Opening the GATE : systems thinking from the global assistive technology alliance

Purpose: This paper describes international actions to collaborate in the assistive technology (AT) arena and provides an update of programmes supporting AT globally. Methods: The World Health Organisation (WHO) identifies the severe global uneven distribution of resources, expertise and extensive unmet need for AT, as well the optimistic substantial capability for innovations and developments in appropriate and sustainable AT design, development and delivery. Systems thinking and market shaping are identified as means to address these challenges and leverage the ingenuity and expertise of AT stakeholders. Results: This paper is a ‘call to action’, showcasing emerging AT networks as exemplars of a distributed, but integrated mechanism for addressing AT needs globally, and describing the Global Alliance of Assistive Technology Organisations (GAATO) as a vehicle to facilitate this global networking. Conclusion: Partners in this Global Alliance aim to advance the field of assistive technology by promoting shared research, policy advocacy, educating people and organisations within and outside the field, teaching, training and knowledge transfer by pulling together broad-based membership organisations

Origin of the Local Bubble

We present a new unbiased search for OB associations in the Solar neighbourhood which have hosted the progenitor stars of the core collapse supernovae responsible for the Local Bubble in the interstellar gas. For this purpose we have analyzed a volume complete set (with a diameter of 400 pc) of B stars drawn from the Hipparcos catalogue and the Arivel data base, from which candidate members were selected by a kinematical criterion. After careful dereddening the star colours we have constructed a colour-magnitude diagram and confirmed that the Upper Scorpius, Upper Centaurus Lupus, and Lower Centaurus Crux subgroups of the Sco OB2 association are the youngest nearby OB associations. We dated their ages with theoretical isochrones in the range of 20–30 Myr, in agreement with previous work. We have traced backwards in time the paths of the stars and found that they entered the volume of the present bubble at 10 to 15 Myr ago. We argue that the Local Bubble began to form then and estimate that 14 to 20 supernovae have exploded since. The implied energy input into the ambient medium can be shown to be sufficient to excavate a bubble of the presently observed size

Daily activity patterns of people provided with a dynamic arm support

Dynamic arm supports are provided to support activities of daily living in people with limited upper extremity function. A cross-sectional study was performed in the Netherlands involving people who were provided with a dynamic arm support in 2012-2013. An adapted version of the Life-Habits questionnaire was used to assess daily activity patterns. Twenty-three subjects filled in the questionnaire. Tasks people perform themselves in daily life include tasks as eating, drinking, and communication tasks. Participants vary in the need for assistance in order to perform certain tasks. This individual character of daily activity performance is important to bear in mind during the provision of dynamic arm supports. More complex tasks in the field of personal care and household are often performed by caregivers. These are regarded a challenge for the field of assistive technology and/or robotics

ICT based technology to support play for children with severe physical disabilities

Play is important for a child''s development. Children with severe physical disabilities experience difficulties engaging in play. With the progress of technology the possibilities to support play are increasing. The purpose of this review was to gain insight into the possibilities and availability of ICT based technology to support play in children with severe physical disabilities. Methods A systematic literature search within the databases PubMed, CINAHL, IEEE and ERIC was carried out. Three reviewers assessed titles and abstracts independently. Additionally, Google Scholar, conference proceedings and reference lists were used. Results and conclusion The included publications reported on 27 different technologies, which can be classified into three main groups; robots, virtual reality systems and computer systems. There are several options that may have great potential in supporting play for this target group

Dynamics of the bacterial gut microbiota during controlled human infection with Necator americanus larvae

Hookworms are soil-transmitted helminths that use immune-evasive strategies to persist in the human duodenum where they are responsible for anemia and protein loss. Given their location and immune regulatory effects, hookworms likely impact the bacterial microbiota. However, microbiota studies struggle to deconvolute the effect of hookworms from confounders such as coinfections and malnutrition. We thus used an experimental human hookworm infection model to explore temporal changes in the gut microbiota before and during hookworm infection. Volunteers were dermally exposed to cumulative dosages of 50, 100 or 150 L3 Necator americanus larvae. Fecal samples were collected for microbiota profiling through 16S rRNA gene amplicon sequencing at weeks zero, four, eight, fourteen and twenty. During the acute infection phase (trial week zero to eight) no changes in bacterial diversity were detected. During the established infection phase (trial week eight to twenty), bacterial richness (Chao1, p = .0174) increased significantly over all volunteers. No relation was found between larval dosage and diversity, stability or relative abundance of individual bacterial taxa. GI symptoms were associated with an unstable microbiota during the first eight weeks and rapid recovery at week twenty. Barnesiella, amongst other taxa, was more abundant in volunteers with more GI symptoms throughout the study. In conclusion, this study showed that clinical GI symptoms following N. americanus infection are associated with temporary microbiota instability and relative abundance of specific bacterial taxa. These results suggest a possible role of hookworm-induced enteritis on microbiota stability.Development and application of statistical models for medical scientific researc

Platform for frail elderly people supporting information and communication

There is a growing need for technology to support the frail elderly living independently in home situations. Several telecommunication systems already exist. These systems are developed mainly from the perspective of healthcare professionals and focus on efficient delivery of healthcare services. They hardly meet the specific needs of the frail elderly. In this project a platform with specific needs of the frail elderly people has been designed, running on standard PCs. This system supports living independently, social participation, wellbeing, and asking for care services. The platform was evaluated and subjects assess the system as user friendly, and supportive for their independence and self-reliance. They recommend it to other users

Risk factors for in-hospital mortality in laboratory-confirmed COVID-19 patients in the Netherlands: A competing risk survival analysis

Contains fulltext : 232508.pdf (Publisher’s version ) (Open Access)BACKGROUND: To date, survival data on risk factors for COVID-19 mortality in western Europe is limited, and none of the published survival studies have used a competing risk approach. This study aims to identify risk factors for in-hospital mortality in COVID-19 patients in the Netherlands, considering recovery as a competing risk. METHODS: In this observational multicenter cohort study we included adults with PCR-confirmed SARS-CoV-2 infection that were admitted to one of five hospitals in the Netherlands (March to May 2020). We performed a competing risk survival analysis, presenting cause-specific hazard ratios (HRCS) for the effect of preselected factors on the absolute risk of death and recovery. RESULTS: 1,006 patients were included (63.9% male; median age 69 years, IQR: 58-77). Patients were hospitalized for a median duration of 6 days (IQR: 3-13); 243 (24.6%) of them died, 689 (69.9%) recovered, and 74 (7.4%) were censored. Patients with higher age (HRCS 1.10, 95% CI 1.08-1.12), immunocompromised state (HRCS 1.46, 95% CI 1.08-1.98), who used anticoagulants or antiplatelet medication (HRCS 1.38, 95% CI 1.01-1.88), with higher modified early warning score (MEWS) (HRCS 1.09, 95% CI 1.01-1.18), and higher blood LDH at time of admission (HRCS 6.68, 95% CI 1.95-22.8) had increased risk of death, whereas fever (HRCS 0.70, 95% CI 0.52-0.95) decreased risk of death. We found no increased mortality risk in male patients, high BMI or diabetes. CONCLUSION: Our competing risk survival analysis confirms specific risk factors for COVID-19 mortality in a the Netherlands, which can be used for prediction research, more intense in-hospital monitoring or prioritizing particular patients for new treatments or vaccination

Favorable Anakinra Responses in Severe Covid-19 Patients with Secondary Hemophagocytic Lymphohistiocytosis

Contains fulltext : 221498.pdf (Publisher’s version ) (Closed access