Design trade-offs in self-management technology: the HeartMan case

ABSTRACT

Health self-management technology has the potential to significantly improve the Quality of Life of patients suffering from chronic diseases. However, designing the technology involves numerous highly context-dependent design decisions. In this paper, we analyse a case study of self-monitoring technology in the field of congestive heart failure. We analyse the design process of the technology from the perspective of design trade-offs. Three important trade-offs related to health self-monitoring technology are described in detail, related to patient autonomy, technology appropriation, and patient well-being. For each of the trade-offs, various mediating factors that influence design decisions are described in detail. On a practical level, this analysis can inform future developments in self-management technology. In addition, this design trade-off analysis provides intermediary knowledge that can contribute to a better theoretical understanding of health self-management technology.     

Cell Sheet Comprised of Mesenchymal Stromal Cells Overexpressing Stem Cell Factor Promotes Epicardium Activation and Heart Function Improvement in a Rat Model of Myocardium Infarction

Cell therapy of the post-infarcted myocardium is still far from clinical use. Poor survival of transplanted cells, insufficient regeneration, and replacement of the damaged tissue limit the potential of currently available cell-based techniques. In this study, we generated a multilayered construct from adipose-derived mesenchymal stromal cells (MSCs) modified to secrete stem cell factor, SCF. In a rat model of myocardium infarction, we show that transplantation of SCF producing cell sheet induced activation of the epicardium and promoted the accumulation of c-kit positive cells in ischemic muscle. Morphometry showed the reduction of infarct size (16%) and a left ventricle expansion index (0.12) in the treatment group compared to controls (24–28%; 0.17–0.32). The ratio of viable myocardium was more than 1.5-fold higher, reaching 49% compared to the control (28%) or unmodified cell sheet group (30%). Finally, by day 30 after myocardium infarction, SCF-producing cell sheet transplantation increased left ventricle ejection fraction from 37% in the control sham-operated group to 53%. Our results suggest that, combining the genetic modification of MSCs and their assembly into a multilayered construct, we can provide prolonged pleiotropic effects to the damaged heart, induce endogenous regenerative processes, and improve cardiac function.     

新产品研发是建陶企业可持续发展的核心

新世纪我国建陶企业在整个国民经济的带动下将进一步发展，入世后经济全球化的市场竞争格局，建陶企业只有走新产口研发之路，严格企业管理，才会在日趋激烈的市场竞争中得以生存和可持续发展。     

Age and gender differences in cardiac reactivity and subjective emotion responses to emotional autobiographical memories.

This research reports age and gender differences in cardiac reactivity and subjective responses to the induction of autobiographical memories related to anger, fear, sadness, and happiness. Heart rate (HR) and subjective state were assessed at baseline and after the induction of each emotion in 113 individuals (61 men, 52 women; 66% European American, 34% African American) ranging in age from 15 to 88 years (M = 50.0; SD = 20.2). Cardiac reactivity was lower in older individuals; however, for anger and fear, these age effects were significantly more pronounced for the women than the men. There were no gender differences in subjective responses, however, suggesting that the lower cardiac reactivity found among older people is dependent on gender and the specific emotion assessed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Immunoelectron localization of mitochondrial F1 factor in cryosections of heart muscle cells

Immunocytochemistry was used to investigate the localization of F1 ATPase in mitochondria of cryosections of adult mouse heart muscle cells. The initial aldehyde fixation was the only denaturation step for antigens. The fine structure was preserved with contrast enhancement as the sections were maintained hydrated, with the advantage that the entire procedure is completed in one working day. The reaction was highly specific, and entire mitochondria were labeled with the Protein A-gold complex. A new analytical technique, electron spectroscopic imaging (ESI), contributed to a better visualization of the localization of the F1 factor.     

冠心病患者循环血中内皮细胞、内皮素和6－酮－前列环素F_（1a）的动态变化及意义

以循环内皮细胞（ＣＥＣ）作为血管内皮细胞（ＶＥＣ）损伤的指示物，以血浆内皮素（ＥＴ）和前列环素（ＰＧＩ２）反映ＶＥＣ的功能变化，对８５例冠心病患者与３０例正常人进行对比研究，并对５０例不稳定型心绞痛及２０例急性心肌梗塞进行了动态观察．结果表明：冠心病外周血中ＣＥＣ、ＥＴ明显升高（Ｐ＜０．００１），ＰＧＩ２明显下降（Ｐ＜０．００１），尤以不稳定型心绞痛和急性心肌梗塞更显著，与病情的严重程度相一致．提示冠心病ＶＥＣ损伤，以及它所分泌的内皮源性舒缩因子失平衡参与了冠心病的病理过程。     

心脏黏液瘤的超微结构研究

对8例心脏黏液瘤进行了临床病理总结，着重进行了超微结构的研究，结果表明黏液瘤细胞有4种超微结构表现：（1）原始间叶细胞；（2）纤维母细胞样；（3）肌纤维母细胞样；（4）上皮样。提出心脏黏液瘤细胞起源于原始间叶细胞，有纤维母细胞、肌及上皮样分化。并且提出瘤细胞参与黏液瘤基质的形成。     

Prenatal development of intrafetal and maternal-fetal synchrony.

Fetal and maternal data were monitored serially at 6 gestational ages from 20 to 38 weeks in 195 Peruvian fetuses. Digitized data included fetal heart rate and motor activity, as well as maternal heart rate and electrodermal conductance. Time series analysis evaluated the development of synchrony in 2 streams of fetal functioning and between mothers and fetuses. Intrafetal synchrony between heart rate and motor activity developed in an orderly fashion, with peak cross-correlation approaching an asymptote at 5 s at 28 weeks. Synchrony was not observed between fetal heart rate and maternal measures. Fetal motor activity exhibited synchrony with both maternal electrodermal and heart rate activity. Implications for revealing fundamental properties of neural development prior to birth are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Fetal Neurobehavioral Development: A Tale of Two Cities.

Longitudinal neurobehavioral development was examined in 237 fetuses of low-risk pregnancies from 2 distinct populations-Baltimore, Maryland, and Lima. Peru-at 20. 24. 28. 32, 36. and 38 weeks gestation. Data were based on digitized Doppler-based fetal heart rate (FHR) and fetal movement (FM). In both groups. FHR declined while variability, episodic accelerations, and FM-FHR coupling increased, with discontinuities evident between 28 and 32 weeks gestation. Fetuses in Lima had higher FHR and lower variability, accelerations, and FM-FHR coupling. Declines in trajectories were typically observed 1 month sooner in Lima, which magnified these disparities. Motor activity differences were less consistent. No sex differences in fetal neurobehaviors were detected. It is concluded that population factors can influence the developmental niche of the fetus. (PsycINFO Database Record (c) 2010 APA, all rights reserved)