Motion-Driven Transparency and Opacity

When two adjacent surfaces move in step, this can generate a sensation of transparency, even in the absence of intersections. Stopping the motion of one surface makes it look suddenly opaque.

Problems with traditional science publishing and finding a wider niche for post-publication peer review

Science affects multiple basic sectors of society. Therefore, the findings made in science impact what takes place at a commercial level. More specifically, errors in the literature, incorrect findings, fraudulent data, poorly written scientific reports, or studies that cannot be reproduced not only serve as a burden on tax-payers' money, but they also serve to diminish public trust in science and its findings. Therefore, there is every need to fortify the validity of data that exists in the science literature, not only to build trust among peers, and to sustain that trust, but to reestablish trust in the public and private academic sectors that are witnessing a veritable battle-ground in the world of science publishing, in some ways spurred by the rapid evolution of the open access (OA) movement. Even though many science journals, traditional and OA, claim to be peer reviewed, the truth is that different levels of peer review occur, and in some cases no, insufficient, or pseudo-peer review takes place. This ultimately leads to the erosion of quality and importance of science, allowing essentially anything to become published, provided that an outlet can be found. In some cases, predatory OA journals serve this purpose, allowing papers to be published, often without any peer review or quality control. In the light of an explosion of such cases in predatory OA publishing, and in severe inefficiencies and possible bias in the peer review of even respectable science journals, as evidenced by the increasing attention given to retractions, there is an urgent need to reform the way in which authors, editors, and publishers conduct the first line of quality control, the peer review. One way to address the problem is through post-publication peer review (PPPR), an efficient complement to traditional peer-review that allows for the continuous improvement and strengthening of the quality of science publishing. PPPR may also serve as a way to renew trust in scientific findings by correcting the literature. This article explores what is broadly being said about PPPR in the literature, so as to establish awareness and a possible first-tier prototype for the sciences for which such a system is undeveloped or weak.

Turning the World Upside Down to Understand Perceived Transparency

Specular surfaces and refractive media are difficult to distinguish from each other because they both generate distorted images of the surrounding lighting environment. Whereas convex refractive objects invert the orientation of the horizon so the sky appears beneath the ground plane, convex specular surfaces preserve the orientation of the horizon so the sky appears above the ground. Here, we show that a refractive transparent object can be made to appear specular and opaque simply by rotating the image by 180°. This result suggests that the visual system relies on information tied to the orientation of the horizon to distinguish between refractive and specular objects.

Transparent reporting of research results in eLife

Manuscripts should include all the experimental and statistical details that are needed to replicate the experiments and analyses reported in them.

Exploring the consistency, transparency and portability of dental technology education: benchmarking across Norway, Ireland and Australia

Dental technology programmes of study must prepare students to practice in a broad range of contemporary workplaces. Currently, there is limited evidence to benchmark dental technology education - locally, nationally or internationally. This research aims to improve consistency, transparency and portability of dental technology qualifications across three countries. Data were accessed from open-source curriculum documents and five calibrated assessment items. Three institutions collaborated with Oslo and Akershus University College, Norway; Trinity College Dublin, Ireland; and Griffith University, Australia. From these, 29-44 students completed 174 assessments. The curricula reflect the community needs of each country and display common themes that underpin professional dental technology practice. Assessment results differed between institutions but no more than a normal distribution. Face-to-face assessment moderation was critical to achieve consistency. This collaborative research has led to the development of a set of guidelines for other dental technology education providers interested in developing or aligning courses internationally to enhance the portability of qualifications.

Development of a novel ex vivo equine corneal model

OBJECTIVE

To develop an ex vivo equine corneal organ culture model. Specifically, to assess the equine cornea's extracellular matrix and cellularity after 7 days using two different culture techniques: either (i) immersion system or (ii) air/liquid interface system, to determine the best ex vivo equine corneal model.

ANIMALS STUDIED

Fourteen healthy equine corneas of various breeds.

PROCEDURES

Equine corneas with 2 mm of perilimbal sclera were freshly harvested from 7 horses undergoing humane euthanasia. One corneal-scleral ring (CSR) from each horse was randomly placed in the (i) immersion condition organ culture system (IC), with the contralateral CSR being placed in the (ii) air/liquid interface organ culture system (ALC) for 7 days. All corneas were evaluated using serial daily gross photography, histology, qPCR, and TUNEL assay.

RESULTS

corneal-scleral rings placed in the IC (i) had complete loss of corneal transparency on gross photography by 7 days, showed a significant level of corneal stromal disorganization, significantly increased α-SMA levels on qPCR, and apoptosis on TUNEL assay compared to controls. The ALC (ii) had weak stromal disorganization on histopathologic examination and was not significantly different from normal equine corneal controls on all other evaluated parameters.

CONCLUSIONS

The air-liquid interface organ culture system maintains the equine cornea's extracellular matrix and preserves corneal transparency, while the immersion condition results in near complete degradation of normal equine corneal architecture after 7 days in culture. The air-liquid organ culture is a viable option to maintain a healthy equine cornea in an ex vivo setting for wound healing studies.

Improving the Transparency of Ultra-Drawn Melt-Crystallized Polyethylenes: Toward High-Modulus/High-Strength Window Application

Highly transparent, ultradrawn high-density polyethylene (HDPE) films were successfully prepared using compression molding and solid-state drawing techniques. The low optical transmittance (<50%) of the pure drawn HDPE films can be drastically improved (>90%) by incorporating a small amount (>1 wt %/wt) of specific additives to HDPE materials prior to drawing. It is shown that additives with relatively high refractive index result in an increased optical transmittance in the visible light wavelength which illustrates that the improvement in optical characteristics probably originates from refractive index matching between the crystalline and noncrystalline regions in the drawn films. Moreover, the optically transparent drawn HDPE films containing additives maintain their physical and mechanical properties, especially their high modulus and high strength, which make these films potentially useful in a variety of applications, such as high-impact windows.

Robust and Stable Transparent Superhydrophobic Polydimethylsiloxane Films by Duplicating via a Femtosecond Laser-Ablated Template

Realizing superhydrophobicity, high transparency on polydimethylsiloxane (PDMS) surface enlarges its application fields. We applied a femtosecond laser to fabricate well-designed structures combining microgrooves with microholes array on mirror finished stainless steel to form a template. Then liquid PDMS was charged for the duplicating process to introduce a particular structure composed of a microwalls array with a certain distance between each other and a microprotrusion positioned at the center of a plate surrounded by microwalls. The parameters such as the side length of microwalls and the height of a microcone were optimized to achieve required superhydrophobicity at the same time as high-transparency properties. The PDMS surfaces show superhydrophobicity with a static contact angle of up to 154.5 ± 1.7° and sliding angle lower to 6 ± 0.5°, also with a transparency over 91%, a loss less than 1% compared with plat PDMS by the measured light wavelength in the visible light scale. The friction robust over 100 cycles by sandpaper, strong light stability by 8 times density treatment, and thermal stability up to 325 °C of superhydrophobic PDMS surface was investigated. We report here a convenient and efficient duplicating method, being capable to form a transparent PDMS surface with superhydrophobicity in mass production, which shows extensive application potentials.

Using Contour Plots to Assess the Sensitivity of Clinical Trial Design Assumptions

BACKGROUND

Sample size calculations are an important part of the design of any clinical trial. These calculations ensure a sufficient number of patients to detect a clinically meaningful difference between 2 treatments with high probability (ie, power). Perhaps less-often discussed, the sample size exercise is important so that resources are not wasted studying too many observations to test a particular hypothesis. Since patients may be randomized to doses of a novel treatment with a limited safety profile, or a placebo which provides no therapeutic benefit, sample size calculations in clinical trials come with an ethical burden not experienced in many subject-matter areas.

METHODS

The sample size of a clinical trial should be determined using as much data as is available, over a range of assumptions, and with input from clinical colleagues. Graphical techniques are often utilized to summarize power and sample size calculations. In this manuscript, we propose the use of contour plots to better assess, report, and communicate the sensitivity of clinical trial design assumptions.

RESULTS

Through several examples, we illustrate that contour plots are applicable to binary, continuous, and time-to-event endpoints for a variety of study design scenarios.

CONCLUSIONS

Contour plots are a useful tool for the study team in designing clinical trials, and they can be included in study documents to better communicate the rationale for sample size for clinicians and regulators. Contour plots provide greater transparency as to the uncertainty of the currently available information, and can be useful in deciding whether to consider adaptive designs.

Mechanical Strength and Broadband Transparency Improvement of Glass Wafers via Surface Nanostructures

In this study, we mechanically strengthened a borosilicate glass wafer by doubling its bending strength and simultaneously enhancing its transparency using surface nanostructures for different applications including sensors, displays and panels. A fabrication method that combines dry and wet etching is used for surface nanostructure fabrication. Specifically, we improved the bending strength of plain borosilicate glass by 96% using these surface nanostructures on both sides. Besides bending strength improvement, a limited optical transmittance enhancement of 3% was also observed in the visible light wavelength region (400–800 nm). Both strength and transparency were improved by using surface nanostructures of 500 nm depth on both sides of the borosilicate glass without affecting its bulk properties or the glass manufacturing process. Moreover, we observed comparatively smaller fragments during the breaking of the nanostructured glass, which is indicative of strengthening. The range for the nanostructure depth is defined for different applications with which improvements of the strength and transparency of borosilicate glass substrate are obtained.

Upconversion Nanoparticles for Bioimaging and Regenerative Medicine

Nanomaterials are proving useful for regenerative medicine in combination with stem cell therapy. Nanoparticles (NPs) can be administrated and targeted to desired tissues or organs and subsequently be used in non-invasive real-time visualization and tracking of cells by means of different imaging techniques, can act as therapeutic agent nanocarriers, and can also serve as scaffolds to guide the growth of new tissue. NPs can be of different chemical nature, such as gold, iron oxide, cadmium selenide, and carbon, and have the potential to be used in regenerative medicine. However, there are still many issues to be solved, such as toxicity, stability, and resident time. Upconversion NPs have relevant properties such as (i) low toxicity, (ii) capability to absorb light in an optical region where absorption in tissues is minimal and penetration is optimal (note they can also be designed to emit in the near-infrared region), and (iii) they can be used in multiplexing and multimodal imaging. An overview on the potentiality of upconversion materials in regenerative medicine is given.

Confessions of PCICU Leaders: Tales From the Past, Lessons for the Future

BACKGROUND

The pediatric cardiac intensive care environment is challenging and unpredictable due to the heterogeneous patient population. Leadership within this complex environment is critical for optimal outcomes.

METHODS

The 10th International Meeting of the Pediatric Cardiac Intensive Care Society provided a forum for leaders to share their own practice and experience that concluded with take-home messages regarding quality, safety, clinical effectiveness, stewardship, and leadership.

RESULTS

Presentations defined vital aspects for successful outcomes and highlighted ongoing challenges.

CONCLUSIONS

Accomplishing exceptional outcomes requires a blend of clinical expertise, leadership, communication skills with briefing and debriefing, meaningful use of data, and transparency among peers and toward patients and their families.

Porous silk fibroin film as a transparent carrier for cultivated corneal epithelial sheets

Biological carriers, such as the amniotic membrane and serum-derived fibrin, are currently used to deliver cultivated corneal epithelial sheets to the ocular surface. Such carriers require being transparent and allowing the diffusion of metabolites in order to maintain a healthy ocular surface. However, safety issues concerning biological agents encouraged the development of safer, biocompatible materials as cell carriers. We examined the application of porous silk fibroin films with high molecular permeability prepared by mixing silk fibroin and poly(ethylene glycol) (PEG), and then removal of PEG from the silk-PEG films. Molecular permeability of porous silk fibroin film is higher than untreated silk fibroin film. Epithelial cells were isolated from rabbit limbal epithelium, and seeded onto silk fibroin coated wells and co-cultured with mitomycin C-treated 3T3 fibroblasts. Stratified epithelial sheets successfully engineered on porous silk fibroin film expressed the cornea-specific cytokeratins K3 and K12, as well as the corneal epithelial marker pax6. Basement membrane components such as type-IV collagen and integrin β1 were expressed in the stratified epithelial sheets. Further more, colony-forming efficiency of dissociated cells was similar to primary corneal epithelial cells showing that progenitor cells were preserved. The biocompatibility of fibroin films was confirmed in rabbit corneas for up to 6 months. Porous silk fibroin film is a highly transparent, biocompatible material that may be useful as a carrier of cultivated epithelial sheets in the regeneration of corneal epithelium.

[Adaptive licensing - a threat to patient safety?]

In 2014, a pilot project of the European licensing authority EMA was launched to explore new ways to license medicinal products. The intention of this project is to open up gradual ("adaptive") licensing pathways, with pharmaceutical developing preparations gaining market authorization on the basis of clearly lower-level evidence of effectiveness and risk of damage than before. Their market authorization shall, initially, be restricted, for example, to subpopulations of patients or to selected indications. When new data from subsequent become available, the extension of the authorization shall follow in a stepwise manner. Data from investigations using less valid methodology shall also find consideration, such as, for example data from uncontrolled studies. The experience with accelerated market access, which is already being offered by several drug authorities, may give rise to concerns about the use of procedures that keep drugs with a negative benefit-risk relation for the patients in the market for many years - apart from the costs for the healthcare system. It is unacceptable that manufacturers will be exempt from (strict) liability for these adaptively licensed pharmaceuticals. If patients suffer damage from taking these medications, they cannot even expect material compensation.

Robust Stability of Scaled-Four-Channel Teleoperation with Internet Time-Varying Delays

We describe the application of a generic stability framework for a teleoperation system under time-varying delay conditions, as addressed in a previous work, to a scaled-four-channel (γ-4C) control scheme. Described is how varying delays are dealt with by means of dynamic encapsulation, giving rise to mu-test conditions for robust stability and offering an appealing frequency technique to deal with the stability robustness of the architecture. We discuss ideal transparency problems and we adapt classical solutions so that controllers are proper, without single or double differentiators, and thus avoid the negative effects of noise. The control scheme was fine-tuned and tested for complete stability to zero of the whole state, while seeking a practical solution to the trade-off between stability and transparency in the Internet-based teleoperation. These ideas were tested on an Internet-based application with two Omni devices at remote laboratory locations via simulations and real remote experiments that achieved robust stability, while performing well in terms of position synchronization and force transparency.

Applicability and feasibility of systematic review for performing evidence-based risk assessment in food and feed safety

Food and feed safety risk assessment uses multi-parameter models to evaluate the likelihood of adverse events associated with exposure to hazards in human health, plant health, animal health, animal welfare, and the environment. Systematic review and meta-analysis are established methods for answering questions in health care, and can be implemented to minimize biases in food and feed safety risk assessment. However, no methodological frameworks exist for refining risk assessment multi-parameter models into questions suitable for systematic review, and use of meta-analysis to estimate all parameters required by a risk model may not be always feasible. This paper describes novel approaches for determining question suitability and for prioritizing questions for systematic review in this area. Risk assessment questions that aim to estimate a parameter are likely to be suitable for systematic review. Such questions can be structured by their "key elements" [e.g., for intervention questions, the population(s), intervention(s), comparator(s), and outcome(s)]. Prioritization of questions to be addressed by systematic review relies on the likely impact and related uncertainty of individual parameters in the risk model. This approach to planning and prioritizing systematic review seems to have useful implications for producing evidence-based food and feed safety risk assessment.

Foveolar Müller Cells of the Pied Flycatcher: Morphology and Distribution of Intermediate Filaments Regarding Cell Transparency

Specialized intermediate filaments (IFs) have critical importance for the clearness and uncommon transparency of vertebrate lens fiber cells, although the physical mechanisms involved are poorly understood. Recently, an unusual low-scattering light transport was also described in retinal Müller cells. Exploring the function of IFs in Müller cells, we have studied the morphology and distribution pattern of IFs and other cytoskeletal filaments inside the Müller cell main processes in the foveolar part of the avian (pied flycatcher) retina. We found that some IFs surrounded by globular nanoparticles (that we suggest are crystallines) are present in almost every part of the Müller cells that span the retina, including the microvilli. Unlike IFs implicated in the mechanical architecture of the cell, these IFs are not connected to any specific cellular membranes. Instead, they are organized into bundles, passing inside the cell from the endfeet to the photoreceptor, following the geometry of the processes, and repeatedly circumventing numerous obstacles. We believe that the presently reported data effectively confirm that the model of nanooptical channels built of the IFs may provide a viable explanation of Müller cell transparency.

An evaluation of the Open and Honest Care Programme in acute NHS trusts in Northern England

AIM

To explore the impact of the National Health Service England's Open and Honest Care Programme on patient safety, patient and staff experience and improvement practices within acute National Health Service settings.

BACKGROUND

The Open and Honest Care Programme forms a key tenet of the Nursing Midwifery and Care Staff Strategy launched by the Department of Health in England and Wales in 2012.

METHODS

An electronic survey (n = 387) was administered to National Health Service staff. Semi-structured telephone interviews (n = 13) were conducted with senior nurses and ward managers.

RESULTS

Over 70% of the survey respondents agreed that the programme increased transparency with the public about the quality of care, helped the working experience of National Health Service staff and improved patient safety respectively. Interviews revealed the Open and Honest Care Programme had enabled National Health Service staff to appraise the effectiveness of their improvement efforts.

CONCLUSION

The Open and Honest Care Programme could be an important part of the National Health Service Improvement Strategy. The collection of metric and narrative information highlighted where patient-centred improvements were required, facilitating the targeting and development of specific interventions or resources.

IMPLICATIONS FOR NURSING MANAGEMENT

The results indicate that the programme may assist managers to identify areas for improvement and that programmes such as this deserve consideration by health-care management globally.

Better research reporting to improve the utility of routine data for making better treatment decisions

The availability of routinely collected health data, such as health administrative data, electronic health records, prescription records and disease registries, has increased in the information age. This has led to an explosion of reports of comparativeness effectiveness research using such data. Guidelines for the REporting of studies Conducted using Observational Routinely-collected Data (RECORD) will improve the completeness and transparency of reporting of research using routinely collected health data. The Journal of Comparative Effectiveness Research has endorsed these guidelines. In this commentary, the RECORD checklist is reprinted and members of the RECORD working committee reflect on the importance of these reporting guidelines for the field of comparative effectiveness research.

Quality of Quality Accounts: transparency of public reporting of Never Events in England. A semi-quantitative and qualitative review

OBJECTIVES

To describe the quality of reporting and investigation into surgical Never Events in public reports.

DESIGN

Semi-quantitative and qualitative review of published Quality Accounts for three years (2011/2-2013/14). Data on Never Events were compared with previously collated Never Events rates. Quality of reported investigations was assessed using the London Protocol.

SETTING

English National Health Service.

PARTICIPANTS

All English acute hospital trusts.

MAIN OUTCOME MEASURES

Quality of Never Event reporting.

RESULTS

Quality Accounts were available for all Trusts for all three years, of which 342 referred to years when a surgical Never Event had occurred. A total of 125 of 342 (37%) accounts failed to report any or all Never Events that had occurred; 13/342 (4%) provided full disclosure; 197 (58%) reported that some investigation had taken place. Of these 197, 61 (31%) were limited in scope; 61 (31%) were categorised as detailed reports. Task and Technology factors were the commonest factor (103/211 (49%)) Identified in investigations, followed by Individual factors (48/211 (23%)). Team and Work environment factors were identified in 29/211 (14%) and 23/211 (11%), respectively. Organisational and Management 5/211 (2%) factors were rarely identified, and the Institutional context was never discussed.

CONCLUSIONS

Reporting of Never Events and their investigations by English NHS Trusts in their Quality Accounts is neither consistently transparent nor adequate. As with clinical error, the true root causes are likely to be organisational rather than individual.

[Patient attitudes and expectations towards conflicts of interest of attending physicians]

BACKGROUND

Patients can truly expect to be treated by their physicians without undue influences of secondary interests. It is not known what patients in Germany know about relationships between physicians and the pharmaceutical industry and if and how they want to be informed about these relationships.

METHOD

An information sheet explaining conflicts of interest and a 19-item questionnaire were distributed to 765 patients at various medical offices and hospitals in two German cities. 80 % (n=612) of the patients completed and returned the questionnaires anonymously.

RESULTS

65 % of the patients did not know of conflicts of interest (COI) doctors may have with the pharmaceutical industry. 74 % of the patients would like to know if their doctor had obtained any benefits through contacts with the pharmaceutical industry. 71 % agreed that a disclosure would increase their confidence, and 74 % wanted their physicians to declare COI verbally to them during a consultation. 40 % would prefer a doctor who is not receiving any benefits from the pharmaceutical industry. The desire for disclosure was significantly higher in patients who had an awareness of the problems of COI (OR 4.95; 95 % CI 3.33 - 7.35). However, 35 % of the patients trusted their attending physicians anyway and did not see a need for disclosure of any COI.

CONCLUSION

The majority of patients, but not all patients want to be informed about COI of their physicians. The best way to do this has yet to be determined.

Hiding personal information reveals the worst

Seven experiments explore people's decisions to share or withhold personal information, and the wisdom of such decisions. When people choose not to reveal information--to be "hiders"--they are judged negatively by others (experiment 1). These negative judgments emerge when hiding is volitional (experiments 2A and 2B) and are driven by decreases in trustworthiness engendered by decisions to hide (experiments 3A and 3B). Moreover, hiders do not intuit these negative consequences: given the choice to withhold or reveal unsavory information, people often choose to withhold, but observers rate those who reveal even questionable behavior more positively (experiments 4A and 4B). The negative impact of hiding holds whether opting not to disclose unflattering (drug use, poor grades, and sexually transmitted diseases) or flattering (blood donations) information, and across decisions ranging from whom to date to whom to hire. When faced with decisions about disclosure, decision-makers should be aware not just of the risk of revealing, but of what hiding reveals.

Upconversion Nanoparticles for Bioimaging and Regenerative Medicine

Nanomaterials are proving useful for regenerative medicine in combination with stem cell therapy. Nanoparticles (NPs) can be administrated and targeted to desired tissues or organs and subsequently be used in non-invasive real-time visualization and tracking of cells by means of different imaging techniques, can act as therapeutic agent nanocarriers, and can also serve as scaffolds to guide the growth of new tissue. NPs can be of different chemical nature, such as gold, iron oxide, cadmium selenide, and carbon, and have the potential to be used in regenerative medicine. However, there are still many issues to be solved, such as toxicity, stability, and resident time. Upconversion NPs have relevant properties such as (i) low toxicity, (ii) capability to absorb light in an optical region where absorption in tissues is minimal and penetration is optimal (note they can also be designed to emit in the near-infrared region), and (iii) they can be used in multiplexing and multimodal imaging. An overview on the potentiality of upconversion materials in regenerative medicine is given.

The Peer Reviewers' Openness Initiative: incentivizing open research practices through peer review

Openness is one of the central values of science. Open scientific practices such as sharing data, materials and analysis scripts alongside published articles have many benefits, including easier replication and extension studies, increased availability of data for theory-building and meta-analysis, and increased possibility of review and collaboration even after a paper has been published. Although modern information technology makes sharing easier than ever before, uptake of open practices had been slow. We suggest this might be in part due to a social dilemma arising from misaligned incentives and propose a specific, concrete mechanism-reviewers withholding comprehensive review-to achieve the goal of creating the expectation of open practices as a matter of scientific principle.

Against vaccine assay secrecy

Increasing the transparency of the evidence base behind health interventions such as pharmaceuticals, biologics, and medical devices, has become a major point of critique, conflict, and policy focus in recent years. Yet the lack of publicly available information regarding the immunogenicity assays upon which many important, widely used vaccines are based has received no attention to date. In this paper we draw attention to this critical public health problem by reporting on our efforts to secure vaccine assay information in respect of 10 vaccines through Canada's access to information law. We argue, under Canadian law, that the public health interest in having access to the methods for these laboratory procedures should override claims by vaccine manufacturers and regulators that this information is proprietary; and, we call upon several actors to take steps to ensure greater transparency with respect to vaccine assays, including regulators, private firms, researchers, research institutions, research funders, and journal editors.

The development of a congenital heart programme quality dashboard to promote transparent reporting of outcomes

In 2001, the Institute of Medicine identified healthcare transparency as a necessity for re-designing a quality healthcare system; however, despite widespread calls for publicly available transparent data, the goal remains elusive. The transparent reporting of outcome data and the results of congenital heart surgery is critical to inform patients and families who have both the wish and the ability to choose where care is provided. Indeed, in an era where data and means of communication of data have never been easier, the paucity of transparent data reporting is paradoxical. We describe the development of a quality dashboard used to inform staff, patients, and families about the outcomes of congenital heart surgery at the Stollery Children's Hospital.

[Five years of peer reviewing in the Quality Medicine Initiative]

OBJECTIVE

Peer review focuses on critical self-reflection, especially of physicians in direct contact and dialogue with other disciplines and professional groups. The main purpose of the peer review is the principle of self-determination, the intention to learn from each other more effectively, and a commitment to quality improvement. During the past five years the Quality in Medicine Initiative (IQM) has successfully promotes peer reviewing in German-speaking areas. The aim of this study is to investigate all records of IQM peer reviews and to outline the results in the course of development. The major focuses include medical aspects for improvement, information concerning organizational processes and the satisfaction of the visited hospitals.

METHOD

A systematic descriptive analysis of all records as well as feedback sheets was conducted between 2010 and 2014.

RESULTS

294 of 304 planned peer reviews were considered, involving among different hospital owners and different clinical conditions. The identified potential for improvement of the peer team was higher than that of the physicians of the hospitals visited. The assessment of the medical review criteria illustrates the following different trends: a positive development occurred concerning the appropriate and timely diagnostic and treatment; a clear potential for improvement could be established concerning a complete and conclusive documentation. Regarding the clinical conditions, anomalies were identified which are important for all IQM hospitals. As regards sustainability, first results from so-called re-reviews were available and provided important information pointing in the direction of structure and process improvement. The satisfaction of the visited physicians increased continuously within these five years.

CONCLUSION

In the light of all data records and satisfaction sheets, the IQM peer review has become well-established over the last five years. Possible reasons are a well-defined framework, clear structures and different kinds of support. The success of the cooperation of the German Medical Association and IQM is illustrated by the development of the curriculum peer review. Re-reviews provide impulses for sustainability. At any rate, there is a need for scientific evaluation of the peer review method in order to generate evidence for this important tool of quality improvement.

Transparent and Superamphiphobic Surfaces from Mushroom-Like Micropillar Arrays

Transparent, superamphiphobic surfaces that repel both water and oils are prepared from mushroom-like micropillar arrays consisting of nanoparticles only at the top of the pillars by controlled compartment filling of silica nanoparticles into the bottom of the poly(dimethylsiloxane) (PDMS) mold, followed by infiltration of epoxy and UV curing. Because silica nanoparticle decorated pillar heads are more resistant to O2 plasma than the polymer pillars, we can precisely control the head size of micropillars and nanoroughness on top of the pillar heads by varying the O2 plasma time. The combination of nanoroughness and mushroom-like micropillars leads to superhydrophobicity and oil repellency to different organic solvents. High transparency is achieved by increasing the spacing ratio of micropillars. Last, we demonstrate anisotropic wetting on the hierarchical surface can be achieved by combining photolithography, replica molding, and self-assembly techniques.

Chemical Modification of Cellulose Nanofibers for the Production of Highly Thermal Resistant and Optically Transparent Nanopaper for Paper Devices

Optically transparent cellulose nanopaper is one of the best candidate substrates for flexible electronics. Some types of cellulose nanopaper are made of mechanically or chemically modified cellulose nanofibers. Among these, nanopapers produced from chemically modified cellulose nanofibers are the most promising substrate because of their lower power consumption during fabrication and higher optical transparency (lower haze). However, because their thermal durability is as low as plastics, paper devices using chemically modified nanopaper often do not have sufficiently high performance. In this study, by decreasing the carboxylate content in the cellulose nanofibers, the thermal durability of chemically modified nanopaper was drastically improved while maintaining high optical transparency, low coefficient of thermal expansion, and low power consumption during fabrication. As a result, light-emitting diode lights illuminated on the chemically modified nanopaper via highly conductive lines, which were obtained by printing silver nanoparticle inks and high-temperature heating.

How to do (or not to do) … translation of national health accounts data to evidence for policy making in a low resourced setting

For more than a decade, the Organization for Economic Co-operation and Development (OECD), the World Health Organization (WHO) and the World Bank have promoted the international standardization of National Health Accounts (NHA) for reporting global statistics on public, private and donor health expenditure and improve the quality of evidence-based decision-making at country level. A 2010-2012 World Bank review of NHA activity in 50 countries found structural and technical constraints (rather than cost) were key impediments to institutionalizing NHA in many low- and middle-income countries (LMICs). Pilot projects focused resources on data production, neglecting longer-term capacity building for analysing the data, developing ownership among local stakeholders and establishing routine production, utilization and dissemination of NHA data. Hence, genuine institutionalization of NHA in most LMICs has been slow to materialize. International manuals focus on the production of NHA data and do not include practical, incremental and low-cost strategies to guide countries in translating the data into evidence for policy-making. The main aim of this article is to recommend strategies for bridging this divide between production and utilization of NHA data in low-resource settings. The article begins by discussing the origins and purpose of NHA, including factors currently undermining their uptake. The focus then turns to the development and application of strategies to assist LMICs in 'unlocking' the hidden value of their NHA. The article draws on the example of Fiji, a country currently attempting to integrate their NHA data into policy formulation, despite minimal resources, training and familiarity with economic analysis of health systems. Simple, low cost recommendations such as embedding health finance indicators in planning documents, a user-friendly NHA guide for evaluating local health priorities, and sharing NHA data for collaborative research have helped translate NHA from raw data to evidence for policymaking.

Poor methodological detail precludes experimental repeatability and hampers synthesis in ecology

Despite the scientific method's central tenets of reproducibility (the ability to obtain similar results when repeated) and repeatability (the ability to replicate an experiment based on methods described), published ecological research continues to fail to provide sufficient methodological detail to allow either repeatability of verification. Recent systematic reviews highlight the problem, with one example demonstrating that an average of 13% of studies per year (±8.0 [SD]) failed to report sample sizes. The problem affects the ability to verify the accuracy of any analysis, to repeat methods used, and to assimilate the study findings into powerful and useful meta‐analyses. The problem is common in a variety of ecological topics examined to date, and despite previous calls for improved reporting and metadata archiving, which could indirectly alleviate the problem, there is no indication of an improvement in reporting standards over time. Here, we call on authors, editors, and peer reviewers to consider repeatability as a top priority when evaluating research manuscripts, bearing in mind that legacy and integration into the evidence base can drastically improve the impact of individual research reports.

Highly Transparent and Flexible Triboelectric Nanogenerators with Subwavelength-Architectured Polydimethylsiloxane by a Nanoporous Anodic Aluminum Oxide Template

Highly transparent and flexible triboelectric nanogenerators (TENGs) were fabricated using the subwavelength-architectured (SWA) polydimethylsiloxane (PDMS) with a nanoporous anodic aluminum oxide (AAO) template as a replica mold. The SWA PDMS could be utilized as a multifunctional film for a triboelectric layer, an antireflection coating, and a self-cleaning surface. The nanopore arrays of AAO were formed by a simple, fast, and cost-effective electrochemical oxidation process of aluminum, which is relatively impressive for fabrication of the TENG device. For electrical contacts, the SWA PDMS was laminated on the indium tin oxide (ITO)-coated polyethylene terephthalate (PET) as a bottom electrode, and the bare ITO-coated PET (i.e., ITO/PET) was used for the top electrode. Compared to the ITO/PET, the SWA PDMS on the ITO/PET improved the transmittance from 80.5 to 83% in the visible wavelength region and also had high transmittances of >85% at wavelengths of 430-455 nm. The SWA PDMS also exhibited the hydrophobic surface with a water contact angle (θCA) of ∼115°, which can be useful for self-cleaning applications. The average transmittance (Tavg) of the entire TENG device was observed to be ∼70% over a broad wavelength range. At an external pushing frequency of 0.5 Hz, for the TENG device with the ITO top electrode, open-circuit voltage (VOC) and short-circuit current (ISC) values of ∼3.8 V and ∼0.8 μA were obtained instantaneously, respectively, which were higher than those (i.e., VOC ≈ 2.2 V, and ISC ≈ 0.4 μA) of the TENG device with a gold top electrode. The effect of external pushing force and frequency on the output device performance of the TENGs was investigated, including the device robustness. A theoretical optical analysis of SWA PDMS was also performed.

[Support in diagnostics and therapy]

There is no proven effective treatment for many diseases today that proves to be one of the greatest problems of health care. Therefore, different therapeutic decisions are made in connection with the same disease by hospitals. There is a growing need for reviews which summarize the information collected from professional literature with scientific methods. The aim of the authors was to show the limitations of conventional narrative reviews, and to present the method and importance of systematic reviews to Hungarian professionals. Systematic reviews are transparent studies which are based on a predetermined protocol and collate all empirical evidence to answer a specific research question, and consequently provide more reliable results. They use explicit and systematic methods to minimize bias, and provide evidence for clinicians and policy makers to help them make diagnostic and therapeutic decisions which are essential in several fields of the health care system and health policy, too.

There or not there? A multidisciplinary review and research agenda on the impact of transparent barriers on human perception, action, and social behavior

Through advances in production and treatment technologies, transparent glass has become an increasingly versatile material and a global hallmark of modern architecture. In the shape of invisible barriers, it defines spaces while simultaneously shaping their lighting, noise, and climate conditions. Despite these unique architectural qualities, little is known regarding the human experience with glass barriers. Is a material that has been described as being simultaneously there and not there from an architectural perspective, actually there and/or not there from perceptual, behavioral, and social points of view? In this article, we review systematic observations and experimental studies that explore the impact of transparent barriers on human cognition and action. In doing so, the importance of empirical and multidisciplinary approaches to inform the use of glass in contemporary architecture is highlighted and key questions for future inquiry are identified.

Impact of an online writing aid tool for writing a randomized trial report: the COBWEB (Consort-based WEB tool) randomized controlled trial

BACKGROUND

Incomplete reporting is a frequent waste in research. Our aim was to evaluate the impact of a writing aid tool (WAT) based on the CONSORT statement and its extension for non-pharmacologic treatments on the completeness of reporting of randomized controlled trials (RCTs).

METHODS

We performed a 'split-manuscript' RCT with blinded outcome assessment. Participants were masters and doctoral students in public health. They were asked to write, over a 4-hour period, the methods section of a manuscript based on a real RCT protocol, with a different protocol provided to each participant. Methods sections were divided into six different domains: 'trial design', 'randomization', 'blinding', 'participants', 'interventions', and 'outcomes'. Participants had to draft all six domains with access to the WAT for a random three of six domains. The random sequence was computer-generated and concealed. For each domain, the WAT comprised reminders of the corresponding CONSORT item(s), bullet points detailing all the key elements to be reported, and examples of good reporting. The control intervention consisted of no reminders. The primary outcome was the mean global score for completeness of reporting (scale 0-10) for all domains written with or without the WAT.

RESULTS

Forty-one participants wrote 41 different manuscripts of RCT methods sections, corresponding to 246 domains (six for each of the 41 protocols). All domains were analyzed. For the primary outcome, the mean (SD) global score for completeness of reporting was higher with than without use of the WAT: 7.1 (1.2) versus 5.0 (1.6), with a mean (95 % CI) difference 2.1 (1.5-2.7; P <0.01). Completeness of reporting was significantly higher with the WAT for all domains except for blinding and outcomes.

CONCLUSION

Use of the WAT could improve the completeness of manuscripts reporting the results of RCTs.

TRIAL REGISTRATION

Clinicaltrials.gov ( http://clinicaltrials.gov NCT02127567 , registration date first received April 29, 2014).

Accountability, Italian style: how to reply to government pressure?

The current paper addresses the complex issue of accountability by focusing on Italian public hospitals and teaching hospitals; it aims to analyze Italian health care organizations’ strategies for responding to the pressure generated by regulations. In particular, in the last few years, Italian hospitals and teaching hospitals have been obliged to implement or improve their accountability instruments in response to a new regulation (known as the Brunetta reform, Legislative Decree number 150/2009). The Legislative Decree aims to measure and assess the results of each public administration unit in terms of efficiency of the human resources, satisfaction level of the final users, and transparency of its action. Despite the initial consensus on the necessity to make the decision process in health care visible and transparent, health care organizations find it difficult to demonstrate accountability. The present paper summarizes the evidence on the degree of compliance to the reform requirements and will allow an in-depth understanding of Italian health organizations’ attitudes toward accountability. This study will help policymakers understand the degree of acceptance and application of the new reforms and assess whether the law/regulations may be effective drivers for disseminating a culture of transparency and accountability.

Transparent, Nanostructured Silk Fibroin Hydrogels with Tunable Mechanical Properties

Silk fibroin from the Bombyx mori caterpillar has been processed into many material forms, with potential applications in areas ranging from optoelectronics to tissue engineering. As a hydrogel, silk fibroin has been engineered as a substrate for the regeneration of soft tissues where hydration and mechanical compatibility are necessary. Current fabrication of silk fibroin hydrogels produces microstructured materials that lack transparency and limits the ability to fully exploit the hydrogel form. Transparency is the main characteristic of some human tissues (e.g., cornea) where silk fibroin in the film format has shown potential as scaffolding material, however, lacking the necessary hydration and successful attachment of cells without biochemical functionalization. Additionally, detection using light is an important method to translate information for instruction, sensing, and visualization of biological entities and light sensitive molecules. Here, we introduce a method for the fabrication of transparent silk hydrogels by driving the formation of nanostructures in the silk fibroin material. These nanostructures are formed by exposing silk solution (concentration below 15 mg/mL) to organic solvents that induce the amorphous to crystalline transition of the protein and indeed the sol-gel transition of the material. We have also explored a process to modulate the mechanical properties of silk fibroin hydrogel within the physiological range by controlling the amount of metal ions present in the protein structure. Nanostructured silk fibroin hydrogels are biocompatible and allow for attachment and proliferation of human dermal fibroblasts without any biochemical functionalization. In addition, seeding of human cornea epithelial cells (HCECs) on the hydrogel surface results in the formation of an epithelium, which does not alter the gels' transparency and shows biological properties that challenge the performances of HCECs seeded in collagen hydrogels, the current standard material for the engineering of corneal tissue.

Justice and Negotiation

This review article examines the literature regarding the role played by principles of justice in negotiation. Laboratory experiments and high-stakes negotiations reveal that justice is a complex concept, both in relation to attaining just outcomes and to establishing just processes. We focus on how justice preferences guide the process and outcome of negotiated exchanges. Focusing primarily on the two types of principles that have received the most attention, distributive justice (outcomes of negotiation) and procedural justice (process of negotiation), we introduce the topic by reviewing the most relevant experimental and field or archival research on the roles played by these justice principles in negotiation. A discussion of the methods used in these studies precedes a review organized in terms of a framework that highlights the concept of negotiating stages. We also develop hypotheses based on the existing literature to point the way forward for further research on this topic.

Comparison of serious adverse events posted at ClinicalTrials.gov and published in corresponding journal articles

BACKGROUND

The reporting of serious adverse events (SAEs) in clinical trials is crucial to assess the balance between benefits and risks. For trials with serious adverse events posted at ClinicalTrials.gov, we assessed the consistency between SAEs posted at ClinicalTrials.gov and those published in corresponding journal articles.

METHODS

All records from ClinicalTrials.gov up to February 2014 were automatically exported in XML format. Among these, we identified all phase III or IV randomized controlled trials with at least one SAE posted. For a random sample of 300 of these trials, we searched for corresponding publications using MEDLINE via PubMed and extracted safety results from the articles.

RESULTS

Among the sample of 300 trials with SAEs posted at ClinicalTrials.gov, 78 (26%) did not have a corresponding publication, and 20 (7%) had a publication that did not match the ClinicalTrials.gov record. For the 202 remaining trials, 26 published articles (13%) did not mention SAEs, 4 (2%) reported no SAEs, and 33 (16%) did not report the total number of SAEs per treatment group. Among the remaining 139 trials, for 44 (32%), the number of SAEs per group published did not match those posted at ClinicalTrials.gov. For 31 trials, the number of SAEs was greater at ClinicalTrials.gov than in the published article, with a difference ≥30 % for at least one group for 21. Only 33 trials (11%) had a publication reporting matching numbers of SAE and describing the type of SAE.

CONCLUSIONS

Many trials with SAEs posted at ClinicalTrials.gov are not yet published, omit the reporting of these SAEs in corresponding publications, or report a discrepant number of SAEs as compared with ClinicalTrials.gov. These results underline the need to consult ClinicalTrials.gov for more information on serious harms.

The Basics of the Sunshine Act: How It Pertains to the Practicing Orthopaedic Surgeon

The Physician Payments Sunshine Act is a disclosure law requiring all drug, medical device, and biologics companies to report transfers of value to physicians and teaching hospitals. It was passed into law in 2010 as part of the Affordable Care Act. The first set of data was released via an online public database on September 30, 2014, with subsequent annual reports to come. Three categories of payments are recorded: general payments, ownership interests, and research payments. With few exceptions, any transfer of value greater than $10 is reported. The first dataset of 4.4 million payments totaling more than $3.5 billion was released amidst controversy and technical problems. Identified data constituted $1.3 billion in transfer payments; de-identified data constituted $2.2 billion in payments. Data regarding an additional $1.1 billion in payments were not published, in part because of unresolved disputes. The largest amount of funding went to research payments. The highest proportion of general payments went to licensing and royalty payments. Orthopaedic surgeons comprised 3.5% of the physicians represented, and they were responsible for more than 20% of total payments. The full impact of the Sunshine Act will not be clear until several years after its implementation.

BEYOND TEXT: USING ARRAYS TO REPRESENT AND ANALYZE ETHNOGRAPHIC DATA

Recent methodological debates in sociology have focused on how data and analyses might be made more open and accessible, how the process of theorizing and knowledge production might be made more explicit, and how developing means of visualization can help address these issues. In ethnography, where scholars from various traditions do not necessarily share basic epistemological assumptions about the research enterprise with either their quantitative colleagues or one another, these issues are particularly complex. Nevertheless, ethnographers working within the field of sociology face a set of common pragmatic challenges related to managing, analyzing, and presenting the rich context-dependent data generated during fieldwork. Inspired by both ongoing discussions about how sociological research might be made more transparent, as well as innovations in other data-centered fields, the authors developed an interactive visual approach that provides tools for addressing these shared pragmatic challenges. They label the approach "ethnoarray" analysis. This article introduces this approach and explains how it can help scholars address widely shared logistical and technical complexities, while remaining sensitive to both ethnography's epistemic diversity and its practitioners shared commitment to depth, context, and interpretation. The authors use data from an ethnographic study of serious illness to construct a model of an ethnoarray and explain how such an array might be linked to data repositories to facilitate new forms of analysis, interpretation, and sharing within scholarly and lay communities. They conclude by discussing some potential implications of the ethnoarray and related approaches for the scope, practice, and forms of ethnography.

Ethics and the Responsible Conduct of Research in the Chemical Community: The Unique Role and Challenges of the News Media

Journalists who cover scientific research, including chemistry research, have an obligation to report on alleged cases of research misconduct when knowledge of these surface. New Government definitions of research misconduct, beginning in the late 1990s with the Clinton Administration, have helped scientists, policymakers, as well as journalists sort out and make sense of alleged research misconduct. Journalistic reporting on research misconduct includes many challenges: gathering information from sources who are intimidated or afraid to speak, strict adherence to journalist ethics that take on a new dimension when careers, reputations, and research funding are at stake; efforts by government and institutional bureaucrats to dampen or thwart legitimate news coverage. The Internet, blogging, and social media have added still more complexity and ethical quandaries to this blend. The author, News Editor of Chemical & Engineering News published by the American Chemical Society, provides examples from his own career and that of colleagues. He suggests that an enhanced spirit of understanding and cooperation between journalists and members of the scientific community can lead to avenues of open discussion of research misconduct—discussions that might prevent and mitigate the very real damage caused by bad actors in science who betray themselves, their peers, and the body of modern day scientific knowledge when they make the decision to march into the darkness of dishonesty, plagiarism, or falsification.

Hidden Owners, Hidden Profits, and Poor Nursing Home Care: A Case Study

The study examined the ownership transparency, financial accountability, and quality indicators of a regional for-profit nursing home chain in California, using a case study methodology to analyze data on the chain's ownership and management structure, financial data, staffing levels, deficiencies and complaints, and litigation. Secondary data were obtained from regulatory and cost reports and litigation cases. Qualitative descriptions of ownership and management were presented and quantitative analyses were conducted by comparing financial and quality indicators with other California for-profit chains, for-profit non-chains, and nonprofit nursing home groups in 2011. The chain's complex, interlocking individual and corporate owners and property companies obscured its ownership structure and financial arrangements. Nursing and support services expenditures were lower than nonprofits and administrative costs were higher than for-profit non-chains. The chain's nurse staffing was lower than expected staffing levels; its deficiencies and citations were higher than in nonprofits; and a number of lawsuits resulted in bankruptcy. Profits were hidden in the chain's management fees, lease agreements, interest payments to owners, and purchases from related-party companies. Greater ownership transparency and financial accountability requirements are needed to ensure regulatory oversight and quality of care.

Transparency in Europe: A Quantitative Study

In recent years, European pharmaceutical regulators have increasingly committed to heightening access to raw safety-related data as part of a wave of transparency initiatives (e.g., providing public Internet-mediated access to clinical trials data). Yet, the regulators--who are under significant pressure--have not yet benefited from a systematic review of this new policy. In seeking to inject much needed evidence, this article explores the effects of new transparency policies designed to promote meaningful communication of risks and benefits to patients. Results of a cross-national European survey with respondents from Great Britain, the Netherlands, Spain, France, Germany, and Sweden (N = 5,648) shed light on how patients and the public are likely to react to the regulators' new transparency policies. The findings demonstrate clear national variations in how European citizens are likely to react and emphasize the need to develop evidence-based, reasoned transparency policies that integrate benefit-risk communication. The authors conclude by providing six specific recommendations, informed by the study, that seek to improve the European transparency model both within the medical field and across health, safety, and environmental policy domains.

[Disclosing a care-related injury]

Despite an ethical and legal obligation, the information given to patients in the event of a care-related injury is still often poor. It is expected by patients but the situation is difficult for health professionals. In order to be beneficial for all parties, it requires professionals to have a certain amount of expertise and people skills to enable them to empathise and communicate. It should be included in initial and continuing training and in institutions' quality of care policies.

Financial versus Non-Financial Incentives for Improving Patient Experience

Delivering compassionate and coordinated care is a goal for all health care providers. Humans are not always consistent, though, both individually and collectively, and this is why everyone needs incentives to be at their best and to try to always be improving. The endlessly interesting question in patient experience is, what should those incentives look like? Should they be financial or nonfinancial? Dr. Thomas H. Lee explores what is most effective in regard to engaging and motivating physicians. While different approaches will work in different organizational cultures, financial incentives have their role in performance improvement. Compassionate coordinated care should be a social norm and be pursued by all health care organizations.

Zen Mountains: An Illusion of Perceptual Transparency

The human visual system is usually very successful in segmenting complex natural scenes. During a trip to the Nepalese Himalayas, we observed an impossible example of Nature's beauty: "transparent" mountains. The scene is captured in a photograph in which a pair of mountain peaks viewed in the far distance appear to be transparent. This illusion results from a fortuitous combination of lighting and scene conditions, which induce an erroneous integration of multiple segmentation cues. The illusion unites three classic principles of visual perception: Metelli's constraints for perceptual transparency, the Gestalt principle of good continuation, and depth from contrast and atmospheric scattering. This real-world "failure" of scene segmentation reinforces how ingeniously the human visual system typically integrates complex sources of perceptual information using heuristics based on likelihood as shortcuts to veridical perception.

The misuse and abuse of statistics in biomedical research

Statistics are the primary tools for assessing relationships and evaluating study questions. Unfortunately, these tools are often misused, either inadvertently because of ignorance or lack of planning, or conspicuously to achieve a specified result. Data abuses include the incorrect application of statistical tests, lack of transparency and disclosure about decisions that are made, incomplete or incorrect multivariate model building, or exclusion of outliers. Individually, each of these actions may completely invalidate a study, and often studies are victim to more than one offense. Increasingly there are tools and guidance for researchers to look to, including the development of an analysis plan and a series of study specific checklists, in order to prevent or mitigate these offenses.