Individual Standard Deviation Research Articles

Proximal humeral fractures in children - controversies in decision making.

Proximal humeral fractures in children are rare and usually treated non-operatively, especially in children younger than ten. The decision between operative and non-operative treatment is mostly based on age and fracture angulation. In the current literature, diverging recommendations regarding fracture angulation that is still tolerable for non-operative treatment can be found. Besides, there is no consensus on how fracture angulation should be determined. This study aimed to determine whether leading experts in pediatric trauma surgery in Germany showed agreement concerning the measurement of fracture angulation, deciding between operative and non-operative treatment, and choosing a treatment modality. Twenty radiographs showing a proximal humeral fracture and the patient's age were assessed twice by twenty-two senior members of the "Section of Pediatric Traumatology of the German Association for Trauma Surgery". Experts determined the fracture angulation and chose between several operative and non-operative treatment modalities. The mean of individual standard deviations was calculated to estimate the accuracy of single measurements for fracture angulation. Besides Intra-Class Correlation and Fleiss' Kappa coefficients were determined. For fracture angulation, experts showed moderate (ICC = 0.60) interobserver and excellent (ICC = 0.90) intraobserver agreement. For the treatment decision, there was fair (Kappa = 0.38) interobserver and substantial (Kappa = 0.77) intraobserver agreement. Finally, experts preferred ESIN over K-wires for operative and a Gilchrist over a Cuff/Collar for non-operative treatment. Firstly, there is a need for consensus among experts on how fracture angulation in PHFs in children should be reliably determined. Our data indicate that choosing one method everybody agrees to use could be more helpful than using the most sophisticated. However, the overall importance of fracture angulation should also be critically discussed. Finally, experts should agree on treatment algorithms that could translate into guidelines to standardize the care and perform reliable outcome studies. III.

Implicit Graphemes Learning among Poor Readers

Poor implicit learning was suggested to be associated with poor orthographic knowledge. The current study examined the differences between twenty typical (age 8.68 ±.15), and twenty poor readers (age 8.45 ±.22) in implicit learning of novel graphemes. In the first stage, each participant was passively displayed with 80 pairs of real and artificial words. The artificial words were composed from artificial symbols. After the passive learning stage, each participant was tested with a grapheme matching decision task. The results showed that the accuracy levels which were recorded among the typical readers were significantly higher than those of the poor readers. The accuracy levels which were recorded among the poor readers showed a type of chance level of performance indicating an absence of implicit learning consolidation. However, the results did not show any significant differences in the response times between the two groups. In addition, significant larger individual standard deviations were recorded for the poor group of readers, for both accuracy and the response time of performance, indicating a non-solid type of implicit learning consolidation among this group. The results were discussed considering the association between poor implicit learning capacities and poor orthographic learning.

Children and Adolescents with Early Treated Phenylketonuria: Cognitive Development and Fluctuations of Blood Phenylalanine Levels.

We assessed the relationship between the cognitive development of children and adolescents with phenylketonuria (PKU) and fluctuations in peripheral phenylalanine (Phe) levels. We examined the neurocognitive performance of 33 children and adolescents with early treated PKU, of whom 18 were treated with sapropterin dihydrochloride, and 15 were on a classic diet. For 26 weeks, patients were assessed weekly for their blood phenylalanine (Phe) levels. Phe levels were analyzed for fluctuations indicated by the individual standard deviation. Fluctuations were compared to the standard deviation of 26 Phe level measurements before the study interval. We also assessed the concurrent IQ of the patients. This was repeated at one-, two-, and seven-year intervals. Full-scale IQ in patients treated with a classic diet did not change within the follow-up. In patients treated with Sapropterin dihydrochloride, however, there was a considerable gain in full-scale IQ. This was particularly true if blood Phe fluctuations increased in patients of this treatment group. Sapropterin dihydrochloride enhances Phe tolerance in patients with PKU. Increasing blood Phe fluctuations following enhanced Phe tolerance may indicate that the treatment not only allows patients to relax their Phe-restricted diet but also may support cognitive development in patients.

Assay error detection when using common quality control targets across multiple instruments: An analysis using simulated and real-world data.

Clinical laboratories frequently implement the same tests and internal quality control (QC) rules on identical instruments. It is unclear whether individual QC targets for each analyser or ones that are common to all instruments are preferable. This study modelled how common QC targets influence assay error detection before examining their effect on real-world data. The effect of variable bias and imprecision on error detection and false rejection rates when using common or individual QC targets on two instruments was simulated. QC data from tests run on two identical Beckman instruments (6-month period, same QC lot, n > 100 points for each instrument) determined likely real-world consequences. Compared to individual QC targets, common targets had an asymmetrical effect on systematic error detection, with one instrument assay losing detection power more than the other gained. If individual in-control assay standard deviations (SDs) differed, then common targets led to one assay failing QC more frequently. Applied to two analysers (95 QC levels and 45 tests), common targets reduced one instrument's error detection by ≥ 0.4 sigma on 15/45 (33%) of tests. Such targets also meant 14/45 (31%) of assays on one in-control instrument would fail over twice as frequently as the other (median ratio 1.62, IQR 1.20-2.39) using a 2SD rule. Compared to instrument-specific QC targets, common targets can reduce the probability of detecting changes in individual assay performance and cause one in-control assay to fail QC more frequently than another. Any impact on clinical care requires further investigation.

STRESSOR VARIETY, SEVERITY, AND IRREGULARITY AND THEIR ASSOCIATIONS WITH DAILY MEMORY LAPSES

Abstract Long-term negative impacts of chronic stress on memory has been well established; however day-to-day associations between stressors and memory have not been fully examined, with lack of understanding on specific manifestations of stressors that may degrade daily memory. This study conceptualized three patterns of daily stressors: variety, severity, and irregularity. Data came from 1,132 adults who participated in an 8-day diary study as part of the Midlife in the United States study. Participants reported 7 types of stressors (e.g., work-related, home-related, discrimination) they encountered, which was summed daily (variety). On days when a stressor was encountered, they reported how stressful it was (severity). Individual standard deviation of stressor severity across the week (irregularity) was also calculated. Memory lapses were reported with 9 items each day. Results from multi-level modeling revealed that, at the within-person level, participants reported more memory lapses on days when they had greater variety (B= 0.126, SE=0.014, p<.001) or higher severity (B=0.071, SE=0.014, p<.001) of stressors. At the between-person level, participants with greater variety (B=0.717, SE=0.052, p<.001), higher severity (B= 0.168, SE= 0.031, p<.001), or greater irregularity (B= 0.141, SE= 0.047, p=.003) of stressors reported more memory lapses on average. These results were found after controlling for sociodemographic and health covariates. These findings highlight that even short-term stress, particularly severe or inconsistent stress may have a negative impact on day-to-day memory. Potential differences between older (age 65+) and younger (below age 65) adults in the relationship between these daily stressors and memory lapses are currently being explored.

Can we separately measure glenoid vs. humeral lateralization and distalization in reverse shoulder arthroplasty?

Lateralization and distalization in reverse shoulder arthroplasty (RSA) can be measured on anteroposterior (AP) radiographs using 2 previously described angles: lateralization shoulder angle (LSA) and distalization shoulder angle (DSA). However, these 2 angles measure global lateralization and distalization but do not allow to differentiate how much lateralization or distalization are attributable to the glenoid and the humerus. We hypothesized that new angles could allow us to separately measure glenoid vs. humeral lateralization and distalization. A more precise understanding of independent glenoid and humeral contributions to lateralization and distalization may be beneficial in subsequent clinical research. Retrospective analysis of postoperative AP radiographs of 100 patients who underwent primary RSA for cuff-tear arthropathy, massive cuff tear, or glenohumeral osteoarthritis were analyzed. The new angles that we proposed use well-known bony landmarks (the acromion, glenoid, and humerus) and the most lateral point of the glenosphere, which we termed the "glenoid pivot point" (GPP). For lateralization, we used the GPP to split LSA into 2 new angles: glenoid lateralization angle (GLA) and humeral lateralization angle (HLA). For distalization, we introduced the modified distalization shoulder angle (mDSA) that can also be split into 2 new angles: glenoid distalization angle (GDA) and humeral distalization angle (HDA). Three orthopedic surgeons measured the new angles, using the online tool Tyche. Mean values with overall and individual standard deviations as well as intraclass correlation coefficients (ICCs) were calculated. Because the angles form a triangle, the following equations can be made: LSA=GLA+HLA, and mDSA=GDA+HDA. All angles showed excellent inter- and intraobserver reliability (ICC=0.92-0.97) with low means of individual standard deviations that indicate a precision of 2° for each angle. Use of the most lateral part of the glenosphere (termed glenoid pivot point) allows us to separately measure glenoid vs. humeral lateralization and distalization. The 4 new angles (HLA, GLA, GDA, HDA) described in the present study can be used on true AP radiographs, routinely obtained after shoulder replacement, and the measured angles may be used with all types of reverse prostheses available.

Actigraphic Sleep Variability is Associated With Lower Positive Mood in Adolescents

PurposePoor sleep health is associated with lower positive mood in adolescents, and more variable sleep is associated with more negative mood. There is a lack of research on the associations between sleep variability and positive mood in adolescents. We investigated whether several types of sleep variability, measured with actigraphy, were associated with positive mood reported on a daily diary in adolescents. MethodsData were collected from a substudy of the Year 15 wave of the Future of Families and Child Wellbeing Study (n = 580; 53% female, mean age ± standard deviation [SD] = 15.4 ± 0.5 years, range 14.7–17.7). Adolescents wore an actigraphy device (M ± SD = 5.6 ± 1.4 nights per adolescent, range: 3–10) and completed daily diaries (M ± SD = 5.5 ± 1.4 days per adolescent, range: 3–9) for ∼1 week, where they rated their levels of happiness and excitement during that day from 0 (not at all) to 4 (extremely). Happiness and excitement were averaged into “positive mood.” Separate linear regression models assessed whether actigraphy-measured variability of sleep duration, onset, and offset (residual individual standard deviation, riSD), sleep regularity index, social jetlag, and free night catch-up sleep were associated with average positive mood per person. Analyses adjusted for age, birth sex, race/ethnicity, household income, and the primary caregiver's education level. ResultsGreater variability in sleep duration (p = .011, β = −0.11) and lower sleep regularity index (p = .034, β = 0.09) were associated with lower ratings of positive mood. There were no other significant associations (p ≥ .10). DiscussionVariable and irregular sleep are associated with lower levels of positive mood in adolescence, which may increase the risk of poor emotional health in adulthood.

The efficacy of mouthwashes on oral microorganisms and gingivitis in patients undergoing orthodontic treatment: a systematic review and meta-analysis

BackgroundMouthwashes were convenient adjuncts to mechanical cleaning procedures. This review aimed to evaluate the efficacy of mouthwashes on oral microorganisms and gingivitis in orthodontic patients.MethodsBy April 16, 2022, multiple databases and grey literature were searched based on the PICOS strategy. Randomized controlled trials in orthodontic patients evaluating the efficacy of mouthwashes with at least one microbial parameter and/or plaque- and/or gingival inflammation-related index were included. Relevant data were extracted, and the risk of bias was evaluated using Cochrane's tool. Individual mean and standard deviation of the outcomes in mouthwashes and placebos/blank controls were pooled to estimate the weighted mean differences (WMDs) and 95% confidence intervals (95%CIs). Sensitivity analysis, and certainty of evidence were evaluated.ResultsOf 1684 articles, 32 studies satisfied the eligibility criteria, and nine were included for meta-analysis. Missing outcome data was the primary source of bias. Compared to blank controls, the short-term application of fluoride mouthwashes significantly reduced the colony counts of Mutans streptococci (MS), while the long-term application may not be effective. Compared to placebos or blank controls, Chlorhexidine mouthwashes significantly reduced the colony counts of multiple microorganisms in the short-term. Compared to placebos or blank controls, herbal mouthwashes showed the inhibitory effect of MS in the short-term, with some results lacking statistical significance. After meta-analysis, significant lower plaque- and gingival inflammation-related indexes were observed in the Chlorhexidine mouthwashes groups [Gingival Index: WMD = -0.45, 95%CI = -0.70 to -0.20 (placebos as control); WMD = -0.54, 95%CI = -0.96 to -0.13 (blank controls); Plaque Index: WMD = -0.70, 95%CI = -1.12 to -0.27 (blank controls)]. Significant lower gingival inflammation-related indexes were observed in the herbal mouthwashes groups [Gingival Index: WMD = -0.20, 95%CI = -0.32 to -0.09 (blank controls)].ConclusionsThe short-term application of fluoride mouthwashes may reduce the colony counts of cariogenic bacteria, but the long-term effect is not evident. Chlorhexidine may reduce the colony counts of multiple microorganisms in the short-term. Short-term application Chlorhexidine and herbal mouthwashes may effectively reduce plaque- and gingival inflammation-related indexes. However, the risk of bias, inconsistency, and imprecision in the included studies may reduce the certainty of the evidence.

Among-individual variation in the swimming behaviour of the amphipod Gammarus pulex under dark and light conditions

In recent years, considerable computational advancements have been made allowing automated analysis of behavioural endpoints using video cameras. However, the results of such analyses are often confounded by a large variation among individuals, making it problematic to derive endpoints that allow distinguishing treatment effects in behavioural studies. In this study, we quantitatively analysed the effects of light conditions on the swimming behaviour of the freshwater amphipod Gammarus pulex by high-throughput tracking, and attempted to unravel among individual variation using size and sex. For this, we developed the R-package Kinematics, allowing for the rapid and reproducible analysis of the swimming behaviour (speed, acceleration, thigmotaxis, curvature and startle response) of G. pulex, as well as any other organism. Our results show a considerable amount of variation among individuals (standard deviation ranging between 5 and 115 % of the average swimming behaviour). The factors size and sex and the interaction between the two only explained a minor part of this found variation. Additionally, our study is the first to quantify the startle response in G. pulex after the light is switched on, and study the variability of this response between individuals. To analyse this startle response, we established two metrics: 1) startle response magnitude (the drop in swimming velocity directly after the light switches on), and 2) startle response duration (the time it takes to recover from the drop in swimming velocity to average swimming speed). Almost 80 % of the individuals showed a clear startle response and, therefore, these metrics demonstrate a great potential for usage in behavioural studies. The findings of this study are important for the development of appropriate experimental set-ups for behavioural experiments with G. pulex.

Uncertainty analysis of chest X-ray lung height measurements and size matching for lung transplantation.

BackgroundErrors in measuring chest X-ray (CXR) lung heights could contribute to the occurrence of size-mismatched lung transplant procedures.MethodsWe first used Bland-Altman analysis for repeated measures to evaluate contributors to measurement error of chest X-ray lung height. We then applied error propagation theory to assess the impact of measurement error on size matching for lung transplantation.ResultsA total 387 chest X-rays from twenty-five donors and twenty-five recipients were measured by two raters. Individual standard deviation for lung height differences were independent of age, sex, donor vs. recipient, diagnostic group and race/ethnicity and all were pooled for analysis. Bias between raters was 0.27 cm (±0.03) and 0.22 cm (±0.06) for the right and left lung respectively. Within subject variability was the biggest contributor to error in measurement, 2.76 cm (±0.06) and 2.78 cm (±0.2) for the right and left lung height. A height difference of 4.4 cm or more (95% CI: ±4.2, ±4.6 cm) between the donor and the recipient right lung height has to be accepted to ensure matching for at least 95% of patients with the same true lung height. This difference decreases to ±1.1 cm (95% CI: ±0.9, ±1.3 cm) when the average from all available chest X-rays is used. The probability of matching a donor and a recipient decreases with increasing true lung height difference.ConclusionsIndividual chest X-ray lung heights are imprecise for the purpose of size matching in lung transplantation. Averaging chest X-rays lung heights reduced uncertainty.

Structural Efficiency of Non-Prismatic Hollow Reinforced Concrete Beams Retrofitted with CFRP Sheets

Non-prismatic reinforced concrete (RC) beams are widely used for various practical purposes, including enhancing architectural aesthetics and increasing the overall thickness in the support area above the column, which gives high assurance to services that this will not result in the distortion of construction features and can reduce heights. The hollow sections (recess) can also be used for the maintenance of large structural sections and the safe passage of utility lines of water, gas, telecommunications, electricity, etc. They are generally used in large and complex civil engineering works like bridges. This study conducted a numerical study using the commercial finite element software ANSYS version 15 for analysing RC beams, hollow longitudinally sectioned and retrofitted with carbon fibre reinforced polymers (CFRPs), which were subjected to concentrated vertical loads. The numerical analysis results on the simulated beam models were in excellent agreements with the previous experimental test results. This convergence was confirmed by a statistical analysis, which considered the correlation coefficients, individual arithmetic means and standard deviations for all the calculated deflections of the simulated beam models. A proposed numerical simulation model with the hypotheses can be considered suitable for modelling the behaviours of simple supported non-prismatic RC beams under vertical concentrated loads. The numerical results showed that altering the cross-section from solid to hollow could reduce the load carrying capacities of the beams by up to 53% and increase the corresponding deflections by up to 40%, respectively. Using steel pipes for making recesses could enhance the loading capacity by up to 56%, increase the ductility, and reduce the corresponding deflections by up to 30%, respectively. Finally, it was found that bonding the CFRP sheets in the lower middle tensile areas of the hollow beams could improve the resistance and reduce the deformations by up to 27%. The failure patterns for all the numerical models were shear failure. The cylinder compressive strength could be used as a mechanical parameter for modelling and assessing the structural behaviours of the beam models, as its increase could improve the load carrying capacities and reduce the deflections by 30–50%.

A Comparison of Full Arch Trueness and Precision of Nine Intra-Oral Digital Scanners and Four Lab Digital Scanners.

(1) Background: The purpose of this study is to evaluate the full arch scan accuracy (precision and trueness) of nine digital intra-oral scanners and four lab scanners. Previous studies have compared the accuracy of some intra-oral scanners, but as this is a field of quickly developing technologies, a more up-to-date study was needed to assess the capabilities of currently available models. (2) Methods: The present in vitro study compared nine different intra-oral scanners (Omnicam 4.6; Omnicam 5.1; Primescan; CS 3600; Trios 3; Trios 4; Runyes; i500; and DL206) as well as four lab light scanners (Einscan SE; 300e; E2; and Ineos X5) to investigate the accuracy of each scanner by examining the overall trueness and precision. Ten aligned and cut scans from each of the intra-oral and lab scanners in the in vitro study were brought into CloudCompare. A comparison was made with the master STL using the CloudCompare 3D analysis best-fit algorithm. The results were recorded along with individual standard deviation and a colorimetric map of the deviation across the surface of the STL mesh; a comparison was made to the master STL, quantified at specific points. (3) Results: In the present study, the Primescan had the best overall trueness (17.3 ± 4.9), followed by (in order of increasing deviation) the Trios 4 (20.8 ± 6.2), i500 (25.2 ± 7.3), CS3600 (26.9 ± 15.9), Trios 3 (27.7 ± 6.8), Runyes (47.2 ± 5.4), Omnicam 5.1 (55.1 ± 9.5), Omnicam 4.6 (57.5 ± 3.2), and Launca DL206 (58.5 ± 22.0). Regarding the lab light scanners, the Ineos X5 had the best overall trueness with (0.0 ± 1.9), followed by (in order of increasing deviation) the 3Shape E2 (3.6 ± 2.2), Up3D 300E (12.8 ± 2.7), and Einscan SE (14.9 ± 9.5). (4) Conclusions: This study confirms that all current generations of intra-oral digital scanners can capture a reliable, reproducible full arch scan in dentate patients. Out of the intra-oral scanners tested, no scanner produced results significantly similar in trueness to the Ineos X5. However, the Primescan was the only one to be statistically of a similar level of trueness to the 3Shape E2 lab scanner. All scanners in the study had mean trueness of under 60-micron deviation. While this study can compare the scanning accuracy of this sample in a dentate arch, the scanning of a fully edentulous arch is more challenging. The accuracy of these scanners in edentulous cases should be examined in further studies.

088 Irregular Sleep Patterns Predict Worse Sleep Quality and Poorer Psychosocial and Academic Outcomes

Abstract Introduction While the consequences of short sleep duration are well understood, relatively little is known about how irregular sleep durations are related to daily functioning. We utilized actigraphy and self-report methods to investigate the correlates of intraindividual sleep variability in two populations. Methods In Study 1, N=699 adults (mean age=38.04, SD=11.65; 44.78% female) completed online questionnaires on sleep, work status, and time management. In Study 2, N=100 college students (mean age=19.08, SD=1.26; 50% female; 50% underrepresented minorities) wore actiwatches for two one-week sessions (1 month apart) and reported sleep, psychosocial functions, and academic outcomes. In both studies, variability of sleep duration was defined as the individual standard deviation (ISD) of sleep durations. Results In Study 1, after controlling for mean sleep duration, greater variability in sleep duration was related to shiftwork (F=8.68, p=.003), younger age (r=-.15, p<.001), male gender (F=4.43, p=.036), and greater vulnerability to stress (r=.15, p=.001). Beyond mean sleep duration, variability in sleep duration also predicted poorer sleep quality (r=.25, p<.001), greater sleepiness during the day (r=.10, p=.014), poorer time management (r=-.09, p=.031), lower work efficiency (r=-.14, p=.002), and more procrastination (r=.11, p=.009). In Study 2, variability in actigraphy-defined sleep duration increased as the semester progressed (ISD=1.25±0.55 hours at T1; ISD=1.57±0.80 hours at T2, t=4.64, p<.001). After controlling for mean sleep duration, sleep variability was associated with greater perceived stress (r=.31, p=.002 at T1), poorer sleep quality (r=.39, p<.001 at T1; r=.30, p=.003 at T2), and lower expected grades (r=-.27, p=.01 at T2). Sleep variability was unrelated to depression or perceptions of one’s overall health. Conclusion Keeping regular sleep habits appear just as important as average sleep duration to psychosocial, work, and academic outcomes. Sleep interventions should incorporate specific guidelines on how to promote regular sleep and employers should institute work schedules that promote regularity. Support (if any) This work is supported by the National Science Foundation, Psi Chi Honor Society, and the American Psychological Association.

Study of cuffless blood pressure estimation method based on multiple physiological parameters

Objective. Noninvasive blood pressure (BP) measurement technologies have been widely studied, but they still have the disadvantages of low accuracy, the requirement for frequent calibration and limited subjects. This work considers the regulation of vascular activity by the sympathetic nervous system and proposes a method for estimating BP using multiple physiological parameters. Approach. The parameters used in the model consist of heart rate variability (HRV), pulse transit time (PTT) and pulse wave morphology features extracted from electrocardiogram (ECG) and photoplethysmogram (PPG) signals. Through four classic machine learning algorithms, a hybrid data set of 3337 subjects from two databases is evaluated to verify the ability of cross-database migration. We also recommend an individual calibration procedure to further improve the accuracy of the method. Main results. The mean absolute error (MAE) and the root mean square error (RMSE) of the proposed algorithm is 10.03 and 14.55 mmHg for systolic BP (SBP), and 5.42 and 8.19 mmHg for diastolic BP (DBP). With individual calibration, the MAE and standard deviation (SD) is −0.16 ± 7.96 (SBP) and −0.13 ± 4.50 (DBP) mmHg, which satisfied the Advancement of Medical Instrumentation (AAMI) standard. In addition, the models are used to test single databases to evaluate their performance on different data sources. The overall performance of the Adaboost algorithm is better on the Multi-parameter Intelligent Monitoring in Intensive Care Unit (MIMIC) database; the MAE between its predicted value and true value reaches 6.6mmHg (SBP) and 3.12mmHg (DBP), respectively. Significance. The proposed method considers the regulation of blood vessels and the heart by the autonomic nervous system, and verifies its effectiveness and robustness across data sources, which is promising for improving the accuracy of continuous and cuffless BP estimation.

Feasibility of Using Commercially Available Accelerometers to Monitor Upper Extremity Home Practice With Persons Post-stroke: A Secondary Data Analysis

Background: Adherence to home practice rehabilitation programs is important for efficacy; however, adherence is challenging for many individuals post-stroke. Accelerometers have emerged as a potential means to support home practice. This secondary data analysis explored the use of a commercially available accelerometer with custom software to collect and analyze data to corroborate self-reported practice collected during a home program.Methods: The initial study was a single subject design trial that investigated the effect of preferred music listening on adherence to an upper extremity home practice program (Trial Number NCT02906956. ClinicalTrials.gov). The participants (n = 7) were post-stroke adults with aphasia and hemiparesis of the upper extremity. Participants completed home program exercises while wearing accelerometers and recorded practice times in a logbook. Data were collected, cleaned, processed, and analyzed to facilitate descriptive comparisons and clinical interpretations of accelerometer output data.Results: Across all participants, an average of 47% of data were captured and usable for analysis. Five out of seven participants self-reported longer practice times compared to accelerometer duration output by a mean of 66.5 s. Individual exercise set mean total angular velocity and standard deviation of acceleration demonstrated potential for use across time to monitor change.Conclusions: One challenge of integrating accelerometers into clinical practice is the amount of data loss and the steps for data processing. The comparisons of available accelerometer data to the self-reported logs, however, were generally representative. Future investigations should explore ways to increase data capture and accessibility of the data for feedback to the client and practitioner.

Integrated pulmonary index can predict respiratory compromise in high\u2010risk patients in the post\u2010anesthesia care unit: a prospective, observational study

BackgroundRespiratory compromise (RC) including hypoxia and hypoventilation is likely to be missed in the postoperative period. Integrated pulmonary index (IPI) is a comprehensive respiratory parameter evaluating ventilation and oxygenation. It is calculated from four parameters: end-tidal carbon dioxide, respiratory rate, oxygen saturation measured by pulse oximetry (SpO2), and pulse rate. We hypothesized that IPI monitoring can help predict the occurrence of RC in patients at high-risk of hypoventilation in post-anesthesia care units (PACUs).MethodsThis prospective observational study was conducted in two centers and included older adults (≥ 75-year-old) or obese (body mass index ≥ 28) patients who were at high-risk of hypoventilation. Monitoring was started on admission to the PACU after elective surgery under general anesthesia. We investigated the onset of RC defined as respiratory events with prolonged stay in the PACU or transfer to the intensive care units; airway narrowing, hypoxemia, hypercapnia, wheezing, apnea, and any other events that were judged to require interventions. We evaluated the relationship between several initial parameters in the PACU and the occurrence of RC. Additionally, we analyzed the relationship between IPI fluctuation during PACU stay and the occurrences of RC using individual standard deviations of the IPI every five minutes (IPI-SDs).ResultsIn total, 288 patients were included (199 elderly, 66 obese, and 23 elderly and obese). Among them, 18 patients (6.3 %) developed RC. The initial IPI and SpO2 values in the PACU in the RC group were significantly lower than those in the non-RC group (6.7 ± 2.5 vs. 9.0 ± 1.3, p < 0.001 and 95.9 ± 4.2 % vs. 98.3 ± 1.9 %, p = 0.040, respectively). We used the area under the receiver operating characteristic curves (AUC) to evaluate their ability to predict RC. The AUCs of the IPI and SpO2 were 0.80 (0.69–0.91) and 0.64 (0.48–0.80), respectively. The IPI-SD, evaluating fluctuation, was significantly greater in the RC group than in the non-RC group (1.47 ± 0.74 vs. 0.93 ± 0.74, p = 0.002).ConclusionsOur study showed that low value of the initial IPI and the fluctuating IPI after admission to the PACU predict the occurrence of RC. The IPI might be useful for respiratory monitoring in PACUs and ICUs after general anesthesia.

Recommendations for the Propagation of Uncertainty in Hydrogen Exchange-Mass Spectrometric Measurements.

Hydrogen exchange-mass spectrometry (HX-MS) is used widely to characterize higher-order protein structure and to locate changes in protein structure and dynamics that accompany, for example, ligand binding and protein-protein interactions. Quantitative differences in the amount of hydrogen exchange between two states (i.e., differential HX) are taken as evidence of significant differences in higher-order structure or dynamics. The quantitative measures range from simple mass differences at one HX labeling time to differences averaged across an HX time course with correction for deuterium recovery. This work applies the principles of uncertainty propagation to differential HX measurements to facilitate the identification of significant differences. Furthermore, it is shown that pooled estimates of experimental uncertainty result in a lower false positive rate than estimates of uncertainty based on individual standard deviations.

The incubation period of COVID-19: A meta-analysis

ObjectivesA valid measurement of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) incubation period is needed for case definitions and for adapting appropriate isolation measures but is challenging in an emergency context. Our objective was to systematically review recent literature reporting estimates of the distribution of the incubation period of SARS-CoV-2 and describe the distribution and its variability and dispersion through a meta-analysis. MethodsA systematic review was carried out on studies published from 1 January 2020 to 10 January 2021 reporting the SARS-CoV-2 incubation period. Individual mean and standard deviation were used to produce the pooled estimate. Sources of heterogeneity were explored by age, gender and study design using a meta-regression. ResultsIn total, 99 studies were eligible for analysis in our meta-analysis. The pooled estimate of the mean incubation period across the studies was 6.38 days, 95% CI (5.79; 6.97). ConclusionCalculation of the mean incubation period will help with the identification of time of exposure, however, determinants of its variations/range might be explored for potential links with the clinical outcome or pathogenic steps at the early stage of infection. A real-time meta-analysis, named the InCoVid Lyon, is proposed following this initial analysis.

Estimation of Uncertainty of a Volumetric Reservoir Model and Optimization of Numerical Inversion in Well Log Data Interpretation

This study considers an approach to joint inversion of logging data in oil and gas wells for finding the volume fractions of reservoir components. The inversion is reduced to a linear least squares problem with additional iterations to account for physical constraints. To analyse the quality of inversion, uncertainty evaluation tools are developed for both the model responses and inversion results – volume fractions of the reservoir components. The tools include algorithms for construction of depth-related “confidence corridors” for individual properties and standard deviation ellipses to analyse cross-correlations. An optimization problem of improving the quality of inversion by tuning specific readings of logging methods for individual reservoir layers (or facies/lithotypes) is also posed and solved by minimizing a mismatch criterion between the actual and simulated log curves. Thus, the developed toolkit provides a means for optimized joint inversion of logging data with visual control of uncertainty and cross-correlation in the inversion results.

Analysis of end-spurt behaviour in elite 800-m and 1500-m freestyle swimming

To analyse the influence of distance, time point of competition, round and finishing position on end-spurt behaviour in swimming. Race results in 800-m and 1500-m freestyle swimming from the last 8 World Championships and 5 Olympic Games (1998–2016) including 1433 races and 528 swimmers were obtained. The end-spurt for each race was determined by means of an End-Spurt Indicator (ESI). The ESI was calculated by dividing the difference between the swim velocity of the last lap (SVLL) and the mean swim velocity of the middle part of the race (SVMP) by the respective individual standard deviation of SVMP. Subsequently, ESI was used as a dependent variable and influences were analysed using a linear mixed model with fixed effects for distance, time point of competition, round and finishing position. An end-spurt was evident in most swims for both race distances. The mean change in swim velocity between the middle part of the race and the last lap was 0.06 ± 0.02 m/s (1.2 ± 0.2 s) in the 800-m and 0.07 ± 0.02 m/s (1.5 ± 0.2 s) in the 1500-m. The finishing position within a race significantly affected the ESI (P < .001, t = 7.28). Specifically, when analysing finals only, ESI was significantly greater in medallists (5.76; quantile: 3.61 and 8.06) compared to non-medallists (4.06; quantile: 1.83 and 6.82; P = .001). The between-subject standard deviation was 1.66 (Cl: 1.42–1.97) with a relative variance component of 23%, while 77% of ESI variance remained unexplained. This is the first study using a newly developed indicator of end-spurt behaviour demonstrating that particularly medallists have a more pronounced end-spurt compared to non-medallists.