Evaluating Unity created teaching simulations within occupational therapy

Purpose – The purpose of this paper is to describe the evaluation of an educational occupational therapy home visit simulation newly built in Unity, compared with a previously created simulation based in the Open Sim platform. The evaluation is based on students’ preferences. Design/methodology/approach – A simulation was built in Unity in which the academic content was identical to the previous Open Sim-based simulation. Student groups used the simulations then completed a questionnaire. Numerical data and descriptive comments were analysed. Findings – Students preferred the simulation built in Unity to the Open Sim simulation. Improvements with the Unity simulation include; reduced time to gain competence to use, ease of use and fewer negative physiological experiences. The small percentage of students experiencing motion sickness is an ongoing concern and warrants further investigation. The Unity simulation may also be useful as an academic assessment tool. Research limitations/implications – Findings are limited by short time usage of the simulations in 3D virtual worlds with confined spaces and no requirement for in-world group interaction, and by some methodological limitations including the research being based within a single higher education institution, and with a profession-specific group of students. Originality/value – This paper highlights student preference for using a purpose built simulation created with Unity over a simulation built in Open Sim, showing where best to spend future development time and funding. Similar comparison research is scarce. Keywords Stroke, Second Life, Higher education, Occupational therapy, Academic assessment, Unity Paper type Research paperN/

Effects of Sex Differences on the myeloid-endothelin system and their implications for blood pressure control

High blood pressure or hypertension is a common clinical condition affecting 25% of the UK adult population. It is a major risk factor for myocardial infarction, cerebral infarction, dementia, heart failure, kidney failure and retinopathy. Despite a broad range of treatment options, the cause of hypertension remains unknown, so patients cannot be easily identified before developing hypertension, nor can therapy be stratified to the cause of their increased blood pressure. The kidneys, heart, brain, immune system and vasculature all contribute to blood pressure. Recent studies have linked macrophages, an important cell type in the innate system, to the endothelin-1 (ET-1), a principal regulator of arterial tone and that the interaction affects blood pressure control. ET-1 is a vasoactive peptide that acts via two G-protein coupled receptors, ETA and ETB receptor, to induce vasoconstriction or vasodilation, respectively. The incidence of cardiovascular disease varies between men and women, with men more likely to develop it earlier. Additionally, women are more likely to develop autoimmunity, which increases their risk of cardiovascular disease. As such, this thesis hypothesised that the macrophage-endothelin system might vary between men and women, and this could be a possible explanation for the differences in risk of cardiovascular disease. Initially, the dynamics of ET-1 uptake were observed using a fluorescently tagged ET-1 and microscopy in male C57BL/6 mice, and the ET system appears to affect cytokine release by macrophages. The use of the same probe indicated that only macrophages isolated from male mice could remove ET-1 in vitro, and this supported by a similar finding using an untagged ET-1. Furthermore, the ETB receptor gene, Ednrb, was shown to have higher expression in male macrophages compared to females, perhaps explaining the difference in ET-1 uptake. Next, sex differences in the macrophage-ET system were also observed in 129/Sv and FVB strains mouse strains. Finally, in vivo studies demonstrated that sex differences in the myeloid-ET system do not affect acute pressure regulation but significantly affect chronic blood pressure control. Female control mice had a greater response to the same dose of Ang II and a high salt diet than female LysMETB mice, where the macrophage ETB receptor has been depleted, and a higher response than male LysMETB mice. The differences could be explained by differences in circulating leucocytes and changes in vasoconstriction. There was no difference in renal injury, although there were differences in circulating ET-1. Differences in the macrophage-ET system may become physiologically relevant when immune function is altered, as can occur in cancer, cardiovascular disease and autoimmunity

Virtually home: feasibility study and pilot randomised controlled trial of a virtual reality intervention to support patient discharge after stroke

Introduction: Virtual reality has the potential to assist occupational therapists in preparing patients for discharge by facilitating discussions and providing education about relevant practical issues and safety concerns. This study aimed to explore the feasibility of using a virtual reality intervention to support patient discharge after stroke and pilot its use. Method: Practical aspects of delivering a virtual reality intervention prior to discharge were explored by means of a non-randomised feasibility study and a subsequent pilot randomised controlled trial. Factors considered included eligibility, recruitment, intervention delivery, attrition and suitability of outcome measures. Outcome measures included standardised assessments of stroke severity, mobility, health-related quality of life, functional ability, satisfaction with services and concerns about falling. Results: Thirty-three participants were recruited in total: 17 to the feasibility study and 16 to the pilot trial. At 1-month follow-up, 14 participants (82%) were re-assessed in the feasibility study and 12 (75%) in the pilot trial. The main difficulties encountered related to recruitment, particularly regarding post-stroke cognitive impairments, the presence of mild deficits or illness. Conclusion: It was feasible to recruit and retain participants, deliver the intervention and collect outcome measures, despite slow recruitment rates. These findings could inform the design of a definitive trial

Label-free biophysical markers from whole blood microfluidic immune profiling reveals severe immune response signatures

10.1002/smll.202006123SMALL171

The global value of coastal wetlands for storm protection

Coastal wetlands provide a range of valuable ecosystem services, including protecting coastal communities from storms. We estimated for the first time the global value of these storm protection services for all coastal wetlands for both damages avoided and lives saved. We used the historical tracks of 1,014 tropical cyclones since 1902 that recorded property damage and/or human casualties in 71 countries/regions. We used Bayesian and OLS statistical techniques to relate storm damages and lives lost to: wind speed, storm forward speed, the year of the storm, the volume of ocean water proximal to landfall, and GDP, population, and coastal wetlands in the swath of the storm. Based on current storm probabilities, we estimate the median annual global value of coastal wetlands for storm protection at $447 billion/yr (2015$US) ($213 -$837 billion/yr, 90% CI) and 4,620 lives saved per year (3,320 – 6,550, 90% CI). The 40 million hectares of coastal wetlands in storm prone areas provided an average of $11,000/ha/yr in avoided storm damages. The frequency and intensity of tropical cyclones has been increasing in recent decades and is projected to further increase with climate change. Consequently, the already significant benefits from protecting and restoring coastal wetlands will become increasingly important and valuable in the future. These results justify much larger investments in conservation and restoration of coastal wetlands

Evaluating diagnostic strategies for early detection of cancer: the CanTest framework

Abstract: Background: Novel diagnostic triage and testing strategies to support early detection of cancer could improve clinical outcomes. Most apparently promising diagnostic tests ultimately fail because of inadequate performance in real-world, low prevalence populations such as primary care or general community populations. They should therefore be systematically evaluated before implementation to determine whether they lead to earlier detection, are cost-effective, and improve patient safety and quality of care, while minimising over-investigation and over-diagnosis. Methods: We performed a systematic scoping review of frameworks for the evaluation of tests and diagnostic approaches. Results: We identified 16 frameworks: none addressed the entire continuum from test development to impact on diagnosis and patient outcomes in the intended population, nor the way in which tests may be used for triage purposes as part of a wider diagnostic strategy. Informed by these findings, we developed a new framework, the ‘CanTest Framework’, which proposes five iterative research phases forming a clear translational pathway from new test development to health system implementation and evaluation. Conclusion: This framework is suitable for testing in low prevalence populations, where tests are often applied for triage testing and incorporated into a wider diagnostic strategy. It has relevance for a wide range of stakeholders including patients, policymakers, purchasers, healthcare providers and industry

The value of manure - Manure as co-product in life cycle assessment

Research ArticleLivestock production is important for food security, nutrition, and landscape maintenance, but it is associated with several environmental impacts. To assess the risk and benefits arising from livestock production, transparent and robust indicators are required, such as those offered by life cycle assessment. A central question in such approaches is how environmental burden is allocated to livestock products and to manure that is re-used for agricultural production. To incentivize sustainable use of manure, it should be considered as a co-product as long as it is not disposed of, or wasted, or applied in excess of crop nutrient needs, in which case it should be treated as a waste. This paper proposes a theoretical approach to define nutrient requirements based on nutrient response curves to economic and physical optima and a pragmatic approach based on crop nutrient yield adjusted for nutrient losses to atmosphere and water. Allocation of environmental burden to manure and other livestock products is then based on the nutrient value from manure for crop production using the price of fertilizer nutrients. We illustrate and discuss the proposed method with two case studiesinfo:eu-repo/semantics/publishedVersio

Atorvastatin Therapy during the Peri-Infarct Period Attenuates Left Ventricular Dysfunction and Remodeling after Myocardial Infarction

Although statins impart a number of cardiovascular benefits, whether statin therapy during the peri-infarct period improves subsequent myocardial structure and function remains unclear. Thus, we evaluated the effects of atorvastatin on cardiac function, remodeling, fibrosis, and apoptosis after myocardial infarction (MI). Two groups of rats were subjected to permanent coronary occlusion. Group II (n = 14) received oral atorvastatin (10 mg/kg/d) daily for 3 wk before and 4 wk after MI, while group I (n = 12) received equivalent doses of vehicle. Infarct size (Masson's trichrome-stained sections) was similar in both groups. Compared with group I, echocardiographic left ventricular ejection fraction (LVEF) and fractional area change (FAC) were higher while LV end-diastolic volume (LVEDV) and LV end-systolic and end-diastolic diameters (LVESD and LVEDD) were lower in treated rats. Hemodynamically, atorvastatin-treated rats exhibited significantly higher dP/dtmax, end-systolic elastance (Ees), and preload recruitable stroke work (PRSW) and lower LV end-diastolic pressure (LVEDP). Morphometrically, infarct wall thickness was greater in treated rats. The improvement of LV function by atorvastatin was associated with a decrease in hydroxyproline content and in the number of apoptotic cardiomyocyte nuclei. We conclude that atorvastatin therapy during the peri-infarct period significantly improves LV function and limits adverse LV remodeling following MI independent of a reduction in infarct size. These salubrious effects may be due in part to a decrease in myocardial fibrosis and apoptosis