Skin-mounted soft electronics incorporating high-bandwidth triaxial accelerometers can provide broad classes of physiologically relevant information, such as mechanoacoustic signatures of underlying body processes (such as those captured by a stethoscope) and precision kinematics of core body motions. Here, we describe a wireless device designed to be conformally placed on the suprasternal notch for the continuous measurement of mechanoacoustic signals, from subtle vibrations of the skin at accelerations of ~10 −3 m•s −2 to large motions of the entire body at ~10 m•s −2 , and at frequencies up to ~800 Hz. Because th measurements are a complex superposition of signals that arise from locomotion, body orientation, swallowing, respiration, cardiac activity, vocal-fold vibrations and other sources, we used frequency-domain analysis and machine learning to obtain, from human subjects during natural daily activities and exercise, real-time recordings of heart rate, respiration rate, energy intensity and other essential vital signs, as well as talking time and cadence, swallow counts and patterns, and other unconventional biomarkers. We also used the device in sleep laboratories, and validated the measurements via polysomnography. Natural processes of the human body yield a multitude of mechano-acoustic (MA) signals, many of which strongly attenuate at the skin-air interface 1-5. Motions with amplitudes and Lee et al.

What are the novel findings of this work?This is the first study to investigate the cost-effectiveness of different screening strategies for congenital heart defects (CHDs) in pregnancies conceived by in-vitro fertilization (IVF). The most cost-effective strategy is to perform fetal echocardiography (echo) only when abnormal cardiac findings are noted on the detailed anatomic ultrasound scan. Routine fetal echo for all IVF pregnancies is not cost-effective. What are the clinical implications of this work?In current practice guidelines, there is no clear consensus on whether conception by IVF is an indication for performing fetal echo. Based on our cost-effectiveness study of CHD screening strategies in IVF pregnancies, only patients with abnormal cardiac findings on the detailed anatomy scan should undergo fetal echo.

OBJECTIVE Idiopathic normal pressure hydrocephalus (iNPH) is characterized by ventriculomegaly, gait difficulty, incontinence, and dementia. The symptoms can be ameliorated by CSF drainage. The object of this study was to identify factors associated with shunt-responsive iNPH. METHODS The authors reviewed the medical records of 529 patients who underwent shunt placement for iNPH at their institution between July 2001 and March 2015. Variables associated with shunt-responsive iNPH were identified using bivariate and multivariate analyses. Detailed alcohol consumption information was obtained for 328 patients and was used to examine the relationship between alcohol and shunt-responsive iNPH. A computerized patient registry from 2 academic medical centers was queried to determine the prevalence of alcohol abuse among 1665 iNPH patients. RESULTS Bivariate analysis identified associations between shunt-responsive iNPH and gait difficulty (OR 4.59, 95% CI 2.32-9.09; p < 0.0001), dementia (OR 1.79, 95% CI 1.14-2.80; p = 0.01), incontinence (OR 1.77, 95% CI 1.13-2.76; p = 0.01), and alcohol use (OR 1.98, 95% CI 1.23-3.16; p = 0.03). Borderline significance was observed for hyperlipidemia (OR 1.56, 95% CI 0.99-2.45; p = 0.054), a family history of hyperlipidemia (OR 3.09, 95% CI 0.93-10.26, p = 0.054), and diabetes (OR 1.83, 95% CI 0.96-3.51; p = 0.064). Multivariate analysis identified associations with gait difficulty (OR 3.98, 95% CI 1.81-8.77; p = 0.0006) and alcohol (OR 1.94, 95% CI 1.10-3.39; p = 0.04). Increased alcohol intake correlated with greater improvement after CSF drainage. Alcohol abuse was 2.5 times more prevalent among iNPH patients than matched controls. CONCLUSIONS Alcohol consumption is associated with the development of shunt-responsive iNPH.

Measuring engagement is feasible in volunteer settings. Engagement appears to be dependent on both structural and experiential components. Easily modifiable components of job design (role definition, expected frequency of volunteering), are key drivers of volunteer engagement.