Investigation of Permanent Tattoos to Increase Myoelectric Signal Connectivity in Prosthetics

Myoelectric prosthetics offer users increased functionality in many facits of their lives. However, maintaining reliable connectivity between sEMG sensors and targeted muscle locations can be problematic. Volume fluctuation of the residual limb, dirt, sweat, and movement of the socket and sensor over the limb can all because of signal disruption leading some users to find the myoelectric prostheses, costing thousands of dollars, to be unreliable, and stop using it. To increase connectivity between the optimal myoelectric sites and sEMG sensors, this paper proposes the use of permanent ink tattoos to create a stable location which a sensor can move over when a prosthetic socket shifts, but still have connectivity to sites with the strongest myoelectric signal. This study proposes to start by testing various permanent bio-compatible tattoo inks for electrical connectivity in skin. Then test for optimal pattern designs in static and dynamic sensor scenarios to determine whether or not levels of myoelectric signals are higher and clearer (less electrical resistance in ohms) than unprepared skin. This technique may provide benefits to those using surface EMG sensor who experience interruptions in myoelectric signals, preventing the performance of intentional prosthetic functions. This could also benefit the development of implanted EMG electrodes or neural implants, as a means to provide efficient signal transmission through the skin

Cohen’s Conservatism and Human Enhancement

In an intriguing essay, G. A. Cohen has defended a conservative bias in favour of existing value. In this paper, we consider whether Cohen's conservatism raises a new challenge to the use of human enhancement technologies. We develop some of Cohen's suggestive remarks into a new line of argument against human enhancement that, we believe, is in several ways superior to existing objections. However, we shall argue that on closer inspection, Cohen's conservatism fails to offer grounds for a strong sweeping objection to enhancement, and may even offer positive support for forms of enhancement that preserve valuable features of human beings. Nevertheless, we concede that Cohen's arguments may suggest some plausible and important constraints on the modality of legitimate and desirable enhancements. © 2013 The Author(s)

Soil carbon management in large-scale Earth system modelling:implications for crop yields and nitrogen leaching

Croplands are vital ecosystems for human well-being and provide important ecosystem services such as crop yields, retention of nitrogen and carbon storage. On large (regional to global)-scale levels, assessment of how these different services will vary in space and time, especially in response to cropland management, are scarce. We explore cropland management alternatives and the effect these can have on future C and N pools and fluxes using the land-use-enabled dynamic vegetation model LPJ-GUESS (Lund–Potsdam–Jena General Ecosystem Simulator). Simulated crop production, cropland carbon storage, carbon sequestration and nitrogen leaching from croplands are evaluated and discussed. Compared to the version of LPJ-GUESS that does not include land-use dynamics, estimates of soil carbon stocks and nitrogen leaching from terrestrial to aquatic ecosystems were improved. Our model experiments allow us to investigate trade-offs between these ecosystem services that can be provided from agricultural fields. These trade-offs are evaluated for current land use and climate and further explored for future conditions within the two future climate change scenarios, RCP (Representative Concentration Pathway) 2.6 and 8.5. Our results show that the potential for carbon sequestration due to typical cropland management practices such as no-till management and cover crops proposed in previous studies is not realised, globally or over larger climatic regions. Our results highlight important considerations to be made when modelling C–N interactions in agricultural ecosystems under future environmental change and the effects these have on terrestrial biogeochemical cycles

RTOG 0518: Randomized Phase III Trial to Evaluate Zoledronic Acid for Prevention of Osteoporosis and Associated Fractures in Prostate Cancer Patients

Background: RTOG 0518 evaluated the potential benefit of zoledronic acid therapy in preventing bone fractures for patients with high grade and/or locally advanced, non-metastatic prostate adenocarcinoma receiving luteinizing hormone-releasing hormone (LHRH) agonist and radiotherapy (RT). Methods: Eligible patients with T-scores of the hip ( −2.5 vs. > −1.0) and negative bone scans were prospectively randomized to either zoledronic acid, 4 mg, concurrently with the start of RT and then every six months for a total of 6 infusions (Arm 1) or observation (Arm 2). Vitamin D and calcium supplements were given to all patients. Secondary objectives included quality of life (QOL) and bone mineral density (BMD) changes over a period of three years. Results: Of 109 patients accrued before early closure, 96 were eligible. Median follow-up was 36.3 months for Arm I and 34.8 months for Arm 2. Only two patients experienced a bone fracture (1 in each arm) resulting in no difference in freedom from any bone fracture (p=0.95), nor in QOL. BMD percent changes from baseline to 36 months were statistically improved with the use of zoledronic acid compared to observation for the lumbar spine (6% vs. −5%, p<0.0001), left total hip (1% vs. −8%, p=0.0002), and left femoral neck (3% vs. −8%, p=0.0007). Conclusions: For patients with advanced, non-metastatic prostate cancer receiving LHRH agonist and RT, the use of zoledronic acid was associated with statistically improved BMD percent changes. The small number of accrued patients resulted in decreased statistical power to detect any differences in the incidence of bone fractures or QOL

Enhancing involvement of people with multiple sclerosis in clinical trial design

Background: Although often overlooked, patient and public involvement (PPI) is vital when considering the design and delivery of complex and adaptive clinical trial designs for chronic health conditions such as multiple sclerosis (MS). Methods: We conducted a rapid review to assess current status of PPI in the design and conduct of clinical trials in MS over the last 5 years. We provide a case study describing PPI in the development of a platform clinical trial in progressive MS. Results: We identified only eight unique clinical trials that described PPI as part of articles or protocols; nearly, all were linked with funders who encourage or mandate PPI in health research. The OCTOPUS trial was co-designed with people affected by MS. They were central to every aspect from forming part of a governance group shaping the direction and strategy, to the working groups for treatment selection, trial design and delivery. They led the PPI strategy which enabled a more accessible, acceptable and inclusive design. Conclusion: Active, meaningful PPI in clinical trial design increases the quality and relevance of studies and the likelihood of impact for the patient community. We offer recommendations for enhancing PPI in future MS clinical trials

SAGES consensus recommendations on surgical video data use, structure, and exploration (for research in artificial intelligence, clinical quality improvement, and surgical education)

BACKGROUND: Surgery generates a vast amount of data from each procedure. Particularly video data provides significant value for surgical research, clinical outcome assessment, quality control, and education. The data lifecycle is influenced by various factors, including data structure, acquisition, storage, and sharing; data use and exploration, and finally data governance, which encompasses all ethical and legal regulations associated with the data. There is a universal need among stakeholders in surgical data science to establish standardized frameworks that address all aspects of this lifecycle to ensure data quality and purpose. METHODS: Working groups were formed, among 48 representatives from academia and industry, including clinicians, computer scientists and industry representatives. These working groups focused on: Data Use, Data Structure, Data Exploration, and Data Governance. After working group and panel discussions, a modified Delphi process was conducted. RESULTS: The resulting Delphi consensus provides conceptualized and structured recommendations for each domain related to surgical video data. We identified the key stakeholders within the data lifecycle and formulated comprehensive, easily understandable, and widely applicable guidelines for data utilization. Standardization of data structure should encompass format and quality, data sources, documentation, metadata, and account for biases within the data. To foster scientific data exploration, datasets should reflect diversity and remain adaptable to future applications. Data governance must be transparent to all stakeholders, addressing legal and ethical considerations surrounding the data. CONCLUSION: This consensus presents essential recommendations around the generation of standardized and diverse surgical video databanks, accounting for multiple stakeholders involved in data generation and use throughout its lifecycle. Following the SAGES annotation framework, we lay the foundation for standardization of data use, structure, and exploration. A detailed exploration of requirements for adequate data governance will follow

Enhancing involvement of people with multiple sclerosis in clinical trial design

Background: Although often overlooked, patient and public involvement (PPI) is vital when considering the design and delivery of complex and adaptive clinical trial designs for chronic health conditions such as multiple sclerosis (MS). Methods: We conducted a rapid review to assess current status of PPI in the design and conduct of clinical trials in MS over the last 5 years. We provide a case study describing PPI in the development of a platform clinical trial in progressive MS. Results: We identified only eight unique clinical trials that described PPI as part of articles or protocols; nearly, all were linked with funders who encourage or mandate PPI in health research. The OCTOPUS trial was co-designed with people affected by MS. They were central to every aspect from forming part of a governance group shaping the direction and strategy, to the working groups for treatment selection, trial design and delivery. They led the PPI strategy which enabled a more accessible, acceptable and inclusive design. Conclusion: Active, meaningful PPI in clinical trial design increases the quality and relevance of studies and the likelihood of impact for the patient community. We offer recommendations for enhancing PPI in future MS clinical trials

The effectiveness, acceptability and cost-effectiveness of psychosocial interventions for maltreated children and adolescents: an evidence synthesis.

BACKGROUND: Child maltreatment is a substantial social problem that affects large numbers of children and young people in the UK, resulting in a range of significant short- and long-term psychosocial problems. OBJECTIVES: To synthesise evidence of the effectiveness, cost-effectiveness and acceptability of interventions addressing the adverse consequences of child maltreatment. STUDY DESIGN: For effectiveness, we included any controlled study. Other study designs were considered for economic decision modelling. For acceptability, we included any study that asked participants for their views. PARTICIPANTS: Children and young people up to 24 years 11 months, who had experienced maltreatment before the age of 17 years 11 months. INTERVENTIONS: Any psychosocial intervention provided in any setting aiming to address the consequences of maltreatment. MAIN OUTCOME MEASURES: Psychological distress [particularly post-traumatic stress disorder (PTSD), depression and anxiety, and self-harm], behaviour, social functioning, quality of life and acceptability. METHODS: Young Persons and Professional Advisory Groups guided the project, which was conducted in accordance with Cochrane Collaboration and NHS Centre for Reviews and Dissemination guidance. Departures from the published protocol were recorded and explained. Meta-analyses and cost-effectiveness analyses of available data were undertaken where possible. RESULTS: We identified 198 effectiveness studies (including 62 randomised trials); six economic evaluations (five using trial data and one decision-analytic model); and 73 studies investigating treatment acceptability. Pooled data on cognitive-behavioural therapy (CBT) for sexual abuse suggested post-treatment reductions in PTSD [standardised mean difference (SMD) -0.44 (95% CI -4.43 to -1.53)], depression [mean difference -2.83 (95% CI -4.53 to -1.13)] and anxiety [SMD -0.23 (95% CI -0.03 to -0.42)]. No differences were observed for post-treatment sexualised behaviour, externalising behaviour, behaviour management skills of parents, or parental support to the child. Findings from attachment-focused interventions suggested improvements in secure attachment [odds ratio 0.14 (95% CI 0.03 to 0.70)] and reductions in disorganised behaviour [SMD 0.23 (95% CI 0.13 to 0.42)], but no differences in avoidant attachment or externalising behaviour. Few studies addressed the role of caregivers, or the impact of the therapist-child relationship. Economic evaluations suffered methodological limitations and provided conflicting results. As a result, decision-analytic modelling was not possible, but cost-effectiveness analysis using effectiveness data from meta-analyses was undertaken for the most promising intervention: CBT for sexual abuse. Analyses of the cost-effectiveness of CBT were limited by the lack of cost data beyond the cost of CBT itself. CONCLUSIONS: It is not possible to draw firm conclusions about which interventions are effective for children with different maltreatment profiles, which are of no benefit or are harmful, and which factors encourage people to seek therapy, accept the offer of therapy and actively engage with therapy. Little is known about the cost-effectiveness of alternative interventions. LIMITATIONS: Studies were largely conducted outside the UK. The heterogeneity of outcomes and measures seriously impacted on the ability to conduct meta-analyses. FUTURE WORK: Studies are needed that assess the effectiveness of interventions within a UK context, which address the wider effects of maltreatment, as well as specific clinical outcomes. STUDY REGISTRATION: This study is registered as PROSPERO CRD42013003889. FUNDING: The National Institute for Health Research Health Technology Assessment programme

Meeting the expectation of industry: an integrated approach for the teaching of mechanics and electronics to design students

This is an Accepted Manuscript of an article published by Taylor & Francis in European Journal of Engineering Education on 19th January 2015, available online: http://dx.doi.org/10.1080/03043797.2014.1001813This paper examines the traditional engineering-based provision delivered to Product Design and Technology (B.Sc.) undergraduates at the Loughborough Design School and questions its relevancy against the increasing expectations of industry. The paper reviews final-year design projects to understand the level of transference of engineering-based knowledge into design practice and highlights areas of opportunity for improved teaching and learning. The paper discusses the development and implementation of an integrated approach to the teaching of Mechanics and Electronics to formalise and reinforce the key learning process of transference within the design context. The paper concludes with observations from the delivery of this integrated teaching and offers insights from student and academic perspectives for the further improvement of engineering-based teaching and learning

tRNA biology in the omics era: Stress signalling dynamics and cancer progression.

Recent years have seen a burst in the number of studies investigating tRNA biology. With the transition from a gene-centred to a genome-centred perspective, tRNAs and other RNA polymerase III transcripts surfaced as active regulators of normal cell physiology and disease. Novel strategies removing some of the hurdles that prevent quantitative tRNA profiling revealed that the differential exploitation of the tRNA pool critically affects the ability of the cell to balance protein homeostasis during normal and stress conditions. Furthermore, growing evidence indicates that the adaptation of tRNA synthesis to cellular dynamics can influence translation and mRNA stability to drive carcinogenesis and other pathological disorders. This review explores the contribution given by genomics, transcriptomics and epitranscriptomics to the discovery of emerging tRNA functions, and gives insights into some of the technical challenges that still limit our understanding of the RNA polymerase III transcriptional machinery