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Peer review is a critical component toward facilitating a robust science in industrial and organizational (I-O) psychology. Peer review exists beyond academic publishing in organizations, university departments, grant agencies, classrooms, and many more work contexts. Reviewers are responsible for judging the quality of research conducted and submitted for evaluation. Furthermore, they are responsible for treating authors and their work with respect, in a supportive and developmental manner. Given its central role in our profession, it is curious that we do not have formalized review guidelines or standards and that most of us never receive formal training in peer reviewing. To support this endeavor, we are proposing a competency framework for peer review. The purpose of the competency framework is to provide a definition of excellent peer reviewing and guidelines to reviewers for which types of behaviors will lead to good peer reviews. By defining these competencies, we create clarity around expectations for peer review, standards for good peer reviews, and opportunities for training the behaviors required to deliver good peer reviews. We further discuss how the competency framework can be used to improve peer reviewing and suggest additional steps forward that involve suggestions for how stakeholders can get involved in fostering high-quality peer reviewing.
Introduction: Point-of-care ultrasonography (PoCUS) is being incorporated into Canadian undergraduate medical school curricula. The purpose of this study was to evaluate novel PoCUS education sessions to determine what aspects of the sessions benefitted from hands-on training and which PoCUS skills were retained over time. Methods: Second year medical students voluntarily received three different PoCUS training sessions, each lasting three hours. Prior to the sessions, participants prepared independently with pre-circulated online learning materials. After a 15-minute lecture, experienced PoCUS providers led small group (1 instructor: 5 students), live scanning sessions. Evaluations were conducted before and after each session using expert validated multiple choice questions testing general and procedural knowledge, image recognition and interpretation. Volunteer students were evaluated via direct observation of live scanning using an objective structured assessment of technical skills (OSAT) based on the O-score and then re-evaluated at 2 months post-training to assess PoCUS skills retention. Results: 40 second year medical students participated in extended Focused Assessment with Sonography for Trauma (eFAST), cardiac, and gallbladder PoCUS sessions. The live-training sessions significantly improved student PoCUS knowledge beyond what they learned independently for eFAST (p < 0.001), cardiac (p < 0.001), and gallbladder (p = 0.02). The largest improvement was noted in procedural knowledge test scores improving from 44.0% to 84.0% (n = 38). 16 students were evaluated after each session with a mean O-score of 2.37. 8 students returned two months later to be re-evaluated demonstrating a change in O-scores for eFAST (2.00 to 2.38, p = 0.15), cardiac (2.28 to 2.00, p = 0.32), and gallbladder (2.91 to 1.88, p < 0.001). Conclusion: Procedural PoCUS knowledge benefited the most with hands-on training. eFAST and cardiac PoCUS competency was maintained over time while gallbladder PoCUS competency degraded suggesting that targeted PoCUS skills training may be possible. Further study is required to determine the best use of PoCUS resources in undergraduate medical education.
Introduction: Increasing opioid prescribing has been linked to an epidemic of opioid misuse. Our objective was to synthesize available evidence about patient-, prescriber-, medication-, and system-level risk factors for developing opioid misuse from prescribed opioids among patients presenting with pain unrelated to cancer. Our hypothesis was that we would identify risk factors predisposing patients to developing opioid misuse. Methods: We developed a systematic search strategy and applied it to nine electronic reference databases and six clinical trial registries. We hand searched related journals and conference proceedings, the reference lists of included studies, and the top 100 hits on Google. We included studies where a medical professional exposed adults or children to an opioid through a prescription. We excluded studies with over 50% cancer patients, palliative patients, and those with illicit opioid initiation. Two reviewers independently reviewed titles, abstracts, and full texts, and extracted data using standardized forms. We assessed study quality using risk of bias. We synthesized effect sizes of dichotomous risk factors on opioid misuse using inverse variance random-effects meta-analysis, and the inverse variance-weighted mean difference between opioid misusers and non-misusers for continuously measured factors. We conducted an a priori defined subgroup analysis among opioid-naïve patients. Results: Among 9,629 studies, 67 met our inclusion criteria. Among those who had been prescribed outpatient opioids, the following factors were associated with the development of misuse: a prior history of illicit drug use (OR: 4.21, 95% CI: 2.31-7.65), recent benzodiazepine use (OR: 2.57, 95% CI: 1.23-5.38), any mental health diagnosis (OR: 2.45, 95% CI: 1.91-3.15), any short acting (IR) opioid prescription (OR: 2.40, 95% CI: 1.15-5.02), younger age (OR: 2.19, 95%CI: 1.81-2.64), and male sex (OR: 1.23, 95% CI: 1.10-1.36). Among studies limiting their population to opioid-naïve patients, younger age was the most significant risk factor for opioid misuse (OR: 5.42, 95% CI:1.51-19.43). Conclusion: Of the risk factors examined, non-cancer pain patients with a prior history of substance use or mental health diagnoses were at highest risk for prescription opioid misuse. Younger opioid-naïve patients were at highest risk of misuse. Clinicians should consider these risk factors when managing acute pain in the emergency department.
Tools applied at the point of care can provide valuable prognostic information for practitioners. In this one-year, prospective observational study, we examined the association of the short performance physical battery (SPPB) and one-year emergency department (ED) visits and hospitalizations. Overall, 191 new referrals attending an outpatient geriatric clinic in Hamilton, Ontario, were approached, and 120 were enrolled. SPPB and other assessments were completed during the routine clinical visit. ED visits and hospitalizations within one year of the baseline assessment were abstracted from electronic medical records. Logistic regression analyses were used to determine ED visits and hospitalization predictors. The mean SPPB score in the study cohort (mean age 80.6, SD 6.3 years; 53% female) was 6.3 (SD 3.2). SPPB score was associated with a one-year ED visit (OR = 0.90 [0.78–1.03]) and hospitalization (OR = 0.84 [0.72–0.97]) after adjusting for age, sex, and co-morbidities.
Global inequity in access to and availability of essential mental health services is well recognized. The mental health treatment gap is approximately 50% in all countries, with up to 90% of people in the lowest-income countries lacking access to required mental health services. Increased investment in global mental health (GMH) has increased innovation in mental health service delivery in LMICs. Situational analyses in areas where mental health services and systems are poorly developed and resourced are essential when planning for research and implementation, however, little guidance is available to inform methodological approaches to conducting these types of studies. This scoping review provides an analysis of methodological approaches to situational analysis in GMH, including an assessment of the extent to which situational analyses include equity in study designs. It is intended as a resource that identifies current gaps and areas for future development in GMH. Formative research, including situational analysis, is an essential first step in conducting robust implementation research, an essential area of study in GMH that will help to promote improved availability of, access to and reach of mental health services for people living with mental illness in low- and middle-income countries (LMICs). While strong leadership in this field exists, there remain significant opportunities for enhanced research representing different LMICs and regions.
Introduction: Aligning health systems appropriately to the needs of the elderly is an urgent global priority, according to the WHO. In Canada, ED length of stay has risen 16% for elderly patients in the last year. Agitation requiring chemical restraint is a common, high-risk problem for elderly in the ED. Improving outcomes in this heterogeneous population remain difficult due to inability to effectively identify and evaluate delirium, frailty, multi-morbidity, and incompatibility with the ED system. A data-driven approach to complex health problems is a recognized emerging tool for healthcare innovation. New opportunities for targeted quality improvement in the ED will be uncovered by identifying the clinical characteristics of elderly patients with agitation, and the system process factors that influence their outcomes. Methods: We studied 400 patients in a case-control study at two tertiary-care EDs over five years. Patients were randomly selected if age was greater than 75 years. 200 cases of patients who received an intravenous dose of haloperidol, midazolam and/or lorazepam were selected as a surrogate data marker for having agitation. Controls were randomly matched by age and ED diagnosis. Standardized clinical, systems and process variables were collected. We conducted a univariate analysis. Results: Elderly given intravenous medications for agitation had increased mortality (OR 3.8 CI: 1.6-10.7, p<0.001) and ED length of stay (27 vs. 15 hours, p<0.001). No statistical significance was found in clinical characteristics, CTAS scores, PRISMA7 frailty scores nor sentinel or return visits. There was no statistical difference in median hospital length of stay (8 vs. 6 days, p<0.70). No differences were found in median time from ED physician seeing a patient to first consultant request (73 vs. 83 mins, p=0.75). The largest time intervals contributing to ED length of stay were from first consultant request to hospital request (15 vs. 12 hours, p=0.056) and hospitalization delay (13 vs. 7 hours, p=0.45). Conclusion: Identification of high-risk elderly patients for targeted intervention through a data-driven approach is feasible and informative. Traditional clinical characteristics remain unhelpful in identifying and evaluating outcomes in elderly with agitation. We have identified a process factor that is clinically relevant and pragmatic to evaluate in our ED system. Future research focused on optimizing systems process factors to improve quality of elderly care should be prioritized.
Introduction: Point of care ultrasound has become an established tool in the initial management of patients with undifferentiated hypotension. Current established protocols (RUSH, ACES, etc) were developed by expert user opinion, rather than objective, prospective data. We wished to use reported disease incidence to develop an informed approach to PoCUS in hypotension using a “4 F’s” approach: Fluid; Form; Function; Filling. Methods: We summarized the incidence of PoCUS findings from an international multicentre RCT, and using a modified Delphi approach incorporating this data we obtained the input of 24 international experts associated with five professional organizations led by the International Federation of Emergency Medicine. The modified Delphi tool was developed to reach an international consensus on how to integrate PoCUS for hypotensive emergency department patients. Results: Rates of abnormal PoCUS findings from 151 patients with undifferentiated hypotension included left ventricular dynamic changes (43%), IVC abnormalities (27%), pericardial effusion (16%), and pleural fluid (8%). Abdominal pathology was rare (fluid 5%, AAA 2%). After two rounds of the survey, using majority consensus, agreement was reached on a SHoC-hypotension protocol comprising: A. Core: 1. Cardiac views (Sub-xiphoid and parasternal windows for pericardial fluid, cardiac form and ventricular function); 2. Lung views for pleural fluid and B-lines for filling status; and 3. IVC views for filling status; B. Supplementary: Additional cardiac views; and C. Additional views (when indicated) including peritoneal fluid, aorta, pelvic for IUP, and proximal leg veins for DVT. Conclusion: An international consensus process based on prospectively collected disease incidence has led to a proposed SHoC-hypotension PoCUS protocol comprising a stepwise clinical-indication based approach of Core, Supplementary and Additional PoCUS views.
Introduction: Point of care ultrasound (PoCUS) provides invaluable information during resuscitation efforts in cardiac arrest by determining presence/absence of cardiac activity and identifying reversible causes such as pericardial tamponade. There is no agreed guideline on how to safely and effectively incorporate PoCUS into the advanced cardiac life support (ACLS) algorithm. We consider that a consensus-based priority checklist using a “4 F’s” approach (Fluid; Form; Function; Filling), would provide a better algorithm during ACLS. Methods: The ultrasound subcommittee of the Australasian College for Emergency Medicine (ACEM) drafted a checklist incorporating PoCUS into the ACLS algorithm. This was further developed using the input of 24 international experts associated with five professional organizations led by the International Federation of Emergency Medicine. A modified Delphi tool was developed to reach an international consensus on how to integrate ultrasound into cardiac arrest algorithms for emergency department patients. Results: Consensus was reached following 3 rounds. The agreed protocol focuses on the timing of PoCUS as well as the specific clinical questions. Core cardiac windows performed during the rhythm check pause in chest compressions are the sub-xiphoid and parasternal cardiac views. Either view should be used to detect pericardial fluid, as well as examining ventricular form (e.g. right heart strain) and function, (e.g. asystole versus organized cardiac activity). Supplementary views include lung views (for absent lung sliding in pneumothorax and for pleural fluid), and IVC views for filling. Additional ultrasound applications are for endotracheal tube confirmation, proximal leg veins for DVT, or for sources of blood loss (AAA, peritoneal/pelvic fluid). Conclusion: The authors hope that this process will lead to a consensus-based SHoC-cardiac arrest guideline on incorporating PoCUS into the ACLS algorithm.
In recent years several multi-body, circumbinary planets have been proposed to orbit short-period eclipsing binaries. In light of the recent discoveries based on the Kepler data, the existence of such systems seems plausible. However, performing a detailed dynamical analysis reveals that the majority of the proposed planetary systems follow highly unstable orbits. In order to solve the origin of this problem, we have started to model synthetic light-travel time signals of stable planetary systems. In particular, we aim to study the response of the model in various circumstances (e.g red/white noise level, various sampling frequencies, in-homogeneous data sets, baseline dependency.) This work will significantly increase the confidence with which model work is carried out for future systems and help towards an understaning when models break down (e.g resulting in unstable systems).
Metal organic frameworks (MOFs) are porous solids that are potential high performance carbon capture materials. We have mined a hypothetical MOF database for structures that have exceptional low-pressure CO2 adsorption properties. We have applied the REPEAT method to generate accurate atomic charges that regenerate the ab initio electrostatic potential. We show that large scale screening at high accuracy is feasible for thousands of structures. We identify promising synthesis targets, like a simple combination of chrysene linker and vanadium inorganic unit, and examine in detail structural features that make better performing MOFs from those that would not be synthesisable. We find that, although screening large numbers of hypothetical structures is necessary to provide experimental targets, there are limitations to the suggestion of using the this database directly for synthesis targets and propose improvements and constraints that should be incorporated into the design of further generations of such a building-block algorithm to reach the accuracy required for high-quality CO2 adsorption simulation.
Nanoporous metal-organic framework (MOF) materials are strong candidates for energy efficient carbon capture and storage (CCS) technologies. A total of ∼20,000 hypothetical MOFs were ab initio screened for CO2 adsorption using grand canonical Monte-Carlo (GCMC) simulations. Novel radial distribution function (RDF) scores were modified for periodic systems to predict the CO2 adsorption of MOFs using chemoinformatic models. The test set predictions yielded accuracies of 0.76 and 0.85 at 0.1 bar and 1 bar, respectively. The models were used to screen a large database for high performing MOFs and the top 100 structures were successfully validated by GCMC simulations. The chemoinformatic predictors of the CO2 adsorption of MOFs are available online at http://titan.chem.uottawa.ca/woolab/MOFIA/#carbondioxide.
Recent smart textile fabrication methods that are aimed at increasing the integration of electronics with textiles have involved fabricating micro-electronic components directly at the yarn level. Our approach to creating smart textiles is to fabricate thin-film devices and interconnects on plastic strips to create ‘e-fibers’ and weave them into a textile using a commercial weaving machine. e-Fibers are exposed to bending radii as small as 165 μm during weaving. If patterned interconnect lines and device layers on the surface of the e-fiber are not designed correctly, they will crack due to the high strain and lose their electronic functionality. Brittle sensor and transistor device layers may be protected locally using rigid encapsulation materials, but cracking remains an issue for long metal interconnect lines which require flexibility. We investigated two strain-control methods to prevent the thin-film interconnect lines from cracking during weaving: (1) patterning the metal interconnect lines with a geometric design to slow propagation and merging of cracks and (2) encapsulation of interconnect lines to shift the deposited films to the neutral plain of the substrate. The mechanical behavior of interconnect lines exposed to tensile bending was studied by measuring the change in interconnect resistance versus bending radii ranging from 5 mm to 50 μm. The critical bending radius, XC, defined as the radius at which the normalized interconnect resistance changes to 1.1 (indicating the onset of film rupturing) was 150 μm for standard interconnect lines. Patterned interconnect lines had a radius XC of 115 μm while encapsulated interconnect lines never reached this critical bending radius and showed a maximum resistance change of 1.02 at 100 μm. These results show that it is possible to design interconnect lines with reduced cracking behavior when exposed to high strain during commercial weaving.
The continual miniaturization of microprocessors has resulted in increased RC delay and cross talk noise. To solve these problems ultralow nanoporous dielectric materials are required but have not developed yet. To develop ultralow dielectric materials with required mechanical and dielectrical properties for next generation semiconductors, it is essential to control the pore size in nm range and its morphology by preventing porogen aggregation. Thus we have used ozone treatment during thermal curing process of the nanoporous dielectrics in order to increase the reactivity between the matrix and reactive porogens and to possibly induced changes in Si bond structures.
Ozone treatment was quite effective in enhancing the reactivity of the low-k matrix and the reactive porogen, which converted effectively the alkoxy or alkyl groups into Si-OH groups, which mostly converted to the formation of Si-O-Si network structures. Therefore, ozone treatment greatly increased modulus up to 11.25 GPa at the same porogen loading (60 vol%). The modulus increased by more than 23% compared with non-treated samples (9.1 GPa). The porosity of the ozone-treated sample reduced to 19.3 vol% at the same porogen loading. Solid state Si-NMR showed that less porosity was related to the breakage of methyl groups in the matrix by ozone irradiation, which also resulted in a little sacrificed dielectric constant.
In general, the mechanical properties of nanoporous dielectrics deteriorate sharply above certain high porosity ca. 15 ~20 vol% due to non-uniform distribution of nanopores, their aggregation and resultant open pores. Therefore, this result may suggest the possibility of increasing mechanical properties of nanoporous dielectrics. However, we need to experimentally control processing variables such as irradiation time, intensity, temperature and so forth in order to optimize both mechanical and dielectrical properties.
Background: This study explored the relationship between “worthlessness” and all cause non-suicide mortality in Chinese elderly men.
Methods: Data from interviews of 1999 men aged 65 years and over were collected. Clinically significant depressive symptoms were measured using the validated Chinese version of Geriatric Depression Scale. “Worthlessness” was defined by one of the 15 questions from the Geriatric Depression Scale with a yes/no response. All-cause mortality over six years was collected using data from the National Death Registry with adjudication by 4-monthly telephone interviews. Two men were excluded after suicide death.
Results: Age-adjusted mortality rates at five years were 44.3 and 23.9 per 1,000 person years for those who felt “worthless” and those did not, respectively. The adjusted relative risk for all-cause mortality associated with feeling worthless was 1.34 (95% CI: 1.02–1.76) after adjusting for potential confounders that included age, marital status, education, smoking, alcohol consumption, number of chronic diseases, self-rated health, body mass index, cognitive status, physical activity, occupation and maximum lifetime income. There was no statistically significant association between other depressive symptoms or overall depression and mortality.
Conclusion: Worthlessness may be independently associated with all-cause mortality in Chinese elderly men.
X-ray photoelectron spectroscopy has been used to characterize a sample of UO2 grown on an underlying substrate of Uranium. Both AlKα (1487 eV) and MgKα (1254 eV) emission were utilized as the excitation.