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BackgroundFree Open-Access Medical education (FOAM) use among residents continues to rise. However, it often lacks quality assurance processes and residents receive little guidance on quality assessment. The Academic Life in Emergency Medicine Approved Instructional Resources tool (AAT) was created for FOAM appraisal by and for expert educators and has demonstrated validity in this context. It has yet to be evaluated in other populations.ObjectivesWe assessed the AAT's usability in a diverse population of practicing emergency medicine (EM) physicians, residents, and medical students; solicited feedback; and developed a revised tool.MethodsAs part of the Medical Education Translational Resources: Impact and Quality (METRIQ) study, we recruited medical students, EM residents, and EM attendings to evaluate five FOAM posts with the AAT and provide quantitative and qualitative feedback via an online survey. Two independent analysts performed a qualitative thematic analysis with discrepancies resolved through discussion and negotiated consensus. This analysis informed development of an initial revised AAT, which was then further refined after pilot testing among the author group. The final tool was reassessed for reliability.ResultsOf 330 recruited international participants, 309 completed all ratings. The Best Evidence in Emergency Medicine (BEEM) score was the component most frequently reported as difficult to use. Several themes emerged from the qualitative analysis: for ease of use-understandable, logically structured, concise, and aligned with educational value. Limitations include deviation from questionnaire best practices, validity concerns, and challenges assessing evidence-based medicine. Themes supporting its use include evaluative utility and usability. The author group pilot tested the initial revised AAT, revealing a total score average measure intraclass correlation coefficient (ICC) of moderate reliability (ICC = 0.68, 95% confidence interval [CI] = 0 to 0.962). The final AAT's average measure ICC was 0.88 (95% CI = 0.77 to 0.95).ConclusionsWe developed the final revised AAT from usability feedback. The new score has significantly increased usability, but will need to be reassessed for reliability in a broad population.

This study analyzes the 2004 Queensland Physical Education (PE) Senior Syllabus to ascertain to what extent it is developing physically educated students. The 2004 QSPES is a fundamental document relevant to the teaching of PE (in Years 11 and 12 of high school) in the Australian state of Queensland. Kirk's (1988) notion of a physically educated person being an intelligent performer guides the research and frames the discussion. The 2004 QSPES syllabus was examined via content inquiry. The 2004 QSPES included concepts such as intelligent performance and complex environments, and it suggested teaching styles to meet these concept developments. It was found that the development of physically educated students was ill-defined, contradictory, and questionable. It is likely that teachers will have trouble applying, teaching, and assessing the concept of intelligent performance.

A semiconductor integrated circuit (IC) fabrication approach is described. It is based on a self-aligned, light junction anodization process.?

Activated T cells drive a range of immune‐mediated inflammatory diseases. LAG‐3 is transiently expressed on recently activated CD4+ and CD8+ T cells. We describe the engineering and first‐in‐human clinical study (NCT02195349) of GSK2831781 (an afucosylated humanized IgG1 monoclonal antibody enhanced with high affinity for Fc receptors and LAG‐3 and antibody‐dependent cellular cytotoxicity capabilities), which depletes LAG‐3 expressing cells. GSK2831781 was tested in a phase I/Ib, double‐blind, placebo‐controlled clinical study, which randomized 40 healthy participants (part A) and 27 patients with psoriasis (part B) to single doses of GSK2831781 (up to 0.15 and 5 mg/kg, respectively) or placebo. Adverse events were generally balanced across groups, with no safety or tolerability concern identified. LAG‐3+ cell depletion in peripheral blood was observed at doses ≥ 0.15 mg/kg and was dose‐dependent. In biopsies of psoriasis plaques, a reduction in mean group LAG‐3+ and CD3+ T‐cell counts was observed following treatment. Downregulation of proinflammatory genes (IL‐17A, IL‐17F, IFNγ, and S100A12) and upregulation of the epithelial barrier integrity gene, CDHR1, was observed with the 5 mg/kg dose of GSK2831781. Psoriasis disease activity improved up to day 43 at all GSK2831781 doses (0.5, 1.5, and 5 mg/kg) compared with placebo. Depletion of LAG‐3‐expressing activated T cells is a novel approach, and this first clinical study shows that GSK2831781 is pharmacologically active and provides encouraging early evidence of clinical effects in psoriasis, which warrants further investigation in T‐cell‐mediated inflammatory diseases. [ABSTRACT FROM AUTHOR]

Aims: The oncostatin M (OSM) pathway drives fibrosis, inflammation and vasculopathy, and is a potential therapeutic target for inflammatory and fibrotic diseases. The aim of this first‐time‐in‐human experimental medicine study was to assess the safety, tolerability, pharmacokinetics and target engagement of single subcutaneous doses of GSK2330811, an anti‐OSM monoclonal antibody, in healthy subjects. Methods: This was a phase I, randomized, double‐blind, placebo‐controlled, single‐dose escalation, first‐time‐in‐human study of subcutaneously administered GSK2330811 in healthy adults (NCT02386436). Safety and tolerability, GSK2330811 pharmacokinetic profile, OSM levels in blood and skin, and the potential for antidrug antibody formation were assessed. The in vivo affinity of GSK2330811 for OSM and target engagement in serum and skin blister fluid (obtained via a skin suction blister model) were estimated using target‐mediated drug disposition (TMDD) models in combination with compartmental and physiology‐based pharmacokinetic (PBPK) models. Results: Thirty subjects were randomized to receive GSK2330811 and 10 to placebo in this completed study. GSK2330811 demonstrated a favourable safety profile in healthy subjects; no adverse events were serious or led to withdrawal. There were no clinically relevant trends in change from baseline in laboratory values, with the exception of a reversible dose‐dependent reduction in platelet count. GSK2330811 exhibited linear pharmacokinetics over the dose range 0.1–6 mg kg–1. The estimated in vivo affinity (nM) of GSK2330811 for OSM was 0.568 [95% confidence interval (CI) 0.455, 0.710] in the compartmental with TMDD model and 0.629 (95% CI 0.494, 0.802) using the minimal PBPK with TMDD model. Conclusions: Single subcutaneous doses of GSK2330811 were well tolerated in healthy subjects. GSK2330811 demonstrated sufficient affinity to achieve target engagement in systemic circulation and target skin tissue, supporting the progression of GSK2330811 clinical development. [ABSTRACT FROM AUTHOR]

Author(s): Philip Stephens [1, 15]; Chris Hunter [1]; Graham Bignell [1]; Sarah Edkins [1]; Helen Davies [1]; Jon Teague [1]; Claire Stevens [1]; Sarah O'Meara [1]; Raffaella Smith [1]; Adrian [...]

It is unknown what teaching styles (range of pedagogies) coaches are employing during coaching sessions and whether these teaching styles are associated with recommended pedagogical principles advocated by sport and coaching scholars. It is unknown whether twenty years of coach education has shifted coaching practice as the insights into the pedagogical diversity and preference of teaching styles that underpin and inform the coaches' decisions to employ particular teaching strategies during coaching sessions are undetermined. This paper addresses these unknowns in the field of tennis coaching in Australia by reporting the findings of a study that address the lack of information on the teaching styles employed by tennis coaches by asking the following research question: What teaching styles are junior coaches in Australia actually using during coaching sessions? This study used The Spectrum (Mosston & Ashworth, 2008) of teaching styles as a tool to assess the observed teaching styles of twelve junior coaches. Contrary to the educational convictions of Australian sport coach education materials the results from this study indicated that the coaches in this study potentially did not offer players developmental opportunities beyond a limited range (i.e., motor skill development in the physical learning domain) due to a narrow pedagogical mix in their coaching. [ABSTRACT FROM AUTHOR]

Background. The aim of this study was to explore junior tennis coaches' insights in relation to teaching styles they employ as well as the motivations and reasons that underpin these practices. Methods. The research consisted of implementing interviews with the 13 tennis coaches. It employed purposive or theoretical sampling. Semi-structured interviews commenced with a prearranged group of questions to permit scope in direction so that the interviewer may follow what is considered as pertinent to the interviewee. The coaches were filmed during three 30 minute sessions. Prior to the interviews, each of the coaches was requested to view a portion of their video-recorded sessions. The interview data were analysed via deductive content analysis. Results. The results highlighted a lack of knowledge concerning the theoretical and practical application of various teaching styles required for coaching tennis to junior players. The coaches lacked self-awareness with regard to their own coaching performance and were incapable of accurately describing the reasons why they implement particular ways of coaching. Coaches used an assortment of terms to identify the way they coach and that their decision to employ certain ways of coaching did not alter as a function of the age group, skill level or ability of the players they were coaching. Observing and/or discussing aspects of coaching with a mentor as well as playing experience had a greater influence on current coaching behaviour than attending an accreditation course. Conclusion. The finding from this study is that the personally anticipated coaching behaviour of the coach was not what they realised upon observation of their coaching. [ABSTRACT FROM AUTHOR]

Presents information regarding changes planned to PES Technical Committee. [ABSTRACT FROM PUBLISHER]

Discusses the need for PES technical committees and technical councils to restructure and improve the reach, quality, and efficiency of the many technical activities of each group. [ABSTRACT FROM PUBLISHER]

Dear Editor, I am replying to last month's article on restraint-related deaths (6, 9, 10-17). The piece tried to 'outline the results and discuss the implications of a project which [...]

This paper describes briefly the academic tenure and its legislative terms in the UK, over the last twenty years. The author refers to the current wider situation/trends in the international higher education arena of two categories of academic staff - "established" staff (on permanent contract) and fixed-term staff - and to how their levels of protection can have an impact on the overall health of the universities and their academic freedom. [ABSTRACT FROM AUTHOR]

It is currently unclear just how widespread this condition is across our population, because it often is not recognized or diagnosed properly by the treating doctor. In this article, I will try to elucidate the background, symptoms, treatment, and identification of the syndrome. [ABSTRACT FROM AUTHOR]

We have developed a self-aligned Nb/Al-AlO[sub ℵ]/Nb junction anodization process that allows outside junction contacts and relaxed contact alignment. In this process, the junction, rather than the junction contact, becomes the minimum definable feature size. Junction size is limited only by the resolution of the lithography and etch tools, which is 0.65 µm in our foundry. The self-aligned junction anodization process allows a significant increase in circuit speed due to the decrease in minimum junction size and increase in junction critical current density without investment in new fabrication tools. This process requires only one additional, noncritical masking step and has no impact on existing design rules. We describe the fabrication and electrical characteristics of lightly anodized junctions and arrays at 8 kA/cm² and the development of new 5 Ω/sq. MoN[sub ℵ] and 0.15 Ω/sq. Mo/Al resistors. We also discuss the 300 GHz T flip-flop benchmark results from our new 8 kA/cm², 1.25 µm Nb integrated circuit process and compare these results to other Nb processes. [ABSTRACT FROM AUTHOR]

Focuses on the characteristics of English poetry. Comparison between a modernist-derived and an avant-garde poetry; Cultural aspect and aesthetic nature of the poems; Use of closed forms to conduct meanings in the poetic texts; Discussion of poems as ordered systems; Analysis of a poem written by Allen Fisher.

The article focuses on the shrubby plant European Blueberry or bilberry. The author reports that bilberry extracts are used in Europe in the treatment of vascular diseases and eye disorders. He mentions standard dosages, side effects and indications for use including cataracts, varicose veins and retinopathy.

The author reflects on the campaign of the Center for Science in the Public Interest against partially hydrated oil in the U.S. The organization aimed to reduce the incidence of heart disease in the country by giving a formal petition to the Food and Drug Administration against the use of oil in food ingredients. The substance has been known to be saturated fat that is capable of thickening cardiac blood vessels leading to heart ailments.

The article presents the studies conducted by several centers in the field of complementary and alternative medicine (CAM) in the U.S. The National Center for Complementary and Alternative Medicine will explore therapies used in traditional Chinese medicine, including acupuncture and Chinese herbal mixtures. Three new Centers of Excellence will apply cutting-edge technologies to identify the potential benefits and underlying mechanisms of CAM practices. The Center for Arthritis and Traditional Chinese Medicine will study traditional Chinese medicine approaches.

Discusses the results of a national survey on the nutritional content of school vending machines in the U.S. Percentage of discovered snacks of poor nutritional value; Number of sugary drinks found in thousands of vending-machine slots; Assertion on the competition between junk foods and the nutritious meals offered by federal school lunch program.

Pregnelolone is a hormone produced in the mitochondria of all body cells, with highest concentrations found in the brain and the glial cells of the nervous system. It is a precursor of neurosteroid hormones including cortisone, testosterone, estrogen, progesterone and dehydroepiandosterone (DHEA). Recent research has shown the effects of renewing the myelin sheath with the application of neurosteroids to demyelinated nerve tissue. [ABSTRACT FROM AUTHOR]

The article describes a situation where an individual got addicted to chemicals produced by his or her own body. One of these chemicals is epinephrine or adrenaline. Epinephrine makes the body on alert and the heart beats more rapidly, the eyes dilate and the breathing quickens. The author hypothesizes the pleasure an individual can gain from the fight or flight response mechanism.

The article presents a case study on a 48 year old female with hypercholesterolemia and hypothyroidism. The patient complained of swollen feet and hands, low energy level and a generalized malaise. She was given thyroid hormone replacement therapy and antihypertensive drugs. After several treatment sessions for three months, the patient has improved and the laboratory result revealed an all time personal best reading.

Offers insights on the life expectancy of Americans. Mortality rate; Life expectancy of women; Increase in active life expectancy; Total number of deaths in the United States in 2003; Infant mortality; Cause of death; Death rate from heart disease; Statistics from the World Health Organization.

Presents several Web sites useful for healthcare professionals specializing in nutrition and nutritional protocols. Services offered; Compilation of news articles at www.NaturalHealthline.com; Web sites for nutritional substances.

Activated T cells drive a range of immune-mediated inflammatory diseases. LAG-3 is transiently expressed on recently activated CD4 + and CD8 + T cells. We describe the engineering and first-in-human clinical study (NCT02195349) of GSK2831781 (an afucosylated humanized IgG1 monoclonal antibody enhanced with high affinity for Fc receptors and LAG-3 and antibody-dependent cellular cytotoxicity capabilities), which depletes LAG-3 expressing cells. GSK2831781 was tested in a phase I/Ib, double-blind, placebo-controlled clinical study, which randomized 40 healthy participants (part A) and 27 patients with psoriasis (part B) to single doses of GSK2831781 (up to 0.15 and 5 mg/kg, respectively) or placebo. Adverse events were generally balanced across groups, with no safety or tolerability concern identified. LAG-3 + cell depletion in peripheral blood was observed at doses ≥ 0.15 mg/kg and was dose-dependent. In biopsies of psoriasis plaques, a reduction in mean group LAG-3 + and CD3 + T-cell counts was observed following treatment. Downregulation of proinflammatory genes (IL-17A, IL-17F, IFNγ, and S100A12) and upregulation of the epithelial barrier integrity gene, CDHR1, was observed with the 5 mg/kg dose of GSK2831781. Psoriasis disease activity improved up to day 43 at all GSK2831781 doses (0.5, 1.5, and 5 mg/kg) compared with placebo. Depletion of LAG-3-expressing activated T cells is a novel approach, and this first clinical study shows that GSK2831781 is pharmacologically active and provides encouraging early evidence of clinical effects in psoriasis, which warrants further investigation in T-cell-mediated inflammatory diseases., (© 2020 GlaxoSmithKline. Clinical Pharmacology & Therapeutics published by Wiley Periodicals LLC on behalf of American Society for Clinical Pharmacology and Therapeutics.)

Issue Addressed: Indigenous Australians have higher morbidity and mortality rates than non-Indigenous Australians. Until recently, few health promotion interventions have had more than limited success in Indigenous populations., Methods: This community-based health promotion initiative introduced traditional Indigenous games into schools and community groups in Cherbourg and Stradbroke Island (Queensland, Australia). A joint community forum managed the project, and the Indigenous community-based project officers co-ordinated training in traditional games and undertook community asset audits and evaluations., Results: The games have been included in the activities of a range of community organisations in Cherbourg and Stradbroke Island. Several other organisations and communities in Australia have included them in their projects. A games video and manual were produced to facilitate the initiative's transferability and sustainability., Conclusions: Conventional approaches to health promotion generally focus on individual risk factors and often ignore a more holistic perspective. This project adopted a culturally appropriate, holistic approach, embracing a paradigm that concentrated on the communities' cultural assets and contributed to sustainable and transferable outcomes. There is a need for appropriate evaluation tools for time-limited community engagement projects.

The protein kinase gene family is the most frequently mutated in human cancer. Previous work has documented activating mutations in the KIT receptor tyrosine kinase in testicular germ-cell tumors (TGCT). To investigate further the potential role of mutated protein kinases in the development of TGCT and to characterize the prevalence and patterns of point mutations in these tumors, we have sequenced the coding exons and splice junctions of the annotated protein kinase family of 518 genes in a series of seven seminomas and six nonseminomas. Our results show a remarkably low mutation frequency, with only a single somatic point mutation, a K277E mutation in the STK10 gene, being identified in a total of more than 15 megabases of sequence analyzed. Sequencing of STK10 in an additional 40 TGCTs revealed no further mutations. Comparative genomic hybridization and LOH analysis using SNP arrays demonstrated that the 13 TGCTs mutationally screened through the 518 protein kinase genes were uniformly aneuploid with consistent chromosomal gains on 12p, 8q, 7, and X and losses on 13q, 18q, 11q, and 4q. Our results do not provide evidence for a mutated protein kinase implicated in the development of TGCT other than KIT. Moreover, they demonstrate that the general prevalence of point mutations in TGCT is low, in contrast to the high frequency of copy number changes., (Copyright 2005 Wiley-Liss, Inc)

Protein kinases are frequently mutated in human cancer and inhibitors of mutant protein kinases have proven to be effective anticancer drugs. We screened the coding sequences of 518 protein kinases (approximately 1.3 Mb of DNA per sample) for somatic mutations in 26 primary lung neoplasms and seven lung cancer cell lines. One hundred eighty-eight somatic mutations were detected in 141 genes. Of these, 35 were synonymous (silent) changes. This result indicates that most of the 188 mutations were "passenger" mutations that are not causally implicated in oncogenesis. However, an excess of approximately 40 nonsynonymous substitutions compared with that expected by chance (P = 0.07) suggests that some nonsynonymous mutations have been selected and are contributing to oncogenesis. There was considerable variation between individual lung cancers in the number of mutations observed and no mutations were found in lung carcinoids. The mutational spectra of most lung cancers were characterized by a high proportion of C:G > A:T transversions, compatible with the mutagenic effects of tobacco carcinogens. However, one neuroendocrine cancer cell line had a distinctive mutational spectrum reminiscent of UV-induced DNA damage. The results suggest that several mutated protein kinases may be contributing to lung cancer development, but that mutations in each one are infrequent.

We examined the coding sequence of 518 protein kinases, approximately 1.3 Mb of DNA per sample, in 25 breast cancers. In many tumors, we detected no somatic mutations. But a few had numerous somatic mutations with distinctive patterns indicative of either a mutator phenotype or a past exposure.