Interactive Distraction Techniques Versus Midazolam in Anxiolysis In Pediatric Patients: A Systematic Review and Meta-Analysis

Background: Many pediatric patients experience high levels of anxiety prior to undergoing surgery. Midazolam is currently one of the most commonly used sedative drugs in the pediatric preoperative environment. A number of studies have evaluated the use of non-pharmacological methods of relaxing pediatric patients prior to surgery, known as ‘Interactive Distraction’. These techniques involve using various methods of distracting the child from the preoperative anesthetic procedures. Some examples of these methods involve giving the patient an iPad with which they can play video games. There have yet to be any systematic reviews comparing the usage of Midazolam alone against utilizing interactive distraction alone techniques to mitigate pediatric anxiolysis in the preoperative setting. We hypothesize that interactive distraction could be noninferior in reducing anxiety levels in these patients. Purpose: This systematic review and meta analysis compared the preoperative anxiolytic effects of Midazolam to interactive distraction techniques on a pediatric population. Methods: The systematic review and meta analysis followed the 2020 PRISMA guidelines. Six online databases were surveyed (Pubmed, Embase, Scopus, Cochrane, Web of Science). The analysis included randomized controlled trials (RCTs) in which pediatric patients received .3 mg/kg Midazolam alone or interactive distraction. Patient anxiety levels were measured using the modified Yale Perioperative Anxiety Scale (myPAS). MyPAS scores were evaluated at two distinct time marks, the first being arrival to the surgical ward whilst the other time mark measured was during induction of anesthesia. Two RCTs fit the inclusion criteria for the review, yielding 217 distinct evaluations. The average patient age was 6.79 ± 2.13. Results: The results portray clinically significant results as there was a low, but apparent difference in mean effect size with a difference of Cohen’s d = 0.21, in favor of utilizing the Midazolam. However, there was no statistical significance (p = 0.57) between utilizing Midazolam alone versus utilizing the interactive distraction techniques. Discussion: Utilization of .3 mg/kg Midazolam had clinically superior anxiolysis compared to the interactive distractions. A main limitation of our study is the relatively small sample size of 217 patients. Conducting additional RCTs with larger sample sizes would be beneficial in reinforcing our findings

Deep learning based decomposition for visual navigation in industrial platforms

In the heavy asset industry, such as oil & gas, offshore personnel need to locate various equipment on the installation on a daily basis for inspection and maintenance purposes. However, locating equipment in such GPS denied environments is very time consuming due to the complexity of the environment and the large amount of equipment. To address this challenge we investigate an alternative approach to study the navigation problem based on visual imagery data instead of current ad-hoc methods where engineering drawings or large CAD models are used to find equipment. In particular, this paper investigates the combination of deep learning and decomposition for the image retrieval problem which is central for visual navigation. A convolutional neural network is first used to extract relevant features from the image database. The database is then decomposed into clusters of visually similar images, where several algorithms have been explored in order to make the clusters as independent as possible. The Bag-of-Words (BoW) approach is then applied on each cluster to build a vocabulary forest. During the searching process the vocabulary forest is exploited to find the most relevant images to the query image. To validate the usefulness of the proposed framework, intensive experiments have been carried out using both standard datasets and images from industrial environments. We show that the suggested approach outperforms the BoW-based image retrieval solutions, both in terms of computing time and accuracy. We also show the applicability of this approach on real industrial scenarios by applying the model on imagery data from offshore oil platforms.publishedVersio

Event-based, 6-DOF Camera Tracking from Photometric Depth Maps

Event cameras are bio-inspired vision sensors that output pixel-level brightness changes instead of standard intensity frames. These cameras do not suffer from motion blur and have a very high dynamic range, which enables them to provide reliable visual information during high-speed motions or in scenes characterized by high dynamic range. These features, along with a very low power consumption, make event cameras an ideal complement to standard cameras for VR/AR and video game applications. With these applications in mind, this paper tackles the problem of accurate, low-latency tracking of an event camera from an existing photometric depth map (i.e., intensity plus depth information) built via classic dense reconstruction pipelines. Our approach tracks the 6-DOF pose of the event camera upon the arrival of each event, thus virtually eliminating latency. We successfully evaluate the method in both indoor and outdoor scenes and show that—because of the technological advantages of the event camera—our pipeline works in scenes characterized by high-speed motion, which are still unaccessible to standard cameras

Soil N2O emissions with different reduced tillage methods during the establishment of Miscanthus in temperate grassland

An increase in renewable energy and the planting of perennial bioenergy crops is expected in order to meet global greenhouse gas (GHG) targets. Nitrous oxide (N2O) is a potent greenhouse gas, and this paper addresses a knowledge gap concerning soil N2O emissions over the possible “hot spot” of land use conversion from established pasture to the biofuel crop Miscanthus. The work aims to quantify the impacts of this land use change on N2O fluxes using three different cultivation methods. Three replicates of four treatments were established: Miscanthus x giganteus (Mxg) planted without tillage; Mxg planted with light tillage; a novel seed‐based Miscanthus hybrid planted with light tillage under bio‐degradable mulch film; and a control of uncultivated established grass pasture with sheep grazing. Soil N2O fluxes were recorded every 2 weeks using static chambers starting from preconversion in April 2016 and continuing until the end of October 2017. Monthly soil samples were also taken and analysed for nitrate and ammonium. There was no significant difference in N2O emissions between the different cultivation methods. However, in comparison with the uncultivated pasture, N2O emissions from the cultivated Miscanthus plots were 550%–819% higher in the first year (April to December 2016) and 469%–485% higher in the second year (January to October 2017). When added to an estimated carbon cost for production over a 10 year crop lifetime (including crop management, harvest, and transportation), the measured N2O conversion cost of 4.13 Mg CO2‐eq./ha represents a 44% increase in emission compared to the base case. This paper clearly shows the need to incorporate N2O fluxes during Miscanthus establishment into assessments of GHG balances and life cycle analysis and provides vital knowledge needed for this process. This work therefore also helps to support policy decisions regarding the costs and benefits of land use change to Miscanthus

The Massive Progenitor of the Possible Type II-Linear Supernova 2009hd in Messier 66

We present observations of SN2009hd in the nearby galaxy M66. This SN is one of the closest to us in recent years but heavily obscured by dust, rendering it unusually faint in the optical, given its proximity. We find that the observed properties of SN2009hd support its classification as a possible Type II-L SN, a relatively rare subclass of CC-SNe. High-precision relative astrometry has been employed to attempt to identify a SN progenitor candidate, based on a pixel-by-pixel comparison between HST F555W and F814W images of the SN site prior to explosion and at late times. A progenitor candidate is identified in the F814W images only; this object is undetected in F555W. Significant uncertainty exists in the astrometry, such that we cannot definitively identify this object as the SN progenitor. Via insertion of artificial stars into the pre-SN HST images, we are able to constrain the progenitor's properties to those of a possible supergiant, with M(F555W)0>-7.6 mag and (V-I) 0>0.99 mag. The magnitude and color limits are consistent with a luminous RSG; however, they also allow for the possibility that the star could have been more yellow than red. From a comparison with theoretical massive-star evolutionary tracks, which include rotation and pulsationally enhanced mass loss, we can place a conservative upper limit on the initial mass for the progenitor of <20 M_sun. If the actual mass of the progenitor is near the upper range allowed by our derived mass limit, then it would be consistent with that for the identified progenitors of the SNII-L 2009kr and the high-luminosity SNII-P 2008cn. The progenitors of these three SNe may possibly bridge the gap between lower-mass RSG that explode as SNeII-P and LBV, or more extreme RSG, from which the more exotic SNeII-n may arise. Very late-time imaging of the SN2009hd site may provide us with more clues regarding the true nature of its progenitor.Comment: 19 pages, 9 figures, 3 tables, accepted for publication in Ap

Hyperspectral imaging and machine learning for the prediction of SSC in kiwi fruits

Solids Content (SSC) of the fruits in a non-destructive way. A&nbsp;database is created which includes the hyperspectral data acquired in the&nbsp;visible and near-infrared region (VNIR) and measurements done with a&nbsp;sugar meter.We have applied di?erent machine learning techniques to investigate&nbsp;the correlation between spectral information and the SSC. The&nbsp;models tested were support vector regression (SVR), k-nearest neighbor&nbsp;(KNN), partial least squares (PLS), and multiple linear regression&nbsp;(MLR) with di?erent variable selection techniques and dimensionality&nbsp;reduction. The best model at determining SSC was Uninformative Variable&nbsp;Elimination (UVE)-PLS, which had RMSE = 1.047 °Brix and R2&nbsp;= 0.39 on the test set

A hard look at the X-ray spectral variability of NGC 7582

NGC 7582 (z = 0.005264; D = 22.5 Mpc) is a highly variable, changing-look AGN. In this work, we explore the X-ray properties of this source using XMM-Newton and NuSTAR archival observations in the 3-40 keV range, from 2001 to 2016. NGC 7582 exhibits a long-term variability between observations but also a short-term variability in two observations that has not been studied before. To study the variability, we perform a time-resolved spectral analysis using a phenomenological model and a physically-motivated model (uxclumpy). The spectral fitting is achieved using a nested sampling Monte Carlo method. uxclumpy enables testing various geometries of the absorber that may fit AGN spectra. We find that the best model is composed of a fully covering clumpy absorber. From this geometry, we estimate the velocity, size and distance of the clumps. The column density of the absorber in the line of sight varies from Compton-thin to Compton-thick between observations. Variability over the timescale of a few tens of kilo-seconds is also observed within two observations. The obscuring clouds are consistent with being located at a distance not larger than 0.6 pc, moving with a transverse velocity exceeding $\sim 700$ km s$^{-1}$. We could put only a lower limit on the size of the obscuring cloud being larger than $10^{13}$ cm. Given the sparsity of the observations, and the limited exposure time per observation available, we cannot determine the exact structure of the obscuring clouds. The results are broadly consistent with comet-like obscuring clouds or spherical clouds with a non-uniform density profile.Comment: 14 pages, 12 figures, accepted for publication in MNRA

Understanding factors impacting patient-reported outcome measures integration in routine clinical practice: an umbrella review

Purpose: Patient-report outcome measures (PROMs) have gained widespread support as a mechanism to improve healthcare quality. We aimed to map out key enablers and barriers influencing PROMs implementation strategies in routine clinical practice. Methods: An umbrella review was conducted to identify reviews exploring enablers and barriers related to the integration of PROMs in routine clinical practice from January 2000 to June 2023. Information on key enablers and barriers was extracted and summarised thematically according to the Theoretical Domains Framework. Results: 34 reviews met our criteria for inclusion. Identified reviews highlighted barriers such as limited PROMs awareness among clinicians and patients, perceived low value by clinicians and patients, PROMs that were too complex or difficult for patients to complete, poor usability of PROMs systems, delayed feedback of PROMs data, clinician concerns related to use of PROMs as a performance management tool, patient concerns regarding privacy and security, and resource constraints. Enablers encompassed phased implementation, professional training, stakeholder engagement prior to implementation, clear strategies and goals, ‘change champions’ to support PROMs implementation, systems to respond to issues raised by PROMs, and integration into patient pathways. No consensus favoured paper or electronic PROMs, yet offering both options to mitigate digital literacy bias and integrating PROMs into electronic health records emerged as important facilitators. Conclusions: The sustainable implementation of PROMs is a complex process that requires multicomponent organisational strategies covering training and guidance, necessary time and resources, roles and responsibilities, and consultation with patients and clinicians

Drug Repositioning and Pharmacophore Identification in the Discovery of Hookworm MIF Inhibitors

SummaryThe screening of bioactive compound libraries can be an effective approach for repositioning FDA-approved drugs or discovering new pharmacophores. Hookworms are blood-feeding, intestinal nematode parasites that infect up to 600 million people worldwide. Vaccination with recombinant Ancylostoma ceylanicum macrophage migration inhibitory factor (rAceMIF) provided partial protection from disease, thus establishing a “proof-of-concept” for targeting AceMIF to prevent or treat infection. A high-throughput screen (HTS) against rAceMIF identified six AceMIF-specific inhibitors. A nonsteroidal anti-inflammatory drug (NSAID), sodium meclofenamate, could be tested in an animal model to assess the therapeutic efficacy in treating hookworm disease. Furosemide, an FDA-approved diuretic, exhibited submicromolar inhibition of rAceMIF tautomerase activity. Structure-activity relationships of a pharmacophore based on furosemide included one analog that binds similarly to the active site, yet does not inhibit the Na-K-Cl symporter (NKCC1) responsible for diuretic activity

“True fan = watch match”? In Search of the ‘Authentic’ Soccer Fan.

Academics have created typologies to divide association football (soccer) fans into categories based upon the assumed ‘authenticity’ of their fandom practices. One of the main requirements of ‘authentic’ fandom has been assumed to be match attendance. The goal of this paper was to critically assess this assumption through considering how fans themselves talk about the significance of match attendance as evidence of ‘authentic’ fandom. In light of the fact that the voices of English non-league fans on the ‘authenticity’ debate have so far been overshadowed by the overbearing focus of much previous research on the upper echelons of English soccer, an e-survey was conducted with 151 members of an online community of fans of English Northern League (NL) clubs (a semi-professional / amateur league based in North East England). Findings revealed that opinion was divided on the constituents of ‘authentic’ fandom and match attendance was not deemed to be the core evidence of support for a club by 42% of the sample. Elias (1978) suggested that dichotomous thinking hinders sociological understanding and it is concluded that fan typologies are not sufficient for assessing the ‘authenticity’ of fan activities