The acceptance of the clinical photographic posture assessment tool (CPPAT)

Abstract Background There is a lack of evidence-based quantitative clinical methods to adequately assess posture. Our team developed a clinical photographic posture assessment tool (CPPAT) and implemented this tool in clinical practice to standardize posture assessment. The objectives were to determine the level of acceptance of the CPPAT and to document predictors as well as facilitators of and barriers to the acceptance of this tool by clinicians doing posture re-education. Methods This is a prospective study focussing on technology acceptance. Thirty-two clinician participants (physical therapists and sport therapists) received a 3–5 h training workshop explaining how to use the CPPAT. Over a three-month trial, they recorded time-on-task for a complete posture evaluation (photo - and photo-processing). Subsequently, participants rated their acceptance of the tool and commented on facilitators and barriers of the clinical method. Results Twenty-three clinician participants completed the trial. They took 22 (mean) ± 10 min (SD) for photo acquisition and 36 min ± 19 min for photo-processing. Acceptance of the CPPAT was high. Perceived ease of use was an indirect predictor of intention to use, mediated by perceived usefulness. Analysis time was an indirect predictor, mediated by perceived usefulness, and a marginally significant direct predictor. Principal facilitators were objective measurements, visualization, utility, and ease of use. Barriers were time to do a complete analysis of posture, quality of human-computer interaction, non-automation of posture index calculation and photo transfer, and lack of versatility. Conclusion The CPPAT is perceived as useful and easy to use by clinicians and may facilitate the quantitative analysis of posture. Adapting the user-interface and functionality to quantify posture may facilitate a wider adoption of the tool

Evidence and ideology as a rationale for light-therapy in Russia: from the Soviet Union to the present day.

Light therapy is still used to treat a number of common diseases in Russia. The practice is firmly anchored in history: Soviet clinical practice was divorced from the emerging field of evidence-based medicine. Medical researchers were cut off from international medical research and scientific literature, with much Soviet scientific activity based on a particular socialist ideology. In this study, the use of light therapy serves as a case study to explore tensions between international evidence-based medicine and practices developed in isolation under the Soviet Union, the legacy of which is to the detriment of many patients today. We used four different search methods to uncover scientific and grey literature, both historical and contemporary. We assessed the changing frequency of publications over time and contrasted the volume of literature on light therapy with more orthodox treatments such as statins and painkillers. Our search found an increasing number and comparatively large body of scientific publications on light therapy in the Russian language, and many publications emanating from prestigious Russian institutions. Combined with our analysis of the historical literature and our appraisal of 22 full text articles, this leads us to suggest that light therapy entered mainstream Soviet medical practice before the Stalinist period and still occupies an important position in contemporary Russian clinical practice. We propose that this outdated treatment survives in Russia in part due to the political, economic and social forces that helped to popularize it during Soviet times, and by the seeming justification offered by poorly executed studies

Left Atrial Structure in Relationship to Age, Sex, Ethnicity, and Cardiovascular Risk Factors MESA (Multi-Ethnic Study of Atherosclerosis)

This research was supported by contracts N01-HC-95159, N01-HC-95160, N01-HC-95161, N01- HC-95162, N01-HC-95163, N01-HC-95164, N01-HC-95165, N01-HC-95166, N01-HC-95167, N01- HC-95168 and N01-HC-95169 from the National Heart, Lung, and Blood Institute and by grants UL1-TR-000040 and UL1-TR-001079 from the National Center for Research Resources. Prof. Petersen and Drs. Zemrak and Mohiddin gratefully acknowledge funding from the National Institute for Health Research Cardiovascular Biomedical Research Unit at Barts. Prof. Petersen’s work is supported by awards establishing the Farr Institute of Health Informatics Research at University College London Partners from the Medical Research Council, in partnership with Arthritis Research United Kingdom, the British Heart Foundation, Cancer Research United Kingdom, the Economic and Social Research Council, the Engineering and Physical Sciences Research Council, the National Institute of Health Research, the National Institute for Social Care and Health Research (Welsh Assembly Government), the Chief Scientist Office (Scottish Government Health Directorates), and the Wellcome Trust (MR/K006584/1)

Assessment of a continuous blood gas monitoring system in animals during circulatory stress

<p>Abstract</p> <p>Background</p> <p>The study was aimed to determine the measurement accuracy of The CDI™ blood parameter monitoring system 500 (Terumo Cardiovascular Systems Corporation, Ann Arbor MI) in the real-time continuous measurement of arterial blood gases under different cardiocirculatory stress conditions</p> <p>Methods</p> <p>Inotropic stimulation (Dobutamine 2.5 and 5 μg/kg/min), vasoconstriction (Arginine-vasopressin 4, 8 and 16 IU/h), hemorrhage (-10%, -20%, -35%, and -50% of the theoretical volemia), and volume resuscitation were induced in ten swine (57.4 ± 10.7 Kg).Intermittent blood gas assessments were carried out using a routine gas analyzer at any experimental phase and compared with values obtained at the same time settings during continuous monitoring with CDI™ 500 system. The Bland-Altman analysis was employed.</p> <p>Results</p> <p>Bias and precision for pO₂were - 0.06 kPa and 0.22 kPa, respectively (r²= 0.96); pCO₂- 0.02 kPa and 0.15 kPa, respectively; pH -0.001 and 0.01 units, respectively ( r²= 0.96). The analysis showed very good agreement for SO₂(bias 0.04,precision 0.33, r²= 0.95), Base excess (bias 0.04,precision 0.28, r²= 0.98), HCO₃(bias 0.05,precision 0.62, r²= 0.92),hemoglobin (bias 0.02,precision 0.23, r²= 0.96) and K⁺(bias 0.02, precision 0.27, r²= 0.93). The sensor was reliable throughout the experiment during hemodynamic variations.</p> <p>Conclusions</p> <p>Continuous blood gas analysis with the CDI™ 500 system was reliable and it might represent a new useful tool to accurately and timely monitor gas exchange in critically ill patients. Nonetheless, our findings need to be confirmed by larger studies to prove its reliability in the clinical setting.</p

Stochastic analysis of the GAL genetic switch in Saccharomyces cerevisiae: Modeling and experiments reveal hierarchy in glucose repression

<p>Abstract</p> <p>Background</p> <p>Transcriptional regulation involves protein-DNA and protein-protein interactions. Protein-DNA interactions involve reactants that are present in low concentrations, leading to stochastic behavior. In addition, multiple regulatory mechanisms are typically involved in transcriptional regulation. In the <it>GAL </it>regulatory system of <it>Saccharomyces cerevisiae</it>, the inhibition of glucose is accomplished through two regulatory mechanisms: one through the transcriptional repressor Mig1p, and the other through regulating the amount of transcriptional activator Gal4p. However, the impact of stochasticity in gene expression and hierarchy in regulatory mechanisms on the phenotypic level is not clearly understood.</p> <p>Results</p> <p>We address the question of quantifying the effect of stochasticity inherent in these regulatory mechanisms on the performance of various genes under the regulation of Mig1p and Gal4p using a dynamic stochastic model. The stochastic analysis reveals the importance of both the mechanisms of regulation for tight expression of genes in the <it>GAL </it>network. The mechanism involving Gal4p is the dominant mechanism, yielding low variability in the expression of <it>GAL </it>genes. The mechanism involving Mig1p is necessary to maintain the switch-like response of certain <it>GAL </it>genes. The number of binding sites for Mig1p and Gal4p further influences the expression of the genes, with extra binding sites lowering the variability of expression. Our experiments involving growth on various substrates show that the trends predicted in mean expression and its variability are transmitted to the phenotypic level.</p> <p>Conclusion</p> <p>The mechanisms involved in the transcriptional regulation and their variability set up a hierarchy in the phenotypic response to growth on various substrates. Structural motifs, such as the number of binding sites and the mechanism of regulation, determine the level of stochasticity and eventually, the phenotypic response.</p

Informal Employment

The myth surrounding negative connotation of informal employment / informal economy work engagement is one that needs to be revisited as research ventures must be pursued in the direction of encouraging those engaged in it to feel quite elated about their boldness in becoming actively involved in economic development activities. Equally, sensitive approaches should be pursued in pursuance of government statutory obligations in addressing core services like expenditures connected with education and health for example, which can only be achieved through revenue raised from genuine contributions made by the workforce, be it through formal or informal work engagement

Understanding Technology as Situated Practice: Everyday use of Voice User Interfaces Among Diverse Groups of Users in Urban India

Abstract: As smartphones have become ubiquitous across urban India, voice user interfaces (VUIs) are increasingly becoming part of diverse groups of users’ daily experiences. These technologies are now generally accessible as a result of improvements in mobile Internet access, [-8.5pc]Biography is Required. Please provide. introduction of low-cost smartphones and the ongoing process of their localisation into Indian languages. However, when people engage with technologies in their everyday lives, they not only enact the material attributes of the artifact but also draw on their skills, social positions, prior experience and societal norms and expectations to make use of the artifact. Drawing on Orlikowski’s analytical framework of “technologies-in-practice” we engage in an interview-based exploratory study among diverse groups of users in urban India to understand use of VUIs as situated practice. We identify three technologies-in-practice emerging through enactment of VUIs on users’ smartphones: looking up, learning and leisure. We argue that – instead of asking why and how users appropriate VUIs – identifying different kinds of enactments of VUIs present researchers and practitioners with a more nuanced understanding of existing and potential use of VUIs across varied contexts

Peer influence in network markets: a theoretical and empirical analysis

Network externalities spur the growth of networks and the adoption of network goods in two ways. First, they make it more attractive to join a network the larger its installed base. Second, they create incentives for network members to actively recruit new members. Despite indications that the latter "peer effect" can be more important for network growth than the installed-base effect, it has so far been largely ignored in the literature. We address this gap using game-theoretical models. When all early adopters can band together to exert peer influence-an assumption that fits, e.g., the case of firms supporting a technical standard-we find that the peer effect induces additional growth of the network by a factor. When, in contrast, individuals exert peer influence in small groups of size n, the increase in network size is by an additive constant-which, for small networks, can amount to a large relative increase. The difference between small, local, personal networks and large, global, anonymous networks arises endogenously from our analysis. Fundamentally, the first type of networks is "tie-reinforcing," the other, "tie-creating". We use survey data from users of the Internet services, Skype and eBay, to illustrate the main logic of our theoretical results. As predicted by the model, we find that the peer effect matters strongly for the network of Skype users-which effectively consists of numerous small sub-networks-but not for that of eBay users. Since many network goods give rise to small, local networks

High Rates of All-cause and Gastroenteritis-related Hospitalization Morbidity and Mortality among HIV-exposed Indian Infants

<p>Abstract</p> <p>Background</p> <p>HIV-infected and HIV-exposed, uninfected infants experience a high burden of infectious morbidity and mortality. Hospitalization is an important metric for morbidity and is associated with high mortality, yet, little is known about rates and causes of hospitalization among these infants in the first 12 months of life.</p> <p>Methods</p> <p>Using data from a prevention of mother-to-child transmission (PMTCT) trial (India SWEN), where HIV-exposed breastfed infants were given extended nevirapine, we measured 12-month infant all-cause and cause-specific hospitalization rates and hospitalization risk factors.</p> <p>Results</p> <p>Among 737 HIV-exposed Indian infants, 93 (13%) were HIV-infected, 15 (16%) were on HAART, and 260 (35%) were hospitalized 381 times by 12 months of life. Fifty-six percent of the hospitalizations were attributed to infections; gastroenteritis was most common accounting for 31% of infectious hospitalizations. Gastrointestinal-related hospitalizations steadily increased over time, peaking around 9 months. The 12-month all-cause hospitalization, gastroenteritis-related hospitalization, and in-hospital mortality rates were 906/1000 PY, 229/1000 PY, and 35/1000 PY respectively among HIV-infected infants and 497/1000 PY, 107/1000 PY, and 3/1000 PY respectively among HIV-exposed, uninfected infants. Advanced maternal age, infant HIV infection, gestational age, and male sex were associated with higher all-cause hospitalization risk while shorter duration of breastfeeding and abrupt weaning were associated with gastroenteritis-related hospitalization.</p> <p>Conclusions</p> <p>HIV-exposed Indian infants experience high rates of all-cause and infectious hospitalization (particularly gastroenteritis) and in-hospital mortality. HIV-infected infants are nearly 2-fold more likely to experience hospitalization and 10-fold more likely to die compared to HIV-exposed, uninfected infants. The combination of scaling up HIV PMTCT programs and implementing proven health measures against infections could significantly reduce hospitalization morbidity and mortality among HIV-exposed Indian infants.</p