Qualitative Fit Research Articles

Analytical evaluation of eight qualitative FIT for haemoglobin products, for professional use in the UK.

Qualitative faecal immunochemical tests for haemoglobin (FIT), for triaging for colorectal cancer investigations, are available for professional use. The aim was to evaluate these lateral flow tests. No previous analytical evaluations have been published. Analytical sensitivity (AS) was assessed using samples spanning manufacturers' quoted AS, concurrently with the quantitative OC-SENSOR PLEDIA, using Hb-spiked samples in manufacturers' buffer (n≥5;≤9-99 ng Hb/mL buffer), Hb-spiked faeces (n=6;<2-34 µg Hb/g faeces) and natural faeces (n=17;<2-82 μg/g); concentrations for 50 %/100 % Hb-detected were compared with quoted AS. Compatibility with two external quality assessment schemes (EQAS) (n=9; 3-96 μg/g) and prozone compared with manufacturers limits (n=9; 2,500-10,000,000 ng/mL) were tested. Ease-of-use by five healthcare personnel was assessed. Seven products showed lower AS (ng/mL) than manufacturers quoted using Hb-spiked aqueous samples compared with OC-SENSOR, one was equivocal; six manufacturers quoted AS in µg/g, five showed lower AS using Hb-spiked faeces. Results were similar but less consistent for natural faeces. Result lines for low concentrations can be faint and open to interpretation. Results were consistent with manufacturers quoted prozone limits. Results were consistent for seven products for two EQAS. The ease-of-use was 68.5-85.6 %; products with lower scores could be improved with better instructions and sample bottles. AS was lower for seven products (aqueous samples) and five products (aqueous/faecal samples) and prozone consistent with manufacturers expected concentrations, compared with OC-SENSOR. EQAS results were mostly consistent with expected results; products can be used by healthcare professionals, though some manufacturer improvements could be made.

Cepheid Metallicity in the Leavitt Law (C- MetaLL) survey. VI. Radial abundance gradients of 29 chemical species in the Milky Way disc

Classical Cepheids (DCEPs) are crucial for calibrating the extragalactic distance ladder, ultimately enabling the determination of the Hubble constant through the period-luminosity ($PL$) and period-Wesenheit ($PW$) relations that they exhibit. Hence, it is vital to understand how the $PL$ and $PW$ relations depend on metallicity. This is the purpose of the C-MetaLL survey, within which this work is situated. The DCEPs are also very important tracers of the young populations placed along the Galactic disc. We aim to enlarge the sample of DCEPs with accurate abundances from high-resolution spectroscopy. In particular, our goal is to extend the range of measured metallicities towards the metal-poor regime to better cover the parameter space. To this end, we observed objects in a wide range of Galactocentric radii, allowing us to study in detail the abundance gradients present in the Galactic disc. We present the results of the analysis of 331 spectra obtained for 180 individual DCEPs with a variety of high-resolution spectrographs. For each target, we derived accurate atmospheric parameters, radial velocities, and abundances for up to 29 different species. The iron abundances range between 0.5 and $-$1 dex with a rather homogeneous distribution in metallicity. The sample presented in this paper was complemented with that already published in the context of the C-MetaLL survey, resulting in a total of 292 pulsators whose spectra have been analysed in a homogeneous way. These data were used to study the abundance gradients of the Galactic disc in a range of Galactocentric radii ($R_ GC $) spanning the range of 5-20 kpc. For most of the elements, we have found a clear negative gradient, with a slope of $-0.064 0.003$ dex $ for Fe/H case. Through a qualitative fit with the Galactic spiral arms, we show how our farthest targets ( $R_ GC $ &gt;10 kpc) trace both the Outer and Outer Scutum-Centaurus arms. The homogeneity of the sample will be of pivotal importance for the study of the metallicity dependence of the DCEP $PL$ relations.

Impact of Hydrocolloid Dressing and Moisturizing Cream as Facial Skin Protectants Among Health Care Workers.

During the novel coronavirus disease 2019 pandemic, health care workers experienced facial problems from prolonged use of N95 masks, including skin irritation, pigmentation changes, and contact dermatitis. We assessed the use of hydrocolloid dressing versus dimethicone cream to prevent skin breakdown among military health care workers while wearing an N95. Participants were recruited using convenience and snowball sampling in this nonblinded, randomized, cross-over study with 2 active treatments, hydrocolloid dressing and dimethicone cream, across 3 time points. The skin was assessed using photographs and subepidermal moisture scanner (SEM). N95 seal integrity was assessed using qualitative fit test. Institutional review board approval was obtained from the Madigan Army Medical Center Institutional Review Board. Among the 73 participants, wearing an N95 alone versus with dimethicone cream or hydrocolloid dressing caused more adverse skin reactions. There were no significant differences in qualitative fit test failure rate between groups. Participants experienced minimal to no dizziness, loss of energy/tiredness/fatigue, claustrophobia, shortness of breath, difficulty breathing, and dry or itchy eyes. For all interventions, wearing an N95 did not interfere with participants' concentration, verbal communication, hearing, vision, and, importantly, delivery of care. Using a skin protectant with an N95 may prevent adverse skin reactions while preserving health care workers' ability to safely and competently care for patients in routine and pandemic conditions.

Does Freehand, Patient-specific Instrumentation or Surgical Navigation Perform Better for Allograft Reconstruction After Tumor Resection? A Preclinical Synthetic Bone Study.

Joint-sparing resection of periarticular bone tumors can be challenging because of complex geometry. Successful reconstruction of periarticular bone defects after tumor resection is often performed with structural allografts to allow for joint preservation. However, achieving a size-matched allograft to fill the defect can be challenging because allograft sizes vary, they do not always match a patient's anatomy, and cutting the allograft to perfectly fit the defect is demanding. (1) Is there a difference in mental workload among the freehand, patient-specific instrumentation, and surgical navigation approaches? (2) Is there a difference in conformance (quantitative measure of deviation from the ideal bone graft), elapsed time during reconstruction, and qualitative assessment of goodness-of-fit of the allograft reconstruction among the approaches? Seven surgeons used three modalities in the same order (freehand, patient-specific instrumentation, and surgical navigation) to fashion synthetic bone to reconstruct a standardized bone defect. National Aeronautics and Space Administration (NASA) mental task load index questionnaires and procedure time were captured. Cone-beam CT images of the shaped allografts were used to measure conformance (quantitative measure of deviation from the ideal bone graft) to a computer-generated ideal bone graft model. Six additional (senior) surgeons blinded to modality scored the quality of fit of the allografts into the standardized tumor defect using a 10-point Likert scale. We measured conformance using the root-mean-square metric in mm and used ANOVA for multipaired comparisons (p < 0.05 was significant). There was no difference in mental NASA total task load scores among the freehand, patient-specific instrumentation, and surgical navigation techniques. We found no difference in conformance root-mean-square values (mean ± SD) between surgical navigation (2 ± 0 mm; mean values have been rounded to whole numbers) and patient-specific instrumentation (2 ± 1 mm), but both showed a small improvement compared with the freehand approach (3 ± 1 mm). For freehand versus surgical navigation, the mean difference was 1 mm (95% confidence interval [CI] 0.5 to 1.1; p = 0.01). For freehand versus patient-specific instrumentation, the mean difference was 1 mm (95% CI -0.1 to 0.9; p = 0.02). For patient-specific instrumentation versus surgical navigation, the mean difference was 0 mm (95% CI -0.5 to 0.2; p = 0.82). In evaluating the goodness of fit of the shaped grafts, we found no clinically important difference between surgical navigation (median [IQR] 7 [6 to 8]) and patient-specific instrumentation (median 6 [5 to 7.8]), although both techniques had higher scores than the freehand technique did (median 3 [2 to 4]). For freehand versus surgical navigation, the difference of medians was 4 (p < 0.001). For freehand versus patient-specific instrumentation, the difference of medians was 3 (p < 0.001). For patient-specific instrumentation versus surgical navigation, the difference of medians was 1 (p = 0.03). The mean ± procedural times for freehand was 16 ± 10 minutes, patient-specific instrumentation was 14 ± 9 minutes, and surgical navigation techniques was 24 ± 8 minutes. We found no differences in procedure times across three shaping modalities (freehand versus patient-specific instrumentation: mean difference 2 minutes [95% CI 0 to 7]; p = 0.92; freehand versus surgical navigation: mean difference 8 minutes [95% CI 0 to 20]; p = 0.23; patient-specific instrumentation versus surgical navigation: mean difference 10 minutes [95% CI 1 to 19]; p = 0.12). Based on surgical simulation to reconstruct a standardized periarticular bone defect after tumor resection, we found a possible small advantage to surgical navigation over patient-specific instrumentation based on qualitative fit, but both techniques provided slightly better conformance of the shaped graft for fit into the standardized post-tumor resection bone defect than the freehand technique did. To determine whether these differences are clinically meaningful requires further study. The surgical navigation system presented here is a product of laboratory research development, and although not ready to be widely deployed for clinical practice, it is currently being used in a research operating room setting for patient care. This new technology is associated with a learning curve, capital costs, and potential risk. The reported preliminary results are based on a preclinical synthetic bone tumor study, which is not as realistic as actual surgical scenarios. Surgical navigation systems are an emerging technology in orthopaedic and reconstruction surgery, and understanding their capabilities and limitations is paramount for clinical practice. Given our preliminary findings in a small cohort study with one scenario of standardized synthetic periarticular bone tumor defects, future investigations should include different surgical scenarios using allograft and cadaveric specimens in a more realistic surgical setting.

The influence of an anticline structure on ambient noise spectral anomalies at an underground gas storage

SUMMARY The purpose of this study is to investigate the seismic ambient noise spectral anomalies that occur near gas reservoirs. These anomalies involve a significant spectral amplification of the vertical component for frequencies generally between 1.5 and 4 Hz and have been reported at various hydrocarbon sites worldwide. There are differing views on the mechanisms responsible for these anomalies. The guideline for this study is that many hydrocarbon reservoirs share a common geological feature: an anticline structure. It appears to cause site effects that influence the amplitude of the ambient noise wavefield. This research examines a dense real data set of ambient noise recorded at the Chémery underground gas storage site in France. The analysis identifies stable spectral anomalies between 1.2 and 2.4 Hz that are correlated to the position of the anticline structure, which also corresponds to the position of the gas bubble. We use a beamforming technique to study the composition and the origin of the ambient noise, and show that the variations of the spectral anomalies over time are correlated to changes in the source wavefield. Finally, we perform numerical simulations of Rayleigh wave propagation within a realistic 3-D velocity model of the Chémery site, while using source distributions directly extracted from real data analysis. The comparison of the simulated anomalies with real data yields a satisfactory qualitative fit. We conclude that the fundamental-mode Rayleigh wave site effect on the anticline is the main mechanism of the spectral anomaly.

Incidence of Fit Test Failure During N95 Respirator Reuse and Extended Use

The COVID-19 pandemic resulted in a widespread acute shortage of N95 respirators, prompting the Centers for Disease Control and Prevention to develop guidelines for extended use and limited reuse of N95s for health care workers (HCWs). While HCWs followed these guidelines to conserve N95s, evidence from clinical settings regarding the safety of reuse and extended use is limited. To measure the incidence of fit test failure during N95 reuse and compare the incidence between N95 types. This prospective cohort study, conducted from April 2, 2021, to July 15, 2022, at 6 US emergency departments (EDs), included HCWs who practiced N95 reuse for more than half of their clinical shift. Those who were unwilling to wear an N95 for most of their shift, repeatedly failed baseline fit testing, were pregnant, or had facial hair or jewelry that interfered with the N95 face seal were excluded. Wearing the same N95 for more than half of each clinical shift and for up to 5 consecutive shifts. Participants chose an N95 model available at their institution; models were categorized into 3 types: dome (3M 1860R, 1860S, and 8210), trifold (3M 1870+ and 9205+), and duckbill (Halyard 46727, 46767, and 46827). Participants underwent 2 rounds of testing using a different mask of the same type for each round. The primary outcome was Occupational Safety and Health Administration-approved qualitative fit test failure. Trained coordinators conducted fit tests after clinical shifts and recorded pass or fail based on participants tasting a bitter solution. A total of 412 HCWs and 824 N95s were fit tested at baseline; 21 N95s (2.5%) were withdrawn. Participants' median age was 34.5 years (IQR, 29.5-41.8 years); 252 (61.2%) were female, and 205 (49.8%) were physicians. The overall cumulative incidence of fit failure after 1 shift was 38.7% (95% CI, 35.4%-42.1%), which differed by N95 type: dome, 25.8% (95% CI, 21.2%-30.6%); duckbill, 28.3% (95% CI, 22.2%-34.7%); and trifold, 61.3% (95% CI, 55.3%-67.3%). The risk of fit failure was significantly higher for trifold than dome N95s (adjusted hazard ratio, 1.75; 95% CI, 1.46-2.10). In this cohort study of ED HCWs practicing N95 reuse, fit failure occurred in 38.7% of masks after 1 shift. Trifold N95s had higher incidence of fit failure compared with dome N95s. These results may inform pandemic preparedness, specifically policies related to N95 selection and reuse practices.

Respiratory protective equipment fit tests for researchers at the national synchrotron radiation research center

Researchers at the National Synchrotron Radiation Research Center should use respiratory protective equipment to prevent respiratory damage caused by gases, steam, solvents, chemicals, materials containing toxic substances, and oxygen-deficient environments. Those working with organic matter and certain chemical substances and those exposed to occupation dust should use respiratory protective gear to ensure their health. This study conducted qualitative and quantitative fit tests for various mask brands and sizes, namely 3M-9042, N95-9211, P95-8576, and 3M-6200 masks. The gear worn by all 18 participants in the qualitative fit test passed. By contrast, the gear worn by 12 of the 15 participants in the quantitative test passed; the failure of the remaining gear was due to differences in face shape. The N95-9211 mask can be used in three-piece protective gear because it exhibited a tight fit. Additionally, the 3M-6200 negative-pressure half-face mask exhibited the most satisfactory fit and can be used in protective gear.

SIR Flat CAP (Safety In Radiology - Flat-Packed Compact Airborne Precaution): A Low-Cost, Portable, Negative-Pressure Isolation Barrier Shield for Protecting Frontline Healthcare Workers.

Introduction Multiple barrier shields have been described since the start of the COVID-19 pandemic. Most of these are bulky and designed for use in the main anesthetic or radiology departments. We developed a portable, negative-pressure barrier shield designed specifically for portable ultrasound examinations.A novel supine cough generation model was developed together with a reverse qualitative fit test to simulate real-world aerosol droplet generation and dispersion for evaluating the effectiveness of the barrier shield.We report the technical specifications of this design, named "SIR Flat CAP" from Safety In Radiology - Flat-packed Compact Airborne Precaution, as well as its performance in reducing the spread of droplets and aerosols. Methods The barrier shield was constructed using 1 mm acrylic panels, clear packing tape, foam double-sided tape, and surgical drapes. Negative pressure was provided via hospital wall suction. A supine cough generation model was developed to simulate cough droplet dispersal. A reverse qualitative fit test was used to assess for airborne transmission of microdroplets. Results The supine cough generation model was able to replicate similar results to previously reported supine human cough generation dispersion. The use of the barrier shield with negative-pressure suction prevented the escape of visible droplets, and no airborne microdroplets were detected by reverse qualitative fit testing from the containment area. Conclusions The barrier shield significantly reduces the escape of visible and airborne droplets from the containment area, providing an additional layer of protection to front-line sonographers.

Evaluation of Removable Partial Denture Metal Frameworks Produced by Digital Methods—A Systematic Review

(1) Introduction: This review aimed to synthesize the significant literature addressing digital techniques for producing removable partial denture (RPD) metal frameworks, focusing on oral fit outcomes. (2) Material and Methods: A systematic review of the Web of Science and Pubmed databases was performed according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) guidelines. The selection was for original articles in English containing relevant data on RPD metal frameworks produced with digital techniques, including study characteristics, digital techniques, and fit assessment methods and outcomes. (3) Results: From the 967 search studies, 405 were duplications, and 521 were excluded after screening against set criteria. A manual search included 21 studies resulting in 62 papers for review. Extra-oral was more frequently used than intra-oral scanning. The computer-assisted design was the most applied digital technique. Additive manufacturing was preferred to milling for direct and indirect fabrication of frameworks. Fit assessments were based on qualitative measures, but quantitative evaluation showed acceptable clinical fit for RPDs made by digital protocols. (4) Conclusions: The combination of direct metal additive manufacturing with conventional impression was the most used protocol and included better qualitative and quantitative fit outcomes than the other digital protocols.

Moist heat as a promising method to decontaminate N95 masks: A large scale clinical study comparing four decontamination modalities—moist heat, steam, ultraviolet-C irradiation, and hydrogen peroxide plasma

BackgroundEarly in the COVID-19 pandemic, there was a global shortage of masks. Although mask reprocessing was practiced, no clinical study has assessed systematically the impact of repeated cycles of wear and decontamination on the integrity of N95 filtering facepiece respirators (FFRs). MethodsWe evaluated mask fit assessed by qualitative respirator fit test (QRFT) after each cycle of wear and decontamination, as well as four measures of mask integrity—bacterial filtration efficacy, particle filtration efficacy, differential pressure, and splash resistance through five cycles of wear and decontamination using one of the four modalities (moist heat, steam, ultraviolet-C irradiation, and hydrogen peroxide plasma). ResultsA total of 60.6% (hydrogen peroxide plasma) to 77.5% (moist heat) of the FFRs passed five cycles of wear and decontamination, as assessed by the wearers passing QRFT all five times. Moist heat-decontaminated FFRs retained all technical measures of integrity through all five cycles. ConclusionsThis is the first large-scale study to assess systematically the impact (clinically and quantitatively) on N95 FFR integrity of repeated cycles of wearing followed by decontamination.Our results suggest that moist heat is a promising method for decontaminating N95 FFRs. Performing QRFT after every cycle of wear and decontamination ensures wearer safety. Although there is currently no mask shortage, reprocessing may reduce medical waste and improve sustainability.

An assessment of the contact rates between individuals when movement is modelled by a correlated random walk

Understanding how individuals come into contact with each other is important in many fields from biology and ecology to robotics and physics. Interaction dynamics are central in understanding how information is spread between agents, how disease spreads through a population, and how group movement or behaviour occurs. However, in many applications, the underlying mode of movement is not considered, and instead, contacts are considered a fraction of all possible contacts amongst a population. This gives rise to the mass-action law which in turn implies a negative quadratic relationship between contacts and individuals. Here we consider how a simple but often used movement model, the correlated random walk, affects the contact rate in a standard Susceptible-Infection (SI) epidemiological model. Via extensive simulation, we show that the contact rate is not always well described by the assumed negative quadratic relationship, I(N-I) (where I is the number of infected at a given time and N the total number of individuals). Instead, we find that a contact rate proportional to {left[I(N-I)right]}^{alpha } with 0<alpha le 1 is a better qualitative fit, where alpha depends upon parameters such as the straightness of the movement and the density of individuals. We highlight that the expected contacts at low densities increase with straight line movement, whereas, at high densities, they increase with more random movement.

Microcosm experiment combined with process-based modeling reveals differential response and adaptation of aquatic primary producers to warming and agricultural run-off.

Fertilizers, pesticides and global warming are threatening freshwater aquatic ecosystems. Most of these are shallow ponds or slow-flowing streams or ditches dominated by submerged macrophytes, periphyton or phytoplankton. Regime shifts between the dominance of these primary producers can occur along a gradient of nutrient loading, possibly triggered by specific disturbances influencing their competitive interactions. However, phytoplankton dominance is less desirable due to lower biodiversity and poorer ecosystem function and services. In this study, we combined a microcosm experiment with a process-based model to test three hypotheses: 1) agricultural run-off (ARO), consisting of nitrate and a mixture of organic pesticides and copper, differentially affects primary producers and enhances the risk of regime shifts, 2) warming increases the risk of an ARO-induced regime shift to phytoplankton dominance and 3) custom-tailored process-based models support mechanistic understanding of experimental results through scenario comparison. Experimentally exposing primary producers to a gradient of nitrate and pesticides at 22°C and 26°C supported the first two hypotheses. ARO had direct negative effects on macrophytes, while phytoplankton gained from warming and indirect effects of ARO like a reduction in the competitive pressure exerted by other groups. We used the process-based model to test eight different scenarios. The best qualitative fit between modeled and observed responses was reached only when taking community adaptation and organism acclimation into account. Our results highlight the importance of considering such processes when attempting to predict the effects of multiple stressors on natural ecosystems.

Development of a Customized Mask Frame Using a Three-Dimensional Facial Scan for an Airtight Seal for Disposable Surgical Face Masks

Abstract Disposable surgical face masks are designed to block the airborne transmission of infectious viruses between patients and healthcare personnel; however, there are limitations to a surgical mask's ability to prevent transmissions because the mask does not provide an airtight seal around the face. This study focuses on the design and development of a custom mask frame, using individuals' three-dimensional (3D) facial scans, to improve the seal of the existing surgical masks. Three participants' facial scans with a wide range of facial dimensions were collected using a 3D hand-held scanner. During design, the contact area between the custom frame and the wearer's skin was determined based on the individual's 3D facial shape. To evaluate the effectiveness of the airtight seal, a qualitative fit (smell/taste) test kit and thermal imaging camera were utilized. When the participants wore the surgical masks without the customized mask frames, the participants smelled the saccharine scent from the test kit. However, while wearing the surgical masks fitted with the custom mask frame that held the mask in place, none of the participants could smell the scent. In addition, thermal images showed ambient temperature changes in the surgical mask suggesting air leakage around the boundary of the mask while the subject was inhaling and exhaling. With the mask frame, thermal images confirmed the effectiveness of the custom frame to block the inflow/outflow of air potentially carrying the virus. The results indicate that the custom-built mask frames are effective in providing a proper and much improved seal compared to a surgical mask without the frame. The developed custom mask frame will be particularly beneficial for frontline medical staff members who treat patients with infectious viruses transmitted through aerosols as part of their PPE.

Ends Against the Middle: Measuring Latent Traits when Opposites Respond the Same Way for Antithetical Reasons

AbstractStandard methods for measuring latent traits from categorical data assume that response functions are monotonic. This assumption is violated when individuals from both extremes respond identically, but for conflicting reasons. Two survey respondents may “disagree” with a statement for opposing motivations, liberal and conservative justices may dissent from the same Supreme Court decision but provide ideologically contradictory rationales, and in legislative settings, ideological opposites may join together to oppose moderate legislation in pursuit of antithetical goals. In this article, we introduce a scaling model that accommodates ends against the middle responses and provide a novel estimation approach that improves upon existing routines. We apply this method to survey data, voting data from the U.S. Supreme Court, and the 116th Congress, and show that it outperforms standard methods in terms of both congruence with qualitative insights and model fit. This suggests that our proposed method may offer improved one-dimensional estimates of latent traits in many important settings.

Inferential results based on Mellin-type statistics for the transmuted inverse Weibull distribution

Different measures of goodness-of-fit provide information to describe how well models fit the data. However, it?s important to note that these measures have shown modest growth in comparison to the emergence of probability distribution models. That said, this research constructed qualitative and quantitative fit measures for Transmuted Inverse Weibull distribution. To develop these Goodness-of-Fit measures, we study some properties of that distribution: we present the Mellin Transform, Log-Moments, and Log-Cumulants. Then, we discuss estimation methods for the model?s parameters, such as Moments, Maximum Likelihood, and the one based on the Log-Cumulants method. The last method mentioned is proposed to estimate the parameters of the distribution. We make the Log-Cumulants diagrams and construct the confidence ellipses. The model is applied to three survival datasets to verify the quality of our estimation methods and Goodness-of-Fitmeasures

THE FIT OF THE HAPA MODEL TO THE EXPERIENCE OF EXERCISING AFTER STROKE: A DEDUCTIVE CONTENT ANALYSIS

Abstract Sustained physical activity is recommended for secondary stroke prevention. Persons with stroke leave rehabilitation having learned exercises to reduce disability. However, once discharged, people may be on their own to navigate psychological, emotional, social, and physical challenges of maintaining those activities and starting new ones. The Health Action Process Approach (HAPA) provides a framework for understanding how self-efficacy differs depending on where a person is in the process of engaging in physical activity. The purpose of this study was to assess the qualitative fit of the HAPA model to the experience of exercise after discharge from formal stroke rehabilitation using a deductive (directed) content analysis approach. Interviews with 12 stroke survivors were analyzed deductively using the HAPA model concepts task self-efficacy, coping self-efficacy, and recovery self-efficacy to create the analysis matrix. In this sample, a period of psychological adjustment interfered with maintaining exercise and included anxiety, depression, embarrassment, and fear of falling that affected motivation and intention to exercise. Experiences with physical activity and exercise as a child and routines prior to the stroke were factors influencing task, coping, and recovery self-efficacy and ease of dealing with interruptions in exercise, including the discharge from formal rehabilitation. The findings support the qualitative fit of the HAPA model with the experience of exercise after having a stroke. A HAPA model framed intervention is being developed to support the transition from formal rehabilitation support to living in the community.

The need for systematic quality controls in implementing N95 reprocessing and sterilization

Due to increased requirement for personal protective equipment during the coronavirus disease 2019 pandemic, many medical centres utilized sterilization systems approved under Food and Drug Administration Emergency Use Authorization for single-use N95 mask re-use. However, few studies have examined the real-world clinical challenges and the role of ongoing quality control measures in successful implementation. To demonstrate successful implementation of quality control measures in mask reprocessing, and the importance of continued quality assurance. A prospective quality improvement study was conducted at a tertiary care medical centre. In total, 982 3M 1860 masks and Kimberly-Clark Tecnol PFR95 masks worn by healthcare workers underwent sterilization using a vaporized hydrogen peroxide gas plasma-based reprocessing system. Post-processing qualitative fit testing (QFT) was performed on 265 masks. Mannequin testing at the National Institute for Occupational Safety and Health (NIOSH) laboratory was used to evaluate the impact of repeated sterilization on mask filtration efficacy and fit. A locally designed platform evaluated the filtration efficiency of clinically used and reprocessed masks. In total, 255 N95 masks underwent QFT. Of these, 240 masks underwent post-processing analysis: 205 were 3M 1860 masks and 35 were PFR95 masks. Twenty-five (12.2%) of the 3M masks and 10 (28.5%) of the PFR95 masks failed post-processing QFT. Characteristics of the failed masks included mask deformation (N=3, all 3M masks), soiled masks (N=3), weakened elastic bands (N=5, three PFR95 masks), and concern about mask shrinkage (N=3, two 3M masks). NIOSH testing demonstrated that while filter efficiency remained >98% after two cycles, mask strap elasticity decreased by 5.6% after reprocessing. This study demonstrated successful quality control implementation for N95 mask disinfection, and highlights the importance of real-world clinical testing beyond laboratory conditions.

A Tsunami Generated by a Strike‐Slip Event: Constraints From GPS and SAR Data on the 2018 Palu Earthquake

AbstractA devastating tsunami struck Palu Bay in the wake of the 28 September 2018 Mw = 7.5 Palu earthquake (Sulawesi, Indonesia). With a predominantly strike‐slip mechanism, the question remains whether this unexpected tsunami was generated by the earthquake itself, or rather by earthquake‐induced landslides. In this study we examine the tsunami potential of the co‐seismic deformation. To this end, we present a novel geodetic data set of Global Positioning System and multiple Synthetic Aperture Radar‐derived displacement fields to estimate a 3D co‐seismic surface deformation field. The data reveal a number of fault bends, conforming to our interpretation of the tectonic setting as a transtensional basin. Using a Bayesian framework, we provide robust finite fault solutions of the co‐seismic slip distribution, incorporating several scenarios of tectonically feasible fault orientations below the bay. These finite fault scenarios involve large co‐seismic uplift (&gt;2 m) below the bay due to thrusting on a restraining fault bend that connects the offshore continuation of two parallel onshore fault segments. With the co‐seismic displacement estimates as input we simulate a number of tsunami cases. For most locations for which video‐derived tsunami waveforms are available our models provide a qualitative fit to leading wave arrival times and polarity. The modeled tsunamis explain most of the observed runup. We conclude that co‐seismic deformation was the main driver behind the tsunami that followed the Palu earthquake. Our unique geodetic data set constrains vertical motions of the sea floor, and sheds new light on the tsunamigenesis of strike‐slip faults in transtensional basins.

Development of a qualitative respirator fit testing program for BSN students

The COVID-19 pandemic has impacted the nursing student clinical experience. At the time of this project, hospitals hosting students for clinical experiences had a high population of COVID-19 positive patients. University and hospital policies at the time prohibited students from caring for COVID-19 patients due to the inability to safely ensure that students could access the proper protective equipment (PPE) necessary when caring for patients in airborne precautions. Infection control guidelines for patients in airborne precautions require a N95 respirator to be always worn by healthcare providers. These respirators require yearly fit test following OSHA (Occupational Safety and Health Administration) standards. Hospitals do have the resources to complete N95 fit tests for nursing students. The solution was to provide qualitative N95 mask fit testing, performed by university faculty, staff, and students using OSHA guidelines and standards. Within 3 months, over 50% of the student population had been fit tested, which increased the clinical opportunities for the students.

External nasal dilator decreases N95 respirator-related respiratory effort and symptoms in gastrointestinal endoscopy unit staff.

Background and study aims N95-filtering facepiece respirators (FFR) use is associated with physiological changes and symptoms due to impaired nasal airflow and increased breathing resistance. We prospectively studied the effect of using an external nasal dilator (END) in gastroenterology laboratory (gastrointestinal lab) staff using N95FFR. Patients and methods N95FFR qualitative saccharine fit testing was performed on study participants with and without an END. Prospective data collection and comparisons included: 1) survey of perceived symptoms and difficulty of performing one day of gastrointestinal procedures with N95FFR and 1 day of gastrointestinal procedures with END plus N95FFR in random sequence; and 2) vitals and respiratory belt plethysmography in ten gastroenterologists performing simulated colonoscopy while wearing a surgical mask (SM), N95FFR plus SM, END plus N95FFR plus SM for 20 minutes each in random sequence and rapid succession. Results Twenty-nine of 31 participants passed the N95FFR and the END plus N95FFR fit test. Twenty-two participants (12 physicians; 11 males; mean age 44.1 years, range 31–61) performed 1 day of gastrointestinal procedures with an N95FFR and 1 day of gastrointestinal procedures with an END plus N95FFR. Significantly less difficulty with nasal breathing and severity of symptoms including breathing difficulty, headache, fatigue and frustration, occurred while using an END plus N95FFR. Respiratory plethysmography peak-to-trough measurement showed an increase during the N95FFR stage compared to the END plus N95FFR stage and the SM stage. Conclusions N95FFR related respiratory changes and symptom development may be mitigated by END use.