Search

Patients and caregivers suffer from alarm-related noise in today’s hospitals. While this is a topic for all fields of care, this challenge is especially relevant for intensive care units (ICUs). The noise harms patients, hinders the recovery process, or can even lead to psychosis. For the caregivers, noise causes an enormous stress level and in combination with the high number of clinically irrelevant or false alarms it leads to alarm fatigue and desensitization. These problems result in documented deaths of patients. Therefore, we present a demonstrator of a Silent ICU. Based on a distributed alarm system, the medical devices at the bedside do not create any audio alarm signals, as long as a remote alarm notification system is connected and works properly. An ICU bed place consists of devices from different manufacturers. Thus, a standardized interconnection is necessary. Therefore, we use IEEE 11073 Service-oriented Device Connectivity (SDC) to create a cross-manufacturer distributed alarm system with components from three different companies. A fourth company provides a documentation system for this demonstrator. Patients and caregivers will greatly benefit from Silent ICUs and smart distributed alarm systems that will be build based on interoperable cross-manufacturer environments.

Building on the extensive production of provenance data recently, this article explains how we can expand the purview of computational analysis in humanistic and social sciences by exploring how digital methods can be applied to provenances. Provenances document chains of events of ownership and socio-economic custody changes of artworks. They promise statistical and comparative insights into social and economic trends and networks. Such analyses, however, necessitate the transformation of provenances from their textual form into structured data. This article first explores some of the analytical avenues aggregate provenance data can offer for transdisciplinary historical research. It then explains in detail the use of deep learning to address natural language processing tasks for transforming provenance text into structured data, such as Sentence Boundary Detection and Span Categorization. To illustrate the potential of this pioneering approach, this article ends with two examples of preliminary analysis of structured provenance data.

Objective: The current study sought to clarify and harness the incremental validity of emotional dysregulation and unawareness (EDU) in emerging adulthood, beyond ADHD symptoms and with respect to concurrent classification of impairment and co-occurring problems, using machine learning techniques. Method: Participants were 1,539 college students (M[subscript age] = 19.5, 69% female) with self-reported ADHD diagnoses from a multisite study who completed questionnaires assessing ADHD symptoms, EDU, and co-occurring problems. Results: Random forest analyses suggested EDU dimensions significantly improved model performance (ps < 0.001) in classifying participants with impairment and internalizing problems versus those without, with the resulting ADHD + EDU classification model demonstrating acceptable to excellent performance (except in classification of Work Impairment) in a distinct sample. Variable importance analyses suggested inattention sum scores and the Limited Access to Emotional Regulation Strategies EDU dimension as the most important features for facilitating model classification. Conclusion: Results provided support for EDU as a key deficit in those with ADHD that, when present, helps explain ADHD's co-occurrence with impairment and internalizing problems. Continued application of machine learning techniques may facilitate actuarial classification of ADHD-related outcomes while also incorporating multiple measures.

The detonation of an (hypothetical) improvised nuclear device (IND) can generate atmospheric release of radioactive material in the form of particles and dust that ultimately contaminate the soil. In this study, the detonation of an IND in an urban area was simulated, and its effects on humans were determined. The risk of solid cancer development due to radiation was calculated by taking into account prompt radiation and whole-body exposure of individuals near the detonation site up to 10 km. The excess relative risk (ERR) of developing solid cancer was evaluated by using the mathematical relationships from the Radiation Effects Research Foundation (RERF) studies and those from the HotSpot code. The methodology consists of using output data obtained from simulations performed with the HotSpot health physics code plugging in such numbers into a specific given equation used by RERF to evaluate the resulting impact. Such a preliminary procedure is expected to facilitate the decision-making process significantly.

The International Classification of Functioning Disability and Health (ICF) provides the language and a framework applying a unified and standardized form to describe health and conditions related to health. Teams who work in an interdisciplinary and multi professional way, as it is the case in neuro rehabilitation, can profit from integrating the ICF. The aim of this paper was to show how well implemented the ICF is in Austria with occupational therapists, speech and language therapists and physiotherapists working in neuro rehabilitation.

This article draws on a digital storytelling approach. The authors describe a pilot study that aimed to activate young learners’ own English language production through collaborative story creation using tablets.

Staphylococcus lugdunensis is a coagulase-negative species responsible for a multitude of infections. These infections often resemble those caused by the more pathogenic staphylococcal species, Staphylococcus aureus, such as skin and soft tissue infections, prosthetic joint infections, and infective endocarditis. Despite a high mortality rate and infections that differ from other coagulase-negative species, little is known regarding S. lugdunensis pathogenesis. The objective of this study is to identify the essential factors for biofilm formation in S. lugdunensis. S. lugdunensis was mutagenized through ethyl methanesulfonate (EMS) exposure, and the individual cells were separated using a cell sorter and examined for biofilm formation at 8 hr and 24 hr timepoints. Mutations that resulted in either increased or decreased biofilm formation were sequenced to identify the genes responsible for the respective phenotypes. A mutation within the S. lugdunensis surface protein A (slsA) gene was common among all of the low biofilm formers, thus suggesting that high expression of this protein is important in biofilm formation. However, other mutations common among the mutants with decreased biofilm formation were in the putative divalent cation transport gene, mgtE. Conversely, a mutation in the gene that codes for the von Willebrand factor binding protein, vwbl, was common among the mutants with increased biofilm formation. Following proteinase K treatment, a significant dispersal of the S. lugdunensis biofilm matrix occurred, thus confirming the presence of primarily protein-mediated biofilms; this is in agreement with previous S. lugdunensis studies. Additionally, all low biofilm formers exhibited decreased protein levels (1.95–2.77 fold change) within the biofilm matrix, while no difference was observed with extracellular DNA (eDNA) or polysaccharides. This study presents a unique methodology to identify genes that affect biofilm formation and sheds light on S. lugdunensis pathogenesis.

Games are a well-suited testbed for the development and evaluation of concepts and tools in artificial intelligence (AI). In our paper we outline the architecture of a web-based game server that was developed to support the teaching of artificial intelligence at the university level as well as research in the domain of AI and rule-based language development. The server combines a Prolog-based declarative approach with Java-based server technologies. The architecture consists of multiple, strictly separated components. Declarative components comprise the gameindependent core engine as well as game-dependent logic and visualization descriptions. General operations (e.g. user management, load balancing, match maintenance etc.) and rendering of the visualization descriptions with actual GUI techniques are implemented imperatively. External interfaces are provided to integrate remote developers and learners to facilitate usage beyond the borders of a single university.

A straightforward experimental set-up, requiring a two-liter bottle, a ruler and a stopwatch, is used to provide data appropriate for modelling with Torricelli's Law in the simplest case, and a more sophisticated differential equation when losses are taken into account and a pipe extension is considered. With only an exit hole included in the model, the governing equation can be integrated analytically to find the liquid height in the tank as a function of time. In the more complicated instance, the governing equation requires numerical integration. In both cases, a discharge coefficient can be employed as a fitting parameter. Excellent agreement between the experimental data and the theoretical modelling results has been obtained. An analytical solution with comparable accuracy to the numerical version is also possible for a pipe extension under the operating conditions considered here. Student reception of the experiment was generally positive, although some nuances were not fully grasped.

Matthias Rother, Ilka RotherDepartment of Clinical Operations, X-pert Med GmbH, Graefelfing, GermanyBackground: Pain related to ultraviolet B radiation (UVR) induced sunburn is an established, simple, acute pain model. One of the major criticisms is related to the potential dermal adverse events caused by the UVR exposure. This study tried to validate the model for oral and topical drugs and to define the minimum required UVR exposure.Methods: This subject- and observer-blinded, placebo-controlled, crossover study evaluated 600 mg oral ibuprofen (IB) and topical hydrocortisone-21-acetate (HC) twice daily (bid) in 24 healthy volunteers. Treatment started immediately after irradiation and again at 12 hours, 24 hours, and 36 hours post-UVR. Assessment of hyperalgesia to heat and signs of inflammation (erythema, skin temperature) for all areas was performed after UVR and again at 6, 12, 24, 36, and 48 hours. Subjects returned within 4–11 days to the study site for the second period of the study. As in the first period, subjects received HC at one side and topical placebo on the other side, but oral treatment was crossed-over.Results: The primary analysis failed to show the expected superiority of the IB-group vs the placebo group in period 1 of the study. Evaluating period 2 alone clearly showed the expected treatment effects of IB for erythema and heat pain threshold. The results were less pronounced for skin temperature. In contrast to IB vs oral placebo, there were no differences in treatment response between HC and topical placebo. UVR at all dosages induced profound erythema and reduction of heat pain threshold without causing blisters or other unexpected discomfort to the subjects. The changes were almost linear between 1 and 2 minimal erythema doses (MED), whereas the change from 2 to 3 MED was less pronounced.Conclusion: Use of 2 MED in upcoming studies seems to be reasonable to limit subjects' UVB exposure. The following procedural changes are suggested:• Intensified training sessions before randomization to treatment• Increase in sample size if they are crossover studies• Simplification in design (either oral or topical treatment)Keywords: ibuprofen, hydrocortisone-21-acetate, pain, inflammation, UV radiation, validation

Werner Kneer,1 Matthias Rother,2 Stefan Mazgareanu,3 Egbert J Seidel4 On behalf of the European IDEA-033 study group 1Orthopaedic Outpatient Centre, Stockach, Germany; 2IMR Partner GmbH, Graefelfing, Germany; 3Cardiorentis Ltd, Zug, Switzerland; 4Sophien- und Hufeland-Clinic, Weimar, Germany Objective: To evaluate the safety and efficacy of ketoprofen in Transfersome® gel (IDEA-033) in comparison with a ketoprofen-free vehicle (TDT 064) for the treatment of osteoarthritis (OA) of the knee. Methods: Patients with knee OA (N = 866) were randomly assigned to receive topical IDEA-033 containing 100, 50, or 25 mg ketoprofen, or TDT 064 twice daily for 12 weeks, in a double-blind trial. The primary efficacy endpoint was the change in the Western Ontario and McMaster Universities (WOMAC®) Osteoarthritis Index pain subscale score. The coprimary efficacy endpoints were the WOMAC function subscale score and the patient global assessment of response to therapy. The secondary endpoints included the numeric pain rating for the first 14 days of treatment and the Outcome Measures in Rheumatology (OMERACT)-Osteoarthritis Research Society International (OARSI) responder rates. Results: The WOMAC pain scores were reduced by approximately 50% or more in all four groups. The 100 and 50 mg ketoprofen groups, but not the 25 mg group, showed a superior reduction in the WOMAC pain score versus the TDT 064 group (100 mg: −57.4% [P = 0.0383]; 50 mg: −57.1% [P = 0.0204]; and 25 mg: −53.4% [P = 0.3616] versus TDT 064: −49.5%). The superiority of the ketoprofen-containing formulations was not demonstrated for the WOMAC function subscale score, whereas the patient global assessment of 50 mg ketoprofen group, but not the 100 or 25 mg group, was superior to that of the TDT 064 group (P = 0.0283). Responder rates were significantly higher for all the IDEA-033 groups versus the TDT 064 group, but were high in all groups (100 mg: 88.6%; 50 mg: 86.8%; 25 mg: 88.6%; and TDT 064: 77.5%). Dermal reactions were the only relevant drug-related adverse events in all four groups. Conclusion: The 50 and 100 mg ketoprofen doses of IDEA-033 were only marginally superior to TDT 064 for reducing pain associated with knee OA. The study indicates a high treatment response to the topical ketoprofen-free vehicle TDT 064. Keyword: SequessomeTM, pain, non-steroidal anti-inflammatory drugs, drug-free, medical device

Abstract The analysis of vascular morphology and functionality enables the assessment of disease activity and therapeutic effects in various pathologies. Raster‐scanning optoacoustic mesoscopy (RSOM) is an imaging modality that enables the visualization of superficial vascular networks in vivo. In murine models of colitis, deep vascular networks in the colon wall can be visualized by transrectal absorber guide raster‐scanning optoacoustic mesoscopy (TAG‐RSOM). In order to accelerate the implementation of this technology in translational studies of inflammatory bowel disease, an image‐processing pipeline for TAG‐RSOM data has been developed. Using optoacoustic data from a murine model of chemically‐induced colitis, different image segmentation methods are compared for visualization and quantification of deep vascular patterns in terms of vascular network length and complexity, blood volume, and vessel diameter. The presented image‐processing pipeline for TAG‐RSOM enables label‐free in vivo assessment of changes in the vascular network in murine colitis with broad applications for inflammatory bowel disease research.