Objective: This study sought to estimate the prevalence of diagnosis of endometriosis (DxE) in Canada and to assess the symptomatic and diagnostic experience of Canadian women with DxE.Method: A cross-sectional, online survey of women in Canada aged 18 to 49 was conducted from December 7, 2018 through January 24, 2019. Survey data were weighted by Canadian population statistics to estimate the prevalence, symptomatic burden, and diagnostic experience of DxE. Logistic regressions were used to assess differences in symptom burden between women with and without DxE.Results: The estimated prevalence of DxE was 7.0% (2004 women of 28 532 women surveyed). Almost half (47.5%) of women with DxE were aged 18 to 29 when they received an endometriosis diagnosis, and 84.1% experienced symptoms before diagnosis. More women with versus without DxE experienced menstrual pelvic pain or cramping (70.3% vs. 50.7%), non-menstrual pelvic pain or cramping (49.5% vs. 18.7%), dyspareunia (52.5% vs. 28.0%), and infertility (22.3% vs. 6.3%). Women with DxE were more likely to report severe menstrual pelvic pain or cramping (odds ratio [OR] 2.9; 95% confidence interval [CI] 2.5−3.3), non-menstrual pelvic pain or cramping (OR 3.4; 95% CI 2.8−4.2), general abdominal pain (OR 3.0; 95% CI 2.5−3.6), and pelvic pressure (OR 3.0; 95% CI 2.3−3.8). Women with DxE reported an average 5.4-year diagnostic delay, with a 3.1-year delay from onset of symptoms to physician consultation and a 2.3-year delay between physician consultation and diagnosis. Conclusion:Self-reported DxE is prevalent among Canadian women and is associated with a substantial symptomatic burden. The 5.4-year diagnostic delay reported here indicates an important unmet need for more timely diagnosis of endometriosis in Canada.Méthodologie : Une enquête transversale en ligne a et e men ee du 7 d ecembre 2018 au 24 janvier 2019 aupr es de Canadiennes âg ees de 18 a 49 ans. Les donn ees de l'enquête ont et e pond er ees au moyen des statistiques d emographiques canadiennes pour

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development and evaluation, which has not as yet Intelligent wheelchair control has been a topic for many research projects in recent years, but few developments have been successfully transferred from the research to 2 service or commercial domains. This paper addresses some of the reasons for the failure of technology transfer, First, we would suggest that the aim of creating and offers suggestions for more successful exploitation of autonomous wheelchairs is in itself not valid. The most research effort in the future. The paper illustrates the key 'intelligent' agent involved with the powered wheelchair issues through the author's experience in participating in is the driver, not the computer controlling sensors and several research projects, funded by the European Union, motors, and so the most important design aim should be charities and UK government agencies, and in bringing to develop systems which complement, maximise and the CALL Centre. Smart Wheelchair to the market. augment the pilot's skills, not replace them. This in tum means that significant effort has to be devoted to understanding how the user and the system communicate generated useful products, has serious deficiencies.The locus of intelligence 1 Background and share control.The majority of research projects developing intelligent 2.1 wheelchair sensors, controls and technology have concentrated upon improving the autonomous function of A key task is to provide controls and control modes so the mobility aid. Sensors have been used to detect and that disabled users can make the most efficient use of avoid obstacles, map the environment, and plan and their skills and abilities. Those unfamiliar with assistive navigate safe routes around it [I, 2, 3, 4, 51. Ultrasonic, technology may be surprised at the range of equipment infra-red, laser and video sensor systems have all been and techniques that exist to control powered wheelchairs. developed, and novel algorithms created for processing For example, users can control standard commercially and fusing sensor data and for path-planning. In the main, available powered wheelchair by means of the traditional the target population for such projects appears to have joystick manipulated by hand, foot, chin, or head; and been adults with severe physical disabilities. Few of the through control and proximity switches operated by these developments have been evaluated for extended periods and others parts of the body. Dynamic Controls, one of by disabled people, in their day to day living. The impact the main global manufacturers of powered wheelchair of the research and development upon service and the drive systems, offer 13 different sizes and types of transfer of technologies to the commercial sector has been joystick in their current DX range [9]. The variety of limited [6]. Products which are commercially available switches and switch-mounting equipment available is include the CALL Smart Wheelchair, SCAD, from even broader: QED 2000, a leading UK supplier, offer Chailey Heritage [7], the Dynamic Con...

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BackgroundFluid resuscitation during cardiac surgery is common with significant variability in clinical practice. Our goal was to investigate current practice patterns of fluid volume expansion in patients undergoing cardiac surgeries in the USA.MethodsWe conducted a cross-sectional online survey of 124 cardiothoracic surgeons, cardiovascular anesthesiologists, and perfusionists. Survey questions were designed to assess clinical decision-making patterns of intravenous (IV) fluid utilization in cardiovascular surgery for five types of patients who need volume expansion: (1) patients undergoing cardiopulmonary bypass (CPB) without bleeding, (2) patients undergoing CPB with bleeding, (3) patients undergoing acute normovolemic hemodilution (ANH), (4) patients requiring extracorporeal membrane oxygenation (ECMO) or use of a ventricular assist device (VAD), and (5) patients undergoing either off-pump coronary artery bypass graft (OPCABG) surgery or transcatheter aortic valve replacement (TAVR). First-choice fluid used in fluid boluses for these five patient types was requested. Descriptive statistics were performed using Kruskal-Wallis test and follow-up tests, including t tests, to evaluate differences among respondent groups.ResultsThe most commonly preferred indicators of volume status were blood pressure, urine output, cardiac output, central venous pressure, and heart rate. The first choice of fluid for patients needing volume expansion during CPB without bleeding was crystalloids, whereas 5% albumin was the most preferred first choice of fluid for bleeding patients. For volume expansion during ECMO or VAD, the respondents were equally likely to prefer 5% albumin or crystalloids as a first choice of IV fluid, with 5% albumin being the most frequently used adjunct fluid to crystalloids. Surgeons, as a group, more often chose starches as an adjunct fluid to crystalloids for patients needing volume expansion during CPB without bleeding. Surgeons were also more likely to use 25% albumin as an adjunct fluid than were anesthesiologists. While most perfusionists reported using crystalloids to prime the CPB circuit, one third preferred a mixture of 25% albumin and crystalloids. Less interstitial edema and more sustained volume expansion were considered the most important colloid traits in volume expansion.ConclusionsFluid utilization practice patterns in the USA varied depending on patient characteristics and clinical specialties of health care professionals.Electronic supplementary materialThe online version of this article (10.1186/s13741-017-0071-6) contains supplementary material, which is available to authorized users.