Development and evaluation of a novel 3D in-shoe plantar strain measurement system: STAMPS3D

The formation of diabetic foot ulcers (DFU) is consequential of peripheral neuropathy, peripheral arterial disease and foot deformity, leading to altered foot biomechanics and plantar loads. Plantar load comprises of normal pressure and shear stress, however, there are currently no in-shoe devices capable of measuring both components. The STrain Analysis and Mapping of the Plantar Surface (STAMPS) system, developed at the University of Leeds, utilises Digital Image Correlation (DIC) to measure the strain captured by a plastically deformable insole, as a method to understand plantar load during gait. A 2D DIC software was used to capture cumulative plantar strain and displacement pointwise data, however this method was limited to the analysis of planar surfaces. To address this, 3D instrumentation and DIC methods have been developed and implemented into the STAMPS3D system, used as a tool to capture data that is representative of the non-planar nature of plantar surfaces of the foot. A case-study is used to demonstrate how STAMPS3D can measure multi-dimensional strain, bringing potential to improve clinical screening of DFU risk

Distance-based (and path-based) covering problems for graphs of given cyclomatic number

We study a large family of graph covering problems, whose definitions rely on distances, for graphs of bounded cyclomatic number (that is, the minimum number of edges that need to be removed from the graph to destroy all cycles). These problems include (but are not restricted to) three families of problems: (i) variants of metric dimension, where one wants to choose a small set S of vertices of the graph such that every vertex is uniquely determined by its ordered vector of distances to the vertices of S; (ii) variants of geodetic sets, where one wants to select a small set S of vertices such that any vertex lies on some shortest path between two vertices of S; (iii) variants of path covers, where one wants to select a small set of paths such that every vertex or edge belongs to one of the paths. We generalize and/or improve previous results in the area which show that the optimal values for these problems can be upper-bounded by a linear function of the cyclomatic number and the degree 1-vertices of the graph. To this end, we develop and enhance a technique recently introduced in (Lu et al., 2022 [53]) and give near-optimal bounds in several cases. This solves (in some cases fully, in some cases partially) some conjectures and open questions from the literature. The method, based on breadth-first search, is of algorithmic nature and thus, all the constructions can be computed in linear time. Our results also imply an algorithmic consequence for the computation of the optimal solutions: for some of the problems, they can be computed in polynomial time for graphs of bounded cyclomatic number

Closed-Loop Shape-Forming Control of a Magnetic Soft Continuum Robot

Continuum manipulators are frequently employed in endoluminal interventions, however, a lack of softness and dexterity in standard manipulators can risk trauma during navigation and limit reachable workspace. Magnetically actuated Soft Continuum Robots (MSCRs) offer enhanced miniaturization potential and reduced rigidity due to their external actuation. Magnetizations pertaining only to the tip of the robot offer a limited range of deformation options where more versatile MSCRs can be embedded with distinct, lengthwise magnetization profiles. These full-body bespoke profiles allow the robots to form pre-determined shapes under actuation. Here we propose an approach to model and control MSCR behavior in closed-loop. We employ this system to achieve shape forming navigations subject to variations in initial conditions. To validate our methodology, we conduct experiments using a 50 mm long by 1.8 mm diameter MSCR navigating through a soft phantom from the tip of a duodenoscope. The proposed system is capable of rejecting variations in the angle at which the MSCR is inserted. We employed homogeneous magnetic fields for actuation and closed-loop vision-based control to manipulate the lengthwise body shape of our MSCR. The performance of this closed-loop approach is compared with an open loop counterpart, which fails in all but one navigation attempts into the pancreatic duct

Reflections on the Diverse Voices speaker series

The impacts of extreme weather and climate change will, and are, affecting a diversity of people in many different ways. Yet the UK field of weather and climate appears to be generally un-diverse. Besides its importance for innovation in any field, having a diversity of voices in this field is especially vital, given the often unequal impacts of weather and climate. In 2024, the Royal Meteorological Society supported the set-up of the Diverse Voices speaker series, aimed at improving representation and elevating role models. Here we reflect on the series so far and its outlook for the future

Modelling diabetes and depression in Pakistan:using economic modelling to inform intervention design and a clinical trial of a behavioural activation intervention

OBJECTIVES: The 'Developing and evaluating an adapted behavioural activation intervention for depression and diabetes in South Asia (DiaDeM)' trial investigates a psychological intervention, behavioural activation (BA), on people with both diabetes and depression in Bangladesh and Pakistan. This study aimed to aid the intervention and trial design. DESIGN: This was a modelling study using microsimulation to assess the intervention's cost-effectiveness. Diabetes was modelled using the UK Prospective Diabetes Study model based on Pakistani patients and depression was modelled using Patient Health Questionnaire-9 (PHQ-9) trajectories allowing for multiple depressive episodes. It was assumed that diabetes-related adverse events increased depression recurrence, while depression impacted haemoglobin A1c, increasing diabetes-related events. The model estimated (1) maximum cost of BA which would be cost-effective (headroom analysis) to inform intervention design, and (2) value of reducing uncertainty around different measures (value of information analysis) to prioritise data collection in the DiaDeM study. SETTING: Analysis was conducted from a Pakistani healthcare perspective over a lifetime with costs and outcomes discounted at 3%. INTERVENTIONS: BA plus usual care was compared against usual care. BA involved six sessions by a trained (non-mental health) facilitator. The usual care comparator was the prevailing mix of pharmacological and non-pharmacological treatments used in Pakistan. PRIMARY AND SECONDARY OUTCOME MEASURES: The primary outcome was disability-adjusted life-years (DALYs). Secondary outcomes included life years, healthcare costs and the rate of depression and diabetes-related events. RESULTS: Over their lifetime, individuals receiving BA plus usual care avoid 3.2 (95% credible interval: 2.7 to 3.8) years of mild depression and experience fewer diabetes-related events. BA plus usual care resulted in an additional 0.27 (0.03 to 0.52) life years, 0.98 (0.45 to 1.86) DALYs averted and had incremental healthcare costs of -US$97 (-US$517 to US$142), excluding BA costs. The maximum cost per BA course at which was cost-effective is US$83 (US$9 to US$214). Value of information analysis found the most important measures to include in the trial are the impact of depression on diabetes and PHQ-9 over time. CONCLUSIONS: This is the first model to jointly model depression and diabetes for South Asia and uses novel methods to reflect the diseases and inform intervention and trial design. This evidence has helped to inform the design of the DiaDeM intervention and the trial to evaluate it. TRIAL REGISTRATION: DiaDeM trial: ISRCTN40885204, DOI: ; pre-results, DOI: https://doi.org/10.1186/ISRCTN40885204, DiaDeM-NIHR200806

Planck-PR4 anisotropy spectra show better consistency with general relativity

Wepresent the results from a series of analyses on two parametric tests of gravity that modify the growth of linear, subhorizon matter perturbations in the ΛCDM model. The first test, known as the ðμ;ΣÞ framework, modifies the Poisson and lensing equations from general relativity (GR). The second test introduces the growth index γ, which directly affects the time evolution of matter density perturbations. Our study is motivated by results from the analysis of the Planck-PR3 2018 spectra, which indicate a preference for Σ0 ≠ 0 and γ0 > 0.55, both of which deviate from the ΛCDM predictions at a significance level of ∼2.5σ. To clarify the nature of these anomalous results and understand how the lensing anomaly fits into the picture, we analyze the most recent Planck-PR4 spectra extracted from the updated NPIPE maps. Overall, the Planck-PR4 data show better consistency with GR. The updated likelihood Camspec provides constraints on Σ0 and γ0 that are consistent with GR within 1.5σ and 2σ, respectively. The updated likelihoods HiLLiPoP and LoLLiPoP show even closer agreement, with all parameter values consistent with a ΛCDM cosmology within 1σ. This enhanced consistency is closely correlated with the lensing anomaly. Across the different likelihoods, the tendency of Σ0 and γ0 to drift toward nonstandard values matches the observed preference for AL > 1, both of which are significantly reduced or disappear within the Planck-PR4 data

A Pneumatic Anchoring Mechanism for Improved Stability in Soft Magnetic Manipulators for Surgery

This paper presents a synergistic soft robotic actuation approach, whereby pneumatically induced anchoring is applied to a Soft Magnetic Manipulator (SMM) to enable improved post navigation stability and tip manipulation accuracy. A SMM is equipped with an integrated pneumatic expansion chamber (anchor) and tool channel to enhance stability during interventional procedures. The pneumatic anchor is tested for its position-locking effectiveness during SMM tip loading. Additionally, tip manipulation stability with and without the anchoring system activated is assessed by measurement of the SMM’s ability to trace a parametric circle using an integrated laser fiber. The anchoring mechanism showed a mean improvement in tip actuation accuracy of 73.26%. The system is further demonstrated in the case study of a brain phantom, with the prototype equipped with a laser fiber. The SMM was navigated through a brain fold through application of external magnetic fields exploiting the dual External Permanent Magnet (dEPM) platform. Upon arrival at target site, the anchor was deployed to stabilize the SMM’s tip while laser targeting was performed, demonstrating the potential of this approach for procedures requiring high precision

3D-Printed Variable-Length Magnetically Steered Catheter Tip for Enhanced Access in Aneurysm Interventions

Recent catheter designs have considered the use of magnetically active soft continuum robots controlled via external magnetic actuation systems. These have proven effective for minimally invasive applications due to their soft structure, high dexterity, and wireless actuation, all at small scales. Single and multiple magnetic segment configurations have been proposed to allow tip-only control or full shape-forming, respectively. However, these approaches utilize fixed-length magnetic segments, which require advancement from the proximal end to enhance the reachability and workspace coverage of the steerable tip. To address this limitation, we propose a dual-actuated catheter tip design comprising a 3D-printed soft tendon-driven helical body for length adaptability coupled with a tip-mounted permanent magnet for steering. We achieve a compact design of 2.4 mm outer diameter and 18 mm nominal length, suitable for carotid artery aneurysm intervention. An existing analytical model based on the Euler-Bernoulli beam theory is adapted to predict tip deflection and tip angle under magnetic actuation at three different actuation lengths: contracted, normal, and extended. We demonstrate tip length actuation spanning from a 37.2% reduction to a 35.6% extension, corresponding to 11.3 mm and 24.4 mm when fully contracted and extended, respectively. The experimental magnetic actuation shows a maximum deflection angle of 89.5° with >68° achievable across all length configurations. We subsequently demonstrate how the proposed hybrid tendon and magnetic actuation approach enables enhanced workspace access when compared to a fixed-length design, improving access within simple and more complex aneurysm phantoms

A history of polymyalgia rheumatica: a narrative review

Polymyalgia rheumatica (PMR) is characterized by stiffness and pain in the shoulders, hips and neck and presents most commonly in the eighth decade. It can coexist with giant cell arteritis and the two diseases may share some pathophysiological mechanisms. This narrative review considers present-day ideas about PMR in a historical context, from the first names and descriptions of this disease entity, via successive generations of classification criteria sets, and finally to implications for clinical diagnosis. The characteristic distribution of musculoskeletal inflammation in PMR and its relationship to vasculitic and synovitic diseases have framed the way that PMR is described, classified, diagnosed and treated. A response to glucocorticoids is not specific to PMR and so it is important for rheumatologists to support general practitioners in making a definite diagnosis. Multi-stakeholder collaboration will improve current pathways for fast, accurate diagnosis and safe and effective treatment