Procedural sedation of elderly patients by emergency physicians: a safety analysis of 740 patients

The elderly are perceived as a high-risk group for procedural sedation. Concern exists regarding the safety of sedation of this patient group by emergency physicians, particularly when using propofol.We analysed prospectively collected data on patients aged 75 yr or older undergoing sedation between October 2006 and March 2017 in the emergency department of a single centre. We used the World Society of Intravenous Anaesthesia International Sedation Task Force adverse event tool, stratifying identified adverse events according to consensus agreement.Accepted manuscript - 12 month embarg

Identification of ER-000444793, a Cyclophilin D-independent inhibitor of mitochondrial permeability transition, using a high-throughput screen in cryopreserved mitochondria

Growing evidence suggests persistent mitochondrial permeability transition pore (mPTP) opening is a key pathophysiological event in cell death underlying a variety of diseases. While it has long been clear the mPTP is a druggable target, current agents are limited by off-target effects and low therapeutic efficacy. Therefore identification and development of novel inhibitors is necessary. To rapidly screen large compound libraries for novel mPTP modulators, a method was exploited to cryopreserve large batches of functionally active mitochondria from cells and tissues. The cryopreserved mitochondria maintained respiratory coupling and ATP synthesis, Ca(2+) uptake and transmembrane potential. A high-throughput screen (HTS), using an assay of Ca(2+)-induced mitochondrial swelling in the cryopreserved mitochondria identified ER-000444793, a potent inhibitor of mPTP opening. Further evaluation using assays of Ca(2+)-induced membrane depolarisation and Ca(2+) retention capacity also indicated that ER-000444793 acted as an inhibitor of the mPTP. ER-000444793 neither affected cyclophilin D (CypD) enzymatic activity, nor displaced of CsA from CypD protein, suggesting a mechanism independent of CypD inhibition. Here we identified a novel, CypD-independent inhibitor of the mPTP. The screening approach and compound described provides a workflow and additional tool to aid the search for novel mPTP modulators and to help understand its molecular nature

Using biological records to infer long-term occupancy trends of mammals in the UK

Conservation action is usually triggered by detecting trends in species’ population size, geographical range, or occupancy (proportion of sites occupied). Robust estimates of these metrics are often required by policy makers and practitioners, yet many species lack dedicated monitoring schemes. An alternative source of data for trend estimation is provided by biological records, i.e., species presence information. In the UK, there are millions of such records, but biological trend assessments are often hindered by biases caused by the unstructured way in which they are collected. Recent advances in occupancy modelling that account for changes in survey effort and detectability over time mean that robust occupancy trends can now be estimated from these records. By grouping mammal species into survey assemblages — species likely to be recorded at the same time — and applying occupancy models, this study provides estimates of long-term (1970 to 2016) occupancy trends for 37 terrestrial mammal species from the UK. The inter-annual occupancy growth rates for these species ranged from -4.26% to 11.25%. This information was used to classify two species as strongly decreasing, five as decreasing, 12 as no change, 11 as increasing and seven as strongly increasing. Viewing the survey assemblages as a whole, the occupancy growth rates for small mammals were, on average, decreasing (-0.8% SD 1.57), whereas bats and deer (0.9% SD 1.30) were increasing (3.8% SD 3.25; 0.9% SD 1.30 respectively), and mid-sized mammals were stable (-0.3 SD 1.72). These results contribute much-needed information on a number of data deficient species, and provide evidence for prioritising conservation action

Surveying the views of pupils attending supplementary schools in England

This report is the first part of a wider research project intended to evaluate the role of supplementary school in supporting pupils’ educational progress. This study reports on the first phase of this research An attitude survey to find out what young people think about mainstream and supplementary education, about the core subjects of reading and mathematics, about themselves as learners and about their reasons for attending supplementary school.. Pupil questionnaires were sent to all schools who were successful in being awarded grants from the support service. Schools were asked to administer the questionnaires to ten nominated pupils within the school, although they could give the questionnaire to more than 10 pupils if they chose. Questionnaires were returned from a total of 772 pupils attending 63 supplementary schools in four major cities in England. This is the first study to systematically explore the attitudes of pupils attending supplementary school in England and is the largest ever study of supplementary schools and their pupils

Meta-analysis reveals that pollinator functional diversity and abundance enhance crop pollination and yield

How insects promote crop pollination remains poorly understood in terms of the contribution of functional trait differences between species. We used meta-analyses to test for correlations between community abundance, species richness and functional trait metrics with oilseed rape yield, a globally important crop. While overall abundance is consistently important in predicting yield, functional divergence between species traits also showed a positive correlation. This result supports the complementarity hypothesis that pollination function is maintained by non-overlapping trait distributions. In artificially constructed communities (mesocosms), species richness is positively correlated with yield, although this effect is not seen under field conditions. As traits of the dominant species do not predict yield above that attributed to the effect of abundance alone, we find no evidence in support of the mass ratio hypothesis. Management practices increasing not just pollinator abundance, but also functional divergence, could benefit oilseed rape agriculture.This study was funded by the Natural Environment Research Council (NERC) under research programme NE/N018125/1 ASSIST–Achieving Sustainable Agricultural Systems www.assist.ceh.ac.uk. ASSIST is an initiative jointly supported by NERC and the Biotechnology and Biological Sciences Research Council (BBSRC). Additional funding for field studies was from the Wessex Biodiversity Ecosystem Services Sustainability (NE/J014680/1) project within the NERC BESS programme. Other data sets were generated from research funded by: (a) the Insect Pollinators Initiative programme funded by BBSRC, Defra, NERC, the Scottish Government and the Wellcome Trust, under the Living with Environmental Change Partnership; (b) Defra project BD5005: Provision of Ecosystem services in the ES scheme; and (c) Irish Government under the National Development Plan 2007–2013 administered by the Irish EPA

Annual estimates of occupancy for bryophytes, lichens and invertebrates in the UK, 1970–2015

Here, we determine annual estimates of occupancy and species trends for 5,293 UK bryophytes, lichens, and invertebrates, providing national scale information on UK biodiversity change for 31 taxonomic groups for the time period 1970 to 2015. The dataset was produced through the application of a Bayesian occupancy modelling framework to species occurrence records supplied by 29 national recording schemes or societies (n = 24,118,549 records). In the UK, annual measures of species status from fine scale data (e.g. 1 × 1 km) had previously been limited to a few taxa for which structured monitoring data are available, mainly birds, butterflies, bats and a subset of moth species. By using an occupancy modelling framework designed for use with relatively low recording intensity data, we have been able to estimate species trends and generate annual estimates of occupancy for taxa where annual trend estimates and status were previously limited or unknown at this scale. These data broaden our knowledge of UK biodiversity and can be used to investigate variation in and drivers of biodiversity change

Academic boredom among students in higher education: a mixed-methods exploration of characteristics, contributors and consequences

Academic boredom contributes usually adversely towards student engagement, learning and overall performance across a diverse range of settings including universities. The formal study of academic boredom in higher education remains, however, a relatively underdeveloped field and one surprisingly neglected in the UK. Adopting contemporary perspectives rooted in Control-Value Theory, details of a mixed-methods exploration of academic boredom among 235 final year undergraduates attending a single university in England are presented. Quantitative data from the principal survey instrument employed included measurement using the BPS-UKHE, a revised boredom proneness scale developed for use across the sector. Qualitative data arose primarily from ten research interviews. Findings indicate that about half of all respondents reported experiencing the most common precursors of academic boredom at least occasionally (e.g. monotony, repetition, time slowing down, lack of desire for challenge, loss of concentration and motivation to learn, restlessness); traditional lectures with a perceived excess and inappropriate use of PowerPoint stimulating the actual onset of boredom more than other interactive forms of delivery. Coping strategies when bored included daydreaming, texting and turning to social media. Boredom also occurred during the completion of assignments used to assess modules. Quantitative and qualitative differences between those identified as more prone to boredom than others extended to self-study (fewer hours), attendance (good rather than excellent) and final degree outcome (lower marks and a lower proportion of first and upper second class degree awards). Findings are considered valuable empirically, as well as theoretically, leading to recommendations surrounding boredom mitigation which challenge cultural traditions and pedagogical norms

ROBITT: a tool for assessing the risk-of-bias in studies of temporal trends in ecology

1. Aggregated species occurrence and abundance data from disparate sources are increasingly accessible to ecologists for the analysis of temporal trends in biodiversity. However, sampling biases relevant to any given research question are often poorly explored and infrequently reported; this can undermine statistical inference. In other disciplines, it is common for researchers to complete ‘risk-of-bias’ assessments to expose and document the potential for biases to undermine conclusions. The huge growth in available data, and recent controversies surrounding their use to infer temporal trends, indicate that similar assessments are urgently needed in ecology. 2. We introduce ROBITT, a structured tool for assessing the ‘Risk-Of-Bias In studies of Temporal Trends in ecology’. ROBITT has a similar format to its counterparts in other disciplines: it comprises signalling questions designed to elicit information on the potential for bias in key study domains. In answering these, users will define study inferential goal(s) and relevant statistical target populations. This information is used to assess potential sampling biases across domains relevant to the research question (e.g. geography, taxonomy, environment), and how these vary through time. If assessments indicate biases, then users must clearly describe them and/or explain what mitigating action will be taken. 3. Everything that users need to complete a ROBITT assessment is provided: the tool, a guidance document and a worked example. Following other disciplines, the tool and guidance document were developed through a consensus-forming process across experts working in relevant areas of ecology and evidence synthesis. 4. We propose that researchers should be strongly encouraged to include a ROBITT assessment when publishing studies of biodiversity trends, especially when using aggregated data. This will help researchers to structure their thinking, clearly acknowledge potential sampling issues, highlight where expert consultation is required and provide an opportunity to describe data checks that might go unreported. ROBITT will also enable reviewers, editors and readers to establish how well research conclusions are supported given a dataset combined with some analytical approach. In turn, it should strengthen evidence-based policy and practice, reduce differing interpretations of data and provide a clearer picture of the uncertainties associated with our understanding of reality

Veterinary students' usage and perception of video teaching resources

<p>Abstract</p> <p>Background</p> <p>The purpose of our study was to use a student-centred approach to develop an online video learning resource (called 'Moo Tube') at the School of Veterinary Medicine and Science, University of Nottingham, UK and also to provide guidance for other academics in the School wishing to develop a similar resource in the future.</p> <p>Methods</p> <p>A focus group in the format of the nominal group technique was used to garner the opinions of 12 undergraduate students (3 from year-1, 4 from year-2 and 5 from year-3). Students generated lists of items in response to key questions, these responses were thematically analysed to generate key themes which were compared between the different year groups. The number of visits to 'Moo Tube' before and after an objective structured practical examination (OSPE) was also analysed to provide data on video usage.</p> <p>Results</p> <p>Students highlighted a number of strengths of video resources which can be grouped into four overarching themes: (1) teaching enhancement, (2) accessibility, (3) technical quality and (4) video content. Of these themes, students rated teaching enhancement and accessibility most highly. Video usage was seen to significantly increase (P < 0.05) prior to an examination and significantly decrease (P < 0.05) following the examination.</p> <p>Conclusions</p> <p>The students had a positive perception of video usage in higher education. Video usage increases prior to practical examinations. Image quality was a greater concern with year-3 students than with either year-1 or 2 students but all groups highlighted the following as important issues: i) good sound quality, ii) accessibility, including location of videos within electronic libraries, and iii) video content. Based on the findings from this study, guidelines are suggested for those developing undergraduate veterinary videos. We believe that many aspects of our list will have resonance in other areas of medicine education and higher education.</p