Modern treatment of cholera under active service conditions : being an account of an outbreak at Tiberias in 1918

The Cholera outbreak at Tiberias on the Sea of Galilee in Oct., 1918, that I am about to describe was of great importance from a military point of view. Consequently, the author and a bacteriologist, (Capt. A. Compton, R.A.M.C., O.C. 32 Mobile Laboratory) were dispatched to the scene of the outbreak in order to investigate the conditions and, in short, to adopt any measures possible to suppress the epidemic. The matter was of considerable urgency. Tiberias lay on the direct line of communication for troops operating in the Damascus area, and it was essential that all reinforcements and food supplies pass through the town. The hilly nature of the country, the arid soil, the daily extremes of temperature at that season of the year - for the days were hot and the nights bitterly cold - the deficient and defective water supply - all these factors had a bearing upon the health of the troops and the nature of the problem. Had Cholera spread at that critical period to any great extent it might have brought, what proved to be, one of the most brilliant feats in military history, to an untimely close

Driven to distraction : a prospective controlled study of a simulated ward round experience to improve patient safety teaching for medical students

Acknowledgments The authors would like to thank The Clinical Skills Managed Educational Network for its financial support, without which this research would not have taken place. Ethics approval Ethics approval for this research study was sought and granted from the University of Aberdeen's College and Ethics Research Board (Application No. CERB/2013/1/837). All participants in the study gave informed written consent before taking part in the research. Data sharing statement The research was carried out as part of a Masters in Medical Education degree. The Masters dissertation includes extensive study data—whereas this article contains the most pertinent quantitative data. The full Masters thesis is available from the University of DundeePeer reviewedPostprin

Interactive effects of vascular risk burden and advanced age on cerebral blood flow.

Vascular risk factors and cerebral blood flow (CBF) reduction have been linked to increased risk of cognitive impairment and Alzheimer's disease (AD); however the possible moderating effects of age and vascular risk burden on CBF in late life remain understudied. We examined the relationships among elevated vascular risk burden, age, CBF, and cognition. Seventy-one non-demented older adults completed an arterial spin labeling MR scan, neuropsychological assessment, and medical history interview. Relationships among vascular risk burden, age, and CBF were examined in a priori regions of interest (ROIs) previously implicated in aging and AD. Interaction effects indicated that, among older adults with elevated vascular risk burden (i.e., multiple vascular risk factors), advancing age was significantly associated with reduced cortical CBF whereas there was no such relationship for those with low vascular risk burden (i.e., no or one vascular risk factor). This pattern was observed in cortical ROIs including medial temporal (hippocampus, parahippocampal gyrus, uncus), inferior parietal (supramarginal gyrus, inferior parietal lobule, angular gyrus), and frontal (anterior cingulate, middle frontal gyrus, medial frontal gyrus) cortices. Furthermore, among those with elevated vascular risk, reduced CBF was associated with poorer cognitive performance. Such findings suggest that older adults with elevated vascular risk burden may be particularly vulnerable to cognitive change as a function of CBF reductions. Findings support the use of CBF as a potential biomarker in preclinical AD and suggest that vascular risk burden and regionally-specific CBF changes may contribute to differential age-related cognitive declines

Lipid bilayer-bound conformation of an integral membrane beta barrel protein by multidimensional MAS NMR

The human voltage dependent anion channel 1 (VDAC) is a 32 kDa β-barrel integral membrane protein that controls the transport of ions across the outer mitochondrial membrane. Despite the determination of VDAC solution and diffraction structures, a structural basis for the mechanism of its function is not yet fully understood. Biophysical studies suggest VDAC requires a lipid bilayer to achieve full function, motivating the need for atomic resolution structural information of VDAC in a membrane environment. Here we report an essential step toward that goal: extensive assignments of backbone and side chain resonances for VDAC in DMPC lipid bilayers via magic angle spinning nuclear magnetic resonance (MAS NMR). VDAC reconstituted into DMPC lipid bilayers spontaneously forms two-dimensional lipid crystals, showing remarkable spectral resolution (0.5–0.3 ppm for [superscript 13]C line widths and <0.5 ppm [superscript 15]N line widths at 750 MHz). In addition to the benefits of working in a lipid bilayer, several distinct advantages are observed with the lipid crystalline preparation. First, the strong signals and sharp line widths facilitated extensive NMR resonance assignments for an integral membrane β-barrel protein in lipid bilayers by MAS NMR. Second, a large number of residues in loop regions were readily observed and assigned, which can be challenging in detergent-solubilized membrane proteins where loop regions are often not detected due to line broadening from conformational exchange. Third, complete backbone and side chain chemical shift assignments could be obtained for the first 25 residues, which comprise the functionally important N-terminus. The reported assignments allow us to compare predicted torsion angles for VDAC prepared in DMPC 2D lipid crystals, DMPC liposomes, and LDAO-solubilized samples to address the possible effects of the membrane mimetic environment on the conformation of the protein. Concluding, we discuss the strengths and weaknesses of the reported assignment approach and the great potential for even more complete assignment studies and de novo structure determination via [superscript 1]H detected MAS NMR.National Institutes of Health (U.S.) (Grant EB001960)National Institutes of Health (U.S.) (Grant EB002026

Magic Angle Spinning Nuclear Magnetic Resonance Characterization of Voltage-Dependent Anion Channel Gating in Two-Dimensional Lipid Crystalline Bilayers

National Institutes of Health (U.S.) (EB001960)National Institutes of Health (EB002026

Electronic Health Record-Based Recruitment and Retention and Mobile Health App Usage: Multisite Cohort Study.

BACKGROUND: To address the obesity epidemic, there is a need for novel paradigms, including those that address the timing of eating and sleep in relation to circadian rhythms. Electronic health records (EHRs) are an efficient way to identify potentially eligible participants for health research studies. Mobile health (mHealth) apps offer available and convenient data collection of health behaviors, such as timing of eating and sleep. OBJECTIVE: The aim of this descriptive analysis was to report on recruitment, retention, and app use from a 6-month cohort study using a mobile app called Daily24. METHODS: Using an EHR query, adult patients from three health care systems in the PaTH clinical research network were identified as potentially eligible, invited electronically to participate, and instructed to download and use the Daily24 mobile app, which focuses on eating and sleep timing. Online surveys were completed at baseline and 4 months. We described app use and identified predictors of app use, defined as 1 or more days of use, versus nonuse and usage categories (ie, immediate, consistent, and sustained) using multivariate regression analyses. RESULTS: Of 70,661 patients who were sent research invitations, 1021 (1.44%) completed electronic consent forms and online baseline surveys; 4 withdrew, leaving a total of 1017 participants in the analytic sample. A total of 53.79% (n=547) of the participants were app users and, of those, 75.3% (n=412), 50.1% (n=274), and 25.4% (n=139) were immediate, consistent, and sustained users, respectively. Median app use was 28 (IQR 7-75) days over 6 months. Younger age, White race, higher educational level, higher income, having no children younger than 18 years, and having used 1 to 5 health apps significantly predicted app use (vs nonuse) in adjusted models. Older age and lower BMI predicted early, consistent, and sustained use. About half (532/1017, 52.31%) of the participants completed the 4-month online surveys. A total of 33.5% (183/547), 29.3% (157/536), and 27.1% (143/527) of app users were still using the app for at least 2 days per month during months 4, 5, and 6 of the study, respectively. CONCLUSIONS: EHR recruitment offers an efficient (ie, high reach, low touch, and minimal participant burden) approach to recruiting participants from health care settings into mHealth research. Efforts to recruit and retain less engaged subgroups are needed to collect more generalizable data. Additionally, future app iterations should include more evidence-based features to increase participant use

Association of Eating and Sleeping Intervals With Weight Change Over Time: The Daily24 Cohort.

Background We aim to evaluate the association between meal intervals and weight trajectory among adults from a clinical cohort. Methods and Results This is a multisite prospective cohort study of adults recruited from 3 health systems. Over the 6-month study period, 547 participants downloaded and used a mobile application to record the timing of meals and sleep for at least 1 day. We obtained information on weight and comorbidities at each outpatient visit from electronic health records for up to 10  years before until 10 months after baseline. We used mixed linear regression to model weight trajectories. Mean age was 51.1 (SD 15.0) years, and body mass index was 30.8 (SD 7.8) kg/

Planning for Sustainability in Small Municipalities: The Influence of Interest Groups, Growth Patterns, and Institutional Characteristics

How and why small municipalities promote sustainability through planning efforts is poorly understood. We analyzed ordinances in 451 Maine municipalities and tested theories of policy adoption using regression analysis.We found that smaller communities do adopt programs that contribute to sustainability relevant to their scale and context. In line with the political market theory, we found that municipalities with strong environmental interests, higher growth, and more formal governments were more likely to adopt these policies. Consideration of context and capacity in planning for sustainability will help planners better identify and benefit from collaboration, training, and outreach opportunities

BeaverCube: Coastal Imaging with VIS/LWIR CubeSats

BeaverCube is a student-built 3U CubeSat that has two main objectives: one science objective and one technology objective. The science goal of BeaverCube is to demonstrate that it is possible to develop and apply platforms that can leverage statistical relationships between temperature and co-varying bio-optical properties, such as light absorption by colored dissolved organic matter. The technology goal of BeaverCube is to demonstrate electrospray propulsion for CubeSats, enabling more coordinated and targeted science missions among multiple spacecraft. The science objective for BeaverCube involves measuring temperature and color, which are key oceanographic properties, through a low-cost platform. Temperature and salinity are used to determine the density of watermasses. This is then used to physically classify them. Thermohaline circulation is a part of large-scale ocean circulation that is driven by global density gradients created by surface heat and freshwater fluxes. Thermohaline circulation plays an important role in supplying heat to the polar regions; it influences the rate of sea ice formation near the poles, which in turn affects other aspects of the climate system, such as the albedo, and thus solar heating, at high latitudes. Small- and meso-scale ocean features such as fronts and eddies canal so be identified and tracked solely using sea surface temperature properties. BeaverCube will track warm core rings on the Northeastern section of the US coast, one of the regions in the world that is heating the fastest due to climate change. Wide geospatial coverage with near-simultaneous measurements of thermal and bio-optical ocean properties by a CubeSat has the potential to address many important oceanographic questions for both basic science and Naval applications. The majority of space-borne optical oceanographic parameters observed from CubeSats rely on atmospheric corrections to provide useful data. BeaverCube will both obtain data and help determine to what extent supplemental data will still be required for atmospheric corrections. BeaverCube will make sea surface and cloud top temperature measurements using three cameras: one visible and two FLIR Boson LWIR cameras. In-situ measurements will be coordinated with an array of ocean buoys to support calibration and validation. The student team successfully tested the LWIR camera on a high-altitude balloon launch in November 2019 to an altitude of 110,000 feet, demonstrating the imaging functionality in a near-space environment. The technology goal for BeaverCube is to demonstrate the operation of the Tiled Ionic Liquid Electrospray (TILE2) propulsion technology from Accion Systems, Inc. for orbital maneuvering. BeaverCube will be deployed in Low Earth Orbit from the International Space Station. The plan is to change the altitude of BeaverCube by 480 meters using 50 micro-Newtons of thrust, detected by an onboard GPS receiver. With a goal of launching in late 2020 or early 2021, BeaverCube passed Critical Design Review in Spring 2020, with subsystems designed and procured, including components from AAC Clyde Space (power), ISIS (ADCS), Near Space Launch (BlackBox with GlobalStar simplex radio and NovAtel GPS), and others (OpenLST radio and Raspberry Pi based C&DH board). Assembly and integration prior to environmental testing are planned for late summer 2020

Psychological determinants of whole-body endurance performance

Background: No literature reviews have systematically identified and evaluated research on the psychological determinants of endurance performance, and sport psychology performance-enhancement guidelines for endurance sports are not founded on a systematic appraisal of endurance-specific research. Objective: A systematic literature review was conducted to identify practical psychological interventions that improve endurance performance and to identify additional psychological factors that affect endurance performance. Additional objectives were to evaluate the research practices of included studies, to suggest theoretical and applied implications, and to guide future research. Methods: Electronic databases, forward-citation searches, and manual searches of reference lists were used to locate relevant studies. Peer-reviewed studies were included when they chose an experimental or quasi-experimental research design, a psychological manipulation, endurance performance as the dependent variable, and athletes or physically-active, healthy adults as participants. Results: Consistent support was found for using imagery, self-talk, and goal setting to improve endurance performance, but it is unclear whether learning multiple psychological skills is more beneficial than learning one psychological skill. The results also demonstrated that mental fatigue undermines endurance performance, and verbal encouragement and head-to-head competition can have a beneficial effect. Interventions that influenced perception of effort consistently affected endurance performance. Conclusions: Psychological skills training could benefit an endurance athlete. Researchers are encouraged to compare different practical psychological interventions, to examine the effects of these interventions for athletes in competition, and to include a placebo control condition or an alternative control treatment. Researchers are also encouraged to explore additional psychological factors that could have a negative effect on endurance performance. Future research should include psychological mediating variables and moderating variables. Implications for theoretical explanations of endurance performance and evidence-based practice are described