165 research outputs found
Epistemic Justification and Methodological Luck in Inflationary Cosmology
I present a recent historical case from cosmology---the story of inflationary cosmology---and on its basis argue that solving explanatory problems can be a reliable method for making progress in science. In particular, I claim that the success of inflationary theory at solving its predecessor’s explanatory problems justified the theory (epistemically), even in advance of the development of novel predictions from the theory and the later confirmation of those predictions
Trial and Error: Socialization’s Failure to Teach Us How to Teach
Socialization is a major component to faculty development, but without intentional direction it can fail to produce effective educators. The purpose of this large-scale mixed-methods study is to explore teaching influences, missed opportunities to prepare faculty for handling challenging teaching situations, and ways we can improve the socialization process. Results highlight the importance of faculty experiences as undergraduate and graduate students, the value of professional associations and conference participation, and the great range in faculty desires for professional development as educators. Potential implications include a focus on early socialization experiences, encouraging the Scholarship of Teaching and Learning, and providing equitable opportunities to support vulnerable populations
Stability in Cosmology, from Einstein to Inflation
I investigate the role of stability in cosmology through two episodes from the recent history of cosmology: (1) Einstein’s static universe and Eddington’s demonstration of its instability, and (2) the flatness problem of the hot big bang model and its claimed solution by inflationary theory. These episodes illustrate differing reactions to instability in cosmological models, both positive ones and negative ones. To provide some context to these reactions, I also situate them in relation to perspectives on stability from dynamical systems theory and its epistemology. This reveals, for example, an insistence on stability as an extreme position in relation to the spectrum of physical systems which exhibit degrees of stability and fragility, one which has a pragmatic rationale, but not any deeper one
Concert recording 2014-10-09
[Track 01]. Aure volanti / Francesca Caccini -- [Track 02]. O anima mea / Isabella Leonarda -- [Track 03]. Mille regrets / Kailey Miller -- [Track 04]. Peaceful evening / Claude Debussy ; arranged by Morgan -- [Track 05]. Wedding cantata. I. Rise up, my love ; II. Many waters ; III. Awake, O north wind ; IV. Epilogue: set me as a seal / Daniel Pinkham -- [Track 06]. City called heaven / arranged by Poelinitz
When information is not power:Community-elected health facility committees and health facility performance indicators
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Genomic Profiling of Childhood Tumor Patient-Derived Xenograft Models to Enable Rational Clinical Trial Design.
Accelerating cures for children with cancer remains an immediate challenge as a result of extensive oncogenic heterogeneity between and within histologies, distinct molecular mechanisms evolving between diagnosis and relapsed disease, and limited therapeutic options. To systematically prioritize and rationally test novel agents in preclinical murine models, researchers within the Pediatric Preclinical Testing Consortium are continuously developing patient-derived xenografts (PDXs)-many of which are refractory to current standard-of-care treatments-from high-risk childhood cancers. Here, we genomically characterize 261 PDX models from 37 unique pediatric cancers; demonstrate faithful recapitulation of histologies and subtypes; and refine our understanding of relapsed disease. In addition, we use expression signatures to classify tumors for TP53 and NF1 pathway inactivation. We anticipate that these data will serve as a resource for pediatric oncology drug development and will guide rational clinical trial design for children with cancer
Stability in Cosmology, from Einstein to Inflation
I investigate the role of stability in cosmology through two episodes from the recent history of cosmology: (1) Einstein’s static universe and Eddington’s demonstration of its instability, and (2) the flatness problem of the hot big bang model and its claimed solution by inflationary theory. These episodes illustrate differing reactions to instability in cosmological models, both positive ones and negative ones. To provide some context to these reactions, I also situate them in relation to perspectives on stability from dynamical systems theory and its epistemology. This reveals, for example, an insistence on stability as an extreme position in relation to the spectrum of physical systems which exhibit degrees of stability and fragility, one which has a pragmatic rationale, but not any deeper one
Antibiotic strategies for eradicating Pseudomonas aeruginosa in people with cystic fibrosis
Background: Respiratory tract infection with Pseudomonas aeruginosa occurs inmost people with cystic fibrosis. Once chronic infection is established, Pseudomonas aeruginosa is virtually impossible to eradicate and is associated with increased mortality and morbidity. Early infection may be easier to eradicate.
This is an update of a Cochrane review first published in 2003, and previously updated in 2006 and 2009.
Objectives: To determine whether antibiotic treatment of early Pseudomonas aeruginosa infection in children and adults with cystic fibrosis eradicates the organism, delays the onset of chronic infection, and results in clinical improvement. To evaluate whether there is evidence that a particular antibiotic strategy is superior to or more cost-effective than other strategies and to compare the adverse effects of different antibiotic strategies (including respiratory infection with other micro-organisms).
Search methods: We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group Trials Register comprising references identified from comprehensive electronic database searches and handsearches of relevant journals and abstract books of conference proceedings.
Most recent search: 08 September 2014.
Selection criteria: We included randomised controlled trials of people with cystic fibrosis, in whom Pseudomonas aeruginosa had recently been isolated from respiratory secretions. We compared combinations of inhaled, oral or intravenous antibiotics with placebo, usual treatment or other combinations of inhaled, oral or intravenous antibiotics. We excluded non-randomised trials, cross-over trials, and those utilising historical controls.
Data collection and analysis: Both authors independently selected trials, assessed risk of bias and extracted data.
Main results: The search identified 49 trials; seven trials (744 participants) with a duration between 28 days and 27 months were eligible for inclusion.
Three of the trials are over 10 years old and their results may be less applicable today given the changes in standard treatment. Some of the trials had low numbers of participants and most had relatively short follow-up periods; however, there was generally a low risk of bias from missing data. In most trials it was difficult to blind participants and clinicians to treatment given the interventions and comparators used. Two trials were supported by the manufacturers of the antibiotic used.
Evidence from two trials (38 participants) at the two-month time-point showed treatment of early Pseudomonas aeruginosa infection with inhaled tobramycin results in microbiological eradication of the organism from respiratory secretions more often than placebo, odds ratio 0.15 (95% confidence interval 0.03 to 0.65) and data from one of these trials, with longer follow up, suggested that this effect may persist for up to 12 months.
One randomised controlled trial (26 participants) compared oral ciprofloxacin and nebulised colistin versus usual treatment. Results after two years suggested treatment of early infection results in microbiological eradication of Pseudomonas aeruginosa more often than no anti-pseudomonal treatment, odds ratio 0.12 (95% confidence interval 0.02 to 0.79).
One trial comparing 28 days to 56 days treatment with nebulised tobramycin solution for inhalation in 88 participants showed that both treatments were effective and well-tolerated, with no notable additional improvement with longer over shorter duration of therapy. However, this trial was not powered to detect non- inferiority or equivalence.
A trial of oral ciprofloxacin with inhaled colistin versus nebulised tobramycin solution for inhalation alone (223 participants) failed to show a difference between the two strategies, although it was underpowered to show this. A further trial of inhaled colistin with oral ciprofloxacin versus nebulised tobramycin solution for inhalation with oral ciprofloxacin also showed no superiority of the former, with increased isolation of Stenotrophomonas maltophilia in both groups.
A recent, large trial in 306 children aged between one and 12 years compared cycled nebulised tobramycin solution for inhalation to culture-based therapy and also ciprofloxacin to placebo. The primary analysis showed no difference in time to pulmonary exacerbation or proportion of Pseudomonas aeruginosa positive cultures. An analysis performed in this review (not adjusted for age) showed fewer participants in the cycled therapy group with one or more isolates of Pseudomonas aeruginosa, odds ratio 0.51 (95% CI 0.31 to 0.28).
Authors’ conclusions: We found that nebulised antibiotics, alone or in combination with oral antibiotics, were better than no treatment for early infection with Pseudomonas aeruginosa. Eradication may be sustained for up to two years. There is insufficient evidence to determine whether antibiotic strategies for the eradication of early Pseudomonas aeruginosa decrease mortality or morbidity, improve quality of life, or are associated with adverse effects compared to placebo or standard treatment. Four trials of two active treatments have failed to show differences in rates of eradication of Pseudomonas aeruginosa. There have been no published randomised controlled trials that investigate the efficacy of intravenous antibiotics to eradicate Pseudomonas aeruginosa in cystic fibrosis. Overall, there is still insufficient evidence from this review to state which antibiotic strategy should be used for the eradication of early Pseudomonas aeruginosa infection in cystic fibrosis
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