Cross validation of bi-modal health-related stress assessment

This study explores the feasibility of objective and ubiquitous stress assessment. 25 post-traumatic stress disorder patients participated in a controlled storytelling (ST) study and an ecologically valid reliving (RL) study. The two studies were meant to represent an early and a late therapy session, and each consisted of a "happy" and a "stress triggering" part. Two instruments were chosen to assess the stress level of the patients at various point in time during therapy: (i) speech, used as an objective and ubiquitous stress indicator and (ii) the subjective unit of distress (SUD), a clinically validated Likert scale. In total, 13 statistical parameters were derived from each of five speech features: amplitude, zero-crossings, power, high-frequency power, and pitch. To model the emotional state of the patients, 28 parameters were selected from this set by means of a linear regression model and, subsequently, compressed into 11 principal components. The SUD and speech model were cross-validated, using 3 machine learning algorithms. Between 90% (2 SUD levels) and 39% (10 SUD levels) correct classification was achieved. The two sessions could be discriminated in 89% (for ST) and 77% (for RL) of the cases. This report fills a gap between laboratory and clinical studies, and its results emphasize the usefulness of Computer Aided Diagnostics (CAD) for mental health care

Improving end-of-life care in acute geriatric hospital wards using the Care Programme for the Last Days of Life : study protocol for a phase 3 cluster randomized controlled trial

Background: The Care Programme for the Last Days of Life has been developed to improve the quality of end-of-life care in acute geriatric hospital wards. The programme is based on existing end-of-life care programmes but modeled to the acute geriatric care setting. There is a lack of evidence of the effectiveness of end-of-life care programmes and the effects that may be achieved in patients dying in an acute geriatric hospital setting are unknown. The aim of this paper is to describe the research protocol of a cluster randomized controlled trial to evaluate the effects of the Care Programme for the Last Days of Life. Methods and design: A cluster randomized controlled trial will be conducted. Ten hospitals with one or more acute geriatric wards will conduct a one-year baseline assessment during which care will be provided as usual. For each patient dying in the ward, a questionnaire will be filled in by a nurse, a physician and a family carer. At the end of the baseline assessment hospitals will be randomized to receive intervention (implementation of the Care Programme) or no intervention. Subsequently, the Care Programme will be implemented in the intervention hospitals over a six-month period. A one-year post-intervention assessment will be performed immediately after the baseline assessment in the control hospitals and after the implementation period in the intervention hospitals. Primary outcomes are symptom frequency and symptom burden of patients in the last 48 hours of life. Discussion: This will be the first cluster randomized controlled trial to evaluate the effect of the Care Programme for the Last Days of Life for the acute geriatric hospital setting. The results will enable us to evaluate whether implementation of the Care Programme has positive effects on end-of-life care during the last days of life in this patient population and which components of the Care Programme contribute to improving the quality of end-of-life care

Mapping the genetic architecture of gene expression in human liver

Genetic variants that are associated with common human diseases do not lead directly to disease, but instead act on intermediate, molecular phenotypes that in turn induce changes in higher-order disease traits. Therefore, identifying the molecular phenotypes that vary in response to changes in DNA and that also associate with changes in disease traits has the potential to provide the functional information required to not only identify and validate the susceptibility genes that are directly affected by changes in DNA, but also to understand the molecular networks in which such genes operate and how changes in these networks lead to changes in disease traits. Toward that end, we profiled more than 39,000 transcripts and we genotyped 782,476 unique single nucleotide polymorphisms (SNPs) in more than 400 human liver samples to characterize the genetic architecture of gene expression in the human liver, a metabolically active tissue that is important in a number of common human diseases, including obesity, diabetes, and atherosclerosis. This genome-wide association study of gene expression resulted in the detection of more than 6,000 associations between SNP genotypes and liver gene expression traits, where many of the corresponding genes identified have already been implicated in a number of human diseases. The utility of these data for elucidating the causes of common human diseases is demonstrated by integrating them with genotypic and expression data from other human and mouse populations. This provides much-needed functional support for the candidate susceptibility genes being identified at a growing number of genetic loci that have been identified as key drivers of disease from genome-wide association studies of disease. By using an integrative genomics approach, we highlight how the gene RPS26 and not ERBB3 is supported by our data as the most likely susceptibility gene for a novel type 1 diabetes locus recently identified in a large-scale, genome-wide association study. We also identify SORT1 and CELSR2 as candidate susceptibility genes for a locus recently associated with coronary artery disease and plasma low-density lipoprotein cholesterol levels in the process. © 2008 Schadt et al

A 10-way power divider based on a transducer and a radial junction operating in the circular TM01 mode

This work presents a 10-way Ku-band power divider using a mode transducer and a radial junction connected by an overmoded circular waveguide operating in the TM 01 mode. The circular symmetry of this mode has been exploited to obtain a power divider with the rectangular output ports radially distributed along the broad wall of the waveguides in H-plane configuration. This topology provides the same amplitude and phase for all the output ports. At the same time, a compact profile has been obtained, introducing a simple manufacturing for the two components of the divider. The first component is a mode transducer converting the TE 10 mode in the rectangular waveguide to the TM 01 mode in the circular waveguide. It is based on a novel topology providing a very high purity in the mode conversion with an attenuation for the other propagating mode, the TE 11c , higher than 60 dB. The second component is a 10-way radial junction that must work under the excitation of the TM 01 , whose special features, since this mode is not the fundamental one of the circular waveguide, will be highlighted. The final design has been validated with an experimental prototype, proposing a manufacturing based on four simple parts. This has been the key to obtain an experimental prototype with specifications in the state-of-the-art. The measured efficiency is better than 96.5% in a 16.7% relative frequency bandwidth from 11 GHz to 13 GHz, with return losses better than 25 dB in the common port. The measured difference between the signals at the output ports of the prototype is ±0.3 dB for the amplitudes and ±0.45° for the phases. A comparison of the obtained results with another divider based on the TE 01 mode shows the potential of the presented design for becoming an alternative to the more extended TE 01 -based power dividersThis work was supported by the Spanish Government through the Agencia Estatal de Investigacion, Fondo Europeo de Desarrollo Regional (AEI/FEDER, UE), under Grant TEC2016-76070-C3-1/2-R (ADDMATE

Safety of Lithium Nickel Cobalt Aluminum Oxide Battery Packs in Transit Bus Applications

The future of mass transportation is clearly moving toward the increased efficiency and greenhouse gas reduction of hybrid and electric vehicles. With the introduction of high-power/high-energy storage devices such as lithium ion battery systems serving as a key element in the system, valid safety and security concerns emerge. This is especially true when the attractive high-specific-energy and power-chemistry lithium nickel cobalt aluminum oxide (NCA) is used. This chemistry provides great performance but presents a safety and security risk when used in large quantities, such as for a large passenger bus. If triggered, the cell can completely fuel its own fire, and this triggering event occurs more easily than one may think. To assist engineers and technicians in this transfer from the use of primarily fossil fuels to battery energy storage on passenger buses, the Battery Application Technology Testing and Energy Research Laboratory (BATTERY) of the Thomas D. Larson Pennsylvania Transportation Institute (LTI) in the College of Engineering at The Pennsylvania State University partnered with advanced chemistry battery and material manufacturers to study the safety concerns of an NCA battery chemistry for use in transit buses. The research team ran various experiments on cells and modules, studying rarely considered thermal events or venting events. Special considerations were made to gather supporting information to help better understand what happens, and most importantly how to best mitigate these events and/or manage them when they occur on a passenger bus. The research team found that the greatest safety concern when using such a high-energy chemistry is ensuring passenger safety when a cell’s electrolyte boils and causes the ventilation of high-temperature toxic material. A cell-venting event can be triggered by a variety of scenarios with differing levels of likelihood. Also, though the duration of a venting event is relatively short, on the order of just a few seconds, the temperature of the venting material and cell is extremely high. During a venting event, the high-pressure, burning gases tend to burn holes in nearby packaging materials. Most interestingly, the team discovered that following a venting event the large-format cells tested immediately reached and remained at extremely high external skin temperatures for very long periods, on the order of hours. The majority of this report covers the testing designed to better understand how high-energy cells of this chemistry fail and what materials can be used to manage these failures in a way that increases passenger survivability

Vibration Alert Bracelet for Notification of the Visually and Hearing Impaired

This paper presents the prototype of an electronic vibration bracelet designed to help the visually and hearing impaired to receive and send emergency alerts. The bracelet has two basic functions. The first function is to receive a wireless signal and respond with a vibration to alert the user. The second function is implemented by pushing one button of the bracelet to send an emergency signal. We report testing on a prototype system formed by a mobile application and two bracelets. The bracelets and the application form a complete system intended to be used in retirement apartment communities. However, the system is flexible and could be expanded to add new features or to serve as a research platform for gait analysis and location services. The medical and professional potential of the proposed system is that it offers a simple, modular, and cost-effective alternative to all the existing medical devices with similar functionality currently on the market. The proposed system has an educational potential as well: it can be used as a starting point for capstone projects and demonstration purposes in schools to attract students to STEM disciplines

A bioprinted cardiac patch composed of cardiac-specific extracellular matrix and progenitor cells for heart repair

Congenital heart defects are present in 8 of 1000 newborns and palliative surgical therapy has increased survival. Despite improved outcomes, many children develop reduced cardiac function and heart failure requiring transplantation. Human cardiac progenitor cell (hCPC) therapy has potential to repair the pediatric myocardium through release of reparative factors, but therapy suffers from limited hCPC retention and functionality. Decellularized cardiac extracellular matrix hydrogel (cECM) improves heart function in animals, and human trials are ongoing. In the present study, a 3D-bioprinted patch containing cECM for delivery of pediatric hCPCs is developed. Cardiac patches are printed with bioinks composed of cECM, hCPCs, and gelatin methacrylate (GelMA). GelMA-cECM bioinks print uniformly with a homogeneous distribution of cECM and hCPCs. hCPCs maintain >75% viability and incorporation of cECM within patches results in a 30-fold increase in cardiogenic gene expression of hCPCs compared to hCPCs grown in pure GelMA patches. Conditioned media from GelMA-cECM patches show increased angiogenic potential (>2-fold) over GelMA alone, as seen by improved endothelial cell tube formation. Finally, patches are retained on rat hearts and show vascularization over 14 d in vivo. This work shows the successful bioprinting and implementation of cECM-hCPC patches for potential use in repairing damaged myocardium