Psychosocial aspects in cardiac rehabilitation: From theory to practice. A position paper from the Cardiac Rehabilitation Section of the European Association of Cardiovascular Prevention and Rehabilitation of the European Society of Cardiology

A large body of empirical research shows that psychosocial risk factors (PSRFs) such as low socio-economic status, social isolation, stress, type-D personality, depression and anxiety increase the risk of incident coronary heart disease (CHD) and also contribute to poorer health-related quality of life (HRQoL) and prognosis in patients with established CHD. PSRFs may also act as barriers to lifestyle changes and treatment adherence and may moderate the effects of cardiac rehabilitation (CR). Furthermore, there appears to be a bidirectional interaction between PSRFs and the cardiovascular system. Stress, anxiety and depression affect the cardiovascular system through immune, neuroendocrine and behavioural pathways. In turn, CHD and its associated treatments may lead to distress in patients, including anxiety and depression. In clinical practice, PSRFs can be assessed with single-item screening questions, standardised questionnaires, or structured clinical interviews. Psychotherapy and medication can be considered to alleviate any PSRF-related symptoms and to enhance HRQoL, but the evidence for a definite beneficial effect on cardiac endpoints is inconclusive. A multimodal behavioural intervention, integrating counselling for PSRFs and coping with illness should be included within comprehensive CR. Patients with clinically significant symptoms of distress should be referred for psychological counselling or psychologically focused interventions and/or psychopharmacological treatment. To conclude, the success of CR may critically depend on the interdependence of the body and mind and this interaction needs to be reflected through the assessment and management of PSRFs in line with robust scientific evidence, by trained staff, integrated within the core CR team.

Vitamin D status among children and adolescents on anticonvulsant drugs in southern Switzerland.

INTRODUCTION It is recognised that vitamin D status is often inadequate (<50 nmol/l) in epileptic children, mainly because some anticonvulsant drugs induce the enzymes responsible for its metabolism. The purpose of the present study was to address vitamin D status among children and adolescents treated with anticonvulsant drugs and control subjects who reside in southern Switzerland, a high solar radiation region. METHODS Between January and May 2013, total serum 25-hydroxyvitamin D was assessed by liquid chromatography-tandem mass spectrometry in 58 children and adolescents with epilepsy and 29 controls residing in southern Switzerland. Dark-skinned individuals, females wearing dress styles covering practically the whole body and subjects with body mass index ≥85th percentile for age and sex were excluded. RESULTS Concentration of serum 25-hydroxyvitamin D was similar in epilepsy patients (48 [37-62] nmol/l; median and interquartile range) and controls (53 [47-64] nmol/l). An inadequate serum 25-hydroxyvitamin D concentration was common both among patients (55%) and control subjects (34%). Serum 25-hydroxyvitamin D was significantly lower among patients treated with anticonvulsant drugs that induce the metabolism of vitamin D (30 [21-51] nmol/l) than among the remaining patients (51 [40-65] nmol/l) and controls. CONCLUSIONS The present study indicates a relevant tendency towards inadequate vitamin D status among children with and without anticonvulsant drug management who reside in southern Switzerland. This tendency is more prominent in patients treated with anticonvulsant drugs that induce the metabolism of 25-hydroxyvitamin D.

The tail plays a major role in the differing manoeuvrability of two sibling species of mouse-eared bats (Myotis myotis and Myotis blythii)

Two sympatrically occurring bat species, the greater mouse-eared bat (Myotis myotis (Borkhausen, 1797)) and the lesser mouse-eared bat (Myotis blythii (Tomes, 1857)) (Chiroptera, Vespertillionidae), share numerous similarities in morphology, roosting behaviour, and echolocation and are often difficult to distinguish. However, despite these similarities, their foraging behaviour is noticeably different. Our aim was to examine the extent to which these different foraging strategies reflect morphological adaptation. We assessed whether the morphology of the wing, body, and tail differed between M. myotis and M. blythii. In addition, in a laboratory experiment involving an obstacle course, we compared differences in manoeuvrability by relating them to our morphological measurements. The two species differed in their overall size, wing-tip shape, and tail-to-body length ratio. The generally smaller sized M. blythii performed better in the obstacle course and was therefore considered to be more manoeuvrable. Although differences in wing-tip shape were observed, we found the most important characteristic affecting manoeuvrability in both species to be the tail-to-body length ratio. Additionally, when we compared two bats with injured wing membranes with unharmed bats of the same species, we found no difference in manoeuvrability, even when the wing shape was asymmetric. We therefore postulate that morphometric differences between the two species in their overall size and, more importantly, in their tail-to-body length ratio are the main physical characteristics providing proof of adaptation to different foraging and feeding strategies.

Islam and the Legal Enforcement of Morality

Over sixty years ago, British high court judge Patrick Devlin and legal philosopher H.L.A. Hart fought out a famous debate over the legal enforcement of morality, which was generated by the question whether homosexuality should be legalized or not. Jurists agree that this debate was won by Hart, also evidenced in the fact that the state has since been retreating from its previous role of moral watchdog. I argue in this paper that the two most conflicted and essentially unresolved issues in the integration of Islam, the regulation of the female body and of free speech, have reopened this debate anew, pushing the liberal state toward the legal regulation of morality, thus potentially putting at risk its liberalness. I use the Hart-Devlin debate as a template for comparing and contrasting the Muslim quest for restricting free speech with the host-society quest for restricting the Islamic veil. Accordingly, there is a double threat to liberalism, which this paper brings into view in tandem, one originating from Islam and another from a hypertrophied defense of liberalism.

A generalisation of the fractional Brownian field based on non-Euclidean norms

We explore a generalisation of the L´evy fractional Brownian field on the Euclidean space based on replacing the Euclidean norm with another norm. A characterisation result for admissible norms yields a complete description of all self-similar Gaussian random fields with stationary increments. Several integral representations of the introduced random fields are derived. In a similar vein, several non-Euclidean variants of the fractional Poisson field are introduced and it is shown that they share the covariance structure with the fractional Brownian field and converge to it. The shape parameters of the Poisson and Brownian variants are related by convex geometry transforms, namely the radial pth mean body and the polar projection transforms.

Uncertain Belongings. Absent mourning, burial, and post-mortem repatriations at the external border of the EU in Spain

Since the mid-1980s, migrants from North African and sub-Saharan countries have irregularly crossed the Strait of Gibraltar, in the hope of a better future for themselves and their families. Travelling in small, poorly equipped boats without experienced captains has cost the lives of myriad border crossers. Many of these bodies will never be recovered and the bereaved will never know whether their relatives and friends are alive or not. The bereaved are thus condemned to a state of not knowing and uncertainty. Exploring the junction of death and belonging, I firstly open a discussion about the enigmatic relation between a dead body and a dead person and argue for the importance of the physical presence of the body for mourning. Secondly, I show how the anonymity of dead border crossers and their uncertain belongings are generated, concealed, or rewritten. Following the story of an undertaker, I thirdly examine post-mortem border crossings. Depicting the power relations within identification processes, I outline the ambiguity of the term belonging by emphasising the constitutive significance of personal belongings such as clothes to restore a person’s identity. Reflecting on the ethical relationships which different actors (including the researcher) undertake with the deceased, I aim at gaining a better understanding of the multiple belonging of dead border crossers found on Spanish shores.

DNA, Red Tide and the Sea: a new exhibit at Mystic Aquarium & IFE

DNA, Red Tide and the Sea is a new exhibit at Mystic Aquarium & IFE. It was developed by UConn Marine Sciences Professor Senjie Lin, and Mystic Aquarium. Children can extract DNA from fruit and learn about genetic codes and red tides in the ocean.

The function of math5 and myocilin in mammalian eye development and disease

Complex molecular events underlie vertebrate eye development and disease. The eye is composed of two major tissue types: the anterior and posterior segments. During development, the retinal progenitor cells differentiate into six neuronal and one non-neuronal cell types. These cell types later organize into the distinct laminar structure of the mature retina which occupies the posterior segment. In the developed anterior segment, both the ciliary body and trabecular meshwork regulate intraocular pressure created by the aqueous humor. The disruption in intraocular pressure can lead to a blinding condition called glaucoma. To characterize molecular mechanisms governing retinal development and glaucoma, two separate mouse knockout lines carrying mutations in math5 and myocilin were subjected to a series of in vivo analyses. ^ Math5 is a murine homologue of Drosophila atonal , a bHLH proneural gene essential for the formation of photoreceptor cells. The expression of math5 coincides with the onset of retinal ganglion cell differentiation. The targeted deletion of mouse math5 revealed that a null mutation inhibits the formation of a majority of the retinal ganglion cells. The mutation also interferes with the normal development of other retinal cell types such as amacrine, bipolar and photoreceptor cells. These results suggest that math5 is a proneural gene responsible for differentiation of retinal ganglion cells and may also have a role in normal development of other neuronal cell types within the retina. ^ Myocilin has two unique protein coding regions bearing homology to non-muscle myosin of Dictyostelium discoideum and to olfactomedin, an extracellular matrix molecule first described in the olfactory epithelium of the bullfrog. Recently, autosomal dominant forms of myocilin mutations have been found in individuals with primary open-angle glaucoma. The genetic linkage to glaucoma suggests a role of myocilin in normal intraocular pressure and ocular function. However, the analysis of mice heterozygous and homozygous for a targeted null mutation in myocilin indicates that it is dispensable for normal intraocular pressure or ocular function. Additionally, the lack of a discernable phenotype in both heterozygous and null mice suggests that haploinsufficiency is not a critical mechanism for MYOC-associated glaucoma in humans. Instead, disease-causing mutations likely act by gain of function. ^ In summary, these studies provide novel insights into the embryonic development of the vertebrate retina, and also begin to uncover the molecular mechanisms responsible for the pathogenesis of glaucoma. ^

Promoting Student Collaboration in a Detracked, Heterogeneous Secondary Mathematics Classroom

Detracking and heterogeneous groupwork are two educational practices that have been shown to have promise for affording all students needed learning opportunities to develop mathematical proficiency. However, teachers face significant pedagogical challenges in organizing productive groupwork in these settings. This study offers an analysis of one teacher’s role in creating a classroom system that supported student collaboration within groups in a detracked, heterogeneous geometry classroom. The analysis focuses on four categories of the teacher’s work that created a set of affordances to support within group collaborative practices and links the teacher’s work with principles of complex systems.

Ayurvedic Concept of Food and Nutrition

Ayurveda places special emphasis on Ahar (diet) and Anna (food) and believes that healthy nutrition nourishes the mind, body and soul. Ayurveda does not discriminate food to be good, or bad, instead it emphasizes various factors that influence food, such as its biological properties, origin, environmental factors, seasons, preparation, freshness, and provides a logical explanation of how to balance food according to one's dosha and physical needs.

Undergraduate Engineering Students' Understanding of Heat, Temperature, and Radiation

Difficulty understanding heat and temperature concepts has been recognized in engineering education. Confusion has been shown to persist after instruction. The purpose of this study was to determine whether undergraduate engineering students’ knowledge of four heat transfer concept areas significantly changed with instruction and whether this varied by major and GPA. Two hundred twenty-eight undergraduate engineering students from six institutions were assessed prior to and after instruction. Results showed significant improvement in most concept areas but mean scores were below mastery. Previously documented misconceptions persisted after instruction. Significant differences were found by major and GPA. Suggestions for future research provided.

DEVELOPMENT OF A BEAM-SPECIFIC PLANNING TARGET VOLUME AND A ROBUST PLAN ANALYSIS TOOL FOR PROTON THERAPY

Proton therapy is growing increasingly popular due to its superior dose characteristics compared to conventional photon therapy. Protons travel a finite range in the patient body and stop, thereby delivering no dose beyond their range. However, because the range of a proton beam is heavily dependent on the tissue density along its beam path, uncertainties in patient setup position and inherent range calculation can degrade thedose distribution significantly. Despite these challenges that are unique to proton therapy, current management of the uncertainties during treatment planning of proton therapy has been similar to that of conventional photon therapy. The goal of this dissertation research was to develop a treatment planning method and a planevaluation method that address proton-specific issues regarding setup and range uncertainties. Treatment plan designing method adapted to proton therapy: Currently, for proton therapy using a scanning beam delivery system, setup uncertainties are largely accounted for by geometrically expanding a clinical target volume (CTV) to a planning target volume (PTV). However, a PTV alone cannot adequately account for range uncertainties coupled to misaligned patient anatomy in the beam path since it does not account for the change in tissue density. In order to remedy this problem, we proposed a beam-specific PTV (bsPTV) that accounts for the change in tissue density along the beam path due to the uncertainties. Our proposed method was successfully implemented, and its superiority over the conventional PTV was shown through a controlled experiment.. Furthermore, we have shown that the bsPTV concept can be incorporated into beam angle optimization for better target coverage and normal tissue sparing for a selected lung cancer patient. Treatment plan evaluation method adapted to proton therapy: The dose-volume histogram of the clinical target volume (CTV) or any other volumes of interest at the time of planning does not represent the most probable dosimetric outcome of a given plan as it does not include the uncertainties mentioned earlier. Currently, the PTV is used as a surrogate of the CTV’s worst case scenario for target dose estimation. However, because proton dose distributions are subject to change under these uncertainties, the validity of the PTV analysis method is questionable. In order to remedy this problem, we proposed the use of statistical parameters to quantify uncertainties on both the dose-volume histogram and dose distribution directly. The robust plan analysis tool was successfully implemented to compute both the expectation value and its standard deviation of dosimetric parameters of a treatment plan under the uncertainties. For 15 lung cancer patients, the proposed method was used to quantify the dosimetric difference between the nominal situation and its expected value under the uncertainties.

Fluxes and meteorological observations on Spitsbergen

Arctic permafrost may be adversely affected by climate change in a number of ways, so that establishing a world-wide monitoring program seems imperative. This thesis evaluates possibilities for permafrost monitoring at the example of a permafrost site on Svalbard, Norway. An energy balance model for permafrost temperatures is developed that evaluates the different components of the surface energy budget in analogy to climate models. The surface energy budget, consisting of radiation components, sensible and latent heat fluxes as well as the ground heat flux, is measured over the course of one year, which has not been accomplished for arctic land areas so far. A considerable small-scale heterogeneity of the summer surface temperature is observed in long-term measurements with a thermal imaging system, which can be reproduced in the energy balance model. The model can also simulate the impact of different snow depths on the soil temperature, that has been documented in field measurements. Furthermore, time series of terrestrial surface temperature measurements are compared to satellite-borne measurements, for which a significant cold-bias is observed during winter. Finally, different possibilities for a world-wide monitoring scheme are assessed. Energy budget models can incorporate different satellite data sets as training data sets for parameter estimation, so that they may constitute an alternative to purely satellite-based schemes.

Composition of hydrothermal massive sulfide deposits from ODP Site 158-957 and Leg 169 sites

Sulfide mineral major and trace element analyses were performed on more than 50 polished slabs representing mineralization from three seafloor hydrothermal massive sulfide deposits. Samples from the Bent Hill and ODP Mound massive sulfide deposits, both on the Juan de Fuca Ridge, can be contrasted with samples from the Trans-Atlantic Geotraverse (TAG) hydrothermal mound on the Mid-Atlantic Ridge. The massive sulfide at Bent Hill is predominantly pyrite and pyrrhotite, with increasing amounts of copper-bearing sulfide minerals at the base of the massive sulfide body and through the stockwork to an interval 200 m below seafloor that hosts high copper mineralization (Deep Copper Zone). ODP Mound contains much more abundant sphalerite and copper-bearing sulfides as compared to either Bent Hill or TAG, which are predominantly pyrite with much less abundant chalcopyrite. Copper-bearing sulfides from the Deep Copper Zone beneath Bent Hill and the lowest sampled interval of ODP Mound are petrographically and chemically similar, but distinct from copper-bearing minerals higher in either sequence.

Enhancing Activity Recognition by Fusing Inertial and Biometric Information

Activity recognition is an active research field nowadays, as it enables the development of highly adaptive applications, e.g. in the field of personal health. In this paper, a light high-level fusion algorithm to detect the activity that an individual is performing is presented. The algorithm relies on data gathered from accelerometers placed on different parts of the body, and on biometric sensors. Inertial sensors allow detecting activity by analyzing signal features such as amplitude or peaks. In addition, there is a relationship between the activity intensity and biometric response, which can be considered together with acceleration data to improve the accuracy of activity detection. The proposed algorithm is designed to work with minimum computational cost, being ready to run in a mobile device as part of a context-aware application. In order to enable different user scenarios, the algorithm offers best-effort activity estimation: its quality of estimation depends on the position and number of the available inertial sensors, and also on the presence of biometric information.