Layered RF Phantom Characterization for Wireless Medical Vital Sign Monitors

Wearable antenna performance measurements were used to characterize a synthetic variable layered phantom testbed, representative of human tissue for operation in the 868/915 MHz, and 2400 MHz industrial, scientific and medical frequency bands. Antenna radiation efficiency measurements on the phantom were compared with measurements on the thorax region of a human test subject. The results show that the phantom is representative of the human body for the application of wireless vital sign monitors, where conductive connections are made to the tissue.

Diagnostic accuracy of pulmonary host inflammatory mediators in the exclusion of ventilator-acquired pneumonia

Background: Excessive use of empirical antibiotics is common in critically ill patients. Rapid biomarker-based exclusion of infection may improve antibiotic stewardship in ventilator-acquired pneumonia (VAP). However, successful validation of the usefulness of potential markers in this setting is exceptionally rare.

Objectives: We sought to validate the capacity for specific host inflammatory mediators to exclude pneumonia in patients with suspected VAP. 

Methods: A prospective, multicentre, validation study of patients with suspected VAP was conducted in 12 intensive care units. VAP was confirmed following bronchoscopy by culture of a potential pathogen in bronchoalveolar lavage fluid (BALF) at >10⁴ colony forming units per millilitre (cfu/mL). Interleukin-1 beta (IL-1β), IL-8, matrix metalloproteinase-8 (MMP-8), MMP-9 and human neutrophil elastase (HNE) were quantified in BALF. Diagnostic utility was determined for biomarkers individually and in combination. 

Results: Paired BALF culture and biomarker results were available for 150 patients. 53 patients (35%) had VAP and 97 (65%) patients formed the non-VAP group. All biomarkers were significantly higher in the VAP group (p<0.001). The area under the receiver operator characteristic curve for IL-1β was 0.81; IL-8, 0.74; MMP-8, 0.76; MMP-9, 0.79 and HNE, 0.78. A combination of IL-1β and IL-8, at the optimal cut-point, excluded VAP with a sensitivity of 100%, a specificity of 44.3% and a post-test probability of 0% (95% CI 0% to 9.2%). 

Conclusions: Low BALF IL-1β in combination with IL-8 confidently excludes VAP and could form a rapid biomarker-based rule-out test, with the potential to improve antibiotic stewardship.

Compact Low-Profile Antenna for Wireless Medical Vital Sign Monitors at 868 MHz

A low-profile wearable antenna suitable for integration into low-cost, disposable medical vital signs monitors is presented. Simulated and measured antenna performance was characterized on a layered human tissue phantom, representative of the thorax region of a range of human bodies. The wearable antenna has sufficient bandwidth for the 868 MHz Industrial, Scientific and Medical frequency band. Wearable radiation efficiency of up to 30 % is reported when mounted in close proximity to the novel human tissue phantom antenna test-bed at 868 MHz.

Wearable inkjet-printed antenna performance for medical applications at 868/915 MHz

The use of biosensors attached to the body for health monitoring is now readily accepted, and the merits of such systems and their potential impact on healthcare receive much attention. Wearable medical systems used in clinical applications to monitor vital signs must be comfortable to wear, yet have robust performance to ensure reliable communications links. Additionally, and vital to the success of these innovations, is that these solutions are disposable to avoid risk of patient infection and this means that they must be ultra-low cost. Antennas optimized for printing using conductive inks offer new exciting advances in making a truly disposable solution.

Inkjet printing of resistively loaded FSS for microwave absorbers

Inkjet printing is proposed as a means to create the resistively loaded elements of a frequency selective surface (FSS) which suppresses radar backscatter when placed above a metal ground plane. Spectral transmission and reflection measurements from 9 to 18 GHz show that the dot density of the printed features and the volume ratio of an aqueous vehicle and nano-silver (Ag) ink mixture can be selected to obtain surface resistances in the range 1.2-200 Ω/sq.

Effectiveness of a biomarker-based exclusion of ventilator-acquired pneumonia to reduce antibiotic use: protocol for a randomised controlled trial (VAPrapid-2):Study protocol for a randomised controlled trial

Background Ventilator-acquired pneumonia (VAP) is a common reason for antimicrobial therapy in the intensive care unit (ICU). Biomarker-based diagnostics could improve antimicrobial stewardship through rapid exclusion of VAP. Bronchoalveloar lavage (BAL) fluid biomarkers have previously been shown to allow the exclusion of VAP with high confidence. Methods/Design This is a prospective, multi-centre, randomised, controlled trial to determine whether a rapid biomarker-based exclusion of VAP results in fewer antibiotics and improved antimicrobial management. Patients with clinically suspected VAP undergo BAL, and VAP is confirmed by growth of a potential pathogen at > 104 colony-forming units per millilitre (CFU/ml). Patients are randomised 1:1, to either a ‘biomarker-guided recommendation on antibiotics’ in which BAL fluid is tested for IL-1β and IL-8 in addition to routine microbiology testing, or to ‘routine use of antibiotics’ in which BAL undergoes routine microbiology testing only. Clinical teams are blinded to intervention until 6 hours after randomisation, when biomarker results are reported to the clinician. The primary outcome is a change in the frequency distribution of antibiotic-free days (AFD) in the 7 days following BAL. Secondary outcome measures include antibiotic use at 14 and 28 days; ventilator-free days; 28-day mortality and ICU mortality; sequential organ failure assessment (SOFA) at days 3, 7 and 14; duration of stay in critical care and the hospital; antibiotic-associated infections; and antibiotic-resistant pathogen cultures up to hospital discharge, death or 56 days. A healthcare-resource-utilisation analysis will be calculated from the duration of critical care and hospital stay. In addition, safety data will be collected with respect to performing BAL. A sample size of 210 will be required to detect a clinically significant shift in the distribution of AFD towards more patients having fewer antibiotics and therefore more AFD. Discussion This trial will test whether a rapid biomarker-based exclusion of VAP results in rapid discontinuation of antibiotics and therefore improves antibiotic management in patients with suspected VAP.

A chromatin-independent role of Polycomb-like 1 to stabilize p53 and promote cellular quiescence

Polycomb-like proteins 1-3 (PCL1-3) are substoichiometric components of the Polycomb-repressive complex 2 (PRC2) that are essential for association of the complex with chromatin. However, it remains unclear why three proteins with such apparent functional redundancy exist in mammals. Here we characterize their divergent roles in both positively and negatively regulating cellular proliferation. We show that while PCL2 and PCL3 are E2F-regulated genes expressed in proliferating cells, PCL1 is a p53 target gene predominantly expressed in quiescent cells. Ectopic expression of any PCL protein recruits PRC2 to repress the INK4A gene; however, only PCL2 and PCL3 confer an INK4A-dependent proliferative advantage. Remarkably, PCL1 has evolved a PRC2- and chromatin-independent function to negatively regulate proliferation. We show that PCL1 binds to and stabilizes p53 to induce cellular quiescence. Moreover, depletion of PCL1 phenocopies the defects in maintaining cellular quiescence associated with p53 loss. This newly evolved function is achieved by the binding of the PCL1 N-terminal PHD domain to the C-terminal domain of p53 through two unique serine residues, which were acquired during recent vertebrate evolution. This study illustrates the functional bifurcation of PCL proteins, which act in both a chromatin-dependent and a chromatin-independent manner to regulate the INK4A and p53 pathways.

Synthesis of novel pyrophosphorothiolate-linked dinucleoside cap analogues in a ball mill

Michaelis–Arbuzov reactions of S-aryl disulfide derivatives of 3′-thiothymidine or 5′-thioadenosine with tris(trimethylsilyl) phosphite proceeded in high yields to the corresponding phosphorothiolate monoesters. Subsequent hydrolytic desilylation and phosphate coupling were effected in one-pot using liquid-assisted grinding in a vibration ball mill. Novel 3′,5′- and 5′,5′-pyrophosphorothiolate-linked dinucleoside cap analogues were thereby prepared.

Wearable antennas for medical monitoring systems

A wearable silver nano particle inkjet printed antenna suitable for wireless biomedical sensing is presented. The performance is evaluated on a synthetic variable layered phantom test-bed, representative of human tissue for operation in the 868/915 MHz, and 2400 MHz industrial, scientific and medical frequency bands. Antenna radiation efficiency measurements on the phantom were compared with antennas prototyped with copper. Total radiation efficiencies up to ???6.5 dB are reported, with less than 0.5 dB difference in performance between copper and silver nano particle variants, showing promising application for low-cost disposable wireless sensing.

Robust implantable antenna for in-body communications

A compact implantable printed meandered folded dipole antenna with a volume of 101.8 mm3 and robust performance is presented for operation in the 2.4 GHz medical ISM bands. The implant antenna is shown to maintain its return loss performance in the 2360???2400 MHz, 2400???2483.5 MHz and 2483.5???2500 MHz frequency bands, simulated in eleven different body tissue types with a broad range of electrical properties. Bandwidth and resonant frequency changes are reported for the same antenna implanted in high water content tissues such as muscle and skin as well as low water content tissues such as subcutaneous fat and bone. The antenna was also shown to maintain its return loss performance as it was moved towards a tissue boundary within a simulated phantom testbed.

Mineralogy, chemistry and biological contingents of an early-middle Miocene Antarctic paleosol and its relevance as a Martian analogue

Fossil mesofauna and bacteria recovered from a paleosol in a moraine situated adjacent to the inland ice, Antarctica, and dating to the earliest glacial event in the Antarctic Dry Valleys opens several questions. The most important relates to understanding of the mineralogy and chemistry of the weathered substrate habitat in which Coleoptera apparently thrived at some point in the Early/Middle Miocene and perhaps earlier. Here, Coleoptera remains are only located in one of six horizons in a paleosol formed in moraine deposited during the alpine glacial event (> 15 Ma). A tendency for quartz to decrease upward in the section may be a detrital effect or a product of dissolution in the early stage of profile morphogenesis when climate was presumably milder and the depositing glacier of temperate type. Discontinuous distributions of smectite, laumontite, and hexahydrite may have provided nutrients and water to mesofauna and bacteria during the early stage of biotic colonization of the profile. Because the mesofauna were members of burrowing Coleoptera species, future work should assess the degree to which the organisms occupied other sites in the Dry Valleys in the past. Whereas there is no reasonable expectations of finding Coleoptera/insect remains on Mars, the chemistry and mineralogy of the paleosol is within a life expectancy window for the presence of microorganisms, principally bacteria and fungi. Thus, parameters discussed here within this Antarctic paleosol could provide an analogue to identifying similar fossil or life-bearing weathered regolith on Mars.

Property and Emotions

Relatively little has been written on the connection between property and emotions from a legal perspective, despite the centrality of property in everyday life and the complex relationships that exist between owners and their property. Scholars working in other disciplines have analyzed these links, identifying ‘proprietary’ emotions and corresponding emotional traits. However, little has been mapped onto the field of law. This paper looks at key emotions surrounding property as identified in psychological and, to a lesser extent, sociological literature. After mapping these onto selected areas of property law, it posits the need for a deeper and more collective field of inquiry.