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ObjectivesTo develop predictive models for blood culture (BC) outcomes in an emergency department (ED) setting.DesignRetrospective observational study.SettingED of a large teaching hospital in the Netherlands between 1 September 2018 and 24 June 2020.ParticipantsAdult patients from whom BCs were collected in the ED. Data of demographic information, vital signs, administered medications in the ED and laboratory and radiology results were extracted from the electronic health record, if available at the end of the ED visits.Main outcome measuresThe primary outcome was the performance of two models (logistic regression and gradient boosted trees) to predict bacteraemia in ED patients, defined as at least one true positive BC collected at the ED.ResultsIn 4885 out of 51 399 ED visits (9.5%), BCs were collected. In 598/4885 (12.2%) visits, at least one of the BCs was true positive. Both a gradient boosted tree model and a logistic regression model showed good performance in predicting BC results with area under curve of the receiver operating characteristics of 0.77 (95% CI 0.73 to 0.82) and 0.78 (95% CI 0.73 to 0.82) in the test sets, respectively. In the gradient boosted tree model, the optimal threshold would predict 69% of BCs in the test set to be negative, with a negative predictive value of over 94%.ConclusionsBoth models can accurately identify patients with low risk of bacteraemia at the ED in this single-centre setting and may be useful to reduce unnecessary BCs and associated healthcare costs. Further studies are necessary for validation and to investigate the potential clinical benefits and possible risks after implementation.

AIMS: To determine the effect of dipeptidyl-peptidase (DPP)-4-inhibitor linagliptin on postprandial glomerular hyperfiltration compared to the sulfonylurea glimepiride in adults with type 2 diabetes (T2DM).MATERIALS AND METHODS: In this pre-defined sub-study within a randomized, double-blind, parallel-group, intervention-trial, overweight people with T2DM without renal-impairment were treated with once-daily linagliptin 5 mg (N = 10) or glimepiride 1 mg (N = 13) as add-on to metformin for 8 weeks. After a standardized liquid protein-rich meal, GFR and effective renal plasma flow were determined by inulin and para-aminohippuric acid clearance, respectively, based on timed urine-sampling. Intrarenal hemodynamics were estimated using Gomez'-equations. Glucoregulatory/vasoactive hormones, urinary-pH and fractional excretions (FE) of sodium, potassium and urea were measured.RESULTS: Linagliptin compared to glimepiride increased postprandial filtration fraction (FF; mean-difference 2.1%; P = 0.016) and estimated glomerular hydraulic pressure (mean-difference 3.0 mmHg; P = 0.050), and tended to increase GFR (P = 0.08) and estimated efferent renal arteriolar resistance (RE ; P = 0.08) from baseline to Week-8. No differences in FE were noted. Glimepiride reduced HbA1c more than linagliptin (mean-difference - 0.40%; P = 0.004), without between-group differences in time-averaged postprandial glucose-levels. In the linagliptin-group, change in FF correlated with change in mean arterial pressure (R = 0.807; P = 0.009) and time-averaged-mean glucagon (R = 0.782; P = 0.008), but not with changes in glucose, insulin, intact GLP-1, renin or FENa . Change in glucagon was associated with change in RE (R = 0.830; P = 0.003).CONCLUSIONS: In contrast to our hypothesis, linagliptin compared to glimepiride does not reduce postprandial hyperfiltration, yet seems to increase FF after meal-ingestion by increasing blood pressure or RE . This article is protected by copyright. All rights reserved.

This paper describes the development of novel visual research methods derived through the application of consumer-grade tools of immersive virtual reality. The research methods highlighted are ideally suited for research in the wild, providing field researchers the means to observe and capture any situated activity within its natural context, including the capability to reexamine or “reexperience” activities observed. The utility of these methods was validated empirically through formal and informal field studies. The methods herein are either completely novel approaches or innovative variations of existing visual research methods, thus expanding the existing arsenal of HCI and UX visual research methodologies for in situ observation of ubiquitous and pervasive technology experiences.

Soccer involves explosive physical actions requiring strength, power, and agility for optimal performance. Such attributes may be trained several ways, of which power-band resistance training has received limited attention regarding the potential for performance improvement in soccer players. This study serves to determine the effect of power-band resistance training on 1-repetition maximal (1RM) strength, speed, standing vertical jump (SVJ) height, and agility of collegiate soccer players. Seventeen male players (age: 20.47 ± 1.85 years, height: 1.77 ± 0.08 m, mass: 70.49 ± 4.15 kg) were matched and randomly allocated into either a conventional resistance group (CON, n = 8), or a power-band resistance training group (EXP, n = 9). Following a 6-week intervention, participants were re-assessed relative to their baseline values, showing improvements in 1RM squat mass (CON: +31.57%; EXP: +34.61%), 1RM deadlift mass (CON: +15.44%; EXP: +13.72%), and SVJ height (CON: +4.15%; EXP: +6.35%). Power-band resistance training produced greater results compared to conventional training in 1RM squat mass, even when between-group baseline values were controlled for (ANCOVA, F(1,14)=5.32, p = 0.037, [Formula: see text]). No other between-group differences were evident, showing no clear methodological superiority. Power-band resistance training shows potential as an effective training methodology compared to conventional resistance training to improve performance variables in university soccer players.