Validating a network hub in leukaemia stem cells

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Research versus practice in quality improvement? Understanding how we can bridge the gap

The gap between implementers and researchers of quality improvement (QI) has hampered the degree and speed of change needed to reduce avoidable suffering and harm in health care. Underlying causes of this gap include differences in goals and incentives, preferred methodologies, level and types of evidence prioritized and targeted audiences. The Salzburg Global Seminar on 'Better Health Care: How do we learn about improvement?' brought together researchers, policy makers, funders, implementers, evaluators from low-, middle- and high-income countries to explore how to increase the impact of QI. In this paper, we describe some of the reasons for this gap and offer suggestions to better bridge the chasm between researchers and implementers. Effectively bridging this gap can increase the generalizability of QI interventions, accelerate the spread of effective approaches while also strengthening the local work of implementers. Increasing the effectiveness of research and work in the field will support the knowledge translation needed to achieve quality Universal Health Coverage and the Sustainable Development Goals.Fil: Hirschhorn, Lisa R.. Northwestern University; Estados UnidosFil: Ramaswamy, Rohit. University of North Carolina; Estados UnidosFil: Devnani, Mahesh. Post Graduate Institute of Medical Education & Research; IndiaFil: Wandersman, Abraham. University Of South Carolina; Estados UnidosFil: Simpson, Lisa A.. Academy Health; Estados UnidosFil: Garcia Elorrio, Ezequiel. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Instituto de Efectividad Clínica y Sanitaria; Argentin

The latent structure and predictors of mood in people with aphasia due to left hemisphere stroke

Most studies of post-stroke mood exclude people with aphasia. Two hundred individuals with aphasia due to left hemisphere stroke of varying acuity, completed a visual analog of mood scale. Factor analysis confirmed a two factor model best represents the relationships among scales, consisting of “anxiety/depression” and “vitality” factors. Unexpectedly, mood factors were not associated with stroke acuity, pre-stroke psychiatric history, or aphasia severity. Self-perceived quality of communication life was associated with “vitality”. We conclude it is important to survey the person with aphasia regarding subjective experiences, and that mood state can be measured in the majority of people with aphasia

Sustainable Building without Certification: An Exploration of Implications and Trends

Background: Sustainable buildings play a pivotal role in meeting the United Nations Sustainable Development Goals (UN SDGs). However, the criteria and process for certification associated with sustainable building rating systems have been seen by many as either cumbersome or too expensive. As a result, some buildings are constructed following sustainable building guidelines without necessarily pursuing external certification. This paper takes a critical look at sustainable building without certification in the US and addresses 3 questions: (1) What is the rationale behind not pursuing certification? (2) When certification is not part of the objective, how are particular sustainability criteria selected? (3) To what extent do sustainable building projects that undergo certification differ from those that do not, and what are the potential implications for building performance? Methods: The study is based on a survey of thirty-two professionals in the building, engineering, and construction industries, followed by semistructured interviews with nine participants about their experience with sustainable building certification. Results: The main rationale for not pursuing certification was associated with cost. The results also suggest that while buildings that have been formally certified may have higher capital costs, they are perceived more favorably with regard to brand reputation, marketability, credibility, meeting sustainability goals, building performance, and value to occupants than buildings without certification. Conclusions: This study provides insights into the implications of assessment-related decisions in building design and construction as we look to transform our societies into more sustainable, healthier, and livable places, and support global goals for sustainable development

High-throughput continuous dielectrophoretic separation of neural stem cells.

We created an integrated microfluidic cell separation system that incorporates hydrophoresis and dielectrophoresis modules to facilitate high-throughput continuous cell separation. The hydrophoresis module consists of a serpentine channel with ridges and trenches to generate a diverging fluid flow that focuses cells into two streams along the channel edges. The dielectrophoresis module is composed of a chevron-shaped electrode array. Separation in the dielectrophoresis module is driven by inherent cell electrophysiological properties and does not require cell-type-specific labels. The chevron shape of the electrode array couples with fluid flow in the channel to enable continuous sorting of cells to increase throughput. We tested the new system with mouse neural stem cells since their electrophysiological properties reflect their differentiation capacity (e.g., whether they will differentiate into astrocytes or neurons). The goal of our experiments was to enrich astrocyte-biased cells. Sorting parameters were optimized for each batch of neural stem cells to ensure effective and consistent separations. The continuous sorting design of the device significantly improved sorting throughput and reproducibility. Sorting yielded two cell fractions, and we found that astrocyte-biased cells were enriched in one fraction and depleted from the other. This is an advantage of the new continuous sorting device over traditional dielectrophoresis-based sorting platforms that target a subset of cells for enrichment but do not provide a corresponding depleted population. The new microfluidic dielectrophoresis cell separation system improves label-free cell sorting by increasing throughput and delivering enriched and depleted cell subpopulations in a single sort

Sistem Kekerabatan Pembentuk Pola Permukiman Dusun Krajan Kabupaten Lumajang

Penduduk Dusun Krajan tergolong sebagai masyarakat Tengger. Mereka memilikiaturan tersendiri mengenai tata letak hunian antar kerabat sebagai perwujudanadat istiadat dan budaya masyarakatnya. Selain kentalnya kebudayaan, dusuntersebut juga memiliki keindahan alam yang berdampak pada bertambahnyajumlah pendatang, yang diindikasikan akan membawa kebudayaan dan tradisiberbeda. Tujuan dari penelitian ini adalah untuk mengidentifikasi dan menganalisispengaruh sistem kekerabatan terhadap pola permukiman Dusun Krajan KabupatenLumajang. Metode identifikasi yang digunakan adalah deskriptif-kualitatif, denganmetode analisis family tree. Hasil menunjukan bahwa sistem kekerabatanmemberikan pengaruh terhadap transparasi antar bangunan hunian, orientasibangunan terhadap Gunung Bromo dan Pesanggrahan, hirarki dan tata letakhunian kakak tertua dalam kelompok bangunan pada permukiman Dusun Kraja

Reactions to uncertainty and the accuracy of diagnostic mammography.

BackgroundReactions to uncertainty in clinical medicine can affect decision making.ObjectiveTo assess the extent to which radiologists' reactions to uncertainty influence diagnostic mammography interpretation.DesignCross-sectional responses to a mailed survey assessed reactions to uncertainty using a well-validated instrument. Responses were linked to radiologists' diagnostic mammography interpretive performance obtained from three regional mammography registries.ParticipantsOne hundred thirty-two radiologists from New Hampshire, Colorado, and Washington.MeasurementMean scores and either standard errors or confidence intervals were used to assess physicians' reactions to uncertainty. Multivariable logistic regression models were fit via generalized estimating equations to assess the impact of uncertainty on diagnostic mammography interpretive performance while adjusting for potential confounders.ResultsWhen examining radiologists' interpretation of additional diagnostic mammograms (those after screening mammograms that detected abnormalities), a 5-point increase in the reactions to uncertainty score was associated with a 17% higher odds of having a positive mammogram given cancer was diagnosed during follow-up (sensitivity), a 6% lower odds of a negative mammogram given no cancer (specificity), a 4% lower odds (not significant) of a cancer diagnosis given a positive mammogram (positive predictive value [PPV]), and a 5% higher odds of having a positive mammogram (abnormal interpretation).ConclusionMammograms interpreted by radiologists who have more discomfort with uncertainty have higher likelihood of being recalled

An Eigenvector-Based Test for Local Stationarity Applied to Array Processing

In sonar array processing, a challenging problem is the estimation of the data covariance matrix in the presence of moving targets in the water column, since the time interval of data local stationarity is limited. This work describes an eigenvector-based method for proper data segmentation into intervals that exhibit local stationarity, providing data-driven higher bounds for the number of snapshots available for computation of time-varying sample covariance matrices. Application of the test is illustrated with simulated data in a horizontal array for the detection of a quiet source in the presence of a loud interferer

A new approach to generating research-quality data through citizen science: The USA National Phenology Monitoring System

Phenology is one of the most sensitive biological responses to climate change, and recent changes in phenology have the potential to shake up ecosystems. In some cases, it appears they already are. Thus, for ecological reasons it is critical that we improve our understanding of species’ phenologies and how these phenologies are responding to recent, rapid climate change. Phenological events like flowering and bird migrations are easy to observe, culturally important, and, at a fundamental level, naturally inspire human curiosity— thus providing an excellent opportunity to engage citizen scientists. The USA National Phenology Network has recently initiated a national effort to encourage people at different levels of expertise—from backyard naturalists to professional scientists—to observe phenological events and contribute to a national database that will be used to greatly improve our understanding of spatio-temporal variation in phenology and associated phenological responses to climate change.

Traditional phenological observation protocols identify specific dates at which individual phenological events are observed. The scientific usefulness of long-term phenological observations could be improved with a more carefully structured protocol. At the USA-NPN we have developed a new approach that directs observers to record each day that they observe an individual plant, and to assess and report the state of specific life stages (or phenophases) as occurring or not occurring on that plant for each observation date. Evaluation is phrased in terms of simple, easy-to-understand, questions (e.g. “Do you see open flowers?”), which makes it very appropriate for a citizen science audience. From this method, a rich dataset of phenological metrics can be extracted, including the duration of a phenophase (e.g. open flowers), the beginning and end points of a phenophase (e.g. traditional phenological events such as first flower and last flower), multiple distinct occurrences of phenophases within a single growing season (e.g multiple flowering events, common in drought-prone regions), as well as quantification of sampling frequency and observational uncertainties. These features greatly enhance the utility of the resulting data for statistical analyses addressing questions such as how phenological events vary in time and space, and in response to global change. This new protocol is an important step forward, and its widespread adoption will increase the scientific value of data collected by citizen scientists.
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A common and unstable copy number variant is associated with differences in Glo1 expression and anxiety-like behavior

Glyoxalase 1 (Glo1) has been implicated in anxiety-like behavior in mice and in multiple psychiatric diseases in humans. We used mouse Affymetrix exon arrays to detect copy number variants (CNV) among inbred mouse strains and thereby identified a approximately 475 kb tandem duplication on chromosome 17 that includes Glo1 (30,174,390-30,651,226 Mb; mouse genome build 36). We developed a PCR-based strategy and used it to detect this duplication in 23 of 71 inbred strains tested, and in various outbred and wild-caught mice. Presence of the duplication is associated with a cis-acting expression QTL for Glo1 (LOD>30) in BXD recombinant inbred strains. However, evidence for an eQTL for Glo1 was not obtained when we analyzed single SNPs or 3-SNP haplotypes in a panel of 27 inbred strains. We conclude that association analysis in the inbred strain panel failed to detect an eQTL because the duplication was present on multiple highly divergent haplotypes. Furthermore, we suggest that non-allelic homologous recombination has led to multiple reversions to the non-duplicated state among inbred strains. We show associations between multiple duplication-containing haplotypes, Glo1 expression and anxiety-like behavior in both inbred strain panels and outbred CD-1 mice. Our findings provide a molecular basis for differential expression of Glo1 and further implicate Glo1 in anxiety-like behavior. More broadly, these results identify problems with commonly employed tests for association in inbred strains when CNVs are present. Finally, these data provide an example of biologically significant phenotypic variability in model organisms that can be attributed to CNVs.These studies were funded by MH070933, MH79103 and MH020065