Mathematical Modelling of Different Types of Body Support Surface for Pressure Ulcer Prevention

Pressure ulcer is a common problem for today’s healthcare industry. It occurs due to external load applied to the skin. Also when the subject is immobile for a longer period of time and there is continuous load applied to a particular area of human body, blood flow gets reduced and as a result pressure ulcer develops. Body support surface has a significant role in preventing ulceration so it is important to know the characteristics of support surface under loading conditions. In this paper we have presented mathematical models of different types of viscoelastic materials and also we have shown the validation of our simulation results with experiments

A Review on Pressure Ulcer: Aetiology, Cost, Detection and Prevention Systems

Pressure ulcer (also known as pressure sore, bedsore, ischemia, decubitus ulcer) is a global challenge for today’s healthcare society. Found in several locations in the human body such as the sacrum, heel, back of the head, shoulder, knee caps, it occurs when soft tissues are under continuous loading and a subject’s mobility is restricted (bedbound/chair bound). Blood flow in soft tissues becomes insufficient leading to tissue necrosis (cell death) and pressure ulcer. The subject’s physiological parameters (age, body mass index) and types of body support surface materials (mattress) are also factors in the formation of pressure ulcer. The economic impacts of these are huge, and the subject’s quality of life is reduced in many ways. There are several methods of detecting and preventing ulceration in human body. Detection depends on assessing local pressure on tissue and prevention on scales of risk used to assess a subject prior to admission. There are also various types of mattresses (air cushioned/liquid filled/foam) available to prevent ulceration. But, despite this work, pressure ulcers remain common.This article reviews the aetiology, cost, detection and prevention of these ulcers

Implementation of a Direct-Imaging and FX Correlator for the BEST-2 Array

A new digital backend has been developed for the BEST-2 array at Radiotelescopi di Medicina, INAF-IRA, Italy which allows concurrent operation of an FX correlator, and a direct-imaging correlator and beamformer. This backend serves as a platform for testing some of the spatial Fourier transform concepts which have been proposed for use in computing correlations on regularly gridded arrays. While spatial Fourier transform-based beamformers have been implemented previously, this is to our knowledge, the first time a direct-imaging correlator has been deployed on a radio astronomy array. Concurrent observations with the FX and direct-imaging correlator allows for direct comparison between the two architectures. Additionally, we show the potential of the direct-imaging correlator for time-domain astronomy, by passing a subset of beams though a pulsar and transient detection pipeline. These results provide a timely verification for spatial Fourier transform-based instruments that are currently in commissioning. These instruments aim to detect highly-redshifted hydrogen from the Epoch of Reionization and/or to perform widefield surveys for time-domain studies of the radio sky. We experimentally show the direct-imaging correlator architecture to be a viable solution for correlation and beamforming.Comment: 12 pages, 17 figures, 2 tables, Accepted to MNRAS January 24, 2014, includes appendix diagram

The role of cardiac biomarkers in early detection of cardiotoxicity in breast cancer treated with trastuzumab in the adjuvant setting: a systematic review

Trastuzumab, a humanized monoclonal antibody against the extracellular domain of human epidermal growth factor receptor 2 (HER-2) prolongs disease-free survival (DFS) and overall survival (OS) in patients with early-stage breast cancer. Although it is generally well tolerated, it has been associated with cardiotoxicity, mainly a reduction of left-ventricular ejection fraction (LVEF), especially if the patient has received anthracyclines.It is generally known that a drop in LVEF has limited diagnostic ability. Therefore, the identification of serum biomarkers of cardiotoxicity, able to detect damage at an earlier phase, has become ideal. Troponins (conventional and high sensitive), natriuretic peptides, reactive C protein (CRP), myeloperoxidase (MPO), etc are different molecular markers which have been assessed to check their role in the detection of treatment induced cardiotoxicity (CTIC) with controversial results.OBJECTIVEThis systematic review will synthesize available evidence assessing the role of different serum biomarkers in early prediction of cardiotoxicity in breast cancer patients treated with adjuvant trastuzumab.METHODS/DESIGNSystematic review conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations. Distinct scientific databases such as Google Scholar, Pubmed, EBSCOhost, and PsycINFO were searched to aid in the investigation of the research problem.Randomized clinical trials (RCT) and observational studies of patients with early breast cancer receiving adjuvant trastuzumab were eligible for inclusion. Two investigators have independently evaluated those studies and used standardized data extraction templates to collect data on the study and patients’ characteristics.RESULTS 11 articles were selected, one RCT and ten observational studies. The most studied biomarker was N-terminal-pro-brain natriuretic peptide (NT-proBNP) followed by troponins. Findings showed that NT-proBNP was not predictive of CTIC while conflictive results were seen with troponins.One study showed a predictive role of high sensitive (hs) CRP and another found a relationship with the levels of MPO.CONCLUSIONBiomarkers offer a unique potential to improve the effectiveness and safety of trastuzumab through timely detection of CTIC and prompt initiation of appropriate treatment. Troponins I and T have shown a predictive role in early detection of CTIC but further research would be needed to enable more insight and improve the overall patient outcome

A methodology for passenger-centred rail network optimisation

Optimising the allocation of limited resources, be they existing assets or investment, is an ongoing challenge for rail network managers. Recently, methodologies have been developed for optimising the timetable from the passenger perspective. However, there is a gap for a decision support tool which optimises rail networks for maximum passenger satisfaction, captures the experience of individual passengers and can be adapted to different networks and challenges. Towards building such a tool, this thesis develops a novel methodology referred to as the Sheffield University Passenger Rail Experience Maximiser (SUPREME) framework. First, a network assessment metric is developed which captures the multi-stage nature of individual passenger journeys as well as the effect of crowding upon passenger satisfaction. Second, an agent-based simulation is developed to capture individual passenger journeys in enough detail for the network assessment metric to be calculated. Third, for the optimisation algorithm within SUPREME, the Bayesian Optimisation method is selected following an experimental investigation which indicates that it is well suited for ‘expensive-to-compute’ objective functions, such as the one found in SUPREME. Finally, in case studies that include optimising the value engineering strategy of the proposed UK High Speed Two network when saving £5 billion initial investment costs, the SUPREME framework is found to improve network performance by the order of 10%. This thesis shows that the SUPREME framework can find ‘good’ resource allocations for a ‘reasonable’ computational cost, and is sufficiently adaptable for application to many rail network challenges. This indicates that a decision support tool developed on the SUPREME framework could be widely applied by network managers to improve passenger experience and increase ticket revenue. Novel contributions made by this thesis are: the SUPREME methodology, an international comparison between the Journey Time Metric and Disutility Metric, and the application of the Bayesian Optimisation method for maximising the performance of a rail network

A Population-Based Study Comparing Child (0-4) and Adult (55-74) Mortality, GDP-Expenditure on-Health and Relative Poverty in the UK and Developed Countries 1989-2014. Some Challenging Outcomes

Purpose: To compare the UK Child (0-4) and Adult (55-74) Mortality with twenty developed countries 1989-2014 to explore whether the UK has lower priorities for children? Design: WHO data on Child and Adult mortality examined within context of World Bank %GDPExpenditure-on-Health (%GDPEH) data and Income Inequality i.e Relative poverty. Settings: 21 developed countries. Patients: National populations. Outcome Measures: Child and Adult mortality rates per million (pm) population between 1989-2014. Confi dence Intervals compares UK with other developed countries (ODC); odds ratios of average European to UK mortality calculated. Correlations explore links between mortalities, %GDPEH and Income Inequality. Important Results: Highest average 1980-2014 %GDPEH is USA 12.6%, the lowest UK 7.0%. European average 8.5% a UK to European odds ratio 1:1.21. Widest Income Inequality was USA 15.9 times, UK 13.8 was third, European average 8.5times. Child Mortality fell in every country but eleven signifi cantly better than Britain. Highest was USA 1383pm the UK fourth at 967pm. European average 728pm yielded a European to UK odds ratio of 1:1.33. Income Inequality and CRM signifi cantly correlated (RHO=+0.6188 p<0.001) and lowest Private: Public %GDP ratio and highest CMR (Rho=+0.3805 p<0.05). Adult Mortality fell substantially in every country but UK signifi cantly greater reductions than Seventeen counties. European average 9545pm to UK 10,754pm gave a European to UK odds ratio of 1:1.13. Conclusion: Implications; Britain’s results suggest a higher priority is given to adult health than children. The socio-economic context in which UK Child health operates appears to disadvantage UK children, indicating the need to address income inequalities and at least match European average health funding