Wearable Knee Health Rehabilitation Assessment using Acoustical Emissions

Each year, approximately 200,000 Americans endure anterior cruciate ligament (ACL) tears, and 100,000 reconstructive procedures are conducted to repair the injured knees (1). The injury itself, and the long rehabilitation process that follows, can majorly disrupt the quality of life for these Americans through missed workdays, reduction of overall physical activity, and increased risk of re-injury in future activities. Wearable technologies for quantifying the state of rehabilitation, and providing feedback to the user regarding which activities or intensities of activities are safe to perform at any given time, could potentially help accelerate the rehabilitation process as well as reduce the risk of re-injury. Our lab has developed a novel, wearable sensing system based on miniature piezoelectric contact microphones for measuring the acoustical emissions from the knee during movements such as unloaded flexion / extension, sit-to-stand, and walking activities. The system consists of two Knowles BU-23173 contact microphones (Knowles, Itasca, IL) positioned on the medial and lateral sides of the patella, connected to custom, analog pre-amplifier circuits and a microcontroller for digitization and data storage on a secure digital (SD) card. In addition to the acoustical sensing, the system includes two integrated inertial measurement sensors including accelerometer and gyroscope modalities to enable joint angle calculations; these sensors, with digital outputs, are connected directly to the same microcontroller via serial peripheral interface (SPI). The system provides low noise, accurate joint acoustical emission and angle measurements in a wearable form factor, and has several hours of battery life. We have also taken measurements from healthy subjects, and athletes following acute ACL tear, to determine initial features from these acoustical emissions that are associated with injured versus healthy joints. We have found that the main acoustic clicks during particular motions occurred at consistent joint angles for healthy subjects based on intraclass correlation coefficient analysis (ICC(1,1) = 0.94 and ICC(1,k) = 0.99) (2). For one subject with an ACL tear, we found that the consistency of the joint acoustical emissions was lower for the injured knee as compared to the healthy knee in the recording immediately following the injury (\u3c 7 days), and improved following six months of rehabilitation. We envision using the wearable system we have recently completed to conduct further experiments with subjects following acute ACL tears, and tracking the progress of the rehabilitation while simultaneously measuring acoustical emissions in the context of particular movements. This data will then serve as a foundation for creating subject-specific algorithms for assessing rehabilitation and providing feedback to the users

Low computational complexity mode division multiplexed OFDM transmission over 130 km of few mode fiber

We demonstrate 337.5-Gb/s MDM-8QAM-OFDM transmission over 130 km of FMF. This confirms that OFDM can significantly reduce the required DSP complexity to compensate for differential mode delay, a key step towards real-time MDM transmission

Risk factors for mortality-morbidity after emergency-urgent colorectal surgery

Background: The aim of this study was to assess the risk factors associated with mortality and morbidity following emergency or urgent colorectal surgery. Materials and methods: All data regarding the 462 patients who underwent emergency colonic resection in our institution between November 2002 and December 2007 were prospectively entered into a computerized database. Results: The median age of patients was 73 (range 17-98)years. The most common indications for surgery were: 171 adenocarcinomas (37%), 129 complicated diverticulitis (28%), and 35 colonic ischemia (7.5%). Overall mortality and morbidity rates were 14% and 36%, respectively. In multivariate analysis, the only parameter significantly associated with postoperative mortality was blood loss >500cm3 (odds ratio (OR) = 3.33, 95% confidence interval (CI) 1.63-6.82, p = 0.001). There were three parameters which correlated with postoperative morbidity: ASA score ≥3 (OR = 2.9, 95% CI 1.9-4.5, p < 0.001), colonic ischemia (OR = 3.4, 95% CI 1.4-7.7, p = 0.006), and stoma creation (OR = 2.2, 95% CI 1.4-3.4, p = 0.0003). Conclusions: The main risk factors for postoperative morbidity and mortality following emergency colorectal surgery are related to: (1) patients' ASA score, (2) colonic ischemia, and (3) perioperative bleeding. These variables should be considered in the elaboration of future scoring systems to predict outcome of emergency colorectal surger

Comparison of a thigh worn accelerometer algorithm with diary estimates of time in bed and time asleep: the 1970 British Cohort Study

Background: Thigh-worn accelerometers have established reliability and validity for measurement of free-living physical activity-related behaviors. However, comparisons of methods for measuring sleep and time in bed using the thigh-worn accelerometer are rare. The authors compared the thigh-worn accelerometer algorithm that estimates time in bed with the output of a sleep diary (time in bed and time asleep). Methods: Participants (N = 5,498), from the 1970 British Cohort Study, wore an activPAL device on their thigh continuously for 7 days and completed a sleep diary. Bland–Altman plots and Pearson correlation coefficients were used to examine associations between the algorithm derived and diary time in bed and asleep. Results: The algorithm estimated acceptable levels of agreement with time in bed when compared with diary time in bed (mean bias of −11.4 min; limits of agreement −264.6 to 241.8). The algorithm-derived time in bed overestimated diary sleep time (mean bias of 55.2 min; limits of agreement −204.5 to 314.8 min). Algorithm and sleep diary are reasonably correlated (ρ = .48, 95% confidence interval [.45, .52] for women and ρ = .51, 95% confidence interval [.47, .55] for men) and provide broadly comparable estimates of time in bed but not for sleep time. Conclusions: The algorithm showed acceptable estimates of time in bed compared with diary at the group level. However, about half of the participants were outside of the ±30 min difference of a clinically relevant limit at an individual level

Late Cretaceous-Early Eocene tectonic development of the Tethyan suture zone in the Erzincan area, Eastern Pontides, Turkey

Six individual tectonostratigraphic units are identified within the Izmir-Ankara-Erzincan Suture Zone in the critical Erzincan area of the Eastern Pontides. The Ayikayasi Formation of Campanian-Maastrichtian age is composed of bedded pelagic limestones intercalated with polymict, massive conglomerates. The Ayikayasi Formation conformably overlies the Tauride passive margin sequence in the Munzur Mountains to the south and is interpreted as an underfilled foredeep basin. The Refahiye Complex, of possible Late Cretaceous age, is a partial ophiolite composed of similar to 75 % (by volume) serpentinized peridotite (mainly harzburgite), similar to 20 % diabase and minor amounts of gabbro and plagiogranite. The complex is interpreted as oceanic lithosphere that formed by spreading above a subduction zone. Unusual screens of metamorphic rocks (e.g. marble and schist) locally Occur between sheeted diabase dykes. The Upper Cretaceous Karayaprak Melange exhibits two lithological associations: (1) the basalt + radiolarite + serpentinite association, including depleted arc-type basalts; (2) the massive neritic limestone + lava + volcaniclastic association that includes fractionated, intermediate-composition lavas, and is interpreted as accreted Neotethyan seamount(s). The several-kilometre-thick Karadag Formation, of Campanian-Maastrichtian age, is composed of greenschist-facies volcanogenic rocks of mainly basaltic to andesitic composition, and is interpreted as an emplaced Upper Cretaceous volcanic arc. The Campanian-Early Eocene Sutpinar Formation (similar to 1500 m thick) is a coarsening-Upward succession of turbiditic calcarenite, sandstone, laminated mudrock, volcaniclastic sedimentary rocks that includes rare andesitic lava, and is interpreted as a regressive forearc basin. The Late Paleocene-Eocene Sipikor Formation is a laterally varied succession of shallow-marine carbonate and siliciclastic lithofacies that overlies deformed Upper Cretaceous units with an angular unconformity. Structural study indicates that the assembled accretionary prism, supra-subduction zone-type oceanic lithosphere and volcanic are units were emplaced northwards onto the Eurasian margin and also southwards onto the Tauride (Gondwana-related) margin during Campanian-Maastrichtian time. Further, mainly southward thrusting took place during the Eocene in this area, related to final closure of Tethys. Our preferred tectonic model involves northward subduction, supra-subduction zone ophiolite genesis and arc magmatism near the northerly, Eurasian margin of the Mesozoic Tethys