Categorizing Fetal Heart Rate Variability With and Without Visual Aids

Objective This study examined the ability of clinicians to correctly categorize images of fetal heart rate (FHR) variability with and without the use of exemplars. Study Design A sample of 33 labor and delivery clinicians inspected static FHR images and categorized them into one of four categories defined by the National Institute of Child Health and Human Development (NICHD) based on the amount of variability within absent, minimal, moderate, or marked ranges. Participants took part in three conditions: two in which they used exemplars representing FHR variability near the center or near the boundaries of each range, and a third control condition with no exemplars. The data gathered from clinicians were compared with those from a previous study using novices. Results Clinicians correctly categorized more images when the FHR variability fell near the center rather than the boundaries of each range, F (1,32) = 71.69, p \u3c 0.001, partial η2 = 0.69. They also correctly categorized more images when exemplars were available, F (2,64) = 5.44, p = 0.007, partial η2 = 0.15. Compared with the novices, the clinicians were more accurate and quicker in their category judgments, but this difference was limited to the condition without exemplars. Conclusion The results suggest that categorizing FHR variability is more difficult when the examples fall near the boundaries of each NICHD-defined range. Thus, clinicians could benefit from training with visual aids to improve judgments about FHR variability and potentially enhance safety in labor and delivery

Mouse tissue harvest-induced hypoxia rapidly alters the in vivo metabolome, between-genotype metabolite level differences, and 13C-tracing enrichments

OBJECTIVE: Metabolomics as an approach to solve biological problems is exponentially increasing in use. Thus, this a pivotal time for the adoption of best practices. It is well known that disrupted tissue oxygen supply rapidly alters cellular energy charge. However, the speed and extent to which delayed mouse tissue freezing after dissection alters the broad metabolome is not well described. Furthermore, how tissue genotype may modulate such metabolomic drift and the degree to which traced METHODS: By combined liquid chromatography (LC)- and gas chromatography (GC)-mass spectrometry (MS), we measured how levels of 255 mouse liver metabolites changed following 30-second, 1-minute, 3-minute, and 10-minute freezing delays. We then performed test-of-concept delay-to-freeze experiments evaluating broad metabolomic drift in mouse heart and skeletal muscle, differential metabolomic change between wildtype (WT) and mitochondrial pyruvate carrier (MPC) knockout mouse livers, and shifts in RESULTS: Our data demonstrate that delayed mouse tissue freezing after dissection leads to rapid hypoxia-driven remodeling of the broad metabolome, induction of both false-negative and false-positive between-genotype differences, and restructuring of CONCLUSIONS: Our findings provide a previously absent, systematic illustration of the extensive, multi-domain metabolomic changes occurring within the early minutes of delayed tissue freezing. They also provide a novel, detailed resource of mouse liver ex vivo, hypoxic metabolomic remodeling

The Influence of a Crosshair Visual Aid on Observer Detection of Simulated Fetal Heart Rate Signals

Objective To determine whether a visual aid overlaid on fetal heart rate (FHR) tracings increases detection of critical signals relative to images with no visual aid. Study Design In an experimental study, 21 undergraduate students viewed 240 images of simulated FHR tracings twice, once with the visual aids and once without aids. Performance was examined for images containing three different types of FHR signals (early deceleration, late deceleration, and acceleration) and four different FHR signal-to-noise ratios corresponding to FHR variability types (absent, minimal, moderate, and marked) identified by the National Institute of Child Health and Human Development (2008). Performance was analyzed using repeated-measures analyses of variance. Results The presence of the visual aid significantly improved correct detections of signals overall and decreased false alarms for the marked variability condition. Conclusion The results of the study provide evidence that the presence of a visual aid was useful in helping novices identify FHR signals in simulated maternal-fetal heart rate images. Further, the visual aid was most useful for conditions in which the signal is most difficult to detect (when FHR variability is highest)

ParaVR: A Virtual Reality Training Simulator for Paramedic Skills maintenance

This document is the Accepted Manuscript version of a Published Work that appeared in final form in Journal of Paramedic Practice, copyright © MA Healthcare, after peer review and technical editing by the publisher. To access the final edited and published work see https://www.paramedicpractice.com/features/article/paravr-a-virtual-reality-training-simulator-for-paramedic-skills-maintenance.Background, Virtual Reality (VR) technology is emerging as a powerful educational tool which is used in medical training and has potential benefits for paramedic practice education. Aim The aim of this paper is to report development of ParaVR, which utilises VR to address skills maintenance for paramedics. Methods Computer scientists at the University of Chester and the Welsh Ambulance Services NHS Trust (WAST) developed ParaVR in four stages: 1. Identifying requirements and specifications 2. Alpha version development, 3. Beta version development 4. Management: Development of software, further funding and commercialisation. Results Needle Cricothyrotomy and Needle Thoracostomy emerged as candidates for the prototype ParaVR. The Oculus Rift head mounted display (HMD) combined with Novint Falcon haptic device was used, and a virtual environment crafted using 3D modelling software, ported (a computing term meaning transfer (software) from one system or machine to another) onto Oculus Go and Google cardboard VR platform. Conclusion VR is an emerging educational tool with the potential to enhance paramedic skills development and maintenance. The ParaVR program is the first step in our development, testing, and scaling up of this technology

A Longitudinal Analysis of Stress in African American Youth: Predictors and Outcomes of Stress Trajectories

Few researchers have studied trajectories of stress over time in relation to psychosocial outcomes and behaviors among adolescents. A sample of African American adolescents were assessed longitudinally on perceived stress, psychological well-being, support, antisocial behaviors, and academic success. Patterns of stress over 4 time points were developed using a cluster-analytic approach. Differences among the trajectory clusters were examined using psychosocial outcomes and behaviors. Adolescents with chronic levels of stress reported more anxiety and depression, engaged in antisocial behaviors, and reported less active coping than youth in other trajectories. Adolescents with low levels of stress over time reported fewer psychological problems, perceived more social support, and were more likely to graduate from high school than those with higher stress levels over time. We also found that an increase in stress coincided with a lack of support and more psychological problems over time.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/45295/1/10964_2004_Article_465298.pd