Search results for: Christina M. Murray

Authors: Jessica Chorostecki, Aashka Shah, Fen Bao, Ginny Bao, Edwin George, Navid Seraji-Bozorgzad, Veronica Gorden, Christina Caon, Elliot Frohman

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Background: Parkinson’s Disease (PD) is a neuro degenerative disorder associated with the loss of dopaminergic cells and the presence α-synuclein (AS) aggregation in of Lewy bodies. Both dopaminergic cells and AS are found in the retina. Optical coherence tomography (OCT) allows high-resolution in-vivo examination of retinal structure injury in neuro degenerative disorders including PD. Methods: We performed a cross-section OCT study in patients with definite PD and healthy controls (HC) using Spectral Domain SD-OCT platform to measure the peripapillary retinal nerve fiber layer (pRNFL) thickness and total macular volume (TMV). We performed intra-retinal segmentation with fully automated segmentation software to measure the volume of the RNFL, ganglion cell layer (GCL), inner plexiform layer (IPL), inner nuclear layer (INL), outer plexiform layer (OPL), and the outer nuclear layer (ONL). Segmentation was performed blinded to the clinical status of the study participants. Results: 101 eyes from 52 PD patients (mean age 65.8 years) and 46 eyes from 24 HC subjects (mean age 64.1 years) were included in the study. The mean pRNFL thickness was not significantly different (96.95 μm vs 94.42 μm, p=0.07) but the TMV was significantly lower in PD compared to HC (8.33 mm3 vs 8.58 mm3 p=0.0002). Intra-retinal segmentation showed no significant difference in the RNFL volume between the PD and HC groups (0.95 mm3 vs 0.92 mm3 p=0.454). However, GCL, IPL, INL, and ONL volumes were significantly reduced in PD compared to HC. In contrast, the volume of OPL was significantly increased in PD compared to HC. Conclusions: Our finding of the enlarged OPL corresponds with mRNA expression studies showing localization of AS in the OPL across vertebrate species and autopsy studies demonstrating AS aggregation in the deeper layers of retina in PD. We propose that the enlargement of the OPL may represent a potential biomarker of AS aggregation in PD. Longitudinal studies in larger cohorts are warranted to confirm our observations that may have significant implications in disease monitoring and therapeutic development.

Keywords: Optical Coherence Tomography, biomarker, Parkinson's disease, alpha-synuclein, retina

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Authors: Murray L. Ireland, Kevin J. Worrall, Rebecca Mackenzie, Thaleia Flessa, Euan McGookin, Douglas Thomson

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Robotic rovers which are designed to work in extra-terrestrial environments present a unique challenge in terms of the reliability and availability of systems throughout the mission. Should some fault occur, with the nearest human potentially millions of kilometres away, detection and identification of the fault must be performed solely by the robot and its subsystems. Faults in the system sensors are relatively straightforward to detect, through the residuals produced by comparison of the system output with that of a simple model. However, faults in the input, that is, the actuators of the system, are harder to detect. A step change in the input signal, caused potentially by the loss of an actuator, can propagate through the system, resulting in complex residuals in multiple outputs. These residuals can be difficult to isolate or distinguish from residuals caused by environmental disturbances. While a more complex fault detection method or additional sensors could be used to solve these issues, an alternative is presented here. Using inverse simulation (InvSim), the inputs and outputs of the mathematical model of the rover system are reversed. Thus, for a desired trajectory, the corresponding actuator inputs are obtained. A step fault near the input then manifests itself as a step change in the residual between the system inputs and the input trajectory obtained through inverse simulation. This approach avoids the need for additional hardware on a mass- and power-critical system such as the rover. The InvSim fault detection method is applied to a simple four-wheeled rover in simulation. Additive system faults and an external disturbance force and are applied to the vehicle in turn, such that the dynamic response and sensor output of the rover are impacted. Basic model-based fault detection is then employed to provide output residuals which may be analysed to provide information on the fault/disturbance. InvSim-based fault detection is then employed, similarly providing input residuals which provide further information on the fault/disturbance. The input residuals are shown to provide clearer information on the location and magnitude of an input fault than the output residuals. Additionally, they can allow faults to be more clearly discriminated from environmental disturbances.

Keywords: fault detection, ground robot, inverse simulation, rover

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Authors: Sumitra Sharma, Christina Parker, Kathleen Finlayson, Clint Douglas, Niall Higgins

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Background: Telehealth services have potential to increase accessibility, utilization, and effectiveness of healthcare services. As the telehealth services are yet to integrate within regular hospital services in Nepal, the use of the telehealth services among adults with diabetes is scarce. Prior to implementation of telehealth services for adults with diabetes, it is necessary to examine influencing factors of telehealth services. Objective: This study aimed to investigate factors influencing telehealth services for diabetes care in Nepal. Methods: This study used a mixed-method study design which included a cross-sectional survey among adults with diabetes and semi-structured interviews among key healthcare professionals of Nepal. The study was conducted in a medical out-patient department of a tertiary hospital of Nepal. The survey adapted a previously validated questionnaire, while semi-structured questions for interviews were developed from literature review and experts consultation. All interviews were audio-recorded, and inductive content analysis was used to code transcripts and develop themes. For a survey, a descriptive analysis, chi-square test, and Mann Whitney U test were used to analyze the data. Results: One hundred adults with diabetes were participated in a survey, and seven healthcare professionals were recruited for interviews. In a survey, just over half of the participants (53%) were male, and others were female. Almost all participants (98%) owned a mobile phone, and 67% of them had a computer with internet access at home. Majority of participants had experience in using Facebook messenger (95%), followed by Viber (60%) and Zoom (26%). Almost all of the participants (96%) were willing to use telehealth services. There were significant associations between female sex and participants living 10 km away from the hospital with their willingness to use telehealth services. There was a significant association between participants' self-perception of good health status with their willingness to use video-conference calls and phone calls to use telehealth services. Seven themes were developed from interview data which are related to predisposing, reinforcing, and enabling factors influencing telehealth services for diabetes care in Nepal. Conclusion: In summary, several factors were found to influence the use of telehealth services for diabetes care in Nepal. For effective implementation of a sustainable telehealth services for adults with diabetes in Nepal, these factors need to be considered.

Keywords: contributing factors, diabetes mellitus, developing countries, telemedicine, telecare

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Authors: Meghan E. Murray, Carri R. Tolmie

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This study aims to identify potential factors and widely applicable best practices that can contribute to improving corporate social responsibility (CSR) and corporate performance for firms by exploring the relationship between transformational leadership, spiritual intelligence, and emotional intelligence. Corporate social responsibility is when companies are cognizant of the impact of their actions on the economy, their communities, the environment, and the world as a whole while executing business practices accordingly. The prevalence of CSR has continuously strengthened over the past few years and is now a common practice in the business world, with such efforts coinciding with what stakeholders and the public now expect from corporations. Because of this, it is extremely important to be able to pinpoint factors and best practices that can improve CSR within corporations. One potential factor that may lead to improved CSR is spiritual intelligence (SQ), or the ability to recognize and live with a purpose larger than oneself. Spiritual intelligence is a measurable skill, just like emotional intelligence (EQ), and can be improved through purposeful and targeted coaching. This research project consists of two studies. Study 1 is a case study comparison of a benefit corporation and a non-benefit corporation. This study will examine the role of SQ and EQ as moderators in the relationship between the transformational leadership of employees within each company and the perception of each firm’s CSR and corporate performance. Project methodology includes creating and administering a survey comprised of multiple pre-established scales on transformational leadership, spiritual intelligence, emotional intelligence, CSR, and corporate performance. Multiple regression analysis will be used to extract significant findings from the collected data. Study 2 will dive deeper into spiritual intelligence itself by analyzing pre-existing data and identifying key relationships that may provide value to companies and their stakeholders. This will be done by performing multiple regression analysis on anonymized data provided by Deep Change, a company that has created an advanced, proprietary system to measure spiritual intelligence. Based on the results of both studies, this research aims to uncover best practices, including the unique contribution of spiritual intelligence, that can be utilized by organizations to help enhance their corporate social responsibility. If it is found that high spiritual and emotional intelligence can positively impact CSR effort, then corporations will have a tangible way to enhance their CSR: providing targeted employees with training and coaching to increase their SQ and EQ.

Keywords: corporate social responsibility, CSR, corporate performance, emotional intelligence, EQ, spiritual intelligence, SQ, transformational leadership

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Authors: Dejen Alemu, Murray E. Jennex, Temtim Assefa

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This paper is investigated to understand the design, the use, and the consequence of Knowledge Management System (KMS) for knowledge systems sharing and integration. A KMS for knowledge systems sharing and integration is designed to meet the challenges raised by knowledge management researchers and practitioners: the technical, the human, and social factors. Agricultural KMS involves various members coming from different Communities of Practice (CoPs) who possess their own knowledge of multiple practices which need to be combined in the system development. However, the current development of the technology ignored the indigenous knowledge of the local communities, which is the key success factor for agriculture. This research employed the multi-methodological approach to KMS research in action research perspective which consists of four strategies: theory building, experimentation, observation, and system development. Using the KMS development practice of Ethiopian agricultural transformation agency as a case study, this research employed an interpretive analysis using primary qualitative data acquired through in-depth semi-structured interviews and participant observations. The Orlikowski's structuration model of technology has been used to understand the design, the use, and the consequence of the KMS. As a result, the research identified three basic components for the architecture of the shared KMS, namely, the people, the resources, and the implementation subsystems. The KMS were developed using web 2.0 tools to promote knowledge sharing and integration among diverse groups of users in a distributed environment. The use of a shared KMS allows users to access diverse knowledge from a number of users in different groups of participants, enhances the exchange of different forms of knowledge and experience, and creates high interaction and collaboration among participants. The consequences of a shared KMS on the social system includes, the elimination of hierarchical structure, enhance participation, collaboration, and negotiation among users from different CoPs having common interest, knowledge and skill development, integration of diverse knowledge resources, and the requirement of policy and guideline. The research contributes methodologically for the application of system development action research for understanding a conceptual framework for KMS development and use. The research have also theoretical contribution in extending structuration model of technology for the incorporation of variety of knowledge and practical implications to provide management understanding in developing strategies for the potential of web 2.0 tools for sharing and integration of indigenous knowledge.

Keywords: communities of practice, indigenous knowledge, participation, structuration model of technology, Web 2.0 tools

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Authors: Pernille K. Christiansen, Mette Maria Skjøth, Line Lorenzen, Eva Draborg, Christina Anne Vinter, Trine Kjær, Mette Juel Rothmann

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Background and aims: Overweight and obesity are an increasing challenge on a global level. In Denmark, more than one-third of all pregnant women are overweight or obese, and many women exceed the gestational weight gain recommendations from the Institute of Medicine. Being overweight or obese, is associated with a higher risk of adverse maternal and fetal outcomes, including gestational diabetes and childhood obesity. Thus, it is important to focus on the women’s lifestyles between their pregnancies to lower the risk of gestational weight retention in the long run. The objective of this study was to explorer what barriers and challenges postpartum women experience with respect to healthy lifestyles during the postpartum period and to access whether an Information Technology based intervention might be a supportive tool to assist and motivate postpartum women to a healthy lifestyle. Materials and methods: The method is inspired by participatory design. A systematic text condensation was applied to semi-structured focus groups. Five focus group interviews were carried out with a total of 17 postpartum women and two interviews with a total of six health professionals. Participants were recruited through the municipality in Svendborg, Denmark, and at Odense University Hospital in Odense, Denmark, during a four-month period in early 2018. Results: From the women’s perspective, better assistance is needed from the health professionals to obtain or maintain a healthy lifestyle. The women need tools that inform and help them understand and prioritise their own health-related risks, and to motivate them to plan and take care of their own health. As the women use Information Technology on a daily basis, the solution could be delivered through Information Technology. Finally, there is room for engaging the partner more in the communication related to the baby and family’s lifestyle. Conclusion: Postpartum women need tools that inform and motivate a healthy lifestyle postpartum. The tools should allow access to high-quality information from health care professionals, when the information is needed, and also allow engagement from the partner. Finally, Information Technology is a potential tool for delivering tools.

Keywords: information technology, lifestyle, overweight, postpartum

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Authors: Christos E. Lampropoulos, Maria Konsta, Tamta Sirbilatze, Ifigenia Apostolou, Vicky Dradaki, Konstantina Panouria, Irini Dri, Christina Kordali, Vaggelis Lambas, Georgios Mavras

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Objectives: Full Mini Nutritional Assessment (MNA) questionnaire is one of the most useful tools in diagnosis of malnutrition in hospitalized patients, which is related to increased morbidity and mortality. The purpose of our study was to assess the nutritional status of elderly, hospitalized patients and examine the hypothesis that MNA may predict mortality and extension of hospitalization. Methods: One hundred fifty patients (78 men, 72 women, mean age 80±8.2) were included in this cross-sectional study. The following data were taken into account in analysis: anthropometric and laboratory data, physical activity (International Physical Activity Questionnaires, IPAQ), smoking status, dietary habits, cause and duration of current admission, medical history (co-morbidities, previous admissions). Primary endpoints were mortality (from admission until 6 months afterwards) and duration of admission. The latter was compared to national guidelines for closed consolidated medical expenses. Logistic regression and linear regression analysis were performed in order to identify independent predictors for mortality and extended hospitalization respectively. Results: According to MNA, nutrition was normal in 54/150 (36%) of patients, 46/150 (30.7%) of them were at risk of malnutrition and the rest 50/150 (33.3%) were malnourished. After performing multivariate logistic regression analysis we found that the odds of death decreased 20% per each unit increase of full MNA score (OR=0.8, 95% CI 0.74-0.89, p < 0.0001). Patients who admitted due to cancer were 23 times more likely to die, compared to those with infection (OR=23, 95% CI 3.8-141.6, p=0.001). Similarly, patients who admitted due to stroke were 7 times more likely to die (OR=7, 95% CI 1.4-34.5, p=0.02), while these with all other causes of admission were less likely (OR=0.2, 95% CI 0.06-0.8, p=0.03), compared to patients with infection. According to multivariate linear regression analysis, each increase of unit of full MNA, decreased the admission duration on average 0.3 days (b:-0.3, 95% CI -0.45 - -0.15, p < 0.0001). Patients admitted due to cancer had on average 6.8 days higher extension of hospitalization, compared to those admitted for infection (b:6.8, 95% CI 3.2-10.3, p < 0.0001). Conclusion: Mortality and extension of hospitalization is significantly increased in elderly, malnourished patients. Full MNA score is a useful diagnostic tool of malnutrition.

Keywords: duration of admission, malnutrition, mini nutritional assessment score, prognostic factors for mortality

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Authors: Lauren A. Bailey, Amber R. Childs, Nicola C. James, Murray I. Duncan, Alexander Winkler, Warren M. Potts

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Changes in behaviour and physiology are the most important responses of marine life to anthropogenic impacts such as climate change and over-fishing. Behavioural changes (such as a shift in distribution or changes in phenology) can ensure that a species remains in an environment suited for its optimal physiological performance. However, if marine life is unable to shift their distribution, they are reliant on physiological adaptation (either by broadening their metabolic curves to tolerate a range of stressors or by shifting their metabolic curves to maximize their performance at extreme stressors). However, since there are links between fish physiology and behaviour, changes to either of these traits may have reciprocal interactions. This paper reviews the current knowledge of the links between the behaviour and physiology of fishes, discusses these in the context of exploitation and climate change, and makes recommendations for future research needs. The review revealed that our understanding of the links between fish behaviour and physiology is rudimentary. However, both are hypothesized to be linked to stress responses along the hypothalamic pituitary axis. The link between physiological capacity and behaviour is particularly important as both determine the response of an individual to a changing climate and are under selection by fisheries. While it appears that all types of capture fisheries are likely to reduce the adaptive potential of fished populations to climate stressors, angling, which is primarily associated with recreational fishing, may induce fission of natural populations by removing individuals with bold behavioural traits and potentially the physiological traits required to facilitate behavioural change. Future research should focus on assessing how the links between physiological capacity and behaviour influence catchability, the response to climate change drivers, and post-release recovery. The plasticity of phenotypic traits should be examined under a range of stressors of differing intensity in several species and life history stages. Future studies should also assess plasticity (fission or fusion) in the phenotypic structuring of social hierarchy and how this influences habitat selection. Ultimately, to fully understand how physiology is influenced by the selective processes driven by fisheries, long-term monitoring of the physiological and behavioural structure of fished populations, their fitness, and catch rates are required.

Keywords: climate change, metabolic shifts, over-fishing, phenotypic plasticity, stress response

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Authors: Joni Asitashvili, Eka Chabashvili, Maya Virsaladze, Alexander Chokhonelidze

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Studying the soundscape is a major challenge in many countries of the civilized world today. The sound environment and music itself are part of the Earth's ecosystem. Therefore, researching its positive or negative impact is important for a clean and healthy environment. The acoustics of nature gave people many musical ideas, and people enriched musical features and performance skills with the ability to imitate the surrounding sound. For example, a population surrounded by mountains invented the technique of antiphonal singing, which mimics the effect of an echo. Canadian composer Raymond Murray Schafer viewed the world as a kind of musical instrument with ever-renewing tuning. He coined the term "Soundscape" as a name of a natural environmental sound, including the sound field of the Earth. It can be said that from which the “music of nature” is constructed. In the 21st century, a new field–Ecomusicology–has emerged in the field of musical art to study the sound ecosystem and various issues related to it. Ecomusicology considers the interconnections between music, culture, and nature–According to the Aaron Allen. Eco-music is a field of ecomusicology concerning with the depiction and realization of practical processes using modern composition techniques. Finding an artificial sound source (instrumental or electronic) for the piece that will blend into the soundscape of Sound Oases. Creating a composition, which sounds in harmony with the vibrations of human, nature, environment, and micro- macrocosm as a whole; Currently, we are exploring the ambient sound of the Georgian urban and suburban environment to discover “Sound Oases" and compose Eco-music works. We called “Sound Oases" an environment with a specific sound of the ecosystem to use in the musical piece as an instrument. The most interesting examples of Eco-music are the round dances, which were already created in the BC era. In round dances people would feel the united energy. This urge to get united revealed itself in our age too, manifesting itself in a variety of social media. The virtual world, however, is not enough for a healthy interaction; we created plan of “contemporary round dance” in sound oasis, found during expedition in Georgian caves, where people interacted with cave's soundscape and eco-music, they feel each other sharing energy and listen to earth sound. This project could be considered a contemporary round dance, a long improvisation, particular type of art therapy, where everyone can participate in an artistic process. We would like to present research result of our eco-music experimental performance.

Keywords: eco-music, environment, sound, oasis

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Authors: Zuzana Sedrlova, Eva Slaninova, Ines Fritz, Christina Daffert, Stanislav Obruca

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Cyanobacteria are ecologically extremely important phototrophic gram-negative bacteria capable of oxygenic photosynthesis. They synthesize many interesting metabolites such as glycogen, carotenoids, but the most interesting metabolites are polyhydroxyalkanoates (PHA). The main advantage of cyanobacteria is the fact they do not require costly organic substrate and, oppositely, cyanobacteria can fix CO₂. PHA serves primarily as a carbon and energy source and occurs in the form of intracellular granules in bacterial cells. It is possible, PHA helps cyanobacteria to survive stress conditions since increased PHA synthesis was observed during cultivation in stress conditions. PHA is microbial biopolymers that are biodegradable with similar properties as petrochemical synthetic plastics. Production of PHA by heterotrophic bacteria is expensive; for price reduction waste materials as input, materials are used. Positively, cyanobacteria principally do not require organic carbon substrate since they are capable of CO₂ fixation. In this work, we demonstrated that stress conditions lead to the highest obtained yields of PHA in cyanobacterial cultures. Two cyanobacterial cultures from genera Synechocystis were used in this work. Cultivations were performed either in Erlenmayer flask or in tube multicultivator. Multiple stressors were applied on cyanobacterial cultures, and stressors include PHA precursors. PHA precursors are chemical substances and some of them do not occur naturally in the environment. Cultivation with the same PHA precursors in the same concentration led to a 1,6x higher amount of PHA when a multicultivator was used. The highest amount of PHA reached 25 % of PHA in dry cyanobacterial biomass. Both strains are capable of co-polymer synthesis in the presence of their structural precursor. The composition of co-polymer differs in Synechocystis sp. PCC 6803 and Synechocystis salina CCALA 192. Synechocystis sp. PCC 6803 cultivated with γ-butyrolakton accumulated co-polymer of 3-hydroxybutyrate (3HB) and 4-hydroxybutyrate (4HB) the composition of the copolymer was 56 % of 4HB and 44 % of 3HB. The total amount of PHA, as well as yield of biomass, was lower than in control due to the toxic properties of γ-butyrolakton. Funding: This study was partly funded by the project GA19- 19-29651L of the Czech Science Foundation (GACR) and partly funded by the Austrian Science Fund (FWF), a project I 4082-B25. This work was supported by Brno, Ph.D. Talent – Funded by the Brno City Municipality.

Keywords: co-polymer, cyanobacteria, PHA, synechocystis

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Authors: Parker Murray, Marci Johnson, Tyson S. Burnham, Alina K. Fong, Mark D. Allen, Bruce McIff

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Purpose: Pathological dysregulation of Neurovascular Coupling (NVC) caused by mild traumatic brain injury (mTBI) is the predominant source of chronic post-concussion syndrome (PCS) symptomology. fNCI has the ability to localize dysregulation in NVC by measuring blood-oxygen-level-dependent (BOLD) signaling during the performance of fMRI-adapted neuropsychological evaluations. With fNCI, 57 brain areas consistently affected by concussion were identified as PCS neural markers, which were validated on large samples of concussion patients and healthy controls. These neuromarkers provide the basis for a computation of PCS severity which is referred to as the Severity Index Score (SIS). The SIS has proven valuable in making pre-treatment decisions, monitoring treatment efficiency, and assessing long-term stability of outcomes. Methods and Materials: After being scanned while performing various cognitive tasks, 476 concussed patients received an SIS score based on the neural dysregulation of the 57 previously identified brain regions. These scans provide an objective measurement of attentional, subcortical, visual processing, language processing, and executive functioning abilities, which were used as biomarkers for post-concussive neural dysregulation. Initial SIS scores were used to develop individualized therapy incorporating cognitive, occupational, and neuromuscular modalities. These scores were also used to establish pre-treatment benchmarks and measure post-treatment improvement. Results: Changes in SIS were calculated in percent change from pre- to post-treatment. Patients showed a mean improvement of 76.5 percent (σ= 23.3), and 75.7 percent of patients showed at least 60 percent improvement. Longitudinal reassessment of 24 of the patients, measured an average of 7.6 months post-treatment, shows that SIS improvement is maintained and improved, with an average of 90.6 percent improvement from their original scan. Conclusions: fNCI provides a reliable measurement of NVC allowing for identification of concussion pathology. Additionally, fNCI derived SIS scores direct tailored therapy to restore NVC, subsequently resolving chronic PCS resulting from mTBI.

Keywords: concussion, functional magnetic resonance imaging (fMRI), neurovascular coupling (NVC), post-concussion syndrome (PCS)

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Authors: R. Blythman, N. Jeffers, T. Persoons, D. B. Murray

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The exploitation of flow pulsation in micro- and mini-channels is a potentially useful technique for enhancing cooling of high-end photonics and electronics systems. It is thought that pulsation alters the thickness of the hydrodynamic and thermal boundary layers, and hence affects the overall thermal resistance of the heat sink. Although the fluid mechanics and heat transfer are inextricably linked, it can be useful to decouple the parameters to better understand the mechanisms underlying any heat transfer enhancement. Using two-dimensional, two-component particle image velocimetry, the current work intends to characterize the heat transfer mechanisms in pulsating flow with a mean Reynolds number of 48 by experimentally quantifying the hydrodynamics of a generic liquid-cooled channel geometry. Flows circulated through the test section by a gear pump are modulated using a controller to achieve sinusoidal flow pulsations with Womersley numbers of 7.45 and 2.36 and an amplitude ratio of 0.75. It is found that the transient characteristics of the measured velocity profiles are dependent on the speed of oscillation, in accordance with the analytical solution for flow in a rectangular channel. A large velocity overshoot is observed close to the wall at high frequencies, resulting from the interaction of near-wall viscous stresses and inertial effects of the main fluid body. The steep velocity gradients at the wall are indicative of augmented heat transfer, although the local flow reversal may reduce the upstream temperature difference in heat transfer applications. While unsteady effects remain evident at the lower frequency, the annular effect subsides and retreats from the wall. The shear rate at the wall is increased during the accelerating half-cycle and decreased during deceleration compared to steady flow, suggesting that the flow may experience both enhanced and diminished heat transfer during a single period. Hence, the thickness of the hydrodynamic boundary layer is reduced for positively moving flow during one half of the pulsation cycle at the investigated frequencies. It is expected that the size of the thermal boundary layer is similarly reduced during the cycle, leading to intervals of heat transfer enhancement.

Keywords: Heat transfer enhancement, particle image velocimetry, localized and time-resolved velocity, photonics and electronics cooling, pulsating flow, Richardson’s annular effect

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Authors: Murray Anderson, Galina Freed, Karli Jahn

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Trauma is increasingly recognized as an important construct that has health implications for those who struggle with various mental health issues. For those individuals who meet the criteria for a diagnosis of hoarding disorder (HD), many have experienced some form of trauma. Further, some of the therapeutic interventions for those with HD can further perpetuate or magnify the experience of trauma. Therefore, the aim of this scoping review is to identify and document the nature and extent of research evidence related to trauma as it connects with HD. This review was guided by the questions, ‘How can our understanding of the trauma cycle help us to better appreciate the experiences of individuals who hoard, and how will a trauma informed lens inform the interventions for hoarding disorder? A comprehensive literature search was performed to identify original studies that contained the words “hoarding” and “trauma.” PsychINFO”,''EBSCO host,” “CINAHL” and “PubMed” were searched between January 2005 and April 2021. Articles were screened by three reviewers. Data extracted included publication date, demographics, study design, type of analysis, and noted connections between hoarding and trauma. Of the 329 articles, all duplicates, articles on hoardings of animals, articles not in English, and those without full-text availability were removed. Five categories were found in the remaining 45 articles, including (a) traumatic and stressful life events; (b) the link between posttraumatic stress disorder, trauma, and hoarding; (c) the relationships between different comorbidities, trauma, and hoarding; (d) the lack of early emotional expression and other forms of parental deprivation; and (e) the role of attachment. Lastly, the literature explains how the links between hoarding and trauma are difficult to study due to the highly stigmatized identities with this population. The review provided strong support for the connections between the experience of trauma and HD. What is missing from the literature is the use of a trauma-informed lens to better account for the ways in which hoarding disorder is understood. Other missing pieces in the literature are the potential uses of a trauma-informed lens to enhance the therapeutic process, to understand and reduce treatment attrition, and to improve treatment outcomes. The application of a trauma informed lens could improve our understanding of effective interactions among clients, families, and communities and improve the education around hoarding-related matters. Exploring the connections between trauma and HD can improve therapeutic delivery and destigmatize the experience of dealing with clutter and hoarding concerns. This awareness can also provide health care professionals with both the language and skills to liberate them from a reductionist view on HD.

Keywords: hoarding, attachment, parental deprivation, trauma

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Authors: Astrid Tannert, Anuradha Ramoji, Christina Ebert, Frederike Gladigau, Lorena Tuchscherr, Jürgen Popp, Ute Neugebauer

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Staphylococcus aureus is a facultative intracellular pathogen, which by entering host cells may evade immunologic host response as well as antimicrobial treatment. In that way, S. aureus can cause persistent intracellular infections which are difficult to treat. Depending on the strain, S. aureus may persist at different intracellular locations like the phagolysosome. The first barrier invading pathogens from the blood stream that they have to cross are the endothelial cells lining the inner surface of blood and lymphatic vessels. Upon proceeding from an acute to a chronic infection, intracellular pathogens undergo certain biochemical and structural changes including a deceleration of metabolic processes to adopt for long-term intracellular survival and the development of a special phenotype designated as small colony variant. In this study, the endothelial cell line Ea.hy 926 was used as a model for acute and chronic S. aureus infection. To this end, Ea.hy 926 cells were cultured on QIAscout™ Microraft Arrays, a special graded cell culture substrate that contains around 12,000 microrafts of 200 µm edge length. After attachment to the substrate, the endothelial cells were infected with GFP-expressing S. aureus for 3 weeks. The acute infection and the development of persistent bacteria was followed by confocal laser scanning microscopy, scanning the whole Microraft Array for the presence and for detailed determination of the intracellular location of fluorescent intracellular bacteria every second day. After three weeks of infection representative microrafts containing infected cells, cells with protruded infections and cells that did never show any infection were isolated and fixed for Raman micro-spectroscopic investigation. For comparison, also microrafts with acute infection were isolated. The acquired Raman spectra are correlated with the fluorescence microscopic images to give hints about a) the molecular alterations in endothelial cells during acute and chronic infection compared to non-infected cells, and b) metabolic and structural changes within the pathogen when entering a mode of persistence within host cells. We thank Dr. Ruth Kläver from QIAGEN GmbH for her support regarding QIAscout technology. Financial support by the BMBF via the CSCC (FKZ 01EO1502) and from the DFG via the Jena Biophotonic and Imaging Laboratory (JBIL, FKZ PO 633/29-1, BA 1601/10-1) is highly acknowledged.

Keywords: correlative image analysis, intracellular infection, pathogen-host adaption, Raman micro-spectroscopy

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Authors: Christina Albertina Ludwinia Parung, I Gusti Ayu Maya Vratasti

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Sexual transmission of HIV among Men who have Sex with Men (MSM) is believed to be one of the sources of the AIDS epidemic. Nowadays, government, communities, and NGOs are taking action to prevent its spread by assisting and educating groups of MSM in their countries. This assistance involves experts in many fields of study, including psychology. In the field of psychology, psychoeducation is believed to be one of the ways to assist the MSM groups. Just like in other countries, this psychoeducation assistance is also needed in Indonesia, where MSM groups are found in many cities within. Surabaya, as the second largest and densely populated city in Indonesia, is known to have a big number of MSM population. In September to December 2020, the author and a colleague conducted a mentoring effort to the MSM community at the MSM community gathering location called Gang Pattaya, in the city of Surabaya. The existence of this community is disguised by the general public, but is well known by NGOs. Community members do MSM out of their liking, although some do it in exchange for money. However, safety factors, such as using condoms for MSM, are not a priority for this community. They do MSM whether they receive a reward or not, just out of a boost of pleasure. There is no attempt to find out the health of the partner once they are attracted to each other. In general, they do not know whether they are infected with HIV. Most of them feel healthy and since they do not show any symptoms, they think it is not necessary to get tested. In the mentoring process, the researchers conduct psychoeducation, which begins with an approach to certain individuals so that they are comfortable with the researchers’ presence, then increasing awareness of safe sex behavior for HIV prevention for groups in the form of counseling using the Theory of Reasoned Action (TRA) approach. Counseling is carried out in various forms including roleplay, games, and seminars. The number of participants was 11 people, varying from 19-47 years old. Pretest related to knowledge of safe sex was carried out before conducting the intervention and post-test after the intervention. The normality test used is the Shapiro-Wilk analysis. Different tests on the data obtained were carried out using the non-parametric Wilcoxon Signed Ranks Test. None of the participants had lower post-test knowledge scores than the pre-test. Prestest and post test for safer sex behavior showed 2 participants with safer sex behavior did not change. Both belong to the senior group, while other participants have an improvement in their safer sex behavior. These findings suggest that intervention programs for MSM as an effort to reduce HIV transmission should pay attention to affective and cognitive coping strategies.

Keywords: HIV, men who have sex with men, psychoeducation, psychology health, safer sex behavior, theory of reasoned action

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Authors: Christina Van Wingerden

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This paper focuses on a sense of belonging, isolation, and the use of a learning management system as a “third space” for connection and community. Given student use of learning management systems (LMS) for courses on campuses, moderate to high use of social media and hand-held devices, the author explores the possibilities of LMS as a third space. The COVID-19 pandemic has exacerbated student experiences of isolation, and research indicates that students who experience a sense of belonging have a greater likelihood for academic retention and success. The impacts on students of an LMS designed for student employee orientation and training were examined through a mixed methods approach, including a survey, individual interviews, and focus groups. The sample involved 250-450 undergraduate student employees at a US northwestern university. The goal of the study was to find out the efficiency and effectiveness of the orientation information for a wide range of student employees from multiple student affairs departments. And unexpected finding emerged within the study in 2015 and was noted again as a finding in the 2017 study. Students reported feeling like they individually connected to the department, and further to the university because of the LMS orientation. They stated they could see themselves as part of the university community and like they belonged. The orientation, through the LMS, was designed for and occurred online (asynchronous), prior to students traveling and beginning university life for the academic year. The students indicated connection and belonging resulting from some of the design features. With the onset of COVID-19 and prolonged sheltering in place in North America, as well as other parts of the world, students have been precluded from physically gathering to educate and learn. COVID-19 essentially paused face-to-face education in 2020. Media, governments, and higher education outlets have been reporting on widespread college student stress, isolation, loneliness, and sadness. In this context, the author conducted a current mixed methods study (online survey, online interviews) of students in advanced degree programs, like Ph.D. and Ed.D. specifically investigating isolation and sense of belonging. As a part of the study a prototype of a Canvas site was experienced by student interviewees for their reaction of this Canvas site prototype as a “third” space. Some preliminary findings of this study are presented. Doctoral students in the study affirmed the potential of LMS as a third space for community and social academic connection.

Keywords: COVID-19, isolation, learning management system, sense of belonging

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Authors: Olivia A. Wilson, Hannah E. Power, Murray Kendall

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Sydney Harbour is an iconic location with a dense population and low-lying development. On the east coast of Australia, facing the Pacific Ocean, it is exposed to several tsunamigenic trenches. This paper presents a component of the most detailed assessment of the potential for earthquake-generated tsunami impact on Sydney Harbour to date. Models in this study use dynamic tides to account for tide-tsunami interaction. Sydney Harbour’s tidal range is 1.5 m, and the spring tides from January 2015 that are used in the modelling for this study are close to the full tidal range. The tsunami wave trains modelled include hypothetical tsunami generated from earthquakes of magnitude 7.5, 8.0, 8.5, and 9.0 M_W from the Puysegur and New Hebrides trenches as well as representations of the historical 1960 Chilean and 2011 Tohoku events. All wave trains are modelled for the peak wave to coincide with both a low tide and a high tide. A single wave train, representing a 9.0 M_W earthquake at the Puysegur trench, is modelled for peak waves to coincide with every hour across a 12-hour tidal phase. Using the hydrodynamic model ANUGA, results are compared according to the impact parameters of inundation area, depth variation and current speeds. Results show that both maximum inundation area and depth variation are tide dependent. Maximum inundation area increases when coincident with a higher tide, however, hazardous inundation is only observed for the larger waves modelled: NH90high and P90high. The maximum and minimum depths are deeper on higher tides and shallower on lower tides. The difference between maximum and minimum depths varies across different tidal phases although the differences are slight. Maximum current speeds are shown to be a significant hazard for Sydney Harbour; however, they do not show consistent patterns according to tide-tsunami phasing. The maximum current speed hazard is shown to be greater in specific locations such as Spit Bridge, a narrow channel with extensive marine infrastructure. The results presented for Sydney Harbour are novel, and the conclusions are consistent with previous modelling efforts in the greater area. It is shown that tide must be a consideration for both tsunami modelling and emergency management planning. Modelling with peak tsunami waves coinciding with a high tide would be a conservative approach; however, it must be considered that maximum current speeds may be higher on other tides.

Keywords: emergency management, sydney, tide-tsunami interaction, tsunami impact

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Authors: Murray David Schane

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Though years of clinical encounters with patients with autism spectrum disorders and those with a schizoid personality the many defining diagnostic features shared between these conditions have been explored and current neurobiological differences have been reviewed; and, critical and different treatment strategies for each have been devised. The paper compares and contrasts the apparent similarities between autism spectrum disorders and the schizoid personality are found in these DSM descriptive categories: restricted range of social-emotional reciprocity; poor non-verbal communicative behavior in social interactions; difficulty developing and maintaining relationships; detachment from social relationships; lack of the desire for or enjoyment of close relationships; and preference for solitary activities. In this paper autism, fundamentally a communicative disorder, is revealed to present clinically as a pervasive aversive response to efforts to engage with or be engaged by others. Autists with the Asperger presentation typically have language but have difficulty understanding humor, irony, sarcasm, metaphoric speech, and even narratives about social relationships. They also tend to seek sameness, possibly to avoid problems of social interpretation. Repetitive behaviors engage many autists as a screen against ambient noise, social activity, and challenging interactions. Also in this paper, the schizoid personality is revealed as a pattern of social avoidance, self-sufficiency and apparent indifference to others as a complex psychological defense against a deep, long-abiding fear of appropriation and perverse manipulation. Neither genetic nor MRI studies have yet located the explanatory data that identifies the cause or the neurobiology of autism. Similarly, studies of the schizoid have yet to group that condition with those found in schizophrenia. Through presentations of clinical examples, the treatment of autists of the Asperger type is revealed to address the autist’s extreme social aversion which also precludes the experience of empathy. Autists will be revealed as forming social attachments but without the capacity to interact with mutual concern. Empathy will be shown be teachable and, as social avoidance relents, understanding of the meaning and signs of empathic needs that autists can recognize and acknowledge. Treatment of schizoids will be shown to revolve around joining empathically with the schizoid’s apprehensions about interpersonal, interactive proximity. Models of both autism and schizoid personality traits have yet to be replicated in animals, thereby eliminating the role of translational research in providing the kind of clues to behavioral patterns that can be related to genetic, epigenetic and neurobiological measures. But as these clinical examples will attest, treatment strategies have significant impact.

Keywords: autism spectrum, schizoid personality traits, neurobiological implications, critical diagnostic distinctions

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Authors: Jannis Kountouras, Nikolaos Kapetanakis, Stergios A. Polyzos, Apostolis Papaeftymiou, Panagiotis Katsinelos, Ioannis Venizelos, Christina Nikolaidou, Christos Zavos, Iordanis Romiopoulos, Elena Tsiaousi, Evangelos Kazakos, Michael Doulberis

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Background & Aims: Helicobacter pylori infection (Hp-I) has been recognized as a substantial risk agent involved in gastrointestinal (GI) tract oncogenesis by stimulating cancer stem cells (CSCs), oncogenes, immune surveillance processes, and triggering GI microbiota dysbiosis. We aimed to investigate the possible involvement of active Hp-I in the sequence: chronic inflammation–adenoma–colorectal cancer (CRC) development. Methods: Four pillars were investigated: (i) endoscopic and conventional histological examinations of patients with CRC, colorectal adenomas (CRA) versus controls to detect the presence of active Hp-I; (ii) immunohistochemical determination of the presence of Hp; expression of CD44, an indicator of CSCs and/or bone marrow-derived stem cells (BMDSCs); expressions of oncogene Ki67 and anti-apoptotic Bcl-2 protein; (iii) expression of CD45, indicator of immune surveillance locally (assessing mainly T and B lymphocytes locally); and (iv) correlation of the studied parameters with the presence or absence of Hp-I. Results: Among 50 patients with CRC, 25 with CRA, and 10 controls, a significantly higher presence of Hp-I in the CRA (68%) and CRC group (84%) were found compared with controls (30%). The presence of Hp-I with accompanying immunohistochemical expression of CD44 in biopsy specimens was revealed in a high proportion of patients with CRA associated with moderate/severe dysplasia (88%) and CRC patients with moderate/severe degree of malignancy (91%). Comparable results were also obtained for Ki67, Bcl-2, and CD45 immunohistochemical expressions. Concluding Remarks: Hp-I seems to be involved in the sequence: CRA – dysplasia – CRC, similarly to the upper GI tract oncogenesis, by several pathways such as the following: Beyond Hp-I associated insulin resistance, the major underlying mechanism responsible for the metabolic syndrome (MetS) that increase the risk of colorectal neoplasms, as implied by other Hp-I related MetS pathologies, such as non-alcoholic fatty liver disease and upper GI cancer, the disturbance of the normal GI microbiota (i.e., dysbiosis) and the formation of an irritative biofilm could contribute to a perpetual inflammatory upper GIT and colon mucosal damage, stimulating CSCs or recruiting BMDSCs and affecting oncogenes and immune surveillance processes. Further large-scale relative studies with a pathophysiological perspective are necessary to demonstrate in-depth this relationship.

Keywords: Helicobacter pylori, colorectal cancer, colorectal adenomas, gastrointestinal oncogenesis

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Authors: Adae Amoako, Daniel Montero, Peter Murray, George Pujalte

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We present a case of a 42-year-old, right-handed Caucasian male who presented to a medical orthopedics clinic with left wrist pain. The patient indicated that the pain started two months prior to the visit. He could only remember helping a friend move furniture prior to the onset of pain. Examination of the left wrist showed limited extension compared to the right. There was clicking with flexion and extension of the wrist on the dorsal aspect. Mild tenderness was noticed over the distal radioulnar joint. There was ulnar and radial deviation on provocation. Initial 4-view x-rays of the left wrist showed mild radiocarpal and scapho-trapezium-trapezoid (ST-T) osteoarthritis, with subchondral cysts seen in the lunate and scaphoid, with no obvious fractures. The patient was initially put in a wrist brace and diclofenac topical gel was prescribed for pain control, as a patient could not take non-steroidal anti-inflammatory drugs (NSAIDs) due to gastritis. Despite diclofenac topical gel use and bracing, symptoms remained, and a steroid injection with 1 mL of lidocaine with 10 mg of triamcinolone acetonide was performed under fluoroscopy. He obtained some relief but after 3 months, the injection had to be repeated. On 2-month follow up after the initial evaluation, symptoms persisted. Magnetic resonance imaging (MRI) was obtained which showed an abnormal T1 hypodense signal involving the proximal pole of the scaphoid and articular collapse proximally of the scaphoid, with marked irregularity of the overlying cartilage, suggesting a remote injury, findings consistent with avascular necrosis of the proximal pole of the scaphoid. A month after that, the patient had the left proximal pole of the scaphoid debrided and an intercompartmental supraretinacular artery vascularized. Pedicle bone graft reconstruction of the proximal pole of the left scaphoid was done. A non-vascularized autograft from the left radius was also applied. He was put in a thumb spica cast with the interphalangeal joint free for 6 weeks. On 6-week follow-up after surgery, the patient was healing well and could make a composite fist with his left hand. The diagnosis of Preiser’s disease is primarily based on radiological findings. Due to the fact that necrosis happens over a period of time, most AVNs are diagnosed at the late stages of the disease. There appear to be no specific guidelines on the management AVN of the scaphoid. In the past, immobilization and arthroscopic debridement had been used. Radial osteotomy has also been tried. Vascularized bone grafts have also been used to treat Preiser’s disease. In our patient, we used three of these treatment modalities, starting with conservative management with topical NSAIDS and immobilization, then debridement with vascularized bone grafts.

Keywords: wrist pain, avascular necrosis of the scaphoid, Preiser’s disease, vascularized bone grafts

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Authors: Cheyenne Johnson, Samantha Robinson, Christina Chant, Ann M. Mitchell, Carol Price, Carmel Clancy, Adam Searby, Deborah S. Finnell

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Introduction: Substance use along the continuum from at-risk use to a substance use disorder (SUD) contributes substantially to the burden of disease and related harms worldwide. There is a growing body of literature that highlights the lack of substance use related content in nursing curricula. Furthermore, there is also a lack of consensus on key competencies necessary for entry-level nurses. Globally, there is a lack of established nursing competencies related to prevention, health promotion, harm reduction and treatment of at-risk substance use and SUDs. At a critical time in public health, this gap in nursing curricula contributes to a lack of preparation for entry-level nurses to support people along the continuum of substance use. Thus, in practice, early opportunities for screening, support, and interventions may be missed. To address this gap, an international committee was convened to develop international entry-level nursing competencies specifying the knowledge, skills, and abilities that all nurses should possess in order to address the continuum of substance use. Methodology: An international steering committee, including representation from Canada, United States, United Kingdom, and Australia was established to lead this work over a one-year time period. The steering committee conducted a scoping review, undertaken to examine nursing competency frameworks, and to inform a competency structure that would guide this work. The next steps were to outline key competency areas and establish leaders for working groups to develop the competencies. In addition, a larger international committee was gathered to contribute to competency working groups, review the collective work and concur on the final document. Findings: A comprehensive framework was developed with competencies covering a wide spectrum of substance use across the lifespan and in the context of prevention, health promotion, harm reduction and treatment, including special populations. The development of this competency-based framework meets an identified need to provide guidance for universities, health authorities, policy makers, nursing regulators and other organizations that provide and support nursing education which focuses on care for patients and families with at-risk substance use and SUDs. Conclusion: Utilizing these global competencies as expected outcomes of an educational and skill building curricula for entry-level nurses holds great promise for incorporating evidence-informed training in the care and management of people across the continuum of substance use.

Keywords: addiction nursing, addiction nursing curriculum, competencies, substance use

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Authors: Katie Dolaghan, Christina Tran, Kim Hamilton, Amanda Beresford, Vicky Adams, Jamie Toole, John Marley

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During the Covid 19 pandemic routine outpatient appointments were not possible face to face. That resulted in many branches of healthcare starting virtual clinics. These clinics have continued following the return to face to face patient appointments. With these new types of clinic it is important to ensure that a high standard of patient care is maintained. In order to improve patient and clinician experience of the telephone clinics a quality improvement project was carried out to ensure the patient and clinician experience of these clinics was enhanced whilst remaining a safe, effective and an efficient use of resources. The project began by developing a process map for the consultation process and agreed on the design of a driver diagram and tests of change. In plan do study act (PDSA) cycle1 a single consultant completed an online survey after every patient encounter over a 5 week period. Baseline patient responses were collected using a follow-up telephone survey for each patient. Piloting led to several iterations of both survey designs. Salient results of PDSA1 included; patients not receiving appointment letters, patients feeling more anxious about a virtual appointment and many would prefer a face to face appointment. The initial clinician data showed a positive response with a provisional diagnosis being reached in 96.4% of encounters. PDSA cycle 2 included provision of a patient information sheet and information leaflets relevant to the patients’ conditions were developed and sent following new patient telephone clinics with follow-up survey analysis as before to monitor for signals of change. We also introduced the ability for patients to send an images of their lesion prior to the consultation. Following the changes implemented we noted an improvement in patient satisfaction and, in fact, many patients preferring virtual clinics as it lead to less disruption of their working lives. The extra reading material both before and after the appointments eased patients’ anxiety around virtual clinics and helped them to prepare for their appointment. Following the patient feedback virtual clinics are now used for review patients as well, with all four consultants within the department continuing to utilise virtual clinics. During this presentation the progression of these clinics and the reasons that these clinics are still operating following the return to face to face appointments will be explored. The lessons that have been gained using a QI approach have helped to deliver an optimal service that is valid and reliable as well as being safe, effective and efficient for the patient along with helping reduce the pressures from ever increasing waiting lists. In summary our work in improving the quality of virtual clinics has resulted in improved patient satisfaction along with reduced pressures on the facilities of the health trust.

Keywords: clinic, satisfaction, telephone, virtual

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Authors: Christina Klippel, Lucia Pezzi, Silvio Neto, Rafael Bertani, Priscila Mendes, Flavio Machado, Aline Szeliga, Maria Cosendey, Adilson Mariz, Raquel Santos, Lys Bendett, Pedro Velasco, Thalita Rolleigh, Bruna Bellote, Daria Coelho, Bruna Martins, Julia Almeida, Juliana Cerqueira

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This project presents a framework for teaching intracranial pressure monitoring (ICP) concepts using a low-cost experimental model in a neurointensive care education program. Data concerning ICP monitoring contribute to the patient's clinical assessment and may dictate the course of action of a health team (nursing, medical staff) and influence decisions to determine the appropriate intervention. This study aims to present a safe method for teaching ICP monitoring to medical students in a Simulation Center. Methodology: Medical school teachers, along with students from the 4th year, built an experimental model for teaching ICP measurement. The model consists of a mannequin's head with a plastic bag inside simulating the cerebral ventricle and an inserted ventricular catheter connected to the ICP monitoring system. The bag simulating the ventricle can also be changed for others containing bloody or infected simulated cerebrospinal fluid. On the mannequin's ear, there is a blue point indicating the right place to set the "zero point" for accurate pressure reading. The educational program includes four steps: 1st - Students receive a script on ICP measurement for reading before training; 2nd - Students watch a video about the subject created in the Simulation Center demonstrating each step of the ICP monitoring and the proper care, such as: correct positioning of the patient, anatomical structures to establish the zero point for ICP measurement and a secure range of ICP; 3rd - Students train the procedure in the model. Teachers help students during training; 4th - Student assessment based on a checklist form. Feedback and correction of wrong actions. Results: Students expressed interest in learning ICP monitoring. Tests concerning the hit rate are still being performed. ICP's final results and video will be shown at the event. Conclusion: The study of intracranial pressure measurement based on an experimental model consists of an effective and controlled method of learning and research, more appropriate for teaching neurointensive care practices. Assessment based on a checklist form helps teachers keep track of student learning progress. This project offers medical students a safe method to develop intensive neurological monitoring skills for clinical assessment of patients with neurological disorders.

Keywords: neurology, intracranial pressure, medical education, simulation

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Authors: Sandra Christina Gressler

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Resting is essentially the physical and mental relaxation. So, can behaviors that go beyond the merely physical relaxation to some extent be understood as a behavior of restoration? Studies on restorative environments emphasize the physical, mental and social benefits that some environments can provide and suggest that activities in natural environments reduce the stress of daily lives, promoting recovery against the daily wear. These studies, though specific in their results, do not unify the different possibilities of restoration. Considering the importance of restorative environments by promoting well-being, this research aims to verify the applicability of the theory on restorative environments in a Brazilian context, inquiring about the environment/behavior of rest. The research sought to achieve its goals by; a) identifying daily ways of how participants interact/connect with nature; b) identifying the resting environments/behavior; c) verifying if rest strategies match the restorative environments suggested by restorative studies; and d) verifying different rest strategies related to time. Workers from different companies in which certain functions require focused attention, and high school students from different schools, participated in this study. An interview was used to collect data and information. The data obtained were compared with studies of attention restoration theory and stress recovery. The collected data were analyzed through the basic descriptive inductive statistics and the use of the software ALCESTE® (Analyse Lexicale par Contexte d'un Ensemble de Segments de Texte). The open questions investigate perception of nature on a daily basis – analysis using ALCESTE; rest periods – daily, weekends and holidays – analysis using ALCESTE with tri-croisé; and resting environments and activities – analysis using a simple descriptive statistics. According to the results, environments with natural characteristics that are compatible with personal desires (physical aspects and distance) and residential environments when they fulfill the characteristics of refuge, safety, and self-expression, characteristics of primary territory, meet the requirements of restoration. Analyzes suggest that the perception of nature has a wide range that goes beyond the objects nearby and possible to be touched, as well as observation and contemplation of details. The restoration processes described in the studies of attention restoration theory occur gradually (hierarchically), starting with being away, following compatibility, fascination, and extent. They are also associated with the time that is available for rest. The relation between rest behaviors and the bio-demographic characteristics of the participants are noted. It reinforces, in studies of restoration, the need to insert not only investigations regarding the physical characteristics of the environment but also behavior, social relationship, subjective reactions, distance and time available. The complexity of the theme indicates the necessity for multimethod studies. Practical contributions provide subsidies for developing strategies to promote the welfare of the population.

Keywords: attention restoration theory, environmental psychology, rest behavior, restorative environments

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Authors: Christian Andrä, Luisa Zimmermann, Christina Müller

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Introduction: The positive relation between physical activity and cognition is commonly known. Relevant studies show that in everyday school life active breaks can lead to improvement in certain abilities (e.g. attention and concentration). A beneficial effect is in particular attributed to moderate activity. It is still unclear whether active breaks are beneficial after relatively short phases of cognitive load and whether the postulated effects of activity really have an immediate impact. The objective of this study was to verify whether an active break after 18 minutes of cognitive load leads to enhanced attention/concentration performance, compared to inactive breaks with voluntary mobile phone activity. Methodology: For this quasi-experimental study, 36 students [age: 14.0 (mean value) ± 0.3 (standard deviation); male/female: 21/15] of a secondary school were tested. In week 1, every student’s maximum heart rate (Hfmax) was determined through maximum effort tests conducted during physical education classes. The task was to run 3 laps of 300 m with increasing subjective effort (lap 1: 60%, lap 2: 80%, lap 3: 100% of the maximum performance capacity). Furthermore, first attention/concentration tests (D2-R) took place (pretest). The groups were matched on the basis of the pretest results. During week 2 and 3, crossover testing was conducted, comprising of 18 minutes of cognitive preload (test for concentration performance, KLT-R), a break and an attention/concentration test after a 2-minutes transition. Different 10-minutes breaks (active break: moderate physical activity with 65% Hfmax or inactive break: mobile phone activity) took place between preloading and transition. Major findings: In general, there was no impact of the different break interventions on the concentration test results (symbols processed after physical activity: 185.2 ± 31.3 / after inactive break: 184.4 ± 31.6; errors after physical activity: 5.7 ± 6.3 / after inactive break: 7.0. ± 7.2). There was, however, a noticeable development of the values over the testing periods. Although no difference in the number of processed symbols was detected (active/inactive break: period 1: 49.3 ± 8.8/46.9 ± 9.0; period 2: 47.0 ± 7.7/47.3 ± 8.4; period 3: 45.1 ± 8.3/45.6 ± 8.0; period 4: 43.8 ± 7.8/44.6 ± 8.0), error rates decreased successively after physical activity and increased gradually after an inactive break (active/inactive break: period 1: 1.9 ± 2.4/1.2 ± 1.4; period 2: 1.7 ± 1.8/ 1.5 ± 2.0, period 3: 1.2 ± 1.6/1.8 ± 2.1; period 4: 0.9 ± 1.5/2.5 ± 2.6; p= .012). Conclusion: Taking into consideration only the study’s overall results, the hypothesis must be dismissed. However, more differentiated evaluation shows that the error rates decreased after active breaks and increased after inactive breaks. Obviously, the effects of active intervention occur with a delay. The 2-minutes transition (regeneration time) used for this study seems to be insufficient due to the longer adaptation time of the cardio-vascular system in untrained individuals, which might initially affect the concentration capacity. To use the positive effects of physical activity for teaching and learning processes, physiological characteristics must also be considered. Only this will ensure optimum ability to perform.

Keywords: active breaks, attention/concentration test, cognitive performance capacity, heart rate, physical activity

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Authors: A. Delimitsou, C. Gouedard, E. Konstanta, A. Koletis, S. Patera, E. Manou, K. Spaho, S. Murray

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Background: There remains a lack of International Standard Control Reference materials for Next Generation Sequencing-based approaches or device calibration. We have designed and validated dsDNA biomimetic reference materials for targeted such approaches incorporating proprietary motifs (patent pending) for device/test calibration. They enable internal single-sample calibration, alleviating sample comparisons to pooled historical population-based data assembly or statistical modelling approaches. We have validated such an approach for BRCA Copy Number Variation analytics using iQRS™-CNVSUITE versus Mixed Ligation-dependent Probe Amplification. Methods: Standard BRCA Copy Number Variation analysis was compared between mixed ligation-dependent probe amplification and next generation sequencing using a cohort of 198 breast/ovarian cancer patients. Next generation sequencing based copy number variation analysis of samples spiked with iQRS™ dsDNA biomimetics were analysed using proprietary CNVSUITE software. Mixed ligation-dependent probe amplification analyses were performed on an ABI-3130 Sequencer and analysed with Coffalyser software. Results: Concordance of BRCA – copy number variation events for mixed ligation-dependent probe amplification and CNVSUITE indicated an overall sensitivity of 99.88% and specificity of 100% for iQRS™-CNVSUITE. The negative predictive value of iQRS-CNVSUITE™ for BRCA was 100%, allowing for accurate exclusion of any event. The positive predictive value was 99.88%, with no discrepancy between mixed ligation-dependent probe amplification and iQRS™-CNVSUITE. For device calibration purposes, precision was 100%, spiking of patient DNA demonstrated linearity to 1% (±2.5%) and range from 100 copies. Traditional training was supplemented by predefining the calibrator to sample cut-off (lock-down) for amplicon gain or loss based upon a relative ratio threshold, following training of iQRS™-CNVSUITE using spiked iQRS™ calibrator and control mocks. BRCA copy number variation analysis using iQRS™-CNVSUITE™ was successfully validated and ISO15189 accredited and now enters CE-IVD performance evaluation. Conclusions: The inclusion of a reference control competitor (iQRS™ dsDNA mimetic) to next generation sequencing-based sequencing offers a more robust sample-independent approach for the assessment of copy number variation events compared to mixed ligation-dependent probe amplification. The approach simplifies data analyses, improves independent sample data analyses, and allows for direct comparison to an internal reference control for sample-specific quantification. Our iQRS™ biomimetic reference materials allow for single sample copy number variation analytics and further decentralisation of diagnostics to single patient sample assessment.

Keywords: validation, diagnostics, oncology, copy number variation, reference material, calibration

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Authors: Christina Y. P. Ting

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Migration is a global phenomenon with movements of migrants from developed and developing countries to the host societies. Migrants have changed the host countries’ demography – its population structure and also its ethnic cultural diversity. Acculturation of migrants in terms of their adoption of the host culture is seen as important to ensure that they ‘fit into’ their adopted country so as to participate in everyday public life. However, this research found that the increase of the China-born migrants’ post-migration consumption level had impact on Australia’s environment reflected not only because of their adoption of elements of the host culture, but also retention of aspects of Chinese culture – indicating that the influence of bi-culturalism was in operation. This research, which was based on the face-to-face interview with 61 China-born migrants in the suburb of Box Hill, Melbourne, investigated the pattern of change in the migrants’ consumption upon their settlement in Australia. Using an ecological footprint calculator, their post-migration footprints were found to be larger than pre-migration footprint. The uniquely-derived CALD (Culturally and Linguistically Diverse) Index was used to measure individuals’ strength of connectedness to ethnic culture. Multi-variant analysis was carried out to understand which independent factors that influence consumption best explain the change in footprint (which is the difference between pre-and post-migration footprints, as a dependent factor). These independent factors ranged from socio-economic and demographics to the cultural context, that is, the CALD Index and indicators of acculturation. The major findings from the analysis were: Chinese culture (as measured by the CALD Index) and indicators of acculturation such as length of residency and using English in communications besides the traditional factors such as age, income and education level made significant contributions to the large increase in the China-born group’s post-migration consumption level. This paper as part of a larger study found that younger migrants’ large change in their footprint were related to high income and low level of education. This group of migrants also practiced bi-cultural consumption in retaining ethnic culture and adopting the host culture. These findings have importantly highlighted that for a host society to tackle environmental crisis, governments need not only to understand the relationship between age and consumption behaviour, but also to understand and embrace the migrants’ ethnic cultures, which may act as bridges and/or fences in relationships. In conclusion, for governments to deal with national issues such as environmental crisis within a cultural diverse population, it necessitates an understanding of age and aspects of ethnic culture that may act as bridges and fences. This understanding can aid in putting in place policies that enable the co-existence of a hybrid of the ethnic and host cultures in order to create and maintain a harmonious and secured living environment for population groups.

Keywords: bicultural consumer, CALD index, consumption, ethnic culture, migrants

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Authors: Christos E. Lampropoulos, Maria Konsta, Vicky Dradaki, Irini Dri, Tamta Sirbilatze, Ifigenia Apostolou, Christina Kordali, Konstantina Panouria, Kostas Argyros, Georgios Mavras

Abstract:

Malnutrition in hospitalized patients is related to increased morbidity and mortality. Purpose of our study was to assess nutritional status of hospitalized, elderly patients with various nutritional scores and to detect unfavorable prognostic factors, related to increased mortality and extended duration of admission. Methods: 150 patients (78 men, 72 women, mean age 80±8.2) were included in this cross-sectional study. Nutritional status was assessed by Mini Nutritional Assessment (MNA full, short-form), Malnutrition Universal Screening Tool (MUST) and short Nutritional Appetite Questionnaire (sNAQ). The following data were incorporated in analysis: Anthropometric and laboratory data, physical activity (International Physical Activity Questionnaires, IPAQ), smoking status, dietary habits and mediterranean diet (assessed by MedDiet score), cause and duration of current admission, medical history (co-morbidities, previous admissions). Primary endpoints were the mortality (from admission until 6 months afterwards) and duration of admission, compared to national guidelines for closed consolidated medical expenses. Mann-Whitney two-sample statistics or t-test was used for group comparisons and Spearman or Pearson coefficients for testing correlation between variables. Results: Normal nutrition was assessed in 54/150 (36%), 92/150 (61.3%) and in 106/150 (70.7%) of patients, according to full MNA, MUST and sNAQ questionnaires respectively. Mortality rate was 20.7% (31/150 patients). The patients who died until 6 months after admission had lower BMI (24±4.4 vs 26±4.8, p=0.04) and albumin levels (2.9±0.7 vs 3.4±0.7, p=0.002), significantly lower full MNA (14.5±7.3 vs 20.7±6, p<0.0001) and short-form MNA scores (7.3±4.2 vs 10.5±3.4, p=0.0002) compared to non-dead one. In contrast, the aforementioned patients had higher MUST (2.5±1.8 vs 0.5±1.02, p=<0.0001) and sNAQ scores (2.9±2.4 vs 1.1±1.3, p<0.0001). Additionally, they showed significantly lower MedDiet (23.5±4.3 vs 31.1±5.6, p<0.0001) and IPAQ scores (37.2±156.2 vs 516.5±1241.7, p<0.0001) compared to remaining one. These patients had extended hospitalization [5 (0-13) days vs 0 (-1-3) days, p=0.001]. Patients who admitted due to cancer depicted higher mortality rate (10/13, 77%), compared to those who admitted due to infections (12/73, 18%), stroke (4/15, 27%) or other causes (4/49, 8%) (p<0.0001). Extension of hospitalization was negatively correlated to both full (Spearman r=-0.35, p<0.0001) and short-form MNA (Spearman r=-0.33, p<0.0001) and positively correlated to MUST (Spearman r=0.34, p<0.0001) and sNAQ (Spearman r=0.3, p=0.0002). Additionally, the extension was inversely related to MedDiet score (Spearman r=-0.35, p<0.0001), IPAQ score (Spearman r=-0.34, p<0.0001), albumin levels (Pearson r=-0.36, p<0.0001), Ht (Pearson r=-0.2, p=0.02) and Hb (Pearson r=-0.18, p=0.02). Conclusion: A great proportion of elderly, hospitalized patients are malnourished or at risk of malnutrition. All nutritional scores, physical activity and albumin are significantly related to mortality and increased hospitalization.

Keywords: dietary habits, duration of admission, malnutrition, prognostic factors for mortality

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Authors: Sahar El Shair, Laura Greco, William Reay, Murray Cairns

Abstract:

Background: Rheumatoid arthritis (RA) is a chronic, systematic, inflammatory, autoimmune disease that involves damages to joints and erosions to the associated bones and cartilage, resulting in reduced physical function and disability. RA is a multifactorial disorder influenced by heterogenous genetic and environmental factors. Whilst different medications have proven successful in reducing inflammation associated with RA, they often come with significant side effects and limited efficacy. To address this, the novel pharmagenic enrichment score (PES) algorithm was tested in self-reported RA patients from the UK Biobank (UKBB), which is a cohort of predominantly European ancestry, and identified individuals with a high genetic risk in clinically actionable biological pathways to identify novel opportunities for precision interventions and drug repurposing to treat RA. Methods and materials: Genetic association data for rheumatoid arthritis was derived from publicly available genome-wide association studies (GWAS) summary statistics (N=97173). The PES framework exploits competitive gene set enrichment to identify pathways that are associated with RA to explore novel treatment opportunities. This data is then integrated into WebGestalt, Drug Interaction database (DGIdb) and DrugBank databases to identify existing compounds with existing use or potential for repurposed use. The PES for each of these candidates was then profiled in individuals with RA in the UKBB (Ncases = 3,719, Ncontrols = 333,160). Results A total of 209 pathways with known drug targets after multiple testing correction were identified. Several pathways, including interferon gamma signaling and TID pathway (which relates to a chaperone that modulates interferon signaling), were significantly associated with self-reported RA in the UKBB when adjusting for age, sex, assessment centre month and location, RA polygenic risk and 10 principal components. These pathways have a major role in RA pathogenesis, including autoimmune attacks against certain citrullinated proteins, synovial inflammation, and bone loss. Encouragingly, many also relate to the mechanism of action of existing RA medications. The analyses also revealed statistically significant association between RA polygenic scores and self-reported RA with individual PES scorings, highlighting the potential utility of the PES algorithm in uncovering additional genetic insights that could aid in the identification of individuals at risk for RA and provide opportunities for more targeted interventions. Conclusions In this study, pharmacologically annotated genetic risk was explored through the PES framework to overcome inter-individual heterogeneity and enable precision drug repurposing in RA. The results showed a statistically significant association between RA polygenic scores and self-reported RA and individual PES scorings for 3,719 RA patients. Interestingly, several enriched PES pathways were targeted by already approved RA drugs. In addition, the analysis revealed genetically supported drug repurposing opportunities for future treatment of RA with a relatively safe profile.

Keywords: rheumatoid arthritis, precision medicine, drug repurposing, system biology, bioinformatics

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Authors: Anna Höfer, Johannes Herrmann, Patrick Meybohm, Christopher Lotz

Abstract:

Mitochondria are pivotal for energy supply and regulation of cellular functions. Deficiencies of mitochondrial metabolism have been implicated in diverse stressful conditions including infections. Platelets are key mediators for thrombo-inflammation during development and resolution of acute respiratory distress syndrome (ARDS). Previous data point to an exhausted platelet phenotype in critically-ill patients with coronavirus 19 disease (COVID-19) impacting the course of disease. The objective of this work was to characterize platelet mitochondrial metabolism in patients suffering from COVID-19 ARDSA longitudinal analysis of platelet mitochondrial metabolism in 24 patients with COVID-19 induced ARDS compared to 35 healthy controls (ctrl) was performed. Blood samples were analyzed at two time points (t1=day 1; t2=day 5-7 after study inclusion). The activity of mitochondrial citrate synthase was photometrically measured. The impact of oxidative stress on mitochondrial permeability was assessed by a photometric calcium-induced swelling assay and the activity of superoxide dismutase (SOD) by a SOD assay kit. The amount of protein carbonylation and the activity of mitochondria complexes I-IV were photometrically determined. Levels of interleukins (IL)-1α, IL-1β and tumor necrosis factor (TNF-) α were measured by a Multiplex assay kit. Median age was 54 years, 63 % were male and BMI was 29.8 kg/m2. SOFA (12; IQR: 10-15) and APACHE II (27; IQR: 24-30) indicated critical illness. Median Murray Score was 3.4 (IQR: 2.8-3.4), 21/24 (88%) required mechanical ventilation and V-V ECMO support in 14/24 (58%). Platelet counts in ARDS did not change during ICU stay (t1: 212 vs. t2: 209 x109/L). However, mean platelet volume (MPV) significantly increased (t1: 10.6 vs. t2: 11.9 fL; p<0.0001). Citrate synthase activity showed no significant differences between ctrl and ARDS patients. Calcium induced swelling was more pronounced in patients at t1 compared to t2 and to ctrl (50µM; t1: 0.006 vs. ctrl: 0.016 ΔOD; p=0.001). The amount of protein carbonylation as marker for irreversible proteomic modification constantly increased during ICU stay and compared to ctrl., without reaching significance. In parallel, superoxid dismutase activity gradually declined during ICU treatment vs. ctrl (t2: - 29 vs. ctrl.: - 17 %; p=0.0464). Complex I analysis revealed significantly stronger activity in ARDS vs. ctrl. (t1: 0.633 vs. ctrl.: 0.415 ΔOD; p=0.0086). There were no significant differences in complex II, III or IV activity in platelets from ARDS patients compared to ctrl. IL-18 constantly increased during the observation period without reaching significance. IL-1α and TNF-α did not differ from ctrl. However, IL-1β levels were significantly elevated in ARDS (t1: 16.8; t2: 16.6 vs. ctrl.: 12.4 pg/mL; p1=0.0335, p2=0.0032). This study reveals new insights in platelet mitochondrial metabolism during COVID-19 caused ARDS. it data point towards enhanced platelet activity with a pronounced turnover rate. We found increased activity of mitochondria complex I and evidence for enhanced oxidative stress. In parallel, protective mechanisms against oxidative stress were narrowed with elevated levels of IL-1β likely causing a pro-apoptotic environment. These mechanisms may contribute to platelet exhaustion in ARDS.

Keywords: acute respiratory distress syndrome (ARDS), coronavirus 19 disease (COVID-19), oxidative stress, platelet mitochondrial metabolism

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