Improving Access to Health Through Collaboration: Lessons Learned from The Colorado Trust's Partnerships for Health Initiative Evaluation

This report presents findings from the evaluation of four Partnerships in Health Initiative grantees that were addressing access to health in their communities through the formation of collaboratives. Outcomes achieved by the grantees as well as lessons learned for others embarking on collaborative processes are described

Dynamics of mass transport during nanohole drilling by local droplet etching

Local droplet etching (LDE) utilizes metal droplets during molecular beam epitaxy for the self-assembled drilling of nanoholes into III/V semiconductor surfaces. An essential process during LDE is the removal of the deposited droplet material from its initial position during post-growth annealing. This paper studies the droplet material removal experimentally and discusses the results in terms of a simple model. The first set of experiments demonstrates that the droplet material is removed by detachment of atoms and spreading over the substrate surface. Further experiments establish that droplet etching requires a small arsenic background pressure to inhibit re-attachment of the detached atoms. Surfaces processed under completely minimized As pressure show no hole formation but instead a conservation of the initial droplets. Under consideration of these results, a simple kinetic scaling model of the etching process is proposed that quantitatively reproduces experimental data on the hole depth as a function of the process temperature and deposited amount of droplet material. Furthermore, the depth dependence of the hole side-facet angle is analyzed

Anthracyclines Strike Back: Rediscovering Non-Pegylated Liposomal Doxorubicin in Current Therapeutic Scenarios of Breast Cancer

Antraciclines; Càncer de mama; Receptor hormonalAntraciclinas; Cáncer de mama; Receptor hormonalAnthracyclines; Breast cancer; Hormone receptorAnthracyclines are among the most active chemotherapies (CT) in breast cancer (BC). However, cardiotoxicity is a risk and peculiar side effect that has been limiting their use in clinical practice, especially after the introduction of taxanes. Non-pegylated liposomal doxorubicin (NPLD) has been developed to optimize the toxicity profile induced by anthracyclines, while maintaining its unquestionable therapeutic index, thanks to its delivering characteristics that increase its diffusion in tumor tissues and reduce it in normal tissues. This feature allows NPLD to be safely administered beyond the standard doxorubicin maximum cumulative dose of 450–480 mg/m2. Following three pivotal first-line phase III trials in HER2-negative metastatic BC (MBC), this drug was finally approved in combination with cyclophosphamide in this specific setting. Given the increasing complexity of the therapeutic scenario of HER2-negative MBC, we have carefully revised the most updated literature on the topic and dissected the potential role of NPLD in the evolving therapeutic algorithms.This study was supported by Mednote, spin-off—University of Trieste, within the Mozart Program

Translational neurophysiology in sheep:Measuring sleep and neurological dysfunction in CLN5 affected Batten disease sheep

This is the final published version of a paper originally published in BRAIN 2015: 138; 862?874, DOI: http://dx.doi.org/10.1093/brain/awv026Creating valid mouse models of slowly progressing human neurological diseases is challenging, not least because the short lifespan of rodents confounds realistic modelling of disease time course. With their large brains and long lives, sheep offer significant advantages for translational studies of human disease. Here we used normal and CLN5 Batten disease affected sheep to demonstrate the use of the species for studying neurological function in a model of human disease. We show that electroencephalography can be used in sheep, and that longitudinal recordings spanning many months are possible. This is the first time such an electroencephalography study has been performed in sheep. We characterized sleep in sheep, quantifying characteristic vigilance states and neurophysiological hallmarks such as sleep spindles. Mild sleep abnormalities and abnormal epileptiform waveforms were found in the electroencephalographies of Batten disease affected sheep. These abnormalities resemble the epileptiform activity seen in children with Batten disease and demonstrate the translational relevance of both the technique and the model. Given that both spontaneous and engineered sheep models of human neurodegenerative diseases already exist, sheep constitute a powerful species in which longitudinal in vivo studies can be conducted. This will advance our understanding of normal brain function and improve our capacity for translational research into neurological disorders.This work was funded by CHDI Inc. (AJM). Founding the\ud sheep flock, and costs in NZ relating to the rearing and\ud genotyping of the animals were funded by a series of grants\ud from the Neurological Foundation of NZ and the Batten\ud Disease Support and Research Association (DNP, NLM)

Racial differences in serum prostate-specific antigen (PSA) doubling time, histopathological variables and long-term PSA recurrence between African-American and white American men undergoing radical prostatectomy for clinically localized prostate cancer

To determine if there are significant differences in biochemical characteristics, biopsy variables, histopathological data, and rates of prostate-specific antigen (PSA) recurrence between African-American (AA) and white American (WA) men undergoing radical prostatectomy (RP), as AA men are twice as likely to die from prostate cancer than their white counterparts. PATIENTS AND METHODS We established a cohort of 1058 patients (402 AA, 646 WA) who had RP and were followed for PSA recurrence. Age, race, serum PSA, biopsy Gleason score, clinical stage, pathological stage, and PSA recurrence data were available for the cohort. The chi-square test of proportions and t -tests were used to assess basic associations with race, and log-rank tests and Cox regression models for time to PSA recurrence. Forward stepwise variable selection was used to assess the effect on the risk of PSA recurrence for race, adjusted by the other variables added one at a time. RESULTS The AA men had higher baseline PSA levels, more high-grade prostatic intraepithelial neoplasia (HGPIN) in the biopsy, and more HGPIN in the pathology specimen than WA men. The AA men also had a shorter mean (sd) PSA doubling time before RP, at 4.2 (4.7) vs 5.2 (5.9) years. However, race was not an independent predictor of PSA recurrence ( P  = 0.225). Important predictors for PSA recurrence in a multivariable model were biopsy HGPIN ( P  < 0.014), unilateral vs bilateral cancer ( P  < 0.006), pathology Gleason score and positive margin status (both P  < 0.001). CONCLUSIONS This study indicates that while there are racial differences in baseline serum PSA and incidence of HGPIN, race is not an independent risk factor for PSA recurrence. Rather, other variables such as pathology Gleason score, bilateral cancers, HGPIN and margin positivity are independently associated with PSA recurrence. The PSA doubling time after recurrence may also be important, leading to the increased mortality of AA men with prostate cancer.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/74706/1/j.1464-410X.2005.05561.x.pd

Changing heterogeneity-related attitudes and perceived self-efficacy of pre-service teachers through diversity-sensitive courses in higher education

Der effektive schulische Umgang mit Heterogenität ist einer der Hauptansatzpunkte, um der Aufrechterhaltung sozialstruktureller, gesamtgesellschaftlicher Ungleichheiten entgegenzuwirken. Dabei spielen die positiven heterogenitätsbezogenen Einstellungen und Selbstwirksamkeitsüberzeugungen von Lehrkräften eine Schlüsselrolle, da empirische Befunde die Rolle von Einstellungen und Überzeugungen für das berichtete Lehrer*innenhandeln, die Schüler*innenleistungen und die Belastungsgefühle auf Seiten der Lehrkräfte wiederholt verdeutlicht haben. Erste Studien zur Förderbarkeit von Einstellungen und Selbstwirksamkeitserwartungen haben zwar positive Wirkungen gezeigt, arbeiten aber mit eher kleinen Stichproben und einem eher eingeschränkten Heterogenitätsbegriff. Auf dieser Grundlage untersucht die vorliegende Studie in einem quasiexperimentellen Design anhand von 1703 Lehramtsstudierenden und mit Hilfe des neu entwickelten Messinstruments MESS H (Münsteraner Einstellungs- und Selbstwirksamkeitsskala zum Umgang mit Heterogenität), inwiefern sich positive Einstellungen sowie Selbstwirksamkeitsüberzeugungen in Bezug auf den Umgang mit Heterogenität durch diversitätssensible hochschuldidaktische Lehrmodule fördern lassen. Die Ergebnisse zeigen, dass die Selbstwirksamkeitsüberzeugungen von Lehramtsstudierenden durch die Lehrmodule verbessert werden können. Die Einstellungsveränderungen im Zeitraum hängen hingegen eher mit Geschlecht und Studierendenstatus (Bachelor/Master) zusammen. Mögliche Implikationen für die Förderung von positiven, heterogenitätsbezogenen Einstellungen und Selbstwirksamkeitsüberzeugungen im Lehramtsstudium werden diskutiert. (DIPF/Orig.)Dealing with students’ diversity is one of the main approaches to counter the maintenance of societal inequality. Teachers’ positive heterogeneity-related attitudes and self-efficacy beliefs play a key role as they correlate with reported adaptive teaching methods, lead to improved student performance and less teacher stress. Although initial studies on the promotion of positive attitudes and self-efficacy beliefs have shown noteworthy effects, they rely on small samples and a limited concept of heterogeneity. Using a quasi-experimental design, 1703 pre-service teachers were examined twice with the newly developed scale MESS-H (Münster‘s attitude and self-efficacy scale for dealing with heterogeneity) to find out, if positive attitudes and self-efficacy beliefs can be increased by diversity-sensitive teaching modules. On the one hand, results show that self-efficacy beliefs can be significantly optimized. On the other hand, changes in attitude during the period were more closely related to gender and student status (Bachelor/Master) than belonging to one of the two experimental groups. Possible implications for promoting positive, heterogeneity-related attitudes and self-efficacy beliefs in teacher training are discussed. (DIPF/Orig.

A 3D printed tool for self urinary catheterization in complete autonomy

The elaboration of a 3D custom made tool for the use of the SpeediCath Compact ® by a multidisciplinary team including the patients has been a success and gives them a complete autonomy in this procedure, in safe, efficient and hygienic conditions

Cornering New Physics in b --> s Transitions

We derive constraints on Wilson coefficients of dimension-six effective operators probing the b --> s transition, using recent improved measurements of the rare decays Bs --> mu+mu-, B --> K mu+mu- and B --> K* mu+mu- and including all relevant observables in inclusive and exclusive decays. We consider operators present in the SM as well as their chirality-flipped counterparts and scalar operators. We find good agreement with the SM expectations. Compared to the situation before winter 2012, we find significantly more stringent constraints on the chirality-flipped coefficients due to complementary constraints from B --> K mu+mu- and B --> K* mu+mu- and due to the LHCb measurement of the angular observable S_3 in the latter decay. We also list the full set of observables sensitive to new physics in the low recoil region of B --> K* mu+mu-.Comment: 18 pages, 6 figures, 4 tables. v3: typos correcte

Filament‐Free Bulk Resistive Memory Enables Deterministic Analogue Switching

Digital computing is nearing its physical limits as computing needs and energy consumption rapidly increase. Analogue‐memory‐based neuromorphic computing can be orders of magnitude more energy efficient at data‐intensive tasks like deep neural networks, but has been limited by the inaccurate and unpredictable switching of analogue resistive memory. Filamentary resistive random access memory (RRAM) suffers from stochastic switching due to the random kinetic motion of discrete defects in the nanometer‐sized filament. In this work, this stochasticity is overcome by incorporating a solid electrolyte interlayer, in this case, yttria‐stabilized zirconia (YSZ), toward eliminating filaments. Filament‐free, bulk‐RRAM cells instead store analogue states using the bulk point defect concentration, yielding predictable switching because the statistical ensemble behavior of oxygen vacancy defects is deterministic even when individual defects are stochastic. Both experiments and modeling show bulk‐RRAM devices using TiO2‐X switching layers and YSZ electrolytes yield deterministic and linear analogue switching for efficient inference and training. Bulk‐RRAM solves many outstanding issues with memristor unpredictability that have inhibited commercialization, and can, therefore, enable unprecedented new applications for energy‐efficient neuromorphic computing. Beyond RRAM, this work shows how harnessing bulk point defects in ionic materials can be used to engineer deterministic nanoelectronic materials and devices.A resistive memory cell based on the electrochemical migration of oxygen vacancies for in‐memory neuromorphic computing is presented. By using the average statistical behavior of all oxygen vacancies to store analogue information states, this cell overcomes the stochastic and unpredictable switching plaguing filament‐forming memristors, and instead achieves linear, predictable, and deterministic switching.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/163547/3/adma202003984_am.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/163547/2/adma202003984-sup-0001-SuppMat.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/163547/1/adma202003984.pd