Federating distributed clinical data for the prediction of adverse hypotensive events

The ability to predict adverse hypotensive events, where a patient's arterial blood pressure drops to abnormally low (and dangerous) levels, would be of major benefit to the fields of primary and secondary health care, and especially to the traumatic brain injury domain. A wealth of data exist in health care systems providing information on the major health indicators of patients in hospitals (blood pressure, temperature, heart rate, etc.). It is believed that if enough of these data could be drawn together and analysed in a systematic way, then a system could be built that will trigger an alarm predicting the onset of a hypotensive event over a useful time scale, e.g. half an hour in advance. In such circumstances, avoidance measures can be taken to prevent such events arising. This is the basis for the Avert-IT project (http://www.avert-it.org), a collaborative EU-funded project involving the construction of a hypotension alarm system exploiting Bayesian neural networks using techniques of data federation to bring together the relevant information for study and system development

Disease surveillance and risk factors affecting mortality of captive cirl buntings (Emberiza cirlus) in a translocation for conservation purposes

Cirl buntings in the UK were translocated over a 5-year period by collecting chicks from the residual population, hand-rearing and releasing them at a site in Cornwall with the aim of establishing a second breeding population. Because mortality and morbidity during captivity restrict the number and fitness of individuals available for release, selected parasites were monitored in the captive chicks, and all deaths were investigated by autopsy, histopathology and bacteriology. Risk factors associated with captive deaths were analysed. Annual mortality during captivity ranged from 4% (3 of 75 chicks in 2006) to 42% (26 of 73 in 2007) of chicks collected. Infectious disease associated with immunosuppression was an important factor in many deaths, and chicks collected with lower body weight were at greater risk of mortality. These findings emphasise the need for rigorous monitoring of all aspects of captive care during passerine translocations and provide evidence-based recommendations for future projects

A shower before bedtime may improve the sleep onset latency of youth soccer players.

During the competitive season, soccer players are likely exposed to numerous factors that may disrupt the process of sleep. The current investigation looked to evaluate a practical sleep hygiene strategy (10-min showering at ∼40°C before lights out), within a group of 11 youth soccer players in comparison to normal sleeping conditions (control). Each condition consisted of three days within a randomised crossover trial design. Sleep information was collected using a commercial wireless bedside sleep monitor. Measures of skin temperature were evaluated using iButton skin thermistors to establish both distal and proximal skin temperatures and distal to proximal gradient. The shower intervention elevated distal skin temperature by 1.1°C (95% CI: 0.1-2.1°C, p = .04) on average prior to lights out. The elevation in distal temperature was also present during the first 30-min following lights out (1.0°C, 95% CI: 0.4-1.6°C, p < .01). The distal to proximal gradient also showed a significant effect between the conditions within the first 30-min after lights out (0.7°C, 95% CI: 0.3-1.2°C, p < .01). On average the sleep latency of the youth soccer players was -7-min lower (95% CI: -13 to -2 min, p < .01) and sleep efficiency +2% higher (95% CI: 1-3%; p < .01) in the shower condition. These findings demonstrate that a warm shower performed before lights out may offer a practical strategy to promote thermoregulatory changes that may advance sleep onset latency and improve sleep efficiency in athletes

Project-based, collaborative, algorithmic robotics for high school students: Programming self-driving race cars at MIT

We describe the pedagogy behind the MIT Beaver Works Summer Institute Robotics Program, a new high-school STEM program in robotics. The program utilizes state-of-the-art sensors and embedded computers for mobile robotics. These components are carried on an exciting 1/10-scale race-car platform. The program has three salient, distinguishing features: (i) it focuses on robotics software systems: the students design and build robotics software towards real-world applications, without being distracted by hardware issues; (ii) it champions project-based learning: the students learn through weekly project assignments and a final course challenge; (iii) the learning is implemented in a collaborative fashion: the students learn the basics of collaboration and technical communication in lectures, and they work in teams to design and implement their software systems. The program was offered as a four-week residential program at MIT in the summer of 2016. In this paper, we provide the details of this new program, its teaching objectives, and its results. We also briefly discuss future directions and opportunities

Cost-effectiveness of a community-delivered multicomponent intervention compared with enhanced standard care of obese adolescents: cost-utility analysis alongside a randomised controlled trial (the HELP trial)

OBJECTIVE: To undertake a cost-utility analysis of a motivational multicomponent lifestyle-modification intervention in a community setting (the Healthy Eating Lifestyle Programme (HELP)) compared with enhanced standard care. DESIGN: Cost-utility analysis alongside a randomised controlled trial. SETTING: Community settings in Greater London, England. PARTICIPANTS: 174 young people with obesity aged 12-19 years. INTERVENTIONS: Intervention participants received 12 one-to-one sessions across 6 months, addressing lifestyle behaviours and focusing on motivation to change and self-esteem rather than weight change, delivered by trained graduate health workers in community settings. Control participants received a single 1-hour one-to-one nurse-delivered session providing didactic weight-management advice. MAIN OUTCOME MEASURES: Mean costs and quality-adjusted life years (QALYs) per participant over a 1-year period using resource use data and utility values collected during the trial. Incremental cost-effectiveness ratio (ICER) was calculated and non-parametric bootstrapping was conducted to generate a cost-effectiveness acceptability curve (CEAC). RESULTS: Mean intervention costs per participant were £918 for HELP and £68 for enhanced standard care. There were no significant differences between the two groups in mean resource use per participant for any type of healthcare contact. Adjusted costs were significantly higher in the intervention group (mean incremental costs for HELP vs enhanced standard care £1003 (95% CI £837 to £1168)). There were no differences in adjusted QALYs between groups (mean QALYs gained 0.008 (95% CI -0.031 to 0.046)). The ICER of the HELP versus enhanced standard care was £120 630 per QALY gained. The CEAC shows that the probability that HELP was cost-effective relative to the enhanced standard care was 0.002 or 0.046, at a threshold of £20 000 or £30 000 per QALY gained. CONCLUSIONS: We did not find evidence that HELP was more effective than a single educational session in improving quality of life in a sample of adolescents with obesity. HELP was associated with higher costs, mainly due to the extra costs of delivering the intervention and therefore is not cost-effective. TRIAL REGISTRATION NUMBER: ISRCTN9984011

Moderate excess alcohol consumption and adverse cardiac remodelling in dilated cardiomyopathy

Objective The effect of moderate excess alcohol consumption is widely debated and has not been well defined in dilated cardiomyopathy (DCM). There is need for a greater evidence base to help advise patients. We sought to evaluate the effect of moderate excess alcohol consumption on cardiovascular structure, function and outcomes in DCM. Methods Prospective longitudinal observational cohort study. Patients with DCM (n=604) were evaluated for a history of moderate excess alcohol consumption (UK government guidelines; >14 units/week for women, >21 units/week for men) at cohort enrollment, had cardiovascular magnetic resonance and were followed up for the composite endpoint of cardiovascular death, heart failure and arrhythmic events. Patients meeting criteria for alcoholic cardiomyopathy were not recruited. Results DCM patients with a history of moderate excess alcohol consumption (n=98, 16%) had lower biventricular function and increased chamber dilatation of the left ventricle, right ventricle and left atrium, as well as increased left ventricular hypertrophy compared to patients without moderate alcohol consumption. They were more likely to be male (alcohol excess group– n =92, 94% vs n =306, 61%, p=<0.001). After adjustment for biological sex, moderate excess alcohol was not associated with adverse cardiac structure. There was no difference in mid-wall myocardial fibrosis between groups. Prior moderate excess alcohol consumption did not affect prognosis (HR 1.29, 0.73 to 2.26, p=0.38) during median follow up of 3.9 years. Conclusion Dilated cardiomyopathy patients with moderate excess alcohol consumption have adverse cardiac structure and function at presentation but this is largely due to biological sex. Alcohol may contribute to sex-specific phenotypic differences in DCM. These findings help to inform lifestyle discussions for patients with dilated cardiomyopathy

Inspiratory muscle warm-up does not improve cycling time-trial performance

Purpose: This study examined the effects of an active cycling warm-up, with and without the addition of an inspiratory muscle warm-up (IMW), on 10-km cycling time-trial performance

Activity of the DNA minor groove cross-linking agent SG2000 (SJG-136) against canine tumours

BACKGROUND: Cancer is the leading cause of death in older dogs and its prevalence is increasing. There is clearly a need to develop more effective anti-cancer drugs in dogs. SG2000 (SJG-136) is a sequence selective DNA minor groove cross-linking agent. Based on its in vitro potency, the spectrum of in vivo and clinical activity against human tumours, and its tolerability in human patients, SG2000 has potential as a novel therapeutic against spontaneously occurring canine malignancies. RESULTS: In vitro cytotoxicity was assessed using SRB and MTT assays, and in vivo activity was assessed using canine tumour xenografts. DNA interstrand cross-linking (ICL) was determined using a modification of the single cell gel electrophoresis (comet) assay. Effects on cell cycle distribution were assessed by flow cytometry and measurement of γ-H2AX by immunofluorescence and immunohistochemistry. SG2000 had a multi-log differential cytotoxic profile against a panel of 12 canine tumour cell lines representing a range of common tumour types in dogs. In the CMeC-1 melanoma cell line, DNA ICLs increased linearly with dose following a 1 h treatment. Peak ICL was achieved within 1 h and no removal was observed over 48 h. A relationship between DNA ICL formation and cytotoxicity was observed across cell lines. The formation of γ-H2AX foci was slow, becoming evident after 4 h and reaching a peak at 24 h. SG2000 exhibited significant anti-tumour activity against two canine melanoma tumour models in vivo. Anti-tumour activity was observed at 0.15 and 0.3 mg/kg given i.v. either once, or weekly x 3. Dose-dependent DNA ICL was observed in tumours (and to a lower level in peripheral blood mononuclear cells) at 2 h and persisted at 24 h. ICL increased following the second and third doses in a repeated dose schedule. At 24 h, dose dependent γ-H2AX foci were more numerous than at 2 h, and greater in tumours than in peripheral blood mononuclear cells. SG2000-induced H2AX phosphorylation measured by immunohistochemistry showed good correspondence, but less sensitivity, than measurement of foci. CONCLUSIONS: SG2000 displayed potent activity in vitro against canine cancer cell lines as a result of the formation and persistence of DNA ICLs. SG2000 also had significant in vivo antitumour activity against canine melanoma xenografts, and the comet and γ-H2AX foci methods were relevant pharmacodynamic assays. The clinical testing of SG2000 against spontaneous canine cancer is warranted. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12917-015-0534-2) contains supplementary material, which is available to authorized users

Sexually dimorphic tibia shape is linked to natural osteoarthritis in STR/Ort mice

Human osteoarthritis (OA) is detected only at late stages. Male STR/Ort mice develop knee OA spontaneously with known longitudinal trajectory, offering scope to identify OA predisposing factors. We exploit the lack of overt OA in female STR/Ort and in both sexes of parental, control CBA mice to explore whether early divergence in tibial bone mass or shape are linked to emergent OA

Gender divisions of domestic labour and paid domestic services

This article investigates the relationship between sharing domestic tasks in dual-earner mixed-sex couples and using of paid domestic services. Results from a small-scale survey of the domestic outsourcing practices of employees of a large service-sector organisation in the UK show that in households: full-time working by women and presence of younger children is positively associated with using of domestic services; there is no association between the gender division of traditionally female domestic tasks carried out within the couple and paid services; in contrast, men’s greater involvement in traditionally male and traditionally gender-neutral tasks is positively associating with using paid domestic services. These findings tentatively suggest a new arrangement may be emerging whereby some couples address a heavy workload and desire for a less traditional division of domestic labour by men participating more in close-ended domestic tasks and outsourcing more time-consuming tasks traditionally undertaken by women to paid service providers