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Effects of Needling Acupoint SI3 on Pressure Pain Threshold in Healthy Participants
Get PDFBackground: There has been a surge in prescribing opioids for pain-related conditions and it has resulted in a prescription "opioid epidemic." It is critical for researchers and clinicians to explore nonpharmacological approaches to manage pain and mitigate the reliance on opioid analgesics. Acupuncture could be an effective therapy to modulate pain. This study examined the effects on regional pressure pain threshold (PPT) following needling of the Small Intestine 3 (SI3 -Houxi) acupoint in healthy participants.Methods: In a randomized, three-arm cross-over design study, 32 healthy participants enrolled between November 2018 and March 2019, received 3 different acupuncture interventions, in different sequences, to the right hand at SI3: (1) SI3 without manual manipulation (SI3m-); (2) SI3 with manual needle manipulation (SI3m+); and (3) sham laser, to assess changes in PPT following the interventions. The mean change in PPT was measured at 10 different regional acupoint sites using an algometer. All PPT scores were reported as a percentage change from the mean preintervention value, the mean of the 3 PPT measurements obtained prior to receiving the intervention.Results: The SI3m+ and SI3m- interventions for the 31 participants (drop out n=1), showed that the postintervention mean % PPT scores were significantly elevated compared to the control (sham laser; p p < 0.001).Conclusion: The needling intervention was an important contributor raising regional PPT in healthy participants
Exploring Human-Robot Collaboration in Surgery: Initial Insights from Mako Product Specialists
Get PDFHuman-Robot Collaboration (HRC) in surgery is often explored from the perspective of surgeons. However, many robotic procedures require the expertise of technical specialists. Their experiences and perspectives in achieving robotically assisted surgeries remain underrepresented. This paper explores the real-world experiences of technical specialists who work alongside Stryker's Mako surgical robotic system in the operating theatre. This work presents initial insights from five expert interviews with Mako Product Specialists (MPSs), who play a central role in supporting Mako-assisted joint replacement surgeries. We identified three themes relating to the MPSs’ ergonomic challenges, teamwork negotiations, and workflow disruptions experienced in the operating theatre. Our findings indicate that surgical HRC extends beyond the surgeon–robot dyad, involving distributed expertise and social negotiation across the surgical team. While robotic systems aim to enhance surgical performance, we argue that their designs should consider the full ecology of human collaborators in the operating theatre
Long-acting intranasal insulin for the treatment of delirium-a randomised clinical trial.
Get PDFBACKGROUND: Delirium affects up to 25% of hospitalised older patients; however, there are no effective pharmacological treatments. Accumulating evidence of brain insulin resistance and altered cerebral glucose metabolism during delirium present a promising therapeutic target. OBJECTIVE: To assess the safety and efficacy of intranasal insulin in the treatment of delirium. DESIGN: Single-centre, randomised, double-blind, placebo-controlled trial. SETTING: Two geriatric medicine wards in a tertiary hospital. PARTICIPANTS: 100 patients aged over 64 years presenting to hospital and admitted under geriatric medicine with delirium. INTERVENTIONS: Participants were randomised in a 1:1 ratio to receive 20 IU of long-acting insulin or placebo intranasally twice daily until delirium resolution, hospital discharge or intervention futility defined by prespecified criteria. MAIN OUTCOME: The primary outcome was delirium duration, assessed daily using the Confusion Assessment Method. Secondary outcomes included acute length of stay (LOS), delirium severity, antipsychotic use, hospital complications and mortality. RESULTS: The intention-to-treat analysis included 97 participants [intranasal insulin n = 48, control n = 49; mean (SD) age, 87.6 (7.0) years; 63% female]. Baseline characteristics were similar between groups. Median delirium duration [days (IQR)] was 4.8 [2.9, 9.2] for intranasal insulin and 6.8 [4.0, 9.8] for the control (HR 0.7, 95% CI 0.43-1.15; P = .16). Median acute LOS (days) was 7.9 [4.6, 14.5] for intranasal insulin and 12.9 [6.9, 16.8] for the control (HR 0.56, 0.35-0.89; P = .014). No significant differences were observed in other secondary outcomes. Intranasal insulin demonstrated favourable tolerability. Overall, 86% of the participants were compliant with the intervention (≥80% of doses). Prespecified subgroup analysis revealed an age-related response, with participants aged ≤88 years showing shorter delirium duration with intranasal insulin [n = 46; intranasal insulin: median 3.9 (IQR 2.9, 6.9) days vs control: 7.0 (4.7, 9.7); HR 0.34, 0.16-0.74; P = .006], whereas no difference was observed in participants aged >88 years [n = 51; intranasal insulin 5.4 (2.9, 11.1) vs control 4.9 (2.6, 12.9); HR 0.87, 0.39-1.94; P = .73]. CONCLUSION AND RELEVANCE: This is the first study of intranasal insulin for delirium treatment. The reduced LOS combined with the observed age-related effects warrants further investigation into the clinical potential of intranasal insulin in managing delirium in older patients. TRIAL REGISTRATION: ACTRN 12618000318280
Preface to parasites of the genital tract: short- and long-term consequences.
Get PDFDioecious species that reproduce by internal fertilization typically carry an associated risk of exposure to sexually transmitted parasites and pathogens. When hosts intermingle for procreation, certain protist and helminth parasites, for example, transfer successfully between individuals and then navigate across various life history traits of their hosts, often probing dimensions in both sex and gender, respectively. In humans, there are many sexually transmitted infections as well as sexually transmitted diseases. A well-known sexually transmitted infection is the flagellated protist Trichomonas vaginalis that causes trichomoniasis, with over 150 million new cases reported annually. By contrast, the schistosome blood fluke Schistosoma haematobium, though not a sexually transmitted infection, causes significant damage to the male and female genital tracts. Such overt damage raises risks of spreading and acquiring Human Immunodeficiency Virus and Human Papilloma Virus. In Africa, over 50 million women continue to suffer from female genital schistosomiasis, alongside a poorly quantified global burden of travel-related infections. In conjunction with male genital schistosomiasis, urogenital schistosomiasis causes much suffering, within and between afflicted households, inclusive of stigmatization. Both trichomoniasis and schistosomiasis expose several public health needs currently addressed inadequately by routine sexual and reproductive health services. This preface to the Parasitology Special Issue entitled 'Parasites of the genital tract: short- and long-term consequences', introduces 19 papers that explore the short - and long-term impacts of parasitic infections within the genital tract. While current parasitological research is weighted towards human medicine, we encourage future studies that explore veterinary contexts and analogous parasitic diseases within wildlife
Toward a comprehensive research agenda: exploring the health economics of palliative care in Australia.
Get PDFBACKGROUND: Despite significant advances in the availability and quality of palliative care globally, health economics research to understand the value of palliative care in Australian settings remains scarce. To address knowledge gaps and foster evidence-informed policy, funding and practice, this paper presents a consensus-driven research agenda for the health economics of palliative care in Australia. METHODS: A panel of 27 Australian experts was convened, including health economists, palliative care clinicians/researchers, policy makers/government officials, and representatives from the national peak body for palliative care. Panel members completed a survey, participated in a forum and collectively drafted the research agenda. RESULTS: The panel recommended 16 health economics research priorities across four key areas: (1) person-centred outcomes; (2) costs; (3) economic evaluation; and (4) data and metrics. Specific priorities included: comprehensively capturing the benefits of palliative care for people with life-limiting illnesses and their informal carers; understanding the diversity of preferences for palliative care across the population; capturing informal caring costs within economic evaluations; embedding economic evaluation within clinical trials and health services studies; and quantifying the extent and location of unmet palliative care needs. CONCLUSIONS: This paper outlines high-priority research actions to generate the economic evidence required for appropriate funding and resource allocation in palliative care. The research agenda serves as a strategic tool to help researchers address gaps without duplicating efforts. By focusing on these priorities, we aim to support the development of more effective, equitable and sustainable palliative care services across Australia
Secure Synchronization Control of Markovian Jump Neural Networks Under DoS Attacks with Memory-Based Adaptive Event-Triggered Mechanism
Get PDFDientamoeba fragilis: a story of contradictions.
Get PDFDientamoeba fragilis is a gastrointestinal parasite of controversial clinical significance. From its discovery until today, contradictory articles have been published on whether infection is correlated with symptoms, treatment is associated with recovery and whether infection is associated with elevated intestinal inflammatory markers (faecal calprotectin). Additionally, there is no consensus on the infective stage of the lifecycle. Competing theories propose that either Enterobius vermicularis ova act as a vector for the transmission of trophozoites or that the cyst stage, which is rarely found, is responsible for infection. In this review, we aim to critique these contradictions to determine if D. fragilis should be considered a pathogen in clinical practice. The frequent limitation of studies is challenges in setting up a reliable, healthy control group and the reliability of diagnostic methods. Many studies are opportunistic in design, using samples that have been submitted for routine pathology testing. Even if all pathology tests are negative for infectious agents, the current health status of people who are submitting samples for pathology testing is unlikely to be the best option, just the most available one. Of greater concern is the reliability of some diagnostic methods. Some studies have suggested that at least one of the lab-based real-time PCR assays used for the diagnosis of D. fragilis has issues with false positives in human samples. This calls into question much of the evidence that has been published on D. fragilis being a commensal instead of a pathogen. As such, D. fragilis should be considered a potential pathogen when investigating gastrointestinal illness. Developing better guidelines on determining when D. fragilis is the causative agent of symptoms and when to treat are important topics for future research
Robust optimization of double pendulum tuned mass damper for vibration control of offshore platforms
No full textPendulum tuned mass dampers (PTMDs) have been utilized to suppress the negative effects of vibrations in high-rise structures. In this work, to further improve the performance of a PTMD with a simpler structure, a double pendulum tuned mass damper (DPTMD) is proposed for passive vibration control of structures. A DPTMD includes two PTMDs with different pendulum lengths and masses, and a dashpot is used to connect both pendulum masses. A system including a single-degree-of-freedom (SDOF) structure equipped with a DPTMD under an external force excitation is established. To assess the vibration control capability of this device, the effectiveness and robustness of an optimal DPTMD are computed and compared with those of an optimal PTMD with the same weight. The obtained results show that the DPTMD significantly outperforms the single PTMD across a wider frequency range of excitation force. With the same level of structural vibration reduction, using the DPTMD instead of the PTMD can significantly reduce the absorber’s weight added to the primary structure. The weight reduction achieved by employing the DPTMD rather than the PTMD ranges from 34.8% to 41.2% when aiming for vibration reduction of 60% to 80%. In addition, the DPTMD is less robust than the PTMD in resisting variations in the structural frequency. Nevertheless, if the efficiency is maintained the same as that of the optimal PTMD, the DPTMD offers multiple options for frequency and damping ratio to improve its robustness
Inclusive Technologies education
Get PDFInclusive education aims to ensure that all students, regardless of their learning needs, culture, location, gender, and backgrounds have the right to engage in meaningful learning experiences that allow them to achieve to their full potential. In the context of technology education, this means providing every student with the opportunity to become a creator using technologies, while also leveraging technology to support their individual learning needs. This chapter explores how assistive technologies can be used to support students with cognitive, physical, language, speech, auditory, and visual challenges. Ways to promote cultural and gender inclusion are also unpacked. The digital divide is considered, including how students in remote locations and from lower socio-economic backgrounds can be disproportionally disadvantaged. The Universal Design for Learning framework is examined as a way to promote more inclusive digital design education through multiple means of engagement, representation, and expression. Examples involving culturally responsive technologies projects, ‘unplugged’ activities, and digital storytelling are showcased, to spark inclusive and creative Technologies education practices by teachers
3D-Printed Multi-Band FSS with Near-Equal Fractional Pass-/Stop-Band Divisions
No full textThis paper presents a frequency-selective surface (FSS) design fabricated by 3D printing techniques and metallization processes. The double-layer spatial filter consists of concentric resonant rings within the hexagonal unit cells, which alternately generate three passbands and two stopbands with equal fractional bandwidths (FBWs). Each passband or stopband contains two transmission poles and zeros, with sharp transitions in the roll-off regions. The tunability can be achieved by reconfiguring the dielectric insertion plate with varied effective permittivities and thickness profiles
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