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Hospitals, payors, and patients increasingly expect us to report our outcomes in more detail and to justify our treatment decisions and costs. Although there are many stakeholders in surgical outcomes, physicians must take the lead role in defining how outcomes are assessed. Skull base lesions interact with surrounding anatomy to produce a complex spectrum of presentations and surgical challenges, requiring a wide variety of surgical approaches. Moreover, many skull base lesions are relatively rare. These factors and others often preclude the use of prospective randomized clinical trials, thus necessitating alternate methods of scientific inquiry. In this paper, we propose a roadmap for implementing a skull base registry, along with expected benefits and challenges.

The nature of tight gas reservoir consists of heterogeneous sub-units separated by impermeable denses and various depletion level has become the greatest challenge on how to exploit this typical reservoir at its maximum. Despite maximum reservoir contact is the best method to deliver the highest well production, this paper tries to tell another success story about UBCTD applied in a triple lateral well which can deliver greater productivity than a normal overbalanced multilateral well. The study methodology begins with the evaluation of the current remaining potential sweetspots throughout the reservoir. The assisted history matching is used to generate 3 different model realizations: Low - Mid - High case that can map-out sweetspot distribution called Simulation Opportunity Index (SOI) map. SOI integrates 3 independent components selected from static and dynamic parameters: reservoir permeability-thickness, movable gas and reservoir pressure from a historically-matched dynamic model. One particular area is then selected and evaluated furthermore for the final new well and trajectory placement. The well was drilled as a triple lateral with one of the lateral was fully placed in prime sub-unit that likely holds the potential remaining sweetspot in the area according to SOI method with expectation to maximize its recovery. During the drilling, UBCTD technique was implemented because it offers several advantages such as reduction of formation damage, reduction of drilling fluid loss into formation, avoiding losses-related drilling problems and risk of differential sticking and creating cost saving for completion and stimulation requirements. Earlier study in the field signified that generally, the well productivity is strongly influenced by the type of the lateral and the geological structure. For instance, the triple lateral well located at higher structure normally gives higher productivity than the triple lateral well located underneath it. Theoretically, higher productivity will be given by the triple lateral compared to the situation if the same area is developed by dual lateral or even by the single lateral well. Currently, the implementation of UBCTD in this triple lateral well was confirmed to provide better productivity up to double exceeding a conventional overbalanced with the same well laterals. Greater initial gas production rate with high THP was evidenced during the well clean-up. UBCTD application in tight gas reservoirs is not only aimed to improve the initial well productivity significantly beyond the conventional overbalanced well but it is also expected to create more equal pressure drawdown distribution along the lateral drain because of many given advantages as stated above. At last, cost saving can be performed because the operating cost which is usually spent on normal wells for well stimulation can be reduced.

The trajectory placement of a horizontal well that crosses a heterogeneous tight gas carbonate reservoir is one of the important elements that contribute to the success of well productivity. Proper placement can yield good production and vice versa improper placement may give low well productivity. An effort was studied to improve the well productivity from an existing single horizontal well that was initially placed in sub optimal location by implementing the Fishbones completion technology (work-over). In this paper, Simulation Opportunity Index (SOI) has been selected as a method to indicate the remaining gas sweet spot throughout the reservoir. SOI integrates 3 independent components extracted from static and dynamic parameters; reservoir permeability-thickness, movable gas, and reservoir pressure from a historically-matched dynamic model. By utilizing SOI, a map of the prospective gas sweet spots can be created; hence low performance existing wells are utilized to exploit the surrounding potential sweet spots using Fishbones completion, which consists of tiny short needles with a maximum effective length of 32 feet placed along the horizontal section. The study reveals that the Fishbones completion application on existing low-productive horizontal well can multiply the well productivity in multi-layer reservoir environment in addition to the significant production gain. Assisted History Matching (AHM) is used to explore the best scenario of Fishbones features combination, such as the number of Subs required as the container room to hold the needles, the optimum needles length, and the optimum lateral drain section to place the Subs and needles. Many sensitivities with the abovementioned variables are run at once, and the analysis is conducted to identify the most impacting parameter to bring the highest well recovery. The use of SOI method to scrutinize the best location of well candidatures for Fishbone application and the required Subs and needles placement is not only able to rejuvenate the performance of the problematic well, but it can aid in generating CAPEX saving and efficient project schedule to manufacture Fishbones with a proper number of Subs and needles compared to blind Fishbone technology installation. A combination of two techniques between reservoir simulation study to generate SOI with the new advanced completion technology called Fishbones applied on low-performance existing horizontal well is the real study integration with the final objective to increase the ultimate gas recovery in a tight gas carbonate reservoir. This is a breakthrough solution to optimize the development of tight carbonate gas fields in addition to the conventional development strategy with normal infill drillings.

OBJECTIVEThe aim of this study was to examine the role of intraoperative neuromonitoring (IONM) during resection of benign peripheral nerve sheath tumors in achieving gross-total resection (GTR) and in reducing postoperative neurological complications.METHODSData from consecutive adult patients who underwent resection of a benign peripheral nerve sheath tumor at 7 participating institutions were combined. Propensity score matching was used to balance covariates. The primary outcomes of interest were the association between IONM and GTR and the association of IONM and the development of a permanent postoperative neurological complication. The secondary outcomes of interest were the association between IONM and GTR and the association between IONM and the development of a permanent postoperative neurological complication in the subgroup of patients with tumors involving a motor or mixed nerve. Univariate and multivariate logistic regression were then performed on the propensity score–matched samples to assess the ability of the independent variables to predict the outcomes of interest.RESULTSA total of 337 patients who underwent resection of benign nerve sheath tumors were included. In multivariate analysis, the use of IONM (OR 0.460, 95% CI 0.199–0.978; p = 0.047) was a significant negative predictor of GTR, whereas none of the variables, including IONM, were associated with the occurrence of a permanent postoperative neurological complication. Within the subgroup of motor/mixed nerve tumors, in the multivariate analysis, IONM (OR 0.263, 95% CI 0.096–0.723; p = 0.010) was a significant negative predictor of a GTR, whereas IONM (OR 3.800, 95% CI 1.925–7.502; p < 0.001) was a significant positive predictor of a permanent postoperative motor deficit.CONCLUSIONSOverall, 12% of the cohort had a permanent neurological complication, with new or worsened paresthesias most common, followed by pain and then weakness. The authors found that formal IONM was associated with a reduced likelihood of GTR and had no association with neurological complications. The authors believe that these data argue against IONM being considered standard of care but do not believe that these data should be used to universally argue against IONM during resection of benign nerve sheath tumors.

Basilar artery occlusion (BAO) is a rare cause of stroke associated with significant morbidity and mortality. It is most frequently thromboembolic in nature, but may be caused by vertebral artery dissection. We present a case of BAO in a 36-year-old woman with Alport syndrome. She was treated with emergent thrombectomy via the right vertebral artery with return to baseline neurological status. Her clinical status deteriorated later the same day and she was found to have re-occlusion. Repeat thrombectomy was complicated by persistent re-occlusion requiring 7 passes to achieve reperfusion. Unfortunately, her neurological exam remained poor and she was transitioned to comfort care, expiring on admission day 3. An autopsy demonstrated acute dissection of the left vertebral artery, basilar artery, and bilateral posterior cerebral arteries. Alport syndrome is a type IV collagenopathy most known for causing kidney disease. It may also be associated with vascular fragility as type IV collagen forms a significant component of the vascular basement membrane. There are reports of aortic, coronary, and cervical dissections, but few reports of intracranial dissections in patients with Alport syndrome. While iatrogenic dissection cannot be ruled out, the histological findings in this case are most consistent with spontaneous arterial dissection as the cause of her initial neurologic presentation. This highlights the need for further investigation into the relationship between Alport syndrome and vascular fragility and should alert clinicians to the possibility of intracranial dissection in patients with AS.

Elizabeth Crosby (1888-1983) is a beloved and well-respected titan of neuroanatomy. Her contributions to our understanding of neuroanatomy are rooted in her seminal text, The Comparative Anatomy of the Nervous System of Vertebrates, Including Man, published in 1936, which is a masterful and comprehensive account of comparative neuroanatomy. Her later texts, Correlative Neurosurgery and Correlative Anatomy of the Nervous System, are standard reference texts to this day. Her mentorship of graduate students, close work with the University of Michigan neurosurgery department, and the quality of her research and scientific publications were recognized with many awards, culminating in the National Medal of Science presented by President Carter in 1980.

BACKGROUND Gelatin sponges, such as Gelfoam, are used as hemostatic agents during surgery and are generally absorbed over the course of 4–6 weeks in most body cavities. The time course of the dissolution of Gelfoam sponges within the cerebral ventricles has not been described. OBSERVATIONS The authors present a case of intraventricular migration of Gelfoam after ventriculoperitoneal shunt placement in a 6-week-old infant. The infant was imaged regularly after ventriculoperitoneal shunt placement, and the Gelfoam sponge persisted within the ventricles on all images until 11 months after surgery. At no time during follow-up did the patient have any symptoms of hydrocephalus requiring retrieval of the sponge or shunt revision. LESSONS This is the first case describing time until absorption of a gelatin sponge within the ventricle and successful conservative management.

Infection of agricultural plants is a serious threat to food safety. It can severely damage plants' yielding capacity. Farmers are the primary victims of this threat. Due to the advancement of AI, image-based intelligent apps can play a vital role in mitigating this threat by quick and early detection of plants infections. In this paper, we present a mobile app in this regard. We have developed MajraDoc to detect some common diseases in local agricultural plants. We have created a dataset of 10886 images for ten classes of plants diseases to train the deep neural network. The VGG-19 network model was modified and trained using transfer learning techniques. The model achieved high accuracy, and the application performed well in predicting all ten classes of infections.

OBJECTIVE Benign expansion of the subarachnoid spaces (BESS) is a condition seen in macrocephalic infants. BESS is associated with mild developmental delays which tend to resolve within a few years. It is accepted that patients with BESS are at increased risk of spontaneous subdural hematomas (SDHs), although the exact pathophysiology is not well understood. The prevalence of spontaneous SDH in BESS patients is poorly defined, with only a few large single-center series published. In this study the authors aimed to better define BESS prevalence and developmental outcomes through the longitudinal review of a large cohort of BESS patients. METHODS A large retrospective review was performed at a single institution from 1995 to 2020 for patients 2 years of age or younger with a diagnosis of BESS by neurology or neurosurgery and head circumference > 85th percentile. Demographic data, head circumference, presence of developmental delay, occurrence of SDH, and need for surgery were extracted from patient charts. The subarachnoid space (SAS) size was measured from the available MR images, and the sizes of those who did and did not develop SDH were compared. RESULTS Free text search revealed BESS mentioned within the medical records of 1410 of 2.6 million patients. After exclusion criteria, 480 patients remained eligible for the study. Thirty-two percent (n = 154) of patients were diagnosed with developmental delay, most commonly gross motor delay (53%). Gross motor delay resolved in 86% of patients at a mean age of 22.2 months. The prevalence of spontaneous SDH in this BESS population over a period of 25 years was 8.1%. There was no significant association between SAS size and SDH formation. CONCLUSIONS This study represents results for one of the largest cohorts of patients with BESS at a single institution. Gross motor delay was the most common developmental delay diagnosed, and a majority of patients had resolution of their delay. These data support that children with BESS have a higher prevalence of SDH than the general pediatric population, although SAS size was not significantly associated with SDH development.

The research addresses the transformations of Iraqi house designs during the period (1980-2020) represented by the cities of Baghdad and Samawah as a case study, adopting the analytical descriptive approach to study house designs, and inductive approach to reach the results. The research process was through an office and field study of the two cities, which dealt with the comparison of pre-war houses (1980-1990), during the war and siege houses (1990-2010) until now.In order to reach the house design transformations caused by the war and siege in the two cities, a comparison was made between the types of houses from both cities and in several aspects, including:• Spaces, mass and void ratio. • Direction• Internal spaces • External spaces• Facades and exterior configurationBy comparison, each city had its own housing type during the 1980s, and gradually the designs in both cities began to resemble principles and ideas in later periods due to events and large intercity migration. The research found a set of results that the events of the period studied had a significant impact on the design of the houses in the cities, where the designs were more stable at the beginning of the period studied, and then became unstable in the 1990s and early 21st century, down to the current type, which is more stable than the previous period (the period of siege). يتناول البحث بالدراسة والتحليل تحولات تصميم المسکن العراقي خلال الفترة ما بين (1980-2020م) متخذا مدينتي بغداد والسماوة حالة دراسية، معتمدا المنهج الوصفي التحليلي لدراسة نماذج تصاميم المساکن والمنهج الاستقرائي للوصول إلى النتائج. من خلال إجراء دراسة مکتبية وميدانية للمدينتين، والتي تناولت المقارنة بين المساکن قبل الحرب (1980-1990م) وخلال الحرب والحصار (1990-2010م) حتى الوقت الراهن. وللوصول إلى التحولات التي حدثت بسبب الحرب والحصار في المدينتين، تم إجراء مقارنة بين مساکن المدينتين ومن عدة جوانب تشمل: المساحات ونسبة الکتلة والفراغ. التوجيه. فراغات المسکن الداخلية. الفراغات الخارجية. الواجهات والتشکيل الخارجي. تم التوصل من خلال المقارنة، أن لکل من مدينتي بغداد والسماوة نمط مسکن خاص بها خلال فترة الثمانينيات، ثم تدريجيا بدأت تتشابه التصاميم في المبادئ والأفکار في الفترات اللاحقة بسبب الأحداث التي حدثت والهجرة الکبيرة بين المدن. توصل البحث إلى مجموعة نتائج تتلخص في کون أحداث الفترة المدروسة قد أثرت بشکل کبير على تصميم المسکن في المدينتين، حيث کانت التصاميم أکثر استقرارا في فترة الثمانينيات، ثم أصبحت غير مستقرة في التسعينيات وبداية القرن الواحد والعشرين، وصولا إلى النمط الحالي والذي هو أکثر استقرارا من الفترة السابقة (فترة الحصار).

e21060 Background: Malignant pleural effusion (MPE) occurs in 7-23% of advanced non-small cell lung cancer (NSCLC) patients with overall survival (OS) of 8.5 months only. The optimum anti-neoplastic regimen in MPE is yet to be determined. Thus, we conducted a meta-analysis to determine the optimum anti-neoplastic agent in managing MPE in NSCLC. Methods: We searched PubMed, Scopus, CENTRAL, ASCO, ESMO, and IASLC meetings libraries to retrieve relevant trials. We included single-arm and controlled trials in which patients with MPE were treated by anti-neoplastic drugs such as chemotherapy and/or targeted therapy. Patients treated with radiotherapy were excluded. Primary and secondary endpoints were efficacy and safety, respectively. Meta-analysis was conducted for the primary endpoint estimated by OS and objective response rate (ORR). In addition, subgroup analysis was conducted to investigate the effect of route of administration (ROA) and randomization on ORR. Results: We included 11 trials with a total of 542 patients. There were 5 randomized clinical trials, 5 phase II trials, and 1 phase I trial with a total of 16 relevant arms. Five arms used single-agent chemotherapy (SC), 11 combined therapy (CT) and 6 arms bevacizumab-based (BEVA) therapy. The ROA was intrapleural (IP) in 10 arms and intravenous (IV) in 6 arms. We pooled 124 patients from 5 trials that reported ORR results for SC patients. The pooled ORR was 41.7% (95% CI: 32.8 to 50.8%) with no heterogeneity ( I2 = 0%, p = 0.47). Pooling of 396 patients who underwent CT in 10 studies results in an ORR of 64.1% (95% CI: 52.7 to 74.8%) with a high heterogeneity rate ( I2 = 84%, p< 0.01). Analysis of BEVA studies yielded an ORR of 62.2% (95% CI: 43.5 to 79.2%), representing 133 patients from 5 trials. The table shows the effect of randomization and ROA on ORR. One-year OS was reported in 4 studies that used CT; pooled 1-year OS estimate for 216 patients was 81.2% (95% CI: 75.5 to 86.4%). As for grade 3/4 AEs, the occurrence of nausea/vomiting (N/V) was higher in CT than SC (14% vs 2%). Chest pain rate was similar (9.8% vs 7.0%), leukopenia was higher in BEVA than SC (19.1% vs 9.8%), and neutropenia was more prevalent in BEVA than CT (22.1% vs 8.1%). Incidence of any-grade N/V was more common in BEVA than SC (42.9% vs 19.3%). Conclusions: Both CT and BEVA-based regimens were effective and safe in treating MPE. IP was superior to IV in CC and BEVA based regimens. ORR was higher in randomized trials, suggesting a better response of MPE under optimum clinical conditions. Further trials of these agents are needed to confirm these results.[Table: see text]

OBJECTIVEVentricular shunts have an unacceptably high failure rate, which approaches 50% of patients at 2 years. Most shunt failures are related to ventricular catheter obstruction. The literature suggests that obstructions are caused by in-growth of choroid plexus and/or reactive cellular aggregation. The authors report endoscopic evidence of overdrainage-related ventricular tissue protrusions (“ependymal bands”) that cause partial or complete obstruction of the ventricular catheter.METHODSA retrospective review was completed on patients undergoing shunt revision surgery between 2008 and 2015, identifying all cases in which the senior author reported endoscopic evidence of ependymal tissue in-growth into ventricular catheters. Detailed clinical, radiological, and surgical findings are described.RESULTSFifty patients underwent 83 endoscopic shunt revision procedures that revealed in-growth of ventricular wall tissue into the catheter tip orifices (ependymal bands), producing partial, complete, or intermittent shunt obstructions. Endoscopic ventricular explorations revealed ependymal bands at various stages of development, which appear to form secondarily to siphoning. Ependymal bands are associated with small ventricles when the shunt is functional, but may dilate at the time of obstruction.CONCLUSIONSVentricular wall protrusions are a significant cause of proximal shunt obstruction, and they appear to be caused by siphoning of surrounding tissue into the ventricular catheter orifices.

Cervical spine injuries are the most common spine injuries in the pediatric population. The authors present the youngest known patient who underwent cervical spine fusion to repair birth trauma–induced cervical fracture dislocation, resulting in spondyloptosis and spinal cord injury. A 2-week-old boy was found to have spondyloptosis and spinal cord injury after concerns arose from reduced movement of the extremities. The patient’s birth was complicated by undiagnosed abdominal dystocia, which led to cervical distraction injury. At 15 days of age, the boy underwent successful C-5 corpectomy, with anterior C4–6 and posterior C2–7 arthrodesis, using an autologous rib graft for a C-5 fracture dislocation. MRI performed 2 weeks postoperatively revealed significant improvement in the alignment of the spinal canal. The patient was discharged from the hospital in a custom Minerva brace and underwent close follow-up in addition to occupational therapy and physical therapy. At the latest follow-up 4.5 years later, the patient was able to walk and ride a tricycle by himself. The authors describe the patient’s surgery and the challenges faced in achieving successful repair and cervical spine stabilization in such a young patient. The authors suggest that significant neurological recovery after spinal cord injury in infants is possible with appropriate, timely, and interdisciplinary management.

COVID-19 is a global crisis that has caused many consequences on societies, including Saudi society. For instance, fear, anxiety, and social divergence due to the disease's rapid spread and the absence of efficacious treatment. In addition to closures and quarantine. This study aims at identifying the psychological, social, and economic effects on Saudi society. We used the analytic approach. More specifically, the snowball sampling method was conducted with (1624 participants) aged between (18 -+60) during the COVID-19 pandemic from Riyadh and Najran cities. Accordingly, an online survey was conducted during the outbreak's peak phase, using the researchers' questionnaire. The results indicated that the psychological impact level was 42.25%, social (64.4%), and economic (51%) on Saudi society during the COVID-19 outbreak. In particular, psychosocial influence levels are exceptionally high for unmarried women, patients, and over 60 years. In contrast, the economic impact is high for married couples, private sector employees, and those living in rural areas with less than SAR 5,000. As a result, the study recommended that the Saudi government pay more attention to individuals' social, psychological, and economic aspects by developing medium and long-term political strategies, such as mapping the rates of psychological, social, and economic health problems to allocate adequate support and creating innovative ways online to increase the people well-being. © 2021 Alkhamshi et al.. This is an open access article licensed under the Creative Commons Attribution-NonCommercial 4.0 International License

Purpose The reliability of lower extremity muscle activation patterns has not been clearly studied in a dual-belt instrumented treadmill environment. The primary study objective was to quantify the day-to-day reliability of quadriceps, hamstrings, gastrocnemius and gluteus medius activation patterns in healthy young adult gait. Secondarily, the reliability of spatiotemporal, and knee/hip motion and moment-based gait outcomes was assessed. Scope: 20 young adults were recruited and tested on two separate days. Using standardized procedures, participants were prepared for surface electromyography and lower extremity motion capture. All individuals walked on a dual-belt instrumented treadmill while muscle activation, segment motions and ground reaction forces were recorded. Sagittal plane motion and net external sagittal and frontal plane moments were calculated. Discrete biomechanical and muscle activation measures were calculated, and non-negative matrix factorization extracted amplitude and temporal muscle activation features. Intraclass Correlation Coefficients, Standard Error of Measurement and Minimum Detectable Change were calculated. Conclusions High to excellent Intraclass correlation coefficients were found between visits for most primary and secondary outcomes. The absolute and relative reliability, including Minimum Detectable Change values, provided in this study support the use of dual-belt instrumented treadmill walking as an acceptable medium to collect biomechanical and lower extremity EMG outcomes for future studies.

Mass spectrometry-based proteomics has been extensively used to map bacterial proteomes, which has led to a better understanding of the molecular mechanisms underlying bacterial infection and bacteria-host interactions. Quantitative proteomics using selected or parallel reaction monitoring is considered one of the most sensitive and specific quantitative MS-based approaches and has significantly advanced proteome studies of pathogenic bacteria. Here, recent applications of targeted proteomics for bacteria identification, biomarker discovery, and the characterization of bacterial virulence and antimicrobial resistance are reviewed among others. Results of such studies are expected to further contribute to improve the fight against the most common human pathogenic bacteria.

Nationally, schools are unable to cope with the increasing demands imposed upon the teachers and students as the learning systems have not changed. On the other hand, there is an increasing need for librarians to assist curriculum needs in schools and the national education agenda of UAE, of having human talents who are knowledge creators, have sufficient 21st century skills, lifelong learning habits, positive beliefs and behaviors, and knowledge and skills related to STREAM as well as a holistic personality. The role of public libraries could be extended further to work closely with schools in a systemic way that enables both entities to reach another milestone. Schools can establish another supportive educational after-school system to empower teachers and students. A more extensive and rigorous as well as controlled system that all stakeholders, teachers, and parents could share to provide the opportunity for students to be effective knowledge-contributors is planned and shared in this chapter.

Introduction:One of the major, most common health issues in the United States, Europe, and around the world is gallbladder disease. About 6.3 million and 14.2 million, men and women, respectively, suffer from a gallbladder disease in the United States alone. Most patients who have gallstones stay asymptomatic for a long time. However, it is still important to address their disease, and prevent it from turning into a symptomatic disease. Aim of work:We will discuss the most recent approaches to gallstone disease treatment, and we will focus on surgical approaches to symptomatic and complicated gallstone disease. Methodology:We conducted a systematic comprehensive search in literature review using Medline, Pubmed, and Embase. We used the terms gallbladder disease, gallbladder stones, gallstones, surgical approaches, laparoscopy, and cholecystectomy as search items. Conclusions:About three quarter of gallstone cases are classified as cholesterol gallstones. Risk factors for developing cholesterol gallstone disease include older age, female sex, pregnancy state, insulin resistance, obesity, decreased physical activity, use of oral contraception, and diabetes mellitus type 2. The definitive treatment for gallstones disease is surgical cholecystectomy. Laparoscopic cholecystectomy was primarily introduced in the year 1985 and led to significant advance in the management of gallstone disease. Since then, it has replaced open cholecystectomy and became the standard surgical approach in the treatment of gallstone disease, due to its safety and cost-effectiveness. Open cholecystectomy could be used in patients who cannot undergo laparoscopic cholecystectomy, or who have severe gallbladder disease. Other options include percutaneous cholecystectomy, and endoscopic drainage. Keywords: gallbladder, gallstones, cholecystectomy, laparoscopy.

Taking care of elderly people is uneasy task, especially when they are diagnosed with Alzheimer's disease. They need a permanent and particular type of care. Therefore, Alzheimer's caregivers have huge burden on them. This project aims to get the benefit of the Internet of Things (IoT) concept along with a mobile application to facilitate Alzheimer's caregiving and avoid burnout. The solution consists of two parts: the first one is that the Alzheimer's patient should have a wearable IoT device which is the Apple Smartwatch. The second part is an iOS application download in the caregiver's iPhone that must be connected to the patient's watch to accessing and storing the patient's heart rate and location data. The application enables the caregivers to track and find their beloved ones, especially if they go out by themselves, also it displays the patients' heart rates to the caregivers when they required. It has another feature which is the reminder list to schedule tasks, such as bathing, exercises, a patient's medication and medical appointments. In addition, the application has a section where the caregivers can get some information about Alzheimer's Disease.

Optimization of deep brain stimulation (DBS) parameters is a weeks to months-long process for many patients, due in part to the inflammatory response caused by electrode implantation. To investigate the effect of inflammation on current delivery. transgenic mice, expressing Thy1-GCaMP6f (a genetically-encoded calcium sensor), were implanted with a DBS electrode in the subthalamic nucleus (STN). Immediately following insertion, high frequency electrical stimulation of the STN was performed and we imaged changes in fluorescence elicited by stimulation to characterize the response of cortical neurons to STN DBS. Our result is consistent with the idea that the acute inflammatory response during the perioperative and early postoperative periods shunt current away from the desired target compared to the chronic inflammatory state weeks later.

Recent work demonstrated the efficacy of combining layer-by-layer assembly with hydrogels to provide the controlled delivery of proteins for use in nerve repair scaffolds. In this work, we augmented the protein dose response by controlling and increasing the hydrogel internal surface area. Sucrose was added to agarose during gelation to homogenize the nanopore morphology, resulting in increased surface area per unit volume of hydrogel. The surface area of a range of compositions (1.5-5.0 wt% agarose and 0, 50 and 65 wt% sucrose) was measured. Gels were supercritically dried to preserve porosity enabling detailed pore morphology measurements using nitrogen adsorption and high resolution scanning electron microscopy. The resulting surface area, normalized by superficial gel volume, ranged between 6m(2)/cm(3)gel and 56 m(2)/cm(3)gel. Using the layer-by-layer process to load lysozyme, a neurotrophic factor analog, a relationship was observed between surface area and cumulative dose response ranging from 176 to 2556 μg/mL, which is in the range of clinical relevance for the delivery of growth factors. In this work, we demonstrated that the ability to control porosity is key in tuning drug delivery dose response from layer-by-layer modified hydrogels.