Haptic Feedback for Wrist Angle Adjustment

Haptic feedback is envisioned to be a powerful tool in (digital) orthosis fitment procedures. In context of a larger research project on digital molding and developing a glove for orthopedic experts, we explored the use of vibrotactile feedback on the wrist for wrist angle adjustments. Five different patterns are presented on both the inside and outside of the wrist as well as crossing signals. Participants were asked to indicate whether the pattern was communicating that the wrist angle had to be increased or decreased by moving the hand up or down. The results show that the vibrotactile stimuli are being interpreted consistently by the participants, provided the patterns are presented on one side of the arm. Although the interpretations were consistent within participants, there were individual differences in the reported directions of the signals, which makes it important to take into account personal preferences and calibration when implementing haptic feedback

Susceptibility to Adrenal Crisis Is Associated With Differences in Cortisol Excretion in Patients With Secondary Adrenal Insufficiency

Objective: To compare cortisol pharmacokinetics and pharmacodynamics mapped through several glucocorticoid sensitive pathways in patients on hydrocortisone substitution with or without an adrenal crisis. Design: A post-hoc analysis of a previously conducted randomized controlled trial in patients with secondary adrenal insufficiency examining the effects of 2 weight-adjusted hydrocortisone doses. Methods: Comparisons were primarily made on a hydrocortisone dose of 0.2-0.3 mg/kg/day for plasma cortisol and cortisone, 24-hour urinary steroid profile, the glucocorticoid sensitive tryptophan-kynurenine pathway, the renin-angiotensin-aldosterone system and aspects of quality of life. Variables of interest were also analyzed on the hydrocortisone dose of 0.4-0.6 mg/kg/day. Results: Out of 52 patients, 9 (17%) experienced at least one adrenal crisis (AC+ group) and 43 did not develop an adrenal crisis (AC- group) during an observation period of 10 years. 24-hour urinary excretion of cortisol and cortisone were lower in the AC+ group (0.05 [IQR 0.03; 0.05] vs. 0.09 [0.05; 0.12] µmol/24h, P=0.01and 0.13 [0.10; 0.23] vs. 0.24 [0.19; 0.38] µmol/24h, P=0.04, respectively). No differences in pharmacokinetics of cortisol were observed. Kynurenine concentrations were higher in the AC+ group (2.64 [2.43; 3.28] vs. 2.23 [1.82; 2.38] µmol/L, P=0.03) as was general fatigue (Z-scores 1.02 [-0.11; 1.42] vs. -0.16 [- 0.80; 0.28], P=0.04). On the higher hydrocortisone dose urinary excretion of cortisol and cortisone was still significantly lower between the AC- and AC + group. The differences in glucocorticoid sensitive variables disappeared. Conclusion: Patients susceptible to an adrenal crisis demonstrated differences in cortisol and cortisone excretion as well as in pharmacodynamics when compared to patients who did not experience an adrenal crisis, suggesting a biological predisposition in certain patients for the development of an adrenal crisis

ClioPatria: A SWI-Prolog Infrastructure for the Semantic Web

ClioPatria is a comprehensive semantic web development framework based on SWI-Prolog. SWI-Prolog provides an efficient C-based main-memory RDF store that is designed to cooperate naturally and efficiently with Prolog, realizing a flexible RDF-based environment for rule based programming. ClioPatria extends this core with a SPARQL and LOD server, an extensible web frontend to manage the server, browse the data, query the data using SPARQL and Prolog and a Git-based plugin manager. The ability to query RDF using Prolog provides query composition and smooth integration with application logic. ClioPatria is primarily positioned as a prototyping platform for exploring novel ways of reasoning with RDF data. It has been used in several research projects in order to perform tasks such as data integration and enrichment and semantic search

Sub-movement organisation, pen pressure and muscle activity are modulated to precision demands in 2D tracking

The authors investigated how tracking performance, submovement organization, pen pressure and muscle activity in forearm and shoulder muscles were affected by target size in a 2D tracking task performed with a pen on a digitizer tablet. Twenty-six subjects took part in an experiment, in which either a small dot or a large dot was tracked, while it moved quasirandomly across a computer screen at a constant velocity of 2cm/s. The manipulation of precision level was successful, because mean distance to target and the standard deviation of this distance were significantly smaller with the small target than with the large target. With a small target, subjects trailed more behind the center of target and used submovements with larger amplitudes and of shorter duration, resulting in higher tracking accuracy. This change in submovement organization was accompanied by higher pen pressure, while at the same time muscle activity in the forearm extensors and flexors was increased, indicating higher endpoint stability. In conclusion, increased precision demands were accommodated by both a different organization of submovements and higher endpoint stability in a 2D tracking task performed with a pen on a digitizer tablet. © 2012 Copyright Taylor and Francis Group, LLC

Rationale and design of the CORE (COrticosteroids REvised) study:protocol

Introduction Corticosteroids are an important pillar in many anti-inflammatory and immunosuppressive treatment regimens and are available in natural and synthetic forms, which are considered equipotent if clinical bioequivalence data are used. Current clinical bioequivalence data are however based on animal studies or studies with subjective endpoints. Furthermore, advancement in steroid physiology with regard to metabolism, intracellular handling and receptor activation have not yet been incorporated. Therefore, this study aims to re-examine the clinical bioequivalence and dose effects of the most widely used synthetic corticosteroids, prednisolone and dexamethasone. Methods and analysis In this double-blind, randomised cross-over clinical trial, 24 healthy male and female volunteers aged 18-75 years, will be included. All volunteers will randomly receive either first a daily dose of 7.5 mg prednisolone for 1 week, immediately followed by a daily dose of 30 mg prednisolone for 1 week, or first a presumed clinical bioequivalent dose of 1.125 mg dexamethasone per day, immediately followed by 4.5 mg of dexamethasone per day for 1 week. After a wash-out period of 4-8 weeks, the other treatment will be applied. The primary study endpoint is the difference in free cortisol excretion in 24 hours urine. Secondary endpoints will include differences in immunological parameters, blood pressure and metabolic measurements. Ethics and dissemination This study has been approved by the Medical Ethics Committee of the University Medical Center Groningen (METC 2020.398). The results of this study will be submitted for publication in peer-reviewed journals

A Novel Fluorescent Imaging Agent for Diffuse Optical Tomography of the Breast: First Clinical Experience in Patients

Purpose: This is the first clinical evaluation of a novel fluorescent imaging agent (Omocianine) for breast cancer detection with diffuse optical tomography (DOT). Procedures: Eleven women suspected of breast cancer were imaged with DOT at multiple time points (up to 24 h) after receiving an intravenous injection of Omocianine (doses 0.01 to 0.1 mg/kg bodyweight). Breast MRI was obtained for comparison. Results: Histopathology showed invasive cancer in ten patients and fibroadenoma in one patient. With the lowest dose of Omocianine, two of three lesions were detected; with the second dose, three of three lesions were detected; with the two highest doses, none of five lesions were detected. Lesion location on DOT showed excellent agreement with MRI. Optimal lesion-tobackground signals were obtained after 8 h. No adverse events occurred. Conclusions: Lowest doses of Omocianine performed best in lesion detection; DOT using a lowdose fluorescent agent is feasible and safe for breast cancer visualization in patients

Follow-up of contacts of middle east respiratory syndrome coronavirus–infected returning travelers, the Netherlands, 2014

Notification of 2 imported cases of infection with Middle East respiratory syndrome coronavirus in the Netherlands triggered comprehensive monitoring of contacts. Observed low rates of virus transmission and the psychological effect of contact monitoring indicate that thoughtful assessment of close contacts is prudent and must be guided by clinical and epidemiologic risk factors

Identification of regulatory variants associated with genetic susceptibility to meningococcal disease.

Non-coding genetic variants play an important role in driving susceptibility to complex diseases but their characterization remains challenging. Here, we employed a novel approach to interrogate the genetic risk of such polymorphisms in a more systematic way by targeting specific regulatory regions relevant for the phenotype studied. We applied this method to meningococcal disease susceptibility, using the DNA binding pattern of RELA - a NF-kB subunit, master regulator of the response to infection - under bacterial stimuli in nasopharyngeal epithelial cells. We designed a custom panel to cover these RELA binding sites and used it for targeted sequencing in cases and controls. Variant calling and association analysis were performed followed by validation of candidate polymorphisms by genotyping in three independent cohorts. We identified two new polymorphisms, rs4823231 and rs11913168, showing signs of association with meningococcal disease susceptibility. In addition, using our genomic data as well as publicly available resources, we found evidences for these SNPs to have potential regulatory effects on ATXN10 and LIF genes respectively. The variants and related candidate genes are relevant for infectious diseases and may have important contribution for meningococcal disease pathology. Finally, we described a novel genetic association approach that could be applied to other phenotypes