RESUMEN
The purpose of the present study is to evaluate whether an online reference system (ORS, STATdx Elsevier, Amsterdam, Netherlands) impacts finding the histologically confirmed diagnosis of rare or atypical abdominal tumors and lesions in radiologic imaging. In total, 101 patients with rare tumor entities or lesions and atypical manifestations of common tumors were enrolled retrospectively. Blinded readings were performed by four radiologists with varying levels of experience, who reported on: (a) correct diagnosis (CD), (b) time needed to find the diagnosis, and (c) diagnostic confidence, initially without followed by the assistance of the ORS. The experienced reader (3 years of experience post-residency, CD 49.5%), as well as the advanced reader with 1 year of experience post-residency (CD 43.6%), and a resident with 5 years of experience (CD 46.5%) made the correct diagnosis more frequently compared to the less experienced reader (CD 25.7%). A significant improvement in making the correct diagnosis was only achieved by the advanced reader, the resident with 5 years of experience (CD with ORS 58.4%; p < 0.001). The advanced reader with 1 year of experience post-residency improved slightly (CD ORS 47.5%). The experienced reader (CD ORS 50.5%) and the less experienced reader (CD ORS 27.7%) did not improve significantly. The overall subjective confidence increased significantly when ORS was used (3.2 ± 0.9 vs. 3.8 ± 0.9; p < 0.001). While the ORS had a positive impact on making the correct diagnosis throughout all readers, it favored radiologists with more clinical experience rather than inexperienced residents. Moreover, the ORS increased the diagnostic confidence of all radiologists significantly. In conclusion, the ORS had no significant impact on the diagnosis of rare or atypical abdominal tumors and lesions except for one reader. The greatest benefit is the increase in diagnostic confidence.
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Neoplasias Abdominales , Humanos , Femenino , Masculino , Persona de Mediana Edad , Anciano , Adulto , Neoplasias Abdominales/diagnóstico , Neoplasias Abdominales/patología , Estudios Retrospectivos , Anciano de 80 o más Años , Adulto Joven , Adolescente , Sistemas en LíneaRESUMEN
Pulmonary aspiration is a particularly problematic condition in patients in hospitals and nursing home. To promote patient safety and prevent serious complications, the nurse's role in preventing and caring for patient at high risk of pulmonary aspiration is crucial. Our team has developed an online training system on pulmonary aspiration for nurses to improve their ability to identify early risk factors, scientifically assess the risk of aspiration, and effectively intervene and manage when pulmonary aspiration occurs. This system was developed via WeChat app, the most popular social media application in China. It has four main functions, such as online training, online assessment, announcement interaction, and learning record. This online training systems offer the benefits of flexible learning time with anytime access, rich resources that are easy to update, and greater cost-effectiveness. This paper presents and discusses the development process of this system.
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Instrucción por Computador , Humanos , China , Instrucción por Computador/métodos , Medios de Comunicación Sociales , Sistemas en Línea , Neumonía por Aspiración/prevención & controlRESUMEN
Objective. Developing neural decoders robust to non-stationary conditions is essential to ensure their long-term accuracy and stability. This is particularly important when decoding the neural drive to muscles during dynamic contractions, which pose significant challenges for stationary decoders.Approach. We propose a novel adaptive electromyography (EMG) decomposition algorithm that builds on blind source separation methods by leveraging the Kullback-Leibler divergence and kurtosis of the signals as metrics for online learning. The proposed approach provides a theoretical framework to tune the adaptation hyperparameters and compensate for non-stationarities in the mixing matrix, such as due to dynamic contractions, and to identify the underlying motor neuron (MN) discharges. The adaptation is performed in real-time (â¼22 ms of computational time per 100 ms batches).Main results. The hyperparameters of the proposed adaptation captured anatomical differences between recording locations (forearm vs wrist) and generalised across subjects. Once optimised, the proposed adaptation algorithm significantly improved all decomposition performance metrics with respect to the absence of adaptation in a wide range of motion of the wrist (80∘). The rate of agreement, sensitivity, and precision were⩾90%in⩾80%of the cases in both simulated and experimentally recorded data, according to a two-source validation approach.Significance. The findings demonstrate the suitability of the proposed online learning metrics and hyperparameter optimisation to compensate the induced modulation and accurately decode MN discharges in dynamic conditions. Moreover, the study proposes an experimental validation method for EMG decomposition in dynamic tasks.
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Electromiografía , Electromiografía/métodos , Humanos , Masculino , Adulto , Algoritmos , Femenino , Adulto Joven , Músculo Esquelético/fisiología , Sistemas en Línea , Contracción Muscular/fisiología , Neuronas Motoras/fisiología , Aprendizaje AutomáticoRESUMEN
An efficient technique for quantitative analysis of tetrodotoxin (TTX) in human plasma and urine has been developed, which combines liquid chromatography-tandem mass spectrometry (LC-MS/MS) with online MCX solid phase extraction (SPE) cleanup. Sample preparation, including extraction with acetonitrile containing 0.5â¯% acetate acid, centrifugation, and filtration, was followed by online SPE cleanup. The whole run-time was less than 15â¯min, including online cleanup, chromatographic separation, and re-equilibration of the online SPE - LC-MS/MS system. The parameters of sample extraction, purification, separation, and detection were optimized. The matrix-matched internal standard calibration standard curves with linear regression coefficients larger than 0.9990 were established for quantification. The LOD and LOQ for this approach were determined to be 0.1â¯ng/mL and 0.3â¯ng/mL, respectively. The recoveries for varied concentrations of TTX in human plasma and urine were 84.9-104.2â¯% and 89.2-109.6â¯%, respectively. The matrix effects of TTX in human plasma and urine matrices were 85.5â¯% and 74.3â¯%, respectively, and both the inter- and intra-day precision values were less than 9.5â¯%. This analytical method was successfully employed for detecting TTX in biological samples from a poisoned patient who accidentally ingested the nassarius glans.
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Extracción en Fase Sólida , Espectrometría de Masas en Tándem , Tetrodotoxina , Tetrodotoxina/sangre , Tetrodotoxina/orina , Extracción en Fase Sólida/instrumentación , Extracción en Fase Sólida/métodos , Cromatografía Líquida de Alta Presión , Humanos , Calibración , Sistemas en Línea , Modelos Lineales , Límite de Detección , Reproducibilidad de los ResultadosRESUMEN
Until recently, the Thai national program of seasonal influenza vaccination for high-risk people has been using a walk-in service system. However, in 2020, an online registration system was introduced in Bangkok to improve vaccine coverage. This study aimed to compare the coverage of influenza vaccination between the walk-in service and online registration systems. The study participants included 374,710 Thai individuals who obtained an influenza vaccination from the national program in the Bangkok health region in 2018 (n = 162,214) and in 2020 (n = 212,496). The registration systems that were examined were the walk-in service system in 2018 and the online registration system in 2020. The characteristics of vaccine recipients and the vaccine coverage in each risk group and health facility level were compared between the two systems. Coverage comparison in Bangkok between the years 2018 and 2020 showed an increase in coverage, particularly among individuals who had an influenza vaccination at health facilities of the primary level and in the elderly and obesity groups. The coverage among children was lowest among all high-risk groups. To improve coverage in Thailand, the online registration system should be introduced in all regions. Additionally, information about influenza vaccination for children should be disseminated to parents using handbooks or by word-of-mouth from healthcare workers.
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Vacunas contra la Influenza , Gripe Humana , Cobertura de Vacunación , Humanos , Tailandia , Vacunas contra la Influenza/uso terapéutico , Vacunas contra la Influenza/administración & dosificación , Masculino , Persona de Mediana Edad , Adulto , Femenino , Gripe Humana/prevención & control , Cobertura de Vacunación/estadística & datos numéricos , Niño , Anciano , Adolescente , Adulto Joven , Preescolar , Lactante , Vacunación/estadística & datos numéricos , Sistemas en LíneaRESUMEN
The aim of this study was to investigate planning target volume (PTV) margin in online adaptive radiation therapy (oART) for gastric mucosa-associated lymphoid tissue (MALT) lymphomas. Four consecutive patients with gastric MALT lymphoma who received oART (30 Gy in 15 fractions) on the oART system were included in this study. One hundred and twenty cone-beam computed tomography (CBCT) scans acquired pre- and post-treatment of 60 fractions for all patients were used to evaluate intra- and interfractional motions. Patients were instructed on breath-holding at exhalation during image acquisition. To assess the intrafraction gastric motion, different PTVs were created by isotropically extending the CTV contoured on a pre-CBCT image (CTVpre) at1 mm intervals. Intrafraction motion was defined as the amount of expansion covering the contoured CTV on post-CBCT images (CTVpost). Interfractional motion was defined as the amount of reference CTV expansion that could cover each CTVpre, as well as the evaluation of the intrafractional motion. PTV margins were estimated from the cumulative proportion of fraction covering the intra- and interfractional motions. The extent of expansion covering the CTVs in 90% of fractions was adopted as the PTV margin. The PTV margin for intrafractional gastric motion using the oART system with breath-holding was 14 mm. In contrast, the PTV margin for interfractional gastric organ motion without the oART system was 25 mm. These results indicated that the oART system can reduce the PTV margin by >10 mm. Our results could be valuable data for oART cases.
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Tomografía Computarizada de Haz Cónico , Linfoma de Células B de la Zona Marginal , Planificación de la Radioterapia Asistida por Computador , Neoplasias Gástricas , Humanos , Linfoma de Células B de la Zona Marginal/radioterapia , Linfoma de Células B de la Zona Marginal/diagnóstico por imagen , Neoplasias Gástricas/radioterapia , Neoplasias Gástricas/diagnóstico por imagen , Neoplasias Gástricas/patología , Planificación de la Radioterapia Asistida por Computador/métodos , Masculino , Femenino , Persona de Mediana Edad , Anciano , Radioterapia Guiada por Imagen/métodos , Sistemas en LíneaRESUMEN
AIM: This study aimed to explore what changes rural placement had on the perceptions of nursing students and the impact of placement frequency and duration on student considerations for rural practice. BACKGROUND: A strong rural healthcare workforce is a global concern and has led countries to look for creative ways to address this challenge. One approach is to train more health professionals, however, nursing students who grew up or lived in metropolitan or urbanised areas are suggested to be less inclined to pursue a rural career. As such it is posited that recurrent exposure to rural settings may exert a positive impact on future intention for rural practice. However, there is a need to explore the specific thresholds related to both the frequency and duration of rural placement exposure, as well as the cumulative impact multiple rural placements may have on the intention to engage in rural practice. DESIGN: A repeated cross-sectional design. METHODS: All nursing students from an Australian regional university were invited to complete an online questionnaire between 2019 and 2023. Demographic and placement specific questions were included. A modified version of the Nursing Community Apgar tool also measured the importance of key variables in rural career decision-making. Data were analysed using independent sample t-tests and one-way ANOVAs. Significance was determined at two-tailed p≤.05. RESULTS: Among the 835 respondents (response rate 15.4%), the average number and duration of rural placements was 2.45 placements and 3.01 weeks respectively. Rural placements did not have an impact on students who resided rurally or regionally. However, among metropolitan students who had experienced more than three rural placements, or more than sixteen cumulative weeks of placement, were significantly more likely to consider rural employment. Greater number of rural placements and longer cumulative duration had the greatest impact. CONCLUSION: Issues related to the nursing rural workforce are dynamic and complex. Understanding the unique drivers that improve the rural experiences among students, particularly metropolitan students, can have an impact on decision-making to pursue employment in rural environments. Importantly, whilst professional and clinical motivation and experiences are influential factors, the socialisation, environment and community features are essential elements that influence students' decisions to pursue a career in rural practice. Undertaking a nuanced approach that facilitates rural practice understanding among students may help shape future employment decision-making.
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Enfermería Rural , Estudiantes de Enfermería , Estudios Transversales , Humanos , Selección de Profesión , Enfermería Rural/educación , Enfermería Rural/estadística & datos numéricos , Sistemas en Línea , Encuestas y Cuestionarios , Australia , Factores de Tiempo , Demografía , Masculino , Femenino , Adulto Joven , Adulto , Persona de Mediana EdadRESUMEN
This paper introduces a forensic psychiatry database established in Japan and discusses its significance and future issues. The purpose of this Database, created under the Medical Treatment and Supervision Act (MTSA) Database Project, is to improve the quality of forensic psychiatry treatment. It can collect monthly data on "basic information," "Orders and hospitalizations under the MTSA," "Treatment process," "Criminal and medical treatment history," and "problematic behavior in the unit." The online system has accumulated data on more than 8,000 items in 24 broad categories. Medical data are exported from the medical care assisting system of 32 designated inpatient facilities in XML format and then saved on USB memory sticks. The files are imported into the Database system client, which sends the data to the Database server via a virtual private network. This system minimizes errors and efficiently imports patient data. However, there is a limitation that it is difficult to set items that need to be analyzed to solve everyday clinical problems into the database system because they tend to change over time. By evaluating the effectiveness of the Database, and collecting appropriate data, it is expected to disseminate a wide range of knowledge that will contribute to the future development of mental health and welfare care.
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Servicios de Salud Mental , Humanos , Psiquiatría Forense , Hospitalización , Japón , Sistemas en LíneaRESUMEN
OBJECTIVE: We developed an online tool for women with epilepsy consisting of two modules: one with information on pregnancy-related issues (information module) and one for reminders about blood test and communication about dose changes (pregnancy module). Our aim was to assess perceived value, user-friendliness and improvement of patient knowledge in users. METHODS: The system was launched in 2019 and patients invited by epilepsy nurses were asked to participate in a survey 1 month after the invitation for the information module, and 1 month postnatally for the pregnancy module. RESULTS: By November 2022, the system had been used by 96 individuals out of 100 invited in the pregnancy module, in a total of 114 pregnancies. One hundred and eleven women had been invited to the information module, and 70 of these accessed it. The survey received 96 answers (44 information, 52 pregnancy). User-friendliness was rated as good or very good by a little over half of the users; 55% in the information module and 52% in the pregnancy module. Among pregnant women, 83% found the TDM part useful and most would prefer a similar system in future pregnancies. Sixty-four percent of users of the information module and 48% of the pregnancy module found that the system had increased their knowledge. Two knowledge questions were answered correctly by a significantly higher proportion of those that had accessed the online information. SIGNIFICANCE: There was great demand for online communication during pregnancy and our experiences of implementation can hopefully assist digitalization of epilepsy care elsewhere. Online information also seems to increase knowledge about pregnancy-related issues, but our invitation-only method of inclusion was not effective for widespread dissemination. Patient-initiated access with optional epilepsy-team contact if questions arise could be an alternative. PLAIN LANGUAGE SUMMARY: We have performed a survey of users of a new Internet-based tool for information to women of childbearing age and communication about dose changes during pregnancy. Users were overall satisfied with the tool and answered some knowledge questions more accurately after accessing the information.
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Epilepsia , Humanos , Femenino , Embarazo , Encuestas y Cuestionarios , Epilepsia/terapia , Mujeres Embarazadas , Sistemas en Línea , ComunicaciónRESUMEN
Evidence-based positive interventions contribute to the promotion of workers' well-being. Accordingly, an intervention was carried out with 11 physiotherapist engaging leaders from a hospital in Porto Alegre to promote their engagement at work as a protection factor. A mixed transformative-sequential study was carried out, consisting of four phases with three stages of assessment. The effectiveness of the intervention was investigated using the Jacobson-Truax Method, evaluating the effects of the intervention on Engagement at Work, Perceived Social Support, Dispositional Hope, Gratitude, and Anxiety. The intervention integrated epistemological assumptions from the Job Demand-Resources Model and the Basic Psychological Needs Theory. The main result was the increased levels of work engagement, which strengthened positive psychological states, and had an anxiety-reducing effect during the COVID-19 pandemic. This study provides relevant contributions to positive development in mental health protection at work. (AU)
Intervenções positivas baseadas em evidências contribuem para promoção do bem-estar dos trabalhadores. Nesse sentido, foi realizada uma intervenção com 11 lideranças engajadoras de fisioterapeutas de um hospital de Porto Alegre para promover seu engajamento no trabalho como fator de proteção. Realizou-se estudo misto transformativo-sequencial, composto por quatro fases em três tempos de avaliação. A efetividade da intervenção foi investigada por meio do Método Jacobson-Truax, avaliando os efeitos da intervenção sobre os níveis de Engajamento no Trabalho, Suporte Social Percebido, Esperança Disposicional, Gratidão e Ansiedade. A intervenção integrou pressupostos epistemológicos do Modelo Recursos e Demandas no Trabalho e da Teoria das Necessidades Psicológicas Básicas. O principal resultado foi o aumento dos níveis de engajamento no trabalho, que fortaleceu estados psicológicos positivos, e teve efeito na redução dos níveis de ansiedade na pandemia de COVID-19. A pesquisa traz contribuições relevantes para o desenvolvimento positivo na proteção da saúde mental no trabalho. (AU)
Intervenciones positivas basadas en evidencia contribuyen a promoción del bienestar de los trabajadores. En ese sentido, se realizó una intervención con 11 fisioterapeutas líderes de compromiso de un hospital de Porto Alegre para promover su Engagement en el Trabajo como factor de protección. Se llevó a cabo un estudio mixto transformativo-secuencial, con cuatro fases y tres etapas de evaluación. Se investigó la efectividad de la intervención mediante el Método de Jacobson-Truax, evaluando los efectos de la intervención sobre los niveles del Engagement en el Trabajo, Apoyo Social Percibido, Esperanza Disposicional, Gratitud y Ansiedad. La intervención integró el Modelo teórico de Demandas y Recursos de Trabajo con la Teoría de Necesidades Psicológicas Básicas. Con un resultado de mayores niveles de Engagement en el Trabajo, lo que fortaleció los estados psicológicos positivos y tuvo un efecto reductor de la ansiedad durante la pandemia. Este estudio aporta contribuciones relevantes al desarrollo positivo en la protección de salud mental en trabajo. (AU)
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Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Ansiedad/psicología , Satisfacción Personal , Servicio de Fisioterapia en Hospital , Psicología Positiva , Liderazgo , Sistemas en Línea , Encuestas y Cuestionarios , COVID-19/psicologíaRESUMEN
The phenomenal increase in technological capabilities that allow the design and training of systems to cope with the complexities of natural language and visual representation in order to develop other formats is remarkable. It has made it possible to make use of image to image and text to image technologies to support those with disabilities in ways not previously explored. It has opened the world of adaptations from one picture to another in a design style of a user's choosing. Automated text simplification alongside graphical symbol representations to enhance understanding of complex content is already being used to support those with cognitive impairments and learning difficulties. Symbol sets have become embedded within applications as dictionaries and look up systems, but the need for flexibility and personalization remains a challenge. Most pictographic symbols are created over time within the bounds of a certain style and schema for particular groups such as those who use augmentative and alternative forms of communication (AAC). By using generative artificial intelligence, it is proposed that symbols could be produced based on the style of those already used by an individual or adapted to suit different requirements within local contexts, cultures and communities. This paper explores these ideas at the start of a small six-month pilot study to adapt a number of open licensed symbols based on the symbol set's original style. Once a collection has been automatically developed from image to image and text descriptions, potential stakeholders will evaluate the outcomes using an online voting system. Successful symbols will be made available and could potentially be added to the original symbol set offering a flexible personalized approach to AAC symbol generation hitherto not experienced by users.
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Inteligencia Artificial , Disfunción Cognitiva , Humanos , Proyectos Piloto , Lenguaje , Sistemas en LíneaRESUMEN
Neural networks implemented in memristor-based hardware can provide fast and efficient in-memory computation, but traditional learning methods such as error back-propagation are hardly feasible in it. Spiking neural networks (SNNs) are highly promising in this regard, as their weights can be changed locally in a self-organized manner without the demand for high-precision changes calculated with the use of information almost from the entire network. This problem is rather relevant for solving control tasks with neural-network reinforcement learning methods, as those are highly sensitive to any source of stochasticity in a model initialization, training, or decision-making procedure. This paper presents an online reinforcement learning algorithm in which the change of connection weights is carried out after processing each environment state during interaction-with-environment data generation. Another novel feature of the algorithm is that it is applied to SNNs with memristor-based STDP-like learning rules. The plasticity functions are obtained from real memristors based on poly-p-xylylene and CoFeB-LiNbO3 nanocomposite, which were experimentally assembled and analyzed. The SNN is comprised of leaky integrate-and-fire neurons. Environmental states are encoded by the timings of input spikes, and the control action is decoded by the first spike. The proposed learning algorithm solves the Cart-Pole benchmark task successfully. This result could be the first step towards implementing a real-time agent learning procedure in a continuous-time environment that can be run on neuromorphic systems with memristive synapses.
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Electrónica , Redes Neurales de la Computación , Sistemas en Línea , Aprendizaje Automático , Electrónica/instrumentación , AlgoritmosRESUMEN
BACKGROUND: In China, a form of online health service called the internet hospital became a prominent means of patient care when face-to-face visits were not possible during the COVID-19 pandemic to minimize transmission of the SARS-CoV-2 virus. Patients' internet hospital experiences largely depend on online physician-patient interaction. Yet, little is known about how physicians can improve patient satisfaction by using specific communication strategies online. OBJECTIVE: This study aimed to identify specific communication strategies to help physicians deliver better quality internet hospital services. We also outline recommendations for hospitals to operate internet hospital platforms more effectively. METHODS: A longitudinal data set was collected from an internet hospital platform operated by a top hospital in China. By extracting communication patterns from approximately 20,000 records of online health care services and by controlling the features of service requests, we tested the impacts of response load, more detailed style, and emotional comfort on patient satisfaction. We further explored the effects of these communication patterns in different service contexts. RESULTS: Physicians with a low response load, a more detailed style, and expressions of emotional comfort received more positive patient feedback. Response load did not affect patient satisfaction with free online health service, whereas a more detailed style and emotional comfort enhanced satisfaction with free service. Response load significantly reduced patient satisfaction with paid online health service, while a more detailed style had no effect. Compared with free service, emotional comfort more strongly promoted patient satisfaction with paid service. CONCLUSIONS: The communication strategies identified can help physicians provide patients with a better internet hospital experience. These strategies require hospitals to schedule each physician's online service period more appropriately. In addition, tailoring the strategies to service situations can facilitate more targeted and effective internet hospital service for patients.
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Satisfacción del Paciente , Relaciones Médico-Paciente , Telemedicina , Humanos , Satisfacción del Paciente/estadística & datos numéricos , COVID-19/prevención & control , Telemedicina/métodos , Telemedicina/normas , Telemedicina/estadística & datos numéricos , Comunicación , Sistemas en LíneaRESUMEN
BACKGROUND & AIMS: The Remote Malnutrition Application (R-MAPP) was developed during the COVID-19 pandemic to provide support for health care professionals (HCPs) working in the community to complete remote nutritional assessments and provide practical guidance for nutritional care. R-MAPP was adapted into Pediatric Remote Malnutrition Application (Pedi-R-MAPP) using a modified Delphi consensus, with the goal of providing a structured approach to completing a nutrition focused assessment as part of a technology enabled care service (TECS) consultation. The aim of this study was to develop and validate a digital version of Pedi-R-MAPP using the IDEAS framework (Integrate, Design, Assess and Share). METHODS: A ten-step process was completed using the IDEAS framework. This involved the four concept processes; Stage-1, Integrate (Step 1-3) identify the problem, specify the goal, and use an evidence-based approach. Stage-2, (Step 4-7) design iteratively and rapidly with user feedback. Stage 3, (Step 8-9) Assess rigorously, and Stage 4 (Step 9-10) publish and launch of the tool. RESULTS: Stage 1:Evidence-based development, Pedi-R-MAPP was developed using Delphi consensus methodology. Stage 2:Iteration & design, HCPs (n = 22) from UK, Europe, South Africa, and North America were involved four workshops to further develop a paper prototype of the tool and complete small-scale testing of a beta version of the tool which resulted in eight iterations. Stage 3:Assess rigorously, Small scale retrospective testing of the tool on children with congenital heart disease (n = 80) was completed by a single researcher, with iterative changes made to improve agreement with summary advice. Large scale testing amongst (n = 745) children in different settings was completed by specialist paediatric dietitians (n = 15) advice who recorded agreement with the summary advice compared with their own clinical assessment. Paediatric dietitians were in overall agreement with the summary advice in the tool 86% (n = 640), compared to their own clinical practice. The main reasons for disagreement were i) frequency of planned review 57.1% (n = 60/105), ii) need for ongoing dietetic review due to chronic condition 20.0% (n = 21/105), iii) disagreement with recommendation for discharge 16.2% (n = 17/105) and iv) concerns with faltering growth and/or need for condition specific growth charts 6.7% (7/105). Iterative changes were made to the algorithm, leading to an improvement in agreement of the summary advice on re-evaluation to 98% (p=<0.0001). CONCLUSION: A digital version of the Pedi-R-MAPP nutrition awareness tool was developed using the IDEAS framework. The summary advice provided by the tool achieved a high level of agreement when compared to paediatric dietetic assessment, by providing a structured approach to completing a remote nutrition focused assessment, along with identifying the frequency of follow-up or an in-person assessment.
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Concienciación , Desnutrición , Estado Nutricional , Humanos , Niño , Estudios Retrospectivos , Encuestas y Cuestionarios , Sistemas en LíneaRESUMEN
experiência do Projeto Ponte no atendimento de grupos terapêuticos online mostra a potência deste dispositivo no atendimento aos migrantes; nosso projeto defronte à pandemia teve de se adaptar a novos parâmetros no atendimento virtual. Participamos de uma rede de serviços específica ao público migrante, essencial na pandemia de COVID-19, para o apoio e continuidade do trabalho. As referências do projeto são: o conceito de interculturalidade, o atendimento grupal no formato slow open, a língua portuguesa e a psicanálise de grupos e vínculos. Nos atendimentos clínicos com migrantes, consideramos os processos de ruptura da migração, a dupla pertença aos países de origem e destino, bem como a dificuldade de se instalar no país de destino, a estranheza da experiência e o lugar de estrangeiro que o migrante ocupa. Por isso adotamos o dispositivo grupal, onde o migrante encontra um lugar para a construção e elaboração da migração, bem como para estabelecer uma possível pertença.
The experience of Ponte Project in attending therapeutic groups online shows the power that this device provokes in attending migrants; this work with the arrival of the COVID-19 pandemic had to adapt to the new parameters of virtual therapy. We also participate in a network in the psychological consultation of the migrant public, essential for the continuity of the project's work. The theoretical framework of the project has always been based on: the concept of interculturality, a slow-open group, Portuguese language and Psychoanalysis with groups and bonds. In clinical sessions with the migrants we will consider the processes of rupture caused by migration, the double belonging, as well as the difficulty of settling in the country of destination, all the strangeness caused by this experience and also the place of foreigner that the migrant occupies. That is why we chose to work with groups, where the migrant finds a place to elaborate the effects of migration, in addition to establishing a possible place of belonging.
La experiencia del Proyecto Puente en la atención terapéutica grupal en línea muestra la potencia de este dispositivo en la atención a migrantes. Nuestro proyecto, frente a la pandemia, tuvo que adaptarse a los nuevos parámetros para la atención virtual. Participamos en una red de servicios específicos para el público migrante, esencial en la pandemia del COVID-19, para brindar apoyo y continuidad al trabajo. Las referencias del proyecto son: el concepto de interculturalidad, la atención grupal en el formato slow open, la lengua portuguesa, el psicoanálisis de grupo y los vínculos. En las sesiones clínicas con migrantes consideramos los procesos de ruptura de la migración, la doble pertenencia a los países de origen y destino, la dificultad de integración en el país de destino, la extrañeza de la experiencia y el lugar de extranjero que ocupa el migrante. Por eso adoptamos el dispositivo grupal, donde el migrante encuentra un lugar para la construcción y elaboración de la experiencia migratoria, permitiéndole así establecer una posible pertenencia.
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Humanos , Psicoterapia de Grupo , Migrantes , Sistemas en Línea , COVID-19RESUMEN
Real-time online monitoring of volatile organic compounds (VOCs) in ambient air is crucial for timely and effective human health protection. Here, we developed an innovative, automated two-staged adsorption/thermal desorption gas chromatography/mass spectrometry (GC/MS) system for real-time online monitoring of 117 regulated volatile organic compounds (VOCs). This system comprised a sampling unit, water management trap, two-staged adsorption/thermal desorption unit, thermoelectric coolers (TECs), and a commercial GC/MS system. By implementing a micro-purge-and-trap (MP & T) step and a two-staged adsorption/thermal desorption unit, the presence of interfering substances was effectively minimized. The utilization of a heart-cutting GC, combined with a single MS detector, facilitated the precise separation and detection of 117 C2-C12 VOCs, while circumventing the identification and coelution challenges commonly associated with traditional GC-FID or GC-FID/MS methods. The performance of our newly developed online system was meticulously optimized and evaluated using standard gas mixtures. Under optimal conditions, we achieved impressive results, with R2 values ≥ 0.9946 for the standard linear curves of all 117 VOCs, demonstrating a precision (RSD) ranging from 0.2% to 6.4%. When applied in the field monitoring, the concentration drifts for 10 ppbv standard gas mixtures were 0.01-5.64% within 24 h. Our study developed a system for online monitoring of 117 atmospheric VOCs with relatively high accuracy and robustness.
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Compuestos Orgánicos Volátiles , Humanos , Compuestos Orgánicos Volátiles/análisis , Cromatografía de Gases y Espectrometría de Masas/métodos , Adsorción , Monitoreo del Ambiente/métodos , Sistemas en Línea , Gases/análisisRESUMEN
Previous studies reveal the limited effectiveness of benefit-based and hedonic-based product recommendations provided by online recommenders, and recommender anthropomorphism is considered a remedy. This paper aims to investigate the positive effect of anthropomorphism by involving the online recommender's perceived ability to learn as a mediator. Based on schema congruity theory, perceived benefit/hedonic appeals appropriateness is considered a dependent variable. In Study 1, subtle anthropomorphic cues within an online recommender had a positive effect on perceived benefit-appeals appropriateness through the perceived ability to learn. Study 2 demonstrated the positive relationship between perceived anthropomorphism and perceived hedonic-appeal appropriateness, with the mediating role of the perceived ability to learn. The results advance the knowledge about consumer response to online recommenders from the perspective of anthropomorphism and schema congruity theory. Marketers and consumer organizations are advised on how to deal with online recommender systems providing benefit and hedonic appeals.
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Señales (Psicología) , Aprendizaje , Organizaciones del Consumidor , Conocimiento , Sistemas en LíneaRESUMEN
Kombucha is widely recognized for its health benefits, and it facilitates high-quality transformation and utilization of tea during the fermentation process. Implementing on-line monitoring for the kombucha production process is crucial to promote the valuable utilization of low-quality tea residue. Near-infrared (NIR) spectroscopy, together with partial least squares (PLS), backpropagation neural network (BPANN), and their combination (PLS-BPANN), were utilized in this study to monitor the total sugar of kombucha. In all, 16 mathematical models were constructed and assessed. The results demonstrate that the PLS-BPANN model is superior to all others, with a determination coefficient (R2p) of 0.9437 and a root mean square error of prediction (RMSEP) of 0.8600 g/L and a good verification effect. The results suggest that NIR coupled with PLS-BPANN can be used as a non-destructive and on-line technique to monitor total sugar changes.
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Té de Kombucha , Sistemas en Línea , Dinámicas no Lineales , Té de Kombucha/análisis , Azúcares/química , Azúcares/metabolismo , Fermentación , Espectroscopía Infrarroja Corta , Calibración , Modelos LinealesRESUMEN
In this paper, two decision support systems have been used to re-analyze the Fukushima accident emissions: the European Realtime Online Decision Support System for Nuclear Emergency Management (RODOS, version JRodos 2019)-providing a set of modules for the dispersion of nuclides following atmospheric and aquatic releases, dosimetry modules for dose estimation to individuals and communities for all exposure pathways with application of countermeasures, and modules for time estimation of the radiological situation in inhabited and agricultural areas-and CBRNE Platform, developed by IFIN-HH within a research project on anticipative and prognostic evaluation of chemical, biological, radiological, nuclear and explosive events (CBRNE), which is a tool for effect diagnosis functions, response measures and consecutive recommendation for a large variety of scenarios. We have reproduced the event on both systems, using accident time weather data and updated source terms. Current and initial results were cross-compared and evaluated.
Asunto(s)
Accidente Nuclear de Fukushima , Radiactividad , Radiología , Humanos , Agricultura , Sistemas en LíneaRESUMEN
BACKGROUND: Bristol Medical School has adopted a near peer-led teaching approach to deliver Basic Life Support training to first year undergraduate medical students. Challenges arose when trying to identify early in the course which candidates were struggling with their learning, in sessions delivered to large cohorts. We developed and piloted a novel, online performance scoring system to better track and highlight candidate progress. METHODS: During this pilot, a 10-point scale was used to evaluate candidate performance at six time-points during their training. The scores were collated and entered on an anonymised secure spreadsheet, which was conditionally formatted to provide a visual representation of the score. A One-Way ANOVA was performed on the scores and trends analysed during each course to review candidate trajectory. Descriptive statistics were assessed. Values are presented as mean scores with standard deviation (x̱SD). RESULTS: A significant linear trend was demonstrated (P < 0.001) for the progression of candidates over the course. The average session score increased from 4.61 ± 1.78 at the start to 7.92 ± 1.22 at the end of the final session. A threshold of less than 1SD below the mean was used to identify struggling candidates at any of the six given timepoints. This threshold enabled efficient highlighting of struggling candidates in real time. CONCLUSIONS: Although the system will be subject to further validation, our pilot has shown the use of a simple 10-point scoring system in combination with a visual representation of performance helps to identify struggling candidates earlier across large cohorts of students undertaking skills training such as Basic Life Support. This early identification enables effective and efficient remedial support.