The Complexity of Engineering Education in a Mission Driven PBL University

In this extended abstract, we will argue that education in a mission driven university holds particularities that call for the transformation of not only the research base of education but also the way in which education is conceptualised and practiced. Following a PBL approach, we put the students in the centre of educational activity and propose a conceptual framework for engineering education in a mission driven PBL university.<br/

Carbon-lite collaboration: a virtual visual matrix

In this article we present an example of psychosocial practice ‐ a visual matrix ‐ which attempted to address and embody carbon-lite research methods in the face of global heating. Combining virtual and face-to-face modes of presence and interaction generated insights as well as posing challenges. In the article we explore two ideas through a discussion of ‘interference’ and ‘inclusion/exclusion’. The article extends our understanding of the method to include an awareness of what comes before and after the matrix. By attuning ourselves to its materialities and the practices of care involved in staging a matrix and then digesting its affects and effects, we are alerted to the front and back stage of the method. Following this insight we discuss how a feminist engagement with psychosocial method can be used to connect ‘matters of concern’ such as global heating with situated practices of care that themselves may constitute a carbon-lite methodology. The article is polyvocal, generated by participants through virtual communication in the month following the matrix. It documents an intense, rich and finite period of communication and collaboration. It is an example of ‘writing which offers to us a space where we are able to confront reality in such a way that we live more fully’ (Back, 2007: 160). Questions of mortality and finitude are a motif for the matrix, expressed in a range of ways

Early telemedicine training and counselling after hospitalization in patients with severe chronic obstructive pulmonary disease: A feasibility study

Background: An essential element in the treatment of patients with chronic obstructive pulmonary disease (COPD) is rehabilitation, of which supervised training is an important part. However, not all individuals with severe COPD can participate in the rehabilitation provided by hospitals and municipal training centres due to distance to the training venues and transportation difficulties. The aim of the study was to assess the feasibility of an individualized home-based training and counselling programme via video conference to patients with severe COPD after hospitalization including assessment of safety, clinical outcomes, patients' perceptions, organisational aspects and economic aspects.&nbsp; Methods: The design was a pre- and post-test intervention study. Fifty patients with severe COPD were included. The telemedicine training and counselling included three weekly supervised exercise sessions by a physiotherapist and up to two supervised counselling and training sessions in energy conservation techniques by an occupational therapist. The telemedicine videoconferencing equipment was a computer containing a screen, a microphone, an on/off switch and a volume control.&nbsp; Results: Thirty seven (74%) participants completed the programme, with improvements in health status assessed by the Clinical COPD Questionnaire and physical performance assessed by a sit-to-stand test and a timed-up-and-go test. There were no cases of patient fall or emergency contact with a general practitioner during the telemedicine training sessions. The study participants believed the telemedicine training and counselling was essential for getting started with being physically active in a secure manner. The business case showed that under the current financing system, the reimbursement to the hospital was slightly higher than the hospital expenditures. Thus, the business case for the hospital was positive. The organizational analysis indicated that the perceptions of the staff were that the telemedicine service had improved the continuity of the rehabilitation programme for the patients and enabled the patients' everyday lives to be included in the treatment.&nbsp; Conclusions: This study showed that home-based supervised training and counselling via video conference is safe and feasible and that telemedicine can help to ensure more equitable access to supervised training in patients with severe COPD.&nbsp; Trial registration: Clinical Trials NCT02085187 (Date of registration 10.03.2014)

Effect of low energy diet for eight weeks to adults with overweight or obesity on folate, retinol, vitamin B₁₂, D and e status and the degree of inflammation: a post hoc analysis of a randomized intervention trial

Abstract Background Obesity is associated with vitamin insufficiency and low grade inflammation. The purpose of this study was to investigate the effect of weight loss on folate, retinol, vitamin B12, D and E status and the degree of inflammation. Methods Out of 110, 85 individuals (75% women) aged 39 ± 11 years with a mean ± SD BMI of 33 ± 4 kg/m2, completed an eight-week low energy diet (LED). Serum concentration of folate, retinol, B12, D and E and C-reactive protein and homocysteine (Hcy) were measured at baseline and at end of the LED. Results At baseline, 8% of the participants were deficient in folate, 13% in vitamin B12, 2% in retinol, 28% in vitamin D (72% were insufficient in vitamin D), and none were deficient in vitamin E. At baseline, BMI was inversely associated with retinol (P < 0.05) as was total and abdominal fat percentage with folate (P < 0.05); further BMI and measures of adiposity were positively associated with CRP (P < 0.01) and Hcy (P < 0.05). Homocysteine was inversely associated with all vitamins but retinol (P < 0.001). After the LED, the participants lost a mean [95% confidence intervals] of 12.3 [− 13.1,-11.6] kg. The serum concentration of folate, vitamin B12 and D were increased (P < 0.001) after the LED whereas the concentration of retinol and vitamin E were reduced (P < 0.001). Conclusion Eight-weeks LED resulted in 13% weight loss and an increase in the serum concentrations of folate, vitamin B12 and D. Baseline adiposity was inversely associated with folate and retinol, and positively associated with markers of inflammation. Trial registration Ethical Committee of Copenhagen as no. H-4-2013-135, NCT01561131

Genetic versus Non-Genetic Regulation of miR-103, miR-143 and miR-483-3p Expression in Adipose Tissue and Their Metabolic Implications-A Twin Study.

Murine models suggest that the microRNAs miR-103 and miR-143 may play central roles in the regulation of subcutaneous adipose tissue (SAT) and development of type 2 diabetes (T2D). The microRNA miR-483-3p may reduce adipose tissue expandability and cause ectopic lipid accumulation, insulin resistance and T2D. We aimed to explore the genetic and non-genetic factors that regulate these microRNAs in human SAT, and to investigate their impact on metabolism in humans. Levels of miR-103, miR-143 and miR-483-3p were measured in SAT biopsies from 244 elderly monozygotic and dizygotic twins using real-time PCR. Heritability estimates were calculated and multiple regression analyses were performed to study associations between these microRNAs and measures of metabolism, as well as between these microRNAs and possible regulating factors. We found that increased BMI was associated with increased miR-103 expression levels. In addition, the miR-103 levels were positively associated with 2 h plasma glucose levels and hemoglobin A1c independently of BMI. Heritability estimates for all three microRNAs were low. In conclusion, the expression levels of miR-103, miR-143 and miR-483-3p in adipose tissue are primarily influenced by non-genetic factors, and miR-103 may be involved in the development of adiposity and control of glucose metabolism in humans

Use of Fermented Red Clover Isoflavones in the Treatment of Overactive Bladder in Postmenopausal Women: A Randomized, Double-Blinded, Placebo-Controlled Trial

Postmenopausal women are at risk of developing an overactive bladder (OAB). Conventional vaginal estrogen has shown promise for symptom relief. Isoflavones have proven effective as an alternative to estrogen treatment against menopause-related symptoms. However, its effect on OAB symptoms has not been studied. This study investigates if fermented red clover isoflavones reduce OAB symptoms in postmenopausal women. In this randomized, double-blinded, placebo-controlled trial, women were administered red clover extract (RCE) or a placebo twice daily for three months. Women filled out the International Consultation on Incontinence Questionnaire Overactive Bladder (ICIQ-OAB) and Urinary Incontinence Short Form (ICIQ-UI-SF), together with a fluid intake and voiding diary. A total of 33 women (16 in the RCE group and 17 in the placebo group) were included in the analysis. Baseline demographics and OAB characteristics were comparable across groups. Intake of RCE did not lead to significant relief in most urinary bladder symptom measures, although a significant reduction in the bother of urinary urgency (p = 0.033) and a tendency towards a decreased ICIQ-OAB score were observed (p = 0.056). In contrast, the placebo exhibited a significant decrease in the ICIQ-OAB score (p = 0.021) and in some diary outcomes. We found that an intake of isoflavones did not relieve OAB symptoms in postmenopausal women.</p

Case Series of a Knowledge Translation Intervention to Increase Upper Limb Exercise in Stroke Rehabilitation

Background and Purpose. Current approaches to upper limb rehabilitation are not sufficient to drive neural reorganization and maximize recovery after stroke. To address this evidence-practice gap, a knowledge translation intervention using the Behaviour Change Wheel was developed. The intervention involves collaboratively working with stroke therapy teams to change their practice and increase therapy intensity by therapists prescribing supplementary self-directed arm exercise. The purposes of this case series are: (1) to provide an illustrative example of how a research-informed process changed clinical practice and (2) to report on staff members’ and patients’ perceptions of the utility of the developed intervention. Case Descriptions. A participatory action research approach was used in 3 stroke rehabilitation units in the United Kingdom. The intervention aimed to change 4 therapist-level behaviors: (1) screening patients for suitability for supplementary self-directed arm exercise, (2) provision of exercises, (3) involving family and caregivers in assisting with exercises, and (4) monitoring and progressing exercises. Data on changes in practice were collected by therapy teams using a bespoke audit tool. Utility of the intervention was explored in qualitative interviews with patients and staff. Outcomes. Components of the intervention were successfully embedded in 2 of the 3 stroke units. At these sites, almost all admitted patients were screened for suitability for supplementary self-directed exercise. Exercises were provided to 77%, 70%, and 88% of suitable patients across the 3 sites. Involving family and care givers and monitoring and progressing exercises were not performed consistently. Conclusions. This case report is an example of how a rigorous research-informed knowledge translation process resulted in practice change. Research is needed to demonstrate that these changes can translate into increased intensity of upper limb exercise and affect patient outcome

Microglia-Secreted Factors Enhance Dopaminergic Differentiation of Tissue- and iPSC-Derived Human Neural Stem Cells

In this article, Schmidt and colleagues show that differentiating human NSCs in co-culture with microglia enhance dopaminergic differentiation. The effect is consistent across different NSC and microglial cell lines but restricted to microglia of embryonic origin. TNFα, IL-1β, and IGF1 are identified as key mediators of the effect, providing new insights into factors stimulating dopaminergic differentiation.Microglia have recently been established as key regulators of brain development. However, their role in neuronal subtype specification remains largely unknown. Using three different co-culture setups, we show that microglia-secreted factors enhance dopaminergic differentiation of somatic and induced pluripotent stem cell-derived human neural stem cells (NSCs). The effect was consistent across different NSC and microglial cell lines and was independent of prior microglial activation, although restricted to microglia of embryonic origin. We provide evidence that the effect is mediated through reduced cell proliferation and decreased apoptosis and necrosis orchestrated in a sequential manner during the differentiation process. tumor necrosis factor alpha, interleukin-1β, and insulinlike growth factor 1 are identified as key mediators of the effect and shown to directly increase dopaminergic differentiation of human NSCs. These findings demonstrate a positive effect of microglia on dopaminergic neurogenesis and may provide new insights into inductive and protective factors that can stimulate in vitro derivation of dopaminergic neurons.Innovation Fund Denmark (BrainStem; www.brainstem.dk), the Lundbeck Foundation, the Danish Parkinson Foundation, the Jascha Foundation, IMK Almene Fond, the A.P. Møller Foundation, and the Faculty of Health Sciences, University of Southern Denmar