A Comparison of U. S. and European University-Industry Relations in the Life Sciences

We draw on diverse data sets to compare the institutional organization of upstream life science research across the United States and Europe. Understanding cross-national differences in the organization of innovative labor in the life sciences requires attention to the structure and evolution of biomedical networks involving public research organizations (universities, government laboratories, nonprofit research institutes, and research hospitals), science-based biotechnology firms, and multinational pharmaceutical corporations. We use network visualization methods and correspondence analyses to demonstrate that innovative research in biomedicine has its origins in regional clusters in the United States and in European nations. But the scientific and organizational composition of these regions varies in consequential ways. In the United States, public research organizations and small firms conduct R&D across multiple therapeutic areas and stages of the development process. Ties within and across these regions link small firms and diverse public institutions, contributing to the development of a robust national network. In contrast, the European story is one of regional specialization with a less diverse group of public research organizations working in a smaller number of therapeutic areas. European institutes develop local connections to small firms working on similar scientific problems, while cross-national linkages of European regional clusters typically involve large pharmaceutical corporations. We show that the roles of large and small firms differ in the United States and Europe, arguing that the greater heterogeneity of the U. S. system is based on much closer integration of basic science and clinical development

Shared decision making in patients with low risk chest pain: prospective randomized pragmatic trial.

OBJECTIVE: To compare the effectiveness of shared decision making with usual care in choice of admission for observation and further cardiac testing or for referral for outpatient evaluation in patients with possible acute coronary syndrome. DESIGN: Multicenter pragmatic parallel randomized controlled trial. SETTING: Six emergency departments in the United States. PARTICIPANTS: 898 adults (aged \u3e17 years) with a primary complaint of chest pain who were being considered for admission to an observation unit for cardiac testing (451 were allocated to the decision aid and 447 to usual care), and 361 emergency clinicians (emergency physicians, nurse practitioners, and physician assistants) caring for patients with chest pain. INTERVENTIONS: Patients were randomly assigned (1:1) by an electronic, web based system to shared decision making facilitated by a decision aid or to usual care. The primary outcome, selected by patient and caregiver advisers, was patient knowledge of their risk for acute coronary syndrome and options for care; secondary outcomes were involvement in the decision to be admitted, proportion of patients admitted for cardiac testing, and the 30 day rate of major adverse cardiac events. RESULTS: Compared with the usual care arm, patients in the decision aid arm had greater knowledge of their risk for acute coronary syndrome and options for care (questions correct: decision aid, 4.2 v usual care, 3.6; mean difference 0.66, 95% confidence interval 0.46 to 0.86), were more involved in the decision (observing patient involvement scores: decision aid, 18.3 v usual care, 7.9; 10.3, 9.1 to 11.5), and less frequently decided with their clinician to be admitted for cardiac testing (decision aid, 37% v usual care, 52%; absolute difference 15%; P CONCLUSIONS: Use of a decision aid in patients at low risk for acute coronary syndrome increased patient knowledge about their risk, increased engagement, and safely decreased the rate of admission to an observation unit for cardiac testing.Trial registration ClinicalTrials.gov NCT01969240

PEMFC Electrochemical Degradation Analysis of a Fuel Cell Range-Extender (FCREx) Heavy Goods Vehicle after a Break-In Period

With the increasing focus on decarbonisation of the transport sector, it is imperative to consider routes to electrify vehicles beyond those achievable using lithium-ion battery technology. These include heavy goods vehicles and aerospace applications that require propulsion systems that can provide gravimetric energy densities, which are more likely to be delivered by fuel cell systems. While the discussion of light-duty vehicles is abundant in the literature, heavy goods vehicles are under-represented. This paper presents an overview of the electrochemical degradation of a proton exchange membrane fuel cell integrated into a simulated Class 8 heavy goods range-extender fuel cell hybrid electric vehicle operating in urban driving conditions. Electrochemical degradation data such as polarisation curves, cyclic voltammetry values, linear sweep voltammetry values, and electrochemical impedance spectroscopy values were collected and analysed to understand the expected degradation modes in this application. In this application, the proton exchange membrane fuel cell stack power was designed to remain constant to fulfil the mission requirements, with dynamic and peak power demands managed by lithium-ion batteries, which were incorporated into the hybridised powertrain. A single fuel cell or battery cell can either be operated at maximum or nominal power demand, allowing four operational scenarios: maximum fuel cell maximum battery, maximum fuel cell nominal battery, nominal fuel cell maximum battery, and nominal fuel cell nominal battery. Operating scenarios with maximum fuel cell operating power experienced more severe degradation after endurance testing than nominal operating power. A comparison of electrochemical degradation between these operating scenarios was analysed and discussed. By exploring the degradation effects in proton exchange membrane fuel cells, this paper offers insights that will be useful in improving the long-term performance and durability of proton exchange membrane fuel cells in heavy-duty vehicle applications and the design of hybridised powertrains

Comparing thigh muscle cross-sectional area and squat strength among national class Olympic weightlifters, power lifters, and bodybuilders

Few studies have compared anthropometric characteristics among national class athletes from different resistance training disciplines, such as Olympic Weightlifting (OL), Power Lifting (PL), and Bodybuilding (BB). Objective: The purpose of the current study was to determine if significant differences exist in the relationship between thigh muscle cross-sectional area and back squat strength among national class athletes from the sports of OL, PL, and BB. Methods: Fifteen national class athletes were assessed for back squat strength, mid-thigh circumference, and mid-thigh skinfold from which total thigh cross-sectional was estimated. A series of One-Way ANOVAs and Pearson Product Moment Correlations were used to compare groups and assess the relationship between variables. Results: The OL (200.18 + 25.16kg) and PL (205.45 + 17.28kg) groups were significantly stronger than the BB (160 + 16.80 kg; p \u3c 0.05) group. However, mid-thigh skinfold thickness (p = 0.36), mid-thigh circumference (p = 0.87), and estimated thigh cross-sectional area (p = 0.34) were not significantly different between groups. Thigh muscle cross-sectional area was weakly correlated to back squat strength in the OL (r = .42) and PL (r = .12) groups, but moderately correlated in the BB (r = .70) group. Conclusion: Thigh cross-sectional area was of relatively minor importance in determining back squat strength for the OL and PL groups, despite these groups being significantly stronger than the BB group. Specific training protocols will elicit different outcomes with regard to muscular hypertrophy that may or may not contribute to a functional increase in back squat strength

Too much sitting and all-cause mortality: is there a causal link?

Background: Sedentary behaviours (time spent sitting, with low energy expenditure) are associated with deleterious health outcomes, including all-cause mortality. Whether this association can be considered causal has yet to be established. Using systematic reviews and primary studies from those reviews, we drew upon Bradford Hill's criteria to consider the likelihood that sedentary behaviour in epidemiological studies is likely to be causally related to all-cause (premature) mortality. Methods: Searches for systematic reviews on sedentary behaviours and all-cause mortality yielded 386 records which, when judged against eligibility criteria, left eight reviews (addressing 17 primary studies) for analysis. Exposure measures included self-reported total sitting time, TV viewing time, and screen time. Studies included comparisons of a low-sedentary reference group with several higher sedentary categories, or compared the highest versus lowest sedentary behaviour groups. We employed four Bradford Hill criteria: strength of association, consistency, temporality, and dose-response. Evidence supporting causality at the level of each systematic review and primary study was judged using a traffic light system depicting green for causal evidence, amber for mixed or inconclusive evidence, and red for no evidence for causality (either evidence of no effect or no evidence reported). Results: The eight systematic reviews showed evidence for consistency (7 green) and temporality (6 green), and some evidence for strength of association (4 green). There was no evidence for a dose-response relationship (5 red). Five reviews were rated green overall. Twelve (67 %) of the primary studies were rated green, with evidence for strength and temporality. Conclusions: There is reasonable evidence for a likely causal relationship between sedentary behaviour and all-cause mortality based on the epidemiological criteria of strength of association, consistency of effect, and temporality

Harnessing endogenous repair mechanisms for targeted gene knock-in of bovine embryos.

Introducing useful traits into livestock breeding programs through gene knock-ins has proven challenging. Typically, targeted insertions have been performed in cell lines, followed by somatic cell nuclear transfer cloning, which can be inefficient. An alternative is to introduce genome editing reagents and a homologous recombination (HR) donor template into embryos to trigger homology directed repair (HDR). However, the HR pathway is primarily restricted to actively dividing cells (S/G2-phase) and its efficiency for the introduction of large DNA sequences in zygotes is low. The homology-mediated end joining (HMEJ) approach has been shown to improve knock-in efficiency in non-dividing cells and to harness HDR after direct injection of embryos. The knock-in efficiency for a 1.8 kb gene was contrasted when combining microinjection of a gRNA/Cas9 ribonucleoprotein complex with a traditional HR donor template or an HMEJ template in bovine zygotes. The HMEJ template resulted in a significantly higher rate of gene knock-in as compared to the HR template (37.0% and 13.8%; P < 0.05). Additionally, more than a third of the knock-in embryos (36.9%) were non-mosaic. This approach will facilitate the one-step introduction of gene constructs at a specific location of the bovine genome and contribute to the next generation of elite cattle

The SWIRE/Chandra Survey: The X-ray Sources

We report a moderate-depth (70 ks), contiguous 0.7 deg^2 Chandra survey in the Lockman Hole Field of the Spitzer/SWIRE Legacy Survey coincident with a completed, ultra-deep VLA survey with deep optical and near-infrared imaging in-hand. The primary motivation is to distinguish starburst galaxies and active galactic nuclei (AGNs), including the significant, highly obscured (log N_H > 23) subset. Chandra has detected 775 X-ray sources to a limiting broadband (0.3-8 keV) flux ~4 × 10^(–16) erg cm^(–2) s^(–1). We present the X-ray catalog, fluxes, hardness ratios, and multi-wavelength fluxes. The log N versus log S agrees with those of previous surveys covering similar flux ranges. The Chandra and Spitzer flux limits are well matched: 771 (99%) of the X-ray sources have infrared (IR) or optical counterparts, and 333 have MIPS 24 μm detections. There are four optical-only X-ray sources and four with no visible optical/IR counterpart. The very deep (~2.7 μJy rms) VLA data yield 251 (>4σ) radio counterparts, 44% of the X-ray sources in the field. We confirm that the tendency for lower X-ray flux sources to be harder is primarily due to absorption. As expected, there is no correlation between observed IR and X-ray fluxes. Optically bright, type 1, and red AGNs lie in distinct regions of the IR versus X-ray flux plots, demonstrating the wide range of spectral energy distributions in this sample and providing the potential for classification/source selection. Many optically bright sources, which lie outside the AGN region in the optical versus X-ray plots (f_r /f_x >10), lie inside the region predicted for red AGNs in IR versus X-ray plots, consistent with the presence of an active nucleus. More than 40% of the X-ray sources in the VLA field are radio-loud using the classical definition, R_L . The majority of these are red and relatively faint in the optical so that the use of R_L to select those AGNs with the strongest radio emission becomes questionable. Using the 24 μm to radio flux ratio (q_(24)) instead results in 13 of the 147 AGNs with sufficient data being classified as radio-loud, in good agreement with the ~10% expected for broad-lined AGNs based on optical surveys. We conclude that q_(24) is a more reliable indicator of radio-loudness. Use of R_L should be confined to the optically selected type 1 AGN

Wet scavenging of soluble gases in DC3 deep convective storms using WRF-Chem simulations and aircraft observations

We examine wet scavenging of soluble trace gases in storms observed during the Deep Convective Clouds and Chemistry (DC3) field campaign. We conduct high-resolution simulations with the Weather Research and Forecasting model with Chemistry (WRF-Chem) of a severe storm in Oklahoma. The model represents well the storm location, size, and structure as compared with Next Generation Weather Radar reflectivity, and simulated CO transport is consistent with aircraft observations. Scavenging efficiencies (SEs) between inflow and outflow of soluble species are calculated from aircraft measurements and model simulations. Using a simple wet scavenging scheme, we simulate the SE of each soluble species within the error bars of the observations. The simulated SEs of all species except nitric acid (HNO_3) are highly sensitive to the values specified for the fractions retained in ice when cloud water freezes. To reproduce the observations, we must assume zero ice retention for formaldehyde (CH_2O) and hydrogen peroxide (H_2O_2) and complete retention for methyl hydrogen peroxide (CH_3OOH) and sulfur dioxide (SO_2), likely to compensate for the lack of aqueous chemistry in the model. We then compare scavenging efficiencies among storms that formed in Alabama and northeast Colorado and the Oklahoma storm. Significant differences in SEs are seen among storms and species. More scavenging of HNO_3 and less removal of CH_3OOH are seen in storms with higher maximum flash rates, an indication of more graupel mass. Graupel is associated with mixed-phase scavenging and lightning production of nitrogen oxides (NO_x), processes that may explain the observed differences in HNO_3 and CH_3OOH scavenging

Future of Leadership in Healthcare: Enabling Complexity Dynamics Across Levels

Healthcare is one of the world\u27s fastest-growing industries with over $10 trillion in projected spending by 2022 (Deloitte, 2019). Despite this growth, the industry faces several challenges including rising costs, care delivery outside urban areas and to marginalized populations, digital transformation, and regulatory compliance. To navigate these challenges and capitalize on growth opportunities, leaders must build and manage complex dynamics occurring in the space between the organization and a wide range of internal and external stakeholders. In this symposium, we address this issue by assembling a group of scholars trained in healthcare management, strategy, leadership, and organizational theory to discuss the role of leaders in the future of healthcare. Through a series of presentations, we will illustrate how leaders in healthcare enable complexity dynamics across organizational levels to drive desired outcomes. In doing so, we bring to the forefront the multilevel and complex nature of healthcare leadership and invite innovative thinking about leadership for the future of healthcare. Building Extra-Organizational Adaptive Networks: Complexity Leadership in Healthcare Presenter: Erin Bass; U. of Nebraska, Omaha Presenter: Ivana Milosevic; College of Charleston Physician CEOs & Patient Safety Presenter: Geoffrey Silvera; Auburn U. Presenter: Timothy J. Vogus; Vanderbilt U. Presenter: Jonathan Clark; U. of Texas At San Antonio Management Practices of Under-Resourced Nursing Homes Presenter: Justin Lord; Louisiana State U. Shreveport Stitching Ties: Team Performance in the Connected Organization Presenter: John Hollingsworth; U. of Michigan Presenter: Jason Owen-Smith; U. of Michigan, Ann Arbor Presenter: Dennie Kim; U. of Virginia Darden School of Business Presenter: Marlon DeMarcie Twyman; U. of Southern California, Annenberg School for Communication and Journalism Identifying Healthcare\u27s Future Leaders: Development of a Leadership Potential Model for Healthcare Presenter: Kevin S. Groves; Pepperdine U. Presenter: Ann E. Feyerherm; Pepperdine Graziadio Business Schoo

Contesting the psychiatric framing of ME / CFS

ME/CFS is a medically contested illness and its understanding, framing and treatment has been the subject of heated debate. This paper examines why framing the condition as a psychiatric issue—what we refer to as ‘psychiatrisation’—has been so heavily contested by patients and activists. We argue that this contestation is not simply about stigmatising mental health conditions, as some have suggested, but relates to how people diagnosed with mental illness are treated in society, psychiatry and the law. We highlight the potentially harmful consequences of psychiatrisation which can lead to people’s experiential knowledge being discredited. This stems, in part, from a psychiatric-specific form of ‘epistemic injustice’ which can result in unhelpful, unwanted and forced treatments. This understanding helps explain why the psychiatrisation of ME/CFS has become the focus of such bitter debate and why psychiatry itself has become such a significant field of contention, for both ME/CFS patients and mental health service users/survivors. Notwithstanding important differences, both reject the way psychiatry denies patient explanations and understandings, and therefore share a collective struggle for justice and legitimation. Reasons why this shared struggle has not resulted in alliances between ME and mental health activists are noted