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Coolah Tops is an isolated high elevation mesic refuge on the dry western slopes of the Great Dividing Range in New South Wales, eastern Australia. Field surveys of the land snail fauna of Coolah Tops National Park in 2000–2001 and 2018 sampled 28 sites between 556 and 1234 m elevation (Australian Height Datum). Over 1200 specimens in total were collected and were assigned to 29 species or morpho-species in six families. Seven taxa are currently known only from Coolah Tops. Preliminary assessment of five of these concluded they meet IUCN criteria for endangered status. The land snail community of the Coolah Tops highland area is threatened by anthropogenic climate change and is considered to be of outstanding conservation value. [ABSTRACT FROM AUTHOR]

The purpose of this study was to determine if strategic placement of portable air purifiers would improve effectiveness of aerosol reduction in a space as compared to use as a general room air purifier. Two sizes of portable air purifiers were placed in two different positions intended to function similar to either a local exhaust ventilation hood or an air curtain to determine if strategic placement would lead to a reduction of particles in a worker's position at a desk in an office environment. Particle generators were used to introduce particulate into the air and personal aerosol monitors measured particles during each test condition. Results showed that when the medium room portable air purifiers used in this study were set to high, corresponding to 98 CFM, and placed near the breathing zone of each office worker with the unit's filter cover removed, the particle concentration was reduced 35% beyond the reduction that would be expected if the same units were placed on the floor behind the occupant's workstation. Results also indicated that the larger portable air purifier tested, positioned as close as reasonable to each occupant's breathing zone with the largest capture area possible (i.e., removing the unit's filter cover), delivers the best aerosol reduction performance. The authors concluded that as a layer of protection against transmission of airborne infectious organisms for office occupants, installing a portable air purifier, sized and operated similar to the units tested in this study on the desk 12 inches from the breathing zone of the worker, has the potential to reduce airborne particulate to a greater degree than if the same units were placed outside of the breathing zone, in the general cubicle area. [ABSTRACT FROM AUTHOR]

A company COVID-19 Heating, Ventilation, and Air Conditioning Guideline was implemented globally, as part of a larger control measure toolset, to minimize the potential for SARS-CoV-2 aerosol transmission. The COVID-19 Heating, Ventilation, and Air Conditioning Guideline informed and provided the process to optimize existing ventilation systems, set occupancy duration limits, and set clearance periods for a given space. Aerosol transmission modeling was used extensively to determine space limitations to reduce the potential for aerosol transmission in various manufacturing, lab, warehouse, aircraft, and administrative workspaces. This paper focuses on the modeling completed for administrative spaces (e.g., offices, conference rooms, restrooms, elevators) due to their lower ventilation rates, higher occupant densities, and greater vocalization levels. A detailed description of how the Guideline was implemented, with examples showing the evaluation and determinations made for specific spaces, is provided. World-wide implementation of this Guideline, as one of the layers of protection, was a key component in the overall strategy to reduce aerosol transmission of the SARS-CoV-2 virus. [ABSTRACT FROM AUTHOR]

Murphy MJJ, Sivarajah B, Grégoire DC, Vermaire JC. 2022. Assessing the ecological responses of a shallow mesotrophic lake to multiple environmental stressors using paleolimnological techniques. Lake Reserv Manage. 38:67–79. White Lake, located in southeastern Ontario, Canada is a long, shallow, multibasin lake that supports recreational activities year-round and has 1538 private and commercial dwelling units. The construction of a dam at Waba Creek in 1845 resulted in the minimum water level at White Lake increasing by ∼1.5 m, and several water-level management strategies have been implemented since the mid 20th century. The lake has also been impacted by land-clearance activities and shoreline development along the eastern shores and is presently mesotrophic. More recently, White Lake was colonized by zebra mussels (Dreissena polymorpha) in 2015, and annual algal blooms have also been observed. In this paleolimnological study, diatom-based approaches and loss on ignition were used to track past changes in water quality and sediment characteristics, respectively, to inform the White Lake Property Owners Association's ongoing lake monitoring program. The diatom-inferred total phosphorus (DI-TP) reconstruction suggests that White Lake has been mesotrophic (DI-TP range 11.5 − 17 µg/L) over the past ∼200 years. Notable changes in the diatom assemblages and declines in sedimentary organic content were recorded around the 1890s in the sediment core retrieved near Hardwood Island. The decrease in sedimentary organic content was likely a response to early land-clearance activities around the lake as erosion often leads to greater inorganic export from the catchment to the lake. The switch among benthic fragilarioid diatom taxa suggests that the light conditions at this shallow lake may have changed in response to higher allochthonous inputs. Continuous monitoring of White Lake is needed to ensure that the cumulative impacts from emerging environmental stressors (e.g., climate-mediated changes, invasion by dreissenids) are considered when making management decisions. [ABSTRACT FROM AUTHOR]

Our findings demonstrate the persistence and widening of geographic disparities in dupilumab access over time and may provide a useful baseline for evaluating the future impact of newly approved therapies on the AD treatment landscape. Our study is limited in that geographic and specialty data were only available for prescribers with >=10 dupilumab claims submitted to Medicare and that the Medicare population may not be the main users of dupilumab in the USA. Trends in the total number of prescribers, beneficiaries, claims, and total cost of dupilumab in the Medicare population from 2017 to 2019. [Extracted from the article]

Mount Kaputar is an isolated high-elevation mesic refuge on the dry inland western slopes of eastern Australia's Great Dividing Range. A field survey in Mount Kaputar National Park in 2007–2014, and collation of existing information, identified a native land snail fauna of 24 species (seven families), including nine endemic taxa and another two occurring as disjunct populations. Additional species probably remain to be identified. Two introduced species of agriolimacid slugs were also recorded. Information from this study was the basis of the successful listing of an endangered land snail community at Mount Kaputar under state threatened species legislation in 2013; the first legal listing of an endangered land snail community in Australia. The recognition of endangered communities is a useful intermediate scale between the extremes of the single-species and broad-landscape conservation approaches, and has significant potential for multi-species conservation initiatives for terrestrial gastropods. Anthropogenic climate change is the most significant threat to this community, with a 100 m rise in environmental envelope likely to reduce the available area of habitat by over 50%. This community, and, in particular, a bright pink endemic athoracophorid slug, is contributing to raising public awareness of the threat to global biodiversity from anthropogenic climate change. [ABSTRACT FROM PUBLISHER]

The Pilliga forest in northern inland New South Wales, Australia, is one of the largest surviving remnants of native forest on the western slopes of the Great Dividing Range. The Pilliga landscape is a challenging environment for molluscs, dominated by dry sclerophyll forest and with limited and largely ephemeral aquatic habitats. A field survey of the area in 2006–2012 identified a surprisingly rich and relatively intact aquatic native molluscan fauna with five species of bivalves in three families and nine species of freshwater gastropods (four families), including some rare species and range extensions. The native land snail fauna comprised 18 species (six families), including an unusually rich pupillid fauna with nine species. Some range extensions are recorded and some species are narrow-range endemics. The distributions of many aquatic and terrestrial species were correlated with geology or soil type. Introduced molluscs were predominantly found in anthropogenic habitats and include two freshwater gastropods (two families) and nine terrestrial snails and slugs (eight families). This study provides insight into the original molluscan fauna of the western slopes prior to landscape-scale agricultural development and provides a benchmark for future reference. [ABSTRACT FROM PUBLISHER]

Background Primary hyperparathyroidism (PHPT) is associated with insulin resistance and an increased cardiovascular mortality. We aimed to see if parathyroidectomy improved insulin resistance. Methods Twelve PHPT patients undergoing parathyroidectomy and ten control patients undergoing non-neck surgery were recruited to the study. Fasting venous blood samples were collected immediately pre-operatively and again at five to six weeks post-operatively. Samples were assayed for plasma glucose, serum insulin, total cholesterol, triglycerides, calcium, alkaline phosphatase, magnesium, parathyroid hormone (PTH), and haemoglobin A1c (HbA1c). Insulin resistance was calculated from fasting insulin and glucose values using Homeostasis Model Assessment (HOMA). Results Parathyroidectomy decreased serum calcium (mean pre-op = 2.85 mmol/L, post-op 2.28 mmol/L, P < 0.001) and PTH concentrations (mean pre-op = 23.33 pmol/L, post-op = 10.23 pmol/L, P < 0.001) and increased phosphate concentration. However, there was no improvement in insulin resistance in the PHPT group at between 5 and 6 weeks post-operatively (geometric mean; pre-op = 0.88 (95% CI 0.59 – 1.33) vs. post-op = 0.88 (0.66 – 1.17) P = 0.95). In the control group, an increase in serum calcium was observed post-operatively (mean pre-op = 2.29 mmol/L, post-op = 2.35 mmol/L, P = 0.03). No change in insulin resistance was observed (geometric mean; pre-op = 1.37 (95% CI 0.89 – 2.11) vs. post-op = 1.38 (0.72 – 2.67) P = 0.96). Conclusion In summary, no significant change in insulin resistance post-parathyroidectomy in patients with PHPT was observed. This indicates that surgical treatment of PHPT does not improve insulin resistance for patients currently selected for parathyroidectomy. [ABSTRACT FROM AUTHOR]

Background: Supervisors of some student selected components (SSCs) may appear to give higher grades than others. It is not known if feedback can influence the behaviour of supervisors in the grades they award. We have introduced feedback letters in our institution. Aims: (1) To assess the feasibility of objectively identifying SSCs where grades awarded are consistently higher or lower than the average; (2) To assess the effect of feedback on the grades awarded by supervisors of SSCs. Methods: The breakdown of SSC grades was examined over four consecutive years, before and after feedback letters were introduced in 2005. The grades awarded globally, and in five individual SSCs, were compared using the χ2 goodness-of-fit test. Results: (1) Individual SSCs were identified which awarded grades that were consistently different from the average. (2) Overall grades awarded in 2003/04 and 2004/05 (before feedback) were similar (χ2= 0.37, df = 2, p = 0.83). Likewise, overall grades awarded in 2005/06 and 2006/07 (after feedback) were similar (χ2= 1.72, df = 2, p = 0.42). Comparison of 2003/04 with 2005/06 (χ2= 16.0, df = 2, p < 0.001), and 2006/07 (χ2= 26.6, df = 2, p < 0.001), and of 2004/05 with 2005/06 (χ2= 13.5, df = 2, p = 0.001), and 2006/07 (χ2= 23.7, df = 2, p < 0.001), revealed highly significant differences. The grades awarded after feedback were higher than the grades awarded before feedback. Conclusions: The χ2 goodness-of-fit test may be used to identify individual SSCs where the grades awarded are different from the average, although the interpretation of the results thus obtained is fraught with difficulty. Our data also suggest that it is possible to influence assessors in the grades they award. [ABSTRACT FROM AUTHOR]

Background: Student selected components (SSCs) are staff-designed modules selected by students from a menu of options provided separately from the 'core' curriculum. Students completing these do not always learn what teachers think they teach. Some medical schools also allow students to design their own modules. It is not known whether greater student input into planning of modules is associated with closer alignment of planned and learnt outcomes. Aims: To compare student perception of learning outcomes addressed by student-designed ('self-proposed') SSCs, before and after completion, using the 'Dundee learning outcomes' template that we apply to all components of the undergraduate curriculum. Methods: Students were required at the time of self-proposal, and subsequently as part of feedback on completed modules, to indicate which of twelve learning outcomes they felt were addressed by their self-proposed SSC. The χ2 test was used to compare student perceptions of learning outcomes before and after completion. Results: More students thought that learning outcome 10 (appropriate decision making skills, clinical reasoning and judgement) was addressed after completion than before (96.3% versus 90.0%, χ2 4.99, p = 0.02); for all other learning outcomes global perceptions were not significantly different after completion. Individual changes in perception ranged from 2.1% for outcome 12 (aptitude for personal development) to 19.6% for outcome 2 (competent to perform practical procedures). Conclusion: Greater student input into planning of modules is associated with closer alignment of planned and learnt outcomes. Our findings provide further evidence for the benefit of student-directed learning. [ABSTRACT FROM AUTHOR]

Background: Student Selected Components (SSCs) are an established feature of UK undergraduate medical curricula that offer students choice. They represent a large investment in time and resources. Although programmes vary between Schools, the major learning objectives remain broadly similar. Providing students engage fully with the activity, the final learning outcomes should also be comparable. However, engaging effectively and purposefully with such programmes may not be a clear and straightforward process for students. Aim: To present the challenges and solutions to inform students how to derive the greatest benefit from the learning activities in their SSC programmes. Methods: Synthesis of the accumulated experience over more than 10 years of developing, running and evaluating SSCs by the Directors of SSCs in five Scottish Medical Schools, combined with analysis of course evaluation and student feedback. Results: Consensus defined 12 tips aimed at improving the approach taken by students to their SSCs, and to provide a structure to maximise their final learning outcomes. Conclusion: SSC programmes provide diverse opportunities for students to develop and expand their learning. With increasing emphasis being placed upon student assessment to judge a wide range of professional skills and standards into foundation and specialist training, much greater importance is now being given to SSCs as an opportunity for personal, professional and academic developments. However, it is important that this is performed in a purposeful manner to maximise this opportunity. These 12 tips provide guidance to students on how they can maximise the opportunity presented to them by SSCs. [ABSTRACT FROM AUTHOR]

Background: It is well recognized that what teachers teach and what students learn may not be the same. This applies to all parts of the undergraduate medical curriculum, but may be especially relevant to student selected components, which vary substantially in their educational content. This has not been studied previously. Aims: To compare perceptions of students and supervisors in relation to learning outcomes addressed by student selected components, and thus to examine differences between what is taught and what is learned. Methods: Supervisors (n = 69) were asked to indicate which of twelve learning outcomes they felt were components of teaching and assessment. Upon completion of each SSC, students were required to complete the same outcomes template as part of their feedback (n = 644). Perceptions were compared in two ways: (1) a colour-coded 'traffic-light' system was used to record agreement/disagreement between students and supervisors of individual SSCs; (2) differences in perception of outcomes across the entire SSC programme were compared using the χ² statistic. Results: (1) The 'traffic-light' system readily identified individual SSCs where significant disagreement existed and which were subject to further scrutiny. (2) More students than supervisors thought that outcome 2 (competent to perform practical procedures) was a component of teaching and assessment (41.8% v 27.5%, χ² = 5.24, p = 0.02), whereas more supervisors than students thought that outcome 6 (competent in communication skills) (97.1% v 82.1%, χ² = 6.91, p = 0.009) and outcome 7 (competent to retrieve and handle information) (100% v 93.7%, χ² = 4.8, p = 0.02) were. Conclusions: Significant disagreement exists about the outcomes addressed by SSCs, suggesting that students do not always learn what teachers think they teach. The use of two complementary approaches allows global and individual comparisons to be drawn and thus provides a powerful tool to address this important issue. [ABSTRACT FROM AUTHOR]

Background: Student selected components (SSCs) represent a significant component of medical curricula in the UK and a new approach in medical education. Despite the prominence given to SSCs by the General Medical Council in each of its seminal papers regarding undergraduate medical education, there remains a diverse view of the purpose, outcomes, structure and assessment of SSCs. Many Schools have adopted their own perspective of SSCs and created different but often innovative courses. Aims: This article brings together the Scottish Medical Schools and their experience in organising SSCs, highlights some of the challenges and offers possible solutions to some of the difficulties encountered. Method: The SSC Director from each of the Scottish medical schools each contributed their own '12 Tips'. From these a consensus was achieved. Results: Even though the Scottish medical schools have a wide range of curriculum and timetable formats, there was a great deal of agreement in the challenges and problems encountered in their SSC programmes, as expressed through these 12 Tips. Conclusion: There is much diversity in SSC programmes at different medical schools, although there is also much commonality in the challenges that arise. We hope that this paper will promote thought and discussion amongst those involved, and be useful to those involved in curriculum and programme development and also to those new to medical education. [ABSTRACT FROM AUTHOR]

Focuses on the role of evaluation information in legislative decision making. Case study of a career ladder reform in the 1987 Utah legislative process; Career ladder program evaluation report; Impact of the report.

Abstract–A well-stirred combustor (WSC) was constructed capable of burning natural gas, and residual fuel oil at equivalence ratios of 0.4 to 1.8 and residence times of 50 or 175 ms. gold-flow tests verified the well-stirred condition. NOy emissions produced by burning these fuels in the WSC were higher than previous WSCs with 1-10 ms residence time, but generally lower than industrial boilers. [ABSTRACT FROM PUBLISHER]

Lay-flat plastic tubing can be used to fill ponds and avoid bank erosion. The lightweight plastic is tear-resistant and can be folded for transport or storage. [ABSTRACT FROM PUBLISHER]