Dashboard design and usability study for geospatially enabled information seeking to assist pandemic response and resilience

Counties in Missouri are primarily rural. Rural communities often consist of individuals with poor health, lower economic status, and lack of public health infrastructure. During the COVID- 19 pandemic, most research was centered around urban-based data and thus did not provide the full-picture of vulnerabilities present in rural counties for stakeholders to consider when proactively planning for pandemics and making policies in regards to mitigation. To bridge the gap of urban and rural data availability, our team developed two interactive COVID-19 risk assessment dashboards using a 3-step design process that included identifying dashboard functionality based on the goals of stakeholders, collecting COVID-19 risk factor data, and selecting the appropriate type of dashboard visualizations in order for stakeholder needs to be met. Database processes were also created to promote a dynamic design in which risk factors can be easily updated, added, and removed from the risk assessment as COVID-19 progresses and more evidence is collected, keeping the risk assessment relevant. Using our dashboards, users can create customized risk assessments based on six categories of risk: susceptibility, transmission, accessibility, socioeconomic, health culture, and exposure, and geospatially visualize risk throughout counties with the ability to apply a rural/urban filter. Users can also drill-down to a specific county and learn about the prevalence and magnitude of 87 risk factors while looking for spatial trends and how counties with specific risk profiles were affected by COVID-19. A usability study was conducted to ensure that our platform is meaningful and can be easily navigated to aid with pandemic mitigation, healthcare planning, and research. An optimized version of this tool would not only help with planning for COVID-19 variants, future pandemics, and research in Missouri, but also be applied to all states of the United StatIncludes bibliographical references

Exercise Makes You Feel Good, But Does Feeling Good Make You Exercise?: An Examination of Obese Dieters

Whereas exercise-induced mood enhancement has been well documented, the relationship between mood and exercise participation is less well understood. Mood states influence evaluative judgments that could plausibly influence a decision to exercise. Further, most exercise-mood research is limited to normal weight adults in response to a single exercise session. The current investigation examines the influence of (a) morning mood on exercise, (b) exercise intensity/duration on mood enhancement, and (c) daily change in mood on exercise days compared with nonexercise days in obese behavioral weight loss program (BWLP) participants. Participants (N=36) recorded morning, evening, and pre- and postexercise mood, as well as the type, duration, and intensity of exercise. Within-person analyses indicated that (a) morning mood was associated with an increased likelihood of exercising, (b) mood ratings were higher following exercise of greater intensity and duration, and (c) daily mood enhancement was associated with greater exercise initiation and greater exercise intensity. Measuring mood before and after exercise may yield important clinical information that can be used to promote physical activity in obese adults

Approaches to in vitro tissue regeneration with application for human disease modeling and drug development

Reliable in vitro human disease models that capture the complexity of in vivo tissue behaviors are crucial to gain mechanistic insights into human disease and enable the development of treatments that are effective across broad patient populations. The integration of stem cell technologies, tissue engineering, emerging biomaterials strategies and microfabrication processes, as well as computational and systems biology approaches, is enabling new tools to generate reliable in vitro systems to study the molecular basis of human disease and facilitate drug development. In this review, we discuss these recently developed tools and emphasize opportunities and challenges involved in combining these technologies toward regenerative science.National Institute for Biomedical Imaging and Bioengineering (U.S.) (Grant 5R01EB010246-02)National Center for Advancing Translational Sciences (U.S.) (Grant 1UH2TR000496)United States. Defense Advanced Research Projects Agency (Cooperative Agreement W911NF-12-2-0039

Safety of non-cuffed tunneled central venous catheters in adults with cystic fibrosis

BACKGROUND: Peripherally inserted central catheters (PICCs) are the most common route of intravenous (I.V.) access for treatment of cystic fibrosis (CF) pulmonary exacerbations, but repeated PICC placement can result in upper extremity peripheral venous stenosis. Once peripheral stenosis develops, a non-cuffed tunneled central venous catheter (NcTCVC) is an alternative route for IV access. While these are regularly used at some CF centers, the safety and complication rate compared to PICCs in adults with CF has not been reported. This study aims to describe the safety of NcTCVCs in adults with CF. METHODS: A retrospective cohort study was performed at a CF Foundation accredited institution including adults with CF who received NcTCVCs in interventional radiology from 7/19/2007 to 3/09/2020. Complications analyzed included catheter related deep venous thrombosis (DVT), central line associated blood stream infection (CLABSI), and catheter related central venous stenosis. Complications were considered attributable if they occurred while the catheter was in place or within 30 days of catheter removal. RESULTS: During the study duration, 386 NcTCVCs were placed in 60 unique patients (55 % female) with a mean of 6.4 catheters per patient. Majority of NcTCVCs placed were 4 French (61.4 %). Average duration of indwelling NcTCVC was 16.2 days. No patients demonstrated catheter attributable symptomatic DVT. The incidence of DVT, CLABSI, and central venous stenosis was 0 (0 %), 4 (1 %), and 1 (0.3 %), respectively. CONCLUSIONS: Many adults with CF have required insertion of numerous PICCs for the treatment of recurrent pulmonary exacerbations. In those adults that develop PICC-associated peripheral vein stenosis precluding PICC placement, these results indicate NcTCVCs are a safe alternative

A microphysiological system model of therapy for liver micrometastases

Metastasis accounts for almost 90% of cancer-associated mortality. The effectiveness of cancer therapeutics is limited by the protective microenvironment of the metastatic niche and consequently these disseminated tumors remain incurable. Metastatic disease progression continues to be poorly understood due to the lack of appropriate model systems. To address this gap in understanding, we propose an all-human microphysiological system that facilitates the investigation of cancer behavior in the liver metastatic niche. This existing LiverChip is a 3D-system modeling the hepatic niche; it incorporates a full complement of human parenchymal and non-parenchymal cells and effectively recapitulates micrometastases. Moreover, this system allows real-time monitoring of micrometastasis and assessment of human-specific signaling. It is being utilized to further our understanding of the efficacy of chemotherapeutics by examining the activity of established and novel agents on micrometastases under conditions replicating diurnal variations in hormones, nutrients and mild inflammatory states using programmable microdispensers. These inputs affect the cues that govern tumor cell responses. Three critical signaling groups are targeted: the glucose/insulin responses, the stress hormone cortisol and the gut microbiome in relation to inflammatory cues. Currently, the system sustains functioning hepatocytes for a minimum of 15 days; confirmed by monitoring hepatic function (urea, α-1-antitrypsin, fibrinogen, and cytochrome P450) and injury (AST and ALT). Breast cancer cell lines effectively integrate into the hepatic niche without detectable disruption to tissue, and preliminary evidence suggests growth attenuation amongst a subpopulation of breast cancer cells. xMAP technology combined with systems biology modeling are also employed to evaluate cellular crosstalk and illustrate communication networks in the early microenvironment of micrometastases. This model is anticipated to identify new therapeutic strategies for metastasis by elucidating the paracrine effects between the hepatic and metastatic cells, while concurrently evaluating agent efficacy for metastasis, metabolism and tolerability.National Institutes of Health (U.S.) (Grant 1UH2TR000496-01)United States. Defense Advanced Research Projects Agency. Microphysiological Systems Program (W911NF-12-2-0039

The impact of theory-based messages on COVID-19 vaccination intentions: a structured summary of a study protocol for a randomised controlled trial

Objectives Uptake of vaccination against COVID-19 is key to controlling the pandemic. However, a significant proportion of people report that they do not intend to have a vaccine, often because of concerns they have about vaccine side effects or safety. This study will assess the impact of theory-based messages on COVID-19 vaccination intention, drawing on the Necessity-Concerns framework to address previously reported beliefs and concerns about COVID-19 vaccination, and assess whether hypothesised variables (illness coherence, perceived necessity and concerns) mediate change in vaccination intention. Trial design Prospective, parallel two-arm, individually randomised (1:1) trial. Participants Adults aged over 18 years, living in Scotland and not vaccinated for COVID-19. A quota sampling approach will be used with the aim of achieving a nationally representative sample on gender, region and ethnic group, with oversampling of individuals with no educational qualifications or with only school-level qualifications. Intervention and comparator Intervention: Brief exposure to online text and image-based messages addressing necessity beliefs and concerns about COVID-19 vaccination. Comparator: Brief exposure to online text and image-based messages containing general information about COVID-19 and COVID-19 vaccination. Main outcomes Primary outcome: Self-reported intention to receive a vaccine for COVID-19 if invited, immediately post-intervention. Secondary outcomes: Self-reported COVID-19 illness coherence, perceived necessity of a COVID-19 vaccine and concerns about a COVID-19 vaccine, immediately post-intervention. Randomisation Quasi-randomisation performed automatically by online survey software, by creating a variable derived from the number of seconds in the minute that the participant initiates the survey. Participants starting the survey at 0-14 or 30-44 seconds in the minute are allocated to the intervention and 15-29 or 45-59 seconds to the comparator. Blinding (masking) Participants will not be blinded to group assignment but will not be informed of the purpose of the study until they have completed the follow-up survey. Investigators will be blinded to allocation as all procedures will be undertaken digitally and remotely without any investigator contact with participants. Numbers to be randomised (sample size) A total of 1,094 will be randomised 1:1 into two groups with 547 individuals in each. Trial Status Protocol version number 1.0, 26th February 2021. Recruitment status: Not yet recruiting, set to start April 2021 and end April 2021. Trial registration ClinicalTrials.gov, NCT04813770, 24th March 2021. Full protocol The full protocol is attached as an additional file, accessible from the Trials website (Additional file 1). In the interest in expediting dissemination of this material, the familiar formatting has been eliminated; this Letter serves as a summary of the key elements of the full protocol