Frequency of home visits where general practitioners are exposed to a problem different from that foreseen - a Swiss cross-sectional study.

BACKGROUND When a home visit is considered, patients' suspected health problems are important for correct triage, the decision for or against the visit and allocation of the visit to a general practitioner (GP) or a nurse practitioner. Misjudgment might lead to suboptimal patient outcomes. OBJECTIVE We aimed to evaluate the accuracy of suspected health problems (based on pre-visit assessments) by comparing them with the actual health problems (post-visit assessments) and investigating associated factors. METHODS GPs of the Swiss Sentinel Surveillance Network (Sentinella) reported pre-visit and post-visit assessments and patient characteristics for up to 20 consecutive home visits, which they conducted in 2019. Using multivariable logistic regressions, we investigated associations between patient and clinical factors and unconfirmed suspected health problems from pre-visit assessments and unforeseen actual health problems from post-visit assessments. RESULTS Overall, 114 GP practices participated. The GPs reported 1496 patient visits with a total of 1789 and 1762 health problems from pre-visit and post-visit assessments, respectively, that were included in the analysis. Musculoskeletal and circulatory problems were the most common in patients receiving home visits. The health problems from pre-visit and post-visit assessments were unconfirmed and unforeseen in15% and 13% of the cases, respectively. Older age (odds ratio [OR] 1.1 in 10-year steps; 95% confidence interval [95% CI] 1.0-1.3) and urgent visits (OR 1.7 compared with regular visits; 95% CI 1.1-2.6) showed a trend for more unforeseen health problems. CONCLUSION When home visits were conducted, about one out of seven health problems from pre-visit and post-visit assessments were unconfirmed and unforeseen. Particularly when patients were older or visits were urgent, there were higher odds of unconfirmed and unforeseen health problems.These results should be considered when triaging patients

Microsaccadic rate signatures correlate under monocular and binocular stimulation conditions

Microsaccades are involuntary eye movements occurring naturally during fixation. In this study, microsaccades were investigated under monocularly and binocularly stimulated conditions with respect to their directional distribution and rate signature, that refers to a curve reporting the frequency modulation of microsaccades over time. For monocular stimulation the left eye was covered by an infrared filter. In both stimulation conditions, participants fixated a Gabor patch presented randomly in orientation of 45° or 135° over a wide range of spatial frequencies appearing in the center of a monitor. Considering the microsaccadic directions, this study showed microsaccades to be preferably horizontally oriented in their mean direction, regardless of the spatial characteristics of the grating. Furthermore, this outcome was found to be consistent between both stimulation conditions. Moreover, this study found that the microsaccadic rate signature curve correlates between both stimulation conditions, while the curve given for binocular stimulation was already proposed as a tool for estimation of visual performance in the past. Therefore, this study extends the applicability of microsaccades to clinical use, since parameters as contrast sensitivity, has been measured monocularly in the clinical attitude

Short-Term Peripheral Contrast Reduction Affects Central Chromatic and Achromatic Contrast Sensitivity

Peripheral retinal contrast reduction is suggested as a potential myopia control strategy. However, the underlying mechanism is yet unknown. Therefore, this study investigated the influence of peripheral contrast reduction on central chromatic and achromatic contrast sensitivity (CS). A total of 19 participants were included. Peripheral contrast reduction was induced via Bangerter foils of 0.4 and 0.8 density, each with a clear central zone of 8.0 mm diameter. Central achromatic and chromatic (for S-, M-, and L-cone types) CS was measured at 3 and 12 cpd in a 2-IFC psychophysical procedure. CS was tested monocularly at 0, 30, and 90 min of adaptation time, while the fellow eye was covered by an infrared filter. With the filter in place, pupil size was controlled to be smaller than the clear central aperture. Data were analyzed using linear mixed models. Cone-type CS showed significant differences among each other (all p < 0.05), except for the achromatic and L-cone type (p = 0.87). The minimum sensitivity was found with the S-cone type and the maximum with the M-cone type. Central achromatic and chromatic CS were equally affected by diffusion. The level of peripheral diffusion also influenced CS, while the 0.8 Bangerter foil led to a higher reduction in CS compared to the 0.4 Bangerter foil (p = 0.0008) and the control condition (p = 0.05). A significant reduction in CS occurred between 30 and 90 min of adaptation time (p < 0.0001). The current study found that peripheral contrast reduction impacted central achromatic and chromatic CS equally. It further showed that the amplitude of reduction was influenced by the level of diffusion, with the reduction becoming more pronounced over time

AVIKOM: Towards a mobile audiovisual cognitive assistance system for modern manufacturing and logistics

Neumann A, Strenge B, Uhlich J, et al. AVIKOM: Towards a mobile audiovisual cognitive assistance system for modern manufacturing and logistics. In: Association for Computing Machinery, ed. Proceedings of the 13th ACM International Conference on PErvasive Technologies Related to Assistive Environments. New York: ACM; 2020: 1-8.This paper introduces the novel Augmented Reality (AR) assistance system AVIKOM, a joint endeavour of three research groups together with four small and medium-sized enterprises (SME) as well as network partners and a diaconal institution. In particular, we investigate how AR-enabled assistance systems can be tailored to individual requirements of workers with diverse cognitive and physical capabilities for today's real-world industrial applications in the areas of (manual) assembly, logistics and operation of industrial machinery. We combine best practices from the domains of artificial intelligence, machine learning, user experience engineering, ethics research, and cognitive science with state-of-the-art insights for multi-modal system development to create a cognitive action assistance system that recognizes and adapts to individual users in various situational contexts, such as picking and training. Proven work and organizational psychology methods and worth-related evaluations will accompany the system introduction into working environments. Using user- and worth-centred system design and change management strategies (e.g. information and participation) right from the beginning of such a technological development facilitates proper involvement of future users in the development process. This can lead to better congruence of technology features with workers' requirements and positively shape future users' attitudes towards the system

Roquin targets mRNAs in a 3′-UTR-specific manner by different modes of regulation

The RNA-binding proteins Roquin-1 and Roquin-2 redundantly control gene expression and cell-fate decisions. Here, we show that Roquin not only interacts with stem-loop structures, but also with a linear sequence element present in about half of its targets. Comprehensive analysis of a minimal response element of the Nfkbid 3'-UTR shows that six stem-loop structures cooperate to exert robust and profound post-transcriptional regulation. Only binding of multiple Roquin proteins to several stem-loops exerts full repression, which redundantly involved deadenylation and decapping, but also translational inhibition. Globally, most Roquin targets are regulated by mRNA decay, whereas a small subset, including the Nfat5 mRNA, with more binding sites in their 3'-UTRs, are also subject to translational inhibition. These findings provide insights into how the robustness and magnitude of Roquin-mediated regulation is encoded in complex cis-elements

Caesarean Section. Guideline of the DGGG, OEGGG and SGGG (S3-Level, AWMF Registry No. 015/084, June 2020).

Purpose This is an official S3-guideline of the German Society of Gynaecology and Obstetrics (DGGG), the Austrian Society of Gynaecology and Obstetrics (ÖGGG) and the Swiss Society of Gynaecology and Obstetrics (SGGG). The guideline contains evidence-based information and recommendations on indications, complications, methods and care associated with delivery by caesarean section for all medical specialties involved as well as for pregnant women. Methods This guideline has adapted information and recommendations issued in the NICE Caesarean Birth guideline. This guideline also considers additional issues prioritised by the Cochrane Institute and the Institute for Research in Operative Medicine (IFOM). The evaluation of evidence was based on the system developed by the Scottish Intercollegiate Guidelines Network (SIGN). A multi-part nominal group process moderated by the AWMF was used to compile this S3-level guideline. Recommendations Recommendations on consultations, indications and the process of performing a caesarean section as well as the care provided to the mother and neonate were drawn up