Comparison of face to face and online delivery of a dementia-specific experiential learning activity.

During the COVID-19 pandemic, healthcare professions shifted from face to face(F2F) to online educational delivery methods. Research evaluating the effectiveness of online educational delivery is mixed.The purpose of this study was to compare the effectiveness of a dementia-specific experiential learning activity(ELA) delivered to Doctor of Physical Therapy(DPT) students face to face(F2F) versus online. Participants included a sample of DPT students (n = 171) from four consecutive cohorts. In this quasi-experimental, single-site two-factor design study, students participated in either a F2F(n = 84) or online version (n = 87) of an ELA. They completed a dementia survey pre-(T1) and post-ELA(T2). Pre- and post-survey analysis demonstrated significant improvements between T1 and T2 for both groups. The interaction of group by time F(1,169) = 287.61, p < 0.01 indicates a main effect for groups over time. Analysis did not demonstrate significance between versions for T1 or T2. The interaction of time by group F(1,169) = 1.08, p = 0.30 indicates there was not an interaction of time by group.This study provided strong evidence that students benefitted from the dementia-specific ELA regardless of delivery method. Both methods proved equally effective, as there was no statistically significant difference between them. Programs may consider online experiences to increase schedule flexibility and content accessibility.

Impact of a short-duration experiential learning activity on DPT students' attitudes toward patients living with a dementia.

Healthcare practitioners (HCP) have expressed inadequate preparation in providing care to patients living with a dementia. Research suggests experiential learning activities (ELAs) can improve HCP knowledge and comfort toward this population. The purpose of this study was to evaluate the impact of a short-duration (2-hour) dementia ELA on Doctor of Physical Therapy (DPT) students' knowledge and comfort toward individuals living with a dementia. Participants included a sample of first-year DPT students (n=82).  In this pre-experimental, single-site, longitudinal study, students participated in an ELA at a memory care facility. They completed a dementia knowledge and comfort survey pre-(T1) and post-ELA(T2), as well as prior to their first clinical experience (nine months post-ELA; T3). Pre- and post-survey analysis demonstrated significant improvements between T1 to T2 and T1 to T3 with overall effect sizes ranging from very large (d=1.256) to huge (d=1.520). There were no significant differences between T2 to T3 analysis. Students demonstrated positive improvements in attitudes toward individuals living with a dementia following this ELA. Improvements were maintained over time. An ELA as short as two hours may improve person-centered care for patients living with a dementia. These types of activities should be considered for inclusion in DPT curricula.

A sterilizing tuberculosis treatment regimen is associated with faster clearance of bacteria in cavitary lesions in marmosets.

Shortening the lengthy treatment duration for tuberculosis patients is a major goal of current drug development efforts. The common marmoset develops human-like disease pathology and offers an attractive model to better understand the basis for relapse and test regimens for effective shorter duration therapy. We treated Mycobacterium tuberculosis-infected marmosets with two drug regimens known to differ in their relapse rates in human clinical trials: the standard four-drug combination of isoniazid, rifampin, pyrazinamide, and ethambutol (HRZE) that has very low relapse rates and the combination of isoniazid and streptomycin that is associated with higher relapse rates. As early as 2 weeks, the more sterilizing regimen significantly reduced the volume of lung disease by computed tomography (P = 0.035) and also significantly reduced uptake of [(18)F]-2-fluoro-2-deoxyglucose by positron emission tomography (P = 0.049). After 6 weeks of therapy, both treatments caused similar reductions in granuloma bacterial load, but the more sterilizing, four-drug regimen caused greater reduction in bacterial load in cavitary lesions (P = 0.009). These findings, combined with the association in humans between cavitary disease and relapse, suggest that the basis for improved sterilizing activity of the four-drug combination is both its faster disease volume resolution and its stronger sterilizing effect on cavitary lesions. Definitive data from relapse experiments are needed to support this observation.

Second generation 2-aminoimidazole based advanced glycation end product inhibitors and breakers.

The formation of advanced glycation end-products (AGE) as a result of the action of reducing sugars on host macromolecules plays a role in increased morbidity of diabetic patients. There are currently no clinically available therapeutics for the prevention or eradication of AGEs. Following our previous identification of 2-aminoimidazole (2-AI) based AGE inhibitors and breakers, we now report the use of a rapid, scalable, two-step procedure to access a second generation of 2-AI based anti-AGE compounds from commercially available amino acids. Several second generation compounds exhibit increased AGE inhibition and breaking activty compared to the first generation compounds and to the known AGE inhibitor aminoguanidine.

Inhibition and breaking of advanced glycation end-products (AGEs) with bis-2-aminoimidazole derivatives.

Advanced glycation end-products (AGEs), unregulated modifications to host macromolecules that occur as a result of metabolic dysregulation, play a role in many diabetes related complications, inflammation and aging, and may lead to increased cardiovascular risk. Small molecules that have the ability to inhibit AGE formation, and even break preformed AGEs have enormous therapeutic potential in the treatment of these disease states. We report the screening of a series of 2-aminoimidazloles for anti-AGE activity, and the identification of a bis-2-aminoimidazole lead compound that possesses superior AGE inhibition and breaking activity compared to the known AGE inhibitor aminoguanidine.

Differences in office-based personal space perception between British and Korean populations.

We sought to understand how the perception of personal space is influenced by different levels of social density, spatial density, and type of window-view in South Korean and United Kingdom workplaces. We employed virtual reality to simulate shared and single occupancy offices. We obtained personal space estimations using a virtual disc around the participant which could be extended and retracted, inside the simulation, to indicate perceived amount of personal space, and compared this measure to questionnaire-based estimations. We found that in both cultures participants experienced greater perceived personal space (1) when in a sparse rather than dense office and (2) having a view of the city outside the office. However, British, but not Korean, participants had significantly higher personal space estimations in single occupancy offices than in shared offices. These results suggest subtle cross-cultural differences in workplace experience, that could only be investigated using virtual reality.

Orientation of tactile attention on the surface of the tongue.

The tongue is an incredibly complex sensory organ, yet little is known about its tactile capacities compared to the hands. In particular, the tongue receives almost no visual input during development and so may be calibrated differently compared to other tactile senses for spatial tasks. Using a cueing task, via an electro-tactile display, we examined how a tactile cue (to the tongue) or an auditory cue can affect the orientation of attention to electro-tactile targets presented to one of four regions on the tongue. We observed that response accuracy was generally low for the same modality condition, especially at the back of the tongue. This implies that spatial localization ability is diminished either because the tongue is less calibrated by the visual modality or because of its position and orientation inside the body. However, when cues were provided cross-modally, target identification at the back of the tongue seemed to improve. Our findings suggest that, while the brain relies on a general mechanism for spatial (and tactile) attention, the surface of the tongue may not have clear access to these representations of space when solely provided via electro-tactile feedback but can be directed by other sensory modalities. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

A Biomechanical Examination of Prefabricated Total Contact Cast Kits: Relevance to Patients With Diabetic Neuropathy.

The traditional Total Contact Cast (TCC) is considered the gold standard for treating plantar diabetic ulcers. A number of prefabricated TCC kits have been introduced, which offer a user-friendly casting process for health care providers. Our objective was to evaluate pressure reduction and gait characteristics after application of a TCC kit (TCC-EZ) and traditional TCC. Fifteen individuals (9 males, 6 females; median age of 51.5 years [range = 40.5-71.2 years]) completed 30-m walking trials while fitted with TCC-EZ and TCC in a randomized order. A pair of automated wireless photogate sensors captured time to traverse the distance and pedobarographic insoles measured and recorded plantar pressures. Paired t tests were used to compare peak pressure, gait speed, and cast weights across the 2 modalities. Peak pressure and cast weight were significantly lower in the TCC-EZ arm (169.6 ± 41.3 kPa vs 214.9 ± 63.2 kPa, P = .0048; and 1.79 ± 0.17 kg vs 2.11 ± 0.25 kg, P = .0004). Contact area and gait speed were not significantly different between the 2 modalities (140.4 ± 25.8 cm2 vs 126.9 ± 37.8 cm2, P = .0228, Cohen's d = 0.40; and 0.94 ± 0.19 m/s vs 0.83 ± 0.26 m/s, P = .0532, Cohen's d = .48). TCC-EZ was found to provide more favorable pressure distributions compared with TCC. TCC-EZ is also lighter and may be a preferred treatment modality for patients. More research is necessary to reveal the clinical effectiveness of prefabricated total contact kits.

Increasing amphetamine use and forensic involvement among clients of three residential Indigenous alcohol and other drug services in Victoria, Australia.

INTRODUCTION AND AIMS: Indigenous people seeking residential alcohol and other drug (AOD) rehabilitation in Victoria are most frequently referred to the Ngwala Willumbong Co-operative (Ngwala). This study aimed to describe socio-demographic changes in clients of Ngwala's residential rehabilitation services between 2015 and 2016. DESIGN AND METHODS: Self-assessment surveys completed upon screening for rehabilitation between May 2015 and November 2016 (n = 117) were analysed for socio-demographic data, AOD use and mental health status. Ngwala's monthly summary reports from January 2015 to December 2016 were analysed to compare primary drugs of concern, proportion of forensic clients assessed and admitted across 2015-2016. Independent t-tests and tests of two proportions were used to compare variables between years, with differences considered significant when P < 0.05. RESULTS: Clients were predominantly Indigenous (n = 100, 91%), male (n = 92, 71%) and unemployed (n = 106, 93%). Most clients (n = 92, 88%) were at high risk of serious mental illness (by Kessler Psychological Distress Scale). A significantly higher proportion of forensic clients were admitted in 2016 (n = 221, 60%) compared to 2015 (n = 158, 43%; P < 0.001; 95% confidence interval -0.24, -0.10). The mean monthly number of clients listing amphetamines as their primary drug of concern upon assessment was greater in 2016 (21 ± 7.19 people) compared to 2015 (12 ± 2.78 people; P = 0.01; 95% confidence interval 3.13, 15.37). DISCUSSION AND CONCLUSIONS: These findings suggest the proportion of Indigenous people in AOD treatment with amphetamine use problems or forensic involvement is increasing. These trends should be considered in service design and funding decisions.

The development of a novel microwave generated plasma reactor for high throughput oxidation processes.

This paper describes the development of a microwave plasma reactor for the oxidation of gaseous organic contaminants in air. The reactor was designed such that plasma could be sustained at atmospheric pressure or greater with an effluent gas flow rate of up to 2000 l/min. The oxidation of methane was chosen as the test reaction for laboratory studies.

Using an exercise program to improve activity tolerance in a female with postural orthostatic tachycardia syndrome: A case report.

The incidence of postural orthostatic tachycardia syndrome (POTS) is estimated to be at least 500,000 in the United States and is most commonly found in premenopausal females. This syndrome shares clinical features with orthostatic hypotension (OH); however, the inclusion criteria and clinical features for POTS are not well known. The purposes of this case report are to: 1) describe the common clinical features of POTS and highlight the differences to orthostatic hypotension and 2) discuss physical therapy management of patients with POTS using exercise. A 34-year-old female with a POTS exacerbation completed a 4-week physical therapy endurance and strengthening 'reconditioning' program. Initial symptoms included the following: dyspnea with mild exertion, light-headedness, fatigue, leg "heaviness," and the inability to perform normal work duties. One-mile track walk test (1-MWT) estimated VO2max improved from the 45-50th percentile to the 65-70th percentile at 8 weeks post-discharge. She returned to work full-time and resumed all previous fitness activities. The patient demonstrated clinically meaningful improvements in estimated VO2max after the "reconditioning" training. Physical therapists should be able to recognize the clinical features and inclusion criteria for POTS as part of a differential diagnosing process for patients complaining of orthostatic symptoms.

Surface Projection of Interosseous Foramen of the Leg: Cadaver Study.

Purpose. This study was conducted to identify the surface projection of the interosseous foramen and associated structures of the proximal leg using the average clinician's thumb width as a quick measurement to assist in differential diagnosis and treatment. Methods. Twelve cadavers (5 males and 7 females, age range = 51-91 years, and mean age = 76.9) were dissected for analysis. Location and size of interosseous foramen, location of anterior tibial artery, location of deep fibular nerve, and corresponding arterial branches were measured and converted into thumb widths. Results. Mean thumb width measured among the cadavers was 17.94 ± 3.9 mm. The interosseous foramen measured was approximately 1 thumb width vertically (18.47 ± 3.0 mm) and 1/2 thumb width horizontally (7.32 ± 2.1 mm) and was located approximately 1 thumb width distally to the tibial tuberosity (20.81 ± 6.8 mm) and 2 thumb widths (37.47 ± 4.7 mm) lateral to the tibial ridge. The anterior tibial artery and deep fibular nerve converged approximately 4 thumb widths (74.31 ± 14.8 mm) inferior to the tibial tuberosity and 2 thumb widths (33.46 ± 4.9 mm) lateral to the tibial ridge. Conclusion. Clinicians may identify anatomical structures of the proximal leg with palpation using the thumb width for measurement.

A scalable system for production of functional pancreatic progenitors from human embryonic stem cells.

Development of a human embryonic stem cell (hESC)-based therapy for type 1 diabetes will require the translation of proof-of-principle concepts into a scalable, controlled, and regulated cell manufacturing process. We have previously demonstrated that hESC can be directed to differentiate into pancreatic progenitors that mature into functional glucose-responsive, insulin-secreting cells in vivo. In this study we describe hESC expansion and banking methods and a suspension-based differentiation system, which together underpin an integrated scalable manufacturing process for producing pancreatic progenitors. This system has been optimized for the CyT49 cell line. Accordingly, qualified large-scale single-cell master and working cGMP cell banks of CyT49 have been generated to provide a virtually unlimited starting resource for manufacturing. Upon thaw from these banks, we expanded CyT49 for two weeks in an adherent culture format that achieves 50-100 fold expansion per week. Undifferentiated CyT49 were then aggregated into clusters in dynamic rotational suspension culture, followed by differentiation en masse for two weeks with a four-stage protocol. Numerous scaled differentiation runs generated reproducible and defined population compositions highly enriched for pancreatic cell lineages, as shown by examining mRNA expression at each stage of differentiation and flow cytometry of the final population. Islet-like tissue containing glucose-responsive, insulin-secreting cells was generated upon implantation into mice. By four- to five-months post-engraftment, mature neo-pancreatic tissue was sufficient to protect against streptozotocin (STZ)-induced hyperglycemia. In summary, we have developed a tractable manufacturing process for the generation of functional pancreatic progenitors from hESC on a scale amenable to clinical entry.

Cell-surface markers for the isolation of pancreatic cell types derived from human embryonic stem cells.

Using a flow cytometry-based screen of commercial antibodies, we have identified cell-surface markers for the separation of pancreatic cell types derived from human embryonic stem (hES) cells. We show enrichment of pancreatic endoderm cells using CD142 and of endocrine cells using CD200 and CD318. After transplantation into mice, enriched pancreatic endoderm cells give rise to all the pancreatic lineages, including functional insulin-producing cells, demonstrating that they are pancreatic progenitors. In contrast, implanted, enriched polyhormonal endocrine cells principally give rise to glucagon cells. These antibodies will aid investigations that use pancreatic cells generated from pluripotent stem cells to study diabetes and pancreas biology.

Pancreatic endoderm derived from human embryonic stem cells generates glucose-responsive insulin-secreting cells in vivo.

Development of a cell therapy for diabetes would be greatly aided by a renewable supply of human beta-cells. Here we show that pancreatic endoderm derived from human embryonic stem (hES) cells efficiently generates glucose-responsive endocrine cells after implantation into mice. Upon glucose stimulation of the implanted mice, human insulin and C-peptide are detected in sera at levels similar to those of mice transplanted with approximately 3,000 human islets. Moreover, the insulin-expressing cells generated after engraftment exhibit many properties of functional beta-cells, including expression of critical beta-cell transcription factors, appropriate processing of proinsulin and the presence of mature endocrine secretory granules. Finally, in a test of therapeutic potential, we demonstrate that implantation of hES cell-derived pancreatic endoderm protects against streptozotocin-induced hyperglycemia. Together, these data provide definitive evidence that hES cells are competent to generate glucose-responsive, insulin-secreting cells.