Clinical signs for identification of neurocysticercosis in swine naturally infected with Taenia solium

Taenia solium infection is a zoonotic disease and swine is the natural intermediate host. Till date no literatures have described clinical signs in swine indicative of brain involvement by cysticerci. In the present study we describe such clinical signs of porcine neurocysticercosis (NCC). These signs were excessive salivation, excessive blinking and tearing, and subconjunctival nodule. A total of 30 swine (18 with 2 or all 3 clinical signs and 12 without any sign) underwent magnetic resonance imaging (MRI). All 18 swine with above signs had NCC on MRI along with variable involvement of other organs that were subsequently confirmed by ex vivo MRI, necropsy and histopathology, while none of the 12 animals without any sign had NCC. As development of a porcine NCC model has proved difficult, we propose that naturally infected swine can be identified on the basis of these clinical signs and thus used as a model for further research on NCC.     

Wireless vitals—Proof of concept for wireless patient monitoring in an emergency department setting

Vital sign assessment is a common task in emergency medicine, but resources for continuous monitoring are restricted, data is often recorded manually, and entangled wires cause frustration. Therefore, we designed a small, wireless photoplethysmographic device capable of continuously assessing pulse, respiratory frequency and oxygen saturation on the sternum and tested the performance and feasibility in an emergency department setting. Fifty (56.3 ± 20.2 years), consenting emergency patients (29 male) were recruited. Heart rate, respiratory rate and oxygen saturation were recorded simultaneously using the device and standard monitoring equipment. Data was compared using Bland‐Altman plotting (heart rate, respiratory rate) and mean difference (oxygen saturation). The bias for heart‐ and respiratory rate was 0.4 (limits of agreements ?11.3, 12.2 and ?6.1, 7.0). Mean difference for oxygen saturation was ?0.21 ± 2.35%. This may be the first wireless device to use photoplethysmography on the sternum for vital sign assessment. We noted good agreement with standard monitors, but lack of standardization in data processing between monitoring systems may limit the generalizability of these findings. Although further improvements are needed, the feasibility of this approach provides proof of concept for a new paradigm of large scale, wireless patient monitoring.      

Monitoring depth of anesthesia using combination of EEG measure and hemodynamic variables

Monitoring depth of anesthesia (DOA) via vital signs is a major ongoing challenge for anesthetists. A number of electroencephalogram (EEG)-based monitors such as the Bispectral (BIS) index have been proposed. However, anesthesia is related to central and autonomic nervous system functions whereas the EEG signal originates only from the central nervous system. This paper proposes an automated DOA detection system which consists of three steps. Initially, we introduce multiscale modified permutation entropy index which is robust in the characterization of the burst suppression pattern and combine multiscale information. This index quantifies the amount of complexity in EEG data and is computationally efficient, conceptually simple and artifact resistant. Then, autonomic nervous system activity is quantified with heart rate and mean arterial pressure which are easily acquired using routine monitoring machine. Finally, the extracted features are used as input to a linear discriminate analyzer (LDA). The method is validated with data obtained from 25 patients during the cardiac surgery requiring cardiopulmonary bypass. The experimental results indicate that an overall accuracy of 89.4 % can be obtained using combination of EEG measure and hemodynamic variables, together with LDA to classify the vital sign into awake, light, surgical and deep anesthetised states. The results demonstrate that the proposed method can estimate DOA more effectively than the commercial BIS index with a stronger artifact-resistance.     

Functional and ecological correlates of ecologically-based dimorphisms in squamate reptiles

Sexual dimorphism in phenotypic traits associated with the useof resources is a widespread phenomenon throughout the animalkingdom. While ecological dimorphisms are often initially generatedby sexual selection operating on an animal's size, natural selectionis believed to maintain, or even amplify, these dimorphismsin certain ecological settings. The trophic apparatus of snakeshas proven to be a model system for testing the adaptive natureof ecological dimorphisms because head size is rarely undersexual selection and it limits the maximum ingestible size ofprey in these gape-limited predators. Significantly less attentionhas been paid to the evolution of ecological dimorphisms inlizards, however, which may be due to the fact that lizards’feeding apparatus can be under both sexual and natural selectionsimultaneously, making it difficult to formulate clear-cut hypothesesto distinguish between the influences of natural and sexualselection. In order to tease apart the respective influencesof natural selection and sexual selection on the feeding apparatusof squamates, we take an integrative approach to formulate twohypotheses for snakes and lizards, respectively: (1) For gape-limitedsnakes, we predict that natural selection will act to generatedifferences in maximum gape, which will translate into differencesin maximum ingestible prey size between the sexes. (2) For lizardswhich mechanically reduce their prey, we predict that the degreeof dimorphism in head size should be positively correlated tothe degree of dimorphism in bite force which, in turn, shouldbe correlated to dimorphism in aspects of size or hardness ofprey. Finally, we predict that functional differences in thefeeding apparatus of these animals will also be linked withdifferences in sex-based feeding behavior and with selectionof prey.     

Feasibility of an Ingestible Sensor-Based System for Monitoring Adherence to Tuberculosis Therapy

Poor adherence to tuberculosis (TB) treatment hinders the individual’s recovery and threatens public health. Currently, directly observed therapy (DOT) is the standard of care; however, high sustaining costs limit its availability, creating a need for more practical adherence confirmation methods. Techniques such as video monitoring and devices to time-register the opening of pill bottles are unable to confirm actual medication ingestions. A novel approach developed by Proteus Digital Health, Inc. consists of an ingestible sensor and an on-body wearable sensor; together, they electronically confirm unique ingestions and record the date/time of the ingestion. A feasibility study using an early prototype was conducted in active TB patients to determine the system’s accuracy and safety in confirming co-ingestion of TB medications with sensors. Thirty patients completed 10 DOT visits and 1,080 co-ingestion events; the system showed 95^.0% (95% CI 93^.5–96^.2%) positive detection accuracy, defined as the number of detected sensors divided by the number of transmission capable sensors administered. The specificity was 99^.7% [95% CI 99^.2–99^.9%] based on three false signals recorded by receivers. The system’s identification accuracy, defined as the number of correctly identified ingestible sensors divided by the number of sensors detected, was 100%. Of 11 adverse events, four were deemed related or possibly related to the device; three mild skin rashes and one complaint of nausea. The system’s positive detection accuracy was not affected by the subjects’ Body Mass Index (p = 0^.7309). Study results suggest the system is capable of correctly identifying ingestible sensors with high accuracy, poses a low risk to users, and may have high patient acceptance. The system has the potential to confirm medication specific treatment compliance on a dose-by-dose basis. When coupled with mobile technology, the system could allow wirelessly observed therapy (WOT) for monitoring TB treatment as a replacement for DOT.     

A Biobattery Capsule for Ingestible Electronics in the Small Intestine: Biopower Production from Intestinal Fluids Activated Germination of Exoelectrogenic Bacterial Endospores

Functioning ingestible capsules offer tremendous promise for a plethora of diagnostic and therapeutic applications. However, the absence of realistic and practical power solutions has greatly hindered the development of ingestible electronics. Microbial fuel cells (MFCs) hold great potential as power sources for such devices as the small intestinal environment maintains a steady internal temperature and a neutral pH. Those conditions and the constant supply of nutrient-rich organics are a perfect environment to generate long-lasting power. Although previous small-scale MFCs have demonstrated many promising applications, little is known about the potential for generating power in the human gut environment. Here, this work reports the design and operation of a microbial biobattery capsule for ingestible applications. Dormant Bacillus subtilis endospores are a storable anodic biocatalyst that will provide on-demand power when revived by nutrient-rich intestinal fluids. A conductive, porous, poly(3,4-ethylenedioxythiophene) polystyrene sulfonate hydrogel anode enables superior electrical performance in what is the world's smallest MFC. Moreover, an oxygen-rich cathode maintains its effective cathodic capability even in the oxygen-deficit intestinal environment. As a proof-of-concept demonstration in stimulated intestinal fluid, the biobattery capsule produces a current density of 470 µA cm⁻² and a power density of 98 µW cm⁻², ensuring its practical efficacy as a novel and sole power source for ingestible applications in the small intestine.     

Disease risks and overabundance of game species

Different studies have evidenced the relationship between host abundance and health status of wildlife populations. Diseases that benefit from wildlife overabundance can affect not only the fitness and trophy quality of game species, but also public health, livestock health, and the conservation of endangered species. This paper reviews a number of European examples to highlight the relationship between overabundance and disease in game species, and discusses the possibilities of limiting the associated risks. Management tools to estimate overabundance are needed for legislative purposes and for the monitoring of wildlife populations, but artificial feeding interferes in the objective measurement of overabundance. Therefore, we propose a multidisciplinary approach to diagnose if a given wildlife population is overabundant. This includes not only signs such as adverse effects on the soil, vegetation or fauna (first group), poor body condition scores, low trophy scores or low reproductive performance (second group), or increased parasite burdens (third group), but also the measurement of infectious disease prevalences (the fourth group of overabundance signs). This combined assessment of overabundance ideally requires the cooperation of wildlife managers, botanists, and veterinarians. Once a given wildlife population is defined as overabundant, it is difficult to establish palliative management actions. These can consist in banning certain management tools (e.g. feeding) or increasing the hunting harvest, but both of them are difficult to implement in practice. A close monitoring of both wildlife densities and wildlife diseases, the establishment of reference values for all signs of overabundance, and the mapping of the disease and density hotspots will be needed to design adequate risk-control measures for each particular situation.     

围术期体温监测及保温的现状分析

体温是人体重要的生命体征,其过低或过高都会对患者的预后造成不利影响,在临床中最常见也最容易被忽视的是围术期低体温。围术期长时间的体温过低会引起麻醉苏醒延迟、心律失常、影响切口愈合等多种并发症,增加死亡率,延迟出院时间。体温监测及相应的保温措施对于防治低体温至关重要,围术期及时有效地体温监测能反映病人术中病情的变化,但目前临床中对于体温的监控却普遍重视不足。本文对近年来临床常用的体温监测方法及保温手段做一综述。     

Measurement of the signs of methyl 13C chemical shift differences between interconverting ground and excited protein states by R 1ρ : an application to αB-crystallin

Carr-Purcell-Meiboom-Gill relaxation dispersion (CPMG RD) NMR spectroscopy has emerged as a powerful tool for quantifying the kinetics and thermodynamics of millisecond time-scale exchange processes involving the interconversion between a visible ground state and one or more minor, sparsely populated invisible 'excited' conformational states. Recently it has also become possible to determine atomic resolution structural models of excited states using a wide array of CPMG RD approaches. Analysis of CPMG RD datasets provides the magnitudes of the chemical shift differences between the ground and excited states, Δ?, but not the sign. In order to obtain detailed structural insights from, for example, excited state chemical shifts and residual dipolar coupling measurements, these signs are required. Here we present an NMR experiment for obtaining signs of (13)C chemical shift differences of (13)CH(3) methyl groups using weak field off-resonance R(1ρ) relaxation measurements. The accuracy of the method is established by using an exchanging system where the invisible, excited state can be converted to the visible, ground state by altering sample conditions so that the signs of Δ? values obtained from the spin-lock approach can be validated against those measured directly. Further, the spin-lock experiments are compared with the established H(S/M)QC approach for measuring signs of chemical shift differences and the relative strengths of each method are discussed. In the case of the 650 kDa human αB-crystallin complex where there are large transverse relaxation differences between ground and excited state spins the R(1ρ) method is shown to be superior to more 'traditional' experiments for sign determination.     

Prognosis and Risk Factors for Deterioration in Patients Admitted to a Medical Emergency Department

Objective

Patients that initially appear stable on arrival to the hospital often have less intensive monitoring of their vital signs, possibly leading to excess mortality. The aim was to describe risk factors for deterioration in vital signs and the related prognosis among patients with normal vital signs at arrival to a medical emergency department (MED).

Design and setting

Single-centre, retrospective cohort study of all patients admitted to the MED from September 2010-August 2011.

Subjects

Patients were included when their vital signs (systolic blood pressure, pulse rate, respiratory rate, Glasgow Coma Scale, oxygen saturation and temperature) were within the normal range at arrival. Deterioration was defined as a deviation from the defined normal range 2–24 hours after arrival.

Results

4292 of the 6257 (68.6%) admitted to the MED had a full set of vital signs at first presentation, 1440/4292 (33.6%) had all normal vital signs and were included in study, 44.0% were male, median age 64 years (5th/95th percentile: 21–90 years) and 446/1440 (31.0%) deteriorated within 24 hours. Independent risk factors for deterioration included age 65–84 years odds ratio (OR): 1.79 (95% confidence interval [CI]: 1.27–2.52), 85+ years OR 1.67 (95% CI: 1.10–2.55), Do-not-attempt-to-resuscitate order OR 3.76 (95% CI: 1.37–10.31) and admission from the open general ED OR 1.35 (95% CI: 1.07–1.71). Thirty-day mortality was 7.9% (95% CI: 5.5–10.7%) among deteriorating patients and 1.9% (95% CI: 1.2–3.0%) among the non-deteriorating, hazard ratio 4.11 (95% CI: 2.38–7.10).

Conclusions

Among acutely admitted medical patients who arrive with normal vital signs, 31.0% showed signs of deterioration within 24 hours. Risk factors included old age, Do-not-attempt-to-resuscitate order, admission from the open general ED. Thirty-day mortality among patients with deterioration was four times higher than among non-deteriorating patients. Further research is needed to determine whether intensified monitoring of vital signs can help to prevent deterioration or mortality among medical emergency patients.     

Error, population structure and the origin of diverse sign systems

Evolutionary models of communication are used to shed some light on the selective pressures involved in the evolution of simple referential signals, and the constraints hindering the emergence of signs. Error-prone communication results from errors in transmission (in which individuals learn the wrong associations) and communication (in which signs are mistaken for one another). We demonstrate how both classes of errors are required to generate diversity and subsequently impose limits on the sign repertoire within a population. We then explore the influence of geographic structuring of a population on the evolution of a shared sign system and the importance of such structure for the maintenance of sign diversity. Deceit tends to erode conventional signs systems thereby reducing signal diversity, we demonstrate that population structure can act as a hedge against deceit, thereby ensuring the persistence of sign systems.     

The consequences of using indirect signs that decay to determine species' occupancy

Statistical models of species' distributions rely on data on species' occupancy, or use, of sites across space and/or time. For rare or cryptic species, indirect signs, such as dung, may be the only realistic means of determining their occupancy status across broad spatial extents. However, the consequences of sign decay for errors in estimates of occupancy have not previously been considered. If signs decay very rapidly, then false‐negative errors may occur because signs at an occupied site have decayed by the time it is surveyed. On the other hand, if signs decay very slowly, false‐positive errors may occur because signs remain present at sites that are no longer occupied. We addressed this issue by quantifying, as functions of sign decay and accumulation rates: 1) the false‐negative error rate due to sign decay and, 2) the expected time interval prior to a survey within which signs indicate the species was present; as this time interval increases, false‐positives become more likely. We then applied this to the specific example of koala Phascolarctos cinereus occupancy derived from faecal pellet surveys using data on faecal pellet decay rates. We show that there is a clear trade‐off between false‐negative error rates and the potential for false‐positive errors. For the koala case study, false‐negative errors were low on average and the expected time interval prior to surveys that detected pellets indicate the species was present within less than 2–3 yr. However, these quantities showed quite substantial spatial variation that could lead to biased parameter estimates for distribution models based on faecal pellet surveys. This highlights the importance of observation errors arising from sign decay and we suggest some modifications to existing methods to deal with this issue.     

Improved human action recognition in a smart home environment setting

In the development of the next generation of smart homes and remote health monitoring system, human action analyzing algorithms are of vital importance. Among different sensor technologies, vision-based systems are superior in the sense that they can provide a non-intrusive interface between human occupants and the environment. It is almost impossible to build an efficient system for human action recognition without fine-tuning and evaluating its performance on a realistic dataset. An important challenge here is the absence of such a comprehensive dataset. To address this issue, we introduce a new dataset designed for human action recognition applications in a smart home environment. The performance of the existing human action recognition algorithms is tested using this dataset. In addition, we propose a heuristic approach based on error-correction codes to prioritized different actions in the learning process and improve the recognition accuracy for difficult actions up to 17%.     

Fluid Biosemiotic Mechanisms Underlie Subconscious Habits

Although research into the biosemiotic mechanisms underlying the purposeful behavior of brainless living systems is extensive, researchers have not adequately described biosemiosis among neurons. As the conscious use of signs is well-covered by the various fields of semiotics, we focus on subconscious sign action. Subconscious semiotic habits, both functional and dysfunctional, may be created and reinforced in the brain not necessarily in a logical manner and not necessarily through repeated reinforcement. We review literature that suggests hypnosis may be effective in changing subconscious dysfunctional habits, and we offer a biosemiotic framework for understanding these results. If it has been difficult to evaluate any psychological approach, including hypnosis, this may be because contemporary neuroscience lacks a theory of the sign. We argue that understanding the fluid nature of representation in biological organisms is prerequisite to understanding the nature of the subconscious and may lead to more effective of treatments for dysfunctional habits developed through personal experience or culture.     

The fitness and functionality of culturally evolved communication systems

This paper assesses whether human communication systems undergo the same progressive adaptation seen in animal communication systems and concrete artefacts. Four experiments compared the fitness of ad hoc sign systems created under different conditions when participants play a graphical communication task. Experiment 1 demonstrated that when participants are organized into interacting communities, a series of signs evolve that enhance individual learning and promote efficient decoding. No such benefits are found for signs that result from the local interactions of isolated pairs of interlocutors. Experiments 2 and 3 showed that the decoding benefits associated with community evolved signs cannot be attributed to superior sign encoding or detection. Experiment 4 revealed that naive overseers were better able to identify the meaning of community evolved signs when compared with isolated pair developed signs. Hence, the decoding benefits for community evolved signs arise from their greater residual iconicity. We argue that community evolved sign systems undergo a process of communicative selection and adaptation that promotes optimized sign systems. This results from the interplay between sign diversity and a global alignment constraint; pairwise interaction introduces a range of competing signs and the need to globally align on a single sign-meaning mapping for each referent applies selection pressure.     

Computerised Decision Support System for Remote Health Monitoring: A Systematic Review

Background

Remote health monitoring plays a major role in handling the critical situation of patients and avoiding death and also enhancing the quality of healthcare services. The effective real time monitoring with accurate decision has to be made in advance with the help of decision making system by continuously acquiring biosignals.

不同浓度罗派卡因用于老年患者臂丛神经阻滞麻醉的临床比较研究

目的：比较不同浓度的罗派卡因对老年患者臂丛神经感觉、运动神经阻滞起效和维持时间的影响。方法：选择60例行择期上肢手术老年患者。男38例,女21例,年龄65—78岁。ASAⅠ-Ⅲ级。随机分为两组。定时记录感觉、运动神经完全阻滞起效时间和维持时间,观察并记录术中生命体征的变化和有无并发症发生。结果：两组患者感觉和运动神经阻滞的起效时间和维持时间有极显著性差异（P〈0．05）,术中生命体征和并发症发生率无显著性差畀。结论：0．37％相较0．25％罗哌卡因用于老年患者臂丛神经阻滞麻醉起效更快,维持时间更长,副作用风险来见增加,可常规用于老年患者的上肢手术麻醉。     

The Cultural Evolution of Human Communication Systems in Different Sized Populations: Usability Trumps Learnability

This study examines the intergenerational transfer of human communication systems. It tests if human communication systems evolve to be easy to learn or easy to use (or both), and how population size affects learnability and usability. Using an experimental-semiotic task, we find that human communication systems evolve to be easier to use (production efficiency and reproduction fidelity), but harder to learn (identification accuracy) for a second generation of naïve participants. Thus, usability trumps learnability. In addition, the communication systems that evolve in larger populations exhibit distinct advantages over those that evolve in smaller populations: the learnability loss (from the Initial signs) is more muted and the usability benefits are more pronounced. The usability benefits for human communication systems that evolve in a small and large population is explained through guided variation reducing sign complexity. The enhanced performance of the communication systems that evolve in larger populations is explained by the operation of a content bias acting on the larger pool of competing signs. The content bias selects for information-efficient iconic signs that aid learnability and enhance usability.