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"Kelly, J."
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The Norton introduction to literature
The most trusted guide for helping students read critically and write carefully. The Norton Introduction to Literature presents an engaging, balanced selection of literature to suit any course. Offering a thorough treatment of historical and critical context, the most comprehensive media package available, and a rich suite of tools to encourage close reading and thoughtful writing, the Twelfth Edition is unparalleled in its guidance of understanding, analyzing, and writing about literature.
Book
Microplastic in riverine fish is connected to species traits
Microplastic is a contaminant of concern worldwide. Rivers are implicated as major pathways of microplastic transport to marine and lake ecosystems, and microplastic ingestion by freshwater biota is a risk associated with microplastic contamination, but there is little research on microplastic ecology within freshwater ecosystems. Microplastic uptake by fish is likely affected by environmental microplastic abundance and aspects of fish ecology, but these relationships have rarely been addressed. We measured the abundance and composition of microplastic in fish and surface waters from 3 major tributaries of Lake Michigan, USA. Microplastic was detected in fish and surface waters from all 3 sites, but there was no correlation between microplastic concentrations in fish and surface waters. Rather, there was a significant effect of functional feeding group on microplastic concentration in fish.
Neogobius melanostomus
(round goby, a zoobenthivore) had the highest concentration of gut microplastic (19 particles fish
−1
) compared to 10 other fish taxa measured, and had a positive linear relationship between body size and number of microplastic particles. Surface water microplastic concentrations were lowest in the most northern, forested watershed, and highest in the most southern, agriculturally dominated watershed. Results suggest microplastic pollution is common in river food webs and is connected to species feeding characteristics. Future research should focus on understanding the movement of microplastic from point-source and diffuse sources and into aquatic ecosystems, which will support pollution management efforts on inland waters.
Journal Article
The Norton introduction to literature
\"The most trusted guide for helping students read critically and write carefully. The Norton Introduction to Literature presents an engaging, balanced selection of literature to suit any course. Offering a thorough treatment of historical and critical context, the most comprehensive media package available, and a rich suite of tools to encourage close reading and thoughtful writing, the Twelfth Edition is unparalleled in its guidance of understanding, analyzing, and writing about literature.\"-- Provided by publisher
Book
Key challenges for delivering clinical impact with artificial intelligence
Background
Artificial intelligence (AI) research in healthcare is accelerating rapidly, with potential applications being demonstrated across various domains of medicine. However, there are currently limited examples of such techniques being successfully deployed into clinical practice. This article explores the main challenges and limitations of AI in healthcare, and considers the steps required to translate these potentially transformative technologies from research to clinical practice.
Main body
Key challenges for the translation of AI systems in healthcare include those intrinsic to the science of machine learning, logistical difficulties in implementation, and consideration of the barriers to adoption as well as of the necessary sociocultural or pathway changes. Robust peer-reviewed clinical evaluation as part of randomised controlled trials should be viewed as the gold standard for evidence generation, but conducting these in practice may not always be appropriate or feasible. Performance metrics should aim to capture real clinical applicability and be understandable to intended users. Regulation that balances the pace of innovation with the potential for harm, alongside thoughtful post-market surveillance, is required to ensure that patients are not exposed to dangerous interventions nor deprived of access to beneficial innovations. Mechanisms to enable direct comparisons of AI systems must be developed, including the use of independent, local and representative test sets. Developers of AI algorithms must be vigilant to potential dangers, including dataset shift, accidental fitting of confounders, unintended discriminatory bias, the challenges of generalisation to new populations, and the unintended negative consequences of new algorithms on health outcomes.
Conclusion
The safe and timely translation of AI research into clinically validated and appropriately regulated systems that can benefit everyone is challenging. Robust clinical evaluation, using metrics that are intuitive to clinicians and ideally go beyond measures of technical accuracy to include quality of care and patient outcomes, is essential. Further work is required (1) to identify themes of algorithmic bias and unfairness while developing mitigations to address these, (2) to reduce brittleness and improve generalisability, and (3) to develop methods for improved interpretability of machine learning predictions. If these goals can be achieved, the benefits for patients are likely to be transformational.
Journal Article
Producing early modern London : a comedy of urban space, 1598-1616
\"Early seventeenth-century London playwrights used actual locations in their comedies while simultaneously exploring London as an imagined, ephemeral, urban space. Producing Early Modern London examines this tension between representing place and producing urban space. In analyzing the theater's use of city spaces and places, Kelly J. Stage shows how the satirical comedies of the early seventeenth century came to embody the city as the city embodied the plays. Stage focuses on city plays by George Chapman, Thomas Dekker, William Haughton, Ben Jonson, John Marston, Thomas Middleton, and John Webster. While the conventional labels of \"city comedy\" or \"citizen comedy\" have often been applied to these plays, she argues that London comedies defy these genre categorizations because the ruptures, expansions, conflicts, and imperfections of the expanding city became a part of their form. Rather than defining the \"city comedy,\" comedy in this period proved to be the genre of London. As the expansion of London's social space exceeded the strict confines of the \"square mile,\" the city burgeoned into a new metropolis. The satiric comedies of this period became, in effect, playgrounds for urban experimentation. Early seventeenth-century playwrights seized the opportunity to explore the myriad ways in which London worked, taking the expected--a romance plot, a typical father-son conflict, a cross-dressing intrigue--and turning it into a multifaceted, complex story of interaction and proximity.\"-- Provided by publisher.
Book
Long-term impact of overweight and obesity in childhood and adolescence on morbidity and premature mortality in adulthood: systematic review
Background and objective: The last systematic review on the health consequences of child and adolescent obesity found little evidence on consequences for adult health. The present study aimed to summarize evidence on the long-term impact of child and adolescent obesity for premature mortality and physical morbidity in adulthood. Methods: Systematic review with evidence searched from January 2002 to June 2010. Studies were included if they contained a measure of overweight and/or obesity between birth and 18 years (exposure measure) and premature mortality and physical morbidity (outcome) in adulthood. Results: Five eligible studies examined associations between overweight and/or obesity, and premature mortality: 4/5 found significantly increased risk of premature mortality with child and adolescent overweight or obesity. All 11 studies with cardiometabolic morbidity as outcomes reported that overweight and obesity were associated with significantly increased risk of later cardiometabolic morbidity (diabetes, hypertension, ischaemic heart disease, and stroke) in adult life, with hazard ratios ranging from 1.1-5.1. Nine studies examined associations of child or adolescent overweight and obesity with other adult morbidity: studies of cancer morbidity were inconsistent; child and adolescent overweight and obesity were associated with significantly increased risk of later disability pension, asthma, and polycystic ovary syndrome symptoms. Conclusions: A relatively large and fairly consistent body of evidence now demonstrates that overweight and obesity in childhood and adolescence have adverse consequences on premature mortality and physical morbidity in adulthood.
Journal Article
The Cuba-U.S. bilateral relationship : new pathways and policy choices
\"This book brings together experts from across three disciplines--politics, economics, and law--to address the key issues that affect Cuba-U.S. bilateral relations today. The chapters identify the opportunities and challenges presented to both nations in each of their respective disciplines while staking out what the future may hold\"-- Provided by publisher.
Book
Effects of Sodium-Glucose Co-Transporter 2 Inhibitors on Vascular Cell Function and Arterial Remodeling
Cardiovascular disease is the leading cause of morbidity and mortality in diabetes. Recent clinical studies indicate that sodium-glucose co-transporter 2 (SGLT2) inhibitors improve cardiovascular outcomes in patients with diabetes. The mechanism underlying the beneficial effect of SGLT2 inhibitors is not completely clear but may involve direct actions on vascular cells. SGLT2 inhibitors increase the bioavailability of endothelium-derived nitric oxide and thereby restore endothelium-dependent vasodilation in diabetes. In addition, SGLT2 inhibitors favorably regulate the proliferation, migration, differentiation, survival, and senescence of endothelial cells (ECs). Moreover, they exert potent antioxidant and anti-inflammatory effects in ECs. SGLT2 inhibitors also inhibit the contraction of vascular smooth muscle cells and block the proliferation and migration of these cells. Furthermore, studies demonstrate that SGLT2 inhibitors prevent postangioplasty restenosis, maladaptive remodeling of the vasculature in pulmonary arterial hypertension, the formation of abdominal aortic aneurysms, and the acceleration of arterial stiffness in diabetes. However, the role of SGLT2 in mediating the vascular actions of these drugs remains to be established as important off-target effects of SGLT2 inhibitors have been identified. Future studies distinguishing drug- versus class-specific effects may optimize the selection of specific SGLT2 inhibitors in patients with distinct cardiovascular pathologies.
Journal Article