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The emphasis on team science in clinical and translational research increases the importance of collaborative biostatisticians (CBs) in healthcare. Adequate training and development of CBs ensure appropriate conduct of robust and meaningful research and, therefore, should be considered as a high-priority focus for biostatistics groups. Comprehensive training enhances clinical and translational research by facilitating more productive and efficient collaborations. While many graduate programs in Biostatistics and Epidemiology include training in research collaboration, it is often limited in scope and duration. Therefore, additional training is often required once a CB is hired into a full-time position. This article presents a comprehensive CB training strategy that can be adapted to any collaborative biostatistics group. This strategy follows a roadmap of the biostatistics collaboration process, which is also presented. A TIE approach (Teach the necessary skills, monitor the Implementation of these skills, and Evaluate the proficiency of these skills) was developed to support the adoption of key principles. The training strategy also incorporates a “train the trainer” approach to enable CBs who have successfully completed training to train new staff or faculty.
Vast improvements have been made to the capabilities of advanced manufacturing (AM), yet there are still limitations on which materials can effectively be used in the technology. To this end, parts created using AM would benefit from the ability to be developed from feedstock materials incorporating additional functionality. A common three-dimensional (3D) printing polymer, acrylonitrile butadiene styrene, was combined with bismuth and polyvinylidene fluoride via a solvent treatment to fabricate multifunctional composite materials for AM. Composites of varying weight percent loadings were extruded into filaments, which were subsequently 3D printed into blocks via fused filament fabrication. Investigating the material properties demonstrated that in addition to the printed blocks successfully performing as radiation shields, the chemical, thermal, and mechanical properties are suitable for AM. Thus, this work demonstrates that it is possible to enhance AM components with augmented capabilities while not significantly altering the material properties which make AM possible.
To evaluate the quality and content of free smoking cessation apps and assess their adherence to the US Public Health Service guideline for treating tobacco use and dependence.
In total 180 apps were downloaded from the App Store and Google Play Store in January 2018; the top-ranking 30 apps were retrieved for the search terms: ‘smoking cessation’, ‘quit smoking’, ‘stop smoking’. Technical quality was rated using the Mobile Application Rating Scale (MARS) and by assessing other characteristics, behavioral change strategies and adherence to the 5As.
A total 67 free-to-download apps were identified for full review (n = 40 from the Apple App Store and n = 27 from the Google Play Store). The average MARS score was 16.2/19.0: Engagement (3.3/5.0), Functionality (4.4/5.0), Aesthetics (4.0/5.0), and Information (2.6/5.0). Overall, 43 apps allowed sharing, 12 allowed for an app community, and five required a password. The following features were observed: assessment (n = 51), feedback (n = 38), information/education (n = 45), monitoring (n = 52), and goal setting (n = 23). Significant differences were found among apps adhering to the 5As: Ask (n = 44), Advise (n = 54), Assess (n = 30), Assist (n = 62), and Arrange (n = 0).
Given the growth in smoking cessation apps, future efforts should focus on improving their technical quality and adherence to the 5As.
Central-line–associated bloodstream infections (CLABSI) are an important cause of morbidity and mortality in neonates. We aimed to determine whether intra-abdominal pathologies are an independent risk factor for CLABSI.
We performed a retrospective matched case–control study of infants admitted to the neonatal intensive care units (NICUs) of the Montreal Children’s Hospital (Montreal) and the Royal Alexandra Hospital, Edmonton, Canada. CLABSI cases that occurred between April 2009 and March 2014 were identified through local infection control databases. For each case, up to 3 controls were matched (National Healthcare Safety Network [NHSN] birth weight category, chronological age, and central venous catheter (CVC) dwell time at the time of CLABSI onset). Data were analyzed using conditional logistic regression.
We identified 120 cases and 293 controls. According to a matched univariate analysis, the following variables were significant risk factors for CLABSI: active intra-abdominal pathology (odds ratio [OR], 3.4; 95% confidence interval [CI], 1.8–6.4), abdominal surgery in the prior 7 days (OR, 3.5; 95% CI, 1.0–10.9); male sex (OR, 1.7; 95% CI, 1.1–2.6) and ≥3 heel punctures (OR, 4.0; 95% CI, 1.9–8.3). According to a multivariate matched analysis, intra-abdominal pathology (OR, 5.9; 95% CI, 2.5–14.1), and ≥3 heel punctures (OR, 5.4; 95% CI, 2.4–12.2) remained independent risk factors for CLABSI.
The presence of an active intra-abdominal pathology increased the risk of CLABSI by almost 6-fold. Similar to CLABSI in oncology patients, a subgroup of CLABSI with mucosal barrier injury should be considered for infants in the NICU with active intra-abdominal pathology.
The use of underground geological repositories, such as in radioactive waste disposal (RWD) and in carbon capture (widely known as Carbon Capture and Storage; CCS), constitutes a key environmental priority for the 21st century. Based on the identification of key scientific questions relating to the geophysics, geochemistry and geobiology of geodisposal of wastes, this paper describes the possibility of technology transfer from high-technology areas of the space exploration sector, including astrobiology, planetary sciences, astronomy, and also particle and nuclear physics, into geodisposal. Synergies exist between high technology used in the space sector and in the characterization of underground environments such as repositories, because of common objectives with respect to instrument miniaturization, low power requirements, durability under extreme conditions (in temperature and mechanical loads) and operation in remote or otherwise difficult to access environments.
More than 50 years of archaeological survey work carried out in Cappadocia in central Turkey has produced a number of important contributions to the understanding of long-term settlement histories. This article synthesises and critically evaluates the results of three field surveys conducted in Cappadocia which recorded material remains dating from the Early Holocene through to the establishment of the Republic of Turkey. Results from the combined Cappadocia surveys reveal temporal patterns over the longue durée that include a lack of detectable pre-Neolithic occupation and important exploitation of obsidian as a raw material during the Neolithic. There was growth and expansion of settlement during the later Chalcolithic and Early Bronze Age, a steady continuation of settlement during the Middle and Late Bronze Ages, followed by rupture in settlement at the end of the Bronze Age. A new phase of settlement expansion began during the Iron Age and continued through Hellenistic and Roman times. This in turn was disrupted during the Byzantine period, which is associated with increased numbers of fortified sites. The succeeding long cycle of settlement began in Seljuk times and continued through to the end of the Ottoman period. Comparison with systematic archaeological site surveys in the adjacent regions of Paphlagonia and Konya shows some differences in settlement patterns, but overall broad sim¬ilarities indicate a coherent trajectory of settlement across central Anatolia over the last ten millennia.
To select staff for a personality disorder service by exposing applicants to anticipated challenges. Applicants took part in a role play, an unstructured group with fellow applicants and numbers of the interviewing panel, and a panel interview. A service user representative was involved from the initial planning stage.
Multiple assessment methods enabled fine discrimination between applicants. Appointed staff said they felt the interviews were a valid test of required skills and have been well regarded by patients in the programme.
Selecting staff for a personality disorder service benefits from using multiple interview methods. The service user representative and role-play actor can contribute crucially by representing the patient's perspective. Key domains to assess include the applicant's psychological qualities, psychiatric skills and ability to work in a team.
Deficits in executive function (EF) are reported to occur in individuals with Klinefelter syndrome (XXY). The degree of impairment, if any, is variable and the nature of these deficits has not been clearly elucidated in young males. In this report, we (a) examine EF skills using multiple tasks in a non-clinic referred group of youth with XXY, (b) describe the extent of EF weaknesses in XXY when this group is compared with typical males of a similar SES or typical males with similar verbal abilities, and (c) evaluate the contribution of comorbid attention-deficit/hyperactivity disorder (ADHD) to EF skills. The sample included 27 males with XXY (ages 9–25), 27 typically developing age- and vocabulary-matched males, and 22 age- and socioeconomic status-matched males. EF tasks included Verbal Fluency, the Trail Making Test, and the CANTAB Spatial Working Memory and Stockings of Cambridge tasks. Mixed model analysis of variance was used to compare the groups on EF tasks and revealed a main effect of group but no group by task interaction. Overall, the XXY group performed less well than both control groups, but performance did not differ significantly as a function of task. ADHD comorbidity in males with XXY was related to poorer EF skills. (JINS, 2011, 17, 522–530)
Using the National Institute for Health and Clinical Excellence (NICE) guidelines on borderline personality disorder as a framework, we describe the profile of the first 100 individuals referred to a personality disorder service in London, captured through the use of record review and case study.
The referral population ethnic profile does not match the wider population of the borough; a third of the borough is Bangladeshi, but only 9% of those referred to the service are. Of those diagnosed with borderline personality disorder and on psychotropic medications, only one person had a clear current indication based on NICE guidelines. Of the 100 individuals who were referred to the service, a quarter were accepted to the programme; a third either did not want to proceed with the assessment or were unprepared for an intensive programme.
The under-representation of Black and minority ethnic individuals in referrals in the peresonality disorder service needs to be actively addressed. Interventions are required to support psychiatrists in reviewing their prescribing practice regarding individuals with borderline personality disorder. Access to the service needs to be improved.
To describe the tumor characteristics and visual function in conservatively managed patients with non-functioning pituitary macroadenoma (NFMA) that contacted/compressed the visual pathway.
Tertiary-care academic institution.
Six patients with diagnosis of NFMA.
Visual function and radiological characteristics of the optic apparatus and pituitary tumor.
All patients had radiological evidence of optic apparatus compression but only one had visual field defect at the initial presentation. While two of the six patients developed visual field changes during follow-up (41±34.8 months), the patient with visual field defect at the time of diagnosis improved to normal vision.
Select NFMAs that contact the optic apparatus, without visual dysfunction, may be managed with close ophthalmological and radiographic monitoring, depending on tumor and imaging characteristics. This may be of particular relevance in patients considered to have a high peri-operative risk, such as advanced age or significant co-morbidities.
Molecular dynamics simulations of the flow of pressurised water through carbon nanotubes of chirality (9,0), (12,0), (15,0) and (18,0) have been undertaken at 298K with a water density of approximately 1240kg/m3. Results show that the rate of filling is least in the smallest diameter nanotube, but that there is less variation in the time taken to reach maximum occupancy. The water molecules are found to undergo restructuring due to their confinement, with detailed molecular arrangement dependent on CNT diameter. Enhanced rates of flow are shown for the (15,0) nanotube, highlighting the effect of nanotube diameter on confinement and thus on flow.
This study aimed to investigate which abilities
are measured by the Austin Maze. One hundred and eight
university students were administered a battery of eight
neuropsychological tests including, the Austin Maze, the
Tower of London, the Wisconsin Card Sort Test, Block Design,
the Visual Spatial Learning Test, Digit Span Backwards,
the Brown-Peterson Task and the Wide Range Achievement
Test of Reading. Results indicated that visuospatial ability
and memory both significantly contributed to performance
on the Austin Maze, but differed in the degree to which
they explained the performance depending on which measure
of maze performance was employed. It appears that visuospatial
ability is measured in early trials of the Austin Maze
when individuals are orienting themselves to the path.
In later trials individuals must call upon visuospatial
memory to consolidate the details of the path. Executive
function and working memory were not found to be significantly
implicated in performance on the Austin Maze. (JINS,
1999, 5, 1–9.)
The electromigration behavior of pure Al lines passivated with oxides of different thicknesses and passivation deposition temperatures was studied. The initial hydrostatic stress states of the passivated Al lines were modeled with finite element modeling (FEM), and, when possible, measured with X-ray diffraction. Conventional wafer-level electromigration tests showed a clear passivation thickness effect, but no detectable effect of initial stress on electromigration lifetimes. Increasing the passivation thickness increased the electromigration lifetimes, which has been observed by other researchers. However, in a sample set where the Al lines were covered with a thin (0. 1µm) oxide layer, the lifetimes were much longer than expected. Differences in the damage morphology and the failure mechanism between the thin and thicker oxides accounted for this unexpected result.
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