Using Google Trends to assess the Australian public's interest in topical gynaecology issues.

Our primary objective is to assess public awareness of topical issues in gynaecology by observing Google Trends information on internet searches in Australia and explore the linear relationship with landmark changes in policy or management. Following notable interventions such as new government policies, action plans and publications, there has been a 26.4% increase in searches for endometriosis, 3.9% increase in searches into transvaginal mesh, a 48.8% increase in searches for cervical screening and a 20.9% overall increase in searches for polycystic ovarian syndrome. This analysis appears to show that patient interest largely mirrors real world events.

Aerobic training and vascular protection: Insight from altered blood flow patterns.

NEW FINDING: What is the central question of this study? This study sought to determine whether prior upper limb aerobic training can attenuate the vascular dysfunction resulting from negative alteration of blood flow patterns. What is the main finding and its importance? We demonstrated that the microvasculature of young men with prior upper limb aerobic training (rowing) was equally susceptible to negatively altered blood flow patterns when compared with untrained control subjects. This finding reveals that aerobic training does not provide adequate protection against this type of vascular insult, highlighting the importance of reducing known vascular insults regardless of training status. ABSTRACT: Acute alteration of blood flow patterns can substantially reduce blood vessel function and, if consistently repeated, may chronically reduce vascular health. Aerobic exercise training is associated with improved vascular health, but it is not well understood whether aerobic training-induced vascular adaptations provide protection against acute vascular insults. This study sought to determine whether prior upper limb aerobic training can attenuate the vascular dysfunction resulting from an acute vascular insult (increased retrograde/oscillatory shear). Ten young arm-trained (AT) men (rowers; 22 ± 1 years of age) and 10 untrained (UT) male control subjects (21 ± 3 years of age) were recruited for this study. Subjects completed two brachial artery (BA) flow-mediated dilatation (FMD) tests separated by an acute bout of subdiastolic cuff inflation (SDCI) of the distal forearm. Brachial artery dilatation (normalized for the shear stimulus) and reactive hyperaemia evaluated during the BA FMD test were used to determine conduit artery and microvascular function, respectively. Data were presented as mean values ± SD. The AT group reported significantly greater whole body (peak oxygen uptake; P = 0.01) and forearm aerobic capacity (P < 0.001). The SDCI intervention significantly increased retrograde (P < 0.001) and oscillatory shear (P < 0.001) in both groups. After the SDCI, microvascular function (post-cuff release hyperaemia), but not conduit artery function (shear-induced BA dilatation), was significantly reduced from pre-SDCI values (P = 0.001) independent of group. This study revealed that young men with prior upper limb aerobic training, when compared with untrained control subjects, were equally susceptible to the microvascular dysfunction associated with an acute increase in retrograde/oscillatory shear.

On using wearable tri-axial accelerometers to examine the striking phase kinematics of expert specialist drag flickers on-field.

Analysing player kinematics during a match using "gold-standard" 3D video-based motion analysis techniques is a difficult prospect indeed. The development of small, wireless, wearable sensors offers the potential to reduce the challenges of measuring kinematics during match-play without hindering performance. The present study examined the viability of using wireless tri-axial accelerometers to examine whether key performance measures of drag flicks executed by expert specialist drag-flickers are predicted by the kinematics of the striking phase. Linear mixed models were used to examine whether the speed and accuracy of players' drag flicks were predicted by the duration of stick-ball contact, and the kinematics of the lead lower limb at stick-ball contact and ball release. Results revealed that stick and lead lower limb kinematics significantly predicted shot accuracy but not shot speed. Shorter drag-time predicted more accurate flicks (p = 0.03) as did a more vertical leg at stick-ball contact (p = 0.016) and a more horizontal thigh at ball release (p = 0.001). This may indicate that there are more ways to produce fast drag flicks than accurate ones. This study illustrates that wireless tri-axial accelerometers can be used on-field to measure the effects of kinematics on key performance measures.

Determinants of pedestrian and bicyclist crash severity by party at fault in San Francisco, CA.

Pedestrian and bicyclist safety is of growing concern, especially given the increasing numbers of urban residents choosing to walk and bike. Sharing the roads with automobiles, these road users are particularly vulnerable. An intuitive conceptual model is proposed of the determinants of injury severity in crashes between vehicles and nonmotorized road users. Using 10 years of crash data from San Francisco, CA, we estimate logistic regression models to illuminate key determinants of crash severity for both pedestrian and bicyclist collisions. The analyses are separated by party at fault to test the novel hypothesis that environmental factors affecting driver speed and reaction time may be especially important when the driver is not at fault. Pedestrian results are broadly consistent with prior research, and offer considerable support for this hypothesis. The strongest predictors of injury severity include pedestrian advanced age, driver sobriety, vehicle type, and a set of variables that help determine driver speed and reaction time. Bicyclist results were weaker overall, and the distinction by party at fault was less important.

Does skill specialisation influence individual differences in drag flicking speed and accuracy?

Research has revealed that individual soccer goalkeepers respond differently to penalty shots, depending on their specific perceptual and motor capabilities. However, it remains unclear whether analogous differences exist between individual penalty takers, and if specialising in penalty taking affects the occurrence of differences between individuals. The present study examined individual differences in penalty shot speed and accuracy for specialists in penalty taking versus non-specialists. Expert specialist field hockey drag flickers and equivalently skilled non-specialists performed drag flicks towards predetermined targets placed in the face of a standard field hockey goal. Comparisons in shot speed and accuracy were made at a group level (specialists vs. non-specialists) as well as between individuals. Results revealed differences in both speed and accuracy between specialists, but only differences in speed between non-specialists. Specialists generated significantly greater shot speed than non-specialists (P < .001) and were more accurate to some, but not all, targets (top left, P < .006, bottom left P < .001). In addition, it was found that in specialists increasing practice correlated with decreasing accuracy. This may indicate that excessive practice could potentially reduce a specialist's accuracy in shooting towards specific targets.

Birth Outcomes, Intervention Frequency, and the Disappearing Midwife-Potential Hazards of Central Fetal Monitoring: A Single Center Review.

INTRODUCTION: Many birth units use central fetal monitoring (CFM) under the assumption that greater surveillance improves perinatal outcomes. The unexpected loss of the CFM system at a tertiary unit provided a unique opportunity to evaluate outcomes and staff attitudes toward CFM. METHODS: This retrospective cohort study compared patient data from 2,855 electronically monitored women delivering over a 12-month period, where CFM was available for the first 6 months but unavailable for the following 6 months. Primary outcomes relating to neonatal morbidity and secondary outcomes relating to intrapartum interventions were examined. Additionally, birth unit staff members were surveyed about aspects of care related to CFM. RESULTS: There were no significant differences in perinatal outcomes between the cohorts. While unadjusted analysis suggested a lower spontaneous vaginal birth rate (55.4% vs 60.3%) and a higher cesarean delivery rate (25.1% vs 22.0%, p = 0.026), together with higher epidural (53.0% vs 49.2%, p = 0.04) and fetal blood sampling (11.8% vs 9.4%, p = 0.03) rates in the presence of CFM, these differences were lost when adjusted for prostaglandin ripening. Over half of the staff (56.0% of midwives, 54.0% of obstetricians) reported spending more time with the laboring woman in the period without CFM. CONCLUSIONS: This single institution's experience indicates that in birth units staffed for one-to-one care in labor, central fetal monitoring does not appear to be associated with either a benefit on perinatal outcomes or an increase in cesarean delivery and other interventions. However, it is associated with a reduction in the time a midwife spends with the laboring woman.

Classification as clustering: a Pareto cooperative-competitive GP approach.

Intuitively population based algorithms such as genetic programming provide a natural environment for supporting solutions that learn to decompose the overall task between multiple individuals, or a team. This work presents a framework for evolving teams without recourse to prespecifying the number of cooperating individuals. To do so, each individual evolves a mapping to a distribution of outcomes that, following clustering, establishes the parameterization of a (Gaussian) local membership function. This gives individuals the opportunity to represent subsets of tasks, where the overall task is that of classification under the supervised learning domain. Thus, rather than each team member representing an entire class, individuals are free to identify unique subsets of the overall classification task. The framework is supported by techniques from evolutionary multiobjective optimization (EMO) and Pareto competitive coevolution. EMO establishes the basis for encouraging individuals to provide accurate yet nonoverlaping behaviors; whereas competitive coevolution provides the mechanism for scaling to potentially large unbalanced datasets. Benchmarking is performed against recent examples of nonlinear SVM classifiers over 12 UCI datasets with between 150 and 200,000 training instances. Solutions from the proposed coevolutionary multiobjective GP framework appear to provide a good balance between classification performance and model complexity, especially as the dataset instance count increases.

TGF-beta2 alters the characteristics of the neuromuscular junction by regulating presynaptic quantal size.

The amount of neurotransmitter released from a presynaptic terminal is the product of the quantal content (number of vesicles) and the presynaptic quantal size (QSpre, amount of transmitter per vesicle). QSpre varies with synaptic use, but its regulation is poorly understood. The motor nerve terminals at the neuromuscular junction (NMJ) contain TGF-beta receptors. We present evidence that TGF-beta2 regulates QSpre at the NMJ. Application of TGF-beta2 to the rat diaphragm NMJ increased the postsynaptic response to both spontaneous and evoked release of acetylcholine, whereas antibodies to TGF-beta2 or its receptor had the converse effect. L-vesamicol and bafilomycin blocked the actions of TGF-beta2, indicating that TGF-beta2 acts by altering the extent of vesicular filling. Recordings of the postsynaptic currents from the diaphragm were consistent with TGF-beta2 having this presynaptic action and a lesser postsynaptic effect on input resistance. TGF-beta2 also decreased quantal content by an atropine-sensitive pathway, indicating that this change is secondary to cholinergic feedback on vesicular release. Consequently, the net actions of TGF-beta2 at the NMJ were to amplify the postsynaptic effects of spontaneous transmission and to diminish the number of vesicles used per evoked stimulus, without diminishing the amount of acetylcholine released.

Multi-National, Multi-Institutional Analysis of Clinical Decision Support Data Needs to Inform Development of the HL7 Virtual Medical Record Standard.

An important barrier to the widespread dissemination of clinical decision support (CDS) is the heterogeneity of information models and terminologies used across healthcare institutions, health information systems, and CDS resources such as knowledge bases. To address this problem, the Health Level 7 (HL7) Virtual Medical Record project (an open, international standards development effort) is developing community consensus on the clinical information exchanged between CDS engines and clinical information systems. As a part of this effort, the HL7 CDS Work Group embarked on a multinational, collaborative effort to identify a representative set of clinical data elements required for CDS. Based on an analysis of CDS systems from 20 institutions representing 4 nations, 131 data elements were identified as being currently utilized for CDS. These findings will inform the development of the emerging HL7 Virtual Medical Record standard and will facilitate the achievement of scalable, standards-based CDS.