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We report the case of a 46-year-old male with long-standing low back pain who presented with a deterioration of symptoms characterised by back and right leg pain corresponding to the L4 and L5 dermatomes. An MRI scan revealed severe central and lateral recess stenosis at L4/5 secondary to a large central disc protrusion. We remotely monitored activity and general health metrics over a time-period exceeding two years. This is the first study to monitor these metrics remotely and continuously in the surgical spine patient. Over this time, he received several interventions including a spinal cord stimulator implant, and an L4/5 microdiscectomy. We tracked his fluctuating health status using the Oura Ring [objectively measuring metrics including step count, sleep patterns, heart rate (HR), heart-rate variability (HRV), and respiratory rate (RR)] and with daily self-reported scores on the Visual Analogue Scale. The Oura Ring is a convenient and lightweight wearable device that is worn on any finger. Taken together, metrics provided a comprehensive picture of deterioration and recovery, paralleling key events in the patient’s history. The use of wearable devices is feasible in enabling long-term remote continuous monitoring. This may assist surgeons and rehabilitation providers in identifying early deterioration and monitoring the post-intervention course of recovery.

Parental and caregivers' hygiene-related knowledge, attitude and practice are compelling factors in the prevention of stunting and malnutrition among the aboriginal children in Malaysia, which are highly modifiable. This study was conducted to explore the knowledge, attitude and practice related to hygiene among primary caregivers of the under three aboriginal (known as Orang Asli) children community in Malaysia.A total of 166 primary caregivers of the under three children of the aboriginal community in Kuala Langat district, Selangor were recruited. Data related to caregivers', child's and environmental factors were collected using a validated and reliable questionnaire, with knowledge, attitude and practice being the dependent variables. IBM Statistical Package for Social Science (SPSS) version 25.0 was used to analyse the data. Pearson's correlation was conducted to identify the relationship between continuous data. Multiple linear regression analysis was performed to determine the relationship between knowledge, attitude and practice related to hygiene, as well as the predictors.The mean scores for knowledge, attitude and practice related to hygiene were 6.91 (2.12), 23.67 (3.16), 29.97 (3.55) and 43.05 (4.41), respectively. Significant moderate positive correlations were found between attitude and hygiene practice (r = 0.445, P 0.001). Self-efficacy was significantly correlated with attitude (r = 0.442, P 0.001) and practice (r = 0.557, P 0.001), with every unit increase in self-efficacy will predict 0.281 and 0.536 increase in attitude (B = 0.281, 95% CI: 0.126-0.435) and practice (B = 0.536, 95% CI: 0.348-0.725) scores respectively.Moderate mean scores for hygiene related knowledge, attitude and practice were observed in this study, with self-efficacy being a significant predictor for both hygiene-related attitude and practice but not knowledge. The self-efficacy of the caregivers should be sustained through continuous health education and counselling, to ensure improved hygiene practice. Future related research should consider the mediating role of self-efficacy on attitude and practice.

Objective: Epistaxis is the most common otolaryngological emergency and up to one third of patients in treated on an inpatient basis take oral anticoagulants (OAC). Direct oral anticoagulants (DOAC), an OAC subgroup, have been on the market since 2010 and are being increasingly prescribed due to the cardiologic and hematologic guidelines that favour them over vitamin K antagonists (VKA), the older of the OAC subgroups. The present study aims to investigate which subgroup of epistaxis patients taking OACs has a more favourable outcome. Design/Setting: A systematic review and meta-analysis were performed according to the PRISMA 2020 statement using the PubMed and Cochrane Library databases. Continuous data was analysed and standardized mean difference (SMD) was calculated according to Hedges’ g. Dichotomous data was analysed and the Mantel-Haenszel method was applied to establish the odds ratio (OR). Heterogeneity was assessed according to the I2 statistics. Main Outcome/Results: A total of 8 reports covering 1390 patients were included in the final synthesis. The pooled analysis demonstrated significantly shorter hospital stays in the DOAC group (SMD= -0.22, 95% CI -0.42 to -0.02, P= .03) and a significantly higher rate of posterior bleeding in the VKA group (OR= .39, 95% CI .23 to .68, P= .001). No statistically significant differences with regard to recurrence rates, admission rates, the need for transfusion, or surgical intervention (P= .57, .12, .57 and .38 respectively) were found. Conclusion: According to this meta-analysis, epistaxis patients taking DOACs have a more favourable outcome than patients taking VKAs.

Introduction: Prediction models of most toxicological assays translate continuous data to binary classifications (“positive” or “negative”) using cutoff values. Mostly these cutoffs do not consider...

Objective:Retrospective self-report is typically used for diagnosing previous pediatric traumatic brain injury (TBI). A new semi-structured interview instrument (New Mexico Assessment of Pediatric TBI; NewMAP TBI) investigated test–retest reliability for TBI characteristics in both the TBI that qualified for study inclusion and for lifetime history of TBI.Method:One-hundred and eight-four mTBI (aged 8–18), 156 matched healthy controls (HC), and their parents completed the NewMAP TBI within 11 days (subacute; SA) and 4 months (early chronic; EC) of injury, with a subset returning at 1 year (late chronic; LC).Results:The test–retest reliability of common TBI characteristics [loss of consciousness (LOC), post-traumatic amnesia (PTA), retrograde amnesia, confusion/disorientation] and post-concussion symptoms (PCS) were examined across study visits. Aside from PTA, binary reporting (present/absent) for all TBI characteristics exhibited acceptable (≥0.60) test–retest reliability for both Qualifying and Remote TBIs across all three visits. In contrast, reliability for continuous data (exact duration) was generally unacceptable, with LOC and PCS meeting acceptable criteria at only half of the assessments. Transforming continuous self-report ratings into discrete categories based on injury severity resulted in acceptable reliability. Reliability was not strongly affected by the parent completing the NewMAP TBI.Conclusions:Categorical reporting of TBI characteristics in children and adolescents can aid clinicians in retrospectively obtaining reliable estimates of TBI severity up to a year post-injury. However, test–retest reliability is strongly impacted by the initial data distribution, selected statistical methods, and potentially by patient difficulty in distinguishing among conceptually similar medical concepts (i.e., PTA vs. confusion).

Objectives To outline the principles and premise, pros and cons of the use of preference signaling (PS) in the Urology Match. Methods PS is a standardized system in which a student may send a signal or token to a particular program to demonstrate genuine interest in advance of application review and interview selection. The available literature of the use of PS in other fields was assessed and applied to the unique construct of the Urology Match. Potential benefits and challenges are discussed and a process and timeline for implementation are presented. Results PS requires a limited number of signals to maintain value, a transparent system to disclose and distribute signals and continuous data assessment for optimization. It standardizes pre interview communication and highlights for programs which applicants have sincere interest although it does not directly address application overload. Conclusion PS is a viable and equitable method for applicants to indicate interest directly, confidentially and intentionally indicate interest in a program which can allow a program to maximize scarce resources such as time and interview slots in the match process.

The nationwide lockdown of Phase-1 in India was started from March 25 to April 14, 2020 and Phase-2 from April 15 to May 3, 2020 with severe restrictions on public activities in India. Utilizing the particulate matter PM10 and PM2.5 data recorded during this adverse time, the present study is undertaken to assess the impact of phase 1 and 2 lockdown on the air quality of Perungudi, Chennai, India. The data obtained from the Tamil Nadu Pollution Control Board was assessed for lockdown phase. We compared particulate matter data for the unlock phase with a coinciding period in March 2020 to determine the changes in pollutant concentrations during the lockdown period of April 2020. The descriptive analysis of PM continuous data was performed to determine the mean, standard deviation, variance, skew and kurtosis to identify the nature of data. Correlogram analysis gives the information that the data under study has non-stationary behaviour and not random. Along with this linear regression analysis were performed to determine the relationship and trend for the data. The results revealed decreasing trend in the concentrations (PM10, PM2.5).

Existing indices of observer agreement for continuous data, such as the intraclass correlation coefficient or the concordance correlation coefficient, measure the total observer-related variability, which includes the variabilities between and within observers. This work introduces a new index that measures the interobserver variability, which is defined in terms of the distances among the 'true values' assigned by different observers on the same subject. The new coefficient of interobserver variability (CIV) is defined as the ratio of the interobserver and the total observer variability. We show how to estimate the CIV and how to use bootstrap and ANOVAbased methods for inference. We also develop a coefficient of excess observer variability, which compares the total observer variability to the expected total observer variability when there are no differences among the observers. This coefficient is a simple function of the CIV. In addition, we show how the value of the CIV, estimated from an agreement study, can be used in the design of measurements studies. We illustrate the new concepts and methods by two examples, where (1) two radiologists used calcium scores to evaluate the severity of coronary artery arteriosclerosis, and (2) two methods were used to measure knee joint angle.

Background Palatal petechiae are predictive of Group A streptococcal (GAS) pharyngitis. We sought to (a) quantify the value of considering petechiae in addition to exudate, and (b) assess provider incorporation of petechiae's predictive nature for GAS into clinical decision making. Methods We conducted a cross-sectional study of patients 3–21 years with sore throat and GAS testing performed in a pediatric emergency department (ED) in 2016. Patients were excluded if immunosuppressed, nonverbal, medically complex, had chronic tonsillitis, or received antibiotics in the preceding week. As a proxy of provider incorporation of petechiae into clinical decision making we assessed how often petechiae were documented, compared with exudate. We performed univariate analysis using χ2 analysis for categorical data and Mann-Whitney U test for continuous data. Results 1574 patients met inclusion criteria. Median age 8 years [IQR 5, 13]; 54% female. 372 patients (24%) were GAS positive. Both palatal petechiae and tonsillar exudates were predictive of GAS [OR 8.5 (95% CI 5.2–13.9), and 1.9 (95% CI 1.4–2.6) respectively]. Examining petechiae or exudate vs. exudate alone increases OR from 1.9 to 2.9 (95% CI 2.2–3.8). Sensitivity improves (23% to 34%) with minimal change to specificity (87% to 85%). Among those with a normal or erythematous throat exam, petechiae were mentioned as a pertinent negative in 28%; absence of tonsillar exudate was mentioned in 78% (p = .02). Conclusions Palatal petechiae are highly associated with GAS, yet rarely addressed in documentation. Incorporating palatal petechiae into common scoring systems could improve prediction and disseminate this knowledge into practice.

Safety of infrastructures represents one of the most significant concerns for governments and service providers to preserve people's well-being. One of the main ways to keep in safe facilities (buildings, bridges, railways, etc.) involves the use of monitoring sensor systems in charge of measuring critical operating conditions. Those measurements together with periodical maintenance, contribute to minimize potential risks that the infrastructure faces. The paper aims at designing, developing, and testing a monitoring system for mechanical stresses acting on the overhead contact wire (OCW) to ensure the operational safety of the railway network. In this regard, the paper proposes two Fiber Bragg Grating (FBG) sensors-based solutions, relying on the ability of these sensors to allow real-time and continuous data acquisition. The first one consists in a polyimide-coated sensor bonded on an OCW clamp, the second one is a copper-coated sensor hanging between the two separated halves of an OCW clamp. Significant results have been obtained mechanically testing both solutions, trying to simulate the operative conditions.

We discuss issues related to the use of the normality assumption in statistical process monitoring with continuous data. Our illustrations involve the Shewhart X-chart. We illustrate some of the da...

The acute care surgery (ACS) model has been shown to improve patient, hospital and surgeon-specific outcomes. To date, however, little has been published on its impact on residency training. Our study compared the emergency general surgery (EGS) operative experiences of residents assigned to ACS versus elective surgical rotations.Resident-reported EGS case logs were prospectively collected over a 9-month period across 3 teaching hospitals. Descriptive statistics were tabulated and group comparisons were made using χ2 statistics for categorical data and t tests for continuous data.Overall, 1061 cases were reported. Resident participation exceeded 90%). Appendiceal and biliary disease accounted for 49.7% of EGS cases. Residents on ACS rotations reported participating in twice as many EGS cases per block as residents on elective rotations (12.64 v. 6.30 cases, p0.01). Most cases occurred after hours while residents were on call rather than during daytime ACS hours (78.8% v. 21.1%, p0.01). Senior residents were more likely than junior residents to report having a primary operator role (71.3% v. 32.0%, p0.01). Although the timing of cases made no difference in the operative role of senior residents, junior residents assumed the primary operator role more often during the daytime than after hours (50.0% v. 33.1%, p = 0.01).Despite implementation of the ACS model, residents in our program obtained most of their EGS operative experience after hours while on call. Although further research is needed, our study suggests that improved daytime access to the operating room may represent an opportunity to improve the quantity and quality of the EGS operative experience at our academic network.Il a été prouvé que le modèle de chirurgie en soins actifs (CSA) améliore les résultats pour le patient, l’hôpital et le chirurgien. Pour le moment, peu de publications s’intéressent aux effets de ce modèle sur les résidents. Notre étude compare l’expérience des chirurgies générales d’urgence (CGU) chez les résidents effectuant un stage en CSA et chez les résidents effectuant un stage optionnel en chirurgie.Les cas de CGU rapportés par les résidents ont été recueillis de manière prospective pendant 9 mois dans 3 hôpitaux universitaires. Les statistiques descriptives ont été compilées, et les 2 groupes ont été comparés à l’aide du test du χ2 pour les variables catégorielles et du test t pour les variables continues.En tout, 1061 cas ont été rapportés (la participation des résidents était de plus de 90 %). Les atteintes de l’appendice et de la vésicule biliaire représentaient 49,7 % des CGU. Les résidents en CSA ont indiqué participer à 2 fois plus de CGU que les résidents en stage optionnel (12,64 c. 6,30 cas, p0,01). La plupart des CGU se sont produites en dehors des heures normales, alors que les résidents étaient de garde, plutôt que pendant les heures de CSA (78,8 % c. 21,1 %, p0,01). Les médecins résidents finissants étaient plus susceptibles d'indiquer avoir tenu le rôle de chirurgien principal que les résidents en début de parcours (71,3 % c. 32,0 %, p0,01). Le moment des chirurgies ne faisait aucune différence pour ce qui est du rôle des résidents finissants, mais les résidents en début de parcours ont davantage assumé le rôle de chirurgien principal pendant les heures de CSA que pendant les périodes de garde (50,0 % c. 33,1 %, p0,01).Malgré l’adoption du modèle de CSA, les résidents de notre programme ont acquis la majorité de leur expérience en CGU en dehors des heures normales, alors qu’ils étaient de garde. Bien que d’autres études soient nécessaires, notre étude laisse croire qu’un meilleur accès aux salles d’opération pendant le jour pourrait augmenter la quantité et la qualité de l’expérience en CGU dans le réseau universitaire.

This paper presents a real-time, false-pick filter based on deep learning to reduce false alarms of an onsite Earthquake Early Warning (EEW) system. Most onsite EEW systems use P-wave to predict S-wave. Therefore, it is essential to properly distinguish P-waves from noises or other seismic phases to avoid false alarms. To reduce false-picks causing false alarms, this study made the EEWNet Part 1 'False-Pick Filter' model based on Convolutional Neural Network (CNN). Specifically, it modified the Pick_FP (Lomax et al.) to generate input data such as the amplitude, velocity, and displacement of three components from 2 seconds ahead and 2 seconds after the P-wave arrival following one-second time steps. This model extracts log-mel power spectrum features from this input data, then classifies P-waves and others using these features. The dataset consisted of 3,189,583 samples: 81,394 samples from event data (727 events in the Korean Peninsula, 103 teleseismic events, and 1,734 events in Taiwan) and 3,108,189 samples from continuous data (recorded by seismic stations in South Korea for 27 months from 2018 to 2020). This model was trained with 1,826,357 samples through balancing, then tested on continuous data samples of the year 2019, filtering more than 99% of strong false-picks that could trigger false alarms. This model was developed as a module for USGS Earthworm and is written in C language to operate with minimal computing resources.

SuperPlotsOfData is a web tool for the transparent display and quantitative comparison of continuous data from different conditions. It offers easy and open access to state-of-the-art data visualization. In addition, it incorporates recent innovations in data visualization and analysis, including raincloud plots and estimation statistics.

To evaluate the effectiveness of different diagnostic variables measured on panoramic radiographs (PAN) to predict spontaneous eruption of palatally displaced canine (PDC) after interceptive extraction in late mixed dentition.Digital databases (MEDLINE, CENTRAL (Cochrane), Scopus, clinicaltrials.gov, ISRCTN registry) and hand searches were performed up to March 2020. Both randomized and non-randomized controlled trials were considered for the review. Study selection, data extraction, risk of bias assessment (RoB2.0 and ROBINS-I), and the certainty of evidence evaluation (GRADE) were performed according to Cochrane Handbook for Systematic Reviews of Interventions. The random-effects method for quantitative synthesis of dichotomous as well as continuous data was used.Out of 767 retrieved records, 4 controlled trials fulfilled the eligibility criteria and were included in the review. Studies were assessed at low risk of bias except one. Overall certainty was strong to moderate. PDCs in distal sectors (RR: 1.621; 95%CI: 1.259 to 2.086; P0.001) and alpha-angle30° (SMD: -1.350; 95%CI: 1.924 to -0.776; P0.001) were significantly benefited from interceptive extraction. However, Vertical distance of PDC cusp tip from occlusal plane had statistically insignificant (p: 0.855) roll on eruption prediction.Interceptive extraction at a younger age, initial horizontal localization (sector position), and alpha-angle (initial mesial inclination) are the most important variables predicting the spontaneous eruption of palatally displaced canines. Findings of this review can be utilized to make evidence-based decisions for managing PDCs with diverse sectors and mesial inclinations. However, well-designed clinical trials are recommended to strengthen the evidence.

With recent evolvement in smart sensing systems, sensor-based activity recognition has endured numerous research studies that mainly emphasize classifying pre-segmented data chunks having a fixed duration. Each data chunk generally involves a single human activity for classification into one of the predefined activity classes. Such activity recognition models, trained with pre-segmented and fixed-size data chunks, cannot adapt well to natural human activities in real-time settings, where the duration of activities varies. Also, the real-time data available from smart devices is in a continuous form and not discrete chunks. As a result, the real-time implementation of activity-aware applications based on the existing models becomes impractical. Therefore, in this paper, a novel framework, i.e., “S-THAD”, is proposed for sensor-based temporal human activity detection from the continuous and untrimmed 3D motion sensor data. The proposed method is capable of detecting when and which activity of interest appears in a continuous data stream. The publicly available PAMAP2 dataset is used to test the proposed scheme, which entails long and untrimmed data streams from the wearable inertial sensors placed at three different body positions, including hand, chest, and ankle. The experimental results indicate that the proposed scheme achieves significant detection performance on this dataset.

In this paper, we identify conditions, based solely on the observed data, for the global well-posedness, regularity, and the asymptotic tracking property of solutions of the Newtonian relaxation (n...

The article presents a novel weak ground truth (WGT) determination procedure on continuous human-rated data. The notion of WGT is essential in cases where there is no direct empirical evidence for an observed construct and human annotations provide the most reliable means for determining the ground truth. The core idea behind the proposed procedure is to transform the ratings to reduce rater bias, maximize inter-rater agreement, and improve WGT. The procedure was evaluated on two behavioral datasets containing continuous annotations of several expressive dimensions. The results show that the procedure improves the size of WGT data by removing the disagreement originating from rater-specific distortions, such as rater mean and scaling bias. The entropy of residuals decreases after WGT optimization, meaning that more relevant information is retained. The average improvement of WGT data size is between 10.1 and 20.9 percentage points, depending on the respective dimension. However, in cases where the rater bias is small, the procedure does not substantially modify WGT. This indicates that the proposed optimization only removes rater biases derived from rater-specific distortions, while retaining and improving valid WGT. The proposed procedure is generalizable on any type and size of continuous or discrete numerical data where multiple raters are involved.

Algeria has experienced catastrophic floods over the second half of the twentieth century, causing many deaths and extensive material damage. This study was conducted to find a suitable event-based rainfall-runoff (RR) model for semi-arid conditions, where continuous data are not available in all regional basins. The study compared, based on data availability, the SCS-CN model based on the antecedent moisture conditions (AMC) and four modified SCS-CN models incorporating antecedent moisture amounts (AMA) in order to find the best model to reproduce the flood hydrographs in two catchments. The modified models were predominant over the SCS-CN method. Nonetheless, the Singh et al. (Water Resour Manag 29:4111–4127, 2015. https://doi.org/10.1007/s11269-015-1048-1 ) model (M4) and the Verma et al. (Environ Earth Sci 76:736, 2017a. https://doi.org/10.1007/s12665-017-7062-2 ) model (M5) were superior and demonstrated more stable structures. Coupled with the Hayami routing model, the models showed promising results and were able to reproduce the observed hydrographs’ shape. However, it was impossible to choose the preferred model since they each excelled as to a criterion. Therefore, the corresponding outputs were combined using the simple average (SA) method and the weighted average (WA) method. We found that the WA method showed better results in the two catchments and allowed a more accurate prediction according to the performance criteria.

There are inconsistencies between the formulas for the variance of standardized mean difference (SMD) in the Cochrane Handbook for Systematic Reviews and the variance reported in other sources. Instead of the variance appropriate for the SMD of a crossover experiment, the Cochrane Handbook uses the variance appropriate for a pre-test post-test experiment. This means that if there is a non-negligible time period effect, the formula reported by the Handbook will underestimate both the effect size and its variance. In addition, the formula for the standard error of SMD reported in the Cochrane Handbook (in section 23.2.7.2) is inconsistent with the variance derived from the variance of the related t-test. Even if the period effect is negligible, the Cochrane Handbook formula is biased toward underestimates. The difference between the estimates from the two formulas will be small if either the correlation between the repeated measures, or the magnitude of the SMD estimate, is small, or if the sample size is large. However, it can be can be quite substantial in other circumstances.

In recent years, flows of many rivers and lakes have become reduced in arid and semi-arid regions around the world. The most typical examples of this phenomenon occur in Central Asia, and the reduction of the Aral Sea area is closely related to agricultural water use. However, due to a lack of continuous data in Central Asia spanning many years, “virtual water” is used to evaluate changes in agricultural water use. Based on virtual water theory, 325 kinds of agricultural products in eight categories are selected as the research object, and changes in virtual water are calculated for Central Asia from 1992 to 2016. Results indicate that: (1) The average annual net export of agricultural virtual water (TVWNE) in Central Asia is about 9 billion m3, concentrated in Kazakhstan, whose annual TVWNE reaches 8.1 billion m3. (2) Since 2007, the TVWNE in Central Asia has dropped significantly, with a drop rate of 86%, while the total volume of agricultural virtual water has gradually increased since 1998. (3) The upstream and downstream countries in Central Asia have different characteristics in the change of virtual water quantity.

Background: A Bayesian network meta-analysis (NMA) model is a statistical method aimed at estimating the relative effects of multiple interventions against the same disease. The method has recently gained prominence, leading to the synthesis of the evidence regarding rank probabilities for each treatment. In several cases, an NMA is performed excluding incomplete data of studies retrieved through a systematic review, resulting in a loss of precision and power. Methods: There are several methods for handling missing or incomplete data in an NMA framework, especially for continuous outcomes. In certain cases, only baseline and follow-up measurements are available; in this framework, to obtain data regarding mean changes, it is necessary to consider the pre-post study correlation. In this context, in a Bayesian setting, several authors suggest imputation strategies for pre-post correlation. In other cases, a variability measure associated with a mean change score might be unavailable. Different imputation methods have been suggested, such as those based on maximum standard deviation imputation. The purpose of this study is to verify the robustness of Bayesian NMA models concerning different imputation strategies through simulations. Results: Simulation results show that the bias is notably small for every scenario, confirming that rankings provided by models are robust concerning different imputation methods in several heterogeneity-correlation settings. Conclusions: This NMA method seems to be more robust to missing data imputation when data reported in different studies are generated in a low-heterogeneity scenario. The NMA method seems to be more robust to missing value imputation if the expectation of the prior distribution, defined on the heterogeneity parameter, approaches the true value of the variability across studies.

Ninety random samples of semi cooked chicken meat products represented by strip, pane and nuggets (30 of each) were collected from different supermarkets at Kaliobyia governorate for bacteriological examination.The mean values of Aerobic plate count,Enterobacteriacea count and Staphylococcus count were4.9x104 ± 1.2x104, 3.1x102 ± 8.2x102 and1.5x102 ±7.1x10 for chicken strips, 8.4x104± 3.3x104,8.9x102 ± 5.6x102and7x103 ± 4.5x103 cfu/g for chicken pane and 7.46x104 ± 1.7x104,1.2x102 ± 2.1x10 and 7.2x103 ± 2.3x103cfu/g for chicken nuggets. Moreover, the incidence of S.entretidis was 6.6% for chicken strips and not detected in pane and nuggets. Staph aureus incidence was 20%, 26.6%and 26.6% for chicken strips, pane and nuggets for total examined samples by using conventional culture method. For more confirmation, identification of Staph.aureus from 5 random samples by Vitek 2 compact system was applied. Results recorded was identical to that of culture method with accuracy 100% for examined chicken products samples and showed that the Vitek 2 system is a suitable tool for rapid and direct identification of gram positive cocci as an ideal detection system should include high specificity and sensitivity; fast response time; capability for mass production; simplification of sample preparation steps ;minimal perturbation of sample;and providing continuous data analysis as that obtained by the Vitek 2compact system. The public health importance of isolated microorganisms and recommended point were discussed.

We report for validation of cloud fraction estimated from high-resolution (hourly) data from MERRA-2 and AIRS instrument aboard NASA’s Aqua satellite during its ascending and descending orbits with hourly ground-based visual observation taken at Indian Astronomical Observatory (IAO), Hanle during 1997-2018. The study reveals 70% useful nights, equivalent to 254 spectroscopic nights in a year. A comparative study of cloud fraction was performed using homogeneous and continuous data spanning six years (2013-2018) from MERRA-2 and AIRS over IAO, Hanle and Merak sites in the Himalayan region, and several astronomical observatories located in Atacama desert in Chile, Canary islands in Spain, National Astronomical Observatory (NAO), Mexico, and Mauna Loa in Hawaii. The study reveals cloud fractions of 0.07-0.11 at 25% (1st Quartile) and 0.32-0.40 at 50% (median) at the Himalayan sites. On the other hand, the median cloud fractions are 0.06-0.13 at the Chilean sites, 0.16 at NAO, and 0.29 at Canary islands. The observed 25% of the cloud fraction at the Himalayan sites during the lowest three cloud-fractional months (October-December) are comparable with other sites located in Chile and Canary islands. The median cloud fraction at Hanle is slightly lower than Mauna Loa. The study further concluded that the percentage of useful nights obtained from the visual observation (70%) at IAO-Hanle is very close to the percentage of clear sky (68%) estimated from the MERRA-2 data.

Digital Twins and Blockchain are key elements that when connected allow continuous data acquisition in the factory. As the connection between digital twins and blockchain is rather under-explored, the key contribution of this paper is the conceptual development of a digital twin prototype connected with an Ethereum-based blockchain. The outcome of the paper provides a concept to ensure the unique tokens represent the physical assets without being tampered with by applying digital twin technology. The paper includes a case study focused on Matrix-Structured Manufacturing Systems for Small and Medium-sized Enterprises.

With the considerable exploration of blockchain in various industrial fields, the storage architectures of mainstream consortium blockchains exhibit significant performance limitations, which can't meet the requirements of efficient data access with massive data storage in enterprise-level business scenarios. In this paper, we creatively divided the underlying data of the consortium blockchain into two categories: continuous data and state data and proposed a new storage architecture to store and operate these two types of data efficiently. For continuous data, we designed a specialized index-based storage engine. For state data, we proposed a multi-level cache mechanism with a secure and integrated data persistence policy. In addition, a pluggable Client/Server mode is employed to achieve flexible distributed extension. A series of experiments are conducted to show the effectiveness of our architecture. Compared with mainstream consortium blockchain storage architecture based on LevelDB, the average time-consuming decreases 81.85%/82.47% for reading/writing continuous data and 22.21%/48.99% for reading/writing state data. Compared with the storage architecture based on distributed database TiKV, the time-consuming decreases more significantly. This storage architecture has been integrated into the enterprise-level consortium blockchain platform Hyperchain, which has supported the efficient running of dozens of large-scale commercial blockchain projects with massive data.

RMSEA estimation given nonnormal continuous data is usually based on the mean-adjusted ( T M ) or mean-variance-adjusted ( T M V ) chi-square statistic, but a plain application of these statistics ...

Background Falls is a major public health concern. In the older population, it is a risk factor for disability, frailty and further disability. However, most data is focused in Nursing Home residence and non-Asian population. Furthermore, despite Orthostatic Hypotension (OH) often attributed to falls, there is little data in the Malaysian population. Objective To identify the prevalence of fall and associated factors among medical patients in the outpatient clinic. Also to determine incidence of orthostatic hypotension and associated factors in the outpatient clinic. This is done through a series of tests that includes blood pressure measurement. Design Cross-sectional study was performed in an outpatient medical clinic. Analysis was performed with independent sample t-test for continuous data and chi-square test for categorical data. Setting Medical Outpatient Clinic in Hospital Sg Buloh. Results A total 352 patients were recruited. 191 (54.3%) reported having history of falls and 51 patients (14.52%) had evidence of orthostatic hypotension (OH). Majority of falls occurred at home (42.9%). Mean age for fallers are 45.37 ( SD 14.859) and for non-fallers are 48.39 (SD 13.12). Those on calcium channel blockers and ACE inhibitors/Angiotensin Receptor blockers is associated with history of falls (p-value Conclusion Those who are single are associated with history of falls. Calcium channel blocker and ACEi/ARB are associated with those with history of prior falls. Amongst medical conditions, only diabetes is associated with OH. The findings so far provided a platform for improving understanding factors for falls in the outpatient setting. As the numbers are relatively small, we hope to continue the study. This will hopefully be able to give insight on possible factors associated in falls in our community.

The aim of this article was to systematically review the methods adopted to collect and interpret external training load (ETL) using microtechnology incorporating global positioning system (GPS). The main deficiencies identified concerned the non-collection of match ETL, and the non-consideration of potential confounders (e.g. playing position, fitness level, starting status or session content). Also, complementary training (individual/reconditioning) and pre-match warm-up were rarely quantified. To provide a full picture of the training demands, ETL was commonly complemented by internal training load monitoring with the rating of perceived exertion predominantly adopted instead of heart rate recordings. Continuous data collection and interpretation of ETL data in professional football vary widely between observational studies, possibly reflecting the actual procedures adopted in practical settings. Evidence about continuous ETL monitoring in female players, and female as well as male goalkeepers is lacking. info:eu-repo/semantics/publishedVersion

Clustering is a data mining technique that has been effectively used in the last few decades for knowledge extraction. Privacy is a major problem while releasing data for clustering and therefore p...

Hospital‐acquired pressure ulcers (HAPUs) affect patients during hospitalisation, putting patients at risk for further complications. HAPU is one of the hospital quality indicators that require quality initiatives or programmes to minimise its occurrence and consequences. The aim of this study was to assess the effectiveness of a developed quality improvement programme in preventing HAPUs. This is a retrospective comparative study, which tracked the outcomes of pressure ulcer prevention programme (PUPP) for 5 years from 2014 to 2018. Data from 50 441 patients were collected from different units in a tertiary hospital in the eastern region of Saudi Arabia. The programme focused on building a wound care team; providing education to hospital staff, patients, and their families; and continuous data monitoring, in addition to follow‐up visits after discharge. Implementation of the programme was successful showing a statistically significant reduction of HAPUs from 0.20% in 2014 to 0.06% in 2018 (P value

The system of the Naroch lakes, which includes the eutrophic Lake Batorino, the mesotrophic Lake Myastro, and the oligo-mesotrophic Lake Naroch, serves as a model object for the study of the factors initially influencing the state of a particular lake ecosystem affected by variable nutrient loading. Throughout the 1970s–2000s, these lakes have been going through the stages of anthropogenic eutrophication, deeutrophication, and benthification. A set of continuous data based on the seasonal means ​​of the eight parameters from each lake for the period 1978–2015 has been analyzed by Principal Component and Singular Spectrum Analysis (SSA, or Caterpillar). In addition, we consider the dynamics of the trophic index of each lake, which had been calculated earlier at the same data set. The first main component is the stability of the lake ecosystem under variable nutrient loading, which is inversely related to the trophic state of the water body. This component determines the condition of the Batorino, Myastro and Naroch lakes by 63, 65, and 43% respectively.

In 2018, the creation of the central part of the NEVOD-EAS cluster-type array aimed at detection of the electron-photon component of extensive air showers in the energy range from 1015 to 1017 eV was completed. At present, a continuous data taking is being performed at the array. The results of the reconstruction of registered extensive air showers using the methods developed within the framework of the cluster approach to experimental data analysis are presented.

Researchers have linked pavements roughness to acceleration signals provided by smartphones, due to their simple handling and low cost, which might facilitate continuous data collection tha...

Background With webinars looking to be the mainstay post-pandemic, it is important to demonstrate if webinars are indeed effective educational tools for professional training and skill acquisition. We aim to demonstrate, via a global survey, the efficacy of webinars on PCNL and how this knowledge transforms clinical practice. Methods A structured online survey covering the following sections: (1) Demographics, (2) PCNL techniques, (3) PCNL equipment, was circulated. The target study population were practicing urologists and residents. Categorical data were presented with counts and percentages, and compared using Chi-square test. Continuous data was analysed with non-parametric methods. Respondents were dichotomised according to attendance of webinars type, attendees of dedicated PCNL webinars (Group A) or attendees of endourological webinars that discussed some aspects of PCNL (Group B). Results A total of 303 respondents participated from 38 countries. 91.7% (n=278) were in Group A with 8.3% (n=25) in Group B. 77.9% were under the age of fifty years while 51.8% had more than 10 years of urology experience. In group A, urologists of all ages, in academic institutions and private practitioners, significantly benefitted in gaining knowledge about the merits of newer devices and the role of suction assisted devices in modern PCNL; Majority of group A also reflected that by attending a dedicated PCNL based webinar they benefited in learning newer positions for PCNL access, especially supine, and how to effectively use laser as energy devices for lithotripsy. In Group B, the only area of benefit was in lasing techniques and the use of newer lasers like the TFL. Conclusion Our survey positively validates the two proposed hypothesis i.e. webinars as a medium of education do benefit practicing urologists in knowledge and the clinical practice domains. Age, experience or place of practice is no barrier to adopting newer mediums of education like webinars.

Estimating excess mortality allows quantification of overall pandemic impact. For recent decades, mortality data are easily accessible for most industrialized countries, but only a few countries have continuous data available for longer periods. Since Spain, Sweden, and Switzerland were militarily neutral and not involved in combat during both world wars, these countries have monthly all-cause mortality statistics available for over 100 years with no interruptions. We show that during the COVID-19 pandemic in 2020, Spain, Sweden and Switzerland recorded the highest aggregated monthly excess mortality (17%, 9% and 14%) since the 1918 influenza pandemic (53%, 33% and 49%), when compared to respective expected values. For Sweden and Switzerland, the highest monthly spikes in 2020 almost reached those of January 1890. These findings emphasize the historical dimensions of the ongoing pandemic and support the notion of a pandemic disaster memory gap.One-Sentence SummaryDuring the COVID-19 pandemic in 2020, Spain, Sweden, and Switzerland recorded their highest monthly excess and all-cause mortality levels since the 1918 influenza pandemic, emphasizing the historical dimension of the ongoing pandemic.

Data stream management has received considerable attention lately, due to continuous sources of collection and devices and is delivered in a different variety of formats to be process within small period of time. Interesting objects will be extract from the continuous data stream by processing the skyline query. However, skyline query processing over data stream poses inherent challenges and demands and require non- traditional techniques. This paper reviews the aims and challenge of skyline approaches that are relevant for data stream. Moreover, studies on the types of queries, type of data and type of sliding window were presented. Finally, an interesting research topic over data stream that have not yet been explored is identified.

Background In Canada, funding for genome‐wide sequencing (GWS; exome and whole genome) is provincially regulated. We characterized the uptake of GWS by genetics health professionals (GHPs) across Canada and describe how they use remote technologies for patient access to GWS and genomic counseling. Methods We distributed a survey to 574 Canadian GHPs addressing: GWS use, remote technologies (e.g., telephone, videoconferencing) for GWS and provider opinions regarding these technologies. Data were summarized using descriptive statistics. Associations between variables were evaluated using Chi‐square and Fisher's Exact tests for categorical data, and t‐tests or Mann–Whitney U tests for continuous data. Results Of 116 GHPs, 50% reported using GWS in the last year and 57% of GWS users reported using remote technologies. Clinical geneticists who did not use GWS reported lack of provincial funding as the principal reason. Remote technologies were most commonly used for informed consent and results, and rarely used for initial consultations. Average wait times for a GWS appointment were shorter for remote appointments (mean 44.2 (SD 40.2) weeks) than for in‐person (mean 58.2 (SD 42.9), p = 0.036). Conclusion The use of GWS varied across Canada, professional designation, and discipline. Funding remains a barrier to GWS access. Remote technologies increase patient access with reduced wait times., Responses regarding genome‐wide sequencing use across Canada.

In the recent past, there were extensive floods in the Western Himalayan region (WHR) due to continuous long spells of heavy rainfall for 3–4 days that caused a huge loss in life and property over the region. WHR is a data sparse region, with limited meteorological stations having a continuous long spell of daily precipitation data. In the present study, spatial and temporal variability of seasonal as well as annual precipitation, precipitation days and maximum accumulated daily, 2 days, 3 days, 4 days and 5 days precipitation over WHR is considered by using daily precipitation data of 18 meteorological stations of the region. Out of 18 meteorological stations, five stations have continuous data from 1901 to 1980 and remaining 13 stations data is considered for their common period from 1981 to 2014. Accordingly, the analysis is carried out in two parts, first for 1901–1980 (for 5 stations) and second for 1981–2014 (for all the 18 stations). The analysis suggests high variability in the spatial and temporal distribution of seasonal as well as maximum accumulated daily to 5 days precipitation over WHR. In general, increasing trends in maximum accumulated precipitation in lower altitude stations and decreasing trends in higher altitude stations are observed in monsoon season and vice-versa in the winter season during the period 1981–2014. The increase in maximum accumulated daily to 5 days precipitation is up to 9.7 mm per decade during 1901–1980 and is up to 45.5 mm per decade during 1981–2014 in monsoon season in lower altitude stations. Thus, the increase in maximum accumulated precipitation during monsoon season becomes manifold during 1981–2014 as compared to the period 1901–1980.

Background The standardized letter of evaluation (SLOE) is used by emergency medicine (EM) faculty during the interview and match process. Data has shown that female allopathic applicants score higher in communal characteristics and have a greater number of ability words in the narrative portion of the SLOE as compared to their male counterparts. Objective To determine if there is a difference in the language used to describe male and female osteopathic applicants within the SLOE. Methods All applicants to a three-year EM residency within a single application cycle were eligible for inclusion. Exclusion criteria included allopathic applicants, applicants without a SLOE, or applicants with a SLOE only from the interviewing program. Data collected included applicant demographics and SLOE narratives. The previously validated Linguistic Inquiry and Word Count (LIWC; Pennebaker Conglomerates, Inc., Austin, TX) product was used to analyze word counts from the narrative portion of each SLOE. Descriptive statistics and t-tests for continuous data were used. Results Of the 577 applicants to the residency program, 318 met inclusion criteria and 33% were female. Females had a higher COMLEX-2 (590 vs 559; p=0.05) as compared to males but no difference was found for the remainder of the baseline demographics. No difference was found for the number of words in the narrative portion of the SLOE between males and females (males = 122 words; females = 127 words; p=0.53). Words within the social (p=0.006), achievement (p=0.007), and standout (p

Background Randomised controlled trials (RCTs) provide valuable information for developing harm profiles but current analysis practices to detect between-group differences are suboptimal. Drug trials routinely screen continuous clinical and biological data to monitor participant harm. These outcomes are regularly dichotomised into abnormal/normal values for analysis. Despite the simplicity gained for clinical interpretation, it is well established that dichotomising outcomes results in a considerable reduction in information and thus statistical power. We propose an automated procedure for the routine implementation of the distributional method for the dichotomisation of continuous outcomes proposed by Peacock and Sauzet, which retains the precision of the comparison of means. Methods We explored the use of a distributional approach to compare differences in proportions based on the comparison of means which retains the power of the latter. We applied this approach to the screening of clinical and biological data as a means to detect ‘signals’ for potential adverse drug reactions (ADRs). Signals can then be followed-up in further confirmatory studies. Three distributional methods suitable for different types of distributions are described. We propose the use of an automated approach using the observed data to select the most appropriate distribution as an analysis strategy in a RCT setting for multiple continuous outcomes. We illustrate this approach using data from three RCTs assessing the efficacy of mepolizumab in asthma or COPD. Published reference ranges were used to define the proportions of participants with abnormal values for a subset of 10 blood tests. The between-group distributional and empirical differences in proportions were estimated for each blood test and compared. Results Within trials, the distributions varied across the 10 outcomes demonstrating value in a practical approach to selecting the distributional method in the context of multiple adverse event outcomes. Across trials, there were three outcomes where the method chosen by the automated procedure varied for the same outcome. The distributional approach identified three signals (eosinophils, haematocrit, and haemoglobin) compared to only one when using the Fisher’s exact test (eosinophils) and two identified by use of the 95% confidence interval for the difference in proportions (eosinophils and potassium). Conclusion When dichotomisation of continuous adverse event outcomes aids clinical interpretation, we advocate use of a distributional approach to retain statistical power. Methods are now easy to implement. Retaining information is especially valuable in the context of the analysis of adverse events in RCTs. The routine implementation of this automated approach requires further evaluation.

A technológiai újítások a gazdaság számos szektorát, így a biztosítást is érintik. Ezen innovációk közül az IoT (Internet of Things) alapú megoldások emelhetőek ki, amelyek legfőbb jellemzője, hogy az internetre kapcsolás segítségével valós idejű és folyamatos adatgyűjtést végeznek, így optimalizálva a biztosító által végzett kockázatkezelést. Tekintettel arra, hogy az így gyűjtött adatok jelentős szelete személyes adatnak minősül, alkalmazni kell az általános adatvédelmi rendelet (GDPR) szabályait. A biztosítás intézményét érintő technológiák adatvédelmi szempontú vizsgálata számos problémát vet fel, amelyek álláspontom szerint jelentősen akadályozzák e technológiai vívmányok alkalmazását. A tanulmány célja, hogy feltárja ezeket a problémákat és kísérletet tegyen ezek megoldására irányuló javaslatok megtételére.

Objectives The COVID-19 pandemic continues to impact health systems across the United States and worldwide in an unprecedented way;however, its influence on front-line medical trainees? educational experiences is unknown Our objective was to determine the effects of COVID-19 on emergency medicine training programs and residents Methods We performed a mixed-methods cross-sectional survey study of faculty and residents at programs registered with Foundations of Emergency Medicine Participants completed an online survey consisting of closed and open-ended response items We reported descriptive statistics for discrete and continuous data Free-response data were analyzed qualitatively using a thematic approach Results Ninety-two percent of faculty (119/129) and 47% (1965/4154) of residents responded to our survey We identified three major themes related to effects on learning: 1) Impact on clinical training, 2) Impact on didactic education, 3) Impact on the trainee Nearly all residencies (96%, 111/116) allowed residents to work with patients suspected of having COVID-19, though fewer (83%, 96/115) allowed residents to intubate them We found that 99% (1918/1928) of residents experienced virtual didactics Faculty and trainees noted multiple educational challenges and strategies for adaptation Trainees also expressed concerns about stress and safety Conclusion COVID-19 has impacted emergency medicine education in many ways including clinical training, didactic education, and trainee emotional state and concentration Challenges and suggested solutions for learning in the virtual environment were also identified While the pandemic continues to evolve and impact EM residents in various ways, our results may inform strategies to support medical educators and trainees during pandemics or other periods of significant disruption or crisis

The Internet of Things (IoT) and Industrial 4.0 bring enormous potential benefits by enabling highly customised services and applications, which create huge volume and variety of data. However, preserving the privacy in IoT and Industrial 4.0 against re-identification attacks is very challenging. In this work, we considered three main data types generated in IoT: context data, continuous data, and media data. We first proposed a stream data anonymisation method based on k-anonymity for data collected by IoT devices; and then privacy enhancing techniques for both continuous data and media data were proposed for different IoT scenarios. The experiment results show that the proposed techniques can well preserve privacy without significantly affecting the utility of the data.

Funding Acknowledgements Type of funding sources: None. Background Interaction with industry is often required for the development of electrophysiology (EP) and devices research. Findings from industry-funded research are often presented at sponsored sessions during international conferences. However, industry interactions produce potential conflict of interests (COIs). Such COIs must be disclosed appropriately when presenting research findings to allow viewers to interpret the results correctly. This is particularly true during sponsored sessions. Purpose To assess whether session sponsorship affects the presentation of potential COIs in EP and devices presentations. Methods Recorded presentations from the Arrhythmia & Devices section of ESC Annual Congresses 2016-2020 were assessed. Presentations were excluded if the original presentation contained no slides, was a panel discussion, it was a non-scientific presentation, or part of the presentation was missing. Sponsorship information was gathered from presentation meta-data. Chi-squared and Mann-Whitney U tests were used to assess differences between groups for dichotomous and continuous data respectively. Results Of 1,153 presentations assessed, 1,017 were suitable for inclusion. Of these 14% (n = 142) were sponsored sessions. COI disclosure slides were more likely to be missing in sponsored sessions (13.4%, n = 19) compared with non-sponsored sessions (6.2%, n = 54), p = 0.002. In those with COI disclosure slides, sponsored presentations contained a greater median number of COIs (12, IQR 6-19) compared with non-sponsored sessions (1, IQR 0-5), p Conclusions Sponsored sessions make up about one seventh of all EP/devices presentations at the ESC annual congress. Presenters at sponsored sessions were less likely to present a COI disclosure slide. Sponsored presentations had a higher number or of potential COIs, yet they were displayed for a far shorter time. This suggests that sponsored sessions have a higher risk of potential bias which viewers are not provided sufficient opportunity to assess.