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Background and aims Methods Results Conclusion Methods for femoral venous haemostasis following electrophysiology (EP) procedures include manual compression (MC) and suture‐based techniques such as a figure‐of‐eight suture secured with a hand‐tied knot (Fo8HT) or a modified figure‐of‐eight suture secured with a 3‐way stopcock (Fo8MOD). We hypothesised that short‐term bleeding outcomes using the Fo8MOD approach would be superior to MC. We additionally compared outcomes between Fo8MOD and Fo8HT approaches.We studied consecutive patients undergoing EP procedures at our institution between March and December 2023. Patients were categorised into three haemostasis groups: MC, Fo8HT and Fo8MOD. Access site complications were classified as major (requiring intervention or blood transfusion, delaying discharge or resulting in death) or minor (bleeding/haematoma requiring additional compression).1089 patients were included: MC 718 (65.9%); Fo8HT 105 (9.6%); Fo8MOD 266 (24.4%). Procedures were most commonly for atrial fibrillation (52.4%), atrial flutter (10.9%), and atrioventricular nodal re‐entrant tachycardia (10.1%). In patients receiving periprocedural anticoagulation (865, 79.4%), Fo8MOD associated with fewer complications than MC or Fo8HT (major: MC 2.2%, Fo8HT 6.0%, Fo8MOD 0.8%, p = .01; minor: MC 16.5%, Fo8HT 12.0%, Fo8MOD 7.4%, p = .002). In patients not receiving periprocedural anticoagulation, complications did not differ between haemostasis methods (total major and minor complications 5.8%, p = .729 for between groups rates). On multivariable logistic regression, Fo8MOD was associated with a significantly lower risk of access site complications (OR 0.29 [95% CI 0.17–0.48], p < .001), whilst intraprocedural heparinisation (OR 5.25 [2.88–9.69], p < .001) and larger maximal sheath size (OR 1.06 [1.00–1.11], p = .04) were associated with a higher risk of complications.Femoral haemostasis with Fo8MOD associates with fewer access site complications than MC and Fo8HT following EP procedures that need periprocedural anticoagulation. [ABSTRACT FROM AUTHOR]

Background Methods Discussion Access to the neuraxial space, including lumbar punctures and neuraxial anaesthesia, is an everyday procedure in clinical practice. Traditionally these procedures rely on manual palpation technique, but ultrasound is a useful tool when patients prove challenging. Presently, there is a lack of evidence‐based guidelines for technical skills acquisition, both with and without ultrasound, and likewise, competency assessment approaches vary globally. Accordingly, we aim to assess the current evidence regarding learning and assessment in neuraxial access ±$$ \pm $$ ultrasound, for future educational recommendations.This scoping review will be conducted in accordance with the Preferred Reporting Items for Systematic and Meta‐Analysis (PRISMA) statement, together with the PRISMA Extension for Scoping Reviews. A systematic search strategy will be based on a PICO approach, focusing on physicians, medical students, or nurses being exposed to education, training, or assessment in procedural neuraxial access ±$$ \pm $$ ultrasound. No comparators are obligated, but outcomes should be assessable using the Kirkpatrick four levels of training evaluation. The search will be performed in Cochrane Library, Embase, Medline, Scopus, PubMed, and CINAHL. Independently, two authors will screen the studies and conflicts will be resolved by a third author. Relevant predefined data will be extracted and analysed using a descriptive approach. The quality of the studies will be assessed using the Medical Education Research Study Quality Instrument.This scoping review will contribute by presenting gathered evidence of an overview of the different approaches to achieving education and training of technical skills in neuraxial access, and how skills are tested, which could guide research and future recommendations for skills development and assessment. [ABSTRACT FROM AUTHOR]

Background: As the opioid public health crisis evolves to include fentanyl and other potent synthetic opioids, more patients are admitted to the hospital with serious complications of drug use and frequently require higher levels of care, including intensive care unit (ICU) admission, for acute and chronic conditions related to opioid use disorder (OUD). This patient population poses a unique challenge when managing sedation and ensuring adequate ventilation while intubated given their high opioid requirements. Starting a patient on medications such as buprenorphine may be difficult for inpatient providers unfamiliar with its use, which may lead to undertreatment of patients with OUD, prolonged mechanical ventilation and length of stay. Methods: We developed a 7-day buprenorphine low dose overlap initiation (LDOI) schedule for patients with OUD admitted to the ICU (Table 1). Buprenorphine tablets were split by pharmacists and placed into pre-made blister packs as a kit to be loaded into the automated medication dispensing machine for nursing to administer daily. An internal quality review validated the appropriate dosing of split-dose tablets. To simplify order entry and increase prescriber comfort with this new protocol, we generated an order set within our electronic health record software with prebuilt buprenorphine titration orders. This protocol was implemented alongside patient and healthcare team education and counseling on the LDOI process, with follow-up offered to all patients upon discharge. Results: Here we report a series of 6 ICU patients started on buprenorphine using the LDOI schedule with split buprenorphine tablets. None of the 6 patients experienced precipitated withdrawal upon buprenorphine initiation using the LDOI schedule, and 5/6 patients were successfully extubated during the buprenorphine initiation. Four of six patients had a decrease in daily morphine milligram equivalents, with 3 patients transitioning to buprenorphine alone. Conclusion: Initiating buprenorphine via LDOI was found to be successful in the development of a protocol for critically ill patients with OUD. We examined LDOI of buprenorphine in intubated ICU patients and found no events of acute precipitated withdrawal. This protocol can be used as a guide for other institutions seeking to start critically ill patients on medication treatment for OUD during ICU admission. [ABSTRACT FROM AUTHOR]

An emergency action plan (EAP) is a written document detailing the preparations and on-site emergency response of health care professionals and other stakeholders to medical emergencies in the prehospital setting. The EAP is developed to address any type of catastrophic injury response and should not be condition specific. The objective of this National Athletic Trainers' Association position statement is to provide evidence-based and consensus-based recommendations for developing and implementing an EAP for sports settings. These recommendations were developed by a multidisciplinary expert panel that performed (1) a comprehensive review of existing EAP evidence, (2) a modified Delphi process to define consensus recommendations, and (3) a strength of recommendation taxonomy determination for each recommendation. An EAP is an essential tool designed to facilitate emergency preparedness and an efficient, coordinated emergency response during an athletic event. A comprehensive EAP should consider modes to optimize patient outcomes, the various stakeholders needed to develop the plan, the factors influencing effective implementation of the EAP, and the roles and responsibilities to ensure a structured response to a catastrophic injury. These evidence-informed recommendations outline the necessary steps for emergency planning and provide considerations for the immediate management of patients with catastrophic injuries. Increasing knowledge and implementation of the EAP to manage patients with catastrophic injuries improves the overall response and decreases errors during an emergency. [ABSTRACT FROM AUTHOR]

Students are increasingly relying on contract cheating (CC), a phenomenon in which a third party completes the assignment, quiz, or homework for students in exchange for a fee. Using an exploratory qualitative method and underpinned by critical theory and social responsibility theory, this study explored the perceptions of faculty members regarding CC in the United Arab Emirates' (UAE's) higher education institutions. In particular, this study addressed how faculty members perceive and deal with CC in contexts where policies towards the practice are absent from higher institution honour codes. Using thematic analysis, the results showed that CC arouses the indignation of faculty and staff to the violation of individual and religious rights. Also, they believe they have a sense of responsibility towards students and the community. The results also showed that faculty members' hesitation in reporting CC incidents was due to their perceived lack of support from higher administration institutions and the lack of clear procedures in ethical manuals. This paper concludes with practical recommendations for faculty and staff, managers, department heads and decision makers to mitigate this phenomenon proactively. [ABSTRACT FROM AUTHOR]

While there has been increased attention to the use of reverse total shoulder arthroplasty (RTSA) to treat rotator cuff intact glenohumeral osteoarthritis (RCIOA) for older age groups, there has not been as precise an assessment of the differences in utilization for female vs. male patients or in specific age groups. Our purpose was to determine if differences existed in the utilization of shoulder arthroplasty to treat RCIOA based on gender and age in North America. Anatomic total shoulder arthroplasty (ATSA) and RTSA cases were queried from the American Academy of Orthopaedic Surgeons Shoulder and Elbow Registry between January 2015 and December 2021. Cases were included if they had a diagnosis of RCIOA, defined by the International Classification of Diseases-10 codes M19.011, M19.012, and M19.019. Cases were stratified by procedure, age, gender, and year of surgery. Chi-square and Fisher's exact tests were calculated to assess the associations between procedure type and patient demographics. There were 2748 (48.06%) ATSA and 2970 (51.94%) RTSA procedures reported to the American Academy of Orthopaedic Surgeons Shoulder and Elbow Registry. There was a significant relationship between procedure type and age group (P <.001) in that ATSA was utilized more frequently than RTSA for patients ages <70 years old, and this relationship reversed for ages ≥ 70 years old. Female patients were more likely to receive RTSA (P <.001). When looking at the relationship between procedure type and gender by age group, both genders were more likely to receive ATSA compared to RTSA for age groups 50-59 and 60-69 (P =.0097 and P =.0005, respectively) but not for other age groups. For patients ≥ 70 years old, both females and males were more likely to receive RTSA, but this relationship did not reach statistical significance (P =.1094). For both genders and ages ≥ 70 years old, there was a significant relationship between year and procedure type (P <.0001) in that RTSA was more commonly utilized in 2017 and onward. When assessing patients with RCIOA, the use of ATSA and RTSA was similar, but for patients 50 to 69 years old, for both genders, the use of ATSA was greater. Although RTSA was more commonly used for both genders in the ≥ 70 years old population, this difference was not significant. Interestingly, for both genders, ages ≥ 70 years old, RTSA was significantly more utilized from 2017 onward. This analysis highlights the influence of age and gender in use of ATSA and RTSA. [ABSTRACT FROM AUTHOR]

In hospital settings, effective risk management is critical to ensuring patient safety, regulatory compliance, and operational effectiveness. Conventional approaches to risk assessment and mitigation frequently rely on manual procedures and retroactive analysis, which might not be sufficient to recognize and respond to new risks as they arise. This study examines how artificial intelligence (AI) technologies can improve risk management procedures in healthcare facilities, fortifying patient safety precautions and guidelines while improving the standard of care overall. Hospitals can proactively identify and mitigate risks, optimize resource allocation, and improve clinical outcomes by utilizing AI-driven predictive analytics, natural language processing, and machine learning algorithms. The different applications of AI in risk management are discussed in this paper, along with opportunities, problems, and suggestions for their effective use in hospital settings. [ABSTRACT FROM AUTHOR]

Objectives Workplace psychosocial risk factors, including low autonomy and high demands, have negative consequences for employee mental health and wellbeing. There is a need to support employees experiencing mental health and well-being problems in these jobs. This scoping review aims to describe group-level workplace interventions and their approaches to improving the mental health and well-being of employees in office-based, low autonomy, and high demands jobs. Methods Following PRISMA-ScR guidelines, a search was conducted across 4 databases (Medline, PsycINFO, CINAHL, ASSIA). We explored studies presenting group-level interventions, mode of implementation, facilitators and barriers, and intervention effectiveness. The search was restricted to include office-based, low autonomy, and high-demands jobs. Primary outcome of interest was mental health and secondary outcomes were work-related and other well-being outcomes. Results Group-level workplace interventions include an array of organizational, relational, and individual components. Almost all included a training session or workshop for intervention delivery. Several had manuals but theories of change were rare. Most workplace interventions did not use participatory approaches to involve employees in intervention development, implementation and evaluation, and challenges and facilitators were not commonly reported. Key facilitators were shorter intervention duration, flexible delivery modes, and formalized processes (e.g. manuals). A key barrier was the changeable nature of workplace environments. All studies employing behavioural interventions reported significant improvements in mental health outcomes, while no clear pattern of effectiveness was observed for other outcomes or types of interventions employed. Conclusions Group-based interventions in low-autonomy office settings can be effective but few studies used participatory approaches or conducted process evaluations limiting our knowledge of the determinants for successful group-based workplace interventions. Involving stakeholders in intervention development, implementation, and evaluation is recommended and can be beneficial for better articulation of the acceptability and barriers and facilitators for delivery and engagement. [ABSTRACT FROM AUTHOR]

Alexandra Farmer takes us through the implications of 'employees behaving badly' on social media, as well as the steps employers can take to implicate reasonable rules that respect an employees right to privacy and freedom of expression, whilst protecting the reputation of the business [ABSTRACT FROM AUTHOR]

Quantitative computed tomography (QCT)-based in silico models have demonstrated improved accuracy in predicting hip fractures with respect to the current gold standard, the areal bone mineral density. These models require that the femur bone is segmented as a first step. This task can be challenging, and in fact, it is often almost fully manual, which is time-consuming, operator-dependent, and hard to reproduce. This work proposes a semi-automated procedure for femur bone segmentation from CT images. The proposed procedure is based on the bone and joint enhancement filter and graph-cut algorithms. The semi-automated procedure performances were assessed on 10 subjects through comparison with the standard manual segmentation. Metrics based on the femur geometries and the risk of fracture assessed in silico resulting from the two segmentation procedures were considered. The average Hausdorff distance (0.03 ± 0.01 mm) and the difference union ratio (0.06 ± 0.02) metrics computed between the manual and semi-automated segmentations were significantly higher than those computed within the manual segmentations (0.01 ± 0.01 mm and 0.03 ± 0.02). Besides, a blind qualitative evaluation revealed that the semi-automated procedure was significantly superior (p < 0.001) to the manual one in terms of fidelity to the CT. As for the hip fracture risk assessed in silico starting from both segmentations, no significant difference emerged between the two (R2 = 0.99). The proposed semi-automated segmentation procedure overcomes the manual one, shortening the segmentation time and providing a better segmentation. The method could be employed within CT-based in silico methodologies and to segment large volumes of images to train and test fully automated and supervised segmentation methods. [ABSTRACT FROM AUTHOR]

Due to today's intense competition and rapid changes in the market, organizations must concentrate on their process management to improve their effectiveness to be able to respond quickly. Studies have shown that organizations are not necessarily even aware of the current primary function of technical management (TM) because their internal procedures are not currently modeled. This results in a lack of efficiency in terms of how businesses operate in organizations. This study aims to create internal procedure manuals for the technical support function of a case company and considers how to pinpoint areas for process improvement. Since TM is a part of the case company internally, it has not been able to update its internal procedure charts to reflect this, so cannot show its current roles in the surrounding organization. The methodology of this study is separated into two stages: modeling swim lane diagrams describing the existing state (as-is) of TM processes and then conducting semi-structured interviews with key stakeholders to ascertain their expectations and suggestions for change. Thematic analysis of the interview data and performing a comparison with the current procedure charts are used to determine whether or not TM's procedures can be strengthened to better assist the surrounding organization. The study concludes that further actions are needed to clarify the role of TM in ways other than in the sub-process task level in the procedure charts of the case company. In addition, TM could conduct further analysis to optimize the case company's business processes to achieve maximum benefit in the future. [ABSTRACT FROM AUTHOR]

Identifying and distinguishing risk factors for heterogeneous disease subtypes has been of great interest. However, missingness in disease subtypes is a common problem in those data analyses. Several methods have been proposed to deal with the missing data, including complete-case analysis, inverse-probability weighting, and multiple imputation. Although extant literature has compared these methods in missing problems, none has focused on the competing risk setting. In this paper, we discuss the assumptions required when complete-case analysis, inverse-probability weighting, and multiple imputation are used to deal with the missing failure subtype problem, focusing on how to implement these methods under various realistic scenarios in competing risk settings. Besides, we compare these three methods regarding their biases, efficiency, and robustness to model misspecifications using simulation studies. Our results show that complete-case analysis can be seriously biased when the missing completely at random assumption does not hold. Inverse-probability weighting and multiple imputation estimators are valid when we correctly specify the corresponding models for missingness and for imputation, and multiple imputation typically shows higher efficiency than inverse-probability weighting. However, in real-world studies, building imputation models for the missing subtypes can be more challenging than building missingness models. In that case, inverse-probability weighting could be preferred for its easy usage. We also propose two automated model selection procedures and demonstrate their usage in a study of the association between smoking and colorectal cancer subtypes in the Nurses' Health Study and Health Professional Follow-Up Study. [ABSTRACT FROM AUTHOR]

Background: Modern high-throughput technologies enable the processing of a large number of samples simultaneously, while also providing rapid and accurate procedures. In recent years, automated liquid handling workstations have emerged as an established technology for reproducible sample preparation. They offer flexibility, making them suitable for an expanding range of applications. Commonly, such approaches are well-developed for experimental procedures primarily designed for cell-line processing and xenobiotics testing. Conversely, little attention is focused on the application of automated liquid handlers in the analysis of whole organisms, which often involves time-consuming laboratory procedures. Results: Here, we present a fully automated workflow for all steps, from RNA extraction to real-time PCR processing, for gene expression quantification in the ascidian marine model Ciona robusta. For procedure validation, we compared the results obtained with the liquid handler with those of the classical manual procedure. The outcome revealed comparable results, demonstrating a remarkable time saving particularly in the initial steps of sample processing. Conclusions: This work expands the possible application fields of this technology to whole-body organisms, mitigating issues that can arise from manual procedures. By minimizing errors, avoiding cross-contamination, decreasing hands-on time and streamlining the procedure, it could be employed for large-scale screening investigations. [ABSTRACT FROM AUTHOR]

Head-mounted displays (HMDs) are hands-free devices particularly useful for guiding near-field tasks such as manual surgical procedures. See-through HMDs do not significantly alter the user's direct view of the world, but the optical merging of real and virtual information can hinder their coherent and simultaneous perception. In particular, the coherence between the real and virtual content is affected by a viewpoint parallax-related misalignment, which is due to the inaccessibility of the user-perceived reality through the semi-transparent optical combiner of the OST Optical See-Through (OST) display. Recent works demonstrated that a proper selection of the collimation optics of the HMD significantly mitigates the parallax-related registration error without the need for any eye-tracking cameras and/or for any error-prone alignment-based display calibration procedures. These solutions are either based on HMDs that projects the virtual imaging plane directly at arm's distance, or they require the integration on the HMD of additional lenses to optically move the image of the observed scene to the virtual projection plane of the HMD. This paper describes and evaluates the pros and cons of both the suggested solutions by providing an analytical estimation of the residual registration error achieved with both solutions and discussing the perceptual issues generated by the simultaneous focalization of real and virtual information. [ABSTRACT FROM AUTHOR]

Objective: To determine how many times Ipas manual vacuum aspiration (MVA) instruments are reused, for what reasons, when the instruments are replaced and/or discarded, and what the barriers are to replacing them. Methods: We conducted a mixed‐methods cross‐sectional study of health care providers who provide MVA services and key stakeholders in the supply chain to understand reuse and replacement of Ipas MVA aspirators and cannulae. Qualitative interviews focused on procurement and replacement of Ipas MVA instruments. Results: The authors interviewed 352 health care providers from nine countries from 2019 to 2021. Providers reported reusing MVA instruments an average of 34.4 times (standard deviation, 45). The reuse averages ranged from one time (Democratic Republic of the Congo) to 500 times (India), with figures varying between providers within the same country. Instrument malfunctioning rather than a specific number of uses drove reuse and subsequent replacement. The decision to replace was most commonly made by the provider during use. Half of the providers said that they knew of no issues with the supply chain, and 85% said they were always able to replace Ipas MVA instruments when needed. Conclusion: Tracking reuse of MVA instruments was uncommon at participating providers' health facilities. Providers' estimates revealed great variability in reuse frequency and tracking procedures. Synopsis: Tracking reuse of manual vacuum aspiration instruments was uncommon at participating providers' health facilities. Providers' estimates revealed great variability in reuse frequency and tracking procedures. [ABSTRACT FROM AUTHOR]

Written health and safety policies mitigate catastrophic outcomes resulting from sport injuries. The purpose of this project was to evaluate athletic trainers' proficiency in evaluating catastrophic policies and procedures alignment with best practices. This study found athletic trainers were not able to identify the majority of policy and procedure components based on evidence-based best practice documents. Furthermore, athletic trainers tended to focus more on aesthetics and feasibility versus alignment with current best practices. Results support the need to enhance education specific to policy and procedure development, evaluation, and implementation in order to improve proficiency of clinicians. [ABSTRACT FROM AUTHOR]

Domestic chimney cleaning is still mostly a manual procedure which can be overly complex, dangerous, and expansive. This paper describes the design of a novel robotic device for chimney cleaning that aims to provide a valuable alternative solution to the traditional manual techniques with user-friendly and low-cost features. The proposed device enables a significant reduction in operator risks, including roof falling and soot dust contact. The paper's content describes, in detail, the design process, including a definition of the main design requirements and steps towards the manufacturing of a preliminary prototype. Moreover, a preliminary validation is described through laboratory tests to demonstrate the engineering feasibility and effectiveness of the proposed design solution for the intended semi-autonomous chimney-cleaning application. [ABSTRACT FROM AUTHOR]

Aim. This study aimed to (a) examine the relationship between staff nurses' perceptions of patient safety rules and procedures and their patient safety performance and (b) investigate potential mediators of this relationship. Background. Implementation of effective management interventions to improve patient safety requires knowledge of the extent to which nurses' perceptions of a hospital's rules and procedures regarding patient safety affect their patient safety performance. Methods. This correlational study involved a secondary analysis of cross-sectional survey data collected from 1,053 staff nurses in South Korea. Structural equation modeling was employed to test the proposed mediation model. Five standardized measures were used to assess key study variables: patient safety compliance, patient safety participation, nurses' perceptions of patient safety rules and procedures, communication about errors, and coworker support. Cronbach's alpha values for the scales ranged from 0.82 to 0.90. Results. Nurses' perceptions regarding the usefulness and effectiveness of rules and procedures about patient safety were positively related to their patient safety performance, measured in terms of safety compliance and participation behaviors. Communication about errors and coworker support showed significant mediating effects on these relationships. Conclusions. The findings indicate that the implementation of effective and useful rules and procedures for improving patient safety would facilitate error communication and coworker support, enhancing nurses' patient safety performance. Implications for Nursing Management. Hospital administrators and nurse managers should consider how they can foster conditions in which nurses perceive rules and procedures regarding patient safety as useful and effective. [ABSTRACT FROM AUTHOR]

• The strength-duration parameters derived by the threshold tracking method and by the manual procedure were strongly correlated. • The median values of the strength-duration parameters obtained by the two techniques were not significantly different. • There was no systematic bias of the manual procedure compared to the threshold tracking reference method. To compare the strength-duration time constant (SDTC) and rheobase measurements obtained by the threshold tracking method (TT) and by a non-automated method (MM). The MM procedure involved measuring, using a routine electrodiagnostic device, the intensity required to evoke a motor response whose amplitude corresponds to 40% of the maximum amplitude for four stimulus duration (1.0, 0.7, 0.5, 0.2 ms), and studying the linear relationship between stimulus charge and stimulus duration (slope = rheobase, intercept on the x-axis = SDTC). Using TT and MM, 30 successive healthy subjects (mean age = 38 years old) underwent a prospective evaluation of SDTC and rheobase of the median nerve motor axons at the wrist. Nerve stimulation and bipolar recording of evoked motor responses were performed with disposable self-adhesive surface electrodes. The Spearman correlations between the two methods were 0.78 (p < 0.0001) for SDTC and 0.96 (p < 0.0001) for the rheobase. The Bland-Altman analysis did not reveal any systematic bias of MM compared to TT. The MM procedure was reliable for strength-duration relationship analysis. We encourage neurophysiologists, who do not have dedicated threshold tracking equipment, not to hesitate to use these simple tools to assess peripheral nerve excitability. [ABSTRACT FROM AUTHOR]

Aims: To evaluate statewide policies restricting e‐cigarette nicotine strength. Design: A difference‐in‐difference regression analysis was used to compare e‐cigarette sales in states that restrict nicotine strength with states with no restrictions. Because flavor restrictions might affect sales and nicotine strength, states with flavor restrictions were also assessed. Setting and cases: United States e‐cigarette retail sales data during January 2017 to March 2022 were licensed from Information Resources Incorporated. States with restrictions included Massachusetts (restricted maximum nicotine strength to 3.5% and nontobacco flavored e‐cigarette sales in December 2019); Utah (restricted nicotine strength to 3.6% in September 2021); and Rhode Island, New York and Washington (restricted nontobacco flavor sales in October 2019, May 2020 and October 2019 to January 2020, respectively). These were compared with data from 34 states with no e‐cigarette nicotine strength or flavor restrictions. Measurements Weighted mean nicotine strength and total unit sales. Total unit sales per 1000 state population were summed into 4‐week periods by state. Models controlled for emergency responses, state demographics, tobacco control policies, time and state fixed effects. Findings Restricting both nicotine strength and flavors in Massachusetts was associated with a 2.04 percentage point (pp) reduction in mean nicotine strength and 86.76‐unit reduction in monthly unit sales per 1000 persons compared with states with no restrictions (all P < 0.01). Restricting nicotine strength only in Utah was associated with a 1.77 pp (P < 0.01) reduction in mean nicotine strength; however, there was no impact on unit sales. Restricting nontobacco flavor sales only in Rhode Island, New York and Washington slightly reduced mean nicotine strength (0.21, 0.62 and 0.19 pp, respectively) and sales (36.66, 34.51 and 16.37 units, respectively) (all P < 0.01). Conclusions: United States statewide policies restricting e‐cigarette nicotine strength appear to be associated with reductions in average nicotine strength in sales within that state; however, there appears to be no impact on unit sales. When these policies are implemented along with flavor restrictions; reductions in average nicotine strength occur in addition to reduced unit sales. [ABSTRACT FROM AUTHOR]

This paper describes a practice-based methodology applied to roundness and cylindricity concepts. Traditionally, technicians encounter difficulties in understanding this topic, especially when they analyze the tolerances involved due to the complexity of their graphic interpretation. Additionally, it is mandatory for industrial engineers to acquire competencies that allow them to validate form and make decisions in this field. With the goal of enhancing the handling of measurement techniques involved in this topic and analyzing the results obtained, a methodology has been designed to address the roundness and cylindricity tolerance evaluation from different perspectives. Firstly, based on a conceptual analysis, an analytical procedure is introduced. Secondly, an engaging manual practice is implemented by using simple measuring instruments that allow the user to be involved in the development of the procedure applied. The conditions that tried to optimize the manual procedure to get good results were analyzed. Moreover, the results obtained under this perspective allow us to ensure that better skills can be acquired regarding the typical method based on the coordinate measuring machines. This experience has been validated based on the practice with ongoing users under a training period. [ABSTRACT FROM AUTHOR]

Purpose: To develop a robust parallel imaging reconstruction method using spatial nulling maps (SNMs). Methods: Parallel reconstruction using null operations (PRUNO) is a k‐space reconstruction method where a k‐space nulling system is derived using null‐subspace bases of the calibration matrix. ESPIRiT reconstruction extends the PRUNO subspace concept by exploiting the linear relationship between signal‐subspace bases and spatial coil sensitivity characteristics, yielding a hybrid‐domain approach. Yet it requires empirical eigenvalue thresholding to mask the coil sensitivity information and is sensitive to signal‐ and null‐subspace division. In this study, we combine the concepts of null‐subspace PRUNO and hybrid‐domain ESPIRiT to provide a more robust reconstruction method that extracts null‐subspace bases of calibration matrix to calculate image‐domain SNMs. Multi‐channel images are reconstructed by solving an image‐domain nulling system formed by SNMs that contain both coil sensitivity and finite image support information, therefore, circumventing the masking‐related procedure. The proposed method was evaluated with multi‐channel 2D brain and knee data and compared to ESPIRiT. Results: The proposed hybrid‐domain method produced quality reconstruction highly comparable to ESPIRiT with optimal manual masking. It involved no masking‐related manual procedure and was tolerant of the actual division of null‐ and signal‐subspace. Spatial regularization could be also readily incorporated to reduce noise amplification as in ESPIRiT. Conclusion: We provide an efficient hybrid‐domain reconstruction method using multi‐channel SNMs that are calculated from coil calibration data. It eliminates the need for coil sensitivity masking and is relatively insensitive to subspace separation, therefore, presenting a robust parallel imaging reconstruction procedure in practice. [ABSTRACT FROM AUTHOR]

Objective : Today, the development mode of public hospitals in China is turning from expansion to efficiency, and the management mode is turning from extensive to refined. This study aims to evaluate the efficiency of clinical departments in a Chinese class A tertiary public hospital (Hospital M) to analyze the allocation of hospital resources among these departments providing a reference for the hospital management. Methods : The hospitalization data of inpatients from 32 clinical departments of Hospital M in 2021 are extracted from the hospital information system (HIS), and a dataset containing 38,147 inpatients is got using stratified sampling. Considering the non-homogeneity of clinical departments, the 38,147 patients are clustered using the K-means algorithm based on workload-related data labels including inpatient days, intensive care workload index, nursing workload index, and operation workload index, so that the medical resource consumption of inpatients from non-homogeneous clinical departments can be transformed into the homogeneous workload of medical staff. Taking the numbers of doctors, nurses, and beds as input indicators, and the numbers of inpatients assigned to certain clusters as output indicators, an input-oriented BCC model is built named the workload-based DEA model. Meanwhile, a control DEA model with the number of inpatients and medical revenue as output indicators is built, and the outputs of the two models are compared and analyzed. Results: Clustering of 38,147 patients into 3 categories is of better interpretability. 14 departments reach DEA efficient in the workload-based DEA model, 10 reach DEA efficient in the control DEA model, and 8 reach DEA efficient in both models. The workload-based DEA model gives a relatively rational judge on the increase of income brought by scale expansion, and evaluates some special departments like Critical Care Medicine Dept., Geriatrics Dept. and Rehabilitation Medicine Dept. more properly, which better adapts to the functional orientation of public hospitals in China. Conclusion: The design of evaluating the efficiency of non-homogeneous clinical departments with the workload as output proposed in this study is feasible, and provides a new idea to quantify professional medical human resources, which is of practical significance for public hospitals to optimize the layout of resources, to provide real-time guidance on manpower grouping strategies, and to estimate the expected output reasonably. [ABSTRACT FROM AUTHOR]

Breast cancer can be successfully treated if diagnosed at its earliest, though it is considered as a fatal disease among women. The histopathology slide turned images are the gold standard for tumor diagnosis. However, the manual diagnosis is still tedious due to its structural complexity. With the advent of computer-aided diagnosis, time and computation intensive manual procedure can be managed with the development of an automated classification system. The feature extraction and classification are quite challenging as these images involve complex structures and overlapping nuclei. A novel nuclei-based patch extraction method is proposed for the extraction of non-overlapping nuclei patches obtained from the breast tumor dataset. An ensemble of pre-trained models is used to extract the discriminating features from the identified and augmented non-overlapping nuclei patches. The discriminative features are further fused using p-norm pooling technique and are classified using a LightGBM classifier with 10-fold cross-validation. The obtained results showed an increase in the overall performance in terms of accuracy, sensitivity, specificity, and precision. The proposed framework yielded an accuracy of 98.3% for binary class classification and 95.1% for multi-class classification on ICIAR 2018 dataset. [ABSTRACT FROM AUTHOR]

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Objective: Disasters adversely affect the mental health of disaster survivors, leading to depression, anxiety, and stress-related disorders. Survivors complain of not only psychological symptoms but also physical symptoms such as insomnia, pain, and fatigue. Providing immediate and effective psychological support to all survivors is difficult because human and physical medical resources are limited. Therefore, the authors developed a manual for disaster medical support using Korean medicine (KM) for disaster survivors to provide prompt, effective, and long-term support that supplement existing psychological support. Methods: In this article, the authors introduce KM treatment protocols, which are unique elements of the manual. In addition, the authors have developed a step-by-step treatment protocol based on the stage and condition of survivors, as well as separate treatment protocols for psychological and physical symptoms. Results: The interventions include ear acupuncture, acupuncture, herbal medicine, breathing relaxation, stabilization techniques, emotional freedom technique, and self-care methods such as acupressure, exercise, and walking meditation. This manual has been certified as an official procedure of the Korean Society of Oriental Neuropsychiatry. Conclusions: The authors believe that this manual will enable KM doctors to be effectively utilized as medical resources at disaster sites. Furthermore, this manual would provide a good model that can be extended to countries that wish to use integrative medicine for disaster support to implement the commitments of the Declaration of Astana. [ABSTRACT FROM AUTHOR]

Investigating realistic visual exploration is quite challenging in sport climbing, but it promises a deeper understanding of how performers adjust their perception-action couplings during task completion. However, the samples of participants and the number of trials analyzed in such experiments are often reduced to a minimum because of the time-consuming treatments of the eye-tracking data. Notably, mapping successive points of gaze from local views to the global scene is generally performed manually by watching eye-tracking video data frame by frame. This manual procedure is not suitable for processing a large number of datasets. Consequently, this study developed an automatic method for solving this global point of gaze localization in indoor sport climbing. Particularly, an eye-tracking device was used for acquiring local image frames and points of gaze from a climber's local views. Artificial landmarks, designed as four-color-disk groups, were distributed on the wall to facilitate localization. Global points of gaze were computed based on planar homography transforms between the local and global positions of the detected landmarks. Thirty climbing trials were recorded and processed by the proposed methods. The success rates (Mean ± SD) were up to 85.72% ± 13.90%, and the errors (Mean ± SD) were up to 0. 1 3 0 2 ± 0. 2 0 5 1 m. The proposed method will be employed for computing global points of gaze in our current climbing dataset for understanding the dynamics intertwining of gaze and motor behaviors during the climbs. [ABSTRACT FROM AUTHOR]

The disinfection procedures aim to reduce the microbial load, but there are doubts about the risks of contamination spreading into the lumens of devices, such as three-way stopcocks (3-WS). This study aimed at an in vitro evaluation of the antibacterial procedure of manual friction of 3-WS intentionally contaminated and to determine the solution dispersion into the lumens. Laboratory experiments were developed in two steps: evaluation of bacterial spread through intentional contamination with Staphylococcus aureus and Pseudomonas aeruginosa, and alcohol dispersion into the 3-WS lumens. After manual friction of the 3-WS with saline solution at 0.85% (w/v) [control group], S. aureus and P. aeruginosa were isolated in the lumens of 55.6% and 27.8% of the devices, respectively. However, after the disinfection of the 3-WS with ethyl alcohol at 70% (w/v), there was no bacterial contamination in the lumens of the 3-WS. On the other hand, the solution dispersion (dye) into the lumens was evidenced by two different techniques: Durham tubes (5.6%) and swabs (46.3%). The manual friction of the 3-WS with ethyl alcohol at 70% demonstrated antibacterial efficacy, but it refers to reflections on the risk of solution diffusion into the venous network and the inherent clinical practice situations and patient safety. [ABSTRACT FROM AUTHOR]

This study aimed to compare the efficacy of robot-assisted and manual cannula insertion in simulated big-bubble deep anterior lamellar keratoplasty (DALK). Novice surgeons with no prior experience in performing DALK were trained to perform the procedure using manual or robot-assisted techniques. The results showed that both methods could generate an airtight tunnel in the porcine cornea, and result in successful generation of a deep stromal demarcation plane representing sufficient depth reached for big-bubble generation in most cases. However, the combination of intraoperative OCT and robotic assistance received a significant increase in the depth of achieved detachment in non-perforated cases, comprising a mean of 89% as opposed to 85% of the cornea in manual trials. This research suggests that robot-assisted DALK may offer certain advantages over manual techniques, particularly when used in conjunction with intraoperative OCT. [ABSTRACT FROM AUTHOR]

Epilepsy is a neurological disorder distinguished by sudden and unexpected seizures. To diagnose epilepsy, clinicians register the signals of brain electric activity (electroencephalograms, EEG) and extract segments with seizures. It enables characterizing their type and finding an onset zone, a brain area where they originate. This procedure requires manual EEG deciphering, which is slow and necessitates the assistance of machine learning (ML) algorithms. Traditionally, ML handles this issue in a supervised fashion, i.e., after the training on the representative data, it constructs a boundary in the feature space that separates classes. As the number of features grows, this boundary becomes complex and less generalized. The feature space of brain data is high dimensional. The standard recording includes 30 signals and 50 frequencies resulting in 1500 features. Using additional time-domain features may further enlarge the feature space. Thus, selecting appropriate features is a big part of the successful classification. The selection procedure relies on either a data-based mathematical approach (e.g., principal components, PCs) or the expert domain knowledge of data (explainable features, EFs). Here, we demonstrate the benefits of using EFs. For the EEG data of 30 epileptic patients, we trained a RandomForest algorithm using PCs and EFs. The feature importance analysis revealed that explainable features outperform principal components. [ABSTRACT FROM AUTHOR]

• Mental health professionals' perspectives are important to intervention design. • The technology acceptance model can facilitate understanding of user perspectives. • Ease of use and utility are two features that can be used to evaluate interventions. • Professionals have helpful feedback on design features of a novel engagement system. User experiences are essential to the adoption of an intervention and can be integral to intervention design. We applied two concepts from the technology acceptance model (i.e., perceived ease of use, perceived utility) to understand how mental health professionals experienced a novel system of resources (i.e., engagement system) designed to improve problem identification, coordination, and treatment planning decisions related to addressing problems of low treatment engagement in school mental health services. We conducted a 1-hour focus group with 10 mental health professionals (provider n = 8, supervisor n = 2) using prompts to elicit their perspectives about the effort involved in using the engagement system and about the usefulness of the system in their work. The focus group was transcribed and segmented into 70 excerpts by trained coders. We analyzed the transcript using a consensual qualitative research approach. Ease of use was coded in 15 (39%) excerpts and utility was coded in 24 (61%) excerpts. The valences of excerpts were neutral (n = 18; 46%), positive (n = 10; 26%), and negative (n = 11; 28%). Thirty-nine (56%) excerpts discussed the engagement system. Excerpts pertained to problem identification (n = 18; 46%), coordination (n = 18; 46%), and treatment planning (n = 3; 8%). Findings revealed that resources and procedures were rated differently on their perceived ease of use and utility. Participants reported that the coordination resource had high utility and positively impacted their clinical practice and supervision, while the problem identification resources had low ease of use and were burdensome or difficult to use. Some lessons learned include the value of designing resources that provide structure to clinical decision processes yet allow for some flexibility, the need for simpler and automated procedures to reduce provider burden, and the importance of clear guidelines on how resources should and should not be used. We used this feedback to inform changes to the engagement system prior to testing in a randomized trial. This brief report highlights how applying the technology acceptance model to evaluate interventions can aid in the successful implementation of novel clinical interventions. [ABSTRACT FROM AUTHOR]

In many coastal areas around the world, the seagrasses provide an essential source of livelihood for many civilizations and support high levels of biodiversity. Seagrasses are highly valuable, as they provide habitat for numerous fish, endangered sea cows, Dugong dugon, and sea turtles. The health of seagrasses is being threatened by many human activities. The process of seagrass conservation requires the annotation of every seagrass species within the seagrass family. The manual annotation procedure is time-consuming and lacks objectivity and uniformity. Automatic annotation based on lightweight DeepSeagrass (LWDS) is proposed to solve this problem. LWDS computes combinations of various resized input images and various neural network structures, to determine the ideal reduced image size and neural network structure with satisfactory accuracy and within a reasonable computation time. The main advantage of this LWDS is it classifies the seagrasses quickly and with lesser parameters. The DeepSeagrass dataset is used to test LWDS's applicability. [ABSTRACT FROM AUTHOR]

Brain tumor segmentation is an important step in the diagnosis and treatment planning of cancer patients. The procedure of manual bl'ain tumor segmentation suffers from a long processing time. In this light, automatic brain tumor segmentation is highly appealing in the clinical routine. This study sets out to segment the tumors from brain MR images and to investigate the effectiveness/usefulness of the different MRI sequences foi' this purpose. Here, the MR images from the BRATS challenge were utilized. 310 patients with four different MRI sequences, including Tl, Tice, T2, and FLAIR were employed to train a ResNet deep CNN. Four separate models were trained with each of the input MR sequences to identify the best sequence for brain tumor segmentation. To assess the performance of these models, 60 patients (external dataset) were quantitatively evaluated. The quantitative results indicated that the FLAIR sequence is more reliable for automatic brain tumor segmentation than other sequences with an accuracy of 0.770.0 in terms of Dice compared to Dice indices of 0.730.12, 0.730.15, and 0.620.17 obtained from Tl, T2, and Tice sequences, respectively. Based on the results of this study, FLAIR is a more reliable sequence than other sequences for brain tumor segmentation. [ABSTRACT FROM AUTHOR]

Universitas Jambi Library (UNJA Library), through its website, should be able to provide information on how to access its E-resources. By fulfilling the guidance information, it is hoped that it will be able to provide industry-based services 4.0, one way is to make a video manual on procedures for using the UNJA library website's E-resources. This was made with the aim that information access activities for all users can be distributed properly and run effectively and efficiently. Many users do not understand how to use the Jambi University library's e-resources. Because this will definitely affect the use of library e-resources, the researcher here developed a video-based web-based E-Resources Usage Procedure Manual for the use of digital libraries at the Jambi University library. The subjects in this study were Jambi University users. This development research procedure refers to the Trollip & Alessi model. To assess the product being developed, a validation test was applied by media experts, material experts, user response questionnaires and to see an increase in knowledge in the use of Jambi University library e-resources. [ABSTRACT FROM AUTHOR]

Copyright of Opuntia Brava is the property of Universidad de Ciencias Pedagogicas de Las Tunas, Centro de Documentacion e Informacion Pedagogica and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

In manufacturing companies, manual material handling (MMH) involves lifting, pushing, pulling, carrying, moving, and lowering objects, which can lead to musculoskeletal disorders (MSDs) among workers, resulting in high labor costs due to excessive overtime incurred for manual product preparation. The aim of this study was to show how ergonomic measures were used to reduce the risk of MSDs and to reduce operating costs in the warehouse department of an oil and gas service company. A preliminary study using the Nordic Body Map survey showed that the workers experienced pain in various parts of the body, indicating the presence of MSDs. The researchers then used methods such as the Rapid Upper Limb Assessment (RULA), Rapid Entire Body Assessment (REBA), and National Institute for Occupational Safety and Health (NIOSH) assessments to verify whether the MMH activities had an acceptable level of risk. The results revealed that certain manual material handling (MMH) activities were assessed as low–very high risk, with RULA scores ranging from 3 to 7 and REBA scores ranging from 4 to 11. An immediate solution was to replace the manual process with a semi-automatic process using a vacuum lifter. A feasibility study was conducted using the net present value (NPV), internal rate of return (IRR), and payback period to justify the economic viability of the solution. The analysis indicated that implementing the vacuum lifter not only mitigated the risk of MSDs but also reduced the operating costs, demonstrating its viability and profitability. Overall, this study suggests that implementing a vacuum lifter as an assistive device in the warehouse would be a beneficial investment for both the workers and the company, improving both well-being and finances. [ABSTRACT FROM AUTHOR]

A soft sensor concept is typically developed and calibrated for individual bioprocesses in a time-consuming manual procedure. Following that, the prediction performance of these soft sensors degrades over time, due to changes in raw materials, biological variability, and modified process strategies. Through automatic adaptation and recalibration, adaptive soft sensor concepts have the potential to generalize soft sensor principles and make them applicable across bioprocesses. In this study, a new generalized adaptation algorithm for soft sensors is developed to provide phase-dependent recalibration of soft sensors based on multiway principal component analysis, a similarity analysis, and robust, generalist phase detection in multiphase bioprocesses. This generalist soft sensor concept was evaluated in two multiphase bioprocesses with various target values, media, and microorganisms. Consequently, the soft sensor concept was tested for biomass prediction in a Pichia pastoris process, and biomass and protein prediction in a Bacillus subtilis process, where the process characteristics (cultivation media and cultivation strategy) were varied. High prediction performance was demonstrated for P. pastoris processes (relative error = 6.9%) as well as B. subtilis processes in two different media during batch and fed-batch phases (relative errors in optimized high-performance medium: biomass prediction = 12.2%, protein prediction = 7.2%; relative errors in standard medium: biomass prediction = 12.8%, protein prediction = 8.8%). [ABSTRACT FROM AUTHOR]

Production forecasting using numerical simulation has become a standard in the oil and gas industry. The model construction process requires an explicit definition of multiple uncertain parameters; thus, the outcome of the modelling is also uncertain. For the reservoirs with production data, the uncertainty can be reduced by history-matching. However, the manual matching procedure is time-consuming and usually generates one deterministic realization. Due to the ill-posed nature of the calibration process, the uncertainty cannot be captured sufficiently with only one simulation model. In this paper, the uncertainty quantification process carried out for a gas-condensate reservoir is described. The ensemble-based uncertainty approach was used with the ES-MDA algorithm, conditioning the models to the observed data. Along with the results, the author described the solutions proposed to improve the algorithm's efficiency and to analyze the factors controlling modelling uncertainty. As a part of the calibration process, various geological hypotheses regarding the presence of an active aquifer were verified, leading to important observations about the drive mechanism of the analyzed reservoir. [ABSTRACT FROM AUTHOR]

The article offers information about the policy standardization across a various hospital health system. It mentions the requirement of improved policies and procedures which define standardized expectations, meet regulatory requirements, improve safety, operational practices and lead to consistent quality care.

Currently, worldwide industries and communities are concerned with building, expanding, and exploring the assets and resources found in the oceans and seas. More precisely, to analyze a stock, archaeology, and surveillance, several cameras are installed underseas to collect videos. However, on the other hand, these large size videos require a lot of time and memory for their processing to extract relevant information. Hence, to automate this manual procedure of video assessment, an accurate and efficient automated system is a greater necessity. From this perspective, we intend to present a complete framework solution for the task of video summarization and object detection in underwater videos. We employed a perceived motion energy (PME) method to first extract the keyframes followed by an object detection model approach namely YoloV3 to perform object detection in underwater videos. The issues of blurriness and low contrast in underwater images are also taken into account in the presented approach by applying the image enhancement method. Furthermore, the suggested framework of underwater video summarization and object detection has been evaluated on a publicly available brackish dataset. It is observed that the proposed framework shows good performance and hence ultimately assists several marine researchers or scientists related to the field of underwater archaeology, stock assessment, and surveillance. [ABSTRACT FROM AUTHOR]

The language used to describe study participants in the medical literature is of paramount importance. The objective is to use the terms that people use to describe themselves while also being sensitive and consistent, supporting diversity, and conveying respect. It is also important to medical editors that a style guide reflects their responsibilities and need for clear guidance. To this end, the AMA Manual of Style committee reassessed our guidance on race and ethnicity soon after its release in February 2020 because we realized that our guidance already needed to be updated. We started with some small steps, like deciding to capitalize all racial and ethnic categories including Black and White, and then ended up dismantling the entire section in our quest to develop more robust, comprehensive, and thoughtful guidance. After almost a year of research, updates, external review, and further revision, we published our efforts to garner public feedback, which was successful and led to further revision and review. When we were con- fident that our guidance met our objectives, we published our revision in August 2021. Our updates include definitions of commonly used terms associated with race and ethnicity, concerns and controversies in health care and research, racial and ethnic collective term usage, alphabetization of racial and ethnic categories, and geographic origin and regionalization considerations, and we provide examples to help guide authors and editors. Our current guidance is more reflective and complete, and we plan to make further revisions as the language and culture evolve. [ABSTRACT FROM AUTHOR]

Copyright of Tesla Revista Científica is the property of Puerto Madero Editorial Academica and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Analysis of karst spring recession hydrographs is essential for determining hydraulic parameters, geometric characteristics, and transfer mechanisms that describe the dynamic nature of karst aquifer systems. The extraction and separation of different fast- and slow-flow components constituting a karst spring recession hydrograph typically involve manual and subjective procedures. This subjectivity introduces a bias that exists, while manual procedures can introduce errors into the derived parameters representing the system. To provide an alternative recession extraction procedure that is automated, fully objective, and easy to apply, we modified traditional streamflow extraction methods to identify components relevant for karst spring recession analysis. Mangin's karst-specific recession analysis model was fitted to individual extracted recession segments to determine matrix and conduit recession parameters. We introduced different parameter optimization approaches into Mangin's model to increase the degree of freedom, thereby allowing for more parameter interaction. The modified recession extraction and parameter optimization approaches were tested on three karst springs under different climate conditions. Our results showed that the modified extraction methods are capable of distinguishing different recession components and derived parameters that reasonably represent the analyzed karst systems. We recorded an average Kling–Gupta efficiency KGE > 0.85 among all recession events simulated by the recession parameters derived from all combinations of recession extraction methods and parameter optimization approaches. While there are variabilities among parameters estimated by different combinations of extraction methods, optimization approaches, and seasons, we found much higher variability among individual recession events. We provided suggestions to reduce the uncertainty among individual recession events and raised questions about how to improve confidence in the system's attributes derived from recession parameters. [ABSTRACT FROM AUTHOR]

Musculoskeletal models (MSKMs) are used to estimate the muscle and joint forces involved in human locomotion, often associated with the onset of degenerative musculoskeletal pathologies (e.g., osteoarthritis). Subject-specific MSKMs offer more accurate predictions than their scaled-generic counterparts. This accuracy is achieved through time-consuming personalisation of models and manual tuning procedures that suffer from potential repeatability errors, hence limiting the wider application of this modelling approach. In this work we have developed a methodology relying on Sobol's sensitivity analysis (SSA) for ranking muscles based on their importance to the determination of the joint contact forces (JCFs) in a cohort of older women. The thousands of data points required for SSA are generated using Gaussian Process emulators, a Bayesian technique to infer the input–output relationship between nonlinear models from a limited number of observations. Results show that there is a pool of muscles whose personalisation has little effects on the predictions of JCFs, allowing for a reduced but still accurate representation of the musculoskeletal system within shorter timeframes. Furthermore, joint forces in subject-specific and generic models are influenced by different sets of muscles, suggesting the existence of a model-specific component to the sensitivity analysis. [ABSTRACT FROM AUTHOR]

During the last two decades, the Etna volcano has undergone several sequences of lava fountaining (LF) events that have had a major impact on road conditions, infrastructure and the local population. In this paper, we consider the LF episodes occurring between 2011 and 2022, calculating their erupted volumes using the images recorded by the monitoring thermal cameras and applying a manual procedure and a dedicated software to determine the lava fountain height over time, which is necessary to obtain the erupted volume. The comparison between the results indicates the two procedures match quite well, the main differences occurring when the visibility is poor and data are interpolated. With the aim of providing insights for hazard assessment, we have fitted some probabilistic models of both the LF inter-event times and the erupted volumes of pyroclastic material. In more detail, we have tested power-law distributions against log-normal, Weibull, generalised Pareto and log-logistic. Results show that the power-law distribution is the most likely among the alternatives. This implies the lack of characteristic scales for both the inter-event time and the pyroclastic volume, which means that we have no indication as to when a new episode of LF will occur and/or how much material will be erupted. What we can reasonably say is only that short inter-event times are more frequent than long inter-event times, and that LF characterised by small volumes are more frequent than LF with high volumes. However, if the hypothesis that magma accumulates on Etna at a rate of about 0.8 m 3 s − 1   holds, the material accumulated in the source region from the beginning of the observation period (2011) to the present (2022) has already been ejected. In simple terms, there is no accumulated magma in the shallow storage that is prone to be erupted in the near future. [ABSTRACT FROM AUTHOR]

Oncology nurses are stakeholders in the global fight against childhood cancer. In low-to middle-income countries, the burden of care on nursing staff is high, and nurses face several unique challenges. To optimize pediatric oncology care, Indus Hospital and Health Network partnered with six public-sector pediatric oncology units across Pakistan to encourage the implementation of baseline nursing standards as developed by the International Society of Paediatric Oncology Nursing Network. [ABSTRACT FROM AUTHOR]

Background COVID-19 is a major public health problem. In mid-2020, due to the health system challenges from increased COVID-19 cases, the Ministry of Health and Social Action in Senegal opted for contact management and care of simple cases at home. The objective of the study was to determine the acceptability of contact and simple case management of COVID-19 at home and its associated factors in Senegal. Methods This was a descriptive and analytical cross-sectional study. We collected data from 11 June to 10 July 2020. We used a marginal quota sampling strategy. A total of 813 individuals took part in the survey. We collected data using a telephone interview. Results The care of simple cases of COVID-19 at home was well accepted (78.5%). The use of home contact management was less accepted (51.4%). Knowledge of the modes of transmission of the virus and confidence in institutional information were associated with the acceptability of home care for simple cases. Regularly searching for information on COVID-19 and confidence in the government's control of the epidemic were associated with the acceptability of managing contacts at home. Conclusions Authorities should take these factors into account for better communication to improve the acceptability and confidence in home-based care for COVID-19 and future epidemics. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the Quality and accuracy of existing Data, to know about the current situation of Infrastructure and Functionality of Primary Health Care (PHC), and to assess the District Health Information System (DHIS) Operational Needs. Study Design: Mixed Method Retrospective Descriptive study. Setting: Seven Tehsils of Rawalpindi District. Period: January to February 2020. Material & Methods: One BHU was randomly selected from each Tehsil to cover all geographical areas. Data was collected using questions derived from the Procedures Manual of DHIS and comparing with the monthly DHIS reports of PHC facilities. Data was analysed after entering into SPSS software (V-22). Results: The 57 % of the facilities' in-charges (4 out of 7) had DHIS training, while the remaining 43% were observed as either not trained or self-trained. The overall accuracy rate in DHIS was 71.43% but variance was observed in different variables. Conclusion: The current situation of DHIS demands initiative for additional collaborations among multiple vertical health programs. Some promising interventions in government policies, including skilled support programs and training of DHIS teams through regular sessions and workshops are highly recommended. [ABSTRACT FROM AUTHOR]