A System to Monitor Cognitive Workload in Naturalistic High-Motion Environments

Across many careers, individuals face alternating periods of high and low attention and cognitive workload can impair cognitive function and undermine job performance. We have designed and are developing an unobtrusive system to Monitor, Extract, and Decode Indicators of Cognitive Workload (MEDIC) in naturalistic, high-motion environments. MEDIC is designed to warn individuals, teammates, or supervisors when steps should be taken to augment cognitive readiness. We first designed and manufactured a forehead sensor device that includes a custom fNIRS sensor and a three-axis accelerometer designed to be mounted on the inside of a baseball cap or headband, or standard issue gear such as a helmet or surgeon’s cap. Because the conditions under which MEDIC is designed to operate are more strenuous than typical research efforts assessing cognitive workload, motion artifacts in our data were a persistent issue. Results show wavelet-based filtering improved data quality to salvage data from even the highest-motion conditions. MARA spline motion correction did not further improve data quality. Our testing shows that each of the methods is extremely effective in reducing the effects of motion transients present in the data. In combination, they are able to almost completely remove the transients in the signal while preserving cardiac and low frequency information in the signal which was previously unrecoverable. This has substantially improved the stability of the physiological measures produced by the sensors in high noise conditions

The impact of infectious disease specialist consultation for Staphylococcus aureus bloodstream infections: A systematic review

Staphylococcus aureus is a common cause of severe bloodstream infection.We performed a systematic review to assess whether consultation with infectious disease specialists decreased all-cause mortality or rate of complications of S aureus bloodstream infections. The review also assessed parameters associated with the quality of management of the infection. We searched for eligible studies in PubMed, Embase, Scopus, and clinical trials.gov as well as the references of included studies. We identified 22 observational studies and 1 study protocol for a randomized trial. A meta-analysis was not performed because of the high risk of bias in the included studies. The outcomes are reported in a narrative review. Most included studies reported survival benefit, in the adjusted analysis. Recommended management strategies were carried out significantly more often among patients seen by an infectious disease specialist. Trials, such as cluster-randomized controlled trials, can more validly assess the studies at low risk of bias.© The Author 2016. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact [email protected]

Response to Professor Olsen's Commentary on ‘Random Sampling – Is It Worth It?’

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/94518/1/ppe12019.pd

Particulate air pollution, fetal growth and gestational length: The influence of residential mobility in pregnancy.

BACKGROUND: It remains unclear as to whether neglecting residential mobility during pregnancy introduces bias in studies investigating air pollution and adverse perinatal outcomes, as most studies assess exposure based on residence at birth. The aim of this study was to ascertain whether such bias can be observed in a study on the effects of PM10 on risk of preterm birth and fetal growth restriction. METHODS: This was a retrospective study using four pregnancy cohorts of women recruited in Connecticut, USA (N=10,025). We ascertained associations with PM10 exposure calculated using first recorded maternal address, last recorded address, and full address histories. We used a discrete time-to-event model for preterm birth, and logistic regression to investigate associations with small for gestational age (SGA) and term low birth weight (LBW). RESULTS: Pregnant women tended to move to areas with lower levels of PM10. For all outcomes, there was negligible difference between effect sizes corresponding to exposures calculated with first, last and full address histories. For LBW, associations were observed for exposure in second trimester (OR 1.09; 95% CI: 1.04-1.14 per 1µg/m(3) PM10) and whole pregnancy (OR 1.08; 95% CI: 1.02-1.14). For SGA, associations were observed for elevated exposure in second trimester (OR 1.02; 95% CI: 1.00-1.04) and whole pregnancy (OR 1.03; 95% CI: 1.01-1.05). There was insufficient evidence for association with preterm birth. CONCLUSION: PM10 was associated with both SGA and term LBW. However, there was negligible benefit in accounting for residential mobility in pregnancy in this study

Work, Leisure-Time Physical Activity, and Risk of Preeclampsia and Gestational Hypertension

Few studies of preeclampsia have assessed physical activity level, yet recent evidence suggests that the pathologic mechanisms in preeclampsia are similar to those in cardiovascular disease, for which physical activity is shown to be protective. The authors assessed the independent and combined effects of work and regular leisure-time physical activity (LTPA) during early pregnancy on risk of de novo preeclampsia (n = 44) and gestational hypertension (n = 172) among women recruited from 13 obstetric practices in the New Haven, Connecticut, area between 1988 and 1991. Control subjects were normotensive throughout pregnancy (n = 2,422). Information on time at work spent sitting, standing, and walking and on LTPA before and during pregnancy was collected via face-to-face interviews. Logistic regression analyses suggested that women who engaged in any regular LTPA regardless of caloric expenditure (adjusted odds ratio (aOR) = 0.66, 95% confidence interval (CI): 0.35, 1.22), were unemployed (aOR = 0.64, 95% CI: 0.21, 2.00), or had nonsedentary jobs (aOR = 0.71, 95% CI: 0.37, 1.36) were at decreased risk of preeclampsia. Analyses of gestational hypertension showed no indication of a protective effect of workplace activity, LTPA, or unemployment. Consistent with other studies, these data suggest that regular physical activity during pregnancy may reduce preeclampsia risk. employment; exercise; hypertension; motor activity; pre-eclampsia; pregnancy Abbreviations: aOR, adjusted odds ratio; CI, confidence interval; LTPA, leisure-time physical activity. Preeclampsia is a disease specific to human pregnancy, marked by hypertension and proteinuria. Despite decades of preventive efforts, preeclampsia remains a leading cause of maternal and perinatal morbidity and mortality worldwide (1). Research into its epidemiology and pathophysiology suggests that preeclampsia is a condition of heterogeneous causes characterized by a two-stage disease process (1). The first stage is punctuated by shallow, insufficient placentation, which is likely immune mediated (2), followed by systemic activation and disruption of the vascular endothelium with progression to the maternal syndrome (stage 2) (3). Oxidative stress is regarded as the mechanism most likely to cause endothelial dysfunction characteristic of preeclamptic pregnancies (4). Findings from the epidemiologic literature provide rational support for this mechanistic model. Factors consistent with an immune-based etiology include the higher risk after partner change among multiparous women with no prior preeclampsia (5-8), a short duration of sexual activity with the baby's father at the time of conception (9), and conception aided by donor insemination or embryos (10, 11), as well as a protective effect of abortion among nulliparous women who conceive again with the same father (12). Numerous lines of evidence implicate oxidative stress as a causal mechanism. Cardiovascular disease and preeclampsia share both a common disease pathway (i.e., endothelial activation) and many of the same constitutional risk factors, including hypertension, dyslipidemia, insulin resistance, an