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Data on response and safety of repeated vaccinations and hybrid immunity in patients with immune-mediated inflammatory diseases on immunosuppressive therapy is needed to further develop vaccination strategies in this vulnerable population. This study aimed to evaluate hybrid immunity and humoral immune response and safety of four SARS-CoV-2 vaccine doses in patients with immune-mediated inflammatory diseases on immunosuppressive therapy.This prospective observational Norwegian study of vaccine response to COVID-19 (Nor-vaC) included adult patients aged 18 years and older with immune-mediated inflammatory diseases (rheumatoid arthritis, spondyloarthritis, psoriatic arthritis, Crohn's disease, or ulcerative colitis) on immunosuppressive therapy, who had received four SARS-CoV-2 vaccine doses (vaccine group) or three vaccine doses followed by COVID-19 (hybrid group), and healthy controls receiving three vaccine doses (control group). Patients were recruited from the Division of Rheumatology at Diakonhjemmet Hospital, Oslo, and the Department of Gastroenterology at Akershus University Hospital, Lørenskog. Patients who had COVID-19 before the third vaccine dose, and patients with allergies or intolerances to elements of the vaccine were excluded. Antibodies to the receptor-binding domain of SARS-CoV-2 spike protein (anti-RBD antibodies) were assessed 2-4 weeks following vaccination or COVID-19. This study is registered at Clinialtrials.gov, NCT04798625.Between Nov 12, 2021, and April 19, 2022, 1458 participants with immune-mediated inflammatory diseases provided post-vaccination samples at 2-4 weeks following a third vaccine dose. After 544 participants were excluded, 715 (78%) of the remaining 914 participants received the fourth dose of the vaccine, and of these, 536 (75%) provided post-vaccination samples 2-4 weeks after their fourth vaccination (vaccine group). 199 (22%) of the 914 had COVID-19 after their third dose of the vaccine and of these, 167 (84%) provided samples (hybrid group). 256 of the eligible 703 patients had rheumatoid arthritis, 107 had spondyloarthritis, 115 had psoriatic arthritis, 130 had Crohn's disease, and 95 had ulcerative colitis). Median age was 56 years [IQR 45-65], 398 (57%) were women, and 305 (43%) were men. Patients in the vaccine group had higher anti-RBD antibody concentrations following the fourth vaccine dose (median 6192 BAU/ml [IQR 2878-11 243]) than after the third dose (median 5087 BAU/ml [1250-9081]; p0·0001), but lower antibody concentrations than the control group following the third dose (median 7595 BAU/ml [5916-12 001]; p0·0001). Antibody concentrations were higher in the patients in the hybrid group (23 548 BAU/ml [IQR 11 440-35 935]) than in the vaccine group (p0·0001). No difference was found in antibody concentrations between the fourth dose of BNT162b2 (full-dose) and mRNA-1273 (half-dose). Patients and controls had a comparable safety profile after both three and four vaccine doses.Vaccine boosters improve humoral immune responses and are safe in patients with immune-mediated inflammatory diseases on immunosuppressive therapy, and administration should be considered regularly in this patient group. Hybrid immunity with omicron induces a strong humoral response suggesting longer intervals between booster doses in this patient group.The South-Eastern Norway Regional Health Authority, The Coalition for Epidemic Preparedness Innovations, Akershus University Hospital.

Background Prehabilitation is the practice of enhancing a patient's functional and psychological capacity before treatment commences. It is of interest in the cancer context because of the impact of treatments on quality of life and cancer survivorship. This work aims to document current practice, barriers and challenges to implementing prehabilitation to inform the development of a national framework. Methods A mixed-methods approach was applied: an on-line survey was sent to stakeholders in cancer care across Scotland, supplemented by in-depth interviews. Key domains explored were the perceived importance of prehabilitation, availability, delivery and content of services, outcome measures, referral processes and funding. Findings A total of 295 survey responses were obtained and 11 interviews completed. Perceived importance of prehabilitation was rated highly. There was uncertainty over the definition of prehabilitation and most respondents did not know if local services were available. Where services were described, a range of health professionals were involved, different outcome measures were utilised and frequency of referrals varied. Respondents highlighted short time frames between referral and treatment, concerns about patient engagement, the evidence base for action and funding priorities. Respondents also commented on which context a referral should be made and to whom, and the need for equity of service across the country. Conclusions The current work found clear evidence of the perceived importance of prehabilitation in cancer patients. However, issues and key gaps were identified within current services (including issues arising from COVID-19) which must be addressed to enable wide-spread development and implementation of equitable programmes.

Enabling autonomous vehicles to maneuver in novel scenarios is a key unsolved problem. A well-known approach, Weighted Multiple Model Adaptive Control (WMMAC), uses a set of pre-tuned controllers and combines their control actions using a weight vector. Although WMMAC offers an improvement to traditional switched control in terms of smooth control oscillations, it depends on accurate fault isolation and cannot deal with unknown disturbances. A recent approach avoids state estimation by randomly assigning the controller weighting vector; however, this approach uses a uniform distribution for control-weight sampling, which is sub-optimal compared to state-estimation methods. In this article, we propose a framework that uses deep reinforcement learning (DRL) to learn weighted control distributions that optimize the performance of the randomized approach for both known and unknown disturbances. We show that RL-based randomized blending dominates pure randomized blending, a switched FDI-based architecture and pre-tuned controllers on a quadcopter trajectory optimisation task in which we penalise deviations in both position and attitude.

We identify multiple periodic dusty structures in Saturn's Roche Division, a faint region spanning the $\sim3000$ km between the A and F rings. The locations and extent of these features vary over Cassini's tour of the Saturn system, being visible in 2006 and 2016-2017, but not in 2012-2014. These changes can be correlated with variations in Saturn's magnetospheric periods. In 2006 and 2016-2017, one of the drifting magnetospheric periods would produce a 3:4 resonance within the Roche Division, but in 2012-2014 these resonances would move into the A ring as the magnetospheric periods converged. A simple model of magnetic perturbations indicates that the magnetic field oscillations responsible for these structures have amplitudes of a few nanotesla, comparable to the magnetic field oscillation amplitudes of planetary period oscillations measured by the magnetometer onboard Cassini. However, some previously unnoticed features at higher radii have expected pattern speeds that are much slower than the magnetospheric periodicities. These structures may reflect an unexpectedly long-range propagation of resonant perturbations within dusty rings., Accepted for publication in Icarus

The safety profession has grown and evolved over recent decades, and despite the prominence of the role within organisations, there is limited research about the current state of safety professional practice. The objective of a safety professional’s role is often stated as ‘preventing incidents and harm to people', although the existing research fails to demonstrate a compelling link between safety professional practice and worker safety. More recently, a model of safety work in organisations proposed that safety activities fulfill broader social and political needs, in addition to the physical reduction of safety risk. In this paper, we report a study that investigated the underlying objectives of individual safety professional tasks, then performed thematic analysis to explore the contemporary role of safety professionals in organisations. 12 mid-level and senior-level safety professionals were interviewed at monthly intervals for six months regarding their work activities, in addition to an embedded researcher performing more than 240 h of field observations. Four categories of safety work in organisations – demonstrated, social, administrative, and physical – were used as priori themes to deductively analyze the data. The findings demonstrate strength of alignment between the safety professional role and line management, the increasing institutionalization of safety professional work, an absence of safety professional work directed at reducing safety risks to workers, and the lack of a clear connection between safety professional practice and safety science research.

The Occupational Health and Safety (OHS) profession is well established in Australia and it would be rare, if not impossible to find a medium to a large public, private or government organisation without an OHS professional department. This paper explores the development and current status of the OHS profession in Australia. To be recognised as a profession, any occupation needs to satisfy a number of individual, collective and external professional criteria. This paper reviews the OHS profession in Australia, through these professional criteria and we describe the: role and career path, defined knowledge and skill base, ethical code of practice, professional status, professional organisations, professional entry criteria, professional education, external requirements, stakeholders, and societal recognition. To further examine the extent to which the OHS occupation deserves professional status we explore in detail the professionalisation strategy of the Safety Institute of Australia (SIA) over the past 8 years. Since 2010 the Safety Institute of Australia (SIA), the largest and broadest Australian OHS professional organisation, has rigorously pursued a strategy aimed at increasing the professionalisation of the OHS profession through concurrent programs of: professional certification, university curriculum accreditation, and the development of an ‘OHS Body of Knowledge’. This paper concludes that the OHS profession in Australia can be considered an ‘emerging profession’. An emerging profession is a recognised discipline or occupation that has established, although not consistently implemented the structures, capability and recognition necessary to be considered an established profession. The current and future challenges and opportunities for the OHS profession are discussed.

‘Safety work’ consists of activities, conducted within organisations, that have the primary purpose of managing safety. Safety work is distinct from operational work, which directly achieves the primary objectives of the organisation. Safety work is also distinct from the ‘safety of work’, which is the prevention of injury. In this paper, we argue that safety work is primarily a performance rather than goal-directed behavior. It may contribute to the safety of work, but this is only part of its purpose. Our argument is presented in the form of a model for organisational safety activity that represents safety as a special case of ‘institutional work’. Evidence of the ‘safety work’ takes the place of evidence of the ‘safety of work’, which is extremely difficult to measure or demonstrate in its own right. Even where it does not contribute to the safety of work, safety work may be necessary for organisations to make sense of safety in an uncertain world. If organisations did not perform safety work, they would be unable to convince stakeholders that they were doing enough for safety, which would in turn prevent them from pursuing their core business.

Workers have a legal obligation not to perform unsafe work. In many organisations this obligation is supported by an explicit authority to discontinue work or to stop the work of others if the conditions of work are unsafe. The supporting document is often called an ‘Authority to Stop an Unsafe Task.’ However, when conducting work at the sharp operational end of the organisation, stopping work for safety might be challenging at times. A better understanding is required about the stopping of work and the application of an ‘Authority to Stop.’ The aim of this research is to identify some of the factors that support and hinder a workforce to effectively stop work when a task is deemed unsafe. 10 focus groups were conducted with workers of various roles in the liquefied petroleum gas (LPG) industry. The findings outline reasons to stop, challenges and supporting factors of stopping, as well as ways of stopping. The results indicate that the stopping of an unsafe task does not solely hinge on the willingness of individual workers to stop, but also depends on contextual factors surrounding the stop work decision.

Summary: Primary immune thrombocytopenia is an autoimmune disease associated with a reduced peripheral blood platelet count. The phenotype is variable with some patients suffering no bleeding whilst others have severe bleeding which may be fatal. Variability in clinical behaviour and treatment responses reflects its complex underlying pathophysiology. Historically the management has relied heavily on immune suppression. Recent studies have shown that the older empirical immune suppressants fail to alter the natural history of the disease and are associated with a poor quality of life for patients. Newer treatments, such as the thrombopoietin receptor agonists, have transformed ITP care. They have high efficacy, are well tolerated and improve patients’ quality of life. A greater understanding of the underlying pathophysiology of this disorder has helped develop a number of new targeted therapies. These include inhibitors of the neonatal Fc receptor inhibitors, Bruton tyrosine kinase and complement pathway. Here we discuss the mechanisms underlying ITP and the new approach to ITP care.

Safety professionals have been working within organizations since the early 1900s. During the past 25 years, societal pressure and political intervention concerning the management of safety risks in organizations has driven dramatic change in safety professional practice. What are the factors that influence the role of safety professionals? This paper reviews more than 100 publications. Thematic analysis identified 25 factors in three categories: institutional, relational, and individual. The review highlights a dearth of empirical research into the practice and role of safety professionals, which may result in some ineffectiveness. Practical implications and an empirical research agenda regarding safety professional practice are proposed.

Microsatellites are highly polymorphic markers which have been used in a wide range of genetic studies. In recent years, various sources of next-generation sequencing data have been used to develop new microsatellite loci, but compared with the more common shotgun genomic sequencing or transcriptome data, the potential utility of RAD-seq data for microsatellite ascertainment is comparatively under-used. In this study, we employed Mi ddRAD-seq data to develop polymorphic microsatellite loci for the endangered yew species Taxus florinii . Of 8,823,053 clean reads generated for ten individuals of a population, 94,851 (∼1%) contained microsatellite motifs. These corresponded to 2993 unique loci, of which 526 (∼18%) exhibited polymorphism. Of which, 237 were suitable for designing microsatellite primer pairs, and 128 loci were randomly selected for PCR validation and microsatellite screening. Out of the 128 primer pairs, 16 loci gave clear, reproducible patterns, and were then screened and characterized in 24 individuals from two populations. The total number of alleles per locus ranged from two to ten (mean = 4.875), and within-population expected heterozygosity from zero to 0.789 (mean = 0.530), indicating that these microsatellite loci will be useful for population genetics and speciation studies of T. florinii . This study represents one of few examples to mine polymorphic microsatellite loci from ddRAD data.

We develop a system for generating embedded diagnostics from an ODE model that can isolate faults given the memory and processing limitations of the embedded processor. This system trades off diagnosis isolation accuracy for inference time and/or memory in a principled manner. We use a Polynomial Regression approach for tuning the performance of an ensemble of low-fidelity ODE diagnosis models such that we achieve the target of embedded processing limits. We demonstrate our approach on a non-linear tank benchmark system.