The purpose of this paper is to illustrate how theoretically driven research can be beneficial to law-enforcement personnel in their day-to-day jobs. Such information can be used as an educational ...tool to assist students in understanding the value of theory and research and its applicability in the field. Specifically, we show how research guided by neutralization theory can be used by police to better elicit confessions from guilty suspects when using the Reid interrogation technique. Using data from 59 federally convicted identity thieves, we provide an illustration of how interrogators can use this information to develop functional themes during the interrogation.
Laser interstitial thermal therapy has been used as an ablative treatment for glioma; however, its development was limited due to technical issues. The NeuroBlate System incorporates several ...technological advances to overcome these drawbacks. The authors report a Phase I, thermal dose-escalation trial assessing the safety and efficacy of NeuroBlate in recurrent glioblastoma multiforme (rGBM).
Adults with suspected supratentorial rGBM of 15- to 40-mm dimension and a Karnofsky Performance Status score of ≥ 60 were eligible. After confirmatory biopsy, treatment was delivered using a rigid, gas-cooled, side-firing laser probe. Treatment was monitored using real-time MRI thermometry, and proprietary software providing predictive thermal damage feedback was used by the surgeon, along with control of probe rotation and depth, to tailor tissue coagulation. An external data safety monitoring board determined if toxicity at lower levels justified dose escalation.
Ten patients were treated at the Case Comprehensive Cancer Center (Cleveland Clinic and University Hospitals-Case Medical Center). Their average age was 55 years (range 34-69 years) and the median preoperative Karnofsky Performance Status score was 80 (range 70-90). The mean tumor volume was 6.8 ± 5 cm(3) (range 2.6-19 cm(3)), the percentage of tumor treated was 78% ± 12% (range 57%-90%), and the conformality index was 1.21 ± 0.33 (range 1.00-2.04). Treatment-related necrosis was evident on MRI studies at 24 and 48 hours. The median survival was 316 days (range 62-767 days). Three patients improved neurologically, 6 remained stable, and 1 worsened. Steroid-responsive treatment-related edema occurred in all patients but one. Three had Grade 3 adverse events at the highest dose.
NeuroBlate represents new technology for delivering laser interstitial thermal therapy, allowing controlled thermal ablation of deep hemispheric rGBM. CLINICAL TRIAL REGISTRATION NO.: NCT00747253 ( ClinicalTrials.gov ).
Synthesizing trait observations and knowledge across the Tree of Life remains a grand challenge for biodiversity science. Species traits are widely used in ecological and evolutionary science, and ...new data and methods have proliferated rapidly. Yet accessing and integrating disparate data sources remains a considerable challenge, slowing progress toward a global synthesis to integrate trait data across organisms. Trait science needs a vision for achieving global integration across all organisms. Here, we outline how the adoption of key Open Science principles-open data, open source and open methods-is transforming trait science, increasing transparency, democratizing access and accelerating global synthesis. To enhance widespread adoption of these principles, we introduce the Open Traits Network (OTN), a global, decentralized community welcoming all researchers and institutions pursuing the collaborative goal of standardizing and integrating trait data across organisms. We demonstrate how adherence to Open Science principles is key to the OTN community and outline five activities that can accelerate the synthesis of trait data across the Tree of Life, thereby facilitating rapid advances to address scientific inquiries and environmental issues. Lessons learned along the path to a global synthesis of trait data will provide a framework for addressing similarly complex data science and informatics challenges.
Healthcare professions faculty at a private Midwestern university designed an Interprofessional Education (IPE) Week, consisting of 12 different interprofessional learning activities over the span of ...one week. The purpose of the study was to determine students' perceptions toward interprofessional healthcare, as measured by the Student Perceptions of Interprofessional Clinical Education-Revised (SPICE-R), one week before and one week after the events to determine if the type of learning activity - more passive, didactic-type events or active learning events - impacted outcomes. Of the over 400 students representing predominantly athletic training, nursing, occupational therapy, and physical therapy programs who attended IPE Week, a total of 190 health professions students completed the pre- and post-IPE Week SPICE-R. Students who attended an active learning activity had a statistically significant increase in all three factors of the tool (interprofessional teamwork and team-based practice, roles/responsibilities for collaborative practice, and patient outcomes from collaborative practice) while students who attended more passive didactic type events only showed a statistically significant increase in roles/responsibilities and patient outcomes. This study demonstrates the utility of an IPE Week on student perceptions and highlights the potential importance of active interprofessional learning offerings.
Anemia during pregnancy is associated with increased risks of preterm birth, preeclampsia, cesarean delivery, and maternal morbidity. The most prevalent modifiable cause of pregnancy-associated ...anemia is iron deficiency. However, it is still unclear whether iron therapy can reduce the risks of adverse outcomes in women with anemia.
This study aimed to determine whether response to iron therapy among women with anemia is associated with a change in odds of adverse maternal and neonatal outcomes.
This was a population-based cohort study (2011–2019) using an institutional database composed of obstetrical patients from 2 delivery hospitals. Patients with adequate prenatal care were classified as being anemic or nonanemic (reference). Patients with anemia were further stratified by success or failure of treatment with oral iron therapy using the American College of Obstetricians and Gynecologists criteria for anemia at the time of admission for delivery: successfully treated (Hgb≥11 g/dL) or unsuccessfully treated (“refractory;” Hgb<11 g/dL). All categories of women with anemia categories were compared with the reference group of women without anemia using chi-square and logistic regression analyses. The primary outcomes were preterm birth and preeclampsia.
Among the 20,690 women observed, 7416 (35.8%) were anemic. Among women with anemia, 1319 (17.8%) were refractory to iron therapy, 2695 (36.3%) had a successful response to therapy, and 3402 (45.9%) were untreated. Successfully treated patients with anemia had a significant reduction in the odds of preterm birth (5.1% vs 8.3%; adjusted odds ratio, 0.59; 95% confidence interval, 0.47–0.72) and preeclampsia (5.9% vs 8.3%; adjusted odds ratio, 0.75; 95% confidence interval, 0.61–0.91). Refractory and untreated patients had significantly increased odds of preterm birth (adjusted odds ratio, 1.44 95% confidence interval, 1.16–1.76 and 1.45 95% confidence interval, 1.26–1.67, respectively) and preeclampsia (adjusted odds ratio, 1.54 95% confidence interval, 1.24–1.89 and 1.44 95% confidence interval, 1.25–1.67, respectively). All groups of women with anemia had increased odds of postpartum hemorrhage and decreased odds of delivering a small for gestational age neonate. There was no difference in composite neonatal morbidity.
Successful treatment of anemia with oral iron therapy was associated with a reduction in the odds of preterm birth and preeclampsia. Women with refractory anemia had similar outcomes to those who were untreated, emphasizing the importance of monitoring response to iron therapy during pregnancy.
Interprofessional collaboration has been identified by healthcare organizations as an important component for healthcare providers. The use of escape rooms is one method to implement ...interprofessional education in healthcare programs. The question is whether escape rooms are effective for interprofessional education while also enabling students to gain the educational content provided in the activity. A diabetes escape room was developed using a single group pretest-posttest design that included athletic training and nursing students and utilized the SPICE-R tool and diabetes knowledge assessment. Results showed the diabetes knowledge assessment was statistically significant when comparing the correct responses and that the SPICE-R was statistically significant for improvement in scores in all three IPE factors after participating in the Diabetes Escape Room. These outcomes indicate that the diabetes escape room was beneficial in exposing students to interprofessional education while also allowing them to learn the content. Specific details of the activities within this escape room are included in the article.
Warming can lead to increased growth of plants or algae at the base of the food web, which may increase the overall complexity of habitat available for other organisms. Temperature and habitat ...complexity have both been shown to alter the structure and functioning of communities, but they may also have interactive effects, for example, if the shade provided by additional habitat negates the positive effect of temperature on understory plant or algal growth. This study explored the interactive effects of these two major environmental factors in a manipulative field experiment, by assessing changes in ecosystem functioning (primary production and decomposition) and community structure in the presence and absence of artificial plants along a natural stream temperature gradient of 5–18°C. There was no effect of temperature or habitat complexity on benthic primary production, but epiphytic production increased with temperature in the more complex habitat. Cellulose decomposition rate increased with temperature, but was unaffected by habitat complexity. Macroinvertebrate communities were less similar to each other as temperature increased, while habitat complexity only altered community composition in the coldest streams. There was also an overall increase in macroinvertebrate abundance, body mass, and biomass in the warmest streams, driven by increasing dominance of snails and blackfly larvae. Presence of habitat complexity, however, dampened the strength of this temperature effect on the abundance of macroinvertebrates in the benthos. The interactive effects that were observed suggest that habitat complexity can modify the effects of temperature on important ecosystem functions and community structure, which may alter energy flow through the food web. Given that warming is likely to increase habitat complexity, particularly at higher latitudes, more studies should investigate these two major environmental factors in combination to improve our ability to predict the impacts of future global change.
Warming is likely to increase the complexity of habitat available to other organisms in the food web due to increased growth of plants and macroalgae, but these two important drivers of biotic change have rarely been studied in combination. We manipulated habitat complexity in seven streams that occur in the same valley, but span a natural temperature gradient of 5–18°C. We found interactive effects of temperature and habitat complexity on both the structure and functioning of freshwater communities.
Diapycnal mixing plays a primary role in the thermodynamic balance of the ocean and, consequently, in oceanic heat and carbon uptake and storage. Though observed mixing rates are on average ...consistent with values required by inverse models, recent attention has focused on the dramatic spatial variability, spanning several orders of magnitude, of mixing rates in both the upper and deep ocean. Away from ocean boundaries, the spatio-temporal patterns of mixing are largely driven by the geography of generation, propagation and dissipation of internal waves, which supply much of the power for turbulent mixing. Over the last five years and under the auspices of US CLIVAR, a NSF- and NOAA-supported Climate Process Team has been engaged in developing, implementing and testing dynamics-based parameterizations for internal-wave driven turbulent mixing in global ocean models. The work has primarily focused on turbulence 1) near sites of internal tide generation, 2) in the upper ocean related to wind-generated near inertial motions, 3) due to internal lee waves generated by low-frequency mesoscale flows over topography, and 4) at ocean margins. Here we review recent progress, describe the tools developed, and discuss future directions.
True to Milankovitch Jochum, Markus; Jahn, Alexandra; Peacock, Synte ...
Journal of climate,
04/2012, Volume:
25, Issue:
7
Journal Article
Peer reviewed
Open access
The equilibrium solution of a fully coupled general circulation model with present-day orbital forcing is compared to the solution of the same model with the orbital forcing from 115 000 years ago. ...The difference in snow accumulation between these two simulations has a pattern and a magnitude comparable to the ones inferred from reconstructions for the last glacial inception. This is a major improvement over previous similar studies, and the increased realism is attributed to the higher spatial resolution in the atmospheric model, which allows for a more accurate representation of the orography of northern Canada and Siberia. The analysis of the atmospheric heat budget reveals that, as postulated by Milankovitch’s hypothesis, the only necessary positive feedback is the snow–albedo feedback, which is initiated by reduced melting of snow and sea ice in the summer. However, this positive feedback is almost fully compensated by an increased meridional heat transport in the atmosphere and a reduced concentration of low Arctic clouds. In contrast to similar previous studies, the ocean heat transport remains largely unchanged. This stability of the northern North Atlantic circulation is explained by the regulating effect of the freshwater import through the Nares Strait and Northwest Passage and the spiciness import by the North Atlantic Current.
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