Microbial composition of Saharan dust plumes deposited as red rain in Granada (Southern Spain).

During durst storms, also biological material is transported from arid areas such as the Sahara Desert. In the present work, rain samples containing significant amounts of mineral dust have been collected in Granada during different red rain episodes. Biological features (bacteria, biofilm, pollen grain and fungal spore) as well as size-particle distribution and mineralogical composition were studied by SEM. Nanobacteria were observed for the first time in red rain samples. A preliminary metabarcoding analysis was performed on three red rain samples. Here, Bacillota made up 18 % and Pseudomonadota 23 % of the whole prokaryotic community. The fungal community was characterized by a high abundance of Ascomycota and, dependent on the origin, the presence of Chytridiomycota. By means of 16S rRNA sequencing, 18 cultivable microorganisms were identified. In general, members of the phyla Pseudomonadota and Bacillota made up the majority of taxa. Some species, such as Peribacillus frigoritolerans and Bacillus halotolerans were isolated during three different red rain episodes. Generally, red rain carries a wide variety of microorganisms, being their ecosystem and health effects largely unknown.

Kinematic response of seated male volunteers in various reclined postures on a sled subjected to a braking pulse.

Vehicle occupants expect greater postural flexibility with the introduction of highly automated vehicles, such as reclined postures. Experiments have been conducted with post mortem human subjects to study the risk of injury under impact conditions in reclined postures. However, the influence of the pre-crash phase on the kinematics in reclined postures has not yet been thoroughly studied. The aim of the present study is to investigate human responses under low g braking conditions focusing on different backrest angles in a generic sled environment. Three 50th percentile male volunteers were recruited to participate in a sled experiment. Each of them was subjected to a total of fourteen trials under a braking pulse with a maximum acceleration of 0.7 g for 700 ms. Different sitting postures were investigated: from 23° to 45°, 60° and 75° backrest tilt with respect to the vertical axis. In addition, two different seat pan tilt angles were considered: a 16° tilt angle for 23°, 45° and 60° backrest inclination and a 36° tilt angle for 60° and 75° backrest inclination. Measurements of volunteer kinematics, muscle activation and interaction forces between the volunteers and the sled, among others, were acquired. Initial results show a significant reduction in maximum forward head displacement from the upright to the reclined postures (p < 0.02), with the exception of the 45° reclined posture. However, no significant difference in maximum head displacement was found between the different reclined postures (p > 0.1). Seat pan tilt angle did significantly influence forward head excursion when considering the same seatback inclination (p < 0.01). It is of great importance to investigate occupant kinematics during the pre-crash phase to understand its influence on the potential injuries that may occur with a reclined posture in the event of a collision.

Société de Biomécanique Young Investigator Award 2019: Upper body behaviour of seated humans in vivo under controlled lateral accelerations.

BACKGROUND: A deep understanding of human reactions and stabilization strategies is required to predict their kinematics under external dynamic loadings, such as those that occur in vehicle passengers. Low-level frontal accelerations have been thoroughly investigated; however, the human response to different lateral accelerations is not well understood. The objective of this study is to gain insight regarding the responses of seated humans to lateral perturbations from volunteer experiments in different configurations. METHODS: Five volunteers anthropometrically comparable to the 50th-percentile American male, were seated on a sled and submitted to 21 lateral pulses. Seven configurations, each repeated three times, were investigated in this study: a relaxed muscular condition with four pulses, namely, sine and plateau pulses of 0.1 and 0.3 g in a straight spinal posture; a relaxed muscular condition with a plateau pulse of 0.3 g in a sagging spinal posture; and a braced condition with both plateau pulses in a straight spinal posture. Upper body segment kinematics were assessed using inertial measurement units. FINDINGS: The maximum lateral bending of the head was found to differ significantly among the four acceleration pulses (p < 0.001). Braced muscles significantly reduced lateral bending compared to relaxed muscles (p < 0.001). However, no significant difference was found in lateral bending between straight and sagging spinal postures (p = 0.23). INTERPRETATION: The study shows that not only pulse amplitude but also pulse shape influences human responses to low accelerations, while spinal posture does not influence lateral head bending. These data can be used to evaluate numerical active human body models.

Reactive Nitrogen Hotspots Related to Microscale Heterogeneity in Biological Soil Crusts.

Biocrusts covering drylands account for major fractions of terrestrial biological nitrogen fixation and release large amounts of gaseous reactive nitrogen (Nr) as nitrous acid (HONO) and nitric oxide (NO). Recent investigations suggested that aerobic and anaerobic microbial nitrogen transformations occur simultaneously upon desiccation of biocrusts, but the spatio-temporal distribution of seemingly contradictory processes remained unclear. Here, we explore small-scale gradients in chemical concentrations related to structural characteristics and organism distribution. X-ray microtomography and fluorescence microscopy revealed mixed pore size structures, where photoautotrophs and cyanobacterial polysaccharides clustered irregularly in the uppermost millimeter. Microsensor measurements showed strong gradients of pH, oxygen, and nitrite, nitrate, and ammonium ion concentrations at micrometer scales in both vertical and lateral directions. Initial oxygen saturation was mostly low (∼30%) at full water holding capacity, suggesting widely anoxic conditions, and increased rapidly upon desiccation. Nitrite concentrations (∼6 to 800 µM) and pH values (∼6.5 to 9.5) were highest around 70% WHC. During further desiccation they decreased, while emissions of HONO and NO increased, reaching maximum values around 20% WHC. Our results illustrate simultaneous, spatially separated aerobic and anaerobic nitrogen transformations, which are critical for Nr emissions, but might be impacted by future global change and land management.

Key Role of Equilibrium HONO Concentration over Soil in Quantifying Soil-Atmosphere HONO Fluxes.

Nitrous acid (HONO) is an important component of the global nitrogen cycle and can regulate the atmospheric oxidative capacity. Soil is an important source of HONO. [HONO]*, the equilibrium gas-phase concentration over the aqueous solution of nitrous acid in the soil, has been suggested as a key parameter for quantifying soil fluxes of HONO. However, [HONO]* has not yet been well-validated and quantified. Here, we present a method to retrieve [HONO]* by conducting controlled dynamic chamber experiments with soil samples applied with different HONO concentrations at the chamber inlet. We show a bi-directional soil-atmosphere exchange of HONO and confirm the existence of [HONO]* over soil: when [HONO]* is higher than the atmospheric HONO concentration, HONO will be released from soil; otherwise, HONO will be deposited. We demonstrate that [HONO]* is a soil characteristic, which is independent of HONO concentrations in the chamber but varies with different soil water contents. We illustrate the robustness of using [HONO]* for quantifying soil fluxes of HONO, whereas the laboratory-determined chamber HONO fluxes can largely deviate from those in the real world for the same soil sample. This work advances the understanding of the soil-atmosphere exchange of HONO and the evaluation of its impact on the atmospheric oxidizing capacity.

Potential effect of pre-activated muscles under a far-side lateral impact.

OBJECTIVE: The goal of this study is to evaluate the potential effect of muscle pre-activation under a lateral impact scenario, in this case focusing on a far-side impact, using an Active Human Body Model. METHODS: In total fourteen simulations were run, out of these, twelve were computed with an Active Human Body Model and two with a passive one. The models were subjected to a far-side impact scenario reaching up to 14 g's. Two different pre-crash scenarios were analyzed with the Active Human Body Model: (1) constant velocity, and (2) braking deceleration. During the pre-crash phase a lambda control based on the muscle length computed the muscle activation. Since there is no available data concerning the neuromuscular strategy of the occupants subjected to high accelerations, six different control strategies were analyzed during the in-crash phase. Besides, rib fracture and brain injury risk were analyzed, since they are the two most relevant body regions in this simplified far-side crash scenario. RESULTS: The pre-activation of the muscles showed an effect on both the occupant kinematics and estimated injury risks. Depending on the considered muscle strategy, the head lateral excursion varied up to 75 mm, specifically for the scenario with constant velocity. Moreover, the rib fracture probability and the brain injury indicator revealed higher injury risks for the passive Human Body Model. When applying the constant velocity during pre-crash, the fracture probability for two or more ribs ranged from 9.91 to 46.06% for the Active Human Body Model, whereas it reached 84.3% for the passive model. The brain injury indicator was reduced by about 10% when using the active model compared to the passive one. CONCLUSIONS: The numerical results show that the pre-activation of the muscles affects the kinematic and injury outcomes in car crashes. In this study, six muscular control strategies have been proposed. The two muscular controls that may be most realistic are: constant activation after the in-crash phase starts, by trying to hold the position prior to the crash, or no stimulation, by not responding to the upcoming in-crash event.

Adapting a System-Theoretic Hazard Analysis Method for the Analysis of an eHealth Interoperability Conformance Profile.

Interoperability between heterogenous (health) IT systems relies on standards, which are communicated to system vendors in the form of so-called conformance profiles. Clinical information systems are often subjected to mandatory conformance testing and certification prior to being admitted into the health information exchange (HIE). The requirements specified in conformance profiles are therefore instrumental for ensuring the correctness and safety of the emerging HIE network. How can we ensure the quality and safety of conformance requirements themselves? We have adapted a system-theoretic hazard analysis method (STPA) for this purpose and applied it to an industrial case study in British Columbia, the Clinical Data eXchange (CDX) system. Our results indicate that the method is effective in detecting missing and erroneous constraints.

Synaptic Plasticity Depends on the Fine-Scale Input Pattern in Thin Dendrites of CA1 Pyramidal Neurons.

Coordinated long-term plasticity of nearby excitatory synaptic inputs has been proposed to shape experience-related neuronal information processing. To elucidate the induction rules leading to spatially structured forms of synaptic potentiation in dendrites, we explored plasticity of glutamate uncaging-evoked excitatory input patterns with various spatial distributions in perisomatic dendrites of CA1 pyramidal neurons in slices from adult male rats. We show that (1) the cooperativity rules governing the induction of synaptic LTP depend on dendritic location; (2) LTP of input patterns that are subthreshold or suprathreshold to evoke local dendritic spikes (d-spikes) requires different spatial organization; and (3) input patterns evoking d-spikes can strengthen nearby, nonsynchronous synapses by local heterosynaptic plasticity crosstalk mediated by NMDAR-dependent MEK/ERK signaling. These results suggest that multiple mechanisms can trigger spatially organized synaptic plasticity on various spatial and temporal scales, enriching the ability of neurons to use synaptic clustering for information processing.SIGNIFICANCE STATEMENT A fundamental question in neuroscience is how neuronal feature selectivity is established via the combination of dendritic processing of synaptic input patterns with long-term synaptic plasticity. As these processes have been mostly studied separately, the relationship between the rules of integration and rules of plasticity remained elusive. Here we explore how the fine-grained spatial pattern and the form of voltage integration determine plasticity of different excitatory synaptic input patterns in perisomatic dendrites of CA1 pyramidal cells. We demonstrate that the plasticity rules depend highly on three factors: (1) the location of the input within the dendritic branch (proximal vs distal), (2) the strength of the input pattern (subthreshold or suprathreshold for dendritic spikes), and (3) the stimulation of neighboring synapses.

Applying Bidirectional Transformations to the Design of Interoperable EMR Systems.

Interoperability between heterogeneous health information systems has remained an elusive goal despite decades of exchange standards development and implementation initiatives. Empirical studies have shown that in many cases, implemented interoperability interfaces fail to function correctly. Unfortunately, the health informatics literature provides little guidance on how to best design and assure interoperability interfaces. Still, healthcare is not the only industry that requires the exchange of highly complex semantic data structures. Similar requirements can be observed in the engineering industry, where complex data models maintained by various types of development tools and environments must be synchronized over a product's life cycle. Research on how to best address this challenge has led to the development of the concept of bidirectional transformations (BX) and associated design theories, methods, and tools. While BX approaches have received little attention in e-Health interoperability applications to date, we believe that they can also facilitate the implementation and assurance of interoperability in that domain. In this paper, we cast the health information exchange (HIE) challenge as a BX problem, review applicable BX theories, and discuss their practical applications from the perspective of software engineers who are tasked with constructing and assuring bidirectional interoperability interfaces for health information systems. We further design a proof-of-concept interoperability interface using BX design methods in the context of a real-world interoperability standard initiative. We compare the new BX-based interoperability interface with a preexisting, conventionally designed implementation. We find that the BX design offers similar runtime performance while providing improved maintainability, testability, and modularity.

Data for Adherence Decision Support.

Technological interventions aimed at addressing medication non-adherence have shown some promise but do not deliver the full potential of an Internet of Things based Adherence Decision Support (ADS) system due, in part, to a lack high-resolution definition and measure of adherence. This paper presents a novel methodology and pilot study aimed at collecting data to support an AI-based measure of adherence. The pilot study results demonstrate the viability of the methodology and that a full-scale study could provide meaningful data to support to an AI-based ADS system.

Towards a Clinical Analytics Adoption Maturity Framework for Primary Care.

Clinical decision support systems are evolving with growing analytics capabilities towards pervasive use of artificial intelligence. Maturity models can guide the adoption of these new technologies in clinical practice to improve patient outcomes in primary care settings. Our literature survey identified the "Health Analytics Adoption Maturity Model" by Canada Health Infoway as a suitable basis for developing an adoption maturity framework with primary care focus. We follow a design-science research paradigm to develop a scientifically-validated mixed-method approach for assessing and guiding the evolution of clinical analytics capabilities in primary care. This paper summarizes the first phase of our research in progress.

New micro/mesoporous nanocomposite material from low-cost sources for the efficient removal of aromatic and pathogenic pollutants from water.

A new micro/mesoporous hybrid clay nanocomposite prepared from kaolinite clay, Carica papaya seeds, and ZnCl2 via calcination in an inert atmosphere is presented. Regardless of the synthesis temperature, the specific surface area of the nanocomposite material is between ≈150 and 300 m2/g. The material contains both micro- and mesopores in roughly equal amounts. X-ray diffraction, infrared spectroscopy, and solid-state nuclear magnetic resonance spectroscopy suggest the formation of several new bonds in the materials upon reaction of the precursors, thus confirming the formation of a new hybrid material. Thermogravimetric analysis/differential thermal analysis and elemental analysis confirm the presence of carbonaceous matter. The new composite is stable up to 900 °C and is an efficient adsorbent for the removal of a water micropollutant, 4-nitrophenol, and a pathogen, E. coli, from an aqueous medium, suggesting applications in water remediation are feasible.

Applying STOPP Guidelines in Primary Care Through Electronic Medical Record Decision Support: Randomized Control Trial Highlighting the Importance of Data Quality.

BACKGROUND: Potentially Inappropriate Prescriptions (PIPs) are a common cause of morbidity, particularly in the elderly. OBJECTIVE: We sought to understand how the Screening Tool of Older People's Prescriptions (STOPP) prescribing criteria, implemented in a routinely used primary care Electronic Medical Record (EMR), could impact PIP rates in community (non-academic) primary care practices. METHODS: We conducted a mixed-method, pragmatic, cluster, randomized control trial in research naïve primary care practices. Phase 1: In the randomized controlled trial, 40 fully automated STOPP rules were implemented as EMR alerts during a 16-week intervention period. The control group did not receive the 40 STOPP rules (but received other alerts). Participants were recruited through the OSCAR EMR user group mailing list and in person at user group meetings. Results were assessed by querying EMR data PIPs. EMR data quality probes were included. Phase 2: physicians were invited to participate in 1-hour semi-structured interviews to discuss the results. RESULTS: In the EMR, 40 STOPP rules were successfully implemented. Phase 1: A total of 28 physicians from 8 practices were recruited (16 in intervention and 12 in control groups). The calculated PIP rate was 2.6% (138/5308) (control) and 4.11% (768/18,668) (intervention) at baseline. No change in PIPs was observed through the intervention (P=.80). Data quality probes generally showed low use of problem list and medication list. Phase 2: A total of 5 physicians participated. All the participants felt that they were aware of the alerts but commented on workflow and presentation challenges. CONCLUSIONS: The calculated PIP rate was markedly less than the expected rate found in literature (2.6% and 4.0% vs 20% in literature). Data quality probes highlighted issues related to completeness of data in areas of the EMR used for PIP reporting and by the decision support such as problem and medication lists. Users also highlighted areas for better integration of STOPP guidelines with prescribing workflows. Many of the STOPP criteria can be implemented in EMRs using simple logic. However, data quality in EMRs continues to be a challenge and was a limiting step in the effectiveness of the decision support in this study. This is important as decision makers continue to fund implementation and adoption of EMRs with the expectation of the use of advanced tools (such as decision support) without ongoing review of data quality and improvement. TRIAL REGISTRATION: Clinicaltrials.gov NCT02130895; https://clinicaltrials.gov/ct2/show/NCT02130895 (Archived by WebCite at http://www.webcitation.org/6qyFigSYT).

Synthesis of mesoporous poly(melamine-formaldehyde) particles by inverse emulsion polymerization.

Mesoporous poly(melamine-formaldehyde) (MF) particles with surface areas of up to 200m2g-1 were synthesized by an inverse emulsion polymerization using dodecane and Span80® as continuous phase. The finer details of the shape control (using emulsion techniques) and the porosity control (using silica nanoparticles as hard-template) are discussed. The impact of phase-separation processes on the observable porosity of the 20-200µm sized spherical particles is analysed by gas sorption methods and electron microscopy. The high density of amine and triazine functional groups in the porous MF particles make the material a promising adsorber for heavy metal ions and methylene blue. In a preliminary column experiment, the synthesized material exhibited a total capacity of 2.54mmol/g (≙ 812.4mg/g) for the adsorption of methylene blue.

An Engagement Model for Medication Management: From Prescription to Description and Conscription.

Medication non-adherence is a global problem that has been studied over the past 40 years. Despite the large number of studies there is not an agreed upon definition of "adherence" in the literature. The lack of a consistent definition has resulted in issues in adherence research, clinical implementation, and HIT system development. In this paper a critical review of adherence literature is conducted. Based on this review, a new Adherence Interaction Model (AIM) is proposed and described in detail. AIM considers provider recommendations, the patient's interpretation of the recommendations, and the patient's behavior and provides the foundation for building a more objective view of adherence. AIM provides a foundation for future formalization of medication adherence concepts.

Considering the Language of Computerized Order Entry Systems.

Computerized Provider Order Entry (CPOE) systems have been shown to introduce new problems into clinical environments. Given the communication intensive nature of these systems considering the language(s) of communication can provide insight into their function and subsequent problems. The current (as November 2015) CPOE literature was reviewed using the language concepts of syntax, semantics, and pragmatics as a lens. In total, 202 articles were considered, of these only 46 received a full review. 145 results related to language concepts were extracted from these articles. These were categorized into five categories: syntax, semantics, system-pragmatics, syntax-pragmatics, and semantic-pragmatics. In total key themes were synthesized. The themes identified can be used to direct further research in the area of CPOE systems. It was found that current literature heavily favors pragmatics concerns of language at the expense of considering underlying factors (syntax and semantics). The results support the use of language as a means of analyzing interactions between actors in communication intensive systems.

Location-dependent synaptic plasticity rules by dendritic spine cooperativity.

Nonlinear interactions between coactive synapses enable neurons to discriminate between spatiotemporal patterns of inputs. Using patterned postsynaptic stimulation by two-photon glutamate uncaging, here we investigate the sensitivity of synaptic Ca(2+) signalling and long-term plasticity in individual spines to coincident activity of nearby synapses. We find a proximodistally increasing gradient of nonlinear NMDA receptor (NMDAR)-mediated amplification of spine Ca(2+) signals by a few neighbouring coactive synapses along individual perisomatic dendrites. This synaptic cooperativity does not require dendritic spikes, but is correlated with dendritic Na(+) spike propagation strength. Furthermore, we show that repetitive synchronous subthreshold activation of small spine clusters produces input specific, NMDAR-dependent cooperative long-term potentiation at distal but not proximal dendritic locations. The sensitive synaptic cooperativity at distal dendritic compartments shown here may promote the formation of functional synaptic clusters, which in turn can facilitate active dendritic processing and storage of information encoded in spatiotemporal synaptic activity patterns.

Detecting short-term change and variation in health-related quality of life: within- and between-person factor structure of the SF-36 health survey.

BACKGROUND: A major goal of much aging-related research and geriatric medicine is to identify early changes in health and functioning before serious limitations develop. To this end, regular collection of patient-reported outcome measure (PROMs) in a clinical setting may be useful to identify and monitor these changes. However, existing PROMs were not designed for repeated administration and are more commonly used as one-time screening tools; as such, their ability to detect variation and measurement properties when administered repeatedly remain unknown. In this study we evaluated the potential of the RAND SF-36 Health Survey as a repeated-use PROM by examining its measurement properties when modified for administration over multiple occasions. METHODS: To distinguish between-person (i.e., average) from within-person (i.e., occasion) levels, the SF-36 Health Survey was completed by a sample of older adults (N = 122, M age = 66.28 years) daily for seven consecutive days. Multilevel confirmatory factor analysis (CFA) was employed to investigate the factor structure at both levels for two- and eight-factor solutions. RESULTS: Multilevel CFA models revealed that the correlated eight-factor solution provided better model fit than the two-factor solution at both the between-person and within-person levels. Overall model fit for the SF-36 Health Survey administered daily was not substantially different from standard survey administration, though both were below optimal levels as reported in the literature. However, individual subscales did demonstrate good reliability. CONCLUSIONS: Many of the subscales of the modified SF-36 for repeated daily assessment were found to be sufficiently reliable for use in repeated measurement designs incorporating PROMs, though the overall scale may not be optimal. We encourage future work to investigate the utility of the subscales in specific contexts, as well as the measurement properties of other existing PROMs when administered in a repeated measures design. The development and integration of new measures for this purpose may ultimately be necessary.

Microwave-Assisted Synthesis of Defects Metal-Imidazolate-Amide-Imidate Frameworks and Improved CO2 Capture.

In this work, we report three isostructural 3D frameworks, named IFP-11 (R = Cl), IFP-12 (R = Br), and IFP-13 (R = Et) (IFP = Imidazolate Framework Potsdam) based on a cobalt(II) center and the chelating linker 2-substituted imidazolate-4-amide-5-imidate. These chelating ligands were generated in situ by partial hydrolysis of 2-substituted 4,5-dicyanoimidazoles under microwave (MW)-assisted conditions in DMF. Structure determination of these IFPs was investigated by IR spectroscopy and a combination of powder X-ray diffraction (PXRD) with structure modeling. The structural models were initially built up from the single-crystal X-ray structure determination of IFP-5 (a cobalt center and 2-methylimidazolate-4-amide-5-imidate linker based framework) and were optimized by using density functional theory calculations. Substitution on position 2 of the linker (R = Cl, Br, and Et) in the isostructural IFP-11, -12, and -13 allowed variation of the potential pore window in 1D hexagonal channels (3.8 to 1.7 Å). The potential of the materials to undergo specific interactions with CO2 was measured by the isosteric heat of adsorption. Further, we resynthesized zinc based IFPs, namely IFP-1 (R = Me), IFP-2 (R = Cl), IFP-3 (R = Br), and IFP-4 (R = Et), and cobalt based IFP-5 under MW-assisted conditions with higher yield. The transition from a nucleation phase to the pure crystalline material of IFP-1 in MW-assisted synthesis depends on reaction time. IFP-1, -3, and -5, which are synthesized by MW-assisted conditions, showed an enhancement of N2 and CO2, compared to the analogous conventional electrical (CE) heating method based materials due to crystal defects.

Lead User Design: Medication Management in Electronic Medical Records.

Improvements in medication management may lead to a reduction of preventable errors. Usability and user experience issues are common and related to achieving benefits of Electronic Medical Records (EMRs). This paper reports on a novel study that combines the lead user method with a safety engineering review to discover an innovative design for the medication management module in EMRs in primary care. Eight lead users were recruited that represented prescribers and clinical pharmacists with expertise in EMR design, evidence-based medicine, medication safety and medication research. Eight separate medication management module designs were prototyped and validated, one with each lead user. A parallel safety review of medicaiton management was completed. The findings were synthesized into a single common set of goals, activities and one interactive, visual prototype. The lead user method with safety review proved to be an effective way to elicit diverse user goals and synthesize them into a common design. The resulting design ideas focus on meeting the goals of quality, efficiency, safety, reducing the cognitive load on the user, and improving communication wih the patient and the care team. Design ideas are being adapted to an existing EMR product, providing areas for further work.