bluuebunny/crossref_metadata_2025 huggingface dataset:
Implementation of electrical tomography in a medical measurement system for innovative imaging and area monitoring
Authors: Sikora Jan , Stefaniak Barbara , Kasperek Dariusz , Girzelska Joanna
Published: August 2024

LETS (Lung Electrical Tomography System) is an innovative medical system enabling comprehensive heart and lung function monitoring. It utilizes advanced techniques such as electrical impedance tomography (EIT), body surface potential mapping (BSPM), and electrical capacitance tomography (ECT) to provide accurate information about physiological parameters. The LETS system allows one-time examinations and continuous monitoring 24 hours a day. Remotely measuring and monitoring parameters such as the electrical activity of the heart muscle, blood flow, blood pressure, pulse, and lung aeration enables rapid identification and intervention in case of abnormalities. The system also allows for the detection of cardiac arrhythmias and other heart disorders, as well as the assessment of lung respiratory capacity and optimization of ventilation strategies. However, it's important to note that the LETS system has some limitations. For example, it may not be suitable for patients with certain pacemakers or other implanted devices. Overall, LETS represents a breakthrough in medical imaging, opening up new possibilities in diagnosing and monitoring heart and lung diseases. Its integration may contribute to improving patient care and increasing the effectiveness of medical interventions.
Monitoring the health of patients using a nodal potential map
Authors: Iskra Katarzyna , Dziadosz Marcin , Oleszek Michał , Piwko Adam
Published: August 2024

Purpose: The article presents the developed device and methods for monitoring the heart's condition using a nodal potential map. The proposal enables monitoring of the patient's health condition.
Methods: Testing the heart's electrical activity in our device's case uses a "nodal potential map" BSPM (Body Surface Potential Mapping) technique. This is an extended version of the standard ECG measurement, which, instead of 12 leads, uses several dozen or even several hundred measurement electrodes placed in appropriate locations on the front and back of the chest.
Results: The developed solution enables monitoring of heart function in a noninvasive way and is more precise than a standard ECG test. The collected measurements allowed us to determine the health and condition of the patient's heart—no anomalies were detected during its operation.
Discussion: The next stage of work will be the development of machine learning algorithms trained on the measurements obtained from the vest. The results obtained so far indicate the potential of models classifying heart diseases.
Analysis of the effectiveness of two different loss functions in training a neural network in lung image reconstruction using impedance tomography
Authors: Lalak-Dybała Malgorzata , Stefaniak Barbara , Olszewski Paweł
Published: August 2024

The article presents research findings on developing a medical diagnostic system based on electrical impedance tomography technology. One of the key components of this project is developing a method for reconstructing the structure of human lungs using this technology. The authors of the article compared the effectiveness of two different loss functions in training a neural network, which is tasked with accurately replicating the lung structure based on electrical impedance tomography data.
The researchers analyzed various approaches to calculating loss functions, including cosine embedding loss and InfoNCE loss. They compared the results obtained using these two functions to identify which one performs better in lung structure reconstruction. The findings of these studies may have significant implications for the development of diagnostic systems based on electrical impedance tomography and for improving the effectiveness of lung disease diagnosis.
Additionally, the authors discuss potential future directions for the project, including possible applications of the research findings in clinical practice. Future research efforts may focus on optimizing neural network parameters, exploring alternative loss functions, or utilizing advanced machine learning techniques for even more precise lung structure reconstruction. The pursuit of improving such diagnostic systems could lead to significant advancements in the field of medicine, particularly in diagnosing and treating respiratory diseases.
Methods of medical image segmentation analysis to improve the effectiveness of diagnosing lung diseases
Authors: Orzeł Zbigniew , Kosior-Romanowska Amelia , Bednarczuk Piotr
Published: August 2024

Methods of medical image segmentation analysis to improve the effectiveness of diagnosing lung diseases. The article aims to review selected methods for segmenting lung medical images based on computed tomography (CT) image data analysis. Included in the analysis are 11 different approaches, including edge algorithms such as Canny, Prewitt, Roberts, Sobel and Log, clustering-based algorithms such as Fuzzy C-means, genetic K-means, k-nearest neighbours, and neural networks such as perceptron, neural and fuzzy sets, and edge binarization techniques, among others. Each method was evaluated for its ability to segment lung structures on CT images accurately. Finally, the contour of the heart from the CT image was determined using the maximum entropy thresholding method. The juxtaposition of different approaches to medical image segmentation is an important contribution to developing medical diagnostic techniques, which can help improve the efficiency of diagnosing lung diseases.
Advanced bladder analysis using ultrasonic and electrical impedance tomography with machine learning algorithms
Authors: Dziadosz Marcin , Bednarczuk Piotr , Pietrzyk Robert , Sutryk Mariusz
Published: August 2024

Purpose: The primary purpose of the study is to reconstruct the bladder based on the tomographic measurements obtained. Depending on the type of tomography used, two approaches are presented.
Methods: In the first presented case, the measurements were collected using ultrasonic tomography, while in the second one, they were gathered with electrical impedance tomography. Deterministic methods and machine learning algorithms, such as Elastic Net, Least Angle Regression, and a Neural Network, were used to obtain the bladder reconstruction.
Results: The bladder's position and size can be recognized based on the tomographic measurements of the UST and EIT. Both methods allow for its effective reconstruction.
Discussion: The research results are satisfactory, but their effectiveness is debatable. Future studies will focus on comparing and optimizing both solutions regarding reconstruction time.
Developing a diagnostic system: combining ultrasound and electrical impedance tomography for enhanced urinary tract analysis
Authors: Girzelska Joanna , Gołąbek Michał , Oleszek Michał , Gil Leszek
Published: August 2024

The study aims to develop a reconstruction and measurement system for data analysis using ultrasound transmission tomography (UST) and electrical impedance tomography (EIT), which can be implemented in wearable solutions for non-invasive monitoring and diagnosis of functional urinary tract disorders. Functional disorders can be associated with many urinary system defects, constipation, and central nervous system defects (spina bifida, cerebral palsy). The lack of non-invasive diagnostic methods for a functional and comprehensive analysis of the state of the urinary tract reduces the likelihood of a correct diagnosis and effective treatment. Furthermore, constructing a physical model of a tomograph is problematic due to the complexity of acoustic phenomena necessary for modeling in the case of a heterogeneous environment of propagation of waves in small, limited spaces. Nevertheless, the radial propagation model used in UST is sufficient for effectively detecting disturbances in the interior of objects and is used in medical solutions. The innovation of the solution lies in the simultaneous assessment of urinary tract function based on the analysis of images obtained using EIT and UST. As a non-invasive diagnostic, UST allows for visualization of the body's internal structures (including muscles, blood vessels, and internal organs). However, UST-based diagnostic systems of the urinary tract are not present in world markets. Moreover, building such a system requires solving many problems: limited research fields, dependence on the body structure, difficulties in imaging bone structures, and areas filled with gases.
Machine learning and IoT system for real-time cough detection and classification
Authors: Miotła Paweł , Szuster Iwona , Wojcik Dariusz , Hyka Oleksii
Published: August 2024

Our research investigates the application of machine learning and Internet of Things (IoT) technologies in healthcare, focusing on detecting and classifying coughing episodes. Leveraging deep learning architectures and a comprehensive IoT infrastructure, we developed an automated system capable of monitoring audio signals from a microphone array module to detect coughs and classify their types accurately. The study utilized the COUGHVID dataset for model training and evaluation, employing rigorous preprocessing techniques to ensure data integrity. Through comparative analysis, we identified MobileNet as the optimal model for cough detection, achieving promising results in accuracy, area under the ROC curve (AUC), and F1 score. Furthermore, our emphasis on privacy safeguards and remote medical examination facilitation underscores the practical implications of our research in enhancing healthcare delivery. Our study contributes to advancing technology-enabled healthcare solutions, offering valuable insights and solutions for improving patient care and outcomes.
The use of non-invasive tomographic imaging to monitor lung condition
Authors: Adamkiewicz Przemysław , Lalak-Dybała Małgorzata , Małek Arkadiusz
Published: August 2024

The development of ultrasound tomography (UST) aimed to significantly enhance the precision and safety of non-invasive UST imaging, particularly for studying crystallization processes in biological tissues. The initiative sought to address the limitations of previous versions by incorporating advanced technological upgrades and providing a more user-friendly interface. The revised system comprises eight four-channel measurement cards interconnected via a high-speed FD CAN bus capable of 8 MBPS data transfer. Each card features a dedicated square wave generator, band-pass filters tailored to specific ultrasonic transducer frequencies, and a sophisticated signal envelope processing unit. The core processing unit is built around a 32-bit STM32G474RE microcontroller, ensuring robust data handling and image reconstruction capabilities. The UST device presented demonstrates improved image clarity and reduced noise interference. The measurement card redesign has achieved a sampling rate of 4 MBPS per channel and includes a two-stage amplification for dynamic range management. Upgraded power components, comprehensive shielding, and the integration of advanced analog switches have led to an enhanced signal-to-noise ratio, pivotal for high-resolution imaging. The advancements presented in the UST device mark a noteworthy progression in ultrasound imaging technology, extending beyond traditional applications. High-speed data collection, precise signal processing, and user-centered design have all come together to make a system that can image crystallization processes more accurately and accurately over and over again.
Human movement monitoring system for classification of strength exercises and verification of their execution technique
Authors: Wójcik Beata , Błaszczykowski Michał , Wąsik Edmund
Published: August 2024

Human movement analysis is critical to optimizing sports training and influencing exercise intensity and effectiveness. In the age of modern technology, more and more advanced systems are emerging to support coaches and expand the range of analysis performed. This article aims to verify that artificial intelligence, together with machine learning algorithms, can accurately classify exercises in a dynamic gym environment and effectively assess the correctness of their performance. For the initial analysis of movement, the Google MediaPipe Pose model was used, which was responsible for detecting the human silhouette and determining the coordinates of the position of critical joints. Based on these coordinates, the angles between each joint were calculated, and then their sequences were further analyzed. The sequences were analyzed using the following three algorithms: support vector machine (SVM), dense neural network, and LSTM recurrent network. As a result, the system based on recurrent LSTM networks achieved the best prediction efficiency of approximately 98%, enabling accurate exercise classification. Subsequently, verification of the activities' correctness was also carried out, and the system, based on recursive LSTM networks, again achieved the best efficiency, this time equal to 96% on average for all exercises. On this basis, it was concluded that the discussed approach enables practical analysis of human movement, which can significantly improve training methods and facilitate coaching work.
Advanced approaches for optimizing logistics and warehouse processes: from planning to delivery
Authors: Gudowski Janusz , Korzeniak Jacek , Piwkowski Jacek , Mędzelowski Tadeusz , Górski Przemysław
Published: August 2024

The article discusses critical aspects of managing logistics and warehousing processes in today's business environment. The authors present modern approaches and strategies to help companies manage their supply chains efficiently and optimally. The first emphasis is on understanding logistics's role in a company's operations. The article presents an application developed to help analyze key elements of logistics management, such as transport, warehousing, and inventory management. Modern technology in logistics and warehouse management has been designed and used. The authors highlight the role of information systems, process automation, and data analytics in improving efficiency and reducing operating costs. The conclusions of the article point to the need for continuous improvement of logistics and warehouse management strategies so that companies can meet growing market demands and remain competitive in a dynamic business environment.
Feedback system for reactor process analysis
Authors: Kaleta Paweł , Król Krzysztof , Opielak Marek , Jarmuł Michał , Nowak Ryszard , Zupok Sebastian
Published: August 2024

The article discusses an approach to analyzing processes in industrial reactors using advanced systems with feedback. The authors describe the system preparation and image reconstruction algorithms of ultrasonic tomographs (USTs) that have applications in industry. The research presented in this paper focuses on developing effective strategies for controlling and monitoring chemical reaction processes in reactors. Using advanced data processing techniques, the authors propose systems with feedback that enable accurate analysis and optimization of reactor operating conditions. A key aspect is ultrasonic tomographic imaging, which provides precise data on the state of the process in the reactor. In summary, the paper presents a state-of-the-art approach to analyzing chemical reaction processes in industrial reactors using advanced feedback systems and ultrasonic imaging technologies. The proposed solutions are essential for improving efficiency and process control in the chemical industry.
Investigating the influence of current trends and behaviours on household structures and housing consumption patterns
Authors: Bagheri Mahsa , Tröger Josephine , Freudenberg Charlotte
Published: August 2024

As a major contributor to overall carbon emissions and energy consumption, the housing sector has great potential to reduce energy consumption, whether by reducing the number of appliances, heating temperature or floor space. Consumption patterns encompass how people choose and consume products that satisfy their needs and wants. However, wants, and to some extent needs, are influenced by various factors and existing material and non-material (infra)structures, especially in the housing sector. Focusing on the floor area, this article aims to identify potentials towards lower consumption lifestyles by applying the Avoid-Shift-Improve framework in the residential sector. Through a conceptual review, the article explores what shapes current patterns of space use and outlines potential future pathways. Starting from the macro level, the article examines existing and emerging (societal) trends with (potential) impacts on housing consumption. It then looks at the structural development of households affected by the studied trends. At the micro level, the article provides an overview of the potential impact of individual behaviour on space use patterns within different categories of housing behaviour. The article identifies the potential for social and technical change in the housing sector and concludes that promoting non-materialistic narratives (avoid), offering alternative and innovative solutions to satisfy people’s spatial needs (shift) and designing flexible buildings (improve) appear to be effective ways for fostering behavioural change towards more efficient use of space.
Cryo-EM structures of the human band 3 transporter indicate a transport mechanism involving the coupled movement of chloride and bicarbonate ions
Authors: Su Chih-Chia , Zhang Zhemin , Lyu Meinan , Cui Meng , Yu Edward W.
Published: August 2024

The band 3 transporter is a critical integral membrane protein of the red blood cell (RBC), as it is responsible for catalyzing the exchange of bicarbonate and chloride anions across the plasma membrane. To elucidate the structural mechanism of the band 3 transporter, detergent solubilized human ghost membrane reconstituted in nanodiscs was applied to a cryo-EM holey carbon grid to define its composition. With this approach, we identified and determined structural information of the human band 3 transporter. Here, we present 5 different cryo-EM structures of the transmembrane domain of dimeric band 3, either alone or bound with chloride or bicarbonate. Interestingly, we observed that human band 3 can form both symmetric and asymmetric dimers with a different combination of outward-facing (OF) and inward-facing (IF) states. These structures also allow us to obtain the first model of a human band 3 molecule at the IF conformation. Based on the structural data of these dimers, we propose a model of ion transport that is in favor of the elevator-type mechanism.
A comprehensive data-driven model of cat primary visual cortex
Authors: Antolík Ján , Cagnol Rémy , Rózsa Tibor , Monier Cyril , Frégnac Yves , Davison Andrew P.
Published: August 2024

Knowledge integration based on the relationship between structure and function of the neural substrate is one of the main targets of neuroinformatics and data-driven computational modeling. However, the multiplicity of data sources, the diversity of benchmarks, the mixing of observables of different natures, and the necessity of a long-term, systematic approach make such a task challenging. Here we present a first snapshot of a long-term integrative modeling program designed to address this issue in the domain of the visual system: a comprehensive spiking model of cat primary visual cortex. The presented model satisfies an extensive range of anatomical, statistical and functional constraints under a wide range of visual input statistics. In the presence of physiological levels of tonic stochastic bombardment by spontaneous thalamic activity, the modeled cortical reverberations self-generate a sparse asynchronous ongoing activity that quantitatively matches a range of experimentally measured statistics. When integrating feed-forward drive elicited by a high diversity of visual contexts, the simulated network produces a realistic, quantitatively accurate interplay between visually evoked excitatory and inhibitory conductances; contrast-invariant orientation-tuning width; center surround interactions; and stimulus-dependent changes in the precision of the neural code. This integrative model offers insights into how the studied properties interact, contributing to a better understanding of visual cortical dynamics. It provides a basis for future development towards a comprehensive model of low-level perception.
Laboratory reference intervals influence referral patterns for hemoglobin abnormalities in the Ontario virtual care system
Authors: Ahmad Maud , Chin-Yee Benjamin , Chin-Yee Ian H. , Hedley Ben , Hsia Cyrus C.
Published: August 2024

This retrospective cross-sectional study investigates the impact of laboratory-specific hemoglobin reference intervals on electronic consultation (eConsult) referral patterns for suspected anemia and elevated hemoglobin at a tertiary care center in London, Ontario that serves Southwestern Ontario. The study analyzed referrals through the Ontario Telemedicine Network’s eConsult platform for hemoglobin abnormalities, excluding patients under 18 years old, between July 1, 2019, and June 30, 2023.The main outcome measures were influence of hemoglobin reference intervals on the referral patterns for suspected anemia and elevated hemoglobin, as well as the extent of pre-referral laboratory testing. Of the 619 eConsults reviewed, 251 referrals for suspected anemia and 93 for elevated hemoglobin were analyzed. Referral patterns showed significant variance in hemoglobin levels based on different laboratory thresholds. Referrals for suspected anemia in females from laboratories whose lower limit was 120 g/L or greater had a hemoglobin concentration 7.5 g/L greater than referrals that used laboratories with a threshold lower than 120 g/L. The study also identified potential areas for improvement in pre-referral investigations; 44% of eConsults did not provide a ferritin level, 53% were missing a B12 level, and 81% were missing a reticulocyte count. In conclusion, laboratory reference intervals for hemoglobin significantly influence referral patterns for suspected hemoglobin abnormalities in Ontario’s eConsult system. There is a need for standardized reference intervals and comprehensive pre-referral testing to avoid unnecessary medicalization and referrals. We propose an anemia management algorithm to guide primary care providers in the pre-referral investigation process.
Snakebite incidence and healthcare-seeking behaviors in Eastern Province, Rwanda: A cross-sectional study
Authors: Hakizimana Dieudonne , MacDonald Lauren E. , Kampire Happy Tahirih , Bonaventure Mihigo , Tadesse Mahlet , Murara Elijah , Dusabe Leila , Ishema Leandre , Schurer Janna M.
Published: August 2024

Background

Snakebite envenoming (SBE) is a potentially life-threatening event that can lead to severe physical, mental, and economic hardships, particularly in under-resourced regions like sub-Saharan Africa. In Rwanda, there have been no epidemiological assessments of SBE to guide the Ministry of Health in its efforts to reduce the burden. This study had two main objectives: first, to estimate the incidence of snakebites across districts, and second, to describe formal versus informal healthcare seeking behaviors among snakebite victims in Eastern Province, Rwanda in 2020.

Methodology

This cross-sectional study utilized a cluster sampling approach, involving Community Health Workers (CHWs) who recorded snakebite cases across seven districts. The descriptive analysis considered sampling weights, and healthcare seeking behavior was assessed based on the type of care sought as the first point of treatment.

Findings

The study surveyed 390,546 individuals across 763 villages and estimated a provincial annual incidence rate of 4.3 cases per 1,000 individuals. Incidence estimates ranged from 1.1 cases per 1,000 in Nyagatare to 9.1 cases per 1,000 individuals in Bugesera and Ngoma districts. Among the 2,545 cases recorded by CHWs, three resulted in deaths. Regarding healthcare-seeking behavior, 13% of snakebite victims (143 out of 1,098) initially consulted formal care providers (CHWs, health post/center, or hospital), while 87% sought informal care (family/friends, pharmacist, or traditional healer). Approximately half of the victims (583, 53.1%) reported severe symptoms. Unsafe practices included skin cutting/burning, tourniquet application, use of black stones, and venom extraction; only 24 cases (2.2%) received anti-venom.

Conclusions

This large-scale community-based assessment highlights variations in snakebite incidence between districts and confirms frequent involvement of traditional healers in management. Improving access to anti-venom and community education on the risks of ineffective practices, along with timely use of formal healthcare, are crucial. Collaboration between healthcare providers, traditional healers, community leaders, and policymakers is essential to implement targeted interventions for enhancing snakebite prevention and management strategies.
Relevance of Mediterranean diet as a nutritional strategy in diminishing COVID-19 risk: A systematic review
Authors: Halim Ceria , Howen Miranda , Fitrisubroto Athirah Amirah Nabilah binti , Pratama Timotius , Harahap Indah Ramadhani , Ganesh Lacman Jaya , Siahaan Andre Marolop Pangihutan
Published: August 2024

Background

Mediterranean Diet has been reported to possess immunomodulatory and anti-inflammatory properties. These properties are closely associated with the immunopathogenesis of COVID-19.

Objective

The present systematic review aimed to determine the association between Mediterranean Diet and COVID-19, COVID-19 symptoms, and COVID-19 severity.

Methods

The protocol for this systematic review was registered in International Prospective Register of Systematic Reviews (PROSPERO) with identification number CRD42023451794. The literature search was conducted through Pubmed, Proquest, and Google Scholar on August 2023. The inclusion criteria were studies with a population of human subjects, reported the association between Mediterranean diet adherence with risk of COVID-19 infection, COVID-19 symptoms, or COVID-19 severity, and full text must be available in English. The exclusion criteria were reviews, editorials, letters, replies, systematic reviews, meta-analyses, studies on animals, and duplicates. Risk of bias in included studies was assessed using Newcastle Ottawa Scale (NOS). Data was synthesized narratively. Each study was compared and a structured summary was developed.

Results

After selection process, 6 articles were included, with a sample size of 55,489 patients. All studies were observational studies and assessed Mediterranean diet adherence using food frequency questionnaires (FFQ), with scoring system varied between each study. Four studies found a significant correlation between increased adherence to Mediterranean Diet and reduced COVID-19 risk, while one study indicated non-significant association. One study reported a significant association between higher adherence to Mediterranean Diet and COVID-19 symptoms, but three studies reported non-significant association. One study found that individuals with higher adherence to Mediterranean Diet had reduced likelihood of developing severe COVID-19, however, two studies yielded inconclusive findings.

Limitations

All studies used self-administrated food frequency questionnaires (FFQs), which were prone to biased responses, such as recall and estimation bias.

Discussion

Lower trends of odds ratios (ORs) were consistently observed in higher Mediterranean diet adherence. In every outcome of the included studies, ORs ranged between 0.06–0.992, however, differing levels of significance were reported in each outcome.

Conclusion

Overall analyses suggest that high adherence to Mediterranean Diet is a protective factor against COVID-19, with unclear benefits against COVID-19 symptoms and severity.
Artificial intelligence-based pulmonary embolism classification: Development and validation using real-world data
Authors: Silva Luan Oliveira da , Silva Maria Carolina Bueno da , Ribeiro Guilherme Alberto Sousa , Camargo Thiago Fellipe Ortiz de , Santos Paulo Victor dos , Mendes Giovanna de Souza , Paiva Joselisa Peres Queiroz de , Soares Anderson da Silva , Reis Márcio Rodrigues da Cunha , Loureiro Rafael Maffei , Calixto Wesley Pacheco
Published: August 2024

This paper presents an artificial intelligence-based classification model for the detection of pulmonary embolism in computed tomography angiography. The proposed model, developed from public data and validated on a large dataset from a tertiary hospital, uses a two-dimensional approach that integrates temporal series to classify each slice of the examination and make predictions at both slice and examination levels. The training process consists of two stages: first using a convolutional neural network InceptionResNet V2 and then a recurrent neural network long short-term memory model. This approach achieved an accuracy of 93% at the slice level and 77% at the examination level. External validation using a hospital dataset resulted in a precision of 86% for positive pulmonary embolism cases and 69% for negative pulmonary embolism cases. Notably, the model excels in excluding pulmonary embolism, achieving a precision of 73% and a recall of 82%, emphasizing its clinical value in reducing unnecessary interventions. In addition, the diverse demographic distribution in the validation dataset strengthens the model’s generalizability. Overall, this model offers promising potential for accurate detection and exclusion of pulmonary embolism, potentially streamlining diagnosis and improving patient outcomes.
Attitudes towards advance care planning amongst community-based older people in England
Authors: Spear Sara , Little Ed , Tapp Alan , Nancarrow Clive , Morey Yvette , Warren Stella , Verne Julia
Published: August 2024

Background

Advance care planning has been advocated as a way for people to have their wishes recorded and respected in relation to types of treatment and place of care. However, uptake in England remains low.

Aims

To examine the views of older, well, adults towards Advance Care Plans (ACPs) and planning for end-of-life care, in order to inform national policy decisions.

Methods

A mixed methods approach was adopted, involving individual and mini-group qualitative interviews (n = 76, ages 45–85), followed by a quantitative survey (n = 2294, age 55+). The quantitative sample was based on quotas in age, gender, region, socio-economic grade, and ethnicity, combined with light weighting to ensure the findings were representative of England.

Results

Knowledge and understanding of advance care planning was low, with only 1% of survey respondents reporting they had completed an ACP for themselves. Common reasons for not putting wishes into writing were not wanting/needing to think about it now, the unpredictability of the future, trusting family/friends to make decisions, and financial resources limiting real choice.

Conclusion

Whilst advance care planning is seen as a good idea in theory by older, well, adults living in the community, there is considerable reticence in practice. This raises questions over the current, national policy position in England, on the importance of written ACPs. We propose that policy should instead focus on encouraging ongoing conversations between individuals and all those (potentially) involved in their care, about what is important to them, and on ensuring there are adequate resources in community networks and health and social care systems, to be responsive to changing needs.
Video exposure through virtual reality can improve older people’s ability to manage postural instability caused by distortive visual environments
Authors: Älmqvist Nae Jenny , Nyström Anastasia , Luccini Francesca , Magnusson Måns , Ekvall Hansson Eva
Published: August 2024

In older adults, age-related degenerative processes and disorders often degrade some sensory systems more than others, which can make postural control disproportionally dependent on one kind of sensory information. The study aims were to investigate 1) the postural stability when healthy older adults were repeatedly exposed to a video in an immersive virtual reality (VR) environment, and 2) the relationship between stability during VR video exposure and self-reported physical activity, balance confidence, and nausea during VR. Twenty-seven older adults (18 females, mean age 71.3 years (SD 4.4)) watched a 120-second VR video 5 times with 10 minutes between sessions, while standing on a force platform recording their stability. The first VR video session produced a marked stability challenge, reflected by significantly increased use of anteroposterior and lateral total (p<0.001) and high frequency (p<0.001) energy compared with the control test quiet stance eyes open. However, repeated VR video sessions produced a multidimensional decrease in used total (p<0.001), low (p = 0.002), and high frequency energy (p<0.001). Participants used more energy in anteroposterior compared with lateral direction across sessions within all spectral ranges (p<0.001). Participants with higher physical activity level used less low frequency energy in anteroposterior direction during VR video session 1 (p = 0.033). No association was seen between balance confidence or nausea during VR and energy used during VR video sessions 1 and 5. Healthy older adults adapt fast to distortive visual environments, and thus, CNS can utilize the information provided by a few repeated VR video sessions into suitable movement strategies that have a simultaneous multidimensionally positive effect. VR may introduce numerous opportunities to customize novel rehabilitation approaches to address when the visual system causes and/or suffers from issues. However, a common problem for the older adult was that about 33% of the participants became nauseated by the VR video stimuli.
Comparing birth experiences and satisfaction with midwifery care before and after the implementation of Canada’s first Alongside Midwifery Unit (AMU)
Authors: Murray-Davis Beth , Grenier Lindsay N. , Li Jenifer , Malott Anne M. , Mattison Cristina A. , Cameron Carol , Hutton Eileen K. , Darling Elizabeth K.
Published: August 2024

Background

Globally, midwifery-led birthing units are associated with favourable clinical outcomes and positive birth experiences. As part of our evaluation of Canada’s first Alongside Midwifery Unit (AMU) at Markham Stouffville Hospital, we sought to explore and compare birth experiences and satisfaction among midwifery clients who gave birth on the AMU with midwifery clients who gave birth on the traditional obstetric unit prior to AMU implementation.

Methods

We conducted a structured, online, cross-sectional survey of midwifery clients in the six months before, and up to 18 months after, opening of the AMU at Markham Stouffville Hospital, Ontario Canada. The survey contained validated measures of satisfaction including personal capacity and participation; perceived safety, control, and security; professional support; and satisfaction. Descriptive statistics and tests of significance were completed in SPSS.

Results

A total of 193 responses were included in our analyses (pre-AMU n = 47, post-AMU n = 146). All participants had positive experiences in the four domains assessed. Compared to those who gave birth with midwives on the Labour unit, those who gave birth on the AMU indicated more positive experiences for some measures. Perceptions pertaining to being an active participant in care, to security and sense of control were more positive among those who gave birth on the AMU.

Conclusion

The AMU in Ontario is associated with high levels of satisfaction during birth, particularly the perception of being actively engaged in decision making, having a sense of control and safety, and having confidence in the care provider team. Care received on the AMU does not compromise birth experiences or satisfaction and may be associated with greater autonomy and agency for the person giving birth.
Perceived school service quality and vocational students’ learning satisfaction: Mediating role of conceptions of vocational education
Authors: Guo Tao , Li Tianxin , Qi Zhanyong
Published: August 2024

This study examined the relationships among vocational students’ perceptions of school service quality, their learning satisfaction, and their conceptions of vocational education in Chinese secondary vocational schools. Using a quantitative approach, data were collected from 10,721 students through multistage sampling. Perceived school service quality was assessed using the five-factor SERVPERF instrument, learning satisfaction was measured with the one-factor SSwLA scale, and conceptions of vocational education were evaluated using the one-factor SCoVE scale. These instruments were subjected to internal, convergent, discriminant, and construct validity tests, including exploratory and confirmatory factor analyses. Structural equation modeling (SEM) analyzed the relationships among the constructs. Additionally, mediation analysis was employed to explore the mediating role of students’ conceptions of vocational education in the relationship between perceived school service quality and learning satisfaction. Results indicated that learning satisfaction was positively influenced by students’ perceptions of school service quality, particularly responsiveness, assurance, reliability, and empathy, but negatively by tangibles. Furthermore, the association between students’ perceived school service quality and learning satisfaction was mediated by their conceptions of vocational education, highlighting the complex interaction between perceived service quality and students’ learning satisfaction. These findings provide critical insights for policymakers and educators seeking to enhance effectiveness and satisfaction within vocational education settings.
Clovis points and foreshafts under braced weapon compression: Modeling Pleistocene megafauna encounters with a lithic pike
Authors: Byram R. Scott , Lightfoot Kent G. , Sunseri Jun Ueno
Published: August 2024

Historical and ethnographic sources depict use of portable braced shaft weapons, or pikes, in megafauna hunting and defense during Late Holocene millennia in North and South America, Africa, Eurasia and Southeast Asia. Given the predominance of megafauna in Late Pleistocene North America during the centuries when Clovis points appeared and spread across much of the continent (13,050–12,650 cal BP), braced weapons may have been used in hunting of megaherbivores and defense against megacarnivores. Drawing from historical examples of pike use against lions, jaguars, boars, grizzlies, carabao and warhorses we consider the possibility of a fluted lithic pike. Associated osseous rods have been problematic as Clovis foreshafts due to the bevel angle and the apparent weakness of the splint haft when great strength is needed for deep penetration in megafauna hunting. However our review of Late Holocene pike use in megafauna encounters indicates the sharp tip becomes less important after hide or armor has been pierced because compression is sustained. Thus, foreshaft collapse after hide entry may not limit but rather increase the efficacy of the braced weapon. We conduct preliminary static experiments to model a fluted pike that adjusts during compression such that haft collapse and point detachment (when point jams on impact with bone) preserve the fluted biface, beveled rod and wooden mainshaft tip. In addition to Clovis point attributes and association with osseous rods, potential archaeological correlates of Clovis pike use include the high frequency of Clovis point isolates and concentrations of complete points with unbutchered mammoth remains at sites such as Naco in Arizona.
Increased homicide played a key role in driving Black-White disparities in life expectancy among men during the COVID-19 pandemic
Authors: Light Michael T. , Vachuska Karl
Published: August 2024

Disparities in life expectancy between Black and White Americans increased substantially during the COVID-19 pandemic. During the same period, the US experienced the largest increase in homicide on record. Yet, little research has examined the contribution of homicide to Black-White disparities in longevity in recent years. Using mortality data and population estimates, we conduct a comprehensive decomposition of the drivers of Black-White inequality in life expectancy and lifespan variability between 2019 and 2021 among men. We find that homicide is one of the principal reasons why lifespans have become shorter for Black men than White men in recent years. In 2020 and 2021, homicide was the leading contributor to inequality in both life expectancy and lifespan variability between Black and White men, accounting for far more of the racial gap in longevity and variability than deaths from COVID-19. Addressing homicides should be at the forefront of any public health discussion aimed at promoting racial health equity.
Slaveholder ancestry and current net worth of members of the United States Congress
Authors: Sehgal Neil K. R. , Sehgal Ashwini R.
Published: August 2024

Background

Whether and how much past slavery affects contemporary social and economic conditions in the United States is an area of active debate. Newly available data on which members of the United States Congress are descendants of slaveholders provides an opportunity to examine this topic. This study sought to determine the relationship between slaveholder ancestry and net worth among members of Congress.

Methods

Total assets and liabilities were collected from financial declarations of all members of Congress as of April 15, 2021. Net worth was estimated as the difference between total assets and liabilities. Information on slaveholder ancestry was obtained from a Reuters investigative series based on an extensive review of historical documents and verification by board-certified genealogists. Quantile regression was used to determine the association between net worth and slaveholder ancestry after adjustment for demographic factors.

Results

The median net worth of the 535 members of Congress was $1.28 million (interquartile range $0.11–5.87 million). On univariate analysis, net worth was associated with increased age, White race, increased education, and number of individuals enslaved by ancestors. On multivariate analysis, net worth was independently associated with age, White race, and number enslaved. Legislators whose ancestors enslaved 16 or more individuals had a $3.93 million (95% confidence interval 2.39–5.46) higher net worth compared to legislators whose ancestors were not slave owners after adjustment for age, sex, race, ethnicity, and education.

Conclusions

Past slaveholding practices are independently associated with current wealth among members of Congress. Because members of Congress are a highly selected group, further work is needed to understand how slaveholder ancestry affects current wealth in the general population to inform efforts to reduce social and economic disparities.
A note on the Wilcoxon-Mann-Whitney test and tied observations
Authors: Neuhäuser Markus , Ruxton Graeme D.
Published: August 2024

Recently, it was recommended to omit tied observations before applying the two-sample Wilcoxon-Mann-Whitney test McGee M. et al. (2018). Using a simulation study, we argue for exact tests using all the data (including tied values) as a preferable approach. Exact tests, with tied observations included guarantee the type I error rate with a better exploitation of the significance level and a larger power than the corresponding tests after the omission of tied observations. The omission of ties can produce a considerable change in the shape of the sample, and so can violate underlying test assumptions. Thus, on both theoretical and practical grounds, the recommendation to omit tied values cannot be supported, relative to analysing the whole data set in the same way whether or not ties occur, preferably with an exact permutation test.
Lower extremity function and cardiovascular disease risk in hemodialysis patients: A multicenter cross‐sectional study
Authors: Zhang Kun , Li Xin , Guo Qi , Ding Wei , Niu Jianying , Zhao Junli , Zhang Liming , Qi Hualin , Zhang Suhua , Yu Chen
Published: August 2024

Physical performance in hemodialysis patients declines and serves as a cardiovascular disease (CVD) incidence and mortality predictor. However, lower extremity function's role remains unclear. This study aimed to quantify the association between lower extremity function and CVD risk in hemodialysis patients. This was a multicenter cross‐sectional study enrolling 868 participants (532 males, 336 females) from seven hemodialysis centers in Shanghai, China. Patients were divided into three groups per lower extremity function, evaluated by short physical performance battery (SPPB) scores: 0–6, 7–9, and 10–12. Upper extremity function was quantified through grip strength assessment. CVD risk was assessed using the Framingham Risk Score. Approximately 35% of hemodialysis patients had impaired lower extremity function (SPPB score < 10). Participants with high SPPB scores had stronger handgrip and lower Framingham CVD risk scores than those with low and moderate SPPB scores (p < 0.05). After adjusting clinical confounders, SPPB was independently associated with CVD risk, as a categorized variable (odds ratio: 0.577, 95% confidence interval [CI]: 0.388–0.857, p = 0.006) and as a continuous variable (odds ratio: 0.858, 95% CI: 0.772–0.953, p = 0.004). An SPPB score < 10 predicted an increased CVD risk (area under curve: 0.649, 95% CI: 0.599–0.699, p < 0.001). Causality between physical performance and CVD risk was not considered. Some upper limb results may not be generalizable to peritoneal dialysis and kidney transplant patients. Lower extremity function was significantly associated with CVD risk in hemodialysis patients. Further studies are needed to explore the long‐term relationship between lower extremity function and CVD risk.
Questionário de Motivação ao Estilo de Vida Saudável: quadro teórico e evidências de validade
Authors: Carvalho Irialda Saboia , Moreira Thereza Maria Magalhães , Arruda Luana Savana Nascimento de Sousa , Lima Gabriela de Sousa , Loureiro Aline Maria Oliveira , Gomes Emiliana Bezerra , Borges José Wicto Pereira
Published: August 2024

Objetivo: construir e verificar evidências de validade do Questionário de Motivação ao Estilo de Vida Saudável. Métodos: estudo metodológico ancorado na Psicometria. O construto foi estruturado na teoria da autodeterminação e elementos constitutivos do estilo de vida saudável. Foram desenvolvidos 29 itens avaliados por oito especialistas e 30 usuários, e aplicados a uma amostra de 972 adultos em nove Unidades de Atenção Primária à Saúde. Resultados: elaborou-se um questionário contendo 29 itens com respostas segundo a qualidade da motivação. As evidências de validade de conteúdo mostraram índices (0,75 a 1,0, p<0,05), com boa formulação teórica, enquanto o processo de resposta permitiu adequações aos seus itens. A estrutura interna revelou um modelo final de 22 itens distribuídos em quatro dimensões com variância explicada de 66,58%, cargas fatoriais (0,349 a 0,911), adequada comunalidade (0,20 ≤ h2 ≤ 0,98) e bons indicadores de precisão. Conclusão: o questionário, com 22 itens em quatro dimensões, demonstrou boas evidências de construção, validade de conteúdo, processo de resposta e de estrutura interna para a mensuração do construto. Contribuições para a prática: a aplicação do questionário pode potencializar as ações de promoção da saúde relacionada às mudanças no estilo de vida para a prevenção efetiva de morbidades.