Nursing informatics and hospital decision-making: The use of information generated by an automated patient classification system

Automated patient classification systems (PCS) are widely used throughout the United States. Their intended purpose is to generate information to be used in decision making by and for nurses and nursing services. Expenditures for this type of information technology are significant, yet no previous research had been conducted regarding the actual use of information generated by an automated PCS. Thus, the purpose of this research was to describe if, how, and why information obtained from an automated PCS is used in hospital decision making. A qualitative design was used for this organizational case study

Design and Characterization of a Textile Electrode System for the Detection of High-Density sEMG

Muscle activity monitoring in dynamic conditions is a crucial need in different scenarios, ranging from sport to rehabilitation science and applied physiology. The acquisition of surface electromyographic (sEMG) signals by means of grids of electrodes (High-Density sEMG, HD-sEMG) allows obtaining relevant information on muscle function and recruitment strategies. During dynamic conditions, this possibility demands both a wearable and miniaturized acquisition system and a system of electrodes easy to wear, assuring a stable electrode-skin interface. While recent advancements have been made on the former issue, detection systems specifically designed for dynamic conditions are at best incipient. The aim of this work is to design, characterize, and test a wearable, HD-sEMG detection system based on textile technology. A 32-electrodes, 15 mm inter-electrode distance textile grid was designed and prototyped. The electrical properties of the material constituting the detection system and of the electrode-skin interface were characterized. The quality of sEMG signals was assessed in both static and dynamic contractions. The performance of the textile detection system was comparable to that of conventional systems in terms of stability of the traces, properties of the electrode-skin interface and quality of the collected sEMG signals during quasi-isometric and highly dynamic tasks

Upper limbs cranking for post-stroke rehabilitation: A pilot study on healthy subjects

Since one of the major consequences of stroke is hemiparesis, the rehabilitation of upper limbs is necessary to improve the quality of life. Arm cranking gesture represents an alternative rehabilitation tool, especially if accompanied by a biofeedback involving and motivating patients. The aim of this pilot study was twofold: (1) to evaluate the effect of a visual and virtual biofeedback on arm cranking gesture and (2) to estimate the duration of pull and push phases of the crank cycle. Nine healthy and young subjects were involved in the test and were asked to perform the arm cranking gesture in different conditions. A stereophotogrammetric system was adopted to create a virtual, visual and real time biofeedback of cadence, to measure the real cadence of participants and to estimate push and pull phases durations. Results showed that the biofeedback helped subjects to follow an externally imposed cadence. Furthermore, the pull phase resulted to be slightly longer than the push one, although the angular amplitude of the two phases suggested they were the same

Intraseasonal Drainage Network Dynamics in a Headwater Catchment of the Italian Alps

In the majority of existing studies, streams are conceived as static objects that occupy predefined regions of the landscape. However, empirical observations suggest that stream networks are systematically and ubiquitously featured by significant expansion/retraction dynamics produced by hydrologic and climatic variability. This contribution presents novel empirical data about the active drainage network dynamics of a 5 km2 headwater catchment in the Italian Alps. The stream network has been extensively monitored with a biweekly temporal resolution during a field campaign conducted from July to November 2018. Our results reveal that, in spite of the wet climate typical of the study area, more than 70% of the observed river network is temporary, with a significant presence of disconnected reaches during wet periods. Available observations have been used to develop a set of simple statistical models that were able to properly reconstruct the dynamics of the active stream length as a function of antecedent precipitation. The models suggest that rainfall timing and intensity represent major controls on the stream network length, while evapotranspiration has a minor effect on the observed intraseasonal changes of drainage density. Our results also indicate the presence of multiple network expansion and retraction cycles that simultaneously operate at different time scales, in response to distinct hydrological processes. Furthermore, we found that observed spatial patterns of network dynamics and unchanneled lengths are related to the underlying heterogeneity of geological attributes. The study offers novel insights on the physical mechanisms driving stream network dynamics in low-order alpine catchments

Quantification of cortical proprioceptive processing through a wireless and miniaturized EEG amplifier

Corticokinematic coherence (CKC) is computed between limb kinematics and cortical activity (e.g. MEG, EEG), and it can be used to detect, quantify and localize the cortical processing of proprioceptive afference arising from the body. EEG-based studies on CKC have been limited to lab environments due to bulky, non-portable instrumentations. We recently proposed a wireless and miniaturized EEG acquisition system aimed at enabling EEG studies outside the laboratory. The purpose of this work is to compare the EEG-based CKC values obtained with this device with a conventional wired-EEG acquisition system to validate its use in the quantification of cortical proprioceptive processing. Eleven healthy right-handed participants were recruited (six males, four females, age range: 24-40 yr). A pneumatic-movement actuator was used to evoke right index-finger flexion-extension movement at 3 Hz for 4 min. The task was repeated both with the wireless-EEG and wired-EEG devices using the same 30-channel EEG cap preparation. CKC was computed between the EEG and finger acceleration. CKC peaked at the movement frequency and its harmonics, being statistically significant (p < 0.05) in 8-10 out of 11 participants. No statistically significant differences (p < 0.05) were found in CKC strength between wireless-EEG (range 0.03-0.22) and wired-EEG (0.02-0.33) systems, that showed a good agreement between the recording systems (3 Hz: r = 0.57, p = 0.071, 6 Hz: r = 0.82, p = 0.003). As expected, CKC peaked in sensors above the left primary sensorimotor cortex contralateral to the moved right index finger. As the wired-EEG device, the tested wireless-EEG system has proven feasible to quantify CKC, and thus can be used as a tool to study proprioception in the human neocortex. Thanks to its portability, the wireless-EEG used in this study has the potential to enable the examination of cortical proprioception in more naturalistic conditions outside the laboratory environment. Clinical Relevance - Our study will contribute to provide innovative technological foundations for future unobtrusive EEG recordings in naturalistic conditions to examine human sensorimotor system

Intraseasonal Drainage Network Dynamics in a Headwater Catchment of the Italian Alps

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Characterization of the stimulation output of four devices for focal muscle vibration

Different devices for mechano-acoustic muscle vibration became available on the market in the last ten years. Although the use of these vibrators is increasing in research and clinical settings, the features of their stimulation output were never described in literature. In this study we aimed to quantify and compare the stimulation output of the four most widespread pneumatic devices for focal muscle vibration available on the market. A piezoelectric pressure sensor was used to measure the pressure profile generated by the four selected devices in the following experimental conditions: i) measurement of the output changes associated with variations of the stimulation amplitude for three stimulation frequencies (100 Hz, 200 Hz, and 300 Hz); ii) measurement of the output changes during a 20-min long stimulation at constant frequency (300 Hz) and amplitude; iii) measurement of the output changes associated with the progressive activation of all stimulation channels at constant frequency (200 Hz) for different amplitudes. The maximum peak-to-peak amplitudes of the pressure waves were in the range 102 mbar - 369 mbar (below the maximum values declared by the different manufacturers). The shape of the pressure waves generated by the four devices was quasi-sinusoidal and asymmetric with respect to the atmospheric pressure. All output features had a remarkable intra- and inter-device variability. Further studies are required to support the technological improvement of the currently available devices and to focus the issues of vibration effectiveness, limitations, proper protocols, modalities of its application and assessment in neuromuscular training and rehabilitation

Transport of fluorobenzoate tracers in a vegetated hydrologic control volume: 2. Theoretical inferences and modeling

A theoretical analysis of transport in a controlled hydrologic volume, inclusive of two willow trees and forced by erratic water inputs, is carried out contrasting the experimental data described in a companion paper. The data refer to the hydrologic transport in a large lysimeter of different fluorobenzoic acids seen as tracers. Export of solute is modeled through a recently developed framework which accounts for nonstationary travel time distributions where we parameterize how output fluxes (namely, discharge and evapotranspiration) sample the available water ages in storage. The relevance of this work lies in the study of hydrologic drivers of the nonstationary character of residence and travel time distributions, whose definition and computation shape this theoretical transport study. Our results show that a large fraction of the different behaviors exhibited by the tracers may be charged to the variability of the hydrologic forcings experienced after the injection. Moreover, the results highlight the crucial, and often overlooked, role of evapotranspiration and plant uptake in determining the transport of water and solutes. This application also suggests that the ways evapotranspiration selects water with different ages in storage can be inferred through model calibration contrasting only tracer concentrations in the discharge. A view on upscaled transport volumes like hillslopes or catchments is maintained throughout the paper