IEEE Access Special Section Editorial: Wearable and Implantable Devices and Systems

© 2013 IEEE. Circuit techniques, sensors, antennas and communications systems are envisioned to help build new technologies over the next several years. Advances in the development and implementation of such technologies have already shown us their unique potential in realizing next-generation sensing systems. Applications include wearable consumer electronics, healthcare monitoring systems, and soft robotics, as well as wireless implants. There have been some interesting developments in the areas of circuits and systems, involving studies related to low-power electronics, wireless sensor networks, wearable circuit behaviour, security, real-time monitoring, connectivity of sensors, and Internet of Things (IoT). The direction for the current technology is electronics systems on large area electronics, integrated implantable systems and wearable sensors. So far, the research in the field has focused on materials, new processing techniques and one-off devices, such as diodes and transistors. However, current technology is not sufficient for future electronics to be useful in new applications; a great demand exists to scale up the research towards circuits and systems. Recent developments indicate that, in addition to fabrication technology, special attention should also be given to design, simulation and modeling of electronics, while keeping sensing system integration, power management, and sensors network under consideration

From Traditional Adaptive Data Caching to Adaptive Context Caching: A Survey

Context data is in demand more than ever with the rapid increase in the development of many context-aware Internet of Things applications. Research in context and context-awareness is being conducted to broaden its applicability in light of many practical and technical challenges. One of the challenges is improving performance when responding to large number of context queries. Context Management Platforms that infer and deliver context to applications measure this problem using Quality of Service (QoS) parameters. Although caching is a proven way to improve QoS, transiency of context and features such as variability, heterogeneity of context queries pose an additional real-time cost management problem. This paper presents a critical survey of state-of-the-art in adaptive data caching with the objective of developing a body of knowledge in cost- and performance-efficient adaptive caching strategies. We comprehensively survey a large number of research publications and evaluate, compare, and contrast different techniques, policies, approaches, and schemes in adaptive caching. Our critical analysis is motivated by the focus on adaptively caching context as a core research problem. A formal definition for adaptive context caching is then proposed, followed by identified features and requirements of a well-designed, objective optimal adaptive context caching strategy.Comment: This paper is currently under review with ACM Computing Surveys Journal at this time of publishing in arxiv.or

Supporting the transition of children and young people with a spinal cord injury from paediatric to adult healthcare services

The seamless transition from the paediatric to the adult healthcare system, termed healthcare transition, is a significant and critical factor in fostering independence and improved health outcomes. Empirical evidence confirms that a structured healthcare transition process can improve outcomes for young people with chronic conditions. However, to date, healthcare transition research has not explored the impact of healthcare transition interventions for young people with paediatric onset spinal cord injuries. Based on lived experience, people with disabilities have knowledge and expertise to share with researchers. In healthcare research and intervention design, end-user involvement is paramount, as interventions designed in this way are better adapted to the specific needs of users and are often more innovative. Although studies report involving young people with chronic conditions in the development of healthcare transition interventions, few details have been provided as to how this was achieved. This study fills an important gap, as it details how a healthcare transition intervention was co-designed and developed with young people with paediatric onset spinal cord injuries and parents/caregivers. The aim of this study was to co-design, develop, implement, and evaluate a healthcare transition intervention to support young people with spinal cord injuries. This study has provided new insight into the healthcare transition needs of young people with spinal cord injuries. It is also the first study to co-design and develop a healthcare transition intervention in partnership with young people with spinal cord injuries and parents/caregivers. Although the sample was small, it has shown that it is possible to meaningfully engage and empower young people with spinal cord injuries and parents/caregivers in the co-design of a healthcare transition intervention. Using a participatory action research approach and co-design activities resulted in enhanced end-user acceptability of the developed healthcare transition intervention. The initial findings from this research also highlight that the ‘SCI Healthcare Transition’ website is a novel, innovative intervention that is feasible and acceptable. However, further evaluation of the website is needed to determine the impact on healthcare transition experiences and success

Development of Targeted Lipid Nanoparticles for Delivery of siRNA to Neuroblastoma

High-risk neuroblastoma is an aggressive childhood cancer, for which 5-year survival remains less than 50%. Current therapies are non-specific and can lead to acute and long-term side effects. Improved therapies that directly target tumour associated genes are required. Polo-like kinase 1 (PLK1) regulates cell cycle progression, and its over expression in tumours encourages growth. Gene silencing using short interfering RNA (siRNA), is a selective method to target PLK1, with reduced off-target effects. However, efficient delivery of siRNA to tumours requires improved delivery vehicles. Whilst lipid nanoparticles (LNPs) are the most clinically advanced RNA delivery vehicle, clinical siRNA-LNPs exhibit rapid accumulation in liver tissue. I hypothesised that changes in LNP formulation, and active targeting of LNPs to antigens such as epidermal growth factor receptor (EGFR) and disialoganglioside GD2 would improve siRNA delivery to neuroblastoma. siRNA-LNPs were formulated with PEG-lipids that have different detachment kinetics from the LNP surface; DMG-PEG (fast detachment), DSG-PEG and DSPE-PEG (slow detachment). Bispecific antibodies (BsAbs) that recognise either EGFR or GD2 and PEG were used to create targeted LNPs. EGFR targeting improved uptake of siRNA-LNPs in high EGFR-expressing SH-SY5Y neuroblastoma cells in vitro. Similarly, GD2 targeting improved uptake of siRNA-LNPs in GD2-expressing CHP-134 cells. BsAb targeting of LNPs containing PLK1 siRNA (siPLK1-LNPs) resulted in improved PLK1 silencing efficiency compared to untargeted siPLK1-LNPs. Additionally, GD2 targeting reduced the IC50 of siPLK1-LNPs up to 13-fold in CHP-134 cells. Next, the biodistribution of siPLK1-LNPS with and without BsAbs was compared in a neuroblastoma xenograft model. We found that DSG-PEG or DSPE-PEG had higher tumour accumulation compared to DMG-PEG siPLK1-LNPs. However, the presence of BsAb did not significantly impact tumour accumulation. Finally, efficacy studies with untargeted and GD2-targeted siPLK1-LNPs demonstrated that siPLK1 has anti-tumour effects in vivo, although further work is required to optimise therapeutic delivery. In conclusion, this study demonstrates the potential of BsAb targeting and increased PEG-lipid stabilities in improving cell specific uptake and PLK1 gene silencing in neuroblastoma

Dentists’ knowledge and experiences of treating patients with Head and Neck Cancer.

Background In Australasia, Head and Neck Cancer (HNC) is more common and survivable than ever before. As a result, the population prevalence of HNC patients (including HNC survivors) in our communities is ever-increasing. Most of these patients are, at least, partially dentate, and are at high risk of dental disease. Most will seek dental care in the private sector with general dentists. Problematically, little is known about the capacity of general dentists to provide treatment for these complex patients. This study, which is believed to be the first of its kind in this space, will seek to describe the knowledge, attitudes and behaviour of general dentists providing treatment for HNC patients. Methods A cross-sectional survey of a random and representative sample of 800 New Zealand general dentists was undertaken. The survey was self-administered, from a digital platform. Participants were invited into the study by email, and this email contained an embedded hyperlink to the survey. Data were collected on sample demographics and various aspects of the knowledge, attitude and behaviour of general dentists treating patients with a history of HNC. A total of 156 surveys were completed (20.4% response rate). Data was analysed using SPSS software (version 25), by the investigator. Qualitative interview of four key informants was undertaken to provide depth of understanding to the data. Results The majority (73.4%) of registered general dentists who responded to the survey invitation felt that providing dental treatment for HNC patients fell within their scope of practice, however one quarter of dentists had not seen any HNC patients during the previous year in practice, and only 1 in 20 had seen significant numbers (20 or more HNC patients). HNC patient flow was positively associated with the dentist being female, in a metropolitan-based practice, having had work experience in the public sector and currently working in both public and private practices. General dentists were found to have sufficient knowledge to treat HNC patients, in practise if not in theory. On average, dentists answered 9.6 questions correctly out of total of 15 questions (64% of questions answered correctly, on average). HNC patient flow over the preceding year, being aged 50 to 59 years, and having 30 to 39 years of clinical experience, were associated with superior knowledge. The study found that dentists lacked confidence in providing dental treatment for HNC patients. Only one quarter of New Zealand graduates and about 10% of overseas graduates reported that they were confident treating HNC patients. Willingness to provide basic dental treatment for a HNC patient was related to the invasiveness of the treatment itself; typically, the more invasive a procedure, the fewer dentists who would consider undertaking it. Similarly, a clinician’s experience providing basic dental care to HNC patients during the previous year in practice was also dependent on procedural invasiveness. Almost all dentists would give oral hygiene instruction to HNC patients, but only one third would drill down into dietary strategies for oral health. Of greatest concern was the low rate of smoking cessation intervention provided, although this was consistent with rates reported in the evidence base. New Zealand graduates tended to score better than their overseas-trained counterparts in knowledge, attitudes and behaviour aspects of providing dental care for HNC patients. Conclusion In general, dentists have a good level of knowledge about HNC, but they are not able to confidently translate this into practise to provide basic dental treatment for this complex group of patients who are at high risk of dental disease. This study has not been able to clearly identify and describe the barriers to this conversion. Some evidence exists that the majority of dentists do not feel that their undergraduate qualification had adequately prepared them to see HNC patients. Further study in this area is needed, and greater use of qualitative techniques is recommended. Contextual frameworks in this space must be reviewed in order to support access to dental care for HNC patients. Dental education requires revision across the scholastic spectrum- including undergraduate learning, seasoning of new-graduates and strategies to update experienced clinicians with current evidence-based knowledge. Funding of public dental services should be reviewed so that it is viable for public dental clinics to integrate their dentists into established cancer care teams. Patient care pathways by which HNC patients can access dental services should be clarified and made transparent to both primary healthcare providers and patients

Enabling Technologies for Ultra-Reliable and Low Latency Communications: From PHY and MAC Layer Perspectives

© 1998-2012 IEEE. Future 5th generation networks are expected to enable three key services-enhanced mobile broadband, massive machine type communications and ultra-reliable and low latency communications (URLLC). As per the 3rd generation partnership project URLLC requirements, it is expected that the reliability of one transmission of a 32 byte packet will be at least 99.999% and the latency will be at most 1 ms. This unprecedented level of reliability and latency will yield various new applications, such as smart grids, industrial automation and intelligent transport systems. In this survey we present potential future URLLC applications, and summarize the corresponding reliability and latency requirements. We provide a comprehensive discussion on physical (PHY) and medium access control (MAC) layer techniques that enable URLLC, addressing both licensed and unlicensed bands. This paper evaluates the relevant PHY and MAC techniques for their ability to improve the reliability and reduce the latency. We identify that enabling long-term evolution to coexist in the unlicensed spectrum is also a potential enabler of URLLC in the unlicensed band, and provide numerical evaluations. Lastly, this paper discusses the potential future research directions and challenges in achieving the URLLC requirements

Vaccine-preventable Disease in Older Australian Adults

Background: There are limited measures of adult vaccination coverage and factors associated with adult vaccination in Australia. Methods: A systematic review and meta-analysis on influenza and pneumococcal vaccination coverage in Australian adults from 1990-2015 were conducted. Self-reported vaccination data from the 45 and Up Study, a large ongoing prospective cohort study of adults in New South Wales (Australia’s most populous state), were compared to data from the national health insurance scheme, the Medicare Benefits Schedule (MBS) and were subsequently used to investigate vaccination coverage and factors associated with vaccine receipt. A log-binomial model was used to estimate prevalence ratios, adjusted for age and other factors. Results: The systematic review identified 22 studies reporting adult influenza and/or pneumococcal vaccination coverage in Australia. Following introduction of funding, in adults aged > 65 years the summary estimates for influenza and pneumococcal vaccine coverage were 74.8% (95% CI 73.4–76.2%) and 56.0% (95% CI 53.2-58.8) respectively. Limited data for Aboriginal and Torres Strait Islander Australians was available. Linkage of the cohort data with MBS data showed overall agreement on reported influenza vaccination was 70%. Analyses of cohort participants found 67.1% (8576/12779) of those aged > 65 years had an influenza vaccination within the last year whilst 23.5% (16202/68964) reported ever receiving an adult pertussis vaccine. Factors consistently associated with receiving either vaccine were female sex (aPR influenza aPR 1.04 [95%CI 1.02-1.06], pertussis aPR 1.80 [95%CI 1.73-1.86]), non-English speaking country of birth (aPR influenza 0.88[0.83-0.94], pertussis 0.56[0.51-0.63]) and smokers (aPR influenza 0.91[0.84-0.99], pertussis 0.67[0.61-0.75). Receipt of influenza vaccine was more likely in overweight or obese individuals and those with a chronic illness but this was not the case for pertussis vaccine. Conclusion: There are limited data on Australian adult vaccination coverage. Coverage levels found for influenza and pertussis vaccines are sub-optimal and there are sub-groups who could be targeted for vaccination campaigns to improve vaccination