Design and evaluation of braced touch for touchscreen input stabilisation.

Incorporating touchscreen interaction into cockpit flight systems offers several potential advantages to aircraft manufacturers, airlines, and pilots. However, vibration and turbulence are challenges to reliable interaction. We examine the design space for braced touch interaction, which allows users to mechanically stabilise selections by bracing multiple fingers on the touchscreen before completing selection. Our goal is to enable fast and accurate target selection during high levels of vibration, without impeding interaction performance when vibration is absent. Three variant methods of braced touch are evaluated, using doubletap, dwell, or a force threshold in combination with heuristic selection criteria to discriminate intentional selection from concurrent braced contacts. We carried out an experiment to test the performance of these methods in both abstract selection tasks and more realistic flight tasks. The study results confirm that bracing improves performance during vibration, and show that doubletap was the best of the tested methods

The effect of selected rest break activities on reaction time, balance, and perceived discomfort after one hour of simulated occupational whole-body vibration exposure in healthy adults

Copyright statement: This is an Open Access article distributed under the terms of the creative commons Attribution license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The terms on which this article has been published allow the posting of the Accepted Manuscript in a repository by the author(s) or with their consent.This work was supported by Agrivita Canada, Mitacs Accelerate, University of Saskatchewan College of Medicine Research Award, University of Saskatchewan College of Medicine MPT Research Project Funding, and WorkSafeBC Ralph McGinn Postdoctoral Fellowship. The funding sources had no involvement in study design, data collection, analysis and interpretation of data, writing the manuscript, and decision to submit the article for publication.Peer ReviewedBackground & Objective Negative health effects from occupational whole-body vibration (WBV) exposure during machinery operation include alterations in proprioception, vestibular function, reaction time, stress, motor response, and decrements in musculoskeletal health. To reduce WBV exposure during machinery operation, it may be possible to incorporate short rest break activities throughout the day. This study aims to determine if there are intervention activities that can minimize decrements in cognitive, proprioceptive, and musculoskeletal effects related to WBV exposure during machine operation. Materials & Methods Eleven healthy adults participated in four 1-hour sessions of ecologically valid WBV exposure followed by one of four 5-minute activities: sitting, walking, 2 minutes of gaze stabilization exercise (GSE) coupled with 3 minutes of trunk mobility exercise (GSE+MOBIL), or 2 minutes of GSE coupled with a 3-minute walk (GSE+WALK). Baseline and post-activity measurements (rating of perceived discomfort, balance and postural sway measurements, 5-minute psychomotor vigilance task test) were submitted to a paired t-test to determine the effect of WBV exposure and activities on physical, cognitive, and sensorimotor systems and to a repeated measures ANOVA to determine any differences across activities. Results We observed degradation of the slowest 10% reaction speed outcomes between baseline and post-activity after walking (7.3%, p<0.05) and sitting (8.6%, p<0.05) but not after GSE+MOBIL or GSE+WALK activities. Slowest 10% reaction speeds after GSE+MOBIL activity was faster than all other activities. Rating of perceived discomfort was higher after SIT and WALK activities. There were no notable differences in balance outcomes. Conclusion When compared to sitting for 5 minutes, an activity including GSE and an active component, such as walking or trunk mobility exercises, resulted in maintenance of reaction time after WBV exposure. If confirmed in occupational environments, GSE may provide a simple, rapid, effective, and inexpensive means to protect against decrements in reaction time after WBV exposure

A route to sustainable aviation : a roadmap for the realization of aircraft components with electrical and structural multifunctionality

Increased electrification of aircraft power systems has been widely presented as a route toward meeting environmental and emissions targets for aircraft performance, via more-electric aircraft and future hybrid-electric aircraft concepts. In parallel, the superior mechanical performance of carbon fiber reinforced polymer (CFRP) has resulted in its increasing use for aircraft structures. The relatively low electrical conductivity of CFRP compared to traditional aluminum structures and copper conductors limits the use of structural CFRP structures as electrical elements, so separate systems are needed. This adds structural mass and volume to a system, negating some of the benefits of using CFRP. Closer integration of the composite structure and electrical power system (EPS), with an ultimate goal of achieving components with multifunctionality (combined thermal, electrical, and structural functionality), offers a route toward the light-weighting of these systems, thus supporting improvements in aircraft performance. This article presents a roadmap to achieve this multifunctionality, supported by the combination of introducing definitions for different levels of multifunctionality, associated design thresholds, and trades between the EPS and CFRP materials/structures. Existing multifunctional (MF) electrical-thermal-structural CFRP-based solutions are contextualized within this roadmap. This enables the realization of viable routes for developing MF systems for the strategic focus of future research efforts

Health-related quality of life and symptoms in patients with rituximab-refractory indolent non-Hodgkin lymphoma treated in the phase III GADOLIN study with obinutuzumab plus bendamustine versus bendamustine alone

F. Hoffmann-La Roche Lt

Finishing the euchromatic sequence of the human genome

The sequence of the human genome encodes the genetic instructions for human physiology, as well as rich information about human evolution. In 2001, the International Human Genome Sequencing Consortium reported a draft sequence of the euchromatic portion of the human genome. Since then, the international collaboration has worked to convert this draft into a genome sequence with high accuracy and nearly complete coverage. Here, we report the result of this finishing process. The current genome sequence (Build 35) contains 2.85 billion nucleotides interrupted by only 341 gaps. It covers ∼99% of the euchromatic genome and is accurate to an error rate of ∼1 event per 100,000 bases. Many of the remaining euchromatic gaps are associated with segmental duplications and will require focused work with new methods. The near-complete sequence, the first for a vertebrate, greatly improves the precision of biological analyses of the human genome including studies of gene number, birth and death. Notably, the human enome seems to encode only 20,000-25,000 protein-coding genes. The genome sequence reported here should serve as a firm foundation for biomedical research in the decades ahead

Effect of Hydrocortisone on Mortality and Organ Support in Patients With Severe COVID-19: The REMAP-CAP COVID-19 Corticosteroid Domain Randomized Clinical Trial.

Importance: Evidence regarding corticosteroid use for severe coronavirus disease 2019 (COVID-19) is limited. Objective: To determine whether hydrocortisone improves outcome for patients with severe COVID-19. Design, Setting, and Participants: An ongoing adaptive platform trial testing multiple interventions within multiple therapeutic domains, for example, antiviral agents, corticosteroids, or immunoglobulin. Between March 9 and June 17, 2020, 614 adult patients with suspected or confirmed COVID-19 were enrolled and randomized within at least 1 domain following admission to an intensive care unit (ICU) for respiratory or cardiovascular organ support at 121 sites in 8 countries. Of these, 403 were randomized to open-label interventions within the corticosteroid domain. The domain was halted after results from another trial were released. Follow-up ended August 12, 2020. Interventions: The corticosteroid domain randomized participants to a fixed 7-day course of intravenous hydrocortisone (50 mg or 100 mg every 6 hours) (n = 143), a shock-dependent course (50 mg every 6 hours when shock was clinically evident) (n = 152), or no hydrocortisone (n = 108). Main Outcomes and Measures: The primary end point was organ support-free days (days alive and free of ICU-based respiratory or cardiovascular support) within 21 days, where patients who died were assigned -1 day. The primary analysis was a bayesian cumulative logistic model that included all patients enrolled with severe COVID-19, adjusting for age, sex, site, region, time, assignment to interventions within other domains, and domain and intervention eligibility. Superiority was defined as the posterior probability of an odds ratio greater than 1 (threshold for trial conclusion of superiority >99%). Results: After excluding 19 participants who withdrew consent, there were 384 patients (mean age, 60 years; 29% female) randomized to the fixed-dose (n = 137), shock-dependent (n = 146), and no (n = 101) hydrocortisone groups; 379 (99%) completed the study and were included in the analysis. The mean age for the 3 groups ranged between 59.5 and 60.4 years; most patients were male (range, 70.6%-71.5%); mean body mass index ranged between 29.7 and 30.9; and patients receiving mechanical ventilation ranged between 50.0% and 63.5%. For the fixed-dose, shock-dependent, and no hydrocortisone groups, respectively, the median organ support-free days were 0 (IQR, -1 to 15), 0 (IQR, -1 to 13), and 0 (-1 to 11) days (composed of 30%, 26%, and 33% mortality rates and 11.5, 9.5, and 6 median organ support-free days among survivors). The median adjusted odds ratio and bayesian probability of superiority were 1.43 (95% credible interval, 0.91-2.27) and 93% for fixed-dose hydrocortisone, respectively, and were 1.22 (95% credible interval, 0.76-1.94) and 80% for shock-dependent hydrocortisone compared with no hydrocortisone. Serious adverse events were reported in 4 (3%), 5 (3%), and 1 (1%) patients in the fixed-dose, shock-dependent, and no hydrocortisone groups, respectively. Conclusions and Relevance: Among patients with severe COVID-19, treatment with a 7-day fixed-dose course of hydrocortisone or shock-dependent dosing of hydrocortisone, compared with no hydrocortisone, resulted in 93% and 80% probabilities of superiority with regard to the odds of improvement in organ support-free days within 21 days. However, the trial was stopped early and no treatment strategy met prespecified criteria for statistical superiority, precluding definitive conclusions. Trial Registration: ClinicalTrials.gov Identifier: NCT02735707

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

Factors Associated with Revision Surgery after Internal Fixation of Hip Fractures

Background: Femoral neck fractures are associated with high rates of revision surgery after management with internal fixation. Using data from the Fixation using Alternative Implants for the Treatment of Hip fractures (FAITH) trial evaluating methods of internal fixation in patients with femoral neck fractures, we investigated associations between baseline and surgical factors and the need for revision surgery to promote healing, relieve pain, treat infection or improve function over 24 months postsurgery. Additionally, we investigated factors associated with (1) hardware removal and (2) implant exchange from cancellous screws (CS) or sliding hip screw (SHS) to total hip arthroplasty, hemiarthroplasty, or another internal fixation device. Methods: We identified 15 potential factors a priori that may be associated with revision surgery, 7 with hardware removal, and 14 with implant exchange. We used multivariable Cox proportional hazards analyses in our investigation. Results: Factors associated with increased risk of revision surgery included: female sex, [hazard ratio (HR) 1.79, 95% confidence interval (CI) 1.25-2.50; P = 0.001], higher body mass index (fo

Balancing efficiencies and tradeoffs in epidemiological field studies : evaluating EMG exposure assessment for low back injury risk factors in heavy industry

In order to investigate the etiology of and evaluate interventions for work-related back injuries, researchers need efficient, accurate occupational exposure assessment methods suitable for large samples. The chapters in this thesis examine critical decisions using electromyography (EMG): How should exposure be measured? For what duration? Who should be measured, and how many times? Low-back EMG, or muscle activity data, was collected during 138 full-shift field measurements over 30 different job titles at 50 different worksites in 5 heavy industries: forestry, transportation, wood products, construction, and warehousing. Observations and self-reports of posture, manual materials handling (MMH), and driving exposures were collected concurrently. 1) Variability of EMG calibration measurements was investigated on right/left sides, multiple trials, 4 positions, and pre/post-shift. Position accounts for the majority of explained variability; there is little to gain by measuring multiple trials or pre- and post-shift, but measuring both sides and multiple positions is worthwhile. 2) Observation and self-report data were easier to collect and cheaper than the EMG direct measure. Costs and successful field performance need to be weighed against the added data detail when making choices about exposure assessment techniques for epidemiological studies. 3) Observed and self-reported exposures were used to predict EMG exposure metrics using mixed multiple linear regression models. Regression models using observed variables predicted 43-50% of the variability in the EMG metrics, while self-reported variables predicted 21%-36%. The observation exposure model provides a low-cost alternative to direct measurement. The self-reported exposure model should be considered with more caution. 4) Full-shift EMG data was resampled for 4, 2, and 1 hour, and for 10 and 2 minute durations to determine the optimal sampling duration. Bias was consistently low, but shorter durations had higher absolute error, percentage error, and limits of agreement. Durations of 4 and 2 hours may be acceptable but those less than 1 hour had large errors. 5) Components of EMG variance were calculated between- and within-subject, and between- industry, company, job, and post hoc grouping. Resolution, contrast, and exposure-response relationship attenuation were calculated for each grouping scheme. The post hoc scheme had the highest contrast and lowest resolution.Medicine, Faculty ofPopulation and Public Health (SPPH), School ofGraduat