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This article reports findings from a one-month design research project in which four textile and fashion designers engaged in collaborative exploration of technical and artistic knowledge inherent in folds and folding. They experimented with textile technologies and construction methods to design, fabricate and analyze three-dimensional dynamic materiality in electronic textiles (e-textiles). The focus was on sensor structures achieved by knitting, weaving, pleating and coating techniques. The analysis of measurements of electrical resistance between one and 36 sensing areas per sample demonstrate the added value of folds integrated into textile sensor structures. The authors discuss types of folding and their aesthetic, textural and sensorial advantages. Detailed information on design, fabrication and experimental results is provided in supplemental materials to the article.

Background and Purpose Post-stroke fatigue is a debilitating and long-lasting condition. However, there are uncertainties regarding its prevalence and variability between studies. This review aims to estimate the prevalence of fatigue and determine the factors responsible for its variation in the literature. Methods A systematic review was conducted for all published studies (search to November 2020) using AMED, CINAHL, EMBASE, MEDLINE, PsycINFO, SCOPUS and Web of Science. Papers were included if they recruited participants with stroke, used a validated scale to measure fatigue and were in English. Two reviewers screened and assessed the relevant studies for eligibility ( n = 96). The included papers were appraised using the Joanna Briggs Institute (JBI) tool for prevalence studies, and data were extracted by one reviewer. To understand the variation in PSF prevalence between papers, data were pooled and analysed based on relevant methodological (e.g. time of assessment) or clinical factors (e.g. depression) using Review Manager 5.4 software. Results While 48 studies were included and summarised ( N = 9004), only 35 were appropriate for the meta-analysis ( N = 6851). The most frequently used tool to measure fatigue was the Fatigue Severity Scale (FSS) ( n = 31). The prevalence was calculated with a cut-off point of four or more using FSS and resulted in an estimate of 48% (95% CI 42–53%). Time of assessment (Conclusions Fatigue is prevalent among stroke survivors. This condition varies in terms of occurrence between studies; however, time of assessment, stroke type and geographical location might explain this variation. As this review estimates the overall burden of fatigue after stroke, it provides a useful indicator to inform policy, planning and healthcare professionals. Further efforts are required to investigate the mechanisms that lead to PSF, particularly in the groups that show high prevalence, in order to prevent or alleviate it.

Patients who have undergone a Fontan's procedure have an abnormal circulation that presents a unique challenge when performing computed tomography pulmonary angiograms. In a standard imaging protocol, contrast is injected into the upper limb veins that feed into the superior vena cava. In Fontan's patients the Computed tomography pulmonary angiograms bypasses the heart and preferentially fills the right lung, with only a small amount of mixture of contrast and noncontrast blood in the pulmonary arteries. In this article, we present the case of a 35-year-old female complaining of chest and abdominal pain with oxygen saturations of 85% on room air. Computed tomography pulmonary angiograms showed suboptimal imaging of the left lung and apparent filling defects in the right lung suggesting a radiological diagnosis of a pulmonary embolism. The abnormal flow and distribution of contrast in the pulmonary arteries can result in a false positive diagnosis of pulmonary embolism. To overcome this, experts advise using a dual-injection of contrast via upper and lower limb central veins to achieve optimal imaging.

The purpose of this article is to anchor public libraries in their conversational history, and to connect the dots between the characteristics of contemporary libraries and the parallel life cycle ...

KEY POINTS Irritable bowel syndrome (IBS) is a disorder of gut–brain interaction (previously referred to as a functional gastrointestinal disorder), characterized by abdominal pain associated with a change in frequency or form of bowel habit. Irritable bowel syndrome accounts for more than 40% of

The COVID-19 pandemic and its profound global effects may be changing the way we think about illness. In summer 2020, 120 American adults were asked to diagnose symptoms of COVID-19, a cold, and cancer, and to answer questions related to the diagnosis, treatment, prevention, time-course, and transmission of each disease. Results showed that participants were more likely to correctly diagnose COVID-19 (91% accuracy) compared to a cold (58% accuracy) or cancer (52% accuracy). We also found that 7% of participants misdiagnosed cold symptoms as COVID-19, and, interestingly, over twice as many participants (16%) misdiagnosed symptoms of cancer as COVID-19. Our findings suggest a distinct mental model for COVID-19 compared to other illnesses. Further, the prevalence of COVID-19 in everyday discourse—especially early in the pandemic—may lead to biased responding, similar to errors in medical diagnosis that result from physicians’ expertise. We also discuss how the focus of public-health messaging on prevention of COVID-19 might contribute to participants’ mental models.

Noise is the non-target search results that people encounter when searching for a particular topic of interest; it is also the cloud of distracting data that can obscure or deflect conservation communication. Online noise associated with large carnivores is particularly dense because their defining characteristics make them salient. Mountain lions (Puma concolor) exemplify noise associated with multiple vernaculars for a species in the crosshairs of conservation conundrums. We compared internet search results, Google Trends reflecting topic interest, use in science publications and sentiment in print and online media for P. concolor's most frequent vernacular names, “mountain lion,” “cougar,” “puma” and “Florida panther.” Puma and panther exhibited greater noise and salience than cougar or mountain lion, but, results for mountain lion, followed by cougar, yielded the highest biological relevance. Online sentiment negatively correlated with biological relevance, with positive sentiment highest for the noisiest vernaculars, puma and panther. As conservation practitioners, we must recognize that public outreach is part of our scientific agenda and be conscious of crafting communication that reaches and resonates with our intended audiences.

BACKGROUND Almost all patients with familial adenomatous polyposis undergo abdominal surgery with a risk of disease and surgery-related complications. This, the familial nature of the syndrome, and its wide-ranging manifestations make patients prone to mental health symptoms. If this is true, patients need appropriate evaluation and treatment. OBJECTIVE The purpose of this study was to record the experience of mental health symptoms in a group of unselected patients with FAP. DESIGN We conducted an observational study using an anonymized mental health symptom survey for patients affected with familial adenomatous polyposis. SETTINGS The study was conducted using the Hereditary Colorectal Cancer Registry in a tertiary referral center. PATIENTS Patients affected with familial adenomatous polyposis were included. MAIN OUTCOME MEASURES Results of the mental health survey were measured. RESULTS Seventy nine of 100 patients completed the survey; 57 endorsed ≥1 psychosocial symptom (72.2%). with a mean of 4 per patient. Nine patients (11.4%) met all 4 of the American Psychiatric Association diagnostic criteria for posttraumatic stress disorder, and 8 (10.1%) endorsed partial posttraumatic stress disorder criteria (3/4 symptoms). Patients who met all of the criteria for posttraumatic stress disorder had an average of 9.3 psychosocial symptoms each compared with 8.3 for those who met 3 of 4 and 2.2 for those who met

The construction industry is one of the oldest industries in the world and one that continues to change with client demand. In recent decades, innovation in the construction industry has greatly improved, increasing productivity. Innovation in construction refers to the generation and implementation of new ideas to enhance the performance of construction processes and to gain economic, environmental, and social benefits. Modern innovative digital technologies in construction include application of virtual reality (VR)/augmented reality (AR), blockchain, 3D printing, building information modeling (BIM), and off-site manufacturing. This chapter will explore the application of these innovative digital technologies in construction. It will particularly include recent case studies and examples from the New Zealand construction industry.

This chapter introduces a model of critical dialogue designed to create a brave space in which previously ignored, silent or marginalised young people can together develop a critical awareness of potentially harmful attitudes and behaviours (often accepted as normal within their social group or national culture) and be inspired to act in solidarity as allies to bring about positive social change. It focuses on a study of the AlcoLOLs project. One headteacher in this study described her typical Monday mornings as ‘picking up the pieces of family or pupil relationships’ damaged by alcohol-fuelled behaviour over weekends. The risks incurred by adolescent drinking make a significant topic on which to focus – not only because of its impact on young people’s social context, but also because alcohol use is the leading risk factor for premature death and disability worldwide for people aged 15–49 years old (...

Background Medical emergency teams are essential in responding to acute deterioration of patients in hospitals, requiring both clinical and non-technical skills. This study aims to assess the non-technical skills of medical emergency teams during hospital ward emergencies and explore team members perceptions and experiences of the use non-technical skills during medical emergencies. Methods A multi-methods study was conducted in two phases. During phase one observation and assessment of non-technical skills used in medical emergencies using the Team Emergency Assessment Measure (TEAM™) was conducted; and in the phase two in-depth interviews were undertaken with medical emergency team members. Results Based on 20 observations, mean TEAM™ ratings for non-technical skill domains were: ‘leadership’ 5.0 out of 8 (±2.0); ‘teamwork’ 21.6 out of 28 (±3.6); and ‘task management’ 6.5 out of 8 (±1.4). The mean ‘global’ score was 7.5 out of 10 (±1.5). The qualitative findings identified three areas, ‘individual’, ‘team’ and ‘other’ contributing factors, which impacted upon the non-technical skills of medical emergency teams. Conclusion Non-technical skills of hospital medical emergency teams differ, and the impact of the skill mix on resuscitation outcomes was recognised by team members. These findings emphasize the importance non-technical skills in resuscitation training and well-developed processes for medical emergency teams.

Social interaction deficits seen in psychiatric disorders emerge in early-life and are most closely linked to aberrant neural circuit organization and function. Due to technical limitations, we have had little understanding of the typical ontogeny of social behavior neural circuits or how early caregiving adversity impacts infant neurobiology to perturb lifelong social interaction. Using a suite of invasive procedures in awake, behaving young infant rats, including optogenetics, microdialysis and microinfusions, we charted the gradual increase in social behavior deficits following adversity-rearing and dissected circuits controlling this process. Persistently elevated dopamine in basolateral amygdala (BLA) was necessary and sufficient in initiating social behavior pathology, as demonstrated by manipulation of amygdala dopamine during adversity and during expression of social behavior deficits with the mother and peers. Taken together, these data highlight mesolimbic dopamine circuit organization and function as a potential therapeutic target in understanding behavioral deficits associated with psychiatric disorders.

Background: Results of small trials indicate that fluoxetine might improve functional outcomes after stroke. The FOCUS trial aimed to provide a precise estimate of these effects.Methods: FOCUS was a pragmatic, multicentre, parallel group, double-blind, randomised, placebo-controlled trial done at 103 hospitals in the UK. Patients were eligible if they were aged 18 years or older, had a clinical stroke diagnosis, were enrolled and randomly assigned between 2 days and 15 days after onset, and had focal neurological deficits. Patients were randomly allocated fluoxetine 20 mg or matching placebo orally once daily for 6 months via a web-based system by use of a minimisation algorithm. The primary outcome was functional status, measured with the modified Rankin Scale (mRS), at 6 months. Patients, carers, health-care staff, and the trial team were masked to treatment allocation. Functional status was assessed at 6 months and 12 months after randomisation. Patients were analysed according to their treatment allocation. This trial is registered with the ISRCTN registry, number ISRCTN83290762.Findings: Between Sept 10, 2012, and March 31, 2017, 3127 patients were recruited. 1564 patients were allocated fluoxetine and 1563 allocated placebo. mRS data at 6 months were available for 1553 (99·3%) patients in each treatment group. The distribution across mRS categories at 6 months was similar in the fluoxetine and placebo groups (common odds ratio adjusted for minimisation variables 0·951 [95% CI 0·839–1·079]; p=0·439). Patients allocated fluoxetine were less likely than those allocated placebo to develop new depression by 6 months (210 [13·43%] patients vs 269 [17·21%]; difference 3·78% [95% CI 1·26–6·30]; p=0·0033), but they had more bone fractures (45 [2·88%] vs 23 [1·47%]; difference 1·41% [95% CI 0·38–2·43]; p=0·0070). There were no significant differences in any other event at 6 or 12 months.Interpretation: Fluoxetine 20 mg given daily for 6 months after acute stroke does not seem to improve functional outcomes. Although the treatment reduced the occurrence of depression, it increased the frequency of bone fractures. These results do not support the routine use of fluoxetine either for the prevention of post-stroke depression or to promote recovery of function.Funding: UK Stroke Association and NIHR Health Technology Assessment Programme.

I respond to an argument made by Gunnar Bjornsson and Ragnar Francen Olinder against motivational internalism. Bjornsson and Olinder present a hypothesis in which all of us are selfishly motivated to act in accordance with our moral judgments. The conceivability of such a possibility, they argue, rules out motivational internalism. I argue that this is not the case, and that, according to one dominant view about moral judgments, the agents in the hypothesis do not make genuine moral judgments. One therefore cannot argue decisively against motivational internalism without arguing against this view about moral judgments.

IntroductionCT coronary angiography (CTCA) has excellent sensitivity but lacks specificity when compared with invasive coronary angiography (ICA) particularly in patients with a high coronary calcium burden. CTCA has been shown in large trials to decrease the requirement for diagnostic ICA and provide diagnostic clarity. We describe the methodology used to provide a standardised CTCA service established in a District General Hospital, which may assist other hospitals aiming to develop a cardiac CT service.MethodsScan request forms, authorisation and patient instruction were recorded. Patient preparation prior to CTCA as well as exclusion and inclusion criteria were documented. Scans were interpreted using a multidisciplinary team (MDT) approach in order to organise follow-up, medication and further investigation.ResultsOver 6 months, 157 consecutive scans were performed. CTCA was completed in 88% (n=138/157) and considered of diagnostic quality in 82% (n=129/157). The median radiation dose was 3.42 mSv. Overall, 64% of patients had evidence of coronary calcium. Following MDT review, 72% (n=113/157) of patients were discharged without requiring invasive angiography. 15% (n=24/157) of patients went on to have invasive angiography showing non-obstructive disease and 13% (20/157) of patients underwent percutaneous coronary intervention (11%) or bypass surgery (1%).DiscussionAppropriate referrals, patient preparation and scan quality remain significant factors in running a CTCA service. Despite this, the vast majority of patients can be discharged on the basis of the CTCA alone. An MDT approach is key to the delivery of a cardiac CT service.

Building off several prior working meetings which mapped and considered the implications of the new and rapidly evolving ecosystem of networked technology being used with education (“ed tech”), the Berkman Center for Internet & Society’s Student Privacy Initiative convened a conversation in May 2015 among multiple stakeholders, including, but not limited to, K-12 educators, district administrators, academics, policy makers, and industry representatives. This working meeting was envisioned as one in a series of conversations which deepens our understanding of emerging and future privacy issues in K-12 learning environments, both formal and informal. Future conversations may focus on specific topics within the broader spectrum of issues relating to student privacy; this particular working meeting prioritized practicality over theoretical discussion, emphasizing the evolving experiences of K-12 administrators, educators, and students.In order to evaluate the challenges and opportunities fostered by the next generation of ed tech, participants were asked to consider the following four layers of the ed tech ecosystem, each of which informs the others in myriad ways: Technological Infrastructure: What kind of technology can be considered “ed tech”? This layer encompasses cloud infrastructure, the Internet of Things, sensor networks, and other new technologies that facilitate connected learning environments (which transcend the traditional classroom set-up, disturb hierarchies, and foster peer-to-peer interactions) and other educational innovations within brick and mortar classrooms, thereby shaping the collection and use of student/educational data. Data: What kinds of data are being collected, and how/by whom are they being used? This layer includes the opportunities afforded by learning analytics (the aggregation of data about learners, offering the potential benefit of individualized learning trajectories and the potential challenge of limiting or discriminatory “tracking”), as well as other uses by educators, administrators, and other stakeholders of individual and cohort-wide student data previously unimaginable in both its breadth and depth. Organizational Structures: Where does learning take place today? This layer maps the institutional forms of current and future educational institutions, from traditional schoolhouses to informal learning environments, which can be situated within the context of schools, cities, libraries, and elsewhere -- and are perhaps best understood as part of the connected learning ecosystem. Norms and values: How do we want ed tech to be used in the classroom, and what are our expectations for/desires of privacy? This layer reflects those principles, policies, pedagogies, and practices that do or should animate the goals, implementation, and stakeholder experiences of twenty-first century digital education in its various iterations.Keeping these layers in mind, discussion ranged widely across numerous themes, reflecting the participants’ diverse backgrounds and perspectives. This report seeks to summarize the conversation’s main themes and highlight suggestions for future action. In the following section, the main themes and observations are considered, including issues dealt with explicitly and at length, in addition to those that more quietly (and perhaps implicitly) surfaced at multiple points during the day. And although the third section concerns suggested areas for moving forward, these are meant to be understood as key highlights, and not a comprehensive summary.

In the introduction to their column, co-authors Emma Wood and Jessica Almeida aptly note that libraries and fines have long been synonymous. The notion of librarians as punitive avengers, be it for enforcing silence or demanding payback for overdue items, is commonly held and has been widely caricatured. The image is one that, more and more, many of us don’t embody or wish to embrace. Against a backdrop of social theory, and with an emphasis on customer service and relationship building, Wood and Almeida present an appealing, practical alternative in the form of a fine-free framework. While not necessarily adaptable to all library environments, the model—along with its broader impacts—is well worth considering.—Editor

As mobile devices become more prominent in the lives of students, the use of mobile devices has the potential to transform learning. Mobile learning, or mLearning, is defined as learning that is personalized, situated, and connected through the use of a mobile device. As mLearning activities are developed, there is a need for a framework within which mLearning activities can be evaluated. The SAMR Model (Puentadura, 2012) provides such a framework. This paper reviews recent literature on mLearning and provides examples of activities that fall within each of the four classifications of the SAMR Model: substitution, augmentation, modification, and redefinition.

Platelet glycoprotein (GP) Ibalpha is a component of the GPIb-IX receptor complex, which is involved in multiple physiological and pathological processes, including platelet adhesion at sites of vascular injury, thrombin binding, Bernard-Soulier syndrome, platelet-type von Willebrand disease, and immune-mediated thrombocytopenias. The amino-terminal domain of approximately 300 residues of GPIbalpha mediates both normal biological function (by providing the sites for direct ligand interaction) and aberrant function (through amino acid substitutions). To investigate the molecular interactions mediated by this region of GPIbalpha, we have developed a recombinant baculovirus to facilitate its expression as a calmodulin fusion protein from insect cells. By employing the calmodulin tag, the fusion protein could be obtained at >90% purity after a single isolation step at yields of 8 mg/L of insect cell medium (purified fusion protein). The recombinant GPIbalpha fragment was shown to be posttranslationally sulfated and glycosylated, although its glycosylation differed from that of the equivalent GPIbalpha fragment isolated from human platelets. The differential glycosylation, however, did not affect the function of the recombinant GPIbalpha fragment in either von Willebrand factor (vWf) or thrombin binding as these were both found to be identical to those of the same-length GPIbalpha fragment derived from human platelets. The calmodulin tag was also exploited in the development of assays to measure directly vWf and thrombin binding, since it did not interfere with either, demonstrating the feasibility for the use of this soluble receptor fusion protein in detailed biophysical assays to investigate the molecular mode of binding of platelet glycoprotein Ibalpha to these ligands.