The clinical associate curriculum . the learning theory underpinning the BCMP programme at the University of Pretoria

The Bachelor of Clinical Medical Practice (BCMP) is a new degree at the University of Pretoria (UP), designed to create a new category of mid-levelmedical workers, namely clinical associates. UP produced its first 44 graduates in 2011. The BCMP created the opportunity to innovate learning andteaching through designing, monitoring and evaluating the transformation of the curriculum as action research. Drawing on the theories and practices of authentic learning, self-directed learning, whole-brain learning and collaborative learning, the curriculum has been transformed. The potential of this curriculum extends beyond the formal education part of the programme . into clinical associate practice, healthcare practice and, potentially, general medical and healthcare education

A Chinese cave links climate change, social impacts, and human adaptation over the last 500 years.

The collapse of some pre-historical and historical cultures, including Chinese dynasties were presumably linked to widespread droughts, on the basis of synchronicities of societal crises and proxy-based climate events. Here, we present a comparison of ancient inscriptions in Dayu Cave from Qinling Mountains, central China, which described accurate times and detailed impacts of seven drought events during the period of 1520-1920 CE, with high-resolution speleothem records from the same cave. The comparable results provide unique and robust tests on relationships among speleothem δ(18)O changes, drought events, and societal unrest. With direct historical evidences, our results suggest that droughts and even modest events interrupting otherwise wet intervals can cause serious social crises. Modeling results of speleothem δ(18)O series suggest that future precipitation in central China may be below the average of the past 500 years. As Qinling Mountain is the main recharge area of two large water transfer projects and habitats of many endangered species, it is imperative to explore an adaptive strategy for the decline in precipitation and/or drought events.We gratefully acknowledge the NBRPC (2013CB955902), NSFC (41372192; 41290254; 41230524; 41023006), and the WLF-CAS for funding this research. This study was also partially supported by Taiwan MOST (103-2119-M-002-022) and NTU (101R7625) grants. H.C. and R.L.E. received financial support from the U.S. NSF (EAR-0908792 and EAR-1211299), and S.F.M.B. received support from the Swiss NSF (CRSI22_132646/1).This is the final version. It was first published by NPG at http://www.nature.com/srep/2015/150717/srep12284/full/srep12284.html#author-information

Animal modelling for inherited central vision loss.

Disease-causing variants of a large number of genes trigger inherited retinal degeneration leading to photoreceptor loss. Because cones are essential for daylight and central vision such as reading, mobility, and face recognition, this review focuses on a variety of animal models for cone diseases. The pertinence of using these models to reveal genotype/phenotype correlations and to evaluate new therapeutic strategies is discussed. Interestingly, several large animal models recapitulate human diseases and can serve as a strong base from which to study the biology of disease and to assess the scale-up of new therapies. Examples of innovative approaches will be presented such as lentiviral-based transgenesis in pigs and adeno-associated virus (AAV)-gene transfer into the monkey eye to investigate the neural circuitry plasticity of the visual system. The models reported herein permit the exploration of common mechanisms that exist between different species and the identification and highlighting of pathways that may be specific to primates, including humans

Super-resolution far-field ghost imaging via compressive sampling

Much more image details can be resolved by improving the system's imaging resolution and enhancing the resolution beyond the system's Rayleigh diffraction limit is generally called super-resolution. By combining the sparse prior property of images with the ghost imaging method, we demonstrated experimentally that super-resolution imaging can be nonlocally achieved in the far field even without looking at the object. Physical explanation of super-resolution ghost imaging via compressive sampling and its potential applications are also discussed.Comment: 4pages,4figure

Adverse prognostic and predictive significance of low DNA-dependent protein kinase catalytic subunit (DNA-PKcs) expression in early-stage breast cancers

Background: DNA-dependent protein kinase catalytic subunit (DNA-PKcs), a serine threonine kinase belonging to the PIKK family (phosphoinositide 3-kinase-like-family of protein kinase), is a critical component of the non-homologous end joining (NHEJ) pathway required for the repair of DNA double strand breaks. DNA-PKcs may be involved in breast cancer pathogenesis. Methods: We evaluated clinicopathological significance of DNA-PKcs protein expression in 1161 tumours and DNA-PKcs mRNA expression in 1950 tumours. We correlated DNA-PKcs to other markers of aggressive phenotypes, DNA repair, apoptosis and cell cycle regulation. Results: Low DNA-PKcs protein expression was associated with higher tumour grade, higher mitotic index, tumour de-differentiation and tumour type (ps<0.05). Absence of BRCA1, low XRCC1/SMUG1/APE1/Polβ were also more likely in low DNA-PKcs expressing tumours (ps<0.05). Low DNA-PKcs protein expression was significantly associated with worse breast cancer specific survival (BCCS) in univariate and multivariate analysis (ps<0.01). At the mRNA level, low DNA-PKcs was associated with PAM50.Her2 and PAM50.LumA molecular phenotypes (ps<0.01) and poor BCSS. In patients with ER positive tumours who received endocrine therapy, low DNA-PKcs (protein and mRNA) was associated with poor survival. In ER negative patients, low DNA-PKcs mRNA remains significantly associated with adverse outcome. Conclusions: Our study suggests that low DNA-PKcs expression may have prognostic and predictive significance in breast cancers

Stronger diversity effects with increased environmental stress : a study of multitrophic interactions between oak, powdery mildew and ladybirds

Recent research has suggested that increasing neighbourhood tree species diversity may mitigate the impact of pests or pathogens by supporting the activities of their natural enemies and/or reducing the density of available hosts. In this study, we attempted to assess these mechanisms in a multitrophic study system of young oak (Quercus), oak powdery mildew (PM, caused by Erysiphe spp.) and a mycophagous ladybird (Psyllobora vigintiduo-punctata). We assessed ladybird mycophagy on oak PM in function of different neighbourhood tree species compositions. We also evaluated whether these species interactions were modulated by environmental conditions as suggested by the Stress Gradient Hypothesis. We adopted a complementary approach of a field experiment where we monitored oak saplings subjected to a reduced rainfall gradient in a young planted forest consisting of different tree species mixtures, as well as a lab experiment where we independently evaluated the effect of different watering treatments on PM infections and ladybird mycophagy. In the field experiment, we found effects of neighbourhood tree species richness on ladybird mycophagy becoming more positive as the target trees received less water. This effect was only found as weather conditions grew drier. In the lab experiment, we found a preference of ladybirds to graze on infected leaves from trees that received less water. We discuss potential mechanisms that might explain this preference, such as emissions of volatile leaf chemicals. Our results are in line with the expectations of the Natural Enemies Hypothesis and support the hypothesis that biodiversity effects become stronger with increased environmental stress

XNAP: Making LSTM-based Next Activity Predictions Explainable by Using LRP

Predictive business process monitoring (PBPM) is a class of techniques designed to predict behaviour, such as next activities, in running traces. PBPM techniques aim to improve process performance by providing predictions to process analysts, supporting them in their decision making. However, the PBPM techniques` limited predictive quality was considered as the essential obstacle for establishing such techniques in practice. With the use of deep neural networks (DNNs), the techniques` predictive quality could be improved for tasks like the next activity prediction. While DNNs achieve a promising predictive quality, they still lack comprehensibility due to their hierarchical approach of learning representations. Nevertheless, process analysts need to comprehend the cause of a prediction to identify intervention mechanisms that might affect the decision making to secure process performance. In this paper, we propose XNAP, the first explainable, DNN-based PBPM technique for the next activity prediction. XNAP integrates a layer-wise relevance propagation method from the field of explainable artificial intelligence to make predictions of a long short-term memory DNN explainable by providing relevance values for activities. We show the benefit of our approach through two real-life event logs

Multiscale spatial mapping of cell populations across anatomical sites in healthy human skin and basal cell carcinoma

\ua9 2024 National Academy of Sciences. All rights reserved.Our understanding of how human skin cells differ according to anatomical site and tumour formation is limited. To address this, we have created a multiscale spatial atlas of healthy skin and basal cell carcinoma (BCC), incorporating in vivo optical coherence tomography, single-cell RNA sequencing, spatial global transcriptional profiling, and in situ sequencing. Computational spatial deconvolution and projection revealed the localisation of distinct cell populations to specific tissue contexts. Although cell populations were conserved between healthy anatomical sites and in BCC, mesenchymal cell populations including fibroblasts and pericytes retained signatures of developmental origin. Spatial profiling and in silico lineage tracing support a hair follicle origin for BCC and demonstrate that cancer-associated fibroblasts are an expansion of a POSTN+ subpopulation associated with hair follicles in healthy skin. RGS5+ pericytes are also expanded in BCC suggesting a role in vascular remodelling. We propose that the identity of mesenchymal cell populations is regulated by signals emanating from adjacent structures and that these signals are repurposed to promote the expansion of skin cancer stroma. The resource we have created is publicly available in an interactive format for the research community

Variational Methods for Biomolecular Modeling

Structure, function and dynamics of many biomolecular systems can be characterized by the energetic variational principle and the corresponding systems of partial differential equations (PDEs). This principle allows us to focus on the identification of essential energetic components, the optimal parametrization of energies, and the efficient computational implementation of energy variation or minimization. Given the fact that complex biomolecular systems are structurally non-uniform and their interactions occur through contact interfaces, their free energies are associated with various interfaces as well, such as solute-solvent interface, molecular binding interface, lipid domain interface, and membrane surfaces. This fact motivates the inclusion of interface geometry, particular its curvatures, to the parametrization of free energies. Applications of such interface geometry based energetic variational principles are illustrated through three concrete topics: the multiscale modeling of biomolecular electrostatics and solvation that includes the curvature energy of the molecular surface, the formation of microdomains on lipid membrane due to the geometric and molecular mechanics at the lipid interface, and the mean curvature driven protein localization on membrane surfaces. By further implicitly representing the interface using a phase field function over the entire domain, one can simulate the dynamics of the interface and the corresponding energy variation by evolving the phase field function, achieving significant reduction of the number of degrees of freedom and computational complexity. Strategies for improving the efficiency of computational implementations and for extending applications to coarse-graining or multiscale molecular simulations are outlined.Comment: 36 page

Identification of the initial molecular changes in response to circulating angiogenic cells-mediated therapy in critical limb ischemia

BackgroundCritical limb ischemia (CLI) constitutes the most aggressive form of peripheral arterial occlusive disease, characterized by the blockade of arteries supplying blood to the lower extremities, significantly diminishing oxygen and nutrient supply. CLI patients usually undergo amputation of fingers, feet, or extremities, with a high risk of mortality due to associated comorbidities.Circulating angiogenic cells (CACs), also known as early endothelial progenitor cells, constitute promising candidates for cell therapy in CLI due to their assigned vascular regenerative properties. Preclinical and clinical assays with CACs have shown promising results. A better understanding of how these cells participate in vascular regeneration would significantly help to potentiate their role in revascularization.Herein, we analyzed the initial molecular mechanisms triggered by human CACs after being administered to a murine model of CLI, in order to understand how these cells promote angiogenesis within the ischemic tissues.MethodsBalb-c nude mice (n:24) were distributed in four different groups: healthy controls (C, n:4), shams (SH, n:4), and ischemic mice (after femoral ligation) that received either 50 mu l physiological serum (SC, n:8) or 5x10(5) human CACs (SE, n:8). Ischemic mice were sacrificed on days 2 and 4 (n:4/group/day), and immunohistochemistry assays and qPCR amplification of Alu-human-specific sequences were carried out for cell detection and vascular density measurements. Additionally, a label-free MS-based quantitative approach was performed to identify protein changes related.ResultsAdministration of CACs induced in the ischemic tissues an increase in the number of blood vessels as well as the diameter size compared to ischemic, non-treated mice, although the number of CACs decreased within time. The initial protein changes taking place in response to ischemia and more importantly, right after administration of CACs to CLI mice, are shown.ConclusionsOur results indicate that CACs migrate to the injured area; moreover, they trigger protein changes correlated with cell migration, cell death, angiogenesis, and arteriogenesis in the host. These changes indicate that CACs promote from the beginning an increase in the number of vessels as well as the development of an appropriate vascular network.Institute of Health Carlos III, ISCIII; Junta de Andaluci