Best Practices for Building Interprofessional Telehealth: Report of a Conference

The Arizona Biomedical Research Centre (ABRC) has funded a series of workshops and conferences since 2016 to build the capacity of local, tribal, and state agencies, healthcare delivery organizations, and non-governmental organizations to engage in meaningful research related to health disparities. With the COVID-19 pandemic, the use of telehealth has dramatically increased, particularly in nursing, occupational therapy (OT), physical therapy (PT), and speech-language pathology (SLP). The purpose of this paper is to summarize the presentations and discussion from the conference titled “Telerehabilitation and Telepractice: An Interprofessional Conference to Build Connections and Best Practices,” held remotely on March 4-5, 2021. Terminology and concepts from the conference were debated, modified, and refined, based on an interprofessional audience. Presenters at the conference, all leaders in their field, discussed the current status of telehealth in their professions, including best practices, challenges, future trends, and research needs

Reversible thrombocytopenia during hibernation originates from storage and release of platelets in liver sinusoids

Immobility is a risk factor for thrombosis due to low blood flow, which may result in activation of the coagulation system, recruitment of platelets and clot formation. Nevertheless, hibernating animals-who endure lengthy periods of immobility-do not show signs of thrombosis throughout or after hibernation. One of the adaptations of hemostasis in hibernators consists of a rapidly reversible reduction of the number of circulating platelets during torpor, i.e., the hibernation phase with reduction of metabolic rate, low blood flow and immobility. It is unknown whether these platelet dynamics in hibernating hamsters originate from storage and release, as suggested for ground squirrel, or from breakdown and de novo synthesis. A reduction in detaching forces due to low blood flow can induce reversible adhesion of platelets to the vessel wall, which is called margination. Here, we hypothesized that storage-and-release by margination to the vessel wall induces reversible thrombocytopenia in torpor. Therefore, we transfused labeled platelets in hibernating Syrian hamster (Mesocricetus auratus) and platelets were analyzed using flow cytometry and electron microscopy. The half-life of labeled platelets was extended from 20 to 30 h in hibernating animals compared to non-hibernating control hamsters. More than 90% of labeled platelets were cleared from the circulation during torpor, followed by emergence during arousal which supports storage-and-release to govern thrombocytopenia in torpor. Furthermore, the low number of immature platelets, plasma level of interleukin-1α and normal numbers of megakaryocytes in bone marrow make platelet synthesis or megakaryocyte rupture via interleukin-1α unlikely to account for the recovery of platelet counts upon arousal. Finally, using large-scale electron microscopy we revealed platelets to accumulate in liver sinusoids, but not in spleen or lung, during torpor. These results thus demonstrate that platelet dynamics in hibernation are caused by storage and release of platelets, most likely by margination to the vessel wall in liver sinusoids. Translating the molecular mechanisms that govern platelet retention in the liver, may be of major relevance for hemostatic management in (accidental) hypothermia and for the development of novel anti-thrombotic strategies

Homozygous whole body Cbs knockout in adult mice features minimal pathology during ageing despite severe homocysteinemia

Deficiencies in Cystathionine-β-synthase (CBS) lead to hyperhomocysteinemia (HHCy), which is considered a risk factor for cardiovascular, bone and neurological disease. Moreover, CBS is important for the production of cysteine, hydrogen sulfide (H2 S) and glutathione. Studying the biological role of CBS in adult mice has been severely hampered by embryological disturbances and perinatal mortality. To overcome these issues and assess the effects of whole-body CBS deficiency in adult mice, we engineered and characterized a Cre-inducible Cbs knockout model during ageing. No perinatal mortality occurred before Cbs-/- induction at 10 weeks of age. Mice were followed until 90 weeks of age and ablation of Cbs was confirmed in liver and kidney but not in brain. Severe HHCy was observed in Cbs-/- (289 ± 58 µM) but not in Cbs+/- or control mice (<10 µM). Cbs-/- showed impaired growth, facial alopecia, endothelial dysfunction in absence of increased mortality, and signs of liver or kidney damage. CBS expression in skin localized to sebaceous glands and epidermis, suggesting local effects of Cbs-/- on alopecia. Cbs-/- showed increased markers of oxidative stress and senescence but expression of other H2 S producing enzymes (CSE and 3-MST) was not affected. CBS deficiency severely impaired H2 S production capacity in liver, but not in brain or kidney. In summary, Cbs-/- mice presented a mild phenotype without mortality despite severe HHCy. The findings demonstrate that HHCy is not directly linked to development of end organ damage

Kinetics of occupancy of defect states in poly(3-hexylthiophene): fullerene solar cells

Energetics and kinetics of defects in the effective band gap of organic bulk heterojunctions are determined by means of capacitance methods. The technique consists of calculating the junction capacitance derivative with respect to the angular frequency of the small voltage perturbation applied to thin film poly(3-hexylthiophene) (P3HT) and [6,6]-phenyl C61-butyric acid methyl ester solar cells, varying the temperature. The analysis reveals the presence of defect bands (shallow acceptors) centered at E0 = 35 meV above the highest-occupied molecular orbital level of P3HT. The total density of defects results of order 1016 cm− 3. Characteristic frequency is obtained to be situated within the range of 1–10 Hz. Defect bands acting as negatively charged levels are responsible for the p-doping of the active layer and the band-bending near the cathode contact, as derived from Mott–Schottky capacitance–voltage analysis