Interprofessional Geriatric Education: Team-based Care for Chronic Conditions

The Eastern Pennsylvania-Delaware Geriatric Education Center (EPaD GEC) mission is to provide interprofessional geriatric education in Northeast and Southeast Pennsylvania and Delaware. EPaD GEC consortium members (Thomas Jefferson University (TJU), Christiana Care Health System (CCHS), Marywood University (MU) and Philadelphia Senior Center (PSC)) are committed to improving the health and quality of life of older adults and their caregivers by translating new evidence and innovative practice models into practical curricula and programs. One of our educational goals is to develop a structured curriculum on geriatric topics that can be integrated into the educational curricula of multiple health disciplines

The use of strong personal media in the context of chronic disease treatment : music as a mediator of depression and pain experience

Thesis (Ph. D.)--Harvard-MIT Program in Health Sciences and Technology, 2013.Cataloged from PDF version of thesis.Includes bibliographical references.Introduction: It is postulated that music has been part of society for at least 50,000 years, since the time that humans lived in one location of the world before dispersing across the globe (44). Over the eras it evolved in its manifestation, from classical performances enjoyed only by the elite, to soulful songs sung in the fields, to myriad forms of expression to be used by anyone. Today, its prominence has even evolved into being used as a tool for cognitive therapy, such as for aphasia patients (41), or to heal those who no longer have the ability to move their bodies (40). Given its incredible, seemingly endless potential, it is fruitful to explore new innovations in its usage - with treatment for chronic diseases such as depression, anxiety, and other mental disorders being ideal candidates. These diseases are high in their cost on resources, both human and monetary, and have weighty long-term impacts on patients' lives as well as their families', with depression being the leading cause of disability worldwide according to the World Health Organization (43). Music is positioned as a potent remedy, as its attributes are almost the mirror negative of the effects from chronic disease: it is low cost, pleasurably pervasive, and socially connecting Thus, the intention behind the design of study 1 in this thesis was to create a pilot, self -driven, wellness-enhancing music treatment that could be used as the basis for a future treatment for depression. It was meant to be a relatively brief longitudinal study examining adherence and feasibility for a personal music augmented mindfulness practice in a small group of healthy subjects. From the insights gleaned during this study, it was determined that the choice of strongly emotional, personal music could be potentially powerful in another disease context. In study 2, the design contracted from a longitudinal one to an acute, nuanced observation of enhanced music analgesia during experimental heat pain with healthy subjects. The clinical tool of interest was a proven analgesia boosting conditioning paradigm, which was combined in this study with personal music. Together, the two studies provide a revealing glimpse of humankind's ability to harness the best attributes it can for self-care from a medium it itself created.by Christine L. Hsieh.Ph.D

Age-related changes to macrophages are detrimental to fracture healing in mice.

The elderly population suffers from higher rates of complications during fracture healing that result in increased morbidity and mortality. Inflammatory dysregulation is associated with increased age and is a contributing factor to the myriad of age-related diseases. Therefore, we investigated age-related changes to an important cellular regulator of inflammation, the macrophage, and the impact on fracture healing outcomes. We demonstrated that old mice (24 months) have delayed fracture healing with significantly less bone and more cartilage compared to young mice (3 months). The quantity of infiltrating macrophages into the fracture callus was similar in old and young mice. However, RNA-seq analysis demonstrated distinct differences in the transcriptomes of macrophages derived from the fracture callus of old and young mice, with an up-regulation of M1/pro-inflammatory genes in macrophages from old mice as well as dysregulation of other immune-related genes. Preventing infiltration of the fracture site by macrophages in old mice improved healing outcomes, with significantly more bone in the calluses of treated mice compared to age-matched controls. After preventing infiltration by macrophages, the macrophages remaining within the fracture callus were collected and examined via RNA-seq analysis, and their transcriptome resembled macrophages from young calluses. Taken together, infiltrating macrophages from old mice demonstrate detrimental age-related changes, and depleting infiltrating macrophages can improve fracture healing in old mice

Antitumor activity of the tea polyphenol epigallocatechin-3-gallate encapsulated in targeted vesicles after intravenous administration

The therapeutic potential of epigallocatechin gallate, a green tea polyphenol with anti-cancer properties, is limited by its inability to specifically reach tumors following intravenous administration. The purpose of this study is to determine whether a tumor-targeted vesicular formulation of epigallocatechin gallate would suppress the growth of A431 epidermoid carcinoma and B16-F10 melanoma in vitro and in vivo. Transferrin-bearing vesicles encapsulating epigallocatechin gallate were intravenously administered to mice bearing subcutaneous A431 and B16-F10 tumors. The intravenous administration of epigallocatechin gallate encapsulated in transferrin-bearing vesicles resulted in tumor suppression for 40% of A431 and B16-F10 tumors. Animal survival was improved by more than 20 days compared to controls. Encapsulation of epigallocatechin gallate in transferrin-bearing vesicles is a promising therapeutic strategy

Cryogenic Detector Technology for Space Science Application

We review the current status of detector development at NASA's Goddard Space Flight Center and address future prospect for space science application. In particular, the IR detector capability and applicability to second generation SOFIA instrument will be discussed. We will examine areas such as 3-dimensional hybridization of large format bolometer arrays to readout multiplexers; advanced light coupling scheme for planar ortho-mode transducer circuitry; integration of high density readout wiring for low temperature detector arrays; and microwave multiplexers for large format superconducting detector arrays

Heterogeneity in HIV and cellular transcription profiles in cell line models of latent and productive infection: implications for HIV latency.

BackgroundHIV-infected cell lines are widely used to study latent HIV infection, which is considered the main barrier to HIV cure. We hypothesized that these cell lines differ from each other and from cells from HIV-infected individuals in the mechanisms underlying latency.ResultsTo quantify the degree to which HIV expression is inhibited by blocks at different stages of HIV transcription, we employed a recently-described panel of RT-ddPCR assays to measure levels of 7 HIV transcripts ("read-through," initiated, 5' elongated, mid-transcribed/unspliced [Pol], distal-transcribed [Nef], polyadenylated, and multiply-sliced [Tat-Rev]) in bulk populations of latently-infected (U1, ACH-2, J-Lat) and productively-infected (8E5, activated J-Lat) cell lines. To assess single-cell variation and investigate cellular genes associated with HIV transcriptional blocks, we developed a novel multiplex qPCR panel and quantified single cell levels of 7 HIV targets and 89 cellular transcripts in latently- and productively-infected cell lines. The bulk cell HIV transcription profile differed dramatically between cell lines and cells from ART-suppressed individuals. Compared to cells from ART-suppressed individuals, latent cell lines showed lower levels of HIV transcriptional initiation and higher levels of polyadenylation and splicing. ACH-2 and J-Lat cells showed different forms of transcriptional interference, while U1 cells showed a block to elongation. Single-cell studies revealed marked variation between/within cell lines in expression of HIV transcripts, T cell phenotypic markers, antiviral factors, and genes implicated in latency. Expression of multiply-spliced HIV Tat-Rev was associated with expression of cellular genes involved in activation, tissue retention, T cell transcription, and apoptosis/survival.ConclusionsHIV-infected cell lines differ from each other and from cells from ART-treated individuals in the mechanisms governing latent HIV infection. These differences in viral and cellular gene expression must be considered when gauging the suitability of a given cell line for future research on HIV. At the same time, some features were shared across cell lines, such as low expression of antiviral defense genes and a relationship between productive infection and genes involved in survival. These features may contribute to HIV latency or persistence in vivo, and deserve further study using novel single cell assays such as those described in this manuscript

FOOT STRIKE PATTERN trends in sub-elite half marathon runners

The purpose of this study was to examine the changes in foot strike patterns throughout a sub elite half-marathon and examine the relationship between foot strike pattern and race performance. Race participants were filmed at mile 2, 5.5 and 12.5. Video was analysed to determine if participants used a forefoot, mid-foot strike or rear foot strike pattern at each camera. Furthermore participants were broken down in performance groups of 50 based off of time taken to reach each camera. At mile 5.5 and 12.5 significant difference in foot strike pattern (

Reconfigurable Microwave Phase Delay Element for Frequency Reference and Phase-Shifter Applications

A technique was developed to provide a reconfigurable high-precision micro - wave electrical phase delay for resonators and phase shifters. The invention employs multiple branches of transmission lines with open-ended or ground-ended terminations as configurable bits or digits. This technique minimizes the errors due to limited precision of switching devices. In addition, the proposed linear analytical approach significantly produces a much simpler design than that of other prior inventions at the time of this reporting. Microwave components such as filters, phase delay elements, or resonators require a method that can accurately adjust their frequency responses. Most tuning techniques offer very wide frequency tuning range; however, it is often difficult and expensive to tune their response in a very narrow operating frequency, especially when the tuning element reaches its minimum discrete step due to fabrication tolerances. The problem becomes worse as the operating frequency is in mm-wave frequency range (>26 GHz). The electrical tuning sensitivity of a microwave line is dependent on the position of the tuning element with respect to the reference termination. By placing this tuning element away from this reference with the main transmission line connecting the two elements together the sensitivity of the tuning element can change significantly. This concept can be used in the system that requires multiple tuning sensitivities. In this case, multiple tuning branches are superimposed in the main transmission line. The proposed invention allows the transmission-line electrical length to be accurately programmed using switching elements that have limited accuracy. The invention consists of multiple branches of transmission lines connected to discrete switching devices with open-ended terminations. They are used as discrete tuning elements. These elements are connected to the main microwave transmission line and are separated by a well-defined electrical degree spacing. Each branch is programmed to have different electrical degree sensitivity, such as a combination of discrete steps in each branch, which results in a reflective line with a unique effective phase response. To reduce the number of switching devices, it is desirable to program the devices in binary configuration where each branch represents one bit in the base-2 number system. This invention allows the transmission line electrical length to be tuned precisely with customizable sensitivity based on the known sensitivity of the base tuning circuit. The tuning resolution is dependent on the distance among tuning branches

Well-Loved Music Robustly Relieves Pain: A Randomized, Controlled Trial

Music has pain-relieving effects, but its mechanisms remain unclear. We sought to verify previously studied analgesic components and further elucidate the underpinnings of music analgesia. Using a well-characterized conditioning-enhanced placebo model, we examined whether boosting expectations would enhance or interfere with analgesia from strongly preferred music. A two-session experiment was performed with 48 healthy, pain experiment-naïve participants. In a first cohort, 36 were randomized into 3 treatment groups, including music enhanced with positive expectancy, non-musical sound enhanced with positive expectancy, and no expectancy enhancement. A separate replication cohort of 12 participants received only expectancy-enhanced music following the main experiment to verify the results of expectancy-manipulation on music. Primary outcome measures included the change in subjective pain ratings to calibrated experimental noxious heat stimuli, as well as changes in treatment expectations. Without conditioning, expectations were strongly in favor of music compared to non-musical sound. While measured expectations were enhanced by conditioning, this failed to affect either music or sound analgesia significantly. Strongly preferred music on its own was as pain relieving as conditioning-enhanced strongly preferred music, and more analgesic than enhanced sound. Our results demonstrate the pain-relieving power of personal music even over enhanced expectations. Trial Information Clinicaltrials.gov NCT01835275

Bill Viola ou l’image sans représentation

Bill Viola affirme que l’ère de la vision optique est terminée et, malgré cela, ses œuvres donnent l’impression d’une parfaite évidence visuelle : ce paradoxe d’une image non destinée à la vue est le thème de cet article. La première thèse développée grâce à la comparaison de la production du vidéaste avec l’art figuratif et le théâtre est qu’elle a une autonomie esthétique spécifique qui se fonde sur l’élision préalable du seuil de la fiction. La deuxième thèse est que B. Viola propose à nouveau la conception de cet œil innocent dont on pensait qu’il n’existait pas, sous la forme d’un corps sincère dont l’existence reste encore à prouver. Il crée en effet des configurations audiovisuelles qui permettent, par la mise en avant de l’expressivité originaire de l’homme, de produire un effet persuasif, affirmatif même, sur le spectateur qu’il soit naïf ou sophistiqué tout en sollicitant son système nerveux. La troisième thèse est que dans toute sa production est à l’œuvre le même problème esthétique, à savoir le délitement de l’identité psychologique du spectateur qui fait l’expérience sur lui-même du véritable thème des vidéos : l’émotion. Ces images vont alors s’incorporer dans l’homme.Bill Viola claims that the era of optical vision is over and, despite this, his works give the impression of a perfect visual evidence. This article sets out to look at the paradox of an image which is not aimed to the sight. First, in comparing the work of this video-maker with figurative art and theatre, we can see that it partakes of a specific aesthetic autonomy grounded in the previous elision of the threshold of vision. Second, we can see that B. Viola offers once more the innocent eye which was believed not to exist, under the form of a sincere body whose existence remains to be proven. He indeed creates audio-visual configurations which allow by bringing forward the original expressivity of man, to produce a persuasive or even claiming effect on the viewer, be he naive or sophisticated in using his nervous system. Thirdly, the same aesthetic problem operates in his whole work: the deleting of psychological identity of the viewer experiencing within himself the theme of the video, this theme being emotion. Such images will then be incorporated within him