Impact of an Electronic Health Service on Child Participation in Pediatric Oncology Care: Quasiexperimental Study.

BACKGROUND: For children 6-12 years old, there is a shortage of electronic Health (eHealth) services that promote their participation in health care. Therefore, a digital communication tool, called Sisom, was developed to give children a voice in their health care. Children with long-term diseases want to be more involved in their health care and have the right to receive information, be listened to, express their opinions, and participate in decision making in health care. However, the outcomes of using Sisom in practice at pediatric oncology clinics have not been investigated. OBJECTIVE: The aim of this study was to investigate children's participation during appointments with pediatricians at pediatric oncology clinics, with or without the use of the eHealth service Sisom. METHODS: A quasiexperimental design with mixed methods was used. We analyzed 27 filmed appointments with pediatricians for 14 children (8 girls and 6 boys) aged 6-12 years (mean 8.3 years) with a cancer diagnosis. The intervention group consisted of children who used Sisom prior to their appointments with pediatricians at a pediatric oncology clinic, and the control group consisted of children who had appointments with pediatricians at 4 pediatric oncology clinics. Data from observations from the videos were quantitatively and qualitatively analyzed. The quantitative analysis included manual calculations of how many times the pediatricians spoke directly to the children, the proportion of the appointment time that the children were talking, and levels of participation by the children. For the qualitative analysis, we used directed content analysis to analyze the children's levels of participation guided by a framework based on Shier's model of participation. RESULTS: Pediatricians directed a greater proportion of their discussion toward the child in the intervention group (731 occasions) than in the control group (624 occasions), but the proportion of the appointment time the children talked was almost the same for both the intervention and control groups (mean 17.0 minutes vs 17.6 minutes). The levels of participation corresponded to the first three levels of Shier's participation model: children were listened to, children were supported to express their views, and children's views were taken into account. The results showed an increased level of participation by the children in the intervention group. Several codes that were found did not fit into any of the existing categories, and a new category was thus formed: children received information. CONCLUSIONS: This study shows that the eHealth service Sisom can increase children's participation during appointments with health care professionals. Further studies employing a randomized control design focusing on the effects of eHealth services on children's health outcomes, perceived participation, and cost-effectiveness could make a significant contribution to guiding the implementation of eHealth services in pediatric care.

Wideband laser locking to an atomic reference with modulation transfer spectroscopy.

We demonstrate that conventional modulated spectroscopy apparatus, used for laser frequency stabilization in many atomic physics laboratories, can be enhanced to provide a wideband lock delivering deep suppression of frequency noise across the acoustic range. Using an acousto-optic modulator driven with an agile oscillator, we show that wideband frequency modulation of the pump laser in modulation transfer spectroscopy produces the unique single lock-point spectrum previously demonstrated with electro-optic phase modulation. We achieve a laser lock with 100 kHz feedback bandwidth, limited by our laser control electronics. This bandwidth is sufficient to reduce frequency noise by 30 dB across the acoustic range and narrows the imputed linewidth by a factor of five.

Narrow-and-sharp or broad-and-blunt--regulations of hazardous chemicals in consumer products in the European Union.

Chemicals are incorporated into a vast number of consumer products, and it has been recognized that considerable exposures of humans and the environment to chemicals are due to diffuse emissions from everyday products. Different approaches to the management of risks concerning chemicals in products are discussed on the international arena, but no general strategy has yet been adopted. The aim of this study is to investigate how health and environmental risks associated with chemicals in consumer products are currently managed in European Union legislations, mainly by the Toys Directive, the RoHS Directive, and REACH. Significant differences were found between the risk reduction strategies in these legislations, including substance prioritization, type of restrictions and requirements, and information dissemination to consumers. REACH regulates chemicals in products to a limited extent, and via quite complicated processes. Product-specific rules are therefore useful supplements to REACH for regulating chemicals in products. The combined effects of the RoHS and WEEE directives seem to be effective in promoting substitution of substances identified as problematic in electrical and electronic equipment, and it is recommended that the possibility to develop similar systems should be considered also for other product categories.

Manufacture and characterization of high Q-factor inductors based on CMOS-MEMS techniques.

A high Q-factor (quality-factor) spiral inductor fabricated by the CMOS (complementary metal oxide semiconductor) process and a post-process was investigated. The spiral inductor is manufactured on a silicon substrate. A post-process is used to remove the underlying silicon substrate in order to reduce the substrate loss and to enhance the Q-factor of the inductor. The post-process adopts RIE (reactive ion etching) to etch the sacrificial oxide layer, and then TMAH (tetramethylammonium hydroxide) is employed to remove the silicon substrate for obtaining the suspended spiral inductor. The advantage of this post-processing method is its compatibility with the CMOS process. The performance of the spiral inductor is measured by an Agilent 8510C network analyzer and a Cascade probe station. Experimental results show that the Q-factor and inductance of the spiral inductor are 15 at 15 GHz and 1.8 nH at 1 GHz, respectively.

Low-cost electronic microwave calibration for rapid on-line moisture sensing of seedcotton.

In order to improve rapid on-line moisture sensing of seedcotton in cotton gins, a means by which to establish a reliable low-cost wide-band electronic calibration is critically needed. This calibration is needed to center the circuit due to changes in the internal signal delays and attenuation drift caused by temperature changes in the various system components and circuit elements. This research examines a hardware technique for use in conjunction with microwave reflective sensing probes having an extended bandwidth from 500 MHz through 2.5 GHz. This new technique was validated experimentally against known electrical propagation delay standards. Results of the measured propagation delay with this type of automatic electronic calibration method was found to agree with results using a vector network analyzer with a traditional S11 single port error correction calibration methodology to within 4% of the measurement, 95% confidence, with a standard error of +/-18.6 ps for the delay measurements. At this level of performance, the proposed low-cost technique exhibits superior performance, over the typical geosciences time-domain reflectometer "TDR", instruments in common use in soil moisture testing and is suitable for use in cotton gin moisture sensing.

Proportional hazards models with discrete frailty.

We extend proportional hazards frailty models for lifetime data to allow a negative binomial, Poisson, Geometric or other discrete distribution of the frailty variable. This might represent, for example, the unknown number of flaws in an item under test. Zero frailty corresponds to a limited failure model containing a proportion of units that never fail (long-term survivors). Ways of modifying the model to avoid this are discussed. The models are illustrated on a previously published set of data on failures of printed circuit boards and on new data on breaking strengths of samples of cord.

Neuroadhesive protein coating improves the chronic performance of neuroelectronics in mouse brain.

Intracortical microelectrodes are being developed to both record and stimulate neurons to understand brain circuitry or restore lost functions. However, the success of these probes is hampered partly due to the inflammatory host tissue responses to implants. To minimize the foreign body reactions, L1, a brain derived neuronal specific cell adhesion molecule, has been covalently bound to the neural electrode array surface. Here we evaluated the chronic recording performance of L1-coated silicon based laminar neural electrode arrays implanted into V1m cortex of mice. The L1 coating enhanced the overall visually evoked single-unit (SU) yield and SU amplitude, as well as signal-to-noise-ratio (SNR) in the mouse brain compared to the uncoated arrays across the 0-1500 µm depth. The improvement in recording is most dramatic in the hippocampus region, where the control group showed severe recording yield decrease after one week, while the L1 implants maintained a high SU yield throughout the 16 weeks. Immunohistological analysis revealed significant increases of axonal and neuronal density along with significantly lowered microglia activation around the L1 probe after 16 weeks. These results collectively confirm the effectiveness of L1 based biomimetic coating on minimizing inflammatory tissue response and improving neural recording quality and longevity. Improving chronic recording will benefit the brain-computer interface technologies and neuroscience studies involving chronic tracking of neural activities.

Biological impact of lead from halide perovskites reveals the risk of introducing a safe threshold.

Regulations currently in force enable to claim that the lead content in perovskite solar cells is low enough to be safe, or no more dangerous, than other electronics also containing lead. However, the actual environmental impact of lead from perovskite is unknown. Here we show that the lead from perovskite leaking into the ground can enter plants, and consequently the food cycle, ten times more effectively than other lead contaminants already present as the result of the human activities. We further demonstrate that replacing lead with tin represents an environmentally-safer option. Our data suggest that we need to treat the lead from perovskite with exceptional care. In particular, we point out that the safety level for lead content in perovskite-based needs to be lower than other lead-containing electronics. We encourage replacing lead completely with more inert metals to deliver safe perovskite technologies.

Heat transfer intensification in an actuated heat exchanger submitted to an imposed pressure drop.

This paper is dedicated to the analysis of the improvement of heat transfer and the reduction of the pressure losses induced by the use of an active exchanger of millimeter size in a cooling loop. For pressure conditions imposed at the terminals of such a mini-channel whose upper wall is deformed by a progressive sinusoidal wave and for low Reynolds numbers (Re < 1000), we study the influence of the deformation parameters on the thermo-hydraulic performance of the exchanger (flow, heat transfer). The mechanical power applied to the deformed wall is connected to these parameters as well as to the pressure difference imposed by the external pump. The overall performance increases slightly with the value of the mechanical power up to a critical value for a given wall corrugation. Nevertheless, overall performance is up to 2 orders of magnitude higher than conventional static corrugated channels.

Performance comparison of two signal multiplexing readouts for SiPM-based pet detector.

PET scanners using SiPMs as photodetectors could have tens of thousands of SiPMs. To simplify the readout electronics, analog signal multiplexing readouts are always preferred to be used as early as possible. In this paper, two simple analog signal multiplexing readouts, a capacitive charge-division readout, and a resistive charge-division readout were evaluated and compared using dual-ended readout detectors based on 10 × 10 arrays of SensL MicroFJ-30035 SiPMs coupled to both ends of a 20 × 20 LYSO array with a pitch size of 1.5 mm and a length of 20 mm. The performance of the detectors were evaluated at different bias voltages (from 27.0 V to 30.5 V with an interval of 0.5 V) and a temperature of 22.8 °C. The flood histograms show that all the crystals in the LYSO array were clearly identified, whilst better flood histogram was obtained using the resistive charge-division readout. At a bias voltage of 29.5V, the flood histogram quality, energy resolution, DOI resolution, and timing resolution of the detector obtained using the capacitive charge-division readout were 3.28 ± 0.85, 18.9% ± 6.2%, 1.93 ± 0.20 mm, 1.25 ± 0.11 ns respectively, and those obtained using the resistive charge-division readout were 3.57 ± 0.81, 16.9% ± 6.5%, 1.96 ± 0.23 mm and 1.23 ± 0.07 ns, respectively. Overall, the detector with the resistive charge-division readout provided better performance.

Towards a second-generation PET/MR insert with enhanced timing and count rate performance.

Previously we have developed a first-generation PET insert prototype for small animal PET/MR imaging, which used resistor-based charge division multiplexing circuits and SensL B-series silicon photomultipliers (SiPMs). In this work we present results from a second-generation readout board with improved timing and count rate performance. Three detector boards were tested: the first-generation readout board with SensL SPMArray4B (SiPM-B), the second-generation readout board with SensL ArrayC-30035-16P-PCB (SiPM-C) using the 'fast' outputs for timing, and the second generation board using Hamamatsu S11361-3050AE-04 MPPC arrays. Timing data were obtained with detector modules in coincidence with a single-pixel SensL MicroFJ-SMA-30035 reference detector and acquired using standard NIM electronics, while count rate data were acquired using the OpenPET data acquisition electronics system. The full-width at half-maximum (FWHM) coincidence time resolution (CTR) for the SiPM-B, SiPM-C and MPPC designs were 2600 ± 200 ps, 550 ± 50 ps, and 570 ± 30 ps, respectively. OpenPET waveform capture determined the mean signal durations, measured as time above 10% of the maximum amplitude, were 1850 ± 150 ns, 600 ± 25 ns, and 350 ± 25 ns, respectively, where the short signal of the MPPC resulted in reduced pileup effects at higher count rates. Decaying source measurements showed a non-paralyzable dead time of 1.30-1.41 µs for all three detectors tested, which was limited by the signal capture and processing time of the OpenPET system.

Agreement between spatiotemporal parameters from a photoelectric system with different filter settings and high-speed video analysis during running on a treadmill at comfortable velocity.

The aim of this study was to determine the level of agreement between spatiotemporal gait characteristics from a photoelectric system with different filter settings and high-speed video analysis during running on a treadmill at comfortable velocity. Forty-nine runners performed a running protocol on a treadmill at comfortable velocity. Two systems were used to determine spatiotemporal parameters (i.e. contact time [CT], flight time [FT], step frequency [SF] and step length [SL]) during running: OptoGait system and high-speed video analysis at 1000 Hz. The collected data was re-filtered in the OptoGait software by using nine different settings (i.e. 0_0, 1_1, 2_2, 3_3, 3_4, 4_4, 4_5, 5_4 and 5_5), and compared to those obtained through video analysis. The Pearson correlation analysis revealed very large correlations (r > 0.9, p < 0.001) in CT, FT, SF and SL between both systems, regardless of the OptoGait's filter settings. The ICC reported an almost perfect association (ICC > 0.9) for both SL and SF regardless of the filter setting. However, large variations between filter settings according to the data from video analysis were reported in CT and FT (0_0, 1_1 and 2_2 filter settings obtained an association ICC > 0.9, whereas other filters obtained lower ICCs). Bland-Altman plots revealed small bias and error and no presence of heteroscedasticity of error for 1_1 setting. In conclusion, the filter setting for the OptoGait system should be considered to minimize the bias and error of spatiotemporal parameters measurement. For running on a treadmill, the 1_1 filter setting is recommended if gait parameters are to be compared to a high-speed video analysis (1000 Hz).

Coincidence error during measurement of cellular osmotic properties by the electrical sensing zone method.

Coincidence is a phenomenon that occurs when electrical sensing zone instruments fail to temporally resolve two or more particles passing through the sensing zone in close proximity. We have investigated the potential for coincidence errors to confound the estimation of cellular osmotic properties. A mathematical model was developed to predict the magnitude of coincidence error as a function of the instrument sensing volume, the cell concentration, and the degree of cell aggregation. The model was validated in a representative instrument (Coulter counter model Z2, with a 100-micron aperture tube), for which the sensing volume was estimated to be approximately 2 nL. Furthermore, we measured the degree of cell aggregation in trypsinized cultures of MIN6 cells, and used these data to estimate the effect of coincidence on MIN6 cell volume measurements. Finally, we simulated water transport experiments, and determined the sensitivity of estimates of the osmotically inactive volume and the membrane water permeability to coincidence error. Our results revealed that coincidence can result in significant overestimation of these two parameter values for high cell concentrations and for suspensions containing cell aggregates.

Validation of electronic performance and tracking systems EPTS under field conditions.

The purpose of this study was to assess the measurement accuracy of the most commonly used tracking technologies in professional team sports (i.e., semi-automatic multiple-camera video technology (VID), radar-based local positioning system (LPS), and global positioning system (GPS)). The position, speed, acceleration and distance measures of each technology were compared against simultaneously recorded measures of a reference system (VICON motion capture system) and quantified by means of the root mean square error RMSE. Fourteen male soccer players (age: 17.4±0.4 years, height: 178.6±4.2 cm, body mass: 70.2±6.2 kg) playing for the U19 Bundesliga team FC Augsburg participated in the study. The test battery comprised a sport-specific course, shuttle runs, and small sided games on an outdoor soccer field. The validity of fundamental spatiotemporal tracking data differed significantly between all tested technologies. In particular, LPS showed higher validity for measuring an athlete's position (23±7 cm) than both VID (56±16 cm) and GPS (96±49 cm). Considering errors of instantaneous speed measures, GPS (0.28±0.07 m⋅s-1) and LPS (0.25±0.06 m⋅s-1) achieved significantly lower error values than VID (0.41±0.08 m⋅s-1). Equivalent accuracy differences were found for instant acceleration values (GPS: 0.67±0.21 m⋅s-2, LPS: 0.68±0.14 m⋅s-2, VID: 0.91±0.19 m⋅s-2). During small-sided games, lowest deviations from reference measures have been found in the total distance category, with errors ranging from 2.2% (GPS) to 2.7% (VID) and 4.0% (LPS). All technologies had in common that the magnitude of the error increased as the speed of the tracking object increased. Especially in performance indicators that might have a high impact on practical decisions, such as distance covered with high speed, we found >40% deviations from the reference system for each of the technologies. Overall, our results revealed significant between-system differences in the validity of tracking data, implying that any comparison of results using different tracking technologies should be done with caution.

Phase-locked 10 MHz reference signal for frequency domain time-resolved fluorescence measurements.

A complete electronic system that is suitable for use in megahertz frequency domain time-resolved fluorescence instruments based on mode-locked lasers is described. The circuit produces a 10 MHz signal, phase locked to the mode-locked laser pulse frequency, which is required by many commercial frequency synthesizers as the external reference signal. This device is particularly useful in conjunction with ultrafast gated intensified charge coupled device cameras capable of being frequency modulated for time-resolved fluorescence imaging.

Characterization of Initial Parameter Information for Lifetime Prediction of Electronic Devices.

Newly manufactured electronic devices are subject to different levels of potential defects existing among the initial parameter information of the devices. In this study, a characterization of electromagnetic relays that were operated at their optimal performance with appropriate and steady parameter values was performed to estimate the levels of their potential defects and to develop a lifetime prediction model. First, the initial parameter information value and stability were quantified to measure the performance of the electronics. In particular, the values of the initial parameter information were estimated using the probability-weighted average method, whereas the stability of the parameter information was determined by using the difference between the extrema and end points of the fitting curves for the initial parameter information. Second, a lifetime prediction model for small-sized samples was proposed on the basis of both measures. Finally, a model for the relationship of the initial contact resistance and stability over the lifetime of the sampled electromagnetic relays was proposed and verified. A comparison of the actual and predicted lifetimes of the relays revealed a 15.4% relative error, indicating that the lifetime of electronic devices can be predicted based on their initial parameter information.

Can electronic stability control replace studded tyres?

Based on recent studies, this paper examines whether an increased use of electronic stability control can replace studded tyres. A re-analysis of a study that evaluated the effects on accidents of changes in the use of studded tyres in major cities in Norway is presented. It is found that if all cars have electronic stability control, the use of studded tyres can be reduced to about 15 percent before any increase in the number of accidents occurs. Even if studded tyres were eliminated entirely, any increase in the number of accidents is likely to be considerably smaller than it would have been if electronic stability control had never been invented.

Comparison of various safety guidelines for electronic article surveillance devices with pulsed magnetic fields.

The paper uses the two methods suggested in both the ICNIRP and proposed IEEE safety guidelines for compliance testing of security systems based on time-varying magnetic fields being introduced for electronic article surveillance (EAS), radiofrequency identification, and other applications. For nonsinusoidal pulses that are often used, the two procedures are to treat the exposure as a multifrequency exposure with various frequency components or to calculate the peak induced current densities or electric fields treating the highest of the pulses of duration t(p) as a single frequency, half sinusoid of the same duration and frequency 1/(2t(p)). Using either of the procedures, the induced current densities (J) or electric fields (E) are compared to the basic restrictions on J or E for compliance testing. Using a heterogeneous, tissue-classified anatomic model of the human body, we calculate the induced J and E for the various tissues for a realistic, EAS system for two typical nonsinusoidal pulses to show that the two methods give substantially different results. While the approximate but simpler method of treating the pulse as a half sinusoid results in peak induced J or E that may be compliant with safety guidelines, the rigorous method of treating such exposures as multifrequency exposures gives induced current densities or electric fields that may be up to twice as large, thus making such systems potentially noncompliant with the safety guidelines. Since it is more accurate, it is suggested that safety assessment based on the Fourier analysis leading to multifrequency components be used for compliance testing of such devices.

A quality study of 35 mm, miniaturization of full-size radiographic film.

Twenty-one radiologists with 6 months--25 years experience judged the quality and the possibilities for the routine use of miniaturized full-size radiographic films for long time archiving. Twenty-eight examinations on full-size radiographs were photographed on 35 mm. film. After mounting in transparent jackets, the miniaturized films were read with enlarging equipment and diagnoses and quality noted. Comparison was later made with the originals. The consensus was that the quality of the miniaturized film was good enough to permit their use for long-term archiving purposes and subsequent comparison with future full-size radiographs. The use of reading equipment was not considered tedious.

An in vitro evaluation of the accuracy of the root ZX in the presence of various irrigants.

The purpose of this study was to evaluate the accuracy of the Root ZX in vitro in the presence of a variety of endodontic irrigants. The in vitro model, described by Donnelly, consisted of refrigerated gelatin made with 0.9% sodium chloride instead of water. The following irrigants were tested: 2% lidocaine with 1:100,000 epinephrine, 5.25% sodium hypochlorite, RC Prep, liquid EDTA, 3% hydrogen peroxide, and Peridex. A total of 30 extracted, single-rooted teeth were used. The experimental measurements in the presence of the various irrigants were compared with the actual canal lengths. The present data indicate that the Root ZX electronic apex locator reliably measured canal lengths to within 0.31 mm and that there was virtually no difference in the length determination as a function of the seven irrigants used. These results strongly support the concept that the Root ZX is a useful, versatile, and accurate device for the determination of canal lengths over a wide range of irrigants commonly used in the practice of endodontics.