How to...deconstruct the research paradigm: supporting the non-social scientist researching in medical education

Finding effective methods to guide novice clinical education researchers to interrogate their beliefs about paradigms can be a challenge for education practitioners leading training in this area. We share why we believe it is important for healthcare educators to build an understanding of research paradigms and how we demystified the teaching of philosophy and the ‘-ologies’ of research, to support novice researchers in their development. Through our use of gamification techniques based on Socratic questioning, we show how educators may be supported in the process of deconstructing their research project’s paradigm into its component parts. This comprises key questions about coherent alignment of their ontologies, epistemologies, and methods, and encouraging researchers to think openly about their assumptions to improve the conduct of research, particularly in the qualitative field

Dysregulation of metabolic-associated pathways in muscle of breast cancer patients: preclinical evaluation of interleukin-15 targeting fatigue

Background Breast cancer patients report a perception of increased muscle fatigue, which can persist following surgery and standardized therapies. In a clinical experiment, we tested the hypothesis that pathways regulating skeletal muscle fatigue are down-regulated in skeletal muscle of breast cancer patients and that different muscle gene expression patterns exist between breast tumour subtypes. In a preclinical study, we tested the hypothesis that mammary tumour growth in mice induces skeletal muscle fatigue and that overexpression of the cytokine interleukin-15 (IL-15) can attenuate mammary tumourinduced muscle fatigue. Methods Early stage non-metastatic female breast cancer patients (n = 14) and female non-cancer patients (n = 6) provided a muscle biopsy of the pectoralis major muscle during mastectomy, lumpectomy, or breast reconstruction surgeries. The breast cancer patients were diagnosed with either luminal (ER+ /PR+ , n = 6), triple positive (ER+ /PR+ /Her2/neu+ , n = 5), or triple negative (ER/PR/Her2/neu, n = 3) breast tumours and were being treated with curative intent either with neoadjuvant chemotherapy followed by surgery or surgery followed by standard post-operative therapy. Biopsies were used for RNA-sequencing to compare the skeletal muscle gene expression patterns between breast cancer patients and non-cancer patients. The C57BL/6 mouse syngeneic mammary tumour cell line, E0771, was used to induce mammary tumours in immunocompetent mice, and isometric muscle contractile properties and fatigue properties were analysed following 4 weeks of tumour growth. Results RNA-sequencing and subsequent bioinformatics analyses revealed a dysregulation of canonical pathways involved in oxidative phosphorylation, mitochondrial dysfunction, peroxisome proliferator-activated receptor signalling and activation, and IL-15 signalling and production. In a preclinical mouse model of breast cancer, the rate of muscle fatigue was greater in mice exposed to mammary tumour growth for 4 weeks, and this greater muscle fatigue was attenuated in transgenic mice that overexpressed the cytokine IL-15. Conclusions Our data identify novel genes and pathways dysregulated in the muscles of breast cancer patients with early stage non-metastatic disease, with particularly aberrant expression among genes that would predispose these patients to greater muscle fatigue. Furthermore, we demonstrate that IL-15 overexpression can attenuate muscle fatigue associated with mammary tumour growth in a preclinical mouse model of breast cancer. Therefore, we propose that skeletal muscle fatigue is an inherent consequence of breast tumour growth, and this greater fatigue can be targeted therapeutically

Global health learning outcomes in pharmacy students completing international advanced pharmacy practice experiences

© 2020, American Association of Colleges of Pharmacy. All rights reserved. Objective. To examine the global health learning outcomes of Doctor of Pharmacy (PharmD) students from three US schools who participated in international advanced pharmacy practice experiences (APPEs). Methods. A mixed-methods, prospective study was used to assess fourth-year PharmD students at three US pharmacy schools who participated in an international APPE during the 2017-2018 academic year and a matched cohort (control group) of PharmD students who did not participate in an international APPE. To evaluate students’ self-perceived growth in the Consortium of Universities for Global Health (CUGH) competencies, all students completed a 13-item retrospective pre-post instrument using a five-point Likert scale. The students who had completed an international APPE were invited to participate in a focus group (N522). Paired and independent t tests and multiple linear regression were used to analyze data. Qualitative open-ended questions and focus group data were mapped to knowledge, skills, and attitudes themes. Results. The students who completed an international APPE (N581) showed significantly more growth in CUGH competencies than students who did not (mean improvement in total score of 10.3 [7.0] vs 2.4 [6.0]). International APPE participation was the only significant predictor of growth in CUGH competencies. The international APPE students reported improvements in cultural awareness and appreciation, communication skills, problem-solving skills, adaptability, self-awareness, personal and professional outlook, and global health perspective. Conclusion. Pharmacy students’ participation in international APPEs led to significant improvement in all CUGH competencies. The CUGH competency framework appears to be a suitable instrument to assess pharmacy students’ global health learning outcomes

Global health learning outcomes by country location and duration for international experiences

© 2020 American Association of Colleges of Pharmacy. Objective. To determine the impact of country income classification and experience duration on learning outcomes for student pharmacists participating in international advanced pharmacy practice experiences (APPEs). Methods. A mixed-methods, longitudinal study evaluated 81 fourth-year student pharmacists participating in an international APPE through one of three US universities. A pre-post survey was administered to evaluate students’ self-perceived growth across 13 competencies established by the Consortium of Universities for Global Health (CUGH). The survey included four additional open-ended questions. Student pharmacists were also invited to participate in a focus group. Paired and independent t tests and multiple linear regression were conducted. Qualitative survey and focus group data underwent a two-cycle, open-coding process using conventional content analysis. Results. Students who completed their APPE in a low-to middle-income country had greater growth in all CUGH competency statements compared to those who completed their APPE in a high-income country. Completing the APPE in a low-to middle-income country and prior travel for non-vacation purposes were significant predictors of student growth. Students who went to a low-to middle-income country demonstrated increased cultural sensitivity, more patient-centered care, and skill development, while students who went to a high-income country displayed increased knowledge regarding differ-ences in health care system components, pharmacy practice, pharmacy education, and an appreciation for alternative patient care approaches. Conclusion. Learning outcomes differed between students who completed an APPE in a high-income rather than a low-to middle-income country, with both types of locations providing valuable educational opportunities and professional and personal development

The Stony Brook / SMARTS Atlas of mostly Southern Novae

We introduce the Stony Brook / SMARTS Atlas of (mostly) Southern Novae. This atlas contains both spectra and photometry obtained since 2003. The data archived in this atlas will facilitate systematic studies of the nova phenomenon and correlative studies with other comprehensive data sets. It will also enable detailed investigations of individual objects. In making the data public we hope to engender more interest on the part of the community in the physics of novae. The atlas is on-line at \url{http://www.astro.sunysb.edu/fwalter/SMARTS/NovaAtlas/} .Comment: 11 figures; 5 table

Patterns of Local-Regional Management Following Neoadjuvant Chemotherapy in Breast Cancer: Results From ACOSOG Z1071 (Alliance)

AXXXXX ZXXXX was a prospective trial evaluating the false negative rate of sentinel node (SLN) surgery after neoadjuvant chemotherapy (NAC) in breast cancer patients with initial node-positive disease. Radiation therapy (RT) decisions were at the discretion of treating physicians, providing an opportunity to evaluate variability in practice patterns following NAC

The Host Galaxy and Redshift of the Repeating Fast Radio Burst FRB 121102

The precise localization of the repeating fast radio burst (FRB 121102) has provided the first unambiguous association (chance coincidence probability $p\lesssim3\times10^{-4}$) of an FRB with an optical and persistent radio counterpart. We report on optical imaging and spectroscopy of the counterpart and find that it is an extended ($0.6^{\prime\prime}-0.8^{\prime\prime}$) object displaying prominent Balmer and [OIII] emission lines. Based on the spectrum and emission line ratios, we classify the counterpart as a low-metallicity, star-forming, $m_{r^\prime} = 25.1$ AB mag dwarf galaxy at a redshift of $z=0.19273(8)$, corresponding to a luminosity distance of 972 Mpc. From the angular size, the redshift, and luminosity, we estimate the host galaxy to have a diameter $\lesssim4$ kpc and a stellar mass of $M_*\sim4-7\times 10^{7}\,M_\odot$, assuming a mass-to-light ratio between 2 to 3$\,M_\odot\,L_\odot^{-1}$. Based on the H$\alpha$ flux, we estimate the star formation rate of the host to be $0.4\,M_\odot\,\mathrm{yr^{-1}}$ and a substantial host dispersion measure depth $\lesssim 324\,\mathrm{pc\,cm^{-3}}$. The net dispersion measure contribution of the host galaxy to FRB 121102 is likely to be lower than this value depending on geometrical factors. We show that the persistent radio source at FRB 121102's location reported by Marcote et al (2017) is offset from the galaxy's center of light by $\sim$200 mas and the host galaxy does not show optical signatures for AGN activity. If FRB 121102 is typical of the wider FRB population and if future interferometric localizations preferentially find them in dwarf galaxies with low metallicities and prominent emission lines, they would share such a preference with long gamma ray bursts and superluminous supernovae.Comment: 12 pages, 3 figures, Published in ApJ Letters. V2: Corrected mistake in author lis

Beaufort Gyre freshwater reservoir : state and variability from observations

Author Posting. © American Geophysical Union, 2009. This article is posted here by permission of American Geophysical Union for personal use, not for redistribution. The definitive version was published in Journal of Geophysical Research 114 (2009): C00A10, doi:10.1029/2008JC005104.We investigate basin-scale mechanisms regulating anomalies in freshwater content (FWC) in the Beaufort Gyre (BG) of the Arctic Ocean using historical observations and data collected in 2003–2007. Specifically, the mean annual cycle and interannual and decadal FWC variability are explored. The major cause of the large FWC in the BG is the process of Ekman pumping (EP) due to the Arctic High anticyclonic circulation centered in the BG. The mean seasonal cycle of liquid FWC is a result of interplay between the mechanical (EP) and thermal (ice transformations) factors and has two peaks. One peak occurs around June–July when the sea ice thickness reaches its minimum (maximum ice melt). The second maximum is observed in November–January when wind curl is strongest (maximum EP) and the salt input from the growing ice has not yet reached its maximum. Interannual changes in FWC during 2003–2007 are characterized by a strong positive trend in the region varying by location with a maximum of approximately 170 cm a−1 in the center of EP influenced region. Decadal FWC variability in the period 1950–2000 is dominated by a significant change in the 1990s forced by an atmospheric circulation regime change. The center of maximum FWC shifted to the southeast and appeared to contract in area relative to the pre-1990s climatology. In spite of the areal reduction, the spatially integrated FWC increased by over 1000 km3 relative to climatology.The funding for Andrey Proshutinsky, Richard Krishfield, John Toole, and Mary-Louise Timmermans (partial financial support of logistics, hydrographic observations on the board of Canadian icebreaker, and full financial coverage of all mooring instrumentation) was provided by the National Science Foundation (under grants ARC- 0806115, ARC-0631951, and ARC-0806306) and Woods Hole Oceanographic Institution internal funding

Your: Your Unified Reader

The advancement in signal processing and GPU based systems has enabled new transient detectors at various telescopes to perform much more sensitive searches than their predecessors. Typically the data output from the telescopes is in one of the two commonly used formats: psrfits and Sigproc filterbank. Software developed for transient searches often only works with one of these two formats, limiting their general applicability. Therefore, researchers have to write custom scripts to read/write the data in their format of choice before they can begin any data analysis relevant for their research. \textsc{Your} (Your Unified Reader) is a python-based library that unifies the data processing across multiple commonly used formats. \textsc{Your} implements a user-friendly interface to read and write in the data format of choice. It also generates unified metadata corresponding to the input data file for a quick understanding of observation parameters and provides utilities to perform common data analysis operations. \textsc{Your} also provides several state-of-the-art radio frequency interference mitigation (RFI) algorithms, which can now be used during any stage of data processing (reading, writing, etc.) to filter out artificial signals.Comment: 3 pages, Published in JOSS, Github: https://github.com/thepetabyteproject/you

Level of Recall Bias Regarding Pneumococcal Vaccination History among Adults Hospitalized with Community-Acquired Pneumonia: Results from the University of Louisville Pneumonia Study

Background: Recall bias is likely to occur in vaccine effectiveness studies using self-reported vaccination history. The validity of patient-reported vaccination status for adults is not well defined. The objective of this study was to evaluate the validity of self-reported pneumococcal vaccination history among patients hospitalized with community-acquired pneumonia (CAP). Methods: Prospective ancillary study of a population-based observational study of hospitalized patients with CAP in the city of Louisville. To be included in the analysis, patients had to (i) be reached by phone 30-days after discharge from the hospital and (ii) report that they remembered whether or not they received a pneumococcal vaccine in the past five years. The vaccination history was classified as 1) Subjective: patient recollection, or 2) Objective: vaccination records from insurance companies or primary care physicians. Results: A total of 2,787 patients who recalled their vaccination history were included in the analysis. Subjective vaccination history was documented to be inaccurate in 1,023 (37%) patients. Conclusions: Our study indicates that in adult patients, self-reported data regarding pneumococcal vaccination is likely to be inaccurate in one out of three patients. This level of recall bias may incorporate a fatal flaw in vaccine effectiveness studies