"We're back in control of the story and we're not letting anyone take that away from us": patient teacher programs as means for patient emancipation.

While patient engagement in healthcare professions education (HPE) has significantly increased in the past decades, a theoretical gap remains. What are the varied reasons as to why patients get involved with HPE programs? With a focus on understanding what drives patient involvement with HPE programs, this study examined how a patient as teacher (PAT) program was experienced by medical students, patient teachers, and faculty within a medical school. Through a phenomenographic approach, this study captures and describes the different ways our study participants experienced a PAT program (the 'phenomenon'). 24 semi-structured interviews were conducted in total, comprised of interviews with patient teachers (N = 10), medical students (N = 10) and program facilitators (N = 4) who participated in a PAT program. Our focus was on participants' description of the program and was grounded in their experiences of as well as their beliefs about it. Our findings captured 4 layers representing the qualitatively different (yet interrelated) ways in which participants experienced/perceived and conceptualized the various aspects of their experience with the PAT program: (1) A productive disruption of the learning space (2) A re-humanization within healthcare (3) A means of empowerment and agency (4) A catalyst for change and emancipation. Our outcome space results can be visually illustrated by a nesting "Matryoshka" doll, representing the four layers and depicting the process of uncovering the less conscious layers of sense-making within this phenomenon. HPE programs that are co-produced with patients and actively involve patients as teachers have the potential, but not guarantee, to be emancipatory. To engage in PAT programs that exhibit an emancipatory potential, we need to consider transformative paradigms of education, which are aligned with social change, and disrupt the traditional teacher-learner hierarchy.

An assessment of multi-family dwelling recycling in Hong Kong: A managerial perspective.

Solid waste is an acute environmental problem in most big cities around the world. Like other highly compact cities, Hong Kong developed a recycling program that primarily targets multi-family dwellings (MFDs). This paper intends to examine the relations between three managerial factors-housing type, recycling mode, and initiative of the property manager-and MFD recycling using data collected from a territory-wide telephone survey (n = 1,016) conducted in 2017. The results indicated that housing type and initiative of the property manager had significant relations with the recycling behavior of residents. The findings may supplement previous recycling studies and provide a reference for the improved implementation of the MFD recycling program in Hong Kong.

Necroptosis inhibition as a therapy for Niemann-Pick disease, type C1: Inhibition of RIP kinases and combination therapy with 2-hydroxypropyl-ß-cyclodextrin.

Niemann-Pick disease, type C1 (NPC1) is an inborn error of metabolism that results in endolysosomal accumulation of unesterified cholesterol. Clinically, NPC1 manifests as cholestatic liver disease in the newborn or as a progressive neurogenerative condition characterized by cerebellar ataxia and cognitive decline. Currently there are no FDA approved therapies for NPC1. Thus, understanding the pathological processes that contribute to neurodegeneration will be important in both developing and testing potential therapeutic interventions. Neuroinflammation and necroptosis contribute to the NPC1 pathological cascade. Receptor Interacting Protein Kinase 1 and 3 (RIPK1 and RIPK3), are protein kinases that play a central role in mediating neuronal necroptosis. Our prior work suggested that pharmacological inhibition of RIPK1 had a significant but modest beneficial effect; however, the inhibitors used in that study had suboptimal pharmacokinetic properties. In this work we evaluated both pharmacological and genetic inhibition of RIPK1 kinase activity. Lifespan in both Npc1-/- mice treated with GSK'547, a RIPK1 inhibitor with better pharmacokinetic properties, and Npc1-/-:Ripk1kd/kd double mutant mice was significantly increased. In both cases the increase in lifespan was modest, suggesting that the therapeutic potential of RIPK1 inhibition, as a monotherapy, is limited. We thus investigated the potential of combining RIPK1 inhibition with 2-hydroxypropyl-ß-cyclodextrin (HPßCD) therapy HPßCD has been shown to slow neurological disease progression in NPC1 mice, cats and patients. HPßCD appeared to have an additive positive effect on the pathology and survival of Npc1-/-:Ripk1kd/kd mice. RIPK1 and RIPK3 are both critical components of the necrosome, thus we were surprised to observe no increase survival in Npc1-/-;Ripk3-/- mice compared to Npc1-/- mice. These data suggest that although necroptosis is occurring in NPC1, the observed effects of RIPK1 inhibition may be related to its RIPK3-independent role in neuroinflammation and cytokine production.

The effects of nickel(II) and chromium(VI) on oxygen demand, nitrogen and metal removal in a sequencing batch reactor.

The objective of this study was to evaluate the effects ofNi(II) and Cr(VI) individually and in combination on the simultaneous removal of chemical oxygen demand (COD), nitrogen and metals under a sequencing batch reactor (SBR) operation. Three identical laboratory-scale SBRs were operated with FILL, REACT, SETTLE, DRAW and IDLE periods in a ratio of 1:12:1:2:8 for a cycle time of 24 h until the steady state was achieved. Nickel(II) at increasing concentrations up to 35 mg/L was added to one of the reactors; Cr(VI) at increasing concentrations up to 25 mg/L was added to a second reactor; while a combination of Ni(II) and Cr(VI) in equal concentrations up to 10 mg/L was added to a third reactor. The results demonstrate that both Ni(II) and Cr(VI) exerted a more pronounced inhibitory effect on the removal of ammonia nitrogen (AN) than on COD removal. Synergistic and antagonistic inhibitory effects on the rates of COD and AN removal, respectively, were observed for the 50% Ni(II) and 50% Cr(VI) (w/w) mixture in the concentration range between 10 and 20 mg/L. The simultaneous presence of 50% Ni(II) and 50% Cr(VI) at a concentration of 20 mg/L resulted in system failure.

Microfluidic on-chip fluorescence-activated interface control system.

A microfluidic dynamic fluorescence-activated interface control system was developed for lab-on-a-chip applications. The system consists of a straight rectangular microchannel, a fluorescence excitation source, a detection sensor, a signal conversion circuit, and a high-voltage feedback system. Aqueous NaCl as conducting fluid and aqueous glycerol as nonconducting fluid were introduced to flow side by side into the straight rectangular microchannel. Fluorescent dye was added to the aqueous NaCl to work as a signal representing the interface position. Automatic control of the liquid interface was achieved by controlling the electroosmotic effect that exists only in the conducting fluid using a high-voltage feedback system. A LABVIEW program was developed to control the output of high-voltage power supply according the actual interface position, and then the interface position is modified as the output of high-voltage power supply. At last, the interface can be moved to the desired position automatically using this feedback system. The results show that the system presented in this paper can control an arbitrary interface location in real time. The effects of viscosity ratio, flow rates, and polarity of electric field were discussed. This technique can be extended to switch the sample flow and droplets automatically.

Bioregeneration of activated carbon and activated rice husk loaded with phenolic compounds: Kinetic modeling.

A kinetic model consisting of first-order desorption and biodegradation processes was developed to describe the bioregeneration of phenol- and p-nitrophenol-loaded powdered activated carbon (PAC) and pyrolyzed rice husk (PRH), respectively. Different dosages of PAC and PRH were loaded with phenol or p-nitrophenol by contacting with the respective phenolic compound at various concentrations. The kinetic model was used to fit the phenol or p-nitrophenol concentration data in the bulk solution during the bioregeneration process to determine the rate constants of desorption, k(d), and biodegradation, k. The results showed that the kinetic model fitted relatively well (R(2)>0.9) to the experimental data for the phenol- and p-nitrophenol-loaded PAC as well as p-nitrophenol-loaded PRH. Comparison of the values of k(d) and k shows that k is much greater than k(d). This indicates clearly that the desorption process is the rate-determining step in bioregeneration and k(d) can be used to characterize the rate of bioregeneration. The trend of the variation of the k(d) values with the dosages of PAC or PRH used suggests that higher rate of bioregeneration can be achieved under non-excess adsorbent dosage condition.

Quantification of bioregeneration of activated carbon and activated rice husk loaded with phenolic compounds.

The bioregeneration efficiencies of powdered activated carbon (PAC) and pyrolyzed rice husk loaded with phenol and p-nitrophenol were quantified by oxygen uptake measurements using the respirometry technique in two approaches: (i) simultaneous adsorption and biodegradation and (ii) sequential adsorption and biodegradation. It was found that the applicability of the simultaneous adsorption and biodegradation approach was constrained by the requirement of adsorption preceding biodegradation in order to determine the initial adsorbent loading accurately. The sequential adsorption and biodegradation approach provides a good estimate of the upper limit of the bioregeneration efficiency for the loaded adsorbent in the simultaneous adsorption and biodegradation processes. The results showed that the mean bioregeneration efficiencies for PAC loaded with phenol and p-nitrophenol, respectively, obtained using the two approaches were in good agreement.

Respiratory suspended particulate (RSP) concentration and its implications to roadside workers: a case study of Hong Kong.

Respiratory Suspended Particulates (RSPs) have attracted increasing interest in recent years because of the potential risk of RSPs to human health. In Hong Kong, a large population of roadside workers is believed to be continuously exposed to high levels of RSPs. In this study, the roadside RSP concentrations at 72 locations in 6 urban districts of different land use types in Hong Kong are examined. Results show that the RSP pollution in Hong Kong's roadside environment is quite serious. The average RSP concentration at 61.11% of sampling sites is over 180 microg m(-3), the highest 24 h RSP mean concentration recommended by the Environmental Protection Department of Hong Kong. Analyses of RSP concentration data with reference to the local environmental conditions indicate that, among various environmental factors, land use, population density and traffic flow are important determinants of the RSP level. Because many roadside workers are exposed to high levels of RSP for prolonged periods, it is necessary to increase the public awareness of the health hazard of roadside workers.

Magnetic properties and heavy-metal contents of contaminated seabed sediments of Penny's Bay, Hong Kong.

Magnetic properties and heavy-metal concentrations of vibrocore samples were found to be potential indicators of shipping contamination in seabed sediments in Hong Kong Harbour. Geochemical results of 74 vibrocores located off Penny's Bay on Lantau Island revealed an enrichment of heavy metals in the upper 1-2 m of the cores within the eastern part of the study site. Whole-core magnetic susceptibility measurements also showed a greater concentration of magnetic particles in the surficial layer of these cores. A significant correlation exists between the magnetic susceptibility and the concentrations of Pb, Zn and Cu, as well as the Tomlinson pollution load index (PLI). The proximity of these cores to a major navigation fairway and an anchorage site suggests probable contamination of the surficial seabed sediments by shipping-related wastes. A study of the magnetic properties of one of the cores, VT60, revealed a difference in the magnetic properties between the contaminated and the uncontaminated sediments. Samples from the contaminated zone exhibited relatively stronger magnetic remanence and susceptibility. The two groups of samples also formed distinct trends on the hysteresis ratios plot. A level of unusually high magnetic susceptibility within the contaminated zone was attributable to the presence of strongly magnetized granules, which were probably refuse from shipping-related activities. Geochemical and magnetic results were also conducted on samples of different size-fractions from this core. The < 63 microns fraction was found to contain a relatively higher magnetic susceptibility and greater heavy-metal content.

Green up-conversion emission in Er3+:BaTiO3 sol-gel powders.

Bright green emissions at 549 and 526 nm have been observed from sol-gel derived Er3+:BaTiO3 powders upon excitations at two near infrared (NIR) wavelengths of 973 and 816 nm. The decay characteristics were measured and studied. It was found that the predominant emission at 549 nm has very different lifetimes upon excitation at 973 and 816 nm, which was explained by the mechanisms of excited state absorption (ESA) of individual Er3+ ion and cooperative energy transfer (CET) between two near Er3+ ions for the up-conversion emission. Analysis also showed that 973-nm excitation is more effective for the green up-conversion emission.

Outcome measure for paediatric rehabilitation: use of the Functional Independence Measure for children (WeeFIM). A pilot study in Chinese children with neurodevelopmental disabilities.

PURPOSE: To study the use of Functional Independence Measure for children (WeeFIM) in monitoring neurorehabilitation programmes for children with neurodevelopmental disabilities. METHODS: The neurorehabilitation team of the Children's Habilitation Institute of the Duchess of Kent Children's Hospital were trained to administer the WeeFIM. The WeeFIM was administered to children with various neuro-developmental impairment groups undergoing neurorehabilitation programmes in the hospital inpatient and also outpatient setting. The WeeFIM was scored on hospital admission and prior to discharge for those admitted for the rehabilitation programme. The WeeFIM profile was then monitored half yearly. The pilot study used WeeFIM in assessing 104 children with different medical disease categories. The disease or impairment categories included very low birth weight babies (n = 44), cerebral palsy (n = 19), Down's syndrome (n = 9), pervasive developmental disorder (n = 11), Duchenne Muscular Dystrophy (n = 18), and others (n = 3). RESULTS: WeeFim could be used to measure disability, monitor progress, enhance communication, measure the effectiveness of treatment, and document the benefits of rehabilitation intervention. It also served as a networking of neurorehabilitation programmes for different impairment categories in a continuum of settings: hospital, community, school and at home. WeeFIM was found to be a quick and reliable functional assessment instrument in this rehabilitation facility. CONCLUSIONS: WeeFIM could be used to assist neurorehabilitation clinicians in the selection of short term realistic goals and long term rehabilitation strategies for children with various neurodevelopmental disabilities, and the subsequent progress of the children could be monitored objectively.

In vivo Doppler shift measurements using multimode fiber-optic catheters.

A new fiber-optic catheter for in vivo blood-flow measurements has been developed. The catheter is designed to measure blood flow in both the forward (toward the catheter tip) and reverse (away from the catheter tip) flow directions. It consists of two multimode optical fibers with core diameter of 50 microns and cladding diameter of 125 microns. One fiber transmits the laser beam into blood and the other receives the backscattered light from the erythrocytes within the probe volume. In the flow experiment, it was found that the flow within the boundary layer is indeed laminar and, hence, the relationship between the Doppler shift frequencies and the flow velocities is linear, thereby making the linear calibration possible for predicting the free stream flow velocity. Plots of the maximum shift frequency (frequency at which the Doppler spectrum disappeared into the noise spectrum) against the flow velocities are found to be more linear in both the forward and reverse flow directions than that of the dominant shift frequency (frequency with the highest amplitude). These results were reaffirmed by the numerical flow simulation along the catheter side wall.

X-ray and NMR structure of human Bcl-xL, an inhibitor of programmed cell death.

THE Bcl-2 family of proteins regulate programmed cell death by an unknown mechanism. Here we describe the crystal and solution structures of a Bcl-2 family member, Bcl-xL (ref. 2). The structures consist of two central, primarily hydrophobic alpha-helices, which are surrounded by amphipathic helices. A 60-residue loop connecting helices alpha1 and alpha2 was found to be flexible and non-essential for anti-apoptotic activity. The three functionally important Bcl-2 homology regions (BH1, BH2 and BH3) are in close spatial proximity and form an elongated hydrophobic cleft that may represent the binding site for other Bcl-2 family members. The arrangement of the alpha-helices in Bcl-xL is reminiscent of the membrane translocation domain of bacterial toxins, in particular diphtheria toxin and the colicins. The structural similarity may provide a clue to the mechanism of action of the Bcl-2 family of proteins.

A community's attitudes towards the mentally ill.

AIM: To assess the general community's knowledge of mental illness and personal experience of people with mental illness. METHOD: Three hundred randomly selected Dunedin residents were surveyed by a postal questionnaire. The instruments used to measure attitudes were a shortened form of the Californian attitudes towards mental illness scale (CAMI scale) and a social distance scale. In addition, questions were asked about the respondent's age, gender, marital status, level of education, their main source of opinion, their experience with the mentally ill, and their beliefs about the causes and types of mental illness. RESULTS: Having known a person with mental illness facilitates more intimate relationships with people with a mental illness. Sociodemographic variables did not predict attitudes on the CAMI scale. Most respondents who had been in contact with the mentally ill held informed and enlightened views. CONCLUSION: The community needs and welcomes information on the subject of mental illness and has a positive outlook for the future planning of the rehabilitation of people with mental illness.

A case of alkaptonuria with root canal stenosis.

Spinal involvement in alkaptonuria is common. Patients usually present in the third or fourth decade with spondylosis or acute intervertebral disc prolapse. Alkaptonuria with root canal stenosis has however hitherto not been reported. We wish to report one such patient.