away from thinking of the arts as cultural activity in need of subsidy and towards treating them as part of the creative economy. The current cultural policy landscape pertaining to popular music is mapped out, drawing on interviews and an online survey with members of the Scottish Music Industry Association (SMIA) and complementary interviews with stakeholders from relevant government and arms-length funding and development bodies. The Scottish Government's (SG) White Paper on independence highlighted the creative industries as one of five growth sectors key to the Scottish economy, but for popular music – and in line with the global music industry – many working in the Scottish music industry face acute challenges. Given EU regulations (and the Scottish Government's preference to remain in the EU) and international agreements in areas like broadcasting and copyright, if they are to flourish many members of the SMIA will likely need to strengthen their relationships with the wider UK and global music industry, regardless of the outcome of the referendum on independence

Generalized linear models for flexible parametric modeling of the hazard function

Background: Parametric modelling of survival data is important and reimbursement decisions may depend on the selected distribution. Accurate predictions require sufficiently flexible models to describe adequately the temporal evolution of the hazard function. A rich class of models is available among the framework of generalised linear models (GLMs) and its extensions, but these models are rarely applied to survival data. This manuscript describes the theoretical properties of these more flexible models, and compares their performance to standard survival models in a reproducible case- study. Methods: We describe how survival data may be analysed with GLMs and its extensions: fractional polynomials, spline models, generalised additive models, generalised linear mixed (frailty) models and dynamic survival models. For each, we provide a comparison of the strengths and limitations of these approaches. For the case-study we compare within-sample fit, the plausibility of extrapolations and extrapolation performance based on data-splitting. Results: Viewing standard survival models as GLMs shows that many impose a restrictive assumption of linearity. For the case-study, GLMs provided better within-sample fit and more plausible extrapolations. However, they did not improve extrapolation performance. We also provide guidance to aid in choosing between the different approaches based on GLMs and its extensions. Conclusions: The use of GLMs for parametric survival analysis can out-perform standard parametric survival models, although the improvements were modest in our case-study. This approach is currently seldom used. We provide guidance on both implementing these models and choosing between them. The reproducible case-study will help to increase uptake of these models

Search for dark matter produced in association with bottom or top quarks in √s = 13 TeV pp collisions with the ATLAS detector

A search for weakly interacting massive particle dark matter produced in association with bottom or top quarks is presented. Final states containing third-generation quarks and miss- ing transverse momentum are considered. The analysis uses 36.1 fb−1 of proton–proton collision data recorded by the ATLAS experiment at √s = 13 TeV in 2015 and 2016. No significant excess of events above the estimated backgrounds is observed. The results are in- terpreted in the framework of simplified models of spin-0 dark-matter mediators. For colour- neutral spin-0 mediators produced in association with top quarks and decaying into a pair of dark-matter particles, mediator masses below 50 GeV are excluded assuming a dark-matter candidate mass of 1 GeV and unitary couplings. For scalar and pseudoscalar mediators produced in association with bottom quarks, the search sets limits on the production cross- section of 300 times the predicted rate for mediators with masses between 10 and 50 GeV and assuming a dark-matter mass of 1 GeV and unitary coupling. Constraints on colour- charged scalar simplified models are also presented. Assuming a dark-matter particle mass of 35 GeV, mediator particles with mass below 1.1 TeV are excluded for couplings yielding a dark-matter relic density consistent with measurements

Performance over professional learning and the complexity puzzle: lesson observation in England’s further education sector

Attempts to measure the quality of teaching and learning have resulted in an overreliance on quantitative performance data and the normalisation of a set of reductionist practices in England’s further education sector in recent years. Focusing on lesson observation as an illustrative example and drawing on data from a national study, this article examines the application of observation and its impact on further education teachers’ practice. In viewing lesson observation through a complexity theory lens and contextualising it against the wider neoliberal backdrop of the marketisation of education, we seek to critique the inadequacies of current reductionist approaches to teacher evaluation, whilst simultaneously opening up a debate regarding the consequences of seeing classrooms as complex adaptive systems. In focusing on performative models of lesson observation in particular, the article exposes what we perceive as some of the epistemological and methodological shortcomings of neoliberalism in practice, but also offers an alternative way forward in dealing with the contested practice of evaluating the quality of teaching and learning

Cost effectiveness of nusinersen for patients with infantile-onset spinal muscular atrophy in US

Background Patients with infantile-onset spinal muscular atrophy (SMA), a rare, genetic neuromuscular disease, do not achieve key motor function milestones (e.g., sitting) and have short life expectancy in the absence of treatment. Nusinersen is a disease-modifying therapy for patients with SMA. Objective The aim of this study was to estimate the cost-effectiveness of nusinersen compared to best supportive care (BSC) in patients diagnosed with infantile-onset SMA in the US. Methods A de novo economic model was developed with the following health states: “permanent ventilation”, “not sitting”, “sitting”, “walking”, and “death”. Short-term data were sourced from the pivotal clinical trials and studies of nusinersen (ENDEAR and SHINE). Motor function milestones achieved at the end of follow-up in the clinical trials were assumed to be sustained until death. Mortality risks were based on survival modelling of relevant published Kaplan–Meier data. Costs, life years (LYs), and quality-adjusted life years (QALYs) were discounted at 3% per annum, and the analyses were performed from a US health care sector perspective. Scenario analyses and sensitivity analyses were conducted to assess the robustness of the results to key parameters. Results In our base-case analysis, nusinersen treatment achieves greater QALYs and more LYs (3.24 and 7.64, respectively) compared with BSC (0.46 QALYs and 2.40 LYs, respectively), resulting in an incremental cost per QALY gained of approximately $1,112,000 and an incremental cost per LY gained of$590,000 for nusinersen compared to BSC. The incremental cost effectiveness ratios did not fall below $990,000 per QALY gained in scenario and sensitivity analyses. Results were most sensitive to the length of survival, background health care costs, and utility in the “not sitting” and “sitting” health states. Conclusions The estimated incremental cost-effectiveness of nusinersen from a US health care sector perspective exceeded traditional cost-effectiveness thresholds. Cost-effectiveness was dependent on assumptions made regarding survival, costs, utilities, and whether the motor function milestones were sustained over lifetime. Given the relatively short-term effectiveness data available for the treatment, a registry to collect long-term data of infantile-onset SMA patients is recommended

Modelling the Cost Effectiveness of Interventions for Osteoporosis: Issues to Consider

Expenditure on treating osteoporotic fractures and on preventative intervention is considerable and is likely to rise in forthcoming years due to the association between fracture risk and age. With funders such as the National Institute for Health and Care Excellence and the Pharmaceutical Benefits Advisory Committee explicitly considering cost-effectiveness analyses within the process of producing guidance, it is imperative that economic models are as robust as possible. This article details issues that need to be considered specifically related to health technology assessments of interventions for osteoporosis, and highlights limitations within the current evidence base. A likely direction of impact on cost effectiveness of addressing the key issues has been included alongside a tentative categorization of the level of these impacts. It is likely that cost-effectiveness ratios presented in previous models that did not address the identified issues were favourable to interventions

Globally coherent water cycle response to temperature change during the past two millennia

The response of the global water cycle to changes in global surface temperature remains an outstanding question in future climate projections and in past climate reconstructions. The stable hydrogen and oxygen isotope compositions of precipitation (δprecip), meteoric water (δMW) and seawater (δSW) integrate processes from microphysical to global scales and thus are uniquely positioned to track global hydroclimate variations. Here we evaluate global hydroclimate during the past 2,000 years using a globally distributed compilation of proxies for δprecip, δMW and δSW. We show that global mean surface temperature exerted a coherent influence on global δprecip and δMW throughout the past two millennia, driven by global ocean evaporation and condensation processes, with lower values during the Little Ice Age (1450–1850) and higher values after the onset of anthropogenic warming (~1850). The Pacific Walker Circulation is a predominant source of regional variability, particularly since 1850. Our results demonstrate rapid adjustments in global precipitation and atmospheric circulation patterns—within decades—as the planet warms and cools

Diverse University Students Across the United States Reveal Promising Pathways to Hunter Recruitment and Retention

Declining participation in hunting, especially among young adult hunters, affects the ability of state and federal agencies to achieve goals for wildlife management and decreases revenue for conservation. For wildlife agencies hoping to engage diverse audiences in hunter recruitment, retention, and reactivation (R3) efforts, university settings provide unique advantages: they contain millions of young adults who are developmentally primed to explore new activities, and they cultivate a social atmosphere where new identities can flourish. From 2018 to 2020, we surveyed 17,203 undergraduate students at public universities across 22 states in the United States to explore R3 potential on college campuses and assess key demographic, social, and cognitive correlates of past and intended future hunting behavior. After weighting to account for demographic differences between our sample and the larger student population, 29% of students across all states had hunted in the past. Students with previous hunting experience were likely to be white, male, from rural areas or hunting families, and pursuing degrees related to natural resources. When we grouped students into 1 of 4 categories with respect to hunting (i.e., non-hunters [50%], potential hunters [22%], active hunters [26%], and lapsed hunters [3%]), comparisons revealed differences based on demographic attributes, beliefs, attitudes, and behaviors. Compared to active hunters, potential hunters were more likely to be females or racial and ethnic minorities, and less likely to experience social support for hunting. Potential hunters valued game meat and altruistic reasons for hunting, but they faced unique constraints due to lack of hunting knowledge and skills. Findings provide insights for marketing and programming designed to achieve R3 objectives with a focus on university students. © 2021 The Wildlife Society

Biomarker-Guided Antibiotic Duration for Hospitalized Patients With Suspected Sepsis

IMPORTANCE: For hospitalized critically ill adults with suspected sepsis, procalcitonin (PCT) and C-reactive protein (CRP) monitoring protocols can guide the duration of antibiotic therapy, but the evidence of the effect and safety of these protocols remains uncertain. OBJECTIVE: To determine whether decisions based on assessment of CRP or PCT safely results in a reduction in the duration of antibiotic therapy. DESIGN, SETTING, AND PARTICIPANTS: A multicenter, intervention-concealed randomized clinical trial, involving 2760 adults (≥18 years), in 41 UK National Health Service (NHS) intensive care units, requiring critical care within 24 hours of initiating intravenous antibiotics for suspected sepsis and likely to continue antibiotics for at least 72 hours. INTERVENTION: From January 1, 2018, to June 5, 2024, 918 patients were assigned to the daily PCT-guided protocol, 924 to the daily CRP-guided protocol, and 918 assigned to standard care. MAIN OUTCOMES AND MEASURES: The primary outcomes were total duration of antibiotics (effectiveness) and all-cause mortality (safety) to 28 days. Secondary outcomes included critical care unit data and hospital stay data. Ninety-day all-cause mortality was also collected. RESULTS: Among the randomized patients (mean age 60.2 [SD, 15.4] years; 60.3% males), there was a significant reduction in antibiotic duration from randomization to 28 days for those in the daily PCT-guided protocol compared with standard care (mean duration, 10.7 [SD, 7.6] days for standard care and 9.8 [SD, 7.2] days for PCT; mean difference, 0.88 days; 95% CI, 0.19 to 1.58, P = .01). For all-cause mortality up to 28 days, the daily PCT-guided protocol was noninferior to standard care, where the noninferiority margin was set at 5.4% (19.4% [170 of 878] of patients receiving standard care; 20.9% [184 of 879], PCT; absolute difference, 1.57; 95% CI, −2.18 to 5.32; P = .02). No difference was found in antibiotic duration for standard care vs daily CRP-guided protocol (mean duration, 10.6 [7.7] days for CRP; mean difference, 0.09; 95% CI, −0.60 to 0.79; P = .79). For all-cause mortality, the daily CRP-guided protocol was inconclusive compared with standard care (21.1% [184 of 874] for CRP; absolute difference, 1.69; 95% CI, −2.07 to 5.45; P = .03). CONCLUSIONS AND RELEVANCE: Care guided by measurement of PCT reduces antibiotic duration safely compared with standard care, but CRP does not. All-cause mortality for CRP was inconclusive. TRIAL REGISTRATION: isrctn.org Identifier: ISRCTN4747324

Granulocyte colony-stimulating factors for febrile neutropenia prophylaxis following chemotherapy: systematic review and meta-analysis

Background: Febrile neutropenia (FN) occurs following myelosuppressive chemotherapy and is associated with morbidity, mortality, costs, and chemotherapy reductions and delays. Granulocyte colony-stimulating factors (G-CSFs) stimulate neutrophil production and may reduce FN incidence when given prophylactically following chemotherapy. Methods: A systematic review and meta-analysis assessed the effectiveness of G-CSFs (pegfilgrastim, filgrastim or lenograstim) in reducing FN incidence in adults undergoing chemotherapy for solid tumours or lymphoma. G-CSFs were compared with no primary G-CSF prophylaxis and with one another. Nine databases were searched in December 2009. Meta-analysis used a random effects model due to heterogeneity. Results: Twenty studies compared primary G-CSF prophylaxis with no primary G-CSF prophylaxis: five studies of pegfilgrastim; ten of filgrastim; and five of lenograstim. All three G-CSFs significantly reduced FN incidence, with relative risks of 0.30 (95% CI: 0.14 to 0.65) for pegfilgrastim, 0.57 (95% CI: 0.48 to 0.69) for filgrastim, and 0.62 (95% CI: 0.44 to 0.88) for lenograstim. Overall, the relative risk of FN for any primary G-CSF prophylaxis versus no primary G-CSF prophylaxis was 0.51 (95% CI: 0.41 to 0.62). In terms of comparisons between different G-CSFs, five studies compared pegfilgrastim with filgrastim. FN incidence was significantly lower for pegfilgrastim than filgrastim, with a relative risk of 0.66 (95% CI: 0.44 to 0.98). Conclusions: Primary prophylaxis with G-CSFs significantly reduces FN incidence in adults undergoing chemotherapy for solid tumours or lymphoma. Pegfilgrastim reduces FN incidence to a significantly greater extent than filgrastim