Audio-tactile stimuli to improve health and well-being : a preliminary position paper

From literature and through common experience it is known that stimulation of the tactile (touch) sense or auditory (hearing) sense can be used to improve people's health and well-being. For example, to make people relax, feel better, sleep better or feel comforted. In this position paper we propose the concept of combined auditory-tactile stimulation and argue that it potentially has positive effects on human health and well-being through influencing a user's body and mental state. Such effects have, to date, not yet been fully explored in scientific research. The current relevant state of the art is briefly addressed and its limitations are indicated. Based on this, a vision is presented of how auditory-tactile stimulation could be used in healthcare and various other application domains. Three interesting research challenges in this field are identified: 1) identifying relevant mechanisms of human perception of combined auditory-tactile stimuli; 2) finding methods for automatic conversions between audio and tactile content; 3) using measurement and analysis of human bio-signals and behavior to adapt the stimulation in an optimal way to the user. Ideas and possible routes to address these challenges are presented

Design of epoxy resin based polymer concrete matrix for composite railway sleeper

A new type of railway sleeper made from composite materials is now being developed to replace deteriorating timber sleepers. To protect it from unfavorable environments and to increase the strength at rail-seat area, the sleeper is coated with epoxy based polymer concrete. This paper investigates the properties of the polymer concrete matrix with different percentages of epoxy resin binder and lightweight particulate filler. The mixing proportion of Particulate Filled Resin (PFR) was optimised while targeting a specific strength and workability. The content of epoxy resin was varied from 40 to 100% whereas the filler material ranged from 0 to 60%. The flexural performance of PFR was evaluated using three-point bending tests and the most suitable mix proportion is determined based on the experimental results

Structural performance of heavy duty composite railway sleeper

Are composite materials a suitable alternative for heavy duty railway sleeper application

Composite railway sleeper: a cost effective and eco-friendly alternative

Motivation • High maintenance cost • Huge CO2 emission • Early failure in the existing sleeper Conclusions: • Optimised shape reduces two-third volume of materials • Composite sleeper behaviour is comparable with timbe

Short-term outcomes of early intensive neurorehabilitation for prolonged disorders of consciousness:A prospective cohort study

Background: Advances in medical care have increased survival in people with severe brain injuries and with that the number of survivors with prolonged disorders of consciousness (PDOC) has increased. In the literature, early intensive neurorehabilitation (EIN) for people with PDOC is recommended to achieve the best possible outcomes. Objectives: To evaluate the frequency and extent of recovery of consciousness, mortality, complications, pain and discomfort, and medication during a nationwide EIN programme in people with PDOC after acquired brain injury. We hypothesized that level of consciousness would improve in half of people with PDOC. Methods: Prospective cohort study. People with PDOC aged 16 years and older admitted to the EIN department centralized in a single rehabilitation centre in the Netherlands (Libra Rehabilitation &amp; Audiology) were included. The EIN delivers a subacute medical level of care and rehabilitation for a maximum duration of 14 weeks. The outcome measures were level of consciousness (CRS-R), mortality, number of complications, medication and pain/discomfort (NCS-R). Results: Of the 104 people included, 68 % emerged to a minimal conscious state with command-following or higher during EIN and 44 % regained consciousness. Mortality during EIN was 6 %, and 50 % of deaths followed a non-treatment decision or withdrawal of life-sustaining treatment. Almost all participants had at least 1 medical complication, leading to hospital readmission for 30 %. 73 % showed no pain or discomfort. During EIN, cardiovascular medication and analgesics were reduced by 15 %. Conclusions: During the EIN programme, a large percentage of people with PDOC regained at least a minimal conscious state or even consciousness. These outcomes and the frequent medical complications in these people suggest that intensive specialized care should be offered to all people with PDOC. The outcomes of this study might help health professionals to better inform the families of people with PDOC about the short-term prognosis of PDOC. Protocol registration number: The Dutch Trial Register, NL 8138.</p

Short-term outcomes of early intensive neurorehabilitation for prolonged disorders of consciousness:A prospective cohort study

Background: Advances in medical care have increased survival in people with severe brain injuries and with that the number of survivors with prolonged disorders of consciousness (PDOC) has increased. In the literature, early intensive neurorehabilitation (EIN) for people with PDOC is recommended to achieve the best possible outcomes. Objectives: To evaluate the frequency and extent of recovery of consciousness, mortality, complications, pain and discomfort, and medication during a nationwide EIN programme in people with PDOC after acquired brain injury. We hypothesized that level of consciousness would improve in half of people with PDOC. Methods: Prospective cohort study. People with PDOC aged 16 years and older admitted to the EIN department centralized in a single rehabilitation centre in the Netherlands (Libra Rehabilitation &amp; Audiology) were included. The EIN delivers a subacute medical level of care and rehabilitation for a maximum duration of 14 weeks. The outcome measures were level of consciousness (CRS-R), mortality, number of complications, medication and pain/discomfort (NCS-R). Results: Of the 104 people included, 68 % emerged to a minimal conscious state with command-following or higher during EIN and 44 % regained consciousness. Mortality during EIN was 6 %, and 50 % of deaths followed a non-treatment decision or withdrawal of life-sustaining treatment. Almost all participants had at least 1 medical complication, leading to hospital readmission for 30 %. 73 % showed no pain or discomfort. During EIN, cardiovascular medication and analgesics were reduced by 15 %. Conclusions: During the EIN programme, a large percentage of people with PDOC regained at least a minimal conscious state or even consciousness. These outcomes and the frequent medical complications in these people suggest that intensive specialized care should be offered to all people with PDOC. The outcomes of this study might help health professionals to better inform the families of people with PDOC about the short-term prognosis of PDOC. Protocol registration number: The Dutch Trial Register, NL 8138.</p

Outcome registry of early intensive neurorehabilitation in patients with disorders of consciousness: study protocol of a prospective cohort study

Background: Prolonged disorders of consciousness (PDOC) may occur after severe brain injury. Two diagnostic entities are distinguished within PDOC: unresponsive wakefulness syndrome (UWS, previously known as vegetative state) and minimally conscious state (MCS). Patients with PDOC may benefit from early intensive neurorehabilitation (EIN). In the Netherlands, the EIN programme is provided by one designated expert rehabilitation centre and forms the starting point of a dedicated chain of specialised rehabilitation and care for this group. This study project, called DOCTOR: Disorders of Consciousness; Treatment and Outcomes Registry, sets up a registry and systematically investigates multiple short- and long-term outcomes of patients with PDOC who receive EIN. Methods: Single-centre prospective cohort study with a 2-year follow-up period. Patients with PDOC due to acute brain injury who receive EIN, aged 16 years and older are included. Measurements will take place at start EIN, in week 5, 10, and at discharge from the EIN programme (duration = max 14 weeks) and at week 28, 40, 52, and 104 after admission to the EIN programme, following patients through the health-care chain. Outcome measures are the changes over time in level of consciousness, using the Coma Recovery Scale-Revised; the frequency and type of medical complications; the mortality rate; level of disability, including the level of motor, cognitive, behavioural and emotional functioning; participation; and quality of life. Secondary outcomes include self-efficacy of caregivers, caregivers’ strain and cost-effectiveness of the programme. Discussion: The DOCTOR study will provide insight in the recovery patterns and predictors of recovery for multiple outcomes in PDOC patients after following EIN. The results of the study will enable us to benchmark and improve EIN and the organisation of the health-care chain, both for patients with PDOC and for their families. Trial registration: Netherlands Trial Register, NL 8138. Retrospectively registered 6 November 2019

Design and analysis of a composite beam for infrastructure applications - Part I: preliminary investigation in bending

The objective of this study is to contribute to the development of a composite beam for use in civil engineering systems. Based on the limitations in existing concepts, a new beam design is proposed and its behaviour studied. Using the classical beam theory, the Timoshenko beam theory, the Timoshenko plate theory, as well as the transformed section approach, borrowed from reinforced concrete, a simplified analytical approach, which could be used in design, is developed to conduct first and second order analysis of the proposed beam in order to achieve a rational sizing of its section before a rigorous testing regime is carried out. Finally, to validate the analytical model and gain confidence in the design, the analytical and experimental results are compared to a rigorous non linear finite element solution. It was found that the analytical model agreed relatively well with the experiments and the FE analyses, giving confidence in the validity of the underlying assumptions