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Sample records for multiple elderly controls

  1. Elder Abuse - Multiple Languages

    ... Are Here: Home → Multiple Languages → All Health Topics → Elder Abuse URL of this page: https://medlineplus.gov/languages/ ... V W XYZ List of All Topics All Elder Abuse - Multiple Languages To use the sharing features on ...

  2. A Spanish pillbox app for elderly patients taking multiple medications: randomized controlled trial.

    Mira, José Joaquín; Navarro, Isabel; Botella, Federico; Borrás, Fernando; Nuño-Solinís, Roberto; Orozco, Domingo; Iglesias-Alonso, Fuencisla; Pérez-Pérez, Pastora; Lorenzo, Susana; Toro, Nuria

    2014-04-04

    Nonadherence and medication errors are common among patients with complex drug regimens. Apps for smartphones and tablets are effective for improving adherence, but they have not been tested in elderly patients with complex chronic conditions and who typically have less experience with this type of technology. The objective of this study was to design, implement, and evaluate a medication self-management app (called ALICE) for elderly patients taking multiple medications with the intention of improving adherence and safe medication use. A single-blind randomized controlled trial was conducted with a control and an experimental group (N=99) in Spain in 2013. The characteristics of ALICE were specified based on the suggestions of 3 nominal groups with a total of 23 patients and a focus group with 7 professionals. ALICE was designed for Android and iOS to allow for the personalization of prescriptions and medical advice, showing images of each of the medications (the packaging and the medication itself) together with alerts and multiple reminders for each alert. The randomly assigned patients in the control group received oral and written information on the safe use of their medications and the patients in the experimental group used ALICE for 3 months. Pre and post measures included rate of missed doses and medication errors reported by patients, scores from the 4-item Morisky Medication Adherence Scale (MMAS-4), level of independence, self-perceived health status, and biochemical test results. In the experimental group, data were collected on their previous experience with information and communication technologies, their rating of ALICE, and their perception of the level of independence they had achieved. The intergroup intervention effects were calculated by univariate linear models and ANOVA, with the pre to post intervention differences as the dependent variables. Data were obtained from 99 patients (48 and 51 in the control and experimental groups, respectively

  3. Balance control in elderly people with osteoporosis

    Hsu, Wei-Li; Chen, Chao-Yin; Tsauo, Jau-Yih; Yang, Rong-Sen

    2014-01-01

    Osteoporosis is a prevalent health concern among older adults and is associated with an increased risk of falls that incur fracture, injury, or mortality. Identifying the risk factors of falls within this population is essential for the development of effective regimes for fall prevention. Studies have shown that muscle quality and good posture alignments are critical for balance control in elderly individuals. People with osteoporosis often have muscle weakness and increased spine kyphosis l...

  4. Multiple vertebral fractures in an elderly male with macroprolactinoma

    Saša Magaš

    2016-09-01

    Full Text Available Hyperprolactinemia is associated with increased bone loss both in men and women. We report a case of an elderly patient with multiple osteoporotic vertebral fractures due to long-lasting hypogonadism caused by prolactinoma. The patient was treated with transphenoidal surgery, small doses of dopamine agonists, teriparatide, calcium and vitamin D supplements. Treatment led to increase in bone mineral density and decrease in lumbar pain intensity. This case highlights that clinicians should bear in mind the fact that osteoporotic vertebral fractures in men may be linked with hypogonadism and hyperprolactinemia. These conditions can be effectively treated. Therefore, detailed medical history and appropriate endocrinological evaluation should be performed in all male patients with osteoporotic fractures.

  5. Balance control in elderly people with osteoporosis

    Wei-Li Hsu

    2014-06-01

    Full Text Available Osteoporosis is a prevalent health concern among older adults and is associated with an increased risk of falls that incur fracture, injury, or mortality. Identifying the risk factors of falls within this population is essential for the development of effective regimes for fall prevention. Studies have shown that muscle quality and good posture alignments are critical for balance control in elderly individuals. People with osteoporosis often have muscle weakness and increased spine kyphosis leading to vertebral fractures and poor balance control, or even falls. Therefore, improving muscle quality, strengthening weak muscles, and correcting postural alignment are essential elements for the prevention of falls and fractures in older adults with osteoporosis. This review reports the necessary information regarding the critical factors of balance control in older adults with osteoporosis, as well as testing the clinical innovations of exercise training to improve the long-term prognosis of osteoporosis in this vulnerable population.

  6. Multiple Hierarchies and Organizational Control

    Evans, Peter B.

    1975-01-01

    Uses a control-loss model to explore the effects of multiple channels in formal organizations, and presents an argument for the superior control properties of dual hierarchies. Two variant forms of multiple hierarchies are considered. (Author)

  7. Impulse control disorders in elderly patients.

    Tamam, Lut; Bican, Mehtap; Keskin, Necla

    2014-05-01

    There is no epidemiological study on the prevalence of impulse control disorders (ICDs) in the elderly population. The studies on ICDs in elderly patients are limited and some of them are case reports about pathological gambling and kleptomania. The comorbidity of other psychiatric disorders makes diagnosis difficult and has negative effects on both treatment and the prognosis of ICDs. The aim of this study was to determine the prevalence of ICDs among elderly patients and to evaluate the related sociodemographic and clinical features. A total of 76 patients aged 60 and over who have been referred to our outpatient clinics in a one-year period were included in the study. A demographic data form was completed. The Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) was used to determine axis I psychiatric disorders. The prevalence of ICDs was investigated by using the modified version of the Minnesota Impulse Disorders Interview (MIDI). Impulsivity was measured with the Barratt Impulsiveness Scale Version 11 (BIS-11). The Mini-Mental State Examination (MMSE) test was performed to evaluate the cognitive status of patients and to exclude the diagnosis of dementia. In addition, all patients completed Symptom Check List-90 (SCL-90). The prevalence rate of at least one comorbid ICD in our sample was 17%. When patients with a diagnosis of ICDs not otherwise specified (ICD-NOS) were included, the prevalence rate increased to 22.4%. The most common ICD was intermittent explosive disorder (15.8%), followed by pathological gambling (9.2%). The majority of the sample was men (54%), married (80%), had a high school education (51%), and mid-level socioeconomic status (79%). The only statistically significant difference between the sociodemographic characteristics of patients with or without ICDs was gender. The lifetime prevalence of ICDs was 34.1% in men and 8.6% in women. The prevalence of childhood conduct disorder

  8. Multiple nuclear ADC controller

    Lovett, A; Rapaport, M S [Center for Nuclear Research, Soreq (Israel)

    1980-12-01

    A controller for an on-line three parameter coincidence and multispectra scaling system has been developed. It has been designed to control, event-by-event, the outputs of three nuclear analog-to-digital converters used at the SOLIS facility. The system utilizes an HP minicomputer with a 32k-word core memory, a disc drive and magnetic tape units.

  9. Birth Control - Multiple Languages

    ... Methods - English PDF How to Switch Birth Control Methods - 简体中文 (Chinese, Simplified (Mandarin dialect)) ... Reproductive Health Access Project Non-Contraceptive Indications for Hormonal Contraceptive Products - English PDF Non- ...

  10. Lower Urinary Tract Symptoms in Elderly Population With Multiple Sclerosis

    Camille Chesnel

    2018-03-01

    Full Text Available Purpose The aim of this study is to compare the clinical and urodynamic characteristics of urinary disorders in multiple sclerosis (MS patients in a geriatric population with a nongeriatric population. Methods This study was conducted retrospectively between 2010 and 2016. Each patient with MS aged 65 and older was matched with 2 patients with MS aged less than 65 in sex, form of MS, and Expended Disability Status Scale (EDSS. Demographic data, urinary symptoms, treatment, quality of life, repercussion of lower urinary tract symptoms on daily life activities and psychological state and urodynamic parameters were collected. Differences between the 2 populations were evaluated using Student test, chi-square, or Fischer tests. Results Twenty-four patients with MS aged 65 and older (mean age, 69.8 years were matched with 48 patients aged less than 65 years (mean age, 49.4 years. Maximum urethral closure pressure was lower in the elderly population than in the nongeriatric population (mean±standard deviation [SD]: 35.6±18.5 cm H2O vs. 78.2±52.3 cm H2O, P<0.001. In the male population, there was no statistical difference in any other clinical or urodynamic endpoints. In the female population, voiding symptoms was more described in the nongeriatric population (Urinary Symptom Profile low stream: 3.4±3.5 vs. 1.7±2.4, P=0.04, geriatric population had less urinary treatment (P=0.05. LUTS had less impact on quality of life (Qualiveen: 1.4±1.0 vs. 2.1±0.9, P=0.02 on the geriatric population than in the nongeriatric of female MS patients. Conclusions Geriatric population of MS has few differences of urinary disorders compared to a nongeriatric population with EDSS, sex, and MS form equal. However, the psychological impact of these urinary disorders is less important in female geriatric population.

  11. Design and implementation of an empowerment model to prevent elder abuse: a randomized controlled trial.

    Estebsari, Fatemeh; Dastoorpoor, Maryam; Mostafaei, Davoud; Khanjani, Narges; Khalifehkandi, Zahra Rahimi; Foroushani, Abbas Rahimi; Aghababaeian, Hamidreza; Taghdisi, Mohammad Hossein

    2018-01-01

    Older adults are more vulnerable to health risks than younger people and may get exposed to various dangers, including elder abuse. This study aimed to design and implement an empowerment educational intervention to prevent elder abuse. This parallel randomized controlled trial was conducted in 2014-2016 for 18 months on 464 older adults aged above 60 years who visited health houses of 22 municipalities in Tehran. Data were collected using standard questionnaires, including the Elder Abuse-Knowledge Questionnaire, Health-Promoting Behavior Questionnaire, Health-Promoting Lifestyle Profile II, Barriers to Healthy Lifestyle, Perceived Social Support, Perceived Self-Efficacy, Loneliness Scale, Geriatric Depression Scale, Multidimensional Health Locus of Control Scale, and the SCARED (stress, coping, argument, resources, events, and dependence) tool. The intervention was done in twenty 45- to 60-minute training sessions over 6 months. Data analysis were performed using χ 2 tests, multiple linear and logistic regression, and structural equation modeling (SEM). The frequency of knowledge of elder abuse, self-efficacy, social support and health promoting lifestyle before the intervention was similar in the two groups. However, the frequency of high knowledge of elder abuse (94.8% in the intervention group and 46.6% in the control group), high self-efficacy (82.8% and 7.8%, respectively), high social support (97.0% and 10.3%, respectively) and high health promoting lifestyle (97.0% and 10.3%, respectively) was significantly higher ( P elder abuse risk (28.0% and 49.6%, respectively) was significantly less in the intervention group after the intervention. SEM standardized beta (Sβ) showed that the intervention had the highest impact on increase social support (Sβ=0.80, β=48.64, SE=1.70, P elder abuse risk was indirect and significant (Sβ=-0.406, β=-0.340, SE=0.03, P elder abuse.

  12. Elderly woman with multiple morbidities presenting with a funny ...

    Multi morbidity is the occurrence of more than one concurrant chronic diseases in a patient1,2. It is very common in the elderly and common to both sexes2.It is more or less the norm in Family Practice than the exception. Its importance lies in the fact that it not only affects the patient's quality of life, it poses a big challenge to ...

  13. Interference Control In Elderly Bilinguals: Appearances Can Be Misleading.

    Ansaldo, Ana Inés; Ghazi-Saidi, Ladan; Adrover-Roig, Daniel

    2015-01-01

    Bilingualism has been associated with successful aging. In particular, research on the cognitive advantages of bilingualism suggests that it can enhance control over interference and help delay the onset of dementia signs. However, the evidence on the so-called cognitive advantage is not unanimous; furthermore, little is known about the neural basis of this supposed cognitive advantage in bilingual as opposed to monolingual elderly populations. In this study, elderly bilingual and monolingual participants performed a visuospatial interference control task during functional magnetic resonance imaging (fMRI) scanning. Response times and accuracy rates were calculated for congruent and incongruent conditions of the Simon task, and the neurofunctional correlates of performance on the Simon task were examined. The results showed equivalent performance on the Simon task across groups but different underlying neural substrates in the two groups. With incongruent trials, monolinguals activated the right middle frontal gyrus, whereas bilinguals relied upon the left inferior parietal lobule. These results show that elderly bilinguals and monolinguals have equivalent interference control abilities, but relay on different neural substrates. Thus, while monolinguals show a classical PASA (posterior-anterior shift in aging) effect, recruiting frontal areas, bilinguals activate visuospatial processing alone and thus do not show this posterior-anterior shift. Moreover, a modulation of frontal activity with task-dynamic control of interference, observed in the elderly bilingual group alone, suggests that elderly bilinguals deal with interference control without recruiting a circuit that is particularly vulnerable to aging.

  14. MULTIPLE ECH LAUNCHER CONTROL SYSTEM

    GREEN, M.T.; PONCE, D.; GRUNLOH, H.J.; ELLIS, R.A.; GROSNICKLE, W.H.; HUMPHREY, R.L.

    2004-03-01

    OAK-B135 The addition of new, high power gyrotrons to the heating and current drive arsenal at DIII-D, required a system upgrade for control of fully steerable ECH Launchers. Each launcher contains two pointing mirrors with two degrees of mechanical freedom. The two flavors of motion are called facet and tilt. Therefore up to four channels of motion per launcher need to be controlled. The system utilizes absolute encoders to indicate mirror position and therefore direction of the microwave beam. The launcher movement is primarily controlled by PLC, but future iterations of design, may require this control to be accomplished by a CPU on fast bus such as Compact PCI. This will be necessary to accomplish real time position control. Safety of equipment and personnel is of primary importance when controlling a system of moving parts. Therefore multiple interlocks and fault status enunciators have been implemented. This paper addresses the design of a Multiple ECH Launcher Control System, and characterizes the flexibility needed to upgrade to a real time position control system in the future

  15. Multisensory training for postural sway control in non-injured elderly ...

    Multisensory training for postural sway control in non-injured elderly females. ... Elderly adults demonstrate increased postural sway, which may ultimately lead to falls. ... Keywords: multisensory training, postural sway control, balance ability, ...

  16. Postural control of elderly: moving to predictable and unpredictable targets.

    Jongman, Vera; Lamoth, Claudine J C; van Keeken, Helco; Caljouw, Simone R

    2012-01-01

    Impaired postural control with muscle weakness is an important predictor of falls within the elderly population.Particular daily activities that require weight shifting in order to be able to reach a specific target (a cup on a table) require continuous adjustments to keep the body's center of mass

  17. The Multiple Control of Verbal Behavior

    Michael, Jack; Palmer, David C.; Sundberg, Mark L.

    2011-01-01

    Amid the novel terms and original analyses in Skinner's "Verbal Behavior", the importance of his discussion of multiple control is easily missed, but multiple control of verbal responses is the rule rather than the exception. In this paper we summarize and illustrate Skinner's analysis of multiple control and introduce the terms "convergent…

  18. [Elder].

    Arroyo, Pedro; Gutiérrez-Robledo, Luis Miguel

    2016-09-01

    The aim of this review is to present scientific evidence on the biological, dietary, cultural and economic advantages of cow´s milk and dairy products intake in adults, with emphasis on the elderly. The role of milk and dairy products as part of the regular diet, as well as their contribution to a healthy diet for the aged population is described. The updated scientific references on the importance of milk and dairy products on the dietary management of the most prevalent diseases of the eldery -among these energy-protein malnutrition, sarcopenia, obesity, sarcopenic obesity, osteoporosis, diabetes and cardiovascular diseases- are presented.

  19. Building control automation for retirement homes :a therapeutic opportunity for the elderly

    Avila, Melinda Plaza

    1993-01-01

    The therapeutic opportunity for the elderly due to building control automation use in a retirement home was investigated. Previous research suggests that a basic understanding of elderly functional needs and building control automation capabilities is required Ifn order to secure the opportunity for maintaining existing elderly functional abilities. This study explores the extent to which building control automation can be applied in retirement homes. The research questions gen...

  20. [Postural control characteristics in elderly women with fallers].

    Gudkov, A B; Dyomin, A V; Gribanov, A V

    Using computer posturografic (stabilometric) complex a study of postural control peculiarities was carried out in 108 women aged 65-74 years who had experienced two or more falls during the year (fallers). These tests were: Sensory Organization Test, Motor Control Test, Rhythmic Weight Shift. It was found that elderly women with fallers had a decrease of sensory information (somatosensory - by 1,8 %, of the visual - by 6 %, and of the vestibular - by 10,1 %), the neurophysiological mechanisms of postural control (by 5,7 points), violation of adaptation possibilities of sensory and motor components of the legs to respond quickly to changes in the center of gravity within the support base of its footing (7,3 ms), as well as reducing balance control in the frontal (by 7,2 %) and sagittal (by 23,2 % ) planes compared with the women of the same age without fallers.

  1. Multiple approaches to understanding and preventing elder abuse: Introduction to the cross-disciplinary National Institutes of Health workshop.

    Saylor, Katherine Witte

    2016-01-01

    On October 30, 2015, the National Institutes of Health (NIH) convened a workshop, "Multiple Approaches to Understanding and Preventing Elder Abuse," in Bethesda, Maryland. The workshop brought together experts from across disciplines to discuss research challenges, opportunities, and lessons learned from other fields. Participants included experts in elder abuse, child abuse, intimate partner violence (IPV), emergency medicine, and neuroscience. In this special issue of the Journal of Elder Abuse and Neglect, participants address topics explored before, during, and after the day-long workshop.

  2. Choice and Outcomes of Rate Control versus Rhythm Control in Elderly Patients with Atrial Fibrillation

    Paciullo, Francesco; Proietti, Marco; Bianconi, Vanessa

    2018-01-01

    BACKGROUND: Among rate-control or rhythm-control strategies, there is conflicting evidence as to which is the best management approach for non-valvular atrial fibrillation (AF) in elderly patients. DESIGN: We performed an ancillary analysis from the 'Registro Politerapie SIMI' study, enrolling el...

  3. Design and implementation of an empowerment model to prevent elder abuse: a randomized controlled trial

    Estebsari F

    2018-04-01

    twenty 45- to 60-minute training sessions over 6 months. Data analysis were performed using χ2 tests, multiple linear and logistic regression, and structural equation modeling (SEM.Results: The frequency of knowledge of elder abuse, self-efficacy, social support and health promoting lifestyle before the intervention was similar in the two groups. However, the frequency of high knowledge of elder abuse (94.8% in the intervention group and 46.6% in the control group, high self-efficacy (82.8% and 7.8%, respectively, high social support (97.0% and 10.3%, respectively and high health promoting lifestyle (97.0% and 10.3%, respectively was significantly higher (P<0.001 and the frequency of elder abuse risk (28.0% and 49.6%, respectively was significantly less in the intervention group after the intervention. SEM standardized beta (Sβ showed that the intervention had the highest impact on increase social support (Sβ=0.80, β=48.64, SE=1.70, P<0.05, self-efficacy (Sβ=0.76, β=13.32, SE=0.52, P<0.05 and health promoting behaviors (Sβ=0.48, β=33.08, SE=2.26, P<0.05, respectively. The effect of the intervention on decrease of elder abuse risk was indirect and significant (Sβ=-0.406, β=-0.340, SE=0.03, P<0.05, and through social support, self-efficacy, and health promoting behaviors.Conclusion: Educational interventions can be effective in preventing elder abuse. Keywords: elder abuse, self-efficacy, social support, health promotion, health education

  4. A comparison in young and elderly subjects of the pharmacokinetics and pharmacodynamics of single and multiple doses of benazepril.

    Macdonald, N J; Elliott, H L; Hughes, D M; Reid, J L

    1993-01-01

    1. The pharmacokinetics and pharmacodynamics of single and multiple oral doses of the ACE inhibitor benazepril were investigated in young and elderly normotensive subjects. 2. Following multiple doses the trough concentrations were significantly higher in the elderly and the areas under the plasma concentration-time curves (AUC0-24) were significantly greater, by approximately 23%. 3. The fall in blood pressure tended to be greater in the elderly subjects but this is likely to be attributable to their higher initial blood pressures, although it may reflect the small differences in pharmacokinetics. 4. The age related differences in kinetics and dynamics following multiple dosing are quantitatively similar to those obtained with single doses. However, there appears to be a quantitative difference between benazepril and other ACE inhibitors in that the age related increases were of a relatively smaller magnitude. PMID:9114904

  5. Elderly patient refractory to multiple pain medications successfully treated with integrative East–West medicine

    Bill Tu

    2008-07-01

    Full Text Available Bill Tu, Michael Johnston, Ka-Kit HuiUCLA Center for East–West Medicine, Department of Internal Medicine, UCLA David Geffen School of Medicine, Los Angeles, CA, USABackground: Polypharmacy is a common and serious problem in the elderly today. Few solutions have been effective in reducing its incidence.Case summary: An 87-year-old female with a history of osteoarthritis and spinal stenosis presented with a five month history of severe right hip pain. She had been seen by multiple specialists and hospitalized many times. During these encounters, she was prescribed a long list of pain medications. However, these medications did not improve her pain and added to her risk of adverse drug events. After exhausting traditional Western medical therapies, she received a referral to the UCLA Center for East–West Medicine. There, clinicians treated her with a nonpharmacological integrative East-West medicine approach that included acupuncture, dry needling of trigger points, and education on self-acupressure. Her pain began improving and she was able to cut back on analgesic use under physician supervision. Ultimately, she improved to the point where she was able to discontinue all of her pain medications. Symptomatic relief was evidenced by improvement in health-related quality of life (HRQOL.Conclusions: This case study suggests that integrative East–West medicine may have the potential to reduce the incidence of polypharmacy in elderly patients presenting with pain conditions and improve their quality of life.Keywords: polypharmacy, pain, osteoarthritis, acupuncture, complementary and alternative medicine, integrative medicine, adverse drug reaction, elderly

  6. Effects of two exercise protocols on postural balance of elderly women: a randomized controlled trial

    Mesquita, Laiana Sep?lveda de Andrade; de Carvalho, Fabiana Texeira; Freire, Lara Sep?lveda de Andrade; Neto, Osmar Pinto; Z?ngaro, Renato Amaro

    2015-01-01

    Background The aging process reduces both sensory capabilities and the capabilities of the motor systems responsible for postural control, resulting in a high number of falls among the elderly. Some therapeutic interventions can directly interrupt this process, including physical exercise. This study compares and examines the effects of two exercise protocols on the balance of elderly women. Methods Elderly women who participated in a local church project (n?=?63) were randomly divided into t...

  7. Multiplicity Control in Structural Equation Modeling

    Cribbie, Robert A.

    2007-01-01

    Researchers conducting structural equation modeling analyses rarely, if ever, control for the inflated probability of Type I errors when evaluating the statistical significance of multiple parameters in a model. In this study, the Type I error control, power and true model rates of famsilywise and false discovery rate controlling procedures were…

  8. Technical Manuals for the Elderly - Can Controlled Language Principles Help?

    Møller, Margrethe H.

    It is a challenge to the elderly to manoeuvre in today’s ICT society, where the command of technology plays an increasing role at all levels. On the one hand, age-related impairments may infl uence the ability of the elderly to familiarize with new technology. On the other hand, technological...

  9. Depression is not associated with diabetes control in minority elderly.

    Palta, Priya; Golden, Sherita Hill; Teresi, Jeanne A; Palmas, Walter; Trief, Paula; Weinstock, Ruth S; Shea, Steven; Manly, Jennifer J; Luchsinger, Jose A

    2014-01-01

    We investigated the longitudinal association of depression, with and without cognitive dysfunction, with hemoglobin A1c (HbA1c), systolic blood pressure (SBP), and low-density lipoprotein (LDL) in a predominantly minority cohort. There were 613 participants. Presence of depression was defined by a score ≥7 on the Short-CARE depression scale. We tested participants for executive dysfunction using the Color Trails Test (CTT), part 2, and for memory dysfunction using the total recall task of the Selective Reminding Test (TR-SRT). We classified performance in these tests as abnormal based on standardized score cutoffs (<16th percentile and one standard deviation below the sample mean). Random effects models were used to compare repeated measures of the diabetes control measures between those with depression versus those without depression and ever versus never cognitively impaired. Baseline depression was present in 36% of participants. Over a median follow-up of 2 years, depression was not related to worse HbA1c, SBP, or LDL. The presence of (1) abnormal performance on a test of executive function and depression (n=57) or (2) abnormal performance on a test of verbal recall and depression (n=43) was also not associated with clinically significant worse change in diabetes control. Depression, with or without low performance in tests of executive function and memory, may not affect clinically significant measures of diabetes control in the elderly. Copyright © 2014. Published by Elsevier Inc.

  10. Control of multiple robots using vision sensors

    Aranda, Miguel; Sagüés, Carlos

    2017-01-01

    This monograph introduces novel methods for the control and navigation of mobile robots using multiple-1-d-view models obtained from omni-directional cameras. This approach overcomes field-of-view and robustness limitations, simultaneously enhancing accuracy and simplifying application on real platforms. The authors also address coordinated motion tasks for multiple robots, exploring different system architectures, particularly the use of multiple aerial cameras in driving robot formations on the ground. Again, this has benefits of simplicity, scalability and flexibility. Coverage includes details of: a method for visual robot homing based on a memory of omni-directional images a novel vision-based pose stabilization methodology for non-holonomic ground robots based on sinusoidal-varying control inputs an algorithm to recover a generic motion between two 1-d views and which does not require a third view a novel multi-robot setup where multiple camera-carrying unmanned aerial vehicles are used to observe and c...

  11. Conceptual design of multiple parallel switching controller

    Ugolini, D.; Yoshikawa, S.; Ozawa, K.

    1996-01-01

    This paper discusses the conceptual design and the development of a preliminary model of a multiple parallel switching (MPS) controller. The introduction of several advanced controllers has widened and improved the control capability of nonlinear dynamical systems. However, it is not possible to uniquely define a controller that always outperforms the others, and, in many situations, the controller providing the best control action depends on the operating conditions and on the intrinsic properties and behavior of the controlled dynamical system. The desire to combine the control action of several controllers with the purpose to continuously attain the best control action has motivated the development of the MPS controller. The MPS controller consists of a number of single controllers acting in parallel and of an artificial intelligence (AI) based selecting mechanism. The AI selecting mechanism analyzes the output of each controller and implements the one providing the best control performance. An inherent property of the MPS controller is the possibility to discard unreliable controllers while still being able to perform the control action. To demonstrate the feasibility and the capability of the MPS controller the simulation of the on-line operation control of a fast breeder reactor (FBR) evaporator is presented. (author)

  12. The relationship between multiple joint flexibility and functional performance in independent and physically active elderly women

    Maria Joana de Carvalho

    2007-09-01

    Full Text Available Multi-joint flexibility assessment seems to be more appropriate for analyzing the association between fl exibility and functional fitness, but there is a lack of studies to confi rm this possibility in elderly people. The present study investigated the relationship between a multiple joint fl exibility assessment and the functional performance of 30 independent and physically active elderly women (age=68±1yr. Flexibility was assessed using the Chair Sit-and-Reach Test (CSRT. Functional performance was tested by a combination of three tasks: a Step Length (SL; b Time to Put on Sneakers (TPS; c Climbing Stairs (CS. The association between fl exibility and functional performance was tested by both simple and multiple correlation techniques. Pearson’s correlation was signifi cant for TPS (r = -.37; p ABSTRACT

  13. Delegation control of multiple unmanned systems

    Flaherty, Susan R.; Shively, Robert J.

    2010-04-01

    Maturing technologies and complex payloads coupled with a future objective to reduce the logistics burden of current unmanned aerial systems (UAS) operations require a change to the 2-crew employment paradigm. Increased automation and operator supervisory control of unmanned systems have been advocated to meet the objective of reducing the crew requirements, while managing future technologies. Specifically, a delegation control employment strategy has resulted in reduced workload and higher situation awareness for single operators controlling multiple unmanned systems in empirical studies1,2. Delegation control is characterized by the ability for an operator to call a single "play" that initiates prescribed default actions for each vehicle and associated sensor related to a common mission goal. Based upon the effectiveness of delegation control in simulation, the U.S. Army Aeroflightdynamics Directorate (AFDD) developed a Delegation Control (DelCon) operator interface with voice recognition implementation for play selection, real-time play modification, and play status with automation transparency to enable single operator control of multiple unmanned systems in flight. AFDD successfully demonstrated delegation control in a Troops-in-Contact mission scenario at Ft. Ord in 2009. This summary showcases the effort as a beneficial advance in single operator control of multiple UAS.

  14. Comparative Analysis of the Paravertebral Analgesic Pump Catheter with the Epidural Catheter in Elderly Trauma Patients with Multiple Rib Fractures.

    Shapiro, Brian S; Wasfie, Tarik; Chadwick, Mathew; Barber, Kimberly R; Yapchai, Raquel

    2017-04-01

    Presently, trauma guidelines recommend epidural analgesia as the optimal modality of pain relief from rib fractures. They are not ideally suited for elderly trauma patients and have disadvantages including bleeding risk. The paravertebral analgesic pump (PVP) eliminates such disadvantages and includes ease of placement in the trauma setting. This study compares pain control in patients treated by EPI versus PVP. This is a retrospective, historical cohort study comparing two methods of pain management in the trauma setting. Before 2010, patients who had epidural catheters (EPI) placed for pain control were compared with patients after 2010 in which the PVP was used. All patients had multiple rib fractures as diagnosed by CT scan. Analysis was adjusted for age, number of fractures, and comorbid conditions. Multiple linear regression analysis was conducted to compare average reported pain. A total of 110 patients, 31 PVP and 79 epidural catheters, were included in the study. Overall mean age was 65 years. The mean Injury Severity Score was 12.0 (EPI) and 11.1 (PVP). Mean number rib fractures was 4.29 (EPI) and 4.71 (PVP). PVP was associated with a 30 per cent greater decrease in pain than that seen with EPI (6.0-1.9 vs 6.4-3.4). After controlling for age, Injury Severity Score, and number of rib fractures, there were no differences in intensive care unit or total length of stay (P = 0.35) or in pain score (3.76 vs 3.56, P = 0.64). In conclusion, the PVP compares well with epidural analgesia in older trauma patients yet is safe, well tolerated, and easily inserted.

  15. Factors Associated With Multiple Falls Among Elderly Patients Admitted to Emergency Department

    Tuba Cimilli Ozturk

    2017-06-01

    Conclusion: Physically active and relatively younger elderlies fall more frequently. As the most commonly described mechanism was stumbling and fall, the importance of environmental risk factors is emphasized. Patients with cardiovascular and neurological diseases should be further evaluated for increased fall risk and indications of benzodiazepines and SSRI's in elderly people should be well evaluated.

  16. Multiple model adaptive control with mixing

    Kuipers, Matthew

    Despite the remarkable theoretical accomplishments and successful applications of adaptive control, the field is not sufficiently mature to solve challenging control problems requiring strict performance and safety guarantees. Towards addressing these issues, a novel deterministic multiple-model adaptive control approach called adaptive mixing control is proposed. In this approach, adaptation comes from a high-level system called the supervisor that mixes into feedback a number of candidate controllers, each finely-tuned to a subset of the parameter space. The mixing signal, the supervisor's output, is generated by estimating the unknown parameters and, at every instant of time, calculating the contribution level of each candidate controller based on certainty equivalence. The proposed architecture provides two characteristics relevant to solving stringent, performance-driven applications. First, the full-suite of linear time invariant control tools is available. A disadvantage of conventional adaptive control is its restriction to utilizing only those control laws whose solutions can be feasibly computed in real-time, such as model reference and pole-placement type controllers. Because its candidate controllers are computed off line, the proposed approach suffers no such restriction. Second, the supervisor's output is smooth and does not necessarily depend on explicit a priori knowledge of the disturbance model. These characteristics can lead to improved performance by avoiding the unnecessary switching and chattering behaviors associated with some other multiple adaptive control approaches. The stability and robustness properties of the adaptive scheme are analyzed. It is shown that the mean-square regulation error is of the order of the modeling error. And when the parameter estimate converges to its true value, which is guaranteed if a persistence of excitation condition is satisfied, the adaptive closed-loop system converges exponentially fast to a closed

  17. ASSISTments Dataset from Multiple Randomized Controlled Experiments

    Selent, Douglas; Patikorn, Thanaporn; Heffernan, Neil

    2016-01-01

    In this paper, we present a dataset consisting of data generated from 22 previously and currently running randomized controlled experiments inside the ASSISTments online learning platform. This dataset provides data mining opportunities for researchers to analyze ASSISTments data in a convenient format across multiple experiments at the same time.…

  18. Cooperative Control of Multiple Unmanned Autonomous Vehicles

    2005-06-03

    I I Final Report 4. TITLE AND SUBTITLE 5. FUNDING NUMBERS Cooperative Control of Multiple Unmanned Autonomous Vehicles F49620-01-1-0337 6. AUTHOR(S... Autonomous Vehicles Final Report Kendall E. Nygard Department of Computer Science and Operations Research North Dakota State University Fargo, ND 58105-5164

  19. Distributed Autonomous Control of Multiple Spacecraft During Close Proximity Operations

    McCamish, Shawn B

    2007-01-01

    This research contributes to multiple spacecraft control by developing an autonomous distributed control algorithm for close proximity operations of multiple spacecraft systems, including rendezvous...

  20. Controlling memory impairment in elderly adults using virtual reality memory training: a randomized controlled pilot study.

    Optale, Gabriele; Urgesi, Cosimo; Busato, Valentina; Marin, Silvia; Piron, Lamberto; Priftis, Konstantinos; Gamberini, Luciano; Capodieci, Salvatore; Bordin, Adalberto

    2010-05-01

    Memory decline is a prevalent aspect of aging but may also be the first sign of cognitive pathology. Virtual reality (VR) using immersion and interaction may provide new approaches to the treatment of memory deficits in elderly individuals. The authors implemented a VR training intervention to try to lessen cognitive decline and improve memory functions. The authors randomly assigned 36 elderly residents of a rest care facility (median age 80 years) who were impaired on the Verbal Story Recall Test either to the experimental group (EG) or the control group (CG). The EG underwent 6 months of VR memory training (VRMT) that involved auditory stimulation and VR experiences in path finding. The initial training phase lasted 3 months (3 auditory and 3 VR sessions every 2 weeks), and there was a booster training phase during the following 3 months (1 auditory and 1 VR session per week). The CG underwent equivalent face-to-face training sessions using music therapy. Both groups participated in social and creative and assisted-mobility activities. Neuropsychological and functional evaluations were performed at baseline, after the initial training phase, and after the booster training phase. The EG showed significant improvements in memory tests, especially in long-term recall with an effect size of 0.7 and in several other aspects of cognition. In contrast, the CG showed progressive decline. The authors suggest that VRMT may improve memory function in elderly adults by enhancing focused attention.

  1. Factors Influencing Quality of Life for Disabled and Nondisabled Elderly Population: The Results of a Multiple Correspondence Analysis

    M. Avolio

    2013-01-01

    Full Text Available Objectives. The aim of our study is to examine the role of some factors (sociodemographic patterns, social relationship support, and trust in healthcare actors on structure of quality of life among the Italian elderly population, by stratifying according to presence or absence of disability. Methods. Using data of the Italian National Institute of Statistics (ISTAT survey, we obtained a sample of 25,183 Italian people aged 65+ years. Multiple Correspondence Analysis (MCA was used to test such a relationship. Results. By applying the MCA between disabled and nondisabled elderly population, we identified three dimensions: “demographic structure and social contacts,” “social relationships,” “trust in the Italian National Health Services (INHS.” Furthermore, the difference in trust on the INHS and its actors was seen among disabled and non-disabled elderly population. Conclusions. Knowledge on the concept of quality of life and its application to the elderly population either with or without disability should make a difference in both people’s life and policies and practices affecting life. New domains, such as information and trusting relationships both within and towards the care network’s nodes, are likely to play an important role in this relationship.

  2. Decentralized fuzzy control of multiple nonholonomic vehicles

    Driessen, B.J.; Feddema, J.T.; Kwok, K.S.

    1997-09-01

    This work considers the problem of controlling multiple nonholonomic vehicles so that they converge to a scent source without colliding with each other. Since the control is to be implemented on simple 8-bit microcontrollers, fuzzy control rules are used to simplify a linear quadratic regulator control design. The inputs to the fuzzy controllers for each vehicle are the (noisy) direction to the source, the distance to the closest neighbor vehicle, and the direction to the closest vehicle. These directions are discretized into four values: Forward, Behind, Left, and Right, and the distance into three values: Near, Far, Gone. The values of the control at these discrete values are obtained based on the collision-avoidance repulsive forces and the change of variables that reduces the motion control problem of each nonholonomic vehicle to a nonsingular one with two degrees of freedom, instead of three. A fuzzy inference system is used to obtain control values for inputs between the small number of discrete input values. Simulation results are provided which demonstrate that the fuzzy control law performs well compared to the exact controller. In fact, the fuzzy controller demonstrates improved robustness to noise.

  3. Phenotype and natural history of elderly onset inflammatory bowel disease: a multicentre, case-control study.

    Mañosa, M; Calafat, M; de Francisco, R; García, C; Casanova, M J; Huelín, P; Calvo, M; Tosca, J; Fernández-Salazar, L; Arajol, C; Zabana, Y; Bastida, G; Hinojosa, J; Márquez, L; Barreiro-de-Acosta, M; Calvet, X; Monfort, D; Gómez-Garcia, M R; Rodríguez, E; Huguet, J M; Rojas-Feria, M; Hervias, D; Atienza, R; Busquets, D; Zapata, E; Dueñas, C; Charro, M; Martínez-Cerezo, F J; Plaza, R; Vázquez, J M; Gisbert, J P; Cañete, F; Cabré, E; Domènech, E

    2018-03-01

    Onset during old age has been reported in upto 10% of total cases of inflammatory bowel disease (IBD). To evaluate phenotypic characteristics and the use of therapeutic resources in patients with elderly onset IBD. Case-control study including all those patients diagnosed with IBD over the age of 60 years since 2000 who were followed-up for >12 months, identified from the IBD databases. Elderly onset cases were compared with IBD patients aged 18 to 40 years at diagnosis, matched by year of diagnosis, gender and type of IBD (adult-onset). One thousand three hundred and seventy-four elderly onset and 1374 adult-onset cases were included (62% ulcerative colitis (UC), 38% Crohn's disease (CD)). Among UC patients, elderly onset cases had a lower proportion of extensive disease (33% vs 39%; P < 0.0001). In CD, elderly onset cases showed an increased rate of stenosing pattern (24% vs 13%; P < 0.0001) and exclusive colonic location (28% vs 16%; P < 0.0001), whereas penetrating pattern (12% vs 19%; P < 0.0001) was significantly less frequent. Regarding the use of therapeutic resources, there was a significantly lower use of corticosteroids (P < 0.0001), immunosuppressants (P < 0.0001) and anti-TNFs agents (P < 0.0001) in elderly onset cases. Regarding surgery, we found a significantly higher surgery rate among elderly onset UC cases (8.3% vs 5.1%; P < 0.009). Finally, elderly onset cases were characterised by a higher rate of hospitalisations (66% vs 49%; P < 0.0001) and neoplasms (14% vs 0.5%; P < 0.0001). Elderly onset IBD shows specific characteristics and they are managed differently, with a lower use of immunosuppressants and a higher rate of surgery in UC. © 2018 John Wiley & Sons Ltd.

  4. Multiple descriptions for packetized predictive control

    Østergaard, Jan; Quevedo, Daniel

    2016-01-01

    be reliably reconstructed at the plant side. For the particular case of LTI plant models and i.i.d. channels, we show that the overall system forms a Markov jump linear system. We provide conditions for mean square stability and derive upper bounds on the operational bit rate of the quantizer to guarantee......In this paper, we propose to use multiple descriptions (MDs) to achieve a high degree of robustness towards random packet delays and erasures in networked control systems. In particular, we consider the scenario, where a data-rate limited channel is located between the controller and the plant...

  5. Current prevention and control of health care-associated infections in long-term care facilities for the elderly in Japan.

    Kariya, Naoko; Sakon, Naomi; Komano, Jun; Tomono, Kazunori; Iso, Hiroyasu

    2018-05-01

    Residents of long-term care facilities for the elderly are vulnerable to health care-associated infections. However, compared to medical institutions, long-term care facilities for the elderly lag behind in health care-associated infection control and prevention. We conducted a epidemiologic study to clarify the current status of infection control in long-term care facilities for the elderly in Japan. A questionnaire survey on the aspects of infection prevention and control was developed according to SHEA/APIC guidelines and was distributed to 617 long-term care facilities for the elderly in the province of Osaka during November 2016 and January 2017. The response rate was 16.9%. The incidence rates of health care-associated infection outbreaks and residents with health care-associated infections were 23.4 per 100 facility-years and 0.18 per 1,000 resident-days, respectively. Influenza and acute gastroenteritis were reported most frequently. Active surveillance to identify the carrier of multiple drug-resistant organisms was not common. The overall compliance with 21 items selected from the SHEA/APIC guidelines was approximately 79.2%. All facilities had infection control manuals and an assigned infection control professional. The economic burdens of infection control were approximately US$ 182.6 per resident-year during fiscal year 2015. Importantly, these data implied that physicians and nurses were actively contributed to higher SHEA/APIC guideline compliance rates and the advancement of infection control measures in long-term care facilities for the elderly. Key factors are discussed to further improve the infection control in long-term care facilities for the elderly, particularly from economic and social structural standpoints. Copyright © 2017 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

  6. Effectiveness of treadmill training on balance control in elderly people: a randomized controlled clinical trial.

    Pirouzi, Soraya; Motealleh, Ali Reza; Fallahzadeh, Fatemeh; Fallahzadeh, Mohammad Amin

    2014-11-01

    Physical exercise would improve postural stability, which is an essential factor in preventing accidental fall among the elderly population. The aim of this study is to examine the effectiveness of treadmill walking on balance improvement among the elderly people. A total of 30 community dwelling older adults with a Berg Balance Scale score of 36-48 and the ability to walk without aid were considered and divided into control (n=15) and experimental (n=15) groups. Individuals in the experimental group participated in 30 minutes of forward and backward treadmill training based on three times a week interval for a period of four weeks. Individuals in the control group were instructed to continue with their daily routine activity. Before and after training, gait speed was measured by six-minute walk test and balance ability was evaluated by Fullerton Advanced Balance Scale (FABS) and Berg Balance Scale (BBS) tests. Postural sway items such as the Center of Pressure (COP), average displacement and velocity were evaluated by using a force platform system. Data were collected in quiet standing, tandem position and standing on foam pads before and after intervention. After intervention, balance variables in the experimental group indicated a significant improvement in quiet standing on firm and foam surfaces, but no considerable improvement was shown in tandem position. A between-group comparison showed a significant reduction in COP velocity in the sagittal plane (P=0.030) during quiet standing and in the frontal plane (P=0.001) during standing on foam, whereas no significant reduction in COP parameters during tandem position was found. It is recommended that twelve sessions of forward and backward treadmill walk are effective in balance improvement in elderly people. IRCT201209199440N2.

  7. Effectiveness of Treadmill Training on Balance Control in Elderly People: A Randomized Controlled Clinical Trial

    Soraya Pirouzi

    2014-11-01

    Full Text Available Physical exercise would improve postural stability, which is an essential factor in preventing accidental fall among the elderly population. The aim of this study is to examine the effectiveness of treadmill walking on balance improvement among the elderly people. A total of 30 community dwelling older adults with a Berg Balance Scale score of 36-48 and the ability to walk without aid were considered and divided into control (n=15 and experimental (n=15 groups. Individuals in the experimental group participated in 30 minutes of forward and backward treadmill training based on three times a week interval for a period of four weeks. Individuals in the control group were instructed to continue with their daily routine activity. Before and after training, gait speed was measured by six-minute walk test and balance ability was evaluated by Fullerton Advanced Balance Scale (FABS and Berg Balance Scale (BBS tests. Postural sway items such as the Center of Pressure (COP, average displacement and velocity were evaluated by using a force platform system. Data were collected in quiet standing, tandem position and standing on foam pads before and after intervention. After intervention, balance variables in the experimental group indicated a significant improvement in quiet standing on firm and foam surfaces, but no considerable improvement was shown in tandem position. A between-group comparison showed a significant reduction in COP velocity in the sagittal plane (P=0.030 during quiet standing and in the frontal plane (P=0.001 during standing on foam, whereas no significant reduction in COP parameters during tandem position was found. It is recommended that twelve sessions of forward and backward treadmill walk are effective in balance improvement in elderly people. Trial Registration Number: IRCT201209199440N2

  8. Postural control among elderly women with and without osteoporosis: is there a difference?

    Thomaz Nogueira Burke

    Full Text Available CONTEXT AND OBJECTIVE: Little is known about postural control among elderly individuals with osteoporosis and its relationship with falls. It has been suggested that elderly women with kyphosis and osteoporosis are at greater risk of falling. The aim of this study was to evaluate posture and postural control among elderly women with and without osteoporosis. DESIGN AND SETTING: Cross-sectional study conducted at the Physical Therapy and Electromyography Laboratory, School of Medicine, Universidade de São Paulo (USP. METHODS: Sixty-six elderly women were selected from the bone metabolism disorders clinic, Division of Rheumatology, USP, and were divided into two groups: osteoporosis and controls, according to their bone mineral density (BMD. Postural control was assessed using the Limits of Stability (LOS test and the Modified Clinical Test of Sensory Interaction and Balance (CTSIBm and posture, using photometry. RESULTS: The elderly women with osteoporosis swayed at higher velocity on a stable surface with opened eyes (0.30 versus 0.20 degrees/second; P = 0.038. In both groups, the center of pressure (COP was at 30% in the LOS, but with different placements: 156° in the osteoporosis group and 178° in the controls (P = 0.045. Osteoporosis patients fell more than controls did (1.0 versus 0.0; P = 0.036. CONCLUSIONS: The postural control in elderly women with osteoporosis differed from that of the controls, with higher sway velocity and maximum displacement of COP. Despite postural abnormalities such as hyperkyphosis and forward head, the COP position was posteriorized.

  9. The Association between Spiritual Health and Blood Sugar Control in Elderly Patients with Type 2 Diabetes

    Moradali Zareipour

    2016-12-01

    Full Text Available Introduction: Spirituality is taken deeply into consideration as a part of health because of its role in the control of chronic diseases and its importance in determination of life purpose in the elderly. This study aimed to investigate the association between spiritual health and blood sugar control in elderly patients with type 2 diabetes. Methods: This cross-sectional study was conducted on 200 elderly patients with type 2 diabetes from 10 rural health centers of Urmia city, North West of Iran. These patients were selected by cluster random sampling. Data were collected by Spiritual Well-Being Scale of Paloutzian and Ellison. Glycated hemoglobin (HbA1c was used to measure blood sugar control status of diabetic patients. Data were analyzed using descriptive statistics and chi-square test and Pearson correlation coefficient in SPSS software. Results: The spiritual health score in 43% of the elderly with diabetes was moderate and 57 % had high spiritual health level. There was statistically significant relationship between Spiritual health and gender, age, education, occupation and economic status. The results also showed that there was no significant correlation between spiritual health and its subdomains with HbA1c (r=0.07. Conclusion: In this study, there was no statistically significant difference between spiritual health scores in patients with uncontrolled and controlled blood sugar. It is suggested to conduct case-control study with larger sample size on factors affecting blood sugar control.

  10. Efficacy and safety of minor endoscopic sphincterotomy combined with endoscopic papillary large balloon dilation in treatment of elderly patients with multiple large common bile duct stones

    HE Yongfeng

    2018-02-01

    Full Text Available Objective To investigate the clinical effect and safety of minor endoscopic sphincterotomy (mEST combined with endoscopic papillary large balloon dilation (EPLBD in the treatment of elderly patients with multiple large common bile duct stones. MethodsA retrospective analysis was performed for 229 patients with multiple large common bile duct stones who underwent endoscopic retrograde cholangiopancreatography (ERCP in Endoscopy Center, Ankang Municipal Central Hospital, from January 2012 to December 2016, and the surgical procedure was selected based on the size of stones and the morphology of the common bile duct. According to the endoscopic surgical procedure, the patients were divided into mEST+EPLBD group (treatment group with 136 patients and endoscopic phincterotomy (EST group (control group with 93 patients. The two groups were compared in terms of the success rate of first stone removal, use rate of mechanical lithotripsy (ML, time spent on stone removal, and the incidence rate of complications. The t-test was used for comparison of continuous data between groups, and the chi-square test was used for comparison of categorical data between groups. ResultsThere was no significant difference in the success rate of first stone removal between the treatment group and the control group (91.17% vs 87.10%, χ2=0.980, P>0.05, while there were significant differences in the time spent on stone removal (18.2±4.3 min vs 37.4±6.7 min, χ2=37.1526, P<0.01 and use rate of ML (6.71% vs 40.00%, t=24.411, P<0.01. There were no significant differences in the incidence rates of pancreatitis (2.94% vs 6.45%, χ2=1.630, P>0.05 and bleeding (2.21% vs 2.15%, χ2=0.001, P>0.05 between the two groups, and no patient experienced perforation or infection. ConclusionmEST+EPLBD has a good clinical effect in the treatment of elderly patients with multiple large common bile duct stones and can effectively shorten the time spent on stone removal, reduce the

  11. Controllability of partial differential equations governed by multiplicative controls

    Khapalov, Alexander Y

    2010-01-01

    The goal of this monograph is to address the issue of the global controllability of partial differential equations in the context of multiplicative (or bilinear) controls, which enter the model equations as coefficients. The mathematical models we examine include the linear and nonlinear parabolic and hyperbolic PDE's, the Schrödinger equation, and coupled hybrid nonlinear distributed parameter systems modeling the swimming phenomenon. The book offers a new, high-quality and intrinsically nonlinear methodology to approach the aforementioned highly nonlinear controllability problems.

  12. Comparison of timing and force control of foot tapping between elderly and young subjects.

    Takimoto, Koji; Takebayashi, Hideaki; Miyamoto, Kenzo; Takuma, Yutaka; Inoue, Yoshikazu; Miyamoto, Shoko; Okabe, Takao; Okuda, Takahiro; Kaba, Hideto

    2016-06-01

    [Purpose] To examine the ability of young and elderly individuals to control the timing and force of periodic sequential foot tapping. [Subjects and Methods] Participants were 10 young (age, 22.1 ± 4.3 years) and 10 elderly individuals (74.8 ± 6.7 years) who were healthy and active. The foot tapping task consisted of practice (stimulus-synchronized tapping with visual feedback) and recall trials (self-paced tapping without visual feedback), periodically performed in this order, at 500-, 1,000-, and 2,000-ms target interstimulus-onset intervals, with a target force of 20% maximum voluntary contraction of the ankle plantar-flexor muscle. [Results] The coefficients of variation of force and intertap interval, used for quantifying the steadiness of the trials, were significantly greater in the elderly than in the young individuals. At the 500-ms interstimulus-onset interval, age-related effects were observed on the normalized mean absolute error of force, which was used to quantify the accuracy of the trials. The coefficients of variation of intertap interval for elderly individuals were significantly greater in the practice than in the recall trials at the 500- and 1,000-ms interstimulus-onset intervals. [Conclusion] The elderly individuals exhibited greater force and timing variability than the young individuals and showed impaired visuomotor processing during foot tapping sequences.

  13. Ethical Issues Relative to Autonomy and Personal Control in Independent and Cognitively Impaired Elders.

    Rice, Virginia Hill; And Others

    1997-01-01

    Discusses ethical issues surrounding health care for independent elders, those in long-term care, and those with cognitive impairments, as well as death, dying, euthanasia, and assisted suicide. Suggests that nurses should focus on older adults' choice, autonomy, and personal control. (SK)

  14. Glycaemic control and the risk of mortality in elderly type 2 diabetic patients (ZODIAC-20)

    van Hateren, K. J. J.; Kleefstra, N.; Drion, I.; Groenier, K. H.; Houweling, S. T.; Bilo, H. J. G.; Landman, G.

    P>Aims: Studies on macrovascular consequences of glucose control in elderly patients (> 75 years) with type 2 diabetes mellitus (T2DM) are lacking. The present study aimed to investigate the relationship between HbA(1c) and mortality in this specific population. Methods: Between 1998 and 1999, 374

  15. Occupational therapy for elderly : evidence mapping of randomised controlled trials from 2004-2012

    Voigt-Radloff, S; Ruf, G.; Vogel, A.; van Nes, F.; Hüll, M.

    OBJECTIVE: Previous systematic reviews on occupational therapy for elderly included studies until 2003. The present evidence mapping summarizes recent evidence for the efficacy of occupational therapy with older persons based on randomised controlled trials from 2004-2012. METHOD: An electronic

  16. Multiple sclerosis in the Faroe Islands. 7. Results of a case control questionnaire with multiple controls

    Kurtzke, J F; Hyllested, K; Arbuckle, J D

    1997-01-01

    Detailed questionnaires were completed in 1978-79 by 23 of the 28 then known resident Faroese multiple sclerosis (MS) patients and 127 controls. These controls were divided into 69 Group A (patient sibs and other relatives), 37 Group B (matched neighbor controls, their spouses and sibs, plus...... facilities, and nature of house construction or heating. Detailed dietary histories, available for half the subjects, revealed no differences, cases versus controls, for four age periods between age 0 and 30 years, and for 16 specified foodstuffs. Animal exposures showed overall no consistent differences...

  17. Active control of multiple resistive wall modes

    Brunsell, P. R.; Yadikin, D.; Gregoratto, D.; Paccagnella, R.; Liu, Y. Q.; Bolzonella, T.; Cecconello, M.; Drake, J. R.; Kuldkepp, M.; Manduchi, G.; Marchiori, G.; Marrelli, L.; Partin, P.; Menmuir, S.; Ortolani, S.; Rachlew, E.; Spizzo, S.; Zanca, P.

    2005-01-01

    Active magnetic feedback suppression of resistive wall modes is of common interest for several fusion concepts relying on close conducting walls for stabilization of ideal magnetohydrodynamic (MHD) modes. In the advanced tokamak without plasma rotation the kink mode is not completely stabilized, but rather converted into an unstable resistive wall mode (RWM) with a growth time comparable to the wall magnetic flux penetration time. The reversed field pinch (RFP) is similar to the advanced tokamak in the sense that it uses a conducting wall for kink mode stabilization. Also both configurations are susceptible to resonant field error amplification of marginally stable modes. However, the RFP has a different RWM spectrum and, in general, a range of modes is unstable. Hence, the requirement for simultaneous feedback stabilization of multiple independent RWMs arises for the RFP configuration. Recent experiments on RWM feedback stabilization, performed in the RFP device EXTRAP T2R [1], are presented. The experimental results obtained are the first demonstration of simultaneous feedback control of multiple independent RWMs [2]. Using an array of active magnetic coils, a reproducible suppression of several RWMs is achieved for the duration of the discharge, 3-5 wall times, through feedback action. An array with 64 active saddle coils at 4 poloidal times 16 toroidal positions is used. The important issues of side band generation by the active coil array and the accompanying coupling of different unstable modes through the feedback action are addressed in this study. Open loop control experiments have been carried out to quantitatively study resonant field error amplification. (Author)

  18. Vibration perception threshold in relation to postural control and fall risk assessment in elderly.

    de Mettelinge, Tine Roman; Calders, Patrick; Palmans, Tanneke; Vanden Bossche, Luc; Van Den Noortgate, Nele; Cambier, Dirk

    2013-09-01

    This study investigates (i) the potential discriminative role of a clinical measure of peripheral neuropathy (PN) in assessing postural performance and fall risk and (ii) whether the integration of a simple screening vibration perception threshold (VPT) for PN in any physical (fall risk) assessment among elderly should be recommended, even if they do not suffer from DM. One hundred and ninety-five elderly were entered in a four-group model: DM with PN (D+; n = 75), DM without PN (D-; n = 28), non-diabetic elderly with idiopathic PN (C+; n = 31) and non-diabetic elderly without PN (C-; n = 61). Posturographic sway parameters were captured during different static balance conditions (AMTI AccuGait, Watertown, MA). VPT, fall data, Mini-Mental State Examination and Clock Drawing Test were registered. Two-factor repeated-measures ANOVA was used to compare between groups and across balance conditions. The groups with PN demonstrated a strikingly comparable, though bigger sway, and a higher prospective fall incidence than their peers without PN. The indication of PN, irrespective of its cause, interferes with postural control and fall incidence. The integration of a simple screening for PN (like bio-thesiometry) in any fall risk assessment among elderly is highly recommended. Implications for Rehabilitation The indication of peripheral neuropathy (PN), irrespective of its cause, interferes with postural control and fall incidence. Therefore, the integration of a simple screening for PN (like bio-thesiometry) in any fall risk assessment among elderly is highly recommended. It might be useful to integrate somatosensory stimulation in rehabilitation programs designed for fall prevention.

  19. The effect of community-based health management on the health of the elderly: a randomized controlled trial from China

    Chao Jianqian

    2012-12-01

    Full Text Available Abstract Background An aging population poses significant challenges to health care in China. Health management has been implemented to reduce the costs of care, raise health service utilization, increase health knowledge and improve quality of life. Several studies have tried to verify the effectiveness of health management in achieving these goals worldwide. However, there have been insufficient randomized control trials (RCTs to draw reliable conclusions. The few small-scale studies conducted in China include mostly the general population rather than the elderly. Our study is designed to evaluate the impact of community-based health management on the health of the elderly through an RCT in Nanjing, China. Methods Two thousand four hundred participants, aged 60 or older and who gave informed consent, were randomly allocated 1:1 into management and control groups, the randomization schedule was concealed from community health service center staff until allocation. Community-based health management was applied in the former while the latter was only given usual care. After 18 months, three categories of variables (subjective grading health indices, objective health indices and health service utilization were measured based on a questionnaire, clinical monitoring and diagnostic measurements. Differences between the two groups were assessed before and after the intervention and analyzed with t-test, χ2-test, and multiple regression analysis. Results Compared with the control group, the management group demonstrated improvement on the following variables (P Conclusion Community-based health management improved both subjective grading health indices, objective health indices and decreased the number of outpatient clinic visits, demonstrating effectiveness in improving elderly health. Trial registration ChiCTR-OCH-11001716

  20. Watching elderly and disabled person's physical condition by remotely controlled monorail robot

    Nagasaka, Yasunori; Matsumoto, Yoshinori; Fukaya, Yasutoshi; Takahashi, Tomoichi; Takeshita, Toru

    2001-10-01

    We are developing a nursing system using robots and cameras. The cameras are mounted on a remote controlled monorail robot which moves inside a room and watches the elderly. It is necessary to pay attention to the elderly at home or nursing homes all time. This requires staffs to pay attention to them at every time. The purpose of our system is to help those staffs. This study intends to improve such situation. A host computer controls a monorail robot to go in front of the elderly using the images taken by cameras on the ceiling. A CCD camera is mounted on the monorail robot to take pictures of their facial expression or movements. The robot sends the images to a host computer that checks them whether something unusual happens or not. We propose a simple calibration method for positioning the monorail robots to track the moves of the elderly for keeping their faces at center of camera view. We built a small experiment system, and evaluated our camera calibration method and image processing algorithm.

  1. Eating habits and appetite control in the elderly: the anorexia of aging.

    Donini, Lorenzo M; Savina, Claudia; Cannella, Carlo

    2003-03-01

    Although a high prevalence of overweight is present in elderly people, the main concern in the elderly is the reported decline in food intake and the loss of the motivation to eat. This suggests the presence of problems associated with the regulation of energy balance and the control of food intake. A reduced energy intake causing body weight loss may be caused by social or physiological factors, or a combination of both. Poverty, loneliness, and social isolation are the predominant social factors that contribute to decreased food intake in the elderly. Depression, often associated with loss or deterioration of social networks, is a common psychological problem in the elderly and a significant cause of loss of appetite. The reduction in food intake may be due to the reduced drive to eat (hunger) resulting from a lower need state, or it arises because of more rapidly acting or more potent inhibitory (satiety) signals. The early satiation appears to be predominantly due to a decrease in adaptive relaxation of the stomach fundus resulting in early antral filling, while increased levels and effectiveness of cholecystokinin play a role in the anorexia of aging. The central feeding drive (both the opioid and the neuropeptide Y effects) appears to decline with age. Physical factors such as poor dentition and ill-fitting dentures or age-associated changes in taste and smell may influence food choice and limit the type and quantity of food eaten in older people. Common medical conditions in the elderly such as gastrointestinal disease, malabsorption syndromes, acute and chronic infections, and hypermetabolism often cause anorexia, micronutrient deficiencies, and increased energy and protein requirements. Furthermore, the elderly are major users of prescription medications, a number of which can cause malabsorption of nutrients, gastrointestinal symptoms, and loss of appetite. There is now good evidence that, although age-related reduction in energy intake is largely a

  2. Altered center of mass control during sit-to-walk in elderly adults with and without history of falling.

    Chen, Tzurei; Chou, Li-Shan

    2013-09-01

    Sit-to-walk (STW) is a commonly performed activity of daily living that requires a precise coordination between momentum generation and balance control. However, there is a lack of biomechanical data demonstrating how the center of mass (COM) momentum and balance control interact. This study examines COM kinetic energy distribution in three movement directions and COM-Ankle inclination angles during STW among 15 healthy young adults, 15 elderly non-fallers, and 15 elderly fallers. We found that elderly adults, especially elderly fallers, chose a COM control strategy that provided more stability than mobility to perform STW. A smaller forward COM velocity, a more upward COM momentum distribution, and a smaller anterior-posterior COM-Ankle angle characterize this strategy. Healthy elderly adults modified their STW movement around seat-off so that they achieved a more upright position before walking. Elderly fallers not only altered COM control around seat-off but also showed limitation in COM control during gait initiation. Furthermore, their COM control in the medial-lateral direction might be perturbed at swing-off due to an increased distribution of kinetic energy. Examining COM momentum distribution in different movement directions and the relationship between positions of the COM and supporting foot during STW could enhance our ability to identify elderly adults who are at risk of falling. Copyright © 2013 Elsevier B.V. All rights reserved.

  3. Elder Care, Multiple Role Involvement, and Well-Being Among Middle-Aged Men and Women in Japan.

    Kikuzawa, Saeko

    2015-12-01

    Japan's population is aging at an unprecedented rate. Combined with the tradition of family responsibility for elder care, this rapid population aging has resulted in middle-aged Japanese people being much more likely today than in past decades to face the responsibility of caring for their elderly parents alongside their other major roles. Using nationally representative Japanese data, this study assessed the individual and combined implications of caregiving and other role involvements for the well-being of middle-aged men and women. Some evidence was found for deleterious psychological consequences of the caregiver role. However, in contrast to expectations, the interaction between the roles of caregiver and worker was positively associated with well-being among both men and women. The results suggest the importance of middle-aged adults being able to keep working when they have to care for their aging parents. Another important finding was significant gender differences in the psychological consequences of holding multiple family- and work-related roles and in combining these with the caregiver role. Further analysis showed that the spousal role was also negatively associated with depressive symptoms and positively associated with satisfaction for men but not for women. Gender differences in the findings appear to reflect the significant gender asymmetry in role experiences in Japan.

  4. Patterns of relapse and outcome of elderly multiple myeloma patients treated as front-line therapy with novel agents combinations

    Aurelio Lopez

    2015-01-01

    Full Text Available We report the characteristics of relapse, treatment response, and outcomes of 145 elderly patients with multiple myeloma in first relapse after front-line treatment with VMP or VTP. Reappearance of CRAB symptoms (113 patients and more aggressive forms of disease (32 patients were the most common patterns of relapse. After second-line therapy, 75 (51.7% patients achieved at partial response and 16 (11% complete response (CR. Overall survival was longer among patients receiving VMP as front-line induction (21.4 vs. 14.4 months, P=0.037, in patients achieving CR (28.3 vs. 14.8 months; P=0.04, and in patients without aggressive relapse (28.6 vs. 7.6 months; P=0.0007.

  5. Correlation between the use of 'over-the-counter' medicines and adherence in elderly patients on multiple medications

    Olesen, Charlotte; Harbig, Philipp; Barat, Ishay

    2014-01-01

    (herbal medicines, dietary supplements, or non-prescribed drugs) was elicited during home visit interviews. Prescription drug adherence was determined by pill counts. A patient was categorised as non-adherent if the mean adherence rate for all drugs consumed was ... to be adherent than were non-users (odds ratio 0.41; 95 % confidence interval 0.18–0.91). Sensitivity analyses where adherence was defined different show no relationship between adherence and use of OTC medicine. Furthermore, separate analyses of herbal medicines, dietary supplements, or non-prescribed drugs did...... not correlate with adherence to prescriptions. Conclusion Amongst elderly patients on multiple medications a positive relationship was found between the overall use of OTC medicines and adherence to prescription drugs, in contrast to none when adherence were defined different or herbal medicines, dietary...

  6. Patterns of relapse and outcome of elderly multiple myeloma patients treated as front-line therapy with novel agents combinations☆

    Lopez, Aurelio; Mateos, Maria-Victoria; Oriol, Albert; Valero, Marta; Martínez, Joaquín; Lorenzo, Jose Ignacio; Perez, Montserrat; Martinez, Rafael; de Paz, Raquel; Granell, Miguel; De Arriba, Felipe; Blanchard, M. Jesús; Peñalver, Francisco Javier; Bello, Jose Luis; Martin, Maria Luisa; Bargay, Joan; Blade, Joan; Lahuerta, Juan Jose; San Miguel, Jesús F.; de la Rubia, Javier

    2015-01-01

    We report the characteristics of relapse, treatment response, and outcomes of 145 elderly patients with multiple myeloma in first relapse after front-line treatment with VMP or VTP. Reappearance of CRAB symptoms (113 patients) and more aggressive forms of disease (32 patients) were the most common patterns of relapse. After second-line therapy, 75 (51.7%) patients achieved at partial response and 16 (11%) complete response (CR). Overall survival was longer among patients receiving VMP as front-line induction (21.4 vs. 14.4 months, P=0.037), in patients achieving CR (28.3 vs. 14.8 months; P=0.04), and in patients without aggressive relapse (28.6 vs. 7.6 months; P=0.0007). PMID:26500850

  7. Social priming improves cognitive control in elderly adults--evidence from the Simon task.

    Daniela Aisenberg

    Full Text Available We examined whether social priming of cognitive states affects the inhibitory process in elderly adults, as aging is related to deficits in inhibitory control. Forty-eight elderly adults and 45 young adults were assigned to three groups and performed a cognitive control task (Simon task, which was followed by 3 different manipulations of social priming (i.e., thinking about an 82 year-old person: 1 negative--characterized by poor cognitive abilities, 2 neutral--characterized by acts irrelevant to cognitive abilities, and 3 positive--excellent cognitive abilities. After the manipulation, the Simon task was performed again. Results showed improvement in cognitive control effects in seniors after the positive manipulation, indicated by a significant decrease in the magnitude of the Simon and interference effects, but not after the neutral and negative manipulations. Furthermore, a healthy pattern of sequential effect (Gratton that was absent before the manipulation in all 3 groups appeared after the positive manipulation. Namely, the Simon effect was only present after congruent but not after incongruent trials for the positive manipulation group. No influence of manipulations was found in young adults. These meaningful results were replicated in a second experiment and suggest a decrease in conflict interference resulting from positive cognitive state priming. Our study provides evidence that an implicit social concept of a positive cognitive condition in old age can affect the control process of the elderly and improve cognitive abilities.

  8. Adiposity and postural balance control: correlations between bioelectrical impedance and stabilometric signals in elderly Brazilian women

    Míriam Raquel Meira Mainenti

    2011-01-01

    Full Text Available OBJECTIVE: The purpose of this study was to investigate the correlation between body adiposity and postural control in elderly women. INTRODUCTION: Aging and obesity account for a significant portion of healthcare spending. Life expectancy is increasing worldwide, and Rio de Janeiro has the largest proportion of elderly residents of all Brazilian states. METHODS: A total of 45 women underwent bioelectrical impedance analysis, waist circumference measurements, weight and height measurements, and stabilometric tests in eight different stance conditions (opened and closed bases with both eyes opened and closed and right and left tandem and unilateral stances with eyes opened. During unilateral stances, the number of hand or foot contacts was counted. RESULTS: Weight, body mass index, waist circumference, fat percentage, and fat mass showed statistically significant (p,0.05 and positive correlations with the number of contacts made during unilateral stances. The subjects with greater fat mass showed significantly higher anterior-posterior standard deviation and range when their eyes were closed. The sway area was also greater for this group in opened base when their eyes were closed. DISCUSSION: The results relating body adiposity and postural control can be explained by the difficulty of maintaining a greater quantity of body fat mass within the limits of the individual support base, especially while assuming a unilateral stance. CONCLUSION: The subjects with a greater fat mass exhibited poor balance control, indicating that body adiposity level was associated with postural control in the elderly women examined in the present study.

  9. Social priming improves cognitive control in elderly adults--evidence from the Simon task.

    Aisenberg, Daniela; Cohen, Noga; Pick, Hadas; Tressman, Iris; Rappaport, Michal; Shenberg, Tal; Henik, Avishai

    2015-01-01

    We examined whether social priming of cognitive states affects the inhibitory process in elderly adults, as aging is related to deficits in inhibitory control. Forty-eight elderly adults and 45 young adults were assigned to three groups and performed a cognitive control task (Simon task), which was followed by 3 different manipulations of social priming (i.e., thinking about an 82 year-old person): 1) negative--characterized by poor cognitive abilities, 2) neutral--characterized by acts irrelevant to cognitive abilities, and 3) positive--excellent cognitive abilities. After the manipulation, the Simon task was performed again. Results showed improvement in cognitive control effects in seniors after the positive manipulation, indicated by a significant decrease in the magnitude of the Simon and interference effects, but not after the neutral and negative manipulations. Furthermore, a healthy pattern of sequential effect (Gratton) that was absent before the manipulation in all 3 groups appeared after the positive manipulation. Namely, the Simon effect was only present after congruent but not after incongruent trials for the positive manipulation group. No influence of manipulations was found in young adults. These meaningful results were replicated in a second experiment and suggest a decrease in conflict interference resulting from positive cognitive state priming. Our study provides evidence that an implicit social concept of a positive cognitive condition in old age can affect the control process of the elderly and improve cognitive abilities.

  10. Relative null controllability of linear systems with multiple delays in ...

    varying multiple delays in state and control are developed. If the uncontrolled system is uniformly asymptotically stable, and if the linear system is controllable, then the linear system is null controllable. Journal of the Nigerian Association of ...

  11. Disability and quality of life in community-dwelling elderly cancer survivors: Case-control study in the Korean population.

    Lee, Myung Kyung

    2016-10-01

    Advanced age is a significant risk factor for cancer and functional disabilities increase with age. The purpose of this case-control study of Korean individuals was to determine the effect of cancer and cancer treatment on functional disability and quality of life (QOL). Thus, we compared community-dwelling elderly cancer patients (ECPs) with individuals from the general elderly population (GEP) who never had diagnoses of cancer. We selected 1776 ECP who were at least 65 years-old from the 2008 Korean Community Health Survey data and used propensity score matching to randomly select 1766 individuals from the GEP who closely resembled the ECPs. Functional disability was measured using the Instrumental Activities of Daily Living (IADL) scale, and QOL was measured by the EuroQol Group EQ-5D. ECPs were more dependent in preparation of food, doing laundry, and shopping (IADL scale), and in mobility and usual activities (EQ-5D). Although ECP had more problems with pain, discomfort, anxiety, and depression, they were more independent in self-care and handling of financial responsibilities. ECPs had multiple physical and psychological symptoms that adversely affected functional disability and QOL, but higher functional ability, such as self-care and handling of financial responsibilities. Promotion of self-care by ECPs is pivotal for effective management in community practice. Copyright © 2016 Elsevier Ltd. All rights reserved.

  12. Optimization of Inventories for Multiple Companies by Fuzzy Control Method

    Kawase, Koichi; Konishi, Masami; Imai, Jun

    2008-01-01

    In this research, Fuzzy control theory is applied to the inventory control of the supply chain between multiple companies. The proposed control method deals with the amountof inventories expressing supply chain between multiple companies. Referring past demand and tardiness, inventory amounts of raw materials are determined by Fuzzy inference. The method that an appropriate inventory control becomes possible optimizing fuzzy control gain by using SA method for Fuzzy control. The variation of ...

  13. [Value of dynamic postural control tests on elderly people with vestibulopathy].

    Ortuño-Cortés, Miguel A; Martín-Sanz, Eduardo; Barona-de Guzmán, Rafael

    2009-01-01

    The stability limits and rhythmic weight shift tests study the functional capacity to achieve voluntary postural control of movement in the standing position. The objectives of this paper are to know the interest of these tests in the evaluation of elderly people with vestibular disorders and their relation with the number of falls suffered during the year prior to the study. Sixty elderly people (65-80 years old) with vestibular disorders (patients) and 60 healthy subjects (control group) of similar age were selected. According to videonystagmographic and clinical criteria, the patients group was divided into compensated and decompensated. All the subjects in the sample performed the stability limits and rhythmic weight shift tests with the NedSVE/IBV system. The number of falls of each subject was determined by a meticulous anamnesis. Compensated patients, decompensated patients and the control group had similar scores in this instrumental functional evaluation, without any statistically significant differences. None of the parameters assessed in this study correlated statistically with the subjects' number of falls during the year prior to the study. The stability limits and rhythmic weight shift tests are of little utility in the functional evaluation of the elderly with vestibular disorders and in the detection of patients with greater risk of falls.

  14. Arginine and antioxidant supplement on performance in elderly male cyclists: a randomized controlled trial

    Carpenter Catherine L

    2010-03-01

    Full Text Available Abstract Background Human exercise capacity declines with advancing age. These changes often result in loss of physical fitness and more rapid senescence. Nitric oxide (NO has been implicated in improvement of exercise capacity through vascular smooth muscle relaxation in both coronary and skeletal muscle arteries, as well as via independent mechanisms. Antioxidants may prevent nitric oxide inactivation by oxygen free radicals. The purpose of this study was to investigate the effects of an L-arginine and antioxidant supplement on exercise performance in elderly male cyclists. Methods This was a two-arm prospectively randomized double-blinded and placebo-controlled trial. Sixteen male cyclists were randomized to receive either a proprietary supplement (Niteworks®, Herbalife International Inc., Century City, CA or a placebo powder. Exercise parameters were assessed by maximal incremental exercise testing performed on a stationary cycle ergometer using breath-by-breath analysis at baseline, week one and week three. Results There was no difference between baseline exercise parameters. In the supplemented group, anaerobic threshold increased by 16.7% (2.38 ± 0.18 L/min, p 2 max between control and intervention groups at either week 1 or week 3 by comparison to baseline. Conclusion An arginine and antioxidant-containing supplement increased the anaerobic threshold at both week one and week three in elderly cyclists. No effect on VO2 max was observed. This study indicated a potential role of L-arginine and antioxidant supplementation in improving exercise performance in elderly.

  15. Effects of horticultural therapy on elderly' health: protocol of a randomized controlled trial.

    Chan, Hui Yu; Ho, Roger Chun-Man; Mahendran, Rathi; Ng, Kheng Siang; Tam, Wilson Wai-San; Rawtaer, Iris; Tan, Chay Hoon; Larbi, Anis; Feng, Lei; Sia, Angelia; Ng, Maxel Kian-Wee; Gan, Goh Lee; Kua, Ee Heok

    2017-08-29

    Due to a rapidly ageing population in the world, it is increasingly pertinent to promote successful ageing strategies which are cost-effective, easily accessible, and more likely to be acceptable to the elderly. Past research associates exposure to natural environments and horticultural therapy (HT) with positive psychological, social and physical health benefits. This Randomized Controlled Trial (RCT) is designed to evaluate the efficacy of HT in promoting Asian elderly' mental health, cognitive functioning and physical health. 70 elderly participants aged 60 to 85 years old will be randomized to participate in either the active horticultural therapy group or be in the waitlist control. Sessions will be weekly for 12 weeks, and monthly for 3 months. Mental health will be assessed through self-reports of depressive and anxiety symptomatology, life satisfaction, social connectedness and psychological well-being, collaborated with immunological markers. Outcome measures of cognitive functioning and physical health include neuropsychological tests of cognitive function and basic health screening. Outcomes will be assessed at baseline, 3 months and 6 months post-intervention. This RCT comprehensively investigates the efficacy of a non-invasive intervention, HT, in enhancing mental health, cognitive functioning and physical health. The results have tremendous potential for supporting future successful ageing programs and applicability to larger populations. ClinicalTrials.gov NCT02495194 . Trial registration date: July 13, 2015. Retrospectively registered.

  16. Inventory control with multiple setup costs

    Alp, O.; Huh, W.T.; Tan, T.

    2014-01-01

    We consider an infinite-horizon, periodic-review, single-item production/inventory system with random demand and backordering, where multiple setups are allowed in any period and a separate fixed cost is associated for each setup. Contrary to the majority of the literature on this topic, we do not

  17. The Future E-Living for Elderly: The Use of Remote Controlled Devices

    Sanches Lam

    2010-02-01

    Full Text Available Elderly populations are growing globally, the need for assistive technologies to facilitate ageing-in-place becomes more prominent for researchers and legislators. Understanding the use of remote controlled devices is crucial to optimize design and application strategies that may reduce caregiver burden, extend healthy ageing in place, and minimize demands on the health care system. This paper will establish strategies for assistance to the elderly in ageing-in-place for the future e-living environment. This research study is to explore attitudes, opinions, and preferences of older adults concerning the use of online technology to support and extend their ability to “ageing in place.” Four major themes emerged as important for older adults to age in place: safety and independence, social interaction, use of technology in the past, and the desire for support.

  18. Automatic detection of health changes using statistical process control techniques on measured transfer times of elderly.

    Baldewijns, Greet; Luca, Stijn; Nagels, William; Vanrumste, Bart; Croonenborghs, Tom

    2015-01-01

    It has been shown that gait speed and transfer times are good measures of functional ability in elderly. However, data currently acquired by systems that measure either gait speed or transfer times in the homes of elderly people require manual reviewing by healthcare workers. This reviewing process is time-consuming. To alleviate this burden, this paper proposes the use of statistical process control methods to automatically detect both positive and negative changes in transfer times. Three SPC techniques: tabular CUSUM, standardized CUSUM and EWMA, known for their ability to detect small shifts in the data, are evaluated on simulated transfer times. This analysis shows that EWMA is the best-suited method with a detection accuracy of 82% and an average detection time of 9.64 days.

  19. Effects of two exercise protocols on postural balance of elderly women: a randomized controlled trial.

    Mesquita, Laiana Sepúlveda de Andrade; de Carvalho, Fabiana Texeira; Freire, Lara Sepúlveda de Andrade; Neto, Osmar Pinto; Zângaro, Renato Amaro

    2015-06-02

    The aging process reduces both sensory capabilities and the capabilities of the motor systems responsible for postural control, resulting in a high number of falls among the elderly. Some therapeutic interventions can directly interrupt this process, including physical exercise. This study compares and examines the effects of two exercise protocols on the balance of elderly women. Elderly women who participated in a local church project (n = 63) were randomly divided into three groups: the proprioceptive neuromuscular facilitation group (PNFG), Pilates group (PG), and control group (CG). Of the 63 women, 58 completed the program. A training program involving 50-min sessions was performed in the PNFG and PG three times a week for 4 weeks. The elderly women in the CG received no intervention and continued with their daily activities. Stabilometric parameters, the Berg Balance Scale score, functional reach test, and timed up and go test (TUG test) were assessed before and 1 month after participation. In the comparison among groups, the women in the PNFG showed a significant reduction in most of the stabilometric parameters evaluated and better Berg Balance Scale score, functional reach test result, and TUG test result than did women in the CG (p functional reach test and TUG test than did women in the CG (p < 0.05). Women in the PNFG showed significantly better static and dynamic balance than did women in the CG. Women in the PG also showed better dynamic balance than did women in the CG. However, no significant differences were observed in any of the balance variables assessed between the PNFG and PG. clinicaltrials.gov, number NCT02278731.

  20. The effect of general and spinal anesthesia on balance control in elderly patients.

    Suárez, Alejo; Macadar, Omar

    2008-01-01

    Falls are a major problem in the elderly population, but few communications address the influence of anesthesia on balance control. This study reports how a general balanced anesthesia (GBA) and a spinal anesthesia (SA) affect balance control in the elderly. We divided into three groups, according to electronystagmography findings and type of anesthesia, 21 men older than 65 years (mean age, 72 years) who were scheduled for prostate adenectomy. One group, designated GBN, consisted of normal subjects who underwent surgery under GBA. In another group, designated GBP, were pathological subjects who had clinically compensated central vestibular disorders (CVDs) and underwent surgery under GBA. The third group, designated SP, contained CVD patients who underwent surgery under SA. We assessed balance control via static posturography preoperatively and 48 hours postoperatively. We observed no change in balance control parameters (center of pressure distribution area [COPa] or COP sway velocity [SV]) for those patients in the GBN group or for those in the SP group. We did observe a significant difference for the patients in the GBP group, with higher postoperative values of COPa and SV (Wilcoxon signed rank test). Our results showed that in subjects with clinically compensated underlying CVD prior to a GBA, balance control worsens after the procedure, whereas no change in balance control occurs after an SA. Balance control in subjects with normal vestibuloocular function did not change even after a GBA.

  1. Bortezomib, melphalan, prednisone (VMP) versus melphalan, prednisone, thalidomide (MPT) in elderly newly diagnosed multiple myeloma patients

    Morabito, Fortunato; Bringhen, Sara; Larocca, Alessandra

    2014-01-01

    Novel agents in combination with melphalan and prednisone (MP) significantly improved progression-free survival (PFS) and overall survival (OS) in multiple myeloma (MM). Randomized trials comparing MP plus bortezomib (VMP) versus MP plus thalidomide (MPT) are lacking. Nine hundred and fifty-six e...

  2. [Descending control of quiet standing and walking: a plausible neurophysiological basis of falls in elderly people].

    Nakajima, Masashi

    2011-03-01

    Quiet standing and walking are generally considered to be an automatic process regulated by sensory feedback. In our report "Astasia without abasia due to peripheral neuropathy," which was published in 1994, we proposed that forced stepping in patients lacking the ankle torque is a compensatory motor control in order to maintain an upright posture. A statistical-biomechanics approach to the human postural control system has revealed open-loop (descending) control as well as closed-loop (feedback) control in quiet standing, and fractal dynamics in stride-to-stride fluctuations of walking. The descending control system of bipedal upright posture and gait may have a functional link to cognitive domains. Increasing dependence on the descending control system with aging may play a role in falls in elderly people.

  3. Hierarchical Control for Multiple DC Microgrids Clusters

    Shafiee, Qobad; Dragicevic, Tomislav; Vasquez, Juan Carlos

    2014-01-01

    This paper presents a distributed hierarchical control framework to ensure reliable operation of dc Microgrid (MG) clusters. In this hierarchy, primary control is used to regulate the common bus voltage inside each MG locally. An adaptive droop method is proposed for this level which determines...

  4. Transcranial Magnetic Stimulation to Address Mild Cognitive Impairment in the Elderly: A Randomized Controlled Study

    Drumond Marra, Hellen Livia; Myczkowski, Martin Luiz; Maia Memória, Cláudia; Arnaut, Débora; Leite Ribeiro, Philip; Sardinha Mansur, Carlos Gustavo; Lancelote Alberto, Rodrigo; Boura Bellini, Bianca; Alves Fernandes da Silva, Adriano; Ciampi de Andrade, Daniel; Teixeira, Manoel Jacobsen; Forlenza, Orestes Vicente; Marcolin, Marco Antonio

    2015-01-01

    Transcranial magnetic stimulation (TMS) is a noninvasive brain stimulation technique with potential to improve memory. Mild cognitive impairment (MCI), which still lacks a specific therapy, is a clinical syndrome associated with increased risk of dementia. This study aims to assess the effects of high-frequency repetitive TMS (HF rTMS) on everyday memory of the elderly with MCI. We conducted a double-blinded randomized sham-controlled trial using rTMS over the left dorsolateral prefrontal cortex (DLPFC). Thirty-four elderly outpatients meeting Petersen's MCI criteria were randomly assigned to receive 10 sessions of either active TMS or sham, 10 Hz rTMS at 110% of motor threshold, 2,000 pulses per session. Neuropsychological assessment at baseline, after the last session (10th) and at one-month follow-up, was applied. ANOVA on the primary efficacy measure, the Rivermead Behavioural Memory Test, revealed a significant group-by-time interaction (p = 0.05), favoring the active group. The improvement was kept after one month. Other neuropsychological tests were heterogeneous. rTMS at 10 Hz enhanced everyday memory in elderly with MCI after 10 sessions. These findings suggest that rTMS might be effective as a therapy for MCI and probably a tool to delay deterioration. PMID:26160997

  5. Effects of Pilates method in elderly people: Systematic review of randomized controlled trials.

    de Oliveira Francisco, Cristina; de Almeida Fagundes, Alessandra; Gorges, Bruna

    2015-07-01

    The Pilates method has been widely used in physical training and rehabilitation. Evidence regarding the effectiveness of this method in elderly people is limited. Six randomized controlled trials studies involving the use of the Pilates method for elderly people, published prior to December 2013, were selected from the databases PubMed, MEDLINE, Embase, Cochrane, Scielo and PEDro. Three articles suggested that Pilates produced improvements in balance. Two studies evaluated the adherence to Pilates programs. One study assessed Pilates' influence on cardio-metabolic parameters and another study evaluated changes in body composition. Strong evidence was found regarding beneficial effects of Pilates over static and dynamic balance in women. Nevertheless, evidence of balance improvement in both genders, changes in body composition in woman and adherence to Pilates programs were limited. Effects on cardio-metabolic parameters due to Pilates training presented inconclusive results. Pilates may be a useful tool in rehabilitation and prevention programs but more high quality studies are necessary to establish all the effects on elderly populations. Copyright © 2015 Elsevier Ltd. All rights reserved.

  6. Multiple Property Cross Direction Control of Paper Machines

    Markku Ohenoja

    2011-07-01

    Full Text Available Cross direction (CD control in sheet-forming process forms a challenging problem with high dimensions. Accounting the interactions between different properties and actuators, the dimensionality increases further and also computational issues arise. We present a multiple property controller feasible to be used especially with imaging measurements that provide high sampling frequency and therefore enable short control interval. The simulation results state the benefits of multiple property CD control over single property control and single property control using full feedforward compensation. The controller presented may also be tuned in automated manner and the results demonstrate the effect of tuning on input saturation.

  7. Supporting multiple control systems at Fermilab

    Nicklaus, Dennis J.; /Fermilab

    2009-10-01

    The Fermilab control system, ACNET, is used for controlling the Tevatron and all of its pre-accelerators. However, other smaller experiments at Fermilab have been using different controls systems, in particular DOOCS and EPICS. This paper reports some of the steps taken at Fermilab to integrate support for these outside systems. We will describe specific tools that we have built or adapted to facilitate interaction between the architectures. We also examine some of the difficulties that arise from managing this heterogeneous environment. Incompatibilities as well as common elements will be described.

  8. Analysis of postural control and muscular performance in young and elderly women in different age groups.

    Gomes, Matheus M; Reis, Júlia G; Carvalho, Regiane L; Tanaka, Erika H; Hyppolito, Miguel A; Abreu, Daniela C C

    2015-01-01

    muscle strength and power are two factors affecting balance. The impact of muscle strength and power on postural control has not been fully explored among different age strata over sixty. the aim of the present study was to assess the muscle strength and power of elderly women in different age groups and determine their correlation with postural control. eighty women were divided into four groups: the young 18-30 age group (n=20); the 60-64 age group (n=20); the 65-69 age group (n=20); and the 70-74 age group (n=20). The participants underwent maximum strength (one repetition maximum or 1-RM) and muscle power tests to assess the knee extensor and flexor muscles at 40%, 70%, and 90% 1-RM intensity. The time required by participants to recover their balance after disturbing their base of support was also assessed. the elderly women in the 60-64, 65-69, and 70-74 age groups exhibited similar muscle strength, power, and postural control (p>0.05); however, these values were lower than those of the young group (ppostural control performance (ppostural control shown by these women.

  9. Managers’ Use of Multiple Management Control Systems

    Willert, Jeanette

    This dissertation addresses the topic Management Control Systems (MCS) as a Package. Many research studies investigate management and control systems individually, whereas fewer research studies take a holistic view and include a larger part of all the MCS managers use to guide and direct...... subordinates behaviour in the best interest of their companies. In the MCS literature, it is stressed that knowledge is particularly lacking about how managers design and use MCS as a package, and the effectiveness of using the MCS. This dissertation responds to this call by carrying out a large survey among...... executive managers in large companies, a survey that investigates the subject: Effective Management and Control Systems. The focus in the survey is to explore how executive management in large companies design and use their management control systems package. Further, this study is supplemented...

  10. Flight mission control for multiple spacecraft

    Ryan, Robert E.

    1990-10-01

    A plan developed by the Jet Propulsion Laboratory for mission control of unmanned spacecraft is outlined. A technical matrix organization from which, in the past, project teams were formed to uniquely support a mission is replaced in this new plan. A cost effective approach was needed to make best use of limited resources. Mission control is a focal point operations and a good place to start a multimission concept. Co-location and sharing common functions are the keys to obtaining efficiencies at minimum additional risk. For the projects, the major changes are sharing a common operations area and having indirect control of personnel. The plan identifies the still direct link for the mission control functions. Training is a major element in this plan. Personnel are qualified for a position and certified for a mission. This concept is more easily accepted by new missions than the ongoing missions.

  11. Prevalence, Awareness, Treatment and Control of Diabetes Among Elderly Persons in an Urban Slum of Delhi

    Arvind Kumar Singh

    2012-01-01

    Full Text Available Background : The increasing proportion of elderly persons is contributing to an increase in the prevalence of diabetes. The residents of urban slums are more vulnerable due to poverty and lack of access to health care. Objective: To estimate the prevalence of diabetes in elderly persons in an urban slum and to assess their awareness, treatment and control of this condition. Materials and Methods : All persons aged 60 years and above, residing in an urban slum of Delhi, were included in this cross-sectional community- based study. Data were collected on sociodemographic variables. The participants′ awareness and treatment of diabetes was recorded. Their fasting blood sugar was estimated using an automated glucometer. Diabetes was diagnosed if fasting blood glucose was ≥126 mg/dL, or if the participant was taking treatment for diabetes. Impaired fasting blood glucose was diagnosed if fasting blood glucose was 110-125 mg/dL. Results: Among the 474 participants studied, the prevalence of diabetes was estimated to be 18.8% (95% CI 15.3-21.5. It decreased with increasing age, and was higher among women. The prevalence of impaired fasting blood glucose was 19.8% (95% CI 16.3-23.7. It was higher among women. One-third of the diabetic participants were aware of their condition; two-thirds of these were on treatment and three-fourths of those on treatment had controlled fasting blood sugar level. The awareness, treatment and control were better among women. Conclusions : Diabetes is common among elderly persons in urban slums. Its magnitude and low awareness warrant effective public health interventions for their treatment and control.

  12. Fractal time series analysis of postural stability in elderly and control subjects

    Doussot Michel

    2007-05-01

    Full Text Available Abstract Background The study of balance using stabilogram analysis is of particular interest in the study of falls. Although simple statistical parameters derived from the stabilogram have been shown to predict risk of falls, such measures offer little insight into the underlying control mechanisms responsible for degradation in balance. In contrast, fractal and non-linear time-series analysis of stabilograms, such as estimations of the Hurst exponent (H, may provide information related to the underlying motor control strategies governing postural stability. In order to be adapted for a home-based follow-up of balance, such methods need to be robust, regardless of the experimental protocol, while producing time-series that are as short as possible. The present study compares two methods of calculating H: Detrended Fluctuation Analysis (DFA and Stabilogram Diffusion Analysis (SDA for elderly and control subjects, as well as evaluating the effect of recording duration. Methods Centre of pressure signals were obtained from 90 young adult subjects and 10 elderly subjects. Data were sampled at 100 Hz for 30 s, including stepping onto and off the force plate. Estimations of H were made using sliding windows of 10, 5, and 2.5 s durations, with windows slid forward in 1-s increments. Multivariate analysis of variance was used to test for the effect of time, age and estimation method on the Hurst exponent, while the intra-class correlation coefficient (ICC was used as a measure of reliability. Results Both SDA and DFA methods were able to identify differences in postural stability between control and elderly subjects for time series as short as 5 s, with ICC values as high as 0.75 for DFA. Conclusion Both methods would be well-suited to non-invasive longitudinal assessment of balance. In addition, reliable estimations of H were obtained from time series as short as 5 s.

  13. Simultaneous Multiple-Location Separation Control

    Greenblatt, David (Inventor)

    2009-01-01

    A method of controlling a shear layer for a fluid dynamic body introduces first periodic disturbances into the fluid medium at a first flow separation location. Simultaneously, second periodic disturbances are introduced into the fluid medium at a second flow separation location. A phase difference between the first and second periodic disturbances is adjusted to control flow separation of the shear layer as the fluid medium moves over the fluid dynamic body.

  14. Least squares reverse time migration of controlled order multiples

    Liu, Y.

    2016-12-01

    Imaging using the reverse time migration of multiples generates inherent crosstalk artifacts due to the interference among different order multiples. Traditionally, least-square fitting has been used to address this issue by seeking the best objective function to measure the amplitude differences between the predicted and observed data. We have developed an alternative objective function by decomposing multiples into different orders to minimize the difference between Born modeling predicted multiples and specific-order multiples from observational data in order to attenuate the crosstalk. This method is denoted as the least-squares reverse time migration of controlled order multiples (LSRTM-CM). Our numerical examples demonstrated that the LSRTM-CM can significantly improve image quality compared with reverse time migration of multiples and least-square reverse time migration of multiples. Acknowledgments This research was funded by the National Nature Science Foundation of China (Grant Nos. 41430321 and 41374138).

  15. Effects of long-term stimulation of textured insoles on postural control in health elderly.

    Annino, Giuseppe; Palazzo, Francesco; Alwardat, Mohammad S; Manzi, Vincenzo; Lebone, Pietro; Tancredi, Virginia; Sinibaldi Salimei, Paola; Caronti, Alfio; Panzarino, Michele; Padua, Elvira

    2018-04-01

    The aim of this study was to confirm the effects of long term (chronic) stimulating surface (textured insole) on body balance of elderly people. Twenty-four healthy elderly individuals were randomly distributed in two groups: control and experimental (67.75±6.04 years, 74.55±12.14 kg, 163.7±8.55 cm, 27.75±3.04 kg/m2). Over one month, control group (CG) used smooth insoles and the experimental group (ExG) used textured insoles every day. Velocity net (Vnet), anteroposterior (VA/P), mediolateral (VM/L) and sway path of CoP were assessed in different eye conditions before and after the experimental procedure. A mixed between-within subject ANOVA was conducted to assess the impact of soft and textured insoles and two visual conditions (vision vs. no vision) across two time periods (α≤0.05). The results showed any statistical difference between groups in each parameter assessed in this study. CoP, Vnet and VM/L in the experimental group showed a statistically significant effect of textured insoles only without vision (CoP: P=0.002; η2=0.35), Vnet P=0.02; η2=0.24, VM/L P=0.04; η2=0.177) whereas VA/P showed no statistically significant effect in the same group and condition. There was no significant effect in Vnet, VA/P, VM/L and COP in control group that used smooth insole for both eye conditions. The results confirm that postural stability improved in healthy elderly individuals, increasing somatosensory information's from feet plantar mechanoreceptors. Long term stimulation with textured insoles decreased CoP, Vnet and VM/L with eyes closed.

  16. Control of multiple filamentation in air

    Fibich, Gadi; Eisenmann, Shmuel; Ilan, Boaz; Zigler, Arie

    2004-08-01

    In this Letter we provide what is believed to be the first experimental evidence of suppression of the number of filaments for high-intensity laser pulses propagating in air by beam astigmatism. We also show that the number, pattern, and spatial stability of the filaments can be controlled by varying the angle that a focusing lens makes with the axial direction of propagation. This new methodology can be useful for applications involving atmospheric propagation, such as remote sensing.

  17. Stator for a rotating electrical machine having multiple control windings

    Shah, Manoj R.; Lewandowski, Chad R.

    2001-07-17

    A rotating electric machine is provided which includes multiple independent control windings for compensating for rotor imbalances and for levitating/centering the rotor. The multiple independent control windings are placed at different axial locations along the rotor to oppose forces created by imbalances at different axial locations along the rotor. The multiple control windings can also be used to levitate/center the rotor with a relatively small magnetic field per unit area since the rotor and/or the main power winding provides the bias field.

  18. Control of Multiple Robotic Sentry Vehicles

    Feddema, J.; Klarer, P.; Lewis, C.

    1999-04-01

    As part of a project for the Defense Advanced Research Projects Agency, Sandia National Laboratories is developing and testing the feasibility of using of a cooperative team of robotic sentry vehicles to guard a perimeter and to perform surround and diversion tasks. This paper describes on-going activities in the development of these robotic sentry vehicles. To date, we have developed a robotic perimeter detection system which consists of eight ''Roving All Terrain Lunar Explorer Rover'' (RATLER{trademark}) vehicles, a laptop-based base-station, and several Miniature Intrusion Detection Sensors (MIDS). A radio frequency receiver on each of the RATLER vehicles alerts the sentry vehicles of alarms from the hidden MIDS. When an alarm is received, each vehicle decides whether it should investigate the alarm based on the proximity of itself and the other vehicles to the alarm. As one vehicle attends an alarm, the other vehicles adjust their position around the perimeter to better prepare for another alarm. We have also demonstrated the ability to drive multiple vehicles in formation via tele-operation or by waypoint GPS navigation. This is currently being extended to include mission planning capabilities. At the base-station, the operator can draw on an aerial map the goal regions to be surrounded and the repulsive regions to be avoided. A potential field path planner automatically generates a path from the vehicles' current position to the goal regions while avoiding the repulsive regions and the other vehicles. This path is previewed to the operator before the regions are downloaded to the vehicles. The same potential field path planner resides on the vehicle, except additional repulsive forces from on-board proximity sensors guide the vehicle away from unplanned obstacles.

  19. Multiple Model Approaches to Modelling and Control,

    on the ease with which prior knowledge can be incorporated. It is interesting to note that researchers in Control Theory, Neural Networks,Statistics, Artificial Intelligence and Fuzzy Logic have more or less independently developed very similar modelling methods, calling them Local ModelNetworks, Operating......, and allows direct incorporation of high-level and qualitative plant knowledge into themodel. These advantages have proven to be very appealing for industrial applications, and the practical, intuitively appealing nature of the framework isdemonstrated in chapters describing applications of local methods...... to problems in the process industries, biomedical applications and autonomoussystems. The successful application of the ideas to demanding problems is already encouraging, but creative development of the basic framework isneeded to better allow the integration of human knowledge with automated learning...

  20. Strength of Structural and Functional Frontostriatal Connectivity Predicts Self-Control in the Healthy Elderly

    Hänggi, Jürgen; Lohrey, Corinna; Drobetz, Reinhard; Baetschmann, Hansruedi; Forstmeier, Simon; Maercker, Andreas; Jäncke, Lutz

    2016-01-01

    Self-regulation refers to the successful use of executive functions and initiation of top-down processes to control one's thoughts, behavior, and emotions, and it is crucial to perform self-control. Self-control is needed to overcome impulses and can be assessed by delay of gratification (DoG) and delay discounting (DD) paradigms. In children/adolescents, good DoG/DD ability depends on the maturity of frontostriatal connectivity, and its decline in strength with advancing age might adversely affect self-control because prefrontal brain regions are more prone to normal age-related atrophy than other regions. Here, we aimed at highlighting the relationship between frontostriatal connectivity strength and DoG performance in advanced age. We recruited 40 healthy elderly individuals (mean age 74.0 ± 7.7 years) and assessed the DoG ability using the German version of the DoG test for adults in addition to the delay discounting (DD) paradigm. Based on diffusion-weighted and resting-state functional magnetic resonance imaging data, respectively, the structural and functional whole-brain connectome were reconstructed based on 90 different brain regions of interest in addition to a 12-node frontostriatal DoG-specific network and the resulting connectivity matrices were subjected to network-based statistics. The 90-nodes whole-brain connectome analyses revealed subnetworks significantly associated with DoG and DD with a preponderance of frontostriatal nodes involved suggesting a high specificity of the findings. Structural and functional connectivity strengths between the putamen, caudate nucleus, and nucleus accumbens on the one hand and orbitofrontal, dorsal, and ventral lateral prefrontal cortices on the other hand showed strong positive correlations with DoG and negative correlations with DD corrected for age, sex, intracranial volume, and head motion parameters. These associations cannot be explained by differences in impulsivity and executive functioning. This pattern

  1. Secure Microprocessor-Controlled Prosthetic Leg for Elderly Amputees: Preliminary Results

    S. Krut

    2011-01-01

    Full Text Available We introduce a new prosthetic leg design, adapted to elderly trans-femoral amputees. Technical progress in prosthesis design mainly concerns active individuals. An important number of elderly amputees are not very mobile, tire easily, present reduced muscle strength, and have difficulties managing their balance. Therefore, the needs and characteristics of this specific population are very different from those of younger ones and the prosthetic solutions are not adapted. Our artificial knee has been designed to fulfill the specific requirements of this population in terms of capabilities, transfer assistance, security, intuitiveness, simplicity of use, and types of physical activity to be performed. We particularly focused our efforts on ensuring safe and secure stand-to-sit transfers. We developed an approach to control the different states of the prosthetic joint (blocked, free, resistant, associated with different physical activities. Amputee posture and motion are observed through a single multi-axis force sensor embedded in the prosthesis. The patient behaves naturally, while the controller analyses his movements in order to detect his intention to sit down. The detection algorithm is based on a reference pattern, calibrated individually, to which the sensor data are compared, and submitted to a set of tests allowing the discrimination of the intention to sit down from other activities. Preliminary validation of the system has been performed in order to verify the applicability of the prosthesis to different tasks: walking, standing, sitting down, standing up, picking up an object from a chair, slope and stair climbing.

  2. Bipedal hopping timed to a metronome to detect impairments in anticipatory motor control in people with mild multiple sclerosis.

    Kirkland, Megan C; Chen, Alice; Downer, Matthew B; Holloway, Brett J; Wallack, Elizabeth M; Lockyer, Evan J; Buckle, Natasha C M; Abbott, Courtney L; Ploughman, Michelle

    2018-06-01

    People with mild multiple sclerosis (MS) often report subtle deficits in balance and cognition but display no measurable impairment on clinical assessments. We examined whether hopping to a metronome beat had the potential to detect anticipatory motor control deficits among people with mild MS (Expanded Disability Status Scale ≤ 3.5). Participants with MS (n = 13), matched controls (n = 9), and elderly subjects (n = 13) completed tests of cognition (Montreal Cognitive Assessment (MoCA)) and motor performance (Timed 25 Foot Walk Test (T25FWT)). Participants performed two bipedal hopping tasks: at 40 beats/min (bpm) and 60-bpm in random order. Hop characteristics (length, symmetry, variability) and delay from the metronome beat were extracted from an instrumented walkway and compared between groups. The MS group became more delayed from the metronome beat over time whereas elderly subjects tended to hop closer to the beat (F = 4.52, p = 0.02). Delay of the first hop during 60-bpm predicted cognition in people with MS (R = 0.55, β = 4.64 (SD 4.63), F = 4.85, p = 0.05) but not among control (R = 0.07, p = 0.86) or elderly subjects (R = 0.17, p = 0.57). In terms of hopping characteristics, at 60-bpm, people with MS and matched controls were significantly different from the elderly group. However, at 40-bpm, the MS group was no longer significantly different from the elderly group, even though matched controls and elderly still differed significantly. This new timed hopping test may be able to detect both physical ability, and feed-forward anticipatory control impairments in people with mild MS. Hopping at a frequency of 40-bpm seemed more challenging. Several aspects of anticipatory motor control can be measured: including reaction time to the first metronome cue and the ability to adapt and anticipate the beat over time. Crown Copyright © 2018. Published by Elsevier Ltd. All rights reserved.

  3. Using virtual reality to distinguish subjects with multiple- but not single-domain amnestic mild cognitive impairment from normal elderly subjects.

    Mohammadi, Alireza; Kargar, Mahmoud; Hesami, Ehsan

    2018-03-01

    Spatial disorientation is a hallmark of amnestic mild cognitive impairment (aMCI) and Alzheimer's disease. Our aim was to use virtual reality to determine the allocentric and egocentric memory deficits of subjects with single-domain aMCI (aMCIsd) and multiple-domain aMCI (aMCImd). For this purpose, we introduced an advanced virtual reality navigation task (VRNT) to distinguish these deficits in mild Alzheimer's disease (miAD), aMCIsd, and aMCImd. The VRNT performance of 110 subjects, including 20 with miAD, 30 with pure aMCIsd, 30 with pure aMCImd, and 30 cognitively normal controls was compared. Our newly developed VRNT consists of a virtual neighbourhood (allocentric memory) and virtual maze (egocentric memory). Verbal and visuospatial memory impairments were also examined with Rey Auditory-Verbal Learning Test and Rey-Osterrieth Complex Figure Test, respectively. We found that miAD and aMCImd subjects were impaired in both allocentric and egocentric memory, but aMCIsd subjects performed similarly to the normal controls on both tasks. The miAD, aMCImd, and aMCIsd subjects performed worse on finding the target or required more time in the virtual environment than the aMCImd, aMCIsd, and normal controls, respectively. Our findings indicated the aMCImd and miAD subjects, as well as the aMCIsd subjects, were more impaired in egocentric orientation than allocentric orientation. We concluded that VRNT can distinguish aMCImd subjects, but not aMCIsd subjects, from normal elderly subjects. The VRNT, along with the Rey Auditory-Verbal Learning Test and Rey-Osterrieth Complex Figure Test, can be used as a valid diagnostic tool for properly distinguishing different forms of aMCI. © 2018 Japanese Psychogeriatric Society.

  4. Effect of Turkish classical music on blood pressure: a randomized controlled trial in hypertensive elderly patients.

    Bekiroğlu, Tansel; Ovayolu, Nimet; Ergün, Yusuf; Ekerbiçer, Hasan Çetin

    2013-06-01

    Existing studies suggest that music therapy can have favorable effects on hypertension and anxiety. We therefore set out to investigate the effect of Turkish classical music. To investigate whether Turkish classical music has positive effects on blood pressures and anxiety levels in elderly patients. This was a randomized controlled trial performed on 60 hypertensive patients living in a local elderly home in Adana, Turkey. Following the completion of a socio-demographic form for each patient, Hamilton anxiety scale was applied. Thereafter, the subjects were randomly divided into two equal-size groups and were allowed to either listen to Turkish classical music (music therapy group) or have a resting period (control group) for 25 min. The primary and secondary outcome measures were blood pressure and Hamilton anxiety scale scores, respectively. The mean reduction in systolic blood pressure was 13.00 mmHg in the music therapy group and 6.50 mmHg in the control group. The baseline adjusted between treatment group difference was not statistically significant (95% CI 6.80-9.36). The median reductions in diastolic blood pressures were 10 mmHg both in the music therapy and control groups. The between treatment group difference was not statistically significant (Mann-Whitney U test, P = 0.839). The mean reduction in HAMA-A was 1.63 in the music therapy group and 0.77 in the control group. The baseline adjusted between treatment group difference was not statistically significant (95% CI 0.82-1.92). The study demonstrated that both Turkish classical music and resting alone have positive effects on blood pressure in patients with hypertension. Copyright © 2013 Elsevier Ltd. All rights reserved.

  5. An artificial neural network estimation of gait balance control in the elderly using clinical evaluations.

    Vipul Lugade

    Full Text Available The use of motion analysis to assess balance is essential for determining the underlying mechanisms of falls during dynamic activities. Clinicians evaluate patients using clinical examinations of static balance control, gait performance, cognition, and neuromuscular ability. Mapping these data to measures of dynamic balance control, and the subsequent categorization and identification of community dwelling elderly fallers at risk of falls in a quick and inexpensive manner is needed. The purpose of this study was to demonstrate that given clinical measures, an artificial neural network (ANN could determine dynamic balance control, as defined by the interaction of the center of mass (CoM with the base of support (BoS, during gait. Fifty-six elderly adults were included in this study. Using a feed-forward neural network with back propagation, combinations of five functional domains, the number of hidden layers and error goals were evaluated to determine the best parameters to assess dynamic balance control. Functional domain input parameters included subject characteristics, clinical examinations, cognitive performance, muscle strength, and clinical balance performance. The use of these functional domains demonstrated the ability to quickly converge to a solution, with the network learning the mapping within 5 epochs, when using up to 30 hidden nodes and an error goal of 0.001. The ability to correctly identify the interaction of the CoM with BoS demonstrated correlation values up to 0.89 (P<.001. On average, using all clinical measures, the ANN was able to estimate the dynamic CoM to BoS distance to within 1 cm and BoS area to within 75 cm2. Our results demonstrated that an ANN could be trained to map clinical variables to biomechanical measures of gait balance control. A neural network could provide physicians and patients with a cost effective means to identify dynamic balance issues and possible risk of falls from routinely collected clinical

  6. Effects of the cognitive tasks in the postural control of elderly: A systematic revision

    Larissa Pires de Andrade

    2011-09-01

    Full Text Available Demanding attention in order to keep postural balance increases with aging and with the presence of concurrent tasks that require information processing. Several studies have demonstrated that motor performance can be related to the complexity of the task and aging process, presenting a possible interaction between these factors. The aim of this review was to identify and analyze published papers about the effects of cognitive tasks on the postural control of elderly individuals. A systematic search in the Web of Science, SportDiscus, CINAHL, Science Direct on line, Biological Abstracts, PsycINFO, and Medline databases was made and 444 articles were found. Eight were selected that studied the variables of interest. These studies showed that postural control seems to be influenced by the individual's attention processes and that deficits in such ability may be associated to an increased risk of falls.

  7. Effects of the cognitive tasks in the postural control of elderly: A systematic revision

    L.P. Andrade

    2011-01-01

    Full Text Available Demanding attention in order to keep postural balance increases with aging and with the presence of concurrent tasks that require information processing. Several studies have demonstrated that motor performance can be related to the complexity of the task and aging process, presenting a possible interaction between these factors. The aim of this review was to identify and analyze published papers about the effects of cognitive tasks on the postural control of elderly individuals. A systematic search in the Web of Science, SportDiscus, CINAHL, Science Direct on line, Biological Abstracts, PsycINFO, and Medline databases was made and 444 articles were found. Eight were selected that studied the variables of interest. These studies showed that postural control seems to be influenced by the individual's attention processes and that deficits in such ability may be associated to an increased risk of falls.

  8. A flexed posture in elderly patients is associated with impairments in postural control during walking.

    de Groot, Maartje H; van der Jagt-Willems, Hanna C; van Campen, Jos P C M; Lems, Willem F; Beijnen, Jos H; Lamoth, Claudine J C

    2014-02-01

    A flexed posture (FP) is characterized by protrusion of the head and an increased thoracic kyphosis (TK), which may be caused by osteoporotic vertebral fractures (VFs). These impairments may affect motor function, and consequently increase the risk of falling and fractures. The aim of the current study was therefore to examine postural control during walking in elderly patients with FP, and to investigate the relationship with geriatric phenomena that may cause FP, such as increased TK, VFs, frailty, polypharmacy and cognitive impairments. Fifty-six elderly patients (aged 80 ± 5.2 years; 70% female) walked 160 m at self-selected speed while trunk accelerations were recorded. Walking speed, mean stride time and coefficient of variation (CV) of stride time were recorded. In addition, postural control during walking was quantified by time-dependent variability measures derived from the theory of stochastic dynamics, indicating smoothness, degree of predictability, and local stability of trunk acceleration patterns. Twenty-five patients (45%) had FP and demonstrated a more variable and less structured gait pattern, and a more irregular trunk acceleration pattern than patients with normal posture. FP was significantly associated with an increased TK, but not with other geriatric phenomena. An increased TK may bring the body's centre of mass forward, which requires correcting responses, and reduces the ability to respond on perturbation, which was reflected by higher variation in the gait pattern in FP-patients. Impairments in postural control during walking are a major risk factor for falling: the results indicate that patients with FP have impaired postural control during walking and might therefore be at increased risk of falling. Copyright © 2013 Elsevier B.V. All rights reserved.

  9. Effects of physical and sporting activities on balance control in elderly people

    Perrin, P. P.; Gauchard, G. C.; Perrot, C.; Jeandel, C.

    1999-01-01

    OBJECTIVE: Balance disorders increase with aging and raise the risk of accidental falls in the elderly. It has been suggested that the practice of physical and sporting activities (PSA) efficiently counteracts these age related disorders, reducing the risk of falling significantly. METHODS: This study, principally based on a period during which the subjects were engaged in PSA, included 65 healthy subjects, aged over 60, who were living at home. Three series of posturographic tests (static, dynamic with a single and fast upward tilt, and dynamic with slow sinusoidal oscillations) analysing the centre of foot pressure displacements or electromyographic responses were conducted to determine the effects of PSA practice on balance control. RESULTS: The major variables of postural control were best in subjects who had always practised PSA (AA group). Those who did not take part in PSA at all (II group) had the worst postural performances, whatever the test. Subjects having lately begun PSA practice (IA group) had good postural performances, close to those of the AA group, whereas the subjects who had stopped the practice of PSA at an early age (AI group) did not perform as well. Overall, the postural control in the group studied decreased in the order AA > IA > AI > II. CONCLUSIONS: The period during which PSA are practised seems to be of major importance, having a positive bearing on postural control. It seems that recent periods of practice have greater beneficial effects on the subject's postural stability than PSA practice only at an early age. These data are compatible with the fact that PSA are extremely useful for elderly people even if it has not been a lifelong habit. 


 PMID:10205695

  10. Clinical effectiveness of telmisartan alone or in combination therapy for controlling blood pressure and vascular risk in the elderly

    Bodh I Jugdutt

    2010-12-01

    Full Text Available Bodh I JugduttDivision of Cardiology, Department of Medicine, University of Alberta and Hospital, Edmonton, CanadaAbstract: Elderly patients (age≥65 years with hypertension are at high risk for vascular complications, especially when diabetes is present. Antihypertensive drugs that inhibit the renin-angiotensin system have been shown to be effective for controlling blood pressure in adult and elderly patients. Importantly, renin-angiotensin system inhibitors were shown to have benefits beyond their classic cardioprotective and vasculoprotective effects, including reducing the risk of new-onset diabetes and associated cardiovascular effects. The discovery that the renin-angiotensin system inhibitor and angiotensin II type 1 (AT1 receptor blocker (ARB, telmisartan, can selectively activate the peroxisome proliferator-activated receptor-γ (PPARγ, an established antidiabetic drug target provides the unique opportunity to prevent and treat cardiovascular complications in high-risk elderly patients with hypertension and new-onset diabetes. Two large clinical trials, ONTARGET (Ongoing Telmisartan Alone in combination with Ramipril Global Endpoint Trial and TRANSCEND (Telmisartan Randomized AssessmeNt Study in ACE-I iNtolerant subjects with cardiovascular disease have assessed the cardioprotective and antidiabetic effects of telmisartan. The collective data suggest that telmisartan is a promising drug for controlling hypertension and reducing vascular risk in high-risk elderly patients with new-onset diabetes.Keywords: elderly, hypertension, telmisartan, angiotensin II type 1 receptor blocker, peroxisome proliferator-activated receptor-γ, diabetes, vascular risk

  11. Arginine and antioxidant supplement on performance in elderly male cyclists: a randomized controlled trial.

    Chen, Steve; Kim, Woosong; Henning, Susanne M; Carpenter, Catherine L; Li, Zhaoping

    2010-03-23

    Human exercise capacity declines with advancing age. These changes often result in loss of physical fitness and more rapid senescence. Nitric oxide (NO) has been implicated in improvement of exercise capacity through vascular smooth muscle relaxation in both coronary and skeletal muscle arteries, as well as via independent mechanisms. Antioxidants may prevent nitric oxide inactivation by oxygen free radicals. The purpose of this study was to investigate the effects of an L-arginine and antioxidant supplement on exercise performance in elderly male cyclists. This was a two-arm prospectively randomized double-blinded and placebo-controlled trial. Sixteen male cyclists were randomized to receive either a proprietary supplement (Niteworks(R), Herbalife International Inc., Century City, CA) or a placebo powder. Exercise parameters were assessed by maximal incremental exercise testing performed on a stationary cycle ergometer using breath-by-breath analysis at baseline, week one and week three. There was no difference between baseline exercise parameters. In the supplemented group, anaerobic threshold increased by 16.7% (2.38 +/- 0.18 L/min, p < 0.01) at week 1, and the effect was sustained by week 3 with a 14.2% (2.33 +/- 0.44 L/min, p < 0.01). In the control group, there was no change in anaerobic threshold at weeks 1 and 3 compared to baseline (1.88 +/- 0.20 L/min at week 1, and 1.86 +/- 0.21 L/min at week 3). The anaerobic threshold for the supplement groups was significantly higher than that of placebo group at week 1 and week 3. There were no significant changes noted in VO2 max between control and intervention groups at either week 1 or week 3 by comparison to baseline. An arginine and antioxidant-containing supplement increased the anaerobic threshold at both week one and week three in elderly cyclists. No effect on VO2 max was observed. This study indicated a potential role of L-arginine and antioxidant supplementation in improving exercise performance in

  12. Effects of tai chi qigong on psychosocial well-being among hidden elderly, using elderly neighborhood volunteer approach: a pilot randomized controlled trial

    Chan AW

    2017-01-01

    Full Text Available Aileen WK Chan, Doris SF Yu, KC Choi The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, NT, Hong Kong SAR Purpose: To test the feasibility and preliminary effectiveness of a tai chi qigong program with the assistance of elderly neighborhood volunteers in strengthening social networks and enhancing the psychosocial well-being of hidden elderly. Patients and methods: “Hidden elderly” is a term used to describe older adults who are socially isolated and refuse social participation. This pilot randomized controlled trial recruited 48 older adults aged 60 or above who did not engage in any social activity. They were randomized into tai chi qigong (n=24 and standard care control (n=24 groups. The former group underwent a three-month program of two 60-minute sessions each week, with the socially active volunteers paired up with them during practice. Standard care included regular home visits by social workers. Primary outcomes were assessed by means of the Lubben social network and De Jong Gieveld loneliness scales, and by a revised social support questionnaire. Secondary outcomes were covered by a mental health inventory and the Rosenberg self-esteem scale, and quality of life by using the 12-Item Short Form Health Survey. Data was collected at baseline, and at three and six months thereafter. Results: The generalized estimating equations model revealed general improvement in outcomes among participants on the tai chi qigong program. In particular, participants reported a significantly greater improvement on the loneliness scale (B=-1.32, 95% confidence interval [CI] -2.54 to -0.11, P=0.033 and the satisfaction component of the social support questionnaire (B=3.43, 95% CI 0.10–6.76, P=0.044 than the control group. Conclusion: The pilot study confirmed that tai chi qigong with elderly neighborhood volunteers is a safe and feasible social intervention for hidden elderly. Its potential benefits in

  13. Effectiveness of pneumococcal vaccination for elderly people in Catalonia, Spain: a case-control study.

    Dominguez, Angela; Salleras, Lluis; Fedson, David S; Izquierdo, Conchita; Ruiz, Laura; Ciruela, Pilar; Fenoll, Asuncion; Casal, Julio

    2005-05-01

    Observational studies offer an approach to evaluating the effectiveness of vaccination programs. We evaluated the effectiveness of a 23-valent pneumococcal vaccination program for elderly people in Catalonia, Spain, in a matched-set case-control study. We identified 149 cases of invasive pneumococcal disease among patients aged > or =65 years who were hospitalized in 12 large hospitals in Catalonia during the period of 1 January 2001 through 31 March 2002. We selected 2 hospital control patients and 1 outpatient control subject for each case patient, matching on the basis of age and underlying medical conditions. We obtained their pneumococcal vaccination histories and used conditional logistic regression to determine effectiveness of vaccination. Among all 149 cases of invasive pneumococcal disease, 131 (87.9%) were caused by vaccine or vaccine-related serotypes. In the adjusted analysis, overall effectiveness of vaccination against infections due to all serotypes was 70% (95% confidence interval [CI], 48%-82%). Among immunocompetent subjects with or without high-risk conditions, effectiveness of vaccination was 76% (95% CI, 51%-88%), but among immunocompromised subjects it was 50% (95% CI, -44% to 82%). Among subjects with infections due to vaccine or vaccine-related serotypes, effectiveness of vaccination was 72% (95% CI, 50%-85%) overall and 78% (95% CI, 50%-90%) in those who were immunocompetent, but it was only 46% (95% CI, -54% to 81%) in those who were immunocompromised. Overall effectiveness of vaccination was 65% (95% CI, 35%-81%) during the noninfluenza period. Pneumococcal vaccination was effective in preventing invasive pneumococcal disease among all elderly persons in Catalonia. Effectiveness was greater in immunocompetent persons, most of whom had underlying high-risk conditions. The number of subjects was too small to determine whether vaccination was effective in those who were immunocompromised.

  14. Cost effectiveness of preventive home visits to the elderly: economic evaluation alongside randomized controlled study

    Kronborg, Christian; Vass, Mikkel; Lauridsen, Jørgen

    2006-01-01

    We evaluated the cost effectiveness of preventive home visits to elderly persons in Denmark alongside a 3-year randomized controlled study. The main outcome measure was incremental costs per active life-year gained. The number of active life-years was defined as those during which the person...... is able independently to transfer, walk indoors, go outdoors, walk outdoors in both pleasant and poor weather, and climb stairs. In 17 of 34 municipalities health visitors and general practitioners were offered geriatric training, which focused on early signs of disability, physical activity......,455 to 744) in 75-year-olds and 694 euro (-2,684 to 4,071) in 80-year-olds. The discounted difference in mean active life-years was 0.034 (-0.058 to 0.125) and 0.197 (0.013 to 0.380), respectively. The study did not provide conclusive evidence on the cost effectiveness of the programs under consideration....

  15. Eicosapentaenoic acid improves glycemic control in elderly bedridden patients with type 2 diabetes.

    Ogawa, Susumu; Abe, Takaaki; Nako, Kazuhiro; Okamura, Masashi; Senda, Miho; Sakamoto, Takuya; Ito, Sadayoshi

    2013-01-01

    Eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) are ω3-polyunsaturated fatty acids mainly contained in the blue-backed fish oil, and are effective in decreasing the lipids disorder and the cardiovascular incidence among diabetic patients. Moreover, it has been suggested that EPA and DHA may improve the insulin resistance and glucose metabolism. However, the clinical effects of EPA and DHA on glucose metabolism remain unclear. We aimed to clarify the effects of EPA/DHA treatment on glycemic control in type 2 diabetes mellitus. This study was a multicenter prospective randomized controlled trial involving 30 elderly type 2 diabetic patients on a liquid diet. Their exercises were almost zero and the content of their meals was strictly managed and understood well. Therefore, the difference by the individual's life was a minimum. The subjects were divided into two groups: those receiving EPA/DHA-rich liquid diet [EPA/DHA (+)] or liquid diet lacking EPA/DHA [EPA/DHA (-)]. Changes in factors related to glucose and lipid metabolism were assessed after the three-month study. Serum concentrations of EPA rose in EPA/DHA (+), although the levels of DHA and fasting C-peptide remained unchanged in EPA/DHA (+). In addition, there was a significant decline in the fasting plasma glucose (FPG), hemoglobin A1c (HbA1c), fasting remnant-like particles and apolipoprotein (apo) B in EPA/DHA (+), compared with the values in EPA/DHA (-). EPA/DHA-rich diet might improve glucose metabolism in elderly type 2 diabetic patients on a liquid diet. This phenomenon may be due to the improved insulin resistance mediated by the rise in serum EPA concentrations.

  16. Contradictory effects for prevention of depression and anxiety in residents in home for the elderly: a pragmatic randomized controlled trial

    Dozeman, Els; van Marwijk, Harm; van Schaik, Digna J.F.; Smit, Filip; Stek, Max; van der Horst, Henriëtte E.; Bohlmeijer, Ernst Thomas; Beekman, Aartjan T.F.

    2012-01-01

    Background: The aim of this study was to evaluate the effectiveness of a stepped-care program to prevent the onset of depression and anxiety disorders in elderly people living in residential homes. Methods: A pragmatic randomized controlled trial was conducted to compare the intervention with usual

  17. Multilateral Telecoordinated Control of Multiple Robots With Uncertain Kinematics.

    Zhai, Di-Hua; Xia, Yuanqing

    2017-06-06

    This paper addresses the telecoordinated control of multiple robots in the simultaneous presence of asymmetric time-varying delays, nonpassive external forces, and uncertain kinematics/dynamics. To achieve the control objective, a neuroadaptive controller with utilizing prescribed performance control and switching control technique is developed, where the basic idea is to employ the concept of motion synchronization in each pair of master-slave robots and among all slave robots. By using the multiple Lyapunov-Krasovskii functionals method, the state-independent input-to-output practical stability of the closed-loop system is established. Compared with the previous approaches, the new design is straightforward and easier to implement and is applicable to a wider area. Simulation results on three pairs of three degrees-of-freedom robots confirm the theoretical findings.

  18. Performance effect of multiple control forms in a Lean organization

    Kristensen, Thomas Borup; Israelsen, Poul

    2012-01-01

    Over the last decades Lean has developed into a prominent management philosophy reaching beyond shop floor tools. However, substantial support of performance effects from Lean is still scarce and at best with mixed results. Recently, research has turned its focus towards perceiving Lean...... as a control package. In this paper we present statistical support for enhanced performance coming from Lean. Furthermore, our results strongly support the perception of Lean as a set of multiple control forms (output, behavioral, and social controls) that complement each other. Therefore, performance...... is increased if the average level of control forms is increased, and performance is further increased if the control forms are balanced at the same level representing a complementary effect between them. Our data are archival data spanning multiple years in a strong Lean organization. The dependent performance...

  19. Combination therapy versus gemcitabine monotherapy in the treatment of elderly pancreatic cancer: a meta-analysis of randomized controlled trials

    Jin JM

    2018-03-01

    Full Text Available Jiamin Jin, Chunbo Teng, Tao Li College of Life Science, Northeast Forestry University, Harbin, China Purpose: We aimed to compare the efficacy of combination therapy versus gemcitabine monotherapy in the treatment of elderly pancreatic cancer (PC by using a meta-analysis.Materials and methods: Databases were searched to identify relevant clinical trials. Hazard ratios (HRs were used to estimate overall survival (OS and progression-free survival (PFS. Statistical analyses were conducted by using Comprehensive Meta Analysis software (version 2.0.Results: A total of 3,401 elderly PC patients from six randomized controlled trials were included for analysis. In comparison with gemcitabine alone, combination therapy in elderly PC patients did not significantly improve OS (HR 0.93, 95% CI: 0.82–1.06, p=0.29. Sub-group analysis according to treatment regimens showed that combined chemotherapy significantly improved OS in comparison with gemcitabine alone (HR 0.73, 95% CI: 0.56–0.94, p=0.016, while gemcitabine plus targeted agents did not improve OS (HR 1.02, 95% CI: 0.87–1.19, p=0.83. Additionally, gemcitabine plus nab-paclitaxel significantly improved PFS in elderly PC patients (HR 0.69, 95% CI: 0.52–0.91, p=0.009 in comparison with gemcitabine alone. No publication bias was detected by Begg’s and Egger’s tests for OS.Conclusion: The findings of this study suggest that combined chemotherapy, but not for gemcitabine plus targeted agents, could be recommended for elderly PC patients due to its survival benefits. Further studies are still needed to assess the treatment tolerance of combination chemotherapy in these patient populations. Keywords: pancreatic cancer, elderly, randomized controlled trials, meta-analysis, targeted agents

  20. Stable schizophrenia patients learn equally well as age-matched controls and better than elderly controls in two sensorimotor rotary pursuit tasks

    Picker, L.J. De; Cornelis, C.; Hulstijn, W.; Dumont, G.J.H.; Fransen, E.; Timmers, M.; Janssens, L.; Morrens, M.; Sabbe, B.G.C.

    2014-01-01

    Objective: To compare sensorimotor performance and learning in stable schizophrenia patients, healthy age- and sex-matched controls and elderly controls on two variations of the rotary pursuit: circle pursuit (true motor learning) and figure pursuit (motor and sequence learning). Method: In the

  1. Influence of regular proprioceptive and bioenergetic physical activities on balance control in elderly women.

    Gauchard, Gérome C; Gangloff, Pierre; Jeandel, Claude; Perrin, Philippe P

    2003-09-01

    Balance disorders increase considerably with age due to a decrease in posture regulation quality, and are accompanied by a higher risk of falling. Conversely, physical activities have been shown to improve the quality of postural control in elderly individuals and decrease the number of falls. The aim of this study was to evaluate the impact of two types of exercise on the visual afferent and on the different parameters of static balance regulation. Static postural control was evaluated in 44 healthy women aged over 60 years. Among them, 15 regularly practiced proprioceptive physical activities (Group I), 12 regularly practiced bioenergetic physical activities (Group II), and 18 controls walked on a regular basis (Group III). Group I participants displayed lower sway path and area values, whereas Group III participants displayed the highest, both in eyes-open and eyes-closed conditions. Group II participants displayed intermediate values, close to those of Group I in the eyes-open condition and those of Group III in the eyes-closed condition. Visual afferent contribution was more pronounced for Group II and III participants than for Group I participants. Proprioceptive exercise appears to have the best impact on balance regulation and precision. Besides, even if bioenergetic activity improves postural control in simple postural tasks, more difficult postural tasks show that this type of activity does not develop a neurosensorial proprioceptive input threshold as well, probably on account of the higher contribution of visual afferent.

  2. Automatic and controlled attentional orienting in the elderly: A dual-process view of the positivity effect.

    Gronchi, G; Righi, S; Pierguidi, L; Giovannelli, F; Murasecco, I; Viggiano, M P

    2018-04-01

    The positivity effect in the elderly consists of an attentional preference for positive information as well as avoidance of negative information. Extant theories predict either that the positivity effect depends on controlled attentional processes (socio-emotional selectivity theory), or on an automatic gating selection mechanism (dynamic integration theory). This study examined the role of automatic and controlled attention in the positivity effect. Two dot-probe tasks (with the duration of the stimuli lasting 100 ms and 500 ms, respectively) were employed to compare the attentional bias of 35 elderly people to that of 35 young adults. The stimuli used were expressive faces displaying neutral, disgusted, fearful, and happy expressions. In comparison to young people, the elderly allocated more attention to happy faces at 100 ms and they tended to avoid fearful faces at 500 ms. The findings are not predicted by either theory taken alone, but support the hypothesis that the positivity effect in the elderly is driven by two different processes: an automatic attention bias toward positive stimuli, and a controlled mechanism that diverts attention away from negative stimuli. Copyright © 2018 Elsevier B.V. All rights reserved.

  3. Effect of estimated glomerular filtration rate on plasma concentrations of B-type natriuretic peptides measured with multiple immunoassays in elderly individuals

    Schou, M.; Alehagen, U.; Goetze, J.P.

    2009-01-01

    linear regression models. RESULTS: In univariate analyses the effect of a 10% decrease in eGFR on proBNP concentrations was a 15% (95% confidence interval 11% to 18%), 9% (5% to 13%) and 21% (14% to 28%) increase. In multivariate models the effect was a 7% (3% to 11%), 4% (2% to 6%) and 13% (4% to 20....... SETTING: 474 elderly outpatients with suspected heart failure (prevalence 13%) from the primary care. MAIN OUTCOME MEASURES: The effects of eGFR on proBNP, measured with three different immunoassays (Roche Diagnostics, Oslo and Copenhagen), and BNP (Shionogi) concentrations were evaluated by multiple...

  4. Accelerated spike resampling for accurate multiple testing controls.

    Harrison, Matthew T

    2013-02-01

    Controlling for multiple hypothesis tests using standard spike resampling techniques often requires prohibitive amounts of computation. Importance sampling techniques can be used to accelerate the computation. The general theory is presented, along with specific examples for testing differences across conditions using permutation tests and for testing pairwise synchrony and precise lagged-correlation between many simultaneously recorded spike trains using interval jitter.

  5. Chance Events in Career Development: Influence, Control and Multiplicity

    Bright, Jim E. H.; Pryor, Robert G. L.; Chan, Eva Wing Man; Rijanto, Jeniyanti

    2009-01-01

    This article reports three studies on the nature and impact of chance events. The first study investigated chance events in terms of the dimensions of influence and control. The second and third studies investigated the effects of multiplicity of chance events on career development are in terms of respondents' own careers and then in terms of…

  6. Evaluation of the Prevention and Reactivation Care Program (PReCaP) for the hospitalized elderly: A prospective nonrandomized controlled trial

    K.J.E. Asmus-Szepesi (Kirsten); L.E. Flinterman (Linda); M.A. Koopmanschap (Marc); A.P. Nieboer (Anna); T.J.E.M. Bakker (Ton); J.P. Mackenbach (Johan); E.W. Steyerberg (Ewout)

    2015-01-01

    textabstractBackground: The hospitalized elderly are at risk of functional decline. We evaluated the effects and care costs of a specialized geriatric rehabilitation program aimed at preventing functional decline among at-risk hospitalized elderly. Methods: The prospective nonrandomized controlled

  7. Body composition influenced by progressive elastic band resistance exercise of sarcopenic obesity elderly women: a pilot randomized controlled trial.

    Huang, Shih-Wei; Ku, Jan-Wen; Lin, Li-Fong; Liao, Chun-De; Chou, Lin-Chuan; Liou, Tsan-Hon

    2017-08-01

    Sarcopenia involves age-related decreases in muscle strength and muscle mass, leading to frailty and disability in elderly people. When combined with obesity, it is defined as sarcopenic obesity (SO), which can result in more functional limitations and metabolic disorders than either disorder alone. The aim of this study was to investigate body composition changes after elastic band resistance training in elderly women with SO. Randomized single-blinded (assessor blinded) controlled pilot trial. Academic medical center. Thirty-five elderly (>60 years old) women with SO. This pilot randomized controlled trial focused on elderly women with SO. The study group underwent progressive elastic band resistance training for 12 weeks (3 times per week). The control group received only a 40-minute lesson about the exercise concept. Dual-energy X-ray absorptiometry was performed before and after intervention to evaluate body composition. Mann-Whitney U and Wilcoxon signed rank tests were used to analyze the differences within and between these groups. In total, 35 elderly women with SO were enrolled and divided into study (N.=18) and control groups (N.=17). No difference was observed in age, biochemical parameters, or Body Mass Index between both groups. After the intervention, the fat proportion of body composition in the right upper extremity (P=0.03), left upper extremity (P=0.04), total fat (P=0.035), and fat percentage (P=0.012) had decreased, and bone mineral density (BMD) (P=0.026), T-score (P=0.028), and Z-score (P=0.021) had increased in the study group. Besides, statistical difference was observed in outcome measurements of right upper extremity (P=0.013), total fat (P=0.023), and fat percentage (P=0.012) between the groups. Our study demonstrated that progressive elastic band resistance exercise can reduce fat mass and increase BMD in elderly women with SO, and that this exercise program is feasible for this demographic. Additional studies with larger sample sizes

  8. The effects of reminiscence therapy on depressive symptoms of Chinese elderly: study protocol of a randomized controlled trial

    Chen Ting-ji

    2012-11-01

    Full Text Available Abstract Background Depression is one of the most common mental disorders with a high prevalence among the older adults. In recent years, after realizing some side effects of the antidepressants, non-pharmacological psychological treatments begin to attract accruing attention. Reminiscence therapy is one of the psychological treatments that specially designed for the elderly to improve their mental health status by recalling and assessing their existing memory. Though some studies indicate reminiscence therapy can be effective and beneficial for the mental health of elderly, the conclusions are not consistent yet. The aim of this research is to assess the effectiveness of reminiscence therapy for Chinese elderly. Methods Sixty older adults (≥60 years of age with mild to moderate depression will be randomly assigned to an experimental or a control condition. The participants in the experiment group will receive the reminiscence therapy under the Watt’s protocol with adaptation to Chinese Culture which consists of six weekly sessions of 90 minutes each. The control group will be treated as before. An assessor who is blind to intervention will conduct the measures before treatment, after treatment immediately, and three months after treatment. Discussion This study will provide the evidence whether the reminiscence therapy is effective to treat depressive symptoms of Chinese elderly. This research has been registered in the clinicaltrials.gov (NCT01553669.

  9. Randomised controlled trial of a general practice programme of home based exercise to prevent falls in elderly women.

    Campbell, A. J.; Robertson, M. C.; Gardner, M. M.; Norton, R. N.; Tilyard, M. W.; Buchner, D. M.

    1997-01-01

    OBJECTIVE: To assess the effectiveness of a home exercise programme of strength and balance retraining exercises in reducing falls and injuries in elderly women. DESIGN: Randomised controlled trial of an individually tailored programme of physical therapy in the home (exercise group, n = 116) compared with the usual care and an equal number of social visits (control group, n = 117). SETTING: 17 general practices in Dunedin, New Zealand. SUBJECTS: Women aged 80 years and older living in the co...

  10. [Evaluation of postural control systems in elderly patients with repeated falls].

    González Ramírez, Alfonso; Lázaro del Nogal, Montserrat; Ribera Casado, José Manuel

    2008-01-01

    a) to describe postural control disorders in elderly patients with recurrent falls; b) to analyze the influence of sensory deficits on centre of gravity control mechanisms; and c) to assess the functional consequences of balance disorders and falls in this group of patients. patients aged more than 65 years old referred to a falls unit with two or more falls in the previous 6 months were included in this study. The protocol included posturographic studies with a Neurocom Balance Master. To evaluate motor control, Rhythmic Weight Shift (RWS test) was performed. To assess sensorial control, Modified Clinical Test of Sensory Interaction on Balance (MCT test) was used. Other tests performed were the Sit to Stand (SS test), Walk across (WA test) and Step up over (SO test). a total of 109 patients (85.3% women) were studied. Mean age was 78.01 years (SD: 5.38). Disorders in one or more afferent sensorial systems were found in 51.7% of the patients (27.5% visual deficiencies, 17.6% vestibular alterations, and 6.6% somatosensorial deficits). Two afferent systems were compromised in 25.3%, and all three were compromised in 11.1% of the patients. No significant differences were found in directional control (RWS) when compared with the number of altered systems. posturographic studies provide sensitive information on static and dynamic centre of gravity control systems, eventual sensory deficits, and patients' ability to carry out basic activities of daily living. In our sample, the most frequent deficit was visual impairment. This information is essential to establish a correct management programme.

  11. [CLINICAL STUDIES ON EFFECT OF ARTHROSCOPIC INTERCONDYLAR FOSSA ANGIOPLASTY ON ABILITY OF NEUROMUSCULAR CONTROL IN ELDERLY PATIENTS WITH KNEE OSTEOARTHRITIS].

    Huang, Jingmin; Wang, Haijiao; Wu, Jiang; Li, Dongchao; Li, Yuhong

    2015-08-01

    To study the effect of arthroscopic intercondylar fossa angioplasty on the ability of neuromuscular control of the knee joint in elderly patients with knee osteoarthritis (KOA). Between June 2012 and March 2013, 20 elderly patients with KOA and in accordance with inclusion and exclusion criteria underwent arthroscopic intercondylar fossa angioplasty (operation group), and 20 healthy elderly people served as control group. There was no significant difference in age, height, weight, and body mass index between 2 groups (P > 0.05). The proprioception capability (using passive regeneration test at measurement angles of 15, 30, and 60°) and quadriceps mobilization [including maximum voluntary contraction (MVC), central activation ratio (CAR), and activation deficit (AD)] were measured to avaluate the neuromuscular control of the knee; the Lysholm score was used to evaluate knee function. The above indexes were measured to assess the knee neuromuscular control and recovery of joint function in patients of operation group at 3, 6, and 9 months after operation. Compared with the control group, MVC, CAR, and Lysholm scores were significantly decreased, and the AD and passive knee angle difference were significantly increased in operation group (P 0.05). Arthroscopic intercondylar fossa angioplasty can relieve ACL pressure, abrasion, and impact, which will recover the ability of neuromuscular control, increase proprioception and quadriceps mobilization capacity, and improve the joint function.

  12. Dynamic coordinated control laws in multiple agent models

    Morgan, David S.; Schwartz, Ira B.

    2005-01-01

    We present an active control scheme of a kinetic model of swarming. It has been shown previously that the global control scheme for the model, presented in [Systems Control Lett. 52 (2004) 25], gives rise to spontaneous collective organization of agents into a unified coherent swarm, via steering controls and utilizing long-range attractive and short-range repulsive interactions. We extend these results by presenting control laws whereby a single swarm is broken into independently functioning subswarm clusters. The transition between one coordinated swarm and multiple clustered subswarms is managed simply with a homotopy parameter. Additionally, we present as an alternate formulation, a local control law for the same model, which implements dynamic barrier avoidance behavior, and in which swarm coherence emerges spontaneously

  13. Realization of quantum gates with multiple control qubits or multiple target qubits in a cavity

    Waseem, Muhammad; Irfan, Muhammad; Qamar, Shahid

    2015-06-01

    We propose a scheme to realize a three-qubit controlled phase gate and a multi-qubit controlled NOT gate of one qubit simultaneously controlling n-target qubits with a four-level quantum system in a cavity. The implementation time for multi-qubit controlled NOT gate is independent of the number of qubit. Three-qubit phase gate is generalized to n-qubit phase gate with multiple control qubits. The number of steps reduces linearly as compared to conventional gate decomposition method. Our scheme can be applied to various types of physical systems such as superconducting qubits coupled to a resonator and trapped atoms in a cavity. Our scheme does not require adjustment of level spacing during the gate implementation. We also show the implementation of Deutsch-Joza algorithm. Finally, we discuss the imperfections due to cavity decay and the possibility of physical implementation of our scheme.

  14. The Multiplicity of Controls and the Making of Innovation

    Revellino, Silvana; Mouritsen, Jan

    2009-01-01

    are mediated by unique sets of technologies of control. In this process the innovation changes and adapts. This thesis is drawn from the case of Italian Autostrade's innovation Telepass which was an automatic toll collection devise developed to make traffic fast, safe and fluid. Throughout its development...... satisfaction, productivity and highly pointed achievement targets. This multiplicity of controls changed and adapted to the innovation as the innovation unfolds. The controls were part of the innovation more likely than an external device to make it transparent. They engaged the individual trials and changed...

  15. Low Vitamin D Levels Do Not Predict Hyperglycemia in Elderly Endurance Athletes (but in Controls.

    Helmuth Haslacher

    Full Text Available Recent studies revealed a link between hypovitaminosis D3 and the risk for hyperglycemia. Further mechanistic and interventional investigations suggested a common reason for both conditions rather than a causal relationship. Exposure to sunlight is the most relevant source of vitamin D3 (25(OHD, whereas adipose tissue is able to store relevant amounts of the lipophilic vitamin. Since running/bicycling leads to increased out-door time and alters physiological response mechanisms, it can be hypothesized that the correlation between hypovitaminosis D3 and hyperglycemia might be disturbed in outdoor athletes.47 elderly marathoners/bicyclists and 47 age/sex matched controls were studied in a longitudinal setting at baseline and after three years. HbA1c as a surrogate for (pre-diabetic states was quantified via HPLC, 25(OHD levels were measured by means of chemiluminescent assays. Physical performance was assessed by ergometry.When adjusted for seasonal variations, 25(OHD was significantly higher in athletes than in controls. 25(OHD levels inversely correlated with triglycerides in both groups, whereas only in controls an association between high BMI or low physical performance with hypovitaminosis D3 had been found. Likewise, the presence of hypovitaminosis D3 at baseline successfully predicted hyperglycemia at the follow up examinations within the control group (AUC = 0.85, 95% CI [0.74, 0.96], p < .001, statistically independent from BMI, but not in athletes.Our data suggest that mechanisms of HbA1c elevation might differ between athletes and controls. Thus, intense physical activity must be taken into account as a potential pre-analytic confounder when it is aimed to predict metabolic risk by vitamin D3 levels.

  16. Nonresonant Multiple-Pulse Control of Molecular Motions in Liquid

    Nikiforov V.G.

    2015-01-01

    Full Text Available We propose the implementation of the multiple-pulse excitation for manipulation of the molecular contributions to the optically-heterodyne-detected optical-Kerr-effect. The key parameters controlling the specificity of the multiple-pulse excitation scenarios are the pulses durations, the delays between pulses, the relation between the pump pulses amplitudes and the pulses polarizations. We model the high-order optical responses and consider some principles of the scenarios construction. We show that it is possible to adjust the excitation scenario in such a way that the some responses can be removed from detected signal along with the enhancement of the interested response amplitude. The theoretical analysis and first experimental data reveal that the multiple-pulse excitation technique can be useful for the selective spectroscopy of the molecular vibrations and rotations in liquid.

  17. Fall prevention by nursing assistants among community-living elderly people. A randomised controlled trial.

    Fahlström, Gunilla; Kamwendo, Kitty; Forsberg, Jenny; Bodin, Lennart

    2017-08-29

    Falls among elderly are a major public health issue in Sweden. The aim was to determine whether nursing assistants can prevent falls by supervising community-living elderly individuals with a history of falling in performing individually designed home exercise programmes. A randomised controlled trial was performed in Sweden, in eight municipalities in the county of Örebro, during 2007-2009. Community-living persons 65 years or older having experienced at least one fall during the last 12 months were included. The intervention group consisted of 76 participants, and there were 72 in the control group. The interventions were free of charge and were shared between a physiotherapist and a nursing assistant. The former designed a programme aiming to improve balance, leg strength and walking ability. The nursing assistant supervised the performance of activities during eight home visits during a 5-month intervention period. The measures and instruments used were health-related quality of life (SF-36), activity of daily living (ADL-staircase), balance, (Falls Efficacy Scale, and Berg Balance Scale), walking ability (Timed Up and Go and the 3-metre walking test), leg strength, (chair stand test). All participants were asked to keep a structured calendar of their physical exercise, walks and occurrence of falls during their 12-month study period. Hospital healthcare consumption data were collected. Although the 5-month intervention did not significantly decrease the risk for days with falls, RR 1.10 (95% CI 0.58, 2.07), p = 0.77, significant changes in favour of the intervention group were noted for balance (p = 0.03), ADL (p = 0.035), bodily pain (p = 0.003) and reported health transition over time (p = 0.008) as well as less hospital care due to fractures (p = 0.025). Additional studies with more participants are needed to establish whether or not falls can be significantly prevented with this model which is workable in home-based fall prevention. © 2017

  18. The efficacy of agomelatine in elderly patients with recurrent major depressive disorder: a placebo-controlled study.

    Heun, Reinhard; Ahokas, Antti; Boyer, Patrice; Giménez-Montesinos, Natalia; Pontes-Soares, Fernando; Olivier, Valérie

    2013-06-01

    The present placebo-controlled study evaluated the efficacy, tolerability, and safety of 8-week treatment with agomelatine (25-50 mg/d by mouth) in elderly patients with major depressive disorder (MDD). Elderly outpatients aged ≥ 65 years with a primary diagnosis of moderate to severe episode of recurrent MDD (DSM-IV-TR) were recruited in 27 clinical centers in Argentina, Finland, Mexico, Portugal, and Romania from November 2009 to October 2011. The primary outcome measure was the 17-item Hamilton Depression Rating Scale (HDRS17) total score. A total of 222 elderly patients entered the study (151 in the agomelatine group, 71 in the placebo group), including 69 patients aged 75 years and older. Agomelatine improved depressive symptoms in the elderly population, as evaluated by the HDRS17 total score, in terms of last postbaseline value (agomelatine-placebo difference: mean estimate [standard error] = 2.67 [1.06] points; P = .013) and response to treatment (agomelatine, 59.5%; placebo, 38.6%; P = .004). The agomelatine-placebo difference according to the Clinical Global Impressions-Severity of Illness scale (CGI-S) score was 0.48 (0.19). The agomelatine-placebo difference (estimate [standard error]) for remission on the HDRS17 was 6.9% (4.7%) and did not achieve statistical significance (P = .179, post hoc analysis). Clinically relevant effects of agomelatine were confirmed on all end points in the subset of severely depressed patients (HDRS17 total score ≥ 25 and CGI-S score ≥ 5 at baseline). Agomelatine was well tolerated by patients, with only minimal distinctions from placebo. The present study provides the first evidence that an 8-week treatment with agomelatine 25-50 mg/d efficiently relieves depressive symptoms and is well tolerated in elderly depressed patients older than 65 years. Controlled-Trials.com identifier: ISRCTN57507360. © Copyright 2011 Physicians Postgraduate Press, Inc.

  19. Altered control strategy between leading and trailing leg increases knee adduction moment in the elderly while descending stairs.

    Karamanidis, Kiros; Arampatzis, Adamantios

    2011-02-24

    The aim of the study was to examine the external knee adduction moments in a group of older and younger adults while descending stairs and thus the possibility of an increased risk of knee osteoarthritis due to altered knee joint loading in the elderly. Twenty-seven older and 16 younger adults descended a purpose-built staircase. A motion capture system and a force plate were used to determine the subjects' 3D kinematics and ground reaction forces (GRF) during locomotion. Calculation of the leg kinematics and kinetics was done by means of a rigid, three-segment, 3D leg model. In the initial portion of the support phase, older adults showed a more medio-posterior GRF vector relative to the ankle joint, leading to lower ankle joint moments (Pstairs by using the trailing leg before the initiation of the double support phase more compared to the younger ones. The consequence of this altered control strategy while stepping down is a more medially directed GRF vector increasing the magnitude of external knee adduction moment in the elderly. The observed changes between leading and trailing leg in the elderly may cause a redistribution of the mechanical load at the tibiofemoral joint, affecting the initiation and progression of knee osteoarthritis in the elderly. Copyright © 2010 Elsevier Ltd. All rights reserved.

  20. Involved accounting and control in health care : Different perceptions of management accounting and control systems in the Dutch branch of nursing homes, homes for the elderly and homecare

    Wil van Erp

    2014-01-01

    The purpose of this study is to explore why and how Management Accounting and Control Systems (MACS) enact and are enacted upon in the Dutch branch of nursing homes, homes for the elderly and home care. In search for answers, this study chooses an actor-network theory (ANT) perspective combined with

  1. Ultrasound analysis of mental artery flow in elderly patients: a case-control study.

    Baladi, Marina G; Tucunduva Neto, Raul R C M; Cortes, Arthur R G; Aoki, Eduardo M; Arita, Emiko S; Freitas, Claudio F

    2015-01-01

    Mental artery flow decreases with age and may have an aetiological role in alveolar ridge atrophy. The aim of this study was to identify factors associated with alterations of mental artery flow, assessed by ultrasonography. This case-control study was conducted on elderly patients (aged above 60 years) at the beginning of dental treatment. Intraoral B-mode Doppler ultrasonography was used to assess mental artery flow. The cases were defined as patients with a weak/absent ultrasound signal, whereas the controls presented a strong ultrasound signal. Demographics and radiographic findings (low bone mineral density on dual-energy X-ray absorptiometry and mandibular cortical index on panoramic radiographs) were analysed as risk factors for weak/absent ultrasound signal and were calculated as adjusted odds ratios (AORs) with 95% confidence intervals (CIs) using conditional logistic regression. In addition, the Student's t-test was used to compare the mean alveolar bone height of the analysed groups. A p-value <0.05 was considered statistically significant. A total of 30 ultrasound examinations (12 cases and 18 controls) were analysed. A weak/absent mental artery pulse strength was significantly associated with edentulism (AOR = 3.67; 95% CI = 0.86-15.63; p = 0.046). In addition, there was a significant difference in alveolar bone height between edentulous cases and controls (p = 0.036). Within the limitations of this study, the present results indicate that edentulism is associated with diminished mental artery flow, which, in turn, affects alveolar bone height.

  2. Ultrasound analysis of mental artery flow in elderly patients: a case–control study

    Baladi, Marina G; Tucunduva Neto, Raul R C M; Aoki, Eduardo M; Arita, Emiko S; Freitas, Claudio F

    2015-01-01

    Objectives: Mental artery flow decreases with age and may have an aetiological role in alveolar ridge atrophy. The aim of this study was to identify factors associated with alterations of mental artery flow, assessed by ultrasonography. Methods: This case–control study was conducted on elderly patients (aged above 60 years) at the beginning of dental treatment. Intraoral B-mode Doppler ultrasonography was used to assess mental artery flow. The cases were defined as patients with a weak/absent ultrasound signal, whereas the controls presented a strong ultrasound signal. Demographics and radiographic findings (low bone mineral density on dual-energy X-ray absorptiometry and mandibular cortical index on panoramic radiographs) were analysed as risk factors for weak/absent ultrasound signal and were calculated as adjusted odds ratios (AORs) with 95% confidence intervals (CIs) using conditional logistic regression. In addition, the Student's t-test was used to compare the mean alveolar bone height of the analysed groups. A p-value <0.05 was considered statistically significant. Results: A total of 30 ultrasound examinations (12 cases and 18 controls) were analysed. A weak/absent mental artery pulse strength was significantly associated with edentulism (AOR = 3.67; 95% CI = 0.86–15.63; p = 0.046). In addition, there was a significant difference in alveolar bone height between edentulous cases and controls (p = 0.036). Conclusions: Within the limitations of this study, the present results indicate that edentulism is associated with diminished mental artery flow, which, in turn, affects alveolar bone height. PMID:26205777

  3. Memory-guided attention: Control from multiple memory systems

    Hutchinson, J. Benjamin; Turk-Browne, Nicholas B.

    2012-01-01

    Attention is strongly influenced by both external stimuli and internal goals. However, this useful dichotomy does not readily capture the ubiquitous and often automatic contribution of past experience stored in memory. We review recent evidence about how multiple memory systems control attention, consider how such interactions are manifested in the brain, and highlight how this framework for ‘memory-guided attention’ might help systematize previous findings and guide future research.

  4. Distributed Autonomous Control of Multiple Spacecraft During Close Proximity Operations

    2007-12-01

    Neubauer [54][55]. 87 VII. LQR/APF CONTROL ALGORITHM APPROACH The LQR approach can be recursively applied to the multiple spacecraft close... Neubauer and Swartwout’s research [55]. It is generally possible to select a closed map over which the algorithm is stable and robust. For these...can be easily edited and transferred into video format for presentations. Modifications of camera key frames ( camera position and angle) and

  5. The importance of a multidisciplinary assistance program in the control of blood pressure in hypertensive elderly patients

    Alberto Macedo-Soares

    2007-06-01

    Full Text Available Objective: To verify if being placed on a geriatric multidisciplinaryassistance program contributes to better blood pressure control.Methods and Design: Cross-section study. Setting: A tertiary-careteaching hospital in São Paulo, Brazil. Participants: 110 hypertensivepatients aged over 60 years. Measurements: Blood pressure of theelderly in the Geriatric Service, called “the reference group”, wasverified. Subsequently, blood pressure of the same elderly patientswas verified after being placed on a multidisciplinary program - “themultidisciplinary group”. Results: A significant difference betweenthe “reference group” x the “multidisciplinary group” was foundregarding the proportion of patients under blood pressure control (p= 0.021. In the “reference group”, 24.7% of patients had controlledblood pressure while in the “multidisciplinary group” this proportionwas 41.1%. Conclusion: Being placed on a geriatric multidisciplinaryassistance exercise program significantly improved blood pressurecontrol in hypertensive elderly.

  6. The effects of physical training without equipment on pain perception and balance in the elderly: A randomized controlled trial

    Patti, Antonino; Bianco, Antonino; Karsten, Bettina; Montalto, Maria Alessandra; Battaglia, Giuseppe; Bellafiore, Marianna; Cassata, Daniela; Scoppa, Fabio; Paoli, Antonio; Iovane, Angelo; Messina, Giuseppe; Palma, Antonio

    2017-01-01

    BACKGROUND: Research supports a link between exercise and falls prevention in the older population. OBJECTIVES: Our aims were to evaluate pain perception and balance skills in a group of elderly subjects and to examine the consequences of a standardized equipment-free exercise program intervention on these variables. The study utilized a randomized controlled trial method. METHODS: 92 subjects were recruited from a rural Sicilian village (Resuttano, Sicily, Italy). Subjects were randomly split into two groups, an experimental group (EG; n = 49) and a control group (CG; n = 43). Qualified fitness instructors delivered the standardized physical exercise program for the EG whilst the CG did not receive this exercise intervention. The Berg Balance Scale and the Oswestry Disability Index were administered in both groups before (T0) and after the intervention (T1). RESULTS: At T1, the EG group significantly improvement in balance (p disability in elderly. PMID:28506013

  7. Stability analysis of multiple-robot control systems

    Wen, John T.; Kreutz, Kenneth

    1989-01-01

    In a space telerobotic service scenario, cooperative motion and force control of multiple robot arms are of fundamental importance. Three paradigms to study this problem are proposed. They are distinguished by the set of variables used for control design. They are joint torques, arm tip force vectors, and an accelerated generalized coordinate set. Control issues related to each case are discussed. The latter two choices require complete model information, which presents practical modeling, computational, and robustness problems. Therefore, focus is on the joint torque control case to develop relatively model independent motion and internal force control laws. The rigid body assumption allows the motion and force control problems to be independently addressed. By using an energy motivated Lyapunov function, a simple proportional derivative plus gravity compensation type of motion control law is always shown to be stabilizing. The asymptotic convergence of the tracing error to zero requires the use of a generalized coordinate with the contact constraints taken into account. If a non-generalized coordinate is used, only convergence to a steady state manifold can be concluded. For the force control, both feedforward and feedback schemes are analyzed. The feedback control, if proper care has been taken, exhibits better robustness and transient performance.

  8. Diagnósticos de enfermagem de idosos que utilizam múltiplos medicamentos Diagnósticos de enfermería de ancianos polimedicados Nursing diagnoses of elderly patients using multiple drugs

    Maria José Sanches Marin

    2010-03-01

    multiple drugs are prone to a higher vulnerability of their health conditions, in this study we proposed to identify nursing diagnoses, according to NANDA´s taxonomy II, in a group of elderly people who use five or more drugs. Sixty-seven elderly people were selected using the Wide Geriatric Evaluation (WGE, out of 301 elderly residents from a Family Health Program (PSF unit. All of the 67 seniors presented a total 16 diagnostic categories, an average of 5.2 diagnostics/elderly: 59.7% of them having chronic pain; 58.2% with impaired physical mobility; 47.7% with unbalanced nutrition: more than the body needs; and 47.7% have an inefficient control of the therapeutic regimen, among others. These diagnoses reveal the need for measures involving changes in lifestyle, as well as a systematic following of these elderly people.

  9. Bright light treatment in elderly patients with nonseasonal major depressive disorder: a randomized placebo-controlled trial.

    Lieverse, Ritsaert; Van Someren, Eus J W; Nielen, Marjan M A; Uitdehaag, Bernard M J; Smit, Jan H; Hoogendijk, Witte J G

    2011-01-01

    Major depressive disorder (MDD) in elderly individuals is prevalent and debilitating. It is accompanied by circadian rhythm disturbances associated with impaired functioning of the suprachiasmatic nucleus, the biological clock of the brain. Circadian rhythm disturbances are common in the elderly. Suprachiasmatic nucleus stimulation using bright light treatment (BLT) may, therefore, improve mood, sleep, and hormonal rhythms in elderly patients with MDD. To determine the efficacy of BLT in elderly patients with MDD. Double-blind, placebo-controlled randomized clinical trial. Home-based treatment in patients recruited from outpatient clinics and from case-finding using general practitioners' offices in the Amsterdam region. Eighty-nine outpatients 60 years or older who had MDD underwent assessment at baseline (T0), after 3 weeks of treatment (T1), and 3 weeks after the end of treatment (T2). Intervention Three weeks of 1-hour early-morning BLT (pale blue, approximately 7500 lux) vs placebo (dim red light, approximately 50 lux). Mean improvement in Hamilton Scale for Depression scores at T1 and T2 using parameters of sleep and cortisol and melatonin levels. Intention-to-treat analysis showed Hamilton Scale for Depression scores to improve with BLT more than placebo from T0 to T1 (7%; 95% confidence interval, 4%-23%; P = .03) and from T0 to T2 (21%; 7%-31%; P = .001). At T1 relative to T0, get-up time after final awakening in the BLT group advanced by 7% (P hour urinary free cortisol level was 37% lower (P = .003) compared with the placebo group. The evening salivary cortisol level had decreased by 34% in the BLT group compared with an increase of 7% in the placebo group (P = .02). In elderly patients with MDD, BLT improved mood, enhanced sleep efficiency, and increased the upslope melatonin level gradient. In addition, BLT produced continuing improvement in mood and an attenuation of cortisol hyperexcretion after discontinuation of treatment. clinicaltrials

  10. The influence of a protocol of aquatic exercises in postural control of obese elderly

    I.S. Avelar

    2018-04-01

    Full Text Available Objective: The objective of this study was to evaluate the effects of a protocol of aquatic exercises in postural control of elderly subjects with overweight and the influence of body mass and body mass index in variables of the center of pressure. Method: Each participant was positioned on the force platform, without shoes, feet apart on the same alignment of the upper limbs along the body. For the collection, the subjects were instructed to stay on in bipedal support on the force platform with eyes fixed on the bright spot for 60 s. Results: Results indicated a notable difference in the variables root mean square-mediolateral and COP area after aquatic exercise practice. However, visual condition analyzed indicates significant differences in the variables root mean square-anteroposterior and speed anteroposterior. Conclusion: Aquatic exercise had positive effects when analyzing the sensory condition suggesting maintenance of postural control. However, when analyzed post aquatic exercise in closed eyes condition and the interaction effects of visual condition did not improve postural stability. In obese elderly, body mass index resulted in a functional adaptation in control of upright stance, suggesting that the balance was preserved in the population studied. Resumen: Objetivo: El objetivo de este estudio fue evaluar los efectos de un protocolo de ejercicios acuáticos en el control postural de sujetos de edad avanzada con exceso de peso y la influencia de masa corporal y el índice de masa corporal en las variables del centro de presiones. Método: Cada participante se posicionó en la plataforma de fuerza sin zapatos, los pies separados con la misma alineación de las extremidades superiores a lo largo del cuerpo. Para el análisis, los sujetos fueron instruidos para permanecer en apoyo bípedo sobre la plataforma de fuerza con los ojos fijos en un punto brillante durante 60 segundos. Resultados: Los resultados indicaron una diferencia

  11. Phase transitions in distributed control systems with multiplicative noise

    Allegra, Nicolas; Bamieh, Bassam; Mitra, Partha; Sire, Clément

    2018-01-01

    Contemporary technological challenges often involve many degrees of freedom in a distributed or networked setting. Three aspects are notable: the variables are usually associated with the nodes of a graph with limited communication resources, hindering centralized control; the communication is subject to noise; and the number of variables can be very large. These three aspects make tools and techniques from statistical physics particularly suitable for the performance analysis of such networked systems in the limit of many variables (analogous to the thermodynamic limit in statistical physics). Perhaps not surprisingly, phase-transition like phenomena appear in these systems, where a sharp change in performance can be observed with a smooth parameter variation, with the change becoming discontinuous or singular in the limit of infinite system size. In this paper, we analyze the so called network consensus problem, prototypical of the above considerations, that has previously been analyzed mostly in the context of additive noise. We show that qualitatively new phase-transition like phenomena appear for this problem in the presence of multiplicative noise. Depending on dimensions, and on the presence or absence of a conservation law, the system performance shows a discontinuous change at a threshold value of the multiplicative noise strength. In the absence of the conservation law, and for graph spectral dimension less than two, the multiplicative noise threshold (the stability margin of the control problem) is zero. This is reminiscent of the absence of robust controllers for certain classes of centralized control problems. Although our study involves a ‘toy’ model, we believe that the qualitative features are generic, with implications for the robust stability of distributed control systems, as well as the effect of roundoff errors and communication noise on distributed algorithms.

  12. Multiple-Vehicle Longitudinal Collision Mitigation by Coordinated Brake Control

    Xiao-Yun Lu

    2014-01-01

    Full Text Available Rear-end collision often leads to serious casualties and traffic congestion. The consequences are even worse for multiple-vehicle collision. Many previous works focused on collision warning and avoidance strategies of two consecutive vehicles based on onboard sensor detection only. This paper proposes a centralized control strategy for multiple vehicles to minimize the impact of multiple-vehicle collision based on vehicle-to-vehicle communication technique. The system is defined as a coupled group of vehicles with wireless communication capability and short following distances. The safety relationship can be represented as lower bound limit on deceleration of the first vehicle and upper bound on maximum deceleration of the last vehicle. The objective is to determine the desired deceleration for each vehicle such that the total impact energy is minimized at each time step. The impact energy is defined as the relative kinetic energy between a consecutive pair of vehicles (approaching only. Model predictive control (MPC framework is used to formulate the problem to be constrained quadratic programming. Simulations show its effectiveness on collision mitigation. The developed algorithm has the potential to be used for progressive market penetration of connected vehicles in practice.

  13. Strength training in elderly people improves static balance: a randomized controlled trial

    Sarabon Nejc

    2013-07-01

    Full Text Available Aim of this study was to investigate the effects of two different types of strength training programs on static balance in elderly subjects. Subjects older than 65 years of age were enrolled and assigned to control group (CG, n =19, electrical stimulation group (ES, n = 27 or leg press group (LP, n = 28. Subjects in both the training groups were exposed to training (2-3x/week for a period of 9 weeks. In the ES group the subjects received neuromuscular electrical stimulation of the anterior thigh muscles. In the LP group the subjects performed strength training on a computer-controlled leg press machine. Before and after the training period, static balance of the subject was tested using a quiet stance task. Average velocity, amplitude and frequency of the center-of-pressure (CoP were calculated from the acquired force plate signal. The data was statistically tested with analysis of (covariance and t-tests. The three groups of subjects showed statistically significant differences (p < 0.05 regarding the pre-training vs. post-training changes in CoP velocity, amplitude and frequency. The differences were more pronounced for CoP velocity and amplitude, while they were less evident in case of mean frequency. The mean improvements were higher in the LP group than in the ES group. Our results provide supportive evidence to the existence of the strength-balance relationship. Additionally, results indicate the role of recruiting central processes and activation of functional kinetic chains for the better end effect.

  14. Active ocular vergence improves postural control in elderly as close viewing distance with or without a single cognitive task.

    Matheron, Eric; Yang, Qing; Delpit-Baraut, Vincent; Dailly, Olivier; Kapoula, Zoï

    2016-01-01

    Performance of the vestibular, visual, and somatosensory systems decreases with age, reducing the capacity of postural control, and increasing the risk of falling. The purpose of this study is to measure the effects of vision, active vergence eye movements, viewing distance/vergence angle and a simple cognitive task on postural control during an upright stance, in completely autonomous elderly individuals. Participated in the study, 23 elderly subjects (73.4 ± 6.8 years) who were enrolled in a center dedicated to the prevention of falling. Their body oscillations were measured with the DynaPort(®) device, with three accelerometers, placed at the lumbosacral level, near the center of mass. The conditions were the following: eyes open fixating on LED at 20 cm or 150 cm (vergence angle 17.0° and 2.3° respectively) with or without additional cognitive tasks (counting down from one hundred), performing active vergence by alternating the fixation between the far and the near LED (convergence and divergence), eyes closed after having fixated the far LED. The results showed that the postural stability significantly decreased when fixating on the LED at a far distance (weak convergence angle) with or without cognitive tasks; active convergence-divergence between the LEDs improved the postural stability while eye closure decreased it. The privilege of proximity (with increased convergence at near), previously established with foot posturography, is shown here to be valid for accelerometry with the center of mass in elderly. Another major result is the beneficial contribution of active vergence eye movements to better postural stability. The results bring new perspectives for the role of eye movement training to preserve postural control and autonomy in elderly. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  15. Reliability Analysis Multiple Redundancy Controller for Nuclear Safety Systems

    Son, Gwangseop; Kim, Donghoon; Son, Choulwoong

    2013-01-01

    This controller is configured for multiple modular redundancy (MMR) composed of dual modular redundancy (DMR) and triple modular redundancy (TMR). The architecture of MRC is briefly described, and the Markov model is developed. Based on the model, the reliability and Mean Time To Failure (MTTF) are analyzed. In this paper, the architecture of MRC for nuclear safety systems is described. The MRC is configured for multiple modular redundancy (MMR) composed of dual modular redundancy (DMR) and triple modular redundancy (TMR). Markov models for MRC architecture was developed, and then the reliability was analyzed by using the model. From the reliability analyses for the MRC, it is obtained that the failure rate of each module in the MRC should be less than 2 Χ 10 -4 /hour and the MTTF average increase rate depending on FCF increment, i. e. ΔMTTF/ΔFCF, is 4 months/0.1

  16. Multiple levels of epigenetic control for bone biology and pathology.

    Montecino, Martin; Stein, Gary; Stein, Janet; Zaidi, Kaleem; Aguilar, Rodrigo

    2015-12-01

    Multiple dimensions of epigenetic control contribute to regulation of gene expression that governs bone biology and pathology. Once confined to DNA methylation and a limited number of post-translational modifications of histone proteins, the definition of epigenetic mechanisms is expanding to include contributions of non-coding RNAs and mitotic bookmarking, a mechanism for retaining phenotype identity during cell proliferation. Together these different levels of epigenetic control of physiological processes and their perturbations that are associated with compromised gene expression during the onset and progression of disease, have contributed to an unprecedented understanding of the activities (operation) of the genomic landscape. Here, we address general concepts that explain the contribution of epigenetic control to the dynamic regulation of gene expression during eukaryotic transcription. This article is part of a Special Issue entitled Epigenetics and Bone. Copyright © 2015 Elsevier Inc. All rights reserved.

  17. The impact of group music therapy on depression and cognition in elderly persons with dementia: a randomized controlled study.

    Chu, Hsin; Yang, Chyn-Yng; Lin, Yu; Ou, Keng-Liang; Lee, Tso-Ying; O'Brien, Anthony Paul; Chou, Kuei-Ru

    2014-04-01

    The aims of this study were to determine the effectiveness of group music therapy for improving depression and delaying the deterioration of cognitive functions in elderly persons with dementia. The study had a prospective, parallel-group design with permuted-block randomization. Older persons with dementia (N = 104) were randomly assigned to the experimental or control group. The experimental group received 12 sessions of group music therapy (two 30-min sessions per week for 6 weeks), and the control group received usual care. Data were collected 4 times: (1) 1 week before the intervention, (2) the 6th session of the intervention, (3) the 12th session of the intervention, and (4) 1 month after the final session. Group music therapy reduced depression in persons with dementia. Improvements in depression occurred immediately after music therapy and were apparent throughout the course of therapy. The cortisol level did not significantly decrease after the group music therapy. Cognitive function significantly improved slightly at the 6th session, the 12th session, and 1 month after the sessions ended; in particular, short-term recall function improved. The group music therapy intervention had the greatest impact in subjects with mild and moderate dementia. The group music intervention is a noninvasive and inexpensive therapy that appeared to reduce elders' depression. It also delayed the deterioration of cognitive functions, particularly short-term recall function. Group music therapy may be an appropriate intervention among elderly persons with mild and moderate dementia.

  18. Stable schizophrenia patients learn equally well as age-matched controls and better than elderly controls in two sensorimotor Rotary Pursuit tasks

    Livia J. De Picker

    2014-11-01

    Full Text Available Objective: To compare sensorimotor performance and learning in stable schizophrenia patients, healthy age- and sex-matched controls and elderly controls on two variations of the Rotary Pursuit: Circle Pursuit (true motor learning and Figure Pursuit (motor and sequence learning.Method: In the Circle Pursuit a target circle, rotating with increasing speed along a predictable circular path on the computer screen, must be followed by a cursor controlled by a pen on a writing tablet. In the eight-trial Figure Pursuit, subjects learn to draw a complex figure by pursuing the target circle that moves along an invisible trajectory between and around several goals. Tasks were administered thrice (day 1, day 2, day 7 to 30 patients with stable schizophrenia (S, 30 healthy age- and sex-matched controls (C and 30 elderly participants (>65y; E and recorded with a digitizing tablet and pressure-sensitive pen. The outcome measure accuracy (% of time that cursor is within the target was used to assess performance.Results: We observed significant group differences in accuracy, both in Circle and Figure Pursuit tasks (Econtrols were equal and both were larger than those of the elderly controls. Conclusion: Despite the reduced sensorimotor performance that was found in the schizophrenia patients their sensorimotor learning seems to be preserved. The relevance of this finding for the evaluation of procedural learning in schizophrenia is discussed. The better performance and learning rate of the patients compared to the elderly controls was unexpected and deserves further study.

  19. An Overview on SDN Architectures with Multiple Controllers

    Othmane Blial

    2016-01-01

    Full Text Available Software-defined networking offers several benefits for networking by separating the control plane from the data plane. However, networks’ scalability, reliability, and availability remain as a big issue. Accordingly, multicontroller architectures are important for SDN-enabled networks. This paper gives a comprehensive overview of SDN multicontroller architectures. It presents SDN and its main instantiation OpenFlow. Then, it explains in detail the differences between multiple types of multicontroller architectures, like the distribution method and the communication system. Furthermore, it provides already implemented and under research examples of multicontroller architectures by describing their design, their communication process, and their performance results.

  20. Comparing the Effects of Reflexology and Footbath on Sleep Quality in the Elderly: A Controlled Clinical Trial.

    Valizadeh, Leila; Seyyedrasooli, Alehe; Zamanazadeh, Vahid; Nasiri, Khadijeh

    2015-11-01

    Sleep disorders are common mental disorders reported among the elderly in all countries, and with nonpharmacological interventions, they could be helped to improve their sleep quality. The aim of this study was to compare the effects of two interventions, foot reflexology and foot bath, on sleep quality in elderly people. This three-group randomized clinical trial (two experimental groups and a control group) was conducted on 69 elderly men. The two experimental groups had reflexology (n = 23) and foot bath (n = 23) interventions for 6 weeks. The reflexology intervention was done in the mornings, once a week for ten minutes on each foot. The participants in the foot bath group were asked to soak their feet in 41°C to 42°C water one hour before sleeping. The pittsburgh sleep quality index (PSQI) was completed before and after the intervention through an interview process. The results showed that the PSQI scores after intervention compared to before it in the reflexology and foot bath groups were statistically significant (P = 0.01 , P = 0.001); however, in the control group did not show a statistically significant difference (P = 0.14). In addition, the total score changes among the three groups were statistically significant (P = 0.01). Comparing the score changes of quality of sleep between the reflexology and foot bath groups showed that there was no significant difference in none of the components and the total score (P = 0.09). The two interventions had the same impact on the quality of sleep. It is suggested that the training of nonpharmacological methods to improve sleep quality such as reflexology and foot bath be included in the elderly health programs. In addition, it is recommended that the impact of these interventions on subjective sleep quality using polysomnographic recordings be explored in future research.

  1. A pilot study on the views of elderly regional Australians of personally controlled electronic health records.

    Kerai, Paresh; Wood, Pene; Martin, Mary

    2014-03-01

    Australia introduced its version of personal health records in July 2012. Success of the personally controlled electronic health record (PCEHR) relies on acceptance during the early stages. The main aim of this study was to investigate the views of a sample of elderly people in a non-metropolitan region in Australia on the PCEHR, and to assess their acceptance levels of this concept. A self-administered questionnaire was distributed to a non-probability convenience sample of respondents recruited from meetings of Probus, a community club for active business and professional retirees. Approximately three-quarters of the respondents had computer and Internet access at home. If not accessed at home a computer at a general practitioner's practice was seen as beneficial in accessing the PCEHR. Respondents felt that access to their health record would help them make decisions about their own health and improve their communication with healthcare providers. The majority of respondents were in favour of the PCEHR although some expressed concerns about the security of their PCEHR. There was mixed opinion surrounding the access by health professionals to an individual's PCEHR. This study has revealed important information about views of the PCEHR. While the respondents were generally in favour of the concept, there were still some concerns about the security of the PCEHR suggesting further reassurance may be required. The study also highlighted some measures, in particular provision of General Practitioner computer access points and print-out facilities that may need to be considered during these initial implementation stages in order to improve adoption rates once the technology is fully available. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  2. Optically controlled multiple switching operations of DNA biopolymer devices

    Hung, Chao-You; Tu, Waan-Ting; Lin, Yi-Tzu; Fruk, Ljiljana; Hung, Yu-Chueh

    2015-01-01

    We present optically tunable operations of deoxyribonucleic acid (DNA) biopolymer devices, where a single high-resistance state, write-once read-many-times memory state, write-read-erase memory state, and single low-resistance state can be achieved by controlling UV irradiation time. The device is a simple sandwich structure with a spin-coated DNA biopolymer layer sandwiched by two electrodes. Upon irradiation, the electrical properties of the device are adjusted owing to a phototriggered synthesis of silver nanoparticles in DNA biopolymer, giving rise to multiple switching scenarios. This technique, distinct from the strategy of doping of pre-formed nanoparticles, enables a post-film fabrication process for achieving optically controlled memory device operations, which provides a more versatile platform to fabricate organic memory and optoelectronic devices

  3. Optically controlled multiple switching operations of DNA biopolymer devices

    Hung, Chao-You; Tu, Waan-Ting; Lin, Yi-Tzu [Institute of Photonics Technologies, National Tsing Hua University, Hsinchu 30013, Taiwan (China); Fruk, Ljiljana [Department of Chemical Engineering and Biotechnology, University of Cambridge, Pembroke Street, Cambridge CB2 3RA (United Kingdom); Hung, Yu-Chueh, E-mail: ychung@ee.nthu.edu.tw [Institute of Photonics Technologies, National Tsing Hua University, Hsinchu 30013, Taiwan (China); Department of Electrical Engineering, National Tsing Hua University, Hsinchu 30013, Taiwan (China)

    2015-12-21

    We present optically tunable operations of deoxyribonucleic acid (DNA) biopolymer devices, where a single high-resistance state, write-once read-many-times memory state, write-read-erase memory state, and single low-resistance state can be achieved by controlling UV irradiation time. The device is a simple sandwich structure with a spin-coated DNA biopolymer layer sandwiched by two electrodes. Upon irradiation, the electrical properties of the device are adjusted owing to a phototriggered synthesis of silver nanoparticles in DNA biopolymer, giving rise to multiple switching scenarios. This technique, distinct from the strategy of doping of pre-formed nanoparticles, enables a post-film fabrication process for achieving optically controlled memory device operations, which provides a more versatile platform to fabricate organic memory and optoelectronic devices.

  4. [Glaucoma and pitfalls in therapy in the elderly with multiple morbidity from the viewpoint of the geriatrician].

    Weber, P; Svacinová, J

    2001-07-19

    Glaucoma in multi-morbid patients is frequently treated by specialists non-ophthalmologists. The growing number of elderly patients with glaucoma and comparatively small knowledge on this disease among the medical workers brought us to review recent findings on the aetiology, pathogenesis, risks of development and namely the problems of glaucoma treatment, possible drug interactions and their side effects. Considering the growing incidence of glaucoma with age, general practitioners, internists, geriatrists and other specialists will face the problems of drug interactions and global or ophthalmological side effects during the polypharmacological treatment of their multi-morbid seniors. The article gives basic information on the problems of using antiglaucoma drugs and their effects on the organism and eyes. Effects of some foodstuff and medicaments used in therapy of other diseases on the intraocular pressure and glaucoma are also summarise.

  5. Improved glycemic control without hypoglycemia in elderly diabetic patients using the ubiquitous healthcare service, a new medical information system.

    Lim, Soo; Kang, Seon Mee; Shin, Hayley; Lee, Hak Jong; Won Yoon, Ji; Yu, Sung Hoon; Kim, So-Youn; Yoo, Soo Young; Jung, Hye Seung; Park, Kyong Soo; Ryu, Jun Oh; Jang, Hak C

    2011-02-01

    To improve quality and efficiency of care for elderly patients with type 2 diabetes, we introduced elderly-friendly strategies to the clinical decision support system (CDSS)-based ubiquitous healthcare (u-healthcare) service, which is an individualized health management system using advanced medical information technology. We conducted a 6-month randomized, controlled clinical trial involving 144 patients aged >60 years. Participants were randomly assigned to receive routine care (control, n = 48), to the self-monitored blood glucose (SMBG, n = 47) group, or to the u-healthcare group (n = 49). The primary end point was the proportion of patients achieving A1C healthcare system refers to an individualized medical service in which medical instructions are given through the patient's mobile phone. Patients receive a glucometer with a public switched telephone network-connected cradle that automatically transfers test results to a hospital-based server. Once the data are transferred to the server, an automated system, the CDSS rule engine, generates and sends patient-specific messages by mobile phone. After 6 months of follow-up, the mean A1C level was significantly decreased from 7.8 ± 1.3% to 7.4 ± 1.0% (P healthcare group and from 7.9 ± 1.0% to 7.7 ± 1.0% (P = 0.020) in the SMBG group, compared with 7.9 ± 0.8% to 7.8 ± 1.0% (P = 0.274) in the control group. The proportion of patients with A1C healthcare group, 23.4% in the SMBG group (23.4%), and 14.0% in the control group (P healthcare service achieved better glycemic control with less hypoglycemia than SMBG and routine care and may provide effective and safe diabetes management in the elderly diabetic patients.

  6. Effect of a geriatric consultation team on functional status of elderly hospitalized patients. A randomized, controlled clinical trial.

    McVey, L J; Becker, P M; Saltz, C C; Feussner, J R; Cohen, H J

    1989-01-01

    To evaluate the impact of a geriatric consultation team on the functional status of hospitalized elderly patients. Randomized controlled clinical trial. University-affiliated referral Veterans Administration Medical Center. One hundred and seventy-eight hospitalized elderly men 75 years or older admitted to medical, surgical, and psychiatry services, but excluding patients admitted to intensive care units. Eighty-eight intervention group patients received multidimensional evaluation by an interdisciplinary geriatric consultation team composed of a faculty geriatrician, geriatrics fellow, geriatric clinical nurse specialist, and a social worker trained in geriatrics. Results of the evaluation, including problem identification and recommendations, were given to the patients' physicians. Ninety control group patients received only usual care. Intervention and control groups were comparable initially. The major outcome variable was the Index of Independence in the Activities of Daily Living (ADL) (Katz). Thirty-nine percent of the total study population was functionally independent on admission, 27% required assistance with one to three ADL, 22% required assistance with four to six ADL, and 12% were completely dependent. Many patients remained unchanged from admission to discharge: intervention group, 38%; control group, 39%. In the intervention group, 34% improved and 28% declined; in the control group, 26% improved and 36% declined. Although these changes reflected a trend toward greater improvement in the intervention group, the results were not statistically significant. Among elderly patients entering an acute-care hospital, approximately 60% had some degree of, and one third had serious functional disability. Such patients are at risk for further decline during hospitalization. A geriatric consultation team was unable to alter the degree of functional decline. Geriatric units or consultation teams may have to offer direct preventive or restorative services in

  7. The prevalence of lacunar infarct decreases with aging in the elderly: a case-controlled analysis

    Cai Z

    2016-05-01

    Full Text Available Zhiyou Cai,1 Wenbo He,1 Chuan-yong Peng,2 Jin Zhou,2 Qi-lan Xu,2 Zong-shan Wu2 1Department of Neurology, Renmin Hospital, Hubei University of Medicine, Shiyan Renmin Hospital, Shiyan, Hubei Province, 2The Examination Center of Magnetic Resonance Imaging, the Lu’an Affiliated Hospital of Anhui Medical University, Lu’an People’s Hospital, Lu’an, Anhui Province, People’s Republic of China Background and purpose: Lacunar infarct (LI is well known as a heterogeneous primary disorder of cerebral small vessel. Compelling results have demonstrated that age is a risk factor to the prevalence of LI. However, the relationship between age and the prevalence of LI remains obscure. It is essential to note the relationship between age and the prevalence of LI through more clinical data. Methods: A total of 3,500 patients were included in the case-controlled study. All data were collected from the Examination Center of Magnetic Resonance Imaging, Lu’an People’s Hospital from January 2014 to December 2015. A primary discharge diagnosis of LI was done, and all subjects were evaluated as retrospective data. The relationship between the risk factors and the prevalence of diabetes and the relationship between age and the prevalence of diabetes was analyzed. A chi-square test was used to analyze the associations between different variables. A one-way analysis of variance was used to test the equality of three or more means at one time by using variances. Statistical significance was defined as a P-value of <0.05. Results: The one-way analysis of variance demonstrated that the prevalence of LI increased with age before 60 years and decreased with age after 69 years. The same results were found in both the male and the female subjects. These results showed that the age-related risk factors (hypertension, diabetes, cerebral infarct, cardiovascular diseases, smoking, and drinking have no relationship with the prevalence of LI on the basis of age. There is

  8. The Elder Problem

    John W. Elder

    2017-03-01

    Full Text Available This paper presents an autobiographical and biographical historical account of the genesis, evolution and resolution of the Elder Problem. It begins with John W. Elder and his autobiographical story leading to his groundbreaking work on natural convection at Cambridge in the 1960’s. His seminal work published in the Journal of Fluid Mechanics in 1967 became the basis for the modern benchmark of variable density flow simulators that we know today as “The Elder Problem”. There have been well known and major challenges with the Elder Problem model benchmark—notably the multiple solutions that were ultimately uncovered using different numerical models. Most recently, it has been shown that the multiple solutions are indeed physically realistic bifurcation solutions to the Elder Problem and not numerically spurious artefacts. The quandary of the Elder Problem has now been solved—a major scientific breakthrough for fluid mechanics and for numerical modelling. This paper—records, reflections, reminiscences, stories and anecdotes—is an historical autobiographical and biographical memoir. It is the personal story of the Elder Problem told by some of the key scientists who established and solved the Elder Problem. 2017 marks the 50 year anniversary of the classical work by John W. Elder published in Journal of Fluid Mechanics in 1967. This set the stage for this scientific story over some five decades. This paper is a celebration and commemoration of the life and times of John W. Elder, the problem named in his honour, and some of the key scientists who worked on, and ultimately solved, it.

  9. Multicomponent Program to Reduce Functional Decline in Frail Elderly People : A Cluster Controlled Trial

    Ruikes, Franca G. H.; Zuidema, Sytse U.; Akkermans, Reinier P.; Assendelft, Willem J. J.; Schers, Henk J.; Koopmans, Raymond T. C. M.

    2016-01-01

    Background: The increasing number of community-dwelling frail elderly people poses a challenge to general practice. We evaluated the effectiveness of a general practitioner-led extensive, multicomponent program integrating cure, care, and welfare for the prevention of functional decline. Methods: We

  10. Multicomponent Program to Reduce Functional Decline in Frail Elderly People: A Cluster Controlled Trial

    Ruikes, F.G.; Zuidema, S.U.; Akkermans, R.P.; Assendelft, W.J.; Schers, H.J.; Koopmans, R.T.

    2016-01-01

    BACKGROUND: The increasing number of community-dwelling frail elderly people poses a challenge to general practice. We evaluated the effectiveness of a general practitioner-led extensive, multicomponent program integrating cure, care, and welfare for the prevention of functional decline. METHODS: We

  11. Co-morbidity and treatment outcomes of elderly pharyngeal cancer patients : A matched control study

    Peters, Thomas T. A.; Langendijk, Johannes A.; Plaat, Boudewijn; Wedman, Jan; Roodenburg, Jan L. N.; van Dijk, Boukje A. C.; Sluiter, Wim J.; van der Laan, Bernard F. A. M.; Halmos, Gyorgy

    2011-01-01

    Treatment choice in elderly pharyngeal cancer patient is disputed. This study was aimed to asses association of co-morbidity, complications and survival in different treatment modalities of pharyngeal cancer patients. Retrospective analysis of pharyngeal cancer patients, diagnosed between 1997 and

  12. The Influence of Control on the Acceptance of Ambient Intelligence by Elderly : an Explorative Study

    Lambert Zaad

    2008-01-01

    This paper presents the results of a study on how elderly people perceive an intelligent system, embedded in their home, which should enable them to live independently longer. Users of a motion sensor system were interviewed about their experiences. A sensor system that autonomously works as well as

  13. Orthostatic circulatory control in the elderly evaluated by non-invasive continuous blood pressure measurement

    Imholz, B. P.; Dambrink, J. H.; Karemaker, J. M.; Wieling, W.

    1990-01-01

    1. Continuous orthostatic responses of blood pressure and heart rate were measured in 40 healthy and active elderly subjects over 70 years of age in order to assess the time course and rapidity of orthostatic cardiovascular adaptation in old age. 2. During the first 30 s (initial phase) the effects

  14. Evaluation of the Prevention and Reactivation Care Program (PReCaP) for the hospitalized elderly: A prospective nonrandomized controlled trial

    Asmus-Szepesi, Kirsten; Flinterman, Linda; Koopmanschap, Marc; Nieboer, Anna; Bakker, Ton; Mackenbach, Johan; Steyerberg, Ewout

    2015-01-01

    textabstractBackground: The hospitalized elderly are at risk of functional decline. We evaluated the effects and care costs of a specialized geriatric rehabilitation program aimed at preventing functional decline among at-risk hospitalized elderly. Methods: The prospective nonrandomized controlled trial reported here was performed in three hospitals in the Netherlands. One hospital implemented the Prevention and Reactivation Care Program (PReCaP), while two other hospitals providing usual car...

  15. Effects of tai chi qigong on psychosocial well-being among hidden elderly, using elderly neighborhood volunteer approach: a pilot randomized controlled trial

    Chan,Aileen; Yu,Doris; Choi,Kai

    2017-01-01

    Aileen WK Chan, Doris SF Yu, KC Choi The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, NT, Hong Kong SAR Purpose: To test the feasibility and preliminary effectiveness of a tai chi qigong program with the assistance of elderly neighborhood volunteers in strengthening social networks and enhancing the psychosocial well-being of hidden elderly. Patients and methods: “Hidden elderly” is a term used to describe older adults w...

  16. Promoting physical activity in sedentary elderly Malays with type 2 diabetes: a protocol for randomised controlled trial

    Sazlina, Shariff-Ghazali; Browning, Colette Joy; Yasin, Shajahan

    2012-01-01

    Introduction Like many countries Malaysia is facing an increase in the number of people with type 2 diabetes mellitus diabetes (T2DM) and modifiable lifestyle factors such as sedentary behaviour are important drivers of this increase. The level of physical activity is low among elderly Malay people. In Malaysia, strategies to promote physical activity in elderly Malay people with T2DM are not well documented in the research literature. This paper discusses an intervention to increase physical activity in elderly Malay people with T2DM. The aim of our study was to evaluate the effectiveness of personalised feedback alone and in combination with peer support in promoting and maintaining physical activity in comparison with usual care. Methods and analysis A three-arm randomised controlled trial will be conducted among sedentary Malay adults aged 60 years and above with T2DM attending an urban primary healthcare clinic in Malaysia. The participants will be randomised into three groups for a 12-week intervention with a follow-up at 24 and 36 weeks to assess adherence. The primary outcome of this study is pedometer-determined physical activity. Glycaemic and blood pressure control, body composition, cardiorespiratory fitness, balance, lipid profile, health-related quality of life, psychological well-being, social support and self-efficacy for exercise are the secondary measures. Linear mixed models will be used to determine the effect of the intervention over time and between groups. Ethical and dissemination The Monash University Human Research Ethics Committee and the Malaysian Ministry of Health's Medical Research Ethics Committee approved this protocol. The findings of this study will be presented at international conferences and published in peer-reviewed journals. Trial registration This study protocol has been registered with the Malaysian National Medical Research Registry and with the Current Controlled Trial Ltd (http://www.controlled

  17. Promoting physical activity in sedentary elderly Malays with type 2 diabetes: a protocol for randomised controlled trial.

    Sazlina, Shariff-Ghazali; Browning, Colette Joy; Yasin, Shajahan

    2012-01-01

    Like many countries Malaysia is facing an increase in the number of people with type 2 diabetes mellitus diabetes (T2DM) and modifiable lifestyle factors such as sedentary behaviour are important drivers of this increase. The level of physical activity is low among elderly Malay people. In Malaysia, strategies to promote physical activity in elderly Malay people with T2DM are not well documented in the research literature. This paper discusses an intervention to increase physical activity in elderly Malay people with T2DM. The aim of our study was to evaluate the effectiveness of personalised feedback alone and in combination with peer support in promoting and maintaining physical activity in comparison with usual care. A three-arm randomised controlled trial will be conducted among sedentary Malay adults aged 60 years and above with T2DM attending an urban primary healthcare clinic in Malaysia. The participants will be randomised into three groups for a 12-week intervention with a follow-up at 24 and 36 weeks to assess adherence. The primary outcome of this study is pedometer-determined physical activity. Glycaemic and blood pressure control, body composition, cardiorespiratory fitness, balance, lipid profile, health-related quality of life, psychological well-being, social support and self-efficacy for exercise are the secondary measures. Linear mixed models will be used to determine the effect of the intervention over time and between groups. ETHICAL AND DISSEMINATION: The Monash University Human Research Ethics Committee and the Malaysian Ministry of Health's Medical Research Ethics Committee approved this protocol. The findings of this study will be presented at international conferences and published in peer-reviewed journals. This study protocol has been registered with the Malaysian National Medical Research Registry and with the Current Controlled Trial Ltd (http://www.controlled-trials.com/ISRCTN71447000/).

  18. Femoral nerve block in a representative sample of elderly people with hip fracture: A randomised controlled trial.

    Unneby, Anna; Svensson, Olle; Gustafson, Yngve; Olofsson, Birgitta

    2017-07-01

    The number of elderly people with hip fracture and dementia is increasing, and many of these patients suffer from pain. Opioids are difficult to adjust and side effects are common, especially with increased age and among patients with dementia. Preoperative femoral nerve block is an alternative pain treatment. To investigate whether preoperative femoral nerve block reduced acute pain and opioid use after hip fracture among elderly patients, including those with dementia. In this randomised controlled trial involving patients aged ≥70years with hip fracture (trochanteric and cervical), including those with dementia, we compared femoral nerve block with conventional pain management, with opioid use if required. The primary outcome was preoperative pain, measured at five timepoints using a visual analogue scale (VAS). Preoperative opioid consumption was also registered. The study sample comprised 266 patients admitted consecutively to the Orthopaedic Ward. The mean age was 84.1 (±6.9)years, 64% of participants were women, 44% lived in residential care facilities, and 120 (45.1%) had dementia diagnoses. Patients receiving femoral nerve block had significantly lower self-rated pain scores from baseline to 12h after admission than did controls. Self-rated and proxy VAS pain scores decreased significantly in these patients from baseline to 12h compared with controls (pblock required less opioids than did controls, overall (2.3±4.0 vs. 5.7±5.2mg, pblock had lower pain scores and required less opioids before surgery compared with those receiving conventional pain management. Femoral nerve block seems to be a feasible pain treatment for elderly people, including those with dementia. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  19. A probiotic fermented dairy drink improves antibody response to influenza vaccination in the elderly in two randomised controlled trials.

    Boge, Thierry; Rémigy, Michel; Vaudaine, Sarah; Tanguy, Jérôme; Bourdet-Sicard, Raphaëlle; van der Werf, Sylvie

    2009-09-18

    Influenza vaccination is recommended for the elderly in many countries, but immune responses are weaker compared to younger adults. To investigate the impact of daily consumption of a probiotic dairy drink on the immune response to influenza vaccination in an elderly population of healthy volunteers over 70 years of age. Two randomised, multicentre, double-blind, controlled studies were conducted during two vaccination seasons in 2005-2006 (pilot) and 2006-2007 (confirmatory). Eighty-six and 222 elderly volunteers consumed either a fermented dairy drink, containing the probiotic strain Lactobacillus casei DN-114 001 and yoghurt ferments (Actimel, or a non-fermented control dairy product twice daily for a period of 7 weeks (pilot) or 13 weeks (confirmatory). Vaccination occurred after 4 weeks of product consumption. Geometric mean antibody titres (GMT) against the 3 viral strains composing the vaccine (H1N1, H3N2, and B) were measured at several time intervals post-vaccination by haemagglutination inhibition test. In the pilot study, the influenza-specific antibody titres increased after vaccination, being consistently higher in the probiotic product group compared to the control group under product consumption. Similarly, in the confirmatory study, titres against the B strain increased significantly more in the probiotic group than in the control group at 3, 6 and 9 weeks post-vaccination under product consumption (p=0.020). Significant differences in seroconversion between the groups by intended to treat analysis were still found 5 months after vaccination. Similar GMT results were observed for the H3N2 strain and H1N1 strain, confirming the results of the pilot study. These studies demonstrate that daily consumption of this particular probiotic product increased relevant specific antibody responses to influenza vaccination in individuals of over 70 years of age and may therefore provide a health benefit in this population.

  20. Improvement of stance control and muscle performance induced by focal muscle vibration in young-elderly women: a randomized controlled trial.

    Filippi, Guido M; Brunetti, Orazio; Botti, Fabio M; Panichi, Roberto; Roscini, Mauro; Camerota, Filippo; Cesari, Matteo; Pettorossi, Vito E

    2009-12-01

    Filippi GM, Brunetti O, Botti FM, Panichi R, Roscini M, Camerota F, Cesari M, Pettorossi VE. Improvement of stance control and muscle performance induced by focal muscle vibration in young-elderly women: a randomized controlled trial. To determine the effect of a particular protocol of mechanical vibration, applied focally and repeatedly (repeated muscle vibration [rMV]) on the quadriceps muscles, on stance and lower-extremity muscle power of young-elderly women. Double-blind randomized controlled trial; 3-month follow-up after intervention. Human Physiology Laboratories, University of Perugia, Italy. Sedentary women volunteers (N=60), randomized in 3 groups (mean age +/- SD, 65.3+/-4.2y; range, 60-72). rMV (100Hz, 300-500microm, in three 10-minute sessions a day for 3 consecutive days) was applied to voluntary contracted quadriceps (vibrated and contracted group) and relaxed quadriceps (vibrated and relaxed group). A third group received placebo stimulation (nonvibrated group). Area of sway of the center of pressure, vertical jump height, and leg power. Twenty-four hours after the end of the complete series of applications, the area of sway of the center of pressure decreased significantly by approximately 20%, vertical jump increased by approximately 55%, and leg power increased by approximately 35%. These effects were maintained for at least 90 days after treatment. rMV is a short-lasting and noninvasive protocol that can significantly and persistently improve muscle performance in sedentary young-elderly women.

  1. A randomized controlled trial of Tai chi for balance, sleep quality and cognitive performance in elderly Vietnamese

    Nguyen MH

    2012-06-01

    Full Text Available Manh Hung Nguyen, Andreas KruseInstitute of Gerontology, Heidelberg University, Heidelberg, GermanyObjective: To evaluate the effects of Tai chi exercise on balance, sleep quality, and cognitive performance in community-dwelling elderly in Vinh city, Vietnam.Design: A randomized controlled trial.Participants: One hundred two subjects were recruited.Intervention: Subjects were divided randomly into two groups. The Tai chi group was assigned 6 months' Tai chi training. The control group was instructed to maintain their routine daily activities.Outcome measures: The Falls Efficacy Scale (FES, Pittsburgh Sleep Quality Index (PSQI, and Trail Making Test (TMT were used as primary outcome measures.Results: Participants in the Tai chi group reported significant improvement in TMT (part A (F [1, 71] = 78.37, P < 0.001 and in TMT (part B, (F [1, 71] = 175.00, P < 0.001 in comparison with the control group. Tai chi participants also reported better scores in FES (F [1, 71] = 96.90, P < 0.001 and in PSQI (F [1,71] = 43.69, P = 0.001 than the control group.Conclusion: Tai chi is beneficial to improve balance, sleep quality, and cognitive performance of the elderly.Keywords: Tai chi, sleep, balance 

  2. Mission control of multiple unmanned aerial vehicles: a workload analysis.

    Dixon, Stephen R; Wickens, Christopher D; Chang, Dervon

    2005-01-01

    With unmanned aerial vehicles (UAVs), 36 licensed pilots flew both single-UAV and dual-UAV simulated military missions. Pilots were required to navigate each UAV through a series of mission legs in one of the following three conditions: a baseline condition, an auditory autoalert condition, and an autopilot condition. Pilots were responsible for (a) mission completion, (b) target search, and (c) systems monitoring. Results revealed that both the autoalert and the autopilot automation improved overall performance by reducing task interference and alleviating workload. The autoalert system benefited performance both in the automated task and mission completion task, whereas the autopilot system benefited performance in the automated task, the mission completion task, and the target search task. Practical implications for the study include the suggestion that reliable automation can help alleviate task interference and reduce workload, thereby allowing pilots to better handle concurrent tasks during single- and multiple-UAV flight control.

  3. Effects of balance Vestibular Rehabilitation Therapy in elderly with Benign Paroxysmal Positional Vertigo: a randomized controlled trial.

    Ribeiro, Karyna Myrelly Oliveira Bezerra de Figueiredo; Freitas, Raysa Vanessa de Medeiros; Ferreira, Lidiane Maria de Brito Macedo; Deshpande, Nandini; Guerra, Ricardo Oliveira

    2017-06-01

    To evaluate short-term effects of balance Vestibular Rehabilitation Therapy (VRT) on balance, dizziness symptoms and quality of life of the elderly with chronic Benign Paroxysmal Positional Vertigo (BPPV). In this randomized, single-blind and controlled trial, older adults with chronic BPPV were randomized into two groups, the experimental group (n = 7, age: 69 (65-78) years) and the control group (n = 7, age: 73 (65-76) years). Patients in the experimental group underwent balance VRT (50 min per session, two times a week) and Canalith Repositioning Maneuver (CRM) as required, for 13 weeks. The control group was treated using only CRM as required. Standing and dynamic balance, dizziness symptoms and quality of life were measured at the baseline, and at one, five, nine and thirteen weeks. There were no between-group differences in dizziness, quality of life and standing balance over the 13 weeks. Significant differences were observed in dynamic balance measures between groups (p CRM. Implications for Rehabilitation The findings that balance VRT in addition to CRM improves dynamic balance in elderly people with BPPV should be useful in guiding rehabilitation professionals' clinical decision making to design interventions for seniors suffering from BPPV; Improvements in tests of dynamic balance suggest that the risk of adverse consequences of BPPV in the elderly such as falls and fractures can be potentially reduced through implementation of CRM in conjunction with balance VRT; Lack of additional improvement in Visual Analogue Scale of dizziness and Dizziness Handicap Index suggests that addition of balance VRT does not influence dizziness symptomatology, per se, and CRM alone is effective to ameliorate vertiginous symptoms and potentially improve quality of life.

  4. Decreased Fronto-Parietal and Increased Default Mode Network Activation is Associated with Subtle Cognitive Deficits in Elderly Controls

    Davide Zanchi

    2017-12-01

    Full Text Available Background: Cognitive functions progressively deteriorate during aging and neurodegenerative diseases. The present study aims at investigating differences in working memory performance as well as functional brain changes during the earliest stages of cognitive decline in health elderly individuals. Methods: 62 elderly individuals (41 females, including 41 controls (35 females and 21 middle cognitive impairment subjects (6 females, underwent neuropsychological assessment at baseline and an fMRI examination in a N-back paradigm contrasting 2-back vs. 0-back condition. Upon a 18 months follow-up, we identified stable controls (sCON with preserved cognition and deteriorating controls (dCON with -1SD decrease of performances in at least two neuropsychological tests. Data analyses included accuracy and reaction time (RT for the 2-back condition and general linear model (GLM for the fMRI sequence. Results: At the behavioral level, sCON and dCON performed better than MCI in terms of accuracy and reaction time. At the brain level, functional differences in regions of the fronto-parietal network (FPN and of the Default Mode Network (DFM were observed. Significantly lower neural activations in the bilateral inferior and middle frontal gyri were found in MCI versus both dCON / sCON and for dCON versus sCON. Significantly increased activations in the anterior cingulate cortex and posterior cingulate cortex and bilateral insula were found in MCI versus both dCON / sCON and in dCON versus sCON. Conclusion: The present study suggests that brain functional changes in FPN and DMN anticipate differences in cognitive performance in healthy elderly individuals with subsequent subtle cognitive decline.

  5. Leap motion controlled videogame-based therapy for rehabilitation of elderly patients with subacute stroke: a feasibility pilot study.

    Iosa, Marco; Morone, Giovanni; Fusco, Augusto; Castagnoli, Marcello; Fusco, Francesca Romana; Pratesi, Luca; Paolucci, Stefano

    2015-08-01

    The leap motion controller (LMC) is a new optoelectronic system for capturing motion of both hands and controlling a virtual environment. Differently from previous devices, it optoelectronically tracks the fine movements of fingers neither using glows nor markers. This pilot study explored the feasibility of adapting the LMC, developed for videogames, to neurorehabilitation of elderly with subacute stroke. Four elderly patients (71.50 ± 4.51 years old) affected by stroke in subacute phase were enrolled and tested in a cross-over pilot trial in which six sessions of 30 minutes of LMC videogame-based therapy were added on conventional therapy. Measurements involved participation to the sessions, evaluated by means of the Pittsburgh Rehabilitation Participation Scale, hand ability and grasp force evaluated respectively by means of the Abilhand Scale and by means of the dynamometer. Neither adverse effects nor spasticity increments were observed during LMC training. Participation to the sessions was excellent in three patients and very good in one patient during the LMC trial. In this period, patients showed a significantly higher improvement in hand abilities (P = 0.028) and grasp force (P = 0.006). This feasibility pilot study was the first one using leap motion controller for conducting a videogame-based therapy. This study provided a proof of concept that LMC can be a suitable tool even for elderly patients with subacute stroke. LMC training was in fact performed with a high level of active participation, without adverse effects, and contributed to increase the recovery of hand abilities.

  6. Decentralized Formation Flying Control in a Multiple-Team Hierarchy

    Mueller, Joseph .; Thomas, Stephanie J.

    2005-01-01

    This paper presents the prototype of a system that addresses these objectives-a decentralized guidance and control system that is distributed across spacecraft using a multiple-team framework. The objective is to divide large clusters into teams of manageable size, so that the communication and computational demands driven by N decentralized units are related to the number of satellites in a team rather than the entire cluster. The system is designed to provide a high-level of autonomy, to support clusters with large numbers of satellites, to enable the number of spacecraft in the cluster to change post-launch, and to provide for on-orbit software modification. The distributed guidance and control system will be implemented in an object-oriented style using MANTA (Messaging Architecture for Networking and Threaded Applications). In this architecture, tasks may be remotely added, removed or replaced post-launch to increase mission flexibility and robustness. This built-in adaptability will allow software modifications to be made on-orbit in a robust manner. The prototype system, which is implemented in MATLAB, emulates the object-oriented and message-passing features of the MANTA software. In this paper, the multiple-team organization of the cluster is described, and the modular software architecture is presented. The relative dynamics in eccentric reference orbits is reviewed, and families of periodic, relative trajectories are identified, expressed as sets of static geometric parameters. The guidance law design is presented, and an example reconfiguration scenario is used to illustrate the distributed process of assigning geometric goals to the cluster. Next, a decentralized maneuver planning approach is presented that utilizes linear-programming methods to enact reconfiguration and coarse formation keeping maneuvers. Finally, a method for performing online collision avoidance is discussed, and an example is provided to gauge its performance.

  7. Ramadan Fasting Effects on Postural Control in the Elderly: A Comparison Between Fallers and Non-fallers.

    Laatar, Rabeb; Baccouch, Rym; Borji, Rihab; Kachouri, Hiba; Rebai, Haithem; Sahli, Sonia

    2016-11-01

    Our purpose was to compare the effects of Ramadan fasting on postural control in elderly fallers and non-fallers. The protocol involved twenty-four healthy old volunteer males divided into two groups: fallers (mean age = 75.43 ± 5.26 years, weight = 67.25 ± 5.30 kg and height = 1.65 ± 0.02 m) and non-fallers (mean age = 72.3 ± 6.42 years, weight = 65.5 ± 6.15 kg and height = 1.64 ± 0.03 m). Participants performed a simple reaction time test (SRT) and a postural control protocol on four different occasions: one week before Ramadan (BR), during the second (SWR) and the fourth week (FWR) of Ramadan and three weeks after Ramadan (AR). Center of pressure (CoP) parameters [the CoP medial-lateral length (CoP X ), and the CoP antero-posterior length (CoP Y )] were assessed using a force platform under two surface conditions: Firm surface and Foam surface. The results showed that Ramadan fasting influences similarly fallers and non-fallers. In fact, for both groups, the CoP X and the CoP Y values increased significantly during the SWR and the FWR compared to BR. These CoP parameters decreased significantly in the Firm surface conditions in the FWR. Moreover, the CoP parameters were significantly higher during the FWR and AR in comparison with BR in the Foam surface conditions. However, the amplitude of increase of the CoP [X] % and the CoP [Y] % (ΔCoP [X] % and ΔCoP [Y] %) between BR and the SWR was significantly higher in the fallers than non-fallers. The SRT of elderly fallers and non-fallers was significantly higher in the SWR and in the FWR compared to BR. In conclusion, Ramadan fasting alters similarly postural control of elderly fallers and non-fallers, but the amplitude (ΔCoP [X] % and ΔCoP [Y] %) of this alteration seems to be more pronounced in fallers than non-fallers. A probable beginning of adaptation occurs at the FWR. However, three weeks seems to be insufficient to recover postural control alterations due to Ramadan

  8. Effect of a 26-month floorball training on male elderly's cardiovascular fitness, glucose control, body composition, and functional capacity

    Pedersen, Mogens Theisen; Vorup, Jacob; Bangsbo, Jens

    2018-01-01

    , and physical function among recreationally active men aged 66–78 years.  Methods: After completing a 12-week randomized and controlled intervention with floorball and petanque training in the autumn 2014 or spring 2015, 15 subjects chose to participate in floorball training (floorball group, FG), whereas 16...... in recreationally active male elderly.......Background: Floorball training offers a motivating and socially stimulating team activity for older adults, and 12 weeks of floorball training twice a week among men aged 65–76 years have been shown to have positive effects on a number of physiological parameters important for health. However...

  9. The effect of telehealth, telephone support or usual care on quality of life, mortality and healthcare utilization in elderly high-risk patients with multiple chronic conditions. A prospective study.

    Valdivieso, Bernardo; García-Sempere, Anibal; Sanfélix-Gimeno, Gabriel; Faubel, Raquel; Librero, Julian; Soriano, Elisa; Peiró, Salvador

    2018-04-25

    To assess the effect of home based telehealth or structured telephone support interventions with respect to usual care on quality of life, mortality and healthcare utilization in elderly high-risk multiple chronic condition patients. 472 elderly high-risk patients with plurimorbidity in the region of Valencia (Spain) were recruited between June 2012 and May 2013, and followed for 12 months from recruitment. Patients were allocated to either: (a) a structured telephone intervention, a nurse-led case management program with telephone follow up every 15 days; (b) telehealth, which adds technology for remote self-management and the exchange of clinical data; or (c) usual care. Main outcome measures was quality of life measured by the EuroQol (EQ-5D) instrument, cognitive impairment, functional status, mortality and healthcare resource use. Inadequate randomization process led us to used propensity scores for adjusted analyses to control for imbalances between groups at baseline. EQ-5D score was significantly higher in the telehealth group compared to usual care (diff: 0.19, 0.08-0.30), but was not different to telephone support (diff: 0.04, -0.05 to 0.14). In adjusted analyses, inclusion in the telehealth group was associated with an additional 0.18 points in the EQ-5D score compared to usual care at 12 months (p<0.001), and with a gain of 0.13 points for the telephone support group (p<0.001). No differences in mortality or utilization were found, except for a borderline significant increase in General Practitioner visits. Telehealth was associated with better quality of life. Important limitations of the study and similarity of effects to telephone intervention call for careful endorsement of telemedicine. Clinicaltrials.gov (identifier: NCT02447562). Copyright © 2018 Elsevier España, S.L.U. All rights reserved.

  10. Brain training game improves executive functions and processing speed in the elderly: a randomized controlled trial.

    Nouchi, Rui; Taki, Yasuyuki; Takeuchi, Hikaru; Hashizume, Hiroshi; Akitsuki, Yuko; Shigemune, Yayoi; Sekiguchi, Atsushi; Kotozaki, Yuka; Tsukiura, Takashi; Yomogida, Yukihito; Kawashima, Ryuta

    2012-01-01

    The beneficial effects of brain training games are expected to transfer to other cognitive functions, but these beneficial effects are poorly understood. Here we investigate the impact of the brain training game (Brain Age) on cognitive functions in the elderly. Thirty-two elderly volunteers were recruited through an advertisement in the local newspaper and randomly assigned to either of two game groups (Brain Age, Tetris). This study was completed by 14 of the 16 members in the Brain Age group and 14 of the 16 members in the Tetris group. To maximize the benefit of the interventions, all participants were non-gamers who reported playing less than one hour of video games per week over the past 2 years. Participants in both the Brain Age and the Tetris groups played their game for about 15 minutes per day, at least 5 days per week, for 4 weeks. Each group played for a total of about 20 days. Measures of the cognitive functions were conducted before and after training. Measures of the cognitive functions fell into four categories (global cognitive status, executive functions, attention, and processing speed). Results showed that the effects of the brain training game were transferred to executive functions and to processing speed. However, the brain training game showed no transfer effect on any global cognitive status nor attention. Our results showed that playing Brain Age for 4 weeks could lead to improve cognitive functions (executive functions and processing speed) in the elderly. This result indicated that there is a possibility which the elderly could improve executive functions and processing speed in short term training. The results need replication in large samples. Long-term effects and relevance for every-day functioning remain uncertain as yet. UMIN Clinical Trial Registry 000002825.

  11. Brain training game improves executive functions and processing speed in the elderly: a randomized controlled trial.

    Rui Nouchi

    Full Text Available The beneficial effects of brain training games are expected to transfer to other cognitive functions, but these beneficial effects are poorly understood. Here we investigate the impact of the brain training game (Brain Age on cognitive functions in the elderly.Thirty-two elderly volunteers were recruited through an advertisement in the local newspaper and randomly assigned to either of two game groups (Brain Age, Tetris. This study was completed by 14 of the 16 members in the Brain Age group and 14 of the 16 members in the Tetris group. To maximize the benefit of the interventions, all participants were non-gamers who reported playing less than one hour of video games per week over the past 2 years. Participants in both the Brain Age and the Tetris groups played their game for about 15 minutes per day, at least 5 days per week, for 4 weeks. Each group played for a total of about 20 days. Measures of the cognitive functions were conducted before and after training. Measures of the cognitive functions fell into four categories (global cognitive status, executive functions, attention, and processing speed. Results showed that the effects of the brain training game were transferred to executive functions and to processing speed. However, the brain training game showed no transfer effect on any global cognitive status nor attention.Our results showed that playing Brain Age for 4 weeks could lead to improve cognitive functions (executive functions and processing speed in the elderly. This result indicated that there is a possibility which the elderly could improve executive functions and processing speed in short term training. The results need replication in large samples. Long-term effects and relevance for every-day functioning remain uncertain as yet.UMIN Clinical Trial Registry 000002825.

  12. Controlling energy transfer between multiple dopants within a single nanoparticle

    DiMaio, Jeffrey R.; Sabatier, Clément; Kokuoz, Baris; Ballato, John

    2008-01-01

    Complex core-shell architectures are implemented within LaF3 nanoparticles to allow for a tailored degree of energy transfer (ET) between different rare earth dopants. By constraining specific dopants to individual shells, their relative distance to one another can be carefully controlled. Core-shell LaF3 nanoparticles doped with Tb3+ and Eu3+ and consisting of up to four layers were synthesized with an outer diameter of ≈10 nm. It is found that by varying the thicknesses of an undoped layer between a Tb3+-doped layer and a Eu3+-doped layer, the degree of ET can be engineered to allow for zero, partial, or total ET from a donor ion to an acceptor ion. More specifically, the ratio of the intensities of the 541-nm Tb3+ and 590 nm Eu3+ peaks was tailored from core-shell configuration that restricts ET is used. Beyond simply controlling ET, which can be limiting when designing materials for optical applications, this approach can be used to obtain truly engineered spectral features from nanoparticles and composites made from them. Further, it allows for a single excitation source to yield multiple discrete emissions from numerous lanthanide dopants that heretofore would have been quenched in a more conventional active optical material. PMID:18250307

  13. The effect of flat and textured insoles on the balance of primary care elderly people: a randomized controlled clinical trial

    de Morais Barbosa C

    2018-02-01

    Full Text Available Cecília de Morais Barbosa,1 Manoel Barros Bértolo,2 Juliana Zonzini Gaino,2 Michael Davitt,3 Zoraida Sachetto,2 Eduardo de Paiva Magalhães3 1Department of Internal Medicine, Gerontology, Faculty of Medical Sciences, State University of Campinas – Unicamp, Campinas, SP, Brazil; 2Department of Internal Medicine, Rheumatology, Faculty of Medical Sciences, State University of Campinas – Unicamp, Campinas, SP, Brazil; 3Orthoses and Prostheses Unit, Clinical Hospital, State University of Campinas – Unicamp, Campinas, SP, Brazil Background: Aging is associated with reduced postural stability and increased fall risk. Foot orthoses have been reported as an adjuvant intervention to improve balance by stimulating foot plantar mechanical receptors and thus increasing somatosensory input. Purpose: The aim of this study is to evaluate the effect of flat and textured insoles on the balance of primary care elderly people. Design: Prospective, parallel, randomized, and single-blind trial. Methods: A total of 100 subjects from a primary care unit, aged ≥65 years, were randomly assigned to intervention groups with flat insoles (n=33, textured insoles (n=33, or control group (n=34 without insoles. The Berg Balance Scale and the Timed Up and Go test were assessed at baseline and after 4 weeks. Results: Improvements in the Berg Balance Scale and the Timed Up and Go test were noted only in intervention groups with insoles but not in control group. No significant difference was found between flat and textured insoles. Minor adverse effects were noted only in the group with textured insoles. Conclusion: The results suggest that foot orthoses (both flat and textured insoles are effective in improving balance in primary care elderly people. They may represent a low-cost and high-availability adjuvant strategy to improve balance and prevent falls in this population. Keywords: balance, elderly, orthoses, insole

  14. Differences of muscle co-contraction of the ankle joint between young and elderly adults during dynamic postural control at different speeds.

    Iwamoto, Yoshitaka; Takahashi, Makoto; Shinkoda, Koichi

    2017-08-02

    Agonist and antagonist muscle co-contractions during motor tasks are greater in the elderly than in young adults. During normal walking, muscle co-contraction increases with gait speed in young adults, but not in elderly adults. However, no study has compared the effects of speed on muscle co-contraction of the ankle joint during dynamic postural control in young and elderly adults. We compared muscle co-contractions of the ankle joint between young and elderly subjects during a functional stability boundary test at different speeds. Fifteen young adults and 16 community-dwelling elderly adults participated in this study. The task was functional stability boundary tests at different speeds (preferred and fast). Electromyographic evaluations of the tibialis anterior and soleus were recorded. The muscle co-contraction was evaluated using the co-contraction index (CI). There were no statistically significant differences in the postural sway parameters between the two age groups. Elderly subjects showed larger CI in both speed conditions than did the young subjects. CI was higher in the fast speed condition than in the preferred speed condition in the young subjects, but there was no difference in the elderly subjects. Moreover, after dividing the analytical range into phases (acceleration and deceleration phases), the CI was larger in the deceleration phase than in the acceleration phase in both groups, except for the young subjects in the fast speed conditions. Our results showed a greater muscle co-contraction of the ankle joint during dynamic postural control in elderly subjects than in young subjects not only in the preferred speed condition but also in the fast speed condition. In addition, the young subjects showed increased muscle co-contraction in the fast speed condition compared with that in the preferred speed condition; however, the elderly subjects showed no significant difference in muscle co-contraction between the two speed conditions. This indicates

  15. Elderly Suicide

    Elderly Suicide Fact Sheet Based on 2012 Data (2014) Overview • The elderly (ages 65 and older) made up 13. ... population; they accounted for 16.37% of all suicides in the US. • The rate of suicides for ...

  16. Lifestyle intervention in general practice for physical activity, smoking, alcohol consumption and diet in elderly: a randomized controlled trial.

    Vrdoljak, Davorka; Marković, Biserka Bergman; Puljak, Livia; Lalić, Dragica Ivezić; Kranjčević, Ksenija; Vučak, Jasna

    2014-01-01

    The purpose of the study was to compare the effectiveness of programmed and intensified intervention on lifestyle changes, including physical activity, cigarette smoking, alcohol consumption and diet, in patients aged ≥ 65 with the usual care of general practitioners (GP). In this multicenter randomized controlled trial, 738 patients aged ≥ 65 were randomly assigned to receive intensified intervention (N = 371) or usual care (N = 367) of a GP for lifestyle changes, with 18-month follow-up. The main outcome measures were physical activity, smoking, alcohol consumption and diet. The study was conducted in 59 general practices in Croatia between May 2008 and May 2010. The patients' mean age was 72.3 ± 5.2 years. Significant diet correction was achieved after 18-month follow-up in the intervention group, comparing to controls. More patients followed strictly Mediterranean diet and consumed healthy foods more frequently. There was no significant difference between the groups in physical activity, tobacco smoking and alcohol consumption or diet after the intervention. In conclusion, an 18-month intensified GP's intervention had limited effect on lifestyle habits. GP intervention managed to change dietary habits in elderly population, which is encouraging since elderly population is very resistant regarding lifestyle habit changes. Clinical trial registration number. ISRCTN31857696. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  17. An Inverse Optimal Control Approach to Explain Human Arm Reaching Control Based on Multiple Internal Models.

    Oguz, Ozgur S; Zhou, Zhehua; Glasauer, Stefan; Wollherr, Dirk

    2018-04-03

    Human motor control is highly efficient in generating accurate and appropriate motor behavior for a multitude of tasks. This paper examines how kinematic and dynamic properties of the musculoskeletal system are controlled to achieve such efficiency. Even though recent studies have shown that the human motor control relies on multiple models, how the central nervous system (CNS) controls this combination is not fully addressed. In this study, we utilize an Inverse Optimal Control (IOC) framework in order to find the combination of those internal models and how this combination changes for different reaching tasks. We conducted an experiment where participants executed a comprehensive set of free-space reaching motions. The results show that there is a trade-off between kinematics and dynamics based controllers depending on the reaching task. In addition, this trade-off depends on the initial and final arm configurations, which in turn affect the musculoskeletal load to be controlled. Given this insight, we further provide a discomfort metric to demonstrate its influence on the contribution of different inverse internal models. This formulation together with our analysis not only support the multiple internal models (MIMs) hypothesis but also suggest a hierarchical framework for the control of human reaching motions by the CNS.

  18. Being left-behind, mental disorder, and elderly suicide in rural China: a case-control psychological autopsy study.

    Zhou, Liang; Wang, Guojun; Jia, Cunxian; Ma, Zhenyu

    2018-04-25

    Suicide rate among rural elderly is the highest among all age groups in China, yet little is known about the suicide risks in this rapidly growing vulnerable population. This matched case-control psychological autopsy study was conducted during June 2014 to September 2015. Consecutive samples of suicides aged 60 or above were identified in three provinces (Shandong, Hunan, and Guangxi) in China. Living comparisons were 1:1 matched with the suicides in age (±3 years old), gender, and living location. Risk factors included demographic characteristics, being left-behind, mental disorder, depressive symptoms, stressful life events, and social support. A total of 242 suicides and 242 comparisons were enrolled: 135 (55.8%) were male, mean (s.d.) age was 74 (8) years. The most frequently used suicide means were pesticides (125, 51.7%) and hanging (95, 39.3%). Independent risks of suicide included unstable marital status [odds ratio (OR) 4.19, 95% confidence interval (CI) 1.61-10.92], unemployed (compared with employed, OR 4.43, 95% CI 1.09-17.95), depressive symptoms (OR 1.34, 95% CI 1.21-1.48), and mental disorder (OR 6.28, 95% CI 1.75-22.54). Structural equation model indicated that the association between being left-behind and suicide was mediated by mental disorder, depressive symptoms, stressful life events, and social support. Unstable marital status, unemployed, depressive symptoms, and mental disorder are independent risk factors for suicide in rural elderly. Being left-behind can elevate the suicide risk through increasing life stresses, depressive symptoms, mental disorder, and decreasing social support. Elderly suicide may be prevented by restricting pesticides, training rural physicians, treating mental disorders, mitigating life stress, and enhancing social connection.

  19. Preserved learning during the Symbol Digit Substitution Test in patients with schizophrenia, age-matched controls and elderly

    Claudia eCornelis

    2015-01-01

    Full Text Available Objective: Speed of processing, one of the main cognitive deficits in schizophrenia is most frequently measured with a digit symbol-coding test. Performance on this test is additionally affected by writing speed and the rate at which symbol-digit relationships are learned, two factors that may be impaired in schizophrenia. This study aims to investigate the effects of sensorimotor speed, short-term learning and long-term learning on task performance in schizophrenia. In addition the study aims to explore differences in learning effects between patients with schizophrenia and elderly individuals. Methods: Patients with schizophrenia (N=30 were compared with age-matched healthy controls (N=30 and healthy elderly volunteers (N=30 during the Symbol Digit Subsstitution Test (SDST. The task was administered on a digitizing tablet, allowing precise measurements of the time taken to write each digit (writing time and the time to decode symbols into their corresponding digits (matching time. The SDST was administered on three separate days (day 1, day 2, day 7. Symbol-digit repetitions during the task represented short-term learning and repeating the task on different days represented long-term learning.Results: The repetition of the same symbol-digit combinations within one test and the repetition of the test over days resulted in significant decreases in matching time. Interestingly, these short-term and long-term learning effects were about equal among the three groups. Individual participants showed a large variation in the rate of short-term learning. In general, patients with schizophrenia had the longest matching time whereas the elderly had the longest writing time. Writing time remained the same over repeated testing.Conclusion: The rate of learning and sensorimotor speed were found to have a substantial influence on the SDST score. However, large individual variation in learning rate should be taken into account in the interpretation of task

  20. Effect of vitamin D replacement on indexes of insulin resistance in overweight elderly individuals: a randomized controlled trial.

    El-Hajj Fuleihan, Ghada; Baddoura, Rafic; Habib, Robert H; Halaby, Georges; Arabi, Asma; Rahme, Maya; Singh, Ravinder J; Kassem, Moustapha; Mahfoud, Ziyad; Hoteit, Maha; Daher, Rose T; Kassir, Mohamed-Faisal

    2016-08-01

    It is unclear whether and at what dose vitamin D supplementation affects insulin resistance (IR). We sought to investigate whether vitamin D at doses higher than currently recommended decreases indexes of IR in an ambulatory population of overweight elderly subjects. This double-blind, randomized, controlled multicenter trial enrolled 257 elderly overweight individuals aged ≥65 y with baseline 25-hydroxyvitamin D [25(OH)D] concentrations between 10 and 30 ng/mL. All subjects received 1000 mg calcium citrate/d, with vitamin D administered weekly at an equivalent dose of 600 or 3750 IU/d. The homeostasis model assessment (HOMA) of IR index at 1 y was the primary outcome. We also assessed the McAuley index. In total, 222 subjects (55% women) with a mean ± SD age and body mass index (BMI; in kg/m(2)) of 71 ± 4 y and 30 ± 4, respectively, completed the study. Subjects' baseline characteristics, including IR indexes, were similar across groups: 69% had prediabetes, 54% had hypertension (47% were taking antihypertensive medications), and 60% had hyperlipidemia, nearly half of whom were receiving lipid-lowering drugs. At 1 y, mean ± SD serum 25(OH)D increased from 20 ± 7 to 26 ± 7 ng/mL in the low-dose arm (P vitamin D dose, baseline serum 25(OH)D, or change in 25(OH)D. Vitamin D3 at 3750 IU/d did not improve HOMA-IR compared with the Institute of Medicine Recommended Dietary Allowance of 600 IU/d in elderly overweight individuals. This trial was registered at clinicaltrials.gov as NCT01315366. © 2016 American Society for Nutrition.

  1. Impact of Calcium and Two Doses of Vitamin D on Bone Metabolism in the Elderly: A Randomized Controlled Trial.

    Rahme, Maya; Sharara, Sima Lynn; Baddoura, Rafic; Habib, Robert H; Halaby, Georges; Arabi, Asma; Singh, Ravinder J; Kassem, Moustapha; Mahfoud, Ziyad; Hoteit, Maha; Daher, Rose T; Bassil, Darina; El Ferkh, Karim; El-Hajj Fuleihan, Ghada

    2017-07-01

    The optimal dose of vitamin D to optimize bone metabolism in the elderly is unclear. We tested the hypothesis that vitamin D, at a dose higher than recommended by the Institute of Medicine (IOM), has a beneficial effect on bone remodeling and mass. In this double-blind trial we randomized 257 overweight elderly subjects to receive 1000 mg of elemental calcium citrate/day, and the daily equivalent of 3750 IU/day or 600 IU/day of vitamin D3 for 1 year. The subjects' mean age was 71 ± 4 years, body mass index 30 ± 4 kg/m 2 , 55% were women, and 222 completed the 12-month follow-up. Mean serum 25 hydroxyvitamin D (25OHD) was 20 ng/mL, and rose to 26 ng/mL in the low-dose arm, and 36 ng/mL in the high-dose arm, at 1 year (p 76 pg/mL showed a trend for higher BMD increments at all skeletal sites, in the high-dose group, that reached significance at the hip. Adverse events were comparable in the two study arms. This controlled trial shows little additional benefit in vitamin D supplementation at a dose exceeding the IOM recommendation of 600 IU/day on BMD and bone markers, in overweight elderly individuals. © 2017 American Society for Bone and Mineral Research. © 2017 American Society for Bone and Mineral Research.

  2. Yogurt supplemented with probiotics can protect the healthy elderly from respiratory infections: A randomized controlled open-label trial.

    Pu, Fangfang; Guo, Yue; Li, Ming; Zhu, Hong; Wang, Shijie; Shen, Xi; He, Miao; Huang, Chengyu; He, Fang

    2017-01-01

    To evaluate whether yogurt supplemented with a probiotic strain could protect middle-aged and elderly people from acute upper respiratory tract infections (URTI) using a randomized, blank-controlled, parallel-group design. Two hundred and five volunteers aged ≥45 years were randomly divided into two groups. The subjects in the intervention group were orally administered 300 mL/d of yogurt supplemented with a probiotic strain, Lactobacillus paracasei N1115 (N1115), 3.6×10 7 CFU/mL for 12 weeks, while those in the control group retained their normal diet without any probiotic supplementation. The primary outcome was the incidence of URTI, and changes in serum protein, immunoglobulins, and the profiles of the T-lymphocyte subsets (total T-cells [CD3 + ], T-helper cells [CD4 + ], and T-cytotoxic-suppressor cells [CD8 + ]) during the intervention were the secondary outcomes. Compared to the control group, the number of persons diagnosed with an acute URTI and the number of URTI events significantly decreased in the intervention group ( P =0.038, P =0.030, respectively). The risk of URTI in the intervention group was evaluated as 55% of that in the control group (relative risk =0.55, 95% CI: 0.307-0.969). The change in the percentage of CD3 + cells in the intervention group was significantly higher than in the control group ( P =0.038). However, no significant differences were observed in the total protein, albumin, globulin, and prealbumin levels in both groups ( P >0.05). The study suggested that yogurt with selected probiotic strains such as N1115 may reduce the risk of acute upper tract infections in the elderly. The enhancement of the T-cell-mediated natural immune defense might be one of the important underlying mechanisms for probiotics to express their anti-infective effects.

  3. A prospective, randomized, controlled study of a suspension positioning system used with elderly bedridden patients with neurogenic fecal incontinence.

    Su, Mei-Yin; Lin, Shi-Quan; zhou, Ye-Wen; Zhou, Ye-Wen; Liu, Si-Ya; Lin, Ai; Lin, Xi-Rong

    2015-01-01

    Elderly patients with acute neurological impairment are prone to severe disability, fecal incontinence (FI), and resultant complications. A suspension positioning system (SPS), based on the orthopedic suspension traction system commonly used for conservative treatment of pediatric femoral fracture and uncomplicated adult pelvic fracture, was developed to facilitate FI management in patients immobilized secondary to an acute neurological condition. To evaluate the effectiveness and safety of the system, a prospective, randomized, controlled study was conducted between October 2009 and July 2012. Two hundred (200) elderly, bedridden, hospitalized patients with acute, nonchronic neurological impairment were randomly assigned to receive routine FI nursing care (ie, individualized dietary modification, psychological support, health education, and social support for caregivers and family members [control group]) or routine incontinence care plus the SPS (experimental group) during the day. Rates of perianal fecal contamination, skin breakdown, incontinence associated dermatitis, pressure ulcer development, and lower urinary tract infection (LUTI) were significantly lower in the SPS than in the control group (P <0.05). Length of hospitalization and costs of care were also lower in the SPS group (P <0.05). Patient quality-of-life (QoL) and FI QoL scores were similar at baseline but significantly higher (better) at the 6-month follow-up interview in the SPS than in the control group (P <0.05). In this study, the rate of FI-associated morbidities was lower and 6-month patient QoL scores were higher in the SPS than in the control group. No adverse events were observed, and all patients completed the study. Further clinical studies are needed to examine the long-term effects of SPS use among neurologically impaired FI patients.

  4. Preserved Learning during the Symbol-Digit Substitution Test in Patients with Schizophrenia, Age-Matched Controls, and Elderly.

    Cornelis, Claudia; De Picker, Livia J; Hulstijn, Wouter; Dumont, Glenn; Timmers, Maarten; Janssens, Luc; Sabbe, Bernard G C; Morrens, Manuel

    2014-01-01

    Speed of processing, one of the main cognitive deficits in schizophrenia is most frequently measured with a digit-symbol-coding test. Performance on this test is additionally affected by writing speed and the rate at which symbol-digit relationships are learned, two factors that may be impaired in schizophrenia. This study aims to investigate the effects of sensorimotor speed, short-term learning, and long-term learning on task performance in schizophrenia. In addition, the study aims to explore differences in learning effects between patients with schizophrenia and elderly individuals. Patients with schizophrenia (N = 30) were compared with age-matched healthy controls (N = 30) and healthy elderly volunteers (N = 30) during the Symbol-Digit Substitution Test (SDST). The task was administered on a digitizing tablet, allowing precise measurements of the time taken to write each digit (writing time) and the time to decode symbols into their corresponding digits (matching time). The SDST was administered on three separate days (day 1, day 2, day 7). Symbol-digit repetitions during the task represented short-term learning and repeating the task on different days represented long-term learning. The repetition of the same symbol-digit combinations within one test and the repetition of the test over days resulted in significant decreases in matching time. Interestingly, these short-term and long-term learning effects were about equal among the three groups. Individual participants showed a large variation in the rate of short-term learning. In general, patients with schizophrenia had the longest matching time whereas the elderly had the longest writing time. Writing time remained the same over repeated testing. The rate of learning and sensorimotor speed was found to have a substantial influence on the SDST score. However, a large individual variation in learning rate should be taken into account in the interpretation of task scores for processing speed. Equal

  5. Effect of a 26-month floorball training on male elderly's cardiovascular fitness, glucose control, body composition, and functional capacity

    Pedersen, Mogens Theisen; Vorup, Jacob; Bangsbo, Jens

    2018-01-01

    , the effect of long-term participation in floorball training among male elderly has not been investigated. The aim of the present study was to examine the effect of 26-month self-organized regular participation in floorball training on cardiovascular fitness, body composition, blood lipids, glucose control...... weekly floorball sessions with 40 min/session over 26-month appear to reduce age-related decline in cardiovascular fitness and glucose control and improve leg bone mineral density, suggesting that long-term participation in floorball training can be considered as a health-enhancing activity......Background: Floorball training offers a motivating and socially stimulating team activity for older adults, and 12 weeks of floorball training twice a week among men aged 65–76 years have been shown to have positive effects on a number of physiological parameters important for health. However...

  6. Prevalence and control of hypertension among a Community of Elderly Population in Changning District of shanghai: a cross-sectional study.

    Yang, Zhi-Qi; Zhao, Qi; Jiang, Ping; Zheng, Song-Bai; Xu, Biao

    2017-12-28

    Hypertension is considered a major public health challenge. It is the most important risk factor for cardiovascular disease and is a prominent risk for China's elderly population. However, few studies have addressed the effect of blood pressure control on elderly hypertension patients in China. In response, this study aimed to investigate the prevalence and control of hypertension in the elderly population in Shanghai's communities. A secondary data analysis based on a government-financed health check-up program for an elderly population aged 65 and older from 2012 to 2014 was conducted in a central district of Shanghai. Of the 44,978 study participants, 20,305 (45.1%) were males and 24,673 (54.9%) were females. The participants' median age was 72. Half of the participants were overweight or obese (BMI ≥ 24.0 kg/m 2 ). The prevalence of hypertension was 59.9%. In the 18,032 participants without prior diagnosis of hypertension, 5530 (30.7%) had increased blood pressure. Among the 26,946 confirmed hypertension patients, the proportions of treatment and blood pressure control were 32.8% and 43.4% respectively. Multivariate analysis showed that the uncontrolled hypertension was significantly associated with older age, being overweight or obese, a lower level of education, an unbalanced dietary pattern, regular drinking and non-comorbidities. The prevalence of hypertension was high in China's elderly population. The proportion of individuals who received treatment remained low, and blood pressure control was poor among hypertension patients. These results indicate that improvement of the ability to manage and control hypertension among urban elderly residents is urgently needed.

  7. Implementation of an active aging model in Mexico for prevention and control of chronic diseases in the elderly.

    Mendoza-Núñez, Víctor Manuel; Martínez-Maldonado, María de la Luz; Correa-Muñoz, Elsa

    2009-08-26

    World Health Organization cites among the main challenges of populational aging the dual disease burden: the greater risk of disability, and the need for care. In this sense, the most frequent chronic diseases during old age worldwide are high blood pressure, type 2 diabetes mellitus, cancer, arthritis, osteoporosis, depression, and dementia. Chronic disease-associated dependency represents an onerous sanitary and financial burden for the older adult, the family, and the health care system. Thus, it is necessary to propose community-level models for chronic disease prevention and control in old age. The aim of the present work is to show our experience in the development and implementation of a model for chronic disease prevention and control in old age at the community level under the active aging paradigm. A longitudinal study will be carried out in a sample of 400 elderly urban and rural-dwelling individuals residing in Hidalgo State, Mexico during five years. All participants will be enrolled in the model active aging. This establishes the formation of 40 gerontological promoters (GPs) from among the older adults themselves. The GPs function as mutual-help group coordinators (gerontological nuclei) and establish self-care and self-promotion actions for elderly well-being and social development. It will be conformed a big-net of social network of 40 mutual-help groups of ten elderly adults each one, in which self-care is a daily practice for chronic disease prevention and control, as well as for achieving maximal well-being and life quality in old age. Indicators of the model's impact will be (i) therapeutic adherence; (ii) the incidence of the main chronic diseases in old age; (iii) life expectancy without chronic diseases at 60 years of age; (iv) disability adjusted life years lost; (v) years of life lost due to premature mortality, and (vi) years lived with disability. We propose that the implementation of the model active aging framework will permits the

  8. Implementation of an active aging model in Mexico for prevention and control of chronic diseases in the elderly

    Correa-Muñoz Elsa

    2009-08-01

    Full Text Available Abstract Background World Health Organization cites among the main challenges of populational aging the dual disease burden: the greater risk of disability, and the need for care. In this sense, the most frequent chronic diseases during old age worldwide are high blood pressure, type 2 diabetes mellitus, cancer, arthritis, osteoporosis, depression, and dementia. Chronic disease-associated dependency represents an onerous sanitary and financial burden for the older adult, the family, and the health care system. Thus, it is necessary to propose community-level models for chronic disease prevention and control in old age. The aim of the present work is to show our experience in the development and implementation of a model for chronic disease prevention and control in old age at the community level under the active aging paradigm. Methods/Design A longitudinal study will be carried out in a sample of 400 elderly urban and rural-dwelling individuals residing in Hidalgo State, Mexico during five years. All participants will be enrolled in the model active aging. This establishes the formation of 40 gerontological promoters (GPs from among the older adults themselves. The GPs function as mutual-help group coordinators (gerontological nuclei and establish self-care and self-promotion actions for elderly well-being and social development. It will be conformed a big-net of social network of 40 mutual-help groups of ten elderly adults each one, in which self-care is a daily practice for chronic disease prevention and control, as well as for achieving maximal well-being and life quality in old age. Indicators of the model's impact will be (i therapeutic adherence; (ii the incidence of the main chronic diseases in old age; (iii life expectancy without chronic diseases at 60 years of age; (iv disability adjusted life years lost; (v years of life lost due to premature mortality, and (vi years lived with disability. Discussion We propose that the

  9. Prognostic factors for ovarian epithelial cancer in the elderly: a case-control study.

    Sabatier, Renaud; Calderon, Benoît; Lambaudie, Eric; Chereau, Elisabeth; Provansal, Magali; Cappiello, Maria-Antonietta; Viens, Patrice; Rousseau, Frederique

    2015-06-01

    Ovarian cancer is the leading cause of mortality by gynecologic cancers in Western countries. Many publications have suggested that age may be an independent prognostic factor in ovarian carcinoma. There are only few data concerning the impact of treatments and geriatric features within the elderly population. We collected data of older (≥ 70 years old) patients treated in our institution for an invasive ovarian carcinoma between 1995 and 2011. First we described usual clinical and pathological features for these patients, as well as their outcome. We compared these parameters with that of young (women (58% vs 41.7%), and older patients received less chemotherapy courses and less taxanes (38.4% vs 67.1%). Young patients had a longer overall survival (median, 65.2 vs 26.2 months, P = 8.5E-10, log-rank test). Multivariate analyses confirmed that age was an independent prognostic factor and that within the elderly set the International Federation of Gynecology and Obstetrics stage, surgery results, number of chemotherapy cycles administered and performance status had a significant prognostic value. No clear correlation could be observed between geriatric characteristics and treatments administration. Ovarian cancer prognosis is poorer for older women, but they are more frequently suboptimally treated. No correlation could be observed between geriatric factors and surgery or chemotherapy achievement. Treatment decision should be based on objective geriatric assessment in order to improve outcome in this population.

  10. The Diuretic Action of Weak and Strong Alcoholic Beverages in Elderly Men: A Randomized Diet-Controlled Crossover Trial.

    Polhuis, Kristel C M M; Wijnen, Annemarthe H C; Sierksma, Aafje; Calame, Wim; Tieland, Michael

    2017-06-28

    With ageing, there is a greater risk of dehydration. This study investigated the diuretic effect of alcoholic beverages varying in alcohol concentration in elderly men. Three alcoholic beverages (beer (AB), wine (AW), and spirits (S)) and their non-alcoholic counterparts (non-alcoholic beer (NAB), non-alcoholic wine (NAW), and water (W)) were tested in a diet-controlled randomized crossover trial. For the alcoholic beverages, alcohol intake equaled a moderate amount of 30 g. An equal volume of beverage was given for the non-alcoholic counterpart. After consumption, the urine output was collected every hour for 4 h and the total 24 h urine output was measured. AW and S resulted in a higher cumulative urine output compared to NAW and W during the first 4 h (effect size: 0.25 mL p 0.40, p > 0.10). AB and NAB did not differ at any time point (effect size: -0.02 mL p > 0.70). For urine osmolality, and the sodium and potassium concentration, the findings were in line. In conclusion, only moderate amounts of stronger alcoholic beverages, such as wine and spirits, resulted in a short and small diuretic effect in elderly men.

  11. International Ballroom Dancing Against Neurodegeneration: A Randomized Controlled Trial in Greek Community-Dwelling Elders With Mild Cognitive impairment.

    Lazarou, Ioulietta; Parastatidis, Themis; Tsolaki, Anthoula; Gkioka, Mara; Karakostas, Anastasios; Douka, Stella; Tsolaki, Magda

    2017-12-01

    Many studies have highlighted the positive effects of dance in people with neurodegenerative diseases. To explore the effects of International Ballroom Dancing on cognitive function in elders with amnestic mild cognitive impairment (aMCI). One-hundred twenty-nine elderly patients with aMCI diagnosis (mean age 66.8 ± 10.1 years) were randomly assigned into 2 groups: intervention group (IG, n = 66) and control group (CG, n = 63). The IG exercised systematically for 10 months, and both groups were submitted to extensive neuropsychological assessment prior and after the 10-month period. According to the independent sample t test at the follow-up, significant differences between groups were found in benefit of the IG while the CG showed worse performance in the majority of neuropsychological tests. According to the Student t test, better performance is detected in IG in contrast with CG, which had worse performance almost in all scales. Dance may be an important nonpharmacological approach that can benefit cognitive functions.

  12. Double-blind randomized controlled trial of isoxicam vs piroxicam in elderly patients with osteoarthritis of the hip and knee

    Bellamy, N.; Buchanan, W. W.; Grace, E.

    1986-01-01

    1 Fifty-seven elderly patients with primary osteoarthritis of the hip and knee were entered into a double-blind, randomized, controlled parallel group trial to compare the efficacy and tolerability of isoxicam (maximum = 200 mg day-1) and piroxicam (maximum = 20 mg day-1). 2 Clinical assessments were made following a 1 week NSAID-free washout period and at biweekly intervals during the next 6 weeks of active treatment. 3 The majority of patients in both groups experienced a clinically important and statistically significant therapeutic response. 4 No statistically significant between-group differences were noted with respect to drug efficacy. 5 One patient was withdrawn from the piroxicam group because of lack of effect, but there were no such withdrawals from the isoxicam group. 6 Five patients were withdrawn from the piroxicam group because of adverse reactions compared to only one withdrawal from the isoxicam group. 7 This study indicates that isoxicam is an efficacious and well-tolerated once-daily NSAID for elderly patients with osteoarthritis. PMID:3620274

  13. Effects of resistance training exercise on cognitive performance in elderly individuals with memory impairment: results of a controlled trial

    Alexandre Leopold Busse

    2008-12-01

    Full Text Available Objective: To detect the effects of a resistance training programon cognitive performance and muscle strength in sedentaryelderly individuals with memory impairment. Methods: Thirty-onesedentary elderly persons with no dementia or depression wererandomly distributed into two groups: Physical Activity Group andControl Group. The resistance training exercise program lastednine months and consisted of three series of six exercises persession, carried out on lever-type equipment for approximatelyone hour, twice a week. Every three months, both groups weresubmitted to the following cognitive tests: Rivermead BehavioralMemory Test (RBMT, Wechsler Adult Intelligence Scale (WAISDirect and Indirect Digit Span, Memory Complaints Scale, andCambridge Cognitive Test (CAMCOG. Results: After nine months,the group that did resistance exercises showed a significantincrease in the standardized RBMT score (p = 0.021 and in musclestrength (p < 0.001, with no significant difference in the otherparameters evaluated. Conclusions: These results indicate thatsupervised resistance exercises can improve memory performancein sedentary elderly individuals with prior memory compromise,besides increasing muscle strength.

  14. Effectiveness of group reminiscence for improving wellbeing of institutionalized elderly adults: study protocol for a randomized controlled trial.

    Gaggioli, Andrea; Scaratti, Chiara; Morganti, Luca; Stramba-Badiale, Marco; Agostoni, Monica; Spatola, Chiara A M; Molinari, Enrico; Cipresso, Pietro; Riva, Giuseppe

    2014-10-25

    Group reminiscence therapy is a brief and structured intervention in which participants share personal past events with peers. This approach has been shown to be promising for improving wellbeing and reducing depressive symptoms among institutionalized older adults. However, despite the considerable interest in reminiscence group therapy, controlled studies to determine its specific benefits as compared to generic social interactions with peers (group conversations about everyday subjects) are still lacking. We have designed a randomized controlled trial aimed at comparing the effects of group reminiscence therapy with those of group recreational activity on the psychological wellbeing of an institutionalized sample of older adults. The study includes two groups of 20 hospitalized elderly participants: the experimental group and the control group. Participants included in the experimental group will receive six sessions of group reminiscence therapy, while the control group will participate in a recreational group discussion. A repeated-measures design will be used post-intervention and three months post-intervention to evaluate changes in self-reported outcome measures of depressive symptoms, self-esteem, life satisfaction, and quality of life from baseline. The protocol of a study aimed at examining the specific effects of group reminiscence therapy on psychological wellbeing, depression, and quality of life among institutionalized elderly people is described. It is expected that the outcomes of this trial will contribute to our knowledge about the process of group reminiscence, evaluate its effectiveness in improving psychological wellbeing of institutionalized individuals, and identify the best conditions for optimizing this approach. This trial was registered with ClinicalTrials.gov (registration number: NCT02077153) on 31 January 2014.

  15. Awareness, treatment and control of type 2 diabetes among Chinese elderly and its changing trend for past decade

    Miao Liu

    2016-03-01

    Full Text Available Abstract Background This study aims to evaluate the awareness, treatment, control rate of type 2 diabetes and its risk factors among Chinese community elderly, and also examine the changing trend for the past decade. Methods We conducted two population-based cross-sectional studies in a representative urban area of Beijing in 2001 and 2010 respectively, using with the same method. A total of 2,277 participants (943 male, 1,334 female in 2001 and 2,102 participants (848 male, 1,254 female in 2010 were recruited. All the participants diagnosed with diabetes were included in this study. Results The prevalence of diabetes was 21.4 % and 24.8 % in 2001 and 2010 respectively. Among participants with diabetes, 74.2 % were aware of the condition, 51.0 % were treated, 20.1 % well controlled the condition in 2001, and the corresponding rates were 78.5 %, 69.3 %,15.9 % in 2010 respectively. Higher education level and a positive family history were related to better management of diabetes, while obesity and alcohol drinking showed a reverse direction. Conclusions The prevalence and awareness of diabetes stayed high for the past decade. The treatment increased 18.3 % while the control rate decreased among community elderly for the past 10 years. It’s urgent to carry out effective measures to raise awareness, treatment, and control rate of diabetes in order to avoid growing disease burden in China.

  16. The effect of music therapy on depression and physiological parameters in elderly people living in a Turkish nursing home: a randomized-controlled trial.

    Gök Ugur, Hacer; Yaman Aktaş, Yeşim; Orak, Oya Sevcan; Saglambilen, Okan; Aydin Avci, İlknur

    2017-12-01

    This study was carried out in an effort to determine the effect of music therapy on depression and physiological parameters in elderly people who were living in a nursing home. The study was a randomized controlled trial. The study sample consisted of 64 elderly people who complied with the criteria of inclusion for the study. The data were collected using the 'Elderly Information Form' and 'Geriatric Depression Scale'. The music group listened to music three days in a week during 8 weeks. The depression levels were assessed at baseline (week 0) and follow-up in the eight week. It was found that the difference between post-test depression scores of the two groups was found to be statistically significant (t = -2.86, p depression level and systolic blood pressure in elderly people. The study results implies that music therapy can be an effective practice for public health and home care nurses attempting to reduce depression and control physiological parameters of elderly people.

  17. Clinical benefits of oral nutritional supplementation for elderly hip fracture patients: a single blind randomised controlled trial.

    Myint, Ma Wai Wai; Wu, Jenny; Wong, Euann; Chan, Suk Ping; To, Tze Shing Jess; Chau, Mei Wa Rosanna; Ting, Kwai Hing; Fung, Pui Man; Au, Kit Sing Derrick

    2013-01-01

    malnutrition is an important risk factor for poor outcome in patients recovering after hip fracture surgery. This study aimed to investigate the clinical, nutritional and rehabilitation effects of an oral nutritional supplementation (ONS) in an inpatient rehabilitation setting. this was an observer-blinded randomised controlled trial of elderly post-surgical proximal femoral fracture patients. A ready-to-use oral liquid nutritional supplementation (18-24 g protein and 500 kcal per day) in addition to hospital diet was compared with hospital diet only. Both groups received usual rehabilitation therapy and oral calcium and vitamin D supplements. Outcomes were compared at discharge from rehabilitation and after 4 weeks of discharge. The primary outcome parameters were the serum albumin level, the body mass index (BMI), the functional independence measure (FIM) and the elderly mobility scale (EMS). Secondary outcome parameters were frequency of complications, inpatient length of stay, mortality and acute hospital use within 6 months after discharge. a total of 126 patients were recruited, 65 in the supplementation arm and 61 in the control arm. There was a significant difference in change in BMI with a decrease of 0.25 and 0.03 kg/m(2) in the ONS group and 0.72 and 0.49 kg/m(2) in the control group at hospital discharge and follow-up, respectively (P = 0.012). The length of stay in rehabilitation ward was shortened by 3.80 (SE = 1.81, P = 0.04) days favouring the ONS group. The total number of infection episodes was also reduced significantly. No difference was observed in the rate of change of the serum albumin level, the FIM and the EMS. clinical and nutritional benefits were seen in this trial but rehabilitation benefits could not be demonstrated.

  18. Slow movement resistance training using body weight improves muscle mass in the elderly: A randomized controlled trial.

    Tsuzuku, S; Kajioka, T; Sakakibara, H; Shimaoka, K

    2018-04-01

    To examine the effect of a 12-week slow movement resistance training using body weight as a load (SRT-BW) on muscle mass, strength, and fat distribution in healthy elderly people. Fifty-three men and 35 women aged 70 years old or older without experience in resistance training participated, and they were randomly assigned to a SRT-BW group or control group. The control group did not receive any intervention, but participants in this group underwent a repeat measurement 12 weeks later. The SRT-BW program consisted of 3 different exercises (squat, tabletop push-up, and sit-up), which were designed to stimulate anterior major muscles. Initially, these exercises were performed by 2 sets of 10 repetitions, and subsequently, the number of repetitions was increased progressively by 2 repetitions every 4 weeks. Participants were instructed to perform each eccentric and concentric phase of movement slowly (spending 4 seconds on each movement), covering the full range of motion. We evaluated muscle mass, strength, and fat distribution at baseline and after 12 weeks of training. Changes over 12 weeks were significantly greater in the SRT-BW group than in the control group, with a decrease in waist circumference, hip circumference, and abdominal preperitoneal and subcutaneous fat thickness, and an increase in thigh muscle thickness, knee extension strength, and hip flexion strength. In conclusion, relatively short-term SRT-BW was effective in improving muscle mass, strength, and fat distribution in healthy elderly people. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  19. Clinical trial: single- and multiple-dose pharmacokinetics of polyethylene glycol (PEG-3350) in healthy young and elderly subjects.

    Pelham, R W; Nix, L C; Chavira, R E; Cleveland, M Vb; Stetson, P

    2008-07-01

    The pharmacokinetics of polyethylene glycol 3350 (PEG-3350) have not been fully described because of lack of a sufficiently sensitive analytical method. To describe the pharmacokinetics of PEG-3350 in humans. A highly sensitive, high performance liquid chromatography with mass spectrometry (HPLC/MS/MS) method was developed for PEG-3350 in urine, plasma and faeces with quantification limits of 30 ng/mL, 100 ng/mL and 500 microg/g respectively. Noncompartmental pharmacokinetics methods were used and the effects of gender, age, renal status and dosing frequency were examined after the oral administration of 17 g to healthy volunteers. Peak PEG-3350 plasma concentrations occurred at 2-4 h and declined to nonquantifiable levels usually within 18 h after single and multiple doses, with a half-life of about 4-6 h. Steady state was reached within 5 days of dosing. Mean urinary excretion of the administered dose ranged from 0.19% to 0.25%. Age, gender or mild kidney impairment did not alter the pharmacokinetics of PEG-3350. Mean faecal excretion of the administered dose was 93% in young subjects. For the first time, a highly sensitive assay allowed comprehensive pharmacokinetics studies of PEG-3350 in humans. These studies confirmed that orally administered PEG-3350 is minimally absorbed, rapidly excreted and primarily eliminated via faeces.

  20. Is there a relationship between complaints of impaired balance and postural control disorder in community-dwelling elderly women? A cross-sectional study with the use of posturography

    Tanaka, Erika H.; Santos, Paulo F.; Reis, J?lia G.; Rodrigues, Natalia C.; Moraes, Renato; Abreu, Daniela C. C.

    2015-01-01

    Background: Risk of falls increases as age advances. Complaints of impaired balance are very common in the elderly age group. Objectives: The objective of this study was to investigate whether the subjective perception of impaired balance was associated with deficits in postural control (objective analysis) in elderly community-dwelling women. Method: Static posturography was used in two groups: elderly women with (WC group) and without (NC group) complaints of impaired balance. The area, mea...

  1. Study of Optimal Replacement of Thyroxine in the ElDerly (SORTED): protocol for a mixed methods feasibility study to assess the clinical utility of lower dose thyroxine in elderly hypothyroid patients: study protocol for a randomized controlled trial.

    Wilkes, Scott; Pearce, Simon; Ryan, Vicky; Rapley, Tim; Ingoe, Lorna; Razvi, Salman

    2013-03-22

    The population of the UK is ageing. There is compelling evidence that thyroid stimulating hormone distribution levels increase with age. Currently, in UK clinical practice elderly hypothyroid patients are treated with levothyroxine to lower their thyroid stimulating hormone levels to a standard non-age-related range. Evidence suggests that mortality is negatively associated with thyroid stimulating hormone levels. We report the protocol of a feasibility study working towards a full-scale randomized controlled trial to test whether lower dose levothyroxine has beneficial cardiovascular outcomes in the oldest old. SORTED is a mixed methods study with three components: SORTED A: A feasibility study of a dual-center single-blinded randomized controlled trial of elderly hypothyroid patients currently treated with levothyroxine. Patients will be recruited from 20 general practices and two hospital trust endocrine units in Northumberland, Tyne and Wear. Target recruitment of 50 elderly hypothyroid patients currently treated with levothyroxine, identified in both primary and secondary care settings. Reduced dose of levothyroxine to achieve an elevated serum thyroid stimulating hormone (target range 4.1 to 8.0 mU/L) versus standard levothyroxine replacement (target range 0.4 to 4.0 mU/L). Using random permuted blocks, in a ratio of 1:1, randomization will be carried out by Newcastle Clinical Trials Unit. Study feasibility (recruitment and retention rates and medication compliance), acceptability of the trial design, assessment of mobility and falls risk, and change in cardiovascular risk factors. Qualitative study using in-depth interviews to understand patients' willingness to take part in a randomized controlled trial and participants' experience of the intervention. Retrospective cohort study of 400 treated hypothyroid patients aged 80 years or over registered in 2008 in primary care practices, studying their 4-year cardiovascular outcomes to inform the power of SORTED

  2. A comprehensive intervention following the clinical pathway of eating and swallowing disorder in the elderly with dementia: historically controlled study.

    Arahata, Masahisa; Oura, Makoto; Tomiyama, Yuka; Morikawa, Naoe; Fujii, Hatsue; Minani, Shinji; Shimizu, Yukihiro

    2017-07-14

    Eating problems in patients with advanced dementia are strongly associated with their deteriorating survival. Food and drink intake in people with dementia may be supported by specific interventions, but the effectiveness of such interventions is backed by almost no evidence. However, comprehensive geriatric assessment (CGA) might potentially clarify the etiology of decreased oral intake in people with dementia; thus improving their clinical outcomes. This study was a single-arm, non-randomized trial that included historically controlled patients for comparison. We defined elderly patients with both severely decreased oral intake depending on artificial hydration and/or nutrition (AHN) and dementia as "Eating and Swallowing Disorder of the Elderly with Dementia (ESDED)". In the intervention group, participants received CGA through the original clinical pathway with multidisciplinary interventions. This was followed by individualized therapeutic interventions according to assessment of the etiology of their eating problems. During the intervention period (between 1st April 2013 and 31st March 2015), 102 cases of ESDED were enrolled in the study and 90 patients had completed receiving CGA. Conversely, 124 ESDED patient controls were selected from the same hospital enrolled during the historical period (between 1st April 2011 and 31st March 2012). Most participants in both groups were bedridden with severe cognitive impairment. For the intervention group, an average of 4.3 interventional strategies was recommended per participant after CGA. Serological tests, diagnostic imaging and other diagnostic examinations were much more frequently performed in the intervention group. Recovery rate from ESDED in the intervention group was significantly higher than that in the historical group (51% v.s. 34%, respectively, P = 0.02). The 1-year AHN-free survival in the intervention group was significantly higher than that in the historical group (28% v.s. 15%, respectively, P

  3. Stroke Rehabilitation in Frail Elderly with the Robotic Training Device ACRE: A Randomized Controlled Trial and Cost-Effectiveness Study

    M. Schoone

    2011-01-01

    Full Text Available The ACRE (ACtive REhabilitation robotic device is developed to enhance therapeutic treatment of upper limbs after stroke. The aim of this study is to assess effects and costs of ACRE training for frail elderly patients and to establish if ACRE can be a valuable addition to standard therapy in nursing home rehabilitation. The study was designed as randomized controlled trial, one group receiving therapy as usual and the other receiving additional ACRE training. Changes in motor abilities, stroke impact, quality of life and emotional well-being were assessed. In total, 24 patients were included. In this small number no significant effects of the ACRE training were found. A large number of 136 patients were excluded. Main reasons for exclusion were lack of physiological or cognitive abilities. Further improvement of the ACRE can best be focused on making the system suitable for self-training and development of training software for activities of daily living.

  4. Trends in Prevalence, Awareness, Treatment and Control of Hypertension during 2001-2010 in an Urban Elderly Population of China.

    Wu, Lei; He, Yao; Jiang, Bin; Sun, Dongling; Wang, Jianhua; Liu, Miao; Yang, Shanshan; Wang, Yiyan

    2015-01-01

    As the most important risk factors of cardiovascular disease, pre-hypertension and hypertension are important public health challenges. Few studies have focused on the trends of pre-hypertension and hypertension specifically for the aging population in China. Given the anticipated growth of the elderly population in China, there is an urgent need to document the conditions of pre-hypertension and hypertension in this aging population. We conducted two cross-sectional surveys of Chinese adults aged ≥60 years in 2001 and 2010. A total of 2,272 (943 males, 1,329 females) and 2,074 (839 males, 1,235 females) participants were included in the two surveys, respectively. The age- and sex-standardized prevalence of hypertension significantly increased from 60.1% to 65.2% from the 2001 to the 2010 survey. Among the participants with hypertension, the awareness, treatment and control of hypertension all significantly increased from 69.8% to 74.5%, 50.3% to 63.7%, and 15.3% to 30.3%, respectively, from 2001 to 2010. A logistic regression showed that a higher education level, a higher BMI, a family history of hypertension and doctor-diagnosed cardiovascular disease were significantly associated with hypertension awareness and treatment. Hypertension prevalence increased rapidly between the years surveyed. Although the awareness, treatment and control of hypertension improved significantly, the values of these variables remained low. More attention should be given to the elderly because the population is aging worldwide, and urgent action, optimal treatment approaches and proper public health strategies must be taken to prevent and manage hypertension.

  5. Memory improvements in elderly women following 16 weeks treatment with a combined multivitamin, mineral and herbal supplement: A randomized controlled trial.

    Macpherson, Helen; Ellis, Kathryn A; Sali, Avni; Pipingas, Andrew

    2012-03-01

    There is potential for multivitamin supplementation to improve cognition in the elderly. This randomized, double-blind, placebo-controlled trial was conducted to investigate the effects of 16 weeks multivitamin supplementation (Swisse Women's 50+ Ultivite ®) on cognition in elderly women. Participants in this study were 56 community dwelling, elderly women, with subjective complaints of memory loss. Cognition was assessed using a computerized battery of memory and attention tasks designed to be sensitive to age-related declines to fluid intelligence, and a measure of verbal recall. Biochemical measures of selected nutrients, homocysteine, markers of inflammation, oxidative stress, and blood safety parameters were also collected. All cognitive and haematological parameters were assessed at baseline and 16 weeks post-treatment. The multivitamin improved speed of response on a measure of spatial working memory, however benefits to other cognitive processes were not observed. Multivitamin supplementation decreased levels of homocysteine and increased levels of vitamin B(6) and B(12), with a trend for vitamin E to increase. There were no hepatotoxic effects of the multivitamin formula indicating this supplement was safe for everyday usage in the elderly. Sixteen weeks ssupplementation with a combined multivitamin, mineral and herbal formula may benefit working memory in elderly women at risk of cognitive decline.

  6. The Effects of Mindfulness-Based Cognitive Therapy on Depressive Symptoms in Elderly Bereaved People with Loss-Related Distress: a Controlled Pilot Study

    O Connor, Maja; Piet, Jacob; Hougaard, Esben

    2014-01-01

    We examined the effects of mindfulness-based cognitive therapy (MBCT) on symptom severity of depression, complicated grief, posttraumatic stress, and working memory in elderly bereaved people with long-term bereavement-related distress. A non-randomized, controlled pilot design was used in a sample...

  7. Multiple-source multiple-harmonic active vibration control of variable section cylindrical structures: A numerical study

    Liu, Jinxin; Chen, Xuefeng; Gao, Jiawei; Zhang, Xingwu

    2016-12-01

    Air vehicles, space vehicles and underwater vehicles, the cabins of which can be viewed as variable section cylindrical structures, have multiple rotational vibration sources (e.g., engines, propellers, compressors and motors), making the spectrum of noise multiple-harmonic. The suppression of such noise has been a focus of interests in the field of active vibration control (AVC). In this paper, a multiple-source multiple-harmonic (MSMH) active vibration suppression algorithm with feed-forward structure is proposed based on reference amplitude rectification and conjugate gradient method (CGM). An AVC simulation scheme called finite element model in-loop simulation (FEMILS) is also proposed for rapid algorithm verification. Numerical studies of AVC are conducted on a variable section cylindrical structure based on the proposed MSMH algorithm and FEMILS scheme. It can be seen from the numerical studies that: (1) the proposed MSMH algorithm can individually suppress each component of the multiple-harmonic noise with an unified and improved convergence rate; (2) the FEMILS scheme is convenient and straightforward for multiple-source simulations with an acceptable loop time. Moreover, the simulations have similar procedure to real-life control and can be easily extended to physical model platform.

  8. Independent exercise for glottal incompetence to improve vocal problems and prevent aspiration pneumonia in the elderly: a randomized controlled trial.

    Fujimaki, Yoko; Tsunoda, Koichi; Kobayashi, Rika; Tonghyo, Chong; Tanaka, Fujinobu; Kuroda, Hiroyuki; Numata, Tsutomu; Ishii, Toyota; Kuroda, Reiko; Masuda, Sawako; Hashimoto, Sho; Misawa, Hayato; Shindo, Naoko; Mori, Takahiro; Mori, Hiroko; Uchiyama, Naoki; Kamei, Yuichirou; Tanaka, Masashi; Hamaya, Hironobu; Funatsuki, Shingo; Usui, Satoko; Ito, Ikuno; Hamada, Kohei; Shindo, Akihito; Tokumaru, Yutaka; Morita, Yoko; Ueha, Rumi; Nito, Takaharu; Kikuta, Shu; Sekimoto, Sotaro; Kondo, Kenji; Sakamoto, Takashi; Itoh, Kenji; Yamasoba, Tatsuya; Matsumoto, Sumio

    2017-08-01

    To evaluate the effect of a self-controlled vocal exercise in elderly people with glottal closure insufficiency. Parallel-arm, individual randomized controlled trial. Patients who visited one of 10 medical centers under the National Hospital Organization group in Japan for the first time, aged 60 years or older, complaining of aspiration or hoarseness, and endoscopically confirmed to have glottal closure insufficiency owing to vocal cord atrophy, were enrolled in this study. They were randomly assigned to an intervention or a control group. The patients of the intervention group were given guidance and a DVD about a self-controlled vocal exercise. The maximum phonation time which is a measure of glottal closure was evaluated, and the number of patients who developed pneumonia during the six months was compared between the two groups. Of the 543 patients enrolled in this trial, 259 were allocated into the intervention group and 284 into the control; 60 of the intervention group and 75 of the control were not able to continue the trial. A total of 199 patients (age 73.9 ±7.25 years) in the intervention group and 209 (73.3 ±6.68 years) in the control completed the six-month trial. Intervention of the self-controlled vocal exercise extended the maximum phonation time significantly ( p < 0.001). There were two hospitalizations for pneumonia in the intervention group and 18 in the control group, representing a significant difference ( p < 0.001). The self-controlled vocal exercise allowed patients to achieve vocal cord adduction and improve glottal closure insufficiency, which reduced the rate of hospitalization for pneumonia significantly. gov Identifier-UMIN000015567.

  9. Resilience of Urban Smart Grids Involving Multiple Control Loops

    Madsen, Jacob Theilgaard; Pillai, Jayakrishnan Radhakrishna; Schwefel, Hans-Peter

    2016-01-01

    Intelligent control of energy distribution grids is implemented via a hierarchy of control loops with different input values and different control targets, which also work on different time-scales. This control is enabled by a bi-directional communication flow, which can be interrupted due to ICT...

  10. Tai Chi for Lower Urinary Tract Symptoms and Quality of Life in Elderly Patients with Benign Prostate Hypertrophy: A Randomized Controlled Trial

    Seil Jung

    2012-01-01

    Full Text Available Tai chi exercise has been recommended as suitable for the improvement of health in the elderly. The purpose of this study was to investigate the effects of tai chi on lower urinary tract symptoms (LUTSs, quality of life (QoL, and sex hormone levels in patients with benign prostate hypertrophy (BPH. The elderly patients with BPH were randomized to receive tai chi or usual care. Fifty-six participants were randomized into either the tai chi group (n=28 or the control group (n=28. After 12 weeks of treatment, the tai chi group showed significant improvement in LUTS and QoL. There was a significant effect of tai chi on testosterone but no significant effect on insulin or glucose. No serious adverse events were observed during the study period. In conclusion, our results suggest that 12 weeks of tai chi may improve LUTS and QoL in elderly patients with BPH.

  11. Finite Control Set Model Predictive Control for Multiple Distributed Generators Microgrids

    Babqi, Abdulrahman Jamal

    This dissertation proposes two control strategies for AC microgrids that consist of multiple distributed generators (DGs). The control strategies are valid for both grid-connected and islanded modes of operation. In general, microgrid can operate as a stand-alone system (i.e., islanded mode) or while it is connected to the utility grid (i.e., grid connected mode). To enhance the performance of a micrgorid, a sophisticated control scheme should be employed. The control strategies of microgrids can be divided into primary and secondary controls. The primary control regulates the output active and reactive powers of each DG in grid-connected mode as well as the output voltage and frequency of each DG in islanded mode. The secondary control is responsible for regulating the microgrid voltage and frequency in the islanded mode. Moreover, it provides power sharing schemes among the DGs. In other words, the secondary control specifies the set points (i.e. reference values) for the primary controllers. In this dissertation, Finite Control Set Model Predictive Control (FCS-MPC) was proposed for controlling microgrids. FCS-MPC was used as the primary controller to regulate the output power of each DG (in the grid-connected mode) or the voltage of the point of DG coupling (in the islanded mode of operation). In the grid-connected mode, Direct Power Model Predictive Control (DPMPC) was implemented to manage the power flow between each DG and the utility grid. In the islanded mode, Voltage Model Predictive Control (VMPC), as the primary control, and droop control, as the secondary control, were employed to control the output voltage of each DG and system frequency. The controller was equipped with a supplementary current limiting technique in order to limit the output current of each DG in abnormal incidents. The control approach also enabled smooth transition between the two modes. The performance of the control strategy was investigated and verified using PSCAD/EMTDC software

  12. Effects of group reminiscence on elderly depression: A meta-analysis

    Dan Song; Qin Shen; Tu-Zhen Xu; Qiu-Hua Sun

    2014-01-01

    Background/purpose: The present meta-analysis was performed to evaluate the effectiveness of group reminiscence on depression in elderly patients. Methods: Published and unpublished randomised controlled trials that assessed the effects of group reminiscence on depression in elderly patients were systematically reviewed using multiple electronic databases. Relative risks for dichotomous data and weighted mean differences for continuous data were calculated with 95% confidence intervals. ...

  13. Postoperative pain and patient-controlled epidural analgesia-related adverse effects in young and elderly patients: a retrospective analysis of 2,435 patients

    Koh JC

    2017-04-01

    Full Text Available Jae Chul Koh, Young Song, So Yeon Kim, Sooyeun Park, Seo Hee Ko, Dong Woo Han Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, South Korea Abstract: In this retrospective study, data of 2,435 patients who received fentanyl and ropivacaine-based patient-controlled epidural analgesia (PCEA for pain relief after elective surgery under general or spinal anesthesia were reviewed. Differences in postoperative pain, incidence of patient-controlled analgesia (PCA-related adverse effects, and risk factors for the need for rescue analgesics for 48 hours postsurgery in young (age 20–39 years and elderly (age ≥70 years patients were evaluated. Although there were no significant differences in postoperative pain intensity between the two groups until 6 hours postsurgery, younger patients experienced greater postoperative pain intensity compared with older patients 6–48 hours postsurgery. While younger patients exhibited greater incidence of numbness, motor weakness, and discontinuation of PCA postsurgery, elderly patients exhibited greater incidence of hypotension, nausea/vomiting, rescue analgesia, and antiemetic administration. Upon multivariate analysis, low fentanyl dosage and history of smoking were found to be associated with an increased need for rescue analgesia among younger patients, while physical status classification III/IV and thoracic surgery were associated with a decreased need for rescue analgesia among the elderly. Discontinuation of PCA was more frequent among younger patients than the elderly (18.5% vs 13.5%, P=0.001. Reasons for discontinuation of PCA among young and elderly patients, respectively, were nausea and vomiting (6.8% vs 26.6%, numbness or motor weakness (67.8% vs 11.5%, urinary retention (7.4% vs 8.7%, dizziness (2.2% vs 5.2%, and hypotension (3.1% vs 20.3%. In conclusion, PCEA was more frequently associated with numbness, motor

  14. Review on Control of DC Microgrids and Multiple Microgrid Clusters

    Meng, Lexuan; Shafiee, Qobad; Ferrari-Trecate, Giancarlo

    2017-01-01

    This paper performs an extensive review on control schemes and architectures applied to DC microgrids. It covers multi-layer hierarchical control schemes, coordinated control strategies, plug-and-play operations, stability and active damping aspects as well as nonlinear control algorithms....... Islanding detection, protection and microgrid clusters control are also briefly summarized. All the mentioned issues are discussed with the goal of providing control design guidelines for DC microgrids. The future research challenges, from the authors’ point of view, are also provided in the final...

  15. Desempenho de idosos com presbiacusia em tarefas de controle inibitório Performance of elderly individuals with presbycusis in tasks involving inhibitory control

    Ana Lúcia Pires Afonso da Costa

    2012-06-01

    Full Text Available OBJETIVO: Avaliar o desempenho de idosos em tarefa não verbal ligada a funções executivas, a fim de verificar a hipótese de que idosos usuários de próteses auditivas obteriam escores mais altos do que idosos não usuários de próteses na tarefa proposta. MÉTODOS: A tarefa Simon, administrada individualmente em um laptop com o software e-prime, foi utilizada para mensurar aspectos ligados a funções executivas por meio de uma condição controle e duas condições de teste. Na condição controle, os estímulos - quadrados coloridos - eram apresentados no centro da tela. As condições de teste subdividiam-se em condições laterais congruentes - estímulos posicionados no mesmo lado da tela em que a tecla do computador a ser selecionada para a resposta - e laterais incongruentes - em que os estímulos aparecem no lado da tela oposto ao da tecla a ser selecionada. A diferença de tempo de reação entre as condições congruente e incongruente é chamada de efeito Simon. Os idosos foram agrupados em três grupos: um grupo controle de indivíduos com audição normal; indivíduos com presbiacusia, usuários de próteses auditivas; e indivíduos com presbiacusia não usuários de próteses auditivas. RESULTADOS: A análise estatística apontou diferença entre o grupo sem perda auditiva (controle e o grupo de não usuários de prótese auditiva somente no tempo de reação (TR na condição controle. Nas demais comparações não foram encontradas diferenças. CONCLUSÃO: A hipótese levantada não foi corroborada, o que aponta a necessidade de utilização de novos métodos exploratórios de observação dos fenômenos estudados.PURPOSE: To evaluate the performance of elderly individuals in a non-verbal task related to executive functions, in order to verify the hypothesis that elderly hearing aid users would obtain higher scores in the proposed task than elderly non-hearing aid users. METHODS: The Simon task, administered individually on

  16. Automatic diagnosis of multiple alarms for reactor-control rooms

    Gimmy, K.L.; Nomm, E.

    1981-01-01

    A system has been developed at the Savannah River Plant to help reactor operators respond to multiple alarms in a developing incident situation. The need for such systems has become evident in recent years, particularly after the three Mile Island incident

  17. Presentation of Malaria Epidemics Using Multiple Optimal Controls

    Abid Ali Lashari

    2012-01-01

    Full Text Available An existing model is extended to assess the impact of some antimalaria control measures, by re-formulating the model as an optimal control problem. This paper investigates the fundamental role of three type of controls, personal protection, treatment, and mosquito reduction strategies in controlling the malaria. We work in the nonlinear optimal control framework. The existence and the uniqueness results of the solution are discussed. A characterization of the optimal control via adjoint variables is established. The optimality system is solved numerically by a competitive Gauss-Seidel-like implicit difference method. Finally, numerical simulations of the optimal control problem, using a set of reasonable parameter values, are carried out to investigate the effectiveness of the proposed control measures.

  18. Medium-Chain Triglycerides in Combination with Leucine and Vitamin D Increase Muscle Strength and Function in Frail Elderly Adults in a Randomized Controlled Trial.

    Abe, Sakiko; Ezaki, Osamu; Suzuki, Motohisa

    2016-05-01

    Sarcopenia, the loss of skeletal muscle mass, strength, and function, is common in elderly individuals but difficult to treat. A combination of nutrients was investigated to treat sarcopenia in very frail elderly adults. We enrolled 38 elderly nursing home residents (11 men and 27 women with a mean ± SD age of 86.6 ± 4.8 y) in a 3-mo randomized, controlled, single-blind, parallel group trial. The participants were randomly allocated to 3 groups. The first group received a daily l-leucine (1.2 g) and cholecalciferol (20 μg)-enriched supplement with 6 g medium-chain triglycerides (TGs) (MCTs) (LD + MCT); the second group received the same leucine and cholecalciferol-enriched supplement with 6 g long-chain TGs (LD + LCT); and the third group did not receive any supplements (control). The supplement and oils were taken at dinner, and changes in muscle mass, strength, and function were monitored. The increase in body weight in the LD + MCT (1.1 ± 1.0 kg) and LD + LCT (0.8 ± 1.1 kg) groups was greater than that in the control group (-0.5 ± 0.9 kg) (P elderly individuals. This trial was registered at the University Hospital Medical Information Network Clinical Trials Registry as UMIN000017567. © 2016 American Society for Nutrition.

  19. Differential effects of decision latitude and control on the job demands-strain relationship: a cross-sectional survey study among elderly care nursing staff.

    Schmidt, Klaus-Helmut; Diestel, Stefan

    2011-03-01

    According to the influential Job Demands-Control (JD-C) model developed by Karasek (1979; Karasek and Theorell, 1990), job strain is expected to result from high job demands and low job control as well as an interaction between both job characteristics. Previous research, however, has found such an interaction only rarely or inconsistently.It has been suggested that the conceptualization of the control variable (formerly referred to as decision latitude) may be particularly responsible for the lack of supportive findings. The present study aimed at clarifying this issue by contrasting a focused measure of control with a traditional measure of decision latitude in their relations to job strain of health care workers. The measure of decision latitude encompassed a wide range of job characteristics including control, task variety, and learning opportunities. A cross-sectional questionnaire survey was conducted with job satisfaction, psychosomatic complaints and emotional exhaustion as criterion measures of job strain. A supra-regional organization for residential elderly care with 11 nursing homes located in a federal state in Germany. Questionnaires were distributed to the whole nursing staff, of which 379 filled in the questionnaire during normal working hours (68% participation rate). In addition to confirmatory factor analyses, descriptive statistics, and bivariate correlations, hierarchical multiple regression analyses were performed for testing the corresponding interaction effects. Findings confirmed the assumption that the focused measure of control and the traditional measure of decision latitude represent distinct, yet correlated factors. Furthermore, findings revealed a significant interaction effect between job demands and control on all outcomes considered. By way of contrast, there was no equivalent interaction effect between job demands and decision latitude. In line with the JD-C model, the adverse influence of increasing demands on job satisfaction

  20. Is oxycodone/naloxone effective and safe in managing chronic pain of a fragile elderly patient with multiple skin ulcers of the lower limbs? A case report 

    Guerriero F

    2015-08-01

    Full Text Available Fabio Guerriero,1,2 Niccolo Maurizi,1 Matthew Francis,1 Carmelo Sgarlata,1 Giovanni Ricevuti,1,2 Mariangela Rondanelli,2,3 Simone Perna,2,3 Marco Rollone21Department of Internal Medicine and Medical Therapy, Section of Geriatrics, University of Pavia, 2Azienda di Servizi alla Persona, Istituto di Cura Santa Margherita of Pavia, 3Department of Public Health, Experimental and Forensic Medicine, Section of Human Nutrition, University of Pavia, Pavia, Italy Abstract: Skin ulcers are a common issue in the elderly, as physiological loss of skin elasticity, alterations in microcirculation, and concomitant chronic diseases typically occur in advanced age, thereby predisposing to these painful lesions. Wound-related pain is often associated with skin ulcers and negatively impacts both the patient’s quality of life and, indirectly, wound healing. Pain management is an ongoing issue in the elderly, and remains underestimated and undertreated in this fragile population. Recent guidelines suggest the use of opioids as the frontline treatment of moderate and severe pain in nononcological pain in the elderly. However, due to the concerns of adverse reactions, drug interactions, and addiction, clinicians frequently hesitate to prescribe opioids. This case report describes an elderly diabetic patient with multiple ulcers of the lower limbs suffering wound-related pain. In our report, oxycodone/naloxone has proved to be an effective and safe drug, providing pain relief as well as increased compliance when redressing wounds and faster healing compared to that in similar patients. Our case provides anecdotal evidence, supported by other studies, to justify future, larger studies on chronic pain using this therapy. Keywords: chronic pain, skin ulcers, elderly, opioids, oxycodone, naloxone

  1. Venlafaxine versus nortriptyline in the treatment of elderly depressed inpatients : a randomised, double-blind, controlled trial

    Kok, Rob M.; Nolen, Willem A.; Heeren, Thea J.

    2007-01-01

    Background The majority of the trials in the elderly are outpatient trials which excluded psychotic patients and patients with common comorbid physical disorders. Consequently information is lacking about the more complex cases of elderly depressed patients, as found in inpatient wards. Objective To

  2. The Relationship of Health Locus of Control, Perceived Health Status and Activity Levels of Non-Institutionalized Elderly Clients.

    Speake, Dianne L.

    Individuals of all ages need to maintain an active lifestyle to promote health. The physiological changes associated with aging, however, make the elderly especially vulnerable to disuse atrophy associated with inactivity. Exercise programs for the elderly are being established in increasing numbers, but high dropout rates from these programs…

  3. Economic outcomes of pharmacist-physician medication therapy management for polypharmacy elderly: A prospective, randomized, controlled trial

    Hsiang-Wen Lin

    2018-03-01

    Conclusion: The pharmacist-physician collaborative MTM program for polypharmacy elderly had significant cost savings and improvement in humanistic measures, demonstrating the importance of clinical pharmacists and MTM programs for elderly patients in Taiwan. The results suggest the possibility of clinical benefits, but the study was not substantially powered to find a statistical difference.

  4. Low-dose B vitamins supplementation ameliorates cardiovascular risk: a double-blind randomized controlled trial in healthy Chinese elderly.

    Wang, Linlin; Li, Hongtian; Zhou, Yuan; Jin, Lei; Liu, Jianmeng

    2015-04-01

    We investigated whether daily supplementation with low-dose B vitamins in the healthy elderly population improves the Framingham risk score (FRS), a predictor of cardiovascular disease risk. Between 2007 and 2012, a double-blind randomized controlled trial was conducted in a rural area of North China. In all, 390 healthy participants aged 60-74 were randomly allocated to receive daily vitamin C (50 mg; control group) or vitamin C plus B vitamins (400 µg folic acid, 2 mg B6, and 10 µg B12; treatment group) for 12 months. FRSs were calculated for all 390 subjects. Folate and vitamin B12 plasma concentrations in the treatment group increased by 253 and 80%, respectively, after 6 months, stopped increasing with continued supplementation after 12 months and returned to baseline levels 6 months after supplementation cessation. Compared with the control group, there was no significant effect of B vitamin supplementation on FRSs after 6 months (mean difference -0.38; 95% CI -1.06, 0.31; p = 0.279), whereas a significant effect of supplementation was evident after 12 months (reduced magnitude 7.6%; -0.77; 95% CI -1.47, -0.06; p = 0.033). However, this reduction disappeared 6 months after supplementation stopped (-0.07; 95% CI -0.80, 0.66; p = 0.855). The reduction in FRS 12 months after supplementation was more pronounced in individuals with a folate deficiency (10.4%; -1.30; 95% CI -2.54, -0.07; p = 0.039) than in those without (4.1%; -0.38; 95% CI -1.12, 0.36; p = 0.313). B vitamins increased high-density lipoprotein cholesterol by 3.4% after 6 months (0.04; 95% CI -0.02, 0.10; p = 0.155) and by 9.2% after 12 months (0.11; 95 % CI 0.04, 0.18; p = 0.003). Compared with the control group, this change in magnitude decreased to 3.3% (0.04; 95 % CI -0.02, 0.10; p = 0.194) 6 months after supplementation cessation. Daily supplementation with a low-dose of B vitamins for 12 months reduced FRS, particularly in healthy elderly subjects with a folate deficiency. These reduced

  5. Multiple Estimation Architecture in Discrete-Time Adaptive Mixing Control

    Simone Baldi

    2013-05-01

    Full Text Available Adaptive mixing control (AMC is a recently developed control scheme for uncertain plants, where the control action coming from a bank of precomputed controller is mixed based on the parameter estimates generated by an on-line parameter estimator. Even if the stability of the control scheme, also in the presence of modeling errors and disturbances, has been shown analytically, its transient performance might be sensitive to the initial conditions of the parameter estimator. In particular, for some initial conditions, transient oscillations may not be acceptable in practical applications. In order to account for such a possible phenomenon and to improve the learning capability of the adaptive scheme, in this paper a new mixing architecture is developed, involving the use of parallel parameter estimators, or multi-estimators, each one working on a small subset of the uncertainty set. A supervisory logic, using performance signals based on the past and present estimation error, selects the parameter estimate to determine the mixing of the controllers. The stability and robustness properties of the resulting approach, referred to as multi-estimator adaptive mixing control (Multi-AMC, are analytically established. Besides, extensive simulations demonstrate that the scheme improves the transient performance of the original AMC with a single estimator. The control scheme and the analysis are carried out in a discrete-time framework, for easier implementation of the method in digital control.

  6. Factors related to falls among community dwelling elderly.

    Kuhirunyaratn, Piyathida; Prasomrak, Prasert; Jindawong, Bangonsri

    2013-09-01

    Falls among the elderly can lead to disability, hospitalization and premature death. This study aimed to determine the factors related to falls among community dwelling elderly. This case-control study was conducted at the Samlium Primary Care Unit (SPCU), Khon Kaen, Thailand. Cases were elderly individuals who had fallen within the previous six months and controls were elderly who had not fallen during that same time period. Subjects were taken from elderly persons registered at the SPCU. The sample size was calculated to be 111 cases and 222 controls. Face to face interviews were conducted with subjects between May and June, 2011. The response rate was 100%. On bivariate analysis, the statistically significant factors related to falls were: regular medication use, co-morbidities, mobility, depression, cluttered rooms, slippery floors, unsupported toilets (without a hand rail), sufficient exercise, rapid posture change and wearing slippers. When controlling for others significant factors, multiple logistic regression revealed significant factors were: regular medication use (AOR: 2.22; 95%CI: 1.19 - 4.12), depression (AOR: 1.76, 95% CI: 1.03 - 2.99), sufficient exercise (AOR: 0.34; 95% CI: 0.19 - 0.58) and wearing slippery shoes (AOR: 2.31; 95% CI: 1.24 - 4.29). Interventions need to be considered to modify these significant factors associated with falls and education should be provided to these at risk.

  7. Multiple Model Adaptive Control Using Dual Youla-Kucera Factorisation

    Bendtsen, Jan Dimon; Trangbæk, Klaus

    2012-01-01

    We propose a multi-model adaptive control scheme for uncertain linear plants based on the concept of model unfalsification. The approach relies on examining the ability of a pre-computed set of plant-controller candidates and choosing the one that is best able to reproduce observed in- and output...

  8. Vitamin D Supplementation in Elderly Black Women Does Not Prevent Bone Loss, a Randomized Controlled Trial.

    Aloia, John F; Fazzari, Melissa; Islam, Shahidul; Mikhail, Mageda; Katumuluwa, Subhashini; Dhaliwal, Ruban; Stolberg, Alexandra; Usera, Gianina; Ragolia, Louis

    2018-06-15

    Black Americans have lower levels of serum 25(OH)D but superior bone health compared to white Americans. There is controversy over whether they should be screened for vitamin D deficiency and have higher vitamin D requirements than recommended by the Institute of Medicine (IOM). The purpose of this trial was to determine whether Vitamin D supplementation in elderly black women prevents bone loss. 260 healthy black American women, 60 years of age and older were recruited to take part in a two arm, double-dummy 3 year RCT of vitamin D 3 vs. placebo. The study was conducted in an ambulatory clinical research center. Vitamin D 3 dose was adjusted to maintain serum 25(OH)D above 75 nmol/L. Bone mineral density (BMD) and serum were measured for [parathyroid hormone (PTH), C-terminal crosslink telopeptide (CTX) and bone specific alkaline phosphatase (BSAP) every 6 months. Baseline serum 25(OH)D 3 was 54.8 ± 16.8 nmol/L. There was no group xtime interaction effect for any BMD measurement. For all BMD measurements, except for total body and spine, there was a statistically significant negative effect of time (P D above 75 nmol/L is comparable to the rate of loss with serum 25(OH)D at the RDA of 50 nmol/L. Black Americans should have the same exposure to vitamin D as white Americans. The trial was registered at clinical trials.gov: NCT01153568. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  9. Circadian phase resetting via single and multiple control targets.

    Neda Bagheri

    2008-07-01

    Full Text Available Circadian entrainment is necessary for rhythmic physiological functions to be appropriately timed over the 24-hour day. Disruption of circadian rhythms has been associated with sleep and neuro-behavioral impairments as well as cancer. To date, light is widely accepted to be the most powerful circadian synchronizer, motivating its use as a key control input for phase resetting. Through sensitivity analysis, we identify additional control targets whose individual and simultaneous manipulation (via a model predictive control algorithm out-perform the open-loop light-based phase recovery dynamics by nearly 3-fold. We further demonstrate the robustness of phase resetting by synchronizing short- and long-period mutant phenotypes to the 24-hour environment; the control algorithm is robust in the presence of model mismatch. These studies prove the efficacy and immediate application of model predictive control in experimental studies and medicine. In particular, maintaining proper circadian regulation may significantly decrease the chance of acquiring chronic illness.

  10. Epilepsy in the Elderly

    Lu-An Chen

    2012-06-01

    Full Text Available Elderly people are the largest and continuously fastest growing population among patients with epilepsy. Elderly patients with epilepsy are very different from other age groups in many respects and clinicians shouldn’t treat them in the same way as younger adults. Accurate diagnosis of epilepsy in the elderly is much more difficult and atypical manifestations and misdiagnoses are certainly not the exception. Syncope is probably the most important differential diagnosis. High clinical suspicion and proper investigation are the best tools for prompt diagnosis. Etiologies of late-onset epilepsy are mainly symptomatic and cerebrovascular diseases are the most common causes in this age group, followed by degenerative diseases such as Alzheimer’s disease. It is appropriate to consider starting antiepileptic drug (AED treatment at the first-ever seizure in elderly patients who have remote symptomatic causes such as stroke and dementia. According to the high recurrence rate of seizure and the good response to AEDs in elderly patients, the proper choice from various AEDs for seizure control is very important. Decision-making for AED choice depends on many different factors, including pharmacological properties, efficacy, tolerability from side effects, drug interactions, and medical comorbidities. The newer AEDs with lesser adverse effects and fewer drug interactions appear to be reasonable treatment options for elderly patients. However, more evidence from clinical trials in this specific age group is warranted.

  11. Efficient Control Law Simulation for Multiple Mobile Robots

    Driessen, B.J.; Feddema, J.T.; Kotulski, J.D.; Kwok, K.S.

    1998-10-06

    In this paper we consider the problem of simulating simple control laws involving large numbers of mobile robots. Such simulation can be computationally prohibitive if the number of robots is large enough, say 1 million, due to the 0(N2 ) cost of each time step. This work therefore uses hierarchical tree-based methods for calculating the control law. These tree-based approaches have O(NlogN) cost per time step, thus allowing for efficient simulation involving a large number of robots. For concreteness, a decentralized control law which involves only the distance and bearing to the closest neighbor robot will be considered. The time to calculate the control law for each robot at each time step is demonstrated to be O(logN).

  12. Dynamic pipe control with a multiple digit automatic measuring device

    Jenzer, P.

    1984-01-01

    With the flow rotating method, thin-walled pipes can be produced with very tight tolerances and high mechanical sturdiness. The measuring device permits a dynamic control of these pipes, the outer diameter of which can lie between 70 and 300 mm, the length between 500 and 2000 mm and the wall thickness between 0,5 and 10 mm. Depending on the pipe type, up to 27 measurements in a maximum of 5 measuring levels are to be controlled. (orig.) [de

  13. Postural control in elderly persons with osteoporosis: Efficacy of an intervention program to improve balance and muscle strength: a randomized controlled trial.

    Burke, Thomaz Nogueira; França, Fábio Jorge Renovato; Ferreira de Meneses, Sarah Rúbia; Cardoso, Viviam Inhasz; Marques, Amélia Pasqual

    2010-07-01

    To assess the efficacy of an exercise program aiming to improve balance and muscular strength, for postural control and muscular strength of women with osteoporosis. Sample consisted of 33 women with osteoporosis, randomized into one of two groups: intervention group, in which exercises for balance and improvement of muscular strength of the inferior members were performed for 8 wks (n = 17, age 72.8 +/- 3.6 yrs); control group, which was women not practicing exercises (n = 16, age 74.4 +/- 3.7 yrs). At baseline and after 8 wks of treatment, postural control was assessed using a force plate (Balance Master, Neurocom), and muscular strength during ankle dorsiflexion, knee extension, and flexion was assessed by dynamometry. Adherence to the program was 82%. When compared with the control group, individuals in the intervention group significantly improved the center of pressure velocity (P = 0.02) in the modified clinical test of sensory interaction for balance test, center of pressure velocity (P control (P postural control and lower-limb strength in elderly women with osteoporosis.

  14. Control of body's center of mass motion relative to center of pressure during uphill walking in the elderly.

    Hong, Shih-Wun; Leu, Tsai-Hsueh; Wang, Ting-Ming; Li, Jia-Da; Ho, Wei-Pin; Lu, Tung-Wu

    2015-10-01

    Uphill walking places more challenges on the locomotor system than level walking does when the two limbs work together to ensure the stability and continuous progression of the body over the base of support. With age-related degeneration older people may have more difficulty in maintaining balance during uphill walking, and may thus experience an increased risk of falling. The current study aimed to investigate using gait analysis techniques to determine the effects of age and slope angles on the control of the COM relative to the COP in terms of their inclination angles (IA) and the rate of change of IA (RCIA) during uphill walking. The elderly were found to show IAs similar to those of the young, but with reduced self-selected walking speed and RCIAs (PIA in the sagittal plane (PIA and RCIA during walking provide a sensitive measure to differentiate individuals with different balance control abilities. The current results and findings may serve as baseline data for future clinical and ergonomic applications. Copyright © 2015 Elsevier B.V. All rights reserved.

  15. Consumption of a fermented dairy product containing the probiotic Lactobacillus casei DN-114001 reduces the duration of respiratory infections in the elderly in a randomised controlled trial.

    Guillemard, E; Tondu, F; Lacoin, F; Schrezenmeir, J

    2010-01-01

    Common infectious diseases (CID) of the airways and the gastrointestinal tract are still a considerable cause of morbidity and mortality in elderly. The present study examined the beneficial effect of a dairy product containing the probiotic strain Lactobacillus casei DN-114 001 (fermented product) on the resistance of free-living elderly to CID. The study was multicentric, double blind and controlled, involving 1072 volunteers (median age = 76.0 years) randomised for consumption of either 200 g/d of fermented (n 537) or control (non-fermented) dairy product (n 535) for 3 months, followed by an additional 1 month's follow-up. The results showed that, when considering all CID, the fermented product significantly reduced the average duration per episode of CID (6.5 v. 8 d in control group; P = 0.008) and the cumulative duration of CID (7 v. 8 d in control group; P = 0.009). Reduction in both episode and cumulative durations was also significant for all upper respiratory tract infections (URTI; P fermented product consumption (2-3.8 x 107 equivalents of colony-forming unit/g of stools, P fermented product was safe and well tolerated. In conclusion, consumption of a fermented dairy product containing the probiotic strain L. casei DN-114 001 in elderly was associated with a decreased duration of CID in comparison with the control group, especially for URTI such as rhinopharyngitis.

  16. Depressive Symptoms, Co-Morbidities, and Glycemic Control in Hong Kong Chinese Elderly Patients With Type 2 Diabetes Mellitus

    Annie C. H. Fung

    2018-05-01

    Full Text Available Background and objectivesUndiagnosed depression is an important comorbidity in type 2 diabetes (T2D which can be detected using the Geriatric Depression Scale (GDS-15 questionnaire. In this cross-sectional study, we examined the associations of depression using GDS score with control of cardiometabolic risk factors and health status in elderly patients with T2D.Setting and participantsBetween February and December 2013, patients aged ≥65 years who underwent structured comprehensive assessment as a quality improvement program at the Diabetes Center of a teaching hospital were invited to complete the GDS-15 questionnaire.Main outcome measuresDepression was defined as a GDS score ≥7. Demographic data, prior history of co-morbidities, frequency of self-reported hypoglycemia, and attainment of treatment targets defined as HbA1c, <7%, blood pressure <130/80 mmHg, and LDL-C <2.6 mmol/L were documented.ResultsAmong 325 participants (65% male, median [interquartile range] age: 69 [8] years, 42 (13% had depression. Patients with depression had longer disease durations (mean ± SD: 15.1 ± 9.1 vs. 11.6 ± 8.1 years, P = 0.02, more frequent self-reported hypoglycemic events (17 vs. 6%, P = 0.03 and were less likely to attain all three treatment targets (0 vs. 16%, P = 0.004 than those without depression. On multivariable analysis, patients with depression had an odds ratio of 2.84 (95% confidence intervals: 1.35–6.00, P = 0.006 of reporting prior history of co-morbidities.ConclusionIn elderly patients with T2D, depression was not uncommon especially in those with poor control of risk factors, hypoglycemia, and co-morbidities. Inclusion of GDS-15 questionnaire during structured assessment for complications and risk factors can identify these high-risk patients for more holistic management of their physical and mental health.

  17. Exercise and Nutritional Supplementation on Community-Dwelling Elderly Japanese Women With Sarcopenic Obesity: A Randomized Controlled Trial.

    Kim, Hunkyung; Kim, Miji; Kojima, Narumi; Fujino, Ken; Hosoi, Erika; Kobayashi, Hisamine; Somekawa, Shinji; Niki, Yoshifumi; Yamashiro, Yukari; Yoshida, Hideyo

    2016-11-01

    To investigate the effects of exercise and/or nutritional supplementation on body composition, blood components, and physical function in community-dwelling elderly Japanese women with sarcopenic obesity. Randomized controlled trial. Urban community in Tokyo, Japan. Among 1213 community-dwelling elderly women over 70 years of age, 307 were defined with sarcopenic obesity, and 139 women participated in the study. Participants were randomly assigned to one of four intervention groups. The exercise and nutrition (Ex + N) and exercise only (Ex) groups attended 60-minute exercise classes twice a week for 3 months. The Ex + N and nutrition only (N) groups were provided with essential amino acid supplementation and tea fortified with catechins to be taken daily for 3 months. Health education classes were provided to the control (HE) group every 2 weeks. Bioelectric impedance analysis was used to measure body composition. Skeletal muscle mass index was calculated using measures of muscle mass and height. Physical function measures included grip strength, knee extension strength, usual walking speed, and walking parameters (stride, step length, width, walking angles). Blood samples were obtained to analyze levels of albumin, triglycerides, cholesterol, hemoglobin A1c, leptin, cystatin C, vitamin D, interleukin-6, and high-sensitivity C-reactive protein. Significant between-group × time interactions were observed in usual walking speed (P = .012), stride (P = .004), right step length (P = .003), average number of steps (P = .029), and vitamin D (P exercise and nutrition have beneficial effects on individual variables of body composition, blood components, and physical function, improvements in muscle mass and variable combinations such as percent fat + skeletal muscle mass index or percent fat + physical functions were not observed in this population. Further large-scale and long-term investigation is necessary. Copyright © 2016 AMDA – The Society

  18. A EUropean study on effectiveness and sustainability of current Cardiac Rehabilitation programmes in the Elderly: Design of the EU-CaRE randomised controlled trial.

    Prescott, Eva; Meindersma, Esther P; van der Velde, Astrid E; Gonzalez-Juanatey, Jose R; Iliou, Marie Christine; Ardissino, Diego; Zoccai, Giuseppe Biondi; Zeymer, Uwe; Prins, Leonie F; Van't Hof, Arnoud Wj; Wilhelm, Matthias; de Kluiver, Ed P

    2016-10-01

    Cardiac rehabilitation (CR) is an evidence-based intervention to increase survival and quality of life. Yet studies consistently show that elderly patients are less frequently referred to CR, show less uptake and more often drop out of CR programmes. The European study on effectiveness and sustainability of current cardiac rehabilitation programmes in the elderly (EU-CaRE) project consists of an observational study and an open prospective, investigator-initiated multicentre randomised controlled trial (RCT) involving mobile telemonitoring guided CR (mCR). The aim of EU-CaRE is to map the efficiency of current CR of the elderly in Europe, and to investigate whether mCR is an effective alternative in terms of efficacy, adherence and sustainability. The EU-CaRE study includes patients aged 65 years or older with ischaemic heart disease or who have undergone heart valve surgery. A total of 1760 patients participating in existing CR programmes in eight regions of Europe will be included. Of patients declining regular CR, 238 will be included in the RCT and randomised in two study arms. The experimental group (mCR) will receive a personalised home-based programme while the control group will receive no advice or coaching throughout the study period. Outcomes will be assessed after the end of CR and at 12 months follow-up. The primary outcome is VO 2peak and secondary outcomes include variables describing CR uptake, adherence, efficacy and sustainability. The study will provide important information to improve CR in the elderly. The EU-CaRE RCT is the first European multicentre study of mCR as an alternative for elderly patients not attending usual CR. © The European Society of Cardiology 2016.

  19. The Beneficial Effects of Cognitive Training With Simple Calculation and Reading Aloud (SCRA) in the Elderly Postoperative Population: A Pilot Randomized Controlled Trial.

    Kulason, Kay; Nouchi, Rui; Hoshikawa, Yasushi; Noda, Masafumi; Okada, Yoshinori; Kawashima, Ryuta

    2018-01-01

    Background: There has been little research conducted regarding cognitive treatments for the elderly postsurgical population. Patients aged ≥60 years have an increased risk of postoperative cognitive decline, a condition in which cognitive functions are negatively affected. This cognitive decline can lead to a decline in quality of life. In order to maintain a high quality of life, the elderly postsurgical population may benefit from treatment to maintain and/or improve their cognitive functions. This pilot study investigates the effect of simple calculation and reading aloud (SCRA) cognitive training in elderly Japanese postsurgical patients. Methods: Elderly patients undergoing non-cardiovascular thoracic surgery under general anesthesia were recruited ( n = 12). Subjects were randomly divided into two groups-one that receives 12 weeks of SCRA intervention, and a waitlisted control group. Before and after the intervention, we measured cognitive function [Mini-Mental Status Exam-Japanese (MMSE-J), Frontal Assessment Battery (FAB), computerized Cogstate Brief Battery (CBB)] and emotional state [General Health Questionnaire-12 (GHQ-12), Geriatric Depression Scale (GDS), Quality of Life Scale-5 (QOL-5)]. Results: Group difference analyses using ANCOVA with permutation test showed that the intervention SCRA group had a significant improvement in FAB motor programming sub-score, GDS, and QOL-5 compared to the control group. Within-group analyses using Wilcoxon signed-rank test to compare baseline and follow-up showed that the SCRA intervention group total FAB scores, FAB motor programming sub-scores, and QOL-5 scores were significantly improved. Discussion: This pilot study showed that there are important implications for the beneficial effects of SCRA intervention on cognitive function and emotional state in the postoperative elderly population; however, further investigations are necessary to reach any conclusions. Trial registration: This study was registered with

  20. Lifestyle intervention using Internet of Things (IoT) for the elderly: A study protocol for a randomized control trial (the BEST-LIFE study).

    Kato, Sawako; Ando, Masahiko; Kondo, Takaaki; Yoshida, Yasuko; Honda, Hiroyuki; Maruyama, Shoichi

    2018-05-01

    Modification of lifestyle habits, including diet and physical activity, is essential for the prevention and control of type 2 diabetes mellitus (T2DM) in elderly patients. However, individualized treatment is more critical for the elderly than for general patients. This study aimed to determine lifestyle interventions that resulted in lowering hemoglobin A 1c (HbA 1c ) in Japanese pre- and early diabetic elderly subjects. The BEST-LIFE trial is an ongoing, open-label, 6-month, randomized (1:1) parallel group trial. Subjects with HbA 1c of ≥5.6%-randomly assigned to the intervention or control group -use wearable monitoring devices loaded with Internet of things (IoT) systems that aids them with self-management and obtaining monthly remote health guidance from a public health nurse. The primary outcome is changes in HbA 1c after a 6-month intervention relative to the baseline values. The secondary outcome is the change of behavior modification stages. The background, rationale, and study design of this trial are also presented. One hundred forty-five subjects have already been enrolled in this lifestyle intervention program, which will end in 2019. The BEST-LIFE trial will provide new evidence regarding the effectiveness and safety of our program on lowering HbA 1c in elderly subjects with T2DM. It will also investigate whether information communication technology tools and monitoring devices loaded with IoT can support health care in elderly subjects. The trial registration number is UMIN-CTR: UMIN 000023356.

  1. The Beneficial Effects of Cognitive Training With Simple Calculation and Reading Aloud (SCRA in the Elderly Postoperative Population: A Pilot Randomized Controlled Trial

    Kay Kulason

    2018-03-01

    Full Text Available Background: There has been little research conducted regarding cognitive treatments for the elderly postsurgical population. Patients aged ≥60 years have an increased risk of postoperative cognitive decline, a condition in which cognitive functions are negatively affected. This cognitive decline can lead to a decline in quality of life. In order to maintain a high quality of life, the elderly postsurgical population may benefit from treatment to maintain and/or improve their cognitive functions. This pilot study investigates the effect of simple calculation and reading aloud (SCRA cognitive training in elderly Japanese postsurgical patients.Methods: Elderly patients undergoing non-cardiovascular thoracic surgery under general anesthesia were recruited (n = 12. Subjects were randomly divided into two groups—one that receives 12 weeks of SCRA intervention, and a waitlisted control group. Before and after the intervention, we measured cognitive function [Mini-Mental Status Exam-Japanese (MMSE-J, Frontal Assessment Battery (FAB, computerized Cogstate Brief Battery (CBB] and emotional state [General Health Questionnaire-12 (GHQ-12, Geriatric Depression Scale (GDS, Quality of Life Scale-5 (QOL-5].Results: Group difference analyses using ANCOVA with permutation test showed that the intervention SCRA group had a significant improvement in FAB motor programming sub-score, GDS, and QOL-5 compared to the control group. Within-group analyses using Wilcoxon signed-rank test to compare baseline and follow-up showed that the SCRA intervention group total FAB scores, FAB motor programming sub-scores, and QOL-5 scores were significantly improved.Discussion: This pilot study showed that there are important implications for the beneficial effects of SCRA intervention on cognitive function and emotional state in the postoperative elderly population; however, further investigations are necessary to reach any conclusions.Trial registration: This study was

  2. Hierarchical Control for Multiple DC-Microgrids Clusters

    Shafiee, Qobad; Dragicevic, Tomislav; Vasquez, Juan Carlos

    2014-01-01

    DC microgrids (MGs) have gained research interest during the recent years because of many potential advantages as compared to the ac system. To ensure reliable operation of a low-voltage dc MG as well as its intelligent operation with the other DC MGs, a hierarchical control is proposed in this p......DC microgrids (MGs) have gained research interest during the recent years because of many potential advantages as compared to the ac system. To ensure reliable operation of a low-voltage dc MG as well as its intelligent operation with the other DC MGs, a hierarchical control is proposed...

  3. Cooperative Control for Multiple Autonomous Vehicles Using Descriptor Functions

    Marta Niccolini

    2014-01-01

    Full Text Available The paper presents a novel methodology for the control management of a swarm of autonomous vehicles. The vehicles, or agents, may have different skills, and be employed for different missions. The methodology is based on the definition of descriptor functions that model the capabilities of the single agent and each task or mission. The swarm motion is controlled by minimizing a suitable norm of the error between agents’ descriptor functions and other descriptor functions which models the entire mission. The validity of the proposed technique is tested via numerical simulation, using different task assignment scenarios.

  4. Effectiveness of a community-based program for suicide prevention among elders with early-stage dementia: A controlled observational study.

    Kim, Jong-Pill; Yang, Jinhyang

    The purpose of this study was to develop a small-group-focused suicide prevention program for elders with early-stage dementia and to assess its effects. This was a quasi-experimental study with a control group pretest-posttest design. A total of 62 elders diagnosed with early-stage dementia who were receiving care services at nine daycare centers in J City Korea participated in this study. The experimental group participated in the suicide prevention program twice a week for 5 weeks with a pretest and two posttests The developed suicide prevention program had a significant effect on the perceived health status, social support, depression, and suicidal ideation of elders with early-stage dementia. Nurses should integrate risk factors such as depression and protective factors such as health status and social support into a suicide prevention program. This community-based program in geriatric nursing practice can be effective in preventing suicide among elders with early-stage dementia. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. The Effects of Functional Training, Bicycle Exercise, and Exergaming on Walking Capacity of Elderly Patients With Parkinson Disease: A Pilot Randomized Controlled Single-blinded Trial.

    Ferraz, Daniel Dominguez; Trippo, Karen Valadares; Duarte, Gabriel Pereira; Neto, Mansueto Gomes; Bernardes Santos, Kionna Oliveira; Filho, Jamary Oliveira

    2018-05-01

    To compare the effects of functional training, bicycle exercise, and exergaming on walking capacity of elderly with Parkinson disease (PD). A pilot randomized, controlled, single-blinded trial. A state reference health care center for elderly, a public reference outpatient clinic for the elderly. Elderly individuals (≥60 years of age; N=62) with idiopathic PD (stage 2 to 3 of modified Hoehn and Yahr staging scale) according to the London Brain Bank. The participants were randomly assigned to three groups. Group 1 (G1) participated in functional training (n=22); group 2 (G2) performed bicycle exercise (n=20), and group 3 (G3) trained with Kinect Adventures (Microsoft, Redmond, WA) exergames (n=20). The primary outcome measure was the 6-minute walk test (6MWT); secondary outcome measures were the 10-m walk test (10MWT), sitting-rising test (SRT), body mass index, Parkinson Disease Questionnaire-39, World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0), and 15-item Geriatric Depression Scale. All groups showed significant improvements in 6MWT (G1 P=.008; G2 P=.001; G3 P=.005), SRT (G1 Ptraining had similar outcomes compared with functional training and bicycle exercise. The three physical exercise modalities presented significant improvements on walking capacity, ability to stand up and sit, and functionality of the participants. Copyright © 2018 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  6. Reminiscence Therapy Improves Cognitive Functions and Reduces Depressive Symptoms in Elderly People With Dementia: A Meta-Analysis of Randomized Controlled Trials.

    Huang, Hui-Chuan; Chen, Yu-Ting; Chen, Pin-Yuan; Huey-Lan Hu, Sophia; Liu, Fang; Kuo, Ying-Ling; Chiu, Hsiao-Yean

    2015-12-01

    Cognitive function impairments and depressive symptoms are common in elderly people with dementia. Previous meta-analyses of outdated and small-scale studies have reported inconsistent results regarding the effects of reminiscence therapy on cognitive functions and depressive symptoms; therefore, we conducted a meta-analysis by including more recent randomized controlled trials (RCTs) with large sample sizes to investigate the immediate and long-term (6-10 months) effects of reminiscence therapy on cognitive functions and depressive symptoms in elderly people with dementia. Electronic databases, including PubMed, Medline, CINAHL, PsycINFO, the Cochrane Central Register of Controlled Trials, ProQuest, Google Scholar, and Chinese databases were searched to select eligible articles. Primary outcome measures included the scores of cognitive functions and depressive symptoms. In total, 12 RCT studies investigating the effects of reminiscence therapy on cognitive functions and depressive symptoms in elderly people with dementia were included. Two reviewers independently extracted data. All analyses were performed using a random-effects model. Reminiscence therapy had a small-size effect on cognitive functions (g = 0.18, 95% confidence interval [CI] 0.05-0.30) and a moderate-size effect on depressive symptoms (g = -0.49, 95% CI -0.70 to -0.28) in elderly people with dementia. Long-term effects of reminiscence therapy on cognitive functions and depressive symptoms were not confirmed. Moderator analysis revealed that institutionalized elderly people with dementia exhibited greater improvement in depressive symptoms than community-dwelling people with dementia did (g = -0.59 vs. -0.16, P = .003). This meta-analysis confirms that reminiscence therapy is effective in improving cognitive functions and depressive symptoms in elderly people with dementia. Our findings suggest that regular reminiscence therapy should be considered for inclusion as routine care for the improvement

  7. Multiple Model Adaptive Attitude Control of LEO Satellite with Angular Velocity Constraints

    Shahrooei, Abolfazl; Kazemi, Mohammad Hosein

    2018-04-01

    In this paper, the multiple model adaptive control is utilized to improve the transient response of attitude control system for a rigid spacecraft. An adaptive output feedback control law is proposed for attitude control under angular velocity constraints and its almost global asymptotic stability is proved. The multiple model adaptive control approach is employed to counteract large uncertainty in parameter space of the inertia matrix. The nonlinear dynamics of a low earth orbit satellite is simulated and the proposed control algorithm is implemented. The reported results show the effectiveness of the suggested scheme.

  8. An agent-based negotiation approach for balancing multiple coupled control domains

    Umair, Aisha; Clausen, Anders; Jørgensen, Bo Nørregaard

    2015-01-01

    Solving multi-objective multi-issue negotiation problems involving interdependent issues distributed among multiple control domains is inherent to most non-trivial cyber-physical systems. In these systems, the coordinated operation of interconnected subsystems performing autonomous control....... The proposed approach can solve negotiation problems with interdependent issues across multiple coupled control domains. We demonstrate our approach by solving a coordination problem where a Combined Heat and Power Plant must allocate electricity for three commercial greenhouses to ensure the required plant...

  9. Synthesis for robust synchronization of chaotic systems under output feedback control with multiple random delays

    Wen Guilin; Wang Qingguo; Lin Chong; Han Xu; Li Guangyao

    2006-01-01

    Synchronization under output feedback control with multiple random time delays is studied, using the paradigm in nonlinear physics-Chua's circuit. Compared with other synchronization control methods, output feedback control with multiple random delay is superior for a realistic synchronization application to secure communications. Sufficient condition for global stability of delay-dependent synchronization is established based on the LMI technique. Numerical simulations fully support the analytical approach, in spite of the random delays

  10. Effect of music-based multitask training on gait, balance, and fall risk in elderly people: a randomized controlled trial.

    Trombetti, Andrea; Hars, Mélany; Herrmann, François R; Kressig, Reto W; Ferrari, Serge; Rizzoli, René

    2011-03-28

    Falls occur mainly while walking or performing concurrent tasks. We determined whether a music-based multitask exercise program improves gait and balance and reduces fall risk in elderly individuals. We conducted a 12-month randomized controlled trial involving 134 community-dwelling individuals older than 65 years, who are at increased risk of falling. They were randomly assigned to an intervention group (n = 66) or a delayed intervention control group scheduled to start the program 6 months later (n = 68). The intervention was a 6-month multitask exercise program performed to the rhythm of piano music. Change in gait variability under dual-task condition from baseline to 6 months was the primary end point. Secondary outcomes included changes in balance, functional performances, and fall risk. At 6 months, there was a reduction in stride length variability (adjusted mean difference, -1.4%; P Balance and functional tests improved compared with the control group. There were fewer falls in the intervention group (incidence rate ratio, 0.46; 95% confidence interval, 0.27-0.79) and a lower risk of falling (relative risk, 0.61; 95% confidence interval, 0.39-0.96). Similar changes occurred in the delayed intervention control group during the second 6-month period with intervention. The benefit of the intervention on gait variability persisted 6 months later. In community-dwelling older people at increased risk of falling, a 6-month music-based multitask exercise program improved gait under dual-task condition, improved balance, and reduced both the rate of falls and the risk of falling. Trial Registration clinicaltrials.gov Identifier: NCT01107288.

  11. Co-administration of Albendazole and Levamisole to control multiple ...

    Albendazole (ABZ) and levamisole (LEV) were co-administered to evaluate their ability to control natural helminth infections in a sheep farm where resistance to the individual anthelmintic had previously been reported. Thirty two sheep of mixed ages and sex were randomly allocated to four equal groups. Group 1 and 2 ...

  12. Multiple Primary LED Lamp Colour Controller with Inherent Brightness Limitation

    Barcena, R.; Ackermann, B.

    2007-01-01

    There is a strong interest in using LEDs for general illumination due to the potential they offer for energy saving, environmental friendliness, new opportunities in lighting design, and control of the intensity, colour, and spatial distribution of light. General illumination requires primarily

  13. Quality control for retinal OCT in multiple sclerosis

    Schippling, S; Balk, Lj; Costello, F

    2015-01-01

    to provide guidance on the use of validated quality control (QC) criteria for the use of OCT in MS research and clinical trials. METHODS: A prospective multi-centre (n = 13) study. Peripapillary ring scan QC rating of an OCT training set (n = 50) was followed by a test set (n = 50). Inter-rater agreement...

  14. Controls of Multiple Stressors on the Black Sea Fishery

    Temel Oguz

    2017-04-01

    Full Text Available Black Sea is one of the most severely degraded and exploited large marine ecosystems in the world. For the last 50 years after the depletion of large predatory fish stocks, anchovy (with the partial contribution of sprat has been acting as the main top predator species and experienced a major stock collapse at the end of 1990s. After the collapse, eastern part of the southern Black Sea became the only region sustaining relatively high anchovy catch (400,000 tons whereas the total catch within the rest of the sea was reduced to nearly its one-third. The lack of recovery of different fish stocks under a slow ecosystem rehabilitation may be attributed, on the one hand, to inappropriate management measures and the lack of harmonized fishery policy among the riparian countries. On the other hand, impacts of multiple stressors (eutrophication, alien species invasions, natural climatic variations on the food web may contribute to resilience of the system toward its recovery. The overfishing/recovery problem therefore cannot be isolated from rehabilitation efforts devoted to the long-term chronic degradation of the food web structure, and alternative fishery-related management measures must be adopted as a part of a comprehensive ecosystem-based management strategy. The present study provides a data-driven ecosystem assessment, underlines the key environmental issues and threats, and points to the critical importance of holistic approach to resolve the fishery-ecosystem interactions. It also stresses the transboundary nature of the problem.

  15. Bright Light Treatment in Elderly Patients With Nonseasonal Major Depressive Disorder A Randomized Placebo-Controlled Trial

    Lieverse, R.; van Someren, E.J.W.; Nielen, M.M.A.; Uitdehaag, B.M.; Smit, J.H.; Hoogendijk, W.J.G.

    2011-01-01

    Context: Major depressive disorder (MDD) in elderly individuals is prevalent and debilitating. It is accompanied by circadian rhythm disturbances associated with impaired functioning of the suprachiasmatic nucleus, the biological clock of the brain. Circadian rhythm disturbances are common in the

  16. Control of hospital endemicity of multiple-drug-resistant Acinetobacter baumannii ST457 with directly observed hand hygiene.

    Cheng, V C C; Chen, J H K; Poon, R W S; Lee, W M; So, S Y C; Wong, S C Y; Chau, P H; Yip, C C Y; Wong, S S Y; Chan, J F W; Hung, I F N; Ho, P L; Yuen, K Y

    2015-04-01

    An increasing endemicity of multiple-drug-resistant Acinetobacter baumannii (MRAB) ST457 was noted in Hong Kong. The epidemiology, risk factors, and infection control measures to prevent nosocomial transmission of this epidemic clone were analyzed. A total of 5,058 patients cultured positive with A. baumannii between 1 January 2004 and 30 June 2014 were included, of which 297 (5.9 %) had bacteremia. The first case of MRAB bacteremia emerged in 2009, with an incidence that increased from 0.27 (one case) in 2009 to 1.86 (14 cases) per 100,000 patient-days in 2013 (p hand hygiene in conscious patients immediately before receiving meals and medications in July 2013, the incidence of MRAB bacteremia reduced from its peak to 0.77 (one case) per 100,000 patient-days in the first 6 months of 2014 (p < 0.001). Patients from long-term care facilities for the elderly [odds ratio (OR) 18.6, confidence interval (CI) 2.1-162.4, p = 0.008] and history of carbapenem (OR 7.0, CI 1.7-28.0, p = 0.006) and beta-lactam/beta-lactamase use (OR 5.6, CI 1.1-28.7, p = 0.038) 90 days prior to admission were independent risk factors for MRAB bacteremia by logistic regression when compared with carbapenem-susceptible A. baumannii bacteremia.

  17. Pointright: a system to redirect mouse and keyboard control among multiple machines

    Johanson, Bradley E [Palo Alto, CA; Winograd, Terry A [Stanford, CA; Hutchins, Gregory M [Mountain View, CA

    2008-09-30

    The present invention provides a software system, PointRight, that allows for smooth and effortless control of pointing and input devices among multiple displays. With PointRight, a single free-floating mouse and keyboard can be used to control multiple screens. When the cursor reaches the edge of a screen it seamlessly moves to the adjacent screen and keyboard control is simultaneously redirected to the appropriate machine. Laptops may also redirect their keyboard and pointing device, and multiple pointers are supported simultaneously. The system automatically reconfigures itself as displays go on, go off, or change the machine they display.

  18. Association Between Depressive Symptoms, Multiple Dimensions of Depression, and Elder Abuse: A Cross-Sectional, Population-Based Analysis of Older Adults in Urban Chicago.

    Roepke-Buehler, Susan K; Simon, Melissa; Dong, XinQi

    2015-09-01

    Depression is conceptualized as both a risk factor for and a consequence of elder abuse; however, current research is equivocal. This study examined associations between elder abuse and dimensions of depressive symptoms in older adults. Participants were 10,419 older adults enrolled in theChicago Health and Aging Project (CHAP), a population-based study of older adults. Regression was used to determine the relationships between depressive symptoms, depression dimensions, and abuse variables. Depressive symptoms were consistently associated with elder abuse. Participants in the highest tertile of depressive symptoms were twice as likely to have confirmed abuse with a perpetrator (odds ratio = 2.07, 95% confidence interval = [1.21, 3.52], p = .008). Elder abuse subtypes and depression dimensions were differentially associated. These findings highlight the importance of routine depression screening in older adults as a component of abuse prevention and intervention. They also provide profiles of depressive symptoms that may more accurately characterize risk for specific types of abuse. © The Author(s) 2015.

  19. The contribution of proprioceptive information to postural control in elderly and patients with Parkinson's disease with a history of falls.

    Bekkers, Esther M J; Dockx, Kim; Heremans, Elke; Vercruysse, Sarah; Verschueren, Sabine M P; Mirelman, Anat; Nieuwboer, Alice

    2014-01-01

    Proprioceptive deficits negatively affect postural control but their precise contribution to postural instability in Parkinson's disease (PD) is unclear. We investigated if proprioceptive manipulations differentially affect balance, measured by force plates, during quiet standing in 13 PD patients and 13 age-matched controls with a history of falls. Perceived limits of stability (LoS) were derived from the differences between maximal center of pressure (CoP) displacement in anterior-posterior (AP) and medio-lateral (ML) direction during a maximal leaning task. Task conditions comprised standing with eyes open (EO) and eyes closed (EC): (1) on a stable surface; (2) an unstable surface; and (3) with Achilles tendon vibration. CoP displacements were calculated as a percentage of their respective LoS. Perceived LoS did not differ between groups. PD patients showed greater ML CoP displacement than elderly fallers (EF) across all conditions (p = 0.043) and tended to have higher postural sway in relation to the LoS (p = 0.050). Both groups performed worse on an unstable surface and during tendon vibration compared to standing on a stable surface with EO and even more so with EC. Both PD and EF had more AP sway in all conditions with EC compared to EO (p postural control in fallers with and without PD. PD fallers showed higher ML sway after sensory manipulations, as a result of which these values approached their perceived LoS more closely than in EF. We conclude that despite a similar fall history, PD patients showed more ML instability than EF, irrespective of sensory manipulation, but had a similar reliance on ankle proprioception. Hence, we recommend that rehabilitation and fall prevention for PD should focus on motor rather than on sensory aspects.

  20. The Effect of Emotional Focused Intervention on Spousal Emotional Abuse and Marital Satisfaction among Elderly Married Couples: A Randomized Controlled Trial

    Maryam Hazrati

    2017-10-01

    Full Text Available Background: This study examined the impacts of an Emotional Focused Intervention on emotional abuse behaviors and marital satisfaction among the elderly married couples. Methods: This randomized controlled trial study was carried out in Shiraz-Iran, during September 2013-2014. The elderly couples were invited to join an emotional focused intervention, following the advertisement and announcement on bulletin boards in the elderly day clinic centers and all governmental primary health care centers. Then, 57 couples (114 participants who were eligible for study were assigned in two groups by block randomization (29 in the experimental and 28 in the control group(.The couples in the experimental group received intervention twice a week for four weeks. Each session lasted 90 minutes. The control group didn’t receive any intervention and the subjects were put in the waiting list. The outcome measures were evaluated by Multidimensional Measure of Emotional Abuse Questionnaire (MMEAQ and Marital Satisfaction Questionnaire for Older People (MSQFOP. Repeated measurement ANOVA was used to detect any significant changes between groups in their mean scores of emotional abuse behaviors and marital satisfaction from pre- to post-test, and 3 months after the intervention. Analysis of data was performed using SPSS, version 19, and P≤0.05 was measured as significant. Results: The mean duration of marriage was 39.56±9.64 years. In the experimental group, the abusive behaviors decreased significantly (P<0.001 at times 2 and 3 compared with time 1, and marital satisfaction improved significantly only at time 3 (P<0.001. These differences were not significant in the control group. Conclusion: Emotion-focused couple-based interventions are helpful in reducing the spousal emotional abuse and improving marital satisfaction in among the elderly couples. Trial Registration Number: 2013111715426N1

  1. Cohesive Motion Control Algorithm for Formation of Multiple Autonomous Agents

    Debabrata Atta

    2010-01-01

    Full Text Available This paper presents a motion control strategy for a rigid and constraint consistent formation that can be modeled by a directed graph whose each vertex represents individual agent kinematics and each of directed edges represents distance constraints maintained by an agent, called follower, to its neighbouring agent. A rigid and constraint consistent graph is called persistent graph. A persistent graph is minimally persistent if it is persistent, and no edge can be removed without losing its persistence. An acyclic (free of cycles in its sensing pattern minimally persistent graph of Leader-Follower structure has been considered here which can be constructed from an initial Leader-Follower seed (initial graph with two vertices, one is Leader and another one is First Follower and one edge in between them is directed towards Leader by Henneberg sequence (a procedure of growing a graph containing only vertex additions. A set of nonlinear optimization-based decentralized control laws for mobile autonomous point agents in two dimensional plane have been proposed. An infinitesimal deviation in formation shape created continuous motion of Leader is compensated by corresponding continuous motion of other agents fulfilling the shortest path criteria.

  2. H-infty Control of systems with multiple i/o delays

    Agoes Ariffin Moelja, A.A.; Meinsma, Gjerrit; Mirkin, Leonid

    2003-01-01

    In this paper the standard (four-block) H-infty control problem for systems with multiple i/o delays in the feedback loop is studied. The central idea is to see the multiple delay operator as a special series connection of elementary delay operators, called the adobe delay operators. The adobe delay

  3. Multiple Acid Sensors Control Helicobacter pylori Colonization of the Stomach.

    Huang, Julie Y; Goers Sweeney, Emily; Guillemin, Karen; Amieva, Manuel R

    2017-01-01

    Helicobacter pylori's ability to respond to environmental cues in the stomach is integral to its survival. By directly visualizing H. pylori swimming behavior when encountering a microscopic gradient consisting of the repellent acid and attractant urea, we found that H. pylori is able to simultaneously detect both signals, and its response depends on the magnitudes of the individual signals. By testing for the bacteria's response to a pure acid gradient, we discovered that the chemoreceptors TlpA and TlpD are each independent acid sensors. They enable H. pylori to respond to and escape from increases in hydrogen ion concentration near 100 nanomolar. TlpD also mediates attraction to basic pH, a response dampened by another chemoreceptor TlpB. H. pylori mutants lacking both TlpA and TlpD (ΔtlpAD) are unable to sense acid and are defective in establishing colonization in the murine stomach. However, blocking acid production in the stomach with omeprazole rescues ΔtlpAD's colonization defect. We used 3D confocal microscopy to determine how acid blockade affects the distribution of H. pylori in the stomach. We found that stomach acid controls not only the overall bacterial density, but also the microscopic distribution of bacteria that colonize the epithelium deep in the gastric glands. In omeprazole treated animals, bacterial abundance is increased in the antral glands, and gland colonization range is extended to the corpus. Our findings indicate that H. pylori has evolved at least two independent receptors capable of detecting acid gradients, allowing not only survival in the stomach, but also controlling the interaction of the bacteria with the epithelium.

  4. Multiple cognitive control mechanisms associated with the nature of conflict.

    Kim, Chobok; Chung, Chongwook; Kim, Jeounghoon

    2010-06-07

    Cognitive control is required to regulate conflict. The conflict monitoring theory suggests that the dorsal anterior cingulate cortex (dACC) is involved in detecting response conflict and the dorsolateral prefrontal cortex (DLPFC) plays a critical role in regulating conflict. Recent studies, however, have suggested that rostral dACC (rdACC) responds to response conflict whereas caudal dACC (cdACC) is associated with perceptual conflict. Moreover, DLPFC has been engaged only in regulation of response conflict. A neural network involved in perceptual conflict, however, remains unclear. In this study, we used functional magnetic resonance imaging (fMRI) in an attempt to reveal monitor-controller networks corresponding to either perceptual conflict or response conflict. A version of the Stroop color matching task was used to manipulate perceptual conflict, response conflict was manipulated by an arrow. The results demonstrated that rdACC and DLPFC were engaged in response conflict whereas cdACC and the dorsal portion of premotor cortex (pre-PMd) were involved in perceptual conflict. Interestingly, the posterior parietal cortex (PPC) was activated by both types of conflict. Correlation analyses between behavioral conflict effects and neural responses demonstrated that rdACC and DLPFC were associated with response conflict whereas cdACC and pre-PMd were associated with perceptual conflict. PPC was not correlated with either perceptual conflict or response conflict. We suggest that cdACC and pre-PMd play critical roles in perceptual conflict processing, and this network is independent from the rdACC/DLPFC network for response conflict processing. We also discussed the function of PPC in conflict processing. Copyright 2010 Elsevier Ireland Ltd. All rights reserved.

  5. Relationship between foot sensibility and postural control in the young and elderly. http://dx.doi.org/10.5007/1980-0037.2013v15n1p215

    Letícia Suemi Ueda

    2013-03-01

    Full Text Available Impairments in the foot sensitivity in the elderly cause changes in locomotion and postural control that may increase fall risk. Understanding the use of foot afference in the elderly may help preventing loss of mobility and fall. However, there are few studies addressing the relation between the sensitivity of different foot regions and postural control. To investigating this lack in literature, the objective of our study was to assess the relationship between foot sensibility and postural control in young and elderly. Forty-two subjects volunteered to this study; they were assigned to a group according to their age (young or elderly. The participants were assessed regarding anthropometry, foot sensibility (using monofilaments and postural control (using a force plate. The indexes of foot sensibility and postural control were correlated and compared between the groups. Elderly had worst foot sensibility and postural control than young. Center of pressure are and amplitude in antero-posterior direction were correlated with the general foot sensibility, but not with a specific point of the foot in the elderly. For young, the sensitivity in the forefoot region was related to improved postural control.

  6. Mild cognitive dysfunction does not affect diabetes mellitus control in minority elderly adults.

    Palta, Priya; Golden, Sherita H; Teresi, Jeanne; Palmas, Walter; Weinstock, Ruth S; Shea, Steven; Manly, Jennifer J; Luchsinger, Jose A

    2014-12-01

    To determine whether older adults with type 2 diabetes mellitus and cognitive dysfunction have poorer metabolic control of glycosylated hemoglobin, systolic blood pressure, and low-density lipoprotein cholesterol than those without cognitive dysfunction. Prospective cohort study. A minority cohort in New York City previously recruited for a trial of telemedicine. Persons aged 73.0 ± 3.0 (N = 613; 69.5% female; 82.5% Hispanic, 15.5% non-Hispanic black). Participants were classified with executive or memory dysfunction based on standardized score cutoffs (<16th percentile) for the Color Trails Test and Selective Reminding Test. Linear mixed models were used to compare repeated measures of the metabolic measures and evaluate the rates of change in individuals with and without dysfunction. Of the 613 participants, 331 (54%) had executive dysfunction, 202 (33%) had memory dysfunction, and 96 (16%) had both. Over a median of 2 years, participants with executive or memory dysfunction did not exhibit significantly poorer metabolic control than those without executive function or memory type cognitive dysfunction. Cognitive dysfunction in the mild range did not seem to affect diabetes mellitus control parameters in this multiethnic cohort of older adults with diabetes mellitus, although it cannot be excluded that cognitive impairment was overcome through assistance from formal or informal caregivers. It is possible that more-severe cognitive dysfunction could affect control. © 2014, Copyright the Authors Journal compilation © 2014, The American Geriatrics Society.

  7. On the diversity of multiple optimal controls for quantum systems

    Shir, O M; Baeck, Th; Beltrani, V; Rabitz, H; Vrakking, M J J

    2008-01-01

    This study presents simulations of optimal field-free molecular alignment and rotational population transfer (starting from the J = 0 rotational ground state of a diatomic molecule), optimized by means of laser pulse shaping guided by evolutionary algorithms. Qualitatively different solutions are obtained that optimize the alignment and population transfer efficiency to the maximum extent that is possible given the existing constraints on the optimization due to the finite bandwidth and energy of the laser pulse, the finite degrees of freedom in the laser pulse shaping and the evolutionary algorithm employed. The effect of these constraints on the optimization process is discussed at several levels, subject to theoretical as well as experimental considerations. We show that optimized alignment yields can reach extremely high values, even with severe constraints being present. The breadth of optimal controls is assessed, and a correlation is found between the diversity of solutions and the difficulty of the problem. In the pulse shapes that optimize dynamic alignment we observe a transition between pulse sequences that maximize the initial population transfer from J = 0 to J = 2 and pulse sequences that optimize the transfer to higher rotational levels

  8. Multiple controls affect arsenite oxidase gene expression in Herminiimonas arsenicoxydans

    Coppée Jean-Yves

    2010-02-01

    Full Text Available Abstract Background Both the speciation and toxicity of arsenic are affected by bacterial transformations, i.e. oxidation, reduction or methylation. These transformations have a major impact on environmental contamination and more particularly on arsenic contamination of drinking water. Herminiimonas arsenicoxydans has been isolated from an arsenic- contaminated environment and has developed various mechanisms for coping with arsenic, including the oxidation of As(III to As(V as a detoxification mechanism. Results In the present study, a differential transcriptome analysis was used to identify genes, including arsenite oxidase encoding genes, involved in the response of H. arsenicoxydans to As(III. To get insight into the molecular mechanisms of this enzyme activity, a Tn5 transposon mutagenesis was performed. Transposon insertions resulting in a lack of arsenite oxidase activity disrupted aoxR and aoxS genes, showing that the aox operon transcription is regulated by the AoxRS two-component system. Remarkably, transposon insertions were also identified in rpoN coding for the alternative N sigma factor (σ54 of RNA polymerase and in dnaJ coding for the Hsp70 co-chaperone. Western blotting with anti-AoxB antibodies and quantitative RT-PCR experiments allowed us to demonstrate that the rpoN and dnaJ gene products are involved in the control of arsenite oxidase gene expression. Finally, the transcriptional start site of the aoxAB operon was determined using rapid amplification of cDNA ends (RACE and a putative -12/-24 σ54-dependent promoter motif was identified upstream of aoxAB coding sequences. Conclusion These results reveal the existence of novel molecular regulatory processes governing arsenite oxidase expression in H. arsenicoxydans. These data are summarized in a model that functionally integrates arsenite oxidation in the adaptive response to As(III in this microorganism.

  9. Semi-active control of a cable-stayed bridge under multiple-support excitations.

    Dai, Ze-Bing; Huang, Jin-Zhi; Wang, Hong-Xia

    2004-03-01

    This paper presents a semi-active strategy for seismic protection of a benchmark cable-stayed bridge with consideration of multiple-support excitations. In this control strategy, Magnetorheological (MR) dampers are proposed as control devices, a LQG-clipped-optimal control algorithm is employed. An active control strategy, shown in previous researches to perform well at controlling the benchmark bridge when uniform earthquake motion was assumed, is also used in this study to control this benchmark bridge with consideration of multiple-support excitations. The performance of active control system is compared to that of the presented semi-active control strategy. Because the MR fluid damper is a controllable energy- dissipation device that cannot add mechanical energy to the structural system, the proposed control strategy is fail-safe in that bounded-input, bounded-output stability of the controlled structure is guaranteed. The numerical results demonstrated that the performance of the presented control design is nearly the same as that of the active control system; and that the MR dampers can effectively be used to control seismically excited cable-stayed bridges with multiple-support excitations.

  10. Inner happiness among Thai elderly.

    Gray, Rossarin Soottipong; Rukumnuaykit, Pungpond; Kittisuksathit, Sirinan; Thongthai, Varachai

    2008-09-01

    This study, based on data collected in 2005 from Chai Nat province, examines the level of happiness of the Thai elderly population and its relationship to various external and internal factors. It was found that mean happiness was slightly above a feeling of "neutral." According to multiple regression analyses, external factors including economic hardship, living arrangements, functional ability, perceived social environment, and consumerism significantly influence the level of happiness. The strongest predictor of happiness is, however, the internal factor-that is, a feeling of relative poverty when compared to their neighbors. Controlling for demographic and all external factors, the respondents who do not feel poor show the highest level of happiness compared to those who feel as poor as or poorer than their neighbors. This is self-interpreted as a feeling of contentment with what one has, which has been influenced by Thai culture, which is pervaded by Buddhism.

  11. Effects of a randomized controlled recurrent fall prevention program on risk factors for falls in frail elderly living at home in rural communities.

    Jeon, Mi Yang; Jeong, HyeonCheol; Petrofsky, Jerrold; Lee, Haneul; Yim, JongEun

    2014-11-14

    Falling can lead to severe health issues in the elderly and importantly contributes to morbidity, death, immobility, hospitalization, and early entry to long-term care facilities. The aim of this study was to devise a recurrent fall prevention program for elderly women in rural areas. This study adopted an assessor-blinded, randomized, controlled trial methodology. Subjects were enrolled in a 12-week recurrent fall prevention program, which comprised strength training, balance training, and patient education. Muscle strength and endurance of the ankles and the lower extremities, static balance, dynamic balance, depression, compliance with preventive behavior related to falls, fear of falling, and fall self-efficacy at baseline and immediately after the program were assessed. Sixty-two subjects (mean age 69.2±4.3 years old) completed the program--31 subjects in the experimental group and 31 subjects in the control group. When the results of the program in the 2 groups were compared, significant differences were found in ankle heel rise test, lower extremity heel rise test, dynamic balance, depression, compliance with fall preventative behavior, fear of falling, and fall self-efficacy (pbalance. This study shows that the fall prevention program described effectively improves muscle strength and endurance, balance, and psychological aspects in elderly women with a fall history.

  12. The effects of plantar perception training on balance and falls efficacy of the elderly with a history of falls: A single-blind, randomized controlled trial.

    Park, Jin-Hyuck

    2018-03-28

    The purpose of this study was to identify the effects of plantar perception training using a hardness discrimination task on balance and falls efficacy of the elderly who have experienced a fall. Sixty-two elderly persons 65 years of age or older were randomly allocated to the experimental group (n = 31) or the control group (n = 31). The experimental group performed a hardness discrimination task using five different levels of hardness of sponge mats, while the control group performed the same task except that they were not asked to discriminate hardness levels of sponge mats. All subjects performed 10 sessions for two weeks. Outcome measures were conducted using center of pressure (CoP) sway in the standing position, the Timed Up and Go (TUG) test, and falls efficacy scale (FES) to measure balance and falls efficacy. There were no significant differences in general characteristics between both groups (p > .05). After 10 sessions, plantar perception was significantly improved in the experimental group (F = 101.18, p falls efficacy as well as balance of the elderly. Copyright © 2018 Elsevier B.V. All rights reserved.

  13. Randomized, double-blind, placebo-controlled trial of fluoxetine treatment for elderly patients with dysthymic disorder.

    Devanand, D P; Nobler, Mitchell S; Cheng, Jocelyn; Turret, Nancy; Pelton, Gregory H; Roose, Steven P; Sackeim, Harold A

    2005-01-01

    The authors compared the efficacy and side effects of fluoxetine and placebo in elderly outpatients with dysthymic disorder. Patients were randomly assigned to fluoxetine (20 mg-60 mg/day) or placebo for 12 weeks in a double-blind trial. Of 90 randomized patients, 71 completed the trial. In the intent-to-treat sample, random regression analyses of the Hamilton Rating Scale for Depression (Ham-D; 24-item) and Cornell Dysthymia Rating Scale (CDRS) scores at each visit produced significant time x treatment group interactions favoring the fluoxetine group. Analysis of percentage change in Ham-D scores yielded no effect for treatment group, but a similar analysis of percentage change in CDRS scores yielded a main effect for treatment group, favoring fluoxetine over placebo. In the intent-to-treat sample, response rates were 27.3% for fluoxetine and 19.6% for placebo. In the completer sample, response rates were 37.5% for fluoxetine and 23.1% for placebo. Fluoxetine had limited efficacy in elderly dysthymic patients. The clinical features of elderly dysthymic patients are typically distinct from those of dysthymic disorder in young adults, and the findings suggest that treatments effective for young adult dysthymic patients may not be as useful in elderly dysthymic patients. Further research is needed to identify efficacious treatments for elderly patients with dysthymic disorder, and investigative tools such as electronic/computerized brain scans and neuropsychological testing may help identify the factors that moderate antidepressant treatment response and resistance.

  14. Effectiveness of 23-valent pneumococcal polysaccharide vaccine and seasonal influenza vaccine for pneumonia among the elderly - Selection of controls in a case-control study.

    Kondo, Kyoko; Suzuki, Kanzo; Washio, Masakazu; Ohfuji, Satoko; Fukushima, Wakaba; Maeda, Akiko; Hirota, Yoshio

    2017-08-24

    We conducted a case-control study to elucidate associations between pneumonia in elderly individuals and 23-valent pneumococcal polysaccharide vaccine (PPSV23) and seasonal influenza vaccine (influenza vaccine). Here, we examined selection of controls in our study using an analytic epidemiology approach. The study period was from October 1, 2009 through September 30, 2014. Cases comprised ≥65-year-old patients newly diagnosed with pneumonia. For every case with pneumonia, two patients with other diseases (one respiratory medicine, one non-respiratory medicine) who were sex-, age-, visit date- and visit hospital-matched were selected as controls. Odds ratios (ORs) and 95% confidence intervals (CIs) of vaccination for pneumonia were calculated using conditional logistic regression model. Similar analyses were also conducted based on the clinical department of controls. Analysis was conducted in 234 cases and 438 controls. Effectiveness of pneumococcal vaccination or influenza vaccination against pneumonia was not detected. Proportions of either vaccination in controls were greater among respiratory medicine (pneumococcal vaccine, 38%; influenza vaccine, 55%) than among non-respiratory medicine (23%; 48%). Analysis using controls restricted to respiratory medicine showed marginally significant effectiveness of pneumococcal vaccination (OR, 0.59; 95%CI, 0.34-1.03; P=0.064) and influenza vaccination (0.64; 0.40-1.04; 0.072). However, this effectiveness might have been overestimated by selection bias of controls, as pneumonia cases are not necessarily respiratory medicine patients. In the analysis using controls restricted to non-respiratory medicine, OR of pneumococcal vaccination for pneumonia was close to 1, presumably because the proportion of pneumococcal vaccination was higher in cases than in controls. Because pneumococcal vaccine was not routinely administered during the study period, differences in recommendations of vaccination by physician in different

  15. The Mortality Risk of Conventional Antipsychotics in Elderly Patients: A Systematic Review and Meta-analysis of Randomized Placebo-Controlled Trials.

    Hulshof, Tessa A; Zuidema, Sytse U; Ostelo, Raymond W J G; Luijendijk, Hendrika J

    2015-10-01

    Numerous observational studies have reported an increased risk of mortality for conventional antipsychotics in elderly patients, and for haloperidol in particular. Subsequently, health authorities have warned against use of conventional antipsychotics in dementia. Experimental evidence is lacking. To assess the mortality risk of conventional antipsychotics in elderly patients with a meta-analysis of trials. Original studies were identified in electronic databases, online trial registers, and hand-searched references of published reviews. Two investigators found 28 potentially eligible studies, and they selected 17 randomized placebo-controlled trials in elderly patients with dementia, delirium, or a high risk of delirium. Two investigators independently abstracted trial characteristics and deaths, and 3 investigators assessed the risk of bias. Deaths were pooled with RevMan to obtain risk differences and risk ratios. Data of 17 trials with a total of 2387 participants were available. Thirty-two deaths occurred. The pooled risk difference of 0.1% was not statistically significant (95% confidence interval (CI) -1.0%-1.2%). The risk ratio was 1.07 (95% CI 0.54-2.13). Eleven of 17 trials tested haloperidol (n = 1799). The risk difference was 0.4% (95% CI -0.9%-1.6%), the risk ratio was 1.25 (95% CI 0.59-2.65). This meta-analysis of placebo-controlled randomized trials does not show that conventional antipsychotics in general or haloperidol in particular increase the risk of mortality in elderly patients. It questions the observational findings and the warning based on these findings. Copyright © 2015 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

  16. Epstein-Barr Virus-Positive Diffuse Large B-Cell Lymphoma in the Elderly: A Matched Case-Control Analysis.

    Chen-Ge Song

    Full Text Available Epstein-Barr virus (EBV-positive diffuse large B-cell lymphoma (DLBCL in the elderly has rarely been reported. This study aimed to explore the clinical characteristics and prognosis of this entity.In situ hybridization (ISH analysis of Epstein-Barr virus (EBV and immunohistochemistry was performed in 230 tumor specimens from consecutive de novo DLBCL patients over 50 years old. A matched-case control analysis (1:3 was utilized to compare EBV-positive and EBV-negative DLBCL in the elderly.A total of 16 patients (7.0% were diagnosed with EBV-positive DLBCL. Of these 16 cases, the median age was 62 years, with a male to female ratio of 11:5. Elderly EBV-positive DLBCL patients had a higher incidence of non-germinal center B-cell (non-GCB subtypes (87.5% and high Ki67 (75% and CD30 expression (93.8%. For EBV-positive patients undergoing initial chemotherapy, 7 of 16 (43.8% had complete remission, 2 (12.5% had partial remission, 2 (12.5% had stable disease, and 5 (31.3% had progressive disease. The median overall survival was 9 months for the EBV-positive patients. A matched-case control analysis suggested that EBV-positive patients had inferior survival outcomes compared with EBV-negative patients (3-year progression-free survival [PFS]: 25% vs. 76.7%, respectively; 3-year overall survival [OS]: 25% vs. 77.4%, respectively; P<0.001.EBV-positive DLBCL of the elderly is associated with an inferior clinical course and inferior survival outcomes. The role of EBV in this disease and the optimal management of this subgroup warrants further investigation.

  17. A New Attribute Control Chart using Multiple Dependent State Repetitive Sampling

    Aldosari, Mansour Sattam; Aslam, Muhammad; Jun, Chi-Hyuck

    2017-01-01

    In this manuscript, a new attribute control chart using multiple dependent state repetitive sampling is designed. The operational procedure and structure of the proposed control chart is given. The required measures to determine the average run length (ARL) for in-control and out-of-control processes are given. Tables of ARLs are reported for various control chart parameters. The proposed control chart is more sensitive in detecting a small shift in the process as compared to the existing attribute control charts. The simulation study shows the efficiency of the proposed chart over the existing charts. An example is given for the illustration purpose.

  18. A New Attribute Control Chart using Multiple Dependent State Repetitive Sampling

    Aldosari, Mansour Sattam

    2017-03-25

    In this manuscript, a new attribute control chart using multiple dependent state repetitive sampling is designed. The operational procedure and structure of the proposed control chart is given. The required measures to determine the average run length (ARL) for in-control and out-of-control processes are given. Tables of ARLs are reported for various control chart parameters. The proposed control chart is more sensitive in detecting a small shift in the process as compared to the existing attribute control charts. The simulation study shows the efficiency of the proposed chart over the existing charts. An example is given for the illustration purpose.

  19. Variations in Static Force Control and Motor Unit Behavior with Error Amplification Feedback in the Elderly

    Yi-Ching Chen

    2017-11-01

    Full Text Available Error amplification (EA feedback is a promising approach to advance visuomotor skill. As error detection and visuomotor processing at short time scales decline with age, this study examined whether older adults could benefit from EA feedback that included higher-frequency information to guide a force-tracking task. Fourteen young and 14 older adults performed low-level static isometric force-tracking with visual guidance of typical visual feedback and EA feedback containing augmented high-frequency errors. Stabilogram diffusion analysis was used to characterize force fluctuation dynamics. Also, the discharge behaviors of motor units and pooled motor unit coherence were assessed following the decomposition of multi-channel surface electromyography (EMG. EA produced different behavioral and neurophysiological impacts on young and older adults. Older adults exhibited inferior task accuracy with EA feedback than with typical visual feedback, but not young adults. Although stabilogram diffusion analysis revealed that EA led to a significant decrease in critical time points for both groups, EA potentiated the critical point of force fluctuations <ΔFc2>, short-term effective diffusion coefficients (Ds, and short-term exponent scaling only for the older adults. Moreover, in older adults, EA added to the size of discharge variability of motor units and discharge regularity of cumulative discharge rate, but suppressed the pooled motor unit coherence in the 13–35 Hz band. Virtual EA alters the strategic balance between open-loop and closed-loop controls for force-tracking. Contrary to expectations, the prevailing use of closed-loop control with EA that contained high-frequency error information enhanced the motor unit discharge variability and undermined the force steadiness in the older group, concerning declines in physiological complexity in the neurobehavioral system and the common drive to the motoneuronal pool against force destabilization.

  20. Life-review therapy with computer supplements for depression in the elderly: a randomized controlled trial.

    Preschl, Barbara; Maercker, Andreas; Wagner, Birgit; Forstmeier, Simon; Baños, Rosa M; Alcañiz, Mariano; Castilla, Diana; Botella, Cristina

    2012-01-01

    Life-review therapy has been recognized as an effective therapeutic approach for depression in older adults. Additionally, the use of new media is becoming increasingly common in psychological interventions. The aim of this study was to investigate a life-review therapy in a face-to-face setting with additional computer use. This study explored whether a six-week life-review therapy with computer supplements from the e-mental health Butler system constitutes an effective approach to treat depression in older adults aged 65 and over. A total of 36 participants with elevated levels of depressive symptoms were randomized to a treatment group or a waiting-list control group and completed the post-assessment. Fourteen individuals in the intervention group completed the follow-up assessment. Analyses revealed significant changes from pre- to post-treatment or follow-up for depression, well-being, self-esteem, and obsessive reminiscence, but not for integrative reminiscence and life satisfaction. Depressive symptoms decreased significantly over time until the three-month follow-up in the intervention group compared to the control group (pre to post: d = 1.13; pre to follow-up: d = 1.27; and group × time effect pre to post: d = 0.72). Furthermore, the therapy led to an increase in well-being and a decrease in obsessive reminiscence among the participants in the intervention group from pre-treatment to follow-up (well-being: d = 0.70; obsessive reminiscence: d = 0.93). Analyses further revealed a significant but small group × time effect regarding self-esteem (d = 0.19). By and large, the results indicate that the life-review therapy in this combined setting could be recommended for depressive older adults.

  1. The protocol of the Oslo Study of Clonidine in Elderly Patients with Delirium; LUCID: a randomised placebo-controlled trial.

    Neerland, Bjørn Erik; Hov, Karen Roksund; Bruun Wyller, Vegard; Qvigstad, Eirik; Skovlund, Eva; MacLullich, Alasdair M J; Bruun Wyller, Torgeir

    2015-02-10

    Delirium affects 15% of hospitalised patients and is linked with poor outcomes, yet few pharmacological treatment options exist. One hypothesis is that delirium may in part result from exaggerated and/or prolonged stress responses. Dexmedetomidine, a parenterally-administered alpha2-adrenergic receptor agonist which attenuates sympathetic nervous system activity, shows promise as treatment in ICU delirium. Clonidine exhibits similar pharmacodynamic properties and can be administered orally. We therefore wish to explore possible effects of clonidine upon the duration and severity of delirium in general medical inpatients. The Oslo Study of Clonidine in Elderly Patients with Delirium (LUCID) is a randomised, placebo-controlled, double-blinded, parallel group study with 4-month prospective follow-up. We will recruit 100 older medical inpatients with delirium or subsyndromal delirium in the acute geriatric ward. Participants will be randomised to oral clonidine or placebo until delirium free for 2 days (Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria), or after a maximum of 7 days treatment. Assessment of haemodynamics (blood pressure, heart rate and electrocardiogram) and delirium will be performed daily until discharge or a maximum of 7 days after end of treatment. The primary endpoint is the trajectory of delirium over time (measured by Memorial Delirium Assessment Scale). Secondary endpoints include the duration of delirium, use of rescue medication for delirium, pharmacokinetics and pharmacodynamics of clonidine, cognitive function after 4 months, length of hospital stay and need for institutionalisation. LUCID will explore the efficacy and safety of clonidine for delirium in older medical inpatients. ClinicalTrials.gov NCT01956604. EudraCT Number: 2013-000815-26.

  2. On the importance of local dynamics in statokinesigram: A multivariate approach for postural control evaluation in elderly.

    Bargiotas, Ioannis; Audiffren, Julien; Vayatis, Nicolas; Vidal, Pierre-Paul; Buffat, Stephane; Yelnik, Alain P; Ricard, Damien

    2018-01-01

    The fact that almost one third of population >65 years-old has at least one fall per year, makes the risk-of-fall assessment through easy-to-use measurements an important issue in current clinical practice. A common way to evaluate posture is through the recording of the center-of-pressure (CoP) displacement (statokinesigram) with force platforms. Most of the previous studies, assuming homogeneous statokinesigrams in quiet standing, used global parameters in order to characterize the statokinesigrams. However the latter analysis provides little information about local characteristics of statokinesigrams. In this study, we propose a multidimensional scoring approach which locally characterizes statokinesigrams on small time-periods, or blocks, while highlighting those which are more indicative to the general individual's class (faller/non-faller). Moreover, this information can be used to provide a global score in order to evaluate the postural control and classify fallers/non-fallers. We evaluate our approach using the statokinesigram of 126 community-dwelling elderly (78.5 ± 7.7 years). Participants were recorded with eyes open and eyes closed (25 seconds each acquisition) and information about previous falls was collected. The performance of our findings are assessed using the receiver operating characteristics (ROC) analysis and the area under the curve (AUC). The results show that global scores provided by splitting statokinesigrams in smaller blocks and analyzing them locally, classify fallers/non-fallers more effectively (AUC = 0.77 ± 0.09 instead of AUC = 0.63 ± 0.12 for global analysis when splitting is not used). These promising results indicate that such methodology might provide supplementary information about the risk of fall of an individual and be of major usefulness in assessment of balance-related diseases such as Parkinson's disease.

  3. On the importance of local dynamics in statokinesigram: A multivariate approach for postural control evaluation in elderly.

    Ioannis Bargiotas

    Full Text Available The fact that almost one third of population >65 years-old has at least one fall per year, makes the risk-of-fall assessment through easy-to-use measurements an important issue in current clinical practice. A common way to evaluate posture is through the recording of the center-of-pressure (CoP displacement (statokinesigram with force platforms. Most of the previous studies, assuming homogeneous statokinesigrams in quiet standing, used global parameters in order to characterize the statokinesigrams. However the latter analysis provides little information about local characteristics of statokinesigrams. In this study, we propose a multidimensional scoring approach which locally characterizes statokinesigrams on small time-periods, or blocks, while highlighting those which are more indicative to the general individual's class (faller/non-faller. Moreover, this information can be used to provide a global score in order to evaluate the postural control and classify fallers/non-fallers. We evaluate our approach using the statokinesigram of 126 community-dwelling elderly (78.5 ± 7.7 years. Participants were recorded with eyes open and eyes closed (25 seconds each acquisition and information about previous falls was collected. The performance of our findings are assessed using the receiver operating characteristics (ROC analysis and the area under the curve (AUC. The results show that global scores provided by splitting statokinesigrams in smaller blocks and analyzing them locally, classify fallers/non-fallers more effectively (AUC = 0.77 ± 0.09 instead of AUC = 0.63 ± 0.12 for global analysis when splitting is not used. These promising results indicate that such methodology might provide supplementary information about the risk of fall of an individual and be of major usefulness in assessment of balance-related diseases such as Parkinson's disease.

  4. Realtime control of multiple-focus phased array heating patterns based on noninvasive ultrasound thermography.

    Casper, Andrew; Liu, Dalong; Ebbini, Emad S

    2012-01-01

    A system for the realtime generation and control of multiple-focus ultrasound phased-array heating patterns is presented. The system employs a 1-MHz, 64-element array and driving electronics capable of fine spatial and temporal control of the heating pattern. The driver is integrated with a realtime 2-D temperature imaging system implemented on a commercial scanner. The coordinates of the temperature control points are defined on B-mode guidance images from the scanner, together with the temperature set points and controller parameters. The temperature at each point is controlled by an independent proportional, integral, and derivative controller that determines the focal intensity at that point. Optimal multiple-focus synthesis is applied to generate the desired heating pattern at the control points. The controller dynamically reallocates the power available among the foci from the shared power supply upon reaching the desired temperature at each control point. Furthermore, anti-windup compensation is implemented at each control point to improve the system dynamics. In vitro experiments in tissue-mimicking phantom demonstrate the robustness of the controllers for short (2-5 s) and longer multiple-focus high-intensity focused ultrasound exposures. Thermocouple measurements in the vicinity of the control points confirm the dynamics of the temperature variations obtained through noninvasive feedback. © 2011 IEEE

  5. Yukmijihwang-tang for the treatment of xerostomia in the elderly: study protocol for a randomized, double-blind, placebo-controlled, two-center trial.

    Han, Gajin; Park, Jae-Woo; Ko, Seok-Jae; Son, Jihee; Seon, Jongki; Kim, Juyeon; Kim, Seulki; Yeo, Inkwon; Ryu, Bongha; Kim, Jinsung

    2013-09-03

    Xerostomia, a subjective sense of dry mouth, is not generally regarded a disease despite its high prevalence among the elderly, and therefore continues to impair affected patients' quality of life. In traditional Korean medicine, 'Yin-Deficiency' has been implicated in the pathogenesis of xerostomia among the elderly. Yukmijihwang-tang is a famous herbal prescription used to relieve 'Yin-Deficiency', and reportedly has antioxidant effects; therefore, it is postulated that Yukmijihwang-tang can be used to treat xerostomia in the elderly. However, to our knowledge, no clinical trial has been conducted on the effects of Yukmijihwang-tang on xerostomia. Thus, we designed a randomized clinical trial to investigate the effects and safety of Yukmijihwang-tang on xerostomia in the elderly. In addition, we will clarify the aforementioned assumption that 'Yin-Deficiency' is the major cause of xerostomia in the elderly by identifying a correlation between xerostomia and 'Yin-Deficiency'. This randomized, double-blind, placebo-controlled trial will be carried out at two centers: Kyung Hee University Korean Medicine Hospital and Kyung Hee University Hospital at Gangdong. We will recruit 96 subjects aged 60-80 years who have experienced xerostomia for 3 months prior to participation. Subjects who present with score >40 on the visual analogue scale for xerostomia and unstimulated salivary flow rate under 0.3mL/min will be included and the randomization will be carried out by an independent statistician by using a random number creation program. The subjects and all researchers except the statistician will be blinded to the group assignment. Yukmijihwang-tang or placebo will be administered to each group for 8 weeks. The primary outcome is change in the scores for the visual analogue scale for xerostomia and the dry mouth symptom questionnaire from 0 to 8 weeks. It will be assessed whether Yukmijihwang-tang can be used as a new herbal treatment for xerostomia in the elderly by

  6. Multiple single-board-computer system for the KEK positron generator control

    Nakahara, Kazuo; Abe, Isamu; Enomoto, Atsushi; Otake, Yuji; Urano, Takao

    1986-01-01

    The KEK positron generator is controlled by means of a distributed microprocessor network. The control system is composed of three kinds of equipment: device controllers for the linac equipment, operation management stations and a communication network. Individual linac equipment has its own microprocessor-based controller. A multiple single board computer (SBC) system is used for communication control and for equipment surveillance; it has a database containing communication and linac equipment status information. The linac operation management that should be the most soft part in the control system, is separated from the multiple SBC system and is carried out by work-stations. The principle that every processor executes only one task is maintained throughout the control system. This made the software architecture very simple. (orig.)

  7. Study design of ASPirin in Reducing Events in the Elderly (ASPREE): a randomized, controlled trial.

    2013-11-01

    Cost-effective strategies to maintain healthy active lifestyle in aging populations are required to address the global burden of age-related diseases. ASPREE will examine whether the potential primary prevention benefits of low dose aspirin outweigh the risks in older healthy individuals. Our primary hypothesis is that daily oral 100 mg enteric-coated aspirin will extend a composite primary endpoint termed 'disability-free life' including onset of dementia, total mortality, or persistent disability in at least one of the Katz Activities of Daily Living in 19,000 healthy participants aged 65 years and above ('US minorities') and 70 years and above (non-'US minorities'). ASPREE is a double-blind, randomized, placebo-controlled trial of oral 100mg enteric-coated acetyl salicylic acid (ASA) or matching placebo being conducted in Australian and US community settings on individuals free of dementia, disability and cardiovascular disease (CVD) events. Secondary endpoints are all-cause and cause specific mortality, fatal and non-fatal cardiovascular events, fatal and non-fatal cancer (excluding non-melanoma skin cancer), dementia, mild cognitive impairment, depression, physical disability, and clinically significant bleeding. To 20 September 2013 14,383 participants have been recruited. Recruitment and study completion are anticipated in July 2014 and December 2018 respectively. In contrast to other aspirin trials that have largely focused on cardiovascular endpoints, ASPREE has a unique composite primary endpoint to better capture the overall risk and benefit of aspirin to extend healthy independent lifespan in older adults in the US and Australia. © 2013. Published by Elsevier Inc. All rights reserved.

  8. A pilot randomized controlled trial using EEG-based brain-computer interface training for a Chinese-speaking group of healthy elderly.

    Lee, Tih-Shih; Quek, Shin Yi; Goh, Siau Juinn Alexa; Phillips, Rachel; Guan, Cuntai; Cheung, Yin Bun; Feng, Lei; Wang, Chuan Chu; Chin, Zheng Yang; Zhang, Haihong; Lee, Jimmy; Ng, Tze Pin; Krishnan, K Ranga Rama

    2015-01-01

    There is growing evidence that cognitive training (CT) can improve the cognitive functioning of the elderly. CT may be influenced by cultural and linguistic factors, but research examining CT programs has mostly been conducted on Western populations. We have developed an innovative electroencephalography (EEG)-based brain-computer interface (BCI) CT program that has shown preliminary efficacy in improving cognition in 32 healthy English-speaking elderly adults in Singapore. In this second pilot trial, we examine the acceptability, safety, and preliminary efficacy of our BCI CT program in healthy Chinese-speaking Singaporean elderly. Thirty-nine elderly participants were randomized into intervention (n=21) and wait-list control (n=18) arms. Intervention consisted of 24 half-hour sessions with our BCI-based CT training system to be completed in 8 weeks; the control arm received the same intervention after an initial 8-week waiting period. At the end of the training, a usability and acceptability questionnaire was administered. Efficacy was measured using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), which was translated and culturally adapted for the Chinese-speaking local population. Users were asked about any adverse events experienced after each session as a safety measure. The training was deemed easily usable and acceptable by senior users. The median difference in the change scores pre- and post-training of the modified RBANS total score was 8.0 (95% confidence interval [CI]: 0.0-16.0, P=0.042) higher in the intervention arm than waitlist control, while the mean difference was 9.0 (95% CI: 1.7-16.2, P=0.017). Ten (30.3%) participants reported a total of 16 adverse events - all of which were graded "mild" except for one graded "moderate". Our BCI training system shows potential in improving cognition in both English- and Chinese-speaking elderly, and deserves further evaluation in a Phase III trial. Overall, participants

  9. Multiple-state based power control for multi-radio multi-channel wireless mesh networks

    Olwal, TO

    2009-01-01

    Full Text Available Multi-Radio Multi-Channel (MRMC) systems are key to power control problems in wireless mesh networks (WMNs). In this paper, we present asynchronous multiple-state based power control for MRMC WMNs. First, WMN is represented as a set of disjoint...

  10. A simple optical fibre-linked remote control system for multiple devices

    We report on the development of a simple control system which can handle multiple devices through an optical fibre data link. The devices are controlled using a set of DACs through serial data communication via a serial port of a PC. Serial data from the PC get converted to parallel mode using a homemade “serial in ...

  11. Second-Order Controllability of Multi-Agent Systems with Multiple Leaders

    Liu Bo; Han Xiao; Shi Yun-Tao; Su Hou-Sheng

    2016-01-01

    This paper proposes a new second-order continuous-time multi-agent model and analyzes the controllability of second-order multi-agent system with multiple leaders based on the asymmetric topology. This paper considers the more general case: velocity coupling topology is different from location coupling topology. Some sufficient and necessary conditions are presented for the controllability of the system with multiple leaders. In addition, the paper studies the controllability of the system with velocity damping gain. Simulation results are given to illustrate the correctness of theoretical results. (paper)

  12. Aural stimulation with capsaicin ointment improved swallowing function in elderly patients with dysphagia: a randomized, placebo-controlled, double-blind, comparative study.

    Kondo, Eiji; Jinnouchi, Osamu; Nakano, Seiichi; Ohnishi, Hiroki; Kawata, Ikuji; Okamoto, Hidehiko; Takeda, Noriaki

    2017-01-01

    The aim of this study was to assess whether aural stimulation with ointment containing capsaicin improves swallowing function in elderly patients with dysphagia. A randomized, placebo-controlled, double-blind, comparative study. Secondary hospital. Twenty elderly dysphagic patients with a history of cerebrovascular disorder or Parkinson's disease were randomly divided into two groups: 10 receiving aural stimulation with 0.025% capsaicin ointment and 10 stimulated with placebo. The ointments were applied to the external auditory canal with a cotton swab. Then, swallowing of a bolus of blue-dyed water was recorded using transnasal videoendoscopy, and the swallowing function was evaluated according to both endoscopic swallowing scoring and Sensory-Motor-Reflex-Clearance (SMRC) scale. The sum of endoscopic swallowing scores was significantly decreased 30 and 60 min after a single administration in patients treated with capsaicin, but not with placebo. Reflex score, but not Sensory, Motion and Clearance scores, of the SMRC scale was significantly increased 5, 30 and 60 min after single administration in patients treated with capsaicin, but not with placebo. No patient showed signs of adverse effects. As capsaicin is an agonist of the transient receptor potential vanilloid 1 (TRPV1), these findings suggest that improvement of the swallowing function, especially glottal closure and cough reflexes, in elderly dysphagic patients was due to TRPV1-mediated aural stimulation of vagal Arnold's nerve with capsaicin, but not with a nonspecific mechanical stimulation with a cotton swab.

  13. A brain-computer interface based cognitive training system for healthy elderly: a randomized control pilot study for usability and preliminary efficacy.

    Lee, Tih-Shih; Goh, Siau Juinn Alexa; Quek, Shin Yi; Phillips, Rachel; Guan, Cuntai; Cheung, Yin Bun; Feng, Lei; Teng, Stephanie Sze Wei; Wang, Chuan Chu; Chin, Zheng Yang; Zhang, Haihong; Ng, Tze Pin; Lee, Jimmy; Keefe, Richard; Krishnan, K Ranga Rama

    2013-01-01

    Cognitive decline in aging is a pressing issue associated with significant healthcare costs and deterioration in quality of life. Previously, we reported the successful use of a novel brain-computer interface (BCI) training system in improving symptoms of attention deficit hyperactivity disorder. Here, we examine the feasibility of the BCI system with a new game that incorporates memory training in improving memory and attention in a pilot sample of healthy elderly. This study investigates the safety, usability and acceptability of our BCI system to elderly, and obtains an efficacy estimate to warrant a phase III trial. Thirty-one healthy elderly were randomized into intervention (n = 15) and waitlist control arms (n = 16). Intervention consisted of an 8-week training comprising 24 half-hour sessions. A usability and acceptability questionnaire was administered at the end of training. Safety was investigated by querying users about adverse events after every session. Efficacy of the system was measured by the change of total score from the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) before and after training. Feedback on the usability and acceptability questionnaire was positive. No adverse events were reported for all participants across all sessions. Though the median difference in the RBANS change scores between arms was not statistically significant, an effect size of 0.6SD was obtained, which reflects potential clinical utility according to Simon's randomized phase II trial design. Pooled data from both arms also showed that the median change in total scores pre and post-training was statistically significant (Mdn = 4.0; pattention (p = 0.039), and delayed memory (pattention in healthy elderly, and appears to be safe, user-friendly and acceptable to senior users. Given the efficacy signal, a phase III trial is warranted. ClinicalTrials.gov NCT01661894.

  14. Effect of vitamin D replacement on indexes of insulin resistance in overweight elderly individuals: a randomized controlled trial

    Fuleihan G, EI-Haij; Baddoura, Rafic; Habib, Robert H

    2016-01-01

    BACKGROUND: It is unclear whether and at what dose vitamin D supplementation affects insulin resistance (IR). OBJECTIVE: We sought to investigate whether vitamin D at doses higher than currently recommended decreases indexes of IR in an ambulatory population of overweight elderly subjects. DESIGN...

  15. The diuretic action of weak and strong alcoholic beverages in elderly men : a randomized diet-controlled crossover trial

    Polhuis, Kristel C M M; Wijnen, Annemarthe H C; Sierksma, Aafje; Calame, Wim; Tieland, Michael

    2017-01-01

    With ageing, there is a greater risk of dehydration. This study investigated the diuretic effect of alcoholic beverages varying in alcohol concentration in elderly men. Three alcoholic beverages (beer (AB), wine (AW), and spirits (S)) and their non-alcoholic counterparts (non-alcoholic beer (NAB),

  16. Comprehensive discharge follow-up in patients' homes by GPs and district nurses of elderly patients. A randomized controlled trial

    Rytter, L.; Jakobsen, Helle; Rønholt, Finn

    2010-01-01

    Many hospital admissions are due to inappropriate medical treatment, and discharge of fragile elderly patients involves a high risk of readmission. The present study aimed to assess whether a follow-up programme undertaken by GPs and district nurses could improve the quality of the medical...

  17. Protein supplementation improves physical performance in frail elderly people: a randomized double-blind, placebo-controlled trial

    Tieland, C.A.B.; Rest, van de O.; Dirks, M.L.; Zwaluw, van der N.L.; Mensink, M.R.; Loon, van L.J.C.; Groot, de C.P.G.M.

    2012-01-01

    Objectives: Protein supplementation has been proposed as an effective dietary strategy to increase skeletal muscle mass and improve physical performance in frail elderly people. Our objective was to assess the impact of 24 weeks of dietary protein supplementation on muscle mass, strength, and

  18. MOVING: Motivation-Oriented interVention study for the elderly IN Greifswald: study protocol for a randomized controlled trial.

    Kleinke, Fabian; Schwaneberg, Thea; Weymar, Franziska; Penndorf, Peter; Ulbricht, Sabina; Lehnert, Kristin; Dörr, Marcus; Hoffmann, Wolfgang; van den Berg, Neeltje

    2018-01-22

    Cardiovascular diseases (CVD) are the leading cause of mortality. In 2014, they were responsible for 38.9% of all causes of death in Germany. One major risk factor for CVD is a lack of physical activity (PA). A health-promoting lifestyle including regular PA and minimizing sitting time (ST) in daily life is a central preventive measure. Previous studies have shown that PA decreases in older age; 2.4-29% of the people aged over 60 years achieve the World Health Organization recommendations. This age group spends on average 9.4 h per day in sedentary activities. To increase PA and decrease ST, a low-threshold intervention, consisting of individualized feedback letters based on objectively measured data of PA and ST, was developed. The research question is: Do individual feedback letters, based on accelerometer data, have a positive effect on PA and ST? MOVING is a two-arm, randomized controlled trial. Inclusion criteria are age ≥ 65 years and the ability to be physically active. Exclusion criteria are the permanent use of a wheelchair and simultaneous participation in another study on PA. At baseline participants who give informed consent will receive general information and recommendations about the positive effects of regular PA and less ST. Participants of both groups will receive an accelerometer device, which records PA and ST over a period of seven consecutive days following by a randomization. Participants in the intervention group will receive automatically generated, individualized feedback letters by mail based on their PA and ST at baseline and at 3-month follow-up. Further follow-up examinations will be carried out at 6 and 12 months. The primary outcome is the increase of PA and the reduction of ST after 6 months in the intervention group compared to the control group. The goal of the study is to examine the effects of a simple feedback intervention on PA and ST in elderly people. We aim to achieve an effect of 20% increase in moderate

  19. [A case-control study on the influencing factors to mild cognitive impairment among the community-based elderly population].

    Ma, Fei; Wang, Ting; Yin, Jiong; Bai, Xu-Jing; Zhang, Xiao-Dong; Meng, Jun; Qu, Cheng-Yi

    2008-09-01

    To explore the influencing factors on mild cognitive impairment among the community-based elderly population. A 'n : m' matched case-control study was conducted to analyze the risk factors. Cox regression model of survival analysis was selected to deal with non-geometric proportional matched data which was difficult to analyze by logistic regression model. Four hundred and twenty-three cases together with nine hundred and twenty-five controls were interviewed with an uniformed questionnaire. Through univariate and multivariate cox regression analysis, the odds ratio and 95% CI of these risk factors appeared to be: physical labor as 1.396 (1.092-1.785); smoking as 1.551 (1.021-2.359); higher level of blood glucose as 1.354 (1.102-1.664); HDL-C in the serum as 1.543 (1.232-1.932); LDL-C in the serum as 1.299 (1.060-1.592); lower level of estrogen in the serum as 1.263 (1.031-1.547); hypertension as 1.967 (1.438-2.689); diabete: 1.381 (1.139-1.675); depressive disorder: 1.406 (1.110-1.780); cerebral thrombosis as 1.593 (1.307-1.943); higher SBP as 1.331 (1.129-1.569) and ApoEepsilon 4 carrier as 1.462 (1.140-1.873) respectively. Odds ratio and 95% CI on protection factors appeared to be: reading newspaper frequently as 0.610 (0.503-0.740); frequently doing housework as 0.804 (0.665-0.973); frequently engaging in social activities as 0.617 (0.502-0.757); reemployment after formal retirement as 0.759 (0.636-0.906); having acumen olfaction as 0.900 (0.845-0.958); having extrovert personality as 0.829 (0.699-0.984); being decisive as 0.811 (0.662-0.993). The major measures to prevent MCI seemed to be including the following factors as: being intellectuals, engaging in healthy life style and decreasing the risk in developing hypertension, diabetes, depressive disorder and cerebrovascular disease. However, olfactory hypoesthesia, cowardice and having introvert character, ApoEepsilon 4 carrier etc could be treated as early indications to signify MCI.

  20. Advanced topics in control and estimation of state-multiplicative noisy systems

    Gershon, Eli

    2013-01-01

    Advanced Topics in Control and Estimation of State-Multiplicative Noisy Systems begins with an introduction and extensive literature survey. The text proceeds to cover solutions of measurement-feedback control and state problems and the formulation of the Bounded Real Lemma for both continuous- and discrete-time systems. The continuous-time reduced-order and stochastic-tracking control problems for delayed systems are then treated. Ideas of nonlinear stability are introduced for infinite-horizon systems, again, in both the continuous- and discrete-time cases. The reader is introduced to six practical examples of noisy state-multiplicative control and filtering associated with various fields of control engineering. The book is rounded out by a three-part appendix containing stochastic tools necessary for a proper appreciation of the text: a basic introduction to nonlinear stochastic differential equations and aspects of switched systems and peak to peak  optimal control and filtering. Advanced Topics in Contr...

  1. Elder abuse

    1999-01-01

    Elder abuse takes many forms and occurs in a variety of settings; it is both under-recognised and under-reported. Despite a lack of statutory guidelines or legislation, effective management is possible. More could be done to recognise abuse, and healthcare workers need to be vigilant, paying attention to both the circumstances in which abuse occurs and its warning signs.

  2. [Suicide in the Elderly].

    Velásquez Suarez, Juliana María

    2013-01-01

    Suicide is a public health problem worldwide, with multiple features and risk factors. It has some common and unique trends in each phase across the lifespan. To review the medical literature related to suicide in the elderly, in order to determine the current status of this problem in the world, and especially in Colombia. Literature review. There is a high volume of articles about suicide in general, even in Colombia, with many papers describing the problem in a comprehensive manner, but there is a need for more studies and publications on the scope of this problem in the elderly. Copyright © 2013 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

  3. Nurse home visits with or without alert buttons versus usual care in the frail elderly: a randomized controlled trial

    Favela J

    2013-01-01

    the baseline questionnaire. The final 133 subjects were randomized into the NV+AB (n = 45, NV-only (n = 44, and control (n = 44 groups. There were no statistically significant differences in the baseline characteristics of the groups. The mean age overall was 76.3 years (standard deviation 4.7 and 45% were men. At the baseline, 61.65% were classified as frail. At end of follow-up the adjusted prevalence of frailty in NV+AB group was 23.3% versus 58.3% in the control group.Conclusion: An intervention based on NV+AB seems to have a positive effect on frailty scores.Keywords: gerontechnology, frailty, elderly

  4. Experiences in simulating and testing coordinated voltage control provided by multiple wind power plants

    Arlaban, T.; Alonso, O.; Ortiz, D. [Acciona Windpower S.A. (Spain); Peiro, J.; Rivas, R. [Red Electrica de Espana SAU (Spain); Quinonez-Varela, G.; Lorenzo, P. [Acciona Energia S.A. (Spain)

    2011-07-01

    This document presents some field tests performed in a transmission system node in order to check the adequacy of voltage control performance by multiple wind power plants, with an overall capacity of 395 MW. It briefly explains the Spanish TSO motivation towards new voltage control requirements and the necessity of performing such tests in order to set the most convenient voltage control parameters and to verify the stable operation. It presents how different the voltage control capability between modern wind turbines (DFIG) and older ones (SCIG) specifically retrofitted for voltage control is. (orig.)

  5. A Memory/Immunology-Based Control Approach with Applications to Multiple Spacecraft Formation Flying

    Liguo Weng

    2013-01-01

    Full Text Available This paper addresses the problem of formation control for multiple spacecrafts in Planetary Orbital Environment (POE. Due to the presence of diverse interferences and uncertainties in the outer space, such as the changing spacecraft mass, unavailable space parameters, and varying gravity forces, traditional control methods encounter great difficulties in this area. A new control approach inspired by human memory and immune system is proposed, and this approach is shown to be capable of learning from past control experience and current behavior to improve its performance. It demands much less system dynamic information as compared with traditional controls. Both theoretic analysis and computer simulation verify its effectiveness.

  6. Greater intake of fruit and vegetables is associated with a lower risk of osteoporotic hip fractures in elderly Chinese: a 1:1 matched case-control study.

    Xie, H-L; Wu, B-H; Xue, W-Q; He, M-G; Fan, F; Ouyang, W-F; Tu, S-L; Zhu, H-L; Chen, Y-M

    2013-11-01

    In this case-control study, we examined the relationship between the consumption of fruit and vegetables and risk of hip fractures in 646 pairs of incident cases and controls in elderly Chinese. We found that greater consumption of both fruit and vegetables in men and vegetables in women was associated with a lower risk of osteoporotic hip fractures in elderly Chinese. The association between fruit and vegetable consumption and the risk of osteoporotic fractures remains controversial due to limited published evidence. The purpose of this study was to determine whether consuming fruits and vegetables has a protective effect against hip fractures. Between January 2008 and December 2012, 646 (162 males, 484 females) incident cases (70.9 ± 6.8 years) of hip fractures were enrolled from five hospitals, with 646 sex- and age-matched (±3 years) controls (70.7 ± 6.8 years) from hospitals or the community. Face-to-face interviews were conducted to assess habitual dietary intakes using a 79-item food frequency questionnaire and various covariates by structured questionnaires. Multivariate conditional logistic regression analyses showed dose-dependent inverse correlations between the intake of total fruit (p-trend = 0.014), total vegetables (p-trend fruits and vegetables combined (p-trend fruits, vegetables and the combination of fruits and vegetables were 0.53 (0.32-0.87), 0.37 (0.23-0.60) and 0.25 (0.15-0.41), respectively. Stratified analyses showed that the benefits remained significant in males (p = 0.001) but not in females (p = 0.210) (p-interaction 0.045). Among the subcategories of fruits and vegetables, similar associations were observed for all subgroups except light-coloured fruits. Our findings suggest that greater consumption of both fruits and vegetables in men and vegetables in women may decrease the risk of osteoporotic hip fractures in elderly Chinese.

  7. Medium-Chain Triglycerides in Combination with Leucine and Vitamin D Benefit Cognition in Frail Elderly Adults: A Randomized Controlled Trial.

    Abe, Sakiko; Ezaki, Osamu; Suzuki, Motohisa

    2017-01-01

    The combined supplementation of medium-chain triglycerides (MCTs), L-leucine-rich amino acids, and cholecalciferol (vitamin D 3 ) increase muscle strength and function in frail elderly individuals. However, their effects on cognition are unknown. We enrolled 38 elderly nursing home residents (mean age±SD, 86.6±4.8 y) in a 3-mo randomized, controlled, parallel group trial. The participants were randomly allocated to 3 groups: the first group received a L-leucine (1.2 g)- and cholecalciferol (20 μg)-enriched supplement with 6 g of MCT (LD+MCT); the second group received the same supplement with 6 g of long-chain triglycerides (LD+LCT); and the third group did not receive any supplements (control). Cognition was assessed at baseline and after the 3-mo intervention. The difference in changes among the groups was assessed with ANCOVA, adjusting for age and the baseline value as covariates. After 3 mo, the Mini-Mental State Examination (MMSE) score in the LD+MCT group increased by 10.6% (from 16.6 to 18.4 points, p<0.05). After 3 mo, the Nishimura geriatric rating scale for mental status (NM scale) score in the LD+MCT group increased by 30.6% (from 24.6 to 32.2 points, p<0.001), whereas that in the LD+LCT and control groups decreased by 11.2% (from 31.2 to 27.7 points, p<0.05) and 26.1% (from 27.2 to 20.1 points, p<0.001), respectively. The combined supplementation of MCTs (6 g), L-leucine-rich amino acids, and cholecalciferol may improve cognitive function in frail elderly individuals.

  8. A feedback control model for network flow with multiple pure time delays

    Press, J.

    1972-01-01

    A control model describing a network flow hindered by multiple pure time (or transport) delays is formulated. Feedbacks connect each desired output with a single control sector situated at the origin. The dynamic formulation invokes the use of differential difference equations. This causes the characteristic equation of the model to consist of transcendental functions instead of a common algebraic polynomial. A general graphical criterion is developed to evaluate the stability of such a problem. A digital computer simulation confirms the validity of such criterion. An optimal decision making process with multiple delays is presented.

  9. Risk factors for falls with severe fracture in elderly people living in a middle-income country: a case control study

    Coutinho, Evandro SF; Fletcher, Astrid; Bloch, Katia V; Rodrigues, Laura C

    2008-01-01

    Abstract Background Fracture after falling has been identified as an important problem in public health. Most studies of risk factors for fractures due to falls have been carried out in developed countries, although the size of the elderly population is increasing fast in middle income countries. The objective of this paper is to identify risk factors for fall related to severe fractures in those aged 60 or more in a middle-income country. Methods A case-control study was carried out in Rio d...

  10. Open- and Closed-Skill Exercise Interventions Produce Different Neurocognitive Effects on Executive Functions in the Elderly: A 6-Month Randomized, Controlled Trial

    Chia-Liang Tsai

    2017-09-01

    Full Text Available This study aimed to explore the effects of open- and closed-skill exercise interventions on the neurocognitive performance of executive functions in the elderly. Sixty-four healthy elderly males were randomly assigned to either a closed-skill (bike riding or brisk walking/jogging, n = 22, open-skill (table tennis, n = 21, or control (n = 21 group. Various neuropsychological [e.g., accuracy rates (AR and reaction time (RT] and electrophysiological [e.g., event-related potential (ERP P3 component] measures were assessed during a variant of the task-switching paradigm, as well as an N-back task at baseline and after either a 6-month exercise intervention or control period. The results showed that, when performing the task-switching paradigm, the two exercise groups relative to control group showed significantly faster RTs in the switch trials after the exercise intervention. However, the RT facilitation in the non-switch and switch trials post-exercise relative to pre-exercise only emerged in the open-skill group. In terms of the N-back task, the two exercise groups significantly increased ARs in the 1-back condition after the exercise intervention, and the beneficial AR effect on the 2-back condition only emerged in the closed-skill group. In addition, the two exercise groups exhibited significantly larger P3 amplitudes on the frontal-to-parietal cortex areas after the exercise intervention relative to the baseline when performing the two cognitive tasks. These neurocognitive results still remained unchanged even when the confounding factors (e.g., cardiorespiratory fitness, social participation, and BMI were controlled for. The present study concluded that, although 6-month open- and closed-skill exercise interventions facilitate overall electrophysiological effects (i.e., increased ERP P3 amplitudes on the frontal-to-parietal cortices in the elderly, the two exercise modes produced different levels of neuropsychologically beneficial effects on

  11. Impulse control disorders are associated with multiple psychiatric symptoms in Parkinson's disease.

    Jaakkola, Elina; Kaasinen, Valtteri; Siri, Chiara; Martikainen, Kirsti; Cilia, Roberto; Niemelä, Solja; Joutsa, Juho

    2014-01-01

    Impulse control disorders can have serious adverse consequences to the life of a patient with Parkinson's disease. Although impulse control disorders are common, a possible psychiatric comorbidity has not been fully characterized. The aim of this study was to investigate the psychiatric symptoms exhibited by Parkinson's disease patients with impulse control disorders. The study was conducted as a postal survey to patients in the registry of the Finnish Parkinson Association. A total of 290 Parkinson's disease patients were evaluated for impulse control disorders using the Questionnaire for Impulsive-Compulsive Disorders in Parkinson's Disease. Psychiatric symptoms were systematically screened using the Symptom Checklist 90. We found that 108 of the evaluated patients had one or more impulse control disorders. Patients with impulse control disorders had markedly higher scores for symptoms of psychoticism (Bonferroni corrected p disorder (p impulse control disorders. Impulse control disorders were shown to be independently associated with these symptoms. Patients with multiple impulse control disorders had higher scores for depression and obsessive-compulsive symptoms when compared with patients that exhibited only one impulse control disorder. COUNCLUSIONS: Our results confirm the previous observations that impulse control disorders in Parkinson's disease are linked with multiple psychiatric symptoms, including psychoticism, interpersonal sensitivity, obsessive-compulsive symptoms and depression. Clinicians treating these patients should acknowledge the concomitant psychiatric symptoms.

  12. Diabetes in the elderly

    Katarzyna Mordarska

    2017-06-01

    Full Text Available The prevalence of both type 2 diabetes and prediabetes increases with advancing age. The most important factors leading to hyperglycaemia are as follows: deficiency of insulin secretion developing with age, and growing insulin resistance caused by a change in body composition and sarcopaenia. Clinical features of diabetes in the elderly could be different. Diabetes in elderly people is often diagnosed with delay due to atypical symptoms (dementia, urinary incontinence and occurrence of mainly postprandial hyperglycaemia. Elderly people are more exposed to diabetes complications, have more risk of myocardial infarction and end-stage renal disease, and are hospitalised more often due to hypoglycaemia than are younger patients. Elderly people with diabetes are a heterogeneous group with different life expectancy, concomitant of chronic diseases, and the ability to self-control blood glucose or give themselves an injection. The therapy should be individualised. Older people with long-term diabetes and numerous chronic complications need a more liberal approach to reach specific goals of therapy. Additional goals should be avoiding hypoglycaemia, safety of the therapy, and its acceptance by the patient.

  13. Control Strategies for Islanded Microgrid using Enhanced Hierarchical Control Structure with Multiple Current-Loop Damping Schemes

    Han, Yang; Shen, Pan; Zhao, Xin

    2017-01-01

    In this paper, the modeling, controller design, and stability analysis of the islanded microgrid (MG) using enhanced hierarchical control structure with multiple current loop damping schemes is proposed. The islanded MG is consisted of the parallel-connected voltage source inverters using LCL...... output filters, and the proposed control structure includes: the primary control with additional phase-shift loop, the secondary control for voltage amplitude and frequency restoration, the virtual impedance loops which contains virtual positive- and negative-sequence impedance loops at fundamental...... frequency, and virtual variable harmonic impedance loop at harmonic frequencies, and the inner voltage and current loop controllers. A small-signal model for the primary and secondary controls with additional phase-shift loop is presented, which shows an over-damped feature from eigenvalue analysis...

  14. Controlled multiple neutral planes by low elastic modulus adhesive for flexible organic photovoltaics.

    Kim, Wansun; Lee, Inhwa; Yoon Kim, Dong; Yu, Youn-Yeol; Jung, Hae-Yoon; Kwon, Seyeoul; Seo Park, Weon; Kim, Taek-Soo

    2017-05-12

    To protect brittle layers in organic photovoltaic devices, the mechanical neutral plane strategy can be adopted through placing the brittle functional materials close to the neutral plane where stress and strain are zero during bending. However, previous research has been significantly limited in the location and number of materials to protect through using a single neutral plane. In this study, multiple neutral planes are generated using low elastic modulus adhesives and are controlled through quantitative analyses in order to protect the multiple brittle materials at various locations. Moreover, the protection of multiple brittle layers at various locations under both concave and convex bending directions is demonstrated. Multilayer structures that have soft adhesives are further analyzed using the finite element method analysis in order to propose guidelines for structural design when employing multiple neutral planes.

  15. Risk factors for falls with severe fracture in elderly people living in a middle-income country: a case control study

    Bloch Katia V

    2008-08-01

    Full Text Available Abstract Background Fracture after falling has been identified as an important problem in public health. Most studies of risk factors for fractures due to falls have been carried out in developed countries, although the size of the elderly population is increasing fast in middle income countries. The objective of this paper is to identify risk factors for fall related to severe fractures in those aged 60 or more in a middle-income country. Methods A case-control study was carried out in Rio de Janeiro-Brazil based general hospitals between 2002–2003. Two hundred-fifty hospitalised cases of fracture were matched with 250 community controls by sex, age group and living area. Data were collected for socio-demographic variables, health status and drugs used before the fall. A conditional logistic regression model was fitted to identify variables associated with the risk of fall related severe fracture. Results Low body mass index, cognitive impairment, stroke and lack of urine control were associated with increased risk of severe fall related fractures. Benzodiazepines and muscle relaxants were also related to an increased risk of severe fractures while moderate use of alcohol was associated with reduced risk. Conclusion Although the association between benzodiazepines and fractures due to fall has been consistently demonstrated for old people, this has not been the case for muscle relaxant drugs. The decision to prescribe muscle relaxants for elderly people should take into account the risk of severe fracture associated with these drugs.

  16. Risk factors for falls with severe fracture in elderly people living in a middle-income country: a case control study.

    Coutinho, Evandro S F; Fletcher, Astrid; Bloch, Katia V; Rodrigues, Laura C

    2008-08-26

    Fracture after falling has been identified as an important problem in public health. Most studies of risk factors for fractures due to falls have been carried out in developed countries, although the size of the elderly population is increasing fast in middle income countries. The objective of this paper is to identify risk factors for fall related to severe fractures in those aged 60 or more in a middle-income country. A case-control study was carried out in Rio de Janeiro-Brazil based general hospitals between 2002-2003. Two hundred-fifty hospitalised cases of fracture were matched with 250 community controls by sex, age group and living area. Data were collected for socio-demographic variables, health status and drugs used before the fall. A conditional logistic regression model was fitted to identify variables associated with the risk of fall related severe fracture. Low body mass index, cognitive impairment, stroke and lack of urine control were associated with increased risk of severe fall related fractures. Benzodiazepines and muscle relaxants were also related to an increased risk of severe fractures while moderate use of alcohol was associated with reduced risk. Although the association between benzodiazepines and fractures due to fall has been consistently demonstrated for old people, this has not been the case for muscle relaxant drugs. The decision to prescribe muscle relaxants for elderly people should take into account the risk of severe fracture associated with these drugs.

  17. Assessment of Personality Types and Locus of Control in Multiple Sclerosis Patients

    Sh. Mazaheri

    2008-07-01

    Full Text Available Introduction & Objective: Multiple sclerosis (MS is an autoimmune disease with unknown cause. MS is one of the disabling neurologic diseases in adult especially young range that myelin part of central nervous system (CNS is destructed. The aim of this study was assessment of types A and B personality and internal and external locus of control in multiple sclerosis (MS patients and comparison of the results with control group.Materials & Methods: In a case-control study, 30 patients with MS and 30 normal persons as control group evaluated with neurological examination, Rotter locus of control test and Friedman-Rosenman questionnaire for detection of types A and B personality. We employed to analyze the results.Results: 43 percent and 57 percent of MS patients had internal and external locus of control respectively. 63 percent and 37 percent of MS patients had type A and B personality respectively. 60 percent and 40 percent of control group had internal and external locus of control respectively. 20 percent and 80 percent of control group had type A and B personality respectively. Difference between personality type in two groups was significant (P<0.01.Conclusions: In this study, MS patients had more type A personality in comparison to control group.

  18. Sirolimus Associated with Tacrolimus at Low Doses in Elderly Kidney Transplant Patients: A Prospective Randomized Controlled Trial.

    Kojima, Cristiane Akemi; Nga, Hong Si; Takase, Henrique Mochida; Bravin, Ariane Moyses; Martinez Garcia, Márcia de Fátima Faraldo; Garcia, Paula Dalsoglio; Contti, Mariana Moraes; de Andrade, Luis Gustavo Modelli

    2018-06-01

    There is no consensus on the best immunosuppressive regimen for elderly renal transplant recipients. The objective of this study was to assess cytomegalovirus infection incidence and kidney transplant outcomes in elderly recipients treated with mammalian target of rapamycin inhibitors sirolimus/ tacrolimus at low doses compared with those receiving tacrolimus/mycophenolate sodium. In this single-center prospective randomized study (Trial Registration No. NCT02683291), kidney transplant recipients over 60 years of age were randomly allocated into 2 groups: tacrolimus-sirolimus (21 patients) and tacrolimus-mycophenolate (23 patients). Cytomegalovirus infection rate and patient survival, biopsy-proven acute rejection, and renal function at 12 months were assessed. Cytomegalovirus infection rate was higher in the mycophenolate group (60.9%) than in the sirolimus group (16.7%; P = .004). The rates of biopsy-proven acute rejection, patient survival, graft survival, and estimated glomerular filtration rate over 12 months did not significantly differ between groups. The incidence of cytomegalovirus infection was significantly lower in the sirolimus group. The use of tacrolimus combined with sirolimus in elderly kidney transplant recipients is safe.

  19. Consensus definitions and application guidelines for control groups in cerebrospinal fluid biomarker studies in multiple sclerosis

    Teunissen, Charlotte; Menge, Til; Altintas, Ayse

    2013-01-01

    The choice of appropriate control group(s) is critical in cerebrospinal fluid (CSF) biomarker research in multiple sclerosis (MS). There is a lack of definitions and nomenclature of different control groups and a rationalized application of different control groups. We here propose consensus......). Furthermore, we discuss the application of these control groups in specific study designs, such as for diagnostic biomarker studies, prognostic biomarker studies and therapeutic response studies. Application of these uniform definitions will lead to better comparability of biomarker studies and optimal use...

  20. Changes in balance, functional performance and fall risk following whole body vibration training and vitamin D supplementation in institutionalized elderly women. A 6 month randomized controlled trial.

    Bogaerts, An; Delecluse, Christophe; Boonen, Steven; Claessens, Albrecht L; Milisen, Koen; Verschueren, Sabine M P

    2011-03-01

    Falls in the elderly constitute a growing public health problem. This randomized controlled trial investigated the potential benefit of 6 months of whole body vibration (WBV) training and/or vitamin D supplementation on balance, functionality and estimated fall risk in institutionalized elderly women. A total of 113 women (mean age: 79.6) were randomly assigned to either a WBV or a no-training group, receiving either a conventional dose (880 IU/d) or a high dose (1600 IU/d) of vitamin D3. The WBV group performed exercises on a vibration platform 3×/week. Balance was evaluated by computerized posturography. Functionality was assessed by 10 m walk test, Timed up and Go (TUG) performance and endurance capacity (Shuttle Walk). Fall risk was determined with the Physiological Profile Assessment. Performance on the 10 m walk test and on TUG improved over time in all groups. For none of the parameters, high-dose vitamin D resulted in a better performance than conventional dosing. The improvements in the WBV group in endurance capacity, walking at preferred speed, and TUG were significantly larger than the changes with supplementation alone. No additional benefit of WBV training could be detected on fall risk and postural control, although sway velocity and maximal isometric knee extension strength improved only in the WBV group. This trial showed that a high-dose vitamin D supplementation is not more efficient than conventional dosing in improving functionality in institutionalized elderly. WBV training on top of vitamin D supplementation provided an added benefit with regard to walking, TUG performance, and endurance capacity. Copyright © 2010 Elsevier B.V. All rights reserved.

  1. A comparison of two short education programs for improving low back pain-related disability in the elderly: a cluster randomized controlled trial.

    Kovacs, Francisco; Abraira, Víctor; Santos, Severo; Díaz, Elena; Gestoso, Mario; Muriel, Alfonso; Gil del Real, María Teresa; Mufraggi, Nicole; Noguera, Juan; Zamora, Javier

    2007-05-01

    Cluster randomized clinical trial. To assess the effectiveness of 2 minimal education programs for improving low back pain (LBP)-related disability in the elderly. No education program has shown effectiveness on low back pain (LBP)-related disability in the elderly. A total of 129 nursing homes (6389 residents) in northern Spain were invited to participate in the study. The actual participants were 12 nursing homes randomly assigned to 3 groups and 661 subjects. An independent physician gave a 20-minute talk with slide projections summarizing the content of the Back Book (active management group), the Back Guide (postural hygiene group), and a pamphlet on cardiovascular health (controls). Disability was measured with the Roland-Morris questionnaire (RMQ). Blind assessments were performed before the intervention, and 30 and 180 days later. The effect of the intervention on disability was estimated by generalized mixed linear random effects models. Mean age of participants ranged between 79.9 and 81.2 years. Disability improved in all groups, but at the 30-day assessment the postural education group showed an additional improvement of 1.1 (95% confidence interval, 0.2-1.9), RMQ points and at the 180-day assessment the active education group an additional improvement of 2.0 (95% confidence interval, 0.6-3.4). In the subset of subjects with LBP when entering the study, postural education had no advantages over controls, while an additional improvement of 3.0 (95% confidence interval, 1.5- 4.5) RMQ points at the 180-day assessment was observed in the active education group. In institutionalized elderly, the handing out of the Back Book supported by a 20-minute group talk improves disability 6 months later, and is even more effective in those subjects with LBP.

  2. Robust Fault Tolerant Control for a Class of Time-Delay Systems with Multiple Disturbances

    Songyin Cao

    2013-01-01

    Full Text Available A robust fault tolerant control (FTC approach is addressed for a class of nonlinear systems with time delay, actuator faults, and multiple disturbances. The first part of the multiple disturbances is supposed to be an uncertain modeled disturbance and the second one represents a norm-bounded variable. First, a composite observer is designed to estimate the uncertain modeled disturbance and actuator fault simultaneously. Then, an FTC strategy consisting of disturbance observer based control (DOBC, fault accommodation, and a mixed H2/H∞ controller is constructed to reconfigure the considered systems with disturbance rejection and attenuation performance. Finally, simulations for a flight control system are given to show the efficiency of the proposed approach.

  3. Smart Control of Multiple Evaporator Systems with Wireless Sensor and Actuator Networks

    Apolinar González-Potes

    2016-02-01

    Full Text Available This paper describes the complete integration of a fuzzy control of multiple evaporator systems with the IEEE 802.15.4 standard, in which we study several important aspects for this kind of system, like a detailed analysis of the end-to-end real-time flows over wireless sensor and actuator networks (WSAN, a real-time kernel with an earliest deadline first (EDF scheduler, periodic and aperiodic tasking models for the nodes, lightweight and flexible compensation-based control algorithms for WSAN that exhibit packet dropouts, an event-triggered sampling scheme and design methodologies. We address the control problem of the multi-evaporators with the presence of uncertainties, which was tackled through a wireless fuzzy control approach, showing the advantages of this concept where it can easily perform the optimization for a set of multiple evaporators controlled by the same smart controller, which should have an intelligent and flexible architecture based on multi-agent systems (MAS that allows one to add or remove new evaporators online, without the need for reconfiguring, while maintaining temporal and functional restrictions in the system. We show clearly how we can get a greater scalability, the self-configuration of the network and the least overhead with a non-beacon or unslotted mode of the IEEE 802.15.4 protocol, as well as wireless communications and distributed architectures, which could be extremely helpful in the development process of networked control systems in large spatially-distributed plants, which involve many sensors and actuators. For this purpose, a fuzzy scheme is used to control a set of parallel evaporator air-conditioning systems, with temperature and relative humidity control as a multi-input and multi-output closed loop system; in addition, a general architecture is presented, which implements multiple control loops closed over a communication network, integrating the analysis and validation method for multi

  4. Hydrotherapy for the Treatment of Pain in People with Multiple Sclerosis: A Randomized Controlled Trial

    Castro-Sánchez, Adelaida María; Matarán-Peñarrocha, Guillermo A.; Lara-Palomo, Inmaculada; Saavedra-Hernández, Manuel; Arroyo-Morales, Manuel; Moreno-Lorenzo, Carmen

    2011-01-01

    Background. Multiple sclerosis (MS) is a chronic demyelinating neurological disease. Several studies have reported that complementary and alternative therapies can have positive effects against pain in these patients. Objective. The objective was to investigate the effectiveness of an Ai-Chi aquatic exercise program against pain and other symptoms in MS patients. Methods. In this randomized controlled trial, 73 MS patients were randomly assigned to an experimental or control group for a 20-we...

  5. Use of wiener nonlinear MPC to control a CSTR with multiple steady state

    Lusson Cervantes, A.; Agamennoni, O.E.; Figueroa, J.L.

    2003-01-01

    In this paper a Nonlinear Model Predictive Control based on a Wiener Model with a Piecewise Linear gain is presented. The major advantages of this algorithm is that it retains all the interesting properties of the classical linear MPC and the computations are easy to solve due to the canonical structure of the nonlinear gain. The proposed control scheme is applied to a nonlinear CSTR that presents multiple steady states.

  6. Towards a decision support system for control of multiple food safety hazards in raw milk production

    Spiegel, van der M.; Sterrenburg, P.; Haasnoot, W.; Fels-Klerx, van der H.J.

    2013-01-01

    Decision support systems (DSS) for controlling multiple food safety hazards in raw milk production have not yet been developed, but the underlying components are fragmentarily available. This article presents the state-of-the-art of essential DSS elements for judging food safety compliance of raw

  7. All Set! Evidence of Simultaneous Attentional Control Settings for Multiple Target Colors

    Irons, Jessica L.; Folk, Charles L.; Remington, Roger W.

    2012-01-01

    Although models of visual search have often assumed that attention can only be set for a single feature or property at a time, recent studies have suggested that it may be possible to maintain more than one attentional control setting. The aim of the present study was to investigate whether spatial attention could be guided by multiple attentional…

  8. Evaluation of biases present in the cohort multiple randomised controlled trial design : a simulation study

    Candlish, Jane; Pate, Alexander; Sperrin, Matthew; Staa, Tjeerd P van

    2017-01-01

    BACKGROUND: The cohort multiple randomised controlled trial (cmRCT) design provides an opportunity to incorporate the benefits of randomisation within clinical practice; thus reducing costs, integrating electronic healthcare records, and improving external validity. This study aims to address a key

  9. Comparison of Intelligibility Measures for Adults with Parkinson's Disease, Adults with Multiple Sclerosis, and Healthy Controls

    Stipancic, Kaila L.; Tjaden, Kris; Wilding, Gregory

    2016-01-01

    Purpose: This study obtained judgments of sentence intelligibility using orthographic transcription for comparison with previously reported intelligibility judgments obtained using a visual analog scale (VAS) for individuals with Parkinson's disease and multiple sclerosis and healthy controls (K. Tjaden, J. E. Sussman, & G. E. Wilding, 2014).…

  10. Robots in Elderly Care

    Alessandro Vercelli

    2018-03-01

    new signs and symptoms through artificial intelligence by machine learning and deep learning and about his/her habitat. On the other, this powerful instrument may represent a dramatic treat to the privacy of the subjects and their caregivers. Therefore, robotics represents an ethically sensitive field. Care robotics bear the risk of reducing human contact, of increasing the objectification and loss of control of the elderly, of losing the privacy and personal freedom of the individual (especially when robots may perform restrictive interventions. Moreover, the use of robots in elderly care may raise in the risk of confusing between reality and appearance, with a potential risk of deception and infantilization of the elder.

  11. A pilot randomized, placebo controlled, double blind phase I trial of the novel SIRT1 activator SRT2104 in elderly volunteers.

    Vincenzo Libri

    Full Text Available SRT2104 has been developed as a selective small molecule activator of SIRT1, a NAD(+-dependent deacetylase involved in the regulation of energy homeostasis and the modulation of various metabolic pathways, including glucose metabolism, oxidative stress and lipid metabolism. SIRT1 has been suggested as putative therapeutic target in multiple age-related diseases including type 2 diabetes and dyslipidemias. We report the first clinical trial of SRT2104 in elderly volunteers.Oral doses of 0.5 or 2.0 g SRT2104 or matching placebo were administered once daily for 28 days. Pharmacokinetic samples were collected through 24 hours post-dose on days 1 and 28. Multiple pharmacodynamic endpoints were explored with oral glucose tolerance tests (OGTT, serum lipid profiles, magnetic resonance imaging (MRI for assessment of whole body visceral and subcutaneous fat, maximal aerobic capacity test and muscle 31P magnetic resonance spectroscopy (MRS for estimation of mitochondrial oxidative capacity.SRT2104 was generally safe and well tolerated. Pharmacokinetic exposure increased less than dose-proportionally. Mean Tmax was 2-4 hours with elimination half-life of 15-20 hours. Serum cholesterol, LDL levels and triglycerides decreased with treatment. No significant changes in OGTT responses were observed. 31P MRS showed trends for more rapid calculated adenosine diphosphate (ADP and phosphocreatine (PCr recoveries after exercise, consistent with increased mitochondrial oxidative phosphorylation.SRT2104 can be safely administered in elderly individuals and has biological effects in humans that are consistent with SIRT1 activation. The results of this study support further development of SRT2104 and may be useful in dose selection for future clinical trials in patients.ClinicalTrials.gov NCT00964340.

  12. Auditory decision aiding in supervisory control of multiple unmanned aerial vehicles.

    Donmez, Birsen; Cummings, M L; Graham, Hudson D

    2009-10-01

    This article is an investigation of the effectiveness of sonifications, which are continuous auditory alerts mapped to the state of a monitored task, in supporting unmanned aerial vehicle (UAV) supervisory control. UAV supervisory control requires monitoring a UAV across multiple tasks (e.g., course maintenance) via a predominantly visual display, which currently is supported with discrete auditory alerts. Sonification has been shown to enhance monitoring performance in domains such as anesthesiology by allowing an operator to immediately determine an entity's (e.g., patient) current and projected states, and is a promising alternative to discrete alerts in UAV control. However, minimal research compares sonification to discrete alerts, and no research assesses the effectiveness of sonification for monitoring multiple entities (e.g., multiple UAVs). The authors conducted an experiment with 39 military personnel, using a simulated setup. Participants controlled single and multiple UAVs and received sonifications or discrete alerts based on UAV course deviations and late target arrivals. Regardless of the number of UAVs supervised, the course deviation sonification resulted in reactions to course deviations that were 1.9 s faster, a 19% enhancement, compared with discrete alerts. However, course deviation sonifications interfered with the effectiveness of discrete late arrival alerts in general and with operator responses to late arrivals when supervising multiple vehicles. Sonifications can outperform discrete alerts when designed to aid operators to predict future states of monitored tasks. However, sonifications may mask other auditory alerts and interfere with other monitoring tasks that require divided attention. This research has implications for supervisory control display design.

  13. Effect of Pet Insects on the Psychological Health of Community-Dwelling Elderly People: A Single-Blinded, Randomized, Controlled Trial.

    Ko, Hae-Jin; Youn, Chang-Ho; Kim, Seong-Hyun; Kim, So-Yun

    2016-01-01

    There is evidence that animal-assisted therapy has positive effects on mental health, especially in elderly people. Caring for insects is easy, relatively inexpensive, and does not require much space. The aim of this 8-week randomized, controlled, single-blinded study was to investigate the effect of pet insects on the psychological health of community-dwelling elderly people. Elderly subjects (≥65 years old) attending a community center in Daegu, Korea, were enrolled in the study between April and May 2014 and randomized at a 1:1 ratio to receive insect therapy and health advice or only health advice. The insect group received 5 crickets in a cage with sufficient fodder and a detailed instruction manual. At baseline and at 8 weeks, all subjects underwent psychometric tests via a direct interview [Beck Anxiety Inventory, Geriatric Depression Scale (GDS-15), Mini-Mental State Examination (MMSE), 36-Item Short Form Health Survey, Insomnia Severity Index, Fatigue Severity Scale, and Brief Encounter Psychosocial Instrument] and laboratory analyses of inflammatory and oxidative stress markers (erythrocyte sedimentation rate, high-sensitivity C-reactive protein, biological antioxidant potential, and derivatives of reactive oxygen metabolites). The insect-caring (n = 46) and control (n = 48) groups did not differ in baseline characteristics. The insect-caring group had significantly lower GDS-15 scores at week 8 (3.20 vs. 4.90, p = 0.004) and, after adjustment for baseline values, a significantly greater change in GDS-15 scores relative to baseline (-1.12 vs. 0.20, p = 0.011). They also had a significantly greater change in MMSE scores relative to baseline (1.13 vs. 0.31, p = 0.045). The two groups did not differ in terms of other psychometric and laboratory tests. No serious risks or adverse events were reported. Caring for insects, which is cost-effective and safe, was associated with a small to medium positive effect on depression and cognitive function in community

  14. Randomized controlled trial of a six-week spiritual reminiscence intervention on hope, life satisfaction, and spiritual well-being in elderly with mild and moderate dementia.

    Wu, Li-Fen; Koo, Malcolm

    2016-02-01

    Reminiscence therapy has been reported to improve the well-being in patients with dementia. However, few studies have examined the effects of spiritual reminiscence, which emphasizes on reconnecting and enhancing the meaning of one's own experience, on patients with dementia. Therefore, this study aimed to investigate the effects of spiritual reminiscence on hope, life satisfaction, and spiritual well-being in elderly Taiwanese with mild or moderate dementia. A randomized controlled trial was conducted on 103 patients with mild or moderate dementia recruited from a medical center in central Taiwan. The patients were randomly assigned to either a 6-week spiritual reminiscence group (n = 53) or control group (n = 50). The Herth Hope Index, the Life Satisfaction Scale, the Spirituality Index of Well-Being were administered before and after the 6-week period. The interaction terms between group and time for the three outcome measures were found to be significant (P hope, life satisfaction, and spiritual well-being of elderly patients with mild or moderate dementia could significantly be improved with a 6-week spiritual reminiscence intervention. Copyright © 2015 John Wiley & Sons, Ltd.

  15. A comparison of synchronized intermittent mandatory ventilation and pressure-regulated volume control ventilation in elderly patients with acute exacerbations of COPD and respiratory failure.

    Chang, Suchi; Shi, Jindong; Fu, Cuiping; Wu, Xu; Li, Shanqun

    2016-01-01

    COPD is the third leading cause of death worldwide. Acute exacerbations of COPD may cause respiratory failure, requiring intensive care unit admission and mechanical ventilation. Intensive care unit patients with acute exacerbations of COPD requiring mechanical ventilation have higher mortality rates than other hospitalized patients. Although mechanical ventilation is the most effective intervention for these conditions, invasive ventilation techniques have yielded variable effects. We evaluated pressure-regulated volume control (PRVC) ventilation treatment efficacy and preventive effects on pulmonary barotrauma in elderly COPD patients with respiratory failure. Thirty-nine intubated patients were divided into experimental and control groups and treated with the PRVC and synchronized intermittent mandatory ventilation - volume control methods, respectively. Vital signs, respiratory mechanics, and arterial blood gas analyses were monitored for 2-4 hours and 48 hours. Both groups showed rapidly improved pH, partial pressure of oxygen (PaO2), and PaO2 per fraction of inspired O2 levels and lower partial pressure of carbon dioxide (PaCO2) levels. The pH and PaCO2 levels at 2-4 hours were lower and higher, respectively, in the test group than those in the control group (P0.05). Vital signs during 2-4 hours and 48 hours of treatment showed no statistical difference in either group (P>0.05). The level of peak inspiratory pressure in the experimental group after mechanical ventilation for 2-4 hours and 48 hours was significantly lower than that in the control group (P0.05). Among elderly COPD patients with respiratory failure, application of PRVC resulted in rapid improvement in arterial blood gas analyses while maintaining a low peak inspiratory pressure. PRVC can reduce pulmonary barotrauma risk, making it a safer protective ventilation mode than synchronized intermittent mandatory ventilation - volume control.

  16. Iatrogenic risk factors associated with hospital readmission of elderly patients: A matched case-control study using a clinical data warehouse.

    Schwab, C; Korb-Savoldelli, V; Escudie, J B; Fernandez, C; Durieux, P; Saint-Jean, O; Sabatier, B

    2018-06-01

    Hospital readmission within 30 days of patient discharge has become a standard to judge the quality of hospitalizations. It is estimated that 14% of the elderly, people over 75 years old or those over 65 with comorbidities, are at risk of readmission, of which 23% are avoidable. It may be possible to identify elderly patients at risk of readmission and implement steps to reduce avoidable readmissions. The aim of this study was to identify iatrogenic risk factors for readmission. The secondary objective was to evaluate the rate of drug-related readmissions (DRRs) among all readmissions and compare it to the rate of readmissions for other reasons. We conducted a retrospective, matched, case-control study to identify non-demographic risk factors for avoidable readmission, specifically DRRs. The study included patients hospitalized between 1 September 2014 and 31 October 2015 in an 800-bed university hospital. We included patients aged 75 and over. Cases consisted of patients readmitted to the emergency department within 30 days of initial discharge. Controls did not return to the emergency department within 30 days. Cases and controls were matched on sex and age because they are known as readmissions risk factors. After comparison of the mean or percentage between cases and controls for each variable, we conducted a conditional logistic regression. The risk factors identified were an emergency admission at the index hospitalization, returning home after discharge, a history of unplanned readmissions and prescription of nervous system drugs. Otherwise, 11.4% of the readmissions were DRRs, of which 30% were caused by an overdose of antihypertensive. The number of drugs at readmission was higher, and potentially inappropriate medications were more widely prescribed for DRRs than for readmissions for other reasons. In this matched case-control retrospective study, after controlling for gender and age, we identified the typical profile of elderly patients at risk of

  17. A randomized, double-blind, placebo-controlled trial of a traditional herbal formula, Yukmijihwang-tang in elderly subjects with xerostomia.

    Han, Gajin; Ko, Seok-Jae; Kim, Juyeon; Oh, Ja-Young; Park, Jae-Woo; Kim, Jinsung

    2016-04-22

    Yukmijihwang-tang (YMJ) is a typical herbal formula to treat Yin-deficiency (YD) syndrome by enriching the fluid-humor of the body. YMJ has been used to treat dry mouth symptoms for hundreds of years in traditional East Asian medicine. Xerostomia, a subjective oral dryness, is common in the elderly and results in impaired quality of life. Many conventional treatments for xerostomia provide only temporary symptom relief, and have side effects. The aim of this study is to investigate the efficacy and safety of YMJ for the treatment of xerostomia in the elderly. This study was designed as a randomized, placebo-controlled, double-blinded, two center trial. Ninety-six subjects aged 60-80 years who had experienced xerostomia for at least 3 months and presented with score>40 on the visual analog scale (VAS) for subjective oral dryness were recruited and randomly allocated to YMJ and placebo groups. YMJ or placebo was administered to each group for 8 weeks (3g of YMJ or placebo, three times per day). The primary outcome was change of VAS for xerostomia from 0 to 8 weeks. VAS for xerostomia was decreased by 22.04±22.76 in the YMJ group and 23.58±23.04 in the placebo group. YMJ had no effect on xerostomia. However, participants with BMIs lower than 29.37kg/m(2) showed improvement of xerostomia after 8 weeks of treatment with YMJ compared to placebo. In addition, YMJ improved oral moisture, which is associated with subjective oral dryness in the YMJ group, and the relationship between VAS for xerostomia and YD was significant. A trend was observed in which YMJ improved oral moisture status and subjective oral dryness in elderly subjects with lower BMI and greater tendency toward YD. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  18. Impact of diet and nutraceutical supplementation on inflammation in elderly people. Results from the RISTOMED study, an open-label randomized control trial.

    Ostan, R; Béné, M C; Spazzafumo, L; Pinto, A; Donini, L M; Pryen, F; Charrouf, Z; Valentini, L; Lochs, H; Bourdel-Marchasson, I; Blanc-Bisson, C; Buccolini, F; Brigidi, P; Franceschi, C; d'Alessio, P A

    2016-08-01

    Eating habits may influence the life span and the quality of ageing process by modulating inflammation. The RISTOMED project was developed to provide a personalized and balanced diet, enriched with or without nutraceutical compounds, to decrease and prevent inflammageing, oxidative stress and gut microbiota alteration in healthy elderly people. This paper focused on the effect on inflammation and metabolism markers after 56 days of RISTOMED diet alone or supplementation with three nutraceutical compounds. A cohort of 125 healthy elderly subjects was recruited and randomized into 4 arms (Arm A, RISTOMED diet; Arm B, RISTOMED diet plus VSL#3 probiotic blend; Arm C, RISTOMED diet plus AISA d-Limonene; Arm D, RISTOMED diet plus Argan oil). Inflammatory and metabolism parameters as well as the ratio between Clostridium cluster IV and Bifidobacteria (CL/B) were collected before and after 56 days of dietary intervention, and their evolution compared among the arms. Moreover, participants were subdivided according to their baseline inflammatory parameters (erythrocytes sedimentation rate (ESR), C-Reactive Protein, fibrinogen, Tumor Necrosis Factor-alfa (TNF-α), and Interleukin 6) in two clusters with low or medium-high level of inflammation. The evolution of the measured parameters was then examined separately in each cluster. Overall, RISTOMED diet alone or with each nutraceutical supplementation significantly decreased ESR. RISTOMED diet supplemented with d-Limonene resulted in a decrease in fibrinogen, glucose, insulin levels and HOMA-IR. The most beneficial effects were observed in subjects with a medium-high inflammatory status who received RISTOMED diet with AISA d-Limonene supplementation. Moreover, RISTOMED diet associated with VSL#3 probiotic blend induced a decrease in the CL/B ratio. Overall, this study emphasizes the beneficial anti-inflammageing effect of RISTOMED diet supplemented with nutraceuticals to control the inflammatory status of elderly

  19. The Dynamics and Sliding Mode Control of Multiple Cooperative Welding Robot Manipulators

    Bin Zi

    2012-08-01

    Full Text Available This paper deals with the design, dynamic modelling and sliding mode control of multiple cooperative welding robot manipulators (MWRMs. The MWRMs can handle complex tasks that are difficult or even impossible for a single manipulator. The kinematics and dynamics of the MWRMs are studied on the basis of the Denavit-Hartenberg and Lagrange method. Following that, considering the MWRM system with nonlinear and unknown disturbances, a non-singular terminal sliding mode control strategy is designed. By means of the Lyapunov function, the stability of the controller is proved. Simulation results indicate that the good control performance of the MWRMs is achieved by the non-singular terminal sliding mode controller, which also illustrates the correctness of the dynamic modelling and effectiveness of the proposed control strategy.

  20. Front-end module readout and control electronics for the PHENIX Multiplicity Vertex Detector

    Ericson, M.N.; Allen, M.D.; Boissevain, J.

    1997-11-01

    Front-end module (FEM) readout and control are implemented as modular, high-density, reprogrammable functions in the PHENIX Multiplicity Vertex Detector. FEM control is performed by the heap manager, an FPGA-based circuit in the FEM unit. Each FEM has 256 channels of front-end electronics, readout, and control, all located on an MCM. Data readout, formatting, and control are performed by the heap manager along with 4 interface units that reside outside the MVD detector cylinder. This paper discusses the application of a generic heap manager and the addition of 4 interface module types to meet the specific control and data readout needs of the MVD. Unit functioning, interfaces, timing, data format, and communication rates will be discussed in detail. In addition, subsystem issues regarding mode control, serial architecture and functions, error handling, and FPGA implementation and programming will be presented

  1. Fast-track surgery protocol in elderly patients undergoing laparoscopic radical gastrectomy for gastric cancer: a randomized controlled trial

    Liu G

    2016-06-01

    Full Text Available Guozheng Liu,1 Fengguo Jian,2 Xiuqin Wang,2 Lin Chen1 1Department of General Surgery, Chinese PLA General Hospital, Beijing, People’s Republic of China; 2Second Department of General Surgery, Changyi People’s Hospital, Shandong, People’s Republic of China Aim: To study the efficacy of the fast-track surgery (FTS program combined with laparoscopic radical gastrectomy for elderly gastric cancer (GC patients.Methods: Eighty-four elderly patients diagnosed with GC between September 2014 and August 2015 were recruited to participate in this study and were divided into four groups randomly based on the random number table as follows: FTS + laparoscopic group (Group A, n=21, FTS + laparotomy group (Group B, n=21, conventional perioperative care (CC + laparoscopic group (Group C, n=21, and CC + laparotomy group (Group D, n=21. Observation indicators include intrasurgery indicators, postoperative recovery indicators, nutritional status indicators, and systemic stress response indicators.Results: Preoperative and intraoperative baseline characteristics showed no significant differences between patients in each group (P>0.05. There were no significant differences between each group in nausea and vomiting, intestinal obstruction, urinary retention, incision infection, pulmonary infection, and urinary tract infection after operation (P>0.05. Time of first flatus and postoperative hospital stay time of FTS Group A were the shortest, and total medical cost of this group was the lowest. For all groups, serum albumin, prealbumin, and transferrin significantly decreased, while CRP and interleukin 6 were significantly increased postoperative day 1. From postoperative day 4–7, all indicators of the four groups gradually recovered, but compared with other three groups, those of Group A recovered fastest.Conclusion: FTS combined with laparoscopic surgery can promote faster postoperative recovery, improve early postoperative nutritional status, and more

  2. [Association between waist circumference and the prevalence/control of hypertension by gender and different body mass index classification in an urban elderly population].

    Wu, Lei; He, Yao; Jiang, Bin; Liu, Miao; Yang, Shanshan; Zeng, Jing; Wang, Yiyan; Wang, Jianhua; Zhang, Di

    2015-12-01

    The aim of the present study was to evaluate the association between waist circumference and the prevalence/control of hypertension in an urban elderly population. From September 2009 to June 2010, a population-based cross-sectional study was conducted in Wanshoulu area of Beijing, China. A total of 2 035 elderly (828 male, 1 207 females) participants aged ≥60 years from a community were included in this study for data analysis. We found that the increased waist circumference could significantly increase the risk of prevalence and poor control of hypertension, with the adjusted odds ratios (95% CI) as 1.04 (1.01-1.08) and 0.96 (0.92-1.00) , respectively. Among those identified pure central obesity females (64.7%) , the prevalence of hypertension was significantly higher than those females with normal body mass index (BMI) or with normal waist circumference (52.2%). The adjusted odds ratio (95%CI) between the above said groups appeared as 1.58 (1.07-2.32). The control rate of hypertension among females (32.9%) with pure central obesity, was lower than that of the females with normal BMI and waist circumference (43.5%) , with an adjusted odds ratio (95%CI) as 0.62 (0.37-1.04, P=0.071). There appeared significant association between people with pure central obesity and the increased risk of prevalence or with poor control of hypertension. More attention should be paid to both the prevalence and control of hypertension programs among females with pure central obesity.

  3. Prevalence of hypertension and hypertension control rates among elderly adults during the cold season in rural Northeast China: a cross-sectional study.

    Kawazoe, Nobuo; Zhang, Xiumin; Chiang, Chifa; Liu, Hongjian; Li, Jinghua; Hirakawa, Yoshihisa; Aoyama, Atsuko

    2018-05-01

    Objective: The burden of noncommunicable diseases (NCDs) is increasing in China, together with economic development and social changes. The prevalence of risk factors for NCDs, such as overweight/obesity, hypertension, diabetes, and dyslipidemia, is reported to be high even among poor residents of rural areas. We aimed to investigate the prevalence of hypertension among elderly adults in rural Northeast China and the proportion with controlled hypertension among those on antihypertensive medication (hypertension control rate). We also aimed to examine the association of hypertension control with health facilities that provide treatment. Methods: We conducted a community-based cross-sectional study in six rural villages of Northeast China from February to early March, 2012. We interviewed 1593 adults aged 50-69 years and measured their blood pressure. We examined the differences in mean blood pressure between participants who obtained antihypertensive medication from village clinics and those who obtained medication from other sources, using analysis of covariance adjusted for several covariates. Results: The prevalence of hypertension among participants was as high as 63.3%, but the hypertension control rate was only 8.4%. Most villagers (98.1%) were not registered in the chronic disease treatment scheme of the public rural health insurance. The mean systolic blood pressure, adjusted for the covariates, of participants who obtained antihypertensive medication from village clinics was significantly lower than that of participants who obtained medication from township hospitals (by 16.5 mmHg) or from private pharmacies (by 7.3 mmHg). Conclusion: The prevalence of hypertension was high and the hypertension control rate low among elderly villagers during the cold season. As treatment at village clinics, which villagers can access during the cold season seems to be more effective than self-medication or treatment at distant hospitals, improving the quality of treatment

  4. Real-Time Optimal Flood Control Decision Making and Risk Propagation Under Multiple Uncertainties

    Zhu, Feilin; Zhong, Ping-An; Sun, Yimeng; Yeh, William W.-G.

    2017-12-01

    Multiple uncertainties exist in the optimal flood control decision-making process, presenting risks involving flood control decisions. This paper defines the main steps in optimal flood control decision making that constitute the Forecast-Optimization-Decision Making (FODM) chain. We propose a framework for supporting optimal flood control decision making under multiple uncertainties and evaluate risk propagation along the FODM chain from a holistic perspective. To deal with uncertainties, we employ stochastic models at each link of the FODM chain. We generate synthetic ensemble flood forecasts via the martingale model of forecast evolution. We then establish a multiobjective stochastic programming with recourse model for optimal flood control operation. The Pareto front under uncertainty is derived via the constraint method coupled with a two-step process. We propose a novel SMAA-TOPSIS model for stochastic multicriteria decision making. Then we propose the risk assessment model, the risk of decision-making errors and rank uncertainty degree to quantify the risk propagation process along the FODM chain. We conduct numerical experiments to investigate the effects of flood forecast uncertainty on optimal flood control decision making and risk propagation. We apply the proposed methodology to a flood control system in the Daduhe River basin in China. The results indicate that the proposed method can provide valuable risk information in each link of the FODM chain and enable risk-informed decisions with higher reliability.

  5. On decentralized adaptive full-order sliding mode control of multiple UAVs.

    Xiang, Xianbo; Liu, Chao; Su, Housheng; Zhang, Qin

    2017-11-01

    In this study, a novel decentralized adaptive full-order sliding mode control framework is proposed for the robust synchronized formation motion of multiple unmanned aerial vehicles (UAVs) subject to system uncertainty. First, a full-order sliding mode surface in a decentralized manner is designed to incorporate both the individual position tracking error and the synchronized formation error while the UAV group is engaged in building a certain desired geometric pattern in three dimensional space. Second, a decentralized virtual plant controller is constructed which allows the embedded low-pass filter to attain the chattering free property of the sliding mode controller. In addition, robust adaptive technique is integrated in the decentralized chattering free sliding control design in order to handle unknown bounded uncertainties, without requirements for assuming a priori knowledge of bounds on the system uncertainties as stated in conventional chattering free control methods. Subsequently, system robustness as well as stability of the decentralized full-order sliding mode control of multiple UAVs is synthesized. Numerical simulation results illustrate the effectiveness of the proposed control framework to achieve robust 3D formation flight of the multi-UAV system. Copyright © 2017 ISA. Published by Elsevier Ltd. All rights reserved.

  6. Are exergames promoting mobility an attractive alternative to conventional self-regulated exercises for elderly people in a rehabilitation setting? Study protocol of a randomized controlled trial.

    Hasselmann, Viviane; Oesch, Peter; Fernandez-Luque, Luis; Bachmann, Stefan

    2015-09-07

    Maintaining mobility in elderly persons has become a primary goal within healthcare services. In older adults, exercise programs significantly reduce the risk of falling and death. Long-lasting and high-intensive multi-component exercises are most effective. In a rehabilitation setting, self-regulated exercises are conventionally taught by physiotherapists, using handouts. However, the adherence of elderly persons to executing these self-administered programs varies considerably. They are often considered tedious and boring, and thus prematurely stopped. The primary aim of this clinical trial is to determine whether elderly persons in a rehabilitation setting show higher adherence to self-regulated training when using exergames than when performing conventional exercises. The second objective is to explore which mode of exercise leads to greater improvement in balance performance. The study consists of a single blind, stratified, randomized control trial with two parallel groups. Once included, study participants will be stratified according to their balance and computer skills and randomly allocated to self-regulated training with conventional exercise programs or with exergames played with the Windows Kinect® sensor and FitBit® pedometer. In both groups, self-administered exercise programs will be taught by experienced physiotherapists and performed at the patient's own discretion during the ten days of intervention. The primary outcome is the performed daily training volume, collected by the participants in a logbook. Secondary outcomes are objective and subjective balance skills measured by an activity tracker and the Fall Efficacy Scale self-administered questionnaire. Both assessments will be performed at pre- and post-intervention. According to the available literature, this study is the first to compare conventional self-regulated exercises with exergames among older patients in a rehabilitation setting. Results of this study will contribute to our

  7. A brain-computer interface based cognitive training system for healthy elderly: a randomized control pilot study for usability and preliminary efficacy.

    Tih-Shih Lee

    Full Text Available Cognitive decline in aging is a pressing issue associated with significant healthcare costs and deterioration in quality of life. Previously, we reported the successful use of a novel brain-computer interface (BCI training system in improving symptoms of attention deficit hyperactivity disorder. Here, we examine the feasibility of the BCI system with a new game that incorporates memory training in improving memory and attention in a pilot sample of healthy elderly. This study investigates the safety, usability and acceptability of our BCI system to elderly, and obtains an efficacy estimate to warrant a phase III trial. Thirty-one healthy elderly were randomized into intervention (n = 15 and waitlist control arms (n = 16. Intervention consisted of an 8-week training comprising 24 half-hour sessions. A usability and acceptability questionnaire was administered at the end of training. Safety was investigated by querying users about adverse events after every session. Efficacy of the system was measured by the change of total score from the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS before and after training. Feedback on the usability and acceptability questionnaire was positive. No adverse events were reported for all participants across all sessions. Though the median difference in the RBANS change scores between arms was not statistically significant, an effect size of 0.6SD was obtained, which reflects potential clinical utility according to Simon's randomized phase II trial design. Pooled data from both arms also showed that the median change in total scores pre and post-training was statistically significant (Mdn = 4.0; p<0.001. Specifically, there were significant improvements in immediate memory (p = 0.038, visuospatial/constructional (p = 0.014, attention (p = 0.039, and delayed memory (p<0.001 scores. Our BCI-based system shows promise in improving memory and attention in healthy

  8. Generic care pathway for elderly patients in need of home care services after discharge from hospital: a cluster randomised controlled trial.

    Røsstad, Tove; Salvesen, Øyvind; Steinsbekk, Aslak; Grimsmo, Anders; Sletvold, Olav; Garåsen, Helge

    2017-04-17

    Improved discharge arrangements and targeted post-discharge follow-up can reduce the risk of adverse events after hospital discharge for elderly patients. Although more care is to shift from specialist to primary care, there are few studies on post-discharge interventions run by primary care. A generic care pathway, Patient Trajectory for Home-dwelling elders (PaTH) including discharge arrangements and follow-up by primary care, was developed and introduced in Central Norway Region in 2009, applying checklists at defined stages in the patient trajectory. In a previous paper, we found that PaTH had potential of improving follow-up in primary care. The aim of this study was to establish the effect of PaTH-compared to usual care-for elderly in need of home care services after discharge from hospital. We did an unblinded, cluster randomised controlled trial with 12 home care clusters. Outcomes were measured at the patient level during a 12-month follow-up period for the individual patient and analysed applying linear and logistic mixed models. Primary outcomes were readmissions within 30 days and functional level assessed by Nottingham extended ADL scale. Secondary outcomes were number and length of inpatient hospital care and nursing home care, days at home, consultations with the general practitioners (GPs), mortality and health related quality of life (SF-36). One-hundred and sixty-three patients were included in the PaTH group (six clusters), and 141 patients received care as usual (six clusters). We found no statistically significant differences between the groups for primary and secondary outcomes except for more consultations with the GPs in PaTH group (p = 0.04). Adherence to the intervention was insufficient as only 36% of the patients in the intervention group were assessed by at least three of the four main checklists in PaTH, but this improved over time. Lack of adherence to PaTH rendered the study inconclusive regarding the elderly's functional level

  9. Coordinated voltage control for multiple wind plants in Eastern Wyoming. Analysis, field experience and validation

    Miller, Nicholas; MacDowell, Jason; Chmiel, Gary; Konopinski, Ryan; Gautam, Durga [GE Energy, Schenectady, NY (United States); Laughter, Grant; Hagen, Dave [PacifiCorp., Salt Lake City, UT (United States)

    2012-07-01

    At high levels of wind power penetration, multiple wind plants may be the predominant generation resource over large geographic areas. Thus, not only do wind plants need to provide a high level of functionality, they must coordinate properly with each other. This paper describes the analysis and field testing of wind plant voltage controllers designed to improve system voltage performance through passive coordination. The described wind power plant controls can coordinate the real and reactive power response of multiple wind turbines and thereby make the plant function as a single ''grid friendly'' power generation source. For this application, involving seven large wind plants with predominantly GE wind turbines in Eastern Wyoming, the voltage portion of the controllers were configured and tuned to allow the collective reactive power response of multiple wind plants in the region to work well together. This paper presents the results of the initial configuration and tuning study, and the results of the subsequent field tuning and testing of the modified controls. The paper also presents some comparisons of the measured field performance with the stability simulation models, which show that the available wind plant models provide accurate, high fidelity results for actual operating conditions of commercial wind power plants. (orig.)

  10. A Telerehabilitation Program Improves Postural Control in Multiple Sclerosis Patients: A Spanish Preliminary Study

    Rosa Ortiz-Gutiérrez

    2013-10-01

    Full Text Available Postural control disorders are among the most frequent motor disorder symptoms associated with multiple sclerosis. This study aims to demonstrate the potential improvements in postural control among patients with multiple sclerosis who complete a telerehabilitation program that represents a feasible alternative to physical therapy for situations in which conventional treatment is not available. Fifty patients were recruited. Control group (n = 25 received physiotherapy treatment twice a week (40 min per session. Experimental group (n = 25 received monitored telerehabilitation treatment via videoconference using the Xbox 360® and Kinect console. Experimental group attended 40 sessions, four sessions per week (20 min per session.The treatment schedule lasted 10 weeks for both groups. A computerized dynamic posturography (Sensory Organization Test was used to evaluate all patients at baseline and at the end of the treatment protocol. Results showed an improvement over general balance in both groups. Visual preference and the contribution of vestibular information yielded significant differences in the experimental group. Our results demonstrated that a telerehabilitation program based on a virtual reality system allows one to optimize the sensory information processing and integration systems necessary to maintain the balance and postural control of people with multiple sclerosis. We suggest that our virtual reality program enables anticipatory PC and response mechanisms and might serve as a successful therapeutic alternative in situations in which conventional therapy is not readily available.

  11. A Telerehabilitation Program Improves Postural Control in Multiple Sclerosis Patients: A Spanish Preliminary Study

    Ortiz-Gutiérrez, Rosa; Cano-de-la-Cuerda, Roberto; Galán-del-Río, Fernando; Alguacil-Diego, Isabel María; Palacios-Ceña, Domingo; Miangolarra-Page, Juan Carlos

    2013-01-01

    Postural control disorders are among the most frequent motor disorder symptoms associated with multiple sclerosis. This study aims to demonstrate the potential improvements in postural control among patients with multiple sclerosis who complete a telerehabilitation program that represents a feasible alternative to physical therapy for situations in which conventional treatment is not available. Fifty patients were recruited. Control group (n = 25) received physiotherapy treatment twice a week (40 min per session). Experimental group (n = 25) received monitored telerehabilitation treatment via videoconference using the Xbox 360® and Kinect console. Experimental group attended 40 sessions, four sessions per week (20 min per session).The treatment schedule lasted 10 weeks for both groups. A computerized dynamic posturography (Sensory Organization Test) was used to evaluate all patients at baseline and at the end of the treatment protocol. Results showed an improvement over general balance in both groups. Visual preference and the contribution of vestibular information yielded significant differences in the experimental group. Our results demonstrated that a telerehabilitation program based on a virtual reality system allows one to optimize the sensory information processing and integration systems necessary to maintain the balance and postural control of people with multiple sclerosis. We suggest that our virtual reality program enables anticipatory PC and response mechanisms and might serve as a successful therapeutic alternative in situations in which conventional therapy is not readily available. PMID:24185843

  12. Hierarchical Robot Control System and Method for Controlling Select Degrees of Freedom of an Object Using Multiple Manipulators

    Abdallah, Muhammad E. (Inventor); Platt, Robert (Inventor); Wampler, II, Charles W. (Inventor)

    2013-01-01

    A robotic system includes a robot having manipulators for grasping an object using one of a plurality of grasp types during a primary task, and a controller. The controller controls the manipulators during the primary task using a multiple-task control hierarchy, and automatically parameterizes the internal forces of the system for each grasp type in response to an input signal. The primary task is defined at an object-level of control, e.g., using a closed-chain transformation, such that only select degrees of freedom are commanded for the object. A control system for the robotic system has a host machine and algorithm for controlling the manipulators using the above hierarchy. A method for controlling the system includes receiving and processing the input signal using the host machine, including defining the primary task at the object-level of control, e.g., using a closed-chain definition, and parameterizing the internal forces for each of grasp type.

  13. Full-order optimal compensators for flow control: the multiple inputs case

    Semeraro, Onofrio; Pralits, Jan O.

    2018-03-01

    Flow control has been the subject of numerous experimental and theoretical works. We analyze full-order, optimal controllers for large dynamical systems in the presence of multiple actuators and sensors. The full-order controllers do not require any preliminary model reduction or low-order approximation: this feature allows us to assess the optimal performance of an actuated flow without relying on any estimation process or further hypothesis on the disturbances. We start from the original technique proposed by Bewley et al. (Meccanica 51(12):2997-3014, 2016. https://doi.org/10.1007/s11012-016-0547-3), the adjoint of the direct-adjoint (ADA) algorithm. The algorithm is iterative and allows bypassing the solution of the algebraic Riccati equation associated with the optimal control problem, typically infeasible for large systems. In this numerical work, we extend the ADA iteration into a more general framework that includes the design of controllers with multiple, coupled inputs and robust controllers (H_{∞} methods). First, we demonstrate our results by showing the analytical equivalence between the full Riccati solutions and the ADA approximations in the multiple inputs case. In the second part of the article, we analyze the performance of the algorithm in terms of convergence of the solution, by comparing it with analogous techniques. We find an excellent scalability with the number of inputs (actuators), making the method a viable way for full-order control design in complex settings. Finally, the applicability of the algorithm to fluid mechanics problems is shown using the linearized Kuramoto-Sivashinsky equation and the Kármán vortex street past a two-dimensional cylinder.

  14. Coordinated Formation Control of Multiple Autonomous Underwater Vehicles for Pipeline Inspection

    Xianbo Xiang

    2010-02-01

    Full Text Available This paper addresses the control problem of inspecting underwater pipeline on the seabed, with coordinated multiple autonomous underwater vehicles in a formation. Based on the leader-follower strategy, the dedicated nonlinear path following controller is rigorously built on Lyapunov-based design, driving a fleet of vehicles onto assigned parallel paths elevated and offset from the underwater pipeline, while keeping a triangle formation to capture complete 3D images for inspection. Due to the spatial-temporal decoupling characteristics of individual path following controller, the velocities of the followers can be adapted in the coordinated control level, only relying on the information of generalized along-path length from the leader, in order to build the desired formation. Thus, the communication variable broadcast from the leader is kept to a minimum, which is feasible under the severely constraints of acoustic communication bandwidth. Simulation results illustrate the efficiency of coordinated formation controller proposed for underwater pipeline inspection.

  15. Comparison of Masking Level Difference in Patients with Multiple Sclerosis and Healthy Control Group

    Soghrat Faghihzadeh

    2012-03-01

    Full Text Available Background and Aim: Multiple sclerosis (MS is a neurological disorder that involves central nervous system. Studies have showed that multiple sclerosis affects behavioral central auditory tests, such as masking release or masking level difference (MLD. The purpose of this study is to compare the masking level difference between multiple sclerosis patients and normal subjects.Methods: This cross sectional and non-interventional study was conducted on 32 multiple sclerosis patients aged between 20-50 years and 32 controls matched for age and gender in Faculty of Rehabilitation, Tehran University of Medical Sciences. masking level difference test was performed on each subject.Results: The mean masking level difference in the two groups was significantly different (p<0.01 however, gender did not prove to play a role in this difference.Conclusion: As part of the multiple sclerosis diagnosis panel, masking level difference test is an efficient modality for evaluation of hearing impairment and monitoring of rehabilitation progress.

  16. A pilot randomized controlled trial using EEG-based brain–computer interface training for a Chinese-speaking group of healthy elderly

    Lee TS

    2015-01-01

    Full Text Available Tih-Shih Lee,1 Shin Yi Quek,1 Siau Juinn Alexa Goh,1 Rachel Phillips,2 Cuntai Guan,3 Yin Bun Cheung,4 Lei Feng,5 Chuan Chu Wang,3 Zheng Yang Chin,3 Haihong Zhang,3 Jimmy Lee,6 Tze Pin Ng,5 K Ranga Rama Krishnan1 1Department of Neuroscience and Behavioral Disorders, Duke-NUS Graduate Medical School, Singapore; 2Singapore Clinical Research Institute, Singapore; 3Institute for Infocomm Research, Agency for Science, Technology and Research, Singapore; 4Centre for Quantitative Medicine, Duke-NUS Graduate Medical School, Singapore; 5Department of Psychological Medicine, National University of Singapore, Singapore; 6Department of General Psychiatry/Department of Research, Institute of Mental Health, Singapore Background: There is growing evidence that cognitive training (CT can improve the cognitive functioning of the elderly. CT may be influenced by cultural and linguistic factors, but research examining CT programs has mostly been conducted on Western populations. We have developed an innovative electroencephalography (EEG-based brain–computer interface (BCI CT program that has shown preliminary efficacy in improving cognition in 32 healthy English-speaking elderly adults in Singapore. In this second pilot trial, we examine the acceptability, safety, and preliminary efficacy of our BCI CT program in healthy Chinese-speaking Singaporean elderly.Methods: Thirty-nine elderly participants were randomized into intervention (n=21 and waitlist control (n=18 arms. Intervention consisted of 24 half-hour sessions with our BCI-based CT training system to be completed in 8 weeks; the control arm received the same intervention after an initial 8-week waiting period. At the end of the training, a usability and acceptability questionnaire was administered. Efficacy was measured using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS, which was translated and culturally adapted for the Chinese-speaking local population. Users were asked

  17. Effect of Tai Ji Quan training on self-reported sleep quality in elderly Chinese women with knee osteoarthritis: a randomized controlled trail.

    Lü, Jiaojiao; Huang, Lingyan; Wu, Xie; Fu, Weijie; Liu, Yu

    2017-05-01

    The purpose of this study was to explore the effects of a 24-week Tai Ji Quan training program on sleep quality, quality of life, and physical performance among elderly Chinese women with knee osteoarthritis (OA). A 24-week randomized, controlled trial of 46 elderly women with knee OA. Participants were randomly assigned to either a Tai Ji Quan group (n = 23) or a control group (n = 23). Participants in the Tai Ji Quan group completed training sessions three times per week, while those in the control group had bi-weekly educational classes. The primary outcome was total score of the Pittsburgh Sleep Quality of Index (PSQI). Secondary outcomes were: seven subscales of the PSQI; sleep latency; total sleep time; sleep efficiency; physical component summary (PCS) and mental component summary (MCS) of the 36-item Short Form Health Survey (SF-36); Berg Balance Scale (BBS); and Timed Up and Go (TUG). Compared with the control group, participants in the Tai Ji Quan group had significantly improved primary outcome (global PSQI score, p = 0.006) and secondary outcomes, including three PSQI sub-scores (sleep latency, p = 0.031; sleep duration, p = 0.043; daytime dysfunction, p = 0.007), total sleep time (p = 0.033), and SF-36 PCS (p = 0.006). The Tai Ji Quan group also had significant improvements compared with baseline in three PSQI sub-scores (sleep latency, p = 0.031; habitual sleep efficiency, p = 0.049; sleep disturbance, p = 0.016), sleep latency (p = 0.003), BBS (p = 0.001), and TUG (p = 0.006). Tai Ji Quan training is an effective treatment approach to improve sleep quality and quality of life in elderly Chinese women with knee OA. Chinese Clinical Trial Registry (June 16, 2013): ChiCTR-TRC-13003264. Copyright © 2017 Elsevier B.V. All rights reserved.

  18. The relationship of SSRI and SNRI usage with interstitial lung disease and bronchiectasis in an elderly population: a case–control study

    Rosenberg T

    2017-11-01

    Full Text Available Ted Rosenberg,1 Rory Lattimer,2 Patrick Montgomery,3 Christian Wiens,4 Liran Levy5 1Department of Family Medicine, University of British Columbia and Island Medical Program, Victoria, BC, 2Home Team Medical Services, Victoria, BC, 3Division of Geriatric Medicine, University of British Columbia, Victoria, BC, 4Geriatric Psychiatry, University of British Columbia, Victoria, BC, 5Lung Transplant Program, Toronto General Hospital, Toronto, ON, Canada Background: The association between interstitial lung disease (ILD and selective serotonin reuptake inhibitors and serotonin norepinephrine reuptake inhibitors (SSRI/SNRI has been previously described in published case reports. However, its prevalence may be more common than expected. We examined the association between SSRI/SNRI usage and presence of ILD and or bronchiectasis (ILD/B in an elderly population.Methods: We conducted a retrospective case series and case–control study involving all 296 eligible elderly patients in one primary care geriatric practice in Victoria, BC, Canada. Cases required the presence of ILD/B on computed tomography (CT or chest X-ray (CXR. Cases were excluded if they had other causes for ILD/B on CXR or CT such as exposure to known pneumotoxic drugs, metastatic cancer, rheumatoid lung disease, sarcoidosis, previous pulmonary tuberculosis, or pneumoconiosis. Data were abstracted from the patients’ medical record. The exposure variable was standardized cumulative person-month (p-m dose of SSRI/SNRI. The study was approved by the Clinical Research Ethics Board of University of British Columbia with a waiver of informed consent.Results: A total of 12 cases and 273 controls were identified. Their mean ages were 89.0 and 88.7 years, respectively (p=0.862. A total of 10/12 cases and 99/273 controls were exposed to SSRI/SNRI. The odds ratio was 8.79, 95% confidence interval 2.40–32.23 (p=0.001. The median p-m exposure to SSRI/SNRI was 110.0 months for cases and 29.5 for

  19. Clinical relevance of specific cognitive complaints in determining Mild Cognitive Impairment from Cognitively Normal States in a study of Healthy Elderly Controls

    Marina Avila Villanueva

    2016-10-01

    Full Text Available Introduction: Subjective memory complaints in the elderly have been suggested as an early sign of dementia. This study aims at investigating whether specific cognitive complaints are more useful than others to discriminate Mild Cognitive Impairment (MCI by examining the dimensional structure of the Everyday Memory Questionnaire (EMQ.Material and Methods: A sample of community-dwelling elderly individuals was recruited (766 controls and 78 MCI. The Everyday Memory Questionnaire (EMQ was administered to measure self-perception of cognitive complaints. All participants also underwent a comprehensive clinical and neuropsychological battery. Combined exploratory factor analysis and item response theory were performed to identify the underlying structure of the EMQ. Furthermore, logistic regression analyses were conducted to study whether single cognitive complaints were able to predict MCI.Results: A suitable five-factor solution was found. Each factor focused on a different cognitive domain. Interestingly, just three of them, namely forgetfulness of immediate information, executive functions and prospective memory proved to be effective in distinguishing between cognitively healthy individuals and MCI. Based on these results we propose a shortened EMQ version comprising 10 items (EMQ-10.Discussion: Not all cognitive complaints have the same clinical relevance. Only subjective complaints on specific cognitive domains are able to discriminate MCI. We encourage clinicians to the EMQ-10 as a useful tool to quantify and monitor the progression of individuals who report cognitive complaints.

  20. Effects of Tai Chi versus Proprioception Exercise Program on Neuromuscular Function of the Ankle in Elderly People: A Randomized Controlled Trial

    Jing Liu

    2012-01-01

    Full Text Available Background. Tai Chi is a traditional Chinese medicine exercise used for improving neuromuscular function. This study aimed to investigate the effects of Tai Chi versus proprioception exercise program on neuromuscular function of the ankle in elderly people. Methods. Sixty elderly subjects were randomly allocated into three groups of 20 subjects per group. For 16 consecutive weeks, subjects participated in Tai Chi, proprioception exercise, or no structured exercise. Primary outcome measures included joint position sense and muscle strength of ankle. Subjects completed a satisfaction questionnaire upon study completion in Tai Chi and proprioception groups. Results. (1 Both Tai Chi group and proprioception exercise group were significantly better than control group in joint position sense of ankle, and there were no significant differences in joint position sense of ankle between TC group and PE group. (2 There were no significant differences in muscle strength of ankle among groups. (3 Subjects expressed more satisfaction with Tai Chi than with proprioception exercise program. Conclusions. None of the outcome measures on neuromuscular function at the ankle showed significant change posttraining in the two structured exercise groups. However, the subjects expressed more interest in and satisfaction with Tai Chi than proprioception exercise.

  1. The effect of lower limb rehabilitation gymnastics on postoperative rehabilitation in elderly patients with femoral shaft fracture: A retrospective case-control study.

    Yang, Si-Dong; Ning, Sheng-Hua; Zhang, Li-Hong; Zhang, Ying-Ze; Ding, Wen-Yuan; Yang, Da-Long

    2016-08-01

    The purpose of this study was to explore the effect of lower limb rehabilitation gymnastics on postoperative rehabilitation in elderly patients with femoral shaft fracture after undergoing intramedullary nail fixation surgery.We collected medical records of elderly patients aged ≥ 60 years with femoral shaft fracture between 03/2010 and 03/2015 in Longyao County Hospital. Totally, 160 patients were identified and divided into the intervention group (n = 80) and the control group (n = 80). During the postoperative period, the intervention group received lower limb rehabilitation gymnastics treatment for 3 months, but the control group did not. All patients were routinely asked to return hospital for a check in the 1st postoperative week, as well as the 2nd week, the 1st month, and the 3rd month, after surgery. The clinical rehabilitation effect was evaluated by checking lower limb action ability, detecting the lower limb deep venous thrombosis (DVT), scoring muscle strength of quadriceps and visual analog scale (VAS) score, and performing satisfaction survey.At the 1st week and 2nd week after surgery, the clinical rehabilitation effect in the intervention group was better regarding lower limb action ability, lower limb DVT, muscle strength of quadriceps, VAS score, and patient satisfaction, as compared with the control group. However, there was no significant difference at the 1st month and the 3rd month after surgery when comparing the intervention group to the control group.In the early postoperative stage, lower limb rehabilitation gymnastics can effectively improve the recovery of lower limb function, beneficial to reducing postoperative complications such as lower limb DVT and muscle atrophy, and increasing patient satisfaction rate.

  2. Risk Factors for new accidental falls in elderly patients at traumatology ambulatory center

    Daiane Porto Gautério

    2015-04-01

    Full Text Available Objective. To identify the risks factors for new accidental falls in elderly patients attended in the Traumatology Ambulatory of a University hospital in Rio Grande do Sul, Brazil. Methodology. Quantitative study of the type of multiple cases. Performed at the traumatology ambulatory, amongst fifteen elders that attended the inclusion criteria: age of sixty or more; patient at the traumatology ambulatory because of a fall motivated by accident, oriented and in conditions of answer an interview of data collectors. The data collection was made between April and June, 2013, with the Elderly Nursing Core Set scale (Lopes & Fonseca. The data analysis was made by a descriptive structure, which helped identify the existence of relation patterns among the cases. Results. The risk factors for new accidental falls identified with larger incidence amongst the elders studied were: impaired balance (15/15, age above 65 (11/15, use of antihypertensive drugs (9/15, absence of non-slip material at home environment (7/15, in seven cases; rugs scattered at the floor of the house (6/15. Conclusion. The combination of intrinsic and extrinsic factors that include the environmental risks is considered a much more relevant cause to occur the new falls. The minimization of the home dangers, allied to the control of the elder intrinsic factors, may reduce the risks of causes. In that sense, is necessary that the nursing team make available more attention to the elderly assisted at the ambulatories, mainly those with sequelae due to fall accidents.

  3. Risk Factors for new accidental falls in elderly patients at traumatology ambulatory center.

    Porto Gautério, Daiane; Zortea, Bruna; Costa Santos, Silvana Sidney; da Silva Tarouco, Bárbara; Lopes, Manoel José; João Fonseca, Cesar

    2015-01-01

    To identify the risks factors for new accidental falls in elderly patients attended in the Traumatology Ambulatory of a University hospital in Rio Grande do Sul, Brazil. Quantitative study of the type of multiple cases. Performed at the traumatology ambulatory, amongst fifteen elders that attended the inclusion criteria: age of sixty or more; patient at the traumatology ambulatory because of a fall motivated by accident, oriented and in conditions of answer an interview of data collectors. The data collection was made between April and June, 2013, with the Elderly Nursing Core Set scale (Lopes & Fonseca). The data analysis was made by a descriptive structure, which helped identify the existence of relation patterns among the cases. The risk factors for new accidental falls identified with larger incidence amongst the elders studied were: impaired balance (15/15), age above 65 (11/15), use of antihypertensive drugs (9/15), absence of non-slip material at home environment (7/15), in seven cases; rugs scattered at the floor of the house (6/15). The combination of intrinsic and extrinsic factors that include the environmental risks is considered a much more relevant cause to occur the new falls. The minimization of the home dangers, allied to the control of the elder intrinsic factors, may reduce the risks of causes. In that sense, is necessary that the nursing team make available more attention to the elderly assisted at the ambulatories, mainly those with sequelae due to fall accidents.

  4. Multiple Model Predictive Hybrid Feedforward Control of Fuel Cell Power Generation System

    Long Wu

    2018-02-01

    Full Text Available Solid oxide fuel cell (SOFC is widely considered as an alternative solution among the family of the sustainable distributed generation. Its load flexibility enables it adjusting the power output to meet the requirements from power grid balance. Although promising, its control is challenging when faced with load changes, during which the output voltage is required to be maintained as constant and fuel utilization rate kept within a safe range. Moreover, it makes the control even more intractable because of the multivariable coupling and strong nonlinearity within the wide-range operating conditions. To this end, this paper developed a multiple model predictive control strategy for reliable SOFC operation. The resistance load is regarded as a measurable disturbance, which is an input to the model predictive control as feedforward compensation. The coupling is accommodated by the receding horizon optimization. The nonlinearity is mitigated by the multiple linear models, the weighted sum of which serves as the final control execution. The merits of the proposed control structure are demonstrated by the simulation results.

  5. Effects of Pilates exercises on sensory interaction, postural control and fatigue in patients with multiple sclerosis.

    Soysal Tomruk, Melda; Uz, Muhammed Zahid; Kara, Bilge; İdiman, Egemen

    2016-05-01

    Decreased postural control, sensory integration deficits and fatigue are important problems that cause functional impairments in patients with multiple sclerosis (pwMS). To examine the effect of modified clinical Pilates exercises on sensory interaction and balance, postural control and fatigue in pwMS. Eleven patients with multiple sclerosis and 12 healthy matched controls were recruited in this study. Limits of stability and postural stability tests were used to evaluate postural control by Biodex Balance System and sensory interaction assessed. Fatigue was assessed by Modified Fatigue Impact Scale. Pilates exercises were applied two times a week for 10 weeks and measurements were repeated to pwMS after exercise training. Postural control and fatigue (except psychosocial parameter) of pwMS were significantly worser than healthy controls (pPilates training (ppilates exercises (p>0.05). Ten-week Pilates training is effective to improve sensory interaction and to decrease fatigue. Pilates exercises can be applied safely in ambulatory pwMS for enhance sensory interaction and balance and combat fatigue. More investigations are needed. Copyright © 2016 Elsevier B.V. All rights reserved.

  6. Relationships between trunk performance, gait and postural control in persons with multiple sclerosis.

    Freund, Jane E; Stetts, Deborah M; Vallabhajosula, Srikant

    2016-06-30

    Multiple sclerosis (MS) is a chronic progressive disease of the central nervous system. Compared to healthy individuals, persons with multiple sclerosis (PwMS) have increased postural sway in quiet stance, decreased gait speed and increased fall incidence. Trunk performance has been implicated in postural control, gait dysfunction, and fall prevention in older adults. However, the relationship of trunk performance to postural control and gait has not been adequately studied in PwMS. To compare trunk muscle structure and performance in PwMS to healthy age and gendered-matched controls (HC); to determine the effects of isometric trunk endurance testing on postural control in both populations; and to determine the relationship of trunk performance with postural control, gait and step activity in PwMS. Fifteen PwMS and HC completed ultrasound imaging of trunk muscles, 10 m walk test, isometric trunk endurance tests, and postural sway test. Participants wore a step activity monitor for 7 days. PwMS had worse isometric trunk endurance compared to HC. PwMS trunk flexion endurance negatively correlated to several postural control measures and positively correlated to gait speed and step activity. Clinicians should consider evaluation and interventions directed at impaired trunk endurance in PwMS.

  7. Design and selection of load control strategies using a multiple objective model and evolutionary algorithms

    Gomes, Alvaro; Antunes, Carlos Henggeler; Martins, Antonio Gomes

    2005-01-01

    This paper aims at presenting a multiple objective model to evaluate the attractiveness of the use of demand resources (through load management control actions) by different stakeholders and in diverse structure scenarios in electricity systems. For the sake of model flexibility, the multiple (and conflicting) objective functions of technical, economical and quality of service nature are able to capture distinct market scenarios and operating entities that may be interested in promoting load management activities. The computation of compromise solutions is made by resorting to evolutionary algorithms, which are well suited to tackle multiobjective problems of combinatorial nature herein involving the identification and selection of control actions to be applied to groups of loads. (Author)

  8. A distributed Synchronous reservation multiple access control protocol for mobile Ad hoc networks

    ZHANG Yanling; SUN Xianpu; LI Jiandong

    2007-01-01

    This study proposes a new multiple access control protocol named distributed synchronous reservation multiple access control protocol.in which the hidden and exposed terminal problems are solved,and the quality of service(QoS)requirements for real-time traffic are guaranteed.The protocol is founded on time division multiplex address and a different type of traffic is assigned to difierent priority,according to which a node should compete for and reserve the free slots in a different method.Moreover,there is a reservation acknowledgement process before data transmit in each reserved slot,so that the intruded terminal problem is solved.The throughput and average packets drop probability of this protocol are analyzed and simulated in a fully connected network.the results of which indicate that this protocol is efficient enough to support the real-time traffic.and it is more suitable to MANETs.

  9. A multiple-fan active control wind tunnel for outdoor wind speed and direction simulation

    Wang, Jia-Ying; Meng, Qing-Hao; Luo, Bing; Zeng, Ming

    2018-03-01

    This article presents a new type of active controlled multiple-fan wind tunnel. The wind tunnel consists of swivel plates and arrays of direct current fans, and the rotation speed of each fan and the shaft angle of each swivel plate can be controlled independently for simulating different kinds of outdoor wind fields. To measure the similarity between the simulated wind field and the outdoor wind field, wind speed and direction time series of two kinds of wind fields are recorded by nine two-dimensional ultrasonic anemometers, and then statistical properties of the wind signals in different time scales are analyzed based on the empirical mode decomposition. In addition, the complexity of wind speed and direction time series is also investigated using multiscale entropy and multivariate multiscale entropy. Results suggest that the simulated wind field in the multiple-fan wind tunnel has a high degree of similarity with the outdoor wind field.

  10. Evidence from intrinsic activity that asymmetry of the human brain is controlled by multiple factors.

    Liu, Hesheng; Stufflebeam, Steven M; Sepulcre, Jorge; Hedden, Trey; Buckner, Randy L

    2009-12-01

    Cerebral lateralization is a fundamental property of the human brain and a marker of successful development. Here we provide evidence that multiple mechanisms control asymmetry for distinct brain systems. Using intrinsic activity to measure asymmetry in 300 adults, we mapped the most strongly lateralized brain regions. Both men and women showed strong asymmetries with a significant, but small, group difference. Factor analysis on the asymmetric regions revealed 4 separate factors that each accounted for significant variation across subjects. The factors were associated with brain systems involved in vision, internal thought (the default network), attention, and language. An independent sample of right- and left-handed individuals showed that hand dominance affects brain asymmetry but differentially across the 4 factors supporting their independence. These findings show the feasibility of measuring brain asymmetry using intrinsic activity fluctuations and suggest that multiple genetic or environmental mechanisms control cerebral lateralization.

  11. A nonlinear disturbance-decoupled elevation axis controller for the Multiple Mirror Telescope

    Clark, Dusty; Trebisky, Tom; Powell, Keith

    2008-07-01

    The Multiple Mirror Telescope (MMT), upgraded in 2000 to a monolithic 6.5m primary mirror from its original array of six 1.8m primary mirrors, was commissioned with axis controllers designed early in the upgrade process without regard to structural resonances or the possibility of the need for digital filtering of the control axis signal path. Post-commissioning performance issues led us to investigate replacement of the original control system with a more modern digital controller with full control over the system filters and gain paths. This work, from system identification through controller design iteration by simulation, and pre-deployment hardware-in-the-loop testing, was performed using latest-generation tools with Matlab® and Simulink®. Using Simulink's Real Time Workshop toolbox to automatically generate C source code for the controller from the Simulink diagram and a custom target build script, we were able to deploy the new controller into our existing software infrastructure running Wind River's VxWorks™real-time operating system. This paper describes the process of the controller design, including system identification data collection, with discussion of implementation of non-linear control modes and disturbance decoupling, which became necessary to obtain acceptable wind buffeting rejection.

  12. Formation Learning Control of Multiple Autonomous Underwater Vehicles With Heterogeneous Nonlinear Uncertain Dynamics.

    Yuan, Chengzhi; Licht, Stephen; He, Haibo

    2017-09-26

    In this paper, a new concept of formation learning control is introduced to the field of formation control of multiple autonomous underwater vehicles (AUVs), which specifies a joint objective of distributed formation tracking control and learning/identification of nonlinear uncertain AUV dynamics. A novel two-layer distributed formation learning control scheme is proposed, which consists of an upper-layer distributed adaptive observer and a lower-layer decentralized deterministic learning controller. This new formation learning control scheme advances existing techniques in three important ways: 1) the multi-AUV system under consideration has heterogeneous nonlinear uncertain dynamics; 2) the formation learning control protocol can be designed and implemented by each local AUV agent in a fully distributed fashion without using any global information; and 3) in addition to the formation control performance, the distributed control protocol is also capable of accurately identifying the AUVs' heterogeneous nonlinear uncertain dynamics and utilizing experiences to improve formation control performance. Extensive simulations have been conducted to demonstrate the effectiveness of the proposed results.

  13. FPGA implementation of high-frequency multiple PWM for variable voltage variable frequency controller

    Boumaaraf, Abdelâali, E-mail: aboumaaraf@yahoo.fr [Université Abbès Laghrour, Laboratoire des capteurs, Instrumentations et procédés (LCIP), Khenchela (Algeria); University of Farhat Abbas Setif1, Sétif, 19000 (Algeria); Mohamadi, Tayeb [University of Farhat Abbas Setif1, Sétif, 19000 (Algeria); Gourmat, Laïd [Université Abbès Laghrour, Khenchela, 40000 (Algeria)

    2016-07-25

    In this paper, we present the FPGA implementation of the multiple pulse width modulation (MPWM) signal generation with repetition of data segments, applied to the variable frequency variable voltage systems and specially at to the photovoltaic water pumping system, in order to generate a signal command very easily between 10 Hz to 60 Hz with a small frequency and reduce the cost of the control system.

  14. Participant recruitment into a randomised controlled trial of exercise therapy for people with multiple sclerosis

    Carter, Anouska; Humphreys, Liam; Snowdon, Nicky; Sharrack, Basil; Daley, Amanda; Petty, Jane; Woodroofe, Nicola; Saxton, John

    2015-01-01

    Background The success of a clinical trial is often dependant on whether recruitment targets can be met in the required time frame. Despite an increase in research into the benefits of exercise in people with multiple sclerosis (PwMS), no trial has reported detailed data on effective recruitment strategies for large-scale randomised controlled trials. The main purpose of this report is to provide a detailed outline of recruitment strategies, rates and estimated costs in the Exercise Intervent...

  15. Evidence from intrinsic activity that asymmetry of the human brain is controlled by multiple factors

    Liu, Hesheng; Stufflebeam, Steven M.; Sepulcre, Jorge; Hedden, Trey; Buckner, Randy L.

    2009-01-01

    Cerebral lateralization is a fundamental property of the human brain and a marker of successful development. Here we provide evidence that multiple mechanisms control asymmetry for distinct brain systems. Using intrinsic activity to measure asymmetry in 300 adults, we mapped the most strongly lateralized brain regions. Both men and women showed strong asymmetries with a significant, but small, group difference. Factor analysis on the asymmetric regions revealed 4 separate factors that each ac...

  16. Características da tuberculose em idosos no Recife (PE: contribuição para o programa de controle Characteristics of elderly tuberculosis patients in Recife, Brazil: a contribution to the tuberculosis control program

    Zilda do Rego Cavalcanti

    2006-12-01

    Full Text Available OBJETIVO: Descrever as características demográficas, de hábitos de vida, socioeconômicas, clínico-epidemiológicas e de acesso aos serviços de saúde de idosos com tuberculose, diagnosticados e tratados no Recife (PE, e compará-las com os adultos jovens em mesmas condições. MÉTODOS: Utilizou-se uma estratégia de análise do tipo caso-controle em uma coorte de pacientes com tuberculose, atendidos nas unidades de saúde pública do Recife no período de maio de 2001 a julho de 2003. RESULTADOS: Foram incluídos no estudo 1.127 pacientes, 136 idosos (casos e 991 adultos jovens (controles. Nos dois grupos o sexo prevalente foi o masculino e a forma da doença a pulmonar. O etilismo foi mais freqüente entre os controles e o analfabetismo entre os casos. Os idosos queixaram-se menos de tosse, sudorese e dor torácica. A sorologia para o vírus da imunodeficiência humana foi realizada em apenas 29 pacientes (2,6%. Os controles tiveram maior percentual de positividade nos exames de baciloscopia e cultura. Ambos os grupos tiveram que procurar mais de dois serviços de saúde e passaram-se mais de dois meses até que se fizesse o diagnóstico da doença. Os idosos tiveram maiores índices de cura e óbito, e abandonaram menos o tratamento. CONCLUSÃO: Na população estudada, os idosos apresentaram menos tosse, sudorese noturna e dor torácica, menor positividade nos exames complementares e maior mortalidade. Devem constituir um grupo com abordagem especial dos serviços de saúde pública.OBJECTIVE: To describe the demographic characteristics, everyday habits, socio-economic conditions, clinico-epidemiological profiles and access to health care services among the elderly patients with tuberculosis diagnosed and treated in the city of Recife, Brazil, comparing them to those observed in young adults with tuberculosis. METHODS: A case-control type strategy was used to evaluate a cohort of patients with tuberculosis, all of whom were treated in

  17. The elderly patients' dignity

    Høy, Bente; Hall, E.O.C.; Wagner, L.

    2007-01-01

    the principles of nursing practice, protecting, enhancing and promoting the elderly patient's health potential. It is suggested that these themes of dignity provide a frame of reference in elder care; they shape the understanding of when health issues become a concern for health-promoting care for the elderly...... patient and what goals should be defined. Key words: Dignity, elderly patient, phenomenological hermeneutical method....

  18. Synthesis of Carbon Dots with Multiple Color Emission by Controlled Graphitization and Surface Functionalization.

    Miao, Xiang; Qu, Dan; Yang, Dongxue; Nie, Bing; Zhao, Yikang; Fan, Hongyou; Sun, Zaicheng

    2018-01-01

    Multiple-color-emissive carbon dots (CDots) have potential applications in various fields such as bioimaging, light-emitting devices, and photocatalysis. The majority of the current CDots to date exhibit excitation-wavelength-dependent emissions with their maximum emission limited at the blue-light region. Here, a synthesis of multiple-color-emission CDots by controlled graphitization and surface function is reported. The CDots are synthesized through controlled thermal pyrolysis of citric acid and urea. By regulating the thermal-pyrolysis temperature and ratio of reactants, the maximum emission of the resulting CDots gradually shifts from blue to red light, covering the entire light spectrum. Specifically, the emission position of the CDots can be tuned from 430 to 630 nm through controlling the extent of graphitization and the amount of surface functional groups, COOH. The relative photoluminescence quantum yields of the CDots with blue, green, and red emission reach up to 52.6%, 35.1%, and 12.9%, respectively. Furthermore, it is demonstrated that the CDots can be uniformly dispersed into epoxy resins and be fabricated as transparent CDots/epoxy composites for multiple-color- and white-light-emitting devices. This research opens a door for developing low-cost CDots as alternative phosphors for light-emitting devices. © 2017 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  19. The relationship between AGT gene polymorphism and carotid ultrasound changes in elderly patients with hypertension and type-2 diabetes mellitus

    Pu Jianhong; Li Jianzhong; Wu Xiuying; Qian Huiying; Liu Jian

    2012-01-01

    Objective: To observe the relation between angiotensinogen (AGT) gene polymorphism and carotid ultrasound change in the elderly hypertensive patients with type 2 diabetes mellitus (T2DM). Methods: Two hundred and three cases of hospitalization of the elderly were divided into three groups, 105 cases of elderly patients with hypertension; 38 cases of elderly hypertensive patients with T2DM; 60 cases of healthy elderly subjects (the control group) and lipids were measured after admission and carotid ultrasonography were performed. The M235T polymorphism detection was carried out by polymerase chain reaction (PCR) and restriction fragment length polymorphism analysis. Results: (1) TT genotype of AGT gene and elderly hypertensive with T2DM group carotid ultrasound abnormal rate increased and multi vessel disease was the main occurrence. (2) Multiple vessel disease of the carotid artery ultrasound and their blood lipid level were significantly increased. Conclusion: Hypertension and T2DM in elderly patients, carotid artery ultrasound abnormalities are significantly increased, while the elevated lipid levels and the TT genotype of the AGT gene artery atherosclerosis is further enhanced. (authors)

  20. A multiple-time-scale approach to the control of ITBs on JET

    Laborde, L.; Mazon, D.; Moreau, D. [EURATOM-CEA Association (DSM-DRFC), CEA Cadarache, 13 - Saint Paul lez Durance (France); Moreau, D. [Culham Science Centre, EFDA-JET, Abingdon, OX (United Kingdom); Ariola, M. [EURATOM/ENEA/CREATE Association, Univ. Napoli Federico II, Napoli (Italy); Cordoliani, V. [Ecole Polytechnique, 91 - Palaiseau (France); Tala, T. [EURATOM-Tekes Association, VTT Processes (Finland)

    2005-07-01

    The simultaneous real-time control of the current and temperature gradient profiles could lead to the steady state sustainment of an internal transport barrier (ITB) and so to a stationary optimized plasma regime. Recent experiments in JET have demonstrated significant progress in achieving such a control: different current and temperature gradient target profiles have been reached and sustained for several seconds using a controller based on a static linear model. It's worth noting that the inverse safety factor profile evolves on a slow time scale (resistive time) while the normalized electron temperature gradient reacts on a faster one (confinement time). Moreover these experiments have shown that the controller was sensitive to rapid plasma events such as transient ITBs during the safety factor profile evolution or MHD instabilities which modify the pressure profiles on the confinement time scale. In order to take into account the different dynamics of the controlled profiles and to better react to rapid plasma events the control technique is being improved by using a multiple-time-scale approximation. The paper describes the theoretical analysis and closed-loop simulations using a control algorithm based on two-time-scale state-space model. These closed-loop simulations using the full dynamic but linear model used for the controller design to simulate the plasma response have demonstrated that this new controller allows the normalized electron temperature gradient target profile to be reached faster than the one used in previous experiments. (A.C.)

  1. A multiple-time-scale approach to the control of ITBs on JET

    Laborde, L.; Mazon, D.; Moreau, D.; Moreau, D.; Ariola, M.; Cordoliani, V.; Tala, T.

    2005-01-01

    The simultaneous real-time control of the current and temperature gradient profiles could lead to the steady state sustainment of an internal transport barrier (ITB) and so to a stationary optimized plasma regime. Recent experiments in JET have demonstrated significant progress in achieving such a control: different current and temperature gradient target profiles have been reached and sustained for several seconds using a controller based on a static linear model. It's worth noting that the inverse safety factor profile evolves on a slow time scale (resistive time) while the normalized electron temperature gradient reacts on a faster one (confinement time). Moreover these experiments have shown that the controller was sensitive to rapid plasma events such as transient ITBs during the safety factor profile evolution or MHD instabilities which modify the pressure profiles on the confinement time scale. In order to take into account the different dynamics of the controlled profiles and to better react to rapid plasma events the control technique is being improved by using a multiple-time-scale approximation. The paper describes the theoretical analysis and closed-loop simulations using a control algorithm based on two-time-scale state-space model. These closed-loop simulations using the full dynamic but linear model used for the controller design to simulate the plasma response have demonstrated that this new controller allows the normalized electron temperature gradient target profile to be reached faster than the one used in previous experiments. (A.C.)

  2. Simultaneous control of multiple instruments at the Advanced Technology Solar Telescope

    Johansson, Erik M.; Goodrich, Bret

    2012-09-01

    The Advanced Technology Solar Telescope (ATST) is a 4-meter solar observatory under construction at Haleakala, Hawaii. The simultaneous use of multiple instruments is one of the unique capabilities that makes the ATST a premier ground based solar observatory. Control of the instrument suite is accomplished by the Instrument Control System (ICS), a layer of software between the Observatory Control System (OCS) and the instruments. The ICS presents a single narrow interface to the OCS and provides a standard interface for the instruments to be controlled. It is built upon the ATST Common Services Framework (CSF), an infrastructure for the implementation of a distributed control system. The ICS responds to OCS commands and events, coordinating and distributing them to the various instruments while monitoring their progress and reporting the status back to the OCS. The ICS requires no specific knowledge about the instruments. All information about the instruments used in an experiment is passed by the OCS to the ICS, which extracts and forwards the parameters to the appropriate instrument controllers. The instruments participating in an experiment define the active instrument set. A subset of those instruments must complete their observing activities in order for the experiment to be considered complete and are referred to as the must-complete instrument set. In addition, instruments may participate in eavesdrop mode, outside of the control of the ICS. All instrument controllers use the same standard narrow interface, which allows new instruments to be added without having to modify the interface or any existing instrument controllers.

  3. The effect of magnesium supplementation on primary insomnia in elderly: A double-blind placebo-controlled clinical trial

    Behnood Abbasi

    2012-01-01

    Full Text Available Background: Nearly 50% of older adults have insomnia, with difficulty in getting to sleep, early awakening, or feeling unrefreshed on waking. With aging, several changes occur that can place one at risk for insomnia, including age-related changes in various circadian rhythms, environmental and lifestyle changes, and decreased nutrients intake, absorption, retention, and utilization. The natural N-methyl-D-aspartic acid (NMDA antagonist and GABA agonist, Mg 2+ , seems to play a key role in the regulation of sleep. The objective of this study was to determine the efficacy of magnesium supplementation to improve insomnia in elderly. Materials and Methods: A double-blind randomized clinical trial was conducted in 46 elderly subjects, randomly allocated into the magnesium or the placebo group and received 500 mg magnesium or placebo daily for 8 weeks. Questionnaires of insomnia severity index (ISI, physical activity, and sleep log were completed at baseline and after the intervention period. Anthropometric confounding factors, daily intake of magnesium, calcium, potassium, caffeine, calories form carbohydrates, and total calorie intake, were obtained using 24-h recall for 3 days. Blood samples were taken at baseline and after the intervention period for analysis of serum magnesium, renin, melatonin, and cortisol. Statistical analyses were performed using SPSS 19 and P values < 0.05 were considered as statistically significant. Results: No significant differences were observed in assessed variables between the two groups at the baseline. As compared to the placebo group, in the experimental group, dietary magnesium supplementation brought about statistically significant increases in sleep time ( P = 0.002, sleep efficiency ( P = 0.03, concentration of serum renin ( P < 0.001, and melatonin ( P = 0.007, and also resulted in significant decrease of ISI score ( P = 0.006, sleep onset latency ( P = 0.02 and serum cortisol concentration ( P = 0

  4. Multiple-Time-Scales Hierarchical Frequency Stability Control Strategy of Medium-Voltage Isolated Microgrid

    Zhao, Zhuoli; Yang, Ping; Guerrero, Josep M.

    2016-01-01

    In this paper, an islanded medium-voltage (MV) microgrid placed in Dongao Island is presented, which integrates renewable-energy-based distributed generations (DGs), energy storage system (ESS), and local loads. In an isolated microgrid without connection to the main grid to support the frequency......, it is more complex to control and manage. Thus in order to maintain the frequency stability in multiple-time-scales, a hierarchical control strategy is proposed. The proposed control architecture divides the system frequency in three zones: (A) stable zone, (B) precautionary zone and (C) emergency zone...... of Zone B. Theoretical analysis, time-domain simulation and field test results under various conditions and scenarios in the Dongao Island microgrid are presented to prove the validity of the introduced control strategy....

  5. Vibration control of uncertain multiple launch rocket system using radial basis function neural network

    Li, Bo; Rui, Xiaoting

    2018-01-01

    Poor dispersion characteristics of rockets due to the vibration of Multiple Launch Rocket System (MLRS) have always restricted the MLRS development for several decades. Vibration control is a key technique to improve the dispersion characteristics of rockets. For a mechanical system such as MLRS, the major difficulty in designing an appropriate control strategy that can achieve the desired vibration control performance is to guarantee the robustness and stability of the control system under the occurrence of uncertainties and nonlinearities. To approach this problem, a computed torque controller integrated with a radial basis function neural network is proposed to achieve the high-precision vibration control for MLRS. In this paper, the vibration response of a computed torque controlled MLRS is described. The azimuth and elevation mechanisms of the MLRS are driven by permanent magnet synchronous motors and supposed to be rigid. First, the dynamic model of motor-mechanism coupling system is established using Lagrange method and field-oriented control theory. Then, in order to deal with the nonlinearities, a computed torque controller is designed to control the vibration of the MLRS when it is firing a salvo of rockets. Furthermore, to compensate for the lumped uncertainty due to parametric variations and un-modeled dynamics in the design of the computed torque controller, a radial basis function neural network estimator is developed to adapt the uncertainty based on Lyapunov stability theory. Finally, the simulated results demonstrate the effectiveness of the proposed control system and show that the proposed controller is robust with regard to the uncertainty.

  6. Cognitive impairment in elderly women

    Rasmussen, Henrik Berg; Bagger, Yu Z; Tankó, László B

    2006-01-01

    BACKGROUND: A variety of factors contribute to the development of cognitive impairment in elderly people. Previous studies have focused upon a single or a few risk factors. In this study we assessed and compared the significance of a wide variety of potential risk factors for cognitive impairment...... in postmenopausal women. METHODS: A total of 208 pairs of elderly women (mean age = 73.2 years) were examined in a cross-sectional case-control study. Each pair consisted of a case (with impaired cognition) and a control subject matched by age and educational status. Cognitive functions were determined using...

  7. A randomized controlled trial of telemonitoring in older adults with multiple chronic conditions: the Tele-ERA study

    Takahashi Paul Y

    2010-09-01

    Full Text Available Abstract Background Older adults with multiple chronic illnesses are at risk for worsening functional and medical status and hospitalization. Home telemonitoring may help slow this decline. This protocol of a randomized controlled trial was designed to help determine the impact of home telemonitoring on hospitalization. The specific aim of the study reads as follows: to determine the effectiveness of home telemonitoring compared with usual care in reducing the combined outcomes of hospitalization and emergency department visits in an at-risk population 60 years of age or older. Methods/Design Two-hundred patients with the highest 10% Mayo Clinic Elder Risk Assessment scores will be randomly assigned to one of two interventions. Home telemonitoring involves the use of a computer device, the Intel Health Guide, which records biometric and symptom data from patients in their homes. This information is monitored by midlevel providers associated with a primary care medical practice. Under the usual care scenario, patients make appointments with their providers as problems arise and use ongoing support such as a 24-hour nurse line. Patients will have initial evaluations of gait and quality of life using instruments such as the SF-12 Health Survey, the Kokmen Short Test of Mental Status, and the PHQ-9 health questionnaire. Patients will be followed for 1 year for primary outcomes of hospitalizations and emergency department visits. Secondary analysis will include quality of life, compliance with the device, and attitudes about telemonitoring. Sample size is based on an 80% power to detect a 36% difference between the two groups. The primary analysis will involve Cox proportional time-to-event analysis. Secondary analysis will use t-test comparisons for continuous variables and the chi square test for proportional analysis. Discussion Patients randomized to home telemonitoring will have daily assessments of their health status using the device

  8. Knee osteoarthritis prevalence in hospitalized elderly patients: a retrospective study.

    Huang, Ke Qiang; Li, Chuan Silvia; Lin, Zhong Qiu; Feng, Guo Fei; Wang, Xiao Hui; Fu, Wen Zhe; Xie, Zhi Quan

    2013-01-01

    This study aimed to determine the prevalence rate of knee osteoarthritis (OA) and the risk factors for OA in hospitalized elderly patients. We conducted this retrospective study in elderly patients (aged 65 years and older) who were hospitalized in the Geriatric Ward of General Hospital of Guangzhou Military Command of the People's Liberation Army between January 2011 and June 2013, including general condition, present history, past history, physical examination, X-ray results, and disease diagnosis. The prevalence, awareness, and treatment rates of knee OA in hospitalized elderly patients were calculated. Risk factors were computed using multiple logistic regression analysis. Of a total of 267 (17.4%) hospitalized elderly patients diagnosed with knee OA, the prevalence rate of OA was 9.95% in males and 37.76% in females. The rate of awareness among those with OA was 51.68%; the rate of treatment was 83.33%; and the rate of control was 77.39%. The medical expenses for both females (1143±315 yuan month-1) and males (1192±357 yuan month-1) in knee OA patients are higher than that of the non-knee OA group (989±274 yuan month-1, 1038±295 yuan month-1). The risk factors for knee OA include gender (OR=2.448), age (OR=1.124), transportation mode (OR= 8.972), exercise (OR=7.374), bowel evacuation position (OR=5.767), family history of knee OA (OR=2.195), and body mass index (OR=2.469). The prevalence of knee OA is unexpectedly high in hospitalized elderly patients, and the rates of awareness and treatment are less than desirable. Prevention and control measures should be taken in patients with concomitant risk factors.

  9. The effect of milrinone on induced hypotension in elderly patients during spinal surgery: a randomized controlled trial.

    Hwang, Wonjung; Kim, Eunsung

    2014-08-01

    Induced hypotension is widely used intraoperatively to reduce blood loss and to improve the surgical field during spinal surgery. To determine the effect of milrinone on induced hypotension during spinal surgery in elderly patients. Prospective randomized clinical trial. Forty patients, 60 to 70 years old, ASA I-II, who underwent elective lumbar fusion surgery. Intraoperative hemodynamics, blood loss, hourly urine output, and grade of surgical field. All patients were randomized to group M or N. The study drug was infused after perivertebral muscle retraction until complete interbody fusion. In group M, 50 μg/kg/min of milrinone was infused over 10 minutes as a loading dose followed by 0.6 μg/kg/min of milrinone as a continuous dose. In group N, an identical volume of normal saline was infused in the same fashion. This study was not funded by commercial or other sponsorship and the authors confirm no conflicts of interest, financial or otherwise. During infusion of the study drug, the systolic and mean blood pressures were maintained within adequate limits of induced hypotension in group M. Intraoperative blood loss was 445.0±226.5 mL in group M and 765.0±339.2 mL in group N (p=.001). Hourly urine output was 1.4±0.6 mL in group M and 0.8±0.2 mL in group N (pmilrinone is useful for induced hypotension in elderly patients during spinal surgery. Copyright © 2014 Elsevier Inc. All rights reserved.

  10. Economic evaluation of a pharmaceutical care program for elderly diabetic and hypertensive patients in primary health care: a 36-month randomized controlled clinical trial.

    Obreli-Neto, Paulo Roque; Marusic, Srecko; Guidoni, Camilo Molino; Baldoni, André de Oliveira; Renovato, Rogério Dias; Pilger, Diogo; Cuman, Roberto Kenji Nakamura; Pereira, Leonardo Régis Leira

    2015-01-01

    Most diabetic and hypertensive patients, principally the elderly, do not achieve adequate disease control and consume 5%-15% of annual health care budgets. Previous studies verified that pharmaceutical care is useful for achieving adequate disease control in diabetes and hypertension. To evaluate the economic cost and the incremental cost-effectiveness ratio (ICER) per quality-adjusted life-year (QALY) of pharmaceutical care in the management of diabetes and hypertension in elderly patients in a primary public health care system in a developing country. A 36-month randomized controlled clinical trial was performed with 200 patients who were divided into a control group (n = 100) and an intervention group (n = 100). The control group received the usual care offered by the Primary Health Care Unit (medical and nurse consultations). The intervention group received the usual care plus a pharmaceutical care intervention. The intervention and control groups were compared with regard to the direct costs of health services (i.e., general practitioner, specialist, nurse, and pharmacist appointments; emergency room visits; and drug therapy costs) and the ICER per QALY. These evaluations used the health system perspective. No statistically significant difference was found between the intervention and control groups in total direct health care costs ($281.97 ± $49.73 per patient vs. $212.28 ± $43.49 per patient, respectively; P = 0.089); pharmaceutical care added incremental costs of $69.60 (± $7.90) per patient. The ICER per QALY was $53.50 (95% CI = $51.60-$54.00; monetary amounts are given in U.S. dollars). Every clinical parameter evaluated improved for the pharmaceutical care group, whereas these clinical parameters remained unchanged in the usual care group. The difference in differences (DID) tests indicated that for each clinical parameter, the patients in the intervention group improved more from pre to post than the control group (P < 0.001). While pharmaceutical

  11. Consensus seeking, formation keeping, and trajectory tracking in multiple vehicle cooperative control

    Ren, Wei

    Cooperative control problems for multiple vehicle systems can be categorized as either formation control problems with applications to mobile robots, unmanned air vehicles, autonomous underwater vehicles, satellites, aircraft, spacecraft, and automated highway systems, or non-formation control problems such as task assignment, cooperative transport, cooperative role assignment, air traffic control, cooperative timing, and cooperative search. The cooperative control of multiple vehicle systems poses significant theoretical and practical challenges. For cooperative control strategies to be successful, numerous issues must be addressed. We consider three important and correlated issues: consensus seeking, formation keeping, and trajectory tracking. For consensus seeking, we investigate algorithms and protocols so that a team of vehicles can reach consensus on the values of the coordination data in the presence of imperfect sensors, communication dropout, sparse communication topologies, and noisy and unreliable communication links. The main contribution of this dissertation in this area is that we show necessary and/or sufficient conditions for consensus seeking with limited, unidirectional, and unreliable information exchange under fixed and switching interaction topologies (through either communication or sensing). For formation keeping, we apply a so-called "virtual structure" approach to spacecraft formation flying and multi-vehicle formation maneuvers. As a result, single vehicle path planning and trajectory generation techniques can be employed for the virtual structure while trajectory tracking strategies can be employed for each vehicle. The main contribution of this dissertation in this area is that we propose a decentralized architecture for multiple spacecraft formation flying in deep space with formation feedback introduced. This architecture ensures the necessary precision in the presence of actuator saturation, internal and external disturbances, and

  12. Home-Based Intervention Program to Reduce Food Insecurity in Elderly Populations Using a TV App: Study Protocol of the Randomized Controlled Trial Saúde.Come Senior.

    Rodrigues, Ana Maria; Gregório, Maria João; Gein, Pierre; Eusébio, Mónica; Santos, Maria José; de Sousa, Rute Dinis; Coelho, Pedro S; Mendes, Jorge M; Graça, Pedro; Oliveira, Pedro; Branco, Jaime C; Canhão, Helena

    2017-03-13

    The limited or uncertain access to adequate food in elderly people includes not only economic restrictions but also inability of food utilization due to functional or cognitive impairment, health problems, and illiteracy. The aim of this work is to present the protocol of the randomized controlled trial Saúde.Come Senior, an educational and motivational television (TV)-based intervention to promote healthy lifestyles and decrease food insecurity in elderly people. A randomized controlled study will be conducted in subjects aged 60 years and older with food insecurity, identified at 17 primary care centers in the Lisboa e Vale do Tejo health region in Lisbon, Portugal. The primary outcome will be the changes in participants' food insecurity score (evaluated by the Household Food Insecurity Scale) at 3 months. Change in other outcomes will be assessed (dietary habits, nutritional status, physical activity, health status, and clinical outcomes). Subjects will be followed over 6 months; the intervention will last 3 months. Data collection will be performed at 3 different time points (baseline, end of intervention at 3 months, and follow-up at 6 months). The intervention is based on an interactive TV app with an educational and motivational program specifically developed for the elderly that has weekly themes and includes daily content in video format: (1) nutrition and diet tips for healthy eating, (2) healthy, easy to cook and low-cost recipes, and (3) physical exercise programs. Furthermore, brief reminders on health behaviors will also be broadcasted through the TV app. The total duration of the study will be 6 months. The intervention is considered to be effective and meaningful if 50% of the individuals in the experimental group have a decrease of 1 point in the food insecurity score, all the remaining being unchanged. We expect to include and randomize 282 (141 experimental and 141 control) elderly with food insecurity. We will recruit a total of 1,128 subjects

  13. Damping-tunable energy-harvesting vehicle damper with multiple controlled generators: Design, modeling and experiments

    Xie, Longhan; Li, Jiehong; Li, Xiaodong; Huang, Ledeng; Cai, Siqi

    2018-01-01

    Hydraulic dampers are used to decrease the vibration of a vehicle, where vibration energy is dissipated as heat. In addition to resulting in energy waste, the damping coefficient in hydraulic dampers cannot be changed during operation. In this paper, an energy-harvesting vehicle damper was proposed to replace traditional hydraulic dampers. The goal is not only to recover kinetic energy from suspension vibration but also to change the damping coefficient during operation according to road conditions. The energy-harvesting damper consists of multiple generators that are independently controlled by switches. One of these generators connects to a tunable resistor for fine tuning the damping coefficient, while the other generators are connected to a control and rectifying circuit, each of which both regenerates electricity and provides a constant damping coefficient. A mathematical model was built to investigate the performance of the energy-harvesting damper. By controlling the number of switched-on generators and adjusting the value of the external tunable resistor, the damping can be fine tuned according to the requirement. In addition to the capability of damping tuning, the multiple controlled generators can output a significant amount of electricity. A prototype was built to test the energy-harvesting damper design. Experiments on an MTS testing system were conducted, with results that validated the theoretical analysis. Experiments show that changing the number of switched-on generators can obviously tune the damping coefficient of the damper and simultaneously produce considerable electricity.

  14. A study on software-based sensing technology for multiple object control in AR video.

    Jung, Sungmo; Song, Jae-Gu; Hwang, Dae-Joon; Ahn, Jae Young; Kim, Seoksoo

    2010-01-01

    Researches on Augmented Reality (AR) have recently received attention. With these, the Machine-to-Machine (M2M) market has started to be active and there are numerous efforts to apply this to real life in all sectors of society. To date, the M2M market has applied the existing marker-based AR technology in entertainment, business and other industries. With the existing marker-based AR technology, a designated object can only be loaded on the screen from one marker and a marker has to be added to load on the screen the same object again. This situation creates a problem where the relevant marker'should be extracted and printed in screen so that loading of the multiple objects is enabled. However, since the distance between markers will not be measured in the process of detecting and copying markers, the markers can be overlapped and thus the objects would not be augmented. To solve this problem, a circle having the longest radius needs to be created from a focal point of a marker to be copied, so that no object is copied within the confines of the circle. In this paper, software-based sensing technology for multiple object detection and loading using PPHT has been developed and overlapping marker control according to multiple object control has been studied using the Bresenham and Mean Shift algorithms.

  15. A Study on Software-based Sensing Technology for Multiple Object Control in AR Video

    Seoksoo Kim

    2010-11-01

    Full Text Available Researches on Augmented Reality (AR have recently received attention. With these, the Machine-to-Machine (M2M market has started to be active and there are numerous efforts to apply this to real life in all sectors of society. To date, the M2M market has applied the existing marker-based AR technology in entertainment, business and other industries. With the existing marker-based AR technology, a designated object can only be loaded on the screen from one marker and a marker has to be added to load on the screen the same object again. This situation creates a problem where the relevant marker should be extracted and printed in screen so that loading of the multiple objects is enabled. However, since the distance between markers will not be measured in the process of detecting and copying markers, the markers can be overlapped and thus the objects would not be augmented. To solve this problem, a circle having the longest radius needs to be created from a focal point of a marker to be copied, so that no object is copied within the confines of the circle. In this paper, software-based sensing technology for multiple object detection and loading using PPHT has been developed and overlapping marker control according to multiple object control has been studied using the Bresenham and Mean Shift algorithms.

  16. Evaluation of an educational "toolbox" for improving nursing staff competence and psychosocial work environment in elderly care: results of a prospective, non-randomized controlled intervention.

    Arnetz, J E; Hasson, H

    2007-07-01

    Lack of professional development opportunities among nursing staff is a major concern in elderly care and has been associated with work dissatisfaction and staff turnover. There is a lack of prospective, controlled studies evaluating the effects of educational interventions on nursing competence and work satisfaction. The aim of this study was to evaluate the possible effects of an educational "toolbox" intervention on nursing staff ratings of their competence, psychosocial work environment and overall work satisfaction. The study was a prospective, non-randomized, controlled intervention. Nursing staff in two municipal elderly care organizations in western Sweden. In an initial questionnaire survey, nursing staff in the intervention municipality described several areas in which they felt a need for competence development. Measurement instruments and educational materials for improving staff knowledge and work practices were then collated by researchers and managers in a "toolbox." Nursing staff ratings of their competence and work were measured pre and post-intervention by questionnaire. Staff ratings in the intervention municipality were compared to staff ratings in the reference municipality, where no toolbox was introduced. Nursing staff ratings of their competence and psychosocial work environment, including overall work satisfaction, improved significantly over time in the intervention municipality, compared to the reference group. Both competence and work environment ratings were largely unchanged among reference municipality staff. Multivariate analysis revealed a significant interaction effect between municipalities over time for nursing staff ratings of participation, leadership, performance feedback and skills' development. Staff ratings for these four scales improved significantly in the intervention municipality as compared to the reference municipality. Compared to a reference municipality, nursing staff ratings of their competence and the

  17. Long-term use of minimal footwear on pain, self-reported function, analgesic intake, and joint loading in elderly women with knee osteoarthritis: A randomized controlled trial.

    Trombini-Souza, Francis; Matias, Alessandra B; Yokota, Mariane; Butugan, Marco K; Goldenstein-Schainberg, Claudia; Fuller, Ricardo; Sacco, Isabel C N

    2015-12-01

    Efforts have been made to retard the progressive debilitating pain and joint dysfunction in patients with knee osteoarthritis. We aimed to evaluate the therapeutic effect of a low-cost minimalist footwear on pain, function, clinical and gait-biomechanical aspects of elderly women with knee osteoarthritis. Throughout a randomized, parallel and controlled clinical trial, fifty-six patients with medial knee osteoarthritis were randomly allocated to an intervention (n=28) or control group (n=28), and assessed at baseline and after three and six months. The intervention involved wearing Moleca(®) footwear for at least 6h/day, 7 days/week, over 6 months. The pain subscale of the Western Ontario and McMaster Universities Osteoarthritis Index was the primary outcome. The secondary outcomes were the other subscales, Lequesne score, distance walked in 6 min, knee oedema and effusion, knee adduction moment and paracetamol intake. Intention-to-treat analysis was performed using two-way casewise ANOVA (coefficient. Intervention group showed improvement in pain (effect size: 1.41, p<.001), function (effect size: 1.22, p=.001), stiffness (effect size: 0.76, p=.001), Lequesne score (effect size: 1.07, p<.001), and reduction by 21.8% in the knee adduction moment impulse (p=.017) during gait wearing Moleca(®). The analgesic intake was lower in the intervention group. The long-term use of Moleca(®) footwear relieves pain, improves self-reported function, reduces the knee loading while wearing Moleca(®), refrains the increase of analgesic intake in elderly women with knee osteoarthritis and can be considered as a conservative mechanical treatment option. ClinicalTrials.gov (NCT01342458). Copyright © 2015 Elsevier Ltd. All rights reserved.

  18. Lower-limb hot-water immersion acutely induces beneficial hemodynamic and cardiovascular responses in peripheral arterial disease and healthy, elderly controls.

    Thomas, Kate N; van Rij, André M; Lucas, Samuel J E; Cotter, James D

    2017-03-01

    Passive heat induces beneficial perfusion profiles, provides substantive cardiovascular strain, and reduces blood pressure, thereby holding potential for healthy and cardiovascular disease populations. The aim of this study was to assess acute responses to passive heat via lower-limb, hot-water immersion in patients with peripheral arterial disease (PAD) and healthy, elderly controls. Eleven patients with PAD (age 71 ± 6 yr, 7 male, 4 female) and 10 controls (age 72 ± 7 yr, 8 male, 2 female) underwent hot-water immersion (30-min waist-level immersion in 42.1 ± 0.6°C water). Before, during, and following immersion, brachial and popliteal artery diameter, blood flow, and shear stress were assessed using duplex ultrasound. Lower-limb perfusion was measured also using venous occlusion plethysmography and near-infrared spectroscopy. During immersion, shear rate increased ( P Lower-limb blood flow increased significantly in both groups, as measured from duplex ultrasound (>200%), plethysmography (>100%), and spectroscopy, while central and peripheral pulse-wave velocity decreased in both groups. Mean arterial blood pressure was reduced by 22 ± 9 mmHg (main effect P lower 3 h afterward. In PAD, popliteal shear profiles and claudication both compared favorably with those measured immediately following symptom-limited walking. A 30-min hot-water immersion is a practical means of delivering heat therapy to PAD patients and healthy, elderly individuals to induce appreciable systemic (chronotropic and blood pressure lowering) and hemodynamic (upper and lower-limb perfusion and shear rate increases) responses. Copyright © 2017 the American Physiological Society.

  19. Effect of whole-body vibration exercise on mobility, balance ability and general health status in frail elderly patients: a pilot randomized controlled trial.

    Zhang, Li; Weng, Changshui; Liu, Miao; Wang, Qiuhua; Liu, Liming; He, Yao

    2014-01-01

    To study the effects of whole-body vibration exercises on the mobility function, balance and general health status, and its feasibility as an intervention in frail elderly patients. Pilot randomized controlled trial. Forty-four frail older persons (85.27 ± 3.63 years) meeting the Fried Frailty Criteria. All eligible subjects were randomly assigned to the experimental group, who received a whole-body vibration exercise alone (vibration amplitude: 1-3 mm; frequency: 6-26 Hz; 4-5 bouts × 60 seconds; 3-5 times weekly), or a control group, who received usual care and exercises for eight weeks. The Timed Up and Go Test, 30-second chair stand test, lower extremities muscle strength, balance function, balance confidence and General Health Status were assessed at the beginning of the study, after four weeks and eight weeks of the intervention. Whole-body vibration exercise reduced the time of the Timed Up and Go Test (40.47 ± 15.94 s to 21.34 ± 4.42 s), improved the bilateral knees extensor strength (6.96 ± 1.70 kg to 11.26 ± 2.08 kg), the posture stability (surface area ellipse: 404.58 ± 177.05 to 255.95 ± 107.28) and General Health Status (Short-form Health Survey score: 24.51 ± 10.69 and 49.63 ± 9.85 to 45.03 ± 11.15 and 65.23 ± 9.39, respectively). The repeated-measures ANOVA showed that there were significant differences in the Timed Up and Go Test, 30-second chair stand test, bilateral knees extensor strength, activities-specific balance confidence score and general health status between the two groups (P balance and the general health status in the frail elderly.

  20. Dose-dependent effects of fish oil on cardio-metabolic biomarkers in healthy middle-aged and elderly Chinese people: a double-blind randomized controlled trial.

    Song, Jia; Hu, Manjiang; Li, Cheng; Yang, Bo; Ding, Qing; Wang, Chunhong; Mao, Limei

    2018-06-20

    n-3PUFA consumption has been widely accepted as a nutritional strategy for the secondary prevention of cardiovascular events in patients at high risk of cardiovascular disease (CVD), but little is known about the dose-response relationship between dietary n-3PUFA and serum biomarkers associated with cardiovascular health in the general population. The present study involved a 12-week double-blind, randomized controlled trial to explore the effects of fish oil with different doses (0.31, 0.62 and 1.24 g d-1 of EPA and DHA) on serum fatty acids and cardio-metabolic biomarkers including adiponectin, inflammatory markers, lipid profiles and fasting glucose in healthy middle-aged and elderly Chinese people. 240 volunteers met our inclusion criteria. A total of 39 subjects dropped out and 201 finally completed the intervention. No significant differences in baseline characteristics and daily intakes of dietary nutrients were detected among all groups. After a 12-week intervention, fish oil dose-dependently enhanced serum EPA, DHA, n-3PUFA and adiponectin (except for 0.31 g d-1), but decreased serum n-6/n-3PUFA, TG and fasting glucose. Changes in the above indicators from the baseline to week 12 in fish oil groups significantly differed from those in the control. Meanwhile, all the doses of EPA and DHA led to decreases in serum CRP; only 1.24 g d-1 led to an increase in HDL-C with a concurrent decrease in TC/HDL-C even though these changes were not significantly different among all groups. All the findings suggested that fish oil dose-dependently regulated serum PUFA and cardio-metabolic biomarkers including adiponectin, CRP, lipid profiles and fasting glucose in healthy middle-aged and elderly Chinese people who consumed insufficient dietary n-3PUFA, and the most desirable changes were observed for 1.24 g d-1.

  1. A comparison of synchronized intermittent mandatory ventilation and pressure-regulated volume control ventilation in elderly patients with acute exacerbations of COPD and respiratory failure

    Chang SC

    2016-05-01

    Full Text Available Suchi Chang,1 Jindong Shi,2 Cuiping Fu,1 Xu Wu,1 Shanqun Li1 1Department of Respiratory Medicine, Zhongshan Hospital, Fudan University, Shanghai, 2Department of Respiratory Medicine, The Fifth People’s Hospital of Shanghai, Fudan University, Shanghai, People’s Republic of China Background: COPD is the third leading cause of death worldwide. Acute exacerbations of COPD may cause respiratory failure, requiring intensive care unit admission and mechanical ventilation. Intensive care unit patients with acute exacerbations of COPD requiring mechanical ventilation have higher mortality rates than other hospitalized patients. Although mechanical ventilation is the most effective intervention for these conditions, invasive ventilation techniques have yielded variable effects. Objective: We evaluated pressure-regulated volume control (PRVC ventilation treatment efficacy and preventive effects on pulmonary barotrauma in elderly COPD patients with respiratory failure. Patients and methods: Thirty-nine intubated patients were divided into experimental and control groups and treated with the PRVC and synchronized intermittent mandatory ventilation – volume control methods, respectively. Vital signs, respiratory mechanics, and arterial blood gas analyses were monitored for 2–4 hours and 48 hours. Results: Both groups showed rapidly improved pH, partial pressure of oxygen (PaO2, and PaO2 per fraction of inspired O2 levels and lower partial pressure of carbon dioxide (PaCO2 levels. The pH and PaCO2 levels at 2–4 hours were lower and higher, respectively, in the test group than those in the control group (P<0.05 for both; after 48 hours, blood gas analyses showed no statistical difference in any marker (P>0.05. Vital signs during 2–4 hours and 48 hours of treatment showed no statistical difference in either group (P>0.05. The level of peak inspiratory pressure in the experimental group after mechanical ventilation for 2–4 hours and 48

  2. Randomized Controlled Trial of Screening, Risk Modification, and Physical Therapy to Prevent Falls Among the Elderly Recently Discharged From the Emergency Department to the Community: The Steps to Avoid Falls in the Elderly Study.

    Matchar, David B; Duncan, Pamela W; Lien, Christopher T; Ong, Marcus Eng Hock; Lee, Mina; Gao, Fei; Sim, Rita; Eom, Kirsten

    2017-06-01

    To evaluate the effectiveness of a multifactorial, tailored program of physical therapy to reduce the occurrence of falls among a heterogeneous group of high-risk elderly Singaporeans recently discharged from the emergency department (ED). Randomized controlled trial. Communities. Adults (N=354) aged ≥65 years who were seen in the ED for a fall or fall-related injuries and discharged home. The intervention primarily consisted of a tailored program of physical therapy focused on progressive training in strength, balance, and gait for a period of 3 months. Participants in the intervention group also received screening and follow-up for vision, polypharmacy, and environmental hazards. Participants in the control group received usual care prescribed by a physician and educational materials on falls prevention. The primary outcome measure was experiencing at least 1 fall during the 9-month study period (a 3-mo active intervention phase and a 6-mo maintenance phase). Secondary outcome measures were the occurrence of at least 1 injurious fall during the study period and a change in the Short Physical Performance Battery (SPPB) score. Participants were assessed both after 3 and 9 months. During the 9-month study period, 37.8% of the control group and 30.5% of the intervention group fell at least once, which was not statistically significantly different (odds ratio [OR]=.72; 95% confidence interval [CI], .46-1.12; P=.146). The intervention group had statistically significantly fewer individuals with injurious falls (OR=.56; 95% CI, .32-.98; P=.041) and less deterioration in physical performance, reflected by a mean difference of 0.6 in SPPB scores (P=.029). Multivariate analyses indicated a strong interaction effect between the intervention and the presence of 2 or more major comorbidities; after accounting for this effect, the intervention program reduced the number of people experiencing at least 1 fall (OR=.34; 95% CI, .17-.67; P=.002). We observed that in this

  3. Sliding-mode control of single input multiple output DC-DC converter

    Zhang, Libo; Sun, Yihan; Luo, Tiejian; Wan, Qiyang

    2016-10-01

    Various voltage levels are required in the vehicle mounted power system. A conventional solution is to utilize an independent multiple output DC-DC converter whose cost is high and control scheme is complicated. In this paper, we design a novel SIMO DC-DC converter with sliding mode controller. The proposed converter can boost the voltage of a low-voltage input power source to a controllable high-voltage DC bus and middle-voltage output terminals, which endow the converter with characteristics of simple structure, low cost, and convenient control. In addition, the sliding mode control (SMC) technique applied in our converter can enhance the performances of a certain SIMO DC-DC converter topology. The high-voltage DC bus can be regarded as the main power source to the high-voltage facility of the vehicle mounted power system, and the middle-voltage output terminals can supply power to the low-voltage equipment on an automobile. In the respect of control algorithm, it is the first time to propose the SMC-PID (Proportion Integration Differentiation) control algorithm, in which the SMC algorithm is utilized and the PID control is attended to the conventional SMC algorithm. The PID control increases the dynamic ability of the SMC algorithm by establishing the corresponding SMC surface and introducing the attached integral of voltage error, which endow the sliding-control system with excellent dynamic performance. At last, we established the MATLAB/SIMULINK simulation model, tested performance of the system, and built the hardware prototype based on Digital Signal Processor (DSP). Results show that the sliding mode control is able to track a required trajectory, which has robustness against the uncertainties and disturbances.

  4. Simulation of neutron multiplicity measurements using Geant4. Open source software for nuclear arms control

    Kuett, Moritz

    2016-07-07

    Nuclear arms control, including nuclear safeguards and verification technologies for nuclear disarmament typically use software as part of many different technological applications. This thesis proposes to use three open source criteria for such software, allowing users and developers to have free access to a program, have access to the full source code and be able to publish modifications for the program. This proposition is presented and analyzed in detail, together with the description of the development of ''Open Neutron Multiplicity Simulation'', an open source software tool to simulate neutron multiplicity measurements. The description includes physical background of the method, details of the developed program and a comprehensive set of validation calculations.

  5. A new adaptive control scheme based on the interacting multiple model (IMM) estimation

    Afshari, Hamed H.; Al-Ani, Dhafar; Habibi, Saeid

    2016-01-01

    In this paper, an Interacting multiple model (IMM) adaptive estimation approach is incorporated to design an optimal adaptive control law for stabilizing an Unmanned vehicle. Due to variations of the forward velocity of the Unmanned vehicle, its aerodynamic derivatives are constantly changing. In order to stabilize the unmanned vehicle and achieve the control objectives for in-flight conditions, one seeks for an adaptive control strategy that can adjust itself to varying flight conditions. In this context, a bank of linear models is used to describe the vehicle dynamics in different operating modes. Each operating mode represents a particular dynamic with a different forward velocity. These models are then used within an IMM filter containing a bank of Kalman filters (KF) in a parallel operating mechanism. To regulate and stabilize the vehicle, a Linear quadratic regulator (LQR) law is designed and implemented for each mode. The IMM structure determines the particular mode based on the stored models and in-flight input-output measurements. The LQR controller also provides a set of controllers; each corresponds to a particular flight mode and minimizes the tracking error. Finally, the ultimate control law is obtained as a weighted summation of all individual controllers whereas weights are obtained using mode probabilities of each operating mode.

  6. Reserve-building activities in multiple sclerosis patients and healthy controls: a descriptive study.

    Schwartz, Carolyn E; Ayandeh, Armon; Ramanathan, Murali; Benedict, Ralph; Dwyer, Michael G; Weinstock-Guttman, Bianca; Zivadinov, Robert

    2015-08-12

    Cognitive reserve has been implicated as a possible protective factor in multiple sclerosis (MS) but to date no study has compared reserve-building activities across disease course or to healthy controls. This study aims to describe differences in reserve-building activities across the MS disease course and healthy controls. Secondary analysis of a cross-sectional cohort study that included 276 healthy controls, and subjects with clinically isolated syndrome (CIS; n = 67), relapsing-remitting MS (RRMS; n = 358) and secondary progressive MS (PMS; n = 109). Past reserve-building activities were operationalized as occupational attainment and education. Current activities comprised 6 strenuous and 6 non-strenuous activities, including 5 reserve-building activities and television-watching. Multivariate Analysis of Variance models examined group differences in past and current activities, after adjusting for covariates. There were group differences in past and current reserve-building activities. SPMS patients had lower past reserve-building activities than healthy controls. All forms of MS engaged in fewer strenuous current reserve-building pursuits than healthy controls. RRMS read less than healthy controls. SPMS engaged in fewer job-related non-strenuous activities. All MS groups watched more television than healthy controls. MS patients show significantly fewer past and present reserve-building activities. Although it is difficult to establish causality without future prospective studies, lifestyle-modifying interventions should prioritize expanding MS patients' repertoire of strenuous and non-strenuous activities.

  7. Multiple-Input Subject-Specific Modeling of Plasma Glucose Concentration for Feedforward Control.

    Kotz, Kaylee; Cinar, Ali; Mei, Yong; Roggendorf, Amy; Littlejohn, Elizabeth; Quinn, Laurie; Rollins, Derrick K

    2014-11-26

    The ability to accurately develop subject-specific, input causation models, for blood glucose concentration (BGC) for large input sets can have a significant impact on tightening control for insulin dependent diabetes. More specifically, for Type 1 diabetics (T1Ds), it can lead to an effective artificial pancreas (i.e., an automatic control system that delivers exogenous insulin) under extreme changes in critical disturbances. These disturbances include food consumption, activity variations, and physiological stress changes. Thus, this paper presents a free-living, outpatient, multiple-input, modeling method for BGC with strong causation attributes that is stable and guards against overfitting to provide an effective modeling approach for feedforward control (FFC). This approach is a Wiener block-oriented methodology, which has unique attributes for meeting critical requirements for effective, long-term, FFC.

  8. Magic Ring: A Finger-Worn Device for Multiple Appliances Control Using Static Finger Gestures

    Tongjun Huang

    2012-05-01

    Full Text Available An ultimate goal for Ubiquitous Computing is to enable people to interact with the surrounding electrical devices using their habitual body gestures as they communicate with each other. The feasibility of such an idea is demonstrated through a wearable gestural device named Magic Ring (MR, which is an original compact wireless sensing mote in a ring shape that can recognize various finger gestures. A scenario of wireless multiple appliances control is selected as a case study to evaluate the usability of such a gestural interface. Experiments comparing the MR and a Remote Controller (RC were performed to evaluate the usability. From the results, only with 10 minutes practice, the proposed paradigm of gestural-based control can achieve a performance of completing about six tasks per minute, which is in the same level of the RC-based method.

  9. The control system for the multiple-pellet injector on the Joint European Torus

    Baylor, L.R.; Jernigan, T.C.; Stewart, K.A.

    1989-01-01

    A stand-alone control and data acquisition system for the Oak Ridge National Laboratory (ORNL) multiple-pellet injector installed on the Joint European Torus (JET) has been designed and installed with the injector. This system, which is based on a MicroVAX II computer and a programmable logic controller (PLC), is an upgrade of previous systems designed for ORNL pellet injectors installed on other fusion experiments. The primary control system upgrades are in the user interface, in the automation of sequential injector operation, and in the analysis of the transient data acquired for each pellet fired. The system is integrated into the JET CODAS environment through CAMAC communications modules with customized communications software. Routine operation of the injector is automated and requires no operator intervention. Details of the hardware and software design and the operation of the system are presented in this paper. 4 refs., 3 figs

  10. Improving information retrieval with multiple health terminologies in a quality-controlled gateway.

    Soualmia, Lina F; Sakji, Saoussen; Letord, Catherine; Rollin, Laetitia; Massari, Philippe; Darmoni, Stéfan J

    2013-01-01

    The Catalog and Index of French-language Health Internet resources (CISMeF) is a quality-controlled health gateway, primarily for Web resources in French (n=89,751). Recently, we achieved a major improvement in the structure of the catalogue by setting-up multiple terminologies, based on twelve health terminologies available in French, to overcome the potential weakness of the MeSH thesaurus, which is the main and pivotal terminology we use for indexing and retrieval since 1995. The main aim of this study was to estimate the added-value of exploiting several terminologies and their semantic relationships to improve Web resource indexing and retrieval in CISMeF, in order to provide additional health resources which meet the users' expectations. Twelve terminologies were integrated into the CISMeF information system to set up multiple-terminologies indexing and retrieval. The same sets of thirty queries were run: (i) by exploiting the hierarchical structure of the MeSH, and (ii) by exploiting the additional twelve terminologies and their semantic links. The two search modes were evaluated and compared. The overall coverage of the multiple-terminologies search mode was improved by comparison to the coverage of using the MeSH (16,283 vs. 14,159) (+15%). These additional findings were estimated at 56.6% relevant results, 24.7% intermediate results and 18.7% irrelevant. The multiple-terminologies approach improved information retrieval. These results suggest that integrating additional health terminologies was able to improve recall. Since performing the study, 21 other terminologies have been added which should enable us to make broader studies in multiple-terminologies information retrieval.

  11. Management Control in Major Brazilian Multiple Banks: the Impact of Internationalization and Convergence of Accounting Standards on the Control Systems

    João Carlos Damasceno Reis

    2014-08-01

    Full Text Available This study verifies the impact caused by the processes of globalization and convergence to international accounting standards on the managerial control systems of the largest multiple banks that operate in Brazil. The study was exploratory in nature, with the use of the case study method and the application of questionnaires containing mostly open questions to upper tier executives of four major Brazilian banks. The analysis showed that globalization has resulted in improved control systems and widespread use of information technology. It was also found that the convergence to international accounting standards occurred properly, thanks to the steps taken by the Central Bank that aimed at an agile updating of the Brazilian accounting standards laid down for banks operating in Brazil, in line with international standards. In general, the researched banks did not report a significant impact of convergence to the IFRS on their management control systems; adherence to the international accounting standards has had more significant impacts on information systems, especially regarding the new reporting and transparency standards, rather than on management controls. This result signals that the management control systems of the four banks in the sample are in line with Anthony (1965’s vision, that is, that flexibility to adapt to every change in the external environment might actually increase risks of failure.

  12. Finite-time tracking control for multiple non-holonomic mobile robots based on visual servoing

    Ou, Meiying; Li, Shihua; Wang, Chaoli

    2013-12-01

    This paper investigates finite-time tracking control problem of multiple non-holonomic mobile robots via visual servoing. It is assumed that the pinhole camera is fixed to the ceiling, and camera parameters are unknown. The desired reference trajectory is represented by a virtual leader whose states are available to only a subset of the followers, and the followers have only interaction. First, the camera-objective visual kinematic model is introduced by utilising the pinhole camera model for each mobile robot. Second, a unified tracking error system between camera-objective visual servoing model and desired reference trajectory is introduced. Third, based on the neighbour rule and by using finite-time control method, continuous distributed cooperative finite-time tracking control laws are designed for each mobile robot with unknown camera parameters, where the communication topology among the multiple mobile robots is assumed to be a directed graph. Rigorous proof shows that the group of mobile robots converges to the desired reference trajectory in finite time. Simulation example illustrates the effectiveness of our method.

  13. Deletion variant near ZNF389 is associated with control of ovine lentivirus in multiple sheep flocks

    White, S N; Mousel, M R; Reynolds, J O; Herrmann-Hoesing, L M; Knowles, D P

    2014-01-01

    Ovine lentivirus (OvLV) is a macrophage-tropic lentivirus found in many countries that causes interstitial pneumonia, mastitis, arthritis and cachexia in sheep. There is no preventive vaccine and no cure, but breed differences suggest marker-assisted selective breeding might improve odds of infection and control of OvLV post-infection. Although variants in TMEM154 have consistent association with odds of infection, no variant in any gene has been associated with host control of OvLV post-infection in multiple animal sets. Proviral concentration is a live-animal diagnostic measure of OvLV control post-infection related to severity of OvLV-induced lesions. A recent genome-wide association study identified a region including four zinc finger genes associated with proviral concentration in one Rambouillet flock. To refine this region, we tested additional variants and identified a small insertion/deletion variant near ZNF389 that showed consistent association with proviral concentration in three animal sets (P sheep from multiple locations and management conditions. Strikingly, one flock had exceptionally high prevalence (>87%, including yearlings) and mean proviral concentration (>950 copies/μg), possibly due to needle sharing. The best estimate of proviral concentration by genotype, obtained from all 1310 OvLV-positive animals tested, showed insertion homozygotes had less than half the proviral concentration of other genotypes (P sheep flocks. PMID:24303974

  14. Large Display Interaction via Multiple Acceleration Curves and Multifinger Pointer Control

    Andrey Esakia

    2014-01-01

    Full Text Available Large high-resolution displays combine high pixel density with ample physical dimensions. The combination of these factors creates a multiscale workspace where interactive targeting of on-screen objects requires both high speed for distant targets and high accuracy for small targets. Modern operating systems support implicit dynamic control-display gain adjustment (i.e., a pointer acceleration curve that helps to maintain both speed and accuracy. However, large high-resolution displays require a broader range of control-display gains than a single acceleration curve can usably enable. Some interaction techniques attempt to solve the problem by utilizing multiple explicit modes of interaction, where different modes provide different levels of pointer precision. Here, we investigate the alternative hypothesis of using a single mode of interaction for continuous pointing that enables both (1 standard implicit granularity control via an acceleration curve and (2 explicit switching between multiple acceleration curves in an efficient and dynamic way. We evaluate a sample solution that augments standard touchpad accelerated pointer manipulation with multitouch capability, where the choice of acceleration curve dynamically changes depending on the number of fingers in contact with the touchpad. Specifically, users can dynamically switch among three different acceleration curves by using one, two, or three fingers on the touchpad.

  15. High power multiple wavelength diode laser stack for DPSSL application without temperature control

    Hou, Dong; Yin, Xia; Wang, Jingwei; Chen, Shi; Zhan, Yun; Li, Xiaoning; Fan, Yingmin; Liu, Xingsheng

    2018-02-01

    High power diode laser stack is widely used in pumping solid-state laser for years. Normally an integrated temperature control module is required for stabilizing the output power of solid-state laser, as the output power of the solid-state laser highly depends on the emission wavelength and the wavelength shift of diode lasers according to the temperature changes. However the temperature control module is inconvenient for this application, due to its large dimension, high electric power consumption and extra adding a complicated controlling system. Furthermore, it takes dozens of seconds to stabilize the output power when the laser system is turned on. In this work, a compact hard soldered high power conduction cooled diode laser stack with multiple wavelengths is developed for stabilizing the output power of solid-state laser in a certain temperature range. The stack consists of 5 laser bars with the pitch of 0.43mm. The peak output power of each bar in the diode laser stack reaches as much as 557W and the combined lasing wavelength spectrum profile spans 15nm. The solidstate laser, structured with multiple wavelength diode laser stacks, allows the ambient temperature change of 65°C without suddenly degrading the optical performance.

  16. A multiple objective test assembly approach for exposure control problems in Computerized Adaptive Testing

    Theo J.H.M. Eggen

    2010-01-01

    Full Text Available Overexposure and underexposure of items in the bank are serious problems in operational computerized adaptive testing (CAT systems. These exposure problems might result in item compromise, or point at a waste of investments. The exposure control problem can be viewed as a test assembly problem with multiple objectives. Information in the test has to be maximized, item compromise has to be minimized, and pool usage has to be optimized. In this paper, a multiple objectives method is developed to deal with both types of exposure problems. In this method, exposure control parameters based on observed exposure rates are implemented as weights for the information in the item selection procedure. The method does not need time consuming simulation studies, and it can be implemented conditional on ability level. The method is compared with Sympson Hetter method for exposure control, with the Progressive method and with alphastratified testing. The results show that the method is successful in dealing with both kinds of exposure problems.

  17. Design of clinical trials involving multiple hypothesis tests with a common control.

    Schou, I Manjula; Marschner, Ian C

    2017-07-01

    Randomized clinical trials comparing several treatments to a common control are often reported in the medical literature. For example, multiple experimental treatments may be compared with placebo, or in combination therapy trials, a combination therapy may be compared with each of its constituent monotherapies. Such trials are typically designed using a balanced approach in which equal numbers of individuals are randomized to each arm, however, this can result in an inefficient use of resources. We provide a unified framework and new theoretical results for optimal design of such single-control multiple-comparator studies. We consider variance optimal designs based on D-, A-, and E-optimality criteria, using a general model that allows for heteroscedasticity and a range of effect measures that include both continuous and binary outcomes. We demonstrate the sensitivity of these designs to the type of optimality criterion by showing that the optimal allocation ratios are systematically ordered according to the optimality criterion. Given this sensitivity to the optimality criterion, we argue that power optimality is a more suitable approach when designing clinical trials where testing is the objective. Weighted variance optimal designs are also discussed, which, like power optimal designs, allow the treatment difference to play a major role in determining allocation ratios. We illustrate our methods using two real clinical trial examples taken from the medical literature. Some recommendations on the use of optimal designs in single-control multiple-comparator trials are also provided. © 2016 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  18. Massage therapy and exercise therapy in patients with multiple sclerosis: a randomized controlled pilot study.

    Negahban, Hossein; Rezaie, Solmaz; Goharpey, Shahin

    2013-12-01

    The primary aim was to investigate the comparative effects of massage therapy and exercise therapy on patients with multiple sclerosis. The secondary aim was to investigate whether combination of both massage and exercise has an additive effect. Randomized controlled pilot trial with repeated measurements and blinded assessments. Local Multiple Sclerosis Society. A total of 48 patients with multiple sclerosis were randomly assigned to four equal subgroups labelled as massage therapy, exercise therapy, combined massage-exercise therapy and control group. The treatment group received 15 sessions of supervised intervention for five weeks. The massage therapy group received a standard Swedish massage. The exercise therapy group was given a combined set of strength, stretch, endurance and balance exercises. Patients in the massage-exercise therapy received a combined set of massage and exercise treatments. Patients in the control group were asked to continue their standard medical care. Pain, fatigue, spasticity, balance, gait and quality of life were assessed before and after intervention. Massage therapy resulted in significantly larger improvement in pain reduction (mean change 2.75 points, P = 0.001), dynamic balance (mean change, 3.69 seconds, P = 0.009) and walking speed (mean change, 7.84 seconds, P = 0.007) than exercise therapy. Patients involved in the combined massage-exercise therapy showed significantly larger improvement in pain reduction than those in the exercise therapy (mean change, 1.67 points, P = 0.001). Massage therapy could be more effective than exercise therapy. Moreover, the combination of massage and exercise therapy may be a little more effective than exercise therapy alone.

  19. Traffic Management by Using Admission Control Methods in Multiple Node IMS Network

    Filip Chamraz

    2016-01-01

    Full Text Available The paper deals with Admission Control methods (AC as a possible solution for traffic management in IMS networks (IP Multimedia Subsystem - from the point of view of an efficient redistribution of the available network resources and keeping the parameters of Quality of Service (QoS. The paper specifically aims at the selection of the most appropriate method for the specific type of traffic and traffic management concept using AC methods on multiple nodes. The potential benefit and disadvantage of the used solution is evaluated.

  20. Tunable arbitrary unitary transformer based on multiple sections of multicore fibers with phase control.

    Zhou, Junhe; Wu, Jianjie; Hu, Qinsong

    2018-02-05

    In this paper, we propose a novel tunable unitary transformer, which can achieve arbitrary discrete unitary transforms. The unitary transformer is composed of multiple sections of multi-core fibers with closely aligned coupled cores. Phase shifters are inserted before and after the sections to control the phases of the waves in the cores. A simple algorithm is proposed to find the optimal phase setup for the phase shifters to realize the desired unitary transforms. The proposed device is fiber based and is particularly suitable for the mode division multiplexing systems. A tunable mode MUX/DEMUX for a three-mode fiber is designed based on the proposed structure.

  1. Multiple shooting applied to robust reservoir control optimization including output constraints on coherent risk measures

    Codas, Andrés; Hanssen, Kristian G.; Foss, Bjarne

    2017-01-01

    The production life of oil reservoirs starts under significant uncertainty regarding the actual economical return of the recovery process due to the lack of oil field data. Consequently, investors and operators make management decisions based on a limited and uncertain description of the reservoir....... In this work, we propose a new formulation for robust optimization of reservoir well controls. It is inspired by the multiple shooting (MS) method which permits a broad range of parallelization opportunities and output constraint handling. This formulation exploits coherent risk measures, a concept...

  2. Multiple model predictive control for optimal drug administration of mixed immunotherapy and chemotherapy of tumours.

    Sharifi, N; Ozgoli, S; Ramezani, A

    2017-06-01

    Mixed immunotherapy and chemotherapy of tumours is one of the most efficient ways to improve cancer treatment strategies. However, it is important to 'design' an effective treatment programme which can optimize the ways of combining immunotherapy and chemotherapy to diminish their imminent side effects. Control engineering techniques could be used for this. The method of multiple model predictive controller (MMPC) is applied to the modified Stepanova model to induce the best combination of drugs scheduling under a better health criteria profile. The proposed MMPC is a feedback scheme that can perform global optimization for both tumour volume and immune competent cell density by performing multiple constraints. Although current studies usually assume that immunotherapy has no side effect, this paper presents a new method of mixed drug administration by employing MMPC, which implements several constraints for chemotherapy and immunotherapy by considering both drug toxicity and autoimmune. With designed controller we need maximum 57% and 28% of full dosage of drugs for chemotherapy and immunotherapy in some instances, respectively. Therefore, through the proposed controller less dosage of drugs are needed, which contribute to suitable results with a perceptible reduction in medicine side effects. It is observed that in the presence of MMPC, the amount of required drugs is minimized, while the tumour volume is reduced. The efficiency of the presented method has been illustrated through simulations, as the system from an initial condition in the malignant region of the state space (macroscopic tumour volume) transfers into the benign region (microscopic tumour volume) in which the immune system can control tumour growth. Copyright © 2017 Elsevier B.V. All rights reserved.

  3. Remote control improves quality of life in elderly pacemaker patients versus standard ambulatory-based follow-up.

    Comoretto, Rosanna Irene; Facchin, Domenico; Ghidina, Marco; Proclemer, Alessandro; Gregori, Dario

    2017-08-01

    Health-related quality of life (HRQoL) improves shortly after pacemaker (PM) implantation. No studies have investigated the HRQoL trend for elderly patients with a remote device monitoring follow-up system. Using EuroQol-5D Questionnaire and the PM-specific Assessment of Quality of Life and Related Events Questionnaire, HRQoL was measured at baseline and then repeatedly during the 6 months following PM implantation in a cohort of 42 consecutive patients. Twenty-five patients were followed-up with standard outpatient visits, while 17 used a remote monitoring system. Aquarel scores were significantly higher in patients with remote device monitoring system regarding chest discomfort and arrhythmia subscales the first month after PM implant and remained stable until 6 months. Remote monitoring affected the rate of HRQoL improvement in the first 3 months after pacemaker implantation more than ambulatory follow-up. Remote device monitoring has a significant impact on HRQoL in pacemaker patients, increasing its levels up to 6 months after implant. © 2017 John Wiley & Sons, Ltd.

  4. Preventive effects of topical washing with miconazole nitrate-containing soap to diaper candidiasis in hospitalized elderly patients: A prospective, double-blind, placebo-controlled study.

    Takahashi, Hidenori; Oyama, Noritaka; Tanaka, Izumi; Hasegawa, Michiko; Hirano, Kaori; Shimada, Chieko; Hasegawa, Minoru

    2017-07-01

    The objective of the present randomized, double-blind trial was to evaluate the efficacy and safety of daily washing with miconazole nitrate-containing soap for candidiasis at diaper-covered sites in elderly subjects under long-term inpatient care. To confirm the onset and disappearance of candidiasis, we microscopically evaluated the existence of the pseudohyphae and/or blastoconidia of Candida spp. We enrolled 75 elderly patients who wore diapers all day in the hospital or nursing home. Patients were randomly assigned to receive treatment with either miconazole soap or miconazole-free placebo soap, and 28 patients in the miconazole group and 27 patients in the placebo group were followed for 4 weeks. Although washing with miconazole soap did not affect the frequency of pseudohyphae/blastoconidia-positive patients, it significantly inhibited the positive conversion of pseudohyphae/blastoconidia compared with the placebo group. As a result, the frequency of patients positive for pseudohyphae/blastoconidia was significantly lower in the miconazole group than in the control group at 4 weeks (17.9% vs 44.4%). Clinically apparent diaper candidiasis did not develop in either group. Washing with miconazole soap was a significant independent factor for reducing the cases positive for pseudohyphae/blastoconidia, while diarrhea and heart failure were significant factors associated with an increase in the positive rate at the end-point. Severe adverse effects were not found in any patients. Thus, washing with miconazole soap is well-tolerated and can inhibit the positive conversion of Candida in patients wearing diapers. Therefore, maintenance of genital hygiene using this soap may prophylactically decrease the overall prevalence of patients with diaper candidiasis. © 2017 Japanese Dermatological Association.

  5. Design considerations of a randomized controlled trial of sedation level during hip fracture repair surgery: a strategy to reduce the incidence of postoperative delirium in elderly patients.

    Li, Tianjing; Wieland, L Susan; Oh, Esther; Neufeld, Karin J; Wang, Nae-Yuh; Dickersin, Kay; Sieber, Frederick E

    2017-06-01

    Background Delirium is an acute change in mental status characterized by sudden onset, fluctuating course, inattention, disorganized thinking, and abnormal level of consciousness. The objective of the randomized controlled trial "A STrategy to Reduce the Incidence of Postoperative Delirium in Elderly Patients" (STRIDE) is to assess the effectiveness of light versus heavy sedation on delirium and other outcomes in elderly patients undergoing hip fracture repair surgery. Our goal is to describe the design considerations and lessons learned in planning and implementing the STRIDE trial. Methods Discussed are challenges encountered including (1) how to ensure that we quickly identify, assess the eligibility of, and randomize traumatic hip fracture patients; (2) how to implement interventions that involve continuous monitoring and adjustment during the surgery; and (3) how to measure and ascertain the primary outcome, delirium. Results To address the first challenge, we monitored the operating room schedule more actively than anticipated. We constructed and organized eligibility assessment data collection forms by purpose and by source of information needed to complete them. We decided that randomization needs to take place in the operating room. To address the second challenge, we designed and implemented a treatment protocol and covered the bispectral index monitor to prevent the Anesthesiologist/Anesthetist from being influenced by the bispectral index reading while administering the intervention. Finally, clinical assessment of delirium consisted of standardized interviews of the patient using validated instruments, interviews of those caring for the patient, and review of the medical record. A consensus panel made the final determination of a delirium diagnosis. We note that STRIDE is a single-center trial. The decisions we took may have different implications for multi-center trials. Conclusions Lessons learned are likely to provide useful information to others

  6. Hybrid Control System for Greater Resilience Using Multiple Isolation and Building Connection

    Masaki Taniguchi

    2016-10-01

    Full Text Available An innovative hybrid control building system of multiple isolation and connection is proposed and investigated using both time-history and input energy responses for various types of ground motions together with transfer functions. It is concerned that the seismic displacement response at the base-isolation layer of the existing base-isolated buildings may extremely increase under long-period and long-duration ground motions which are getting great attention recently. In order to enhance the seismic performance of those base-isolated buildings, a novel hybrid system of multiple isolation and building-connection is proposed and compared with other structural systems such as an independent multiple isolation system, a hybrid system of base-isolation and building-connection. Furthermore, the robustness of seismic responses of the proposed hybrid system for various types of ground motion is discussed through the comparison of various structural systems including non-hybrid systems. Finally the optimal connection damper location is investigated using a sensitivity-type optimization approach.

  7. Analysis of the immune system of multiple myeloma patients achieving long-term disease control by multidimensional flow cytometry

    Pessoa de Magalhães, Roberto J.; Vidriales, María-Belén; Paiva, Bruno; Fernandez-Gimenez, Carlos; García-Sanz, Ramón; Mateos, Maria-Victoria; Gutierrez, Norma C.; Lecrevisse, Quentin; Blanco, Juan F; Hernández, Jose; de las Heras, Natalia; Martinez-Lopez, Joaquin; Roig, Monica; Costa, Elaine Sobral; Ocio, Enrique M.; Perez-Andres, Martin; Maiolino, Angelo; Nucci, Marcio; De La Rubia, Javier; Lahuerta, Juan-Jose; San-Miguel, Jesús F.; Orfao, Alberto

    2013-01-01

    Multiple myeloma remains largely incurable. However, a few patients experience more than 10 years of relapse-free survival and can be considered as operationally cured. Interestingly, long-term disease control in multiple myeloma is not restricted to patients with a complete response, since some patients revert to having a profile of monoclonal gammopathy of undetermined significance. We compared the distribution of multiple compartments of lymphocytes and dendritic cells in the bone marrow and peripheral blood of multiple myeloma patients with long-term disease control (n=28), patients with newly diagnosed monoclonal gammopathy of undetermined significance (n=23), patients with symptomatic multiple myeloma (n=23), and age-matched healthy adults (n=10). Similarly to the patients with monoclonal gammopathy of undetermined significance and symptomatic multiple myeloma, patients with long-term disease control showed an expansion of cytotoxic CD8+ T cells and natural killer cells. However, the numbers of bone marrow T-regulatory cells were lower in patients with long-term disease control than in those with symptomatic multiple myeloma. It is noteworthy that B cells were depleted in patients with monoclonal gammopathy of undetermined significance and in those with symptomatic multiple myeloma, but recovered in both the bone marrow and peripheral blood of patients with long-term disease control, due to an increase in normal bone marrow B-cell precursors and plasma cells, as well as pre-germinal center peripheral blood B cells. The number of bone marrow dendritic cells and tissue macrophages differed significantly between patients with long-term disease control and those with symptomatic multiple myeloma, with a trend to cell count recovering in the former group of patients towards levels similar to those found in healthy adults. In summary, our results indicate that multiple myeloma patients with long-term disease control have a constellation of unique immune changes

  8. Coordination of networked systems on digraphs with multiple leaders via pinning control

    Chen, Gang; Lewis, Frank L.

    2012-02-01

    It is well known that achieving consensus among a group of multi-vehicle systems by local distributed control is feasible if and only if all nodes in the communication digraph are reachable from a single (root) node. In this article, we take into account a more general case that the communication digraph of the networked multi-vehicle systems is weakly connected and has two or more zero-in-degree and strongly connected subgraphs, i.e. there are two or more leader groups. Based on the pinning control strategy, the feasibility problem of achieving second-order controlled consensus is studied. At first, a necessary and sufficient condition is given when the topology is fixed. Then the method to design the controller and the rule to choose the pinned vehicles are discussed. The proposed approach allows us to extend several existing results for undirected graphs to directed balanced graphs. A sufficient condition is proposed in the case where the coupling topology is variable. As an illustrative example, a second-order controlled consensus scheme is applied to coordinate the movement of networked multiple mobile robots.

  9. Flocking Control of Multiple Mobile Agents with the Rules of Avoiding Collision

    Hongtao Zhou

    2015-01-01

    Full Text Available This paper investigates the flocking and the coordinative control problems of multiple mobile agents with the rules of avoiding collision. We propose a set of control laws using hysteresis in adding new links and applying new potential function to guarantee that the fragmentation of the network can be avoided, under which all agents approach a common velocity vector, and asymptotically converge to a fixed value of interagent distances and collisions between agents can be avoided throughout the motion. Furthermore, we extend the flocking algorithm to solve the flocking situation of the group with a virtual leader agent. The laws can make all agents asymptotically approach the virtual leader and collisions can be avoided between agents in the motion evolution. Finally, some numerical simulations are showed to illustrate the theoretical results.

  10. Improvements in cognition, quality of life, and physical performance with clinical Pilates in multiple sclerosis: a randomized controlled trial

    K???k, Fadime; Kara, Bilge; Poyraz, Esra ?o?kuner; ?diman, Egemen

    2016-01-01

    [Purpose] The aim of this study was to determine the effects of clinical Pilates in multiple sclerosis patients. [Subjects and Methods] Twenty multiple sclerosis patients were enrolled in this study. The participants were divided into two groups as the clinical Pilates and control groups. Cognition (Multiple Sclerosis Functional Composite), balance (Berg Balance Scale), physical performance (timed performance tests, Timed up and go test), tiredness (Modified Fatigue Impact scale), depression ...

  11. Channel selection for simultaneous and proportional myoelectric prosthesis control of multiple degrees-of-freedom

    Hwang, Han-Jeong; Hahne, Janne Mathias; Müller, Klaus-Robert

    2014-10-01

    Objective. Recent studies have shown the possibility of simultaneous and proportional control of electrically powered upper-limb prostheses, but there has been little investigation on optimal channel selection. The objective of this study is to find a robust channel selection method and the channel subsets most suitable for simultaneous and proportional myoelectric prosthesis control of multiple degrees-of-freedom (DoFs). Approach. Ten able-bodied subjects and one person with congenital upper-limb deficiency took part in this study, and performed wrist movements with various combinations of two DoFs (flexion/extension and radial/ulnar deviation). During the experiment, high density electromyographic (EMG) signals and the actual wrist angles were recorded with an 8 × 24 electrode array and a motion tracking system, respectively. The wrist angles were estimated from EMG features with ridge regression using the subsets of channels chosen by three different channel selection methods: (1) least absolute shrinkage and selection operator (LASSO), (2) sequential feature selection (SFS), and (3) uniform selection (UNI). Main results. SFS generally showed higher estimation accuracy than LASSO and UNI, but LASSO always outperformed SFS in terms of robustness, such as noise addition, channel shift and training data reduction. It was also confirmed that about 95% of the original performance obtained using all channels can be retained with only 12 bipolar channels individually selected by LASSO and SFS. Significance. From the analysis results, it can be concluded that LASSO is a promising channel selection method for accurate simultaneous and proportional prosthesis control. We expect that our results will provide a useful guideline to select optimal channel subsets when developing clinical myoelectric prosthesis control systems based on continuous movements with multiple DoFs.

  12. A full scope nuclear power plant simulator for multiple reactor types with virtual control panels

    Yonezawa, Hisanori; Ueda, Hiroki; Kato, Takahisa

    2017-01-01

    This paper summarizes a full scope nuclear power plant simulator for multiple reactor types with virtual control panels which Toshiba developed and delivered. After the Fukushima DAIICHI nuclear power plants accident, it is required that all the people who are engaged in the design, manufacturing, operation, maintenance, management and regulation for the nuclear power plant should learn the wide and deep knowledge about the nuclear power plant design including the severe accident. For this purpose, the training with a full scope simulator is one of the most suitable ways. However the existing full scope simulators which are consist of the control panels replica of the referenced plants are costly and they are hard to remodel to fit to the real plant of the latest condition. That's why Toshiba developed and delivered the new concept simulator system which covers multiple referenced plants even though they have different design like BWR and PWR. The control panels of the simulator are made by combining 69 large Liquid Crystal Display (LCD) panels with touch screen instead of a control panel replica of referenced plant. The screen size of the each panel is 42 inches and 3 displays are arranged in tandem for one unit and 23 units are connected together. Each panel displays switches, indicators, recorders and lamps with the Computer Graphics (CG) and trainees operate them with touch operations. The simulator includes a BWR and a PWR simulator model, which enable trainees to learn the wide and deep knowledge about the nuclear power plant of BWR and PWR reactor types. (author)

  13. Selective control of multiple ferroelectric switching pathways using a trailing flexoelectric field

    Park, Sung Min; Wang, Bo; Das, Saikat; Chae, Seung Chul; Chung, Jin-Seok; Yoon, Jong-Gul; Chen, Long-Qing; Yang, Sang Mo; Noh, Tae Won

    2018-05-01

    Flexoelectricity is an electromechanical coupling between electrical polarization and a strain gradient1 that enables mechanical manipulation of polarization without applying an electrical bias2,3. Recently, flexoelectricity was directly demonstrated by mechanically switching the out-of-plane polarization of a uniaxial system with a scanning probe microscope tip3,4. However, the successful application of flexoelectricity in low-symmetry multiaxial ferroelectrics and therefore active manipulation of multiple domains via flexoelectricity have not yet been achieved. Here, we demonstrate that the symmetry-breaking flexoelectricity offers a powerful route for the selective control of multiple domain switching pathways in multiaxial ferroelectric materials. Specifically, we use a trailing flexoelectric field that is created by the motion of a mechanically loaded scanning probe microscope tip. By controlling the SPM scan direction, we can deterministically select either stable 71° ferroelastic switching or 180° ferroelectric switching in a multiferroic magnetoelectric BiFeO3 thin film. Phase-field simulations reveal that the amplified in-plane trailing flexoelectric field is essential for this domain engineering. Moreover, we show that mechanically switched domains have a good retention property. This work opens a new avenue for the deterministic selection of nanoscale ferroelectric domains in low-symmetry materials for non-volatile magnetoelectric devices and multilevel data storage.

  14. MANAGEMENT OF DIABETES IN THE ELDERLY

    congestive heart failure often co-occur in elderly patients with geriatric conditions such as urinary incontinence and injurious falls.8 Nevertheless, ... complications, although a case for improved diabetes control and the prevention of ...

  15. $H^\\infty$ control of systems with multiple I/O delays via decomposition to adobe problems

    Meinsma, Gjerrit; Mirkin, Leonid

    In this paper, the standard (four-block) $H^\\infty$ control problem for systems with multiple input-output delays in the feedback loop is studied. The central idea is to see the multiple delay operator as a special series connection of elementary delay operators, called the adobe delay operators.

  16. Combining Exergame Training with Omega-3 Fatty Acid Supplementation: Protocol for a Randomized Controlled Study assessing the Effect on Neuronal Structure/Function in the Elderly Brain

    Alexandra Schättin

    2016-11-01

    Full Text Available A common problem in the older population is the risk of falling that might lead to injury, immobility, and reduced survival. Age-related neuronal changes, e.g. decline in grey- and white-matter, affect neuronal, cognitive, and motor functioning. The improvement of these factors might decrease fall events in elderly. Studies showed that the sole administration of video game-based physical exercise, a so-called exergame, or omega-3 fatty acid (FA may improve motor and/or cognitive functioning through neuronal changes in the brain of older adults. The aim of this study is to assess the effects of a combination of exergame training with omega-3 FA supplementation on the elderly brain. We hypothesize that an intervention using a combination approach differently effects on the neuronal structure and function of the elderly’s brain as compared to the sole administration of exergame training. The study is a parallel, double-blinded, randomized controlled trial lasting 26 weeks. Sixty autonomous living, non-smoking, and right-handed healthy older (>65 years adults who live independently or in a senior residency are included, randomized, and allocated to one of two study groups. The experimental group receives a daily amount of 13.5ml fish oil (including 2.9g of omega-3 FA, whereas the control group receives a daily amount of 13.5ml olive oil for 26 weeks. After 16 weeks, both groups start with an exergame training program three times per week. Measurements are performed on three time-points by treatment blinded investigators: pre-intervention measurement, blood sample after 16 week, and post-intervention measurements. The main outcomes are motor evoked potentials of the right M. tibialis anterior (transcranial magnetic stimulation and response-related potentials (electroencephalography during a cognitive test. For secondary outcomes, reaction times during cognitive tests and spatio-temporal parameters during gait performance are measured. Statistics

  17. PREDOMOS study, impact of a social intervention program for socially isolated elderly cancer patients: study protocol for a randomized controlled trial.

    Crétel-Durand, Elodie; Nouguerède, Emilie; Le Caer, Hervé; Rousseau, Frédérique; Retornaz, Frédérique; Guillem, Olivier; Couderc, Anne-Laure; Greillier, Laurent; Norguet, Emmanuelle; Cécile, Maud; Boulahssass, Rabia; Le Caer, Francoise; Tournier, Sandrine; Butaud, Chantal; Guillet, Pierre; Nahon, Sophie; Poudens, Laure; Kirscher, Sylvie; Loubière, Sandrine; Diaz, Nadine; Dhorne, Jean; Auquier, Pascal; Baumstarck, Karine

    2017-04-12

    Cancer incidence and social isolation increase along with advanced age, and social isolation potentiates the relative risk of death by cancer. Once spotted, social isolation can be averted with the intervention of a multidisciplinary team. Techniques of automation and remote assistance have already demonstrated their positive impact on falls prevention and quality of life (QoL), though little is known about their impact on socially isolated elderly patients supported for cancer. The primary objective of the PREDOMOS study is to evaluate the impact of establishing a Program of Social intervention associated with techniques of Domotic and Remote assistance (PS-DR) on the improvement of QoL of elderly isolated patients, treated for locally advanced or metastatic cancer. The secondary objectives include treatment failure, tolerance, survival, and autonomy. This trial is a multicenter, prospective, randomized, placebo-controlled, open-label, two-parallel group study. The setting is 10 French oncogeriatric centers. Inclusion criteria are patients aged at least 70 years with a social isolation risk and a histological diagnosis of cancer, locally advanced or metastatic disease. The groups are (1) the control group, receiving usual care; (2) the experimental group, receiving usual care associating with monthly social assistance, domotic, and remote assistance. Participants are randomized in a 1:1 allocation ratio. Evaluation times involve inclusion (randomization) and follow-up (12 months). The primary endpoint is QoL at 3 months (via European Organization for Research and Treatment of Cancer (EORTC) QLQ C30); secondary endpoints are social isolation, time to treatment failure, toxicity, dose response-intensity, survival, autonomy, and QoL at 6 months. For the sample size, 320 individuals are required to obtain 90% power to detect a 10-point difference (standard deviation 25) in QoL score between the two groups (20% loss to follow-up patients expected). The randomized

  18. Optimal planning approaches with multiple impulses for rendezvous based on hybrid genetic algorithm and control method

    JingRui Zhang

    2015-03-01

    Full Text Available In this article, we focus on safe and effective completion of a rendezvous and docking task by looking at planning approaches and control with fuel-optimal rendezvous for a target spacecraft running on a near-circular reference orbit. A variety of existent practical path constraints are considered, including the constraints of field of view, impulses, and passive safety. A rendezvous approach is calculated by using a hybrid genetic algorithm with those constraints. Furthermore, a control method of trajectory tracking is adopted to overcome the external disturbances. Based on Clohessy–Wiltshire equations, we first construct the mathematical model of optimal planning approaches of multiple impulses with path constraints. Second, we introduce the principle of hybrid genetic algorithm with both stronger global searching ability and local searching ability. We additionally explain the application of this algorithm in the problem of trajectory planning. Then, we give three-impulse simulation examples to acquire an optimal rendezvous trajectory with the path constraints presented in this article. The effectiveness and applicability of the tracking control method are verified with the optimal trajectory above as control objective through the numerical simulation.

  19. Comparison of Personality Characteristics and Coping Strategies in Patients With Multiple Sclerosis and Control Group

    Mohammadi

    2015-09-01

    Full Text Available Background The present study aimed to investigate personality traits and coping strategies in patients with multiple sclerosis (MS who were admitted to Sina hospital compared with healthy individuals. Objectives The aim of the present study was to compare personality characteristics and coping strategies between patients with MS and healthy controls. Materials and Methods The study sample included 55 patients with MS and 57 matched healthy control individuals. The data were gathered via a demographic form, the ways of coping questionnaire, and the NEO five-factor inventory. The data were analyzed by multivariate analysis of variance (MANOVA, Pearson’s correlation coefficient, and logistic regression. Results No significant differences in personality characteristics were observed between patients and healthy controls (all P > 0.05. Only the coping strategy subscale of Distancing was significant between patients and healthy controls (P 0.05. Only the Neuroticism personality trait and the Distancing coping strategy were predictive of group membership (i.e., healthy or patient. Conclusions Our study suggests that the personality traits of patients with MS and healthy individuals are not significantly different. Patients with MS are likely to use the same coping strategies as healthy individuals, except in the subscale of Distancing.

  20. Ultrasonographic evaluation of cerebral arterial and venous haemodynamics in multiple sclerosis: a case-control study.

    Pasquale Marchione

    Full Text Available OBJECTIVE: Although recent studies excluded an association between Chronic Cerebrospinal Venous Insufficiency and Multiple Sclerosis (MS, controversial results account for some cerebrovascular haemodynamic impairment suggesting a dysfunction of cerebral autoregulation mechanisms. The aim of this cross-sectional, case-control study is to evaluate cerebral arterial inflow and venous outflow by means of a non-invasive ultrasound procedure in Relapsing Remitting (RR, Primary Progressive (PP Multiple Sclerosis and age and sex-matched controls subjects. MATERIAL AND METHODS: All subjects underwent a complete extra-intracranial arterial and venous ultrasound assessment with a color-coded duplex sonography scanner and a transcranial doppler equipment, in both supine and sitting position by means of a tilting chair. Basal arterial and venous morphology and flow velocities, postural changes in mean flow velocities (MFV of middle cerebral arteries (MCA, differences between cerebral venous outflow (CVF in clinostatism and in the seated position (ΔCVF and non-invasive cerebral perfusion pressure (CPP were evaluated. RESULTS: 85 RR-MS, 83 PP-MS and 82 healthy controls were included. ΔCVF was negative in 45/85 (52.9% RR-MS, 63/83 (75.9% PP-MS (p = 0.01 and 11/82 (13.4% controls (p<0.001, while MFVs on both MCAs in sitting position were significantly reduced in RR-MS and PP-MS patients than in control, particularly in EDSS ≥ 5 subgroup (respectively, 42/50, 84% vs. 66/131, 50.3%, p<0.01 and 48.3 ± 2 cm/s vs. 54.6 ± 3 cm/s, p = 0.01. No significant differences in CPP were observed within and between groups. CONCLUSIONS: The quantitative evaluation of cerebral blood flow (CBF and CVF and their postural dependency may be related to a dysfunction of autonomic nervous system that seems to characterize more disabled MS patients. It's not clear whether the altered postural control of arterial inflow and venous outflow is a specific MS condition or simply an

  1. Molecular evolution of multiple-level control of heme biosynthesis pathway in animal kingdom.

    Tzou, Wen-Shyong; Chu, Ying; Lin, Tzung-Yi; Hu, Chin-Hwa; Pai, Tun-Wen; Liu, Hsin-Fu; Lin, Han-Jia; Cases, Ildeofonso; Rojas, Ana; Sanchez, Mayka; You, Zong-Ye; Hsu, Ming-Wei

    2014-01-01

    Adaptation of enzymes in a metabolic pathway can occur not only through changes in amino acid sequences but also through variations in transcriptional activation, mRNA splicing and mRNA translation. The heme biosynthesis pathway, a linear pathway comprised of eight consecutive enzymes in animals, provides researchers with ample information for multiple types of evolutionary analyses performed with respect to the position of each enzyme in the pathway. Through bioinformatics analysis, we found that the protein-coding sequences of all enzymes in this pathway are under strong purifying selection, from cnidarians to mammals. However, loose evolutionary constraints are observed for enzymes in which self-catalysis occurs. Through comparative genomics, we found that in animals, the first intron of the enzyme-encoding genes has been co-opted for transcriptional activation of the genes in this pathway. Organisms sense the cellular content of iron, and through iron-responsive elements in the 5' untranslated regions of mRNAs and the intron-exon boundary regions of pathway genes, translational inhibition and exon choice in enzymes may be enabled, respectively. Pathway product (heme)-mediated negative feedback control can affect the transport of pathway enzymes into the mitochondria as well as the ubiquitin-mediated stability of enzymes. Remarkably, the positions of these controls on pathway activity are not ubiquitous but are biased towards the enzymes in the upstream portion of the pathway. We revealed that multiple-level controls on the activity of the heme biosynthesis pathway depend on the linear depth of the enzymes in the pathway, indicating a new strategy for discovering the molecular constraints that shape the evolution of a metabolic pathway.

  2. Sympathetic skin response in multiple sclerosis: a meta-analysis of case-control studies.

    Margaritella, Nicolò; Mendozzi, Laura; Garegnani, Massimo; Gilardi, Elisabetta; Nemni, Raffaello; Pugnetti, Luigi

    2018-01-01

    The usefulness of sympathetic skin responses (SSR) in multiple sclerosis (MS) has been advocated by several studies in the last 20 years; however, due to a great heterogeneity of findings, a comprehensive meta-analysis of case-control studies is in order to pinpoint consistencies and investigate the causes of discrepancies. We searched MEDLINE, EMBASE and Cochrane databases for case-control studies comparing SSR absence frequency and latency between patients with MS and healthy controls. Thirteen eligible studies including 415 MS patients and 331 healthy controls were identified. The pooled analysis showed that SSR can be always obtained in healthy controls while 34% of patients had absent SSRs in at least one limb (95% CI 22-47%; p studies (I 2  = 90.3%). Patients' age explained 22% of the overall variability and positive correlations were found with Expanded Disability Status Scale and disease duration. The pooled mean difference of SSR latency showed a significant increase in patients on both upper (193 ms; 95% CI 120-270 ms) and lower (350 ms; 95% CI 190-510 ms) extremities. We tested the discriminatory value of SSR latency thresholds defined as the 95% confidence interval (CI) upper bound of the healthy controls, and validated the results on a new dataset. The lower limb threshold of 1.964 s produces the best results in terms of sensitivity 0.86, specificity 0.67, positive predicted value 0.75 and negative predicted value 0.80. Despite a considerable heterogeneity of findings, there is evidence that SSR is a useful tool in MS.

  3. Neural-adaptive control of single-master-multiple-slaves teleoperation for coordinated multiple mobile manipulators with time-varying communication delays and input uncertainties.

    Li, Zhijun; Su, Chun-Yi

    2013-09-01

    In this paper, adaptive neural network control is investigated for single-master-multiple-slaves teleoperation in consideration of time delays and input dead-zone uncertainties for multiple mobile manipulators carrying a common object in a cooperative manner. Firstly, concise dynamics of teleoperation systems consisting of a single master robot, multiple coordinated slave robots, and the object are developed in the task space. To handle asymmetric time-varying delays in communication channels and unknown asymmetric input dead zones, the nonlinear dynamics of the teleoperation system are transformed into two subsystems through feedback linearization: local master or slave dynamics including the unknown input dead zones and delayed dynamics for the purpose of synchronization. Then, a model reference neural network control strategy based on linear matrix inequalities (LMI) and adaptive techniques is proposed. The developed control approach ensures that the defined tracking errors converge to zero whereas the coordination internal force errors remain bounded and can be made arbitrarily small. Throughout this paper, stability analysis is performed via explicit Lyapunov techniques under specific LMI conditions. The proposed adaptive neural network control scheme is robust against motion disturbances, parametric uncertainties, time-varying delays, and input dead zones, which is validated by simulation studies.

  4. Percentage height of center of mass is associated with the risk of falls among elderly women: A case-control study.

    Almeida, Cláudio W L; Castro, Charlles H M; Pedreira, Paulo G; Heymann, Roberto E; Szejnfeld, Vera L

    2011-06-01

    Falls are a serious health problem for aged people, causing social and economic burden. Despite being an important determinant of balance, the positioning of the center of mass (COM) has not been evaluated as a risk factor for falls. This study examined the association between the percentage height of COM (%COM) and the risk of falls in the elderly. Healthy women aged 60 years and older were consecutively selected in a case-control study. Forty-eight individuals classified as "fallers" (having suffered two or more falls in the previous year) were the cases while 48 age and weight-matched women with one fall or no falls in the previous year were the controls ("non-fallers"). Body composition and bone mineral density (BMD) by DXA, 30-second chair stand test, abdominal circumference, Berg's balance scale and %COM using the reaction board method were evaluated in all participants. Body composition parameters were not significantly different between groups. Spine and hip BMD tended to be lower in the fallers, but the difference was significant only at the femoral neck (0.80±0.10g/cm(2) versus 0.87±0.76g/cm(2); pfalls. Further work is needed in order to determine the value of board reaction measurements in a clinical setting to identify patients at high risk. Copyright © 2011 Elsevier B.V. All rights reserved.

  5. Evaluation of an intra-institutional diabetes disease management program for the glycemic control of elderly long-term care diabetic patients.

    Lubart, Emily; Segal, Refael; Wainstein, Julio; Marinov, Galina; Yarovoy, Alexandra; Leibovitz, Arthur

    2014-04-01

    Increasing numbers of nursing home elderly patients suffer from diabetes requiring individually optimized glycemic control. This is a complicated challenge because of their high comorbidity level, and heterogeneous and changing eating status varying from independent to dysphagia and enteral feeding. In order to cope with these complex needs, we developed and implemented a diabetes disease management program. The purpose of the present study was to evaluate this program. We used the point prevalence approach by checking for fasting blood glucose, glycated hemoglobin and other routine biochemical tests. Eating status was evaluated by the Functional Outcome Swallowing Scale. Details about the diabetes disease management program are given in the text. A total of 86 (36%) of the 234 patients on the study day were diabetics. Of these, 80 were eligible for the study. Their mean fasting blood glucose was 143.1 ± 60.6 mg/dL. The mean glycated hemoglobin level was 7.23 ± 1.39%. No case of hypoglycemia was detected on the examination day, or during the preceding 3 weeks. No significant difference was found among the different Functional Outcome Swallowing Scale categories. These results are within satisfactory range for this category of patients suggesting that our diabetes disease management program contributes to a better glycemic control. © 2013 Japan Geriatrics Society.

  6. [Homebound elderly in a Japanese community: related factors and change of mobility].

    Imuta, H; Yasumura, S; Fujita, M; Arai, H; Fukao, A

    1998-09-01

    The aim of this study was to identify the prevalence of homebound elderly (defined as people whose daily activities were limited to their home) and factors related to it among 300 community elderly residents aged 60 and over in Yamagata city. In 1995, the baseline survey was performed and the follow-up survey was conducted one year later. Subjects were divided into two groups according to the extent of their daily activities: the non-homebound group (defined as people whose daily activities extended into their community) and the homebound group. The main results were as follows; 1. The prevalence of homebound elderly was 7.7% in 1995. 2. Chi-square test or t test was performed to examine the relationship between homebound and various factors. Significant factors were age, history of hypertension, history of mental disease, incompetence of ADLs (walking, eating, toileting, bathing, dressing), interpersonal dependency, subjective health, 'ikigai' (meaningfulness of life), life style (cooking, cleaning, reading newspaper or magazine, watching TV, exercise, associate with friend) and TMIG (Tokyo Metropolitan Institute of Gerontology) index of competence. The present study reveals that daily activities in community elderly residents is related to not only physical factors but also psychosocial factors. Using the significant variables in univariate analysis, multiple logistic regression analysis controlling for age was performed. Significant factors for homebound were incompetence of ADLs (walking, toileting), subjective health and TMIG index of competence. 3. Three out of 214 non-homebound elderly persons in 1995 changed to homebound in 1996.

  7. Participant recruitment into a randomised controlled trial of exercise therapy for people with multiple sclerosis.

    Carter, Anouska; Humphreys, Liam; Snowdon, Nicky; Sharrack, Basil; Daley, Amanda; Petty, Jane; Woodroofe, Nicola; Saxton, John

    2015-10-15

    The success of a clinical trial is often dependant on whether recruitment targets can be met in the required time frame. Despite an increase in research into the benefits of exercise in people with multiple sclerosis (PwMS), no trial has reported detailed data on effective recruitment strategies for large-scale randomised controlled trials. The main purpose of this report is to provide a detailed outline of recruitment strategies, rates and estimated costs in the Exercise Intervention for Multiple Sclerosis (ExIMS) trial to identify best practices for future trials involving multiple sclerosis (MS) patient recruitment. The ExIMS researchers recruited 120 PwMS to participate in a 12-week exercise intervention. Participants were randomly allocated to either exercise or usual-care control groups. Participants were sedentary, aged 18-65 years and had Expanded Disability Status Scale scores of 1.0-6.5. Recruitment strategies included attendance at MS outpatient clinics, consultant mail-out and trial awareness-raising activities. A total of 120 participants were recruited over the course of 34 months. To achieve this target, 369 potentially eligible and interested participants were identified. A total of 60 % of participants were recruited via MS clinics, 29.2 % from consultant mail-outs and 10.8 % through trial awareness. The randomisation yields were 33.2 %, 31.0 % and 68.4 % for MS clinic, consultant mail-outs and trial awareness strategies, respectively. The main reason for ineligibility was being too active (69.2 %), whilst for eligible participants the most common reason for non-participation was the need to travel to the study site (15.8 %). Recruitment via consultant mail-out was the most cost-effective strategy, with MS clinics being the most time-consuming and most costly. To reach recruitment targets in a timely fashion, a variety of methods were employed. Although consultant mail-outs were the most cost-effective recruitment strategy, use of this

  8. Future elderly care in China, how should it be?

    Cai, Hao; Cai, Yanguang; Tao, Yingshan

    2016-01-01

    The Chinese healthcare system is at a crossroads of the history. Multiple challenges are encountered due to the demographic changes. The aim of this study was to investigate the aspects of the Chinese youngsters on the future elderly care system. A significant social-cultural consciousness...... difference of youngsters on elderly care was found between China and other parts of the world....

  9. Falls prediction in elderly people : A 1-year prospective study

    Swanenburg, Jaap; de Bruin, Eling D.; Uebelhart, Daniel; Mulder, Theo

    The aim of the present study was to determine whether force plate variables in single- and dual-task situations are able to predict the risk of multiple falls in a community-dwelling elderly population. Two hundred and seventy elderly persons (225 females, 45 males; age, 73 7 years) performed

  10. Polypharmacy and falls in the middle age and elderly population

    G. Ziere; J.P. Dieleman (Jeanne); A. Hofman (Albert); H.A.P. Pols (Huib); T.J.M. van der Cammen (Tischa); B.H.Ch. Stricker (Bruno)

    2006-01-01

    textabstractAim: Falls in the elderly are common and often serious. We studied the association between multiple drug use (polypharmacy) and falls in the elderly. Methods: This was a population-based cross-sectional study, part of the Rotterdam Study. The participants were 6928 individuals aged ≥55

  11. Human placenta-derived cells (PDA-001) for the treatment of adults with multiple sclerosis: a randomized, placebo-controlled, multiple-dose study.

    Lublin, Fred D; Bowen, James D; Huddlestone, John; Kremenchutzky, Marcelo; Carpenter, Adam; Corboy, John R; Freedman, Mark S; Krupp, Lauren; Paulo, Corri; Hariri, Robert J; Fischkoff, Steven A

    2014-11-01

    Infusion of PDA-001, a preparation of mesenchymal-like cells derived from full-term human placenta, is a new approach in the treatment of patients with multiple sclerosis. This safety study aimed to rule out the possibility of paradoxical exacerbation of disease activity by PDA-001 in patients with multiple sclerosis. This was a phase 1b, multicenter, randomized, double-blind, placebo-controlled, 2-dose ranging study including patients with relapsing-remitting multiple sclerosis or secondary progressive multiple sclerosis. The study was conducted at 6 sites in the United States and 2 sites in Canada. Patients were randomized 3:1 to receive 2 low-dose infusions of PDA-001 (150×10(6) cells) or placebo, given 1 week apart. After completing this cohort, subsequent patients received high-dose PDA-001 (600×10(6) cells) or placebo. Monthly brain magnetic resonance imaging scans were performed. The primary end point was ruling out the possibility of paradoxical worsening of MS disease activity. This was monitored using Cutter׳s rule (≥5 new gadolinium lesions on 2 consecutive scans) by brain magnetic resonance imaging on a monthly basis for six months and also the frequency of multiple sclerosis relapse. Ten patients with relapsing-remitting multiple sclerosis and 6 with secondary progressive multiple sclerosis were randomly assigned to treatment: 6 to low-dose PDA-001, 6 to high-dose PDA-001, and 4 to placebo. No patient met Cutter׳s rule. One patient receiving high-dose PDA-001 had an increase in T2 and gadolinium lesions and in Expanded Disability Status Scale score during a multiple sclerosis flare 5 months after receiving PDA-001. No other patient had an increase in Expanded Disability Status Scale score>0.5, and most had stable or decreasing Expanded Disability Status Scale scores. With high-dose PDA-001, 1 patient experienced a grade 1 anaphylactoid reaction and 1 had grade 2 superficial thrombophlebitis. Other adverse events were mild to moderate and included

  12. Light therapy for multiple sclerosis-associated fatigue: Study protocol for a randomized controlled trial.

    Mateen, Farrah J; Manalo, Natalie C; Grundy, Sara J; Houghton, Melissa A; Hotan, Gladia C; Erickson, Hans; Videnovic, Aleksandar

    2017-09-01

    Fatigue is the most commonly reported symptom among multiple sclerosis (MS) patients, more than a quarter of whom consider fatigue to be their most disabling symptom. However, there are few effective treatment options for fatigue. We aim to investigate whether supplemental exposure to bright white light will reduce MS-associated fatigue. Eligible participants will have clinically confirmed multiple sclerosis based on the revised McDonald criteria (2010) and a score ≥36 on the Fatigue Severity Scale (FSS). Participants will be randomized 1:1 to bright white light (10,000 lux; active condition) or dim red light (treatment period, and a 4-week washout period. Participants will record their sleep duration, exercise, caffeine, and medication intake daily. Participants will record their fatigue using the Visual Analogue Fatigue Scale (VAFS) 4 times every third day, providing snapshots of their fatigue level at different times of day. Participants will self-report their fatigue severity using FSS on 3 separate visits: at baseline (week 0), following completion of the treatment phase (week 6), and at study completion (week 10). The primary outcome will be the change in the average FSS score after light therapy. We will perform an intention-to-treat analysis, comparing the active and control groups to assess the postintervention difference in fatigue levels reported on FSS. Secondary outcome measures include change in global VAFS scores during the light therapy and self-reported quality of life in the Multiple Sclerosis Quality of Life-54. We present a study design and rationale for randomizing a nonpharmacological intervention for MS-associated fatigue, using bright light therapy. The study limitations relate to the logistical issues of a self-administered intervention requiring frequent participant self-report in a relapsing condition. Ultimately, light therapy for the treatment of MS-associated fatigue may provide a low-cost, noninvasive, self-administered treatment

  13. Improvements in cognition, quality of life, and physical performance with clinical Pilates in multiple sclerosis: a randomized controlled trial.

    Küçük, Fadime; Kara, Bilge; Poyraz, Esra Çoşkuner; İdiman, Egemen

    2016-03-01

    [Purpose] The aim of this study was to determine the effects of clinical Pilates in multiple sclerosis patients. [Subjects and Methods] Twenty multiple sclerosis patients were enrolled in this study. The participants were divided into two groups as the clinical Pilates and control groups. Cognition (Multiple Sclerosis Functional Composite), balance (Berg Balance Scale), physical performance (timed performance tests, Timed up and go test), tiredness (Modified Fatigue Impact scale), depression (Beck Depression Inventory), and quality of life (Multiple Sclerosis International Quality of Life Questionnaire) were measured before and after treatment in all participants. [Results] There were statistically significant differences in balance, timed performance, tiredness and Multiple Sclerosis Functional Composite tests between before and after treatment in the clinical Pilates group. We also found significant differences in timed performance tests, the Timed up and go test and the Multiple Sclerosis Functional Composite between before and after treatment in the control group. According to the difference analyses, there were significant differences in Multiple Sclerosis Functional Composite and Multiple Sclerosis International Quality of Life Questionnaire scores between the two groups in favor of the clinical Pilates group. There were statistically significant clinical differences in favor of the clinical Pilates group in comparison of measurements between the groups. Clinical Pilates improved cognitive functions and quality of life compared with traditional exercise. [Conclusion] In Multiple Sclerosis treatment, clinical Pilates should be used as a holistic approach by physical therapists.

  14. A Limb Action Detector Enabling People with Multiple Disabilities to Control Environmental Stimulation through Limb Action with a Nintendo Wii Remote Controller

    Shih, Ching-Hsiang; Chang, Man-Ling; Shih, Ching-Tien

    2010-01-01

    This study assessed whether two persons with multiple disabilities would be able to control environmental stimulation using limb action with a Nintendo Wii Remote Controller and a newly developed limb action detection program (LADP, i.e., a new software program that turns a Wii Remote Controller into a precise limb action detector). This study was…

  15. Multiple memory systems, multiple time points: how science can inform treatment to control the expression of unwanted emotional memories.

    Visser, Renée M; Lau-Zhu, Alex; Henson, Richard N; Holmes, Emily A

    2018-03-19

    Memories that have strong emotions associated with them are particularly resilient to forgetting. This is not necessarily problematic, however some aspects of memory can be. In particular, the involuntary expression of those memories, e.g. intrusive memories after trauma, are core to certain psychological disorders. Since the beginning of this century, research using animal models shows that it is possible to change the underlying memory, for example by interfering with its consolidation or reconsolidation. While the idea of targeting maladaptive memories is promising for the treatment of stress and anxiety disorders, a direct application of the procedures used in non-human animals to humans in clinical settings is not straightforward. In translational research, more attention needs to be paid to specifying what aspect of memory (i) can be modified and (ii) should be modified. This requires a clear conceptualization of what aspect of memory is being targeted, and how different memory expressions may map onto clinical symptoms. Furthermore, memory processes are dynamic, so procedural details concerning timing are crucial when implementing a treatment and when assessing its effectiveness. To target emotional memory in its full complexity, including its malleability, science cannot rely on a single method, species or paradigm. Rather, a constructive dialogue is needed between multiple levels of research, all the way 'from mice to mental health'.This article is part of a discussion meeting issue 'Of mice and mental health: facilitating dialogue between basic and clinical neuroscientists'. © 2018 The Authors.

  16. Does self-reported sleep quality predict poor cognitive performance among elderly living in elderly homes?

    Amer, Motassem S; Hamza, Sarah A; El Akkad, Rania M; Abdel Galeel, Yamen I I

    2013-01-01

    Sleep complaints are common among elderly, especially institutionalized elderly, as they experience poorer sleep quality and higher use of sedative hypnotics, when compared to community-dwelling elderly. Recent findings suggest that there may be a relationship between poor quality of sleep and cognitive deficits. This study aimed at studying the relation between sleep quality and cognitive performance in older adults living in elderly homes. 100 elderly living in an elderly home in El Mansoura, Egypt, were recruited in this study, 50 cases with subjective poor quality of sleep and 50 controls with subjective good quality of sleep as assessed by Pittsburgh sleep quality index (PSQI). Each participant went through comprehensive geriatric assessment (CGA), including geriatric depression scale (GDS), assessment of cognitive function by mini mental state examination (MMSE). 52% of poor sleepers showed impaired MMSE, while only 24% of good sleepers had impaired MMSE. Both orientation and (attention and calculation) were more affected (P = 0.027 and 0.035, respectively). Linear correlation coefficient between PSQI and different variables revealed significant negative correlation with total MMSE score, attention and calculation. Poor quality of sleep is related to cognitive impairment among elderly living in elderly homes and this problem should be taken in consideration among this group of elders.

  17. Decentralized Model Predictive Control for Cooperative Multiple Vehicles Subject to Communication Loss

    Hojjat A. Izadi

    2011-01-01

    Full Text Available The decentralized model predictive control (DMPC of multiple cooperative vehicles with the possibility of communication loss/delay is investigated. The neighboring vehicles exchange their predicted trajectories at every sample time to maintain the cooperation objectives. In the event of a communication loss (packet dropout, the most recent available information, which is potentially delayed, is used. Then the communication loss problem changes to a cooperative problem when random large communication delays are present. Such large communication delays can lead to poor cooperation performance and unsafe behaviors such as collisions. A new DMPC approach is developed to improve the cooperation performance and achieve safety in the presence of the large communication delays. The proposed DMPC architecture estimates the tail of neighbor's trajectory which is not available due to the large communication delays for improving the performance. The concept of the tube MPC is also employed to provide the safety of the fleet against collisions, in the presence of large intervehicle communication delays. In this approach, a tube shaped trajectory set is assumed around the trajectory of the neighboring vehicles whose trajectory is delayed/lost. The radius of tube is a function of the communication delay and vehicle's maneuverability (in the absence of model uncertainty. The simulation of formation problem of multiple vehicles is employed to illustrate the effectiveness of the proposed approach.

  18. Structural controls on the megathrust segmentation of the Middle America Trench from multiple geophysical observations

    Naif, S.; Bassett, D.

    2016-12-01

    Subduction zone megathrusts display complex seismogenic behaviors that vary at intra- and inter-margin scales. Many different physical properties have been proposed to be primarily responsible for this behavior, such as the composition of subducted sediments, the hydration state of the incoming oceanic plate, and the pore-fluid pressure at the plate interface. Here, we focus on the northern Middle America Trench and show that subducting plate structures control megathrust segmentation. We analyze multiple types of seafloor geophysical observations and compare them to the distinct behavioral and spatial characteristics of the 1992 Nicaragua (Mw7.6), 2012 El Salvador (Mw7.3), 2012 Guatemala (Mw7.4), and 2012 Costa Rica (Mw7.6) events. The residual topography, residual gravity, and magnetic anomaly structure of the incoming oceanic plate and forearc seafloor are correlated. The forearc is composed of multiple unique segments that are bounded by subducting fracture zones. These boundaries correlate with foreshock and aftershock seismicity and also coincide with the hypocenter of all four earthquakes. The relationship between observed structures, earthquake slip inversions, and radiated energy of the four large events will be discussed.

  19. Glucose uptake heterogeneity of the leg muscles is similar between patients with multiple sclerosis and healthy controls during walking.

    Kindred, John H; Ketelhut, Nathaniel B; Rudroff, Thorsten

    2015-02-01

    Difficulties in ambulation are one of the main problems reported by patients with multiple sclerosis. A previous study by our research group showed increased recruitment of muscle groups during walking, but the influence of skeletal muscle properties, such as muscle fiber activity, has not been fully elucidated. The purpose of this investigation was to use the novel method of calculating glucose uptake heterogeneity in the leg muscles of patients with multiple sclerosis and compare these results to healthy controls. Eight patients with multiple sclerosis (4 men) and 8 healthy controls (4 men) performed 15 min of treadmill walking at a comfortable self-selected speed following muscle strength tests. Participants were injected with ≈ 8 mCi of [(18)F]-fluorodeoxyglucose during walking after which positron emission tomography/computed tomography imaging was performed. No differences in muscle strength were detected between multiple sclerosis and control groups (P>0.27). Within the multiple sclerosis, group differences in muscle volume existed between the stronger and weaker legs in the vastus lateralis, semitendinosus, and semimembranosus (Pmuscle group or individual muscle of the legs (P>0.16, P≥0.05). Patients with multiple sclerosis and healthy controls showed similar muscle fiber activity during walking. Interpretations of these results, with respect to our previous study, suggest that walking difficulties in patients with multiple sclerosis may be more associated with altered central nervous system motor patterns rather than alterations in skeletal muscle properties. Published by Elsevier Ltd.

  20. Multimodal exercise training in multiple sclerosis: A randomized controlled trial in persons with substantial mobility disability.

    Sandroff, Brian M; Bollaert, Rachel E; Pilutti, Lara A; Peterson, Melissa L; Baynard, Tracy; Fernhall, Bo; McAuley, Edward; Motl, Robert W

    2017-10-01

    Mobility disability is a common, debilitating feature of multiple sclerosis (MS). Exercise training has been identified as an approach to improve MS-related mobility disability. However, exercise randomized controlled trials (RCTs) on mobility in MS have generally not selectively targeted those with the onset of irreversible mobility disability. The current multi-site RCT compared the efficacy of 6-months of supervised, multimodal exercise training with an active control condition for improving mobility, gait, physical fitness, and cognitive outcomes in persons with substantial MS-related mobility disability. 83 participants with substantial MS-related mobility disability underwent initial mobility, gait, fitness, and cognitive processing speed assessments and were randomly assigned to 6-months of supervised multimodal (progressive aerobic, resistance, and balance) exercise training (intervention condition) or stretching-and-toning activities (control condition). Participants completed the same outcome assessments halfway through and immediately following the 6-month study period. There were statistically significant improvements in six-minute walk performance (F(2158)=3.12, p=0.05, η p 2 =0.04), peak power output (F(2150)=8.16, pmobility disability. This is critical for informing the development of multi-site exercise rehabilitation programs in larger samples of persons with MS-related mobility disability. Copyright © 2017 Elsevier Inc. All rights reserved.

  1. Tracking Control Based on Recurrent Neural Networks for Nonlinear Systems with Multiple Inputs and Unknown Deadzone

    J. Humberto Pérez-Cruz

    2012-01-01

    Full Text Available This paper deals with the problem of trajectory tracking for a broad class of uncertain nonlinear systems with multiple inputs each one subject to an unknown symmetric deadzone. On the basis of a model of the deadzone as a combination of a linear term and a disturbance-like term, a continuous-time recurrent neural network is directly employed in order to identify the uncertain dynamics. By using a Lyapunov analysis, the exponential convergence of the identification error to a bounded zone is demonstrated. Subsequently, by a proper control law, the state of the neural network is compelled to follow a bounded reference trajectory. This control law is designed in such a way that the singularity problem is conveniently avoided and the exponential convergence to a bounded zone of the difference between the state of the neural identifier and the reference trajectory can be proven. Thus, the exponential convergence of the tracking error to a bounded zone and the boundedness of all closed-loop signals can be guaranteed. One of the main advantages of the proposed strategy is that the controller can work satisfactorily without any specific knowledge of an upper bound for the unmodeled dynamics and/or the disturbance term.

  2. Discrete event command and control for networked teams with multiple missions

    Lewis, Frank L.; Hudas, Greg R.; Pang, Chee Khiang; Middleton, Matthew B.; McMurrough, Christopher

    2009-05-01

    During mission execution in military applications, the TRADOC Pamphlet 525-66 Battle Command and Battle Space Awareness capabilities prescribe expectations that networked teams will perform in a reliable manner under changing mission requirements, varying resource availability and reliability, and resource faults. In this paper, a Command and Control (C2) structure is presented that allows for computer-aided execution of the networked team decision-making process, control of force resources, shared resource dispatching, and adaptability to change based on battlefield conditions. A mathematically justified networked computing environment is provided called the Discrete Event Control (DEC) Framework. DEC has the ability to provide the logical connectivity among all team participants including mission planners, field commanders, war-fighters, and robotic platforms. The proposed data management tools are developed and demonstrated on a simulation study and an implementation on a distributed wireless sensor network. The results show that the tasks of multiple missions are correctly sequenced in real-time, and that shared resources are suitably assigned to competing tasks under dynamically changing conditions without conflicts and bottlenecks.

  3. Hydrotherapy for the Treatment of Pain in People with Multiple Sclerosis: A Randomized Controlled Trial

    Adelaida María Castro-Sánchez

    2012-01-01

    Full Text Available Background. Multiple sclerosis (MS is a chronic demyelinating neurological disease. Several studies have reported that complementary and alternative