Study protocol of a randomized control trial on the effectiveness of improvisational music therapy for autistic children.

BACKGROUND: Music therapy is the clinical use of musical interventions to improve mental and physical health across multiple domains, including social communication. Autistic children, who have difficulties in social communication and often increased anxiety, tend to show a strong preference for music, because it can be structured and systematic, and therefore more predictable than social interaction. This makes music therapy a promising medium for therapeutic support and intervention. Previous clinical trials of music therapy compared to traditional therapy for autistic children have shown encouraging but nevertheless mixed results. KEY AIMS: The primary aim is to conduct a randomised controlled trial (RCT) of improvisational music therapy for autistic children and test its effectiveness in at improving social communication and wellbeing, and to reduce anxiety. RESEARCH PLAN: The RCT will be conducted with 200 autistic children in the UK aged 7 to 11 years old. Participants will be randomly assigned to either improvisational music therapy or support as usual. The trial will be an assessor-blind, pragmatic two-arm cluster RCT comparing the impact of 12-weeks of improvisational music therapy in addition to support as usual, vs. support as usual for autistic children. METHODS: Researchers who are blind to which arm the children are in will conduct assessments and obtain data via caregiver reports. The primary outcome will be the absolute change in the total score of the Brief Observation of Social Communication Change (BOSCC) assessed at baseline, T1 (13 weeks) and T2 (39 weeks) follow-ups. The BOSCC consists of specific items that were developed to identify changes in social-communication behaviours. Secondary outcome measures include: (1) Parent reported anxiety scale for youth with ASD (Note that we do not use the term 'ASD' or Autism Spectrum Disorder, because many autistic people feel it is stigmatising. Instead, we use the term 'autism') (PRAS-ASD) (2) Young Child Outcome Rating Scale, for wellbeing (YCORS), (3) Strengths and Difficulties Questionnaire (SDQ); and (4) Vineland Adaptive Behaviour Scale (VABS). (5) The Children's Communication Checklist-2 (CCC-2) will be completed to evaluate pragmatic speech with fluent speakers only; (6) The Music Engagement Scale (MES); and (7) Assessment of the Quality of Relationship (AQR) will be used to evaluate the child-therapist relationships using video-analysis of music therapy sessions. Additional data will be collected by administering the Wechsler Abbreviated Scale of Intelligence (WASI-II), Music at Home Questionnaire (M@H), and children's versions of the Empathy Quotient (EQ) and Systemizing Quotient (SQ). Audio and video data from the therapy sessions will be collected and analysed (using both human and computer-based feature-coding, e.g., machine learning and AI-driven methods) to identify how music and non-musical interactions foster change throughout the therapy. DISCUSSION: This study aims to observe if the interactions, engagement, and therapeutic modalities fostered during music therapy sessions can translate to non-musical contexts and improve autistic children's social communication skills, identifying possible mediating factors contributing to the effectiveness of music therapy, potentially informing policy making and governance. TRIAL REGISTRATION: This randomised control trial is registered with the NIH U.S. National Library of Medicine:  https://clinicaltrials.gov/search?term=NCT06016621 , clinicalTrials.gov Identifier: NCT0601662, Registration Date 19th August 2023.

Experiences of Inpatient Healthcare Services Among Children With Medical Complexity and Their Families: A Scoping Review.

BACKGROUND: Children with medical complexity (CMC) have high healthcare utilization and face unique challenges during hospital admissions. The evidence describing their experiences of inpatient care is distributed across disciplines. The aim of this scoping review was to map the evidence related to the inpatient experience of care for CMC and their families, particularly related to key aspects and methodological approaches, and identify gaps that warrant further study. METHODS: This scoping review was conducted in accordance with JBI methodology and included all studies that reported experiences of acute hospital care for CMC/families. All study designs were included. Databases searched included EMBASE, CINAHL Plus with Full Text, Web of Science, MEDLINE(R) and APA PsycInfo from 2000 to 2022. Details about the participants, concepts, study methods and key findings were abstracted using a data abstraction tool. A thematic analysis was conducted. RESULTS: Forty-nine papers were included: 27 qualitative studies, 10 quantitative studies, six mixed methods studies, two descriptive studies and four reviews. Some quantitative studies used validated instruments to measure experience of care, but many used non-validated surveys. There were a few interventional studies with a small sample size. Results of thematic analysis described the importance of negotiating care roles, shared decision-making, common goal setting, relationship-building, communication, sharing expertise and the hospital setting itself. CONCLUSION: CMC and families value relational elements of care and partnering through sharing expertise, decision-making and collaborative goal-setting when admitted to hospital. PATIENT OR PUBLIC CONTRIBUTION: This review was conducted in alignment with the principles of patient and family engagement. The review was conceptualized, co-designed and conducted with the full engagement of the project's parent-partner. This team member was involved in all stages from constructing the review question, to developing the protocol, screening articles and drafting this manuscript.

The impact of inter-limb leg lean tissue mass asymmetry on stair climb performance in career firefighters.

The purpose of this study was to examine the influence of inter-limb leg lean tissue mass (LTM) asymmetry on stair climb (SC) performance in firefighters. Forty-one career firefighters (age = 32.3 ± 8.2 years, body mass = 92.1 ± 18.6 kg, stature = 178.3 ± 7.9 cm) visited the laboratory on one occasion and completed a whole body and leg composition assessment followed by a timed and weighted SC task. Percent body fat (%BF) and leg LTM were determined during a DEXA scan and regional thigh analysis. Asymmetry was assessed by the percent difference between limbs (dominant limb LTM - non-dominant limb LTM)/dominant limb LTM × 100) and a ± 3% cut-off for asymmetry classification. Participants ascended and descended 26 stairs four times as quickly as possible while wearing a weighted (22 kg) vest. Point biserial correlations were used to assess the relationship of inter-limb leg LTM asymmetry and SC performance before and after controlling for age and %BF. Results indicated that inter-limb leg LTM asymmetry was associated with longer SC task time (poorer performance) both before (r = 0.432, P = 0.005) and after (r = 0.502, P = 0.001) controlling for age and %BF. Our findings indicated that inter-limb leg LTM asymmetry negatively impacts firefighter SC performance, which may be improved with appropriate exercise interventions.

This study examined the influence of leg inter-limb lean tissue mass (LTM) asymmetry on SC performance in career firefighters. We found that inter-limb leg LTM asymmetry was associated with reduced SC performance, prior to and after controlling for age and percent body fat. Interventions that mitigate these asymmetries may improve occupational performance.

Ethyl Cellulose-Based Thermoreversible Organogel Photoresist for Sedimentation-Free Volumetric Additive Manufacturing.

Liquid photoresists are abundant in the field of light-based additive manufacturing (AM). However, printing unsupported directly into a vat of material in emerging volumetric AM technologies-typically a benefit due to fewer geometric constraints and less material waste-can be a limitation when printing low-viscosity liquid monomers and multimaterial constructs due to part drift or sedimentation. With ethyl cellulose (EC), a thermoplastic soluble in organic liquids, a simple three-component transparent thermoreversible gel photoresist with melting temperature of ≈64 °C is formulated. The physically crosslinked network of the gel leads to storage moduli in the range of 0.1-10 kPa and maximum yield stress of 2.7 kPa for a 10 wt% EC gel photoresist. Nonzero yield stress enables sedimentation-free tomographic volumetric patterning in low-viscosity monomer without additional hardware or modification of apparatus. In addition, objects inserted into the print container can be suspended in the gel material which enables overprinting of multimaterial devices without anchors connecting the object to the printing container. Flexural strength is also improved by 100% compared to the neat monomer for a formulation with 7 wt% EC.

When should an athlete retire or discontinue participating in contact or collision sports following sport-related concussion? A systematic review.

OBJECTIVE: To systematically review the scientific literature regarding factors to consider when providing advice or guidance to athletes about retirement from contact or collision sport following sport-related concussion (SRC), and to define contraindications to children/adolescent athletes entering or continuing with contact or collision sports after SRC. DATA SOURCES: Medline, Embase, SPORTSDiscus, APA PsycINFO, CINAHL and Cochrane Central Register of Controlled Trials were searched systematically. STUDY ELIGIBILITY CRITERIA: Studies were included if they were (1) original research, (2) reported on SRC as the primary source of injury, (3) evaluated the history, clinical assessment and/or investigation of findings that may preclude participation in sport and (4) evaluated mood disturbance and/or neurocognitive deficits, evidence of structural brain injury or risk factors for increased risk of subsequent SRC or prolonged recovery. RESULTS: Of 4355 articles identified, 93 met the inclusion criteria. None of the included articles directly examined retirement and/or discontinuation from contact or collision sport. Included studies examined factors associated with increased risk of recurrent SRC or prolonged recovery following SRC. In general, these were low-quality cohort studies with heterogeneous results and moderate risk of bias. Higher number and/or severity of symptoms at presentation, sleep disturbance and symptom reproduction with Vestibular Ocular Motor Screen testing were associated with prolonged recovery and history of previous concussion was associated with a risk of further SRC. CONCLUSION: No evidence was identified to support the inclusion of any patient-specific, injury-specific or other factors (eg, imaging findings) as absolute indications for retirement or discontinued participation in contact or collision sport following SRC. PROSPERO REGISTRATION NUMBER: CRD42022155121.

Examining later-in-life health risks associated with sport-related concussion and repetitive head impacts: a systematic review of case-control and cohort studies.

OBJECTIVE: Concern exists about possible problems with later-in-life brain health, such as cognitive impairment, mental health problems and neurological diseases, in former athletes. We examined the future risk for adverse health effects associated with sport-related concussion, or exposure to repetitive head impacts, in former athletes. DESIGN: Systematic review. DATA SOURCES: Search of MEDLINE, Embase, Cochrane, CINAHL Plus and SPORTDiscus in October 2019 and updated in March 2022. ELIGIBILITY CRITERIA: Studies measuring future risk (cohort studies) or approximating that risk (case-control studies). RESULTS: Ten studies of former amateur athletes and 18 studies of former professional athletes were included. No postmortem neuropathology studies or neuroimaging studies met criteria for inclusion. Depression was examined in five studies in former amateur athletes, none identifying an increased risk. Nine studies examined suicidality or suicide as a manner of death, and none found an association with increased risk. Some studies comparing professional athletes with the general population reported associations between sports participation and dementia or amyotrophic lateral sclerosis (ALS) as a cause of death. Most did not control for potential confounding factors (eg, genetic, demographic, health-related or environmental), were ecological in design and had high risk of bias. CONCLUSION: Evidence does not support an increased risk of mental health or neurological diseases in former amateur athletes with exposure to repetitive head impacts. Some studies in former professional athletes suggest an increased risk of neurological disorders such as ALS and dementia; these findings need to be confirmed in higher quality studies with better control of confounding factors. PROSPERO REGISTRATION NUMBER: CRD42022159486.

Targeted interventions and their effect on recovery in children, adolescents and adults who have sustained a sport-related concussion: a systematic review.

OBJECTIVES: We evaluated interventions to facilitate recovery in children, adolescents and adults with a sport-related concussion (SRC). DESIGN: Systematic review including risk of bias (modified Scottish Intercollegiate Guidelines Network tool). DATA SOURCES: MEDLINE(R) and Epub Ahead of Print, In-Process & Other Non-Indexed Citations, Embase, APA PsycINFO, Cochrane Central Register of Controlled Trials, CINAHL Plus with Full Text, SPORTDiscus and Scopus searched until March 2022. STUDY ELIGIBILITY CRITERIA: (1) Original research including randomised controlled trials (RCTs), quasi-experimental designs, cohort, comparative effectiveness studies; (2) focus on SRC; (3) English; (4) peer-reviewed and (5) evaluated treatment. RESULTS: 6533 studies were screened, 154 full texts reviewed and 13 met inclusion (10 RCTs, 1 quasi-experimental and 2 cohort studies; 1 high-quality study, 7 acceptable and 5 at high risk of bias). Interventions, comparisons, timing and outcomes varied, precluding meta-analysis. For adolescents and adults with dizziness, neck pain and/or headaches >10 days following concussion, individualised cervicovestibular rehabilitation may decrease time to return to sport compared with rest followed by gradual exertion (HR 3.91 (95% CI 1.34 to 11.34)) and when compared with a subtherapeutic intervention (HR 2.91 (95% CI 1.01 to 8.43)). For adolescents with vestibular symptoms/impairments, vestibular rehabilitation may decrease time to medical clearance (vestibular rehab group 50.2 days (95% CI 39.9 to 60.4) compared with control 58.4 (95% CI 41.7 to 75.3) days). For adolescents with persisting symptoms >30 days, active rehabilitation and collaborative care may decrease symptoms. CONCLUSIONS: Cervicovestibular rehabilitation is recommended for adolescents and adults with dizziness, neck pain and/or headaches for >10 days. Vestibular rehabilitation (for adolescents with dizziness/vestibular impairments >5 days) and active rehabilitation and/or collaborative care (for adolescents with persisting symptoms >30 days) may be of benefit.

Amsterdam 2022 process: A summary of the methodology for the Amsterdam International Consensus on Concussion in Sport.

The purpose of this paper is to summarise the consensus methodology that was used to inform the International Consensus Statement on Concussion in Sport (Amsterdam 2022). Building on a Delphi process to inform the questions and outcomes from the 5th International Conference on Concussion in Sport, the Scientific Committee identified key questions, the answers to which would help encapsulate the current science in sport-related concussion and help guide clinical practice. Over 3½ years, delayed by 2 years due to the pandemic, author groups conducted systematic reviews on each selected topic. The 6th International Conference on Concussion in Sport was held in Amsterdam (27-30 October 2022) and consisted of 2 days of systematic review presentations, panel discussions, question and answer engagement with the 600 attendees, and abstract presentations. This was followed by a closed third day of consensus deliberations by an expert panel of 29 with observers in attendance. The fourth day, also closed, was dedicated to a workshop to discuss and refine the sports concussion tools (Concussion Recognition Tool 6 (CRT6), Sport Concussion Assessment Tool 6 (SCAT6), Child SCAT6, Sport Concussion Office Assessment Tool 6 (SCOAT6) and Child SCOAT6). We include a summary of recommendations for methodological improvements for future research that grew out of the systematic reviews.

Solving the plastic dilemma: the fungal and bacterial biodegradability of polyurethanes.

Polyurethane (PU) is a plastic polymer which, due to its various desirable characteristics, has been applied extensively in domestic, industrial and medical fields for the past 50 years. Subsequently, an increasing amount of PU waste is generated annually. PU, like many other plastics, is highly resistant to degradation and is a substantial threat to our environment. Currently PU wastes are handled through conventional disposal techniques such as landfill, incineration and recycling. Due to the many drawbacks of these techniques, a 'greener' alternative is necessary, and biodegradation appears to be the most promising option. Biodegradation has the potential to completely mineralise plastic waste or recover the input materials and better enable recycling. There are hurdles to overcome however, primarily the efficiency of the process and the presence of waste plastics with inherently different chemical structures. This review will focus on polyurethanes and their biodegradation, outlining the difficulty of degrading different versions of the same material and strategies for achieving more efficient biodegradation.

Lens-free motion analysis via neuromorphic laser speckle imaging.

Laser speckle imaging (LSI) is a powerful tool for motion analysis owing to the high sensitivity of laser speckles. Traditional LSI techniques rely on identifying changes from the sequential intensity speckle patterns, where each pixel performs synchronous measurements. However, a lot of redundant data of the static speckles without motion information in the scene will also be recorded, resulting in considerable resources consumption for data processing and storage. Moreover, the motion cues are inevitably lost during the "blind" time interval between successive frames. To tackle such challenges, we propose neuromorphic laser speckle imaging (NLSI) as an efficient alternative approach for motion analysis. Our method preserves the motion information while excluding the redundant data by exploring the use of the neuromorphic event sensor, which acquires only the relevant information of the moving parts and responds asynchronously with a much higher sampling rate. This neuromorphic data acquisition mechanism captures fast-moving objects on the order of microseconds. In the proposed NLSI method, the moving object is illuminated using a coherent light source, and the reflected high frequency laser speckle patterns are captured with a bare neuromorphic event sensor. We present the data processing strategy to analyze motion from event-based laser speckles, and the experimental results demonstrate the feasibility of our method at different motion speeds.

Latent image volumetric additive manufacturing.

Volumetric additive manufacturing (VAM) enables rapid printing into a wide range of materials, offering significant advantages over other printing technologies, with a lack of inherent layering of particular note. However, VAM suffers from striations, similar in appearance to layers, and similarly limiting applications due to mechanical and refractive index inhomogeneity, surface roughness, etc. We hypothesize that these striations are caused by a self-written waveguide effect, driven by the gelation material nonlinearity upon which VAM relies, and that they are not a direct recording of non-uniform patterning beams. We demonstrate a simple and effective method of mitigating striations via a uniform optical exposure added to the end of any VAM printing process. We show this step to additionally shorten the period from initial gelation to print completion, mitigating the problem of partially gelled parts sinking before print completion, and expanding the range of resins printable in any VAM printer.

Compassion in healthcare: an updated scoping review of the literature.

BACKGROUND: A previous review on compassion in healthcare (1988-2014) identified several empirical studies and their limitations. Given the large influx and the disparate nature of the topic within the healthcare literature over the past 5 years, the objective of this study was to provide an update to our original scoping review to provide a current and comprehensive map of the literature to guide future research and to identify gaps and limitations that remain unaddressed. METHODS: Eight electronic databases along with the grey literature were searched to identify empirical studies published between 2015 and 2020. Of focus were studies that aimed to explore compassion within the clinical setting, or interventions or educational programs for improving compassion, sampling clinicians and/or patient populations. Following title and abstract review, two reviewers independently screened full-text articles, and performed data extraction. Utilizing a narrative synthesis approach, data were mapped onto the categories, themes, and subthemes that were identified in the original review. Newly identified categories were discussed among the team until consensus was achieved. RESULTS: Of the 14,166 number of records identified, 5263 remained after removal of duplicates, and 50 articles were included in the final review. Studies were predominantly conducted in the UK and were qualitative in design. In contrast to the original review, a larger number of studies sampled solely patients (n = 12), and the remainder focused on clinicians (n = 27) or a mix of clinicians and other (e.g. patients and/or family members) (n = 11). Forty-six studies explored perspectives on the nature of compassion or compassionate behaviours, traversing six themes: nature of compassion, development of compassion, interpersonal factors related to compassion, action and practical compassion, barriers and enablers of compassion, and outcomes of compassion. Four studies reported on the category of educational or clinical interventions, a notable decrease compared to the 10 studies identified in the original review. CONCLUSIONS: Since the original scoping review on compassion in healthcare, while a greater number of studies incorporated patient perspectives, clinical or educational interventions appeared to be limited. More efficacious and evidence-based interventions or training programs tailored towards improving compassion for patients in healthcare is required.

Self-care Practices of Patients With Heart Failure Using Wearable Electronic Devices: A Systematic Review.

BACKGROUND: Heart failure (HF) is the fastest growing cardiovascular condition globally; associated management costs and hospitalizations place an immense burden on healthcare systems. Wearable electronic devices (WEDs) may be useful tools to enhance HF management and mitigate negative health outcomes. OBJECTIVE: We aimed to perform a systematic review to examine the potential of WEDs to support HF self-care in ambulatory patients at home. METHODS: Five databases were searched for studies published between 2007 and May 2022, including OVID MEDLINE, EMBASE (OVID), APA PsycINFO (OVID), Cochrane Central Register of Controlled Trials (OVID), and CINAHL Plus with Full Text (Ebsco). After 6210 duplicates were removed, 4045 records were screened and 6 were included for review (2 conference abstracts and 4 full-text citations). All studies used WEDs as 1 component of a larger intervention. RESULTS: Outcome measures included quality of life, physical activity, self-efficacy, self-care, functional status, time to readmission, social isolation, and mood. Studies were of moderate to high quality and mixed findings were reported. Enhanced exercise habits and motivational behavior to exercise, as well as decreased adverse symptoms of fatigue and dyspnea, were identified in 2 studies. However, improvements in exercise capacity and increased motivational behavior did not lead to exercise adherence in another 2 studies. CONCLUSIONS: The findings from this review suggest that WEDs may be a viable health behavior improvement strategy for patients with HF. However, studies of higher quality, with the primary intervention being a WED, and consistent outcome measures are needed to replicate the positive findings of studies identified in this review.

The impact of repeated bouts of shiftwork on rapid strength and reaction time in career firefighters.

The purpose of this study was to examine the influence of repeated bouts of shiftwork on lower extremity maximal and rapid strength and reaction time in career firefighters. Thirty-five firefighters (3 females; 34.3 ± 9.1 years) performed a psychomotor vigilance test (PVT) and reactive maximal isometric strength assessment prior to and following a full shift rotation (three 24-hr on-off shifts). Reaction time (RT), maximal, absolute and normalised rapid strength (50, 100, 150, 200 ms), and PVT measures were assessed on-site. Separate linear regression models were used to evaluate the POST-PRE change in variables adjusted for BMI, age, sleep, and call duration. Early (50 ms) absolute rapid strength was the only variable significantly reduced (-25.9%; p = 0.031) following the full shift rotation. Our findings indicate that early rapid strength may be a sensitive measure in detecting work-related fatigue, despite minimal changes in sleep between work and non-work nights and a low call duration. Practitioner summary: We examined the impact of repeated shiftwork on changes in reaction time and neuromuscular function. Early rapid strength was a sensitive, portable lab assessment that feasibly measured work-related fatigue in career firefighters. Interventions that mitigate work-related fatigue may be impactful at preventing falls and/or risk of musculoskeletal injury.

PARC: ultrafast and accurate clustering of phenotypic data of millions of single cells.

MOTIVATION: New single-cell technologies continue to fuel the explosive growth in the scale of heterogeneous single-cell data. However, existing computational methods are inadequately scalable to large datasets and therefore cannot uncover the complex cellular heterogeneity. RESULTS: We introduce a highly scalable graph-based clustering algorithm PARC-Phenotyping by Accelerated Refined Community-partitioning-for large-scale, high-dimensional single-cell data (>1 million cells). Using large single-cell flow and mass cytometry, RNA-seq and imaging-based biophysical data, we demonstrate that PARC consistently outperforms state-of-the-art clustering algorithms without subsampling of cells, including Phenograph, FlowSOM and Flock, in terms of both speed and ability to robustly detect rare cell populations. For example, PARC can cluster a single-cell dataset of 1.1 million cells within 13 min, compared with >2 h for the next fastest graph-clustering algorithm. Our work presents a scalable algorithm to cope with increasingly large-scale single-cell analysis. AVAILABILITY AND IMPLEMENTATION: https://github.com/ShobiStassen/PARC. SUPPLEMENTARY INFORMATION: Supplementary data are available at Bioinformatics online.

Event-based laser speckle correlation for micro motion estimation.

Micro motion estimation has important applications in various fields such as microfluidic particle detection and biomedical cell imaging. Conventional methods analyze the motion from intensity images captured using frame-based imaging sensors such as the complementary metal-oxide semiconductor (CMOS) and the charge-coupled device (CCD). Recently, event-based sensors have evolved with the special capability to record asynchronous light changes with high dynamic range, high temporal resolution, low latency, and no motion blur. In this Letter, we explore the potential of using the event sensor to estimate the micro motion based on the laser speckle correlation technique.

Event-based laser speckle correlation for micro motion estimation: erratum.

We present an erratum to our Letter [Opt. Lett.46, 3885 (2021)OPLEDP0146-959210.1364/OL.430419]. This erratum corrects an inadvertent error in Eq. (4). The corrections have no influence on the results and conclusions of the original Letter.

What works for whom in compassion training programs offered to practicing healthcare providers: a realist review.

BACKGROUND: Patients and families want their healthcare to be delivered by healthcare providers that are both competent and compassionate. While compassion training has begun to emerge in healthcare education, there may be factors that facilitate or inhibit the uptake and implementation of training into practice. This review identified the attributes that explain the successes and/or failures of compassion training programs offered to practicing healthcare providers. METHODS: Realist review methodology for knowledge synthesis was used to consider the contexts, mechanisms (resources and reasoning), and outcomes of compassion training for practicing healthcare providers to determine what works, for whom, and in what contexts. RESULTS: Two thousand nine hundred ninety-one articles underwent title and abstract screening, 53 articles underwent full text review, and data that contributed to the development of a program theory were extracted from 45 articles. Contexts included the clinical setting, healthcare provider characteristics, current state of the healthcare system, and personal factors relevant to individual healthcare providers. Mechanisms included workplace-based programs and participatory interventions that impacted teaching, learning, and the healthcare organization. Contexts were associated with certain mechanisms to effect change in learners' attitudes, knowledge, skills and behaviors and the clinical process. CONCLUSIONS: In conclusion this realist review determined that compassion training may engender compassionate healthcare practice if it becomes a key component of the infrastructure and vision of healthcare organizations, engages institutional participation, improves leadership at all levels, adopts a multimodal approach, and uses valid measures to assess outcomes.

RedCap: residual encoder-decoder capsule network for holographic image reconstruction.

A capsule network, as an advanced technique in deep learning, is designed to overcome information loss in the pooling operation and internal data representation of a convolutional neural network (CNN). It has shown promising results in several applications, such as digit recognition and image segmentation. In this work, we investigate for the first time the use of capsule network in digital holographic reconstruction. The proposed residual encoder-decoder capsule network, which we call RedCap, uses a novel windowed spatial dynamic routing algorithm and residual capsule block, which extends the idea of a residual block. Compared with the CNN-based neural network, RedCap exhibits much better experimental results in digital holographic reconstruction, while having a dramatic 75% reduction in the number of parameters. It indicates that RedCap is more efficient in the way it processes data and requires a much less memory storage for the learned model, which therefore makes it possible to be applied to some challenging situations with limited computational resources, such as portable devices.

Transition in Care from EMS Providers to Emergency Department Nurses: A Systematic Review.

Background: Transitions in care between emergency medical services (EMS) providers and emergency department (ED) nurses are critical to patient care and safety. However, interactions between EMS providers and ED nurses can be problematic with communication gaps and have not been extensively studied. The aim of this review was to examine (1) factors that influence transitions in care from EMS providers to ED nurses and (2) the effectiveness of interventional strategies to improve these transitions. Methods: We conducted a mixed-methods systematic review that included searches of electronic databases (DARE, MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, CINAHL, Joanna Briggs Institute EBP), gray literature databases, organization websites, querying experts in emergency medicine, and the reference lists cited in included studies. All English-language studies of any design were eligible for inclusion. Two reviewers independently screened titles/abstracts and full-texts for inclusion and methodological quality, as well as extracted data from included studies. We used narrative and thematic synthesis to integrate and explore relationships within the data. Results: In total, 8,348 studies were screened and 130 selected for full text review. The final synthesis included 20 studies. Across 15 studies of moderate-to-high methodological quality, 6 factors influenced transitions: different professional lenses, operational constraints, professional relationships, information shared between the professions, components of the transition process, and patient presentation and involvement. Three interventions were identified in 6 methodologically weak studies: (1) transition guideline (DeMIST, Identification, Mechanism/Medical complaint, Injuries/Information related to the complaint, Signs, Treatment and Trends - Allergies, Medication, Background history, Other information [IMIST-AMBO]) with training, (2) mobile web-based technology (EMS smartphone and geographic information system location data), and (3) a new clinical role (ED ambulance off-load nurse dedicated to triaging and assessing EMS patients). There were mixed findings for the effectiveness of transition guidelines and the new clinical role. Mobile technology was seen positively by both EMS providers and ED nurses as helpful for better describing the pre-hospital context and for planning flow in the ED. Conclusion: While multimedia applications may potentially improve the handoff process, future intervention studies need to be rigorously designed. We recommend interdisciplinary training of EMS and ED staff in the use of flexible structured protocols, especially given review findings that interdisciplinary communication and relationships can be challenging.