Augmenting forearm crutches with wireless sensors for lower limb rehabilitation

Forearm crutches are frequently used in the rehabilitation of an injury to the lower limb. The recovery rate is improved if the patient correctly applies a certain fraction of their body weight (specified by a clinician) through the axis of the crutch, referred to as partial weight bearing (PWB). Incorrect weight bearing has been shown to result in an extended recovery period or even cause further damage to the limb. There is currently no minimally invasive tool for long-term monitoring of a patient's PWB in a home environment. This paper describes the research and development of an instrumented forearm crutch that has been developed to wirelessly and autonomously monitor a patient's weight bearing over the full period of their recovery, including its potential use in a home environment. A pair of standard forearm crutches are augmented with low-cost off-the-shelf wireless sensor nodes and electronic components to provide indicative measurements of the applied weight, crutch tilt and hand position on the grip. Data are wirelessly transmitted between crutches and to a remote computer (where they are processed and visualized in LabVIEW), and the patient receives biofeedback by means of an audible signal when they put too much or too little weight through the crutch. The initial results obtained highlight the capability of the instrumented crutch to support physiotherapists and patients in monitoring usage

Early animal farming and zoonotic disease dynamics: modelling brucellosis transmission in Neolithic goat populations

Zoonotic pathogens are frequently hypothesized as emerging with the origins of farming, but evidence of this is elusive in the archaeological records. To explore the potential impact of animal domestication on zoonotic disease dynamics and human infection risk, we developed a model simulating the transmission of Brucella melitensis within early domestic goat populations. The model was informed by archaeological data describing goat populations in Neolithic settlements in the Fertile Crescent, and used to assess the potential of these populations to sustain the circulation of Brucella. Results show that the pathogen could have been sustained even at low levels of transmission within these domestic goat populations. This resulted from the creation of dense populations and major changes in demographic characteristics. The selective harvesting of young male goats, likely aimed at improving the efficiency of food production, modified the age and sex structure of these populations, increasing the transmission potential of the pathogen within these populations. Probable interactions between Neolithic settlements would have further promoted pathogen maintenance. By fostering conditions suitable for allowing domestic goats to become reservoirs of Brucella melitensis, the early stages of agricultural development were likely to promote the exposure of humans to this pathogen

Approaching ancient disease from a One Health perspective: Interdisciplinary review for the investigation of zoonotic brucellosis

Today, brucellosis is the most common global bacterial zoonosis, bringing with it a range of significant health and economic consequences, yet it is rarely identified from the archaeological record. Detection and understanding of past zoonoses could be improved by triangulating evidence and proxies generated through different approaches. The complex socio‐ecological systems that support zoonoses involve humans, animals, and pathogens interacting within specific environmental and cultural contexts, and as such there is a diversity of potential datasets that can be targeted. To capture this, in this paper we consider how to approach the study of zoonotic brucellosis in the past from a One Health perspective, one which explicitly acknowledges the health link between people, animals and environments (both physical and cultural). One Health research is explicitly interdisciplinary and conceptually moves away from an anthropocentric approach, allowing the component parts to be considered in holistic and integrated ways to deliver more comprehensive understanding. To this end, in this paper we review the methods, selected evidence and potential for past brucellosis identification and understanding, focussing on osteological markers in humans and animals, historical, biomolecular and epidemiological approaches. We also present an agenda and potential for future research

Mapping the Stellar Dynamics of M31

Using the Planetary Nebula Spectrograph, we have observed and measured the velocities for some 2764 PNe in the disk and halo of the Andromeda galaxy. Preliminary analysis using a basic ring model shows a rotation curve in good agreement with that obtained from HI data out to ~20kpc. Some substructure has also been detected within the velocity field, which can be modeled as the continuation of the tidal-remnant known as the Southern Stream, as it passes through Andromeda's disk.Comment: 5 pages, 3 figures, to appear in the proceedings of the ESO-Workshop "Planetary Nebulae beyond the Milky Way", May 19 - 21 (2004), ed. J. R. Walsh, L. Stanghellini, Springer-Verla

Tracing the star stream through M31 using planetary nebula kinematics

We present a possible orbit for the Southern Stream of stars in M31, which connects it to the Northern Spur. Support for this model comes from the dynamics of planetary nebulae (PNe) in the disc of M31: analysis of a new sample of 2611 PNe obtained using the Planetary Nebula Spectrograph reveals ∼20 objects with kinematics inconsistent with the normal components of the galaxy, but which lie at the right positions and velocities to connect the two photometric features via this orbit. The satellite galaxy M32 is coincident with the stream both in position and velocity, adding weight to the hypothesis that the stream comprises its tidal debri

A deep kinematic survey of planetary nebulae in the Andromeda galaxy using the Planetary Nebula Spectrograph

We present a catalogue of positions, magnitudes and velocities for 3300 emission-line objects found by the Planetary Nebula Spectrograph in a survey of the Andromeda galaxy, M31. Of these objects, 2615 are found likely to be planetary nebulae (PNe) associated with M31. The survey area covers the whole of M31's disc out to a radius of . Beyond this radius, observations have been made along the major and minor axes, and the Northern Spur and Southern Stream regions. The calibrated data have been checked for internal consistency and compared with other catalogues. With the exception of the very central, high surface brightness region of M31, this survey is complete to a magnitude limit of m5007∼ 23.75, 3.5 mag into the PN luminosity function. We have identified emission-line objects associated with M31's satellites and other background galaxies. We have examined the data from the region tentatively identified as a new satellite galaxy, Andromeda VIII, comparing it to data in the other quadrants of the galaxy. We find that the PNe in this region have velocities that appear to be consistent with membership of M31 itself. The luminosity function of the surveyed PNe is well matched to the usual smooth monotonic function. The only significant spatial variation in the luminosity function occurs in the vicinity of M31's molecular ring, where the luminosities of PNe on the near side of the galaxy are systematically ∼0.2 mag fainter than those on the far side. This difference can be explained naturally by a modest amount of obscuration by the ring. The absence of any difference in luminosity function between bulge and disc suggests that the sample of PNe is not strongly populated by objects whose progenitors are more massive stars. This conclusion is reinforced by the excellent agreement between the number counts of PNe and the R-band light. The number counts of kinematically selected PNe also allow us to probe the stellar distribution in M31 down to very faint limits. There is no indication of a cut-off in M31's disc out to beyond four scalelengths, and no signs of a spheroidal halo population in excess of the bulge out to 10 effective bulge radii. We have also carried out a preliminary analysis of the kinematics of the surveyed PNe. The mean streaming velocity of the M31 disc PNe is found to show a significant asymmetric drift out to large radii. Their velocity dispersion, although initially declining with radius, flattens out to a constant value in the outer parts of the galaxy. There are no indications that the disc velocity dispersion varies with PN luminosity, once again implying that the progenitors of PNe of all magnitudes form a relatively homogeneous old population. The dispersion profile and asymmetric drift results are shown to be mutually consistent, but require that the disc flares with radius if the shape of its velocity ellipsoid remains invarian

Tracing the star stream through M31 using planetary nebula kinematics

We present a possible orbit for the Southern Stream of stars in M31, which connects it to the Northern Spur. Support for this model comes from the dynamics of planetary nebulae (PNe) in the disk of M31: analysis of a new sample of 2611 PNe obtained using the Planetary Nebula Spectrograph reveals ~20 objects whose kinematics are inconsistent with the normal components of the galaxy, but which lie at the right positions and velocities to connect the two photometric features via this orbit. The satellite galaxy M32 is coincident with the stream both in position and velocity, adding weight to the hypothesis that the stream comprises its tidal debris.Comment: 6 pages, 2 figures, MNRAS Letters, accepted; for hi-res version see http://as1.chem.nottingham.ac.uk/~Aaron/m31stream.pdf (pdf) or http://as1.chem.nottingham.ac.uk/~Aaron/m31stream.ps.gz (ps

Planetary Nebula Velocities in the Disk and Bulge of M31

We present radial velocities for a sample of 723 planetary nebulae (PNe) in the disk and bulge of M31, measured using the WYFFOS fibre spectrograph on the William Herschel telescope. Velocities are determined using the [OIII] 5007 Angstrom emission line. Rotation and velocity dispersion are measured to a radius of 50 arcminutes (11.5 kpc), the first stellar rotation curve and velocity dispersion profile for M31 to such a radius. Our kinematics are consistent with rotational support at radii well beyond the bulge effective radius of 1.4kpc, although our data beyond a radius of 5kpc are limited. We present tentative evidence for kinematic substructure in the bulge of M31 to be studied fully in a later work. This paper is part of an ongoing project to constrain the total mass, mass distribution and velocity anisotropy of the disk, bulge and halo of M31.Comment: 27 pages, accepted for publication in MNRA

Liquidity and uncertainty: digital adaptation of a complex intervention for people with severe mental illness during the COVID-19 lockdown

This is the final version. Available on open access from BMC via the DOI in this recordAvailability of data and materials: Transcripts will not be shared in their entirety to protect the anonymity of participants and the facilitators delivering the intervention. However, requests for excerpts of the data will be considered on an individual basis. Please contact the corresponding author.Background This paper explores the extent to which the implementation and evaluation of a collaborative care model of face-to-face service delivery for people with severe mental illness was viable during the first UK lockdown associated with COVID-19. The PARTNERS2 cluster randomised controlled trial and process evaluation were co-designed with service users and carers. The aim of this paper is to explore whether digital adaptation of the PARTNERS model for people with severe mental illness during the COVID-19 lockdown was equitable, in terms of fostering collaboration and trust in a vulnerable population. Results We collected qualitative data from multiple sources during lockdown and subsequently constructed case-studies of participating secondary care workers. We adopted Bauman’s notions of liquid modernity to inform our analysis, and identified that digital adaptation during lockdown was only successful where organisational policies, care partner skills and service users’ existing resources were optimal. Conclusion PARTNERS2 can be delivered digitally by a care partner to support people with severe mental illness to identify and work towards their goals when existing resources are optimal. However, at a time of increased need, we identified that people who are very unwell and living with limited access to resources and opportunities, remained disenfranchised at great cost. Trial registration ISRCTN 95702682, registered 26.10.2017National Institute for Health and Care Research (NIHR

Lost in translation: Returning germline genetic results in genome-scale cancer research

Background: The return of research results (RoR) remains a complex and well-debated issue. Despite the debate, actual data related to the experience of giving individual results back, and the impact these results may have on clinical care and health outcomes, is sorely lacking. Through the work of the Australian Pancreatic Cancer Genome Initiative (APGI) we: (1) delineate the pathway back to the patient where actionable research data were identified; and (2) report the clinical utilisation of individual results returned. Using this experience, we discuss barriers and opportunities associated with a comprehensive process of RoR in large-scale genomic research that may be useful for others developing their own policies. Methods: We performed whole-genome (n = 184) and exome (n = 208) sequencing of matched tumour-normal DNA pairs from 392 patients with sporadic pancreatic cancer (PC) as part of the APGI. We identified pathogenic germline mutations in candidate genes (n = 130) with established predisposition to PC or medium-high penetrance genes with well-defined cancer associated syndromes or phenotypes. Variants from candidate genes were annotated and classified according to international guidelines. Variants were considered actionable if clinical utility was established, with regard to prevention, diagnosis, prognostication and/or therapy. Results: A total of 48,904 germline variants were identified, with 2356 unique variants undergoing annotation and in silico classification. Twenty cases were deemed actionable and were returned via previously described RoR framework, representing an actionable finding rate of 5.1%. Overall, 1.78% of our cohort experienced clinical benefit from RoR. Conclusion: Returning research results within the context of large-scale genomics research is a labour-intensive, highly variable, complex operation. Results that warrant action are not infrequent, but the prevalence of those who experience a clinical difference as a result of returning individual results is currently low