Frequent Intervals Research Articles

Time-Dependent Bacterial Contamination of a Surgical Suction Tip.

Background: No in vitro surgical study has evaluated the time-dependent contamination of surgical suction tips compared with controls. Our purpose was to determine the difference in suction tip bacterial contamination rates between suction-positive and suction-negative tips. Materials and Methods: A matched-pair analysis of the contamination of surgical suction tips over a six-hour period was performed in two clean operating rooms. One suction tip was connected to standard wall suction (suction-positive group), with a matched control tip not connected to wall suction (suction-negative group). At time zero and then at hourly intervals for six hours, the distal 3 cm of suction tips were removed, placed in nutrient broth for 48 hours, then plate cultured. One hundred tips were collected for each time interval. Results: Eighty-two of 700 (11.7%) suction tips had bacterial contamination. Sixty-three (18.0%) of 350 suction-positive tips were contaminated, with 19 (5.4%) of the 350 suction-negative tips contaminated (χ2 = 26.7, p < 0.001). Suction tip contamination was time-dependent with the first significant difference between groups occurring after two hours of continuous suction (χ2 = 4.0, p = 0.04). Contamination rate in the suction-positive group increased significantly after one hour compared with time-zero controls (χ2 = 7.1, p = 0.008). There was no significant difference in frequency of positive cultures over time in the suction-negative group compared with time-zero controls. Conclusions: This is the first controlled laboratory study suggesting a time-dependent increase in positive suction tip cultures. From our data, operating room staff should have an awareness that suction tips represent a potential source of bacterial concentration. We recommend that when not in use, suction tip valves be closed if this feature is available, that hosing be manipulated to cease suction when not needed, that suckers be disconnected from tubing, or that suckers be exchanged at frequent intervals. Doing so may reduce bacterial contamination on the suction tip.

Trusted Head Node for Node Behaviour Analysis for Malicious Node Detection in Wireless Sensor Networks

There has been a rise in the use of Wireless Sensor Networks (WSNs) in several fields. Depending on the malicious actions, attacks on WSN can take many forms. This research demonstrates how to leverage request and response data from each node to pinpoint the location of malicious nodes. If a node is malevolent, it will prohibit data from being sent to other nodes. They do an excellent job of pretending to be someone else. To enhance route quality, packet dropping can be used to perform a Denial of Service (DoS) assault by rejecting data packets and cutting them off from their destinations. The primary goal of this research is to expose malicious nodes within the network. To avoid being attacked by the false information fed by the adversary through compromised nodes, it is crucial to discover and isolate the nodes that have been compromised. Unfortunately, flat topology networks are difficult to keep safe because of their limited scalability and substantial communication overhead. By computing the packet drop and throughput values with valid nodes, efficient security architecture for the WSN can be proposed, allowing for the detection of malicious activity. If sensor networks are susceptible to attacks, they will be unable to fulfill their duty in a variety of event detection applications. Malicious nodes can cause unacceptable drops in event detection effectiveness and spikes in false alarm rates by producing fake readings and deceptive information. In this research, a method for identifying malicious nodes in WSNs is proposed. This research considers a Trusted Head Node (THN) for monitoring the nodes behaviour in the network to detect the malicious actions in the network. This research proposes a Trusted Head Node for Node Behaviour Analysis for Malicious Node Detection (THN-NBA-MND) in WSN. The proposed model based on node behavior analysis in frequent time intervals; detect the malicious nodes to improve the network performance in data transmission. The proposed model when contrasted with the existing model performs better in malicious node detection.

Effect of Fungicides and Application Intervals for the Control of Black Spot of Roses

The efficacy of the fungicide pydiflumetofen + difenoconazole (Postiva) was evaluated at varying application rates and intervals to control black spot disease (Diplocarpon rosae) in rose (Rosa spp. ‘Coral Drift’). Container-grown roses were arranged in a completely randomized design with five single-plant replications. Experiments were conducted under greenhouse and shade-house conditions (56% shade) in 2021/2022 and 2023. Black spot disease in roses was developed naturally. Pydiflumetofen + difenoconazole at 1.1 , 1.6, and 2.2 mL⋅L–1, and standard fungicide azoxystrobin + benzovindiflupyr (Mural) at 0.5⋅g L–1 were sprayed on foliage to runoff on a 2- or 4-week interval. Plants that were not treated with fungicide served as the controls. Plants were evaluated weekly for disease severity (0%–100% foliage affected) and defoliation (0%–100% defoliation). The season-long area under the disease progress curve (AUDPC) and area under the defoliation progress curve (AUDFC) were calculated for the evaluation period. Pydiflumetofen + difenoconazole reduced significantly black spot disease severity, AUDPC, defoliation, and AUDFC both in greenhouse and shade-house conditions compared with control plants, and was as effective as azoxystrobin + benzovindiflupyr. All the application rates and intervals of pydiflumetofen + difenoconazole were equally effective in reducing black spot severity and AUDPC. Our findings suggest that pydiflumetofen + difenoconazole at the lowest rate with the longest application interval is the most cost-effective, and has similar efficacy as treatments with higher rates and more frequent intervals.

Return to Sports After Anterior Cruciate Ligament Reconstruction.

Anterior cruciate ligament (ACL) tears are one of the most common orthopedic injuries among athletes. Although a small proportion of patients with isolated tears can return to sports after completing a nonsurgical rehabilitation program, ACL reconstruction is frequently recommended for young athletes, especially those with concomitant knee injuries or symptomatic knee instability. Alongside emerging evidence for the effect of prehabilitation, the current standard of care for postoperative ACL physical therapy includes pain control, range of motion, quadriceps strengthening, weight bearing, postoperative bracing, and dynamic limb stabilization and control. The early rehabilitation period includes non-weight-bearing exercises and passive range of motion, which is followed by a longer period of gradual strengthening focused on regaining preinjury strength, proprioception, and control with progressively more demanding dynamic movements. The total rehabilitation period is expected to take around 9 months, during which the patient should be evaluated at frequent intervals by a licensed physical therapist in addition to a daily home exercise program. Prior to discharge from the rehabilitation program, patients should be evaluated by both the surgeon and physical therapist. Patients are encouraged to return to sports once they meet a set of perceptual, subjective, objective, neuromuscular, functional, sport-specific drills, and load management testing criteria.

Remote pulmonary function testing allows for early identification of need for non-invasive ventilation in a subset of persons with ALS

The traditional ALS multidisciplinary clinical practice of quarterly respiratory assessment may leave some individuals in danger of developing untreated respiratory insufficiency between visits or beginning non-invasive ventilation (NIV) later than would be optimal. Remote, or home-based, pulmonary function testing (rPFT) allows patients with ALS to perform regular respiratory testing at more frequent intervals in the home. The aim of this study was to determine the clinical benefit of weekly rPFT compared to standard, quarterly in-clinic respiratory assessments: the number of individuals with earlier identification of NIV need, the magnitude of this advance notice, and the individual factors predicting benefit. Participants with ALS (n = 39) completed rPFT training via telemedicine and then completed one year of weekly self-guided assessments in the home. Over this period, 17 individuals exhibited remotely-measured FVC dropping below 50% of predicted, the value often used for recommendation of NIV initiation. In 13 individuals with clinical detection of this event, the median and range of advance notice of need for NIV was 53 (−61–294) days. Prescription of NIV occurred for 21 individuals on the study, six of whom began NIV as a result of remote testing, prior to indication of need as determined by in-person assessments. Weekly home assessments appeared to be of greatest clinical value in a subset of patients with low baseline respiratory test values and rapid respiratory decline. This has potential implications for clinical management of ALS as well as the conduct of clinical trials that rely on respiratory endpoints.

In vivo measurement of pediatric extracorporeal oxygenator insensible losses; a single center pilot study.

Fluid overload on Extracorporeal Membrane Oxygenation (ECMO) is associated with worse outcomes. Previous in vitro studies have attempted to quantify oxygenator-related insensible losses, as failure to account for this fluid loss may lead to inaccurate fluid balance assessment and potentially harmful clinical management, such as unnecessary exposure to diuretics, slow continuous ultrafiltration (SCUF), or continuous kidney replacement therapy (CKRT). We performed a novel in vivo study to measure insensible fluid losses in pediatric ECMO patients. Pediatric ECMO patients were approached over eleven months in the pediatric and cardiac intensive care units. The water content of the oxygenator inflow sweep gas and exhaust gas were calculated by measuring the ambient temperature and relative humidity at frequent intervals and various sweep flow. Nine subjects were enrolled, generating 431 data points. The cohort had a median age of 11 years IQR [0.83, 13], weight of 23.2 kg IQR [6.48, 44.28], and body surface area of 0.815 m2 IQR [0.315, 1.3725]. Overall, the cohort had a median sweep of 2.5 L/min [0.9, 4], ECMO flow of 3.975 L/m2/min [0.75, 4.51], and a set ECMO temperature of 37 degrees Celsius [36.6, 37.2]. The calculated net water loss per L/min of sweep was 75.93 ml/day, regardless of oxygenator size or patient weight. There was a significant difference in median documented vs. calculated fluid balance incorporating the insensible fluid loss, irrespective of oxygenator size (pediatric oxygenator: 7.001 ml/kg/day [-12.37, 28.59] vs. -6.11 ml/kg/day [-17.44, 13.01], respectively, p = 0.005 and adult oxygenator: 14.36 ml/kg/day [1.54, 25.77] and 9.204 ml/kg/day [-1.28, 22.05], respectively, p = <0.001). We present this pilot study of measured oxygenator-associated insensible fluid losses on ECMO. Our results are consistent with prior in vitro methods and provide the basis for future studies evaluating the impact of incorporating these fluid losses into patients' daily fluid balance on patient management and outcomes.

HormoneBayes: A novel Bayesian framework for the analysis of pulsatile hormone dynamics.

The hypothalamus is the central regulator of reproductive hormone secretion. Pulsatile secretion of gonadotropin releasing hormone (GnRH) is fundamental to physiological stimulation of the pituitary gland to release luteinizing hormone (LH) and follicle stimulating hormone (FSH). Furthermore, GnRH pulsatility is altered in common reproductive disorders such as polycystic ovary syndrome (PCOS) and hypothalamic amenorrhea (HA). LH is measured routinely in clinical practice using an automated chemiluminescent immunoassay method and is the gold standard surrogate marker of GnRH. LH can be measured at frequent intervals (e.g., 10 minutely) to assess GnRH/LH pulsatility. However, this is rarely done in clinical practice because it is resource intensive, and there is no open-access, graphical interface software for computational analysis of the LH data available to clinicians. Here we present hormoneBayes, a novel open-access Bayesian framework that can be easily applied to reliably analyze serial LH measurements to assess LH pulsatility. The framework utilizes parsimonious models to simulate hypothalamic signals that drive LH dynamics, together with state-of-the-art (sequential) Monte-Carlo methods to infer key parameters and latent hypothalamic dynamics. We show that this method provides estimates for key pulse parameters including inter-pulse interval, secretion and clearance rates and identifies LH pulses in line with the widely used deconvolution method. We show that these parameters can distinguish LH pulsatility in different clinical contexts including in reproductive health and disease in men and women (e.g., healthy men, healthy women before and after menopause, women with HA or PCOS). A further advantage of hormoneBayes is that our mathematical approach provides a quantified estimation of uncertainty. Our framework will complement methods enabling real-time in-vivo hormone monitoring and therefore has the potential to assist translation of personalized, data-driven, clinical care of patients presenting with conditions of reproductive hormone dysfunction.

Evaluation of Continuous Infusion Vancomycin in a Pediatric Hematology/Oncology Population.

Continuous infusion vancomycin (CIV) may benefit children who are unable to achieve therapeutic concentrations with intermittent vancomycin dosing and may facilitate outpatient administration by alleviating the burden of frequent dosing intervals. Previous studies have used variable dosing regimens and steady-state concentration goals. The purpose of this study was to evaluate the total daily dose (TDD) of CIV required to achieve therapeutic steady-state concentrations of 15-25 µg/mL in pediatric hematology/oncology patients. A single-center retrospective study was performed for patients treated with CIV from January 2017 to June 2019. The primary outcome was the TDD required to achieve therapeutic steady-state concentrations on CIV. Secondary outcomes included time to reach therapeutic steady-state concentrations, CIV indications and adverse events associated with CIV. Data were collected for 71 courses of CIV in 60 patients. Median patient age was 4 years (range: 0.4-20 years). The median TDD required to achieve initial therapeutic concentrations was 50.3 mg/kg/d (interquartile range: 38.8-59.2) and was further divided into age-based cohorts. TDD in mg/kg was significantly lower in the older cohort ( P < 0.001), but there was no statistically significant difference between age-based cohorts with TDD in mg/m 2 ( P = 0.97). Median time to achieve first therapeutic concentration was 19.3 hours (range: 8.6-72.3 hours). The most common indication for CIV was ease of outpatient administration (69.0%). Acute kidney injury incidence was minimal (4.2%). CIV is associated with rapid attainment of target concentrations in pediatric hematology/oncology patients and is safe and well tolerated.

Economy of Scale of Energy Intensity in Aquifer Storage and Recovery (ASR)

More water utilities are adopting aquifer storage and recovery (ASR) to balance long-term water supply and demand. Due to large implementation and operation costs, ASR projects need to be optimized, particularly for energy use, which is a major operating expense. This study examines the relationships among energy use, recharge, and recovery at two ASR projects in the western United States. The major finding is an economy of scale for recovery processes, but not for gravity-fed recharge processes. The economy of scale found is as follows: the energy intensity recovered decreases with volume. This suggests it is more energy-efficient to recover large volumes of water in one interval instead of recovering smaller volumes at more frequent intervals. The H2Oaks recovery process experienced a 78% decrease in energy intensity from 0 to 50,000 m3 recovered, while the Sand Hollow site experienced a 43% decrease in energy intensity from 0 to 50,000 m3 recovered. Statistical analyses of the recovery process showed p values lower than 0.0001, R2 values between 0.43 and 0.57, and a RMSE value between 0.55 and 2.1, indicating the presence of a moderate correlation between energy and volume. This economy of scale has been observed in multiple instances in water and wastewater treatment. This finding not only has applications to ASR but also to all recovery or recharge wells, whether or not they are paired with each other. Furthermore, this study confirms the need for more reliable and accessible energy data to fully understand the implications of the energy–water nexus.

Abstract WP187: Association of Renin Angiotensin Aldosterone Blockade and Hypotension After Carotid Artery Stenting

Background: Persistent hypotension after carotid artery stenting (CAS) can lead to adverse outcomes, prolong length of stay (LOS), and increase hospital costs. As catecholamine plays a critical role in blood pressure (BP) regulation, we aimed to determine the relationship between the use of renin-angiotensin-aldosterone inhibitor (RASI) drugs and post-CAS hypotension. Methods: A multicenter prospective study of patients with extracranial internal carotid artery stenosis and history of hypertension requiring CAS at two hospitals in China between January 2020 to May 2023. BP was recorded at frequent intervals for at least 24 hours post-CAS. Blood catecholamine concentrations were assessed in the morning of, and day immediately after, CAS in a subset of patients. Persistent hypotension was defined as systolic BP &lt;90 mmHg or requiring vasopressor treatment for at least 6 hours. Logistic regression models assessed differences in the rates of post-CAS hypotension between RASI and non-RASI patients with adjustment for known confounding variables. Findings: There were 329 patients included: 160 in the RASI group and 169 in the non-RASI group. The RASI group had a higher rate of persistent hypotension (relative risk 1.52, P=0.031). The RASI group showed a greater decline in norepinephrine concentration after CAS compared with the non-RASI group (P=0.008). Patients with persistent post-CAS hypotension showed a similar decline in norepinephrine concentration (P=0.004) when compared with patients without persistent hypotension. Persistent hypotension prolonged LOS (P=0.014). Conclusion: Prior use of RASI for the treatment of hypertension is associated with persistent hypotension after CAS. A relation between decline of norepinephrine after stenting and persistent hypotension supports the role of catecholamine in BP control.

The effect of exogenous glucagon on circulating amino acids in individuals with and without type 2 diabetes and obesity.

In obesity and type 2 diabetes, hyperglucagonaemia may be caused by elevated levels of glucagonotropic amino acids due to hepatic glucagon resistance at the level of amino acid turnover. Here, we investigated the effect of exogenous glucagon on circulating amino acids in obese and non-obese individuals with and without type 2 diabetes. This was a post hoc analysis in a glucagon infusion study performed in individuals with type 2 diabetes (n = 16) and in age, sex, and body mass index-matched control individuals without diabetes (n = 16). Each group comprised two subgroups of eight individuals with and without obesity, respectively. All participants received a 1-h glucagon infusion (4 ng/kg/min) in the overnight fasted state. Plasma amino acid concentrations were measured with frequent intervals. Compared to the control subgroup without obesity, baseline total amino acid levels were elevated in the control subgroup with obesity and in the type 2 diabetes subgroup without obesity. In all subgroups, amino acid levels decreased by up to 20% in response to glucagon infusion, which resulted in high physiological steady-state glucagon levels (mean concentration: 74 pmol/L, 95% CI [68;79] pmol/L). Following correction for multiple testing, no intergroup differences in changes in amino acid levels reached significance. Obesity and type 2 diabetes status was associated with elevated fasting levels of total amino acids. The glucagon infusion decreased circulating amino acid levels similarly in all subgroups, without significant differences in the response to exogenous glucagon between individuals with and without obesity and type 2 diabetes. The hormone glucagon stimulates glucose production from the liver, which may promote hyperglycaemia if glucagon levels are abnormally elevated, as is often seen in type 2 diabetes and obesity. Glucagon levels are closely linked to, and influenced by, the levels of circulating amino acids. To further investigate this link, we measured amino acid levels in individuals with and without obesity and type 2 diabetes before and during an infusion of glucagon. We found that circulating amino acid levels were higher in type 2 diabetes and obesity, and that glucagon infusion decreased amino acid levels in both individuals with and without type 2 diabetes and obesity. The study adds novel information to the link between circulating levels of glucagon and amino acids.

Validation of behavioural sampling techniques for 20-25 kg pigs during transport

Monitoring behaviour during transport is challenging due to the design of vehicles and often limited deck height. The aim of the present study was to validate behavioural sampling techniques during transport. This study used data from four journeys, constituting a subset of 32 experimental journeys in a commercial vehicle transporting weaners of 20–25 kg for 23 h. In each journey, behaviour was observed in two compartments holding pigs, each with a deck height of either 60 cm or 90 cm.Body posture (upright, lying, sitting) was recorded using instantaneous scan sampling at 1 min intervals (considered ‘true’ occurrence). Based on these, less frequent sampling intervals were created (5, 10, 15, 30, and 60 min) and the resulting percentages of behaviour per hour were compared. Occurrences of inter-pig aggressive events were recorded using continuous sampling. It was investigated whether the occurrence of aggression when observed during selected recording sessions per hour (20, 30 and 40 min/h) differed from observing the whole hour throughout the journey (the ‘true’ occurrence).Two methods were used to compare sampling techniques. First, estimates of body posture and aggression were pairwise compared with the ‘true’ occurrence using regression metrics (RMSE, MAE, R2). The results showed that instantaneous scan sampling of body posture at 15 min intervals or less did reflect the ‘true’ values, whereas for aggression use of shorter recording sessions of 20 min/h generally did not reflect the ‘true’ values.Secondly, similar results were achieved by using mixed effects logistic regression. These models showed that sampling every 30 min differed from the ‘true’ values, whereas scanning in 5-, 15- or 60 min intervals did not. Compared with sampling the whole hour, the total duration of aggression was significantly underestimated in all three recording sessions (20, 30 and 40 min/h), while the total frequency of aggression was only significantly underestimated in 20 min/h recording session.Based on results of this study, the use of instantaneous scan sampling intervals of 15 min or less is considered valid for analyses of body postures during long distance transport of 20–25 kg pigs. Due to the sporadic occurrence of aggressive interactions, continuous sampling using recording sessions of 20 min cannot be recommended. Using longer recording sessions of 30 or 40 min/h should be approached with caution dependent on the specific scientific context.

Fate of Papilledema in Cerebral Venous Thrombosis Patients and its Correlation to Affected Cerebral Venous Sinuses

Background: Cerebral venous thrombosis is an important cause of stroke in young and middle-aged adults with estimated (3-4) cases per million annual incidences. Papilledema is the most common sign detected in these patients that can end by blindness if not monitored and treated well. This research aims to assess development and prognosis of papilledema and its association with certain cerebral venous sinuses thrombosis. Evaluation of the optic nerve head has been done clinically and by using optical coherence tomography. Methods: A descriptive analytic hospital-based study was conducted in neurology unit at wad medani teaching hospital from December 2021 to July 2022. 20 patients were included in the study. Data including optical coherence tomography reports was collected at admission and after 2 months. Analysis was done using SPSS version 25 to report frequency of papilledema, 2months visual outcome, correlation of MRI\MRV findings with the development and outcome of papilledema. Results: This study include 20 cerebral venous thrombosis patients with mean age of 35.75 years. Papilledema present in 70% at initial presentation in whom the superior sagittal sinus was affected in 78.6%, after two months period papilledema regressed in80%, 10% developed optic atrophy and10% died. There is clear correlation between the sinus affected and the development of papilledema (P value=0.009); in contrast no relation between the sinus affected and the two months visual outcome of papilledema (P value=0.417). Conclusion: Papilledema regressed in most CVT patients while small number of them developed optic atrophy confirming the importance of regular ophthalmological follow up of CVT patients at frequent intervals using OCT in addition to other papilledema assessment tools in order to prevent irreversible blindness. Affection of certain cerebral venous sinus can predict development of papilledema in CVT patients, but not the outcome.

Magnitude and Durability of the Antibody Response to mRNA-Based Vaccination Among SARS-CoV-2 Seronegative and Seropositive Health Care Personnel.

Few studies have described changes in SARS-CoV-2 antibody levels in response to infection and vaccination at frequent intervals and over extended follow-up periods. The purpose of this study was to assess changes in SARS-CoV-2-specific antibody responses among a prospective cohort of health care personnel over 18 months with up to 22 samples per person. Antibody levels and live virus neutralization were measured before and after mRNA-based vaccination with results stratified by (1) SARS-CoV-2 infection status prior to initial vaccination and (2) SARS-CoV-2 infection at any point during follow-up. We found that the antibody response to the first dose was almost 2-fold higher in individuals who were seropositive prior to vaccination, although neutralization titers were more variable. The antibody response induced by vaccination appeared to wane over time but generally persisted for 8 to 9 months, and those who were infected at any point during the study had slightly higher antibody levels over time vs those who remained uninfected. These findings underscore the need to account for SARS-CoV-2 natural infection as a modifier of vaccine responses, and they highlight the importance of frequent testing of longitudinal antibody titers over time. Together, our results provide a clearer understanding of the trajectories of antibody response among vaccinated individuals with and without prior SARS-CoV-2 infection.

Forecasting hourly WTI oil front monthly price volatility densities

&lt;p&gt;Financial commodity markets have an impact on company values and cash flows, where price movements within frequent time intervals can be both significant and random. Understanding highly frequent price movements is both important and difficult. In this paper, I measured and forecasted volatility for high-frequency (mostly twelve hours per day) WTI Oil front month price movements from 2012 to 2024 (about 40,500 observations). I created a new stochastic volatility model for extracting latent volatility using the non-linear Kalman filter. Stable and strictly ergodic hourly price series, along with the BIC optimal non-linear (generic) general method of moments model coefficients, enabled this process. The latent volatility seemed to separate into two volatility factors. One factor that was very persistent suggested slow mean reversion, and one choppy strongly mean-reverting factor. The data dependence found in the factor volatility series suggested forecasting ability. I applied classical static forecasts and three machine learning regression techniques to predict one-step-ahead volatility. The two volatility factors and one summarizing exponential factor were reported, along with several fit measures, including the root mean square error and Theil's measure of covariance.&lt;/p&gt;

Effect of Positive Deviance Approach on Promotion of Safe Disposal of Child's Feces in Rural Tamil Nadu: A Community-Based Quasi-Experimental Study.

Safe disposal of feces is ensured when it is deposited into a toilet, whereas unsafe disposal of child's feces plays a crucial role in disease transmission and environmental pollution. These areas are overlooked by many sanitation promotion interventions. To determine the effect of positive deviance (PD) approach on safe disposal of child's feces among households who owned a toilet. A community-based quasi-experimental study was conducted in the four field practice villages of the Urban Health Training Center, Villupuram, for 18 months. Households who owned a toilet and had a child less than 5 years old were included. After IEC clearance, information was collected from a representative sample of 100 households before intervention and another 100 households after intervention. PD approach was applied for 6 months to promote safe disposal practices in the study villages. Data were analyzed using the Statistical Package for the Social Sciences (SPSS) software (version 24). The Chi-square test was used to determine the significance of difference between baseline and endline data. The effect size was calculated to estimate the magnitude of difference between baseline and endline data. Before intervention, only 3% of households disposed the feces into a toilet, while after intervention, almost 38% of households disposed in the toilet (χ2 = 37.39; df = 1; P = 0.001). The effect size (Cramer's V) was found to be 0.43. PD approach demonstrated considerable improvements in safe disposal of child's feces in rural settings. Further, to sustain the behavior change, frequent reinforcement of key messages at frequent intervals needs to be emphasized.

Evaluation of the Impact of Maternal Educational Models on Early Childhood Caries in Preterm Infants

Purpose: This prospective cohort study aimed to assess the impact of different educational models on maternal awareness and dental caries development in preterm infants. Methods: This study included 56 preterm infants and their mothers. Participants were divided into two groups based on the education models provided to their mothers: visual and verbal education (Group 1) and verbal education alone (Group 2). Mothers received either visual or verbal presentations focusing on maternal oral hygiene, early childhood caries, and infant oral hygiene. Training and oral examinations were repeated at 3-month intervals for 18 months. Intraoral examinations of the infants were performed again 9 months after the last visit. Demographic factors, oral hygiene and caries development were assessed through clinical examinations and questionnaires. Results: There is no significant difference in demographic variables between the two groups. Both education models significantly increased maternal knowledge, as evidenced by pre-test and post-test scores (p=0.001). However, no statistically significant difference was observed in caries development between the two groups (p=0.322). Only verbal education and visual and verbal education methods were effective in preventing early childhood caries. Conclusion: The study demonstrates that both visual and verbal educational models, repeated at frequent intervals, effectively increase maternal knowledge about oral and dental health in preterm infants.

Physical activity/exercise and diabetes: a review statement of the American Diabetes Association

Ensuring regular physical exercise is crucial for managing blood glucose levels and promoting overall health in those with diabetes and prediabetes. Recommendations and precautions differ based on individual attributes and health conditions. This article aimed to provide a comprehensive assessment and evidence-based guidelines on physical activity and exercise for diabetic patients. An electronic literature search was conducted in the MEDLINE database using the specified search keywords: Physical, Activity, Exercise, Diabetes, Statement, and American Diabetes Association. The search was limited to publications between 2014 and 2024 to identify relevant material. Relevant search terms were utilized on Google Scholar to locate and explore relevant scholarly articles. The selection of papers was guided by certain inclusion criteria. The study was organized into several sections with particular headers in the discussion. It is advisable to suggest and prescribe physical activity and exercise to all patients with diabetes as a means of managing glucose control and promoting overall health. The advice and precautions for managing diabetes depend on factors such as the specific type of diabetes, age, level of physical activity, and any existing diabetes-related health issues. Recommendations should be customized to address the unique requirements of each individual. All adults should be encouraged to not only participate in regular physical exercise but also to reduce the overall amount of time spent being sedentary each day. It is important to interrupt prolonged periods of sitting with frequent intervals of physical activity. Ultimately, behavior- change tactics might be employed to encourage the acceptance and continuation of lifelong physical exercise.

SMARTCOPE: Smartphone Change Of Possession Evaluation for continuous authentication

The goal of continuous smartphone authentication is to detect when the adversary has gained possession of the user’s device post-login. This is achieved by triggering re-authentication at fixed, frequent intervals. However, these intervals do not take into account external information that might indicate that the impostor has gained physical access to the user’s device. Continuous smartphone authentication typically relies on behavioral cues, such as hand movement and touchscreen swipes, that can be collected without interrupting the user’s activity. Because these behavioral signals are characterized by relatively high error rates compared to physiological biometrics, their use at fixed intervals leads to unnecessary interruptions to the user’s activity in case of a false reject, and to not recognizing the impostor in case of a false accept.To address these issues, in this paper we introduce a novel framework called SMARTCOPE: Smartphone Change Of Possession Evaluation. In this work, SMARTCOPE leverages smartphone movement signals collected during user activity to determine when the smartphone is no longer in the hands of its owner. When this occurs, SMARTCOPE triggers re-authentication. By using these signals, we are able to reduce the total number of re-authentication points while simultaneously lowering re-authentication error rates. Our analysis shows that our technique can reduce equal error rates by over 40%, from 7.8% to 4.6% using movement and keystroke features. Further, we show that SMARTCOPE can be used to transform a static (login-time) authentication system, such as face recognition, to a continuous re-authentication system, with a significant increase in security and limited impact on usability.

Association Between Daily Toothbrushing and Hospital-Acquired Pneumonia

Hospital-acquired pneumonia (HAP) is the most common and morbid health care-associated infection, but limited data on effective prevention strategies are available. To determine whether daily toothbrushing is associated with lower rates of HAP and other patient-relevant outcomes. A search of PubMed, Embase, Cumulative Index to Nursing and Allied Health, Cochrane Central Register of Controlled Trials, Web of Science, Scopus, and 3 trial registries was performed from inception through March 9, 2023. Randomized clinical trials of hospitalized adults comparing daily oral care with toothbrushing vs regimens without toothbrushing. Data extraction and risk of bias assessments were performed in duplicate. Meta-analysis was performed using random-effects models. The primary outcome of this systematic review and meta-analysis was HAP. Secondary outcomes included hospital and intensive care unit (ICU) mortality, duration of mechanical ventilation, ICU and hospital lengths of stay, and use of antibiotics. Subgroups included patients who received invasive mechanical ventilation vs those who did not, toothbrushing twice daily vs more frequently, toothbrushing provided by dental professionals vs general nursing staff, electric vs manual toothbrushing, and studies at low vs high risk of bias. A total of 15 trials met inclusion criteria, including 10 742 patients (2033 in the ICU and 8709 in non-ICU departments; effective population size was 2786 after shrinking the population to account for 1 cluster randomized trial in non-ICU patients). Toothbrushing was associated with significantly lower risk for HAP (risk ratio [RR], 0.67 [95% CI, 0.56-0.81]) and ICU mortality (RR, 0.81 [95% CI, 0.69-0.95]). Reduction in pneumonia incidence was significant for patients receiving invasive mechanical ventilation (RR, 0.68 [95% CI, 0.57-0.82) but not for patients who were not receiving invasive mechanical ventilation (RR, 0.32 [95% CI, 0.05-2.02]). Toothbrushing for patients in the ICU was associated with fewer days of mechanical ventilation (mean difference, -1.24 [95% CI, -2.42 to -0.06] days) and a shorter ICU length of stay (mean difference, -1.78 [95% CI, -2.85 to -0.70] days). Brushing twice a day vs more frequent intervals was associated with similar effect estimates. Results were consistent in a sensitivity analysis restricted to 7 studies at low risk of bias (1367 patients). Non-ICU hospital length of stay and use of antibiotics were not associated with toothbrushing. The findings of this systematic review and meta-analysis suggest that daily toothbrushing may be associated with significantly lower rates of HAP, particularly in patients receiving mechanical ventilation, lower rates of ICU mortality, shorter duration of mechanical ventilation, and shorter ICU length of stay. Policies and programs encouraging more widespread and consistent toothbrushing are warranted.