Learning From Incidents Questionnaire (LFIQ): the validation of an instrument designed to measure the quality of learning from incidents in organisations

Effective learning is essential for a safe workplace. Through learning from incidents (LFI), knowledge is applied and embedded within the work environment in ways that can prevent future incidents. In order to improve their LFI processes, such as incident reporting and analysis, or the dissemination of investigation outputs, organisations need an instrument that allows them to diagnose the quality and effectiveness of their LFI processes, making sure that LFI leads to positive safety outcomes. This paper outlines an instrument that measures the quality of LFI processes and practices: the Learning from Incident Questionnaire (LFIQ). The LFIQ identifies employees’ perceptions and experiences of LFI processes and practices. This paper describes the validation of the LFIQ instrument via a pilot study conducted at two energy companies involving 781 participants. Through factor analysis the instrument was shown to have sufficient validity to become a useful tool for industry; by gaining insight into employees’ perspectives on LFI, frontline managers and supervisors can have evidence on which to base improvements to the local work environment and prioritise areas for improvement

Comprehensive Data Management System for National Patient-Centered Outcomes Research for Comparative Effectiveness in Total Joint Replacement

Introduction: The Agency for Healthcare Research and Quality (AHRQ) funded research program, Function and Outcomes Research for Comparative Effectiveness in Total Joint Replacement (FORCE-TJR), is a national patient-centered outcomes research registry. To serve such multi-center longitudinal patient-reported outcomes research, we designed an innovative system to support systematic data collection, management and quality monitoring for long-term outcome evaluation of care. Methods: The system structure design explicitly considered the continuum of study procedures, including patient enrollment, patient-reported baseline and follow-up surveys, joint implant components, and ambulatory record review for future potential adverse events. Patient enrollment process is recorded through a web-based data capture system. Patient-reported outcomes are completed by patients via scannable paper or web-based standardized surveys before and after surgery. Patient risk factors and implant components are collected from community-based orthopedic practices and hospital operating rooms. All data from the different sources are combined into a centralized database. Quality checks and monitoring processes are routinely conducted for each source of data. De-identified data are cleaned and scored for research analysis and surgeon quality reporting. Results: This system for the registry program was initiated in 2011. As of Feburary 2014, over 16,000 patients have been enrolled from more than 130 surgeons in 22 states. The centralized database integrating data from patients, surgeons and hospitals is updated weekly. Cleaned, scored data are provided quaterly for all surgeons to review their site- and individual-surgeon-specific outcomes through web reports. Discussion: This comprehensive data management system is expected to enhance future uses of multi-source data to guide surgeon decisions and drive quality improvement. We anticipate that this system will facilitate translation of data integration to broad clinical research to inform best practices in TJR

Fatigue in Medical Residents Leads to Reactivation of Herpes Virus Latency

The main objective of this study was to detect fatigue-induced clinical symptoms of immune suppression in medical residents. Samples were collected from the subjects at rest, following the first night (low-stress), and the last night (high-stress) of night float. Computerized reaction tests, Epworth Sleepiness Scale, and Wellness Profile questionnaires were used to quantify fatigue level. DNA of human herpes viruses HSV-1, VZV, EBV, as well as cortisol and melatonin concentrations, were measured in saliva. Residents at the high-stress interval reported being sleepier compared to the rest interval. EBV DNA level increased significantly at both stress intervals, while VZV DNA level increased only at low-stress. DNA levels of HSV-1 decreased at low-stress but increased at high-stress. Combined assessment of the viral DNA showed significant effect of stress on herpes virus reactivation at both stress intervals. Cortisol concentrations at both stress intervals were significantly higher than those at rest

WALLABY Early Science - I. The NGC 7162 Galaxy Group

We present Widefield ASKAP L-band Legacy All-sky Blind Survey (WALLABY) early science results from the Australian Square Kilometre Array Pathfinder (ASKAP) observations of the NGC 7162 galaxy group. We use archival HIPASS and Australia Telescope Compact Array (ATCA) observations of this group to validate the new ASKAP data and the data reduction pipeline ASKAPsoft. We detect six galaxies in the neutral hydrogen (HI) 21-cm line, expanding the NGC 7162 group membership from four to seven galaxies. Two of the new detections are also the first HI detections of the dwarf galaxies, AM 2159-434 and GALEXASC J220338.65-431128.7, for which we have measured velocities of $cz=2558$ and $cz=2727$ km s$^{-1}$, respectively. We confirm that there is extended HI emission around NGC 7162 possibly due to past interactions in the group as indicated by the $40^{\circ}$ offset between the kinematic and morphological major axes for NGC 7162A, and its HI richness. Taking advantage of the increased resolution (factor of $\sim1.5$) of the ASKAP data over archival ATCA observations, we fit a tilted ring model and use envelope tracing to determine the galaxies' rotation curves. Using these we estimate the dynamical masses and find, as expected, high dark matter fractions of $f_{\mathrm{DM}}\sim0.81-0.95$ for all group members. The ASKAP data are publicly available.Comment: 20 pages, 11 figures, accepted for publication in MNRA

Both intratumoral regulatory T cell depletion and CTLA-4 antagonism are required for maximum efficacy of anti-CTLA-4 antibodies

Anti-CTLA-4 antibodies have successfully elicited durable tumor regression in the clinic; however, long-term benefit is limited to a subset of patients for select cancer indications. The incomplete understanding of their mechanism of action has hindered efforts at improvement, with conflicting hypotheses proposing either antagonism of the CTLA-4:B7 axis or Fc effector-mediated regulatory T cell (Treg) depletion governing efficacy. Here, we report the engineering of a nonantagonistic CTLA-4 binding domain (b1s1e2) that depletes intratumoral Tregs as an Fc fusion. Comparison of b1s1e2-Fc to 9d9, an antagonistic anti-CTLA-4 antibody, allowed for interrogation of the separate contributions of CTLA-4 antagonism and Treg depletion to efficacy. Despite equivalent levels of intratumoral Treg depletion, 9d9 achieved more long-term cures than b1s1e2-Fc in MC38 tumors, demonstrating that CTLA-4 antagonism provided additional survival benefit. Consistent with prior reports that CTLA-4 antagonism enhances priming, treatment with 9d9, but not b1s1e2-Fc, increased the percentage of activated T cells in the tumor-draining lymph node (tdLN). Treg depletion with either construct was restricted to the tumor due to insufficient surface CTLA-4 expression on Tregs in other compartments. Through intratumoral administration of diphtheria toxin in Foxp3-DTR mice, we show that depletion of both intratumoral and nodal Tregs provided even greater survival benefit than 9d9, consistent with Treg-driven restraint of priming in the tdLN. Our data demonstrate that anti-CTLA-4 therapies require both CTLA-4 antagonism and intratumoral Treg depletion for maximum efficacy-but that potential future therapies also capable of depleting nodal Tregs could show efficacy in the absence of CTLA-4 antagonism

Volume 05

Introduction from Dean Dr. Charles Ross The Tallis House as an Extension of Emily Tallis in McEwan\u27s Atonement by Ian Karamarkovich Graphic Design by Jessica Cox Graphic Design by Kyle Fowlkes Graphic Design by Allison Pawlowski Incorporating Original Research in The Classroom: A Case Study Analyzing the Influence of the Chesapeake Bay on Local Temperatures by Kaitlin Major, Carrie Dunham and Dr. Kelsey Scheitlin Graphic Design by Kathryn Grayson Graphic Design by Ashley Johnson Facing the Music: Environmental Impact Assessment of Building A Concert Hall on North Campus by Jennifer Nehrt, Kelsey Stolzenbach And Dr. Kelsey Scheitlin Art by Kristin McQuarrie Art by Sara Nelson Art by Melisa Michelle Prosocial Behavior as a Result of Prosocial Music by Jessica Sudlow Graphic Design by Perry Bason Graphic Design by Danielle Dmuchawski Graphic Design by Mariah Asbell Graphic Design by Matthew Sakach Identifying Pathogenic Salmonella Serotypes Isolated from Prince Edward County, VA Waterways via Mutiplex PCR Analysis by Timothy Smith, Jr. Art by Annaliese Troxell Art by T. Dane Summerell Development of Salicylidene Anilines for Application in the High School Laboratory by Sarah Ganrude Graphic Design by Malina Rutherford Graphic Design by Hannah Hopper, and Matthew Sakach Because That\u27s What Daddies Do: Effects of Fathering Patterns on Son\u27s Self and Gender Identities by John Berry, Jr. Graphic Design by James Early Graphic Design by Colleen Festa The Influence of Tropical Cyclones on Chesapeake Bay Dead Zones by Chelsea D. Taylor and Dr. Kelsey Scheitlin Graphic Design by Michelle Maddox Graphic Design by Kaitlyn Smith Graphic Design by Sarah Schu Graphic Design by Perry Bason, Cabell Edmunds, Katherine Grayson, Matthew Sakach, and Kayla Torna

Models of classroom assessment for course-based research experiences

Course-based research pedagogy involves positioning students as contributors to authentic research projects as part of an engaging educational experience that promotes their learning and persistence in science. To develop a model for assessing and grading students engaged in this type of learning experience, the assessment aims and practices of a community of experienced course-based research instructors were collected and analyzed. This approach defines four aims of course-based research assessment—(1) Assessing Laboratory Work and Scientific Thinking; (2) Evaluating Mastery of Concepts, Quantitative Thinking and Skills; (3) Appraising Forms of Scientific Communication; and (4) Metacognition of Learning—along with a set of practices for each aim. These aims and practices of assessment were then integrated with previously developed models of course-based research instruction to reveal an assessment program in which instructors provide extensive feedback to support productive student engagement in research while grading those aspects of research that are necessary for the student to succeed. Assessment conducted in this way delicately balances the need to facilitate students’ ongoing research with the requirement of a final grade without undercutting the important aims of a CRE education

Risk factors for Coronavirus disease 2019 (Covid-19) death in a population cohort study from the Western Cape province, South Africa

Risk factors for coronavirus disease 2019 (COVID-19) death in sub-Saharan Africa and the effects of human immunodeficiency virus (HIV) and tuberculosis on COVID-19 outcomes are unknown. We conducted a population cohort study using linked data from adults attending public-sector health facilities in the Western Cape, South Africa. We used Cox proportional hazards models, adjusted for age, sex, location, and comorbidities, to examine the associations between HIV, tuberculosis, and COVID-19 death from 1 March to 9 June 2020 among (1) public-sector “active patients” (≥1 visit in the 3 years before March 2020); (2) laboratory-diagnosed COVID-19 cases; and (3) hospitalized COVID-19 cases. We calculated the standardized mortality ratio (SMR) for COVID-19, comparing adults living with and without HIV using modeled population estimates.Among 3 460 932 patients (16% living with HIV), 22 308 were diagnosed with COVID-19, of whom 625 died. COVID19 death was associated with male sex, increasing age, diabetes, hypertension, and chronic kidney disease. HIV was associated with COVID-19 mortality (adjusted hazard ratio [aHR], 2.14; 95% confidence interval [CI], 1.70–2.70), with similar risks across strata of viral loads and immunosuppression. Current and previous diagnoses of tuberculosis were associated with COVID-19 death (aHR, 2.70 [95% CI, 1.81–4.04] and 1.51 [95% CI, 1.18–1.93], respectively). The SMR for COVID-19 death associated with HIV was 2.39 (95% CI, 1.96–2.86); population attributable fraction 8.5% (95% CI, 6.1–11.1)