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Background: The prevalence of cerebral small vessel disease (CSVD) is increasing due to the accelerating global aging process, resulting in a substantial burden on all countries, as cognitive dysfunction associated with CSVD is also on the rise. Clock genes have a significant impact on cognitive decline and dementia. Furthermore, the pattern of DNA methylation in clock genes is strongly associated with cognitive impairment. Methods: We recruited patients with CSVD admitted to the Geriatrics Department of the Lianyungang Second People's Hospital between March 2021 and June 2022. Based on their Mini-Mental State Examination score, patients were categorized into two groups: 65 cases with cognitive dysfunction and 36 cases with normal cognitive function. Clinical data, 24-hour ambulatory blood pressure monitoring parameters, and CSVD total load scores were collected. Moreover, we employed methylation-specific PCR to analyze the peripheral blood promoter methylation levels of clock genes PER1 and CRY1 in all CSVD patients who were enrolled. Finally, we used binary logistic regression models to assess the association between the promoter methylation of clock genes (PER1 and CRY1) and cognitive dysfunction in patients with CSVD. Results: A total of 101 individuals with CSVD were included in this study. There were no statistical differences between the two groups in baseline clinical data except MMSE and AD8 scores. After B/H correction, the promoter methylation rate of PER1 was higher in the cognitive dysfunction group than that in the normal group, and the difference was statistically significant (adjusted P0.05). Binary logistic regression models showed that the influence of promoter methylation of PER1 and CRY1 on cognitive dysfunction were statistically significant in Model 1 (P<0.001;P=0.025), and it still existed after adjusting for confounding factors in Model 2. Conclusions: The promoter methylation rate of PER1 gene was higher in the cognitive dysfunction group among CSVD patients. And the hypermethylation of the promoters of clock genes PER1 and CRY1 may be involved in affecting cognitive dysfunction in patients with CSVD.
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The concepts of short agri-food supply chains and circular bioeconemy are complementary and mutually reinforcing, while they may play an important role in sustainability transitions. The elimination of middlemen and the possibilities of forward vertical integration of farmers are the key components ofshort agri-food supply chains, while bioeconomy refers to the sustainable production and use of biological resources stemming from forestry, agriculture, fisheries, and waste streams. The development of closed-loop systems where waste is converted into new resources, lies in the core of circular bioeconomy, which seeks to reduce waste and maximize resource usage. A sustainable and regenerative economy where waste is viewed as a resource and the use of finite resources is decreased is what this strategy seeks to achieve. When combined, short agri-food supply chains and circular bioeconomy can support sustainable economic growth, social advancement, and environmental protection by encouraging local manufacturing, minimizing waste, and developing innovative bio-based goods and procedures. In this article, we examine the benefits which occur in short agri-food supply when they adopt the principles of circular bioeconomy. Also, we examine how can the ideas of the circular bioeconomy be applied to short agri-food supply chains in order to minimize waste and maximize resource usage. In addition, we explore the corresponding difficulties and opportunities for creating bio-based goods and procedures in short agri-food supply chains. Last but not least, we discuss the effects of short agri-food supply chains and the circular bioeconomy on global agri-food systems and how these concepts are connected with issues at stake, such as food security and sustainability.
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The practice of giving presentations online has exploded during the Covid pandemic. However, in these settings, presenters often find themselves overlooking questions and feedback, e.g. via chat, from the audience, because the presenter's screen is dominated by their slides, with other channels becoming less noticeable. This causes frustration among presenters and their audience alike. We investigate the impact of additional visual, auditory, and haptic cues for presenters in online scenarios, using a wrist-worn prototype. For this, we conducted a study where participants gave presentations via the videoconferencing tool Zoom on specific topics while trying to notice and correctly identify incoming notifications. Our findings indicate that supplementary notifications can be helpful in online presentations without inappropriately disturbing the presenter. © 2023 Owner/Author.
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The scarcity of professional ophthalmic equipment in rural areas and during exceptional situations such as the COVID-19 pandemic highlights the need for tele-ophthalmology. This late-breaking work presents a novel method for guiding users to a specific pose (3D position and 3D orientation) near the eye for mobile self-eye examinations using a smartphone. The user guidance is implemented utilizing haptic and visual modalities to guide the user and subsequently capture a close-up photo of the user's eyes. In a within-subject user study (n=24), the required time, success rate, and perceived demand for the visual and haptic feedback conditions were examined. The results indicate that haptic feedback was the most efficient and least cognitively demanding in the positioning task near the eye, whereas relying on only visual feedback can be more difficult due to the near focus point or refractive errors. © 2023 Owner/Author.
ABSTRACT
In the age of COVID-19, online physical education (OLPE) has emerged as a major part of the day-to-day professional practice of P-12 physical education teachers and physical education teacher education (PETE) faculty. Yet little is known about what would optimize an OLPE resource from the perspective of physical educators. This study addressed this knowledge gap. A convenience sample of P-12 physical education teachers (n = 9) and PETE faculty (n = 10) was recruited to participate in six focus groups. Data were qualitatively analyzed with both deductive techniques and inductive techniques and themes across both participant groups (physical education teachers and PETE faculty) and by group were identified. Across-group themes included generally negative views of OLPE, concerns of equity and context, thoughts on assessment, and design ideas for virtual resources. Within groups, P-12 physical educators shared concerns about grading and providing meaningful feedback, whereas PETE faculty focused on ensuring that OLPE was designed and delivered considering best practices. This study builds on a nascent line of inquiry that informs the development of an OLPE resource to meets physical educators' professional needs during the pandemic and into an inevitable future where virtual teaching and learning are status quo. [ FROM AUTHOR] Copyright of Physical Educator is the property of Sagamore Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)
ABSTRACT
Background As a result of the corona pandemic, the implementation of physiotherapy as teletherapy was initially permitted for a limited period of time and subsequently approved for an unlimited period of time. Patients with gonarthrosis and coxarthrosis can be a target group.Aim To explore the behavior and feedback of patients with gonarthrosis and coxarthrosis, including patients who have had endoprosthetic treatment, during teletherapeutic treatments using screencasts.Method Patients with gonarthrosis or coxarthrosis, possibly after endoprosthetic treatment, received 6 treatment sessions including 5 by teletherapy. Participants completed the Musculoskeletal and Joint Health Questionnaire (MSK-HQ) and the Western Ontario and McMaster Universities Arthritis Index (WOMAC). The first and last treatment sessions were videotaped and thereafter transcribed. Coding of the text passages was deductively content-analytic.Results 5 patients were included (2 m, 3w;56 to 78 years;3 gonarthrosis, 2 coxarthrosis;of those 2 with endoprosthesis). The behavior and patients' perspectives were assigned to the main categories of person-related factors, treatment characteristics, point of view or environment-related factors, each with 2-5 subcategories. The evaluation showed a thoroughly positive attitude towards teletherapy. This despite initial doubts and lack of knowledge about the method. Factors such as framework conditions, technology, personal motivation and compliance, as well as the relationship between patient and therapist, were found to influence the patients' attitude towards this method. A mixed therapy design consisting of teletherapy and conventional methods received a preferred resonance. For all participants, a clinically relevant improvement of the WOMAC was observed (7-47 points;improvement MSK-HQ 1-13 points).Conclusion The behavior of the participants shows that a sound planned teletherapy can be well implemented in practice. The description of the patient perspective provides researchers and practitioners with information that can be used for the further development of teletherapeutic treatment concepts for patients with gonarthrosis or coxarthrosis as well as for patients with musculoskeletal complaints in general.
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Background/Aims The COVID-19 pandemic has placed unprecedented pressures on NHS departments, with demand rapidly outstripping capacity. The British Society for Rheumatology 'Rheumatology Workforce: a crisis in numbers (2021)' highlighted the need to provide innovative ways of delivering rheumatology specialist care. At University College London Hospitals (UCLH) we created a rheumatology multidisciplinary team (MDT) clinic to meet rising demands on our service. The aims of the Rheumatology MDT clinic were to: reduce new appointment/follow-up waiting times, increase clinic capacity, incorporate musculoskeletal (MSK) point of care ultrasound, reduce number of hospital visits and add value to each clinic encounter. Methods We ran a 6-month pilot, supported by our outpatient transformation team, incorporating a Rheumatology Advanced Practice Physiotherapist (APP), Clinical Nurse Specialist (CNS) and MSK ultrasound within a Consultant clinic. The success of the pilot helped secure funding for a further 12 months. Over 18 months we have implemented: APP/Consultant enhanced triage - up to 40% of referrals were appropriate for APP assessment, including regional MSK problems and back pain. This increased capacity for consultant-led appointments. Standardisation of time-lapse between CNS and consultant follow-up appointments to ensure appropriate spacing between patient encounters. Facilitated overbooking of urgent cases afforded by additional capacity provided by the APP. MSK ultrasound embedded in the clinic template. 'Zoom' patient education webinars facilitated by MDT members and wider disciplines e.g. dietetics, to empower self-management and reduce the administrative burden of patient emails/phone calls occurring outside the clinic. Patient participation sessions and feedback to help shape the service. Results During the 6-month pilot we reduced our waiting time for follow-up appointments from 9 months to 2. We now have capacity to book 1-2 urgent cases each week. Pre-MDT the average wait from consultant referral to physiotherapist appointment was 55 days. The MDT allows for same day assessment (reducing 2-3 patient journeys a clinic) and where suitable, facilitates discharge or onwards referral to the appropriate service. A dedicated MDT CNS has shortened treatment times, reduced email traffic between CNS and consultant and allows for same day, joint decision-making resulting in fewer appointments. Zoom webinar feedback has been positive. Patients value the broad expertise of allied health professionals which supports self-management. Embedding ultrasound allows for same day diagnostics, decreased referrals to radiology and reduced hospital visits. Conclusion Our MDT model has reduced waiting lists, decreased treatment delays and cut hospital attendances. Point of care ultrasound allows for same day decision making and abolishes the cost and diagnostic delay associated with referrals to radiology or outsourced providers. Shared decision-making adds value to outpatient attendances, which is reflected in patients' positive feedback. The MDT model maximises the existing workforce skill set by enhancing the APP and CNS role, allowing patients immediate access to their expertise.
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Students are commonly in a high cognitive load state when they encounter sophisticated knowledge. Whether the novel augmented reality (AR) technology can be utilized in an online learning course to explain complicated scientific concepts in a more understandable manner to students during the COVID-19 period is an unaddressed issue. This study aims to investigate the influences of reducing the physical touch or face-to-face teaching/learning practices via using mobile augmented reality learning systems (MARLS) on students' perceived learning effectiveness. The information feedback viewpoint, flow theory, and cognitive load theory are integrated to examine the effects of the information feedback of MARLS on students' learning effectiveness. This study recruited 204 participants from ten universities to complete a learning task via a MARLS and fill out a questionnaire to collect data for the proposed research model. The empirical results revealed information feedback positively and significantly affected flow experience, perceived learning effectiveness, and continued intention. The improved learning performance of learners was positively related to their continued intention. Also, the extraneous cognitive load negatively and significantly moderated the relationship between information feedback and perceived learning effectiveness. This study proposes meaningful implications and suggestions for future research based on the findings of this experiment.
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Low wages of health professionals are widely recognized as one of the drivers of informal payments in Romania's healthcare system. In January 2018, the government increased wages by an average of 70% to 172% in the public healthcare sector. This study examined the trends in patient-reported informal healthcare payments, discussing the effect of a one-time wage increase in 2018 and the impact of the COVID-19 pandemic in 2020 and 2021. It draws on monthly survey data of patient-reported informal payments collected between January 2017 and December 2021. We analyzed three periods: before the wage rise ("low pay"), between the wage rise and the COVID-19 pandemic ("high pay"), and during the COVID-19 pandemic. We found that patient-reported informal payments decreased between the "low pay" and "high pay" period but with a sharper decline during the COVID-19 pandemic. The share of respondents willing to report informal payments increased during the "high pay" period, indicating a stronger willingness to voice dissatisfaction with health services and informal payments, but slowed down during the first lockdown in 2020. Informal payments were more frequently reported in larger hospitals and the poorest geographical areas. While the 2018 wage increase may have contributed to less prevalent informal payments, survey coverage and design must be improved to draw robust, system-level conclusions to inform tailored policy actions.