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Experimentation and/or learning by doing, where students apply and secure concepts gained in other concurrent courses, are an essential intrinsic component to any engineering discipline in higher education. Moreover, practical skills in chemical engineering are important for the formation and development of our students as well as being within the (Institution of Chemical Engineers) IChemE accreditation requirements. To cope with the restricted access to the university laboratories at the University of Edinburgh (UoE) during the academic year 2020–21 (AY20/21) caused by the COVID-19 lockdown, the different Chemical Engineering courses with laboratory components at the UoE made use of a wide range of digital tools including videos, quizzes, assignments, etc. to provide the necessary and relevant learning environment and ensure students could follow the different experimentations online as if they were in the lab. The quality and quantity of digital material and resources created motivated a subsequent development of a detailed step-by-step interactive online preparation experience prior to current in-person laboratory sessions. During this online preparation, students are guided through the introduction, experimental apparatus, risk assessment, start-up and shut-down via videos and videos embedded with quizzes, interactive activities such as fill in the blank and mix and match, as well as assignment submissions. The aims of the online preparation are three-fold: 1. provide the students with a more engaging and interactive mode of deepening their understanding on the experiment to be tackled; 2. furnish the student with a higher level of confidence and preparation prior the actual in-person experimentation; and 3. ensure students prepare and submit the necessary risk assessment before the laboratory session as expected by the IChemE. Overall, an enhancement in the students' satisfaction when compared to other traditional preparation modes, such as making use of the laboratory manual, is reported. In particular, a 140 % increase in the confidence and practice are highlighted with an 80 % improvement in securing fundamentals, when compared to no preparation or the sole use of the laboratory manual. The better confidence and understanding prior to the laboratory session also played a role on the enjoyable and rewarding of such hands-on experimentation with the consequent better practical preparation of future professional engineers. [Display omitted] [ABSTRACT FROM AUTHOR]

Human induced pluripotent stem cell-derived cardiomyocytes (hiPSC CMs) offer numerous advantages as a biological model, yet their inherent immaturity compared to adult cardiomyocytes poses significant limitations. This study addresses hiPSC CM immaturity by introducing a physiologically relevant micropatterned substrate for long-term culture and maturation. An innovative microfabrication methodology combining laser etching and casting creates a micropatterned polydimethylsiloxane (PDMS) substrate with varying stiffness, from 2 to 50 kPa, mimicking healthy and fibrotic cardiac tissue. Platinum electrodes were integrated into the cell culture chamber enable pacing of cells at various frequencies. Subsequently, cells were transferred to the incubator for time-course analysis, ensuring contamination-free conditions. Cell contractility, cytosolic Ca2+ transient, sarcomere orientation, and nucleus aspect ratio were analyzed in a 2D hiPSC CM monolayer up to 90 days post-replating in relation to substrate micropattern dimensions. Culturing hiPSC CMs for three weeks on a micropatterned PDMS substrate (2.5–5 µm deep, 20 µm center-to-center spacing of grooves, 2–5 kPa stiffness) emerges as optimal for cardiomyocyte alignment, contractility, and cytosolic Ca2+ transient. The study provides insights into substrate stiffness effects on hiPSC CM contractility and Ca2+ transient at immature and mature states. Maximum contractility and fastest Ca2+transient kinetics occur in mature hiPSC CMs cultured for two to four weeks, with the optimum at three weeks, on a soft micropatterned PDMS substrate. MS proteomic analysis further revealed that hiPSC CMs cultured on soft micropatterned substrates exhibit advanced maturation, marked by significant upregulation of key structural, electrophysiological, and metabolic proteins. This new substrate offers a promising platform for disease modeling and therapeutic interventions. Human induced pluripotent stem cell derived cardiomyocytes (hiPSC CMs) have been transformative to disease-in-a-dish modeling, drug discovery and testing, and autologous regeneration for human hearts and their role will continue to expand dramatically. However, one of the major limitations of hiPSC CMs is that without intervention, the cells are immature and represent those in the fetal heart. We developed protocols for the fabrication of the PDMS matrices that includes variations in its stiffness and micropatterning. Growing our hiPSC CMs on matrices of comparable stiffness to a healthy heart (5 kPa) and grooves of 20 μm, generate heart cells typical of the healthy adult human heart. [Display omitted] [ABSTRACT FROM AUTHOR]

Robotic surgery is perceived to be more complex in obese patients. Objective performance indicators , machine learning–enabled metrics, can provide objective data regarding surgeon movements and robotic arm kinematics. In this feasibility study, we identified differences in objective performance indicators during robotic proctectomy in obese and nonobese patients. Endoscopic videos were annotated to delineate individual surgical steps across 39 robotic proctectomies (1880 total steps). Thirteen patients were obese and 26 were nonobese. Objective performance indicators during the following steps were analyzed: splenic flexure mobilization, left colon mobilization, pelvic dissection, and rectal transection. The following differences were noted during robotic proctectomy in obese patients: during splenic flexure mobilization , more arm swaps, longer camera path length and velocity; during left colon mobilization , longer step time, more arm swaps, higher camera-related metrics (movement, path length, velocity, acceleration, and jerk), greater dominant arm path length, moving time, and wrist articulation; during anterior pelvic dissection , longer energy activation time, camera path length, and moving time; during posterior pelvic dissection , lower nondominant arm velocity, jerk, and acceleration; during left pelvic dissection , longer energy activation time; during right pelvic dissection , greater camera-related metrics (movement, path length, moving time, and velocity); and during rectal transection , longer step time, more arm swaps, master clutch use and camera movements, greater dominant wrist articulation, and longer dominant arm path length. We report step-specific objective performance indicators that differ during robotic proctectomy for obese and nonobese patients. This is the first study to use objective performance indicators to correlate a patient attribute with surgeon movements and robotic arm kinematics during robotic colorectal surgery. [ABSTRACT FROM AUTHOR]

This study aimed to assess the effectiveness of a systems-based secondary injury prevention intervention aimed at early detection and management of hamstring strain injury (HSI) and time-loss groin injury in an Australian male professional football club. Prospective cohort study. Australian male professional football club. Data were collected from male professional football players (n = 73) from a single football club. Unilateral knee flexion and side-lying hip adduction maximum voluntary isometric contractions were monitored routinely in-season, two days post-match (≥40 h [h]) during a three-season intervention period. Strength reductions greater than the tests' minimal detectable change percentage prompted intervention. HSI and time-loss groin injury burdens were calculated per 1000 player hours and compared with those from an immediately preceding two-season control period, to assess the effectiveness of the intervention. Across the intervention period, there was a decrease in HSI (4.98 days absence/1000 h (19.8%) decrease) and time-loss groin injury burdens (0.57 days absence/1000 h (49.1%) decrease) when compared with the control period. A systems-based secondary injury prevention intervention shows preliminary positive findings in reducing HSI and time-loss groin injury burdens within a male professional football club, compared with usual care only. • Maximum voluntary isometric contractions may be safely monitored post-match play. • Indicated interventions may be individual- and position-specific. • Systems-based prevention may reduce hamstring and time-loss groin injury burden. [ABSTRACT FROM AUTHOR]

Dissection and re-entry techniques are essential to achieve safe and effective chronic total occlusion recanalization. Several studies have demonstrated similar outcomes following extraplaque stenting compared with intraplaque stenting. Dissection techniques most often involve the use of knuckled wires to progress within and beyond the chronic total occlusion segment. In this expert consensus document, the authors compare the properties of different polymer-jacketed wires for their use in dissection techniques. The authors also describe 2 principal knuckle wire behaviors, the rolling and the traveling knuckles. Finally, several adjunctive techniques for safer dissection are described. [Display omitted] • DARTs are advocated for long and calcified CTO segments to avoid perforation. • We describe 2 fundamental knuckle behaviors, the rolling and traveling knuckles, and their use. • Better description of knuckle behavior should enhance communication and knowledge transfer. [ABSTRACT FROM AUTHOR]

Current surgical assessment tools are subjective and nonscalable. Objective performance indicators, calculated from robotic systems data, provide automated data regarding surgeon movements and robotic arm kinematics. We identified objective performance indicators that significantly differed among expert and trainee surgeons during specific steps of robotic right colectomy. Endoscopic videos were annotated to delineate surgical steps during robotic right colectomies. Objective performance indicators were compared during mesenteric dissection, ascending colon mobilization, hepatic flexure mobilization, and bowel preparation for transection. Twenty-five robotic right colectomy procedures (461 total surgical steps) performed by 2 experts and 8 trainees were analyzed. Experts exhibited faster camera acceleration and jerk during all steps, as well as faster dominant and nondominant arm acceleration and dominant arm jerk during all steps except distal bowel preparation. During mesenteric dissection, experts used faster camera and dominant arm velocity. During medial-to-lateral ascending colon mobilization, experts used less-dominant wrist yaw and pitch, faster nondominant arm velocity, shorter dominant arm path length, and shorter moving times for camera, dominant arm, and nondominant arm. During lateral-to-medial ascending colon mobilization, experts had faster dominant and nondominant arm velocity and third-arm acceleration. During hepatic flexure mobilization, experts exhibited more camera movements, greater velocity for camera, dominant and nondominant arms, and faster third-arm acceleration. During distal bowel preparation, experts used greater dominant wrist articulation, faster camera velocity, and longer nondominant arm path length. During proximal bowel preparation, experts demonstrated faster nondominant arm velocity. Objective performance indicators can differentiate experts from trainees during distinct steps of robotic right colectomy. These automated, objective and scalable metrics can provide personalized feedback for trainees. [ABSTRACT FROM AUTHOR]

Explore if implementing an individualised Sub-Symptom Heart Rate Threshold (SSHeRT) rehabilitation program within 48 hours versus physical rest for 14 days affects recovery following SRC in university-aged student-athletes. Prospective, observational cohort study. Two UK university-aged student-athlete rugby union cohorts were compared (Physical Rest Group (PRG), n = 140, July 2019–March 2020 and Controlled Early-Exercise Group (CEG), n = 167, July 2021–April 2023). Both groups completed the test battery (Post-Concussion Symptom Scale (PCSS), Immediate Post-Concussion and Cognitive Test (ImPACT), Vestibular-Ocular Motor Screening Tool (VOMS)) during pre-season to provide a baseline and within 48 hours, at 4, 8, 14-days post-SRC and at Return to Play (RTP). The PRG (n = 42) physically rested for 14 days as per the nationwide community guidelines. The CEG (n = 52) followed the SSHeRT rehabilitation program. Individual change to baseline was used in all analyses. The CEG performed better on ImPACT's verbal memory at 4 (PRG; − 5.5 (− 10.8–0.0), CEG; 1.0 (− 2.0–10.5), p = 0.05) and 14 days (PRG; − 2.0 (− 10.0–3.0), CEG; 4.0 (− 1.0–11.0), p = 0.05) and on the VOMS at 4 (PRG; 3.0 (0.0–12.0), CEG; 0.0 (0.0–5.0), p = 0.03, OR; 2.910) and 14-days post-SRC (PRG; 0.0 (0.0–1.0), CEG; 0.0 (0.0–0.0), OR; 5.914). Near point convergence was better at all time points for the CEG. The CEG was 26.7 % more likely to have RTP within 30 days, and 6.7 and 5.1 times more likely to have resumed non-contact and contact academic activities by 4 days. SSHeRT is safe, can be used within 48 hours of a SRC and may hasten university-aged student-athletes recovery following an SRC. [ABSTRACT FROM AUTHOR]

Optimizing donor use and achieving maximal survival following lung transplantation (LTx) require a pretransplant assessment that identifies clinical, physiological, and psychosocial patient factors associated with both poor and optimal post-LTx survival. We examined the utility of a psychosocial tool, the Stanford Integrated Psychosocial Assessment for Transplant (SIPAT), to identify patient suitability for LTx, as well as its association with clinical outcomes before and after LTx. This was a retrospective single-center study analyzing LTx assessment clinical variables (age, gender, diagnosis, functional capacity, nutrition, renal function), with a particular focus on the utility of the SIPAT score, to predict patient suitability for LTx. The same variables were analyzed against LTx waitlist mortality, as well as post-LTx survival. Over an 8-year period dating from December 2012, 914 patients (male 54.4%, mean age 55.2 years) underwent LTx assessment. Patients declined for LTx (n = 152, 16.6%) were older and had reduced functional capacity, nutritional markers, and renal function but had a higher SIPAT score. Once listed for LTx, a higher SIPAT score was not associated with waitlist mortality or reduced post-LTx survival. The SIPAT tool measures psychosocial suitability for transplantation that can be incorporated into a standardized assessment of LTx suitability. While patients with higher SIPAT score were more likely to be declined for LTx, the SIPAT score did not predict outcome in transplanted patients. A subgroup of patients with high SIPAT scores were successfully transplanted, suggesting that unfavorable psychosocial variables are potentially modifiable with a well-resourced multidisciplinary LTx team. [ABSTRACT FROM AUTHOR]