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Shrihari Jathanakodi,1 Charlotte Both,1 Ines Brueckmann,1 Laura Rose,2 Nahal Nasseri,3 Jean-Pierre Raynauld,4 Neeraj Narula5 1Sandoz Group AG, Holzkirchen, Germany; 2Sandoz Inc., Princeton, NJ, USA; 3Sandoz Canada Inc., Boucherville, QC, Canada; 4Division of Rheumatology, Department of Medicine, Montreal Institute of Rheumatology, Université de Montréal, Montreal, QC, Canada; 5Division of Gastroenterology, Department of Medicine, and Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, ON, CanadaCorrespondence: Neeraj Narula, Division of Gastroenterology, Department of Medicine, Farncombe Family Digestive Health Research Institute, McMaster University, 1280 Main Street West, Hamilton, ON, L8S 4K1, Canada, Tel +1 905 521 2100, Email neeraj.narula@medportal.caPurpose: Medication delivery device design impacts treatment satisfaction, adherence, and compliance in patients receiving biologics. This survey assessed autoinjector attributes that are important to patients, and assessed patient perceptions and preferences between an adalimumab biosimilar autoinjector (Hyrimoz® SensoReady® Pen [SDZ-ADL pen]) and the reference adalimumab autoinjector (Humira® Pen [ref-ADL pen]) in patients with rheumatoid arthritis (RA) or Crohn’s disease (CD) in Canada.Patients and Methods: In this survey, adult patients were recruited for web-assisted telephone interviews. Patients had ≥ 3 months’ experience with the ref-ADL pen and 1– 12 months’ experience with the SDZ-ADL pen.Results: The survey included 120 patients with RA (n = 32) or CD (n = 88). Mean experience with the ref-ADL pen was 7 years for RA or 5 years for CD vs 9 months with the SDZ-ADL pen. The most important autoinjector attributes were the ability to use the pen independently and the ease and simplicity of self-injection. When comparing the two autoinjectors, patients significantly preferred the SDZ-ADL pen over the ref-ADL pen for nearly every attribute evaluated, with the greatest differences reported for visual and audible feedback mechanisms, ease of self-injection, and ability to use the device independently. Overall, 82% of patients preferred the SDZ-ADL pen over the ref-ADL pen, with buttonless activation and less injection pain being the main drivers for this preference.Conclusion: Patients with RA or CD indicated a preference for the SDZ-ADL pen over the ref-ADL pen, independent of the duration of use of the pen. The preference for a biosimilar device within 1 year of switching provides reassurance of rapid patient acceptance of biosimilars and may simplify the switching process. These results confirm the importance of ensuring autoinjector design supports independent self-administration of medication and align with previous data showing high patient satisfaction with the SDZ-ADL pen.Keywords: adalimumab, adherence, autoinjector, biosimilar, patient preference

Background and Aim: Presently, lecturing is widely used as a teaching method at all Universities particularly, if the aim is to convey the materials to a large class of students. However, nowadays recording the voice of the lecturer has become a common practice and has introduced as a new learning technique. There are studies in which researchers acknowledged this method and have mentioned many advantages for it. On the other hand, many others have declared that this method which might be used for students with certain disabilities may cause distraction and reduces the learning that can occur. The purpose of this study was to compare the method of recorded lectures with note-making in class on undergraduate physiotherapy students' learning. Materials and Methods: In a descriptive- cross sectional study 29 undergraduate physiotherapy students classified in two groups according to studying methods; one group used the method of note-making in class and the other one utilized the method of the voice recording. Four dependent variables including; written exam grades, teacher's evaluation scores, course satisfaction scores, and students' grades on difficult questions were measured. Results: There were no significant differences between two groups in written exam grades (P=0.92), teacher's evaluation scores (P=0.55), course satisfaction scores (P=0.57), and on difficult questions grades (P=0.53). Conclusion: Using voice recorders had no significant effect on students' learning. The results are related to one specific course and can not be extended to other courses. [ABSTRACT FROM AUTHOR]

Ankle sprains are one of the most common injuries during sport activities. Gait impairment is a significant problem in ankle sprained cases, leading to decreased activity and limitations in function. The early assessment of sprained ankle is concomitant with early treatment that can limit the necessary time of rest for the patient. Limiting the rest time is very important specially, for an injured athlete who wants to decrease the time lost in practice. In this study the design and construction of a simple and low cost embedded pressure sensor system with application in signal processing works is presented. This paper is focused on the ability of the constructed system in addressing the hypothesis that gait characteristics differ in normal people and in patients with sprained ankle. [ABSTRACT FROM AUTHOR]

Background: Adenomyosis can lead to infertility and failure of in vitro fertilization. Limited evidence suggests that the use of long-term treatment with gonadotropin-releasing hormone (GnRH) agonists followed by frozen-thawed embryo transfer (FET) may be the preferred approach for women with adenomyosis., Objective: The aim of this randomized controlled trial is to compare the efficacy of an ultra-long GnRH agonist with standard downregulation in women with adenomyosis undergoing FET., Materials and Methods: This randomized controlled trial enrolled 72 women with adenomyosis diagnosed by sonographic criteria who underwent FET cycles at the Avicenna Infertility Center. These women were randomly assigned to two equal groups: one received GnRH agonist treatment for three months before the FET cycle and the other served as the standard downregulation group. Results were reported as chemical and clinical pregnancy rates., Results: The two groups were similar in age, body mass index, anti-Müllerian hormone levels, number of previous pregnancies and miscarriages, presence of uterine myomas, and endometriosis. However, the total dose of estradiol used until embryo transfer was significantly higher in the ultra-long GnRH agonist group than in the standard group (96.14 mg vs. 80.52 mg, p-value = 0.004). Nevertheless, chemical and clinical pregnancy rates did not differ significantly between the two groups., Conclusions: Ultra-long GnRH agonist downregulation did not improve the chemical and clinical pregnancy rate in the FET cycle in women with adenomyosis compared with standard GnRH agonist downregulation in the other words, ultra-long GnRH agonist downregulation is not superior to standard protocol. In women with adenomyosis (without history of endometriosis), downregulation of standard GnRH agonists prior to frozen-thawed embryo transfer may be the preferred embryo transfer protocol to gain higher clinical/chemical pregnancy rate., Trial Registration: Clinical trial registry: IRCT20160717028967N9, available at: https://irct.behdasht.gov.ir/trial/36103 ., (© 2024. The Author(s).)

Purpose: Medication delivery device design impacts treatment satisfaction, adherence, and compliance in patients receiving biologics. This survey assessed autoinjector attributes that are important to patients, and assessed patient perceptions and preferences between an adalimumab biosimilar autoinjector (Hyrimoz ® SensoReady ® Pen [SDZ-ADL pen]) and the reference adalimumab autoinjector (Humira ® Pen [ref-ADL pen]) in patients with rheumatoid arthritis (RA) or Crohn's disease (CD) in Canada., Patients and Methods: In this survey, adult patients were recruited for web-assisted telephone interviews. Patients had ≥ 3 months' experience with the ref-ADL pen and 1-12 months' experience with the SDZ-ADL pen., Results: The survey included 120 patients with RA (n = 32) or CD (n = 88). Mean experience with the ref-ADL pen was 7 years for RA or 5 years for CD vs 9 months with the SDZ-ADL pen. The most important autoinjector attributes were the ability to use the pen independently and the ease and simplicity of self-injection. When comparing the two autoinjectors, patients significantly preferred the SDZ-ADL pen over the ref-ADL pen for nearly every attribute evaluated, with the greatest differences reported for visual and audible feedback mechanisms, ease of self-injection, and ability to use the device independently. Overall, 82% of patients preferred the SDZ-ADL pen over the ref-ADL pen, with buttonless activation and less injection pain being the main drivers for this preference., Conclusion: Patients with RA or CD indicated a preference for the SDZ-ADL pen over the ref-ADL pen, independent of the duration of use of the pen. The preference for a biosimilar device within 1 year of switching provides reassurance of rapid patient acceptance of biosimilars and may simplify the switching process. These results confirm the importance of ensuring autoinjector design supports independent self-administration of medication and align with previous data showing high patient satisfaction with the SDZ-ADL pen., Competing Interests: Shrihari Jathanakodi and Charlotte Both were employees of Sandoz Group AG. Ines Brueckmann is an employee of Sandoz Group AG. Laura Rose is an employee of Sandoz Inc. Nahal Nasseri is an employee of Sandoz Canada Inc. Jean-Pierre Raynauld has been a speaker or advisor for AbbVie, Amgen, BIOJAMP, Janssen, Novartis, Organon, Orimed, Pfizer, Sandoz, Sanofi, and UCB. Neeraj Narula has been a speaker or advisor for AbbVie, Bristol Myers Squibb, Eli Lilly, Ferring, Fresenius Kabi, Innomar Strategies, Iterative Health, Janssen, Merck, Pfizer, Sandoz, Takeda, and Viatris. The authors report no other conflicts of interest in this work., (© 2024 Jathanakodi et al.)

Sexually active adolescents tend to have a wider range of psychosocial problems, including depression, anger, poor academic achievement, low self-esteem, and substance use. Developing a high-quality and curriculum-based comprehensive sexuality education (CSE) program is of great importance for adolescents following Iranian culture. Due to the lack of such an educational program, the purpose of this study was to investigate the effectiveness of psycho-religious CSE upon anger and depression of Iranian female adolescents, as well as the relationship of quality family relationships and birth order. The research design is quasi-experimental with pre-test and post-test with experimental and control groups. The statistical population of this study comprised all Iranian female adolescents aged 15 to 18 years in Mashhad who participated in this workshop voluntarily. For data collection, the Child and Adolescent Depression Inventory and Spielberger's State-Trait Anger Expression Inventory (STAXI) were used. SPSS 21 software and analysis of variance (ANOVA) and covariance (ANCOVA) were used for data analysis. The results showed that there was a significant difference in the mean difference between depression and anger in the control and experimental groups (p-Value < 0.05). The results also showed a significant relationship between birth order and the quality of family relationships on depression and anger. Psycho-religious-based SE can reduce depression and anger in female students. These findings can be used in planning educational interventions with a psycho-religious-based approach to reducing anger, depressive symptoms and dangerous sexual behaviors among adolescents., (© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

There is a clinical need to measure local tissue oxygen saturation (StO 2 ), oxy-, deoxy- and total haemoglobin concentration ([O 2 Hb], [HHb], [tHb]) in human tissue. The aim was to validate an oximeter called OxyVLS applying visible light spectroscopy (VLS) to determine these parameters without needing to assume a reduced scattering coefficient (μ' s ). This problem is solved by appropriate calibrations. Compared to near-infrared spectroscopy (NIRS), OxyVLS determines the oxygenation in a much smaller more superficial volume of tissue, which is useful in many clinical cases. OxyVLS was validated in liquid phantoms with known StO 2 , [tHb], and μ' s and compared to frequency domain NIRS as a reliable reference. OxyVLS showed a high accuracy for all the mentioned parameters and was even able to measure μ' s . Thus, OxyVLS was successfully tested in vitro., (© 2022. Springer Nature Switzerland AG.)

Background: Mobility impairment is common in persons with multiple sclerosis (pwMS) and can be assessed with clinical tests and surveys that have restricted ecological validity. Commercial research-based accelerometers are considered to be more valuable as they measure real-life mobility. Smartphone accelerometry might be an easily accessible alternative. Objective: To explore smartphone accelerometry in comparison to clinical tests, surveys, and a wrist-worn ActiGraph in pwMS and controls. Methods: Sixty-seven pwMS and 70 matched controls underwent mobility tests and surveys. Real-life data were collected with a smartphone and an ActiGraph over 7 days. We explored different smartphone metrics in a technical validation course and computed afterward correlation between ActiGraph (steps per minute), smartphone accelerometry (variance of vector magnitude), clinical tests, and surveys. We also determined the ability to separate between patients and controls as well as between different disability groups. Results: Based on the technical validation, we found the variance of the vector magnitude as a reliable estimate to discriminate wear time and no wear-time of the smartphone. Due to a further association with different activity levels, it was selected for real-life analyses. In the cross-sectional study, ActiGraph correlated moderately ( r = 0.43, p < 0.05) with the smartphone but less with clinical tests (rho between |0.211| and |0.337|). Smartphone data showed stronger correlations with age (rho = -0.487) and clinical tests (rho between |0.565| and |0.605|). ActiGraph only differed between pwMS and controls ( p < 0.001) but not between disability groups. At the same time, the smartphone showed differences between pwMS and controls, between RRMS and PP-/SPMS, and between participants with/without ambulatory impairment (all p < 0.001). Conclusions: Smartphone accelerometry provides better estimates of mobility and disability than a wrist-worn standard accelerometer in a free-living context for both controls and pwMS. Given the fact that no additional device is needed, smartphone accelerometry might be a convenient outcome of real-life ambulation in healthy individuals and chronic diseases such as MS., (Copyright © 2020 Zhai, Nasseri, Pöttgen, Gezhelbash, Heesen and Stellmann.)

Objective: To compare the efficacy of honey mouthwash 12.5% and chlorhexidine solution 0.2% to reduce the rate of oropharyngeal bacterial colonization in mechanically-ventilated patients., Methods: This study was a randomized, single blind, phase Ⅲ controlled clinical trial. Sixty patients newly admitted to internal and trauma Intensive Care Units of the two educational hospitals of Sanandaj city affiliated with Kurdistan University of Medical Sciences were selected by convenience sampling and allocated to two groups of 30 patients using random blocks design. In each group, the mouthwash was applied twice a day for four consecutive days. Swab samples were taken from the mouth and throat of all patients three times a day (pre- intervention, two days, and four days after the intervention) and then the samples were transferred onto the blood agar and eosin methylene blue (EMB) culture plates and investigated for bacterial growth and colonization after 24-48 h., Results: The findings showed that oropharyngeal colonization was not significantly different between the two groups, pre-intervention, two days, and four days after the intervention (P > 0.05). Rinsing with honey mouthwash 12.5% led to the inhibition of Staphylococcus aureus and Pseudomonas aeruginosa on the fourth day of the intervention in all samples., Conclusion: None of the studied solutions contributed to the reduction of oropharyngeal bacterial colonization. It seems that the growth inhibition of Staphylococcus aureus and Pseudomonas aeruginosa by the honey 12.5% mouthwash in mechanically-ventilated patients need further investigation.

Background: The present study aimed to introduce a rapid transmission dosimetry through an electronic portal-imaging device (EPID) to achieve two-dimensional (2D) dose distribution for homogenous environments., Material and Methods: In this Phantom study, first, the EPID calibration curve and correction coefficients for field size were obtained from EPID and ionization chamber. Second, the EPID off-axis pixel response was measured, and the grey-scale image of the EPID was converted into portal dose image using the calibration curve. Next, the scattering contribution was calculated to obtain the primary dose. Then, by means of a verified back-projection algorithm and the Scatter-to-Primary dose ratio, a 2D dose distribution at the mid-plane was obtained., Results: The results obtained from comparing the transmitted EPID dosimetry to the calculated dose, using commercial treatment planning system with gamma function while there is 3% dose difference and 3mm distance to agreement criteria, were in a good agreement. In addition, the pass rates of γ < 1 was 94.89% for the homogeneous volumes., Conclusion: Based on the results, the method proposed can be used in EPID dosimetry., (Copyright: © Shiraz University of Medical Sciences.)

Background: Educational justice is one of the fundamental dimensions of social justice, and the progress of each society depends on its realization. Since students are engaged in the educational process, recognizing their viewpoints can provide useful guidance to correct existing problems. The purpose of this study is to investigate the observance of educational justice from the viewpoint of medical students in southeastern Iran., Methodology: This cross-sectional study was carried out on 200 students of Zahedan University of Medical Sciences, southeastern Iran, in 2017 by stratified sampling. The tool for measuring organizational justice was a questionnaire. The validity of the questionnaire was confirmed by content validity method, and its reliability was confirmed by Cronbach's alpha (0.8). Descriptive statistics (frequency and percentage), Chi-square test, and analysis of variance (ANOVA) test were used to analyze data., Results: The mean age of students was 21.7 ± 2.91 years. Fifty percent of students assessed the educational justice as good to excellent, and based on a general score, educational justice was observed in 73.2% of cases. The one-way ANOVA showed a significant difference between the scores of educational justice from the viewpoints of students in different faculties of Zahedan University of Medical Sciences ( P < 0.001)., Conclusion: According to the results, students' needs for achieving educational justice have been identified in this study. This study can provide useful guidance to correct existing problems and help policymakers in Zahedan University of Medical Sciences to achieve a full educational justice., Competing Interests: There are no conflicts of interest., (Copyright: © 2019 Journal of Education and Health Promotion.)

It is essential to measure tissue oxygen saturation (StO 2 ) locally and in thin layers of tissue, for example, the bronchial mucosa, skin flaps and small bones. Visible light spectroscopy (VLS) with a shallow penetration depth is suitable method. Although several VLS algorithms have been developed and described, they have not yet been compared to each other. This hinders attempts to compare the clinical results obtained by different algorithms. To address this issue, we compared the algorithms of Harrison, Knoefel, Pittman-Duling, Sato and our OxyVLS oximeter, which applies the algorithm from Wodick and Lübbers, in a liquid phantom with optical properties of human tissue. We generally observed considerable differences between the algorithms, which were StO 2 dependent. Exceptions were OxyVLS and Sato, showing a high level of agreement with negligible StO 2 dependency. In spite of the considerable deviation between the other algorithms, the difference of StO 2 between them in clinically normal StO 2 was <10%. We did not observe any dependency of the algorithms on hemoglobin content of the phantom or temperature., (© 2018 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.)

The aim was to determine the precision of a noninvasive near-infrared spectroscopy (NIRS)-based tissue oximeter (OxyPrem v1.3). Using a linear mixed-effects model, we quantified the variability for cerebral tissue oxygenation (StO2) measurements in 35 preterm neonates to be 2.64%, a value that meets the often-articulated clinicians' demand for a precise tissue oxygenation measurement. We showed that the variability of StO2 values measured was dominated by spontaneous systemic hemodynamic fluctuations during the measurement, meaning that precision of the instrument was actually even better. Based on simultaneous and continuous measurements of peripheral arterial oxygenation and cerebral StO2 with a second sensor, we were able to determine and quantify the physiological instability precisely. We presented different methods and analyses aiming at reducing this systematic physiological error of in vivo precision assessments. Using these methods, we estimated the precision of the OxyPrem tissue oximeter to be   ≤  1.85  %  . With our study, we deliver relevant information to establish highly precise cerebral oxygenation measurements with NIRS-based oximetry, facilitating the further development toward a substantially improved diagnosis and treatment of patients with respect to brain oxygenation., ((2018) COPYRIGHT Society of Photo-Optical Instrumentation Engineers (SPIE).)

Objective: The Goal Oriented controL of Diabetes in the Elderly populatioN (GOLDEN) Program assessed the management of older persons with type 2 diabetes in Canadian primary care., Methods: Data were extracted from the records of 833 consecutively identified persons 65 years of age or older who had type 2 diabetes and were taking 1 antihyperglycemic agent or more; they were managed by 64 physicians from 36 Ontario clinics., Results: More than half (53%) had glycated hemoglobin (A1C) levels of 7.0% or lower, 41% had blood pressure levels below 130/80 mm Hg, and 73% had low-density lipoprotein levels of 2.0 mmol/L or lower; 19% met all 3 criteria. Over the past year, 11% had been assessed for frailty, 16% for cognitive dysfunction and 19% for depression; 88% were referred for eye checkups, and 83% had undergone foot examinations. One-tenth were taking 4 or more antihyperglycemic agents, 87% statins and 52% an angiotensin-converting enzyme inhibitor. More than half of those with high clinical complexity had A1C levels of 7.0% or lower; of these, one-third were taking a sulfonylurea, and one-fifth were taking insulin. In the patients with A1C levels of 7.0% or above and low clinical complexity, there was often no up-titration or initiation of additional antihyperglycemic agents., Conclusions: Older persons with type 2 diabetes often have multiple comorbidities. Unlike eye and foot examinations, there was less emphasis on evaluating for frailty, cognitive dysfunction and depression. The GOLDEN patients had generally well-controlled glycemic, blood pressure and cholesterol profiles, but whether these would be reflected in a "sicker" population is not known. Personalized strategies are necessary to avoid undertreatment of "healthy" older patients and overtreatment of the frail elderly., (Copyright © 2017 Diabetes Canada. Published by Elsevier Inc. All rights reserved.)

Several cerebral oximeters based on near-infrared spectroscopy (NIRS) are commercially available that determine tissue oxygen saturation (StO 2 ). One problem is an inconsistency of StO 2 readings between different brands of instruments. Liquid blood phantoms mimicking optical properties of the neonatal head enable quantitative device comparisons. However, occasionally, the reduced scattering coefficient (μ s ') of these phantoms decreases over time., Aim: To investigate whether this decrease in μ s ' affects the validity of comparison of these devices. StO 2 was measured by several NIRS oximeters simultaneously on a phantom, which exhibited a particularly strong decrease in μ s '. We found that a decrease in μ s ' by ≤16% from baseline led to deviations in StO 2 of ≤3%.

Frequency-domain near-infrared spectroscopy (FD-NIRS) enables to measure absolute optical properties (i.e. the absorption coefficient, μ a , and the reduced scattering coefficient, [Formula: see text]) of the brain tissue. The aim of this study was to investigate how the optical properties changed during the course of a functional NIRS experiment. The analyzed dataset comprised of FD-NIRS measurements of 14 healthy subjects (9 males, 5 females, aged: 33.4 ± 10.5 years, range: 24-57 years old). Each measurement lasted 33 min, i.e. 8 min baseline in darkness, 10 min intermittent light stimulation, and 15 min recovery in darkness. Optical tissue properties were obtained bilaterally over the prefrontal cortex (PFC) and visual cortex (VC) with FD-NIRS (Imagent, ISS Inc., USA). Changes in μ a and [Formula: see text] were directly measured and two parameters were calculated, i.e. the differential pathlength factor (DPF) and the effective attenuation coefficient (μ eff ). Differences in the behavior of the optical changes were observed when comparing group-averaged data versus single datasets: no clear overall trend was presented in the group data, whereas a clear long-term trend was visible in almost all of the single measurements. Interestingly, the changes in [Formula: see text] statistically significantly correlated with μ a , positively in the PFC and negatively in the VC. Our analysis demonstrates that all optical brain tissue properties (μ a , [Formula: see text], μ eff and DPF) change during these functional neuroimaging experiments. The change in [Formula: see text] is not random but follows a trend, which depends on the single experiment and measurement location. The change in the scattering properties of the brain tissue during a functional experiment is not negligible. The assumption [Formula: see text] ≈ const during an experiment is valid for group-averaged data but not for data from single experiments.

Background: Absolute optical properties (i.e., the absorption coefficient, μ a , and the reduced scattering coefficient, [Formula: see text]) of head tissue can be measured with frequency-domain near-infrared spectroscopy (FD-NIRS)., Aim: We investigated how the absolute optical properties depend on the individual subject and the head region., Materials and Methods: The data set used for the analysis comprised 31 single FD-NIRS measurements of 14 healthy subjects (9 men, 5 women, aged 33.4 ± 10.5 years). From an 8-min measurement (resting-state; FD-NIRS device: Imagent, ISS Inc.; bilateral over the prefrontal cortex, PFC, and visual cortex, VC) median values were calculated for μ a and [Formula: see text] as well as the effective attenuation coefficient (μ eff ) and the differential pathlength factor (DPF). The measurement was done for each subject one to three times with at least 24 h between the measurements., Results: (i) A Bayesian ANOVA analysis revealed that head region and subject were the most significant main effects on μ a , [Formula: see text] and μ eff , as well as DPF, respectively. (ii) At the VC, μ a , [Formula: see text] and μ eff had higher values compared to the PFC. (iii) The differences in the optical properties between PFC and VC were age-dependent. (iv) All optical properties also were age-dependent. This was strongest for the properties of the PFC compared to the VC., Discussion and Conclusion: Our analysis demonstrates that all optical head tissue properties (μ a , [Formula: see text], μ eff and DPF) were dependent on the head region, individual subject and age. The optical properties of the head are like a 'fingerprint' for the individual subject. Assuming constant optical properties for the whole head should be carefully reconsidered.

Measurements of cerebral and muscle oxygenation (StO 2 ) and perfusion ([tHb]) with functional near-infrared spectroscopy (fNIRS) and near infrared spectroscopy (NIRS), respectively, can be influenced by changes in systemic physiology. The aim of our study was to apply the oblique subspace projections signal decomposition (OSPSD) to find the contribution from systemic physiology, i.e. heart rate (HR), electrocardiography (ECG)-derived respiration (EDR) and partial pressure of carbon dioxide (pCO 2 ) to StO 2 and [tHb] signals measured on the prefrontal cortex (PFC) and calf muscle. OSPSD was applied to two datasets (n 1  = 42, n 2  = 79 measurements) from two fNIRS/NIRS speech studies. We found that (i) all StO 2 and [tHb] signals contained components related to changes in systemic physiology, (ii) the contribution from systemic physiology varied strongly between subjects, and (iii) changes in systemic physiology generally influenced fNIRS signals on the left and right PFC to a similar degree.

Change of muscle tissue oxygen saturation ( StO 2 ), due to exercise, measured by near infrared spectroscopy (NIRS) is known to be lower for subjects with higher adipose tissue thickness. This is most likely not physiological but caused by the superficial fat and adipose tissue. In this paper we assessed, in vitro, the influence of adipose tissue thickness on muscle StO 2 , measured by NIRS oximeters. We measured StO 2 of a liquid phantom by 3 continuous wave (CW) oximeters (Sensmart Model X-100 Universal Oximetry System, INVOS 5100C, and OxyPrem v1.3), as well as a frequency-domain oximeter, OxiplexTS, through superficial layers with 4 different thicknesses. Later, we employed the results to calibrate OxyPrem v1.3 for adipose tissue thickness in-vivo.

The aim was to develop and test a new device (OxyVLS) to measure tissue oxygen saturation by visible light spectroscopy independently of the optical pathlength and scattering. Its local applicability provides the possibility of real time application in flap reconstruction surgery. We tested OxyVLS in a liquid phantom with optical properties similar to human tissue. Our results were in good agreement with a conventional near infrared spectroscopy device.

We recently introduced a novel textile-based NIRS sensor (TexNIRS). Here, we evaluate TexNIRS in ten subjects (16 legs, age 28.5 ± 2.32 years, adipose tissue thickness (ATT) 4.17 ± 1.71 mm). Three venous occlusions at 50 mmHg were performed on their calf muscle. After 3 min of occlusion, oxy/deoxy hemoglobin concentration ([O₂Hb], [HHb]) changes were 3.71 ± 1.89/1.79 ± 1.08 μM; venous oxygen saturation (SvO₂) was 75 ± 9.7 %, oxygen consumption (VO₂) was 0.02 ± 0.01 mL/100 g/min, hemoglobin flow (HF) was 0.93 ± 0.48 μmol/100 mL/min, and blood flow (BF) was 2.01 ± 1.04 mL/100 mL/min. Our results are in good agreement with the literature, but the TexNIRS enables a much higher level of comfort.

Being the closest layer to our body, textiles provide an ideal platform for integrating sensors and actuators to monitor physiological signals. We used a woven textile to integrate photodiodes and light emitting diodes. LEDs and photodiodes enable near-infrared spectroscopy (NIRS) systems to monitor arterial oxygen saturation and oxygenated and deoxygenated hemoglobin in human tissue. Photodiodes and LEDs are mounted on flexible plastic strips with widths of 4 mm and 2 mm, respectively. The strips are woven during the textile fabrication process in weft direction and interconnected with copper wires with a diameter of 71 μm in warp direction. The sensor textile is applied to measure the pulse waves in the fingertip and the changes in oxygenated and deoxygenated hemoglobin during a venous occlusion at the calf. The system has a signal-to-noise ratio of more than 70 dB and a system drift of 0.37% ± 0.48%. The presented work demonstrates the feasibility of integrating photodiodes and LEDs into woven textiles, a step towards wearable health monitoring devices.

Background: Left internal thoracic artery (LITA) grafts to the left anterior descending coronary artery (LAD) during coronary bypass surgery (CABG) have greater patency rates than saphenous vein grafts and reduce long-term cardiac morbidity and mortality rates. The benefits of multiple versus single arterial grafts and the role of different arterial conduits with respect to short- and medium-term outcome remains controversial. The purpose of this study was to compare the perioperative and intermediate-term results of: (1) patients receiving 2 arterial grafts versus 1 arterial graft and (2) patients receiving a right internal thoracic artery (RITA) versus a radial artery (RA) as the second arterial graft., Methods and Results: Retrospective analysis of prospectively gathered data on consecutive patients undergoing isolated CABG at our institution between 1989 and 1996 was conducted. The first section of the study compared outcomes for 1 arterial graft (LITA to LAD, n = 2333) versus 2 arterial grafts (LITA + RA or LITA + RITA, n = 378). The second section of the study compared outcomes for the RITA (n = 132) versus the RA (n = 171) as second arterial grafts since 1992, when the radial series was initiated. Part I: By multivariable stepwise logistic regression, the use of 1 arterial graft was associated with an increased incidence of perioperative cardiac morbidity and mortality (odds ratio 2.2, 95% confidence interval 1.4 to 3.3), with the use of our current patient selection criteria. Double-arterial graft patients had a nonsignificant trend toward increased intermediate-term actuarial survival (P = 0.12) and cardiac event-free survival (P = 0.09). Part II: Comparison of preoperative demographics revealed a higher incidence of diabetes (27% vs 11%, P < 0.001), peripheral vascular disease (16% vs 8%, P = 0.03), and elderly age (13% vs 2%, P = 0.001) in patients receiving an RA versus those receiving a RITA as the second arterial graft. Perioperative outcome analysis revealed a decreased intensive care unit stay in the RA versus RITA group (median 30.4 vs 36.2 hours, respectively, P = 0.005) but no significant difference in hospital length of stay. There was no significant difference in perioperative mortality or cardiac morbidity rates. RITA patients had a higher incidence of sternal wound infection (5.3% vs 0.6%, P = 0.01), however, and tended to have increased blood product transfusion rates (51% vs 40%, P = 0.06)., Conclusions: The use of 2 arterial grafts is safe, with a reduction in perioperative cardiac morbidity or mortality rates compared with 1 arterial graft after adjustment for other risk variables. When comparing RITA to RA as second arterial grafts, patients receiving an RA have a lower incidence of sternal wound infection and decreased transfusion requirements, with no difference in perioperative or intermediate-term cardiac morbidity or mortality rates.

Ferritin is a ubiquitous protein which plays a major role in iron sequestration, detoxification and storage. In this paper we highlight the role of ferritin in iron homeostasis and describe factors and diseases that affect its expression. We also describe new studies which further characterize the structure and expression of a novel form of ferritin heavy (H) chain mRNA that was identified in brain and discuss possible implications of these findings. Human fetal and adult brain cDNA libraries previously were screened with cDNA for well-characterized liver ferritin H. In addition to 'liver-like' brain ferritin H cDNA, novel ferritin H cDNAs with an additional 279 nucleotide sequence at the 3'untranslated region (UTR) were identified in both libraries (see refs. 1 and 2; Dhar, M., Chauthaiwale, V., and Joshi, J. G., Gene, 1993, 126, 275 and Dhar, M., and Joshi, J. G., J. Neurochem., 1993, 61, 2140). However, relative to liver ferritin H cDNA, these novel cDNAs were incomplete at their 5'ends [see ref. 3; Joshi, J. G., Fleming, J. T., Dhar, M. S., and Chauthaiwale, V., J. Neurol Sci., 1995, 134, (Suppl.), 52]. In the present paper, by sequencing of cDNAs using reverse transcriptase polymerase chain reaction, we show that the 279 nt 3'UTR sequence, a coding sequence identical to that in human liver ferritin H, and a full-length 5'UTR that includes one mRNA regulatory iron-response element sequence, co-exist in at least one species of ferritin H transcript in six normal human adult and six late-onset, sporadic Alzheimer disease (AD) brains. This sequence is the same in the normal and AD brains. Dot-blot analysis of poly A+ RNAs from different human tissues indicates that relative to the coding sequence of ferritin H, expression of the 279 nt 3'UTR sequence varies among different tissues, is highest in the adult brain, and is very low in fetal brain. In normal adult hippocampus, ferritin H RNA with the novel 279 nt sequence localizes strongly to small non-neuronal cells, capillary endothelial cells, and to selected populations of neurons (granule cells of the dentate gyrus). Significant homology was observed between a region in the 279 nt 3'UTR segment of ferritin H RNA and the 3'UTR of cyclooxygenase-2 mRNA (an inducible iron-containing enzyme involved in prostaglandin synthesis). Possible functions for ferritin H protein derived from the novel message and for the elongated 3'UTR and 5'UTR are discussed.