Search

Marty Coyne,1,2 Amy Rinaldi,1 Katherine Brigham,1 James Hawthorne,1,2 Dimos Katsaros,1,2 Morgan Perich,2 Nicholas Carrara,1 Flore Pericaud,3 Chris Franzese,1,2 Graham Jones4 1Matchstick, Boonton, NJ, USA; 2University of Rhode Island School of Pharmacy, Kingston, RI, USA; 3Technical Research and Development, Novartis Pharmaceuticals, Basel, Switzerland; 4Technical Research and Development, Novartis Pharmaceuticals, East Hanover, NJ, USACorrespondence: Graham Jones, Technical Research and Development, Novartis Pharmaceuticals, East Hanover, NJ, USA, Email graham.jones@novartis.comBackground: Self-injection of biologics is a mainstay of chronic disease treatment, yet the process of self-injection often causes persistent apprehension and anxiety, distinct from needle phobia. While literature alludes to the role that routines and rituals play in self-injection, there is no comprehensive study on the routines and rituals self-injectors employ, nor of the process by which they are discovered and ingrained.Methods: We conducted a mixed-method, observational pilot ethnography study of 27 patients with plaque psoriasis, psoriatic arthritis, or ankylosing spondylitis with and without prior biologic self-injection experience. Patients submitted self-made videos, photos, and projective exercises of an actual biologic self-injection and completed validated instruments to assess burden of treatment. Videos and photos containing routine and ritual elements were thematically categorized based on functional and emotional benefit, and analyzed for differences based on current biologic, dosing frequency, time on current biologic, and burden of treatment measures.Results: During patients’ initial at-home injections, training gaps became apparent, leading to a process of experimentation aimed at reducing pain/anxiety, increasing confidence, and building a consistent injection process. Routines were present in 27/27 (100%) patients and anchored the time, place, and process for injection, and incorporated approved use steps for the injection device. Ritual elements served as emotional coping strategies for patients and were present in 21/27 (77.8%) of patients.Conclusion: Our findings suggest that providing patients device training using adult learning principles, teaching routines and rituals concurrently, and providing at-home opportunities for practice with a device trainer may be useful strategies to reduce anxiety, avoid unnecessary experimentation, and improve adherence to injection therapy. While further studies are needed to generalize our findings, we posit that routine and ritual elements can be incorporated into existing patient-clinician interactions or novel digital interventions through mobile medical applications, smart training devices, and connected injection ecosystems.Keywords: training, drug delivery device, combination product, patient support, routines, rituals, burden of treatment, chronic disease, injection trainer, mixed methods research

Relaxor ferroelectric polymers exhibiting a giant electrocaloric effect (ECE) can potentially be used to create next-generation solid-state coolers. Under an electric field, poly(vinylidene fluoride-trifluoroethylene-chlorofluoroethylene) terpolymer goes through a large dipolar entropy change producing a high adiabatic temperature change (ΔTECE). This work resolves the molecular origins of the large entropy change behind the electric field-induced dipole switching. A Fourier transform infrared spectroscopy equipped with a high voltage source is used to operandoly observe the characteristic molecular vibrational modes. A short-range trans (T) conformation of the CF2-CH2 dyads interrupted by a gauche (G) conformation, e.g., TTTG in the terpolymer chain, undergoes a dynamic transformation that leads to a corresponding ΔTECE whenever an electric field is applied. The molecular dynamics simulation also proves that the energy barrier that the transformation from TTTGs into a long T sequence overcomes is smaller than that for all other conformations. A mixed solvent system is used to obtain T3G-enriched terpolymer films exhibiting a 4.02 K ΔTECE at 60 MVm−1 and these films are employed to manufacture a 2-layer-cascaded cooling device that achieves a 6.7 K temperature lift, the highest reported value for a 2-layer cascaded device made of fluoropolymers.

BACKGROUND: Alcohol-associated hepatitis (AH) is one of the clinical presentations of alcohol-associated liver disease. AH has poor prognosis, and corticosteroids remain the mainstay of drug therapy. However, ~40% of patients do not respond to this treatment, and the mechanisms underlying the altered response to corticosteroids are not understood. The current study aimed to identify changes in hepatic protein expression associated with responsiveness to corticosteroids and prognosis in patients with AH. METHODS: Patients with AH were enrolled based on the National Institute on Alcohol Abuse and Alcoholism inclusion criteria for acute AH and further confirmed by a diagnostic liver biopsy. Proteomic analysis was conducted on liver samples acquired from patients with AH grouped as nonresponders (AH-NR, n = 7) and responders (AH-R, n = 14) to corticosteroids, and nonalcohol-associated liver disease controls (n = 10). The definition of responders was based on the clinical prognostic model, the Lille Score, where a score < 0.45 classified patients as AH-R and a score > 0.45 as AH-NR. Primary outcomes used to assess steroid response were Lille Score (eg, improved liver function) and survival at 24 weeks. RESULTS: Reduced levels of the glucocorticoid receptor and its transcriptional co-activator, glucocorticoid modulatory element-binding protein 2, were observed in the hepatic proteome of AH-NR versus AH-R. The corticosteroid metabolizing enzyme, 11-beta-hydroxysteroid dehydrogenase 1, was increased in AH-NR versus AH-R along with elevated mitochondrial DNA repair enzymes, while several proteins of the heat shock pathway were reduced. Analysis of differentially expressed proteins in AH-NR who survived 24 weeks relative to AH-NR nonsurvivors revealed several protein expression changes, including increased levels of acute phase proteins, elevated coagulation factors, and reduced mast cell markers. CONCLUSIONS: This study identified hepatic proteomic changes that may predict responsiveness to corticosteroids and mortality in patients with AH.

Rehearsals have become an increasingly popular pedagogy to support preservice teachers in developing competency in enacting challenging instructional practices and communicating associated pedagogical commitments. To understand how best to support learners participating in rehearsals, researchers have begun to analyse the facilitation of teacher educators leading such pedagogy. These studies have revealed a variety of ways teacher educators can structure rehearsals. We contribute to this emerging body of knowledge by studying the facilitation of rehearsals in the context of professional development with experienced teachers. Our results expand researchers' understanding of the facilitation of rehearsals in three ways. First, our analysis revealed a range of new ways teacher educators can structure rehearsal interactions. This elaboration and refinement of earlier descriptions offers a variety of new tools for teacher educators to use when leading rehearsals. Second, we categorise these different structures based on their purpose and present three dimensions that contrast the different facilitation choices available. Such an organisation provides a framework that has the potential to aid teacher educators to be more purposeful as they consider the type of interactions they would like to support as well as researchers studying rehearsals to better understand the rationale and effect of such decisions. Third, our reflection about our choices in how we structured interactions when working with experienced teachers presents an example of how the facilitation of rehearsals might be adapted to better respond to the needs and strengths of in-service teachers.

Abstract: This paper unfolds in three parts. In Part 1, I describe how I have contended with the fraught relationships among mapping, nationalism, and colonialism in my teaching and research. When writing my first book, Contesting Race and Citizenship, I had to reckon with the positivist impulse to enumerate and map Black Italianness—and, more broadly, with the politics of visibility at a time of increasingly virulent racial nationalisms, xenophobia, and outright anti‐Black violence. In Part 2, I describe the ways my own thinking about mapping has been pushed in new directions by insights from Black geographies. Drawing on Clyde Woods, Katherine McKittrick, and Édouard Glissant—as well as essays from the edited volume The Black Geographic—I argue that Black geographic counter‐cartographies foreground insurgent Black spatial knowledges and practices that have always exceeded racial‐spatial violence, and approach mapping as both a material and poetic process. In Part 3, I conclude by advancing some tentative ideas about what it might mean to map new or alternative geographies of abolitionist struggle that attend to the interconnections between Black Atlantic and Black Mediterranean histories of racial capitalism.

INTRODUCTION: Intracranial pressure (ICP) monitoring is a very commonly performed neurosurgical procedure but there is a wide variation in how it is reported, hindering analysis of it. The current study sought to generate consensus on the reporting of ICP monitoring recording data. RESEARCH QUESTION: What should be included in an ICP monitoring report? MATERIAL AND METHODS: The exercise was completed via a modified eDelphi survey. An expert panel discussion was held from which themes were identified and used to produce a code to annotate the transcript of the discussion. Statements were generated for a further two rounds of electronic questionnaires distributed via the REDcap platform. A Likert scale was used to grade agreement with each statement in the survey. A statement was accepted if more than 70% agreement was achieved between respondents. Data was collated using Microsoft Excel and analysed using R. RESULTS: 149 relevant statements were identified from the transcript and categorised into recording parameters, waveform characteristics or reporting. A total of 22 statements were generated for the first round of the survey which was answered by 39 respondents. Following the electronic round of surveys consensus was achieved for all but one statement regarding the acceptability of automating ICP reporting. This was put forward to a second round after which 79% agreement was reached. DISCUSSION AND CONCLUSION: The themes and statements from this eDelphi can be used as a framework to allow the standardisation of the reporting of intracranial pressure monitoring data.

Precise modulation of brain activity is fundamental for the proper establishment and maturation of the cerebral cortex. To this end, cortical organoids are promising tools to study circuit formation and the underpinnings of neurodevelopmental disease. However, the ability to manipulate neuronal activity with high temporal resolution in brain organoids remains limited. To overcome this challenge, we introduce a bioelectronic approach to control cortical organoid activity with the selective delivery of ions and neurotransmitters. Using this approach, we sequentially increased and decreased neuronal activity in brain organoids with the bioelectronic delivery of potassium ions (K+) and γ-aminobutyric acid (GABA), respectively, while simultaneously monitoring network activity. This works highlights bioelectronic ion pumps as tools for high-resolution temporal control of brain organoid activity toward precise pharmacological studies that can improve our understanding of neuronal function.