Combining High-Impact Practices to Facilitate Hope for Young Adults Transitioning into College

Today’s societal challenges are causing young people to feel less hopeful about the future, negatively impacting their mental health. Educators are called to address this crisis and provide opportunities for young people to experience hope. Jesuit colleges and universities are uniquely poised to do so given their focus on caring for the whole person and the recent release of the Universal Apostolic Preferences, which prioritize “journeying with youth in the creation of a hope-filled future.” High-impact practices at Jesuit institutions could particularly be effective given the ways in which they intellectually engage students and help students cultivate a sense of belonging. Therefore, this study examines the combination of two high-impact practices (first-year seminars/experiences and service-learning) at The College of the Holy Cross to better understand if and how they facilitate and cultivate hope. Findings indicate that first-year seminars with a service-learning component do positively impact students’ sense of hope for the future because of the ways they help students: connect with others; witness individuals and institutions who are impacting change; increase their confidence and feeling of worthiness; develop a sense of purpose and understanding of mission; and reflect on and live out their personal values

From a Morning Forest to a Sunset Beach:Understanding Visual Experiences and the Roles of Personal Characteristics for Designing Relaxing Digital Nature

Nature experiences, especially the visual aspects of nature, have been widely used to facilitate relaxation. Fueled by digital technology, simulated visual nature experiences have gained popularity in creating healing environments that induce relaxation. However, while easily applicable, not all nature-imitating visuals lead to relaxation. How to effectively design relaxing visual nature experiences remains largely unexplored. This paper investigates how different nature qualities facilitate relaxing visual experiences and the roles of two personal characteristics (mood and nature-relatedness) play. Through an online survey and interviews, we assessed 16 nature video clips, representing eight distinctive nature qualities, and compared perceived experiences while considering the influence of personal characteristics. The results indicate four types of visual qualities (engaging, instinctive, ambient, and derivative) underlying nature-induced relaxation, and show that nature relatedness influences the degree to which nature video clips elicit relaxation. We discuss design implications for creating personalized digital nature

Phototrophic N2 and CO2 Fixation Using a Rhodopseudomonas palustris-H2 Mediated Electrochemical System With Infrared Photons

A promising approach for the synthesis of high value reduced compounds is to couple bacteria to the cathode of an electrochemical cell, with delivery of electrons from the electrode driving reductive biosynthesis in the bacteria. Such systems have been used to reduce CO2 to acetate and other C-based compounds. Here, we report an electrosynthetic system that couples a diazotrophic, photoautotrophic bacterium, Rhodopseudomonas palustris TIE-1, to the cathode of an electrochemical cell through the mediator H2 that allows reductive capture of both CO2 and N2 with all of the energy coming from the electrode and infrared (IR) photons. R. palustris TIE-1 was shown to utilize a narrow band of IR radiation centered around 850 nm to support growth under both photoheterotrophic, non-diazotrophic and photoautotrophic, diazotrophic conditions with growth rates similar to those achieved using broad spectrum incandescent light. The bacteria were also successfully cultured in the cathodic compartment of an electrochemical cell with the sole source of electrons coming from electrochemically generated H2, supporting reduction of both CO2 and N2 using 850 nm photons as an energy source. Growth rates were similar to non-electrochemical conditions, revealing that the electrochemical system can fully support bacterial growth. Faradaic efficiencies for N2 and CO2 reduction were 8.5 and 47%, respectively. These results demonstrate that a microbial-electrode hybrid system can be used to achieve reduction and capture of both CO2 and N2 using low energy IR radiation and electrons provided by an electrode

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Feasibility of a new ‘balanced binocular viewing’ treatment for unilateral amblyopia in children aged 3–8 years (BALANCE): results of a phase 2a randomised controlled feasibility trial

Objectives: This study aimed to evaluate the safety of dichoptic balanced binocular viewing (BBV) for amblyopia in children, plus feasibility, adherence, acceptability, trial methodology and clinical measures of visual function. Design: We carried out an observer-masked parallel-group phase 2a feasibility randomised controlled trial. Setting: Two study sites, a secondary/tertiary and a community site. Participants: We enrolled 32 children aged 3–8 years with unilateral amblyopia who had completed optical adaptation where indicated. 20 children attended the 16-week exit visit (retention 63%). Interventions: Children were randomised to BBV (movies customised to interocular acuity difference at baseline) for 1 hour a day (active intervention) or standard management as per parental choice (part-time occlusion or atropine blurring, control). All interventions were used at home, daily for 16 weeks. Primary outcome measure: ‘VacMan suppression test’ of interocular balance at 16 weeks from randomisation. Secondary outcome measures: feasibility outcomes (recruitment and retention ratios, adherence with the allocated intervention); safety outcomes at other time points (changes in prevalence of diplopia, manifest strabismus, suppression/interocular balance on a range of tests); efficacy outcomes (clinical measures of visual function, such as best-corrected visual acuity, BCVA). Outcome measures were identical to those planned in the protocol. Results: Primary outcome: At baseline, values for the interocular balance point were higher (indicating greater suppression of the amblyopic eye) in the occlusion group than in the BBV group. These values shifted downwards on average for the occlusion group, significantly decreasing from baseline to week 16 (t8=4.49, p=0.002). Balance values did not change between baseline and week 16 for the BBV group (t9=−0.82, p=0.435). At 16 weeks, there was no statistical difference in interocular balance/suppression change over time between the two arms. The difference at follow-up between the arms, adjusted for baseline, was −0.02 (95% CI −0.28 to 0.23, p=0.87). Feasibility: We prescreened 144 records of potentially eligible children. Between 28 October 2019 and 31 July 2021, including an interruption due to the COVID-19 pandemic, 32 children were screened and randomised (recruitment rate 22%), 16 to BBV and 16 to standard treatment. 20 children attended the 16-week exit visit (retention 63%). Mean adherence with BBV as proportion of viewing time prescribed was 56.1% (SD36) at 8 and 57.9% (SD 30.2) at 16 weeks. Mean adherence with prescribed occlusion time was 90.1% (SD 19.7) at 8 and 59.2% (SD 24.8) at 16 weeks. Secondary safety/efficacy outcomes: One child in the BBV arm reported transient double vision, which resolved; two reported headaches, which led to withdrawal. BCVA improved from mean 0.47 (SD0.18) logMAR at randomisation to 0.26 (0.14) with standard treatment, and from 0.55 (0.28) to 0.32 (0.26) with BBV. Outcomes at 16 weeks did not differ between treatments. Participant experience: Families were generally positive about BBV, but families found both patching and BBV difficult to integrate into family routines. Conclusions: Recruitment rates indicate that a future phase 3 trial will require multiple sites or a longer enrolment period. Retention and adherence rates were lower than anticipated, which will influence future study designs. Dichoptic treatment may be equal to occlusion treatment in safety and efficacy; headaches may lead to discontinuation. Integration into family routines may constitute a barrier to implementation. Trial registration number NCT03754153

Phase 2a randomised controlled feasibility trial of a new ‘balanced binocular viewing’ treatment for unilateral amblyopia in children age 3–8 years : trial protocol

Introduction Treatments for amblyopia, the most common vision deficit in children, often have suboptimal results. Occlusion/atropine blurring are fraught with poor adherence, regression and recurrence. These interventions target only the amblyopic eye, failing to address imbalances of cortical input from the two eyes (‘suppression’). Dichoptic treatments manipulate binocular visual experience to rebalance input. Poor adherence in early trials of dichoptic therapies inspired our development of balanced binocular viewing (BBV), using movies as child-friendly viewable content. Small observational studies indicate good adherence and efficacy. A feasibility trial is needed to further test safety and gather information to design a full trial. Methods/analysis We will carry out an observer-masked parallel-group phase 2a feasibility randomised controlled trial at two sites, randomising 44 children aged 3–8 years with unilateral amblyopia to either BBV or standard occlusion/atropine blurring, with 1:1 allocation ratio. We will assess visual function at baseline, 8 and 16 weeks. The primary outcome is intervention safety at 16 weeks, measured as change in interocular suppression, considered to precede the onset of potential diplopia. Secondary outcomes include safety at other time points, eligibility, recruitment/retention rates, adherence, clinical outcomes. We will summarise baseline characteristics for each group and assess the treatment effect using analysis of covariance. We will compare continuous clinical secondary endpoints between arms using linear mixed effect models, and report feasibility endpoints using descriptive statistics. Ethics/dissemination This trial has been approved by the London-Brighton & Sussex Research Ethics Committee (18/LO/1204), National Health Service Health Research Authority and Medicines and Healthcare products Regulatory Agency. A lay advisory group will be involved with advising on and disseminating the results to non-professional audiences, including on websites of funder/participating institutions and inputting on healthcare professional audience children would like us to reach. Reporting to clinicians and scientists will be via internal and external meetings/conferences and peer-reviewed journals

Sharing of carbapenemase-encoding plasmids between Enterobacteriaceae in UK sewage uncovered by MinION sequencing

Dissemination of carbapenem resistance among pathogenic Gram-negative bacteria is a looming medical emergency. Efficient spread of resistance within and between bacterial species is facilitated by mobile genetic elements. We hypothesized that wastewater contributes to the dissemination of carbapenemase-producing Enterobacteriaceae (CPE), and studied this through a cross-sectional observational study of wastewater in the East of England. We isolated clinically relevant species of CPE in untreated and treated wastewater, confirming that waste treatment does not prevent release of CPE into the environment. We observed that CPE-positive plants were restricted to those in direct receipt of hospital waste, suggesting that hospital effluent may play a role in disseminating carbapenem resistance. We postulated that plasmids carrying carbapenemase genes were exchanged between bacterial hosts in sewage, and used short-read (Illumina) and long-read (MinION) technologies to characterize plasmids encoding resistance to antimicrobials and heavy metals. We demonstrated that different CPE species ($\textit{Enterobacter kobei}$ and $\textit{Raoultella ornithinolytica}$) isolated from wastewater from the same treatment plant shared two plasmids of 63 and 280 kb. The former plasmid conferred resistance to carbapenems ($bla_\text{OXA-48}$), and the latter to numerous drug classes and heavy metals. We also report the complete genome sequence for $\textit{Enterobacter kobei}$. Small, portable sequencing instruments such as the MinION have the potential to improve the quality of information gathered on antimicrobial resistance in the environment.This publication presents independent research supported by the Health Innovation Challenge Fund (WT098600, HICF-T5-342), a parallel funding partnership between the Department of Health, UK, and the Wellcome Trust. C. L. is a Wellcome Trust Sir Henry Postdoctoral Fellow (110243/Z/15/Z). T. G. is a Wellcome Trust Research Training Fellow (103387/Z/13/Z)

The use of a physiologically based pharmacokinetic model to evaluate deconvolution measurements of systemic absorption

BACKGROUND: An unknown input function can be determined by deconvolution using the systemic bolus input function (r) determined using an experimental input of duration ranging from a few seconds to many minutes. The quantitative relation between the duration of the input and the accuracy of r is unknown. Although a large number of deconvolution procedures have been described, these routines are not available in a convenient software package. METHODS: Four deconvolution methods are implemented in a new, user-friendly software program (PKQuest, ). Three of these methods are characterized by input parameters that are adjusted by the user to provide the "best" fit. A new approach is used to determine these parameters, based on the assumption that the input can be approximated by a gamma distribution. Deconvolution methodologies are evaluated using data generated from a physiologically based pharmacokinetic model (PBPK). RESULTS AND CONCLUSIONS: The 11-compartment PBPK model is accurately described by either a 2 or 3-exponential function, depending on whether or not there is significant tissue binding. For an accurate estimate of r the first venous sample should be at or before the end of the constant infusion and a long (10 minute) constant infusion is preferable to a bolus injection. For noisy data, a gamma distribution deconvolution provides the best result if the input has the form of a gamma distribution. For other input functions, good results are obtained using deconvolution methods based on modeling the input with either a B-spline or uniform dense set of time points

Extended optical treatment versus early patching with an intensive patching regimen in children with amblyopia in Europe (EuPatch): a multicentre, randomised controlled trial

Background: Amblyopia, the most common visual impairment of childhood, is a public health concern. An extended period of optical treatment before patching is recommended by the clinical guidelines of several countries. The aim of this study was to compare an intensive patching regimen, with and without extended optical treatment (EOT), in a randomised controlled trial. Methods: EuPatch was a randomised controlled trial conducted in 30 hospitals in the UK, Greece, Austria, Germany, and Switzerland. Children aged 3–8 years with newly detected, untreated amblyopia (defined as an interocular difference ≥0·30 logarithm of the minimum angle of resolution [logMAR] best corrected visual acuity [BCVA]) due to anisometropia, strabismus, or both were eligible. Participants were randomly assigned (1:1) via a computer-generated sequence to either the EOT group (18 weeks of glasses use before patching) or to the early patching group (3 weeks of glasses use before patching), stratified for type and severity of amblyopia. All participants were initially prescribed an intensive patching regimen (10 h/day, 6 days per week), supplemented with motivational materials. The patching period was up to 24 weeks. Participants, parents or guardians, assessors, and the trial statistician were not masked to treatment allocation. The primary outcome was successful treatment (ie, ≤0·20 logMAR interocular difference in BCVA) after 12 weeks of patching. Two primary analyses were conducted: the main analysis included all participants, including those who dropped out, but excluded those who did not provide outcome data at week 12 and remained on the study; the other analysis imputed this missing data. All eligible and randomly assigned participants were assessed for adverse events. This study is registered with the International Standard Randomised Controlled Trial Number registry (ISRCTN51712593) and is no longer recruiting. Findings: Between June 20, 2013, and March 12, 2020, after exclusion of eight participants found ineligible after detailed screening, we randomly assigned 334 participants (170 to the EOT group and 164 to the early patching group), including 188 (56%) boys, 146 (44%) girls, and two (1%) participants whose sex was not recorded. 317 participants (158 in the EOT group and 159 in the early patching group) were analysed for the primary outcome without imputation of missing data (median follow-up time 42 weeks [IQR 42] in the EOT group vs 27 weeks [27] in the early patching group). 24 (14%) of 170 participants in the EOT group and ten (6%) of 164 in the early patching group were excluded or dropped out of the study, mostly due to loss to follow-up and withdrawal of consent; ten (6%) in the EOT group and three (2%) in the early patching group missed the 12 week visit but remained on the study. A higher proportion of participants in the early patching group had successful treatment (107 [67%] of 159) than those in the EOT group (86 [54%] of 158; 13% difference; p=0·019) after 12 weeks of patching. No serious adverse events related to the interventions occurred. Interpretation: The results from this trial indicate that early patching is more effective than EOT for the treatment of most children with amblyopia. Our findings also provide data for the personalisation of amblyopia treatments. Funding: Action Medical Research, NIHR Clinical Research Network, and Ulverscroft Foundation