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OBJECTIVES/SPECIFIC AIMS: Background: The importance of engaging community in research and fostering community-academic research partnerships is increasingly acknowledged by Clinical and Translational Science Award (CTSA) institutes. However, forming and maintaining such collaborations is often hampered by numerous challenges. It is critical to investigate the barriers to effective community-academic partnerships and to develop novel approaches to overcome these barriers. Objective: To explore community and academic perspectives of the challenges faced by community-academic research partnerships and potential solutions to these identified challenges. METHODS/STUDY POPULATION: Methods: In an effort to explore creative approaches to address these issues, the Community Engagement Program at the Michigan Institute for Clinical & Health Research (MICHR), the CTSA site that serves Michigan, hosted a retreat to elicit the input of community members and academics from across the state. There was a mix of participants ranging from those with established community-academic partnerships to others who were new to community-engaged research and in early stages of forming partnerships. At the retreat, attendees were randomly divided into groups and asked to answer the specific question, “What are your barriers to partnering in research?” After each group identified a set of barriers and reported their findings to the entire room, attendees were asked to work again in their small groups to discuss potential solutions to these barriers. Ideas for solutions were also shared with the entire room. As part of the process of brainstorming about these questions, attendees were asked to document their ideas --- for both barriers and solutions --- on post-it notes which were then grouped by category. Artifacts from the retreat were saved digitally and transcripts made from these records. The findings were then analyzed to identify common themes. RESULTS/ANTICIPATED RESULTS: Results: Eighty-six participants attended the retreat from across the state of Michigan. Forty-three represented community organizations that focus on addressing a wide array of social determinants of health issues. The remaining forty-three participants represented various academic institutions. The most frequently mentioned challenges to community-academic partnerships were related to communication and relationship building. To overcome barriers in these areas, participants noted that it is critical to collaboratively and explicitly identify shared goals, values and norms in the early stages of partnership development. This was closely linked to the need for additional funding to help foster and strengthen relationships by allowing partners to spend time together to both work and socialize informally, preferably in face-to-face settings. These were deemed crucial for building trust and common ground. In addition, more equitable funding and role distribution --- including shared leadership and governance of research projects between community and academia--- that recognizes and supports the true costs of involvement in research for community members was viewed as important. Other frequently noted issues on the part of community members were the need for greater respect for community partners and for more training opportunities to build capacity within communities to participate in research. Participants from academic institutions emphasized that the current requirements and timeline for promotion in academia make it harder for them to participate in community-engaged research, especially as early career researchers. They maintained that wider recognition of the value of community-engaged research is necessary and that this requires the support of home departments. Finally, participants underscored the importance of building infrastructure to better connect potential partners from the community and academia by making it easier to identify common interests and reciprocal strengths. DISCUSSION/SIGNIFICANCE OF IMPACT: Conclusion: The problems faced by community-academic partnerships may be alleviated by working with community and academic members to identify potential solutions. Further work is needed to systematically examine barriers and the efficacy of solutions to enhance community-academic partnerships. Acknowledgements: We thank all attendees of the MICHR Community Engagement retreat for their participation in this activity that explored barriers to effective community-academic partnerships. Their honest and frank feedback was essential to broaching sensitive topics related to partnership development, and to identify realistic and practical solutions. We also thank all members of the planning committee and our colleagues in the Community Engagement Program for their work on bringing together community and academic members for this retreat. This project was supported by grant number UL1TR002240 from the National Center for Advancing Translational Sciences (NCATS).
Identifying routes of transmission among hospitalized patients during a healthcare-associated outbreak can be tedious, particularly among patients with complex hospital stays and multiple exposures. Data mining of the electronic health record (EHR) has the potential to rapidly identify common exposures among patients suspected of being part of an outbreak.
We retrospectively analyzed 9 hospital outbreaks that occurred during 2011–2016 and that had previously been characterized both according to transmission route and by molecular characterization of the bacterial isolates. We determined (1) the ability of data mining of the EHR to identify the correct route of transmission, (2) how early the correct route was identified during the timeline of the outbreak, and (3) how many cases in the outbreaks could have been prevented had the system been running in real time.
Correct routes were identified for all outbreaks at the second patient, except for one outbreak involving >1 transmission route that was detected at the eighth patient. Up to 40 or 34 infections (78% or 66% of possible preventable infections, respectively) could have been prevented if data mining had been implemented in real time, assuming the initiation of an effective intervention within 7 or 14 days of identification of the transmission route, respectively.
Data mining of the EHR was accurate for identifying routes of transmission among patients who were part of the outbreak. Prospective validation of this approach using routine whole-genome sequencing and data mining of the EHR for both outbreak detection and route attribution is ongoing.
Different diagnostic interviews are used as reference standards for major depression classification in research. Semi-structured interviews involve clinical judgement, whereas fully structured interviews are completely scripted. The Mini International Neuropsychiatric Interview (MINI), a brief fully structured interview, is also sometimes used. It is not known whether interview method is associated with probability of major depression classification.
To evaluate the association between interview method and odds of major depression classification, controlling for depressive symptom scores and participant characteristics.
Data collected for an individual participant data meta-analysis of Patient Health Questionnaire-9 (PHQ-9) diagnostic accuracy were analysed and binomial generalised linear mixed models were fit.
A total of 17 158 participants (2287 with major depression) from 57 primary studies were analysed. Among fully structured interviews, odds of major depression were higher for the MINI compared with the Composite International Diagnostic Interview (CIDI) (odds ratio (OR) = 2.10; 95% CI = 1.15–3.87). Compared with semi-structured interviews, fully structured interviews (MINI excluded) were non-significantly more likely to classify participants with low-level depressive symptoms (PHQ-9 scores ≤6) as having major depression (OR = 3.13; 95% CI = 0.98–10.00), similarly likely for moderate-level symptoms (PHQ-9 scores 7–15) (OR = 0.96; 95% CI = 0.56–1.66) and significantly less likely for high-level symptoms (PHQ-9 scores ≥16) (OR = 0.50; 95% CI = 0.26–0.97).
The MINI may identify more people as depressed than the CIDI, and semi-structured and fully structured interviews may not be interchangeable methods, but these results should be replicated.
Declaration of interest
Drs Jetté and Patten declare that they received a grant, outside the submitted work, from the Hotchkiss Brain Institute, which was jointly funded by the Institute and Pfizer. Pfizer was the original sponsor of the development of the PHQ-9, which is now in the public domain. Dr Chan is a steering committee member or consultant of Astra Zeneca, Bayer, Lilly, MSD and Pfizer. She has received sponsorships and honorarium for giving lectures and providing consultancy and her affiliated institution has received research grants from these companies. Dr Hegerl declares that within the past 3 years, he was an advisory board member for Lundbeck, Servier and Otsuka Pharma; a consultant for Bayer Pharma; and a speaker for Medice Arzneimittel, Novartis, and Roche Pharma, all outside the submitted work. Dr Inagaki declares that he has received grants from Novartis Pharma, lecture fees from Pfizer, Mochida, Shionogi, Sumitomo Dainippon Pharma, Daiichi-Sankyo, Meiji Seika and Takeda, and royalties from Nippon Hyoron Sha, Nanzando, Seiwa Shoten, Igaku-shoin and Technomics, all outside of the submitted work. Dr Yamada reports personal fees from Meiji Seika Pharma Co., Ltd., MSD K.K., Asahi Kasei Pharma Corporation, Seishin Shobo, Seiwa Shoten Co., Ltd., Igaku-shoin Ltd., Chugai Igakusha and Sentan Igakusha, all outside the submitted work. All other authors declare no competing interests. No funder had any role in the design and conduct of the study; collection, management, analysis and interpretation of the data; preparation, review or approval of the manuscript; and decision to submit the manuscript for publication.
The market structure and recipes for beer has been rapidly changing with craft beers attracting more consumers. Perceived hops quality (hoppiness) is one of the main attributes that microbrewers alter to differentiate their products to satisfy consumers’ changing tastes and preferences. We hypothesize that, in addition to manipulating beer-processing conditions, the conditions under which the hops are grown may also influence the final sensory properties of the beer. Using hops from a field experiment coupled with sensory attributes and sociodemographic characteristics from a contingent valuation survey, we analyzed the impact of under-fertilized hop treatments during the growing season on consumers’ willingness to pay for beer. The results indicate that uninformed consumers in a blind tasting could identify the differences in beer made from hops across the fertilization treatments and, thus, implying that all else equal sufficient fertilizer is required to achieve satisfactory hoppiness for which consumers are willing to pay. (JEL Classifications: C91, D12, L66, Q11)
Because the 14C calibration curves IntCal and SHCal are based on data from temperate latitudes, it remains unclear which curve is more suitable for archaeological and paleoenvironmental records from tropical South America. A review of climate dynamics reveals a significant influx of Northern Hemisphere air masses and moisture over a substantial part of the continent during the South American Summer Monsoon (SASM). Areas affected by the SASM receive unknown amounts of input from both hemispheres, where an argument could be made for either curve. Until localized tree-ring data can resolve this, we suggest using a mixed calibration curve, which accounts for inputs from both hemispheres, as a third calibration option. We present a calibration example from a crucial period of environmental and cultural change in the southern Lake Titicaca. Given our current lack of data on past ∆14C variation in South America, our calibrations and chronologies will likely change in the future. We hope this paper spurs new research into this topic and encourages researchers to make an informed and explicit choice of which curve to use, which is particularly relevant in research on past human–environmental relationships.
We report the discovery of one unique cataclysmic variable drawn from the Hamburg Quasar Survey, HS 2331 + 3905. Follow-up observations obtained over three years unveiled a very unusual picture. The large amplitude 3.5 h radial velocity variations obtained from our optical spectroscopy is not the orbital period of the system, as one would normally expect. Instead, extensive CCD photometry strongly suggests that HS 2331 + 3005 is a short orbital period cataclysmic variable with Рorb = 81.09 min, containing a cold white dwarf which appears to exhibit ZZ Ceti pulsations.
Objectives: Patient preferences should be a central consideration in healthcare decision making. However, stories of patients challenging regulatory and reimbursement decisions has led to questions on whether patient voices are being considered sufficiently during those decision making processes. This has led some to argue that it is necessary to quantify patient preferences before they can be adequately considered.
Methods: This study considers the lessons from the use of multi-criteria decision analysis (MCDA) for efforts to quantify patient preferences. It defines MCDA and summarizes the benefits it can provide to decision makers, identifies examples of MCDAs that have involved patients, and summarizes good practice guidelines as they relate to quantifying patient preferences.
Results: The guidance developed to support the use of MCDA in healthcare provide some useful considerations for the quantification of patient preferences, namely that researchers should give appropriate consideration to: the heterogeneity of patient preferences, and its relevance to decision makers; the cognitive challenges posed by different elicitation methods; and validity of the results they produce. Furthermore, it is important to consider how the relevance of these considerations varies with the decision being supported.
Conclusions: The MCDA literature holds important lessons for how patient preferences should be quantified to support healthcare decision making.
Norovirus is the leading cause of acute gastroenteritis in the USA. Although secondary household transmission of norovirus is frequently reported in outbreaks, little is known about specific risk factors for susceptibility and infectiousness in the household. Three norovirus outbreaks were investigated and data were collected on individuals exposed in the primary outbreak setting and their household members. Potential individual- and household-level risk factors for susceptibility and infectiousness were assessed using univariate and multivariate generalised linear mixed models. In the univariate models, the secondary attack rate (SAR) was significantly higher when living in a household with two or more primary cases (incidence rate ratio (IRR) = 2·1; 95% confidence interval (CI) 1·37–3·29), more than one primary case with vomiting (IRR = 1·9; CI 1·11–3·37), and at least one primary case with diarrhoea (IRR = 3·0; CI 1·46–6·01). After controlling for other risk factors in the multivariate models, the SAR was significantly higher among those living in a household with two or more primary cases (adjusted IRR = 2·0; CI 1·17–3·47) and at least one primary case with diarrhoea (adjusted IRR = 2·8; CI 1·35–5·93). These findings underscore the importance of maintaining proper hygiene and isolating ill household members to prevent norovirus transmission in the household.
Horn growth rate does not appear to be related to the amino acid profile of the major protein source for dairy cattle (Offer, Logue & Roberts, 1997), but it is possible that sulphur amino acids are limiting in early lactation, when the homeorhetic drive to milk production is most extreme. Supplementation of a high production ration for dairy cows with protected methionine should increase milk production, and allow any sulphur amino acid limitation on horn growth to be alleviated (Mengal, Galbraith, Souri & Scaife, 1997).
A total of 60 in-calf Holstein heifers were divided into two groups in a randomised block design. The study commenced approximately three weeks pre-calving until 26 weeks post calving, and animals were housed in one of three systems for the duration. Two diets were formulated based on a grass silage:maize silage mixture (50:50 DM basis), with rolled wheat, soya bean meal, sugar beet feed and rapeseed meal and were offered from approximately five days post calving for the remainder of the 26 week period.
Language provides us with convenient generalisations that often conceal as much as they reveal. The term ‘rural economy’ fits into this category. In the UK the rural economy ranges from the lush pastures of Cheshire, interspersed with the residences of the wealthy, to the bleak Highlands and the isolated, windswept Western Isles. When we look for the optimum use of the resources involved in such areas no one solution can suit all. Equally our emotional attachment to rural economies often embraces the idea that they are timeless. In reality all rural economies are dynamic and some are changing very rapidly as this conference takes place. Probably the most useful task for those who seek to help farmers and planners is to come to an understanding of the moving economic equilibrium, towards which at any one time we are tending. That equilibrium can be represented as a balance between the inflows and outflows of people, money and physical resources at any one time.
Intensive cereal based rations for beef cattle are typically formulated to contain 175 g/kg DM crude protein. Many different sources of protein have been successfully used to supplement cereals. In this study, the performance of bulls fed three different protein supplements were compared, namely rapeseed meal (R), urea (U) and a combination of urea and soya (S). The study also examined the performance of beef cattle fed a yeast culture (Diamond V ‘XP’ Yeast - Rumenco).
A total of 48 Limousin x (Hereford x Friesian) suckled bull calves at approximately 8 months old were allocated to one of three treatments with four replicates per treatment. Two replicates from each treatment were fed 40 g/head/day of yeast culture. Each diet was fed ad libitum with free access to barley straw and water. The feed ingredient inclusions in the rations were: R, 0.775 barley, 0.15 rape, 0.05 molasses, 0.025 minerals; U, 0.85 barley, 0.10 mineralised urea concentrate (Promol™ Rumenco), 0.05 molasses; S, 0.80 barley, 0.10 mineralised urea concentrate, 0.05 soya and 0.05 molasses. The R diet was used as the control. The bulls were slaughtered at fat class 4L. Statistical analysis was by ANOVA unless otherwise indicated.
Maize silage is a popular feed for dairy and beef cattle in the United Kingdom, but its popularity for sheep production has never been great. Several reasons for the lack of interest in maize silage for ewes and lambs have been cited; the growth of an annual crop for silage on holdings with a predominance of long-term leys, the low requirement of ewes and lambs for conserved feed, the possibility of low voluntary DM intakes and the risk of a high degree of selection of dietary components of the diet (Brown and Thomas, 1989). The research reported here examines the use of maize silage for ewes in late pregnancy and early lactation.
Tidal flexure in ice shelf grounding zones has been used extensively in the past to determine grounding line position and ice properties. Although the rheology of ice is viscoelastic at tidal loading frequencies, most modelling studies have assumed some form of linear elastic beam approximation to match observed flexure profiles. Here we use density, radar and DInSAR measurements in combination with full-Stokes viscoelastic modelling to investigate a range of additional controls on the flexure of the Southern McMurdo Ice Shelf. We find that inclusion of observed basal crevasses and density dependent ice stiffness can greatly alter the flexure profile and yet fitting a simple elastic beam model to that profile will still produce an excellent fit. Estimates of the effective Young's modulus derived by fitting flexure profiles are shown to vary by over 200% depending on whether these factors are included, even when the local thickness is well constrained. Conversely, estimates of the grounding line position are relatively insensitive to these considerations for the case of a steep bed slope in our study region. By fitting tidal amplitudes only, and ignoring phase information, elastic beam theory can provide a good fit to observations in a wide variety of situations. This should, however, not be taken as an indication that the underlying rheological assumptions are correct.
Motivated by disease outbreaks and trade shocks, a dynamic equilibrium displacement model is calibrated for the U.S. pear industry to simulate welfare from various shocks compared to a baseline. Our contribution is assessing the impact to intermediary packers for fresh fruit and processors for processed fruit in addition to growers and consumers. The processed market is more sensitive than the fresh market generally, and supply shocks induce larger impacts on both markets than trade sanctions. Impacts to intermediaries are on par with growers, indicating that not considering them misstates the distribution of damages to the industry from a shock.
Ice-thickness measurements in Antarctic ice-shelf grounding zones are necessary for calculating the mass balance of individual catchments, but remain poorly constrained for most of the continent. We describe a new inverse modelling optimization approach to estimate ice thickness in the grounding zone of Antarctic outlet glaciers and ice shelves using spatial patterns of tide-induced flexure derived from differential interferometric synthetic aperture radar (InSAR). We demonstrate that the illposedness of the inverse formulation of the elastic-plate equations for bending can be controlled by regularization. In one dimension, the model recreates smooth, synthesized profiles of ice thickness from flexure information to within 1–2%. We test the method in two dimensions and validate it in the grounding zone of Beardmore Glacier, a major outlet glacier in the Transantarctic Mountains, using interferograms created from TerraSAR-X satellite imagery acquired in 2012. We compare our results with historic and modern ice-thickness data (radio-echo sounding from 1967 and ground-penetrating radar from 2010). We match both longitudinal and transverse thickness transects to within 50 m root-mean-square error using an effective Young’s modulus of 1.4 GPa. The highest accuracy is achieved close to the grounded ice boundary, where current estimates of thickness based on surface elevation measurements contain a systematic bias towards thicker ice.
We present a diagnostic glacier flowline model parameterized and constrained by new velocity data from ice-surface GPS installations and speckle tracking of TerraSAR-X satellite images, newly acquired airborne-radar data, and continental gridded datasets of topography and geothermal heat flux, in order to better understand two outlet glaciers of the East Antarctic ice sheet. Our observational data are employed as primary inputs to a modelling procedure that first calculates the basal thermal regime of each glacier, then iterates the basal sliding coefficient and deformation rate parameter until the fit of simulated to observed surface velocities is optimized. We find that the two glaciers have both frozen and thawed areas at their beds, facilitating partial sliding. Glacier flow arises from a balance between sliding and deformation that fluctuates along the length of each glacier, with the amount of sliding typically varying by up to two orders of magnitude but with deformation rates far more constant. Beardmore Glacier is warmer and faster-flowing than Skelton Glacier, but an up-glacier deepening bed at the grounding line, coupled with ice thicknesses close to flotation, lead us to infer a greater vulnerability of Skelton Glacier to grounding-line recession if affected by ocean-forced thinning and concomitant acceleration.
Modelling of Solar Energetic Particles (SEPs) is usually carried out by means of the 1D focused transport equation and the same approach is adopted within several SEP Space Weather forecasting frameworks. We present an alternative approach, based on test particle simulations, which naturally describes 3D particle propagation. The SPARX forecasting system is an example of how test particle simulations can be used in real time in a Space Weather context. SPARX is currently operational within the COMESEP Alert System. The performance of the system, which is triggered by detection of a solar flare of class >M1.0 is evaluated by comparing forecasts for flare events between 1997 and 2017 with actual SEP data from the GOES spacecraft.
Grounding zones are vital to ice-sheet mass balance and its coupling to the global ocean circulation. Processes here determine the mass discharge from the grounded ice sheet, to the floating ice shelves. The response of this transition zone to tidal forcing has been described by both elastic and viscoelastic models. Here we examine the validity of these models for grounding zone flexure over tidal timescales using field data from the Southern McMurdo Ice Shelf (78° 15′S, 167° 7′E). Observations of tidal movement were carried out by simultaneous tiltmeter and GPS measurements along a profile across the grounding zone. Finite-element simulations covering a 64 d period reveal that the viscoelastic model fits best the observations using a Young's modulus of 1.6 GPa and a viscosity of 1013.7 Pa s (≈ 50.1 TPa s). We conclude that the elastic model is only well-constrained for tidal displacements >35% of the spring-tidal amplitude using a Young's modulus of 1.62 ± 0.69 GPa, but that a viscoelastic model is necessary to adequately capture tidal bending at amplitudes below this threshold. In grounding zones where bending stresses are greater than at the Southern McMurdo Ice Shelf or ice viscosity is lower, the threshold would be even higher.
The chronology of the Inca Empire has traditionally relied on ethnohistoric dates, which suggest that a northern expansion into modern Ecuador began in AD 1463 and a southern expansion into modern Argentina began in AD 1471. We test the validity of these dates with two Bayesian models, which show that the ethnohistoric dates are incorrect and that the southern expansion began before the northern one. The first model of seven dates shows that the site of Chamical, Ecuador, was first occupied cal AD 1410–1480 (95% probability) and has a high probability of being built prior to the ethnohistoric date. The second is an outlier model of 26 14C dates and 19 thermoluminescence (TL) dates from 10 sites along the empire’s southeastern limit in northwestern Mendoza, Argentina. Here, the Inca occupation began cal AD 1350–1440 (95% probability), also earlier than the ethnohistoric date. The model also suggests that the Inca occupation of Mendoza lasted 70–230 yr (95% probability), longer than previously thought, which calls for new perspectives on the timing and nature of Inca conquests and relationships with local groups. Based on these results, we argue it is time to abandon the traditional chronology in favor of Inca chronologies based on Bayesian models.