The value of experiments in futures and foresight science as illustrated by the case of scenario planning

An already pressing need to evidence the effectiveness of futures and foresight tools has been further amplified by the coronavirus pandemic, which highlighted more mainstream tools’ difficulty with uncertainty. In light of this, the recent discussion in this journal on providing futures and foresight science with a stronger scientific basis is welcome. In this discussion critical realism has been proffered as a useful philosophical foundation and experiments a useful method for improving this field’s scientific basis. Yet, experiments seek to isolate specific causal effects through closure (i.e., by controlling for all extraneous factors) and this may cause it to jar with critical realism’s emphasis on uncertainty and openness. We therefore extend the recent discussion on improving the scientific basis of futures and foresight science by doing three things. Firstly, we elaborate on critical realism and why the experimental method may jar with it. Secondly, we explain why the distinction between a conceptual and a direct replication can help overcome this jarring, meaning experiments can still be a valuable research tool for a futures and foresight science underpinned by critical realism. Thirdly, we consider the appropriate unit of analysis for experiments on futures and foresight tools. In so doing, we situate the recent discussion on improving the scientific basis of futures and foresight science within the much longer running one on improving the scientific basis of business, management and strategy research more broadly. We use the case of scenario planning to illustrate our argument in relation to futures and foresight science

Mice lacking C1q or C3 show accelerated rejection of minor H disparate skin grafts and resistance to induction of tolerance

Complement activation is known to have deleterious effects on organ transplantation. On the other hand, the complement system is also known to have an important role in regulating immune responses. The balance between these two opposing effects is critical in the context of transplantation. Here, we report that female mice deficient in C1q (C1qa(−/−)) or C3 (C3(−/−)) reject male syngeneic grafts (HY incompatible) at an accelerated rate compared with WT mice. Intranasal HY peptide administration, which induces tolerance to syngeneic male grafts in WT mice, fails to induce tolerance in C1qa(−/−) or C3(−/−) mice. The rejection of the male grafts correlated with the presence of HY D(b)Uty-specific CD8(+) T cells. Consistent with this, peptide-treated C1qa(−/−) and C3(−/−) female mice rejecting male grafts exhibited more antigen-specific CD8(+)IFN-γ(+) and CD8(+)IL-10(+) cells compared with WT females. This suggests that accumulation of IFN-γ- and IL-10-producing T cells may play a key role in mediating the ongoing inflammatory process and graft rejection. Interestingly, within the tolerized male skin grafts of peptide-treated WT mice, IFN-γ, C1q and C3 mRNA levels were higher compared to control female grafts. These results suggest that C1q and C3 facilitate the induction of intranasal tolerance

Heat-dried sclerotia of Sclerotinia sclerotiorum myceliogenically germinate in water and are able to infect Brassica napus

The phytopathogenic fungus Sclerotinia sclerotiorum forms dormant structures (termed sclerotia) that germinate myceliogenically under certain environmental conditions. During myceliogenic germination, sclerotia produce hyphae, which can infect leaves or stems of host plants directly from the ground; this is termed basal infection. This study determined which abiotic conditions were most important for promoting myceliogenic germination of sclerotia in vitro. A high sclerotium hydration level and low incubation temperature (158C) improved mycelial growth in the presence of a nutrient source. Sclerotia incubated without a nutrient source on moist sand, vigorously myceliogenically germinated most frequently (63%) when they had been previously imbibed and then conditioned at -20°C. By far the most consistent amount of vigorous myceliogenic germination (>75%) was produced when sclerotia were heat-dried before being submerged in water. The hyphae of these sclerotia were shown to infect and proliferate on leaves of intact Brassica napus plants. This research provides a better understanding of the abiotic conditions that are likely to increase the risk of basal infection by S. sclerotiorum

Does video feedback analysis improve CPR performance in phase 5 medical students?

BACKGROUND: The use of simulation in medical education is increasing, with students taught and assessed using simulated patients and manikins. Medical students at Queen’s University of Belfast are taught advanced life support cardiopulmonary resuscitation as part of the undergraduate curriculum. Teaching and feedback in these skills have been developed in Queen’s University with high-fidelity manikins. This study aimed to evaluate the effectiveness of video compared to verbal feedback in assessment of student cardiopulmonary resuscitation performance. METHODS: Final year students participated in this study using a high-fidelity manikin, in the Clinical Skills Centre, Queen’s University Belfast. Cohort A received verbal feedback only on their performance and cohort B received video feedback only. Video analysis using ‘StudioCode’ software was distributed to students. Each group returned for a second scenario and evaluation 4 weeks later. An assessment tool was created for performance assessment, which included individual skill and global score evaluation. RESULTS: One hundred thirty eight final year medical students completed the study. 62 % were female and the mean age was 23.9 years. Students having video feedback had significantly greater improvement in overall scores compared to those receiving verbal feedback (p = 0.006, 95 % CI: 2.8–15.8). Individual skills, including ventilation quality and global score were significantly better with video feedback (p = 0.002 and p < 0.001, respectively) when compared with cohort A. There was a positive change in overall score for cohort B from session one to session two (p < 0.001, 95 % CI: 6.3–15.8) indicating video feedback significantly benefited skill retention. In addition, using video feedback showed a significant improvement in the global score (p < 0.001, 95 % CI: 3.3–7.2) and drug administration timing (p = 0.004, 95 % CI: 0.7–3.8) of cohort B participants, from session one to session two. CONCLUSIONS: There is increased use of simulation in medicine but a paucity of published data comparing feedback methods in cardiopulmonary resuscitation training. Our study shows the use of video feedback when teaching cardiopulmonary resuscitation is more effective than verbal feedback, and enhances skill retention. This is one of the first studies to demonstrate the benefit of video feedback in cardiopulmonary resuscitation teaching. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12909-016-0726-x) contains supplementary material, which is available to authorized users

ABSORPTION OF CONTROLLED RELEASE MORPHINE SULPHATE IN THE IMMEDIATE POSTOPERATIVE PERIOD

The absorption of morphine sulphate, given orally as a controlled release preparation, was studied in 10 patients who had undergone peripheral vascular surgery with a standard opioid-based general anaesthetic technique. Serum morphine concentrations were measured (high pressure liquid chromatography) every 2 h for the first 16 h after surgery and the results were strongly suggestive of a decrease in the rate of absorption of morphine in this situatio

Moving towards a wave-resolved approach to forecasting mountain wave induced clear air turbulence

Mountain wave breaking in the lower stratosphere is one of the major causes of atmospheric turbulence encountered in commercial aviation, which in turn is the cause of most weather-related aircraft incidents. In the case of clear air turbulence (CAT), there are no visual clues and pilots are reliant on operational forecasts and reports from other aircraft. Traditionally mountain waves have been sub-grid-scale in global numerical weather prediction (NWP) models, but recent developments in NWP mean that some forecast centres (e.g. the UK Met Office) are now producing operational global forecasts that resolve mountain wave activity explicitly, allowing predictions of mountain wave induced turbulence with greater accuracy and confidence than previously possible. Using a bespoke turbulent kinetic energy diagnostic, the Met Office Unified Model (MetUM) is shown to produce useful forecasts of mountain CAT during three case studies over Greenland, and to outperform the current operational Met Office CAT prediction product (the World Area Forecast Centre (WAFC) London gridded CAT product) in doing so. In a long term, 17-month, verification, MetUM forecasts yield a turbulence prediction hit rate of 80% with an accompanying false alarm rate of under 40%. These skill scores are a considerable improvement on those reported for the mountain wave component of the WAFC product, although no direct comparison is available. The major implication of this work is that sophisticated global NWP models are now sufficiently advanced to provide skilful forecasts of mountain wave turbulence

Damage function for historic paper. Part I: Fitness for use

Background In heritage science literature and in preventive conservation practice, damage functions are used to model material behaviour and specifically damage (unacceptable change), as a result of the presence of a stressor over time. For such functions to be of use in the context of collection management, it is important to define a range of parameters, such as who the stakeholders are (e.g. the public, curators, researchers), the mode of use (e.g. display, storage, manual handling), the long-term planning horizon (i.e. when in the future it is deemed acceptable for an item to become damaged or unfit for use), and what the threshold of damage is, i.e. extent of physical change assessed as damage. Results In this paper, we explore the threshold of fitness for use for archival and library paper documents used for display or reading in the context of access in reading rooms by the general public. Change is considered in the context of discolouration and mechanical deterioration such as tears and missing pieces: forms of physical deterioration that accumulate with time in libraries and archives. We also explore whether the threshold fitness for use is defined differently for objects perceived to be of different value, and for different modes of use. The data were collected in a series of fitness-for-use workshops carried out with readers/visitors in heritage institutions using principles of Design of Experiments. Conclusions The results show that when no particular value is pre-assigned to an archival or library document, missing pieces influenced readers/visitors’ subjective judgements of fitness-for-use to a greater extent than did discolouration and tears (which had little or no influence). This finding was most apparent in the display context in comparison to the reading room context. The finding also best applied when readers/visitors were not given a value scenario (in comparison to when they were asked to think about the document having personal or historic value). It can be estimated that, in general, items become unfit when text is evidently missing. However, if the visitor/reader is prompted to think of a document in terms of its historic value, then change in a document has little impact on fitness for use

***TEST SUBMISSION*** BMJ-15: Acceptance within last 3 months (01/03/2020); Online publication within 12 months (10/12/2020); Embargo (10/09/2021) less than 12 months from pub date; VoR

From UAT Test publisher via Jisc Publications RouterHistory: accepted 2020-03-01, epub 2020-12-10Article version: VoRPublication status: PublishedAbstract: TEST: THIS IS A PUBLICATIONS ROUTER TEST SUBMISSION. Objectives: To quantify post-colonoscopy colorectal cancer (PCCRC) rates in England by using recent World Endoscopy Organisation guidelines, compare incidence among colonoscopy providers, and explore associated factors that could benefit from quality improvement initiatives. Design: Population based cohort study. Setting: National Health Service in England between 2005 and 2013. Population: All people undergoing colonoscopy and subsequently diagnosed as having colorectal cancer up to three years after their investigation (PCCRC-3yr). Main outcome measures: National trends in incidence of PCCRC (within 6-36 months of colonoscopy), univariable and multivariable analyses to explore factors associated with occurrence, and funnel plots to measure variation among providers. Results: The overall unadjusted PCCRC-3yr rate was 7.4% (9317/126 152), which decreased from 9.0% in 2005 to 6.5% in 2013 (P<0.01). Rates were lower for colonoscopies performed under the NHS bowel cancer screening programme (593/16 640, 3.6%), while they were higher for those conducted by non-NHS providers (187/2009, 9.3%). Rates were higher in women, in older age groups, and in people with inflammatory bowel disease or diverticular disease, in those with higher comorbidity scores, and in people with previous cancers. Substantial variation in rates among colonoscopy providers remained after adjustment for case mix. Conclusions: Wide variation exists in PCCRC-3yr rates across NHS colonoscopy providers in England. The lowest incidence was seen in colonoscopies performed under the NHS bowel cancer screening programme. Quality improvement initiatives are needed to address this variation in rates and prevent colorectal cancer by enabling earlier diagnosis, removing premalignant polyps, and therefore improving outcomes