ECOSENSUS: developing collaborative learning systems for stakeholding development in environmental planning

ECOSENSUS *(Electronic/Ecological Collaborative Sensemaking Support System) investigates the socio-technological issues around developing collaboration tools for participatory environmental decision making amongst (a) marginalised natural resource users, (b) professional 'experts' from different countries, and (c) key decision makers associated with managing ecosystems. An integral activity is the production of open content learning resources to support stakeholders in facilitating distributed environmental decision making. This involves the integrated use of three open source software tools: Moodle (online course management), Compendium (dialogue mapping) and uDig (user friendly desktop/internet GIS). In the first ECOSENSUS-1 phase, the pilot collaborative effort has been focused on supporting stakeholders in developing adaptive management plans for the Rupununi Wetlands in southern Guyana, a region rich in flora and fauna but also under intense pressure to expand the exploitation of its natural resources, including timber, gold, and commercially viable fish species. Results of the ECOSENSUS-1 are briefly described along with some preliminary notes on the current ECOSENUS-2 phase of associated research in Guyana supported by an additional grant from DEFRA. The paper prompts questions on how ECOSENSUS can feed into wider open source course development using the LabSpace on the OpenLearn project

The ECOSENSUS Project: Co-Evolving Tools, Practices and Open Content for Participatory Natural Resource Management

ECOSENSUS (Electronic/Ecological Collaborative Sensemaking Support System)[www.ecosensus.info] is an ESRC e-Social Science pilot project, using a Participatory Action Research methodology to evolve tools and work practices for collaborative work in environmental and natural resource management between a European-based team, and stakeholders involved in the region of concern, the North Rupununi District of Guyana. To promote long term capacity building in the region and beyond, the project's outputs will be disseminated as open source learning resources. Given the disparities in knowledge and power in such a project, central to our work are issues of stakeholder empowerment in the geographical modelling, interpretation and decision making practices that constitute environmental management. We argue that in e-Science, such factors have yet to receive much attention. This paper reports work accomplished to date: progress towards an environment which integrates GIS modelling with participatory deliberation about the implications of the models, and reactions from the indigenous Amerindians to this tool

Effect of a 25 ingredient sport drink on exercise performance and muscle oxygen extraction: a randomized controlled cross-over trial

Many sport drinks contain a mixture of potential ergogenic substances. Recently, a new sport drink with 25 different ingredients was introduced to the market. Various athletes reported beneficial performance effects from the supplement, though without scientific evidence. The aim of this study was to investigate the effects of the sport drink on exercise performance. Nine sport students performed 3 test sessions including a cycle exercise tests to exhaustion, a leg strength test and a jump test. Each session was separated by 1 week. The first session was performed as a familiarization trial. In a random order, half of the participants performed the second session after consumption of the multi ingredient sport drink (MISD intake of 40g, 24 and 1h before each test) and half after placebo ingestion (same amount). During test session 3 the conditions were reversed (cross-over setting). Near infrared spectroscopy analyses were performed on the vastus lateralis during the MISD and placebo cycling test. The sport drink compared to placebo, improved maximal power output (7 watts, 95% CI 1.1-13.4), increased maximal lactate concentration (2.5 mmol/l, 95% CI 1.6-3.4), and power output at the individual threshold (Dmax) (6.1 watts, 95% CI 1.9-10.3). Power output at the 4 mmol/l threshold was reduced (9.0 watts, 95% CI -17.4 to -0.6) during the MISD trial. Additionally, the sport drink led to a steeper tissue oxygenation index decrease (TOI, slope: -0.0182±0.0084 vs. -0.0256±0.0073, p<0.005) during the test. Leg strength and jump ability was not affected by the supplement. The sport drink slightly increased power output during an incremental exercise test. Due to the broad range of substances in the supplement and their different effects, the factors involved in the performance enhancement are speculative. Data show that factors other than muscle oxygen extraction (represented by TOI) are involved in the improved maximal power output

Associations of Novel and Traditional Vascular Biomarkers of Arterial Stiffness: Results of the SAPALDIA 3 Cohort Study

There is a lack of evidence concerning associations between novel parameters of arterial stiffness as cardiovascular risk markers and traditional structural and functional vascular biomarkers in a population-based Caucasian cohort. We examined these associations in the second follow-up of the Swiss Cohort Study on Air Pollution and Lung and Heart Diseases in Adults (SAPALDIA 3).; Arterial stiffness was measured oscillometrically by pulse wave analysis to derive the cardio-ankle vascular index (CAVI), brachial-ankle (baPWV) and aortic pulse wave velocity (aPWV), and amplitude of the forward and backward wave. Carotid ultrasonography was used to measure carotid intima-media thickness (cIMT) and carotid lumen diameter (LD), and to derive a distensibility coefficient (DC). We used multivariable linear regression models adjusted for several potential confounders for 2,733 people aged 50-81 years.; CAVI, aPWV and the amplitude of the forward and backward wave were significant predictors of cIMT (p &lt; 0.001). All parameters were significantly associated with LD (p &lt; 0.001), with aPWV and the amplitude of the forward wave explaining the highest proportion of variance (2%). Only CAVI and baPWV were significant predictors of DC (p &lt; 0.001), explaining more than 0.3% of the DC variance.; We demonstrated that novel non-invasive oscillometric arterial stiffness parameters are differentially associated with specific established structural and functional local stiffness parameters. Longitudinal studies are needed to follow-up on these cross-sectional findings and to evaluate their relevance for clinical phenotypes

Practices to support co-design processes: A case-study of co-designing a program for children with parents with a mental health problem in the Austrian region of Tyrol

Forms of collaborative knowledge production, such as community-academic partnerships (CAP), have been increasingly used in health care. However, instructions on how to deliver such processes are lacking. We aim to identify practice ingredients for one element within a CAP, a 6-month co-design process, during which 26 community- and 13 research-partners collaboratively designed an intervention programme for children whose parent have a mental illness. Using 22 published facilitating and hindering factors for CAP as the analytical framework, eight community-partners reflected on the activities which took place during the co-design process. From a qualitative content analysis of the data, we distilled essential practices for each CAP factor. Ten community- and eight research-partners revised the results and co-authored this article. We identified 36 practices across the 22 CAP facilitating or hindering factors. Most practices address more than one factor. Many practices relate to workshop design, facilitation methods, and relationship building. Most practices were identified for facilitating ‘trust among partners’, ‘shared visions, goals and/or missions’, ‘effective/frequent communication’, and ‘well-structured meetings’. Fewer practices were observed for ‘effective conflict resolution’, ‘positive community impact’ and for avoiding ‘excessive funding pressure/control struggles’ and ‘high burden of activities’. Co-designing a programme for mental healthcare is a challenging process that requires skills in process management and communication. We provide practice steps for delivering co-design activities. However, practitioners may have to adapt them to different cultural contexts. Further research is needed to analyse whether co-writing with community-partners results in a better research output and benefits for participants

Elective cancer surgery in COVID-19-free surgical pathways during the SARS-CoV-2 pandemic: An international, multicenter, comparative cohort study

PURPOSE As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19–free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. PATIENTS AND METHODS This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19–free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). RESULTS Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19–free surgical pathways. Patients who underwent surgery within COVID-19–free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19–free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score–matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19–free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76). CONCLUSION Within available resources, dedicated COVID-19–free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks

Elective Cancer Surgery in COVID-19-Free Surgical Pathways During the SARS-CoV-2 Pandemic: An International, Multicenter, Comparative Cohort Study.

PURPOSE: As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19-free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. PATIENTS AND METHODS: This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19-free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). RESULTS: Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19-free surgical pathways. Patients who underwent surgery within COVID-19-free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19-free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score-matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19-free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76). CONCLUSION: Within available resources, dedicated COVID-19-free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks

Model based methods for early diagnosis of cardiovascular diseases

Laut der Global Burden of Disease Study wurden rund 17,9 Millionen Todesfälle im Jahr 2015 von Herz-Kreislauf-Erkrankungen verursacht. Das entspricht mehr als 30% der Gesamtmortalität. Sie sind damit die mit Abstand häufigste Todesursache weltweit. Herz-Kreislauf-Erkrankungen stellen nicht eine einzelne Krankheit dar, sondern sind ein Sammelbegriff für mehrere Erkrankungen wie koronare Herzkrankheit, Schlaganfall, Vorhofflimmern und -flattern, Bluthochdruck und periphere arterielle Verschlusskrankheit. Während diese Erkrankungen unterschiedliche Funktionen des Herz-Kreislauf-Systems betreffen und unterschiedliche Symptome aufweisen, hängen die zu Grunde liegenden Ursachen zusammen und beeinflussen sich gegenseitig. Dies erfordert, dass Mediziner sowie Wissenschaftler bei Untersuchungen zahlreiche Faktoren berücksichtigen. Leitlinien für die Behandlung von Herz-Kreislauf-Erkrankungen empfehlen daher die Auswertung mehrerer Biomarker und biomedizinischer Aufzeichnungen, z. B. Elektrokardiographie und Pulswellen. Der beste Weg, um Interaktionen im Herz-Kreislauf-System zu untersuchen, ist, diese Biosignale synchron zu messen. Daher ist das Ziel dieser Arbeit, bestehende Modelle und Methoden zur Ermittlung elektrophysiologischer und mechanischer Biomarker zu untersuchen und weiter zu entwickeln. Darüber hinaus sollen sie durch die Implementierung in einer Forschungsplattform in Form eines embedded Systems umgesetzt werden. Konkret geht es darum, Methoden zur automatischen Annotation des Elektrokardiogramms (EKG), zur Messung der Pulswellengeschwindigkeit (PWV) und zur Quantifizierung der Herzfrequenzvariabilität (HRV) weiter zu entwickeln und zu untersuchen. Die Auswertung des EKGs lässt Rückschlüsse auf die Funktion des Herzmuskels und des Erregungsleitungssystem des Herzens zu. Da automatische Methoden zur Analyse des EKG zahlreiche Vorteile gegenüber manuellen Verfahren haben, wird in dieser Arbeit ein Algorithmus zur automatische EKG-Annotation vorgestellt und getestet. Die Ergebnisse zeigen Erkennungsraten von Herzschlägen mit einer Sensitivität von 98,7% und einem positiven prädiktiven Wert von 98,6%. Diese Ergebnisse sind mit heute üblichen Algorithmen vergleichbar. Des Weiteren zeigen die Ergebnisse der Bestimmung der einzelnen EKG-Abschnitte eine hohe Übereinstimmung von Algorithmus und MedizinerInnen. Die PWV spiegelt arterielle Gefäßsteifigkeit sowie Blutdruckveränderungen zwischen aufeinanderfolgenden Herzschlägen wider. Da die Bestimmung der Geschwindigkeit von der Messung der genauen Zeit abhängt, die die Pulswelle benötigt, um eine gewisse Distanz zurückzulegen, werden in dieser Arbeit mehrere Methoden zur Bestimmung der Ankunftszeit verglichen. Die stabilste und zuverlässigste Methode, das Diastole-Patching, wurde schließlich im embedded System implementiert und in klinischen Studien eingesetzt. Die HRV ist die zeitliche Variation der Intervalle zwischen aufeinanderfolgenden Herzschlägen und kann unter anderem aus dem EKG abgeleitet werden. Sie erlaubt Rückschlüsse auf den Zustand der regulatorischen Mechanismen im Herz-Kreislauf- und Nervensystem. In dieser Arbeit wurden zahlreiche Methoden auf ihre Anwendbarkeit in einem embedded System untersucht. Schließlich wurden die Zeitbereichsmethoden nach etablierten Standards, die Frequenzbereichsmethoden basierend auf dem weniger bekannten Lomb-Scargle-Periodogramm und der Poincaré-Plot zur Visualisierung der nichtlinearen Dynamik implementiert. Die Forschungsplattform und die in dieser Arbeit entwickelten Methoden wurden bereits in mehreren biomedizinischen Studien in verschiedenen Bereichen eingesetzt. Rückmeldungen und vorläufige Ergebnisse zeigen die gute Einsetzbarkeit des Systems für den beabsichtigten Verwendungszweck: die synchrone Aufzeichnung und Auswertung mehrerer Biosignale, die den Zustand der verschiedenen Teile des Herz-Kreislaufsystems widerspiegeln und damit eine gründliche Untersuchung von physiologischen und pathologischen Wechselwirkungen von Herz-Kreislauf-Erkrankungen ermöglichen.According to the Global Burden of Disease Study, about 17.9 million deaths were caused by cardiovascular diseases (CVDs) in 2015, which corresponds to more than 30% of total mortality. CVDs are by far the most frequent cause of death worldwide. CVD is not a single disease, but is a collective term for several diseases such as coronary heart disease, stroke, atrial fibrillation and flutter, hypertension, and peripheral artery disease. While these diseases affect different functions of the cardiovascular system and have different symptoms, the underlying causes depend on and influence each other. This requires that physicians as well as scientists take numerous factors into account. Guidelines for the treatment of CVDs therefore recommend the evaluation of several biomarkers and biomedical recordings, e.g., electrocardiography and pulse waves. The best way to study interactions in the cardiovascular system is to measure these biosignals synchronously. Therefore, the aim of this work is to investigate and further develop existing models and methods for obtaining electrophysiological and mechanical biomarkers. In addition, they are to be implemented in a research platform in the form of an embedded system. Specifically, the aim is to further develop and investigate methods for the automatic annotation of the electrocardiogram (ECG), the measurement of the pulse wave velocity (PWV) and the quantification of the heart rate variability (HRV). The evaluation of the ECG allows conclusions to be drawn about the function of the heart muscle and the conductive system of the heart. Since automatic methods for analyzing the ECG have numerous advantages over manual methods, an algorithm for automatic ECG annotation is presented and tested. The results show recognition rates of beats with a sensitivity of 98.7% and a positive predictive value of 98.6%, which is comparable to today's algorithms. Furthermore, the results of the waveform boundary detection show a high agreement of algorithm and medical experts. The PWV reflects arterial stiffness as well as blood pressure changes between successive heartbeats. Since the determination of the speed depends on the measurement of the exact time required by the pulse wave to travel a certain distance, several methods for determining the arrival time are compared in this work. The most stable and reliable method, the diastolic patching method, was finally implemented in the embedded system and used in clinical trials. The HRV is the temporal variation of the intervals between successive heartbeats and can be derived from the ECG. It allows conclusions to be drawn about the state of the regulatory mechanisms in the cardiovascular and nervous system. In this work, numerous methods were analyzed for their applicability in an embedded system. Finally, the time-domain methods were implemented according to established standards, the frequency-domain methods based on the lesser known Lomb-Scargle periodogram, and the Poincaré Plot to visualize non-linear dynamics. The research platform and the methods developed in this work were used in several biomedical studies in various fields. Feedback and preliminary results demonstrate the viability of the system for the intended use: the synchronous recording and evaluation of several biosignals that reflect the condition of the different parts of the cardiovascular system and thus enable a thorough investigation of physiological and pathological interactions of cardiovascular diseases.14

Dancing on the Grid: Using e-Science tools to extend choreographic research

This paper considers the role and impact of new and emerging e-Science tools on practice-led research in dance. Specifically it draws on the findings from the e-Dance project. This two-year project brings together an interdisciplinary team combining research aspects of choreography, next generation of video conferencing, and Human-Computer Interaction analysis incorporating hypermedia and non-linear annotations for recording and documentation

Real-Time Monitoring of Psychotherapeutic Processes: Concept and Compliance

Objective: The feasibility of a high-frequency real-time monitoring approach to psychotherapy is outlined and tested for patients' compliance to evaluate its integration to everyday practice. Criteria concern the ecological momentary assessment, the assessment of therapy-related cognitions and emotions, equidistant time sampling, real-time nonlinear time series analysis, continuous participative process control by client and therapist, and the application of idiographic (person-specific) surveys. Methods: The process-outcome monitoring is technically realized by an internet-based device for data collection and data analysis, the Synergetic Navigation System. Its feasibility is documented by a compliance study on 151 clients treated in an inpatient and a day-treatment clinic. Results: We found high compliance rates (mean: 78.3%, median: 89.4%) amongst the respondents, independent of the severity of symptoms or the degree of impairment. Compared to other diagnoses, the compliance rate was lower in the group diagnosed with personality disorders. Conclusion: The results support the feasibility of high-frequency monitoring in routine psychotherapy settings. Daily collection of psychological surveys allows for the assessment of highly resolved, equidistant time series data which gives insight into the nonlinear qualities of therapeutic change processes (e.g., pattern transitions, critical instabilities)