88 research outputs found

    Micro Vascular Reconstruction of Maxilla using Free Fibula Flap

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    AIM: The purpose of the study was to evaluate the aesthetic and functional outcome after free fibula flap reconstruction for maxillary defects. OBJECTIVES: The long term outcome is evaluated in the following manner, 1. Fibula as a suitable reconstruction method for maxillary defects. 2. Patient satisfaction In terms of functional and aesthetic satisfaction at donor and recipient site. (annexure). 3. Wound infection and dehiscence. 4. Donor site morbidity. MATERIALS & METHODS: 3 patients were included in the study. Two patients were secondarily reconstructed due to post traumatic defect and mucormycosis, and third patient was primarily reconstructed after resection for squamous cell carcinoma. RESULTS: All the three patients had an improvement in speech and aesthetically acceptable results. One patient had wound dehiscence in the recipient site; one patient had pain in donor site for 3 weeks while walking downstairs. No difficulty in deglutition in any patients. CONCLUSION: Low donor site morbidity, acceptable aesthetic and functional outcome recommends micro vascularized free fibula flap to be considered as one of the ideal option for maxillary reconstruction. It improves the quality of life by improving the speech and swallowing

    Computational tracking of Parkinsonian motor fluctuations in a real-world setting: a case study

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    Digital biomarkers based on accurate tracking of motor behaviour can provide a cost-effective, objective, and robust measure for Parkinson’s Disease progression, changes in care needs, and the effect of interventions. Markerless motion capture technology offers a promising approach for running it in the home. This technology uses depth sensors to capture movement unobtrusively and generate objective and quantifiable movement features. Here we present a 4-month long case study during which the patient visits our lab every month to perform mobility tasks and daily living tasks. Our data suggest accurate tracking of symptom fluctuations during both task types. This is a promising proof-of-concept towards passive tracking in-the-home of Parkinsonian symptom fluctuations

    Brain-like associative learning using a nanoscale non-volatile phase change synaptic device array

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    Recent advances in neuroscience together with nanoscale electronic device technology have resulted in huge interests in realizing brain-like computing hardwares using emerging nanoscale memory devices as synaptic elements. Although there has been experimental work that demonstrated the operation of nanoscale synaptic element at the single device level, network level studies have been limited to simulations. In this work, we demonstrate, using experiments, array level associative learning using phase change synaptic devices connected in a grid like configuration similar to the organization of the biological brain. Implementing Hebbian learning with phase change memory cells, the synaptic grid was able to store presented patterns and recall missing patterns in an associative brain-like fashion. We found that the system is robust to device variations, and large variations in cell resistance states can be accommodated by increasing the number of training epochs. We illustrated the tradeoff between variation tolerance of the network and the overall energy consumption, and found that energy consumption is decreased significantly for lower variation tolerance.Comment: Original article can be found here: http://journal.frontiersin.org/Journal/10.3389/fnins.2014.00205/abstrac

    Dosimetric Validation of Physical and Biological Indexes from the Dose-Volume Histogram for Evaluation of 3D-CRT and IMRT Techniques with VMAT Treatment Plan Techniques in Cervical Tumors from In-House Developed Software

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    Introduction:This study aims to investigate the Normal Tissue Complication Probability (NTCP) and Tumor Control Probability (TCP) of cervical cancer from Niemierko radiobiological model and compared with Lyman-Kutcher-Butcher (LKB) model’s effective volume parameter in three different planning techniques such as 3-Dimensional Conformal Radiation Therapy (3D-CRT), Intensity Modulated Radiotherapy (IMRT) and Volumetric Arc Therapy (VMAT).Material and Methods:Twenty patients were selected with Grade II and Grade III and the treatment plan was initially generated for 3D-CRT, IMRT and VMAT. The physical dose from each voxel in radiotherapy treatment planning was extracted through a dose volume histogram (DVH) text file from in-built software developed using python program.  Software was developed by freely available python integration with an integrated Oracle database to store the outcome results with user-friendly graphical user interface for editing the radiological parameter values and viewing the DVH graph. The dosimetricconformalities parameters such as homogeneity index (HI) and conformity index (CI) along with radiobiological parameters such as TCP, NTCP and effective volume (Veff) were compared with three different planning techniques.Results:The IMRT and VMAT dose delivery techniques improve the efficiency of the treatment of cervical cancer with good coverage of target volume as well as low irradiation of Organ at Risk (OARs) compared with 3D-CRT.Conclusion: There is no significant difference in effective volume for IMRT and VMAT, which proportionally increases with the advanced planning techniques, causes insignificant complication probability to normal tissues. Other conformalities parameters were showing good agreement for all the three techniques

    Multicohort cross-sectional study of cognitive and behavioural digital biomarkers in neurodegeneration: the Living Lab Study protocol

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    INTRODUCTION AND AIMS: Digital biomarkers can provide a cost-effective, objective and robust measure for neurological disease progression, changes in care needs and the effect of interventions. Motor function, physiology and behaviour can provide informative measures of neurological conditions and neurodegenerative decline. New digital technologies present an opportunity to provide remote, high-frequency monitoring of patients from within their homes. The purpose of the living lab study is to develop novel digital biomarkers of functional impairment in those living with neurodegenerative disease (NDD) and neurological conditions. METHODS AND ANALYSIS: The Living Lab study is a cross-sectional observational study of cognition and behaviour in people living with NDDs and other, non-degenerative neurological conditions. Patients (n≥25 for each patient group) with dementia, Parkinson's disease, amyotrophic lateral sclerosis, mild cognitive impairment, traumatic brain injury and stroke along with controls (n≥60) will be pragmatically recruited. Patients will carry out activities of daily living and functional assessments within the Living Lab. The Living Lab is an apartment-laboratory containing a functional kitchen, bathroom, bed and living area to provide a controlled environment to develop novel digital biomarkers. The Living Lab provides an important intermediary stage between the conventional laboratory and the home. Multiple passive environmental sensors, internet-enabled medical devices, wearables and electroencephalography (EEG) will be used to characterise functional impairments of NDDs and non-NDD conditions. We will also relate these digital technology measures to clinical and cognitive outcomes. ETHICS AND DISSEMINATION: Ethical approvals have been granted by the Imperial College Research Ethics Committee (reference number: 21IC6992). Results from the study will be disseminated at conferences and within peer-reviewed journals

    The Effect of Plant Inbreeding and Stoichiometry on Interactions with Herbivores in Nature: Echinacea angustifolia and Its Specialist Aphid

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    Fragmentation of once widespread communities may alter interspecific interactions by changing genetic composition of interacting populations as well as their abundances and spatial distributions. In a long-term study of a fragmented population of Echinacea angustifolia, a perennial plant native to the North American prairie, we investigated influences on its interaction with a specialist aphid and tending ants. We grew plant progeny of sib-matings (I), and of random pairings within (W) and between (B) seven remnants in a common field within 8 km of the source remnants. During the fifth growing season, we determined each plant's burden of aphids and ants, as well as its size and foliar elemental composition (C, N, P). We also assayed composition (C, N) of aphids and ants. Early in the season, progeny from genotypic classes B and I were twice as likely to harbor aphids, and in greater abundance, than genotypic class W; aphid loads were inversely related to foliar concentration of P and positively related to leaf N and plant size. At the end of the season, aphid loads were indistinguishable among genotypic classes. Ant abundance tracked aphid abundance throughout the season but showed no direct relationship with plant traits. Through its potential to alter the genotypic composition of remnant populations of Echinacea, fragmentation can increase Echinacea's susceptibility to herbivory by its specialist aphid and, in turn, perturb the abundance and distribution of aphids
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