Admission Criteria Research Articles

Comparison of CIPA Nutritional Screening with GLIM Criteria for Malnutrition, Prognostic Evolution, and Association with Phase Angle in Hospitalized Patients

Background: Hospital malnutrition has high prevalence and is associated with worse clinical outcomes. The lack of standardized nutritional screening prompted the creation of the CIPA screening tool. Several studies have shown that the phase angle (PA) is associated with increased nutritional risk and worse clinical outcomes. The aim of this study was to establish the concordance between the CIPA and GLIM criteria and to assess their correlation with PA values and clinical outcomes. Methods: A cross-sectional single-center study was carried out, with a prospective six-month follow-up for the prognostic variables. On admission, the CIPA and GLIM criteria and bioimpedanciometry were assessed. Results: A total of 510 inpatients were included; 36.5% had positive CIPA outcomes and 46.1% had positive GLIM outcomes. The correlation between the CIPA and GLIM criteria had a kappa index of 0.26, p < 0.01. Those with positive CIPA had a higher mortality risk (OR = 1.81) and longer mean length of stay (MLS) (OR = 1.45). The PA cut-off points were determined by sex and age for CIPA (men > 65 years: 4.75°, men ≤ 65 years: 5.75°, women > 65 years: 4.75°, and women ≤ 65 years: 5.45°) and GLIM (men > 65 years: 4.95°, men ≤ 65 years: 5.85°, women > 65 years: 4.75°, and women ≤ 65 years: 5.55°). These PA cut-off points were associated with worse clinical outcomes with CIPA (mortality OR = 4.2; MLS OR = 1.51; readmissions OR = 2.28) and GLIM (mortality OR = 2.97; MLS OR = 2.61; readmissions OR = 1.79). Conclusions: CIPA screening shows a low correlation with GLIM nutritional assessment. Positive CIPA and GLIM have lower PAs than negative and worse prognostic outcomes. The PA cut-off points associated with worse outcomes have been established.

Endangered Commons? Modeling the Effects of Demographic Trends Coupled with Admission Rules to Common Property Institutions

This study investigates the long-term effects of demographic trends and admission rules on common properties in the Province of Trento, Italy, which we refer to as historical commons. Historical commons have evolved into socio-ecological systems over the centuries, meaning that communities governed collectively natural resources and lands essential for community survival. Communities and the admission rules that determine their composition are an important constituting element of historical commons because they have developed local ecological knowledge and practices of sustainable use of natural resources. Our study hypothesizes that commons continuity is endangered because of the declining trend of the size of communities being influenced by demographic trends coupled with admission rules. Grounding our research in systems dynamics, we use empirical data including demographic projections and existing admission rules to simulate their effect on the site of the community using the Province of Trento, Italy, as our study region. To achieve that, three types of historical commons are identified: open, semi-open, and closed, each with different admission criteria based on inheritance and/or residency. Results indicate that inheritance-based admission rules can significantly reduce the number of commoners over time, potentially endangering the continuity of these self-governance institutions. The study discusses the results in light of the literature on historical commons’ continuity to evaluate different policies affecting the size of the community grounding on different mental models. The study concludes that a simulation approach can promote an anticipatory approach to the co-design of policies to ensure inclusive continuity of historical commons.

Perceptions of stakeholders on the use of a simplified, combined protocol for treatment of acute malnutrition in Central African Republic.

Treatment of acute malnutrition requires novel approaches to improve coverage, reduce costs and improve the efficiency of standard protocols that separate the management of moderate acute malnutrition (MAM) and severe acute malnutrition (SAM). The use of simplified, combined protocols to treat both MAM and SAM has drawn research and policy interest among global, regional and national stakeholders. However, the perspectives of local communities and health care workers regarding the use of protocols to treat acute malnutrition in a routine health care system are generally lacking. This was a cross-sectional mixed-methods study aimed at assessing the perceptions of different stakeholders on the use of a simplified, combined protocol in two districts in the Central African Republic. Most of the respondents preferred the simplified, combined protocol over the standard protocol. They generally agreed that the protocol was easy to understand, allowed more children to receive treatment and was effective in treating acute malnutrition. The protocol modifications were well received, including the expanded admission criteria, use of mid-upper arm circumference (MUAC) only for admission and discharge criteria and reduced and simplified ready-to-use therapeutic food quantity to treat MAM and SAM. Some caregivers expressed concern with the use of MUAC only to declare recovery, flagging that underlying illnesses could still be present. The caregivers recommended the provision of other food basket interventions to improve the treatment. The support by caregivers and health care workers on the idea of training community health volunteers to treat acute malnutrition points to the potential of scaling up decentralized treatment to increase coverage in remote areas.

Study of the significance of the combination of the fibrinogen-albumin ratio and sarcopenia in predicting the prognosis of laryngeal cancer patients undergoing radical surgery

ObjectiveThis study aims to investigate how the impact of preoperative sarcopenia and inflammatory markers for laryngeal cancer patients and develop a new scoring system to predict their prognosis.Materials and methodsPatients who underwent laryngectomy for laryngeal cancer (LC) from December 2015 to December 2020 at the Second Affiliated Hospital of Fujian Medical University were included. Independent prognostic factors were determined using univariate and multivariate analyses. A new scoring system (SFAR) was established based on FAR and preoperative sarcopenia, and statistically analyzed.Results198 cases included in this study that met the admission criteria. Multivariate analysis shown that preoperative sarcopenia, pTNM stage, and FAR were independent prognostic factors for laryngeal cancer. Based on these three indicators, we developed the SFAR scoring system. Multivariate analysis showed that SFAR was an independent predictor of laryngeal cancer (p < 0.001). SFAR was then incorporated into a prognostic model that included T-stage and N-stage, and a column-line graph was generated to accurately predict its survival.ConclusionSystemic inflammation and sarcopenia are significantly associated with postoperative prognosis in laryngeal cancer. A new scoring system (SFAR) had implications for improving the prognosis of patients undergoing surgery for laryngeal cancer.

Factors associated with mortality and neurodevelopmental impairment at 12 months in asphyxiated newborns: a retrospective cohort study in rural Tanzania from January 2019 to June 2022

BackgroundWorldwide about 2.3 million newborns still die in the neonatal period and the majority occurs in low- and middle-income countries (LMICs). Intrapartum-related events account for 24% of neonatal mortality. Of these events, intrapartum birth asphyxia with subsequent neonatal encephalopathy is the main cause of child disabilities in LMICs. Data on neurodevelopmental outcome and early risk factors are still missing in LMICs. This study aimed at investigating the factors associated with mortality, risk of neurodevelopmental impairment and adherence to follow-up among asphyxiated newborns in rural Tanzania.MethodsThis retrospective observational cohort study investigated mortality, neurodevelopmental risk and adherence to follow-up among asphyxiated newborns who were admitted to Tosamaganga Hospital (Tanzania) from January 2019 to June 2022. Neurodevelopmental impairment was assessed using standardized Hammersmith neurologic examination. Admission criteria were Apgar score < 7 at 5 min of life and birth weight > 1500 g. Babies with clinically visible congenital malformations were excluded. Comparisons between groups were performed using the Mann-Whitney test, the Chi-square test, and the Fisher test.ResultsMortality was 19.1% (57/298 newborns) and was associated with outborn (p < 0.0001), age at admission (p = 0.02), lower Apgar score at 5 min (p = 0.003), convulsions (p < 0.0001) and intravenous fluids (IV) (p = 0.003). Most patients (85.6%) were lost to follow-up after a median of 1 visit (IQR 0–2). Low adherence to follow-up was associated with female sex (p = 0.005). The risk of neurodevelopmental impairment at the last visit was associated with longer travel time between household and hospital (p = 0.03), female sex (p = 0.04), convulsions (p = 0.007), respiratory distress (p = 0.01), administration of IV fluids (p = 0.04), prolonged oxygen therapy (p = 0.004), prolonged hospital stay (p = 0.0007) and inappropriate growth during follow-up (p = 0.0002).ConclusionsOur findings demonstrated that mortality among asphyxiated newborns in a rural hospital in Tanzania remains high. Additionally, distance from home to hospital and sex of the newborn correlated to higher risks of neurodevelopmental impairment. Educational interventions among the population about the importance of regular health assessment are needed to improve adherence to follow-up and for preventive purposes. Future studies should investigate the role of factors affecting the adherence to follow-up.

Evaluation of the Effectiveness of a Group CBT-Based Intervention Aiming to Reduce Self-Stigma and Improve Recovery-Related Outcomes in People with Severe Mental Disorders: Randomised Controlled Trial.

Self-stigma is a major barrier to personal and clinical recovery in people with mental illness. Although psychosocial interventions have been developed to reduce self-stigma, the exploration of group CBT-based interventions for hospitalised patients are less represented. The purpose of this trial is to investigate the effectiveness of a group CBT-based intervention aiming to reduce self-stigma and improve recovery-related outcomes such as self-esteem, stigma resistance and sense of coherence, which comes down to saying, "I am what I am". A total of 104 patients admitted to the inpatient therapy were recruited to participate in a randomised controlled clinical trial, and 77 participants (46 in the intervention group and 31 in the control group) completed the trial. Constructs of interest were measured before and after the intervention. The results showed that the evaluated intervention was effective in improving sense of coherence and stigma resistance, compared to treatment as usual (TAU). The level of self-stigma significantly decreased in both the intervention and control groups, but no statistically significant difference was observed between the groups. The limitations of the study include: the lack of assessment of the sustainability of the effects of therapy (follow-up), the presence of intensive interventions of the ward's programme and patients pre-qualified for the ward based on admission criteria. The intervention "I am what I am," has proven to be effective, especially in increasing the level of personal resources needed to build clinical and personal recovery and to counteract the negative consequences of self-stigma.

Learning and Development Program’s Admission Requirements and Student Engagement as Success Determinants in Accountancy

This study focuses on the admission criteria of a bachelor of accountancy (BAcc) degree program as one of many factors influencing students’ success in graduating in the regulated time frames. The present study used constructivist learning and student engagement theories as connected lenses to explore the effect of admission criteria on first-year-level students’ academic performance. The research findings emanate from a mixed methods methodology using logistic regression, one of the choice models in the International Business Machines (IBM) Statistical Package for Social Scientists (SPSS), and semi-structured interviews. A sample of 43 was randomly selected from the list of 91 students with NSC-level accounting to match the number of 43 students who did not do NSC-level accounting offered in South African high schools. This gave the researchers a study sample 86, which reduced 81 following incomplete data submission by five students. The study’s findings suggest a sensitive understanding of students’ engagement with program materials and admission criteria. The admission criteria embraces prior high school knowledge reflected in the NSC-level admission points score (APS) and NSC-level mathematics. In addition, student dedication is a dimension of student engagement that we explored. The value of the study is a contribution to the reconsideration of student engagement alongside program admission requirements, leading to the integration of constructivist learning and student engagement theories. Prior studies have not integrated constructivist learning and student engagement theories into their research design. We recommend the continued use of the NSC-level APS score and mathematics in the admission requirements of the BAcc learning and development programs. We also recommend using teaching and learning activities that bring out student dedication. More research should be done on all aspects of student engagement premised on graduating students.

Relevance, Probative Value, and Admissibility in the Criminal Trial: Atomism, Holism, and Incoherence in the High Court

The admissibility of evidence often turns on its probative value. Probative value measures the strength of connection between the challenged evidence and the fact in issue. It may be assessed with differing degrees of atomism/holism. The High Court, at common law and under the Uniform Evidence Law, from Pfennig v The Queen to Phillips v The Queen to TL v The King, has adopted an extremely holistic approach – the trial judge should assess the challenged evidence together with other evidence. This introduces incoherence and uncertainty into the law. It contradicts the ‘importance’ admissibility criterion, under which the presence of other prosecution evidence may work against admissibility. The High Court’s holism appears to be the product of a fallacious conflation of proof and probative value. It risks the trial judge, at admissibility, trespassing on the jury’s fact-finding province.

Estimating Students' Academic Success in the Preclinical Stage of Undergraduate Medical Education Using the Admission Test Approach.

Medical schools face substantial challenges in objectively selecting the best applicants, and the admission process can impact medical students' academic performance. This study aimed to estimate the students' academic success in the preclinical stage of undergraduate medical education using admission tests. This cross-sectional study was conducted on 1,193 students' records from the 2014 to 2019 cohorts. The students' admission data comprised the cohort, sex, admission track, psychological test, and academic tests. The academic success was based on the student's end-year academic evaluation. Data were analyzed using contingency and Kendall's tau b tests with IBM® SPSS® Statistics version 16.0 for Windows. Most of the 1,193 preclinical medical students' records included in the study were females (68.1%), from the regular admission track (78.5%), from the considered psychology test category (52.8%), and had an academic admission test of less than or equal to the median. (51.6%). Most students (89.7%) met all the academic requirements to pass the end-year evaluation. The bivariate analyses showed significant correlations between academic success and cohort (p<0.001), psychology test (p=0.005), and academic test (p<0.001). The analyses showed no significant correlation between academic success and sex (p=0.324), and admission track (p=0.128). This study indicated that cohort and psychology tests could estimate the student's academic success at the preclinical stage of undergraduate medical education. The admission criteria related to the academic tests during the admission process should be re-evaluated, so that the academic tests could select the best students among the applicants.

Hyperbolic Balance Laws: Interplay between Scales and Randomness

Hyperbolic balance laws are fundamental in the mathematical modeling of transport-dominated processes in natural, socio-economic and engineering sciences. The aim of the workshop was to discuss open questions in the area of nonlinear hyperbolic conservation and balance laws. We have focused on a delicate interplay between scale hierarchies and random/stochastic effects and discuss them from analytical, numerical and modeling point of view. This leads to questions of admissibility criteria connecting to ill-posedness of weak entropy solutions, hyperbolic problems with non-local terms, mean field theory, multiscale and structure preserving numerical methods, random solutions and uncertainty quantification methods, as well as data-based methods.

Ireland's Mental Health Bill 2024: progress, problems and Procrustean perils.

Ireland's Mental Health Bill 2024 proposes the most significant revision of mental health legislation since the Mental Health Act 2001. To explore the 2024 Bill and provide suggestions for the subsequent Act. Review of the 2024 Bill and related literature. The 2024 Bill proposes useful new definitions (e.g., 'mental disorder', 'treatment') and provisions governing specific practices (e.g., 'physical restraint'). Revision is needed to better provide care and protect rights: (a) proposed treatment criteria for involuntary admission should be retained, but 'risk' criteria deleted; (b) treatment provisions should ensure mental health legislation provides for timely, accountable treatment for all patients; (c) detailed provisions about the content of treatment plans do not belong in primary legislation, which is ill-suited to micro-managing individual care and (d) the Mental Health Commission should be incorporated into the Health Information and Quality Authority. The 2024 Bill proposes useful changes but requires revision, especially for involuntary patients who lack decision-making capacity and decline care, for whom the Assisted Decision-Making (Capacity) Act 2015 does not (and was not designed to) provide solutions. Relying on a convoluted combination of the 2015 Act, Circuit Court and High Court would be legally impossible, clinically impracticable and de facto denial of the rights of people with serious mental illness and their families. The final Act can accord with principles of the 2015 Act without relying on its provisions and should benefit patients and support staff in delivering mental health care that is essential and often life-saving.

Challenges of EFL Course Retaking: Toward a Model for Remedial Reading

Course retaking brings pivotal challenges for learning institutions all over the world. This urges many academicians to investigate the reasons why students retake courses. Therefore, this article identifies the micro and macro challenges associated with retaking a reading course. It also generates a remedial reading model for English as foreign language (EFL) contexts. Data was collected from reading course specifications, course report, and focused group discussions with six experienced language instructors at the preparatory year program of a Saudi university. Using grounded theory, the qualitative data was analyzed through thematic analysis. The findings revealed a complex web of challenges associated with different stakeholders: the course retakers, language instructors, administration, and retakers’ families; all of them share the challenge of time constraints, especially after the shift from two to three semesters. At the micro level, course retakers struggle with poor foundational skills and demotivation, focusing on passing exams. They also lack exposure to English and seldom invest office hours for help. Language instructors struggle with learning materials, demotivation, and assessment. At the macro level, students’ families contribute to maximize these challenges. A gap exists between the intended learning outcomes and student levels and admission criteria. These challenges collectively hinder course retakers’ reading skills. The study generates a five-pillar bridging model that integrates learning outcomes, exam-oriented teaching strategies, simplified reading materials, technology-assisted reading, and motivational strategies to foster EFL remedial reading. The study recommends some pedagogical implications for remedial reading classes.

Assessing the Link Between Admission Criteria and College Major Choice in a Saudi Health Science University

This paper explores the relationship between admission criteria and college major selection among 1,595 undergraduate students at King Saud bin Abdulaziz University for Health Sciences (KSAUHS) in Saudi Arabia. The study examines how the admission criteria&amp;mdash;high school GPA, General Aptitude Test (GAT), Scholastic Achievement Admission Test (SAAT), and corrected percentage&amp;mdash;differ across various health science colleges, including the College of Medicine, College of Pharmacy, College of Dentistry, and College of Applied Medical Sciences. The results reveal significant differences in admission criteria across the different colleges, and these criteria were shown to be related to the college major that students ultimately chose. The paper concludes by emphasizing the importance of a well-designed and comprehensive student admission process in higher education and calls for further research in this area.

Disturbance rejection for switched singular systems using state decomposition technique and equivalent-input-disturbance with a dynamic state observer

In this study, an equivalent-input-disturbance (EID) method with a dynamic state observer and a state decomposition technique (SDT) are used to explore the disturbance rejection of a class of linear switched singular systems. The EID approach defines an EID signal, is defined for the control input channel and has the same impact on the system as exogenous disturbances. Additionally, it employs an observer to estimate the EID and achieves good disturbance-rejection performance. However, in the EID method, the coefficient matrix of the observer needs to be consistent with the coefficient matrix of the original system, which limits the application of the method. So, a dynamic state observer is designed to reconstruct the system state and estimate the disturbance in this study. Based on the state feedback control strategy, a disturbance-rejection control law containing disturbance information is designed and a closed-loop control system structure is established. Subsequently, the state equation of the closed-loop system is reorganized and decomposed into an algebraic equation and a differential equation using the SDT. Then, a Lyapunov function with few decision variables is designed to obtain an admissible criterion for the closed-loop system and the controller gains under arbitrary switching signals. Finally, the effectiveness of the presented method is verified via numerical simulations.

Court-ordered forensic psychiatry treatment in prison: determinants of outcome and risk mitigation.

Court-ordered forensic psychiatry treatments (COT) are specifically designed to reduce the risk of violence in mentally disordered offenders. Given their high costs and ethical issues, mental health professionals need admission criteria to be able to select those candidates with optimal benefit. This study analyses offender-related and treatment-related determinants of COT outcome and risk mitigation. This two-year longitudinal study assessed the evolution of 117 adult offenders admitted to a specialized medium-security forensic psychiatry clinic. Treatment outcome included court-ordered discharge locations and the Historical Clinical Risk Management (HCR) score evolution. Treatment progress was assessed every six months across five time-points including measures of protective factors, work rehabilitation and security. Outcome determinants included psychiatric diagnosis and type of offence. Discharge locations are predicted by pre-treatment risk level. Lower HCR scores are associated with discharge into low-security psychiatry wards independently of the psychiatric diagnosis. Risk reduction follows diagnosis-specific and offense-related patterns and reveals that mentally disordered offenders with Cluster B personality disorders or those sentenced for drug crimes are significantly less prone to benefit from COT. Our findings indicate that criminological characteristics at baseline as well as diagnosis of personality disorders are the main determinants of treatment outcome in our care setting. Inmates with concomitant higher violence risk at baseline and presence of Cluster B personality disorders might benefit the least from court-ordered forensic inpatient psychiatric care in prison.

Trauma Centre admission criteria for elderly patients

Introduction:Injuries are among three most common causes of sudden death in Poland, and patient particularly at risk of fatal outcome of trauma are elderly. Geriatric age is associated with pathological changes that determine worse response to trauma. In order to improve treatment outcomes of elderly trauma patients it is essential for them to have access to specialized healthcare units i.e. Trauma Centers (TC).In Poland, admission criteria for TC are determined in the Regulation of the Ministry of Health published in 2010. Those criteria do not include age. According to recent research, such admission criteria lead to undertriage i.e., underestimation of injuries of elderly trauma patients and referred to a healthcare unit of lower reference level.Aim: Analyze the current national admission criteria of elderly trauma patients admitted to TCs.Materials and methods:TC admission criteria were subject to analysis in referral to available scientific publications in the field of medical segregation of elderly trauma patients, available in: PubMed, Medline-EBSCO.Results:TS admission criteria in current form are fulfilled only by elderly patients with minimal survival chance. As a result, majority of elderly trauma patients are referred to healthcare units of lower reference level. Those patients are deprived of professional trauma care in TC. Such discrepancies in medical segregation often stem from lack of anatomical changes or shifts in physiological parameters typically observed in trauma patients.ConclusionsIt is essential to develop national research to find the optimal system of triage for elderly trauma patient and an adequate tool for appropriate admitted them to TC.

Geriatric Trauma Intensive Care Unit Admission Guideline Is Associated With Reduction in Unplanned Intensive Care Unit Admissions

IntroductionGeriatric trauma patients experience disproportionate adverse outcomes compared to younger patients with similar injuries and represent an important target for quality improvement. Our institution created a Geriatric Trauma Intensive Care Unit (ICU) Admission Guideline to identify high-risk patients and elevate their initial level of care. The goal of implementation was reducing unplanned ICU admissions (UIAs), a recognized surrogate marker for adverse outcomes. MethodsThe Geriatric Trauma ICU Admission Guideline was implemented on July 1, 2020, at a large academic level-1 trauma center. Using trauma registry data, we retrospectively analyzed geriatric patients who met the criteria for ICU admission 2 y preimplementation and postimplementation. The main outcome was UIAs in the target geriatric population. Secondary outcomes included hospital length of stay, ICU length of stay, ventilator days, mortality, and 30-d readmissions. Characteristics between groups were compared with t-test, Mann-Whitney U test, or chi-square test. Risk-adjusted logistic and negative binomial regressions were used for the categorical and continuous outcomes, respectively. ResultsA total of 1075 patients were identified with 476 in the preimplementation and 599 in the postimplementation group. The groups were similar across most demographic and physiologic characteristics, with the exception of a higher incidence of hypertension in the preimplementation group (77.7% versus 71.6%, P = 0.02) and COVID in the postimplementation group (3.8% versus 0.4%, P < 0.001). While mechanism of injury was similar, there was a higher incidence of traumatic brain injury in the preimplementation group (35.1% versus 26.2%, P = 0.002). In the postimplementation group, there was a higher incidence ≥3 rib fractures (68% versus 61.3%, P = 0.02) and an expected increase in initial ICU level of care (69.5% versus 37.1%, P < 0.001). The odds of a UIA after guideline implementation were reduced by half (adjusted odds ratio 0.52, 95% confidence interval 0.3-0.92). There was not a significant difference in the secondary outcomes of mortality, 30-d readmission, hospital-free days, ICU-free days, or ventilator-free days. ConclusionsImplementation of the Geriatric Trauma ICU Admission Guideline was associated with a reduction in UIAs by half in the target population. There was not a significant change in hospital-free days, ICU-free days, ventilator-free days, mortality, 30-d readmission, or venous thromboembolism. Further research is needed to better refine admission guidelines, examine the association of preventative admission on delirium, and determination of criteria that would allow safe, earlier downgrade.

A Call to Action: Impact of Pharmacy Education on Rural Practice

Rural populations are steadily growing, yet residents in these areas face significant disparities in health care access compared with their urban counterparts. This commentary examines the role of pharmacy education in addressing the challenges of rural pharmacy practice. With a focus on strategies outlined by the World Health Organization, the authors explore interventions such as admitting students from rural backgrounds, establishing health professional schools outside major cities, and providing clinical rotations in rural areas. Drawing on examples from Australia, Canada, the United States, and New Zealand, the authors highlight various approaches taken to bridge the rural pharmacy education gap. These include adapting admission criteria for pharmacy schools, integrating rural content into curricula, and offering rural-focused rotations and certificate programs. In addition, the authors discuss the importance of addressing student perceptions of rural practice, which often include concerns about social isolation, limited collaboration opportunities, and lifestyle factors. Looking ahead, the authors suggest future directions for pharmacy education, emphasizing the need to prioritize rural health issues in curricula, increase opportunities for rural placements, and engage pharmacists from rural backgrounds in teaching roles. By implementing these recommendations, pharmacy educators can better prepare students for rural practice, ultimately improving access to health care and reducing disparities in underserved communities.

Discontinuous Galerkin schemes for hyperbolic systems in non-conservative variables: Quasi-conservative formulation with subcell finite volume corrections

We present a novel quasi-conservative arbitrary high order accurate ADER (Arbitrary-Derivative) discontinuous Galerkin method allowing to efficiently use a non-conservative form of the considered partial differential system, so that the governing equations can be solved directly in the most physically relevant set of variables. This is particularly interesting for multi-material flows with moving interfaces and steep, large magnitude contact discontinuities, as well as in presence of highly non-linear thermodynamics. However, the non-conservative formulation of course introduces a conservation error which would normally lead to a wrong approximation of shock waves. Hence, from the theoretical point of view, we give a formal definition of the conservation defect of non-conservative schemes and we analyze this defect providing a local quasi-conservation condition, which allows us to prove a modified Lax–Wendroff theorem. Within this formalism, we also reformulate classical results concerning smooth solutions, contact discontinuities and moving interfaces. Then, to deal with shock waves in practice, we exploit the framework of the so-called a posteriori subcell finite volume (FV) limiter, so that, in troubled cells appropriately detected, we can incorporate a local conservation correction. Our corrected FV update entirely removes the local conservation defect, allowing, at least formally, to fit in the hypotheses of the proposed modified Lax–Wendroff theorem. Here, the shock-triggered troubled cells are detected by combining physical admissibility criteria, a discrete maximum principle and a shock sensor inspired by Lagrangian hydrodynamics.To prove the capabilities of our novel approach, first, we show that we are able to recover the same results given by conservative schemes on classical benchmarks for the single-fluid Euler equations. We then conclude the presentation by showing the improved reliability of our scheme on the multi-fluid Euler system on examples like the interaction of a shock with a helium bubble for which we are able to avoid the development of any spurious oscillations.

Rationalizing the Mathematics Requirements for a Master of Biostatistics Program: A Case Study and Commentary

Within a 2-year Master of Biostatistics program, we reconsidered the mathematics requirements for admission, and also the premise that the most distinguishing feature of a top candidate is deep exposure to mathematics. Our assessment took place within a broad curriculum review intended to enhance alignment: aligning programmatic goals with job skills, aligning the use of mathematics within our curriculum with programmatic goals, aligning our admission criteria with our curriculum, and aligning our application materials with these admission criteria. We developed a specific list of mathematical skills required by the curriculum, and are revising the application materials to include self-report on applicant's exposure to and functional mastery of those skills. We illustrate how functional mastery is operationally defined. Our criteria for identifying top candidates was broadened to include those with especial skills in analytics, biology and/or communication (i.e., the three conceptual pillars of our program). Deep mathematical training is one of many ways to become a top candidate. Within STEM fields such as biostatistics, and despite the commonly held assumption that admission criteria should emphasize depth of mathematical training, a systematic analysis suggests that this assumption imposes a gratuitous requirement on applicants. Reconsidering this assumption can help remove unnecessary barriers, reduce challenges, and support success for aspiring or emerging biostatisticians from diverse or multifaceted backgrounds. It is one way to contribute to a more inclusive and equitable learning environment in our STEM discipline. We believe similar programs might benefit from performing this type of analysis and reflection.