MyPad – Intelligent Bladder Pre-void Alerting System: A project collaborated with NHS to treat Nocturnal Enureses (NE)

Unsatisfactory cure rates with currently available treatments of NE have led to the need to explore alternative modalities. New treatment methods that focus on preventing enuretic episodes by means of a pre-void alerting system could improve outcomes for children with NE in many aspects such as voiding in a dignified manner, reducing cost, reducing time to tackle the problem, improving the psychology of the sufferers. The aim of this project is to build, refine and evaluate a new safe, comfortable and non-invasive wearable intelligent electronic device to monitor the bladder and to treat NE by warning the patient at the pre- void stage, enhancing quality of life for these sufferers starting from the first use. No such technology exists currently to monitor bladder to alarm before bedwetting. Beyond this study, there are numerous other areas of application i.e. elder care (geriatric) settings, stroke patients and veterinary science in which My-PAD can be of potential benefit

Lessons learnt from OS operations

This report focuses on the specific lessons learnt from the data collection in UDRIVE, derived from the difficulties encountered by the operation sites and the solutions applied to mitigate the problems where possible. These lessons learnt concern all aspects of the data collection. Such lessons learnt will provide useful insights for any future naturalistic driving study or field operational test. During the project, the operation sites provided three feedbacks related to their lessons learnt. These reports covered the pilot phase, the first six months of data collection and the last one at the end of the data collection. This iterative process gathered 71 lessons learnt. After the data collection, the final questionnaire was filled in by the participants and they provided with some interesting feedback. Most important lesssons learned were: Selecting only one or two vehicle types contributed to easier instrumentation of the Data Acquisaition System to the vehicles. However, this decision put some constraints in the recruitment of participants due the different fleet of vehicles across the European countries, especially some models were not very common in certain countries. One of the common problems across the Operation Sites (OS) was the participants’ drop-outs. The main lesson learnt was that it is important to maintain a set of replacement participants until the end of the project to cover any eventual drop out. Data protection was one of the most challenging aspects of the project. Dealing with images and personal data create some difficulties between the partners and their country data protection agencies. From the participants’ questionnaires, it was noted that even if they felt comfortable, their driving behaviour was somehow affected. Hide the equipment, and especially the cameras, the best it can be will help the participants drive normally. They also were pleased to have all the information beforehand and happy when dates, deadlines, incentives, etc., were respected as explained to them. When involving any external supplier (e.g. rental vehicle company, garage, equipment supplier, etc.). the role, responsibilities, response time, liability, etc., of every supplier have to be defined in more detail to avoid misunderstandings, delays or ambiguities. Developing as early as possible a very detailed and realistic plan of action allows to avoid delays, overspending, save resources and to achieve the project objectives

Intelligent autonomous treatment of bedwetting using non-invasive wearable advanced mechatronics systems and MEMS sensors

Post-void alarm systems to monitor bed wetting in Nocturnal Enuresis (NE) have been deemed unsatisfactory. The aim in this study is to develop a safe, comfortable and non-invasive pre-void wearable alarm and associated technology using advanced mechatronics. Each stage of development includes patient and public involvement and engagement (PPI). The early stage of the development involved children with and without nocturnal enuresis (NE) (and parents) who were tested at a hospital under the supervision of physicians, radiologists, psychologists, and nurses. The readings were simultaneously compared to B-mode images and measurements, acquired from a conventional ultrasound device, and were found to correlate highly. The results showed that determining imminent voiding need is viable using non-invasive sensors. Following on from "proof of concept", a bespoke advanced mechatronics device has been created. The device houses custom electronics, an ultrasound system, intelligent software, a user-friendly smartphone application, bedside alarm box and a dedicated undergarment, along with a self-adhesive gel pad - designed to keep the MEMS sensors aligned with the abdomen. Testing of the device with phantoms and volunteers has been successful in determining bladder volume and associated voiding need. Five miniaturized, and therefore more ergonomic, versions of the device are being developed, with an enabled connection to the cloud platform for location independent control and monitoring. Thereafter, the enhanced device will be tested with children with NE at their homes for 14 weeks, to gain feedback relating to wearability and data collection involving the cloud platform

Overview of OS preparation, sample characteristics and piloting

The deliverable presents the preparation for data collection for each OS. It elaborates on prerequisites for each OS, in terms of logistics, documentation, and instrumentation. Moreover, it details the pilot test procedures to dictate the experimentation. Lastly, the feedback for each OS is reported through a checklist in all possible contexts of the trial and also through reporting of issues

Firm finances, weather derivatives and geography

This paper considers some intellectual, practical and political dimensions of collaboration between human and physical geographers exploring how firms are using relatively new financial products – weather derivatives – to displace any costs of weather-related uncertainty and risk. The paper defines weather derivatives and indicates how they differ from weather insurance products before considering the geo-political, cultural and economic context for their creation. The paper concludes by reflecting on the challenges of research collaboration across the human–physical geography divide and suggests that while such initiatives may be undermined by a range of institutional and intellectual factors, conversations between physical and human geographers remain and are likely to become increasingly pertinent. The creation of a market in weather derivatives raises a host of urgent political and regulatory questions and the confluence of natural and social knowledges, co-existing within and through the geography academy, provides a constructive and creative basis from which to engage with this new market and wider discourses of uneven economic development and climate change

Operation sites description and planning

This deliverable presents the seven operating sites (OS): Austria (PTWs, KFV), France (Cars, CEESAR), Germany (Cars, DLR), Netherlands (Trucks, TNO), Poland (Cars, IBDIM), Spain (PTWs, CIDAUT), UK (Cars, UNIVLEEDS/LOUGHBOROU). Each OS determines its geographical coverage and personnel responsible for trial operation. They confirm compliance with the global schedule and with site specific schedules. Further planning issues consider participant liaison strategies, collection of subjective data, data acquisition system installation and maintenance procedure, data collection and management, data and operational quality assurance, end of trial management and ethical ap-proval and legal issues. All OS planned the trials following the common guidelines, but also accommodated the trial preparation to local circumstances

Computation of protein geometry and its applications: Packing and function prediction

This chapter discusses geometric models of biomolecules and geometric constructs, including the union of ball model, the weigthed Voronoi diagram, the weighted Delaunay triangulation, and the alpha shapes. These geometric constructs enable fast and analytical computaton of shapes of biomoleculres (including features such as voids and pockets) and metric properties (such as area and volume). The algorithms of Delaunay triangulation, computation of voids and pockets, as well volume/area computation are also described. In addition, applications in packing analysis of protein structures and protein function prediction are also discussed.Comment: 32 pages, 9 figure

Physiotherapy versus placebo or no intervention in Parkinson's disease

Background: Despite medical therapies and surgical interventions for Parkinson's disease (PD), patients develop progressive disability. Physiotherapy aims to maximise functional ability and minimise secondary complications through movement rehabilitation within a context of education and support for the whole person. The overall aim is to optimise independence, safety, and well-being, thereby enhancing quality of life.  Objectives: To assess the effectiveness of physiotherapy intervention compared with no intervention in patients with PD.  Search methods: We identified relevant trials by conducting electronic searches of numerous literature databases (e.g. MEDLINE, EMBASE) and trial registers, and by handsearching major journals, abstract books, conference proceedings, and reference lists of retrieved publications. The literature search included trials published up to the end of January 2012.  Selection criteria: Randomised controlled trials of physiotherapy intervention versus no physiotherapy intervention in patients with PD.  Data collection and analysis: Two review authors independently extracted data from each article. We used standard meta-analysis methods to assess the effectiveness of physiotherapy intervention compared with no physiotherapy intervention. Trials were classified into the following intervention comparisons: general physiotherapy, exercise, treadmill training, cueing, dance, and martial arts. We used tests for heterogeneity to assess for differences in treatment effect across these different physiotherapy interventions.  Main results: We identified 39 trials with 1827 participants. We considered the trials to be at a mixed risk of bias as the result of unreported allocation concealment and probable detection bias. Compared with no intervention, physiotherapy significantly improved the gait outcomes of speed (mean difference 0.04 m/s, 95% confidence interval (CI) 0.02 to 0.06, P = 0.0002); two- or six-minute walk test (13.37 m, 95% CI 0.55 to 26.20, P = 0.04) and Freezing of Gait questionnaire (-1.41, 95% CI -2.63 to -0.19, P = 0.02); functional mobility and balance outcomes of Timed Up & Go test (-0.63 s, 95% CI -1.05 to -0.21, P = 0.003), Functional Reach Test (2.16 cm, 95% CI 0.89 to 3.43, P = 0.0008), and Berg Balance Scale (3.71 points, 95% CI 2.30 to 5.11, P < 0.00001); and clinician-rated disability using the Unified Parkinson’s Disease Rating Scale (UPDRS) (total -6.15 points, 95% CI-8.57 to -3.73, P < 0.00001; activities of daily living: -1.36, 95% CI -2.41 to -0.30, P = 0.01; and motor: -5.01, 95% CI -6.30 to -3.72, P < 0.00001). No difference between arms was noted in falls (Falls Efficacy Scale: -1.91 points, 95% CI -4.76 to 0.94, P = 0.19) or patient-rated quality of life (PDQ-39 Summary Index: -0.38 points, 95% CI -2.58 to 1.81, P = 0.73). One study reported that adverse events were rare; no other studies reported data on this outcome. Indirect comparisons of the different physiotherapy interventions revealed no evidence that the treatment effect differed across physiotherapy interventions for any of the outcomes assessed.  Authors' conclusions: Benefit for physiotherapy was found in most outcomes over the short term (i.e. < 3 months) but was significant only for speed, two- or six-minute walk test, Freezing of Gait questionnaire, Timed Up & Go, Functional Reach Test, Berg Balance Scale, and clinician-rated UPDRS. Most of the observed differences between treatments were small. However, for some outcomes (e.g. speed, Berg Balance Scale, UPDRS), the differences observed were at, or approaching, what are considered minimal clinically important changes. These benefits should be interpreted with caution because the quality of most of the included trials was not high. Variation in measurements of outcome between studies meant that our analyses include a small proportion of the participants recruited.  This review illustrates that a wide range of approaches are employed by physiotherapists to treat patients with PD. However, no evidence of differences in treatment effect was noted between the different types of physiotherapy interventions being used, although this was based on indirect comparisons. A consensus menu of 'best practice' physiotherapy is needed, as are large, well-designed randomised controlled trials undertaken to demonstrate the longer-term efficacy and cost-effectiveness of 'best practice' physiotherapy in PD

Rituximab in B-Cell Hematologic Malignancies: A Review of 20 Years of Clinical Experience

Rituximab is a human/murine, chimeric anti-CD20 monoclonal antibody with established efficacy, and a favorable and well-defined safety profile in patients with various CD20-expressing lymphoid malignancies, including indolent and aggressive forms of B-cell non-Hodgkin lymphoma. Since its first approval 20 years ago, intravenously administered rituximab has revolutionized the treatment of B-cell malignancies and has become a standard component of care for follicular lymphoma, diffuse large B-cell lymphoma, chronic lymphocytic leukemia, and mantle cell lymphoma. For all of these diseases, clinical trials have demonstrated that rituximab not only prolongs the time to disease progression but also extends overall survival. Efficacy benefits have also been shown in patients with marginal zone lymphoma and in more aggressive diseases such as Burkitt lymphoma. Although the proven clinical efficacy and success of rituximab has led to the development of other anti-CD20 monoclonal antibodies in recent years (e.g., obinutuzumab, ofatumumab, veltuzumab, and ocrelizumab), rituximab is likely to maintain a position within the therapeutic armamentarium because it is well established with a long history of successful clinical use. Furthermore, a subcutaneous formulation of the drug has been approved both in the EU and in the USA for the treatment of B-cell malignancies. Using the wealth of data published on rituximab during the last two decades, we review the preclinical development of rituximab and the clinical experience gained in the treatment of hematologic B-cell malignancies, with a focus on the well-established intravenous route of administration. This article is a companion paper to A. Davies, et al., which is also published in this issue

Identifying potential terrorists: visuality, security and the channel project

This article analyses how British counter-radicalization policy in general, and the Channel project in particular, constitute individuals who are vulnerable to radicalization as visible, producing them as subjects of intervention. It thus asks, how can potential terrorists be identified and made knowable? The article first argues that to understand Channel, it is crucial to develop a conceptual account of the security politics of (in)visibilization that draws attention to the ways in which security regimes can, at times, function primarily through the production of regimes of (in)visibility. Using this approach, the article focusses on the role of ‘indicators’ as a technology of (in)visibilization. This role is central to the functioning of Channel, visibilizing certain subjects as threatening. Yet such a production is political. In bringing together a politics of care and a politics of identity, it is a regime of (in)visibility that produces new sites of intervention, contains significant potential consequences for the expression of certain identities, and raises new and troubling possibilities for how contemporary life may be secured