Development and application of a nitrogen oxides analyzer based on the cavity attenuated phase shift technique.

Nitrogen oxides (NOx) are crucial in tropospheric photochemical ozone (O3) production and oxidation capacity. Currently, the widely used NOx measurement technique is chemiluminescence (CL) (CL-NOx), which tends to overestimate NO2 due to atmospheric oxidation products of NOx (i.e., NOz). We developed and characterized a NOx measurement system using the cavity attenuated phase shift (CAPS) technique (CAPS-NOx), which is free from interferences with nitrogen-containing species. The NOx measured by the CAPS-NOx and CL-NOx analyzers were compared. Results show that both analyzers showed consistent measurement results for NO, but the NO2 measured by the CAPS-NOx analyzer (NO2_CAPS) was mostly lower than that measured by the CL-NOx analyzer (NO2_CL), which led to the deviations in O3 formation sensitivity regime and Ox (= O3 + NO2) sources (i.e., regional background and photochemically produced Ox) determined by the ozone production efficiencies (OPE) calculated from NO2_CL and NO2_CAPS. Overall, OPE_CL exceeded OPE_CAPS by 18.9%, which shifted 3 out of 13 observation days from the VOCs-limited to the transition regime when judging using OPE_CL, as compared to calculations using OPE_CAPS. During the observation period, days dominated by regional background Ox accounted for 46% and 62% when determined using NO2_CL and NO2_CAPS, respectively. These findings suggest that the use of the CL-NOx analyzer tends to underestimate both the VOCs-limited regime and the regional background Ox dominated days. The newly built CAPS-NOx analyzer here can promote the accurate measurement of NO2, which is meaningful for diagnosing O3 formation regimes and Ox sources.

La aplicación del saber médico. Hipertensión y daño cognitivo

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Introduction: High blood pressure (HBP) is the leading cause of death from cardiovascular disease. Despite the advances, the percentage of undiagnosed and untreated hypertensive patients is 58.4%. The evaluation of cognitive damage in HBP focuses on preventing stroke, while functional damage is ignored. This inadequate management may be multifactorial. The objective was to analyze the opinions that doctors have about the relationship between high blood pressure and cognitive damage. Methodology: Observational, descriptive, cross-sectional study developed in the period between August 2020 and August 2023. Analysis of data obtained from a self-administered, anonymous and voluntary questionnaire. Revealing information on the professional profile, knowledge of HBP, its link with cognitive impairment (CD), diagnosis and treatment. Results: 222 professionals were included, 215 (96.8%) agree with the existence of a link between HBP and other cardiovascular risk factors in CD, and 218 (98.1%) acknowledge assisting patients at risk of suffering from CD. The CD evaluation is carried out in selected cases by 132 (59.4%) participants and 59 (26.7%) always do it. Of those who perform evaluation, 103 (54%) use the Mini Mental State Examination (MMSE), 10 (5.2%) use the Montreal Cognitive Assessment (MoCA) and 9 (4.7%) use the Clock Drawing Test. Regarding the decrease in blood pressure in elderly patients and the link with risk of CD: 54 (24.3%) do not recognize risk and 65 (29.2%) recognize a moderate-high risk. In reference to the implication of the treatment of cardiovascular disease and CD: 217 (97.7%) recognized a beneficial effect. Discussion: Given the recognition of the link between HBP and CD, it would be expected that CD would be investigated in the vast majority, however only 26.7% always evaluate it. There is no consensus on the method, the MMSE being the most used, with a low application of the MoCA test and/or Clock Drawing Test, the latter being the ones that evaluate executive function, mostly altered in CD linked to HBP. Although the treatment of cardiovascular disease is recognized as beneficial with respect to CD, the control of HBP in older adults is considered risky. A diagnosis is made of a situation where a disparity is evident between what one recognizes as knowing and what one claims to do. Conclusions: The role of vascular disease in functional brain damage is recognized, considering it necessary to know the cognitive status of patients, however there is a low application of screening tests that evaluate executive function. In this context, a gap between medical knowledge and practice is shown.

Introdução: A hipertensão arterial (HA) é a principal causa de morte por doenças cardiovasculares. Apesar dos avanços, o percentual de hipertensos não diagnosticados e não tratados é de 58,4%. A avaliação do dano cognitivo na hipertensão concentra-se na prevenção do acidente vascular cerebral, enquanto o dano funcional é ignorado. Esse manejo inadequado pode ser multifatorial. É objetivo fue analisar a opinião dos médicos sobre a relação entre hipertensão arterial e danos cognitivos. Metodologia: Estudo observacional, descritivo, transversal desenvolvido no período entre agosto de 2020 e agosto de 2023. Análise de dados obtidos a partir de questionário autoaplicável, anônimo e voluntário. Revelar informações sobre o perfil profissional, conhecimento sobre a HA, sua ligação com o comprometimento cognitivo (DC), diagnóstico e tratamento. Resultados: Foram incluídos 222 profissionais, 215 (96,8%) concordam com a existência de ligação entre hipertensão e outros fatores de risco cardiovascular na DC e 218 (98,1%) reconhecem ajudar pacientes com risco de sofrer de D.C. A avaliação da DC é realizada em casos selecionados por 132 (59,4%) participantes e 59 (26,7%) a fazem sempre. Dos que realizam avaliação, 103 (54%) utilizam o Mini Exame do Estado Mental (MEEM), 10 (5,2%) utilizam a Avaliação Cognitiva de Montreal (MoCA) e 9 (4,7%) utilizam o Clock Drawing Test. Em relação à diminuição da pressão arterial em pacientes idosos e a ligação com o risco de DC: 54 (24,3%) não reconhecem risco e 65 (29,2%) reconhecem risco moderado-alto. Em referência à implicação do tratamento de doenças cardiovasculares e DC: 217 (97,7%) reconheceram o efeito benéfico. Discussão: Dado o reconhecimento da ligação entre hipertensão e DC, seria de esperar que a DC fosse investigada na grande maioria, no entanto apenas 26,7% sempre a avaliam. Não há consenso sobre o método, sendo o MEEM o mais utilizado, com baixa aplicação do teste MoCA e/ou Clock Drawing Test, sendo estes últimos os que avaliam a função executiva, majoritariamente alterada nos DC vinculados à HA. Embora o tratamento das doenças cardiovasculares seja reconhecido como benéfico em relação à DC, o controle da HA em idosos é considerado arriscado. É feito um diagnóstico de uma situação em que é evidente uma disparidade entre o que se reconhece como saber e o que se afirma fazer. Conclusões: O papel da doença vascular no dano cerebral funcional é reconhecido, considerando-se necessário conhecer o estado cognitivo dos pacientes, porém há baixa aplicação de testes de triagem que avaliam a função executiva. Nesse contexto, evidencia-se uma lacuna entre o conhecimento e a prática médica.

Cultural adaptation and psychometric analysis of Communication Activities of Daily Living third edition in Spanish and Catalan for people with aphasia.

BACKGROUND: In the Spanish and Catalan context, there is currently a lack of standardized, linguistically adapted tools to assess people with communication disorders. This lack is especially evident when it comes to instruments designed to assess functional communication. AIMS: The main objective of this study is to adapt the instrument entitled Communication Activities of Daily Living 3rd edition (CADL-3) into European Spanish (CADL-3VE) and Catalan (CADL-3VC), thus providing a new tool to assess the functional communication of patients with aphasia in the Spanish and Catalan populations. METHODS & PROCEDURES: A total of 152 people, all residents of Catalonia, took part in the study. The CADL-3VE test was administered to 125 Spanish-speaking participants, who were divided into two groups, one consisting of patients with aphasia and the other a control group. The CADL-3VC test was administered to 27 Catalan-speaking patients with aphasia. Other tests and assessment scales were used for the external validation of the test. OUTCOMES & RESULTS: Reliability scores were recorded for both new versions of the test. There was a very strong correlation between the CADL-3VE test and external criteria. The scores for both of the new versions showed significant differences in terms of performance between the aphasia and control groups. Both versions displayed similarities with the original test with respect to most of the psychometric analyses carried out. CONCLUSION & IMPLICATIONS: The test makes it possible to assess everyday communicative functioning and participation in real-world contexts. As such, it helps inform the creation of personalized, interdisciplinary treatment plans aimed at functional objectives that consider the patient's context. WHAT THIS PAPER ADDS: What is already known on the subject In order to effectively assess aphasia based on a bio-psycho-social perspective, it is necessary to examine functional communication. In other words, there is a need to explore the kinds of communication difficulties that people face in their everyday lives. Communication Activities of Daily Living (CADL-3) is an English-language test that was developed to assess functional communication by simulating certain everyday activities. What this study adds This paper offers an analysis of the items, reliability and validity of the Spanish and Catalan versions of the CADL-3 test. What are the clinical implications of this work? This new instrument has the potential to play an essential role in assessing the everyday functional communication of people with aphasia in Spain.

The effect of animal-assisted intervention on fear in children in the emergency department: A randomized controlled trial.

AIM: This study aimed to determine the effect of animal-assisted intervention on the fears of hospitalized children in the emergency department (ED). MATERIALS AND METHODS: The randomized controlled trial was conducted between April and June 2023 in the Central Black Sea Region of Turkiye. The study included 70 children aged 5 to 7 years old (the study group was 35, and the control group was 35). The study and control groups were randomly assigned to strata using simple randomization. While goldfish were used for animal-assisted intervention in the study group, routine care was continued in the control group. The "Child Fear Scale" and "The Scale of Children's Fear of Nursing Interventions and Instruments Used in Hospital" were used as data collection tools. RESULTS: The mean score of the fear scale in the post-test scores of the study group children was significantly lower than the control group (p < 0.001). After the animal-assisted intervention, the mean fear scores of the children in the care study group toward nursing interventions and the materials used decreased significantly (p < 0.001). Furthermore, when the two groups were compared, the difference between the post-test scores was not significant (p > 0.05). CONCLUSION: Animal-assisted intervention was determined to be effective in decreasing the fear levels of the children in the study group. PRACTICE IMPLICATIONS: During hospitalization in the emergency department, methods appropriate to the child's developmental level and animal-assisted interventions were found to be effective in reducing children's fear levels.

Dynamic analysis of a NiTi rotary file by using finite element analysis: Effect of cross-section and pitch length.

This study assessed stress distribution, maximum stress values and fatigue life of experimentally designed NiTi rotary files with different cross-sectional geometry and pitch length using finite element analysis (FEA). Four cross-sectional shapes (Convex triangle, S-shaped, Triple helix and Concave triangle) and two pitch lengths (2 mm and 3 mm) were tested in simulated root canals with curvatures of 30°, 45° and 60°. The FEA results indicated that convex triangle and triple helix geometries exhibited lower stress values compared to the S-shaped and concave triangle designs. Increasing the canal curvature angle resulted in higher stress values, with the S-shaped instrument showing the most significant increase (up to 12%). Instruments with shorter pitch lengths showed more even stress distribution enhancing fatigue life. The maximum stress was concentrated 5-8 mm from the tip, varying across cutting edges, with S-shaped sections experiencing the lowest forces but higher stress due to lower moments of inertia.

Strategies for Improving Aptamer Screening Efficiency: Library Design, Awareness Innovation, and Instrument Assistance.

Aptamers, as short single-stranded nucleic acids, can bind to targets in a similar way to antibodies. Relying on the advantages of low cost, high stability, and flexibility, they are widely applied in biosensors, disease therapy, and synthetic biology. As an aptamer screening method, the Systematic Evolution of Ligands by Exponential Enrichment (SELEX) offers almost unlimited possibilities for functional aptamer generation. However, at present, the SELEX procedure has not reached a satisfactory level, and it still faces some challenges in practical application, such as the relatively blind initial library, laborious and time-consuming selection process, typically requires 9-20 rounds for screening, and the entire process generally extends over 2-3 months, and sub-optimal performance of aptamers obtained. In the past few years, researchers have made great efforts to address these obstacles. Hence, in this review, we first summarize the aptamer screening mechanism and the existing limitations of SELEX. Then analyze the principle and technical key points of the SELEX optimization screening strategy. By incorporating rational library design, novel screening awareness, and advanced screening equipment, the number of aptamer screening cycles is significantly reduced to <8 rounds, with some methods achieving single-round screenings. This has led to a considerable decrease in the overall screening time to <3 weeks, while simultaneously enhancing the performance of the aptamers. Finally, critically discuss the present challenges and future directions of aptamer screening. This review aims to provide a practical reference for designing suitable aptamer screening methods.

Cognitive interviews on the Swedish occupational balance questionnaire.

BACKGROUND: The Occupational Balance Questionnaire (OBQ11) is a commonly used instrument for measuring self-rated occupational balance. It needs further development, and therefore an additional 11 tentative items have been developed. One aspect of this is studying the interpretations and reasoning of people responding to the items/instrument. AIM: The aim of this study was to explore and describe how adults interpret and reason in relation to OBQ11 overall, the individual items in the instrument as well as the new tentative items. METHOD: Cognitive interviews were conducted with eight participants varying in age, gender, living situation, education, native language, and self-reported disability. They were included using a combination of purposive and convenience sampling. The interviews were analysed using a content analysis with an inductive approach. RESULTS: The analysis resulted in three main categories: 'Difficulties understanding the items' (with two subcategories), 'Structure of the instrument' (with four subcategories) and 'Missed perspectives in the instrument' (with four subcategories). CONCLUSIONS: The participants considered the items and the instrument relevant for assessing occupational balance. However, the results also revealed the need for more clarifications and changed item order prior to introducing a potential new version of the instrument.

New Insight into the Role of Vitamin D in the Stroke Risk: A Meta-Analysis of Stratified Data by 25(OH)D Levels.

Mendelian Randomization (MR) studies have emerged as a powerful tool for investigating causal relationships between modifiable risk factors and clinical outcomes, using genetic variants as instrumental variables. In the context of vitamin D research, MR is a promising approach to elucidate the effects of vitamin D on various health outcomes, including adverse cardiovascular events. However, the validity of MR analyses relies heavily on the strength of the genetic associations found. "Weak instrument bias", arising from instruments with low explanatory power for the exposure of interest, can lead to biased estimates and compromise causal inference. We have, herein, briefly reviewed the challenges posed by weak instrument bias in a large MR study on vitamin D [25(OH)D] and stroke, exploring implications for the study's validity and reliability of findings. We have then added an original meta-analysis stratified by 25(OH)D levels. By using aggregated data from a recent MR study, an original meta-analysis stratified by population mean levels of 25(OH)D has indicated that interventions based on vitamin D supplementations in population mean levels ranging from 50 to 70 nmol/L are likely to translate into a 13% reduction of stroke risk (pooled odds ratio=0.873, 95% CI: 0.764-0.997, p-value=0.04). MR studies are a valuable approach for discerning causal relationships between exposures, such as vitamin D, and health outcomes. However, the effectiveness of MR analyses depends on the robustness of the genetic instruments employed. By recognizing and addressing weak instrument bias in MR studies of vitamin D, researchers can enhance the credibility and utility of causal inference in understanding the health effects of this essential nutrient. A metaanalysis stratified by population mean levels of 25(OH)D has revealed the potential benefits of targeted interventions with vitamin D supplementations for stroke.

Rasch analysis of a palliative care self-efficacy instrument for nursing assistants.

This study used Rasch models to evaluate the psychometric properties of a self-efficacy instrument focused on psychosocial aspects of palliative care developed for nursing assistants (NAs). NAs from 6 skilled nursing facilities in Illinois, U.S. (n=102) were divided into intervention and control groups and answered 16 questions at baseline and 1-month follow-up. A total of 84 NAs completed assessments at both times. The rating scale structure improved when 3 instead of 5 response categories were used. After removing 4 items, the instrument demonstrated unidimensionality and local independence. A person-item threshold map indicated a ceiling effect. For the intervention group, 2 items and 1 item became easier and more difficult respectively post-training. With adjustments, the 12-item instrument became an adequate measure of palliative care self-efficacy. By using PCSE-NA as a tool to assess palliative care self-efficacy of NAs, geriatric nurses can identify weaknesses of and ways to improve training for NAs.

Design and Implementation of a Desorption Electro-flow Focusing Sprayer on an Orbitrap Mass Spectrometer for DESI Mass Spectrometry Imaging at High Spatial Resolution and at High Speed.

Since desorption electrospray ionization mass spectrometry (DESI-MS) was first presented in 2004, the fundamental design of the sprayer has undergone relatively minor modifications. This changed in 2022 when Takats and co-workers implemented the desorption electro-flow focusing (DEFFI) sprayer design by modifying the sprayer from a commercial DESI system, leading to significantly improved spatial resolution and robustness compared with the traditional DESI-MSI sprayer design. Here, we present the design of a new DEFFI sprayer that can be built from standard fittings and connectors in combination with an aluminum spray head that can be machined in most mechanic workshops. The new design represents a cost-efficient approach to improved DESI-MSI on mass spectrometers from all vendors, including high-resolution instruments such as Orbitraps and FT-ICR. The new DEFFI sprayer is demonstrated on a QExactive Orbitrap mass spectrometer, resulting in a massively improved ion yield compared with the classic DESI sprayer. The improved ion yield enables DESI-MSI at ion injection times down to 5 ms, allowing for DESI-MSI at a potentially very high speed. More importantly, the DEFFI sprayer delivers a more robust and focused spray, which is easier to use and requires less optimization. It provides high spatial resolution with limited effort compared with previous modifications of the traditional DESI design. Imaging of rat testis was performed at pixel sizes down to 12 µm, suggesting a spatial resolution of approximately 30 µm, which may have potential for further improvement.

Refinement and Evaluation of the Critical Thinking Self-Assessment Scale.

Background and Purpose: Critical thinking (CT) skills are necessary tools for enhancing patient care. The Critical Thinking Self-Assessment Scale (CTSAS) was based on Facione et al.'s (1990) schema of 6 CT skills and 16 subskills. Although early results indicated a strong instrument, it was lengthy at 115 items. The study purpose was to statistically reduce the number of items in the instrument. Methods: Using a sample of 712 undergraduate nursing students, item analysis and confirmatory factor analysis were used to determine items to retain and delete. The scale was validated by comparing to the Need for Cognition Scale. Results: Items were reduced to 46 and spread over the 16 subskills. Conclusions: The revised CTSAS is a valid, reliable tool that is greatly reduced in length without compromising its psychometric properties. Faculty could use the measure as a reflection of students' levels on these skills and design learning activities to target problem areas.

The Development and Content Validation of the Sjögren's Related Quality of Life Instrument (SRQoL).

INTRODUCTION: Several clinical outcome assessment (COA) instruments assess Sjögren's disease (Sjögren's) symptoms, but do not provide comprehensive assessment of the health-related quality of life (HRQoL) impact of Sjögren's. This study aimed to develop a patient-reported outcome (PRO) instrument for the assessment of HRQoL, intended for use in clinical trials and clinical practice in the assessment of treatment benefit. METHODS: Review of study sponsor proprietary data and qualitative interviews informed the development of a conceptual model, the Sjögren's Related Quality of Life (SRQoL) and patient global impression of severity (PGI-S) and change (PGI-C) items. Combined concept elicitation and cognitive debriefing interviews with patients with Sjögren's explored their HRQoL impact experience and content validity of the SRQoL and PGI items. RESULTS: Twenty participants were interviewed about their Sjögren's experience. Following inductive analysis of interviews, concepts were categorized into eight domains: emotional well-being (e.g., worry and stress; n = 20/20; 100%), sleep (e.g., daytime sleepiness and waking up during the night; n = 20/20; 100%), activities of daily living (e.g., difficulty looking at screens and difficulty driving; n = 20/20; 100%), cognition (e.g., concentration difficulties and word finding difficulties; n = 19/20; 95.0%), physical functioning (e.g., difficulty walking and difficulty exercising; n = 19/20; 95.0%), social and family functioning (e.g., dependent on others and relationship difficulties; n = 17/20; 85.0%), work (n = 15/20; 75.0%), and sexual functioning (n = 12/20; 60.0%). SRQoL and PGI items, instructions, response options, and recall period were well understood and relevant to participants. CONCLUSIONS: The SRQoL is a new PRO instrument to assess Sjögren's impact on HRQoL, developed in accordance with regulatory guidance. This study provides considerable insight into the patient experience of Sjögren's and evidence to support the content validity of the SRQoL. Future research should evaluate the psychometric properties of the SRQoL to support its use in clinical trials and clinical practice and further validate its use as an assessment of treatment benefit.

Patient and physician completed questionnaires used in clinical trials and clinical practice have previously focused on symptoms. These questionnaires do not cover the full experience of living with Sjögren's, such as differences in symptoms between individual patients, and their use has also been known to result in inaccurate reports. Another way of thinking about patients' experiences is to use a questionnaire to ask about the impact Sjögren's has on patients' health-related quality of life, meaning how Sjögren's might affect their life in different ways including physically, emotionally, and socially. The goal of this study was to develop a new questionnaire (named the Sjögren's-Related Quality of Life [SRQoL] questionnaire) to measure the impact that Sjögren's has on patients' lives. Interviews were conducted with people with Sjögren's to explore their understanding of the new questionnaire and how relevant the content is to their experience of the condition. The results of this study suggest that the SRQoL includes relevant and easy-to-understand questions, suitable for use in future clinical trials and clinical practice, to measure if patients' HRQoL improves with treatment. Future research is needed to confirm that the questionnaire accurately measures the impact of Sjögren's on HRQoL for use with patients with Sjögren's.

Effect of 6-week BFRT combined with IASTAM therapy on international standard dancers with chronic ankle instability.

Background: In sports dance events, athletes often face the risk of ankle injury and instability, which may have a negative impact on their training and athletic performance, and even hinder their rehabilitation process and increase the likelihood of re-injury. Objective: This study aims to observe the effects of exercise intervention (low-load ankle muscle strength training with blood flow restriction training (BFRT) equipment and balance training with blood flow restriction training equipment) combined with instrumentation therapy (Instrument-assisted soft tissue mobilization, IASTM) on ankle function, joint range of motion, and strength in sports dancers with chronic ankle instability (CAI). This study aims to provide an evidence-based approach to rehabilitation for athletes by comparing the effects of combination therapy approaches to traditional ankle strength and stability training. Methods: Forty-two subjects with ankle instability, restriction, or discomfort were selected as observation objects and randomly divided into three groups: the combined group (n = 14, blood flow restriction training combined with IASTM), the simple blood flow restriction training group (n = 15), and the conventional ankle strength and stability training group (n = 13). The intervention lasted for 6 weeks, once a week. The three groups were assessed with the Cumberland ankle instability assessment, Foot and Ankle Ability Measure (FAAM) ankle function assessment score, and ankle range of motion measurement before intervention, after the first intervention, and after 6 weeks of intervention. The ankle strength test was compared and analyzed only before and after intervention. Result: There was no significant difference in the participant characteristics of the three intervention groups. In terms of Cumberland Ankle Instability Tool (CAIT) scores, within-group comparisons showed that the scores after the first intervention and at the 6-week mark were significantly higher than before the intervention (P < 0.05). Between-group comparisons revealed that the combined intervention group had higher CAIT scores than the other two groups after the 6-week intervention. Regarding the FAAM functional scores, all three interventions significantly improved ankle joint function in patients with chronic ankle instability (P < 0.05), with the BFRT group showing significantly higher FAAM - Activities of Daily Living scale (FAAM-ADL) scores than the control group (P < 0.05). Both the combined and BFRT groups also had significantly higher FAAM-SPORT scores after the first intervention compared to the control (P < 0.05). In terms of ankle range of motion improvement, the combined intervention group showed a significant increase in ankle joint motion after the intervention (P < 0.05), particularly in the improvement of dorsiflexion ability (P < 0.05). As for ankle strength enhancement, all three intervention groups experienced an increase in ankle strength after the intervention (P < 0.05), with the combined intervention group showing a significant improvement in both dorsiflexion and inversion strength compared to the control group (P < 0.05). Conclusion: BFRT combined with IASTM, isolated BFRT, and conventional ankle strength and stability training significantly improve stability, functionality, and strength in CAI patients. The combined intervention demonstrates superior efficacy in improving ankle range of motion compared to isolated BFRT and conventional approaches.

Siamese network for classification of Raman spectroscopy with inter-instrument variation for biological applications.

Raman spectroscopy has emerged as a highly sensitive, rapid, and label-free detection method, extensively utilized in biological research. Presently, it is frequently paired with artificial intelligence (AI) algorithms to facilitate identification and classification tasks. However, variations in the settings across different Raman spectrometers, along with the sensitive and continuous nature of biological Raman signals, can subtly alter the acquisition of these signals. This can potentially impact the classification outcomes of the spectra. Moreover, Raman spectra with disparate resolutions pose challenges for effective model training. In this study, we introduce a modularized Siamese neural network, equipped with multiple projection layers to segregate the model components. This design allows our model to support the core module spectral encoder's pluggability. The model determines the classification results by extracting the features of Raman spectra with inter-instrument variation, mapping these feature distances into spectral similarities, and finally, comparing a set of similarities. Our experimental results demonstrate the feasibility of training the model with only 10 spectra per category, using bacterial datasets we created. We compared the classification outcomes of three distinct spectral encoders, with the most effective model achieving a classification accuracy exceeding 90%. Furthermore, we successfully implemented the fusion training and prediction of Raman spectra with different resolutions. In conclusion, our model enhances the validity and comparability of Raman spectral acquisition for biological applications and diversifies the methods of Raman spectral acquisition.

Estimating Time-Varying Exposure Effects Through Continuous-Time Modelling in Mendelian Randomization.

Mendelian randomization is an instrumental variable method that utilizes genetic information to investigate the causal effect of a modifiable exposure on an outcome. In most cases, the exposure changes over time. Understanding the time-varying causal effect of the exposure can yield detailed insights into mechanistic effects and the potential impact of public health interventions. Recently, a growing number of Mendelian randomization studies have attempted to explore time-varying causal effects. However, the proposed approaches oversimplify temporal information and rely on overly restrictive structural assumptions, limiting their reliability in addressing time-varying causal problems. This article considers a novel approach to estimate time-varying effects through continuous-time modelling by combining functional principal component analysis and weak-instrument-robust techniques. Our method effectively utilizes available data without making strong structural assumptions and can be applied in general settings where the exposure measurements occur at different timepoints for different individuals. We demonstrate through simulations that our proposed method performs well in estimating time-varying effects and provides reliable inference when the time-varying effect form is correctly specified. The method could theoretically be used to estimate arbitrarily complex time-varying effects. However, there is a trade-off between model complexity and instrument strength. Estimating complex time-varying effects requires instruments that are unrealistically strong. We illustrate the application of this method in a case study examining the time-varying effects of systolic blood pressure on urea levels.

What validated instruments, that measure implementation outcomes, are suitable for use in the Paediatric Intensive Care Unit (PICU) setting? A systematic review of systematic reviews.

BACKGROUND/AIMS: The measurement of implementation outcomes can establish the success of implementing evidence into practice. However, implementation outcomes are seldom measured in acute healthcare settings, such as Paediatric Intensive Care Units (PICU), and if they are used, are likely to be non-validated, site or intervention-specific measures. To address this literature gap, this systematic review of systematic reviews aims to identify validated instruments to measure implementation outcomes of new EBP interventions in a PICU setting. METHODS: A systematic review of systematic reviews was conducted in two phases. Phase One: Five electronic databases were searched between 06/10/22 and 14/10/22. Systematic reviews were selected using pre-determined eligibility criteria. Methodological quality was assessed using the Critical Appraisal Skills Programme tool and a data extraction table was used to allow further synthesis. Phase Two: Secondary eligibility criteria were used to extract and review instruments from the systematic reviews selected in Phase One. Instruments were analysed and mapped to the Consolidated Framework of Implementation Research (CFIR). RESULTS: Phase One: Searches resulted in 3195 unique papers. Five systematic reviews were eligible for inclusion. All examined the psychometric properties of each instrument, utilising different methods to do so; three considered their pragmatic or usability properties; and one identified instruments that were transferrable to different settings. Each systematic review identified that most included instruments had limited evidence of their validity or reliability and had poor psychometric properties. Phase two: 93 instruments were screened, and nine were eligible for analysis. After analysis and CFIR mapping, two instruments were identified as potentially adaptable to the PICU setting. CONCLUSIONS: The methodological quality of implementation outcome measurement instruments is inadequate, warranting further validation research. Two instruments were identified that cover multiple CFIR domains and have scope to be adapted for use when implementing evidence-based practice into the PICU. Further work is needed to adapt and further validate an instrument for use in practice. TRIAL REGISTRATION: For transparency of procedures and methods, the protocol for this systematic review was registered with PROSPERO (registration number CRD42022361638L).

Development and validation of an instrument to evaluate the perspective of using the electronic health record in a hospital setting.

BACKGROUND: Evaluating healthcare information systems, such as the Electronic Health Records (EHR), is both challenging and essential, especially in resource-limited countries. This study aims to psychometrically develop and validate an instrument (questionnaire) to assess the factors influencing the successful adoption of the EHR system by healthcare professionals in Moroccan university hospitals. METHODS: The questionnaire validation process occurred in two main stages. Initially, data collected from a pilot sample of 164 participants underwent analysis using exploratory factor analysis (EFA) to evaluate the validity and reliability of the retained factor structure. Subsequently, the validity of the overall measurement model was confirmed using confirmatory factor analysis (CFA) in a sample of 368 healthcare professionals. RESULTS: The structure of the modified HOT-fit model, comprising seven constructs (System Quality, Information Quality, Information technology Service Quality, User Satisfaction, Organization, Environment, and Clinical Performance), was confirmed through confirmatory factor analysis. Absolute, incremental, and parsimonious fit indices all indicated an appropriate level of acceptability, affirming the robustness of the measurement model. Additionally, the instrument demonstrated adequate reliability and convergent validity, with composite reliability values ranging from 0.75 to 0.89 and average variance extracted (AVE) values ranging from 0.51 to 0.63. Furthermore, the square roots of AVE values exceeded the correlations between different pairs of constructs, and the heterotrait-monotrait ratio of correlations (HTMT) was below 0.85, confirming suitable discriminant validity. CONCLUSIONS: The resulting instrument, due to its rigorous development and validation process, can serve as a reliable and valid tool for assessing the success of information technologies in similar contexts.

Development of theoretical framework and digital competence assessment checklist (DCAC) for nursing students.

Background: The rapid development of digital technology impacts all aspects, including nursing education. Nursing programs are tasked with equipping graduates with both clinical skills and digital competence. However, inconsistencies in the conceptual understanding of digital competence in nursing literature, underscore the need to refine the concept. Design: This study involved two phases including a modified Delphi approach and psychometric testing. In Phase 1, the panel of experts in nursing was invited to evaluate the theoretical framework, domain, and item of assessment checklist. In Phase 2, the psychometric properties of the assessment checklist were tested using a quantitative survey. Setting: The study was conducted in Taiwan, Indonesia, and Vietnam. Participant: Participants included 12 nursing experts from Taiwan, Indonesia, and Vietnam during the development phase and 417 nursing students from these countries in the validation phase. Methods: Phase 1 utilized a modified Delphi approach establishing a theoretical framework and assessment checklist. Experts provided feedback on a Likert scale, aiming for consensus. Phase 2 involved a quantitative survey where graduate nursing students rated the DCAC. The analysis process following the recommendation of the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN). Results: The theoretical framework defined digital competence across four domains. In the first Delphi round, all items were rated above the consensus threshold. After two rounds, the CVI ranged from .8 to 1.0, suggesting strong agreement among experts. The second phase revealed high discriminant validity among survey items, with Cronbach's alpha indicating high internal consistency. The refined 22-item DCAC showed improved fit indices, confirming the assessment checklist's structure. Conclusion: The developed 22-item DCAC is a valid and reliable tool for measuring digital competence among nursing students. Integration of digital competence into nursing education is essential for preparing students to excel in the healthcare environment.

Modified Fresno test to assess Physical therapists' use of evidence-based practice: measurement properties of the Brazilian-Portuguese short version: Modified Fresno test Brazilian-Portuguese short version.

BACKGROUND: The modified Fresno test is a questionnaire developed to evaluate Evidence-Based Practice among physical therapists. A previous study has indicated that a shorter version with 9 items would be more appropriate for Brazilian physical therapists. OBJECTIVES: To test the measurement properties of the modified Fresno test - Brazilian-Portuguese short version. METHODS: To analyze the reliability of the modified Fresno test - Brazilian-Portuguese short version by two raters (intra and inter-rater) in a sample of 133 physical therapists. The intraclass correlation coefficient (ICC2,1) and standard error of measurement (SEM) was used to assess the test-retest reliability. Internal consistency was tested using the Cronbach's alpha coefficient. An expert committee analyzed content validity using the content validity index (CVI). Confirmatory factor analysis (CFA) using the principal components method was used to assess construct validity. Responsiveness was estimated using effect size, and ceiling and floor effects were also investigated. RESULTS: Inter-rater and intra-rater reliability were, respectively: ICC= 0.93 (95 % CI 0.91, 0.95); rater 1 - ICC= 0.95 (95 % CI 0.94, 0.97); rater 2 - ICC= 0.98 (95 % CI 0.98, 0.99). The agreement was very good (values ≤ 5 %). Internal consistency was good for most instrument items (≥ 0.80). The CVI showed agreement among the expert committee members (0.96). The Cronbach's alpha coefficients calculated for the corrected item total showed values greater than 0.40. In the CFA, the "model 2" showed acceptable indices (≥ 0.90). Responsiveness was classified as very small. No ceiling and floor effects. CONCLUSION: The Fresno Modified Test - Brazilian-Portuguese short version has good to excellent reliability. CFA showed that the fit indices were adequate to be used in the population of interest.

Frequency Detection for String Instruments Using 1D-2D Non-Contact Mode Triboelectric Sensors.

The proliferation of small electronic devices has significantly increased the demand for self-powered sensors. This study introduces a triboelectric frequency sensor (TFS) that combines the frequency-responsive characteristics of triboelectric nanogenerators with a simple one-dimensional structure for sustainable vibration measurement. This sensor is specifically designed to aid in the tuning of string instruments, capable of detecting frequency responses up to 330 Hz generated by string vibrations. Structural optimization was achieved by setting a non-contact mode with a gap distance of 3 mm and utilizing perfluoroalkoxy alkane (PFA) as the contact dielectric material. The TFS exhibits dynamic response characteristics by varying the vibrating frequency and the tension of the string, facilitated by a custom-built testing setup. Frequency data captured by the sensor can be visualized on a monitor through the integration of a microcontroller unit (MCU) and dedicated coding. The practical applicability and effectiveness of this sensor in real-world scenarios are demonstrated experimentally. This innovation represents a significant step forward in the development of self-sustaining sensing technologies for precision instrument tuning.