An application of miniscale experiments on Earth to refine microgravity analysis of adiabatic multiphase flow in space

Adiabatic two-phase flow is of interest to the design of multiphase fluid and thermal management systems for spacecraft. This paper presents original data and unifies existing data for capillary tubes as a step toward assessing existing multiphase flow analysis and engineering software. Comparisons of theory with these data once again confirm the broad accuracy of the theory. Due to the simplicity and low cost of the capillary tube experiments, which were performed on earth, we were able to closely examine for the first time a flow situation that had not previously been examined appreciably by aircraft tests. This is the situation of a slug flow at high quality, near transition to annular flow. Our comparison of software calculations with these data revealed overprediction of pipeline pressure drop by up to a factor of three. In turn, this finding motivated a reexamination of the existing theory, and then development of a new analytical and is in far better agreement with the data. This sequence of discovery illustrates the role of inexpensive miniscale modeling on earth to anticipate microgravity behavior in space and to complete and help define needs for aircraft tests

The Indigenous digital divide: COVID-19 and its impacts on educational delivery to First Nation university students

The global COVID 19 pandemic highlighted that the delivery of online education inadvertently disadvantaged Indigenous Australian university students. This situation was particularly critical for Indigenous students from rural and remote locations. Australian universities increased the use of digital technologies to engage, support and teach due to students’ inability to access campuses. This presented universities with challenges in supporting Indigenous students living in and returning to non-urban settings. Often not recognised is the need for better strategies and plans for Indigenous students returning to their rural or remote community to continue their studies due to COVID. These communities often lack suitable infrastructure that would allow access to pedagogical and learning support opportunities. This paper explores how the business decision made by Australian universities to increase reliance on teaching online during COVID impacted the education of Indigenous students. This paper will then canvas ways this ongoing dilemma can be addressed by considering risks, measuring and monitoring performance to guide transformation, including universities’ more inclusive and respectful use of digital technologies involving First Nations people and culture

The Indigenous Digital Divide: COVID-19 and its impacts on education delivery to First Nations university students

The global COVID 19 pandemic highlighted that the delivery of online education inadvertently disadvantaged Indigenous Australian university students. This situation was particularly critical for Indigenous students from rural and remote locations. Australian universities increased the use of digital technologies to engage, support and teach due to students’ inability to access campuses. This presented universities with challenges in supporting Indigenous students living in and returning to non-urban settings. Often not recognised is the need for better strategies and plans for Indigenous students returning to their rural or remote community to continue their studies due to COVID. These communities often lack suitable infrastructure that would allow access to pedagogical and learning support opportunities. This paper explores how the business decision made by Australian universities to increase reliance on teaching online during COVID impacted the education of Indigenous students. This paper will then canvas ways this ongoing dilemma can be addressed by considering risks, measuring and monitoring performance to guide transformation, including universities’ more inclusive and respectful use of digital technologies involving First Nations people and cultures

Report of the 2019-2020 strategic engagement standing committee

© 2020, American Association of Colleges of Pharmacy. All rights reserved. For the American Association of Colleges of Pharmacy (AACP) strategic engagement is critical to the success of colleges and schools of pharmacy in expanding pharmacy and public health practice, meeting programmatic needs, and fulfilling institutional missions. The 2019-2020 Strategic Engagement Committee was charged with exploring the collaborative relationships colleges and schools have within their state to advance pharmacy practice. More specifically, this committee was tasked to examine those relationships with current state pharmacy and medical associations. This report seeks to provide insights from this work and share recommendations to assist AACP in facilitating practice transformation. To uncover current schools’ relationships with state and medical associations, the committee utilized AACP’s ability in convening members to conduct focus groups at INsight 2020 and one-on-one interviews with key faculty members. Overall, partnerships with state pharmacy associations are successful or growing, whereas there is still work to be done in developing relationships and collaborating with medical and health care societies. We found that there are several schools with “best practices” related to state association collaborations and look to highlight exemplar practices in this report as they are critical towards practice transformations

Fourteen propositions for resilience, fourteen years later

In 2006, Walker et al. published an article titled, “A Handful of Heuristics and Some Propositions for Understanding Resilience in Social-ecological Systems.” The article was incorporated into the Ecology and Society special feature, Exploring Resilience in Social-Ecological Systems. Walker et al. identified five heuristics and posed 14 propositions for understanding resilience in social-ecological systems. At the time, the authors hoped the paper would promote experimentation, critique, and application of these ideas in resilience and social-ecological systems research. To determine the extent to which these propositions have achieved the authors’ hopes, we reviewed the scientific literature on socialecological systems since the article was published. Using Scopus, we identified 627 articles that cited the Walker et al. article. We then identified and assessed the articles relative to each proposition. In addition, we conducted a more general Scopus review for articles that did not cite the Walker et al. article specifically but incorporated a proposition’s concepts. Overall, articles often cite Walker et al. as a reference for a definition of a heuristic or ecological resilience generally and not to reference a specific proposition. Nonetheless, every proposition was at least mentioned in the literature and used to advance resilience scholarship on social-ecological systems. Eleven propositions were tested by multiple articles through application of case studies or other research, and 7 of the 11 propositions were substantially discussed and advanced. Finally, three propositions were heavily critiqued either as concepts in resilience literature or in their application

Neurofibromin is a novel regulator of Ras-induced reactive oxygen species production in mice and humans

Neurofibromatosis type 1 (NF1) predisposes individuals to early and debilitating cardiovascular disease. Loss of function mutations in the NF1 tumor suppressor gene, which encodes the protein neurofibromin, leads to accelerated p21(Ras) activity and phosphorylation of multiple downstream kinases, including Erk and Akt. Nf1 heterozygous (Nf1(+/-)) mice develop a robust neointima that mimics human disease. Monocytes/macrophages play a central role in NF1 arterial stenosis as Nf1 mutations in myeloid cells alone are sufficient to reproduce the enhanced neointima observed in Nf1(+/-) mice. Though the molecular mechanisms underlying NF1 arterial stenosis remain elusive, macrophages are important producers of reactive oxygen species (ROS) and Ras activity directly regulates ROS production. Here, we use compound mutant and lineage-restricted mice to demonstrate that Nf1(+/-) macrophages produce excessive ROS, which enhance Nf1(+/-) smooth muscle cell proliferation in vitro and in vivo. Further, use of a specific NADPH oxidase-2 inhibitor to limit ROS production prevents neointima formation in Nf1(+/-) mice. Finally, mononuclear cells from asymptomatic NF1 patients have increased oxidative DNA damage, an indicator of chronic exposure to oxidative stress. These data provide genetic and pharmacologic evidence that excessive exposure to oxidant species underlie NF1 arterial stenosis and provide a platform for designing novels therapies and interventions

Applying Digital Health in Cancer and Palliative Care in Europe : Policy Recommendations from an International Expert Workshop (MyPal Project)

Background: Digital health interventions are becoming increasingly important for adults, children, and young people with cancer and palliative care needs, but there is little research to guide policy and practice. Objectives: To identify recommendations for policy development of digital health interventions in cancer and palliative care. Design: Expert elicitation workshop. Setting: European clinical (cancer and palliative care, adult and pediatric), policy, technical, and research experts attended a one-day workshop in London, England, in October 2022, along with MyPal research consortium members. Methods: As part of the European Commission-funded MyPal project, we elicited experts' views on global, national, and institutional policies within structured facilitated groups, and conducted qualitative analysis on these discussions. Results/Implementation: Thirty-two experts from eight countries attended. Key policy drivers and levers in digital health were highlighted. Global level: global technology regulation, definitions, access to information technology, standardizing citizens' rights and data safety, digital infrastructure and implementation guidance, and incorporation of technology into existing health systems. National level: country-specific policy, compatibility of health apps, access to digital infrastructure including vulnerable groups and settings, development of guidelines, and promoting digital literacy. Institutional level: undertaking a needs assessment of service users and clinicians, identifying best practice guidelines, providing education and training for clinicians on digital health and safe digital data sharing, implementing plans to minimize barriers to accessing digital health care, minimizing bureaucracy, and providing technical support. Conclusions: Developers and regulators of digital health interventions may find the identified recommendations useful in guiding policy making and future research initiatives. MyPal child study Clinical Trial Registration NCT04381221; MyPal adult study Clinical Trial Registration NCT0437045

Evaluating Cognition in Individuals with Huntington Disease: NeuroQoL Cognitive Functioning Measures

PURPOSE: Cognitive functioning impacts health-related quality of life (HRQOL) for individuals with Huntington disease (HD). The Neuro-QoL includes two patient-reported outcome (PRO) measures of cognition-Executive Function (EF) and General Concerns (GC). These measures have not previously been validated for use in HD. The purpose of this analysis is to evaluate the reliability and validity of the Neuro-QoL Cognitive Function measures for use in HD. METHODS: Five hundred ten individuals with prodromal or manifest HD completed the Neuro-QoL Cognition measures, two other PRO measures of HRQOL (WHODAS 2.0 and EQ5D), and a depression measure (PROMIS Depression). Measures of functioning The Total Functional Capacity and behavior (Problem Behaviors Assessment) were completed by clinician interview. Objective measures of cognition were obtained using clinician-administered Symbol Digit Modalities Test and the Stroop Test (Word, Color, and Interference). Self-rated, clinician-rated, and objective composite scores were developed. We examined the Neuro-QoL measures for reliability, convergent validity, discriminant validity, and known-groups validity. RESULTS: Excellent reliabilities (Cronbach\u27s alphas ≥ 0.94) were found. Convergent validity was supported, with strong relationships between self-reported measures of cognition. Discriminant validity was supported by less robust correlations between self-reported cognition and other constructs. Prodromal participants reported fewer cognitive problems than manifest groups, and early-stage HD participants reported fewer problems than late-stage HD participants. CONCLUSIONS: The Neuro-QoL Cognition measures provide reliable and valid assessments of self-reported cognitive functioning for individuals with HD. Findings support the utility of these measures for assessing self-reported cognition

Mapping pediatric palliative care development in the WHO-European Region: children living in low-middle income countries are less likely to access it

Context: Approximately 170,000 children in need of palliative care die every year in Europe without access to it. This field remains an evolving specialty with unexplored development. Objectives: To conduct the first regional assessment of pediatric palliative care (PPC) development and provision using data from the European Association for Palliative Care atlas of palliative care 2019. Methods: Two surveys were conducted. The first one included a single question regarding PPC service provision and was addressed by European Association for Palliative Care atlas informants. The second one included 10 specific indicators derived from an open-ended interview and rating process; a specific network of informants was enabled and used as respondents. Data were analyzed and presented in the map of the figure. Results: Data on PPC service provision were gathered from 51 of 54 (94%) European countries. Additional data were collected in 34 of 54 (62%) countries. A total of 680 PPC services were identified including 133 hospices, 385 home care services, and 162 hospital services. Nineteen countries had specific standards and norms for the provision of PPC. Twenty-two countries had a national association, and 14 countries offered education for either pediatric doctors or nurses. In seven countries, specific neonatal palliative care referral services were identified. Conclusion: PPC provision is flourishing across the region; however, development is less accentuated in low-to-middle-income countries. Efforts need to be devoted to the conceptualization and definition of the models of care used to respond to the unmet need of PPC in Europe. The question whether specialized services are required or not should be further explored. Strategies to regulate and cover patients in need should be adapted to each national health system

Neurofibromin Deficient Myeloid Cells are Critical Mediators of Aneurysm Formation In Vivo

Background Neurofibromatosis Type 1 (NF1) is a genetic disorder resulting from mutations in the NF1 tumor suppressor gene. Neurofibromin, the protein product of NF1, functions as a negative regulator of Ras activity in circulating hematopoietic and vascular wall cells, which are critical for maintaining vessel wall homeostasis. NF1 patients have evidence of chronic inflammation resulting in development of premature cardiovascular disease, including arterial aneurysms, which may manifest as sudden death. However, the molecular pathogenesis of NF1 aneurysm formation is unknown. Method and Results Utilizing an angiotensin II-induced aneurysm model, we demonstrate that heterozygous inactivation of Nf1 (Nf1+/−) enhanced aneurysm formation with myeloid cell infiltration and increased oxidative stress in the vessel wall. Using lineage-restricted transgenic mice, we show loss of a single Nf1 allele in myeloid cells is sufficient to recapitulate the Nf1+/− aneurysm phenotype in vivo. Finally, oral administration of simvastatin or the antioxidant apocynin, reduced aneurysm formation in Nf1+/− mice. Conclusion These data provide genetic and pharmacologic evidence that Nf1+/− myeloid cells are the cellular triggers for aneurysm formation in a novel model of NF1 vasculopathy and provide a potential therapeutic target