Supporting the Biomedical Science UG Project Research Journey Through Staff-Student Partnerships.

Introduction: Developing research skills enhances graduate attributes and student employability. The UG research project is coined the pedagogy of the 21st century but the diversity of supervisory styles is a source of student perceived inequality of experience. The goal of this study was to provide structure and support to undergraduate (UG) biomedical science research students and supervisors by co-creating research informed resources that are accessible, engaging and student centred. We asked 1) How do UG students experience research supervision? 2) What approaches do supervisors use to support UG project students? 3) How do students as partners benefit from being involved in pedagogical research? Materials and Methods: In Stage One, 3 UG student research partners co-developed questionnaires and followed these up with semi-structured interviews. Fifty two UG project students took part in an interactive poll and 14 supervisors answered a questionnaire. Seven students and 4 supervisors were interviewed. These were analysed by thematic analysis. In Stage Two, the questions were asked of UG project students (n = 79) via an interactive poll and the resource developed in Stage One was trialled with students (n = 68) and supervisors (n = 37). Results: The global theme identified was that students feel strongly that the student-supervisor relationship influences their experience, satisfaction and success. In all polls, >90% of students but <60% of supervisors agree that a good student/supervisor partnership has an effect on the success of the final project. A smaller percentage of students felt strongly that they were able to develop a successful partnership with their supervisor. We co-created a visual model and a list of discussion points of how the student-supervisor partnership can be developed, aimed at making supervision more effective whilst being non-prescriptive. Discussion: The resource can be easily adapted. Students believe it helped them to develop a staff-student partnership and supervisors commented that it helps to clarify roles and manage student expectations. This scalable project will support the practice of future UG biomedical science project research students and supervisors. Working with students as partners enabled the development of richer ideas whilst supporting their employability.

Falling through the gap: Dental treatment experiences of patients affected by cleft lip and/or palate.

Introduction: In the UK, one in 600­700 infants is born with a cleft lip and/or palate (CL/P). Previous research has identified patients with CL/P to be at high risk of long-term oral health issues. Yet, few of these patients are currently accessing community dental care. Aims: To assess patients' dental treatment experiences and their suggestions for improving services. Materials and methods: Five focus groups were conducted with 24 adults with CL/P. Thematic analysis was performed on the data. Results: Participants perceived local dental practitioners to lack knowledge about CL/P and its treatment. Consequently, some participants had stopped visiting a dental practice altogether. Participants were also largely unaware of the specialist CL/P services they are entitled to. Discussion: Suggestions are made for the integration of improved training and resources for local dental practitioners. Closer communication between specialist cleft teams and local dental practitioners could also help to bridge the gap in knowledge and improve patients' engagement with dental services. The tertiary sector has a crucial role to play in empowering patients to take more control of their oral health and dental treatment.

Quality of questionnaires for the assessment of otitis media with effusion in children.

OBJECTIVES: Audiometric tests provide information about hearing in otitis media with effusion (OME). Questionnaires can supplement this information by supporting clinical history-taking as well as potentially providing a standardized and comprehensive assessment of the impact of the disease on a child. There are many possible candidate questionnaires. This study aimed to assess the quality and usability of parent / child questionnaires in OME assessment. DESIGN AND MAIN OUTCOME MEASURES: Fifteen, published questionnaires, commonly used in audiological departments (Auditory Behaviour in Everyday Life (ABEL), Children's Auditory Performance Scale (CHAPS), Children's Home Inventory for Listening Difficulties (CHILD), Children's Outcome Worksheets (COW), Evaluation of Children's Listening and Processing Skills (ECLiPS), Early Listening Function (ELF), Fisher's Auditory Problem Checklist (FAPC), Hearing Loss 7 (HL-7), Listening Inventory for Education- Revised (LIFE-R Student), Listening Inventory for Education UK Individual Hearing Profile (LIFE-UK IHP), LittlEARS Auditory Questionnaire (LittlEARS), Listening Situations Questionnaire (LSQ), Otitis Media 6 (OM-6), Quality of Life in Children's Ear Problems (OMQ-14), Parents' Evaluation of Aural/Oral Performance of Children (PEACH) were assessed according to the following 8 criteria: conceptual clarity, respondent burden, reliability, validity, normative data, item bias, ceiling/ floor effects, and administrative burden. RESULTS: ECLiPS, LittlEARS and PEACH scored highest overall based on the assessment criteria established for this study. None of the questionnaires fully satisfied all 8 criteria. Although all questionnaires assessed issues considered to be of at least adequate relevance to OME, the majority had weaknesses with respect to the assessment of psychometric properties, such as item bias, floor/ceiling effects or measurement reliability and validity. Publications reporting on the evaluation of reliability, validity, normative data, item bias and ceiling/floor effects were not available for most of the questionnaires. CONCLUSIONS: This formal evaluation of questionnaires, currently available to clinicians, highlights three questionnaires as potentially offering a useful adjunct in the assessment of OME in clinical or research settings. These were the ECLiPS, which is suitable for children aged 6 years and older, and either the LittlEARS or the PEACH for younger children. The latter two are narrowly focused on hearing, whereas ECLiPS has a broader focus on listening, language and social difficulties.

Treatment of inflammatory arthritis via targeting of tristetraprolin, a master regulator of pro-inflammatory gene expression.

OBJECTIVES: Tristetraprolin (TTP), a negative regulator of many pro-inflammatory genes, is strongly expressed in rheumatoid synovial cells. The mitogen-activated protein kinase (MAPK) p38 pathway mediates the inactivation of TTP via phosphorylation of two serine residues. We wished to test the hypothesis that these phosphorylations contribute to the development of inflammatory arthritis, and that, conversely, joint inflammation may be inhibited by promoting the dephosphorylation and activation of TTP. METHODS: The expression of TTP and its relationship with MAPK p38 activity were examined in non-inflamed and rheumatoid arthritis (RA) synovial tissue. Experimental arthritis was induced in a genetically modified mouse strain, in which endogenous TTP cannot be phosphorylated and inactivated. In vitro and in vivo experiments were performed to test anti-inflammatory effects of compounds that activate the protein phosphatase 2A (PP2A) and promote dephosphorylation of TTP. RESULTS: TTP expression was significantly higher in RA than non-inflamed synovium, detected in macrophages, vascular endothelial cells and some fibroblasts and co-localised with MAPK p38 activation. Substitution of TTP phosphorylation sites conferred dramatic protection against inflammatory arthritis in mice. Two distinct PP2A agonists also reduced inflammation and prevented bone erosion. In vitro anti-inflammatory effects of PP2A agonism were mediated by TTP activation. CONCLUSIONS: The phosphorylation state of TTP is a critical determinant of inflammatory responses, and a tractable target for novel anti-inflammatory treatments.

When ideas have sex: the role of exchange in cultural evolution.

Human economic and technological progress has been dominated for the last 100,000 years by natural selection among variants of cultures, rather than among variants of genes. Evidence suggests that cultural evolution depends on exchange and trade to bring together ideas in much the same way that genetic evolution depends on sex to spread genetic mutations, or in the case of bacteria, on horizontal gene transfer. When starved of access to a large "collective brain" by isolation from trade and exchange, people may experience not just less innovation, but even regress. The capacity for ideas to have sex on the Internet is likely to accelerate cultural evolution still further.

Effects of packaging environments on free radicals in gamma-irradiated UHMWPE resin powder blend with vitamin E.

Ultra-high molecular weight polyethylene (UHMWPE) powder (GUR 1020) was blended with high concentration (20%) of vitamin E (alpha-Tocopherol (alpha-T)) for direct detection of alpha-T radicals in presence of PE radicals. Samples were gamma-irradiated in sealed packages filled with N(2), or in open air. Free radicals were measured in open air environment for 71 days using electron spin resonance (ESR) technique. When irradiated in air, both alpha-T and alpha-T-resin produced identical ESR signals characteristics of tochopheroxyl radicals (alpha-T-O(*)), suggesting that PE radicals are quenched by alpha-T. There was no indication of growth of oxygen-induced radicals (OIR) either. However, when alpha-T-resin was irradiated in N(2), presence of both PE and alpha-T radicals were evident in the ESR spectra. And, OIR were produced by the same samples when they were subsequently exposed to air (for 71 days). Oxidation data recorded 85 days after postirradiation aging in air using Fourier transform infra-red (FTIR) spectroscopy, however, did not show any measurable difference between samples irradiated in N(2) and air.

Ion adsorption at the rutile-water interface: linking molecular and macroscopic properties.

A comprehensive picture of the interface between aqueous solutions and the (110) surface of rutile (alpha-TiO2) is being developed by combining molecular-scale and macroscopic approaches, including experimental measurements, quantum calculations, molecular simulations, and Gouy-Chapman-Stern models. In situ X-ray reflectivity and X-ray standing-wave measurements are used to define the atomic arrangement of adsorbed ions, the coordination of interfacial water molecules, and substrate surface termination and structure. Ab initio calculations and molecular dynamics simulations, validated through direct comparison with the X-ray results, are used to predict ion distributions not measured experimentally. Potentiometric titration and ion adsorption results for rutile powders having predominant (110) surface expression provide macroscopic constraints of electrical double layer (EDL) properties (e.g., proton release) which are evaluated by comparison with a three-layer EDL model including surface oxygen proton affinities calculated using ab initio bond lengths and partial charges. These results allow a direct correlation of the three-dimensional, crystallographically controlled arrangements of various species (H2O, Na+, Rb+, Ca2+, Sr2+, Zn2+, Y3+, Nd3+) with macroscopic observables (H+ release, metal uptake, zeta potential) and thermodynamic/electrostatic constraints. All cations are found to be adsorbed as "inner sphere" species bonded directly to surface oxygen atoms, while the specific binding geometries and reaction stoichiometries are dependent on ionic radius. Ternary surface complexes of sorbed cations with electrolyte anions are not observed. Finally, surface oxygen proton affinities computed using the MUSIC model are improved by incorporation of ab initio bond lengths and hydrogen bonding information derived from MD simulations. This multitechnique and multiscale approach demonstrates the compatibility of bond-valence models of surface oxygen proton affinities and Stern-based models of the EDL structure, with the actual molecular interfacial distributions observed experimentally, revealing new insight into EDL properties including specific binding sites and hydration states of sorbed ions, interfacial solvent properties (structure, diffusivity, dielectric constant), surface protonation and hydrolysis, and the effect of solution ionic strength.

Nutritional supplements after hip fracture: poor compliance limits effectiveness.

BACKGROUND: Undernutrition and weight loss are important determinants of clinical outcome in older patients after hip fracture but the effectiveness of nutritional support programs in routine clinical practice remains controversial. AIMS OF THE PROJECT: To determine if oral nutritional supplements given daily for 28 days after hip fracture surgery could prevent weight loss and/or lead to improved clinical outcomes (mortality rates, discharge destination, activities of daily living or length of hospital stay) in non-malnourished community-dwelling older women with hip fracture. METHODS: One hundred and nine women with BMI range 20-30 kg/m(2) were allocated to either nutritional supplements (352 kcal/day) or usual hospital nutrition using a quasi-randomisation technique. Body weight changes were monitored at 4 and 8 weeks and clinical outcomes were recorded at discharge and at 6 months. RESULTS: No significant differences in weight change or clinical outcomes were seen between the two groups. Compliance with consuming the nutritional supplements was quite variable and there was a significant negative correlation between the amount of supplement consumed and subsequent weight change (r=-0.36, P=0.019). CONCLUSIONS: Poor compliance with oral nutritional supplements is an important determinant of the effectiveness of oral nutritional interventions in preventing weight loss after hip fracture. Whilst this may explain the lack of clinical improvements seen, our data do not support the routine use of oral nutritional supplements in non-malnourished hip fracture patients.

Aphthous ulcers: a difficult clinical entity.

Recurrent aphthous ulcers (RAU) are the most common oral ulcerative disease, affecting 10% to 20% of the population. There are 3 clinical subtypes-minor, major, and herpetiform. Minor aphthous ulcers are the most common subtype, representing 80% to 90% of all recurrent aphthous ulcers. Clinically, RAU present as extremely painful, shallow ulcerations with an erythematous halo on unattached oral mucosa. The primary differential diagnosis is oral herpes simplex. The etiology of RAU is unknown. Topical corticosteroids are the mainstay of therapy.

Reconstruction after temporal bone resection.

Reconstruction of soft tissue defects after temporal bone resection can vary from simple closure of the external auditory canal to complex flap coverage of extensive defects. Between 1987 and 1996, 34 patients underwent lateral skull base resections and reconstruction for invasive carcinoma of the temporal bone. Seven underwent sleeve resection and/or radical mastoidectomy. Sleeve resection was managed with tympanoplasty, canalplasty, or obliteration of the external auditory canal (10). There were 24 lateral temporal bone resections and four subtotal temporal bone resections. Larger defects created by lateral and subtotal temporal bone resections required closure with a combination of temporalis flaps and local rotational cutaneous flaps (13). Lower island trapezius flaps (five), free flaps (four), and pectoralis major flaps (two) were also used. Indications and efficacy of each method are discussed, and treatment outcomes are presented.

Postoperative accelerated radiotherapy in high-risk squamous cell carcinoma of the head and neck: long-term results of a prospective trial.

BACKGROUND: For patients treated with combination resection and postoperative radiotherapy, the interval between surgery and completion of radiotherapy represents an opportunity for tumor repopulation and treatment failure. A prospective trial to test the feasibility and efficacy of accelerated postoperative radiotherapy was concluded in August of 1990. METHODS: Thirty-two patients with high-risk pathologic findings were treated with 63 Gy in 35 fractions of 1.8 Gy over 5.2 weeks using a modified concomitant-boost technique. RESULTS: Acute mucosal and skin reactions were increased but tolerable. At a median follow-up of 6 years, the crude in-field recurrence rate for the entire group was 10/32 (31%), with 0/10 (0%) recurrences in patients commencing accelerated radiotherapy within 4 weeks of surgery and 10/22 (45%) recurrences in patients with a delay of more than 4 weeks (p = .006). The rate of late complications appears similar to that seen with conventional radiotherapy, with possibly a higher rate of "consequential"-type late effects. CONCLUSIONS: This pilot study suggests that prompt application of accelerated postoperative radiotherapy significantly improves local-regional control and supports the concept of rapid tumor repopulation in the postoperative setting. Various strategies to overcome tumor repopulation are discussed.

A new model for discrete character evolution.

The paper provides an explicit justification for the principle that a uniform taxon should contribute only one datapoint in comparative analyses with discrete variables. The justification is that phylogenetic patterns in variables unincluded in the proposed test vitiate the assumption of independence, both at the level of species and at the level of branch segments. The consequence is that a uniform taxon cannot safely be counted as more than one datapoint. The arguments use a branching discrete Markov process in continuous time, with the new feature that the tested variables are only a subset of the evolving characters. This model is proposed as a useful criterion for measuring the merit of proposed tests, and illustrates the necessity for models in evaluating comparative methods.

Non-independence in statistical tests for discrete cross-species data.

The paper described three previously undetected effects, due to biases and non-independence, that can arise in statistical tests for associations between character states in cross-species data. One kind, which we call the family problem, is general to all known methods. In phytogenetic data, the ancestral character state from which changes occur, or below which variation is found, is likely to be the same for many regions of the tree. The family problem interacts with two kinds of non-independence that arise because of the methods of reconstruction of character states that existing tests use. Different kinds of non-independence arise in methods that reconstruct joint, or single, character states, respectively. Methods, like Ridley's (1983), that work with joint character states suffer from the problem that a character state cannot change to itself with parsimony. Other methods that work with single character states suffer from the problem that within a locally variable region of the tree it is more likely with null data that there will be two single changes in the two characters in separate branches than one double change in both; associations opposite to the locally ancestral state are therefore likely to be found in more than 50% of the variable regions. In real data sets, the family problem acts to spotlight the other kinds of bias: if the family problem is large the bias in tests due to the way they reconstruct characters will be large, whereas if it is small, the local biases tend to cancel and disappear in the aggregate.

Anterior approach for CT-guided biopsy of skull base and parapharyngeal space lesions.

At our institution we use an anterior approach to biopsy of the parapharyngeal space or skull base lesions because it provides more direct access than the traditional lateral approach through the mandibular notch. The anterior approach follows a course lateral to the alveolar ridge of the maxilla and lateral pterygoid plate, and inferior to the zygomatic process of the maxilla. Biopsy was performed on 15 patients with either a skull base or a parapharyngeal space mass, none of which could be palpated externally or through the oral cavity by the ear, nose, and throat surgeon. In 12 patients the needle biopsy correlated with the surgical pathology. Three needle biopsies were nondiagnostic.

Simultaneous squamous cell carcinoma of the head and neck and reticuloendothelial malignancies.

BACKGROUND: Multiple primary neoplasms have been reported 4% to 26% of patients with a squamous cell carcinoma (SCC) of the head and neck. The vast majority of these second primaries are SCC and occur in the upper aerodigestive tract; however, head and neck SCC patients are also at higher risk for nonepidermoid neoplasms at any site. Reticuloendothelial malignancies (REM) have been reported in many patients that have SCC of the head and neck as well. METHODS: Retrospective case series of 5 advanced cases of SCC of the head and neck with synchronous REM. RESULTS: There was 40% mortality with 19.4 months mean follow-up. Fifty percent of the case had simultaneous cervical involvement with both processes. CONCLUSION: REM can occur simultaneously with SCC of the head and neck and confound staging of nodal status. Head and neck SCC patients are at increased risk for REM secondary to age and treatment factors.