Supporting Vermont Families in Packing Healthy Lunches for Children in Childcare

Introduction. Partnering with Hunger Free Vermont, an organization that works to end hunger and malnutrition across the state, we investigated the nutritional value of the packed meals parents provide for their children in early childcare. The USDA\u27s My Plate resource was used as a measure to assess variety, dividing foods into five groups: grains, dairy, vegetables, fruits, and protein. The results will help Hunger Free Vermont design nutrition education materials for childcare centers to provide to the families they serve. Methods. Online surveys were distributed, asking parents to report the foods they recently provided for their children in packed lunches, to rate how \u27healthy\u27 they thought those lunches were, and to note any barriers they experience to packing healthy foods. Results. Survey results showed that the average number of sweets packed by parents who had low confidence in their ability to pack healthy meals was significantly higher than the average number packed by parents with high confidence (p \u3c 0.05). Additionally, the total number of cited barriers was significantly higher in parents who had low confidence in their ability to pack healthy meals (p \u3c 0.01). Conclusions. Many parents cited time constraints and ‘picky’ children as barriers to providing healthy meals, with concerns about the expense of healthy items and lack of childcare for shopping or food-prep time following close behind. In the future, education materials that address children’s unhealthy food preferences or further investigations into barriers to providing healthy lunches may facilitate development of resources for Vermont families.https://scholarworks.uvm.edu/comphp_gallery/1259/thumbnail.jp

Effects of Bedrock Landsliding on Cosmogenically Determined Erosion Rates

The successful quantification of long-term erosion rates underpins our understanding of landscape. formation, the topographic evolution of mountain ranges, and the mass balance within active orogens. The measurement of in situ-produced cosmogenic radionuclides (CRNs) in fluvial and alluvial sediments is perhaps the method with the greatest ability to provide such long-term erosion rates. In active orogens, however, deep-seated bedrock landsliding is an important erosional process, the effect of which on CRN-derived erosion rates is largely unquantified. We present a numerical simulation of cosmogenic nuclide production and distribution in landslide-dominated catchments to address the effect of bedrock landsliding on cosmogenic erosion rates in actively eroding landscapes. Results of the simulation indicate that the temporal stability of erosion rates determined from CRN concentrations in sediment decreases with increased ratios of landsliding to sediment detachment rates within a given catchment area, and that larger catchment areas must be sampled with increased frequency of landsliding in order to accurately evaluate long-term erosion rates. In addition, results of this simulation suggest that sediment sampling for CRNs is the appropriate method for determining long-term erosion rates in regions dominated by mass-wasting processes, while bedrock surface sampling for CRNs is generally an ineffective means of determining long-term erosion rates. Response times of CRN concentrations to changes in erosion rate indicate that climatically driven cycles of erosion may be detected relatively quickly after such changes occur, but that complete equilibration of CRN concentrations to new erosional conditions may take tens of thousands of years. Simulation results of CRN erosion rates are compared with a new, rich dataset of CRN concentrations from the Nepalese Himalaya, supporting conclusions drawn from the simulation

Kimera: from SLAM to Spatial Perception with 3D Dynamic Scene Graphs

Humans are able to form a complex mental model of the environment they move in. This mental model captures geometric and semantic aspects of the scene, describes the environment at multiple levels of abstractions (e.g., objects, rooms, buildings), includes static and dynamic entities and their relations (e.g., a person is in a room at a given time). In contrast, current robots' internal representations still provide a partial and fragmented understanding of the environment, either in the form of a sparse or dense set of geometric primitives (e.g., points, lines, planes, voxels) or as a collection of objects. This paper attempts to reduce the gap between robot and human perception by introducing a novel representation, a 3D Dynamic Scene Graph(DSG), that seamlessly captures metric and semantic aspects of a dynamic environment. A DSG is a layered graph where nodes represent spatial concepts at different levels of abstraction, and edges represent spatio-temporal relations among nodes. Our second contribution is Kimera, the first fully automatic method to build a DSG from visual-inertial data. Kimera includes state-of-the-art techniques for visual-inertial SLAM, metric-semantic 3D reconstruction, object localization, human pose and shape estimation, and scene parsing. Our third contribution is a comprehensive evaluation of Kimera in real-life datasets and photo-realistic simulations, including a newly released dataset, uHumans2, which simulates a collection of crowded indoor and outdoor scenes. Our evaluation shows that Kimera achieves state-of-the-art performance in visual-inertial SLAM, estimates an accurate 3D metric-semantic mesh model in real-time, and builds a DSG of a complex indoor environment with tens of objects and humans in minutes. Our final contribution shows how to use a DSG for real-time hierarchical semantic path-planning. The core modules in Kimera are open-source.Comment: 34 pages, 25 figures, 9 tables. arXiv admin note: text overlap with arXiv:2002.0628

Virtual classroom proficiency-based progression for robotic surgery training (VROBOT): a randomised, prospective, cross-over, effectiveness study

Robotic surgery training has lacked evidence-based standardisation. We aimed to determine the effectiveness of adjunctive interactive virtual classroom training (VCT) in concordance with the self-directed Fundamentals of Robotic Surgery (FRS) curriculum. The virtual classroom is comprised of a studio with multiple audio-visual inputs to which participants can connect remotely via the BARCO weConnect platform. Eleven novice surgical trainees were randomly allocated to two training groups (A and B). In week 1, both groups completed a robotic skills induction. In week 2, Group A received training with the FRS curriculum and adjunctive VCT; Group B only received access to the FRS curriculum. In week 3, the groups received the alternate intervention. The primary outcome was measured using the validated robotic-objective structured assessment of technical skills (R-OSAT) at the end of week 2 (time-point 1) and 3 (time-point 2). All participants completed the training curriculum and were included in the final analyses. At time-point 1, Group A achieved a statistically significant greater mean proficiency score compared to Group B (44.80 vs 35.33 points, p = 0.006). At time-point 2, there was no significant difference in mean proficiency score in Group A from time-point 1. In contrast, Group B, who received further adjunctive VCT showed significant improvement in mean proficiency by 9.67 points from time-point 1 (95% CI 5.18-14.15, p = 0.003). VCT is an effective, accessible training adjunct to self-directed robotic skills training. With the steep learning curve in robotic surgery training, VCT offers interactive, expert-led learning and can increase training effectiveness and accessibility

Bound by the Bounty: Collaboratively Shaping Evaluation Processes for Queer AI Harms

Bias evaluation benchmarks and dataset and model documentation have emerged as central processes for assessing the biases and harms of artificial intelligence (AI) systems. However, these auditing processes have been criticized for their failure to integrate the knowledge of marginalized communities and consider the power dynamics between auditors and the communities. Consequently, modes of bias evaluation have been proposed that engage impacted communities in identifying and assessing the harms of AI systems (e.g., bias bounties). Even so, asking what marginalized communities want from such auditing processes has been neglected. In this paper, we ask queer communities for their positions on, and desires from, auditing processes. To this end, we organized a participatory workshop to critique and redesign bias bounties from queer perspectives. We found that when given space, the scope of feedback from workshop participants goes far beyond what bias bounties afford, with participants questioning the ownership, incentives, and efficacy of bounties. We conclude by advocating for community ownership of bounties and complementing bounties with participatory processes (e.g., co-creation).Comment: To appear at AIES 202

Global Variation in Magnetic Resonance Imaging Quality of the Prostate

BACKGROUND: High variability in prostate MRI quality might reduce accuracy in prostate cancer detection. PURPOSE: To prospectively evaluate the quality of MRI scanners taking part in the quality control phase of the global PRIME (Prostate Imaging Using MRI ± Contrast Enhancement) trial using the Prostate Imaging Quality (PI-QUAL) standardized scoring system, give recommendations on how to improve the MRI protocols, and establish whether MRI quality could be improved by these recommendations. MATERIALS AND METHODS: In the prospective clinical trial (PRIME), for each scanner, centers performing prostate MRI submitted five consecutive studies and the MRI protocols (phase I). Submitted data were evaluated in consensus by two expert genitourinary radiologists using the PI-QUAL scoring system that evaluates MRI diagnostic quality using five points (1 and 2 = nondiagnostic; 3 = sufficient; 4 = adequate, 5 = optimal) between September 2021 and August 2022. Feedback was provided for scanners not achieving a PI-QUAL 5 score, and centers were invited to resubmit new imaging data using the modified protocol (phase II). Descriptive comparison of outcomes was made between the MRI scanners, feedback provided, and overall PI-QUAL scores. RESULTS: In phase I, 41 centers from 18 countries submitted a total of 355 multiparametric MRI studies from 71 scanners, with nine (13%) scanners achieving a PI-QUAL score of 3, 39 (55%) achieving a score of 4, and 23 (32%) achieving a score of 5. Of the 48 (n = 71 [68%]) scanners that received feedback to improve, the dynamic contrast-enhanced sequences were those that least adhered to the Prostate Imaging Reporting and Data System, version 2.1, criteria (44 of 48 [92%]), followed by diffusion-weighted imaging (20 of 48 [42%]) and T2-weighted imaging (19 of 48 [40%]). In phase II, 36 centers from 17 countries resubmitted revised studies, resulting in a total of 62 (n = 64 [97%]) scanners with a final PI-QUAL score of 5. CONCLUSION: Substantial variation in global prostate MRI acquisition parameters as a measure of quality was observed, particularly with DCE sequences. Basic evaluation and modifications to MRI protocols using PI-QUAL can lead to substantial improvements in quality. Clinical trial registration no. NCT0457184

Immediate post-operative PDE5i therapy improves early erectile function outcomes after robot assisted radical prostatectomy (RARP).

To assess whether the timing of post-operative Phosphodiesterase Inhibitor (PDE5i) therapy after Robot-Assisted Radical Prostatectomy (RARP) is associated with a change in early erectile function (EF) outcomes, continence or safety outcomes. Data were prospectively collected from a single surgeon in one tertiary centre. 158 patients were treated with PDE5i therapy post RARP over a 2-year period. PDE5i therapy was started: immediately (day 1-2) post-op in 29%, early (day 3-14) post-op in 37% and late (after day 14) post-op in 34%. EPIC-26 EF scores were collected pre-op and post-op. There were no significant differences in pre-operative characteristics between the therapy groups. Drop in EF scores and percentage return to baseline for unilateral nerve sparing was, respectively, 9 and 11.1% of immediate therapy, 7 and 14.8% of early therapy and 9.7 and 9.5% of late therapy (p = 0.9 and p = 0.6). For bilateral nerve sparing, this was, respectively, 3.5 and 42.9% immediate therapy, 5.5 and 35.5% early therapy and 7.3 and 25% late therapy (p = 0.017 and p = 0.045). Pad free and social continence were achieved in 54% and 37% of those receiving immediate therapy, 60% and 33% for early therapy and 26% and 54% for late therapy. There were no differences in compliance, complication or readmission outcomes. In patients with bilateral nerve sparing RARP, immediate post-operative PDE5i therapy can protect EF and improve early continence outcomes. Therefore, immediate PDE5i therapy should be considered in patients following nerve sparing RARP to maximise functional outcomes

Pre-existing autoimmunity is associated with increased severity of COVID-19: A retrospective cohort study using data from the National COVID Cohort Collaborative (N3C)

Identifying individuals with a higher risk of developing severe COVID-19 outcomes will inform targeted or more intensive clinical monitoring and management. To date, there is mixed evidence regarding the impact of pre-existing autoimmune disease (AID) diagnosis and/or immunosuppressant (IS) exposure on developing severe COVID-19 outcomes.A retrospective cohort of adults diagnosed with COVID-19 was created in the National COVID Cohort Collaborative enclave. Two outcomes, life-threatening disease, and hospitalization were evaluated by using logistic regression models with and without adjustment for demographics and comorbidities.Of the 2,453,799 adults diagnosed with COVID-19, 191,520 (7.81%) had a pre-existing AID diagnosis and 278,095 (11.33%) had a pre-existing IS exposure. Logistic regression models adjusted for demographics and comorbidities demonstrated that individuals with a pre-existing AID (OR = 1.13, 95% CI 1.09 - 1.17; P< 0.001), IS (OR= 1.27, 95% CI 1.24 - 1.30; P< 0.001), or both (OR = 1.35, 95% CI 1.29 - 1.40; P< 0.001) were more likely to have a life-threatening COVID-19 disease. These results were consistent when evaluating hospitalization. A sensitivity analysis evaluating specific IS revealed that TNF inhibitors were protective against life-threatening disease (OR = 0.80, 95% CI 0.66- 0.96; P=0.017) and hospitalization (OR = 0.80, 95% CI 0.73 - 0.89; P< 0.001).Patients with pre-existing AID, exposure to IS, or both are more likely to have a life-threatening disease or hospitalization. These patients may thus require tailored monitoring and preventative measures to minimize negative consequences of COVID-19

Comparing biparametric to multiparametric MRI in the diagnosis of clinically significant prostate cancer in biopsy-naive men (PRIME): a prospective, international, multicentre, non-inferiority within-patient, diagnostic yield trial protocol

Introduction: Prostate MRI is a well-established tool for the diagnostic work-up for men with suspected prostate cancer (PCa). Current recommendations advocate the use of multiparametric MRI (mpMRI), which is composed of three sequences: T2-weighted sequence (T2W), diffusion-weighted sequence (DWI) and dynamic contrast-enhanced sequence (DCE). Prior studies suggest that a biparametric MRI (bpMRI) approach, omitting the DCE sequences, may not compromise clinically significant cancer detection, though there are limitations to these studies, and it is not known how this may affect treatment eligibility. A bpMRI approach will reduce scanning time, may be more cost-effective and, at a population level, will allow more men to gain access to an MRI than an mpMRI approach. Methods: Prostate Imaging Using MRI±Contrast Enhancement (PRIME) is a prospective, international, multicentre, within-patient diagnostic yield trial assessing whether bpMRI is non-inferior to mpMRI in the diagnosis of clinically significant PCa. Patients will undergo the full mpMRI scan. Radiologists will be blinded to the DCE and will initially report the MRI using only the bpMRI (T2W and DWI) sequences. They will then be unblinded to the DCE sequence and will then re-report the MRI using the mpMRI sequences (T2W, DWI and DCE). Men with suspicious lesions on either bpMRI or mpMRI will undergo prostate biopsy. The main inclusion criteria are men with suspected PCa, with a serum PSA of ≤20 ng/mL and without prior prostate biopsy. The primary outcome is the proportion of men with clinically significant PCa detected (Gleason score ≥3+4 or Gleason grade group ≥2). A sample size of at least 500 patients is required. Key secondary outcomes include the proportion of clinically insignificant PCa detected and treatment decision. Ethics and dissemination: Ethical approval was obtained from the National Research Ethics Committee West Midlands, Nottingham (21/WM/0091). Results of this trial will be disseminated through peer-reviewed publications. Participants and relevant patient support groups will be informed about the results of the trial. Trial registration number: NCT04571840