Bug-in-Ear Technology as a Clinical Teaching Tool for Au.D. Education: A Pilot Study

Traditional forms of clinical pedagogy include post-observation feedback and side-by-side coaching. The purpose of this pilot study was to evaluate a newer strategy, bug-in-ear technology (BIET), in which clinical supervisors provide live feedback through a discrete earpiece. BIET has the potential to overcome limitations associated with traditional clinical pedagogy. This pilot study compared side-by-side coaching to BIET coaching, using standardized patients in an on-campus audiology clinic. In this study, first-year Au.D. students conducted a case history assessment for two standardized patients. Likert-response ratings and qualitative data from open-set questions indicated BIET coaching was well received by supervisors because it provided a discrete way to deliver quick, live feedback to students. Although supervisor ratings of BIET were slightly more positive than student ratings, comments from both students and supervisors indicated they could see BIET coaching working well in the future, with modifications. Likert-response items indicated student preference for BIET was associated with feelings of confidence and desire to use BIET. More research is needed to examine ways in which BIET coaching can be operationalized to support audiology clinical education

Blue Whales Respond to Anthropogenic Noise

Anthropogenic noise may significantly impact exposed marine mammals. This work studied the vocalization response of endangered blue whales to anthropogenic noise sources in the mid-frequency range using passive acoustic monitoring in the Southern California Bight. Blue whales were less likely to produce calls when mid-frequency active sonar was present. This reduction was more pronounced when the sonar source was closer to the animal, at higher sound levels. The animals were equally likely to stop calling at any time of day, showing no diel pattern in their sensitivity to sonar. Conversely, the likelihood of whales emitting calls increased when ship sounds were nearby. Whales did not show a differential response to ship noise as a function of the time of the day either. These results demonstrate that anthropogenic noise, even at frequencies well above the blue whales' sound production range, has a strong probability of eliciting changes in vocal behavior. The long-term implications of disruption in call production to blue whale foraging and other behaviors are currently not well understood

Shorting the Climate: Fossil Fuel Finance Report Card 2016

This seventh annual report card on energy financing evaluates top global private sector banks based on their financing for the fossil fuel industry. For 2016, the report has been expanded to high-risk subsectors of the oil and gas industry. It also analyzes patterns of private bank financing for coal, oil, and gas projects that have been financially disastrous and inflicted severe damage on communities, ecosystems, and the climate. The report identifies pervasive risk management failures across the North American and European banking sector on fossil fuel financing and calls for a fundamental realignment of bank energy financing to end support for fossil fuel projects and companies that are incompatible with climate stabilization.In the past three years, the North American and European commercial and investment banking sector has engaged in fossil fuel financing practices that are deeply at odds with the global climate agreement reached at COP 21 last December. The Paris Climate Agreement's target of limiting warming to 1.5°C (or, at most, 2°C) above pre-industrial levels will require a rapid decarbonization of the global energy system. Distressingly, levels of fossil fuel financing by major North American and European banks between 2013 and 2015 are incompatible with these climate stabilization targets:Coal mining - As leaders of climate-vulnerable states called for a global moratorium on new coal mines, top banks financed $42.39 billion for companies active in coal mining, led by Deutsche Bank with$6.73 billion.Coal power - In spite of a recent study concluding that the current pipeline of planned coal power plants would put the 2°C climate target out of reach by the end of 2017, these banks financed $154 billion for top operators of coal power plants, led by Citigroup with$24.06 billion.Extreme oil (Arctic, tar sands, and ultra-deep offshore) - Future development of most of these high-cost, highrisk oil reserves is incompatible with even the 2°C target, but banks financed $307 billion for the top owners of the world's untapped "extreme oil" reserves, led by JPMorgan Chase with$37.77 billion.Liquefied Natural Gas (LNG) export - Banks financed $283 billion, led by JPMorgan Chase with$30.58 billion, for companies involved with LNG export terminals in North America, which have enormous carbon footprints and are stranded assets in the making based on a 2°C climate scenario.Under pressure from global civil society, several U.S. and European banks have announced restrictions on financing for coal since last year. However, most of these policies fall well short of the necessary full phase-out of financing for coal mining and coal power production; as the report's grades for extreme oil and LNG export finance indicate, banks continue to finance these sectors on a nearly unrestricted basis. Banks also continue to fall distressingly short of their human rights obligations according to the United Nations Guiding Principles on Business and Human Rights, leaving banks complicit in human rights abuses by several of their corporate clients in the fossil fuel industry

Determining the extragalactic extinction law with SALT. II. Additional sample

We present new results from an on-going programme to study the dust extragalactic extinction law in E/S0 galaxies with dust lanes with the Southern African Large Telescope (SALT) during its performance-verification phase. The wavelength dependence of the dust extinction for seven galaxies is derived in six spectral bands ranging from the near-ultraviolet atmospheric cutoff to the near-infrared. The derivation of an extinction law is performed by fitting model galaxies to the unextinguished parts of the image in each spectral band, and subtracting from these the actual images. We compare our results with the derived extinction law in the Galaxy and find them to run parallel to the Galactic extinction curve with a mean total-to-selective extinction value of 2.71+-0.43. We use total optical extinction values to estimate the dust mass for each galaxy, compare these with dust masses derived from IRAS measurements, and find them to range from 10^4 to 10^7 Solar masses. We study the case of the well-known dust-lane galaxy NGC2685 for which HST/WFPC2 data is available to test the dust distribution on different scales. Our results imply a scale-free dust distribution across the dust lanes, at least within ~1 arcsec (~60 pc) regions.Comment: 11 pages, 7 figures, 3 tables. Accepted for publication in MNRAS. R-band contour maps and B-R colour-index maps are low-resolution versions of those used in the MNRAS versio

Does patient-provider race/ethnicity concordance impact outcomes for adults with lupus?

Background: Health disparities exist among the 1.5 million Americans with lupus, with women of color bearing higher disease rates and burden. Complex reasons include genetics, comorbidities, and socioeconomics. These factors may lead to differences in health-related outcomes in lupus. Aim: To determine if patient-provider racial/ethnic concordance plays a role in outcomes for adults with lupus. Method: For this scoping review, the authors searched PubMed Medline and CINAHL using keywords and subject headings for lupus, race or ethnicity, and patient-health professional concordance. Results: Despite an intentionally broadened search of literature, the authors identified a lack of studies examining the topic. Conclusions: Certain factors may explain the results: a lack of scientists studying the phenomenon, a focus of funding on bench science, and a non-diverse U.S. healthcare provider workforce. Other factors may exist. Implications for practice, policy, and research are presented

Total elbow arthroplasty: a prospective clinical outcome study of Discovery Elbow System with a 4-year mean follow-up

BACKGROUND: Total elbow arthroplasty (TEA) is increasingly used for the treatment of advanced elbow conditions to reduce pain and improve function. However, TEA is still associated with a higher complication rate than total hip and knee arthroplasty despite advances in the design and surgical techniques. This prospective clinical study reports the outcome of the Discovery Elbow System (Biomet, Warsaw IN, USA), which has been in clinical use in the United Kingdom since 2003. METHODS: The study included a total of 100 Discovery Elbows (April 2003 to January 2010) with a minimum 2-year follow-up, including 75 primary and 25 revisions (60% women and 40% men; mean age, 62 years). Outcome was assessed by means of the Liverpool Elbow Score, pain experience, patient satisfaction, range of motion, and radiographic imaging. RESULTS: The mean follow-up period was 48.5 months (range, 24-108 months). The Liverpool Elbow Score improved from 3.79 to 6.36 (P < .001). The percentage of pain-free patients was substantially increased from 7% preoperatively to 64% at the final follow-up. The patient satisfaction rate was over 90%. The flexion-extension arc and pronation-supination arc increased from 72° to 93° and from 86° to 111°, respectively (P < .001). Major postoperative complications included deep infection (2%), progressive aseptic loosening requiring revision (primary, 5%; revision 12%), persistent ulnar neuropathy (3%), and periprosthetic fracture (primary, 6.8%; revision, 8%). CONCLUSION: The Discovery Elbow System resulted in improved function, reduced pain, and high patient satisfaction. Long-term results are required to assess the survivorship of this syste

Improving the development, monitoring and reporting of stroke rehabilitation research: consensus-based core recommendations from the Stroke Recovery and Rehabilitation Roundtable (SRRR)

Recent reviews have demonstrated that the quality of stroke rehabilitation research has continued to improve over the last four decades but despite this progress there are still many barriers in moving the field forward. Rigorous development, monitoring and complete reporting of interventions in stroke trials are essential in providing rehabilitation evidence that is robust, meaningful and implementable. An international partnership of stroke rehabilitation experts committed to develop consensus-based core recommendations with a remit of addressing the issues identified as limiting stroke rehabilitation research in the areas of developing, monitoring and reporting stroke rehabilitation interventions. Work exploring each of the three areas took place via multiple teleconferences and a two-day meeting in Philadelphia in May 2016. A total of 15 recommendations were made. To validate the need for the recommendations the group reviewed all stroke rehabilitation trials published in 2015 (n=182 papers). Our review highlighted that the majority of publications did not clearly describe how interventions were developed or monitored during the trial. In particular, under-reporting of the theoretical rationale for the intervention and the components of the intervention calls into question many interventions that have been evaluated for efficacy. More trials were found to have addressed the reporting of interventions recommendations than those related to development or monitoring. Nonetheless the majority of reporting recommendations were still not adequately described. To progress the field of stroke rehabilitation research and to ensure stroke patients receive optimal evidence based clinical care we urge the research community to endorse and adopt our recommendations

A Novel Biochemical Route for Fuels and Chemicals Production from Cellulosic Biomass

The conventional biochemical platform featuring enzymatic hydrolysis involves five key steps: pretreatment, cellulase production, enzymatic hydrolysis, fermentation, and product recovery. Sugars are produced as reactive intermediates for subsequent fermentation to fuels and chemicals. Herein, an alternative biochemical route is proposed. Pretreatment, enzymatic hydrolysis and cellulase production is consolidated into one single step, referred to as consolidated aerobic processing, and sugar aldonates are produced as the reactive intermediates for biofuels production by fermentation. In this study, we demonstrate the viability of consolidation of the enzymatic hydrolysis and cellulase production steps in the new route using Neurospora crassa as the model microorganism and the conversion of cellulose to ethanol as the model system. We intended to prove the two hypotheses: 1) cellulose can be directed to produce cellobionate by reducing β-glucosidase production and by enhancing cellobiose dehydrogenase production; and 2) both of the two hydrolysis products of cellobionate—glucose and gluconate—can be used as carbon sources for ethanol and other chemical production. Our results showed that knocking out multiple copies of β-glucosidase genes led to cellobionate production from cellulose, without jeopardizing the cellulose hydrolysis rate. Simulating cellobiose dehydrogenase over-expression by addition of exogenous cellobiose dehydrogenase led to more cellobionate production. Both of the two hydrolysis products of cellobionate: glucose and gluconate can be used by Escherichia coli KO 11 for efficient ethanol production. They were utilized simultaneously in glucose and gluconate co-fermentation. Gluconate was used even faster than glucose. The results support the viability of the two hypotheses that lay the foundation for the proposed new route

Granzyme B Cleaves Decorin, Biglycan and Soluble Betaglycan, Releasing Active Transforming Growth Factor-β1

Objective: Granzyme B (GrB) is a pro-apoptotic serine protease that contributes to immune-mediated target cell apoptosis. However, during inflammation, GrB accumulates in the extracellular space, retains its activity, and is capable of cleaving extracellular matrix (ECM) proteins. Recent studies have implicated a pathogenic extracellular role for GrB in cardiovascular disease, yet the pathophysiological consequences of extracellular GrB activity remain largely unknown. The objective of this study was to identify proteoglycan (PG) substrates of GrB and examine the ability of GrB to release PG-sequestered TGF-b1 into the extracellular milieu. Methods/Results: Three extracellular GrB PG substrates were identified; decorin, biglycan and betaglycan. As all of these PGs sequester active TGF-b1, cytokine release assays were conducted to establish if GrB-mediated PG cleavage induced TGF-b1 release. Our data confirmed that GrB liberated TGF-b1 from all three substrates as well as from endogenous ECM and this process was inhibited by the GrB inhibitor 3,4-dichloroisocoumarin. The released TGF-b1 retained its activity as indicated by the induction of SMAD-3 phosphorylation in human coronary artery smooth muscle cells. Conclusion: In addition to contributing to ECM degradation and the loss of tissue structural integrity in vivo, increase

Transcriptomic response of the red tide dinoflagellate, Karenia brevis, to nitrogen and phosphorus depletion and addition

<p>Abstract</p> <p>Background</p> <p>The role of coastal nutrient sources in the persistence of <it>Karenia brevis </it>red tides in coastal waters of Florida is a contentious issue that warrants investigation into the regulation of nutrient responses in this dinoflagellate. In other phytoplankton studied, nutrient status is reflected by the expression levels of N- and P-responsive gene transcripts. In dinoflagellates, however, many processes are regulated post-transcriptionally. All nuclear encoded gene transcripts studied to date possess a 5' <it>trans</it>-spliced leader (SL) sequence suggestive, based on the trypanosome model, of post-transcriptional regulation. The current study therefore sought to determine if the transcriptome of <it>K. brevis </it>is responsive to nitrogen and phosphorus and is informative of nutrient status.</p> <p>Results</p> <p>Microarray analysis of N-depleted <it>K. brevis </it>cultures revealed an increase in the expression of transcripts involved in N-assimilation (nitrate and ammonium transporters, glutamine synthetases) relative to nutrient replete cells. In contrast, a transcriptional signal of P-starvation was not apparent despite evidence of P-starvation based on their rapid growth response to P-addition. To study transcriptome responses to nutrient addition, the limiting nutrient was added to depleted cells and changes in global gene expression were assessed over the first 48 hours following nutrient addition. Both N- and P-addition resulted in significant changes in approximately 4% of genes on the microarray, using a significance cutoff of 1.7-fold and p ≤ 10^-4. By far, the earliest responding genes were dominated in both nutrient treatments by pentatricopeptide repeat (PPR) proteins, which increased in expression up to 3-fold by 1 h following nutrient addition. PPR proteins are nuclear encoded proteins involved in chloroplast and mitochondria RNA processing. Correspondingly, other functions enriched in response to both nutrients were photosystem and ribosomal genes.</p> <p>Conclusions</p> <p>Microarray analysis provided transcriptomic evidence for N- but not P-limitation in <it>K. brevis</it>. Transcriptomic responses to the addition of either N or P suggest a concerted program leading to the reactivation of chloroplast functions. Even the earliest responding PPR protein transcripts possess a 5' SL sequence that suggests post-transcriptional control. Given the current state of knowledge of dinoflagellate gene regulation, it is currently unclear how these rapid changes in such transcript levels are achieved.</p