Location method for emergency rescue node on expressways based on spatio-temporal characteristics of vehicle operation.

Expressway networks are continuously developing and emergency rescue demand is increasing proportionately. The location of expressway emergency rescue nodes needs refinement to meet changing requirements. In this study, the expressway was modeled as an expressway network. The differences in the origin destination (OD) distribution matrices for working days and major holidays were used as the bases for determining the need for temporary emergency rescue nodes. Overlapping and non-overlapping community detection algorithms were used to extract the distribution characteristics of OD during both day categories. These distributions were used to determine permanent and temporary emergency rescue sites. In this study, we considered the differences in traffic volume, distance, and impact of four vehicle types on traffic accidents to select the location of emergency rescue nodes, and allocate emergency resources. An emergency rescue node selection model for an expressway network was established based on spatio-temporal characteristics. The results based on a regional example determined that 22 permanent and 25 temporary emergency rescue nodes were appropriate. The average rescue time for traffic accidents during working days and major holidays compared to the P-center location model, was reduced by approximately 27.08% and 6.70%, respectively. The coefficient of variation of emergency rescue time was reduced by approximately 28.22% and 21.41%, respectively. The results indicated that the model satisfied the expressway emergency rescue demand requirements, and improved the rationality of the rescue center node layout.

Impact of primary tumor sidedness and sex on prognosis and anti-epidermal growth factor receptor antibody efficacy in BRAF-mutant metastatic colorectal cancer: a pooled analysis of AIO studies FIRE-1, CIOX, FIRE-3, XELAVIRI, and VOLFI.

BACKGROUND: Primary tumor (PT) sidedness is an established prognostic marker in metastatic colorectal cancer (mCRC) and has a predictive impact on the efficacy of anti-epidermal growth factor receptor (anti-EGFR) antibody [monoclonal antibody (mAb)] in patients with RAS wild-type mCRC. This investigation focuses on patients with BRAFV600E-mutated (BRAFmt) mCRC and examines the efficacy of anti-EGFR mAbs in relation to primary tumor sidedness (PTS). PATIENT AND METHODS: This pooled analysis was carried out using individual patient data from five randomized studies in the first-line setting of mCRC. The population of interest was limited to patients with BRAFmt mCRC and known PTS. For analysis, treatment was stratified into two groups: those treated with anti-EGFR mAbs and those without. Dichotomous variables, such as overall response rate and objective response rate (ORR), were compared using chi-square or Fisher's exact test. Time-to-event endpoints [progression-free survival (PFS) and overall survival (OS)] were analyzed using the Kaplan-Meier method, log-rank test, and Cox regression. An interaction test was carried out via Cox regression. RESULTS: A total of 102 patients with BRAFmt mCRC were identified. The type of targeted therapy (anti-EGFR-based versus non-anti-EGFR) did not significantly impact the outcome. However, in patients with left-sided primary tumors, anti-EGFR mAb-based treatment, compared with non-anti-EGFR, was associated with a higher ORR (58% versus 34%; P < 0.01), trended toward improved PFS [hazard ratio (HR) 0.62; 95% confidence interval (CI) 0.34-1.13; P = 0.12], and demonstrated prolonged OS (HR 0.38; 95% CI 0.20-0.72; P < 0.01). In patients with right-sided primary tumors, anti-EGFR-based therapy had no effect on ORR (33% versus 36%; P > 0.99), induced inferior PFS (HR 1.97; 95% CI 1.12-3.47; P = 0.02), and trended toward a worse OS (HR 1.76; 95% CI 0.99-3.13; P = 0.05). CONCLUSION: This analysis suggests that PTS has predictive value for the efficacy of anti-EGFR mAb in the first-line treatment of BRAFmt mCRC.

School environmental factors, pupils' characteristics, and academic performance: The case of junior high school pupils of the Krachi west district of Ghana.

Background: Data suggest that Ghana has made significant improvements in the educational system, resulting in some accomplishments. Nonetheless, pupils' academic performance at the junior high school level and in the Basic Education Certificate Examination (BECE) remains poor nationally. Some factors have been identified to influence poor academic performance in some parts of Ghana, but none in the Krachi West district. Thus, it has become imperative to determine the local factors accountable for this trend and identify the most appropriate localised solutions. Materials and methods: An embedded research design was employed to ascertain the influence of pupils' characteristics and school environment factors on academic performance. In all, 361 participants (325 BECE candidates, 12 teachers, 12 head teachers and 12 PTA/SMC Chairpersons) were selected using cluster sampling, simple random and purposive sampling across 12 schools in the district. The academic performance of pupils was assessed using scores from six (6) subjects in the standardised district-level mock examination. Results: Based on the examination scores, half of the pupils performed poorly in the six subjects. Even though from the quantitative study, pupils' characteristics had no significant influence on academic performance, school location (ß = -3.29, p < 0.01), school type (ß = 1.15, p < 0.01), and school environmental factors (ß = 0.807, p = 0.024) were significant predictors of academic performance in the district. Pupils in private schools were thrice more likely to achieve average academic performance than pupils from public schools (OR = 3.2, CI = 1.06-9.47). Also, schools with good environmental factors were twice as likely to have average academic performance than schools with poor environmental factors (OR = 2.2 CI = 1.11-4.52). Conclusion: While school environment factors and pupil characteristics have a relationship with academic performance as suggested by the ecological theory, it was established in this study that only school location, school type and school environment factors were the significant predictors of academic performance in the Krachi West District. Therefore, education stakeholders need to consider these predictors when coming up with integrated but local strategies to improve pupils' academic performance in that district.

Strategic location model for oil spill response vessels (OSRVs) considering oil transportation and weather uncertainties.

In the event of oil spills in offshore oil and gas projects, containment and dispersion equipment must be sent to the affected areas within a critical time by vessels known as oil spill response vessels (OSRVs). Here, we developed an optimization tool, integrated with an oil spill trajectory simulation model, both in deterministic and stochastic alternatives, to support decision-making during the strategic planning of OSRV operations. The tool was constructed in Python using GNOME for oil spill simulations and the GUROBI to solve the optimization model. The tool was applied to a case study in Brazil and afforded relevant recommendations. In terms of research contributions, we proved the viability of the integration between oil spill simulation and mathematical modeling for OSRV strategic operation planning, we explored the stochasticity of the problem with an innovative strategy and we demonstrated flexibility and easy applicability of the framework on real operations.

Development of automatic arc sag measurement equipment for tensioned line tightening construction on overhead transmission lines.

Due to the low degree of automation of the existing arc droop measurement device, the tension line digital twin system is not yet able to simulate the change of arc droop in the actual engineering situation in a high degree of real time. To this end, a kind of arc droop automatic measuring equipment applicable to the working condition of tension frame line tightening construction is developed. In terms of hardware, firstly, the STC microcontroller is used to control the motor to achieve free movement of the equipment on the wire. Secondly, the Beidou positioning module is used to collect the spatial coordinates of each point on the wire, thereby obtaining the spatial attitude of the wire and calculating the final sag. Finally, LoRa technology with long transmission distance and low power consumption is selected for wireless transmission of controlled data and collected data. The software system of the device is equipped with the motor's action logic, which cooperates with the hardware to respond to the control commands issued by the terminal. The developed arc droop measurement equipment has been successfully applied in the project, compared with the traditional arc droop observation construction method construction efficiency increased by 28%, the difference between the observation file arc droop and the design arc droop after erection of the line is 1.96%. Digital simulation and remote guidance of arc sag variations by the digital twin system for tension racking lines was realized while ensuring the engineering requirements.

An App for Navigating Patient Transportation and Acute Stroke Care in Northwestern Ontario Using Machine Learning: Retrospective Study.

BACKGROUND: A coordinated care system helps provide timely access to treatment for suspected acute stroke. In Northwestern Ontario (NWO), Canada, communities are widespread with several hospitals offering various diagnostic equipment and services. Thus, resources are limited, and health care providers must often transfer patients with stroke to different hospital locations to ensure the most appropriate care access within recommended time frames. However, health care providers frequently situated temporarily (locum) in NWO or providing care remotely from other areas of Ontario may lack sufficient information and experience in the region to access care for a patient with a time-sensitive condition. Suboptimal decision-making may lead to multiple transfers before definitive stroke care is obtained, resulting in poor outcomes and additional health care system costs. OBJECTIVE: We aimed to develop a tool to inform and assist NWO health care providers in determining the best transfer options for patients with stroke to provide the most efficient care access. We aimed to develop an app using a comprehensive geomapping navigation and estimation system based on machine learning algorithms. This app uses key stroke-related timelines including the last time the patient was known to be well, patient location, treatment options, and imaging availability at different health care facilities. METHODS: Using historical data (2008-2020), an accurate prediction model using machine learning methods was developed and incorporated into a mobile app. These data contained parameters regarding air (Ornge) and land medical transport (3 services), which were preprocessed and cleaned. For cases in which Ornge air services and land ambulance medical transport were both involved in a patient transport process, data were merged and time intervals of the transport journey were determined. The data were distributed for training (35%), testing (35%), and validation (30%) of the prediction model. RESULTS: In total, 70,623 records were collected in the data set from Ornge and land medical transport services to develop a prediction model. Various learning models were analyzed; all learning models perform better than the simple average of all points in predicting output variables. The decision tree model provided more accurate results than the other models. The decision tree model performed remarkably well, with the values from testing, validation, and the model within a close range. This model was used to develop the "NWO Navigate Stroke" system. The system provides accurate results and demonstrates that a mobile app can be a significant tool for health care providers navigating stroke care in NWO, potentially impacting patient care and outcomes. CONCLUSIONS: The NWO Navigate Stroke system uses a data-driven, reliable, accurate prediction model while considering all variations and is simultaneously linked to all required acute stroke management pathways and tools. It was tested using historical data, and the next step will to involve usability testing with end users.

The weekend warrior effect: Consistent intermittent exercise induces persistent cognitive benefits.

Exercise provides a range of cognitive benefits, including improved memory performance. Previously, we demonstrated that 14 days of continuous voluntary wheel-running exercise enables learning in a hippocampus-dependent Object Location Memory (OLM) task under insufficient, subthreshold training conditions in adult mice. Whether similar exercise benefits can be obtained from consistent intermittent exercise as continuous exercise is unknown. Here, we examine whether intermittent exercise (the weekend warrior effect: 2 days of exercise a week for 7 weeks) displays similar or distinct cognitive benefits as previously examined with 14 days of continuous exercise. We find that both continuous and intermittent exercise parameters similarly enable hippocampus-dependent OLM compared to the 2-day exercise control group. Mice receiving intermittent exercise maintained cognitive benefits following a 7-day sedentary delay, whereas mice that underwent 14 continuous days of exercise showed diminished cognitive benefits as previously reported. Further, compared to continuous exercise, intermittent exercise mice exhibited persistently elevated levels of the genes Acvr1c and Bdnf which we know to be critically involved in hippocampus-dependent long-term memory in the dorsal hippocampus. Together findings suggest that consistent intermittent exercise persistently enables hippocampal-dependent long-term memory. Understanding the optimal parameters for persistent cognitive function and the mechanisms mediating persistent effects will aid in therapeutic pursuits investigating the mitigation of cognitive ailments.

Navigating the disappointment of manuscript rejection: An author's dialogue with a reviewer and editor of tropical doctor (TD).

With the majority of medical journals having a rejection rate of >80% of submitted manuscripts, it does come as a shock and as grief to the author who great expectations before submission. Though the majority of literature available does mention how to overcome the lacunae in the manuscript before considering resubmission in another journal, none addresses the mental agony and setback the author faces and the way to overcome this setback. Every author should develop immunity and also be adequately mentally prepared to overcome this misery.

Literature analysis of the location selection studies related to the waste facilities within MCDM approaches.

The increase in waste and related environmental problems is one of the major problems compromising health and environmental quality in urban and rural areas. There are a number of policies that can be implemented to reduce waste, but since it cannot be completely eliminated, recycling and disposal facilities for waste will always be required. Researchers and professionals are currently grappling with the issue of where to locate waste facilities. In the light of all this information, a literature review is presented so that researchers can easily access and systematically review previous studies on the waste facility location selection problem. At this point, in order to reduce the reviewed studies to a reasonable level and to conduct a more organized research, this literature research has conducted within the framework of multi-criteria decision-making (MCDM) approaches, which is one of the most applied methods in location selection problems. The subsequent strengths, weaknesses, opportunities, and threats (SWOT) analysis delves into the strengths, weaknesses, opportunities, and threats in the field, offering a concise guide for future research in waste facility location selection problem. The SWOT analysis highlights the strengths of global environmental awareness and versatile MCDM approaches, while addressing weaknesses in emerging technology integration and potential biases. Opportunities for interdisciplinary collaboration and integration of sustainability metrics provide strategic pathways, but threats such as regulatory changes and limited funding underscore challenges. This analysis serves as a concise guide for future research in waste facility location selection.

The odorant-binding protein genes obp67 and obp56d-like encode products that guide oviposition site selection in the Asian tiger mosquito, Aedes albopictus.

Aedes albopictus is an important vector of arboviruses and prefers small containers of stagnant water as oviposition sites. One of the mechanisms mosquitoes use to search for suitable oviposition sites is relying on odor cues from prospective sites and their surroundings. The genetic and molecular bases of this behavior are not known for Ae. albopictus. Oviposition site-searching behavior can be separated into 2 stages: container location and water detection. We applied a glue compound to the antennae and the maxillary palps of adult females to mask their ability to detect molecules that may guide them to preferred oviposition sites. Treatment of the antennae significantly reduces the location index (P < 0.001), indicating a decreased ability to find oviposition sites, whereas no significant difference was observed in mosquitoes with maxillary palps treated with the same glue compound (P > 0.05). The detection time, measured as the duration from contact with the water surface to the deposition of the first egg, was extended in mosquitoes with treated antennae or maxillary palps, supporting the conclusion that olfaction is involved in the detection of oviposition site. Transcriptomic analysis identified differentially expressed olfactory-related genes, including obp67, obp56d-like, obp19d-like and obp67-like. RNA interference (RNAi)-mediated knockdown of obp67 and obp56d-like significantly affected the location index and detection time, respectively. Cas9/guide RNA-mediated knockout of obp56d-like resulted in a prolonged detection time, compared with the wild type (P < 0.05). These findings help to elucidate aspects of the olfactory mechanisms involved in Ae. albopictus oviposition site selection, and provide a basis for the development of mosquito surveillance and control strategies.

The mechanism for the specificity of gaze direction: Inhibiting background location.

The experiment combined the spatial Stroop paradigm to examine the effect of background location on the perception of arrow or gaze direction in the vertical dimension by manipulating the congruence between the target direction and background location, and to validate a possible cognitive mechanism for gaze direction specificity - inhibiting background location. The results showed that when subjects were required to identify the target direction in a Stroop task (Experiment 1), the gaze cue failed to induce the Stroop effect. However, when subjects were required to judge the congruence between the target direction and the background location (Experiment 2), the gaze cue and the arrow cue both induced the Stroop effect. This suggests that " inhibiting background location" is responsible for the elimination of the spatial Stroop effect by gaze direction, which may one of the mechanisms for gaze direction specificity.

Prognostic impact of tumor location and gene expression profile in sporadic desmoid tumor.

PURPOSE: Prognostic biomarkers remain necessary in sporadic desmoid tumor (DT) because the clinical course is unpredictable. DT location along with gene expression between thoracic and abdominal wall locations was analyzed. METHOD: Sporadic DT patients (GEIS Registry) diagnosed between 1982 and 2018 who underwent upfront surgery were enrolled retrospectively in this study. The primary endpoint was relapse-free survival (RFS). Additionally, the gene expression profile was analyzed in DT localized in the thoracic or abdominal wall, harboring the most frequent CTNNB1 T41A mutation. RESULTS: From a total of 454 DT patients, 197 patients with sporadic DT were selected. The median age was 38.2 years (1.8-89.1) with a male/female distribution of 33.5/66.5. Most of them harbored the CTNNB1 T41A mutation (71.6 %), followed by S45F (17.8 %) and S45P (4.1 %). A significant worse median RFS was associated with males (p = 0.019), tumor size ≥ 6 cm (p = 0.001), extra-abdominal DT location (p < 0.001) and the presence of CTNNB1 S45F mutation (p = 0.013). In the multivariate analysis, extra-abdominal DT location, CTNNB1 S45F mutation and tumor size were independent prognostic biomarkers for worse RFS. DTs harboring the CTNNB1 T41A mutation showed overexpression of DUSP1, SOCS1, EGR1, FOS, LIF, MYC, SGK1, SLC2A3, and IER3, and underexpression of BMP4, PMS2, HOXA9, and WISP1 in thoracic versus abdominal wall locations. CONCLUSION: Sporadic DT location exhibits a different prognosis in terms of RFS favoring the abdominal wall compared to extra-abdominal sites. A differential gene expression profile under the same CTNNB1 T41A mutation is observed in the abdominal wall versus the thoracic wall, mainly affecting the Wnt/ß-catenin, TGFß, IFN, and TNF pathways.

Are Hair Scalp Trace Elements Correlated with Atherosclerosis Location in Coronary Artery Disease?

Coronary artery disease is among the leading current epidemiological challenges. The genetic, clinical, and lifestyle-related risk factors are well documented. The reason for specific epicardial artery locations remains unsolved. The coronary artery topography and blood flow characteristics may induce local inflammatory activation. The atherosclerotic plaque formation is believed to represent inflammatory response involving enzymatic processes co-factored by trace elements. The possible relation between trace elements and coronary artery disease location was the subject of the study. There were 175 patients (107 (61) men and 68 (39) females) in a median (Q1-3) age of 71 years (65-76) admitted for coronary angiography due to chronic coronary syndrome. The angiographic results focused on the percentage of lumen stenosis in certain arteries and were compared with the results for hair scalp trace elements. The correlation between left main coronary artery atherosclerotic plaques and nickel (Ni), zinc (Zn), and antimony (Sb) hair scalp concentration was noted. The analysis revealed a positive relation between left descending artery disease and chromium (Cr), sodium (Na), arsenic (As), and molybdenum (Mo) and a negative correlation with strontium (Sr). The atherosclerotic lesion in the circumflex artery revealed correlations in our analysis with sodium (Na), potassium (K), chromium (Cr), nickel (Ni), arsenic (As), and negative with strontium (Sr) (r) hair scalp concentrations. The negative correlations between right coronary artery disease and magnesium (Mg) and strontium (Sr) concentrations were noted. The possible explanation of different epicardial artery involvement and severity by atherosclerotic processes may lay in their topography and blood rheological characteristics that induce different inflammatory reactions co0factored by specific trace elements. The trace element concentration in the hair scalp may correlate with a particular coronary atherosclerotic involvement, including the severity of lumen reduction. This may indicate the missing link between the pathophysiological processes of atherosclerosis development and its location in coronary arteries.

Optimizing defibrillator deployment with bus-mounted automated external defibrillator.

OBJECTIVES: Early defibrillation with an automated external defibrillator (AED) can effectively improve the survival rate of patients with out-of-hospital cardiac arrest (OHCA). Placing AEDs in public locations can reduce the defibrillation response interval from collapse to defibrillation. Most public AEDs are currently placed in a stationary way (S-AED) with limited coverage area. Bus mounted AED (B-AED) can be delivered directly to the demand point. Although B-AEDs are only available during bus operating hours, they provide greater coverage area. When the number of available AEDs is insufficient, better coverage may be achieved by placing a portion of AEDs as B-AEDs. Our purpose is developing a model to determine the optimal locations of B-AEDs and S-AEDs with a predetermined number of available AEDs. The goal is to maximize the total coverage level of all demand points. METHODS: We proposed a joint location model to place B-AEDs and S-AEDs based on the p-median problem (JPMP). Using data from Chang'an District, Xi'an City, China, we determined the optimal AED deployment. The performance of JPMP was compared with several other models. The coverage results of JPMP are analyzed in details, including the quantity assignment, coverage level, and geographical location of B-AEDs and S-AEDs. The impact of the bus departure intervals on coverage was also discussed. RESULTS: The use of B-AEDs results in an average 98.43% increase in the number of covered demand points, and an average 74.05% increase in total coverage level. In optimal AED deployment, B-AEDs coverage follows an inverted U-shaped curve with increasing number of available AEDs. It begins to decrease when all demand points during the operating hours are covered. With a constant number of available AEDs, the total coverage level increases and then decreases as the bus departure interval increases. The larger the number of available AEDs, the smaller the optimal departure interval. CONCLUSIONS: With a given number of available AEDs, combinational deployment of B-AEDs and S-AEDs significantly improves the coverage level. B-AEDs are recommended when AEDs are insufficient. If more AEDs are available, better coverage can be obtained with reasonable location of S-AEDs and B-AEDs.

Medial Patellofemoral Ligament Injury. Location-Based Rate of Recurrent Patellar Dislocation After Non-Operative Treatment.

OBJECTIVES: The role of the medial patellofemoral ligament (MPFL) as a patellofemoral joint stabilizing structure is undisputable. After traumatic patellar dislocation, MPFL injury, together with bone edema in the medial patellar facet and lateral femoral condyle, is a pathognomonic finding in magnetic resonance imagine. MPFL injury in the femoral insertion has been reported to most likely predict recurrent dislocations. The objective of this study was to detect if any MPFL injury location predicts the earliest onset of the patellar re-dislocation. METHODS: In total, 64 eligible patients with a first-time traumatic patellar dislocation were recruited to the trial. The diagnosis was confirmed within three weeks with 3 Tesla magnetic resonance imaging (MRI). The location of the MPFL injury in MRI was localized at the patellar insertion, midsubstance area, femoral insertion, or a combination of these. During the three-year follow-up period, patellar re-dislocations, range of motion, quadriceps muscle atrophy, and daily symptoms were determined. All the patients were treated non-operatively. RESULTS: Out of 64 patients, 33 (51.6%) had at least one episode of patellar re-dislocation. Re-dislocations occurred in 8 out of 25 (32.0%) patients with the main injury at the femoral insertion, 5 out of 15 (33.3%) patients with the main injury at the midsubstance area, and 10 out of 24 (41.7%) patients with the main injury at the patellar insertion during the 36 months follow-up (p=0.758). According to Kaplan-Meier analysis, the location of MPFL injury did not have statistically significant effect on timing of re-dislocations. At 36 months, survival of patients with MPFL injury at the patellar insertion was 70.8%, which was not statistically significantly different than the survival in patients with injury at the femoral insertion (88.0%) or at the midsubstance area (93.3%). No differences between single and multiple MPFL injuries were found. At 4 weeks, range of motion was more restricted in patients with MPFL injury at the femoral insertion (93.4° vs. 108.0° for injury at the midsubtance area and 107.7° at the patellar insertion). CONCLUSION: The location of MPFL injury did not have statistically significant effect on timing or rate of re-dislocations. The MPFL injury at the femoral insertion predicts decreased ROM of the knee and increased quadriceps muscle atrophy during the first three months after sustaining injury. LEVEL OF EVIDENCE: Level III.

Intraoperative 3D fluoroscopy accurately predicts final electrode position in deep brain stimulation surgery.

PURPOSE: In the absence of an intraoperative CT or MRI setup, post-implantation confirmation of electrode position in deep brain stimulation (DBS) requires patient transportation to the radiology unit, prolonging surgery time. This project aims to validate intraoperative 3D fluoroscopy (3DF), a widely available tool in Neurosurgical units, as a method to determine final electrode position. METHODS: We performed a retrospective study including 64 patients (124 electrodes) who underwent DBS at our institution. Intraoperative 3DF after electrode implantation and postoperative volumetric CT were acquired. The Euclidean coordinates of the electrode tip displayed in both imaging modalities were determined and inter-method deviations were assessed. Pneumocephalus was quantified and its potential impact in determining the electrode position analyzed. Finally, 3DF and CT-imposed exposure to radiation was compared. RESULTS: The difference between the electrode tip estimated by 3DF and CT was 0.85 ± 0.03 mm, and not significantly different (p = 0.11 for the distance to MCP assessed by both methods), but was, instead, highly correlated (p = 0.91; p < 0.0001). Even though pneumocephalus was larger in 3DF (6.89 ± 1.76 vs 5.18 ± 1.37 mm3 in the CT group, p < 0.001), it was not correlated with the difference in electrode position measured by both techniques (p = 0.17; p = 0.06). Radiation exposure from 3DF is significantly lower than CT (0.36 ± 0.03 vs 2.08 ± 0.05 mSv; p < 0.0001). CONCLUSIONS: Intraoperative 3DF is comparable to CT in determining the final DBS electrode position. Being a method with fewer radiation exposure, less expensive, faster and that avoids patient transportation outside the operation room, it is a valid tool to replace postoperative CT.

The impact of His bundle location and direction on the efficacy and safety of ablation.

BACKGROUND: The impact of the His bundle location and distance from the ablation site on ablation efficacy and complication risk remains unexplored. We determined the correlation between age, height, body mass index (BMI), and the His bundle location, and whether the distance between the His bundle and ablation target (DHIS-ABL) affects ablation safety and efficacy. METHODS: Overall, 346 patients with atrioventricular nodal re-entrant tachycardia (AVNRT) and 96 with atrioventricular re-entrant tachycardia (AVRT) were retrospectively analyzed. The distance between the His bundle and the coronary sinus ostium (DHis-CS), the height of the His bundle (HHIS), and DHIS-ABL were measured. Electrocardiograms were obtained 3 months post-ablation to assess recurrence and complications. RESULTS: Multiple linear regression showed that HHIS was negatively correlated with age in both groups. In AVNRT patients, DHIS-ABL was associated with age, height, and BMI; DHIS-CS was only negatively correlated with age. In AVRT patients, there was no significant correlation between the DHIS-ABL and age, height, or BMI. The recurrence rates in the AVNRT and AVRT groups were 0.9% and 8.7%, respectively. Subgroup analysis showed that patients with DHIS-ABL ≤ 10 mm had a higher recurrence rate than those with DHIS-ABL > 10 mm (p = .013). The incidence of third-degree atrioventricular block (AVB) complications was 0.2%. CONCLUSIONS: HHIS was negatively correlated with age but not with height and BMI. The DHIS-ABL correlated with age, height, and BMI in AVNRT patients. A short DHIS-ABL led to a higher rate of supraventricular tachycardia recurrence; whether this affects AVB risk warrants further studies with larger sample sizes.

Preliminary findings on the experiences of care for women who suffered early pregnancy losses during the COVID-19 pandemic: a qualitative study.

BACKGROUND: Women who suffer an early pregnancy loss require specific clinical care, aftercare, and ongoing support. In the UK, the clinical management of early pregnancy complications, including loss is provided mainly through specialist Early Pregnancy Assessment Units. The COVID-19 pandemic fundamentally changed the way in which maternity and gynaecological care was delivered, as health systems moved to rapidly reconfigure and re-organise services, aiming to reduce the risk and spread of SARS-CoV-2 infection. PUDDLES is an international collaboration investigating the pandemic's impact on care for people who suffered a perinatal bereavement. Presented here are initial qualitative findings undertaken with UK-based women who suffered early pregnancy losses during the pandemic, about how they navigated the healthcare system and its restrictions, and how they were supported. METHODS: In-keeping with a qualitative research design, in-depth semi-structured interviews were undertaken with an opportunity sample of women (N = 32) who suffered any early pregnancy loss during the COVID-19 pandemic. Data were analysed using a template analysis to understand women's access to services, care, and networks of support, during the pandemic following their pregnancy loss. The thematic template was based on findings from parents who had suffered a late-miscarriage, stillbirth, or neonatal death in the UK, during the pandemic. RESULTS: All women had experienced reconfigured maternity and early pregnancy services. Data supported themes of: 1) COVID-19 Restrictions as Impractical & Impersonal; 2) Alone, with Only Staff to Support Them; 3) Reduction in Service Provision Leading to Perceived Devaluation in Care; and 4) Seeking Their Own Support. Results suggest access to early pregnancy loss services was reduced and pandemic-related restrictions were often impractical (i.e., restrictions added to burden of accessing or receiving care). Women often reported being isolated and, concerningly, aspects of early pregnancy loss services were reported as sub-optimal. CONCLUSIONS: These findings provide important insight for the recovery and rebuilding of health services in the post-pandemic period and help us prepare for providing a higher standard of care in the future and through any other health system shocks. Conclusions made can inform future policy and planning to ensure best possible support for women who experience early pregnancy loss.

Augmented future: tracing the trajectory of location-based augmented reality gaming for the next ten years.

Location-based games are a highly technology-dependent game genre that has witnessed an exponential increase in popularity with the democratisation of smartphones as well as ubiquitous mobile data and access to satellite navigation. Moving forward into the future, location-based games can be expected to evolve as the technologies underlying the genre improve. In this conceptual work, we review the current state of the art in location-based games, and identify key trajectories and trends. We discovered 12 trends, based on which we jump ten years into the future and evaluate how current technology trends may end up influencing location-based gaming. For example, we propose that in the year 2035 through improvements in map data services and sensor data coverage, we will see locative games that are increasingly connected to elements in the physical world. We also expect to see gameplay that moves away from solely taking place on a smartphone screen to the adoption of multiple forms of interactions with location-based game worlds, especially as head-mounted displays and other wearables become more commonplace.