The use of a proficiency-based clinical tool in the evaluation of clinical knowledge and skills in the athletic training setting

Context. Athletic training clinical education has changed significantly since the Commission on Accreditation of Athletic Training Education (CAATE) became the accrediting body for the profession. One of the changes is to require proficiency in both didactic knowledge and clinical performance through evaluation. Clinical education studies are evident and methods of teaching and learning are explored frequently, however little is known about the connection of athletic training students\u27 didactic performance and clinical proficiency competencies with on the field experiences. Objective. The purpose of this study was to create a clinical proficiency evaluation tool as a means to evaluate an athletic training student\u27s clinical skills. Design. The design of this study was a correlation study to note the relationship between GPAs, clinical performance evaluation grades, proficiency grades and the score obtained on the clinical proficiency evaluation tool. Setting. One Division I Mid-Atlantic University with a CAATE-accredited undergraduate athletic training program. Participants. This study included fifteen senior undergraduate athletic training students (6 males and 9 females) with a mean age of 22.5+/-1.5 years. This was a sample of convenience based on availability. Participants included in this study were required to be in their third year in the athletic training program and in good standing in order to graduate at the end of their final semester. The individuals had successfully completed all sophomore, junior, and first semester senior course and proficiency work with a minimum of proficient scores. Exclusion criteria included senior students in any other curriculum other than athletic training, individuals in the athletic training program but not in their third year, and individuals who had not scored at least proficient in all the proficiencies through the Fall semester of 2009. Intervention. Senior athletic training students were asked to participate in this study, and upon agreement were required to fill out the necessary informed consent paperwork and FERPA forms giving the examiner permission to access their individual scholastic files since acceptance into the athletic training education program through the fall 2009 semester. The students completed the clinical proficiency evaluation tool, which is based upon video scenarios within the established clinical proficiency and competency requirements of the athletic training education program. The tool consists of pictures, questions, situations, and video scenarios that students could experience in the athletic training setting. While viewing the tool, the students completed a 50 item multiple choice test. Upon completion of the examination, answer sheets were collected, and results were recorded. Main Outcome Measures. Based on the results, athletic training students\u27 clinical site grades will correlate highly with the grades obtained from the clinical proficiency evaluation tool, and athletic training students\u27 clinical site grades will improve over the course of each semester. Results. From the possible 16 senior students athletic training students, 15 individuals (n=15) submitted the required material for a participation rate of 93.75%. The mean GPA was 3.40+/-.33. As sophomore students, the mean score for their clinical evaluation grades is 90.2% +/-3.1%. As juniors, the mean clinical evaluation grade is 92.7%+/-4.5%, and as seniors, the mean clinical evaluation grade is 91.4% +/-5.7%. Clinical proficiency score results showed a mean of 88.2% +/-3.0%, and ranged from a minimum of 85.0% and a maximum score of a 93.0%. Results of the clinical proficiency evaluation tool had a mean of 63.1% +/-5.8%, and scores ranged from a minimum of 48% to a maximum score of 72%. Strong correlational relationships were found between the junior year clinical evaluation grades and GPA (r =.639, P=.010), clinical proficiency grades and GPA (r =.711, P=.003), as well as clinical proficiency grades and the junior year clinical evaluation grades (r =.754, P=.001). Conclusion. This study shows a strong correlation between GPA and clinical performance evaluation grades, and a moderate correlation between proficiency grades and the clinical proficiency evaluation tool. The clinical proficiency evaluation tool may have some areas of correlation and significance in accordance to the grades and scores already being obtained by programs. Information obtained in this study could be used by individual athletic training education programs to evaluate clinical proficiencies near the end of the athletic training student\u27s senior year

Effects of Detritus on the Mosquito Culex pipiens: Phragmites and Schedonorus (Festuca) Invasion Affect Population Performance

Partial funding for Open Access provided by the UMD Libraries' Open Access Publishing Fund.Species interactions that influence the performance of the exotic mosquito Culex pipiens can have important effects on the transmission risk of West Nile virus (WNV). Invasive plants that alter the vegetation communities of ephemeral ground pools may facilitate or resist the spread of C. pipiens (L.) by altering allochthonous inputs of detritus in those pools. To test this hypothesis, we combined field surveys of roadside stormwater ditches with a laboratory microcosm experiment to examine relationships between C. pipiens performance and water quality in systems containing detritus from invasive Phragmites australis (Cav.) Trin. Ex Steud., introduced Schedonorus arundinaceus (Schreb.) Dumort., or native Juncus effusus L. or Typha latifolia L. In ditches, C. pipiens abundance was unrelated to detritus species but female C. pipiens were significantly larger from ditches with S. arundinaceus and smaller with J. effusus. Larger and smaller C. pipiens were also produced in microcosms provisioned with S. arundinaceus and J. effusus, respectively, yet the per capita rate of population of change did not vary. Larger females from habitats with S. arundinaceus were likely caused by faster decay rates of S. arundinaceus and resultant increases in microbial food, but lower survival as a result of fouling and higher tannin-lignin concentrations resulted in little changes to overall population performance. Larger female mosquitoes have been shown to have greater potential for transmitting arboviruses. Our findings suggest that changed community-level interactions from plant invasions in urban ephemeral ground pools can affect the fitness of C. pipiens and possibly increase WNV risk

Modern optical astronomy: technology and impact of interferometry

The present `state of the art' and the path to future progress in high spatial resolution imaging interferometry is reviewed. The review begins with a treatment of the fundamentals of stellar optical interferometry, the origin, properties, optical effects of turbulence in the Earth's atmosphere, the passive methods that are applied on a single telescope to overcome atmospheric image degradation such as speckle interferometry, and various other techniques. These topics include differential speckle interferometry, speckle spectroscopy and polarimetry, phase diversity, wavefront shearing interferometry, phase-closure methods, dark speckle imaging, as well as the limitations imposed by the detectors on the performance of speckle imaging. A brief account is given of the technological innovation of adaptive-optics (AO) to compensate such atmospheric effects on the image in real time. A major advancement involves the transition from single-aperture to the dilute-aperture interferometry using multiple telescopes. Therefore, the review deals with recent developments involving ground-based, and space-based optical arrays. Emphasis is placed on the problems specific to delay-lines, beam recombination, polarization, dispersion, fringe-tracking, bootstrapping, coherencing and cophasing, and recovery of the visibility functions. The role of AO in enhancing visibilities is also discussed. The applications of interferometry, such as imaging, astrometry, and nulling are described. The mathematical intricacies of the various `post-detection' image-processing techniques are examined critically. The review concludes with a discussion of the astrophysical importance and the perspectives of interferometry.Comment: 65 pages LaTeX file including 23 figures. Reviews of Modern Physics, 2002, to appear in April issu

A microengineered vascularized bleeding model that integrates the principal components of hemostasis

Hemostasis encompasses an ensemble of interactions among platelets, coagulation factors, blood cells, endothelium, and hemodynamic forces, but current assays assess only isolated aspects of this complex process. Accordingly, here we develop a comprehensive in vitro mechanical injury bleeding model comprising an “endothelialized” microfluidic system coupled with a microengineered pneumatic valve that induces a vascular “injury”. With perfusion of whole blood, hemostatic plug formation is visualized and “in vitro bleeding time” is measured. We investigate the interaction of different components of hemostasis, gaining insight into several unresolved hematologic issues. Specifically, we visualize and quantitatively demonstrate: the effect of anti-platelet agent on clot contraction and hemostatic plug formation, that von Willebrand factor is essential for hemostasis at high shear, that hemophilia A blood confers unstable hemostatic plug formation and altered fibrin architecture, and the importance of endothelial phosphatidylserine in hemostasis. These results establish the versatility and clinical utility of our microfluidic bleeding model

Recruitment of rare 3-grams at functional sites: Is this a mechanism for increasing enzyme specificity?

<p>Abstract</p> <p>Background</p> <p>A wealth of unannotated and functionally unknown protein sequences has accumulated in recent years with rapid progresses in sequence genomics, giving rise to ever increasing demands for developing methods to efficiently assess functional sites. Sequence and structure conservations have traditionally been the major criteria adopted in various algorithms to identify functional sites. Here, we focus on the distributions of the 20³different types of <it>3</it>-grams (or triplets of sequentially contiguous amino acid) in the entire space of sequences accumulated to date in the UniProt database, and focus in particular on the rare <it>3</it>-grams distinguished by their high entropy-based information content.</p> <p>Results</p> <p>Comparison of the UniProt distributions with those observed near/at the active sites on a non-redundant dataset of 59 enzyme/ligand complexes shows that the active sites preferentially recruit <it>3</it>-grams distinguished by their low frequency in the UniProt. Three cases, Src kinase, hemoglobin, and tyrosyl-tRNA synthetase, are discussed in details to illustrate the biological significance of the results.</p> <p>Conclusion</p> <p>The results suggest that recruitment of rare <it>3</it>-grams may be an efficient mechanism for increasing specificity at functional sites. Rareness/scarcity emerges as a feature that may assist in identifying key sites for proteins function, providing information complementary to that derived from sequence alignments. In addition it provides us (for the first time) with a means of identifying potentially functional sites from sequence information alone, when sequence conservation properties are not available.</p

An RNAi in silico approach to find an optimal shRNA cocktail against HIV-1

<p>Abstract</p> <p>Background</p> <p>HIV-1 can be inhibited by RNA interference <it>in vitro </it>through the expression of short hairpin RNAs (shRNAs) that target conserved genome sequences. <it>In silico </it>shRNA design for HIV has lacked a detailed study of virus variability constituting a possible breaking point in a clinical setting. We designed shRNAs against HIV-1 considering the variability observed in naïve and drug-resistant isolates available at public databases.</p> <p>Methods</p> <p>A Bioperl-based algorithm was developed to automatically scan multiple sequence alignments of HIV, while evaluating the possibility of identifying dominant and subdominant viral variants that could be used as efficient silencing molecules. Student t-test and Bonferroni Dunn correction test were used to assess statistical significance of our findings.</p> <p>Results</p> <p>Our <it>in silico </it>approach identified the most common viral variants within highly conserved genome regions, with a calculated free energy of ≥ -6.6 kcal/mol. This is crucial for strand loading to RISC complex and for a predicted silencing efficiency score, which could be used in combination for achieving over 90% silencing. Resistant and naïve isolate variability revealed that the most frequent shRNA per region targets a maximum of 85% of viral sequences. Adding more divergent sequences maintained this percentage. Specific sequence features that have been found to be related with higher silencing efficiency were hardly accomplished in conserved regions, even when lower entropy values correlated with better scores. We identified a conserved region among most HIV-1 genomes, which meets as many sequence features for efficient silencing.</p> <p>Conclusions</p> <p>HIV-1 variability is an obstacle to achieving absolute silencing using shRNAs designed against a consensus sequence, mainly because there are many functional viral variants. Our shRNA cocktail could be truly effective at silencing dominant and subdominant naïve viral variants. Additionally, resistant isolates might be targeted under specific antiretroviral selective pressure, but in both cases these should be tested exhaustively prior to clinical use.</p

ChIP-seq Defined Genome-Wide Map of TGFβ/SMAD4 Targets: Implications with Clinical Outcome of Ovarian Cancer

Deregulation of the transforming growth factor-β (TGFβ) signaling pathway in epithelial ovarian cancer has been reported, but the precise mechanism underlying disrupted TGFβ signaling in the disease remains unclear. We performed chromatin immunoprecipitation followed by sequencing (ChIP-seq) to investigate genome-wide screening of TGFβ-induced SMAD4 binding in epithelial ovarian cancer. Following TGFβ stimulation of the A2780 epithelial ovarian cancer cell line, we identified 2,362 SMAD4 binding loci and 318 differentially expressed SMAD4 target genes. Comprehensive examination of SMAD4-bound loci, revealed four distinct binding patterns: 1) Basal; 2) Shift; 3) Stimulated Only; 4) Unstimulated Only. TGFβ stimulated SMAD4-bound loci were primarily classified as either Stimulated only (74%) or Shift (25%), indicating that TGFβ-stimulation alters SMAD4 binding patterns in epithelial ovarian cancer cells. Furthermore, based on gene regulatory network analysis, we determined that the TGFβ-induced, SMAD4-dependent regulatory network was strikingly different in ovarian cancer compared to normal cells. Importantly, the TGFβ/SMAD4 target genes identified in the A2780 epithelial ovarian cancer cell line were predictive of patient survival, based on in silico mining of publically available patient data bases. In conclusion, our data highlight the utility of next generation sequencing technology to identify genome-wide SMAD4 target genes in epithelial ovarian cancer and link aberrant TGFβ/SMAD signaling to ovarian tumorigenesis. Furthermore, the identified SMAD4 binding loci, combined with gene expression profiling and in silico data mining of patient cohorts, may provide a powerful approach to determine potential gene signatures with biological and future translational research in ovarian and other cancers

Global change effects on plant communities are magnified by time and the number of global change factors imposed

Global change drivers (GCDs) are expected to alter community structure and consequently, the services that ecosystems provide. Yet, few experimental investigations have examined effects of GCDs on plant community structure across multiple ecosystem types, and those that do exist present conflicting patterns. In an unprecedented global synthesis of over 100 experiments that manipulated factors linked to GCDs, we show that herbaceous plant community responses depend on experimental manipulation length and number of factors manipulated. We found that plant communities are fairly resistant to experimentally manipulated GCDs in the short term (<10 y). In contrast, long-term (≥10 y) experiments show increasing community divergence of treatments from control conditions. Surprisingly, these community responses occurred with similar frequency across the GCD types manipulated in our database. However, community responses were more common when 3 or more GCDs were simultaneously manipulated, suggesting the emergence of additive or synergistic effects of multiple drivers, particularly over long time periods. In half of the cases, GCD manipulations caused a difference in community composition without a corresponding species richness difference, indicating that species reordering or replacement is an important mechanism of community responses to GCDs and should be given greater consideration when examining consequences of GCDs for the biodiversity–ecosystem function relationship. Human activities are currently driving unparalleled global changes worldwide. Our analyses provide the most comprehensive evidence to date that these human activities may have widespread impacts on plant community composition globally, which will increase in frequency over time and be greater in areas where communities face multiple GCDs simultaneously

Quantifying sources of variability in infancy research using the infant-directed-speech preference

Psychological scientists have become increasingly concerned with issues related to methodology and replicability, and infancy researchers in particular face specific challenges related to replicability: For example, high-powered studies are difficult to conduct, testing conditions vary across labs, and different labs have access to different infant populations. Addressing these concerns, we report on a large-scale, multisite study aimed at (a) assessing the overall replicability of a single theoretically important phenomenon and (b) examining methodological, cultural, and developmental moderators. We focus on infants’ preference for infant-directed speech (IDS) over adult-directed speech (ADS). Stimuli of mothers speaking to their infants and to an adult in North American English were created using seminaturalistic laboratory-based audio recordings. Infants’ relative preference for IDS and ADS was assessed across 67 laboratories in North America, Europe, Australia, and Asia using the three common methods for measuring infants’ discrimination (head-turn preference, central fixation, and eye tracking). The overall meta-analytic effect size (Cohen’s d) was 0.35, 95% confidence interval = [0.29, 0.42], which was reliably above zero but smaller than the meta-analytic mean computed from previous literature (0.67). The IDS preference was significantly stronger in older children, in those children for whom the stimuli matched their native language and dialect, and in data from labs using the head-turn preference procedure. Together, these findings replicate the IDS preference but suggest that its magnitude is modulated by development, native-language experience, and testing procedure. (This project has received funding from the European Union’s Horizon 2020 research and innovation programme under the Marie Skłodowska-Curie grant agreement No 798658.