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Delirium assessment, management and barriers to effective care across Scotland: a secondary analysis of survey data from World Delirium Awareness Day 2023
Get PDFIntroduction:
Delirium is a common, severe neuropsychiatric syndrome in hospitalised older adults. We evaluated use of validated delirium assessment tools, adherence to national guidelines and prevalence and management of delirium across Scotland, identifying barriers to effective care.
Methods:
Secondary analysis of national survey data, collected by participating clinicians on World Delirium Awareness Day (15 March 2023).
Results:
Among 120 responses (3,257 patients), the 4AT was the most frequently used assessment tool (75%), while 14% of units reported using clinical judgement alone. The delirium assessment rate was 74%, with a prevalence of 22% at 8 am. Management protocols varied, with frequent routine non-pharmacological interventions including pain management (88%), hydration (87%) and open family visiting (80%). Barriers to delirium care included insufficient staffing and training.
Conclusion:
While many hospital settings follow national delirium guidelines, some still rely on clinical judgement for assessment, with variability in management protocols and practices. We have highlighted key barriers to effective delirium care in Scotland
Heterogenous and Flexible E-Textile Power Electronics: Enabling Novel Battery-Free Wearable Applications and Outperforming Rigid Electronics
No full textHigh-efficiency power electronics are crucial to any energy harvesting or high-power e-textile system. This paper will detail the design of passive power electronics components, going beyond state-of-the-art in both e-textiles and compared to rigid counterparts. The heterogeneous e-textiles integration, combining multiple fabrication approaches, including embroidery, screen printing, and flexible printed circuits (FPCs), is compared systematically in wireless power transfer applications, outperforming rigid circuits. Inductors, capacitors, thermistors, and resistors are successfully demonstrated with high quality-factor and in system level demonstrators with wireless power handling capabilities ranging from 1 W to over 15 W, while maintaining safety in terms of thermals. Showcased demonstrators include charging consumer devices with Airfuel-compliant systems, battery-free heaters, and anti-bacterial bandages. Comparisons with prior art show a 5-fold improvement in power handling and 2-fold improvement in efficiency, demonstrating the importance of hybrid integration of e-textile power systems
Dynamic navigation-guided robotic placement of zygomatic implants
Get PDFObjectives: To assess the feasibility and accuracy of a new prototype robotic implant system for the placement of zygomatic implants in edentulous maxillary models.
Methods: The study was carried out on eight plastic models. Cone beam computed tomographs were captured for each model to plan the positions of zygomatic implants. The hand-eye calibration technique was used to register the dynamic navigation system to the robotic spaces. A total of 16 zygomatic implants were placed, equally distributed between the anterior and the posterior parts of the zygoma. The placement of the implants (ZYGAN®, Southern Implants) was carried out using an active six-jointed robotic arm (UR3e, Universal Robots) guided by the dynamic navigation coordinate transformation matrix. The accuracy of the implant placement was assessed using EvaluNav and GeoMagicDesignX® software based on pre- and post-operative CBCT superimposition. Descriptive statistics for the implant deviations and Pearson's correlation analysis of these deviations to force feedback recorded by the robotic arm were conducted.
Results: The 3D deviations at the entry and exit points were 1.80 ± 0.96 mm and 2.80 ± 0.95 mm, respectively. The angular deviation was 1.74 ± 0.92°. The overall registration time was 23.8 ± 7.0 minutes for each side of the model. Operative time excluding registration was 66.8 ± 8.8 minutes for each trajectory.
The exit point and angular deviations of the implants were positively correlated with the drilling force perpendicular to the long axis of the handpiece and negatively correlated with the drilling force parallel to the long axis of the handpiece.
Conclusion: The errors of the dynamic navigation-guided robotic placement of zygomatic implants were within the clinically acceptable limits. Further refinements are required to facilitate the clinical application of the tested integrated robotic-dynamic navigation system.
Clinical Significance: Robotic placement of zygomatic implants has the potential to produce a highly predictable outcome irrespective of the operator's surgical experience or fatigue. The presented study paves the way for clinical applications
Ruiz‐Serna, D.(2023) When Forests Run Amok: War and Its Afterlives in Indigenous and Afro‐Colombian Territories, Duke University Press (Durham, NC), xi+ 262 pp. $26.95
No full textNo abstract available
A value-free, diversity-sensitive measure of freedom
Get PDFNumerous philosophers and economists have argued that the extent of one’s freedom depends in part on how diverse one’s options are. However, such efforts have met resistance from political philosophers who regard diversity-sensitive measures of freedom as objectionably value-laden. I present a new way of incorporating diversity considerations in the measure of freedom that is scrupulously value-neutral. It is also quite successful in capturing common intuitions about freedom and diversity: in particular, it is sensitive to the degree of dissimilarity between extremal and non-extremal options
Access to civics content and evidence-based instructional approaches in U.S. schools
Get PDFBackground:
Civic learning is an increasingly salient topic in research, policy, and practice. However, the recent empirical evidence on access to civic learning opportunities in the U.S. is limited, and monitoring learning opportunities is equally as important as monitoring learning outcomes.
Methods:
We build on prior research using survey items from the 2018 National Assessment of Educational Progress (NAEP) Civics Assessment and provide descriptive evidence on disparities in access to three categories of civics content and four evidence-based instructional approaches. We describe inequalities in opportunities by student characteristics, school characteristics, and state characteristics among a national sample of more than 10,000 Grade 8 students.
Results:
Our findings diverge from most of the prior evidence regarding disparities in access by race, ethnicity, or socioeconomic background, favoring Black students, Hispanic students, and students of relatively lower socioeconomic backgrounds. English learners and students with disabilities also reported greater exposure to civic learning opportunities than their counterparts. Other findings include inequalities across school type/sector, school location, and state testing policy.
Conclusions:
These novel findings raise new questions about the distribution of civic learning opportunities in U.S. schools. We discuss implications and the need for further research on this important topic with data that allows for continued improvements with internal and external validity
Purification of Influenza Virions
No full textThis chapter describes basic workflows for concentrating and for purifying influenza virions. It presents several ways in which ultracentrifugation can be used to concentrate influenza virions from the growth media of infected cells, with notes on the different degrees of purity that can be expected when using different approaches. These approaches are also suitable for purifying influenza virions from the allantoic fluid of embryonated chicken eggs. As a small quantity of cell-derived microvesicles is invariably co-purified with virions, optional steps are included to increase the stringency of purification by enriching material with viral receptor binding and cleaving activity. In addition to methods that will concentrate the approximately spherical virions produced by many laboratory-adapted influenza strains, a density gradient protocol is presented which can be used to separate the virions of filamentous influenza strains based on their morphology. In order to monitor the enrichment of different virion morphologies, a simple protocol for measuring the length of filamentous virions by indirect immunofluorescence and automated image analysis is also given. Influenza virions purified in the ways described here can be used in a variety of downstream protocols in virology, biochemistry, and immunology
A’ cumail taic ri Tidsearan gus a dhol an sàs ann an Rannsachadh. Geàrr-phàipear Rannsachaidh
Get PDFNo abstract available
De novo assembly of RNA m6A modification factors into viral genome-associated nuclear bodies drives HCMV RNA accumulation
Get PDFSummary:
The factors that install and recognize N6-methyladenosine (m6A) on RNA to regulate gene expression are well characterized, but how their spatial organization responds to physiological stress, including infection, is unclear. Here, we show that human cytomegalovirus (HCMV) infection induces accumulation of m6A methyltransferase subunits, including WTAP, together with nuclear m6A reader YTHDC1, into distinctive, membraneless nuclear bodies (NBs) overlapping with incoming virus genomes and immediate-early (IE) RNA transcripts. De novo assembly and integrity of these DNA-associated, IE, virus-activated NBs requires RNAPII transcription, METTL3 m6A methyltransferase activity, and m6A recognition by YTHDC1, but not new protein synthesis. Depleting YTHDC1 or WTAP limits the accumulation of critical HCMV RNAs required for virus DNA replication, interfering with virus reproduction. This reveals a surprising strategy whereby a discrete sub-nuclear RNA biogenesis compartment replete with RNAPII and m6A modification components is swiftly consolidated in proximity to infecting HCMV genomes to initialize and sustain virus gene expression
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