Prospective review of 30-day morbidity and mortality in a paediatric neurosurgical unit

Purpose: The purpose of this study is to record the 30-day and inpatient morbidity and mortality in paediatric patients in a tertiary neuroscience centre over a 2-year period. The intentions were to establish the frequency of significant adverse events, review the current published rates of morbidity in paediatric neurosurgical patients and propose three clinical indicators for future comparison. Methods: All deaths and adverse events were prospectively recorded from 1 January 2014 to 31 December 2015. Each adverse event was categorised, allocated a clinical impact severity score and linked to a neurosurgical procedure wherever possible. Where a patient suffered several adverse events in the same admission, each event was recorded separately. If a patient had been discharged home, an adverse event was recorded if it occurred within 30 days of admission. Results: Five hundred forty-nine procedures were performed in 287 patients (aged <16 years). One hundred thirty significant adverse events were identified. The following are the three clinical indicators: significant adverse event rate: 111 (20.2%) operations were linked to at least one significant adverse event; unscheduled return to theatre rate: 81 (14.8%) operations were associated with an adverse event that resulted in an unscheduled return to theatre; and surgical site infection rate: 29 (5.3%) operations were associated with an infection. Conclusion: Complications and adverse events are common in paediatric neurosurgery. Prospective, continuous surveillance will promote both quality assurance and quality improvement in the neurosurgical care delivered to patients

Designing and Implementing a Platform for Collecting Multi-Modal Data of Human-Robot Interaction

This paper details a method of collecting video and audio recordings of people inter- acting with a simple robot interlocutor. The interaction is recorded via a number of cameras and microphones mounted on and around the robot. The system utilised a number of technologies to engage with interlocutors including OpenCV, Python, and Max MSP. Interactions over a three month period were collected at The Science Gallery in Trinity College Dublin. Visitors to the gallery freely engaged with the robot, with interactions on their behalf being spontaneous and non-scripted. The robot dialogue was a set pattern of utterances to engage interlocutors in a simple conversation. A large number of audio and video recordings were collected over a three month period

Investigating Fine Temporal Dynamics of Prosodic and Lexical Accommodation

Conversational interaction is a dynamic activity in which participants engage in the construction of meaning and in establishing and maintaining social relationships. Lexical and prosodic accommodation have been observed in many studies as contributing importantly to these dimensions of social interaction. However, while previous works have considered accommodation mechanisms at global levels (for whole conversations, halves and thirds of conversations), this work investigates their evolution through repeated analysis at time intervals of increasing granularity to analyze the dynamics of alignment in a spoken language corpus. Results show that the levels of both prosodic and lexical accommodation fluctuate several times over the course of a conversation

Speech & Multimodal Resources: the Herme Database of Spontaneous Multimodal Human-Robot Dialogues

This paper presents methodologies and tools for language resource (LR) construction. It describes a database of interactive speech collected over a three-month period at the Science Gallery in Dublin, where visitors could take part in a conversation with a robot. The system collected samples of informal, chatty dialogue – normally difficult to capture under laboratory conditions for human-human dialogue, and particularly so for human-machine interaction. The conversations were based on a script followed by the robot consisting largely of social chat with some task-based elements. The interactions were audio-visually recorded using several cameras together with microphones. As part of the conversation the participants were asked to sign a consent form giving permission to use their data for human-machine interaction research. The multimodal corpus will be made available to interested researchers and the technology developed during the three-month exhibition is being extended for use in education and assisted-living applications

MILLA-Multimodal Interactive Language Learning Agent

Learning a new language involves the acquisition and integration of a range of skills. A human tu�tor aids learners by (i) providing tasks suitable to the learner’s needs, (ii) monitoring progress and adapting task content and delivery style, and (iii) providing a source of speaking practice and motivation

5 Year Expression and Neutrophil Defect Repair after Gene Therapy in Alpha-1 Antitrypsin Deficiency

Alpha-1 antitrypsin deficiency is a monogenic disorder resulting in emphysema due principally to the unopposed effects of neutrophil elastase. We previously reported achieving plasma wild-type alpha-1 antitrypsin concentrations at 2.5%-3.8% of the purported therapeutic level at 1 year after a single intramuscular administration of recombinant adeno-associated virus serotype 1 alpha-1 antitrypsin vector in alpha-1 antitrypsin deficient patients. We analyzed blood and muscle for alpha-1 antitrypsin expression and immune cell response. We also assayed previously reported markers of neutrophil function known to be altered in alpha-1 antitrypsin deficient patients. Here, we report sustained expression at 2.0%-2.5% of the target level from years 1-5 in these same patients without any additional recombinant adeno-associated virus serotype-1 alpha-1 antitrypsin vector administration. In addition, we observed partial correction of disease-associated neutrophil defects, including neutrophil elastase inhibition, markers of degranulation, and membrane-bound anti-neutrophil antibodies. There was also evidence of an active T regulatory cell response (similar to the 1 year data) and an exhausted cytotoxic T cell response to adeno-associated virus serotype-1 capsid. These findings suggest that muscle-based alpha-1 antitrypsin gene replacement is tolerogenic and that stable levels of M-AAT may exert beneficial neutrophil effects at lower concentrations than previously anticipated

Young women's decisions to accept chlamydia screening: influences of stigma and doctor-patient interactions

<p>Abstract</p> <p>Background</p> <p>An understanding of the factors that encourage young women to accept, and discourage them from accepting, STI (sexually transmitted infection) testing is needed to underpin opportunistic screening programs for the STI <it>Chlamydia trachomatis </it>(opportunistic screening involves healthcare professionals offering chlamydia tests to people while they are attending health services for reasons that are usually unrelated to their sexual health). We conducted a qualitative study to identify and explore: how young women would feel about being offered opportunistic tests for chlamydia?; how young women would like to be offered screening, and who they wanted to be offered screening by?; and what factors would influence young women's partner notification preferences for chlamydia (who they would notify in the event of a positive diagnosis of chlamydia, how they would want to do this).</p> <p>Methods</p> <p>Semi-structured interviews with 35 young women between eighteen and twenty nine years of age. The study was conducted in the Dublin and Galway regions of the Republic of Ireland. Young adults were recruited from General Practice (GP) practices, Third Level College health services, Family Planning clinics and specialist STI treatment services.</p> <p>Results</p> <p>Respondents were worried that their identities would become stigmatised if they accepted screening. Younger respondents and those from lower socio-economic backgrounds had the greatest stigma-related concerns. Most respondents indicated that they would accept screening if it was offered to them, however; accepting screening was seen as a correct, responsible action to engage in. Respondents wanted to be offered screening by younger female healthcare professionals. Respondents were willing to inform their current partners about positive chlamydia diagnoses, but were more ambivalent about informing their previous partners.</p> <p>Conclusions</p> <p>If an effort is not put into reducing young women's stigma-related concerns the population coverage of Chlamydia screening might be reduced.</p