A tool for the evaluation of human lower arm injury: approach, experimental validation and application to safe robotics

This paper treats the systematic injury analysis of lower arm robot–human impacts. For this purpose, a passive mechanical lower arm (PMLA) was developed that mimics the human impact response and is suitable for systematic impact testing and prediction of mild contusions and lacerations. A mathematical model of the passive human lower arm is adopted to the control of the PMLA. Its biofidelity is verified by a number of comparative impact experiments with the PMLA and a human volunteer. The respective dynamic impact responses show very good consistency and support the fact that the developed device may serve as a human substitute in safety analysis for the described conditions. The collision tests were performed with two different robots: the DLR Lightweight Robot III (LWR-III) and the EPSON PS3L industrial robot. The data acquired in the PMLA impact experiments were used to encapsulate the results in a robot independent safety curve, taking into account robot's reflected inertia, velocity and impact geometry. Safety curves define the velocity boundaries on robot motions based on the instantaneous manipulator dynamics and possible human injury due to unforeseen impacts. Copyright © Cambridge University Press 201

Integrated on-chip mass spectrometry reaction monitoring in microfluidic devices containing porous polymer monolithic columns

Chip-based microfluidics enable the seamless integration of different functions into single devices. Here, we present microfluidic chips containing porous polymer monolithic columns as a means to facilitate chemical transformations as well as both downstream chromatographic separation and mass spectrometric analysis. Rapid liquid phase lithography prototyping creates the multifunctional device economically

National initiatives to improve outcomes from out-of-hospital cardiac arrest in England

NHS England report that the ambulance services attempt to resuscitate approximately 28 000 people from out-of-hospital cardiac arrest each year (approximately 1 per 2000 inhabitants per year).1 The rate of initial success (return of spontaneous circulation) was 25%, with less than half of those who are successfully resuscitated initially surviving to go home from hospital (survival to discharge 7%–8%, 2011–2014).1 (see figure 1). The survival rates contrast sharply with those observed in the best-performing emergency medical services systems, which have survival rates of 20%–25%.2–4 In 2013, the government's Cardiovascular Disease Outcomes Strategy for England set the ambitious, but achievable target of increasing survival from out-of-hospital cardiac arrest by 50%, leading to an additional 1000 lives saved each year

Variation in emergency percutaneous coronary intervention in ventilated patients in the UK: insights from a national database

Aims Pre-procedural ventilation is a marker of high risk in PCI patients. Causes include out-of-hospital cardiac arrest (OHCA) and cardiogenic shock. OHCA occurs in approximately 60,000 patients in the UK per annum. No consensus exists regarding the need/timing of coronary angiography ± revascularization without ST elevation. The aim was to describe the national variation in the rate of emergency PCI in ventilated patients. Methods and Results Using the UK national database for PCI in 2013, we identified all procedures performed as ‘emergency’ or ‘salvage’ for whom ventilation had been initiated before the PCI. Of the 92,589 patients who underwent PCI, 1342 (5.5%) fulfilled those criteria. There was wide variation in practice. There was no demonstrable relationship between the number of emergency PCI patients with pre-procedure ventilation per annum and (i) total number of PPCIs in a unit (r = −0.186), and (ii) availability of 24 h PCI, (iii) on-site surgical cover. Conclusion We demonstrated a wide variation in practice across the UK in rates of pre-procedural ventilation in emergency PCI. The majority of individuals will have suffered an OHCA. In the absence of a plausible explanation for this discrepant practice, it is possible that (a) some patients presenting with OHCA that may benefit from revascularization are being denied treatment and (b) procedures may be being undertaken that are futile. Further prospective data are needed to aid in production of guidelines aiming at standardized care in OHCA

Can drip irrigation improve the livelihoods of smallholders? Lessons learned from Zimbabwe:Global Theme on Agroecosystems Report no. 33

It is estimated that one third of the rural population in sub-Saharan Africa is malnourished. Strategies to mitigate the effects of poor agricultural productivity and drought involve developing the continent’s unexploited irrigation potential. One intervention, based on successes from Asia, which shows promisein improving household nutrition in the rural areas through better vegetable production, is small-scale drip irrigation. This system is said to save water and labor. Since 2002, some 70,000 low-cost, low-head drip irrigation kits have been distributed through humanitarian relief initiatives in the rural areas ofZimbabwe. In the dry season of 2006, a country-wide survey was undertaken in Zimbabwe to determine the impacts of drip kits that had been delivered to needy households. Survey results showed that disadoption of drip kits occurred as a function of time and after 3 years only 16% of the kits were still being used. Reasons for disadoption included lack of water, lack of understanding of the drip kit concept, and, more importantly, a lack of technical support and follow up by the non-governmental organizations that distributed the kits and the extension services. A cost-effectiveness analysis showed that drip kits are more cost-effective than traditional hand watering only when potential water savings are achieved. However, this was hardly ever the case due to the benefi ciaries’ lack of knowledge on crop water requirements when using the kits and a perception that the soil surface should be wet. Consequently, the study concluded that a relatively complex technology such as drip kits should not be part of short-term relief programs, but should instead be embedded in long-term developmental programs that involve both the public and private sector. This will ensure that appropriate technical support is provided in terms of crop management and the development of supply chains for spare parts and additional kits

Primary progressive aphasia: six questions in search of an answer

Here, we review recent progress in the diagnosis and management of primary progressive aphasia—the language-led dementias. We pose six key unanswered questions that challenge current assumptions and highlight the unresolved difficulties that surround these diseases. How many syndromes of primary progressive aphasia are there—and is syndromic diagnosis even useful? Are these truly ‘language-led’ dementias? How can we diagnose (and track) primary progressive aphasia better? Can brain pathology be predicted in these diseases? What is their core pathophysiology? In addition, how can primary progressive aphasia best be treated? We propose that pathophysiological mechanisms linking proteinopathies to phenotypes may help resolve the clinical complexity of primary progressive aphasia, and may suggest novel diagnostic tools and markers and guide the deployment of effective therapies

Prevalence of Cardiovascular Disease in Patients With Potentially Curable Malignancies: A National Registry Dataset Analysis.

BACKGROUND: Although a common challenge for patients and clinicians, there is little population-level evidence on the prevalence of cardiovascular disease (CVD) in individuals diagnosed with potentially curable cancer. OBJECTIVES: We investigated CVD rates in patients with common potentially curable malignancies and evaluated the associations between patient and disease characteristics and CVD prevalence. METHODS: The study included cancer registry patients diagnosed in England with stage I to III breast cancer, stage I to III colon or rectal cancer, stage I to III prostate cancer, stage I to IIIA non-small-cell lung cancer, stage I to IV diffuse large B-cell lymphoma, and stage I to IV Hodgkin lymphoma from 2013 to 2018. Linked hospital records and national CVD databases were used to identify CVD. The rates of CVD were investigated according to tumor type, and associations between patient and disease characteristics and CVD prevalence were determined. RESULTS: Among the 634,240 patients included, 102,834 (16.2%) had prior CVD. Men, older patients, and those living in deprived areas had higher CVD rates. Prevalence was highest for non-small-cell lung cancer (36.1%) and lowest for breast cancer (7.7%). After adjustment for age, sex, the income domain of the Index of Multiple Deprivation, and Charlson comorbidity index, CVD remained higher in other tumor types compared to breast cancer patients. CONCLUSIONS: There is a significant overlap between cancer and CVD burden. It is essential to consider CVD when evaluating national and international treatment patterns and cancer outcomes

Prevalence of Cardiovascular Disease in Patients With Potentially Curable Malignancies: A National Registry Dataset Analysis

Background: Although a common challenge for patients and clinicians, there is little population-level evidence on the prevalence of cardiovascular disease (CVD) in individuals diagnosed with potentially curable cancer. Objectives: We investigated CVD rates in patients with common potentially curable malignancies and evaluated the associations between patient and disease characteristics and CVD prevalence. Methods: The study included cancer registry patients diagnosed in England with stage I to III breast cancer, stage I to III colon or rectal cancer, stage I to III prostate cancer, stage I to IIIA non-small-cell lung cancer, stage I to IV diffuse large B-cell lymphoma, and stage I to IV Hodgkin lymphoma from 2013 to 2018. Linked hospital records and national CVD databases were used to identify CVD. The rates of CVD were investigated according to tumor type, and associations between patient and disease characteristics and CVD prevalence were determined. Results: Among the 634,240 patients included, 102,834 (16.2%) had prior CVD. Men, older patients, and those living in deprived areas had higher CVD rates. Prevalence was highest for non-small-cell lung cancer (36.1%) and lowest for breast cancer (7.7%). After adjustment for age, sex, the income domain of the Index of Multiple Deprivation, and Charlson comorbidity index, CVD remained higher in other tumor types compared to breast cancer patients. Conclusions: There is a significant overlap between cancer and CVD burden. It is essential to consider CVD when evaluating national and international treatment patterns and cancer outcomes

Can Drip Irrigation Improve Food Security for Vulnerable Households in Zimbabwe?.Briefing Note No. 7

Drought relief programs have been implemented almost every other year since Zimbabwe’s independence in 1980 as smallholder farmers frequently face dry spells that significantly reduce production levels and compromise food security. The use of micro-irrigation technologies, notably small-scale drip irrigation kits, has become an area of growing interest and investment...........