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Competence based

Mira Hidajat, Damien Martin McElvenny, Peter Ritchie, Andrew Darnton, William Mueller, Martie van Tongeren, Raymond M Agius, John W Cherrie, Frank de Vocht
OBJECTIVES: To quantitatively evaluate exposure-response associations between occupational exposures to rubber dust, fumes and N-nitrosamines and cancer mortality in the UK rubber industry. METHODS: Competing risk survival analyses were used to examine cancer mortality risk in a cohort of 36 441 males aged 35+ years employed in the British rubber industry in 1967, followed up to 2015 (94% mortality). Exposure measurements are based on a population-specific quantitative job-exposure matrix for rubber dust, rubber fumes and N-nitrosamines from the EU-EXASRUB project...
February 16, 2019: Occupational and Environmental Medicine
Alyssa Nickell, Susan L Stewart, Nancy J Burke, Claudia Guerra, Elly Cohen, Catherine Lawlor, Susan Colen, Janice Cheng, Galen Joseph
OBJECTIVE: Evaluate a community-based navigator intervention to increase breast cancer patients' and survivors' access to information about health research participation opportunities. METHODS: In the context of a Community Based Participatory Research collaboration, we conducted a prospective randomized controlled trial of the Health Research Engagement Intervention with pre- and post-intervention surveys (n = 133). The primary outcome was health research information-seeking behavior...
February 11, 2019: Patient Education and Counseling
Nikolas Löw, Jürgen Hesser, Manuel Blessing
The performance of case-based reasoning (CBR) depends on an accurate ranking of similar cases in the retrieval phase that affects all subsequent phases and profits from the potential of large databases. Unfortunately, growing databases come along with a rising amount of missing data that reduces the stability of the ranking since incomplete cases cannot be ranked as reliable as complete ones. In context of CBR hardly any work was done so far to rigorously analyze the impact of missing data and solutions to tackle this issue...
February 13, 2019: Journal of Biomedical Informatics
Tong-Peng Xu, Pei Ma, Wen-Yu Wang, You Shuai, Yan-Fen Wang, Tao Yu, Rui Xia, Yong-Qian Shu
It was found in this study that long intergenic non-protein coding RNA 346 (LINC00346) was an lncRNA aberrantly expressed in gastric cancer (GC) based on multiple Gene Expression Omnibus (GEO) databases of GC cohorts. The LINC00346 gene was recurrently amplified and upregulated in GC, and its expression was positively correlated with poor pathologic stage, large tumor size, and poor prognosis. In addition, the oncogenic transcription factors KLF5 and MYC could bind to the LINC00346 promoter and enhance its expression...
February 15, 2019: Cell Death and Differentiation
Douglas D Richman, Karissa Huang, Steven M Lada, Xiaoying Sun, Sonia Jain, Marta Massanella, Bryson Menke
Latently infected CD4 lymphocytes preclude cure of HIV infection, even with the most effective antiretroviral therapy. The replication competent latent HIV reservoir has been quantified with the terminal dilution quantitative viral outgrowth assay, which induces virus propagation in CD4+ T cell culture supernatants following cellular activation. Efforts to improve the sensitivity of this inefficient assay have introduced more sensitive p24 ELISA and RNA PCR based endpoints, but these more sensitive endpoints have raised the question whether they are measuring induced replication competent or defective virions...
February 15, 2019: Retrovirology
Kirsty Bowman, Lindsay Jones, Luke C Pilling, João Delgado, George A Kuchel, Luigi Ferrucci, Richard H Fortinsky, David Melzer
OBJECTIVE: To estimate effects of vitamin D levels on incident delirium hospital admissions using inherited genetic variants in mendelian randomization models, which minimize confounding and exclude reverse causation. METHODS: Longitudinal analysis using the UK Biobank, community-based, volunteer cohort (2006-2010) with incident hospital-diagnosed delirium (ICD-10 F05) ascertained during ≤9.9 years of follow-up of hospitalization records (to early 2016). We included volunteers of European descent aged 60-plus years by end of follow-up...
February 15, 2019: Neurology
Lisa Van de Wijer, Deborah N Mchaile, Quirijn de Mast, Blandina T Mmbaga, Nanda N J Rommelse, Ashanti Duinmaijer, André J A M van der Ven, Arnt F A Schellekens, Grace D Kinabo
BACKGROUND: Efavirenz is commonly prescribed for children with HIV infection, yet little is known about risks of neuropsychiatric side-effects. We aimed to compare competence (social involvement, activities, and school performance) and psychopathology (internalising and externalising problems), cognitive performance (intelligence and working memory), and adherence in Tanzanian children on an efavirenz-based versus a non-efavirenz-based regimen. METHODS: In this multicentre, cross-sectional, observational study, we included consecutive children (aged 6-12 years) with HIV infection, on combination antiretroviral therapy (cART) for at least 6 months, and with viral loads of less than 1000 copies per mL from HIV care clinics of three primary health facilities and three referral hospitals in Moshi, Kilimanjaro, Tanzania...
February 12, 2019: Lancet HIV
Ammara Mehmood, Naveed Ishtiaq Chaudhary, Aneela Zameer, Muhammad Asif Zahoor Raja
In this work, novel application of evolutionary computational heuristics is presented for parameter identification problem of nonlinear Hammerstein controlled auto regressive auto regressive (NHCARAR) systems through global search competency of backtracking search algorithm (BSA), differential evolution (DE) and genetic algorithms (GAs). The mean squared error metric is used for the fitness function of NHCARAR system based on difference between actual and approximated design variables. Optimization of the cost function is conducted with BSA for NHCARAR model by varying degrees of freedom and noise variances...
February 6, 2019: ISA Transactions
C Herion, L Egger, R Greif, C Violato
AIM: To investigate whether the CanMEDS-based International Federation of Nurse Anesthetists' Standards could adequately define the scope of practice and reliably be used to train and evaluate Swiss nurse anesthetists (NAs). BACKGROUND: Although nurse anesthetists represent a majority of the global workforce in anesthesia, policies that define the scope of practice are frequently non-existent. In low- and middle-income countries, the lack of anesthesia providers with adequate training is a major challenge...
February 15, 2019: International Nursing Review
Natalia Z Bielczyk, Katarzyna Piskała, Martyna Płomecka, Piotr Radziński, Lara Todorova, Urszula Foryś
It is known that cortical networks operate on the edge of instability, in which oscillations can appear. However, the influence of this dynamic regime on performance in decision making, is not well understood. In this work, we propose a population model of decision making based on a winner-take-all mechanism. Using this model, we demonstrate that local slow inhibition within the competing neuronal populations can lead to Hopf bifurcation. At the edge of instability, the system exhibits ambiguity in the decision making, which can account for the perceptual switches observed in human experiments...
2019: PloS One
Nico M Franz, Lukas J Musher, Joseph W Brown, Shizhuo Yu, Bertram Ludäscher
Phylogenomic research is accelerating the publication of landmark studies that aim to resolve deep divergences of major organismal groups. Meanwhile, systems for identifying and integrating the products of phylogenomic inference-such as newly supported clade concepts-have not kept pace. However, the ability to verbalize node concept congruence and conflict across multiple, in effect simultaneously endorsed phylogenomic hypotheses, is a prerequisite for building synthetic data environments for biological systematics and other domains impacted by these conflicting inferences...
February 15, 2019: PLoS Computational Biology
David Li, Kulamakan Kulasegaram, Brian D Hodges
Recently in medicine, the accuracy of machine learning models in predictive tasks has started to meet or exceed that of board certified specialists. The ability to automate cognitive tasks using software has raised new questions about the future role of human physicians in health care. Emerging technologies can displace people from their jobs, forcing them to learn new skills, so it is clear that this looming challenge needs to be addressed by the medical education system. While current medical education seeks to prepare the next generation of physicians for a rapidly evolving health care landscape to meet the needs of the communities they serve, strategic decisions about disruptive technologies should be informed by a deeper investigation of how machine learning will function in the context of medicine...
February 12, 2019: Academic Medicine: Journal of the Association of American Medical Colleges
LaToya Lewis-Pierre, Mary McKay, Jill Sanko, Karina Gattamorta, Khitam Azaiza
BACKGROUND: Opportunities to provide competent and compassionate End-of Life (EOL) care to patients and families are limited for nursing students. METHOD: A mixed methods approach was used to explore the students' attitudes towards caring for an EOL patient in two groups: an on-line-module only group and an on-line module plus simulation group. RESULTS: Statistically significant effect of time was found across the two conditions (F [1, 69] = 7...
February 15, 2019: Journal of Palliative Care
Roxanne J Kovacs, Mylene Lagarde, John Cairns
Despite its importance in health care, empirical evidence on patient trust is limited. This is likely because, as with many complex concepts, trust is difficult to measure. This study measured patient trust in health care providers in a sample of 667 patients in Senegal. Two instruments were used to measure patient trust in providers: a survey questionnaire and an incentivised behavioural economic experiment-a "trust game." The results show that the two measures are significantly, but weakly, associated...
February 14, 2019: Health Economics
Evgeniy Tropin, Maxim Ananyev, Natalia Porotnikova, Anna Khodimchuk, Saim Saher, Andrey Farlenkov, Edhem Kurumchin, Denis Shepel, Evgeny Antipov, Sergei Istomin, Henny Bouwmeester
Oxygen surface exchange and diffusion in Pr1.75Sr0.25Ni0.75Co0.25O4±δ have been investigated using two methods: pulsed isotope exchange (PIE) and oxygen isotope exchange with gas phase equilibration (IE GPE). Oxygen surface exchange kinetics is considered in the framework of two-step models including two consecutive stages: dissociative adsorption of oxygen and incorporation of oxygen adatoms into the crystal lattice. The rates of oxygen heterogeneous exchange (rH) as well as the rates of dissociative adsorption (ra) and oxygen incorporation (ri) have been calculated...
February 15, 2019: Physical Chemistry Chemical Physics: PCCP
Sarah L Griffin, Claire Wilson, Ross S Forgan
Metal-organic frameworks (MOFs)-network structures built from metal ions or clusters and connecting organic ligands-are typically synthesized by solvothermal self-assembly. For transition metal based MOFs, structural predictability is facilitated by control over coordination geometries and linker connectivity under the principles of isoreticular synthesis. For rare earth (RE) MOFs, coordination behavior is dominated by steric and electronic factors, leading to unpredictable structures, and poor control over self-assembly...
2019: Frontiers in Chemistry
Hsiao-Fang Wang, Kai-Chieh Yang, Wen-Chun Hsu, Jing-Yu Lee, Jung-Tzu Hsu, Gregory M Grason, Edwin L Thomas, Jing-Cherng Tsai, Rong-Ming Ho
We explore the generality of the influence of segment chirality on the self-assembled structure of achiral-chiral diblock copolymers. Poly(cyclohexylglycolide) (PCG)-based chiral block copolymers (BCPs*), poly(benzyl methacrylate)- b -poly(d-cyclohexylglycolide) (PBnMA-PDCG) and PBnMA- b -poly(l-cyclohexyl glycolide) (PBnMA-PLCG), were synthesized for purposes of systematic comparison with polylactide (PLA)-based BCPs*, previously shown to exhibit chirality transfer from monomeric unit to the multichain domain morphology...
February 14, 2019: Proceedings of the National Academy of Sciences of the United States of America
Denise Traicoff, Alice Pope, Peter Bloland, Dharmesh Lal, Jhilmil Bahl, Steven Stewart, Tove Ryman, Molly Abbruzzese, Carla Lee, Johannes Ahrendts, Lorraine Shamalla, Hardeep Sandhu
Despite global support for immunization as a core component of the human right to health and the maturity of immunization programs in low- and middle-income countries throughout the world, there is no comprehensive description of the standardized competencies needed for immunization programs at the national, multiple sub-national, and community levels. The lack of defined and standardized competencies means countries have few guidelines to help them address immunization workforce planning, program management, and performance monitoring...
February 11, 2019: Vaccine
Ana Echenique, Evelyn P Wempe
Advanced practice registered nurses, such as Nurse Practitioners (NPs), can be found working in a variety of settings. Niche practices, such as Interventional Radiology, are highly specialized areas and are often specialties in which few NPs get to orient through during their graduate nursing program clinical rotations. For the NP transitioning into an Interventional Radiology practice, formal on-the-job orientation and training can assist in gaining specialty-based knowledge and competencies in performing interventional procedures...
March 2019: Techniques in Vascular and Interventional Radiology
Luke Witherspoon, Shreya Jalali, Matthew T Roberts
INTRODUCTION: In a competency-based approach to resident education, a component of training should focus on skills needed for the transition from residency to independent practice. The ability to run an outpatient clinic represents one such skill. Resident-run clinics (RRC) have been implemented in family medicine programs to allow residents to practice this skill, and have enhanced learning while providing excellent patient satisfaction. To date, there has been little experience with RRCs in surgical residency programs...
January 21, 2019: Canadian Urological Association Journal, Journal de L'Association des Urologues du Canada
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