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Rural Orthopedic Consultation services: Market research associated with General Practitioner Registrars' A higher level Self-assurance, Acceptability, and also Operations.

The heat production of cardiac muscle, determined by calorimetry, can be used as a measure of cardiac metabolism. learn more However, heat produced while a muscle is actively-shortening, thereby performing force-length work, comprises both active and basal metabolic processes. In this paper, we present a method for post-experimental processing of calorimetric measurements of muscle heat production, that uncovers and compensates for the measured basal heat rate during work. In this method, the relationships between muscle length, velocity of length change and muscle heat output are coupled with a simulation of the measurement instrument, providing a model-based estimate of change of measured basal heat while the muscle is performing work. We demonstrate the use of this technique in an experiment conducted on a working cardiac muscle sample. learn more The ability to identify the various components of heat release in these muscles provides useful insight into their mechanical and energetic capabilities.Mitral valve regurgitation is one of the most common heart valve diseases and mitral valve repair is the favored therapy, in which a part of the mitral valve is resected. To improve preoperative planning of this challenging surgery, patient-specific mitral valve replicas have been developed on which the repair can be simulated. However, there is no possibility yet to transfer the planning from the replica to the surgery of the patient. To solve this problem, we developed a patient-specific instrument with a cutting template, intraoperatively visualizing the part of the mitral valve to be resected as planned on the replica. To realize this instrument, the surgeon first simulates mitral valve repair by resection on a patient-specific mitral valve replica. This postoperative mitral valve replica is then digitalized and from it and a preoperative mitral valve model the instrument with cutting template is automatically designed and then 3D printed. An expert heart surgeon successfully tested the functional principle of the instrument on a pig mitral valve.People make decisions multiple times on a daily basis. However, some decisions are easier to make than others and perhaps require more attention to ensure a positive outcome. During gambling, one should attempt to compute the expected rewards and risks associated with decisions. Failing to allocate attention and neural resources to estimate these values can be costly, and in some cases can lead to bankruptcy. Alpha-band (8-12 Hz) oscillatory power in the brain is thought to reflect attention, but how this influences financial decision making is not well understood. Using local field potential recordings in nine human subjects performing a gambling task, we compared alpha-band power from the cingulate cortex (CC) during trials of low and high attention. We found that alpha-band power tended to be higher during a 2 second window after a fixation cue was shown in low attention trials.This paper presents a methodology to tune an artificial pancreas controller by minimizing the time spent in endangering glycaemic ranges (hypo- and hyperglycaemia). The risk associated to the patient's glycaemia is evaluated with an objective metric (the blood glucose risk index), which has an established clinical relevance. The tuned controller is validated in the UVA/Padova environment where the resulting artificial pancreas achieves minimal glucose risk index in realistic 24-hour long scenarios with unannounced glucose intake.Clinical and biological changes during the prodromal stages of dementia are both complicated and expensive. A biomarker for cognitive reserve exposure would be highly useful as a dementia risk predictor, but has eluded researchers. Speech, which exhibits disfluencies due to dementia, is a good candidate as it is easy to collect and non-invasive. However, previous studies have only looked at the impact of dementia on speech after diagnosis. Here we extend our previous work that showed paralinguistic features extracted from audio recordings of older participants completing the LOGOS episodic memory test can be used to discriminate between high vs low cognitive reserve, hence low vs high risk of dementia. Specifically, we use the clinically validated Lifetime of Experiences Questionnaire (LEQ) to refine our ground truth estimate of cognitive reserve instead of an abridged version. Also, we improve the generalizability of our system by using feature warping to normalize across speakers. Our k-nearest neighbours (KNN) based classifier achieved an accuracy of 84% when trained with paralinguistic features alone and 91% with paralinguistic and episodic memory features.Clinical Relevance- This establishes efficacy of using speech from older participants completing the LOGOS episodic memory test to estimate risk of dementia.Atherosclerosis is one of the most common vascular pathologies in the world. Among the most commonly performed endovascular treatments, percutaneous transluminal angioplasty (PTA) has been showing significantly positive clinical outcomes. Due to the complex geometries, material properties and interactions that characterize PTA procedures, finite element analyses of acute angioplasty balloon deployment are limited. In this work, finite element method (FEM) was used to simulate the inflation and deflation of a semi-compliant balloon within the 3D model of a stenosed artery with two different plaque types (lipid and calcified). Self-defined constitutive models for the balloon and the plaque were developed based on experimental and literature data respectively. Balloon deployment was simulated at three different inflation pressures (10, 12 and 14 atm) within the two plaque types. Balloon sizing influence on the arterial elastic recoil obtained immediately after PTA was then investigated. The simulated results show that calcified plaques may lead to higher elastic recoil ratios compared to lipid stenosis, when the same balloon inflation pressures are applied. Also, elastic recoil increases for higher balloon inflation pressure independent of the plaque type. These findings open the way for a data-driven assessment of angioplasty balloon sizing selection and clinical procedures optimization.Clinical Relevance- The FE model developed in this work aims at providing quantitative evaluation of recoil after balloon angioplasty. It may be useful for both manufacturers and clinicians to improve efficiency of angioplasty balloon device design and sizing selection with respect to plaque geometry and constitution, consequently enhancing clinical outcomes.