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Objectives/Goals: A summer research program for medical students was implemented using real-world evidence (RWE) – electronic health record (EHR) databases to develop and answer research questions. Medical students were trained in capabilities of traversing the large RWE-EHR so they may query, extract, and analyze data as well as refine their research questions. Methods/Study Population: Ten medical students and 9 non-data scientist mentors underwent training in how to use the IU School of Medicine-Evansville RWEdataLab (CRC/Sidus Insights) national real-world cardiology and psychiatry deidentified EHR databases. The program began with students attending introductory training teaching database, spreadsheet, and statistical program usage. During the remainder of the program, a weekly best practices meeting took place among mentors and a weekly cohort meeting of students and mentors discussed student presented findings. At the end of the program, students generated abstracts and poster or podium presentations to share their findings at local symposia. A survey was also distributed to students to assess the impact of the tools, trainings, and program. Results/Anticipated Results: All students were able to define a question of interest, query and extract data related to their research question, and analyze multiple aspects of their data. Projects were well received at local symposia, with 2 receiving special honors, and 2 projects have been presented at regional/national conferences. Students rated the program highly and were likely to recommend the program to other students. They self-rated improvements in asking scientific questions, using excel, data presentations, and problem-solving. Students valued weekly “check-in” meetings and interactions with mentors more than lectures or technical “help desk” support. Discussion/Significance of Impact: The program provides mechanisms for non-data scientists and medical trainees, to learn and access RWE-EHR databases to address research questions. The cohort interactions fostered discussion among mentors and students promoting research question refinement and clarity findings. The program also introduces a new tool for potential patient care.
A simple procedure for testing heterogeneity of variance is developed which generalizes readily to complex, multi-factor experimental designs. Monte Carlo Studies indicate that the Z-variance test statistic presented here yields results equivalent to other familiar tests for heterogeneity of variance in simple one-way designs where comparisons are feasible. The primary advantage of the Z-variance test is in the analysis of factorial effects on sample variances in more complex designs. An example involving a three-way factorial design is presented.
A method of computing ΣX, ΣX2, ΣXY and higher moments on IBM equipment is described. The basic method is that of successively summary punching, collating a variable number of blank cards behind these summary cards, gang-punching the data from the summary cards into the blank cards, and totalling the entries on these summary cards. The method appears to have several advantages over those previously described, especially if coded data are used.
The Students Participating as Ambassadors for Research in Kentucky (SPARK) program provides novel health equity research training and targeted mentorship for undergraduates, particularly those from groups underrepresented in the biomedical and behavioral research and workforce. SPARK aims to address inadequate diversity in the medical and scientific research fields by providing comprehensive research mentorship and skill-building. Unlike most existing research training programs that are brief, focus on laboratory research, or are limited to graduate students and junior faculty, SPARK delivers a 16-month intensive behavioral and population health science training, equipping students with needed tools to conceptualize, plan, execute, and analyze their own health equity research study. Trainees complete didactic coursework on health equity, study design and proposal development, data analysis, and ethics. Students receive a stipend and research expenses, and multiple mentors guide them in creating original research projects for which they serve as Principal Investigator. Students disseminate their findings annually at an academic research conference as a capstone. Evaluation data from the first three cohorts suggest SPARK has been pivotal in preparing students for graduate studies and research careers in health equity and behavioral and population health sciences, providing strong support for further investments in similar undergraduate research training models.
The expensive-tissue hypothesis (ETH) posited a brain–gut trade-off to explain how humans evolved large, costly brains. Versions of the ETH interrogating gut or other body tissues have been tested in non-human animals, but not humans. We collected brain and body composition data in 70 South Asian women and used structural equation modelling with instrumental variables, an approach that handles threats to causal inference including measurement error, unmeasured confounding and reverse causality. We tested a negative, causal effect of the latent construct ‘nutritional investment in brain tissues’ (MRI-derived brain volumes) on the construct ‘nutritional investment in lean body tissues’ (organ volume and skeletal muscle). We also predicted a negative causal effect of the brain latent on fat mass. We found negative causal estimates for both brain and lean tissue (−0.41, 95% CI, −1.13, 0.23) and brain and fat (−0.56, 95% CI, −2.46, 2.28). These results, although inconclusive, are consistent with theory and prior evidence of the brain trading off with lean and fat tissues, and they are an important step in assessing empirical evidence for the ETH in humans. Analyses using larger datasets, genetic data and causal modelling are required to build on these findings and expand the evidence base.
The washing of synthetic materials has been named as the largest contributor of microplastic pollution to our oceans. With the consumption of petrochemical-based synthetic materials expected to grow, due to an increased demand, the release of microplastic fibres to our environments is expected to also accelerate. To combat microplastic fibre release, this study explores source-directed interventions within the design and manufacturing process of textiles to reduce the amount of pollution released from the surface and the edges of the fabric structure. Using standardised wash tests and polyester fabric swatches that were created in-house with systematic structural adjustments, single jersey knit fabrics were shown to release over three times more microplastic pollution than twill woven fabric. This illustrates that increasing the tightness of a fabric could be implemented within the design of fabrics for environmental benefits. Additionally, the laser cutting technique reduced microplastic fibres released by over a third compared to scissor cutting and overlock serging, showing that the edge of the fabric is a significant source of microplastic pollution released during laundering. This research highlights the adaptable and innovative eco-design approaches to clothing production which is necessary to help the sector reach international sustainability targets and regulations.
Globally, human rights violations experienced by persons with psychosocial, intellectual or cognitive disabilities continue to be a concern. The World Health Organization's (WHO) QualityRights initiative presents practical remedies to address these abuses. This paper presents an overview of the implementation of the initiative in Ghana.
Aims
The main objective of the QualityRights initiative in Ghana was to train and change attitudes among a wide range of stakeholders to promote recovery and respect for human rights for people with psychosocial, intellectual and cognitive disabilities.
Method
Reports of in-person and online training, minutes of meetings and correspondence among stakeholders of the QualityRights initiative in Ghana, including activities of international collaborators, were analysed to shed light on the implementation of the project in Ghana.
Results
In-person and online e-training on mental health were conducted. At the time of writing, 40 443 people had registered for the training, 25 416 had started the training and 20 865 people had completed the training and obtained a certificate. The team conducted 27 in-person training sessions with 910 people. The successful implementation of the project is underpinned by a committed partnership among stakeholders, strong leadership from the coordinating agency, the acceptance of the initiative and the outcome. A few challenges, both in implementation and acceptance, are discussed.
Conclusions
The exposure of the WHO QualityRights initiative to a substantial number of key stakeholders involved in mental healthcare in Ghana is critical to reducing human rights abuses for people with psychosocial, intellectual and cognitive disabilities.
Both Apolipoprotein z4 (APOz4) and Brain-Derived Neurotropic Factor val66met (BDNF-met) have been implicated as cognitive risk polymorphisms and may signal a more rapid trajectory of cognitive decline (Boots et al., 2017; Lim et al., 2015). The presence of both risk alleles may additively result in greater cognitive difficulties (Cechova et al., 2020), specifically executive functioning (Sapkota et al., 2017). As executive functioning difficulties can be associated with Posttraumatic Stress Disorder (PTSD; Woon et al., 2017), individuals with PTSD who carry these polymorphisms may be at higher risk for decline in executive functioning. In this study, we examined the cross-sectional and longitudinal impact of these alleles on executive functioning performance in Veterans with PTSD.
Participants and Methods:
Seventy community-dwelling male Veterans were enrolled as part of a larger study at VAPAHCS and consented to genetic analysis. A current or lifetime history of PTSD (score > 40 on the CAPS-IV; Blake et al., 1995) was required for study participation. Trail Making Test B (TMT-B; Army Individual Test Battery, 1994) was used to assess executive functioning. TMT-B was part of a comprehensive neuropsychological battery administered at baseline and yearly over the following three years. Mean age and education were 61 years old (SD = 4.5; range = 55-78) and 14 years (SD = 2.3; range = 8-20), respectively.
The majority of the sample was White (71%) and were from the Korean and Vietnam War eras.
Results:
APOz4 and BDNF-met were present in 29% and 27% of the sample, respectively; both were present in six participants. Regression models were fitted separately for TMT-B raw time-to-complete and number of errors, both cross-sectionally at screening and then longitudinally. The presence of BDNF-met was a significant predictor of TMT-B time and number of errors in both models (Time: ß = 0.09, p = 0.03 and ß = 0.11, p < 0.01; Errors: IRR = 2.4, p = 0.01 and IRR = 1.9, p = 0.01), while APOz4 only predicted errors longitudinally (IRR = 1.8, p = 0.03). There was no significant allelic interaction; however, the presence of both alleles additively multiplied TMT-B errors by approximately 3.7 times at screening (IRR = 3.7; p = 0.01) and 3.3 times longitudinally (IRR = 3.3; p < 0.01).
Conclusions:
Altogether, these results are suggestive of an adverse, additive, effect of the APOz4 and BDNF-met polymorphisms on executive functioning, in particular error-proneness, with their combined presence tripling the errors made on TMT-B cross-sectionally and longitudinally. Consistent with previous research, the TMT-B error analysis increases detection of cognitive impairment, similar to other clinical samples (Varjacic et al., 2018). While TMT-B errors are typically interpreted qualitatively, the strong effect of these established risk alleles on error rates further support this metric as a clinically useful indicator of executive dysfunction in a PTSD population. In keeping with the Boston Process approach, these findings support the importance of error analysis in clinical interpretation of neuropsychological performance.
Affective disturbances in schizophrenia and bipolar disorder may represent a transdiagnostic etiological process as well as a target of intervention. Hypotheses on similarities and differences in various parameters of affective dynamics (intensity, successive/acute changes, variability, and reactivity to stress) between the two disorders were tested.
Methods
Experience sampling method was used to assess dynamics of positive and negative affect, 10 times a day over 6 consecutive days. Patients with schizophrenia (n = 46) and patients with bipolar disorder (n = 46) were compared against age-matched healthy controls (n = 46).
Results
Compared to controls, the schizophrenia group had significantly more intense momentary negative affect, a lower likelihood of acute changes in positive affect, and reduced within-person variability of positive affect. The bipolar disorder group was not significantly different from either the schizophrenia group or the healthy control group on any affect indexes. Within the schizophrenia group, level of depression was associated with weaker reactivity to stress for negative affect. Within the bipolar disorder group, level of depression was associated with lower positive affect.
Conclusions
Patients with schizophrenia endured a more stable and negative affective state than healthy individuals, and were less likely to be uplifted in response to happenings in daily life. There is little evidence that these affective constructs characterize the psychopathology of bipolar disorder; such investigation may have been limited by the heterogeneity within group. Our findings supported the clinical importance of assessing multiple facets of affective dynamics beyond the mean levels of intensity.
Includes 'The Assessment of Knight Service in Bedfordshire, no. 2', by John E. Morris. 'St. John of SouthilI', by F. A. Page-Turner. 'Some Saxon Charters', by G. Herbert Fowler. 'A Late Example of a Deodand', by William Austin. 'Domesday Notes II: Kenemondwick', by G. Herbert Fowler. 'The Hillersdens of Elstow', by F. A. Page-Turner. 'Grant of Free Warren to Newnham Priory', by J. Hamson. 'Cutenho, Farley Hospital, and Kurigge', by William Austin. 'Munitions in 1224', by G. Herbert Fowler. 'The Becher Family of Howbury', by F. A. Page-Turner. 'Yttingaford and the Tenth-Century Bounds of Chalgrave and Linslade,’ by Frederick G. Gurney. 'The Paper Register of St. Mary's Church in Bedford, 1539-1558', by the Rev. A. G. Kealey. 'Calendar of Inquisitions Post Mortem No. I,’ by G. Herbert Fowler. 'Notes and queries: Information requested on some Anglo-Saxon charters; ancient parish maps; Simon Fitz; and healing wells.'.
People often perform poorly on stock-flow reasoning tasks, with many (but not all) participants appearing to erroneously match the accumulation of the stock to the inflow – a response pattern attributed to the use of a “correlation heuristic”. Efforts to improve understanding of stock-flow systems have been limited by the lack of a principled approach to identifying and measuring individual differences in reasoning strategies. We present a principled inferential method known as Hierarchical Bayesian Latent Mixture Models (HBLMMs) to analyze stock-flow reasoning. HBLMMs use Bayesian inference to classify different patterns of responding as coming from multiple latent populations. We demonstrate the usefulness of this approach using a dataset from a stock-flow drawing task which compared performance in a problem presented in a climate change context, a problem in a financial context, and a problem in which the financial context was used as an analogy to assist understanding in the climate problem. The hierarchical Bayesian model showed that the proportion of responses consistent with the “correlation heuristic” was lower in the financial context and financial analogy context than in the pure climate context. We discuss the benefits of HBLMMs and implications for the role of contexts and analogy in improving stock-flow reasoning.
This volume of translations unites three shorter works by Arthur Schopenhauer that expand on themes from his book The World as Will and Representation. In On the Fourfold Root he takes the principle of sufficient reason, which states that nothing is without a reason why it is, and shows how it covers different forms of explanation or ground that previous philosophers have tended to confuse. Schopenhauer regarded this study, which he first wrote as his doctoral dissertation, as an essential preliminary to The World as Will. On Will in Nature examines contemporary scientific findings in search of corroboration of his thesis that processes in nature are all a species of striving towards ends; and On Vision and Colours defends an anti-Newtonian account of colour perception influenced by Goethe's famous colour theory. This is the first English edition to provide extensive editorial notes on the different published versions of these works.