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Using a human-centered design method, our team sought to envision a new model of care for women experiencing low-risk pregnancy. This model, called OB Nest, aimed to demedicalize the experience of pregnancy by providing a supportive and empowering experience that fits within patients' daily lives. To explore this topic, we invited women to use self-monitoring tools, a text-based smartphone application to communicate with their care team, and moderated online communities to connect with other pregnant women. Through observations of tool use and patient- and care team-provided feedback, we found that self-measurement and access to a fetal heart monitor provided women with confidence and joy in the progress of their pregnancies while shifting their position to being an active participant in their care. The smartphone application gave women direct access to their care team, provided continuity, and removed hurdles in establishing communication. The online community platform was a space where women in the same obstetric clinic could share nonmedical questions and advice with one another. This created a sense of community, leveraged the knowledge of women, and provided a venue beyond the clinic visit for information exchange. These findings were integrated into the design of the Mayo Clinic OB Nest model. This model redistributes care based on the individual needs of patients by providing self-measurement tools and continuous flexible access to their care team. By enabling women to meaningfully participate in their care, there is potential for cost savings and improved patient satisfaction.

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Background: We examined patient interest in a telehealth model in which the patient supplies the hardware and Internet connectivity to meet with a healthcare provider from his or her home via video call (video appointment). We hoped to understand prospectively the desirability, feasibility, and viability from the patient perspective. Materials and Methods: A phone survey was conducted of a random sample of patients who had been seen in the outpatient setting at a single institution. The sample was stratified by proximity to the local institution with oversampling for patients living outside a 120-mile radius. Results: Out of 500 total patients, 301 patients responded, and 263 met the inclusion criteria. Of those 263 respondents, 38% indicated ''very likely'' to accept an invitation to see their provider via video, 28.1% ''somewhat likely,'' and 33.8% ''not at all likely.'' Of respondents, 75% have broadband, although only 36% reported having a Web camera. The primary factors affecting willingness to participate in a video appointment include comfort in setting up a video call, age, and distance participants would have traveled for an in-clinic appointment. Conclusions: Patient survey data indicate that most patients are likely to be accepting of telehealth care to the home using video call and that most have the required technology. Nevertheless, there are still significant hurdles to effectively implement this adaptation of telehealth care as part of mainstream practice.

Binding proteins that transport and/or modify the biological action of peptide hormones and growth factors have been identified for an increasing number of endocrinologically important substances. Since these binding proteins can mask epitopes critical for recognition in immunoassays and can neutralize the bioactivity of their targets, elucidation of hormonal physiology can be intricately tied to analysis of binding protein structure and function. Therefore, we investigated whether circulating activin- and inhibin-binding proteins exist in human serum by incubating purified recombinant human 125I-activin with serum samples. After gel permeation chromatography, radioactive activin was identified in three peaks, a high molecular wt (mol wt) binding protein peak (230 kDa), a lower mol wt binding protein peak (60 kDa), and free activin (22.5 kDa). Bound activin was displaced from the lower mol wt binding protein with either activin or inhibin, but was not displaced from the high mol wt peak with a 10-fold greater concentration of activin. Since an activin-binding protein, follistatin, has been identified in ovarian and pituitary extracts, these same analytical techniques were applied to analysis of human follicular fluid as well. A large, 60 kDa binding protein peak eluting in a position similar to the lower mol wt peak in serum was observed, consistent with this protein being follistatin. These results demonstrate the presence of at least two activin-binding proteins, distinguishable by size, in human serum that may interfere with attempts to assay activin levels in circulation without prior extraction, and may also be involved in regulating the biological actions of activin.

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The looming threat orbital debris poses to assets in orbit demands solutions. As the orbital population grows, so does this hazard, but so does the sea of data. The problem is also an opportunity for interdisciplinary innovation and cooperation. This paper focuses on the data and information management aspect of developing solutions for a sustainable and safe orbital space environment. The corresponding author's in-progress work to develop an orbital debris domain ontology is summarized in order to discuss knowledge modeling for this domain. Methodological approaches of this effort can also contribute to standards efforts and address terminological and policy questions.Leveraging the growing volumes of orbital debris and space situational awareness (SSA) data will create a more complete picture of the orbital space environment. Part of the solution will be: consistent and correct data interpretation, sharing orbital debris and SSA data in one form or another, terminology development & harmonization, and knowledge or domain modeling. To facilitate this, [Rovetto, 2015/16] discussed ontology development for the orbital debris domain. This paper lists concepts from that paper, and subsequently developed concepts [2-9].Ontology engineering is an interdisciplinary field related to knowledge representation and reasoning in artificial intelligence, semantic technologies and the so-called semantic web. An ontology is effectively a computable and semantically rich terminology that presents a knowledge or domain model for a topic area. Expressions of knowledge or assertions are stored using formally defined term. This knowledge base is reasoned over to yield answers to queries, among other things. Ontologies have been developed in knowledge-based projects across various disciplines, and used for such things as search engines, chatbots, enterprise knowledge graphs, etc. Ontologies support: interoperability, automated reasoning, data sharing and integration, data search and retrieval, and communicating the meaning of data.The Orbital Debris Ontology (ODO) [1], and related ontologies [Rovetto & Kelso 2016, were proposed to help achieve this. ODO, for instance, is intended as a domain ontology that can be used across federated databases, offering an explicitly specified set of concepts describing the orbital debris domain. Its meaning-rich taxonomy will provide a sharable semantics for orbital debris data to, in part, consistently communicate the meaning of data to both humans and machines, and tag data elements in space object catalogs to help afford inference tasks, decision support, knowledge discovery, and information integration. ODO and the SSA ontology (SSAO) [2] is part of the overall Orbital Space Domain Ontology concept, which is conceived as a broader domain reference ontology. It aims to provide a knowledge representation structure of the orbital space environment, a common semantic model, and develop a sharable terminology. Collectively this will provide common meaning for datasets, a high-level taxonomy or classi...

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