Medicina: methods, models, strategies

The School of Nursing & Midwifery at Flinders University provides dedicated support for the English language needs of over 500 international students. As part of a strategic plan to deal with communication difficulties among these students, a series of language-learning initiatives are being implemented. One of these is a game called Medicina, which has already undergone the full cycle of development, testing, and release. This game familiarizes students with confusable and common medication names. It also aims to improve phonological awareness through a focus on word form. This chapter discusses the creation of Medicina from inception through to dissemination, detailing the stages, challenges, and lessons learned in the process, in the hope of informing other educators of the level of commitment involved in a digital game-based project

Analysis of absolute lymphocyte count in patients with COVID-19

INTRODUCTION: Symptoms of COVID-19 vary in severity and presentation. When admitting patients to the hospital, it is desirable to isolate patients with COVID-19 from those without the disease. However, reliably identifying patients with COVID-19 in the emergency department before hospital admission is often limited by the speed and availability of testing. Previous studies determined a low lymphocyte count is commonly found in patients with COVID-19. We sought to explore the sensitivity of absolute lymphocyte count in patients presenting to the emergency department requiring subsequent hospitalization who were found to have COVID-19. METHODS: A retrospective chart review was performed on 312 patients with laboratory-confirmed COVID-19 who were admitted to the hospital from the emergency department. The absolute lymphocyte count for these patients was used to calculate sensitivities at various cut-off values. The relationships between absolute lymphocyte count and variables, including age, sex, need for intubation, and mortality, were also explored. RESULTS: Cut-off values for absolute lymphocyte count ranged from 1.1 K/uL to 2.0 K/uL, with sensitivities of 72% and 94%, respectively. Additionally, lower mean absolute lymphocyte counts were identified in males, patients who required intubation, and patients who died. CONCLUSION: Knowing the sensitivity of absolute lymphocyte count in patients with COVID-19 may help identify patients who are unlikely to have the disease. Additionally, absolute lymphocyte count can be used as a marker of disease severity in patients with COVID-19

A short upstream promoter region mediates transcriptional regulation of the mouse doublecortin gene in differentiating neurons.

peer reviewedABSTRACT: BACKGROUND: Doublecortin (Dcx), a MAP (Microtubule-Associated Protein), is transiently expressed in migrating and differentiating neurons and thereby characterizes neuronal precursors and neurogenesis in developing and adult neurogenesis. In addition, reduced Dcx expression during development has been related to appearance of brain pathologies. Here, we attempt to unveil the molecular mechanisms controlling Dcx gene expression by studying its transcriptional regulation during neuronal differentiation. RESULTS: To determine and analyze important regulatory sequences of the Dcx promoter, we studied a putative regulatory region upstream from the mouse Dcx coding region (pdcx2kb) and several deletions thereof. These different fragments were used in vitro and in vivo to drive reporter gene expression. We demonstrated, using transient expression experiments, that pdcx2kb is sufficient to control specific reporter gene expression in cerebellar cells and in the developing (E14.5) brain. We determined the temporal profile of Dcx promoter activity during neuronal differentiation of mouse embryonic stem cells (mESC) and found that transcriptional activation of the Dcx gene varies along with neuronal differentiation of mESC. Deletion experiments and sequence comparison of Dcx promoters across rodents, human and chicken revealed the importance of a highly conserved sequence in the proximal region of the promoter required for specific and strong expression in neuronal precursors and young neuronal cells. Further analyses revealed the presence in this short sequence of several conserved, putative transcription factor binding sites: LEF/TCF (Lymphoid Enhancer Factor/T-Cell Factor) which are effectors of the canonical Wnt pathway; HNF6/OC2 (Hepatocyte Nuclear Factor-6/Oncecut-2) members of the ONECUT family; and NF-Y/CAAT (Nuclear Factor-Y). CONCLUSIONS: Studies of Dcx gene regulatory sequences using native, deleted and mutated constructs suggest that fragments located upstream of the Dcx coding sequence are sufficient to induce specific Dcx expression in vitro: in heterogeneous differentiated neurons from mESC, in primary mouse cerebellar neurons (PND3) and in organotypic slices cultures. Furthermore, a region in the 3'-end region of the Dcx promoter is highly conserved across several species and exerts positive control on Dcx transcriptional activation. Together, these results indicate that the proximal 3'-end region of the mouse Dcx regulatory sequence is essential for Dcx gene expression during differentiation of neuronal precursors

Optimising End-to-End Maritime Supply Chains: a Carbon Footprint Perspective

Purpose – The purpose of this paper is to illustrate an optimisation method, and resulting insights, for minimising total logistics-related carbon emissions for end-to-end supply chains. Design/methodology/approach – The research is based on two real-life UK industrial cases. For the first case, several alternative realistic routes towards the UK are analysed and the optimal route minimising total carbon emissions is identified and tested in real conditions. For the second case, emissions towards several destinations are calculated and two alternative routes to southern Europe are compared, using several transport modes (road, Ro-Ro, rail and maritime). An adapted Value Stream Mapping (VSM) approach is used to map carbon footprint and calculate emissions; in addition Automatic Identification Systems (AIS) data provided information for vessel specification allowing the use of more accurate emission factors for each shipping leg. Findings – The analysis of the first case demonstrates that end-to-end logistics-related carbon emissions can be reduced by 16-21 per cent through direct delivery to the UK as opposed to transhipment via a Continental European port. The analysis of the second case shows that deliveries to southern Europe have the highest potential for reduction through deliveries by sea. Both cases show that for distant overseas destinations, the maritime leg represents the major contributor to CO2 emissions in the end-to-end supply chain. It is notable that one of the main apportionment approaches (that of Defra in the UK) generate higher carbon footprints for routes using Ro-Pax vessels, making those not optimal. The feasibility of the optimal route was demonstrated with real-life data. Originality/value – This research used real-life data from two UK companies and highlighted where carbon emissions are generated in the inbound and outbound transport chain, and how these can be reduced

Autonomously Navigating a Surgical Tool Inside the Eye by Learning from Demonstration

A fundamental challenge in retinal surgery is safely navigating a surgical tool to a desired goal position on the retinal surface while avoiding damage to surrounding tissues, a procedure that typically requires tens-of-microns accuracy. In practice, the surgeon relies on depth-estimation skills to localize the tool-tip with respect to the retina in order to perform the tool-navigation task, which can be prone to human error. To alleviate such uncertainty, prior work has introduced ways to assist the surgeon by estimating the tool-tip distance to the retina and providing haptic or auditory feedback. However, automating the tool-navigation task itself remains unsolved and largely unexplored. Such a capability, if reliably automated, could serve as a building block to streamline complex procedures and reduce the chance for tissue damage. Towards this end, we propose to automate the tool-navigation task by learning to mimic expert demonstrations of the task. Specifically, a deep network is trained to imitate expert trajectories toward various locations on the retina based on recorded visual servoing to a given goal specified by the user. The proposed autonomous navigation system is evaluated in simulation and in physical experiments using a silicone eye phantom. We show that the network can reliably navigate a needle surgical tool to various desired locations within 137 microns accuracy in physical experiments and 94 microns in simulation on average, and generalizes well to unseen situations such as in the presence of auxiliary surgical tools, variable eye backgrounds, and brightness conditions.Comment: Accepted to ICRA 202

Barcoding life to conserve biological diversity: Beyond the taxonomic imperative

Barcoding scientists aspire to adhere to the objectives of the Convention on Biological Diversity by promoting conservation, sustainability, and the equitable sharing of benefits arising from use of genetic resources. (Image: Juan Manuel Escalante, wwww.realitat.com