Fluorogenic RNA-based biomaterials for imaging and tracking the cargo of extracellular vesicles.

Extracellular vesicles (EVs), or exosomes, play important roles in physiological and pathological cellular communication and have gained substantial traction as biological drug carriers. EVs contain both short and long non-coding RNAs that regulate gene expression and epigenetic processes. To fully capitalize on the potential of EVs as drug carriers, it is important to study and understand the intricacies of EV function and EV RNA-based communication.

The effect of human decomposition on bullet examination.

Most firearm related homicides involve the deceased being forensically examined within a day or two, however, there are times when bodies have been examined and the fired components removed several days or weeks after death, when the body is in an active or advanced state of decomposition. In these cases, ballistic investigation has been found to be complicated due to the damage to the bullets, however the extent of this is not yet known. To date, there have been no studies investigating the effect of human decomposition and the subsequent analysis of bullets lodged in the body in an Australian context.

Saw marks in bone: A preliminary empirical study to inform decision making and best practice.

Forensic toolmark examiners compare marks between those observed on an item/surface and those made by a reference implement, such as a particular tool or weapon, to provide an opinion of the likelihood of common origin. It is widely accepted that such comparison opinions need to be underpinned by empirical research, and this study aimed to add to the knowledge base relied upon when developing and comparing saw marks in bone, a substrate encountered in body dismemberment cases. Porcine bones were used as a human proxy; they were either fresh with residual soft tissue and bodily fluids present ('wet') to replicate dismembered bones shortly post-mortem, or processed to remove soft tissue and moisture content ('dry') to represent cases of dismemberment after an extended period of decomposition and exposure.

Lack of recognition and documentation of stress hyperglycemia is a disruptor of optimal continuity of care.

Stress hyperglycemia (SH) is a manifestation of altered glucose metabolism in acutely ill patients which worsens outcomes and may represent a risk factor for diabetes. Continuity of care can assess this risk, which depends on quality of hospital clinical documentation. We aimed to determine the incidence of SH and documentation tendencies in hospital discharge summaries and continuity notes.

Clinical decision support to improve management of diabetes and dysglycemia in the hospital: a path to optimizing practice and outcomes.

Introduction: Innovative approaches are needed to design robust clinical decision support (CDS) to optimize hospital glycemic management. We piloted an electronic medical record (EMR), evidence-based algorithmic CDS tool in an academic center to alert clinicians in real time about gaps in care related to inpatient glucose control and insulin utilization, and to provide management recommendations.

Research Design And Methods: The tool was designed to identify clinical situations in need for action: (1) severe or recurrent hyperglycemia in patients with diabetes: blood glucose (BG) ≥13.

Masking Between Reserved Alarm Sounds of the IEC 60601-1-8 International Medical Alarm Standard: A Systematic, Formal Analysis.

Objective: In this work, we systematically evaluated the reserved alarm sounds of the IEC 60601-1-8 international medical alarm standard to determine when and how they can be totally and partially masked.

Background: IEC 60601-1-8 gives engineers instruction for creating human-perceivable auditory medical alarms. This includes reserved alarm sounds: common types of alarms where each is a tonal melody.

Themes of Worry Among Psychiatric Inpatients That Persist Through Acute Hospitalization.

Introduction: Problems that worry patients throughout hospitalization are complex and varied, but they fall within the scope of safe, effective, patient-centered care. To our knowledge, there is no evidence describing the problems that worry patients in inpatient psychiatric units.

Aim: The purpose of this quality improvement project was to describe common themes of worry experienced by individuals in psychiatric inpatient units in order to improve patient experience.

Effects of Inhaled Corticosteroids and Particle Size on Risk of Obstructive Sleep Apnea: A Large Retrospective Cohort Study.

Inhaled corticosteroids (ICS) produce local effects on upper airway dilators that could increase the risk of developing obstructive sleep apnea (OSA). Given that the particle size of ICS changes their distribution, the particle size of ICS may impact the risk of developing OSA. In this large retrospective study, we explore the relationship of ICS use and OSA in patients with asthma.

Can a Community-Led Intervention Offering Social Support and Health Education Improve Maternal Health? A Repeated Measures Evaluation of the PACT Project Run in a Socially Deprived London Borough.

Social adversity can significantly influence the wellbeing of mothers and their children. Maternal health may be improved through strengthened support networks and better health literacy. Health improvement at the population level requires optimizing of the collaboration between statutory health services, civic organizations (e.

Evaluation of a Community-Led Intervention in South London: How Much Standardization Is Possible?

It is widely recognized that public health interventions benefit from community engagement and leadership, yet there are challenges to evaluating complex, community-led interventions assuming hierarchies of evidence derived from laboratory experimentation and clinical trials. Particular challenges include, first, the inconsistency of the intervention across sites and, second, the absence of researcher control over the sampling frame and methodology. This report highlights these challenges as they played out in the evaluation of a community-organized health project in South London.

An Experimental Validation of Masking in IEC 60601-1-8:2006-Compliant Alarm Sounds.

Objective: This research investigated whether the psychoacoustics of simultaneous masking, which are integral to a model-checking-based method, previously developed for detecting perceivability problems in alarm configurations, could predict when IEC 60601-1-8-compliant medical alarm sounds are audible.

Background: The tonal nature of sounds prescribed by IEC 60601-1-8 makes them potentially susceptible to simultaneous masking: where concurrent sounds render one or more inaudible due to human sensory limitations. No work has experimentally assessed whether the psychoacoustics of simultaneous masking accurately predict IEC 60601-1-8 alarm perceivability.

A story of data won, data lost and data re-found: the realities of ecological data preservation.

This paper discusses the process of retrieval and updating legacy data to allow on-line discovery and delivery. There are many pitfalls of institutional and non-institutional ecological data conservation over the long term. Interruptions to custodianship, old media, lost knowledge and the continuous evolution of species names makes resurrection of old data challenging.

Diabetes Intervention Accentuating Diet and Enhancing Metabolism (DIADEM-I): a randomised controlled trial to examine the impact of an intensive lifestyle intervention consisting of a low-energy diet and physical activity on body weight and metabolism in early type 2 diabetes mellitus: study protocol for a randomized controlled trial.

Background: Type 2 diabetes mellitus (T2DM) and obesity are syndemic and will have a significant impact on affected individuals and healthcare services worldwide. Evidence shows that T2DM remission can be achieved with significant weight loss in those who are younger with early diabetes and requiring fewer medications for glycaemic control. DIADEM-I aims to examine the impact of an intensive lifestyle intervention (ILI) using a low-energy diet (LED) meal replacement approach combined with physical activity in younger individuals with early T2DM.

A formal approach to discovering simultaneous additive masking between auditory medical alarms.

The failure of humans to respond to auditory medical alarms has resulted in numerous patient injuries and deaths and is thus a major safety concern. A relatively understudied source of response failures has to do with simultaneous masking, a condition where concurrent sounds interact in ways that make one or more of them imperceptible due to physical limitations of human perception. This paper presents a method, which builds on a previous implementation, that uses a novel combination of psychophysical modeling and formal verification with model checking to detect masking in a modeled configuration of medical alarms.

Community organizing and community health: piloting an innovative approach to community engagement applied to an early intervention project in south London.

Background: The importance of community engagement in health is widely recognized, and key themes in UK National Institute for Health and Clinical Excellence (NICE) recommendations for enhancing community engagement are co-production and community control. This study reports an innovative approach to community engagement using the community-organizing methodology, applied in an intervention of social support to increase social capital, reduce stress and improve well-being in mothers who were pregnant and/or with infants aged 0-2 years.

Methods: Professional community organizers in Citizens-UK worked with local member civic institutions in south London to facilitate social support to a group of 15 new mothers.

Generating Phenotypical Erroneous Human Behavior to Evaluate Human-automation Interaction Using Model Checking.

Breakdowns in complex systems often occur as a result of system elements interacting in unanticipated ways. In systems with human operators, human-automation interaction associated with both normative and erroneous human behavior can contribute to such failures. Model-driven design and analysis techniques provide engineers with formal methods tools and techniques capable of evaluating how human behavior can contribute to system failures.

Using Task Analytic Models and Phenotypes of Erroneous Human Behavior to Discover System Failures Using Model Checking.

Breakdowns in complex systems often occur as a result of system elements interacting in ways unanticipated by analysts or designers. In systems with human operators, human-automation interaction associated with both normative and erroneous human behavior can contribute to such failures. This paper presents a method for automatically generating task analytic models encompassing both erroneous and normative human behavior from normative task models.

Formally verifying human-automation interaction as part of a system model: limitations and tradeoffs.

Both the human factors engineering (HFE) and formal methods communities are concerned with improving the design of safety-critical systems. This work discusses a modeling effort that leveraged methods from both fields to perform formal verification of human-automation interaction with a programmable device. This effort utilizes a system architecture composed of independent models of the human mission, human task behavior, human-device interface, device automation, and operational environment.

A Method for the Formal Verification of Human-interactive Systems.

Predicting failures in complex, human-interactive systems is difficult as they may occur under rare operational conditions and may be influenced by many factors including the system mission, the human operator's behavior, device automation, human-device interfaces, and the operational environment. This paper presents a method that integrates task analytic models of human behavior with formal models and model checking in order to formally verify properties of human-interactive systems. This method is illustrated with a case study: the programming of a patient controlled analgesia pump.

Comparing perceptual judgment and subjective measures of spatial awareness.

Spatial awareness is important in domains where safety hinges on human operators keeping track of the relative locations of objects in the environment. While a variety of subjective and judgment-based measures have been used to evaluate spatial awareness, none have probed all three of its levels: (1) identification of environmental objects, (2) their current locations relative to the operator, and (3) their relative positions over time. This work compares new judgment-based measures of spatial awareness that probe all three levels of spatial awareness to conventional subjective measures.

The politics of NGO registration in international protectorates: the cases of Bosnia and Iraq.

Following international interventions in Bosnia-Herzegovina(1) and Iraq, non-governmental organisations (NGOs) have played a central role in delivering humanitarian relief, encouraging participation in new systems of government, and advocating on behalf of marginalised groups. Although intervening agencies have framed such autonomous organisations as unquestionably virtuous, scholars have increasingly questioned the agency of NGOs, pointing to the constraining effects of funding and regulatory mechanisms. This paper contributes to this body of work by offering a detailed examination of legislation requiring NGOs to register with nascent state institutions.

Spatial awareness in synthetic vision systems: using spatial and temporal judgments to evaluate texture and field of view.

Objective: This work introduced judgment-based measures of spatial awareness and used them to evaluate terrain textures and fields of view (FOVs) in synthetic vision system (SVS) displays.

Background: SVSs are cockpit technologies that depict computer-generated views of terrain surrounding an aircraft. In the assessment of textures and FOVs for SVSs, no studies have directly measured the three levels of spatial awareness with respect to terrain: identification of terrain, its relative spatial location, and its relative temporal location.