Narrative Medicine: Community Poetry Heals Young and Old

This is a snapshot of a service learning course founded on narrative medicine, a clinical practice designed to replace impersonal care with empathic listening. By utilizing poetry therapy techniques among nursing home populations, a program called HPU LifeLines promotes a community literacy of illness and provides psychological and physical benefits to elders and students alike through intergenerational relationships sustained by a community writing infrastructure

Influence of Visual Feedback On Dynamic Balance Control in Chronic Stroke Survivors

Chronic stroke survivors have an increased incidence of falls during walking, suggesting changes in dynamic balance control post-stroke. Despite this increased incidence of falls during walking, balance control is often studied only in standing. The purpose of this study was to quantify deficits in dynamic balance control during walking, and to evaluate the influence of visual feedback on this control in stroke survivors. Ten individuals with chronic stroke, and ten neurologically intact individuals participated in this study. Walking performance was assessed while participants walked on an instrumented split-belt treadmill with different types of visual feedback. Dynamic balance control was quantified using both the extent of center of mass (COM) movement in the frontal plane over a gait cycle (COM sway), and base of support (step width). Stroke survivors walked with larger COM sway and wider step widths compared to controls. Despite these baseline differences, both groups walked with a similar ratio of step width to COM sway (SW/COM). Providing a stationary target with a laser reference of body movement reduced COM sway only in the stroke group, indicating that visual feedback of sway alters dynamic balance control post-stroke. These results demonstrate that stroke survivors attempt to maintain a similar ratio of step width to COM movement, and visual cues can be used to help control COM movement during walking post-stroke

Junior Recital

List of performers and performances

Rotamer-Restricted Fluorogenicity Of The Bis-Arsenical ReAsH

Fluorogenic dyes such as FlAsH and ReAsH are used widely to localize, monitor, and characterize proteins and their assemblies in live cells. These bis-arsenical dyes can become fluorescent when bound to a protein containing four proximal Cys thiols—a tetracysteine (Cys4) motif. Yet the mechanism by which bis-arsenicals become fluorescent upon binding a Cys4 motif is unknown, and this nescience limits more widespread application of this tool. Here we probe the origins of ReAsH fluorogenicity using both computation and experiment. Our results support a model in which ReAsH fluorescence depends on the relative orientation of the aryl chromophore and the appended arsenic chelate: the fluorescence is rotamer-restricted. Our results do not support a model in which fluorogenicity arises from the relief of ring strain. The calculations identify those As–aryl rotamers that support fluorescence and those that do not and correlate well with prior experiments. The rotamer-restricted model we propose is supported further by biophysical studies: the excited-state fluorescence lifetime of a complex between ReAsH and a protein bearing a high-affinity Cys4 motif is longer than that of ReAsH-EDT2, and the fluorescence intensity of ReAsH-EDT2 increases in solvents of increasing viscosity. By providing a higher resolution view of the structural basis for fluorogenicity, these results provide a clear strategy for the design of more selective bis-arsenicals and better-optimized protein targets, with a concomitant improvement in the ability to characterize previously invisible protein conformational changes and assemblies in live cells

How did a Quality Premium financial incentive influence antibiotic prescribing in primary care? Views of Clinical Commissioning Group and general practice professionals

Background: The Quality Premium (QP) was introduced for Clinical Commissioning Groups (CCGs) in England to optimize antibiotic prescribing, but it remains unclear how it was implemented. Objectives: To understand responses to the QP and how it was perceived to influence antibiotic prescribing. Methods: Semi-structured telephone interviews were conducted with 22 CCG and 19 general practice professionals. Interviews were analysed thematically. Results: The findings were organized into four categories. (i) Communication: this was perceived as unstructured and infrequent, and CCG professionals were unsure whether they received QP funding. (ii) Implementation: this was influenced by available local resources and competing priorities, with multifaceted and tailored strategies seen as most helpful for engaging general practices. Many antimicrobial stewardship (AMS) strategies were implemented independently from the QP, motivated by quality improvement. (iii) Mechanisms: the QP raised the priority of AMS nationally and locally, and provided prescribing targets to aim for and benchmark against, but money was not seen as reinvested into AMS. (iv) Impact and sustainability: the QP was perceived as successful, but targets were considered challenging for a minority of CCGs and practices due to contextual factors (e.g. deprivation, understaffing). CCG professionals were concerned with potential discontinuation of the QP and prescribing rates levelling off. Conclusions: CCG and practice professionals expressed positive views of the QP and associated prescribing targets and feedback. The QP helped influence change mainly by raising the priority of AMS and defining change targets rather than providing additional funding. To maximize impact, behavioural mechanisms of financial incentives should be considered pre-implementation

Overview on spectral line source finding and visualisation

Here I will outline successes and challenges for finding spectral line sources in large data cubes that are dominated by noise. This is a 3D challenge as the sources we wish to catalog are spread over several spatial pixels and spectral channels. While 2D searches can be applied, e.g., channel by channel, optimal searches take into account the 3-dimensional nature of the sources. In this overview I will focus on HI 21-cm spectral line source detection in extragalactic surveys, in particular HIPASS, the "HI Parkes All-Sky Survey" and WALLABY, the "ASKAP HI All-Sky Survey". I use the original HIPASS data to highlight the diversity of spectral signatures of galaxies and gaseous clouds, both in emission and absorption. Among others, I report the discovery of a 680 km/s wide HI absorption trough in the megamaser galaxy NGC 5793. Issues such as source confusion and baseline ripples, typically encountered in single-dish HI surveys, are much reduced in interferometric HI surveys. Several large HI emission and absorption surveys are planned for the Australian Square Kilometre Array Pathfinder (ASKAP): here we focus on WALLABY, the 21-cm survey of the sky (Dec < +30 degr; z < 0.26) which will take about one year of observing time with ASKAP. Novel phased array feeds ("radio cameras") will provide 30 square degrees instantaneous field-of-view. WALLABY is expected to detect more than 500 000 galaxies, unveil their large-scale structures and cosmological parameters, detect their extended, low-surface brightness disks as well as gas streams and filaments between galaxies. It is a precursor for future HI surveys with SKA Phase I and II, exploring galaxy formation and evolution. The compilation of highly reliable and complete source catalogs will require sophisticated source-finding algorithms as well as accurate source parametrisation.Comment: 14 pages, 6 figures, PASA Special Issue on "Source Finding & Visualisation", submitte

The laurentian record of neoproterozoic glaciation, tectonism, and eukaryotic evolution in Death Vally, California

Neoproterozoic strata in Death Valley, California contain eukaryotic microfossils and glacial deposits that have been used to assess the severity of putative Snowball Earth events and the biological response to extreme environmental change. These successions also contain evidence for syn-sedimentary faulting that has been related to the rifting of Rodinia, and in turn the tectonic context of the onset of Snowball Earth. These interpretations hinge on local geological relationships and both regional and global stratigraphic correlations. Here we present new geological mapping, measured stratigraphic sections, carbon and strontium isotope chemostratigraphy, and micropaleontology from the Neoproterozoic glacial deposits and bounding strata in Death Valley. These new data enable us to refine regional correlations both across Death Valley and throughout Laurentia, and construct a new age model for glaciogenic strata and microfossil assemblages. Particularly, our remapping of the Kingston Peak Formation in the Saddle Peak Hills and near the type locality shows for the first time that glacial deposits of both the Marinoan and Sturtian glaciations can be distinguished in southeastern Death Valley, and that beds containing vase-shaped microfossils are slump blocks derived from the underlying strata. These slump blocks are associated with multiple overlapping unconformities that developed during syn-sedimentary faulting, which is a common feature of Cyrogenian strata along the margin of Laurentia from California to Alaska. With these data, we conclude that all of the microfossils that have been described to date in Neoproterozoic strata of Death Valley predate the glaciations and do not bear on the severity, extent or duration of Neoproterozoic Snowball Earth events

Sensory Electrical Stimulation Improves Foot Placement during Targeted Stepping Post-Stroke

Proper foot placement is vital for maintaining balance during walking, requiring the integration of multiple sensory signals with motor commands. Disruption of brain structures post-stroke likely alters the processing of sensory information by motor centers, interfering with precision control of foot placement and walking function for stroke survivors. In this study, we examined whether somatosensory stimulation, which improves functional movements of the paretic hand, could be used to improve foot placement of the paretic limb. Foot placement was evaluated before, during, and after application of somatosensory electrical stimulation to the paretic foot during a targeted stepping task. Starting from standing, twelve chronic stroke participants initiated movement with the non-paretic limb and stepped to one of five target locations projected onto the floor with distances normalized to the paretic stride length. Targeting error and lower extremity kinematics were used to assess changes in foot placement and limb control due to somatosensory stimulation. Significant reductions in placement error in the medial–lateral direction (p = 0.008) were observed during the stimulation and post-stimulation blocks. Seven participants, presenting with a hip circumduction walking pattern, had reductions (p = 0.008) in the magnitude and duration of hip abduction during swing with somatosensory stimulation. Reductions in circumduction correlated with both functional and clinical measures, with larger improvements observed in participants with greater impairment. The results of this study suggest that somatosensory stimulation of the paretic foot applied during movement can improve the precision control of foot placement

Feasibility of a community pharmacy antimicrobial stewardship intervention (PAMSI): an innovative approach to improve patients’ understanding of their antibiotics

Background Community pharmacy staff have an opportunity to play a pivotal role in antimicrobial stewardship (AMS) due to their expertise in medicines and accessibility to patients. Objectives To develop and test the feasibility of a pharmacy AMS intervention (PAMSI) to increase community pharmacy staff’s capability, opportunity and motivation to check antibiotic appropriateness and provide self-care and adherence advice when dispensing antibiotics. Methods The PAMSI was centred around an Antibiotic Checklist, completed by patients and pharmacy staff, to facilitate personalized advice to the patient, based on their reported knowledge. An educational webinar for staff and patient-facing materials were also developed. Staff and patients completing Antibiotic Checklists were invited to provide feedback via questionnaires. Results In February 2019, 12 community pharmacies in England trialled the intervention. Forty-three pharmacy staff evaluated the educational webinar and reported increases in their understanding, confidence, commitment and intention to use the tools provided to give adherence and self-care advice. Over 4 weeks, 931 Antibiotic Checklists were completed. Staff reported being more focused on giving advice and able to address patients’ knowledge gaps (mainly: likely symptom duration; alcohol and food consumption advice; possible side effects from antibiotics; returning unused antibiotics to the pharmacy), resulting in increased self-reported effective and meaningful conversations. Conclusions Implementation of a PAMSI is feasible and effectively promotes AMS. Pharmacy staff and commissioners should consider this within their AMS plans. An optional digital format of the Antibiotic Checklist should be explored, for patients who are not collecting their antibiotic prescriptions themselves, and to save printing costs

Surface Temperature Measurements from a Stator Vane Doublet in a Turbine Engine Afterburner Flame Using a YAG:Tm Thermographic Phosphor

Luminescence-based surface temperature measurements were obtained from a YAG:Tm-coated stator vane doublet exposed to the afterburner flame of a J85 test engine at University of Tennessee Space Institute (UTSI). The objective of the testing was to demonstrate that reliable surface temperatures based on luminescence decay of a thermographic phosphor producing short-wavelength emission could be obtained from the surface of an actual engine component in a high gas velocity, highly radiative afterburner flame environment. YAG:Tm was selected as the thermographic phosphor for its blue emission at 456 nm (1D23F4 transition) and UV emission at 365 nm (1D23H6 transition) because background thermal radiation is lower at these wavelengths, which are shorter than those of many previously used thermographic phosphors. Luminescence decay measurements were acquired using a probe designed to operate in the afterburner flame environment. The probe was mounted on the sidewall of a high-pressure turbine vane doublet from a Honeywell TECH7000 turbine engine coated with a standard electron-beam physical vapor deposited (EB-PVD) 200-m-thick TBC composed of yttria-stabilized zirconia (YSZ) onto which a 25-m-thick YAG:Tm thermographic phosphor layer was deposited by solution precursor plasma spray (SPPS). Spot temperature measurements were obtained by measuring luminescence decay times at different afterburner power settings and then converting decay time to temperature via calibration curves. Temperature measurements using the decays of the 456 and 365 nm emissions are compared. While successful afterburner environment measurements were obtained to about 1300C with the 456 nm emission, successful temperature measurements using the 365 nm emission were limited to about 1100C due to interference by autofluorescence of probe optics at short decay times