Measuring a moving target: Techniques for engineering leadership evaluation and assessment.

This article provides engineering educators with a comprehensive overview of engineering leadership assessment and evaluation for undergraduate engineering students to help instigate positive change for the future of the field.

U.S. postdoctoral careers in life sciences, physical sciences and engineering: Government, industry, and academia.

Discussions about science and engineering postdoctoral researchers focus almost exclusively on academic postdocs and their chances of eventually securing tenure-track faculty positions. Further, biological sciences dominate policy research and published advice for new PhDs regarding postdoctoral employment. Our analysis uses the Survey of Earned Doctorates and Survey of Doctorate Recipients to understand employment implications for physical sciences and engineering (PSE) and life sciences (LS) graduates who took postdoctoral positions in government, industry, and academic sectors. We examine postdoc duration, reasons for staying in a postdoc, movement between sectors, and salary implications. There is considerable movement between employment sectors within the first six years post-PhD. Additionally, postdocs in PSE are shorter, better paid, and more often in nonacademic sectors than postdocs in LS. These results can help science and engineering faculty discuss a broader range of career pathways with doctoral students and help new PhDs make better informed early career decisions.

Illuminating systematic differences in no job offers for STEM doctoral recipients.

This study examines differences across demographic subgroups in the phenomenon of recent doctoral recipients seeking work but having no job offers for employment. Gender and race/ethnicity have been identified as two characteristics with considerable issues of representation in a number of science and engineering fields, particularly at the doctoral level. Using the NSF Survey of Earned Doctorates dataset, which includes over 298,000 respondents in the biological sciences, engineering, and physical sciences since 1977, we use logistic regression modelling to examine the likelihood of doctoral recipients having no offers at the time of graduation as a function of race, gender, family and funding variables. We find that across the fields of biology, engineering, and physical sciences, women and underrepresented minorities have a higher prevalence of having no job offers, but this relationship has notable interaction effects for family variables and doctoral program funding mechanism. Importantly, marital status accounts for differences in job offers between genders that deserves further exploration.

A respiratory alert model for the Shenandoah Valley, Virginia, USA.

Respiratory morbidity (particularly COPD and asthma) can be influenced by short-term weather fluctuations that affect air quality and lung function. We developed a model to evaluate meteorological conditions associated with respiratory hospital admissions in the Shenandoah Valley of Virginia, USA. We generated ensembles of classification trees based on six years of respiratory-related hospital admissions (64,620 cases) and a suite of 83 potential environmental predictor variables. As our goal was to identify short-term weather linkages to high admission periods, the dependent variable was formulated as a binary classification of five-day moving average respiratory admission departures from the seasonal mean value. Accounting for seasonality removed the long-term apparent inverse relationship between temperature and admissions. We generated eight total models specific to the northern and southern portions of the valley for each season. All eight models demonstrate predictive skill (mean odds ratio = 3.635) when evaluated using a randomization procedure. The predictor variables selected by the ensembling algorithm vary across models, and both meteorological and air quality variables are included. In general, the models indicate complex linkages between respiratory health and environmental conditions that may be difficult to identify using more traditional approaches.

Improvement in mortality of very low birthweight infants and the changing pattern of neonatal mortality: the 50-year experience of one perinatal centre.

AIM: Neonatology is a relatively new sub-specialty so we aimed to review survival data in the context of advances in neonatal care. METHOD: Review of neonatal survival for very low birthweight babies over the last 50 years. RESULTS: In the data collected from a single tertiary neonatal unit, survival for babies 501-1000 g improved from below 10% in 1959 to over 60% in 2009. Similarly, survival for babies 1001 to 1500 g has improved from approximately 50% to over 90%. During the study period, death due to extreme prematurity or cardiorespiratory problems, namely respiratory distress syndrome, fell from 90% in 1964 to only 45% of neonatal deaths in 2008. CONCLUSION: In addition to reporting the remarkable improvement in neonatal survival over this period, we have highlighted items of historical context.

Does retrograde diastolic flow in the descending aorta signify impaired systemic perfusion in preterm infants?

High-volume systemic-to-pulmonary ductal shunting occurs frequently in preterm infants and is indicated by diastolic flow reversal in the descending aorta (DAo). We studied the relationship between ductal diameter, diastolic DAo reversal, and left ventricular output (LVO); and superior vena caval (SVC) flow (upper body perfusion) and DAo flow (lower body perfusion) in preterm (<31 wk) infants. Echocardiographic assessments were performed at 5, 12, 24, and 48 h postnatal age (80 infants, median gestation 28 wk, 1060 g). Incidence of ductal patency fell from 100% at 5 h to 72% at 48 h; incidence of pure systemic-to-pulmonary shunting increased from 66% to 95% of infants with patent ducts. In infants with duct diameter greater than the median, 35-48% of infants had DAo flow reversal. In infants with duct diameter greater than median, DAo reversal was associated with 23-29% increases in LVO at 5-48 h, and 35% decreases in DAo flow volume at 24-48 h, but no differences in SVC flow. In conclusion, a large duct with left-to-right shunting is common in preterm infants. Retrograde DAo flow is a marker of high-volume shunt, evidenced by increased LVO. Preterm infants with high-volume ductal shunt may have preserved upper body perfusion but reduced lower body perfusion.

Effect of pacifier use on mandibular position in preterm infants.

AIM: It has been hypothesized that the association of pacifier use with reduced risk of sudden infant death is mediated by forward movement of the mandible and tongue that helps open the upper airway. Our aim was to examine whether the mandible is moved forward when an infant is sucking on a pacifier, and if so, whether the mandible remains advanced after the pacifier is removed. METHODS: In sixty clinically stable premature infants (corrected gestation age 36.5 +/- 0.3 weeks, mean +/- SEM) the distance from each ear where the pinna met the cheek to the most prominent point of the chin was measured bilaterally, and the average was used as an index of mandibular position. Mandibular position was determined before and after allowing the infants to suck on a pacifier for 10-15 min, and after removing the pacifier. RESULTS: There was a significant forward movement of the mandible when the infants were sucking on the pacifier (59.5 +/- 0.7 vs. 58.6 +/- 0.7 mm, p = 0.001), with no significant change after the pacifier was removed. CONCLUSIONS: Pacifier use in preterm infants was associated with a small significant forward displacement of the jaw. These data suggest that pacifier use may help protect the upper airway.

Antenatal antecedents of moderate or severe neonatal encephalopathy in term infants--a regional review.

BACKGROUND: Regional audits of term infants with neonatal encephalopathy (NE) provide an opportunity to examine issues related to causation and quality of care. AIM: To document antenatal and intrapartum antecedents in a contemporary cohort of term infants with moderate or severe neonatal encephalopathy. METHODS: Term infants admitted with moderate-severe neonatal encephalopathy over 4 years were identified. The clinical records were reviewed for information about the pregnancy and birth including interpretation of monitoring and subsequent management of the labour and delivery. RESULTS: Fifty-two maternal records were reviewed. No mothers were diabetic or had gestations > 42 weeks, but 17% of the babies were small for gestational age (SGA). The cohort had evidence of antenatal hypoxia in 15%, a sentinel event in 25% and suboptimal fetal monitoring practice in at least 42% of cases. CONCLUSIONS: Peripartum events were the major contributors to neurological damage in infants with neonatal encephalopathy. Suboptimal fetal monitoring practice and sentinel events remain the most common contributors. Ongoing education and training to address these issues should be available to all involved with intrapartum care in New Zealand.

Demographic characteristics and clinical course in infants with moderate or severe neonatal encephalopathy.

A chart review of 64 infants with moderate or severe neonatal encephalopathy showed that resuscitation was required for 61 (95%), respiratory support for 53 (83%) and anticonvulsants for 58 (91%). Death occurred in 2 (4%) infants with moderate encephalopathy and 12 (86%) with severe encephalopathy. In addition, subsequent neurodevelopment was abnormal in approximately a quarter of infants who survived after a moderate to severe encephalopathy.

Premature birth and later insulin resistance.

BACKGROUND: Term infants who are small for gestational age appear prone to the development of insulin resistance during childhood. We hypothesized that insulin resistance, a marker of type 2 diabetes mellitus, would be prevalent among children who had been born prematurely, irrespective of whether they were appropriate for gestational age or small for gestational age. METHODS: Seventy-two healthy prepubertal children 4 to 10 years of age were studied: 50 who had been born prematurely (32 weeks' gestation or less), including 38 with a birth weight that was appropriate for gestational age (above the 10th percentile) and 12 with a birth weight that was low (i.e., who were small) for gestational age, and 22 control subjects (at least 37 weeks' gestation, with a birth weight above the 10th percentile). Insulin sensitivity was measured with the use of paired insulin and glucose data obtained by frequent measurements during intravenous glucose-tolerance tests. RESULTS: Children who had been born prematurely, whether their weight was appropriate or low for gestational age, had an isolated reduction in insulin sensitivity as compared with controls (appropriate-for-gestational-age group, 14.2x10(-4) per minute per milliunit per liter [95 percent confidence interval, 11.5 to 16.2]; small-for-gestational-age group, 12.9x10(-4) per minute per milliunit per liter [95 percent confidence interval, 9.7 to 17.4]; and control group, 21.6x10(-4) per minute per milliunit per liter [95 percent confidence interval, 17.1 to 27.4]; P=0.002). There were no significant differences in insulin sensitivity between the two premature groups (P=0.80). As compared with controls, both groups of premature children had a compensatory increase in acute insulin release (appropriate-for-gestational-age group, 2002 pmol per liter [95 percent confidence interval, 1434 to 2432] [corrected]; small-for-gestational-age group, 2253 pmol per liter [95 percent confidence interval, 1622 to 3128]; and control group, 1148 pmol per liter [95 percent confidence interval, 875 to 1500]; P<0.001). CONCLUSIONS: Like children who were born at term but who were small for gestational age, children who were born prematurely have an isolated reduction in insulin sensitivity, which may be a risk factor for type 2 diabetes mellitus.