Charges of twisted branes: the exceptional cases

The charges of the twisted D-branes for the two exceptional cases (SO(8) with the triality automorphism and E_6 with charge conjugation) are determined. To this end the corresponding NIM-reps are expressed in terms of the fusion rules of the invariant subalgebras. As expected the charge groups are found to agree with those characterising the untwisted branes.Comment: 15 page

A Utility Framework for COVID-19 Online Forward Triage Tools: A Swiss Telehealth Case Study.

The SARS-CoV-2 pandemic caused a surge in online tools commonly known as symptom checkers. The purpose of these symptom checkers was mostly to reduce the health system burden by providing worried people with testing criteria, where to test and how to self-care. Technical, usability and organizational challenges with regard to online forward triage tools have also been reported. Very few of these online forward triage tools have been evaluated. Evidence for decision frameworks may be of particular value in a pandemic setting where time frames are restricted, uncertainties are ubiquitous and the evidence base is changing rapidly. The objective was to develop a framework to evaluate the utility of COVID-19 online forward triage tools. The development of the online forward triage tool utility framework was conducted in three phases. The process was guided by the socio-ecological framework for adherence that states that patient (individual), societal and broader structural factors affect adherence to the tool. In a further step, pragmatic incorporation of themes on the utility of online forward triage tools that emerged from our study as well as from the literature was performed. Seven criteria emerged; tool accessibility, reliability as an information source, medical decision-making aid, allaying fear and anxiety, health system burden reduction, onward forward transmission reduction and systems thinking (usefulness in capacity building, planning and resource allocation, e.g., tests and personal protective equipment). This framework is intended to be a starting point and a generic tool that can be adapted to other online forward triage tools beyond COVID-19. A COVID-19 online forward triage tool meeting all seven criteria can be regarded as fit for purpose. How useful an OFTT is depends on its context and purpose

Muscular Torque Output During Neuromuscular Electrical Stimulation Following a 4-week Training Intervention in Older Adults

Neuromuscular electrical stimulation (NMES) can be used to induce muscle torque by generating involuntary muscle contractions. If a greater muscular torque and torque maintenance could be induced by NMES training bouts, it may lead to improvements in electrically induced muscular endurance. However, little is known regarding torque output during NMES pre-post training. PURPOSE: The purpose of this study was to determine if a 4-week NMES training intervention would alter involuntary muscular torque output during the NMES protocol in older, healthy adults. METHODS: Eleven older adults (68.7 ± 2.1 years) completed 12 (Day 1 – Day 12), 40-min NMES training sessions of the quadriceps muscles three times a week, over 4-weeks, with the stimulation frequency set at 60 Hz. Maximal voluntary contractions (MVC) were measured pre-training and mid-training. NMES was delivered through stimulation electrodes placed on the quadriceps muscles and torque output was recorded during the training sessions. Stimulation intensity was set to generate muscular torque output to meet a target representing 15% MVC and was adjusted every 5 minutes to achieve target torque. During each training session, 96 total contractions were generated during the NMES protocol. For Day 1 and Day 12, mean torque, peak torque, and torque time integral (TTI) were measured for each contraction and were then normalized to the pre-training MVC for Day 1 and mid-training MVC for Day 12. The overall mean of the 96 contractions was then calculated for each torque parameter. Sum of TTI (STTI) was calculated by summing the normalized TTI for all contractions. The average stimulation intensity was recorded, and the mean was calculated for each day. Paired sample t-tests were used to test for differences between Days (Day 1 and Day 12) for torque parameters and stimulation intensity. Statistical significance was set at p ≤ 0.05. RESULTS: TTI (Day 1: 90.5 ± 6.1% MVC vs Day 12: 75.9 ± 9.4% MVC; p = 0.036) and STTI (Day 1: 8,686.4 ± 582.0% MVC vs Day 12: 7,2801.0 ± 903.8% MVC; p = 0.036) were lower on Day 12 compared to Day 1. Additionally, there was a trend toward lower mean torque after training (Day 1: 8.7 ± 0.5% MVC vs Day 12: 7.3 ± 0.9% MVC; p = 0.055). Peak torque was not different between days (Day 1: 12.9 ± 0.6% MVC vs Day 12: 13.0 ± 0.7% MVC; p = 0.859). Stimulation intensity showed a trend toward higher stimulation intensity on Day 12 compared to Day 1 (Day 1: 13.3 ± 0.7 mA vs Day 12: 14.6 ± 1.0 mA, p = 0.10). CONCLUSION: Torque output during the NMES protocol was not improved with NMES training and demonstrated a decrease in some torque parameters. The inability of the muscle to produce similar torque output after training may be due to muscle accommodation to the NMES stimulation with repeated bouts. If the goal is to improve involuntary muscular endurance, allowing for more recovery between NMES sessions and use of a lower stimulation frequency may facilitate greater overall muscular torque output following NMES training

Use of telehealth and outcomes before a visit to the emergency department: a cross-sectional study on walk-in patients in Switzerland

AIMS OF THE STUDY An increasing number of patients are using telehealth before contacting the healthcare system. If we are to optimise future telehealth strategies and adequately respond to patient needs, we need to know more about the frequency and characteristics of telehealth use. Our objectives were (i) to investigate whether patients use telehealth before consulting the emergency department (ED), (ii) to compare patients with and without use of telehealth, and (iii) to investigate adherence, confidence and satisfaction. MATERIALS AND METHODS A survey was conducted among ED walk-in patients at a tertiary university hospital in Switzerland. Eligible patients were questioned about their use of telehealth before current presentation, during 30 shifts from 23 October to 15 December 2019. RESULTS A total of 183 (43.9%) of 417 surveyed patients used telehealth, with the telephone being the most commonly used modality, especially among elderly patients. Patients using telehealth were more likely to be male (53.5%, p = 0.001) and were similar in age to non-users. Telehealth users tended to be better educated. Telehealth was predominantly used for semi-urgent non-traumatic diseases that did not lead to hospitalisation. All age groups expressed satisfaction with telehealth, trusted the recommendations and adhered to them. The main reason for "non-use" of telehealth was lack of knowledge. CONCLUSIONS Lack of knowledge about telehealth opportunities and barriers in specific patient groups should be addressed to include all patients, and thus to exploit telehealth’s many advantages

Changes in Physical Function Following 4-Weeks of Neuromuscular Electrical Stimulation Training in Older Adults

Sarcopenia, the age-related loss of muscle mass and strength, can result in a decline in physical function. Neuromuscular electrical stimulation (NMES) has been shown to induce muscular adaptations that have the potential to translate to functional improvements; however, little is known regarding functional adaptations pre-post short-term NMES training, especially in older adults. PURPOSE: The aim of this study was to determine NMES-induced changes in lower extremity physical function following 4 weeks of an NMES training intervention of the quadriceps muscle in older adults. METHODS: Seventeen healthy, older adults (68.8 ± 1.8 years old) were divided into two groups: NMES (n = 12) and SHAM (n = 5). The NMES group underwent 12, 40-minute NMES training sessions to the quadriceps muscles on each leg 3x/week over 4 weeks, with the stimulation intensity adjusted every 5 minutes, as needed, to achieve a 15% target torque of each participant’s maximal voluntary contraction (MVC). The stimulation parameters consisted of a 60 Hz stimulation frequency and a duty cycle of 10s on and 15s off. The SHAM group was blinded and did not receive any treatment. The following functional assessments were measured before and after the 4-week training period: Timed Up and Go (TUG), 5x Sit-to-Stand (5XSTS), Stair Climb (SC), and 6-Minute Walk Test (6MWT). Repeated-measures ANOVAs were used to determine changes in TUG, 5XSTS, SC, and 6MWT assessments pre-post NMES training and data are reported as mean ± SE. Statistical significance was set at P \u3c 0.05. RESULTS: NMES training significantly improved TUG (NMES: 8.81 ± 0.54s vs. 7.67 ± 0.39s; P = 0.002; SHAM: 10.60 ± 2.41 vs. 10.93 ± 3.01s; P = 0.652; pre- and post-training, respectively) and SC (NMES: 4.03 ± 0.20s vs. 3.76 ± 0.16s; P = 0.023; SHAM: 6.53 ± 2.11 vs. 6.0 ± 1.78s; P = 0.215; pre- and post-training, respectively); however, 5XSTS (NMES: 9.70 ± 0.75 vs. 8.83 ± 0.72; P \u3e 0.05; SHAM: 14.34 ± 3.64 vs. 13.28 ± 3.89; P \u3e 0.05; pre- and post-training, respectively) and 6MWT (NMES: 610.10 ± 22.68 vs. 623.74 ± 14.73; P \u3e 0.05; SHAM: 533.43 ± 82.44 vs. 587.81 ± 80.52; P \u3e 0.05; pre- and post-training, respectively) did not change following the NMES intervention. CONCLUSION: Improvements in TUG and SC following 4 weeks of NMES training demonstrate augmented lower body physical function, suggesting that short-term NMES training programs may induce neuromuscular adaptations that contribute to these early improvements in physical function in older adults

The Utility of a Pediatric COVID-19 Online Forward Triage Tool in Switzerland.

Background To offset the burden on the health system, hospitals set up telehealth interventions, such as online forward triage tools (OFTT). The website www.coronabambini.ch was developed to specifically address the needs of children and their families in Switzerland and to facilitate the decision to test, isolate, attend school, or access the health care system. Methods Video interviews were held with key informants (n = 20) from a population of parents, teachers, guardians, as well as doctors who had used the child-specific COVID-19 OFTT and had consented to a further study. Convenience and quota sampling were done to include a variety of key informants. Interviews were recorded, transcribed verbatim, and analyzed for themes. Results Three main themes emerged: i) the usefulness of the OFTT to the users, ii) expectation management and importance of stakeholder involvement in OFTT development, and iii) OFTT limitations. Conclusion Our study highlights opportunities, limitations, and lessons to consider when developing a pediatric COVID-19 OFTT. The involvement of stakeholders, parents, teachers, and health care providers in the design, set up, implementation, and evaluation of telehealth interventions is critical as this can help with expectation management and enhance OFTT utility

The Utility of an Online Forward Triage Tool During the SARS-CoV-2 Pandemic: Health Care Provider and Health Authority Perspectives.

Introduction The SARS CoV-2 pandemic poses major challenges not only to patients but also to health care professionals and policy-makers, with rapidly changing, sometimes complex, recommendations, and guidelines to the population. Online forward triage tools (OFTT) got a major boost from the pandemic as they helped with the implementation and monitoring of recommendations. Methods A multiphase mixed method sequential explanatory study design was employed. Quantitative data were collected first and informed the qualitative interview guides. Video interviews were held with key informants (health care providers and health authorities) between 2 September and 10 December 2020. Audio-recordings were transcribed verbatim, coded thematically and compared with patient perspectives (framework). Objectives To explore the perspectives of health care providers and authorities in Canton Bern on the utility of a COVID-19 OFTT, as well as elicit recommendations for telehealth in future. Results The following themes emerged; (i) accessibility (ii) health system burden reduction (iii) utility in preventing onward transmission (iv) utility in allaying fear and anxiety (v) medical decision-making utility (vi) utility as information source (vii) utility in planning and systems thinking. The health care providers and health authorities further provided insights on potential barriers and facilitators of telehealth in future. Conclusion Similar to patients, health care providers acknowledge the potential and utility of the COVID-19 OFTT particularly as an information source and in reducing the health system burden. Data privacy, doctor-patient relationship, resistance to change, regulatory, and mandate issues, and lack of systems thinking were revealed as barriers to COVID-19 OFTT utility

Telehealth use by walk-in patients who subsequently visited an academic emergency department: a repeated cross-sectional study during the COVID-19 summer 2021.

AIM OF THE STUDY During the COVID-19 pandemic, telehealth use increased worldwide in a variety of medical specialities and reached new population groups. A baseline survey of telehealth use prior to admission to the emergency department (ED) conducted before COVID-19 concluded that predominantly well-educated men used telehealth. It is unclear how COVID-19 changed the use of telehealth in Swiss emergency patients. We therefore aimed to investigate (i) the frequency of telehealth use during the pandemic, and (ii) how the pandemic has influenced telehealth use and users. MATERIALS AND METHODS A repeated cross-sectional study was conducted among ED walk-in patients at a tertiary university hospital in Switzerland. The study took place one and a half years after the first confirmed COVID-19 case, during 30 shifts from 8 to 29 July 2021 and compared with the baseline survey conducted in 2019. Eligible patients were questioned about their use of, and attitudes to telehealth. RESULTS A total of 1020 patients were screened for the COVID survey and 443 complete questionnaires were evaluated. A trend towards a general increase (+6.4%) in telehealth use was demonstrated (50.3%, n = 223 COVID survey vs 43.9%, n = 183 baseline survey; p = 0.058), with a shift to more female patients using telehealth in the COVID survey (female 54.9%, n = 124 vs 45.1%, n = 102; p = 0.052). During the pandemic, first use of telehealth was reported by 12.2% (n = 54) of patients, with a significant increase among patients with low educational status, and the latter patients often indicated that they did not plan to use telehealth after the pandemic. The perceived usefulness of telehealth and adherence to recommendations increased in the COVID survey compared with the baseline survey (adherence 90.3%, n = 149, vs 78.0%, n = 131; p = 0.002). CONCLUSION We found a trend towards increased use of telehealth among Swiss ED patients. First-time users of telehealth were predominantly less educated and inclusion of these user groups may not be sustainable, as was indicated by the patients. COVID-19 led to greater adherence to telehealth recommendations and higher perceived usefulness. This could be due to the limited access to healthcare providers due to pandemic precautions. When offering telehealth, the needs of all patient groups must be considered, in order to ensure that telehealth provides the greatest benefit with lower barriers to use