Tools to Assess Behavioral and Social Science Competencies in Medical Education: A Systematic Review

Behavioral and social science (BSS) competencies are needed to provide quality health care, but psychometrically validated measures to assess these competencies are difficult to find. Moreover, they have not been mapped to existing frameworks, like those from the Liaison Committee on Medical Education (LCME) and Accreditation Council for Graduate Medical Education (ACGME). This systematic review aimed to identify and evaluate the quality of assessment tools used to measure BSS competencies

CHD8 Regulates Neurodevelopmental Pathways Associated with Autism Spectrum Disorder in Neural Progenitors

Truncating mutations of chromodomain helicase DNA-binding protein 8 (CHD8), and of many other genes with diverse functions, are strong-effect risk factors for autism spectrum disorder (ASD), suggesting multiple mechanisms of pathogenesis. We explored the transcriptional networks that CHD8 regulates in neural progenitor cells (NPCs) by reducing its expression and then integrating transcriptome sequencing (RNA sequencing) with genome-wide CHD8 binding (ChIP sequencing). Suppressing CHD8 to levels comparable with the loss of a single allele caused altered expression of 1,756 genes, 64.9% of which were up-regulated. CHD8 showed widespread binding to chromatin, with 7,324 replicated sites that marked 5,658 genes. Integration of these data suggests that a limited array of direct regulatory effects of CHD8 produced a much larger network of secondary expression changes. Genes indirectly down-regulated (i.e., without CHD8-binding sites) reflect pathways involved in brain development, including synapse formation, neuron differentiation, cell adhesion, and axon guidance, whereas CHD8-bound genes are strongly associated with chromatin modification and transcriptional regulation. Genes associated with ASD were strongly enriched among indirectly down-regulated loci (P < 10[superscript −8]) and CHD8-bound genes (P = 0.0043), which align with previously identified coexpression modules during fetal development. We also find an intriguing enrichment of cancer-related gene sets among CHD8-bound genes (P < 10[superscript −10]). In vivo suppression of chd8 in zebrafish produced macrocephaly comparable to that of humans with inactivating mutations. These data indicate that heterozygous disruption of CHD8 precipitates a network of gene-expression changes involved in neurodevelopmental pathways in which many ASD-associated genes may converge on shared mechanisms of pathogenesis.Simons FoundationNancy Lurie Marks Family FoundationNational Institutes of Health (U.S.) (Grant MH095867)National Institutes of Health (U.S.) (Grant MH095088)National Institutes of Health (U.S.) (Grant GM061354)March of Dimes Birth Defects FoundationCharles H. Hood FoundationBrain & Behavior Research FoundationAutism Genetic Resource ExchangeAutism Speaks (Organization)Pitt–Hopkins Research Foundatio

A comparative analysis of predictive models of morbidity in intensive care unit after cardiac surgery – Part II: an illustrative example

<p>Abstract</p> <p>Background</p> <p>Popular predictive models for estimating morbidity probability after heart surgery are compared critically in a unitary framework. The study is divided into two parts. In the first part modelling techniques and intrinsic strengths and weaknesses of different approaches were discussed from a theoretical point of view. In this second part the performances of the same models are evaluated in an illustrative example.</p> <p>Methods</p> <p>Eight models were developed: Bayes linear and quadratic models, <it>k</it>-nearest neighbour model, logistic regression model, Higgins and direct scoring systems and two feed-forward artificial neural networks with one and two layers. Cardiovascular, respiratory, neurological, renal, infectious and hemorrhagic complications were defined as morbidity. Training and testing sets each of 545 cases were used. The optimal set of predictors was chosen among a collection of 78 preoperative, intraoperative and postoperative variables by a stepwise procedure. Discrimination and calibration were evaluated by the area under the receiver operating characteristic curve and Hosmer-Lemeshow goodness-of-fit test, respectively.</p> <p>Results</p> <p>Scoring systems and the logistic regression model required the largest set of predictors, while Bayesian and <it>k</it>-nearest neighbour models were much more parsimonious. In testing data, all models showed acceptable discrimination capacities, however the Bayes quadratic model, using only three predictors, provided the best performance. All models showed satisfactory generalization ability: again the Bayes quadratic model exhibited the best generalization, while artificial neural networks and scoring systems gave the worst results. Finally, poor calibration was obtained when using scoring systems, <it>k</it>-nearest neighbour model and artificial neural networks, while Bayes (after recalibration) and logistic regression models gave adequate results.</p> <p>Conclusion</p> <p>Although all the predictive models showed acceptable discrimination performance in the example considered, the Bayes and logistic regression models seemed better than the others, because they also had good generalization and calibration. The Bayes quadratic model seemed to be a convincing alternative to the much more usual Bayes linear and logistic regression models. It showed its capacity to identify a minimum core of predictors generally recognized as essential to pragmatically evaluate the risk of developing morbidity after heart surgery.</p

Long non-coding antisense RNA controls Uchl1 translation through an embedded SINEB2 repeat.

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Empiricism Without the Senses: How the Instrument Replaced the Eye

On receiving news of Galileo’s observations of the four satellites of Jupiter and the rugged face of the moon through his newly invented perspicillum, Kepler in great excitement exclaimed: Therefore let Galileo take his stand by Kepler’s side. Let the former observe the moon with his face turned skyward, while the latter studies the sun by looking down at a screen (lest the lens injure his eyes). Let each employ his own device, and from this partnership may there some day arise an absolutely perfect theory of the distances. This Hollywood-like scene of the two astronomers marching hand in hand toward the dawn of a new scientific era was no attempt by Kepler to appropriate Galileo’s success or to diminish the novelty of the telescope. On the contrary, Kepler repeatedly asserted how short sighted he was in misjudging the potential for astronomical observations inherent in lenses, and how radically Galileo’s instrument transformed the science of astronomy. It was a deep sense of recognition that beyond their different scientific temperaments and projects, they shared a common agenda of a new mode of empirical engagement with the phenomenal world: the instrument. For Kepler and Galileo, empirical investigation was no longer a direct engagement with nature, but an essentially mediated endeavor. The new instruments were not to assist the human senses, but to replace them

Unravelling legacy: a triadic actor-network theory approach to understanding the outcomes of mega events

Mega events have recently attracted the attention of social scientists due to their important role for festival capitalism, urban regeneration and political propaganda. Their planning stage often produces elaborate strategies for maximising the benefits before, during and after the actual event, which has given rise to interdisciplinary studies of event legacy and leveraging. This paper aims to advance ongoing debates on the outcomes of sports mega events by bringing together the literatures on mega event legacy, leveraging and actor-network theory. Drawing on a case study on the usage of the Queen Elizabeth Olympic Park, the main legacy of the London 2012 Olympic Games, the paper develops a novel conceptual framework for researching the multi-scalar outcomes of mega events and locating respective studies within the resulting wider research agenda. The proposed concept extends Preuss’ (2007) legacy cube in two ways by visualising its five research dimensions in the legacy rings and using three rather than two sub-dimensions per ring, thereby replacing the restrictive dyads of dualistic thinking through more comprehensive but still manageable triads of triadic thought (Jöns, 2006)

The new political economy of higher education: between distributional conflicts and discursive stratification

The higher education sector has been undergoing a far-reaching institutional re-orientation during the past two decades. Many adjustments appear to have strengthened the role of competition in the governance of higher education, but the character of the sector?s emerging new political economy has frequently remained unclear. Serving as the introduction for the special issue, this article makes the case for a multidimensional strategy to probe higher education?s competitive transformation. In terms of conceptualizing the major empirical shifts, we argue for analyzing three core phenomena: varieties of academic capitalism, the discursive construction of inequality, and the transformation of hierarchies in competitive settings. With respect to theoretical tools, we emphasize the complementary contributions of institutional, class-oriented, and discourse analytical approaches. As this introduction elaborates and the contributions to the special issue demonstrate, critical dialog among different analytical traditions over the interpretation of change is crucial for improving established understandings. Arguably, it is essential for clarifying the respective roles of capitalist power and hierarchical rule in the construction of the sector?s new order