A Pilot Study: Observations of Patients Participating in Heart Failure Shared Medical Appointments while Receiveing Nutrition Education

The purpose of this pilot project was to examine descriptive statistics from patients who participated in heart failure (HF) shared medical appointments (SMAs) at a mid-sized heart center in the Northwest, in which nutrition education was provided by an RD. Information collected included blood pressure (BP), heart rate (HR), weight, scores from the Minnesota Living with Heart Failure (MLHF) Survey, and the Atlanta Heart Failure Knowledge (AHFK) questionnaire. Due to small sample size and lack of control group, simple descriptive statistics, such as mean and median were used to examine the data. Three of the participants were female and 4 were male. Five patients in this group had a diagnosis of HF with reduced ejection fraction (HFrEF), and two patients had a diagnosis of HF with preserved ejection fraction (HFpEF). Average weights of the participants ranged from 171.4 lbs to 339.6lbs. Quality of life (QOL) for this group of patients was diverse, average MLHF scores ranging from 0.4-78.3. The 3 lowest scores on the MLHF questionnaire and the 3 lowest average HRs were observed in the 3 patients (21, 22 & 32) who had the lowest recorded weights in the group (200lbs

CPU Cooling Pulse Device for Enhanced Heat Transfer

Ice Dragon Cooling is a company which researches thermofluids and heat transfer technologies. The company’s present research focuses on HVAC and computer applications, with an emphasis on nanofluid development. To support Ice Dragon’s mission, the company wants a product that enhances heat transfer efficiency in liquid-cooled CPU systems. The product is to be a pulse device which increases the turbulence of a liquid across a computer CPU cooling block, thereby expediting heat transfer away from the CPU. The needs for Ice Dragon Cooling were determined based on engineering knowledge and industry consultation. After further analysis, it was determined that increasing the heat transfer rate, achieving turbulent flow, maintaining net-zero energy, preserving the original system’s pump, and ensuring durability were critical to satisfying those needs. Furthermore, it was determined that in order to satisfy the requirements, the pulse device would need to increase flow rate and Reynold’s number value, be made of a sturdy and waterproof material, and consume minimal power. It was thus determined that the project mission should be to create a CPU liquid-cooling pulse device that will increase heat transfer and efficiency within the system. Given the above requirements, various concepts were researched and discussed, as detailed in the full report. The final selected concept to best satisfy Ice Dragon’s needs was a piston-jet combined concept. Information pertaining to concept selection and product architecture are provided. A detailed engineering analysis is provided, displaying flow velocity, temperature, and pressure. The analysis also demonstrates how these elements lead to the generation of turbulence and inducement of heat transfer. Under the assumptions that heat in the system is generated from both the cooling block and the jets and that the flow is homogeneous, incompressible, and laminar, the tested parameters included dissipated heat from the cooling block, pressure drop from the pistons pushing water through the jets, and velocity change at jet inlets and across the microchannels. The prototype testing process involved three separate tests, with one as a control experiment and two to assess the degree of functionality of the device. By running the original system without the pulse device, a baseline was established against which the data of the new system could be compared. The second test focused on demonstration of the pulses in relation to the flow through the device. A flowmeter monitored the flow rate for trials of varying inputted frequencies. The third test focused on the heat transfer rate across the cooling block. Thermocouples placed at the inlet and outlet of the cooling block are used to record the temperature differentials necessary to calculate the heat transfer rate. Economic analysis of the scope of expenses associated with development of the prototype indicates that, for a $153.70 investment per presealed system, Ice Dragon Cooling will recover costs within the first month of production. Applications of this device to the server farm industry and individual consumers are suggested viable options for the company. The Ice Dragon pulse device can and should be ameliorated in the future, with improvements including more reliable sealing, standardization of fittings, and upgraded piston functionality. Sealing of the pistons and cylinder should be improved to effectively prohibit the presence of water into the piston-cylinder mechanism and to prevent fluid losses from the circulatory system. Tube fittings at the inlets and outlets of the device can be bettered by standardization to ensure CPU cooling market consistency and availability of parts in the future. The current piston function is too slow to meet the efficiency needs of the product, but all other parts run smoothly. Therefore, the primary change to be made with respect to device functionality is in terms of the removal of resistance by the pistons. Further testing of the design is also recommended to obtain a fuller and more accurate analysis of the results

Consumer internet purchasing of medicines using a population sample:A mixed methodology approach

Background: Malta has an average of 3–4 private community pharmacies per locality, providing patients with easy access to medicines yet according to general statistics gathered from European organisations, Internet is used to purchase various online products with medicines being amongst them. Objectives: To identify patterns around internet purchasing of medicines among Maltese residents. Methods: The study followed a mixed methods approach, employing a cross-sectional survey followed by semi-structured interviews. A random sample of 1996 residents were selected from the Maltese electoral register to participate in a postal questionnaire designed to gather data about purchasing prescription-only-medicines (POM) as well as over-the-counter (OTC) medicines. Results were analysed using descriptive statistics and Chi-square to establish associations between responses. Five interviews investigated participants’ concerns related to sourcing of medicines. The participants were purposively chosen from the questionnaire respondents. Data were analysed using thematic analysis. Results: The survey had a 22% response rate (N = 444) (60% female; mean age 52 years ± 17). Two (0.45%) participants reported purchasing POMs online in the past, while 4.3% (n = 19) purchased OTCs including vitamins, supplements and herbal combinations. The main reasons for OTC online purchasing were lack of local availability (n = 6; 1.4%) and lower price (n = 11; 2.5%). A total of 89% (n = 395) of respondents provided a reason for not purchasing online, with safety issues being the primary reason for 41% (n = 181) of these. Interviewees expressed disregard towards internet purchasing of medicines that was evident from the themes that emerged: definition of ‘medicines’, health autonomy and trust in self-care, relationships and trust in health professional, restrictions of medicine supply, influence of cost, need for options. Conclusions: The Maltese appear to be rather cautious and do not purchase POMs online, citing the risks that may be associated with internet purchasing. With regards to OTCs, a small percentage purchase these online and exposing them to risks associated with unauthorised sites.</p

Control of inherited structures and mechanical heterogeneities on the internal deformation of the Dolomites Indenter, eastern Southern Alps: a multi-scale analogue modelling study

During the Cenozoic evolution of the Alps, the Adriatic plate is traditionally considered as a rigid indenter. The structure of the northernmost part of the Adriatic plate in the eastern Southern Alps of Italy and Slovenia, referred to as Dolomites Indenter (DI), however, demonstrates significant internal deformation. Mostly Miocene shortening is accommodated within a WSW-ENE striking, S-vergent fold-and-thrust belt overprinting a pre-existing platform-basin geometry related to Jurassic extension. In this contribution we present two new sets of physical analogue experiments, addressing the effect of lateral crustal heterogeneities on the internal deformation of the DI on crustal- and lithospheric scale. The upper crust of the western Trento platform (western DI) is compositionally heterogeneous linked to Permian intrusives and extrusives (i.e., Athesian Volcanic Complex). Together with inherited basement structures this lateral heterogeneity, which strengthened the platform locally, is key for understanding upper crustal deformation and surface uplift patterns associated with Miocene basin inversion. We present brittle crustal-scale analogue experiments with inversion of pre-scribed platform-basin geometries, which indicate that variations in thickness, shape, and basement structure of especially the western platform (WP) have impact on timing and uplift of the DI’s upper crust. The mentioned variations in crustal composition, lead, compared to the reference model with simple platform-basin geometry, to (i) overall fewer thrust sheets, (ii) footwall cut-offs of the frontal thrust further in the hinterland, and to (iii) longer and flatter flats of the frontal thrust. Regarding the topographic evolution, a variation in, e.g., basement structure shows strain localization at the margin of the basal plate and stronger uplift within the southern part of the WP compared to limited uplift of the northern WP, which is consistent with documented little vertical movement north of the Valsugana fault system since the Jurassic. On the scale of the lithosphere, new analogue experiments with pre-scribed platform and basin geometries in the upper crust show similar lateral variations in thrust fault orientation across transfer zones as crustal-scale analogue models (Sieberer et al., 2023). Additionally, lateral variability of ductile lower crustal thickness predicts stronger uplift in areas of thicker lower crust. Documented thickening of the lower crust in some parts of the Southern Alps close to areas of higher uplift, tentatively interpreted being Miocene in age (Jozi Najafabadi et al., 2022), might support this finding. Ultimately our crustal and lithosphere-scale modelling predictions will be validated by high resolution low-temperature thermochronological data which cover the entire Dolomites Indenter

The Nutritional Dual-Burden in Developing Countries – How is it Assessed and What Are the Health Implications?

This paper focuses on the phenomenon of the nutritional dual-burden in the developing world. Nutritional dual-burden is defined as the coexistence of under-and-over nutrition in the same population/group, the same household/family, or the same person. In this paper we aim: a) to describe the different types of nutritional dual-burden, b) to identify the anthropometric indicators generally used to classify the nutritional dual-burden, c) to focus our attention on a dual-burden group (the Maya from Merida, Yucatan, Mexico), d) to illustrate problems in the categorization of the dual-burden, and e) to suggest possible health implications. Our results show that, for our sample, the prevalence of individual dual- -burden among children is very low, but is very high among the mothers and for mother-child pairs (household dual-burden). Most importantly, the criteria used to assess the nutritional status of the individuals and of the families will play an important role in the estimated prevalence of nutritional dual-burden, and this will have practical impacts for health intervention programs

Development of optimised tissue-equivalent materials for proton therapy

OBJECTIVE: In proton therapy there is a need for proton optimised tissue-equivalent materials as existing phantom materials can produce large uncertainties in the determination of absorbed dose and range measurements. The aim of this work is to develop and characterise optimised tissue-equivalent materials for proton therapy. APPROACH: A mathematical model was developed to enable the formulation of epoxy-resin based tissue-equivalent materials that are optimised for all relevant interactions of protons with matter, as well as photon interactions, which play a role in the acquisition of CT numbers. This model developed formulations for vertebra bone- and skeletal muscle-equivalent plastic materials. The tissue equivalence of these new materials and commercial bone- and muscle-equivalent plastic materials were theoretical compared against biological tissue compositions. The new materials were manufactured and characterised by their mass density, relative stopping power (RSP) measurements, and CT scans to evaluate their tissue-equivalence. MAIN RESULTS: Results showed that existing tissue-equivalent materials can produce large uncertainties in proton therapy dosimetry. In particular commercial bone materials showed to have a relative difference up to 8 % for range. On the contrary, the best optimised formulations were shown to mimic their target human tissues within 1-2 % for the mass density and RSP. Furthermore, their CT-predicted RSP agreed within 1-2 % of the experimental RSP, confirming their suitability as clinical phantom materials. SIGNIFICANCE: We have developed a tool for the formulation of tissue-equivalent materials optimised for proton dosimetry. Our model has enabled the development of proton optimised tissue-equivalent materials which perform better than existing tissue-equivalent materials. These new materials will enable the advancement of clinical proton phantoms for accurate proton dosimetry

Goal-seeking compresses neural codes for space in the human hippocampus and orbitofrontal cortex

Humans can navigate flexibly to meet their goals. Here, we asked how the neural representation of allocentric space is distorted by goal-directed behavior. Participants navigated an agent to two successive goal locations in a grid world environment comprising four interlinked rooms, with a contextual cue indicating the conditional dependence of one goal location on another. Examining the neural geometry by which room and context were encoded in fMRI signals, we found that map-like representations of the environment emerged in both hippocampus and neocortex. Cognitive maps in hippocampus and orbitofrontal cortices were compressed so that locations cued as goals were coded together in neural state space, and these distortions predicted successful learning. This effect was captured by a computational model in which current and prospective locations are jointly encoded in a place code, providing a theory of how goals warp the neural representation of space in macroscopic neural signals

Albumin-mediated extracellular zinc speciation drives cellular zinc uptake

This work was financially supported by the Leverhulme Trust (RPG-2017-214) and BBSRC (BB/J006467/1 and BB/V014684/1). We thank Prof. Andrew Riches (University of St. Andrews) for provision of materials, and Dr. Elizabeth Bolitho (University of Warwick) for assistance with cell culture experiments.The role of the extracellular medium in influencing metal uptake into cells has not been described quantitatively. In a chemically defined model system containing albumin, zinc influx into endothelial cells correlates with the extracellular free zinc concentration. Allosteric inhibition of zinc-binding to albumin by free fatty acids increased zinc flux.Publisher PDFPeer reviewe