Seizure Detection, Seizure Prediction, and Closed-Loop Warning Systems in Epilepsy

Nearly one-third of patients with epilepsy continue to have seizures despite optimal medication management. Systems employed to detect seizures may have the potential to improve outcomes in these patients by allowing more tailored therapies and might, additionally, have a role in accident and SUDEP prevention. Automated seizure detection and prediction require algorithms which employ feature computation and subsequent classification. Over the last few decades, methods have been developed to detect seizures utilizing scalp and intracranial EEG, electrocardiography, accelerometry and motion sensors, electrodermal activity, and audio/video captures. To date, it is unclear which combination of detection technologies yields the best results, and approaches may ultimately need to be individualized. This review presents an overview of seizure detection and related prediction methods and discusses their potential uses in closed-loop warning systems in epilepsy

Smart Sensors for Healthcare and Medical Applications

This book focuses on new sensing technologies, measurement techniques, and their applications in medicine and healthcare. Specifically, the book briefly describes the potential of smart sensors in the aforementioned applications, collecting 24 articles selected and published in the Special Issue “Smart Sensors for Healthcare and Medical Applications”. We proposed this topic, being aware of the pivotal role that smart sensors can play in the improvement of healthcare services in both acute and chronic conditions as well as in prevention for a healthy life and active aging. The articles selected in this book cover a variety of topics related to the design, validation, and application of smart sensors to healthcare

Pilot Medical Monitoring: State of the Science Review on Identification of Pilot Incapacitation

693KA8-22-C-00001Organizations have begun to explore the use of human physiological monitoring technologies in critical safety systems to mitigate risk and adapt to evolving operator concepts. This report describes the initial capabilities needed to support safe flight operations in the case of an incapacitated pilot. We describe aspects of a pilot\u2019s physiological state which, in the absence of a second flight deck crewmember, would instead need to be monitored through sensing technology. We review the maturity of the science of sensing technologies for incapacitation detection. Six types of incapacitation were identified to review the state of the science for incapacitation detection technology: sudden cardiac death, sleep, epileptic seizure, stroke, hypoxia, and acute pain syndrome

Contributory studies to the development, validation and field use of a telemetry system to monitor ventilation and trophic activity in wild Brown Trout

This work was performed as part of a major research project into the evaluation of the ecology of lake dwelling Brown Trout, Salmo trutta L. using ultrasonic biotelemetry techniques. The supplementary research results. leading up to and after the execution of a program of experiments involving the telemetry of feeding and ventilatory rhythms are described: 1. The presence of red (slow) fibres in the adductor mandibulae muscle of Brown Trout was confirmed to be as previously described in the Rainbow Trout, Sälmo gairdneri Richardson and other salmonids. 2. By electromyographic (EMG) and pharmacological means, the red fibres in the a. mandibulae were shown to be active during ventilation and the mosaic fibres comprising the bulk of the muscle were recruited during more dynamic events such as feeding and coughing. Observations were made on the innervation of the red fibres. 3. Comparative investigations made at sea on large deep sea Squaloid and Galeoid sharks (which have a simple adductor muscle like the Trout) showed an identical functional differentiation as obtained in the Trout. 4. The presence of a migratory 'pace setter potential' was found for the first time in Fish. Its use as an indicator of feeding activity by telemetry was rejected on practical grounds. ýýY NO 5. An ultrasonic transmitter was developed to telemeter an analogue of the adductor mandibulae EMG from wild Brown Trout, using a novel electrode design. Four fish were so equipped and released into Airthrey Loch, University of Stirling and tracked for up to 24 hours (following a 24 hr allowance for post-anaesthetic recovery). Feeding and ventilatory periodicity, linear and angular movement patterns and photoperiod were intercorrelated. Angle of turn and subsequent step length were positively correlated and feeding activity was marked by a preference for dextral turning. 'Area restricted searching' and 'area avoided searching' were the probable causes of the movement patterns seen in this and previous investigations at Airthrey Loch. A depth preference and orientation of the fish to topography was demonstrated. Following analysis of the angle of turn and step length data, it was concluded that the larger transmitter package and more severe surgery materially affected the fishes' behaviour relative to data previously obtained at Airthrey Loch using smaller transmitters. 6. Due to difficulties experienced in 5 above due to an unsuspected effect on the a. mandibulae EMG detectable up to 24 hrs post-anaesthesia, a frequency analysis was made of the a. mandibulae EMG of the Brown Trout and several other species. This disclosed that the EMG from red fibres has a frequency spectrum considerably lower than that of 'standard' mammalian muscle. The progressive failure of the EMG transmitter with time was due to a combination of the anaesthetic effect and the frequency spectrum relative to certain design features. (vii, In the light of these observations, subsequent designs of the EMG transmitter were able to take this into account

Pathogenesis and Prevention of Fetal and Neonatal Brain Injury

Recent advances in the clinical management of at-risk pregnancy and care of the newborn have reduced morbidity and mortality among sick neonates, and improved our knowledge of factors that influence the risks of brain injury. In parallel, the refinement of imaging techniques has added to the ability of clinicians to define the etiology, timing and location of pathologic changes with diagnostic and prognostic relevance to the developing fetus and newborn infant. Abnormalities of brain growth, or injury to the developing brain can occur during pregnancy; during labor and delivery, hypoxia, acidosis and ischemia pose major risks to the fetus. Defined practices for the management of pregnancy and delivery, and evidence-based strategies for care in the newborn period are influencing outcome. However, newborn infants, especially those born prematurely, remain at risk from situations that can cause or worsen brain injury. The literature reviewed here explains the mechanisms and timing of injury, and the importance of hypoxia, ischemia, hypotension and infection; describes current diagnostic strategies, neuroimaging technologies and care entities available; and outlines approaches that can be used to prevent or mitigate brain injury. Some show particular promise, and all are relevant to lowering the incidence and severity of brain damage

Anatomical and physiological investigation of pathways mediating the effects of electrical stimulation of the external auricle of the ear on autonomic nervous system activity in rats

The Auricular Branch of the Vagus Nerve (ABVN) is a sensory nerve that innervates select areas of the external auricular dermatome. Electrical stimulation of the auricular region innervated by the ABVN influences the autonomic nervous system, observed by changes in control of the heart in humans and animals. However, the pathways and mechanisms for these effects are unknown. This thesis investigated in rats the pathways mediating the effects of electrical stimulation of the external auricle, comparing an ABVN innervated site of the external ear (the tragus) to an area not reported to receive ABVN innervation, the earlobe. Injection of the neuronal tracer cholera toxin B chain (CTB) into the right tragus (n=4) and right earlobe (n=4) revealed a large degree of similarity in sensory afferent termination sites. Afferent terminals were predominantly labelled ipsilateral to the injection site, with the densest labelling within laminae III-IV of the dorsal horn of the upper cervical spinal cord. In the medulla oblongata, CTB labelled afferents were observed in the paratrigeminal nucleus, cuneate nucleus, and to a minor extent in the nucleus tractus solitarius. Efforts were made to identify the targets of labelled afferents using immunofluorescence for choline acetyltransferase, calbindin, parvalbumin, glutamate decarboxylase 67 and neurokinin receptor 1 expressing cells, but inputs to each cell type were rare. Physiological recordings of the responses to ear stimulation were made in an anaesthetic free Working Heart Brainstem Preparation (WHBP) of the rat. Autonomic profiles of WHBP rats were first examined. Recordings made from rats at night time, revealed more robust sympathetic activity in comparison to day time rats, thus subsequent experiments were conducted in rats at night time. Electrical stimulation (100 Hz, 2.5 mA) was delivered for 5 minutes into the auricular stimulation sites in the WHBP. Direct recording from the sympathetic chain revealed a central sympathoinhibition from both tragus and earlobe stimulation. Sectioning of upper cervical afferent nerve roots silenced the sympathoinhibitory effects of tragus stimulation. Considering the predominance of afferent labelling in the cervical spinal cord dorsal horn and that cervical afferent nerve section reduced the sympathoinhibition evoked by tragus stimulation, this suggests that the autonomic effects of auricular stimulation are conveyed through somatosensory afferents rather than the ABVN

The right to privacy through the development of smart technologies : how our personal health data is affected

L’évolution de la technologie, nonobstant ses apports, peut enfreindre certains de nos droits fondamentaux puisqu’elle se développe plus rapidement que ces derniers. Ce mémoire vise à relever les défis que les technologies intelligentes peuvent poser tant sur la santé des communautés que sur les droits fondamentaux. La thèse porte sur les contraintes juridiques, présentes et à venir, notamment sur le droit à la vie privée à travers le développement et l’usage des technologies intelligentes qui captent notre information personnelle en lien avec la santé. Plus précisément, ce travail analyse si les bénéfices de l’accès à notre information à travers les technologies intelligentes en vue d’améliorer la santé et la sécurité des populations surpassent les conséquences juridiques. Ce travail explore, entre autres, le potentiel des technologies intelligentes, leurs avantages individuels et collectifs, notamment en matière de santé publique, et les violations des droits de l’Homme que leur usage peut générer. Mais encore, il présente des innovations technologiques qui permettent d’améliorer les systèmes de santé étatiques afin d’être en mesure de mieux réagir aux futures épidémies, notamment au niveau international, comme à l’OMS. Ces données, suivies des autres complications possibles du fait d’un usage accru des technologies intelligentes qui restreignent notre vie privée, permettront de conclure si une telle intrusion peut être justifiée dans une société libre et démocratique. Finalement, ce travail regarde les limites de l’acceptabilité sociale de l’intrusion dans la vie privée en échange à de meilleures conditions de santé afin que les organes étatiques et supraétatiques puissent prendre des décisions éclairées, sans que les droits constitutionnels soient violés. Ce travail permettra de comprendre les enjeux que notre système judiciaire inévitablement devra surmonter en proposant des stratégies visant la prévention des maladies et autres problèmes de santé à travers l’usage des technologies intelligentes. Une des solutions principales proposées est la création de bases de données nationale et internationale à l’OMS qui captent les données des appareils intelligents portables.The evolution of technology, notwithstanding its benefits, can negatively impact some of our fundamental rights as it develops faster than the latter. Indeed, this thesis aims to meet challenges generated by smart technologies and the impact they can have on the health of communities as well as on our fundamental rights. This thesis focuses on the legal constraints, present and to come, including the right to privacy, through the development and use of smart technologies that seize our personal health information. More specifically, this work seeks to analyze whether the benefits of accessing our information through smart technologies to improve the health and safety of populations outweigh the legal consequences. This work explores the potential of smart technologies, the interest in using them individually and collectively, especially in the public health sector, and the human rights violations their use can generate. Moreover, it looks at technological innovations that help improve State health systems to be able to better respond to future epidemics, particularly at the international level, such as at the WHO. These data, followed by other possible complications due to the increased use of intelligent technologies that restrict our privacy, will allow us to conclude whether such an intrusion in our right to privacy can be justified in a free and democratic society. Finally, this work examines the limits of the social acceptability of the invasion of privacy in exchange for better health conditions so that States and supra-State bodies can make informed decisions, without violating constitutional rights. This work will help us understand the issues that our judicial system will inevitably face while proposing strategies for the prevention of diseases and other health problems through the use of smart technologies. One of the main proposed solutions is the creation of a national and international database at the WHO generated by the data of smart health devices

Activation of the pro-resolving receptor Fpr2 attenuates inflammatory microglial activation

Poster number: P-T099 Theme: Neurodegenerative disorders & ageing Activation of the pro-resolving receptor Fpr2 reverses inflammatory microglial activation Authors: Edward S Wickstead - Life Science & Technology University of Westminster/Queen Mary University of London Inflammation is a major contributor to many neurodegenerative disease (Heneka et al. 2015). Microglia, as the resident immune cells of the brain and spinal cord, provide the first line of immunological defence, but can become deleterious when chronically activated, triggering extensive neuronal damage (Cunningham, 2013). Dampening or even reversing this activation may provide neuronal protection against chronic inflammatory damage. The aim of this study was to determine whether lipopolysaccharide (LPS)-induced inflammation could be abrogated through activation of the receptor Fpr2, known to play an important role in peripheral inflammatory resolution. Immortalised murine microglia (BV2 cell line) were stimulated with LPS (50ng/ml) for 1 hour prior to the treatment with one of two Fpr2 ligands, either Cpd43 or Quin-C1 (both 100nM), and production of nitric oxide (NO), tumour necrosis factor alpha (TNFα) and interleukin-10 (IL-10) were monitored after 24h and 48h. Treatment with either Fpr2 ligand significantly suppressed LPS-induced production of NO or TNFα after both 24h and 48h exposure, moreover Fpr2 ligand treatment significantly enhanced production of IL-10 48h post-LPS treatment. As we have previously shown Fpr2 to be coupled to a number of intracellular signaling pathways (Cooray et al. 2013), we investigated potential signaling responses. Western blot analysis revealed no activation of ERK1/2, but identified a rapid and potent activation of p38 MAP kinase in BV2 microglia following stimulation with Fpr2 ligands. Together, these data indicate the possibility of exploiting immunomodulatory strategies for the treatment of neurological diseases, and highlight in particular the important potential of resolution mechanisms as novel therapeutic targets in neuroinflammation. References Cooray SN et al. (2013). Proc Natl Acad Sci U S A 110: 18232-7. Cunningham C (2013). Glia 61: 71-90. Heneka MT et al. (2015). Lancet Neurol 14: 388-40