The high temporal and intensity resolution of modern accelerometers gives the opportunity of detecting even tiny body movements via motion-based sensors. In this paper, we demonstrate and evaluate an ...approach to identify pulse waves and heartbeats from acceleration data of the human wrist during sleep. Specifically, we have recorded simultaneously full-night polysomnography and 3d wrist actigraphy data of 363 subjects during one night in a clinical sleep laboratory. The acceleration data was segmented and cleaned, excluding body movements and separating episodes with different sleep positions. Then, we applied a bandpass filter and a Hilbert transform to uncover the pulse wave signal, which worked well for an average duration of 1.7 h per subject. We found that 81 percent of the detected pulse wave intervals could be correctly associated with the R peak intervals from independently recorded ECGs and obtained a median Pearson cross-correlation of 0.94. While the low-frequency components of both signals were practically identical, the high-frequency component of the pulse wave interval time series was increased, indicating a respiratory modulation of pulse transit times, probably as an additional contribution to respiratory sinus arrhythmia. Our approach could be used to obtain long-term nocturnal heartbeat interval time series and pulse wave signals from wrist-worn accelerometers without the need of recording ECG or photoplethysmography. This is particularly useful for an ambulatory monitoring of high-risk cardiac patients as well as for assessing cardiac dynamics in large cohort studies solely with accelerometer devices that are already used for activity tracking and sleep pattern analysis.
Mobile fitness applications provide the opportunity to show users real-time feedback on their current fitness activity. For such applications, it is essential to accurately track the user's current ...fitness activity using available mobile sensors, such as inertial measurement units (IMUs). Convolutional neural networks (CNNs) have been shown to produce strong results in different time series classification tasks, including the recognition of daily living activities. However, fitness activities can present unique challenges to the human activity recognition task (HAR), including greater similarity between individual activities and fewer available data for model training. In this paper, we evaluate the applicability of CNNs to the fitness activity recognition task (FAR) using IMU data and determine the impact of input data size and sensor count on performance. For this purpose, we adapted three existing CNN architectures to the FAR task and designed a fourth CNN variant, which we call the scaling fully convolutional network (Scaling-FCN). We designed a preprocessing pipeline and recorded a running exercise data set with 20 participants, in which we evaluated the respective recognition performances of the four networks, comparing them with three traditional machine learning (ML) methods commonly used in HAR. Although CNN architectures achieve at least 94% test accuracy in all scenarios, two traditional ML architectures surpass them in the default scenario, with support vector machines (SVMs) achieving 99.00 ± 0.34% test accuracy. The removal of all sensors except one foot sensor reduced the performance of traditional ML architectures but improved the performance of CNN architectures on our data set, with our Scaling-FCN reaching the highest accuracy of 99.86 ± 0.11% on the test set. Our results suggest that CNNs are generally well suited for fitness activity recognition, and noticeable performance improvements can be achieved if sensors are dropped selectively, although traditional ML architectures can still compete with or even surpass CNNs when favorable input data are utilized.
Endoscopic ear surgery (EES) has become firmly established internationally. In Germany this technology is controversially discussed and used very differently. Therefore, a survey was carried out on ...the availability, indications, contraindications, and future significance of EES.
A questionnaire with 20 questions was sent to 141 German university and central departments of otorhinolaryngology, head and neck surgery. The results are discussed on the basis of current literature retrieved in a search of PubMed and Google Scholar.
The response rate was 32% (45 clinics). Of these respondents, 27 clinics (60%) stated that EES was usually carried out as an accompanying measure. Only one clinic performed ear surgery endoscopically alone. In cases of intraoperative bleeding, mastoid drilling, or if bimanual work was required, the surgeons switched to microscopic ear surgery (MES). The most common indications for EES were tympanoscopy, cholesteatoma, retraction pockets, and interventions on the tympanic membrane and external auditory canal. The necessary resources for EES were estimated to be higher than for MES in 49-50% of the responding clinics. Tragus cartilage dominated as the graft material for reconstruction in EES clinics, at 78%. Only 4 of 45 responding clinics rated the future significance of ESS in Germany as high.
Although EES is used in Germany, only few ENT clinics use it extensively. Reservations relate to one-handed working, drilling, management of bleeding, and the expected high resource demand. Thus, EES in Germany is often performed as an accompanying procedure, with switching between EES and MES.
We present spin pumping and inverse spin Hall effect (ISHE) in an epitaxial complex oxide heterostructure. Ferromagnetic La0.7Sr0.3MnO3 (LSMO) is used as a source of spin pumping while the spin sink ...exhibiting the ISHE consists of SrRuO3 (SRO). SRO is a ferromagnetic oxide with metallic conductivity, however, with a Curie temperature (TC) of 155 K, thus well below room temperature. This choice allows to perform the experiment above and below TC of the SRO and to demonstrate that SRO not only shows an ISHE of a magnitude comparable to Pt (though with opposite sign) in its non magnetic state but also exhibits a finite ISHE even 50 K below TC.
Physical literacy (PL), given as a multidimensional construct, is considered a person's capacity and commitment to a physically active lifestyle. We investigated the effect of a holistic physical ...exercise training on PL among physically inactive adults.
A non-randomised controlled study was conducted. Thirty-one physically inactive adults in the intervention group (IG; 81% females, 44 ± 16 years) participated in a holistic physical exercise training intervention once weekly for 15 weeks. A matched, non-exercising control group (CG) consisted of 30 physically inactive adults (80% female, 45 ± 11 years). PL, compliance and sociodemographic parameters were measured. PL was evaluated by a questionnaire, covering five domains: physical activity behaviour, attitude towards a physically active lifestyle, exercise motivation, knowledge and self-confidence/self-efficacy. Data were analysed using ANCOVA models, adjusted for age, gender and BMI at baseline.
At post-training intervention, the IG showed significant improvements in PL (p = 0.001) and in the domains physical activity behaviour (p = 0.02) and exercise self-confidence/self-efficacy (p = 0.001), with no changes overserved for the CG regarding PL and those domains. No intervention effect were found for the other three domains, i.e. attitude, knowledge and motivation. Additionally, for the IG baseline BMI was identified to be positively correlated with physical exercise-induced improvements in PL (β = 0.51, p = 0.01).
The results from this study are very useful for further public health activities, which aim at helping physically inactive adults to adopt a physically active lifestyle as well as for the development of further PL intervention strategies. This pilot-study was a first attempt to measure PL in inactive adults. Yet, a validated measurement tool is still not available. Further research is necessary to determine the psychometric properties for this PL questionnaire.
German Clinical Trials Register (DRKS), DRKS00013991 , date of registration: 09.02.2018, retrospectively registered.
Transmission of all known pathogenic orthohantaviruses (family Hantaviridae) usually occurs via inhalation of aerosols contaminated with viral particles derived from infected rodents and organ ...manifestation of infections is characterized by lung and kidney involvement. Orthohantaviruses found in Eurasia cause hemorrhagic fever with renal syndrome (HFRS) and New World orthohantaviruses cause hantavirus cardiopulmonary syndrome (HCPS). However, cases of infection with Old World orthohantaviruses with severe pulmonary manifestations have also been observed. Therefore, human airway cells may represent initial targets for orthohantavirus infection and may also play a role in the pathogenesis of infections with Eurasian orthohantaviruses.
We analyzed the permissiveness of primary endothelial cells of the human pulmonary microvasculature and of primary human epithelial cells derived from bronchi, bronchioles and alveoli for Old World orthohantavirus Puumala virus (PUUV) in vitro. In addition, we examined the expression of orthohantaviral receptors in these cell types. To minimize donor-specific effects, cells from two different donors were tested for each cell type.
Productive infection with PUUV was observed for endothelial cells of the microvasculature and for the three tested epithelial cell types derived from different sites of the respiratory tract. Interestingly, infection and particle release were also detected in bronchial and bronchiolar epithelial cells although expression of the orthohantaviral receptor integrin β
was not detectable in these cell types. In addition, replication kinetics and viral release demonstrate enormous donor-specific variations.
The human respiratory epithelium is among the first targets of orthohantaviral infection and may contribute to virus replication, dissemination and pathogenesis of HFRS-causing orthohantaviruses. Differences in initial pulmonary infection due to donor-specific factors may play a role in the observed broad variance of severity and symptoms of orthohantavirus disease in patients. The absence of detectable levels of integrin α
β
surface expression on bronchial and small airway epithelial cells indicates an alternate mode of orthohantaviral entry in these cells that is independent from integrin β
.
A 29 nucleotide deletion in open reading frame 8 (ORF8) is the most obvious genetic change in severe acute respiratory syndrome coronavirus (SARS-CoV) during its emergence in humans. In spite of ...intense study, it remains unclear whether the deletion actually reflects adaptation to humans. Here we engineered full, partially deleted (-29 nt), and fully deleted ORF8 into a SARS-CoV infectious cDNA clone, strain Frankfurt-1. Replication of the resulting viruses was compared in primate cell cultures as well as Rhinolophus bat cells made permissive for SARS-CoV replication by lentiviral transduction of the human angiotensin-converting enzyme 2 receptor. Cells from cotton rat, goat, and sheep provided control scenarios that represent host systems in which SARS-CoV is neither endemic nor epidemic. Independent of the cell system, the truncation of ORF8 (29 nt deletion) decreased replication up to 23-fold. The effect was independent of the type I interferon response. The 29 nt deletion in SARS-CoV is a deleterious mutation acquired along the initial human-to-human transmission chain. The resulting loss of fitness may be due to a founder effect, which has rarely been documented in processes of viral emergence. These results have important implications for the retrospective assessment of the threat posed by SARS.
Survivors of an acute myocardial infarction with diabetes mellitus retain an increased mortality risk. Reliable assessment of individual risk is required for effective and cost-efficient medical care ...in these patients. The Polyscore is a previously established risk predictor consisting of seven autonomic tests derived from electrocardiogram, blood pressure, and respiration. The Polyscore allows classification of survivors of myocardial infarction in groups at low, intermediate and high mortality risk. The aim of this study was to investigate the prognostic value of the Polyscore in diabetic survivors of acute myocardial infarction, which may be impaired by the presence of diabetic autonomic neuropathy. Survivors of an acute myocardial infarction were included in a prospective cohort study during hospitalisation due to the index event at two university hospitals in Munich, Germany. The Polyscore was determined from simultaneous non-invasive 30-min recordings of electrocardiogram, continuous arterial blood pressure, and respiration which were performed in all participants. Patients were followed for 5 years. The primary and secondary outcomes were all-cause mortality and cardiac mortality. 184 of 941 enrolled patients (19.6%) suffered from diabetes mellitus. 5-year-mortality was higher in diabetic patients (15.2%) compared to non-diabetic patients (5.8%). A multivariable Cox regression model confirmed the Polyscore as a strong predictor of mortality in diabetic post-MI patients (intermediate risk: HR 6.56, 95% CI 1.61-26.78, p = 0.004, mortality 22.8%; high risk: HR 18.76, 95% CI 4.35-80.98, p < 0.001, mortality 68.8%). There was no interaction between diabetes mellitus and the Polyscore regarding mortality prediction (p = 0.775). Interestingly, in contrast to the groups at intermediate and high risk (73 patients, 39.7%), the Polyscore identified a majority of diabetic patients (111, 60.3%) with a low mortality risk, comparable to that of low-risk non-diabetic patients (3.6% and 2.1%, respectively, p = 0.339). Consistent results were observed for cardiac mortality. This analysis shows that the Polyscore predicts all-cause and cardiac mortality in diabetic survivors of acute myocardial infarction. Within these patients it identifies a large population not affected by the excess mortality associated with diabetes in this setting. Thus, the Polyscore may facilitate risk-adapted follow-up strategies in diabetic survivors of myocardial infarction.
The poor state of the ocean and the transboundary nature of the marine environment require bold action by States coordinated across sectors and territorial boundaries in order to deal with the ...manifold challenges the ocean is facing—and with it humankind. Cooperation and coordination among States and stakeholders in marine regions have proven to be important levers for policy implementation and to strengthen ocean governance, yet remain challenging. Transparent and engaging stakeholder dialogue processes have the potential to provide guidance for the necessary transformation toward ocean sustainability and support the attainment of Sustainable Development Goal (SDG) for the ocean, SDG 14 and other interlinked ocean-related targets. The aim of this study is to review the challenges and opportunities of current collaborative efforts, namely multi-stakeholder dialogue and exchange processes, within and between marine regions to accelerate transformative action, contributing to these global goals. This paper builds on knowledge co-production and collaborative governance literature, and reviews experiences by stakeholders with ocean-related science-policy interfaces in an effort to strengthen regional ocean governance. As an exemplary case of such interfaces, this study assesses the Marine Regions Forum, a newly established inclusive dialogue and exchange platform for diverse actors from marine regions that aims to provide an informal space for joint learning and support regional action and international governance processes alike. Employing latent content analysis of interviews with experts, critical common barriers that hamper current collaborative efforts amongst stakeholders in marine regions are identified, such as fragmented governance frameworks, power and resource imbalances, and lack of meaningful stakeholder engagement. Pathways to address these challenges, such as through common goal orientation, contextualisation, inclusivity, trust building and meaningful continuous interactions are also identified. This paper concludes by discussing the value added of transparent and inclusive collaborative processes in the transformation of ocean governance toward achieving sustainability.
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