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IntroductionAfter legal restrictions regarding coerced medication in Saxony, we monitored significant increases in aggressive behaviour and regarding the use of physical restraints at our closed psychiatric ward. Alternative measures for managing dangerous behaviour were discussed.ObjectivesThere are limitations regarding the use of treatment interventions in emergency psychiatry, e.g. the use of constant observation is limited in its efficiency generally and video surveillance is prohibited by law in high-risk areas (e.g. bathroom).AimsTo find appropriate solutions for patient safety improvement in emergency psychiatry including high-risk areas, prospects of the field of “technical assistance” entered the limelight of interest.MethodsIn 2014, a cooperation of Chemnitz University of Technology, Intenta GmbH, Eckstein Design and the affiliated partner Klinikum Chemnitz started a project*, which focuses on the development of a technical assistance system for recognizing high-risk behavioural patterns (e.g. suicide attempt) in risk areas in emergency psychiatry. The system is based on a smart-sensor technology and waives a recording and storing of sound and vision.ResultsIn the 1st half of the project technical development and the design of the system were the focus of attention. Special requirements regarding use cases, user acceptance, data protection and ethical concerns were processed by our psychiatric department. Testing and further development of the system in clinical settings are planned.ConclusionsThe development of the system must be seen as a big challenge in many regards. Further research is indispensable.*Sponsored by the Central Innovation Program Mittelstand of the Federal Ministry for Economic Affairs and Energy.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Little data exist regarding the acute assessment of blast concussion and the course of recovery in the combat zone, as most research has examined service members long after they have returned home. This manuscript examined a case series of 377 service members seen for acute concussion evaluation following medical evacuation from the battlefield in Helmand Province, Afghanistan. Of these, 111 were assessed for concussion prior to their return to the continental USA for other severe physical injuries. Of the remainder, and when comparing those who returned to duty (RTD)/recovered from concussion in the combat zone and those who did not, data indicate that those who did not RTD were older and were more likely to endorse symptoms of combat stress. Quicker recovery times were associated with less severe headaches and fewer acute symptoms at the time of injury as well as the absence of combat stress reaction. Variables that were not associated with RTD and/or recovery were Military Acute Concussion Evaluation (MACE) cognitive scores and whether or not individuals suffered loss of consciousness. While MACE scores were not associated with recovery, they were deemed clinically useful as a part of a serial concussion evaluation if the initial MACE was given within 6 h of the blast. Implications for battlefield concussion assessment and management as well as future research directions are discussed. Language: en

Objective: Agitated behaviors are one of the most frequent reasons that patients with dementia are placed in long-term care settings. This study aims to validate the ability of a custom Body Sensor Network (BSN) to capture the presence of agitation against currently accepted subjective measures, the Cohen-Mansfield Agitation Inventory (CMAI) and the Aggressive Behavior Scale (ABS) and to discriminate between agitation and cognitive decline. Methods: Six patients identified as being at high risk for agitated behaviors were enrolled in this study. The devices were applied at three sites for three hours while behaviors were annotated simultaneously and subsequently repeated twice for each enrolled subject. Results: We found that the BSN was a valid measure of agitation based on construct validity testing and secondary validation using non-parametric ANOVAs. Discussion: The BSN shows promise from these pilot results. Further testing with a larger sample is needed to replicate these results.

The formation of the flow field and spatial aerosol particle distribution play an important role in various industrial applications. Regarding experiments on aerosol particle transport phenomena in turbulent flows it is of essential interest to generate a homogeneously mixed air stream. Particle Image Velocimetry (PIV) measurements have been conducted in order to characterize the turbulent mixing process in a small-scale gas/aerosol test facility which is designed for the investigation of deposition and resuspension of nuclear aerosol particles. The turbulent flow field in a square duct (Red = 8.9k..43k) is seeded with DEHS droplets in the size range of approximately dPaero = 2 μm. Firstly, the downstream formation of particle mixing is quantified in terms of the spatial distribution of the scatter light intensity of the PIV images. It is found that sufficient mixing of the aerosol particles is accomplished at 8 to 10 hydraulic diameters downstream of the injection point. Furthermore, the formation of the flow field is evaluated in terms of the time mean averaged velocity as well as velocity fluctuations. These values are presented at successive downstream positions and display the development of the turbulent boundary layer. It is shown that the near wall turbulent region of the test section nicely follows the universal slope of a well developed turbulent boundary layer. Nevertheless, the flow field formation still takes place after 20 hydraulic diameters.

Over the past forty years, a tremendous amount of information has been gained on the mechanisms and consequences of mild traumatic brain injuries. Using sports as a laboratory to study this phenomenon, a natural recovery curve emerged, along with standards for managing concussions and returning athletes back to play. Although advances have been made in this area, investigation into recovery and return to play continues. With the increase in combat-related traumatic brain injuries in the military setting, lessons learned from sports concussion research are being applied by the Department of Defense to the assessment of blast concussions and return to duty decision making. Concussion management and treatment for military personnel can be complicated by additional combat related stressors not present in the civilian environment. Cognitive behavioral therapy is one of the interventions that has been successful in treating symptoms of postconcussion syndrome. While we are beginning to have an understanding of the impact of multiple concussions and subconcussive blows in the sports world, much is still unknown about the impact of multiple blast injuries.

The IncP alpha promiscuous plasmid (R18, R68, RK2, RP1 and RP4) comprises 60,099 bp of nucleotide sequence, encoding at least 74 genes. About 40 kb of the genome, designated the IncP core and including all essential replication and transfer functions, can be aligned with equivalent sequences in the IncP beta plasmid R751. The compiled IncP alpha sequence revealed several previously unidentified reading frames that are potential genes. IncP alpha plasmids carry genetic information very efficiently: the coding sequences of the genes are closely packed but rarely overlap, and occupy almost 86% of the genome's nucleotide sequence. All of the 74 genes should be expressed, although there is as yet experimental evidence for expression of only 60 of them. Six examples of tandem-in-frame initiation sites specifying two gene products each are known. Two overlapping gene arrangements occupy different reading frames of the same region. Intergenic regions include most of the 25 promoters; transcripts are usually polycistronic. Translation of most of the open reading frames seems to be initiated independently, each from its own ribosomal binding and initiation site, although, a few cases of coupled translation have been reported. The most frequently used initiation codon is AUG but translation for a few open reading frames begins at GUG or UUG. The most common stop-codon is UGA followed by UAA and then UAG. Regulatory circuits are complex and largely dependent on two components of the central control operon. KorA and KorB are transcriptional repressors controlling at least seven operons. KorA and KorB act synergistically in several cases by recognizing and binding to conserved nucleotide sequences. Twelve KorB binding sites were found around the IncP alpha sequence and these are conserved in R751 (IncP beta) with respect to both sequence and location. Replication of IncP alpha plasmids requires oriV and the plasmid-encoded initiator protein TrfA in combination with the host-encoded replication machinery. Conjugative plasmid transfer depends on two separate regions occupying about half of the genome. The primary segregational stability system designated Par/Mrs consists of a putative site-specific recombinase, a possible partitioning apparatus and a post-segregational lethality mechanism, all encoded in two divergent operons. Proteins related to the products of F sop and P1 par partitioning genes are separately encoded in the central control operon.

The effect of two GnRH-As – des Gly10 (D-Ala)6 LHRH and des Gly10 (D-Tle)6 GnRH in total doses 10–249mu;g/kg – and four neuroleptics – pimozide, sulpiride, metoclopramide and isofloxythepin in total doses 1–50mg/kg - and environmental temperatures on the development of final stages of Pacific mullet oogenesis was investigated. The best technique of those used by us for spawning stimulation of Pacific mullet, Mugil so-iuy Bas., females is shown to be administration of neuroleptics in doses of l-8mg/kg with posterior injections on GnRH-A in doses of 25 and 50mu; g/kg applied 4 and 28h respectively after the neuroleptic injection. At water temperatures below 17°C, ovulation does not occur unless the optimal stimulation is applied.

In 1982, the Wall Street Journal coined the term ‘silent epidemic’ in a front page article based upon research findings on minor head injury or what is now refered to as mild traumatic brain injury...

Mild traumatic brain injury (mTBI) has been called the signature injury of recent wars in Iraq and Afghanistan. Estimates of mTBI in deployed personnel are as high as 20%. Postconcussive symptoms (PCS), regarded as the core problem following mTBI, comprise headaches, dizziness, sensitivity to light and sound, fatigue, and concentration deficits. Although PCS have traditionally been presumed to result from neurological insult, evidence points to a role of psychological factors in these symptoms. Current military evidence is limited by the reliance on retrospective reports collected after deployment through surveys. Research on mTBI in combat setting is needed to more accurately determine the nature of blast-related mTBI. This study reports the first analysis of military personnel assessed in theatre shortly after exposure to a blast.

Patients with end stage renal diseases (ESRD) on hemodialysis (HD) have high morbidity and mortality due to multiple causes, one of which is dramatically higher fall rates than the general population. The mobility mechanisms that contribute to falls in this population must be understood if adequate interventions for fall prevention are to be achieved. This study utilizes emerging non-invasive, portable gait, posture, strength, and stability assessment technologies to extract various mobility parameters that research has shown to be predictive of fall risk in the general population. As part of an ongoing human subjects study, mobility measures such as postural and locomotion profiles were obtained from five (5) ESRD patients undergoing HD treatments. To assess the effects of post-HD-fatigue on fall risk, both the pre- and post-HD measurements were obtained. Additionally, the effects of inter-HD periods (two days vs. three days) were investigated using the non-invasive, wireless, body-worn motion capture technology and novel signal processing algorithms. The results indicated that HD treatment influenced strength and mobility (i.e., weaker and slower after the dialysis, increasing the susceptibility to falls while returning home) and inter-dialysis period influenced pre-HD profiles (increasing the susceptibility to falls before they come in for a HD treatment). Methodology for early detection of increased fall risk -- before a fall event occurs -- using the portable mobility assessment technology for out-patient monitoring is further explored, including targeting interventions to identified individuals for fall prevention.

Assessment of gait and posture as symptoms has been the primary concern in the diagnosis and treatment of normal pressure hydrocephalus (NPH), a disease in which there is excessive accumulation of cerebrospinal fluid (CSF) in the brain. Diagnosis of NPH is usually initiated by a high volume lumbar puncture (HVLP) followed by the evaluation of clinical response to removal of CSF. In this paper, we analyze the gait movement of a patient using inertial body sensor nodes and capture features pre and post HVLP. This method provides a quantitative measure of gait assessment. The features extracted from a patient's gait are found to strongly correlate with the assessment recorded manually by the physician conducting the study.

In this proposal, we describe the technology of Wireless Health Interactive, LLC (BeClose.com) and demonstrate the capabilities of the BeClose platform for in home assessment of health and wellness to promote aging-in-place. We describe recent efforts to incorporate ambient, artificial intelligence to contextualize data for recognition of activities of daily living. Finally, we illustrate the potential of the technology regarding the aged demographic -- as a tool to manage independent living with dementia. This work will showcase recent innovations in the development and commercialization of wireless health products and provide outcome-oriented use cases derived from ongoing research.

Agitated behavior is one of the most frequent reasons that patients with dementia are placed in long-term care settings. These behaviors are indicators of distress and are associated with increased risk of injury to the patients and their caregivers. This study aims to explore the ability of a custom inertial wireless body sensor network (BSN) to objectively detect and quantify agitation, validating against currently accepted subjective clinical measures -- the Cohen-Mansfield Agitation Inventory (CMAI) and the Aggressive Behavior Scale (ABS) -- within the nursing home setting. The ultimate goal is to enable continuous, real-time monitoring of physical agitation in any location over an extended period. Continuous, longitudinal assessment facilitates timely response to agitation events in order to minimize patient distress and risk for injury, to more appropriately titrate pharmacotherapy, and to enable staff (or caregivers) to successfully intervene.Six patients identified as being at high risk for agitated behaviors were enrolled in this pilot study. Patients underwent a series of the above validated tests of memory and agitation. The BSN nodes were applied at three sites on body for three hours while behaviors were annotated simultaneously. This process was subsequently repeated twice for each enrolled subject. The BSN data was then processed using Teager energy analysis, which an earlier study suggested was a promising method for extracting jerky and repetitive movements from inertial data. Results based on construct validity testing for agitation (CMAI) and aggression (ABS) were promising and suggest that additional study with larger sample sizes is warranted.

We report on a 19-year-old male patient with chronic HBeAg-positive hepatitis B-infection and agranulocytosis as a severe side effect of pegylated interferon alpha therapy. Within the first six months of therapy the hepatitis B virus DNA became undetectable in parallel with a significant decrease of the HBsAg serum concentration. After a six-month course of therapy the patient was admitted to our emergency unit. He appeared significantly ill and reported that he had fever for two days, painful oral mucosa, throat pain and general fatigue and discomfort. A complete blood cell count was performed and revealed a complete agranulocytosis with no detectable neutrophilic granulocytes in the blood smear. Antiviral therapy was immediately stopped and he was admitted to our clinic where a supportive therapy and an empirical course of broadband antibiotics were initiated. A few days later an additional treatment with intravenous prednisolone was started. Within the next week the agranulocytosis resolved and the neutrophil count was completely restored. In parallel, the clinical status improved quickly. This case demonstrates the need for our awareness of agranulocytosis as a rare but severe and potentially life-threatening side effect of interferon alpha therapy.

This chapter gives an overview of biaxially oriented polyamide film. To begin with, the different stretching methods for polyamide film are outlined and finally, the main properties of polyamide film and the typical applications are specified. Also, the main differences between polypropylene and polyester film are described.

Disability following head injury varies depending on injury mechanism, neuropathology, and other factors, including medical complications. Mild head injury (Glasgow Coma Scale score 13-15) has been shown to have considerable variability in outcome. Some persons experience rapid symptom resolution whereas others continue to evidence symptoms for an extended duration. A small, but clinically significant number of patients may be neuropsychologically and occupationally disabled at least up to 1 year postinjury. Methodological problems continue to plague mild head injury outcome studies. In contrast, moderate (Glasgow Coma Scale score 9-12) and severe head injury (Glasgow Coma Scale score 3-8) result in more consistent patterns of disability following injury. In general, patients who sustain moderate to severe head injury tend to experience persistent and extensive neuropsychological, psychiatric, and occupational impairment. The impact of rehabilitative interventions is variable and dependent on injury severity, intervention type, and outcome criteria.

Postconcussive symptomatology was studied in 587 patients with uncomplicated mild head injury. There was a linear decrease in symptomatology over the 1-year follow-up period. Headache was the most frequently reported postconcussive symptom. Symptom constellations consistent with postconcussive syndr

The present case study examines the sequelae of disulfiram overdose and resulting chronic organic brain syndrome, with a 45-year-old, white, male alcoholic. Previous reports have discussed acute organic brain syndromes that are reversed after discontinuance of the drug. This particular case, however, resulted in significant cerebral impairment that was irreversible. Full neuropsychological testing which describes the extent of these neurologic deficits is presented, along with some possible reasons for these chronic sequelae.

Gait analysis has long been used for various medical and healthcare assessments [1]. In orthopedics and prosthetics, gait analysis is essential for identifying the pathology and assessing the efficacy of the orthopedic assistants or prosthetics prescribed. For example, the efficacy of ankle-foot orthoses (AFOs), usually prescribed to patients with muscle disorders, (e.g., cerebral palsy, spinal cord injury, muscular dystrophy, etc.) to prevent contractures [2], remains unclear. Studies on recovery and rehabilitation from knee surgery have shown that gait analysis focusing on knee joint angles is the key to evaluating the efficacy of treatment. In elderly healthcare, gait analysis has also played an important role in studies of fall risks and fall prevention [3]. Even in cognitive and neuropsychology studies, gait analysis becomes an important parameter because of the close relationship between human cognitive skills and motor function. For example, [4] and [5] have shown the research value of gait analysis in Parkinson's disease and early childhood autism diagnosis, respectively.

Power consumption in many BSN devices is dominated by the wireless transmission of raw sensed data. On-node data reduction techniques can be employed to enhance energy efficiency but often come at the expense of application fidelity. This energy-fidelity relationship, however, is subject to both inter- and intra-individual variations, calling for dynamically adaptable on-node signal processing techniques that adjust key parameters based on real-time phenomena. This work presents the tools, methods, and framework for dynamic energy-fidelity optimization, including online data profiling for information content, on-node data rate reduction techniques, energy and resource profiling for executing those techniques, and application fidelity assessment. This approach is demonstrated on an inertial BSN platform using data collected in a clinical study of tremor. Compared to static data reduction settings that are based on patient-specific data profiling, dynamic energy-fidelity optimization through online profiling is shown to reduce energy by 76% for a given data distortion or reduce distortion by 90% for a given energy.

While many BSN applications require that sensor nodes be able to operate for extended periods of time, they also often require the wireless transmission of copious amounts of sensor data to a data aggregator or base station, where the raw data is processed into application-relevant information. The energy requirements of such streaming can be prohibitive, given the competing considerations of form factor and battery life requirements. Making intelligent decisions on the node about which data to store or transmit, and which to ignore, is a promising method of reducing energy consumption. Artificial neural network (ANN) classifiers are among several competitive techniques for such data selection. However, no systematic metrics exist for determining if an ANN classifier is suited for a particular resource constrained computing environment of a typical BSN node. An especially difficult task is assessing, at the design stage, which classifier architectures are feasible on a given resource-constrained node, what computational resources are required to execute a given classifier, and what classification performance might be achieved by a particular classifier on a given set of resources. This paper describes techniques for quantifying and predicting the performance of ANN classifiers on wearable sensor nodes using scalable synthetic test data. Additionally, the paper shows a comparison of synthetic data with gait data collected using an inertial BSN node, and classification results of the gait data using a cerebellar model arithmetic computer (CMAC) architecture show excellent agreement with theoretical predictions.

Assessment of concussion is primarily based on self-reported symptoms, neurological examination and neuropsychological testing. The neurophysiologic sequelae and the integrity of the corticomotor pathways could be obtained by evaluating motor evoked potentials (MEPs).To compare MEPs obtained through transcranial magnetic stimulation (TMS) in acutely concussed and non-concussed collegiate athletes.Eighteen collegiate athletes (12 males, six females, aged 20.4 +/- 1.3 years) including nine subjects with acute concussion (or=24 hours) matched to nine control subjects. TMS was applied over the motor cortex and MEP responses were recorded from the contralateral upper extremity. MEP thresholds (%), latencies (milliseconds per metre) and amplitudes were assessed. Central motor conduction time (CMCT) was calculated from MEP, M response and F wave latencies. Testing was performed on days 1, 3, 5 and 10 post-concussion.Ulnar MEP amplitudes were significantly different between post-concussion days 3 and 5 (F(3,48) = 3.13, p = 0.041) with smaller amplitudes recorded on day 3 (0.28 +/- 0.10 ms m(-1)). Median MEP latencies were significantly longer (F(3,48) = 4.53, p = 0.023) 10 days post-concussion (27.1 +/- 1.4 ms m(-1)) compared to day 1 (25.7 +/- 1.5 ms m(-1)). No significant differences for motor thresholds or CMCTs were observed (p0.05).MEP abnormalities among acutely concussed collegiate athletes provide direct electrophysiologic evidence for the immediate effects of concussion.

There is currently a pressing need for safe, reliable, cost-effective methods of evaluating driving ability. With recent improvements in virtual reality technology, driving simulators seem to offer a promising alternative to on-road methods of driving assessment. One population at risk for driving difficulties may be veterans returning from combat in Iraq or Afghanistan. The use of driving simulators to evaluate and remediate veterans' abilities to operate a motor vehicle is a rehabilitative goal. However, there are no consistent standardized procedures for determining safe from unsafe driving using driving simulators, which limit the clinical utility of this important tool. The purposes of this article are (1) to give the reader a better understanding of the parameters that are most commonly measured in the driving simulation literature and (2) to review parameters that are most relevant for the Operation Enduring Freedom/Operation Iraqi Freedom veteran population.

In 18 healthy age- and sex- matched controls and 13 patients with Wilsons disease (18-50 years) under continuous copper chelating therapy sinusoidal forearm movements of a given target rates (target rates: 0.2, 0.3, 0.4, 0.5, 0.6 Hz) as well as breathing movements were recorded by means of a goniometer and a breathing girdle in parallel. Additionally, controls and patients had to perform spontaneous forearm movements at their most comfortable rate. The percentage of time during which forearm and breathing movements were coupled was significantly reduced in the patients. With increasing target rate the mean breathing rate significantly increased in the controls but not in the patients. Furthermore, the variability of breathing rate significantly increased in the patients but not in the controls. These two factors probably caused that the coupling of breathing and extremity movements was significantly reduced in the patients.

A line beam electron gun based on the Pierce gun type was developed. The line cathode was realized by a directly heated tungsten rod. The temperature distribution along the tungsten rod was simulated numerically. The simulation shows a flat temperature across 2/3 of the cathode length and it agrees with appropriate measurable parameters. The beam profiles of the electron gun perpendicular to the line direction were examined as a function of electrical and geometrical parameters: The space‐charge distribution in front of the cathode was found to be responsible for the shape of the beam profile. The shape of the beam profile is weakly influenced by the acceleration to the anode. The heating current induced voltage drop along the cathode was found to be responsible for the nonuniform emission in line direction. A model for the emission behavior of the line beam electron gun was developed. The model is based on the results of the measurements and on a numerical simulation of the potential distribution in the area between Pierce reflectors and anode. The emission model shows a solution to homogenize the emission by a suitable variation of geometrical parameters in line direction. A linear variation was realized in experiment which enables a uniform emission across 2/3 of the cathode length. The beam profile is adjustable by a bias voltage between the cathode and the Pierce reflectors.

Summary The Incl1 conjugative plasmid Collb-P9 carries a psiB gene that prevents induction of the SOS response in host bacteria. This locus is located 2.5 kb downstream of the ssb (single-stranded DNA-binding protein) gene in the leading region. This portion of Collb is strikingly similar to part of the leading region of the otherwise distinct F plasmid. Expression of psiB and ssb is increased when the host cell is exposed to an SOS-inducing treatment or the Collb transfer system is derepressed. Moreover, expression of both genes on a derepressed plasmid is strongly enhanced in conjugatively infected recipient cells. Carriage of the psiB gene by Collb is shown to prevent a low level of SOS induction following conjugation. Plasmid ssb and psiB genes may function to promote installation of the replicon in the new cell.

In 18 healthy age- and sex- matched controls and 13 patients with Wilsons disease (18-50 years) under continuous copper chelating therapy sinusoidal forearm movements of a given target rates (target rates: 0.2, 0.3, 0.4, 0.5, 0.6 Hz) as well as breathing movements were recorded by means of a goniometer and a breathing girdle in parallel. Additionally, controls and patients had to perform spontaneous forearm movements at their most comfortable rate. The percentage of time during which forearm and breathing movements were coupled was significantly reduced in the patients. With increasing target rate the mean breathing rate significantly increased in the controls but not in the patients. Furthermore, the variability of breathing rate significantly increased in the patients but not in the controls. These two factors probably caused that the coupling of breathing and extremity movements was significantly reduced in the patients.

Falls are dangerous for the aged population as they can adversely affect health. Therefore, many fall detection systems have been developed. However, prevalent methods only use accelerometers to isolate falls from activities of daily living (ADL). This makes it difficult to distinguish real falls from certain fall-like activities such as sitting down quickly and jumping, resulting in many false positives. Body orientation is also used as a means of detecting falls, but it is not very useful when the ending position is not horizontal, e.g. falls happen on stairs. In this paper we present a novel fall detection system using both accelerometers and gyroscopes. We divide human activities into two categories: static postures and dynamic transitions. By using two tri-axial accelerometers at separate body locations, our system can recognize four kinds of static postures: standing, bending, sitting, and lying. Motions between these static postures are considered as dynamic transitions. Linear acceleration and angular velocity are measured to determine whether motion transitions are intentional. If the transition before a lying posture is not intentional, a fall event is detected. Our algorithm, coupled with accelerometers and gyroscopes, reduces both false positives and false negatives, while improving fall detection accuracy. In addition, our solution features low computational cost and real-time response.

Clinicians have determined that continuous ambulatory monitoring provides significant preventative and diagnostic benefit, especially to the aged population. In this paper we describe gait classification techniques based on data obtained using a new body area sensor network platform named TEMPO 3. The platform and its supporting infrastructure enable six-degrees-of-freedom inertial sensing, signal processing, and wireless transmission. The proposed signal processing includes data normalization to improve robustness, feature extraction optimized for classification, and wavelet pre-processing. The effectiveness of the platform is validated by implementing a binary classifier between shuffle and normal gait. Artificial neural networks and classifiers based on the Cerebellar Model Articulation Controller were tested and yielded classification accuracies (68%-98%) comparable to previous efforts that required more restrictive or intrusive apparatus. These results suggest a viable path to resource-constrained, on-body gait classification.

This work presents TEMPO (Technology-Enabled Medical Precision Observation) 3.1, a third generation body area sensor platform that accurately and precisely captures, processes, and wirelessly transmits six-degrees-of-freedom inertial data in a wearable, non-invasive form factor. TEMPO 3.1 is designed to be usable to both the wearer and researcher, thereby enabling motion capture applications in body area sensor networks (BASNs). A complete system is designed and developed that includes the following: (1) enabling technologies and hardware design of TEMPO 3.1, (2) a custom real-time operating system (TEMPOS) that manages all aspects of signal acquisition, signal processing, data management, peripheral control, and wireless communication on a TEMPO node, and (3) a custom case design. The system is evaluated and compared to existing BASN hardware platforms. TEMPO 3.1 creates new opportunities for wearable, continuous monitoring applications and extends the research space of current efforts.

Neuropsychologists are occasionally asked to have neuropsychological testing observed via the presence of a third party, through one-way mirrors, or with audio or video monitoring or recording devices. The primary reasons for not allowing observation are its effect on the validity of the examination results and the security of copyrighted test materials. To overcome the problem of observer effects on the examinee's performance, some individuals have suggested that examinations be monitored or recorded without the examinee's awareness (i.e., secretly). However, secretive recording of neuropsychological interviews and testing is deceptive, which is inconsistent with ethical principles. In addition, such recording may affect the behavior of the examiner. For these reasons, neuropsychologists do not, and should not, encourage, condone, or engage in secret recording of neuropsychological interviews or testing.

A special interest group of the American Congress of Rehabilitation Medicine [ACRM; Mild Traumatic Brain Injury Committee. (1993). Definition of mild traumatic brain injury. Journal of Head Trauma Rehabilitation, 8 (3), 86-87.] was the first organized interdisciplinary group to advocate four specific criteria for the diagnosis of a mild traumatic brain injury (TBI). More recently, the World Health Organization (WHO) Collaborative Center Task Force on Mild Traumatic Brain Injury [Carroll, L. J., Cassidy, J. D., Holm, L., Kraus, J., & Coronado, V. G. (2004). Methodological issues and research recommendations for mild traumatic brain injury: the WHO Collaborating Centre Task Force on Mild Traumatic Brain Injury. Journal of Rehabilitation Medicine, (Suppl. 43), 113-125.] conducted a comprehensive review of the definitions utilized in evidence-based studies with mild TBI patients. Based on this review, the WHO task force maintained the same four criteria but offered two modifications. The similarities and differences between these two definitions are discussed. The authors of the ACRM and the WHO definitions do not provide guidelines or specific recommendations for diagnosing the four criteria. Thus, we provide recommendations for assessing loss of consciousness, retrograde and post-traumatic amnesia, disorientation and confusion as well as clarification of the neurologic signs that can be indicative of a diagnosis of mild TBI. Finally, confounding factors mentioned in both definitions that should exclude a mild TBI diagnosis are summarized.

Body area sensor networks (BASNs) have implicit stringent power requirements to meet battery life and form factor expectations, especially in long-term medical monitoring applications. The largest power consumer in BASNs is typically the wireless transceiver, so recent research has focused on increasing on-node signal processing to reduce the number of bits for wireless transmission. This shift increases the importance of power efficient signal processing. Given that the processing workloads and throughput requirements can change dynamically in a BASN, dynamic voltage-frequency scaling (DVFS) becomes an attractive option for providing the necessary processing rate with the minimum power. However, commercial off the shelf (COTS) components typically used in BASN nodes are not designed for DVFS. This paper characterizes the DVFS capabilities of a COTS processor commonly used on BASN nodes -- the TI MSP430 -- and explores the usefulness of these capabilities within the context of BASN applications.

Energy-fidelity tradeoffs are central to many battery-constrained systems, but they are essential in body area sensor networks (BASNs) due to energy and resource constraints, and the critical nature of many healthcare applications. On-node signal processing and compression techniques can save energy by greatly reducing the amount of data transmitted over the wireless channel, but lossy techniques can incur a reduction in application fidelity. In order to maximize system performance, these tradeoffs must be considered at run-time due to the variable nature of BASN application, including sensed data, operating environments, user actuation, etc. BASNs therefore require energy-fidelity scalability, so automated and user-initiated tradeoff decisions can be made dynamically. This paper explores the utility of energy-fidelity scalability in BASNs from a data-centric perspective. Compression algorithms are identified that can be implemented on resource constrained BASN nodes and that have "knobs" capable of trading off compression ratios (and resulting transmission energy) with fidelity. To demonstrate the potential of energy-fidelity scalability on a real BASN and for a real application, the tradeoff space is established by adjusting these algorithms for different movement disorder data sets collected by a custom accelerometer-based BASN. Finally, mechanisms for energy-fidelity dynamic control are explored.

Risk stratification in GIST is under debate. Therefore, we evaluated the prognostic value of p16 staining in GIST.

Three isoforms of human tau protein were compared for their abilities to induce microtubule assembly. The three isoforms, tau 3 (tau containing three microtubule-binding domains), tau 4 (tau containing four microtubule-binding domains) and tau 4L (tau containing four microtubule binding domains plus a 58-amino-acid insert near the N-terminus) were expressed in E. coli and purified using ammonium sulfate precipitation, ion exchange, and size exclusion chromatography. All three isoforms induced microtubule assembly at micromolar concentrations and showed similar critical concentrations for assembly of 0.4-0.45 microM. However, tau 4 induced microtubule formation at a rate five- to tenfold faster than either tau 3 or tau 4L. The rate of microtubule elongation seen with tau 4 was twofold greater than with tau 3 or tau 4L, suggesting that the faster rate of microtubule assembly seen with tau 4 was due, at least in part, to faster elongation. Tau 4 induced a greater number of microtubules to form at steady state than did tau 3 or tau 4L. The microtubules generated with each tau isoform had similar steady-state length distributions and were equally susceptible to cold-induced disassembly. These results indicate that the additional microtubule-binding domain in tau 4 enhances microtubule assembly, while the 58-amino-acid insert negates the stimulatory effect of the fourth microtubule-binding domain.

Various critics or "method skeptics" have contended that clinical neuropsychology is not sufficiently developed as a science to be offered as evidence in legal or trial proceedings. The present article attempts to balance the extreme position of the method skeptics with an overview of legal and research data that support forensic applications of neuropsychology. It is suggested that clinical evidence can usefully inform legal decision making and that the modern trend has been for courts to be increasingly open to such expert testimony. The relevance of studies of clinical judgement, experience, and actuarial prediction is discussed, and neuropsychological assessment validity is specifically addressed. It is concluded that the arguments of the method skeptics should guide future research and caution forensic neuropsychologists, but that a retreat from the courtroom is unwarranted.

The effects of oxytocin (OXT), arginine- and lysine-vasopressin (AVP and LVP) and an OXT-receptor antagonist on cocaine-induced sniffing behaviour were investigated in rats. OXT, but not AVP or LVP injected subcutaneously (s.c.) attenuated cocaine-induced sniffing. The effect of OXT (s.c.) was inhibited by an OXT-receptor antagonist administered intracerebroventricularly (i.c.v.). l.c.v. administration of different doses of OXT in nanogram quantities caused a dose-dependent attenuation of cocaine-induced sniffing. Local cerebral microinjection of OXT into the accumbens nucleus and olfactory tubercle but not into the olfactory nucleus, central amygdaloid nucleus or caudate nucleus, inhibited the cocaine-induced sniffing behaviour. These results demonstrate that OXT selectively attenuates the cocaine-induced stereotyped behaviour through basal forebrain target sites.

Body sensor networks (BSNs) offer a wealth of opportunities for precise, accurate, continuous, and non-invasive sensing of physiological phenomena, but their unique operating environment, the body-area, poses unique technical challenges. Popular communications solutions that utilize 2.4 GHz radio transmission suffer from significant and highly variable path loss in this setting. To compensate for such loss, radio transceivers often transmit at power levels at or above 1 mW -- a reality that limits battery life. We propose the use of body-coupled communication to address this issue, as it presents several distinct advantages over existing solutions, namely: reduced power consumption, minimal interference, and increased privacy. In this paper, we demonstrate a 23 MHz body-coupled channel that supports reliable data transfer with an average received power of 30 dBm over a 2.4 GHz radio frequency link. This scheme reduces power needed for transmission and increases battery life by up to 100%, while maintaining a favorable environment for application-specific quality of service requirements. Finally, we propose a system-level hardware architecture and explore its implications on BSN infrastructure.

Traumatic brain injury (TBI) is a major health problem in civilian, military, and veteran populations. Individuals experiencing moderate to severe TBI require a continuum of care involving acute hospitalization and postacute rehabilitation, including community reintegration and, one would hope, a return home to function as a productive member of the community. In the military, the goal is to help individuals with TBI return to active duty or make an optimal return to civilian life if the extent of their injuries necessitates a "medical board" discharge. Whether civilian, military, or veteran with TBI, individuals who move beyond the need to live in a facility must be reintegrated back into the community. This article discusses four treatment models for community reintegration, reviews treatment standardization and outcome issues, and describes a manualized rehabilitation pilot program designed to provide community reintegration and return to duty/work for civilians, veterans, and military personnel with TBI.

A mild traumatic brain injury in sports is typically referred to as a concussion. This is a common injury in amateur and professional athletics, particularly in contact sports. This injury can be very distressing for the athlete, his or her family, coaches, and school personnel. Fortunately, most athletes recover quickly and fully from this injury. However, some athletes have a slow recovery, and there are reasons to be particularly concerned about re-injury during the acute recovery period. Moreover, some athletes who have experienced multiple concussions are at risk for long-term adverse effects. Neuropsychologists are uniquely qualified to assess the neurocognitive and psychological effects of concussion. The National Academy of Neuropsychology recommends neuropsychological evaluation for the diagnosis, treatment, and management of sports-related concussion at all levels of play.

A learning disability (LD) is a neurobiological disorder that presents as a serious difficulty with reading, arithmetic, and/or written expression that is unexpected, given the individual's intellectual ability. A learning disability is not an emotional disorder nor is it caused by an emotional disorder. If inadequately or improperly evaluated, a learning disability has the potential to impact an individual's functioning adversely and produce functional impairment in multiple life domains. When a learning disability is suspected, an evaluation of neuropsychological abilities is necessary to determine the source of the difficulty as well as the areas of neurocognitive strength that can serve as a foundation for compensatory strategies and treatment options.