Recovery Criterion Research Articles

Assessing criterion and longitudinal validity of submaximal heart rate indices as measures of cardiorespiratory fitness: A preliminary study in football

ObjectivesTo evaluate the criterion and longitudinal validity of field- and laboratory-derived heart rate (HR) indices of resting and submaximal fitness tests (SMFTs) as measures of cardiorespiratory fitness. DesignObservational, repeated measures. MethodsTwenty-nine semi-professional footballers participated. Laboratory assessments took place at the start and end of a preseason training period, whereby resting, SMFT HR-derived indices, and criterion measures of cardiorespiratory fitness (running economy [RE], maximal oxygen uptake [V̇O2 max] and aerobic speed [MAS]) were collected. Throughout this training period, two field-based SMFT protocols, prescribed at different intensities, were administered weekly. Individual slopes were calculated from the analysis of within-athlete change scores. Associations between laboratory and field measures were assessed via Pearson's correlation coefficient (r) and linear regression models. ResultsRelationships between SMFT HR-derived indices from laboratory and field were very-large for exercise HR (r = 0.74 to 0.87) and moderate to very-large for HR recovery (0.43 to 0.76). Moderate to very-large inverse relationships were observed between exercise HR and HR recovery with V̇O2 max and MAS (−0.41 to −0.78), whereas resting HR showed no substantial relationships. Changes in exercise HR showed large and very-large inverse correlations with preseason changes in V̇O2 max (−0.54 to −0.60) and MAS (−0.64 to −0.83). Relationships between changes in HR recovery and maximal cardiorespiratory criterion measures were moderate to large (−0.32 to −0.63). ConclusionSMFT exercise HR is a valid proxy measure of cardiorespiratory fitness irrespective of test setting, whereas the validity of HRR remains elusive and appears to vary between exercise intensities.

Substrate moisture and texture affect germination in Houghton’s goldenrod (Solidago houghtonii), a federally protected Great Lakes endemic plant

Rare plants garner significant conservation attention, but many have knowledge gaps associated with their life histories. This missing information presents a substantial hurdle for applied conservation. Houghton’s goldenrod (<i>Solidago houghtonii</i> Torrey &amp; A. Gray [Asteraceae]) is a Great Lakes endemic perennial that is often locally abundant but is limited to a narrow region in Michigan, New York, and Ontario. This species is federally listed in the US as threatened, state listed as threatened in Michigan and endangered in New York, and is a species of special concern in Canada. There may be enough viable <i>S. houghtonii</i> populations to meet the US federal recovery criterion, but more data are needed regarding long-term persistence within and across populations, especially related to successful sexual reproduction—key in most seed plants’ long-term persistence. As part of a range-wide study on the species, we performed greenhouse and field experiments to evaluate the effects of substrate moisture and texture on germination success. In both experimental contexts, we found that <i>S. houghtonii</i> germination significantly increased with increased substrate moisture and smoother substrate texture. In addition, a post hoc exploratory analysis on the effects of disturbance on germination showed higher germination in plots with higher disturbance levels, though this trend was not statistically significant. These results add to the limited life history information available for <i>S. houghtonii</i>. Our findings also suggest that substrate texture may be an easily characterized habitat variable that predicts germination for other species because of its relationship to consistent moisture contact for seeds. Weber JB, Leopold DL. 2023. Substrate moisture and texture affect germination in Houghton’s goldenrod (<i>Solidago houghtonii</i>), a federally protected Great Lakes endemic plant. Native Plants Journal 24(1):33–43.

Multi-objective collaborative assembly line design problem with the optimisation of ergonomics and economics

Manufacturing systems are socio-technical systems, with explicit interactions between humans and technologies in shared workspaces. These shared workspaces could also be called hybrid collaborative manufacturing systems, which involve workers as well as technological equipment and combine the benefits of human workers and new Industry 4.0 technologies, such systems are particularly useful in a context requiring flexibility and adaptability. Furthermore, the new Industry 5.0 approach has the objective to shift toward more human-centric and resilient manufacturing systems. The key problems to solve in the design of collaborative manufacturing systems are the combinatorial assembly line balancing problem and the equipment selection problem. An efficient and sustainable line requires a cost-effective choice of equipment while improving the ergonomics and the safety of workers. Both decisions of balancing workload and the assignment of equipment impact the ergonomics of a collaborative system and present conflicting criteria. To this end, we propose a multi-objective approach, the objectives are the optimisation of the investment costs and the ergonomics with a fatigue and recovery criterion. We propose to linearise the fatigue and recovery to formulate a new Mixed Integer Linear Programming formulation. We developed an exact multi-objective solving algorithm based on the ϵ-constraint to obtain the trade-off between these objectives. We conducted numerical experiments with different instances from the literature with promising results for instances with up to 45 operations. Finally, we discuss insightful managerial conclusions and future research perspectives.

Pain and functional recovery from chronic low back pain over 12months: implications for osteopathic medicine.

Although low back pain is a common medical condition that often progresses to become a chronic problem, little is known about the likelihood of recovery from chronic low back pain (CLBP). This study aimed to measure the risk of recovery from CLBP based on low back pain intensity and back-related functioning measures reported by participants within a pain research registry over 12months of observation and to consider the implications for osteopathic medicine. A total of 740 participants with CLBP in the Pain Registry for Epidemiological, Clinical, and Interventional Studies and Innovation in the United States were studied between April 2016 and October 2021. Inception cohorts for pain recovery and functional recovery were assembled from the participants who did not meet the recovery criteria at registry enrollment. The pain recovery criterion was having a score of≤1/10 on a numerical rating scale for low back pain intensity, and the functional recovery criterion was having a score of≤4/24 on the Roland-Morris Disability Questionnaire. A total of 737 and 692 participants were included in the inception cohorts for pain recovery and functional recovery, respectively. Participants provided follow-up data at quarterly encounters over 12months to determine if they achieved and maintained a pain or functional recovery from CLBP over the entire period of observation. Logistic regression was utilized to identify factors associated with recovery. The mean age of the participants at baseline was 52.9years (SD, 13.1years) and 551 (74.5%) were female. No participant reported a pain recovery that was maintained over all four quarterly encounters, whereas 16 participants (2.3%; 95% CI, 1.2-3.4%) maintained a functional recovery. Having high levels of pain self-efficacy (OR, 17.50; 95% CI, 2.30-133.23; p=0.006) and being Hispanic (OR, 3.55; 95% CI, 1.11-11.37; p=0.03) were associated with functional recovery, and high levels of pain catastrophizing (OR, 0.15; 95% CI, 0.03-0.65; p=0.01) and having chronic widespread pain (OR, 0.23; 95% CI, 0.08-0.66; p=0.007) were inversely associated with functional recovery. The findings for pain self-efficacy and Hispanic ethnicity remained significant in the multivariate analysis that adjusted for potential confounders. The absence of pain recovery and the low likelihood of functional recovery observed in our study suggests that osteopathic physicians should embrace a biopsychosocial approach to CLBP management and work with patients to set realistic expectations based on more pragmatic outcome measures, such as those that address health-related quality of life. The findings also suggest the potential importance of patient education and counseling to enhance pain self-efficacy.

Residual cognitive and psychosocial functional impairment in outpatients in Greece who responded to conventional antidepressant monotherapy treatments for major depressive disorder (MDD)

BackgroundPatients with MDD may experience diverse residual symptoms after clinical response to antidepressant treatment. Among these symptoms, cognitive problems in executive functioning are prominent and make functional recovery largely an unmet need for MDD patients. In this study we assessed cognitive symptoms and functional impairment in patients with MDD responding to antidepressant treatment. MethodsThis was a national, multi-site, non-interventional, cross-sectional study of depressive symptomatology, cognitive performance and psychosocial functioning in Greek outpatients with MDD who had clinically responded to antidepressant treatment. Both clinician- and patient- rated measures were employed. Symptom remission was assessed with the Montgomery Asberg Depression Rating Scale (MADRS) total score (≤12) and functional recovery was assessed with the Sheehan Disability Scale (SDS) score (<6). Results335 MDD patients participated in the study. After antidepressant monotherapy approximately 60 % of responders and 40 % of remitted patients did not meet the functional recovery criterion. More than 60 % of responders had concentration difficulties as assessed by MADRS item. Patient reported cognitive symptoms were statistically significantly associated with functionality (β coefficient = 0.126, p-value = 0.027). LimitationsNon-interventional study design and lack of a control group or active comparator/reference. ConclusionsThis study highlights the persistence of decreased cognitive performance, particularly in executive functioning in patients with MDD who have shown response and/or remission to antidepressant treatment. This appears to contribute to psychosocial functional impairment. Patient-reported cognitive and psychosocial functioning impairment should be included in routine clinical monitoring of outcomes in MDD treatments.

Real-Time Adaptive UVLS by Optimized Fuzzy Controllers for Short-Term Voltage Stability Control

This paper proposes a novel real-time adaptive under voltage load shedding (UVLS) method by using optimized fuzzy logic controllers to address fault-induced delayed voltage recovery (FIDVR) and short-term voltage instability (STVIS) problems. An intelligent multi-input multi-output fuzzy logic load shedding controller is developed based on a short-term voltage recovery criterion (STVRC). For the controller, the magnitude deviation and the recovery time deviation of voltage trajectory are extracted as inputs, while the load shedding amount at the current load shedding stage and the time delay of the next stage are taken as outputs. Particle swarm optimization (PSO) technique is further employed for the tuning of the controller parameters to realize the voltage recovery requirement at the lowest cost of load shedding. The proposed UVLS method is formed by a group of the fuzzy logic controllers deployed at the load buses, each monitoring its own bus voltage and shedding load in closed-loop. Responding to the severity of voltage variations, the proposed method is able to adaptively determine the location, time and amount of load shedding in real-time to make the voltage satisfy the STVRC. The effectiveness of the proposed method compared to other methods is testified by simulations on the Nordic test system.

Long-Term Outcomes of First-Admission Psychosis: A Naturalistic 21-Year Follow-Up Study of Symptomatic, Functional and Personal Recovery and Their Baseline Predictors.

This study was aimed at characterizing long-term outcomes of first-admission psychosis and examining their baseline predictors. Participants were assessed at baseline for 38 candidate predictors and re-assessed after a median follow-up of 21 years for symptomatic, functional, and personal recovery. Associations between the predictors and the outcomes were examined using univariate and multivariate Cox regression models. At baseline, 623 subjects were assessed for eligibility, 510 met the inclusion/exclusion criteria and 243 were successfully followed-up (57.3% of the survivors). At follow-up, the percentages of subjects achieving symptomatic, functional, and personal recovery were 51.9%, 52.7%, and 51.9%, respectively; 74.2% met at least one recovery criterion and 32.5% met all three recovery criteria. Univariate analysis showed that outcomes were predicted by a broad range of variables, including sociodemographics, familial risk, early risk factors, premorbid functioning, triggering factors, illness-onset features, neurological abnormalities, deficit symptoms and early response to treatment. Many of the univariate predictors became nonsignificant when entered into a hierarchical multivariate model, indicating a substantial degree of interdependence. Each single outcome component was independently predicted by parental socioeconomic status, family history of schizophrenia spectrum disorders, early developmental delay, childhood adversity, and mild drug use. Spontaneous dyskinesia/parkinsonism, neurological soft signs and completion of high school remained specific predictors of symptomatic, functional, and personal outcomes, respectively. Predictors explained between 27.5% and 34.3% of the variance in the outcomes. In conclusion, our results indicate a strong potential for background and first-episode characteristics in predicting long-term outcomes of psychotic disorders, which may inform future intervention research.

Assembly line balancing problem with ergonomics: a new fatigue and recovery model

ABSTRACT Assembly lines are production lines used to manufacture products, ranging from mass-production products to mass-customisation with low unit products. Assembly lines consume the largest parts of investment funds and involve the largest proportion of companies' labour force. However, workers in assembly lines are exposed to work-related musculoskeletal disorders (MSDs) and ergonomics problems. Poor distribution of workloads reduces the performance of assembly lines and causes workers MSDs and injuries, largely affecting the economics of production systems and resulting in high workers' compensation and absenteeism costs. Furthermore, ergonomics problems and MSDs impact product quality and decrease productivity. We propose a methodology for taking physical ergonomics into account as early as in the design phase of assembly lines. This methodology is based on Integer Linear Programming for the assembly line balancing problem with consideration of ergonomics with a quantitative fatigue and recovery criterion. As solving approach, we develop a dedicated exact algorithm, denoted Iterative Dichotomic Search, to solve low and medium-size instances of the problem. We validate our approach by proposing numerical experiments and analysis on instances from the literature.

Support Recovery in the Phase Retrieval Model: Information-Theoretic Fundamental Limit

The support recovery problem consists of determining a sparse subset of variables that is relevant in generating a set of observations. In this paper, we study the support recovery problem in the phase retrieval model consisting of noisy phaseless measurements, which arises in a diverse range of settings such as optical detection, X-ray crystallography, electron microscopy, and coherent diffractive imaging. Our focus is on information-theoretic fundamental limits under an approximate recovery criterion, considering both discrete and Gaussian models for the sparse non-zero entries, along with Gaussian measurement matrices. In both cases, our bounds provide sharp thresholds with near-matching constant factors in several scaling regimes on the sparsity and signal-to-noise ratio. As a key step towards obtaining these results, we develop new concentration bounds for the conditional information content of log-concave random variables, which may be of independent interest.

On the All-or-Nothing Behavior of Bernoulli Group Testing

In this article, we study the problem of non-adaptive group testing, in which one seeks to identify which items are defective given a set of suitably-designed tests whose outcomes indicate whether or not at least one defective item was included in the test. The most widespread recovery criterion seeks to exactly recover the entire defective set, and relaxed criteria such as approximate recovery and list decoding have also been considered. In contrast, we study the fundamental limits of group testing under the significantly relaxed weak recovery criterion, which only seeks to identify a small fraction (e.g., 0.01) of the defective items. Given the near-optimality of i.i.d. Bernoulli testing for exact recovery in sufficiently sparse scaling regimes, it is natural to ask whether this design additionally succeeds with much fewer tests under weak recovery. Our main negative result shows that this is not the case, and in fact, under i.i.d. Bernoulli random testing in the sufficiently sparse regime, an all-or-nothing phenomenon occurs: When the number of tests is slightly below a threshold, weak recovery is impossible, whereas when the number of tests is slightly above the same threshold, high-probability exact recovery is possible. In establishing this result, we additionally prove similar negative results under Bernoulli designs for the weak detection problem (distinguishing between the group testing model vs. completely random outcomes) and the problem of identifying a single item that is definitely defective. On the positive side, we show that all three relaxed recovery criteria can be attained using considerably fewer tests under suitably-chosen non-Bernoulli designs. Thus, our results collectively indicate that when too few tests are available, naively applying i.i.d. Bernoulli testing can lead to catastrophic failure, whereas “cutting one’s losses” and adopting a more carefully-chosen design can still succeed in attaining these less stringent criteria.

Off-grid DOA estimation of correlated sources for nonuniform linear array through hierarchical sparse recovery in a Bayesian framework and asymptotic minimum variance criterion

This paper provides a method to solve off-grid direction-of-arrival (DOA) estimation for nonuniform linear array (NLA) correlated source condition through hierarchical sparse recovery and asymptotic minimum variance (AMV) criterion. In this method, space is firstly divided into a discretized grid. Most rows and columns of the signal covariance matrix modeled on this grid are zero vectors because the number of sources is considerably smaller than that of grid points. Hence, the vectorized signal covariance matrix is regarded as a block-sparse vector, and active blocks are sparse vectors. Based on this, a hierarchical sparse prior is then assigned on the vectorized signal covariance matrix to encourage the sparsity between and within blocks. Finally, the variational Bayesian inference is applied to estimate the vectorized signal covariance matrix. Furthermore, first-order Taylor series expansion is applied to approximate the steering vector as a function of the grid error between the true DOA and the closest grid point. Grid error is estimated under the AMV criterion and applied to modify the grid iteratively, thus alleviating the basis mismatch. Simulation results show that the proposed method achieves high estimation accuracy for the NLA correlated source condition.

Can Alcohol Use Disorder Recovery Include Some Heavy Drinking? A Replication and Extension up to 9 Years Following Treatment.

BackgroundRecent research indicates some individuals who engage in heavy drinking following treatment for alcohol use disorder fare as well as those who abstain with respect to psychosocial functioning, employment, life satisfaction, and mental health. The current study evaluated whether these findings replicated in an independent sample and examined associations between recovery profiles and functioning up to 6 years later.MethodsData were from the 3‐year and 7‐ to 9‐year follow‐ups of subsamples initially recruited for the COMBINE study (3‐year follow‐up: n = 694; 30.1% female, 21.0% non‐White; 7‐ to 9‐year follow‐up: n = 127; 38.9% female, 27.8% non‐White). Recovery at 3 years was defined by latent profile analyses including measures of health functioning, quality of life, employment, alcohol consumption, and cannabis and other drug use. Functioning at the 7‐ to 9‐year follow‐up was assessed using single items of self‐rated general health, hospitalizations, and alcohol consumption.ResultsWe identified 4 profiles at the 3‐year follow‐up: (i) low‐functioning frequent heavy drinkers (13.9%), (ii) low‐functioning infrequent heavy drinkers (15.8%), (iii) high‐functioning heavy drinkers (19.4%), and (iv) high‐functioning infrequent drinkers (50.9%). At the 7‐ to 9‐year follow‐up, the 2 high‐functioning profiles had the best self‐rated health, and the high‐functioning heavy drinking profile had significantly fewer hospitalizations than the low‐functioning frequent heavy drinking profile.ConclusionsPrevious findings showing heterogeneity in recovery outcomes were replicated. Most treatment recipients functioned well for years after treatment, and a subset who achieved stable recovery engaged in heavy drinking and reported good health outcomes up to 9 years after treatment. Results question the long‐standing emphasis on drinking practices as a primary outcome, as well as abstinence as a recovery criterion in epidemiologic and treatment outcome research and among stakeholder groups and funding/regulatory agencies. Findings support an expanded recovery research agenda that considers drinking patterns, health, life satisfaction, and functioning.

Using the interaction of speed and acceleration to detect repeated-sprint activity in team sports

ABSTRACT Purpose To compare the occurrence and characteristics of repeated-sprint (RS) activity in elite team sport competition when classified according to speed and/or acceleration, and their interaction via metabolic power (Pmet). Methods: Elite male hockey players (N = 16) wore player-tracking devices in six international matches. Sprint efforts were defined using four separate classifications: speed >5.5 m∙s−1, acceleration >1.5 m∙s−2, speed-or-acceleration, and Pmet >25.5 W∙kg−1. RS bouts were defined as ≥3 efforts with mean recovery ≤21 s. For Pmet, RS bouts were also classified using a maximal recovery period ≤21 s. The number of sprint efforts and RS bouts, and the number of efforts, effort durations and recovery periods within RS bouts, were compared across each classification method, and between mean and maximal recovery criteria. Results: More RS bouts were identified via Pmet (8.5 ± 2.8) than either speed and/or acceleration, and comprised more efforts (4.0 ± 0.4) with shorter recovery periods (11.5 ± 1.8 s). Fewer RS bouts (7.3 ± 2.8 vs. 8.5 ± 2.8) were identified with a maximum rather than mean recovery criterion. Conclusions: Definitions of sprint efforts and recovery periods which reflect ATP depletion and replenishment via Pmet suggest that RS activity occurs frequently in team sport competition, and is more demanding than when speed and/or acceleration are used to define RS activity in variable-speed locomotion.

Biopsychosocial Influences on Shoulder Pain: Analyzing the Temporal Ordering of Postoperative Recovery

Shoulder surgery is a primary intervention for shoulder pain, yet many individuals experience persistent postoperative pain. Previously, we found individuals categorized as having a high-risk phenotype (comprised of COMT variation and pain catastrophizing) had approximately double the chance of not reaching a 12-month pain recovery criterion. As a means to better understand the development of persistent postoperative shoulder pain, this study advanced our previous work by examining temporal ordering of postoperative shoulder recovery based on potential mediating factors, and expansion of outcomes to include movement-evoked pain and shoulder active range of motion. Before surgery, individuals were categorized as either high-risk (high pain catastrophizing, COMT-genotype linked to low enzyme activity [n = 41]) or low-risk (low pain catastrophizing, COMT-genotype linked to normal enzyme activity [n = 107]). We then compared potential mediating variables at 3, 6, and 12 months postoperatively 1) endogenous pain modulation defined by a conditioned pain modulation paradigm; and 2) and emotion factors such as anxiety, fear of movement, and depressive symptoms. At 3 months, the high-risk subgroup had higher fear and movement-evoked pain, and causal mediation analysis confirmed the direct effect of risk subgroup on 12-month movement evoked pain. However, baseline to 12-month change in depressive symptoms were found to mediate 53% of the total effect of risk subgroup on 12-month movement-evoked pain. This study introduces potential temporal components and relationships to the development of persistent postoperative shoulder pain, which future studies will confirm and assess for potential therapeutic targets. PerspectiveThis study expands upon postoperative shoulder recovery measures to include movement-evoked pain and depressive symptoms, and provides preliminary indication of temporal ordering to postoperative shoulder recovery for a preidentified high-risk subgroup. Future studies will distinguish temporal components of shoulder surgery that may optimize treatment targets of postoperative recovery.

Attention allocation to illness-compatible information discriminates women with active versus weight-recovered anorexia nervosa.

Biased attention for disorder-relevant information plays a crucial role in the maintenance of different mental disorders including eating disorders and might be of use to define recovery beyond symptom-related criteria. We assessed attention deployment using eye tracking in a cued choice viewing paradigm to two different categories of disorder-relevant stimuli in 24 individuals with acute anorexia nervosa (AN), 20 weight-recovered individuals with a history of AN (WRAN) and 23 healthy control participants (CG). Picture pairs consisted of a food stimulus or a picture depicting physical activity and a matched control stimulus (household item/physical inactivity). Participants rated the valence of stimuli afterwards. The groups did not differ in initial attention deployment. In later processing stages, AN patients showed a generalized attentional avoidance of food and control pictures as compared to CG, while WRAN individuals were in between. AN patients showed an attentional bias toward physical activity pictures as compared to WRAN individuals, but not the CG. AN individuals rated the food pictures and the pictures showing physical inactivity as less pleasant than the CG, while WRAN individuals were in between. Attention deployment is partly changed in WRAN as compared to the acute AN group, especially with regard to a shift away from illness-compatible stimuli (physical activity), and this might be a useful recovery criterion. Valence rating of food stimuli might be an additional useful tool to distinguish between acutely ill and weight-recovered individuals. Attentional biases for illness-compatible stimuli might qualify as a valuable approach to defining recovery in AN.

Safety and Effectiveness of an Individualized Risk Stratification Based Medication Intervention Strategy: The Intervene HF Study

Background Risk stratification models using integrated device diagnostics have been developed to predict heart failure (HF) events. However, effective management strategies to reduce this HF risk have not been developed. The purpose of the INTERVENE-HF study was to determine whether a physician-directed, nurse-implemented ambulatory medication intervention strategy could be safely and effectively instituted in HF patients with an increased HF risk score. Methods A prospective, non-randomized, single arm, multi-center feasibility study was conducted in HF patients implanted with a Medtronic CRT-D device with Triage HF dynamic risk score (HFRS) diagnostic feature. HFRS was based on Bayesian analysis of CRT-D measured variables: transthoracic impedance, heart rate, heart rate variability, arrhythmia parameters, and activity. Ambulatory medication intervention strategy was remotely implemented by certified HF nurses (CHFN) following a guided action pathway triggered by a risk based alert. CHFN received alert notification to evaluate a patient when there was an impedance based OptiVolTM fluid threshold crossing. Patients not excluded due to safety or protocol-mandated criteria were managed by CHFN using a personalized, 3 day course of diuretic up titration (PRN Tx) prescribed by a physician at enrollment. Safety was monitored through daily CHFN remote review of weight, blood pressure and symptoms. Sufficient recovery after PRN Tx was defined as ≥ 70% recovery of impedance to baseline levels on day 4. If recovery criterion was not met on day 4, a second PRN Tx was initiated and impedance was reassessed on day 8. Results 66 patients had the alert feature enabled and were followed by CHFNs for 8.2 ± 3.9 months. CHFNs received alerts triggered by 49 OptiVolTM crossings. 23 of 49 crossings were not acted on due to safety or protocol-mandated criteria. 26 of 49 crossings received PRN Tx, 19 with 1 round, 7 with two rounds. Of 26 PRN Tx, 22 were completed, 19 led to ≥ 70% impedance recovery within 4 - 8 days. 4 interventions were stopped early for safety without leading to a serious adverse event (AE). 1 of 26 PRN Tx was followed by a HF event within 30 days of PRN Tx. Safety endpoint (# of PRN Tx without PRN Tx AE / # of PRN Tx) was 22/26 (85%). Effectiveness endpoint (# recovered without HF event within 14 days and without PRN Tx AE / # of PRN Tx) was 18/26 (69%). Conclusion An individualized risk stratification based ambulatory medication intervention strategy that is physician-directed and CHFN-implemented can be safely and successfully instituted in HF patients using an integrated device diagnostics based HF risk score.

Analytical performance evaluation of the Elecsys® Troponin T Gen 5 STAT assay

BackgroundWe report the analytical performance of the Elecsys® Troponin T Gen 5 STAT (TnT Gen 5 STAT; Roche Diagnostics) assay. MethodsMeasuring limits/ranges were determined in lithium-heparin plasma samples per Clinical and Laboratory Standards Institute (CLSI) EP17-A2. Precision was evaluated per CLSI EP05-A2 using lithium-heparin plasma/quality control samples on cobas e 411/cobas e 601 analyzers; two duplicated runs per day for 21 days (n = 84). Cross-reactivity with other troponin forms and interference from endogenous substances/drugs was tested; recovery criterion for no cross-reactivity was within ±10%. ResultsCoefficients of variation (CV) for repeatability/intermediate precision were 0.7–5.6%/1.4–10.3% (cobas e 411; mean cardiac troponin T [cTnT]: 7.3–9341 ng/L) and 0.7–3.0%/1.5–6.4% (cobas e 601; mean cTnT: 7.4–9455 ng/L). There was no cross-reactivity with skeletal muscle troponin T (≤ 10,000 ng/L), skeletal muscle troponin I (≤ 100,000 ng/L), cardiac troponin I (≤ 10,000 ng/L), or human troponin C (≤ 80,000 ng/L). No interference was observed with biotin (≤ 20 ng/mL) or 34 drugs. ConclusionThe TnT Gen 5 STAT assay demonstrated a CV of <10% at the 99th percentile upper reference limit, meeting precision requirements (Fourth Universal Definition of Myocardial Infarction) for high-sensitivity troponin assays.

Establishing a test procedure for evaluating the electromechanical properties of practical REBCO coated conductor tapes by the uniaxial tension test at 77 K

Nowadays, the superior electrical and mechanical properties of second generation (2G) practical coated conductor (CC) tapes make them viable options for various applications such as power cables, magnets and coils. The CC tapes are composite conductors where the constituent layers are directly affected by the mechanical and the electromechanical properties of the superconducting layer under operating conditions. It is therefore important to investigate the strain effect on the critical current (Ic) and to determine the irreversible limits for Ic degradation in CC tapes. However, standards or codes for testing the electromechanical properties of high-temperature superconductors are lacking. Therefore, the establishment of a test method or procedure for determining the electromechanical properties of 2G CC tapes in both engineering and practical aspects is needed. This study is a standardization activity, wherein the strain/stress sensitivity of Ic and the reversible strain/stress limits for Ic degradation of practical CC tapes using uniaxial tension tests were evaluated at 77 K and self-field. The reversible strain/stress limits of CC tapes were defined and the reversible recovery of Ic during loading–unloading was measured when using the 99% Ic (ε) recovery, 99% Ic0 recovery and 95% Ic0 retention criteria. The electromechanically determined irreversible limits were also compared to the mechanically determined stress and strain at the yield point. The obtained reversible stress limits showed a similar value regardless of criteria adopted, excepting Sample 2. However, the irreversible strain limit value obtained using the 99% Ic(ε) recovery criterion showed the largest value as compared to the cases using other criteria. Through repeated tests, the electromechanical test procedure of the CC tapes was evaluated based on statistical estimates. The obtained results can provide a fundamental basis for establishing test procedures comparing the criterion that should be considered in determining irreversible limits, whether normalized to the original state Ic value, Ic0 or determined using the reversible degradation of Ic(ε) at residual strain, when unloaded.

Influence of Obesity Surgery on Restless Leg Syndrome.

To investigate whether restless leg syndrome (RLS) symptoms improved and treatment requirement decreased through weight loss on postoperative follow-ups of the patients who underwent laparoscopic sleave gastrectomy (LSG) due to obesity and who were started medical therapy due to RLS. A descriptive study. General Surgery Outpatient Clinics of Research and Training Hospital of Medical School, Adiyaman, Turkey, from May 2014 to December 2017. A total of 14 patients who underwent LSG due to morbid obesity and who received medical treatment due to RLS were retrospectively included in the study. The improvement of the symptoms and no need for medical treatment were considered as treatment or recovery criterion. Those who were not diagnosed with RLS before the operation or who did not receive medical treatment due to RLS were excluded. The study subjects comprised 6 females (42.9%) and 8 males (57.1%). Mean BMI was 46.50 ±3.43 Kg/m² before LSG and 28.28 ±2.26 Kg/m² on months 12 after LSG. Mean BMI values 12 months after LSG were significantly reduced compared to preoperative BMI (p=0.001). Out of the 14 patients who had been receiving medical therapy before LSG, 12 patients (85.7%) had discontinued medical therapy 12 months after LSG. A statistically significant difference was detected between the number of the patients who were receiving medical therapy due to RLS on month 12 after LSG and the number of the patients who were receiving medical therapy before LSG (p=0.001). Treatment requirements of morbid obese patients who were receiving medical therapy due to RLS significantly decreased through weight loss following RLS.

Estimated population size of pallid sturgeon Scaphirhynchus albus in a novel reach of the lower Missouri River

The recovery criterion for pallid sturgeon Scaphirhynchus albus consists of attaining a self-sustaining genetically diverse population for two generations. The suppressed pallid sturgeon population is theorized as a potential factor limiting recovery; therefore, the Pallid Sturgeon Conservation and Augmentation Program (PSCAP) was implemented to proliferate the overall population. The pallid sturgeon population has been quantified in the lower basin of the Missouri River (Gavins Point Dam [rkm 1,305.2] to the confluence of the Missouri and Mississippi rivers [rkm 0.0]), but previous population estimates have only covered less than ten percent of the lower basin. Therefore, the objectives of this study were to quantify the annual pallid sturgeon population (2015–2017) in a novel, unquantified 30.1 rkm reach of the lower Missouri River basin and compare these results to previously published population estimates in the lower Missouri River basin. The study area included a six-bend reach in the upper channelized Missouri River, approximately 226.3 rkm below the last main-stem dam. Population estimates (Nsp) for the “super-population” of pallid sturgeon within the 30.1 rkm study area varied from 593 (95% CI 471–716) in 2015 to 471 (373–569) in 2016 and 608 (482–734) in 2017. The population estimates (fish/rkm ± SE) ranged from 15.6 ± 1.0 to 20.2 ± 1.3 fish/rkm. This study aligned with a previously published estimate in the same proximal reach but was two or three times higher compared to an estimate reported from approximately 500 rkm downstream. Understanding the temporal and spatial variations of the pallid sturgeon population is critical as recovery efforts continue, especially to seed input parameters into population prediction models that provide management guidance.