Synthesis of aesthetics for ship design

In the search for consensus on a definition of beauty, fitting the task of appreciating a ship’s design, this research revealed that other components of visual appraisal and 3d pattern analysis are required for a systemic approach. The model process presented is built around local adaptation and Gestalt psychology and uses retrospective case studies to categorise and calculate proportions, and recognisable patterns. The number of results from each type of vessel were found to be different, due to each ship or boats various geometries and anatomy, which illuminated the importance of standardising a procedure of categorisation in the appreciative approach.The categorisation of functions around the philosophy of functional beauty and the maths of summation series, it is suggested here, will allow a library of algebraic patterns and parameters to penetrate further into the impending or emulated integrated systems of ship design. The process to derive physical parameters via the culturally focussed narrative of functional beauty, is deemed as a manageable and novel addition to the naval architect's role. However, for the results to have a decisive impact on commercial design or education, variance and validation through further case studies is required

Faculty Format Preferences in the Performing Arts: A Multi-Institutional Study

Resources for teaching in higher education have undergone a tremendous evolution during the past several decades. The Internet and commercial services, such as YouTube and Google, have revolutionized the manner by which students and faculty access information to both conduct research and meet course requirements. This mixed methods study implemented an online survey and interviews to determine how performing arts faculty at three institutions integrate library resources and services into their teaching. Conclusions indicate that, while personal collections and Internet resources provide a majority of teaching content, the academic library still offers important access to materials for instruction

Minocycline attenuates lipopolysaccharide (LPS)-induced neuroinflammation, sickness behavior, and anhedonia

© 2008 Henry et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution Licens

Changes to DPPC domain structure in the presence of carbon nanoparticles

DPPC (dipalmitoylphosphatidylcholine) is a disaturated lipid capable of forming closely packed monolayers at the air–liquid interface of the lung and allows the surface tension within the alveoli to reduce to almost zero and thus prevent alveolar collapse. Carbon nanoparticles are formed in natural and man-made combustion events, including diesel engines, and are capable of reaching the alveolar epithelium during breathing. In this work, we have used Brewster angle microscopy and neutron reflectivity to study the effect of differing concentrations of carbon nanoparticles on the structure of DPPC monolayer as the monolayer is subject to compression and expansion. The results show that the inclusion of carbon nanoparticles within a DPPC monolayer affects the formation and structure of the lipid domains. The domains lose their circular structure and show a crenated structure as well as a reduction in overall size of the domains. This change in structure is also evident following expansion of the lipid monolayer, suggesting that some carbon nanoparticles may remain associated with the monolayer. This observation could have an important implication regarding the removal of nanosized airborne pollutants from the human lung

Hospital nurse-staffing models and patient- and staff-related outcomes

Background: Nurses comprise the largest component of the health workforce worldwide and numerous models of workforce allocation and profile have been implemented. These include changes in skill mix, grade mix or qualification mix, staff‐allocation models, staffing levels, nursing shifts, or nurses’ work patterns. This is the first update of our review published in 2011. Objectives: The purpose of this review was to explore the effect of hospital nurse‐staffing models on patient and staff‐related outcomes in the hospital setting, specifically to identify which staffing model(s) are associated with: 1) better outcomes for patients, 2) better staff‐related outcomes, and, 3) the impact of staffing model(s) on cost outcomes. Search methods: CENTRAL, MEDLINE, Embase, two other databases and two trials registers were searched on 22 March 2018 together with reference checking, citation searching and contact with study authors to identify additional studies. Selection criteria: We included randomised trials, non‐randomised trials, controlled before‐after studies and interrupted‐time‐series or repeated‐measures studies of interventions relating to hospital nurse‐staffing models. Participants were patients and nursing staff working in hospital settings. We included any objective reported measure of patient‐, staff‐related, or economic outcome. The most important outcomes included in this review were: nursing‐staff turnover, patient mortality, patient readmissions, patient attendances at the emergency department (ED), length of stay, patients with pressure ulcers, and costs. Data collection and analysis: We worked independently in pairs to extract data from each potentially relevant study and to assess risk of bias and the certainty of the evidence. Main results: We included 19 studies, 17 of which were included in the analysis and eight of which we identified for this update. We identified four types of interventions relating to hospital nurse‐staffing models: introduction of advanced or specialist nurses to the nursing workforce; introduction of nursing assistive personnel to the hospital workforce; primary nursing; and staffing models. The studies were conducted in the USA, the Netherlands, UK, Australia, and Canada and included patients with cancer, asthma, diabetes and chronic illness, on medical, acute care, intensive care and long‐stay psychiatric units. The risk of bias across studies was high, with limitations mainly related to blinding of patients and personnel, allocation concealment, sequence generation, and blinding of outcome assessment. The addition of advanced or specialist nurses to hospital nurse staffing may lead to little or no difference in patient mortality (3 studies, 1358 participants). It is uncertain whether this intervention reduces patient readmissions (7 studies, 2995 participants), patient attendances at the ED (6 studies, 2274 participants), length of stay (3 studies, 907 participants), number of patients with pressure ulcers (1 study, 753 participants), or costs (3 studies, 617 participants), as we assessed the evidence for these outcomes as being of very low certainty. It is uncertain whether adding nursing assistive personnel to the hospital workforce reduces costs (1 study, 6769 participants), as we assessed the evidence for this outcome to be of very low certainty. It is uncertain whether primary nursing (3 studies, > 464 participants) or staffing models (1 study, 647 participants) reduces nursing‐staff turnover, or if primary nursing (2 studies, > 138 participants) reduces costs, as we assessed the evidence for these outcomes to be of very low certainty. Authors' conclusions: The findings of this review should be treated with caution due to the limited amount and quality of the published research that was included. We have most confidence in our finding that the introduction of advanced or specialist nurses may lead to little or no difference in one patient outcome (i.e. mortality) with greater uncertainty about other patient outcomes (i.e. readmissions, ED attendance, length of stay and pressure ulcer rates). The evidence is of insufficient certainty to draw conclusions about the effectiveness of other types of interventions, including new nurse‐staffing models and introduction of nursing assistive personnel, on patient, staff and cost outcomes. Although it has been seven years since the original review was published, the certainty of the evidence about hospital nurse staffing still remains very low

Factor structure of the Montreal Cognitive Assessment in Parkinson’s disease

Objectives: The Montreal Cognitive Assessment (MoCA) is a common tool for screening mild cognitive impairment (MCI) and dementia. Studies in multiple clinical groups provide evidence for various factor structures mapping to different cognitive domains. We tested the factor structure of the MoCA in a large cohort of early Parkinson disease (PD). Materials and Methods: Complete MoCA data were available from an observational cohort study for 1738 patients with recent‐onset PD (64.6% male, mean age 67.6, SD 9.2). Confirmatory factor analysis (CFA) was applied to test previously defined two‐factor, six‐factor, and three‐factor models in the full sample and in a subgroup with possible cognitive impairment (MoCA < 26). Secondary analysis used exploratory factor analysis (EFA; principal factors with oblique rotation). Results: The mean MoCA score was 25.3 (SD 3.4, range 10‐30). Fit statistics in the six‐factor model (χ2/df 17.77, root mean square error of approximation [RMSEA] 0.10, comparative fit index [CFI] 0.74, Tucker‐Lewis index [TLI] 0.69, standardised root mean square residual [SRMR] 0.07) indicated poorer fit than did previous studies. Findings were similar in the two‐factor and three‐factor models. EFA suggested an alternative six‐factor solution (short‐term recall, visuospatial‐executive, attention/working memory, verbal‐executive, orientation, and expressive language), although CFA did not support the validity of the new model. Conclusions: The factor structure of the MoCA in early PD was not consistent with that of previous research. This may reflect higher cognitive performance and differing demographics in our sample. The results do not support a clear, clinically relevant factor structure in an early PD group, suggesting that the MoCA should be followed with detailed assessment to obtain domain‐specific cognitive profiles

Statistical significance and sports medicine trials

Objectives: Lowering the threshold for statistical significance in medical research from a P value of .05 to .005 was recently proposed to reduce misinterpretation of study results. What effect this proposal would have on orthopaedic sports medicine literature is currently unclear.Research Question/Hypothesis: We seek to determine how the newly proposed threshold could affect the interpretation of previously published sports medicine RCTs.Methods: We searched PubMed from January 01, 2016 to December 31, 2017 for RCTs published in the American Journal of Sports Medicine, Arthroscopy, and Knee Surgery, Sports Traumatology, Arthroscopy. We extracted P value data for primary endpoints, since RCTs are most often powered for these endpoints. We used Google Forms for data extraction and STATA 13.1 for the data analysis.Results: Of the 159 studies, only 13 (8%) of the studies have endpoints in which all P values are below the new threshold of .005. 40 (25%) of the studies have endpoints in which some would meet the new P value threshold of .005, and some would not meet this new threshold. 106 (67%) of the studies have no endpoints in which the P value(s) was less than .005. Overall, 38% (59/157) of the previously statistically significant primary endpoints were less than .005, while 62% (98/157) would be reclassified as suggestive.Conclusions: Of statistically significant endpoints in our sample, only 17% (59/350) would maintain their statistical significance with a P value threshold of less than .005, and only 8% of studies would maintain their overall significance with all P values falling below the new threshold

Doctoral Recital

List of performers or performances

Delirium and the risk of developing dementia: a cohort study of 12 949 patients

Background: Delirium is an important risk factor for subsequent dementia. However, the field lacks large studies with long-term follow-up of delirium in subjects initially free of dementia to clearly establish clinical trajectories. Methods: We undertook a retrospective cohort study of all patients over the age of 65 diagnosed with an episode of delirium who were initially dementia free at onset of delirium within National Health Service Greater Glasgow & Clyde between 1996 and 2020 using the Safe Haven database. We estimated the cumulative incidence of dementia accounting for the competing risk of death without a dementia diagnosis. We modelled the effects of age at delirium diagnosis, sex and socioeconomic deprivation on the cause-specific hazard of dementia via cox regression. Results: 12 949 patients with an incident episode of delirium were included and followed up for an average of 741 days. The estimated cumulative incidence of dementia was 31% by 5 years. The estimated cumulative incidence of the competing risk of death without dementia was 49.2% by 5 years. The cause-specific hazard of dementia was increased with higher levels of deprivation and also with advancing age from 65, plateauing and decreasing from age 90. There did not appear to be a relationship with sex. Conclusions: Our study reinforces the link between delirium and future dementia in a large cohort of patients. It highlights the importance of early recognition of delirium and prevention where possible