In Vitro Flow Modelling for Mitral Valve Leakage Quantification

In this study particle image velocimetry (PIV) is used to measure and visualise the blood flow through a leaking mitral heart valve. The results are compared with the results from Doppler echocardiography and computational fluid dynamics (CFD). Using CAD, five-axis milling and Rapid Prototyping Machining (RPM) technology, a hydraulic in vitro flow model was developed and constructed which is compatible with flow investigation with 2D normal speed PIV and 2D Doppler echocardiography. The same CAD model was used to conduct the CFD analysis. PIV results compared successfully with Doppler echo and CFD results, both in the upstream converging region and downstream the turbulent regurgitated jet zone. These results are expected to improve the assessment of mitral valve regurgitation severity with Doppler echocardiography in clinical practice

Event Specific Body Characteristics of Elite Alpine Skiers in Relation to International Rankings.

Objective: This explorative study examined potential performance indicators through a correlational analysis between morphological measures and international ranking within each alpine ski event for each gender separately. Methods: A cross-sectional sample of 58 elite alpine skiers were allocated into a technical or speed event group based on their international ski rankings. Several two-way (2 * 2) (M)ANOVA’s were used to examine the effect of gender and event group on age, BMI, sum of 6 skinfolds and somatotype. Forward stepwise discriminant analysis selected the most discriminating somatotype component between gender and/or event. Bivariate Pearson correlations between registered variables and international rankings per alpine ski event were examined for each gender separately. Results: Female speed specialists possessed more relative fat mass (P = 0.022) than female technical specialists. Irrespective of gender, technical specialists were lighter (P < 0.001) and had less relative fat mass than speed specialists (P = 0.008). Pearson values indicated moderate associations between speed rankings and body weight. High female speed rankings were associated with higher relative fat mass. High male speed rankings were associated with lower ectomorphy. Conclusion: Additional body weight appears to be beneficial in SPEED events. Fat mass correlated positively with higher rankings of female SPEED specialists. This observation should be monitored in female alpine skiers so that performance thresholds of relative body fat can be determined

Digital Behaviour Change Interventions to Break and Form Habits

Digital behaviour change interventions, particularly those using pervasive computing technology, hold great promise in supporting users to change their behaviour. However, most interventions fail to take habitual behaviour into account, limiting their potential impact. This failure is partly driven by a plethora of overlapping behaviour change theories and related strategies that do not consider the role of habits. We critically review the main theories and models used in the research to analyse their application to designing effective habitual behaviour change interventions. We highlight the potential for Dual Process Theory, modern habit theory, and Goal Setting Theory, which together model how users form and break habits, to drive effective digital interventions. We synthesise these theories into an explanatory framework, the Habit Alteration Model, and use it to outline the state of the art. We identify the opportunities and challenges of habit-focused interventions.</jats:p

Low-value home-based nursing care:A national survey study

Aims: To explore potential areas of low-value home-based nursing care practices, their prevalence and related influencing factors of nurses and nursing assistants working in home-based nursing care. Design: A quantitative, cross-sectional design. Methods: An online survey with questions containing scaled frequencies on five-point Likert scales and open questions on possible related influencing factors of low-value nursing care. The data collection took place from February to April 2022. Descriptive statistics and linear regression were used to summarize and analyse the results. Results: A nationwide sample of 776 certified nursing assistants, registered nurses and nurse practitioners responded to the survey. The top five most delivered low-value care practices reported were: (1) ‘washing the client with water and soap by default’, (2) ‘application of zinc cream, powders or pastes when treating intertrigo’, (3) ‘washing the client from head to toe daily’, (4) ‘re-use of a urinary catheter bag after removal/disconnection’ and (5) ‘bladder irrigation to prevent clogging of urinary tract catheter’. The top five related influencing factors reported were: (1) ‘a (general) practitioner advices/prescribes it’, (2) ‘written in the client's care plan’, (3) ‘client asks for it’, (4) ‘wanting to offer the client something’ and (5) ‘it is always done like this in the team’. Higher educational levels and an age above 40 years were associated with a lower provision of low-value care. Conclusion: According to registered nurses and certified nursing assistants, a number of low-value nursing practices occurred frequently in home-based nursing care and they experienced multiple factors that influence the provision of low-value care such as (lack of) clinical autonomy and handling clients' requests, preferences and demands. The results can be used to serve as a starting point for a multifaceted de-implementation strategy. Reporting Method: STROBE checklist for cross-sectional studies. Patient or Public Contribution: No Patient or Public Contribution. Implications for the Profession and/or Patient Care: Nursing care is increasingly shifting towards the home environment. Not all nursing care that is provided is effective or efficient and this type of care can therefore be considered of low-value. Reducing low-value care and increasing appropriate care will free up time, improve quality of care, work satisfaction, patient safety and contribute to a more sustainable healthcare system.</p

Age-related changes in matching novel objects across viewpoints

Peer reviewedPreprin

International study of childhood leukemia in residences near electrical transformer rooms.

OBJECTIVES New epidemiologic approaches are needed to reduce the scientific uncertainty surrounding the association between extremely low frequency magnetic fields (ELF-MF) and childhood leukemia. While most previous studies focused on power lines, the Transformer Exposure study sought to assess this association using a multi-country study of children who had lived in buildings with built-in electrical transformers. ELF-MF in apartments above built-in transformers can be 5 times higher than in other apartments in the same building. This novel study design aimed to maximize the inclusion of highly exposed children while minimising the potential for selection bias. METHODS We assessed associations between residential proximity to transformers and risk of childhood leukemia using registry based matched case-control data collected in five countries. Exposure was based on the location of the subject's apartment relative to the transformer, coded as high (above or adjacent to transformer), intermediate (same floor as apartments in high category), or unexposed (other apartments). Relative risk (RR) for childhood leukemia was estimated using conditional logistic and mixed logistic regression with a random effect for case-control set. RESULTS Data pooling across countries yielded 16 intermediate and 3 highly exposed cases. RRs were 1.0 (95% CI: 0.5, 1.9) for intermediate and 1.1 (95% CI: 0.3, 3.8) for high exposure in the conditional logistic model. In the mixed logistic model, RRs were 1.4 (95% CI: 0.8, 2.5) for intermediate and 1.3 (95% CI: 0.4, 4.4) for high. Data of the most influential country showed RRs of 1.1 (95% CI: 0.5, 2.4) and 1.7 (95% CI: 0.4, 7.2) for intermediate (8 cases) and high (2 cases) exposure. DISCUSSION Overall, evidence for an elevated risk was weak. However, small numbers and wide confidence intervals preclude strong conclusions and a risk of the magnitude observed in power line studies cannot be excluded

In the eye of a hurricane there is quiet, for just a moment, —

CHI can be a multisensory overload. Attendees endure days of workshops, presentations, evening parties, and ephemeral interactions. This paper attempts to disrupt that onslaught of activities [9]. It draws inspiration from theories and methods already in HCI—e.g. mindfulness [1], reflec- tive design [8], and slow design [4, 7]—to bring eight pages of silence to the conference. This is meant to disrupt CHI’s busy schedule and help attendees foster resilience. In pur- suit of these aims, the authors will use the time and pages offered by this paper to facilitate a group silence; quiet, for just a moment, in the midst of the hurricane that is CHI

Effects of digital chatbot on gender attitudes and exposure to intimate partner violence among young women in South Africa

Background South Africa has among the highest rates of intimate partner violence (IPV) globally, with young women at heightened risk due to inequitable gender roles, limited relationship skills, and inadequate social support. Despite an urgent need for violence prevention in low- and middle-income settings, most efficacious approaches are time-intensive and costly to deliver. Digital, interactive chatbots may help young women navigate safer relationships and develop healthier gender beliefs and skills Methods Young women (18–24 years old) across South Africa were recruited via Facebook for participation in an individually randomised controlled trial (n = 19,643) during the period of June 2021-September 2021. Users were randomly allocated, using a pipeline algorithm, to one of four trial arms: Pure Control (PC) had no user engagement outside of study measures; Attention Treatment (T0) provided didactic information about sexual health through a text-based chatbot; Gamified Treatment (T1) was a behaviourally-informed gamified text-based chatbot; Narrative Treatment (T2) was a behaviourally-informed drama delivered through pre-recorded voice notes. All chatbots were delivered in WhatsApp, through which users were invited to complete brief “quizzes” comprising adapted versions of validated scales. Primary outcomes were short-form adaptations of scales for gender attitudes (Gender Relations Scale) and past-month IPV (WHO Multi-country Study Instrument). Secondary outcomes were identification of unhealthy relationship behaviours (Intimate Partner Violence Attitudes Scale) and brief screener for depressive symptoms (Patient Health Questionnaire). A direct chat link to a trained counsellor was a safety measure (accessed by 4.5% of the sample). We estimated treatment effects using ordinary least squares and heteroskedasticity robust standard errors Findings The trial retained 11,630 (59.2%) to the primary endpoint of gender attitudes. Compared to control, all treatments led to moderate and significant changes in attitudes towards greater gender equity (Cohen’s D = 0.10, 0.29, 0.20 for T0, T1, and T2, respectively). The gamified chatbot (T1) had modest but significant effects on IPV: 56% of young women reported past-month IPV, compared to 62% among those without treatment (marginal effects = -0.07, 95%CI = -0.09to-0.05). The narrative treatment (T2) had no effect on IPV exposure. T1 increased identification of unhealthy relationship behaviours at a moderate and significant level (Cohen’s D = 0.25). Neither T1 nor T2 had a measurable effect on depressive symptoms as measured by the brief screener. Interpretation: A behaviourally-informed, gamified chatbot increased gender equitable attitudes and was protective for IPV exposure among young women in South Africa. These effects, while modest in magnitude, could represent a meaningful impact given potential to scale the low-cost intervention