Number Of Position Changes Research Articles

Epileptic seizure forecasting with wearable-based nocturnal sleep features.

Non-invasive biomarkers have recently shown promise for seizure forecasting in people with epilepsy. In this work, we developed a seizure-day forecasting algorithm based on nocturnal sleep features acquired using a smart shirt. Seventy-eight individuals with epilepsy admitted to the Centre hospitalier de l'Université de Montréal epilepsy monitoring unit wore the Hexoskin biometric smart shirt during their stay. The shirt continuously measures electrocardiography, respiratory, and accelerometry activity. Ten sleep features, including sleep efficiency, sleep latency, sleep duration, time spent in non-rapid eye movement sleep (NREM) and rapid eye movement sleep (REM), wakefulness after sleep onset, average heart and breathing rates, high-frequency heart rate variability, and the number of position changes, were automatically computed using the Hexoskin sleep algorithm. Each night's features were then normalized using a reference night for each patient. A support vector machine classifier was trained for pseudo-prospective seizure-day forecasting, with forecasting horizons of 16- and 24-h to include both diurnal and nocturnal seizures (24-h) or diurnal seizures only (16-h). The algorithm's performance was assessed using a nested leave-one-patient-out cross-validation approach. Improvement over chance (IoC) performances were achieved for 48.7% and 40% of patients with the 16- and 24-h forecasting horizons, respectively. For patients with IoC performances, the proposed algorithm reached mean IoC, sensitivity and time in warning of 34.3%, 86.0%, and 51.7%, respectively for the 16-h horizon, and 34.2%, 64.4% and 30.2%, respectively, for the 24-h horizon. Smart shirt-based nocturnal sleep analysis holds promise as a non-invasive approach for seizure-day forecasting in a subset of people with epilepsy. Further investigations, particularly in a residential setting with long-term recordings, could pave the way for the development of innovative and practical seizure forecasting devices. Seizure forecasting with wearable devices may improve the quality of life of people living with epilepsy who experience unpredictable, recurrent seizures. In this study, we have developed a seizure forecasting algorithm using sleep characteristics obtained from a smart shirt worn at night by a large number of hospitalized patients with epilepsy (78). A daily seizure forecast was generated following each night using machine learning methods. Our results show that around half of people with epilepsy may benefit from such an approach.

Comparative evaluation of the sleep quality metrics between a cardboard bed and a camp cot: a randomized controlled crossover study.

Health-beneficial emergency bedding has become increasingly important for dealing with natural disasters such as the anticipated Nankai Trough earthquake in Japan. When the Great East Japan Earthquake occurred, cardboard beds were provided to evacuees. However, there were concerns about lower back pain and sleep disturbances, as cardboard beds offer insufficient pressure distribution. This study aimed to compare the effects of cardboard beds with those of foldable camp cots on sleep quality. A randomized controlled crossover study involving 20 healthy participants aged 18-45 years was conducted between June 2022 and January 2023. Participants were asked to sleep for one night on a camp cot and for another night on a cardboard bed, with a minimum three-day washout period between the two nights. Body pressure distribution and sleep metrics obtained from polysomnography (PSG) and questionnaires were compared between the two-bed types (P < 0.05). The camp cot exhibited better body pressure distribution than a cardboard bed, leading to improved sleep satisfaction, bedding comfort, and reduced morning sleepiness. Nevertheless, polysomnography revealed no notable differences in sleep metrics or sleep architecture between the two types of beds. Our findings indicate that cardboard beds have lower pressure dispersion capabilities than camp cots, leading to an increased number of position changes during sleep. Additionally, subjective sleep quality, such as alertness on waking, sleep comfort, and sleep satisfaction, was lower for cardboard beds, suggesting that camp cots might offer a more comfortable bedding option for evacuees. However, there were no discernible differences between the two-bed types in terms of objective sleep metrics derived from PSG. The potential for sleep disturbances caused by lower back pain from a hard mattress has been noted, and it is possible that a single night's experience in healthy individuals might not be enough for sleep issues to manifest.

To compare the recovery rates of modified Epley's against Semont's manoeuvres in patients with posterior canal benign paroxysmal positional vertigo: a randomized clinical trial.

Benign paroxysmal positional vertigo (BPPV) is one of the commonest causes of peripheral vertigo. It is treated with various canalolith repositioning manoeuvres by changing the head positions to allow the otoconial debris to fall back from the affected canal back to the utricle. The present study has compared the rate of recovery of vertigo with modified Epley's manoeuvres as compared to Semont's manoeuvre in patients with posterior canal BPPV. One hundred and seventy patients diagnosed by positive Dix-Hallpike test as posterior canal BPPV were included in this clinical trial. Subjective analysis of vertigo was done using visual analogue scale. 85 patients each were recruited in two arms by simple randomization using lottery method. Modified Epley's manoeuvre was administered to one group and Semont's manoeuvre to the other. They were recalled after 2weeks for clinical assessment with repeat Dix-Hallpike and VAS. Repeat Dix-Hallpike manoeuvres after two weeks revealed that 95.3 and 90.6% patients improved in Modified Epley's and Semont's group, respectively. After the second manoeuvre, the resolution rate was significantly higher in Semont's manoeuvre 100% (8 out of 8 patients), as compared to 25% (1 out of 4 patients) in Modified Epley's manoeuvre. Comparison of the mean values of VAS day 0 and VAS 2 weeks has been found to be statistically significant (p value of < 0.001). Both Epley's and Semont's manoeuvre are equally efficacious in treatment of BPPV. However, use of Semont's manoeuvre required fewer repeat manoeuvres for complete resolution of symptoms in patients. The Semont's manoeuvre is also comparatively easier to perform with less number of position changes, takes less time, and has no requirement of post-manoeuvre mobility restrictions. Hence, it is recommended that Semont's manoeuvre can be routinely used for the management of PC BPPV especially in older population and patients with spinal problems.

Improving Nurse Management of the Second Stage of Labor

ObjectiveTo develop, implement, and evaluate an educational program to improve nurses’ management of the second stage of labor. DesignEvidence-based practice project guided by the Iowa Model–Revised. SettingAcute care teaching hospital in central California averaging 2,100 births/year with 12 labor, delivery, and recovery rooms and a Level III nursery. ParticipantsEighteen registered nurses participated in the educational intervention. InterventionAn instructional course addressed contemporary labor management guidelines and delayed and open/closed glottis pushing. Assessment/documentation of maternal–fetal status, progress/fetal descent, and nurse/provider communication were discussed. Participants engaged in an interactive experience regarding maternal positions. MeasurementsData collected from the electronic health record included the number of position changes, nurse/provider communication interactions, and minutes from 10 cm to birth and minutes in delayed pushing. ResultsSecond-stage labor outcomes for nulliparous patients at term with a singleton in vertex presentation improved with more position changes and percentage of spontaneous vaginal births. Patients of nurses who participated in the educational intervention (n = 18) had a vaginal birth rate of 87.5% and a surgical birth rate of 6.2%. Patients of nurses who did not participate in the educational intervention (n = 31) had a vaginal birth rate of 81.8% and a surgical birth rate of 9.1%. ConclusionBased on the positive response to the intervention and improved clinical outcomes, regularly scheduled interactive nursing education focused on strategies to improve the second stage of labor may be beneficial.

Analysis of image-based sow activity patterns reveals several associations with piglet survival and early growth.

An activity pattern describes variations in activities over time. The objectives of this study are to automatically predict sow activity from computer vision over 11 days peripartum and estimate how sow behavior influences piglet's performance during early lactation. The analysis of video images used the convolutional neural network (CNN) YOLO for sow detection and posture classification of 21 Large White and 22 Meishan primiparous sows housed in individual farrowing pens. A longitudinal analysis and a clustering method were combined to identify groups of sows with a similar activity pattern. Traits under study are as follows: (i) the distribution of time spent daily in different postures and (ii) different activities while standing. Six postures were included along with three classes of standing activities, i.e., eating, drinking, and other, which can be in motion or not and root-pawing or not. They correspond to a postural budget and a standing-activity budget. Groups of sows with similar changes in their budget over the period (D-3 to D-1; D0 and D1-D7) were identified with the k-means clustering method. Next, behavioral traits (time spent daily in each posture, frequency of postural changes) were used as explanatory variables in the Cox proportional hazards model for survival and in the linear model for growth. Piglet survival was influenced by sow behavior on D-1 and during the period D1-D7. Piglets born from sows that were standing and doing an activity other than drinking and eating on D-1 had a 26% lower risk of dying than other piglets. Those born from sows that changed posture more frequently on D1-D7 had a 44% lower risk of dying. The number of postural changes, which illustrate sow restlessness, influenced piglet growth in the three periods. The average daily gain of piglets born from sows that were more restless on D1-D7 and that changed posture more frequently to hide their udder on D0 decreased by 22 and 45 g/d, respectively. Conversely, those born from sows that changed posture more frequently to hide their udder during the period of D1-D7 grew faster (+71 g/d) than the other piglets. Sow restlessness at different time periods influenced piglet performance.

Relationship Between Neck Pain, Disability and Head Posture in Women Six Months Post Delivery

Background: In pregnancy and post-partum period, there are different structural, hormonal and physiological changes occurring in women’s body. The musculoskeletal changes women undergo are ligamentous and collagenous connective tissue changes that lead to increased joint laxity and hypermobility. Usually, these hormonally mediated changes return to their normal pre-pregnant state by six months post-delivery. During the postpartum period, women have to deal with emotional and ergonomic stress due to increased responsibilities such as breastfeeding, nappy changing, maneuvering the baby causing a number of postural changes in them leading to pain which can cause disability and other musculoskeletal discomfort to perform daily activities. Aim and Objectives: To assess the relationship between neck pain, disability and head posture in women six months post delivery. Method: Sixty subjects were selected as per inclusion and exclusion criteria. Numerical Pain Rating Scale (NPRS) and Neck Disability Index (NDI) Questionnaire was used to evaluate neck pain and disability. The forward head posture was measured via craniovertebral (CV) angle by using Marcus Brader (MB) Ruler Software. Pearson’s correlation coefficient between NPRS, NDI and CV angle were determined. Result: NPRS was positively correlated with NDI (r = 0.9072, p= &lt;0.0001) and negatively correlated with CV angle (r = -0.3643, p=0.0036). No significant correlation was shown between NDI and CV angle. Conclusion: The present study concluded that women with small craniovertebral angle have a greater forward head posture, and the greater the forward head posture the greater is the pain and disability. Keywords: Correlation, neck pain, neck disability, craniovertebral angle.

0713 Longitudinal Sleep Position Patterns and Breathing Parameters in Pregnancy

Abstract Introduction Supine sleep position during pregnancy has been linked to increased risk of stillbirth in retrospective studies. However, existing literature is largely cross-sectional and limited by recall bias and self-reporting of sleep position. This study aims to use objectively-measured sleep position to quantify sleep position change between trimesters and its influence on maternal respiratory health. Methods This study is a secondary analysis of data from a study investigating maternal sleep, among women with singleton pregnancies and overweight or obesity. Each participant underwent level III sleep apnea monitoring using Noxturnal T3 devices (Nox Medical, Georgia, US), in the first (0-12 weeks) and third (29-40 weeks) trimester of pregnancy. Using accelerometry, the software differentiated 5 positions including supine, right lateral, left lateral, prone, and upright. The studies were scored using AASM 2012 recommended criteria. The first non-upright position was recorded as going-to-bed position. The number of sleep position changes was calculated using only positions that lasted ≥30 seconds. Results A total of 126 women were included. Mean BMI was 34.00±5.14 and mean age was 30.46±5.40 years. Mean number of position changes was similar in early (14.19±7.82) vs. late (14.58±8.25) pregnancy. There was a significant correlation between sleep onset position and predominant sleep position in both early (p=0.001) and late (p&amp;lt;0.01) pregnancy. However, supine going-to-bed position predicted predominant supine sleep in only 47% of women. There was a significant change in sleep position between early and late pregnancy (p=0.04) with a reduction in supine sleep (51.6% to 30.2%) and an increase in left lateral sleep (24.6% to 37.3%). Only in the third trimester, there was a significant positive correlation between time spent supine and oxygen desaturation index (r=0.22, p=0.01), and a trend toward positive correlation with respiratory event index (r=0.15, p=0.08). Conclusion Going-to-bed position predicts predominant sleep position in less than half of women with overweight and obesity. Time spent supine in late pregnancy correlates with measures of sleep-disordered breathing. More prospective studies are needed to evaluate the potential for sleep position changes over time as a potentially modifiable risk factor for maternal and neonatal health outcomes. Support (If Any) R01HL130702, R01HD078515, SRA grant

Incidence and risk factors for mechanical injuries caused by the transesophageal ultrasound probe manipulation in the setting of transfemoral transcatheter tricuspid repair

Abstract Funding Acknowledgements Type of funding sources: None. Background Leading right heart failure due to tricuspid regurgitation results in retrograde hepatic venous congestion with subsequent gastropathy and hyperemia of the gastric mucosa. Due to increased portal pressure as well as possible cirrhosis cardiaque, the risk for esophageal varices is greatly increased. In addition, associated with atrial dilatation, these patients usually suffer from atrial fibrillation and receive an oral anticoagulation/ direct anticoagulation (OAC/DOAC) as insult prophylaxis. Heparinization with a target ACT &amp;gt; 250 seconds is necessary during transfemoral transcatheter tricuspid repair (TTTR). Alternation between transgastric and midesophageal view with the transesophageal ultrasound probe is usually performed to better guide TTTR. Sufficient wall contact is crucial for good imaging. All of these conditions increase the risk for periprocedural gastric and/or esophageal injury. Purpose The aim of this study was to assess the incidence and risk factors for mechanical irritation and bleeding caused by the TEE probe manipulation in the setting of TTTR. Methods In this prospective cohort study patients received gastroscopy preinterventional and on the first day after TTTR. Statistical analysis was performed with IBM SPSS.28, t-Test was used to compare patients with and without postinterventional lesions. Results From December 2020 to July 2021, 18 patients with indication for TTTR were included in this study. The mean age of the patients was 77.8 (± 7.5) years. Thirteen patients (72.2%) had antral gastritis and 4 patients (22.2%) had corpus gastritis preinterventionally. Esophageal varices were not detectable in any patient. Postinterventionally, 10 patients (55.6%) showed lesions (hematoma or coagulated pressure points) (Fig. 1), and 2 patients (11%) required interventional treatment with hemoclips. The main lesion sites were midesophageal at 20-25 cm, 1 lesion at the Z-line. A mean of 5.7 (± 2.5) position changes took place; the mean procedural duration was 88 (± 27.8) min. The number of clips placed (p = 0.64), the procedural duration (p = 0.99) and the number of position changes (p = 0.48) did not differ between the group of patients with and without injuries after TTTR (Tab 1). Conclusion More than 50% of patients with TTTR showed postprocedural injuries (lesions) of the esophagus. Contrary to our assumption, mainly lesions midesophageal could be detected. Due to the procedure as well as the severe underlying disease, gastrointestinal bleeding is a potential complication in the context of a TTTR. Consideration should be given to implementing regular control gastroscopy after TTTR to reduce the procedure-related complication rate. Due to the high incidence of procedure-related lesions, further research in larger patient collectives is necessary. Abstract Figure. Abstract Figure.

Efficient Position Change Algorithms for Prolonging Driving Range of a Truck Platoon

Cooperative automated driving technology has emerged as a potential way to increase the efficiency of transportation systems and enhance traffic safety by allowing vehicles to exchange relevant information via wireless communication. Truck platooning utilizes this technology and achieves synchronized braking and acceleration, controlling two or more trucks simultaneously. This synchronized control makes driving with a very short inter-vehicle distance among trucks possible and reduces aerodynamic drag. This provides significant fuel consumption reduction, both in leading and trailing trucks, and achieves fuel-saving improvement. However, the static positioning sacrifices trucks in the front since they consume more fuel energy because of more air resistance than the rears. To solve this in-equivalent fuel consumption reduction benefit, this paper presents several heuristic algorithms to balance fuel consumption reduction and prolong the driving ranges by exploiting position changes among trucks in a platoon. Furthermore, the proposed algorithms try to reduce the number of position changes as much as possible to prevent any fuel waste caused by the unnecessary position change operations. In this manner, each truck in the platoon is likely to share a similar fuel consumption reduction with fewer position change counts, thus addressing the challenge of in-equivalent fuel savings distribution and obtaining optimal fuel efficiency. Our extensive simulation results show that the proposed algorithms can prolong the total distance by approximately 3% increased in two-truck platooning and even higher in six-trucks platooning of approximately 8%. Moreover, our proposed algorithms can decrease the position change count and ensure that trucks only switch to position arrangement once with no duplicate. Therefore, truck platooning obtains the maximum driving range with fewer position change counts, thus achieving efficient fuel saving.

Postural Sway Characteristics Are Affected by Alzheimer's Disease.

The vestibular system, responsible for balance, is affected by Alzheimer's disease (AD). In this paper, linear and non-linear balance features were used to assess the postural stability of 13 AD individuals at mild stages in comparison with 16 healthy controls. Utilizing two accelerometers, the anterior-posterior (AP) and medial-lateral (ML) sways were recorded from the T2 vertebrae and lateral malleolus of participants standing on a solid and soft foam surface under both eyes-open and eyes-closed conditions. From the recorded signals, four features were extracted and used for statistical analysis: Number of Position Changes (NPC), Number of Non-Zero Accelerations (NNZA), Katz, and Higuchi fractal dimensions (KFD and HFD, respectively). The results show: 1) postural stability is significantly worse for the eyes-closed compared to eyes-open condition (P<0.05 for all features except HFD) as well as whilst standing on soft foam compared to the solid surface (P<0.05 for all features) in both groups; 2) balance perturbations were larger for AP sway than ML on both solid and foam surfaces in both groups (P<0.05 for NPC and NNZA); and 3) stationary balance is significantly poorer for AD individuals compared to controls (P<0.05 for all features). These observations show that both linear and non-linear characteristics of postural stability data have the potentials to be used as objective diagnostic aids for the detection of AD.

Estrus detection in tie-stall housed cows through supervised machine learning using a multimodal tail-attached device

In this study, the authors developed a novel multimodal tail-attached device with a thermistor and 3-axis accelerometer that can monitor physiological (body surface temperature (ST)) and behavioral (activity intensity, standing time, and posture changes: standing to lying or vice versa) parameters in cattle. The applicability of the device for estrus detection was also evaluated based on supervised machine learning using the data obtained by continuous measurements of these parameters in tie-stalled cows. Data were collected at 3-min intervals for a total of 25 estrous cycles of 13 cows from Day 10 of the cycle (Day 0 = ovulation day) until Day 11 of the subsequent cycle. Estrus was confirmed based on the standing-to-be-mounted behavior by testing with herd mates at 6-h intervals. After the end of estrus, transrectal ultrasonography was performed every 2 h to confirm ovulation time. The maximum ST, average activity, standing time, and number of posture changes were calculated per hour. For analysis, the calculated data were expressed as residual values and ratios, namely, residual ST (rST = actual ST − mean ST for the same time in the previous three days) and ratios of activity intensity, standing time, and posture change (each ratio = total value during the last 24 h / total value during the last 24–48 h). The mean rST and ratios of activity intensity and standing time gradually increased to approximately 60 h before ovulation, with a peak at estrus (approximately 24 h before ovulation). The posture change ratio started to decrease from approximately 48 h before ovulation and reached its lowest level at the onset of estrus (approximately 30 h before ovulation). A total of 20 features (5 physiological and 15 behavioral features) that could to follow-up the estrus-associated changes were extracted and used for developing nine estrus detection models based on 3 feature sets (physiological features alone, behavioral features alone, and a combination of these features) and 3 machine learning algorithms (decision tree, artificial neural network, and support vector machine (SVM)). Cross-validation showed that the sensitivity of the models tended to be high when using a combination of physiological and behavioral features, regardless of the algorithms, although there was no statistical difference in precision among the nine models. The best model generated by the SVM could detect the estrus with a sensitivity of 92.0% and precision of 54.8%, indicating that the newly developed multimodal tail-attached device has the potential for estrous detection in tie-stalled cows.

Optimization of Robot Posture and Workpiece Setup in Robotic Milling With Stiffness Threshold

Industrial robot provides a promising alternative in freeform surface milling. However, due to its low stiffness, it is difficult to guarantee the machining quality. While existing research considers mainly the influence of robot posture on stiffness, the workpiece setup&#x0027;s influence is equally important. In this article, to ensure the overall workpiece&#x0027;s robot stiffness meets the requirement of stiffness threshold in robotic milling, a method for simultaneously optimizing the robot posture and the workpiece setup is proposed. First, to evaluate the robot stiffness during machining, this article presents a new stiffness index considering the robot&#x0027;s rotational deformation. And then, an optimization model is established to optimize both the robot redundancy and the workpiece setup, considering the constraints of joint limitation, singularity-free and collision-free. Moreover, for complex freeform surfaces, to obtain the minimum number of posture changes of the robot and workpiece under the premise of meeting the limit of stiffness threshold, this article constructs a minimum set covering problem, which is solved by a clustering algorithm and a greedy algorithm. Finally, simulations and experimental studies are conducted to validate the effectiveness of the proposed robot stiffness index and the proposed optimization method, showing that the robot stiffness is improved during a milling process of the entire workpiece.

Strategic use of straw as environmental enrichment for prepartum sows in farrowing crates

Sows are highly motivated to build a nest prior to farrowing, but, given the barren environment of farrowing crates, this behaviour is limited and improperly expressed. We aimed to assess the effects of a straw provision in the farrowing crate as environmental enrichment in the prepartum period on: 1) sows' reproductive and behavioural responses before, during and after farrowing, and 2) piglets' performance during lactation. Multiparous sows (N = 32) were assigned according to parity to two enrichment conditions: 1) Control sows, and 2) Straw sows, (N = 16 sows/treatment). In the control treatment, the sows were kept in farrowing crates with no environmental enrichment. In the straw treatment, straw was provided in the farrowing crate by purpose-built boxes attached to the crate bars next to the sows. Straw was provided 24 h prior to the expected due date and removed after farrowing. Sows' behaviours (N = 12 sows/treatment) were recorded uninterruptedly from 12 h prior to farrowing until the 13th day of lactation. Data on reproductive performance (number of liveborn and stillborns, farrowing duration, and births interval) were collected. Five piglets were selected from each sow for assessment of performance and levels of blood lactate. All piglet deaths, as well as their causes, were recorded. Sows from straw treatment exhibited a higher frequency of nest-building behaviour and lower frequency of stereotyped behaviour and sitting posture (P < 0.05). No differences were found in the sows’ behaviours during farrowing (P > 0.05). The sows from control treatment exhibited a higher number of posture changes (P = 0.057). The frequency of nursing was higher in the sows that had access to straw (P < 0.05). No differences were observed in reproductive performance (P> 0.05). Providing straw had no effects on performance, lactate levels, or postnatal mortality of piglets (P > 0.05). Providing nesting material in the farrowing crate improves the welfare of sows by increasing their motivation to build the nest and reducing the stereotyped behaviours prior to farrowing. Moreover, access to straw reduces sow unrest during farrowing and stimulates the maternal behaviour of nursing.

Cyclosporine Improves Sleep Quality in Patients with Atopic Dermatitis

IntroductionAtopic dermatitis (AD) is a chronic, relapsing, inflammatory skin disease characterized by eczema and pruritus, and frequently impairs sleep quality. Although cyclosporine improves symptoms of AD, objective evaluation of sleep in patients with AD treated with cyclosporine has not been reported. This study was conducted to elucidate the effects of cyclosporine on sleep quality for patients with AD.MethodsTwelve patients with moderate-to-severe AD were recruited. Nocturnal sleep quality was evaluated for 7 days using a sleep analyzer, which patients wore at the waist before and after cyclosporine was administered at 2.0–4.0 mg/kg per day. Seven parameters of sleep quality were measured before and after cyclosporine administration for a period of 7 days for each patient.ResultsThe administration of cyclosporine significantly improved total sleep time in four cases, sleep latency in two cases, wake after sleep onset in six cases, number of awakenings in two cases, sleep efficiency in seven cases, number of awakenings for more than 8 min in three cases, and number of position changes recorded every 2 min in three cases. The mean values of sleep latency significantly decreased after cyclosporine administration (P = 0.023). The mean value of sleep efficiency significantly increased after the administration (P = 0.002).ConclusionCyclosporine improves sleep quality in patients with moderate-to-severe AD.Electronic supplementary materialThe online version of this article (10.1007/s13555-020-00451-2) contains supplementary material, which is available to authorized users.

Social behaviour of European grayling before and after flow peaks in restored and unrestored habitats

AbstractCost‐effective implementation of fish‐friendly hydropower flow operation and habitat restoration measures require an understanding of their effects on fitness‐related behaviours of stream fish. Here, we investigated how changes in flow and bottom structure influence the social behaviour of European grayling, using large experimental flumes (700 L s−1), with and without added boulders (i.e., restored and unrestored habitat). Grayling increased their distance to nearest neighbour at the start of flow ramping up and after a flow peak compared to stable base flow. At the start of ramping up the flow, grayling made less position changes (movements &gt;1 m) than at stable base flow and after a flow peak. In the unrestored habitat, the proportion of time grayling spent actively swimming was lower before a flow peak than it was both at the start of ramping up the flow and after the peak, an effect not found in the restored habitat. In addition, we compared two static flows, and habitat restoration mediated their effect on distance to nearest neighbour. Grayling in the restored habitat were positioned closer to each other in the low (~10 cm s−1) than in the intermediate static flow (~40 cm s−1), whereas in the unrestored habitat, grayling showed the opposite pattern. Moreover, grayling reduced their number of position changes in the intermediate static flow, which was reflected by a reduction in active swimming. Stomach analysis after the trials revealed that foraging success was higher in variable than in the stable flow treatment. These results show that flow magnitude, flow changes and instream structure play important roles in the behaviour of stream fishes.

Role of Wearable Accelerometer Devices in Delirium Studies: A Systematic Review.

PubMed, Embase, and Web of Science. Screening was performed using predefined search terms to identify original research studies using accelerometer devices for studying physical activity in relation to delirium. Key data were extracted from the selected articles. Among the 14 studies identified, there were a total of 315 patients who wore accelerometer devices to record movements related to delirium. Eight studies (57.1%) used accelerometer devices to compare the activity of delirious and nondelirious patients. Delirious patients had lower activity levels, lower restlessness index, higher number of daytime immobility minutes, lower mean activity levels during the day, and higher mean activity levels at night. Delirious patients also had lower actual sleep time, lower sleep efficiency, fewer nighttime minutes resting, fewer minutes resting over 24 hours, and smaller change in activity from day to night. Six studies (42.9%) evaluated the feasibility of using accelerometer devices for detection of delirium and its subtype. Variables including number of postural changes during daytime, frequency of ultrashort, short, and continuous movements were significantly different among the nondelirium and the three delirium subtypes. The results from the studies using accelerometer devices in studying delirium demonstrate that accelerometer devices can potentially detect the differences between delirious and nondelirious patients, detect delirium, and determine delirium subtype. We suggest the following directions as the next steps for future studies using accelerometer devices for predicting delirium: benchmark studies with longer data collection, larger and more diverse population size, incorporating related factors (e.g., medications), and evaluating delirium subtype and severity.

The course of parturition in two sow genotypes and two hut designs under free-range conditions

High piglet mortality remains a major challenge in outdoor pig production. The use of hyper prolific sow genotypes giving birth to large litters may prolong parturition and cause parturition-related problems under outdoor conditions where birth assistance cannot easily be provided. Therefore, the aim of the current study was to investigate the course of parturition and maternal protectiveness in two sow genotypes and two farrowing hut designs. Secondly, the aim was to investigate if the course of parturition (parturition duration and posture changes during parturition) constituted a significant risk for pre- and postnatal piglet mortality. Sows gave birth in four batches of 10–11 Danbred Landrace × Yorkshire crossbred sows (in first and then second parity) and 10–12 Topigs Norsvin TN70 sows (in first and then second parity). Within batch, six sows of each genotype gave birth in a communal hut, and the remaining sows in each batch in standard A-frame huts. Neither genotype nor hut design significantly affected parturition duration. Sows spent the majority of time lying in lateral position during the first 3 h of parturition (median 120.0 min, range 0–180 min) although they changed posture 23 times (median, range 0–110) during these three hours. The behaviour (time spent in lateral and sternal position, standing and number of posture changes) of the sows during the first 3 h of parturition depended on both sow genotype and parity. Furthermore, Topigs Norsvin sows stayed closer to their piglets during piglet processing, but sow agitation score was unaffected by genotype. A longer parturition increased the risk of having at least one stillborn piglet in the litter (P = 0.003) and the risk of postnatal mortality (P = 0.051). The hourly number of posture changes during parturition did, however, not influence postnatal mortality.

Can Water Exchange Improve Patient Tolerance in Unsedated Colonoscopy A Prospective Comparative Study

Background & Aims: Unsedated colonoscopy can be painful, poorly tolerated by patients, and associated with unsatisfactory technical performance. Previous studies report an advantage of water exchange over conventional air insufflation in reducing pain during unsedated colonoscopy. Our goal was to analyze the impact of water exchange colonoscopy on the level of maximum pain reported by patients submitted to unsedated colonoscopy, compared to conventional air insufflation. Methods: We performed a single-center, patient-blinded, prospective randomized comparative study, where patients were either allocated to the water group, in which the method of colonoscopy used was water exchange, or the standard air group, in which the examination was accomplished with air insufflation. Results: A total of 141 patients were randomized, 70 to the water and 71 to the air group. The maximum level of pain reported by patients during unsedated colonoscopy, measured by a numeric scale of pain (0-10), was significantly lower in the water group (3.39 ± 2.32), compared to the air group (4.94 ± 2.10), p < 0.001. The rate of painless colonoscopy was significantly higher in the water group (12.9 vs. 1.4%, p = 0.009). There were no significant differences between the two groups regarding indications for the procedure, quality of bowel preparation, cecal intubation time, withdrawal time, number of position changes, adenoma detection rate, and postprocedural complications. Only the number of abdominal compressions was significantly different, showing that water exchange decreases the number of compressions needed during colonoscopy. Conclusions: Water exchange was a safe and equally effective alternative to conventional unsedated colonoscopy, associated with less intraprocedural pain without impairing key performance measures.

Ergonomic Evaluation of Office Furniture on Team Dynamics

Office workers are at high-risk for work-related musculoskeletal disorders (WMSDs), which can inhibit productivity and perceived comfort through associated disorders (Piligian et al, 2000). An increase in WMSDs has created a demand for ergonomic office interventions. Recent ergonomic advancements have focused on dynamic office furniture that aim to promote chairs featuring structural designs (Ellegast et al, 2012). Dynamic office furniture lacking a range of specific and modifiable adjustments can lead to adverse outcomes, such as nerve compression, resulting in perceived discomfort and increased risk of musculoskeletal disorders (Groenesteijn et al, 2009; Legg et al, 2002). However, there is limited research regarding the relationship of posture changes and the effects on perceived comfort and task performance. The objective of the study was to explore the relationship between perceived comfort, productivity, postural changes, and adjustability in chairs with varying degrees of adjustability. The study consisted of 44 participants (54.5% males, 22.8 (2.89) years) attending three different days, working together in teams of 2-3, to complete a 3-hour simulated office task related to construction science. Tasks required team collaboration to evaluate construction bids, develop plan of actions, and present conclusions to each task. To determine the ergonomic impact of office furniture on team creativity and productivity on the design project, two different types of chairs were employed that varied in the level of user involvement for chair adjustments – no involvement without adjustment and high involvement with adjustment, each presented on separate days. Subjective surveys were used at the end of every session to evaluate the chair used in that session that determined individual satisfaction, usability, and perceived discomfort levels. Continuous video obtained during the sessions were analyzed to obtain the number of postural changes (e.g., bending from side to side, shoulders or back ‘drooping’), chair adjustments made, unintended jerks, and chair switches throughout each time period (for a total of 3 time periods) on each day. Performance on the simulated construction science tasks were assessed using a predetermined rubric that included components such as document completion, completed summaries, and presentations to obtain a total performance score. Reported here are preliminary findings from the video analyses and discomfort surveys. A 2-chair x 3-time repeated measures analysis of variance (ANOVA) on postural change over time revealed that postural changes on the chair associated with no involvement without adjustment was higher than that of high involvement with adjustment, however this was only seen in times 1 and 2. This implies that the benefit of adjustments are likely lost over time. Separate one-way ANOVAs were performed on discomfort scores to test the effects of the two chairs. Overall, perceived discomfort across different body regions did not differ between chairs. It is likely that more postural changes were needed to maintain initial comfort levels in the no involvement no adjustment chair studied and were necessary to minimize discomfort. Preliminary findings obtained here will help identify the extent to which postural deviations affect team productivity and responses on discomfort and strain.

Spatial exploration and changes in infant-mother dyads around transitions in infant locomotion.

Infants' motor skill development triggers changes in parent-infant interactions, exploration, and play behaviors, particularly during periods of locomotor transitions. We investigated how these transitions reorganized infants' and mothers' explorations of spatial layouts. Thirteen infants and their mothers were followed biweekly from the age of 6 to 17 months. This report focused on 2 periods of 6 sessions surrounding infants' hands-and-knees crawling and walking onsets. Infants' and mothers' activities were monitored during 10-min free-play sessions held in a laboratory room provided with toys and furniture. Using location coordinates for the mother and infant, we derived several measures of spatial displacement and exploration as both mother and infant moved around the room. We also observed variations in mothers' and infants' interactive behaviors and postural changes within and across sessions. Infants increased interactive behaviors, traveled further distances, and visited more places in the room over time than their mothers. This increase occurred particularly after infants became experienced hands-and-knees crawlers. The distance between infant and mother and number of postural changes also increased as infants became more mobile. This study reveals that mother-infant explorations of spatial layouts diversify and reorganize over time as infants develop new locomotor skills. (PsycINFO Database Record