Teleconsulta de enfermagem: desenvolvimento de plataforma para atendimento de casos de Covid-19 / Nursing teleconsultation: development of a platform for Covid-19 case management / Telecosulta en enfermería: desarrollo de una plataforma para el manejo de casos de Covid-19

Objetivo: Desenvolver uma plataforma virtual de Teleconsulta para atendimento a casos suspeitos de Síndromes Gripais e infecção por COVID-19. Metodologia: Trata-se de um estudo de natureza aplicada, com desenvolvimento de produção tecnológica e inovadora, prospectivo, ecológico, descritivo, de série temporal. A população do estudo foi formada por qualquer pessoa sintomática para Síndromes Gripais por COVID-19, suspeitos ou confirmados, de qualquer local do Brasil. Este estudo foi realizado em duas etapas, a saber: Etapa I: Desenvolvimento da Aplicação para Plataforma de Teleconsulta. Etapa II: atendimento por meio de Teleconsulta de Casos suspeitos de COVID-19 e Sindromes Gripais. A metodologia utilizada para o desenvolvimento da aplicação proposta foi a modelagem por prototipação evolucionária. Resultados: Foram realizados 209 atendimentos na Plataforma de Teleconsulta, sendo 151 (70%) do sexo feminino e 65 (30%) do sexo masculino, com prevalência de idade variando de 20 a 29 anos (41%). Quanto ao risco de infecção por COVID-19, 42 (20%) tinham alto risco, 75 (36%) médio risco e 92 (44%) baixo risco. Os sintomas mais prevalentes foram: secreção nasal ou espirros (53%), dores no corpo (49%), dor de cabeça (47%), dor de garganta (46%), tosse seca (35%), Febre (31%), falta de ar (25%) e diarreia (23%). Inicialmente o teleatendimento foi composto por teletriagem com classificação de risco com base na sintomatologia dos pacientes que foram codificados com pontuações conforme a gravidade do sintoma para formas graves de COVID-19. A classificação de risco categorizou os pacientes em risco baixo (1 a 9 pontos), risco médio (10 a 19 pontos) e risco alto (20 a 36 pontos). Em seguida, a teleconsulta foi agendada conforme disponibilidade do paciente por meio do método SBAR para comunicação efetiva e ao término do atendimento um plano de cuidados com Sistematização da Assistência de Enfermagem ­ SAE era encaminhado ao paciente por meio de WhatsApp ou e-mail. Conclusão: A plataforma de teleconsulta possibilitou a triagem dos pacientes, reduziu as visitas desnecessárias às unidades de emergência, permitiu a avaliação e monitoramento dos casos, bem como o acompanhamento de pacientes ambulatoriais que não necessitam de avaliação presencial.

Objective: To develop a virtual Teleconsultation platform for care of suspected cases of influenza syndromes and infection by COVID-19. Methodology: This is a study of applied nature, with development of technological and innovative production, prospective, ecological, descriptive, time series. The study population was made up of any person symptomatic for COVID-19 influenza syndromes, suspected or confirmed, from any location in Brazil. This study was conducted in two stages, namely: Stage I: Development of the Application for Teleconsultation Platform. Stage II: care through Teleconsultation of suspected cases of COVID-19 and influenza syndromes. The methodology used to develop the proposed application was evolutionary prototyping modeling. Results: There were 209 consultations in the Teleconsultation Platform, 151 (70%) were female and 65 (30%) were male, with prevalence of age ranging from 20 to 29 years (41%). As for the risk of infection by COVID-19, 42 (20%) had high risk, 75 (36%) medium risk and 92 (44%) low risk. The most prevalent symptoms were: nasal discharge or sneezing (53%), body aches (49%), headache (47%), sore throat (46%), dry cough (35%), fever (31%), shortness of breath (25%), and diarrhea (23%). Initially, the telecare was composed of teletry with risk classification based on the symptomatology of the patients who were coded with scores according to symptom severity for severe forms of COVID-19. The risk classification categorized patients into low risk (1 to 9 points), medium risk (10 to 19 points), and high risk (20 to 36 points). Then, the teleconsultation was scheduled according to the patient's availability through the SBAR method for effective communication and at the end of the service a care plan with Nursing Assistance Systematization - SAE was forwarded to the patient through WhatsApp or e-mail. Conclusion: Teleconsultation platform enabled patient triage, reduced unnecessary visits to emergency units, allowed the evaluation and monitoring of cases, as well as the follow- up of outpatients who do not need face-to-face evaluation.

Objetivo: Desarrollar una plataforma de Teleconsulta virtual para atender casos sospechosos de síndromes gripales e infección por COVID-19. Metodología: Se trata de un estudio aplicado, con desarrollo de producción tecnológica e innovadora, prospectivo, ecológico, descriptivo, con serie de tiempo. La población de estudio estuvo formada por cualquier persona sintomática de síndromes gripales por COVID-19, sospechada o confirmada, de cualquier localidad de Brasil. Este estudio se realizó en dos etapas, a saber: Etapa I: Desarrollo de Aplicaciones para la Plataforma de Teleconsulta. Etapa II: atención mediante teleconsulta de casos sospechosos de COVID-19 y síndromes gripales. La metodología utilizada para el desarrollo de la aplicación propuesta fue el modelado por prototipo evolutivo. Resultados: Se realizaron 209 consultas en la Plataforma de Teleconsulta, 151 (70%) del sexo femenino y 65 (30%) del masculino, con prevalencia de edades entre 20 a 29 años (41%). En cuanto al riesgo de infección por COVID-19, 42 (20%) fueron de alto riesgo, 75 (36%) de riesgo medio y 92 (44%) de bajo riesgo. Los síntomas más prevalentes fueron: secreción nasal o estornudos (53%), dolor de cuerpo (49%), dolor de cabeza (47%), dolor de garganta (46%), tos seca (35%), fiebre (31%), falta de aliento (25%) y diarrea (23%). Inicialmente, la teleasistencia consistía en teleselección con clasificación de riesgo en función de la sintomatología de los pacientes a los que se codificaba con puntuaciones según la gravedad del síntoma para formas graves de COVID-19. La clasificación de riesgo clasificó a los pacientes en riesgo bajo (1 a 9 puntos), riesgo medio (10 a 19 puntos) y riesgo alto (20 a 36 puntos). Luego, se programó la teleconsulta de acuerdo a la disponibilidad del paciente a través del método SBAR para una comunicación efectiva y al final de la atención se remitió al paciente un plan de cuidados con Sistematización de Atención de Enfermería - SAE vía WhatsApp o correo electrónico. Conclusión: La plataforma de teleconsulta posibilitó el triaje de pacientes, redujo las visitas innecesarias a las unidades de emergencia, permitió la evaluación y seguimiento de casos, así como el seguimiento de pacientes ambulatorios que no requieren evaluación presencial.

Endodontia guiada: tecnologia aplicada na resolução de tratamentos de canais calcificados / Guided endodontics: technology applied in the resolution of treatments of calcified canals / Endodoncia guiada: tecnología aplicada en la resolución de tratamientos de conductos calcificados

As calcificações pulpares provocam alterações morfológicas no interior dos canais radiculares que dificultam o tratamento endodôntico. Para solucionar essa dificuldade, a ferramenta Endoguide ou Endodontia Guiada foi desenvolvida para a resolução de casos complexos. Esta pesquisa objetivou descrever as aplicações da ferramenta Endoguide no tratamento de canais calcificados na endodontia. Todas as buscas foram realizadas por um único pesquisador na base de dados PubMed/MEDLINE e busca manual utilizando os descritores "Endodontics", "Digital", "Cone beam", "Guided". Foram considerados elegíveis os artigos publicados entre 2010 e 2022 e excluídos os estudos cuja publicação não foi obtida na íntegra e ainda aqueles em que os resultados não apresentaram embasamento teórico e prático suficientes para que pudessem ser incluídos no trabalho. Após as buscas, foram encontrados 47 artigos, selecionados inicialmente pelo título e resumos, excluindo as duplicatas. Ao final, a leitura completa e coleta de dados foi realizada em 6 artigos. As informações relevantes dos artigos selecionados foram transcritas em forma de quadro para sumarizar os achados. A endodontia guiada pode ser uma excelente alternativa para tratamentos de casos complexos, necessitando um investimento financeiro mínimo no consultório, pois os equipamentos de captura de imagem, planejamento virtual e de guias podem ser realizados em laboratórios capacitados. Assim, concluímos que o emprego da Endoguide como ferramenta no tratamento de canais calcificados se mostrou bem-sucedido e sua utilização não requer um conhecimento amplo, podendo ser usada por profissionais menos experientes.

Pulp calcifications cause morphological changes inside the root canals that make endodontic treatment difficult. To solve this difficulty, the tool Endoguide or Guided Endodontics was developed to solve complex cases. This research aimed to describe the applications of the Endoguide tool in the treatment of calcified root canals in endodontics. All searches were performed by a single researcher in the PubMed/MEDLINE database and manual search using the descriptors "Endodontics", "Digital", "Cone beam", "Guided". Articles published between 2010 and 2022 were considered eligible, and studies whose publication was not obtained in full text were excluded, as well as those in which the results did not have sufficient theoretical and practical basis for them to be included in the study. After the searches, 47 articles were found, initially selected by title and abstract, excluding duplicates. In the end, the complete reading and data collection was performed with 6 articles. Relevant information from the selected articles was transcribed for a table to summarize the findings. Guided endodontics can be an excellent alternative for treating complex cases, requiring minimal financial investment in the office, as image capture equipment, virtual planning and guides can be performed in trained laboratories. Thus, we conclude that the use of Endoguide as a tool in the treatment of calcified canals proved to be successful and its use does not require extensive knowledge and can be used by less experienced professionals.

Las calcificaciones pulpares provocan cambios morfológicos en el interior de los conductos radiculares que dificultan el tratamiento endodóntico. Para solventar esta dificultad se desarrolló la herramienta Endoguide o Endodoncia Guiada para resolver casos complejos. El objetivo de esta investigación fue describir las aplicaciones de la herramienta Endoguide en el tratamiento de conductos radiculares calcificados en endodoncia. Todas las búsquedas fueron realizadas por un único investigador en la base de datos PubMed/MEDLINE y búsqueda manual utilizando los descriptores "Endodontics", "Digital", "Cone beam", "Guided". Se consideraron elegibles los artículos publicados entre 2010 y 2022, y se excluyeron los estudios cuya publicación no se obtuvo a texto completo, así como aquellos en los que los resultados no tenían suficiente base teórica y práctica para ser incluidos en el estudio. Tras las búsquedas, se encontraron 47 artículos, seleccionados inicialmente por título y resumen, excluyendo los duplicados. Al final, se realizó la lectura completa y la recogida de datos con 6 artículos. La información relevante de los artículos seleccionados se transcribió para elaborar una tabla que resumiera los hallazgos. La endodoncia guiada puede ser una excelente alternativa para el tratamiento de casos complejos, requiriendo una mínima inversión financiera en el consultorio, ya que los equipos de captura de imágenes, la planificación virtual y las guías pueden realizarse en laboratorios capacitados. Así, concluimos que el uso de la Endoguía como herramienta en el tratamiento de conductos calcificados demostró ser exitoso y su uso no requiere de grandes conocimientos y puede ser utilizado por profesionales menos experimentados.

O sexting no Brasil: a percepção sobre mensagens sexuais / Sexting en Brasil: la percepción sobre los mensajes sexuales / Sexting in Brazil: the perception about sexual messages

RESUMO. O sexting é uma prática cada vez mais frequente na sociedade atual, mas ainda há poucos estudos sobre como os brasileiros veem a troca de mensagens sexuais. O objetivo desse estudo foi investigar a percepção de brasileiros acerca do sexting e fornecer um panorama de como o fenômeno ocorre na realidade brasileira. Foi realizado um survey online com perguntas discursivas com 41 participantes sobre a dinâmica da prática e foi utilizada a análise de conteúdo para tratamento dos dados. Os resultados revelaram que algumas visões sociais são permeadas por estereótipos, como se observa em pesquisas de outros países. O sexting ainda é em muitos momentos confundido com diferentes formas de violência, apesar de estar sendo naturalizado no país e de já ser parte da experiência sexual cotidiana de muitas pessoas. Evidenciou-se que a educação sexual no contexto digital se faz necessária para que as pessoas compreendam seus direitos e reconheçam as diferenças entre sexting saudável e violências possivelmente atreladas à prática.

RESUMEN. El sexting es una práctica cada vez más frecuente en la sociedad actual, pero todavía hay pocos estudios sobre cómo algunos brasileños ven los mensajes sexuales. El objetivo de este estudio fue investigar la percepción de los brasileños sobre el sexting y proporcionar una visión general de cómo se produce el fenómeno en la realidad brasileña. Se realizó un survey online con preguntas discursivas con 41 participantes sobre la dinámica de la práctica y se utilizó el análisis de contenido para el tratamiento de datos. Los resultados revelaron que algunos puntos de vista sociales están impregnados de estereotipos, como se observó en investigaciones de otros países. El sexting aún se confunde con diferentes formas de violencia, a pesar de estar naturalizado en el país y ya es parte de la experiencia sexual diaria de muchas personas. Se hizo evidente que la educación sexual en el contexto digital es necesaria para que las personas entiendan sus derechos y reconozcan las diferencias entre el sexting saludable y la violencia posiblemente vinculada a la práctica.

ABSTRACT. Sexting is an increasingly frequent practice in today's society, but there are still few studies about the perceptions of Brazilians about sexual messages. The aim of this study was to investigate the perception of some Brazilians about sexting and provide an overview of the characteristics of the phenomenon in the Brazilian reality. An online survey was conducted with discursive questions with 41 participants about the dynamics of the practice and content analysis was used for data treatment. The results revealed that some social views are permeated by stereotypes, as observed in research from other countries. Sexting is still often confused with different forms of violence, despite being naturalized around the country and already being part of the daily sexual experience of many people. It became evident that sex education in the digital context is necessary for people to understand their rights and recognize the differences between healthy sexting practice and violence possibly linked to the messages.

Accuracy and reliability of inertial devices for load assessment during flywheel workout / Precisión y confiabilidad de los dispositivos inerciales para la evaluación de la carga durante entrenamiento con polea cónica

Abstract There is currently an increase in inertial flywheel application in strength training; thus, it must be monitored by an accurate and reliable device. The present study tested: (1) the accuracy of an inertial measurement device (IMU) to correctly measure angular velocity and (2) its inter-unit reliability for the measurement of external load. The analysis was performed using Pearson Correlation and Intraclass Correlation Coefficient (ICC). The IMU accuracy was tested using Bland-Altman and the reliability with the coefficient of variation (CV). Ten elite-level football players performed ten series of 5 repetitions in a one-hand standing row exercise (5 series with each arm). A nearly perfect accuracy (ICC=.999) and a very good between-device reliability (Bias=-.010; CV=.017%) was found. IMU is a reliable and valid device to assess angular velocity in inertial flywheel workout objectively.

Resumen Actualmente, hay un aumento en la utilización de la polea cónica en el entrenamiento de fuerza; por lo tanto, es necesario monitorearlo con un dispositivo preciso y confiable. El presente estudio probó: (1) la precisión de un dispositivo de medición inercial (IMU), para medir correctamente la velocidad angular y (2) su confiabilidad entre unidades para la medición de carga externa. El análisis se realizó utilizando la correlación de Pearson y el Coeficiente de Correlación Intra-clase (CCI). La precisión de la IMU se probó usando Bland-Altman y la confiabilidad con el Coeficiente de Variación (CV). Diez jugadores de fútbol de nivel élite realizaron 10 series de 5 repeticiones en un ejercicio de fila de pie con una mano (5 series con cada brazo). Se encontró una precisión casi perfecta (ICC = .999) y una muy buena confiabilidad entre dispositivos (Sesgo = -. 010; CV = .017%). IMU´s es un dispositivo confiable y válido para evaluar objetivamente la velocidad angular en el entrenamiento inercial de la polea cónica.

Resumo Atualmente, há um aumento na utilização da polia cônica no treinamento de força; portanto, é necessário monitorá-lo com um dispositivo preciso e confiável. O presente estudo testou: (1) a precisão de um dispositivo de medição inercial (IMU), para medir corretamente a velocidade angular e (2) sua confiabilidade interunidades para medição de carga externa. A análise foi realizada por meio da correlação de Pearson e do Coeficiente de Correlação Intraclasse (ICC). A precisão do IMU foi testada usando Bland-Altman e a confiabilidade com o Coeficiente de Variação (CV). Dez jogadores de futebol de elite realizaram 10 séries de 5 repetições em um exercício de linha em pé com uma mão (5 séries com cada braço). Foi encontrado uma precisão quase perfeita (ICC = 0,999) e confiabilidade entre dispositivos muito boa (Bias = - 0,010; CV = 0,017%). IMU's é um dispositivo confiável e válido para avaliar objetivamente a velocidade angular no treinamento inercial da polia cônica.

Capturing in-field root system dynamics with RootTracker.

Optimizing root system architecture offers a promising approach to developing stress tolerant cultivars in the face of climate change, as root systems are critical for water and nutrient uptake as well as mechanical stability. However, breeding for optimal root system architecture has been hindered by the difficulty in measuring root growth in the field. Here, we describe the RootTracker, a technology that employs impedance touch sensors to monitor in-field root growth over time. Configured in a cylindrical, window shutter-like fashion around a planted seed, 264 electrodes are individually charged multiple times over the course of an experiment. Signature changes in the measured capacitance and resistance readings indicate when a root has touched or grown close to an electrode. Using the RootTracker, we have measured root system dynamics of commercial maize (Zea mays) hybrids growing in both typical Midwest field conditions and under different irrigation regimes. We observed rapid responses of root growth to water deficits and found evidence for a "priming response" in which an early water deficit causes more and deeper roots to grow at later time periods. Genotypic variation among hybrid maize lines in their root growth in response to drought indicated a potential to breed for root systems adapted for different environments. Thus, the RootTracker is able to capture changes in root growth over time in response to environmental perturbations.

Direct dynamic read-out of molecular chirality with autonomous enzyme-driven swimmers.

A key approach for designing bioinspired machines is to transfer concepts from nature to man-made structures by integrating biomolecules into artificial mechanical systems. This strategy allows the conversion of molecular information into macroscopic action. Here, we describe the design and dynamic behaviour of hybrid bioelectrochemical swimmers that move spontaneously at the air-water interface. Their motion is governed by the diastereomeric interactions between immobilized enantiopure oligomers and the enantiomers of a chiral probe molecule present in solution. These dynamic bipolar systems are able to convert chiral information present at the molecular level into enantiospecific macroscopic trajectories. Depending on the enantiomer in solution, the swimmers will move clockwise or anticlockwise; the concept can also be used for the direct visualization of the degree of enantiomeric excess by analysing the curvature of the trajectories. Deciphering in such a straightforward way the enantiomeric ratio could be useful for biomedical applications, for the read-out of food quality or as a more general analogue of polarimetric measurements.

Living Through the COVID-19 Pandemic: Community-Dwelling Older Adults' Experiences.

Increasing research is investigating the COVID-19 pandemic's impact on older adults, but relatively little is known about the complexities of community-dwelling older adults' lived experiences during this historical period. This study aimed to address this gap in the literature by taking a bottom-up, theory-generating, inductive approach. Older adults living in Central Texas (N = 200; age, 65-92 years, M = 73.6 ± 6.33) responded to a telephone interview during June-August 2020. Data were analyzed using inductive thematic analysis. We identified three key themes: positive, mixed, and negative experiences, with a total of 11 subthemes. A thematic map was developed, illustrating potential connections to mental health. These findings reveal the complexities of older adults' lived experiences during COVID-19 and have implications for developing aging-related policies and community-based interventions during future public health crises. Recognizing the complexities of older adults' lived experiences, tailored policies and interventions can be developed to effectively leverage older adults' effective coping and resilience while at the same time helping overcome negative effects among specific subgroups.

Plant single-cell solutions for energy and the environment.

Progress in sequencing, microfluidics, and analysis strategies has revolutionized the granularity at which multicellular organisms can be studied. In particular, single-cell transcriptomics has led to fundamental new insights into animal biology, such as the discovery of new cell types and cell type-specific disease processes. However, the application of single-cell approaches to plants, fungi, algae, or bacteria (environmental organisms) has been far more limited, largely due to the challenges posed by polysaccharide walls surrounding these species' cells. In this perspective, we discuss opportunities afforded by single-cell technologies for energy and environmental science and grand challenges that must be tackled to apply these approaches to plants, fungi and algae. We highlight the need to develop better and more comprehensive single-cell technologies, analysis and visualization tools, and tissue preparation methods. We advocate for the creation of a centralized, open-access database to house plant single-cell data. Finally, we consider how such efforts should balance the need for deep characterization of select model species while still capturing the diversity in the plant kingdom. Investments into the development of methods, their application to relevant species, and the creation of resources to support data dissemination will enable groundbreaking insights to propel energy and environmental science forward.

Bio-sensing technologies in aquaculture: how remote monitoring can bring us closer to our farm animals.

Farmed aquatic animals represent an increasingly important source of food for a growing human population. However, the aquaculture industry faces several challenges with regard to producing a profitable, ethical and environmentally sustainable product, which are exacerbated by the ongoing intensification of operations and increasingly extreme and unpredictable climate conditions. Fortunately, bio-sensors capable of measuring a range of environmental, behavioural and physiological variables (e.g. temperature, dissolved gases, depth, acceleration, ventilation, heart rate, blood flow, glucose and l-lactic acid) represent exciting and innovative tools for assessing the health and welfare of farmed animals in aquaculture. Here, we illustrate how these state-of-the-art technologies can provide unique insights into variables pertaining to the inner workings of the animal to elucidate animal-environment interactions throughout the production cycle, as well as to provide insights on how farmed animals perceive and respond to environmental and anthropogenic perturbations. Using examples based on current challenges (i.e. sub-optimal feeding strategies, sub-optimal animal welfare and environmental changes), we discuss how bio-sensors can contribute towards optimizing the growth, health and welfare of farmed animals under dynamically changing on-farm conditions. While bio-sensors currently represent tools that are primarily used for research, the continuing development and refinement of these technologies may eventually allow farmers to use real-time environmental and physiological data from their stock as 'early warning systems' and/or for refining day-to-day operations to ethically and sustainably optimize production. This article is part of the theme issue 'Measuring physiology in free-living animals (Part I)'.

Animal tag technology keeps coming of age: an engineering perspective.

Animal-borne tags (biologgers) have now become extremely sophisticated, recording data from multiple sensors at high frequencies for long periods and, as such, have become a powerful tool for behavioural ecologists and physiologists studying wild animals. But the design and implementation of these tags is not trivial because engineers have to maximize performance and ability to function under onerous conditions while minimizing tag mass and volume (footprint) to maximize the wellbeing of the animal carriers. We present some of the major issues faced by tag engineers and show how tag designers must accept compromises while maintaining systems that can answer the questions being posed. We also argue that basic understanding of engineering issues in tag design by biologists will help feedback to engineers to better tag construction but also reduce the likelihood that tag-deploying biologists will misunderstand their own results. Finally, we suggest that proper consideration of conventional technology together with new approaches will lead to further step changes in our understanding of wild-animal biology using smart tags. This article is part of the theme issue 'Measuring physiology in free-living animals (Part II)'.

Técnicas y herramientas de activos para la salud, utilizadas en centros municipales de salud comunitaria de Madrid / Health assets techniques and tools used in community municipal health centres in Madrid

Se recogen las herramientas utilizadas en el proceso de mapeo que, de manera simultánea, se está llevando a cabo en los centros municipales de salud comunitarios de 13 distritos de la ciudad de Madrid. Las técnicas y herramientas seleccionadas fueron: Fotovoz, la baraja saludable, radio como medio de difusión de activos para la salud (AS), mapa emocional, diana de evaluación y el árbol. Este artículo explica el proceso de mapeo de activos para la salud de la ciudad de Madrid y propone una guía sencilla de utilización de diferentes herramientas, aportando algunas nuevas como la diana de evaluación y el árbol, que han sido implementadas en los distintos procesos de mapeo de la ciudad de Madrid entre 2017 y 2019. El objetivo principal es: identificar y describir las diferentes técnicas y herramientas que se han utilizado en los CMSc, en sus procesos de identificación y mapeo de AS

The tools used in the mapping process are collected and performed simultaneously in Municipal Community Health Centres in 13 city of Madrid districts. The techniques and tools selected were: photovoice, the healthy deck, radio as a means of disseminating health assets, emotional map, evaluation target and tree. This article explains the process of mapping health assets in the city of Madrid and proposes a simple guide to use different tools, which provides some new ones such as the evaluation target and the tree, that have been implemented in the different mapping processes for health assets in Madrid between 2017 and 2019

Stakeholder consensus for decision making in eye-gaze control technology for children, adolescents and adults with cerebral palsy service provision: findings from a Delphi study.

BACKGROUND: Limited research exists to guide clinical decisions about trialling, selecting, implementing and evaluating eye-gaze control technology. This paper reports on the outcomes of a Delphi study that was conducted to build international stakeholder consensus to inform decision making about trialling and implementing eye-gaze control technology with people with cerebral palsy. METHODS: A three-round online Delphi survey was conducted. In Round 1, 126 stakeholders responded to questions identified through an international stakeholder Advisory Panel and systematic reviews. In Round 2, 63 respondents rated the importance of 200 statements generated by in Round 1. In Round 3, 41 respondents rated the importance of the 105 highest ranked statements retained from Round 2. RESULTS: Stakeholders achieved consensus on 94 of the original 200 statements. These statements related to person factors, support networks, the environment, and technical aspects to consider during assessment, trial, implementation and follow-up. Findings reinforced the importance of an individualised approach and that information gathered from the user, their support network and professionals are central when measuring outcomes. Information required to support an application for funding was obtained. CONCLUSION: This Delphi study has identified issues which are unique to eye-gaze control technology and will enhance its implementation with people with cerebral palsy.

AI-Based Methods and Technologies to Develop Wearable Devices for Prosthetics and Predictions of Degenerative Diseases.

Neurodegenerative diseases, mainly amyotrophic lateral sclerosis, Parkinson, Alzheimer, and rarer diseases, have gained the attention of healthcare service providers due to their impact on the economy of countries where healthcare is a public service. These diseases increase with aging and affect the neuromotor cells and cognitive areas in the brain, causing serious disabilities in people affected by them.Early prediction of these syndromes is the first strategy to be implemented, then the developing of prostheses that rehabilitate motion and the primary cognitive functions. Prostheses could recover some important disabilities such as motion and aphasia, reduce the cost of assistance and increase the life quality of people affected by neurodegenerative diseases.Due to recent advances in the field of artificial intelligence (AI) (deep learning, brain-inspired computational paradigms, nonlinear predictions, neuro-fuzzy modeling), the early prediction of neurodegenerative diseases is possible using state-of-the-art computational technologies. The latest generation of artificial neural networks (ANNs) exploits capabilities such as online learning, fast training, high level knowledge representation, online evolution, learning by data and inferring rules.Wearable electronics is also developing rapidly and represents an important enabling technology to deploy physical and practical (noninvasive) devices using AI-based models for early prediction of neurodegenerative diseases and of intelligent prostheses.Here we describe how to apply advanced brain-inspired methods for inference and prediction, the evolving fuzzy neural network (EFuNN) paradigm and the spiking neural network (SNN) paradigm, and the system requirements to develop a wearable electronic prosthesis for functional rehabilitation.

Telehealth: improving maternity services by modern technology.

Hypertension is considered one of the most common medical disorders causing complexities in pregnancy. It could be a newly developed pregnancy-induced hypertension (PIH) or a pre-existing hypertension developing into superimposed pre-eclamptic toxaemia. PIH affects approximately 10% of pregnancies and can have a serious impact on both maternal and fetal well-being; hence requires frequent monitoring and timely intervention. National Institute for Health and Care Excellence (NICE) guidelines recommends once or twice weekly monitoring of blood pressure for such patients. The required frequent monitoring comes with certain implications for patients and healthcare services. An average patient with PIH would need to see her healthcare provider once or twice a week until delivery and 6 weeks thereafter. This certainly increases pressure on limited National Health Service (NHS) resources. Home-based monitoring using Telehealth technology can represent a potential solution for achieving good-quality care for the patient without increasing the workload for healthcare providers. We used 'Florence', a text-based technology platform to support home monitoring. We tested its acceptability, feasibility and safety to replace face-to-face appointments for blood pressure monitoring in selected patients with PIH. We implemented our project in three progressive phases using a plan, do, study, act methodology. Florence, telehealth technology was used for blood pressure monitoring instead of face-to-face appointments, and the effect of this innovative technology on the services and the patient experience was studied and necessary modifications were made before progression into the next phase. We recruited 75 patients over 12 months through the progressive phases and replaced around 800 face-to-face appointments by remotely supervised monitoring sessions with Florence successfully, with improved care and patient satisfaction. We also achieved better compliance with the NICE guidelines for blood pressure monitoring in PIH. Our project concluded that Telehealth can be a potential solution for improving care in maternity services, with lesser burden on NHS resources.

Nubian Levallois reduction strategies in the Tankwa Karoo, South Africa.

The Middle Stone Age record in southern Africa is recognising increasing diversity in lithic technologies as research expands beyond the coastal-montane zone. New research in the arid Tankwa Karoo region of the South African interior has revealed a rich surface artefact record including a novel method of point production, recognised as Nubian Levallois technology in Late Pleistocene North Africa, Arabia and the Levant. We analyse 121 Nubian cores and associated points from the surface site Tweefontein against the strict criteria which are used to define Nubian technology elsewhere. The co-occurrence of typically post-Howiesons Poort unifacial points suggests an MIS 3 age. We propose that the occurrence of this distinctive technology at numerous localities in the Tankwa Karoo region reflects an environment-specific adaptation in line with technological regionalisation seen more widely in MIS 3. The arid setting of these assemblages in the Tankwa Karoo compares with the desert context of Nubian technology globally, consistent with convergent evolution in our case. The South African evidence contributes an alternative perspective on Nubian technology removed from the 'dispersal' or 'diffusion' scenarios of the debate surrounding its origin and spread within and out of Africa.

Concurrent heart rate validity of wearable technology devices during trail running.

Validation of heart rate responses in wearable technology devices is generally composed of laboratory-based protocols that are steady state in nature and as a result, high accuracy measures are returned. However, there is a need to understand device validity in applied settings that include varied intensities of exercise. The purpose was to determine concurrent heart rate validity during trail running. Twenty-one healthy participants volunteered (female n = 10, [mean (SD)]: age = 31 [11] years, height = 173.0 [7] cm, mass = 75.6 [13] kg). Participants were outfitted with wearable technology devices (Garmin Fenix 5 wristwatch, Jabra Elite Sport earbuds, Motiv ring, Scosche Rhythm+ forearm band, Suunto Spartan Sport watch with accompanying chest strap) and completed a self-paced 3.22 km trail run while concurrently wearing a criterion heart rate strap (Polar H7 heart rate monitor). The trail runs were out-and-back with the first 1.61 km in an uphill direction, and the 1.61 return being downhill in nature. Validity was determined through three methods: Mean Absolute Percent Error (MAPE), Bland-Altman Limits of Agreement (LOA), and Lin's Concordance Coefficient (rC). Validity measures overall are as follows: Garmin Fenix 5 (MAPE = 13%, LOA = -32 to 162, rC = 0.32), Jabra Elite Sport (MAPE = 23%, LOA = -464 to 503, rC = 0.38), Motiv ring (MAPE = 16%, LOA = -52 to 96, rC = 0.29), Scosche Rhythm+ (MAPE = 6%, LOA = -114 to 120, rC = 0.79), Suunto Spartan Sport (MAPE = 2%, LOA = -62 to 61, rC = 0.96). All photoplethysmography-based (PPG) devices displayed poor heart rate agreement during variable intensity trail running. Until technological advances occur in PPG-based devices allowing for acceptable agreement, heart rate in outdoor environments should be obtained using an ECG-based chest strap that can be connected to a wristwatch or other comparable receiver.

Technology Solutions for Nurse Leaders.

Over the next 10 years, the World Health Organization estimates that there will be global shortage of 18 000 000 health care workers. A perfect storm of an aging demographic, long-term drop in birth rate, and a retiring workforce has all the factors contributing to this impending crisis. In nursing, efforts to narrow the shortage gap through strategies that increase the number of admissions to nursing schools, such as increasing faculty members, clinical sites, preceptors, and scholarships, will likely not be enough to offset the shortfall. Solutions, in part, will be to make nurses more productive by reducing waste through the use of technology. This article evaluates how various types of technology such as electronic health records, data analytics, predictive modeling, artificial intelligence, speech recognition, natural language processing, robotics, the Internet of Things, and others can improve nurse productivity by using a Lean framework to eliminate waste and create value.

Expert Drivers' Prospective Thinking-Aloud to Enhance Automated Driving Technologies - Investigating Uncertainty and Anticipation in Traffic.

Current automated driving technology cannot cope in numerous conditions that are basic daily driving situations for human drivers. Previous studies show that profound understanding of human drivers' capability to interpret and anticipate traffic situations is required in order to provide similar capacities for automated driving technologies. There is currently not enough a priori understanding of these anticipatory capacities for safe driving applicable to any given driving situation. To enable the development of safer, more economical, and more comfortable automated driving experience, expert drivers' anticipations and related uncertainties were studied on public roads. First, driving instructors' expertise in anticipating traffic situations was validated with a hazard prediction test. Then, selected driving instructors drove in real traffic while thinking aloud anticipations of unfolding events. The results indicate sources of uncertainty and related adaptive and social behaviors in specific traffic situations and environments. In addition, the applicability of these anticipatory capabilities to current automated driving technology is discussed. The presented method and results can be utilized to enhance automated driving technologies by indicating their potential limitations and may enable improved situation awareness for automated vehicles. Furthermore, the produced data can be utilized for recognizing such upcoming situations, in which the human should take over the vehicle, to enable timely take-over requests.