Search

Should teachers have complete autonomy over teaching methods and practices, or should some aspects of their practice be determined by school or government policy? We address this question using repeated (value-added) maths test scores linked to rich survey data from the TALIS video study. With the possible exception of inexperienced teachers, we generally find no relationship between teacher autonomy and pupil outcomes (test scores, maths self-efficacy or interest in maths). In partial contrast with our findings for pupil outcomes, teachers with very low levels of autonomy are more likely to report reduced job satisfaction. It may hence be that some level of restriction on teacher autonomy is justified, especially among inexperienced teachers, particularly when it represents only partial control of teachers' approaches in the classroom and is done to introduce evidence-based methods.

Background We started a primary care residency program intended to prepare graduates for primary care and increase entry into primary care, using time-limited funds from the Health Resources and Services Administration (HRSA). Objective To compare the graduates of the primary care residency program to their categorical peers, and whether they remained in the state, began primary care careers, and whether they identified as underrepresented in medicine. Methods This is a retrospective study of a cohort of 39 residents who graduated from the University of North Carolina primary care residency program from 2014-2023. In 2016, HRSA grant funding expired and the program continued with ongoing financial support from the 2 institutions. Graduate demographics and career choices were compared to categorical residents (159 total) for graduate years 2014 to 2023. Results The primary care pediatrics residency has graduated 39 residents to date. Job placement data was obtained for all 39 graduates. Graduates of the program have 5.5-fold greater odds (95% CI, 2.5-12.5) of working in primary care roles following graduation than peer categorical residents. Most graduates (33 of 39, 85%) have taken jobs in general pediatrics (including primary care, urgent care, adolescent medicine, or hospital medicine). The program has recruited a large proportion of its residents (12 of 39, 31%) from groups historically underrepresented in medicine. Conclusions We developed an innovative primary care pediatric residency in collaboration with a community partner, spurred by HRSA funds, that has trained a diverse group of new primary care pediatricians. [ABSTRACT FROM AUTHOR]

BACKGROUND: We sought to evaluate changes in In-Training Examination (ITE) scores and associations with clinical work during the COVID-19 pandemic. We hypothesized that residents saw a decrease in clinical encounters during the pandemic and that this would be associated with smaller gains in ITE scores. METHODS: We compared ITE score changes with data on patient notes for three classes of pediatric residents at four residency programs: one not exposed to the pandemic during their intern year who entered residency in 2018, one partially exposed to COVID-19 in March of their intern year (2019-2020), and one that was fully exposed to the pandemic, starting residency in June of 2020. RESULTS: ITE scores on average improved from the PGY1 to PGY2 year in the "no covid" and "partial COVID" cohorts. The "full COVID" cohort had little to no improvement, on average. The total number of patient encounters was not associated with a change in ITE scores from PGY1 to PGY2. There was a small but statistically significant association between change in ITE score and number of inpatient H+P notes. CONCLUSIONS: A drop in ITE scores occurred in pediatric residents who entered residency during the COVID-19 pandemic. This change was largely unrelated to clinical encounter number changes. [ABSTRACT FROM AUTHOR]

Humans regularly use all inner surfaces of the hand during manipulation, whereas traditional formulations for robots tend to use only the tips of their fingers, limiting overall dexterity. In this paper, we explore the use of the whole hand during spatial robotic dexterous within-hand manipulation. We present a novel four-fingered robotic hand called the Model B, which is designed and controlled using a straight-forward potential energy-based motion model that is based on the hand configuration and applied actuator torques. In this way the handobject system is driven to a new desired configuration, often through sliding and rolling between the object and hand, and with the fingers "caging" the object to prevent ejection. This paper presents the first ever application of the energy model in three dimensions, which was used to compare the theoretical manipulability of popular robotic hands, which then inspired the design of the Model B. We experimentally validate the hand's performance with extensive benchtop experimentation with test objects and real world objects, as well as on a robotic arm, and demonstrate complex spatial caging manipulation on a variety of objects in all six object dimensions (three translation and three rotation) using all inner surfaces of the fingers and the palm. [ABSTRACT FROM AUTHOR]

Should teachers have complete autonomy over teaching methods and practices, or should some aspects of their practice be determined by school or government policy? We address this question using repeated (value‐added) maths test scores linked to rich survey data from the TALIS video study. With the possible exception of inexperienced teachers, we generally find no relationship between teacher autonomy and pupil outcomes (test scores, maths self‐efficacy or interest in maths). In partial contrast with our findings for pupil outcomes, teachers with very low levels of autonomy are more likely to report reduced job satisfaction. It may hence be that some level of restriction on teacher autonomy is justified, especially among inexperienced teachers, particularly when it represents only partial control of teachers' approaches in the classroom and is done to introduce evidence‐based methods. [ABSTRACT FROM AUTHOR]

Intuitively, a speaker who uses slurs to refer to people is doing something morally objectionable even if no one is measurably affected by their speech. Perhaps they are only talking to themselves, or they are speaking with bigots who are already as vicious as they can be. This paper distinguishes between slurring as an expressive act and slurring as the act of causing a psychological effect. It then develops an expression-focused ethical account in order to explain the intuition that slurring involves an effect-independent moral wrong. The core idea is that the act of expressing a morally defective attitude is itself pro tanto morally objectionable. Unlike theories that focus only on problematic effects, this view is able to shift the moral burden of proof away from victims of slurring acts and onto speakers. It also offers moral guidance with respect to metalinguistic and pedagogical utterances of slurs. [ABSTRACT FROM AUTHOR]

Diseases occurring during pregnancy create a dilemma of managing the patient without causing harm to the unborn child. Three percent of the peak incidence of Hodgkin lymphoma (HL) is congruent with the reproductive period, particularly with pregnancy. Pregnant patients with HL always require a team of medical experts ranging from a medical oncologist, high-risk obstetrician, and neonatologist. Effective communication with both the patient and family is also necessary. The treatment goal for these patients should focus on achieving complete remission for the mother while permitting the delivery of a healthy child. Pregnant patients diagnosed with HL should undergo similar clinical investigations as other non-pregnant patients with accurate disease staging and appropriate non-radiation imaging such as ultrasound while avoiding invasive procedures. [ABSTRACT FROM AUTHOR]

Background: Technological advances have led to cancer prognostication that is increasingly accurate but often unalterable. However, a reliable prognosis of limited life expectancy can cause psychological distress. People should carefully consider offers of prognostication, but little is known about how and why they decide on prognostication. Using uveal melanoma (UM) patients, we aimed to identify (i) how and why do people with UM decide to accept prognostication and (ii) alignment and divergence of their decision‐making from conceptualizations of a 'well‐considered' decision. Methods: UM provides a paradigm to elucidate clinical and ethical perspectives on prognostication, because prognostication is reliable but prognoses are largely nonameliorable. We used qualitative methods to examine how and why 20 UM people with UM chose prognostication. We compared findings to a template of 'well‐considered' decision‐making, where 'well‐considered' decisions involve consideration of all likely outcomes. Results: Participants wanted prognostication to reduce future worry about uncertain life expectancy. They spontaneously spoke of hoping for a good prognosis when making their decisions, but largely did not consider the 50% possibility of a poor prognosis. When pressed, they argued that a poor outcome at least brings certainty. Conclusions: While respecting decisions as valid expressions of participants' wishes, we are concerned that they did not explicitly consider the realistic possibility of a poor outcome and how this would affect them. Thus, it is difficult to see their decisions as 'well‐considered'. We propose that nondirective preference exploration techniques could help people to consider the possibility of a poor outcome. Patient or Public Contribution: This paper is a direct response to a patient‐identified and defined problem that arose in therapeutic and conversational discourse. The research was informed by the responses of patient participants, as we used the material from interviews to dynamically shape the interview guide. Thus, participants' ideas drove the analysis and shaped the interviews to come. [ABSTRACT FROM AUTHOR]

Improvements in x-ray optics critically depend on the measurement of their optical performance. The knowledge of wavefront aberrations, for example, can be used to improve the fabrication of optical elements or to design phase correctors to compensate for these errors. At present, the characterization of such optics is made using intense x-ray sources, such as synchrotrons. However, the limited access to these facilities can substantially slow down the development process. Improvements in the brightness of lab-based x-ray micro-sources in combination with the development of new metrology methods, particularly ptychographic x-ray speckle tracking, enable characterization of x-ray optics in the lab with a precision and sensitivity not possible before. Here, we present a laboratory setup that utilizes a commercially available x-ray source and can be used to characterize different types of x-ray optics. The setup is used in our laboratory on a routine basis to characterize multilayer Laue lenses of high numerical aperture and other optical elements. This typically includes measurements of the wavefront distortions, optimum operating photon energy, and focal length of the lens. To check the sensitivity and accuracy of this laboratory setup, we compared the results to those obtained at the synchrotron and saw no significant difference. To illustrate the feedback of measurements on performance, we demonstrated the correction of the phase errors of a particular multilayer Laue lens using a 3D printed compound refractive phase plate. [ABSTRACT FROM AUTHOR]

Cell–cell signaling in microorganisms is still poorly characterized. In this Methods paper, we describe a genetic procedure for detecting cell-nonautonomous genetic effects, and in particular cell–cell signaling, termed the chimeric colony assay (CCA). The CCA measures the effect of a gene on a biological response in a neighboring cell. This assay can measure cell autonomy for range of biological activities including transcript or protein accumulation, subcellular localization, and cell differentiation. To date, the CCA has been used exclusively to investigate colony patterning in the budding yeast Saccharomyces cerevisiae. To demonstrate the wider potential of the assay, we applied this assay to two other systems: the effect of Grr1 on glucose repression of GAL1 transcription in yeast and the effect of rpsL on stop-codon translational readthrough in Escherichia coli. We also describe variations of the standard CCA that address specific aspects of cell–cell signaling, and we delineate essential controls for this assay. Finally, we discuss complementary approaches to the CCA. Taken together, this Methods paper demonstrates how genetic assays can reveal and explore the roles of cell–cell signaling in microbial processes. [ABSTRACT FROM AUTHOR]

Epigenetic therapy augments neoadjuvant chemotherapy (NACT) in breast cancer and may aid post-surgical wound healing affected by NACT. Our study investigates: (1) The cytotoxicity of classic paclitaxel chemotherapy on triple negative breast cancer (TNBC) independently and in combination with epigenetic drugs. (2) The sustainable inhibition of breast cancer regrowth following paclitaxel and epigenetic therapies. (3) The effects of paclitaxel with and without epigenetic therapy on the post-treatment viability and wound healing potential of adipose stem cells (ASCs). Cytotoxicity assays were performed on TNBC and ASCs. Cells were treated and recovered in drug-free medium. Cell viability was measured via cell counts and MTT assays. W -ound healing was tested with scratch assays. The combination of epigenetic drugs shows increased toxicity against TNBC cells compared to standard chemotherapy alone. Moreover, the combination of paclitaxel with epigenetic treatments causes cancer toxicity that is sustainable to TNBC cells after the drugs' removal with minimal effect on ASCs wound healing ability. The use of epigenetic drugs in addition to standard chemotherapy is cytotoxic to TNBC cells and prevents post-treatment recovery of TNBC while maintaining ASC wound healing ability. This strategy may be useful in maximizing post-surgical wound healing following NACT in TNBC. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has led to enormous practical and emotional challenges for healthcare workers globally, including NHS staff. Psychological support provisions have been established by an NHS healthcare trust in the North of England, including 1:1 psychological support provided by the in-house psychology team. This study sought to understand how staff experienced the service, what worked well and what could be improved. Five participants who had accessed the staff support service took part in semi-structured interviews. Data were analysed using Interpretative Phenomenological Analysis (IPA). Three main themes emerged from the data: 'The need for a flexible, responsive approach', 'Individual and group benefits' and 'The future of staff support: "we need to invest in staff mentally"'. Accessing the service was seen as personally and professionally rewarding for the NHS staff interviewed. These findings are discussed in relation to the relevant literature. Clinical implications, methodological limitations and directions for future research are discussed. [ABSTRACT FROM AUTHOR]

Learning accurate representations of robot models remains a challenging problem, and is typically approached though large, system-specific feature sets. This method inherently introduces practical shortcomings, as interpretability and transferability of the learned model typically decreases as more features are introduced into the learning framework in order to handle increasing task complexity. In this article, we examine the problem of developing transferable learned models for dexterous manipulation that are able to accurately predict the behavior of physically distinct systems without retraining. We introduce the notion of learning from visually-extracted grasp mechanics-based features, which are formulated by combining geometrically-inspired, analytical representations of the gripper into the feature set to more holistically represent the state of varied systems performing manipulation. We characterize the added utility of using such features through simulation and incorporate them into a classifier to predict specific phenomena, or modes of manipulation, that occur during prehensile within-hand movement. Four modes of manipulation—normal (rolling contact), drop, stuck, and sliding—are defined, collected physically, and trained via a self-supervised learning approach. The classifier is first trained on a single sensorless underactuated hand variant for all four modes. We, then, investigate the transferability of the learned classifier on five different planar gripper variants—analyzing applicability of this approach with both online and offline evaluation. [ABSTRACT FROM AUTHOR]

Developmental trajectories regarding the age onset of violence and offending have not routinely considered the role of major mental illness (MMI). In parallel, despite several studies investigating the relationship between MMI, violence and offending, fewer have identified motivational processes that may link illness to these outcomes in a more direct and proximal manner. This study investigates whether subtypes of forensic psychiatric patients deemed Not Criminally Responsible on account of Mental Disorder (N = 91) can be identified based on the age onset of mental illness and offending behavior, and whether information on motivational influences for offending—elicited both from the patient directly and detailed collateral information—contributes to the clinical utility of this typology. Results indicated that most patients reported engaging in violence (51%) or antisocial behaviors (72%) prior to the onset of MMI, but that the index offense(s) resulting in forensic admission were predominantly psychotically motivated. In contrast to patients for whom the onset of MMI occurred prior to offending, patients exhibiting premorbid violence had higher levels of risk and criminogenic need; they were more likely to be diagnosed with personality and substance use disorders, and to have conventional (i.e., non-illness-related) motivations ascribed to their index offense. Findings are consistent with the existing literature regarding subgroups of mentally disordered offenders, but provide new information regarding proximal risk factors for violence through better identification of motivational processes. [ABSTRACT FROM AUTHOR]

Background: Newly emerged mutations within the Plasmodium falciparum chloroquine resistance transporter (PfCRT) can confer piperaquine resistance in the absence of amplified plasmepsin II (pfpm2). In this study, we estimated the prevalence of co-circulating piperaquine resistance mutations in P. falciparum isolates collected in northern Cambodia from 2009 to 2017.Methods: The sequence of pfcrt was determined for 410 P. falciparum isolates using PacBio amplicon sequencing or whole genome sequencing. Quantitative polymerase chain reaction was used to estimate pfpm2 and pfmdr1 copy number.Results: Newly emerged PfCRT mutations increased in prevalence after the change to dihydroartemisinin-piperaquine in 2010, with >98% of parasites harboring these mutations by 2017. After 2014, the prevalence of PfCRT F145I declined, being outcompeted by parasites with less resistant, but more fit PfCRT alleles. After the change to artesunate-mefloquine, the prevalence of parasites with amplified pfpm2 decreased, with nearly half of piperaquine-resistant PfCRT mutants having single-copy pfpm2.Conclusions: The large proportion of PfCRT mutants that lack pfpm2 amplification emphasizes the importance of including PfCRT mutations as part of molecular surveillance for piperaquine resistance in this region. Likewise, it is critical to monitor for amplified pfmdr1 in these PfCRT mutants, as increased mefloquine pressure could lead to mutants resistant to both drugs. [ABSTRACT FROM AUTHOR]

De novo mutations are central for evolution, since they provide the raw material for natural selection by regenerating genetic variation. However, studying de novo mutations is challenging and is generally restricted to model species, so we have a limited understanding of the evolution of the mutation rate and spectrum between closely related species. Here, we present a mutation accumulation (MA) experiment to study de novo mutation in the unicellular green alga Chlamydomonas incerta and perform comparative analyses with its closest known relative, Chlamydomonas reinhardtii. Using whole-genome sequencing data, we estimate that the median single nucleotide mutation (SNM) rate in C. incerta is μ  = 7.6 × 10−10, and is highly variable between MA lines, ranging from μ  = 0.35 × 10−10 to μ  = 131.7 × 10−10. The SNM rate is strongly positively correlated with the mutation rate for insertions and deletions between lines (r  >   0.97). We infer that the genomic factors associated with variation in the mutation rate are similar to those in C. reinhardtii , allowing for cross-prediction between species. Among these genomic factors, sequence context and complexity are more important than GC content. With the exception of a remarkably high C→T bias, the SNM spectrum differs markedly between the two Chlamydomonas species. Our results suggest that similar genomic and biological characteristics may result in a similar mutation rate in the two species, whereas the SNM spectrum has more freedom to diverge. [ABSTRACT FROM AUTHOR]

Bicuspid aortic valve and coarctation of the aorta are risk factors for infective endocarditis and endarteritis. We describe a case of a 4-year-old boy whose severe aortic coarctation was diagnosed only when he presented with endarteritis due to Streptococcus pneumoniae , which evolved into a mycotic pseudoaneurysm requiring urgent repair. • Mycotic (pseudo-)aneurysm of the aorta is very rare in children but is associated with aortic coarctation. • Prompt recognition is important, as surgical repair is usually required. • Sensitivity of transthoracic echocardiography is limited so multimodal imaging is useful for diagnosis. • We describe a case of mycotic pseudoaneurysm due to a non-vaccine strain of Streptococcus pneumoniae in a 4 year old boy. [ABSTRACT FROM AUTHOR]