Shear stress activation of nitric oxide synthase and increased NO levels in human red blood cells

Since the discovery of nitric oxide (NO) as a vasoactive molecule, red blood cells (RBC) have been considered to participate in NO-mediated control of the circulation. The classical role attributed to RBC was scavenging of NO, thereby impacting the local bioavailability of this important regulator of vascular tone^1^. RBC have been shown to be a source of NO, primarily via its transport bound to haemoglobin^2, 3^. Under specific conditions, haemoglobin plays an active role in converting NO derivatives (e.g., nitrite) to NO^4, 5^, with this NO originating from RBC being an effective modulator of vascular smooth muscle tone^6^. Interestingly, RBC contain a NO synthase (NOS) protein^7^, can actively synthesize NO using L-arginine as a substrate^8^, and can export NO under appropriate conditions^8, 9^. It has been previously hypothesized that RBC NOS may be activated by shear forces acting on the cell^10^, and we have recently shown that RBC NOS phosphorylation can be enhanced by subjecting RBC in suspension to shearing forces^9^: NO concentration in the suspending medium was increased subsequent to flow of RBC suspensions through five [mu]m pores^11^. We have now directly demonstrated increased RBC NOS activity and intracellular NO levels in immobilized RBC exposed to well-defined fluid shear stress. Immunostaining for serine 1177 phosphorylation and the NO-sensitive fluorescent probe diaminofluorescein were employed. Our results suggest that RBC deformation in constricted vessels may increase NO levels and favor vasodilation, thereby providing an important role for RBC in regulating the circulation

Determination of the Odour Adsorption Behaviour of Wool

In this study, the adsorption/desorption behaviours of water vapor on wool, as well as of the redolents, such as acetic acid and benzaldehyde, have been investigated. For this purpose, static and dynamic experiments were carried out. Static experiments were conducted to model stagnant environments. In the experiments, wool came into contact with the material to be adsorbed or dry air and the weight increase/decrease was recorded for a certain period of time. The results obtained showed that the wool adsorbed the benzaldehyde very little, whereas the adsorbed amount and the rate were abundantly increased for acetic acid under the same conditions. From these findings, the adsorption capacity of wool for the redolents was tentatively ranked in accordance with their adsorbed amounts as acetic acid>water>benzaldehyde

An optimization‐based decision‐support tool for post‐disaster debris operations

Debris generated by disasters can hinder relief efforts and result in devastating economic, environmental, and health problems. In this study, we present a decision‐support tool employing analytical models to assist disaster and waste management officials with decisions regarding collection, transportation, reduction, recycling, and disposal of debris. The tool enables optimizing and balancing the financial and environmental costs, duration of the collection and disposal operations, landfill usage, and the amount of recycled materials. In addition to post‐disaster operational decisions, the tool can also support the challenging task of developing strategic plans for disaster preparedness. We illustrate the applicability and effectiveness of the tool with a disaster scenario based on Hurricane Andrew

Applying Backward Design Principles to Online Continuing Education Course Design and Development for Working Professionals

Communication and information technologies continue to evolve and provide new opportunities for continuing education for working professionals in the field of engineering. As the number of online continuing education courses continues to increase, the need for evaluation of the efficacy of them also increases. Applying backward design principles (Wiggins & McTighe, 2011) into the course design and development ensures the efficacy of continuing education courses and programs. This paper aims to provide in-depth descriptions of the employment of backward design principles in design and development of courses. Detailed steps of the framework can be applied to any online continuing education course to achieve course outcomes, to ensure efficacy through design and development, and to maximize the impact of the online courses in engineering education. Paper describes the framework to design and develop of an online continuing education course on Cost Engineering. First, it outlines the analysis of the learners’ needs in the field of Cost Engineering. Second, the paper provides details on the steps taken to design the course. It specifically describes (1) how the course outcomes and objectives were written based on the analysis of learners’ needs; (2) how course learning activities and assessments were determined to achieve the intended learning outcomes and objectives; and (3) how the course content was constructed to successfully complete the learning activities and assessments in the course. Third, the paper describes the development and implementation of the course in the learning management system. Particularly, it explains (1) how the course activities and assessments were created and implemented; (2) how the course materials were prepared with stakeholders; and (3) how the visual identity of the course was designed with Universal Design Principles. The paper concludes by providing lessons learned from user feedback and directions for future development of the online continuing education courses using backward design principles

Helical tomotherapy experience in breast cancer adjuvant radiotherapy and acute toxicity results

Background: This study aimed to evaluate acute toxicity and oncological outcomes of breast cancer patients who underwent adjuvant radiotherapy (RT) with tomotherapy. Materials and methods: The results of 114 patients who underwent adjuvant RT with tomotherapy device between 17.08.10–12.06.2021 in XXX Hospital were evaluated retrospectively. The primary endpoint of the study was acute adverse events, and the secondary endpoints were overall survival (OS) and disease-free survival (DFS). Results: The results of 103 patients who met the inclusion criteria were analyzed.  The median follow-up was 21 (range 1–125.8) months. Grade +3 esophagitis was not observed in any patient; no esophagitis was observed in 60 (58.3%) patients. Grade 3 dermatitis was observed in 3 (2.9%) patients. In addition, dermatitis was not observed in 47 (45.6%) patients. The relationship between chest wall volume and esophagitis development was statistically significant (p = 0.006; Z score: –2769). The median OS was 24.1 (range 1–128.5) and median disease-free survival was 21.1 (range 1–125.8) months. Five patients (4.9%) died and 9 patients (8.7%) relapsed. Local recurrence was observed in only 1 (1%) patient. There was a statistically significant correlation between OS and contralateral lung V20 dose [p < 0.001; Spearman Correlation Coefficient (SCC) –406) and heart mean dose (p < 0.001; SCC –370)]. There was a statically significant correlation between DFS and cN (p < 0.001); pN (p < 0.001); heart mean dose (p < 0.001; SCC –351); contralateral lung V5 dose (p = 0.041; SCC –213); contralateral lung V20 dose (p < 0.001; SCC –434). Conclusion: Acute toxicity results show improvement in breast cancer adjuvant radiotherapy with helical tomotherapy

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Background: Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. // Methods: We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung's disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. // Findings: We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung's disease) from 264 hospitals (89 in high-income countries, 166 in middle-income countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in low-income countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. // Interpretation: Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between low-income, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

The effectiveness of school-based child sexual abuse prevention programmes among primary school-aged children: A systematic review

This systematic review provides a comprehensive overview of child sexual abuse prevalence globally, along with an examination of the effectiveness of school-based prevention education programmes for primary school-aged children. These prevention programmes utilise social cognitive learning theories to teach children the importance of identifying and responding to abusive situations. A total of 676 papers were evaluated with 13 Randomised Controlled Trial (RCT) or cluster RCT design studies identified as meeting the study's inclusion criteria. These studies were published in English between January 2000 and May 2022, and focus on outcomes of school-based prevention programmes designed for primary school-aged children (5–12 years old). To ensure a comprehensive and academically rigorous analysis, the following databases were included: Science Direct, Web of Science, Scopus, the American Psychiatric Association (APA) PsycINFO, Ovid Medline, and Embase. The studies reviewed aim to evaluate the effectiveness of various child sexual abuse prevention programmes in improving children's knowledge and recognition of, and response to potentially unsafe situations. In terms of outcomes and results, the interventions have significantly impacted knowledge, skills, confidence, and awareness in the short and long term. These studies used different intervention methods, including mobile applications, personal safety programmes, and protective behaviour programmes, delivered in various formats such as web-based, textbooks, and in-person sessions. This systematic review highlights the importance of child sexual abuse prevention programmes in schools and the need for further research

Examination of the applied instructional design process in transforming tacit knowledge into explicit knowledge through communities of practice

This dissertation examines how instructional designers navigate the daily challenges of their work as a group; how do they successfully respond to the changing demands of designing instruction for online learning; and replicate their work and practices in higher education context. This is accomplished by investigating the role of instructional design process in transforming tacit knowledge into explicit knowledge through communities of practice. This study was designed to address four research questions: (1) What are the attributes of the instructional design process at Online Learning Unit? (2) How do instructional designers at Online Learning Unit describe their roles within the instructional design process? (3) How do roles of the faculty and instructional design process influence the roles of instructional designers? And (4) how do the instructional designers at Online Learning Unit build and utilize their community of practice? To answer these research questions a collective case study was conducted in a higher education setting under IRB # 19-321-00. Participants of this study were instructional designers and their director who have been working with Colleges of Engineering and Liberal Arts and Sciences, to support online course design and delivery, at a state university in the mid-west United States. Findings of this research for each research question are the following. (1) Instructional design process is an iterative, collaborative, continuously reflective partnership. (2) Roles of the instructional designer are collaborator, mentor, coach, motivator, partner, and technical support. (3) There are three aspects that influence the roles of instructional designers within the instructional design process: time and time-management; course needs; and faculty experiences. (4) There are two ways instructional designers can build their communities of practice: (i) among themselves through their weekly meetings and impromptu conversations and (ii) with faculty that they work with through their weekly meetings during the design and development phases of an online course. In the light of these findings, higher education organizations can benefit from supporting and fostering instructional design communities of practices where instructional designers transform not only their tacit knowledge, but also that of the organization’s

Examination of the applied instructional design process in transforming tacit knowledge into explicit knowledge through communities of practice

This dissertation examines how instructional designers navigate the daily challenges of their work as a group; how do they successfully respond to the changing demands of designing instruction for online learning; and replicate their work and practices in higher education context. This is accomplished by investigating the role of instructional design process in transforming tacit knowledge into explicit knowledge through communities of practice. This study was designed to address four research questions: (1) What are the attributes of the instructional design process at Online Learning Unit? (2) How do instructional designers at Online Learning Unit describe their roles within the instructional design process? (3) How do roles of the faculty and instructional design process influence the roles of instructional designers? And (4) how do the instructional designers at Online Learning Unit build and utilize their community of practice? To answer these research questions a collective case study was conducted in a higher education setting under IRB # 19-321-00. Participants of this study were instructional designers and their director who have been working with Colleges of Engineering and Liberal Arts and Sciences, to support online course design and delivery, at a state university in the mid-west United States. Findings of this research for each research question are the following. (1) Instructional design process is an iterative, collaborative, continuously reflective partnership. (2) Roles of the instructional designer are collaborator, mentor, coach, motivator, partner, and technical support. (3) There are three aspects that influence the roles of instructional designers within the instructional design process: time and time-management; course needs; and faculty experiences. (4) There are two ways instructional designers can build their communities of practice: (i) among themselves through their weekly meetings and impromptu conversations and (ii) with faculty that they work with through their weekly meetings during the design and development phases of an online course. In the light of these findings, higher education organizations can benefit from supporting and fostering instructional design communities of practices where instructional designers transform not only their tacit knowledge, but also that of the organization’s