Agonistic and mating behaviour of the endemic lizard Trachylepis atlantica from the Fernando de Noronha archipelago, Brazil

The skink Trachylepis atlantica is endemic to the Fernando de Noronha archipelago. Although this species is abundant in the archipelago, it is increasingly threatened by invasive species, predation, and anthropic interference. However, little is known about its natural history. Here we report on territory use, male-male combat, and mating behaviour of freeranging T. atlantica. During the dry season, we observed two bouts of male combat and two copulations, which suggests some mating seasonality. In male combat, T. atlantica displays ritualised agonistic behaviour with escalated aggressiveness that include - i) visualisation, approaching or following, ii) visual display, iii) bite and body confrontation, and iv) dominance. Adult males were always alert to invaders within their territories. After combat, resident males showed scars on their heads resulting from agonistic encounters. During the two copulations, we observed courtship, immobilisation, and mating.

Changes in Electroencephalographic Results and Heart Rate Variability after Exposure to Green Landscape Photographs Correlated with Color Temperature and Illumination Level

Background and objective: Various images from visual display terminals (VDTs) as well as living lighting are important parts of our daily life; thus, properly controlling the lighting environment – that is, illuminance, color temperature and good images from VDTs – can have a substantial effect on improving the mental health and work efficiency in everyday life. We examined electroencephalography (EEG) and heart rate variability (HRV) responses to various lighting conditions in 25 university students as they viewed images of a green landscape or traffic congestion.Methods: EEG was performed in darkness and when the room was illuminated with 10 different light-emitting diode (LED) color temperatures, while the EEG and HRV responses to green landscape or traffic congestion image stimuli were measured in darkness and during room illumination with three different LED color temperatures.Results: We found a significant difference between darkness and high LED illumination (400 lx) at 7 (CZ, F4, FZ, O1, O2, OZ, and T6) of 30 channels, while the alpha wave activity increased during darkness. In the second experiment, the green landscape image stimuli in the 30 lx–2600 K lighting condition elicited theta wave activity on the EEG, whereas the traffic congestion image stimuli under high LED illumination elicited high beta and gamma wave activities. Moreover, the subjects exhibited better stress coping ability and heart rate stability in response to green landscape image stimuli under illuminated conditions, according to their HRV.Conclusion: These results suggest that lower color temperatures and illumination levels alleviate tension, and that viewing green landscape image stimuli at low illumination, or in darkness, is effective for reducing stress. Conversely, high illumination levels and color temperatures are likely to increase tension and stress in response to traffic congestion image stimuli.

Engineering a Clinical Force Measuring Walker for Patients Recovering from Median Sternotomy

Background: Patients often need the use of their arms to assist with functional activities, but after median sternotomy, pushing is frequently limited to less than 4.5 kg. No method exists to objectively measure arm weight bearing in clinical settings. This project aimed to design, construct, and test a walker for patients recovering from median sternotomy to prevent excessive bone stress during ossification. Methods: First, a qualitative study was conducted to obtain critiques of a Clinical Force Measuring (CFM) Walker prototype from rehabilitation professionals. Key statements and phrases were coded that allowed “themes” to emerge from transcribed interviews, which guided device revisions. Next, a second CFM Walker prototype was designed based on the qualitative data and device criteria/constraints and finally tested. Results: The result was fabrication of a new lightweight, streamlined, and cost-effective prototype walker with a simple visual display and auditory cue with upper limit alarms. Key features included attachments for medical equipment and thin film force-sensing resistors integrated into the walker handles that progressively activated 3 LEDs and a buzzer when arm force exceeded programmed thresholds. Conclusions: The innovative CFM Walker will help patients with restricted upper extremity weight bearing, especially elderly adults, recover safer and faster in the future.

Using the BBraun BSmartTM Pressure Manometer to Prevent Unsafe Injection Pressures During Simulated Peripheral Nerve Blockade: A Pilot Study

Background: Peripheral nerve injury during regional anaesthesia may result from accidental intraneural placement of the needle, or forceful needle nerve contact. Intraneural injections are associated with increased resistance to injection, typically >15 psi. The BBraun BSmart™ is an inline mechanical manometer, offering a visual display of injection pressures. Objective: The primary objective of this study was to determine if using the BBraun BSmartTM manometer successfully prevents 90% of anaesthetists and anaesthetic assistants from injecting at pressures > 15 psi during simulated nerve block. Methods: This was a prospective observational study involving anaesthetists and anaesthetic assistants. Two 20 ml injections were performed by each participant, once when the BBraun BSmartTM manometer was obscured from view, and once with the manometer visible. A PendoTech PressureMATTMS recorded injection pressures. Results: 39 participants completed the study, with a total of 78 injections recorded. During the study, 32 peak pressures during the 78 procedures were recorded above the recommended upper limit of 15 psi, 41% of the total injections. The peak pressure rose above 15 psi in 24/39 (62%) injections when the BBraun Bsmart™ manometer was obscured, but only in 8/39 (21%) injections when the manometer was visible. Conclusion: The BBraun Bsmart™ manometer did not successfully prevent 90% of anaesthetists or anaesthetic assistants from injecting at unsafe pressures. However, using the BBraun BSmart™ did reduce the number of unsafe injection pressures generated by participants. When utilised in conjunction with PNS and ultrasound guidance, this may offer additional safety during peripheral nerve blockade.

Improving Newborn Resuscitation by Making Every Birth a Learning Event

One third of all neonatal deaths are caused by intrapartum-related events, resulting in neonatal respiratory depression (i.e., failure to breathe at birth). Evidence-based resuscitation with stimulation, airway clearance, and positive pressure ventilation reduces mortality from respiratory depression. Improving adherence to evidence-based resuscitation is vital to preventing neonatal deaths caused by respiratory depression. Standard resuscitation training programs, combined with frequent simulation practice, have not reached their life-saving potential due to ongoing gaps in bedside performance. Complex neonatal resuscitations, such as those involving positive pressure ventilation, are relatively uncommon for any given resuscitation provider, making consistent clinical practice an unrealistic solution for improving performance. This review discusses strategies to allow every birth to act as a learning event within the context of both high- and low-resource settings. We review strategies that involve clinical-decision support during newborn resuscitation, including the visual display of a resuscitation algorithm, peer-to-peer support, expert coaching, and automated guidance. We also review strategies that involve post-event reflection after newborn resuscitation, including delivery room checklists, audits, and debriefing. Strategies that make every birth a learning event have the potential to close performance gaps in newborn resuscitation that remain after training and frequent simulation practice, and they should be prioritized for further development and evaluation.

Visual world eyetracking using WebGazer.js

The visual world paradigm is one of the most influential paradigms to study real-time language processing. The present study tested whether visual world studies can be moved online, using PCIbex software (Zehr & Schwarz, 2018) and the WebGazer.js algorithm (Papoutsaki et al., 2016) to collect eye-movement data. Experiment 1 was a fixation task in which the participants looked at a fixation cross in multiple positions on the computer screen. Experiment 2 was a web-based replication of a visual world experiment by Dijkgraaf, Hartsuiker and Duyck (2017). Firstly, both experiments revealed that the spatial accuracy of the data allowed us to distinguish looks across the four quadrants of the computer screen. This suggest that the spatial resolution of WebGazer.js is fine-grained enough for most visual world experiments (which typically involve a four-by-four quadrant-based set-up of the visual display). Secondly, both experiments revealed a delay of roughly 300 ms in the time course of the eye movements, most likely caused by the internal processing speed of the browser or WebGazer.js. This delay can be problematic in studying questions that require a fine-grained temporal resolution and requires further investigation.

Predicting Medical Fees for Hospitalized Inpatients and the Determination of Inflection Point

Background: Taiwan’s Bureau of National Health Insurance (BNHI) implemented an inpatient DRG payment system scheduled for January 2008. Many hospital managers urgently invent initiatives to decrease the impacts of DRGs. Predicting medical fees for hospitalized inpatients every day and the corresponding inflection points (IPs) are required for investigations. The aims of this study include (1) verifying the efficacy of the exponential growth model on accumulative publications of mobile health research between 1997 and 2016 in the literature; (2) building the model of predicting medical fees for hospitalized inpatients and determining the inflection points; and (3) demonstrating visualizations of the prediction model online in use for hospital physicians.Methods: An exponential growth model was applied to determine the IP and predict the medical fees to help physicians contain the medical fees of a specific patient during hospitalization. The IP is equal to the item difficulty proven using the differential equation in calculus. An online visual display of the medically contained and predicted inpatient hospitalization was demonstrated in this study.Results: We observed (1) a model accuracy (R2 = 0.99) higher than that (R2 = 0.98) in the literature based on identical data; (2) 231 samples of medical fees for inpatients in the study module with a length of days between 6 and 20 and an IPS falling in the range between 1 and 10 (Q1=0.98, Q3=1.00); and (3) online visualization demonstration of medical fees predicted for hospital inpatients and IP determination on ogive curves.Conclusion: The exponential growth model can be applied to a clinical setting to help physicians consecutively predict medical fees for hospitalized inpatients and upgrade the level of hospital management in the future.

Engineering a Clinical Force Measuring Walker for Patients Recovering from Median Sternotomy

Patients often need the use of their arms to assist with functional activities, but after bone disruption, pushing is frequently limited to less than 4.5 kg. No method exists to measure arm weight bearing objectively in clinical settings. This project aimed to design, construct, and test a walker for patients who need to limit arm force to prevent excessive bone stress during post-fracture (iatrogenic or traumatic) ossification. First, a qualitative study was conducted to obtain critiques of a Clinical Force Measuring (CFM) walker prototype from rehabilitation professionals. Key statements and phrases were coded that allowed “themes” to emerge from transcribed interviews, which guided device revisions. Next, a second CFM Walker prototype was designed based on the qualitative data and device criteria/constraints and finally tested. The result was fabrication of a new lightweight, streamlined, and cost-effective prototype walker with a simple visual display and auditory cue with upper limit alarms. Key features included attachments for medical equipment and thin film force-sensing resistors integrated into the walker handles that progressively activated 3 LEDs and a buzzer when arm force exceeded programmed thresholds. The innovative CFM Walker will help patients with restricted arm weight bearing, especially elderly adults, recover safer and faster in the future.