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Background:. Little is known about the volume and scope of surgical procedures performed in ambulatory surgery centers (ASCs) and the resources that ASCs may provide to assist local health systems. The purpose of this study was to evaluate elective surgical procedures in the inpatient and outpatient ASC setting using currently available administrative claims data. Methods:. We used the 2019 Medicare Point of Service (POS) file to evaluate the geographic distribution of Medicare-certified ASCs in the U.S. To evaluate the volume and scope of elective procedures in the inpatient and outpatient ASC setting, we used the 2016 Healthcare Cost and Utilization Project (HCUP) National Inpatient Sample (NIS) and the 2018 California HHS Open Data Portal ambulatory surgery database. HCUP software programs were used to clinically categorize procedures and determine Elixhauser comorbidity profiles for each patient. Results:. Among the 8,540 Medicare certified ASCs in 2019, the majority are freestanding (99.5%) and privately owned (92.9%). In the inpatient setting, 13.3% of elective operating room procedures occur in patients without any Elixhauser comorbidities and require < 2 days of hospital stay. However, the types of elective procedures performed in the inpatient setting are different from the types of procedures routinely performed in ASCs. Conclusions:. Current administrative data lack robust facility, provider, and procedure level information to inform surge capacity protocols for elective surgery. Plastic surgeons are uniquely positioned to work with other specialties and local health systems to guide future development of surge capacity protocols that maintain and improve patient care.

Introduction Most patient-reported outcome measures (PROM) for chronic wounds are specific to a single wound type (eg, pressure ulcer) or part of the body. A barrier to outcome assessment in wound care and research is the lack of a rigorously designed PROM that can be used across wound types and locations. This mixed method study describes the protocol for an international collaboration to develop and validate a new PROM called the WOUND-Q for adults with chronic wounds.Methods and analysis In phase I, the qualitative approach of interpretive description is used to elicit concepts important to people with wounds regarding outcome. Participants from Canada, Denmark, the Netherlands, and the USA are aged 18 years and older and have a wound that has lasted 3 months or longer. Interviews are digitally recorded, transcribed and coded. A conceptual framework and preliminary item pool are developed from the qualitative dataset. Draft scales are formed to cover important themes in the conceptual framework. These scales are refined using feedback from people with chronic wounds and wound care experts. After refinement, the scales are translated into Danish and Dutch, following rigorous methods, to prepare for an international field-test study. In phase II, data are collected in Canada, Denmark, the Netherlands, and the USA. An international sample of people with a large variety of chronic wounds complete the WOUND-Q. Rasch Measurement Theory analysis is used to identify the best subset of items to retain for each scale and to examine reliability and validity.Ethics and dissemination This study is coordinated at Brigham and Women’s Hospital (Boston, USA). Ethics board approval was received at each participating site for both study phases. Findings will be published in peer-reviewed journals and presented at national and international conferences and meetings.

This study aims to demonstrate the feasibility of using a new wireless electroencephalography (EEG)-electromyography (EMG) wearable approach to generate characteristic EEG-EMG mixed patterns with mouth movements in order to detect distinct movement patterns for severe speech impairments. This paper describes a method for detecting mouth movement based on a new signal processing technology suitable for sensor integration and machine learning applications. This paper examines the relationship between the mouth motion and the brainwave in an effort to develop nonverbal interfacing for people who have lost the ability to communicate, such as people with paralysis. A set of experiments were conducted to assess the efficacy of the proposed method for feature selection. It was determined that the classification of mouth movements was meaningful. EEG-EMG signals were also collected during silent mouthing of phonemes. A few-shot neural network was trained to classify the phonemes from the EEG-EMG signals, yielding classification accuracy of 95%. This technique in data collection and processing bioelectrical signals for phoneme recognition proves a promising avenue for future communication aids., Competing Interests: The authors declare no conflicts of interest.

Although mice are social, multiple animals' neural activities are rarely explored. To characterise the neural activities during multi-brain interaction, we simultaneously recorded local field potentials (LFP) in the prefrontal cortex of four mice. The social context and locomotive states predominately modulated the entire LFP structure. The power of lower frequency bands-delta to alpha-were correlated with each other and anti-correlated with gamma power. The high-to-low-power ratio (HLR) provided a useful measure to understand LFP changes along the change of behavioural and locomotive states. The HLR during huddled conditions was lower than that during non-huddled conditions, dividing the social context into two. Multi-brain analyses of HLR indicated that the mice in the group displayed high cross-correlation. The mice in the group often showed unilateral precedence of HLR by Granger causality analysis, possibly comprising a hierarchical social structure. Overall, this study shows the importance of the social environment in brain dynamics and emphasises the simultaneous multi-brain recordings in social neuroscience., (© 2024. The Author(s).)

Wireless sensing systems are required for continuous health monitoring and data collection. It allows for patient data collection in real time rather than through time-consuming and expensive hospital or lab visits. This technology employs wearable sensors, signal processing, and wireless data transfer to remotely monitor patients' health. The research offers a novel approach to providing primary diagnostics remotely with a digital health system for monitoring pulmonary health status using a multimodal wireless sensor device. The technology uses a compact wearable with new integration of acoustics and biopotentials sensors to monitor cardiovascular and respiratory activity to provide comprehensive and fast health status monitoring. Furthermore, the small wearable sensor size may stick to human skin and record heart and lung activities to monitor respiratory health. This paper proposes a sensor data fusion method of lung sounds and cardiograms for potential real-time respiration pattern diagnostics, including respiratory episodes like low tidal volume and coughing. With a p -value of 0.003 for sound signals and 0.004 for electrocardiogram (ECG), preliminary tests demonstrated that it was possible to detect shallow breathing and coughing at a meaningful level.

Purpose: To investigate the agreement between an online nurse-assisted eye-screening tool and reference tests in older adults receiving home healthcare and to collect user experiences., Methods: Older adults (65+) receiving home healthcare were included. Home healthcare nurses assisted in administering the eye-screening tool at participants' homes. Approximately 2 weeks later, a researcher administered reference tests at participants' homes. Experiences from participants and home healthcare nurses were collected. Agreement in outcomes (distance and near visual acuity, with the latter being measured using two different optotypes, and macular problems) between the eye-screening tool and reference clinical testing was compared. A difference of less than ±0.15 logMAR was considered acceptable., Results: A total of 40 participants were included. Here, we describe the results for the right eye; results for the left eye were similar. The mean difference between the eye-screening tool and reference tests for distance visual acuity was 0.02 logMAR. The mean difference between the eye-screening tool and reference tests using two different optotypes for near visual acuity was 0.06 and 0.03 logMAR, respectively. The majority of the individual data points were within the ±0.15 logMAR threshold (75%, 51% and 58%, respectively). The agreement between tests for macular problems was 75%. Participants and home healthcare nurses were generally satisfied with the eye-screening tool, although remarks for further improvements were made., Conclusions: The eye-screening tool is promising for nurse-assisted eye screening in older adults receiving home healthcare, with the mostly satisfactory agreement. After implementing the eye-screening tool in practice, cost-effectiveness needs to be investigated., (© 2023 The Authors. Ophthalmic and Physiological Optics published by John Wiley & Sons Ltd on behalf of College of Optometrists.)

Purpose: Type III endoleak can be difficult to distinguish from Type I endoleak. Depending on the stent graft anatomy, the use of standard bifurcated endografts may not be technically feasible, and patients may have to be subject to an aorto-uni-iliac repair with femoral-femoral bypass or open surgery., Case Report: We report a case of an 86-year-old male who had a Type IIIb endoleak 20 years post EVAR which was characterized on angiography to be from a hole close to the bifurcation limb origin. The initial Talent (Medtronic, Santa Rosa, California) device had a 50 mm main body common trunk, which was not amenable to treatment with standard devices. He was successfully treated with a custom-made device with an inverted contralateral limb., Conclusions: Our case highlights the need for lifelong surveillance post EVAR as endoleak may present decades post initial EVAR. It also demonstrates that many Type III endoleak which were otherwise deemed unsuitable for treatment with standard devices may potentially be treatable with custom-made device (CMD). This solution preserves a percutaneous option in a now older person which avoids surgical bypass. Further studies are required to establish the durability of this treatment and survey for recurrence.

Mucosal immunity plays a critical role in the protection of teleost fish against infection, but mucosal immunoglobulin of important aquaculture species unique to Southeast Asia remained greatly understudied. In this study, the sequence of immunoglobulin T (IgT) from Asian sea bass (ASB) is described for the first time. IgT of ASB possesses the characteristic structure of immunoglobulin with a variable heavy chain and four CH4 domains. The CH2-CH4 domains and full-length IgT were expressed and CH2-CH4 specific antibody was validated against full-length IgT expressed in Sf9 III cells. Subsequent use of the anti-CH2-CH4 antibody in immunofluorescence staining confirmed the presence of IgT-positive cells in the ASB gill and intestine. The constitutive expression of ASB IgT was characterized in different tissues and in response to red-spotted grouper nervous necrosis virus (RGNNV) infection. The highest basal expression of secretory IgT (sIgT) was observed in the mucosal and lymphoid tissues such as the gills, intestine and head kidney. Following NNV infection, IgT expression was upregulated in the head kidney and mucosal tissues. Moreover, a significant increase in localized IgT was found in gills and intestines of infected fish on day 14 post-infection. Interestingly, a significant increase in NNV-specific IgT secretion was only observed in the gills of the infected group. Our results suggest that ASB IgT may play an important role in the adaptive mucosal immune responses against viral infection and could potentially be adapted as a tool for the evaluation of prospective mucosal vaccines and adjuvants for the species., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Chan, Carmen, Lee and Prabakaran.)

Background: Peritoneal dialysis catheter (PDC)-related infections account for significant morbidity, PD disruptions and costs. Patients with refractory exit-site or tunnel track infections without peritonitis may need catheter removal and reinsertion which can be complicated by bleeding, organ injury, catheter failure or malposition. Some patients may need to switch to haemodialysis in such a setting. An alternative is a salvage procedure. The purpose of this systematic review is to evaluate the safety and efficacy of salvage techniques., Methods: A comprehensive search of PubMed, Medline and Scopus databases was performed from inception to December 2021 in accordance with PRISMA guidelines. After a broad search, articles were stratified into two main categories for assessment: (1) cuff-shaving (CS) techniques and its variations of en-bloc resection (BR) and/or catheter diversion (CD) and (2) partial reimplantation with CD., Results: A total of 409 patients (445 salvage procedures) from 20 studies were included in analysis. Of 409 patients, 234 patients (57.2%) underwent 251 (56.4%) CS procedures and its variations, 163 patients (39.9%) underwent 182 (40.9%) partial PDC reimplantations with CD and 12 patients (2.7%) underwent local curettage. Overall PDC salvage rate after intervention was 73.2%. Overall PDC removal rate attributable to infection was 26.8%. Overall complication rate attributable to the procedures was 2.7%, with the most common complication being dialysate leakage ( n = 10) followed by PDC laceration ( n = 1) and subcutaneous haematoma ( n = 1). We also included a description of our technique of BR of infected tissue, CS and CD. In a series of six patients, the PDC salvage rate was 83.3% and median PDC survival after intervention was 10 months., Conclusion: PDC salvage techniques are relatively safe and provide reasonable catheter salvage rates in selected patients. Results of this review should lend weight to consideration of a salvage-first approach as an option in selected patients.

Background: An increasing aging population has become a pressing problem in many countries. Smart systems and intelligent technologies support aging in place, thereby alleviating the strain on health care systems., Objective: This study aims to identify decision-making factors involved in the adoption of smart home sensors (SHS) by older adults in Singapore., Methods: The study involved 3 phases: as an intervention, SHS were installed in older adults' homes (N=42) for 4 to 5 weeks; in-depth semistructured interviews were conducted with 18 older adults, 2 center managers, 1 family caregiver, and 1 volunteer to understand the factors involved in the decision-making process toward adoption of SHS; and follow-up feedback was collected from 42 older adult participants to understand the reasons for adopting or not adopting SHS., Results: Of the 42 participants, 31 (74%) adopted SHS after the intervention, whereas 11 (26%) did not adopt SHS. The reasons for not adopting SHS ranged from privacy concerns to a lack of family support. Some participants did not fully understand SHS functionality and did not perceive the benefits of using SHS. From the interviews, we found that the decision-making process toward the adoption of SHS technology involved intrinsic factors, such as understanding the technology and perceiving its usefulness and benefits, and more extrinsic factors, such as considering affordability and care support from the community., Conclusions: We found that training and a strong support ecosystem could empower older adults in their decision to adopt technology. We advise the consideration of human values and involvement of older adults in the design process to build user-centric assistive technology., (©Yuanyuan Cao, Mojisola Erdt, Caroline Robert, Nurhazimah Binte Naharudin, Shan Qi Lee, Yin-Leng Theng. Originally published in JMIR Aging (https://aging.jmir.org), 24.06.2022.)

Background: Chronic pain has a major impact on a patient's quality of life, affecting physical and psychological functioning. It has debilitating consequences on social and economic aspects too. This study aimed to explore the status of health-related quality of life (HRQoL) of Malaysian patients suffering from chronic non-malignant pain., Methods: Four hospitals offering pain clinic services were involved in this multicentre cross-sectional study conducted between June and September 2020. Adult patients who had been diagnosed with non-malignant chronic pain lasting for at least three months and able to communicate in English or Malay language were recruited in this study. Participants were informed about the study and were made aware that their participation was entirely voluntary. A battery of questionnaires consists of the EuroQol-5 dimensions-5 levels questionnaire (EQ-5D-5L) and the EuroQol visual analogue scale (EQ VAS), the Pain Self-Efficacy questionnaire (PSEQ) and the Pain Catastrophizing Scale (PCS) were self-administered by the patients. Besides, a structured questionnaire was used to collect their socio-demographic information, pain condition, sleep quality and working status. Participants' usage of pain medications was quantified using the Quantitative Analgesic Questionnaire (QAQ)., Results: A total of 255 patients participated in this study. A median EQ-5D index value of 0.669 (IQR: 0.475, 0.799) and a median EQ VAS score of 60.0 (IQR: 50.0, 80.0) were recorded. Malay ethnicity (Adj. B: 0.77; 95% CI: 0.029, 0.126; p = 0.002) and a higher level of self-efficacy (Adj. B: 0.008; 95% CI: 0.006, 0.011; p < 0.001) were predictors of a better HRQoL, while suffering from pain in the back and lower limb region (Adj. B: -0.089; 95% CI: - 0.142, - 0.036; p = 0.001), the use of a larger amount of pain medications (Adj. B: -0.013; 95% CI: - 0.019, - 0.006; p < 0.001), and a higher degree of pain magnification (Adj. B: -0.015; 95% CI: - 0.023, - 0.008; p < 0.001) were associated with a poorer HRQoL., Conclusions: These findings suggested that Malay ethnicity and a higher level of self-efficacy were predictors of a better HRQoL in patients with chronic pain, whereas pain-related factors such as higher usage of medication, specific pain site and pain magnification style were predictors of poorer HRQoL., (© 2022. The Author(s).)

Introduction: With the increasing complexity of healthcare problems worldwide, the demand for better-coordinated care delivery is on the rise. However, current hospital-based practices remain largely disease-centric and specialist-driven, resulting in fragmented care. This study aimed to evaluate the effectiveness and feasibility of an integrated general hospital (IGH) inpatient care model., Methods: Retrospective analysis of medical records between June 2018 and August 2019 compared patients admitted under the IGH model and patients receiving usual care in public hospitals. The IGH model managed patients from one location with a multidisciplinary team, performing needs-based care transition utilizing acuity tagging to match the intensity of care to illness acuity., Results: 5,000 episodes of IGH care entered analysis. In the absence of care transition in intervention and control, IGH average length of stay (ALOS) was 0.7 days shorter than control. In the group with care transition in intervention but not in control, IGH acute ALOS was 2 days shorter, whereas subacute ALOS was 4.8 days longer. In the presence of care transition in intervention and control, IGH acute ALOS was 6.4 and 10.2 days shorter and subacute ALOS was 15.8 and 26.9 days shorter compared with patients under usual care at acute hospitals with and without co-located community hospitals, respectively. The 30- and 60-days readmission rates of IGH patients were marginally higher than usual care, though not clinically significant., Discussions: The IGH care model maybe associated with shorter ALOS of inpatients and optimize resource allocation and service utilization. Patients with dynamic acuity transition benefited from a seamless care transition process., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Lai, Lee, Tan, Lau, Phua, Khoo, Gollamudi, Lim and Lim.)

Background: Carpal tunnel decompression is commonly performed open or endoscopically. Carpal tunnel release using the KnifeLight instrument (Stryker, Kalamazoo, MI) is an alternative method established in 2000., Method: The instrument has a cutting blade placed between two blunt flat tips with an integrated light source which helps to locate the tool blade by transillumination through the tissues. The instrument is inserted into an opening made in the wrist crease and transverse carpal ligament and used to divide the ligament., Conclusion: This is a simple, efficient, and reproducible alternative for carpal tunnel decompression.

Respiratory activity is an important vital sign of life that can indicate health status. Diseases such as bronchitis, emphysema, pneumonia and coronavirus cause respiratory disorders that affect the respiratory systems. Typically, the diagnosis of these diseases is facilitated by pulmonary auscultation using a stethoscope. We present a new attempt to develop a lightweight, comprehensive wearable sensor system to monitor respiration using a multi-sensor approach. We employed new wearable sensor technology using a novel integration of acoustics and biopotentials to monitor various vital signs on two volunteers. In this study, a new method to monitor lung function, such as respiration rate and tidal volume, is presented using the multi-sensor approach. Using the new sensor, we obtained lung sound, electrocardiogram (ECG), and electromyogram (EMG) measurements at the external intercostal muscles (EIM) and at the diaphragm during breathing cycles with 500 mL, 625 mL, 750 mL, 875 mL, and 1000 mL tidal volume. The tidal volumes were controlled with a spirometer. The duration of each breathing cycle was 8 s and was timed using a metronome. For each of the different tidal volumes, the EMG data was plotted against time and the area under the curve (AUC) was calculated. The AUC calculated from EMG data obtained at the diaphragm and EIM represent the expansion of the diaphragm and EIM respectively. AUC obtained from EMG data collected at the diaphragm had a lower variance between samples per tidal volume compared to those monitored at the EIM. Using cubic spline interpolation, we built a model for computing tidal volume from EMG data at the diaphragm. Our findings show that the new sensor can be used to measure respiration rate and variations thereof and holds potential to estimate tidal lung volume from EMG measurements obtained from the diaphragm.

Objectives: Deep venous stenting with intravascular ultrasound (IVUS) guidance is gaining favour as the treatment modality of choice for symptomatic ilio-femoral venous occlusive disease. The aim was to determine the short-term patency and symptomatic relief gained using the Bard Venovo™ and Optimed Sinus Obliquus™ stents in the endovascular treatment of non-thrombotic iliac vein lesions (NIVL) and post-thrombotic venous obstruction (PTO) from two Asian tertiary vascular centres., Methods: Sixty patients (males = 21/60 (35.0%); median age 67 years (interquartile range 54-77)) who underwent IVUS interrogation and ilio-femoral stenting (June 2018-May 2019) in two Asian centres were prospectively followed. Clinical improvement was determined by the revised Venous Clinical Severity Score (rVCSS), pain using the Visual Analogue Scale (VAS) and ulcer healing rate. Patency rates were evaluated using Duplex ultrasound and computer tomography venogram., Results: Seventy-one legs were interrogated and stented; 11/60 (18.3%) patients had a bilateral procedure. Indications for surgery were PTO ( n  = 11/71 (15.5%)) and NIVL ( n  = 60/71 (84.5%)). Twenty-seven of 71 (38.0%) patients had CEAP 6 disease. The median follow-up was 283 (interquartile range 211-370) days. Technical and procedural success was both 100%. Twenty-one of 71 (29.6%) legs had a combination of Venovo™ and Sinus Obliquus™ stents inserted for concurrent ilio-caval and iliac lesions. There were no major post-operative complications. Six-month primary, assisted primary and secondary patency rates were 94.1, 97.1 and 100%, respectively. There were no stent fractures. Mean rVCSS and VAS improved from 12.26 (±3.31) to 4.33 (±2.78) and 6.97 (±1.38) to 2.03 (±1.65), respectively, at three months (p < 0.01). Complete ulcer healing was seen in 27/27 (100%) patients at three months., Conclusion: Use of Venovo™ and Sinus Obliquus™ stents for symptomatic ilio-femoral venous disease showed excellent six-month primary patency rate with no stent fractures. There were significant clinical improvement and low-device-related complications. Longer follow-up is awaited to see how these dedicated venous stents perform.

Social cognition requires neural processing, yet a unifying method linking particular brain activities and social behaviors is lacking. Here, we embedded mobile edge computing (MEC) and light emitting diodes (LEDs) on a neurotelemetry headstage, such that a particular neural event of interest is processed by the MEC and subsequently an LED is illuminated, allowing simultaneous temporospatial visualization of that neural event in multiple, socially interacting mice. As a proof of concept, we configured our system to illuminate an LED in response to gamma oscillations in the basolateral amygdala (BLA gamma) in freely moving mice. We identified (i) BLA gamma responses to a spider robot, (ii) affect-related BLA gamma during conflict, and (iii) formation of defensive aggregation under a threat by the robot, and reduction of BLA gamma responses in the inner-located mice. Our system can provide an intuitive framework for examining brain-behavior connections in various ecological situations and population structures., (Copyright © 2020 The Authors, some rights reserved; exclusive licensee American Association for the Advancement of Science. No claim to original U.S. Government Works. Distributed under a Creative Commons Attribution NonCommercial License 4.0 (CC BY-NC).)

Backgrounds/aims: This study aims to describe our experience with minimally-invasive distal pancreatectomies, with emphasis on the comparison between robotic distal pancreatectomy (RDP) and laparoscopic distal pancreatectomy (LDP)., Methods: Retrospective review of 102 consecutive RDP and LDP from 2006 to 2019 was performed., Results: There were 27 and 75 patients who underwent RDP and LDP, respectively. There were 12 (11.8%) open conversions and 16 (15.7%) patients had major (＞grade 2) morbidities. Patients who underwent RDP had significantly higher rates of splenic preservation (44.4% vs. 13.3%, p=0.002), higher rates of splenic-vessel preservation (40.7% vs. 9.3%, p=0.001), higher median difficulty score (5 vs. 3, p=0.002) but longer operation time (385 vs. 245 minutes, p＜0.001). The rate of open conversion tended to be lower with RDP (3.7% vs. 14.7%, p=0.175)., Conclusions: In our institution practice, both RDP and LDP were safe and effective. The use of RDP appeared to be complementary to LDP, allowing us to perform more difficult procedures with comparable postoperative outcomes.

Gait signifies the walking pattern of an individual. It may be normal or abnormal, depending on the health condition of the individual. This paper considers the development of a gait sensor network system that uses a pair of wireless inertial measurement unit (IMU) sensors to monitor the gait cycle of a user. The sensor information is used for determining the normality of movement of the leg. The sensor system places the IMU sensors on one of the legs to extract the three-dimensional angular motions of the hip and knee joints while walking. The wearable sensor is custom-made at San Diego State University with wireless data transmission capability. The system enables the user to collect gait data at any site, including in a non-laboratory environment. The paper also presents the mathematical calculations to decompose movements experienced by a pair of IMUs into individual and relative three directional hip and knee joint motions. Further, a new approach of gait pattern classification based on the phase difference angles between hip and knee joints is presented. The experimental results show a potential application of the classification method in the areas of smart detection of abnormal gait patterns.

Background: The behavior of medication nonadherence is distinguished into primary and secondary nonadherence. Primary nonadherence (PNA) is not as thoroughly studied as secondary nonadherence., Objective: To explore and synthesize contributing factors to PNA based on the existing body of literature., Methods: A search was performed on the PubMed, PsycINFO, CINAHL, and ScienceDirect databases to identify previously published scholarly articles that described the "factors," "reasons," "determinants" or "facilitators" of PNA. The alternate spelling of "nonadherence" was used as well. The effect that the articles had in the research community, as well as across social media, was also explored., Results: 22 studies met the inclusion criteria for this review. The PNA factors that the studies identified were diverse, spanning economic, social, and medical dimensions. A multilevel classification method was applied to categorize the factors into 5 broad groups-patient, medication, health care provider, health care system, and socioeconomic factors. Patient factors were reported the most. Some groups overlapped and shared a dynamic causal relationship where one group influenced the outcome of the other., Conclusions: Like all nonadherence behaviors, PNA is multifaceted with highly varied contributing factors that are closely associated with one another. Given the multidimensional nature of PNA, future intervention studies should focus on the dynamic relationship between these factor groups for more efficient outcomes., Disclosures: This research was supported by the National Research Foundation Singapore under its National Innovation Challenge on Active and Confident Ageing (Award No. MOH/NIC/CAHIG03/2016) and administered by the Singapore Ministry of Health's National Medical Research Council. This research was also supported by the National Research Foundation within the Prime Minister's Office of Singapore, under its Science of Research, Innovation and Enterprise Programme (SRIE Award No. NRF2014-NRF-SRIE001-019). The authors have no relevant conflicts of interest to disclose.

Background: Recently, many studies have been conducted to investigate the effects of exergames on the social well-being of older adults., Objective: The aim of this paper is to synthesize existing studies and provide an overall picture on the social effects of exergames on older adults., Methods: A comprehensive literature search with inclusive criteria was conducted in major social science bibliographic databases. The characteristics of exergames, participants, methodology, as well as outcome measurements were extracted from the relevant studies included in the review. The bibliometric and altmetric outreach of the included studies were also investigated., Results: A total of 10 studies were included in the review, with 8 studies having used the Nintendo Wii platform. Most of the studies recruited healthy older adults from local communities or senior activity centers. Three groups of social-related outcomes have been identified, including emotion-related, behavior-related, and attitude-related outcomes. A metric analysis has shown that the emotion-related and behavior-related outcomes received high attention from both the academic community and social media platforms., Conclusions: Overall, the majority of exergame studies demonstrated promising results for enhanced social well-being, such as reduction of loneliness, increased social connection, and positive attitudes towards others. The paper also provided implications for health care researchers and exergame designers., (©Jinhui Li, Mojisola Erdt, Luxi Chen, Yuanyuan Cao, Shan-Qi Lee, Yin-Leng Theng. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 28.06.2018.)

Respiratory activity is an essential vital sign of life that can indicate changes in typical breathing patterns and irregular body functions such as asthma and panic attacks. Many times, there is a need to monitor breathing activity while performing day-to-day functions such as standing, bending, trunk stretching or during yoga exercises. A single IMU (inertial measurement unit) can be used in measuring respiratory motion; however, breathing motion data may be influenced by a body trunk movement that occurs while recording respiratory activity. This research employs a pair of wireless, wearable IMU sensors custom-made by the Department of Electrical Engineering at San Diego State University. After appropriate sensor placement for data collection, this research applies principles of robotics, using the Denavit-Hartenberg convention, to extract relative angular motion between the two sensors. One of the obtained relative joint angles in the "Sagittal" plane predominantly yields respiratory activity. An improvised version of the proposed method and wearable, wireless sensors can be suitable to extract respiratory information while performing sports or exercises, as they do not restrict body motion or the choice of location to gather data., Competing Interests: The authors declare no conflict of interest.

Over the years of research, Electroencephalogram (EEG) signal study has grown to give promising outcomes. A lot of research has been done on implementing brain-computer-interfaces, and the brain-computer interface (BCI) algorithm as well as the study of the effects of different stimuli on brain signals. This paper intends to make progress toward that goal by developing a responsive real-time EEG-based brain-to-machine communication system by generating distinct EEG signals at will and identification of the explicit pattern that they reflect for the presented self-induced internal visual and auditory stimuli. The brain-to-machine communication system delivers the real-time capture, analysis, and visualization of the brain signal patterns that can be used for smart medical applications such as rehabilitation robotic control, smart wheelchair, etc.

Coenzyme Q 10 (CoQ 10 ), a benzoquinone present in most organisms, plays an important role in the electron-transport chain, and its deficiency is associated with various neuropathies and muscular disorders. CoQ 10 is the only lipid-soluble antioxidant found in humans, and for this, it is gaining popularity in the cosmetic and healthcare industries. To meet the growing demand for CoQ 10 , there has been considerable interest in ways to enhance its production, the most effective of which remains microbial fermentation. Previous attempts to increase CoQ 10 production to an industrial scale have thus far conformed to the strategies used in typical metabolic engineering endeavors. However, the emergence of new tools in the expanding field of synthetic biology has provided a suite of possibilities that extend beyond the traditional modes of metabolic engineering. In this review, we cover the various strategies currently undertaken to upscale CoQ 10 production, and discuss some of the potential novel areas for future research.

All neural information systems (NIS) rely on sensing neural activity to supply commands and control signals for computers, machines and a variety of prosthetic devices. Invasive systems achieve a high signal-to-noise ratio (SNR) by eliminating the volume conduction problems caused by tissue and bone. An implantable brain machine interface (BMI) using intracortical electrodes provides excellent detection of a broad range of frequency oscillatory activities through the placement of a sensor in direct contact with cortex. This paper introduces a compact-sized implantable wireless 32-channel bidirectional brain machine interface (BBMI) to be used with freely-moving primates. The system is designed to monitor brain sensorimotor rhythms and present current stimuli with a configurable duration, frequency and amplitude in real time to the brain based on the brain activity report. The battery is charged via a novel ultrasonic wireless power delivery module developed for efficient delivery of power into a deeply-implanted system. The system was successfully tested through bench tests and in vivo tests on a behaving primate to record the local field potential (LFP) oscillation and stimulate the target area at the same time., Competing Interests: The authors declare no conflict of interest.

There has recently been an increasing interest in the generation of a sound field that is audible in one spatial region and inaudible in an adjacent region. The method proposed here ensures the control of the amplitude and phase of multiple acoustic sources in order to maximize the acoustic energy difference between two adjacent regions while also ensuring that evenly distributed source strengths are used. The performance of the method proposed is evaluated by computer simulations and experiments with real loudspeaker arrays in the shape of a circle and a sphere. The proposed method gives an improvement in the efficiency of radiation into the space in which the sound should be audible, while maintaining the acoustic pressure difference between two acoustic spaces. This is shown to give an improvement of performance compared to the contrast control method previously proposed.

We have developed a low cost and a highly compact bio-chip detection technology by modifying a commercially available optical pick-up head for CD/DVD. The highly parallel and miniaturized hybridization assays are addressed by the fluorescence emitted by the DNA-chip using the optical pick-up head. The gap between the objective lens and the bio-chip is regulated by the focus servo during the detection of the fluorescence signal. High-resolution and high-speed scanning is effectively realized by this simple scanning system instead of utilizing high-precision mechanism. Regardless of achievement of effective detection mechanism, the technique of fluorescence detection can prove to be disadvantageous because of the low stability of the dyes with low S/N ratio and an expensive setup such as a PMT detector is always required for fluorescence detection. We propose, for the first time, a novel scanning scheme based on metal nanoparticles in combination with a bio-chip substrate having a phase change recording layer. We found that the phase change process is highly affected by the existence of the densely condensed metal nanoparticles on the phase change layer during the writing process of the pick-up head.

We obtained scanning near-field optical microscopy images to study the excitation of surface plasmons on metallic dots fabricated using scanning probe lithography. Gold nano-dots were fabricated by applying electric voltages to conducting probes installed in an atomic force microscope using the mechanism of field-induced diffusion and nano-oxidation plus Au-coating. High spatial resolution of scanning near-field optical microscopy revealed a 'bifold' pattern of surface plasmon mode on fabricated Au dots in the polarization direction of incident light. We found that scanning near-field optical microscopy imaging combined with scanning probe lithography is able to provide a systematic study of surface plasmon excitation on nano-metallic structures.

This study explored social distance and trait attribution and the relationship between the two variables in persons of four Southeast Asian ethnic groups. 100 Cambodians, 102 Hmong, 102 Laotians, and 101 Vietnamese in the United States were administered a modified Bogardus Social Distance Scale with respect to seven different ethnic groups (the other three Southeast Asian groups, African American, Hispanic, and White), and rated these other groups on 10 traits: friendly and likable, in good health, unattractive, law abiding, hardworking, loyal, peaceful, unfair and dishonest, unintelligent, and have good morals. Cambodians expressed willingness to have the closest social distance with Whites and Laotians and their trait attributions were more favorable for these two groups. Theoretical and practical implications were suggested.

Two strains of cucumber mosaic virus (CMV) differed in three characteristics of value for cross-protection experiments. Their virions and also two of their double-stranded RNAs could be separated and distinguished by electrophoresis on polyacrylamide gels, and the symptoms of one strain were milder than the other in tobacco, tomato, and squash. The mild strain, CMV-S, protected plants of these three hosts from the effects of the second strain, CMV-P, and also prevented the accumulation of virions and ds RNAs of the challenge strain. Protection was detected in leaves inoculated with the challenge strain and also in later formed leaves. The only exception to this result was the accumulation of ds RNAs and to a lesser extent virions of the challenge strain when infectious viral RNA was used as the challenge inoculum instead of virus particles. This breakdown of cross protection occurred only in those leaves inoculated with the challenge strain RNA. No accumulation of challenge ds RNAs or virions occurred in later formed leaves. Tomato and tobacco plants infected with CMV-S were not protected from infection by tobacco mosaic virus.