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The publication of social work research and scholarship is integral to generating and disseminating knowledge for the profession and the human services field. Previous research has found a large proportion of nonresearch articles in social work journals, but there has been little exploration of the nature of this scholarship. Using a scoping review method supplemented by analysis of national research assessment output data, this study examined the quantity, format, and characteristics of scholarly publications between 2010–2020 by Australian social workers. It found they produced proportionately more journal articles than other disciplines and relatively fewer books and book chapters. Of 1,389 Australian social work articles published in top-cited social work journals, 821 (59.1%) were research articles. Of the nonresearch articles, almost half provided an analysis of policy or practice without stating a method. Understanding the scope of social work research provides a foundation for reflection on the discipline's research endeavours. Information about the scope of social work research is useful for developing both individual and disciplinary research strategy. A clear statement of method that describes the processes used for observation and analysis would enhance the quality of nonresearch social work publications. [ABSTRACT FROM AUTHOR]

Lesbian, gay, bisexual, transgender, intersex, and queer (LGBTIQ+) people in Australia are actively engaged in civic life, contributing volunteer service to various political, activist, and community organisations. Although there is emerging evidence that civic engagement contributes to the health and wellbeing of the general population, information about how volunteerism contributes to LGBTIQ+ community wellbeing has only recently emerged. We used a prospective cross-sectional design to investigate responsibility for civic engagement, sense of community, and loneliness among a convenience sample of LGBTIQ+ volunteers (N = 195). Findings were that volunteers reported a consistent and high degree of community engagement and a strong sense of attachment to the Australian LGBTIQ+ community. A higher-than-expected degree of loneliness was reported in this sample of volunteers, and it was notable that being transgender or gender diverse was a significant predictor of loneliness. This highlights the importance of loneliness among transgender and gender diverse people and the value of discerning differences between groups in the LGBTIQ+ community. IMPLICATIONS Social workers must be mindful that, despite being connected to communities and demonstrating civic engagement, certain LGBTIQ+ volunteers could be at risk of loneliness. The higher rate of loneliness among transgender and gender diverse volunteers indicates a need for LGBTIQ+-affirming organisations to develop particular strategies to address isolation and loneliness among this group. [ABSTRACT FROM AUTHOR]

While social work research in Australia is in reasonable shape, it requires a strong research culture promoting rigorous research to enhance its credibility and influence on social policy discourses. This study explored proposals to advance social work research, based on interviews with 20 experienced Australian social work researchers. Strategies identified include improving research culture and training, the development of research infrastructure to promote and stimulate research, and forming new partnerships both among researchers and between researchers and research end-users. Growing and strengthening the research foundations of the discipline is essential to its future relevance. IMPLICATIONS The Australian social work community would benefit from a more deliberate and strategic approach to increasing the quality and quantity of research to inform practice and policy. Opportunities for social work researchers to connect with each other to disseminate, discuss, and plan research could provide a hub for increasing research development and research collaboration. The responsibility and capacity to lead research development and advocate for social work research is shared between the academy, the human services sector, and representative professional associations. The Australian social work community would benefit from a more deliberate and strategic approach to increasing the quality and quantity of research to inform practice and policy.Opportunities for social work researchers to connect with each other to disseminate, discuss, and plan research could provide a hub for increasing research development and research collaboration.The responsibility and capacity to lead research development and advocate for social work research is shared between the academy, the human services sector, and representative professional associations. [ABSTRACT FROM AUTHOR]

This study sought to understand the social and individual factors that predict loneliness among older lesbian and gay people in Australia. A sample of 508 gay men and 241 lesbian women, aged 60 and over, completed a survey including measures of loneliness, internalized homonegativity, sexual orientation discrimination, and connectedness to lesbian and gay communities. A multivariable linear regression predicting loneliness was conducted. Not being in an intimate relationship and having less connection to lesbian and gay communities were significant predictors of loneliness for both older lesbian women and gay men. For the men, younger age, internalized homonegativity and more frequent lifetime experiences of sexual orientation discrimination also appeared to predict greater likelihood of loneliness. More frequent recent experiences of sexual orientation discrimination predicted loneliness for the women. The findings confirmed loneliness as an issue of concern among older lesbian and gay people and identified factors amenable to intervention to address loneliness. [ABSTRACT FROM AUTHOR]

Men volunteering to mentor other men is a growing form of social engagement in Australia. Masculine norms associated with not disclosing emotional distress or discussing loneliness are often set aside by participating in these one‐to‐one relationships. Mentors have reported improvement in their well‐being and a desire to contribute more. In this phenomenological study, which draws on hermeneutic methodology, 12 men who voluntarily met and mentored another adult man for a minimum of 6 months participated in a semi‐structured interview. Findings showed non‐judgement and deep listening facilitated a rewarding and personally developmental relationship. Most voluntary mentors experienced substantial changes in their masculine views, particularly with the regard to trust and openness with others. This experience has implications for men realising their ability to engage others and for community well‐being. [ABSTRACT FROM AUTHOR]

In contemporary western cultures, such as Australia, there is increasing reported social disconnection. This disconnection is associated with loneliness and for some suicide, particularly for men. Voluntary male mentoring organisations aim to socially connect and improve men's wellbeing through facilitating men's one‐to‐one relationships. As is the case with most people, men value someone with whom they may communicate openly and safely, as occurs in voluntary mentoring. However, there is limited research on voluntary male mentoring or the experiences of the participants. This scoping review of the literature from voluntary adult male mentoring thematically synthesises the reported narratives from mentors. A systematic search was undertaken of five academic databases on voluntary adult male mentoring for scholarly articles in English. Additionally, the returned articles had their references reviewed for relevant authoritative reports and publications. After duplicates were removed, there were 471 publications. Sources included publications from humanities, social science, psychology and the health sciences. Once screened for eligibility this number was reduced to 29 publications. A thematic synthesis of the literature found the concepts of intentional relationship, journey and mutual growth were present. The implications of these findings are that men in community settings, informed by the experience of voluntary mentors, may be prepared to engage with other men. Additional research on the lived experience of mentors may offer further insights into facilitating male connection. [ABSTRACT FROM AUTHOR]

Building natural classifications for genera with complex morphological variations such as Centaurea needs the support of molecular analysis and knowledge of morphological character diversification. Here we use parsimony and Bayesian analyses of nuclear ribosomal ITS sequences to gain insight into the sectional relationships and character evolution in Centaurea sections Chartolepis, Cheirolepis, Cynaroides, Grosheimia, Microlophus, Paraphysis, Phaeopappus, Plumosipappus, Pseudoserida, Pseudophaeopappus, Ptheracantha, Ptosimopappus, and Rhizocalathium, from Turkey. In particular, we increase sampling in Turkish endemic species of Centaurea sect. Cynaroides and related taxa. The new ITS sequences for 26 taxa from 48 locations are given. Sequences of 17 taxa are given here the first time. The phylogeny derived from ITS data provides a reasonably resolved and reasonably supported phylogenetic framework for the genus. Our analysis shows characters traditionally used in Centaurea taxonomy such as flower colour, appendage width, spine length, and pappus length evolved several times independently and show a lot of homoplasies. However, we can confirm the validity of character combinations for a reliable subgeneric classification of Centaurea. [ABSTRACT FROM AUTHOR]

We report the effects of high pressure, up to 10.45 GPa, on the photoluminescence of Bi-doped yttria-alumina-silica glass under 532 nm excitation. We identify three emission bands attributed to Bi3+, Bi+ and a NIR emitting Bi centre, BiNIR. As the pressure is increased up to ∼6 GPa, an irreversible discontinuity in the trend for emission band energies indicates that an irreversible structural modification occurs. This irreversible discontinuity results in the peak energy of emission bands attributed to Bi+ and BiNIR shifting from those typical of Bi-doped oxide glasses to those observed in Bi-doped gallium-lanthanum-sulfide glass. The Bi3+ emission band can be almost eliminated at ∼6 GPa, but its intensity increases rapidly as the pressure is further increased. The ability we report here to irreversibly modify the emission of Bi-doped glass using pressure treatment adds an extra processing technique to researchers looking to optimize the emission from Bi-doped glasses. [ABSTRACT FROM AUTHOR]

Background: Surgical training emphasizes technical competence. Growing evidence indicates that nontechnical skills are also significant in determining performance. Critically, surgeons should be aware how performance is affected by pressure or distraction. We assessed the impact of novel auditory and visual stressors on performance during a simulated laparoscopic task. We hypothesized that the stressors would worsen performance, and that stress-induced diminution in performance would be inversely related to surgical experience. Methods: Twenty participants (10 surgeons and 10 medical students) completed a peg-threading task using a laparoscopic simulator: three times under control conditions, next with a visual distraction overlay (progressive red saturation of the surgical field, timing personalized to the user's index performance), and then with an auditory distraction overlay (operating theater environment noise). Task completion time and instrument tracking metrics (instrument tip distance traveled and instrument smoothness) were measured. Results: Under control conditions, surgeons completed the task significantly faster, with greater economy of movement, and improved instrument smoothness-compared with students. When exposed to distracting stimuli, the groups behaved differently. Surgeons completed the task more slowly, instrument movements became less smooth (significantly so under audio distraction conditions), but total distance traveled by instruments was unchanged. By contrast, student performance was not impaired and, in some ways, improved. Conclusion: The impact of visual and auditory distraction on surgical performance can be modeled in a laparoscopic simulation environment. The effect of distraction varies according to expertise. This environment may be an effective setting within which to learn to mitigate stress-induced diminution in performance. [ABSTRACT FROM AUTHOR]

Six new species of Begonia sect. Jackia from Sumatra are described and illustrated: B. araneumoides, B. batuphila, B. hijauvenia, B. mursalaensis, B. panjangfolia, and B. perunggufolia. All morphological characters and measurements were observed from living plants in the Bogor Botanical Gardens greenhouse or the wild. Using IUCN criteria, 4 species are considered to be Data Deficient, 1 Vulnerable, and 1 Least Concern. [ABSTRACT FROM AUTHOR]

Abstract Background Methods Results Conclusions 30 years ago, a paper chart was developed in Edinburgh by Cullen et al. and validated as a swift, supplementary method for perimetric evaluation of visual fields. We have re-developed this concept in digital form (on smartphone screen) and assessed its sensitivity and specificity in detecting visual field loss, by comparison with formal machine-based perimetry.Patients with sellar and parasellar tumours, being managed in a single neurosurgical centre, underwent formal visual field perimetry as part of standard care. They also underwent assessment using the smartphone-based Cullen chart. 37 eye testing episodes were assessed, incorporating pre- and post-treatment assessments for a range of potentially compressive pathologies (non-secretory and secretory pituitary adenoma, craniopharyngioma, and parasellar meningioma). The smartphone-based Cullen chart was compared with formal machine-based perimetry for concordance in detecting visual field loss.The digital Cullen chart had a sensitivity of 75% and specificity of 98% compared with machine-based perimeters. The positive predictive value was 93% and the negative predictive value was 92%.For the visual field assessment of patients with sellar/parasellar tumours, this simple and swift smartphone-based chart shows good concordance with machine-based perimeters. With amendments to the user interface, there may be potential for telemetric patient-led visual field monitoring. [ABSTRACT FROM AUTHOR]

Older gay men experience an elevated prevalence of adverse health conditions that may be compounded by age‐related deterioration. Some of these conditions may be ameliorated by regular adherence to physical activity (PA). However, many gay men participate in less PA than their age‐matched heterosexual counterparts. With a focus on gay men aged 60 and over, the aims of this review were to examine the evidence for older gay men's engagement with PA and the research approaches used to describe this group. A systematic search of six academic databases (Academic Search Premier, Cinahl, PubMed, Sport Discus, APA PsychInfo and APA PsychArticles) generated 23 papers from 1970 to 2020 that focused on older gay men's engagement with PA. Although surveys were well represented in the literature, further studies utilising qualitative methodological frameworks have the potential to inform targeted interventional programs aimed at reducing less health disparities. The value of PA in older adults lies principally in improved performance of activities of daily living, independent living, increased longevity, decreased cognitive decline and improved mental well‐being. [ABSTRACT FROM AUTHOR]

Objective  Postoperative meningitis is a rare but potentially fatal complication of endoscopic endonasal skull base surgery. Prophylactic antibiotic use varies considerably worldwide. We sought to analyze the safety of a single-agent, single-dose protocol. Design, Setting, and Participants  A retrospective review of 422 procedures performed during 404 admission episodes from 2009 to 2019, encompassing sella, parasella, and other anterior skull base pathologies. Main Outcome Measures  Primary outcome measure was development of meningitis within 30 days of surgery. Additional information collected: underlying pathological diagnosis, intraoperative cerebrospinal fluid (CSF) leak, postoperative CSF leak, and primary or revision surgery. Results  Of 404 admission episodes for endoscopic anterior skull base surgery, 12 cases developed meningitis. Seven had positive CSF cultures and all 12 recovered. For pathology centered on the sella (including pituitary adenoma), the rate of meningitis was 1.1% (3/283). For pathologies demanding an extended approach (including meningioma and craniopharyngioma), the rate of meningitis was 14.5% (9/62). Postoperative CSF leak requiring surgical repair increased the relative risk by 37-fold. There were no cases of meningitis following repair of long-standing CSF fistula or encephalocoele (0/26) and no cases following surgery for sinonasal tumors with skull base involvement (0/33). Conclusion  For sella-centered pathologies, a single dose of intravenous co-amoxiclav (or teicoplanin) is associated with rates of meningitis comparable to those reported in the literature. Postoperative meningitis was significantly higher for extended, intradural transphenoidal approaches, especially when postoperative CSF leak occurred. Fastidious efforts to prevent postoperative CSF leak are crucial to minimizing risk of meningitis. [ABSTRACT FROM AUTHOR]

Erbium implanted silicon as a quantum technology platform has both telecommunications and integrated circuit processing compatibility. In Si implanted with Er to a concentration of 3 × 1017 cm−3 and O to a concentration of 1020 cm−3, the electron spin coherence time, T2, and the spin-lattice relaxation time, T1, were measured to be 7.5 μs and ∼1 ms, respectively, at 5 K. The spin echo decay profile displayed strong modulation, which was consistent with the super-hyperfine interaction between Er3+ and a spin bath of 29Si nuclei. The calculated spectral diffusion time was similar to the measured T2, which indicated that T2 was limited by spectral diffusion due to T1-induced flips of neighboring Er3+ spins. The origin of the echo is an Er center surrounded by six O atoms with monoclinic C1h site symmetry. [ABSTRACT FROM AUTHOR]

Objectives: To assess the prevalence of impaired sleep quality and depression in a rheumatoid arthritis population and determine their correlation with Disease Activity Score (DAS) and its components. Methods: In this single-centre observational cross-sectional study, data was collected by the assessing clinician for DAS28, age and gender in various treatment groups according to use of csDMARDs, biologics and long-term steroids. Presence of impaired sleep quality and depression was assessed by the Pittsburgh Sleep Quality Index (PSQI) and Public Health Questionnaire 9 (PHQ 9). Correlation for DAS and its components with the outcomes was determined by Pearson's correlation coefficient. Multivariate analysis was performed by logistic regression. Results: Two hundred patients were included. The prevalence across all subgroups of poor sleep quality and depression were 86.5% and 30%, respectively, with a correlation coefficient of 0.69 between the two and poor sleep quality amongst all RA patients with comorbid depression. Multivariate analysis found only subjective DAS components, tender joint count (TJC) and patient global health visual analogue score (VAS) to significantly correlate with both outcomes. Age inversely correlated with depression. Long-term steroid use was associated with poorer sleep quality, but there was no significant effect of csDMARDs or biologics. There was no significant difference in prevalence of depression amongst treatment subgroups. Conclusion: Poor sleep quality and to a lesser extent depression are prevalent in the general rheumatoid arthritis population. Patients would benefit from clinicians measuring these outcomes routinely as they constitute a significant non-inflammatory burden of living with rheumatoid disease. Key Points • Subjective components of DAS independently correlate with sleep quality and depression, while objective components do not. • Poor sleep quality is highly prevalent in RA and present in all those with comorbid depression. • Poor sleep quality and depression incidence in RA are much lower when DAS is low or remission. [ABSTRACT FROM AUTHOR]

Background: Enhanced recovery after surgery (ERAS) is a constant motivation. There is growing evidence that an endoscopic (rather than microscopic) transsphenoidal approach to pituitary tumours can play a role, facilitating faster recovery and a commensurate reduction in length of stay (LOS). Reducing LOS is beneficial to both patients and healthcare systems. We sought to assess the safety, patient feedback, and resource implications of adopting an enhanced recovery and accelerated discharge policy for elective pituitary surgery. Methods: We retrospectively assessed two consecutive cohorts of patients undergoing elective surgery for pituitary adenoma in a single UK centre between July 2016 and November 2019. The pre-ERAS cohort included 52 sequential patients operated prior to protocol change. The ERAS cohort included 55 sequential patients operated after a protocol change. Patient demographic data, tumour characteristics, intra- and post-operative CSF leak, the rate and cause of readmission (within 30 days), and the mean and median LOS were recorded. Patient feedback was collected from a subset of patients (n = 23) in the ERAS group. Results: The two cohorts were well-matched with respect to their demographic, pathological, and operative characteristics. The rates of readmission within 30 days of discharge were similar between the two groups (8% pre-ERAS cohort, 9% ERAS cohort, p = 0.75). In the pre-ERAS cohort, the mean LOS was 4.5 days and median LOS was 3 days. This compares with significant reduction in LOS for the ERAS group: mean of 1.7 days and median of 1 day (p < 0.05). Thirty-nine of 55 patients in the ERAS group were discharged on post-operative day 1. Patient feedback was very positive in the ERAS group (mean patient satisfaction score of 9.7/10 using a Likert scale). Conclusions: An enhanced recovery protocol after elective endoscopic pituitary surgery is safe, reduces length of stay, and is associated with high patient satisfaction. [ABSTRACT FROM AUTHOR]

In this paper, we use artificial neural networks to predict and help compute the values of certain knot invariants. In particular, we show that neural networks are able to predict when a knot is quasipositive with a high degree of accuracy. Given a knot with unknown quasipositivity, we use these predictions to identify braid representatives that are likely to be quasipositive, which we then subject to further testing to verify. Using these techniques, we identify 84 new quasipositive 11 and 12-crossing knots. Furthermore, we show that neural networks are also able to predict and help compute the slice genus and Ozsváth-Szabó τ -invariant of knots. [ABSTRACT FROM AUTHOR]

Begonia phouchomvoyensis, a new species from Phou Chom Voy Provincial Protected Area, Bolikhamxai province, Lao PDR, is described and illustrated. It is placed in Begonia sect. Platycentrum, and is assessed as belonging to the Vulnerable IUCN Category. [ABSTRACT FROM AUTHOR]

Er implanted Si is a candidate for quantum and photonic applications; however, several different Er centres are generated, and their symmetry, energy level structure, magnetic and optical properties, and mutual interactions have been poorly understood, which has been a major barrier to the development of these applications. Optically modulated magnetic resonance (OMMR) gives a spectrum of the modulation of an electron paramagnetic resonance (EPR) signal by a tuneable optical field. Our OMMR spectrum of Er implanted Si agrees with three independent measurements, showing that we have made the first measurement of the crystal field splitting of the 4I13/2 manifold of Er implanted Si, and allows us to revise the crystal field splitting of the 4I15/2 manifold. This splitting originates from a photoluminescence (PL) active O coordinated Er centre with orthorhombic C2v symmetry, which neighbours an EPR active O coordinated Er centre with monoclinic C1h symmetry. This pair of centres could form the basis of a controlled NOT (CNOT) gate. [ABSTRACT FROM AUTHOR]

Summary Little is known about the quantity, nature and range of Australian social work research on ageing and aged care. This scoping review involved a comprehensive search of seven online bibliographic databases. The review identified 108 peer-reviewed journal articles, published between January 2007 and June 2014, that reported Australian social work research on ageing and aged care. Findings The average number of authors per paper was 2.10 with most social work researchers co-authoring papers with non-social workers. The main topics of research focus were health and rehabilitation, elder abuse, asset management, community services and caregiving, housing and residential aged care, and ageing with an intellectual disability. The findings highlight the contribution social work researchers make to multidisciplinary gerontological research, and to understanding the lived experiences of older people and the provision of services. However, they also point to the relative paucity of research focusing on direct social work practice with older people, and the little evidence of the participation of older people and carers in the design and delivery of research. Applications The findings indicate the need for capacity-building strategies, such as developing networks of Australian social work researchers on ageing and aged care, to improve research outputs in this area. [ABSTRACT FROM AUTHOR]

The Philippine island of Palawan is highly biodiverse. During fieldwork there in 2011 & 2014 we found five unknown species in the large genus Begonia. The species are similar in their rhizomatous stems, four-tepaled flowers, inferior two- or three-locular ovaries with bilamellate placentas, and are assignable to Begonia sect. Baryandra. Our observations support the recognition of these as five new species endemic to Palawan: B. elnidoensis, B. gironellae, B. quinquealata, B. tabonensis and B. tenuibracteata which are described here. The five new species were added to phylogenies based Bayesian analysis of nrDNA (ITS) and chloroplast DNA (ndhA, ndhF-rpl32, rpl32-trnL, trnC-trnD), along with 45 other allied ingroup species. A majority of the species show incongruent positions in the two phylogenies, with evidence of prevalent chloroplast capture. Models show chloroplast capture is more likely in plant populations with high levels of inbreeding following a reduction in selfing rate after hybridisation; we suggest that this is a possible explanation for the massive amount of chloroplast exchange seen in our phylogeny, as Begonia species often exist as small isolated populations and may be prone to inbreeding depression. Our data also indicate a level of nuclear genetic exchange between species. The high prevalence of hybrid events in Begonia is potentially an important factor in driving genomic change and species evolution in this mega-diverse genus. [ABSTRACT FROM AUTHOR]

While there is evidence of the cultural scripts lesbian, gay, bisexual and transgender (LGBT) older people use in making sense of their lives, little attention has been given to how these scripts are themselves produced. This article examines cultural representations of LGBT ageing and older people in 40 UK and Australian websites. It is argued that these sites form part of a cultural imaginary about LGBT ageing and older people accessed by policy makers and service providers. Employing membership categorization analysis, the study revealed attributes attached to LGBT ageing categories that related to constraint and celebration narratives. It also uncovered anomalies within the text of 23 websites where celebration and constraint attributes were juxtaposed, although in 15 websites only celebration representations were apparent. The findings highlight the complexity of some representations of LGBT ageing and older people, and the limitations of framing LGBT ageing and older people in homogenous ways. [ABSTRACT FROM AUTHOR]

Objectives. The aim of the present study was to examine the health and well being of older lesbian, gay, bisexual, transgender and intersex (LGBTI) people, the health issues that concern them, the services they use and challenges accessing services. Methods. This study comprised a survey of the health and well being of 312 LGBTI people aged 50 years and over in New South Wales. The survey included the Short-Form 12 (SF-12) measure of health-related quality of life, the Kessler 10 (K10) measure of psychological distress, and the three-item Loneliness Scale. Results. Higher levels of psychological distress, lower mental health and greater loneliness were found among this sample than is typically found in the general population. Mental health was lower among carers and those not in a relationship, while psychological distress was greater among those living alone and those experiencing higher rates of loneliness. The most commonly accessed health service was a general practitioner (GP), with most respondents reporting that they were open about their sexuality to their GP and that they had a regular GP. Some reported difficulties accessing health services because of their gender or sexual diversity. Conclusions. Although many older LGBTI people are well, both physically and mentally, they do appear to face increased risk of certain health issues compared with the general population. [ABSTRACT FROM AUTHOR]

A shift in our understanding of macrophage biology has come about as a result of recent discoveries in the area of metabolic reprogramming of macrophages. The NLRP3 inflammasome drives the activation of caspase-1, leading to the production of IL-1β, IL-18, and a type of cell death termed pyroptosis. The NLRP3 inflammasome has been shown to sense metabolites such as palmitate, uric acid, and cholesterol crystals and is inhibited by ketone bodies produced during metabolic flux. The NLRP3 inflammasome has also been shown to be regulated by mitochondrial reactive oxygen species and components of glycolysis, such as Hexokinase. Here, we review these findings and discuss their importance for inflammation and furthermore discuss potential therapeutic benefits of targeting NLRP3. [ABSTRACT FROM AUTHOR]

Context: Patients with terminal illnesses often require surrogate decision makers. Prior research has demonstrated high surrogate stress, and that despite standards promoting substituted judgment, most patients do not want their surrogates to make pure substituted judgments for them. It is not known how best to help loved ones fulfill the surrogate role.Objectives: To test the effectiveness of an intervention to help surrogate decision makers.Methods: One hundred sixty-six patients (41% with amyotrophic lateral sclerosis and 59% with gastrointestinal cancers) and their surrogates at two university medical centers were randomized to an intensive nurse-directed discussion of the end-of-life decision control preferences of the patient (TAILORED) or a discussion of nutrition (CONTROL); 163 completed baseline interviews and underwent the intervention.Results: Twelve patients died during follow-up and 137 dyads completed the study. Post-intervention, using all available data, TAILORED patients and surrogates became more likely to endorse mutual surrogate decision making, that is, a balance of their own wishes and what the surrogate thinks best (adjusted odds compared with baseline for patients = 1.78, P = 0.04; adjusted odds for surrogates = 2.05, P = 0.03). CONTROL patients became 40% less likely to endorse mutual surrogate decision making (P = 0.08), and CONTROL surrogates did not change significantly from baseline (adjusted odds = 1.44, P = 0.28). Stress levels decreased for TAILORED surrogates (impact of events scale = 23.1 ± 14.6 baseline, 20.8 ± 15.3 f/u, P = 0.046), but not for CONTROL (P = 0.85), and post-intervention stress was lower for TAILORED than CONTROL (P = 0.04). Surrogates' confidence was uniformly high at baseline and did not change. Caregiver burden (Zarit) increased from 12.5 ± 6.5 to 14.7 ± 8.1 for TAILORED (P < 0.01), while not changing for CONTROL, yet satisfaction with involvement in decision making was higher at follow-up for TAILORED than for CONTROL (71% vs. 52%, P = 0.03).Conclusion: TAILORED patients and surrogates who completed the study adopted a more mutual decision-making style, balancing their own wishes with what the surrogate thinks would be best for them. Surrogates reported less stress and more satisfaction. Confidence was high at baseline and did not change. There was a modest increase in caregiver burden. These findings suggest that interventions like TAILORED might positively impact surrogate decision making. [ABSTRACT FROM AUTHOR]

The article discusses the author's views with regards to the issues to be considered by pharmacists in formulating their opinions relating to medical aid in dying. Topics covered include the highlights of the reported debates relating to assisted suicide, the important functions of organizational position statements from professional organizations, and the palliative care principles and guidance relating to medical aid in dying. It also discusses pharmacists' responses to medical aid in dying.

MyD88 adaptor-like (MAL) is a critical protein in innate immunity, involved in signaling by several Toll-like receptors (TLRs), key pattern recognition receptors (PRRs). Crystal structures of MAL revealed a nontypical Toll/interleukin-1 receptor (TIR)-domain fold stabilized by two disulfide bridges. We therefore undertook a structural and functional analysis of the role of reactive cysteine residues in the protein. Under reducing conditions, the cysteines do not form disulfides, but under oxidizing conditions they are highly amenable to modification. The solution structure of the reduced form of the MAL TIR domain, determined by NMR spectroscopy, reveals a remarkable structural rearrangement compared with the disulfide-bonded structure, which includes the relocation of a β-strand and repositioning of the functionally important "BB-loop" region to a location more typical for TIR domains. Redox measurements by NMR further reveal that C91 has the highest redox potential of all cysteines in MAL. Indeed, mass spectrometry revealed that C91 undergoes glutathionylation in macrophages activated with the TLR4 ligand lipopolysaccharide (LPS). The C91A mutation limits MAL glutathionylation and acts as a dominant negative, blocking the interaction of MAL with its downstream target MyD88. The H92P mutation mimics the dominant-negative effects of the C91A mutation, presumably by preventing C91 glutathionylation. The MAL C91A and H92P mutants also display diminished degradation and interaction with interleukin-1 receptor-associated kinase 4 (IRAK4). We conclude that in the cell, MAL is not disulfide-bonded and requires glutathionylation of C91 for signaling. [ABSTRACT FROM AUTHOR]

Background: To define the efficacy, complication profile and cost of surgical options for treating idiopathic intracranial hypertension (IIH) with respect to the following endpoints: vision and headache improvement, normal CSF pressure restoration, papilloedema resolution, relapse rate, operative complications, cost of intervention and quality of life. Methods: A systematic review of the surgical treatment of IIH was carried out. Cochrane Library, MEDLINE and EMBASE databases were systematically searched from 1985 to 2014 to identify all relevant manuscripts written in English. Additional studies were identified by searching the references of retrieved papers and relative narrative reviews. Results: Forty-one (41) studies were included (36 case series and 5 case reports), totalling 728 patients. Three hundred forty-one patients were treated with optic nerve sheath fenestration (ONSF), 128 patients with lumboperitoneal shunting (LPS), 72 patients with ventriculoperitoneal shunting (VPS), 155 patients with venous sinus stenting and 32 patients with bariatric surgery. ONSF showed considerable efficacy in vision improvement, while CSF shunting had a superior headache response. Venous sinus stenting demonstrated satisfactory results in both vision and headache improvement along with the best complication profile and low relapse rate, but longer follow-up periods are needed. The complication rate of bariatric surgery was high when compared to other interventions and visual outcomes have not been reported adequately. ONSF had the lowest cost. Conclusions: No surgical modality proved to be clearly superior to any other in IIH management. However, in certain contexts, a given approach appears more justified. Therefore, a treatment algorithm has been formulated, based on the extracted evidence of this review. The traditional treatment paradigm may need to be re-examined with sinus stenting as a first-line treatment modality. [ABSTRACT FROM AUTHOR]

Loneliness is a debilitating condition with particular negative health effects, including psychological distress. While the vast majority of older people do not experience significant degrees of loneliness, a minority do and there are some reports that this is even greater among lesbian, gay, bisexual, transgender and intersex (LGBTI) seniors. This article examines the experience of loneliness and social support among LGBTI people aged 50 and over living in New South Wales, Australia. It also explores their interest in participating in social and health-promoting activities. Findings from an online survey delivered to 312 people are reported. Loneliness was associated with living alone, not being in a relationship, higher psychological distress and lower mental health. Nonetheless, most respondents reported that they are able to gain support from both biological family and friends if they need it in a crisis. The social and health-promoting activities that were most preferred among all respondents were fitness groups, walking groups, swimming and meditation. Those who experienced the greatest degree of loneliness were much more likely than those who were less lonely to want to participate in social and health-promoting activities with other LGBTI people. The findings indicate scope for community organisations to develop targeted interventions, such as those social and health-promoting activities most preferred by the participants of this study. [ABSTRACT FROM AUTHOR]

A story is told here of an investigation into change management's apparent death, provoked by the dubious business novel Who Killed Change [Blanchard, K., J. Britt, P. Zigarmi, and J. Hoekstra. 2009. Who Killed Change? Solving the Mystery of Leading People Through Change. London: Harper Collins Publishers]. The story is told over eight chapters inviting you to investigate competing explanations for the death of change management using the structure of the story arc: stasis, trigger, quest, surprise, critical choice, climax, reversal and resolution. An annoying voice (sometimes interior monologue and at other times dialogue) of another reader keen to inform and frame your understanding of the status of change management remains ever present. The case is solved with the story's resolution providing insights into advantages of investigating over literature reviewing, the problematic/masculine nature of murder metaphors, the academic potential of story arcs and the mystery which characterises organizational change. [ABSTRACT FROM AUTHOR]

There is an expanding interface between electronic engineering and neurosurgery. Rapid advances in microelectronics and materials science, driven largely by consumer demand, are inspiring and accelerating development of a new generation of diagnostic, therapeutic, and prosthetic devices for implantation in the nervous system. This paper reviews some of the basic science underpinning their development and outlines some opportunities and challenges for their use in neurosurgery. [ABSTRACT FROM AUTHOR]

The use of wood-based products might contribute to the mitigation of climate change and resource depletion in the building sector. However, the increasing demand for wood-based products might generate a trade-off affecting biomass availability, forest ecosystem services, and the climate change mitigation potential of forests. Therefore, it is important to couple the use of wood-based products with the adoption of circular economy strategies. Upstream strategies can facilitate the future reuse of wood elements in new buildings, whilst downstream strategies aim at the reuse wood elements originating from demolished or disassembled buildings, in new buildings. The aim of this study was to identify patterns describing upstream and downstream strategies currently adopted in architectural practice. A sample of real-world case-study buildings was identified and the respective designers were interviewed. The interviews identified three patterns for upstream strategies, namely the reversibility of joints, independence of different building components and prefabrication, and two patterns for downstream strategies, namely the recovery of salvaged wood and adaptability of the building layout. Several challenges were also highlighted. The use of upstream and downstream strategies can increase the time (and costs) in the design and manufacturing phase. Downstream strategies can also be influenced by the quality of salvaged wood. Upstream strategies showed difficulties to comply with current building standards (e.g. acoustic standards). Finally, metrics and indicators are needed in order to measure the efficiency of wood recirculation in upstream and downstream strategies, as well as to support their implementation. • Coupling bio and circular economy can support the increased demand of bio-products. • Wood cascading, especially reuse, can increase the efficient use of wood resources. • The study focused on design strategies to facilitate the reuse of wood in buildings. • A sample of case-study buildings served to analyze strategies adopted by designers. • Strategies can focus on the future reuse (upstream) or post-use (downstream) of wood. [ABSTRACT FROM AUTHOR]

Focused ultrasound (FUS) is an incision-less intervention that is a Food and Drug Association (FDA) approved surgical treatment for various pathologies including uterine fibroids and bone metastases. Recent advances in magnetic resonance imaging thermometry and ability to use FUS across the intact calvarium have re-opened interest in the use of FUS in the treatment of neurological diseases. FUS currently has a European CE mark for use in movement disorders. However, it shows potential in the treatment of other neuropathologies including tumours and as a lesional tool in epilepsy. FUS may exert its therapeutic effect through thermal or mechanical fragmentation of intracranial lesions, or by enhancing delivery of pharmaceutical agents across the blood–brain barrier. In this review, we summarise the mechanisms, clinical applications and potential future of FUS for the treatment of neurological disease. We have searched for and described the recently completed and on-going clinical trials investigating FUS for the treatment of neurological disorders. We identified phase one trials investigating utility of FUS in: movement disorders (including essential tremor and Parkinson’s disease), chronic pain, obsessive-compulsive disorder and cerebral tumours. Current literature also reports pre-clinical work exploring utility in epilepsy, neurodegenerative conditions (such as Alzheimer’s disease) and thrombolysis. Safety and early efficacy data are now emerging, suggesting that transcalvarial FUS is a feasible and safe intervention. Further evidence is required to determine whether FUS is an effective alternative in comparison to current neurosurgical interventions. The cost of requisite hardware is currently a barrier to widespread uptake in UK neurosurgical centres. [ABSTRACT FROM PUBLISHER]

The fracture behaviour of wood is affected by, amongst other factors, its microscopic structure, moisture content and temperature, as well as the direction of crack propagation. Spruce (Picea abies [L.] Karst.) and birch (Betula pendula Roth.) compact tension specimens were subjected to pure mode I loading in both the radial-tangential (RT) and tangential-radial (TR) orientations under four climatic conditions. The effect of microscopic structure on crack propagation was observed, and the "crack mouth opening displacement vs. load" histories were recorded, from which characteristic fracture parameters were calculated. The fracture surfaces were subsequently examined by optical microscopy. In both species, distinct changes in the fracture behaviour were observed as moisture content (MC) and temperature (T) were varied. The results were specific for the wood species, but MC and T influenced fracture behaviour in a similar way. The effects were more pronounced in birch than in spruce. Elevated T and MC did not affect the failure mode, except in the case of spruce in the RT orientation. [ABSTRACT FROM AUTHOR]

Silicon underpins microelectronics but lacks the photonic capability needed for next-generation systems and currently relies on a highly undesirable hybridization of separate discrete devices using direct band gap semiconductors. Rare-earth (RE) implantation is a promising approach to bestow photonic capability to silicon but is limited to internal RE transition wavelengths. Reported here is the first observation of direct optical transitions from the silicon band edge to internal f-levels of implanted REs (Ce, Eu, and Yb); this overturns previously held assumptions about the alignment of RE levels to the silicon band gap. The photoluminescence lines are massively redshifted to several technologically useful wavelengths and modeling of their splitting indicates that they must originate from the REs. Eu-implanted silicon devices display a greatly enhanced electroluminescence efficiency of 8%. Also observed is the first crystal field splitting in Ce luminescence. Mid-IR silicon photodetectors with specific detectivities comparable to existing state-of-the-art mid-IR detectors are demonstrated. [ABSTRACT FROM AUTHOR]

The aim of the present study was to investigate the effect of moisture content and temperature on the fracture behaviour of thermally modified Norway spruce ( Picea abies [L.] Karst.) in the transverse plane. Spruce was thermally modified at two heat treatment temperatures, 190 and 210 °C. Mode I fracture tests were carried out at temperatures of 22 and 50 °C on air-dried and fully water-saturated (>fibre saturation point) material. Small CT specimens were used, and load-CMOD curves were recorded. Characteristic fracture parameters were calculated. The fracture surfaces were subsequently examined using optical microscopy. Thermal modification altered all the calculated fracture parameter values and the changes increased as the severity of heat treatment increased. The parameters were altered more in the radial-tangential (RT) than in tangential-radial (TR) orientation. The failure mode changed due to heat treatment in the TR orientation but in the RT orientation the failure mode of unmodified and heat treated material differs only at high moisture content and elevated temperature. [ABSTRACT FROM AUTHOR]

The effect of the microscopic structure and the moisture content (MC) of wood on its fracture behaviour has been investigated. Green and air-dried spruce ( Picea abies [L.] Karst.) and birch ( Betula pendula Roth.) wood were subjected to pure mode I loading in the radial- tangential (RT) crack propagation system. Tests were carried out in situ in an environmental scanning electron microscope to observe crack propagation at the cellular level. Crack-tip displacement fields were computed by digital image correlation, and crack propagation was observed from the images captured during testing. Both the MC and the microscopic structure were found to affect the fracture process. In the air-dried birch and spruce, only microcracking caused large displacements ahead of the crack-tip. In spruce, the microcracking zone was larger than in birch. In green birch and spruce, microcracking was less evident than in the air-dried specimens, and in some cases, there were notable deformations in a few cells ahead of the crack-tip before crack extension. Microcracking is considered to be the main toughening mechanism in spruce and birch in the RT crack propagation system. [ABSTRACT FROM AUTHOR]

The mechanical properties of thermally modified wood are discussed with regard to toughness. The molecular origins of the mechanical properties and, in particular, the role of the hemicelluloses are considered. The important role of water and its interaction with the cell wall components is also examined. The properties are discussed from the point of view of composite theory, with the three main macromolecular components acting as reinforcement, matrix and interfacial coupling agent. The important role that hemicelluloses play as a coupling agent between the cellulosic microfibril reinforcement and the lignin-rich matrix is highlighted. Destruction of the hemicelluloses during the thermal modification process has a profound effect upon the mechanical behaviour. [ABSTRACT FROM AUTHOR]

Background: Begonia is a mega-diverse genus of flowering plants prone to generating micro-endemic species, especially on limestone habitats. During fieldwork in the Puerto Princesa Subterranean River National Park, Palawan (Philippines), three species were encountered which did not match any previously described from the region. Results: Following morphological, anatomical, molecular phylogenetic and cytological investigation a hypothesis of three new species is supported. The three new species belong to a clade endemic to Palawan and Borneo. Conclusions: The limestone habitats in the Puerto Princesa Subterranean River National Park environs support a unique flora. The description of three new species from a small area within the park demonstrates how much remains to be discovered there, and the importance of its continued protection. [ABSTRACT FROM AUTHOR]

Aims and objectives To investigate women's experience of early miscarriage (the first 16 weeks of pregnancy) by reviewing the literature since 1990, identifying and exploring critical themes. Background Early miscarriage loss accounts for 50,000 inpatient admissions per year in the UK reported in 2010. It can result in anxiety, depression, guilt, emptiness and other features of bereavement. Design A structured literature review of qualitative literature was undertaken to explore the evidence of women's experience of early miscarriage, and elicit common themes emerging. Methods A systematic electronic database search was conducted using a range of search engines. Nine papers were identified; four from the UK and one paper each from the USA, Australia, Canada, Israel and Sweden. Results Four predominant themes were identified from the experiences of 211 women in the nine studies: 'What I feel', 'Care for me and communicate with me', 'Me, my baby and others' and 'Help me to cope with the future'. Conclusions Early miscarriage is a potentially devastating experience, and the diversity of experiences of women must be reflected in the provision of appropriate and sensitive nursing care. Relevance to clinical practice The study demonstrated a significant training need for nurses and midwives to provide women with individualised care. [ABSTRACT FROM AUTHOR]

* Premise of the study: One third of the species-rich Philippine flora is endemic, and most of the islands in the archipelago have never been connected to a continental region. We currently lack any well-sampled angiosperm phylogenies that span the archipelago, prohibiting the formation of informed hypotheses as to the evolution of this rich and highly endemic flora. * Methods: We produced time-calibrated phylogenetic trees from both nuclear (ITS) and chloroplast (ndhA intron, ndhF-rpl32 spacer, rpl32-trnL spacer, trnC-trnD spacer) regions of 41 species of Begonia sect. Baryandra, all except one endemic to the Philippines. Historical biogeography was reconstructed across the chloroplast phylogeny using a Bayesian binary method of character optimization. Comparison of phylogenies from the two genomes permitted insight into the prevalence of hybridization in the group. * Key results: The Philippine archipelago was colonized by Begonia sect. Baryandra in the late Miocene, via long-distance dispersal from western Malesia and a point of entry likely to be in the northwestern region of the archipelago. Palawan, Luzon, and Panay all bear early-branching lineages from this initial colonization. There have been Plio-Pleistocene dispersals from these islands into Borneo and Mindanao. Hybridization was common between species as evidenced by haplotype sharing and phylogenetic incongruence. * Conclusions: The phylogenies show a high degree of geographic structure, which millions of years of exposure to typhoons have not blurred, showing long-term species and population stability. The recent dispersals to Mindanao are congruent with the geologically recent arrival of the island at its current latitude in the southern Philippines. [ABSTRACT FROM AUTHOR]

Introduction. Society of British Neurological Surgeons (SBNS) meetings are important national events which allow for the presentation of current academic work. The publication rate of presented abstracts is considered a proxy marker of the scientific strength of a conference. We aimed to determine the publication fate of presented abstracts at SBNS meetings over a 5-year period. Methods. A retrospective review of SBNS conference proceedings between 2001 and 2005 was performed. To ascertain whether an abstract resulted in peer-reviewed publication, a range of databases (PubMed, Google Scholar, Medline and Ovid) were interrogated. Abstracts published in full were subsequently assessed for journal impact factor (IF), time of publication and number of citations received (per Google Scholar). Results. A total of 494 abstracts were presented. Of these, 181 abstracts were subsequently published in full, giving the conference a publication rate of 36.6%. The mean time to publication from presentation was 22 months (range 35 months pre-presentation to 133 months afterwards). The top three journals for publication were the British Journal of Neurosurgery (23.2%), Neurosurgery (7.7%) and Journal of Neurosurgery (7.7%). The IF of journal destinations ranged from no IF to 38.28 (median = 1.97). Number of citations ranged from 0 to 963 (median = 22). Abstracts with positive results were significantly more likely to be published in full compared to those with negative results (p = 0.0001). Conclusions. SBNS conferences have a respectable publication rate. Those abstracts that are published in full have gone on to gain a considerable number of citations reflecting their scientific relevance. However, studies presented at SBNS are susceptible to positive outcome bias. [ABSTRACT FROM AUTHOR]

While research has identified challenges lesbians face in the workplace, there is limited understanding of the particular experiences of older lesbians, especially those working in the health and aged care sector. This article draws on the stories of four women who participated in a narrative research project on lesbian and gay people's experiences of health and aged care. It highlights the need for future research to examine the complexity of identity expression and community affiliation, how people negotiate “coming out” in the workplace, the impact of discrimination, and the resources (such as friends) available to lesbians in the workplace. [ABSTRACT FROM AUTHOR]

The author reflects on some of ethical issues that the journal has experienced in 2014 as well as its policy in relation to blind peer reviewing. Topics discussed include the concept of and the problems arising form salami slicing, the practice of extracting several publications from a single study, the concept of text recycling, the use of material published in one paper in a different paper, and the pros and cons of single- and double-blind peer reviewing.

In this paper we present an explicit isomorphism between Khovanov-Rozansky sl2-homology and ordinary Khovanov homology. This result was originally claimed in Khovanov and Rozansky's paper [Matrix factorizations and link homology, Fund. Math. 199(1) (2008) 1-91, MR 2391017 (2010a:57011)], though the proof was never presented. The main missing detail is providing a coherent choice of signs when identifying variables in the sl2-homology. Along with the behavior of the signs and local orientations in the sl2-homology, both theories behave differently when we try to extend their definitions to virtual links, which seemed to suggest that the sl2-homology may instead correspond to a different variant of Khovanov homology. In this paper we describe both theories and prove that they are in fact isomorphic by showing that a coherent choice of signs can be made. In doing so we emphasize the interpretation of the sl2-complex as a cube of resolutions. [ABSTRACT FROM AUTHOR]

Despite the devastating impact of HIV/AIDS, end-of-life care planning among lesbian, gay, bisexual and transgender (LGBT) communities is relatively under-researched, especially in Australia. This paper reports findings of a survey of 305 LGBT people living in New South Wales, which examined their knowledge of and attitudes towards end-of-life care. The focus of this paper is their preparedness to discuss with healthcare providers any end-of-life care plans. The results highlight that while the majority of respondents were aware of three of the four key end-of-life care planning options available in New South Wales -- enduring powers of attorney, enduring guardians and person responsible (only a minority had heard of advance healthcare directives) -- a much smaller number of people had actually taken up these options. Only a minority of respondents were able to identify correctly who had the legal right to make treatment decisions for a person who is unconscious following a car accident. A small proportion of people had discussed end-of-life care options with general practitioners or another main healthcare provider, and only in very few cases were these issues raised by the practitioners themselves. Those most likely to not feel comfortable discussing these issues with practitioners included younger people, those not fully open about their sexuality to family members, and transgender people and others who do not define their gender as male or female. The paper highlights the importance of education strategies to raise awareness of the end-of-life care planning options among LGBT people, as well as strategies for increasing health providers' preparedness to discuss these issues with LGBT patients. [ABSTRACT FROM AUTHOR]

We report amorphous GaLaSO-based resistive switching devices, with and without Pb-implantation before deposition of an Al active electrode, which switch due to deposition and dissolution of Al metal filaments. The devices set at 2-3 and 3-4 V with resistance ratios of 6 x 104 and 3 x 109 for the unimplanted and Pb-implanted devices, respectively. The devices reset under positive Al electrode bias, and Al diffused 40 nm further into GaLaSO in the unimplanted device. We attribute the positive reset and higher set bias, compared to devices using Ag or Cu active electrodes, to the greater propensity of Al to oxidise. [ABSTRACT FROM AUTHOR]

Introduction: Objective performance feedback has potential to maximize the training benefit of laparoscopic simulators. Instrument movement metrics are, however, currently the preserve of complex and expensive systems. We aimed to develop and validate affordable, user-ready software that provides objective feedback by tracking instrument movement in a "take-home" laparoscopic simulator. Materials and Methods: Computer-vision processing tracks the movement of colored bands placed around the distal instrument shafts. The position of each instrument is logged from the simulator camera feed and movement metrics calculated in real time. Ten novices (junior doctors) and 13 general surgery trainees (StR) (training years 3-7) performed a standardized task (threading string through hoops) on the eoSim (eoSurgical™ Ltd., Edinburgh, Scotland, United Kingdom) take-home laparoscopic simulator. Statistical analysis was performed using unpaired t tests with Welch's correction. Results: The software was able to track the instrument tips reliably and effectively. Significant differences between the two groups were observed in time to complete task (StR versus novice, 2 minutes 33 seconds versus 9 minutes 53 seconds; P=.01), total distance traveled by instruments (3.29 m versus 11.38 m, respectively; P=.01), average instrument motion smoothness (0.15 mm/second(3) versus 0.06 mm/second(3), respectively; P<.01), and handedness (mean difference between dominant and nondominant hand) (0.55 m versus 2.43 m, respectively; P=.03). There was no significant difference seen in the distance between instrument tips, acceleration, speed of instruments, or time off-screen. Conclusions: We have developed software that brings objective performance feedback to the portable laparoscopic box simulator. Construct validity has been demonstrated. Removing the need for additional motion-tracking hardware makes it affordable and accessible. It is user-ready and has the potential to enhance the training benefit of portable simulators both in the workplace and at home. [ABSTRACT FROM AUTHOR]

Introduction: Objective performance feedback has potential to maximize the training benefit of laparoscopic simulators. Instrument movement metrics are, however, currently the preserve of complex and expensive systems. We aimed to develop and validate affordable, user-ready software that provides objective feedback by tracking instrument movement in a 'take-home' laparoscopic simulator. Materials and Methods: Computer-vision processing tracks the movement of colored bands placed around the distal instrument shafts. The position of each instrument is logged from the simulator camera feed and movement metrics calculated in real time. Ten novices (junior doctors) and 13 general surgery trainees (StR) (training years 3-7) performed a standardized task (threading string through hoops) on the eoSim (eoSurgical™ Ltd., Edinburgh, Scotland, United Kingdom) take-home laparoscopic simulator. Statistical analysis was performed using unpaired t tests with Welch's correction. Results: The software was able to track the instrument tips reliably and effectively. Significant differences between the two groups were observed in time to complete task (StR versus novice, 2 minutes 33 seconds versus 9 minutes 53 seconds; P=.01), total distance traveled by instruments (3.29 m versus 11.38 m, respectively; P=.01), average instrument motion smoothness (0.15 mm/second3 versus 0.06 mm/second3, respectively; P<.01), and handedness (mean difference between dominant and nondominant hand) (0.55 m versus 2.43 m, respectively; P=.03). There was no significant difference seen in the distance between instrument tips, acceleration, speed of instruments, or time off-screen. Conclusions: We have developed software that brings objective performance feedback to the portable laparoscopic box simulator. Construct validity has been demonstrated. Removing the need for additional motion-tracking hardware makes it affordable and accessible. It is user-ready and has the potential to enhance the training benefit of portable simulators both in the workplace and at home. [ABSTRACT FROM AUTHOR]