Patients infected with SARS-CoV-2 may deteriorate rapidly and therefore continuous monitoring is necessary. We conducted an observational study involving patients with mild COVID-19 to explore the ...potentials of wearable biosensors and machine learning-based analysis of physiology parameters to detect clinical deterioration. Thirty-four patients (median age: 32 years; male: 52.9%) with mild COVID-19 from Queen Mary Hospital were recruited. The mean National Early Warning Score 2 (NEWS2) were 0.59 ± 0.7. 1231 manual measurement of physiology parameters were performed during hospital stay (median 15 days). Physiology parameters obtained from wearable biosensors correlated well with manual measurement including pulse rate (r = 0.96, p < 0.0001) and oxygen saturation (r = 0.87, p < 0.0001). A machine learning-derived index reflecting overall health status, Biovitals Index (BI), was generated by autonomous analysis of physiology parameters, symptoms, and other medical data. Daily BI was linearly associated with respiratory tract viral load (p < 0.0001) and NEWS2 (r = 0.75, p < 0.001). BI was superior to NEWS2 in predicting clinical worsening events (sensitivity 94.1% and specificity 88.9%) and prolonged hospitalization (sensitivity 66.7% and specificity 72.7%). Wearable biosensors coupled with machine learning-derived health index allowed automated detection of clinical deterioration.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
Underutilization of guideline-directed heart failure with reduced ejection fraction (HFrEF) medications contributes to poor outcomes.
A pilot study to evaluate the safety and efficacy of a home-based ...remote monitoring system for HFrEF management was performed. The system included wearable armband monitors paired with the smartphone application. An HFrEF medication titration algorithm was used to adjust medication daily. The primary endpoint was HFrEF medication utilization at 120 days. Twenty patients (60.5 ± 8.2 years, men: 85%) with HFrEF were recruited. All received angiotensin-converting enzyme inhibitor (ACEI)/angiotensin receptor blocker (ARB)/angiotensin receptor-neprilysin inhibitor (ARNI) at recruitment; 45% received ≥50% maximal targeted dose (MTD) with % MTD of 44.4 ± 31.7%. At baseline, 90 and 70% received beta-adrenergic blocker and mineralocorticoid receptor antagonist (MRA), 35% received ≥50% MTD beta-adrenergic blocker with % MTD of 34.1 ± 29.6%, and 25% received ≥50% MTD MRA with % MTD of 25.0 ± 19.9%. At 120 days, 70% received ≥50% MTD ACEI/ARB/ARNI (
= 0.110) with % MTD increased to 64.4 ± 33.5% (
= 0.060). The proportion receiving ≥50% MTD ARNI increased from 15 to 55% (
= 0.089) with % MTD ARNI increased from 20.6 ± 30.9 to 53.1 ± 39.5% (
= 0.006*). More patients received ≥50% MTD MRA (65 vs. 25%,
= 0.011*) with % MTD MRA increased from 25.0 ± 19.9 to 46.2 ± 28.8% (
= 0.009*). Ninety-five per cent of patients had reduced NT-proBNP with the percentage reduction of 26.7 ± 19.7%.
Heart failure with reduced ejection fraction medication escalation with remote monitoring appeared feasible.
Many Chinese companies rely on externally acquired innovations rather than developing their own. The best way to rapidly commercialize externally acquired innovations in a Chinese company, however, ...is still a rather new research topic. This paper reports research towards development of an integrated model for commercialization of acquired innovations. Development of the preliminary model was based upon a review of the literature. The preliminary model covers four main factors, namely, technological collaboration, organizational collaboration, customer collaboration and resource collaboration. Managers from four entrepreneurial Chinese companies evaluated the model. Each of the four case companies had acquired innovations from external sources. Our empirical results indicate that the factors of partner matches/relationships, product champions, pioneer users and financial alliances tend to be more important than other factors. The managers also added two more factors, namely, government regulations and university support. This paper provides initial empirical evidence that demonstrates the multifaceted determinants of rapid commercialization of acquired innovations in the context of Chinese manufacturing. Our findings suggest that the innovative firms operating in China integrate technological collaboration, government policies and university research activities in order to facilitate commercialization of their acquired innovations. In summary, collaborations both inside and outside of companies are critical for successful commercialization.
In this paper we have described the development of a system level vehicle architecture simulation model for self-propelled off highway vehicle. Model based systems simulation approach has been ...deployed for this project. Detailed requirement analysis is performed to derive system/sub-system level requirements. Top-down vehicle decomposition has been carried out for identifying different systems/sub-systems and rightly scoping the model. Functional interface analysis has been performed in order to understand interfaces and energy flows between systems/sub-systems. It helps identify vehicle interactions with externals like operator and environment. Using inputs from the system engineering tools, a complex system level model is developed. The model consists of operator model, controller models, environment interactions and various vehicle systems. The model is modular enough to adapt easily for architectural evaluation at various phases of product development. Model has been parameterized to ease automated evaluations. The model is modular enough to adapt easily for architectural evaluation. The full vehicle model is correlated against test data for various field operations. Model has further been used for driving architectural design decisions, system optimization and energy analysis.
Recently developed optogenetic technologies offer the promise of high‐speed mapping of brain circuitry. Genetically targeted light‐gated channels and pumps, such as channelrhodopsins and ...halorhodopsin, allow optical control of neuronal activity with high spatial and temporal resolution. Optogenetic probes of neuronal activity, such as Clomeleon and Mermaid, allow light to be used to monitor the activity of a genetically defined population of neurons. Combining these two complementary sets of optogenetic probes will make it possible to perform all‐optical circuit mapping. Owing to the improved efficiency and higher speed of data acquisition, this hybrid approach should enable high‐throughput mapping of brain circuitry.
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BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SBCE, SBMB, UL, UM, UPUK
Complexes of secretin (SecR) and angiotensin 1a (Atr1a) receptors have been proposed to be functionally important in osmoregulation, providing an explanation for overlapping and interdependent ...functions of hormones that bind and activate different classes of GPCRs. However, the nature of these cross-class complexes has not been well characterized and their signaling properties have not been systematically explored. We now use competitive inhibition of receptor bioluminescence resonance energy transfer and bimolecular fluorescence complementation to establish the dominant functionally important state as a symmetrical homodimeric form of SecR decorated by monomeric Atr1a, interacting through lipid-exposed faces of Atr1a TM1 and TM4. Conditions increasing prevalence of this complex exhibited negative allosteric modulatory impact on secretin-stimulated cAMP responses at SecR. In contrast, activating Atr1a with full agonist in such a complex exhibited a positive allosteric modulatory impact on the same signaling event. This modulation was functionally biased, with secretin-stimulated calcium responses unaffected, whereas angiotensin-stimulated calcium responses through the complex were reduced or absent. Further supporting this interpretation, Atr1a with mutations of lipid-exposed faces of TM1 and TM4 that did not affect its ability to bind or signal, could be expressed in the same cell as SecR, yet not exhibit either the negative or positive allosteric impact on cAMP observed with the inactive or activated states of wild type Atr1a on function, and not interfere with angiotensin-stimulated calcium responses like complexes with Atr1a. This may provide a more selective means of exploring the physiologic functional impact of this cross-class receptor complex without interfering with the function of either component receptor.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Here we characterize several new lines of transgenic mice useful for optogenetic analysis of brain circuit function. These mice express optogenetic probes, such as enhanced halorhodopsin or several ...different versions of channelrhodopsins, behind various neuron-specific promoters. These mice permit photoinhibition or photostimulation both in vitro and in vivo. Our results also reveal the important influence of fluorescent tags on optogenetic probe expression and function in transgenic mice.
In light of the growing evidence base for better clinical results with the use of the dual bronchodilator indacaterol/glycopyrronium (IND/GLY) over inhaled corticosteroid-containing ...salmeterol/fluticasone combination (SFC), this study aimed to evaluate the cost-effectiveness of IND/GLY over SFC in patients with moderate-to-severe chronic obstructive pulmonary disease (COPD) who are at low risk of exacerbations, in the Singapore healthcare setting.
A previously published patient-level simulation model was adapted for use in Singapore by applying local unit costs. The model was populated with clinical data from the LANTERN and ECLIPSE studies. Both costs and health outcomes were predicted for the lifetime horizon from a payer's perspective and were discounted at 3% per annum. Costs were expressed in 2015 USD exchange rates. Uncertainty was assessed through probabilistic sensitivity analysis.
Compared to SFC, use of IND/GLY increased mean life expectancy by 0.316 years and mean quality-adjusted life years (QALYs) by 0.246 years, and decreased mean total treatment costs (drug costs and management of associated events) by USD 1,474 over the entire lifetime horizon. IND/GLY was considered to be 100% cost-effective at a threshold of 1 × gross domestic product per capita. The cost-effectiveness acceptability curve showed that IND/GLY was 100% cost-effective at a willingness-to-pay threshold of USD 0 (additional cost) when compared to SFC.
IND/GLY was estimated to be highly cost-effective compared to SFC in patients with moderate-to-severe COPD who are not at high risk of exacerbations in the Singapore healthcare setting.
Electro-Mechanical Actuators (EMAs) in the aerospace field will provide major benefits to reduce overall weight, cost, and easier maintenance when servicing the aircraft. In the present study, two ...cooling fans were tested experimentally to determine the effects of the blade count and ambient pressure on the fan performance and efficiency. Both fans were tested at the same rotational speed of 13,000 rpm and four pressure conditions, (1, 0.7, 0.5, 0.3) atm. The lowest ambient pressure tested was 0.3 atm. Typical commercial aircraft operate at this ambient pressure at cruising altitudes. Selecting a 2-bladed and 7-bladed fan accommodates for testing of the extrema in terms of solidity, fan performance, and efficiency. The 7-bladed fan yielded the best performance to the 2-bladed fan in terms of static pressure to the volumetric flow rate, but the 2-bladed fan demonstrated to operate more efficiently than the 7-bladed fan in some ambient pressure conditions. The 7-bladed fan demonstrated turbulent flow regimes with Reynolds numbers, Re ≫ 4000, for all cases except for at the high resistance when operating at 0.3 atm.; on the other hand, the 2-bladed fan-operated in the laminar and transitional flow regimes for 0.3 atm. and during shutoff conditions at 0.5 atm. The higher Reynolds numbers allow for more air mixing which will, in turn, enhance the cooling of the system. In terms of volumetric flow rate delivery, the higher blade counts can deliver higher volumetric flow rates. The smaller blade counts perform more efficiently at (0.7, 0.5) atm which is due to lower power requirement to drive the blades. The current work addresses the effects of pressure on fan efficiency and performance. Both fans demonstrated higher efficiencies at pressure lower than ambient pressure due to the density changes at the lower pressure conditions.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
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