No abstract

In the past decade, neuroscientists and clinicians have begun to use implantable MEMS multielectrode arrays (e.g., [1]) to observe the simultaneous activity of many neurons in the brain. By observing the action potentials, or "spikes," of many neurons in a localized region of the brain it is possible to gather enough information to predict hand trajectories in real time during reaching tasks [2]. Recent experiments have shown that it is possible to develop neuroprosthetic devices -machines controlled directly by thoughts -if the activity of multiple neurons can be observed.Currently, data is recorded from implanted multielectrode arrays using bundles of fine wires and head-mounted connectors; all electronics for amplification and recording is external to the body. This presents three major barriers to the development of practical neuroprosthetic devices: (1) the transcutaneous connector provides a path for infection, (2) external noise and interfering signals easily couple to the wires conveying weak neural signals (<500µV) from high-impedance electrodes (>100kΩ), and (3) the connector and external electronics are typically large and bulky compared to the ~5mm electrode arrays. To eliminate these problems, data from the implanted electrodes should be transmitted out of the body wirelessly. This requires electronics at the recording site to amplify, condition, and digitize the neural signals from each electrode. These circuits must be powered wirelessly since rechargeable batteries are relatively large and have limited lifetimes. Low power operation (<100mW) is essential for any implanted electronics as elevated temperatures can easily kill neurons.A wireless, fully-implantable neural recording system is being developed to facilitate neuroscience research and neuroprosthetic applications (see Fig. 30.2.

Increasing connection of variable distributed generation, like wind power, to distribution networks requires new control strategies to provide greater flexibility and use of existing network assets. Active Network Management (ANM) will play a major role in this but there is a continuing need to demonstrate the benefit in facilitating connection of new generation without the need for traditional reinforcements. This paper proposes a multi-period AC Optimal Power Flow (OPF)-based technique for evaluating the maximum capacity of new variable distributed generation able to be connected to a distribution network when ANM control strategies are in place. The ANM schemes embedded into the OPF include coordinated voltage control, adaptive power factor and energy curtailment. A generic UK medium voltage distribution network is analysed using coincident demand and wind availability data derived from hourly time-series. Results clearly show that very high penetration levels of new variable generation capacity can be achieved by considering ANM strategies compared to the widely used passive operation (i.e., 'fit and forget'). The effects on network losses are also discussed.

Summary. We have examined the toxicity and overall outcome of the Medical Research Council UKALL R1 protocol for 256 patients with relapsed childhood acute lymphoblastic leukaemia (ALL). Second remission was achieved in over 95% of patients. Two patients died during induction and seven patients died of resistant disease. The overall actuarial event-free survival (EFS) at 5 years for all patients experiencing a ®rst relapse was 46% (95% CI 40± 52). Duration of ®rst remission, site of relapse, age at diagnosis and sex emerged as factors of prognostic signi®cance. Fiveyear EFS was only 7% for children relapsing in the bone marrow within 2 years of diagnosis, but was 77% for those relapsing without bone marrow involvement > 2´5 years from diagnosis. All analyses in this report are by treatment received. For those receiving chemotherapy alone, the 5-year EFS was 48%; for autologous bone marrow transplantation (BMT), the 5-year EFS was 47%; for unrelated donor BMT, it was 52%; and for related donor BMT, the 5-year EFS was 45%. The groups, however, were not comparable with respect to risk factor pro®le, and therefore direct comparison of EFS is misleading. Adjustment for time to transplant and prognostic factors was used to reduce the effects of biases between treatment groups, but did not suggest bene®t for any particular treatment. There was failure of our planned randomization scheme in this trial with only 9% of those eligible being randomized, which highlights the dif®culties in running randomized trials especially in patients who have relapsed from a previous trial. The optimal treatment for relapsed ALL therefore remains uncertain. Alternative approaches are clearly needed for those with early bone marrow relapse if outcome is to improve.

Background: Surgical mortality data are collected routinely in high-income countries, yet virtually no low-or middle-income countries have outcome surveillance in place. The aim was prospectively to collect worldwide mortality data following emergency abdominal surgery, comparing findings across countries with a low, middle or high Human Development Index (HDI).Methods: This was a prospective, multicentre, cohort study. Self-selected hospitals performing emergency surgery submitted prespecified data for consecutive patients from at least one 2-week interval during July to December 2014. Postoperative mortality was analysed by hierarchical multivariable logistic regression.