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The COVID-19 pandemic has put the UK's National Health Service under extreme pressure, and acute psychiatric services have had to rapidly adapt to a new way of working. This editorial describes the experience of a London psychiatric intensive care unit (PICU) where all nine in-patients ultimately tested COVID-19 positive.
Douglas Nakashima, United Nations Educational, Scientific and Cultural Organization (UNESCO), France,Igor Krupnik, Smithsonian Institution, Washington DC,Jennifer T. Rubis, United Nations Educational, Scientific and Cultural Organization (UNESCO), France
Whether monozygotic (MZ) and dizygotic (DZ) twins differ from each other in a variety of phenotypes is important for genetic twin modeling and for inferences made from twin studies in general. We analyzed whether there were differences in individual, maternal and paternal education between MZ and DZ twins in a large pooled dataset. Information was gathered on individual education for 218,362 adult twins from 27 twin cohorts (53% females; 39% MZ twins), and on maternal and paternal education for 147,315 and 143,056 twins respectively, from 28 twin cohorts (52% females; 38% MZ twins). Together, we had information on individual or parental education from 42 twin cohorts representing 19 countries. The original education classifications were transformed to education years and analyzed using linear regression models. Overall, MZ males had 0.26 (95% CI [0.21, 0.31]) years and MZ females 0.17 (95% CI [0.12, 0.21]) years longer education than DZ twins. The zygosity difference became smaller in more recent birth cohorts for both males and females. Parental education was somewhat longer for fathers of DZ twins in cohorts born in 1990–1999 (0.16 years, 95% CI [0.08, 0.25]) and 2000 or later (0.11 years, 95% CI [0.00, 0.22]), compared with fathers of MZ twins. The results show that the years of both individual and parental education are largely similar in MZ and DZ twins. We suggest that the socio-economic differences between MZ and DZ twins are so small that inferences based upon genetic modeling of twin data are not affected.
Training for the clinical research workforce does not sufficiently prepare workers for today’s scientific complexity; deficiencies may be ameliorated with training. The Enhancing Clinical Research Professionals’ Training and Qualifications developed competency standards for principal investigators and clinical research coordinators.
Clinical and Translational Science Awards representatives refined competency statements. Working groups developed assessments, identified training, and highlighted gaps.
Forty-eight competency statements in 8 domains were developed.
Training is primarily investigator focused with few programs for clinical research coordinators. Lack of training is felt in new technologies and data management. There are no standardized assessments of competence.
The translation of discoveries to drugs, devices, and behavioral interventions requires well-prepared study teams. Execution of clinical trials remains suboptimal due to varied quality in design, execution, analysis, and reporting. A critical impediment is inconsistent, or even absent, competency-based training for clinical trial personnel.
In 2014, the National Center for Advancing Translational Science (NCATS) funded the project, Enhancing Clinical Research Professionals’ Training and Qualifications (ECRPTQ), aimed at addressing this deficit. The goal was to ensure all personnel are competent to execute clinical trials. A phased structure was utilized.
This paper focuses on training recommendations in Good Clinical Practice (GCP). Leveraging input from all Clinical and Translational Science Award hubs, the following was recommended to NCATS: all investigators and study coordinators executing a clinical trial should understand GCP principles and undergo training every 3 years, with the training method meeting the minimum criteria identified by the International Conference on Harmonisation GCP.
We anticipate that industry sponsors will acknowledge such training, eliminating redundant training requests. We proposed metrics to be tracked that required further study. A separate task force was composed to define recommendations for metrics to be reported to NCATS.
A trend toward greater body size in dizygotic (DZ) than in monozygotic (MZ) twins has been suggested by some but not all studies, and this difference may also vary by age. We analyzed zygosity differences in mean values and variances of height and body mass index (BMI) among male and female twins from infancy to old age. Data were derived from an international database of 54 twin cohorts participating in the COllaborative project of Development of Anthropometrical measures in Twins (CODATwins), and included 842,951 height and BMI measurements from twins aged 1 to 102 years. The results showed that DZ twins were consistently taller than MZ twins, with differences of up to 2.0 cm in childhood and adolescence and up to 0.9 cm in adulthood. Similarly, a greater mean BMI of up to 0.3 kg/m2 in childhood and adolescence and up to 0.2 kg/m2 in adulthood was observed in DZ twins, although the pattern was less consistent. DZ twins presented up to 1.7% greater height and 1.9% greater BMI than MZ twins; these percentage differences were largest in middle and late childhood and decreased with age in both sexes. The variance of height was similar in MZ and DZ twins at most ages. In contrast, the variance of BMI was significantly higher in DZ than in MZ twins, particularly in childhood. In conclusion, DZ twins were generally taller and had greater BMI than MZ twins, but the differences decreased with age in both sexes.
Literature made front-page news in Australia on 3 November 2006: not a common occurrence. In Patrick White's home town, the lead story in the broadsheet Sydney Morning Herald was a report by his biographer David Marr about the National Library of Australia's purchase of a collection of Patrick White's papers, previously thought destroyed, from his agent and literary executor, Barbara Mobbs. ‘The old bastard,’ Marr began. ‘Patrick White told the world over and over again that none of this existed. “Don't bother hunting for drafts and manuscripts,” he snapped when I asked him years ago. “They've all gone into the pit.” They hadn't.’ Other media, both in Australia and internationally, picked up the story. The Times Literary Supplement ran a major essay on White by novelist David Malouf, while the Australian Book Review carried a piece by Marie-Louise Ayres, then the Library's curator of manuscripts, in which she described the material and indicated some of the insights it provides.
In preparation for the announcement of this extraordinary acquisition, Dr Ayres had led National Library of Australia (NLA) staff in an operation conducted in secrecy. They compiled a finding list of the 33 boxes of material found for release simultaneously with the announcement: an extremely valuable document describing the various items in the collection, which itself made history because of the way in which it was put together. Such catalogues are usually the work of a single librarian over an extended period, whereas this team performed the task in a matter of weeks. A small exhibition accompanied the announcement: it included realia like White's trademark beret and beanie, a pair of his spectacles and a selection of manuscript material. The librarians involved were aware that they were part of a once-in-a-lifetime experience; scholars round the world were stirred (there were early enquiries from as far afield as Scandinavia and the United States); and there was considerable public interest.
Soon, it was apparent that this material constituted ‘literary treasure’ in Marr's phrase. He was able to show, for example, that throughout the 10 working notebooks are scattered drafts for the openings of half a dozen of White's novels, including The Aunt's Story (1948). The richness of the treasure has become even more apparent as we have embarked on plumbing the depths of MS9982.
For over 100 years, the genetics of human anthropometric traits has attracted scientific interest. In particular, height and body mass index (BMI, calculated as kg/m2) have been under intensive genetic research. However, it is still largely unknown whether and how heritability estimates vary between human populations. Opportunities to address this question have increased recently because of the establishment of many new twin cohorts and the increasing accumulation of data in established twin cohorts. We started a new research project to analyze systematically (1) the variation of heritability estimates of height, BMI and their trajectories over the life course between birth cohorts, ethnicities and countries, and (2) to study the effects of birth-related factors, education and smoking on these anthropometric traits and whether these effects vary between twin cohorts. We identified 67 twin projects, including both monozygotic (MZ) and dizygotic (DZ) twins, using various sources. We asked for individual level data on height and weight including repeated measurements, birth related traits, background variables, education and smoking. By the end of 2014, 48 projects participated. Together, we have 893,458 height and weight measures (52% females) from 434,723 twin individuals, including 201,192 complete twin pairs (40% monozygotic, 40% same-sex dizygotic and 20% opposite-sex dizygotic) representing 22 countries. This project demonstrates that large-scale international twin studies are feasible and can promote the use of existing data for novel research purposes.
Prodigiously learned, alive to the massive social changes of her time, defiant of many Victorian orthodoxies, George Eliot has always challenged her readers. She is at once chronicler and analyst, novelist of nostalgia and monumental thinker. In her great novel Middlemarch she writes of 'that tempting range of relevancies called the universe'. This volume identifies a range of 'relevancies' that inform both her fictional and her non-fictional writings. The range and scale of her achievement are brought into focus by cogent essays on the many contexts - historical, intellectual, political, social, cultural - to her work. In addition there are discussions of her critical history and legacy, as well as of the material conditions of production and distribution of her novels and her journalism. The volume enables fuller understanding and appreciation, from a twenty-first-century standpoint, of the life and work of one of the nineteenth century's major writers.