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Nature Synthesis Jan 2023The use of step count as a metric of synthetic efficiency carries opportunities and challenges. Here, proposals are made to standardize what constitutes a synthetic step...
The use of step count as a metric of synthetic efficiency carries opportunities and challenges. Here, proposals are made to standardize what constitutes a synthetic step and how steps are counted. These proposals may be beneficial in the holistic evaluation of published synthetic routes.
PubMed: 37600476
DOI: 10.1038/s44160-022-00204-3 -
Anesthesiology Mar 2023Electromyography has advantages over mechanomyography and acceleromyography. Previously, agreement of the train-of-four counts between acceleromyography and...
BACKGROUND
Electromyography has advantages over mechanomyography and acceleromyography. Previously, agreement of the train-of-four counts between acceleromyography and electromyography was found to be fair. The objective of this study was to assess the agreement of posttetanic count including agreement of neuromuscular blockade status (intense block, posttetanic count equal to 0; or deep block, posttetanic count 1 or greater and train-of-four count equal to 0) between acceleromyography and electromyography.
METHODS
Thirty-six patients, aged 20 to 65 yr, participated in this study. A dose of 0.6 mg/kg rocuronium, with additional dose of 0.3 mg/kg if required, was administered to the patients. The train-of-four and posttetanic counts were monitored in the contralateral arm using electromyography at the first dorsal interosseus or adductor pollicis, and acceleromyography at the adductor pollicis. Posttetanic count measurements were performed at 6-min intervals; the responses were recorded until the train-of-four count reached 1. The authors evaluated the agreement of degree of neuromuscular blockade (intense or deep block) and that of posttetanic count between acceleromyography and electromyography.
RESULTS
The authors analyzed 226 pairs of measurements. The percentage agreement indicating the same neuromuscular blockade status (intense or deep block) between acceleromyography and electromyography was 73%. Cohen's kappa coefficient value was 0.26. After excluding data with acceleromyography-posttetanic counts greater than 15, a total of 184 pairs of posttetanic counts were used to evaluate the agreement between the two monitoring methods. For acceleromyography-posttetanic count, 42 (23%) pairs had the same electromyography-posttetanic count, and 93 (50%) pairs had more than the electromyography-posttetanic count. The mean posttetanic count on electromyography was 38% (95% CI, 20 to 51%) lower than that on acceleromyography (P = 0.0002).
CONCLUSIONS
Acceleromyography frequently counted more twitches than electromyography in posttetanic count monitoring. Acceleromyography- and electromyography-posttetanic counts cannot be used interchangeably to assess the degree of neuromuscular blockade.
Topics: Humans; Electromyography; Neuromuscular Nondepolarizing Agents; Rocuronium; Neuromuscular Blockade; Muscle, Skeletal
PubMed: 36520831
DOI: 10.1097/ALN.0000000000004466 -
Journal of Exercise Science and Fitness Jun 2015Advances in technology continue to provide numerous options for physical activity assessment. These advances necessitate evaluation of the validity of newly developed...
BACKGROUND/OBJECTIVE
Advances in technology continue to provide numerous options for physical activity assessment. These advances necessitate evaluation of the validity of newly developed activity monitors being used in clinical and research settings. The purpose of this study was to validate the SenseWear Pro3 Armband (SWA) step counts during treadmill walking and free-living conditions.
METHODS
Study 1 observed 39 individuals (17 males, 22 females) wearing an SWA and a Yamax Digiwalker SW-701 pedometer (DIGI) during treadmill walking, utilizing manually counted steps as the criterion. Study 2 compared free-living step count data from 35 participants (17 males, 18 females) wearing the SWA and DIGI (comparison) for 3 consecutive days.
RESULTS
During Study 1, the SWA underestimated steps by 16.0%, 10.7%, 5.6%, 6.1%, and 6.5% at speeds of 54 m/min, 67 m/min, 80 m/min, 94 m/min, and 107 m/min, respectively, compared to manually counted steps. During Study 2, the intraclass correlation (ICC) coefficient of mean steps/d between the SWA and DIGI was strong (r = 0.98, < 0.001). Unlike Study 1, the SWA overestimated step counts during the 3-day wear period by an average of 1028 steps/d (or +11.3%) compared to the DIGI. When analyzed individually, the SWA consistently overestimated step counts for each day ( < 0.05).
CONCLUSION
The SWA underestimates steps during treadmill walking and appears to overestimate steps during free-living compared to the DIGI pedometer. Caution is warranted when using the SWA to count steps. Modifications are needed to enhance step counting accuracy.
PubMed: 29541094
DOI: 10.1016/j.jesf.2014.11.002 -
History and Philosophy of the Life... Apr 2021This article examines the relation between counting, counts and accountability. It does so by comparing the responses of the British government to deaths associated with...
This article examines the relation between counting, counts and accountability. It does so by comparing the responses of the British government to deaths associated with Covid-19 in 2020 to its responses to deaths associated with the 2003 invasion of Iraq. Similarities and dissimilarities between the cases regarding what counted as data, what data were taken to count, what data counted for, and how data were counted provide the basis for considering how the bounds of democratic accountability are constituted. Based on these two cases, the article sets out the metaphors of leaks and cascades as ways of characterising the data practices whereby counts, counting and accountability get configured. By situating deaths associated with Covid-19 against previous experience with deaths from war, the article also proposes how claims to truth and ignorance might figure in any future official inquiry into the handling of the pandemic.
Topics: COVID-19; History, 21st Century; Humans; Iraq War, 2003-2011; Mortality; Pandemics; Social Responsibility; United Kingdom
PubMed: 33900513
DOI: 10.1007/s40656-021-00415-5 -
Neural Regeneration Research Aug 2016Glaucoma is a multifactorial optic neuropathy characterized by the damage and death of the retinal ganglion cells. This disease results in vision loss and blindness. Any... (Review)
Review
Glaucoma is a multifactorial optic neuropathy characterized by the damage and death of the retinal ganglion cells. This disease results in vision loss and blindness. Any vision loss resulting from the disease cannot be restored and nowadays there is no available cure for glaucoma; however an early detection and treatment, could offer neuronal protection and avoid later serious damages to the visual function. A full understanding of the etiology of the disease will still require the contribution of many scientific efforts. Glial activation has been observed in glaucoma, being microglial proliferation a hallmark in this neurodegenerative disease. A typical project studying these cellular changes involved in glaucoma often needs thousands of images - from several animals - covering different layers and regions of the retina. The gold standard to evaluate them is the manual count. This method requires a large amount of time from specialized personnel. It is a tedious process and prone to human error. We present here a new method to count microglial cells by using a computer algorithm. It counts in one hour the same number of images that a researcher counts in four weeks, with no loss of reliability.
PubMed: 27651757
DOI: 10.4103/1673-5374.189166 -
Medical Physics Dec 2022All photon counting detectors have a characteristic count rate over which their performance degrades. Degradation in the clinical setting takes the form of increased...
BACKGROUND
All photon counting detectors have a characteristic count rate over which their performance degrades. Degradation in the clinical setting takes the form of increased noise, reduced material quantification accuracy, and image artifacts. Count rate is a function of patient attenuation, beam filtration, scanner geometry, and X-ray technique.
PURPOSE
To guide protocol and technology development in the photon counting space, knowledge of clinical count rates spanning the complete range of clinical indications and patient sizes is needed. In this paper, we use clinical data to characterize the range of computed tomography (CT) count rates.
METHODS
We retrospectively gathered 1980 patient exams spanning the entire body (head/neck/chest/abdomen/extremity) and sampled 36 951 axial image slices. We assigned the tissue labels air/lung/fat/soft tissue/bone to each voxel for each slice using CT number thresholds. We then modeled four different bowtie filters, 70/80/100/120/140 kV spectra, and a range of mA values. We forward-projected each slice to obtain detector-incident count rates, using the geometry of a GE Revolution Apex scanner. Our analysis divided the detector into thirds: the central one-third, one-third of the detector split into two equal regions adjacent to the central third, and the final one-third divided equally between the outer detector edges. We report the 99th percentile of counts to mimic the upper limits of count rates making passing through a patient as a function of patient water equivalent diameter. We also report the percentage of patient scans, by body region, over different count rate thresholds for all combinations of bowtie and beam energy.
RESULTS
For routine exam types, we recorded count rates of approximately 3.5 × 10 counts/mm /s in the torso, extremities, and brain. For neck scans, we observed count rates near 6 × 10 counts/mm /s. Our simulations of 1000 mA, appropriately mimicking the mA needs for fast pediatric, fast thoracic, and cardiac scanning, resulted in count rates of over 10 × 10 counts/mm /s for the torso, extremities, and brain. At 1000 mA, for the neck region, we observed count rates close to 2 × 10 counts/mm /s. Importantly, we saw only a small change in maximum count rate needs over patient size, which we attribute to patient mis-positioning with respect to the bowtie filters. As expected, combinations of kV and bowtie filter with higher beam energies and wider/less attenuating bowtie fluence profiles lead to higher count rates relative to lower energies. The 99th-50th percentile count rate changed the most for the torso region, with a maximum variation of 3.9 × 10 to 1.2 × 10 counts/mm /s. The head/neck/extremity regions had less than a 50% change in count rate from the 99th to 50th percentiles.
CONCLUSIONS
Our results are the first to use a large patient cohort spanning all body regions to characterize count rates in CT. Our results should be useful in helping researchers understand count rates as a function of body region and mA for various combinations of bowtie filter designs and beam energies. Our results indicate clinical rates >1 × 10 counts/mm /s, but they do not predict the image quality impact of using a detector with lower characteristic count rates.
Topics: Humans; Child; Retrospective Studies; Tomography, X-Ray Computed; Head; Brain; Radionuclide Imaging; Phantoms, Imaging
PubMed: 36195999
DOI: 10.1002/mp.15997 -
Cells May 2021The analysis of cells in the cerebrospinal fluid (CSF) is a routine procedure that is usually performed manually using the Fuchs-Rosenthal chamber and cell microscopy... (Review)
Review
The analysis of cells in the cerebrospinal fluid (CSF) is a routine procedure that is usually performed manually using the Fuchs-Rosenthal chamber and cell microscopy for cell counting and differentiation. In order to reduce the requirement for manual assessment, automated analyses by devices mainly used for blood cell analysis have been also used for CSF samples. Here, we summarize the current state of investigations using these automated devices and critically review their limitations. Despite technical improvements, the lower limit for reliable leukocyte counts in the CSF is still at approximately 20 cells/µL, to be validated depending on the device. Since the critical range for clinical decisions is in the range of 5-30 cells/µL this implies that cell numbers < 30/µL require a manual confirmation. Moreover, the lower limit of reliable erythrocyte detection by automated devices is at approximately 1000/µL. However, even low erythrocyte numbers may be of clinical importance. In contrast, heavily hemorrhagic samples from neurosurgery may be counted automatically at an acceptable precision more quickly. Finally, cell differentiation by automated devices provides only a rough orientation for lymphocytes, granulocytes and monocytes. Other diagnostically important cell types such as tumor cells, siderophages, blasts and others are not reliably detected. Thus, although the automation may give a gross estimate sufficient for the emergency room situation, each CSF requires a manual microscopy for cytological evaluation for the final report. In conclusion, although automated analysis of CSF cells may provide a first orientation of the cell profile in an individual sample, an additional manual cell count and a microscopic cytology are still required and represent the gold standard.
Topics: Automation, Laboratory; Blood Cell Count; Blood Cells; Cerebrospinal Fluid; Equipment Design; Erythrocyte Count; Humans; Lymphocyte Count; Predictive Value of Tests; Reproducibility of Results
PubMed: 34069775
DOI: 10.3390/cells10051232 -
BMC Nursing Apr 2024Operating rooms are complex working environments with high workloads and high levels of cognitive demand. The first surgical count which occurs during the chaotic...
BACKGROUND
Operating rooms are complex working environments with high workloads and high levels of cognitive demand. The first surgical count which occurs during the chaotic preoperative stage and is considered a critical phase, is a routine task in ORs. Interruptions often occur during the first surgical count; however, little is known about the first surgical counting interruptions. This study aimed to observe and analyse the sources, outcomes, frequency of the first surgical counting interruptions and responses to interruptions.
METHODS
A retrospective observational study was carried out to examine the occurrence of the first surgical counting interruptions between 1st August 2023 and 30th September 2023. The data were collected using the "Surgical Counting Interruption Event Form", which was developed by the researchers specifically for this study.
RESULTS
A total of 66 circulating nurses (CNs) and scrub nurses (SNs) were observed across 1015 surgeries, with 4927.8 min of surgical count. The mean duration of the first surgical count was 4.85 min, with a range of 1.03 min to 9.51 min. In addition, 697 interruptions were identified, with full-term interruptions occurring an average of 8.7 times per hour. The most frequent source of interruption during the first surgical counts was instruments (N = 144, 20.7%). The first surgical counting interruptions mostly affected the CN (336 times; 48.2%), followed by the ORNs (including CNs and SNs) (243 times; 34.9%) and the SN (118 times; 16.9%). Most of the outcomes of interruptions were negative, and the majority of the nurses responded immediately to interruptions.
CONCLUSIONS
The frequency of the first surgical counting interruption is high. Managers should develop interventions for interruptions based on different surgical specialties and different nursing roles.
PubMed: 38600519
DOI: 10.1186/s12912-024-01912-1 -
BMC Research Notes May 2016There are many different methodologies used in the literature for determining the number of drugs used by a patient, and many are incompletely described. This may be...
BACKGROUND
There are many different methodologies used in the literature for determining the number of drugs used by a patient, and many are incompletely described. This may be attributable to the lack of a framework to help investigators choose and describe their methods and the lack of evidence on the implications of the choice. The purpose of the study was to propose a framework and illustrate how that framework can be used to create and succinctly describe various approaches to counting the number of drugs used by patients and to examine the impact of varying individual components of the framework on the resulting drug count.
METHODS
The three component framework requires specification of scope, uniqueness, and timeframe. The framework was applied to Medicare beneficiaries admitted for acute myocardial infarction in 2008. Drug use was ascertained by Part D prescription drug event files. A default measure for drug count was established, and fourteen additional measures were created by separately altering individual components of the default to illustrate the application of the framework and understand how these changes impacted drug count. Median drug counts and the frequency distributions of beneficiaries experiencing a change in count from default were produced for each measure.
RESULTS
The median drug count for the default measure was 4. Alteration of the timeframe component had the largest impact on drug counts, with a look-back period of 180 days producing a median count of 8 and changing the count by at least two for 73 % of patients. Variations of the other components had less impact.
CONCLUSION
Our framework is intended to be used by investigators to select an approach to counting number of drugs in their studies. Extending the timeframe over which fills from a pharmacy refill database could be counted toward the drug count produced the greatest changes in the number of drugs.
Topics: Humans; Medicare Part D; Myocardial Infarction; Polypharmacy; United States
PubMed: 27178197
DOI: 10.1186/s13104-016-2076-5 -
British Journal of Haematology May 2017
Topics: Blood Platelets; Humans; Platelet Count; Purpura, Thrombocytopenic, Idiopathic
PubMed: 28466987
DOI: 10.1111/bjh.14626