1,481 research outputs found
Towards magnetic slowing of atoms and molecules
We outline a method to slow paramagnetic atoms or molecules using pulsed
magnetic fields. We also discuss the possibility of producing trapped particles
by adiabatic deceleration of a magnetic trap. We present numerical simulation
results for the slowing and trapping of molecular oxygen
Autopsy Standardized Mortality Review: A Pilot Study Offering a Methodology for Improved Patient Outcomes
A standardized mortality review of hospital autopsies identified discrepancies between clinical diagnoses and autopsy findings, unexpected deaths, adequacy of diagnostic workup, presence of adverse event, and type of a quality issue if present. The standardized review elements were chosen based on a review of quality metrics commonly used by hospitals. The review was completed by the pathologist based on their initial autopsy findings. The final autopsy report was later reviewed to confirm the initial review findings. Major discrepancies in diagnosis were categorized as class I or II based on the modified Goldman criteria.
Ninety-six hospital autopsy cases from January 2015 to February 2018 were included in the study. The overall major discrepancy rate was 27%. Class I discrepancies, where a diagnosis found at autopsy might have improved survival had it been made premortem, were identified in 16% of cases. Categories associated with increased discrepancy rates included unexpected deaths, inadequate workup, abnormal labs or imaging not addressed, and certain quality issues. Deaths not expected at admission but
expected at the time of death, those with adverse events, those within 48 hours of a procedure, those within 48 hours of admission, those with physician-specific quality issues, and those with system or process issues were not significantly related to diagnostic accuracy
Cumulative and Differential Effects of Early Child Care and Middle Childhood Out-of-School Time on Adolescent Functioning.
Effects associated with early child care and out-of-school time (OST) during middle childhood were examined in a large sample of U.S. adolescents (N = 958). Both higher quality early child care AND more epochs of organized activities (afterschool programs and extracurricular activities) during middle childhood were linked to higher academic achievement at age 15. Differential associations were found in the behavioral domain. Higher quality early child care was associated with fewer externalizing problems, whereas more hours of early child care was linked to greater impulsivity. More epochs of organized activities was associated with greater social confidence. Relations between early child care and adolescent outcomes were not mediated or moderated by OST arrangements in middle childhood, consistent with independent, additive relations of these nonfamilial settings
Going beyond defining: Preschool educators\u27 use of knowledge in their pedagogical reasoning about vocabulary instruction
Previous research investigating both the knowledge of early childhood educators and the support for vocabulary development present in early childhood settings has indicated that both educator knowledge and enacted practice are less than optimal, which has grave implications for children\u27s early vocabulary learning and later reading achievement. Further, the nature of the relationship between educators\u27 knowledge and practice is unclear, making it difficult to discern the best path towards improved knowledge, practice, and children\u27s vocabulary outcomes. The purpose of the present study was to add to the existing literature by using stimulated recall interviews and a grounded approach to examine how 10 preschool educators used their knowledge to made decisions about their moment-to-moment instruction in support of children\u27s vocabulary development. Results indicate that educators were thinking in highly context-specific ways about their goals and strategies for supporting vocabulary learning, taking into account important knowledge of their instructional history with children and of the children themselves to inform their decision making in the moment. In addition, they reported thinking about research-based goals and strategies for supporting vocabulary learning that went beyond simply defining words for children. Implications for research and professional development are discussed
Phase separation transition in liquids and polymers induced by electric field gradients
Spatially uniform electric fields have been used to induce instabilities in
liquids and polymers, and to orient and deform ordered phases of
block-copolymers. Here we discuss the demixing phase transition occurring in
liquid mixtures when they are subject to spatially nonuniform fields. Above the
critical value of potential, a phase-separation transition occurs, and two
coexisting phases appear separated by a sharp interface. Analytical and
numerical composition profiles are given, and the interface location as a
function of charge or voltage is found. The possible influence of demixing on
the stability of suspensions and on inter-colloid interaction is discussed.Comment: 7 pages, 3 figures. Special issue of the J. Phys. Soc. Ja
Mobilising Knowledge through Global Partnerships to Support Research-informed Teaching: Five Models for Translational Research
Education Futures Collaboration Charity
The file attached to this record is the author's final peer reviewed version. The Publisher's final version can be found by following the DOI link.Improving the quality of teaching is of global concern: UNESCO’s Sustainable Development Goal (SDG) 4c in the Education 2030: Framework for Action calls for high quality teaching for all. The OECD challenges the education system to improve Knowledge Management. JET’s (2015) special issue: Translational Research (TR) and Knowledge Mobilisation in Teacher Education introduced the concept of ‘translational’ or ‘theory to practice’ research - well-established in medicine but not in education. Five TR models were subsequently developed by the MESH charity’s international network with organisations in South Africa, Bangladesh, Australia, Pakistan, UK. These distinct models engage 1) university staff and teachers 2) subject associations, 3) research units, 4) an international NGO working in crisis settings, 5) PhD tutors and students. Each model shares common features forming the MESH Translational Research methodology introduced in this article. A TR repository is part of the MESH knowledge mobilisation strategy giving teachers access to research summaries which, overtime, accumulate knowledge. TR publications called MESHGuides (www.meshguides.org) complement existing forms of publication. This article proposes the MESH TR methodology as one affordable and scalable solution to OECD and UNESCO’s challenges of keeping teachers up-to-date and making new knowledge accessible to teachers regardless of location
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Aspiration therapy for the treatment of obesity: 4-year results of a multicenter randomized controlled trial.
BackgroundThe AspireAssist is the first Food and Drug Administration-approved endoluminal device indicated for treatment of class II and III obesity.ObjectivesWe earlier reported 1-year results of the PATHWAY study. Here, we report 4-year outcomes.SettingUnited States-based, 10-center, randomized controlled trial involving 171 participants with the treatment arm receiving Aspiration Therapy (AT) plus Lifestyle Therapy and the control arm receiving Lifestyle Therapy (2:1 randomization).MethodsAT participants were permitted to continue in the study for an additional year up to a maximum of 5 years providing they maintained at least 10% total weight loss (TWL) from baseline at each year end. For AT participants who continued the study, 5 medical monitoring visits were provided at weeks 60, 68, 76, 90, and 104 and thereafter once every 13 weeks up to week 260. Exclusion criteria were a history of eating disorder or evidence of eating disorder on a validated questionnaire. Follow-up weight, quality of life, and co-morbidities were compared with the baseline levels. In addition, rates of serious adverse event, persistent fistula, withdrawal, and A-tube replacement were reported. All analyses were performed using a per-protocol analysis.ResultsOf the 82 AT participants who completed 1 year, 58 continued to this phase of the trial. Mean baseline body mass index of these 58 patients was 41.6 ± 4.5 kg/m2. At the end of first year (at the beginning of the follow-up study), these 58 patients had a body mass index of 34.1 ± 5.4 kg/m2 and had achieved an 18.3 ± 8.0% TWL. On a per protocol basis, patients experienced 14.2%, 15.3%, 16.6%, and 18.7% TWL at 1, 2, 3, and 4 years, respectively (P < .01 for all). Forty of 58 patients (69%) achieved at least 10% TWL at 4 years or at time of study withdrawal. Improvements in quality of life scores and select cardiometabolic parameters were also maintained through 4 years. There were 2 serious adverse events reported in the second through fourth years, both of which resolved with removal or replacement of the A tube. Two persistent fistulas required surgical repair, representing approximately 2% of all tube removals. There were no clinically significant metabolic or electrolytes disorders observed, nor any evidence for development of any eating disorders.ConclusionsThe results of this midterm study have shown that AT is a safe, effective, and durable weight loss alternative for people with class II and III obesity and who are willing to commit to using the therapy and adhere to adjustments in eating behavior
Association between anesthesia duration and outcome in dogs with surgically treated acute severe spinal cord injury caused by thoracolumbar intervertebral disk herniation
Involving Children and Teenagers With Bilateral Cochlear Implants in the Design of the BEARS (Both EARS) Virtual Reality Training Suite Improves Personalization
Older children and teenagers with bilateral cochlear implants often have poor spatial hearing because they cannot fuse sounds from the two ears. This deficit jeopardizes speech and language development, education, and social well-being. The lack of protocols for fitting bilateral cochlear implants and resources for spatial-hearing training contribute to these difficulties. Spatial hearing develops with bilateral experience. A large body of research demonstrates that sound localisation can improve with training, underpinned by plasticity-driven changes in the auditory pathways. Generalizing training to non-trained auditory skills is best achieved by using a multi-modal (audio-visual) implementation and multi-domain training tasks (localisation, speech-in-noise, and spatial music). The goal of this work was to develop a package of virtual-reality games (BEARS, Both EARS) to train spatial hearing in young people (8–16 years) with bilateral cochlear implants using an action-research protocol. The action research protocol used formalized cycles for participants to trial aspects of the BEARS suite, reflect on their experiences, and in turn inform changes in the game implementations. This participatory design used the stakeholder participants as co-creators. The cycles for each of the three domains (localisation, spatial speech-in-noise, and spatial music) were customized to focus on the elements that the stakeholder participants considered important. The participants agreed that the final games were appropriate and ready to be used by patients. The main areas of modification were: the variety of immersive scenarios to cover age range and interests, the number of levels of complexity to ensure small improvements were measurable, feedback, and reward schemes to ensure positive reinforcement, and an additional implementation on an iPad for those who had difficulties with the headsets due to age or balance issues. The effectiveness of the BEARS training suite will be evaluated in a large-scale clinical trial to determine if using the games lead to improvements in speech-in-noise, quality of life, perceived benefit, and cost utility. Such interventions allow patients to take control of their own management reducing the reliance on outpatient-based rehabilitation. For young people, a virtual-reality implementation is more engaging than traditional rehabilitation methods, and the participatory design used here has ensured that the BEARS games are relevant
Cancer survival in England and Wales at the end of the 20th century
Survival has risen steadily since the 1970s for most cancers in adults in England and Wales, but persistent inequalities exist between those living in affluent and deprived areas. These differences are not seen for children. For many of the common adult cancers, these inequalities in survival (the 'deprivation gap') became more marked in the 1990s. This volume presents extended analyses of survival for adults diagnosed during the 14 years 1986-1999 and followed up to 2001, including trends in overall survival in England and Wales and trends in the deprivation gap in survival. The analyses include individual tumour data for 2.2 million cancer patients. This article outlines the structure of the supplement - an article for each of the 20 most common cancers in adults, followed by an expert commentary from one of the leading UK clinicians specialising in malignancies of that organ or system. The available data, quality control and methods of analysis are described here, rather than repeated in each of the 20 articles. We open the discussion between clinicians and epidemiologists on how to interpret the observed trends and inequalities in cancer survival, and we highlight some of the most important contrasts in these very different points of view. Survival improved substantially for adult cancer patients in England and Wales up to the end of the 20th century. Although socioeconomic inequalities in survival are remarkably persistent, the overall patterns suggest that these inequalities are largely avoidable
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