The Iterative Development of the Humanoid Robot Kaspar: An Assistive Robot for Children with Autism

This paper gives an overview of the design and development of the humanoid robot Kaspar. Since the first Kaspar robot was developed in 2005, the robotic platform has undergone continuous development driven by the needs of users and technological advancements enabling the integration of new features. We discuss in detail the iterative development of Kaspar’s design and clearly explain the rational of each development, which has been based on the user requirements as well as our years of experience in robot assisted therapy for children with autism, particularly focusing on how the developments benefit the children we work with. Further to this, we discuss the role and benefits of robotic autonomy on both children and therapist along with the progress that we have made on the Kaspar robot’s autonomy towards achieving a semi-autonomous child-robot interaction in a real world setting.Peer reviewe

A Review of Graphene-Based Memristive Neuromorphic Devices and Circuits

As data processing volume increases, the limitations of traditional computers and the need for more efficient computing methods become evident. Neuromorphic computing mimics the brain's low-power and high-speed computations, making it crucial in the era of big data and artificial intelligence. One significant development in this field is the memristor, a device that exhibits neuromorphic tendencies. The performance of memristive devices and circuits relies on the materials used, with graphene being a promising candidate due to its unique properties. Researchers are investigating graphene-based memristors for large-scale, sustainable fabrication. Herein, progress in the development of graphene-based memristive neuromorphic devices and circuits is highlighted. Graphene and its common fabrication methods are discussed. The fabrication and production of graphene-based memristive devices are reviewed and comparisons are provided among graphene- and nongraphene-based memristive devices. Next, a detailed synthesis of the devices utilizing graphene-based memristors is provided to implement the basic building blocks of neuromorphic architectures, that is, synapses, and neurons. This is followed by reviewing studies building graphene memristive spiking neural networks (SNNs). Finally, insights on the prospects of graphene-based neuromorphic memristive systems including their device- and network-level challenges and opportunities are given

Factors associated with discontinuation of antidepressant treatment after a single prescription among patients aged 55 or over:evidence from English primary care

Purpose: Antidepressants are frequently prescribed to older people with depression but little is known on predictors of discontinuation in this population. We therefore investigated factors associated with early discontinuation of antidepressants in older adults with new diagnoses or symptoms of depression in English primary care. / Methods: Data from a nationally representative cohort of patients aged 55 and over were used to evaluate the association between discontinuation of antidepressant medication after a single prescription and potential explanatory variables, including socio-demographic factors, polypharmacy and agerelated problems such as dementia. / Results: Overall, during the study period we observed 34,715 new courses of antidepressant treatment initiated after recorded symptoms or diagnoses of depression. Antidepressant discontinuation after a single prescription was more common in people with depressive symptoms (32%) than in those with diagnosed depression (21.6%). In those diagnosed with depression and in women with depressive symptoms we found that, after adjusting for confounders, the odds of early discontinuation significantly increased after age 65 with a peak at around age 80 and then either levelled or reduced thereafter. Early discontinuation was also significantly less common in people with dementia and in those with diagnosed depression living in more rural areas. / Conclusions: Early discontinuation of antidepressants increases in the post retirement years and is higher in those with no formal diagnosis of depression, those without dementia and those with diagnosed depression living in urban areas. Alternative treatment strategies, such as non-drug therapies, or more active patient follow-up should be further considered in these circumstances

Cochlear implantation under local anesthetic: A systematic review and meta-analysis.

OBJECTIVES: As the population ages and implantation criteria are relaxed, more patients with complex comorbidities are becoming eligible for cochlear implantation (CI). These patients have higher risks associated with general anesthesia. This systematic review assesses outcomes and complications following CI under local anesthetic to examine utility for patients deemed not suitable or at high risk for general anesthesia. METHODS: A systematic review and meta-analysis performed according to the 2020 PRISMA guidelines. Databases searched were MEDLINE, PubMed, EMBASE, CINAHL, Web of Science Core Collection, Cochrane Database of Systematic Reviews, and Cochrane Central Register of Controlled Trials and ClinicalTrials.gov. There were no limitations on year of publication or language. RESULTS: Then, 132 unique were identified. After screening abstracts and full texts for eligibility criteria a total of 18 articles were included. In the nine studies where audiological data were reported, all patients demonstrated improvement in audiological outcomes following implantation under local anesthetic (LA). Only minor complications of transient vertigo, wound infection, facial nerve paralysis, confusion, and tinnitus were reported but all were transient. Meta-analysis showed surgical time was significantly shorter under LA. CONCLUSIONS: CI under LA is safe for patients with comorbidities which preclude them from general anesthesia, with minimal complications and an improved cost-effectiveness profile. However, larger scale, robust trials are required to assess this further

Management of depression and referral of older people to psychological therapies:a systematic review of qualitative studies

BACKGROUND: Depressive symptoms are common in later life and increase both the risk of functional and cognitive decline and the use of healthcare services. Despite older people expressing preferences for talking therapies, they are less likely to be referred than younger adults, particularly when aged ≥80 years. AIM: To explore how healthcare professionals (HCPs) manage older people in relation to depression and referrals to psychological therapies. DESIGN AND SETTING: Systematic review and thematic synthesis of qualitative studies. METHOD: MEDLINE, Embase, PsycINFO, CINAHL, and the Social Sciences Citation Index (inception-March 2018) were searched for studies exploring HCPs' views regarding management of late-life depression across all settings. Studies of older people's views or depression management across all ages were excluded. RESULTS: In total, 27 studies, were included; these predominantly focused on the views of GPs and primary and community care nurses. Many HCPs felt that late-life depression was mainly attributable to social isolation and functional decline, but treatments appropriate for this were limited. Clinicians perceived depression to have associated stigma for older adults, which required time to negotiate. Limited time in consultations and the complexity of needs in later life meant physical health was often prioritised over mental health, particularly in people with frailty. Good management of late-life depression appeared to depend more on the skills and interest of individual GPs and nurses than on any structured approach. CONCLUSION: Mental ill health needs to be a more-prominent concern in the care of older adults, with greater provision of psychological services tailored to later life. This may facilitate future identification and management of depression

Exploring the cultural effects of gender on perceptions of cutaneous leishmaniasis: a systematic literature review

Background More than one million people each year become infected by parasites that cause the disease cutaneous leishmaniasis (CL). This disease manifests as one or more skin lesions or ulcers that are slow to heal with variable response rates to drug treatments. Thus far, little attention has been paid to how the cultural effects of gender shape perceptions and experiences of CL. This review aims to bring together and analyse existing studies which use qualitative data to explore these differences. These studies offered insights into our specific research questions. Methods We conducted a systematic review of the literature pertaining to either CL or muco-cutaneous leishmaniasis (MCL) through EBSCO, EMBASE, Medline, Scopus and Web of Science databases. To meet inclusion criteria, articles had to be either qualitative or mixed-method with a qualitative component. They also had to include a reflection on how the gender of participants impacted the findings and addressed the lived experiences of CL. We did not exclude articles based on the language they were published in or in which country the study took place. Results From a total of 1589 potential articles, we found that thirteen met the inclusion criteria. These articles were published in English, Spanish or Portuguese and reported on studies carried out in various countries in Africa, Asia and South America. After using the principles of a meta-ethnography to analyse these studies, we generated several key themes. We found that health-seeking behaviours, treatment choices, stigma and the impact of scarring are shaped by gender in a variety of contexts. Conclusions Gender impacts on an individual’s experience of CL. In particular, women are more constricted in their health-seeking behaviours and experience more stigma both from the active lesions and from scarring than men. In many contexts, however, men are more at risk of becoming infected by the parasite that causes CL and may turn to more harmful or aggressive self-treatments. We recommend that future research on CL should consider the impact of gender as this can create very different experiences for individuals

The SED Machine: a robotic spectrograph for fast transient classification

Current time domain facilities are finding several hundreds of transient astronomical events a year. The discovery rate is expected to increase in the future as soon as new surveys such as the Zwicky Transient Facility (ZTF) and the Large Synoptic Sky Survey (LSST) come on line. At the present time, the rate at which transients are classified is approximately one order or magnitude lower than the discovery rate, leading to an increasing "follow-up drought". Existing telescopes with moderate aperture can help address this deficit when equipped with spectrographs optimized for spectral classification. Here, we provide an overview of the design, operations and first results of the Spectral Energy Distribution Machine (SEDM), operating on the Palomar 60-inch telescope (P60). The instrument is optimized for classification and high observing efficiency. It combines a low-resolution (R$\sim$100) integral field unit (IFU) spectrograph with "Rainbow Camera" (RC), a multi-band field acquisition camera which also serves as multi-band (ugri) photometer. The SEDM was commissioned during the operation of the intermediate Palomar Transient Factory (iPTF) and has already proved lived up to its promise. The success of the SEDM demonstrates the value of spectrographs optimized to spectral classification. Introduction of similar spectrographs on existing telescopes will help alleviate the follow-up drought and thereby accelerate the rate of discoveries.Comment: 21 pages, 20 figure

Age-related references in national public health, technology appraisal and clinical guidelines and guidance: documentary analysis

$\textbf{BACKGROUND}$: older people may be less likely to receive interventions than younger people. Age bias in national guidance may influence entire public health and health care systems. We examined how English National Institute for Health & Care Excellence (NICE) guidance and guidelines consider age. $\textbf{METHODS}$: we undertook a documentary analysis of NICE public health ($\textit{n}$ = 33) and clinical ($\textit{n}$ = 114) guidelines and technology appraisals ($\textit{n}$ = 212). We systematically searched for age-related terms, and conducted thematic analysis of the paragraphs in which these occurred ('age-extracts'). Quantitative analysis explored frequency of age-extracts between and within document types. Illustrative quotes were used to elaborate and explain quantitative findings. $\textbf{RESULTS}$: 2,314 age-extracts were identified within three themes: age documented as an $\textit{a-priori}$ consideration at scope-setting (518 age-extracts, 22.4%); documentation of differential effectiveness, cost-effectiveness or other outcomes by age (937 age-extracts, 40.5%); and documentation of age-specific recommendations (859 age-extracts, 37.1%). Public health guidelines considered age most comprehensively. There were clear examples of older-age being considered in both evidence searching and in making recommendations, suggesting that this can be achieved within current processes. $\textbf{CONCLUSIONS}$: we found inconsistencies in how age is considered in NICE guidance and guidelines. More effort may be required to ensure age is consistently considered. Future NICE committees should search for and document evidence of age-related differences in receipt of interventions. Where evidence relating to effectiveness and cost-effectiveness in older populations is available, more explicit age-related recommendations should be made. Where there is a lack of evidence, it should be stated what new research is needed.This work was supported by the National Institute for Health Research's School for Public Health Research (NIHR SPHR http://sphr.nihr.ac.uk/). J.A. & M.W. are members of the Centre for Diet and Activity Research (CEDAR) a UKCRC Public Health Research Centre of Excellence

Sociodemographic inequalities in the management of depression in adults aged 55 and over:An analysis of English primary care data

We do not know how primary care treatment of depression varies by age across both psychotropic medication and psychological therapies. Cohort study including 19 710 people aged 55+ with GP recorded depression diagnoses and 26 276 people with recorded depression symptoms during the period 2009–2013, from 373 General Practices in The Health Improvement Network (THIN) database in England. Main outcomes were initiation of treatment with anti-depressants, anxiolytics, hypnotics, anti-psychotic drugs, referrals to psychological therapies within 6 months of onset. Treatment rates with antidepressants are high for those recorded with new depression diagnoses (87.1%) or symptoms of depression (58.7%). Treatment in those with depression diagnoses varies little by age. In those with depressive symptoms there was a J-shaped pattern with reduced antidepressant treatment in those in their 60s and 70s followed by increased treatment in the oldest age groups (85+ years), compared with those aged 55–59 years. Other psychotropic drug prescribing (hypnotics/anxiolytics, antipsychotics) all increase with increasing age. Recorded referrals for psychological therapies were low, and decreased steadily with increasing age, such that women aged 75–79 years with depression diagnoses had around six times lower odds of referral (OR 0.17, 95% CI 0.1–0.29) than those aged 55–59 years, and men aged 80–84 years had around seven times lower (OR 0.14, 95% CI 0.05–0.36). The oldest age groups with new depression diagnoses and symptoms have fewer recorded referrals to psychological therapies, and higher psychotropic drug treatment rates in primary care. This suggests potential inequalities in access to psychological therapies

Second best toll and capacity optimisation in network: solution algorithm and policy implications

This paper looks at the first and second-best jointly optimal toll and road capacity investment problems from both policy and technical oriented perspectives. On the technical side, the paper investigates the applicability of the constraint cutting algorithm for solving the second-best problem under elastic demand which is formulated as a bilevel programming problem. The approach is shown to perform well despite several problems encountered by our previous work in Shepherd and Sumalee (2004). The paper then applies the algorithm to a small sized network to investigate the policy implications of the first and second-best cases. This policy analysis demonstrates that the joint first best structure is to invest in the most direct routes while reducing capacities elsewhere. Whilst unrealistic this acts as a useful benchmark. The results also show that certain second best policies can achieve a high proportion of the first best benefits while in general generating a revenue surplus. We also show that unless costs of capacity are known to be low then second best tolls will be affected and so should be analysed in conjunction with investments in the network