Supporting Vermont Families in Packing Healthy Lunches for Children in Childcare

Introduction. Partnering with Hunger Free Vermont, an organization that works to end hunger and malnutrition across the state, we investigated the nutritional value of the packed meals parents provide for their children in early childcare. The USDA\u27s My Plate resource was used as a measure to assess variety, dividing foods into five groups: grains, dairy, vegetables, fruits, and protein. The results will help Hunger Free Vermont design nutrition education materials for childcare centers to provide to the families they serve. Methods. Online surveys were distributed, asking parents to report the foods they recently provided for their children in packed lunches, to rate how \u27healthy\u27 they thought those lunches were, and to note any barriers they experience to packing healthy foods. Results. Survey results showed that the average number of sweets packed by parents who had low confidence in their ability to pack healthy meals was significantly higher than the average number packed by parents with high confidence (p \u3c 0.05). Additionally, the total number of cited barriers was significantly higher in parents who had low confidence in their ability to pack healthy meals (p \u3c 0.01). Conclusions. Many parents cited time constraints and ‘picky’ children as barriers to providing healthy meals, with concerns about the expense of healthy items and lack of childcare for shopping or food-prep time following close behind. In the future, education materials that address children’s unhealthy food preferences or further investigations into barriers to providing healthy lunches may facilitate development of resources for Vermont families.https://scholarworks.uvm.edu/comphp_gallery/1259/thumbnail.jp

Effects of Bedrock Landsliding on Cosmogenically Determined Erosion Rates

The successful quantification of long-term erosion rates underpins our understanding of landscape. formation, the topographic evolution of mountain ranges, and the mass balance within active orogens. The measurement of in situ-produced cosmogenic radionuclides (CRNs) in fluvial and alluvial sediments is perhaps the method with the greatest ability to provide such long-term erosion rates. In active orogens, however, deep-seated bedrock landsliding is an important erosional process, the effect of which on CRN-derived erosion rates is largely unquantified. We present a numerical simulation of cosmogenic nuclide production and distribution in landslide-dominated catchments to address the effect of bedrock landsliding on cosmogenic erosion rates in actively eroding landscapes. Results of the simulation indicate that the temporal stability of erosion rates determined from CRN concentrations in sediment decreases with increased ratios of landsliding to sediment detachment rates within a given catchment area, and that larger catchment areas must be sampled with increased frequency of landsliding in order to accurately evaluate long-term erosion rates. In addition, results of this simulation suggest that sediment sampling for CRNs is the appropriate method for determining long-term erosion rates in regions dominated by mass-wasting processes, while bedrock surface sampling for CRNs is generally an ineffective means of determining long-term erosion rates. Response times of CRN concentrations to changes in erosion rate indicate that climatically driven cycles of erosion may be detected relatively quickly after such changes occur, but that complete equilibration of CRN concentrations to new erosional conditions may take tens of thousands of years. Simulation results of CRN erosion rates are compared with a new, rich dataset of CRN concentrations from the Nepalese Himalaya, supporting conclusions drawn from the simulation

A short history of the British Urology Researchers in Surgical Training (BURST): The power of collaborative research

The British Urology Researchers in Surgical Training (BURST) is a UK-based, trainee-led urology research collaborative. Since inception in 2014, BURST has led projects in several urological subspecialties with the aim of improving urological practice for patient benefit. Key innovations we have used include an emphasis on social media communications and developing innovative technology solutions to improve collaboration. In this review article, we summarise our recent studies and highlight important strategies for performing collaborative research. Level of evidence: Not applicable

Kimera: from SLAM to Spatial Perception with 3D Dynamic Scene Graphs

Humans are able to form a complex mental model of the environment they move in. This mental model captures geometric and semantic aspects of the scene, describes the environment at multiple levels of abstractions (e.g., objects, rooms, buildings), includes static and dynamic entities and their relations (e.g., a person is in a room at a given time). In contrast, current robots' internal representations still provide a partial and fragmented understanding of the environment, either in the form of a sparse or dense set of geometric primitives (e.g., points, lines, planes, voxels) or as a collection of objects. This paper attempts to reduce the gap between robot and human perception by introducing a novel representation, a 3D Dynamic Scene Graph(DSG), that seamlessly captures metric and semantic aspects of a dynamic environment. A DSG is a layered graph where nodes represent spatial concepts at different levels of abstraction, and edges represent spatio-temporal relations among nodes. Our second contribution is Kimera, the first fully automatic method to build a DSG from visual-inertial data. Kimera includes state-of-the-art techniques for visual-inertial SLAM, metric-semantic 3D reconstruction, object localization, human pose and shape estimation, and scene parsing. Our third contribution is a comprehensive evaluation of Kimera in real-life datasets and photo-realistic simulations, including a newly released dataset, uHumans2, which simulates a collection of crowded indoor and outdoor scenes. Our evaluation shows that Kimera achieves state-of-the-art performance in visual-inertial SLAM, estimates an accurate 3D metric-semantic mesh model in real-time, and builds a DSG of a complex indoor environment with tens of objects and humans in minutes. Our final contribution shows how to use a DSG for real-time hierarchical semantic path-planning. The core modules in Kimera are open-source.Comment: 34 pages, 25 figures, 9 tables. arXiv admin note: text overlap with arXiv:2002.0628

Virtual classroom proficiency-based progression for robotic surgery training (VROBOT): a randomised, prospective, cross-over, effectiveness study

Robotic surgery training has lacked evidence-based standardisation. We aimed to determine the effectiveness of adjunctive interactive virtual classroom training (VCT) in concordance with the self-directed Fundamentals of Robotic Surgery (FRS) curriculum. The virtual classroom is comprised of a studio with multiple audio-visual inputs to which participants can connect remotely via the BARCO weConnect platform. Eleven novice surgical trainees were randomly allocated to two training groups (A and B). In week 1, both groups completed a robotic skills induction. In week 2, Group A received training with the FRS curriculum and adjunctive VCT; Group B only received access to the FRS curriculum. In week 3, the groups received the alternate intervention. The primary outcome was measured using the validated robotic-objective structured assessment of technical skills (R-OSAT) at the end of week 2 (time-point 1) and 3 (time-point 2). All participants completed the training curriculum and were included in the final analyses. At time-point 1, Group A achieved a statistically significant greater mean proficiency score compared to Group B (44.80 vs 35.33 points, p = 0.006). At time-point 2, there was no significant difference in mean proficiency score in Group A from time-point 1. In contrast, Group B, who received further adjunctive VCT showed significant improvement in mean proficiency by 9.67 points from time-point 1 (95% CI 5.18-14.15, p = 0.003). VCT is an effective, accessible training adjunct to self-directed robotic skills training. With the steep learning curve in robotic surgery training, VCT offers interactive, expert-led learning and can increase training effectiveness and accessibility

Prostate cancer outcomes following whole-gland and focal high-intensity focused ultrasound

Objective: To report the 5-year failure-free survival (FFS) following high-intensity focused ultrasound (HIFU). Patients and Methods: This observational cohort study used linked National Cancer Registry data, radiotherapy data, administrative hospital data and mortality records of 1381 men treated with HIFU for clinically localised prostate cancer in England. The primary outcome, FFS, was defined as freedom from local salvage treatment and cancer-specific mortality. Secondary outcomes were freedom from repeat HIFU, prostate cancer-specific survival (CSS) and overall survival (OS). Cox regression was used to determine whether baseline characteristics, including age, treatment year, T stage and International Society of Urological Pathology (ISUP) Grade Group were associated with FFS. Results: The median (interquartile range [IQR]) follow-up was 37 (20–62) months. The median (IQR) age was 65 (59–70) years and 81% had an ISUP Grade Group of 1–2. The FFS was 96.5% (95% confidence interval [CI] 95.4%–97.4%) at 1 year, 86.0% (95% CI 83.7%–87.9%) at 3 years and 77.5% (95% CI 74.4%–80.3%) at 5 years. The 5-year FFS for ISUP Grade Groups 1–5 was 82.9%, 76.6%, 72.2%, 52.3% and 30.8%, respectively (P < 0.001). Freedom from repeat HIFU was 79.1% (95% CI 75.7%–82.1%), CSS was 98.8% (95% CI 97.7%–99.4%) and OS was 95.9% (95% CI 94.2%–97.1%) at 5 years. Conclusion: Four in five men were free from local salvage treatment at 5 years but treatment failure varied significantly according to ISUP Grade Group. Patients should be appropriately informed with respect to salvage radical treatment following HIFU

Treatment-related toxicity using prostate bed versus prostate bed and pelvic lymph node radiation therapy following radical prostatectomy: A national population-based study

Purpose There is debate about the effectiveness and toxicity of pelvic lymph node (PLN) irradiation in addition to prostate bed radiotherapy when used to treat disease recurrence following radical prostatectomy. We compared toxicity from radiation therapy (RT) to the prostate bed and pelvic lymph nodes (PBPLN-RT) with prostatebed only radiation therapy (PBO-RT) following radical prostatectomy. Methods and Materials Patients with prostate cancer who underwent post-prostatectomy RT between 2010 and 2016 were identified by using the National Prostate Cancer Audit (NPCA) database. Follow-up data was available up to December 31, 2018. Validated outcome measures, based on a framework of procedural and diagnostic codes, were used to capture ≥Grade 2 gastrointestinal (GI) and genitourinary (GU) toxicity. An adjusted competing-risks regression analysis estimated subdistribution hazard ratios (sHR). A sHR > 1 indicated a higher incidence of toxicity with PBPLN-RT than with PBO-RT. Results 5-year cumulative incidences in the PBO-RT (n = 5,087) and PBPLNRT (n = 593) groups was 18.2% and 15.9% for GI toxicity, respectively. For GU toxicity it was 19.1% and 20.7%, respectively. There was no evidence of difference in GI or GU toxicity after adjustment between PBO-RT and PBPLN-RT (GI: adjusted sHR, 0.90, 95% CI, 0.67–1.19; P = 0.45); (GU: adjusted sHR, 1.19, 95% CI, 0.99–1.44; P = 0.09). Conclusions This national population-based study found that including PLNs in the radiation field following radical prostatectomy is not associated with a significant increase in rates of ≥Grade 2 GI or GU toxicity at 5 years

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

Bound by the Bounty: Collaboratively Shaping Evaluation Processes for Queer AI Harms

Bias evaluation benchmarks and dataset and model documentation have emerged as central processes for assessing the biases and harms of artificial intelligence (AI) systems. However, these auditing processes have been criticized for their failure to integrate the knowledge of marginalized communities and consider the power dynamics between auditors and the communities. Consequently, modes of bias evaluation have been proposed that engage impacted communities in identifying and assessing the harms of AI systems (e.g., bias bounties). Even so, asking what marginalized communities want from such auditing processes has been neglected. In this paper, we ask queer communities for their positions on, and desires from, auditing processes. To this end, we organized a participatory workshop to critique and redesign bias bounties from queer perspectives. We found that when given space, the scope of feedback from workshop participants goes far beyond what bias bounties afford, with participants questioning the ownership, incentives, and efficacy of bounties. We conclude by advocating for community ownership of bounties and complementing bounties with participatory processes (e.g., co-creation).Comment: To appear at AIES 202