Food Lion and the Media’s Liability for Newsgathering Torts: A Symposium Preview

Abans de l'arribada de Pere Alberch a la catedral de Barcelona, el magisteri de l'orgue havia estat en mans de l'organista Joan Ferrer, el qual l'exercí entre 1515 i 1536, essent mestre de cant entre 1513 i 1517. La identitat de l'organista de la catedral de Barcelona correspon a la del compositor «Johannes Ffarer», autor del motet «Domine non secundum» del Cancionero musical de Segovia (CMS). La identificació entre «Johannes Ffarer» i Joan Ferrer, i la presència del seu motet processional «Domine non secundum» juntament amb la de l'himne «Conditor alme siderunt» de Marturià Prats, fan palesa la recepció que la capella flamenca va fer del repertori polifònic d'aquests dos compositors catalans, les obres dels quals es devien incorporar al cançoner durant el prolongat sojorn que la capella de Carles I va fer a Barcelona, en el transcurs de l'any 1519. D'altra banda, i gràcies a la documentació capitular de les seus de Vic, Tortosa i Tarragona, sabem que Marturià Prats, i també Antoni Marlet, romanien vinculats a la capella nobiliària que l'infant Enric, comte d'Empúries, mantenia al seu palau del carrer Ample de Barcelona. En el marc del context urbà, social i musical de la Barcelona de principis del segle xvi no costa gaire d'imaginar com devien sovintejar els contactes, i, amb ells, les avinences i els intercanvis musicals en- tre els músics de la capella flamenca i els de les capelles nobiliàries dels Cardona, l'infant Enric, els Montcada, a banda dels cantors de la catedral i dels de les grans parròquies de la ciutat. Un esdeveniment d'aquestes característiques pot ajudar a explicar el motiu de la presència de les dues obres de Joan Ferrer i Marturià Prats en el CMS, convivint amb la riquesa del seu repertori francoflamenc i castellà.Before Pere Alberch arrived at Barcelona Cathedral, the organ master had been the organist Joan Ferrer in the period between 1515 and 1536, and he had also been the magister cantus between 1513 and 1517. The identity of the organist of Barcelona Cathedral corresponds to that of the composer Johannes Ffarer, who was the author of the motet Domine non secundum of the Cancionero musical de Segovia. The identification between Johannes Ffarer and Joan Ferrer, and the presence of his processional motet Domine non secundum together with that of the hymn Conditor alme siderunt of Marturià Prats, evidence the Flemish chapel's reception of the polyphonic repertoire of these two Catalan composers, whose works must have been added to the cancionero or song-book during the long stay of Charles I's chapel in Barcelona in the course of the year 1519. Moreover, thanks to the chapter documents of the cathedrals of Vic, Tortosa and Tarragona, we know that Marturià Prats as well as Antoni Marlet remained attached to the noble chapel which Prince Henry, Count of Empúries, kept in his palace at Carrer Ample in Barcelona. Within the urban, social and musical context of the Barcelona of the early 16th century, it is easy to imagine how frequent the contacts must have been and consequently the understandings and musical exchanges between the musicians of the Flemish chapel and those of the noble chapels of the Cardonas, Prince Henry, the Montcadas, etc., as well as the singers of the Cathedral and those of the major parish churches of the city. An event of this type could help to explain the reason for the presence of the two works of Joan Ferrer and Marturià Prats in the CMS, together with the rich Franco-Flemish and Castilian repertoire to be found there

The cosmology of minimal varying Lambda theories

Inserting a varying Lambda in Einstein's field equations can be made consistent with the Bianchi identities by allowing for torsion, without the need to add scalar field degrees of freedom. In the minimal such theory, Lambda is totally free and undetermined by the field equations in the absence of matter. Inclusion of matter ties Lambda algebraically to it, at least when homogeneity and isotropy are assumed, i.e. when there is no Weyl curvature. We show that Lambda is proportional to the matter density, with a proportionality constant depending on the equation of state. Unfortunately, the proportionality constant becomes infinite for pure radiation, ruling out the minimal theory prima facie despite of its novel internal consistency. It is possible to generalize the theory still without the addition of kinetic terms, leading to a new algebraically-enforced proportionality between Lambda and the matter density. Lambda and radiation may now coexist in a form consistent with Big Bang Nucleosynthesis, though this places strict constraints on the single free parameter of the theory, $\theta$. In the matter epoch Lambda behaves just like a dark matter component. Its density is proportional to the baryonic and/or dark matter, and its presence and gravitational effects would need to be included in accounting for the necessary dark matter in our Universe. This is a companion paper to Ref. [1] where the underlying gravitational theory is developed in detail.Comment: Companion paper to arXiv:1905.10380. Minor updates to match published versio

Accuracy of pulse interval timing in ambulatory blood pressure measurement

Blood pressure (BP) monitors rely on pulse detection. Some blood pressure monitors use pulse timings to analyse pulse interval variability for arrhythmia screening, but this assumes that the pulse interval timings detected from BP cuffs are accurate compared with RR intervals derived from ECG. In this study we compared the accuracy of pulse intervals detected using an ambulatory blood pressure monitor (ABPM) with single lead ECG. Twenty participants wore an ABPM for three hours and a data logger which synchronously measured cuff pressure and ECG. RR intervals were compared with corresponding intervals derived from the cuff pressure tracings using three different pulse landmarks. Linear mixed effects models were used to assess differences between ECG and cuff pressure timings and to investigate the effect of potential covariates. In addition, the maximum number of successive oscillometric beats detectable in a measurement was assessed. From 243 BP measurements, the foot landmark of the oscillometric pulse was found to be associated with fewest covariates and had a random error of 9.5 ms. 99% of the cuff pressure recordings had more than 10 successive detectable oscillometric beats. RR intervals can be accurately estimated using an ABPM

A Zero-Parameter Extension of General Relativity with Varying Cosmological Constant

We provide a new extension of general relativity (GR) which has the remarkable property of being more constrained than GR plus a cosmological constant, having one less free parameter. This is implemented by allowing the cosmological constant to have a consistent space-time variation, through coding its dynamics in the torsion tensor. We demonstrate this mechanism by adding a `quasi-topological' term to the Einstein action, which naturally realizes a dynamical torsion with an automatic satisfaction of the Bianchi identities. Moreover, variation of the action with respect to this dynamical $\Lambda$ fixes it in terms of other variables, thus providing a scenario with less freedom than general relativity with a cosmological constant. Once matter is introduced, at least in the homogeneous and isotropic reduction, $\Lambda$ is uniquely determined by the field content of the model. We make an explicit construction using the Palatini formulation of GR and describe the striking properties of this new theory. We also highlight some possible extensions to the theory. A companion paper [1] explores the Friedmann--Robertson--Walker reduction for cosmology, and future work will study Solar System tests of the theory.Comment: Companion paper to arXiv:1905.10382. Minor updates to match published versio

Opportunistic detection of atrial fibrillation using blood pressure monitors: a systematic review

Background: Atrial Fibrillation (AF) affects around 2% of the population and early detection is beneficial, allowing patients to begin potentially life-saving anticoagulant therapies. Blood pressure (BP) monitors may offer an opportunity to screen for AF. Aim: To identify and appraise studies which report the diagnostic accuracy of automated BP monitors used for opportunistic AF detection. Methods: A systematic search was performed of the Medline, Medline-in-process and Embase literature databases. Papers were eligible if they described primary studies of the evaluation of a BP device for AF detection, were published in a peer reviewed journal and reported values for the sensitivity and specificity. Included studies were appraised using the QUADAS-2 tool to assess their risk of bias and applicability to opportunistic AF detection. Values for the sensitivity and specificity of AF detection were extracted from each paper and compared. Results and Conclusion: We identified seven papers evaluating six devices from two manufacturers. Only one study scored low risk in all of the QUADAS-2 domains. All studies reported specificity greater than 85% and six reported sensitivity greater than 90%. The studies showed that blood pressure devices with embedded algorithms for detecting arrhythmias show promise as screening tools for AF, comparing favourably with manual pulse palpation. But the studies used different methodologies and many were subject to potential bias. More studies are needed to more precisely define the sensitivity and specificity of opportunistic screening for AF during blood pressure measurement before its clinical utility in the population of interest can be assessed fully

Computerized clinical decision support for the early recognition and management of acute kidney injury: a qualitative evaluation of end-user experience

Background - Although the efficacy of computerized clinical decision support (CCDS) for acute kidney injury (AKI) remains unclear, the wider literature includes examples of limited acceptability and equivocal benefit. Our single-centre study aimed to identify factors promoting or inhibiting use of in-patient AKI CCDS. Methods - Targeting medical users, CCDS triggered with a serum creatinine rise of ≥25 μmol/L/day and linked to guidance and test ordering. User experience was evaluated through retrospective interviews, conducted and analysed according to Normalization Process Theory. Initial pilot ward experience allowed tool refinement. Assessments continued following CCDS activation across all adult, non-critical care wards. Results - Thematic saturation was achieved with 24 interviews. The alert was accepted as a potentially useful prompt to early clinical re-assessment by many trainees. Senior staff were more sceptical, tending to view it as a hindrance. ‘Pop-ups’ and mandated engagement before alert dismissal were universally unpopular due to workflow disruption. Users were driven to close out of the alert as soon as possible to review historical creatinines and to continue with the intended workflow. Conclusions - Our study revealed themes similar to those previously described in non-AKI settings. Systems intruding on workflow, particularly involving complex interactions, may be unsustainable even if there has been a positive impact on care. The optimal balance between intrusion and clinical benefit of AKI CCDS requires further evaluation

Peripheral arterial disease: diagnostic challenges and how photoplethysmography may help

Peripheral arterial disease (PAD) affects approximately 20% of patients aged ≥60 years.1 A GP with an average list size of 1800 patients can expect to have 50–60 patients with PAD. Ankle-brachial pressure index (ABPI), which is the ratio of the ankle to brachial systolic pressure measured by sphygmomanometer and hand-held Doppler ultrasound probe, is used to assess PAD in general practice. ABPI has been shown to have a sensitivity of 95% and specificity of 99% compared to angiographic imaging,2 however it is relatively time-consuming and requires adequately trained staff. There are limitations with ABPI in patients with diabetes, renal disease, and older people where an underestimation of disease can occur with a falsely high ratio due to the presence of incompressible calcified blood vessels

Direct integration of intensity-level data from Affymetrix and Illumina microarrays improves statistical power for robust reanalysis

BACKGROUND: Affymetrix GeneChips and Illumina BeadArrays are the most widely used commercial single channel gene expression microarrays. Public data repositories are an extremely valuable resource, providing array-derived gene expression measurements from many thousands of experiments. Unfortunately many of these studies are underpowered and it is desirable to improve power by combining data from more than one study; we sought to determine whether platform-specific bias precludes direct integration of probe intensity signals for combined reanalysis. RESULTS: Using Affymetrix and Illumina data from the microarray quality control project, from our own clinical samples, and from additional publicly available datasets we evaluated several approaches to directly integrate intensity level expression data from the two platforms. After mapping probe sequences to Ensembl genes we demonstrate that, ComBat and cross platform normalisation (XPN), significantly outperform mean-centering and distance-weighted discrimination (DWD) in terms of minimising inter-platform variance. In particular we observed that DWD, a popular method used in a number of previous studies, removed systematic bias at the expense of genuine biological variability, potentially reducing legitimate biological differences from integrated datasets. CONCLUSION: Normalised and batch-corrected intensity-level data from Affymetrix and Illumina microarrays can be directly combined to generate biologically meaningful results with improved statistical power for robust, integrated reanalysis

The T Box Transcription Factor TBX2 Promotes Epithelial-Mesenchymal Transition and Invasion of Normal and Malignant Breast Epithelial Cells

The T box transcription factor TBX2, a master regulator of organogenesis, is aberrantly amplified in aggressive human epithelial cancers. While it has been shown that overexpression of TBX2 can bypass senescence, a failsafe mechanism against cancer, its potential role in tumor invasion has remained obscure. Here we demonstrate that TBX2 is a strong cell-autonomous inducer of the epithelial-mesenchymal transition (EMT), a latent morphogenetic program that is key to tumor progression from noninvasive to invasive malignant states. Ectopic expression of TBX2 in normal HC11 and MCF10A mammary epithelial cells was sufficient to induce morphological, molecular, and behavioral changes characteristic of EMT. These changes included loss of epithelial adhesion and polarity gene (E-cadherin, ß-catenin, ZO1) expression, and abnormal gain of mesenchymal markers (N-cadherin, Vimentin), as well as increased cell motility and invasion. Conversely, abrogation of endogenous TBX2 overexpression in the malignant human breast carcinoma cell lines MDA-MB-435 and MDA-MB-157 led to a restitution of epithelial characteristics with reciprocal loss of mesenchymal markers. Importantly, TBX2 inhibition abolished tumor cell invasion and the capacity to form lung metastases in a Xenograft mouse model. Meta-analysis of gene expression in over one thousand primary human breast tumors further showed that high TBX2 expression was significantly associated with reduced metastasis-free survival in patients, and with tumor subtypes enriched in EMT gene signatures, consistent with a role of TBX2 in oncogenic EMT. ChIP analysis and cell-based reporter assays further revealed that TBX2 directly represses transcription of E-cadherin, a tumor suppressor gene, whose loss is crucial for malignant tumor progression. Collectively, our results uncover an unanticipated link between TBX2 deregulation in cancer and the acquisition of EMT and invasive features of epithelial tumor cells