In this paper, we analyze the needs of individuals with Autism Spectrum Disorders (ASD) to have a pervasive, feasible and non-stigmatizing form of assistance in their emotional self-regulation, in ...order to ease certain behavioral issues that undermine their mental health throughout their life. We argue the potential of recent widespread wearables, and more specifically smartwatches, to achieve this goal. Then, a smartwatch system that implements a wide range of self-regulation strategies and infers outburst patterns from physiological signals and movement is presented, along with an authoring tool for smartphones that is to be used by caregivers or family members to create and edit these strategies, in an adaptive way. We conducted an intensive experiment with two individuals with ASD who showed varied, representative behavioral responses to their emotional dysregulation. Both users were able to employ effective, customized emotional self-regulation strategies by means of the system, recovering from the majority of mild stress episodes and temper tantrums experienced in the nine days of experiment in their classroom.
Active ageing is described as the process of optimizing health, empowerment, and security to enhance the quality of life in the rapidly growing population of older adults. Meanwhile, multimorbidity ...and neurological disorders, such as Parkinson's disease (PD), lead to global public health and resource limitations. We introduce a novel user-centered paradigm of ageing based on wearable-driven artificial intelligence (AI) that may harness the autonomy and independence that accompany functional limitation or disability, and possibly elevate life expectancy in older adults and people with PD.
ActiveAgeing is a 4-year, multicentre, mixed method, cyclic study that combines digital phenotyping via commercial devices (Empatica E4, Fitbit Sense, and Oura Ring) with traditional evaluation (clinical assessment scales, in-depth interviews, and clinical consultations) and includes four types of participants: (1) people with PD and (2) their informal caregiver; (3) healthy older adults from the Helgetun living environment in Norway, and (4) people on the Helgetun waiting list. For the first study, each group will be represented by N = 15 participants to test the data acquisition and to determine the sample size for the second study. To suggest lifestyle changes, modules for human expert-based advice, machine-generated advice, and self-generated advice from accessible data visualization will be designed. Quantitative analysis of physiological data will rely on digital signal processing (DSP) and AI techniques. The clinical assessment scales are the Unified Parkinson's Disease Rating Scale (UPDRS), Montreal Cognitive Assessment (MoCA), Geriatric Depression Scale (GDS), Geriatric Anxiety Inventory (GAI), Apathy Evaluation Scale (AES), and the REM Sleep Behaviour Disorder Screening Questionnaire (RBDSQ). A qualitative inquiry will be carried out with individual and focus group interviews and analysed using a hermeneutic approach including narrative and thematic analysis techniques.
We hypothesise that digital phenotyping is feasible to explore the ageing process from clinical and lifestyle perspectives including older adults and people with PD. Data is used for clinical decision-making by symptom tracking, predicting symptom evolution, and discovering new outcome measures for clinical trials.
Decontamination of patients' clinical devices in intensive care units is generally performed with an antifungal suspension. Nystatin is a widely-used high spectrum antifungal due to its low systemic ...absorption. However, nystatin has high hydrophobicity which hinders the contact with the internal lumen of the devices. In this work, hydrophilic micellar systems of nystatin were developed with sodium deoxycholate on silicone endotracheal tubes. The physical characteristics of the micellar system at different nystatin:deoxycholate ratios were studied using scanning electron microscopy, X-ray powder diffraction and differential scanning calorimetry. The electron microscopy results reveal that the deoxycholate micellar system altered the surface morphology, and the size of the aggregates was observed to be smaller. The hydrophilic structures of deoxycholate produce systems with a high surface area containing nystatin molecules on their interior. The X-ray and differential scanning calorimetry assays revealed a typical change in the crystallinity of micellar systems when the deoxycholate proportion increases. The endothermic peak of nystatin was not observed in the micellar systems as a consequence of the reduced crystallinity. Nystatin was homogenously dispersed in the surfactant matrix. Micellar systems with 1:0.8 nystatin:deoxycholate ratio (MS-N:DC 1:0.8) showed increased antifungal activity compared to nystatin raw material. Micellar systems also achieved an over 40% inhibition of
biofilm formation. The results obtained in this study conclude that the higher hydrophilic characteristic of the surfactant deoxycholate enhances nystatin penetration into the surface of the endotracheal tubes.
In the recent years, the use of Information and Communication Technologies (ICTs) to enhance the educational and developmental interventions of individuals with intellectual disabilities has ...increased drastically. Current literature about the efficacy of assistive technologies for people with intellectual disabilities includes numerous examples of co-design and research involving people with intellectual disabilities and their stakeholders. However, literature regarding the challenges and opportunities presented by this research is scarce. The discussion and reflection presented in this work is based on the authors' previous experience and ground-breaking literature in the field. After a review of relevant work, the the authors' research is described in detail, in order to reflect on the challenges encountered, and on opportunities for new researchers and open questions. The paper concludes with a reflection on the use of technologies to support people with intellectual disabilities, adopted strategies and limitations.
En Polynésie Française, le taux d’obésité infantile est parmi les plus élevés dans le monde. L’épiphysiolyse de hanche est un accident qui touche les enfants en période pré- ou péri-pubertaire, liée ...à un double mécanisme de diminution de résistance du cartilage de conjugaison en fin de croissance et d’augmentation des contraintes mécaniques par prise rapide de poids. Les déformations importantes relèvent d’ostéotomies difficiles avec abord postérieur et isolement soigneux de l’artère circonflexe postérieure, stabilisées par voie extra-articulaire avec une vis. La scintigraphie osseuse est généralement demandée pour apprécier la vitalité de la tête fémorale.
Dix enfants (6 garçons ; 4 filles), âge moyen 10,70±1,70 ans, poids moyen 74,10±18,96kg (IMC moyen 28,60±5,40) dont 7 obèses (IMC 31,34±3,61) ont été adressés dans le service de médecine nucléaire pour évaluation de la vitalité de la tête fémorale avant éventuelle chirurgie (n=2) ou 75±30jours après une chirurgie dans le cadre d’épiphysiolyses (n=13 ; unilatérale n=7 ; bilatérale n=3). Neuf sur dix enfants ont finalement été opérés (15 articulations) : ostéotomie de Dunn (n=10 ; glissements importants de stade III) ou vissage externe (n=5 ; stabilisation (n=3) ou préventif controlatéral (n=2).
Une absence totale de fixation évoquant une nécrose de tête fémorale a été retrouvée dans 3/15 articulations, en concordance avec l’IRM (2/3) et le suivi évolutif (3/3). Une bonne fixation de la tête fémorale a été retrouvée dans les autres cas, en concordance avec l’IRM (11/12) et le suivi évolutif (12/12). Pour les deux discordances scintigraphie et IRM, l’IRM ne pouvait pas conclure en raison d’artéfacts générés par le matériel. La fixation des physes fémorales supérieures dépendaient du délai par rapport à la chirurgie, avec disparition des hyperfixations physiologiques pour les délais>3 mois. Dans les 2 cas d’enclouage préventif controlatéral, il persistait une hyperfixation franche physiologique de la physe plus de 3 mois après la chirurgie. La tomoscintigraphie couplée à un scanner de repérage anatomique était particulièrement utile pour différencier correctement la part de la fixation due à la tête fémorale de celle due à la physe.
La scintigraphie osseuse reste un outil particulièrement intéressant pour apprécier la vitalité des têtes fémorales après épiphysiolyse.
Chromium has been proven to be extremely phytotoxic. This study explored the impacts of increasing Cr(VI) exposure (up to 10 mg L−1 K2Cr2O7) on the growth and development of alfalfa plants and ...adaptation responses employed, in an environmentally relevant context. The threshold concentration of K2Cr2O7 in irrigation water beyond which stress responses are initiated is 1 mg L−1. Lower Cr(VI) exposure (0.5 mg L−1 K2Cr2O7) induced hormesis, evident through increased biomass and larger leaves, likely mediated by increased NO content (supported by elevated NR enzymatic activity and overexpression of NR and ndh genes). Elevated Cr(VI) exposure (5 and 10 mg L−1 K2Cr2O7) resulted in reduced biomass and smaller leaves, and lower levels of photosynthetic pigment (10 mg L−1 K2Cr2O7). Higher levels of lipid peroxidation, H2O2 and NO contents in these plants suggested nitro-oxidative stress. Stress responses included increased SOD and CAT enzymatic activities, further supported to some extent by MnSOD, FeSOD, Cu/ZnSOD and CAT transcripts levels. GST7 and GST17 gene expression patterns, as well as proline content, P5CS enzymatic activity and corresponding P5CS and P5CR gene expression levels emphasized the role of proline and GSTs in the adaptation responses. Results highlight the importance of managing Cr(VI) levels in irrigation water.
Display omitted
•Alfalfa plants were exposed to Cr(VI) through irrigation in an agricultural setting.•Low exposure (0.5 mg L−1 K2Cr2O7) induced hormesis, mediated by elevated NO content.•Phytotoxic effects are initiated when K2Cr2O7 in irrigation water exceeded 1 mg L−1.•Elevated Cr(VI) exposure (5, 10 mg L−1 K2Cr2O7) resulted in nitro-oxidative stress.•Accumulation of proline and GSTs leads to enhanced tolerance to Cr(VI) toxicity.
Display omitted
In this study, a new surface-modified naproxen was developed to enhance brain concentration in acute migraine treatment. Fast-dissolving naproxen granules were made by mixing ...hydroxypropylmethylcellulose (HPMC) sodium dodecyl sulphate (SDS) and sodium croscarmellose with micronized naproxen particles. The aim of this study was to evaluate the effect of adding proportions of SDS to the HPMC film caused changes in the polymer chains of the HPMC, producing a new hydrophilic HPMC-SDS structure. These formulations with different HPMC/SDS ratios were characterised using electron microscopy (SEM), powder X-ray diffraction (PXRD), and differential scanning calorimetry (DSC). SDS 10% (w/w) produced a highly hydrophilic HPMC-SDS structure on the surface of the naproxen microparticles. The fast dissolution granules (SF-10%) showed a significant improvement in the dissolution rate of naproxen. Pharmacokinetic studies were conducted with mice, showing an improvement of Cmax (1.38 and 1.41-fold) and AUC0-2h (30% and 10% higher) for plasma and brain samples compared to the reference naproxen suspension. The faster Tmax ratio for SF-10% may be related to increased hydration in the gastrointestinal environment, enabling the drug to permeate the gastrointestinal hydration layer more easily due to the presence of the hydrophilic HPMC-SDS structure in the formulation.
Abstract Background Renal failure (RF) is a frequent complication in non-renal solid organ transplants. In the present study, we analyze our experience with intestinal transplants (ITx). Methods ...Between 2004 and 2012, we performed 21 ITx in 19 adult patients. Alemtuzumab was used as an induction agent followed by tacrolimus. Renal function was assessed before ITx and during the perioperative period. Results The main cause for transplants was non-resectable desmoids tumors (33.3%), followed by vascular thrombosis (19%) and others. Medical complications were frequent, especially infectious diseases, which were the most common (51%). Surgical complications were also frequent, but most of them (>50%) were mild but leading to a great number of re-operations and prolonged stays in hospital. Acute rejection is very frequent (66.6%) but mild in more than 70% of the cases. Finally, RF was very frequent (68.4%; 13/19 patients) and accounted for 15.6% of all medical complications. Causes were multiple. One patient is awaiting a kidney transplant, but no other patients need renal replacement therapy at the moment. Ileostomy closure was performed in 5 of 12 patients alive, showing improved renal function in 3 of them. Conclusions RF is a problem in ITx and is always multifactorial. Increases in hospital stay, higher morbidity and is a cause for hospital readmission. Almost all patients had an impaired renal function when discharged. Immunosuppressants and ileostomy closure as soon as possible might prevent RF.
To investigate the time course and the relation to prognosis of coagulation and fibrinolytic abnormalities in patients with septic shock.
Forty-eight consecutive patients admitted to the medical ICU ...with the diagnosis of septic shock (diagnosed by defined criteria) were studied. Mortality was 25 of 48. Mean age was 57 ±7.3 years. Blood samples were obtained on days 1, 4, and 7 after hospital admission to measure tissue-type plasminogen activator antigen (t-PA), urokinase-type plasminogen activator (u-PA), plasminogen activator inhibitor antigen (PAI-1), plasminogen, α2-antiplasmin, fibrinogen, antithrombin III, protein C, protein S, thrombin-antithrombin complexes (TAT), D-dimer, and von Willebrand factor-related antigen (vWF:Ag).
All patients showed marked abnormalities in both the coagulation and fibrinolytic systems. There were signs of coagulation activation and elevation of both activators and inhibitors of fibrinolysis. Nonsurvivors showed lower levels of protein C and antithrombin III and higher concentration of TAT than survivors. While both t-PA and PAI-1 concentrations were high in survivors and nonsurvivors, only survivors showed a progressive normalization of both parameters during the study period. Low plasminogen levels and plasminogen/α2-antiplasmin ratio were found in both groups, presenting a trend toward normalization only in survivors. The differences reported were not apparent at the time of hospital admission.
Septic shock is characterized by coagulation activation and fibrinolysis activation and inhibition. Nonsurvivors present a particular hemostatic profile characterized by a more marked activation of coagulation and a more intense inhibition of fibrinolysis. None of the abnormalities studied was significantly different between survivors and nonsurvivors at the time of hospital admission. In the presence of fibrin formation, nonsurvivors present a maintained imbalance in the fibrinolytic response determined by higher PAI-1 plasma concentration, probably contributing to their poor outcome.
This paper presents the system AmICog, designed specifically to assist people with cognitive disabilities in their workplaces. To do that we employ mobile devices for two different purposes: on the ...one hand, to show interactive guides adapted to the user, the task and the user’s context. On the other hand, to locate and provide directions in indoors environments.
PDF
