Dexterity test data contribute to reduction in leaded glovebox gloves use

Programmatic operations at the Los Alamos National Laboratory Plutonium Facility (T A-55) involve working with various amounts of plutonium and other highly toxic, alpha-emitting materials. The spread of radiological contamination on surfaces, airborne contamination, and excursions of contaminants into the operator's breathing zone are prevented through the use of a variety of gloveboxes. Using an integrated approach, controls have been developed and implemented through an efficient Glovebox Glove Integrity Program. A key element of this program is to consider measures that lower the overall risk of glovebox operations. Line management who own glovebox processes through this program make decisions on which type of glovebox gloves (hereafter referred to as gloves), the weakest component of this safety-significant system, would perform best in these aggressive environments. As Low as Reasonably Achievable considerations must be balanced with glove durability and worker dexterity, both of which affect the final overall risk of the operation. In the past, lead-loaded (leaded) gloves made from Hypalon(reg.) were the primary glove for programmatic operations at TA55. Replacing leaded gloves with unleaded gloves for certain operations would lower the overall risk as well as reduce the amount of mixed transuranic waste. This effort contributes to the Los Alamos National Laboratory Continuous Improvement Program by improving the efficiency, cost-effectiveness, and formality of glovebox operations. In this report, the pros and cons of wearing leaded gloves, the effect of leaded gloves versus unleaded gloves on task performance using standard dexterity tests, the justification for switching from leaded to unleaded gloves, and the pollution prevention benefits of this dramatic change in the glovebox system are presented

A multicomponent intervention for the management of chronic pain in older adults: study protocol for a randomized controlled trial

Background: Studies have shown that physical interventions and psychological methods based on the cognitive behavioral approach are efficacious in alleviating pain and that combining both tends to yield more benefits than either intervention alone. In view of the aging population with chronic pain and the lack of evidence-based pain management programs locally, we developed a multicomponent intervention incorporating physical exercise and cognitive behavioral techniques and examined its long-term effects against treatment as usual (i.e., pain education) in older adults with chronic musculoskeletal pain in Hong Kong. Methods/design: We are conducting a double-blind, cluster-randomized controlled trial. A sample of 160 participants aged ≥ 60 years will be recruited from social centers or outpatient clinics and will be randomized on the basis of center/clinic to either the multicomponent intervention or the pain education program. Both interventions consist of ten weekly sessions of 90 minutes each. The primary outcome is pain intensity, and the secondary outcomes include pain interference, pain persistence, pain self-efficacy, pain coping, pain catastrophizing cognitions, health-related quality of life, depressive symptoms, and hip and knee muscle strength. All outcome measures will be collected at baseline, postintervention, and at 3 and 6 months follow-up. Intention-to-treat analysis will be performed using mixed-effects regression to see whether the multicomponent intervention alleviates pain intensity and associated outcomes over and above the effects of pain education (i.e., a treatment × time intervention effect). Discussion: Because the activities included in the multicomponent intervention were carefully selected for ready implementation by allied health professionals in general, the results of this study, if positive, will make available an efficacious, nonpharmacological pain management program that can be widely adopted in clinical and social service settings and will hence improve older people’s access to pain management services

Dexterity tests data contribute to reduction in leaded glovebox gloves use

Programmatic operations at the Los Alamos National Laboratory Plutonium Facility (TA-55) involve working with various amounts of plutonium and other highly toxic, alphaemitting materials. The spread of radiological contamination on surfaces and airborne contamination and excursions of contaminants into the operator's breathing zone are prevented through the use of a variety of gloveboxes. Through an integrated approach, controls have been developed and implemented through an efficient Glovebox Glove Integrity Program (GGJP). A key element of this program is to consider measures that lower the overall risk of glovebox operations. Line management owning glovebox processes through this program make decisions on which type of glovebox gloves (the weakest component of this safety significant system) would perform in these aggressive environments. As Low As Reasonably Achievable (ALARA) considerations must be balanced with glove durability and worker dexterity, both of which affect the final overall risk of the operation. In the past, lead-loaded (leaded) glovebox gloves made from Hypalon(reg.) had been the workhorse of programmatic operations at TA-55. Replacing leaded gloves with unleaded gloves for certain operations would lower the overall risk as well as reduced the amount of mixed TRU waste. This effort contributes to Los Alamos National Laboratory Continuous Improvement Program by improving the efficiency, cost effectiveness, and formality of glovebox operations. In the following report, the pros and cons of wearing leaded glovebox gloves, the effect of leaded gloves versus unleaded gloves on task performance using standard dexterity tests, the justification for switching from leaded to unleaded gloves, and pollution prevention benefits of this dramatic change in the glovebox system are presented

Connecting the person with dementia and family: a feasibility study of a telepresence robot

Background: Maintenance of communication is important for people with dementia living in long-term care. The purpose of this study was to assess the feasibility of using “Giraff”, a telepresence robot to enhance engagement between family and a person with dementia living in long-term care. Methods: A mixed-methods approach involving semi-structured interviews, call records and video observational data was used. Five people with dementia and their family member participated in a discussion via the Giraff robot for a minimum of six times over a six-week period. A feasibility framework was used to assess feasibility and included video analysis of emotional response and engagement. Results: Twenty-six calls with an average duration of 23 mins took place. Residents showed a general state of positive emotions across the calls with a high level of engagement and a minimal level of negative emotions. Participants enjoyed the experience and families reported that the Giraff robot offered the opportunity to reduce social isolation. A number of software and hardware challenges were encountered. Conclusions: Participants perceived this novel approach to engage families and people with dementia as a feasible option. Participants were observed and also reported to enjoy the experience. The technical challenges identified have been improved in a newer version of the robot. Future research should include a feasibility trial of longer duration, with a larger sample and a cost analysis

Densely Interconnected Transcriptional Circuits Control Cell States in Human Hematopoiesis

Though many individual transcription factors are known to regulate hematopoietic differentiation, major aspects of the global architecture of hematopoiesis remain unknown. Here, we profiled gene expression in 38 distinct purified populations of human hematopoietic cells and used probabilistic models of gene expression and analysis of cis-elements in gene promoters to decipher the general organization of their regulatory circuitry. We identified modules of highly coexpressed genes, some of which are restricted to a single lineage but most of which are expressed at variable levels across multiple lineages. We found densely interconnected cis-regulatory circuits and a large number of transcription factors that are differentially expressed across hematopoietic states. These findings suggest a more complex regulatory system for hematopoiesis than previously assumed.National Institutes of Health (U.S.). Pioneer AwardBurroughs Wellcome Fund (Career Award at the Scientific Interface)Landon and Lavinia ClayHoward Hughes Medical Institut

Densely Interconnected Transcriptional Circuits Control Cell States in Human Hematopoiesis

While many individual transcription factors are known to regulate hematopoietic differentiation, major aspects of the global architecture of hematopoiesis remain unknown. Here, we profiled gene expression in 38 distinct purified populations of human hematopoietic cells and used probabilistic models of gene expression and analysis of cis-elements in gene promoters to decipher the general organization of their regulatory circuitry. We identified modules of highly co-expressed genes, some of which are restricted to a single lineage, but most are expressed at variable levels across multiple lineages. We found densely interconnected cis-regulatory circuits and a large number of transcription factors that are differentially expressed across hematopoietic states. These findings suggest a more complex regulatory system for hematopoiesis than previously assumed

Association between ultrasound quadriceps muscle status with premorbid functional status and 60-day mortality in mechanically ventilated critically ill patient: A single-center prospective observational study

Background & aims: In critically ill patients, direct measurement of skeletal muscle using bedside ultrasound (US) may identify a patient population that might benefit more from optimal nutrition practices. When US is not available, survey measures of nutrition risk and functional status that are associated with muscle status may be used to identify patients with low muscularity. This study aims to determine the association between baseline and changing ultrasound quadriceps muscle status with premorbid functional status and 60-day mortality. Methods: This single-center prospective observational study was conducted in a general ICU. Mechanically ventilated critically ill adult patients (age ≥18 years) without pre-existing systemic neuromuscular diseases and expected to stay for ≥96 h in the ICU were included. US measurements were performed within 48 h of ICU admission (baseline), at day 7, day 14 of ICU stay and at ICU discharge (if stay >14 days). Quadriceps muscle layer thickness (QMLT), rectus femoris cross sectional area (RFCSA), vastus intermedius pennation angle (PA) and fascicle length (FL), and rectus femoris echogenicity (mean and standard deviation [SD]) were measured. Patients' next-of-kin were interviewed by using established questionnaires for their pre-hospitalization nutritional risk (nutrition risk screening-2002) and functional status (SARC-F, clinical frailty scale [CFS], Katz activities of daily living [ADL] and Lawton Instrumental ADL). Results: Ninety patients were recruited. A total of 86, 53, 24 and 10 US measures were analyzed, which were performed at a median of 1, 7, 14 and 22 days from ICU admission, respectively. QMLT, RFCSA and PA reduced significantly over time. The overall trend of change of FL was not significant. The only independent predictor of 60-day mortality was the change of QMLT from baseline to day 7 (adjusted odds ratio 0.95 for every 1% less QMLT loss, 95% confidence interval 0.91-0.99; p = 0.02). Baseline measures of high nutrition risk (modified nutrition risk in critically ill ≥5), sarcopenia (SARC-F ≥4) and frailty (CFS ≥5) were associated with lower baseline QMLT, RFCSA and PA and higher 60-day mortality. Conclusions: Every 1% loss of QMLT over the first week of critical illness was associated with 5% higher odds of 60-day mortality. SARC-F, CFS and mNUTRIC are associated with quadriceps muscle status and 60-day mortality and may serve as a potential simple and indirect measures of premorbid muscle status at ICU admission