Science teacher education in Australia: Initiatives and challenges to improve the quality of teaching

In this article, we describe how teachers in the Australian school system are educated to teach science and the different qualifications that teachers need to enter the profession. The latest comparisons of Australian students in international science assessments have brought about various accountability measures to improve the quality of science teachers at all levels. We discuss the issues and implications of government initiatives in preservice and early career teacher education programs, such as the implementation of national science curriculum, the stricter entry requirements to teacher education programs, an alternative pathway to teaching and the measure of effectiveness of teacher education programs. The politicized discussion and initiatives to improve the quality of science teacher education in Australia are still unfolding as we write in 2014

Flipping the Model: A Values-Based Consortial Approach to Journal Negotiations

When negotiating journal pricing, the disadvantages libraries face are well documented. In addition to financially incompatible acquisition models that are out of sync with both library budgets and any predicted growth, libraries are also presented with rising inflationary costs, content added to an already overloaded system, and vendor consolidation. Pricing issues are further exacerbated by traditional negotiations, where libraries begin negotiations based on the offers made by publishers and vendors. These offers too often are predicated on historical spend and coupled with list prices that come with few explanations for their sums. Big package deals, that arguably expand access to resources and may lower costs on an article basis, have also increased overall costs and pushed out diverse resources. In attempting to move away from such deals institutions are faced with similar pricing for dramatically reduced access. The difficulties in navigating our way to a sustainable model become clear when the loss of researcher access is coupled with the increased staffing needed to manage individual subscriptions. New, and potentially viable pathways are beginning to emerge, including open access initiatives and the application of new models, such as read/publish. Although these pathways are not yet fully formed, they are promising developments that attempt to more holistically account for the contributions of the academy, the public good, and the costs of publishing. This presentation detailed the efforts of a task force within VIVA (Virginia’s academic library consortium) to create a bridge-solution between the current acquisition model and the future vision of its members. It creates a space to rethink what these deals could be and relies on consortial criteria to determine the value of content. The approach remains conscious of the real long-term institutional trust and communication risks to such endeavors, and is built on concerted, collective action

Diagnosis of invasive aspergillus tracheobronchitis facilitated by endobronchial ultrasound-guided transbronchial needle aspiration: a case report

<p>Abstract</p> <p>Introduction</p> <p>Invasive pulmonary aspergillosis is the most common form of infection by <it>Aspergillus species </it>among immunocompromised patients. Although this infection frequently involves the lung parenchyma, it is unusual to find it limited to the tracheobronchial tree, a condition known as invasive aspergillus tracheobronchitis.</p> <p>Case presentation</p> <p>A 65 year-old Hispanic man from Bolivia with a history of chronic lymphocytic leukemia developed cough and malaise eight months after having an allogenic stem cell transplant. A computed tomography of the chest revealed an area of diffuse soft tissue thickening around the left main stem bronchus, which was intensely fluorodeoxyglucose-avid on positron emission tomography scanning. An initial bronchoscopic exam revealed circumferential narrowing of the entire left main stem bronchus with necrotic and friable material on the medial wall. Neither aspirates from this necrotic area nor bronchial washing were diagnostic. A second bronchoscopy with endobronchial ultrasound evidenced a soft tissue thickening on the medial aspect of the left main stem bronchus underlying the area of necrosis visible endoluminally. Endobronchial ultrasound-guided transbronchial needle aspiration performed in this area revealed multiple fungal elements suggestive of <it>Aspergillus species</it>.</p> <p>Conclusion</p> <p>We describe the first case of invasive aspergillus tracheobronchitis in which the diagnosis was facilitated by the use of endobronchial ultrasound guided trans-bronchial needle aspiration. To the best of our knowledge, we are also presenting the first positron emission tomography scan images of this condition in the literature. We cautiously suggest that endobronchial ultrasound imaging may be a useful tool to evaluate the degree of invasion and the involvement of vascular structures in these patients prior to bronchoscopic manipulation of the affected areas in an effort to avoid potentially fatal hemorrhage.</p

Does pleural fluid appearance really matter? The relationship between fluid appearance and cytology, cell counts, and chemical laboratory measurements in pleural effusions of patients with cancer

<p>Abstract</p> <p>Background</p> <p>Previous reports have suggested that the appearance of pleural effusions (i.e., the presence or absence of blood) might help to establish the etiology of the effusions. This study explores the relationship between pleural fluid appearance and the results of chemical and cytological analyses in a group of patients with recurrent symptomatic pleural effusions and a diagnosis of cancer.</p> <p>Methods</p> <p>Medical records were reviewed from all 390 patients who were diagnosed with cancer, who underwent thoracentesis before placement of an intrapleural catheter (IPC) between April 2000 and January 2006. Adequate information for data analysis was available in 365 patients. The appearance of their pleural fluid was obtained from procedure notes dictated by the pulmonologists who had performed the thoracenteses. The patients were separated into 2 groups based on fluid appearance: non-bloody and bloody. Group differences in cytology interpretation were compared by using the chi square test. Cellular counts, chemical laboratory results, and survival after index procedure were compared by using the student's t test.</p> <p>Results</p> <p>Pleural fluid cytology was positive on 82.5% of the non-bloody effusions and on 82.4% of the bloody ones. The number of red blood cells (220.5 × 10³/μL vs. 12.3 × 10³/μL) and LDH values (1914 IU/dl vs. 863 IU/dl) were statistically higher in bloody pleural effusions.</p> <p>Conclusion</p> <p>The presence or absence of blood in pleural effusions cannot predict their etiology in patients with cancer and recurrent symptomatic pleural effusions.</p

NEXMIF encephalopathy:an X-linked disorder with male and female phenotypic patterns

Purpose Pathogenic variants in the X-linked gene NEXMIF (previously KIAA2022) are associated with intellectual disability (ID), autism spectrum disorder, and epilepsy. We aimed to delineate the female and male phenotypic spectrum of NEXMIF encephalopathy. Methods Through an international collaboration, we analyzed the phenotypes and genotypes of 87 patients with NEXMIF encephalopathy. Results Sixty-three females and 24 males (46 new patients) with NEXMIF encephalopathy were studied, with 30 novel variants. Phenotypic features included developmental delay/ID in 86/87 (99%), seizures in 71/86 (83%) and multiple comorbidities. Generalized seizures predominated including myoclonic seizures and absence seizures (both 46/70, 66%), absence with eyelid myoclonia (17/70, 24%), and atonic seizures (30/70, 43%). Males had more severe developmental impairment; females had epilepsy more frequently, and varied from unaffected to severely affected. All NEXMIF pathogenic variants led to a premature stop codon or were deleterious structural variants. Most arose de novo, although X-linked segregation occurred for both sexes. Somatic mosaicism occurred in two males and a family with suspected parental mosaicism. Conclusion NEXMIF encephalopathy is an X-linked, generalized developmental and epileptic encephalopathy characterized by myoclonic-atonic epilepsy overlapping with eyelid myoclonia with absence. Some patients have developmental encephalopathy without epilepsy. Males have more severe developmental impairment. NEXMIF encephalopathy arises due to loss-of-function variants

Complement lectin pathway activation is associated with COVID-19 disease severity, independent of MBL2 genotype subgroups

IntroductionWhile complement is a contributor to disease severity in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections, all three complement pathways might be activated by the virus. Lectin pathway activation occurs through different pattern recognition molecules, including mannan binding lectin (MBL), a protein shown to interact with SARS-CoV-2 proteins. However, the exact role of lectin pathway activation and its key pattern recognition molecule MBL in COVID-19 is still not fully understood.MethodsWe therefore investigated activation of the lectin pathway in two independent cohorts of SARS-CoV-2 infected patients, while also analysing MBL protein levels and potential effects of the six major single nucleotide polymorphisms (SNPs) found in the MBL2 gene on COVID-19 severity and outcome.ResultsWe show that the lectin pathway is activated in acute COVID-19, indicated by the correlation between complement activation product levels of the MASP-1/C1-INH complex (p=0.0011) and C4d (p&lt;0.0001) and COVID-19 severity. Despite this, genetic variations in MBL2 are not associated with susceptibility to SARS-CoV-2 infection or disease outcomes such as mortality and the development of Long COVID.ConclusionIn conclusion, activation of the MBL-LP only plays a minor role in COVID-19 pathogenesis, since no clinically meaningful, consistent associations with disease outcomes were noted

Single-cell multi-omics analysis of the immune response in COVID-19

Funder: Lister Institute of Preventive Medicine; doi: https://doi.org/10.13039/501100001255Funder: University College London, Birkbeck MRC Doctoral Training ProgrammeFunder: The Jikei University School of MedicineFunder: Action Medical Research (GN2779)Funder: NIHR Clinical Lectureship (CL-2017-01-004)Funder: NIHR (ACF-2018-01-004) and the BMA FoundationFunder: Chan Zuckerberg Initiative (grant 2017-174169) and from Wellcome (WT211276/Z/18/Z and Sanger core grant WT206194)Funder: UKRI Innovation/Rutherford Fund Fellowship allocated by the MRC and the UK Regenerative Medicine Platform (MR/5005579/1 to M.Z.N.). M.Z.N. and K.B.M. have been funded by the Rosetrees Trust (M944)Funder: Barbour FoundationFunder: ERC Consolidator and EU MRG-Grammar awardsFunder: Versus Arthritis Cure Challenge Research Grant (21777), and an NIHR Research Professorship (RP-2017-08-ST2-002)Funder: European Molecular Biology Laboratory (EMBL)Abstract: Analysis of human blood immune cells provides insights into the coordinated response to viral infections such as severe acute respiratory syndrome coronavirus 2, which causes coronavirus disease 2019 (COVID-19). We performed single-cell transcriptome, surface proteome and T and B lymphocyte antigen receptor analyses of over 780,000 peripheral blood mononuclear cells from a cross-sectional cohort of 130 patients with varying severities of COVID-19. We identified expansion of nonclassical monocytes expressing complement transcripts (CD16+C1QA/B/C+) that sequester platelets and were predicted to replenish the alveolar macrophage pool in COVID-19. Early, uncommitted CD34+ hematopoietic stem/progenitor cells were primed toward megakaryopoiesis, accompanied by expanded megakaryocyte-committed progenitors and increased platelet activation. Clonally expanded CD8+ T cells and an increased ratio of CD8+ effector T cells to effector memory T cells characterized severe disease, while circulating follicular helper T cells accompanied mild disease. We observed a relative loss of IgA2 in symptomatic disease despite an overall expansion of plasmablasts and plasma cells. Our study highlights the coordinated immune response that contributes to COVID-19 pathogenesis and reveals discrete cellular components that can be targeted for therapy

Westworld: Die Musikalische DNA des Posthumanismus

Westworld schafft eine komplexe, affektive Verbindung zwischen synthetischen Klängen und Motiven aus der Popmusik über ein altmodisches Player-Piano oder ein leierndes Grammophon. So positioniert der Soundtrack die vertrauten analogen Klänge von Instrumenten in einer künstlichen akustischen Umgebung, die dem Visuellen eine weitere Abstraktionsebene hinzufügt. Tatsächlich kommt der Musik eine Schlüsselfunktion im Dechiffrieren der posthumanen Suche nach Identität zu. Im Verlauf der Serie spielt der iranisch-deutsche Komponist Ramin Djawadi virtuos mit der musikalischen Erinnerung der Zuschauer*innen: Er versteckt Hinweise auf den digitalen Code des Bewusstseins in subtil verfremdeten Versatzstücken der Klassik (etwa Georges Bizets Carmen Suites, Claude Debussys „Rêverie“ oder Frédéric Chopins Nocturnes) sowie der Pop-Musik (von den Animals via Rolling Stones bis Radiohead und Soundgarden). Wie verändern sich die Narrative und Affekte, mit denen Kino und Film das spannungsgeladene Verhältnis von Mensch und Maschine ausloten? Wenn die Tonspur die Hälfte des filmischen Erlebens bestimmt, wie dies beispielsweise der Filmeditor und Autor Vincent LoBrutto bekräftigte (S. xi), gibt es dann einen bestimmten Sound, eine Art Klangsignatur der Maschinenmenschen? In diesem Artikel werde ich der musikalischen DNA von Maschinenmenschen im Hollywood-Kino nachspüren

Does physician gender effect ordering practice.

BACKGROUND: Breast cancer cases represent 14.6% of all new cancer diagnosis in the United States. However, medical societies disagree when, and how often, we should be screening. The United States Preventative Service Task Force recommends starting at 50 years of age and screening biennially, while others recommend starting at 40 years of age, or screening annually. This has created an environment where physicians must decide which guideline is best for their patients. We sought to find out what factors influence this decision, specifically if the gender of the ordering physician was associated with different screening practices in women aged 40-49. METHODS: We examined every office visit for female patients age 40-49 with an internal medicine (IM), family medicine (FM) or gynecology (Gyn) provider in our health system between July 1, 2015 to May 30, 2016. Patients with a history of breast cancer or other malignant neoplasm were excluded. The association between physician gender and mammogram ordering rates was assessed via chi-squared testing. Other factors, such as comparison between specialties, were assessed via multivariable binary logistic regression. RESULTS: In female patients aged 40-49, female physicians are more likely to order mammograms than male physicians overall. This disparity between genders was largest in internal medicine. Gynecology physicians order mammograms at a higher rate than internal medicine or family medicine physicians. Women aged 45-49 were more likely to receive a mammogram order than women aged 40-44. Also, black patients were less likely to receive a mammogram order compared to white patients. CONCLUSIONS: Physician ordering practices do appear to vary by gender, however, this pattern is also influenced by specialty. The decision also seems to be effected by the age and/or race of the patient. The results of this study support the need for more research in factors contributing to preventive healthcare disparities

Overutilization of the observation unit for decompensated heart failure.

BACKGROUND: Acutely decompensated heart failure (ADHF) remains a significant health burden in the United States, with high mortality and cost. To promote quality care, the Centers for Medicare and Medicaid Services have decreased reimbursement for hospital systems with high readmission rates. Observation Units (OU) are a less-costly option for treatment of ADHF, however outcome data beyond 30 days is sparse. We sought to evaluate long-term outcomes and utilization for patients treated in the OU for ADHF. METHODS: We performed a retrospective cohort study with patients admitted from the Emergency Department (ED) with ADHF. Patients with heart transplant, ventricular-assist device, or end-stage renal disease were excluded. Demographic and 12-month outcomes were collected. Patients discharged from the OU were compared with those admitted using Chi-Square Analysis, Fisher Exact Test, and Two-Sample T-Test. OU patients later admitted were also compared with those admitted from the ED. RESULTS: Of the 535 patients included in the study, 427 were triaged to OU. Of these, 156 (37%) had LOS \u3e 48 hours and required admission. The mean age was 71.4 years (standard deviation, 14.9 years) and 52% were female. OU patients converted to admission had higher Charlson Comorbidity Index (4.5 vs 3.9, p = 0.012) and higher 12-month mortality (17.3% vs 9.2%, p = 0.014) compared to those discharged. When converted patients were compared to those admitted from the ED, mortality (17.3% vs 10.3%, p = 0.210) and Charlson (4.3 vs 4.5, p = 0.552) were comparable. Patients triaged to OU showed no difference in readmissions, downstream OU visits, or adverse cardiac events. However, OU patients later admitted had shorter time to death compared to patients triaged directly to inpatient units (137.3 vs 257.9 days, p = 0.023). Patients cared for in the OU were more likely to follow-up outpatient (41.0% vs 25.9%, p = 0.041). CONCLUSIONS: The OU is a venue for high-quality care for ADHF. Our study showed over utilization of the OU, commonly defined as over 15% conversion. A possible difference in time to death exists due to suboptimal triage, but multivariate analysis is needed to confirm. Enhanced risk stratification for patient triage is needed