REAL-TIME HAPTIC FEEDBACK SYSTEM VALIDITY AND ITS FESIBILITY FOR RUNNERS IN A REAL-WORLD TRAINING ENVIRONMENT

This study sought to assess the use of a novel integrated haptic feedback system for use during running; specifically, the study aimed to 1) assess the validity of the system in measuring trunk inclination and step rate during running and 2) assess the feasibility of the system to modify running technique in a real-world training environment. Ten recreational runners initially ran on an instrumented treadmill in a laboratory where trunk angle and step rate data were collected from an IMU-based system and compared against 3D motion capture and instrumented treadmill data. Participants then completed three outdoor training sessions using the haptic system to modify step rate. The haptic system was found to be valid when compared to gold-standard laboratory methods for measuring step rate (max 1.1% difference). It was also found to be feasible and intuitive in providing real-time feedback via a vibrating wrist-mounted unit in a real-world training environment. Overall, the system showed promise for application to real-world gait retraining, however further refinements are needed to improve the validity of trunk inclination measurements

Development of a HERT Trained Interprofessional Student Decontamination Team for Hospital Mass Casualty Response

Introduction: FEMA’s Hospital Emergency Response Training (HERT) prepares healthcare workers to decontaminate patients during a mass casualty incident. This depletes the emergency department (ED) staff when they are needed most though. Developing an interprofessional student composed HERT team to screen and decontaminate affected populations will allow ED staff to handle more medically complex situations during a mass casualty event. Methods: Likert scale surveys were conducted among ED physicians and nurses at Jefferson Hospital and HERT trained medical and nursing students at Jefferson University. These were to evaluate the training program and ED staff opinions of utilizing a student HERT team to respond to a mass casualty events compared to standard ED practices without student involvement. The survey results were tabulated and averaged in Excel. Results: Between February and September 2019, 46 students and 26 ED staff completed the HERT training. The student evaluation of the program was excellent (4.9/5) as was the value of the student decontamination team for mass casualty response (4.95/5). Discussion: These findings suggest that the ED staff highly values the involvement of a student HERT team in the disaster plan. It also supports student interest in HERT and that HERT trained students feel prepared to respond if necessary. This is essential to establish the effectiveness and efficacy of utilizing a student HERT team to ensure adequate staff is available in the case of a mass casualty event. This model is one that should be considered for academic centers that are affiliated with nursing and medical schools

Fully Dynamic Numerical Simulation of the Hammer Peening Fatigue Life Improvement Technique

AbstractThis paper presents the results of the development process for a Finite Element Analysis of the Hammer Peening Fatigue Life Improvement Technique. The Fatigue Life of welded structures is still in need for improvement. The sheer number of Fatigue Live Improvement Techniques parameters leads to the need of simulating and predicting their results. For this study, two different materials were used, an Austenitic Stainless Steel and a Duplex Stainless Steel. Non-load carrying cruciform weld joints were produced and fatigue tested, with and without the Hammer Peening treatment. Finally a FEA code (ABAQUS®) was used to simulate the Hammer Peening technique. A fully dynamic model was used, combined with the Chaboche Kinematic-hardening material model and different Hammering parameter experimentally determined. Alongside the residual stresses introduced by the Hammer Peening Technique, the predicted Fatigue Life using the FEA model were compared with the experimental results, showing a very good agreement between them. Also the effect of several parameters, like the hammering impact load, the hammer positioning or the number of hammering passages, were analysed as a way to validate the FEA model. The most important result was of course the Fatigue Strength Gain factor, for the Hammer Peening Technique, that in both cases was found to be superior to 1.3

The Deep Water Abundance on Jupiter: New Constraints from Thermochemical Kinetics and Diffusion Modeling

We have developed a one-dimensional thermochemical kinetics and diffusion model for Jupiter's atmosphere that accurately describes the transition from the thermochemical regime in the deep troposphere (where chemical equilibrium is established) to the quenched regime in the upper troposphere (where chemical equilibrium is disrupted). The model is used to calculate chemical abundances of tropospheric constituents and to identify important chemical pathways for CO-CH4 interconversion in hydrogen-dominated atmospheres. In particular, the observed mole fraction and chemical behavior of CO is used to indirectly constrain the Jovian water inventory. Our model can reproduce the observed tropospheric CO abundance provided that the water mole fraction lies in the range (0.25-6.0) x 10^-3 in Jupiter's deep troposphere, corresponding to an enrichment of 0.3 to 7.3 times the protosolar abundance (assumed to be H2O/H2 = 9.61 x 10^-4). Our results suggest that Jupiter's oxygen enrichment is roughly similar to that for carbon, nitrogen, and other heavy elements, and we conclude that formation scenarios that require very large (>8 times solar) enrichments in water can be ruled out. We also evaluate and refine the simple time-constant arguments currently used to predict the quenched CO abundance on Jupiter, other giant planets, and brown dwarfs.Comment: 42 pages, 7 figures, 4 tables, with note added in proof. Accepted for publication in Icarus [in press

Temporal trends and patterns of infective endocarditis in a Chinese population:A territory-wide study in Hong Kong (2002-2019)

BACKGROUND: The characteristics of infective endocarditis (IE) in Asians are poorly understood. Therefore, we aim to describe the epidemiological trends and clinical features of IE in Hong Kong. METHODS: All patients with incident IE from 2002–2019 in a territory-wide clinical database in Hong Kong were identified. We studied the age- and sex-adjusted and one-year mortality of IE between 2002 and 2019 and identified significant contributors to 1-year all-cause death using the attributable fraction. We used propensity score and inverse propensity of treatment weighting to study the association of surgery with mortality. FINDINGS: A total of 5139 patients (60.4 ± 18.2years, 37% women) were included. The overall incidence of IE was 4.9 per 100,000 person-year, which did not change over time (P = 0.17). Patients in 2019 were older and more comorbid than those in 2002. The one-year crude mortality rate was 30% in 2002, which did not change significantly over time (P = 0.10). Between 2002 and 2019, the rate of surgery increased and was associated with a 51% risk reduction in 1-year all-cause mortality (Hazard Ratio 0.49 [0.28–0.87], P = 0.015). Advanced age (attributable fraction 19%) and comorbidities (attributable fraction 15%) were significant contributors to death. INTERPRETATION: The incidence of IE in Hong Kong did not change between 2002 and 2019. Patients with IE in 2019 were older and had more comorbidities than those in 2002. Mortality of IE remains persistently high in Hong Kong. Together, these data can guide public health strategies to improve the outcomes of patients with IE. FUNDING: This work was supported by Sanming Project of Medicine in Shenzhen, China [No. SZSM201911020] and HKU-SZH Fund for Shenzhen Key Medical Discipline [No. SZXK2020081]

Inhibiting cardiac myeloperoxidase alleviates the relaxation defect in hypertrophic cardiomyocytes.

AIMS: Hypertrophic cardiomyopathy (HCM) is characterised by cardiomyocyte hypertrophy and disarray, and myocardial stiffness due to interstitial fibrosis, which result in impaired left ventricular filling and diastolic dysfunction. The latter manifests as exercise intolerance, angina, and dyspnoea. There is currently no specific treatment for improving diastolic function in HCM. Here, we investigated whether myeloperoxidase (MPO) is expressed in cardiomyocytes and provides a novel therapeutic target for alleviating diastolic dysfunction in HCM. METHODS AND RESULTS: Human cardiomyocytes derived from control induced pluripotent stem cells (iPSC-CMs) were shown to express MPO, with MPO levels being increased in iPSC-CMs generated from two HCM patients harbouring sarcomeric mutations in the MYBPC3 and MYH7 genes. The presence of cardiomyocyte MPO was associated with higher chlorination and peroxidation activity, increased levels of 3-chlorotyrosine-modified cardiac myosin binding protein-C (MYBPC3), attenuated phosphorylation of MYBPC3 at Ser-282, perturbed calcium signalling, and impaired cardiomyocyte relaxation. Interestingly, treatment with the MPO inhibitor, AZD5904, reduced 3-chlorotyrosine-modified MYBPC3 levels, restored MYBPC3 phosphorylation, and alleviated the calcium signalling and relaxation defects. Finally, we found that MPO protein was expressed in healthy adult murine and human cardiomyocytes, and MPO levels were increased in diseased hearts with left ventricular hypertrophy. CONCLUSION: This study demonstrates that MPO inhibition alleviates the relaxation defect in hypertrophic iPSC-CMs through MYBPC3 phosphorylation. These findings highlight cardiomyocyte MPO as a novel therapeutic target for improving myocardial relaxation associated with HCM, a treatment strategy which can be readily investigated in the clinical setting, given that MPO inhibitors are already available for clinical testing. TRANSLATIONAL PERSPECTIVE: There are currently no specific therapies for improving diastolic function in patients with HCM. We show for the first time that myeloperoxidase (MPO) is present in and is up-regulated in cardiomyocytes derived from human iPSCs obtained from HCM patients, where it impairs cardiomyocyte relaxation by reducing phosphorylation of cardiac MYBPC3. Treatment with the MPO inhibitor, AZD5904, restored MYBPC3 phosphorylation and alleviated the relaxation defect, demonstrating cardiomyocyte MPO to be a novel therapeutic target for improving diastolic function in HCM, a treatment strategy which can be evaluated in HCM patients given that MPO inhibitors are already available for clinical testing

A systematic review of what factors attract and retain nurses in aged and dementia care

Aim. To present evidence-based factors for the recruitment and retention of licensed nurses caring for older people and persons with dementia. Background. The international nurse shortage crisis is intensified in the aged and dementia care sector. Strategies to address this crisis rely on qualitative, quasi-experimental, anecdotal and unsubstantiated literature. Design. Systematic literature review. Method. Search terms 'nurse''nurses''nursing''clinical supervision''staff''staffing''staff mix''staff levels''recruitment''retention''aged care''gerontology''gerontological''dementia care''residential''nursing home,' were used in all possible combinations and applied in a wide range of relevant academic databases, with secondary hand searches of selected bibliographies. Results. Two hundred and twenty-six papers were retrieved and scanned, with 105 chosen for closer examination that were relevant to recruitment and retention strategies for dementia and aged care nursing. Twenty-five of the papers chosen for review were rated at level 2++ to 3, according to the guidelines of the National Institute for Health and Clinical Excellence (The NICE Guidelines Manual, National Institute for Health and Clinical Excellence, London). The 25 critically reviewed papers are organised as promising strategies for (1) nurse recruitment and (2) nurse retention. Conclusions. The intrinsic rewards of the caring role attract nurses to dementia and aged care. Essential strategies linking recruitment with retention are: careful selection of student nurse clinical placements and their ongoing supervision and education, training for skills, leadership and teamwork for new and existing nurses, increased staffing levels, pay parity across different health settings and family friendly policies. Relevance to clinical practice. A family-friendly, learning environment that values and nurtures its nursing staff, in the same way as nurses are expected to value and care for their patients and residents, is critical in ensuring their retention in dementia and aged care. © 2010 Blackwell Publishing Ltd