Low-Cost Wearable Fluidic Sweat Collection Patch for Continuous Analyte Monitoring and Offline Analysis.

Sweat sensors allow for new unobtrusive ways to continuously monitor an athlete's performance and health status. Significant advances have been made in the optimization of sensitivity, selectivity, and durability of electrochemical sweat sensors. However, comparing the in situ performance of these sensors in detail remains challenging because standardized sweat measurement methods to validate sweat sensors in a physiological setting do not yet exist. Current collection methods, such as the absorbent patch technique, are prone to contamination and are labor-intensive, which limits the number of samples that can be collected over time for offline reference measurements. We present an easy-to-fabricate sweat collection system that allows for continuous electrochemical monitoring, as well as chronological sampling of sweat for offline analysis. The patch consists of an analysis chamber hosting a conductivity sensor and a sequence of 5 to 10 reservoirs that contain level indicators that monitor the filling speed. After testing the performance of the patch in the laboratory, elaborate physiological validation experiments (3 patch locations, 6 participants) were executed. The continuous sweat conductivity measurements were compared with laboratory [Na+] and [Cl-] measurements of the samples, and a strong linear relationship (R2 = 0.97) was found. Furthermore, sweat rate derived from ventilated capsule measurement at the three locations was compared with patch filling speed and continuous conductivity readings. As expected from the literature, sweat conductivity was linearly related to sweat rate as well. In short, a successfully validated sweat collection patch is presented that enables sensor developers to systematically validate novel sweat sensors in a physiological setting.

An End-to-End Deep Learning Pipeline for Football Activity Recognition Based on Wearable Acceleration Sensors.

Action statistics in sports, such as the number of sprints and jumps, along with the details of the corresponding locomotor actions, are of high interest to coaches and players, as well as medical staff. Current video-based systems have the disadvantage that they are costly and not easily transportable to new locations. In this study, we investigated the possibility to extract these statistics from acceleration sensor data generated by a previously developed sensor garment. We used deep learning-based models to recognize five football-related activities (jogging, sprinting, passing, shooting and jumping) in an accurate, robust, and fast manner. A combination of convolutional (CNN) layers followed by recurrent (bidirectional) LSTM layers achieved up to 98.3% of accuracy. Our results showed that deep learning models performed better in evaluation time and prediction accuracy than traditional machine learning algorithms. In addition to an increase in accuracy, the proposed deep learning architecture showed to be 2.7 to 3.4 times faster in evaluation time than traditional machine learning methods. This demonstrated that deep learning models are accurate as well as time-efficient and are thus highly suitable for cost-effective, fast, and accurate human activity recognition tasks.

Development of Low Hysteresis, Linear Weft-Knitted Strain Sensors for Smart Textile Applications.

In recent years, knitted strain sensors have been developed that aim to achieve reliable sensing and high wearability, but they are associated with difficulties due to high hysteresis and low gauge factor (GF) values. This study investigated the electromechanical performance of the weft-knitted strain sensors with a systematic approach to achieve reliable knitted sensors. For two elastic yarn types, six conductive yarns with different resistivities, the knitting density as well as the number of conductive courses were considered as variables in the study. We focused on the 1 × 1 rib structure and in the sensing areas co-knit the conductive and elastic yarns and observed that positioning the conductive yarns at the inside was crucial for obtaining sensors with low hysteresis values. We show that using this technique and varying the knitting density, linear sensors with a working range up to 40% with low hysteresis can be obtained. In addition, using this technique and varying the knitting density, linear sensors with a working range up to 40% strain, hysteresis values as low as 0.03, and GFs varying between 0 and 1.19 can be achieved.

Performance Evaluation of Knitted and Stitched Textile Strain Sensors.

By embedding conductive yarns in, or onto, knitted textile fabrics, simple but robust stretch sensor garments can be manufactured. In that way resistance based sensors can be fully integrated in textiles without compromising wearing comfort, stretchiness, washability, and ease of use in daily life. The many studies on such textile strain sensors that have been published in recent years show that these sensors work in principle, but closer inspection reveals that many of them still have severe practical limitations like a too narrow working range, lack of sensitivity, and undesired time-dependent and hysteresis effects. For those that intend to use this technology it is difficult to determine which manufacturing parameters, shape, stitch type, and materials to apply to realize a functional sensor for a given application. This paper therefore aims to serve as a guideline for the fashion designers, electronic engineers, textile researchers, movement scientists, and human-computer interaction specialists planning to create stretch sensor garments. The paper is limited to textile based sensors that can be constructed using commercially available conductive yarns and existing knitting and embroidery equipment. Within this subtopic, relevant literature is discussed, and a detailed quantitative comparison is provided focusing on sensor characteristics like the gauge factor, working range, and hysteresis.

Towards High Performance Metal-Organic Framework-Microporous Polymer Mixed Matrix Membranes: Addressing Compatibility and Limiting Aging by Polymer Doping.

Membrane separation for gas purification is an energy-efficient and environment-friendly technology. However, the development of high performance membranes is still a great challenge. In principle, mixed matrix membranes (MMMs) have the potential to overcome current materials limitations, but in practice there is no straightforward method to match the properties of fillers and polymers (the main components of MMMs) in such a way that the final membrane performance reflects the high performance of the microporous filler and the processability of the continuous polymer phase. This issue is especially important when high flux polymers are utilized. In this work, we demonstrate that the use of small amounts of a glassy polymer in combination with high performance PIM-1 allow for the preparation of metal-organic framework (MOF)-based MMMs with superior separation properties and low aging rates under humid conditions, meeting the commercial target for post-combustion CO2 capture.

CRP genetic variants are associated with mortality and depressive symptoms in chronic heart failure patients.

OBJECTIVE: Heart failure (HF) is a complex medical condition with a multitude of genetic and other factors being involved in the pathogenesis. Emerging evidence points to an involvement of inflammatory mechanisms at least in subgroups of patients. The same is true for depression and depressive symptoms, which have a high prevalence in HF patients and are risk factors for the development and outcomes of cardiovascular disease. METHODS: In 936 patients of the Interdisciplinary Network Heart Failure (INH) program, CRP and IL-6 protein blood levels were measured and genetic variants (single nucleotide polymorphisms) of the CRP and IL6 gene analyzed regarding their influence on mortality. RESULTS: Less common recessive genotypes of two single nucleotide polymorphisms in the CRP gene (rs1800947 and rs11265263) were associated with significantly higher mortality risk (p < 0.006), higher CRP levels (p = 0.029, p = 0.006) and increased depressive symptoms in the PHQ-9 (p = 0.005, p = 0.003). Variants in the IL-6 gene were not associated with mortality. CONCLUSION: Our results hint towards an association of less common CRP genetic variants with increased mortality risk, depressive symptoms and peripheral CRP levels in this population of HF patients thereby suggesting a possible role of the inflammatory system as link between poor prognosis in HF and depressive symptoms.

[Network for Oncological Advisory Service (NOF) - a Pilot Project for (Long-Term) Follow-Up Care of Pediatric Cancer Patients]. / Netzwerk für onkologische Fachberatung (NOF) ­ Modellprojekt für (Langzeit-) Nachsorge nach einer Krebserkrankung im Kindes- und Jugendalter.

Background: In Germany some 2 000 children and adolescent are diagnosed with cancer every year. Curing rates are increasing and therewith also the number of survivors is growing. Survivors frequently suffer from long-term effects of the disease and its treatment, but long-term follow-up care shows deficits. Method: The Network for oncological advisory service (NOF) started in 11/2013, researching and building up a network of available support in Lower Saxony. A telephone hotline was installed in 01/2014 in order to advice survivors on their problems. At the same time, an interview study on survivors needs was conducted throughout Germany. Results: In the first 2 years, the NOF gave advice to 79 patients. Whilst enquiries of medical or psychological nature were transferred to the cooperation partner, requests on psychosocial and social legal issues are being deled by the NOF due to lack of appropriate partners. The evaluation of 25 interviews shows key issues in long-term after-care: (1) transition from acute therapy to everyday life, (2) problems due to pediatric cancer and therapy, (3) patients perception of own disposition, (4) social reactions towards survivors, (5) structure of long-term follow-up care, (6) information flow. Conclusion: Many survivors suffer from long-term effects of cancer and treatment. The lack of available contact person and being in limbo between cured and simultaneously affected by the cancer treatment and chronic diseases is perceived as being problematic. This translates to various requirements on a patient-oriented long-term care, mainly in the psychosocial field.

Influence of hepatitis C virus infection and high virus serum load on biliary complications in liver transplantation.

BACKGROUND: Biliary complications (BCs) and recurrent hepatitis C virus (HCV) infection are among the major causes of morbidity and graft loss following liver transplantation. The influence of HCV on BCs has not been definitely clarified. PATIENTS AND METHODS: We performed a retrospective cohort study to analyze risk factors and outcome of post orthotopic liver transplantation (OLT) BCs in 352 liver transplant recipients over 12 years in Munich, Germany (n = 84 with HCV; living donor and re-OLT were excluded). BCs diagnosed with imaging techniques and abnormal liver enzyme pattern, requiring an intervention, were considered. RESULTS: In a multivariate analysis, HCV serostatus and a high pre-and post-surgery HCV RNA serum load were independent risk factors for anastomotic strictures. HCV positivity and BCs alone did not alter graft loss. HCV-positive patients with BCs, however, had a significantly worse graft outcome (P = 0.02). Non-anastomotic strictures, bile leaks, and the number of interventions needed to treat bile leaks led to worse graft outcome in all patients. CONCLUSION: HCV positivity and a high HCV RNA serum load were risk factors for anastomotic strictures. BCs and HCV had an additive effect on graft loss.

Palliative treatment of the advanced gastric cancer by means of surgery and HIPEC.

OBJECTIVES: We demonstrate a case report of the patient who suffered from advanced gastric cancer and was treated by means of surgery and HIPEC. BACKGROUND: Gastric cancer is a therapeutic challenge in the European countries due to late diagnosis, advanced stages of the disease in time of diagnosis and early recurrence in cases where a radical surgery is possible. METHOD: The patient with an advanced gastric cancer (pT3N2M1 - peritoneal and ovarian metastases) was treated by means of radical surgery in combination with hyperthermic intraoperative intraperitoneal chemotherapy (HIPEC) and early postoperative intraperitoneal chemotherapy (EPIC). Surgical treatment was followed by a standard chemotherapy. Due to recurrence, there was the second look surgery one year later again with HIPEC procedure. RESULTS: Patient survived 32 months after diagnosis and despite intraperitoneal recurrence she never developed clinically significant ascites and she never suffered from intestinal obstruction. CONCLUSION: This case demonstrate a potential benefit of new oncosurgical approach -radical surgery + HIPEC + EPIC in the treatment of gastric cancers (Tab. 2, Fig. 6, Graph 4, Ref. 18). Text in PDF www.elis.sk.

[Stabilisation of the dislocated acromioclavicular joint and lateral fractures of the clavicle using a hook plate]. / Stabilizace luxace AC skloubení a zlomenin akromiálního konce klícku pomocí háckové dlahy.

INTRODUCTION: The aim of this study was to verify the hypothesis that the technique of stabilizing the acromioclavicular joint and lateral fractures of the clavicle using a clavicular hook plate can be considered a method of choice in the given types of injury. MATERIAL AND METHODS: The clinical part of the study included a total of 40 patients. The indication group was formed by patients with type III acromioclavicular joint dislocation, according to Tossy. As for lateral fractures of the clavicle, the patients of group II and types IIa, IIb according to revised Allman and Neers classification, underwent surgery. 40 patients with type III acromioclavicular luxation, operated on at the same clinic, were chosen as the control group; however, the technique of traction cerclage was used here. RESULTS: When evaluating our results, we recorded a lower occurrence of infectious complications in patients with a hook plate. No method failure or joint redislocation was observed in the hook plate group. There was no change in position even after the implant was removed. On the other hand, where traction cerclage was used, redislocation in the acromioclavicular joint occurred due to mechanical failure in 5 cases, in 15 cases mechanical implant failure was seen. As for patients with a hook plate, 11 cases showed irritation of the lower surface of the acromion. Statistical evaluation of parameters of the main set of patients was carried out in cooperation with the Institute of Biostatistics and Analyses of Masaryk University in Brno. CONCLUSION: Based on our results, the stabilisation of complete acromioclavicular separation and lateral end clavicle fractures using clavicle hook plate can be regarded as a suitable method for treating these lesions. Timely removal of the implant within 12 weeks of the intervention is needed to prevent irritation of the lower surface of the acromion.

Design of Wearable Finger Sensors for Rehabilitation Applications.

As an emerging technology, smart textiles have attracted attention for rehabilitation purposes or to monitor heart rate, blood pressure, breathing rate, body posture, as well as limb movements. Traditional rigid sensors do not always provide the desired level of comfort, flexibility, and adaptability. To improve this, recent research focuses on the development of textile-based sensors. In this study, knitted strain sensors that are linear up to 40% strain with a sensitivity of 1.19 and a low hysteresis characteristic were integrated into different versions of wearable finger sensors for rehabilitation purposes. The results showed that the different finger sensor versions have accurate responses to different angles of the index finger at relaxation, 45° and 90°. Additionally, the effect of spacer layer thickness between the finger and sensor was investigated.

Affine Deformation and Self-Assembly Alignment in Hydrogel Nanocomposites.

Tailoring the order in hierarchical structures is a key goal of bioinspired nanocomposite design. Recently, nacre-like materials have been developed by solvent evaporation methods that are scalable and attain advanced functionalities. However, understanding the alignment mechanisms of 2D fillers, nanosheets, or platelets remains challenging. This work explores possible pathways for nanocomposite ordering via orientation distribution functions. We demonstrate how the immobilization of 2D materials via (pseudo)network formation is crucial to alignment based on evaporation. We show a modified affine deformation model that describes such evaporative methods. In this, a gel network develops enough yield stress and uniformly deforms as drying proceeds, along with the immobilized particles, causing an in-plane orientation. Herein, we tested the dominance of this approach by using a thermo-reversible gel for rapid montmorillonite (MMT) particle fixation. We researched gelatin/MMT as a model system to investigate the effects of high loadings, orientational order, and aspect ratio. The nacre-like nanocomposites showed a semiconstant order parameter (⟨P2⟩ ∼ 0.7) over increasing nanofiller content up to 64 vol % filler. This remarkable alignment resulted in continuously improved mechanical and water vapor barrier properties over unusually large filler fractions. Some variations in stiffness and diffusion properties were observed, possibly correlated to the applied drying conditions of the hybrid hydrogels. The affine deformation strategy holds promise for developing next-generation advanced materials with tailored properties even at (very) high filler loadings. Furthermore, a gelling approach offers the advantages of simplicity and versatility in the formulation of the components, which is useful for large-scale fabrication methods.

Upper-Body versus Lower-Body Cooling in Individuals with Paraplegia during Arm-Crank Exercise in the Heat.

PURPOSE: For wheelchair users with a spinal cord injury, the lower body may be a more convenient cooling site than the upper body. However, it remains unknown if leg cooling reduces thermal strain in these individuals. We compared the impact of upper-body versus lower-body cooling on physiological and perceptual outcomes during submaximal arm-crank exercise under heat stress in individuals with paraplegia. METHODS: Twelve male participants with paraplegia (T4-L2, 50% complete lesion) performed a maximal exercise test in temperate conditions, and three heat stress tests (32°C, 40% relative humidity) in which they received upper-body cooling (COOL-UB), lower-body cooling (COOL-LB), or no cooling (CON) in a randomized counterbalanced order. Each heat stress test consisted of four exercise blocks of 15 min at 50% of peak power output, with 3 min of rest in between. Cooling was applied using water-perfused pads, with 14.8-m tubing in both COOL-UB and COOL-LB. RESULTS: Gastrointestinal temperature was 0.2°C (95% confidence interval (CI), 0.1°C to 0.3°C) lower during exercise in COOL-UB versus CON (37.5°C ± 0.4°C vs 37.7°C ± 0.3°C, P = 0.009), with no difference between COOL-LB and CON ( P = 1.0). Heart rate was lower in both COOL-UB (-7 bpm; 95% CI, -11 to -3 bpm; P = 0.01) and COOL-LB (-5 bpm; 95% CI, -9 to -1 bpm; P = 0.049) compared with CON. The skin temperature reduction at the cooled skin sites was larger in COOL-LB (-10.8°C ± 1.1°C) than in COOL-UB (-6.7°C ± 1.4°C, P < 0.001), which limited the cooling capacity in COOL-LB. Thermal sensation of the cooled skin sites was improved and overall thermal discomfort was lower in COOL-UB ( P = 0.01 and P = 0.04) but not in COOL-LB ( P = 0.17 and P = 0.59) compared with CON. CONCLUSIONS: Upper-body cooling more effectively reduced thermal strain than lower-body cooling in individuals with paraplegia, as it induced greater thermophysiological and perceptual benefits.

[The NanoKnife and two successful cases of intracavitary irreversible electroporation of main bronchus tumours]. / NanoKnife a dva úspesné prípady intrakavitální ireverzibilní elektroporatizace nádoru hlavního bronchu.

We have used the method of irreversible electroporation (IRE) twice to treat central non-small cell lung tumours. Both tumours obstructed the right main stem bronchus. Due to a high risk of right-sided pneumonectomy we chose to apply the tissue sparing device called NanoKnife and an alternative IRE method. The first surgery was performed in August 2011 and the second one in June 2012. The first case was an epidermoid carcinoma, 3 cm in size, which completely obstructed the right main stem bronchus on the boundary line with the upper lobar bronchus and caused lung atelectasis. The second case was a carcinoid, 2 cm in size, which grew from the main stem bronchus to the carina. Pneumonectomy was contraindicated due to lung function in the first case, and the other patient preferred the IRE method to radical but risky resection with bronchoplasty. IRE was performed through open thoracotomy. No complications were detected after the surgery in both cases. The first patient was discharged on the 12th postoperative day and the second one on the 5th postoperative day. 98% regression of the tumour was detected by CT scan in the first patient, and complete regression occurred in the case of the second one. 100% apoptosis and "disparition" of the carcinoma in the first case was verified by bronchoscopy and cytology after 6 months. Both patients remain in follow-up after surgery using the IRE method and are without subjective or objective complaints and without any signs of tumour recurrence. NanoKnife and IRE without lung resection resulted in the destruction of lung tumours while preserving the lung parenchyma and pulmonary functions.

Impact of different climatic conditions on peak core temperature of elite athletes during exercise in the heat: a Thermo Tokyo simulation study.

Objectives: To evaluate how separate and combined climatic parameters affect peak core temperature during exercise in the heat using computer simulations fed with individual data. Methods: The impact of eight environmental conditions on rectal temperature (Tre) was determined for exercise under heat stress using the Fiala-thermal-Physiology-and-Comfort simulation model. Variations in ambient temperature (Ta±6°C), relative humidity (RH±15%) and solar radiation (SR+921 W/m2) were assessed in isolation and combination (worst-case/best-case scenarios) and compared with baseline (Ta32°C, RH 75%, SR 0 W/m2). The simulation model was fed with personal, anthropometric and individual exercise characteristics. Results: 54 athletes exercised for 46±10 min at baseline conditions and achieved a peak core temperature of 38.9±0.5°C. Simulations at a higher Ta (38°C) and SR (921 W/m2) resulted in a higher peak Tre compared with baseline (+0.6±0.3°C and +0.5±0.2°C, respectively), whereas a higher RH (90%) hardly affected peak Tre (+0.1±0.1°C). A lower Ta (26°C) and RH (60%) reduced peak Tre by -0.4±0.2°C and a minor -0.1±0.1°C, respectively. The worst-case simulation yielded a 1.5±0.4°C higher Tre than baseline and 2.0±0.7°C higher than the best-case condition. Conclusion: Combined unfavourable climatic conditions produce a greater increase in peak core temperature than the sum of its parts in elite athletes exercising in the heat.

Multiomics assessment of dietary protein titration reveals altered hepatic glucose utilization.

Dietary protein restriction (PR) has rapid effects on metabolism including improved glucose and lipid homeostasis, via multiple mechanisms. Here, we investigate responses of fecal microbiome, hepatic transcriptome, and hepatic metabolome to six diets with protein from 18% to 0% of energy in mice. PR alters fecal microbial composition, but metabolic effects are not transferable via fecal transplantation. Hepatic transcriptome and metabolome are significantly altered in diets with lower than 10% energy from protein. Changes upon PR correlate with calorie restriction but with a larger magnitude and specific changes in amino acid (AA) metabolism. PR increases steady-state aspartate, serine, and glutamate and decreases glucose and gluconeogenic intermediates. 13C6 glucose and glycerol tracing reveal increased fractional enrichment in aspartate, serine, and glutamate. Changes remain intact in hepatic ATF4 knockout mice. Together, this demonstrates an ATF4-independent shift in gluconeogenic substrate utilization toward specific AAs, with compensation from glycerol to promote a protein-sparing response.

Abdominal ventral hernia repair with current biological prostheses: an experimental large animal model.

Biologic prostheses have emerged to address the limitations of synthetic materials for ventral hernia repairs; however, they lack experimental comparative data. Fifteen swine were randomly assigned to 1 of 3 bioprosthetic groups (DermaMatrix, AlloDerm, and Permacol) after creation of a full thickness ventral fascial defect. At 15 weeks, host incorporation, hernia recurrence, adhesion formation, neovascularization, inflammation, and biomechanical properties were assessed. No animals had hernia recurrence or eventration. DermaMatrix and Alloderm implants demonstrated more adhesions, greater inflammatory infiltration, and more longitudinal laxity, but near identical neovascularization and tensile strength to Permacol. We found that porcine acellular dermal products (Permacol) contain following essential properties of an ideal ventral hernia repair material: low inflammation, less elastin and stretch, lower adhesion rates and cost, and more contracture. The addition of lower cost xenogeneic acellular dermal products to the repertoire of available acellular dermal products demonstrates promise, but requires long-term clinical studies to verify advantages and efficacy.

Total protein, not amino acid composition, differs in plant-based versus omnivorous dietary patterns and determines metabolic health effects in mice.

Plant-based dietary patterns are associated with improved cardiometabolic health, but causal dietary components are unclear. Protein has been proposed to play a role, but the importance of protein quantity versus quality remains unknown. We investigated the contributions of total protein amount, amino acid (AA) composition, and plant versus animal source. Analysis of total protein and AA composition of food items and dietary patterns revealed differences between individual food items, but few differences between AA profiles of vegan versus omnivorous dietary patterns. Effects of protein quantity, but not quality, on cardiometabolic health markers were observed in mice using semi-purified diets with crystalline AAs in plant versus animal-based ratios and naturally sourced diets with whole-food ingredients. Our data show relatively little difference in protein quality between plant-based and omnivorous dietary patterns and that reduced total protein intake in plant-based dietary patterns may be a contributor to the benefits of plant-based diets.

Performance and thermoregulation of Dutch Olympic and Paralympic athletes exercising in the heat: Rationale and design of the Thermo Tokyo study: The journal Temperature toolbox.

The environmental conditions during the Tokyo Olympic and Paralympic Games are expected to be challenging, which increases the risk for participating athletes to develop heat-related illnesses and experience performance loss. To allow safe and optimal exercise performance of Dutch elite athletes, the Thermo Tokyo study aimed to determine thermoregulatory responses and performance loss among elite athletes during exercise in the heat, and to identify personal, sports-related, and environmental factors that contribute to the magnitude of these outcomes. For this purpose, Dutch Olympic and Paralympic athletes performed two personalized incremental exercise tests in simulated control (15°C, relative humidity (RH) 50%) and Tokyo (32°C, RH 75%) conditions, during which exercise performance and (thermo)physiological parameters were obtained. Thereafter, athletes were invited for an additional visit to conduct anthropometric, dual-energy X-ray absorptiometry (DXA), and 3D scan measurements. Collected data also served as input for a thermophysiological computer simulation model to estimate the impact of a wider range of environmental conditions on thermoregulatory responses. Findings of this study can be used to inform elite athletes and their coaches on how heat impacts their individual (thermo)physiological responses and, based on these data, advise which personalized countermeasures (i.e. heat acclimation, cooling interventions, rehydration plan) can be taken to allow safe and maximal performance in the challenging environmental conditions of the Tokyo 2020 Olympic and Paralympic Games.