Making the road while walking: Co-creation, teaching excellence and university leadership (Stimulus Paper)

Our latest stimulus paper – Making the Road while Walking was commissioned to inform leadership decision-making on how student engagement in higher education can be enhanced through curriculum co-creation. While drawing on relevant policy and theoretical perspectives, the discussion is underpinned by practical insights generated by our experiences of developing co-created Masters programmes for professional students on behalf of the Cabinet Office and the NHS. This experience enabled authors, Paul Willis of Leeds Business School, Leeds Beckett University and Anne Gregory of the University of Huddersfield to consider the organisational implications of co-creation and to highlight a range of leadership issues relevant to both undergraduate and postgraduate curricula. Based on the insights from other sectors, this paper sets out a list of questions for leaders to consider their institution’s capacity for co-creation of programmes and curriculum development

Functional organisation for verb generation in children with developmental language disorder

Developmental language disorder (DLD) is characterised by difficulties in learning one's native language for no apparent reason. These language difficulties occur in 7% of children and are known to limit future academic and social achievement. Our understanding of the brain abnormalities associated with DLD is limited. Here, we used a simple four-minute verb generation task (children saw a picture of an object and were instructed to say an action that goes with that object) to test children between the ages of 10–15 years (DLD N = 50, typically developing N = 67). We also tested 26 children with poor language ability who did not meet our criteria for DLD. Contrary to our registered predictions, we found that children with DLD did not have (i) reduced activity in language relevant regions such as the left inferior frontal cortex; (ii) dysfunctional striatal activity during overt production; or (iii) a reduction in left-lateralised activity in frontal cortex. Indeed, performance of this simple language task evoked activity in children with DLD in the same regions and to a similar level as in typically developing children. Consistent with previous reports, we found sub-threshold group differences in the left inferior frontal gyrus and caudate nuclei, but only when analysis was limited to a subsample of the DLD group (N = 14) who had the poorest performance on the task. Additionally, we used a two-factor model to capture variation in all children studied (N = 143) on a range of neuropsychological tests and found that these language and verbal memory factors correlated with activity in different brain regions. Our findings indicate a lack of support for some neurological models of atypical language learning, such as the procedural deficit hypothesis or the atypical lateralization hypothesis, at least when using simple language tasks that children can perform. These results also emphasise the importance of controlling for and monitoring task performance

Far Ultraviolet Spectroscopic Explorer Spectroscopy of the O VI Resonance Doublet in Sand 2 (WO)

We present Far Ultraviolet Spectroscopic Explorer spectroscopy of Sand 2, an LMC WO-type Wolf-Rayet star, revealing the O VI resonance P Cygni doublet at 1032-1038 Å. These data are combined with Hubble Space Telescope Faint Object Spectrograph ultraviolet and Mount Stromlo 2.3 m optical spectroscopy and analyzed using a spherical, non-LTE, line-blanketed code. Our study reveals exceptional stellar parameters: T* ~ 150,000 K, v∞ = 4100 km s-1, log(L/L☉) = 5.3, andimg1.gif = 1 × 10-5 M☉ yr-1, if we adopt a volume filling factor of 10%. Elemental abundances of C/He ~ 0.7 ± 0.2 and O/He ~ 0.15img2.gif by number qualitatively support previous recombination line studies. We confirm that Sand 2 is more chemically enriched in carbon than LMC WC stars and that it is expected to undergo a supernova explosion within the next 5 × 104 yr

The revised FLACC observational pain tool: improved reliability and validity for pain assessment in children with cognitive impairment

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/72254/1/j.1460-9592.2005.01773.x.pd

Outcomes following kidney transplantation in patients with sickle cell disease: The impact of automated exchange blood transfusion

There are over 12,000 people with sickle cell disease (SCD) in the UK, and 4–12% of patients who develop Sickle Cell Nephropathy (SCN) progress to End Stage Renal Disease (ESRD). Renal transplantation offers the best outcomes for these patients with but their access to transplantation is often limited. Regular automated exchange blood transfusions (EBT) reduce the complications of SCD and may improve outcomes. However, concerns over alloimmunisation limit its widespread implementation. In this retrospective multicenter study, data were collected on 34 SCD patients who received a kidney transplant across 6 London Hospitals between 1997 and 2017. 20/34 patients were on an EBT program, pre or post renal transplantation. Overall patient and graft survival were inferior to contemporaneous UK data in the ESRD population as a whole, a finding which is well-recognised. However, patient survival (CI 95%, p = 0.0032), graft survival and graft function were superior at all time-points in those who received EBT versus those who did not. 4/20 patients (20%) on EBT developed de novo donor specific antibodies (DSAs). 3/14 patients (21%) not on EBT developed de novo DSAs. The incidence of rejection in those on EBT was 5/18 (28%), as compared with 7/13 (54%) not on EBT. In conclusion, our data, while limited by an inevitably small sample size and differences in the date of transplantation, do suggest that long-term automated EBT post renal transplant is effective and safe, with improvement in graft and patient outcomes and no increase in antibody formation or graft rejection

Delayed acquisition of airway commensals in antibiotic naïve children and its relationship with wheezing in rural Ecuador.

INTRODUCTION: The hygiene hypothesis identified a relationship between living in rural areas and acquiring protective environmental factors against the development of asthma and atopy. In our previous study, we found a correlation between particular bacterial species and early-onset wheezing in infants from the rural tropics of Ecuador who were corticosteroid-naïve and had limited antibiotic exposure. We now describe a longitudinal study of infants conducted to determine the age-related changes of the microbiome and its relationship with wheezing. METHODS: We performed an amplicon sequencing of the 16S rRNA bacterial gene from the oropharyngeal samples obtained from 110 infants who had a history of recurrent episodic wheezing sampled at different ages (7, 12, and 24 months) and compared it to the sequencing of the oropharyngeal samples from 150 healthy infants sampled at the same time points. Bioinformatic analyses were conducted using QIIME and R. RESULTS: As expected, the microbiota diversity consistently increased as the infants grew older. Considering age-based microbiota changes, we found that infants with wheeze had significantly lower species richness than the healthy infants at 7 months, but not at 12 or 24 months. Most of the core and accessory organisms increased in abundance and prevalence with age, except for a few which decreased. At 7 months of age, infants with wheeze had notably higher levels of a single Streptococcus operational taxonomic unit and core microbiota member than controls. CONCLUSIONS: In a cohort with limited antibiotic and corticosteroid use, a progressively more complex and diverse respiratory microbial community develops with age. The respiratory microbiota in early life is altered in infants with wheeze, but this does not hold true in older infants

Physical Properties of Wolf-Rayet Stars

The striking broad emission line spectroscopic appearance of Wolf-Rayet (WR) stars has long defied analysis, due to the extreme physical conditions within their line and continuum forming regions. Recently, model atmosphere studies have advanced sufficiently to enable the determination of stellar temperatures, luminosities, abundances, ionizing fluxes and wind properties. The observed distributions of nitrogen (WN) and carbon (WC) sequence WR stars in the Milky Way and in nearby star forming galaxies are discussed; these imply lower limits to progenitor masses of ~25, 40, 75 Msun for hydrogen-depleted (He-burning) WN, WC, and H-rich (H-burning) WN stars, respectively. WR stars in massive star binaries permit studies of wind-wind interactions and dust formation in WC systems. They also show that WR stars have typical masses of 10-25 Msun, extending up to 80 Msun for H-rich WN stars. Theoretical and observational evidence that WR winds depend on metallicity is presented, with implications for evolutionary models, ionizing fluxes, and the role of WR stars within the context of core-collapse supernovae and long-duration gamma ray bursts.Comment: 76 pages, 8 figures. Minor revision to "Annual Review of Astronomy & Astrophysics" review article Volume 45 (2007) following editors comments. Version with full resolution figures is available from ftp://astro1.shef.ac.uk/pub/pac/AnnRev_revised.pd

Multi-institutional evaluation of a Pareto navigation guided automated radiotherapy planning solution for prostate cancer

\ua9 The Author(s) 2024.Background: Current automated planning solutions are calibrated using trial and error or machine learning on historical datasets. Neither method allows for the intuitive exploration of differing trade-off options during calibration, which may aid in ensuring automated solutions align with clinical preference. Pareto navigation provides this functionality and offers a potential calibration alternative. The purpose of this study was to validate an automated radiotherapy planning solution with a novel multi-dimensional Pareto navigation calibration interface across two external institutions for prostate cancer. Methods: The implemented ‘Pareto Guided Automated Planning’ (PGAP) methodology was developed in RayStation using scripting and consisted of a Pareto navigation calibration interface built upon a ‘Protocol Based Automatic Iterative Optimisation’ planning framework. 30 previous patients were randomly selected by each institution (IA and IB), 10 for calibration and 20 for validation. Utilising the Pareto navigation interface automated protocols were calibrated to the institutions’ clinical preferences. A single automated plan (VMATAuto) was generated for each validation patient with plan quality compared against the previously treated clinical plan (VMATClinical) both quantitatively, using a range of DVH metrics, and qualitatively through blind review at the external institution. Results: PGAP led to marked improvements across the majority of rectal dose metrics, with Dmean reduced by 3.7 Gy and 1.8 Gy for IA and IB respectively (p < 0.001). For bladder, results were mixed with low and intermediate dose metrics reduced for IB but increased for IA. Differences, whilst statistically significant (p < 0.05) were small and not considered clinically relevant. The reduction in rectum dose was not at the expense of PTV coverage (D98% was generally improved with VMATAuto), but was somewhat detrimental to PTV conformality. The prioritisation of rectum over conformality was however aligned with preferences expressed during calibration and was a key driver in both institutions demonstrating a clear preference towards VMATAuto, with 31/40 considered superior to VMATClinical upon blind review. Conclusions: PGAP enabled intuitive adaptation of automated protocols to an institution’s planning aims and yielded plans more congruent with the institution’s clinical preference than the locally produced manual clinical plans

Trading people versus trading time: What is the difference?

BACKGROUND: Person trade-off (PTO) elicitations yield different values than standard utility measures, such as time trade-off (TTO) elicitations. Some people believe this difference arises because the PTO captures the importance of distributive principles other than maximizing treatment benefits. We conducted a qualitative study to determine whether people mention considerations related to distributive principles other than QALY-maximization more often in PTO elicitations than in TTO elicitations and whether this could account for the empirical differences. METHODS: 64 members of the general public were randomized to one of three different face-to-face interviews, thinking aloud as they responded to TTO and PTO elicitations. Participants responded to a TTO followed by a PTO elicitation within contexts that compared either: 1) two life-saving treatments; 2) two cure treatments; or 3) a life-saving treatment versus a cure treatment. RESULTS: When people were asked to choose between life-saving treatments, non-maximizing principles were more common with the PTO than the TTO task. Only 5% of participants considered non-maximizing principles as they responded to the TTO elicitation compared to 68% of participants who did so when responding to the PTO elicitation. Non-maximizing principles that emerged included importance of equality of life and a desire to avoid discrimination. However, these principles were less common in the other two contexts. Regardless of context, though, participants were significantly more likely to respond from a societal perspective with the PTO compared to the TTO elicitation. CONCLUSION: When lives are at stake, within the context of a PTO elicitation, people are more likely to consider non-maximizing principles, including the importance of equal access to a life-saving treatment, avoiding prejudice or discrimination, and in rare cases giving treatment priority based purely on the position of being worse-off

Методи управління екологічними ризиками в системі забезпечення економічного розвитку регіону

Метою статті є дослідження методів управління екологічними ризиками в системі забезпечення економічного розвитку регіону