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We present the Evolutionary Map of the Universe (EMU) survey conducted with the Australian Square Kilometre Array Pathfinder (ASKAP). EMU aims to deliver the touchstone radio atlas of the southern hemisphere. We introduce EMU and review its science drivers and key science goals, updated and tailored to the current ASKAP five-year survey plan. The development of the survey strategy and planned sky coverage is presented, along with the operational aspects of the survey and associated data analysis, together with a selection of diagnostics demonstrating the imaging quality and data characteristics. We give a general description of the value-added data pipeline and data products before concluding with a discussion of links to other surveys and projects and an outline of EMU’s legacy value.
Poisonous birds are rare but on New Guinea, including Indonesia’s easternmost provinces, no less than nine poisonous species, eight pitohuis and one species of ifrita, are found. Pitohuis when handled can cause sneezing with numbness and burning of nasal tissue and nausea in humans. In the bird markets of western Indonesia novelty birds are traded at a premium and overexploitation of popular songbirds leads traders to find replacement species to meet demand. We conducted over 800 surveys in the bird markets of Sumatra, Java, Bali, Lombok, and Sulawesi between 1994 and 2023 and from 2015 onwards we assessed the online trade in pitohuis and Blue-capped Ifrit Ifrita kowaldi. We identified the species, recorded their prices and location, and the date when the birds were offered for sale. We analysed temporal trends, volumes, prices, and geographical origin of the sellers. Between 1994 and 2014 we did not encounter a single pitohui in the Indonesian bird markets. In the following years we recorded 113 pitohuis in 12 bird markets and we recorded 199 pitohuis for sale online; 248 were variable pitohuis and 54 were Hooded Pitohui Pitohui dichrous. No ifritas were recorded. Most pitohuis were recorded in eastern Java and Bali. Prices differed between eastern Java (mean of US$93) and western Java and Bali (US$185), possibly suggesting pitohuis arrive from West Papua in eastern Java and from there make their way to the outer markets. Pitohuis are marketed as “Papuan Straw-headed Bulbuls”; the Straw-headed Bulbul Pycnonotus zeylanicus is a very popular and expensive songbird from Southeast Asia, including western Indonesia, that has become rare both in the wild and in the markets due to overexploitation. Discussions about pitohuis on online forums rarely mention “poisonous” but when it is mentioned traders dismiss this as something not to worry about and they claim it to be dietary-dependent. Poisonous pitohuis are novelty, as well as master, birds in Indonesia, where they are marketed for their song ignoring any negative side-effects of them being poisonous. The trade in novelty species, when detected early, does allow for the authorities to intervene in a timely manner to ensure that this trade does not impede their conservation.
Children’s externalizing behaviors are associated with impairments across the lifespan. Developmental psychopathology theories propose transactional (bidirectional) associations between child externalizing behaviors and parenting during childhood and adolescence. Yet, these foundational relations in early childhood are not well-studied. Utilizing a large, mixed-sex sample, we examined the reciprocal nature of parenting and child externalizing behaviors across early childhood using robust repeated-measures models. Repeated measures data were drawn from a socioeconomically diverse, longitudinal pregnancy cohort of 1287 (64% Black, 31% White) mother-child dyads at four time points (ages one to six). Three variables were included in cross-lagged panel models: observed parenting quality, child externalizing symptoms, and a maternal risk composite. In covariate-adjusted models, higher parenting quality at Wave 1 predicted lower child externalizing symptoms at Wave 2. Higher externalizing symptoms at Wave 1 and Wave 2 predicted lower parenting quality at Wave 2 and Wave 3, respectively. Maternal risk and parenting quality were not significantly associated. Findings showed both parent-driven and child-driven effects across early childhood that did not vary by child sex. The transactional nature of the parent-child relationship begins in infancy, underscoring the importance of early screening and provision of supports for families to minimize and prevent the development of serious psychopathology.
The seminal contributions of Dante Cicchetti to the field/paradigm/metaparadigm of developmental psychopathology (DP) – and its continuing ascendance as a guiding force for multidisciplinary investigation of normative and atypical development – are legion. Our aim is to illustrate a number of DP’s core principles in the context of (a) prospective longitudinal research on children (particularly girls) with attention-deficit hyperactivity disorder and (b) theoretical and empirical work dedicated to alleviating the stigma and discrimination toward those experiencing mental health, substance use, and neurodevelopmental challenges. We feature (i) the mutual interplay of perspectives on normative and non-normative development, (ii) reciprocal and transactional processes, and the constructs of equifinaliy and multifinality; (iii) continuities and discontinuities in developmental processes and outcomes, with particular focus on heterotypic continuity; (iv) the inseparability of heritable and environmental risk; (v) multiple levels of analysis, and (vi) the benefits of qualitative perspectives. We highlight that interventions promoting recovery, along with the multi-level facilitation of protective factors/strengths, lie at the heart of both DP and anti-stigma efforts. The ongoing youth mental-health crisis provides a sobering counterpoint to the gains of the DP enterprise over the past half century.
The aim of this study was to summarize the literature on the applications of machine learning (ML) and their performance in Emergency Medical Services (EMS).
Methods:
Four relevant electronic databases were searched (from inception through January 2024) for all original studies that employed EMS-guided ML algorithms to enhance the clinical and operational performance of EMS. Two reviewers screened the retrieved studies and extracted relevant data from the included studies. The characteristics of included studies, employed ML algorithms, and their performance were quantitively described across primary domains and subdomains.
Results:
This review included a total of 164 studies published from 2005 through 2024. Of those, 125 were clinical domain focused and 39 were operational. The characteristics of ML algorithms such as sample size, number and type of input features, and performance varied between and within domains and subdomains of applications. Clinical applications of ML algorithms involved triage or diagnosis classification (n = 62), treatment prediction (n = 12), or clinical outcome prediction (n = 50), mainly for out-of-hospital cardiac arrest/OHCA (n = 62), cardiovascular diseases/CVDs (n = 19), and trauma (n = 24). The performance of these ML algorithms varied, with a median area under the receiver operating characteristic curve (AUC) of 85.6%, accuracy of 88.1%, sensitivity of 86.05%, and specificity of 86.5%. Within the operational studies, the operational task of most ML algorithms was ambulance allocation (n = 21), followed by ambulance detection (n = 5), ambulance deployment (n = 5), route optimization (n = 5), and quality assurance (n = 3). The performance of all operational ML algorithms varied and had a median AUC of 96.1%, accuracy of 90.0%, sensitivity of 94.4%, and specificity of 87.7%. Generally, neural network and ensemble algorithms, to some degree, out-performed other ML algorithms.
Conclusion:
Triaging and managing different prehospital medical conditions and augmenting ambulance performance can be improved by ML algorithms. Future reports should focus on a specific clinical condition or operational task to improve the precision of the performance metrics of ML models.
OBJECTIVES/GOALS: * Patients with skin of color (SOC) are disproportionately affected by systemic lupus erythematosus (SLE) and cutaneous lupus erythematosus (CLE). In this study, we aim to address this disparity and characterize the real-world efficacy and tolerability of anifrolumab in CLE patients using validated disease activity instruments. METHODS/STUDY POPULATION: This single-center, prospective observational cohort study includes SLE patients with severe or refractory CLE who have received ≥ 1 dose of anifrolumab. Cutaneous disease activity is assessed periodically at 2, 6, 9, 12, and 18 months using the Cutaneous Lupus Disease Area and Severity Index (CLASI). Adverse events and concurrent treatments are also routinely evaluated. To date, 22 patients have been enrolled, with 6-month follow-up data available for 15. At the time of anifrolumab initiation, 95% of participants had discoid LE (DLE), 60% had mucosal DLE, and 13% had subacute CLE. Nine patients identified as SOC, two as White, and four did not report race/ethnicity. RESULTS/ANTICIPATED RESULTS: A Friedman test showed statistically significant changes over time in CLASI activity score (CLASI-A) (χ2(2) =20, p<0.0001) (Figure 1) and CLASI damage score (CLASI-D) (χ2(2) =9.5789, p=0.0083) (Figure. To estimate effect sizes, we employed linear mixed models, which demonstrated statistically significant reductions in the CLASI-A score from baseline by an average of 14 points at 2 months (p<0.001) and 18 points at 6 months (p<0.001); notably, a reduction in CLASI-A of 4 is considered clinically meaningful. At 2 months, 20% of patients experienced a 50% or more reduction in CLASI, which increased to 60% of patients at 6 months. Patients on systemic corticosteroids could taper off. Adverse events were minimal and did not lead to treatment discontinuation. Fig. 1:[blob:https://acts.slayte.com/045319b4-7272-4351-a771-78ba9ee57f5c] Fig. 2:[blob:https://acts.slayte.com/67df7653-0cd8-4e8e-a3e1-d5c565b19dce] DISCUSSION/SIGNIFICANCE: As SOC patients with CLE have significant potential for permanent pigmentary alternations, early treatment is imperative. Effective treatments for refractory CLE are elusive. Our study represents the largest single-center cohort of CLE patients treated with anifrolumab and suggests that it is a promising therapeutic option for patients with SOC.
The aim of this study was to evaluate the effect of the sprinkler cycle and flow rate on physiological, behavioural, and productive responses in dairy buffaloes. Nine Nili Ravi lactating buffaloes were subjected to three sprinkler cycles and two flow rates using a double replicated 3 × 3 Latin square design. The flow rates were 1.25 and 2 l/min, and the sprinkler cycles (minutes water on/off, number of cycles/h) were: 3/3, 10 cycles; 3/6, 7 cycles and 3/9, 5 cycles. The showering was applied from 0800 till 1630 h daily. In the first square of 21 d, each of the three sprinkler cycles was applied using a 1.25 l/min flow rate for 7 d per cycle. In the later square, the same treatments (sprinkler cycles) were applied using the 2 l/min flow rate. The average temperature humidity index during the study period was 85.7 ± 3.8 (Mean ± sd). The result showed that the 3/3 treatment group had lower body temperature and respiration rate than the other groups. The buffaloes in the 3/3 group produced 0.5 and 0.7 kg more milk with 1.4 and 2.4% more fat than the 3/6 and the 3/9 treatment groups, respectively. Similarly, the 2 l/min flow rate had a lower core body temperate and respiration rate and higher milk yield than the 1.25 l/min group. The 3/3 showering cycle with a 2 l/min flow rate appeared effective in improving physiological responses and milk yield in dairy buffaloes.
We sought to determine whether increased antimicrobial use (AU) at the onset of the coronavirus disease 2019 (COVID-19) pandemic was driven by greater AU in COVID-19 patients only, or whether AU also increased in non–COVID-19 patients.
Design:
In this retrospective observational ecological study from 2019 to 2020, we stratified inpatients by COVID-19 status and determined relative percentage differences in median monthly AU in COVID-19 patients versus non–COVID-19 patients during the COVID-19 period (March–December 2020) and the pre–COVID-19 period (March–December 2019). We also determined relative percentage differences in median monthly AU in non–COVID-19 patients during the COVID-19 period versus the pre–COVID-19 period. Statistical significance was assessed using Wilcoxon signed-rank tests.
Setting:
The study was conducted in 3 acute-care hospitals in Chicago, Illinois.
Patients:
Hospitalized patients.
Results:
Facility-wide AU for broad-spectrum antibacterial agents predominantly used for hospital-onset infections was significantly greater in COVID-19 patients versus non–COVID-19 patients during the COVID-19 period (with relative increases of 73%, 66%, and 91% for hospitals A, B, and C, respectively), and during the pre–COVID-19 period (with relative increases of 52%, 64%, and 66% for hospitals A, B, and C, respectively). In contrast, facility-wide AU for all antibacterial agents was significantly lower in non–COVID-19 patients during the COVID-19 period versus the pre–COVID-19 period (with relative decreases of 8%, 7%, and 8% in hospitals A, B, and C, respectively).
Conclusions:
AU for broad-spectrum antimicrobials was greater in COVID-19 patients compared to non–COVID-19 patients at the onset of the pandemic. AU for all antibacterial agents in non–COVID-19 patients decreased in the COVID-19 period compared to the pre–COVID-19 period.
The Eighth World Congress of Pediatric Cardiology and Cardiac Surgery (WCPCCS) will be held in Washington DC, USA, from Saturday, 26 August, 2023 to Friday, 1 September, 2023, inclusive. The Eighth World Congress of Pediatric Cardiology and Cardiac Surgery will be the largest and most comprehensive scientific meeting dedicated to paediatric and congenital cardiac care ever held. At the time of the writing of this manuscript, The Eighth World Congress of Pediatric Cardiology and Cardiac Surgery has 5,037 registered attendees (and rising) from 117 countries, a truly diverse and international faculty of over 925 individuals from 89 countries, over 2,000 individual abstracts and poster presenters from 101 countries, and a Best Abstract Competition featuring 153 oral abstracts from 34 countries. For information about the Eighth World Congress of Pediatric Cardiology and Cardiac Surgery, please visit the following website: [www.WCPCCS2023.org]. The purpose of this manuscript is to review the activities related to global health and advocacy that will occur at the Eighth World Congress of Pediatric Cardiology and Cardiac Surgery.
Acknowledging the need for urgent change, we wanted to take the opportunity to bring a common voice to the global community and issue the Washington DC WCPCCS Call to Action on Addressing the Global Burden of Pediatric and Congenital Heart Diseases. A copy of this Washington DC WCPCCS Call to Action is provided in the Appendix of this manuscript. This Washington DC WCPCCS Call to Action is an initiative aimed at increasing awareness of the global burden, promoting the development of sustainable care systems, and improving access to high quality and equitable healthcare for children with heart disease as well as adults with congenital heart disease worldwide.
Mixing of fluids in a coaxial jet is studied under four distinct viscosity ratios, $m=1$, $10$, $20$ and $40$, using highly resolved large-eddy simulations (LES), particle image velocimetry and planar laser-induced fluorescence. The accuracy of predictions is tested against data obtained by the simultaneous experimental measurements of velocity and concentration fields. For the highest and lowest viscosity ratios, standard RANS models with unclosed terms pertaining to viscosity variations are employed. We show that the standard Reynolds-averaged Navier–Stokes (RANS) approach with no explicit modelling for variable-viscosity terms is not applicable whereas dynamic LES models provide high-quality agreement with the measurements. To identify the underlying mixing physics and sources of discrepancy in RANS predictions, two distinct mixing modes are defined based on the viscosity ratio. Then, for each mode, the evolution of mixing structures, momentum budget analysis with emphasis on variable-viscosity terms, analysis of the turbulent activity and decay of turbulence are investigated using highly resolved LES data. The mixing dynamics is found to be quite distinct in each mixing mode. Variable viscosity manifests multiple effects that are working against each other. Viscosity gradients induce additional instabilities while increasing overall viscosity decreases the effective Reynolds number leading to laminarization of the turbulent jet, explaining the lack of dispersion and turbulent diffusion. Momentum budget analysis reveals that variable-viscosity terms are significant to be neglected. The scaling of the energy spectrum cascade suggests that in the TLL mode the unsteady laminar shedding is responsible for the eddies observed.
Despite the fact that adolescents have been at higher risk of distress during the COVID-19 pandemic, the effect of pandemic on psychotic-like experiences (PLEs) is not well described.
Objectives
The study’s objective is to evaluate if PLEs are induced in young individuals aged 18-24 during the pandemic.
Methods
A total of 201 college students from Pakistan (ages 18-24) were recruited for a cross-sectional research. We investigated the incidence of PLEs in Pakistan during the pandemic, their links to socio-demographic factors, COVID-19-related characteristics, depression, anxiety, and sleep difficulties. Community Assessment of Psychic Experience’s positive symptom component (CAPE), Patient Health Questionnaire, Generalized Anxiety Disorder Scale, and IBM SPSS 25 were used.
Results
CAPE-Frequency and CAPE-stress were positively associated with PHQ total (p<0.0010); GAD total (p<0.001); time spent indoors due to COVID-19 (p<0.001). Psychiatric disorder other than bipolar disorder or psychosis (p<0.001 for CAPE-frequency and stress), family history of psychiatric disorders (p<0.001 for CAPE-frequency and stress), chronic medical disease (p=0.021 CAPE-frequency and p=0.026 CAPE-stress), illegal drug usage (p<0.001 for CAPE-frequency and stress) were associated with CAPE-Frequency and CAPE-stress. In linear stepwise regression analysis, the best model predicted CAPE-Frequency explained 77.4% of variance with the following variables: PHQ total (B=0.552, SE= 0.08, t=6.909, p<0.001), GAD total (p<0.001), duration at home (p<0.001), and psychiatric disorder in family (p<0.001).
Conclusions
PLEs have been linked with anxiety and depression during the pandemic. Individuals with a mental condition, family history of psychiatric disorder, chronic medical illness, illicit drug use, and increased time spent at home experienced more PLEs and stress.
In 2020, European Network for Health Technology Assessment (EUnetHTA) published a relative effectiveness analysis (REA) of Pretomanid in combination with Bedaquiline and Linezolid for the treatment of extensively drug-resistant (XDR) or treatment-intolerant or nonresponsive multidrug-resistant (MDR) tuberculosis (TB) (REA PTJA14). This REA may have a significant value for low- and middle-income countries (LMICs) outside Europe, particularly those with a high burden of drug-resistant TB. This commentary focuses on whether the REA PTJA14 can be transferred and to what extent a REA can be translated to LMICs context outside Europe. We found that the assessments on the clinical effectiveness and risks of bias reported in REA PTJA14 are useful for LMICs outside Europe. The highly standardized management of TB will support the applicability of the REA to LMICs outside of Europe. Transferring this REA can reduce workload and efficiently use limited resources to conduct health technology assessment (HTA). However, the transfer should consider several critical issues, including variations in health system delivery and clinical practice and setting-specific constraints. In the TB context, the differences in the current standard treatment for XDR or nonresponsive MDR TB, resources availability for drug-resistant TB management, and how healthcare is delivered in the countries can complicate the applicability of the REA PTJA14. Given that LMICs have limitations in doing HTA, it is now critical to develop standard guidelines for transferring REA or other HTA results from high-income countries or other LMICs to maximize the benefits of the REA for LMICs outside Europe.
The huge explosion that occurred at Beirut Port led to a high number of casualties. Consequently, 7 field hospitals (FHs) were deployed in Lebanon. The purpose of this study is to explore the challenges that emergency medical teams (EMTs) faced and explain the gaps at the national level related to deploying a FH.
Methods:
A qualitative study was conducted. To collect the data, semi-structured interviews were done with 8 key informants (5 from the FHs, 2 from Lebanese Army Forces, and 1 from Ministry of Public Health). In this study, purposive sampling was used and data were analyzed using Braun and Clarke (2006) thematic analysis and MAXQDA software.
Results:
Three major themes (logistical challenges, staff challenges, and coronavirus disease [COVID-19] pandemic) and 10 subthemes emerged for the challenges that EMTs faced. The gaps at the national level were categorized into 2 themes (absence of needs-based response and limited effective coordination between the host country and donor countries) and 5 sub-themes.
Conclusion:
Lebanon focuses on response rather than preparedness for disasters. EMTs that arrived didn’t meet the medical needs. Hence, there is a need to strengthen the national capacities and to ensure better communication and coordination between the disaster-affected country and the EMTs.
Maternal adversity and prenatal stress confer risk for child behavioral health problems. Few studies have examined this intergenerational process across multiple dimensions of stress; fewer have explored potential protective factors. Using a large, diverse sample of mother–child dyads, we examined associations between maternal childhood trauma, prenatal stressors, and offspring socioemotional-behavioral development, while also examining potential resilience-promoting factors. The Conditions Affecting Neurocognitive Development and Learning and Early Childhood (CANDLE) study prospectively followed 1503 mother–child dyads (65% Black, 32% White) from pregnancy. Exposures included maternal childhood trauma, socioeconomic risk, intimate partner violence, and geocode-linked neighborhood violent crime during pregnancy. Child socioemotional-behavioral functioning was measured via the Brief Infant Toddler Social Emotional Assessment (mean age = 1.1 years). Maternal social support and parenting knowledge during pregnancy were tested as potential moderators. Multiple linear regressions (N = 1127) revealed that maternal childhood trauma, socioeconomic risk, and intimate partner violence were independently, positively associated with child socioemotional-behavioral problems at age one in fully adjusted models. Maternal parenting knowledge moderated associations between both maternal childhood trauma and prenatal socioeconomic risk on child problems: greater knowledge was protective against the effects of socioeconomic risk and was promotive in the context of low maternal history of childhood trauma. Findings indicate that multiple dimensions of maternal stress and adversity are independently associated with child socioemotional-behavioral problems. Further, modifiable environmental factors, including knowledge regarding child development, can mitigate these risks. Both findings support the importance of parental screening and early intervention to promote child socioemotional-behavioral health.
Children of mothers with adverse childhood experiences (ACEs) are at increased risk for developmental problems. However, the mechanisms through which a mother's experience of ACEs are transmitted to her offspring are understudied. The current study investigates potential modifiable mediators (maternal psychopathology and parenting) of the association between maternal ACEs and children's behavioral problems.
Methods
We utilized data from a pregnancy cohort study (N = 1030; CANDLE study) to investigate longitudinal associations between maternal ACEs, postpartum anxiety, observed parenting behavior, and child internalizing behaviors (meanage = 4.31 years, s.d.age = 0.38) in a racially diverse (67% Black; 33% White/Other) sample. We used structural equation modeling to test for direct associations between maternal ACEs and children's internalizing behaviors, as well as indirect associations via two simple mediations (maternal anxiety and parenting), and one serial mediation (sequence of maternal anxiety to parenting).
Results
Simple mediation results indicated that maternal anxiety and cognitive growth fostering behaviors independently mediated the association between maternal ACEs and child internalizing. We observed no evidence of a serial mediation from ACEs to internalizing via the effects of maternal anxiety on parenting.
Conclusions
This study supports and refines extant literature by confirming the intergenerational association between maternal ACEs and child internalizing behaviors in a large, diverse sample, and identifies potential modifiable mediators: maternal anxiety and parenting behaviors related to fostering cognitive development. Findings may inform interventions targeting mothers who have experienced ACEs and suggest that providing support around specific parenting behaviors and addressing maternal anxiety may reduce internalizing behaviors in children.
The coronavirus disease 2019 pandemic resulted in the cessation of elective surgery. The continued provision of complex head and neck cancer surgery was extremely variable, with some UK centres not performing any cancer surgery. During the pandemic, Guy's and St Thomas’ NHS Foundation Trust received high numbers of coronavirus disease 2019 admissions. This paper presents our experience of elective complex major head and neck cancer surgery throughout the pandemic.
Methods
A head and neck cancer surgery hub was set up that provided a co-ordinated managed care pathway for cancer patients during the pandemic; the Guy's Cancer Centre provided a separate, self-enclosed coronavirus-free environment within the hospital campus.
Results
Sixty-nine head and neck cancer patients were operated on in two months, and 13 patients had a microvascular free tissue transfer. Nosocomial infection with coronavirus disease 2019 was detected in two cases (3 per cent), neither required critical care unit admission. Both patients made a complete recovery and were discharged home. There were no deaths.
Conclusion
Performing major head and neck surgery, including free flap surgery, is possible during the pandemic; however, significant changes to conventional practice are required to achieve desirable patient outcomes.
Infantile hemiplegia due to brain injury is associated with poor attention span, which critically affects the learning and acquisition of new skills, especially among children with left-sided infantile hemiplegia (LSIH). This study aimed to improve the selective visual attention (SVA) of children with LSIH through transcranial direct current stimulation (tDCS).
Methods:
A total of 15 children participated in this randomized, double-blinded, pilot study; of them, 10 experienced LSIH, and the remaining 5 were healthy age-matched controls. All the children performed the Computerized Stroop Color-Word Test (CSCWT) at baseline, during the 5th and 10th treatment sessions, and at follow-up. The experimental (n = 5) and control groups (n = 5) received tDCS, while the sham group (n = 5) received placebo tDCS. All three groups received cognitive training on alternate days, for 3 weeks, with the aim to improve SVA.
Results:
Two-way repeated measures analysis of variance (ANOVA) showed a statistically significant change in the mean scores of CSCWT between time points (baseline, 5th and 10th sessions, and follow-up) within-subject factor, group (experimental, sham) between-subject factor and interaction (time points X group) (p < 0.005). Furthermore, a one-way repeated measures ANOVA showed significant differences between time point (p < 0.005) for the experimental and control group but not the sham group.
Conclusion:
These pilot results suggest that future research should be conducted with adequate samples to enable conclusions to be drawn.
Tracheostomy for coronavirus disease 2019 pneumonitis patients requiring prolonged invasive mechanical ventilation remains a matter of debate. This study analysed the timing and outcomes of percutaneous tracheostomy, and reports our experience of a dedicated ENT–anaesthetics department led tracheostomy team.
Method
A prospective single-centre observational study was conducted of patients undergoing tracheostomy, who had been diagnosed with coronavirus disease 2019 pneumonitis, between 21st March and 20th May 2020.
Results
Eighty-one patients underwent tracheostomy after a median (interquartile range) of 16 (13–20) days of invasive mechanical ventilation. Median follow-up duration was 32 (23–40) days. Of patients, 86.7 per cent were successfully liberated from invasive mechanical ventilation in a median (interquartile range) of 12 (7–16) days. Moreover, 68.7 per cent were subsequently discharged from hospital. On univariate analysis, there was no difference in outcomes between early (before day 14) and late (day 14 or later) tracheostomy. The mortality rate was 8.6 per cent and no deaths were tracheostomy related.
Conclusion
Outcomes appear favourable when patients are carefully selected. Percutaneous tracheostomy performed via a multidisciplinary approach, with appropriate training, was safe and optimised healthcare resource utilisation.
In various scenarios, the motion of a tracked object, for example, a pointing apparatus, pedestrian, animal, vehicle, and others, is driven by achieving a premeditated goal such as reaching a destination. This is albeit the various possible trajectories to this endpoint. This paper presents a generic Bayesian framework that utilizes stochastic models that can capture the influence of intent (viz., destination) on the object behavior. It leads to simple algorithms to infer, as early as possible, the intended endpoint from noisy sensory observations, with relatively low computational and training data requirements. This framework is introduced in the context of the novel predictive touch technology for intelligent user interfaces and touchless interactions. It can determine, early in the interaction task or pointing gesture, the interface item the user intends to select on the display (e.g., touchscreen) and accordingly simplify as well as expedite the selection task. This is shown to significantly improve the usability of displays in vehicles, especially under the influence of perturbations due to road and driving conditions, and enable intuitive contact-free interactions. Data collected in instrumented vehicles are shown to demonstrate the effectiveness of the proposed intent prediction approach.