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OBJECTIVE: To compare transcatheter aortic valve replacement (TAVR) outcomes during the period when public health emergency (PHE) flexibilities were in place with outcomes during a period before they were introduced. METHODS: Patients who received a native TAVR with either a SAPIEN 3 or SAPIEN 3 Ultra valve from the Society of Thoracic Surgeons/American College of Cardiology Transcatheter Valve Therapy Registry between June 22, 2019, and August 30, 2022, were placed into one of two cohorts: (1) pre-PHE cohort, and (2) peri-PHE cohort. Outcomes included in-hospital events and events occurring 30 days post-TAVR. Patients were matched 1:1 on their propensity of receiving a TAVR during the pre- or peri-PHE periods. After matching, relative risk was calculated for each in-hospital outcome and HRs for outcomes 30 days post-TAVR. RESULTS: In this study, 173,434 patients met inclusion criteria; after 1:1 matching, there were 37,063 patients in each cohort. There was no difference between cohorts in in-hospital outcomes, including all-cause mortality, stroke, composite of mortality and stroke, pacemaker, or major vascular complications. Similarly, there was no statistically significant difference in 30-day outcomes between the cohorts. CONCLUSION: In this large-scale retrospective study of 74,126 patients undergoing TAVR procedures from 2019 to 2022, no significant differences existed in TAVR outcomes during the PHE period.

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Heavy machinery allows for the efficient, precise, and safe management of large-scale operations that are beyond the abilities of humans. Heavy machinery breakdowns or failures lead to unexpected downtime, increasing maintenance costs, project delays, and leading to a negative impact on personnel safety. Predictive maintenance is a maintenance strategy that predicts possible breakdowns of equipment using data analysis, pattern recognition, and machine learning. In this paper, vibration-based condition monitoring studies are reviewed with a focus on the devices and methods used for data collection. For measuring vibrations, different accelerometers and their technologies were investigated and evaluated within data collection contexts. The studies collected information from a wide range of sources in the heavy machinery. Throughout our review, we came across some studies using simulations or existing datasets. We concluded in this review that due to the complexity of the situation, we need to use more advanced accelerometers that can measure vibration.

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The transformative events during early organismal development lay the foundation for body formation and long-term phenotype. The rapid progression of events and the limited material available present major barriers to studying these earliest stages of development. Herein, we report an operationally simple RNA sequencing approach for high-resolution, time-sensitive transcriptome analysis in early (≤3 h) Drosophila embryos. This method does not require embryo staging but relies on single-embryo RNA sequencing and transcriptome ordering along a developmental trajectory (pseudo-time). The resulting high-resolution, time-sensitive mRNA expression profiles reveal the exact onset of transcription and degradation for thousands of transcripts. Further, using sex-specific transcription signatures, embryos can be sexed directly, eliminating the need for Y chromosome genotyping and revealing patterns of sex-biased transcription from the beginning of zygotic transcription. Our data provide an unparalleled resolution of gene expression during early development and enhance the current understanding of early transcriptional processes.

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Non-centrosomal microtubules are essential cytoskeletal filaments that are important for neurite formation, axonal transport, and neuronal migration. They require stabilization by microtubule minus-end-targeting proteins including the CAMSAP family of molecules. Using exome sequencing on samples from five unrelated families, we show that bi-allelic CAMSAP1 loss-of-function variants cause a clinically recognizable, syndromic neuronal migration disorder. The cardinal clinical features of the syndrome include a characteristic craniofacial appearance, primary microcephaly, severe neurodevelopmental delay, cortical visual impairment, and seizures. The neuroradiological phenotype comprises a highly recognizable combination of classic lissencephaly with a posterior more severe than anterior gradient similar to PAFAH1B1(LIS1)-related lissencephaly and severe hypoplasia or absence of the corpus callosum; dysplasia of the basal ganglia, hippocampus, and midbrain; and cerebellar hypodysplasia, similar to the tubulinopathies, a group of monogenic tubulin-associated disorders of cortical dysgenesis. Neural cell rosette lineages derived from affected individuals displayed findings consistent with these phenotypes, including abnormal morphology, decreased cell proliferation, and neuronal differentiation. Camsap1-null mice displayed increased perinatal mortality, and RNAScope studies identified high expression levels in the brain throughout neurogenesis and in facial structures, consistent with the mouse and human neurodevelopmental and craniofacial phenotypes. Together our findings confirm a fundamental role of CAMSAP1 in neuronal migration and brain development and define bi-allelic variants as a cause of a clinically distinct neurodevelopmental disorder in humans and mice.

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The Industrial Internet of Things (IIoT) is bringing evolution with remote monitoring, intelligent analytics, and control of industrial processes. However, as the industrial world is currently in its initial stage of adopting full-stack development solutions with IIoT, there is a need to address the arising challenges. In this regard, researchers have proposed IIoT architectures based on different architectural layers and emerging technologies for the end-to-end integration of IIoT systems. In this paper, we review and compare three widely accepted IIoT reference architectures and present a state-of-the-art review of conceptual and experimental IIoT architectures from the literature. We identified scalability, interoperability, security, privacy, reliability, and low latency as the main IIoT architectural requirements and detailed how the current architectures address these challenges by using emerging technologies such as edge/fog computing, blockchain, SDN, 5G, Machine Learning, and Wireless Sensor Networks (WSN). Finally, we discuss the relation between the current challenges and emergent technologies and present some opportunities and directions for future research work.

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Autonomous sensory meridian response (ASMR) is a phenomenon characterised by a static-like tingling sensation spreading from the scalp and neck to the periphery in response to a variety of audio, visual, and tactile triggers resulting in a highly relaxed state and boosted positive affect. The limited literature on this phenomenon points to a potential of ASMR to alleviate pain. Emerging evidence also suggests that ASMR may be linked to increased sensory sensitivity more broadly. This study aimed to objectively address these claims by administering an algometer (measure of pain tolerance), and a visual analog scale (VAS) (measure of subjective pain sensitivity) to ASMR experiencers and controls at baseline, following an ASMR video, and a control video. Findings indicate that ASMR experiencers have a higher pain sensitivity than controls; however, there was no difference between the two groups in terms of pain tolerance. In addition, any potential analgesic properties associated with experiencing ASMR may reflect protective properties of ASMR buffering against the increased pain sensitivity among ASMR experiencers relative to controls.

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The objective of this scoping review is to develop a model to understand the factors that influence clinical downtimes or clinical activities in a healthcare organization. To report on the results of searches preformed using seven bibliographic databases, using the logical search criteria of (downtime AND (EMR OR Electronic Medical Record OR EHR OR Electronic Health Record). After a title, abstract and full-text review 26 articles remained. The articles were coded and analyzed for themes. Downtime planning activities mitigate the effects of disasters on patient safety outcomes and clinical delays. A model was developed representing the relationships between disasters, the moderating variable of downtime planning activities and patient safety as well as clinical outcomes. Disasters can have significant impact on patients and health professionals. Downtime planning activities can be enacted when a disaster occurs to moderate the effects of the downtime on patients and clinical activities and can improve safety.

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Fine-grained change detection in sensor data is very challenging for artificial intelligence though it is critically important in practice. It is the process of identifying differences in the state of an object or phenomenon where the differences are class-specific and are difficult to generalise. As a result, many recent technologies that leverage big data and deep learning struggle with this task. This review focuses on the state-of-the-art methods, applications, and challenges of representation learning for fine-grained change detection. Our research focuses on methods of harnessing the latent metric space of representation learning techniques as an interim output for hybrid human-machine intelligence. We review methods for transforming and projecting embedding space such that significant changes can be communicated more effectively and a more comprehensive interpretation of underlying relationships in sensor data is facilitated. We conduct this research in our work towards developing a method for aligning the axes of latent embedding space with meaningful real-world metrics so that the reasoning behind the detection of change in relation to past observations may be revealed and adjusted. This is an important topic in many fields concerned with producing more meaningful and explainable outputs from deep learning and also for providing means for knowledge injection and model calibration in order to maintain user confidence.

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This study investigated whether there are gender differences in attention to bodily expressions of pain and core emotions. Three experiments are reported using the attentional dot probe task. Images of men and women displaying bodily expressions, including pain, were presented. The task was used to determine whether participants' attention was drawn towards or away from target expressions. Inconsistent evidence was found for an attentional bias towards body expressions, including pain. While biases were affected by gender, patterns varied across the Experiments. Experiment 1, which had a presentation duration of 500 ms, found a relative bias towards the location of male body expressions compared to female expressions. Experiments 2 and 3 varied stimulus exposure times by including both shorter and longer duration conditions (e.g., 100 vs. 500 vs. 1250 ms). In these experiments, a bias towards pain was confirmed. Gender differences were also found, especially in the longer presentation conditions. Expressive body postures captured the attention of women for longer compared to men. These results are discussed in light of their implications for why there are gender differences in attention to pain, and what impact this has on pain behaviour. PERSPECTIVE: We show that men and women might differ in how they direct their attention towards bodily expressions, including pain. These results have relevance to understanding how carers might attend to the pain of others, as well as highlighting the wider role that social-contextual factors have in pain.

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BACKGROUND: Recent evidence suggests that pain dampens attentional processes. However, much of this work has been based on higher-order attentional tasks that involve only spatial attention. Other aspects of the process through which pain engages and holds attention are relatively understudied, in particular, temporal attention. The present set of studies explored how naturally occurring pain (i.e. acute headache) and pain-valenced stimuli affect the ability to recall the second of two targets presented in rapid succession. METHODS: Across both experiments participants were required to indicate the presence of a predefined probe (T2) and, in the dual task, identify a target (T1). The probe (T2) was placed in three different temporal proximities (ranging from 70 to 1000 ms) following presentation of the target (T1). In Experiment 1, 36 participants completed a task that comprised a rapid stream of letters. Experiment 2 manipulated the threat value, and the complexity, of the stimuli by replacing letters with words. In the dual task condition, T1 was a word from one of four valence categories (neutral, positive, negative, pain). RESULTS: Being in acute pain reduced the accuracy of identification. This reduction in performance occurred regardless of the temporal positioning of the probe, consistent with previous work that suggests pain has an overall dampening effect. Furthermore, when the valence category of the word was pain-related, T2 accuracy performance was negatively affected. CONCLUSION: These findings add to the previous evidence that pain has a general dampening effect on attention and that pain-related stimuli are difficult to disengage from. SIGNIFICANCE: Pain captures attention to allow cognate resources to be directed appropriately in response. However, the temporal effects of this attentional capture are poorly understood. Findings indicate that acute headache pain has a negative impact on participants' performance when identifying the second of two targets presented in close temporal proximity, and that pain-valenced stimuli exacerbate this effect. These findings demonstrate how pain affects early attention and highlights the potential role of disengagement, rather than orientation, of attention in the pain experience.

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With the significant advancement of sensor and communication technology and the reliable application of obstacle detection techniques and algorithms, automated driving is becoming a pivotal technology that can revolutionize the future of transportation and mobility. Sensors are fundamental to the perception of vehicle surroundings in an automated driving system, and the use and performance of multiple integrated sensors can directly determine the safety and feasibility of automated driving vehicles. Sensor calibration is the foundation block of any autonomous system and its constituent sensors and must be performed correctly before sensor fusion and obstacle detection processes may be implemented. This paper evaluates the capabilities and the technical performance of sensors which are commonly employed in autonomous vehicles, primarily focusing on a large selection of vision cameras, LiDAR sensors, and radar sensors and the various conditions in which such sensors may operate in practice. We present an overview of the three primary categories of sensor calibration and review existing open-source calibration packages for multi-sensor calibration and their compatibility with numerous commercial sensors. We also summarize the three main approaches to sensor fusion and review current state-of-the-art multi-sensor fusion techniques and algorithms for object detection in autonomous driving applications. The current paper, therefore, provides an end-to-end review of the hardware and software methods required for sensor fusion object detection. We conclude by highlighting some of the challenges in the sensor fusion field and propose possible future research directions for automated driving systems.

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AIM: To validate a reverse transcriptase-quantitative polymerase chain reaction (RT-qPCR) assay to detect SARS-CoV-2 in saliva in two independent Aotearoa New Zealand laboratories. METHODS: An RT-qPCR assay developed at University of Illinois Urbana-Champaign, USA, was validated in two New Zealand laboratories. Analytical measures, such as limit of detection (LOD) and cross-reactivity, were performed. One hundred and forty-seven saliva samples, each paired with a contemporaneously collected nasal swab, mainly of nasopharyngeal origin, were received. Positive (N=33) and negative (N=114) samples were tested blindly in each laboratory. Diagnostic sensitivity and specificity were then calculated. RESULTS: The LOD was <0.75 copy per µL and no cross-reactivity with MERS-CoV was detected. There was complete concordance between laboratories for all saliva samples with the quantification cycle values for all three genes in close agreement. Saliva had 98.7% concordance with paired nasal samples: and a sensitivity, specificity and accuracy of 97.0%, 99.1% and 99.1%, respectively. CONCLUSION: This saliva RT-qPCR assay produces reproducible results with a low LOD. High sensitivity and specificity make it a reliable option for SARS-CoV-2 testing, including for asymptomatic people requiring regular screening.

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PURPOSE: To report a case of macular vortex vein imaged with indocyanine green angiography, spectral domain optical coherence tomography, and optical coherence tomography angiography. METHODS: Observational case report. RESULTS: A 51-year-old myopic man presented with the complaint of a floater in his left eye for the previous 2 weeks. His visual acuity was 20/25 in the right eye and 20/40 in the left eye. Biomicroscopy was normal. Retinoscopy revealed lattice degeneration and posterior vitreous detachment of both eyes with dilated submacular vasculature in the right eye and submacular hemorrhage in the left eye. Spectral domain optical coherence tomography demonstrated dilated vessels in the choroid of the right eye and a choroidal neovascular membrane in the left eye. Fluorescein angiography and indocyanine green angiography showed a macular vortex vein in the right eye. Optical coherence tomography angiography demonstrated normal vessel densities in the superficial and deep capillary plexuses. No abnormalities were detected in the outer retina or choriocapillaris. Optical coherence tomography angiography delineated the macular vortex vein with a relative flow void in the right eye. His vision remained stable in the right eye. CONCLUSION: Macular vortex veins may be a prominent, albeit rare, incidental finding in highly myopic eyes. Further studies with application of newer optical coherence tomography angiography modalities, such as swept-source optical coherence tomography angiography, are recommended to improve our understanding and monitoring of these structures.

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Pain signals the presence of potential harm, captures attention, and can inhibit performance on concurrent tasks. What is less well known, however, is whether such attentional capture also occurs in a wider social context, such as when observing people in pain. To explore this possibility, we adopted a novel social-cue detection methodology: the bodies-in-the-crowd task. Two experiments are reported that consider whether nonverbal cues of pain, happiness, and anger as expressed through body postures would capture and hold attention. Both experiments recruited 40 (20 male and 20 female) pain-free individuals. Overall, results show that pain postures do not capture attention any more than happiness or anger postures, but disengagement from pain postures was significantly slower across both studies. Gender differences were also found, and were more likely to be found when crowds comprised both men and women. Male pain postures were more likely to capture attention. However, female observers had faster target detection speed, and were quicker to disengage from distractors. They also showed slower disengagement from female expressions overall. Male observers showed no variation based on target or distractor gender. Implications and potential directions for future research are discussed.

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PURPOSE: This review will identify dominant themes, common to published articles that discuss downtime planning in a clinical setting. These common themes will represent key considerations for healthcare organizations' comprehensive downtime plans. METHOD: A scoping study was performed using search results from PubMed, CINAHL and Medline. The 4 articles meeting the inclusion criteria were analyzed for common themes and findings. RESULTS: Four common themes were found in the included articles: 1) Communications plans, 2) Procedure review and revision, 3) Managing system availability and 4) Preparing staff for handling incidents. CONCLUSION: Organizations must have comprehensive downtime plans available to ensure continuity of patient care during the periods of limited availability. A comprehensive downtime plan that includes these four strategies can become the framework for a set of organizational procedures that ensures the best possible access to vital patient information before, during, and after a downtime event.

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BACKGROUND: To study MMP activity in vivo in disease, several radiolabeled MMP inhibitors functioning as radiotracers have been evaluated by means of SPECT and PET. Unfortunately, most of them suffer from metabolic instability, mainly hepatobiliary clearance and insufficient target binding. The introduction of a fluorine atom into MMPIs could contribute to target binding, enhance the metabolic stability and might shift the clearance towards more renal elimination. Recently developed α-sulfonylaminohydroxamic acid based γ-fluorinated inhibitors of MMP-2 and -9 provide promising fluorine interactions with the enzyme active site and high MMP inhibition potencies. The aim of this study is the (radio)synthesis of a γ-fluorinated MMP-2 and -9 inhibitor to evaluate its potential as a radiotracer to image MMP activity in vivo. RESULTS: Two new fluorine-containing, enantiomerically pure inhibitors for MMP-2 and -9 were synthesized in a six step sequence. Both enantiomers exhibited equal inhibition potencies in the low nanomolar and subnanomolar range. LogD value indicated better water solubility compared to the CGS 25966 based analog. The most potent inhibitor was successfully radiofluorinated. In vivo biodistribution in wild type mice revealed predominantly hepatobiliary clearance. Two major radioactive metabolites were found in different organs. Defluorination of the radiotracer was not observed. CONCLUSION: (Radio)synthesis of a CGS based γ-fluorinated MMP inhibitor was successfully accomplished. The (S)-enantiomer, which normally shows no biological activity, also exhibited high MMP inhibition potencies, which may be attributed to additional interactions of fluorine with enzyme's active site. Despite higher hydrophilicity no significant differences in the clearance characteristics compared to non-fluorinated MMPIs was observed. Metabolically stabilizing effect of the fluorine was not monitored in vivo in wild type mice.

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INTRODUCTION: Dysregulated MMP expression or activation is associated with several diseases. To study MMP activity in vivo by means of PET a radiolabeled MMP inhibitor (MMPI) functioning as radiotracer has been developed by our group based on the lead structure CGS 25966. MATERIALS AND METHODS: Aiming at the modification of the pharmacokinetics of this lipophilic model tracer a new class of MMPIs has been discovered, consisting of additional fluorinated hydrophilic substructures, such as mini-PEG and/or 1,2,3-triazole units. To identify the best candidate for further clinical applications, radiofluorinated compounds of each subgroup have been (radio) synthesized and evaluated regarding their biodistribution behavior and their metabolic stability. RESULTS: Radiosyntheses of different triazole based MMPIs could be realized using two step "click chemistry" procedures. Compared to lead structure [(18)F]FEtO-CGS 25966 ([(18)F]1e, log D(exp) =2.02, IC50=2-50nM) all selected candidates showed increased hydrophilicities and inhibition potencies (log D(exp) =0.23-1.25, IC50=0.006-6nM). Interestingly, despite different hydrophilicities most triazole based MMPIs showed no significant differences in their in vivo biodistribution behavior and were cleared predominantly via the hepatobiliary excretion route. Biostability and metabolism studies in vitro and in vivo revealed significant higher metabolic stability for the triazole moiety compared to the benzyl ring in the lead structure. Cleavage of ethylene glycol subunits of the mini-PEG chain led to a faster metabolism of mini-PEG containing MMPIs. CONCLUSION: The introduction of hydrophilic groups such as mini-PEG and 1,2,3-triazole units did not lead to a significant shift of the hepatobiliary elimination towards renal clearance. Particularly the introduction of mini-PEG chains led to an intense metabolic decomposition. Substitution of the benzyl moiety in lead structure 1e by a 1,2,3-trizole ring resulted in an increased metabolic stability. Therefore, the 1,2,3-triazole-1-yl-methyl substituted MMPI [(18)F]3a was found to be the most stable candidate in this series and should be chosen for further preclinical evaluation.

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Many case managers in mental health settings occasionally experience a client's suicide, and this can be an emotionally devastating event. The symptoms of schizophrenia, including the difficulties those client face in forming trusting relationships with others, brings special challenges to the case manager's recovery because of the efforts put into developing that relationship. The purposes of this article are to describe a range of possible reactions of case managers following the suicide of a client with schizophrenia and how those persons can be helped to make a positive recovery from such an event. A summary of suicide risk factors for case managers to assess when working with clients who have schizophrenia is included.

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