The Southern Regional Asset Building Coalition Survey

The Southern Regional Asset Building Coalition Surve

Asset-Building Coalitions in Oregon and North Carolina: Two Case Studies

Asset-Building Coalitions in Oregon and North Carolina: Two Case Studie

Asset Building in the South: Organizations and Services

Asset Building in the South: Organizations and Service

Asset-Building Coalitions in States: Innovative Coalition Development and Policy Advocacy Strategies Meeting

Asset-Building Coalitions in States: Innovative Coalition Development and Policy Advocacy Strategies Meetin

Feasibility and Acceptability of a Wrist-worn Transdermal Alcohol Biosensor to Collect Data in the Field

Transdermal alcohol monitoring allows for continuous, non-invasive, objective, and remote measurement of alcohol consumption. We evaluated feasibility and acceptability of participant use of the BACtrack Skyn biosensor bracelet in daily life. Heavy drinkers (n=20) wore the Skyn and self-reported drinking behavior for 7 days, followed by an individual interview. Recruitment and retention benchmarks were met, supporting feasibility. Participants provided both positive and constructive feedback on the Skyn during interviews, and usability of the bracelet was deemed “good”. Most missing data were inconsequential (<5 mins), with data available 85% of the time participants were asked to wear it. Missing data was largely expected and due to bracelet removal during bathing or charging. Overall, results indicate promise in our ability to integrate this tool into research and/or clinical practice, passively and objectively monitoring alcohol use in participants and/or patients with minimal burden

Workflow for real-time in-vivo Cherenkov-excited luminescence imaging during radiotherapy

Radiotherapy is a common method for treating tumors, however, radiosensitivity can vary between tumor types or within the tumor microenvironment. The ability to deliver oxygen is crucial for the generation of reactive oxygen species resulting in increased localized cytotoxic effects. Alternatively, hypoxic tumors are thought to indicate a poor prognosis and may benefit from more aggressive treatments, yet identifying tumor hypoxia early in the course of a multi-week fractionated dose regimen is currently impractical. Using a time-gated imaging system and oxygen-sensitive phosphorescent compound (PtG4) we are able to estimate in vivo pO2 distribution at a rate of 2.6 estimates per second, which corresponds to 50+ values during a common 2Gy dose fraction. While our previous work has reported using Cherenkov-excited luminescence to estimate in vivo pO2 during external beam radiotherapy, the dose required was often greater than a standard fraction and camera acquisition parameters required modification during treatments, resulting in interrupted workflows. The current method utilizes custom control software which cycles through camera timing parameters during acquisition. Python code using the web-based user interface JupyterLab allows for interactive analysis of the resulting image stack without the need to pay expensive licensing fees for scientific computing packages. Using open source libraries, the analysis code is able to split the image stack into respective Cherenkov excitation and phosphorescence images, which can then be further automatically segmented to find regions of interest including the subject and phosphorescent region. The intensity of the regions in the phosphorescence images are used to estimate the compound lifetime, which can then be used in the Stern-Volmer relationship to estimate pO2. This entire process does not compromise clinical workflow and is able to provide a pO2 estimate within minutes after delivering the fractionated dose, providing clinicians early feedback about trends in tumor hypoxia. The current method has been validated with both direct injection of 50mM PtG4 in Matrigel in a mouse flank, and 24hrs post IV injection of mouse with MDA-MB-231 tumor implanted in the flank. The mouse with the direct injection was imaged under anesthesia and while awake and mobile to test the ability of the automated segmentation algorithm (Figure below). While the signal from the IV injection was less intense, simultaneous imaging using the previously reported method and current method resulted in similar lifetime estimates. While oxygen-sensitive PtG4 exhibits a lifetime between 16ms under atmospheric oxygen and 47ms when deprived of oxygen, other compounds have also been investigated. Europium chelate nanoparticle (~600ms), Iridium-based small molecules (~5ms), Si nanoparticles (~60ms), and UV-sensitive tattoo inks (~15ms) have all been imaged using Cherenkov-excitation. Camera time-gating can be utilized to discriminate these compound when mixed in the same field, allowing for additional tools in the realm of contrast enhancement during radiotherapy imaging. Ongoing studies with PtG4 and other compounds are being conducted to further improve system sensitivity and refine imaging workflows so they are more clinically translatable. Please click Additional Files below to see the full abstract

A self-management programme to reduce falls and improve safe mobility in people with secondary progressive MS: the BRiMS feasibility RCT

This is the final version, also available from NIHR journals library via the DOI in this record.Abstract Background Balance, mobility impairments and falls are common problems for people with multiple sclerosis (MS). Our ongoing research has led to the development of Balance Right in MS (BRiMS), a 13-week home- and group-based exercise and education programme intended to improve balance and encourage safer mobility. Objective This feasibility trial aimed to obtain the necessary data and operational experience to finalise the planning of a future definitive multicentre randomised controlled trial. Design Randomised controlled feasibility trial. Participants were block randomised 1 : 1. Researcher-blinded assessments were scheduled at baseline and at 15 and 27 weeks post randomisation. As is appropriate in a feasibility trial, statistical analyses were descriptive rather than involving formal/inferential comparisons. The qualitative elements utilised template analysis as the chosen analytical framework. Setting Four sites across the UK. Participants Eligibility criteria included having a diagnosis of secondary progressive MS, an Expanded Disability Status Scale (EDSS) score of between ≥ 4.0 and ≤ 7.0 points and a self-report of two or more falls in the preceding 6 months. Interventions Intervention – manualised 13-week education and exercise programme (BRiMS) plus usual care. Comparator – usual care alone. Main outcome measures Trial feasibility, proposed outcomes for the definitive trial (including impact of MS, mobility, quality of life and falls), feasibility of the BRiMS programme (via process evaluation) and economic data. Results A total of 56 participants (mean age 59.7 years, standard deviation 9.7 years; 66% female; median EDSS score of 6.0 points, interquartile range 6.0–6.5 points) were recruited in 5 months; 30 were block randomised to the intervention group. The demographic and clinical data were broadly comparable at baseline; however, the intervention group scored worse on the majority of baseline outcome measures. Eleven participants (19.6%) withdrew or were lost to follow-up. Worsening of MS-related symptoms unrelated to the trial was the most common reason (n = 5) for withdrawal. Potential primary and secondary outcomes and economic data had completion rates of > 98% for all those assessed. However, the overall return rate for the patient-reported falls diary was 62%. After adjusting for baseline score, the differences between the groups (intervention compared with usual care) at week 27 for the potential primary outcomes were MS Walking Scale (12-item) version 2 –7.7 [95% confidence interval (CI) –17.2 to 1.8], MS Impact Scale (29-item) version 2 (MSIS-29vs2) physical 0.6 (95% CI –7.8 to 9) and MSIS-29vs2 psychological –0.4 (95% CI –9.9 to 9) (negative score indicates improvement). After the removal of one outlier, a total of 715 falls were self-reported over the 27-week trial period, with substantial variation between individuals (range 0–93 falls). Of these 715 falls, 101 (14%) were reported as injurious. Qualitative feedback indicated that trial processes and participant burden were acceptable, and participants highlighted physical and behavioural changes that they perceived to result from undertaking BRiMS. Engagement varied, influenced by a range of condition- and context-related factors. Suggestions to improve the utility and accessibility of BRiMS were highlighted. Conclusions The results suggest that the trial procedures are feasible and acceptable, and retention, programme engagement and outcome completion rates were sufficient to satisfy the a priori progression criteria. Challenges were experienced in some areas of data collection, such as completion of daily diaries.National Institute for Health Research (NIHR

Signal Intensity Analysis and Optimization for in Vivo Imaging of Cherenkov and Excited Luminescence.

During external beam radiotherapy (EBRT), in vivo Cherenkov optical emissions can be used as a dosimetry tool or to excite luminescence, termed Cherenkov-excited luminescence (CEL) with microsecond-level time-gated cameras. The goal of this work was to develop a complete theoretical foundation for the detectable signal strength, in order to provide guidance on optimization of the limits of detection and how to optimize near real time imaging. The key parameters affecting photon production, propagation and detection were considered and experimental validation with both tissue phantoms and a murine model are shown. Both the theoretical analysis and experimental data indicate that the detection level is near a single photon-per-pixel for the detection geometry and frame rates commonly used, with the strongest factor being the signal decrease with the square of distance from tissue to camera. Experimental data demonstrates how the SNR improves with increasing integration time, but only up to the point where the dominance of camera read noise is overcome by stray photon noise that cannot be suppressed. For the current camera in a fixed geometry, the signal to background ratio limits the detection of light signals, and the observed in vivo Cherenkov emission is on the order of 100×  stronger than CEL signals. As a result, imaging signals from depths  \u3c 15 mm is reasonable for Cherenkov light, and depths  \u3c 3 mm is reasonable for CEL imaging. The current investigation modeled Cherenkov and CEL imaging of two oxygen sensing phosphorescent compounds, but the modularity of the code allows for easy comparison of different agents or alternative cameras, geometries or tissues

Monstrous Domesticity – Home as a Site of Oppression in Crimson Peak

This paper begins by offering a brief overview of the popular culture narrative Crimson Peak (2015), directed by Guillermo del Toro. The analysis focuses on the most compelling Gothic trope del Toro reintroduces, the proverbial mansion, simultaneously displaying Freud’s heimlich and unheimlich elements, oppressing and liberating its inhabitants. Since the narrative revolves around two female protagonists, Lucille Sharpe and Edith Cushing, the paper also refers to feminist socio-cultural perspectives on space, primarily Gillian Rose’s and Shelley Mallett’s, in order to understand the position of the two protagonists within the decidedly Gothic space. This paper aims to emphasize that Lucille’s liberation as the mistress of the house is illusory regardless of the fact that she is represented as the embodiment of domestic corruption. It is precisely because she is a sexually active woman and a disruptor of the patriarchal order that she must ultimately be punished. Even though del Toro subverts the traditional image of the madwoman in the attic by positioning her at the center of the narrative, Allerdale Hall does not reveal itself as a space of female empowerment

Testing Models of Intrinsic Brightness Variations in Type Ia Supernovae, and their Impact on Measuring Cosmological Parameters

For spectroscopically confirmed Type Ia supernovae we evaluate models of intrinsic brightness variations with detailed data/Monte Carlo comparisons of the dispersion in the following quantities: Hubble-diagram scatter, color difference (B-V-c) between the true B-V color and the fitted color (c) from the SALT-II light curve model, and photometric redshift residual. The data sample includes 251 ugriz light curves from the 3-season Sloan Digital Sky Survey-II, and 191 griz light curves from the Supernova Legacy Survey 3-year data release. We find that the simplest model of a wavelength-independent (coherent) scatter is not adequate, and that to describe the data the intrinsic scatter model must have wavelength-dependent variations. We use Monte Carlo simulations to examine the standard approach of adding a coherent scatter term in quadrature to the distance-modulus uncertainty in order to bring the reduced chi2 to unity when fitting a Hubble diagram. If the light curve fits include model uncertainties with the correct wavelength dependence of the scatter, we find that the bias on the dark energy equation of state parameter $w$ is negligible. However, incorrect model uncertainties can lead to a significant bias on the distance moduli, with up to ~0.05 mag redshift-dependent variation. For the recent SNLS3 cosmology results we estimate that this effect introduces an additional systematic uncertainty on $w$ of ~0.02, well below the total uncertainty. However, this uncertainty depends on the samples used, and thus this small $w$-uncertainty is not guaranteed in future cosmology results.Comment: accepted by Ap