Lessons from Triadic Supervisors: Maximizing Effectiveness

Through this hermeneutic-phenomenological qualitative study, 10 supervisors of a CACREP accredited program identified emergent themes and challenges of triadic supervision: relationship dynamics, feedback, time management, contextual learning, and matching of supervisees. The researchers offer specific methods to approach these challenges within triadic supervision to maximize effectiveness

Lessons from Triadic Supervisors: Maximizing Effectiveness

Through this hermeneutic-phenomenological qualitative study, 10 supervisors of a CACREP accredited program identified emergent themes and challenges of triadic supervision: relationship dynamics, feedback, time management, contextual learning, and matching of supervisees. The researchers offer specific methods to approach these challenges within triadic supervision to maximize effectiveness

Accurate measurement of long range proton-carbon scalar coupling constants

The accuracy and ease-of-use of various experimental NMR methods for measuringnJCHvalues is assessed.</p

Early PREdiction of sepsis using leukocyte surface biomarkers: the ExPRES-sepsis cohort study.

PURPOSE: Reliable biomarkers for predicting subsequent sepsis among patients with suspected acute infection are lacking. In patients presenting to emergency departments (EDs) with suspected acute infection, we aimed to evaluate the reliability and discriminant ability of 47 leukocyte biomarkers as predictors of sepsis (Sequential Organ Failure Assessment score ≥ 2 at 24 h and/or 72 h following ED presentation). METHODS: In a multi-centre cohort study in four EDs and intensive care units (ICUs), we standardised flow-cytometric leukocyte biomarker measurement and compared patients with suspected acute infection (cohort-1) with two comparator cohorts: ICU patients with established sepsis (cohort-2), and ED patients without infection or systemic inflammation but requiring hospitalization (cohort-3). RESULTS: Between January 2014 and February 2016, we recruited 272, 59 and 75 patients to cohorts 1, 2, and 3, respectively. Of 47 leukocyte biomarkers, 14 were non-reliable, and 17 did not discriminate between the three cohorts. Discriminant analyses for predicting sepsis within cohort-1 were undertaken for eight neutrophil (cluster of differentiation antigens (CD) CD15; CD24; CD35; CD64; CD312; CD11b; CD274; CD279), seven monocyte (CD35; CD64; CD312; CD11b; HLA-DR; CD274; CD279) and a CD8 T-lymphocyte biomarker (CD279). Individually, only higher neutrophil CD279 [OR 1.78 (95% CI 1.23-2.57); P = 0.002], higher monocyte CD279 [1.32 (1.03-1.70); P = 0.03], and lower monocyte HLA-DR [0.73 (0.55-0.97); P = 0.03] expression were associated with subsequent sepsis. With logistic regression the optimum biomarker combination was increased neutrophil CD24 and neutrophil CD279, and reduced monocyte HLA-DR expression, but no combination had clinically relevant predictive validity. CONCLUSIONS: From a large panel of leukocyte biomarkers, immunosuppression biomarkers were associated with subsequent sepsis in ED patients with suspected acute infection. CLINICAL TRIAL REGISTRATION: NCT02188992.The study was funded by Innovate UK (Sepsis 2: 101193). Dr Shankar-Hari is supported by the National Institute for Health Research Clinician Scientist Award (CS-2016-16-011). Dr Conway Morris is supported by a Clinical Research Career Development Fellowship from the Wellcome Trust (WT 2055214/Z/16/Z)

TEF, Vol. 4 No. 1

This is the fourth issue of the annually published literary magazine TEF.https://scholarworks.sfasu.edu/tef/1003/thumbnail.jp

Independent fashion designers in the elusive fashion city

This article examines the cultural geography of fashion cities, focusing on independent fashion designers’ relationships with their city. Through discussing the Australian city of Brisbane and its place within the hierarchy of fashion cities, we examine the position of modern yet peripheral locations that have what we term an ‘elusive’ fashion identity. The discussion highlights the complexities that make a city a fashion city, specifically the interplay between industry, culture, retail and design, commonly identified as fundamental elements in the construction or transformation of fashion cities. The paper unravels the dynamics and discourses that have contributed to the contemporary conceptualisation of the fashion city; it evaluates the way in which local independent fashion designers (IFDs) can contribute to a reorientation of thinking about cities and their fashion; and it gauges how IFDs sustain a local fashion identity within cities that do not present the commonly recognised characteristics of a fashion city such as infrastructures. We argue that IFDs in peripheral cities have a very different relationship with their city than do IFDs in so-called fashion cities. By examining this relationship, and Brisbane’s modestly placed position on fashion cities’ hierarchy, we propose that, except for the traditional fashion centres, other cities are in a constant state of flux, arguing that the concept of the fashion city itself is elusive. We propose that as cities experience fashion narratives that ebb and flow, they may present multiple characteristics that make them unique at a particular moment, thus they are ‘elusive’ fashion cities

Genetic mechanisms of critical illness in COVID-19.

Host-mediated lung inflammation is present1, and drives mortality2, in the critical illness caused by coronavirus disease 2019 (COVID-19). Host genetic variants associated with critical illness may identify mechanistic targets for therapeutic development3. Here we report the results of the GenOMICC (Genetics Of Mortality In Critical Care) genome-wide association study in 2,244 critically ill patients with COVID-19 from 208 UK intensive care units. We have identified and replicated the following new genome-wide significant associations: on chromosome 12q24.13 (rs10735079, P = 1.65 × 10-8) in a gene cluster that encodes antiviral restriction enzyme activators (OAS1, OAS2 and OAS3); on chromosome 19p13.2 (rs74956615, P = 2.3 × 10-8) near the gene that encodes tyrosine kinase 2 (TYK2); on chromosome 19p13.3 (rs2109069, P = 3.98 ×  10-12) within the gene that encodes dipeptidyl peptidase 9 (DPP9); and on chromosome 21q22.1 (rs2236757, P = 4.99 × 10-8) in the interferon receptor gene IFNAR2. We identified potential targets for repurposing of licensed medications: using Mendelian randomization, we found evidence that low expression of IFNAR2, or high expression of TYK2, are associated with life-threatening disease; and transcriptome-wide association in lung tissue revealed that high expression of the monocyte-macrophage chemotactic receptor CCR2 is associated with severe COVID-19. Our results identify robust genetic signals relating to key host antiviral defence mechanisms and mediators of inflammatory organ damage in COVID-19. Both mechanisms may be amenable to targeted treatment with existing drugs. However, large-scale randomized clinical trials will be essential before any change to clinical practice