Autonomous surveillance for biosecurity

The global movement of people and goods has increased the risk of biosecurity threats and their potential to incur large economic, social, and environmental costs. Conventional manual biosecurity surveillance methods are limited by their scalability in space and time. This article focuses on autonomous surveillance systems, comprising sensor networks, robots, and intelligent algorithms, and their applicability to biosecurity threats. We discuss the spatial and temporal attributes of autonomous surveillance technologies and map them to three broad categories of biosecurity threat: (i) vector-borne diseases; (ii) plant pests; and (iii) aquatic pests. Our discussion reveals a broad range of opportunities to serve biosecurity needs through autonomous surveillance.Comment: 26 pages, Trends in Biotechnology, 3 March 2015, ISSN 0167-7799, http://dx.doi.org/10.1016/j.tibtech.2015.01.003. (http://www.sciencedirect.com/science/article/pii/S0167779915000190

Robotic Exploration of an Unknown Nuclear Environment Using Radiation Informed Autonomous Navigation

From MDPI via Jisc Publications RouterHistory: accepted 2021-05-15, pub-electronic 2021-05-24Publication status: PublishedThis paper describes a novel autonomous ground vehicle that is designed for exploring unknown environments which contain sources of ionising radiation, such as might be found in a nuclear disaster site or a legacy nuclear facility. While exploring the environment, it is important that the robot avoids radiation hot spots to minimise breakdowns. Broken down robots present a real problem: they not only cause the mission to fail but they can block access routes for future missions. Until now, such robots have had no autonomous gamma radiation avoidance capabilities. New software algorithms are presented that allow radiation measurements to be converted into a format in which they can be integrated into the robot’s navigation system so that it can actively avoid receiving a high radiation dose during a mission. An unmanned ground vehicle was fitted with a gamma radiation detector and an autonomous navigation package that included the new radiation avoidance software. The full system was evaluated experimentally in a complex semi-structured environment that contained two radiation sources. In the experiment, the robot successfully identified both sources and avoided areas that were found to have high levels of radiation while navigating between user defined waypoints. This advancement in the state-of-the-art has the potential to deliver real benefit to the nuclear industry, in terms of both increased chance of mission success and reduction of the reliance on human operatives to perform tasks in dangerous radiation environments

A myxoid fibrotic reaction pattern is associated with metastatic risk in cutaneous squamous cell carcinoma

Metastasis; Fibrosis; Cutaneous squamous cell carcinomaMetástasis; Fibrosis; Carcinoma cutáneo de células escamosasMetàstasi; Fibrosi; Carcinoma cutani de cèl·lules escamosesAlthough desmoplasia has been associated with poor prognoses in cutaneous squamous cell carcinoma, little attention has been paid to the patterns of fibrosis. This study aimed to examine the different stromal fibrotic patterns as markers of metastatic risk. We performed a multicenter retrospective study that included 102 cutaneous squamous cell carcinomas (52 non-metastatic and 50 metastatic carcinomas). Clinical and histopa-thological data were registered. The fibrotic reaction pattern was classified as mature, intermediate or immature depending on the presence of keloid-like collagen and myxoid stroma. The immature pattern (areas characterized by myxoid changes with no inflammation) was observed in 18 samples and its presence was significantly associated with immuno-suppression, budding, desmoplasia, perineural invasion, anatomic level, tumoural depth and metastatic risk in the multivariate analysis. Our findings suggest that the presence of an immature myxoid fibrotic pattern, which can be easily identified by routine hematoxylin-eosin staining, is strongly associated with metastatic risk.This work has been supported by grant PI15/00236 from Fondo de Investigación Sanitaria (FIS), Fondo Europeo de Desarrollo Regional (FEDER), Instituto de Salud Carlos III, Ministerio de Sanidad, and the ‘‘Xarxa de Bancs de Tumours”

Experimental evaluation of a passive fuel cell/ battery hybrid power system for an unmanned ground vehicle

Unmanned vehicles are increasing the performance of monitoring and surveillance in several applications. Endurance is a key issue in these systems, in particular in electric vehicles, powered at present mainly by batteries. Hybrid power systems based on batteries and fuel cells have the potential to achieve high energy density and specific energy, increasing also the life time and safe operating conditions of the power system. The objective of this research is to analyze the performance of a passive hybrid power system, designed and developed to be integrated into an existing Unmanned Ground Vehicle (UGV). The proposed solution is based on six LiPo cells, connected in series, and a 200 W PEM fuel cell stack, directly connected in parallel to the battery without any limitation to its charge. The paper presents the characterization of the system behavior, and shows the main results in terms of performance and energy management.The authors would like to acknowledge the NATO Science for Peace and Security Program for partially funding this work through the project “Improving efficiency and operational range in low-power unmanned vehicles through the use of hybrid fuel-cell power systems” (IUFCV), Ref. 985079

Prospective cohort study for assessment of integrated care with a triple aim approach: hospital at home as use case

Background: Applicability of comprehensive assessment of integrated care services in real world settings is an unmet need. To this end, a Triple Aim evaluation of Hospital at Home (HaH), as use case, was done. As ancillary aim, we explored use of the approach for monitoring the impact of adoption of integrated care at health system level in Catalonia (Spain). Methods: Prospective cohort study over one year period, 2017-2018, comparing hospital avoidance (HaH-HA) with conventional hospitalization (UC) using propensity score matching. Participants were after the first episode directly admitted to HaH-HA or the corresponding control group. Triple Aim assessment using multiple criteria decision analysis (MCDA) was done. Moreover, applicability of a Triple Aim approach at health system level was explored using registry data. Results: HaH-HA depicted lower: i) Emergency Room Department (ER) visits (p < .001), ii) Unplanned re-admissions (p = .012); and iii) costs (p < .001) than UC. The weighted aggregation of the standardized values of each of the eight outcomes, weighted by the opinions of the stakeholder groups considered in the MCDA: i) enjoyment of life; ii) resilience; iii) physical functioning; iv) continuity of care; v) psychological wellbeing; (vi) social relationships & participation; (vii) person-centeredness; and (viii) costs, indicated better performance of HaH-HA than UC (p < .05). Actionable factors for Triple Aim assessment of the health system with a population-health approach were identified. Conclusions: We confirmed health value generation of HaH-HA. The study identified actionable factors to enhance applicability of Triple Aim assessment at health system level for monitoring the impact of adoption of integrated care. Registration: ClinicalTrials.gov (26/04/2017; NCT03130283). Keywords: Chronic care, Health Delivery Assessment, Health Services Research, Hospital at Home, Implementation Science, Multiple Criteria Decision Analysis, Triple Ai

The Ginninderra CH4 and CO2 release experiment: An evaluation of gas detection and quantification techniques

A methane (CH4) and carbon dioxide (CO2) release experiment was held from April to June 2015 at the Ginninderra Controlled Release Facility in Canberra, Australia. The experiment provided an opportunity to compare different emission quantification techniques against a simulated CH4 and CO2 point source release, where the actual release rates were unknown to the participants. Eight quantification techniques were assessed: three tracer ratio techniques (two mobile); backwards Lagrangian stochastic modelling; forwards Lagrangian stochastic modelling; Lagrangian stochastic (LS) footprint modelling; atmospheric tomography using point and using integrated line sensors. The majority of CH4 estimates were within 20% of the actual CH4 release rate (5.8 g/min), with the tracer ratio technique providing the closest estimate to both the CH4 and CO2 release rates (100 g/min). Once the release rate was known, the majority of revised estimates were within 10% of the actual release rate. The study illustrates the power of measuring the emission rate using multiple simultaneous methods and obtaining an ensemble median or mean. An ensemble approach to estimating the CH4 emission rate proved successful with the ensemble median estimate within 16% for the actual release rate for the blind release experiment and within 2% once the release rate was known. The release also provided an opportunity to assess the effectiveness of stationary and mobile ground and aerial CH4 detection technologies. Sensor detection limits and sampling rates were found to be significant limitations for CH4 and CO2 detection. A hyperspectral imager\u27s capacity to image the CH4 release from 100 m, and a Boreal CH4 laser sensor\u27s ability to track moving targets suggest the future possibility to map gas plumes using a single laser and mobile aerial reflector

Evaluation of integrated care services in Catalonia:population-based and service-based real-life deployment protocols

BackgroundComprehensive assessment of integrated care deployment constitutes a major challenge to ensure quality, sustainability and transferability of both healthcare policies and services in the transition toward a coordinated service delivery scenario. To this end, the manuscript articulates four different protocols aiming at assessing large-scale implementation of integrated care, which are being developed within the umbrella of the regional project Nextcare (2016-2019), undertaken to foster innovation in technologically-supported services for chronic multimorbid patients in Catalonia (ES) (7.5M inhabitants).Whereas one of the assessment protocols is designed to evaluate population-based deployment of care coordination at regional level during the period 2011-2017, the other three are service-based protocols addressing: i) Home hospitalization; ii) Prehabilitation for major surgery; and, iii) Community-based interventions for frail elderly chronic patients. All three services have demonstrated efficacy and potential for health value generation. They reflect different implementation maturity levels. While full coverage of the entire urban health district of Barcelona-Esquerra (520k inhabitants) is the main aim of home hospitalization, demonstration of sustainability at Hospital Clinic of Barcelona constitutes the core goal of the prehabilitation service. Likewise, full coverage of integrated care services addressed to frail chronic patients is aimed at the city of Badalona (216k inhabitants).MethodsThe population-based analysis, as well as the three service-based protocols, follow observational and experimental study designs using a non-randomized intervention group (integrated care) compared with a control group (usual care) with a propensity score matching method. Evaluation of cost-effectiveness of the interventions using a Quadruple aim approach is a central outcome in all protocols. Moreover, multi-criteria decision analysis is explored as an innovative method for health delivery assessment. The following additional dimensions will also be addressed: i) Determinants of sustainability and scalability of the services; ii) Assessment of the technological support; iii) Enhanced health risk assessment; and, iv) Factors modulating service transferability.DiscussionThe current study offers a unique opportunity to undertake a comprehensive assessment of integrated care fostering deployment of services at regional level. The study outcomes will contribute refining service workflows, improving health risk assessment and generating recommendations for service selection.Trials registrationNCT03130283 (date released 04/06/2018), NCT03768050 (date released 12/05/2018), NCT03767387 (date released 12/05/2018).</p

Risk factors for developing ventilator-associated lower respiratory tract infection in patients with severe COVID-19:a multinational, multicentre study, prospective, observational study

Around one-third of patients diagnosed with COVID-19 develop a severe illness that requires admission to the Intensive Care Unit (ICU). In clinical practice, clinicians have learned that patients admitted to the ICU due to severe COVID-19 frequently develop ventilator-associated lower respiratory tract infections (VA-LRTI). This study aims to describe the clinical characteristics, the factors associated with VA-LRTI, and its impact on clinical outcomes in patients with severe COVID-19. This was a multicentre, observational cohort study conducted in ten countries in Latin America and Europe. We included patients with confirmed rtPCR for SARS-CoV-2 requiring ICU admission and endotracheal intubation. Only patients with a microbiological and clinical diagnosis of VA-LRTI were included. Multivariate Logistic regression analyses and Random Forest were conducted to determine the risk factors for VA-LRTI and its clinical impact in patients with severe COVID-19. In our study cohort of 3287 patients, VA-LRTI was diagnosed in 28.8% [948/3287]. The cumulative incidence of ventilator-associated pneumonia (VAP) was 18.6% [610/3287], followed by ventilator-associated tracheobronchitis (VAT) 10.3% [338/3287]. A total of 1252 bacteria species were isolated. The most frequently isolated pathogens were Pseudomonas aeruginosa (21.2% [266/1252]), followed by Klebsiella pneumoniae (19.1% [239/1252]) and Staphylococcus aureus (15.5% [194/1,252]). The factors independently associated with the development of VA-LRTI were prolonged stay under invasive mechanical ventilation, AKI during ICU stay, and the number of comorbidities. Regarding the clinical impact of VA-LRTI, patients with VAP had an increased risk of hospital mortality (OR [95% CI] of 1.81 [1.40-2.34]), while VAT was not associated with increased hospital mortality (OR [95% CI] of 1.34 [0.98-1.83]). VA-LRTI, often with difficult-to-treat bacteria, is frequent in patients admitted to the ICU due to severe COVID-19 and is associated with worse clinical outcomes, including higher mortality. Identifying risk factors for VA-LRTI might allow the early patient diagnosis to improve clinical outcomes. Trial registration: This is a prospective observational study; therefore, no health care interventions were applied to participants, and trial registration is not applicable

Computational and experimental approaches to chart the Escherichia coli cell-envelope-associated proteome and interactome

The bacterial cell-envelope consists of a complex arrangement of lipids, proteins and carbohydrates that serves as the interface between a microorganism and its environment or, with pathogens, a human host. Escherichia coli has long been investigated as a leading model system to elucidate the fundamental mechanisms underlying microbial cell-envelope biology. This includes extensive descriptions of the molecular identities, biochemical activities and evolutionary trajectories of integral transmembrane proteins, many of which play critical roles in infectious disease and antibiotic resistance. Strikingly, however, only half of the c. 1200 putative cell-envelope-related proteins of E. coli currently have experimentally attributed functions, indicating an opportunity for discovery. In this review, we summarize the state of the art of computational and proteomic approaches for determining the components of the E. coli cell-envelope proteome, as well as exploring the physical and functional interactions that underlie its biogenesis and functionality. We also provide a comprehensive comparative benchmarking analysis on the performance of different bioinformatic and proteomic methods commonly used to determine the subcellular localization of bacterial proteins

Evaluation of integrated care services in Catalonia: Population-based and service-based real-life deployment protocols

Background: Comprehensive assessment of integrated care deployment constitutes a major challenge to ensure quality, sustainability and transferability of both healthcare policies and services in the transition toward a coordinated service delivery scenario. To this end, the manuscript articulates four different protocols aiming at assessing large-scale implementation of integrated care, which are being developed within the umbrella of the regional project Nextcare (2016-2019), undertaken to foster innovation in technologically-supported services for chronic multimorbid patients in Catalonia (ES) (7.5 M inhabitants). Whereas one of the assessment protocols is designed to evaluate population-based deployment of care coordination at regional level during the period 2011-2017, the other three are service-based protocols addressing: i) Home hospitalization; ii) Prehabilitation for major surgery; and, iii) Community-based interventions for frail elderly chronic patients. All three services have demonstrated efficacy and potential for health value generation. They reflect different implementation maturity levels. While full coverage of the entire urban health district of Barcelona-Esquerra (52