Utility Versus Creativity in Biomedical Musification

Sonification techniques provide a well-documented methodology for auditory display of data, which can be particularly useful when combined with other display types for the presentation and analysis of complex data streams (including multidimensional data arrays). Creativity in sonification often becomes a function of the chosen mapping scheme, whereby deliberate specification of data mapping to auditory events provides opportunities to creative expression. Thus, such techniques can be used as part of the music creation process, if mapping strategies are carefully designed with specific musical outcomes in mind. Increasingly this particular type of sonification is therefore referred to as musification. However, the creative decision making process involved in designing these mapping strategies can by its nature compromise the presentation of the data in terms of accuracy, and perhaps in terms of overall utility. This article reviews an example of this work with both creative and utilitarian ends, and considers techniques for the evaluation of the success versus the utility that musification of complex biological or biomedical data might achieve, whilst maintaining the necessary integrity of the source data

Membrane Ballooning in Aggregated Platelets is Synchronised and Mediates a Surge in Microvesiculation:Synchronised ballooning and microvesiculation

AbstractHuman platelet transformation into balloons is part of the haemostatic response and thrombus architecture. Here we reveal that in aggregates of platelets in plasma, ballooning in multiple platelets occurs in a synchronised manner. This suggests a mechanism of coordination between cells, previously unrecognised. We aimed to understand this mechanism, and how it may contribute to thrombus development. Using spinning-disc confocal microscopy we visualised membrane ballooning in human platelet aggregates adherent to collagen-coated surfaces. Within an aggregate, multiple platelets undergo ballooning in a synchronised fashion, dependent upon extracellular calcium, in a manner that followed peak cytosolic calcium levels in the aggregate. Synchrony was observed in platelets within but not between aggregates, suggesting a level of intra-thrombus communication. Blocking phosphatidylserine, inhibiting thrombin or blocking PAR1 receptor, largely prevented synchrony without blocking ballooning itself. In contrast, inhibition of connexins, P2Y12, P2Y1 or thromboxane formation had no effect on synchrony or ballooning. Importantly, synchronised ballooning was closely followed by a surge in microvesicle formation, which was absent when synchrony was blocked. Our data demonstrate that the mechanism underlying synchronised membrane ballooning requires thrombin generation acting effectively in a positive feedback loop, mediating a subsequent surge in procoagulant activity and microvesicle release.</jats:p

Predictors of hospital admission when presenting with acute-on-chronic breathlessness: binary logistic regression

BackgroundBreathlessness due to medical conditions commonly causes emergency department presentations and unplanned admissions. Acute-on-chronic breathlessness is a reason for 20% of emergency presentations by ambulance with 69% of these being admitted. The emergency department may be inappropriate for many presenting with acute-on-chronic breathlessness. AimTo examine predictors of emergency department departure status in people with acute-on-chronic breathlessness. Design, Setting and MethodSecondary analysis of patient-report survey and clinical record data from consecutive eligible attendees by ambulance. Variables associated with emergency department departure status (unifactorial analyses; p<0.05) were included in a binary logistic regression model. The study was conducted in a single tertiary hospital.Consecutive survey participants presenting in May 2015 with capacity were eligible. 1,212/1,345 surveys were completed. 245/1,212 presented with acute-on-chronic breathlessness, 171 of whom consented to clinical record review and were included in this analysis. ResultsIn the final model, the odds of admission were increased with every extra year of age [OR 1.041 (95% CI: 1.016 to 1.066)], having talked to a specialist doctor about breathlessness [9.262 (1.066 to 80.491)] and having a known history of a heart condition [4.177 (1.680 to 10.386)]. Odds of admission were decreased with every percentage increase in oxygen saturation [0.826 (0.701 to 0.974)].Conclusion Older age, lower oxygen saturation, having talked to a specialist, and having history of a cardiac condition predict hospital admission in people presenting to the emergency department with acute-on-chronic breathlessness. These clinical factors could be assessed in the community and may inform the decision regarding conveyance

Knowledge and information needs of informal caregivers in palliative care : a qualitative systematic review

Objectives: To review current understanding of the knowledge and information needs of informal caregivers in palliative settings. Data sources: Seven electronic databases were searched for the period January 1994–November 2006: Medline, CINAHL, PsychINFO, Embase, Ovid, Zetoc and Pubmed using a meta-search engine (Metalib®). Key journals and reference lists of selected papers were hand searched. Review methods: Included studies were peer-reviewed journal articles presenting original research. Given a variety of approaches to palliative care research, a validated systematic review methodology for assessing disparate evidence was used in order to assign scores to different aspects of each study (introduction and aims, method and data, sampling, data analysis, ethics and bias, findings/results, transferability/generalizability, implications and usefulness). Analysis was assisted by abstraction of key details of study into a table. Results: Thirty-four studies were included from eight different countries. The evidence was strongest in relation to pain management, where inadequacies in caregiver knowledge and the importance of education were emphasized. The significance of effective communication and information sharing between patient, caregiver and service provider was also emphasized. The evidence for other caregiver knowledge and information needs, for example in relation to welfare and social support was weaker. There was limited literature on non-cancer conditions and the care-giving information needs of black and minority ethnic populations. Overall, the evidence base was predominantly descriptive and dominated by small-scale studies, limiting generalizability. Conclusions: As palliative care shifts into patients’ homes, a more rigorously researched evidence base devoted to understanding caregivers knowledge and information needs is required. Research design needs to move beyond the current focus on dyads to incorporate the complex, three-way interactions between patients, service providers and caregivers in end-of-life care setting

“E-books are good if there are no copies left”: a survey of e-book usage at UWE Library Services

This article outlines research carried out with students and academic staff at a large UK university library on how e-books are being used for learning, teaching and research. It was discovered that e-books are meeting many of users’ needs,especially in terms of accessibility, but there are still concerns about subject coverage and the impact on students’ learning. There are various reasons why ebooksare beneficial in developing an academic library collection, most particularly for reference materials and essential readings, but librarians need to work closely with academic staff to integrate use of e-books effectively into learning and teaching, taking care that licence and access implications are better understood. The drivers to the use of e-books appear to be outweighing the barriers, although the latter will require considerable effort on the part of librarians within their institutions and also in terms of communicating concerns to e-book providers

Training in positivity for stroke? A qualitative study of acceptability of use of Positive Mental Training (PosMT) as a tool to assist stroke survivors with post-stroke psychological problems and in coping with rehabilitation.

BACKGROUND: Post-stroke psychological problems predict poor recovery, while positive affect enables patients to focus on rehabilitation and may improve functional outcomes. Positive Mental Training (PosMT), a guided self-help audio shows promise as a tool in promoting positivity, optimism and resilience. OBJECTIVE: To assess acceptability of training in positivity with PosMT for prevention and management of post-stroke psychological problems and to help with coping with rehabilitation. METHODS: A modified PosMT tool consisted of 12 audio tracks each lasting 18 minutes, one listened to every day for a week. Survivors and carers were asked to listen for 4 weeks, but could volunteer to listen for more. Interviews took place about experiences of the tool after 4 and 12 weeks. SUBJECTS: 10 stroke survivors and 5 carers from Stroke Support Groups in the UK. RESULTS: Three stroke survivors did not engage with the tool. The remainder reported positive physical and psychological benefits including improved relaxation, better sleep and reduced anxiety after four weeks. Survivors who completed the programme gained a positive outlook on the future, increased motivation, confidence and ability to cope with rehabilitation. No adverse effects were reported. CONCLUSIONS: The PosMT shows potential as a tool for coping with rehabilitation and overcoming post-stroke psychological problems including anxiety and depression.This work was supported through the Royal College of General Practitioners (RCGP), UK Scientific Foundation Board, United Kingdom.This is the author accepted manuscript. The final version is available from IOS Press via https://doi.org/10.3233/NRE-16141