Extracorporeal shockwave therapy for the treatment of lower limb intermittent claudication: Study protocol for a randomised controlled trial (the SHOCKWAVE 1 trial)

© 2017 The Author(s). Background: Peripheral arterial disease (PAD) has a population prevalence of 4.6% with intermittent claudication (IC) presenting as one of the earliest and most common symptoms. PAD has detrimental effects on patients' walking ability in terms of maximum walking distance (MWD) and pain-free walking distance (PFWD). Research has suggested extracorporeal shockwave therapy (ESWT) may induce angiogenesis in treated tissue; therefore, our objective is to assess the tolerability and efficacy of ESWT as a novel treatment of intermittent claudication. Methods/design: Patients with unilateral claudication will be randomised to receive either ESWT (PiezoWave 2 shockwave system) or sham treatment to the calf muscle bulk three times per week for 3 weeks. All patients are blinded to treatment group, and all assessments will be performed by a masked assessor. Treatment tolerability using a visual analogue scale, ankle-brachial pressure index, MWD, PFWD and safety will all be formally assessed as outcome measures at baseline and at 4, 8 and 12 weeks follow-up. Discussion: This trial will be the first of its kind in terms of methodology in relation to ESWT for intermittent claudication. A double-masked randomised controlled trial will provide useful information about the potential for the use of ESWT as a non-invasive treatment option and the need for further robust research. Trial registration: ClinicalTrials.gov, NCT02652078. Registered on 17 October 2014

A systematic review and meta-analysis of systemic intraoperative anticoagulation during arteriovenous access formation for dialysis

Purpose: Surgical arteriovenous fistula (AVF) or graft (AVG) is preferred to a central venous catheter for dialysis access. Surgical access may suffer thrombosis early after placement and systemic anticoagulation during surgical access formation may increase patency rates but would be expected to increase bleeding-related complications. A systematic review and meta-analysis of randomised controlled trials was conducted to examine the impact of systemic anticoagulation on access surgery perioperative bleeding and patency rates. Methods: We included randomised controlled trials testing systemic anticoagulation during access formation versus a control group without systemic anticoagulation reporting bleeding complications and access patency. Medline, Embase, CENTRAL and CINAHL were searched up to March 2015. Risk of bias was assessed using the Cochrane risk of bias tool and the Jadad score. Meta-analysis was performed using Cochrane Revman ® software. Results: Searches identified 445 reports of which four randomised studies involving 411 participants were included. Three studies pertained to AVF only and one included both AVF and AVG. Systemic anticoagulation led to increased bleeding events in all access [four trials; risk ratio (RR) 7.18; confidence interval (CI), 2.41 to 21.38; p < 0.001]. Patency was not improved for all access (four trials; RR, 0.64; CI, 0.37 to 1.09; p = 0.10) but was improved when AVF analysed alone (three trials; RR, 0.57; CI, 0.33 to 0.97; p = 0.04). Conclusions: The use of intraoperative systemic anticoagulation during access formation is associated with a highly significant increased risk of bleeding-related complications. A significant improvement in AVF patency was seen, though not when AVF and AVG were analysed together

Building community cyclone resilience through academic and insurance industry partnership

This paper presents research from collaboration between the Cyclone Testing Station (CTS) at James Cook University and insurer Suncorp over the last two years. A key outcome of this work has been an insurance premium reduction program by Suncorp known as the 'Cyclone Resilience Benefit'. Background research conducted for the program by the CTS is discussed and its details are briefly reviewed. Insights from the program delivery to over 14,000 homeowners to date are discussed. Although still in preliminary stages, the development of this industry program based on academic research demonstrates the benefits of strategic partnerships in the field of natural disaster risk mitigation

Building community cyclone resilience through academic and insurance industry partnership

This paper presents research from collaboration between the Cyclone Testing Station (CTS) at James Cook University and insurer Suncorp over the last two years. A key outcome of this work has been an insurance premium reduction program by Suncorp known as the 'Cyclone Resilience Benefit'. Background research conducted for the program by the CTS is discussed and its details are briefly reviewed. Insights from the program delivery to over 14,000 homeowners to date are discussed. Although still in preliminary stages, the development of this industry program based on academic research demonstrates the benefits of strategic partnerships in the field of natural disaster risk mitigation

Robot acting on moving bodies (RAMBO): Preliminary results

A robot system called RAMBO is being developed. It is equipped with a camera, which, given a sequence of simple tasks, can perform these tasks on a moving object. RAMBO is given a complete geometric model of the object. A low level vision module extracts and groups characteristic features in images of the object. The positions of the object are determined in a sequence of images, and a motion estimate of the object is obtained. This motion estimate is used to plan trajectories of the robot tool to relative locations nearby the object sufficient for achieving the tasks. More specifically, low level vision uses parallel algorithms for image enchancement by symmetric nearest neighbor filtering, edge detection by local gradient operators, and corner extraction by sector filtering. The object pose estimation is a Hough transform method accumulating position hypotheses obtained by matching triples of image features (corners) to triples of model features. To maximize computing speed, the estimate of the position in space of a triple of features is obtained by decomposing its perspective view into a product of rotations and a scaled orthographic projection. This allows the use of 2-D lookup tables at each stage of the decomposition. The position hypotheses for each possible match of model feature triples and image feature triples are calculated in parallel. Trajectory planning combines heuristic and dynamic programming techniques. Then trajectories are created using parametric cubic splines between initial and goal trajectories. All the parallel algorithms run on a Connection Machine CM-2 with 16K processors

Robot Acting on Moving Bodies (RAMBO): Interaction with tumbling objects

Interaction with tumbling objects will become more common as human activities in space expand. Attempting to interact with a large complex object translating and rotating in space, a human operator using only his visual and mental capacities may not be able to estimate the object motion, plan actions or control those actions. A robot system (RAMBO) equipped with a camera, which, given a sequence of simple tasks, can perform these tasks on a tumbling object, is being developed. RAMBO is given a complete geometric model of the object. A low level vision module extracts and groups characteristic features in images of the object. The positions of the object are determined in a sequence of images, and a motion estimate of the object is obtained. This motion estimate is used to plan trajectories of the robot tool to relative locations rearby the object sufficient for achieving the tasks. More specifically, low level vision uses parallel algorithms for image enhancement by symmetric nearest neighbor filtering, edge detection by local gradient operators, and corner extraction by sector filtering. The object pose estimation is a Hough transform method accumulating position hypotheses obtained by matching triples of image features (corners) to triples of model features. To maximize computing speed, the estimate of the position in space of a triple of features is obtained by decomposing its perspective view into a product of rotations and a scaled orthographic projection. This allows use of 2-D lookup tables at each stage of the decomposition. The position hypotheses for each possible match of model feature triples and image feature triples are calculated in parallel. Trajectory planning combines heuristic and dynamic programming techniques. Then trajectories are created using dynamic interpolations between initial and goal trajectories. All the parallel algorithms run on a Connection Machine CM-2 with 16K processors

Taking a Call Is Facilitated by the Multisensory Processing of Smartphone Vibrations, Sounds, and Flashes

Many electronic devices that we use in our daily lives provide inputs that need to be processed and integrated by our senses. For instance, ringing, vibrating, and flashing indicate incoming calls and messages in smartphones. Whether the presentation of multiple smartphone stimuli simultaneously provides an advantage over the processing of the same stimuli presented in isolation has not yet been investigated. In this behavioral study we examined multisensory processing between visual (V), tactile (T), and auditory (A) stimuli produced by a smartphone. Unisensory V, T, and A stimuli as well as VA, AT, VT, and trisensory VAT stimuli were presented in random order. Participants responded to any stimulus appearance by touching the smartphone screen using the stimulated hand (Experiment 1), or the non-stimulated hand (Experiment 2). We examined violations of the race model to test whether shorter response times to multisensory stimuli exceed probability summations of unisensory stimuli. Significant violations of the race model, indicative of multisensory processing, were found for VA stimuli in both experiments and for VT stimuli in Experiment 1. Across participants, the strength of this effect was not associated with prior learning experience and daily use of smartphones. This indicates that this integration effect, similar to what has been previously reported for the integration of semantically meaningless stimuli, could involve bottom-up driven multisensory processes. Our study demonstrates for the first time that multisensory processing of smartphone stimuli facilitates taking a call. Thus, research on multisensory integration should be taken into consideration when designing electronic devices such as smartphones