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Rationale: Chronic lung diseases (CLDs) have been variably associated with a risk for more severe manifestations and death with coronavirus disease (COVID-19). Objectives: To determine the risk overall and by type of CLD for severity of COVID-19 outcomes in a U.S. national cohort. Methods: Using data from the Veterans Health Administration, we determined the risk associated with CLDs, including chronic obstructive pulmonary disease (COPD) (mild or severe), asthma (mild, active, or severe), idiopathic pulmonary fibrosis (IPF), sarcoidosis, and other interstitial lung diseases (ILDs) for outcomes among veterans with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-positive tests between March 1, 2020 and April 30, 2021. We used multinomial regression to estimate risk of four mutually exclusive COVID-19 outcomes within 30 days: outpatient management, hospitalization, hospitalization with indicators of critical illness, or death. We calculated the overall proportion with each outcome, the absolute risk difference, and risk ratios for each outcome between those with and without CLD. We also describe clinical and laboratory abnormalities by CLD in those hospitalized. Results: We included 208,283 veterans with COVID-19; 35,587 (17%) had CLD. Compared with no CLD, veterans with CLD were older and had more comorbidities. Hospitalized veterans with CLD were more likely to have low temperature, mean arterial pressure, oxygen saturation, and leukopenia and thrombocytopenia and were more likely to receive oxygen, mechanical ventilation, and vasopressors. Veterans with CLD were significantly less likely to have mild COVID-19 (−4.5%; adjusted risk ratio [aRR], 0.94; 95% confidence interval [CI], 0.94–0.95), and more likely to have a moderate (+2.5%; aRR, 1.21; 95% CI, 1.18–1.24), critical (+1.4%; aRR, 1.38; 95% CI, 1.32–1.45), or fatal (+0.7%; aRR, 1.15; 95% CI, 1.10–1.20) outcome. IPF was most strongly associated with COVID-19 severity, especially mortality (+3.2%; aRR, 1.69; 95% CI, 1.46–1.96), followed by other ILDs and COPD, whereas asthma was less likely to be associated with severity of COVID-19. In veterans younger than age 65 years, worse COVID-19 outcomes were generally more likely with IPF, sarcoidosis, and other ILDs. Conclusions: Veterans who had CLD, particularly IPF, other ILDs, and COPD, had an increased probability of more severe 30-day outcomes with COVID-19. These results provide insight into the absolute and relative risk of different CLDs with severity of COVID-19 outcomes and can help inform considerations of healthcare utilization and prognosis. Observational clinical epidemiology study registered with (NCT04628039). [ABSTRACT FROM AUTHOR]

The aim of this paper is to investigate technological advancements made to a robotic tele-ultrasound system for musculoskeletal imaging, the MSK-TIM (Musculoskeletal Telerobotic Imaging Machine). The hardware was enhanced with a force feedback sensor and a new controller was introduced. Software improvements were developed which allowed the operator to access ultrasound functions such as focus, depth, gain, zoom, color, and power Doppler controls. The device was equipped with Wi-Fi network capability which allowed the master and slave stations to be positioned in different locations. A trial assessing the system to scan the wrist was conducted with twelve participants, for a total of twenty-four arms. Both the participants and radiologist reported their experience. The images obtained were determined to be of satisfactory quality for diagnosis. The system improvements resulted in a better user and patient experience for the radiologist and participants. Latency with the VPN configuration was similar to the WLAN in our experiments. This research explores several technologies in medical telerobotics and provides insight into how they should be used in future. This study provides evidence to support larger-scale trials of the MSK-TIM for musculoskeletal imaging. [ABSTRACT FROM AUTHOR]

Speech rate reduction is a global speech therapy approach for speech deficits in Parkinson's disease (PD) that has the potential to result in changes across multiple speech subsystems. While the overall goal of rate reduction is usually improvements in speech intelligibility, not all people with PD benefit from this approach. Speech rate is often targeted as a means of improving articulatory precision, though less is known about rate-induced changes in other speech subsystems that could help or hinder communication. The purpose of this study was to quantify phonatory changes associated with speech rate modification across a broad range of speech rates from very slow to very fast in talkers with and without PD. Four speaker groups participated: younger and older healthy controls, and people with PD with and without deep brain stimulation of the subthalamic nucleus (STN-DBS). Talkers read aloud standardized sentences at 7 speech rates elicited using magnitude production: habitual, three slower rates, and three faster rates. Acoustic measures of speech intensity, cepstral peak prominence, and fundamental frequency were measured as a function of speech rate and group. Overall, slower rates of speech were associated with differential effects on phonation across the four groups. While all talkers spoke at a lower pitch in slow speech, younger talkers showed increases in speech intensity and cepstral peak prominence, while talkers with PD and STN-DBS showed the reverse pattern. Talkers with PD without STN-DBS and older healthy controls behaved in between these two extremes. At faster rates, all groups uniformly demonstrated increases in cepstral peak prominence. While speech rate reductions are intended to promote positive changes in articulation to compensate for speech deficits in dysarthria, the present results highlight that undesirable changes may be invoked across other subsystems, such as at the laryngeal level. In particular, talkers with STN-DBS, who often demonstrate speech deterioration following DBS surgery, demonstrated more phonatory detriments at slowed speech rates. Findings have implications for speech rate candidacy considerations and speech motor control processes in PD. [ABSTRACT FROM AUTHOR]

Solar panels are an environmentally friendly alternative to fossil fuels; however, their useful life is limited to approximately 25 years, after which they become a waste management issue. Proper management and recycling of end-of-life (EOL) solar panels are paramount. It protects the environment because of the high energy consumption of silicon production. We can effectively decrease energy and cost requirements by recovering silicon from recycled solar panels. This is one-third of those needed for manufacturing silicon directly. Moreover, solar panels include heavy metals, such as lead, tin, and cadmium, which pose risks to human health and the environment. Empirical evidence suggests that the costs of mining materials can exceed those of recycled materials, thereby making recycling a more cost-effective means of resource harvesting. This review paper focuses on the techniques developed to delaminate solar panels, which are considered a crucial step in the recycling of EOL solar panels. Initially, various classifications of solar panels are given. Subsequently, an analysis of the diverse methods of solar panel delamination and their efficacy in the retrieval of valued materials is presented. This investigation has identified three primary modes of delamination, namely mechanical, thermal, and chemical. Among these, mechanical delamination is deemed to be a sustainable and cost-effective option when compared to thermal and chemical delamination. The current most popular method of thermal delamination is characterized by its high energy consumption and potential emission, and the chemical delamination generates hazardous liquids that pose their own threat to the environment. This study emphasizes the mechanical delamination techniques, characterized by their environmentally friendly nature, minimal ecological footprint, and capacity to retrieve entire glass panels intact. This paper also discusses the current gaps and potential enhancements for mechanical delamination techniques. For example, some delamination techniques result in crushed materials. Thus, the handling and recovery of materials such as glass and silicon cells require the implementation of an appropriate sorting technique. Also, the value obtained from recovering crushed materials is lower than that of intact glass and silicon cells. [ABSTRACT FROM AUTHOR]

Utilising a flexible intracortical microprobe to record/stimulate neurons minimises the incompatibility between the implanted microprobe and the brain, reducing tissue damage due to the brain micromotion. Applying bio-dissolvable coating materials temporarily makes a flexible microprobe stiff to tolerate the penetration force during insertion. However, the inability to adjust the dissolving time after the microprobe contact with the cerebrospinal fluid may lead to inaccuracy in the microprobe positioning. Furthermore, since the dissolving process is irreversible, any subsequent positioning error cannot be corrected by re-stiffening the microprobe. The purpose of this study is to propose an intracortical microprobe that incorporates two compressible structures to make the microprobe both adaptive to the brain during operation and stiff during insertion. Applying a compressive force by an inserter compresses the two compressible structures completely, resulting in increasing the equivalent elastic modulus. Thus, instant switching between stiff and soft modes can be accomplished as many times as necessary to ensure high-accuracy positioning while causing minimal tissue damage. The equivalent elastic modulus of the microprobe during operation is ≈ 23 kPa, which is ≈ 42% less than the existing counterpart, resulting in ≈ 46% less maximum strain generated on the surrounding tissue under brain longitudinal motion. The self-stiffening microprobe and surrounding neural tissue are simulated during insertion and operation to confirm the efficiency of the design. Two-photon polymerisation technology is utilised to 3D print the proposed microprobe, which is experimentally validated and inserted into a lamb’s brain without buckling. [ABSTRACT FROM AUTHOR]

Purpose: Medical imaging can be used to estimate a patient's biological age, which may provide complementary information to clinicians compared to chronological age. In this study, we aimed to develop a method to estimate a patient's age based on their chest CT scan. Additionally, we investigated whether chest CT estimated age is a more accurate predictor of lung cancer risk compared to chronological age. Methods: To develop our age prediction model, we utilized composite CT images and Inception-ResNet-v2. The model was trained, validated, and tested on 13,824 chest CT scans from the National Lung Screening Trial, with 91% for training, 5% for validation, and 4% for testing. Additionally, we independently tested the model on 1849 CT scans collected locally. To assess chest CT estimated age as a risk factor for lung cancer, we computed the relative lung cancer risk between two groups. Group 1 consisted of individuals assigned a CT age older than their chronological age, while Group 2 comprised those assigned a CT age younger than their chronological age. Results: Our analysis revealed a mean absolute error of 1.84 years and a Pearson's correlation coefficient of 0.97 for our local data when comparing chronological age with the estimated CT age. The model showed the most activation in the area associated with the lungs during age estimation. The relative risk for lung cancer was 1.82 (95% confidence interval, 1.65–2.02) for individuals assigned a CT age older than their chronological age compared to those assigned a CT age younger than their chronological age. Conclusion: Findings suggest that chest CT age captures some aspects of biological aging and may be a more accurate predictor of lung cancer risk than chronological age. Future studies with larger and more diverse patients are required for the generalization of the interpretations. [ABSTRACT FROM AUTHOR]

Purpose: This scoping review describes the assessment methodologies for physical activity (PA) and physical fitness assessments used in studies focusing on adolescents and young adults (AYAs) diagnosed with cancer. Methods: A search of the literature was conducted in PubMed, CINAHL, Web of Science, and Cochrane Library following the PRISMA-ScR statement. A total of 34 studies were included in this review. Results: PA was primarily assessed via self-reported questionnaires (30/34) either completed in-person (n = 17) or online (n = 13) at different time points and different stages along the cancer trajectory (i.e., from diagnosis onward). A total of 9 studies conducted a physical fitness assessment. Conclusions: PA and physical fitness measurements are key when trying to describe outcomes, assess for associations, track changes, measure intervention adherence, and test intervention efficacy and effectiveness. Considerable heterogeneity across studies was reported limiting the generation of formal recommendations or guidance for researchers, healthcare providers, and policy makers. [ABSTRACT FROM AUTHOR]

Purpose: The usage of iodinated contrast media (ICM) can improve the sensitivity and specificity of computed tomography (CT) for many clinical indications. However, the adverse effects of ICM administration can include renal injury, life-threatening allergic-like reactions, and environmental contamination. Deep learning (DL) models can generate full-dose ICM CT images from non-contrast or low-dose ICM administration or generate non-contrast CT from full-dose ICM CT. Eliminating the need for both contrast-enhanced and non-enhanced imaging or reducing the amount of required contrast while maintaining diagnostic capability may reduce overall patient risk, improve efficiency and minimize costs. We reviewed the current capabilities of DL to reduce the need for contrast administration in CT. Methods: We conducted a systematic review of articles utilizing DL to reduce the amount of ICM required in CT, searching MEDLINE, Embase, Compendex, Inspec, and Scopus to identify papers published from 2016 to 2022. We classified the articles based on the DL model and ICM reduction. Results: Eighteen papers met the inclusion criteria for analysis. Of these, ten generated synthetic full-dose (100%) ICM from real non-contrast CT, while four augmented low-dose to full-dose ICM CT. Three used DL to create synthetic non-contrast CT from real 100% ICM CT, while one paper used DL to translate the 100% ICM to non-contrast CT and vice versa. DL models commonly used generative adversarial networks trained and tested by paired contrast-enhanced and non-contrast or low ICM CTs. Image quality metrics such as peak signal-to-noise ratio and structural similarity index were frequently used for comparing synthetic versus real CT image quality. Conclusion: DL-generated contrast-enhanced or non-contrast CT may assist in diagnosis and radiation therapy planning; however, further work to optimize protocols to reduce or eliminate ICM for specific pathology is still needed along with a dedicated assessment of the clinical utility of these synthetic images. [ABSTRACT FROM AUTHOR]

E‐cigarette taxes are an active area of legislation and have important regulatory implications by proxying e‐cigarette accessibility. We examine the effect of e‐cigarette taxes on prepregnancy and prenatal smoking using the near‐universe of births to mothers conceiving between 2013 and 2019 in the United States. Using fixed effect regressions, we show that e‐cigarette taxes increase prepregnancy and prenatal smoking. We also find evidence that e‐cigarette taxes reduce prepregnancy and 3rd trimester e‐cigarette use. Finally, we show that e‐cigarette taxes increase news coverage of e‐cigarettes and raise perceptions of risk of e‐cigarettes. [ABSTRACT FROM AUTHOR]

Purpose: The primary purpose of this study was to evaluate how individuals with hypophonia (HP; also referred to as HP participants) and their primary communication partners (PCPs; also referred to as PCP participants) rate communicative participation before and after experience with a speech amplification device. A secondary purpose was to evaluate pre- and post-device effects on self-rated communicative participation for each of the three speech amplification devices trialed outside of the laboratory. Method: Seventeen individuals with HP and their PCPs participated in a crossover design study that compared three different amplification devices: a wired belt-pack amplifier, a wireless stationary amplifier, and a personal frequency modulation (FM) system. Both the individuals with HP and their PCPs self-rated communicative participation at baseline and after trialing each device following 1-week device trial periods at home. Patient-reported outcome measures included the Communicative Effectiveness Survey (CES) and the Voice Activity and Participation Profile (VAPP). Following study completion, participants indicated whether they would like to select a specific device to continue using. Results: Overall, HP participants rated communicative participation following device use higher than that in the pre-device condition, with the FM system resulting in the overall highest VAPP ratings and second highest CES ratings. Furthermore, HP and PCP participants rated these measures similarly. Finally, HP participants who selected a device to continue using self-reported lower total communicative effectiveness scores and greater voice activity limitations and participation restrictions at baseline in comparison to the nonselectors. Conclusions: This study contributes to an increased understanding of how communicative participation is experienced within this clinical population resulting from speech amplification. It is suggested that the inclusion of participationbased outcome measurement is essential to ensure a multidimensional and comprehensive approach to device prescription for individuals with HP. [ABSTRACT FROM AUTHOR]

During the COVID-19 pandemic, there has been an increasing rollout of non-contact fever screening solutions to assist in curbing the spread of disease. This study begins by describing how screening for disease has historically been performed. It proposes four measurement characteristics of an ideal screening solution: non-contact, effective, rapid and low-cost measurements. Next, it reviews the existing literature on fever-screening using non-contact infrared thermometer (NCIT) devices as well as infrared thermography (IRT) devices, as these are two technologies which have experienced increasing use. For this review, 185 research papers were identified, 21 research studies were included after inclusion and exclusion criteria were applied. A total of 35 experiments were identified for analysis and their results tabulated. Of these studies, 66% are IRT and 34% are NCIT, with a median sample size of 430 subjects. 26 experiments involve febrile participants, with a median febrile percentage of 11.22 % of population. The reported sensitivity of febrile detection using NCIT varies from 3.7% to 97% and when using IRT it varies from 15% to 100%. Both indoor and outdoor studies are investigated, as well as those conducted in acute and non-acute settings. The results of this review show a clear lack of consensus on the effectiveness of these systems. Overall, these results indicate that sensitivity and specificity are reduced when using IRT and NCIT technologies compared to other thermometers used in medical practice. Their use should be carefully assessed based on the risks present in each particular measurement scenario. [ABSTRACT FROM AUTHOR]

Morquio syndrome, also known as Morquio-Brailsford syndrome or mucopolysaccharidosis type IV (MPS IV), is a subgroup of mucopolysaccharidosis. It is an autosomal recessive lysosomal storage disorder. Two subtypes of Morquio syndrome have been identified. In MPS IVA, a deficiency in N-acetylgalactosamine-6-sulfate sulfatase interrupts the normal metabolic pathway of degrading glycosaminoglycans. Accumulated undigested glycosaminoglycans in the tissue and bones result in complications leading to severe skeletal deformity. In MPS IVB, a deficiency in beta-galactosidase results in a milder phenotype than in MPS IVA. Morquio syndrome presents a variety of clinical manifestations in a spectrum of mild to severe. It classically has been considered a skeletal dysplasia with significant skeletal involvement. However, the extraskeletal features can also provide valuable information to guide further work-up to assess the possibility of the disorder. Although the disease involves almost all parts of the body, it most commonly affects the axial skeleton, specifically the vertebrae. The characteristic radiologic findings in MPS IV, such as paddle-shaped ribs, odontoid hypoplasia, vertebral deformity, metaphyseal and epiphyseal bone dysplasia, and steep acetabula, are encompassed in the term "dysostosis multiplex," which is a common feature among other types of MPS and storage disorders. Myelopathy due to spinal cord compression and respiratory airway obstruction are the most critical complications related to mortality and morbidity. The variety of clinical features, as well as overlapping of radiological findings with other disorders, make diagnosis challenging, and delays in diagnosis and treatment may lead to critical complications. Timely imaging and radiologic expertise are important components for diagnosis. Gene therapies may provide robust treatment, particularly if genetic variations can be screened in utero. [ABSTRACT FROM AUTHOR]

The SARS-CoV-2 Omicron variant is more immune evasive and less virulent than other major viral variants that have so far been recognized1–12. The Omicron spike (S) protein, which has an unusually large number of mutations, is considered to be the main driver of these phenotypes. Here we generated chimeric recombinant SARS-CoV-2 encoding the S gene of Omicron (BA.1 lineage) in the backbone of an ancestral SARS-CoV-2 isolate, and compared this virus with the naturally circulating Omicron variant. The Omicron S-bearing virus robustly escaped vaccine-induced humoral immunity, mainly owing to mutations in the receptor-binding motif; however, unlike naturally occurring Omicron, it efficiently replicated in cell lines and primary-like distal lung cells. Similarly, in K18-hACE2 mice, although virus bearing Omicron S caused less severe disease than the ancestral virus, its virulence was not attenuated to the level of Omicron. Further investigation showed that mutating non-structural protein 6 (nsp6) in addition to the S protein was sufficient to recapitulate the attenuated phenotype of Omicron. This indicates that although the vaccine escape of Omicron is driven by mutations in S, the pathogenicity of Omicron is determined by mutations both in and outside of the S protein.Comparisons of a chimeric recombinant version of SARS-CoV-2, the ancestral SARS-CoV-2 strain and an Omicron isolate show that the attenuated virulence of Omicron is caused by mutations in both the spike protein and nsp6. [ABSTRACT FROM AUTHOR]

Kaposi’s sarcoma-associated herpesvirus (KSHV) is the etiologic agent of Kaposi’s sarcoma (KS), yet the viral genetic factors that lead to the development of KS in KSHV-infected individuals have not been fully elucidated. Nearly, all previous analyses of KSHV genomic evolution and diversity have excluded the three major internal repeat regions: the two origins of lytic replication, internal repeats 1 and 2 (IR1 and IR2), and the latency-associated nuclear antigen (LANA) repeat domain (LANAr). These regions encode protein domains that are essential to the KSHV infection cycle but have been rarely sequenced due to their extended repetitive nature and high guanine and cytosine (GC) content. The limited data available suggest that their sequences and repeat lengths are more heterogeneous across individuals than in the remainder of the KSHV genome. To assess their diversity, the full-length IR1, IR2, and LANAr sequences, tagged with unique molecular identifers (UMIs), were obtained by Pacifc Biosciences’ single-molecule real-time sequencing (SMRT-UMI) from twenty-four tumors and six matching oral swabs from sixteen adults in Uganda with advanced KS. Intra-host single-nucleotide variation involved an average of 0.16 per cent of base positions in the repeat regions compared to a nearly identical average of 0.17 per cent of base positions in the remainder of the genome. Tandem repeat unit (TRU) counts varied by only one from the intra-host consensus in a majority of individuals. Including the TRU indels, the average intra-host pairwise identity was 98.3 per cent for IR1, 99.6 per cent for IR2 and 98.9 per cent for LANAr. More individuals had mismatches and variable TRU counts in IR1 (twelve/sixteen) than in IR2 (two/sixteen). There were no open reading frames in the Kaposin coding sequence inside IR2 in at least ffty-fve of ninety-six sequences. In summary, the KSHV major internal repeats, like the rest of the genome in individuals with KS, have low diversity. IR1 was the most variable among the repeats, and no intact Kaposin reading frames were present in IR2 of the majority of genomes sampled. [ABSTRACT FROM AUTHOR]

Introduction: Telerobotic ultrasound technology allows radiologists and sonographers to remotely provide ultrasound services in underserved areas. This study aimed to compare costs associated with using telerobotic ultrasound to provide ultrasound services in rural and remote communities to costs associated with alternate models. Methods: A cost‐minimization approach was used to compare four ultrasound service delivery models: telerobotic ultrasound (Model 1), telerobotic ultrasound and an itinerant sonographer (Model 2), itinerant sonographer without telerobotic ultrasound (Model 3), and travel to another community for all exams (Model 4). In Models 1–3, travel was assumed when exams could not be successfully performed telerobotically or by an itinerant sonographer. A publicly funded healthcare payer perspective was used for the reference case and a societal perspective was used for a secondary non‐reference case. Costs were based on the literature and experience using telerobotic ultrasound in Saskatchewan, Canada. Costs were expressed in 2020 Canadian dollars. Results: Average cost per ultrasound exam was $342, $323, $368, and $478 for Models 1, 2, 3, and 4, respectively, from a publicly funded healthcare payer perspective, and $461, $355, $447, and $849, respectively, from a societal perspective. In one‐way sensitivity analyses, Model 2 was the lowest cost from a payer perspective for communities with population >2075 people, distance >350 km from the nearest ultrasound facility, or >47% of the population eligible for publicly funded medical transportation. Conclusion: Health systems may wish to consider solutions such as telerobotic ultrasound and itinerant sonographers to reduce healthcare costs and improve access to ultrasound in rural and remote communities. [ABSTRACT FROM AUTHOR]

Kaposi sarcoma (KS), a common HIV-associated malignancy, presents a range of clinicopathological features. Kaposi sarcoma-associated herpesvirus (KSHV) is its etiologic agent, but the contribution of viral genomic variation to KS development is poorly understood. To identify potentially influential viral polymorphisms, we characterized KSHV genetic variation in 67 tumors from 1–4 distinct sites from 29 adults with advanced KS in Kampala, Uganda. Whole KSHV genomes were sequenced from 20 tumors with the highest viral load, whereas only polymorphic genes were screened by PCR and sequenced from 47 other tumors. Nine individuals harbored ≥1 tumors with a median 6-fold over-coverage of a region centering on K5 and K6 genes. K8.1 gene was inactivated in 8 individuals, while 5 had mutations in the miR-K10 microRNA coding sequence. Recurring inter-host polymorphisms were detected in K4.2 and K11.2. The K5-K6 region rearrangement breakpoints and K8.1 mutations were all unique, indicating that they arise frequently de novo. Rearrangement breakpoints were associated with potential G-quadruplex and Z-DNA forming sequences. Exploratory evaluations of viral mutations with clinical and tumor traits were conducted by logistic regression without multiple test corrections. K5-K6 over-coverage and K8.1 inactivation were tentatively correlated (p<0.001 and p = 0.005, respectively) with nodular rather than macular tumors, and with individuals that had lesions in ≤4 anatomic areas (both p≤0.01). Additionally, a trend was noted for miR-K10 point mutations and lower survival rates (HR = 4.11, p = 0.053). Two instances were found of distinct tumors within an individual sharing the same viral mutation, suggesting metastases or transmission of the aberrant viruses within the host. To summarize, KSHV genomes in tumors frequently have over-representation of the K5-K6 region, as well as K8.1 and miR-K10 mutations, and each might be associated with clinical phenotypes. Studying their possible effects may be useful for understanding KS tumorigenesis and disease progression. Author summary: How chronic KSHV infection leads to the development of KS is poorly understood, however, evaluation of KSHV mutations found in vivo may assist this understanding. Here, targeted and whole genome sequencing of KSHV in multiple tumors from individuals in Uganda revealed an increase in copy number of the region of the genome encompassing the K5 and K6 genes or inactivation of the K8.1 gene in at least a third of the individuals. In an exploratory analysis these mutations were found more in tumors of nodular than macular morphotype and in individuals with fewer lesions. These mutations were unique across individuals, indicating that they arise frequently de novo. Point mutations in the miR-K10 micro-RNA sequence were weakly associated with lower survival. Occasionally, distinct tumors within an individual shared the same viral mutation, suggesting metastases or transmission of the aberrant viruses within the host. Clustering of genome rearrangement breakpoints were associated with potential G-quadruplex and Z-DNA forming regions in the viral DNA. The viral genetic differences uncovered and their associated clinical phenotypes call for targeted surveys of these genes to potentially establish a prognostic or treatment-selective biomarker and more studies into their roles in tumorigenesis. [ABSTRACT FROM AUTHOR]

Introduction: Obstetrical ultrasound imaging is critical in identifying at-risk pregnancies and informing clinical management. The coronavirus disease 2019 (COVID-19) pandemic has exacerbated challenges in accessing obstetrical ultrasound for patients in underserved rural and remote communities where this service is not available. This prospective descriptive study describes our experience of providing obstetrical ultrasound services remotely using a telerobotic ultrasound system in a northern Canadian community isolated due to a COVID-19 outbreak. Methods: A telerobotic ultrasound system was used to perform obstetrical ultrasound exams remotely in La Loche, Canada, a remote community without regular access to obstetrical ultrasound. Using a telerobotic ultrasound system, a sonographer 605 km away remotely controlled an ultrasound probe and ultrasound settings. Twenty-one exams were performed in a five-week period during a COVID-19 outbreak in the community, including limited first-, second- and third-trimester exams (n = 11) and complete second-trimester exams (n = 10). Participants were invited to complete a survey at the end of the telerobotic ultrasound exam describing their experiences with telerobotic ultrasound. Radiologists subsequently interpreted all exams and determined the adequacy of the images for diagnosis. Results: Of 11 limited obstetrical exams, radiologists indicated images were adequate in nine (81%) cases, adequate with some reservations in one (9%) case and inadequate in one (9%) case. Of 10 second-trimester complete obstetrical exams, radiologists indicated images were adequate in two (20%) cases, adequate with some reservations in three (30%) cases and inadequate in five (50%) cases. Second-trimester complete obstetrical exams were limited due to a combination of body habitus, foetal lie and telerobotic technology. Discussion: A telerobotic ultrasound system may be used to answer focused clinical questions such as foetal viability, dating and foetal presentation in a timely manner while minimising patient travel to larger centres and potential exposure to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), during the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Most artificial intelligence (AI) studies have focused primarily on adult imaging, with less attention to the unique aspects of pediatric imaging. The objectives of this study were to (1) identify all publicly available pediatric datasets and determine their potential utility and limitations for pediatric AI studies and (2) systematically review the literature to assess the current state of AI in pediatric chest radiograph interpretation. We searched PubMed, Web of Science and Embase to retrieve all studies from 1990 to 2021 that assessed AI for pediatric chest radiograph interpretation and abstracted the datasets used to train and test AI algorithms, approaches and performance metrics. Of 29 publicly available chest radiograph datasets, 2 datasets included solely pediatric chest radiographs, and 7 datasets included pediatric and adult patients. We identified 55 articles that implemented an AI model to interpret pediatric chest radiographs or pediatric and adult chest radiographs. Classification of chest radiographs as pneumonia was the most common application of AI, evaluated in 65% of the studies. Although many studies report high diagnostic accuracy, most algorithms were not validated on external datasets. Most AI studies for pediatric chest radiograph interpretation have focused on a limited number of diseases, and progress is hindered by a lack of large-scale pediatric chest radiograph datasets. [ABSTRACT FROM AUTHOR]

Current camera traps use passive infrared triggers; therefore, they only capture images when animals have a substantially different surface body temperature than the background. Endothermic animals, such as mammals and birds, provide adequate temperature contrast to trigger cameras, while ectothermic animals, such as amphibians, reptiles, and invertebrates, do not. Therefore, a camera trap that is capable of monitoring ectotherms can expand the capacity of ecological research on ectothermic animals. This study presents the design, development, and evaluation of a solar-powered and artificial-intelligence-assisted camera trap system with the ability to monitor both endothermic and ectothermic animals. The system is developed using a central processing unit, integrated graphics processing unit, camera, infrared light, flash drive, printed circuit board, solar panel, battery, microphone, GPS receiver, temperature/humidity sensor, light sensor, and other customized circuitry. It continuously monitors image frames using a motion detection algorithm and commences recording when a moving animal is detected during the day or night. Field trials demonstrate that this system successfully recorded a high number of animals. Lab testing using artificially generated motion demonstrated that the system successfully recorded within video frames at a high accuracy of 0.99, providing an optimized peak power consumption of 5.208 W. No water or dust entered the cases during field trials. A total of 27 cameras saved 85,870 video segments during field trials, of which 423 video segments successfully recorded ectothermic animals (reptiles, amphibians, and arthropods). This newly developed camera trap will benefit wildlife biologists, as it successfully monitors both endothermic and ectothermic animals. [ABSTRACT FROM AUTHOR]

The SPitzer InfraRed Intensive Transients Survey (SPIRITS) searched for luminous infrared (IR) transients and variables in nearly 200 nearby galaxies from 2014 to 2019, using the warm Spitzer telescope at 3.6 and 4.5 ÎĽ m. Among the SPIRITS variables are IR-bright objects that are undetected in ground-based optical surveys. We classify them as (1) transients, (2) periodic variables, and (3) irregular variables. The transients include eSPecially Red Intermediate-luminosity Transient Events (SPRITEs), having maximum luminosities fainter than supernovae, red IR colors, and a wide range of outburst durations (days to years). Here we report deep optical and near-IR imaging with the Hubble Space Telescope (HST) of 21 SPIRITS variables. They were initially considered SPRITE transients, but many eventually proved instead to be periodic or irregular variables as more data were collected. HST images show most of these cool and dusty variables are associated with star-forming regions in late-type galaxies, implying an origin in massive stars. Two SPRITEs lacked optical progenitors in deep preoutburst HST images; however, one was detected during eruption at J and H, indicating a dusty object with an effective temperature of ∼1050 K. One faint SPRITE turned out to be a dusty classical nova. About half the HST targets proved to be periodic variables, with pulsation periods of 670â€"2160 days; they are likely dusty asymptotic-giant-branch (AGB) stars with masses of ∼5â€"10 M ⊙. A few of them were warm enough to be detected in deep HST frames, but most are too cool. Out of six irregular variables, two were red supergiants with optical counterparts in HST images; four were too enshrouded for HST detection. [ABSTRACT FROM AUTHOR]

Piezoelectric nanogenerator (PENG) is a leading-edge mechanical energy harvesting device used in portable power supply and self-powered sensor systems. Advanced 3D printers have been recently used to create 3D printed (3DP) PENGs. This has facilitated the rapid fabrication of PENGs and their integration into wearable electronics, biomedical systems, and internet of things devices. However, researchers face several critical challenges in developing robust 3DP-PENGs that can produce adequate electrical energy for self-powered systems. Therefore, this review on 3DP-PENGs is conducted to highlight their recent developments and challenges. This paper presents the latest 3D-printed piezoelectric nanogenerators in terms of their materials selection and functionalization, design and architecture formation, and applications including pressure sensors, flow sensors, microphones, and implants. Finally, crucial challenges and optimization strategies that considerably impact the output performance of 3DP-PENGs, along with a roadmap for their future enhancement are given. It is envisioned that this work will help reduce the gap between 3D printing and PENG technologies and accelerate the research and development of 3DP-PENGs. [ABSTRACT FROM AUTHOR]

Introduction: Chronic kidney disease-mineral and bone disorders (CKD-MBD) are prevalent in patients undergoing maintenance dialysis. Yet, there are limited and mixed evidence on the effects of different dialysis modalities involving longer treatment times or higher frequencies on CKD-MBD markers. Methods: This cohort study used data from 132,523 incident dialysis patients treated with any of the following modalities: conventional thrice-weekly in-center hemodialysis, nocturnal in-center hemodialysis (NICHD), home hemodialysis (HHD), or peritoneal dialysis (PD) from 2007 to 2011. We used marginal structural models fitted with inverse probability weights to adjust for fixed and time-varying confounding and informative censoring. We estimated the average effects of treatments with different dialysis modalities on time-varying serum concentrations of CKD-MBD markers: albumin-corrected calcium, phosphate, parathyroid hormone (PTH), and alkaline phosphatase (ALP) using pooled linear regression. Results: Most of the cohort were exclusively treated with conventional in-center hemodialysis, while few were ever treated with NICHD or HHD. At the baseline, PD patients had the lowest mean and median values of PTH, while NICHD patients had the highest median values. During follow-up, compared to hemodialysis patients, patients treated with NICHD had lower mean serum PTH (19.8 pg/mL [95% confidence interval: 2.8, 36.8] lower), whereas PD and HHD patients had higher mean PTH (39.7 pg/mL [31.6, 47.8] and 51.2 pg/mL [33.0, 69.3] higher, respectively). Compared to hemodialysis patients, phosphate levels were lower for patients treated with NICHD (0.44 mg/dL [0.37, 0.52] lower), PD (0.15 mg/dL [0.12, 0.19] lower), or HHD (0.33 mg/dL [0.27, 0.40] lower). There were no clinically meaningful associations between dialysis modalities and concentrations of calcium or ALP. Conclusion: In incident dialysis patients, compared to treatment with conventional in-center hemodialysis, treatments with other dialysis modalities with longer treatment times or higher frequency were associated with different patterns of serum phosphate and PTH. Given the recent growth in the use of dialysis modalities other than hemodialysis, the associations between the treatment and the CKD-MBD markers warrant additional study. [ABSTRACT FROM AUTHOR]

Analyzes the role of guilt in intensifying the literary works of Henry Adams, Scott Fitzgerald and his wife Zelda Fitzgerald. Personification of women in Adams' literary works; Crosslacing of character by Fitzgerald; Display of Adam's law applied to Fitzgerald's nature and art in Zelda's novels.

This article examines petitionary prayer in Revelation 5:8; 6:10; 8:3–4; and 22:20 for the purpose of ascertaining its rhetorical function with respect to the vindication of the martyrs, the judgment of the wicked, the coming of Jesus, and the completion of God's mission in the earth. This analysis also places Revelation in conversation with prayer passages within the Fourth Gospel in order to discern how these documents, read on their own terms and then taken together, provide a fuller picture concerning the function of Johannine prayer. 1 [ABSTRACT FROM AUTHOR]

In people living with HIV (PLWH) on antiretroviral therapy (ART), virus persists in a latent form where there is minimal transcription or protein expression. Latently infected cells are a major barrier to curing HIV. Increasing HIV transcription and viral production in latently infected cells could facilitate immune recognition and reduce the pool of infected cells that persist on ART. Given that programmed cell death protein 1 (PD-1) expressing CD4+ T cells are preferentially infected with HIV in PLWH on ART, we aimed to determine whether administration of antibodies targeting PD-1 would reverse HIV latency in vivo. We therefore evaluated the impact of intravenous administration of pembrolizumab every 3 weeks on HIV latency in 32 PLWH and cancer on ART. After the first infusion of anti–PD-1, we observed a median 1.32-fold increase in unspliced HIV RNA and 1.61-fold increase in unspliced RNA:DNA ratio in sorted blood CD4+ T cells compared to baseline. We also observed a 1.65-fold increase in plasma HIV RNA. The frequency of CD4+ T cells with inducible virus evaluated using the tat/rev limiting dilution assay was higher after 6 cycles compared to baseline. Phylogenetic analyses of HIV env sequences in a participant who developed low concentrations of HIV viremia after 6 cycles of pembrolizumab did not demonstrate clonal expansion of HIV-infected cells. These data are consistent with anti–PD-1 being able to reverse HIV latency in vivo and support the rationale for combining anti–PD-1 with other interventions to reduce the HIV reservoir. PD-1 blockade for HIV: Strategies to target and reverse the latent HIV reservoir are required to cure HIV. Because CD4+ T cells expressing programmed cell death protein 1 (PD-1) are preferentially infected with HIV in an individual on antiretroviral therapy, PD-1 is an attractive target to manipulate the latent reservoir. To this end, Uldrick et al. measured the impact of anti–PD-1 treatment with pembrolizumab on the HIV reservoir in 32 individuals living with HIV on suppressive antiretroviral therapy and diagnosed with cancer. They observed evidence of increased unspliced HIV RNA and of the unspliced RNA:DNA ratio, consistent with anti–PD-1 treatment having the potential to reverse HIV latency. Further studies are needed to evaluate the dose and frequency of anti–PD-1 treatment required for latency reversal. [ABSTRACT FROM AUTHOR]

Unmanned aerial vehicles, or drones, are a technology that has seen rapid growth. Their ability to offload tasks that are once considered labor intensive is one of their many appealing aspects. This aspect increases time for tasks of higher importance, meaning reliance on this technology is ever increasing. These tasks include land geo‐mapping, firefighting, surveillance, delivery services, search and rescue among others. As with every growing technology, however, comes the negative exposure, shadowing further expansion and growth. For drones, this includes noise pollution, and hazardous, low efficiency propulsion systems. Regulations and laws are beginning to surface, regulating the use of drones and their noise levels within airspace, as future growth can overcrowd airspace. Current drones use propulsion systems that expose the public to hazardous propellers and high levels of noise, thus unsuitable for their expected growth. This paper presents a novel variable‐geometry exit nozzle to improve the efficiency of current propulsion systems in drones, in turn reducing noise levels and hazards, that are currently foreshadowing drones. The presented propulsion method achieves results that show better performance than a ducted fan and propeller under static conditions. Three experiments are conducted, and the results are reported and discussed. [ABSTRACT FROM AUTHOR]

Ultrasound imaging is an essential component of healthcare services. This study sought to explore perceptions of access, and factors which shape access, to ultrasound imaging in two northern, remote, Indigenous communities in Canada. Using interpretive description as a methodological approach and a multi-dimensional conceptualisation of access to care as a theoretical framework, 15 semi-structured interviews were conducted in the northern Canadian communities of Stony Rapids and Black Lake, Saskatchewan. All participants had an obstetrical or non-obstetrical ultrasound exam performed in the past 10 years. Interviews were audio recorded and interview transcripts were analysed using constant comparative analysis. Geographic isolation from imaging facilities was a central barrier to participants accessing ultrasound imaging. Other barriers became apparent when participants had to travel for ultrasound, including fear of air travel, isolation from family, financial means, and unfamiliarity with larger cities. Barriers such as family and work responsibilities were exacerbated by the barrier of geography. Participants overcame these barriers as they were motivated by potential diagnostic benefits of ultrasound imaging. This study highlights disparities in access to ultrasound for northern, remote, Indigenous populations. Future efforts to improve access to imaging should consider barriers of distance to imaging facilities and strategies to bridge these barriers. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to quantify changes in acoustic distinctiveness in two groups of talkers with Parkinson's disease as they modify across a wide range of speaking rates. Method: People with Parkinson's disease with and without deep brain stimulation and older healthy controls read 24 carrier phrases at different speech rates. Target nonsense words in the carrier phrases were designed to elicit stop consonants and corner vowels. Participants spoke at seven self-selected speech rates from very slow to very fast, elicited via magnitude production. Speech rate was measured in absolute words per minute and as a proportion of each talker's habitual rate. Measures of segmental distinctiveness included a temporal consonant measure, namely, voice onset time, and a spectral vowel measure, namely, vowel articulation index. Results: All talkers successfully modified their rate of speech from slow to fast. Talkers with Parkinson's disease and deep brain stimulation demonstrated greater baseline speech impairment and produced smaller proportional changes at the fast end of the continuum. Increasingly slower speaking rates were associated with increased temporal contrasts (voice onset time) but not spectral contrasts (vowel articulation). Faster speech was associated with decreased contrasts in both domains. Talkers with deep brain stimulation demonstrated more aberrant productions across all speaking rates. Conclusions: Findings suggest that temporal and spectral segmental distinctiveness are asymmetrically affected by speaking rate modifications in Parkinson's disease. Talkers with deep brain stimulation warrant further investigation with regard to speech changes they make as they adjust their speaking rate. [ABSTRACT FROM AUTHOR]

Objective: To develop a collision engine (haptic force feedback simulator) compatible with a 5-degrees-of-freedom (DOF) haptic wand. This has broad applications such as telerobotic ultrasound systems. Integrating force feedback into systems is critical to optimize remote scanning. A collision engine compatible with a 5-DOF haptic wand was developed based on the Gilbert–Johnson–Keerthi algorithm. The collision engine calculated force during collision between the wand and a virtual object based on code developed using MATLAB. A proportional force was subsequently returned to a user via the haptic wand, thereby simulating the collision force for the user. Three experiments were conducted to assess the accuracy of the collision engine on curved and flat surfaces. Results: The average errors in calculation of distances between the wand and virtual object were 2.1 cm, 3.4 cm, and 4.2 cm for the model of the human hand, cylinder, and cuboid, respectively. The collision engine accurately simulated forces on a flat surface, though was less accurate on curved surfaces. Future work will incorporate haptic force feedback into a telerobotic ultrasound system. The haptic force simulator presented here may also be used in the development of ultrasound simulators for training and education. [ABSTRACT FROM AUTHOR]

The purpose of this study was to describe body image among young adult (YA) cancer survivors and examine relationships between body image and personal, medical, and psychosocial variables. Methods: YAs (n = 522; Mage = 34 ± 6 years) completed an online survey and data were analyzed using descriptive statistics, bivariate correlations, and appropriate tests of mean differences. Results: Higher body image concerns were related to less time since diagnosis, lower post-traumatic growth and social support, greater distress, and a higher number of treatments received (rs =.09 to.42; ps <.05). Body image concerns were higher for those currently on treatment (p <.05). Conclusions: Findings suggest greater attention to YAs' body image is necessary. Specifically, longitudinal research and the development of strategies dedicated to reducing body image concerns among YAs are needed. [ABSTRACT FROM AUTHOR]

Over the years, prayer passages within the Fourth Gospel and 1 John have been examined in detail apart from one another. This work seeks to analyse them in light of one another, particularly the prayer passages located within the Farewell Discourse (14:12–14; 15:7–8, 16; 16:23) and 1 John (3:21–22; 5:14–18). This article begins by exploring how the Farewell Discourse prescribes prayer as the means by which greater works will be performed and much fruit produced in Jesus's physical absence. Then attention is given to demonstrating that the author of 1 John, dissatisfied with the prayer tradition in the Farewell Discourse, provides a nuanced account that focuses on how confidence in prayer relates to real-life, ethical scenarios within the community he addresses (3:11–24; 5:14–17). Finally, this article concludes by arguing that the discussion of prayer in 1 John 5:14–17 is more concerned with the preservation of the believing community than its numerical growth. Attention will be given to analysing the prerequisites, privileges and purposes of prayer in both documents in order to provide a more complete, nuanced profile of Johannine prayer. It is my distinct honour and privilege to dedicate this article to the great Johannine scholar, Dr Jan van der Watt. [ABSTRACT FROM AUTHOR]

We develop and evaluate a deep learning algorithm to classify multiple catheters on neonatal chest and abdominal radiographs. A convolutional neural network (CNN) was trained using a dataset of 777 neonatal chest and abdominal radiographs, with a split of 81%–9%–10% for training-validation-testing, respectively. We employed ResNet-50 (a CNN), pre-trained on ImageNet. Ground truth labelling was limited to tagging each image to indicate the presence or absence of endotracheal tubes (ETTs), nasogastric tubes (NGTs), and umbilical arterial and venous catheters (UACs, UVCs). The dataset included 561 images containing two or more catheters, 167 images with only one, and 49 with none. Performance was measured with average precision (AP), calculated from the area under the precision-recall curve. On our test data, the algorithm achieved an overall AP (95% confidence interval) of 0.977 (0.679–0.999) for NGTs, 0.989 (0.751–1.000) for ETTs, 0.979 (0.873–0.997) for UACs, and 0.937 (0.785–0.984) for UVCs. Performance was similar for the set of 58 test images consisting of two or more catheters, with an AP of 0.975 (0.255–1.000) for NGTs, 0.997 (0.009–1.000) for ETTs, 0.981 (0.797–0.998) for UACs, and 0.937 (0.689–0.990) for UVCs. Our network thus achieves strong performance in the simultaneous detection of these four catheter types. Radiologists may use such an algorithm as a time-saving mechanism to automate reporting of catheters on radiographs. [ABSTRACT FROM AUTHOR]

Barriers, facilitators, and motivators to exercise for cancer survivors living in urban settings are well described in the literature. However, there is a lack of comparable information for cancer survivors living in rural communities. We describe the exercise behaviours, barriers, facilitators, and motivators to exercise participation of cancer survivors living in a rural Canadian community. Adult cancer survivors with a primary address in a rural region of Ontario, Canada, who had visited a community hospital in the previous five years were mailed a cross-sectional survey assessing current exercise volume (minutes of moderate-to-vigorous aerobic and resistance exercise), as well as exercise preferences, barriers, and facilitators. Seventy-two survivors (mean age 65 years) completed the survey (16% response rate). A majority of respondents were diagnosed with breast cancer (49%) in the last 5 years (61%). Aerobic- and resistance-training guidelines for cancer survivors were met by 38% and 10% of respondents, respectively. Physical side effects were the most common barrier to exercise during treatment (65%) and post-treatment (35%). Being unaware of available exercise programs, time for exercise, distance to exercise services, and cost were commonly reported barriers during and post-treatment (reported by 10-22%). Respondents reported needing information from a qualified exercise professional (46%), access to a gym (33%) and exercise equipment (26%), and social support (25%) to facilitate exercise participation. Consistent with urban-based cancer survivors, most rural survivors surveyed in this study were not meeting the physical-activity guidelines and reported numerous exercise barriers. These findings can serve as a resource for this and similar rural communities when developing community-based exercise-support services for cancer survivors. [ABSTRACT FROM AUTHOR]

Background: Telesonography systems have been developed to overcome barriers to accessing diagnostic ultrasound for patients in rural and remote communities. However, most previous telesonography systems have been designed for performing only abdominal and obstetrical exams. In this paper, we describe the development and assessment of a musculoskeletal (MSK) telesonography system. Methods: We developed a 4-degrees-of-freedom (DOF) robot to manipulate an ultrasound probe. The robot was remotely controlled by a radiologist operating a joystick at the master site. The telesonography system was used to scan participants' forearms, and all participants were conventionally scanned for comparison. Participants and radiologists were surveyed regarding their experience. Images from both scanning methods were independently assessed by an MSK radiologist. Results: All ten ultrasound exams were successfully performed using our developed MSK telesonography system, with no significant delay in movement. The duration (mean ± standard deviation) of telerobotic and conventional exams was 4.6 ± 0.9 and 1.4 ± 0.5 min, respectively (p = 0.039). An MSK radiologist rated quality of real-time ultrasound images transmitted over an internet connection as "very good" for all telesonography exams, and participants rated communication with the radiologist as "very good" or "good" for all exams. Visualisation of anatomic structures was similar between telerobotic and conventional methods, with no statistically significant differences. Conclusions: The MSK telesonography system developed in this study is feasible for performing soft tissue ultrasound exams. The advancement of this system may allow MSK ultrasound exams to be performed over long distances, increasing access to ultrasound for patients in rural and remote communities. [ABSTRACT FROM AUTHOR]

Introduction: Exercise is vital to health and well-being after a cancer diagnosis yet is poorly integrated in cancer care. Knowledge mobilization (KM) is essential to enhance exercise opportunities. We aimed to (1) develop and refine a list of highly important exercise oncology research and KM themes and (2) establish the relative importance of the themes for supporting the implementation of exercise as a standard of care for people living with and beyond cancer. Methods: Informed by the Co-Produced Pathway to Impact KM framework, a modified Delphi study approach was used to develop, rate, and rank exercise oncology research and KM themes through an international stakeholder workshop and a three-round iterative online survey. Open-ended stakeholder feedback from cancer survivors, healthcare practitioners (HCPs), qualified exercise professionals (QEPs), policy makers, and researchers was used to update themes between survey rounds. Themes were ranked from highest to lowest importance and agreement was examined across all stakeholders and within stakeholder groups. Results: A total of 269 exercise oncology stakeholders from 13 countries participated in the study. Twelve final exercise oncology research and KM themes were produced. The final top ranked research themes were related to: (1) QEP integration into primary cancer care teams, (2) Exercise oncology education for HCPs, and (3) Accessibility of cancer exercise programs & support services. There was statistically significant agreement between stakeholders (p <0.001) and within stakeholder groups (p 's≤0.02) on the general rankings of themes (i.e., some themes generally ranked higher and lower compared to others). Low Kendall's W statistics indicated variability related to the specific ranked order of the themes between stakeholders and within stakeholder groups. Moreover, there were key differences in the rankings for specific themes between policy makers and other stakeholder groups that highlight potentially important discordance in the research and KM priorities for policy makers that warrants further study. Conclusion: These findings can be used to guide initiatives and align stakeholders on priorities to support exercise implementation as a standard of cancer care. Additional research is needed to better understand the differences in the proposed research and KM priorities across stakeholders. [ABSTRACT FROM AUTHOR]

Background: As rates of advanced imaging for lower back pain (LBP) continue to increase, there is a need to ensure the appropriateness of imaging.Objective: The goal of this project was to reduce the number of inappropriate magnetic resonance imaging (MRI) and computed tomography (CT) requests for LBP patients and facilitate appropriate imaging by developing a combined imaging appropriateness checklist for lumbar spine MRI and CT.Methods: In prior work, we developed and adopted individual evidence-based lumbar spine MRI and CT checklists into the radiology requisition process. In the current project, a combined checklist was developed and trialed in one of the former Saskatchewan health regions (Five Hills) beginning in May 2018. Using statistical process control, control charts compared the monthly number of imaging requests pre-checklist implementation and post-checklist implementation from May 2017 to February 2020. The monthly number of lumbar spine MRI and CT requisitions in the nearby former Saskatchewan Regina Qu'Appelle Health Region, in which the combined checklist was not trialed, was also plotted and compared as a balancing measure.Results: In Five Hills, a shift (decrease) was observed in the monthly number of lumbar spine MRI requisitions 7 months following the implementation of the combined checklist. However, the monthly number of lumbar spine CT requisitions did not change significantly. In the Regina Qu'Appelle Health Region, there was a shift (increase) in the monthly number of lumbar spine MRI requisitions, while the monthly number of lumbar spine CT requests decreased after the implementation of the combined checklist.Conclusions: The combined checklist with evidence-based indications for lumbar spine MRI and CT imaging in LBP patients appeared to reduce the complexity associated with two previous individual checklists and facilitate imaging appropriateness. Accountable benefits may include the reduction of radiation exposure as a result of unnecessary and repeated imaging and reduction in wait times for CT and/or MRI. [ABSTRACT FROM AUTHOR]

Purpose: Exercise and physical activity (hereafter, collectively referred to as PA) preferences and benefits are becoming increasingly well characterised in cancer survivors, yet evidence from adolescent and young adult cancer survivors (AYAs) is scant. We describe the overall PA behaviour and support preferences of AYAs and explore subgroup differences to inform AYA-specific research and support. Methods: AYAs diagnosed with cancer between the ages of 18–39 years, irrespective of current age, were approached in clinic at a large cancer centre for this cross-sectional survey that assessed self-reported demographics, medical history, PA behaviour and PA support preferences. Results: A total of 318 AYAs completed the survey. Approximately 40% of AYAs were not meeting PA guidelines, and only 5% reported engagement with cancer PA support services. Most AYAs wanted PA support (78%), to increase PA levels (70%), and were interested in engaging in PA interventions that were individually supervised (82%), home-based (79%), performed ≥ 3 days/week (75%) and for ≥ 30 minutes/session (78%), offered following treatment (63%), restricted by age (63%), and involved strength (83%), walking (78%), and flexibility (75%) exercise. PA preferences most often differed according to sex, treatment status, current PA behaviour and PA support setting. Conclusion: AYAs have a great capacity and interest in specific types of PA support. Poor engagement with existing PA support services highlights the need for further AYA-specific research. Better understanding of AYAs' unique PA behaviour and support preferences can inform the development of urgently needed research and support services for this understudied and rapidly growing population. [ABSTRACT FROM AUTHOR]

Background Neutropenic fever (NF) is associated with significant morbidity and mortality for patients receiving cancer treatment in sub-Saharan Africa (sSA). However, the antibiotic management of NF in sub-Saharan Africa has not been well described. We evaluated the timing and selection of antibiotics for patients with NF at the Uganda Cancer Institute (UCI). Methods We conducted a retrospective chart review of adults with acute leukemia admitted to UCI from 1 January 2016 to 31 May 2017, who developed NF. For each NF event, we evaluated the association of clinical presentation and demographics with antibiotic selection as well as time to both initial and guideline-recommended antibiotics. We also evaluated the association between ordered antibiotics and the in-hospital case fatality ratio (CFR). Results Forty-nine NF events occurred among 39 patients. The time to initial antibiotic order was <1 day. Guideline-recommended antibiotics were ordered for 37 (75%) NF events. The median time to guideline-recommended antibiotics was 3 days. Fever at admission, a documented physical examination, and abdominal abnormalities were associated with a shorter time to initial and guideline-recommended antibiotics. The in-hospital CFR was 43%. There was no difference in in-hospital mortality when guideline-recommended antibiotics were ordered as compared to when non-guideline or no antibiotics were ordered (hazard ratio, 0.51 [95% confidence interval {CI},.10–2.64] and 0.78 [95% CI,.20–2.96], respectively). Conclusions Patients with acute leukemia and NF had delayed initiation of guideline-recommended antibiotics and a high CFR. Prospective studies are needed to determine optimal NF management in sub-Saharan Africa, including choice of antibiotics and timing of antibiotic initiation. [ABSTRACT FROM AUTHOR]

Access to sonographers and sonologists is limited in many communities around the world. Telerobotic sonography (robotic ultrasound) is a new technology to increase access to sonography, providing sonographers and sonologists the ability to manipulate an ultrasound probe from a distant location and remotely perform ultrasound examinations. This narrative review discusses the development of telerobotic ultrasound systems, clinical studies evaluating the feasibility and diagnostic accuracy of telerobotic sonography, and emerging use of telerobotic sonography in clinical settings. Telerobotic sonography provides an opportunity to provide real‐time ultrasound examinations to underserviced rural and remote communities to increase equity in the delivery of diagnostic imaging. [ABSTRACT FROM AUTHOR]

Fast-scan cyclic voltammetry (FSCV) is an electrochemical sensing method used for measuring the concentration of neurotransmitters within the brain. FSCV is typically conducted using benchtop equipment, providing accurate and high temporal resolution measurements. However, the large size and high cost of benchtop FSCV systems pose significant limitations in widespread preclinical use of FSCV. Recent technological improvements have facilitated the miniaturization of FSCV equipment, creating systems that can be mounted on the subject as they are small and lightweight. One key remaining bottleneck in the emerging miniaturized FSCV systems is that their data typically needs to be transmitted to an external computer for analysis. This paper presents a review on the current miniature FSCV devices. It discusses the latest improvements in voltage scan waveforms that help increase the sensitivity of measuring specific analytes, for use in miniaturized FSCV. It also tabulates analytes that have been detected using FSCV. It also details current issues with FSCV and the latest achievements in post-processing of FSCV data to better identify target analytes. Furthermore, the emerging miniature FSCV devices that have integrated on-board data processing capabilities to mitigate external data processing are discussed. These advances can accelerate neurochemistry research, reducing time spent analysing data on external computers, and allowing for investigation into questions on neurotransmitter dynamics in target brain regions. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has led to the rapid adoption and rollout of thermal camera-based Infrared Thermography (IRT) systems for fever detection. These systems use facial infrared emissions to detect individuals exhibiting an elevated core-body temperature, which is present in many symptomatic presentations of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Despite the rollout of these systems, there is little independent research supporting their efficacy. The primary objective of this study was to assess the precision and accuracy of IRT screening solutions in a real-world scenario. The method used was a single-centre, observational study investigating the agreement of three IRT systems compared to digital oral thermometer measurements of body temperature. Over 5 days, 107 measurements were taken from individuals wearing facial masks. During each entry, two measurements of the subject's body temperature were made from each system to allow for the evaluation of the measurement precision, followed by an oral thermometer measurement. Each participant also answered a short demographic survey. This study found that the precision of the IRT systems was wider than 0.3 °C claimed accuracy of two of the systems. This study also found that the IRT measurements were only weakly correlated to those of the oral temperature. Additionally, it was found that demographic characteristics (age, gender, and mask-type) impacted the measurement error. This study indicates that using IRT systems in front-line scenarios poses a potential risk, where a lack of measurement accuracy could possibly allow febrile individuals to pass through undetected. Further research is required into methods which could increase accuracy and improve the techniques viability. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to explore the psychosocial impact of botulinum toxin (BoNT) injections for oromandibular dystonia (OMD) and to gain a better understanding of how participants judge the success of this treatment. Method: Eight individuals with OMD and dysarthria participated in one face-to-face, semistructured interview. Interviews were audio-recorded and transcribed verbatim. Qualitative, phenomenological methods of coding, immersion, and emergence were used in the analysis of interview data. Results: Two major themes and six subthemes emerged from the analysis of interview data. The first theme, Botox has changed me and my experiences, explored the participants' perspective of receiving BoNT injections and its psychosocial impact. The second theme, What communication is like for me, explored the psychosocial impact of BoNT on speech production and participation. Conclusions: Our results suggest that BoNT has a variable impact on domains related to quality of life, satisfaction with treatment, speech production, and communicative participation. This study adds novel information related to the psychosocial consequences of BoNT treatment in the management of OMD and builds on a literature that studies the consequences and experiences of living with OMD. [ABSTRACT FROM AUTHOR]

Purpose: Hypophonia (low speech intensity) is the most common speech symptom experienced by individuals with Parkinson's disease (IWPD). Previous research suggests that, in IWPD, there may be abnormal integration of sensory information for motor production of speech intensity. In the current study, intensity of auditory feedback was systematically manipulated (altered in both positive and negative directions) during sensorimotor conditions that are known to modulate speech intensity in everyday contexts in order to better understand the role of auditory feedback for speech intensity regulation. Method: Twenty-six IWPD and 24 neurologically healthy controls were asked to complete the following tasks: converse with the experimenter, start vowel production, and read sentences at a comfortable loudness, while hearing their own speech intensity randomly altered. Altered intensity feedback conditions included 5-, 10-, and 15-dB reductions and increases in the feedback intensity. Speech tasks were completed in no noise and in background noise. Results: IWPD displayed a reduced response to the altered intensity feedback compared to control participants. This reduced response was most apparent when participants were speaking in background noise. Specific task-based differences in responses were observed such that the reduced response by IWPD was most pronounced during the conversation task. Conclusions: The current study suggests that IWPD have abnormal processing of auditory information for speech intensity regulation, and this disruption particularly impacts their ability to regulate speech intensity in the context of speech tasks with clear communicative goals (i.e., conversational speech) and speaking in background noise. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to quantify changes in speech intelligibility in two cohorts of people with Parkinson's disease (PD; those with and without deep brain stimulation [DBS]) across a broad range of self-selected speech rate alterations in (a) read sentences and (b) extemporaneous speech (monologues). Method: Four speaker groups participated in this study: younger and older controls, people with PD undergoing standard pharmaceutical treatment, and people with PD and DBS. Naïve listeners rated the intelligibility of read sentences and extemporaneous monologues, spoken by participants at seven self-selected speech rates from very slow to very fast. Intelligibility was modeled as a function of group, speech rate condition, and speech task. Results: Overall, compared to habitual speech rate, slower speech rate conditions were not associated with changes in speech intelligibility, whereas faster-than-habitual conditions were associated in declines in intelligibility. Results were mediated by group and task effects, such that talkers with PD and DBS were more likely to see intelligibility benefits at slower self-selected speech rates and less likely to see detriments at faster rates, and these differences were amplified in monologues compared to sentences. Conclusion: Findings suggest differences in the ways in which slower and faster speech rate adjustments impact speech intelligibility in people with PD with and without DBS, with the latter demonstrating greater magnitudes of change. [ABSTRACT FROM AUTHOR]

The nova rate in the Milky Way remains largely uncertain, despite its vital importance in constraining models of Galactic chemical evolution as well as understanding progenitor channels for Type Ia supernovae. The rate has been previously estimated to be in the range of ≈10–300 yr−1, either based on extrapolations from a handful of very bright optical novae or the nova rates in nearby galaxies; both methods are subject to debatable assumptions. The total discovery rate of optical novae remains much smaller (≈5–10 yr−1) than these estimates, even with the advent of all-sky optical time-domain surveys. Here, we present a systematic sample of 12 spectroscopically confirmed Galactic novae detected in the first 17 months of Palomar Gattini-IR (PGIR), a wide-field near-infrared time-domain survey. Operating in the J band (≈1.2 μm), which is significantly less affected by dust extinction compared to optical bands, the extinction distribution of the PGIR sample is highly skewed to a large extinction values (>50% of events obscured by AV ≳ 5 mag). Using recent estimates for the distribution of Galactic mass and dust, we show that the extinction distribution of the PGIR sample is commensurate with dust models. The PGIR extinction distribution is inconsistent with that reported in previous optical searches (null-hypothesis probability <0.01%), suggesting that a large population of highly obscured novae have been systematically missed in previous optical searches. We perform the first quantitative simulation of a 3π time-domain survey to estimate the Galactic nova rate using PGIR, and derive a rate of yr−1. Our results suggest that all-sky near-infrared time-domain surveys are well poised to uncover the Galactic nova population. [ABSTRACT FROM AUTHOR]

Survivors of adolescent and young adult cancers (AYAs) often live 50 to 60 years beyond their diagnosis. This rapidly growing cohort is at increased risk for cancer- and treatment-related 'late effects' that persist for decades into survivorship. Recognition of similar issues in pediatric cancer survivors has prompted the development of evidence-based guidelines for late effects screening and care. However, corresponding evidence-based guidelines for AYAs have not been developed. We hosted an AYA survivorship symposium for a large group of multidisciplinary AYA stakeholders (approximately 200 were in attendance) at Princess Margaret Cancer Centre (Toronto, Ontario, Canada) to begin addressing this disparity. The following overview briefly summarizes and discusses the symposium's stakeholder-identified high-priority targets for late effects screening and care and highlights knowledge gaps to direct future research in the field of AYA survivorship. This overview, although not exhaustive, is intended to stimulate clinicians to consider these high-priority screening and care targets when seeing survivors in clinical settings and, ultimately, to support the development of evidence-based late effects screening and care guidelines for AYAs. [ABSTRACT FROM AUTHOR]