Reflections on a coaching pilot project in healthcare settings

This paper draws on personal reflection of coaching experiences and learning as a coach to consider the relevance of these approaches in a management context with a group of four healthcare staff who participated in a pilot coaching project. It explores their understanding of coaching techniques applied in management settings via their reflections on using coaching approaches and coaching applications as healthcare managers. Coaching approaches can enhance a manager’s skill portfolio and offer the potential benefits in terms of successful goal achievement, growth, mutual learning and development for both themselves and staff they work with in task focused scenarios

Biomarkers of Tuberculosis Severity and Treatment Effect: A Directed Screen of 70 Host Markers in a Randomized Clinical Trial.

More efficacious treatment regimens are needed for tuberculosis, however, drug development is impeded by a lack of reliable biomarkers of disease severity and of treatment effect. We conducted a directed screen of host biomarkers in participants enrolled in a tuberculosis clinical trial to address this need. Serum samples from 319 protocol-correct, culture-confirmed pulmonary tuberculosis patients treated under direct observation as part of an international, phase 2 trial were screened for 70 markers of infection, inflammation, and metabolism. Biomarker assays were specifically developed for this study and quantified using a novel, multiplexed electrochemiluminescence assay. We evaluated the association of biomarkers with baseline characteristics, as well as with detailed microbiologic data, using Bonferroni-adjusted, linear regression models. Across numerous analyses, seven proteins, SAA1, PCT, IL-1β, IL-6, CRP, PTX-3 and MMP-8, showed recurring strong associations with markers of baseline disease severity, smear grade and cavitation; were strongly modulated by tuberculosis treatment; and had responses that were greater for patients who culture-converted at 8weeks. With treatment, all proteins decreased, except for osteocalcin, MCP-1 and MCP-4, which significantly increased. Several previously reported putative tuberculosis-associated biomarkers (HOMX1, neopterin, and cathelicidin) were not significantly associated with treatment response. In conclusion, across a geographically diverse and large population of tuberculosis patients enrolled in a clinical trial, several previously reported putative biomarkers were not significantly associated with treatment response, however, seven proteins had recurring strong associations with baseline radiographic and microbiologic measures of disease severity, as well as with early treatment response, deserving additional study

Disruption of beta cell acetyl-CoA carboxylase-1 in mice impairs insulin secretion and beta cell mass

Aims/hypothesis: Pancreatic beta cells secrete insulin to maintain glucose homeostasis, and beta cell failure is a hallmark of type 2 diabetes. Glucose triggers insulin secretion in beta cells via oxidative mitochondrial pathways. However, it also feeds mitochondrial anaplerotic pathways, driving citrate export and cytosolic malonyl-CoA production by the acetyl-CoA carboxylase 1 (ACC1) enzyme. This pathway has been proposed as an alternative glucose-sensing mechanism, supported mainly by in vitro data. Here, we sought to address the role of the beta cell ACC1-coupled pathway in insulin secretion and glucose homeostasis in vivo. Methods: Acaca, encoding ACC1 (the principal ACC isoform in islets), was deleted in beta cells of mice using the Cre/loxP system. Acaca floxed mice were crossed with Ins2cre mice (βACC1KO; life-long beta cell gene deletion) or Pdx1creER mice (tmx-βACC1KO; inducible gene deletion in adult beta cells). Beta cell function was assessed using in vivo metabolic physiology and ex vivo islet experiments. Beta cell mass was analysed using histological techniques. Results: βACC1KO and tmx-βACC1KO mice were glucose intolerant and had defective insulin secretion in vivo. Isolated islet studies identified impaired insulin secretion from beta cells, independent of changes in the abundance of neutral lipids previously implicated as amplification signals. Pancreatic morphometry unexpectedly revealed reduced beta cell size in βACC1KO mice but not in tmx-βACC1KO mice, with decreased levels of proteins involved in the mechanistic target of rapamycin kinase (mTOR)-dependent protein translation pathway underpinning this effect. Conclusions/interpretation: Our study demonstrates that the beta cell ACC1-coupled pathway is critical for insulin secretion in vivo and ex vivo and that it is indispensable for glucose homeostasis. We further reveal a role for ACC1 in controlling beta cell growth prior to adulthood.</p

Axonal transport defects are a common phenotype in Drosophila models of ALS

Amyotrophic lateral sclerosis (ALS) is characterized by the degeneration of motor neurons resulting in a catastrophic loss of motor function. Current therapies are severely limited owing to a poor mechanistic understanding of the pathobiology. Mutations in a large number of genes have now been linked to ALS, including SOD1, TARDBP (TDP-43), FUS and C9orf72. Functional analyses of these genes and their pathogenic mutations have provided great insights into the underlying disease mechanisms. Defective axonal transport is hypothesized to be a key factor in the selective vulnerability of motor nerves due to their extraordinary length and evidence that ALS occurs as a distal axonopathy. Axonal transport is seen as an early pathogenic event that precedes cell loss and clinical symptoms and so represents an upstream mechanism for therapeutic targeting. Studies have begun to describe the impact of a few pathogenic mutations on axonal transport but a broad survey across a range of models and cargos is warranted. Here, we assessed the axonal transport of different cargos in multiple Drosophila models of ALS. We found that axonal transport defects are common across all models tested, although they often showed a differential effect between mitochondria and vesicle cargos. Motor deficits were also common across the models and generally worsened with age, though surprisingly there was not a clear correlation between the severity of axonal transport defects and motor ability. These results further support defects in axonal transport as a common factor in models of ALS that may contribute to the pathogenic process

The use of medicaments in the management of symptomatic irreversible pulpitis: a community-based cohort study

Aim: To investigate patient outcomes from either pulpotomy or pulpectomy for the management of symptomatic irreversible pulpitis, with and without application of antibiotic/corticosteroid pastes in urgent primary dental care settings in the United Kingdom. Methodology: All patients receiving intervention for symptomatic irreversible pulpitis in three different primary care settings were invited to participate. Pre-operatively, data regarding patients’ numerical ratings scale (NRS), pain score (0-10), analgesic use, oral-health impact profile-14 (OHIP-14) and need for time away from work were collected. For seven days post operatively, participants recorded their NRS pain score, global rating of change score, medication use and their ability to work. Analysis used a mixed-effects model with post-hoc Tukey’s multiple comparisons test for continuous data and chi-squared or Fisher\ub4s exact test for categorical data. To test the effect of the corticosteroid/antibiotic paste, pulpectomy and pulpotomy groups were combined following Mantel-Haenszel stratified analysis or a weighted average of the difference between pulpotomy and pulpectomy with and without the use of corticosteroid/antibiotic paste. A binary composite score was constructed using pre- and post-operative data, whereby overall treatment success was defined as: i. patients did not return for treatment due to pain by day seven; ii. at day three there was a 33% (or 2-points) reduction in NRS pain score; iii. there was a change score of +3 in global rating; iv. the patient was no-longer using analgesia and able to return to work. Results Eighty-five participants were recruited, with 83 completing follow-up. Overall treatment success was 57%, with 25% of participants returning for more treatment due to inadequate pain relief. Overall treatment success did not differ between the two groups (p=0.645), although patients self-reported greater improvement with an antibiotic/corticosteroid dressing for global rating of change (p=0.015). Conclusions: This study identified limited evidence of improved outcomes using antibiotic/corticosteroid dressings in the management of symptomatic irreversible pulpitis in the emergency setting. Further clinical research is needed to understand if these medications are beneficial in affording pain relief, above that of simple excision of irreversibly inflamed pulp tissue. Funding This study was funded by the European Society of Endodontology Young Investigator Grant (2020). Conflict of interest None to declare

Foot rot in cattle

The Oklahoma Cooperative Extension Service periodically issues revisions to its publications. The most current edition is made available. For access to an earlier edition, if available for this title, please contact the Oklahoma State University Library Archives by email at [email protected] or by phone at 405-744-6311

Collapse of Rotating Magnetized Molecular Cloud Cores and Mass Outflows

Collapse of the rotating magnetized molecular cloud core is studied with the axisymmetric magnetohydrodynamical (MHD) simulations. Due to the change of the equation of state of the interstellar gas, the molecular cloud cores experience several different phases as collapse proce eds. In the isothermal run-away collapse ($n \lesssim 10^{10}{\rm H_2 cm}^{-3}$), a pseudo-disk is formed and it continues to contract till the opaque core is fo rmed at the center. In this disk, a number of MHD fast and slow shock pairs appear running parallelly to the disk. After the equation of state becomes hard, an adiabatic core is formed, which is separated from the isothermal contracting pseudo-disk by the accretion shock front facing radially outwards. By the effect of the magnetic tension, the angular momentum is transferred from the disk mid-plane to the surface. The gas with excess angular momentum near the surface is finally ejected, which explains the molecular bipolar outflow. Two types of outflows are observed. When the poloidal magnetic field is strong (magnetic energy is comparable to the thermal one), a U-shaped outflow is formed in which fast moving gas is confined to the wall whose shape looks like a capit al letter U. The other is the turbulent outflow in which magnetic field lines and velocity fi elds are randomly oriented. In this case, turbulent gas moves out almost perpendicularly from the disk. The continuous mass accretion leads to the quasistatic contraction of the first core. A second collapse due to dissociation of H$_2$ in the first core follows. Finally another quasistatic core is again formed by atomic hydrogen (the second core). It is found that another outflow is ejected around the second atomic core, which seems to correspond to the optical jets or the fast neutral winds.Comment: submitted to Ap

Veterinary feed directive

The Oklahoma Cooperative Extension Service periodically issues revisions to its publications. The most current edition is made available. For access to an earlier edition, if available for this title, please contact the Oklahoma State University Library Archives by email at [email protected] or by phone at 405-744-6311

A PPMAP analysis of the filamentary structures in Ophiuchus L1688 and L1689

We use the PPMAP (Point Process MAPping) algorithm to re-analyse the \textit{Herschel} and SCUBA-2 observations of the L1688 and L1689 sub-regions of the Ophiuchus molecular cloud. PPMAP delivers maps with high resolution (here $14''$, corresponding to $\sim 0.01\,{\rm pc}$ at $\sim 140\,{\rm pc}$), by using the observations at their native resolutions. PPMAP also delivers more accurate dust optical depths, by distinguishing dust of different types and at different temperatures. The filaments and prestellar cores almost all lie in regions with $N_{\rm H_2}\gtrsim 7\times 10^{21}\,{\rm cm}^{-2}$ (corresponding to $A_{_{\rm V}}\gtrsim 7$). The dust temperature, $T$, tends to be correlated with the dust opacity index, $\beta$, with low $T$ and low $\beta$ tend concentrated in the interiors of filaments. The one exception to this tendency is a section of filament in L1688 that falls -- in projection -- between the two B stars, S1 and HD147889; here $T$ and $\beta$ are relatively high, and there is compelling evidence that feedback from these two stars has heated and compressed the filament. Filament {\sc fwhm}s are typically in the range $0.10\,{\rm pc}$ to $0.15\,{\rm pc}$. Most filaments have line densities in the range $25\,{\rm M_{_\odot}\,pc^{-1}}$ to $65\,{\rm M_{_\odot}\,pc^{-1}}$. If their only support is thermal gas pressure, and the gas is at the canonical temperature of $10\,{\rm K}$, the filaments are highly supercritical. However, there is some evidence from ammonia observations that the gas is significantly warmer than this, and we cannot rule out the possibility of additional support from turbulence and/or magnetic fields. On the basis of their spatial distribution, we argue that most of the starless cores are likely to disperse (rather than evolving to become prestellar).Comment: 22 pages, 18 figures, Accepted for publication by MNRAS March 202

Rhythm in the speech of a person with right hemisphere damage: Applying the pairwise variability index

Although several aspects of prosody have been studied in speakers with right hemisphere damage (RHD), rhythm remains largely uninvestigated. This study compares the rhythm of an Australian English speaker with right hemisphere damage (due to a stroke, but with no concomitant dysarthria) to that of a neurologically unimpaired individual. The speakers' rhythm is compared using the pairwise variability index (PVI) which allows for an acoustic characterization of rhythm by comparing the duration of successive vocalic and intervocalic intervals. A sample of speech from a structured interview between a speech and language therapist and each participant was analysed. Previous research has shown that speakers with RHD may have difficulties with intonation production, and therefore it was hypothesized that there may also be rhythmic disturbance. Results show that the neurologically normal control uses a similar rhythm to that reported for British English (there are no previous studies available for Australian English), whilst the speaker with RHD produces speech with a less strongly stress-timed rhythm. This finding was statistically significant for the intervocalic intervals measured (t(8) = 4.7, p < .01), and suggests that some aspects of prosody may be right lateralized for this speaker. The findings are discussed in relation to previous findings of dysprosody in RHD populations, and in relation to syllable-timed speech of people with other neurological conditions