Use of mobile apps for teaching and research - implications for digital literacy

This paper reports on the results of an online survey about mobile application (app) use for academic purposes, i.e. teaching and research, by Higher Degree Research (HDR) students and academic staff at one of the eight New Zealand universities. Two thirds of the 138 respondents reported they used apps for academic purposes. In teaching, apps were reported to be used as a means to push information to students. In research, apps appeared to be used to self-organise, collaborate with colleagues, store information, and to stay current with research. This paper presents the survey results and discusses implications for personal information management in education context and opportunities for university library services

Capecitabine (oral 5-fluorouracil pro-drug) treatment for colorectal carcinoma causing ischaemic chest pain

We present a case of cardiac ischaemia associated with capecitabine chemotherapy. An elderly female receiving capecitabine chemotherapy developed acute onset severe anterior chest pain associated with ischaemic changes on ECG. The pain and ECG changes failed to respond to thrombolysis and she proceeded to coronary angiogram and stenting of a thrombosed right coronary vessel. She inadvertently recommenced her capecitabine with a further episode of chest pain. On cessation of capecitabine she had no further episodes of chest pain

Pulmonary Artery Catheter (PAC) Accuracy and Efficacy Compared with Flow Probe and Transcutaneous Doppler (USCOM): An Ovine Cardiac Output Validation

Background. The pulmonary artery catheter (PAC) is an accepted clinical method of measuring cardiac output (CO) despite no prior validation. The ultrasonic cardiac output monitor (USCOM) is a noninvasive alternative to PAC using Doppler ultrasound (CW). We compared PAC and USCOM CO measurements against a gold standard, the aortic flow probe (FP), in sheep at varying outputs. Methods. Ten conscious sheep, with implanted FPs, had measurements of CO by FP, USCOM, and PAC, at rest and during intervention with inotropes and vasopressors. Results. CO measurements by FP, PAC, and USCOM were 4.0 ± 1.2 L/min, 4.8 ± 1.5 L/min, and 4.0 ± 1.4 L/min, respectively, (n = 280, range 1.9 L/min to 11.7 L/min). Percentage bias and precision between FP and PAC, and FP and USCOM was −17 and 47%, and 1 and 36%, respectively. PAC under-measured Dobutamine-induced CO changes by 20% (relative 66%) compared with FP, while USCOM measures varied from FP by 3% (relative 10%). PAC reliably detected −30% but not +40% CO changes, as measured by receiver operating characteristic area under the curve (AUC), while USCOM reliably detected ±5% changes in CO (AUC > 0.70). Conclusions. PAC demonstrated poor accuracy and sensitivity as a measure of CO. USCOM provided equivalent measurements to FP across a sixfold range of outputs, reliably detecting ±5% changes

Curriculum implementation exploratory studies: Final report

Throughout the history of schooling in New Zealand the national curriculum has been revised at fairly regular intervals. Consequently, schools are periodically faced with having to accommodate to new curriculum. In between major changes other specifically-focused changes may arise; for example, the increased recent emphasis upon numeracy and literacy

Characterisation and outcomes of patients referred to a regional cancer of unknown primary team: a 10-year analysis

BACKGROUND: In the United Kingdom, national guidance published in 2010 recommended the establishment of specialist teams to improve clinical pathways for patients presenting with malignancies of undefined primary origin (MUO) and cancer of unknown primary (CUP). This study sought to define outcomes of patients referred to a regional MUO/CUP service. METHODS: Data were collected prospectively on all patients (n = 1225) referred to a regional CUP team over a 10-year period. Patient demographics, clinical, pathological and outcome data were recorded and analysed. RESULTS: Confirmed CUP (cCUP) was diagnosed in 25% of patients. A primary metastatic cancer was identified in 36%, 5% were diagnosed with provisional CUP (pCUP), 27% retained the diagnosis of MUO and in 8% a non-cancer diagnosis was made. Median survival was low in all patients with a final malignant diagnosis: primary identified 9.0 months, cCUP 4.0 months, pCUP 1.5 months and MUO 1.5 months. CONCLUSIONS: Patients presenting with MUO have poor outcomes irrespective of the final diagnosis. These patients need a patient-centred, streamlined, rapid diagnostic pathway. There are clear benefits to primary and secondary care teams having access to a dedicated, multidisciplinary MUO/CUP service, with clinical nurse specialists supporting the patients, to help facilitate this pathway and ensure early oncology review

Use of mobile apps for teaching and research

Applications (apps) are software specifically designed for mobile de-vices. This paper reports on the results of an online survey about app use for teaching and research by students and academic staff at the University of Wai-kato. The questionnaire had 138 respondents. The results of the data analysis in-dicate that among respondents apps are primarily used for communication, data storage, and collaborative work. Nearly a third of respondents reported not using. any apps for academic purposes, with almost half that number citing a lack of knowledge about possible uses. In teaching practice, apps were reported to be used as a means to push information to students, e.g., for distributing reading materials and other teaching resources. In research, apps appeared to be used to self-organise, collaborate with other researchers, store information, and to stay current with research. This paper concludes with a list of implications

Embracing model-based designs for dose-finding trials

Background: Dose-finding trials are essential to drug development as they establish recommended doses for later-phase testing. We aim to motivate wider use of model-based designs for dose finding, such as the continual reassessment method (CRM). Methods: We carried out a literature review of dose-finding designs and conducted a survey to identify perceived barriers to their implementation. Results: We describe the benefits of model-based designs (flexibility, superior operating characteristics, extended scope), their current uptake, and existing resources. The most prominent barriers to implementation of a model-based design were lack of suitable training, chief investigators’ preference for algorithm-based designs (e.g., 3 þ 3), and limited resources for study design before funding. We use a real-world example to illustrate how these barriers can be overcome. Conclusions: There is overwhelming evidence for the benefits of CRM. Many leading pharmaceutical companies routinely implement model-based designs. Our analysis identified barriers for academic statisticians and clinical academics in mirroring the progress industry has made in trial design. Unified support from funders, regulators, and journal editors could result in more accurate doses for later-phase testing, and increase the efficiency and success of clinical drug development. We give recommendations for increasing the uptake of model-based designs for dose-finding trials in academia

Doing cold smarter

Cold has been much neglected in the energy debate. Governments are developing strategies and policies to green everything from electricity to transport to heat, but the energy and environmental impacts of cooling have so far been largely ignored. This is a serious oversight, since making things cold is energy intensive and can be highly polluting, and demand for cooling in all its forms is booming worldwide – especially in developing countries. According to one projection, by the end of this century global demand for air conditioning alone could consume the equivalent of half our worldwide electricity generation today – and most of the increase will come in developing markets. The ‘greening’ of cold is clearly an urgent global problem – but it may also offer Britain a massive business opportunity. Cold may have been ignored but is vitally important to many aspects of modern life. An effective cold chain, for example, is essential for tackling problems such as food waste, food security, water conservation and public health. Cooling is also critical for many less obvious but essential functions: data centres couldn’t operate without it, nor for example MRI scanners in medicine or superconductors in power electronics. Cooling also provides modern levels of comfort in hot countries – and can make the difference between some regions being habitable or not. At the same time, vast amounts of cold are wasted – for instance during the regasification of LNG – which could in principle be recycled to satisfy some of this demand and start to reduce the environmental damage caused by cooling. Such a system-level approach – which starts by asking what energy services we need, and what is the least damaging way to provide them, rather than accepting existing practices as a fait accompli – has recently been coined the ‘Cold Economy’. It is clear the Cold Economy could unleash a wide range of innovative clean cold technologies and provide energy resilience, economic growth and environmental benefits, but there is an urgent need to develop a system-level analysis of this problem and the potential solutions to inform both industry and policymakers. The Birmingham Policy Commission: Doing Cold Smarter was convened to start this work

Targeting gp100 and TRP-2 with a DNA vaccine: incorporating T cell epitopes with a human IgG1 antibody induces potent T cell responses that are associated with favourable clinical outcome in a phase I/II trial

A DNA vaccine, SCIB1, incorporating two CD8 and two CD4 epitopes from TRP-2/gp100 was evaluated in patients with metastatic melanoma. Each patient received SCIB1 via intramuscular injection with electroporation. The trial was designed to find the safest dose of SCIB1 which induced immune/clinical responses in patients with or without tumour. Fifteen patients with tumor received SCIB1 doses of 0.4-8 mg whilst 20 fully-resected patients received 2-8 mg doses. Twelve patients elected to continue immunization every 3 months for up to 39 months. SCIB1 induced dose-dependent T cell responses in 88% of patients with no serious adverse effects or dose limiting toxicities. The intensity of the T cell responses was significantly higher in patients receiving 4 mg doses without tumor when compared to those with tumor (p< 0.01). In contrast, patients with tumor showed a significantly higher response to the 8 mg dose than the 4 mg dose (p< 0.03) but there was no significant difference in the patients without tumor. One of 15 patients with measurable disease showed an objective tumor response and 7/15 showed stable disease. 5/20 fully-resected patients have experienced disease recurrence but all remained alive at the cut-off date with a median observation time of 37 months. A positive clinical outcome was associated with MHC-I and MHC-II expression on tumors prior to therapy (p=0.027). We conclude that SCIB1 is well tolerated and stimulates potent T cell responses in melanoma patients. It deserves further evaluation as a single agent adjuvant therapy or in combination with checkpoint inhibitors in advanced disease

Estimating the prevalence, quality of life, economic and societal impact of arthritis in Tanzania: protocol for a mixed methods study [Protocol]

Introduction: Musculoskeletal (MSK) disorders are one of the major causes of disability globally. A 2010 Global Burden of Disease study reported that MSK diseases account for 20% of all Years Lived with Disability (YLDs) in Low- and Middle-Income countries. This study will use mixed methods to generate new findings on the prevalence, quality of life, economic and societal impact of musculoskeletal disorders (including arthritis) in the Hai district in Tanzania. Methods and analysis: In this mixed-methods study funded by the UK’s National Institute for Health Research (NIHR) Global Health Research Units and Groups (Award no: 17/63/35) we will conduct quantitative, community-based (urban, peri - urban and rural) and hospital based prospective surveys, supported by rapid ethnographic assessments (REAs), in-depth interviews, focus group discussions (FGDs) and clinical diagnostic screening to estimate the prevalence, economic and societal impact of arthritis. A retrospective medical records baseline review at the Kilimanjaro Christian Medical Centre (KCMC) will also be conducted to assess prevailing documentation and management of arthritis. Ethics and dissemination: Ethical approval has been obtained through Kilimanjaro Christian Medical University College (KCMUCo) Research Ethics and Review committee (CRERC) in Moshi, National Health Research Ethics Committee (NatHREC) of the National Institute for Medical research (NIMR) in Tanzania and the Medical Veterinary and Life Sciences (MVLS) Ethics committee at the University of Glasgow, UK (MVLS ethics project number:20018010). We will disseminate the findings in clinical, epidemiological, and economic peer reviewed journals. Other dissemination modalities include professional conferences, short reports, community leaflets, policy briefs and dissemination events to communities and various stakeholders including the Ministry of health in Tanzania