Exercise prescription improves exercise tolerance in young children with CHD:a randomised clinical trial

Objective The main objective of this study was to ascertain if a structured intervention programme can improve the biophysical health of young children with congenital heart disease (CHD). The primary end point was an increase in measureable physical activity levels following the intervention.Methods Patients aged 5–10 years with CHD were identified and invited to participate. Participants completed a baseline biophysical assessment, including a formal exercise stress test and daily activity monitoring using an accelerometer. Following randomisation, the intervention group attended a 1 day education session and received an individual written exercise plan to be continued over the 4-month intervention period. The control group continued with their usual level of care. After 4 months, all participants were reassessed in the same manner as at baseline.Results One hundred and sixty-three participants (mean age 8.4 years) were recruited, 100 of whom were male (61.3%). At baseline, the majority of the children were active with good exercise tolerance. The cyanotic palliated subgroup participants, however, were found to have lower levels of daily activity and significantly limited peak exercise performance compared with the other subgroups. One hundred and fifty-two participants (93.2%) attended for reassessment. Following the intervention, there was a significant improvement in peak exercise capacity in the intervention group. There was also a trend towards increased daily activity levels.Conclusion Overall physical activity levels are well preserved in the majority of young children with CHD. A structured intervention programme significantly increased peak exercise capacity and improved attitudes towards positive lifestyle changes

Assessing Survival and Grading the Severity of Complications in Octogenarians Undergoing Pulmonary Lobectomy.

Introduction. Octogenarians are at increased risk for complications after lung resection. With alternatives such as radiation, understanding the risks of surgery and associated survival are valuable. Data grading the severity of complications and long-term survival in this population is lacking. We reviewed our experience with lobectomy in octogenarians, grading complications using a validated thoracic morbidity and mortality schema. Methods. We retrospectively reviewed consecutive patients aged ≥80 undergoing lobectomy between 2004 and 2012. Demographics, clinical/pathologic stage, complications, recurrence, and mortality were collected. Complications were graded by the Seely thoracic morbidity and mortality model. Results. 45 patients (mean age 82.2 years) were analyzed. The majority of patients (28/45, 62%) were clinical stage IA/IB. 62% (28/45) of patients experienced a complication. Only 15.6% (7/45) were considered significantly morbid (≥ grade IIIB) per the Seely model. Perioperative mortality was 2% and half of patients were living at a follow-up of 53 months. Overall five-year survival was 52%. Conclusions. In carefully selected octogenarians, lobectomy carries a 15.6% rate of significantly morbid complications with encouraging overall survival. These data provide the basis for a more complete discussion with patients regarding lobectomy for lung cancer

Taking balance measurement out of the laboratory and into the home: discriminatory capability of novel centre of pressure measurement in fallers and non-fallers

We investigated three methods for estimating centre of pressure excursions, as measured using a portable pressure sensor matrix, in order to deploy similar technology into the homes of older adults for longitudinal monitoring of postural control and falls risk. We explored the utility of these three methods as markers of falls risk in a cohort of 120 community dwelling older adults with and without a history of falls (65 fallers, 55 non-fallers). A number of standard quantitative balance parameters were derived using each centre of pressure estimation method. Rank sum tests were used to test for significant differences between fallers and non-fallers while intra-class correlation coefficients were also calculated to determine the reliability of each method. A method based on estimating the changes in the magnitude of pressure exerted on the pressure sensor matrix was found to be the most reliable and discriminative. Our future work will implement this method for home-based balance measurement

Measurement of diets that are healthy, environmentally sustainable, affordable, and equitable: A scoping review of metrics, findings, and research gaps

IntroductionResearch on the impacts of dietary patterns on human and planetary health is a rapidly growing field. A wide range of metrics, datasets, and analytical techniques has been used to explore the role of dietary choices/constraints in driving greenhouse gas (GHG) emissions, environmental degradation, health and disease outcomes, and the affordability of food baskets. Many argue that each domain is important, but few have tackled all simultaneously in analyzing diet-outcome relationships.MethodsThis paper reviews studies published between January 2015 and December 2021 (inclusive) that examined dietary patterns in relation to at least two of the following four thematic pillars: (i) planetary health, including, climate change, environmental quality, and natural resource impacts, (ii) human health and disease, (iii) economic outcomes, including diet cost/affordability, and (iv) social outcomes, e.g., wages, working conditions, and culturally relevant diets. We systematically screened 2,425 publications by title and abstract and included data from 42 eligible publications in this review.ResultsMost dietary patterns used were statistically estimated or simulated rather than observed. A rising number of studies consider the cost/affordability of dietary scenarios in relation to optimized environmental and health outcomes. However, only six publications incorporate social sustainability outcomes, which represents an under-explored dimension of food system concerns.DiscussionThis review suggests a need for (i) transparency and clarity in datasets used and analytical methods; (ii) explicit integration of indicators and metrics linking social and economic issues to the commonly assessed diet-climate-planetary ecology relationships; (iii) inclusion of data and researchers from low- and middle-income countries; (iv) inclusion of processed food products to reflect the reality of consumer choices globally; and (v) attention to the implications of findings for policymakers. Better understanding is urgently needed on dietary impacts on all relevant human and planetary domains simultaneously

Experiences in firmware development for a CubeSat instrument payload

Recent advancements in gamma-ray detector technology have brought new opportunities to study gamma-ray bursts and other high-energy phenomena. However, there is a lack of dissemination on the development methods, tools and techniques used in the production of instrument flight firmware. This is understandable as firmware for spacecraft payloads may be proprietary or exceptionally hardware specific and so is not always published. However, this leaves a gap in the knowledge for CubeSat teams, especially those consisting of university students who may be building a custom spacecraft payload with limited initial experience. The Gamma-Ray Module (GMOD) on-board EIRSAT-1, a 2U CubeSat in the 2nd European Space Agency Fly Your Satellite! programme, is one such instrument. GMOD features a 25x25x40mm Scionix CeBr3 scintillator, coupled to an array of 16 (4x4) JSeries OnSemiconductor MicroFJ-60035-TSV silicon photomultipliers (SiPMs) with readout provided by the SIPHRA IDE3380 application specific integrated circuit. The instrument is supported by the Gamma-Ray Module motherboard which controls and configures the instrument, providing regulated voltage and current sources as well as generating time tagged event packets and a temporary on-board flash storage. At the core of this system is the Texas Instruments MSP430FR5994 microcontroller. A custom firmware was produced for the instrument by the EIRSAT-1 team over numerous cycles of testing and development to reliably perform the long duration tasks of readout, storage and transfer of time tagged event data to the EIRSAT-1 on-board computer. Recognising the value of sharing our experiences and pitfalls on firmware development with the wider CubeSat community, this paper will provide an introduction to GMOD, with focus primarily on the development approach of the firmware. The development, testing, version control, essential tools and an overview of how the resources provided by the device manufacturer were used will be examined, such that the lessons learned may be extended to other payloads from student-led mission

The Challenge of Spoken Language Systems: Research Directions for the Nineties

A spoken language system combines speech recognition, natural language processing and human interface technology. It functions by recognizing the person's words, interpreting the sequence of words to obtain a meaning in terms of the application, and providing an appropriate response back to the user. Potential applications of spoken language systems range from simple tasks, such as retrieving information from an existing database (traffic reports, airline schedules), to interactive problem solving tasks involving complex planning and reasoning (travel planning, traffic routing), to support for multilingual interactions. We examine eight key areas in which basic research is needed to produce spoken language systems: (1) robust speech recognition; (2) automatic training and adaptation; (3) spontaneous speech; (4) dialogue models; (5) natural language response generation; (6) speech synthesis and speech generation; (7) multilingual systems; and (8) interactive multimodal systems. In each area, we identify key research challenges, the infrastructure needed to support research, and the expected benefits. We conclude by reviewing the need for multidisciplinary research, for development of shared corpora and related resources, for computational support and far rapid communication among researchers. The successful development of this technology will increase accessibility of computers to a wide range of users, will facilitate multinational communication and trade, and will create new research specialties and jobs in this rapidly expanding area

Representations of mental health and arts participation in the national and local British press, 2007-2015

We analysed news articles published in national and local British newspapers between 2007 and 2015 to understand 1) how mental health and arts participation were framed and 2) how the relationships between participants in arts initiatives were conceptualised. Using corpus-assisted qualitative frame analysis, we identified frames of recovery, stigma and economy. The recovery frame, which emphasised that mental illness can be treated similarly to physical illness, positioned arts participation as a form of therapy that can complement or substitute medication. The stigma frame presented arts participation as a mechanism for challenging social conceptions that mentally ill individuals are incapable of productive work. The economy frame discussed the economic burden of mentally ill individuals and portrayed arts participation as facilitating their return to employment. Using thematic analysis, which paid attention to the representation of social actors, we found that service users were identified as the prime beneficiaries of arts initiatives and arts participation was conceptualised as a way to bring people with mental health issues together. We discuss these findings against existing research on media representations of mental health and the concept of ‘mutual recovery’ and suggest what wider concurrent developments in the areas of mental health and the media may account for the uncovered frames and themes