Freeman Hospital

Newcastle upon Tyne, United Kingdom

Freeman Hospital

Newcastle upon Tyne, United Kingdom

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In the last 25 years, chromogenic culture media have found widespread application in diagnostic clinical microbiology. In the last decade, the range of media available to clinical laboratories has expanded greatly, allowing specific detection of additional pathogens, including Pseudomonas aeruginosa, group B streptococci, Clostridium difficile, Campylobacter spp., and Yersinia enterocolitica. New media have also been developed to screen for pathogens with acquired antimicrobial resistance, including vancomycin-resistant enterococci, carbapenem-resistant Acinetobacter spp., and Enterobacteriaceae with extended-spectrum β-lactamases and carbapenemases. This review seeks to explore the utility of chromogenic media in clinical microbiology, with particular attention given to media that have been commercialized in the last decade. The impact of laboratory automation and complementary technologies such as matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) is also assessed. Finally, the review also seeks to demarcate the role of chromogenic media in an era of molecular diagnostics. © Crown copyright 2017.


DUBLIN - May 15, 2017 - Medtronic plc (NYSE: MDT) today announced new data supporting the clinical performance of the company's exclusive EffectivCRT(TM) Diagnostic and AdaptivCRT(TM) algorithm in heart failure patients who receive cardiac resynchronization therapy (CRT) devices. The data were recently presented at Heart Rhythm 2017, the Heart Rhythm Society's 38th Annual Scientific Sessions in Chicago. CRT is an established treatment that uses an implantable defibrillator or pacemaker to improve the pumping efficiency of the heart. Many CRT devices report "percent pacing" - a measure of whether the device sends a pacing pulse to stimulate the heart. However, they do not report the effectiveness of each pacing stimulus - that is, whether the pacing pulse "captures" the heart muscle and improves its pumping ability. The EffectivCRT Diagnostic - available on the newest Medtronic CRT-defibrillators and CRT-pacemakers - automatically determines the effectiveness of left ventricular pacing. Chris Plummer, M.D., of Freeman Hospital, Newcastle-on-Tyne, United Kingdom, presented an analysis of 335 patients implanted with a Claria MRI(TM) CRT-D SureScan(TM), which provides diagnostics to help determine the cause of ineffective pacing. Awareness of effective CRT can help physicians provide a more personalized approach to treatment. Additionally, a large (40,000+ patients) observational study compared the risk of developing  atrial fibrillation (AF) in patients with CRT-Ds treated with AdaptivCRT vs. standard biventricular pacing. Patients treated with AdaptivCRT experienced a 35 percent reduction in the subsequent development of AF compared to patients treated with standard biventricular pacing. The data presented at Heart Rhythm 2017 are consistent with previous findings from the randomized Adaptive CRT clinical trial, which demonstrated a 46 percent reduction  in the risk of developing AF1. "These outcomes further confirm the benefits of these advanced cardiac resynchronization therapy technologies delivered in a contemporary real-world clinical setting," said Jonathan Hsu, M.D., cardiac electrophysiologist and assistant professor of medicine at the University of California, San Diego. "AdaptivCRT gives us more insights and automatically makes adjustments based on each patient's unique needs, and our study suggests that its use is associated with a decreased risk of developing atrial fibrillation." The AdaptivCRT algorithm, available in the Medtronic Claria MRICRT-D, Amplia MRI(TM) Quad CRT-D SureScan(TM), Percepta(TM) Quad CRT-P MRI SureScan(TM), and Serena(TM) Quad CRT-P MRI SureScan(TM), adjusts the way the device stimulates (paces) the heart according to minute-to-minute evaluations of each patient's rhythm. The Percepta Quad CRT-P also features the EffectivCRT Diagnostic. "Medtronic is committed to providing the most advanced technologies that are shown to help improve the delivery and effectiveness of cardiac resynchronization therapy in both controlled and real-world environments," said David Steinhaus, M.D., vice president and general manager of the Heart Failure business, which is part of the Cardiac and Vascular Group at Medtronic. "Our portfolio of cardiac devices and technologies continues to lead the way in personalized care, creating better solutions and improving individual patient outcomes." In collaboration with leading clinicians, researchers and scientists worldwide, Medtronic offers the broadest range of innovative medical technology for the interventional and surgical treatment of cardiovascular disease and cardiac arrhythmias. The company strives to offer products and services of the highest quality that deliver clinical and economic value to healthcare consumers and providers around the world. Medtronic plc (www.medtronic.com), headquartered in Dublin, Ireland, is among the world's largest medical technology, services and solutions companies - alleviating pain, restoring health and extending life for millions of people around the world. Medtronic employs more than 88,000 people worldwide, serving physicians, hospitals and patients in approximately 160 countries. The company is focused on collaborating with stakeholders around the world to take healthcare Further, Together. Any forward-looking statements are subject to risks and uncertainties such as those described in Medtronic's periodic reports on file with the Securities and Exchange Commission. Actual results may differ materially from anticipated results. 1 Martin D, et al. Clinical outcomes with adaptive cardiac resynchronization therapy: Long-term outcomes of the Adaptive CRT Trial. HFSA Annual Scientific Meeting. September 23, 2013.


DUBLIN - May 15, 2017 - Medtronic plc (NYSE: MDT) today announced new data supporting the clinical performance of the company's exclusive EffectivCRT(TM) Diagnostic and AdaptivCRT(TM) algorithm in heart failure patients who receive cardiac resynchronization therapy (CRT) devices. The data were recently presented at Heart Rhythm 2017, the Heart Rhythm Society's 38th Annual Scientific Sessions in Chicago. CRT is an established treatment that uses an implantable defibrillator or pacemaker to improve the pumping efficiency of the heart. Many CRT devices report "percent pacing" - a measure of whether the device sends a pacing pulse to stimulate the heart. However, they do not report the effectiveness of each pacing stimulus - that is, whether the pacing pulse "captures" the heart muscle and improves its pumping ability. The EffectivCRT Diagnostic - available on the newest Medtronic CRT-defibrillators and CRT-pacemakers - automatically determines the effectiveness of left ventricular pacing. Chris Plummer, M.D., of Freeman Hospital, Newcastle-on-Tyne, United Kingdom, presented an analysis of 335 patients implanted with a Claria MRI(TM) CRT-D SureScan(TM), which provides diagnostics to help determine the cause of ineffective pacing. Awareness of effective CRT can help physicians provide a more personalized approach to treatment. Additionally, a large (40,000+ patients) observational study compared the risk of developing  atrial fibrillation (AF) in patients with CRT-Ds treated with AdaptivCRT vs. standard biventricular pacing. Patients treated with AdaptivCRT experienced a 35 percent reduction in the subsequent development of AF compared to patients treated with standard biventricular pacing. The data presented at Heart Rhythm 2017 are consistent with previous findings from the randomized Adaptive CRT clinical trial, which demonstrated a 46 percent reduction  in the risk of developing AF1. "These outcomes further confirm the benefits of these advanced cardiac resynchronization therapy technologies delivered in a contemporary real-world clinical setting," said Jonathan Hsu, M.D., cardiac electrophysiologist and assistant professor of medicine at the University of California, San Diego. "AdaptivCRT gives us more insights and automatically makes adjustments based on each patient's unique needs, and our study suggests that its use is associated with a decreased risk of developing atrial fibrillation." The AdaptivCRT algorithm, available in the Medtronic Claria MRICRT-D, Amplia MRI(TM) Quad CRT-D SureScan(TM), Percepta(TM) Quad CRT-P MRI SureScan(TM), and Serena(TM) Quad CRT-P MRI SureScan(TM), adjusts the way the device stimulates (paces) the heart according to minute-to-minute evaluations of each patient's rhythm. The Percepta Quad CRT-P also features the EffectivCRT Diagnostic. "Medtronic is committed to providing the most advanced technologies that are shown to help improve the delivery and effectiveness of cardiac resynchronization therapy in both controlled and real-world environments," said David Steinhaus, M.D., vice president and general manager of the Heart Failure business, which is part of the Cardiac and Vascular Group at Medtronic. "Our portfolio of cardiac devices and technologies continues to lead the way in personalized care, creating better solutions and improving individual patient outcomes." In collaboration with leading clinicians, researchers and scientists worldwide, Medtronic offers the broadest range of innovative medical technology for the interventional and surgical treatment of cardiovascular disease and cardiac arrhythmias. The company strives to offer products and services of the highest quality that deliver clinical and economic value to healthcare consumers and providers around the world. Medtronic plc (www.medtronic.com), headquartered in Dublin, Ireland, is among the world's largest medical technology, services and solutions companies - alleviating pain, restoring health and extending life for millions of people around the world. Medtronic employs more than 88,000 people worldwide, serving physicians, hospitals and patients in approximately 160 countries. The company is focused on collaborating with stakeholders around the world to take healthcare Further, Together. Any forward-looking statements are subject to risks and uncertainties such as those described in Medtronic's periodic reports on file with the Securities and Exchange Commission. Actual results may differ materially from anticipated results. 1 Martin D, et al. Clinical outcomes with adaptive cardiac resynchronization therapy: Long-term outcomes of the Adaptive CRT Trial. HFSA Annual Scientific Meeting. September 23, 2013.


DUBLIN - May 15, 2017 - Medtronic plc (NYSE: MDT) today announced new data supporting the clinical performance of the company's exclusive EffectivCRT(TM) Diagnostic and AdaptivCRT(TM) algorithm in heart failure patients who receive cardiac resynchronization therapy (CRT) devices. The data were recently presented at Heart Rhythm 2017, the Heart Rhythm Society's 38th Annual Scientific Sessions in Chicago. CRT is an established treatment that uses an implantable defibrillator or pacemaker to improve the pumping efficiency of the heart. Many CRT devices report "percent pacing" - a measure of whether the device sends a pacing pulse to stimulate the heart. However, they do not report the effectiveness of each pacing stimulus - that is, whether the pacing pulse "captures" the heart muscle and improves its pumping ability. The EffectivCRT Diagnostic - available on the newest Medtronic CRT-defibrillators and CRT-pacemakers - automatically determines the effectiveness of left ventricular pacing. Chris Plummer, M.D., of Freeman Hospital, Newcastle-on-Tyne, United Kingdom, presented an analysis of 335 patients implanted with a Claria MRI(TM) CRT-D SureScan(TM), which provides diagnostics to help determine the cause of ineffective pacing. Awareness of effective CRT can help physicians provide a more personalized approach to treatment. Additionally, a large (40,000+ patients) observational study compared the risk of developing  atrial fibrillation (AF) in patients with CRT-Ds treated with AdaptivCRT vs. standard biventricular pacing. Patients treated with AdaptivCRT experienced a 35 percent reduction in the subsequent development of AF compared to patients treated with standard biventricular pacing. The data presented at Heart Rhythm 2017 are consistent with previous findings from the randomized Adaptive CRT clinical trial, which demonstrated a 46 percent reduction  in the risk of developing AF1. "These outcomes further confirm the benefits of these advanced cardiac resynchronization therapy technologies delivered in a contemporary real-world clinical setting," said Jonathan Hsu, M.D., cardiac electrophysiologist and assistant professor of medicine at the University of California, San Diego. "AdaptivCRT gives us more insights and automatically makes adjustments based on each patient's unique needs, and our study suggests that its use is associated with a decreased risk of developing atrial fibrillation." The AdaptivCRT algorithm, available in the Medtronic Claria MRICRT-D, Amplia MRI(TM) Quad CRT-D SureScan(TM), Percepta(TM) Quad CRT-P MRI SureScan(TM), and Serena(TM) Quad CRT-P MRI SureScan(TM), adjusts the way the device stimulates (paces) the heart according to minute-to-minute evaluations of each patient's rhythm. The Percepta Quad CRT-P also features the EffectivCRT Diagnostic. "Medtronic is committed to providing the most advanced technologies that are shown to help improve the delivery and effectiveness of cardiac resynchronization therapy in both controlled and real-world environments," said David Steinhaus, M.D., vice president and general manager of the Heart Failure business, which is part of the Cardiac and Vascular Group at Medtronic. "Our portfolio of cardiac devices and technologies continues to lead the way in personalized care, creating better solutions and improving individual patient outcomes." In collaboration with leading clinicians, researchers and scientists worldwide, Medtronic offers the broadest range of innovative medical technology for the interventional and surgical treatment of cardiovascular disease and cardiac arrhythmias. The company strives to offer products and services of the highest quality that deliver clinical and economic value to healthcare consumers and providers around the world. Medtronic plc (www.medtronic.com), headquartered in Dublin, Ireland, is among the world's largest medical technology, services and solutions companies - alleviating pain, restoring health and extending life for millions of people around the world. Medtronic employs more than 88,000 people worldwide, serving physicians, hospitals and patients in approximately 160 countries. The company is focused on collaborating with stakeholders around the world to take healthcare Further, Together. Any forward-looking statements are subject to risks and uncertainties such as those described in Medtronic's periodic reports on file with the Securities and Exchange Commission. Actual results may differ materially from anticipated results. 1 Martin D, et al. Clinical outcomes with adaptive cardiac resynchronization therapy: Long-term outcomes of the Adaptive CRT Trial. HFSA Annual Scientific Meeting. September 23, 2013.


"We hope the money raised will help The Sick Children’s Trust continue its great work and reach out to more families who needs its support.” The North East regional branch of The Institution of Mechanical Engineers (IMechE) has raised an outstanding £5,050 for The Sick Children’s Trust from its annual Chairman’s dinner held earlier this month. IMechE North East Chairman Chris Briggs chose The Sick Children’s Trust as the chosen charity for the event and hoped to raise £2,500 for the charity which supports families with children undergoing lifesaving treatment. However, following generous donations from attendees, a superb raffle and auction the evening doubled the initial fundraising target, raising over £5,000. The Sick Children’s Trust runs ten ‘Homes from Homes’ across the country supporting families with seriously ill children in hospital. Two of its ‘Homes from Home’ are located in Newcastle upon Tyne at the Royal Victoria Infirmary and Freeman Hospital. The money raised from the North East IMechE dinner will go towards running both ‘Homes from Home’ in the North East. Chris Briggs says: “We’d like to say a huge thank you to our sponsors, British Engines, and all our guests for making the event at Hardwick Hall such a huge success. Because of everyone’s support, we were able to raise more than double our target for The Sick Children’s Trust, a charity that helps so many families going through the most traumatic times. We hope the money raised will help The Sick Children’s Trust continue its great work and reach out to more families who needs its support.” The Sick Children’s Trust supports over 4,000 families with seriously ill children in hospital every year. Caroline O’Doherty, Campaigns and Appeals Manager at The Sick Children’s Trust says: “We’re absolutely delighted with the tremendous amount raised. The guests were so generous with their donations and we simply can’t thank Chris and the rest of the IMechE members enough for choosing The Sick Children’s Trust as the benefiting charity of the dinner. “Thanks to everyone’s generosity, we can be there for the increasing number of families from the North East and beyond who rely on us to keep them together with their sick child.” For more information about The Sick Children’s Trust, please visit: www.sickchildrenstrust.org


News Article | May 4, 2017
Site: www.cnet.com

Mind-controlled robotics look like the future of prosthetics -- but what if your prosthetic limb has a mind of its own? A team of researchers at Newcastle University has developed a hand that is able to "see" objects in front of it using a simple Logitech webcam, and respond via software to assess and grasp them. Their research was published this week in the Journal of Neural Engineering. "Using computer vision, we have developed a bionic hand which can respond automatically," said co-author Kianoush Nazarpour, senior lecturer in Biomedical Engineering. "In fact, just like a real hand, the user can reach out and pick up a cup or a biscuit with nothing more than a quick glance in the right direction." The problem with the current crop of prosthetics, which are controlled via the electrical signals sent to the limb's muscles from the brain, the team asserts, is that they don't respond quickly enough. Nazapour's team, however, said their hand is much more intuitive. They trained it using neural network software to recognise a variety of objects, and what sort of grip is required for those objects, such as the difference between a stick, a TV remote and a mug. Moreover, it can recognise the grasp required for specific objects it hasn't encountered before, using the camera to "see" them and then automatically pick the most appropriate grasp. The team has trialed the faster technology with two amputee volunteers previously using split-hook prosthetics. Now, the team is looking to offer the hand to patients at Freeman Hospital in Newcastle to develop it further. The ultimate aim of the research is a bionic hand that can sense pressure and temperature. "It's a stepping stone towards our ultimate goal," Nazarpour said. "But importantly, it's cheap and it can be implemented soon because it doesn't require new prosthetics -- we can just adapt the ones we have." Tech Culture: From film and television to social media and games, here's your place for the lighter side of tech. Batteries Not Included: The CNET team shares experiences that remind us why tech stuff is cool.


The North East regional branch of IMechE will hold their annual Chairman's Dinner on 12 May to raise money for The Sick Children's Trust The North East regional branch of an international engineering society has chosen The Sick Children’s Trust to benefit from its prestigious annual dinner next month. The Institution of Mechanical Engineers (IMechE), which represents over 115,000 members worldwide, has chosen The Sick Children’s Trust to benefit from its regional annual charity dinner on Friday 12 May at Hardwick Hall Hotel in Sedgefield. The organisers of the event, which celebrates the achievements of its members in the North East, are hoping it will raise over £2,500 for the charity which supports families with seriously ill children in hospital with ‘Home from Home’ accommodation. The Sick Children’s Trust runs two ‘Homes from Home’ in Newcastle upon Tyne, supporting thousands of families from across the North East when their child is undergoing lifesaving treatment at both the Freeman Hospital and Royal Victoria Infirmary. IMechE North East Chairman Chris Briggs, says: “We are thrilled to be supporting The Sick Children’s Trust. We always choose a charity active in the region and The Sick Children’s Trust helps so many families who have children in hospital in Newcastle. We hope by choosing them as our benefitting charity, our guests will dig deep to help the charity help even more families with seriously ill children in hospital.” The dinner is the keynote event in the IMechE’s Regional calendar, and is sponsored once again by British Engines Ltd. Guests who attend can expect a fantastic evening, with guest speaker Kevin Connelly, the celebrated impressionist from TV's 'Dead Ringers' and a four-course dinner with wine. The evening promises to be a great opportunity to network with peers from across the engineering community. The Sick Children’s Trust runs ten ‘Homes from Home’ across the country supporting, over 4,000 families with seriously ill children in hospital every year. Although ‘Home from Home’ accommodation is provided free to families, it costs the charity £30 to support a family for one night. Caroline O’Doherty, Campaigns and Appeals Manager at The Sick Children’s Trust says: “We were delighted when Chris told us that we were IMechE’s chosen charity for the annual dinner. The money raised from the event will go a long way towards providing families in the region with a ‘Home from Home’ when their child is undergoing lifesaving treatment in hospital. We’d like to say a huge thank you to IMechE for choosing to support us; thanks to your generosity, we can be there for the increasing number of families who rely on us to keep them together with their sick child..” Ticket sales for the dinner are now closed but it’s still possible to make a donation to the charity at http://www.sickchildrenstrust.org/Donate/index.html For more information: Please contact Alexandra Glatman on 0207 337 2213 or email [email protected]


News Article | May 3, 2017
Site: phys.org

Led by biomedical engineers at Newcastle University, UK, and funded by the Engineering and Physical Sciences Research Council (EPSRC), the bionic hand is fitted with a camera which instantaneously takes a picture of the object in front of it, assesses its shape and size and triggers a series of movements in the hand. Bypassing the usual processes which require the user to see the object, physically stimulate the muscles in the arm and trigger a movement in the prosthetic limb, the hand 'sees' and reacts in one fluid movement. A small number of amputees have already trialled the new technology and now the Newcastle University team are working with experts at Newcastle upon Tyne Hospitals NHS Foundation Trust to offer the 'hands with eyes' to patients at Newcastle's Freeman Hospital. Publishing their findings today in the Journal of Neural Engineering, co-author on the study Dr Kianoush Nazarpour, a Senior Lecturer in Biomedical Engineering at Newcastle University, explains: "Prosthetic limbs have changed very little in the past 100 years—the design is much better and the materials' are lighter weight and more durable but they still work in the same way. "Using computer vision, we have developed a bionic hand which can respond automatically—in fact, just like a real hand, the user can reach out and pick up a cup or a biscuit with nothing more than a quick glance in the right direction. "Responsiveness has been one of the main barriers to artificial limbs. For many amputees the reference point is their healthy arm or leg so prosthetics seem slow and cumbersome in comparison. "Now, for the first time in a century, we have developed an 'intuitive' hand that can react without thinking." Recent statistics show that in the UK there are around 600 new upper-limb amputees every year, of which 50% are in the age range of 15-54 years old. In the US there are 500,000 upper limb amputees a year. Current prosthetic hands are controlled via myoelectric signals - that is electrical activity of the muscles recorded from the skin surface of the stump. Controlling them, says Dr Nazarpour, takes practice, concentration and, crucially, time. Using neural networks—the basis for Artificial Intelligence—lead author on the study Ghazal Ghazaei showed the computer numerous object images and taught it to recognise the 'grip' needed for different objects. "We would show the computer a picture of, for example, a stick," explains Miss Ghazaei, who carried out the work as part of her PhD in the School of Electrical and Electronic Engineering at Newcastle University. "But not just one picture, many images of the same stick from different angles and orientations, even in different light and against different backgrounds and eventually the computer learns what grasp it needs to pick that stick up. "So the computer isn't just matching an image, it's learning to recognise objects and group them according to the grasp type the hand has to perform to successfully pick it up. "It is this which enables it to accurately assess and pick up an object which it has never seen before—a huge step forward in the development of bionic limbs." Grouping objects by size, shape and orientation, according to the type of grasp that would be needed to pick them up, the team programmed the hand to perform four different 'grasps': palm wrist neutral (such as when you pick up a cup); palm wrist pronated (such as picking up the TV remote); tripod (thumb and two fingers) and pinch (thumb and first finger). Using a 99p camera fitted to the prosthesis, the hand 'sees' an object, picks the most appropriate grasp and sends a signal to the hand—all within a matter of milliseconds and ten times faster than any other limb currently on the market. "One way would have been to create a photo database of every single object but clearly that would be a massive task and you would literally need every make of pen, toothbrush, shape of cup—the list is endless," says Dr Nazarpour. "The beauty of this system is that it's much more flexible and the hand is able to pick up novel objects—which is crucial since in everyday life people effortlessly pick up a variety of objects that they have never seen before." The work is part of a larger research project to develop a bionic hand that can sense pressure and temperature and transmit the information back to the brain. Led by Newcastle University and involving experts from the universities of Leeds, Essex, Keele, Southampton and Imperial College London, the aim is to develop novel electronic devices that connect to the forearm neural networks to allow two-way communications with the brain. Reminiscent of Luke Skywalker's artificial hand, the electrodes in the bionic limb would wrap around the nerve endings in the arm. This would mean for the first time the brain could communicate directly with the prosthesis. The 'hand that sees', explains Dr Nazarpour, is an interim solution that will bridge the gap between current designs and the future. "It's a stepping stone towards our ultimate goal," he says. "But importantly, it's cheap and it can be implemented soon because it doesn't require new prosthetics—we can just adapt the ones we have." Anne Ewing, Advanced Occupational Therapist at Newcastle upon Tyne Hospitals NHS Foundation Trust, has been working with Dr Nazarpour and his team. "I work with upper limb amputee patients which is extremely rewarding, varied and at times challenging," she said. "We always strive to put the patient at the heart of everything we do and so make sure that any interventions are client centred to ensure patients' individual goals are met either with a prosthesis or alternative method of carrying out a task. "This project in collaboration with Newcastle University has provided an exciting opportunity to help shape the future of upper limb prosthetics, working towards achieving patients' prosthetic expectations and it is wonderful to have been involved." "For me it was literally a case of life or limb," says Doug McIntosh, who lost his right arm in 1997 through cancer. "I had developed a rare form of cancer called epithelial sarcoma, which develops in the deep tissue under the skin, and the doctors had no choice but to amputate the limb to save my life. "Losing an arm and battling cancer with three young children was life changing. I left my job as a life support supervisor in the diving industry and spent a year fund-raising for cancer charities. "It was this and my family that motivated me and got me through the hardest times." Since then, Doug has gone on to be an inspiration to amputees around the world. Becoming the first amputee to cycle from John O'Groats to Land's End in 100hrs, cycle around the coast line of Britain, he has run three London Marathons, cycled The Dallaglio Flintoff Cycle Slam 2012 and 2014 and in 2014 cycled with the British Lions Rugby Team to Murrayfield Rugby Stadium for "Walking with Wounded" Charity. He is currently preparing to do Mont Ventoux this September, three cycle climbs in one day for Cancer Research UK and Maggie's Cancer Centres. Involved in the early trials of the first myoelectric prosthetic limbs, Doug has been working with the Newcastle team to trail the new hand that sees. "The problem is there's nothing yet that really comes close to feeling like the real thing," explains the father-of-three who lives in Westhill, Aberdeen with his wife of 32 years, Diane. "Some of the prosthetics look very realistic but they feel slow and clumsy when you have a working hand to compare them to. "In the end I found it easier just to do without and learn to adapt. When I do use a prosthesis I use a split hook which doesn't look pretty but does the job." But he says the new, responsive hand being developed in Newcastle is a 'huge leap forward'. "This offers for the first time a real alternative for upper limb amputees," he says. "For me, one of the ways of dealing with the loss of my hand was to be very open about it and answer people's questions. But not everyone wants that and so to have the option of a hand that not only looks realistic but also works like a real hand would be an amazing breakthrough and transform the recovery time—both physically and mentally—for many amputees." Explore further: Bionic hand that is 'sensitive' to touch and temperature More information: G. Ghazaei, A. Alameer, P. Degenaar, G. Morgan, and K. Nazarpour, "Deep learning-based artificial vision for grasp classification in myoelectric hands," Journal of Neural Engineering, 17(3): 036025, 2017.


News Article | May 3, 2017
Site: www.eurekalert.org

A new generation of prosthetic limbs which will allow the wearer to reach for objects automatically, without thinking -- just like a real hand -- are to be trialled for the first time. Led by biomedical engineers at Newcastle University, UK, and funded by the Engineering and Physical Sciences Research Council (EPSRC), the bionic hand is fitted with a camera which instantaneously takes a picture of the object in front of it, assesses its shape and size and triggers a series of movements in the hand. Bypassing the usual processes which require the user to see the object, physically stimulate the muscles in the arm and trigger a movement in the prosthetic limb, the hand 'sees' and reacts in one fluid movement. A small number of amputees have already trialled the new technology and now the Newcastle University team are working with experts at Newcastle upon Tyne Hospitals NHS Foundation Trust to offer the 'hands with eyes' to patients at Newcastle's Freeman Hospital. Publishing their findings today in the Journal of Neural Engineering, co-author on the study Dr Kianoush Nazarpour, a Senior Lecturer in Biomedical Engineering at Newcastle University, explains: "Prosthetic limbs have changed very little in the past 100 years -- the design is much better and the materials' are lighter weight and more durable but they still work in the same way. "Using computer vision, we have developed a bionic hand which can respond automatically -- in fact, just like a real hand, the user can reach out and pick up a cup or a biscuit with nothing more than a quick glance in the right direction. "Responsiveness has been one of the main barriers to artificial limbs. For many amputees the reference point is their healthy arm or leg so prosthetics seem slow and cumbersome in comparison. "Now, for the first time in a century, we have developed an 'intuitive' hand that can react without thinking." Recent statistics show that in the UK there are around 600 new upper-limb amputees every year, of which 50% are in the age range of 15-54 years old. In the US there are 500,000 upper limb amputees a year. Current prosthetic hands are controlled via myoelectric signals - that is electrical activity of the muscles recorded from the skin surface of the stump. Controlling them, says Dr Nazarpour, takes practice, concentration and, crucially, time. Using neural networks -- the basis for Artificial Intelligence -- lead author on the study Ghazal Ghazaei showed the computer numerous object images and taught it to recognise the 'grip' needed for different objects. "We would show the computer a picture of, for example, a stick," explains Miss Ghazaei, who carried out the work as part of her PhD in the School of Electrical and Electronic Engineering at Newcastle University. "But not just one picture, many images of the same stick from different angles and orientations, even in different light and against different backgrounds and eventually the computer learns what grasp it needs to pick that stick up. "So the computer isn't just matching an image, it's learning to recognise objects and group them according to the grasp type the hand has to perform to successfully pick it up. "It is this which enables it to accurately assess and pick up an object which it has never seen before -- a huge step forward in the development of bionic limbs." Grouping objects by size, shape and orientation, according to the type of grasp that would be needed to pick them up, the team programmed the hand to perform four different 'grasps': palm wrist neutral (such as when you pick up a cup); palm wrist pronated (such as picking up the TV remote); tripod (thumb and two fingers) and pinch (thumb and first finger). Using a 99p camera fitted to the prosthesis, the hand 'sees' an object, picks the most appropriate grasp and sends a signal to the hand -- all within a matter of milliseconds and ten times faster than any other limb currently on the market. "One way would have been to create a photo database of every single object but clearly that would be a massive task and you would literally need every make of pen, toothbrush, shape of cup -- the list is endless," says Dr Nazarpour. "The beauty of this system is that it's much more flexible and the hand is able to pick up novel objects -- which is crucial since in everyday life people effortlessly pick up a variety of objects that they have never seen before." The work is part of a larger research project to develop a bionic hand that can sense pressure and temperature and transmit the information back to the brain. Led by Newcastle University and involving experts from the universities of Leeds, Essex, Keele, Southampton and Imperial College London, the aim is to develop novel electronic devices that connect to the forearm neural networks to allow two-way communications with the brain. Reminiscent of Luke Skywalker's artificial hand, the electrodes in the bionic limb would wrap around the nerve endings in the arm. This would mean for the first time the brain could communicate directly with the prosthesis. The 'hand that sees', explains Dr Nazarpour, is an interim solution that will bridge the gap between current designs and the future. "It's a stepping stone towards our ultimate goal," he says. "But importantly, it's cheap and it can be implemented soon because it doesn't require new prosthetics -- we can just adapt the ones we have." Anne Ewing, Advanced Occupational Therapist at Newcastle upon Tyne Hospitals NHS Foundation Trust, has been working with Dr Nazarpour and his team. "I work with upper limb amputee patients which is extremely rewarding, varied and at times challenging," she said. "We always strive to put the patient at the heart of everything we do and so make sure that any interventions are client centred to ensure patients' individual goals are met either with a prosthesis or alternative method of carrying out a task. "This project in collaboration with Newcastle University has provided an exciting opportunity to help shape the future of upper limb prosthetics, working towards achieving patients' prosthetic expectations and it is wonderful to have been involved." "For me it was literally a case of life or limb," says Doug McIntosh, who lost his right arm in 1997 through cancer. "I had developed a rare form of cancer called epithelial sarcoma, which develops in the deep tissue under the skin, and the doctors had no choice but to amputate the limb to save my life. "Losing an arm and battling cancer with three young children was life changing. I left my job as a life support supervisor in the diving industry and spent a year fund-raising for cancer charities. "It was this and my family that motivated me and got me through the hardest times." Since then, Doug has gone on to be an inspiration to amputees around the world. Becoming the first amputee to cycle from John O'Groats to Land's End in 100hrs, cycle around the coast line of Britain, he has run three London Marathons, cycled The Dallaglio Flintoff Cycle Slam 2012 and 2014 and in 2014 cycled with the British Lions Rugby Team to Murrayfield Rugby Stadium for "Walking with Wounded" Charity. He is currently preparing to do Mont Ventoux this September, three cycle climbs in one day for Cancer Research UK and Maggie's Cancer Centres. Involved in the early trials of the first myoelectric prosthetic limbs, Doug has been working with the Newcastle team to trail the new hand that sees. "The problem is there's nothing yet that really comes close to feeling like the real thing," explains the father-of-three who lives in Westhill, Aberdeen with his wife of 32 years, Diane. "Some of the prosthetics look very realistic but they feel slow and clumsy when you have a working hand to compare them to. "In the end I found it easier just to do without and learn to adapt. When I do use a prosthesis I use a split hook which doesn't look pretty but does the job." But he says the new, responsive hand being developed in Newcastle is a 'huge leap forward'. "This offers for the first time a real alternative for upper limb amputees," he says. "For me, one of the ways of dealing with the loss of my hand was to be very open about it and answer people's questions. But not everyone wants that and so to have the option of a hand that not only looks realistic but also works like a real hand would be an amazing breakthrough and transform the recovery time -- both physically and mentally -- for many amputees."


The use of impaction grafting in revisions with larger acetabular bone defects has mixed outcomes and sometimes high failures rates. This prospective, single-center study involved a consecutive series of 24 patients who underwent complex reconstruction of the acetabulum using a trabecular metal augment, impaction bone grafting, and a cemented high-density polyethylene cup. Patients were followed for median 5 (3-7) years. The 2-year WOMAC pain, function, and stiffness scores improved, as did certain components (bodily pain, physical function, role physical, role emotional, physical component score, and social function) of the SF-36 (p < 0.05). 23 of the patients were very satisfied with the overall outcome of the surgery and would have undergone the surgery again for a similar problem, and 19 reported great improvement in their quality of life after surgery. Radiographs at the latest follow-up revealed incorporation of the augment with mean change in acetabular component inclination of less than 1 degree (p > 0.05) and cup migration of less than 5 mm in both horizontal and vertical axes (p > 0.05). 1 patient required further revision at 13 months and was found to have a fractured augment at re-revision. This study shows that trabecular metal augments are effective in filling the bone defect and provide a stable foundation for impaction bone grafting. We found satisfactory clinical and radiographic results using this technique, with low failure rate at a median follow-up time of 5 years.

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