Developing an alternative response format for the script concordance test

Introduction: Clinical reasoning is essential for the practice of medicine. In theory of development of medical expertise it is stated, that clinical reasoning starts from analytical processes namely the storage of isolated facts and the logical application of the ‘rules’ of diagnosis. Then the learners successively develop so called semantic networks and illness-scripts which finally are used in an intuitive non-analytic fashion [1], [2]. The script concordance test (SCT) is an example for assessing clinical reasoning [3]. However the aggregate scoring [3] of the SCT is recognized as problematic [4]. The SCT`s scoring leads to logical inconsistencies and is likely to reflect construct-irrelevant differences in examinees’ response styles [4]. Also the expert panel judgments might lead to an unintended error of measurement [4]. In this PhD project the following research questions will be addressed: 1. How does a format look like to assess clinical reasoning (similar to the SCT but) with multiple true-false questions or other formats with unambiguous correct answers, and by this address the above mentioned pitfalls in traditional scoring of the SCT? 2. How well does this format fulfill the Ottawa criteria for good assessment, with special regards to educational and catalytic effects [5]? Methods: 1. In a first study it shall be assessed whether designing a new format using multiple true-false items to assess clinical reasoning similar to the SCT-format is arguable in a theoretically and practically sound fashion. For this study focus groups or interviews with assessment experts and students will be undertaken. 2. In an study using focus groups and psychometric data Norcini`s and colleagues Criteria for Good Assessment [5] shall be determined for the new format in a real assessment. Furthermore the scoring method for this new format shall be optimized using real and simulated data.

Analysis of the Heat-Shock Response Displayed by Two Chaetomium Species Originating from Different Thermal Environments

Three features of the heat shock response, reorganization of protein expression, intracellular accumulation of trehalose, and alteration in unsaturation degree of fatty acids were investigated in the thermophilic fungus Chaetomium thermophile and compared to the response displayed by a closely related mesophilic species, C. brasiliense. Thermophilic heat shock response paralleled the mesophilic response in many respects like (i) the temperature difference observed between normothermia and the upper limit of translational activity, (ii) the transient nature of the heat shock response at the level of protein expression including both the induction of heat shock proteins (HSPs) as well as the repression of housekeeping proteins, (iii) the presence of representatives of high-molecular-weight {HSPs} families, (iv) intracellular accumulation of trehalose, and finally (v) modifications in fatty acid composition. On the other hand, a great variability between the two organisms was observed for the proteins expressed during stress, in particular a protein of the {HSP60} family that was only observed in C. thermophile. This peptide was also present constitutively at normal temperature and may thus fulfil thermophilic functions. It is shown that accumulation of trehalose does not play a part in thermophily but is only a stress response. C. thermophile contains less polyunsaturated fatty acids at normal temperature than C. brasiliense, a fact that can be directly related to thermophily. When subjected to heat stress, both organisms tended to accumulate shorter and less unsaturated fatty acids.

Planktic foraminifera from the Paleocene-Eocene Thermal Maximum at Shatsky Rise, Pacific Ocean

High-resolution biostratigraphic and quantitative studies of subtropical Pacific planktonic foraminiferal assemblages (Ocean Drilling Program, Leg 198 Shatsky Rise, Sites 1209 and 1210) are performed to analyse the faunal changes associated with the Paleocene-Eocene Thermal Maximum (PETM) at about 55.5 Ma. At Shatsky Rise, the onset of the PETM is marked by the abrupt onset of a negative carbon isotope excursion close to the contact between carbonate-rich ooze and overlying clay-rich ooze and corresponds to a level of poor foraminiferal preservation as a result of carbonate dissolution. Lithology, planktonic foraminiferal distribution and abundances, calcareous plankton and benthic events, and the negative carbon isotope excursion allow precise correlation of the two Shatsky Rise records. Results from quantitative analyses show that Morozovella dominates the assemblages and that its maximum relative abundance is coincident with the lowest delta 13C values, whereas subbotinids are absent in the interval of maximum abundance of Morozovella. The excursion taxa (Acarinina africana, Acarinina sibaiyaensis, and Morozovella allisonensis) first appear at the base of the event. Comparison between the absolute abundances of whole specimens and fragments of genera demonstrate that the increase in absolute abundance of Morozovella and the decrease of Subbotina are not an artifact of selective dissolution. Moreover, the shell fragmentation data reveal Subbotina to be the more dissolution-susceptible taxon. The upward decrease in abundance of Morozovella species and the concomitant increase in test size of Morozovella velascoensis are not controlled by dissolution. These changes could be attributed to the species' response to low nutrient supply in the surface waters and to concomitant changes in the physical and chemical properties of the seawater, including increased surface stratification and salinity. Comparison of the planktonic foraminiferal changes at Shatsky Rise to those from other PETM records (Sites 865 and 690) highlights significant similarities, such as the decline of Subbotina at the onset of the event, and discrepancies, including the difference in abundance of the excursion taxa. The observed planktonic foraminifera species response suggests a warm-oligotrophic scenario with a high degree of complexity in the ocean structure.

Ocean acidification has no effect on thermal bleaching in the coral Seriatopora caliendrum

The objective of this study was to test whether elevated pCO2 predicted for the year 2100 (85.1 Pa) affects bleaching in the coral Seriatopora caliendrum (Ehrenberg 1834) either independently or interactively with high temperature (30.5 °C). Response variables detected the sequence of events associated with the onset of bleaching: reduction in the photosynthetic performance of symbionts as measured by maximum photochemical efficiency (F v/F m) and effective photochemical efficiency (delta F/F m') of PSII, declines in net photosynthesis (P net) and photosynthetic efficiency (alpha), and finally, reduced chlorophyll a and symbiont concentrations. S. caliendrum was collected from Nanwan Bay, Taiwan, and subjected to combinations of temperature (27.7 vs. 30.5 °C) and pCO2 (45.1 vs. 85.1 Pa) for 14 days. High temperature reduced values of all dependent variables (i.e., bleaching occurred), but high pCO2 did not affect Symbiodinium photophysiology or productivity, and did not cause bleaching. These results suggest that short-term exposure to 81.5 Pa pCO2, alone and in combination with elevated temperature, does not cause or affect coral bleaching.

Physiological response of the cold-water coral Desmophyllum dianthus to thermal stress and ocean acidification

Rising temperatures and ocean acidification driven by anthropogenic carbon emissions threaten both tropical and temperate corals. However, the synergistic effect of these stressors on coral physiology is still poorly understood, in particular for cold-water corals. This study assessed changes in key physiological parameters (calcification, respiration and ammonium excretion) of the widespread cold-water coral Desmophyllum dianthus maintained for 8 months at two temperatures (ambient 12 °C and elevated 15 °C) and two pCO2 conditions (ambient 390 ppm and elevated 750 ppm). At ambient temperatures no change in instantaneous calcification, respiration or ammonium excretion rates was observed at either pCO2 levels. Conversely, elevated temperature (15 °C) significantly reduced calcification rates, and combined elevated temperature and pCO2 significantly reduced respiration rates. Changes in the ratio of respired oxygen to excreted nitrogen (O:N), which provides information on the main sources of energy being metabolized, indicated a shift from mixed use of protein and carbohydrate/lipid as metabolic substrates under control conditions, to less efficient protein-dominated catabolism under both stressors. Overall, this study shows that the physiology of D. dianthus is more sensitive to thermal than pCO2 stress, and that the predicted combination of rising temperatures and ocean acidification in the coming decades may severely impact this cold-water coral species.

Study on the response of IFMIF fission chambers to mixed neutron-gamma fields: PH-2 experimental tests

The engineering design of fissionchambers as on-line radiation detectors for IFMIF is being performed in the framework of the IFMIF-EVEDA works. In this paper the results of the experiments performed in the BR2 reactor during the phase-2 of the foreseen validation activities are addressed. Two detectors have been tested in a mixedneutron-gamma field with high neutron fluence and gamma absorbed dose rates, comparable with the expected values in the HFTM in IFMIF. Since the neutron spectra in all BR2 channels are dominated by the thermal neutron component, the detectors have been surrounded by a cylindrical gadolinium screen to cut the thermal neutron component, in order to get a more representative test for IFMIF conditions. The integrated gamma absorbed dose was about 4 × 1010 Gy and the fast neutron fluence (E > 0.1 MeV) 4 × 1020 n/cm2. The fissionchambers were calibrated in three BR2 channels with different neutron-to-gamma ratio, and the long-term evolution of the signals was studied and compared with theoretical calculations

Longitudinal Changes in Response to a Cycle-Run Field Test of Young Male National "Talent identification" and Senior Elite Triathlon Squads.

This study investigated the changes in cardiorespiratory response and running performance of 9 male ?Talent Identification? (TID) and 6 male Senior Elite (SE) Spanish National Squad triathletes during a specific cycle-run test. The TID and SE triathletes (initial age 15.2±0.7 vs. 23.8±5.6 years, p=0.03; tests through the competitive period and the preparatory period, respectively, of two consecutive seasons: Test 1 was an incremental cycle test to determine the ventilatory threshold (Thvent); Test 2 (C-R) was 30 min constant load cycling at the Thvent power output followed by a 3-km time trial run; and Test 3 (R) was an isolated 3-km time trial control run, in randomized counterbalanced order. In both seasons the time required to complete the C-R 3-km run was greater than for R in TID (11:09±00:24 vs. 10:45±00:16 min:ss, pmenor que 0.01; and 10:24±00:22 vs. 10:04±00:14, p=0.006, for season 2005/06 and 2006/07, respectively) and SE (10:15±00:19 vs. 09:45±00:30, pmenor que 0.001 and 09:51±00:26 vs. 09:46±00:06, p= 0.02 for season 2005/06 and 2006/07, respectively). Compared to the first season, completion of the time trial run was faster in the second season (6.6%, pmenor que 0.01 and 6.4%, pmenor que 0.01, for C-R and R test, respectively) only in TID. Changes in post-cycling run performance were accompanied by changes in pacing strategy but only slight or non-significant changes in the cardiorespiratory response. Thus, the negative effect of cycling on performance may persist, independently of the period, over two consecutive seasons in TID and SE triathletes; however A improvements over time suggests that monitoring running pacing strategy after cycling may be a useful tool to control performance and training adaptations in TID. O2max 77.0±5.6 vs. 77.8±3.6 mL·kg-1·min-1, NS) underwent three TE D EP C C

Transient thermal analysis during the ascent phase of a balloon-borne payload. Comparison with SUNRISE test flight measurements

The thermal design of stratospheric balloon payloads usually focuses on the cruise phase of the missions, that is, the floating altitude conditions. The ascent phase usually takes between 2 and 4 h, a very small period compared to the duration of the whole mission, which can last up to 4 weeks. However, during this phase payloads are subjected to very harsh conditions due mainly to the convective cooling that occurs as the balloon passes through the cold atmosphere, with minimum temperatures in the tropopause. The aim of this work is to study the thermal behaviour of a payload carried by a long duration balloon during the ascent phase. Its temperature has been calculated as a function of the altitude from sea level to floating conditions. To perform this analysis it has been assumed that the thermal interactions (convection and radiation) depend on the altitude, on the environmental conditions (which in turn depend also on the altitude) and on the temperature of the system itself. The results have been compared with the measurements taken during the SUNRISE test flight, launched in October 2007 by CSBF from Fort Sumner (New Mexico).

Modeling and validation of the thermal behavior of buildings for the development of demand response methods

The representation of the thermal behaviour of the building is achieved through a relatively simple dynamic model that takes into account the effects due to the thermal mass of the building components. The model of a intra-floor apartment has been built in the Matlab-Simulink environment and considers the heat transmission through the external envelope, wall and windows, the internal thermal masses, (i.e. furniture, internal wall and floor slabs) and the sun gain due to opaque and see-through surfaces of the external envelope. The simulations results for the entire year have been compared and the model validated, with the one obtained with the dynamic building simulation software Energyplus.