Respiration rate and volume measurements using wearable strain sensors.

Current methods for continuous respiration monitoring such as respiratory inductive or optoelectronic plethysmography are limited to clinical or research settings; most wearable systems reported only measures respiration rate. Here we introduce a wearable sensor capable of simultaneously measuring both respiration rate and volume with high fidelity. Our disposable respiration sensor with a Band-Aid© like formfactor can measure both respiration rate and volume by simply measuring the local strain of the ribcage and abdomen during breathing. We demonstrate that both metrics are highly correlated to measurements from a medical grade continuous spirometer on participants at rest. Additionally, we also show that the system is capable of detecting respiration under various ambulatory conditions. Because these low-powered piezo-resistive sensors can be integrated with wireless Bluetooth units, they can be useful in monitoring patients with chronic respiratory diseases in everyday settings

A Rare Association of Giant Cell Arteritis with Recurrent Corneal Ulcer

We report a rare case of association of temporal arteritis with recurrent central corneal ulcer. A 91-year-old male with a remote history of clinically diagnosed giant cell arteritis (GCA) and penetrating keratoplasty (PK) for corneal edema in 1990’s in the left eye presented with irritation and severe dry eye. He progressively developed central corneal ulcer regardless of treatment with aggressive lubrication and patching. The clinical course, blood tests and temporal artery biopsy results yielded the diagnosis of recurrent GCA. The clinical course improved after starting oral steroids. The case report illustrates the importance of ruling out GCA in patients with recurrent corneal ulcers and history of GCA. It also highlights the significance of shared understanding between primary care physicians and specialists to handle common and chronic diseases to make efficient diagnoses and plan treatment regimens. This is the first plausible case of reported GCA association with central corneal ulcer in the United States

An examination of Advanced Clinical Practice: Qualitative insights from therapeutic radiography advanced and consultant practitioners based in England

Introduction: Therapeutic radiographers play a vital and changing role in the delivery of radiotherapy services treating patients with cancer. Advanced Practitioners (AP) and Consultant Practitioners (CP) in radiotherapy have developed advanced clinical skills and specialisms, enhancing the ability of the profession to offer a greater depth of cancer services and ease pressure elsewhere in the system. The aim of this study was to define the opportunity and potential for Advanced Clinical Practice (ACP) roles in oncology services. Specific objectives were to explore local profiles, role development and opportunities for standardisation of ACPs in therapeutic radiography and to determine resource requirements to roll out and ensure continuation of the existing and new roles. Material and methods: The research was addressed through a qualitative study design using focus groups. Convenience sampling was used to recruit therapeutic radiography advanced and consultant practitioners (N = 36) from the respective radiotherapy departments in England to participate in regional focus groups. Four regional areas were identified for inclusion. Data generated was analysed thematically. Results: The findings are presented in four themes: ownership of professional identity, desire for standardisation and guidance, drivers of role development and self-directed educational routes. Conclusion: Key findings from the focus groups indicated the need for standardisation in job descriptions, roles and responsibilities and a key understanding of career progression. The professional identity of the AP is acknowledged by independent, autonomous working; however, this can only be facilitated if the correct training is undertaken and the necessary support structures are in place to enable career progression. Challenges associated with role development are 1) lack of career and pathway guidance, 2) lack of clear educational routes, 3) lack of standardised roles

Radiotherapy students' perceptions of support provided by clinical supervisors

Aim: The aim of this study was to explore the experiences of radiotherapy students on clinical placement, specifically focussing on the provision of well-being support from clinical supervisors. Materials and methods: Twenty-five students from the University of the West of England and City University of London completed an online evaluation survey relating to their experiences of placement, involving Likert scales and open-ended questions. Results: The quantitative results were generally positive; however, the qualitative findings were mixed. Three themes emerged: (1) provision of information and advice; (2) an open, inclusive and supportive working environment; and (3) a lack of communication, understanding, and consistency. Findings: Students' experiences on placement differed greatly and appeared to relate to their specific interactions with different members of staff. It is suggested that additional training around providing well-being support to students may be of benefit to clinical supervisors

Multiscale biomimetic topography for the alignment of neonatal and embryonic stem cell-derived heart cells

Nano- and microscale topographical cues play critical roles in the induction and maintenance of various cellular functions, including morphology, adhesion, gene regulation, and communication. Recent studies indicate that structure and function at the heart tissue level is exquisitely sensitive to mechanical cues at the nano-scale as well as at the microscale level. Although fabrication methods exist for generating topographical features for cell culture, current techniques, especially those with nanoscale resolution, are typically complex, prohibitively expensive, and not accessible to most biology laboratories. Here, we present a tunable culture platform comprised of biomimetic wrinkles that simulate the heart's complex anisotropic and multiscale architecture for facile and robust cardiac cell alignment. We demonstrate the cellular and subcellular alignment of both neonatal mouse cardiomyocytes as well as those derived from human embryonic stem cells. By mimicking the fibrillar network of the extracellular matrix, this system enables monitoring of protein localization in real time and therefore the high-resolution study of phenotypic and physiologic responses to in-vivo like topographical cues.published_or_final_versio

Multiscale biomimetic topography for the alignment of neonatal and embryonic stem cell-derived heart cells

Nano- and microscale topographical cues play critical roles in the induction and maintenance of various cellular functions, including morphology, adhesion, gene regulation, and communication. Recent studies indicate that structure and function at the heart tissue level is exquisitely sensitive to mechanical cues at the nano-scale as well as at the microscale level. Although fabrication methods exist for generating topographical features for cell culture, current techniques, especially those with nanoscale resolution, are typically complex, prohibitively expensive, and not accessible to most biology laboratories. Here, we present a tunable culture platform comprised of biomimetic wrinkles that simulate the heart's complex anisotropic and multiscale architecture for facile and robust cardiac cell alignment. We demonstrate the cellular and subcellular alignment of both neonatal mouse cardiomyocytes as well as those derived from human embryonic stem cells. By mimicking the fibrillar network of the extracellular matrix, this system enables monitoring of protein localization in real time and therefore the high-resolution study of phenotypic and physiologic responses to in-vivo like topographical cues.published_or_final_versio

An ultrasensitive reverse transcription polymerase chain reaction assay to detect asymptomatic low-density Plasmodium falciparum and Plasmodium vivax infections in small volume blood samples.

BackgroundHighly sensitive, scalable diagnostic methods are needed to guide malaria elimination interventions. While traditional microscopy and rapid diagnostic tests (RDTs) are suitable for the diagnosis of symptomatic malaria infection, more sensitive tests are needed to screen for low-density, asymptomatic infections that are targeted by interventions aiming to eliminate the entire reservoir of malaria infection in humans.MethodsA reverse transcription polymerase chain reaction (RT- PCR) was developed for multiplexed detection of the 18S ribosomal RNA gene and ribosomal RNA of Plasmodium falciparum and Plasmodium vivax. Simulated field samples stored for 14 days with sample preservation buffer were used to assess the analytical sensitivity and specificity. Additionally, 1750 field samples from Southeastern Myanmar were tested both by RDT and ultrasensitive RT-PCR.ResultsLimits of detection (LoD) were determined under simulated field conditions. When 0.3 mL blood samples were stored for 14 days at 28 °C and 80% humidity, the LoD was less than 16 parasites/mL for P. falciparum and 19.7 copies/µL for P. vivax (using a plasmid surrogate), about 10,000-fold lower than RDTs. Of the 1739 samples successfully evaluated by both ultrasensitive RT-PCR and RDT, only two were RDT positive while 24 were positive for P. falciparum, 108 were positive for P. vivax, and 127 were positive for either P. vivax and/or P. falciparum using ultrasensitive RT-PCR.ConclusionsThis ultrasensitive RT-PCR method is a robust, field-tested screening method that is vastly more sensitive than RDTs. Further optimization may result in a truly scalable tool suitable for widespread surveillance of low-level asymptomatic P. falciparum and P. vivax parasitaemia

Gamification in radiotherapy education: adopting competitive task elements in simulation using the virtual environment of a radiotherapy treatment room (VERT) system

Introduction: Educational gamification is the introduction of game elements into other activities such as teaching and learning. VERT is a tool in therapeutic radiography that lends itself to gamification as it allows students to experiment and learn at no risk to the patient. The aim of this study was to evaluate the use of a gamified simulation using competitive task elements. Method: A total of 78 participants undertook the study which involved a demonstration and practice patient set-up followed by an unassisted timed patient set-up. Once complete the students score was added to a leaderboard. Results: Results show very good students’ feedback on the simulation elements, and that skills were transferable and would improve clinical performance. Gender differences were observed in the competitive feedback on two items, satisfaction from competing and competition encouraging performance. Conclusion: Overall the competitive aspect was viewed positively by students, although females appeared to enjoy the competitive aspects less than the male students, deriving significantly less satisfaction from the competitive element of the simulation. Despite the emphasis on teamwork within the profession, competitive gamification does appear to have a role within the undergraduate curriculum if carried out correctly