Unbearable wearables

As wearable devices play an increasing role in the management of health and disease, adverse skin reactions to wearables have become more common. However, the management of allergic contact dermatitis is challenging and new treatment options more compatible with wearable devices are needed. In a 40-year-old woman with contact dermatitis to a continuous glucose monitoring device, topical clobetasol propionate 0.05% spray proved to be an effective treatment that was compatible with the application of adhesive wearables. This case demonstrates that spray formulations of topical steroids are a good option for the treatment of dermatitis under wearable devices such as continuous glucose monitors or ostomy appliance

Effectiveness of Gamification Activities in a Project-based Learning Classroom

The purpose of this research is to analyze the effectiveness, and student\u27s self-reported engagement with gamification tools on a student\u27s learning of technical concepts when used in a project-based learning (PBL) engineering classroom environment. Gamification, as defined in this study, is the use of game-based elements such as online audience response systems with automated feedback in non-game situations. By adding gamification to the classroom, we hope to further build on the active and collaborative learning environment that our PBL program already provides. Five gamification activities were implemented during the Fall 2017 semester with junior and senior student engineers enrolled in Iron Range Engineering, a program of Minnesota State University, Mankato. The Iron Range Engineering (IRE) model is a project-based-learning program in which students work closely with industry on design projects throughout their 3rd and 4th years. The goal of this program’s approach is to prepare and produce graduates with significant integrated technical and professional knowledge and skills to enter the engineering workforce. The three game-based online platforms along with two hands-on activities were used in six technical courses: Signals & Systems, Engineering Economics, Statistics, Linear Control Systems, Lean Principles, and Electric Machines. All five gamification tools allowed for real-time assessment, so students were given instant feedback from the game on their level of understanding of a technical concept. The in-class gaming activities were used in approximately five instances within the six courses; with about 8 - 12 participants in each class (n is approx 300 student gaming interaction instances). Feedback was collected via student surveys, student and faculty reflections and data received automatically by the game programs. Preliminary analysis of student feedback and faculty reflections indicates increased learner motivation, enhanced review of technical content and an upbeat atmosphere to the classroom. Faculty reflections also noted that the use of games that allow learners to answer the questions individually helped faculty identify those students who had successfully mastered the concepts, which allowed the instructor to structure peer-to-peer active learning opportunities during class more effectively. Future work includes analyzing test scores, and other measures of long-term retention of concepts. Overall, use of these gamification tools was found to be a significant addition to the project-based learning environment at Iron Range Engineering, bringing value to the overall learning process and will continue to be used to improve our teaching and student learning

Growing Entrepreneurial Mindset in Interdisciplinary Student Engineers: Experiences of a Project-Based Engineering Program

Engineering education models have recently embraced the entrepreneurial mindset as a desired outcome of undergraduate engineering education. Interdisciplinary active learning strategies have been suggested as an effective pedagogy for engaging student engineers in undergraduate engineering education. Recent research suggests that active, social learning in context can lead to improvements in learner innovation, problem-solving, curiosity, retention and accessibility of knowledge, value-creation, and other desired learning outcomes. Much of the recent adoption of active and collaborative learning, self-directed learning, problem-based and project-based learning (PBL), peer to peer learning, and other similar learning strategies are aimed at developing innovative and entrepreneurial mindset skills, but they have been limited to Capstone Design courses. Our aim is to develop the entrepreneurial mindset much earlier in the student engineers’ undergraduate education. The Iron Range Engineering program is entrepreneurial in nature, based on continuous improvement, self-directed learning, and reflective practice. Our student engineers learn in context, by applying technical engineering knowledge in project teams working on industry-sourced projects, each of the four semesters of their junior and senior years. In addition, freshman and sophomores enrolled in pre-engineering studies in a closely aligned community college are included in the culture, many activities, and teaching staff of the upper division program. Drawing from the Kern Family Foundation’s Engineering Unleashed program and Innovating Curriculum with Entrepreneurial Mindset (ICE) workshops, faculty in the program were introduced to the entrepreneurial mindset in the summer of 2017. In the Fall, 2017 semester, they developed and piloted several entrepreneurial-minded learning (EML) modules across the curriculum of our program (approx. 100 students in lower and upper divisions), ranging from Statics in Sophomore year, to Entrepreneurship and Statistics in the Junior year, and Three-Phase and Signals and Systems for the Seniors, among others. Entrepreneurial Mindset was also reinforced in Design class and applied in project work. This paper describes the experiences of faculty and students in the implementation of entrepreneurial mindset modules adopted in our program, as well as preliminary results of this rapid deployment in an interdisciplinary engineering program. We use a case study format to report auto-ethnographic stories from both faculty and student perspectives. Early results are promising. After two semesters of simultaneous deployment of entrepreneurial mindset across the curriculum, faculty are engaged and working collaboratively to improve and extend this type of entrepreneurial learning even further into the program. The impact on ABET and KEEN outcomes are addressed. Student feedback is also positive. The pervasiveness of the application of entrepreneurial mindset is present in student reflections, project technical documents, design reviews, oral exams, and other student work. The entrepreneurial mindset has become part of the culture of our program in a short time, which we view as a positive outcome. The experiences of the participating faculty members are presented in the paper, as well as student reflections on the application of entrepreneurial mindset in their courses and design projects. Planned next steps are also addressed in the paper

Exploring intentional medication non-adherence in patients with systemic lupus erythematosus: The role of physician-patient interactions

OBJECTIVE: Medication non-adherence contributes to worse health outcomes among SLE patients. The underlying mechanisms that drive medication non-adherence are poorly understood. The purpose of this study was to explore possible mechanisms of medication non-adherence by eliciting patient experiences. METHODS: Consented adult patients with ACR- or SLICC-classified SLE were recruited. Ten semi-structured interviews were conducted across six participants. Interviews were audio recorded, transcribed, and analysed using an iterative process. The findings were presented to an interactive public forum with SLE patients, family members and friends of patients, and health-care professionals to assess validity and for elaboration of the concepts developed. RESULTS: The following three interrelated themes emerged from the interviews. First, why do rheumatologists not know more about lupus or share what they do know with their patients? Second, why do I have to take so many drugs and why do the drugs not work? Third, if my rheumatologist cannot communicate with me, why should I follow the prescribed medication regimen? CONCLUSION: Our exploratory findings lay out a possible underlying logic by which patients might choose intentionally to engage with medication non-adherence behaviours. Patients suggested that poor communication with their rheumatologists along with a lack of validation of their symptoms contributed to them not valuing the recommendations of physicians. This also contributed to development of a cynical outlook and little belief that medication would improve their condition. Although further work is needed to validate these findings, our preliminary work suggests that interventions focusing on the development of communication skills among both patients and rheumatologists are necessary to reduce medication non-adherence

Development of a digital toolkit to improve quality of life of patients with systemic lupus erythematosus

OBJECTIVE: The purpose of this manuscript is to detail development and initial usability testing of an e-toolkit designed to provide skills and knowledge around self-management behaviors for individuals living with systemic lupus erythematosus. METHODS: Researchers worked with a steering committee of patients and providers to (1) develop a clickable prototype of an e-toolkit and (2) conduct alpha (individuals not affiliated with an academic clinic as patient or provider) and beta (individual patients with systemic lupus erythematosus as well as members of the clinic healthcare team and individuals who work in patient advocacy organizations) usability testing through semistructured interviews. RESULTS: During the review of the e-toolkit, the feedback provided by participants in both alpha and beta groups centered on two overarching themes: (1) improving user interface and materials and (2) integration of information and supports between toolkit and clinical personnel. CONCLUSION: Digital approaches that are tailored to individual symptom variation and integrated with a clinical system have the opportunity to enhance ongoing clinical care. These findings support movement toward integrated, team-based care models, tailored digital resources, and use of expanded virtual interaction options to ensure on-going engagement between healthcare providers and systemic lupus erythematosus patients

Drosophila Muller F Elements Maintain a Distinct Set of Genomic Properties Over 40 Million Years of Evolution

The Muller F element (4.2 Mb, similar to 80 protein-coding genes) is an unusual autosome of Drosophila melanogaster; it is mostly heterochromatic with a low recombination rate. To investigate how these properties impact the evolution of repeats and genes, we manually improved the sequence and annotated the genes on the D. erecta, D. mojavensis, and D. grimshawi F elements and euchromatic domains from the Muller D element. We find that F elements have greater transposon density (25-50%) than euchromatic reference regions (3-11%). Among the F elements, D. grimshawi has the lowest transposon density (particularly DINE-1: 2% vs. 11-27%). F element genes have larger coding spans, more coding exons, larger introns, and lower codon bias. Comparison of the Effective Number of Codons with the Codon Adaptation Index shows that, in contrast to the other species, codon bias in D. grimshawi F element genes can be attributed primarily to selection instead of mutational biases, suggesting that density and types of transposons affect the degree of local heterochromatin formation. F element genes have lower estimated DNA melting temperatures than D element genes, potentially facilitating transcription through heterochromatin. Most F element genes (similar to 90%) have remained on that element, but the F element has smaller syntenic blocks than genome averages (3.4-3.6 vs. 8.4-8.8 genes per block), indicating greater rates of inversion despite lower rates of recombination. Overall, the F element has maintained characteristics that are distinct from other autosomes in the Drosophila lineage, illuminating the constraints imposed by a heterochromatic milieu

Preparation and Characterization of Monoclonal Antibodies Directed Against Antigenic Determinants of Recombinant Human Tumour Necrosis Factor (rTNF)

A large number of monoclonal antibodies (McAb) binding to antigenic determinants of human tumour necrosis factor (TNF) were prepared from two fusions of mouse myeloma NSO cells with spleen cells from Balb/c mice immunized with highly purified recombinant (r)TNF. Several of these McAbs were highly neutralizing with respect to the biological activity (cytotoxicity) of TNF manifested in L-929 C1.10 cells. Antibody competition experiments suggested the presence of at least two antigenic determinants on the rTNF molecule through which binding of McAb effects neutralization of biological activity. Some of these McAbs were shown to be suitable for the development of immuoassays to quantify rTNF

Age differences in the prosocial influence effect

Social influence occurs when an individual's thoughts or behaviours are affected by other people. There are significant age effects on susceptibility to social influence, typically a decline from childhood to adulthood. Most research has focused on negative aspects of social influence, such as peer influence on risky behaviour, particularly in adolescence. The current study investigated the impact of social influence on the reporting of prosocial behaviour (any act intended to help another person). In this study, 755 participants aged 8–59 completed a computerized task in which they rated how likely they would be to engage in a prosocial behaviour. Afterwards, they were told the average rating (in fact fictitious) that other participants had given to the same question, and then were asked to rate the same behaviour again. We found that participants' age affected the extent to which they were influenced by other people: children (8–11 years), young adolescents (12–14 years) and mid-adolescents (15–18 years) all significantly changed their ratings, while young adults (19–25 years) and adults (26–59 years) did not. Across the three youngest age groups, children showed the most susceptibility to prosocial influence, changing their reporting of prosocial behaviour the most. The study provides evidence that younger people's increased susceptibility to social influence can have positive outcomes

Do cognitive impairments limit treatment gains in a standalone digital intervention for psychosis? A test of the digital divide

Digital mental health interventions, such as those provided by smartphone applications (apps), show promise as cost-effective approaches to increasing access to evidence-based psychosocial interventions for psychosis. Although it is well known that limited financial resources can reduce the benefits of digital approaches to mental healthcare, the extent to which cognitive functioning in this population could impact capacity to engage in and benefit from these interventions is less studied. In the current study we examined the extent to which cognitive functioning (premorbid cognitive abilities and social cognition) were related to treatment engagement and outcome in a standalone digital intervention for social functioning. Premorbid cognitive abilities generally showed no association with aggregated treatment engagement markers, including proportion of notifications responded to and degree of interest in working on app content, though there was a small positive association with improvements in social functioning. Social cognition, as measured using facial affect recognition ability, was unrelated to treatment engagement or outcome. These preliminary findings suggest that cognitive functioning is generally not associated with engagement or outcomes in a standalone digital intervention designed for and with people with schizophrenia spectrum disorders.Accepted manuscrip

Rethinking the difficult patient: Formative qualitative study using participatory theater to improve physician-patient communication in rheumatology

BACKGROUND: Effective physician-patient communication is crucial for positive health outcomes for patients with chronic diseases. However, current methods of physician education in communication are often insufficient to help physicians understand how patients\u27 actions are influenced by the contexts within which they live. An arts-based participatory theater approach can provide the necessary health equity framing to address this deficiency. OBJECTIVE: The aim of this study was to develop, pilot, and conduct a formative evaluation of an interactive arts-based communication skills intervention for graduate-level medical trainees grounded in a narrative representative of the experience of patients with systemic lupus erythematosus. METHODS: We hypothesized that the delivery of interactive communication modules through a participatory theater approach would lead to changes in both attitudes and the capacity to act on those attitudes among participants in 4 conceptual categories related to patient communication (understanding social determinants of health, expressing empathy, shared decision-making, and concordance). We developed a participatory, arts-based intervention to pilot this conceptual framework with the intended audience (rheumatology trainees). The intervention was delivered through routine educational conferences at a single institution. We conducted a formative evaluation by collecting qualitative focus group feedback to evaluate the implementation of the modules. RESULTS: Our formative data suggest that the participatory theater approach and the design of the modules added value to the participants\u27 learning experience by facilitating interconnection of the 4 communication concepts (eg, participants were able to gain insight into both what physicians and patients were thinking about on the same topic). Participants also provided several suggestions for improving the intervention such as ensuring that the didactic material had more active engagement and considering additional ways to acknowledge real-world constraints (eg, limited time with patients) in implementing communication strategies. CONCLUSIONS: Our findings from this formative evaluation of communication modules suggest that participatory theater is an effective method for framing physician education with a health equity lens, although considerations in the realms of functional demands of health care providers and use of structural competency as a framing concept are needed. The integration of social and structural contexts into the delivery of this communication skills intervention may be important for the uptake of these skills by intervention participants. Participatory theater provided an opportunity for dynamic interactivity among participants and facilitated greater engagement with the communication module content