Pediatric Liver Transplantation: Then and Now

This paper reviews the past 50 years of liver transplantation in children from the perspective of patient demographics, perioperative patient management, surgical techniques, immunosuppression and patient outcomes

Associations between health-related quality of life, physical function and fear of falling in older fallers receiving home care

Falls and injuries in older adults have significant consequences and costs, both personal and to society. Although having a high incidence of falls, high prevalence of fear of falling and a lower quality of life, older adults receiving home care are underrepresented in research on older fallers. The objective of this study is to determine the associations between health-related quality of life (HRQOL), fear of falling and physical function in older fallers receiving home care

A Pilot Study: Baseline Educational Achievements of Children Raised by Grandparents in a Kinship Care Program

This pilot study reports the baseline data of a prospective longitudinal study examining the educational achievements of grandchildren being raised by grandparents in parent absent homes. The baseline data includes 117 grandchildren in grades K-12 in two school districts in a southeastern state. School records reporting 2,230 grades were examined for grade point average (GPA) and attendance for K-12 and conduct in grades K-5. The majority of the grandchildren achieved A/B averages. There were no significant differences between gender, pre-care experiences, placement by welfare agencies or paternal involvement across years of schooling. GPAs were lower in the grandchildren who had been exposed to drugs in-utero across the school trajectory in math, languages arts, science and conduct

Establishing the precise evolutionary history of a gene improves prediction of disease-causing missense mutations

PURPOSE: Predicting the phenotypic effects of mutations has become an important application in clinical genetic diagnostics. Computational tools evaluate the behavior of the variant over evolutionary time and assume that variations seen during the course of evolution are probably benign in humans. However, current tools do not take into account orthologous/paralogous relationships. Paralogs have dramatically different roles in Mendelian diseases. For example, whereas inactivating mutations in the NPC1 gene cause the neurodegenerative disorder Niemann-Pick C, inactivating mutations in its paralog NPC1L1 are not disease-causing and, moreover, are implicated in protection from coronary heart disease. METHODS: We identified major events in NPC1 evolution and revealed and compared orthologs and paralogs of the human NPC1 gene through phylogenetic and protein sequence analyses. We predicted whether an amino acid substitution affects protein function by reducing the organism’s fitness. RESULTS: Removing the paralogs and distant homologs improved the overall performance of categorizing disease-causing and benign amino acid substitutions. CONCLUSION: The results show that a thorough evolutionary analysis followed by identification of orthologs improves the accuracy in predicting disease-causing missense mutations. We anticipate that this approach will be used as a reference in the interpretation of variants in other genetic diseases as well. Genet Med 18 10, 1029–1036

Divergent mathematical treatments in utility theory

In this paper I study how divergent mathematical treatments affect mathematical modelling, with a special focus on utility theory. In particular I examine recent work on the ranking of information states and the discounting of future utilities, in order to show how, by replacing the standard analytical treatment of the models involved with one based on the framework of Nonstandard Analysis, diametrically opposite results are obtained. In both cases, the choice between the standard and nonstandard treatment amounts to a selection of set-theoretical parameters that cannot be made on purely empirical grounds. The analysis of this phenomenon gives rise to a simple logical account of the relativity of impossibility theorems in economic theory, which concludes the paper

Spontaneous vortices in the formation of Bose-Einstein condensates

Phase transitions are ubiquitous in nature, ranging from protein folding and denaturisation, to the superconductor-insulator quantum phase transition, to the decoupling of forces in the early universe. Remarkably, phase transitions can be arranged into universality classes, where systems having unrelated microscopic physics exhibit identical scaling behaviour near the critical point. Here we present an experimental and theoretical study of the Bose-Einstein condensation phase transition of an atomic gas, focusing on one prominent universal element of phase transition dynamics: the spontaneous formation of topological defects during a quench through the transition. While the microscopic dynamics of defect formation in phase transitions are generally difficult to investigate, particularly for superfluid phase transitions, Bose-Einstein condensates (BECs) offer unique experimental and theoretical opportunities for probing such details. Although spontaneously formed vortices in the condensation transition have been previously predicted to occur, our results encompass the first experimental observations and statistical characterisation of spontaneous vortex formation in the condensation transition. Using microscopic theories that incorporate atomic interactions and quantum and thermal fluctuations of a finite-temperature Bose gas, we simulate condensation and observe vortex formation in close quantitative agreement with our experimental results. Our studies provide further understanding of the development of coherence in superfluids, and may allow for direct investigation of universal phase-transition dynamics.Comment: 14 pages, 6 figures. Accepted for publication in Nature. Supplementary movie files are available at http://www.physics.uq.edu.au/people/mdavis/spontaneous_vortice

smt: a Matlab structured matrices toolbox

We introduce the smt toolbox for Matlab. It implements optimized storage and fast arithmetics for circulant and Toeplitz matrices, and is intended to be transparent to the user and easily extensible. It also provides a set of test matrices, computation of circulant preconditioners, and two fast algorithms for Toeplitz linear systems.Comment: 19 pages, 1 figure, 1 typo corrected in the abstrac

Formative Debriefing in Team Observed Simulation Encounters to Promote Team Performance

To bridge the gap between interprofessional education (IPE) and interprofessional collaborative practice (IPCP), educators need to foster innovation in healthcare education. Students need opportunities and experiences to practice team skills prior to patient encounters. One innovation includes the use of high-fidelity interprofessional simulation in the form of Team Observed Structured Clinical Encounters (TOSCEs) with standardized patients (SP) and realistic case scenarios. The primary objective of this study was to demonstrate the impact of formative debriefing on team-based performance during TOSCEs. At a large academic medical center, 49 health profession students from the College of Medicine, College of Nursing, College of Health Sciences, and Graduate College volunteered to participate in an interprofessional education program. Prior to participating in TOSCEs students completed two interactive student workshops on: 1) Interprofessional Education and Collaborative Practice (IPEC) domains and 2) chronic disease self-management with motivational interviewing. Fourteen interprofessional student teams (IPST) were formed. Teams consisted of 2-3 students representing a minimum of two disciplines. They were assigned to participate in two separate TOSCEs. The IPST evaluated their individual and team’s performance using the McMaster-Ottawa and the Jefferson Teamwork Observation Guide (JTOG), respectively. Facilitators with established inter-rater reliability guided a formative debriefing session and evaluated the teams’ performance after both TOSCE 1 and 2. Paired t-tests documented improvement in pre-post McMaster-Ottawa and JTOG scores for participants across all four IPEC domains. A comparison between mean ratings of TOSCE 1 and 2, given by students and facilitators, showed a significant difference (p Learning objectives: The learners will be able to define the IPEC domains The learners will be able to list tools for evaluating interprofessional team members and team functionality. The learners will be able discuss the debriefing process as a formative learning experience to increase competencies in the IPEC domains

Propagation of an Earth-directed coronal mass ejection in three dimensions

Solar coronal mass ejections (CMEs) are the most significant drivers of adverse space weather at Earth, but the physics governing their propagation through the heliosphere is not well understood. While stereoscopic imaging of CMEs with the Solar Terrestrial Relations Observatory (STEREO) has provided some insight into their three-dimensional (3D) propagation, the mechanisms governing their evolution remain unclear due to difficulties in reconstructing their true 3D structure. Here we use a new elliptical tie-pointing technique to reconstruct a full CME front in 3D, enabling us to quantify its deflected trajectory from high latitudes along the ecliptic, and measure its increasing angular width and propagation from 2-46 solar radii (approximately 0.2 AU). Beyond 7 solar radii, we show that its motion is determined by an aerodynamic drag in the solar wind and, using our reconstruction as input for a 3D magnetohydrodynamic simulation, we determine an accurate arrival time at the Lagrangian L1 point near Earth.Comment: 5 figures, 2 supplementary movie