Interhemispheric communication during haptic self-perception

During the haptic exploration of a planar surface, slight resistances against the hand's movement are illusorily perceived as asperities (bumps) in the surface. If the surface being touched is one's own skin, an actual bump would also produce increased tactile pressure from the moving finger onto the skin. We investigated how kinaesthetic and tactile signals combine to produce haptic perceptions during self-touch. Participants performed two successive movements with the right hand. A haptic force-control robot applied resistances to both movements, and participants judged which movement was felt to contain the larger bump. An additional robot delivered simultaneous but task-irrelevant tactile stroking to the left forearm. These strokes contained either increased or decreased tactile pressure synchronized with the resistance-induced illusory bump encountered by the right hand. We found that the size of bumps perceived by the right hand was enhanced by an increase in left tactile pressure, but also by a decrease. Tactile event detection was thus transferred interhemispherically, but the sign of the tactile information was not respected. Randomizing (rather than blocking) the presentation order of left tactile stimuli abolished these interhemispheric enhancement effects. Thus, interhemispheric transfer during bimanual self-touch requires a stable model of temporally synchronized events, but does not require geometric consistency between hemispheric information, nor between tactile and kinaesthetic representations of a single common object

Testing and development of transfer functions for weighing precipitation gauges in WMO-SPICE

Weighing precipitation gauges are used widely for the measurement of all forms of precipitation, and are typically more accurate than tipping-bucket precipitation gauges. This is especially true for the measurement of solid precipitation; however, weighing precipitation gauge measurements must still be adjusted for undercatch in snowy, windy conditions. In WMO-SPICE (World Meteorological Organization Solid Precipitation InterComparison Experiment), different types of weighing precipitation gauges and shields were compared, and adjustments were determined for the undercatch of solid precipitation caused by wind. For the various combinations of gauges and shields, adjustments using both new and previously existing transfer functions were evaluated. For most of the gauge and shield combinations, previously derived transfer functions were found to perform as well as those more recently derived. This indicates that wind shield type (or lack thereof) is more important in determining the magnitude of wind-induced undercatch than the type of weighing precipitation gauge. It also demonstrates the potential for widespread use of the previously developed transfer functions. Another overarching result was that, in general, the more effective shields, which were associated with smaller unadjusted errors, also produced more accurate measurements after adjustment. This indicates that although transfer functions can effectively reduce measurement biases, effective wind shielding is still required for the most accurate measurement of solid precipitation

Nurse practitioner coverage is associated with a decrease in length of stay in a pediatric chronic ventilator dependent unit

AIM: To hypothesize a dedicated critical care nurse practitioner (NP) is associated with a decreased length of stay (LOS) from a pediatric chronic ventilator dependent unit (PCVDU). METHODS: We retrospectively reviewed patients requiring care in the PCVDU from May 2001 through May 2011 comparing the 5 years prior to the 5 years post implementation of the critical care NP in 2005. LOS and room charges were obtained. RESULTS: The average LOS decreased from a median of 55 d [interquartile range (IQR): 9.8-108.3] to a median of 12 (IQR: 4.0-41.0) with the implementation of a dedicated critical care NP (P < 1.0001). Post implementation of a dedicated NP, a savings of 25738049 in room charges was noted over 5 years. CONCLUSION: Our data demonstrates a critical care NP coverage model in a PCVDU is associated with a significantly reduced LOS demonstrating that the NP is an efficient and likely cost-effective addition to a medically comprehensive service

SEPARATION OF CHOPPED NETTLE MATERIAL ON PLANE SIEVE LENGTH

The paper presents the results of several experimental researches regarding to a separation mixture of dried and chopped nettle fragments on a dimensional separator of medicinal plants, equipped with oscillating flat sieves. Three parameters were varied (material flow rate, sieves angle of inclination and oscillations sieves frequency). For separation process description along chopped vegetal material sieves, the experimental results have been tested by Rosin-Rammler distribution law

Measuring solid precipitation using heated tipping bucket gauges: an overview of performance and recommendations from WMO‐SPICE

Comunicación presentada en: TECO-2016 (Technical Conference on Meteorological and Environmental Instruments and Methods of Observation) celebrada en Madrid, del 27 al 30 de septiembre de 2016

Drug-Survival Profiling of Second-Line Biologic Therapy in Rheumatoid Arthritis: Choice of Another TNFi or a Biologic of Different Mode of Action?

OBJECTIVES: Aiming to assess the best choice of second-line therapy between second-line TNF-inhibitor (TNFi) and biologics of different mode of action (BDMA-rituximab/tocilizumab/abatacept) in rheumatoid arthritis (RA) by assessing their drug-survival spanning more that 10years, after discontinuation of the first-line TNFi. METHODS: This retrospective-observational drug-survival study was performed across 2-different hospitals in UK by conventional-statistics and machine-learning approach. RESULTS: From a total of 435-patients, 213 [(48.9%); TNFi-n=122 (57.3%), BDMA-n=91(42.7%)] discontinued their second-line biologic [median-drug-survival: TNFi-27months (95%CI 22-32months) vs BDMA-37months (95%CI 32-52months)]. As second-line, BDMA was likely to reduce the risk of treatment-discontinuation [Hazard-ratio/HR-0.63 (95%CI 0.48-0.83)] compared to TNFi, but only in seropositive-patients [HR-0.52 (95%CI 0.38-0.73)], not in seronegative-RA. Uncovered by the survival-tree and adjusted by propensity-score, drug-survival benefit of BDMA over TNFi was not observed if the seropositive-patients were previously exposed to monoclonal-TNFi (HR-0.77, 95% CI 0.49-1.22) versus soluble TNFi (etanercept or its biosimilar) or if first-line TNFi was terminated within 23.9months of initiation (HR-0.97, 95%CI 0.56-1.68). CONCLUSION: BDMA, as second-line biologic, is more likely to be sustained in seropositive-patients particularly if they were previously not exposed monoclonal TNFi. Drug-survival benefit of BDMA was not observed in seronegative-patients or if the first-line TNFi was stopped within 2 years

Analysis of single-Alter-shielded and unshielded measurements of mixed and solid precipitation from WMO-SPICE

Precipitation measurements were combined from eight separate precipitation testbeds to create multi-site transfer functions for the correction of unshielded and single-Alter-shielded precipitation gauge measurements. Site-specific errors and more universally applicable corrections were created from these WMO-SPICE measurements. The importance and magnitude of such wind speed corrections were demonstrated.This research was funded by the Korean Ministry of Land, Infrastructure and Transport through a grant (16AWMP-B079625-03) from the Water Management Research Program

A Phase 3 Study to Compare Delafloxacin With Moxifloxacin for the Treatment of Adults With Community-Acquired Bacterial Pneumonia (DEFINE-CABP)

The clinical and economic burden of community-acquired bacterial pneumonia (CABP) is significant and is anticipated to increase as the population ages and pathogens become more resistant. Delafloxacin is a fluoroquinolone antibiotic approved in the United States for the treatment of adults with acute bacterial skin and skin structure infections. Delafloxacin's shape and charge profile uniquely impact its spectrum of activity and side effect profile. This phase 3 study compared the efficacy and safety of delafloxacin with moxifloxacin for the treatment of CABP. A randomized, double-blind, comparator-controlled, multicenter, global phase 3 study compared the efficacy and safety of delafloxacin 300 mg twice daily or moxifloxacin 400 mg once daily in adults with CABP. The primary end point was early clinical response (ECR), defined as improvement at 96 (±24) hours after the first dose of study drug. Clinical response at test of cure (TOC) and microbiologic response were also assessed. In the intent-to-treat analysis population (ITT), ECR rates were 88.9% in the delafloxacin group and 89.0% in the moxifloxacin group. Noninferiority of delafloxacin compared with moxifloxacin was demonstrated. At TOC in the ITT population, the success rates were similar between groups. Treatment-emergent adverse events that were considered at least possibly related to the study drug occurred in 65 subjects (15.2%) in the delafloxacin group and 54 (12.6%) in the moxifloxacin group. Intravenous/oral delafloxacin monotherapy is effective and well tolerated in the treatment of adults with CABP, providing coverage for Gram-positive, Gram-negative, and atypical pathogens. NCT03534622. This Phase-3 study showed IV/oral delafloxacin monotherapy is well tolerated without QT restrictions or major drug interactions and effective in treatment of adults with CABP due to gram positive and negative as well as atypical pathogens

Racial disparities in the SOFA score among patients hospitalized with COVID-19

BACKGROUND: Sequential Organ Failure Assessment (SOFA) score predicts probability of in-hospital mortality. Many crisis standards of care suggest the use of SOFA scores to allocate medical resources during the COVID-19 pandemic. RESEARCH QUESTION: Are SOFA scores elevated among Non-Hispanic Black and Hispanic patients hospitalized with COVID-19, compared to Non-Hispanic White patients? STUDY DESIGN AND METHODS: Retrospective cohort study conducted in Yale New Haven Health System, including 5 hospitals with total of 2681 beds. Study population drawn from consecutive patients aged ≥18 admitted with COVID-19 from March 29th to August 1st, 2020. Patients excluded from the analysis if not their first admission with COVID-19, if they did not have SOFA score recorded within 24 hours of admission, if race and ethnicity data were not Non-Hispanic Black, Non-Hispanic White, or Hispanic, or if they had other missing data. The primary outcome was SOFA score, with peak score within 24 hours of admission dichotomized as \u3c6 or ≥6. RESULTS: Of 2982 patients admitted with COVID-19, 2320 met inclusion criteria and were analyzed, of whom 1058 (45.6%) were Non-Hispanic White, 645 (27.8%) were Hispanic, and 617 (26.6%) were Non-Hispanic Black. Median age was 65.0 and 1226 (52.8%) were female. In univariate logistic screen and in full multivariate model, Non-Hispanic Black patients but not Hispanic patients had greater odds of an elevated SOFA score ≥6 when compared to Non-Hispanic White patients (OR 1.49, 95%CI 1.11-1.99). INTERPRETATION: Given current unequal patterns in social determinants of health, US crisis standards of care utilizing the SOFA score to allocate medical resources would be more likely to deny these resources to Non-Hispanic Black patients