201 research outputs found
Hepatitis C viral evolution in genotype 1 treatment-naïve and treatment-experienced patients receiving telaprevir-based therapy in clinical trials
Background: In patients with genotype 1 chronic hepatitis C infection, telaprevir (TVR) in combination with peginterferon and ribavirin (PR) significantly increased sustained virologic response (SVR) rates compared with PR alone. However, genotypic changes could be observed in TVR-treated patients who did not achieve an SVR.
Methods: Population sequence analysis of the NS3•4A region was performed in patients who did not achieve SVR with TVR-based treatment.
Results: Resistant variants were observed after treatment with a telaprevir-based regimen in 12% of treatment-naïve patients (ADVANCE; T12PR arm), 6% of prior relapsers, 24% of prior partial responders, and 51% of prior null responder patients (REALIZE, T12PR48 arms). NS3 protease variants V36M, R155K, and V36M+R155K emerged frequently in patients with genotype 1a and V36A, T54A, and A156S/T in patients with genotype 1b. Lower-level resistance to telaprevir was conferred by V36A/M, T54A/S, R155K/T, and A156S variants; and higher-level resistance to telaprevir was conferred by A156T and V36M+R155K variants. Virologic failure during telaprevir treatment was more common in patients with genotype 1a and in prior PR nonresponder patients and was associated with higher-level telaprevir-resistant variants. Relapse was usually associated with wild-type or lower-level resistant variants. After treatment, viral populations were wild-type with a median time of 10 months for genotype 1a and 3 weeks for genotype 1b patients.
Conclusions: A consistent, subtype-dependent resistance profile was observed in patients who did not achieve an SVR with telaprevir-based treatment. The primary role of TVR is to inhibit wild-type virus and variants with lower-levels of resistance to telaprevir. The complementary role of PR is to clear any remaining telaprevir-resistant variants, especially higher-level telaprevir-resistant variants. Resistant variants are detectable in most patients who fail to achieve SVR, but their levels decline over time after treatment
Electronic Structure and Valence Band Spectra of Bi4Ti3O12
The x-ray photoelectron valence band spectrum and x-ray emission valence-band
spectra (Ti K _beta_5, Ti L_alpha, O K_alpha) of Bi4Ti3O12 are presented
(analyzed in the common energy scale) and interpreted on the basis of a
band-structure calculation for an idealized I4/mmm structure of this material.Comment: 6 pages + 7 PostScript figures, RevTex3.0, to be published in
Phys.Rev.B52 (Oct.95). Figures also available via anonymous ftp at
ftp://ftp.physik.uni-osnabrueck.de/pub/apostnik/BiTiO
Exchange bias between van der Waals materials: tilted magnetic states and field-free spin-orbit-torque switching
Magnetic van der Waals heterostructures provide a unique platform to study
magnetism and spintronics device concepts in the two-dimensional limit. Here,
we report studies of exchange bias from the van der Waals antiferromagnet CrSBr
acting on the van der Waals ferromagnet Fe3GeTe2 (FGT). The orientation of the
exchange bias is along the in-plane easy axis of CrSBr, perpendicular to the
out-of-plane anisotropy of the FGT, inducing a strongly tilted magnetic
configuration in the FGT. Furthermore, the in-plane exchange bias provides
sufficient symmetry breaking to allow deterministic spin-orbit torque switching
of the FGT in CrSBr/FGT/Pt samples at zero applied magnetic field. A minimum
thickness of the CrSBr greater than 10 nm is needed to provide a non-zero
exchange bias at 30 K
It’s not just what you eat but when: The impact of eating a meal during simulated shift work on driving performance
Published online: 13 Oct 2016.Shiftworkers have impaired performance when driving at night and they also alter their eating patterns during nightshifts. However, it is unknown whether driving at night is influenced by the timing of eating. This study aims to explore the effects of timing of eating on simulated driving performance across four simulated nightshifts. Healthy, non-shiftworking males aged 18-35 years (n = 10) were allocated to either an eating at night (n = 5) or no eating at night (n = 5) condition. During the simulated nightshifts at 1730, 2030 and 0300 h, participants performed a 40-min driving simulation, 3-min Psychomotor Vigilance Task (PVT-B), and recorded their ratings of sleepiness on a subjective scale. Participants had a 6-h sleep opportunity during the day (1000-1600 h). Total 24-h food intake was consistent across groups; however, those in the eating at night condition ate a large meal (30% of 24-h intake) during the nightshift at 0130 h. It was found that participants in both conditions experienced increased sleepiness and PVT-B impairments at 0300 h compared to 1730 and 2030 h (p < 0.001). Further, at 0300 h, those in the eating condition displayed a significant decrease in time spent in the safe zone (p < 0.05; percentage of time within 10 km/h of the speed limit and 0.8 m of the centre of the lane) and significant increases in speed variability (p < 0.001), subjective sleepiness (p < 0.01) and number of crashes (p < 0.01) compared to those in the no eating condition. Results suggest that, for optimal performance, shiftworkers should consider restricting food intake during the night.Charlotte C. Gupta, Jill Dorrian, Crystal L. Grant, Maja Pajcin, Alison M. Coates, David J. Kennaway, Gary A. Wittert, Leonie K. Heilbronn, Chris B. Della Vedova, and Siobhan Bank
Developing an objective indicator of fatigue: An alternative mobile version of the Psychomotor Vigilance Task (m-PVT)
Approximately 20% of the working population report symptoms of feeling fatigued at work. The aim of the study was to investigate whether an alternative mobile version of the ‘gold standard’ Psychomotor Vigilance Task (PVT) could be used to provide an objective indicator of fatigue in staff working in applied safety critical settings such as train driving, hospital staffs, emergency services, law enforcements, etc., using different mobile devices. 26 participants mean age 20 years completed a 25-min reaction time study using an alternative mobile version of the Psychomotor Vigilance Task (m-PVT) that was implemented on either an Apple iPhone 6s Plus or a Samsung Galaxy Tab 4. Participants attended two sessions: a morning and an afternoon session held on two consecutive days counterbalanced. It was found that the iPhone 6s Plus generated both mean speed responses (1/RTs) and mean reaction times (RTs) that were comparable to those observed in the literature while the Galaxy Tab 4 generated significantly lower 1/RTs and slower RTs than those found with the iPhone 6s Plus. Furthermore, it was also found that the iPhone 6s Plus was sensitive enough to detect lower mean speed of responses (1/RTs) and significantly slower mean reaction times (RTs) after 10-min on the m-PVT. In contrast, it was also found that the Galaxy Tab 4 generated mean number of lapses that were significant after 5-min on the m-PVT. These findings seem to indicate that the m-PVT could be used to provide an objective indicator of fatigue in staff working in applied safety critical settings such as train driving, hospital staffs, emergency services, law enforcements, etc
How much is left in your "sleep tank"? Proof of concept for a simple model for sleep history feedback
Available online 07 May 2018Technology-supported methods for sleep recording are becoming increasingly affordable. Sleep history feedback may help with fatigue-related decision making - Should I drive? Am I fit for work? This study examines a "sleep tank" model (SleepTank™), which is analogous to the fuel tank in a car, refilled by sleep, and depleted during wake. Required inputs are sleep period time and sleep efficiency (provided by many consumer-grade actigraphs). Outputs include suggested hours remaining to "get sleep" and percentage remaining in tank (Tank%). Initial proof of concept analyses were conducted using data from a laboratory-based simulated nightshift study. Ten, healthy males (18-35y) undertook an 8h baseline sleep opportunity and daytime performance testing (BL), followed by four simulated nightshifts (2000 h-0600 h), with daytime sleep opportunities (1000 h-1600 h), then an 8 h night-time sleep opportunity to return to daytime schedule (RTDS), followed by daytime performance testing. Psychomotor Vigilance Task (PVT) and Karolinska Sleepiness Scale were performed at 1200 h on BL and RTDS, and at 1830 h, 2130 h 0000 h and 0400 h each nightshift. A 40-minute York Driving Simulation was performed at 1730 h, 2030 h and 0300 h on each nightshift. Model outputs were calculated using sleep period timing and sleep efficiency (from polysomnography) for each participant. Tank% was a significant predictor of PVT lapses (p < 0.001), and KSS (p < 0.001), such that every 5% reduction resulted in an increase of two lapses, or one point on the KSS. Tank% was also a significant predictor of %time in the Safe Zone from the driving simulator (p = 0.001), such that every 1% increase in the tank resulted in a 0.75% increase in time spent in the Safe Zone. Initial examination of the correspondence between model predictions and performance and sleepiness measures indicated relatively good predictive value. Results provide tentative evidence that this "sleep tank" model may be an informative tool to aid in individual decision-making based on sleep history.Jillian Dorrian, Steven Hursh, Lauren Waggoner, Crystal Grant, Maja Pajcin, Charlotte Gupta, Alison Coates, David Kennaway, Gary Wittert, Leonie Heilbronn, Chris Della Vedova, Siobhan Bank
Children’s participation in school grounds developments: creating a place for education that promotes children’s social inclusion
Abstract This paper advances the idea that ‘education for the social inclusion of children’ is similar but different to ‘inclusive education’ as it has come to be understood and used by some authors and UK government documents. ‘Inclusive education’ tends to carry an inward emphasis on the participation of children in the education system (with discussions on school culture, transitions, truancy, exclusion rates, underachievement, and school leaving age). In contrast, education for the promotion of children’s social inclusion requires an outward emphasis on children's participation in 'mainstream' society while they are still children. The latter emphasis is seen to be lacking in educational policy discourse in Scotland though a recent shift in policy towards education for active citizenship is noted. Examples are provided to show how many policy statements enact a limitation on the scope for education to promote children’s social inclusion by emphasising children’s deficits as social actors and focussing on the ‘condition’ of social exclusion. The paper draws on an empirical study of children’s participation in changing school grounds in Scotland. The analysis shows how the enclosure of learning in books, classrooms and normative curricula was challenged. Learning from school grounds developments was constructed relationally and spatially but the scope of what was to be learned was often delineated by adults. The paper closes with a discussion of how education that promotes the social inclusion of children will benefit from seeing both children and adults as current though partial citizens and utilising socio-spatial opportunities for the generation of uncertain curricula through their shared and/or differentiated participation
Healthcare Staff Wellbeing, Burnout, and Patient Safety: A Systematic Review
Objective
To determine whether there is an association between healthcare professionals’ wellbeing and burnout, with patient safety.
Design
Systematic research review.
Data Sources
PsychInfo (1806 to July 2015), Medline (1946 to July 2015), Embase (1947 to July 2015) and Scopus (1823 to July 2015) were searched, along with reference lists of eligible articles.
Eligibility Criteria for Selecting Studies
Quantitative, empirical studies that included i) either a measure of wellbeing or burnout, and ii) patient safety, in healthcare staff populations.
Results
Forty-six studies were identified. Sixteen out of the 27 studies that measured wellbeing found a significant correlation between poor wellbeing and worse patient safety, with six additional studies finding an association with some but not all scales used, and one study finding a significant association but in the opposite direction to the majority of studies. Twenty-one out of the 30 studies that measured burnout found a significant association between burnout and patient safety, whilst a further four studies found an association between one or more (but not all) subscales of the burnout measures employed, and patient safety.
Conclusions
Poor wellbeing and moderate to high levels of burnout are associated, in the majority of studies reviewed, with poor patient safety outcomes such as medical errors, however the lack of prospective studies reduces the ability to determine causality. Further prospective studies, research in primary care, conducted within the UK, and a clearer definition of healthcare staff wellbeing are needed.
Implications
This review illustrates the need for healthcare organisations to consider improving employees’ mental health as well as creating safer work environments when planning interventions to improve patient safety
Utilisation of an operative difficulty grading scale for laparoscopic cholecystectomy
Background
A reliable system for grading operative difficulty of laparoscopic cholecystectomy would standardise description of findings and reporting of outcomes. The aim of this study was to validate a difficulty grading system (Nassar scale), testing its applicability and consistency in two large prospective datasets.
Methods
Patient and disease-related variables and 30-day outcomes were identified in two prospective cholecystectomy databases: the multi-centre prospective cohort of 8820 patients from the recent CholeS Study and the single-surgeon series containing 4089 patients. Operative data and patient outcomes were correlated with Nassar operative difficultly scale, using Kendall’s tau for dichotomous variables, or Jonckheere–Terpstra tests for continuous variables. A ROC curve analysis was performed, to quantify the predictive accuracy of the scale for each outcome, with continuous outcomes dichotomised, prior to analysis.
Results
A higher operative difficulty grade was consistently associated with worse outcomes for the patients in both the reference and CholeS cohorts. The median length of stay increased from 0 to 4 days, and the 30-day complication rate from 7.6 to 24.4% as the difficulty grade increased from 1 to 4/5 (both p < 0.001). In the CholeS cohort, a higher difficulty grade was found to be most strongly associated with conversion to open and 30-day mortality (AUROC = 0.903, 0.822, respectively). On multivariable analysis, the Nassar operative difficultly scale was found to be a significant independent predictor of operative duration, conversion to open surgery, 30-day complications and 30-day reintervention (all p < 0.001).
Conclusion
We have shown that an operative difficulty scale can standardise the description of operative findings by multiple grades of surgeons to facilitate audit, training assessment and research. It provides a tool for reporting operative findings, disease severity and technical difficulty and can be utilised in future research to reliably compare outcomes according to case mix and intra-operative difficulty
Sheep Updates 2007 - part 4
This session covers eight papers from different authors:
GRAZING
1. The impact of high dietary salt and its implications for the management of livestock grazing saline land, Dean Thomas, Dominique Blache, Dean Revell, Hayley Norman, Phil Vercoe, Zoey Durmic, Serina Digby, Di Mayberry, Megan Chadwick, Martin Sillence and David Masters, CRC for Plant-based Management of Dryland Salinity, Faculty of Natural & Agricultural Sciences, The University of Western Australia, WA.
2. Sustainable Grazing on Saline Lands - outcomes from the WA1 research project, H.C. Norman1,2, D.G. Masters1,2, R. Silberstein1,2, F. Byrne2,3, P.G.H. Nichols2,4, J. Young3, L. Atkins1,2, M.G. Wilmot1,2, A.J. Rintoul1,2, T. Lambert1,2, D.R. McClements2,4, P. Raper4, P. Ward1,2, C. Walton5 and T. York6 1CSIRO Centre for Environment and Life Sciences, Wembley, WA 2CRC for Plant-based Management of Dryland Salinity. 3School of Agricultural and Resource Economics, University of Western Australia. 4Department of Agriculture and Food WA. 5Condering Hills, Yealering. 6Anameka Farms, Tammin.
MEAT QUALITY
3. Development of intramuscular fat in prime lambs, young sheep and beef cattle, David Pethick1, David Hopkins2 and Malcolm McPhee3,1School of Veterinary and Biomedical Sciences, Murdoch University, Murdoch, WA, 2NSW Department of Primary Industries, Cowra, NSW,3NSW Dept. of Primary Industries, University of New England, Armidale, NSW,
4. Importance of drinking water temperature for managing heat stress in sheep, Savage DB, Nolan JV, Godwin IR, Aoetpah A, Nguyen T, Baillie N and Lawler C University of New England, Armidale, NSW, Australia
EWE MANAGEMENT TOOLS
5. E - sheep Management of Pregnant Merino Ewes and their Finishing Lambs, Ken GeentyA, John SmithA, Darryl SmithB, Tim DyallA and Grant UphillA A Sheep CRC and CSIRO Livestock Industries, Chiswick, NSW B Turretfield Research Station, SARDI, Roseworthy, SA
6. Is it important to manage ewes to CS targets? John Young, Farming Systems Analysis Service, Kojonup, WA
MULESING
7. Mulesing accreditation - Vital for Wool\u27s Future, Dr Michael Paton, Department of Agriculture and Food WA,
8. Mulesing Alternatives, Jules Dorrian, Affiliation Project Manager Blowfly Control Australian Wool Inovatio
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