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The COVID-19 pandemic propelled many employees into remote work arrangements, and face-to-face meetings were quickly replaced with virtual meetings. This rapid uptick in the use of virtual meetings led to much popular press discussion of virtual meeting fatigue (i.e., "Zoom fatigue"), described as a feeling of being drained and lacking energy following a day of virtual meetings. In this study, we aimed to better understand how one salient feature of virtual meetings-the camera-impacts fatigue, which may affect outcomes during meetings (e.g., participant voice and engagement). We did so through the use of a 4-week within-person experience sampling field experiment where camera use was manipulated. Drawing from theory related to self-presentation, we propose and test a model where study condition (camera on versus off) was linked to daily feelings of fatigue; daily fatigue, in turn, was presumed to relate negatively to voice and engagement during virtual meetings. We further predict that gender and organizational tenure will moderate this relationship such that using a camera during virtual meetings will be more fatiguing for women and newer members of the organization. Results of 1,408 daily observations from 103 employees supported our proposed model, with supplemental analyses suggesting that fatigue affects same-day and next-day meeting performance. Given the anticipated prevalence of remote work even after the pandemic subsides, our study offers key insights for ongoing organizational best practices surrounding virtual meetings. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Mg 0.95 Ni 0.05 TiO 3 ceramics were prepared by traditional solid-state route using sintering temperatures between 1300 and 1425 °C and holding time of 2-8 h. The sintered samples were characterized for their phase composition, micro-crystalline structure, unit-cell constant, and dielectric properties. A two-phase combination region was identified over the entire compositional range. The effect of sintering conditions was analyzed for various properties. Both permittivity ( ε r ) and Q factor (Q f ) were sensitive to sintering temperatures and holding times, and the optimum performance was found at 1350 °C withholding time of 4 h. The temperature coefficient of resonant frequency ( τ f ) in a range from -45.2 to -52 (ppm/°C) and unit-cell constant were not sensitive to both the sintering temperature and holding time. An optimized Q factor of 192,000 (GHz) related with a permittivity ( ε r ) of 17.35 and a temperature coefficient ( τ f ) of -47 (ppm/°C) was realized for the specimen sintered at 1350 °C withholding time of 4 h. For applications of 5G communication device (filter, antennas, etc.), Mg 0.95 Ni 0.05 TiO 3 is considered to be a suitable candidate for substrate materials.

Towers are important structures for installing radio equipment to emit electromagnetic waves that allow radio, television and/or mobile communications to function. Feasibility, cost, and speed of the construction are considered in the design process as well as providing stability and functionality for the communication tower. This study proposes the new design for construction of segmental tubular section communication tower with ultra-high-performance fibre concrete (UHPFC) material and prestress tendon to gain durability, ductility, and strength. The proposed mix design for UHPFC in this study which used for construction of communication tower is consisted of densified Silica Fume, Silica fine and coarse Sand and hooked-ends Steel Fiber. The prestressed tendon is used in the tower body to provide sufficient strength against the lateral load. The proposed design allows the tower to be built with three precast segments that are connected using bolts and nuts. This paper presents a novel method of construction and installation of the communication tower. The advantages of proposed design and construction process include rapid casting of the precast segment for the tower and efficient installation of segments in the project. The use of UHPFC material with high strength and prestress tendon can reduce the size and thickness of the tower as well as the cost of construction. Notably, this material can also facilitate the construction and installation procedure., Competing Interests: This research receives support from Dura Technology Sdn. Bhd. (https://dura.com.my). This does not alter our adherence to PLOS ONE policies on sharing data and materials.

The coverage of the fifth-generation network has increased steadily since the network was introduced in 2019. However, public protests around the globe against the construction of 5G network base stations have continued to occur for fear that electromagnetic (EM) waves emitted from the stations would cause adverse health effects. To identify factors that have contributed to such increased risk perception, we conducted a cross-sectional study using data obtained from a survey that assessed Korean adults' risk perception of EM wave-related objects. We found that female gender, high level of perceived exposure to EM waves, evaluation of public policies as ineffective, and high level of objective knowledge on EM waves were associated with increased risk perception. Furthermore, we found that higher ratings on a few risk characteristics such as "personal knowledge," "seriousness of the risk to future generations," "dreadfulness," and "severity of consequences" were also associated with increased risk perception as well. Bioelectromagnetics. © 2020 The Authors. Bioelectromagnetics published by Wiley Periodicals LLC on behalf of Bioelectromagnetics Society., (© 2020 The Authors. Bioelectromagnetics published by Wiley Periodicals LLC on behalf of Bioelectromagnetics Society.)

Background: Smartphone to-do list app was hypothesized to be more efficient than a paper-based list in the management of workflow and to provide additional benefits., Purpose: To analyze the impact of a mobile task-management application on the workflow of an ICU medical staff., Methods: Superiority by a margin test, quasi-experimental study comparing the use of a smartphone application versus standard practice regarding tasks management in an academic ICU. Superiority margin was set at 8 % based on a pilot study. During two periods of 20 working days each (October 2018 and January 2019), medical staff managed tasks with both methods on a weekly rotation basis. Primary outcome was the proportion of daily tasks completed. Secondary outcomes assessed users' satisfaction and the impact of the app in terms of changes in clinical practice., Results: 25 ICU physicians were enrolled. A total of 1983 tasks were recorded. The proportion of completed tasks per day was higher when using the smartphone app (99 % [96-100] versus 95 % [93-98] for the standard group, p = 0.006), but did not reach the superiority margin. Smartphone application was perceived as positive experience, as participants felt that they forgot fewer tasks (p = 0.02), were more aware of their progress on ongoing or remaining tasks (p = 0.03) and observed an improvement in communication among the medical staff (p = 0.03)., Conclusion: This study failed to demonstrate the superiority of a smartphone app over paper-based lists regarding the proportion of daily tasks completed. However, positive feedback regarding the application was received from the medical staff., Competing Interests: Declaration of Competing Interest None., (Copyright © 2020 Elsevier B.V. All rights reserved.)

Objective: The aim of the study was to explore the feasibility of using telepresence robots to encourage interactive communication in dementia care, from the perspective of family carers., Methods: Qualitative findings from semi-structured interviews with six family carers., Results: Generally, family carers reported a feeling of presence and connectedness when talking to their family member via the telepresence robots. They reported the robots as helping to enhance longer conversations and social connection with their family member., Conclusion: Telepresence may offer potential to encourage social connection, in particular where families are unable to make regular visits to the nursing home., (© 2019 AJA Inc.)

Background: Dispatcher-assisted cardiopulmonary resuscitation (DACPR) could improve the survival rate of out-of-hospital cardiac arrest (OHCA). However, the efficiency of DACPR varies. Our study compared the effectiveness of DACPR instructed via landline calls, mobile calls, and landline calls transferred to mobiles., Method: This prospective cohort study enrolled patients with OHCA between 1 July 2017 and 30 November 2018 in Taichung. Patients were divided into a mobile group and a landline group according to device used to call emergency medical services (EMS). The landline group was subdivided according to whether the call was transferred to a mobile. We compared the DACPR rate and call to chest compression time between groups., Results: The study comprised 2404 cases after exclusion: 934 cases of DACPR via mobile and 1470 via landline. In the mobile group, DACPR rate (54% vs. 47.5%, P <  0.001) was higher and call to chest compression time (median: 156 s vs. 174 s P < 0.001) was shorter than in the landline group. In the transferred group, DACPR rate (72.7% vs. 28.8%, P <  0.001) was higher than in the non-transferred group, but no difference was observed in call to chest compression time (median: 173 s vs. 177 s, P = 0.69)., Conclusion: According to this city-based prospective clinical study, communication over mobiles resulted in higher DACPR rate and shorter call to chest compression time than that over landlines. Transferring calls from a landline to a mobile could increase the DACPR rate without delaying the initiation of chest compression., (Copyright © 2019 Elsevier B.V. All rights reserved.)

Objectives: To explore the acceptability of telepresence robots in dementia care from the perspectives of people with dementia, family carers, and health professionals/trainees, and investigate the utility of a social presence assessment tool, the Modified-Temple Presence Inventory (Modified-TPI), for people with dementia. Method: A mixed-methods pilot study conducted in a social robotics laboratory. Three participant groups ( n  = 22) - dyads of people with dementia and their carers ( n  = 5 respectively), and health professionals/trainees ( n  = 12) - participated in individual one-off intervention sessions with the telepresence robot, Giraff , with follow-up interviews. Sessions covered how to use Giraff , followed by interactive practice in making a video-call involving conversation and manoeuvring of Giraff . Participants with dementia experienced receiving a call made by their carer; healthcare professionals/trainees experienced making and receiving a call. Outcomes of interest were sense of presence [Modified-TPI], affective response (International Positive and Negative Affect Schedule [I-PANAS-S]; Observable Displays of Affect Scale [ODAS]), and attitudes and reactions to Giraff (semi-structured interviews). Results: Participants reported a sense of authenticity and social connection through the experience. They indicated positive social presence through Giraff , and significantly higher positive (mean score 18.77; ±4.00) than negative affect (mean score 8.05; ±1.76) on the I-PANAS-SF, and on the facial display subscale of the ODAS (positive - mean score 15.50; ±3.51 versus negative - mean score 4.00; ±0.00). Conclusion: Telepresence has potential use in situations where people with dementia require social connection. Studies with larger sample sizes, varied characteristics, and cost-effectiveness analysis are needed to inform the application of telepresence in healthcare practice.

The Network Function Virtualization (NFV) paradigm is one of the key enabling technologies in the development of the 5 th generation of mobile networks. This technology aims to lessen the dependence on hardware in the provision of network functions and services by using virtualization techniques that allow the softwarization of those functionalities over an abstraction layer. In this context, there is increasing interest in exploring the potential of unmanned aerial vehicles (UAVs) to offer a flexible platform capable of enabling cost-effective NFV operations over delimited geographic areas. To demonstrate the practical feasibility of utilizing NFV technologies in UAV platforms, a protocol is presented to set up a functional NFV environment based on open source technologies, in which a set of small UAVs supply the computational resources that support the deployment of moderately complex network services. Then, the protocol details the different steps needed to support the automated deployment of an internet protocol (IP) telephony service over a network of interconnected UAVs, leveraging the capacities of the configured NFV environment. Experimentation results demonstrate the proper operation of the service after its deployment. Although the protocol focuses on a specific type of network service (i.e., IP telephony), the described steps may serve as a general guide to deploy other type of network services. On the other hand, the protocol description considers concrete equipment and software to set up the NFV environment (e.g., specific single board computers and open source software). The utilization of other hardware and software platforms may be feasible, although the specific configuration aspect of the NFV environment and the service deployment may present variations with respect to those described in the protocol.

Background: This quantitative, comparative-descriptive study of inpatient units in a large military medical center was designed to compare the effectiveness of compact ultraviolet (UV-C) decontamination to standard chemical decontamination in reducing the microbial burden on Vocera (San Jose, CA) communication devices and to characterize changes in staff cleaning practices following UV-C device implementation., Methods: Aerobic and anaerobic swabs were used to collect microbial samples from Vocera devices (n = 60) before and after chemical decontamination (first sampling) and before and after UV decontamination (second sampling). Cleaning behaviors were assessed by observation and oral inquiry during the baseline sampling and surveyed 8 weeks after UV-C device implementation. Outcomes included aerobic and anaerobic colony-forming units and prevalence of methicillin-resistant Staphylococcus aureus, vancomycin-resistant enterococci, or Clostridium difficile, as determined by standard microbiological methods., Results: No differences were found between the two cleaning methods in their ability to reduce aerobic bacteria; however, UV-C was significantly more effective at reducing bacteria grown anaerobically (P < .01). This study elucidated an 8.3% prevalence of methicillin-resistant Staphylococcus aureus on Vocera devices in the inpatient environment. Initially, 42% of respondents reported deviations from manufacturer's cleaning guidelines, and 16.7% reported daily or more frequent cleaning of the Vocera devices., Conclusions: After implementation, UV-C decontamination reduced average cleaning time by 43% and increased the rate of daily Vocera cleaning to 86.5%. Respondents reported an overall 98% user satisfaction with the UV-C device., (Published by Elsevier Inc.)

There is widespread anxiety and speculation about RF-EMF emissions by telecommunication base stations and structures, as it is perceived by some to be unsafe and a threat to public health. Scientists, medical experts, politicians, journalists, and mobile telecommunication company specialists are involved in an active debate on whether people are immune to RF or if we are gambling with our future. Interviews with 31 individuals from 7 stakeholder groups in Malaysia reveal that the residents' main concerns are that the telecommunication companies do not follow guidelines and as a result the telecommunication structures are constructed close to their homes, which they perceive as a threat to public health. Some residents also do not want these structures because of cultural reasons, while some are jealous over rental income received by the landlords. Meanwhile, the authorities entrusted with safe-guarding public health are involved in a blame game as there is no agency that is clearly in charge. The interviews also highlight that the current risk communication initiatives are more reactive rather than proactive, and that the authorities do not speak in one voice. Based on the outcome of the interviews, eleven recommendations are formulated to improve risk communication initiatives in Malaysia. The recommendations stress on repairing, building, and strengthening trust, because trust in agencies, along with credibility, determines risk communication initiatives' effectiveness. These strategies can also be effectively replicated across regions to deal with contestations over RF-EMF emissions and the impact on health.

Background: Telementoring is the technology for providing surgical instruction from a remote place via a network. To demonstrate the use of telementoring in craniofacial surgery, Skype and a mixed reality device HoloLens were adopted, and 3-layer facial models had been developed., Methods: A resident in hospital A used the model surgery under remote guidance by a mentor surgeon in hospital B 4 times on different dates. The straight-line between hospitals A and B is 250 km. The mentor gave the resident guidance via Skype and HoloLens, communicating by voice, and video of the surgical field, and providing reference data., Results: There was no delay in voice communication and a delay of <0.5 seconds in the video. The resident was able to confirm the main landmarks of the surgical field and to grasp the situation without problems. The mentor could send appropriate instructions by voice, could point out a specific part by telestration function, and could draw lines on the 2-dimentional images pasted on the operator's field of vision., Discussion: With the use of HoloLens, Skype, and the 3-layer models, it was possible to demonstrate telementoring. The risk of personal information leakage due to data interception seems to be very low because its data communication is encrypted with advanced encryption standard., Conclusion: This telementoring system has various advantages and many improvable aspects in the field of craniofacial surgery.

This paper presents a method for automatic detection of fish sounds in an underwater environment. There exist two difficulties: (i) features and classifiers that provide good detection results differ depending on the underwater environment and (ii) there are cases where a large amount of training data that is necessary for supervised machine learning cannot be prepared. A method presented in this paper (the proposed hybrid method) overcomes these difficulties as follows. First, novel logistic regression (NLR) is derived via adaptive feature weighting by focusing on the accuracy of classification results by multiple classifiers, support vector machine (SVM), and k -nearest neighbors ( k-NN ). Although there are cases where SVM or k-NN cannot work well due to divergence of useful features, NLR can produce complementary results. Second, the proposed hybrid method performs multi-stage classification with consideration of the accuracy of SVM, k-NN , and NLR. The multi-stage acquisition of reliable results works adaptively according to the underwater environment to reduce performance degradation due to diversity of useful classifiers even if abundant training data cannot be prepared. Experiments on underwater recordings including sounds of Sciaenidae such as silver croakers ( Pennahia argentata ) and blue drums ( Nibea mitsukurii ) show the effectiveness of the proposed hybrid method.

Objective: To determine if pager interruptions affect operative time, safety, or complications and management of pager issues during a simulated laparoscopic cholecystectomy., Design: Twelve surgery resident volunteers were tested on a Simbionix Lap Mentor II simulator. Each resident performed 6 randomized simulated laparoscopic cholecystectomies; 3 with pager interruptions (INT) and 3 without pager interruptions (NO-INT). The pager interruptions were sent in the form of standardized patient vignettes and timed to distract the resident during dissection of the critical view of safety and clipping of the cystic duct. The residents were graded on a pass/fail scale for eliciting appropriate patient history and management of the pager issue. Data was extracted from the simulator for the following endpoints: operative time, safety metrics, and incidence of operative complications. The Mann-Whitney U test and contingency table analysis were used to compare the 2 groups (INT vs. NO-INT)., Setting: Level I trauma center; Simulation laboratory., Participants: Twelve general surgery residents., Results: There was no significant difference between the 2 groups in any of the operative endpoints as measured by the simulator. However, in the INT group, only 25% of the time did the surgery residents both adequately address the issue and provide effective patient management in response to the pager interruption., Conclusion: Pager interruptions did not affect operative time, safety, or complications during the simulated procedure. However, there were significant failures in the appropriate evaluations and management of pager issues. Consideration for diversion of patient care issues to fellow residents not operating to improve quality and safety of patient care outside the operating room requires further study., (Copyright © 2018 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.)

Medical facilities may struggle to maintain effective communications during a major disaster. Natural and man-made disasters threaten connectivity by degrading or crippling Internet, cellular/mobile, and landline telephone services across wide areas. Communications among staff, between facilities, and to resources outside the disaster area may be lost for an extended time. A prototype communications system created by the National Library of Medicine (NLM) provides basic communication services that ensure essential connectivity in the face of widespread infrastructure loss. It leverages amateur radio to provide resilient email service to local users, enabling them to reach intact communications networks outside the disaster zone. Because amateur radio is inexpensive, always available, and sufficiently independent of terrestrial telecommunications infrastructure, it has often augmented telecommunications capabilities of medical facilities. NLM's solution is unique in that it provides end-user to end-user direct email communications, without requiring the intervention of a radio operator in the handling of the messages. Medical staff can exchange email among themselves and with others outside the communications blackout zone. The technology is portable, is deployable on short notice, and can be powered in a variety of ways to adapt to the circumstances of each crisis. (Disaster Med Public Health Preparedness. 2018;12:257-264).

Objective: To explore older adults' preferences regarding e-health applications through use of generated concepts that inform wellness tool design., Methods: The 6-8-5 method and affinity mapping were used to create e-health design ideas that were translated into storyboards and scenarios. Focus groups were conducted to obtain feedback on the prototypes and included participant sketching. A qualitative analysis of the focus groups for emerging themes was conducted, and sketches were analyzed., Results: Forty-three older adults participated in six focus group sessions. The majority of participants found the wellness tools useful. Preferences included features that supported participants in areas of unmet needs, such as ability to find reliable health information, cognitive training, or maintaining social ties. Participants favored features such as use of voice navigation, but were concerned over cost and the need for technology skills and access. Sketches reinforced these wants, including portability, convenience, and simplicity., Conclusions: Several factors were found to increase the desirability of such devices including convenient access to their health and health information, a simple, accessible interface, and support for memory issues. Researchers and designers should incorporate the feedback of older adults regarding wellness tools, so that future designs meet the needs of older adults.

The Long-Term Evolution (LTE) system represents the evolution of the Universal Mobile Telecommunication System technology. This technology introduces two duplex modes: Frequency Division Duplex and Time Division Duplex (TDD). Despite having experienced a limited expansion in the European countries since the debut of the LTE technology, a renewed commercial interest for LTE TDD technology has recently been shown. Therefore, the development of extrapolation procedures optimised for TDD systems becomes crucial, especially for the regulatory authorities. This article presents an extrapolation method aimed to assess the exposure to LTE TDD sources, based on the detection of the Cell-Specific Reference Signal power level. The method introduces a βTDD parameter intended to quantify the fraction of the LTE TDD frame duration reserved for downlink transmission. The method has been validated by experimental measurements performed on signals generated by both a vector signal generator and a test Base Transceiver Station installed at Linkem S.p.A facility in Rome., (© The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.)

This paper presents an effective method for high-gain orbital angular momentum (OAM) vortex wave generation based on the integration of a circular antenna array (CAA) with a parasitic electromagnetic band gap (EBG) structure, which is referred to as the EP-CAA. The resonant height of the EBG structure at different oblique incidences is analyzed parametrically based on the defect mode transmission mechanism to achieve reasonable predictions of a consistent 3-dB gain bandwidth with optimal gain enhancement for different OAM modes. The effective radiation aperture of the EP-CAA at oblique incidence is proposed for analytical calculation of the aperture efficiency of the OAM beams (OAM-AE). A Wilkinson power divider (W-PD) is designed to extend the operating bandwidth of the EP-CAA, and the proposed W-PD arrangement is applicable for feasible OAM modes. Fabricated prototypes of the EP-CAA carrying four OAM modes operating at 10 GHz are measured to verify the effectiveness of the theoretical analysis, the maximum realized gain for different OAM modes are confirmed to be enhanced by at least 6 dB in 5% 3-dB gain bandwidth. The divergence angles of different OAM modes can be effectively concentrated using the proposed EP-CAA.

Objective: Drawing from a larger study that identified the supports and services that facilitate wellness among older people from rural communities, this study examined the specific contribution made by information and communication technology (ICT)., Methods: Qualitative interviews were undertaken with 60 older adults from six Australian rural areas. A preliminary thematic analysis was conducted, followed by a higher-order inductive analysis., Results: Information and communication technology use was discussed in terms of individual enrichment, and in terms of enabling connections between the individual and their social networks, community and wider service environments., Conclusion: Information and communication technologies may facilitate wellness for rural older people by compensating for geographical and social isolation. In the changing world of health and aged care service delivery, ICTs will be more important than ever for rural older people in building their capacity to access the services, socialisation and support that they need, regardless of location., (© 2017 AJA Inc.)

This study demonstrated the feasibility of a device for monitoring pressure relief maneuvers and physical activity for wheelchair users. The device counts the number of wheel pushes based on wheelchair acceleration and measures pressure relief maneuvers using a seat sensor consisting of three force sensing resistors (FSRs). To establish the feasibility of the seat sensor for the detection of pressure relief maneuvers, 10 wheelchair users and 10 non-disabled controls completed a series of wheelchair depression raises, forward trunk leans, and lateral trunk leans. The seat sensor was placed underneath the user's seat cushion. To establish the feasibility of wheel push counting, 10 full-time wheelchair users navigated a flat 50-m outdoor track and a 100-m outdoor obstacle course during self-propulsion (e.g., wheel pushes) and during assisted-propulsion (e.g., no wheel pushes). Of the 240 performed pressure relief, 225 were properly classified by the seat sensor (accuracy: 94%, sensitivity: 96%, specificity: 80%). Sensitivity was highest for depression raises (98%) and lowest for front lean maneuvers (80%). The wheelchair activity monitor measured 2,112 pushes during the self-propulsion trials compared to 2,162 pushes measured with the instrumented push-rim (97.7%). During assisted-propulsion trials, there were 477 incorrectly identified pushes (8.0 per trial).

In this paper, a neural networks (NNs) enhanced telerobot control system is designed and tested on a Baxter robot. Guaranteed performance of the telerobot control system is achieved at both kinematic and dynamic levels. At kinematic level, automatic collision avoidance is achieved by the control design at the kinematic level exploiting the joint space redundancy, thus the human operator would be able to only concentrate on motion of robot's end-effector without concern on possible collision. A posture restoration scheme is also integrated based on a simulated parallel system to enable the manipulator restore back to the natural posture in the absence of obstacles. At dynamic level, adaptive control using radial basis function NNs is developed to compensate for the effect caused by the internal and external uncertainties, e.g., unknown payload. Both the steady state and the transient performance are guaranteed to satisfy a prescribed performance requirement. Comparative experiments have been performed to test the effectiveness and to demonstrate the guaranteed performance of the proposed methods.

Objective: The objective of the study was to characterize house staff time to response and intervention when notified of a patient care issue by pager vs. smartphone. We hypothesized that smartphones would reduce house staff time to response and intervention., Design: Prospective study of all electronic communications was conducted between nurses and house staff between September 2015 and October 2015. The 4-week study period was randomly divided into two 2-week study periods where all electronic communications between intensive care unit nurses and intensive care unit house staff were exclusively by smartphone or by pager, respectively. Time of communication initiation, time of house staff response, and time from response to clinical intervention for each communication were recorded. Outcomes are time from nurse contact to house staff response and intervention., Setting: Single-center surgical intensive care unit of Cedars-Sinai Medical Center in Los Angeles, California, an academic tertiary care and level I trauma center., Participants: All electronic communications occurring between nurses and house staff in the study unit during the study period were considered. During the study period, 205 nurse-house staff electronic communications occurred, 100 in the phone group and 105 in the pager group., Results: House staff response to communication time was significantly shorter in the phone group (0.5 [interquartile range = 1.7] vs. 2 [3]min, p < 0.001). Time to house staff intervention after response was also significantly more rapid in the phone group (0.8 [1.7] vs. 1 [2]min, p = 0.003)., Conclusions: Dedicated clinical smartphones significantly decrease time to house staff response after electronic nursing communications compared with pagers., (Copyright © 2017 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.)

In this paper, a novel L network (LN) is presented, which is composed of a frequency-selected section (FSS) and a middle stub (MS). Based on the proposed LN, a tri-band T-junction power divider (TTPD) with impedance transformation and independent power division ratios is designed. Moreover, the closed-form design theory of the TTPD is derived based on the transmission line theory and circuit theory. Finally, a microstrip prototype of the TTPD is simulated, fabricated, and measured. The design is for three arbitrarily chosen frequencies, 1 GHz, 1.6 GHz, and 2.35 GHz with the independent power division ratios of 0.5, 0.7, and 0.9. The measured results show that the fabricated prototype is consistent with the simulation, which demonstrates the effectiveness of this proposed design.

Military personnel are at risk for hearing loss due to noise exposure during deployment (USACHPPM, 2008). Despite mandated use of hearing protection, hearing loss and tinnitus are prevalent due to reluctance to use hearing protection. Bone conduction headsets can offer good speech intelligibility for normal hearing (NH) listeners while allowing the ears to remain open in quiet environments and the use of hearing protection when needed. Those who suffer from tinnitus, the experience of perceiving a sound not produced by an external source, often show degraded speech recognition; however, it is unclear whether this is a result of decreased hearing sensitivity or increased distractibility (Moon et al., 2015). It has been suggested that the vibratory stimulation of a bone conduction headset might ameliorate the effects of tinnitus on speech perception; however, there is currently no research to support or refute this claim (Hoare et al., 2014). Speech recognition of words presented over air conduction and bone conduction headsets was measured for three groups of listeners: NH, sensorineural hearing impaired, and/or tinnitus sufferers. Three levels of speech-to-noise (SNR = 0, -6, -12 dB) were created by embedding speech items in pink noise. Better speech recognition performance was observed with the bone conduction headset regardless of hearing profile, and speech intelligibility was a function of SNR. Discussion will include study limitations and the implications of these findings for those serving in the military., (Published by Elsevier B.V.)

The aim of this paper is to analyse teledildonics from a phenomenological perspective in order to show the possible effects they will have on ourselves and on our society. The new way of using digital technologies is to merge digital activities with our everyday praxes, and there are already devices which enable subjects to be digitally connected in every moment of their lives. Even the most intimate ones are becoming mediated by devices such as teledildonics which digitally provide a tactual stimulation allowing users to have sexual intercourse through them. The efforts made in order to provide such an intertwinement of our everyday lives and digital technologies are evident, but the effects produced by them are not clear at all. This paper will analyse these technologies from a phenomenological perspective in order to understand their effects on the constitution of the subjects and on our society at the intimate level.

Background: Telecommunication is limited or even impossible for more than one-thirds of all cochlear implant (CI) users., Objective: We sought therefore to study the impact of voice quality on speech perception with voice over Internet protocol (VoIP) under real and adverse network conditions., Methods: Telephone speech perception was assessed in 19 CI users (15-69 years, average 42 years), using the German HSM (Hochmair-Schulz-Moser) sentence test comparing Skype and conventional telephone (public switched telephone networks, PSTN) transmission using a personal computer (PC) and a digital enhanced cordless telecommunications (DECT) telephone dual device. Five different Internet transmission quality modes and four accessories (PC speakers, headphones, 3.5 mm jack audio cable, and induction loop) were compared. As a secondary outcome, the subjective perceived voice quality was assessed using the mean opinion score (MOS)., Results: Speech telephone perception was significantly better (median 91.6%, P<.001) with Skype compared with PSTN (median 42.5%) under optimal conditions. Skype calls under adverse network conditions (data packet loss > 15%) were not superior to conventional telephony. In addition, there were no significant differences between the tested accessories (P>.05) using a PC. Coupling a Skype DECT phone device with an audio cable to the CI, however, resulted in higher speech perception (median 65%) and subjective MOS scores (3.2) than using PSTN (median 7.5%, P<.001)., Conclusions: Skype calls significantly improve speech perception for CI users compared with conventional telephony under real network conditions. Listening accessories do not further improve listening experience. Current Skype DECT telephone devices do not fully offer technical advantages in voice quality., (©Georgios Mantokoudis, Roger Koller, Jérémie Guignard, Marco Caversaccio, Martin Kompis, Pascal Senn. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 24.04.2017.)

With radiofrequency exposure caused by electronic applications increasing, some members of the public are worrying about potential health risks. In this paper, methods of performing large-scale radiofrequency exposure evaluation are described. All studied sites were divided into three categories: commercial-area, residential-urban, and residential-rural. Then a series of site investigations were conducted on a car-mounted system in the years 2014 and 2015, aiming to characterize electric field exposure from 12 different radiofrequency sources. The results indicate that the studied environment is safe as indicated by exposure below guidelines and standards. The highest exposure measured in the 2 y of monitoring was from an FM source, 316.23 mV m. Telecommunication sources dominate exposure, contributing the most power density (65-90%). Meanwhile, intergroup differences are discussed and summarized. The spatial distributions of FM and GSM1800 exposure are demonstrated on a map. This study describes an approach for the assessment of the spatiotemporal pattern of radiofrequency exposures in Chengdu and facilitates the identification of any sources causing exposure above relevant guidelines and standards.

This work focuses on the design of transmitting coils in weakly coupled magnetic induction communication systems. We propose several optimization methods that reduce the active, reactive and apparent power consumption of the coil. These problems are formulated as minimization problems, in which the power consumed by the transmitting coil is minimized, under the constraint of providing a required magnetic field at the receiver location. We develop efficient numeric and analytic methods to solve the resulting problems, which are of high dimension, and in certain cases non-convex. For the objective of minimal reactive power an analytic solution for the optimal current distribution in flat disc transmitting coils is provided. This problem is extended to general three-dimensional coils, for which we develop an expression for the optimal current distribution. Considering the objective of minimal apparent power, a method is developed to reduce the computational complexity of the problem by transforming it to an equivalent problem of lower dimension, allowing a quick and accurate numeric solution. These results are verified experimentally by testing a number of coil geometries. The results obtained allow reduced power consumption and increased performances in magnetic induction communication systems. Specifically, for wideband systems, an optimal design of the transmitter coil reduces the peak instantaneous power provided by the transmitter circuitry, and thus reduces its size, complexity and cost., Competing Interests: The authors have declared that no competing interests exist.

We, the Architectural and Transportation Barriers Compliance Board (Access Board or Board), are revising and updating, in a single rulemaking, our standards for electronic and information technology developed, procured, maintained, or used by Federal agencies covered by section 508 of the Rehabilitation Act of 1973, as well as our guidelines for telecommunications equipment and customer premises equipment covered by Section 255 of the Communications Act of 1934. The revisions and updates to the section 508-based standards and section 255-based guidelines are intended to ensure that information and communication technology covered by the respective statutes is accessible to and usable by individuals with disabilities.

Background: Methodological shortcomings of gambling studies relying on self-report or on data sets derived from gambling operators tend to result in biased conclusions. The aim of this study was to analyze online gambling behavior using a novel network database approach., Methods: From October 13 to October 26, 2014, telecommunications network data from a major telecommunications provider in Switzerland were analyzed. Netflows between mobile devices and a poker operator were quantified to measure the gambling duration and session number., Results: Time spent gambling during night and working hours was compared between devices with longest (red group), intermediate (orange group), and shortest gambling time (green group). Online gambling behavior differed depending on overall gambling time, F (2, 3,143). Night and working hours gambling was the highest in the red group (53%), compared to the orange (50.1%) and the green groups (41.5%). Post hoc analyses indicated significant differences between the orange and green groups (p < 0.05). No differences were observed between the red and orange groups (p = 0.850), and the red and green groups (p = 0.053)., Conclusions: On mobile devices, distinct gambling patterns were observed depending on the overall gambling time. This methodology could also be used to investigate online gaming, social media use, and online pornography., (© 2017 S. Karger AG, Basel.)

Optical frequency combs-coherent light sources that connect optical frequencies with microwave oscillations-have become the enabling tool for precision spectroscopy, optical clockwork, and attosecond physics over the past decades. Current benchmark systems are self-referenced femtosecond mode-locked lasers, but Kerr nonlinear dynamics in high-Q solid-state microresonators has recently demonstrated promising features as alternative platforms. The advance not only fosters studies of chip-scale frequency metrology but also extends the realm of optical frequency combs. We report the full stabilization of chip-scale optical frequency combs. The microcomb's two degrees of freedom, one of the comb lines and the native 18-GHz comb spacing, are simultaneously phase-locked to known optical and microwave references. Active comb spacing stabilization improves long-term stability by six orders of magnitude, reaching a record instrument-limited residual instability of [Formula: see text]. Comparing 46 nitride frequency comb lines with a fiber laser frequency comb, we demonstrate the unprecedented microcomb tooth-to-tooth relative frequency uncertainty down to 50 mHz and 2.7 × 10(-16), heralding novel solid-state applications in precision spectroscopy, coherent communications, and astronomical spectrography.

Mobile technology is increasingly used to measure visual acuity. Standards for chart-based acuity tests specify photometric requirements for luminance, optotype contrast and luminance uniformity. Manufacturers provide some photometric data but little is known about tablet performance for visual acuity testing. This study photometrically characterised seven tablet computers (iPad, Apple inc.) and three ETDRS (Early Treatment Diabetic Retinopathy Study) visual acuity charts with room lights on and off, and compared findings with visual acuity measurement standards. Tablet screen luminance and contrast were measured using nine points across a black and white checkerboard test screen at five arbitrary brightness levels. ETDRS optotypes and adjacent white background luminance and contrast were measured. All seven tablets (room lights off) exceeded the most stringent requirement for mean luminance (≥ 120 cd/m2) providing the nominal brightness setting was above 50%. All exceeded contrast requirement (Weber ≥ 90%) regardless of brightness setting, and five were marginally below the required luminance uniformity threshold (Lmin/Lmax ≥ 80%). Re-assessing three tablets with room lights on made little difference to mean luminance or contrast, and improved luminance uniformity to exceed the threshold. The three EDTRS charts (room lights off) had adequate mean luminance (≥ 120 cd/m2) and Weber contrast (≥ 90%), but all three charts failed to meet the luminance uniformity standard (Lmin/Lmax ≥ 80%). Two charts were operating beyond manufacturer's recommended lamp replacement schedule. With room lights on, chart mean luminance and Weber contrast increased, but two charts still had inadequate luminance uniformity. Tablet computers showed less inter-device variability, higher contrast, and better luminance uniformity than charts in both lights-on and lights-off environments, providing brightness setting was >50%. Overall, iPad tablets matched or marginally out-performed ETDRS charts in terms of photometric compliance with high contrast acuity standards.

Objective: This article is a systematic review of the impact of technology-based intervention on outcomes related to care providers for those who survived a stroke., Materials and Methods: Literature was identified in the PubMed, PsycINFO, Scopus, and Cochrane databases for evidence on technology-based interventions for stroke survivors' caregivers. The search was restricted for all English-language articles from 1970 to February 2015 that implied technology-based interventions. This review included studies that measured the impact of these types of approaches on one or more of the following: depression and any of the following-problem-solving ability, burden, health status, social support, preparedness, and healthcare utilization by care recipient-as secondary outcomes. Telephone or face-to-face counseling sessions were not of interest for this review. The search strategy yielded five studies that met inclusion criteria: two randomized clinical trials and three pilot/preliminary studies, with diverse approaches and designs., Results: Four studies have assessed the primary outcome, two of which reported significant decreases in caregivers' depressive symptoms. Two studies had measured each of the following outcomes-burden, problem-solving ability, health status, and social support-and they revealed no significant differences following the intervention. Only one study assessed caregivers' preparedness and showed improved posttest scores. Healthcare services use by the care recipient was assessed by one study, and the results indicated significant reduction in emergency department visits and hospital re-admissions., Conclusions: Despite various study designs and small sample sizes, available data suggest that an intervention that incorporates a theoretical-based model and is designed to target caregivers as early as possible is a promising strategy. Furthermore, there is a need to incorporate a cost-benefit analysis in future studies.

Introduction: The quality and performance of several videoconferencing applications (apps) tested on iOS (Apple, Cupertino, CA) and Android (Google, Mountain View, CA) mobile platforms using Wi-Fi (802.11), third-generation (3G), and fourth-generation (4G) cellular networks are described., Materials and Methods: The tests were done to determine how well apps perform compared with videoconferencing software installed on computers or with more traditional videoconferencing using dedicated hardware. The rationale for app assessment and the testing methodology are described., Results: Findings are discussed in relation to operating system platform (iOS or Android) for which the apps were designed and the type of network (Wi-Fi, 3G, or 4G) used. The platform, network, and apps interact, and it is impossible to discuss videoconferencing experienced on mobile devices in relation to one of these factors without referencing the others., Conclusions: Apps for mobile devices can vary significantly from other videoconferencing software or hardware. App performance increased over the testing period due to improvements in network infrastructure and how apps manage bandwidth.

Background: The diagnosis and treatment of cancer is a continuum, with multiple steps and interfaces between patients and providers allowing for potential delays in cancer recognition and subsequent treatment. The diagnosis and treatment of hepatocellular carcinoma (HCC) is especially prone to missteps along the continuum, leading to treatment delays due to non-tissue-based diagnosis and multiprovider treatments. The aim of this study was to evaluate outcome measures after implementation of a voice messaging system (VMS) designed to streamline patient referrals to downstream treatment physicians and ultimately reduce delays in HCC treatment, thereby improving outcome measures., Methods: A retrospective study of outpatients with HCC was conducted in a safety net hospital between February 2008 and January 2012. In February 2010, VMS notification of HCC to the ordering physician and downstream treating physicians was implemented. Patients were divided into 2 groups: (1) preintervention: diagnosis 2 years before implementation or failure of notification following implementation, and (2) postintervention: diagnosis 2 years after implementation. Demographics, tumor characteristics, treatment, and survival were compared., Results: This study included 96 patients diagnosed with HCC: 51 in the preintervention group and 45 in the postintervention group. The main cause of chronic liver disease was HCV infection, and no differences in symptoms, liver dysfunction, tumor characteristics, or treatment were observed between groups. The time from diagnosis to clinic contact (0.5 vs 2.9 months; P=.003) and time from detection to treatment (2.2 vs 5.5 months; P=.005) was significantly shorter after implementation of the VMS. Barcelona Clinic Liver Cancer stage A status (hazard ratio [HR], 3.1; 95% CI, 2, 6), treatment (HR, 1.9; 95% CI, 1, 4), and VMS (HR, 1.8; 95% CI, 1, 3) were independently associated with overall survival. Patients diagnosed after implementation of the VMS had a median survival of 28.5 versus 15.7 months (P=.02)., Conclusions: Implementation of VMS reduces time to treatment and time to clinic visit. Reduction in time to treatment is associated with improved outcome independent of tumor stage, underlying liver function, and treatment., (Copyright © 2016 by the National Comprehensive Cancer Network.)

Introduction: Touch-screen mobile phones/devices (TMPs/Ds) are increasingly used in hospitals. They may act as a mobile reservoir for microbial pathogens. The rates of microbial contamination of TMPs/Ds and keypad mobile phones (KMPs) with respect to different variables including use by healthcare workers (HCWs)/non-HCWs and the demographic characteristics of users were investigated., Methodology: A total of 205 mobile phones/devices were screened for microbial contamination: 76 devices belonged to HCWs and 129 devices belonged to the non-HCW group. By rubbing swabs to front screen, back, keypad, and metallic surfaces of devices, 444 samples were collected., Results: Of 205 mobile phones/devices, 143 (97.9%) of the TMPs/Ds and 58 (98.3%) of the KMPs were positive for microbial contamination, and there were no significant differences in contamination rates between these groups, although TMPs/Ds had significantly higher microbial load than KMPs (p <0.05). The significant difference in this analysis was attributable to the screen size of mobile phones ≥ 5". Microbial contamination rates increased significantly as phone size increased (p <0.05). Higher numbers of coagulase-negative Staphylococci (CNS) were isolated from KMPs than TMPs/Ds (p = 0.049). The incidence of Enterococcus spp. was higher on the KMPs of HCWs, and methicillin resistant CNS was higher from the TMPs/Ds of non-HCWs (p <0.05). Isolation of CNS, Streptococcus spp. and Escherichia coli was higher from the TMPs/Ds of HCWs (p <0.05)., Conclusions: We found no significant difference between TMP/Ds and KMPs in terms of microbial contamination, but TMP/Ds harboured more colonies and total microbial counts increased with screen size.

Four-mode phase-sensitive (4MPS) process has been employed in a parametric mixer based wavelength multicaster, enhancing the multicasting conversion efficiency and signal-to-noise ratio. In addition, the 4MPS parametric multicaster is an outstanding candidate for all-optical regeneration, owing to its inherent capabilities to clamp amplitude fluctuations by the saturated parametric effect and to squeeze phase distortions by the phase sensitive process. The investigation in this paper focuses on the 4MPS multicaster operated in the saturation gain regime, including theoretical simulations and experimental demonstrations on amplitude and phase noise regeneration over 20 multicasting signal copies.

We demonstrate interrogation of a large-capacity sensor array with nearly identical weak fiber Bragg gratings (FBGs) based on frequency-shifted interferometry (FSI). In contrast to time-division multiplexing, FSI uses continuous-wave light and therefore requires no pulse modulation or high-speed detection/acquisition. FSI utilizes a frequency shifter in the Sagnac interferometer to encode sensor location information into the relative phase between the clock-wise and counter-clockwise propagating lightwaves. Sixty-five weak FBGs with reflectivities in the range of -31 ~-34 dB and with near identical peak reflection wavelengths around 1555 nm at room temperature were interrogated simultaneously. Temperature sensing was conducted and the average measurement accuracy of the peak wavelengths was ± 3.9 pm, corresponding to a temperature resolution of ± 0.4 °C. Our theoretical analysis taking into account of detector noise, fiber loss, and sensor cross-talk noise shows that there exists an optimal reflectivity that maximizes multiplexing capacity. The multiplexing capacity can reach 3000 with the corresponding sensing range of 30 km, when the peak reflectivity of each grating is -40 dB, the sensor separation 10 m and the source power 14 mW. Experimental results and theoretical analysis reveal that FSI has distinct cost and speed advantages in multiplexing large-scale FBG networks.

Objective: The objective of this study is to assess the efficacy of WhatsApp application as a communication method among the emergency physician (EP) in a rural hospital without percutaneous coronary intervention (PCI) capability and the interventional cardiologist at a tertiary PCI center., Background: Current guidelines recommend that patients with ST-segment elevation myocardial infarction (STEMI) receive primary PCI within 90 minutes. This door-to-balloon (D2B) time has been difficult to achieve in rural STEMI., Methods and Results: We evaluated 108 patients with STEMI in a rural hospital with emergency department but without PCI capability to determine the impact of WhatsApp triage and activation of the cardiac catheterization laboratory on D2B time. The images were obtained from cases of suspected STEMI using the smartphones by the EP and were sent to the interventional cardiologist via the WhatsApp application (group 1, n=53). The control group included concurrently treated patients with STEMI during the same period but not receiving triage (group 2, n=55). The D2B time was significantly shorter in the intervention group (109±31 vs 130±46 minutes, P<.001) with significant reduction in false STEMI rate as well., Conclusion: This study demonstrates that use of WhatsApp triage with activation of the cardiac catheterization laboratory was associated with shorter D2B time and results in a greater proportion of patients achieving guideline recommendations. The method is cheap, quick, and easy to operate., (Copyright © 2015 Elsevier Inc. All rights reserved.)

The use of fourth-generation (4G) mobile telecommunications to provide real-time video consultations were investigated in this study with the aims of determining if 4G is a suitable telecommunications technology; and secondly, to identify if variation in perceived audio and video quality were due to underlying network performance. Three patient end-points that used 4G Internet connections were evaluated. Consulting clinicians recorded their perception of audio and video quality using the International Telecommunications Union scales during clinics with these patient end-points. These scores were used to calculate a mean opinion score (MOS). The network performance metrics were obtained for each session and the relationships between these metrics and the session's quality scores were tested. Clinicians scored the quality of 50 hours of video consultations, involving 36 clinic sessions. The MOS for audio was 4.1 ± 0.62 and the MOS for video was 4.4 ± 0.22. Image impairment and effort to listen were also rated favourably. There was no correlation between audio or video quality and the network metrics of packet loss or jitter. These findings suggest that 4G networks are an appropriate telecommunication technology to deliver real-time video consultations. Variations in quality scores observed during this study were not explained by the packet loss and jitter in the underlying network. Before establishing a telemedicine service, the performance of the 4G network should be assessed at the location of the proposed service. This is due to known variability in performance of 4G networks., (© The Author(s) 2015.)

Teleconferencing, whereby a meeting is conducted over the telephone, is a convenient way of getting clinical, management or research business done for people residing in different locations, saving travelling time and costs, and reducing carbon emissions. Despite the convenience, teleconferences are often run poorly, due to inadequate planning or lack of understanding of the technology. Non-engaged participants typing emails, loud background noises and failure of the chair to bring in all participants and sum up are common problems. This Perspectives article seeks to offer some simple practical guidance to those hosting and participating in teleconferences in order to improve effective communication and efficient decision making., (© 2015 British Association of Dermatologists.)

How are fundamental constants, such as "c" for the speed of light, related to the technological environments that produce them? Relativistic cosmology, developed first by Albert Einstein, depended on military and commercial innovations in telecommunications. Prominent physicists (Hans Reichenbach, Max Born, Paul Langevin, Louis de Broglie, and Léon Brillouin, among others) worked in radio units during WWI and incorporated battlefield lessons into their research. Relativity physicists, working at the intersection of physics and optics by investigating light and electricity, responded to new challenges by developing a novel scientific framework. Ideas about lengths and solid bodies were overhauled because the old Newtonian mechanics assumed the possibility of "instantaneous signaling at a distance." Einstein's universe, where time and space dilated, where the shortest path between two points was often curved and non-Euclidean, followed the rules of electromagnetic "signal" transmission. For these scientists, light's constant speed in the absence of a gravitational field-a fundamental tenet of Einstein's theory-was a lesson derived from communication technologies.