AdventHealth Murray is pleased to announce the appointment of Michael Ciurea as its new administrator
Ciurea brings a wealth of experience and a proven track record of leadership within AdventHealth
In his most recent position as the director of operations at AdventHealth Celebration in Celebration
Ciurea provided operational oversight for multiple departments
He has demonstrated exceptional leadership in business planning
process improvement initiatives and capital allocation
Ciurea’s previous roles include director of operations at AdventHealth East Orlando and AdventHealth Winter Park
where he successfully led major construction projects and played a key role in the Epic EMR transition
His experience also includes serving as a management resident at AdventHealth Altamonte Springs
where he managed a system-wide behavioral health initiative and led supply chain operations
"We are excited to have Michael on board at AdventHealth Murray," said Chris Self
AdventHealth Murray and AdventHealth Gordon president and CEO
"Michael's leadership will be instrumental as we continue to bring new programs and services to Murray County and further develop our partnerships in the community."
He has been actively involved with the Ulman Foundation and Big Brothers Big Sisters of Central Florida
Please join us in welcoming Michael Ciurea to AdventHealth Murray
His leadership will be instrumental in driving AdventHealth’s mission forward and enhancing the care provided to the Chatsworth community
A nurse at AdventHealth Palm Coast surprised a colleague with an extraordinary gift: a car
AdventHealth is expanding its nursing workforce
enhancing hands-on training programs and reinforcing its commitment to exceptional patient care
AdventHealth Manchester hosted a heartfelt celebration for National Day of Prayer
The event began with a flag presentation by Clay County High School JROTC
our organization embarked on multiple global mission projects that made a significant impact on the lives of two families in need
we honor the extraordinary acts of kindness and compassion demonstrated by our nurses across the region
Three remarkable nurses from AdventHealth Avista's surgery center have embarked on..
A local nurse and a CEO were recognized by the Central Florida Hispanic Chamber of Commerce
the new senior executive officer of AdventHealth for Children
speaks with Becker's Hospital Review about the future of pediatric care
AdventHealth North Pinellas achieves elite national status as a straight- ‘A’ for patient safety
All AdventHealth hospitals in Pasco County continue to earn straight ‘A’ hospital safety grades from The Leapfrog Group
Fish Memorial and New Smyrna Beach earn top marks from national watchdog
AdventHealth Waterman Foundation honors Dr
Jonathan Schroeder and Florida Cancer Specialists and Research Institute for their transformative philanthropy
AdventHealth President/CEO David Banks saw early on how caring for others with compassion and purpose could make a difference
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If you are experiencing an emergency, please call "911" or go to the nearest UCI Emergency Department
Calif. — The UCI Health bone marrow transplant program has reached a major milestone
recently performing its 200th lifesaving procedure since it opened in May 2020
The fast-growing program at the Chao Family Comprehensive Cancer Center also is expanding access to cellular therapies
including chimeric antigen receptor (CAR) T cells
which offer hope to patients with some of the most difficult-to-treat blood cancers and solid tumors
As Orange County’s only adult bone marrow service
programs to transplant hematopoietic stem cells in patients with multiple sclerosis and other autoimmune conditions
also have undergone transplants at UCI Medical Center
“This program has taken off like a rocket,” said Dr. Richard A. Van Etten
director of the Chao Family Comprehensive Cancer Center and a member of the transplant team
In less than two years, Van Etten noted, the program accomplished an exceptional feat, accreditation for achieving the national standard of excellence for cellular therapy programs
It also is the only program in Orange County approved by CalOptima Health
the county’s healthcare insurance plan for low-income adults
“We opened this program to provide our patients with much-needed access to these treatments close to home,” he said
“Now we are seeing patients coming from all over the region and the country.”
To date, the Hematopoietic Stem Cell Transplant and Cellular Therapy Program has performed more than 200 blood and bone marrow-derived stem cell transplants
including 13 procedures for autoimmune diseases
These include autologous transplants using the patient’s own cells and allogeneic procedures using matched
mismatched and half-matched (haploidentical) donor cells
“Two hundred-plus patients is quite remarkable considering that most new programs initially offer only autologous transplants in their first several years,” said Dr. Stefan O. Ciurea
a UCI Health hematologic oncologist and professor at the UC Irvine School of Medicine
He was recruited from the renowned MD Anderson Cancer Center in Houston to lead the program
we have become a mature transplant and cell therapy service
performing all types of procedures associated with established programs,” said Ciurea
a national leader in haploidentical transplantation
which make up the majority of the program’s allogeneic transplants
The team also is performing a growing number of FDA-approved CAR T-cell treatments
in which a patient’s own immune cells are genetically modified in a laboratory
then returned to the patient to attack their cancer cells
the team is enrolling numerous patients in highly promising early phase clinical trials of investigational CAR T and other cellular therapies
including several that have emerged from UCI scientists’ discoveries
Other trials focused on improving transplant outcomes and success rates are underway
with more expected to open in coming months
and others offered at only a few other academic medical centers in the country,” Ciurea said
Transplantation of hematopoietic stem cells — immature cells found in bone marrow and blood — can prolong the survival of and cure many patients with high-risk blood cancers
it requires considerable expertise and specialized facilities
Treatment generally starts with the patient getting high doses of chemotherapy
This usually eliminates the patient’s bone marrow stem cells
either taken from the patient or a tissue-matched donor
are then infused to settle in the bone marrow and make healthy new blood cells
patients typically are hospitalized for several weeks to rebuild their blood and immune systems
Their progress and any side effects are carefully monitored in numerous follow-up visits
The UCI Health program has an experienced transplant team of physicians
pharmacists and other support personnel. They also have a training program for physicians interested in stem cell transplantation and cellular therapies
To accommodate the burgeoning CAR T and transplant patient population
Ciurea will add at least two fellowship-trained specialists to the team
as well as staff to operate a new processing laboratory
The Cellular Processing Lab at the medical center in Orange is designed to prepare cell products for patient use
including hematopoietic stem cells and immune cells
for both FDA-approved commercial therapies and investigational cancer clinical trials at UCI Health
The investigator-initiated trials also are supported by a state-of-the-art regenerative medicine manufacturing center on the university campus. The Good Manufacturing Practice facility
a suite of ultraclean lab and quality-control rooms
was built to create FDA-approved next-generation gene and cellular products for patient treatment and clinical research
collects data on all hematopoietic cell transplant procedures
“We have very good survival numbers and our confidence is high that this will translate to superior transplant outcomes.”
He also is eager for this month’s opening of the Chao Family Comprehensive Cancer Center — Irvine and its large infusion facilities
which will greatly expand access for outpatient transplant procedures and cellular therapies
It also permits better continuity of care closer to home for patients living in coastal and south Orange County
“For folks who are receiving intensive treatments
being close to home is very important,” he said
When the UCI Health — Irvine medical complex opens a 144-bed acute care hospital in 2025
it will become the transplant program’s new home
a more advanced processing lab will offer more opportunities to investigate novel cellular therapies
Ciurea credits the program’s sound footing and rapid growth to the “extraordinary institutional support” from Van Etten, Dr. Michael J. Stamos, dean of UC Irvine School of Medicine, and Chad Lefteris
“We also have an exceptionally dedicated team
without which none of this would have been possible,” he said
“I could never really have imagined being where we are today
We will continue to expand to serve the many patients who need transplant and cellular therapy in Orange County and beyond
And we will continued to develop more innovative approaches to improve treatment outcomes for our patients."
168,000-square-foot medical facility offering the full range of multidisciplinary specialty care for children and adults under a single roof
the Center for Children’s Health and the UCI Health Center for Autism & Neurodevelopmental Disorders
Opening this summer: The Chao Family Comprehensive Cancer Center and Ambulatory Care
An official website of the United States government
NNSA and Romania’s National Commission for Nuclear Activities Control celebrated 15 years of partnership in advancing radiological security
National Nuclear Security Administration
Department of Energy’s National Nuclear Security Administration and Romania’s National Commission for Nuclear Activities Control (CNCAN) celebrate 15 years of partnership in advancing radiological security.
NNSA’s Office of Radiological Security (ORS) hosted an anniversary event and site visits in Bucharest
Ambassador Kathleen Kavalec joined CNCAN and other Romanian Government representatives for the anniversary ceremony
Follow-on visits to the Gendarmerie Central Monitoring Center
and Fundeni Clinical Institute further highlighted the wide scope of radiological security cooperation
”Our collaboration has strengthened over time and reflects both better approaches to nuclear and radiological security as well as evolving standards to meet new threats
we are focused on promoting non-radioisotopic alternative technologies in select areas
This radiological source replacement project aims to completely remove high activity Cesium-137 from Romania
said Administrator Hruby during the anniversary event in Bucharest
“I am confident the next 15 years of cooperation between our two great organizations will be important
I am confident the next 15 years of cooperation between our two great organizations will be important
Over the course of the 15-year partnership
“Facilitating the continuous use of radioactive sources while ensuring they are used in a secure manner to protect individuals
and the environment remains a challenge for the actors involved in this area
the Romanian facilities received valuable support which helped to prevent radioactive sources from being used in malicious acts globally,” said Cantemir Ciurea-Ercau
ORS’s mission is to enhance global security by preventing radioactive materials from use in acts of terrorism
and businesses across the globe to protect radioactive sources used for medical
and commercial purposes; removes and disposes of disused radioactive sources; and reduces the global reliance on radioactive sources through the promotion of non-radioisotopic alternative technologies.
Metrics details
we investigated the safety and efficacy of high doses of mb-IL21 ex vivo expanded donor-derived NK cells to decrease relapse in 25 patients with myeloid malignancies receiving haploidentical stem-cell transplantation (HSCT)
Three doses of donor NK cells (1 × 105–1 × 108 cells/kg/dose) were administered on days −2
Results were compared with an independent contemporaneously treated case-matched cohort of 160 patients from the CIBMTR database
and disease-free survival (DFS) was 66% vs
Only one relapse occurred in the study group
in a patient with the high level of donor-specific anti-HLA antibodies (DSA) presented before transplantation
The 2-year relapse and DFS in patients without DSA was 0% vs
respectively with HR for DFS in controls of 2.64 (p = 0.029)
NK cells in recipient blood were increased at day +30 in a dose-dependent manner compared with historical controls
Administration of donor-derived expanded NK cells after haploidentical transplantation was safe, associated with NK cell-dominant immune reconstitution early post-transplant, preserved T-cell reconstitution, and improved relapse and DFS. TRIAL REGISTRATION: NCT01904136 (https://clinicaltrials.gov/ct2/show/NCT01904136)
Here we report final results of a phase II extension study and long-term follow-up of all patients treated on this clinical trial
as well as results of an independent comparison with contemporaneous case-matched controls performed by the Center for International Blood and Marrow Transplant Research (CIBMTR)
This single arm, phase I/II study was conducted at the University of Texas MD Anderson Cancer Center (MDACC) between 06/2014 and 07/2019. Patients, 18–65 years of age, with myeloid malignancies and <5% bone marrow blasts were enrolled (Supplemental Protocol)
Haploidentical donors donated 1 unit (500 ml) of blood collected on day −16 for NK-cell production and underwent a bone marrow harvest (goal 3 × 108 TNC/kg)
collected and infused on day 0 of transplant
The trial was approved by the Institutional Review Board of MDACC and conducted under an Investigational New Drug application from the US Food and Drug Administration (ClinicalTrials.gov number NCT01904136)
Patients and donors provided written informed consent according to the Declaration of Helsinki
establishing the target dose for the phase II part of the study at 108 NK cells/kg/dose
All patients with at least 1-year follow-up were independently matched by a CIBMTR statistician with controls who received first haploidentical transplant with PTCy during the same period
Analysis was performed for all patients and separately for myeloablative (MAC) and reduced-intensity conditioning (RIC) controls
The primary outcome was disease-free survival (DFS)
Secondary outcomes included overall survival (OS)
cumulative incidence of neutrophil and platelet engraftment
All outcomes were computed from the date of stem cell infusion until occurrence of the first outcome event
The impact of NK-cell therapy on clinical outcomes in comparison with the CIBMTR matched controls was computed using marginal Cox regression models
disease- and transplant characteristics that were not included in the matching process were considered for adjustment in the comparison analyses
Immunophenotyping by mass cytometry with stochastic clustering was performed to compare immune reconstitution in patients to healthy controls and FC21-NK cell products using a 34-parameter panel of heavy-metal conjugated antibodies as summarized in Supplementary Information Table S1
The funders of the study had no role in study design
All authors had full access to all the data in the study and had final responsibility for the decision to submit for publication
the only patient that relapsed was the patient with DSA who was not desensitized prior to transplant
A higher failure rate was observed in the five patients with DSA
of which one patient relapsed and two died of NRM
A Relapse between cases and controls with the cumulative incidence at 2 years of 4% (95% CI 0–16) vs
controls with the probability at 2 years of 66% (95% CI 51–87) vs
C DFS of cases and controls who did not have DSA before transplant
A significantly higher DFS was observed in patients without DSA treated with NK cell infusion compared with controls without DSA with probability at 2 years of 72% vs
controls with the probability at 2 years of 30% (95% CI 13–51) vs
Causes of death are described in Supplementary Information Table S5
None of the patients treated on study died from disease relapse as compared with 36 of 67 patients (54%) of those who died in the control group
Lymphocyte subsets were evaluated from blood samples collected at days 30, 90, 180, and 360 post transplant (Supplementary Information Table S6)
The mean absolute NK-cell count at day 30 (before the third NK-cell infusion) was 636 cells/mm3 (standard deviation; SD 964)
Patients who received the highest NK-cell dose (108/kg/dose) had a mean absolute NK-cell number of 1084 (SD 1282) cells/mm3
compared to 284 (SD 305) cells/mm3 for those receiving 1 × 107–3 × 107/Kg/dose
and 122 (SD 136) cells/mm3 for <1 × 107/Kg/dose (p = 0.064)
A The median number of absolute lymphocytes (ALC)
Number of all lymphocyte subsets gradually increased and returned to normal by day 90 after transplant
B Number of B and T cell subsets after transplant stratified by NK cell dose level
High number of CD56+ cells was observed in patients who received high NK cell dose (dose level 3: 1 × 108/Kg/dose) compared with low (dose level 1: <1 × 107/Kg/dose) and intermediate dose (dose level 2: 1 × 107–3 × 107/Kg/dose) (P = 0.064)
a significantly lower number of CD25+ cells in patients who received higher NK cell dose was observed when compared with low and intermediate dose
The mean number of CD25+ cells at day 90 for patients who received low
and high NK dose was 15 cells/mm3 (SD 4.2)
42 cells/mm3 (SD 38) and 6.3 cells/mm3 (SD 5.1)
and at day 180 were 151 cells/mm3 (SD 108)
66 cells/mm3 (SD 44) and 16 cells/mm3 (SD 14)
No significant difference in number of CD19+
and CD3+ cells between patients who received different dose of NK cells
Bars and whiskers represent median ± interquartile range
B NK cell immune reconstitution in patients over time maintains FC21-NK “superbright” phenotype with high proliferation
of cluster 3 (superbright FC21-NK cells) in healthy donors
and in patients receiving FC21-NK cell products (across all timepoints)
C Proportion of Cluster 1 (T cells) and total NK cells (Cluster 2 + Cluster 3) in blood of study subjects across time
D The ratio of NK cells and T cells for all patients and timepoints assessed (n = 24)
E Ki67 staining in FC21-NK cells (Cluster 3)
and T cells (Cluster 1) in four representative patient samples obtained at day 14 (7 days after the NK cell infusion at day 7)
G The percent of Ki67+ and Ki67 mean metal intensity (MMI)
and T cells for all patients and timepoints assessed (n = 24)
H NK cells in clusters 2 (standard NK) and 3 (FC21-NK) as assessed for expression of NKG2C across all patients at all timepoints
with FC21-NK cell infusion products and healthy subjects shown for reference
I the percent of NKG2C + NK cells from all patients at all timepoints
with early (Days 7 and 14) and late (>day 28) timepoints pooled
J NK cells (CD3−/CD56+) gated and assessed for KIR expression and summed for total percentage of KIR + NK cells
we evaluated viral reactivation post-transplant
Only 5/23 patients (22%) had BK virus cystitis (all grade 1)
and only 9/23 (39%) had CMV reactivation (>137 copies/ml)
OS for all CIBMTR controls were 38% (95% CI 30–40)
NK cells were manufactured from the same haploidentical transplant donor
which could have potential advantages as there is no risk of rejecting the cells by the graft
Infusion of higher NK-cell doses was associated with progressively higher NK-cell numbers early post-transplant
a shift in early immune reconstitution of effector cell subsets to highly functional NK cells was noted
we observed ~100-fold higher NK-cell numbers by day 30
and were associated with a functional improvement and dramatic decrease in relapse rate post transplant
we have shown that high doses of donor-derived FC21-NK cells can be safely administered after haploidentical transplant
are associated with an NK cell-dominant immune reconstitution in the early post-transplant period
and a very low relapse in patients with myeloid malignancies
For original data please contact sciurea@uci.edu
The study protocol is included as a data supplement available with the online version of this article
Bill Young Cell Transplantation Program operated through the US Department of Health and Human Services
Health Resources and Services Administration
Reduced mortality after allogeneic hematopoietic-cell transplantation
Death after hematopoietic stem cell transplantation: changes over calendar year time
Relapse and survival after transplantation for complex karyotype acute myeloid leukemia: a report from the Acute Leukemia Working Party of the European Society for blood and marrow transplantation and the University of Texas MD Anderson Cancer Center
Significance of minimal residual disease before myeloablative allogeneic hematopoietic cell transplantation for AML in first and second complete remission
Alloreactive natural killer cells for the treatment of acute myeloid leukemia: from stem cell transplantation to adoptive immunotherapy
NK cell therapy: targeting disease relapse after hematopoietic stem cell transplantation
Membrane-bound IL-21 promotes sustained ex vivo proliferation of human natural killer cells
Phase 1 clinical trial using mbIL21 ex vivo-expanded donor-derived NK cells after haploidentical transplantation
The European Society for Blood and Marrow Transplantation (EBMT) consensus recommendations for donor selection in haploidentical hematopoietic cell transplantation
Donor selection for natural killer cell receptor genes leads to superior survival after unrelated transplantation for acute myelogenous leukemia
HLA-C-dependent prevention of leukemia relapse by donor activating KIR2DS1
Complement-binding donor-specific Anti-HLA antibodies and risk of primary graft failure in hematopoietic stem cell transplantation
Correction: the European Society for Blood and Marrow Transplantation (EBMT) consensus guidelines for the detection and treatment of donor-specific Anti-HLA antibodies (DSA) in haploidentical hematopoietic cell transplantation
Saliba RM, Veltri L, Rondon G, Chen J, Al-Atrash G, Alousi A, et al. Impact of graft composition on outcomes of haploidentical bone marrow stem cell transplantation. Haematologica. 2020. https://doi.org/10.3324/haematol.2019.227371
NK cell recovery after haploidentical HSCT with posttransplant cyclophosphamide: dynamics and clinical implications
Posttransplant cyclophosphamide and antithymocyte globulin versus posttransplant cyclophosphamide as graft-versus-host disease prophylaxis for peripheral blood stem cell haploidentical transplants: comparison of T cell and NK effector reconstitution
Impact of KIR/HLA incompatibilities on NK Cell reconstitution and clinical outcome after T cell-replete haploidentical hematopoietic stem cell transplantation with posttransplant cyclophosphamide
Improved outcomes for patients receiving high-doses of IL-21 ex vivo expanded NK cells after haploidentical transplantation (haploSCT): long-term follow-up of a phase 1/2 clinical trial with comparison to CIBMTR controls
Comparative outcomes after haploidentical or unrelated donor bone marrow or blood stem cell transplantation in adult patients with hematological malignancies
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This work was supported in part by grants from the National Institutes of Health
National Cancer Institute (P30 CA016672 and P01 CA49639)
Leukemia & Lymphoma Society Translational Research Program Award 6149-14
the Cancer Prevention Research Institute of Texas (RP110553)
The University of Texas MD Anderson Cancer Center AML Moonshot Program and High Impact Clinical Research Support Program
and the Taylor Trudeau Cycle for Life Charitable Foundation
Department of Stem Cell Transplantation and Cellular Therapy
The University of Texas MD Anderson Cancer Center
Abigail Wexner Research Institute at Nationwide Children’s Hospital
Center for International Bone Marrow Transplant Research
SOC contributed with conception and design of the clinical study
PK contributed with interpretation of results and manuscript writing
DS contributed with the enrollment of patients onto the study
and AMG contributed with the treatment of patients on study
and EJS contributed with NK cell manufacturing
KC contributed with HLA and KIR typing of the patients
DAL contributed with conception and design of the clinical trial
acquisition and analysis of laboratory data and manuscript writing
SOC served as advisory board member for Cellularity
received research funds from Miltenyi Biotech and Kiadis
and has intellectual property and equity in Kiadis
PK served as advisory board member for CareDx
PT has intellectual property licensing to Kiadis Pharma
and intellectual property in Kiadis Pharma
Consulting fees and equity in Courier Therapeutics
All other authors had no potential conflict of interest to declare
Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations
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DOI: https://doi.org/10.1038/s41375-021-01349-4
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Two-time widower Paul Nielsen was in excellent health at age 67. So the former marathon runner knew something was wrong when he started feeling tired all the time in the fall of 2015
“I had to nap for a couple of hours almost every afternoon,” he says
“We were looking for something and that was it
Paul’s local doctor didn’t treat leukemia, so he got a referral to MD Anderson. It was here that Paul met Stefan Ciurea, M.D. — and found his future wife
Ciurea confirmed Paul’s acute myeloid leukemia diagnosis, then recommended a mild form of chemotherapy. It was not as effective as they’d hoped, so Ciurea switched Paul to a more aggressive form of chemotherapy. Paul received five rounds of it, followed by an allogeneic stem cell transplant
The woman who would eventually become Paul’s third wife was already a professional friend of his in the oil and gas industry. He’d actually known Cyndi – whose husband had died suddenly just a few months earlier – for about 10 or 15 years. “But I think God put us in each other’s lives,” Paul says of their connecting through his leukemia treatment
A mutual friend dragged Cyndi to MD Anderson in June explicitly to pray for Paul’s recovery
Cyndi and Paul kept running into each other at group lunches and benefit functions
and tied the knot on a Florida beach on June 30
but Cyndi said she didn’t care,” Paul recalls
“She said I looked handsome with or without it
So I think we’re supposed to be together.”
Paul is also convinced that God led him to MD Anderson
and we believe physical and spiritual healing go hand in hand,” Paul says
This is the place in the universe to be if you have cancer
It’s not like going to a governmental bureaucracy
to inspire them and offer them hope in their own trials in life
but nothing like before,” says the newlywed
Request an appointment at MD Anderson online or by calling 1-877-632-6789
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Chris passed away peacefully at home in the loving care of wife Michelle Ciurea and sons Nicholas and Brendan Ciurea King
He also leaves brother Desmond King (Carolyn Cowey)
and extended family in Ireland and the UK. He was pre-deceased by parents Desmond and Margaret (Brady) King of Stillorgan
his parents left the Catholic Church in the early 1960s and joined Churchtown Meeting of the Ireland Religious Society of Friends
raising Chris and his brother as Quakers. This imbued Chris with values of integrity
simplicity and equality that pervaded how he walked in the world as a scientist
Chris demonstrated unusual academic prowess
His parents prioritized education for their sons
Chris’ natural talent in math and physics profited from rigorous pedagogy
including under his strict but beloved math teacher Victor ‘Pip’ Graham
a visiting university lecturer. In 1976
Chris achieved exceptional marks in his Leaving Certificate exam
winning a scholarship for top performance in the country in mathematics
At 17 he matriculated at Trinity College
Dublin. There he pursued two full degrees concurrently
in Physics and Mathematics – an endeavor unprecedented at the time; equally so was to win a First and a Gold Medal in each discipline. At 21 he began graduate studies at Harvard University
completing his PhD in Mathematical Physics in 1984.
But it was not all study. Among the pleasures of his youth were Quaker youth excursions to Europe as a teenager; memorizing Monty Python sketches by heart including from the film Life of Brian
discovering American pleasures such as motorcycles
A post-doctoral fellowship at Princeton University followed
and then a Visiting Professorship in Mathematics at Cornell University. Until that point Chris’ path through life had been linear and clear
dictated by a talent that had always suggested what the next step should be. However
he began to question whether it all added up to the type of life he wanted to lead. He used a professional sojourn at the ETH in Zurich
to explore other ways of being. In his spare time
He returned to Cornell having confirmed his love for mathematics
but with a clearer sense of what else he wanted out of life. Tai chi
He began attending Quaker meeting again in Ithaca. In this period
In Boston Chris began what was to be a lengthy and satisfying career in mathematics at Northeastern University. Over the years
he was known as a congenial colleague who could be reliably counted on to help with necessary but unglamorous tasks in his department
and helped create Masters’ programs in Applied Mathematics and in Operations Research. For graduate students interested in non-academic careers
he developed a co-op program so they could gain work experience in applied fields
In all these roles his style was to treat everyone – staff members
professors and students alike – with equal respect
“creating an even playing field for all.”
Although Chris’ intellectual starting point had been mathematical physics
over the years his research interests broadened and became more applied. He found great pleasure in interdisciplinary collaborations in which his role was to mine the mathematics underlying important applications. His contributions spanned the domains of Theoretical Physics
and application areas such as Quantum Information
and the study of Distributed Ledgers. While on sabbatical at Microsoft Research in 1998 he earned a patent on routers and methods for optimal routing table compression. In 2013 he was named an inaugural Fellow of the American Mathematical Society. From the 1990’s until his death
he maintained close collaborations with Irish colleagues
including at the Dublin Institute for Advanced Studies
the Hamilton Institute at Maynooth University and
Imperial College London. A colleague
commenting on the breadth and depth of his mathematical interests
“mathematics was a garden.” Another characterized him as “a Mozart of mathematics” for the elegance and clarity of his work.
In his last few years he was a math mentor and curriculum developer for Northeastern’s Bridge to Calculus program
which provides supplemental math instruction outside of school hours for students in Boston Public Schools
Chris enjoyed learning from them as much as teaching them
he was initially puzzled as to why some recently arrived immigrant students had trouble with basic algebra
He soon realized it was not because they didn’t understand the concepts but because they did not know the English names of variables
He soon began lessons by asking the students to teach him the variable names in their own language.
Throughout the years he found the time for those coming up behind him. Many younger mathematicians remarked memorable instances in which his assistance with a thorny intellectual problem
or simply encouragement at a critical juncture
proved pivotal in their development as mathematicians. A former student noted
“he was a good role model on how to be a mathematician and a human being at the same time. “
not in self-promotion. As one young friend said
but he did not take himself overly seriously.” Few people outside his profession knew of his mathematical accomplishments. Rather
a bird afficionado whose goodwill firmly excluded “bully birds” and poaching squirrels. As the long-time Treasurer of his Quaker meeting (Beacon Hill Friends Meeting) his clear explanations and reassuring calmness led many to joke he should start a second career as a therapist to the mathematically traumatized. Friends remembered him as an affable and witty companion who enjoyed talking more about ideas than about himself.
steadfast and true. Children never felt he was talking down to them -- one of his wonderful qualities as a father -- and he never made his children feel that his work was more important than them
For years he was his sons’ notably easygoing soccer coach
enthusiastic supporter of their life’s journeys wherever they might lead
and advisor -- but only when asked to be. Disinclined to pedantry
by simply living them. He opened the door to the worlds of science
sailor and skier. The West of Ireland
and he loved sharing it with his wife and sons on their frequent trips to Ireland.
Chris never lost his love of Irish music and could sing long songs
from memory with his own guitar accompaniment. He’d taken up the guitar as an adult and inspired both his sons to enjoy playing as well
Among his happiest moments were rollicking evenings making music with his sons and close friends
created space for people to be their truest selves. In a crowd he was usually the last to speak or claim the floor
“he was always the smartest man in the room
and wore his brilliance lightly.”
he was disinclined to moral pronouncements; generous and warm-hearted
he was not inclined to sentimentality. Self-pity was no part of his temperament. Even in difficult circumstances
such as the few years following a cancer diagnosis
he comported himself with a stoic grace that spared his loved ones additional burdens
Even under the shadow of daunting odds
he maintained a sense of gratitude about what life had given him
2023 at Cambridge Friends Meeting in Cambridge MA.
Women with ankylosing spondylitis showed a reduced response to TNF inhibitors compared with men
according to findings published in the Journal of Rheumatology
“Data on sex differences in ankylosing spondylitis (AS) and particularly on differences concerning response to treatment in male and female patients were scarce and not always consistent,” Adrian Ciurea
“We confirm in this large real-life cohort
differences in disease expression between men and women with AS found in previous analyses: Men had more severely impaired spinal mobility and higher CRP levels
while a higher proportion of women presented with peripheral disease [such as arthritis and enthesitis].”
To evaluate this, Ciurea and colleagues conducted a longitudinal analysis of 440 patients from the ongoing Swiss Clinical Quality Management cohort of patients with axial spondyloarthritis
ther researchers took particular effort to exclude patients with concurrent fibromyalgia
women had lower mean C-reactive protein levels
better spinal mobility and more peripheral disease at baseline compared to men
52% of women and 63% of men demonstrated an ASAS20 response (OR = 0.63; 95%
18% of women achieved inactive disease status compared with 26% of men (OR = 0.65; 95% CI
The differences in response to TNF inhibitors were more pronounced in adjusted analyses for ASAS20 (OR = 0.34; 95% CI
0.16-0.71; P = .005) and inactive disease status (OR = 0.1; 95% CI
there were no differences between the sexes in terms of ASDAS and quality of life
as well as the Bath Ankylosing Spondylitis Disease Activity and Functional indices
smoking and BMI — demonstrated however that women with AS show a significantly impaired response to anti-TNF agents in comparison to men
Whether the differences are due to an uncoupling between symptoms and objective signs of inflammation in women will have to be assessed prospectively.” – by Jason Laday
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Orange, Calif. — The UCI Health Chao Family Comprehensive Cancer Center and its adult bone marrow and hematopoietic stem cell transplant program have received accreditation by the Foundation for the Accreditation of Cellular Therapy (FACT) for meeting the national standard of excellence in cellular therapy programs
and also serves patients from across Southern California
the program offers leading-edge cellular immunotherapy options and access to novel clinical trials
FACT-accredited organizations voluntarily seek and maintain accreditation of their program through a rigorous process
demonstrating the shared belief that adhering to the highest standards in patient care are paramount
“FACT accreditation is extremely important for any transplant program, both to ensure quality of care and to meet requirements of third party payers,” said Dr. Stefan O. Ciurea
UCI Health hematologic-oncologist and director of the cancer center's stem cell transplantation and cell therapy program
“We started this program less than two years ago and our team has worked extremely hard to obtain full accreditation of all components of an established program
including autologous and allogeneic transplantation
FACT accreditation is based upon compliance with the most comprehensive standards in the field
verified by rigorous peer-reviewed inspections
qualified by training and experience to perform cellular therapy in their daily practice
cellular therapy programs must meet the follow standards:
“Having our transplant and cell therapy program join the prestigious community of FACT-accredited programs demonstrates to our patients, referring physicians and third-party payers our commitment to the highest quality patient care and UCI Health’s commitment to the highest standards in cellular therapy services,” said Richard Van Etten, MD, PhD
a UCI Health hematologic-oncologist and director of the Chao Family Comprehensive Cancer Center
AdventHealth supply chain resident Michael Ciurea knew he was going in the water on a recent Saturday—just not in a retention pond
a financial analyst for AdventHealth Global Missions
the two made their way for a relaxing day at Ponce Inlet beach when they saw the hazard lights of a parked car near Maitland Boulevard in Orlando
they would be doing what countless caregivers at AdventHealth do every day
The drivers of the parked car quickly pointed out to Michael and Jeffrey that a silver SUV had driven into a nearby pond and was completely submerged with a man still inside
the two threw off their shirts and jumped in
swimming down and back up in several attempts to unbuckle the man inside
unlock the car door and bring him safely to shore
and we yelled out if anyone knew CPR.” Michael said
but confidence kind of goes out the window when you’re there.”
Michael and Jeffrey pumped the man’s chest
kept his air passage open and checked for a pulse until EMS arrived minutes later
They never found out how the SUV got into the pond
the man’s daughter contacted Michael and Jeffrey
she said she finally got to have her dad back home
“That was a really emotional experience when she reached out,” said Michael
who guessed that just a couple more minutes underwater could have been the difference between life and death
Michael says he doesn’t think he’ll quit his day job in supply chain to become a caregiver anytime soon
It’s what drew him to work for AdventHealth in the first place
“Being able to be used in any way is great
“God just knows where we need to be and when we need to be there.”
Baby Mattie needed a liver transplant but was too sick to even get on the list
For the nurses at AdventHealth for Children
AdventHealth is proud to join Nemours Children’s Health System as the official medical services provider for the USTA National Campus in Lake Nona
The spring 2025 Leapfrog grades have been released
and four AdventHealth Rocky Mountain Region hospitals have achieved top honors for patient safety
Three UChicago Medicine AdventHealth hospitals have earned “A” safety grades from The Leapfrog Group
ranking among the safest hospitals in the nation
“Achieving an ‘A’ Hospital Safety Grade reflects enormous dedication to patient safety,” said Leah Binder
If you have dark skin, you may think you have natural protection from sunburns, sun damage and skin cancer
But the relationship between skin color and skin cancer is complicated
“People with dark skin may have the misconception that they are immune to skin cancer because their skin has more melanin – or pigment,” says Ana Ciurea, M.D. “While they are less likely to get skin cancer
But skin cancer is often detected in those with darker skin at later stages
their cancers are less likely to be treated successfully
a recent study showed that only 67% of Black patients were alive five years after their diagnosis
Skin cancer is not harder to detect in people with dark skin
the lack of awareness among patients and medical care providers
along with the fact that the cancers develop in unusual locations
makes it less likely that cancers will be found
“Skin cancer is highly curable if it’s found early,” says Ciurea
It’s a good idea to examine these areas regularly
family member or your hairdresser to examine your scalp
Use a hand-held mirror for hard-to-see areas
Basal cell carcinoma is the most common type of skin cancer in darker skin
“The most important thing to look for is change
Any suspicious mole or spot should prompt a visit to a professional,” says Ciruea
Melanin helps protect against sun damage and reduces the chances of sunburn
but the best way to protect your skin is to avoid the sun between 10 a.m
when the sun’s rays are strongest,” says Ciurea
a broad-brimmed hat and sunglasses with broad-spectrum protection
And remember to reapply your sunscreen every two hours or after sweating or swimming
Request an appointment at MD Anderson online or by calling 1-877-632-6789
director of the UCI Health Hematopoietic Stem Cell Transplant and Cellular Therapy Program
Orange, Calif. — CAR T-cell therapy is rapidly transforming treatment methods for some of the most intractable blood malignancies, raising hopes for better disease management and even progression-free survival, said UCI Health hematologic oncologist Stefan O. Ciurea, MD, director of the Hematopoietic Stem Cell Transplant and Cellular Therapy Program
The fast-growing program at the Chao Family Comprehensive Cancer Center has performed nearly 200 procedures since it opened in May 2020 and an increasing number of CAR T-cell treatments
programs that offers hematopoietic stem cell transplants to patients with a range of nonmalignant disorders
including multiple sclerosis and other autoimmune diseases
To fully realize the potential of this revolutionary therapy
which uses the body's enhanced immune cells to combat blood and other cancers
Ciurea emphasized the importance of collaborative research
careful patient selection and close monitoring to advance the boundaries of CAR T-cell treatment
a global provider of critical digital infrastructure and continuity solutions
Middle East & Africa (EMEA) senior leadership team
The reshape of the team includes the appointment of Ana Maria Ciurea as VP commercial operations
Peter Lambrecht as VP sales and Rastislav Jasenovsky as VP operations for infrastructure and solutions (I&S)
supporting Vertiv’s dedication to customer success in the market
Ciurea has driven the sales operations department at Vertiv in EMEA for the past four years as sales strategy and operations director and has been in the company for almost 15 years
In her new role as VP commercial operations
she will continue to manage the sales operations function
but with broader responsibilities including oversight of end-to-end processes
enabling overall efficiency and optimal resource allocation
The newly created role will serve as a central point to enhance cross functional effectiveness and identify ways to optimise client service
Lambrecht will step up to VP sales for the EMEA region
having served at the organisation for more than 20 years
he will be responsible for leading product and service sales and go-to-market programmes for the company’s key accounts
national accounts and Vertiv’s channel partners across the EMEA region
price initiatives and margin growth for all countries
Lambrecht will continue to lead and develop sales teams across the region
and sales management standards to create an inclusive and innovative culture focused on growth
Jasenovsky has been with Vertiv for 19 years and has been instrumental in driving operations strategy and execution in EMEA
His appointment as VP operations I&S EMEA will strengthen the connection between sales and operations leaders and teams to continue to improve customer service levels
Most recently serving as senior director operations EMEA and general manager for Slovakia
Jasenovsky will now serve as a key member of the EMEA leadership team
Ensuring strong leadership within sales and operations while also developing talent internally has been a key priority for Vertiv in 2022
These appointments not only align with our strategy to progress services for our EMEA customer base
but also show our commitment to our staff to advance their skills and capabilities
With these new changes to the EMEA senior leadership team
I’m confident that we will only continue to improve satisfaction for all of Vertiv’s customers in the region
Sign up for our weekly newsletter and get the latest industry insights right in your inbox
Following the success of OMFIF’s inaugural European agency and sub-sovereign forum in March
the Sovereign Debt Institute is hosting a second in-person event focusing exclusively on this set of prestigious issuers in the public sector bond market
The event convenes leading agency and sub-sovereign borrowers in Europe alongside high-profile investors from across the continent for in-depth
The forum explores a range of key issues affecting the sub-sovereign and agency bond market in Europe
social and governance regulation and secondary market liquidity
as well as having a specific session on the German Laender market
we encourage interactive discussions among speakers in a lively format
Deputy Chairman of the Federal Working Group on State/Public Finance
Jürgen Martinschledde is senior portfolio manager at MEAG
he was a portfolio manager at Tecta and portfolio risk manager and quantitative analyst at at Pacific Investment Management Company
Mike Richter is Senior Vice President at the DZ BANK AG
In January 2023 he joined the Senior Executive Banking team where he is responsible for the EMEA region
Mike has a strong focus on Africa and here especially on the transition from fossil fuels to renewable energies
Prior to his actual Position he was in public sector DCM in Germany for more than 20 years
then LBBW and Depfa Germany before he joined DZ BANK AG in 2008
Since 2008 he was leading the DCM Team for German Länder and municipalities
This meeting is open to the OMFIF network, with priority given to OMFIF members. Interested in membership? Contact us at Partnerships@omfif.org
Metrics details
Survey and long-term clinical post-trial follow-up (interviews/correspondence) on nine chronic
post spinal cord injury (SCI) tetraplegics
To assess feasibility of the use of Electroencephalography-based Brain–Computer Interface (EEG–BCI) for reaching/grasping assistance in tetraplegics
Physical and (neuromuscular) Rehabilitation Medicine
Neurosurgery Clinic Divisions of TEHBA and UMPCD
in collaboration with ‘Brain2Robot’ (composed of the European Commission-funded Marie Curie Excellence Team by the same name
Enrolled patients underwent EEG–BCI preliminary training and robot control sessions
Statistics entailed multiple linear regressions and cluster analysis
A follow-up—custom questionnaire based—including patients’ perception of their EEG–BCI control capacity was continued up to 14 months after initial experiments
EEG–BCI performance/calibration-phase classification accuracy averaged 81.0%; feedback training sessions averaged 70.5% accuracy for 7 subjects who completed at least one feedback training session; 7 (77.7%) of 9 subjects reported having felt control of the cursor; and 3 (33.3%) subjects felt that they were also controlling the robot through their movement imagination
BCI performance was positively correlated with beta (13–30 Hz) EEG spectral power density (coefficient 0.432
P-value=0.025); another possible influence was sensory AIS score (range: 0 min to 224 max
Limited but real potential for self-assistance in chronic tetraplegics by EEG–BCI-actuated mechatronic devices was found
which was mainly related to spectral density in the beta range positively (increasing therewith) and to AIS sensory score negatively
subject to engineering improvements and extensive clinical testing
has the potential to improve motor complete tetraplegics’ QOL
mainly in terms of autonomy and self-esteem
as a consequence of regaining even a limited capacity to voluntarily control some common actions
It is still an open research question as to which of the various BCI designs tested by now has the more advantageous mix of safety
The current study addresses the potential impact/usefulness of noninvasive EEG–BCI for the accomplishment of an ADL such as bringing to the mouth a glass in order to drink
which do not correspond to an agreed-upon mental command (that is
limited surveys have been undertaken also with non-locked-in paralyzed users
implying slow brain rhythm modulation as the BCI modality—a paradigm requiring lengthy training (on order of weeks)
Open questions central to clinical and assistive/rehabilitative EEG–BCI/BMI feasibility
included the distribution of SMR–EEG–BCI performance among tetraplegics
what could be done in terms of test paradigm to maximize this performance
how a case-by-case evaluation of EEG–BCI/BMI feasibility could eventually be implemented in a clinical setting and
what the patients’ informed qualitative opinion of EEG–BCI/BMI potential is
including an assistive robotic arm as in our study
a novel subject must previously undergo BCI training; the proficiency he/she achieves is critical to overall success
including written informed consent from each subject and ethical review board commissions’ approvals by the appropriate local affiliations (TEHBA and UMPCD)
longer than 6 months) post SCI patients with tetraplegia
History of associated moderate or severe traumatic brain injury at the time of SCI and/or other brain current/previous condition(s)
including the need for specific medication
Current or previous psychiatric-associated condition(s)
Excessive spasticity—>3 on Modified Ashworth Scale32
Active period of severe postural hypotension
of autonomous dysreflexia (AD) and/or other cardiovascular conditions
As not all of the participants in the study were able to sit in a wheel chair during the BCI sessions
we tried to maximize the patients’ comfort on a case-by-case basis
especially the choice of upright or supine position (see further)
Our initial (pre/intra/post training) survey (that is
the clinical–functional aforementioned examinations and medical assistance
using the cap with electrodes for EEG recording
computer tuning and robot control sessions) was carried out during 10 days at the premises of TEHBA
of the initial (pre/intra/post training) survey
each of the tetraplegic participants was assisted and medically supervised by a physician from the P(nm)RM Clinic Division of TEHBA in case of any autonomous dysreflexia or other problems that might have appeared (although all patients were stable
Subjects were instructed to solicit the termination of the session if they felt any discomfort
Telephone interviews and mail/e-mail correspondence were carried out based on a custom-designed
simple questionnaire (such that participants could respond comfortably given their difficulties in assisted/unassisted writing; see Table 3)
referring to their health-related state during training and post training
within the 10 days of the experiments and at about 6 and 12 months after the initial trial
we asked them whether they felt any discomfort/trouble (boredom
or any other relevant discomfort and a description thereof) during
immediately after and/or a long time after the experiments
We also enquired about their personal qualitative assessment of whether they felt they were in control of the BCI (the cursor) and/or the BCI/BMI (the robotic arm) system
The study entailed three consecutive phases: calibration (alternatively
by ‘tuning’ we refer to learning by computer and by ‘learning’ we refer to subjects
whereas the procedure of obtaining calibration data and for the subject to practice motor imagination was denoted ‘training’
The term ‘cues’ refers to audio-visual signals that were used in the training phase (for example
a voice command that says ‘left’ and a video of a left hand movement
and the corresponding initial command letter is displayed on the center of the computer screen)
The types of mental tasks chosen as BCI commands are referred to as ‘classes’
Both training and feedback were presented in two variants
according to protocols standard at the time of the study and ones for which we had encouraging preliminary results— ‘video’/VR
in order to explore the means of increasing the percentage of proficient subjects for whom BCI/robot use would be ultimately successful
In the first part of the experiment (‘training’), 1–2 sessions of 140 sequences each (see Table 2 )
consisting of random sequences of 35 trials of four classes (mental tasks)
‘foot’ and ‘relax’ cues were presented visually by means of a letter
which appeared in the middle of the computer screen (‘S’
corresponding to beginning letters for each cue/class name in the subjects’ native language
The instructions were to imagine arrhythmic movements of the fingers of the right hand (‘D’
The subject was asked to imagine the cued class while moving neither the limbs nor the eyes
There were two types of training cue sequences: ‘letter’
in which a video of the movement to be imagined (arrhythmic fluttering of fingers or ankle flexion/extension) was presented along with the letter
The timing of the imagination was cued by four sounds (beeps)
the subject being instructed to begin the movement imagination at the fourth beep
surface electromyograms (bipolar EMGs placed on flexor carpi radialis or the most distal arm muscles
for which contraction could be previously observed or felt) and electrooculograms (vertical/horizontal—bipolar for left eye) were monitored
The duration of each training session was about 30 min compared with a maximal duration of the complete experiment of 3 h
This phase lasted longer in the case of VR feedback use or in the case that a second pair of classes was tested to improve performance
The subjects then performed multiple idle-to-active feedback trial attempts
The cues were given to imagine one of the motor imaginations or to relax by means of large targets on either side of the screen: the cursor movement started from the middle of the screen as soon as the cue was given
Training session for the tetraplegics: the patient was lying on a bed and was receiving cues from a screen displayed by means of a projector on the ceiling above him/her (FRAUNHOFER-FIRST, Berlin/TEHBA, Bucharest; 2008).
Training session with a tetraplegic subject in wheel chair and in front of a standard table (on the display there can be seen a virtual representation of a pair of upper limbs: their movement can be controlled by the subject through EEG sensory motor rhythms
The position and rotation of the head reference frame
as well as the gaze tracking calibration target
were located and tracked in 6 degrees of freedom using an OptiTrack system with the Rigid Body Software (Natural Point
and then at their own volition and pace to activate the BCI system by performing the agreed-to ‘grab’ class (the first of the feedback class pair) and by focusing steadily on it
After the robot grab action sequence was completed
they were instructed to perform the imagination again
and the entire sequence could commence again
with success (glass grabbing) observed in at least three trials in each subject
CSP assumes that the signal measured by EEG sensors is a linear spatial mixture of (unknown) original sources. In the equation below, the EEG measurements are denoted by v(t), the matrix of 2k filters W is the CSP filter matrix and h(t) is the impulse response of the frequency band filter (5th order Butterworth with low- and high-pass parameters as in Table 2
The frequency band is calculated from the R2 statistic of the difference among spectral density averaged over Laplace-filtered central–parietal electrodes at 2 Hz resolution
by iteratively and symmetrically expanding an interval from the frequencies with the two highest R2 values
until the total R2 score is greater than 85% of the total score
using the root-mean-square power after band filtering instead of spectral power
is used to obtain a poststimulus time interval for integration
and c(t) is the classifier output after scaling by the linear discriminant analysis classifier vector a and additional bias b
whereas the cursor position p(t) is a time-integrated version thereof
The rows of the unknown mixing matrix W are called patterns
whereas the columns of the de-mixing matrix W−1
which can be interpreted as possible solutions of the so-called inverse problem
The goal of CSP is to find spatial projections in sensor space that optimally de-mix the measured signal by maximizing the variance in one class while minimizing the variance in the other class
thereby achieving optimal discrimination for subsequent classification
The filters are obtained by solving a generalized eigenvalue problem while simultaneously diagonalizing the covariances of both classes
The cursor integration speed r varied among feedback sessions (min 0.5 max 4 mean 1.16)
and was chosen such that the subject could reach a threshold value of ±0.85 between 2 and 4 s
and were included in the clustering linear regression-based analysis
During the initial clinical (pre/intra/post training) survey and, respectively, the long-term post-trial follow-up period, no significant adverse reaction occurred, except for headache in one patient, 1 day after the experiment, discomfort/fatigue felt by three subjects (see Table 3 )
including one patient who fell asleep during one of the training sessions
and mild transient postural hypotension in one patient who could therefore not perform the feedback phase of the study
In synthesis, one subject felt discomfort after the calibration session and therefore did not perform feedback trials, two subjects felt discomfort after the feedback trials, three other subjects did not reach 70% accuracy, and two of them, see Table 3
verbally reported being not certain of mentally controlling the cursor
and under mutual agreement further sessions were not attempted
Three subjects completed all phases including robot control
All subjects completed the calibration phase
seven out of nine completed the feedback phase and three out of seven completed the robot control phase as well
These self-assessments are consistent with the numerical results of feedback/training accuracy except for subjects CU and DZ who reported having controlled the cursor despite a peak accuracy of only around 52% in feedback sessions
There was a significant (P<0.05) Pearson's correlation coefficient between training trial accuracy and feedback trial accuracy of 0.902
There was no statistically significant difference (as indicated by the bilateral t-test) of average BCI performance for patients performing calibration in a supine position (86%) compared with patients who did it in sitting position (79%)
There was no significant difference (t-test) between sessions using video or normal training cues (P<0.33)
there was no such difference among VR and normal feedback sessions (P<0.57
and two others used left/right hand imagination suitable for VR)
In designing our subject assessment procedure
we were forced to make rational compromises between maximizing the chance of success of EEG–BCI (and subsequently of robot use) on one hand and of subject comfort and potential performance-reducing effects of boredom and fatigue on the other hand
The calibration phase was uniformly undertaken by all subjects
being just long enough to be able to ascertain the potential of any combination of recorded mental imaginations to provide a useful level of classification accuracy
As the ultimate reliable test of EEG–BCI proficiency in robot use is feedback (that is
featuring different mental imagination combinations (among promising pairs from calibration data analysis)
different types of feedback were performed
with a goal of 70% accuracy as prerequisite to robot use
Spectral shapes and class-related variation at electrode ‘C4’. The spectra (dB) are averaged from 1 Hz resolution FFT of 500 ms windows with Hamming windowing and 250 ms overlap, and staggered (for readability) according to BCI performance with best performers at the top. Width of each line is proportional to mean class difference divided by pooled s.d. Dotted lines represent stagger in the y axis for each patient and 1/f2 spectral roll-off.
The variables considered in the study represented in the main components plane
Taking into account only the beta component of the EEG spectrum influence
in order to reduce the number of predictors considered
the additional influence of clinical variables/factors on EEG–BCI performance was tested in a second linear regression model
The results showed that the sensory AIS score (range: 0 min to 224 max
the level of deficit being 224; coefficient −0.177
The rest of the assessed independent variables in the model (including subject age: P=0.31
and time elapsed since SCI) had negligible regression coefficients
Cluster analysis (Ward's method where the distance was determined by the Pearson's correlation coefficients) revealed that EEG–BCI performance is grouped near to the beta spectral density and to feedback performance (‘feedback_ perf’)
The interrelation among these variables can be confirmed by looking at Figure 5 and considering its caption/ explanatory text below it
We did not observe differences in performance among subjects and trials with and without video/audio-enhanced training or VR-perspective feedback control
It was hoped that including VR perspectives and audio/video-based imitation cues would increase final (feedback) performance
to make the paradigm more easily understandable and interesting to our subjects
there should be approximately 35 000 persons in Europe alone who may benefit from a specialized market of EEG–BCI/BMI-based assistive technology
For those patients who are not SMR–EEG–BCI proficient
either other residual muscle control modalities or other types of BCI and/or other—possibly including combined—kinds of assistive related devices might possibly be used
Further practice could increase the number of SMR–EEG–BCI proficient subjects
Among other possible factors underlying inter-subject EEG–BCI proficiency are wide variations in innate ability/proficiency
personal determination and motivation—factors that are very difficult to assess individually
The influence of AIS sensory score would imply that a higher sensory deficit could favor a slightly increased ability to perform motor-imagery-based BCI
One reason for this effect might be the task itself: motor imagery
For a healthy subject this is a difficult action to perform
as he/she must monitor sensory feedback to ensure that no movement is elicited
Our tetraplegic subjects never reported difficulty in performing it
as the elicited hand movement imagination involved highly affected somatic areas
bioelectric patterns of cortical activity and related modulation of neuropsychological aspects (motivated perception and implementation of goal-directed behavioral responses) is complex and not completely understood
Although the sympathetic–adrenergic system in chronic tetraplegics is generally re-adapted to an upright sitting position from the supine one
which dominates the acute and subacute post-SCI stages
for two of the enrolled subjects the risk of postural/orthostatic hypotension was judged to be most safely minimized in the supine position
one of the two patients who did train in a supine position succeeded to control the robot too
mainly from the concentration required: this can be seen as a disadvantage (motor imagination does require concentration
even in the case of paralysis) and an advantage (it encourages the patient to play an active part in attaining concrete motor action goals using motor imagination)
Besides BCI there are three other technologies needed for the implementation of the Brain2Robot system: eye tracking, head tracking and a robot. The basic technology in all three cases is evolving rapidly: head tracking is now part of commonly available gaming consoles such as the Microsoft Xbox/Kinekt, and eye tracking is now incorporated in multiple open-source software based on low-cost webcams (http://thirtysixthspan.com/openEyes/)
Many of these platforms appeared in a short time since the experiments were conducted; robustness and cost depend on market size
and the standardization of the requisite supply chain of basic parts and software components has also evolved positively
The system tested in this study is merely a proof of concept
prerequisite and hopefully encouraging for entities willing to test and commercialize such systems; the market size
certainly allows for opportunities to do so
The potential of motor imagery EEG–BCI/BMI to be useful for daily self assistance in chronic tetraplegics relates to their BCI training accuracy performance
can be predicted by relative beta spectral power density
negatively (higher sensory deficit may mean a slightly increased ability to perform motor imagery based BCI)
although data from more subjects are necessary to validate this latter finding
EEG–BCI/BMI could be a valuable method to compensate for some important limitations in chronic tetraplegics and possibly other severely disabled patients
useful in daily self assistance for basic ADL
such as using/manipulating a drinking glass
and thus has a potential to improve their QOL
given further improvements in miniaturization
user friendliness and cost of the underlying technology
The current study promises the development of a rational and effective procedure of screening and training post-SCI tetraplegics for EEG–BCI/BMI use
given the reality that only a moderate fraction of these may be able to ultimately benefit
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This work was supported by the European Commission's Marie Curie Excellence Team grant MEXT-CT-2004-014194 ‘Brain2Robot’ and The Teaching Emergency Hospital ‘Bagdasar-Arseni’ (TEHBA)
Postgraduate from the P(nm)RM Clinic Division of TEHBA
also contributed to improving the final version of this paper
The Teaching Emergency Hospital ‘Bagdasar-Arseni’ (TEHBA)
The University of Medicine and Pharmacy ‘Carol Davila’ (UMPCD)
The authors declare no conflict of interest
This work is licensed under the Creative Commons Attribution-NonCommercial-No Derivative Works 3.0 Unported License
visit http://creativecommons.org/licenses/by-nc-nd/3.0/
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Journal of NeuroEngineering and Rehabilitation (2023)
13 January: The holiday season and the excitement of a new year are waning
another seemingly ordinary day in the first month of the year
13th January holds a pivotal place in world history
Many significant events transpired on this day
Dive in to find out what happened on this day (Jan
along with famous birthdays and deaths in world history
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