When a young British woman with learning difficulties announced she was marrying an Egyptian she’d met online, her guardians were unsurprisingly sceptical.
The 21-year-old, who’d been brain injured in a car accident as a child, was going to pay for Asrat to come to the UK, where they’d live happily ever after.
What her support workers found next highlights the dangers lurking on the web. After being told he wasn’t getting a one-way ticket to England, Asrat proceeded to explain in detail to the girl how and why she should commit suicide.
She didn’t follow his advice but the case was passed on to the police. Since Asrat used the encrypted messaging platform BBM, however, tracking him down was an immense challenge.
The case shows the toxic combination formed when vulnerable people stumble into dark forces intent on preying on them via social media.
This and other such stories were shared by case management expert Angela Kerr with a room full of brain injury professionals in Westminster recently.
“There’s this massive void of virtual space and there are people in boats hanging on the edge with fishing lines, hoping to catch people,” she said.
These victims include the brain injured boy who sent intimate pictures to a girl via Facebook.
Rather than reporting it, the girl’s father secretly tried to blackmail the boy. Kerr, who chairs brain injury case management body BABICM and runs AKA Case Management in Nottingham, also told the tale of a 13-year-old with a history of trauma who became a pariah in her village.
“She used Facebook to share an intimate picture of herself with some boys and was prosecuted for circulating child pornography.
“She was facing a custodial sentence and being added to the sex offenders register, until the clinical arm of the government’s disability programme stepped in to stop it.
“Due to the girl being from a small community, and the story appearing in the press, the local community turned against her, labelling her a sexual deviant and a pervert. She was bullied by children, and adults, and had to move areas.”
What astounded Kerr in her research into social media, and brain injury case managers’ experiences of it, is the sheer number of platforms in existence.
“The main risk from many of them is the ability to talk to strangers, which can lead to exploitation, grooming and bullying,” she said.
Added to the well-known stable of Twitter, Facebook and LinkedIn, are scores of emerging platforms. From joke-rating sites to ‘Fmylife’, which charts users’ daily disasters, platforms of every niche imaginable are bringing strangers together online.
Research suggests social media users with brain injuries tend to use multiple sites.
A US study published in April, which monitored individuals with traumatic brain injury (TBI) at 10 specialist centres, found that 74 per cent of them were internet users – compared to the general North American population’s 84 per cent average.
Of the TBI internet users, 79 per cent had a profile account on a social networking site, with more than half using at least two sites. Smartphones were the most prevalent means of internet access for TBI persons.
Speaking at the Head First conference, Kerr drew attention to a number of particularly risky sites. Among them is Habbo Hotel, an online game and community aimed at teenagers, that enables users to navigate an imaginary world via an avatar, meeting real-world people along the way and customising ‘hotel’ rooms.
It was hit by scandal in 2012 when undercover journalists found children were being exposed to explicit content. The Daily Mail reported that a 13-year-old girl was bombarded with pornographic chat and asked to strip naked on a webcam.
The site has since set out guidelines to parents and vowed to get tough on anything that puts young users at risk. Games can be a particularly dangerous area for vulnerable adults, as well as young people.
The ugly realities of the internet can very quickly come crashing into the fantasy realms in which users are immersed. The starkest proof of this is the murder of Breck Bednar in 2014.
At just 14, he was stabbed to death by a ‘predator’ he met online who groomed him through video games. Risks loom for vulnerable adults too.
“Some brain injury clients are obsessed by playing on their Xbox or Playstations until the early hours of the morning,” said Kerr.
“Gaming platforms are mostly about creating virtual worlds and linking users with people across the world in chatrooms. MovieStarPlanet is one of the highest risk ones.
“You can create a chatroom where you can be any kind of movie star you wish. “This is dangerous as you can be anonymous yet attractive due to the person you are representing.”
Chatrooms are a common denominator among the riskier social media platforms.
“MeowChat, for example, is a social network that allows you to talk with strangers in a public room, with an option to go into a private room.
“The risk is that clients can talk to strangers and no-one else would know.”
The blossoming relationship between location technology and social networks is bringing new dangers to the fore.
While dating app Tinder shows users other singles within a few miles of them, Happn is a little creepier.
When a user opens it on their phone, they see other users with whom they’ve physically crossed paths with throughout their day.
“It’s like we’re moving towards a situation where, if it hasn’t happened on social media, it hasn’t happened at all,” said Kerr.
Pressure is mounting on social media sites to improve the way they protect children and vulnerable adults.
Peter Wanless, the chief executive of children’s charity NSPCC, said in June that letting children on social media sites was as dangerous as letting them go to a nightclub.
The government has urged sites to be more vigilant about dangerous content and activity, in the wake of recent terror attacks. Google, which owns YouTube, along with Facebook, which owns WhatsApp, and Twitter are among the tech companies being urged to take the responsibilities that come with their great influence more seriously.
As Kerr closed her talk in London, she le delegates with the words of murdered teenager Breck Bednar’s mother: “I want this tragedy to open the eyes of everyone to the dangers of online predators.”
Sector-changing entrepreneur launches new app to support whole neurorehab community
A man whose frustration at the lack of cohesion within stroke care spawned the development of an award-winning app has now developed a platform to enable this revolutionary approach to be extended throughout the neuro sector.
Neuro ProActive has been created to enable a fully multi-disciplinary approach to rehabilitation, covering both inpatient and community care and involving patients and their families in the process.
Through the app, therapists can use end-to-end encrypted messaging and video calling to offer remote services and patient monitoring – factors which were planned before the pandemic, but have now taken on new importance within rehabilitation care.
Set to launch into six NHS Trusts initially, national and international expansion is planned for Neuro Proactive in the near future.
Neuro ProActive is the successor to Stroke Active, developed by Ian Pearce, whose father had a stroke in 2017, and the lack of co-ordination in his care spurred him to create a platform to help families like his.
It received the Innovation of the Year Award at the 2019 European Neuro Convention, in recognition of the role it played in revolutionising communication between stroke professionals and promoting patient self-management.
But rather than just revising and rebranding his existing software, Ian has invested in creating Neuro ProActive from scratch, appointing specialist healthcare software developer L2S2 to oversee its development.
“We scrapped it and started again, there is not a single piece of code that is the same as in Stroke Active,” says Ian, who worked in the City before becoming an unexpected health tech entrepreneur.
“It’s so important we were giving exactly what was wanted and needed, not a revised version of what we did before, which is why we have built something totally new.
“We want Neuro ProActive to stand on its own two feet – it is designed to be a global platform and through it being built from scratch with the best software, there is huge potential.”
Following the success of Stroke Active and its adoption by stroke professionals nationwide, Ian realised the need for its expansion into all aspects of neuro care.
“Frequently, there is a gap between inpatient and outpatient – early supported discharge too often is just early discharge, you hear stories of people waiting six weeks before their therapy starts, which makes things so much more difficult further down the line,” says Ian.
“But by using the platform, we have enabled patients to connect with their community rehab team. We work across all six disciplines – neurophysio, speech and language therapy, occupational therapy, diet, arts and neuropsychology – and the whole MDT can contribute to the dashboard in real time.
“Enabling patients to have the ability to self-manage, while also including family members in the rehabilitation process, is so important. Through using the app, everyone can be involved in the process. Each patient has their own message board too, so can instantly get in touch with their team.”
As well as enabling better communication and a more joined up approach for neuro patients, the fact Neuro ProActive covers remote services has proved an invaluable addition, given the current ways of working.
“This was developed pre-COVID, but now we have this horrendous virus and with it new ways of working, it is even more important,” says Ian.
Could paralysed patients be walking again by 2024?
People who have been paralysed for years could be enabled to stand and walk again through revolutionary technology set to launch within the next four years – and a breakthrough in upper body movement is expected even sooner.
The groundbreaking work of ONWARD is set to deliver the long-awaited advances for people with spinal cord injury in enabling them to regain the ability of movement.
Through the development of its ARC EX and ARC IM technologies, ONWARD is committed to delivering life-changing outcomes for spinal cord injured people.
Trials of its ARC EX device got underway in the UK – at the Queen Elizabeth University Hospital in Glasgow – United States, Canada and the Netherlands, in January, with the technology expected to be commercially available in late 2023.
An external, non-invasive platform, the ARC EX is set to deliver movement and strength in the hands and upper body of people with spinal cord injury, compared to rehabilitation training alone.
And in one of the most keenly-awaited health tech breakthroughs of recent years, its ARC IM technology – an implantable pulse generator and lead which stimulates the spinal cord and is controlled by wearable components and a smartwatch – is set to go into trials mid next year, with its commercial launch anticipated in 2024.
Alongside its potential to enable paralysed people to stand and walk again with little or no assistance, other benefits could include improvements in blood pressure regulation, sexual function, bladder and bowel control and reduction in spasticity.
“This is very real and it is happening, and we hope it will bring strength, function and meaningful quality of life to so many people,” Dave Marver, CEO of ONWARD, tells NR Times.
The technology breakthroughs come after many years of groundbreaking pre-clinical research, which led to the formation of ONWARD – formerly known as GTX Medical – in 2014 to take this forward.
Bringing together researchers and surgeons in Switzerland, working together at the Swiss Federal Institute of Technology (EPFL) and Centre Hospitalier Universitaire Vaudois (CHUV), the company is backed by many of Europe’s leading life science venture capital investors in bringing its solutions to reality.
“A lot of funding has gone into this field of research and we are taking this forward to create the products which can translate into commercial reality globally,” says Dave.
“We have put together a great team to build this company, raise the capital needed to fund the trials and the R&D, and this is a very fulfilling challenge and responsibility for all of us.
“We are well on the way towards ARC EX and we have started pivotal trials at 15 sites worldwide, and we hope to launch this in late 2023.
“We know that the movement and function of the upper extremities is what people with spinal cord injury value the highest, so we are targeting that first. In the near future, that should be a reality.
“Following that will be our implant, which will help unlock more autonomous benefits. We expect the pivotal trials to begin in mid 2022 with commercialisation most likely in 2024.”
Despite the COVID-19 pandemic and the many challenges it has presented to global businesses, ONWARD has managed to continue with its work as planned.
“We’ve been affected like everyone else in having to work from home and close our offices, we also have a growing team and have had to bring people into the business with limited interactions, but the pandemic has not impeded us,” says Dave.
“Our vision of helping people with spinal cord injury is very unifying and we are all dedicated to trying to achieve that. We’re all highly motivated in the team, as are our research partners, and we’re working towards delivering our platforms in the very near future.”
New tech ‘can classify child brain tumours’
Cutting-edge new technology can successfully classify the diagnosis and characteristics of common types of paediatric brain tumours, new research has found.
Through the use of weighted imaging, an advanced imaging technique, combined with machine learning (AI), a brain tumour’s type can potentially be classified without the use of biopsy.
This will enable to tumour to be characterised and then treated more efficiently, the UK study concluded.
The largest cause of death from cancer in children are brain tumours in the posterior fossa area of the brain. However, within this area, there are three main types of brain tumour, and being able to characterise them quickly and efficiently can be challenging.
Currently a qualitative assessment of MRI by radiologists is used, although overlapping radiological characteristics can make it difficult to distinguish which type of tumour it is, without the confirmation of biopsy.
In the paper ‘Classification of paediatric brain tumours by diffusion weighted imaging and machine learning’ – led by the University of Birmingham and including researchers from WMG, University of Warwick – researchers found that tumour diagnostic classification can be improved by using non-invasive diffusion weighted imaging, when combined with machine learning.
“If this advanced imaging technique, combined with AI technology, can be routinely enrolled into hospitals it means that childhood brain tumours can be characterised and classified more efficiently, and in turn means that treatments can be pursued in a quicker manner with favourable outcomes for children suffering from the disease,” says Professor Theo Arvanitis, Director of the Institute of Digital Health at WMG, University of Warwick and one of the authors of the study.
Diffusion weighted imaging involves the use of specific advanced MRI sequences, as well as software that generates images from the resulting data that uses the diffusion of water molecules to generate contrast in MR image.
An Apparent Diffusion Coefficient (ADC) map can then be extracted, analysed values of which can be used to give more information about the tumour.
The study involved 117 patients from five primary treatment centres across the UK, with scans from 12 different hospitals on a total of 18 different scanners, the images from them were then analysed and region of interests were drawn by both an experienced radiologist and an expert scientist in paediatric neuroimaging.
Values from the analysis of ADC maps from these images’ regions have been fed to AI algorithms to successfully discriminate the three most common types of paediatric posterior fossa brain tumours, non-invasively.
“Using AI and advance Magnetic Resonance imaging characteristics, such as Apparent Diffusion Coefficient (ADC) values from diffusion weighted images, can potentially help distinguish, in a non-invasive way, between the main three different types of paediatric tumours in the posterior fossa, the area of the brain where such tumours are most commonly found in children,” continues Prof Arvanitis.
Professor Andrew Peet, NIHR Professor in Clinical Paediatric Oncology at the University of Birmingham and Birmingham Children’s Hospital, adds: “When a child comes to hospital with symptoms that could mean they have a brain tumour that initial scan is such a difficult time for the family and understandably they want answers as soon as possible.
“Here, we have combined readily available scans with artificial intelligence to provide high levels of diagnostic accuracy that can start to give some answers.
“Previous studies using these techniques have largely been limited to single expert centres. Showing that they can work across such a large number of hospitals opens the door to many children benefitting from rapid non-invasive diagnosis of their brain tumour.
“These are very exciting times and we are working hard now to start making these artificial intelligence techniques widely available.”
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