A giant mystery in giant cell myocarditis: navigating diagnosis, immunosuppression, and mechanical circulatory support.

Giant cell myocarditis is a rare but often devastating diagnosis. Advances in cardiac imaging and mechanical circulatory support have led to earlier and more frequent diagnoses and successful management. This disease state has wide variation in acuity of presentation, and consequently, optimal treatment ranging from intensity and type of immunosuppression to mechanical circulatory support is not well defined. The following case describes the management of a patient with an unusual presentation of giant cell myocarditis over a 10 year course of advanced heart failure therapies and immunomodulatory support. This case highlights emerging concepts in the management of giant cell myocarditis including sub-acute presentations, challenges in diagnosis, and treatment modalities in the modern era

Clinical Legal Education as Qualifying Work Experience for Solicitors

The Solicitors Regulation Authority (the “SRA”) is proposing radical changes to solicitor education and training. The Solicitors Qualification Examination (“SQE”) has been extensively debated, but less attention has been paid to the proposed changes relating to qualifying work experience (“QWE”). In future, a much broader range of work experience, including that gained through clinical legal education, will potentially be able to count as QWE. This article addresses the key questions arising from the proposals, as yet unchartered in any depth in journals and scholarly writing. The background and detail of the SRA’s plans is analysed, before consideration is given to both the arguments for and against clinical legal education counting as QWE. The practical challenges are then deconstructed. Who will be able to supervise and sign off clinical legal education as QWE? What type of clinical legal education could count? How much time should students be credited for? What policies will law schools need to put in place? Practical advice is offered based on the authors’ experience and knowledge. The discussion is intended to stimulate further debate and the development of consensus on best practice

QuickCut Waterjet Cutter

The QuickCut Waterjet Cutter was created in 2019 as a senior design project. This is the third iteration of the waterjet cutter. The goal of this project was to create an operable CNC waterjet cutter that is able to cut 1/16” tensile specimens consisting of nonferrous metal or plastic. This machine will be utilized in the Manufacturing Laboratory at the University of Akron to provide education to interested students on the waterjet cutting process, how it operates, and industrial application of the technology. Waterjet cutting is a subtractive manufacturing process which is recognized for its specialized applications such as cutting dangerous materials or preserving heat treatment. Waterjet cutting utilizes high pressurized water with entrained garnet to cut through materials with precision and accuracy. The QuickCut Waterjet Cutter aims to bring the applications of industrial waterjet cutting operations to the smaller, tabletop scale to cut softer materials with precision. This report goes in depth on what defines an abrasive waterjet cutter, important components and the benefits of the waterjet cutting process. Detailed steps on how the newest rendition of the Quickcut Waterjet Cutter was created are covered. This includes brainstorming, design of components, design of controls, manufacturing process, as well as testing and future work to be completed

Enabling Hybrid Architectures and Mesh Network Topologies to Support the Global Multi-Domain Community

The turn of the new decade also represents the dawn of a new shift in domain operations. Concepts such as “Space Dial Tone,” reliable global access to internet, on-demand Earth observation, and remote sensing, while still not fully realized, are no longer purely imaginative. These concepts are in high demand and are coupled with the goals of Global Multi-Domain Operations (MDO). Small satellites (smallsats) have emerged as functionally reliable platforms, driving the development of next-generation satellite constellations. To achieve the potential of tomorrow’s technology, these constellations must embrace space mission architectures based on interoperable, open-system constructs such as hybrid architectures and mesh network topologies. This paper presents the full timeline for realization of multi-node, disparate (sovereign, coalition, commercial, etc.) multi-domain (Space, Air, Maritime, Land, and Cyber) systems to support future space mission architectures. It identifies and discusses the underlying technologies needed to bring new “system-of-systems” concepts to operational capability. Technologies to be discussed include: message-agnostic physical/protocol “Bridges”; Machine-to-Machine (M2M) data sharing enabled through Electronic Data Sheet (EDS) standards; and, new concepts related to Artificial Intelligence (AI) enabled human decision making. Tying these technologies together effectively will positively impact the smallsat market and fundamentally change mission architectures in the near future

Improving the use of technology enhanced learning environments in higher education in the UK: A qualitative visualisation of students’ views

In recent years, the use of Technology Enhanced Learning (TEL) has risen exponentially throughout higher education in the UK. Whilst TEL is an umbrella term for a range of technologies, evidence suggests that in the UK, TEL is usually delivered via the medium of Virtual Learning Environments (VLEs) for the provision of lecture materials and additional content. An emerging literature has established both the pedagogical potential and students’ perceived usefulness of TEL. However, researchers have yet to establish how the use of TEL via VLEs can be improved – a core requirement of establishing best practice. The current study sought to address this in a sample of 487 predominately undergraduate students. Content analysis revealed that views were overwhelmingly positive, but that students had clear views on what they wanted to see improved. Students expressed clear desires for the more consistent and more frequent use of TEL within lectures. Further, they felt that the potential of TEL to encourage and facilitate interactions, both within their University and with external stakeholders, has thus far gone unexploited. Implications for teaching practice and future research are discussed

Technology enhanced learning in higher education; motivations, engagement and academic achievement

Technology Enhanced Learning (TEL) has become a common feature of Higher Education. However, research has been hindered by a lack of differentiation between usage and engagement and not recognising the heterogeneity of TEL applications. The current study aimed to assess the impact of emotional, cognitive and behavioural engagement with TEL on students’ grades and to also look at how motivation levels differentially predict engagement across different types of TEL. In a sample of 524 undergraduate students, we measured engagement and usage of TEL, student learning motivations and self-report student grades. Our results indicate that intrinsic motivations predict engagement, whilst extrinsic motivations predict usage. Importantly, engagement was predictive of grades whereas usage was not. Furthermore, when TEL was broken down by type, the use of social media groups was a significant predictor of grade, whereas reviewing lecture slides/ recordings, reading additional content and using course blogs/ discussion boards were not. We conclude that a sole focus on usage of TEL is misleading. Implications for researchers and educators are discussed

Blockade of Immunosuppressive Cytokines Restores NK Cell Antiviral Function in Chronic Hepatitis B Virus Infection

NK cells are enriched in the liver, constituting around a third of intrahepatic lymphocytes. We have previously demonstrated that they upregulate the death ligand TRAIL in patients with chronic hepatitis B virus infection (CHB), allowing them to kill hepatocytes bearing TRAIL receptors. In this study we investigated whether, in addition to their pathogenic role, NK cells have antiviral potential in CHB. We characterised NK cell subsets and effector function in 64 patients with CHB compared to 31 healthy controls. We found that, in contrast to their upregulated TRAIL expression and maintenance of cytolytic function, NK cells had a markedly impaired capacity to produce IFN-gamma in CHB. This functional dichotomy of NK cells could be recapitulated in vitro by exposure to the immunosuppressive cytokine IL-10, which was induced in patients with active CHB. IL-10 selectively suppressed NK cell IFN-gamma production without altering cytotoxicity or death ligand expression. Potent antiviral therapy reduced TRAIL-expressing CD56 bright NK cells, consistent with the reduction in liver inflammation it induced; however, it was not able to normalise IL-10 levels or the capacity of NK cells to produce the antiviral cytokine IFN-gamma. Blockade of IL-10 +/- TGF-beta restored the capacity of NK cells from both the periphery and liver of patients with CHB to produce IFN-gamma, thereby enhancing their non-cytolytic antiviral capacity. In conclusion, NK cells may be driven to a state of partial functional tolerance by the immunosuppressive cytokine environment in CHB. Their defective capacity to produce the antiviral cytokine IFN-gamma persists in patients on antiviral therapy but can be corrected in vitro by IL-10+/- TGF-beta blockade

Staff/Student Partnership to Encourage Active and Blended Learning

This poster and GASTA talk are a reflective commentary on the steps and collaboration undertaken to redevelop the VLE pages of the University of Glasgow Dental Programme. There are two primary aims of this project, the first is to improve the usability of Moodle by altering the structure and layout. The secondary aim is to facilitate creativity from academic staff by removing barriers that are present in the confines of the current platform and enabling them with a more tailored and functional Moodle. Staff will receive support in the development of more interactive teaching methods, such as interactive videos, flipped classroom, active and blended learning techniques. Moodle is currently primarily used as a repository for lecture slides and lacks a sense of cohesion as each lecturer formats their folders in different ways. Staff experience confusion over what they are responsible for and which files belong to which academic, resulting in increased clutter over many years. For some time, students – through staff/student liaison committees – and staff have complained about the difficulty of navigating and finding resources within our Moodle section. Also, as the current layout does not lend itself well to enabling staff wishing to try innovative active or use blended learning approaches only a few early adopters have tried. So, at the beginning of academic year 2018/19 a decision was made to consider a full redevelopment of programme Moodle structures with a ‘blank slate’ philosophy. Utilising Adekola et al’s (2017) framework for guiding transitions into blended and online education we identified the key factors, stakeholders, and barriers & enablers to making this scale of change. As part of engaging stakeholders, the project would initially be carried out as a collaboration between early innovator academics, technical support, and students. The Dental School already has many years of experience in engaging students in e-learning development (McKerlie et al, 2016) so could engage with the student experience through our established Technology Enhanced Learning & Teaching Partnership staff/student forum. As we also already had extensive School experience in the use of flipped classroom techniques (Crothers et al, 2017) we could use these structures and lessons learned as a starting point from which to develop templates. Using the ABC Learning Design technique (Young & Perovic, 2016) to support lecturers to build their content around the Biggs (2003) model of Constructive Alignment the aim was to utilise the Clinical Dentistry course to create Moodle pages organised both chronologically and by subject, with active and blended learning elements embedded throughout. With the development of these structures and templates we expect more lecturers will find it easier to engage with and utilise TELT techniques. This poster and session will reflect on the journey and experience of collaborating to redevelop the Clinical Dentistry section into the new model and offer insights into how to support academic staff to utilise creative approaches through online and blended learning

Staff/Student Partnership to Encourage Active and Blended Learning

This poster and GASTA talk are a reflective commentary on the steps and collaboration undertaken to redevelop the VLE pages of the University of Glasgow Dental Programme. There are two primary aims of this project, the first is to improve the usability of Moodle by altering the structure and layout. The secondary aim is to facilitate creativity from academic staff by removing barriers that are present in the confines of the current platform and enabling them with a more tailored and functional Moodle. Staff will receive support in the development of more interactive teaching methods, such as interactive videos, flipped classroom, active and blended learning techniques. Moodle is currently primarily used as a repository for lecture slides and lacks a sense of cohesion as each lecturer formats their folders in different ways. Staff experience confusion over what they are responsible for and which files belong to which academic, resulting in increased clutter over many years. For some time, students – through staff/student liaison committees – and staff have complained about the difficulty of navigating and finding resources within our Moodle section. Also, as the current layout does not lend itself well to enabling staff wishing to try innovative active or use blended learning approaches only a few early adopters have tried. So, at the beginning of academic year 2018/19 a decision was made to consider a full redevelopment of programme Moodle structures with a ‘blank slate’ philosophy. Utilising Adekola et al’s (2017) framework for guiding transitions into blended and online education we identified the key factors, stakeholders, and barriers & enablers to making this scale of change. As part of engaging stakeholders, the project would initially be carried out as a collaboration between early innovator academics, technical support, and students. The Dental School already has many years of experience in engaging students in e-learning development (McKerlie et al, 2016) so could engage with the student experience through our established Technology Enhanced Learning & Teaching Partnership staff/student forum. As we also already had extensive School experience in the use of flipped classroom techniques (Crothers et al, 2017) we could use these structures and lessons learned as a starting point from which to develop templates. Using the ABC Learning Design technique (Young & Perovic, 2016) to support lecturers to build their content around the Biggs (2003) model of Constructive Alignment the aim was to utilise the Clinical Dentistry course to create Moodle pages organised both chronologically and by subject, with active and blended learning elements embedded throughout. With the development of these structures and templates we expect more lecturers will find it easier to engage with and utilise TELT techniques. This poster and session will reflect on the journey and experience of collaborating to redevelop the Clinical Dentistry section into the new model and offer insights into how to support academic staff to utilise creative approaches through online and blended learning

Clinical Legal Education as Qualifying Work Experience

The LETR set out many recommendations and findings for legal education, such as the professional competencies required for legal practice, derived from Epstein and Hundert’s Professional Competencies in Medicine. In response to this, the Solicitors Regulation Authority (SRA) published a Statement of Solicitor Competence, underpinned by a Statement of Legal Knowledge. Such competencies are to be assessed by way of the Solicitors Qualifying Examination (SQE), which is intended to test both a candidate’s legal knowledge (SQE 1) and their legal skills (SQE 2). In addition, Recommendation 15 of the LETR report stated that “arrangements for periods of supervised practice should also be reviewed to remove unnecessary restrictions on training environments and organisations and to facilitate additional opportunities for qualification”. Following the spirit of this recommendation, the SRA has confirmed that in future, work experience undertaken outside of a traditional training contract, including in a student law clinic, will count towards the required period of qualifying work experience (QWE). This decision will of course be of interest to law schools, particularly those that already have some form of clinical programme where there is the potential for students to develop solicitor competences. However, a consideration must be made of the challenges that law schools may face if they choose to engage in QWE; and what practical considerations will they need to bear in mind if they decide to certify that the student has had the opportunity to develop the solicitor competences. Legal clinics, focused on the practical application of the law to real life legal problems, potentially present an opportunity for students to begin to develop their solicitor competences. However, the extent to which such competences are developed, and the consequences of signing off on QWE require further exploration. Based on the presenters’ experiences in a live client legal clinic, this paper will explore whether law clinics can offer QWE and the practicalities which will have to be considered if law schools wish to do so