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Effective patient engagement is central to patient-centered outcomes research. A well-designed infrastructure supports and facilitates patient engagement, enabling study development and implementation. We sought to understand infrastructure needs from recipients of Patient-Centered Outcomes Research Institute (PCORI) pilot grant awards.
We surveyed recipients of PCORI pilot project awards on self-perceived strengths in engagement infrastructure through PCORI’s Ways of Engaging-Engagement Activity Tool survey, and interviewed leaders of 8 projects who volunteered as exemplars. Descriptive statistics summarized the survey findings. We conducted a thematic analysis of the interview transcripts.
Of the 50 surveyed pilots, 22 answered the engagement infrastructure questions (44% response rate). Survey and interview findings emphasized the importance of committed institutional leadership, ongoing relationships with stakeholder organizations, and infrastructure funding through Clinical and Translational Science Awards, PCORI, and institutional discretionary funds.
These findings highlight the importance of and how to improve upon existing institutional infrastructure.
The water-undersaturated melting relationships of an orendite (with 1.23% H2O as shown by chemical analysis) from the Leucite Hills, Wyoming, have been determined at pressures up to 30 kbar. The dominant liquidus and near-liquidus phases are leucite, olivine, orthopyroxene, clinopyroxene, and garnet. Leucite is stable only at pressures below 5 kbar, but at 27 kbar, minor olivine, orthopyroxene, clinopyroxene, and garnet crystallize simultaneously at or near the liquidus. The following reaction relationships occur with falling temperature in the orendite magma: (a) a reaction between olivine and melt to yield orthopyroxene at pressures above 12 kbar; (b) a reaction between olivine and melt to yield phlogopite at pressures below 12 kbar; (c) a reaction between olivine, orthopyroxene and melt to yield phlogopite and probably clinopyroxene at pressures above 12 kbar; (d) a reaction between leucite and melt to yield sanidine at pressures below 5 kbar. Electron microprobe analyses demonstrate that the ortho- and clinopyroxenes crystallized from orendite are aluminium-poor; the clinopyroxenes contain insufficient aluminium to balance sodium and titanium (Al < Na+2Ti) and these elements must either be partly balanced by (undetermined) chromium or ferric iron or be involved in substitutions which do not require trivalent ions for charge balance. The experimental results indicate that relatively silica-rich potassic magmas such as orendite form under water-undersaturated (essentially carbon dioxide free) conditions at pressures of about 27 kbar by small degrees of melting of phlogopite-garnet-lherzolite or by larger degrees of melting of peridotite which has been enriched in potassium and incompatible elements. The peralkalinity of some potassic magmas (such as orendite and wyomingite) could reflect a primary geochemical characteristic of the source rock, but could also result from the melting of phlogopite in the presence of residual pyroxenes. The association of silica-poor, mafic madupites and relatively silica-rich orendites and wyomingites in the Leucite Hills can be explained in terms of the relative effects of water and carbon dioxide on melting processes within the upper mantle.
In this paper, we compile recent 14C dates related to the Neolithic transition in Mediterranean Iberia and present a Bayesian chronological approach for testing the dual model, a mixed model proposed to explain the spread of farming and husbandry processes in eastern Iberia. The dual model postulates the coexistence of agricultural pioneers and indigenous Mesolithic foraging groups in the Middle Holocene. We test this general model with more regional models of four geographical areas (Northeast, Upper, and Middle Ebro Valley, and Eastern and South/Southeastern regions) and present a filtered summed probability of all 14C dates known in the region in order to compare socioecological dynamics over a long period. Finally, we discuss the results and analyze how certain specific characteristics of sites and their chronologies can serve for timing the Neolithic expansion in Mediterranean Iberia.
We present the analysis of 29 human-transported limestone pebbles found during recent excavations (2009–11) in the Final Epigravettian levels at the Caverna delle Arene Candide, Italy. All pebbles are oblong, most bear traces of red ochre and many appear intentionally broken. Macroscopic analyses demonstrate morphological similarity with pebbles used as grave goods in the Final Epigravettian necropolis excavated at the site in the 1940s. Mediterranean beaches are the most plausible source for the pebbles, which were carefully selected for their specific shape. Microscopic observation of the pebbles’ surfaces shows traces of ochre located on the edges and/or centres of most pebbles. A breakage experiment suggests that many pebbles were broken with intentional, direct blows to their centre. We propose that these pebbles were used to apply ochre ritually to the individuals buried at the site, and that some were subsequently ritually ‘killed’. This study emphasizes the importance of studying artefacts that are often ignored due to their similarities to simple broken rocks. It also provides a method to study pebbles as a distinct artefact category, and shows that even broken parts should be studied to understand the story told by such objects in the context of prehistoric human social systems.
We describe a versatile infrared camera/spectrograph, IRIS, designed and constructed at the Anglo-Australian Observatory for use on the Anglo-Australian Telescope. A variety of optical configurations can be selected under remote control to provide several direct image scales and a few low-resolution spectroscopic formats. Two cross-dispersed transmission echelles are of novel design, as is the use of a modified Bowen-Burch system to provide a fast f/ratio in the widest-field option. The drive electronics includes a choice of readout schemes for versatility, and continuous display when the array is not taking data, to facilitate field acquisition and focusing.
The linearity of the detector has been studied in detail. Although outwardly good, slight nonlinearities prevent removal of fixed-pattern noise from the data without application of a cubic linearising function.
Specific control and data-reduction software has been written. We describe also a scanning mode developed for spectroscopic imaging.
This paper will discuss the structure-property model developed that correlates the tensile modulus to the elastic properties and angular distribution of constituent graphitic layers for carbon fiber derived from a polyethylene precursor. In addition, a high-temperature fiber tensile device was built to enable heating of carbon fiber bundles at a variable rate from 25 °C to greater than ∼2300 °C, while simultaneously applying a tensile stress. This capability combined with synchrotron wide-angle x-ray diffraction (WAXD), enabled observation in situ and in real time of the microstructural transformation from different carbon fiber precursors to high-modulus carbon fiber. Experiments conducted using PAN- and PE-derived fiber precursors reveal stark differences in their carbonization and high-temperature graphitization behavior.
The assemblages from four sites in Spain and Gibraltar form the basis of a study that addresses the behavioral significance of the variability in Middle Paleolithic chipped stone artifacts. Quantitative analysis of artifact edge morphology forms the primary focus of this work.
It is suggested that (1) morphological variability is generally continuous for the features examined, (2) retouched and unretouched lithics are extremes in a continuum of the degree of edge use, (3) lithic morphology is dynamic and artifacts may be multi-functional and (4) lithic morphoplogy is conditioned by the time of discard in the use-life of the artifact. Retouched artifacts may be more the end result of the extent and nature of the use of their various edges than preconceived tools determined by cultural traditions or intended function.
These results are applied to a study of Middle Paleolithic settlement strategies using data from the four primary sites of the study and an additional five sites in the Iberian peninsula. Differences are noted between upland and lowland strategies. Upland sites may represent more of a ‘forager’ strategy, with frequent, short-term occupations of sites. Lowland sites seem more characteristic of a ‘collector’ strategy, with longer occupations and less frequent visits to sites. Settlement response to changing Upper Pleistocene environments during the onset of the last glacial may include a shift to a more ‘forager’-like strategy in lowland settings.
The paper describes the initial results from renewed investigations at Niah Cave in Sarawak on the island of Borneo, famous for the discovery in 1958 of the c. 40,000–year old ‘Deep Skull’. The archaeological sequences from the West Mouth and the other entrances of the cave complex investigated by Tom and Barbara Harrisson and other researchers have potential implications for three major debates regarding the prehistory of south-east Asia: the timing of initial settlement by anatomically modern humans; the means by which they subsisted in the late Pleistocene and early Holocene; and the timing, nature, and causation of the transition from foraging to farming. The new project is informing on all three debates. The critical importance of the Niah stratigraphies was commonly identified – including by Tom Harrisson himself – as because the site provided a continuous sequence of occupation over the past 40,000 years. The present project indicates that Niah was first used at least 45,000 years ago, and probably earlier; that the subsequent Pleistocene and Holocene occupations were highly variable in intensity and character; and that in some periods, perhaps of significant duration, the caves may have been more or less abandoned. The cultural sequence that is emerging from the new investigations may be more typical of cave use in tropical rainforests in south-east Asia than the Harrisson model.
Due to an increased need for new antimalarial chemotherapies that show potency against Plasmodium falciparum, researchers are targeting new processes within the parasite in an effort to circumvent or delay the onset of drug resistance. One such promising area for antimalarial drug development has been the parasite mitochondrial electron transport chain (ETC). Efforts have been focused on targeting key processes along the parasite ETC specifically the dihydroorotate dehydrogenase (DHOD) enzyme, the cytochrome bc1 enzyme and the NADH type II oxidoreductase (PfNDH2) pathway. This review summarizes the most recent efforts in antimalarial drug development reported in the literature and describes the evolution of these compounds.
Physician trainees were surveyed to assess intention to perform hand hygiene (HH). Compared with preclinical medical students (MS), clinical MS and residents reported less confidence that HH prevents carrying home microorganisms (P = .006, P = .003) or protects oneself from antibiotic-resistant microorganisms (P = .01, P = .006). Clinical trainees may need targeted interventions focusing on intention to perform HH.
Autobiographical memory involves the recall of personal facts (semantic memory) and re-experiencing of specific personal events (episodic memory). Although impairments in autobiographical memory have been found in adults with unilateral temporal lobe epilepsy (TLE) and attributed to compromised hippocampal integrity, it is not yet known whether this occurs in children with TLE. In the current study, 21 children with TLE and 24 healthy controls of comparable age, sex, and socioeconomic status were administered the Children's Autobiographical Interview. Compared to controls, children with TLE recalled fewer episodic details, but only when no retrieval prompts were provided. There was no difference between the groups for semantic autobiographic details. Interestingly, the number of episodic details recalled increased significantly from 6 to 16 years of age in healthy control children, but not in children with TLE. Exploratory analyses revealed that, within the group of children with TLE, epilepsy factors, including presence or absence of structural hippocampal abnormalities, did not relate to the richness of episodic recall. Our results provide first evidence of autobiographical episodic memory deficits in children with TLE. (JINS, 2013, 19, 1–12)
Anti-Wolbachia therapy delivers safe macrofilaricidal activity with superior therapeutic outcomes compared to all standard anti-filarial treatments, with the added benefit of substantial improvements in clinical pathology. These outcomes can be achieved, in principle, with existing registered drugs, e.g. doxycycline, that are affordable, available to endemic communities and have well known, albeit population-limiting, safety profiles. The key barriers to using doxycycline as an mass drug administration (MDA) strategy for widespread community-based control are the logistics of a relatively lengthy course of treatment (4–6 weeks) and contraindications in children under eight years and pregnancy. Therefore, the primary goal of the anti-Wolbachia (A·WOL) consortium is to find drugs and regimens that reduce the period of treatment from weeks to days (7 days or less), and to find drugs which would be safe in excluded target populations (pregnancy and children). A secondary goal is to refine regimens of existing antibiotics suitable for a more restricted use, prior to the availability of a regimen that is compatible with MDA usage. For example, for use in the event of the emergence of drug-resistance, in individuals with high loiasis co-infection and at risk of severe adverse events (SAE) to ivermectin, or in post-MDA ‘endgame scenarios’, where test and treat strategies become more cost effective and deliverable.
The thermo-optical properties of gold nanoparticles suspended in liquid water droplets have been explored. A water droplet containing suspended gold nanoparticles was irradiated with a laser beam and the efficiency of light-to-heat conversion (η) was determined. Heat generated by the optically stimulated nanoparticles was found to dissipate through several mechanisms. Convection currents were observed visually inside the droplet by the addition of silica beads (˜3-10 micrometers). This was determined to be the dominant mechanism of stirring within the droplet.