Understanding the Sensitive Skin Subject to Achieve a More Holistic Diagnosis

Sensitive skin Syndrome (SSS) is a complex global clinical phenomenon that is defined by the self-reported presence of different sensory perceptions, including tightness, stinging, burning, tingling, pain and pruritus and often without objective signs. Due to the subjective nature of this clinical condition, the diagnosis is complex and there is often a disconnect between what subjects feel and what medical professionals can observe. This chapter reviews the known underlying physiology, some of the triggering factors associated with SSS, co-morbidities as well as the psychological impact on individuals suffering from this condition. The goal is to bridge the gap between the physicians’ understanding and the subjects’ perceptions of this real-life condition that affects so many.

Frequency of Non-motor Symptoms in Parkinson's Patients With Motor Fluctuations

Background: Non-motor symptoms (NMS), including neuropsychiatric, sleep, autonomic, and sensory domains, are an integral aspect of the clinical presentation of Parkinson disease (PD) and affect neurocognitive functioning as well as patients' and caregivers' well-being.Objective: To describe the occurrence of NMS in PD patients with motor fluctuations in real-life condition.Methods: The present study is a secondary analysis of a previous multinational, multicenter, retrospective-prospective cohort observational study (SYNAPSES). Patients with PD diagnosis and motor fluctuations aged ≥18 years were included. Data collected at the baseline visit were used for this study, and descriptive analyzes were conducted to describe the distribution of NMS in motor-fluctuating PD patients distributed according to different clinical characteristics.Results: Of the 1,610 patients enrolled, 1,589 were included for the analysis (978 males and 611 females), with a mean age of 68.4 (SD = 9.6). Most patients had at least one NMS (88.5%). Sleep problems and psychiatric symptoms were the most prevalent NMS in motor fluctuating PD patients in all H and Y stages. Psychiatric disorders were more frequent in older patients and in patients with a larger number of years of PD diagnosis, while sleep problems were more preeminent in younger patients and with inferior disease duration.Conclusions: The present findings further support the high prevalence of NMS in PD patients with motor fluctuations, thus reinforcing the need for assessing them for diagnostic accuracy and for delivering holistic care.

NUMERICAL SIMULATION OF THERMAL CONDITION OF A LOW CURRENT ELECTRIC CONTACT

Electrical contacts may include various sub-systems or wiring harness connected via detachable connectors which depend on physical contacts for the electrical connectivity. Electrical contacts range from high, medium to low current depending on their usage. However, in the real-life condition, electrical contacts characteristics, especially at the interface, undergoes a gradual change which can be due to corrosion, temperature variation, aging, strained harnesses, discontinuities induced by vibration etc. These changes introduce additional parasitic circuits in the system. Moreover, in some cases where the contact resistance increases due to electrical loses, the local temperature may increase, thereby accelerating contact degradation. This paper presents a numerical analysis on the variation of temperature of a simple low current contact model having a thin oxide film layer at the interface which serves as the ageing factor using finite element method (FEM).

Management of Hypoglycemia in Adults with Type 1 Diabetes in Real-Life Condition

<b><i>Introduction:</i></b> Hypoglycemia is the most common acute complication in individuals with type 1 diabetes (T1D). Episodes of mild or moderate hypoglycemia should be treated in adults with a dose of around 15–20 g fast-acting carbohydrates. However, this self-treatment of hypoglycemia in real-life condition is not well documented. <b><i>Objective:</i></b> The aim of this study wasto determine the characteristics of hypoglycemia treatment in adults with T1D in a prospective study design. <b><i>Methods:</i></b> Individuals with T1D were advised to record information related to hypoglycemia episodes for a period of 14 days. Quantity and quality (including glycemic index [GI] and glycemic load) of carbohydrates consumed in every hypoglycemia episode and others factors related with hypoglycemia such as physical activity, fear of hypoglycemia, or hypoglycemia awareness were analyzed. <b><i>Results:</i></b> A total of 93 individuals (36.5 ± 16.2 years old, BMI of 24.9 ± 3.8 kg/m², diabetes duration of 14.9 ± 10.4 years, and HbA1c levels of 7.3 ± 0.8%) were included in the study. A total of 483 episodes of mild or moderate hypoglycemia were reported, which supposed on average 2.7 ± 2.0 episodes a week. The quantity of carbohydrates consumed in all episodes of hypoglycemia was 25.9 ± 9.2 g. GI of food consumed in all episodes of hypoglycemia was classified as low (53.9 ± 8.3). Overtreatment of hypoglycemia, defined as ingestion of more than 20 g of carbohydrates, occurred in 50.3% of hypoglycemic episodes; even 22.3% of these episodes were treated with more than 30 g of carbohydrates. Fruit juice was the most popular option, chosen in almost 70% of the events. In addition, we observed other moderate or low GI foods such as milk, bread, cookies, and bakery products among the most consumed foods. <b><i>Conclusion:</i></b> A majority of the studied individuals with T1D does not manage hypoglycemia according to current American Diabetes Association guidelines, in most cases by overtreating, choosing foods with low glycemic effect, and not varying the dose of carbohydrates, depending on the physical activity performed.

Towards the Real-Life EEG Applications

Electroencephalogram (EEG) is one of the most popular approaches for brain monitoring in many research fields. While the detailed working flows for in-lab neuroscience-targeted EEG experiments conditions have been well established, carrying out EEG experiments under a real-life condition can be quite confusing because of various practical limitations. This chapter gives a brief overview of the practical issues and techniques that help real-life EEG experiments come into being, and the well-known artifact problems for EEG. As a guideline for performing a successful EEG data analysis with the low-electrode-density limitation of portable EEG devices, recently proposed techniques for artifact suppression or removal are briefly surveyed as well.

Static and Dynamic Strain Measurements using Sensing Sheets for Damage Detection

<p>Damage detection in structures is an important part of structural health monitoring (SHM). Two approaches for detecting damages are indirect and direct sensing. Indirect sensing uses sparse array of sensors and complex algorithms to determine the extent and localization of damage. Crack initiation can best be captured with direct sensing as it provides resolved information about the anomalous behavior near cracks. Direct sensing, however, is expensive because of the need to install a large array of densely packed sensors. A novel solution developed recently is the use of two-dimensional sensing sheets designed to cover large areas of structures. Such sheets are based on large area electronics (LAE) with flexible thin film resistive strain sensors embedded in polyimide substrate along with the relevant electronics. This paper explores the use of sensing sheets for damage detection using static and dynamic measurement. Laboratory testing on aluminum beam is used to demonstrate the performance of these sheets in idealized conditions. Sensing sheets employed on a pedestrian bridge are used to evaluate their performance in real life condition where the strains measurements are compared with the fiber-optic sensors already present on the bridge. Finally, sources of measurement errors and limitations are discussed.</p>

Embolic stroke of undetermined source: a retrospective analysis from an Italian Stroke Unit

The new clinical construct of embolic stroke of undetermined source (ESUS) suggests that many cryptogenic strokes are related to minor-risk covert embolic cardiac sources or to embolus from non-occlusive plaques in the aortic arch or in the cerebral arteries. The authors analyzed the prevalence of ESUS in a real-life condition in Italy and compared the recurrence rates in cryptogenic strokes, cardioembolic strokes, and ESUS. The authors retrospectively reassessed according to ESUS criteria 391 consecutive admissions in a stroke unit where extensive diagnostic search was routinely performed. Recurrences in each stroke type within a 3-year follow-up period (mean time: 25.44 months - standard deviation: 9.42) were also compared. The prevalence of ESUS in the aforementioned cohort was 10.5%. All ESUS patients received antiplatelet agents. Warfarin was prescribed in 56.9% of cardioembolic strokes. The recurrence rate in ESUS patients was 4.4% per year, slightly higher than in cardioembolic strokes (3.5%) and significantly higher than in cryptogenic non-ESUS (1.2%) (P&lt;0.0001). This is the first description of a cohort of ESUS patients in an Italian stroke unit. Patients with ESUS have a significantly higher risk of recurrence than in those with non-ESUS cryptogenic strokes, and slightly higher than in those with cardioembolic strokes. Results support the hypothesis of a more extensive diagnostic evaluation in cryptogenic strokes and the feasibility of such approach.

Assessment of Physical Activity and Energy Expenditure by GPS Combined With Accelerometry in Real-Life Conditions

Background:Physical activity (PA) and related energy expenditure (EE) is often assessed by means of a single technique. Because of inherent limitations, single techniques may not allow for an accurate assessment both PA and related EE. The aim of this study was to develop a model to accurately assess common PA types and durations and thus EE in free-living conditions, combining data from global positioning system (GPS) and 2 accelerometers.Methods:Forty-one volunteers participated in the study. First, a model was developed and adjusted to measured EE with a first group of subjects (Protocol I, n = 12) who performed 6 structured and supervised PA. Then, the model was validated over 2 experimental phases with 2 groups (n = 12 and n = 17) performing scheduled (Protocol I) and spontaneous common activities in real-life condition (Protocol II). Predicted EE was compared with actual EE as measured by portable indirect calorimetry.Results:In protocol I, performed PA types could be recognized with little error. The duration of each PA type could be predicted with an accuracy below 1 minute. Measured and predicted EE were strongly associated (r = .97, P < .001).Conclusion:Combining GPS and 2 accelerometers allows for an accurate assessment of PA and EE in free-living situations.