1,060 research outputs found
Coarse--graining, fixed points, and scaling in a large population of neurons
We develop a phenomenological coarse--graining procedure for activity in a
large network of neurons, and apply this to recordings from a population of
1000+ cells in the hippocampus. Distributions of coarse--grained variables seem
to approach a fixed non--Gaussian form, and we see evidence of scaling in both
static and dynamic quantities. These results suggest that the collective
behavior of the network is described by a non--trivial fixed point
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Implementation research for the prevention of antimicrobial resistance and healthcare-associated infections; 2017 Geneva infection prevention and control (IPC)-think tank (part 1)
Background
Around 5–15% of all hospital patients worldwide suffer from healthcare-associated infections (HAIs), and years of excessive antimicrobial use in human and animal medicine have created emerging antimicrobial resistance (AMR). A considerable amount of evidence-based measures have been published to address these challenges, but the largest challenge seems to be their implementation.
Methods
In June 2017, a total of 42 experts convened at the Geneva IPC-Think Tank to discuss four domains in implementation science: 1) teaching implementation skills; 2) fostering implementation of IPC and antimicrobial stewardship (AMS) by policy making; 3) national/international actions to foster implementation skills; and 4) translational research bridging social sciences and clinical research in infection prevention and control (IPC) and AMR.
Results
Although neglected in the past, implementation skills have become a priority in IPC and AMS. They should now be part of any curriculum in health care, and IPC career paths should be created. Guidelines and policies should be aligned with each other and evidence-based, each document providing a section on implementing elements of IPC and AMS in patient care. International organisations should be advocates for IPC and AMS, framing them as patient safety issues and emphasizing the importance of implementation skills. Healthcare authorities at the national level should adopt a similar approach and provide legal frameworks, guidelines, and resources to allow better implementation of patient safety measures in IPC and AMS. Rather than repeating effectiveness studies in every setting, we should invest in methods to improve the implementation of evidence-based measures in different healthcare contexts. For this, we need to encourage and financially support collaborations between social sciences and clinical IPC research.
Conclusions
Experts of the 2017 Geneva Think Tank on IPC and AMS, CDC, and WHO agreed that sustained efforts on implementation of IPC and AMS strategies are required at international, country, and hospital management levels, to provide an adequate multimodal framework that addresses (not exclusively) leadership, resources, education and training for implementing IPC and AMS. Future strategies can build on this agreement to make strategies on IPC and AMS more effective
A study of clinicoradiological and functional outcomes of intramedullary nailing in diaphyseal radius ulna fractures
Background: The aim of this study was to evaluate the results of intramedullary nailing in diaphyseal fractures of radius and ulna in age group of 10 to 49 years and to understand its clinicoradiological and functional results.Methods: This is a retrospective case series study of forearm bone fractures and the selected management for the same over a period of 3 years. We chose the cases in which intramedullary nailing was the treatment modality which were followed up over a period of minimum 6 months. Patients with galeazzi variety, monteggia variety, pathological fracture or non-union after previous surgery were excluded. The outcomes were then evaluated with disabilities of the arm, shoulder and hand (DASH) score, Green and O’Brien score, and Grace and Eversmann functional outcome score.Results: Of the 22 patients, 10 patients had excellent functional outcome according to Grace and Eversmann score, 7 patients had good outcome, 4 patients had acceptable while 1 was unacceptable. Green and O’Brien also had similar results, except that patients among fair category were 3 and poor category were 3. The mean DASH score was 16.2.Conclusions: This study shows that closed method for fixation by intramedullary nailing of both bone forearm fractures leads to excellent to good functional outcomes (according to DASH score, Green and O Brien, and Grace and Eversmann score) with less complications. In 6 months follow up x ray there is radiological union in all cases with no angulation, malunion or non-union.
Baby Steps toward Meeting Engineering-rich Science Standards: Approaches and Results from a Short What is Engineering? Course for K-5 Pre-service Teachers (Work in Progress)
Elementary teacher preparation programs are generally tightly packed, with limited room for additional coursework. As states adopt Next Generation Science Standards (NGSS ), the need for teacher education programs to provide meaningful exposure to engineering is growing, and a multitude of approaches can be taken to meet this need. While the topics of engineering and engineering design are typically incorporated into science teaching methods courses, this research presents an alternative approach where we expose elementary pre-service teachers to engineering prior to or concurrently with enrollment in their methods courses. Specifically, we describe here our efforts in building a 12-contact-hour non-credit short course – based upon NGSS-aligned learning outcomes – that was delivered to 10 students in fall 2016. We provide details on our approaches, including examples used in the course, and explain our decision to offer this as a short course instead of a full-semester course. We also report on results from the pre- and post-surveys which we used to assess student learning in the course, and to understand what aspects of the course needed improvement
Cultivating equality: delivering just and sustainable food systems in a changing climate
T
oday, the world faces a greater challenge perhaps than ever before:
tackling hunger and malnutrition in the face of climate change
and increasing natural resource scarcity. Civil society, governments,
researchers, donors, and the private sector are simultaneously debating
and collaborating to find solutions. But the dialogue is over-emphasizing
food production.
Improving yields is important, particularly in places where there is not
enough food or where food producers live in poverty. But simply producing
more is not enough to tackle hunger. Furthermore, acknowledging that
lack of food is not the sole cause of hunger is important. Inequality
shapes who has access to food and the resources to grow it and buy it.
It governs who eats first and who eats worst. Inequality determines who
can adapt more readily to a changing climate. Hunger and poverty are
not an accident – they are the result of social and economic injustice and
inequality at all levels, from household to global. The reality of inequality
is no truer for anyone than it is for women – half the world’s population,
with far less than their fair share of the world’s resources.
If we are to achieve the new Sustainable Development Goal of ending
hunger by 2030, we must address the underlying inequalities in food
systems. In a changing climate, agriculture and food systems must be
sustainable and productive – but our efforts cannot end there. They
must be profitable for those for whom it is a livelihood; they must be
equitable, to facilitate a level playing field in the market, to secure rights
to resources for food producers, and to ensure access to nutritious food for
all; they must be resilient to build the capacity of populations vulnerable
to economic shocks, political instability, and increasing, climate-induced
natural hazards to recover and still lift themselves out of poverty
Real-Time Magnetic Resonance Imaging to Study Orthostatic Intolerance Mechanisms in Human Beings: Proof of Concept
Background:Discerning the mechanisms driving orthostatic symptoms in human beings remains challenging. Therefore, we developed a novel approach combining cardiac and cerebral real‐time magnetic resonance imaging, beat‐to‐beat physiological monitoring, and orthostatic stress testing through lower‐body negative pressure (LBNP). We conducted a proof‐of‐concept study in a patient with severe orthostatic hypotension.Methods and Results:We included a 46‐year‐old man with pure autonomic failure. Without and during −30 mmHg LBNP, we obtained 3T real‐time magnetic resonance imaging of the cardiac short axis and quantitative flow measurements in the pulmonary trunk and middle cerebral artery. Blood pressure was 118/74 mmHg during supine rest and 58/35 mmHg with LBNP. With LBNP, left ventricular stroke volume decreased by 44.6%, absolute middle cerebral artery flow by 37.6%, and pulmonary trunk flow by 40%.Conclusions:Combination of real‐time magnetic resonance imaging, LBNP, and continuous blood pressure monitoring provides a promising new approach to study orthostatic intolerance mechanisms in human beings
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