The role of theta and gamma oscillations in item memory, source memory, and memory confidence.

Theta and gamma oscillations have been linked to episodic memory processes in various studies. Both oscillations seem to be vital for processes guided by the medial temporal lobe, such as the retrieval of information from memory. While theta oscillations increase with successful memory, it is unclear what the unique contribution of theta is to various subcomponents of memory. On the other hand, memory-related gamma oscillations have been mainly reported in the hippocampus, leaving the role of neocortical gamma in memory underexplored. In this study, we investigated how unique variability in memory accuracy and memory confidence contributes to fluctuations in theta and gamma power. To this end, we recorded EEG from 54 participants while they performed a source memory task. From this task we obtained their item memory accuracy, source memory accuracy, item memory confidence, and source memory confidence. These behavioral measures were put in a trial-by-trial linear mixed effects model to uncover their unique contribution to the oscillatory power in frontal and parietal regions. Our results are in line with the involvement of theta oscillations in both memory accuracy and confidence, but seem to indicate a main role for theta oscillations in memory-related confidence. In addition, we found that gamma oscillations play various roles in memory processing, dependent on brain region.

The role of theta and gamma oscillations in item memory, source memory, and memory confidence.

Theta and gamma oscillations have been linked to episodic memory processes in various studies. Both oscillations seem to be vital for processes guided by the medial temporal lobe, such as the retrieval of information from memory. While theta oscillations increase with successful memory, it is unclear what the unique contribution of theta is to various subcomponents of memory. On the other hand, memory-related gamma oscillations have been mainly reported in the hippocampus, leaving the role of neocortical gamma in memory underexplored. In the current study, we explored how unique variability in memory accuracy and memory confidence contributes to fluctuations in theta and gamma power. To this end, we recorded EEG from 54 participants while they performed a source memory task. From this task we obtained their item memory accuracy, source memory accuracy, item memory confidence, and source memory confidence. These behavioral measures were put in a trial-by-trial linear mixed effects model to uncover their unique contribution to the oscillatory power in frontal and parietal regions. Our results are in line with the involvement of theta oscillations in both memory accuracy and confidence, but seem to indicate a main role for theta oscillations in memory-related confidence. In addition, we found that gamma oscillations play various roles in memory-processing, dependent of brain region.

COVID-19 vaccine uptake among healthcare workers: an achievable quality improvement target.

There is a need to optimize SARS-CoV-2 vaccination rates amongst healthcare workers (HCWs) to protect staff and patients from healthcare-associated COVID-19 infection. During the COVID-19 pandemic, many organizations implemented vaccine mandates for HCWs. Whether or not a traditional quality improvement approach can achieve high-rates of COVID-19 vaccination is not known. Our organization undertook iterative changes that focused on the barriers to vaccine uptake. These barriers were identified through huddles, and addressed through extensive peer outreach, with a focus on access and issues related to equity, diversity and inclusion. The outreach interventions were informed by real-time data on COVID-19 vaccine uptake in our organization. The vaccine rate reached 92.3% by 6 December 2021 with minimal differences in vaccine uptake by professional role, clinical department, facility or whether the staff had a patient facing role. Improving vaccine uptake should be a quality improvement target in healthcare organizations and our experience shows that high vaccine rates are achievable through concerted efforts targeting specific barriers to vaccine confidence.

Investing in our human capital: Sharing the experience of implementing a retention strategy at a large academic hospital from a leadership lens.

The impact of the COVID-19 pandemic on healthcare providers is well documented and has resulted in significant pressures from a health human resources perspective with many point-of-care providers taking extended leave or moreover, leaving the healthcare sector altogether. As part of a larger Health Human Resources (HHR) strategy at Sunnybrook Health Sciences Centre (Sunnybrook) in Toronto, Canada, a time-limited interprofessional working group titled Supporting Team Sunnybrook (STS) was created. The working group was created to focus on staff retention to respond to ongoing concerns by leaders with regard to staff leaving the organization at an increased rate as documented by our organization's decision support team. Anecdotally, many staff cited their decision to leave the organization as a consequence of the pandemic. As no staff retention committee had been formally created at our organization, STS was established to engage all staff members while addressing and resolving current feedback, concerns, suggestions and issues. The objective of our working group was to review published literature, establish themes from this review, and align these themes to priority themes brought forward by staff through a number of data capture activities. Data capture activities included reviewing existing survey data, new survey data and meetings with staff members. Analysis of the data resulted in the identification of five key consensus areas (priority themes): Staff recognition, wellbeing, grow at Sunnybrook, leaderful leaders, and communication. Our team created five corresponding working groups with the aim to create short- and long-term goals, as well as time sensitive and sustainable operational activities that would contribute to improved staff retention at our organization. Outcomes from our work provided two key learnings to leaders on their ongoing work to retain staff which were the importance of: (1) engagement across all roles, professions including non-clinical team members and support staff and (2) broad communication on the outcomes of our working group to demonstrate that that their feedback was taken seriously and acted upon.

The effectiveness of gaming interventions for depression and anxiety in young people: systematic review and meta-analysis.

BACKGROUND: Recent research has investigated the use of serious games as a form of therapeutic intervention for depression and anxiety in young people. AIMS: To conduct a systematic review and meta-analysis into the effectiveness of gaming interventions for treating either depression or anxiety in individuals aged 12-25 years. METHOD: An electronic search was conducted on the 30 March 2020, using PsycINFO, ISI Web of Science Core Collection, Medline and EMBASE databases. Standardised effect sizes (Hedge's g) were calculated for between-participant comparisons between experimental (therapeutic intervention) and control conditions, and within-participant comparisons between pre- and post-intervention time points for repeated measures designs. RESULTS: Twelve studies (seven randomised controlled trials (RCTs) and five non-randomised studies) were included. For RCTs, there was a statistically significant and robust effect (g = -0.54, 95% CI -1.00 to -0.08) favouring the therapeutic intervention when treating youth depression. For non-RCTs, using a repeated measures design, the overall effect was also strong (g = -0.75, 95% CI -1.64 to 0.14) favouring therapeutic intervention, but this was not statistically significant. Interestingly, we found no statistically significant effect for treating youth anxiety. CONCLUSIONS: There is preliminary evidence to suggest that gaming interventions are an effective treatment for youth depression, but not anxiety. Further research is warranted to establish the utility, acceptability and effectiveness of gaming interventions in treating mental health problems in young people.

mapMECFS: a portal to enhance data discovery across biological disciplines and collaborative sites.

BACKGROUND: Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a debilitating disease which involves multiple body systems (e.g., immune, nervous, digestive, circulatory) and research domains (e.g., immunology, metabolomics, the gut microbiome, genomics, neurology). Despite several decades of research, there are no established ME/CFS biomarkers available to diagnose and treat ME/CFS. Sharing data and integrating findings across these domains is essential to advance understanding of this complex disease by revealing diagnostic biomarkers and facilitating discovery of novel effective therapies. METHODS: The National Institutes of Health funded the development of a data sharing portal to support collaborative efforts among an initial group of three funded research centers. This was subsequently expanded to include the global ME/CFS research community. Using the open-source comprehensive knowledge archive network (CKAN) framework as the base, the ME/CFS Data Management and Coordinating Center developed an online portal with metadata collection, smart search capabilities, and domain-agnostic data integration to support data findability and reusability while reducing the barriers to sustainable data sharing. RESULTS: We designed the mapMECFS data portal to facilitate data sharing and integration by allowing ME/CFS researchers to browse, share, compare, and download molecular datasets from within one data repository. At the time of publication, mapMECFS contains data curated from public data repositories, peer-reviewed publications, and current ME/CFS Research Network members. CONCLUSIONS: mapMECFS is a disease-specific data portal to improve data sharing and collaboration among ME/CFS researchers around the world. mapMECFS is accessible to the broader research community with registration. Further development is ongoing to include novel systems biology and data integration methods.

Control Limitations in Models of T1DM and the Robustness of Optimal Insulin Delivery.

BACKGROUND: In insulin therapy, the blood glucose level is constrained from below by the hypoglycemic threshold, that is, the blood glucose level must remain above this threshold. It has been shown that this constraint fundamentally limits the ability to lower the maxima of the blood glucose level predicted by many mathematical models of glucose metabolism. However, it is desirable to minimize hyperglycemia as well. Hence, a desirable insulin input is one that minimizes the maximum glucose concentration while causing it to remain above the hypoglycemic, or higher, threshold. It has been shown that this input, which we call optimal, is characterized by glucose profiles for which either each maximum of the glucose concentration is followed by a minimum or each minimum is followed by a maximum. METHODS: We discuss the implication of this inherent control limitation for clinical practice and test, through simulation, the robustness of the optimal input to a number of different model and parameter uncertainties. We further develop guidelines on how to design an optimal insulin input that is robust to such uncertainties. RESULTS: The optimal input is in general not robust to uncertainties. However, a number of strategies may be used to ensure the blood glucose level remains above the hypoglycemic threshold and the maximum blood glucose level achieved is less than that achieved by standard therapy. CONCLUSIONS: An understanding of the limitations on the controllability of the blood glucose level is important for future treatment improvements and the development of artificial pancreas systems.

Developing and Evaluating Multimedia Patient Education Tools to Better Prepare Prostate-Cancer Patients for Radiotherapy Treatment (Randomized Study).

The purpose of this study is to determine the effectiveness of multimedia educational tools to improve CT planning preparation for intensity modulated radiotherapy (IMRT) for prostate cancer. Many patients are not prepared when given verbal preparation instructions to have a full bladder and empty rectum for their IMRT and require being rescanned, which results in additional costs for the patient and the hospital. A pamphlet and video outlining the proper preparation for prostate IMRT was created to decrease additional scans and the associated costs, while increasing patient satisfaction. A controlled, randomized experimental group study was conducted to examine the effectiveness of the multimedia tools (the video and the pamphlet), as compared to the pamphlet only, in preparing patients for their planning CT appointment. We found no statistical difference between the multimedia group and the pamphlet group in patients' preparedness for their appointments and the rescanning rate. However, patients in the multimedia group indicated that they felt more prepared about their treatment after watching the video and stated that they would recommend the video to other patients with prostate cancer. Furthermore, patients who had to wait longer for their planning CT appointment felt less prepared by the materials than those with a shorter wait time. We recommend reducing wait times between appointments as much as possible to increase patients' preparedness for the planning CT. We conclude that providing multimedia treatment information and minimizing wait times increases patients' feelings of preparedness leading to a more positive treatment experience and reducing costly rescans. TRIAL REGISTRATION: ClinicalTrials.gov NCT02410291.

RBApp: Creation and Patterns of Use of an Educational Mobile Application for Radiobiology Calculations in Radiation Therapy.

INTRODUCTION: RBApp is an educational software program that calculates the biologically effective dose and equivalent dose in 2-Gy fractions, permitting conversion between dose-fractionation schemes in radiation therapy. The purposes of this study were to describe the adoption and current patterns of use of this tool and evaluate user satisfaction with RBApp. METHODS: RBApp is available as a native app for Android and BlackBerry and a web app for iOS and other devices. User and device characteristics were collected from app store dashboards and server logs; expected values were retrieved from StatCounter Global Stats. A voluntary web-based questionnaire was created to evaluate the patterns of use of RBApp. This questionnaire collected information on user demographics, purpose of use, and user satisfaction. RESULTS: Over a 2.75-year period, there were 2,291 installations on Android and BlackBerry devices; 8,074 unique visits were logged to the web app; and 25 respondents completed the web-based questionnaire. Among this group, RBApp was used by radiation oncologists (44.0%), physicists (32.0%), and resident physicians (24.0%). It was used for clinical decision making by 78.3% of users, education and training by 43.5%, and research by 30.4%. Twenty of 22 users (90.9%) were satisfied with RBApp. A greater proportion of web app users used obsolete software to access the application compared with the rest of the global Internet population; 15.2% (95% confidence interval, 12.3%-18.6%) used Windows XP, and 16.0% (95% confidence interval, 13.0%-19.5%) used Internet Explorer 8.0 (expected global proportions 8.5% and 3.1%, respectively). CONCLUSIONS: In this study, a mobile application for radiobiology calculations and its adoption by the radiation oncology community was evaluated. Users were satisfied with RBApp, and this tool is used for both clinical decision making and educational purposes. However, legacy software use remained prevalent, which may have implications for information security.

OMIT: a domain-specific knowledge base for microRNA target prediction.

Identification and characterization of the important roles microRNAs (miRNAs) perform in human cancer is an increasingly active research area. Unfortunately, prediction of miRNA target genes remains a challenging task to cancer researchers. Current processes are time-consuming, error-prone, and subject to biologists' limited prior knowledge. Therefore, we propose a domain-specific knowledge base built upon Ontology for MicroRNA Targets (OMIT) to facilitate knowledge acquisition in miRNA target gene prediction. We describe the ontology design, semantic annotation and data integration, and user-friendly interface and conclude that the OMIT system can assist biologists in unraveling the important roles of miRNAs in human cancer. Thus, it will help clinicians make sound decisions when treating cancer patients.

A multiaxial force-sensing implantable tibial prosthesis.

Accurate in vivo measurement of tibiofemoral forces is important in total knee arthroplasty. These forces determine polyethylene stresses and cold-flow, stress distribution in the implant, and stress transfer to the underlying implant bone interface. Theoretic estimates of tibiofemoral forces have varied widely depending on the mathematical models used. The six degrees of freedom of motion, complex articular surface topography, changing joint-contact position, intra- and extra-articular ligaments, number of muscles crossing the knee joint, and the presence of the patellofemoral joint contribute to the difficulty in developing reliable models of the knee. A prototype instrumented total knee replacement tibial prosthesis was designed, manufactured, and tested. This prosthesis accurately measured all six components of tibial forces (R2>0.997). The prosthesis was also instrumented with an internal microtransmitter for wireless data transmission. Remote powering of the sealed implanted electronics was achieved using magnetic coil induction. This device can be used to validate existing models of the knee that estimate these forces or to develop more accurate models. In conjunction with kinematic data, accurate tibiofemoral force data may be used to design more effective knee-testing rigs and wear simulators. Additional uses are intraoperative measurement of forces to determine soft-tissue balancing and to evaluate the effects of rehabilitation, external bracing, and athletic activities, and activities of daily living.

An implantable telemetry device to measure intra-articular tibial forces.

Tibial forces are important because they determine polyethylene wear, stress distribution in the implant, and stress transfer to underlying bone. Theoretic estimates of tibiofemoral forces have varied between three and six times the body weight depending on the mathematical models used and the type of activity analyzed. An implantable telemetry system was therefore developed to directly measure tibiofemoral compressive forces. This system was tested in a cadaver knee in a dynamic knee rig. A total knee tibial arthroplasty prosthesis was instrumented with four force transducers located at the four corners of the tibial tray. These transducers measured the total compressive forces on the tibial tray and the location of the center of pressure. A microprocessor performed analog-to-digital signal conversion and performed pulse code modulation of a surface acoustic wave radio frequency oscillator. This signal was then transmitted through a single pin hermetic feed-through tantalum wire antenna located at the tip of the stem. The radio frequency signal was received by an external antenna connected to a receiver and to a computer for data acquisition. The prosthesis was powered by external coil induction. The tibial transducer accurately measured both the magnitude and the location of precisely applied external loads. Successful transmission of the radio frequency signal up to a range of 3m was achieved through cadaveric bone, bone cement, and soft tissue. Reasonable accuracy was obtained in measuring loads applied through a polyethylene insert. The implant was also able to detect unicondylar loading with liftoff.