Missed Treatments of Hemodialysis Patients after Hurricane Maria in Puerto Rico

The consequences of a natural event such as a hurricane can especially have a negative impact on vulnerable patients such as hemodialysis patients. In former incidences such as Hurricane Katrina, factors such as living relocations disrupted hemodialysis patients’ ability to adhere to their thrice-weekly treatments (Anderson et al, 2009). In this study, 44% of the 386 hemodialysis patients who experienced Hurricane Katrina reported missing one or more dialysis sessions. Thus, the hurricane had significant negative influence on patients’ attendance at the dialysis clinic. In the aftermath of Hurricane Maria, Puerto Rico suffered extensive road blockages, electricity shortages, and lacking natural resources. Recovery procedures such as clearing of roads were not completed until several months afterward. By October, there was still a significant portion of people without sufficient resources. The primary objectives of this study are to assess the percentage of hemodialysis patients who missed dialysis sessions in the aftermath of Hurricane Maria and the social factors influencing their missed sessions. From a total of 16 facilities, three dialysis clinics in cities most highly impacted by the hurricane will be selected to participate. Data will be collected through patient interviews, surveys, and charts, to examine potential demographic characteristics and social factors that may have affected the patients’ attendance to these dialysis facilities. If there is a significant correlation between the social factors and missed treatments, then management strategies can be suggested to help hemodialysis patients adjust to post-disaster conditions and help develop planning strategies in case of future natural disasters

Programmable active pixel sensor to investigate neural interactions within the retina

Detection of the visual scene by the eye and the resultant neural interactions of the retina-brain system give us our perception of sight. We have developed an Active Pixel Sensor (APS) to be used as a tool for both furthering understanding of these interactions via experimentation with the retina and to make developments towards a realisable retinal prosthesis. The sensor consists of 469 pixels in a hexagonal array. The pixels are interconnected by a programmable neural network to mimic lateral interactions between retinal cells. Outputs from the sensor are in the form of biphasic current pulse trains suitable to stimulate retinal cells via a biocompatible array. The APS will be described with initial characterisation and test results

EEG markers for early detection and characterization of vascular dementia during working memory tasks

The aim of the this study was to reveal markers using spectral entropy (SpecEn), sample entropy (SampEn) and Hurst Exponent (H) from the electroencephalography (EEG) background activity of 5 vascular dementia (VaD) patients, 15 stroke-related patients with mild cognitive impairment (MCI) and 15 control healthy subjects during a working memory (WM) task. EEG artifacts were removed using independent component analysis technique and wavelet technique. With ANOVA (p < 0.05), SpecEn was used to test the hypothesis of slowing the EEG signal down in both VaD and MCI compared to control subjects, whereas the SampEn and H features were used to test the hypothesis that the irregularity and complexity in both VaD and MCI were reduced in comparison with control subjects. SampEn and H results in reducing the complexity in VaD and MCI patients. Therefore, SampEn could be the EEG marker that associated with VaD detection whereas H could be the marker for stroke-related MCI identification. EEG could be as a valuable marker for inspecting the background activity in the identification of patients with VaD and stroke-related MCI

Revision Total Hip Arthroplasty With Proximal Bone Loss

Abstract: The presence of a deficient or mechanically compromised proximal femur represents a particular challenge to revision total hip arthroplasty. This article details the results of reconstructing these challenging cases using a modular, tapered, and distally fixed femoral stem component that allows independent control of length, offset, and anteversion of the femur. Mid-term results suggest that distal fixation in the presence of a deficient or mechanically compromised femur is a reliable solution to these difficult problems