Design and performance of personal cooling garments based on three-layer laminates

Personal cooling systems are mainly based on cold air or liquids circulating through a tubing system. They are weighty, bulky and depend on an external power source. In contrast, the laminate-based technology presented here offers new flexible and light weight cooling garments integrated into textiles. It is based on a three-layer composite assembled from two waterproof, but water vapor permeable membranes and a hydrophilic fabric in between. Water absorbed in the fabric will be evaporated by the body temperature resulting in cooling energy. The laminate's high adaptiveness makes it possible to produce cooling garments even for difficult anatomic topologies. The determined cooling energy of the laminate depends mainly on the environmental conditions (temperature, relative humidity, wind): heat flux at standard climatic conditions (20°C, 65% R.H., wind 5km/h) has measured 423.2±52.6W/m2, water vapor transmission resistance, R et, 10.83±0.38m2Pa/W and thermal resistance, R ct, 0.010±0.002m2K/W. Thermal conductivity, k, changed from 0.048±0.003 (dry) to 0.244±0.018W/mK (water added). The maximum fall in skin temperature, ∆T max, under the laminate was 5.7±1.2°C, taken from a 12 subject study with a thigh cooling garment during treadmill walking (23°C, 50% R.H., no wind) and a significant linear correlation (R=0.85, P=0.01) between body mass index and time to reach 67% of ∆T max could be determine

Fingolimod versus interferon beta 1-a: Benefit-harm assessment approach based on TRANSFORMS individual patient data

BACKGROUND Fingolimod is a disease-modifying drug approved for multiple sclerosis but its benefit-harm balance has never been assessed compared to other active treatments. OBJECTIVES Our aim was to compare the benefits and harms of fingolimod with interferon beta-1a using individual patient data from TRial Assessing injectable interferon versus FTY720 Oral in RRMS trial. METHODS We modelled the health status of patients over time including Expanded Disability Status Scale measurements, relapses and any adverse events. We assessed the mean health status between arms and the proportion of patients whose health deteriorated or improved relatively to baseline, using a prespecified minimal important difference of 4.6. We performed sensitivity analyses to test our assumptions. RESULTS Main and sensitivity analyses favoured fingolimod 0.5 mg over interferon beta-1a. The average health status difference was 1.01 (95% CI 0.93-1.08). Patients on fingolimod 0.5 mg were 0.47 (95% CI: 0.35-0.63, p < 0.001) times less likely to experience a relevant decline in health status compared to interferon beta-1a patients, with a number needed to treat of 7.10 [5.18, 11.23]. CONCLUSIONS Fingolimod's net benefit over interferon beta-1a did not reach the clinical relevance over 1 year, but the decreased risk for health status deterioration may be more pronounced more long term and patients may prefer less treatment burden associated with fingolimod

Do not attempt resuscitation : the importance of consensual decisions

Aims: To describe the involvement and input of physicians and nurses in cardiopulmonary resuscitation (cpr / do not attempt resuscitation (dnar) decisions; to analyse decision patterns; and understand the practical implications. Design: A qualitative grounded theory study using one-time open-ended interviews with 40 volunteer physicians and 52 nurses drawn from acute care wards with mixes of heterogeneous cases in seven different hospitals in German-speaking Switzerland. Results: Establishing dnar orders in the best interests of patients was described as a challenging task requiring the leadership of senior physicians and nurses. Implicit decisions in favour of cpr predominated at the beginning of hospitalisation; depending on the context, they were relieved/superseded by explicit dnar decisions. Explicit decisions were the result of hierarchical medical expertise, of multilateral interdisciplinary expertise, of patient autonomy and/or of negotiated patient autonomy. Each type of decision, implicit or explicit, potentially represented a team consensus. Non-consensual decisions were prone to precipitate personal or team conflicts, and, occasionally, led to non-compliance. Conclusion: Establishing dnar orders is a demanding task. Reaching a consensus is of crucial importance in guaranteeing teamwork and good patient care. Communication and negotiation skills, professional and personal life experience and empathy for patients and colleagues are pivotal. Therefore, leadership by experienced senior physicians and nurses is needed and great efforts should be made with regard to multidisciplinary education

Optimal box-covering algorithm for fractal dimension of complex networks

The self-similarity of complex networks is typically investigated through computational algorithms the primary task of which is to cover the structure with a minimal number of boxes. Here we introduce a box-covering algorithm that not only outperforms previous ones, but also finds optimal solutions. For the two benchmark cases tested, namely, the E. Coli and the WWW networks, our results show that the improvement can be rather substantial, reaching up to 15% in the case of the WWW network.Comment: 5 pages, 6 figure

Functioning and disability in multiple sclerosis from the patient perspective

Multiple sclerosis (MS) has a great impact on functioning and disability. The perspective of those who experience the health problem has to be taken into account to obtain an in-depth understanding of functioning and disability. The objective was to describe the areas of functioning and disability and relevant contextual factors in MS from the patient perspective. A qualitative study using focus group methodology was performed. The sample size was determined by saturation. The focus groups were digitally recorded and transcribed verbatim. The meaning condensation procedure was used for data analysis. Identified concepts were linked to International Classification of Functioning, Disability and Health (ICF) categories according to established linking rules. Six focus groups with a total of 27 participants were performed. In total, 1327 concepts were identified and linked to 106 ICF categories of the ICF components Body Functions, Activities and Participation and Environmental Factors. This qualitative study reports on the impact of MS on functioning and disability from the patient perspective. The participants in this study provided information about all physical aspects and areas of daily life affected by the disease, as well as the environmental factors influencing their lives

Study on promoting cross-border activities for social economy; description of 52 cases

The current report has been elaborated during the course of the study entitled “Promoting cross-border activities for social economy, including social enterprises” (EASME/COSME/2018/032). The overarching objective of the study has been to study, assess and diffuse transnational social economy initiatives and activities of as well as corresponding European and national policies. In the framework of the study, 52 cases of social economy entities involved in crossborder activities have been selected and interviewed by the partnership.The pool of social economy entities includes initiatives either already engaged in transnational business activities (exporting or importing) or multinational social economy start-ups with international outreach

Guide on promoting cross-border activities for social economy

Social economy entities combine societal goals with an entrepreneurial spirit. They are formed as entities with focus on achieving wider social, environmental or community objectives. Based on these goals and aspirations, the European Commission aims to create a favourable financial, administrative, and legal environment for social economy actors so that they operate on an equal footing with other types of for-profit enterprises. To this end, to pursue access to the Single Market as well as on an international level, social enterprises need appropriate business models that simultaneously serve their mission and vision, support them in their cross-border activities and – where feasible and relevant – help them use technological advancements and digital solutions. The study report, forming the basis of this guide has the objective to identify barriers and challenges related to cross border ambitions of social economy entities. Such barriers might cover different dimensions such as legal, cultural, capacity and business model. However, it should be noted that this study does not provides a comprehensive analysis of specific legal obstacles and features. Secondly the study has the aim to picture existing success stories, potentials and processes related to social economy internationalisation and cross border activities. Third, several types of support services are identified supporting internationalisation of businesses in general as well as social economy specific support

Finite-size scaling investigation of the liquid-liquid critical point in ST2 water and its stability with respect to crystallization.

The liquid-liquid critical point scenario of water hypothesizes the existence of two metastable liq- uid phases low-density liquid (LDL) and high-density liquid (HDL) deep within the supercooled region. The hypothesis originates from computer simulations of the ST2 water model, but the stabil- ity of the LDL phase with respect to the crystal is still being debated. We simulate supercooled ST2 water at constant pressure, constant temperature, and constant number of molecules N for N ≤ 729 and times up to 1 μs. We observe clear differences between the two liquids, both structural and dynamical. Using several methods, including finite-size scaling, we confirm the presence of a liquid-liquid phase transition ending in a critical point. We find that the LDL is stable with respect to the crystal in 98% of our runs (we perform 372 runs for LDL or LDL-like states), and in 100% of our runs for the two largest system sizes (N = 512 and 729, for which we perform 136 runs for LDL or LDL-like states). In all these runs, tiny crystallites grow and then melt within 1 μs. Only for N ≤ 343 we observe six events (over 236 runs for LDL or LDL-like states) of spontaneous crystal- lization after crystallites reach an estimated critical size of about 70 ± 10 molecules

A single amino acid switch converts the sleeping beauty transposase into an efficient unidirectional excisionase with utility in stem cell reprogramming

The Sleeping Beauty (SB) transposon is an advanced tool for genetic engineering and a useful model to investigate cut-and-paste DNA transposition in vertebrate cells. Here, we identify novel SB transposase mutants that display efficient and canonical excision but practically unmeasurable genomic re-integration. Based on phylogenetic analyses, we establish compensating amino acid replacements that fully rescue the integration defect of these mutants, suggesting epistasis between these amino acid residues. We further show that the transposons excised by the exc(+)/int(-) transposase mutants form extrachromosomal circles that cannot undergo a further round of transposition, thereby representing dead-end products of the excision reaction. Finally, we demonstrate the utility of the exc(+)/int(-) transposase in cassette removal for the generation of reprogramming factor-free induced pluripotent stem cells. Lack of genomic integration and formation of transposon circles following excision is reminiscent of signal sequence removal during V(D)J recombination, and implies that cut-and-paste DNA transposition can be converted to a unidirectional process by a single amino acid change

Real-world disease-modifying therapy usage in persons with relapsing-remitting multiple sclerosis: Cross-sectional data from the Swiss Multiple Sclerosis Registry.

INTRODUCTION Several disease-modifying therapies (DMTs), covering a broad spectrum of mechanisms of action, have been approved by regulatory agencies for the treatment of relapsing-remitting multiple sclerosis (RRMS). However, only little is known about the current real-world treatment situation in Switzerland. Based on data from a diverse population of 668 persons with RRMS from the Swiss Multiple Sclerosis Registry (SMSR), the present study aims to fill this gap with a descriptive, cross-sectional approach. METHODS Data originated from the SMSR baseline questionnaire and follow-up surveys. Data on current health status and life situation in the last 6 months were extracted from the survey distributed throughout 2020 and 2021, while data on disease-modifying therapy (DMT) histories were included from preceding surveys. Initially, data was stratified into three DMT groups according to the current DMT status (NO (No DMT), CONTINUED (DMT started more than 6 months ago), and NEW (DMT started less than 6 months ago)). In a subsequent analysis, the sample was stratified into groups corresponding to the five most frequently prescribed DMTs. Self-reported outcomes including therapy discontinuation or interruption, relapses and side-effects in the last 6 months were analyzed per group. Life and health situation parameters were also determined and analyzed. RESULTS The study population consisted of 445 (66.6%) individuals belonging to the CONTINUED, 84 (12.6%) to the NEW, and 139 (20.8%) to the NO group. Within the NO group, 24 (17.3%) reported relapses. Furthermore, self-reported relapses (28 (33.3%)), side-effects (39 (46.4%)), and treatment discontinuations or interruptions (30 (35.7%)) occurred more frequently in the NEW compared to the CONTINUED group (37 (8.3%), 125 (28.1%), 8 (1.8%), respectively). The three groups also differed with respect to age, time since diagnosis, number of symptoms, DMT history, and health-related quality of life. The five most frequently prescribed DMTs included fingolimod (33.4%), dimethyl fumarate (25.0%), ocrelizumab (23.6%), natalizumab (10.6%) and teriflunomide (7.5%). The frequency of self-reported relapses ranged from 9.7% to 13.6%. Notable differences were found in the number of self-reported side-effects, ranging from 9.1% with natalizumab to 56.7% with dimethyl fumarate. DISCUSSION This cross-sectional analysis suggested that the majority of individuals with RRMS in Switzerland continuously receive tolerable DMT. However, groups not receiving DMT or struggling with side-effects or continued disease worsening while on DMT still persist. It is conceivable that the number of self-reported symptoms indicates the need for more detailed clarification of the DMT characteristics and expectations of treatment outcomes. Injectable DMTs no longer play a major role in the treatment of RRMS in Switzerland and a trend toward an early use of potent drugs is emerging