Interprofessional Collaborator Curriculum

Background: Physicians are often expected to participate with teams of health professionals; however, postgraduate training infrequently includes interprofessional (IP) or team training. Purpose: This curriculum was developed to demonstrate the knowledge, skills and attitudes which lead to successful IP collaboration. Curriculum: During a four-week geriatrics rotation, medicine interns complete a fifty-minute, in-person, multimedia lecture to introduce the IP collaborator concept and the Canadian and American IP competency frameworks. The IP pocket card is demonstrated and interns complete a guided, team-meeting video observation exercise. Using a Survey Monkey, narrative reporting tool, interns analyze team competencies that they observe or initiate during geriatrics team meetings during the rotation. They report on two interactions. They complete a closing Survey Monkey questionnaire and have an in-person debriefing. Results: We will have quantitative and qualitative data on interns’ recognition of IP collaborator competencies. Conclusion: Recognition of IP collaborator competencies will provide a framework for improving health professional effectiveness for systems-based care. Relevance to IP education or practice: Disseminating IP competencies. Learning Objectives: 1. The audience will be able to describe a new strategy for teaching IP competencies to health professionals. 2. The audience will become aware of a new method for combining the Canadian and American IP competencies. Todd James, MD, FACP Assistant Professor of Clinical Medicine Indiana University School of Medicine, Geriatrics Faculty Office Building, Floor 2 720 Eskenazi Avenue Indianapolis, IN 46202 Phone: 317-880-6582 Fax: 317-880-0332 Email: [email protected]

Posttransplant lymphoproliferative disorders in neuronal xenotransplanted macaques

Posttransplant lymphoproliferative disorders (PTLDs) are a heterogeneous group of lymphoid proliferations that occur in the setting of depressed T-cell function due to immunosuppressive therapy used following solid organ transplantation, hematopoietic stem cell transplantation, and also xenotransplantation. In the present study, 28 immunosuppressed parkinsonian Macaca fascicularis were intracerebrally injected with wild-type or CTLA4-Ig transgenic porcine xenografts to identify a suitable strategy to enable long-term cell survival, maturation, and differentiation. Nine of 28 (32%) immunosuppressed primates developed masses compatible with PTLD, located mainly in the gastrointestinal tract and/or nasal cavity. The masses were classified as monomorphic PTLD according to the World Health Organization classification. Immunohistochemistry and polymerase chain reaction (PCR) analyses revealed that the PTLDs were associated with macaca lymphocryptovirus as confirmed by double-labeling immunohistochemistry for CD20 and Epstein-Barr nuclear antigen 2 (EBNA-2), where the viral protein was located within the CD20+ neoplastic B cells. In sera from 3 distinct phases of the experimental life of the primates, testing by quantitative PCR revealed a progression of the viral load that paralleled the PTLD progression and no evidence of zoonotic transmission of porcine lymphotropic herpesvirus through xenoneuronal grafts. These data suggest that monitoring the variation of macaca lymphocryptovirus DNA in primates could be used as a possible early diagnostic tool for PTLD progression, allowing preemptive treatment such as immunosuppression therapy reduction

Indeterminate-length quantum coding

The quantum analogues of classical variable-length codes are indeterminate-length quantum codes, in which codewords may exist in superpositions of different lengths. This paper explores some of their properties. The length observable for such codes is governed by a quantum version of the Kraft-McMillan inequality. Indeterminate-length quantum codes also provide an alternate approach to quantum data compression.Comment: 32 page

Prenatal smoking, alcohol and caffeine exposure and offspring externalizing disorders:a systematic review and meta-analysis

BACKGROUND AND AIMS: Several studies have indicated an association between maternal prenatal substance use and offspring externalizing disorders; however, it is uncertain whether this relationship is causal. We conducted a systematic review to determine: (1) if the literature supports a causal role of maternal prenatal substance use on offspring externalizing disorders diagnosis and (2) whether these associations differ across externalizing disorders. METHODS: We searched Web of Science, Embase, PsycINFO and Medline databases. Risk of bias assessment was conducted using the Newcastle-Ottawa Scale (NOS), and where possible meta-analysis was conducted for studies classed as low risk of bias. We included studies of any design that examined prenatal smoking, alcohol or caffeine use. Studies in non-English language, fetal alcohol syndrome and comorbid autism spectrum disorders were excluded. Participants in the included studies were mothers and their offspring. Measurements included prenatal smoking, alcohol or caffeine use as an exposure, and diagnosis of attention-deficit hyperactivity disorder (ADHD), conduct disorder (CD) and oppositional defiant disorder (ODD) in offspring as an outcome. RESULTS: We included 63 studies, 46 of which investigated smoking and ADHD. All studies were narratively synthesized, and seven studies on smoking and ADHD were meta-analysed. The largest meta-analysis based on genetically sensitive design included 1 011 546 participants and did not find evidence for an association [odds ratio (OR)  = 0.90, 95% confidence interval (CI) = 0.83-1.11; OR   = 1.04, 95% CI = 0.79-1.36). Studies on alcohol exposure in all the outcomes reported inconsistent findings and no strong conclusions on causality can be made. Studies on caffeine exposure were mainly limited to ADHD and these studies do not support a causal effect. CONCLUSIONS: There appears to be no clear evidence to support a causal relationship between maternal prenatal smoking and offspring attention-deficit hyperactivity disorder. Findings with alcohol and caffeine exposures and conduct disorder and oppositional-defiant disorder need more research, using more genetically sensitive designs

On asymptotic continuity of functions of quantum states

A useful kind of continuity of quantum states functions in asymptotic regime is so-called asymptotic continuity. In this paper we provide general tools for checking if a function possesses this property. First we prove equivalence of asymptotic continuity with so-called it robustness under admixture. This allows us to show that relative entropy distance from a convex set including maximally mixed state is asymptotically continuous. Subsequently, we consider it arrowing - a way of building a new function out of a given one. The procedure originates from constructions of intrinsic information and entanglement of formation. We show that arrowing preserves asymptotic continuity for a class of functions (so-called subextensive ones). The result is illustrated by means of several examples.Comment: Minor corrections, version submitted for publicatio

Classical information deficit and monotonicity on local operations

We investigate classical information deficit: a candidate for measure of classical correlations emerging from thermodynamical approach initiated in [Phys. Rev. Lett 89, 180402]. It is defined as a difference between amount of information that can be concentrated by use of LOCC and the information contained in subsystems. We show nonintuitive fact, that one way version of this quantity can increase under local operation, hence it does not possess property required for a good measure of classical correlations. Recently it was shown by Igor Devetak, that regularised version of this quantity is monotonic under LO. In this context, our result implies that regularization plays a role of "monotoniser".Comment: 6 pages, revte

A Comparative Study of the Formation of Aromatics in Rich Methane Flames Doped by Unsaturated Compounds

For a better modeling of the importance of the different channels leading to the first aromatic ring, we have compared the structures of laminar rich premixed methane flames doped with several unsaturated hydrocarbons: allene and propyne, because they are precursors of propargyl radicals which are well known as having an important role in forming benzene, 1,3-butadiene to put in evidence a possible production of benzene due to reactions of C4 compounds, and, finally, cyclopentene which is a source of cyclopentadienylmethylene radicals which in turn are expected to easily isomerizes to give benzene. These flames have been stabilized on a burner at a pressure of 6.7 kPa (50 Torr) using argon as dilutant, for equivalence ratios (?) from 1.55 to 1.79. A unique mechanism, including the formation and decomposition of benzene and toluene, has been used to model the oxidation of allene, propyne, 1,3 butadiene and cyclopentene. The main reaction pathways of aromatics formation have been derived from reaction rate and sensitivity analyses and have been compared for the three types of additives. These combined analyses and comparisons can only been performed when a unique mechanism is available for all the studied additives

Parenting ‘gifted and talented’ children in urban areas: Parents' voices

This is the author's accepted manuscript. The final published article is available from the link below. Copyright © 2014 by SAGE Publications.International evidence demonstrates the importance of engaging parents in the education of their ‘high-potential’ children, yet limited research has focused on the involvement of parents from differing economic strata/backgrounds. The current study explored the dilemmas of parenting academically high-ability children from economically deprived urban areas in the UK. Data were gathered from a sample of parents whose children attended a university-based sustained intervention programme for designated ‘gifted’ pupils aged 12–16. Parental perceptions were sought in relation to (a) the usefulness/impact of the intervention programme, (b) parents’ aspirations for their children growing up in economically deprived urban areas and (c) parents’ views on the support provided by the extended family, peer groups and the wider community. The findings have significant implications for both policy and practice and, more specifically, for engaging parents in intervention programmes offered by universities and schools to children in order to increase their access to higher education and for enhancing their life chances

A Two-Tier Golgi-Based Control of Organelle Size Underpins the Functional Plasticity of Endothelial Cells

Weibel-Palade bodies (WPBs), endothelial-specific secretory granules that are central to primary hemostasis and inflammation, occur in dimensions ranging between 0.5 and 5 μm. How their size is determined and whether it has a functional relevance are at present unknown. Here, we provide evidence for a dual role of the Golgi apparatus in controlling the size of these secretory carriers. At the ministack level, cisternae constrain the size of nanostructures (“quanta”) of von Willebrand factor (vWF), the main WPB cargo. The ribbon architecture of the Golgi then allows copackaging of a variable number of vWF quanta within the continuous lumen of the trans-Golgi network, thereby generating organelles of different sizes. Reducing the WPB size abates endothelial cell hemostatic function by drastically diminishing platelet recruitment, but, strikingly, the inflammatory response (the endothelial capacity to engage leukocytes) is unaltered. Size can thus confer functional plasticity to an organelle by differentially affecting its activities