Patients’ Perspectives Regarding Digital Health Technology to Support Self-management and Improve Integrated Stroke Care:Qualitative Interview Study

Background: Digital technologies such as mobile apps and robotics have the potential to involve stroke patients better in the care process and to promote self-management. However, barriers exist that constrain the adoption and acceptance of technology in clinical practice. Examples of barriers are privacy concerns, challenges regarding usability, and the perception that there is no need for health-related technology. To address these barriers, co-design can be used to enable patients to reflect on their experiences of a service and to tailor digital technologies to the needs and preferences of end users regarding content and usability. Objective: This study aims to explore the perspectives of stroke patients toward how digital health technology could support self-management regarding health and well-being, as well as integrated stroke care. Methods: A qualitative study was conducted to understand patient perspectives. Data were collected in co-design sessions during the ValueCare study. Patients from a Dutch hospital who experienced an ischemic stroke (n=36) within the past 18 months were invited to participate. Data collection took place between December 2020 and April 2021 via one-to-one telephone interviews. A short self-report questionnaire was used to collect data on sociodemographics, disease-specific information, and technology use. All interviews were audio-taped and transcribed verbatim. The interview data were analyzed using a thematic approach. Results: Patients held mixed attitudes toward digital health technologies. Some patients viewed digital technology as a convenient product or service, while others expressed no desire or need to use technology for self-management or care. Digital features suggested by stroke patients included (1) information about the causes of stroke, medication, prognosis, and follow-up care; (2) an online library with information regarding stroke-related health and care issues; (3) a personal health record by which patients can retrieve and manage their own health information; and (4) online rehabilitation support to empower patients to exercise at home. Regarding the user interface of future digital health technology, patients emphasized the need for easy-to-use and simple designs. Conclusions: Stroke patients mentioned credible health information, an online library with stroke-related health and care information, a personal health record, and online rehabilitation support as the main features to include in future digital health technologies. We recommend that developers and designers of digital health for stroke care listen to the “voice of the stroke patients” regarding both functionality and the characteristics of the interface.</p

Production of Medical Radioisotopes with High Specific Activity in Photonuclear Reactions with γ\gamma Beams of High Intensity and Large Brilliance

We study the production of radioisotopes for nuclear medicine in $(\gamma,x{\rm n}+y{\rm p})$ photonuclear reactions or ($\gamma,\gamma'$) photoexcitation reactions with high flux [($10^{13}-10^{15}$)$\gamma$/s], small diameter $\sim (100 \, \mu$m$)^2$ and small band width ($\Delta E/E \approx 10^{-3}-10^{-4}$) $\gamma$ beams produced by Compton back-scattering of laser light from relativistic brilliant electron beams. We compare them to (ion,$x$n$+ y$p) reactions with (ion=p,d,$\alpha$) from particle accelerators like cyclotrons and (n,$\gamma$) or (n,f) reactions from nuclear reactors. For photonuclear reactions with a narrow $\gamma$ beam the energy deposition in the target can be managed by using a stack of thin target foils or wires, hence avoiding direct stopping of the Compton and pair electrons (positrons). $(\gamma,\gamma')$ isomer production via specially selected $\gamma$ cascades allows to produce high specific activity in multiple excitations, where no back-pumping of the isomer to the ground state occurs. We discuss in detail many specific radioisotopes for diagnostics and therapy applications. Photonuclear reactions with $\gamma$ beams allow to produce certain radioisotopes, e.g. $^{47}$Sc, $^{44}$Ti, $^{67}$Cu, $^{103}$Pd, $^{117m}$Sn, $^{169}$Er, $^{195m}$Pt or $^{225}$Ac, with higher specific activity and/or more economically than with classical methods. This will open the way for completely new clinical applications of radioisotopes. For example $^{195m}$Pt could be used to verify the patient's response to chemotherapy with platinum compounds before a complete treatment is performed. Also innovative isotopes like $^{47}$Sc, $^{67}$Cu and $^{225}$Ac could be produced for the first time in sufficient quantities for large-scale application in targeted radionuclide therapy.Comment: submitted to Appl. Phys.

Revisiting Cardassian Model and Cosmic Constraint

In this paper, we revisit the Cardassian model in which the radiation energy component is included. It is important for early epoch when the radiation cannot be neglected because the equation of state (EoS) of the effective dark energy becomes time variable. Therefore, it is not equivalent to the quintessence model with a constant EoS anymore. This situation was almost overlooked in the literature. By using the recent released Union2 557 of type Ia supernovae (SN Ia), the baryon acoustic oscillation (BAO) from Sloan Digital Sky Survey and the WiggleZ data points, the full information of cosmic microwave background (CMB) measurement given by the seven-year Wilkinson Microwave Anisotropy Probe observation, we constrain the Cardassian model via the Markov Chain Monte Carlo (MCMC) method. A tight constraint is obtained: $n= -0.0479_{- 0.0732- 0.148}^{+ 0.0730+ 0.142}$ in $1,2\sigma$ regions. The deviation of Cardassian model from quintessence model is shown in CMB anisotropic power spectra at high l's parts due to the evolution of EoS. But it is about the order of 0.1% which cannot be discriminated by current data sets. The Cardassian model is consistent with current cosmic observational data sets.Comment: 6 pages, 5 figures, match the published versio

A screen for hoxb1-regulated genes identifies ppp1r14al as a regulator of the rhombomere 4 Fgf-signaling center

AbstractSegmentation of the vertebrate hindbrain into multiple rhombomeres is essential for proper formation of the cerebellum, cranial nerves and cranial neural crest. Paralog group 1 (PG1) hox genes are expressed early in the caudal hindbrain and are required for rhombomere formation. Accordingly, loss of PG1 hox function disrupts development of caudal rhombomeres in model organisms and causes brainstem defects, associated with cognitive impairment, in humans. In spite of this important role for PG1 hox genes, transcriptional targets of PG1 proteins are not well characterized. Here we use ectopic expression together with embryonic dissection to identify novel targets of the zebrafish PG1 gene hoxb1b. Of 100 genes up-regulated by hoxb1b, 54 were examined and 25 were found to represent novel hoxb1b regulated hindbrain genes. The ppp1r14al gene was analyzed in greater detail and our results indicate that Hoxb1b is likely to directly regulate ppp1r14al expression in rhombomere 4. Furthermore, ppp1r14al is essential for establishment of the earliest hindbrain signaling-center in rhombomere 4 by regulating expression of fgf3

LHC as πp\pi p and ππ\pi\pi Collider

We propose an experiment at the LHC with leading neutron production.The latter can be used to extract from it the total $\pi^+ p$ cross-sections. With two leading neutrons we can get access to the total $\pi^+\pi^+$ cross-sections. In this note we give some estimates and discuss related problems and prospects.Comment: 22 pages, 18 figures, 8 tables, to be publishe

Unwrapping Closed Timelike Curves

Closed timelike curves (CTCs) appear in many solutions of the Einstein equation, even with reasonable matter sources. These solutions appear to violate causality and so are considered problematic. Since CTCs reflect the global properties of a spacetime, one can attempt to change its topology, without changing its geometry, in such a way that the former CTCs are no longer closed in the new spacetime. This procedure is informally known as unwrapping. However, changes in global identifications tend to lead to local effects, and unwrapping is no exception, as it introduces a special kind of singularity, called quasi-regular. This "unwrapping" singularity is similar to the string singularities. We give two examples of unwrapping of essentially 2+1 dimensional spacetimes with CTCs, the Gott spacetime and the Godel universe. We show that the unwrapped Gott spacetime, while singular, is at least devoid of CTCs. In contrast, the unwrapped Godel spacetime still contains CTCs through every point. A "multiple unwrapping" procedure is devised to remove the remaining circular CTCs. We conclude that, based on the two spacetimes we investigated, CTCs appearing in the solutions of the Einstein equation are not simply a mathematical artifact of coordinate identifications, but are indeed a necessary consequence of General Relativity, provided only that we demand these solutions do not possess naked quasi-regular singularities.Comment: 29 pages, 9 figure

Parametrization of Born-Infeld Type Phantom Dark Energy Model

Applying the parametrization of dark energy density, we can construct directly independent-model potentials. In Born-Infeld type phantom dark energy model, we consider four special parametrization equation of state parameter. The evolutive behavior of dark energy density with respect to red-shift $z$, potentials with respect to $\phi$ and $z$ are shown mathematically. Moreover, we investigate the effect of parameter $\eta$ upon the evolution of the constructed potential with respect to $z$. These results show that the evolutive behavior of constructed Born-Infeld type dark energy model is quite different from those of the other models.Comment: 5 pages, 4 figures, Accepted for publication in Astrophysics & Space Scienc

The kk-essence scalar field in the context of Supernova Ia Observations

A $k$-essence scalar field model having (non canonical) Lagrangian of the form $L=-V(\phi)F(X)$ where $X=1/2g^{\mu\nu}\nabla_{\mu}\phi\nabla_{\nu}\phi$ with constant $V(\phi)$ is shown to be consistent with luminosity distance-redshift data observed for type Ia Supernova. For constant $V(\phi)$, $F(X)$ satisfies a scaling relation which is used to set up a differential equation involving the Hubble parameter $H$, the scale factor $a$ and the $k$-essence field $\phi$. $H$ and $a$ are extracted from SNe Ia data and using the differential equation the time dependence of the field $\phi$ is found to be: $\phi(t) \sim \lambda_0 + \lambda_1 t + \lambda_2 t^2$. The constants $\lambda_i$ have been determined. The time dependence is similar to that of the quintessence scalar field (having canonical kinetic energy) responsible for homogeneous inflation. Furthermore, the scaling relation and the obtained time dependence of the field $\phi$ is used to determine the $X$-dependence of the function $F(X)$.Comment: 8 pages, 5 figures, Late

Language and anxiety: an ethnographic study of international postgraduate students

This paper presents some findings from an ethnographic study of international postgraduate students at a university in the South of England, which involved interviews and participant observation over a twelve-month academic year. One of the major themes that emerged from this research was students’ anxiety over their level of English language. Although all students entered their course with a minimum level of IELTS 6, the majority felt disadvantaged by particularly poor spoken English, and suffered feelings of anxiety, shame and inferiority. Low self-confidence meant that they felt ill-equipped to engage in class discussion and in social interaction which used English as the medium of communication. A common reaction to stress caused by language problems was to retreat into monoethnic communication with students from the same country, further inhibiting progress in language. Whilst some linguistic progress was made by nearly all students during the academic sojourn, the anxiety suffered by students in the initial stage must not be underestimated, and appropriate support systems must be put in place to alleviate their distress