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Clinical and Translational Science Award (CTSA) TL1 trainees and KL2 scholars were surveyed to determine the immediate impact of the COVID-19 pandemic on training and career development. The most negative impact was lack of access to research facilities, clinics, and human subjects, plus for KL2 scholars lack of access to team members and need for homeschooling. TL1 trainees reported having more time to think and write. Common strategies to maintain research productivity involved time management, virtual connections with colleagues, and shifting to research activities not requiring laboratory/clinic settings. Strategies for mitigating the impact of the COVID-19 pandemic on training and career development are described.
Surgical site infections (SSIs) following colorectal surgery (CRS) are among the most common healthcare-associated infections (HAIs). Reduction in colorectal SSI rates is an important goal for surgical quality improvement.
To examine rates of SSI in patients with and without cancer and to identify potential predictors of SSI risk following CRS
American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) data files for 2011–2013 from a sample of 12 National Comprehensive Cancer Network (NCCN) member institutions were combined. Pooled SSI rates for colorectal procedures were calculated and risk was evaluated. The independent importance of potential risk factors was assessed using logistic regression.
Of 22 invited NCCN centers, 11 participated (50%). Colorectal procedures were selected by principal procedure current procedural technology (CPT) code. Cancer was defined by International Classification of Disease, Ninth Revision, Clinical Modification (ICD-9-CM) codes.
The primary outcome of interest was 30-day SSI rate.
A total of 652 SSIs (11.06%) were reported among 5,893 CRSs. Risk of SSI was similar for patients with and without cancer. Among CRS patients with underlying cancer, disseminated cancer (SSI rate, 17.5%; odds ratio [OR], 1.66; 95% confidence interval [CI], 1.23–2.26; P=.001), ASA score ≥3 (OR, 1.41; 95% CI, 1.09–1.83; P=.001), chronic obstructive pulmonary disease (COPD; OR, 1.6; 95% CI, 1.06–2.53; P=.02), and longer duration of procedure were associated with development of SSI.
Patients with disseminated cancer are at a higher risk for developing SSI. ASA score >3, COPD, and longer duration of surgery predict SSI risk. Disseminated cancer should be further evaluated by the Centers for Disease Control and Prevention (CDC) in generating risk-adjusted outcomes.
The discovery of the first electromagnetic counterpart to a gravitational wave signal has generated follow-up observations by over 50 facilities world-wide, ushering in the new era of multi-messenger astronomy. In this paper, we present follow-up observations of the gravitational wave event GW170817 and its electromagnetic counterpart SSS17a/DLT17ck (IAU label AT2017gfo) by 14 Australian telescopes and partner observatories as part of Australian-based and Australian-led research programs. We report early- to late-time multi-wavelength observations, including optical imaging and spectroscopy, mid-infrared imaging, radio imaging, and searches for fast radio bursts. Our optical spectra reveal that the transient source emission cooled from approximately 6 400 K to 2 100 K over a 7-d period and produced no significant optical emission lines. The spectral profiles, cooling rate, and photometric light curves are consistent with the expected outburst and subsequent processes of a binary neutron star merger. Star formation in the host galaxy probably ceased at least a Gyr ago, although there is evidence for a galaxy merger. Binary pulsars with short (100 Myr) decay times are therefore unlikely progenitors, but pulsars like PSR B1534+12 with its 2.7 Gyr coalescence time could produce such a merger. The displacement (~2.2 kpc) of the binary star system from the centre of the main galaxy is not unusual for stars in the host galaxy or stars originating in the merging galaxy, and therefore any constraints on the kick velocity imparted to the progenitor are poor.
Tett, Hundley, and Christiansen (2017) raise an important issue related to meta-analysis and our frequent overinterpretation of point estimates to the diminishment of variability of the estimate. We view this as analogous to the situation in which weather forecasters communicate the likely track of hurricanes. Such predictions involve point estimates of where the center of the storm is likely to be at some future time. These point estimates can be connected to identify the most likely path of the storm. In addition to these point estimates, however, forecasters caution that we should also attend to the “cone of uncertainty.” That is, we should not focus exclusively on the point estimate to the exclusion of the errors of prediction.
Tett, Hundley, and Christiansen (2017) argue that the concept of validity generalization in meta-analysis is a myth, as the variability of the effect size appears to decrease with increasing moderator specificity such that the level of precision needed to deem an estimate “generalizable” is actually reached at levels of situational specificity that are so high as to (paradoxically) refute an inference of generalizability. This notion highlights the need to move away from claiming that effects are either “generalizable” or “situationally specific” and instead look more critically and less dichotomously at degrees of generalizability, or effect size variability.
Pale swallowwort and black swallowwort are European viny milkweeds that have become invasive in many habitats in the northeastern United States and southeastern Canada. A multiyear seedbank study was initiated in fall 2011 to assess annual emergence of seedlings and longevity of seeds of pale swallowwort and black swallowwort at four different burial depths (0, 1, 5, and 10 cm) over 4 yr. One hundred swallowwort seeds were sown in seed pans buried in individual pots, and emerged seedlings were counted and removed from May through September each year. A subset of seed pans was retrieved annually in October, and recovered seeds were counted and tested for viability. The majority of seedling emergence occurred during the first year (92% in 2012), and no new seedlings emerged in the third (2014) or fourth (2015) years. Pale swallowwort had relatively poor emergence at sowing depths of 0 cm (11%), 5 cm (6%), and 10 cm (0.05%—only one seedling), while 37% of pale swallowwort seeds emerged at 1 cm. The larger-seeded black swallowwort was more successful, with two-thirds of all sown seeds emerging at depths of 1 cm (71%) and 5 cm (66%), and 26% emerging at 10 cm. Only 16% of the surface-sown black swallowwort emerged. A large portion of the seeds that germinated at 10 cm, as well as at 5 cm for pale swallowwort, died before reaching the soil surface. Of filled seeds that were recovered in 2012 (black swallowwort at the 0-cm depth), 66% were viable. No viable seeds were recovered after the second growing season. Seeds recovered following the third year had become too deteriorated to accurately assess. Swallowwort seeds do not appear to survive more than 2 yr in the soil, at least in our experiment, suggesting that the elimination of seed production over 3 yr will exhaust the local seedbank. Seeds would need to be buried at least 10 cm for pale swallowwort but more than 10 cm for black swallowwort to prevent seedling emergence. Burial of swallowwort seeds as a management strategy may, however, only be practical in natural areas where high swallowwort densities occur.
The European vines pale swallowwort and black swallowwort are invading various habitats in northeastern North America. It is unclear how these plants might respond to potential biological control agents, as they experience little herbivore damage in North America, or longer durations of mowing given the reported lack of efficacy of mechanical control. We evaluated the effect of six seasons of artificial defoliation (50 or 100% defoliation once or twice per season) and clipping (once, twice, or four times at 8 cm above the soil level) on the survival, growth, and reproduction of mature plants of the two species grown in a common garden field experiment. No plants died from damage after 6 yr. Black swallowwort produced more aboveground biomass, whereas pale swallowwort produced more root biomass and root crown buds, compared with its congener species. For most damage treatments, root biomass and the number of crown buds and stems increased over time, whereas aboveground biomass and viable seeds per plant generally did not change. Substantial overlap in plant size and seed production occurred among damage treatments and species. The most severe defoliation treatment did not substantially limit growth and reproduction compared with undamaged plants. While two clippings per season sometimes prevented seed production, four clippings per season was the only type of damage that consistently prevented plant growth and eliminated seed production. Pale and black swallowwort display a high tolerance to aboveground tissue loss in high-light environments without plant competition. The annual increase in plant size calls into question the potential efficacy of a defoliating insect against field populations of swallowworts, and it seems likely the only benefits of a long-term mowing regime will be to eliminate seed production.
The effect of the dietary n-3 long-chain PUFA, DHA (22 : 6n-3), on the growth of pre-term infants is controversial. We tested the effect of higher-dose DHA (approximately 1 % dietary fatty acids) on the growth of pre-term infants to 18 months corrected age compared with standard feeding practice (0·2–0·3 % DHA) in a randomised controlled trial. Infants born < 33 weeks gestation (n 657) were randomly allocated to receive breast milk and/or formula with higher DHA or standard DHA according to a concealed schedule stratified for sex and birth-weight ( < 1250 and ≥ 1250 g). The dietary arachidonic acid content of both diets was constant at approximately 0·4 % total fatty acids. The intervention was from day 2 to 5 of life until the infant's expected date of delivery (EDD). Growth was assessed at EDD, and at 4, 12 and 18 months corrected age. There was no effect of higher DHA on weight or head circumference at any age, but infants fed higher DHA were 0·7 cm (95 % CI 0·1, 1·4 cm; P = 0·02) longer at 18 months corrected age. There was an interaction effect between treatment and birth weight strata for weight (P = 0·01) and length (P = 0·04). Higher DHA resulted in increased length in infants born weighing ≥ 1250 g at 4 months corrected age and in both weight and length at 12 and 18 months corrected age. Our data show that DHA up to 1 % total dietary fatty acids does not adversely affect growth.
A flow-excited Helmholtz resonator was investigated experimentally and theoretically. The analysis was focused on a simplified momentum balance integrated over the region of the orifice. The resulting expressions were used to guide an experimental programme designed to obtain measurements of the resonator pressure under flow excitation, as well as the dynamics of the shear layer in the orifice using particle image velocimetry (PIV). The pressure measurements indicated a number of distinctive features as the flow speed varied. The PIV results provided a detailed representation of the shear layer vorticity field, as well as the equivalent hydrodynamic forcing of the resonator. The forcing magnitude was found to be roughly constant over a range of flow speeds. A model was proposed that provides a prediction of the resonator pressure fluctuations based on the thickness of the approach boundary layer, the free stream speed and the acoustic properties of the resonator. The model was shown to provide an accurate representation of the resonating frequency as well as the magnitude of the resonance to within a few decibels.
There is evidence that the prevalence of common mental disorders varies
To compare prevalence of common mental disorders in general practice
attendees in six European countries.
Unselected attendees to general practices in the UK, Spain, Portugal,
Slovenia, Estonia and The Netherlands were assessed for major depression,
panic syndrome and other anxiety syndrome. Prevalence of DSM–IV major
depression, other anxiety syndrome and panic syndrome was compared
between the UK and other countries after taking account of differences in
demographic factors and practice consultation rates.
Prevalence was estimated in 2344 men and 4865 women. The highest
prevalence for all disorders occurred in the UK and Spain, and lowest in
Slovenia and The Netherlands. Men aged 30–50 and women aged 18–30 had the
highest prevalence of major depression; men aged 40–60 had the highest
prevalence of anxiety, and men and women aged 40–50 had the highest
prevalence of panic syndrome. Demographic factors accounted for the
variance between the UK and Spain but otherwise had little impact on the
significance of observed country differences.
These results add to the evidence for real differences between European
countries in prevalence of psychological disorders and show that the
burden of care on general practitioners varies markedly between
Pale swallow-wort is a nonnative vine, invading natural areas across much of the northeastern United States and southeastern Canada. Control of this clump-forming herbaceous perennial has been difficult. We conducted a 2-yr study (2005–2006) in a heavily infested site in Chaumont, NY to assess the response of swallow-wort to triclopyr applied once as a foliar treatment (1.9 kg ae/ha) (2005 only) alone or in combination with clipping 4 wk later, followed by a single clipping in 2006. We also evaluated the response of swallow-wort to one or two clippings during each of the 2 yr. Two yr after treatments began, swallow-wort cover was lower in plots treated with triclopyr (20 ± 5%) compared with plots subjected to clipping-only (56 ± 6%) or unmanaged controls (76 ± 6%). Stem densities were also lower in triclopyr-treated plots (25 ± 5 stems/m2) than in clipping-only (188 ± 9 stems/m2) and control (178 ± 10 stems/m2) plots across three different sample dates. Seedling densities were lower in triclopyr-treated plots (160 ± 50 seedlings/m2) relative to clipping-only (1,120 ± 180 seedlings/m2) and control (960 ± 50 seedlings/m2) plots after the 2005 growing season. The cover of other plant species was negatively correlated with swallow-wort cover and was higher in triclopyr-treated plots (75 ± 3%) than in clipping-only (5 ± 1%) and control (7 ± 4%) plots in 2006. Across both years, swallow-wort in control and clipped plots produced follicles, but not in triclopyr-treated plots. Regardless of clipping frequency, clipping in June or July was not effective in reducing swallow-wort stem density, cover, or follicle production. Although a single application of triclopyr provided considerable suppression of swallow-wort after two growing seasons, application of triclopyr in subsequent years is likely required to achieve long-term control.