Background: Phantom limb pain is a frequent and persistent problem following amputation. Achieving sustainable favorable effects on phantom limb pain requires therapeutic interventions such as mirror therapy that target maladaptive neuroplastic changes in the central nervous system. Unfortunately, patients’ adherence to unsupervised exercises is generally poor and there is a need for effective strategies such as telerehabilitation to support long-term self-management of patients with phantom limb pain. Objective: The main aim of this study was to describe the user-centered approach that guided the design and development of a telerehabilitation platform for patients with phantom limb pain. We addressed 3 research questions: (1) Which requirements are defined by patients and therapists for the content and functions of a telerehabilitation platform and how can these requirements be prioritized to develop a first prototype of the platform? (2) How can the user interface of the telerehabilitation platform be designed so as to match the predefined critical user requirements and how can this interface be translated into a medium-fidelity prototype of the platform? (3) How do patients with phantom limb pain and their treating therapists judge the usability of the medium-fidelity prototype of the telerehabilitation platform in routine care and how can the platform be redesigned based on their feedback to achieve a high-fidelity prototype?
Het project Cracking the Criminal Mind is een samenwerking tussen politie-experts en studenten. In een learning community wordt getracht om te anticiperen op nieuwe, frauduleuze verdienmethodes. Welke strategieën zouden criminelen – al dan niet gebruikmakend van nieuwe digitale afschermingsmethodes – kunnen bedenken om geld te verdienen en om uit zicht te blijven van politie en justitie? Het identificeren van innovatieve criminele verdienmethoden vindt plaats in een learning community waar politie-experts en studenten met verschillende soorten kennis en expertise samenkomen. Deelnemers aan de learning community denken ook na over strategieën om de geïdentificeerde verdienmethoden tijdig te herkennen en te verstoren.
Background: Profiling the plant root architecture is vital for selecting resilient crops that can efficiently take up water and nutrients. The high-performance imaging tools available to study root-growth dynamics with the optimal resolution are costly and stationary. In addition, performing nondestructive high-throughput phenotyping to extract the structural and morphological features of roots remains challenging. Results: We developed the MultipleXLab: a modular, mobile, and cost-effective setup to tackle these limitations. The system can continuously monitor thousands of seeds from germination to root development based on a conventional camera attached to a motorized multiaxis-rotational stage and custom-built 3D-printed plate holder with integrated light-emitting diode lighting. We also developed an image segmentation model based on deep learning that allows the users to analyze the data automatically. We tested the MultipleXLab to monitor seed germination and root growth of Arabidopsis developmental, cell cycle, and auxin transport mutants non-invasively at high-throughput and showed that the system provides robust data and allows precise evaluation of germination index and hourly growth rate between mutants. Conclusion: MultipleXLab provides a flexible and user-friendly root phenotyping platform that is an attractive mobile alternative to high-end imaging platforms and stationary growth chambers. It can be used in numerous applications by plant biologists, the seed industry, crop scientists, and breeding companies.
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In het ziekenhuis kan elke fout een leven kosten. Zo kan al een kleine bereidingsfout bij het klaarmaken van intraveneuze medicijnen (IV) leiden tot levensbedreigende omstandigheden voor de patiënt. Bereiding van dit type medicijnen gebeurt in de apotheek en op de verpleegafdeling. Met name op de verpleegafdeling is het een drukke en onvoorspelbare setting. Wereldwijd komen in deze setting ernstige bereidingsfouten nog te frequent voor. Om deze menselijke fouten te reduceren, wordt in deze KIEM aanvraag een proof-of-concept ‘slim oog’ ontwikkeld die vlak voor de toediening detecteert of de juiste dosis aanwezig is, of het type medicijn correct is en geen vervuiling aanwezig is. Het slimme oog maakt gebruik van hyperspectrale technologie en artificial intelligence, en is een samenwerking tussen de Computer Vision & Data Science afdeling van NHL Stenden Hogeschool, de automatische medicijncontrole specialist ZiuZ, en het Tjongerschans ziekenhuis. De unieke combinatie tussen nieuwe AI-technieken, hyperspectrale techniek en de toepassing op intraveneuze medicijnen is voor dit consortium technisch nieuw, en is nog niet eerder ontwikkeld voor de toepassing aan het bed of in de medicijnkamer op de verpleegafdeling. De onvoorspelbare setting en de urgentie aan het bed maakt dit onderzoek technisch uitdagend. Tevens moet het uiteindelijke device klein en draagbaar en snel werkzaam zijn. Om de grote verscheidenheid aan mogelijke gebruik scenario's en menselijke fouten te vangen in het algoritme, wordt een door NHLS ontwikkelde simulatie procedure gevolgd: met nabootsing van de praktijksituatie in samenwerking met zorgverleners, met opzettelijke fouten, en computer gegenereerde beeldmanipulatie. Het project zal geïntegreerd worden in het onderwijs volgens de design-based methode, met teams bestaande uit domein experts, bedrijven, docent-onderzoekers en studenten. Het uiteindelijke doel is om met een proof-of-concept aan-het-bed demonstrator een groot consortium van ziekenhuizen, ontwikkelaars en eindgebruikers enthousiast te maken voor een groter vervolgproject.
Huntington’s disease (HD) and various spinocerebellar ataxias (SCA) are autosomal dominantly inherited neurodegenerative disorders caused by a CAG repeat expansion in the disease-related gene1. The impact of HD and SCA on families and individuals is enormous and far reaching, as patients typically display first symptoms during midlife. HD is characterized by unwanted choreatic movements, behavioral and psychiatric disturbances and dementia. SCAs are mainly characterized by ataxia but also other symptoms including cognitive deficits, similarly affecting quality of life and leading to disability. These problems worsen as the disease progresses and affected individuals are no longer able to work, drive, or care for themselves. It places an enormous burden on their family and caregivers, and patients will require intensive nursing home care when disease progresses, and lifespan is reduced. Although the clinical and pathological phenotypes are distinct for each CAG repeat expansion disorder, it is thought that similar molecular mechanisms underlie the effect of expanded CAG repeats in different genes. The predicted Age of Onset (AO) for both HD, SCA1 and SCA3 (and 5 other CAG-repeat diseases) is based on the polyQ expansion, but the CAG/polyQ determines the AO only for 50% (see figure below). A large variety on AO is observed, especially for the most common range between 40 and 50 repeats11,12. Large differences in onset, especially in the range 40-50 CAGs not only imply that current individual predictions for AO are imprecise (affecting important life decisions that patients need to make and also hampering assessment of potential onset-delaying intervention) but also do offer optimism that (patient-related) factors exist that can delay the onset of disease.To address both items, we need to generate a better model, based on patient-derived cells that generates parameters that not only mirror the CAG-repeat length dependency of these diseases, but that also better predicts inter-patient variations in disease susceptibility and effectiveness of interventions. Hereto, we will use a staggered project design as explained in 5.1, in which we first will determine which cellular and molecular determinants (referred to as landscapes) in isogenic iPSC models are associated with increased CAG repeat lengths using deep-learning algorithms (DLA) (WP1). Hereto, we will use a well characterized control cell line in which we modify the CAG repeat length in the endogenous ataxin-1, Ataxin-3 and Huntingtin gene from wildtype Q repeats to intermediate to adult onset and juvenile polyQ repeats. We will next expand the model with cells from the 3 (SCA1, SCA3, and HD) existing and new cohorts of early-onset, adult-onset and late-onset/intermediate repeat patients for which, besides accurate AO information, also clinical parameters (MRI scans, liquor markers etc) will be (made) available. This will be used for validation and to fine-tune the molecular landscapes (again using DLA) towards the best prediction of individual patient related clinical markers and AO (WP3). The same models and (most relevant) landscapes will also be used for evaluations of novel mutant protein lowering strategies as will emerge from WP4.This overall development process of landscape prediction is an iterative process that involves (a) data processing (WP5) (b) unsupervised data exploration and dimensionality reduction to find patterns in data and create “labels” for similarity and (c) development of data supervised Deep Learning (DL) models for landscape prediction based on the labels from previous step. Each iteration starts with data that is generated and deployed according to FAIR principles, and the developed deep learning system will be instrumental to connect these WPs. Insights in algorithm sensitivity from the predictive models will form the basis for discussion with field experts on the distinction and phenotypic consequences. While full development of accurate diagnostics might go beyond the timespan of the 5 year project, ideally our final landscapes can be used for new genetic counselling: when somebody is positive for the gene, can we use his/her cells, feed it into the generated cell-based model and better predict the AO and severity? While this will answer questions from clinicians and patient communities, it will also generate new ones, which is why we will study the ethical implications of such improved diagnostics in advance (WP6).
