Despite understanding its impact on organizational effectiveness, practical guidance on how to train translational team (TT) leaders is lacking. Previously, we developed an evolutionary learning model of TT maturation consisting of three goal-directed phases: (1). team assembly (Formation); (2). conducting research (Knowledge Generation); and (3). dissemination and implementation (Translation). At each phase, the team acquires group-level knowledge, skills, and attitudes (KSAs) that enhance its performance. Noting that the majority of team-emergent KSAs are promoted by leadership behaviors, we examine the SciTS literature to identify the relevant behaviors for each phase. We propose that effective team leadership evolves from a hierarchical, transformational model early in team Formation to a shared, functional leadership model during Translation. We synthesized an integrated model of TT leadership, mapping a generic “functional leadership” taxonomy to relevant leadership behaviors linked to TT performance, creating an evidence-informed Leadership and Skills Enhancement for Research (LASER) training program. Empirical studies indicate that leadership behaviors are stable across time; to enhance leadership skills, ongoing reflection, evaluation, and practice are needed. We provide a comprehensive multi-level evaluation framework for tracking the growth of TT leadership skills. This work provides a framework for assessing and training relevant leadership behaviors for high-performance TTs.

As an effective drag reduction and thermal protection technology, the opposing jet can guarantee the flight safety of the hypersonic vehicle. In this paper, the jet mode transition is realised by controlling the total jet pressure ratio value (PR) with a function. The jet mode transition from the long penetration mode (LPM) to the short penetration mode (SPM) uses an increasing function. However, the jet mode transition from SPM to LPM uses a decreasing function. The flow field reconstruction process of a two-dimensional axisymmetric blunt body model in the hypersonic flow is studied when the jet mode transition between SPM and LPM changes into each other. The flow field structures and wall parameters of the LPM and SPM transition processes are obtained. The results indicate that the drag and Stanton number both decrease in the transition stage from LPM to SPM, and this is beneficial for the improvement of the drag reduction and thermal protection effect. The peak values of drag and Stanton number fall by 36.39% and 46.40%, respectively. When the jet mode transforms from SPM to LPM, the Stanton number increases, and the drag force first increases and then decreases. However, the final drag reduction effect is not obvious. With the increase in the change rate of the total pressure ratio of the two jet transformation modes, the jet mode transition time is advanced, and the flow field changes more violently.

Background: Tuberculosis is an airborne disease caused by Mycobacterium Tuberculosis. Intracranial tuberculoma is a rare complication of extrapulmonary tuberculosis due to hematogenous spread to subpial and subependymal regions. Intracranial tuberculoma can occur with or without meningitis. Methods: A 3-year-old male who recently emigrated from Sudan presented to the emergency department with right-sided seizures lasting 30 minutes which were aborted with levetiracetam and midazolam. CT head revealed a multilobulated left supratentorial mass, with solid and cystic components measuring 8.0 x 4.8 x 6.5 cm. The patient had successful surgical resection of the mass which was positive for Mycobacterium Tuberculosis. He was started on rifampin, isoniazid, pyrazinamide, ethambutol, and fluoroquinolone and discharged home in stable condition. Results: Literature review on pediatric intracranial tuberculoma was performed which included 48 studies (n=49). The mean age was 8.8 ± 5.4 years with slight female predilection (59%). Predominant solitary tuberculomas (63%) were preferentially managed with both surgical resection and antitubercular therapy (ATT) compared to multifocal tuberculomas that were preferentially managed with ATT. Conclusions: Intracranial tuberculoma is a rare but treatable cause of space-occupying lesions in children. Clinicians should maintain high-level of suspicion in patients from endemic regions and involve infectious disease service early in patient’s care.

Background: Neurosurgery is a high-risk specialty with a low margin of error. We aim to assess the risk of neurosurgeons being involved in medicolegal cases in Canada. Methods: This retrospective descriptive study evaluated ten years (2012-2021) of closed legal cases, college cases, and hospital complaints against neurosurgeons with data from the CMPA. Included cases were cranial cases, VP shunts, or cases where a catheter or wire was inserted into the brain. Cases excluded angiography, radiation, ultrasound, or percutaneous procedures. Results: We identified 77 cases (66 urgent or emergent). Neurosurgeons had a significantly higher medicolegal risk than the CMPA surgeon membership, however lower risk compared to all physician specialties. Legal cases accounted for 69% with favourable outcomes in 52%. Forty-one cases involved post-operative complications and 16 cases involved VP shunts. Multiple surgeons or residents could be involved spanning age groups and years in practice. Thirty-four cases had a harmful incident, 41% of these severe. The majority of cases occurred at urban centers. The average case duration was 41 months. Conclusions: This study provides a recent medicolegal analysis of cranial neurosurgery in Canada. We identified areas of common complaints and hope the data can be used to mitigate risk surgical risk in the future.

Background: In meningiomas, CDKN2A/B deletions are associated with poor outcomes but are rare in most cohorts (1-5%). Large molecular datasets are therefore required to explore these deletions and their relationship to other prognostic CDKN2A alterations. Methods: We utilized multidimensional molecular data of 560 meningiomas from 5 independent cohorts to comprehensively interrogate the spectrum of CDKN2A alterations through DNA methylation, copy number variation, transcriptomics, and proteomics using an integrated molecular approach. Results: Meningiomas with either CDKN2A/B deletions (partial or homozygous loss) or an intact CDKN2A gene locus but elevated mRNA expression (CDKN2Ahigh) both had poor clinical outcomes. Increased CDKN2A mRNA expression was a poor prognostic factor independent of CDKN2A deletion. CDKN2A expression and p16 protein increased with tumor grade and more aggressive molecular and methylation groups. CDKN2Ahigh meningiomas and meningiomas with CDKN2A deletions were enriched for similar cell cycling pathways dysregulated at different checkpoints. p16 immunohistochemistry was unreliable in differentiating between meningiomas with and without CDKN2A deletions, but increased positivity was associated with increased mRNA expression. CDKN2Ahigh meningiomas were associated with gene hypermethylation, Rb-deficiency, and lack of response to CDK inhibition. Conclusions: These findings support the role of CDKN2A mRNA expression as a biomarker of clinically aggressive meningiomas with potential therapeutic implications.

Opportunities exist to leverage mobile phones to replace or supplement in-person supervision of lay counselors. However, contextual variables, such as network connectivity and provider preferences, must be considered. Using an iterative and mixed methods approach, we co-developed implementation guidelines to support the implementation of mobile phone supervision with lay counselors and supervisors delivering a culturally adapted trauma-focused cognitive behavioral therapy in Western Kenya. Guidelines were shared and discussed with lay counselors in educational outreach visits led by supervisors. We evaluated the impact of guidelines and outreach on the acceptability, feasibility, and usability of mobile phone supervision. Guidelines were associated with significant improvements in acceptability and usability of mobile phone supervision. There was no evidence of a significant difference in feasibility. Qualitative interviews with lay counselors and supervisors contextualized how guidelines impacted acceptability and feasibility – by setting expectations for mobile phone supervision, emphasizing importance, increasing comfort, and sharing strategies to improve mobile phone supervision. Introducing and discussing co-developed implementation guidelines significantly improved the acceptability and usability of mobile phone supervision. This approach may provide a flexible and scalable model to address challenges with implementing evidence-based practices and implementation strategies in lower-resourced areas.

Preterm birth has been associated with insulin resistance and beta-cell dysfunction, a hallmark characteristic of type 2 diabetes. However, studies investigating the relationship between a personal history of being born preterm and type 2 diabetes are sparse. We sought to investigate the potential association between a personal history of being born preterm and risk for type 2 diabetes in a racially and ethnically diverse population. Baseline and incident data (>16 years of follow-up) from the Women’s Health Initiative (n = 85,356) were used to examine the association between personal history of being born preterm (born 1910–1940s) and prevalent (baseline enrollment; cross-sectional) or incident (prospective cohort) cases of type 2 diabetes. Logistic and Cox proportional hazards regression models were used to estimate odds and hazards ratios. Being born preterm was significantly, positively associated with odds for prevalent type 2 diabetes at enrollment (adjOR = 1.79, 95% CI 1.43–2.24; P < 0.0001). Stratified regression models suggested the positive associations at baseline were consistent across race and ethnicity groups. However, being born preterm was not significantly associated with risk for incident type 2 diabetes. Regression models stratified by age at enrollment suggest the relationship between being born preterm and type 2 diabetes persists only among younger age groups. Preterm birth was associated with higher risk of type 2 diabetes but only in those diagnosed with type 2 diabetes prior to study enrollment, suggesting the association between preterm birth and type 2 diabetes may exist at earlier age of diagnosis but wane over time.

Collaborative planning for multiple hypersonic vehicles can effectively improve operational effectiveness. Time coordination is one of the main forms of cooperation among multi-hypersonic glide vehicles, and time cooperation trajectory optimisation is a key technology that can significantly increase the success rate of flight missions. However, it is difficult to obtain satisfactory time as a constraint condition during trajectory optimisation. To solve this problem, a multilayer Perceptrona is trained and adopted in a time-decision module, whose input is a four-dimensional vector selected according to the trajectory characteristics. Additionally, the MLP will be capable of determining the optimal initial heading angle of each aircraft to reduce unnecessary manoeuvering performance consumption in the flight mission. Subsequently, to improve the cooperative flight performance of hypersonic glide vehicles, the speed-dependent angle-of-attack and bank command were designed and optimised using the Artificial Bee Colony algorithm. The final simulation results show that the novel strategy proposed in this study can satisfy terminal space constraints and collaborative time constraints simultaneously. Meanwhile, each aircraft saves an average of 13.08% flight range, and the terminal speed is increased by 315.6m/s compared to the optimisation results of general purpose optimal control software (GPOPS) tools.

We consider the stability of laminar high-Reynolds-number flow through a planar channel formed by a rigid wall and a heavy compliant wall under longitudinal tension with motion resisted by structural damping. Numerical simulations indicate that the baseline state (with Poiseuille flow and a flat wall) exhibits two unstable normal modes: the Tollmien–Schlichting (TS) mode and a surface-based mode which manifests as one of two flow-induced surface instabilities (FISI), known as travelling wave flutter (TWF) and static divergence (SD), respectively. In the absence of wall damping the system is unstable to TWF, where the neutrally stable wavelength becomes shorter as the wall mass increases. With wall damping, TWF is restricted to long wavelengths through interaction with the most unstable centre mode, while for wall damping greater than a critical value the system exhibits an SD mode with a two branch neutral stability curve; the critical conditions along the upper and lower branches are constructed in the limit of large wall damping. We compute the Reynolds–Orr and activation energy descriptions of these neutrally stable FISI by continuing the linear stability analysis to the following order in perturbation amplitude. We find that both FISI are primarily driven by the working of normal stress on the flexible wall, lower-branch SD has negative activation energy, while upper-branch SD approaches zero activation energy in the limit of large wall damping. Finally, we elucidate interaction between TS and TWF modes for large wall mass, resulting in stable islands within unstable regions of parameter space.