Zoom and its discontents: group decision making in pediatric cardiology in the time of COVID (and beyond)

The emergence of Covid-19 has led to change within hospital-based healthcare. An example, has been to reconfigure clinical decision making meetings from traditional in-person (Face-to-face, FtF) to online video-conferencing (VC) format inorder to decrease contagion risk. Despite its widespread uptake, there is minimal empirical data evaluating this format. This narrative review considers the implications on medical decision-making when clinicians communicate remotely via Microsoft Teams. The discussion is informed by the psychological literature and by commentary obtained from a survey of paediatric cardiac clinicians who participated in clinical meetings when video-conferencing was first introduced. Whist video-conferencing can optimize clinician presence, this is potentially offset by compromises in current imaging quality, the group discussion, information sharing and decision quality. Implementing a shift from face-to-face to VC within the group decision-making process requires an appreciation of the changed environment, appropriate adaptations and the implemention of new technology solutions. Meanwhile, healthcare should carefully consider the potential implications of clinical decision making using online video conferencing, be prepared to adapt and evaluate prior to a shift away from face-to-face formats

Multicenter assessment of quantitative sensory testing (QST) for the detection of neuropathic-like pain responses using the topical capsaicin model

Background: The use of quantitative sensory testing (QST) in multicenter studies has been quite limited, due in part to lack of standardized procedures among centers. Aim: The aim of this study was to assess the application of the capsaicin pain model as a surrogate experimental human model of neuropathic pain in different centers and verify the variation in reports of QST measures across centers. Methods: A multicenter study conducted by the Quebec Pain Research Network in six laboratories allowed the evaluation of nine QST parameters in 60 healthy subjects treated with topical capsaicin to model unilateral pain and allodynia. The same measurements (without capsaicin) were taken in 20 patients with chronic neuropathic pain recruited from an independent pain clinic. Results: Results revealed that six parameters detected a significant difference between the capsaicin-treated and the control skin areas: (1) cold detection threshold (CDT) and (2) cold pain threshold (CPT) are lower on the capsaicin-treated side, indicating a decreased in cold sensitivity; (3) heat pain threshold (HPT) was lower on the capsaicin-treated side in healthy subjects, suggesting an increased heat pain sensitivity; (4) dynamic mechanical allodynia (DMA); (5) mechanical pain after two stimulations (MPS2); and (6) mechanical pain summation after ten stimulations (MPS10), are increased on the capsaicin-treated side, suggesting an increased in mechanical pain (P < 0.002). CDT, CPT and HPT showed comparable effects across all six centers, with CPT and HPT demonstrating the best sensitivity. Data from the patients showed significant difference between affected and unaffected body side but only with CDT. Conclusion: These results provide further support for the application of QST in multicenter studies examining normal and pathological pain responses

Distinction of representations via Bruhat-Tits buildings of p-adic groups

Introductory and pedagogical treatmeant of the article : P. Broussous "Distinction of the Steinberg representation", with an appendix by Fran\c{c}ois Court\`es, IMRN 2014, no 11, 3140-3157. To appear in Proceedings of Chaire Jean Morlet, Dipendra Prasad, Volker Heiermann Ed. 2017. Contains modified and simplified proofs of loc. cit. This article is written in memory of Fran\c{c}ois Court\`es who passed away in september 2016.Comment: 33 pages, 4 figure

Integrated Ocean, Earth, and Atmospheric Observations for Resilience Planning in Hampton Roads, Virginia

Building flood resilience in coastal communities requires a precise understanding of the temporal and spatial scales of inundation and the ability to detect and predict changes in flooding. In Hampton Roads, the Intergovernmental Pilot Project’s Scientific Advisory Committee recommended an integrated network of ocean, earth, and atmospheric data collection from both private and public sector organizations that engage in active scientific monitoring and observing. Since its establishment, the network has grown to include monitoring of water levels, land subsidence, wave measurements, current measurements, and atmospheric conditions. High-resolution land elevation and land cover data sets have also been developed. These products have been incorporated into a number of portals and integrated tools to help support resilience planning. Significant challenges to building the network included establishing consistent data standards across organizations to allow for the integration of the data into multiple, unique products and funding the expansion of the network components. Recommendations to the network development in Hampton Roads include the need to continue to support and expand the publicly available network of sensors; enhance integration between ocean, earth, and atmospheric networks; and improve shallow water bathymetry data used in spatial flooding models

Toluene inhalation exposure for 13 weeks causes persistent changes in electroretinograms of Long–Evans rats

Studies of humans chronically exposed to volatile organic solvents have reported impaired visual functions, including low contrast sensitivity and reduced color discrimination. These reports, however, lacked confirmation from controlled laboratory experiments. To address this question experimentally, we examined visual function by recording visual evoked potentials (VEP) and/or electroretinograms (ERG) from four sets of rats exposed repeatedly to toluene. In addition, eyes of the rats were examined with an ophthalmoscope and some of the retinal tissues were evaluated for rod and M-cone photoreceptor immunohistochemistry. The first study examined rats following exposure to 0, 10, 100 or 1000 ppm toluene by inhalation (6 hr/d, 5 d/wk) for 13 weeks. One week after the termination of exposure, the rats were implanted with chronically indwelling electrodes and the following week pattern-elicited VEPs were recorded. VEP amplitudes were not significantly changed by toluene exposure. Four to five weeks after completion of exposure, rats were dark-adapted overnight, anesthetized, and several sets of electroretinograms (ERG) were recorded. In dark-adapted ERGs recorded over a 5-log (cd-s/m2) range of flash luminance, b-wave amplitudes were significantly reduced at high stimulus luminance values in rats previously exposed to 1000 ppm toluene. A second set of rats, exposed concurrently with the first set, was tested approximately one year after the termination of 13 weeks of exposure to toluene. Again, dark-adapted ERG b-wave amplitudes were reduced at high stimulus luminance values in rats previously exposed to 1000 ppm toluene. A third set of rats was exposed to the same concentrations of toluene for only 4 weeks, and a fourth set of rats exposed to 0 or 1000 ppm toluene for 4 weeks were tested approximately 1 year after the completion of exposure. No statistically significant reductions of ERG b-wave amplitude were observed in either set of rats exposed for 4 weeks. No significant changes were observed in ERG a-wave amplitude or latency, b-wave latency, UV- or green-flicker ERGs, or in photopic flash ERGs. There were no changes in the density of rod or M-cone photoreceptors. The ERG b-wave reflects the firing patterns of on-bipolar cells. The reductions of b-wave amplitude after 13 weeks of exposure and persisting for 1 year suggest that alterations may have occurred in the inner nuclear layer of the retina, where the bipolar cells reside, or the outer or inner plexiform layers where the bipolar cells make synaptic connections. These data provide experimental evidence that repeated exposure to toluene may lead to subtle persistent changes in visual function. The fact that toluene affected ERGs, but not VEPs, suggests that elements in the rat retina may be more sensitive to organic solvent exposure than the rat visual cortex

Evolving and Sustaining Ocean Best Practices to Enable Interoperability in the UN Decade of Ocean Science for Sustainable Development

The UN Decade of Ocean Science for Sustainable Development (Ocean Decade) challenges marine science to better inform and stimulate social and economic development while conserving marine ecosystems. To achieve these objectives, we must make our diverse methodologies more comparable and interoperable, expanding global participation and foster capacity development in ocean science through a new and coherent approach to best practice development. We present perspectives on this issue gleaned from the ongoing development of the UNESCO Intergovernmental Oceanographic Commission (IOC) Ocean Best Practices System (OBPS). The OBPS is collaborating with individuals and programs around the world to transform the way ocean methodologies are managed, in strong alignment with the outcomes envisioned for the Ocean Decade. However, significant challenges remain, including: (1) the haphazard management of methodologies across their lifecycle, (2) the ambiguous endorsement of what is "best" and when and where one method may be applicable vs. another, and (3) the inconsistent access to methodological knowledge across disciplines and cultures. To help address these challenges, we recommend that sponsors and leaders in ocean science and education promote consistent documentation and convergence of methodologies to: create and improve context-dependent best practices; incorporate contextualized best practices into Ocean Decade Actions; clarify who endorses which method and why; create a global network of complementary ocean practices systems; and ensure broader consistency and flexibility in international capacity development

Exploring the evidence base for national and regional policy interventions to combat resistance

The effectiveness of existing policies to control antimicrobial resistance is not yet fully understood. A strengthened evidence base is needed to inform effective policy interventions across countries with different income levels and the human health and animal sectors. We examine three policy domains—responsible use, surveillance, and infection prevention and control—and consider which will be the most effective at national and regional levels. Many complexities exist in the implementation of such policies across sectors and in varying political and regulatory environments. Therefore, we make recommendations for policy action, calling for comprehensive policy assessments, using standardised frameworks, of cost-effectiveness and generalisability. Such assessments are especially important in low-income and middle-income countries, and in the animal and environmental sectors. We also advocate a One Health approach that will enable the development of sensitive policies, accommodating the needs of each sector involved, and addressing concerns of specific countries and regions

Technologies for a FAIRer use of Ocean Best Practices

The publication and dissemination of best practices in ocean observing is pivotal for multiple aspects of modern marine science, including cross-disciplinary interoperability, improved reproducibility of observations and analyses, and training of new practitioners. Often, best practices are not published in a scientific journal and may not even be formally documented, residing solely within the minds of individuals who pass the information along through direct instruction. Naturally, documenting best practices is essential to accelerate high-quality marine science; however, documentation in a drawer has little impact. To enhance the application and development of best practices, we must leverage contemporary document handling technologies to make best practices discoverable, accessible, and interlinked, echoing the logic of the FAIR data principles [1]

Developmental pathways to autism: a review of prospective studies of infants at risk

Autism Spectrum Disorders (ASDs) are neurodevelopmental disorders characterized by impairments in social interaction and communication, and the presence of restrictive and repetitive behaviors. Symptoms of ASD likely emerge from a complex interaction between pre-existing neurodevelopmental vulnerabilities and the child's environment, modified by compensatory skills and protective factors. Prospective studies of infants at high familial risk for ASD (who have an older sibling with a diagnosis) are beginning to characterize these developmental pathways to the emergence of clinical symptoms. Here, we review the range of behavioral and neurocognitive markers for later ASD that have been identified in high-risk infants in the first years of life. We discuss theoretical implications of emerging patterns, and identify key directions for future work, including potential resolutions to several methodological challenges for the field. Mapping how ASD unfolds from birth is critical to our understanding of the developmental mechanisms underlying this disorder. A more nuanced understanding of developmental pathways to ASD will help us not only to identify children who need early intervention, but also to improve the range of interventions available to them

Best practice summary Report

Report summarizing the relevant best practices available in the GEOSS (AtlantOS) best practices registr