The TexiSense « Smart Sock » - a device for a daily prevention of pressure ulcers in the diabetic foot

International audienceGoals.– The term « diabetic foot » refers to a set of foot pathologies essentially stemming from the neuropathy and arteriopathy of the lower limb associated with diabetes mellitus. Chronic ischemia weakens the healing potential and favors the development of wounds on a more vulnerable foot. Friction or repeated micro-traumas can lead to an ulceration (which in turn can end up in an amputation) that will remain unnoticed because of the somato-sensory deficiency. The current prevention techniques largely relying on visual inspection of the foot and enhancement of the foot/insole interface are not fully satisfying as the prevalence of plantar ulcers remains very high.Patients and methods.– A device for the prevention of plantar ulcers–called “Smart Sock” is described. It consists of:– a sock made of a 100% textile pressure sensing fabric developed by the TexiSense company;– a microcontroller running a biomechanical model of the soft tissues of the foot of the diabetic person;– a vibrating watch (and eventually a smartphone) used to warn the bearer if a pressure pattern threatens the soft tissues integrity.Results.– Internal overpressures within the soft tissues, especially nearby bony prominences are likely to develop into deep foot ulcerations. The biomechanical model gives an estimation of their magnitude based on the external pressures measured by the sock/sensor. This modeling relies on a faithful representation of the morphology of the diabetic subject. The device sends a vibro-tactile alert in case of occasional overpressure or excessive stress dose accumulated during daytime activities.Discussion.– The continuous use of the device, compatible with daytime activities of the diabetic person, helps compensate for the lack of attention in the prevention of pressure ulcer formation. The TexiSense “Smart Sock” can be designed so that when worn, pressure sensors fall onto sensitive anatomical areas such as the dorsal side of the toes or the posterior side of the heel, which makes it also possible to monitor regions located outside the sole of the foot

Body numerical phantoms for estimating soft tissue pains or injuries when interacting with shoes, seats and mattresses

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Influence of the calcaneus shape on the risk of posterior heel ulcer using 3D patient-specific biomechanical modeling.

International audienceMost posterior heel ulcers are the consequence of inactivity and prolonged time lying down on the back. They appear when pressures applied on the heel create high internal strains and the soft tissues are compressed by the calcaneus. It is therefore important to monitor those strains to prevent heel pressure ulcers. Using a biomechanical lower leg model, we propose to estimate the influence of the patient-specific calcaneus shape on the strains within the foot and to determine if the risk of pressure ulceration is related to the variability of this shape. The biomechanical model is discretized using a 3D Finite Element mesh representing the soft tissues, separated into four domains implementing Neo Hookean materials with different elasticities: skin, fat, Achilles' tendon, and muscles. Bones are modelled as rigid bodies attached to the tissues. Simulations show that the shape of the calcaneus has an influence on the formation of pressure ulcers with a mean variation of the maximum strain over 6.0 percentage points over 18 distinct morphologies. Furthermore, the models confirm the influence of the cushion on which the leg is resting: a softer cushion leading to lower strains, it has less chances of creating a pressure ulcer. The methodology used for patient-specific strain estimation could be used for the prevention of heel ulcer when coupled with a pressure sensor

Pressure ulcer prevention in spinal cord injury subjects using the TexiSense pressure sensing textile

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Inter-Destination Multimedia Synchronization; Schemes, Use Cases and Standardization

Traditionally, the media consumption model has been a passive and isolated activity. However, the advent of media streaming technologies, interactive social applications, and synchronous communications, as well as the convergence between these three developments, point to an evolution towards dynamic shared media experiences. In this new model, geographically distributed groups of consumers, independently of their location and the nature of their end-devices, can be immersed in a common virtual networked environment in which they can share multimedia services, interact and collaborate in real-time within the context of simultaneous media content consumption. In most of these multimedia services and applications, apart from the well-known intra and inter-stream synchronization techniques that are important inside the consumers playout devices, also the synchronization of the playout processes between several distributed receivers, known as multipoint, group or Inter-destination multimedia synchronization (IDMS), becomes essential. Due to the increasing popularity of social networking, this type of multimedia synchronization has gained in popularity in recent years. Although Social TV is perhaps the most prominent use case in which IDMS is useful, in this paper we present up to 19 use cases for IDMS, each one having its own synchronization requirements. Different approaches used in the (recent) past by researchers to achieve IDMS are described and compared. As further proof of the significance of IDMS nowadays, relevant organizations (such as ETSI TISPAN and IETF AVTCORE Group) efforts on IDMS standardization (in which authors have been and are participating actively), defining architectures and protocols, are summarized.This work has been financed, partially, by Universitat Politecnica de Valencia (UPV), under its R&D Support Program in PAID-05-11-002-331 Project and in PAID-01-10, and by TNO, under its Future Internet Use Research & Innovation Program. The authors also want to thank Kevin Gross for providing some of the use cases included in Sect. 1.2.Montagud, M.; Boronat Segui, F.; Stokking, H.; Van Brandenburg, R. (2012). Inter-Destination Multimedia Synchronization; Schemes, Use Cases and Standardization. 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A simulated annealing based genetic local search algorithm for multi-objective multicast routing problems

This paper presents a new hybrid evolutionary algorithm to solve multi-objective multicast routing problems in telecommunication networks. The algorithm combines simulated annealing based strategies and a genetic local search, aiming at a more flexible and effective exploration and exploitation in the search space of the complex problem to find more non-dominated solutions in the Pareto Front. Due to the complex structure of the multicast tree, crossover and mutation operators have been specifically devised concerning the features and constraints in the problem. A new adaptive mutation probability based on simulated annealing is proposed in the hybrid algorithm to adaptively adjust the mutation rate according to the fitness of the new solution against the average quality of the current population during the evolution procedure. Two simulated annealing based search direction tuning strategies are applied to improve the efficiency and effectiveness of the hybrid evolutionary algorithm. Simulations have been carried out on some benchmark multi-objective multicast routing instances and a large amount of random networks with five real world objectives including cost, delay, link utilisations, average delay and delay variation in telecommunication networks. Experimental results demonstrate that both the simulated annealing based strategies and the genetic local search within the proposed multi-objective algorithm, compared with other multi-objective evolutionary algorithms, can efficiently identify high quality non-dominated solution set for multi-objective multicast routing problems and outperform other conventional multi-objective evolutionary algorithms in the literature

Complex geomorphologic assemblage of terrains in association with the banded terrain in Hellas basin, Mars

Hellas basin acts as a major sink for the southern highlands of Mars and is likely to have recorded several episodes of sedimentation and erosion. The north-western part of the basin displays a potentially unique Amazonian landscape domain in the deepest part of Hellas, called “banded terrain”, which is a deposit characterized by an alternation of narrow band shapes and inter-bands displaying a sinuous and relatively smooth surface texture suggesting a viscous flow origin. Here we use high-resolution (HiRISE and CTX) images to assess the geomorphological interaction of the banded terrain with the surrounding geomorphologic domains in the NW interior of Hellas to gain a better understanding of the geological evolution of the region as a whole. Our analysis reveals that the banded terrain is associated with six geomorphologic domains: a central plateau named Alpheus Colles, plain deposits (P1 and P2), reticulate (RT1 and RT2) and honeycomb terrains. Based on the analysis of the geomorphology of these domains and their cross-cutting relationships, we show that no widespread deposition post-dates the formation of the banded terrain, which implies that this domain is the youngest and latest deposit of the interior of Hellas. Therefore, the level of geologic activity in the NW Hellas during the Amazonian appears to have been relatively low and restricted to modification of the landscape through mechanical weathering, aeolian and periglacial processes. Thermophysical data and cross-cutting relationships support hypotheses of modification of the honeycomb terrain via vertical rise of diapirs such as ice diapirism, and the formation of the plain deposits through deposition and remobilization of an ice-rich mantle deposit. Finally, the observed gradual transition between honeycomb and banded terrain suggests that the banded terrain may have covered a larger area of the NW interior of Hellas in the past than previously thought. This has implications on the understanding of the evolution of the deepest part of Hellas

The heparan sulfate sulfotransferase 3-OST3A (HS3ST3A) is a novel tumor regulator and a prognostic marker in breast cancer

International audienceHeparan sulfate (HS) proteoglycan chains are key components of the breast tumor microenvironment that critically influence the behavior of cancer cells. It is established that abnormal synthesis and processing of HS play a prominent role in tumorigenesis, albeit mechanisms remain mostly obscure. HS function is mainly controlled by sulfotransferases, and here we report a novel cellular and pathophysiological significance for the 3-O-sulfotransferase 3-OST3A (HS3ST3A), catalyzing the final maturation step of HS, in breast cancer. We show that 3-OST3A is epigenetically repressed in all breast cancer cell lines of a panel representative of distinct molecular subgroups, except in human epidermal growth factor receptor 2-positive (HER2+) sloan-kettering breast cancer (SKBR3) cells. Epigenetic mechanisms involved both DNA methylation and histone modifications, producing different repressive chromatin environments depending on the cell molecular signature. Gain and loss of function experiments by cDNA and siRNA transfection revealed profound effects of 3-OST3A expression on cell behavior including apoptosis, proliferation, response to trastuzumab in vitro and tumor growth in xenografted mice. 3-OST3A exerted dual activities acting as tumor-suppressor in lumA-michigan cancer foundation (MCF)-7 and triple negative-MD Anderson (MDA) metastatic breast (MB)-231 cells, or as an oncogenic factor in HER2+-SKBR3 cells. Mechanistically, fluorescence-resonance energy transfer-fluorescence-lifetime imaging microscopy experiments indicated that the effects of 3-OST3A in MCF-7 cells were mediated by altered interactions between HS and fibroblast growth factor-7 (FGF-7). Further, this interplay between HS and FGF-7 modulated downstream ERK, AKT and p38 cascades, suggesting that altering 3-O-sulfation affects FGFR2IIIb-mediated signaling. Corroborating our cellular data, a clinical study conducted in a cohort of breast cancer patients uncovered that, in HER2+ patients, high level expression of 3-OST3A in tumors was associated with reduced relapse-free survival. Our findings define 3-OST3A as a novel regulator of breast cancer pathogenicity, displaying tumor-suppressive or oncogenic activities in a cell-and tumor-dependent context, and demonstrate the clinical value of the HS-O-sulfotransferase 3-OST3A as a prognostic marker in HER2+ patients

Demographic, clinical and antibody characteristics of patients with digital ulcers in systemic sclerosis: data from the DUO Registry

OBJECTIVES: The Digital Ulcers Outcome (DUO) Registry was designed to describe the clinical and antibody characteristics, disease course and outcomes of patients with digital ulcers associated with systemic sclerosis (SSc). METHODS: The DUO Registry is a European, prospective, multicentre, observational, registry of SSc patients with ongoing digital ulcer disease, irrespective of treatment regimen. Data collected included demographics, SSc duration, SSc subset, internal organ manifestations, autoantibodies, previous and ongoing interventions and complications related to digital ulcers. RESULTS: Up to 19 November 2010 a total of 2439 patients had enrolled into the registry. Most were classified as either limited cutaneous SSc (lcSSc; 52.2%) or diffuse cutaneous SSc (dcSSc; 36.9%). Digital ulcers developed earlier in patients with dcSSc compared with lcSSc. Almost all patients (95.7%) tested positive for antinuclear antibodies, 45.2% for anti-scleroderma-70 and 43.6% for anticentromere antibodies (ACA). The first digital ulcer in the anti-scleroderma-70-positive patient cohort occurred approximately 5 years earlier than the ACA-positive patient group. CONCLUSIONS: This study provides data from a large cohort of SSc patients with a history of digital ulcers. The early occurrence and high frequency of digital ulcer complications are especially seen in patients with dcSSc and/or anti-scleroderma-70 antibodies