Continuous non-invasive eye tracking in intensive care

Delirium, an acute confusional state, is a common occurrence in Intensive Care Units (ICUs). Patients who develop delirium have globally worse outcomes than those who do not and thus the diagnosis of delirium is of importance. Current diagnostic methods have several limitations leading to the suggestion of eye-tracking for its diagnosis through in-attention. To ascertain the requirements for an eye-tracking system in an adult ICU, measurements were carried out at Chelsea & Westminster Hospital NHS Foundation Trust. Clinical criteria guided empirical requirements of invasiveness and calibration methods while accuracy and precision were measured. A non-invasive system was then developed utilising a patient-facing RGB camera and a scene-facing RGBD camera. The system’s performance was measured in a replicated laboratory environment with healthy volunteers revealing an accuracy and precision that outperforms what is required while simultaneously being non-invasive and calibration-free The system was then deployed as part of CONfuSED, a clinical feasibility study where we report aggregated data from 5 patients as well as the acceptability of the system to bedside nursing staff. To the best of our knowledge, the system is the first eye-tracking systems to be deployed in an ICU for delirium monitoring

Management of Post Traumatic Stress Disorder (PTSD) in Patients’ Relatives and Intensive Care Personnel in a Teaching Hospital

Post-traumatic stress disorder (PTSD) is a condition triggered by the experience of traumatic events and it can lead to long-term difficulties for patients and relatives in regards with their quality of life. There is growing body of evidence regarding the prevalence of PTSD amongst intensive care personnel. We set out to investigate whether there is a need for psychological support for both critically ill patients’ relatives and the intensive care unit (ICU) personnel. Method: A prospective two-stage survey was conducted in the ICU of a teaching hospital in the United Kingdom. Two predefined questionnaires composed of closed and open questions focusing on emotional needs and individual views of psychological support were distributed to Group 1 formed by families members (Group 1A) and ICU personnel (Group 1B) in the surveySupporting Families Emotional Needs, and to Group 2 composed by ICU personnel in the survey Supporting Staff Emotional Needs. Results: There were 77 questionnaires completed. In Group 1 there were 41 questionnaires completed on the “Supporting Families Emotional Needs” survey (16 by Group 1A and 25 by Group 1B members) and in Group 2 there were 36 questionnaires completed on the “Supporting Staff Emotional Needs” survey. Both surveys highlighted the need for a psychological support service. The design of this type of service was also investigated and was formed by opinions of the participants. Conclusion: There is a need for additional emotion support within the ICU. Yet further work is needed to identify strategies in order to provide this support

Double-Staged Syndrome Coding Scheme for Improving Information Transmission Security over the Wiretap Channel

This paper presents a study of a syndrome coding scheme for different binary linear error correcting codes that refer to the code families such as BCH, BKLC, Golay, and Hamming. The study is implemented on Wyner’s wiretap channel model when the main channel is error-free and the eavesdropper channel is a binary symmetric channel with crossover error probability (0 < Pe ≤ 0.5) to show the security performance of error correcting codes while used in the single-staged syndrome coding scheme in terms of equivocation rate. Generally, these codes are not designed for secure information transmission, and they have low equivocation rates when they are used in the syndrome coding scheme. Therefore, to improve the transmission security when using these codes, a modified encoder which consists of a double-staged syndrome coding scheme, is proposed. Two models are implemented in this paper: the first model utilizes one encoding stage of the conventional syndrome coding scheme. In contrast, the second model utilizes two encoding stages of the syndrome coding scheme to improve the results obtained from the first model. The C++ programming language, in conjunction with the NTL library, is used for obtaining simulation results for the implemented models. The equivocation rate results from the second model were compared to both the results of the first model and of the unsecured transmission (transmission of data without encryption). The comparison revealed that the security performance of the second model is better than the first model and the insecure system, as the equivocation for all the simulated codes over the proposed model reaches at least %97 at the Pe = 0.1.

Microwave irradiation synthesis and characterization of reduced-(graphene oxide-(polystyrene-polymethyl methacrylate))/silver nanoparticle nanocomposites and their anti-microbial activity.

Herein, we report a facile process for the preparation of styrene and methyl-methacrylate copolymer nanocomposites containing reduced graphene oxide and silver nanoparticles ((R-(GO-(PS-PMMA))/AgNPs)) by using (i) microwave irradiation (MWI) to obtain R-(GO-(PSPMMA))/AgNPs and (ii) the in situ bulk polymerization technique to produce RGO/AgNPs-(PSPMMA). Various characterization techniques, including FT-IR, XPS, Raman spectroscopy, XRD, SEM, HR-TEM, DSC, and TGA analysis, were used to characterize the prepared nanocomposites. The Berkovich nanoindentation method was employed to determine the hardness and elastic modulus of the nanocomposites. The results showed that the MWI-produced nanocomposites were found to have enhanced morphological, structural, and thermal properties compared with those of the nanocomposites prepared by the in situ method. In addition, the antibacterial activity of the prepared nanocomposites against the E. coli HB 101 K-12 was investigated, whereby an inhibition zone of 3 mm (RGO/AgNPs-(PS-PMMA) and 27 mm (R-(GO-(PS-PMMA))/AgNPs) was achieved. This indicates that the MWI-prepared nanocomposite has stronger antibacterial activity than the in situ-prepared nanocomposite

Perioperative Research into Memory (PRiMe): Cognitive impairment following a severe burn injury and critical care admission, part 1

Introduction An investigation into long-term cognitive impairment and Quality of Life (QoL) after severe burns. Methods A proof of principle, cohort design, prospective, observational clinical study. Patients with severe burns (>15% TBSA) admitted to Burns ICU for invasive ventilation were recruited for psychocognitive assessment with a convenience sample of age and sex-matched controls. Participants completed psychological and QoL questionnaires, the Cogstate® electronic battery, Hopkins Verbal Learning, Verbal Fluency and Trail making tasks. Results 15 patients (11M, 4F; 41 ± 14 years; TBSA 38.4% ± 18.5) and comparators (11M, 4F; 40 ± 13 years) were recruited. Burns patients reported worse QoL (Neuro-QoL Short Form v2, patient 30.1 ± 8.2, control 38.7 ± 3.2, p = 0.0004) and cognitive function (patient composite z-score 0.01, IQR −0.11 to 0.33, control 0.13, IQR 0.47–0.73, p = 0.02). Compared to estimated premorbid FSIQ, patients dropped an equivalent of 8 IQ points (p = 0.002). Cognitive function negatively correlated with burn severity (rBaux score, p = 0.04). QoL strongly correlated with depressive symptoms (Rho = −0.67, p = 0.009) but not cognitive function. Conclusions Severe burns injuries are associated with a significant, global, cognitive deficit. Patients also report worse QoL, depression and post-traumatic stress. Perceived QoL from cognitive impairment was more closely associated with depression than cognitive impairment

COVID-19 Prognostic Models: A Pro-con Debate for Machine Learning vs. Traditional Statistics.

The SARS-CoV-2 virus, which causes the COVID-19 pandemic, has had an unprecedented impact on healthcare requiring multidisciplinary innovation and novel thinking to minimize impact and improve outcomes. Wide-ranging disciplines have collaborated including diverse clinicians (radiology, microbiology, and critical care), who are working increasingly closely with data-science. This has been leveraged through the democratization of data-science with the increasing availability of easy to access open datasets, tutorials, programming languages, and hardware which makes it significantly easier to create mathematical models. To address the COVID-19 pandemic, such data-science has enabled modeling of the impact of the virus on the population and individuals for diagnostic, prognostic, and epidemiological ends. This has led to two large systematic reviews on this topic that have highlighted the two different ways in which this feat has been attempted: one using classical statistics and the other using more novel machine learning techniques. In this review, we debate the relative strengths and weaknesses of each method toward the specific task of predicting COVID-19 outcomes

f(R) theories

Over the past decade, f(R) theories have been extensively studied as one of the simplest modifications to General Relativity. In this article we review various applications of f(R) theories to cosmology and gravity - such as inflation, dark energy, local gravity constraints, cosmological perturbations, and spherically symmetric solutions in weak and strong gravitational backgrounds. We present a number of ways to distinguish those theories from General Relativity observationally and experimentally. We also discuss the extension to other modified gravity theories such as Brans-Dicke theory and Gauss-Bonnet gravity, and address models that can satisfy both cosmological and local gravity constraints.Comment: 156 pages, 14 figures, Invited review article in Living Reviews in Relativity, Published version, Comments are welcom