The Lecturer's Guide to Quality and Standards in Colleges and Universities

A follow-up volume to "Managing Teaching and Learning in Further Education and Higher Education", this text provides a guide to managing quality and standards from the lecturer's point of view. It covers key issues such as teaching, learning, student support, assessment, evaluation, course design, bidding for and managing resources, marketing and research.; Based on the model of lecturer as reflective practitioner, this book is intended to help enable the lecturer to make sense of the changing climate of quality control and academic standards. Its interactive design introduces stimulating ideas and suggestions for further reading and provides guidelines on issues of relevance to individual readers

Active Solar Sail Designs for Chip-Scale Spacecraft

Centimeter-scale spacecraft, known as ”Chipsats,” have very high surface-area-to-mass ratios, which accentuates solar radiation pressure (SRP) effects. In contrast to traditional. large solar sails, chip-scale solar sails have the potential to be highly agile in terms of attitude because of their structural rigidity and low moments of inertia. This ability to easily reorient a solar sail greatly expands the orbits that a solar-sail spacecraft can achieve. Solar sail actuation through electrochromic surfaces or MEMs mirrors represents an interesting, low-power way to further extend the capability of chip-scale solar-sail spacecraft. However, there remain a number of challenges. In particular, most of these technologies are on/off and have limited, highly nonlinear behavior. Ensuring that an active solar sail of this type performs as desired demands a systems-level perspective on dynamics and control design

Exploration Architecture with Quantum Inertial Gravimetry and In-Situ ChipSat Sensors

The Dual Exploration Architecture is a mission concept that combines remote sensing and in-situ observations into a single mission to answer planetary science questions that can only be answered with both types of data. Adoption of dual exploration architectures may short circuit the long, slow cycle of missions to inaccessible bodies by eliminating the need for separate precursor and follow-up missions. Additionally, the dual architecture possesses inherent flexibility that enables the design of adaptive, event-driven missions that are very different from traditional, largely pre-planned missions. Five key observations about the state and trends of planetary science exploration lead us to the dual architecture: increasing complexity of observations; scarcity of future mission opportunities; desire to capture transitory events; continued miniaturization of spacecraft components; and the Mars exploration cycle. Our goal in this study is to explore missions that can only happen using the dual architecture concept and find technology development needs that must be filled for those missions to compete. A survey of historical and current missions finds that opportunities for exploration are becoming less frequent, causing the flexibility and dual-nature elements of each mission to become more common. The dual exploration architecture takes these trends to their far conclusion, attempting to eliminate precursor and follow-up missions while still returning more scientific payoff. A study of the future of planetary science goals through the decadal survey reveals broad applicability of dual missions to solve mysteries that cannot be answered with a traditional mission architecture. These missions fall into three broad classes: choosing a local target from a global survey; dynamic/reactive science; and global in-situ networks. Two example missions of each class are notionally described. A deeper look at these dual architecture classes reveals four technology development needs that must be addressed for wide adoption of dual missions: passive landers; guided atmospheric probes; robust sensing packages; and small, precise orbital instruments. This study pursues a specific focus on two examples of such enabling technologies: the ChipSat and cold atom gravimetry. The ChipSat is a fully functional spacecraft-on-a-chip system that has broad versatility in the dual architecture mission space. Initial studies show that ChipSats could survive as passive impactor landers on bodies up to the size of Europa. Furthermore, COTS (Commercial Off-The-Shelf) components could provide an in-situ sensor suite that readily answers a number of pressing planetary science questions. Cold atom gravimetry uses inertial sensors based on light-pulse atom interferometry in a small form factor to map the gravity field of a body to precision equaling what would normally require two full spacecraft to achieve. The cold atom gravimeter provides an example of how advanced remote sensing capability can enable dual missions by providing greater returns in a significantly smaller package. Using the above two technologies, we study an example dual-architecture mission to both characterize and sample the subsurface oceans at Europa. The greatest scientific return in terms of detecting extraterrestrial life is in those regions where Europas ice crust is thin. The identification of regions with thin ice should therefore precede the selection of surface targets and dispatch of probes to those targets. This two-step process, if accomplished by separate flagship-scale missions, might take decades. As a result, a combined mission to both identify thin areas of Europas ice and follow up with surface observations at those regions is a good candidate for the dual-exploration architecture. This example mission consists of an orbiter spacecraft carrying a cold atom gravimeter capable of sensing or inferring the ice thickness on regional to local scales, along with a number of ChipSat probes capable of landing on the moon. The small size and weight of the ChipSats allows large numbers of them to be carried, ensuring that enough can be dropped to ensure survival of a minimum number of probes and potentially allowing for the in-situ sampling of multiple locations on the moon. The example missions and Europa case study show that amazing scientific return can obtained from dual-exploration architecture missions with a single launch by breaking the long timescales of planetary exploration and providing the flexibility to capturing transitory events and collect data across the local, regional, and global scales

Cumbria Rural Health Forum

This presentation was a project update given by Alison Marshall of the University of Cumbria, on The Cumbria Rural Health Forum. It was delivered at an Academic Health Science Network for the North East and North Cumbria (AHSN NENC) event: Telehealth: project updates. The Cumbria Rural Health Forum is a project receiving funding from the Academic Health Science Network for North East and North Cumbria (AHSN NENC) and the North West Coast Academic Health Science Network (NWC AHSN), managed by the University of Cumbria, with input from the Cumbria Partnership NHS Foundation Trust, Cumbria Clinical Commissioning Group, Action for Communities in Cumbria and Cumbria County Council

Natural selection shaped the rise and fall of passenger pigeon genomic diversity.

The extinct passenger pigeon was once the most abundant bird in North America, and possibly the world. Although theory predicts that large populations will be more genetically diverse, passenger pigeon genetic diversity was surprisingly low. To investigate this disconnect, we analyzed 41 mitochondrial and 4 nuclear genomes from passenger pigeons and 2 genomes from band-tailed pigeons, which are passenger pigeons' closest living relatives. Passenger pigeons' large population size appears to have allowed for faster adaptive evolution and removal of harmful mutations, driving a huge loss in their neutral genetic diversity. These results demonstrate the effect that selection can have on a vertebrate genome and contradict results that suggested that population instability contributed to this species's surprisingly rapid extinction

Computerized clinical decision support systems for therapeutic drug monitoring and dosing: A decision-maker-researcher partnership systematic review

<p>Abstract</p> <p>Background</p> <p>Some drugs have a narrow therapeutic range and require monitoring and dose adjustments to optimize their efficacy and safety. Computerized clinical decision support systems (CCDSSs) may improve the net benefit of these drugs. The objective of this review was to determine if CCDSSs improve processes of care or patient outcomes for therapeutic drug monitoring and dosing.</p> <p>Methods</p> <p>We conducted a decision-maker-researcher partnership systematic review. Studies from our previous review were included, and new studies were sought until January 2010 in MEDLINE, EMBASE, Evidence-Based Medicine Reviews, and Inspec databases. Randomized controlled trials assessing the effect of a CCDSS on process of care or patient outcomes were selected by pairs of independent reviewers. A study was considered to have a positive effect (<it>i.e.</it>, CCDSS showed improvement) if at least 50% of the relevant study outcomes were statistically significantly positive.</p> <p>Results</p> <p>Thirty-three randomized controlled trials were identified, assessing the effect of a CCDSS on management of vitamin K antagonists (14), insulin (6), theophylline/aminophylline (4), aminoglycosides (3), digoxin (2), lidocaine (1), or as part of a multifaceted approach (3). Cluster randomization was rarely used (18%) and CCDSSs were usually stand-alone systems (76%) primarily used by physicians (85%). Overall, 18 of 30 studies (60%) showed an improvement in the process of care and 4 of 19 (21%) an improvement in patient outcomes. All evaluable studies assessing insulin dosing for glycaemic control showed an improvement. In meta-analysis, CCDSSs for vitamin K antagonist dosing significantly improved time in therapeutic range.</p> <p>Conclusions</p> <p>CCDSSs have potential for improving process of care for therapeutic drug monitoring and dosing, specifically insulin and vitamin K antagonist dosing. However, studies were small and generally of modest quality, and effects on patient outcomes were uncertain, with no convincing benefit in the largest studies. At present, no firm recommendation for specific systems can be given. More potent CCDSSs need to be developed and should be evaluated by independent researchers using cluster randomization and primarily assess patient outcomes related to drug efficacy and safety.</p

Assessing the impact of COVID-19 on liver cancer management (CERO-19).

BACKGROUND & AIMS: The coronavirus disease 2019 (COVID-19) pandemic has posed unprecedented challenges to healthcare systems and it may have heavily impacted patients with liver cancer (LC). Herein, we evaluated whether the schedule of LC screening or procedures has been interrupted or delayed because of the COVID-19 pandemic. METHODS: An international survey evaluated the impact of the COVID-19 pandemic on clinical practice and clinical trials from March 2020 to June 2020, as the first phase of a multicentre, international, and observational project. The focus was on patients with hepatocellular carcinoma or intrahepatic cholangiocarcinoma, cared for around the world during the first COVID-19 pandemic wave. RESULTS: Ninety-one centres expressed interest to participate and 76 were included in the analysis, from Europe, South America, North America, Asia, and Africa (73.7%, 17.1%, 5.3%, 2.6%, and 1.3% per continent, respectively). Eighty-seven percent of the centres modified their clinical practice: 40.8% the diagnostic procedures, 80.9% the screening programme, 50% cancelled curative and/or palliative treatments for LC, and 41.7% modified the liver transplantation programme. Forty-five out of 69 (65.2%) centres in which clinical trials were running modified their treatments in that setting, but 58.1% were able to recruit new patients. The phone call service was modified in 51.4% of centres which had this service before the COVID-19 pandemic (n = 19/37). CONCLUSIONS: The first wave of the COVID-19 pandemic had a tremendous impact on the routine care of patients with liver cancer. Modifications in screening, diagnostic, and treatment algorithms may have significantly impaired the outcome of patients. Ongoing data collection and future analyses will report the benefits and disadvantages of the strategies implemented, aiding future decision-making. LAY SUMMARY: The coronavirus disease 2019 (COVID-19) pandemic has posed unprecedented challenges to healthcare systems globally. Herein, we assessed the impact of the first wave pandemic on patients with liver cancer and found that routine care for these patients has been majorly disrupted, which could have a significant impact on outcomes

Finishing the euchromatic sequence of the human genome

The sequence of the human genome encodes the genetic instructions for human physiology, as well as rich information about human evolution. In 2001, the International Human Genome Sequencing Consortium reported a draft sequence of the euchromatic portion of the human genome. Since then, the international collaboration has worked to convert this draft into a genome sequence with high accuracy and nearly complete coverage. Here, we report the result of this finishing process. The current genome sequence (Build 35) contains 2.85 billion nucleotides interrupted by only 341 gaps. It covers ∼99% of the euchromatic genome and is accurate to an error rate of ∼1 event per 100,000 bases. Many of the remaining euchromatic gaps are associated with segmental duplications and will require focused work with new methods. The near-complete sequence, the first for a vertebrate, greatly improves the precision of biological analyses of the human genome including studies of gene number, birth and death. Notably, the human enome seems to encode only 20,000-25,000 protein-coding genes. The genome sequence reported here should serve as a firm foundation for biomedical research in the decades ahead

Thoracic empyema: a 12-year study from a UK tertiary cardiothoracic referral centre.

Empyema is an increasingly frequent clinical problem worldwide, and has substantial morbidity and mortality. Our objectives were to identify the clinical, surgical and microbiological features, and management outcomes, of empyema

Adding 6 months of androgen deprivation therapy to postoperative radiotherapy for prostate cancer: a comparison of short-course versus no androgen deprivation therapy in the RADICALS-HD randomised controlled trial

Background Previous evidence indicates that adjuvant, short-course androgen deprivation therapy (ADT) improves metastasis-free survival when given with primary radiotherapy for intermediate-risk and high-risk localised prostate cancer. However, the value of ADT with postoperative radiotherapy after radical prostatectomy is unclear. Methods RADICALS-HD was an international randomised controlled trial to test the efficacy of ADT used in combination with postoperative radiotherapy for prostate cancer. Key eligibility criteria were indication for radiotherapy after radical prostatectomy for prostate cancer, prostate-specific antigen less than 5 ng/mL, absence of metastatic disease, and written consent. Participants were randomly assigned (1:1) to radiotherapy alone (no ADT) or radiotherapy with 6 months of ADT (short-course ADT), using monthly subcutaneous gonadotropin-releasing hormone analogue injections, daily oral bicalutamide monotherapy 150 mg, or monthly subcutaneous degarelix. Randomisation was done centrally through minimisation with a random element, stratified by Gleason score, positive margins, radiotherapy timing, planned radiotherapy schedule, and planned type of ADT, in a computerised system. The allocated treatment was not masked. The primary outcome measure was metastasis-free survival, defined as distant metastasis arising from prostate cancer or death from any cause. Standard survival analysis methods were used, accounting for randomisation stratification factors. The trial had 80% power with two-sided α of 5% to detect an absolute increase in 10-year metastasis-free survival from 80% to 86% (hazard ratio [HR] 0·67). Analyses followed the intention-to-treat principle. The trial is registered with the ISRCTN registry, ISRCTN40814031, and ClinicalTrials.gov, NCT00541047. Findings Between Nov 22, 2007, and June 29, 2015, 1480 patients (median age 66 years [IQR 61–69]) were randomly assigned to receive no ADT (n=737) or short-course ADT (n=743) in addition to postoperative radiotherapy at 121 centres in Canada, Denmark, Ireland, and the UK. With a median follow-up of 9·0 years (IQR 7·1–10·1), metastasis-free survival events were reported for 268 participants (142 in the no ADT group and 126 in the short-course ADT group; HR 0·886 [95% CI 0·688–1·140], p=0·35). 10-year metastasis-free survival was 79·2% (95% CI 75·4–82·5) in the no ADT group and 80·4% (76·6–83·6) in the short-course ADT group. Toxicity of grade 3 or higher was reported for 121 (17%) of 737 participants in the no ADT group and 100 (14%) of 743 in the short-course ADT group (p=0·15), with no treatment-related deaths. Interpretation Metastatic disease is uncommon following postoperative bed radiotherapy after radical prostatectomy. Adding 6 months of ADT to this radiotherapy did not improve metastasis-free survival compared with no ADT. These findings do not support the use of short-course ADT with postoperative radiotherapy in this patient population