Incorporating translational research with clinical research to increase effectiveness in healthcare for better health

BACKGROUND: The transfer of new scientific discoveries into healthcare interventions requires that basic and clinical researchers work together with health care providers to generate team science. These innovative models require translational teams, and need to extend beyond the academic environment. The future of translational science requires partnerships with the healthcare community as well as the broader, general community. This new integrated model of effective translational teams holds promise for addressing thorny and persistent health disparities, is consistent with the nation’s strategic priority of eliminating health disparities, and bodes well for increasing healthcare effectiveness aimed at better health for all. DISCUSSION: As part of the 13th Research Centers in Minority Institutions (RCMI) International Symposium on Health Disparities, several senior academic leaders joined efforts to hold a workshop to discuss a model that considers the incorporation of two translational research strategies in research career development programs: Comparative effectiveness research (CER) and community-based participatory research (CBPR) for increasing healthcare effectiveness and eliminating healthcare disparities. Discussion included what issues may be most germane to the concept of a unified model for research workforce development through formal training and career development leading to increased effectiveness in healthcare for better health. SUMMARY: We believe that there is a gap in knowledge and skills in formal research career development programs that will enable physicians, other clinicians, and basic scientists to actively participate in these two translational research strategies. The purpose of this paper is to share the outcomes of these discussions, and encourage further discussion and possible innovation in the formulation of a new model for translational research workforce development

Neuromorphic Event-based Action Recognition

An action can be viewed as spike trains or streams of events when observed and captured by neuromorphic imaging hardware such as the iniLabs DVS128. These streams are unique to each action enabling them to be used to form descriptors. This paper describes an approach for detecting specific actions based on space-time template matching by forming such descriptors and using them as comparative tools. The developed approach is used to detect symbols from the popular RoShambo (rock, paper and scissors) game. The results demonstrate that the developed approach can be used to correctly detect the motions involved in producing RoShambo symbols

Fit for purpose? Pattern cutting and seams in wearables development

This paper describes how a group of practitioners and researchers are working across disciplines at Nottingham Trent University in the area of Technical Textiles. It introduces strands of ongoing enquiry centred around the development and application of stretch sensors on the body, focusing on how textile and fashion knowledge are being reflexively revealed in the collaborative development of seamful wearable concepts, and on the tensions between design philosophies as revealed by definitions of purpose. We discuss the current research direction of the Aeolia project, which seeks to exploit the literal gaps found in pattern cutting for fitted stretch garments towards experiential forms and potential interactions. Normative goals of fitness for purpose and seamlessness are interrogated and the potential for more integrated design processes, which may at first appear ‘upside down’, is discussed

An evaluation of persistent meteorological drought using a homogeneous Island of Ireland precipitation network

This paper investigates the spatial and temporal properties of persistent meteorological droughts using the homogeneous Island of Ireland Precipitation (IIP) network. Relative to a 1961-1990 baseline period it is shown that the longest observed run of below average precipitation since the 1850s lasted up to 5 years (10 half-year seasons) at sites in southeast and east Ireland, or 3 years across the network as a whole. Dry- and wet-spell length distributions were represented by a first-order Markov model which yields realistic runs of below average rainfall for individual sites and IIP series. This model shows that there is relatively high likelihood (p=0.125) of a 5 year dry-spell at Dublin, and that near unbroken dry runs of 10 years or more are conceivable. We suggest that the IIP network and attendant rainfall deficit modelling provide credible data for stress testing water supply and drought plans under extreme conditions

HLA-Associated viral mutations are common in human immunodeficiency virus type 1 elite controllers

Elite controllers (EC) of human immunodeficiency virus type 1 (HTV-1) maintain viremia below the limit of detection without antiretroviral treatment. Virus-specific cytotoxic CD8+ T lymphocytes are believed to play a crucial role in viral containment, but the degree of immune imprinting and compensatory mutations in EC is unclear. We obtained plasma gag, pol, and nef sequences from HLA-diverse subjects and found that 30 to 40% of the predefined HLA-associated polymorphic sites show evidence of immune selection pressure in EC., compared to approximately 50% of the sites in chronic progressors. These data indicate ongoing viral replication and escape from cytotoxic T lymphocytes are present even in strictly controlled HTV-1 infection

Revisiting consistency conditions for quantum states of systems on closed timelike curves: an epistemic perspective

There has been considerable recent interest in the consequences of closed timelike curves (CTCs) for the dynamics of quantum mechanical systems. A vast majority of research into this area makes use of the dynamical equations developed by Deutsch, which were developed from a consistency condition that assumes that mixed quantum states uniquely describe the physical state of a system. We criticise this choice of consistency condition from an epistemic perspective, i.e., a perspective in which the quantum state represents a state of knowledge about a system. We demonstrate that directly applying Deutsch's condition when mixed states are treated as representing an observer's knowledge of a system can conceal time travel paradoxes from the observer, rather than resolving them. To shed further light on the appropriate dynamics for quantum systems traversing CTCs, we make use of a toy epistemic theory with a strictly classical ontology due to Spekkens and show that, in contrast to the results of Deutsch, many of the traditional paradoxical effects of time travel are present.Comment: 10 pages, 6 figures, comments welcome; v2 added references and clarified some points; v3 published versio

Future hot-spots for hydro-hazards in Great Britain: a probabilistic assessment

In an increasing hydro-climatic risk context as a result of climate change, this work aims to identify future hydro-hazard hot-spots as a result of climate change across Great Britain. First, flood and drought hazards were defined and selected in a consistent and parallel approach with a threshold method. Then, a nation-wide systematic and robust statistical framework was developed to quantify changes in frequency, magnitude, and duration, and assess time of year for both droughts and floods, and the uncertainty associated with climate model projections. This approach was applied to a spatially coherent statistical database of daily river flows (Future Flows Hydrology) across Great Britain to assess changes between the baseline (1961–1990) and the 2080s (2069–2098). The results showed that hydro-hazard hot-spots are likely to develop along the western coast of England and Wales and across north-eastern Scotland, mainly during the winter (floods) and autumn (droughts) seasons, with a higher increase in drought hazard in terms of magnitude and duration. These results suggest a need for adapting water management policies in light of climate change impact, not only on the magnitude, but also on the timing of hydro-hazard events, and future policy should account for both extremes together, alongside their potential future evolution.</p

Physical Therapy for Hospitalized COVID-19 Patients in Isolation: Feasibility and pilot implementation of telehealth for delivering individualized therapy.

Objective To optimize the ability of hospitalized patients isolated due to COVID-19 to participate in physical therapy. Design This was a prospective, quality improvement trial of the feasibility and acceptability of a hybrid in-person and telerehabilitation platform to deliver physical therapy to hospitalized adults. Setting Inpatient wards of a tertiary care, multi-specialty academic medical center in the greater New York City metropolitan area. Participants A convenience sample of 39 COVID-19+ adults, mean age 57.3 years, 69% male, all previously community dwelling agreed to participate in a combination of in-person and telerehabilitation sessions (TR). Intervention Initial in-person evaluation by physical therapist followed by twice daily PT sessions, one in-person and one via a telehealth platform meeting Health Insurance Portability and Accountability Act (HIPAA) confidentiality requirements. The communication platform was downloaded to each participant\u27s personal smart device to establish audiovisual contact with the Physical Therapist. Measures The 6-clicks Activity Measure for Post-Acute Care (AM-PAC) was used to score self-reported functional status pre-morbidly by, and by the therapist at baseline and discharge. Results Functional status measured by AM-PAC 6-clicks demonstrated improvement from admission to discharge. Barriers to participation were identified and strategies are planned to facilitate use of the platform in future. Conclusions A consistent and structured protocol for engaging patient participation in PT delivered via a telehealth platform was successfully developed. A process was put in place to allow for further development, recruitment and testing in a randomized trial

Light my elbows: a cycling jacket incorporating electronic yarn

There is a need for illuminated cycle clothing that is comfortable and safe when cycling, and stylish to wear during other activities. It is particularly challenging to integrate lighting within textiles without compromising the drape and comfort of the textile structure. A team of electronics, textiles and fashion specialists was formed to design and make an illuminated jacket for use by cyclists. The jacket incorporates bespoke woven panels that integrate electronic yarns within the pattern. These were designed and made for this project, with fluorescent and retroreflective yarns also included in the weave. LEDs integrated within the electronic yarns illuminate the elbows of the jacket, without causing constraint or adding excess volume. The movement of the jacket elbows during cycling widens the body outline and makes the lighting eye-catching. The collaboration between electronics and textiles experts overcame challenges including development of electrical circuitry designed specifically to fit into the jacket unobtrusively, without interfering with movement or rucksack straps. Electrical connections were required between the electronic yarns assimilated within the weave. Standard, rigid solder joints would have been difficult to form without damaging the cloth and would have been liable to breakage within the garment structure, so embroidery techniques were used to create flexible, conductive connections. The illuminated jacket provides a working prototype, demonstrating the potential for further collaborative ventures in which electronics are integrated into garments that are stylish, functional and 'wearable'. Further interdisciplinary research will include the development of additional wearable prototypes that enhance safety and wellbeing, whilst addressing the recycling of the textiles and garments, including the safe separation and disposal of electronic yarn and other components that provide electrical functionality

Trends in the GloFAS-ERA5 river discharge reanalysis

The main objective of this study is to analyse the GloFAS-ERA5 river discharge reanalysis for any noticeable change (including gradual trends or discontinuities) in the annual mean time series across the 1979-2018 (40-year) period, and to evaluate how realistic these are compared with available observed river discharge time series. These variabilities are quantified by linear regression in order to highlight any concerning features in the GloFAS-ERA5 time series. This work is particularly important for GloFAS, as large trends, discontinuities or other similar features could have a major consequence on the GloFAS flood thresholds in around 50% of catchments, which are based on GloFAS-ERA5, and thus subsequently on the issuing of flood warnings. In addition, this study also contributes to the understanding of the water cycle variable behaviour in ERA5 (driver of GloFAS-ERA5) and ERA5-Land (higher resolution land reanalysis forced by ERA5, produced offline) by exploring the linear trends in river discharge and related hydrological variables. In exploring the stability of the time series in ERA5, we seek to trigger potential further discussions and research studies, which subsequently should help with the planning and development for the next generation ECMWF reanalysis, ERA6