The Battle of The Marne

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Snappy App: a mobile continuous performance test with physical activity measurement for assessing Attention Deficit Hyperactivity Disorder

A Continuous Performance Test (CPT) was incorporated into a smartphone application (App) to measure three symptom domains associated with Attention Deficit Hyperactivity Disorder (ADHD); attention, impulsivity and hyperactivity. The App was pilot tested on 11 healthy adults over three test-ing sessions. No differences in performance were found between testing ses-sions suggesting good test consistency. A decrement in performance over time was only found for one measure of attention and on one testing session. The CPT showed some sensitivity to ADHD-related symptoms where self-reported impulsive behaviour was related to the CPT measures of impulsivity and activi-ty. User acceptability was good although some design improvements were sug-gested. Further pilot testing of the App in a clinical population is needed

Developing a comprehensive information security framework for mHealth: a detailed analysis

It has been clearly shown that mHealth solutions, which is the use of mobile devices and other wireless technology to provide healthcare services, deliver more patient-focused healthcare, and improve the overall efficiency of healthcare systems. In addition, these solutions can potentially reduce the cost of providing healthcare in the context of the increasing demands of the aging populations in advanced economies. These solutions can also play an important part in intelligent environments, facilitating real-time data collection and input to enable various functionalities. However, there are several challenges regarding the development of mHealth solutions: the most important of these being privacy and data security. Furthermore, the use of cloud computing is becoming an option for the healthcare sector to store healthcare data; but storing data in the cloud raises serious concerns. This paper investigates how data are managed both on mHealth devices as well as in the cloud. Firstly, a detailed analysis of the entire mHealth domain is undertaken to determine domain-specific features and a taxonomy for mHealth, from which a set of security requirements are identified in order to develop a new information security framework. It then examines individual information security frameworks for mHealth devices and the cloud, noting similarities and differences. Furthermore, key mechanisms to implement the new framework are discussed and the new framework is then presented. Finally, the paper presents how the new framework could be implemented in order to develop an Advanced Digital Medical Platform

Comparing counselling alone versus counselling supplemented with guided use of a well-being app for university students experiencing anxiety or depression (CASELOAD): protocol for a feasibility trial.

BACKGROUND: University counselling services face a unique challenge to offer short-term therapeutic support to students presenting with complex mental health needs and in a setting which suits the academic timetable. The recent availability of mobile phone applications (apps) offers an opportunity to supplement face-to-face therapy and has the potential to reach a wider audience, maintain engagement between therapy sessions, and enhance therapeutic outcomes. The present study, entitled Counselling plus Apps for Students Experiencing Levels of Anxiety or Depression (CASELOAD), aims to explore the feasibility of supplementing counselling with guided use of a well-being app. METHODS/DESIGN: Forty help-seeking university students (aged 18 years and over) with symptoms of moderate anxiety or depression will be recruited from a University Counselling Service (UCS) in the United Kingdom (UK). Participants will be recruited via counsellors who provide the initial clinical assessment and who determine treatment allocation to one of two treatments on the basis of client-treatment fit. The two conditions comprise (1) counselling alone (treatment as usual/TAU) or (2) counselling supplemented with guided use of a well-being app (enhanced intervention). Trained counsellors will deliver up to six counselling sessions in each treatment arm across a 6-month period, and the session frequency will be decided by client-counsellor discussion. Assessments will occur at baseline, every counselling session, post-intervention (3 months after consent) and follow-up (6 months after consent). Assessments will include clinical measures of anxiety, depression, psychological functioning, specific mental health concerns (e.g. academic distress and substance misuse), resilience and therapeutic alliance. The usage, acceptability, feasibility and potential implications of combining counselling with guided use of the well-being app will be assessed through audio recordings of counselling sessions, telephone interviews with participants, focus groups with counsellors and counsellor notes. DISCUSSION: This study will inform the design of a randomised pilot trial and a definitive trial which aim to improve therapy engagement, reduce dropout and enhance clinical outcomes of student counselling. TRIAL REGISTRATION: ISRCTN55102899

Comorbid chronic tic disorder and tourette syndrome in children requiring inpatient mental health treatment

Objective: Children needing admission to an inpatient mental health unit often present with severe neuropsychiatric disorders characterised by complex psychopathology. We aimed to examine all admitted children with comorbid chronic tic disorder (CTD) and Tourette syndrome (TS) over a 10-year period and determine the clinical significance of these diagnoses. Method: A retrospective, naturalistic study was conducted, comparing children with and without CTD/TS in terms of co-morbid diagnoses, medication use, access to education, aggression contributing to the admission, duration of admission, functional outcomes and satisfaction with treatment. Data were analysed using Chi-square/Fisher’s exact test and t-test for categorical and continuous variables, respectively, and subsequently with unadjusted and adjusted linear and logistic regression analyses. Results: A relatively high proportion of children had co-morbid CTD/TS (19.7%). There was a significant association with co-morbid obsessive-compulsive disorder, intellectual disability and autism spectrum disorder but not attention deficit hyperactivity disorder. CTD/TS were associated with longer admissions even after adjustments for confounding but did not seem to be independently associated with other examined clinical characteristics. Conclusions: The prevalence of CTD/TS in children needing inpatient treatment is significant. In our sample, comorbid CTD/TS seem to represent a marker of overall symptom severity as evidenced by longer admissions

Integration of copy number and transcriptomics provides risk stratification in prostate cancer : a discovery and validation cohort study

Study data are deposited in NCBI GEO (unique identifier number GSE70770).Background : Understanding the heterogeneous genotypes and phenotypes of prostate cancer is fundamental to improving the way we treat this disease. As yet, there are no validated descriptions of prostate cancer subgroups derived from integrated genomics linked with clinical outcome. Methods : In a study of 482 tumour, benign and germline samples from 259 men with primary prostate cancer, we used integrative analysis of copy number alterations (CNA) and array transcriptomics to identify genomic loci that affect expression levels of mRNA in an expression quantitative trait loci (eQTL) approach, to stratify patients into subgroups that we then associated with future clinical behaviour, and compared with either CNA or transcriptomics alone. Findings : We identified five separate patient subgroups with distinct genomic alterations and expression profiles based on 100 discriminating genes in our separate discovery and validation sets of 125 and 103 men. These subgroups were able to consistently predict biochemical relapse (p = 0.0017 and p = 0.016 respectively) and were further validated in a third cohort with long-term follow-up (p = 0.027). We show the relative contributions of gene expression and copy number data on phenotype, and demonstrate the improved power gained from integrative analyses. We confirm alterations in six genes previously associated with prostate cancer ( MAP3K7, MELK, RCBTB2, ELAC2, TPD52, ZBTB4), and also identify 94 genes not previously linked to prostate cancer progression that would not have been detected using either transcript or copy number data alone. We confirm a number of previously published molecular changes associated with high risk disease, including MYC amplification, and NKX3-1, RB1 and PTEN deletions, as well as over-expression of PCA3 and AMACR, and loss of MSMB in tumour tissue. A subset of the 100 genes outperforms established clinical predictors of poor prognosis (PSA, Gleason score), as well as previously published gene signatures (p = 0.0001). We further show how our molecular profiles can be used for the early detection of aggressive cases in a clinical setting, and inform treatment decisions. Interpretation : For the first time in prostate cancer this study demonstrates the importance of integrated genomic analyses incorporating both benign and tumour tissue data in identifying molecular alterations leading to the generation of robust gene sets that are predictive of clinical outcome in independent patient cohorts.Peer reviewe

Feminist everyday political economy : space, time and violence

It goes without saying that feminist International Political Economy (IPE) is concerned in one way or another with the everyday – conceptualized as both a site of political struggle and a site within which social relations are (re)produced and governed. Given the long-standing grounding of feminist research in everyday gendered experiences, many would ask: Why do we need an explicit feminist theorization of the everyday? After all, notions of everyday life and everyday political struggle infuse feminist analysis. This paper seeks to interrogate the concept of the everyday – questioning prevalent understandings of the everyday and asking whether there is analytical and conceptual utility to be gained in articulating a specifically feminist understanding of it. We argue that a feminist political economy of the everyday can be developed in ways that push theorizations of social reproduction in new directions. We suggest that one way to do this is through the recognition that social reproduction is the everyday alongside a three-part theorization of space, time and violence (STV). It is an approach that we feel can play an important role in keeping IPE honest – that is, one that recognizes how important gendered structures of everyday power and agency are to the conduct of everyday life within global capitalism

Initial trail results of a magnetic biosensor for the rapid detection of Porcine Reproductive and Respiratory Virus (PRRSV) infection

© 2019 The resonant coil magnetometer quantifies paramagnetic particles (PMPs) and has been used to develop magneto-immunoassays in a range of formats. The advantage of magneto-immunoassays is that they are relatively inexpensive, portable, easy to perform and give results in under 5 min. Porcine Reproductive and Respiratory Virus (PRRSV) is an infection of domesticated pigs producing large economic losses in the swine industry current diagnosis is performed using commercially available ELISA kits. Here we describe the development of a competitive magneto-immunoassay (MIA) and pilot study with porcine serum samples. The data show that this technology has the potential for use as a rapid and portable in field system for the detection of antibodies in porcine serum to PRRSV. A range of assay parameters and magnetometer settings were optimised, including the concentration of antibody conjugated PMPs used in the assay and movement of an external magnet to pull particles to a sensor surface. PRRSV positive control serum demonstrated competition with antibody conjugated PMPs with a dose dependent relationship. The magneto-immunoassay developed showed good agreement with the PRRS IDEXX X3 ELISA. The PRRSV magneto-immunoassay demonstrated a sensitivity of 73% and specificity of 100%. The results suggest that a rapid assay using the magnetometer technology detects specific anti-PRRSV antibody in pig serum. The magneto-immunoassay is suitable for use as a rapid ‘on-site’ method for the serological detection of PRRSV infection

Exercise referral for drug users aged 40 and over: results of a pilot study in the UK.

OBJECTIVES: To test whether older drug users (aged 40 and over) could be recruited to an exercise referral (ER) scheme, to evaluate the feasibility and acceptability and measure the impact of participation on health. DESIGN: Observational pilot. SETTING: Liverpool, UK. PARTICIPANTS: (1) 12 men and 5 women recruited to ER. (2) 7 specialist gym instructors. OUTCOME MEASURES: Logistic feasibility and acceptability of ER and associated research, rate of recruitment, level of participation over 8 weeks and changes in health. RESULTS: 22 gym inductions were arranged (recruitment time: 5 weeks), 17 inductions were completed and 14 participants began exercising. Attendance at the gym fluctuated with people missing weeks then re-engaging; in week 8, seven participants were in contact with the project and five of these attended the gym. Illness and caring responsibilities affected participation. Participants and gym instructors found the intervention and associated research processes acceptable. In general, participants enjoyed exercising and felt fitter, but would have welcomed more support and the offer of a wider range of activities. Non-significant reductions in blood pressure and heart rate and improvements in metabolic equivalents (METs; a measure of fitness) and general well-being were observed for eight participants who completed baseline and follow-up assessments. The number of weeks of gym attendance was significantly associated with a positive change in METs. CONCLUSIONS: It is feasible to recruit older drug users into a gym-based ER scheme, but multiple health and social challenges affect their ability to participate regularly. The observed changes in health measures, particularly the association between improvements in METs and attendance, suggest further investigation of ER for older drug users is worthwhile. Measures to improve the intervention and its evaluation include: better screening, refined inclusion/exclusion criteria, broader monitoring of physical activity levels, closer tailored support, more flexible exercise options and the use of incentives

Passive impedance sensing using a SAW resonator-coupled biosensor for zero-power wearable applications

A bio-sensing scheme, which acquires impedance information of a capacitive biosensor by using the reflected RF signal from a surface acoustic wave (SAW) resonator connected to the biosensor, is proposed. This technique requires no power to be supplied to the biosensor node and hence is highly applicable to wearable applications. Theoretical analysis has demonstrated that the sensitivity of the SAW resonator-coupled biosensor is higher than that of traditional impedance loaded SAW sensors and therefore it is more suitable for measuring the very small impedance changes in biosensors. The passive detection of the change in the impedance of a capacitive biosensor, as a result of biological binding events associated with the capture of a target analyte, has been demonstrated by preliminary experimentation. Dry tests of the SAW coupled capacitive biosensor using a cable connected network analyzer showed the aF level capacitance measurement resolution, which was only achieved in transistor level circuits previously, could be attained. When liquid samples with concentrations of C-Reactive Protein (CRP) in the range of 0.1 to 2 μg/ml were applied to the biosensor, a corresponding change in the resonant frequency of the SAW resonator-coupled biosensor (in the order of sub-hundred kHz) was observed. This has demonstrated the potential for applying this technique in applications where a zero-power requirement at the biosensor node could be a distinct advantage, when the cable link between the network analyzer and the biosensor node is replaced by the RF transmission