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Virtual reality (VR) is a promising tool with the potential to enhance care of cognitive and affective disorders in the aging population. VR has been implemented in clinical settings with adolescents and children; however, it has been less studied in the geriatric population.
The objective of this study is to determine the existing levels of evidence for VR use in clinical settings and identify areas where more evidence may guide translation of existing VR interventions for older adults.
Design and measurements:
We conducted a systematic review in PubMed and Web of Science in November 2019 for peer-reviewed journal articles on VR technology and its applications in older adults. We reviewed article content and extracted the number of study participants, study population, goal of the investigation, the level of evidence, and categorized articles based on the indication of the VR technology and the study population.
The database search yielded 1554 total results, and 55 articles were included in the final synthesis. The most represented study design was cross-sectional, and the most common study population was subjects with cognitive impairment. Articles fell into three categories for VR Indication: Testing, Training, and Screening. There was a wide variety of VR environments used across studies.
Existing evidence offers support for VR as a screening and training tool for cognitive impairment in older adults. VR-based tasks demonstrated validity comparable to some paper-based assessments of cognition, though more work is needed to refine diagnostic specificity. The variety of VR environments used shows a need for standardization before comparisons can be made across VR simulations. Future studies should address key issues such as usability, data privacy, and confidentiality. Since most literature was generated from high-income countries (HICs), it remains unclear how this may be translated to other parts of the world.
The snow leopard Panthera uncia is the flagship species of the high mountains of the Himalayas. There is potentially continuous habitat for the snow leopard along the northern border of Nepal, but there is a gap in information about the snow leopard in Gaurishankar Conservation Area. Previous spatial analysis has suggested that the Lamabagar area in this Conservation Area could serve as a transboundary corridor for snow leopards, and that the area may connect local populations, creating a metapopulation. However, there has been no visual confirmation of the species in Lamabagar. We set 11 infrared camera traps for 7 months in Lapchi Village of Gaurishankar Conservation Area, where blue sheep Pseudois nayaur, musk deer Moschus leucogaster and Himalayan tahr Hemitragus jemlahicus, all snow leopard prey species, had been observed. In November 2018 at 4,100 m, 5 km south-west of Lapchi Village, one camera recorded three images of a snow leopard, the first photographic evidence of the species in the Conservation Area. Sixteen other species of mammals were also recorded. Camera-trap records and sightings indicated a high abundance of Himalayan tahr, blue sheep and musk deer. Lapchi Village may be a potentially important corridor for snow leopard movement between the east and west of Nepal and northwards to Quomolongma National Park in China. However, plans for development in the region present increasing threats to this corridor. We recommend development of a transboundary conservation strategy for snow leopard conservation in this region, with participation of Nepal, China and international agencies.
The coronavirus disease 2019 (COVID-19) pandemic has led to significant strain on front-line healthcare workers.
In this multicentre study, we compared the psychological outcomes during the COVID-19 pandemic in various countries in the Asia-Pacific region and identified factors associated with adverse psychological outcomes.
From 29 April to 4 June 2020, the study recruited healthcare workers from major healthcare institutions in five countries in the Asia-Pacific region. A self-administrated survey that collected information on prior medical conditions, presence of symptoms, and scores on the Depression Anxiety Stress Scales and the Impact of Events Scale-Revised were used. The prevalence of depression, anxiety, stress and post-traumatic stress disorder (PTSD) relating to COVID-19 was compared, and multivariable logistic regression identified independent factors associated with adverse psychological outcomes within each country.
A total of 1146 participants from India, Indonesia, Singapore, Malaysia and Vietnam were studied. Despite having the lowest volume of cases, Vietnam displayed the highest prevalence of PTSD. In contrast, Singapore reported the highest case volume, but had a lower prevalence of depression and anxiety. In the multivariable analysis, we found that non-medically trained personnel, the presence of physical symptoms and presence of prior medical conditions were independent predictors across the participating countries.
This study highlights that the varied prevalence of psychological adversity among healthcare workers is independent of the burden of COVID-19 cases within each country. Early psychological interventions may be beneficial for the vulnerable groups of healthcare workers with presence of physical symptoms, prior medical conditions and those who are not medically trained.
Primary pests such as Rhyzoperta dominica may increase the contents of dockage, dust, and frass in grain mass. Although it has been suggested that frass can affect the population growth of stored product pests and ecological interactions among primary and secondary pests in stored grain, this has not been validated experimentally. Therefore, this work experimentally tested the hypothesis that R. dominica wheat frass may support population increases in secondary pests such as Tribolium confusum, T. castaneum, and Oryzaephilus surinamensis for the first time. The effect of frass on secondary pest performance was compared with the effects of various physical qualities of wheat grain (i.e., intact grain kernels, grain fragments, flour, grain + frass) and an artificially enriched control diet (milled wheat kernels, oat flakes, and yeast). The results showed that the clean intact grain kernels did not support the population growth of any tested species, and the nutrient-rich control diet provided the best support. Frass was a significantly better food medium for O. surinamensis and T. castaneum than flour or cracked grain, while T. confusum performed equally well on flour and frass. Our results showed that in terms of food quality and suitability for the tested species, frass occupied an intermediate position between the optimized breeding diet and simple uniform cereal diets such as cracked grain or flour. The results suggest that (i) the wheat frass of primary pest R. dominica is a riskier food source for the development of the tested secondary pests than intact or cracked wheat grain or flour; (ii) frass has the potential to positively influence interspecific interactions between R. dominica and the tested secondary pests; and (iii) wheat grain should be cleaned if increases in R. dominica populations and/or accumulated frass are detected.
Contributing to poor global functioning, auditory hallucinations (AH) also interfere with elementary cognitive processes, including auditory discrimination. This is evidenced in schizophrenic (SZ) hallucinators (vs. non-hallucinators) by a greater reduction of the MMN, an auditory event-related brain potential (ERP) generated in part by NMDA receptor activity and normalized with nicotinic (nACh) agonist treatment.
To increase our understanding of NMDA-nACh interactions with auditory processing, using healthy young adults varying in their degree of experience with AH, thereby reducing the confounding influence of illness chronicity and medication associated with the study of SZ patients.
To investigate MMN differences between low and high AH subjects during separate and combined administration of ketamine, an NMDA antagonist, and nicotine, an nACh agonist.
In 40 healthy controls, all rated for AH with the Bell Object Relations and Reality Testing Inventory, MMN to frequency deviants was assessed in a randomized, placebo-controlled crossover design involving the separate and combined administration of a intravenous sub-psychotomimetic dose of ketamine (0.04 mg/kg) and a dose of nicotine gum (4 mg).
In high AH subjects, ketamine reduced MMN, with the resulting amplitude being smaller than that of low AH subjects. This ketamine-induced MMN reduction was evident only with placebo gum; furthermore combined nicotine-ketamine treatment acted to increase MMN in high scorers.
AH in otherwise healthy individuals is associated with heightened sensitivity to NMDA receptor blockade, the effects of which are moderated by nicotinic neurotransmission. Both neurotransmitters may interact to moderate auditory processing and AH in SZ.
Familial risk for psychosis may interact with environmental risk factors.
We are studying a large birth cohort of children of mothers with psychotic disorders, themselves at high risk of developing a psychotic illness, to understand the developmental aetiology of psychotic illness.
Our aim is to examine whether exposure to environmental stressors in childhood, including timing of exposure, is a risk factor for psychotic illness, independent of familial liability. Specificity to maternal schizophrenia is explored.
We used record-linkage across state-wide registers (midwives, psychiatric, child protection and mortality, among others) to identify 15,486 offspring born in Western Australia 1980–2001 to mothers with a lifetime history of psychotic illness (case children) and compared them with 452,459 offspring born in the same period to mothers with no known psychiatric history (comparison children).
A total of 4.1% of case children had developed a psychotic illness compared to 1.1% of comparison children. Exposure to environmental risk factors including obstetric complications, aboriginality, lower socioeconomic status, discontinuity in parenting and childhood abuse significantly increased risk of psychotic illness in offspring. Length and age at time of discontinuity in parenting impacted on risk. At the same time, case children were also significantly more likely than comparison children to be at risk of experiencing these adverse life events.
Exposure to environmental stressors is associated with psychotic illness, and timing of exposure is important. However, children already at increased familial risk for psychotic illness are also at increased risk of experiencing these environmental stressors.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
Introduction: Intranasal dexmedetomidine (IND) is an emerging agent for procedural distress in children. However, studies to date have been limited by small samples and imprecise estimates of effect size. We sought to summarize the evidence on the effectiveness of IND for procedures associated with distress in children. Methods: We performed electronic searches of MEDLINE (1946-2018), EMBASE (1980-2018), Google Scholar (2018), CINAHL (1981-2018), Cochrane Central Register of Controlled Trials (2018), 6 clinical trials registries and conference proceedings (2010-2018). Title searches, data abstraction, and risk of bias assessments were performed in duplicate. We included all published and unpublished, randomized and quasi-randomized trials of IND for procedures in children younger than 19 years of age without language restriction. The methodological quality of studies was evaluated using the Cochrane Collaboration's Risk of Bias tool. The primary outcome was the proportion of participants that were deemed to be adequately sedated for the procedure. Results: Of 661 studies, 18 met inclusion criteria. Trials involved 2128 participants, age 1 month - 14 years (836, 39.3% females), who received IND 1 - 4 mcg/kg either by drops (n = 12), atomizer (n = 4), or both (n = 2). 12 trials were eligible for meta-analysis. 13 trials used validated instruments to assess sedation. All studies except one were associated with low or moderate risk of bias. For painful procedures (IV insertion; laceration repair; dental extraction), the pooled OR (95% CI) for adequate sedation and need for additional analgesia was non-significant [1.19 (0.53, 2.65)] and [2.16 (0.62, 7.49)], respectively (n = 5). For non-painful procedures (diagnostic imaging), the corresponding pooled OR (95% CI) favored IND [3.04 (1.58, 5.82)] and [4.44 (2.11, 9.35)], respectively (n = 7). Time to onset and duration of sedation ranged from 13-31 minutes and 41-91.5 minutes, respectively. For adverse effects, the pooled OR (95% CI) was not significantly different between IND and comparators [0.58 (0.22, 1.55] and there were no serious adverse events. Conclusion: IND at doses 1 to 4 mcg/kg are safe and adequately sedate children undergoing non-painful procedures, although the ease of administration must be weighed against the risk of prolonged sedation. Additional trials with larger sample sizes and greater methodologic rigor are needed for painful emergency department procedures such as laceration repair and IV insertion.
We observed pediatric S. aureus hospitalizations decreased 36% from 26.3 to 16.8 infections per 1,000 admissions from 2009 to 2016, with methicillin-resistant S. aureus (MRSA) decreasing by 52% and methicillin-susceptible S. aureus decreasing by 17%, among 39 pediatric hospitals. Similar decreases were observed for days of therapy of anti-MRSA antibiotics.
This paper discusses the concept and parameter design of a robust stair-climbing compliant modular robot, capable of tackling stairs with overhangs. Geometry modifications of the periphery of the wheels of our robot helped in tackling overhangs. Along with establishing a concept design, the robust design parameters are set to minimize performance variations. The Grey-based Taguchi method is applied to provide an optimal setting for the design parameters of the robot. The robot prototype is shown to have successfully scaled stairs of varying dimensions, with overhang, thus corroborating the analysis performed.
Section 1 of the FM14 focus on bridging the astronomy research and outreach communities - recent highlights, emerging collaborations, best practices and support structures. This paper also contains supplementary materials that point to contributed talks and poster presentations that can be found online.
Echinacea purpurea is one of the most widely used medicinal herbs that is of interest to animal scientists due to its valuable immuno-stimulatory and anti-inflammatory properties. It is thought that it activates the immune system through stimulating T-cell production, lymphocytic activity, phagocytosis, cellular respiration and inhibiting the secretion of the hyaluronidase enzyme. Chicoric acid (CA) is a major active constituent of Echinacea purpurea. The CA content in roots ranges between 16.80-24.30 mg/g which has gained a lot of renown due to its promising bio-activities. CA has shown to simulate growth promoters and have antioxidant, anti-diabetic, anti-inflammatory, anti-HIV, anti-bacterial, hypoglycaemic and hepatocyte protective properties. There have been very few studies relevant to CA and its use in poultry diets. Previously published studies have included pharmacological and nutritional investigations in the poultry industry. CA could be used as an alternative to antibiotics, and may improve meat quality and health status in broiler chickens.
The Learning Health System Network clinical data research network includes academic medical centers, health-care systems, public health departments, and health plans, and is designed to facilitate outcomes research, pragmatic trials, comparative effectiveness research, and evaluation of population health interventions.
The Learning Health System Network is 1 of 13 clinical data research networks assembled to create, in partnership with 20 patient-powered research networks, a National Patient-Centered Clinical Research Network.
Results and Conclusions
Herein, we describe the Learning Health System Network as an emerging resource for translational research, providing details on the governance and organizational structure of the network, the key milestones of the current funding period, and challenges and opportunities for collaborative science leveraging the network.
In August 2015 a gastroenteritis outbreak occurred following a wedding. An outbreak investigation was undertaken and a cohort study was conducted using an online survey. Of 140 guests, 134 received the survey and 113 responded (84·3% response rate). Seventy respondents met the case definition of vomiting and/or diarrhoea within 72 h of the wedding (61·9% attack rate). Fifteen exposures were associated with illness; on stratification, all were confounded by the ham hock starter. Multivariable analysis showed a significant association with exposure to ham hock (risk ratio 6·62, 95% confidence interval 2·19–20·03). Eight guests and two catering staff submitted stool samples. All tested positive for norovirus GI-6 infection, including a food handler who had vomiting less than 48 h before the wedding. A single genotype was detected among all samples, suggesting a single source of contamination. The transmission pattern suggested point-source exposure. The most plausible cause of the outbreak was transmission from an infected food handler via contaminated food. This highlights the importance of appropriate exclusions for symptomatic food handlers. Additionally, the food handler's stool sample was submitted 7 days after symptom resolution. The potential for extended viral excretion, and the extremely low infective dose of norovirus, may mean that current exclusion guidelines are not of sufficient duration.
Experiments on the National Ignition Facility show that multi-dimensional effects currently dominate the implosion performance. Low mode implosion symmetry and hydrodynamic instabilities seeded by capsule mounting features appear to be two key limiting factors for implosion performance. One reason these factors have a large impact on the performance of inertial confinement fusion implosions is the high convergence required to achieve high fusion gains. To tackle these problems, a predictable implosion platform is needed meaning experiments must trade-off high gain for performance. LANL has adopted three main approaches to develop a one-dimensional (1D) implosion platform where 1D means measured yield over the 1D clean calculation. A high adiabat, low convergence platform is being developed using beryllium capsules enabling larger case-to-capsule ratios to improve symmetry. The second approach is liquid fuel layers using wetted foam targets. With liquid fuel layers, the implosion convergence can be controlled via the initial vapor pressure set by the target fielding temperature. The last method is double shell targets. For double shells, the smaller inner shell houses the DT fuel and the convergence of this cavity is relatively small compared to hot spot ignition. However, double shell targets have a different set of trade-off versus advantages. Details for each of these approaches are described.
This paper discusses the development of an optimal wheel-torque controller for a compliant modular robot. The wheel actuators are the only actively controllable elements in this robot. For this type of robots, wheel-slip could offer a lot of hindrance while traversing on uneven terrains. Therefore, an effective wheel-torque controller is desired that will also improve the wheel-odometry and minimize power consumption. In this work, an optimal wheel-torque controller is proposed that minimizes the traction-to-normal force ratios of all the wheels at every instant of its motion. This ensures that, at every wheel, the least traction force per unit normal force is applied to maintain static stability and desired wheel speed. The lower this is, in comparison to the actual friction coefficient of the wheel-ground interface, the more margin of slip-free motion the robot can have. This formalism best exploits the redundancy offered by a modularly designed robot. This is the key novelty of this work. Extensive numerical and experimental studies were carried out to validate this controller. The robot was tested on four different surfaces and we report an overall average slip reduction of 44% and mean wheel-torque reduction by 16%.
Obesity is a growing problem in India, the dietary determinants of which have been studied using an ‘individual food/nutrient’ approach. Examining dietary patterns may provide more coherent findings, but few studies in developing countries have adopted this approach. The present study aimed to identify dietary patterns in an Indian population and assess their relationship with anthropometric risk factors.
FFQ data from the cross-sectional sib-pair Indian Migration Study (IMS; n 7067) were used to identify dietary patterns using principal component analysis. Mixed-effects logistic regression was used to examine associations with obesity and central obesity.
The IMS was conducted at four factory locations across India: Lucknow, Nagpur, Hyderabad and Bangalore.
The participants were rural-to-urban migrant and urban non-migrant factory workers, their rural and urban resident siblings, and their co-resident spouses.
Three dietary patterns were identified: ‘cereals–savoury foods’ (cooked grains, rice/rice-based dishes, snacks, condiments, soups, nuts), ‘fruit–veg–sweets–snacks’ (Western cereals, vegetables, fruit, fruit juices, cooked milk products, snacks, sugars, sweets) and ‘animal-food’ (red meat, poultry, fish/seafood, eggs). In adjusted analysis, positive graded associations were found between the ‘animal-food’ pattern and both anthropometric risk factors. Moderate intake of the ‘cereals–savoury foods’ pattern was associated with reduced odds of obesity and central obesity.
Distinct dietary patterns were identified in a large Indian sample, which were different from those identified in previous literature. A clear ‘plant food-based/animal food-based pattern’ dichotomy emerged, with the latter being associated with higher odds of anthropometric risk factors. Longitudinal studies are needed to further clarify this relationship in India.
Tolerance toward extreme groups was measured by asking respondents for their level of agreement with the following statements: “I feel sorry for groups that are the targets of FBI surveillance,” “the media should give extremist groups the opportunity to express their views,” “a group that is targeted by the FBI probably deserves the treatment it gets” (reverse-coded), and “the media should not encourage extremist groups by providing news coverage” (reverse-coded). Tolerance toward extreme groups was constructed by averaging respondents’ answers on a 10-point scale (Cronbach’s alpha = .75, M = 6.00, SD = 1.77).
Tolerance for Targeted Group Index
Tolerance for the targeted group was operationalized with an additive index of four statements taken from Marcus et al. (1995), but modified to fit the current social context. Subjects were asked how they felt about a set of statements regarding the treatment of the hypothetical group that had appeared on the manipulation stories: group members should be allowed to work as a teacher in public schools, hold public rallies, broadcast public access cable programs, and share their views over the Internet. Items were measured on 10-point scales from “strongly disagree” to “strongly agree.” Responses were used to create an index averaging the scores from these items (Cronbach’s α = .77, M = 7.12, SD = 1.86).
According to the coding scheme, coders focused exclusively on manifest content in order to establish a high degree of reliability in coding three factors: the degrees of differentiation (i.e., the number of discrete cognitive categories mentioned), the average elaboration (i.e., the extent of detail provided for each mentioned category), and integration (i.e., the interconnectedness of the various cognitive categories mentioned) in the answers provided by respondents.
The coding instrument asked coders to focus on nine conceptual categories that had been identified from a preliminary examination of the open-ended responses. To establish differentiation, coders were asked to judge which constructs were present in an explicit fashion in each answer. For example, if a respondent mentioned in her answer the “importance of ensuring due process for all,” this would have been coded as one construct (category #6: rights/constitution/freedoms). If in addition to mentioning due process, the respondent wrote about the threats posed to national security by the activities of certain groups and the need to ensure public safety, the coder, recognizing the presence of a second construct (category #5: national security/safety), would give this response a value of 2 in terms of construct differentiation.
In addition to the number of constructs present in the answer, coders were asked to rate the degree of elaboration for each concept that was present. Following the example given, just mentioning the importance of due process would have been coded as low in elaboration. A one-sentence explanation of due process would have received a medium elaboration grade, while an extended explanation of due process (two sentences or more on the subject) would have been coded as high on elaboration.