RADAR-base: Epilepsy Case Study

The traditional hospital set-up is not appropriate for long-term epilepsy seizure detection in naturalistic ambulatory settings. To explore the feasibility of seizure detection in such a setting, an in-hospital study was conducted to evaluate three wearable devices and a data collection platform for ambulatory seizure detection. The platform collects and processes data for study administrators, clinicians and data scientists, who use it to create models to detect seizures. For that purpose, all data collected from the wearable devices is additionally synchronized with the hospital EEG and video, with gold-standard seizure labels provided by trained clinicians. Data collected by wearable devices shows potential for seizure detection in out-of-hospital based and ambulatory settings

Challenges & solutions in a hybrid mHealth mobile app

The paper describes the various problems and challenges encountered during the development and remote data collection in a cross-platform hybrid application developed for remote monitoring of participants and what solutions were implemented to mitigate them. These problems and challenges are universal for hybrid applications and this paper digs deep into these in the domain of large-scale, long-duration mHealth research studies. From technical issues to issues with user compliance, this paper discusses the core problems inherent to these types of studies and technologies, and how to mitigate them

Sensitivity analysis and determination of free relaxation parameters for the weakly-compressible MRT-LBM schemes

It is well-known that there exist several free relaxation parameters in the MRT-LBM. Although these parameters have been tuned via linear analysis, the sensitivity analysis of these parameters and other related parameters are still not sufficient for detecting the behaviors of the dispersion and dissipation relations of the MRT-LBM. Previous researches have shown that the bulk dissipation in the MRT-LBM induces a significant over-damping of acoustic disturbances. This indicates that MRT-LBM cannot be used to obtain the correct behavior of pressure fluctuations because of the fixed bulk relaxation parameter. In order to cure this problem, an effective algorithm has been proposed for recovering the linearized Navier-Stokes equations from the linearized MRT-LBM. The recovered L-NSE appear as in matrix form with arbitrary order of the truncation errors with respect to ${\delta}t$. Then, in wave-number space, the first/second-order sensitivity analyses of matrix eigenvalues are used to address the sensitivity of the wavenumber magnitudes to the dispersion-dissipation relations. By the first-order sensitivity analysis, the numerical behaviors of the group velocity of the MRT-LBM are first obtained. Afterwards, the distribution sensitivities of the matrix eigenvalues corresponding to the linearized form of the MRT-LBM are investigated in the complex plane. Based on the sensitivity analysis and the recovered L-NSE, we propose some simplified optimization strategies to determine the free relaxation parameters in the MRT-LBM. Meanwhile, the dispersion and dissipation relations of the optimal MRT-LBM are quantitatively compared with the exact dispersion and dissipation relations. At last, some numerical validations on classical acoustic benchmark problems are shown to assess the new optimal MRT-LBM

Can the radiopaque marker in surgical swabs scratch orthopaedic implant surfaces?

Aims: To determine whether the radiopaque marker strip, which is woven in surgical swabs, causes measureable wear on metal implants at pressures typically used to wipe off fluid from their surface. Materials and methods: Finger pressure used to wipe a surface was measured and used as a reference pressure for further testing. A tribological wear rig was then used to analyse the wear caused on polished titanium plates by a cobalt chromium pin (the control test), the pin covered by a surgical swab and the pin covered by a radiopaque marker strip. Results: It was found that the cotton part or the radiopaque marker of surgical swabs on polished medical grade titanium plates caused no significant wear. In contrast severe scratching was observed from the cobalt chromium pin on its own. Conclusion: To our knowledge, this is the first study in the literature analysing the wear caused by the surgical swabs and radiopaque strip on metal implants. The results suggest that surgical swabs are safe to use on metallic implants at pressures typical of a wiping motion

Effect of Different Prosthetic Knees/feet on the Roll-Over Shape

Roll-over shape (ROS) of knee-ankle-foot (KAF) is a scientific method which has been used to compare performance and design of the different prosthetic foot. In the current study, however, we aimed to understand the influence of the prosthetic components (i.e. knee and foot) on the knee-ankle-foot roll-over shape in a unilateral transfemoral amputee. We performed a case study based on series of experiments with repeated measures on single amputee wearing two different commercially available microprocessor prosthetic knees, during two weeks adaptation period to understand the influence of the prosthetic knee/foot using KAF ROS as an objective measure during level ground walking. The kinematics of the center of pressure (COP), lateral knee and ankle markers were collected and processed to obtain ROS and the results were used to fit a circular shape arc to obtain radius of curvature (ROC). The results indicated that the prosthetic knees have influenced ROC outcomes. The analysis of variance (ANOVA) and post hoc test of the normalized radius of curvature showed the mean of ROC were significantly different between Rheo3 knee, Orion2 and Orion2 with Echelon foot. The amputee reflected his comfort with Rheo3 plus College park foot and Orion with Echelon foot. A conclusion is drawn that multiple comfort zones may exists based on amputee’s ROS metrics. This finding suggests that the design of prosthetic knee should not be considered as a single component but rather as part of a whole system with different comfort zones

Behaviour of carbon-14 containing low molecular weight organic compounds in contaminated groundwater under aerobic conditions

Short chain carbon-14 (14C) containing organic compounds can be formed by abiotic oxidation of carbides and impurities within nuclear fuel cladding. During fuel reprocessing and subsequent waste storage there is potential for these organic compounds to enter shallow subsurface environments due to accidental discharges. Currently there is little data on the persistence of these compounds in such environments. Four 14C labelled compounds (acetate; formate; formaldehyde and methanol) were added to aerobic microcosm experiments that contained glacial outwash sediments and groundwater simulant representative of the Sellafield nuclear reprocessing site, UK. Two concentrations of each electron donor were used, low concentration (10-5 M) to replicate predicted concentrations from an accidental release and high concentration (10-2 M) to study the impact of the individual electron donor on the indigenous microbial community in the sediment. In the low concentration system only ~5% of initial 14C remained in solution at the end of experiments in contact with atmosphere (250-350 hours). The production of 14CO2(g) (measured after 48 hours) suggests microbially mediated breakdown is the primary removal mechanism for these organic compounds, although methanol loss may have been partially by volatilisation. Highest retention of 14C by the solid fractions was found in the acetate experiment, with 12% being associated with the inorganic fraction, suggesting modest precipitation as solid carbonate. In the high concentration systems only ~5% of intial 14C remains in solution at the end of the experiments for acetate, formate and methanol. In the formaldehyde experiment only limited loss from solution was observed (76% remained in solution). The microbial populations of unaltered sediment and those in the low concentration experiments were broadly similar, with highly diverse bacterial phyla present. Under high concentrations of the organic compounds the abundance of common operational taxonomic units was reduced by 66% and the community structure was dominated by Proteobacteria (particularly Betaproteobacteria) signifying a shift in community structure in response to the electron donor available. The results of this study suggest that many bacterial phyla that are ubiquitous in near surface soils are able to utilise a range of 14C-containing low molecular weight organic substances very rapidly, and thus such substances are unlikely to persist in aerobic shallow subsurface environments

Adrenal suppression in patients taking inhaled glucocorticoids is highly prevalent and management can be guided by morning cortisol

Context Up to 3% of US and UK populations are prescribed glucocorticoids (GC). Suppression of the hypothalamo–pituitary–adrenal axis with the potential risk of adrenal crisis is a recognized complication of therapy. The 250 μg short Synacthen stimulation test (SST) is the most commonly used dynamic assessment to diagnose adrenal insufficiency. There are challenges to the use of the SST in routine clinical practice, including both the staff and time constraints and a significant recent increase in Synacthen cost. Methods We performed a retrospective analysis to determine the prevalence of adrenal suppression due to prescribed GCs and the utility of a morning serum cortisol for rapid assessment of adrenal reserve in the routine clinical setting. Results In total, 2773 patients underwent 3603 SSTs in a large secondary/tertiary centre between 2008 and 2013 and 17.9% (n=496) failed the SST. Of 404 patients taking oral, topical, intranasal or inhaled GC therapy for non-endocrine conditions, 33.2% (n=134) had a subnormal SST response. In patients taking inhaled GCs without additional GC therapy, 20.5% (34/166) failed an SST and suppression of adrenal function increased in a dose-dependent fashion. Using receiver operating characteristic curve analysis in patients currently taking inhaled GCs, a basal cortisol ≥348 nmol/l provided 100% specificity for passing the SST; a cortisol value <34 nmol/l had 100% sensitivity for SST failure. Using these cut-offs, 50% (n=83) of SSTs performed on patients prescribed inhaled GCs were unnecessary. Conclusion Adrenal suppression due to GC treatment, particularly inhaled GCs, is common. A basal serum cortisol concentration has utility in helping determine which patients should undergo dynamic assessment of adrenal function

Design and evaluation of the immunogenicity and efficacy of a biomimetic particulate formulation of viral antigens

Subunit viral vaccines are typically not as efficient as live attenuated or inactivated vaccines at inducing protective immune responses. This paper describes an alternative 'biomimetic' technology; whereby viral antigens were formulated around a polymeric shell in a rationally arranged fashion with a surface glycoprotein coated on to the surface and non-structural antigen and adjuvant encapsulated. We evaluated this model using BVDV E2 and NS3 proteins formulated in poly-(D, L-lactic-co-glycolic acid) (PLGA) nanoparticles adjuvanted with polyinosinic:polycytidylic acid (poly(I:C) as an adjuvant (Vaccine-NP). This Vaccine-NP was compared to ovalbumin and poly(I:C) formulated in a similar manner (Control-NP) and a commercial adjuvanted inactivated BVDV vaccine (IAV), all inoculated subcutaneously and boosted prior to BVDV-1 challenge. Significant virus-neutralizing activity, and E2 and NS3 specific antibodies were observed in both Vaccine-NP and IAV groups following the booster immunisation. IFN-γ responses were observed in ex vivo PBMC stimulated with E2 and NS3 proteins in both vaccinated groups. We observed that the protection afforded by the particulate vaccine was comparable to the licenced IAV formulation. In conclusion, the biomimetic particulates showed a promising immunogenicity and efficacy profile that may be improved by virtue of being a customisable mode of delivery

Mechanisms Promoting the Long-Term Persistence of a Wolbachia Infection in a Laboratory-Adapted Population of Drosophila melanogaster

Intracellular bacteria of the genus Wolbachia are widespread endosymbionts across diverse insect taxa. Despite this prevalence, our understanding of how Wolbachia persists within populations is not well understood. Cytoplasmic incompatibility (CI) appears to be an important phenotype maintaining Wolbachia in many insects, but it is believed to be too weak to maintain Wolbachia in Drosophila melanogaster, suggesting that Wolbachia must also have other effects on this species. Here we estimate the net selective effect of Wolbachia on its host in a laboratory-adapted population of D. melanogaster, to determine the mechanisms leading to its persistence in the laboratory environment. We found i) no significant effects of Wolbachia infection on female egg-to-adult survival or adult fitness, ii) no reduced juvenile survival in males, iii) substantial levels of CI, and iv) a vertical transmission rate of Wolbachia higher than 99%. The fitness of cured females was, however, severely reduced (a decline of 37%) due to CI in offspring. Taken together these findings indicate that Wolbachia is maintained in our laboratory environment due to a combination of a nearly perfect transmission rate and substantial CI. Our results show that there would be strong selection against females losing their infection and producing progeny free from Wolbachia