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1.
Aging Ment Health ; 28(3): 551-556, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-37545400

RESUMO

OBJECTIVES: Suicide in late life is a public health concern. Determining profiles of psychiatric/medical comorbidity in those who attempt while engaged in mental health services may assist with prevention. We identified comorbidity profiles and their association with utilization, means, and fatality in a national sample who attempted suicide. METHODS: Using latent class analysis, all patients aged ≥ 65 from the Department of Veterans Affairs (VA) healthcare services (2012-2018) last seen in mental health prior to suicide attempt were included. Diagnoses and attempt data were obtained from VA and Center for Medicare & Medicaid Services, VA Suicide Prevention Applications Network, and VA National Mortality Data Repository. RESULTS: 2,269 patients were clustered into three profiles, all with high probability of depression. Profiles included minimal comorbidity (50.4%), high medical comorbidity (28.6%), and high (psychiatric/medical) comorbidity (21.0%). Over half (61.7%) attempted suicide within one week of their visit. The class with highest comorbidity had lowest proportion of fatal attempts, while minimal comorbidity class had highest proportion. CONCLUSIONS: Older patients last seen in mental health prior to suicide attempt were characterized by depression and varying additional comorbidity and attempt-related factors. Findings have implications for risk assessment and intervention in mental health settings, beyond depression.


Assuntos
Tentativa de Suicídio , Veteranos , Humanos , Idoso , Estados Unidos/epidemiologia , Tentativa de Suicídio/psicologia , Saúde Mental , Medicare , Comorbidade , Prevenção do Suicídio , Veteranos/psicologia
2.
J Appl Clin Med Phys ; 25(5): e14295, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38335253

RESUMO

PURPOSE/OBJECTIVE: Field size limitations on Halcyon and Ethos treatment machines largely preclude use of the conventional monoisocentric three-field technique for breast/chest wall and regional lymph nodes. We present an alternative, IMRT-based planning approach that facilitates treatment on Halcyon and Ethos while preserving plan quality. MATERIALS/METHODS: Eight breast and regional node cases (four left-sided, four right-sided) were planned for an Ethos machine using a 15-17 field IMRT technique. Institutional plan quality metrics for CTV and PTV coverage and OAR sparing were assessed. Five plans (four right-sided, one left-sided) were also planned using a hybrid 3D multisocenter technique. CTV coverage and OAR sparing were compared to the IMRT plans. Eclipse scripting tools were developed to aid in beam placement and plan evaluation through a set of dosimetric scorecards, and both are shared publicly. RESULTS: On average, the IMRT plans achieved breast CTV and PTV coverage at 50 Gy of 97.9% and 95.7%, respectively. Supraclavicular CTV and PTV coverages at 45 Gy were 100% and 95.5%. Axillary lymph node CTV and PTV coverages at 45 Gy were 100% and 97.1%, and IMN CTV coverage at 45 Gy was 99.2%. Mean ipsilateral lung V20 Gy was 19.3%, and average mean heart dose was 1.6 Gy for right-sided cases and 3.0 Gy for left-sided. In comparison to the hybrid 3D plans, IMRT plans achieved higher breast and supraclavicular CTV coverage (99.9% vs. 98.6% and 99.9% vs. 93.4%), higher IMN coverage (99.6% vs. 78.2%), and lower ipsilateral lung V20 Gy (19.6% vs. 28.2%). CONCLUSION: Institutional plan quality benchmarks were achieved for all eight cases using the IMRT-based planning approach. The IMRT-based planning approach offered superior conformity and OAR sparing than a competing hybrid 3D approach.


Assuntos
Neoplasias da Mama , Linfonodos , Órgãos em Risco , Dosagem Radioterapêutica , Planejamento da Radioterapia Assistida por Computador , Radioterapia de Intensidade Modulada , Parede Torácica , Humanos , Planejamento da Radioterapia Assistida por Computador/métodos , Radioterapia de Intensidade Modulada/métodos , Feminino , Parede Torácica/efeitos da radiação , Órgãos em Risco/efeitos da radiação , Neoplasias da Mama/radioterapia , Linfonodos/efeitos da radiação
3.
J Therm Biol ; 120: 103814, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38402729

RESUMO

Urbanization alters natural landscapes and creates unique challenges for urban wildlife. Similarly, the Urban Heat Island (UHI) effect can produce significantly elevated temperatures in urban areas, and we have a relatively poor understanding of how this will impact urban biodiversity. In particular, most studies quantify the UHI using broad-scale climate data rather than assessing microclimate temperatures actually experienced by organisms. In addition, studies often fail to address spatial and temporal complexities of the UHI. Here we examine the thermal microclimate and UHI experienced in the web of Western black widow spiders (Latrodectus hesperus), a medically-important, superabundant urban pest species found in cities across the Western region of North America. We do this using replicate urban and desert populations across an entire year to account for seasonal variation in the UHI, both within and between habitats. Our findings reveal a strong nighttime, but no daytime, UHI effect, with urban spider webs being 2-5 °C warmer than desert webs at night. This UHI effect is most prominent during the spring and least prominent in winter, suggesting that the UHI need not be most pronounced when temperatures are most elevated. Urban web temperatures varied among urban sites in the daytime, whereas desert web temperatures varied among desert sites in the nighttime. Finally, web temperature was significantly positively correlated with a spider's boldness, but showed no relationship with voracity towards prey, web size, or body condition. Understanding the complexities of each organism's thermal challenges, the "functional microclimate", is crucial for predicting the impacts of urbanization and climate change on urban biodiversity and ecosystem functioning.


Assuntos
Artrópodes , Viúva Negra , Animais , Temperatura , Temperatura Alta , Cidades , Microclima , Ecossistema
4.
Am J Geriatr Psychiatry ; 31(7): 525-539, 2023 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-36494291

RESUMO

Older veterans are vastly underrepresented in studies that shape national suicide prevention strategies. This is of great concern because factors that impact younger veterans may not be as robust in later life. Although younger veterans have higher rate of suicide, the highest counts of death by suicide are in older veterans. However, it remains unclear from the extant literature what factors may influence increased or decreased risk of late-life suicide in veterans. The objective of this systematic review was to identify risk and protective factors related to suicide outcomes (i.e., ideation, attempt, death, or suicide-related behavior [SRB]) among older veterans. Furthermore, it offers data regarding future study directions and hypothesis generation for late-life suicide research and for informing potential intervention and prevention efforts in this area. We searched 4 databases from inception up to May 5, 2022. We screened 2,388 abstracts for inclusion and 508 articles required full text review. The final sample included 19 studies published between 2006 and 2022. We found five domains of factors studied (i.e., neuropsychiatric, social determinants of health, aging stereotypes, residential and supportive housing settings, and multifactorial-neuropsychiatric/mental health and physical health) with more risk factors than protective factors reported. Across the three suicide outcomes only neuropsychiatric factors were consistently identified as risk factors. Neuropsychiatric factors also comprised the largest group of risk factors studied. More innovative targets to consider for intervention and more innovative methods to predict suicide in late-life are needed. There is also continued necessity to design suicide prevention interventions for older veterans given lethality trends.


Assuntos
Suicídio , Veteranos , Humanos , Idoso , Veteranos/psicologia , Ideação Suicida , Prevenção do Suicídio , Fatores de Risco
5.
Med Teach ; 45(1): 58-67, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-35981566

RESUMO

BACKGROUND: Doctors are increasingly expected to demonstrate medical leadership and management (MLM) skills. The Faculty of Medical Leadership and Management (FMLM) has published an indicative undergraduate curriculum to guide the development of MLM content at UK medical schools. METHOD: Students from 30 medical schools were surveyed to determine their understanding of MLM teaching at their school. Timetables for 21 schools were searched for MLM-related keywords. Student-reported teaching and timetabled teaching were coded according to predefined themes. Aggregated demographic and postgraduate performance data were obtained through collaboration with the Medical Student Investigators Collaborative (msico.org). RESULTS: Whilst 88% of medical students see MLM teaching as relevant, only 18% believe it is well integrated into their curriculum. MLM content represented ∼2% of timetabled teaching in each 5-year undergraduate medical course. Most of this teaching was dedicated to teamwork, performance/reflection and communication skills. There was minimal association between how much of a topic students believed they were taught, and how much they were actually taught. We found no association between the volume of MLM teaching and performance in postgraduate examinations, trainee career destinations or fitness to practice referrals. CONCLUSION: Our findings demonstrate limited and variable teaching of MLM content. Delivery was independent of broader teaching and assessment factors.


Assuntos
Educação de Graduação em Medicina , Humanos , Liderança , Faculdades de Medicina , Currículo , Reino Unido
6.
Sensors (Basel) ; 23(14)2023 Jul 21.
Artigo em Inglês | MEDLINE | ID: mdl-37514889

RESUMO

Space situational awareness (SSA) refers to collecting, analyzing, and keeping track of detailed knowledge of resident space objects (RSOs) in the space environment. With the rapidly increasing number of objects in space, the need for SSA grows as well. Traditional methods rely heavily on imaging RSOs from large, narrow field-of-view (FOV), ground-based telescopes. This research outlines the technology demonstration payload, Resident Space Object Near-space Astrometric Research (RSONAR)-a star tracker-like, wide FOV camera combined with commercial off-the-shelf (COTS) hardware to image RSOs from the stratosphere, overcoming the disadvantages of ground-based observations. The hardware components and software algorithm are described and evaluated. The eligibility of the payload for SSA is proven by the image processing algorithms, which detect the RSOs in the images captured during flight and the survival of the COTS components in the near-space environment. The payload features a low-resolution, wide FOV camera coupled with a Field Programmable Gate Array (FPGA)-based platform that houses the altitude and time-based image capture algorithm. The newly developed payload in a 2U-CubeSat form factor was flown as a space-ready payload on the CSA/CNES stratospheric balloon research platform to carry out algorithm and functionality tests in August 2022.

7.
Mol Syst Biol ; 17(10): e10355, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34693621

RESUMO

Understanding the principles of colonization resistance of the gut microbiome to the pathogen Clostridioides difficile will enable the design of defined bacterial therapeutics. We investigate the ecological principles of community resistance to C. difficile using a synthetic human gut microbiome. Using a dynamic computational model, we demonstrate that C. difficile receives the largest number and magnitude of incoming negative interactions. Our results show that C. difficile is in a unique class of species that display a strong negative dependence between growth and species richness. We identify molecular mechanisms of inhibition including acidification of the environment and competition over resources. We demonstrate that Clostridium hiranonis strongly inhibits C. difficile partially via resource competition. Increasing the initial density of C. difficile can increase its abundance in the assembled community, but community context determines the maximum achievable C. difficile abundance. Our work suggests that the C. difficile inhibitory potential of defined bacterial therapeutics can be optimized by designing communities featuring a combination of mechanisms including species richness, environment acidification, and resource competition.


Assuntos
Clostridioides difficile , Infecções por Clostridium , Microbioma Gastrointestinal , Bactérias , Clostridioides , Infecções por Clostridium/tratamento farmacológico , Humanos
8.
J Chem Phys ; 156(20): 204312, 2022 May 28.
Artigo em Inglês | MEDLINE | ID: mdl-35649863

RESUMO

Ionic liquids (ILs) are novel promising materials widely used in various fields. Their structures and properties can be tuned by means of external perturbations, thus further broadening their applications. Herein, forces proportional to atomic mass (mass-related field) and atomic charge (electric field) are applied in molecular dynamics simulations to the IL 1-butyl-3-methylimidazolium bis(trifluoromethylsulfonyl)imide to investigate the origin of the resulting changes in structures and dynamics. The results show that both electric and mass-related fields cause the ion cages to expand and deform, eventually leading to their breakdown to produce a transformation of ILs from the cage structure to a channel-like structure, which results in faster self-diffusion of ions in the directions of the applied force and to a lesser extent other directions. Further comparison of electric and mass-related fields demonstrates that only the electric fields reorientate cations to produce a hydrodynamically favored conformation in the force direction, which shows faster diffusion. The cis isomer of the anion is preferred in the presence of the electric fields, whereas applying the forces proportional to mass does not change the anion conformer equilibrium significantly. The results presented in this work aid in the understanding of how ions adjust their structures to adapt to external perturbations and facilitate the application of ILs as electrolytes.

9.
J Biomech Eng ; 144(7)2022 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-34951462

RESUMO

Most motion capture measurements suffer from soft-tissue artifacts (STA). Especially affected are rotations about the long axis of a limb segment, such as humeral internal-external rotation (HIER) and forearm pronation-supination (FPS). Unfortunately, most existing methods to compensate for STA were designed for optoelectronic motion capture systems. We present and evaluate an STA compensation method that (1) compensates for STA in HIER and/or FPS, (2) is developed specifically for electromagnetic motion capture systems, and (3) does not require additional calibration or data. To compensate for STA, calculation of HIER angles relies on forearm orientation, and calculation of FPS angles rely on hand orientation. To test this approach, we recorded whole-arm movement data from eight subjects and compared their joint angle trajectories calculated according to progressive levels of STA compensation. Compensated HIER and FPS angles were significantly larger than uncompensated angles. Although the effect of STA compensation on other joint angles (besides HIER and FPS) was usually modest, significant effects were seen in certain degrees-of-freedom under some conditions. Overall, the method functioned as intended during most of the range of motion of the upper limb, but it becomes unstable in extreme elbow extension and extreme wrist flexion-extension. Specifically, this method is not recommended for movements within 20 deg of full elbow extension, full wrist flexion, or full wrist extension. Since this method does not require additional calibration of data, it can be applied retroactively to data collected without the intent to compensate for STA.


Assuntos
Artefatos , Extremidade Superior , Fenômenos Biomecânicos , Fenômenos Eletromagnéticos , Humanos , Movimento , Pronação , Amplitude de Movimento Articular , Supinação
10.
Sensors (Basel) ; 22(15)2022 Jul 29.
Artigo em Inglês | MEDLINE | ID: mdl-35957245

RESUMO

A catalogue of over 22,000 objects in Earth's orbit is currently maintained, and that number is expected to double within the next decade. Novel data collection regimes are needed to scale our ability to detect, track, classify and characterize resident space objects in a crowded low Earth orbit. This research presents RSOnet, an image-processing framework for space domain awareness using star trackers. Star trackers are cost-effective, flight proven, and require basic image processing to be used as an attitude-determination sensor. RSOnet is designed to augment the capabilities of a star tracker by becoming an opportunistic space-surveillance sensor. Our research demonstrates that star trackers are a feasible source for RSO detections in LEO by demonstrating the performance of RSOnet on real detections from a star-tracker-like imager in space. RSOnet convolutional-neural-network model architecture, graph-based multi-object classifier and characterization results are described in this paper.

11.
Langmuir ; 37(17): 5193-5201, 2021 May 04.
Artigo em Inglês | MEDLINE | ID: mdl-33886322

RESUMO

Ionic liquids (ILs) under electric fields play essential roles in the electrochemical utilization of ILs. Recently, long-range organization of ILs in the vicinity of charged (and even neutral) surfaces has been revealed, but experimental evidence for such an ordering is still limited and its spatial length scale remains controversial. Here, we use confocal Raman microspectroscopy to investigate the effect of an applied electric potential on the IL 1-butyl-3-methylimidazolium bis(trifluoromethylsulfonyl)imide and its analogues in a space-resolved manner. Much to our surprise, the observed Raman difference spectra of the ILs obtained with and without an applied potential exhibit uniform intensity changes independent of vibrational modes of cations and anions, a finding in sharp contrast with the electric field effects on molecular liquids that we have previously observed. We interpret this unexpected finding in terms of the Pockels effect that occurs as a result of a potential-induced ordering of the IL near an IL-electrode interface. The refractive index changes due to the applied potential are estimated using the experimental Raman intensity changes. The results allow us to deduce that the length scale of the ordering in the ILs is tens to hundreds of nanometers, extending more than would be expected for the electrical double layer but not as far as a micrometer scale.

12.
Proc Natl Acad Sci U S A ; 115(28): E6595-E6603, 2018 07 10.
Artigo em Inglês | MEDLINE | ID: mdl-29941598

RESUMO

Conjugal cell-cell contact between strains of Mycobacterium smegmatis induces the esxUT transcript, which encodes the putative primary substrates of the ESAT-6 secretion system 4 (ESX-4) secretion system. This recipient response was required for conjugal transfer of chromosomal DNA from the donor strain. Here we show that the extracytoplasmic σ factor, SigM, is a cell contact-dependent activator of ESX-4 expression and is required for conjugal transfer of DNA in the recipient strain. The SigM regulon includes genes outside the seven-gene core esx4 locus that we show are also required for conjugation, and we show that some of these SigM-induced proteins likely function through ESX-4. A fluorescent reporter revealed that SigM is specifically activated in recipient cells in direct contact with donor cells. Coculture RNA-seq experiments indicated that SigM regulon induction occurred early and before transconjugants are detected. This work supports a model wherein donor contact with the recipient cell surface inactivates the transmembrane anti-SigM, thereby releasing SigM. Free SigM induces an extended ESX-4 secretion system, resulting in changes that facilitate chromosomal transfer. The contact-dependent inactivation of an extracytoplasmic σ-factor that tightly controls ESX-4 activity suggests a mechanism dedicated to detect, and appropriately respond to, external stimuli from mycobacteria.


Assuntos
Proteínas de Bactérias , Conjugação Genética/fisiologia , Regulação Bacteriana da Expressão Gênica/fisiologia , Mycobacterium smegmatis , Fatores de Transcrição , Sistemas de Secreção Tipo IV , Sistemas de Secreção Tipo VII , Proteínas de Bactérias/genética , Proteínas de Bactérias/metabolismo , Redes Reguladoras de Genes/fisiologia , Mycobacterium smegmatis/genética , Mycobacterium smegmatis/metabolismo , Fatores de Transcrição/genética , Fatores de Transcrição/metabolismo , Sistemas de Secreção Tipo IV/genética , Sistemas de Secreção Tipo IV/metabolismo , Sistemas de Secreção Tipo VII/genética , Sistemas de Secreção Tipo VII/metabolismo
13.
BMC Med Educ ; 21(1): 371, 2021 Jul 08.
Artigo em Inglês | MEDLINE | ID: mdl-34238273

RESUMO

BACKGROUND: The undergraduate five-year MBChB programme at the University of Glasgow has a high volume of pathology teaching integrated into the course. The ability to better understand what pathology is taught and when, so as to build a picture of the types and depth of pathology topics covered across the programme stages is crucial, especially in a spiral curriculum. A novel method of curriculum mapping, known as curriculum heat mapping, was developed as a way to visualise where and when topics are taught, in an easier to understand format. METHODS: This method involved comparing the Glasgow curriculum to a pre-determined standard of what should be taught. In this case, The Royal College of Pathologists' 'Pathology Undergraduate Curriculum' was used as a comparison of what a graduating doctor should know about pathology. RESULTS: Following the developed template, heat maps showcasing the range of pathology topics covered, and where they are covered, were developed for local use. These heat maps provided a clear visual representation of where and when topics are taught, and how they cluster. CONCLUSIONS: Heat mapping is a novel low-cost, high-input method of curriculum mapping. It requires a person to input the data which can take a long time for large curricula. There are no other upfront financial costs. It can be used in any area with a curriculum and an external or internal comparator. Examples of gold standard external comparators include validated national or international curricula. Heat mapping can help integrated, spiral curriculum programmes to identify where core topics are taught throughout their course. The heat maps themselves successfully demonstrate the required information and are easy to interpret. The process of mapping, as well as the final heat map, can yield important information. This includes information about trends within the curriculum, areas for potential improvement in sessional design and a clearer understanding of the depth to which each topic is covered in each lecture. Overall, it is a viable novel method, which has been successful locally and is easily transferable to other areas such as pharmacology.


Assuntos
Educação de Graduação em Medicina , Currículo , Escolaridade , Temperatura Alta , Ensino , Universidades
14.
Sensors (Basel) ; 21(23)2021 Nov 26.
Artigo em Inglês | MEDLINE | ID: mdl-34883871

RESUMO

With the rapid increase in resident space objects (RSO), there is a growing demand for their identification and characterization to advance space simulation awareness (SSA) programs. Various AI-based technologies are proposed and demonstrated around the world to effectively and efficiently identify RSOs from ground and space-based observations; however, there remains a challenge in AI training due to the lack of labeled datasets for accurate RSO detection. In this paper, we present an overview of the starfield simulator to generate a realistic representation of images from space-borne imagers. In particular, we focus on low-resolution images such as those taken with a commercial-grade star tracker that contains various RSO in starfield images. The accuracy and computational efficiency of the simulator are compared to the commercial simulator, namely STK-EOIR to demonstrate the performance of the simulator. In comparing over 1000 images from the Fast Auroral Imager (FAI) onboard CASSIOPE satellite, the current simulator generates both stars and RSOs with approximately the same accuracy (compared to the real images) as STK-EOIR and, an order of magnitude faster in computational speed by leveraging parallel processing methodologies.

15.
BMC Med ; 18(1): 136, 2020 05 14.
Artigo em Inglês | MEDLINE | ID: mdl-32404148

RESUMO

BACKGROUND: Medical schools differ, particularly in their teaching, but it is unclear whether such differences matter, although influential claims are often made. The Medical School Differences (MedDifs) study brings together a wide range of measures of UK medical schools, including postgraduate performance, fitness to practise issues, specialty choice, preparedness, satisfaction, teaching styles, entry criteria and institutional factors. METHOD: Aggregated data were collected for 50 measures across 29 UK medical schools. Data include institutional history (e.g. rate of production of hospital and GP specialists in the past), curricular influences (e.g. PBL schools, spend per student, staff-student ratio), selection measures (e.g. entry grades), teaching and assessment (e.g. traditional vs PBL, specialty teaching, self-regulated learning), student satisfaction, Foundation selection scores, Foundation satisfaction, postgraduate examination performance and fitness to practise (postgraduate progression, GMC sanctions). Six specialties (General Practice, Psychiatry, Anaesthetics, Obstetrics and Gynaecology, Internal Medicine, Surgery) were examined in more detail. RESULTS: Medical school differences are stable across time (median alpha = 0.835). The 50 measures were highly correlated, 395 (32.2%) of 1225 correlations being significant with p < 0.05, and 201 (16.4%) reached a Tukey-adjusted criterion of p < 0.0025. Problem-based learning (PBL) schools differ on many measures, including lower performance on postgraduate assessments. While these are in part explained by lower entry grades, a surprising finding is that schools such as PBL schools which reported greater student satisfaction with feedback also showed lower performance at postgraduate examinations. More medical school teaching of psychiatry, surgery and anaesthetics did not result in more specialist trainees. Schools that taught more general practice did have more graduates entering GP training, but those graduates performed less well in MRCGP examinations, the negative correlation resulting from numbers of GP trainees and exam outcomes being affected both by non-traditional teaching and by greater historical production of GPs. Postgraduate exam outcomes were also higher in schools with more self-regulated learning, but lower in larger medical schools. A path model for 29 measures found a complex causal nexus, most measures causing or being caused by other measures. Postgraduate exam performance was influenced by earlier attainment, at entry to Foundation and entry to medical school (the so-called academic backbone), and by self-regulated learning. Foundation measures of satisfaction, including preparedness, had no subsequent influence on outcomes. Fitness to practise issues were more frequent in schools producing more male graduates and more GPs. CONCLUSIONS: Medical schools differ in large numbers of ways that are causally interconnected. Differences between schools in postgraduate examination performance, training problems and GMC sanctions have important implications for the quality of patient care and patient safety.


Assuntos
Faculdades de Medicina/normas , Estudantes de Medicina/estatística & dados numéricos , Feminino , Humanos , Masculino , Reino Unido
16.
BMC Med ; 18(1): 126, 2020 05 14.
Artigo em Inglês | MEDLINE | ID: mdl-32404194

RESUMO

BACKGROUND: What subjects UK medical schools teach, what ways they teach subjects, and how much they teach those subjects is unclear. Whether teaching differences matter is a separate, important question. This study provides a detailed picture of timetabled undergraduate teaching activity at 25 UK medical schools, particularly in relation to problem-based learning (PBL). METHOD: The Analysis of Teaching of Medical Schools (AToMS) survey used detailed timetables provided by 25 schools with standard 5-year courses. Timetabled teaching events were coded in terms of course year, duration, teaching format, and teaching content. Ten schools used PBL. Teaching times from timetables were validated against two other studies that had assessed GP teaching and lecture, seminar, and tutorial times. RESULTS: A total of 47,258 timetabled teaching events in the academic year 2014/2015 were analysed, including SSCs (student-selected components) and elective studies. A typical UK medical student receives 3960 timetabled hours of teaching during their 5-year course. There was a clear difference between the initial 2 years which mostly contained basic medical science content and the later 3 years which mostly consisted of clinical teaching, although some clinical teaching occurs in the first 2 years. Medical schools differed in duration, format, and content of teaching. Two main factors underlay most of the variation between schools, Traditional vs PBL teaching and Structured vs Unstructured teaching. A curriculum map comparing medical schools was constructed using those factors. PBL schools differed on a number of measures, having more PBL teaching time, fewer lectures, more GP teaching, less surgery, less formal teaching of basic science, and more sessions with unspecified content. DISCUSSION: UK medical schools differ in both format and content of teaching. PBL and non-PBL schools clearly differ, albeit with substantial variation within groups, and overlap in the middle. The important question of whether differences in teaching matter in terms of outcomes is analysed in a companion study (MedDifs) which examines how teaching differences relate to university infrastructure, entry requirements, student perceptions, and outcomes in Foundation Programme and postgraduate training.


Assuntos
Currículo/normas , Educação de Graduação em Medicina/organização & administração , Feminino , Humanos , Masculino , Inquéritos e Questionários , Reino Unido
17.
J Biomech Eng ; 142(7)2020 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-31891379

RESUMO

Electromagnetic (EM) motion tracking systems are suitable for many research and clinical applications, including in vivo measurements of whole-arm movements. Unfortunately, the methodology for in vivo measurements of whole-arm movements using EM sensors is not well described in the literature, making it difficult to perform new measurements and all but impossible to make meaningful comparisons between studies. The recommendations of the International Society of Biomechanics (ISB) have provided a great service, but by necessity they do not provide clear guidance or standardization on all required steps. The goal of this paper was to provide a comprehensive methodology for using EM sensors to measure whole-arm movements in vivo. We selected methodological details from past studies that were compatible with the ISB recommendations and suitable for measuring whole-arm movements using EM sensors, filling in gaps with recommendations from our own past experiments. The presented methodology includes recommendations for defining coordinate systems (CSs) and joint angles, placing sensors, performing sensor-to-body calibration, calculating rotation matrices from sensor data, and extracting unique joint angles from rotation matrices. We present this process, including all equations, for both the right and left upper limbs, models with nine or seven degrees-of-freedom (DOF), and two different calibration methods. Providing a detailed methodology for the entire process in one location promotes replicability of studies by allowing researchers to clearly define their experimental methods. It is hoped that this paper will simplify new investigations of whole-arm movement using EM sensors and facilitate comparison between studies.


Assuntos
Fenômenos Biomecânicos , Fenômenos Eletromagnéticos , Simulação por Computador , Movimento , Amplitude de Movimento Articular
18.
J Chem Phys ; 151(16): 164503, 2019 Oct 28.
Artigo em Inglês | MEDLINE | ID: mdl-31675893

RESUMO

Simulations of the ionic liquid 1-butyl-3-methylimidazolium bis(trifluoromethylsulfonyl)imide in an external electric field have been performed using a Drude particle polarizable force field. The structure of the ions has been analyzed, with close attention paid to the configurations of the ions. The "charge arm" concept is used to explain certain changes of these configurations that would be difficult to rationalize otherwise, e.g., trans → cis isomerization of the bis(trifluoromethylsulfonyl)imide anion and extension of the alkyl chain of the cation. It has also been shown that the ions orient themselves so that their charge arms align with and stretch out along the field, and these effects occur at lower external electric field strengths than cause a change in the inherent diffusion of the ions. The dynamics of the system parallel and perpendicular to the field were analyzed, and it was found that the applied field affected the diffusion normal to the field. This is explained as a secondary effect of a change in the ion cage formed by the surrounding counterions of a given ion in the ionic liquid. The breakdown of the ion cages was rationalized by correlating changes to the inherent diffusion of the ions with other changes to the diffusion and bulk structure of the liquid, as well as considering the average forces on the ions compared to the force the ions would be expected to experience in an electric field. Parallel to the field, a drift was observed at every electric field studied. In electric fields with no changes to the ion cage structure, the relationship between the drift and electric field was found to be linear, becoming nonlinear as the ion cage structure breaks down.

20.
Metab Eng ; 47: 230-242, 2018 05.
Artigo em Inglês | MEDLINE | ID: mdl-29601856

RESUMO

Cyanobacteria are photosynthetic microorganisms whose metabolism can be modified through genetic engineering for production of a wide variety of molecules directly from CO2, light, and nutrients. Diverse molecules have been produced in small quantities by engineered cyanobacteria to demonstrate the feasibility of photosynthetic biorefineries. Consequently, there is interest in engineering these microorganisms to increase titer and productivity to meet industrial metrics. Unfortunately, differing experimental conditions and cultivation techniques confound comparisons of strains and metabolic engineering strategies. In this work, we discuss the factors governing photoautotrophic growth and demonstrate nutritionally replete conditions in which a model cyanobacterium can be grown to stationary phase with light as the sole limiting substrate. We introduce a mathematical framework for understanding the dynamics of growth and product secretion in light-limited cyanobacterial cultures. Using this framework, we demonstrate how cyanobacterial growth in differing experimental systems can be easily scaled by the volumetric photon delivery rate using the model organisms Synechococcus sp. strain PCC7002 and Synechococcus elongatus strain UTEX2973. We use this framework to predict scaled up growth and product secretion in 1L photobioreactors of two strains of Synechococcus PCC7002 engineered for production of l-lactate or L-lysine. The analytical framework developed in this work serves as a guide for future metabolic engineering studies of cyanobacteria to allow better comparison of experiments performed in different experimental systems and to further investigate the dynamics of growth and product secretion.


Assuntos
Biomassa , Reatores Biológicos , Ácido Láctico/biossíntese , Luz , Lisina/biossíntese , Synechococcus/crescimento & desenvolvimento , Lisina/genética , Engenharia Metabólica , Synechococcus/genética
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