Resolved Imaging of the HD191089 Debris Disc

Two thirds of the F star members of the 12 Myr old Beta Pictoris Moving Group (BPMG) show significant excess emission in the mid-infrared, several million years after the expected dispersal of the protoplanetary disc. Theoretical models of planet formation suggest that this peak in the mid-infrared emission could be due to the formation of Pluto-sized bodies in the disc, which ignite the collisional cascade and enhance the production of small dust. Here we present resolved mid-infrared imaging of the disc of HD191089 (F5V in the BPMG) and consider its implications for the state of planet formation in this system. HD191089 was observed at 18.3 microns using T-ReCS on Gemini South and the images were compared to models of the disc to constrain the radial distribution of the dust. The emission observed at 18.3 microns is shown to be significantly extended beyond the PSF at a position angle of 80 degrees. This is the first time dust emission has been resolved around HD191089. Modelling indicates that the emission arises from a dust belt from 28-90 AU, inclined at 35 degrees from edge on with very little emission from the inner 28AU of the disc, indicating the presence of an inner cavity. The steep slope of the inner edge is more consistent with truncation by a planet than with ongoing stirring. A tentative brightness asymmetry F(W)/F(E)=0.80+/-0.12 (1.8 sigma) between the two sides of the disc could be evidence for perturbations from a massive body on an eccentric orbit in the system.Comment: 11 Pages Accepted to MNRA

Learning health systems need to bridge the ‘two cultures’ of clinical informatics and data science

Background UK health research policy and plans for population health management are predicated upon transformative knowledge discovery from operational 'Big Data'. Learning health systems require not only data, but feedback loops of knowledge into changed practice. This depends on knowledge management and application, which in turn depends upon effective system design and implementation. Biomedical informatics is the interdisciplinary field at the intersection of health science, social science and information science and technology that spans this entire scope. Issues In the UK, the separate worlds of health data science (bioinformatics, 'Big Data') and effective healthcare system design and implementation (clinical informatics, 'Digital Health') have operated as 'two cultures'. Much National Health Service and social care data is of very poor quality. Substantial research funding is wasted on 'data cleansing' or by producing very weak evidence. There is not yet a sufficiently powerful professional community or evidence base of best practice to influence the practitioner community or the digital health industry. Recommendation The UK needs increased clinical informatics research and education capacity and capability at much greater scale and ambition to be able to meet policy expectations, address the fundamental gaps in the discipline's evidence base and mitigate the absence of regulation. Independent evaluation of digital health interventions should be the norm, not the exception. Conclusions Policy makers and research funders need to acknowledge the existing gap between the 'two cultures' and recognise that the full social and economic benefits of digital health and data science can only be realised by accepting the interdisciplinary nature of biomedical informatics and supporting a significant expansion of clinical informatics capacity and capability.</p

Reducing Hospital-Acquired Pressure Injuries through Measure-vention

The Braden scale may be outdated in the critical care setting to prevent hospital acquired pressure injuries (HAPIs). Applying evidence from the literature on Braden subscales and using “Measure-vention” for quality improvement, a quality improvement project using Braden subscales implemented in a 30-bed ICU reduced HAPIs by 63.5 percent

Successfully Spreading Improvement Work Using a Proven Framework

Background: Hospital-acquired pressure injuries (HAPIs) are rising in the United States, increasing six percent between 2014 and 2017 alone (Agency for Healthcare Research and Quality [AHRQ], 2019). Approximately 60,000 patients die from complications related to HAPI annually (Padula & Delarmente, 2019). Local Problem: In a Northern California Level II Trauma acute care hospital, HAPIs increased by 422% over two years, 2016-2018, with most of the HAPIs occurring in the Intensive Care Unit (ICU). Context: This project sought to spread the Interventions by Braden Subscale protocol to seven medical-surgical units in the hospital using the Institute for Healthcare Improvement’s (IHI) Framework for Spread and Lewin’s Change Management Theory. Interventions: A baseline survey was disseminated to ascertain the level of knowledge on the IHI Framework for Spread, and education was subsequently developed based on the results. The Interventions by Braden Subscale protocol was spread utilizing the framework to multiple medical-surgical units with the goal of reducing HAPIs. Outcome Measures: Improve the level of knowledge among nurse leaders by 30% on the IHI Framework for Spread and reduce HAPIs in the medical-surgical units by 30%. Results: The successful spread led to a net reduction of 34% in the incidence of all-stage HAPIs. No improvement was seen in the level of knowledge among nursing leaders on the IHI Framework for Spread. Results were analyzed from the pre-and post-education surveys and were found to not be statistically significant and may have been impacted by the SARS-COV-2 pandemic. Conclusions: Using a structured framework to spread improvement work demonstrated benefit in this project and became the platform for the development of a committee where improvement work could be reported in a standardized way, monitored for performance, spread, and sustained over time

Comparing the effects of sun exposure and vitamin D supplementation on vitamin D insufficiency, and immune and cardio-metabolic function: the Sun Exposure and Vitamin D Supplementation (SEDS) Study

BACKGROUND Adults living in the sunny Australian climate are at high risk of skin cancer, but vitamin D deficiency (defined here as a serum 25-hydroxyvitamin D (25(OH)D) concentration of less than 50 nmol/L) is also common. Vitamin D deficiency may be a risk factor for a range of diseases. However, the optimal strategies to achieve and maintain vitamin D adequacy (sun exposure, vitamin D supplementation or both), and whether sun exposure itself has benefits over and above initiating synthesis of vitamin D, remain unclear. The Sun Exposure and Vitamin D Supplementation (SEDS) Study aims to compare the effectiveness of sun exposure and vitamin D supplementation for the management of vitamin D insufficiency, and to test whether these management strategies differentially affect markers of immune and cardio-metabolic function. METHODS/DESIGN The SEDS Study is a multi-centre, randomised controlled trial of two different daily doses of vitamin D supplementation, and placebo, in conjunction with guidance on two different patterns of sun exposure. Participants recruited from across Australia are aged 18-64 years and have a recent vitamin D test result showing a serum 25(OH)D level of 40-60 nmol/L. DISCUSSION This paper discusses the rationale behind the study design, and considers the challenges but necessity of data collection within a non-institutionalised adult population, in order to address the study aims. We also discuss the challenges of participant recruitment and retention, ongoing engagement of referring medical practitioners and address issues of compliance and participant retention. TRIAL REGISTRATION Australia New Zealand Clinical Trials Registry: ACTRN12613000290796 Registered 14 March 2013

Interview with Jean Wyatt

Jean Wyatt talks about her involvement with the County Fairhttps://digital.kenyon.edu/ps_interviews/1022/thumbnail.jp

Fibrinogen regulates the cytotoxicity of mycobacterial trehalose dimycolate, but is not required for cell recruitment, cytokine response, or control of mycobacterial infection

During inflammatory responses and wound healing, the conversion of soluble fibrinogen to fibrin, an insoluble extracellular matrix, long has been assumed to create a scaffold for the migration of leukocytes and fibroblasts. Previous studies concluded that fibrinogen is a necessary cofactor for mycobacterial trehalose 6,6-dimycolate-induced responses, because trehalose dimycolate-coated beads, to which fibrinogen was ad-sorbed, were more inflammatory than those to which other plasma proteins were adsorbed. Herein, we investigate roles for fibrin(ogen) in an in vivo model of mycobacterial granuloma formation and in infection with Mycobacterium tuberculosis, the causative agent of tuberculosis. In wild-type mice, the subcutaneous injection of trehalose dimycolate-coated polystyrene microspheres, suspended within Matrigel, elicited a pyogranulomatous response during the course of 12 days. In fibrinogen-deficient mice, neutrophils were recruited but a more suppurative lesion developed, with the marked degradation and disintegration of the matrix. Compared to that in wild-type mice, the early formation of granulation tissue in fibrinogen-deficient mice was edematous, hypocellular, and disorganized. These deficiencies were complemented by the addition of exogenous fibrinogen. The absence of fibrinogen had no effect on cell recruitment or cytokine production i

Degree show learning curves

Degree shows are an integral part of a creative practice higher education, but sitting outside the curriculum, they remain a largely un-studied entity. After taking part in several of their own student exhibitions, two LCC design graduates undertook a summer residency with SUARTs, to investigate the concept of the degree show. By speaking to a number of key LCC stakeholders, the paper shares multiple perspectives on the purpose, drawbacks, value and future of the degree show, and offers advice for students about to undertake their own exhibitions

What is the evidence base for integrating health and environmental approaches into the school context to nurture healthy and environmentally aware young people? A systematic scoping review of global evidence

This scoping review collates empirical and grey literature that examines how schools are acting to nurture healthier and more environmentally aware young people through integrated approaches. Over the last twenty years, integration has been increasing within school contexts. Approaches include teaching and learning, physical environmental adaptations, developing ecologically focused policy, and reorienting wider school culture. We noted a developing discourse around what constitutes evidence in this emerging interdisciplinary field. Developing a better understanding of integrated approaches, and an evidence base of what works and how, could inform interdisciplinary collaboration and enable a clearer message to be communicated to stakeholders about how the school context can nurture healthier and more environmentally aware young people.PostprintPeer reviewe