Human Factors and Simulation in Emergency Medicine

This consensus group from the 2017 Academic Emergency Medicine Consensus Conference Catalyzing System Change through Health Care Simulation: Systems, Competency, and Outcomes held in Orlando, Florida, on May 16, 2017, focused on the use of human factors (HF) and simulation in the field of emergency medicine (EM). The HF discipline is often underutilized within EM but has significant potential in improving the interface between technologies and individuals in the field. The discussion explored the domain of HF, its benefits in medicine, how simulation can be a catalyst for HF work in EM, and how EM can collaborate with HF professionals to effect change. Implementing HF in EM through health care simulation will require a demonstration of clinical and safety outcomes, advocacy to stakeholders and administrators, and establishment of structured collaborations between HF professionals and EM, such as in this breakout group

HDAC-mediated control of ERK- and PI3K-dependent TGF-β-induced extracellular matrix-regulating genes

Histone deacetylases (HDACs) regulate the acetylation of histones in the control of gene expression. Many non-histone proteins are also targeted for acetylation, including TGF-ß signalling pathway components such as Smad2, Smad3 and Smad7. Our studies in mouse C3H10T1/2 fibroblasts suggested that a number of TGF-ß-induced genes that regulate matrix turnover are selectively regulated by HDACs. Blockade of HDAC activity with trichostatin A (TSA) abrogated the induction of a disintegrin and metalloproteinase 12 (Adam12) and tissue inhibitor of metalloproteinases-1 (Timp-1) genes by TGF-ß, whereas plasminogen activator inhibitor-1 (Pai-1) expression was unaffected. Analysis of the activation of cell signalling pathways demonstrated that TGF-ß induced robust ERK and PI3K activation with delayed kinetics compared to the phosphorylation of Smads. The TGF-ß induction of Adam12 and Timp-1 was dependent on such non-Smad signalling pathways and, importantly, HDAC inhibitors completely blocked their activation without affecting Smad signalling. Analysis of TGF-ß-induced Adam12 and Timp-1 expression and ERK/PI3K signalling in the presence of semi-selective HDAC inhibitors valproic acid, MS-275 and apicidin implicated a role for class I HDACs. Furthermore, depletion of HDAC3 by RNA interference significantly down-regulated TGF-ß-induced Adam12 and Timp-1 expression without modulating Pai-1 expression. Correlating with the effect of HDAC inhibitors, depletion of HDAC3 also blocked the activation of ERK and PI3K by TGF-ß. Collectively, these data confirm that HDACs, and in particular HDAC3, are required for activation of the ERK and PI3K signalling pathways by TGF-ß and for the subsequent gene induction dependent on these signalling pathways

LIM kinase function and renal growth: potential role for LIM kinases in fetal programming of kidney development

Aims Maternal dietary restriction during pregnancy impairs nephron development and results in offspring with fewer nephrons. Cell turnover in the early developing kidney is altered by exposure to maternal dietary restriction and may be regulated by the LIM-kinase family of enzymes. We set out to establish whether disturbance of LIM-kinase activity might play a role in the impairment of nephron formation. Main methods E12.5 metanephric kidneys and HK2 cells were grown in culture with the pharmacological LIM-kinase inhibitor BMS5. Organs were injected with DiI, imaged and cell numbers measured over 48 h to assess growth. Cells undergoing mitosis were visualised by pH 3 labelling. Key findings Growth of cultured kidneys reduced to 83% of controls after exposure to BMS5 and final cell number to 25% of control levels after 48 h. Whilst control and BMS5 treated organs showed cells undergoing mitosis (100 ± 11 cells/field vs 113 ± 18 cells/field respectively) the proportion in anaphase was considerably diminished with BMS5 treatment (7.8 ± 0.8% vs 0.8 ± 0.6% respectively; P < 0.01). This was consistent with effects on HK2 cells highlighting a severe impact of BMS5 on formation of the mitotic spindle and centriole positioning. DiI labelled cells migrated in 100% of control cultures vs 0% BMS5 treated organs. The number of nephrogenic precursor cells appeared depleted in whole organs and formation of new nephrons was blocked by exposure to BMS5. Significance Pharmacological blockade of LIM-kinase function in the early developing kidney results in failure of renal development. This is likely due to prevention of dividing cells from completion of mitosis with their resultant loss

Grand Challenges in Immersive Analytics

The definitive version will be published in CHI 2021, May 8–13, 2021, Yokohama, JapanInternational audienceImmersive Analytics is a quickly evolving field that unites several areas such as visualisation, immersive environments, and humancomputer interaction to support human data analysis with emerging technologies. This research has thrived over the past years with multiple workshops, seminars, and a growing body of publications, spanning several conferences. Given the rapid advancement of interaction technologies and novel application domains, this paper aims toward a broader research agenda to enable widespread adoption. We present 17 key research challenges developed over multiple sessions by a diverse group of 24 international experts, initiated from a virtual scientific workshop at ACM CHI 2020. These challenges aim to coordinate future work by providing a systematic roadmap of current directions and impending hurdles to facilitate productive and effective applications for Immersive Analytics

Transcriptional control of microglia phenotypes in health and disease

Microglia are the main resident macrophage population of the CNS and perform numerous functions required for CNS development, homeostasis, immunity, and repair. Many lines of evidence also indicate that dysregulation of microglia contributes to the pathogenesis of neurodegenerative and behavioral diseases. These observations provide a compelling argument to more clearly define the mechanisms that control microglia identity and function in health and disease. In this Review, we present a conceptual framework for how different classes of transcription factors interact to select and activate regulatory elements that control microglia development and their responses to internal and external signals. We then describe functions of specific transcription factors in normal and pathological contexts and conclude with a consideration of open questions to be addressed in the future

A future for Hashima: pornography, representation and time

This article sets out to investigate the relationship between ruins, futurity, and ‘ruin porn’ - a visual mode of representation that all too often seeks to fix post-industrial ruins as mere aesthetic objects, devoid of history and/or temporality. It does so by focusing on performance, which, in this context, is understood as a processual mode of art-making that provides spectators with an experience of time. In this expanded definition of performance, as one may perhaps expect, the performativity of the object is not limited to the theatrical event alone; rather, it now inheres in sometimes uncanny durational aspects of both still and moving images. The essay proceeds in three stages. Part one provides a historical and theoretical overview of the type of performance inherent in ‘ruin porn’; part two critiques two images from Yves Marchand's and Romain Meffre's Gunkanjima (2013), a photo album that attempted to document the ruins of Hashima, an island situated 15 kilometres from Nagasaki City in the East China Sea; and part three investigates the very different aesthetic at work in Lee Hassall's film Return to Battleship Island (2013) which was made in response to AHRC- funded project, ‘The Future of Ruins: Reclaiming Abandonment and Toxicity on Hashima Island’ (2013). In this reading of Return to Battleship Island , the onus is on showing how Hassall's film, in its representation of Hashima's crumbling apartment blocks and industrial buildings, intentionally sought to contest the atemporal logic of ‘ruin porn’ by attempting to endow the viewing experience with a sense of futurity. Crucially, this does not mean that film represented the future as an object, but, on the contrary, tried to make it palpable, as something one undergoes physically in the very act of reception

SAGEXR - DESIGN, DEVELOPMENT AND STUDY OF EFFICACY AND USER BEHAVIOR IN VIRTUAL AND AUGMENTED REALITY PROJECT ROOMS

Ph.D

SageXR, an Application to Enable Remote Participation on Tiled Display Walls

Tiled display walls have numerous benefits proven by research (such as, performing analytical tasks). However, tiled display walls can be costly, space consuming, and may have limited physical access. This paper describes the ongoing design of SageXR, an application developed to provide users with the benefits of a tiled display wall through XR devices (augmented, mixed, or virtual reality). We rely on the technology of SAGE2 - an open-source middleware used to drive tiled display walls. The application we are developing, SageXR, is designed to allow XR clients to join a SAGE2 workspace and operate as an equal client. The SageXR application is developed using an iterative process that includes participatory design. As part of our process, we asked SAGE2 users to assess our initial design and features of SageXR, their critique informed our design. This paper’s main contributions include describing the system and features as well as how it can integrate with unaltered SAGE2 servers, feedback from SAGE2 users regarding the features, and a discussion of future possibilities provided by XR devices

Accessible general aviation.

This project explores the possibility of improving the national transportation system by giving more people increased access to general aviation. Based on the research, a plan to accomplish the objective is proposed. The technologies that are needed and the social impacts that this improvement might have on society are also analyzed

The Design and Development of the Destiny-Class CyberCANOE Hybrid Reality Environment

The Destiny-class CyberCANOE (Destiny) is a Hybrid Reality environment that provides 20/20 visual acuity in a 13-foot-wide, 320-degree cylindrical structure comprised of tiled passive stereo-capable organic light emitting diode (OLED) displays. Hybrid Reality systems combine surround-screen virtual reality environments with ultra-high-resolution digital project-rooms. They are intended as collaborative environments that enable multiple users to work minimally encumbered for long periods of time in rooms surrounded by data in the form of visualizations that benefit from being displayed at resolutions matching visual acuity and/or in stereoscopic 3D. Destiny is unique in that it is the first Hybrid Reality system to use OLED displays and it uses a real-time GPU-based approach for minimizing stereoscopic crosstalk. This paper chronicles the non-trivial engineering research and attention-to-detail that is required to develop a production quality hybrid-reality environment by providing details about Destiny’s design and construction process. This detailed account of how a Hybrid Reality system is designed and constructed from the ground up will help VR researchers and developers understand the engineering complexity of developing such systems. This paper also discusses a GPU-based crosstalk mitigation technique and evaluation, and the use of Microsoft’s augmented reality headset, the HoloLens, as a design and training aid during construction