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Sample records for stroke power mobility

  1. mStroke: "Mobile Stroke"-Improving Acute Stroke Care with Smartphone Technology.

    Science.gov (United States)

    Andrew, Benjamin Y; Stack, Colleen M; Yang, Julian P; Dodds, Jodi A

    2017-07-01

    This study aimed to evaluate the effect of method and time of system activation on clinical metrics in cases utilizing the Stop Stroke (Pulsara, Inc.) mobile acute stroke care coordination application. A retrospective cohort analysis of stroke codes at 12 medical centers using Stop Stroke from March 2013 to May 2016 was performed. Comparison of metrics (door-to-needle time [DTN] and door-to-CT time [DTC], and rate of DTN ≤ 60 minutes [goal DTN]) was performed between subgroups based on method (emergency medical service [EMS] versus emergency department [ED]) and time of activation. Effects were adjusted for confounders (age, sex, National Institutes of Health Stroke Scale [NIHSS] score) using multiple linear and logistic regression. The final dataset included 2589 cases. Cases activated by EMS were more severe (median NIHSS score 8 versus 4, P technology provides unique insight into acute stroke codes. Activation of mobile electronic stroke coordination in the field appears to promote a more expedited and successful care process. Copyright © 2017 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  2. Morphological classification of mobile plaques and their association with early recurrence of stroke.

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    Ogata, Toshiyasu; Yasaka, Masahiro; Wakugawa, Yoshiyuki; Kitazono, Takanari; Okada, Yasushi

    2010-01-01

    The present study investigated the frequency and morphological characteristics of carotid mobile plaques and examined the relationship between carotid mobile plaques and recurrent strokes. The study included 94 consecutive acute stroke patients with large-artery atherosclerosis associated with extracranial carotid stenosis. We investigated the presence of mobile plaques by carotid ultrasonography and classified patients into two groups (mobile group and non-mobile group). We compared backgrounds, MRI and ultrasonographic findings, neurological severity on admission and at discharge, and the rate of early recurrent stroke between both groups. Mobile plaques were detected in 12 patients (12.8%). There were four types of mobile plaques: (1) the jellyfish-type plaque, in which the fibrous cap fluctuated like a jellyfish; (2) the streaming-band-type plaque, in which the string attached to the plaque was swaying; (3) the mobile-thrombus-type plaque, in which a mobile mass was attached to the plaque surface, and (4) the fluctuating-ulcer-type plaque, which contained a mobile substance in the plaque ulcer. Although National Institutes of Health Stroke Scale (NIHSS) scores on admission were less severe in the mobile group than in the non-mobile group (median 1 vs. 4, respectively; p = 0.004), the rate of early recurrent stroke was significantly higher in the mobile group than in the non-mobile group (33.3 vs. 7.3%, respectively; p = 0.022). There were no significant differences in NIHSS scores at discharge between groups. Morphologically, several types of mobile plaques were detected in consecutive patients with acute stroke associated with carotid stenosis. Mobile plaques are strongly associated with an early recurrence of stroke. Copyright © 2010 S. Karger AG, Basel.

  3. Transport mobility 5 years after stroke in an urban setting.

    Science.gov (United States)

    Persson, Hanna C; Selander, Helena

    2018-04-01

    Background People after stroke may have residual problems with mobility that can affect their independence and mode of transport. However, there is limited knowledge about transport mobility several years after stroke. Objective The objective was to survey the outdoor mobility and transportation in an urban setting five years post-stroke. Method This cross-sectional study was based on a mail survey focusing on long-term consequences after stroke. The survey comprises a set of self-evaluated questionnaires and was sent to 457 persons, of whom 281 responded (61.5%). From the survey, items regarding transportation and mobility were selected and analyzed. Results A high level of mobility function was reported with regard to outdoor mobility and different modes of transport. However, one-fifth still reported problems with outdoor mobility and mode of transport. Some perceived barriers were reported, predominantly mobility aspects such as transfer to/from, and getting on/off specific transportation mode/s. The respondents reported some communication problems and cognitive impairments, but these were not reported as prominent barriers when using public transport. A total of 67% were active drivers and were more often men (p = 0.002), younger (p ≤ 0.001), and were less dependent at discharge from the acute hospital (p ≤ 0.001). Conclusions Five years post-stroke, mobility problems were the dominant barrier reported when using transport modes. Individualized transport training is needed during rehabilitation to increase possibility to participate. Infrastructure and transportation planning should focus on older, women, and people with impairments to be able to facilitate the use of public transport and mobility.

  4. FREQUENCY RATE OF OBESITY AND LOW MOBILITY IN NORTH AMERICAN AND IRANIAN STROKE PATIENTS

    Directory of Open Access Journals (Sweden)

    Kavian Ghandehari

    2010-12-01

    Full Text Available Abstract   INTRODUCTION: Obesity and low mobility are among the risk factors of stroke and cardiovascular diseases. A pilot double-center study evaluated frequency rate of obesity and low mobility in patients with ischemic stroke.   METHODS: This prospective clinical study was conducted on 100 consecutive stroke patients in Mackenzie hospital, Canada and 100 consecutive stroke patients in Ghaem hospital, Iran in 2007. The patients were age- and sex- matched. Diagnosis of ischemic stroke was made by stroke neurologists. Obesity and low mobility was detected based on the standard method in the two studied groups. Chi-Square and Fisher tests served for statistical analysis and P < 0.05 was declared as significant.   RESULTS: 92 males and 108 females with ischemic stroke were investigated. Obesity was present in 26% of the Canadians and 21% of Iranian stroke patients, df = 1, P = 0.403. Low mobility was reported in 29% of Canadian and 5% of Iranian stroke patients, df = 1, P < 0.0001. The frequency rate of obesity was not significantly different in the two groups and in each gender separately (P > 0.05, while the difference was significant for low mobility, P < 0.05.   CONCLUSIONS: There is no significant difference in frequency rate of obesity between Canadian and Iranian stroke patients. However, low mobility is significantly more frequent in the old Canadian individuals with stroke. Keywords: Obesity, Stroke, Race.

  5. Effects of virtual reality training on mobility and physical function in stroke.

    Science.gov (United States)

    Malik, Arshad Nawaz; Masood, Tahir

    2017-10-01

    Stroke is a common disabling condition which declines the functional and mobility level. The purpose of the case series was to determine the effect of virtual reality training on sensorimotor function and mobility level in stroke patients. Ten male (40-60 year) patients of stroke (08 Infarction, 02 Haemorrhagic) were selected from Physiotherapy department of Pakistan Railway Hospital, Rawalpindi. The additional virtual reality training (15-20 minutes) was provided 03 days per week for 06weeks along with task oriented training. All patients were assessed through Fugl-Meyer Assessment-Lower Extremity (FMA-LE) and Timed Get Up and Go Test (TUG) at baseline and after 06 weeks of training. The results showed that there was significant improvement in mobility level of stroke patients. It is concluded that combination of task oriented and virtual reality training considerably improves the physical performance and mobility level in stroke patients.

  6. A zero-footprint 3D visualization system utilizing mobile display technology for timely evaluation of stroke patients

    Science.gov (United States)

    Park, Young Woo; Guo, Bing; Mogensen, Monique; Wang, Kevin; Law, Meng; Liu, Brent

    2010-03-01

    When a patient is accepted in the emergency room suspected of stroke, time is of the utmost importance. The infarct brain area suffers irreparable damage as soon as three hours after the onset of stroke symptoms. A CT scan is one of standard first line of investigations with imaging and is crucial to identify and properly triage stroke cases. The availability of an expert Radiologist in the emergency environment to diagnose the stroke patient in a timely manner only increases the challenges within the clinical workflow. Therefore, a truly zero-footprint web-based system with powerful advanced visualization tools for volumetric imaging including 2D. MIP/MPR, 3D display can greatly facilitate this dynamic clinical workflow for stroke patients. Together with mobile technology, the proper visualization tools can be delivered at the point of decision anywhere and anytime. We will present a small pilot project to evaluate the use of mobile technologies using devices such as iPhones in evaluating stroke patients. The results of the evaluation as well as any challenges in setting up the system will also be discussed.

  7. Does evidence really matter? Professionals’ opinions on the practice of early mobilization after stroke

    Science.gov (United States)

    Sjöholm, Anna; Skarin, Monica; Linden, Thomas; Bernhardt, Julie

    2011-01-01

    Introduction: Early mobilization after stroke may be important for a good outcome and it is currently recommended in a range of international guidelines. The evidence base, however, is limited and clear definitions of what constitutes early mobilization are lacking. Aims: To explore stroke care professionals’ opinions about (1) when after stroke, first mobilization should take place, (2) whether early mobilization may affect patients’ final outcome, and (3) what level of evidence they require to be convinced that early mobilization is beneficial. Methods: A nine-item questionnaire was used to interview stroke care professionals during a conference in Sydney, Australia. Results: Among 202 professionals interviewed, 40% were in favor of mobilizing both ischemic and hemorrhagic stroke patients within 24 hours of stroke onset. There was no clear agreement about the optimal time point beyond 24 hours. Most professionals thought that patients’ final motor outcome (76%), cognitive outcome (57%), and risk of depression (75%) depends on being mobilized early. Only 19% required a large randomized controlled trial or a systematic review to be convinced of benefit. Conclusion: The spread in opinion reflects the absence of clear guidelines and knowledge in this important area of stroke recovery and rehabilitation, which suggests further research is required. PMID:22096341

  8. Monitoring mobility assistive device use in post-stroke patients

    DEFF Research Database (Denmark)

    Boissy, Patrice; Hester, Todd; Sherrill, Delsey

    2007-01-01

    Mobility assistive devices (MAD) such as canes can improve mobility and allow independence in the performance of mobility-related tasks. The use of MAD is often prescribed for stroke survivors. Despite their acknowledged qualities, MAD in real life conditions are typically underutilized, misused...

  9. Telemedicine Can Replace the Neurologist on a Mobile Stroke Unit.

    Science.gov (United States)

    Wu, Tzu-Ching; Parker, Stephanie A; Jagolino, Amanda; Yamal, Jose-Miguel; Bowry, Ritvij; Thomas, Abraham; Yu, Amy; Grotta, James C

    2017-02-01

    The BEST-MSU study (Benefits of Stroke Treatment Delivered Using a Mobile Stroke Unit) is a comparative effectiveness trial in patients randomized to mobile stroke unit or standard management. A substudy tested interrater agreement for tissue-type plasminogen activator eligibility between a telemedicine vascular neurologist and onboard vascular neurologist. On scene, both the telemedicine vascular neurologist and onboard vascular neurologist independently evaluated the patient, documenting their tissue-type plasminogen activator treatment decision, National Institutes of Health Stroke Scale score, and computed tomographic interpretation. Agreement was determined using Cohen κ statistic. Telemedicine-related technical failures that impeded remote assessment were recorded. Simultaneous and independent telemedicine vascular neurologist and onboard vascular neurologist assessment was attempted in 174 patients. In 4 patients (2%), the telemedicine vascular neurologist could not make a decision because of technical problems. The telemedicine vascular neurologist agreed with the onboard vascular neurologist on 88% of evaluations (κ=0.73). Remote telemedicine vascular neurologist assessment is reliable and accurate, supporting either telemedicine vascular neurologist or onboard vascular neurologist assessment on our mobile stroke unit. URL: http://www.clinicaltrials.gov. Unique identifier: NCT02190500. © 2017 American Heart Association, Inc.

  10. Carotid Artery Stenting Successfully Prevents Progressive Stroke Due to Mobile Plaque

    Directory of Open Access Journals (Sweden)

    Masahiro Oomura

    2015-05-01

    Full Text Available We report a case of progressive ischemic stroke due to a mobile plaque, in which carotid artery stenting successfully prevented further infarctions. A 78-year-old man developed acute multiple infarcts in the right hemisphere, and a duplex ultrasound showed a mobile plaque involving the bifurcation of the left common carotid artery. Maximal medical therapy failed to prevent further infarcts, and the number of infarcts increased with his neurological deterioration. Our present case suggests that the deployment of a closed-cell stent is effective to prevent the progression of the ischemic stroke due to the mobile plaque.

  11. Reliability and validity of the de Morton Mobility Index in individuals with sub-acute stroke.

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    Braun, Tobias; Marks, Detlef; Thiel, Christian; Grüneberg, Christian

    2018-02-04

    To establish the validity and reliability of the de Morton Mobility Index (DEMMI) in patients with sub-acute stroke. This cross-sectional study was performed in a neurological rehabilitation hospital. We assessed unidimensionality, construct validity, internal consistency reliability, inter-rater reliability, minimal detectable change and possible floor and ceiling effects of the DEMMI in adult patients with sub-acute stroke. The study included a total sample of 121 patients with sub-acute stroke. We analysed validity (n = 109) and reliability (n = 51) in two sub-samples. Rasch analysis indicated unidimensionality with an overall fit to the model (chi-square = 12.37, p = 0.577). All hypotheses on construct validity were confirmed. Internal consistency reliability (Cronbach's alpha = 0.94) and inter-rater reliability (intraclass correlation coefficient = 0.95; 95% confidence interval: 0.92-0.97) were excellent. The minimal detectable change with 90% confidence was 13 points. No floor or ceiling effects were evident. These results indicate unidimensionality, sufficient internal consistency reliability, inter-rater reliability, and construct validity of the DEMMI in patients with a sub-acute stroke. Advantages of the DEMMI in clinical application are the short administration time, no need for special equipment and interval level data. The de Morton Mobility Index, therefore, may be a useful performance-based bedside test to measure mobility in individuals with a sub-acute stroke across the whole mobility spectrum. Implications for Rehabilitation The de Morton Mobility Index (DEMMI) is an unidimensional measurement instrument of mobility in individuals with sub-acute stroke. The DEMMI has excellent internal consistency and inter-rater reliability, and sufficient construct validity. The minimal detectable change of the DEMMI with 90% confidence in stroke rehabilitation is 13 points. The lack of any floor or ceiling effects on hospital admission indicates

  12. Rehabilitation after stroke: predictive power of Barthel Index versus a cognitive and a motor index

    DEFF Research Database (Denmark)

    Engberg, A; Bentzen, L; Garde, B

    1995-01-01

    The aim of the present study was to investigate the predictive power of ratings of Barthel Index at Day 40 post stroke, compared with and/or combined with simultaneous ratings from a mobility scale (EG motor index) and a rather simple cognitive test scale (CT50). The parameter to be individually...

  13. Factors affecting mobility milestones and activities of daily living after stroke

    International Nuclear Information System (INIS)

    Takeuchi, Masahito

    2008-01-01

    Mobility milestones are elementary movements related to activities of daily living (ADL) and have a significant influence on functional recovery after stroke. This study aimed to identify the factors affecting mobility milestones and to clarify the relationships between mobility milestones and ADL. Participants were in the acute phase after first-ever strokes (ischemic, n=77; hemorrhagic, n=84). Clinical and radiological factors within the first week were determined and their effects on mobility milestones after 4 weeks were analyzed using logistic regression analysis. After 4 weeks the patients were divided into four groups on the basis of sitting balance, standing balance, and walking ability. Then total ADL score was calculated using the Barthel index (BI), and percentage of independent patients in each 10 items of BI was transition rate of ADL for each of the four groups. Patients with ischemic stroke showed the following findings. Sitting balance was affected by severity of lower limb paralysis, consciousness level, and presence of an internal capsule lesion on computed tomography (CT) (R 2 =0.86); standing balance was influenced by severity of lower limb paralysis and consciousness level (R 2 =0.72); and walking ability was affected by severity of lower limb paralysis (R 2 =0.64). Patients with hemorrhagic stroke showed the following findings. Sitting balance was influenced by severity of lower limb paralysis, intraventricular hemorrhage on CT, blood pressure instability, and fever (R 2 =0.75); standing balance was affected by severity of lower limb paralysis, consciousness level, and presence of an internal capsule lesion (R 2 =0.58); and walking ability was influenced by severity of lower limb paralysis and presence of an internal capsule lesion (R 2 =0.70). In both types of stroke, sitting and standing balance and walking ability were directly associated with total ADL score, and sitting and standing balance became independent earlier than ADL. Severity of

  14. Virtual reality exercise improves mobility after stroke: an inpatient randomized controlled trial.

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    McEwen, Daniel; Taillon-Hobson, Anne; Bilodeau, Martin; Sveistrup, Heidi; Finestone, Hillel

    2014-06-01

    Exercise using virtual reality (VR) has improved balance in adults with traumatic brain injury and community-dwelling older adults. Rigorous randomized studies regarding its efficacy, safety, and applicability with individuals after stroke are lacking. The purpose of this study was to determine whether an adjunct VR therapy improves balance, mobility, and gait in stroke rehabilitation inpatients. A blinded randomized controlled trial studying 59 stroke survivors on an inpatient stroke rehabilitation unit was performed. The treatment group (n=30) received standard stroke rehabilitation therapy plus a program of VR exercises that challenged balance (eg, soccer goaltending, snowboarding) performed while standing. The control group (n=29) received standard stroke rehabilitation therapy plus exposure to identical VR environments but whose games did not challenge balance (performed in sitting). VR training consisted of 10 to 12 thirty-minute daily sessions for a 3-week period. Objective outcome measures of balance and mobility were assessed before, immediately after, and 1 month after training. Confidence intervals and effect sizes favored the treatment group on the Timed Up and Go and the Two-Minute Walk Test, with both groups meeting minimal clinical important differences after training. More individuals in the treatment group than in the control group showed reduced impairment in the lower extremity as measured by the Chedoke McMaster Leg domain (P=0.04) immediately after training. This VR exercise intervention for inpatient stroke rehabilitation improved mobility-related outcomes. Future studies could include nonambulatory participants as well as the implementation strategies for the clinical use of VR. http://www.ANZCTR.org.au/. Unique identifier: ACTRN12613000710729. © 2014 American Heart Association, Inc.

  15. Prestroke Mobility and Dementia as Predictors of Stroke Outcomes in Patients Over 65 Years of Age: A Cohort Study From The Swedish Dementia and Stroke Registries.

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    Garcia-Ptacek, Sara; Contreras Escamez, Beatriz; Zupanic, Eva; Religa, Dorota; von Koch, Lena; Johnell, Kristina; von Euler, Mia; Kåreholt, Ingemar; Eriksdotter, Maria

    2018-02-01

    To explore the association between prestroke mobility dependency and dementia on functioning and mortality outcomes after stroke in patients>65 years of age. Longitudinal cohort study based on SveDem, the Swedish Dementia Registry and Riksstroke, the Swedish Stroke Registry. A total of 1689 patients with dementia >65 years of age registered in SveDem and suffering a first stroke between 2007 and 2014 were matched with 7973 controls without dementia with stroke. Odds ratios (ORs) and 95% confidence intervals (CIs) for intrahospital mortality, and functioning and mortality outcomes at 3 months were calculated. Functioning included level of residential assistance (living at home without help, at home with help, or nursing home) and mobility dependency (independent, needing help to move outdoors, or needing help indoors and outdoors). Prestroke dependency in activities of daily living and mobility were worse in patients with dementia than controls without dementia. In unadjusted analyses, patients with dementia were more often discharged to nursing homes (51% vs 20%; P mobility (OR 2.57; 2.20-3.02). Patients with dementia who were independent for mobility prestroke were more likely to be discharged to a nursing home compared with patients without dementia with the same prestroke mobility (37% vs 16%; P mobility limitations were associated with higher odds for poorer mobility, needing more residential assistance, and death. Patients with mobility impairments and/or dementia present a high burden of disability after a stroke. There is a need for research on stroke interventions among these populations. Copyright © 2017 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

  16. Rehabilitation after stroke: predictive power of Barthel Index versus a cognitive and a motor index

    DEFF Research Database (Denmark)

    Engberg, A; Bentzen, L; Garde, B

    1995-01-01

    The aim of the present study was to investigate the predictive power of ratings of Barthel Index at Day 40 post stroke, compared with and/or combined with simultaneous ratings from a mobility scale (EG motor index) and a rather simple cognitive test scale (CT50). The parameter to be individually...... predicted was the need for special living facilities and support at discharge from a rehabilitation hospital, as well as six months later; 53 stroke patients with age median 68 years were included in this prospective study. It was shown that a combination of Barthel Index and CT50 had a stronger predictive...

  17. Assessing Mobile Health Capacity and Task Shifting Strategies to Improve Hypertension Among Ghanaian Stroke Survivors.

    Science.gov (United States)

    Nichols, Michelle; Sarfo, Fred Stephen; Singh, Arti; Qanungo, Suparna; Treiber, Frank; Ovbiagele, Bruce; Saulson, Raelle; Patel, Sachin; Jenkins, Carolyn

    2017-12-01

    There has been a tremendous surge in stroke prevalence in sub-Saharan Africa. Hypertension (HTN), the most potent, modifiable risk factor for stroke, is a particular challenge in sub-Saharan Africa. Culturally sensitive, efficacious HTN control programs that are timely and sustainable are needed, especially among stroke survivors. Mobile health (mHealth) technology and task-shifting offer promising approaches to address this need. Using a concurrent triangulation design, we collected data from stroke survivors, caregivers, community leaders, clinicians and hospital personnel to explore the barriers, facilitators and perceptions toward mHealth related to HTN management among poststroke survivors in Ghana. Exploration included perceptions of a nurse-led navigational model to facilitate care delivery and willingness of stroke survivors and caregivers to use mHealth technology. Two hundred stroke survivors completed study surveys while focus groups (n = 4) were conducted with stroke survivors, caregivers and community leaders (n = 28). Key informant interviews were completed with clinicians and hospital personnel (n = 10). A total of 93% of survey respondents had HTN (60% uncontrolled). Findings support mHealth strategies for poststroke care delivery and HTN management and for task-shifting through a nurse-led model. Of survey and focus group participants, 76% and 78.6%, respectively, have access to mobile phones and 90% express comfort in using mobile phones and conveyed assurance that task-shifting through a nurse-led model could facilitate management of HTN. Findings also identified barriers to care delivery and medication adherence across all levels of the social ecological model. Participants strongly supported enhanced care delivery through mobile health and were receptive toward a nurse-led navigational model. Copyright © 2017 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.

  18. Effect of Core Stability Training on Trunk Function, Standing Balance, and Mobility in Stroke Patients.

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    Haruyama, Koshiro; Kawakami, Michiyuki; Otsuka, Tomoyoshi

    2017-03-01

    Trunk function is important for standing balance, mobility, and functional outcome after stroke, but few studies have evaluated the effects of exercises aimed at improving core stability in stroke patients. To investigate the effectiveness of core stability training on trunk function, standing balance, and mobility in stroke patients. An assessor-blinded, randomized controlled trial was undertaken in a stroke rehabilitation ward, with 32 participants randomly assigned to an experimental group or a control group (n = 16 each). The experimental group received 400 minutes of core stability training in place of conventional programs within total training time, while the control group received only conventional programs. Primary outcome measures were evaluated using the Trunk Impairment Scale (TIS), which reflects trunk function. Secondary outcome measures were evaluated by pelvic tilt active range of motion in the sagittal plane, the Balance Evaluation Systems Test-brief version (Brief-BESTest), Functional Reach test, Timed Up-and-Go test (TUG), and Functional Ambulation Categories (FAC). A general linear repeated-measures model was used to analyze the results. A treatment effect was found for the experimental group on the dynamic balance subscale and total score of the TIS ( P = .002 and P Core stability training has beneficial effects on trunk function, standing balance, and mobility in stroke patients. Our findings might provide support for introducing core stability training in stroke rehabilitation.

  19. Mobile Phone-Based Questionnaire for Assessing 3 Months Modified Rankin Score After Acute Stroke: A Pilot Study.

    Science.gov (United States)

    Cooray, Charith; Matusevicius, Marius; Wahlgren, Nils; Ahmed, Niaz

    2015-10-01

    In many countries, a majority of stroke patients are not assessed for long-term functional outcome owing to limited resources and time. We investigated whether automatic assessment of the modified Rankin Scale (mRS) based on a mobile phone questionnaire may serve as an alternative to mRS assessments at clinical visits after stroke. We enrolled 62 acute stroke patients admitted to our stroke unit during March to May 2014. Forty-eight patients completed the study. During the stay, patients and/or caregivers were equipped with a mobile phone application in their personal mobile phones. The mobile phone application contained a set of 20 questions, based on the Rankin Focused Assessment, which we previously tested in a pilot study. Three months after inclusion, the mobile phone application automatically prompted the study participants to answer the mRS questionnaire in the mobile phones. Each question or a group of questions in the questionnaire corresponded to a certain mRS score. Using a predefined protocol, the highest mRS score question where the study participant had answered yes was deemed the final mobile mRS score. A few days later, a study personnel performed a clinical visit mRS assessment. The 2 assessments were compared using quadratic weighing κ-statistics. Mean age was 67 years (38% females), and median baseline National Institutes of Health Stroke Scale (NIHSS) score was 5 (interquartile range 2-10.5, range 0-23). Median and mean clinical visit mRS at 3 months was 2 and 2.3, respectively. We found a 62.5% agreement between clinical visit and mobile mRS assessment, weighted kappa 0.89 (95% confidence interval 0.82-0.96), and unweighted kappa 0.53 (95% confidence interval 0.36-0.70). Dichotomized mRS outcome separating functionally independent (mRS score 0-2) from dependent (mRS score 3-5) showed 83% agreement and unweighted kappa of 0.66 (95% confidence interval 0.45-0.87). Mobile phone-based automatic assessments of mRS performed well in comparison with

  20. Exercise intervention to prevent falls and enhance mobility in community dwellers after stroke: a protocol for a randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Barker Ruth N

    2009-07-01

    Full Text Available Abstract Background Stroke is the most common disabling neurological condition in adults. Falls and poor mobility are major contributors to stroke-related disability. Falls are more frequent and more likely to result in injury among stroke survivors than among the general older population. Currently there is good evidence that exercise can enhance mobility after stroke, yet ongoing exercise programs for general community-based stroke survivors are not routinely available. This randomised controlled trial will investigate whether exercise can reduce fall rates and increase mobility and physical activity levels in stroke survivors. Methods and design Three hundred and fifty community dwelling stroke survivors will be recruited. Participants will have no medical contradictions to exercise and be cognitively and physically able to complete the assessments and exercise program. After the completion of the pre-test assessment, participants will be randomly allocated to one of two intervention groups. Both intervention groups will participate in weekly group-based exercises and a home program for twelve months. In the lower limb intervention group, individualised programs of weight-bearing balance and strengthening exercises will be prescribed. The upper limb/cognition group will receive exercises aimed at management and improvement of function of the affected upper limb and cognition carried out in the seated position. The primary outcome measures will be falls (measured with 12 month calendars and mobility. Secondary outcome measures will be risk of falling, physical activity levels, community participation, quality of life, health service utilisation, upper limb function and cognition. Discussion This study aims to establish and evaluate community-based sustainable exercise programs for stroke survivors. We will determine the effects of the exercise programs in preventing falls and enhancing mobility among people following stroke. This program, if

  1. Performance and emission characteristics of LPG powered four stroke SI engine under variable stroke length and compression ratio

    International Nuclear Information System (INIS)

    Ozcan, Hakan; Yamin, Jehad A.A.

    2008-01-01

    A computer simulation of a variable stroke length, LPG fuelled, four stroke, single cylinder, water cooled spark ignition engine was done. The engine capacity was varied by varying the stroke length of the engine, which also changed its compression ratio. The simulation model developed was verified with experimental results from the literature for both constant and variable stroke engines. The performance of the engine was simulated at each stroke length/compression ratio combination. The simulation results clearly indicate the advantages and utility of variable stroke engines in fuel economy and power issues. Using the variable stroke technique has significantly improved the engine's performance and emission characteristics within the range studied. The brake torque and power have registered an increase of about 7-54% at low speed and 7-57% at high speed relative to the original engine design and for all stroke lengths and engine speeds studied. The brake specific fuel consumption has registered variations from a reduction of about 6% to an increase of about 3% at low speed and from a reduction of about 6% to an increase of about 8% at high speed relative to the original engine design and for all stroke lengths and engine speeds studied. On the other hand, an increase of pollutants of about 0.65-2% occurred at low speed. Larger stroke lengths resulted in a reduction of the pollutants level of about 1.5% at higher speeds. At lower stroke lengths, on the other hand, an increase of about 2% occurred. Larger stroke lengths resulted in increased exhaust temperature and, hence, make the exhaust valve work under high temperature

  2. Perturbation training to promote safe independent mobility post-stroke: study protocol for a randomized controlled trial.

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    Mansfield, Avril; Aqui, Anthony; Centen, Andrew; Danells, Cynthia J; DePaul, Vincent G; Knorr, Svetlana; Schinkel-Ivy, Alison; Brooks, Dina; Inness, Elizabeth L; McIlroy, William E; Mochizuki, George

    2015-06-06

    Falls are one of the most common medical complications post-stroke. Physical exercise, particularly exercise that challenges balance, reduces the risk of falls among healthy and frail older adults. However, exercise has not proven effective for preventing falls post-stroke. Falls ultimately occur when an individual fails to recover from a loss of balance. Thus, training to specifically improve reactive balance control could prevent falls. Perturbation training aims to improve reactive balance control by repeatedly exposing participants to postural perturbations. There is emerging evidence that perturbation training reduces fall rates among individuals with neurological conditions, such as Parkinson disease. The primary aim of this work is to determine if perturbation-based balance training can reduce occurrence of falls in daily life among individuals with chronic stroke. Secondary objectives are to determine the effect of perturbation training on balance confidence and activity restriction, and functional balance and mobility. Individuals with chronic stroke will be recruited. Participants will be randomly assigned to one of two groups: 1) perturbation training, or 2) 'traditional' balance training. Perturbation training will involve both manual perturbations (e.g., a push or pull from a physiotherapist), and rapid voluntary movements to cause a loss of balance. Training will occur twice per week for 6 weeks. Participants will record falls and activity for 12 months following completion of the training program. Standardized clinical tools will be used to assess functional balance and mobility, and balance confidence before and after training. Falls are a significant problem for those with stroke. Despite the large body of work demonstrating effective interventions, such as exercise, for preventing falls in other populations, there is little evidence for interventions that prevent falls post-stroke. The proposed study will investigate a novel and promising

  3. Effects of an aquatic therapy approach (Halliwick-Therapy) on functional mobility in subacute stroke patients: a randomized controlled trial.

    Science.gov (United States)

    Tripp, Florian; Krakow, Karsten

    2014-05-01

    To evaluate the effects of an aquatic physiotherapy method (Halliwick-Therapy) upon mobility in the post-acute phase of stroke rehabilitation. Randomized controlled trial. Hospital for neurological rehabilitation. Adult patients after first-ever stroke in post-acute inpatient rehabilitation at least two weeks after the onset of stroke (n = 30). In the Halliwick-Therapy group (n = 14) the treatment over a period of two weeks included 45 minutes of aquatic therapy three times per week and a conventional physiotherapeutic treatment twice a week. Subjects in the control group (n = 16) received conventional physiotherapeutic treatment over a period of two weeks five times per week. The primary outcome variable was postural stability (Berg Balance Scale). Secondary outcome variables were functional reach, functional gait ability and basic functional mobility. Compared to the control group, significantly more subjects in the Halliwick-Therapy group (83.3% versus 46.7%) attained significant improvement of the Berg Balance Scale (P stroke patients in post-acute rehabilitation and has positive effects upon some aspects of mobility.

  4. Powered robotic exoskeletons in post-stroke rehabilitation of gait: a scoping review.

    Science.gov (United States)

    Louie, Dennis R; Eng, Janice J

    2016-06-08

    Powered robotic exoskeletons are a potential intervention for gait rehabilitation in stroke to enable repetitive walking practice to maximize neural recovery. As this is a relatively new technology for stroke, a scoping review can help guide current research and propose recommendations for advancing the research development. The aim of this scoping review was to map the current literature surrounding the use of robotic exoskeletons for gait rehabilitation in adults post-stroke. Five databases (Pubmed, OVID MEDLINE, CINAHL, Embase, Cochrane Central Register of Clinical Trials) were searched for articles from inception to October 2015. Reference lists of included articles were reviewed to identify additional studies. Articles were included if they utilized a robotic exoskeleton as a gait training intervention for adult stroke survivors and reported walking outcome measures. Of 441 records identified, 11 studies, all published within the last five years, involving 216 participants met the inclusion criteria. The study designs ranged from pre-post clinical studies (n = 7) to controlled trials (n = 4); five of the studies utilized a robotic exoskeleton device unilaterally, while six used a bilateral design. Participants ranged from sub-acute (6 months) stroke. Training periods ranged from single-session to 8-week interventions. Main walking outcome measures were gait speed, Timed Up and Go, 6-min Walk Test, and the Functional Ambulation Category. Meaningful improvement with exoskeleton-based gait training was more apparent in sub-acute stroke compared to chronic stroke. Two of the four controlled trials showed no greater improvement in any walking outcomes compared to a control group in chronic stroke. In conclusion, clinical trials demonstrate that powered robotic exoskeletons can be used safely as a gait training intervention for stroke. Preliminary findings suggest that exoskeletal gait training is equivalent to traditional therapy for chronic stroke

  5. Translating knowledge for action against stroke--using 5-minute videos for stroke survivors and caregivers to improve post-stroke outcomes: study protocol for a randomized controlled trial (Movies4Stroke).

    Science.gov (United States)

    Kamal, Ayeesha Kamran; Khoja, Adeel; Usmani, Bushra; Muqeet, Abdul; Zaidi, Fabiha; Ahmed, Masood; Shakeel, Saadia; Soomro, Nabila; Gowani, Ambreen; Asad, Nargis; Ahmed, Asma; Sayani, Saleem; Azam, Iqbal; Saleem, Sarah

    2016-01-27

    Two thirds of the global mortality of stroke is borne by low and middle income countries (LMICs). Pakistan is the world's sixth most populous country with a stroke-vulnerable population and is without a single dedicated chronic care center. In order to provide evidence for a viable solution responsive to this health care gap, and leveraging the existing >70% mobile phone density, we thought it rational to test the effectiveness of a mobile phone-based video intervention of short 5-minute movies to educate and support stroke survivors and their primary caregivers. Movies4Stroke will be a randomized control, outcome assessor blinded, parallel group, single center superiority trial. Participants with an acute stroke, medically stable, with mild to moderate disability and having a stable primary caregiver will be included. After obtaining informed consent the stroke survivor-caregiver dyad will be randomized. Intervention participants will have the movie program software installed in their phone, desktop, or Android device which will allow them to receive, view and repeat 5-minute videos on stroke-related topics at admission, discharge and first and third months after enrollment. The control arm will receive standard of care at an internationally accredited center with defined protocols. The primary outcome measure is medication adherence as ascertained by a locally validated Morisky Medication Adherence Scale and control of major risk factors such as blood pressure, blood sugar and blood cholesterol at 12 months post discharge. Secondary outcome measures are post-stroke complications and mortality, caregiver knowledge and change in functional outcomes after acute stroke at 1, 3, 6, 9 and 12 months. Movies4Stroke is designed to enroll 300 participant dyads after inflating 10% to incorporate attrition and non-compliance and has been powered at 95% to detect a 15% difference between intervention and usual care arm. Analysis will be done by the intention

  6. The Effect of Rocker Bar Ankle Foot Orthosis on Functional Mobility in Post-Stroke Hemiplegic Patients

    Directory of Open Access Journals (Sweden)

    Farzad Farmani

    2015-09-01

    Full Text Available Objectives: Ankle Foot Orthoses (AFOs are widely utilized to improve walking ability in hemiplegic patients. The present study aimed to evaluate the effect of Rocker bar Ankle Foot Orthosis (RAFO on functional mobility in post-stroke hemiplegic patients. Methods: Fifteen hemiplegic patients (men and women who were at least 6-months post-stroke and able to walk without assistive device for at least 10 meters voluntarily participated in this study. The patients were examined with and without RAFO. Their functional mobility was evaluated through 10-meter walk test and Timed Up and Go (TUG test. Also, paired t-test was used to analyze obtained data. Results: When patients used RAFO, their gait speed significantly increased (P<0.05. Also, the time of performing TUG test experienced a significant decrease using RAFO compared with utilizing shoe only (P<0.05. Discussion: RAFO led to a significant improvement in functional mobility in hemiplegic patient’s secondary to stroke. It seems that, it has been due to the positive effect of rocker modification on improving push off and transferring weight during stance phase of gait.

  7. Optimal control of the power adiabatic stroke of an optomechanical heat engine.

    Science.gov (United States)

    Bathaee, M; Bahrampour, A R

    2016-08-01

    We consider the power adiabatic stroke of the Otto optomechanical heat engine introduced in Phys. Rev. Lett. 112, 150602 (2014)PRLTAO0031-900710.1103/PhysRevLett.112.150602. We derive the maximum extractable work of both optomechanical normal modes in the minimum time while the system experiences quantum friction effects. We show that the total work done by the system in the power adiabatic stroke is optimized by a bang-bang control. The time duration of the power adiabatic stroke is of the order of the inverse of the effective optomechanical-coupling coefficient. The optimal phase-space trajectory of the Otto cycle for both optomechanical normal modes is also obtained.

  8. Mobilization of endogenous bone marrow derived endothelial progenitor cells and therapeutic potential of parathyroid hormone after ischemic stroke in mice.

    Directory of Open Access Journals (Sweden)

    Li-Li Wang

    Full Text Available Stroke is a major neurovascular disorder threatening human life and health. Very limited clinical treatments are currently available for stroke patients. Stem cell transplantation has shown promising potential as a regenerative treatment after ischemic stroke. The present investigation explores a new concept of mobilizing endogenous stem cells/progenitor cells from the bone marrow using a parathyroid hormone (PTH therapy after ischemic stroke in adult mice. PTH 1-34 (80 µg/kg, i.p. was administered 1 hour after focal ischemia and then daily for 6 consecutive days. After 6 days of PTH treatment, there was a significant increase in bone marrow derived CD-34/Fetal liver kinase-1 (Flk-1 positive endothelial progenitor cells (EPCs in the peripheral blood. PTH treatment significantly increased the expression of trophic/regenerative factors including VEGF, SDF-1, BDNF and Tie-1 in the brain peri-infarct region. Angiogenesis, assessed by co-labeled Glut-1 and BrdU vessels, was significantly increased in PTH-treated ischemic brain compared to vehicle controls. PTH treatment also promoted neuroblast migration from the subventricular zone (SVZ and increased the number of newly formed neurons in the peri-infarct cortex. PTH-treated mice showed significantly better sensorimotor functional recovery compared to stroke controls. Our data suggests that PTH therapy improves endogenous repair mechanisms after ischemic stroke with functional benefits. Mobilizing endogenous bone marrow-derived stem cells/progenitor cells using PTH and other mobilizers appears an effective and feasible regenerative treatment after ischemic stroke.

  9. Validity of the performance-oriented mobility assessment in predicting fall of stroke survivors: a retrospective cohort study.

    Science.gov (United States)

    An, SeungHeon; Lee, YunBok; Lee, GyuChang

    2014-06-01

    Falling is one of the most common complications in stroke survivors. It is therefore important to evaluate the risk of falls. In this study, we investigated the usability of the performance-oriented mobility assessment (POMA) for predicting falls in stroke patients. The POMA examines the level of balance and mobility. Data were collected on the number of falls and physical functions from 72 stroke survivors. Physical functions were measured using the POMA balance subscale, One Leg Stand test (OLS), Sit To Stand test (STS), 10-m Walk Test (10WT), Fugl-Meyer assessment (FM), and Trunk Impairment Scale (TIS). Since the accuracy of the POMA balance subscale was moderate, the cutoff value used for predicting falls was 12.5 points (sensitivity: 72%; specificity: 74%), and the area under the curve was 0.78 (95% confidence interval: 0.66-0.91, p risk of falling increased by 0.304 times more than the group over 12.5 points. The POMA balance subscale is a valid tool for assessing the physical function and fall risk of stroke survivors.

  10. Fall-related self-efficacy, not balance and mobility performance, is related to accidental falls in chronic stroke survivors with low bone mineral density.

    Science.gov (United States)

    Pang, M Y C; Eng, J J

    2008-07-01

    Chronic stroke survivors with low hip bone density are particularly prone to fractures. This study shows that fear of falling is independently associated with falls in this population. Thus, fear of falling should not be overlooked in the prevention of fragility fractures in these patients. Chronic stroke survivors with low bone mineral density (BMD) are particularly prone to fragility fractures. The purpose of this study was to identify the determinants of balance, mobility and falls in this sub-group of stroke patients. Thirty-nine chronic stroke survivors with low hip BMD (T-score fall-related self-efficacy. Any falls in the past 12 months were also recorded. Multiple regression analysis was used to identify the determinants of balance and mobility performance, whereas logistic regression was used to identify the determinants of falls. Multiple regression analysis revealed that after adjusting for basic demographics, fall-related self-efficacy remained independently associated with balance/mobility performance (R2 = 0.494, P fall-related self-efficacy, but not balance and mobility performance, was a significant determinant of falls (odds ratio: 0.18, P = 0.04). Fall-related self-efficacy, but not mobility and balance performance, was the most important determinant of accidental falls. This psychological factor should not be overlooked in the prevention of fragility fractures among chronic stroke survivors with low hip BMD.

  11. Unsupervised Power Profiling for Mobile Devices

    DEFF Research Database (Denmark)

    Kjærgaard, Mikkel Baun; Blunck, Henrik

    Today, power consumption is a main limitation for mobile phones. To minimize the power consumption of popular and traditionally power-hungry location-based services requires knowledge of how individual phone features consume power, so that those features can be utilized intelligently for optimal...... power savings while at the same time maintaining good quality of service. This paper proposes an unsupervised API-level method for power profiling mobile phones based on genetic algorithms. The method enables accurate profiling of the power consumption of devices and thereby provides the information...

  12. Unsupervised Power Profiling for Mobile Devices

    DEFF Research Database (Denmark)

    Kjærgaard, Mikkel Baun; Blunck, Henrik

    2011-01-01

    Today, power consumption is a main limitation for mobile phones. To minimize the power consumption of popular and traditionally power-hungry location-based services requires knowledge of how individual phone features consume power, so that those features can be utilized intelligently for optimal...... power savings while at the same time maintaining good quality of service. This paper proposes an unsupervised API-level method for power profiling mobile phones based on genetic algorithms. The method enables accurate profiling of the power consumption of devices and thereby provides the information...

  13. Mobile nuclear power systems

    International Nuclear Information System (INIS)

    Andersson, B.

    1988-11-01

    This report is meant to present a general survey of the mobile nuclear power systems and not a detailed review of their technical accomplishments. It is based in published material mainly up to 1987. Mobile nuclear power systems are of two fundamentally different kinds: nuclear reactors and isotopic generators. In the reactors the energy comes from nuclear fission and in the isotopic generators from the radioactive decay of suitable isotopes. The reactors are primarily used as power sourves on board nuclear submarines and other warships but have also been used in the space and in remote places. Their thermal power has ranged from 30 kWth (in a satellite) to 175 MWth (on board an aircraft carrier). Isotopic generators are suitable only for small power demands and have been used on board satellites and spaceprobes, automatic weatherstations, lighthouses and marine installations for navigation and observation. (author)

  14. Swipe out Stroke: Feasibility and efficacy of using a smart-phone based mobile application to improve compliance with weight loss in obese minority stroke patients and their carers.

    Science.gov (United States)

    Ifejika, Nneka Lotea; Noser, Elizabeth Anne; Grotta, James C; Savitz, Sean I

    2016-07-01

    Swipe out Stroke (SOS) examines the use of a smartphone-based mobile application to reduce obesity in high-risk minority stroke patients. At record-high levels in the United States, obesity disproportionately affects minorities and is highly correlated with cerebrovascular disease. Unfortunately, structured weight loss programs are expensive, and compliance significantly decreases upon program completion. Mobile health (mHealth) technology is an innovative, cost-effective way to bridge this gap. Minorities spend over 4.5 billion dollars annually on consumer electronics, making studies that utilize mHealth applications ideal for health promotion and disease prevention. SOS is a prospective, randomized-controlled trial with open blinded endpoint comparing an mHealth based dietary intervention to usual care to facilitate weight reduction. Ischemic and hemorrhagic stroke survivors and their carers are recruited from the acute care service of a Houston-based comprehensive stroke center. A neurorehabilitation physician or vascular neurologist meets with participants during the index hospitalization, a baseline clinic visit, followed by visits at 1, 3, and 6 month intervals. The SOS Team focuses on feasible modifications to the Southern dietary pattern (fried foods, fatty foods, added fats, eggs, processed meats, such as bacon and ham, organ meats (e.g., liver), and sweetened drinks) and caloric restriction to facilitate a 5% reduction in total body weight. Practical barriers to adherence are addressed, such as access to transportation, financial limitations, and depression. The primary dependent measure is a reduction of total body weight. Secondary outcomes include systolic blood pressure, hemoglobin A1c, low-density lipoprotein, triglycerides, and Factor VIII. SOS will determine whether a Phase III effectiveness trial of a smartphone-based mobile application to address obesity-related health disparities is warranted throughout the Southeastern United States (Stroke

  15. Facilitating Stroke Management using Modern Information Technology.

    Science.gov (United States)

    Nam, Hyo Suk; Park, Eunjeong; Heo, Ji Hoe

    2013-09-01

    Information technology and mobile devices may be beneficial and useful in many aspects of stroke management, including recognition of stroke, transport and triage of patients, emergent stroke evaluation at the hospital, and rehabilitation. In this review, we address the contributions of information technology and mobile health to stroke management. Rapid detection and triage are essential for effective thrombolytic treatment. Awareness of stroke warning signs and responses to stroke could be enhanced by using mobile applications. Furthermore, prehospital assessment and notification could be streamlined for use in telemedicine and teleradiology. A mobile telemedicine system for assessing the National Institutes of Health Stroke Scale scores has shown higher correlation and fast assessment comparing with face-to-face method. Because the benefits of thrombolytic treatment are time-dependent, treatment should be initiated as quickly as possible. In-hospital communication between multidisciplinary team members can be enhanced using information technology. A computerized in-hospital alert system using computerized physician-order entry was shown to be effective in reducing the time intervals from hospital arrival to medical evaluations and thrombolytic treatment. Mobile devices can also be used as supplementary tools for neurologic examination and clinical decision-making. In post-stroke rehabilitation, virtual reality and telerehabilitation are helpful. Mobile applications might be useful for public awareness, lifestyle modification, and education/training of healthcare professionals. Information technology and mobile health are useful tools for management of stroke patients from the acute period to rehabilitation. Further improvement of technology will change and enhance stroke prevention and treatment.

  16. Increasing physical activity in stroke survivors using STARFISH, an interactive mobile phone application: a pilot study.

    Science.gov (United States)

    Paul, Lorna; Wyke, Sally; Brewster, Stephen; Sattar, Naveed; Gill, Jason M R; Alexander, Gillian; Rafferty, Danny; McFadyen, Angus K; Ramsay, Andrew; Dybus, Aleksandra

    2016-06-01

    Following stroke, people are generally less active and more sedentary which can worsen outcomes. Mobile phone applications (apps) can support change in health behaviors. We developed STARFISH, a mobile phone app-based intervention, which incorporates evidence-based behavior change techniques (feedback, self-monitoring and social support), in which users' physical activity is visualized by fish swimming. To evaluate the potential effectiveness of STARFISH in stroke survivors. Twenty-three people with stroke (12 women; age: 56.0 ± 10.0 years, time since stroke: 4.2 ± 4.0 years) from support groups in Glasgow completed the study. Participants were sequentially allocated in a 2:1 ratio to intervention (n = 15) or control (n = 8) groups. The intervention group followed the STARFISH program for six weeks; the control group received usual care. Outcome measures included physical activity, sedentary time, heart rate, blood pressure, body mass index, Fatigue Severity Scale, Instrumental Activity of Daily Living Scale, Ten-Meter Walk Test, Stroke Specific Quality of Life Scale, and Psychological General Well-Being Index. The average daily step count increased by 39.3% (4158 to 5791 steps/day) in the intervention group and reduced by 20.2% (3694 to 2947 steps/day) in the control group (p = 0.005 for group-time interaction). Similar patterns of data and group-time interaction were seen for walking time (p = 0.002) and fatigue (p = 0.003). There were no significant group-time interactions for other outcome measures. Use of STARFISH has the potential to improve physical activity and health outcomes in people after stroke and longer term intervention trials are warranted.

  17. Feasibility and effects of newly developed balance control trainer for mobility and balance in chronic stroke patients: a randomized controlled trial.

    Science.gov (United States)

    Lee, So Hyun; Byun, Seung Deuk; Kim, Chul Hyun; Go, Jin Young; Nam, Hyeon Uk; Huh, Jin Seok; Jung, Tae Du

    2012-08-01

    To investigate the feasibility and effects of balance training with a newly developed Balance Control Trainer (BCT) that applied the concept of vertical movement for the improvements of mobility and balance in chronic stroke patients. Forty chronic stroke patients were randomly assigned to an experimental or a control group. The experimental group (n=20) underwent training with a BCT for 20 minutes a day, 5 days a week for 4 weeks, in addition to concurrent conventional physical therapy. The control group (n=20) underwent only conventional therapy for 4 weeks. All participants were assessed by: the Functional Ambulation Categories (FAC), 10-meter Walking Test (10mWT), Timed Up and Go test (TUG), Berg Balance Scale (BBS), Korean Modified Barthel Index (MBI), and Manual Muscle Test (MMT) before training, and at 2 and 4 weeks of training. There were statistically significant improvements in all parameters except knee extensor power at 2 weeks of treatment, and in all parameters except MBI which showed further statistically significant progress in the experimental group over the next two weeks (pgait in ambulatory chronic stroke patients. Furthermore, it may provide additional benefits when used in conjunction with conventional therapies.

  18. Clinical Evidence of Exercise Benefits for Stroke.

    Science.gov (United States)

    Han, Peipei; Zhang, Wen; Kang, Li; Ma, Yixuan; Fu, Liyuan; Jia, Liye; Yu, Hairui; Chen, Xiaoyu; Hou, Lin; Wang, Lu; Yu, Xing; Kohzuki, Masahiro; Guo, Qi

    2017-01-01

    Even though stroke is the third, not the first, most common cause of disability-adjusted life years in developed countries, it is one of the most expensive to treat. Part of the expense is due to secondary problems in the post-stroke period including: cognition, memory, attention span, pain, sensation loss, psychological issues, and problems with mobility and balance. Research has identified that exercise has both positive physical and psychosocial effects for post-stroke patients. Therefore, this scientific statement provides an overview on exercise rehabilitation for post-stroke patients.We will use systematic literature reviews, clinical and epidemiology reports, published morbidity and mortality studies, clinical and public health guidelines, patient files, and authoritative statements to support this overview.Evidence clearly supports the use of various kinds of exercise training (e.g., aerobic, strength, flexibility, neuromuscular, and traditional Chinese exercise) for stroke survivors. Aerobic exercise, the main form of cardiac rehabilitation, may play an important role in improving aerobic fitness, cardiovascular fitness, cognitive abilities, walking speed and endurance, balance, quality of life, mobility, and other health outcomes among stroke patients. Strength exercise, included in national stroke guidelines and recommended for general health promotion for stroke survivors, can lead to improvements in functionality, psychosocial aspects, and quality of life for post-stroke patients. Flexibility exercises can relieve muscle spasticity problems, improve motor function, range of motion, and prevent contractures. Stretching exercises can also prevent joint contractures, muscle shortening, decrease spasticity, reduce joint stiffness and improve a post-stroke patient's overall function. Neuromuscular exercises can improve activities of daily living (ADL) through coordination and balance activities. Traditional Chinese exercises are used to improve walking and

  19. Rehabilitation that incorporates virtual reality is more effective than standard rehabilitation for improving walking speed, balance and mobility after stroke: a systematic review

    Directory of Open Access Journals (Sweden)

    Davide Corbetta

    2015-07-01

    Full Text Available Question: In people after stroke, does virtual reality based rehabilitation (VRBR improve walking speed, balance and mobility more than the same duration of standard rehabilitation? In people after stroke, does adding extra VRBR to standard rehabilitation improve the effects on gait, balance and mobility? Design: Systematic review with meta-analysis of randomised trials. Participants: Adults with a clinical diagnosis of stroke. Intervention: Eligible trials had to include one these comparisons: VRBR replacing some or all of standard rehabilitation or VRBR used as extra rehabilitation time added to a standard rehabilitation regimen. Outcome measures: Walking speed, balance, mobility and adverse events. Results: In total, 15 trials involving 341 participants were included. When VRBR replaced some or all of the standard rehabilitation, there were statistically significant benefits in walking speed (MD 0.15 m/s, 95% CI 0.10 to 0.19, balance (MD 2.1 points on the Berg Balance Scale, 95% CI 1.8 to 2.5 and mobility (MD 2.3 seconds on the Timed Up and Go test, 95% CI 1.2 to 3.4. When VRBR was added to standard rehabilitation, mobility showed a significant benefit (0.7 seconds on the Timed Up and Go test, 95% CI 0.4 to 1.1, but insufficient evidence was found to comment about walking speed (one trial and balance (high heterogeneity. Conclusion: Substituting some or all of a standard rehabilitation regimen with VRBR elicits greater benefits in walking speed, balance and mobility in people with stroke. Although the benefits are small, the extra cost of applying virtual reality to standard rehabilitation is also small, especially when spread over many patients in a clinic. Adding extra VRBR time to standard rehabilitation also has some benefits; further research is needed to determine if these benefits are clinically worthwhile. [Corbetta D, Imeri F, Gatti R (2015 Rehabilitation that incorporates virtual reality is more effective than standard

  20. Mobile game-based virtual reality rehabilitation program for upper limb dysfunction after ischemic stroke.

    Science.gov (United States)

    Choi, Yoon-Hee; Ku, Jeonghun; Lim, Hyunmi; Kim, Yeo Hyung; Paik, Nam-Jong

    2016-05-02

    Virtual reality (VR) has the potential to provide intensive, repetitive, and task-oriented training, and game-based therapy can enhance patients' motivation and enjoyment. The objective of the present study was to develop a mobile game-based upper extremity VR program for patients who have experienced stroke, and to evaluate the feasibility and effectiveness of the program. This randomized, double-blind, controlled trial included 24 patients with ischemic stroke. The intervention group (n = 12) received 30 min of conventional occupational therapy (OT) and 30 min of the mobile upper extremity rehabilitation program using a smartphone and a tablet PC (MoU-Rehab). The controls (n = 12) received conventional OT alone for 1 h per day. Rehabilitation consisted of 10 sessions of therapy, 5 days per week, for 2 weeks. The outcome measures (Fugl-Meyer Assessment of the upper extremity [FMA-UE], Brunnström stage [B-stage] for the arm and the hand, manual muscle testing [MMT], modified Barthel index [MBI], EuroQol-5 Dimension [EQ-5D], and Beck Depression Inventory [BDI]) were assessed at the beginning and end of treatment, and at 1 month. User satisfaction was evaluated by a questionnaire. A greater improvement in the FMA-UE, B-stage, and MMT was found after treatment with the MoU-Rehab than with conventional therapy. The extent of improvements in the MBI, EQ-5D, and BDI was not significantly different between the two groups. Patients in the experimental group completed the 2-weeks treatment without adverse effects, and they were generally satisfied with MoU-Rehab. This mobile game-based VR rehabilitation program appears to be feasible and effective for promoting upper limb recovery after ischemic stroke.

  1. Development and content validation of the power mobility training tool.

    Science.gov (United States)

    Kenyon, Lisa K; Farris, John P; Cain, Brett; King, Emily; VandenBerg, Ashley

    2018-01-01

    This paper outlines the development and content validation of the power mobility training tool (PMTT), an observational tool designed to assist therapists in developing power mobility training programs for children who have multiple, severe impairments. Initial items on the PMTT were developed based on a literature review and in consultation with therapists experienced in the use of power mobility. Items were trialled in clinical settings, reviewed, and refined. Items were then operationalized and an administration manual detailing scoring for each item was created. Qualitative and quantitative methods were used to establish content validity via a 15 member, international expert panel. The content validity ratio (CVR) was determined for each possible item. Of the 19 original items, 10 achieved minimum required CVR values and were included in the final version of the PMTT. Items related to manoeuvring a power mobility device were merged and an item related to the number of switches used concurrently to operate a power mobility device were added to the PMTT. The PMTT may assist therapists in developing training programs that facilitate the acquisition of beginning power mobility skills in children who have multiple, severe impairments. Implications for Rehabilitation The Power Mobility Training Tool (PMTT) was developed to help guide the development of power mobility intervention programs for children who have multiple, severe impairments. The PMTT can be used with children who access a power mobility device using either a joystick or a switch. Therapists who have limited experience with power mobility may find the PMTT to be helpful in setting up and conducting power mobility training interventions as a feasible aspect of a plan of care for children who have multiple, severe impairments.

  2. RecoverNow: Feasibility of a Mobile Tablet-Based Rehabilitation Intervention to Treat Post-Stroke Communication Deficits in the Acute Care Setting.

    Science.gov (United States)

    Mallet, Karen H; Shamloul, Rany M; Corbett, Dale; Finestone, Hillel M; Hatcher, Simon; Lumsden, Jim; Momoli, Franco; Shamy, Michel C F; Stotts, Grant; Swartz, Richard H; Yang, Christine; Dowlatshahi, Dar

    2016-01-01

    Approximately 40% of patients diagnosed with stroke experience some degree of aphasia. With limited health care resources, patients' access to speech and language therapies is often delayed. We propose using mobile-platform technology to initiate early speech-language therapy in the acute care setting. For this pilot, our objective was to assess the feasibility of a tablet-based speech-language therapy for patients with communication deficits following acute stroke. We enrolled consecutive patients admitted with a stroke and communication deficits with NIHSS score ≥1 on the best language and/or dysarthria parameters. We excluded patients with severe comprehension deficits where communication was not possible. Following baseline assessment by a speech-language pathologist (SLP), patients were provided with a mobile tablet programmed with individualized therapy applications based on the assessment, and instructed to use it for at least one hour per day. Our objective was to establish feasibility by measuring recruitment rate, adherence rate, retention rate, protocol deviations and acceptability. Over 6 months, 143 patients were admitted with a new diagnosis of stroke: 73 had communication deficits, 44 met inclusion criteria, and 30 were enrolled into RecoverNow (median age 62, 26.6% female) for a recruitment rate of 68% of eligible participants. Participants received mobile tablets at a mean 6.8 days from admission [SEM 1.6], and used them for a mean 149.8 minutes/day [SEM 19.1]. In-hospital retention rate was 97%, and 96% of patients scored the mobile tablet-based communication therapy as at least moderately convenient 3/5 or better with 5/5 being most "convenient". Individualized speech-language therapy delivered by mobile tablet technology is feasible in acute care.

  3. Identification of tasks performed by stroke patients using a mobility assistive device

    DEFF Research Database (Denmark)

    Hester, Todd; Sherrill, Delsey M; Hamel, Mathieu

    2006-01-01

    of these devices. In this study, we propose the use of wearable sensors to identify tasks performed by stroke patients with a mobility assistive device. Subjects performed ten tasks with a three-axis accelerometer attached to their ankle and a neural network was trained to identify the task being performed...... tasks associated with the use of a cane. Therefore, we envision that the methodology presented in this paper could be used to evaluate the use of a cane in the context of the task being performed........ Results from 15 stroke patients indicated that these motor tasks can be reliably identified with a median sensitivity of 90 % at a median specificity of 95%. These results indicate that it is possible to use a single module with a three-axis accelerometer attached to the ankle to reliably identify motor...

  4. What is Bobath? A survey of UK stroke physiotherapists' perceptions of the content of the Bobath concept to treat postural control and mobility problems after stroke

    OpenAIRE

    Tyson, Sarah F.; Connell, L. A.; Busse, M. E.; Lennon, S.

    2009-01-01

    Objective. The aim of this study was to identify which interventions used to treat postural control and mobility are considered part of the Bobath concept (BC). Design. Hospital-based UK stroke physiotherapists identified interventions which they perceived to be part of the BC from a pre-published list of interventions used to treat postural control and mobility problems. Interventions that >75% of participants felt were part of the BC were classified as 'definitely Bobath'. Interventions ...

  5. Wireless Power for Mobile Devices

    NARCIS (Netherlands)

    Waffenschmidt, E.

    2011-01-01

    Wireless power transfer allows a convenient, easy to use battery charging of mobile phones and other mobile devices. No hassle with cables and plugs, just place the device on a pad and that’s it. Such asystem even has the potential to become a standard charging solution. Where are the limits for

  6. Mobility in pictures: a participatory photovoice narrative study exploring powered mobility provision for children and families.

    Science.gov (United States)

    Feldner, Heather A; Logan, Samuel W; Galloway, James C

    2018-03-09

    Rehabilitation professionals are increasingly recognizing mobility as a basic human right and endorsing the efficacy of early powered mobility for children with mobility impairments to foster independence, promote socialization with peers and facilitate participation in family and community life. However, the relationship between mobility and technology provision, when considered in the context of lived experiences of children with mobility impairments and their families, is complex and understudied. Perceptions of these experiences from children's own points of view are especially limited, as is the use of participatory research methods in describing these experiences. The purpose of this study was to empower children and families as co-researchers, investigating their experiences and perspectives of powered mobility provision processes and early use of their mobility technology in their own words and images.  Methods: Two families in a major Midwest metropolitan area- one who was receiving a powered wheelchair and one who was receiving a modified powered ride-on toy car- participated as co-researchers from 2015-2016, documenting their experiences with a research camera and narrating their photos to describe meaningful or important aspects of their respective powered mobility provision processes and early use of their devices. Four themes emerged: (1) Dys/Function of Mobility Technology; (2) Daily Life, Play and Participation; (3) Emerging Self/Advocacy and (4) Complex Family/Industry Interplay.  Conclusions: These themes and experiences may inform further innovation in powered mobility practices, generate new hypotheses about the role of technology in shaping disability identity and demonstrate the feasibility and impact of using participatory methods more broadly in rehabilitation research. Implications for Rehabilitation Participatory methods may be a useful and underutilized research tool in describing the impact of powered mobility provision processes on

  7. What is Bobath? A survey of UK stroke physiotherapists' perceptions of the content of the Bobath concept to treat postural control and mobility problems after stroke.

    Science.gov (United States)

    Tyson, S F; Connell, L A; Busse, M E; Lennon, S

    2009-01-01

    The aim of this study was to identify which interventions used to treat postural control and mobility are considered part of the Bobath concept (BC). DESIGN. Hospital-based UK stroke physiotherapists identified interventions which they perceived to be part of the BC from a pre-published list of interventions used to treat postural control and mobility problems. Interventions that > 75% of participants felt were part of the BC were classified as 'definitely Bobath'. Interventions that Bobath'. Other interventions were classified as 'unsure'; those indentified by 50-74% of participants as part of the BC were classified as 'probably Bobath' and those indentified 26-49% were classified as 'probably not Bobath'. Seventy-four physiotherapists from 33 hospitals participated. Facilitation, mobilizations and practicing components of activities were most strongly associated with the BC. Exercise and the use of equipment were identified as 'not' or 'probably not Bobath'. There was uncertainty about practicing activities, teaching patients and carers and arranging independent practice. UK stroke physiotherapists perceive that the BC involves interventions that focus on facilitating movement, mobilization, practicing components of activities and some whole activities. Their views about what is not part of the BC and the areas where they are uncertain contrast with British and international teachers of the BC. Consequently, it was not possible to define a 'typical package' of treatment for postural control and mobility that represents the BC. Future research into the BC should focus on the effectiveness of specific, well-defined interventions.

  8. Mobile Real-time Tracking of Acute Stroke Patients and Instant, Secure Inter-team Communication - the Join App.

    Science.gov (United States)

    Munich, Stephan A; Tan, Lee A; Nogueira, Danilo M; Keigher, Kiffon M; Chen, Michael; Crowley, R Webster; Conners, James J; Lopes, Demetrius K

    2017-09-01

    The primary correlate to survival and preservation of neurologic function in patients suffering from an acute ischemic stroke is time from symptom onset to initiation of therapy and reperfusion. Communication and coordination among members of the stroke team are essential to maximizing efficiency and subsequently early reperfusion. In this work, we aim to describe our preliminary experience using the Join mobile application as a means to improve interdisciplinary team communication and efficiency. We describe our pilot experience with the initiation of the Join mobile application between July 2015 and July 2016. With this application, a mobile beacon is transported with the patient on the ambulance. Transportation milestone timestamps and geographic coordinates are transmitted to the treating facility and instantly communicated to all treatment team members. The transport team / patient can be tracked en route to the treating facility. During our pilot study, 62 patients were triaged and managed using the Join application. Automated time-stamping of critical events, geographic tracking of patient transport and summary documents were obtained for all patients. Treatment team members had an overall favorable impression of the Join application and recommended its continued use. The Join application is one of several components of a multi-institutional, interdisciplinary effort to improve the treatment of patients with acute ischemic stroke. The ability of the treatment team to track patient transport and communicate with the transporting team may improve reperfusion time and, therefore, improve neurologic outcomes.

  9. RecoverNow: Feasibility of a Mobile Tablet-Based Rehabilitation Intervention to Treat Post-Stroke Communication Deficits in the Acute Care Setting.

    Directory of Open Access Journals (Sweden)

    Karen H Mallet

    Full Text Available Approximately 40% of patients diagnosed with stroke experience some degree of aphasia. With limited health care resources, patients' access to speech and language therapies is often delayed. We propose using mobile-platform technology to initiate early speech-language therapy in the acute care setting. For this pilot, our objective was to assess the feasibility of a tablet-based speech-language therapy for patients with communication deficits following acute stroke.We enrolled consecutive patients admitted with a stroke and communication deficits with NIHSS score ≥1 on the best language and/or dysarthria parameters. We excluded patients with severe comprehension deficits where communication was not possible. Following baseline assessment by a speech-language pathologist (SLP, patients were provided with a mobile tablet programmed with individualized therapy applications based on the assessment, and instructed to use it for at least one hour per day. Our objective was to establish feasibility by measuring recruitment rate, adherence rate, retention rate, protocol deviations and acceptability.Over 6 months, 143 patients were admitted with a new diagnosis of stroke: 73 had communication deficits, 44 met inclusion criteria, and 30 were enrolled into RecoverNow (median age 62, 26.6% female for a recruitment rate of 68% of eligible participants. Participants received mobile tablets at a mean 6.8 days from admission [SEM 1.6], and used them for a mean 149.8 minutes/day [SEM 19.1]. In-hospital retention rate was 97%, and 96% of patients scored the mobile tablet-based communication therapy as at least moderately convenient 3/5 or better with 5/5 being most "convenient".Individualized speech-language therapy delivered by mobile tablet technology is feasible in acute care.

  10. Systematic review of power mobility outcomes for infants, children and adolescents with mobility limitations.

    Science.gov (United States)

    Livingstone, Roslyn; Field, Debra

    2014-10-01

    To summarize and critically appraise the evidence related to power mobility use in children (18 years or younger) with mobility limitations. Searches were performed in 12 electronic databases along with hand searching for articles published in English to September 2012 and updated February 2014. The search was restricted to quantitative studies including at least one child with a mobility limitation and measuring an outcome related to power mobility device use. Articles were appraised using American Academy of Cerebral Palsy and Developmental Medicine (AACPDM) criteria for group and single-subject designs. The PRISMA statement was followed with inclusion criteria set a priori. Two reviewers independently screened titles, abstracts and full-text articles. AACPDM quality ratings were completed for levels I-III studies. Of 259 titles, 29 articles met inclusion criteria, describing 28 primary research studies. One study, rated as strong level II evidence, supported positive impact of power mobility on overall development as well as independent mobility. Another study, rated as moderate level III evidence, supported positive impact on self-initiated movement. Remaining studies, rated evidence levels IV and V, provided support for a positive impact on a broad range of outcomes from to International Classification of Functioning (ICF) components of body structure and function, activity and participation. Some studies suggest that environmental factors may be influential in successful power mobility use and skill development. The body of evidence supporting outcomes for children using power mobility is primarily descriptive rather than experimental in nature, suggesting research in this area is in its infancy. © The Author(s) 2014.

  11. Power and signal transmission for mobile teleoperated systems

    International Nuclear Information System (INIS)

    Morris, A.C. Jr.; Hamel, W.R.

    1985-01-01

    Appropriate means must be furnished for supplying power and for sending controlling commands to mobile teleoperated systems. Because a sizable number of possibilities are available for such applications, methods used in designing both the power and communications systems built into mobile vehicles that serve in radiological emergencies must be carefully selected. This paper describes a number of umbilical, on-board, and wireless systems used in tranmitting power that are available for mobile teleoperator services. The pros and cons of selecting appropriate methods from a list of possible communication systems (wired, fiber optic, and radio frequency) are also examined. Moreover, hybrid systems combining wireless power transmissions with command-information signals are also possible

  12. Mobile CT. Technical aspects of prehospital stroke imaging before intravenous thrombolysis

    International Nuclear Information System (INIS)

    Gierhake, Daniel; Villringer, K.; Fiebach, J.B.; Weber, J.E.; Audebert, H.J.; Charite - Universitaetsmedizin Berlin; Ebinger, M.; Charite - Universitaetsmedizin Berlin

    2013-01-01

    To reduce the time from symptom onset to treatment with tissue plasminogen activator (tPA) in ischemic stroke, an ambulance was equipped with a CT scanner. We analyzed process and image quality of CT scanning during the pilot study regarding image quality and safety issues. The pilot study of a stroke emergency mobile unit (STEMO) ran over a period of 12 weeks on 5 weekdays from 7a. m. to 6:30 p. m. A teleradiological service for the justifying indication and reporting was established. The radiographer was responsible for the performance of the CT scan on the ambulance. 64 cranial CT scans and 1 intracranial CT angiography were performed. We compared times from ambulance alarm to treatment decision (time of last brain scan) with a cohort of 50 consecutive tPA treatments before implementation of STEMO. 62 (95 %) of the 65 scans performed had sufficient quality for reading. Technical quality was not optimal in 45 cases (69 %) mainly caused by suboptimal positioning of patient or eye lense protection. Motion artefacts were observed in 8 exams (12 %). No safety issues occurred for team or patients. 23 patients were treated with thrombolysis. Time from alarm to last CT scan was 18 minutes shorter than in the tPA cohort before STEMO implementation. A teleradiological support for primary stroke imaging by CT on-site is feasible, quality-wise of diagnostic value and has not raised safety issues. (orig.)

  13. Do Smartphone Power Users Protect Mobile Privacy Better than Nonpower Users? Exploring Power Usage as a Factor in Mobile Privacy Protection and Disclosure.

    Science.gov (United States)

    Kang, Hyunjin; Shin, Wonsun

    2016-03-01

    This study examines how consumers' competence at using smartphone technology (i.e., power usage) affects their privacy protection behaviors. A survey conducted with smartphone users shows that power usage influences privacy protection behavior not only directly but also indirectly through privacy concerns and trust placed in mobile service providers. A follow-up experiment indicates that the effects of power usage on smartphone users' information management can be a function of content personalization. Users, high on power usage, are less likely to share personal information on personalized mobile sites, but they become more revealing when they interact with nonpersonalized mobile sites.

  14. The child and family experience of power mobility: a qualitative synthesis.

    Science.gov (United States)

    Livingstone, Roslyn; Field, Debra

    2015-04-01

    The aim of this study was to critically synthesize qualitative evidence regarding the child and family experience of power mobility, and to examine how this evidence fits with current theoretical concepts. Electronic database/hand searches were undertaken in September 2012 and updated in February 2014. The searches were restricted to qualitative studies published in English before February 2014 that included at least one child under the age of 19 with a disability and described an outcome related to the use of power mobility. Inclusion criteria were set a priori. Two reviewers independently screened titles, abstracts, and full-text articles and extracted data. McMaster qualitative review forms were used for quality appraisal. Of 259 titles, 21 met inclusion criteria. From 143 codes, 15 second-order themes were developed using constant comparison and analysis. Three overarching themes emerged: power mobility experience promotes developmental change and independent mobility; power mobility enhances social relationships and engagement in meaningful life experiences; and power mobility access and use is influenced by factors in the physical, social, and attitudinal environment. This qualitative research provides rich and rigorous evidence supporting the benefits of power mobility for children and families. Numerous factors, which warrant careful consideration, influence power mobility access and use. © 2014 Mac Keith Press.

  15. Passive accessory joint mobilization in the multimodal management of chronic dysesthesia following thalamic stroke.

    Science.gov (United States)

    Griffin, Kristina; O'Hearn, Michael; Franck, Carla C; Courtney, Carol A

    2018-03-20

    Case Report. Stroke is the most common cause of long-term disability. Dysesthesia, an unpleasant sensory disturbance, is common following thalamic stroke and evidence-based interventions for this impairment are limited. The purpose of this case report was to describe a decrease in dysesthesia following manual therapy intervention in a patient with history of right lacunar thalamic stroke. A 66-year-old female presented with tingling and dysesthesia in left hemisensory distribution including left trunk and upper/lower extremities, limiting function. Decreased left shoulder active range of motion, positive sensory symptoms but no sensory loss in light touch was found. She denied pain and moderate shoulder muscular weakness was demonstrated. Laterality testing revealed right/left limb discrimination deficits and neglect-like symptoms were reported. Passive accessory joint motion assessment of glenohumeral and thoracic spine revealed hypomobility and provoked dysesthesia. Interventions included passive oscillatory joint mobilization of glenohumeral joint, thoracic spine, ribs and shoulder strengthening. After six sessions, shoulder function, active range of motion, strength improved and dysesthesia decreased. Global Rating of Change Scale was +5 and QuickDASH score decreased from 45% to 22% disability. Laterality testing was unchanged. Manual therapy may be a beneficial intervention in management of thalamic stroke-related dysesthesia. Implications for Rehabilitation While pain is common following thalamic stroke, patients may present with chronic paresthesia or dysesthesia, often in a hemisensory distribution. Passive movement may promote inhibition of hyperexcitable cortical pathways, which may diminish aberrant sensations. Passive oscillatory manual therapy may be an effective way to treat sensory disturbances such as paresthesias or dysesthesia.

  16. Mobile health as a viable strategy to enhance stroke risk factor control: A systematic review and meta-analysis.

    Science.gov (United States)

    Liu, Shimeng; Feng, Wuwei; Chhatbar, Pratik Y; Liu, Yumei; Ji, Xunming; Ovbiagele, Bruce

    2017-07-15

    With the rapid growth worldwide in cell-phone use, Internet connectivity, and digital health technology, mobile health (mHealth) technology may offer a promising approach to bridge evidence-treatment gaps in stroke prevention. We aimed to evaluate the effectiveness of mHealth for stroke risk factor control through a systematic review and meta-analysis. We searched PubMed from January 1, 2000 to May 17, 2016 using the following keywords: mobile health, mHealth, short message, cellular phone, mobile phone, stroke prevention and control, diabetes mellitus, hypertension, hyperlipidemia and smoking cessation. We performed a meta-analysis of all eligible randomized control clinical trials that assessed a sustained (at least 6months) effect of mHealth. Of 78 articles identified, 13 met eligibility criteria (6 for glycemic control and 7 for smoking cessation) and were included for the final meta-analysis. There were no eligible studies for dyslipidemia or hypertension. mHealth resulted in greater Hemoglobin A1c reduction at 6months (6 studies; 663 subjects; SMD: -0.44; 95% CI: [-0.82, -0.06], P=0.02; Mean difference of decrease in HbA1c: -0.39%; 95% CI: [-0.74, -0.04], P=0.03). mHealth also lead to relatively higher smoking abstinence rates at 6months (7 studies; 9514 subjects; OR: 1.54; 95% CI: [1.24, 1.90], P<0.0001). Our meta-analysis supports that use of mHealth improves glycemic control and smoking abstinence rates. Copyright © 2017 Elsevier B.V. All rights reserved.

  17. Power and signal transmission for mobile teleoperated systems

    International Nuclear Information System (INIS)

    Morris, A.C. Jr.; Hamel, W.R.

    1986-01-01

    Appropriate means must be furnished for supplying power and for sending controlling commands to mobile teleoperated systems. This paper describes a number of umbilical, onboard, and wireless systems used in transmitting power that are available for mobile teleoperator services. The pros and cons of selecting appropriate methods from a list of possible communication systems (wired, fiber optic, and radio frequency) are also examined. Moreover, hybrid systems combining wireless power transmissions with command-information signals are also possible. 20 refs., 6 figs., 1 tab

  18. Measurement of power and energy consumption of a competition-mobile-robot

    Directory of Open Access Journals (Sweden)

    Tsung Tsing-Tshih

    2017-01-01

    Full Text Available Power and energy consumption are the two most important factors for successful operation; they also play important roles in performance identification. The measurement of power and energy consumption is a common test in the development process of a competition mobile robot. If the power of a competition mobile robot is not sufficient, the running time in the competition will be too long and winning the competition will not be possible. Thus, the power and energy consumption are basic and important measurement parameters for a competition mobile robot. In this paper, five types of hand-made competition mobile robots are successfully developed and their performances are measured. From the measurements, their powers and energy consumptions are evaluated and analyzed, respectively. The test results show large differences in the powers and energy consumptions of the five models, even though the same motors were used. The design and construction of the competition mobile robot are the key parameters that cause these huge differences. It is possible to develop the measurement techniques for power and energy consumption, quickly and precisely, to determine how to modify a competition mobile robot rapidly and efficiently to a condition optimal for a mobile robot competition.

  19. A neuromechanics-based powered ankle exoskeleton to assist walking post-stroke: a feasibility study.

    Science.gov (United States)

    Takahashi, Kota Z; Lewek, Michael D; Sawicki, Gregory S

    2015-02-25

    In persons post-stroke, diminished ankle joint function can contribute to inadequate gait propulsion. To target paretic ankle impairments, we developed a neuromechanics-based powered ankle exoskeleton. Specifically, this exoskeleton supplies plantarflexion assistance that is proportional to the user's paretic soleus electromyography (EMG) amplitude only during a phase of gait when the stance limb is subjected to an anteriorly directed ground reaction force (GRF). The purpose of this feasibility study was to examine the short-term effects of the powered ankle exoskeleton on the mechanics and energetics of gait. Five subjects with stroke walked with a powered ankle exoskeleton on the paretic limb for three 5 minute sessions. We analyzed the peak paretic ankle plantarflexion moment, paretic ankle positive work, symmetry of GRF propulsion impulse, and net metabolic power. The exoskeleton increased the paretic plantarflexion moment by 16% during the powered walking trials relative to unassisted walking condition (p exoskeleton assistance appeared to reduce the net metabolic power gradually with each 5 minute repetition, though no statistical significance was found. In three of the subjects, the paretic soleus activation during the propulsion phase of stance was reduced during the powered assistance compared to unassisted walking (35% reduction in the integrated EMG amplitude during the third powered session). This feasibility study demonstrated that the exoskeleton can enhance paretic ankle moment. Future studies with greater sample size and prolonged sessions are warranted to evaluate the effects of the powered ankle exoskeleton on overall gait outcomes in persons post-stroke.

  20. Minimizing the Power Consumption of Location-Based Services on Mobile Phones

    DEFF Research Database (Denmark)

    Kjærgaard, Mikkel Baun

    2012-01-01

    Location-based services have to pay careful attention to their power consumption in order not to drain the batteries of mobile phones. It is not a simple task to build low power location-based services that can run for hours because such services make heavy use of many power consuming features...... of mobile phones. In this article we discuss the power consumption of location-based services and mobile phone features, survey methods for how to minimize power consumption and summarize a number of design considerations for location-based service developers....

  1. Low power offloading strategy for femto-cloud mobile network

    Directory of Open Access Journals (Sweden)

    Anwesha Mukherjee

    2016-03-01

    Full Text Available Nowadays offloading is a popular method of mobile cloud computing where the required computation takes place remotely inside the cloud. But whether to process an application inside the mobile device or to the cloud is a challenging issue because communication with the cloud involves latency and power consumption. This paper has proposed a method of decision making regarding whether to offload or not-to-offload an application to the cloud. According to the proposed strategy, application is offloaded only if it results in lower power consumption than local execution within the mobile device itself. If this condition is satisfied, computation time and deadline of the job are considered as the basic parameters to decide whether to offload or not. Experimental results demonstrate that the proposed offloading algorithm reduces the power consumption to approximately 3–32%. To achieve power-efficiency and security both, femto-cloud architecture is used in the proposed work. In this case offloading from the mobile device to the cloud takes place through the low power and secure femtocell base station. Simulation results present that using femto-cloud architecture 70–83% and 52–66% power savings are achieved than using macrocell and microcell base stations respectively while offloading an application to the cloud.

  2. Evaluation of predictive factors influencing community reintegration in adult patients with stroke

    Directory of Open Access Journals (Sweden)

    Olajide Ayinla Olawale

    2018-01-01

    Full Text Available Objectives: Patients with stroke are faced with gait, balance, and fall difficulties which could impact on their community reintegration. In Nigeria, community reintegration after stroke has been understudied. The objective of this study was to evaluate the predictors of community reintegration in adult patients with stroke. Materials and Methods: Participants were 91 adult patients with stroke. Gait variables, balance self-efficacy, community balance/mobility, and fall self-efficacy were assessed using Rivermead Mobility Index, Activities-specific Balance Confidence Scale, Community Balance and Mobility Scale, and Falls Efficacy Scale-International respectively. Reintegration to Normal Living Index was used to assess satisfaction with community reintegration. Pearson Product-Moment Correlation Coefficient was used to determine the relationship between community reintegration and gait spatiotemporal variables, balance performance, and risk of fall. Multiple regression analysis was used to determine predictors of community reintegration (P ≤ 0.05. Results: There was significant positive relationship between community reintegration and cadence (r = 0.250, P = 0.017, functional mobility (r = 0.503, P = 0.001, balance self-efficacy (r = 0.608, P = 0.001, community balance/mobility (r = 0.586, P = 0.001, and duration of stroke (r = 0.220, P = 0.036. Stride time (r = −0.282, P = 0.073 and fall self-efficacy (r = 0.566, P = 0.001 were negatively correlated with community reintegration. Duration of stroke, balance self-efficacy, community balance/mobility, and fall self-efficacy (52.7% of the variance were the significant predictors of community reintegration. Conclusion: Community reintegration is influenced by cadence, functional mobility, balance self-efficacy, community balance/mobility, and duration of stroke. Hence, improving balance and mobility during rehabilitation is important in enhancing community reintegration in patients with stroke.

  3. Estimating Energy Consumption of Mobile Fluid Power in the United States

    Energy Technology Data Exchange (ETDEWEB)

    Lynch, Lauren [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Zigler, Bradley T. [National Renewable Energy Laboratory (NREL), Golden, CO (United States)

    2017-11-02

    This report estimates the market size and energy consumption of mobile off-road applications utilizing hydraulic fluid power, and summarizes technology gaps and implementation barriers. Mobile fluid power is the use of hydraulic fluids under pressure to transmit power in mobile equipment applications. The mobile off-road fluid power sector includes various uses of hydraulic fluid power equipment with fundamentally diverse end-use application and operational requirements, such as a skid steer loader, a wheel loader or an agriculture tractor. The agriculture and construction segments dominate the mobile off-road fluid power market in component unit sales volume. An estimated range of energy consumed by the mobile off-road fluid power sector is 0.36 - 1.8 quads per year, which was 1.3 percent - 6.5 percent of the total energy consumed in 2016 by the transportation sector. Opportunities for efficiency improvements within the fluid power system result from needs to level and reduce the peak system load requirements and develop new technologies to reduce fluid power system level losses, both of which may be facilitated by characterizing duty cycles to define standardized performance test methods. There are currently no commonly accepted standardized test methods for evaluating equipment level efficiency over a duty cycle. The off-road transportation sector currently meets criteria emissions requirements, and there are no efficiency regulations requiring original equipment manufacturers (OEM) to invest in new architecture development to improve the fuel economy of mobile off-road fluid power systems. In addition, the end-user efficiency interests are outweighed by low equipment purchase or lease price concerns, required payback periods, and reliability and durability requirements of new architecture. Current economics, low market volumes with high product diversity, and regulation compliance challenge OEM investment in commercialization of new architecture development.

  4. Method for enhancing the resolving power of ion mobility separations over a limited mobility range

    Science.gov (United States)

    Shvartsburg, Alexandre A; Tang, Keqi; Smith, Richard D

    2014-09-23

    A method for raising the resolving power, specificity, and peak capacity of conventional ion mobility spectrometry is disclosed. Ions are separated in a dynamic electric field comprising an oscillatory field wave and opposing static field, or at least two counter propagating waves with different parameters (amplitude, profile, frequency, or speed). As the functional dependencies of mean drift velocity on the ion mobility in a wave and static field or in unequal waves differ, only single species is equilibrated while others drift in either direction and are mobility-separated. An ion mobility spectrum over a limited range is then acquired by measuring ion drift times through a fixed distance inside the gas-filled enclosure. The resolving power in the vicinity of equilibrium mobility substantially exceeds that for known traveling-wave or drift-tube IMS separations, with spectra over wider ranges obtainable by stitching multiple segments. The approach also enables low-cutoff, high-cutoff, and bandpass ion mobility filters.

  5. Electromyography-controlled exoskeletal upper-limb-powered orthosis for exercise training after stroke.

    Science.gov (United States)

    Stein, Joel; Narendran, Kailas; McBean, John; Krebs, Kathryn; Hughes, Richard

    2007-04-01

    Robot-assisted exercise shows promise as a means of providing exercise therapy for weakness that results from stroke or other neurological conditions. Exoskeletal or "wearable" robots can, in principle, provide therapeutic exercise and/or function as powered orthoses to help compensate for chronic weakness. We describe a novel electromyography (EMG)-controlled exoskeletal robotic brace for the elbow (the active joint brace) and the results of a pilot study conducted using this brace for exercise training in individuals with chronic hemiparesis after stroke. Eight stroke survivors with severe chronic hemiparesis were enrolled in this pilot study. One subject withdrew from the study because of scheduling conflicts. A second subject was unable to participate in the training protocol because of insufficient surface EMG activity to control the active joint brace. The six remaining subjects each underwent 18 hrs of exercise training using the device for a period of 6 wks. Outcome measures included the upper-extremity component of the Fugl-Meyer scale and the modified Ashworth scale of muscle hypertonicity. Analysis revealed that the mean upper-extremity component of the Fugl-Meyer scale increased from 15.5 (SD 3.88) to 19 (SD 3.95) (P = 0.04) at the conclusion of training for the six subjects who completed training. Combined (summated) modified Ashworth scale for the elbow flexors and extensors improved from 4.67 (+/-1.2 SD) to 2.33 (+/-0.653 SD) (P = 0.009) and improved for the entire upper limb as well. All subjects tolerated the device, and no complications occurred. EMG-controlled powered elbow orthoses can be successfully controlled by severely impaired hemiparetic stroke survivors. This technique shows promise as a new modality for assisted exercise training after stroke.

  6. Evaluation of functional mobility of patients with stroke sequela after treatment in hydrotherapy pool using the Timed Up and Go Test

    Directory of Open Access Journals (Sweden)

    Daniel Gonçalves dos Santos

    2011-09-01

    Full Text Available Objective: To evaluate the functional mobility of patients with strokeover 12 sessions of hydrotherapy. Methods: Ten stroke patients agedbetween 5 and 85 years were evaluated by means of the Timed Up andGo test, which contains some items, such as balance, walking speed,changing directions, and standing up from a seated position. Thestudy patients performed the test before and after each hydrotherapysession (total of 12 sessions. Each individual was compared to him/herself both short-term (pre- and post-therapy and long-term (after 12 therapy sessions. Result: Comparing baseline and after 12 sessions, it was noted that the 10 patients improved their performance, with a decrease in time to execute the Timed Up and Go test. Conclusion: An exercise program in a hydrotherapy pool was beneficial for functional mobility performance improvement in stroke patients.

  7. An Adaptive and Integrated Low-Power Framework for Multicore Mobile Computing

    Directory of Open Access Journals (Sweden)

    Jongmoo Choi

    2017-01-01

    Full Text Available Employing multicore in mobile computing such as smartphone and IoT (Internet of Things device is a double-edged sword. It provides ample computing capabilities required in recent intelligent mobile services including voice recognition, image processing, big data analysis, and deep learning. However, it requires a great deal of power consumption, which causes creating a thermal hot spot and putting pressure on the energy resource in a mobile device. In this paper, we propose a novel framework that integrates two well-known low-power techniques, DPM (Dynamic Power Management and DVFS (Dynamic Voltage and Frequency Scaling for energy efficiency in multicore mobile systems. The key feature of the proposed framework is adaptability. By monitoring the online resource usage such as CPU utilization and power consumption, the framework can orchestrate diverse DPM and DVFS policies according to workload characteristics. Real implementation based experiments using three mobile devices have shown that it can reduce the power consumption ranging from 22% to 79%, while affecting negligibly the performance of workloads.

  8. Expertise of using striking techniques for power stroke in badminton.

    Science.gov (United States)

    Zhu, Qin

    2013-10-01

    Two striking techniques (fast swing and angled striking) were examined to see if they allowed effective use of string tension for the power stroke in badminton. 12 participants (4 novices, 4 recreational, and 4 expert badminton players) were recorded by a fast-speed camera while striking a shuttlecock with racquets of 8 different string tensions. The peak speed of the shuttlecock, the racquet angle and the shuttlecock angle were analyzed. The results showed that expert players succeeded in using both striking techniques to overcome the constraint of string tension and produce a consistently superior stroke. Failure to use either striking technique resulted in inferior performance that was constrained by string tension. Expertise in badminton allows the necessary motor adjustments based on the affordance perception of the string tension.

  9. Power Management of Hybrid Power Systems with Li-Fe Batteries and Supercapacitors for Mobile Robots

    Directory of Open Access Journals (Sweden)

    Guohui Wang

    2014-05-01

    Full Text Available This paper presents an energy management strategy of a Li-Fe battery and supercapacitor hybrid power system to provide both high power density and energy density for mobile robots with fluctuating workloads. A two-phase power-optimization approach is proposed to exploit the high power density of supercapacitors and the high energy density of Li-Fe batteries. With our strategy, large peak power can be provided for a short time period whenever needed, while low power can be provided for very long time. A set of experiments have been conducted. The experimental results show that our strategy can effectively improve the performance of mobile robots and extend the lifetime of batteries.

  10. Power Mobility Training Methods for Children: A Systematic Review.

    Science.gov (United States)

    Kenyon, Lisa K; Hostnik, Lisa; McElroy, Rachel; Peterson, Courtney; Farris, John P

    2018-01-01

    To summarize and critically appraise the existing evidence related to power mobility training methods used in research studies conducted with children 21 years or younger. A systematic review was conducted using 16 electronic databases to identify primary source quantitative studies published in peer-reviewed journals. Data extraction, determination of level of evidence, evaluation of methodological rigor, and assessment of the risk of bias were completed. The Evidence Alert Traffic Light Grading System (EATLS) was used. Twenty-seven studies were included in the review. Levels of evidence were II to V; scientific rigor scores were 2 to 7. An overall Yellow EATLS level of evidence was found indicating that therapists should use caution when providing power mobility training interventions and measure outcomes related to established goals in areas such as development, functional skills, or use of a power mobility device.

  11. Call-related factors influencing output power from mobile phones.

    Science.gov (United States)

    Hillert, Lena; Ahlbom, Anders; Neasham, David; Feychting, Maria; Järup, Lars; Navin, Roshan; Elliott, Paul

    2006-11-01

    Mobile phone use is increasing but there is also concern for adverse health effects. Well-designed prospective studies to assess several health outcomes are required. In designing a study of mobile phone use, it is important to assess which factors need to be considered in classifying the exposure to radiofrequency fields (RF). A pilot study was performed in Sweden and in the UK 2002 to 2003 to test the feasibility of recruiting a cohort of mobile phone users from a random population sample and from mobile phone subscription lists for a prospective study. As one part of this pilot study, different factors were evaluated regarding possible influence on the output power of the phones. By local switch logging, information on calls made from predefined subscriptions or dedicated handsets were obtained and the output power of phones during calls made indoors and outdoors, in moving and stationary mode, and in rural as well in urban areas were compared. In this experiment, calls were either 1, 1.5 or 5 min long. The results showed that high mobile phone output power is more frequent in rural areas whereas the other factors (length of call, moving/stationary, indoor/outdoor) were of less importance. Urban and rural area should be considered in an exposure index for classification of the exposure to RF from mobile phones and may be assessed by first base station during mobile phone calls or, if this information is not available, possibly by using home address as a proxy.

  12. Graphical analysis of power systems for mobile robotics

    Science.gov (United States)

    Raade, Justin William

    The field of mobile robotics places stringent demands on the power system. Energetic autonomy, or the ability to function for a useful operation time independent of any tether, refueling, or recharging, is a driving force in a robot designed for a field application. The focus of this dissertation is the development of two graphical analysis tools, namely Ragone plots and optimal hybridization plots, for the design of human scale mobile robotic power systems. These tools contribute to the intuitive understanding of the performance of a power system and expand the toolbox of the design engineer. Ragone plots are useful for graphically comparing the merits of different power systems for a wide range of operation times. They plot the specific power versus the specific energy of a system on logarithmic scales. The driving equations in the creation of a Ragone plot are derived in terms of several important system parameters. Trends at extreme operation times (both very short and very long) are examined. Ragone plot analysis is applied to the design of several power systems for high-power human exoskeletons. Power systems examined include a monopropellant-powered free piston hydraulic pump, a gasoline-powered internal combustion engine with hydraulic actuators, and a fuel cell with electric actuators. Hybrid power systems consist of two or more distinct energy sources that are used together to meet a single load. They can often outperform non-hybrid power systems in low duty-cycle applications or those with widely varying load profiles and long operation times. Two types of energy sources are defined: engine-like and capacitive. The hybridization rules for different combinations of energy sources are derived using graphical plots of hybrid power system mass versus the primary system power. Optimal hybridization analysis is applied to several power systems for low-power human exoskeletons. Hybrid power systems examined include a fuel cell and a solar panel coupled with

  13. Research on DTX Technology and Power Consumption Performance of Mobile Communication Terminal

    Directory of Open Access Journals (Sweden)

    Xie Shui Zhen

    2016-01-01

    Full Text Available In order to reduce the power consumption of GSM and TD-SCDMA mobile communication system terminal, the paper starts with DTX (Discontinuous Transmission technology of GSM and TD-SCDMA systems, offers a detailed analysis of the DTX’s function in optimizing power consumption of GSM and TDSCDMA mobile communication system terminal and reducing system interference, and verifies DTX’s positive role in reducing the power consumption of the mobile terminal by experiment.

  14. Complex Mobile Independent Power Station for Urban Areas

    Science.gov (United States)

    Tunik, A. A.; Tolstoy, M. Y.

    2017-11-01

    A new type of a complex mobile independent power station developed in the Department of Engineering Communications and Life-Support Systems of Irkutsk National Research Technical University, is presented in this article. This station contains only solar panel, wind turbine, accumulator, diesel generator and microbial fuel cell for to produce electric energy, heat pump and solar collector to generate heat energy and also wastewater treatment plant and new complex control system. The complex mobile independent power station is intended for full power supply of a different kind of consumers located even in remote areas thus reducing their dependence from centralized energy supply systems, decrease the fossil fuel consumption, improve the environment of urban areas and solve the problems of the purification of industrial and municipal wastewater.

  15. Low wireless power transfer using inductive coupling for mobile phone charger

    International Nuclear Information System (INIS)

    Fareq, M; Fitra, M; Irwanto, M; Hasan, Syafruddin; Arinal, M

    2014-01-01

    A wireless power transfer (WPT) using inductive coupling for mobile phone charger is studied. The project is offer to study and fabricate WPT using inductive coupling for mobile phone charger that will give more information about distance is effect for WPT performance and WPT is not much influenced by the presence of hands, books and types of plastics. The components used to build wireless power transfer can be divided into 3 parts components, the transceiver for power transmission, the inductive coils in this case as the antenna, receiver and the rectifier which act convert AC to DC. Experiments have been conducted and the wireless power transfer using inductive coupling is suitable to be implemented for mobile phone charger.

  16. Mobility and power in networked European space

    DEFF Research Database (Denmark)

    Richardson, Tim; Jensen, Ole B.

    This paper seeks to contribute to debates about how urban, social and critical theory can conceptualise the socio-technologies of connection, resilience, mobility, and collapse in contemporary urban space. The paper offers a theoretical frame for conceptualising this New Urban Condition, focusing...... on themes of mobility, power, flow, network and scale. The analysis suggests the importance of close atention to the knowledge claims which are deployed in multi-level struggles to assert smooth futures in face of dysfunction....

  17. Develop a wearable ankle robot for in-bed acute stroke rehabilitation.

    Science.gov (United States)

    Ren, Yupeng; Xu, Tao; Wang, Liang; Yang, Chung Yong; Guo, Xin; Harvey, Richard L; Zhang, Li-Qun

    2011-01-01

    Movement training is important in motor recovery post stroke and early intervention is critical to stroke rehabilitation. However, acute stroke survivors are actively trained with activities helpful for recovery of mobility in only 13% of the time in the acute phase. Considering the first few months post stroke is critical in stroke recovery (neuroplasticity), there is a strong need for movement therapy and manipulate/mobilize the joints. There is a lack of in-bed robotic rehabilitation in acute stroke. This study seeks to meet the clinic need and deliver intensive passive and active movement therapy using a wearable robot to enhance motor function in acute stroke. Passively, the wearable robot stretches the joint to its extreme positions safely and forcefully. Actively, movement training is conducted and game playing is used to guide and motivate the patient in movement training.

  18. Joint Transmit Antenna Selection and Power Allocation for ISDF Relaying Mobile-to-Mobile Sensor Networks.

    Science.gov (United States)

    Xu, Lingwei; Zhang, Hao; Gulliver, T Aaron

    2016-02-19

    The outage probability (OP) performance of multiple-relay incremental-selective decode-and-forward (ISDF) relaying mobile-to-mobile (M2M) sensor networks with transmit antenna selection (TAS) over N-Nakagami fading channels is investigated. Exact closed-form OP expressions for both optimal and suboptimal TAS schemes are derived. The power allocation problem is formulated to determine the optimal division of transmit power between the broadcast and relay phases. The OP performance under different conditions is evaluated via numerical simulation to verify the analysis. These results show that the optimal TAS scheme has better OP performance than the suboptimal scheme. Further, the power allocation parameter has a significant influence on the OP performance.

  19. Electron Microscopic Recording of the Power and Recovery Strokes of Individual Myosin Heads Coupled with ATP Hydrolysis: Facts and Implications

    Directory of Open Access Journals (Sweden)

    Haruo Sugi

    2018-05-01

    Full Text Available The most straightforward way to get information on the performance of individual myosin heads producing muscle contraction may be to record their movement, coupled with ATP hydrolysis, electron-microscopically using the gas environmental chamber (EC. The EC enables us to visualize and record ATP-induced myosin head movement in hydrated skeletal muscle myosin filaments. When actin filaments are absent, myosin heads fluctuate around a definite neutral position, so that their time-averaged mean position remains unchanged. On application of ATP, myosin heads are found to move away from, but not towards, the bare region, indicating that myosin heads perform a recovery stroke (average amplitude, 6 nm. After exhaustion of ATP, myosin heads return to their neutral position. In the actin–myosin filament mixture, myosin heads form rigor actin myosin linkages, and on application of ATP, they perform a power stroke by stretching adjacent elastic structures because of a limited amount of applied ATP ≤ 10 µM. The average amplitude of the power stroke is 3.3 nm and 2.5 nm at the distal and the proximal regions of the myosin head catalytic domain (CAD, respectively. The power stroke amplitude increases appreciably at low ionic strength, which is known to enhance Ca2+-activated force in muscle. In both the power and recovery strokes, myosin heads return to their neutral position after exhaustion of ATP.

  20. Effect of Rocker Bar Ankle Foot Orthosis on Functional Mobility in Post-Stroke Hemiplegic Patients: Timed Up and Go and Gait Speed Assessments

    Directory of Open Access Journals (Sweden)

    Farzad Farmani

    2016-03-01

    Discussion: RAFO led to a significant improvement in functional mobility in hemiplegic patients post stroke. This may be due to the positive effect of rocker modification on improving push off and transferring weight during the stance phase of gait.

  1. Power Management in Mobile Hydraulic Applications - An Approach for Designing Hydraulic Power Supply Systems

    DEFF Research Database (Denmark)

    Pedersen, Henrik Clemmensen

    2004-01-01

    Throughout the last three decades energy consumption has become one of the primary design aspects in hydraulic systems, especially for mobile hydraulic systems, as power and cooling capacity here is at limited disposal. Considering the energy usage, this is dependent on component efficiency, but ...... the hydraulic power supply in the most energy efficient way, when considering a number of load situations. Finally an example of the approach is shown to prove its validity.}......Throughout the last three decades energy consumption has become one of the primary design aspects in hydraulic systems, especially for mobile hydraulic systems, as power and cooling capacity here is at limited disposal. Considering the energy usage, this is dependent on component efficiency...

  2. Gait characteristics of hemiparetic stroke survivors in Osun State ...

    African Journals Online (AJOL)

    Stroke is one of the leading causes of severe handicap. Deficiencies in walking may present significant challenges to mobility, resulting in abnormal and inefficient gait patterns in stroke survivors. This study compared the gait characteristics of hemiparetic stroke survivors and those of healthy individuals and determined the ...

  3. A multi-centre randomised controlled trial of rehabilitation aimed at improving outdoor mobility for people after stroke: Study protocol for a randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Logan Pip A

    2012-06-01

    Full Text Available Abstract Background Up to 42% of all stroke patients do not get out of the house as much as they would like. This can impede a person’s quality of life. This study is testing the clinical effectiveness and cost effectiveness of a new outdoor mobility rehabilitation intervention by comparing it to usual care. Methods/design This is a multi-centre parallel group individually randomised, controlled trial. At least 506 participants will be recruited through 15 primary and secondary care settings and will be eligible if they are over 18 years of age, have had a stroke and wish to get out of the house more often. Participants are being randomly allocated to either the intervention group or the control group. Intervention group participants receive up to 12 rehabilitation outdoor mobility sessions over up to four months. The main component of the intervention is repeated practice of outdoor mobility with a therapist. Control group participants are receiving the usual intervention for outdoor mobility limitations: verbal advice and provision of leaflets provided over one session. Outcome measures are being collected using postal questionnaires, travel calendars and by independent assessors. The primary outcome measure is the Social Function domain of the SF36v2 quality of life assessment six months after recruitment. The secondary outcome measures include: functional ability, mobility, the number of journeys (monthly travel diaries, satisfaction with outdoor mobility, mood, health-related quality of life, resource use of health and social care. Carer mood information is also being collected. The mean Social Function score of the SF-36v2 will be compared between treatment arms using a multiple membership form of mixed effects multiple regression analysis adjusting for centre (as a fixed effect, age and baseline Social Function score as covariates and therapist as a multiple membership random effect. Regression coefficients and 95% confidence

  4. Early Rehabilitation After Stroke: a Narrative Review.

    Science.gov (United States)

    Coleman, Elisheva R; Moudgal, Rohitha; Lang, Kathryn; Hyacinth, Hyacinth I; Awosika, Oluwole O; Kissela, Brett M; Feng, Wuwei

    2017-11-07

    Despite current rehabilitative strategies, stroke remains a leading cause of disability in the USA. There is a window of enhanced neuroplasticity early after stroke, during which the brain's dynamic response to injury is heightened and rehabilitation might be particularly effective. This review summarizes the evidence of the existence of this plastic window, and the evidence regarding safety and efficacy of early rehabilitative strategies for several stroke domain-specific deficits. Overall, trials of rehabilitation in the first 2 weeks after stroke are scarce. In the realm of very early mobilization, one large and one small trial found potential harm from mobilizing patients within the first 24 h after stroke, and only one small trial found benefit in doing so. For the upper extremity, constraint-induced movement therapy appears to have benefit when started within 2 weeks of stroke. Evidence for non-invasive brain stimulation in the acute period remains scant and inconclusive. For aphasia, the evidence is mixed, but intensive early therapy might be of benefit for patients with severe aphasia. Mirror therapy begun early after stroke shows promise for the alleviation of neglect. Novel approaches to treating dysphagia early after stroke appear promising, but the high rate of spontaneous improvement makes their benefit difficult to gauge. The optimal time to begin rehabilitation after a stroke remains unsettled, though the evidence is mounting that for at least some deficits, initiation of rehabilitative strategies within the first 2 weeks of stroke is beneficial. Commencing intensive therapy in the first 24 h may be harmful.

  5. Observations on Power-Efficiency Trends in Mobile Communication Devices

    Directory of Open Access Journals (Sweden)

    Kari Jyrkkä

    2007-03-01

    Full Text Available Computing solutions used in mobile communications equipment are similar to those in personal and mainframe computers. The key differences between the implementations at chip level are the low leakage silicon technology and lower clock frequency used in mobile devices. The hardware and software architectures, including the operating system principles, are strikingly similar, although the mobile computing systems tend to rely more on hardware accelerators. As the performance expectations of mobile devices are increasing towards the personal computer level and beyond, power efficiency is becoming a major bottleneck. So far, the improvements of the silicon processes in mobile phones have been exploited by software designers to increase functionality and to cut development time, while usage times, and energy efficiency, have been kept at levels that satisfy the customers. Here we explain some of the observed developments and consider means of improving energy efficiency. We show that both processor and software architectures have a big impact on power consumption. Properly targeted research is needed to find the means to explicitly optimize system designs for energy efficiency, rather than maximize the nominal throughputs of the processor cores used.

  6. Observations on Power-Efficiency Trends in Mobile Communication Devices

    Directory of Open Access Journals (Sweden)

    Jyrkkä Kari

    2007-01-01

    Full Text Available Computing solutions used in mobile communications equipment are similar to those in personal and mainframe computers. The key differences between the implementations at chip level are the low leakage silicon technology and lower clock frequency used in mobile devices. The hardware and software architectures, including the operating system principles, are strikingly similar, although the mobile computing systems tend to rely more on hardware accelerators. As the performance expectations of mobile devices are increasing towards the personal computer level and beyond, power efficiency is becoming a major bottleneck. So far, the improvements of the silicon processes in mobile phones have been exploited by software designers to increase functionality and to cut development time, while usage times, and energy efficiency, have been kept at levels that satisfy the customers. Here we explain some of the observed developments and consider means of improving energy efficiency. We show that both processor and software architectures have a big impact on power consumption. Properly targeted research is needed to find the means to explicitly optimize system designs for energy efficiency, rather than maximize the nominal throughputs of the processor cores used.

  7. AUTOMATIC RAILWAY POWER LINE EXTRACTION USING MOBILE LASER SCANNING DATA

    Directory of Open Access Journals (Sweden)

    S. Zhang

    2016-06-01

    Full Text Available Research on power line extraction technology using mobile laser point clouds has important practical significance on railway power lines patrol work. In this paper, we presents a new method for automatic extracting railway power line from MLS (Mobile Laser Scanning data. Firstly, according to the spatial structure characteristics of power-line and trajectory, the significant data is segmented piecewise. Then, use the self-adaptive space region growing method to extract power lines parallel with rails. Finally use PCA (Principal Components Analysis combine with information entropy theory method to judge a section of the power line whether is junction or not and which type of junction it belongs to. The least squares fitting algorithm is introduced to model the power line. An evaluation of the proposed method over a complicated railway point clouds acquired by a RIEGL VMX450 MLS system shows that the proposed method is promising.

  8. Chromium supplementation improved post-stroke brain infarction and hyperglycemia.

    Science.gov (United States)

    Chen, Wen-Ying; Mao, Frank Chiahung; Liu, Chia-Hsin; Kuan, Yu-Hsiang; Lai, Nai-Wei; Wu, Chih-Cheng; Chen, Chun-Jung

    2016-04-01

    Hyperglycemia is common after acute stroke and is associated with a worse outcome of stroke. Thus, a better understanding of stress hyperglycemia is helpful to the prevention and therapeutic treatment of stroke. Chromium is an essential nutrient required for optimal insulin activity and normal carbohydrate and lipid metabolism. Beyond its nutritional effects, dietary supplement of chromium causes beneficial outcomes against several diseases, in particular diabetes-associated complications. In this study, we investigated whether post-stroke hyperglycemia involved chromium dynamic mobilization in a rat model of permanent focal cerebral ischemia and whether dietary supplement of chromium improved post-stroke injury and alterations. Stroke rats developed brain infarction, hyperglycemia, hyperinsulinemia, glucose intolerance, and insulin resistance. Post-stroke hyperglycemia was accompanied by elevated secretion of counter-regulatory hormones including glucagon, corticosterone, and norepinephrine, decreased insulin signaling in skeletal muscles, and increased hepatic gluconeogenesis. Correlation studies revealed that counter-regulatory hormone secretion showed a positive correlation with chromium loss and blood glucose increased together with chromium loss. Daily chromium supplementation increased tissue chromium levels, attenuated brain infarction, improved hyperglycemia, and decreased plasma levels of glucagon and corticosterone in stroke rats. Our findings suggest that stroke rats show disturbance of tissue chromium homeostasis with a net loss through urinary excretion and chromium mobilization and loss might be an alternative mechanism responsible for post-stroke hyperglycemia.

  9. Mobile user forecast and power-law acceleration invariance of scale-free networks

    International Nuclear Information System (INIS)

    Guo Jin-Li; Guo Zhao-Hua; Liu Xue-Jiao

    2011-01-01

    This paper studies and predicts the number growth of China's mobile users by using the power-law regression. We find that the number growth of the mobile users follows a power law. Motivated by the data on the evolution of the mobile users, we consider scenarios of self-organization of accelerating growth networks into scale-free structures and propose a directed network model, in which the nodes grow following a power-law acceleration. The expressions for the transient and the stationary average degree distributions are obtained by using the Poisson process. This result shows that the model generates appropriate power-law connectivity distributions. Therefore, we find a power-law acceleration invariance of the scale-free networks. The numerical simulations of the models agree with the analytical results well. (interdisciplinary physics and related areas of science and technology)

  10. 14 CFR 382.127 - What procedures apply to stowage of battery-powered mobility aids?

    Science.gov (United States)

    2010-01-01

    ...-powered mobility aids? 382.127 Section 382.127 Aeronautics and Space OFFICE OF THE SECRETARY, DEPARTMENT... DISABILITY IN AIR TRAVEL Stowage of Wheelchairs, Other Mobility Aids, and Other Assistive Devices § 382.127 What procedures apply to stowage of battery-powered mobility aids? (a) Whenever baggage compartment...

  11. Effect of stroke on fall rate, location and predictors: a prospective comparison of older adults with and without stroke.

    Directory of Open Access Journals (Sweden)

    Lisa A Simpson

    Full Text Available BACKGROUND: The literature suggests that stroke is a major risk factor for falls, but there is a lack of prospective, controlled studies which quantify fall-risk after stroke. The purpose of this study was to compare the rates, location and predictors among individuals recently discharged home from stroke rehabilitation to age and sex matched controls. METHODOLOGY/PRINCIPAL FINDINGS: A sample of 80 people with stroke and 90 controls received baseline assessments of balance, mobility and balance confidence. Falls were recorded prospectively over 13 months for both groups. Group differences in fall rates and contribution of clinical measures to falls were determined using negative binomial regression. Fall location was compared between groups using χ(2 statistics. The rate of falls for individuals with stroke was 1.77 times the rate for the control group. People with stroke were more likely to fall at home. Poorer balance (Berg Balance Scale was associated with greater falls for both stroke and control groups (incidence rate ratio [IRR]: 0.908 and IRR: 0.877 respectively. A faster Timed Up and Go Test was associated with greater falls for the stroke group (IRR: 0.955 while better walking endurance (Six Minute Walk Test was associated with greater falls for the controls (IRR: 1.004. Balance confidence was not an independent predictor in either group. CONCLUSIONS: Individuals recently discharged home are at greater risk of falling than individuals without stroke. Attention to home environment is warranted. Balance function can predict falls for both people with stroke and age and sex matched controls. Increased mobility may increase exposure to fall opportunities.

  12. Effect of Stroke on Fall Rate, Location and Predictors: A Prospective Comparison of Older Adults with and without Stroke

    Science.gov (United States)

    Simpson, Lisa A.; Miller, William C.; Eng, Janice J.

    2011-01-01

    Background The literature suggests that stroke is a major risk factor for falls, but there is a lack of prospective, controlled studies which quantify fall-risk after stroke. The purpose of this study was to compare the rates, location and predictors among individuals recently discharged home from stroke rehabilitation to age and sex matched controls. Methodology/Principal Findings A sample of 80 people with stroke and 90 controls received baseline assessments of balance, mobility and balance confidence. Falls were recorded prospectively over 13 months for both groups. Group differences in fall rates and contribution of clinical measures to falls were determined using negative binomial regression. Fall location was compared between groups using χ2 statistics. The rate of falls for individuals with stroke was 1.77 times the rate for the control group. People with stroke were more likely to fall at home. Poorer balance (Berg Balance Scale) was associated with greater falls for both stroke and control groups (incidence rate ratio [IRR]: 0.908 and IRR: 0.877 respectively). A faster Timed Up and Go Test was associated with greater falls for the stroke group (IRR: 0.955) while better walking endurance (Six Minute Walk Test) was associated with greater falls for the controls (IRR: 1.004). Balance confidence was not an independent predictor in either group. Conclusions Individuals recently discharged home are at greater risk of falling than individuals without stroke. Attention to home environment is warranted. Balance function can predict falls for both people with stroke and age and sex matched controls. Increased mobility may increase exposure to fall opportunities. PMID:21559367

  13. 30 CFR 36.4 - Mobile diesel-powered transportation equipment for which certificates of approval may be granted.

    Science.gov (United States)

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Mobile diesel-powered transportation equipment... REQUIREMENTS FOR PERMISSIBLE MOBILE DIESEL-POWERED TRANSPORTATION EQUIPMENT General Provisions § 36.4 Mobile... of approval will be granted for completely assembled mobile diesel-powered transportation equipment...

  14. The effects of posterior talar glide with dorsiflexion of the ankle on mobility, muscle strength and balance in stroke patients: a randomised controlled trial

    OpenAIRE

    Lee, Jin; Kim, Ju-O; Lee, Byoung-Hee

    2017-01-01

    [Purpose] The purpose of this study was to examine the effectiveness of posterior talar glide (PTG) with dorsiflexion of the ankle on stroke patients ankle mobility, muscle strength, and balance ability. [Subjects and Methods] Thirty-four subjects were randomly assigned to either a PTG with dorsiflexion group (PTG; n=17), or a weight-bearing with placebo PTG group (control; n=17). Subjects in the PTG group performed PTG with dorsiflexion, designed to improve ankle mobility, muscle strength an...

  15. Autonomous Power Control MAC Protocol for Mobile Ad Hoc Networks

    Directory of Open Access Journals (Sweden)

    2006-01-01

    Full Text Available Battery energy limitation has become a performance bottleneck for mobile ad hoc networks. IEEE 802.11 has been adopted as the current standard MAC protocol for ad hoc networks. However, it was developed without considering energy efficiency. To solve this problem, many modifications on IEEE 802.11 to incorporate power control have been proposed in the literature. The main idea of these power control schemes is to use a maximum possible power level for transmitting RTS/CTS and the lowest acceptable power for sending DATA/ACK. However, these schemes may degrade network throughput and reduce the overall energy efficiency of the network. This paper proposes autonomous power control MAC protocol (APCMP, which allows mobile nodes dynamically adjusting power level for transmitting DATA/ACK according to the distances between the transmitter and its neighbors. In addition, the power level for transmitting RTS/CTS is also adjustable according to the power level for DATA/ACK packets. In this paper, the performance of APCMP protocol is evaluated by simulation and is compared with that of other protocols.

  16. Measuring the power consumption of social media applications on a mobile device

    Science.gov (United States)

    Dunia, A. I. M.; Suherman; Rambe, A. H.; Fauzi, R.

    2018-03-01

    As fully connected social media applications become popular and require all time connection, the power consumption on mobile device battery increases significantly. As power supplied by a battery is limited, social media application should be designed to be less power consuming. This paper reports the power consumption measurement of social media running on a mobile device. Experimental circuit was developed by using a microcontroller measuring an android smartphone on a 802.11 controlled network. The experiment results show that whatsapp consumes the power less than others in stand by and chat. While other states are dominated by line. The blackberry consumes the power the worst.

  17. Does power mobility training impact a child's mastery motivation and spectrum of EEG activity? An exploratory project.

    Science.gov (United States)

    Kenyon, Lisa K; Farris, John P; Aldrich, Naomi J; Rhodes, Samhita

    2017-08-30

    The purposes of this exploratory project were: (1) to evaluate the impact of power mobility training with a child who has multiple, severe impairments and (2) to determine if the child's spectrum of electroencephalography (EEG) activity changed during power mobility training. A single-subject A-B-A-B research design was conducted with a four-week duration for each phase. Two target behaviours were explored: (1) mastery motivation assessed via the dimensions of mastery questionnaire (DMQ) and (2) EEG data collected under various conditions. Power mobility skills were also assessed. The participant was a three-year, two-month-old girl with spastic quadriplegic cerebral palsy, gross motor function classification system level V. Each target behaviour was measured weekly. During intervention phases, power mobility training was provided. Improvements were noted in subscale scores of the DMQ. Short-term and long-term EEG changes were also noted. Improvements were noted in power mobility skills. The participant in this exploratory project demonstrated improvements in power mobility skill and function. EEG data collection procedures and variability in an individual's EEG activity make it difficult to determine if the participant's spectrum of EEG activity actually changed in response to power mobility training. Additional studies are needed to investigate the impact of power mobility training on the spectrum of EEG activity in children who have multiple, severe impairments. Implications for Rehabilitation Power mobility training appeared to be beneficial for a child with multiple, severe impairments though the child may never become an independent, community-based power wheelchair user. Electroencephalography may be a valuable addition to the study of power mobility use in children with multiple, severe impairments. Power mobility training appeared to impact mastery motivation (the internal drive to solve complex problems and master new skills) in a child who has multiple

  18. Perspectives on Early Power Mobility Training, Motivation, and Social Participation in Young Children with Motor Disabilities

    Directory of Open Access Journals (Sweden)

    Hsiang-Han Huang

    2018-01-01

    Full Text Available The efficacy of traditional training programs (e.g., neurodevelopmental therapy in promoting independent mobility and early child development across all three International Classification of Functioning, Disability, and Health levels lacks rigorous research support. Therefore, early power mobility training needs to be considered as a feasible intervention for very young children who are unlikely to achieve independent mobility. This perspective article has three aims: (1 to provide empirical evidence of differences in early independent mobility, motivation, daily life activities, and social participation between young children with typical development and motor disabilities; (2 to discuss the contemporary concepts of and approaches to early power mobility training for young children with motor disabilities and the current need for changes to such training; and (3 to provide recommendations for early power mobility training in pediatric rehabilitation. Independent mobility is critical for social participation; therefore, power mobility can be accessible and implemented as early as possible, specifically for infants who are at risk for mobility or developmental delay. To maximize the positive effects of independent mobility on children’s social participation, early power mobility training must consider their levels of functioning, the amount of exploration and contextual factors, including individual and environmental factors.

  19. A soft robotic exosuit improves walking in patients after stroke.

    Science.gov (United States)

    Awad, Louis N; Bae, Jaehyun; O'Donnell, Kathleen; De Rossi, Stefano M M; Hendron, Kathryn; Sloot, Lizeth H; Kudzia, Pawel; Allen, Stephen; Holt, Kenneth G; Ellis, Terry D; Walsh, Conor J

    2017-07-26

    Stroke-induced hemiparetic gait is characteristically slow and metabolically expensive. Passive assistive devices such as ankle-foot orthoses are often prescribed to increase function and independence after stroke; however, walking remains highly impaired despite-and perhaps because of-their use. We sought to determine whether a soft wearable robot (exosuit) designed to supplement the paretic limb's residual ability to generate both forward propulsion and ground clearance could facilitate more normal walking after stroke. Exosuits transmit mechanical power generated by actuators to a wearer through the interaction of garment-like, functional textile anchors and cable-based transmissions. We evaluated the immediate effects of an exosuit actively assisting the paretic limb of individuals in the chronic phase of stroke recovery during treadmill and overground walking. Using controlled, treadmill-based biomechanical investigation, we demonstrate that exosuits can function in synchrony with a wearer's paretic limb to facilitate an immediate 5.33 ± 0.91° increase in the paretic ankle's swing phase dorsiflexion and 11 ± 3% increase in the paretic limb's generation of forward propulsion ( P exosuit was sufficient to facilitate more normal walking in ambulatory individuals after stroke. Future work will focus on understanding how exosuit-induced improvements in walking performance may be leveraged to improve mobility after stroke. Copyright © 2017 The Authors, some rights reserved; exclusive licensee American Association for the Advancement of Science. No claim to original U.S. Government Works.

  20. A Survey on the Reliability of Power Electronics in Electro-Mobility Applications

    DEFF Research Database (Denmark)

    Gadalla, Brwene Salah Abdelkarim; Schaltz, Erik; Blaabjerg, Frede

    2015-01-01

    Reliability is an important issue in the field of power electronics since most of the electrical energy is today processed by power electronics. In most of the electro-mobility applications, e.g. electric and hybridelectric vehicles, power electronic are commonly used in very harsh environment...... and extending the service lifetime as well. Research within power electronics is of high interest as it has an important impact in the industry of the electro-mobility applications. According to the aforementioned explanations, this paper will provide an overview of the common factors (thermal cycles, power...... cycles, vibrations, voltage stress and current ripple stress) affecting the reliability of power electronics in electromobility applications. Also, the researchers perspective is summarized from 2001 to 2015....

  1. Comprehensive Outpatient Rehabilitation Program: Hospital-Based Stroke Outpatient Rehabilitation.

    Science.gov (United States)

    Rice, Danielle; Janzen, Shannon; McIntyre, Amanda; Vermeer, Julianne; Britt, Eileen; Teasell, Robert

    2016-05-01

    Few studies have considered the effectiveness of outpatient rehabilitation programs for stroke patients. The objective of this study was to assess the effectiveness of a hospital-based interdisciplinary outpatient stroke rehabilitation program with respect to physical functioning, mobility, and balance. The Comprehensive Outpatient Rehabilitation Program provides a hospital-based interdisciplinary approach to stroke rehabilitation in Southwestern Ontario. Outcome measures from physiotherapy and occupational therapy sessions were available at intake and discharge from the program. A series of paired sample t-tests were performed to assess patient changes between time points for each outcome measure. A total of 271 patients met the inclusion criteria for analysis (56.1% male; mean age = 62.9 ± 13.9 years). Significant improvements were found between admission and discharge for the Functional Independence Measure, grip strength, Chedoke-McMaster Stroke Assessment, two-minute walk test, maximum walk test, Timed Up and Go, Berg Balance Scale, and one-legged stance (P rehabilitation program was effective at improving the physical functioning, mobility, and balance of individuals after a stroke. A hospital-based, stroke-specific rehabilitation program should be considered when patients continue to experience deficits after inpatient rehabilitation. Copyright © 2016 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  2. Explaining the power-law distribution of human mobility through transportation modality decomposition

    Science.gov (United States)

    Zhao, Kai; Musolesi, Mirco; Hui, Pan; Rao, Weixiong; Tarkoma, Sasu

    2015-03-01

    Human mobility has been empirically observed to exhibit Lévy flight characteristics and behaviour with power-law distributed jump size. The fundamental mechanisms behind this behaviour has not yet been fully explained. In this paper, we propose to explain the Lévy walk behaviour observed in human mobility patterns by decomposing them into different classes according to the different transportation modes, such as Walk/Run, Bike, Train/Subway or Car/Taxi/Bus. Our analysis is based on two real-life GPS datasets containing approximately 10 and 20 million GPS samples with transportation mode information. We show that human mobility can be modelled as a mixture of different transportation modes, and that these single movement patterns can be approximated by a lognormal distribution rather than a power-law distribution. Then, we demonstrate that the mixture of the decomposed lognormal flight distributions associated with each modality is a power-law distribution, providing an explanation to the emergence of Lévy Walk patterns that characterize human mobility patterns.

  3. Behavioral System Level Power Consumption Modeling of Mobile Video Streaming applications

    OpenAIRE

    Benmoussa , Yahia; Boukhobza , Jalil; Hadjadj-Aoul , Yassine; Lagadec , Loïc; Benazzouz , Djamel

    2012-01-01

    National audience; Nowadays, the use of mobile applications and terminals faces fundamental challenges related to energy constraint. This is due to the limited battery lifetime as compared to the increasing hardware evolution. Video streaming is one of the most energy consuming applications in a mobile system because of its intensive use of bandwidth, memory and processing power. In this work, we aim to propose a methodology for building and validating a high level global power consumption mo...

  4. Are activity limitations associated with lower urinary tract symptoms in stroke patients? A cross-sectional, clinical survey

    DEFF Research Database (Denmark)

    Tibaek, Sigrid; Gard, Gunvor; Klarskov, Peter

    2009-01-01

    stroke patients were invited to complete four activity limitations measurements: Barthel Index, mobility velocity, mobility distance, mobility aids and one LUTS measurement: the Danish Prostatic Symptom Score (DAN-PSS-1) questionnaire. Of 519 stroke patients, 482 subjects were eligible. Results......Objective. To assess self-reported activity limitations in a clinical sample of stroke patients and to identify their association with prevalence, severity and impact on daily life of lower urinary tract symptoms (LUTS). Material and methods. A cross-sectional, clinical survey was initiated whereby...... time that activity limitations are closely related to LUTS in stroke patients and that rehabilitation should also be directed towards the treatment of LUTS....

  5. Active video-gaming effects on balance and mobility in individuals with chronic stroke: a randomized controlled trial.

    Science.gov (United States)

    Fritz, Stacy L; Peters, Denise M; Merlo, Angela M; Donley, Jonathan

    2013-01-01

    Treatments that provide feedback, increase practice with multiple repetitions, and motivate patients are essential to rehabilitation post stroke. To determine whether playing active video games results in improved balance and mobility post stroke. Thirty participants with chronic (time since stroke = 3.0 [2.9] years) hemiparesis post stroke were randomly assigned to a gaming group or normal activity control group. Gaming systems provided participants with an interactive interface of real-time movement of either themselves or an avatar on the screen. Participants played games 50-60 minutes/day, 4 days/week, for 5 weeks. The intervention was strictly game-play, in standing position, without physical therapy. The control group received no special intervention and continued with normal activity. Both groups were tested prior to, following the 5 weeks (post test), and 3 months following the completion of the study. Outcome measures included the Fugl-Meyer Assessment, Berg Balance Scale, Dynamic Gait Index, Timed Up & Go, 6-minute walk test, 3-meter walk (self-selected and fast), and perception of recovery. No statistically significant differences between or within groups were found through analysis of covariance (covaried for side of hemiparesis) at post test or follow-up. Although the within-group effect sizes were primarily indexed as "small" (gaming group exhibited higher within-group effect sizes before and after testing than did the control group on all 7 dependent variables analyzed. Even though the only intervention was game-play, there were small positive effects. Therapist assistance in making more optimum movement choices may be needed before significant improvements are seen with commercially available, general purpose games.

  6. Mobile applications for handheld devices to screen and randomize acute stroke patients in clinical trials.

    Science.gov (United States)

    Qureshi, Ai; Connelly, B; Abbott, Ei; Maland, E; Kim, J; Blake, J

    2012-08-01

    The availability of internet connectivity and mobile application software used by low-power handheld devices makes smart phones of unique value in time-sensitive clinical trials. Trial-specific applications can be downloaded by investigators from various mobile software distribution platforms or web applications delivered over HTTP. The Antihypertensive Treatment in Acute Cerebral Hemorrhage (ATACH) II investigators in collaboration with MentorMate released the ATACH-II Patient Recruitment mobile application available on iPhone, Android, and Blackberry in 2011. The mobile application provides tools for pre-screening, assessment of eligibility, and randomization of patients. Since the release of ATACH-II mobile application, the CLEAR-IVH (Clot Lysis Evaluating Accelerated Resolution of Intraventricular Hemorrhage) trial investigators have also adopted such a mobile application. The video-conferencing capabilities of the most recent mobile devices open up additional opportunities to involve central coordinating centers in the recruitment process in real time.

  7. Effects of a predefined mini-trampoline training programme on balance, mobility and activities of daily living after stroke: a randomized controlled pilot study.

    Science.gov (United States)

    Miklitsch, Claudia; Krewer, Carmen; Freivogel, Susanna; Steube, Diethard

    2013-10-01

    To investigate the effects of a predefined mini-trampoline therapy programme for increasing postural control, mobility and the ability to perform activities of daily living after stroke. Randomized non-blinded controlled pilot study. Neurological rehabilitation hospital. First-time stroke; age 18-80 years; independent standing ability for a minimum of 2 minutes. Patients were randomized into two groups: the mini-trampoline group (n = 20) received 10 sessions of balance training using the mini-trampoline over three weeks. The patients of the control group (n =20) participated 10 times in a group balance training also over three weeks. Postural control (Berg Balance Scale, BBS), mobility and gait endurance (timed 'up and go' test, TUG; 6-minute walk test, 6MWT) and the ability to perform activities of daily living (Barthel Index, BI). Measurements were undertaken prior to and after the intervention period. Both groups were comparable before the study. The mini-trampoline group improved significantly more in the BBS (P = 0.003) compared to the control group. Mean or median differences of both groups showed improvements in the TUG 10.12 seconds/7.23 seconds, the 6MWT 135 m/75 m and the BI 20 points/13 points for the mini-trampoline and control group, respectively. These outcome measurements did not differ significantly between the two groups. A predefined mini-trampoline training programme resulted in significantly increased postural control in stroke patients compared to balance training in a group. Although not statistically significant, the mini-trampoline training group showed increased improvement in mobility and activities of daily living. These differences could have been statistically significant if we had investigated more patients (i.e. a total sample of 84 patients for the TUG, 98 patients for the 6MWT, and 186 patients for the BI).

  8. Security attack detection algorithm for electric power gis system based on mobile application

    Science.gov (United States)

    Zhou, Chao; Feng, Renjun; Wang, Liming; Huang, Wei; Guo, Yajuan

    2017-05-01

    Electric power GIS is one of the key information technologies to satisfy the power grid construction in China, and widely used in power grid construction planning, weather, and power distribution management. The introduction of electric power GIS based on mobile applications is an effective extension of the geographic information system that has been widely used in the electric power industry. It provides reliable, cheap and sustainable power service for the country. The accurate state estimation is the important conditions to maintain the normal operation of the electric power GIS. Recent research has shown that attackers can inject the complex false data into the power system. The injection attack of this new type of false data (load integrity attack LIA) can successfully bypass the routine detection to achieve the purpose of attack, so that the control center will make a series of wrong decision. Eventually, leading to uneven distribution of power in the grid. In order to ensure the safety of the electric power GIS system based on mobile application, it is very important to analyze the attack mechanism and propose a new type of attack, and to study the corresponding detection method and prevention strategy in the environment of electric power GIS system based on mobile application.

  9. EFFICACY OF MELDONIUM IN ACUTE PERIOD OF ISCHEMIC STROKE

    Directory of Open Access Journals (Sweden)

    S. V. Kotov

    2015-01-01

    Full Text Available Background: As long as systemic thrombolysis is indicated to not more than 10% of patients with ischemic stroke, the search for medical agents for basic treatment of stroke is an important problem of today’s neurology.Aim: To evaluate efficacy of meldonium in patients with acute ischemic stroke.Materials and methods: One hundred and fourteen patients were assessed in the acute period of strokes in the internal carotid artery system. The main group included 70 patients who were given meldonium (Mildronate in addition to their basic treatment regimen. The drug was administered intravenously in daily drop infusions at dose of 10 ml of 10% solution for 10 days, thereafter they were switched to oral treatment at 250 mg daily for 2 to 3 weeks. The control group consisted of 40 patients who received only basic treatment regimen. Both groups were compatible for their age, gender distribution, severity of stroke and degree of neurologic dysfunction.Results: In the patients who were given meldonium in addition to basic treatment of ischemic stroke, neurological deficiency, assessed by NIHSS, scored significantly better than in those from the control group (3.1 ± 0.1 vs. 2.6 ± 0.17, p < 0.05. Also, they had significantly less disability on modified Rankin scale (1.3 ± 0.03 vs. 1.07 ± 0.07, p < 0.01 and more improvement in mobility as per Rivermead mobility index (3.6 ± 0.17 vs. 2.9 ± 0.25, p < 0.05.Conclusion: The addition of meldonium to the set of medical treatment in ischemic stroke patients gives positive results reflecting a decreased neurological deficiency, increased levels of mobility and daily activities.

  10. The Importance of Patient Involvement in Stroke Rehabilitation

    Science.gov (United States)

    2016-01-01

    Objective To investigate the perceived needs for health services by persons with stroke within the first year after rehabilitation, and associations between perceived impact of stroke, involvement in decisions regarding care/treatment, and having health services needs met. Method Data was collected, through a mail survey, from patients with stroke who were admitted to a university hospital in 2012 and had received rehabilitation after discharge from the stroke unit. The rehabilitation lasted an average of 2 to 4.6 months. The Stroke Survivor Needs Survey Questionnaire was used to assess the participants' perceptions of involvement in decisions on care or treatment and needs for health services in 11 problem areas: mobility, falls, incontinence, pain, fatigue, emotion, concentration, memory, speaking, reading, and sight. The perceived impact of stroke in eight areas was assessed using the Stroke Impact Scale (SIS) 3.0. Eleven logistic regression models were created to explore associations between having health services needs met in each problem area respectively (dependent variable) and the independent variables. In all models the independent variables were: age, sex, SIS domain corresponding to the dependent variable, or stroke severity in cases when no corresponding SIS domain was identified, and involvement in decisions on care and treatment. Results The 63 participants who returned the questionnaires had a mean age of 72 years, 33 were male and 30 were female. Eighty percent had suffered a mild stroke. The number of participants who reported problems varied between 51 (80%, mobility) and 24 (38%, sight). Involvement in decisions on care and treatment was found to be associated with having health services needs met in six problem areas: falls, fatigue, emotion, memory, speaking, and reading. Conclusions The results highlight the importance of involving patients in making decisions on stroke rehabilitation, as it appears to be associated with meeting their health

  11. Power-Aware DVB-H Mobile TV System on Heterogeneous Multicore Platform

    Directory of Open Access Journals (Sweden)

    Chao Han-Chieh

    2010-01-01

    Full Text Available In mobile communication network, the mobile device integrated with TV player is a novel technology that provides TV program services to end users. As TV program is a real-time video service, it has greater technical difficulties to overcome than a traditional video file download or online streaming, especially when TV programs are played on handheld devices. A challenge is how to save power in order to provide users with longer TV program services. To address this issue, this study proposes a mobile TV system on a heterogeneous multicore platform, which utilizes a Digital Video Broadcasting-Handheld (DVB-H wireless network to receive the TV program signal, thus, saving power according to the features of DVB-H TV signal and heterogeneous multi-core.

  12. Early versus late rehabilitation for stroke survivors: A prospective study

    Directory of Open Access Journals (Sweden)

    Moshiur Rahman Khasru

    2017-11-01

    Full Text Available The aim of this study was to examine the optimum time of rehabilitation initiation after stroke in terms of disabilities, mobility and fall risk assessment. Data were collected prospectively at seven tertiary level health care centers in Bangladesh during the 36 months period from 2013 to 2016. All respondents were divided into four groups based on the initiation of rehabilitation as: a 0-24 hours, b 25-72 hours, c 4-7 days and d 8-60 days. Results show that significant improvement on stroke recovery, disabilities reduction, improvement in mobility restriction and reduction of fall risks in all the four groups but more improvement was observed in 0-24 hour’s group during follow-up after 3 and 12 weeks. On multinomial logistic regression analysis, the independent factors shows the mobility restriction and fall risk were more in the younger patients, male gender, married, hemorrhagic lesion and bilateral stroke.

  13. Power control algorithms for mobile ad hoc networks

    Directory of Open Access Journals (Sweden)

    Nuraj L. Pradhan

    2011-07-01

    We will also focus on an adaptive distributed power management (DISPOW algorithm as an example of the multi-parameter optimization approach which manages the transmit power of nodes in a wireless ad hoc network to preserve network connectivity and cooperatively reduce interference. We will show that the algorithm in a distributed manner builds a unique stable network topology tailored to its surrounding node density and propagation environment over random topologies in a dynamic mobile wireless channel.

  14. Single molecule measurements of F1-ATPase reveal an interdependence between the power stroke and the dwell duration.

    Science.gov (United States)

    Spetzler, David; Ishmukhametov, Robert; Hornung, Tassilo; Day, Lixia Jin; Martin, James; Frasch, Wayne D

    2009-08-25

    Increases in the power stroke and dwell durations of single molecules of Escherichia coli F(1)-ATPase were measured in response to viscous loads applied to the motor and inhibition of ATP hydrolysis. The load was varied using different sizes of gold nanorods attached to the rotating gamma subunit and/or by increasing the viscosity of the medium using PEG-400, a noncompetitive inhibitor of ATPase activity. Conditions that increase the duration of the power stroke were found to cause 20-fold increases in the length of the dwell. These results suggest that the order of hydrolysis, product release, and substrate binding may change as the result of external load on the motor or inhibition of hydrolysis.

  15. Assessment of learning powered mobility use--applying grounded theory to occupational performance.

    Science.gov (United States)

    Nilsson, Lisbeth; Durkin, Josephine

    2014-01-01

    Collaboration by two grounded theory researchers, who each had developed a learning continuum instrument, led to the emergence of a new tool for assessment of learning powered mobility use. We undertook a rigorous process of comparative reanalysis that included merging, modifying, and expanding our previous research findings. A new instrument together with its facilitating strategies emerged in the course of revisits to our existing rich account of data taken from real environment powered mobility practice over an extensive time period. Instrument descriptors, categories, phases, and stages allow a facilitator to assess actual phase and plot actual occupational performance and provide a learner with the just right challenge through the learning process. Facilitating strategies are described for each of the phases and provide directions for involvement during learner performance. The learning approach is led by a belief system that the intervention is user-led, working in partnership and empowering the learner. The new assessment tool is inclusive of every potential powered mobility user because it focuses on the whole continuum of the learning process of powered mobility use from novice to expert. The new tool was appraised by clinicians and has been used successfully in clinical practice in the United Kingdom and Sweden.

  16. Effectiveness of Circuit-Based Exercises on Gait Speed, Balance, and Functional Mobility in People Affected by Stroke: A Meta-Analysis.

    Science.gov (United States)

    Bonini-Rocha, Ana Clara; de Andrade, Anderson Lúcio Souza; Moraes, André Marques; Gomide Matheus, Liana Barbaresco; Diniz, Leonardo Rios; Martins, Wagner Rodrigues

    2018-04-01

    Several interventions have been proposed to rehabilitate patients with neurologic dysfunctions due to stroke. However, the effectiveness of circuit-based exercises according to its actual definition, ie, an overall program to improve strength, stamina, balance or functioning, was not provided. To examine the effectiveness of circuit-based exercise in the treatment of people affected by stroke. A search through PubMed, Embase, Cochrane Library, and Physiotherapy Evidence Database databases was performed to identify controlled clinical trials without language or date restriction. The overall mean difference with 95% confidence interval was calculated for all outcomes. Two independent reviewers assessed the risk of bias. Eleven studies met the inclusion criteria, and 8 presented suitable data to perform a meta-analysis. Quantitative analysis showed that circuit-based exercise was more effective than conventional intervention on gait speed (mean difference of 0.11 m/s) and circuit-based exercise was not significantly more effective than conventional intervention on balance and functional mobility. Our results demonstrated that circuit-based exercise presents better effects on gait when compared with conventional intervention and that its effects on balance and functional mobility were not better than conventional interventions. I. Copyright © 2018 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

  17. Early sitting, standing, and walking in conjunction with contemporary Bobath approach for stroke patients with severe motor deficit.

    Science.gov (United States)

    Tang, Qingping; Tan, Lihong; Li, Baojun; Huang, Xiaosong; Ouyang, Chunhong; Zhan, Hailan; Pu, Qinqin; Wu, Lixiang

    2014-01-01

    The commonly used therapeutic approach, the contemporary Bobath approach (CBA), is not sufficient to restore independent locomotion for individuals with severe motor deficit (SMD) after stroke. Therefore, we propose that the early sitting, standing, and walking in conjunction with the CBA (ECBA) be used to treat individuals with SMD after stroke. To investigate whether ECBA may enhance mobility and balance in subjects with SMD after stroke. Thirty-three men and 15 women, aged 60 to 74 years, with SMD after stroke were recruited for the study. CBA or ECBA was performed with the subjects 5 times per week in 50-minute sessions for 8 weeks. The Stroke Rehabilitation Assessment of Movement (STREAM) and the Berg Balance Scale were implemented before treatment and at 4 and 8 weeks after treatment, respectively. The STREAM scores indicated that ECBA was more efficient than the CBA intervention for lower extremity mobility, F(1, 46) = 24.0, P < .001, and basic mobility, F(1, 46) = 102.6, P < .001. Overall STREAM scores were higher in the ECBA group, F(1, 46) =24.1, P < .001, after 8 weeks of therapy. Balance scores of the ECBA subjects were higher than those of the CBA subjects after 8 weeks of therapy, F(1, 46) = 73.1, P < .001. However, there was no difference in upper extremity mobility between the 2 groups. ECBA is a valuable intervention to improve lower extremity mobility, basic mobility, and balance ability for individuals with SMD after stroke.

  18. Exploring Mobility Options for Children with Physical Disabilities: A Focus on Powered Mobility

    Science.gov (United States)

    Wiart, Lesley

    2011-01-01

    The study by Tefft et al. (2011, in this issue) is one of the few studies that have explored the impact of pediatric powered mobility on families. The parents who participated in their study reported increased satisfaction with their children's social and play skills, ability to move independently, sleeping patterns, and public perception of their…

  19. Assessing Walking Strategies Using Insole Pressure Sensors for Stroke Survivors.

    Science.gov (United States)

    Munoz-Organero, Mario; Parker, Jack; Powell, Lauren; Mawson, Susan

    2016-10-01

    Insole pressure sensors capture the different forces exercised over the different parts of the sole when performing tasks standing up such as walking. Using data analysis and machine learning techniques, common patterns and strategies from different users to achieve different tasks can be automatically extracted. In this paper, we present the results obtained for the automatic detection of different strategies used by stroke survivors when walking as integrated into an Information Communication Technology (ICT) enhanced Personalised Self-Management Rehabilitation System (PSMrS) for stroke rehabilitation. Fourteen stroke survivors and 10 healthy controls have participated in the experiment by walking six times a distance from chair to chair of approximately 10 m long. The Rivermead Mobility Index was used to assess the functional ability of each individual in the stroke survivor group. Several walking strategies are studied based on data gathered from insole pressure sensors and patterns found in stroke survivor patients are compared with average patterns found in healthy control users. A mechanism to automatically estimate a mobility index based on the similarity of the pressure patterns to a stereotyped stride is also used. Both data gathered from stroke survivors and healthy controls are used to evaluate the proposed mechanisms. The output of trained algorithms is applied to the PSMrS system to provide feedback on gait quality enabling stroke survivors to self-manage their rehabilitation.

  20. Assessing Walking Strategies Using Insole Pressure Sensors for Stroke Survivors

    Directory of Open Access Journals (Sweden)

    Mario Munoz-Organero

    2016-10-01

    Full Text Available Insole pressure sensors capture the different forces exercised over the different parts of the sole when performing tasks standing up such as walking. Using data analysis and machine learning techniques, common patterns and strategies from different users to achieve different tasks can be automatically extracted. In this paper, we present the results obtained for the automatic detection of different strategies used by stroke survivors when walking as integrated into an Information Communication Technology (ICT enhanced Personalised Self-Management Rehabilitation System (PSMrS for stroke rehabilitation. Fourteen stroke survivors and 10 healthy controls have participated in the experiment by walking six times a distance from chair to chair of approximately 10 m long. The Rivermead Mobility Index was used to assess the functional ability of each individual in the stroke survivor group. Several walking strategies are studied based on data gathered from insole pressure sensors and patterns found in stroke survivor patients are compared with average patterns found in healthy control users. A mechanism to automatically estimate a mobility index based on the similarity of the pressure patterns to a stereotyped stride is also used. Both data gathered from stroke survivors and healthy controls are used to evaluate the proposed mechanisms. The output of trained algorithms is applied to the PSMrS system to provide feedback on gait quality enabling stroke survivors to self-manage their rehabilitation.

  1. Psychometrics of the wrist stability and hand mobility subscales of the Fugl-Meyer assessment in moderately impaired stroke.

    Science.gov (United States)

    Page, Stephen J; Hade, Erinn; Persch, Andrew

    2015-01-01

    There remains a need for a quickly administered, stroke-specific, bedside measure of active wrist and finger movement for the expanding stroke population. The wrist stability and hand mobility scales of the upper extremity Fugl-Meyer Assessment (w/h UE FM) constitute a valid, reliable measure of paretic UE impairment in patients with active wrist and finger movement. The aim of this study was to determine performance on the w/h UE FM in a stable cohort of survivors of stroke with only palpable movement in their paretic wrist flexors. A single-center cohort study was conducted. Thirty-two individuals exhibiting stable, moderate upper extremity hemiparesis (15 male, 17 female; mean age=56.6 years, SD=10.1; mean time since stroke=4.6 years, SD=5.8) participated in the study, which was conducted at an outpatient rehabilitation clinic in the midwestern United States. The w/h UE FM and Action Research Arm Test (ARAT) were administered twice. Intraclass correlation coefficients (ICCs), Cronbach alpha, and ordinal alpha were computed to determine reliability, and Spearman rank correlation coefficients and Bland-Altman plots were computed to establish validity. Intraclass correlation coefficients for the w/h UE FM and ARAT were .95 and .99, respectively. The w/h UE FM intrarater reliability and internal consistency were greater than .80, and concurrent validity was greater than .70. This also was the first stroke rehabilitative study to apply ordinal alpha to examine internal consistency values, revealing w/h UE FM levels greater than .85. Concurrent validity findings were corroborated by Bland-Altman plots. It appears that the w/h UE FM is a promising tool to measure distal upper extremity movement in patients with little active paretic wrist and finger movement. This finding widens the segment of patients on whom the w/h UE FM can be effectively used and addresses a gap, as commonly used measures necessitate active distal upper extremity movement. © 2015 American

  2. The Rivermead Mobility Index Allows Valid Comparisons Between Subgroups of Patients Undergoing Rehabilitation After Stroke Who Differ With Respect to Age, Sex, or Side of Lesion

    NARCIS (Netherlands)

    Roorda, Leo D.; Green, John R.; Houwink, Annemieke; Bagley, Pam J.; Smith, Jane; Molenaar, Ivo W.; Geurts, Alexander C.

    Roorda LD, Green JR, Houwink A, Bagley PJ, Smith J, Molenaar IW, Geurts AC. The Rivermead Mobility index allows valid comparisons between subgroups of patients undergoing rehabilitation after stroke who differ with respect to age, sex, or side of lesion. Arch Phys Med Rehabil 2012;93:1086-90.

  3. Design of Mobile Operation and Maintenance System Based on Power GIS and GPS

    Directory of Open Access Journals (Sweden)

    Jing TAO

    2017-01-01

    Full Text Available In order to solve the low efficiency of operation and maintenance and the problems of management coordination caused by the coexistence of off-line operation and maintenance and multi system coexistence in current power telecommunication operation and maintenance, this paper proposes a mobile operation and maintenance system based on power GIS and GPS location technology. The system is based on the C/S architecture, and the mobile operation and maintenance terminal is connected with the operation and maintenance management terminal through wireless and wired network. In addition to meeting basic business requirements, the system integrates power GIS functions to visually demonstrate communication resources, personnel, and failures. The staff can use the wireless mobile terminal which integrated GPS module for to operate and maintain, and can locate accurately in real time.

  4. Frontal EEG delta/alpha ratio and screening for post-stroke cognitive deficits: the power of four electrodes.

    Science.gov (United States)

    Schleiger, Emma; Sheikh, Nabeel; Rowland, Tennille; Wong, Andrew; Read, Stephen; Finnigan, Simon

    2014-10-01

    This study analysed correlations between post-stroke, quantitative electroencephalographic (QEEG) indices, and cognition-specific, functional outcome measures. Results were compared between QEEG indices calculated from the standard 19 versus 4 frontal (or 4 posterior) electrodes to assess the feasibility and efficacy of employing a reduced electrode montage. Resting-state EEG was recorded at the bedside within 62-101 h after onset of symptoms of middle cerebral artery, ischaemic stroke (confirmed radiologically). Relative power for delta, theta, alpha and beta, delta/alpha ratio (DAR) and pairwise-derived brain symmetry index (pdBSI) were averaged; over all electrodes (global), over F3, F4, F7, F8 (frontal) and P3, P4, T5, T6 (posterior). The functional independence measure and functional assessment measure (FIM-FAM) was administered at mean 105 days post-stroke. Total (30 items) and cognition-specific (5 items) FIM-FAM scores were correlated with QEEG indices using Spearman's coefficient, with a Bonferroni correction. Twenty-five patients were recruited, 4 died within 3 months and 1 was lost to follow-up. Hence 20 cases (10 female; 9 left hemisphere; mean age 68 years, range 38-84) were analysed. Two QEEG indices demonstrated highly-significant correlations with cognitive outcomes: frontal DAR (ρ = -0.664, p ≤ 0.001) and global, relative alpha power (ρ = 0.67, p ≤ 0.001). After correction there were no other significant correlations. Alpha activity - particularly frontally - may index post-stroke attentional capacity, which appears to be a key determinant of functional and cognitive outcomes. Likewise frontal delta pathophysiology influences such outcomes. Pending further studies, DAR from 4 frontal electrodes may inform early screening for post-MCA stroke cognitive deficits, and thereby, clinical decisions. Copyright © 2014 Elsevier B.V. All rights reserved.

  5. The design of a linear L-band high power amplifier for mobile communication satellites

    Science.gov (United States)

    Whittaker, N.; Brassard, G.; Li, E.; Goux, P.

    1990-01-01

    A linear L-band solid state high power amplifier designed for the space segment of the Mobile Satellite (MSAT) mobile communication system is described. The amplifier is capable of producing 35 watts of RF power with multitone signal at an efficiency of 25 percent and with intermodulation products better than 16 dB below carrier.

  6. Mobile radiological monitoring around Nuclear Power Plant site at Tarapur

    International Nuclear Information System (INIS)

    Patil, S.S.; Saindane, S.S.; Sharma, R.; Suri, M.M.K.; Pradeepkumar, K.S.; Sharma, D.N.; Rao, D.D.

    2008-01-01

    Real time mobile radiological monitoring around nuclear facilities is required for establishing background radiation dose rate data and to detect any increase in the radiation level which is attributable to the atmospheric releases from Nuclear facilities. Mobile radiation survey using mobile monitoring systems was carried out in the Emergency Planning Zone around Tarapur Atomic Power station during plant operation, taking the wind direction also into consideration. For identifying the potential difficulties during an emergency scenario and to understand the variation of the measured values several systems/instruments were used simultaneously for mapping the dose rates. As demonstrated during this monitoring programme, 40mm x 40mm NaI(Tl) detector based Portable Mobile Gamma Spectrometry System (PMGSS) which is attached with a GPS can acquire and store large amount of gamma spectra tagged with positional coordinates and can enhance the capacity of decision makers during any accidental situation. The average of dose rates measured from various locations around Tarapur Atomic Power Station is 70 - 80 nGy.h -1 . The higher dose rate in the range of 110-125 nGy.h -1 measured at one of the location is due to higher concentration of natural radioactivity mainly by 40 K which was confirmed by the gamma spectrometric measurement. (author)

  7. On the electromagnetic fields, Poynting vector, and peak power radiated by lightning return strokes

    Science.gov (United States)

    Krider, E. P.

    1992-01-01

    The initial radiation fields, Poynting vector, and total electromagnetic power that a vertical return stroke radiates into the upper half space have been computed when the speed of the stroke, nu, is a significant fraction of the speed of light, c, assuming that at large distances and early times the source is an infinitesimal dipole. The initial current is also assumed to satisfy the transmission-line model with a constant nu and to be perpendicular to an infinite, perfectly conducting ground. The effect of a large nu is to increase the radiation fields by a factor of (1-beta-sq cos-sq theta) exp -1, where beta = nu/c and theta is measured from the vertical, and the Poynting vector by a factor of (1-beta-sq cos-sq theta) exp -2.

  8. Attractive Mobile Corridors - The Power of Light Rail Infrastructures

    DEFF Research Database (Denmark)

    Olesen, Mette; Lassen, Claus

    2013-01-01

    Light rail is a popular tool in urban development strategies in many European cities. One argument for choosing a rail-based solution is that it signals stability to investors and will attract development and investments in the corridor. The choice of corridor in the various light rail cities...... and redistributes urban space. Furthermore light rail is not only a physical infrastructure but also an infrastructure of power that is carefully planned and designed creating both mental and physical patterns of mobilities and immobilities. Hence it is important to underline that mobility systems, such as light...

  9. Mobile power plant units

    Energy Technology Data Exchange (ETDEWEB)

    Radtke, R

    1979-10-05

    Diesel engines of the MaK line 282 AK/332 with a cylinder power up to 160 kW are used, either as 6-cylinder or 8-cylinder in-line engine or as 12-cylinder V engine. Fuel consumption is between 207 and 212 g/kW. The engine is mounted on a frame, together with a generator. The fuel reserve in the tank will last for 8 hours. The lubricating system, the cooling water and starting air system, the switchboard system, and the frame are described. The switchboard plant is mounted either on a skid undercarriage or on the undercarriage. The plant can be operated independently or parallel to the network. The unit can be remote-controlled via push buttons or control knobs. A picture is presented of a mobile diesel aggregate which is in service in Libya.

  10. An integrated neuro-robotic interface for stroke rehabilitation using the NASA X1 powered lower limb exoskeleton.

    Science.gov (United States)

    He, Yongtian; Nathan, Kevin; Venkatakrishnan, Anusha; Rovekamp, Roger; Beck, Christopher; Ozdemir, Recep; Francisco, Gerard E; Contreras-Vidal, Jose L

    2014-01-01

    Stroke remains a leading cause of disability, limiting independent ambulation in survivors, and consequently affecting quality of life (QOL). Recent technological advances in neural interfacing with robotic rehabilitation devices are promising in the context of gait rehabilitation. Here, the X1, NASA's powered robotic lower limb exoskeleton, is introduced as a potential diagnostic, assistive, and therapeutic tool for stroke rehabilitation. Additionally, the feasibility of decoding lower limb joint kinematics and kinetics during walking with the X1 from scalp electroencephalographic (EEG) signals--the first step towards the development of a brain-machine interface (BMI) system to the X1 exoskeleton--is demonstrated.

  11. Concurrent neuromechanical and functional gains following upper-extremity power training post-stroke

    Directory of Open Access Journals (Sweden)

    Patten Carolynn

    2013-01-01

    Full Text Available Abstract Background Repetitive task practice is argued to drive neural plasticity following stroke. However, current evidence reveals that hemiparetic weakness impairs the capacity to perform, and practice, movements appropriately. Here we investigated how power training (i.e., high-intensity, dynamic resistance training affects recovery of upper-extremity motor function post-stroke. We hypothesized that power training, as a component of upper-extremity rehabilitation, would promote greater functional gains than functional task practice without deleterious consequences. Method Nineteen chronic hemiparetic individuals were studied using a crossover design. All participants received both functional task practice (FTP and HYBRID (combined FTP and power training in random order. Blinded evaluations performed at baseline, following each intervention block and 6-months post-intervention included: Wolf Motor Function Test (WMFT-FAS, Primary Outcome, upper-extremity Fugl-Meyer Motor Assessment, Ashworth Scale, and Functional Independence Measure. Neuromechanical function was evaluated using isometric and dynamic joint torques and concurrent agonist EMG. Biceps stretch reflex responses were evaluated using passive elbow stretches ranging from 60 to 180º/s and determining: EMG onset position threshold, burst duration, burst intensity and passive torque at each speed. Results Primary outcome: Improvements in WMFT-FAS were significantly greater following HYBRID vs. FTP (p = .049, regardless of treatment order. These functional improvements were retained 6-months post-intervention (p = .03. Secondary outcomes: A greater proportion of participants achieved minimally important differences (MID following HYBRID vs. FTP (p = .03. MIDs were retained 6-months post-intervention. Ashworth scores were unchanged (p > .05. Increased maximal isometric joint torque, agonist EMG and peak power were significantly greater following HYBRID vs. FTP (p p

  12. Poor stroke risk perception despite moderate public stroke awareness: insight from a cross-sectional national survey in Greece.

    Science.gov (United States)

    Ntaios, George; Melikoki, Vasiliki; Perifanos, George; Perlepe, Kalliopi; Gioulekas, Fotios; Karagiannaki, Anastasia; Tsantzali, Ioanna; Lazarou, Chrysanthi; Beradze, Nikolaos; Poulianiti, Evdoxia; Poulikakou, Matina; Palantzas, Theofanis; Kaditi, Stavrina; Perlepe, Fay; Sidiropoulos, George; Papageorgiou, Kyriaki; Papavasileiou, Vasileios; Vemmos, Konstantinos; Makaritsis, Konstantinos; Dalekos, George N

    2015-04-01

    Although stroke is the fourth cause of death in Western societies, public stroke awareness remains suboptimal. The aim of this study was to estimate stroke risk perception and stroke awareness in Greece through a cross-sectional telephone survey. A trained interview team conducted this cross-sectional telephone survey between February and April 2014 using an online structured questionnaire. Participants were selected using random digit dialing of landline and mobile telephone numbers with quota sampling weighted for geographical region based on the most recent General Population Census (2011). Between February and April 2014, 723 individuals (418 women [58%], 47.4 ± 17.8 years) agreed to respond. Among all respondents, 642 (88.8%) were able to provide at least 1 stroke risk factor; 673 respondents (93.08%) were able to provide correctly at least 1 stroke symptom or sign. When asked what would they do in case of acute onset of stroke symptoms, 497 (68.7%) responded that they would either call the ambulance or visit the closest emergency department. Only 35.3%, 18.9%, 17.2%, 20.7%, and 15.0% of respondents with atrial fibrillation, arterial hypertension, dyslipidemia, diabetes mellitus, and current smoking, respectively, considered themselves as being in high risk for stroke. Stroke risk perception in Greece is low despite moderate public stroke awareness. Copyright © 2015 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  13. The Environment Friendly Power Source for Power Supply of Mobile Communication Base Stations

    Science.gov (United States)

    Rudenko, N. V.; Ershov, V. V.; Evstafiev, V. V.

    2017-05-01

    The article describes the technical proposals to improve environmental and resource characteristics of the autonomous power supply systems of mobile communication base stations based on renewable energy sources, while ensuring the required reliability and security of power supply. These include: the replacement of diesel-generator with clean energy source - an electrochemical generator based on hydrogen fuel cells; the use of wind turbines with a vertical axis; use of specialized batteries. Based on the analysis of the know technical solutions, the structural circuit diagram of the hybrid solar-wind-hydrogen power plant and the basic principles of the algorithm of its work were proposed. The implementation of these proposals will improve the environmental and resource characteristics.

  14. Sit to stand activity during stroke rehabilitation.

    Science.gov (United States)

    Kerr, Andy; Dawson, Jesse; Robertson, Chris; Rowe, Philip; Quinn, Terence J

    2017-12-01

    Objectives The sit to stand (STS) movement is key to independence and commonly affected by stroke. Repetitive practice is likely to improve STS ability during rehabilitation, however current practice levels are unknown. The objective of this study was simply to count the number of STS movements performed during the rehabilitation period of stroke patients using a physical activity monitor (PAM) and test whether being observed altered outcome. Methods Participants were medically stable patients referred for rehabilitation following stroke. Participants were randomly allocated to either wear or not wear the PAM for 14 days. STS ability and general mobility were recorded before and after. Results Sixty-one patients was recruited; aged 68.4 ± 13.15 years, weight 77.12 ± 22.73 Kg, Height 1.67 ± 0.1 m, within 9 ± 9 days of their stroke and an NIHSS score of 6.4 ± 3.3. The monitored group (n = 38) performed 25.00 ± 17.24 daily STS movements. Those requiring assistance achieved 14.29 ± 16.10 per day while those independent in the movement achieved 34.10 ± 12.44. There was an overall improvement in mobility (p = 0.002) but not STS performance (p = 0.053) neither outcome was affected by group allocation (p = 0.158). Cognition and mobility at baseline explained around 50% of daily STS variability. Discussion Low levels of STS activity were recorded during the rehabilitation period of stroke patient. The mean daily STS activity was lower than reports for frail older people receiving rehabilitation, and substantially below levels recorded by community living older adults. STS repetitions may represent general physical activity and these low levels support previous reports of sedentary behavior during rehabilitation.

  15. Adaptive Power Saving Method for Mobile Walking Guidance Device Using Motion Context

    Directory of Open Access Journals (Sweden)

    Jin-Hee Lee

    2015-01-01

    Full Text Available It is important to recognize the motion of the user and the surrounding environment with multiple sensors. We developed a guidance system based on mobile device for visually impaired person that helps the user to walk safely to the destination in the previous study. However, a mobile device having multiple sensors spends more power when the sensors are activated simultaneously and continuously. We propose a method for reducing the power consumption of a mobile device by considering the motion context of the user. We analyze and classify the user’s motion accurately by means of a decision tree and HMM (Hidden Markov Model that exploit the data from a triaxial accelerometer sensor and a tilt sensor. We can reduce battery power consumption by controlling the number of active ultrasonic sensors and the frame rate of the camera used to acquire spatial context around the user. This helps us to extend the operating time of the device and reduce the weight of the device’s built-in battery.

  16. Spectrum Reorganization and Bundling for Power Efficient Mobile Networks

    DEFF Research Database (Denmark)

    Micallef, Gilbert; Mogensen, Preben; Scheck, Hans-Otto

    2012-01-01

    are still required for supporting legacy devices and providing wider network coverage. In order to facilitate and reduce the cost of rolling out a new network, mobile operators often reuse existing sites. Radio frequency modules in base station sites house power amplifiers, which are designed to operate...

  17. Determinants of mobile phone output power in a multinational study: implications for exposure assessment

    DEFF Research Database (Denmark)

    Vrijheid, M; Madsen, Stine Mann; di Vecchia, Paolo

    2009-01-01

    OBJECTIVES: The output power of a mobile phone is directly related to its radiofrequency (RF) electromagnetic field strength, and may theoretically vary substantially in different networks and phone use circumstances due to power control technologies. To improve indices of RF exposure for epidemi......OBJECTIVES: The output power of a mobile phone is directly related to its radiofrequency (RF) electromagnetic field strength, and may theoretically vary substantially in different networks and phone use circumstances due to power control technologies. To improve indices of RF exposure...... on the average output power and the percentage call time at maximum power for each call. RESULTS: Measurements of over 60,000 phone calls showed that the average output power was approximately 50% of the maximum, and that output power varied by a factor of up to 2 to 3 between study centres and network operators...

  18. Kualitas Hidup Pasien Stroke dalam Perawatan Palliative Homecare

    Directory of Open Access Journals (Sweden)

    Ulfa N Karim

    2017-05-01

    Full Text Available Stroke is a neurological deficit multi complex disease that causes physical or mental disability can affect all aspects of an individual's life, including the quality of life of patients. Quality of life related to the welfare of patients and families with the provision of Palliative homecare Phenomenological study was conducted to explore in depth the quality of life of patients in palliative care homecare. Participants in this study with 13 respondents using purposive sampling technique. Themes related to the quality of life is domains includes physical activity, diet, memory and concentration, physical mobility, speech, pain, sleep and rest. Psychological domains include self-image, motivation of life, happiness and sadness. Among other social domains of social change include changes in the social function and the role change. Quality of life domains increased physical activity, diet, mobilization of physical and speech. Quality of life increased in the psychological domains motivation alive, happy feelings. Quality of life increased in the social domains changes in social function. This study shows that the quality of life patients stroke increasing and study recommended importance further research is important and palliative care as an intervention homecare nursing which plays an important role for improving the quality of life stroke patient. This study shows that the quality of life patients stroke increasing and study recommended importance further research is important and palliative care as an intervention homecare nursing which plays an important role for improving the quality of life stroke patient.

  19. Assessments in Australian stroke rehabilitation units: a systematic review of the post-stroke validity of the most frequently used.

    Science.gov (United States)

    Kitsos, Gemma; Harris, Dawn; Pollack, Michael; Hubbard, Isobel J

    2011-01-01

    In Australia, stroke is the leading cause of adult disability. For most stroke survivors, the recovery process is challenging, and in the first few weeks their recovery is supported with stroke rehabilitation services. Stroke clinicians are expected to apply an evidence-based approach to stroke rehabilitation and, in turn, use standardised and validated assessments to monitor stroke recovery. In 2008, the National Stroke Foundation conducted the first national audit of Australia's post acute stroke rehabilitation services and findings identified a vast array of assessments being used by clinicians. This study undertook a sub-analysis of the audit's assessment tools data with the aim of making clinically relevant recommendations concerning the validity of the most frequently selected assessments. Data reduction ranked the most frequently selected assessments across a series of sub-categories. A serial systematic review of relevant literature using Medline and the Cumulative Index to Nursing and Allied Health Literature identified post-stroke validity ranking. The study found that standardised and non-standardised assessments are currently in use in stroke rehabilitation. It recommends further research in the sub-categories of strength, visual acuity, dysphagia, continence and nutrition and found strengths in the sub-categories of balance and mobility, upper limb function and mood. This is the first study to map national usage of post-stroke assessments and review that usage against the evidence. It generates new knowledge concerning what assessments we currently use post stroke, what we should be using and makes some practical post stroke clinical recommendations.

  20. The Nottingham Fatigue After Stroke (NotFAST) study: results from follow-up six months after stroke.

    Science.gov (United States)

    Hawkins, Louise; Lincoln, Nadina B; Sprigg, Nikola; Ward, Nick S; Mistri, Amit; Tyrrell, Pippa; Worthington, Esme; Drummond, Avril

    2017-12-01

    Background Post-stroke fatigue is common and disabling. Objectives The aim of NotFAST was to examine factors associated with fatigue in stroke survivors without depression, six months after stroke. Methods Participants were recruited from four UK stroke units. Those with high levels of depressive symptoms (score ≥7 on Brief Assessment Schedule Depression Cards) or aphasia were excluded. Follow-up assessment was conducted at six months after stroke. They were assessed on the Fatigue Severity Scale, Rivermead Mobility Index, Nottingham Extended Activities of Daily Living scale, Barthel Index, Beck Anxiety Index, Brief Assessment Schedule Depression Cards, Impact of Event Scale-Revised, and Sleep Hygiene Index. Results Of the 371 participants recruited, 263 (71%) were contacted at six months after stroke and 213 (57%) returned questionnaires. Approximately half (n = 109, 51%) reported fatigue at six months. Of those reporting fatigue initially (n = 88), 61 (69%) continued to report fatigue. 'De novo' (new) fatigue was reported by 48 (38%) of those not fatigued initially. Lower Nottingham Extended Activities of Daily Living scores and higher Beck Anxiety Index scores were independently associated with fatigue at six months. Conclusions Half the stroke survivors reported fatigue at six months post-stroke. Reduced independence in activities of daily living and higher anxiety levels were associated with the level of fatigue. Persistent and delayed onset fatigue may affect independence and participation in rehabilitation, and these findings should be used to inform the development of appropriate interventions.

  1. Power frequency spectrum analysis of surface EMG signals of upper limb muscles during elbow flexion - A comparison between healthy subjects and stroke survivors.

    Science.gov (United States)

    Angelova, Silvija; Ribagin, Simeon; Raikova, Rositsa; Veneva, Ivanka

    2018-02-01

    After a stroke, motor units stop working properly and large, fast-twitch units are more frequently affected. Their impaired functions can be investigated during dynamic tasks using electromyographic (EMG) signal analysis. The aim of this paper is to investigate changes in the parameters of the power/frequency function during elbow flexion between affected, non-affected, and healthy muscles. Fifteen healthy subjects and ten stroke survivors participated in the experiments. Electromyographic data from 6 muscles of the upper limbs during elbow flexion were filtered and normalized to the amplitudes of EMG signals during maximal isometric tasks. The moments when motion started and when the flexion angle reached its maximal value were found. Equal intervals of 0.3407 s were defined between these two moments and one additional interval before the start of the flexion (first one) was supplemented. For each of these intervals the power/frequency function of EMG signals was calculated. The mean (MNF) and median frequencies (MDF), the maximal power (MPw) and the area under the power function (APw) were calculated. MNF was always higher than MDF. A significant decrease in these frequencies was found in only three post-stroke survivors. The frequencies in the first time interval were nearly always the highest among all intervals. The maximal power was nearly zero during first time interval and increased during the next ones. The largest values of MPw and APw were found for the flexor muscles and they increased for the muscles of the affected arm compared to the non-affected one of stroke survivors. Copyright © 2017 Elsevier Ltd. All rights reserved.

  2. An in-pipe mobile micromachine using fluid power. A mechanism adaptable to pipe diameters

    International Nuclear Information System (INIS)

    Yoshida, Kazuhiro; Yokota, Shinichi; Takahashi, Ken

    2000-01-01

    To realize micro maintenance robots for small diameter pipes of nuclear reactors and so on, high power in-pipe mobile micromachines have been required. The authors have proposed the bellows microactuator using fluid power and have tried to apply the actuators to in-pipe mobile micromachines. In the previous papers, some inchworm mobile machine prototypes with 25 mm in diameter are fabricated and the traveling performances are experimentally investigated. In this paper, to miniaturize the in-pipe mobile machine and to make it adaptable to pipe diameters, firstly, a simple rubber-tube actuator constrained with a coil-spring is proposed and the static characteristics are investigated. Secondly, a supporting mechanism which utilizes a toggle mechanism and is adaptable to pipe diameters is proposed and the supporting forces are investigated. Finally, an in-pipe mobile micromachine for pipe with 4 - 5 mm in diameter is fabricated and the maximum traveling velocity of 7 mm/s in both ahead and astern movements is experimentally verified. (author)

  3. Power consumption analysis of constant bit rate data transmission over 3G mobile wireless networks

    DEFF Research Database (Denmark)

    Wang, Le; Ukhanova, Ann; Belyaev, Evgeny

    2011-01-01

    This paper presents the analysis of the power consumption of data transmission with constant bit rate over 3G mobile wireless networks. Our work includes the description of the transition state machine in 3G networks, followed by the detailed energy consumption analysis and measurement results...... of the radio link power consumption. Based on these description and analysis, we propose power consumption model. The power model was evaluated on the smartphone Nokia N900, which follows a 3GPP Release 5 and 6 supporting HSDPA/HSPA data bearers. Further we propose method of parameters selection for 3GPP...... transition state machine that allows to decrease power consumption on the mobile device....

  4. Harnessing the power of mobile technologies for collaborating, crowdsourcing, and creating

    Science.gov (United States)

    Crompton, H.

    2015-12-01

    Today's digital technologies can have a powerful influence on teaching and learning. M-learning and u-learning in particular are changing pedagogical practice. Sub categories are rapidly emerging, such as context-aware ubiquitous learning, that involve students learning subject content while immersed in authentic and relevant surroundings. Learning cultures are a nebulous blend of traditions, values, beliefs, and rituals built up over time. For a long time, education has long been conceived as classroom-based and predominantly sedentary (Merchant, 2012). Recent mobile technologies are disrupting this culture in favor of learning that is contextualized, personalized, on demand, and ubiquitous (Crompton, 2013). 21st century students are a different breed than past generations (Prensky, 2001). These students have grown up in a time that has not only altered their perceptions and practices but modified the wiring of the brain through neuroplasticity (Crompton, 2012). Students now cognitively receive information quickly through non-linear methods (Gross, 2003, Oblinger & Oblinger, 2005). They think differently. They also seem to be attached to mobile devices 24/7, although the content of the lesson does not match what they seem to be doing on the mobile devices. This presentation will showcase how to get your students to harness the power of mobile devices for educational purposes. For example, students in your classes will be using devices to collaborate on activities with Google Forms, crowdsourcing the best class questions in Slido, and screencasting thoughts and ideas to share with others with Educreations. These are examples of free apps or Web 2.0 tools that can be used on all the major mobile platforms. Crompton, H. (2013). Mobile learning: New approach, new theory. In Z. L. Berge & L. Y. Muilenburg (Eds.), Handbook of mobile learning (pp. 47-57). Prensky, M. (2001). Digital natives, digital immigrants. Mcb University Press, 9(5). Oblinger, D., & Oblinger, J

  5. Analysis of Characteristics of Power Consumption for Context-Aware Mobile Applications

    Directory of Open Access Journals (Sweden)

    Meeyeon Lee

    2014-11-01

    Full Text Available In recent years, a large portion of smartphone applications (Apps has targeted context-aware services. They aim to perceive users’ real-time context like his/her location, actions, or even emotion, and to provide various customized services based on the inferred context. However, context-awareness in mobile environments has some challenging issues due to limitations of devices themselves. Limited power is regarded as the most critical problem in context-awareness on smartphones. Many studies have tried to develop low-power methods, but most of them have focused on the power consumption of H/W modules of smartphones such as CPU and LCD. Only a few research papers have recently started to present some S/W-based approaches to improve the power consumption. That is, previous works did not consider energy consumed by context-awareness of Apps. Therefore, in this paper, we focus on the power consumption of context-aware Apps. We analyze the characteristics of context-aware Apps in a perspective of the power consumption, and then define two main factors which significantly influence the power consumption: a sort of context that context-aware Apps require for their services and a type of ways that a user uses them. The experimental result shows the reasonability and the possibility to develop low-power methods based on our analysis. That is, our analysis presented in this paper will be a foundation for energy-efficient context-aware services in mobile environments.

  6. Power mobility with collision avoidance for older adults: user, caregiver, and prescriber perspectives.

    Science.gov (United States)

    Wang, Rosalie H; Korotchenko, Alexandra; Hurd Clarke, Laura; Mortenson, W Ben; Mihailidis, Alex

    2013-01-01

    Collision avoidance technology has the capacity to facilitate safer mobility among older power mobility users with physical, sensory, and cognitive impairments, thus enabling independence for more users. Little is known about consumers' perceptions of collision avoidance. This article draws on interviews (29 users, 5 caregivers, and 10 prescribers) to examine views on design and utilization of this technology. Data analysis identified three themes: "useful situations or contexts," "technology design issues and real-life application," and "appropriateness of collision avoidance technology for a variety of users." Findings support ongoing development of collision avoidance for older adult users. The majority of participants supported the technology and felt that it might benefit current users and users with visual impairments, but might be unsuitable for people with significant cognitive impairments. Some participants voiced concerns regarding the risk for injury with power mobility use and some identified situations where collision avoidance might be beneficial (driving backward, avoiding dynamic obstacles, negotiating outdoor barriers, and learning power mobility use). Design issues include the need for context awareness, reliability, and user interface specifications. User desire to maintain driving autonomy supports development of collaboratively controlled systems. This research lays the groundwork for future development by illustrating consumer requirements for this technology.

  7. Clinical Information Systems Integration in New York City's First Mobile Stroke Unit.

    Science.gov (United States)

    Kummer, Benjamin R; Lerario, Michael P; Navi, Babak B; Ganzman, Adam C; Ribaudo, Daniel; Mir, Saad A; Pishanidar, Sammy; Lekic, Tim; Williams, Olajide; Kamel, Hooman; Marshall, Randolph S; Hripcsak, George; Elkind, Mitchell S V; Fink, Matthew E

    2018-01-01

    Mobile stroke units (MSUs) reduce time to thrombolytic therapy in acute ischemic stroke. These units are widely used, but the clinical information systems underlying MSU operations are understudied. The first MSU on the East Coast of the United States was established at New York Presbyterian Hospital (NYP) in October 2016. We describe our program's 7-month pilot, focusing on the integration of our hospital's clinical information systems into our MSU to support patient care and research efforts. NYP's MSU was staffed by two paramedics, one radiology technologist, and a vascular neurologist. The unit was equipped with four laptop computers and networking infrastructure enabling all staff to access the hospital intranet and clinical applications during operating hours. A telephone-based registration procedure registered patients from the field into our admit/discharge/transfer system, which interfaced with the institutional electronic health record (EHR). We developed and implemented a computerized physician order entry set in our EHR with prefilled values to permit quick ordering of medications, imaging, and laboratory testing. We also developed and implemented a structured clinician note to facilitate care documentation and clinical data extraction. Our MSU began operating on October 3, 2016. As of April 27, 2017, the MSU transported 49 patients, of whom 16 received tissue plasminogen activator (t-PA). Zero technical problems impacting patient care were reported around registration, order entry, or intranet access. Two onboard network failures occurred, resulting in computed tomography scanner malfunctions, although no patients became ineligible for time-sensitive treatment as a result. Thirteen (26.5%) clinical notes contained at least one incomplete time field. The main technical challenges encountered during the integration of our hospital's clinical information systems into our MSU were onboard network failures and incomplete clinical documentation. Future

  8. Computer program for afterheat temperature distribution for mobile nuclear power plant

    Science.gov (United States)

    Parker, W. G.; Vanbibber, L. E.

    1972-01-01

    ESATA computer program was developed to analyze thermal safety aspects of post-impacted mobile nuclear power plants. Program is written in FORTRAN 4 and designed for IBM 7094/7044 direct coupled system.

  9. Promise of a low power mobile CPU based embedded system in artificial leg control.

    Science.gov (United States)

    Hernandez, Robert; Zhang, Fan; Zhang, Xiaorong; Huang, He; Yang, Qing

    2012-01-01

    This paper presents the design and implementation of a low power embedded system using mobile processor technology (Intel Atom™ Z530 Processor) specifically tailored for a neural-machine interface (NMI) for artificial limbs. This embedded system effectively performs our previously developed NMI algorithm based on neuromuscular-mechanical fusion and phase-dependent pattern classification. The analysis shows that NMI embedded system can meet real-time constraints with high accuracies for recognizing the user's locomotion mode. Our implementation utilizes the mobile processor efficiently to allow a power consumption of 2.2 watts and low CPU utilization (less than 4.3%) while executing the complex NMI algorithm. Our experiments have shown that the highly optimized C program implementation on the embedded system has superb advantages over existing PC implementations on MATLAB. The study results suggest that mobile-CPU-based embedded system is promising for implementing advanced control for powered lower limb prostheses.

  10. Mobility Device Quality Affects Participation Outcomes for People With Disabilities: A Structural Equation Modeling Analysis.

    Science.gov (United States)

    Magasi, Susan; Wong, Alex; Miskovic, Ana; Tulsky, David; Heinemann, Allen W

    2018-01-01

    To test the effect that indicators of mobility device quality have on participation outcomes in community-dwelling adults with spinal cord injury, traumatic brain injury, and stroke by using structural equation modeling. Survey, cross-sectional study, and model testing. Clinical research space at 2 academic medical centers and 1 free-standing rehabilitation hospital. Community-dwelling adults (N=250; mean age, 48±14.3y) with spinal cord injury, traumatic brain injury, and stroke. Not applicable. The Mobility Device Impact Scale, Patient-Reported Outcomes Measurement Information System Social Function (version 2.0) scale, including Ability to Participate in Social Roles and Activities and Satisfaction with Social Roles and Activities, and the 2 Community Participation Indicators' enfranchisement scales. Details about device quality (reparability, reliability, ease of maintenance) and device type were also collected. Respondents used ambulation aids (30%), manual (34%), and power wheelchairs (30%). Indicators of device quality had a moderating effect on participation outcomes, with 3 device quality variables (repairability, ease of maintenance, device reliability) accounting for 20% of the variance in participation. Wheelchair users reported lower participation enfranchisement than did ambulation aid users. Mobility device quality plays an important role in participation outcomes. It is critical that people have access to mobility devices and that these devices be reliable. Copyright © 2017 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  11. Evaluation of a smartphone human activity recognition application with able-bodied and stroke participants.

    Science.gov (United States)

    Capela, N A; Lemaire, E D; Baddour, N; Rudolf, M; Goljar, N; Burger, H

    2016-01-20

    Mobile health monitoring using wearable sensors is a growing area of interest. As the world's population ages and locomotor capabilities decrease, the ability to report on a person's mobility activities outside a hospital setting becomes a valuable tool for clinical decision-making and evaluating healthcare interventions. Smartphones are omnipresent in society and offer convenient and suitable sensors for mobility monitoring applications. To enhance our understanding of human activity recognition (HAR) system performance for able-bodied and populations with gait deviations, this research evaluated a custom smartphone-based HAR classifier on fifteen able-bodied participants and fifteen participants who suffered a stroke. Participants performed a consecutive series of mobility tasks and daily living activities while wearing a BlackBerry Z10 smartphone on their waist to collect accelerometer and gyroscope data. Five features were derived from the sensor data and used to classify participant activities (decision tree). Sensitivity, specificity and F-scores were calculated to evaluate HAR classifier performance. The classifier performed well for both populations when differentiating mobile from immobile states (F-score > 94 %). As activity recognition complexity increased, HAR system sensitivity and specificity decreased for the stroke population, particularly when using information derived from participant posture to make classification decisions. Human activity recognition using a smartphone based system can be accomplished for both able-bodied and stroke populations; however, an increase in activity classification complexity leads to a decrease in HAR performance with a stroke population. The study results can be used to guide smartphone HAR system development for populations with differing movement characteristics.

  12. Neurophysiologic Correlates of Post-Stroke Mood and Emotional Control

    Directory of Open Access Journals (Sweden)

    Deniz Doruk

    2016-08-01

    Full Text Available Objective: Emotional disturbance is a common complication of stroke significantly affecting functional recovery and quality of life. Identifying relevant neurophysiologic markers associated with post-stroke emotional disturbance may lead to a better understanding of this disabling condition, guiding the diagnosis, development of new interventions and the assessments of treatment response. Methods: Thirty-five subjects with chronic stroke were enrolled in this study. The emotion sub-domain of Stroke Impact Scale (SIS-Emotion was used to assess post-stroke mood and emotional control. The relation between SIS-Emotion and neurophysiologic measures was assessed by using covariance mapping and univariate linear regression. Multivariate analyses were conducted to identify and adjust for potential confounders. Neurophysiologic measures included power asymmetry and coherence assessed by electroencephalography (EEG; and motor threshold, intracortical inhibition (ICI and intracortical facilitation (ICF measured by transcranial magnetic stimulation (TMS. Results: Lower scores on SIS-Emotion was associated with 1 frontal EEG power asymmetry in alpha and beta bands, 2 central EEG power asymmetry in alpha and theta bands, and 3 lower inter-hemispheric coherence over frontal and central areas in alpha band. SIS-Emotion also correlated with higher ICF and MT in the unlesioned hemisphere as measured by TMS. Conclusions: To our knowledge, this is the first study using EEG and TMS to index neurophysiologic changes associated with post-stroke mood and emotional control. Our results suggest that inter-hemispheric imbalance measured by EEG power and coherence, as well as an increased intracortical facilitation in the unlesioned hemisphere measured by TMS might be relevant markers associated with post-stroke mood and emotional control which can guide future studies investigating new diagnostic and treatment modalities in stroke rehabilitation.

  13. Optimizing MEMS-Based Storage Devices for Mobile Battery-Powered Systems

    NARCIS (Netherlands)

    Khatib, M.G.; Hartel, Pieter H.

    An emerging storage technology, called MEMS-based storage, promises nonvolatile storage devices with ultrahigh density, high rigidity, a small form factor, and low cost. For these reasons, MEMS-based storage devices are suitable for battery-powered mobile systems such as PDAs. For deployment in such

  14. Wireless power transfer for electric vehicles and mobile devices

    CERN Document Server

    Rim, Chun T

    2017-01-01

    From mobile, cable-free re-charging of electric vehicles, smart phones and laptops to collecting solar electricity from orbiting solar farms, wireless power transfer (WPT) technologies offer consumers and society enormous benefits. Written by innovators in the field, this comprehensive resource explains the fundamental principles and latest advances in WPT and illustrates key applications of this emergent technology.

  15. Integration of Pneumatic Technology in Powered Mobility Devices.

    Science.gov (United States)

    Daveler, Brandon; Wang, Hongwu; Gebrosky, Benjamin; Grindle, Garrett G; Schneider, Urs; Cooper, Rory A

    2017-01-01

    Advances in electric motors, electronics, and control systems have enhanced the capability and drivability of electric power mobility devices over the last 60 years. Yet, battery technologies used in powered mobility devices (PMDs) have not kept pace. Recent advances in pneumatic technology, primarily the high torque, low speed design of rotary piston air motors, directly align with the needs of PMD. Pneumatic technology has advantages over battery-powered technology, including lighter weight, lower operating costs, decreased environmental impact, better reliability, and increased safety. Two prototypes were created that incorporated rotary piston air motors, high-pressure air tanks, and air-pressure regulators. Prototype 1 was created by modifying an existing electric PMD. Range tests were performed to determine the feasibility of pneumatic technology and the optimal combination of components to allow the longest range possible at acceptable speeds over ideal conditions. Using a 1.44 L air tank for feasibility testing, prototype 1 was capable of traveling 800 m, which confirmed the feasibility of pneumatic technology usage in PMDs. Prototype 2 was designed based on the testing results from prototype 1. After further optimization of prototype 2, the average maximum range was 3,150 m. Prototype 2 is up to 28.3% lighter than an equivalent size electric PMD and can be fully recharged in approximately 2 minutes. It decreases the cost of PMDs by approximately $1,500, because batteries do not need to be replaced over the lifetime of the device. The results provide justification for the use of pneumatic technology in PMDs.

  16. Epidemiology of stroke patients in Tikur Anbessa Specialized Hospital

    African Journals Online (AJOL)

    unhcc

    2013-09-20

    Sep 20, 2013 ... stroke has been increasing in sub-Saharan Africa. (SSA). Approximately ... setups (12). Delayed presentation and diagnosis, inadequate emergency care .... use of mass media, mobile technology and improved transportation ...

  17. A Mobile Self-Reconfigurable Microrobot with Power and Communication Relays

    Directory of Open Access Journals (Sweden)

    Dawei Zhang

    2010-12-01

    Full Text Available A modular mobile self-reconfigurable microrobot is developed to enlarge the whole surveillance range of mobile microrobot. The microrobot is designed as differential driven vehicle equipped with a passive universal connector with autonomic engagement/disengagement function, and actuated by MEMS-based electromagnetic micromotors. To realize that the microrobot is autonomous, its electrical system is designed in modularity and integrated. A simple autonomous docking approach based on infrared sensors is presented. Experimental results verify high efficiency and reliability of the proposed docking method, and demonstrate the improved ability of performing large-range vision-based surveillance by power and communication relays.

  18. A Mobile Self-reconfigurable Microrobot with Power and Communication Relays

    Directory of Open Access Journals (Sweden)

    Dawei Zhang

    2011-01-01

    Full Text Available A modular mobile self-reconfigurable microrobot is developed to enlarge the whole surveillance range of mobile microrobot. The microrobot is designed as differential driven vehicle equipped with a passive universal connector with autonomic engagement/disengagement function, and actuated by MEMS-based electromagnetic micromotors. To realize that the microrobot is autonomous, its electrical system is designed in modularity and integrated. A simple autonomous docking approach based on infrared sensors is presented. Experimental results verify high efficiency and reliability of the proposed docking method, and demonstrate the improved ability of performing large-range vision-based surveillance by power and communication relays.

  19. Modified ride-on toy cars for early power mobility: a technical report.

    Science.gov (United States)

    Huang, Hsiang-Han; Galloway, James C

    2012-01-01

    Children with significantly decreased mobility have limited opportunities to explore their physical and social environment. A variety of assistive technologies are available to increase mobility; however, no single device provides the level of functional mobility that children developing typically enjoy. The purpose of this technical report is to formally introduce a new power mobility option--the modified ride-on toy car. This report will provide (a) an overview of toy car features, (b) examples of basic electrical and mechanical modifications, and (c) a brief clinical case. With creative use and customized modifications, toy cars can function as a "general learning environment" for use in the clinic, home, and school. As such, we anticipate that these cars will become a multiuse clinical tool to address not only mobility goals but also goals involving body function and structure such as posture and movement impairments.

  20. Mobile concrete solidification systems for power reactor waste

    International Nuclear Information System (INIS)

    Tchemitcheff, E.; Bordas, Y.

    1990-01-01

    In late 1988 SGN received an order from Electricite de France (EDF) for the construction of a mobile concrete solidification system to process secondary system resins generated by the P'4 and N4 series PWR power plants in France. This order was placed in view of SGN's experience with low- and medium-level radioactive waste treatment and conditioning over a period of almost 20 years. In addition to the construction of fixed waste processing facilities using more conventional technologies, SGN has been involved in application of the mobile system concept to the bituminization process in the United States, which led to the construction and commissioning of two transportable systems in collaboration with its American licensee US Ecology. It has also conducted large-scale R ampersand D on LLW/MLW concrete solidification, particularly for ion exchange resins. 5 figs

  1. Powered mobility intervention: understanding the position of tool use learning as part of implementing the ALP tool.

    Science.gov (United States)

    Nilsson, Lisbeth; Durkin, Josephine

    2017-10-01

    To explore the knowledge necessary for adoption and implementation of the Assessment of Learning Powered mobility use (ALP) tool in different practice settings for both adults and children. To consult with a diverse population of professionals working with adults and children, in different countries and various settings; who were learning about or using the ALP tool, as part of exploring and implementing research findings. Classical grounded theory with a rigorous comparative analysis of data from informants together with reflections on our own rich experiences of powered mobility practice and comparisons with the literature. A core category learning tool use and a new theory of cognizing tool use, with its interdependent properties: motivation, confidence, permissiveness, attentiveness and co-construction has emerged which explains in greater depth what enables the application of the ALP tool. The scientific knowledge base on tool use learning and the new theory conveys the information necessary for practitioner's cognizing how to apply the learning approach of the ALP tool in order to enable tool use learning through powered mobility practice as a therapeutic intervention in its own right. This opens up the possibility for more children and adults to have access to learning through powered mobility practice. Implications for rehabilitation Tool use learning through powered mobility practice is a therapeutic intervention in its own right. Powered mobility practice can be used as a rehabilitation tool with individuals who may not need to become powered wheelchair users. Motivation, confidence, permissiveness, attentiveness and co-construction are key properties for enabling the application of the learning approach of the ALP tool. Labelling and the use of language, together with honing observational skills through viewing video footage, are key to developing successful learning partnerships.

  2. Community reintegration and related factors in a Nigerian stroke sample.

    Science.gov (United States)

    Akosile, Christopher; Nworah, Chioma; Okoye, Emmanuel; Adegoke, Babatunde; Umunnah, Joseph; Fabunmi, Ayodeji

    2016-09-01

    The goal of stroke rehabilitation has shifted from mere survival of a victim to how well a survivor can be effectively reintegrated back into the community. The present study determined the level of satisfaction with community reintegration (CR) and related factors among Nigerian community-dwelling stroke survivors (CDSS). This was a cross-sectional survey of 71 volunteering CDSS (35 males, 36 females) from selected South-Eastern Nigerian communities. Reintegration to Normal Living Index was used to assess participants' CR. Data was analysed using Spearman rank-order correlation, Kruskal-Wallis and Mann-Whitney U tests at p≤0.05. Participants generally had deficits in CR which was either mild/moderate (52.1%) or severe (47.9%). Scores in the CR domains of distance mobility, performance of daily activities, recreational activities and family roles were particularly low (median scores ≤ 4). CR was significantly correlated with and influenced by age (r=-0.35; p=0.00) and presence/absence of diabetes mellitus (u=3.56.50; p=0.01), pre- (k=6.13; p=0.05) and post-stroke employment (k=18.26; p=0.00) status, type of assistive mobility device being used (AMD) (k=25.39; p=0.00) and support from the community (k=7.15; p=0.03) respectively. CR was generally poor for this CDSS sample. Survivors who are older, having diabetes as co-morbidity, using AMD (particularly wheel-chair) and without employment pre- and/or post-stroke may require keener attention. Rehabilitation focus may be targeted at enhancing mobility functions, vocational and social skills.

  3. Gross efficiency during rowing is not affected by stroke rate

    NARCIS (Netherlands)

    Hofmijster, M.J.; van Soest, A.J.; de Koning, J.J.

    2009-01-01

    Purpose: It has been suggested that the optimal stroke rate in rowing is partly determined by the stroke-rate dependence of internal power losses. This should be reflected in a stroke-rate dependency of gross efficiency (e

  4. Flexible power and bandwidth allocation in mobile satellites

    Science.gov (United States)

    Keyes, L. A.

    The introduction of L-band mobile communication services by spot beam satellites creates a payload design challenge due to uncertainty in the location and size of the new market to be served. A combination of payload technologies that allow a flexible allocation of power and bandwidth to any portion of the coverage area is described. Power flexibility is achieved by a novel combination of a low-level beam-forming network and a matrix power module which ensures equal sharing of power among individual amplifiers. This eliminates the loss of efficiency and increased mass when an amplifier associated with a beam must be over-designed to meet uncertainties in power distribution between beams. Flexibility in allocation of bandwidth to beams is achieved by intermediate frequency subdivision of the L-band service categories defined by ITU. These spectral subdivisions are assigned to beams by an IF interconnect matrix having beam ports and filter ports as inputs and outputs, respectively. Two such filter switch matrices are required, one for the inbound L-band to feeder link transponder, and one for the outbound feeder link to L-band transponder.

  5. Functional limitation and health-related quality of life, and associated factors among long term stroke survivors in a Malaysian community.

    Science.gov (United States)

    Nor Azlin, M N; Aziz, N A; Saperi, B S; Aljunid, S M

    2016-12-01

    this study aimed to evaluate function and quality of life (QoL) and associated factors among long term stroke survivors in the Malaysian community. A cross-sectional study was conducted involving stroke survivors living in the community at two or more years post-stroke. Eligible participants with the diagnosis of stroke were identified from 2005-2010 case mix database of a tertiary hospital. the patients' medical records were analysed and data on demographic and clinical profiles were collected. telephone interviews were conducted to assess existing stroke-related impairments, comorbidities, stroke recurrences, current level of function and QoL, with the usage of rivermead mobility index (rMI), barthel index (bI) and stroke specific quality of life scale (ssQOL). A total of 203 stroke survivors; mean age 64.5 (standard Deviation(sD) 12.2) years, 45.3% males, stroke duration 44.7 (sD 13.8) months completed the interviews. Mean rMI was 11.7 (sD 3.4) and bI was 89.8 (sD 19.8). Forty three percent and 99% had difficulty in ascending/descending stairs and fast walking, respectively. Up to 20% had limitations in most of the bI subsets. Mean ssQOL was 207.6 (sD 37.2), with domains mostly affected were 'energy' and 'social role'. Function and QOL were both influenced by age (p<0.01) and stroke related impairments (p<0.05), but not by co-morbidities or stroke recurrence. QoL and function (both mobility and ADL) were strongly positively correlated with each other (p<0.01). It was observed that functional limitations especially mobility, remains post-stroke major problem and were attributed mainly to stroke-related impairments.

  6. Comprehensive stroke units: a review of comparative evidence and experience.

    Science.gov (United States)

    Chan, Daniel K Y; Cordato, Dennis; O'Rourke, Fintan; Chan, Daniel L; Pollack, Michael; Middleton, Sandy; Levi, Chris

    2013-06-01

    Stroke unit care offers significant benefits in survival and dependency when compared to general medical ward. Most stroke units are either acute or rehabilitation, but comprehensive (combined acute and rehabilitation) model (comprehensive stroke unit) is less common. To examine different levels of evidence of comprehensive stroke unit compared to other organized inpatient stroke care and share local experience of comprehensive stroke units. Cochrane Library and Medline (1980 to December 2010) review of English language articles comparing stroke units to alternative forms of stroke care delivery, different types of stroke unit models, and differences in processes of care within different stroke unit models. Different levels of comparative evidence of comprehensive stroke units to other models of stroke units are collected. There are no randomized controlled trials directly comparing comprehensive stroke units to other stroke unit models (either acute or rehabilitation). Comprehensive stroke units are associated with reduced length of stay and greatest reduction in combined death and dependency in a meta-analysis study when compared to other stroke unit models. Comprehensive stroke units also have better length of stay and functional outcome when compared to acute or rehabilitation stroke unit models in a cross-sectional study, and better length of stay in a 'before-and-after' comparative study. Components of stroke unit care that improve outcome are multifactorial and most probably include early mobilization. A comprehensive stroke unit model has been successfully implemented in metropolitan and rural hospital settings. Comprehensive stroke units are associated with reductions in length of stay and combined death and dependency and improved functional outcomes compared to other stroke unit models. A comprehensive stroke unit model is worth considering as the preferred model of stroke unit care in the planning and delivery of metropolitan and rural stroke services

  7. A Framework for (Tele-) Monitoring of the Rehabilitation Progress in Stroke Patients

    Science.gov (United States)

    David, V.; Haller, M.; Kotzian, S.; Hofmann, M.; Schlossarek, S.; Eichholzer, K.; Winkler, M.; Frohner, M.; Reichel, M.; Mayr, W.; Rafolt, D.

    2015-01-01

    Background Preservation of mobility in conjunction with an independent life style is one of the major goals of rehabilitation after stroke. Objectives The Rehab@Home framework shall support the continuation of rehabilitation at home. Methods The framework consists of instrumented insoles, connected wirelessly to a 3G ready tablet PC, a server, and a web-interface for medical experts. The rehabilitation progress is estimated via automated analysis of movement data from standardized assessment tests which are designed according to the needs of stroke patients and executed via the tablet PC application. Results The Rehab@Home framework’s implementation is finished and ready for the field trial (at five patients’ homes). Initial testing of the automated evaluation of the standardized mobility tests shows reproducible results. Conclusions Therefore it is assumed that the Rehab@Home framework is applicable as monitoring tool for the gait rehabilitation progress in stroke patients. PMID:26767068

  8. Hand Passive Mobilization Performed with Robotic Assistance: Acute Effects on Upper Limb Perfusion and Spasticity in Stroke Survivors

    Directory of Open Access Journals (Sweden)

    Massimiliano Gobbo

    2017-01-01

    Full Text Available This single arm pre-post study aimed at evaluating the acute effects induced by a single session of robot-assisted passive hand mobilization on local perfusion and upper limb (UL function in poststroke hemiparetic participants. Twenty-three patients with subacute or chronic stroke received 20 min passive mobilization of the paretic hand with robotic assistance. Near-infrared spectroscopy (NIRS was used to detect changes in forearm tissue perfusion. Muscle tone of the paretic UL was assessed by the Modified Ashworth Scale (MAS. Symptoms concerning UL heaviness, joint stiffness, and pain were evaluated as secondary outcomes by self-reporting. Significant (p=0.014 improvements were found in forearm perfusion when all fingers were mobilized simultaneously. After the intervention, MAS scores decreased globally, being the changes statistically significant for the wrist (from 1.6±1.0 to 1.1±1.0; p=0.001 and fingers (from 1.2±1.1 to 0.7±0.9; p=0.004. Subjects reported decreased UL heaviness and stiffness after treatment, especially for the hand, as well as diminished pain when present. This study supports novel evidence that hand robotic assistance promotes local UL circulation changes, may help in the management of spasticity, and acutely alleviates reported symptoms of heaviness, stiffness, and pain in subjects with poststroke hemiparesis. This opens new scenarios for the implications in everyday clinical practice. Clinical Trial Registration Number is NCT03243123.

  9. Hand Passive Mobilization Performed with Robotic Assistance: Acute Effects on Upper Limb Perfusion and Spasticity in Stroke Survivors.

    Science.gov (United States)

    Gobbo, Massimiliano; Gaffurini, Paolo; Vacchi, Laura; Lazzarini, Sara; Villafane, Jorge; Orizio, Claudio; Negrini, Stefano; Bissolotti, Luciano

    2017-01-01

    This single arm pre-post study aimed at evaluating the acute effects induced by a single session of robot-assisted passive hand mobilization on local perfusion and upper limb (UL) function in poststroke hemiparetic participants. Twenty-three patients with subacute or chronic stroke received 20 min passive mobilization of the paretic hand with robotic assistance. Near-infrared spectroscopy (NIRS) was used to detect changes in forearm tissue perfusion. Muscle tone of the paretic UL was assessed by the Modified Ashworth Scale (MAS). Symptoms concerning UL heaviness, joint stiffness, and pain were evaluated as secondary outcomes by self-reporting. Significant ( p = 0.014) improvements were found in forearm perfusion when all fingers were mobilized simultaneously. After the intervention, MAS scores decreased globally, being the changes statistically significant for the wrist (from 1.6 ± 1.0 to 1.1 ± 1.0; p = 0.001) and fingers (from 1.2 ± 1.1 to 0.7 ± 0.9; p = 0.004). Subjects reported decreased UL heaviness and stiffness after treatment, especially for the hand, as well as diminished pain when present. This study supports novel evidence that hand robotic assistance promotes local UL circulation changes, may help in the management of spasticity, and acutely alleviates reported symptoms of heaviness, stiffness, and pain in subjects with poststroke hemiparesis. This opens new scenarios for the implications in everyday clinical practice. Clinical Trial Registration Number is NCT03243123.

  10. Stroke patients and their attitudes toward mHealth monitoring to support blood pressure control and medication adherence.

    Science.gov (United States)

    Jenkins, Carolyn; Burkett, Nina-Sarena; Ovbiagele, Bruce; Mueller, Martina; Patel, Sachin; Brunner-Jackson, Brenda; Saulson, Raelle; Treiber, Frank

    2016-05-01

    Mobile health, or mHealth, has increasingly been signaled as an effective means to expedite communication and improve medical regimen adherence, especially for patients with chronic health conditions such as stroke. However, there is a lack of data on attitudes of stroke patients toward mHealth. Such information will aid in identifying key indicators for feasibility and optimal implementation of mHealth to prevent and/or decrease rates of secondary stroke. Our objective was to ascertain stroke patients' attitudes toward using mobile phone enabled blood pressure (BP) monitoring and medication adherence and identify factors that modulate these attitudes. Sixty stroke patients received a brief demonstration of mHealth devices to assist with BP control and medication adherence and a survey to evaluate willingness to use this technology. The 60 participants had a mean age of 57 years, were 43.3% male, and 53.3% were White. With respect to telecommunication prevalence, 93.3% owned a cellular device and 25% owned a smartphone. About 70% owned a working computer. Regarding attitudes, 85% felt comfortable with a doctor or nurse using mHealth technologies to monitor personal health information, 78.3% believed mHealth would help remind them to follow doctor's directions, and 83.3% were confident that technology could effectively be used to communicate with health care providers for medical needs. Mobile device use is high in stroke patients and they are amenable to mHealth for communication and assistance in adhering to their medical regimens. More research is needed to explore usefulness of this technology in larger stroke populations.

  11. Study of variations of radiofrequency power density from mobile phone base stations with distance

    International Nuclear Information System (INIS)

    Ayinmode, B. O.; Farai, I. P.

    2013-01-01

    The variations of radiofrequency (RF) radiation power density with distance around some mobile phone base stations (BTSs), in ten randomly selected locations in Ibadan, western Nigeria, were studied. Measurements were made with a calibrated hand-held spectrum analyser. The maximum Global System of Mobile (GSM) communication 1800 signal power density was 323.91 μW m -2 at 250 m radius of a BTS and that of GSM 900 was 1119.00 μW m -2 at 200 m radius of another BTS. The estimated total maximum power density was 2972.00 μW m -2 at 50 m radius of a different BTS. This study shows that the maximum carrier signal power density and the total maximum power density from a BTS may be observed averagely at 200 and 50 m of its radius, respectively. The result of this study demonstrates that exposure of people to RF radiation from phone BTSs in Ibadan city is far less than the recommended limits by International scientific bodies. (authors)

  12. Albany Interim Landfill gas extraction and mobile power system: Using landfill gas to produce electricity. Final report

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1997-06-01

    The Albany Interim Landfill Gas Extraction and Mobile Power System project served three research objectives: (1) determination of the general efficiency and radius of influence of horizontally placed landfill gas extraction conduits; (2) determination of cost and effectiveness of a hydrogen sulfide gas scrubber utilizing Enviro-Scrub{trademark} liquid reagent; and (3) construction and evaluation of a dual-fuel (landfill gas/diesel) 100 kW mobile power station. The horizontal gas extraction system was very successful; overall, gas recovery was high and the practical radius of influence of individual extractors was about 50 feet. The hydrogen sulfide scrubber was effective and its use appears feasible at typical hydrogen sulfide concentrations and gas flows. The dual-fuel mobile power station performed dependably and was able to deliver smooth power output under varying load and landfill gas fuel conditions.

  13. A geographical model of radio-frequency power density around mobile phone masts

    International Nuclear Information System (INIS)

    Briggs, David; Beale, Linda; Bennett, James; Toledano, Mireille B.; Hoogh, Kees de

    2012-01-01

    Public concern about possible health effects of EMF radiation from mobile phone masts has led to an increase of epidemiological studies and health risk assessments which, in turn, require adequate methods of exposure estimation. Difficulties in exposure modelling are exacerbated both by the complexity of the propagation processes, and the need to obtain estimates for large study populations in order to provide sufficient statistical power to detect or exclude the small relative risks that might exist. Use of geographical information system (GIS) techniques offers the means to make such computations efficiently. This paper describes the development and field validation of a GIS-based exposure model (Geomorf). The model uses a modified Gaussian formulation to represent spatial variations in power densities around mobile phone masts, on the basis of power output, antenna height, tilt and the surrounding propagation environment. Obstruction by topography is allowed for, through use of a visibility function. Model calibration was done using field data from 151 measurement sites (1510 antenna-specific measurements) around a group of masts in a rural location, and 50 measurement sites (658 antenna-specific measurements) in an urban area. Different parameter settings were found to be necessary in urban and rural areas to obtain optimum results. The calibrated models were then validated against independent sets of data gathered from measurement surveys in rural and urban areas, and model performance was compared with that of two commonly used path-loss models (the COST-231 adaptations of the Hata and Walfisch–Ikegami models). Model performance was found to vary somewhat between the rural and urban areas, and at different measurement levels (antenna-specific power density, total power density), but overall gave good estimates (R 2 = 0.641 and 0.615, RMSE = 10.7 and 6.7 dB m at the antenna and site-level respectively). Performance was considerably better than that of both

  14. Cross-Layer Design Approach for Power Control in Mobile Ad Hoc Networks

    Directory of Open Access Journals (Sweden)

    A. Sarfaraz Ahmed

    2015-03-01

    Full Text Available In mobile ad hoc networks, communication among mobile nodes occurs through wireless medium The design of ad hoc network protocol, generally based on a traditional “layered approach”, has been found ineffective to deal with receiving signal strength (RSS-related problems, affecting the physical layer, the network layer and transport layer. This paper proposes a design approach, deviating from the traditional network design, toward enhancing the cross-layer interaction among different layers, namely physical, MAC and network. The Cross-Layer design approach for Power control (CLPC would help to enhance the transmission power by averaging the RSS values and to find an effective route between the source and the destination. This cross-layer design approach was tested by simulation (NS2 simulator and its performance over AODV was found to be better.

  15. Healthy Living after Stroke

    Science.gov (United States)

    ... Nutrition Cooking for Health Food for Thought: Heart-healthy Diet is Also Good For Your Brain Physical Activity Get Moving and Boost Your Brain Power Understanding Risky Conditions Converging Risk Factors for Stroke ...

  16. 30 CFR 57.12005 - Protection of power conductors from mobile equipment.

    Science.gov (United States)

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Protection of power conductors from mobile equipment. 57.12005 Section 57.12005 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR METAL AND NONMETAL MINE SAFETY AND HEALTH SAFETY AND HEALTH STANDARDS-UNDERGROUND METAL AND...

  17. Increased reward in ankle robotics training enhances motor control and cortical efficiency in stroke.

    Science.gov (United States)

    Goodman, Ronald N; Rietschel, Jeremy C; Roy, Anindo; Jung, Brian C; Diaz, Jason; Macko, Richard F; Forrester, Larry W

    2014-01-01

    Robotics is rapidly emerging as a viable approach to enhance motor recovery after disabling stroke. Current principles of cognitive motor learning recognize a positive relationship between reward and motor learning. Yet no prior studies have established explicitly whether reward improves the rate or efficacy of robotics-assisted rehabilitation or produces neurophysiologic adaptations associated with motor learning. We conducted a 3 wk, 9-session clinical pilot with 10 people with chronic hemiparetic stroke, randomly assigned to train with an impedance-controlled ankle robot (anklebot) under either high reward (HR) or low reward conditions. The 1 h training sessions entailed playing a seated video game by moving the paretic ankle to hit moving onscreen targets with the anklebot only providing assistance as needed. Assessments included paretic ankle motor control, learning curves, electroencephalograpy (EEG) coherence and spectral power during unassisted trials, and gait function. While both groups exhibited changes in EEG, the HR group had faster learning curves (p = 0.05), smoother movements (p power (p mobility.

  18. Motor operated valve stroke timing; is there value?

    International Nuclear Information System (INIS)

    Green, K.; Rosch, F. Jr.; Neckowicz, T.

    1990-01-01

    Both ASME Section XI, Subsection IWV and ASME/ANSI OMa-1988, Part 10 require stroke timing of certain power operated valves. This requirement is intended to detect valve degradation and subsequent maintenance, repair or replacement needs. However, the adequacy of stroke timing, especially for motor operated valves, has met much skepticism in the industry. This paper will demonstrate that stroke timing for ac motor operated valves is inadequate and provide a non-intrusive testing alternative. It will also discuss the value of stroke timing for dc motor operated valves

  19. Impaired voluntary neuromuscular activation limits muscle power in mobility-limited older adults

    Science.gov (United States)

    Background. Age-related alterations of neuromuscular activation may contribute to deficits in muscle power and mobility function. This study assesses whether impaired activation of the agonist quadriceps and antagonist hamstrings, including amplitude- and velocity-dependent characteristics of activa...

  20. 30 CFR 56.12005 - Protection of power conductors from mobile equipment.

    Science.gov (United States)

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Protection of power conductors from mobile equipment. 56.12005 Section 56.12005 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR METAL AND NONMETAL MINE SAFETY AND HEALTH SAFETY AND HEALTH STANDARDS-SURFACE METAL AND NONMETAL...

  1. Velocity, aerobic power and metabolic cost of whole body and arms only front crawl swimming at various stroke rates.

    Science.gov (United States)

    Morris, Kirstin S; Osborne, Mark A; Shephard, Megan E; Skinner, Tina L; Jenkins, David G

    2016-05-01

    Stroke rate (SR) has not been considered in previous research examining the relative roles of the limbs in front-crawl performance. This study compared velocity, aerobic power ([Formula: see text]) and metabolic cost (C) between whole body (WB) and arms only (AO) front-crawl swimming across various intensities while controlling SR. Twenty Australian national swimmers performed six 200 m front-crawl efforts under two conditions: (1) WB swimming and, (2) AO swimming. Participants completed the 200 m trials under three SR conditions: "low" (22-26 stroke-cycles min(-1)), "moderate" (30-34 stroke-cycles min(-1) and "high" (38-42 stroke-cycles min(-1)). [Formula: see text] was continuously measured, with C, velocity, SR, and kick rate calculated for each effort. Regardless of the SR condition and sex, AO velocity was consistently lower than WB velocity by ~11.0 % (p  0.01). When C was expressed as a function of velocity, WB and AO regression equations differed for males (p = 0.01) but not for females (p = 0.087). Kick rate increased as SR increased (p swimming is the same. Coaches should consider these results when prescribing AO sets if their intention is to reduce the metabolic load.

  2. A smart mobile pouch as a biomechanical energy harvester towards self-powered smart wireless power transfer applications.

    Science.gov (United States)

    Chandrasekhar, Arunkumar; Alluri, Nagamalleswara Rao; Sudhakaran, M S P; Mok, Young Sun; Kim, Sang-Jae

    2017-07-20

    A Smart Mobile Pouch Triboelectric Nanogenerator (SMP-TENG) is introduced as a promising eco-friendly approach for scavenging biomechanical energy for powering next generation intelligent devices and smart phones. This is a cost-effective and robust method for harvesting energy from human motion, by utilizing worn fabrics as a contact material. The SMP-TENG is capable of harvesting energy in two operational modes: lateral sliding and vertical contact and separation. Moreover, the SMP-TENG can also act as a self-powered emergency flashlight and self-powered pedometer during normal human motion. A wireless power transmission setup integrated with SMP-TENG is demonstrated. This upgrades the traditional energy harvesting device into a self-powered wireless power transfer SMP-TENG. The wirelessly transferred power can be used to charge a Li-ion battery and light LEDs. The SMP-TENG opens a wide range of opportunities in the field of self-powered devices and low maintenance energy harvesting systems for portable and wearable electronic gadgets.

  3. Use of Rasch Analysis to Evaluate and Refine the Community Balance and Mobility Scale for Use in Ambulatory Community-Dwelling Adults Following Stroke

    Science.gov (United States)

    Pollock, Courtney L.; Brouwer, Brenda; Garland, S. Jayne

    2016-01-01

    Background The Community Balance and Mobility Scale (CB&M) is increasingly used to evaluate walking balance following stroke. Objective This study applied Rasch analysis to evaluate and refine the CB&M for use in ambulatory community-dwelling adults following stroke. Methods The CB&M content was linked to task demands and motor skill classifications. Rasch analysis was used to evaluate internal construct validity (structural validity) and refine the CB&M for use with ambulatory community-dwelling adults following stroke. The CB&M data were collected at 3 time points: at discharge from inpatient rehabilitation and at 6 and 12 months postdischarge (N=238). Rasch analysis evaluated scale dimensionality, item and person fit, item response bias, scoring hierarchy, and targeting. Disordered scoring hierarchy was resolved by collapsing scoring categories. Highly correlated and “misfitting” items were removed. Sensitivity to change was evaluated with standardized response means (SRMs) and one-way repeated-measures analysis of variance. Results The CB&M was primarily linked to closed body transport task demands. Significant item-trait interaction, disordered scoring hierarchies, and multidimensionality were found. Scoring categories were collapsed in 15/19 items, and 5 misfitting items were removed. The resulting stroke-specific 14-item unidimensional CB&M (CB&MStroke) fit Rasch model expectations, with no item response bias, acceptable targeting (13% floor effects and 0% ceiling effects), and moderate-to-strong sensitivity to change at 6 months postdischarge (SRM=0.63; 95% confidence interval=−1.523, −0.142) and 12 months postdischarge (SRM=0.73; 95% confidence interval=−2.318, −0.760). Limitations Findings are limited to a modest-sized sample of individuals with mild-to-moderate balance impairment following stroke. Conclusions The CB&MStroke shows promise as a clinical scale for measuring change in walking balance in ambulatory community-dwelling adults

  4. Development and Pilot Testing of 24/7 In-Ambulance Telemedicine for Acute Stroke: Prehospital Stroke Study at the Universitair Ziekenhuis Brussel-Project.

    Science.gov (United States)

    Valenzuela Espinoza, Alexis; Van Hooff, Robbert-Jan; De Smedt, Ann; Moens, Maarten; Yperzeele, Laetitia; Nieboer, Koenraad; Hubloue, Ives; de Keyser, Jacques; Convents, Andre; Fernandez Tellez, Helio; Dupont, Alain; Putman, Koen; Brouns, Raf

    2016-01-01

    In-ambulance telemedicine is a recently developed and a promising approach to improve emergency care. We implemented the first ever 24/7 in-ambulance telemedicine service for acute stroke. We report on our experiences with the development and pilot testing of the Prehospital Stroke Study at the Universitair Ziekenhuis Brussel (PreSSUB) to facilitate a wider spread of the knowledge regarding this technique. Successful execution of the project involved the development and validation of a novel stroke scale, design and creation of specific hardware and software solutions, execution of field tests for mobile internet connectivity, design of new care processes and information flows, recurrent training of all professional caregivers involved in acute stroke management, extensive testing on healthy volunteers, organisation of a 24/7 teleconsultation service by trained stroke experts and 24/7 technical support, and resolution of several legal issues. In all, it took 41 months of research and development to confirm the safety, technical feasibility, reliability, and user acceptance of the PreSSUB approach. Stroke-specific key information can be collected safely and reliably before and during ambulance transportation and can adequately be communicated with the inhospital team awaiting the patient. This paper portrays the key steps required and the lessons learned for successful implementation of a 24/7 expert telemedicine service supporting patients with acute stroke during ambulance transportation to the hospital. © 2016 S. Karger AG, Basel.

  5. mobile nuclear energy power plants for Turkey and III. world

    International Nuclear Information System (INIS)

    Oezden, H.

    2001-01-01

    It is estimated that if there is no alternative energy source, there will be increase in building nuclear energy power plants. This source of energy and know how along with technology must be put into the possession of Turkey. Since almost all of Turkey is 1 st degree earthquake region and in view of the regional political instability, the requirement of ample amount of water for prolonged times, the density of settlement, environmental problems, high cost of building nuclear energy power plants it becomes necessary to think about their application techniques. In this study, mobile nuclear energy power plants having a wide area of use in conditions prevailing in Turkey , their draft drawings for making them by using metal/steel are shown. The positive-negative aspects of the topic is presented for discussions

  6. Enersave API: Android-based power-saving framework for mobile devices

    Directory of Open Access Journals (Sweden)

    A.M. Muharum

    2017-06-01

    Full Text Available Power consumption is a major factor to be taken into consideration when using mobile devices in the IoT field. Good Power management requires proper understanding of the way in which it is being consumed by the end-devices. This paper is a continuation of the work in Ref. [1] and proposes an energy saving API for the Android Operating System in order to help developers turn their applications into energy-aware ones. The main features heavily used for building smart applications, greatly impact battery life of Android devices and which have been taken into consideration are: Screen brightness, Colour scheme, CPU frequency, 2G/3G network, Maps, Low power localisation, Bluetooth and Wi-Fi. The assessment of the power-saving API has been performed on real Android devices and also compared to the most powerful power-saving applications – DU Battery Saver and Battery Saver 2016 – currently available on the Android market. Comparisons demonstrate that the Enersave API has a significant impact on power saving when incorporated in android applications. While DU Battery Saver and Battery Saver 2016 help saving 22.2% and 40.5% of the battery power respectively, the incorporation of the Enersave API in android applications can help save 84.6% of battery power.

  7. Post Stroke Fatigue; Point Prevalence, Characterization, Associations and Radiological Correlation in a Rehabilitation Hospital

    LENUS (Irish Health Repository)

    Khan, A

    2017-11-01

    Post stroke fatigue (PSF) is a frequently reported symptom by stroke survivors undergoing rehabilitation. This cross sectional observational study was undertaken in a rehabilitation facility to look at its prevalence and relationship with various variables like personal factors, type of stroke, social context, hemispheric involvement on CT scan and mobility status. The results showed that PSF was present in 83% (25 out of 30) of the patients included in the study. No clear association could be established between PSF, social, radiological and functional characteristics.

  8. Scalable single point power extraction for compact mobile and stand-alone solar harvesting power sources based on fully printed organic photovoltaic modules and efficient high voltage DC/DC conversion

    DEFF Research Database (Denmark)

    Garcia Valverde, Rafael; Villarejo, José A.; Hösel, Markus

    2015-01-01

    (AM1.5G, 1000 W m−2). As a demonstration we present a scalable fully integrated and compact power unit for mobile applications comprising solar energy harvesting OPV modules, power conversion and storage. Applications possible include electrical charging of mobile devices, illumination using LED lamps...

  9. Accuracy of clinical observations of push-off during gait after stroke.

    Science.gov (United States)

    McGinley, Jennifer L; Morris, Meg E; Greenwood, Ken M; Goldie, Patricia A; Olney, Sandra J

    2006-06-01

    To determine the accuracy (criterion-related validity) of real-time clinical observations of push-off in gait after stroke. Criterion-related validity study of gait observations. Rehabilitation hospital in Australia. Eleven participants with stroke and 8 treating physical therapists. Not applicable. Pearson product-moment correlation between physical therapists' observations of push-off during gait and criterion measures of peak ankle power generation from a 3-dimensional motion analysis system. A high correlation was obtained between the observational ratings and the measurements of peak ankle power generation (Pearson r =.98). The standard error of estimation of ankle power generation was .32W/kg. Physical therapists can make accurate real-time clinical observations of push-off during gait following stroke.

  10. Empowered to Play: A Case Study Describing the Impact of Powered Mobility on the Exploratory Play of Disabled Children.

    Science.gov (United States)

    Sonday, Amshuda; Gretschel, Pam

    2016-03-01

    Exploratory play is one of the most vital ways in which children learn about their environment and develop. It is well documented that limited mobility restricts a child's ability to engage in their environment through exploratory play. In this study, a qualitative, collective case study design explored the impact of powered mobility on the exploratory play of two children with physical disabilities. Data were collected from the children, their parents and their siblings through participant observation and in-depth, informal interviews. This paper focuses on two themes: Opportunity to Play revealed how powered mobility increased opportunities for the children to become more actively engaged in exploratory play with others across a wider array of contexts, and My Child was Transformed highlighted significant changes in the affect and motivation of each child, which seemed to be linked to their increased internal control over their play choices. The findings suggest that the provision of powered mobility is a key contributor promoting the participation of physically disabled children in exploratory play. Because of undergraduate curricular constraints, a limitation of this study was that data were only confined to 2 months; affecting the depth of data gained that prolonged engagement would have offered. The study recommends for occupational therapy practice that occupational therapists advocate for easier access to powered mobility through governmental and policy means. The study also recommends further research be conducted on the experiences of the caregivers on how these powered mobility devices have influenced their day-to-day occupations. Copyright © 2015 John Wiley & Sons, Ltd.

  11. Assessing the stroke-specific quality of life for outcome measurement in stroke rehabilitation: minimal detectable change and clinically important difference.

    Science.gov (United States)

    Lin, Keh-chung; Fu, Tiffany; Wu, Ching-yi; Hsieh, Ching-ju

    2011-01-19

    This study was conducted to establish the minimal detectable change (MDC) and clinically important differences (CIDs) of the physical category of the Stroke-Specific Quality of Life Scale in patients with stroke. MDC and CIDs scores were calculated from the data of 74 participants enrolled in randomized controlled trials investigating the effects of two rehabilitation programs in patients with stroke. These participants received treatments for 3 weeks and underwent clinical assessment before and after treatment. To obtain test-retest reliability for calculating MDC, another 25 patients with chronic stroke were recruited. The MDC was calculated from the standard error of measurement (SEM) to indicate a real change with 95% confidence for individual patients (MDC95). Distribution-based and anchor-based methods were adopted to triangulate the ranges of minimal CIDs. The percentage of scale width was calculated by dividing the MDC and CIDs by the total score range of each physical category. The percentage of patients exceeding MDC95 and minimal CIDs was also reported. The MDC95 of the mobility, self-care, and upper extremity (UE) function subscales were 5.9, 4.0, and 5.3 respectively. The minimal CID ranges for these 3 subscales were 1.5 to 2.4, 1.2 to 1.9, and 1.2 to 1.8. The percentage of patients exceeding MDC95 and minimal CIDs of the mobility, self-care, and UE function subscales were 9.5% to 28.4%, 6.8% to 28.4%, and 12.2% to 33.8%, respectively. The change score of an individual patient has to reach 5.9, 4.0, and 5.3 on the 3 subscales to indicate a true change. The mean change scores of a group of patients with stroke on these subscales should reach the lower bound of CID ranges of 1.5 (6.3% scale width), 1.2 (6.0% scale width), and 1.2 (6.0% scale width) to be regarded as clinically important change. This information may facilitate interpretations of patient-reported outcomes after stroke rehabilitation. Future research is warranted to validate these findings.

  12. Guidance for Deployment of Mobile Technologies for Nuclear Power Plant Field Workers

    Energy Technology Data Exchange (ETDEWEB)

    Heather D. Medema; Ronald K. Farris

    2012-09-01

    This report is a guidance document prepared for the benefit of commercial nuclear power plants’ (NPPs) supporting organizations and personnel who are considering or undertaking deployment of mobile technology for the purpose of improving human performance and plant status control (PSC) for field workers in an NPP setting. This document especially is directed at NPP business managers, Electric Power Research Institute, Institute of Nuclear Power Operations, and other non-Information Technology personnel. This information is not intended to replace basic project management practices or reiterate these processes, but is to support decision-making, planning, and preparation of a business case.

  13. Neuropsychology and the relearning of motor skills following stroke

    NARCIS (Netherlands)

    Hochstenbach, J; Mulder, T

    Regaining independent mobility is one of the most important goals in physical therapy with patients suffering from the consequences of stroke. Both physical therapy and occupational therapy are learning processes in which the patient has to remaster old skills or has to learn novel skills. It is

  14. [NDT-Bobath method used in the rehabilitation of patients with a history of ischemic stroke].

    Science.gov (United States)

    Klimkiewicz, Paulina; Kubsik, Anna; Woldańska-Okońska, Marta

    2012-01-01

    Ischemic stroke is the third leading cause of death and disability in human. The vitally important problem after ischemic stroke is hemiparesis of the body. The most common methods used in improving the mobility of patients after ischemic stroke is a Bobath-NDT (Neuro-Developmental Treatment - Bobath), which initiated the Berta and Karel Bobath for children with cerebral palsy. It is a method designed to neurophysiological recovery of these vital functions that the patient was lost due to illness, and wants it back.

  15. Testing of mobile surveillance robot at a nuclear power plant

    International Nuclear Information System (INIS)

    White, J.R.; Harvey, H.W.; Farnstrom, K.A.

    1987-01-01

    In-plant testing of a mobile surveillance robot (SURBOT) was performed at the Browns Ferry Nuclear Plant by TVA personnel. The results verified that SURBOT can be used for remote surveillance in 54 separate controlled radiation rooms at the plant. High-quality color video, audio, and other data are collected, digitized by an on-board computer, and transmitted through a cable to the control console for real-time display and videotaping. TVA projects that the use of SURBOT for surveillance during plant operation will produce annual savings of about 100 person-rem radiation exposure and $200,000 in operating costs. Based on the successful results of this program, REMOTEC is now commercializing the SURBOT technology on both wheeled and tracked mobile robots for use in nuclear power plants and other hazardous environments

  16. Processes of early stroke care and hospital costs.

    Science.gov (United States)

    Svendsen, Marie Louise; Ehlers, Lars H; Hundborg, Heidi H; Ingeman, Annette; Johnsen, Søren P

    2014-08-01

    The relationship between processes of early stroke care and hospital costs remains unclear. We therefore examined the association in a population based cohort study. We identified 5909 stroke patients who were admitted to stroke units in a Danish county between 2005 and 2010.The examined recommended processes of care included early admission to a stroke unit, early initiation of antiplatelet or anticoagulant therapy, early computed tomography/magnetic resonance imaging (CT/MRI) scan, early physiotherapy and occupational therapy, early assessment of nutritional risk, constipation risk and of swallowing function, early mobilization,early catheterization, and early thromboembolism prophylaxis.Hospital costs were assessed for each patient based on the number of days spent in different in-hospital facilities using local hospital charges. The mean costs of hospitalization were $23 352 (standard deviation 27 827). The relationship between receiving more relevant processes of early stroke care and lower hospital costs followed a dose–response relationship. The adjusted costs were $24 566 (95% confidence interval 19 364–29 769) lower for patients who received 75–100% of the relevant processes of care compared with patients receiving 0–24%. All processes of care were associated with potential cost savings, except for early catheterization and early thromboembolism prophylaxis. Early care in agreement with key guidelines recommendations for the management of patients with stroke may be associated with hospital savings.

  17. Telestroke a viable option to improve stroke care in India.

    Science.gov (United States)

    Srivastava, Padma V; Sudhan, Paulin; Khurana, Dheeraj; Bhatia, Rohit; Kaul, Subash; Sylaja, P N; Moonis, Majaz; Pandian, Jeyaraj Durai

    2014-10-01

    In India, stroke care services are not well developed. There is a need to explore alternative options to tackle the rising burden of stroke. Telemedicine has been used by the Indian Space Research Organization (ISRO) to meet the needs of remote hospitals in India. The telemedicine network implemented by ISRO in 2001 presently stretches to around 100 hospitals all over the country, with 78 remote/rural/district health centers connected to 22 specialty hospitals in major cities, thus providing treatment to more than 25 000 patients, which includes stroke patients. Telemedicine is currently used in India for diagnosing stroke patients, subtyping stroke as ischemic or hemorrhagic, and treating accordingly. However, a dedicated telestroke system for providing acute stroke care is needed. Keeping in mind India's flourishing technology sector and leading communication networks, the hub-and-spoke model could work out really well in the upcoming years. Until then, simpler alternatives like smartphones, online data transfer, and new mobile applications like WhatsApp could be used. Telestroke facilities could increase the pool of patients eligible for thrombolysis. But this primary aim of telestroke can be achieved in India only if thrombolysis and imaging techniques are made available at all levels of health care. © 2014 World Stroke Organization.

  18. Measuring Scaling Effects in Small Two-Stroke Internal Combustion Engines

    Science.gov (United States)

    2014-06-20

    was used [9]. Compression ignition (CI) engines rely on auto - ignition to initiate combustion during an engine cycle. During intake, only air flows...9 Figure 2: Four-stroke IC engine cycle. (a) Intake stroke (b) Compression stroke (c) Ignition (d) Power...CAD crank angle degrees CI compression ignition COTS commercial off the shelf CoV coefficient of variance DAQ data acquisition system DI

  19. A Powered Lower Limb Orthosis for Providing Legged Mobility in Paraplegic Individuals.

    Science.gov (United States)

    Quintero, Hugo A; Farris, Ryan J; Hartigan, Clare; Clesson, Ismari; Goldfarb, Michael

    2011-01-01

    This paper presents preliminary results on the development of a powered lower limb orthosis intended to provide legged mobility (with the use of a stability aid, such as forearm crutches) to paraplegic individuals. The orthosis contains electric motors at both hip and both knee joints, which in conjunction with ankle-foot orthoses, provides appropriate joint kinematics for legged locomotion. The paper describes the orthosis and the nature of the controller that enables the SCI patient to command the device, and presents data from preliminary trials that indicate the efficacy of the orthosis and controller in providing legged mobility.

  20. Selection for inpatient rehabilitation after severe stroke: what factors influence rehabilitation assessor decision-making?

    Science.gov (United States)

    Hakkennes, Sharon; Hill, Keith D; Brock, Kim; Bernhardt, Julie; Churilov, Leonid

    2013-01-01

    This study aimed to identify factors that assessors considered important in decision-making regarding suitability for inpatient rehabilitation after acute severe stroke. Multi-site prospective observational cohort study. Consecutive acute, severe stroke patients and their assessors for inpatient rehabilitation. Rehabilitation assessors completed a questionnaire, rating the importance (10 point visual analogue scale) and direction (positive, negative or neutral) of 15 patient related and 2 organisational items potentially affecting their decision regarding patients' acceptance to rehabilitation. Of the 75 patients referred to rehabilitation and included in this study 61 (81.3%) were accepted for inpatient rehabilitation. The items considered to be most important in the decision to accept the patient for rehabilitation were pre-morbid cognition, pre-morbid mobility and pre-morbid communication. For those not accepted the most important items were current mobility, social support and current cognition. Factor analysis revealed 3 underlying factors, interpreted as post-stroke status, pre-morbid status, and social attributes, accounting for 61.8% of the total variance. All were independently associated with acceptance for rehabilitation (p decision making process for acceptance to rehabilitation following severe stroke. Future models for selection for rehabilitation should consider inclusion of these factors.

  1. Atorvastatin in stroke: a review of SPARCL and subgroup analysis

    Directory of Open Access Journals (Sweden)

    Branko N Huisa

    2010-03-01

    Full Text Available Branko N Huisa, Andrew B Stemer, Justin A ZivinDepartment of Neuroscience University of California, San Diego, CA, USAAbstract: Statin therapy in patients with cardiovascular disease is associated with reduced incidence of stroke. The Stroke Prevention by Aggressive Reduction of Cholesterol Levels (SPARCL trial showed daily treatment with 80 mg of atorvastatin in patients with a recent stroke or transient ischemic attack (TIA reduced the incidence of fatal or nonfatal stroke by 16%. Several post hoc analyses of different subgroups followed the SPARCL study. They have not revealed any significant differences when patients were sorted by age, sex, presence of carotid disease or type of stroke, with the exception of intracranial hemorrhage as the entry event. Lower low-density lipoprotein cholesterol levels in addition to possible neuroprotective mechanisms due to atorvastatin treatment correlate with improved risk reduction. Although not predefined subgroups and subject to an insufficient power, these post hoc studies have generated new clinical questions. However, clinicians should avoid denying therapy based on such subgroup analysis. At this point, the best evidence powerfully demonstrates stroke and TIA patients should be prescribed high dose statin therapy for secondary stroke prevention.Keywords: statins, intracranial hemorrhage, neuroprotection, outcome, prevention, carotid stenosis, transient ischemic attack

  2. Feasibility and utility of an integrated medical imaging and informatics smartphone system for management of acute stroke.

    Science.gov (United States)

    Shkirkova, Kristina; Akam, Eftitan Y; Huang, Josephine; Sheth, Sunil A; Nour, May; Liang, Conrad W; McManus, Michael; Trinh, Van; Duckwiler, Gary; Tarpley, Jason; Vinuela, Fernando; Saver, Jeffrey L

    2017-12-01

    Background Rapid dissemination and coordination of clinical and imaging data among multidisciplinary team members are essential for optimal acute stroke care. Aim To characterize the feasibility and utility of the Synapse Emergency Room mobile (Synapse ERm) informatics system. Methods We implemented the Synapse ERm system for integration of clinical data, computerized tomography, magnetic resonance, and catheter angiographic imaging, and real-time stroke team communications, in consecutive acute neurovascular patients at a Comprehensive Stroke Center. Results From May 2014 to October 2014, the Synapse ERm application was used by 33 stroke team members in 84 Code Stroke alerts. Patient age was 69.6 (±17.1), with 41.5% female. Final diagnosis was: ischemic stroke 64.6%, transient ischemic attack 7.3%, intracerebral hemorrhage 6.1%, and cerebrovascular-mimic 22.0%. Each patient Synapse ERm record was viewed by a median of 10 (interquartile range 6-18) times by a median of 3 (interquartile range 2-4) team members. The most used feature was computerized tomography, magnetic resonance, and catheter angiography image display. In-app tweet team, communications were sent by median 1 (interquartile range 0-1, range 0-13) users per case and viewed by median 1 (interquartile range 0-3, range 0-44) team members. Use of the system was associated with rapid treatment times, faster than national guidelines, including median door-to-needle 51.0 min (interquartile range 40.5-69.5) and median door-to-groin 94.5 min (interquartile range 85.5-121.3). In user surveys, the mobile information platform was judged easy to employ in 91% (95% confidence interval 65%-99%) of uses and of added help in stroke management in 50% (95% confidence interval 22%-78%). Conclusion The Synapse ERm mobile platform for stroke team distribution and integration of clinical and imaging data was feasible to implement, showed high ease of use, and moderate perceived added utility in therapeutic management.

  3. Clinical effect size of an educational intervention in the home and compliance with mobile phone-based reminders for people who suffer from stroke: protocol of a randomized controlled trial.

    Science.gov (United States)

    Merchán-Baeza, Jose Antonio; Gonzalez-Sanchez, Manuel; Cuesta-Vargas, Antonio

    2015-03-10

    Stroke is the third-leading cause of death and the leading cause of long-term neurological disability in the world. Cognitive, communication, and physical weakness combined with environmental changes frequently cause changes in the roles, routines, and daily occupations of stroke sufferers. Educational intervention combines didactic and interactive intervention, which combines the best choices for teaching new behaviors since it involves the active participation of the patient in learning. Nowadays, there are many types of interventions or means to increase adherence to treatment. The aim of this study is to enable patients who have suffered stroke and been discharged to their homes to improve the performance of the activities of daily living (ADL) in their home environment, based on advice given by the therapist. A secondary aim is that these patients continue the treatment through a reminder app installed on their mobile phones. This study is a clinical randomized controlled trial. The total sample will consist of 80 adults who have suffered a stroke with moderate severity and who have been discharged to their homes in the 3 months prior to recruitment to the study. The following tests and scales will be used to measure the outcome variables: Barthel Index, the Functional Independence Measure, the Mini-Mental State Examination, the Canadian Neurological Scale, the Stroke Impact Scale-16, the Trunk Control Test, the Modified Rankin Scale, the Multidimensional Scale of Perceived Social Support, the Quality of Life Scale for Stroke, the Functional Reach Test, the Romberg Test, the Time Up and Go test, the Timed-Stands Test, a portable dynamometer, and a sociodemographic questionnaire. Descriptive analyses will include mean, standard deviation, and 95% confidence intervals of the values for each variable. The Kolmogov-Smirnov (KS) test and a 2x2 mixed-model analysis of variance (ANOVA) will be used. Intergroup effect sizes will be calculated (Cohen's d). Currently

  4. Smart caching based on mobile agent of power WebGIS platform.

    Science.gov (United States)

    Wang, Xiaohui; Wu, Kehe; Chen, Fei

    2013-01-01

    Power information construction is developing towards intensive, platform, distributed direction with the expansion of power grid and improvement of information technology. In order to meet the trend, power WebGIS was designed and developed. In this paper, we first discuss the architecture and functionality of power WebGIS, and then we study caching technology in detail, which contains dynamic display cache model, caching structure based on mobile agent, and cache data model. We have designed experiments of different data capacity to contrast performance between WebGIS with the proposed caching model and traditional WebGIS. The experimental results showed that, with the same hardware environment, the response time of WebGIS with and without caching model increased as data capacity growing, while the larger the data was, the higher the performance of WebGIS with proposed caching model improved.

  5. Mechanical Implementation and Simulation of MoboLab, A Mobile Robot for Inspection of Power Transmission Lines

    Directory of Open Access Journals (Sweden)

    Mahmud Saadat Foumani

    2008-11-01

    Full Text Available This paper describes the first phase in development of a mobile robot that can navigate aerial power transmission lines completely unattended by human operator. Its ultimate purpose is to automate inspection of power transmission lines and their equipments. The authors have developed a scaled functional model of such a mobile robot with a preliminary simple computer based on-off controller. MoboLab (Mobile Laboratory navigates a power transmission line between two strain towers. It can maneuver over obstructions created by line equipments such as insulators, warning spheres, dampers, and spacer dampers. It can also easily negotiate the towers by its three flexible arms. MoboLab has an internal main screw which enables the robot to move itself or its two front and rear arms independently through changing gripped points. When the front arm gets close to an obstacle, the arm detaches from the line and goes down, the robot moves forward, the arm passes the obstacle and grippes the line again. In a same way another arms pass the obstacle.

  6. Stroke dynamics and frequency of 3 phacoemulsification machines.

    Science.gov (United States)

    Tognetto, Daniele; Cecchini, Paolo; Leon, Pia; Di Nicola, Marta; Ravalico, Giuseppe

    2012-02-01

    To measure the working frequency and the stroke dynamics of the phaco tip of 3 phacoemulsification machines. University Eye Clinic of Trieste, Italy. Experimental study. A video wet fixture was assembled to measure the working frequency using a micro camera and a micropulsed strobe-light system. A different video wet fixture was created to measure tip displacement as vectorial movement at different phaco powers using a microscopic video apparatus. The working frequency of the Infiniti Ozil machine was 43.0 kHz in longitudinal mode and 31.6 kHz in torsional mode. The frequency of the Whitestar Signature machine was 29.0 kHz in longitudinal mode and 38.0 kHz with the Ellips FX handpiece. The Stellaris machine had a frequency of 28.8 kHz. The longitudinal stroke of the 3 machines at different phaco powers was statistically significantly different. The Stellaris machine had the highest stroke extent (139 μm). The lateral movement of the Infiniti Ozil and Whitestar Signature machines differed significantly. No movement on the y-axis was observed for the Infiniti Ozil machine in torsional mode. The elliptical path of the Ellips FX handpiece had different x and y components at different phaco powers. The 3 phaco machines performed differently in terms of working frequency and stroke dynamics. The knowledge of the peculiar lateral and elliptical path strokes of Infiniti and Whitestar Signature machines may allow the surgeon to fully use these features for lens removal. Copyright © 2012 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  7. Gross domestic product and health expenditure associated with incidence, 30-day fatality, and age at stroke onset: a systematic review.

    Science.gov (United States)

    Sposato, Luciano A; Saposnik, Gustavo

    2012-01-01

    Differences in definitions of socioeconomic status and between study designs hinder their comparability across countries. We aimed to analyze the correlation between 3 widely used macrosocioeconomic status indicators and clinical outcomes. We selected population-based studies reporting incident stroke risk and/or 30-day case-fatality according to prespecified criteria. We used 3 macrosocioeconomic status indicators that are consistently defined by international agencies: per capita gross domestic product adjusted for purchasing power parity, total health expenditures per capita at purchasing power parity, and unemployment rate. We examined the correlation of each macrosocioeconomic status indicator with incident risk of stroke, 30-day case-fatality, proportion of hemorrhagic strokes, and age at stroke onset. Twenty-three articles comprising 30 population-based studies fulfilled the eligibility criteria. Age-adjusted incident risk of stroke using the standardized World Health Organization World population was associated to lower per capita gross domestic product adjusted for purchasing power parity (ρ=-0.661, P=0.027, R(2)=0.32) and total health expenditures per capita at purchasing power parity (ρ=-0.623, P=0.040, R(2)=0.26). Thirty-day case-fatality rates and proportion of hemorrhagic strokes were also related to lower per capita gross domestic product adjusted for purchasing power parity and total health expenditures per capita at purchasing power parity. Moreover, stroke occurred at a younger age in populations with low per capita gross domestic product adjusted for purchasing power parity and total health expenditures per capita at purchasing power parity. There was no correlation between unemployment rates and outcome measures. Lower per capita gross domestic product adjusted for purchasing power parity and total health expenditures per capita at purchasing power parity were associated with higher incident risk of stroke, higher case-fatality, a greater

  8. Automated Hydraulic System Design and Power Management in Mobile Applications

    DEFF Research Database (Denmark)

    Pedersen, Henrik Clemmensen

    force, torque and power density. One of these areas is the mobile hydraulic area, which generally comprise all type of off-highway machinery, such as construction equipment, agricultural equipment etc. But where hydraulic systems earlier was designed with primary focus on cost, dynamic performance...... and accuracy, energy consumption is becoming an ever more important design parameter. At the same time as the first oil crisis the first hydraulic load sensing (LS) systems also emerged on the market, which, compared to the other systems of the time, offered significant energy saving potentials and which today...... are found on most medium and high-end mobile hydraulic machinery. Despite the energy saving potentials that these systems posses, compared to the other open-circuit hydraulic system topologies, LS-system may still be subject to very low system efficiencies if not designed correctly. This is typically...

  9. A novel crustacean swimming stroke: coordinated four-paddled locomotion in the cypridoidean ostracode Cypridopsis vidua (Müller).

    Science.gov (United States)

    Hunt, Gene; Park, Lisa E; Labarbera, Michael

    2007-02-01

    Despite the diversity and ecological importance of cypridoidean ostracodes, there have been no kinematic studies of how they swim. We used regular and high-speed video of tethered ostracodes to document locomotion in the cypridoidean species Cypridopsis vidua. Swimming in this species is drag-based, with thrust provided by both antennulae and antennae. About 15 complete power and recovery strokes occur per second; maximal speeds for the limb tips were about 30 mm/s for the antennulae and 50 mm/s for the antennae. These speeds correspond to Reynolds numbers on the order of 10(-1) to 10(0) for the limb tips and 10(-2) to 10(-1) for the setae that extend outward from the swimming limbs and provide much of the surface area of the limb. The strokes of the four thrust-producing limbs are coordinated in a manner that seems to be unique among aquatic arthropods. When viewed from the anterior, power strokes are synchronized diagonally: left antennula and right antenna power strokes start at the same time and terminate just as the power strokes for the right antennula and left antenna begin. Because power strokes occur throughout the stroke cycle, swimming in this species is smoothly continuous, without the rapid accelerations and decelerations characteristic of most small aquatic arthropods.

  10. Controller Development for a Separate Meter-In Separate Meter-Out Fluid Power Valve for Mobile Applications

    OpenAIRE

    Nielsen, Brian

    2005-01-01

    In most mobile vehicles which are used within construction, agriculture, material handling, forestry, garbage handling etc. a fluid power system is used for power transport and power distribution. The transported/distributed power is usually generated by a diesel engine or from an electrical battery. The largest advantages of the fluid power system are its high energy density and its robustness. Currently there is no cost effective and robust alternative to using a fluid power system for the ...

  11. Digital compensation of receiver clipping for DVB reception on low-power mobile

    NARCIS (Netherlands)

    Linnartz, J.P.M.G.; Rietman, R.

    2007-01-01

    Battery life-time is a critical issue for digital television (DVB) viewing on mobile phones. The number of quantization steps used in the analog-to-digital converter (ADC) is an important factor in the total power consumption of a DVB receiver. The OFDM signals require a large resolution of the ADC.

  12. In Hospital Stroke Mortality: Rates and Determinants in Southwestern Saudi Arabia

    Directory of Open Access Journals (Sweden)

    Adel A. Alhazzani

    2018-05-01

    Full Text Available Objectives: The present study analyzed in-hospital first-time stroke mortality in southwestern Saudi Arabia over one-year to assess the in-hospital stroke case fatality rate, mortality rate and explore the factors associated with in-hospital stroke mortality. Study Design: Hospital based follow-up study. Methods: First-time stroke patients admitted to all hospitals in Asser region over one-year period (January through December 2016 were included in the study. Data about personal characteristics, pre-stroke history and clinical criteria, on admission clinical criteria, in-hospital complications and survival status were collected. The last reported Aseer region population was used to calculate age and sex stroke mortality rate per 100,000 population/year. Hazard ratios (HR and concomitant 95% confidence intervals (95% CI were computed using multivariate Cox regression survival analysis. Kaplan-Meier curve survival analysis for stroke patients were plotted. Results: A total of 121 in-hospital deaths out of 1249 first-time stroke patients giving an overall case fatality rate (CFR of 9.7%. Non-significant difference with gender and age were observed in CFR. Overall, in-hospital stroke mortality rate was 5.58 per 100,000/year. Males and elders showed a significantly higher mortality rates. Multivariable Cox regression analyses revealed pre-stroke smoking (HR = 2.36, pre-stroke hypertension (HR = 1.77, post-stroke disturbed consciousness (HR = 6.86, poor mobility (HR = 2.60 and developing pulmonary embolism (HR = 2.63 as significant predictors of in-hospital stroke mortality. Conclusions: In Southwestern Saudi Arabia, the in-hospital stroke mortality rate is higher in men and increases with aging. The prognosis of acute stroke could be improved by smoking cessation, better control of hypertension and prevention of in hospital complication particularly pulmonary embolism.

  13. Residential mobility of populations near UK power lines and implications for childhood leukaemia

    International Nuclear Information System (INIS)

    Swanson, John

    2013-01-01

    Epidemiological studies suggest associations between childhood leukaemia and living near high-voltage power lines, but the most obvious potential causative agent, the magnetic fields produced by the power lines, is not supported by laboratory studies or a known mechanism. An alternative hypothesised explanation is if there is greater population mobility near power lines, linking to the findings of Kinlen that population mixing increases leukaemia rates. We used the names recorded in electoral registers to see whether people near power lines move house more often than the population as a whole. We did find variations, but only small ones, and not such as to support the hypothesis. (note)

  14. Telestroke ambulances in prehospital stroke management: concept and pilot feasibility study.

    Science.gov (United States)

    Liman, Thomas G; Winter, Benjamin; Waldschmidt, Carolin; Zerbe, Norman; Hufnagl, Peter; Audebert, Heinrich J; Endres, Matthias

    2012-08-01

    Pre- and intrahospital time delays are major concerns in acute stroke care. Telemedicine-equipped ambulances may improve time management and identify patients with stroke eligible for thrombolysis by an early prehospital stroke diagnosis. The aims of this study were (1) to develop a telestroke ambulance prototype; (2) to test the reliability of stroke severity assessment; and (3) to evaluate its feasibility in the prehospital emergency setting. Mobil, real-time audio-video streaming telemedicine devices were implemented into advanced life support ambulances. Feasibility of telestroke ambulances and reliability of the National Institutes of Health Stroke Scale assessment were tested using current wireless cellular communication technology (third generation) in a prehospital stroke scenario. Two stroke actors were trained in simulation of differing right and left middle cerebral artery stroke syndromes. National Institutes of Health Stroke Scale assessment was performed by a hospital-based stroke physician by telemedicine, by an emergency physician guided by telemedicine, and "a posteriori" on the basis of video documentation. In 18 of 30 scenarios, National Institutes of Health Stroke Scale assessment could not be performed due to absence or loss of audio-video signal. In the remaining 12 completed scenarios, interrater agreement of National Institutes of Health Stroke Scale examination between ambulance and hospital and ambulance and "a posteriori" video evaluation was moderate to good with weighted κ values of 0.69 (95% CI, 0.51-0.87) and 0.79 (95% CI, 0.59-0.98), respectively. Prehospital telestroke examination was not at an acceptable level for clinical use, at least on the basis of the used technology. Further technical development is needed before telestroke is applicable for prehospital stroke management during patient transport.

  15. Power-Aware Intrusion Detection in Mobile Ad Hoc Networks

    Science.gov (United States)

    Şen, Sevil; Clark, John A.; Tapiador, Juan E.

    Mobile ad hoc networks (MANETs) are a highly promising new form of networking. However they are more vulnerable to attacks than wired networks. In addition, conventional intrusion detection systems (IDS) are ineffective and inefficient for highly dynamic and resource-constrained environments. Achieving an effective operational MANET requires tradeoffs to be made between functional and non-functional criteria. In this paper we show how Genetic Programming (GP) together with a Multi-Objective Evolutionary Algorithm (MOEA) can be used to synthesise intrusion detection programs that make optimal tradeoffs between security criteria and the power they consume.

  16. Nuclear power supports sensible entry into electric mobility; Kernenergie unterstuetzt den sinnvollen Einstieg in die Elektromobilitaet

    Energy Technology Data Exchange (ETDEWEB)

    Kuczera, Bernhard

    2010-10-15

    The German federal government established the environmental goal of reducing carbon emissions from 1,033 million t in 1990 by 40% to 620 million t/a by 2020. The Federal Environmental Office reports a reduction by 26% for the past economic crisis year of 2009 over the reference year. Consequently, further efforts are needed along these lines if the objective is to be reached in 2020. Towards this end, the German government and industry founded the National Electric Mobility Platform on May 3, 2010 in an effort to make Germany a lead market for electric mobility and have one million electric vehicles operate on German roads by 2020. Federal Chancellor Angela Merkel in addition demands mobility in future to be ''more independent of resources, less pollutant to the environment, and more sustainable.'' These target criteria basically are met in the power supply sector when nuclear power is used to generate electricity. Against this backdrop, perspectives of electric mobility are outlined in terms of their environmental characteristics, and various approaches to achieving adequate electricity supply are explained. In view of the boundary conditions in power technology and power economy, the agreement reached by the present coalition government on September 6, 2010 about extending the plant life of the 17 German nuclear power plants supports the objective referred to above. This compromise of coalition politics exercises a bridge function in providing for an average plant life extension of 12 years over the current plant life limitations. The federal government considers this plant life extension a key feature of its new overall energy concept, which is to be more independent of resources, less polluting to the environment, and more sustainable than the current status quo. (orig.)

  17. Output power distributions of mobile radio base stations based on network measurements

    International Nuclear Information System (INIS)

    Colombi, D; Thors, B; Persson, T; Törnevik, C; Wirén, N; Larsson, L-E

    2013-01-01

    In this work output power distributions of mobile radio base stations have been analyzed for 2G and 3G telecommunication systems. The approach is based on measurements in selected networks using performance surveillance tools part of the network Operational Support System (OSS). For the 3G network considered, direct measurements of output power levels were possible, while for the 2G networks, output power levels were estimated from measurements of traffic volumes. Both voice and data services were included in the investigation. Measurements were conducted for large geographical areas, to ensure good overall statistics, as well as for smaller areas to investigate the impact of different environments. For high traffic hours, the 90th percentile of the averaged output power was found to be below 65% and 45% of the available output power for the 2G and 3G systems, respectively.

  18. Output power distributions of mobile radio base stations based on network measurements

    Science.gov (United States)

    Colombi, D.; Thors, B.; Persson, T.; Wirén, N.; Larsson, L.-E.; Törnevik, C.

    2013-04-01

    In this work output power distributions of mobile radio base stations have been analyzed for 2G and 3G telecommunication systems. The approach is based on measurements in selected networks using performance surveillance tools part of the network Operational Support System (OSS). For the 3G network considered, direct measurements of output power levels were possible, while for the 2G networks, output power levels were estimated from measurements of traffic volumes. Both voice and data services were included in the investigation. Measurements were conducted for large geographical areas, to ensure good overall statistics, as well as for smaller areas to investigate the impact of different environments. For high traffic hours, the 90th percentile of the averaged output power was found to be below 65% and 45% of the available output power for the 2G and 3G systems, respectively.

  19. Magnetic Resonance Imaging of Stroke

    NARCIS (Netherlands)

    Bouts, Mark. J. R. J.; Wu, O.; Dijkhuizen, R. M.

    2017-01-01

    Magnetic resonance imaging (MRI) provides a powerful (neuro)imaging modality for the diagnosis and outcome prediction after (acute) stroke. Since MRI allows noninvasive, longitudinal, and three-dimensional assessment of vessel occlusion (with magnetic resonance angiography (MRA)), tissue injury

  20. A Framework for (Tele-) Monitoring of the Rehabilitation Progress in Stroke Patients: eHealth 2015 Special Issue.

    Science.gov (United States)

    Jagos, H; David, V; Haller, M; Kotzian, S; Hofmann, M; Schlossarek, S; Eichholzer, K; Winkler, M; Frohner, M; Reichel, M; Mayr, W; Rafolt, D

    2015-01-01

    Preservation of mobility in conjunction with an independent life style is one of the major goals of rehabilitation after stroke. The Rehab@Home framework shall support the continuation of rehabilitation at home. The framework consists of instrumented insoles, connected wirelessly to a 3G ready tablet PC, a server, and a web-interface for medical experts. The rehabilitation progress is estimated via automated analysis of movement data from standardized assessment tests which are designed according to the needs of stroke patients and executed via the tablet PC application. The Rehab@Home framework's implementation is finished and ready for the field trial (at five patients' homes). Initial testing of the automated evaluation of the standardized mobility tests shows reproducible results. Therefore it is assumed that the Rehab@Home framework is applicable as monitoring tool for the gait rehabilitation progress in stroke patients.

  1. Supporting Stroke Motor Recovery Through a Mobile Application: A Pilot Study.

    Science.gov (United States)

    Lawson, Sonia; Tang, Ziying; Feng, Jinjuan

    Neuroplasticity and motor learning are promoted with repetitive movement, appropriate challenge, and performance feedback. ARMStrokes, a smartphone application, incorporates these qualities to support motor recovery. Engaging exercises are easily accessible for improved compliance. In a multiple-case, mixed-methods pilot study, the potential of this technology for stroke motor recovery was examined. Exercises calibrated to the participant's skill level targeted forearm, elbow, and shoulder motions for a 6-wk protocol. Visual, auditory, and vibration feedback promoted self-assessment. Pre- and posttest data from 6 chronic stroke survivors who used the app in different ways (i.e., to measure active or passive motion, to track endurance) demonstrated improvements in accuracy of movements, fatigue, range of motion, and performance of daily activities. Statistically significant changes were not obtained with this pilot study. Further study on the efficacy of this technology is supported. Copyright © 2017 by the American Occupational Therapy Association, Inc.

  2. Knee posture during gait and global functioning post-stroke: a theoretical ICF framework using current measures in stroke rehabilitation

    OpenAIRE

    Neves Rosa, Marlene Cristina; Marques, Alda; Demain, Sara; Metcalf, Cheryl D.

    2015-01-01

    Purpose: To characterise the global functioning post-stroke in patients with normal knee posture (NKP) and abnormal knee posture (AKP) during loading-response. Methods: 35 people, 6 months post-stroke. with NKP and AKP were identified and assessed using clinical measures classified into the corresponding International Classification of Functioning, Disability and Health (ICF) domains: weight function (body mass index); muscle power (knee isometric strength); muscle tone (Modified Ashworth Sca...

  3. Two Strokes Diesel Engine - Promising Solution to Reduce CO2 Emissions

    OpenAIRE

    Tribotte, Pascal; Ravet, Frederic; Dugue, Vincent; Obernesser, Philippe; Quechon, Nicolas; Benajes, Jesus; Novella, Ricardo; De Lima, Daniela

    2012-01-01

    Two-stroke engines have dropped out of the automobile market for a long time due to severe drawbacks. Unfortunately, the comparison with the performances of four-stroke engines was not in favour of two-stroke ones. Nevertheless, the needs of a more compact engine with a better ratio of the mass and size versus power motivated research efforts at the beginning of the 90's. Regrettably, these efforts did not result in commercial success and automobile manufacturers kept four-stroke engine archi...

  4. Downlink power distributions for 2G and 3G mobile communication networks.

    Science.gov (United States)

    Colombi, Davide; Thors, Björn; Persson, Tomas; Wirén, Niklas; Larsson, Lars-Eric; Jonsson, Mikael; Törnevik, Christer

    2013-12-01

    Knowledge of realistic power levels is key when conducting accurate EMF exposure assessments. In this study, downlink output power distributions for radio base stations in 2G and 3G mobile communication networks have been assessed. The distributions were obtained from network measurement data collected from the Operations Support System, which normally is used for network monitoring and management. Significant amounts of data were gathered simultaneously for large sets of radio base stations covering wide geographical areas and different environments. The method was validated with in situ measurements. For the 3G network, the 90th percentile of the averaged output power during high traffic hours was found to be 43 % of the maximum available power. The corresponding number for 2G, with two or more transceivers installed, was 65 % or below.

  5. Cultural adaptation and validation of Stroke Impact Scale 3.0 version in Uganda: A small-scale study.

    Science.gov (United States)

    Kamwesiga, Julius T; von Koch, Lena; Kottorp, Anders; Guidetti, Susanne

    2016-01-01

    Knowledge is scarce about the impact of stroke in Uganda, and culturally adapted, psychometrically tested patient-reported outcome measures are lacking. The Stroke Impact Scale 3.0 is recommended, but it has not been culturally adapted and validated in Uganda. To culturally adapt and determine the psychometric properties of the Stroke Impact Scale 3.0 in the Ugandan context on a small scale. The Stroke Impact Scale 3.0 was culturally adapted to form Stroke Impact Scale 3.0 Uganda ( in English ) by involving 25 participants in three different expert committees. Subsequently, Stroke Impact Scale 3.0 Uganda from English to Luganda language was done in accordance with guidelines. The first language in Uganda is English and Luganda is the main spoken language in Kampala city and its surroundings. Translation of Stroke Impact Scale 3.0 Uganda ( both in English and Luganda ) was then tested psychometrically by applying a Rasch model on data collected from 95 participants with stroke. Overall, 10 of 59 (17%) items in the eight domains of the Stroke Impact Scale 3.0 were culturally adapted. The majority were 6 of 10 items in the domain Activities of Daily Living, 2 of 9 items in the domain Mobility, and 2 of 5 items in the domain Hand function. Only in two domains, all items demonstrated acceptable goodness of fit to the Rasch model. There were also more than 5% person misfits in the domains Participation and Emotion, while the Communication, Mobility, and Hand function domains had the lowest proportions of person misfits. The reliability coefficient was equal or larger than 0.90 in all domains except the Emotion domain, which was below the set criterion of 0.80 (0.75). The cultural adaptation and translation of Stroke Impact Scale 3.0 Uganda provides initial evidence of validity of the Stroke Impact Scale 3.0 when used in this context. The results provide support for several aspects of validity and precision but also point out issues for further adaptation and improvement

  6. Long-term functional outcome of pediatric stroke survivors.

    Science.gov (United States)

    Hurvitz, Edward; Warschausky, Seth; Berg, Michelle; Tsai, Shane

    2004-01-01

    To examine the long-term functional, psychosocial, and medical outcome of pediatric stroke survivors. This was a descriptive survey performed on patients with childhood stroke who participated in an earlier study. Measures included the Vineland Adaptive Behavior Scales (VABS) and the Diener Satisfaction with Life Scale. Current information on living situation, school placement, employment, and medical outcome were obtained. Twenty-nine (58%) patients participated. The mean age was 19.3 years (SD = 6.6), mean age of onset of stroke was 7.0 years (SD = 5.4), and mean follow-up time was 11.9 years (SD = 3.9). Diagnoses included hemorrhagic (31%) and ischemic (69%) stroke. All but one adult had finished high school, and the majority of participants had gone to college. 60% of patients over age 16 were employed. The average VABS levels for communication, daily living skills, socialization, and adaptive behavior fell into the moderately low range. Use of seizure medications and ADL dependence were the predictors for lower VABS levels (p life satisfaction. Patients who scored below adequate on VABS tended toward lower life satisfaction. Pediatric stroke survivors had good educational and mobility outcomes, but communication, ADL, and socialization fell into the low-moderate range. The different predictors of functional and subjective quality of life outcomes suggest that functional outcomes may mediate the relations between medical factors and satisfaction with life.

  7. Katanin spiral and ring structures shed light on power stroke for microtubule severing

    Energy Technology Data Exchange (ETDEWEB)

    Zehr, Elena; Szyk, Agnieszka; Piszczek, Grzegorz; Szczesna, Ewa; Zuo, Xiaobing; Roll-Mecak, Antonina

    2017-08-07

    Microtubule-severing enzymes katanin, spastin and fidgetin are AAA ATPases critical for the biogenesis and maintenance of complex microtubule arrays in axons, spindles and cilia. Because of a lack of 3D structures, their mechanism has remained poorly understood. We report the first X-ray structure of the monomeric AAA katanin module and cryo-EM reconstructions of the hexamer in two conformations. These reveal an unexpected asymmetric arrangement of the AAA domains mediated by structural elements unique to severing enzymes and critical for their function. Our reconstructions show that katanin cycles between open spiral and closed ring conformations, depending on the ATP occupancy of a gating protomer that tenses or relaxes inter-protomer interfaces. Cycling of the hexamer between these conformations would provide the power stroke for microtubule severing.

  8. Novel Long Stroke Reciprocating Compressor for Energy Efficient Jaggery Making

    Science.gov (United States)

    Rane, M. V.; Uphade, D. B.

    2017-08-01

    Novel Long Stroke Reciprocating Compressor is analysed for jaggery making while avoiding burning of bagasse for concentrating juice. Heat of evaporated water vapour along with small compressor work is recycled to enable boiling of juice. Condensate formed during heating of juice is pure water, as oil-less compressor is used. Superheat of compressor is suppressed by flow of superheated vapours through condensate. It limits heating surface temperature and avoids caramelization of sugar. Thereby improves quality of jaggery and eliminates need to use chemicals for colour improvement. Stroke to bore ratio is 0.6 to 1.2 in conventional reciprocating drives. Long stroke in reciprocating compressors enhances heat dissipation to surrounding by providing large surface area and increases isentropic efficiency by reducing compressor outlet temperature. Longer stroke increases inlet and exit valve operation timings, which reduces inertial effects substantially. Thereby allowing use of sturdier valves. This enables handling liquid along with vapour in compressors. Thereby supressing the superheat and reducing compressor power input. Longer stroke increases stroke to clearance ratios which increases volumetric efficiency and ability of compressor to compress through higher pressure ratios efficiently. Stress-strain simulation is performed in SolidWorks for gear drive. Long Stroke Reciprocating Compressor is developed at Heat Pump Laboratory, stroke/bore 292 mm/32 mm. It is operated and tested successfully at different speeds for operational stability of components. Theoretical volumetric efficiency is 93.9% at pressure ratio 2.0. Specific energy consumption is 108.3 kWhe/m3 separated water, considering free run power.

  9. High Thermoelectric Power Factor of High-Mobility 2D Electron Gas.

    Science.gov (United States)

    Ohta, Hiromichi; Kim, Sung Wng; Kaneki, Shota; Yamamoto, Atsushi; Hashizume, Tamotsu

    2018-01-01

    Thermoelectric conversion is an energy harvesting technology that directly converts waste heat from various sources into electricity by the Seebeck effect of thermoelectric materials with a large thermopower ( S ), high electrical conductivity (σ), and low thermal conductivity (κ). State-of-the-art nanostructuring techniques that significantly reduce κ have realized high-performance thermoelectric materials with a figure of merit ( ZT = S 2 ∙σ∙ T ∙κ -1 ) between 1.5 and 2. Although the power factor (PF = S 2 ∙σ) must also be enhanced to further improve ZT , the maximum PF remains near 1.5-4 mW m -1 K -2 due to the well-known trade-off relationship between S and σ. At a maximized PF, σ is much lower than the ideal value since impurity doping suppresses the carrier mobility. A metal-oxide-semiconductor high electron mobility transistor (MOS-HEMT) structure on an AlGaN/GaN heterostructure is prepared. Applying a gate electric field to the MOS-HEMT simultaneously modulates S and σ of the high-mobility electron gas from -490 µV K -1 and ≈10 -1 S cm -1 to -90 µV K -1 and ≈10 4 S cm -1 , while maintaining a high carrier mobility (≈1500 cm 2 V -1 s -1 ). The maximized PF of the high-mobility electron gas is ≈9 mW m -1 K -2 , which is a two- to sixfold increase compared to state-of-the-art practical thermoelectric materials.

  10. Speed-dependent body weight supported sit-to-stand training in chronic stroke: a case series.

    Science.gov (United States)

    Boyne, Pierce; Israel, Susan; Dunning, Kari

    2011-12-01

    Body weight support (BWS) and speed-dependent training protocols have each been used for poststroke gait training, but neither approach has been tested in the context of sit-to-stand (STS) training. This study evaluated the feasibility and outcomes of speed-dependent BWS STS training for 2 persons with chronic stroke. Two individuals 68 and 75 years old, and 2.3 and 8.7 years post-ischemic stroke, respectively, participated. Both exhibited right hemiparesis, required moderate (25%-50%) assistance for STS, and ambulated household distances with assistive devices. Participants performed speed-dependent BWS STS training 3 days/week for 45 to 60 minutes until able to perform STS independently. Gait parameters, the Stroke Impact Scale Mobility Domain (SIS-mobility), and the 3-Repetition STS test (3RSTS) were assessed before and after intervention. Each participant completed more than 750 STS repetitions over the course of the intervention, achieving independence in 8 to 11 sessions. Aside from muscle soreness, no adverse effects occurred. Participants also exhibited increased gait velocity (0.17-0.24 m/s and 0.25-0.42 m/s), SIS-mobility score (78-88 and 63-66), and decreased 3RSTS time (18-8 seconds and 40-21 seconds). Speed-dependent BWS STS training appears to be a feasible and promising method to increase STS independence and speed for persons with chronic stroke. In this small case series, a potential transfer effect to gait parameters was also observed. Future randomized controlled study is warranted to evaluate efficacy and long-term effects.

  11. Experimental Stroke Differentially Affects Discrete Subpopulations of Splenic Macrophages

    Directory of Open Access Journals (Sweden)

    Laura McCulloch

    2018-05-01

    Full Text Available Changes to the immune system after stroke are complex and can result in both pro-inflammatory and immunosuppressive consequences. Following ischemic stroke, brain resident microglia are activated and circulating monocytes are recruited to the injury site. In contrast, there is a systemic deactivation of monocytes/macrophages that may contribute to immunosuppression and the high incidence of bacterial infection experienced by stroke patients. The manipulation of macrophage subsets may be a useful therapeutic strategy to reduce infection and improve outcome in patients after stroke. Recent research has enhanced our understanding of the heterogeneity of macrophages even within the same tissue. The spleen is the largest natural reservoir of immune cells, many of which are mobilized to the site of injury after ischemic stroke and is notable for the diversity of its functionally distinct macrophage subpopulations associated with specific micro-anatomical locations. Here, we describe the effects of experimental stroke in mice on these distinct splenic macrophage subpopulations. Red pulp (RP and marginal zone macrophages (MZM specifically showed increases in density and alterations in micro-anatomical location. These changes were not due to increased recruitment from the bone marrow but may be associated with increases in local proliferation. Genes associated with phagocytosis and proteolytic processing were upregulated in the spleen after stroke with increased expression of the lysosome-associated protein lysosomal-associated membrane proteins specifically increased in RP and MZM subsets. In contrast, MHC class II expression was reduced specifically in these populations. Furthermore, genes associated with macrophage ability to communicate with other immune cells, such as co-stimulatory molecules and inflammatory cytokine production, were also downregulated in the spleen after stroke. These findings suggest that selective splenic macrophage functions

  12. The Siblings With Ischemic Stroke Study (SWISS Protocol

    Directory of Open Access Journals (Sweden)

    Hardy John

    2002-02-01

    Full Text Available Abstract Background Family history and twins studies suggest an inherited component to ischemic stroke risk. Candidate gene association studies have been performed but have limited capacity to identify novel risk factor genes. The Siblings With Ischemic Stroke Study (SWISS aims to conduct a genome-wide scan in sibling pairs concordant or discordant for ischemic stroke to identify novel genetic risk factors through linkage analysis. Methods Screening at multiple clinical centers identifies patients (probands with radiographically confirmed ischemic stroke and a family history of at least 1 living full sibling with stroke. After giving informed consent, without violating privacy among other family members, the proband invites siblings concordant and discordant for stroke to participate. Siblings then contact the study coordinating center. The diagnosis of ischemic stroke in potentially concordant siblings is confirmed by systematic centralized review of medical records. The stroke-free status of potentially discordant siblings is confirmed by validated structured telephone interview. Blood samples for DNA analysis are taken from concordant sibling pairs and, if applicable, from 1 discordant sibling. Epstein-Barr virus-transformed lymphoblastoid cell lines are created, and a scan of the human genome is planned. Discussion Conducting adequately powered genomics studies of stroke in humans is challenging because of the heterogeneity of the stroke phenotype and the difficulty of obtaining DNA samples from clinically well-characterized members of a cohort of stroke pedigrees. The multicentered design of this study is intended to efficiently assemble a cohort of ischemic stroke pedigrees without invoking community consent or using cold-calling of pedigree members.

  13. Power Optimization of Multimode Mobile Embedded Systems with Workload-Delay Dependency

    Directory of Open Access Journals (Sweden)

    Hoeseok Yang

    2016-01-01

    Full Text Available This paper proposes to take the relationship between delay and workload into account in the power optimization of microprocessors in mobile embedded systems. Since the components outside a device continuously change their values or properties, the workload to be handled by the systems becomes dynamic and variable. This variable workload is formulated as a staircase function of the delay taken at the previous iteration in this paper and applied to the power optimization of DVFS (dynamic voltage-frequency scaling. In doing so, a graph representation of all possible workload/mode changes during the lifetime of a device, Workload Transition Graph (WTG, is proposed. Then, the power optimization problem is transformed into finding a cycle (closed walk in WTG which minimizes the average power consumption over it. Out of the obtained optimal cycle of WTG, one can derive the optimal power management policy of the target device. It is shown that the proposed policy is valid for both continuous and discrete DVFS models. The effectiveness of the proposed power optimization policy is demonstrated with the simulation results of synthetic and real-life examples.

  14. Pediatric Stroke

    Science.gov (United States)

    ... and Patient Resources Home » Patients & Families » About Stroke » Pediatric Stroke » Introduction Introduction What is a Stroke? Ischemic Stroke Intracerebral Hemorrhage Subarachnoid Hemorrhage Pediatric Stroke Introduction Types of Stroke Diagnosis and Treatment ...

  15. Energy and Power Measurements for Network Coding in the Context of Green Mobile Clouds

    DEFF Research Database (Denmark)

    Paramanathan, Achuthan; Pedersen, Morten Videbæk; Roetter, Daniel Enrique Lucani

    2013-01-01

    results for inter-session network coding in Open-Mesh routers underline that the energy invested in performing network coding pays off by dramatically reducing the total energy for the transmission of data over wireless links. We also show measurements for intra-session network coding in three different......This paper presents an in-depth power and energy measurement campaign for inter- and intra-session network coding enabled communication in mobile clouds. The measurements are carried out on different commercial platforms with focus on routers and mobile phones with different CPU capabilities. Our...

  16. Incidence and predictors of new-onset constipation during acute hospitalisation after stroke.

    Science.gov (United States)

    Lim, S-F; Ong, S Y; Tan, Y L; Ng, Y S; Chan, Y H; Childs, C

    2015-04-01

    We investigated new-onset constipation in patients with stroke compared with orthopaedic conditions and explored the predictors associated with constipation during acute hospitalisation. This was a prospective matched cohort study of 110 patients comparing stroke patients (n = 55) with orthopaedic patients (n = 55) admitted to a large tertiary acute hospital. Both cohorts were matched by age and sex. The incidence of new-onset constipation which occurred during a patient's acute hospitalisation was determined. Demographics, comorbidity, clinical factors, laboratory parameters and medications were evaluated as possible predictors of constipation. The incidence of new-onset constipation was high for both stroke (33%) and orthopaedic patients (27%; p = 0.66). Seven stroke patients (39%) and four orthopaedic patients (27%) developed their first onset of constipation on day 2 of admission. Mobility gains (RR 0.741, p constipation. Bedpan use (RR 2.058, p constipation. New-onset constipation is common among patients admitted for stroke and orthopaedic conditions during acute hospitalisation. The early occurrence, on day 2 of admission, calls for prompt preventive intervention for constipation. © 2015 John Wiley & Sons Ltd.

  17. Stroke mimic diagnoses presenting to a hyperacute stroke unit.

    Science.gov (United States)

    Dawson, Ang; Cloud, Geoffrey C; Pereira, Anthony C; Moynihan, Barry J

    2016-10-01

    Stroke services have been centralised in several countries in recent years. Diagnosing acute stroke is challenging and a high proportion of patients admitted to stroke units are diagnosed as a non-stroke condition (stroke mimics). This study aims to describe the stroke mimic patient group, including their impact on stroke services. We analysed routine clinical data from 2,305 consecutive admissions to a stroke unit at St George's Hospital, London. Mimic groupings were derived from 335 individual codes into 17 groupings. From 2,305 admissions, 555 stroke mimic diagnoses were identified (24.2%) and 72% of stroke mimics had at least one stroke risk factor. Common mimic diagnoses were headache, seizure and syncope. Medically unexplained symptoms and decompensation of underlying conditions were also common. Median length of stay was 1 day; a diagnosis of dementia (p=0.028) or needing MRI (p=0.006) was associated with a longer stay. Despite emergency department assessment by specialist clinicians and computed tomography brain, one in four suspected stroke patients admitted to hospital had a non-stroke diagnosis. Stroke mimics represent a heterogeneous patient group with significant impacts on stroke services. Co-location of stroke and acute neurology services may offer advantages where service reorganisation is being considered. © Royal College of Physicians 2016. All rights reserved.

  18. Simulating Global AeroMACS Airport Ground Station Antenna Power Transmission Limits to Avoid Interference With Mobile Satellite Service Feeder Uplinks

    Science.gov (United States)

    Wilson, Jeffrey D.

    2013-01-01

    The Aeronautical Mobile Airport Communications System (AeroMACS), which is based upon the IEEE 802.16e mobile wireless standard, is expected to be implemented in the 5091 to 5150 MHz frequency band. As this band is also occupied by Mobile Satellite Service feeder uplinks, AeroMACS must be designed to avoid interference with this incumbent service. The aspects of AeroMACS operation that present potential interference are under analysis in order to enable the definition of standards that assure that such interference will be avoided. In this study, the cumulative interference power distribution at low Earth orbit from transmitters at global airports was simulated with the Visualyse Professional software. The dependence of the interference power on antenna distribution, gain patterns, duty cycle, and antenna tilt was simulated. As a function of these parameters, the simulation results are presented in terms of the limitations on transmitter power from global airports required to maintain the cumulative interference power under the established threshold.

  19. The Reliability and Validity of the Japanese Version of the Stroke Impact Scale Version 3.0.

    Science.gov (United States)

    Ochi, Mitsuhiro; Ohashi, Hiroshi; Hachisuka, Kenji; Saeki, Satoru

    It is important to evaluate body functions and structures, activity, and participation in stroke rehabilitation. The Stroke Impact Scale (SIS), a new stroke-specific self-report measure that was developed by Duncan et al, is widely used to measure multidimensional consequences about health-related quality of life. The SIS version 3.0 includes 9 domains (strength, hand function, activity of daily living and instrumental activity of daily living, mobility, communication, emotion, memory and thinking, participation, and recovery). Patients are asked to make a percentage rating of their recovery since their stroke on a visual analog scale of 0 to 100 for the stroke recovery domain. Each item in the 8 domains other than stroke recovery are scored in a range of 1 to 5 as a raw score and calculated using the manual to a final score. We developed a Japanese version of the SIS version 3.0 and assessed its reliability and validity in 32 chronic stroke survivors. The internal consistency (Cronbach's α 3.0 is valid, reliable, and clinically useful for stroke survivors.

  20. Mobile telephones: a comparison of radiated power between 3G VoIP calls and 3G VoCS calls.

    Science.gov (United States)

    Jovanovic, Dragan; Bragard, Guillaume; Picard, Dominique; Chauvin, Sébastien

    2015-01-01

    The purpose of this study is to assess the mean RF power radiated by mobile telephones during voice calls in 3G VoIP (Voice over Internet Protocol) using an application well known to mobile Internet users, and to compare it with the mean power radiated during voice calls in 3G VoCS (Voice over Circuit Switch) on a traditional network. Knowing that the specific absorption rate (SAR) is proportional to the mean radiated power, the user's exposure could be clearly identified at the same time. Three 3G (High Speed Packet Access) smartphones from three different manufacturers, all dual-band for GSM (900 MHz, 1800 MHz) and dual-band for UMTS (900 MHz, 1950 MHz), were used between 28 July and 04 August 2011 in Paris (France) to make 220 two-minute calls on a mobile telephone network with national coverage. The places where the calls were made were selected in such a way as to describe the whole range of usage situations of the mobile telephone. The measuring equipment, called "SYRPOM", recorded the radiation power levels and the frequency bands used during the calls with a sampling rate of 20,000 per second. In the framework of this study, the mean normalised power radiated by a telephone in 3G VoIP calls was evaluated at 0.75% maximum power of the smartphone, compared with 0.22% in 3G VoCS calls. The very low average power levels associated with use of 3G devices with VoIP or VoCS support the view that RF exposure resulting from their use is far from exceeding the basic restrictions of current exposure limits in terms of SAR.

  1. Channel Access and Power Control for Mobile Crowdsourcing in Device-to-Device Underlaid Cellular Networks

    Directory of Open Access Journals (Sweden)

    Yue Ma

    2018-01-01

    Full Text Available With the access of a myriad of smart handheld devices in cellular networks, mobile crowdsourcing becomes increasingly popular, which can leverage omnipresent mobile devices to promote the complicated crowdsourcing tasks. Device-to-device (D2D communication is highly desired in mobile crowdsourcing when cellular communications are costly. The D2D cellular network is more preferable for mobile crowdsourcing than conventional cellular network. Therefore, this paper addresses the channel access and power control problem in the D2D underlaid cellular networks. We propose a novel semidistributed network-assisted power and a channel access control scheme for D2D user equipment (DUE pieces. It can control the interference from DUE pieces to the cellular user accurately and has low information feedback overhead. For the proposed scheme, the stochastic geometry tool is employed and analytic expressions are derived for the coverage probabilities of both the cellular link and D2D links. We analyze the impact of key system parameters on the proposed scheme. The Pareto optimal access threshold maximizing the total area spectral efficiency is obtained. Unlike the existing works, the performances of the cellular link and D2D links are both considered. Simulation results show that the proposed method can improve the total area spectral efficiency significantly compared to existing schemes.

  2. Group therapy task training versus individual task training during inpatient stroke rehabilitation: a randomised controlled trial.

    Science.gov (United States)

    Renner, Caroline Ie; Outermans, Jacqueline; Ludwig, Ricarda; Brendel, Christiane; Kwakkel, Gert; Hummelsheim, Horst

    2016-07-01

    To compare the efficacy of intensive daily applied progressive group therapy task training with equally dosed individual progressive task training on self-reported mobility for patients with moderate to severe stroke during inpatient rehabilitation. Randomized controlled clinical trial. In-patient rehabilitation center. A total of 73 subacute patients with stroke who were not able to walk without physical assistance at randomisation. Patients were allocated to group therapy task training (GT) or individual task training (IT). Both interventions were intended to improve walking competency and comprised 30 sessions of 90 minutes over six weeks. Primary outcome was the mobility domain of the Stroke Impact Scale (SIS-3.0). Secondary outcomes were the other domains of SIS-3.0, standing balance, gait speed, walking distance, stair climbing, fatigue, anxiety and depression. No adverse events were reported in either arm of the trial. There were no significant differences between groups for the SIS mobility domain at the end of the intervention (Z= -0.26, P = 0.79). No significant differences between groups were found in gait speed improvements (GT:0.38 ±0.23; IT:0.26±0.35), any other gait related parameters, or in non-physical outcomes such as depression and fatigue. Inpatient group therapy task training for patients with moderate to severe stroke is safe and equally effective as a dose-matched individual task training therapy. Group therapy task training may be delivered as an alternative to individual therapy or as valuable adjunct to increase time spent in gait-related activities. © The Author(s) 2015.

  3. Towards High Power Density Metal Supported Solid Oxide Fuel Cell for Mobile Applications

    DEFF Research Database (Denmark)

    Nielsen, Jimmi; Persson, Åsa H.; Muhl, Thuy Thanh

    2018-01-01

    For use of metal supported solid oxide fuel cell (MS-SOFC) in mobile applications it is important to reduce the thermal mass to enable fast startup, increase stack power density in terms of weight and volume and reduce costs. In the present study, we report on the effect of reducing the Technical...

  4. Telemedicine Based on Mobile Devices and Mobile Cloud Computing

    OpenAIRE

    Lidong Wang; Cheryl Ann Alexander

    2014-01-01

    Mobile devices such as smartphones and tablets support kinds of mobile computing and services. They can access to the cloud or offload the computation-intensive part to the cloud computing resources. Mobile cloud computing (MCC) integrates the cloud computing into the mobile environment, which extends mobile devices’ battery lifetime, improves their data storage capacity and processing power, and improves their reliability and information security. In this paper, the applications of smartphon...

  5. Combined Effect of Random Transmit Power Control and Inter-Path Interference Cancellation on DS-CDMA Packet Mobile Communications

    Science.gov (United States)

    Kudoh, Eisuke; Ito, Haruki; Wang, Zhisen; Adachi, Fumiyuki

    In mobile communication systems, high speed packet data services are demanded. In the high speed data transmission, throughput degrades severely due to severe inter-path interference (IPI). Recently, we proposed a random transmit power control (TPC) to increase the uplink throughput of DS-CDMA packet mobile communications. In this paper, we apply IPI cancellation in addition to the random TPC. We derive the numerical expression of the received signal-to-interference plus noise power ratio (SINR) and introduce IPI cancellation factor. We also derive the numerical expression of system throughput when IPI is cancelled ideally to compare with the Monte Carlo numerically evaluated system throughput. Then we evaluate, by Monte-Carlo numerical computation method, the combined effect of random TPC and IPI cancellation on the uplink throughput of DS-CDMA packet mobile communications.

  6. Inter-generational micro-class mobility during and after socialism: The power, education, autonomy, capital, and horizontal (PEACH) model in Hungary.

    Science.gov (United States)

    Lippényi, Zoltán; Gerber, Theodore P

    2016-07-01

    We propose a theoretical model of how occupational mobility operates differently under socialism than under market regimes. Our model specifies four vertical dimensions of occupational resources-power, education, autonomy, and capital-plus a horizontal dimension consisting of linkages among occupations in the same economic branch. Given the nature of state socialist political-economic institutions, we expect power to exhibit much stronger effects in the socialist mobility regime, while autonomy and capital should play greater stratifying roles after the market transition. Education should have stable effects, and horizontal linkages should diminish in strength with market reforms. We estimate our model's parameters using data from surveys conducted in Hungary during and after the socialist period. We adopt a micro-class approach, though we test it against approaches that use more aggregated class categories. Our model provides a superior fit to other mobility models, and our results confirm our hypotheses about the distinctive features of the state socialist mobility regime. Mobility researchers often look for common patterns characterizing mobility in all industrialized societies. Our findings suggest that national institutions can produce fundamentally distinct patterns of mobility. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. Physiological Effects of Early Incremental Mobilization of a Patient with Acute Intracerebral and Intraventricular Hemorrhage Requiring Dual External Ventricular Drainage.

    Science.gov (United States)

    Kumble, Sowmya; Zink, Elizabeth K; Burch, Mackenzie; Deluzio, Sandra; Stevens, Robert D; Bahouth, Mona N

    2017-08-01

    Recent trials have challenged the notion that very early mobility benefits patients with acute stroke. It is unclear how cerebral autoregulatory impairments, prevalent in this population, could be affected by mobilization. The safety of mobilizing patients who have external ventricular drainage (EVD) devices for cerebrospinal fluid diversion and intracranial pressure (ICP) monitoring is another concern due to risk of device dislodgment and potential elevation in ICP. We report hemodynamic and ICP responses during progressive, device-assisted mobility interventions performed in a critically ill patient with intracerebral hemorrhage (ICH) requiring two EVDs. A 55-year-old man was admitted to the Neuroscience Critical Care Unit with an acute thalamic ICH and complex intraventricular hemorrhage requiring placement of two EVDs. Progressive mobilization was achieved using mobility technology devices. Range of motion exercises were performed initially, progressing to supine cycle ergometry followed by incremental verticalization using a tilt table. Physiological parameters were recorded before and after the interventions. All mobility interventions were completed without any adverse event or clinically detectable change in the patient's neurological state. Physiological parameters including hemodynamic variables and ICP remained within prescribed goals throughout. Progressive, device-assisted early mobilization was feasible and safe in this critically ill patient with hemorrhagic stroke when titrated by an interdisciplinary team of skilled healthcare professionals. Studies are needed to gain insight into the hemodynamic and neurophysiological responses associated with early mobility in acute stroke to identify subsets of patients who are most likely to benefit from this intervention.

  8. Mobile Election

    OpenAIRE

    Long, Elena; Lovitskii, Vladimir; Thrasher, Michael; Traynor, David

    2009-01-01

    Mobile phones have the potential of fostering political mobilisation. There is a significant political power in mobile technology. Like the Internet, mobile phones facilitate communication and rapid access to information. Compared to the Internet, however, mobile phone diffusion has reached a larger proportion of the population in most countries, and thus the impact of this new medium is conceivably greater. There are now more mobile phones in the UK than there are people (ave...

  9. Down-link power distributions for 2G and 3G mobile communication networks

    International Nuclear Information System (INIS)

    Colombi, D.; Thors, B.; Persson, T.; Wiren, N.; Larsson, L. E.; Jonsson, M.; Toernevik, C.

    2013-01-01

    Knowledge of realistic power levels is key when conducting accurate EMF exposure assessments. In this study, down-link output power distributions for radio base stations in 2G and 3G mobile communication networks have been assessed. The distributions were obtained from network measurement data collected from the Operations Support System, which normally is used for network monitoring and management. Significant amounts of data were gathered simultaneously for large sets of radio base stations covering wide geographical areas and different environments. The method was validated with in situ measurements. For the 3G network, the 90. percentile of the averaged output power during high traffic hours was found to be 43 % of the maximum available power. The corresponding number for 2G, with two or more transceivers installed, was 65 % or below. (authors)

  10. Towards High Power Density Metal Supported Solid Oxide Fuel Cell for Mobile Applications

    DEFF Research Database (Denmark)

    Nielsen, Jimmi; Persson, Åsa Helen; Muhl, Thuy

    2017-01-01

    For use of metal supported SOFC in mobile applications it is important to reduce the thermal mass to enable fast start up, increase stack power density in terms of weight and volume and reduce costs. In the present study, we report on the effect of reducing the support layer thickness of 313 μm...

  11. Cultural adaptation and validation of Stroke Impact Scale 3.0 version in Uganda: A small-scale study

    Directory of Open Access Journals (Sweden)

    Julius T Kamwesiga

    2016-09-01

    Full Text Available Background: Knowledge is scarce about the impact of stroke in Uganda, and culturally adapted, psychometrically tested patient-reported outcome measures are lacking. The Stroke Impact Scale 3.0 is recommended, but it has not been culturally adapted and validated in Uganda. Objective: To culturally adapt and determine the psychometric properties of the Stroke Impact Scale 3.0 in the Ugandan context on a small scale. Method: The Stroke Impact Scale 3.0 was culturally adapted to form Stroke Impact Scale 3.0 Uganda (in English by involving 25 participants in three different expert committees. Subsequently, Stroke Impact Scale 3.0 Uganda from English to Luganda language was done in accordance with guidelines. The first language in Uganda is English and Luganda is the main spoken language in Kampala city and its surroundings. Translation of Stroke Impact Scale 3.0 Uganda (both in English and Luganda was then tested psychometrically by applying a Rasch model on data collected from 95 participants with stroke. Results: Overall, 10 of 59 (17% items in the eight domains of the Stroke Impact Scale 3.0 were culturally adapted. The majority were 6 of 10 items in the domain Activities of Daily Living, 2 of 9 items in the domain Mobility, and 2 of 5 items in the domain Hand function. Only in two domains, all items demonstrated acceptable goodness of fit to the Rasch model. There were also more than 5% person misfits in the domains Participation and Emotion, while the Communication, Mobility, and Hand function domains had the lowest proportions of person misfits. The reliability coefficient was equal or larger than 0.90 in all domains except the Emotion domain, which was below the set criterion of 0.80 (0.75. Conclusion: The cultural adaptation and translation of Stroke Impact Scale 3.0 Uganda provides initial evidence of validity of the Stroke Impact Scale 3.0 when used in this context. The results provide support for several aspects of validity and precision

  12. Cultural adaptation and validation of Stroke Impact Scale 3.0 version in Uganda: A small-scale study

    Science.gov (United States)

    Kamwesiga, Julius T; von Koch, Lena; Kottorp, Anders; Guidetti, Susanne

    2016-01-01

    Background: Knowledge is scarce about the impact of stroke in Uganda, and culturally adapted, psychometrically tested patient-reported outcome measures are lacking. The Stroke Impact Scale 3.0 is recommended, but it has not been culturally adapted and validated in Uganda. Objective: To culturally adapt and determine the psychometric properties of the Stroke Impact Scale 3.0 in the Ugandan context on a small scale. Method: The Stroke Impact Scale 3.0 was culturally adapted to form Stroke Impact Scale 3.0 Uganda (in English) by involving 25 participants in three different expert committees. Subsequently, Stroke Impact Scale 3.0 Uganda from English to Luganda language was done in accordance with guidelines. The first language in Uganda is English and Luganda is the main spoken language in Kampala city and its surroundings. Translation of Stroke Impact Scale 3.0 Uganda (both in English and Luganda) was then tested psychometrically by applying a Rasch model on data collected from 95 participants with stroke. Results: Overall, 10 of 59 (17%) items in the eight domains of the Stroke Impact Scale 3.0 were culturally adapted. The majority were 6 of 10 items in the domain Activities of Daily Living, 2 of 9 items in the domain Mobility, and 2 of 5 items in the domain Hand function. Only in two domains, all items demonstrated acceptable goodness of fit to the Rasch model. There were also more than 5% person misfits in the domains Participation and Emotion, while the Communication, Mobility, and Hand function domains had the lowest proportions of person misfits. The reliability coefficient was equal or larger than 0.90 in all domains except the Emotion domain, which was below the set criterion of 0.80 (0.75). Conclusion: The cultural adaptation and translation of Stroke Impact Scale 3.0 Uganda provides initial evidence of validity of the Stroke Impact Scale 3.0 when used in this context. The results provide support for several aspects of validity and precision but also point

  13. Determinations of vertical stroke V{sub cb} vertical stroke and vertical stroke V{sub ub} vertical stroke from baryonic Λ{sub b} decays

    Energy Technology Data Exchange (ETDEWEB)

    Hsiao, Y.K. [Shanxi Normal University, School of Physics and Information Engineering, Linfen (China); National Tsing Hua University, Department of Physics, Hsinchu (China); Geng, C.Q. [Shanxi Normal University, School of Physics and Information Engineering, Linfen (China); National Tsing Hua University, Department of Physics, Hsinchu (China); Hunan Normal University, Synergetic Innovation Center for Quantum Effects and Applications (SICQEA), Changsha (China)

    2017-10-15

    We present the first attempt to extract vertical stroke V{sub cb} vertical stroke from the Λ{sub b} → Λ{sub c}{sup +}l anti ν{sub l} decay without relying on vertical stroke V{sub ub} vertical stroke inputs from the B meson decays. Meanwhile, the hadronic Λ{sub b} → Λ{sub c}M{sub (c)} decays with M = (π{sup -},K{sup -}) and M{sub c} =(D{sup -},D{sup -}{sub s}) measured with high precisions are involved in the extraction. Explicitly, we find that vertical stroke V{sub cb} vertical stroke =(44.6 ± 3.2) x 10{sup -3}, agreeing with the value of (42.11 ± 0.74) x 10{sup -3} from the inclusive B → X{sub c}l anti ν{sub l} decays. Furthermore, based on the most recent ratio of vertical stroke V{sub ub} vertical stroke / vertical stroke V{sub cb} vertical stroke from the exclusive modes, we obtain vertical stroke V{sub ub} vertical stroke = (4.3 ± 0.4) x 10{sup -3}, which is close to the value of (4.49 ± 0.24) x 10{sup -3} from the inclusive B → X{sub u}l anti ν{sub l} decays. We conclude that our determinations of vertical stroke V{sub cb} vertical stroke and vertical stroke V{sub ub} vertical stroke favor the corresponding inclusive extractions in the B decays. (orig.)

  14. Functional improvements following the use of the NVT Vision Rehabilitation program for patients with hemianopia following stroke.

    Science.gov (United States)

    Hayes, Allison; Chen, Celia S; Clarke, Gayle; Thompson, Annette

    2012-01-01

    The incidence of visual deficits following stroke ranges from 20%-68% and has significant impact on activities of daily living. The NVT system is a compensatory visual scanning training program that consists of combined static and mobility training and transfer to activities of daily living. The study aims to evaluate functional changes following the NVT program for people who have homonymous hemianopia (HH) following stroke. Interventional case series of 13 consecutive participants with HH undergoing NVT vision rehabilitation. The primary outcome measure was the number of targets missed on a standardized Mobility Assessment Course (MAC). Other outcome measures included assessment of visual scanning, vision specific Quality of Life questionnaires and reading performance. The average number of targets (sd) missed on the MAC course was 39.6 ± 20.9% before intervention, 27.5 ± 16.3% immediately post intervention and 20.8 ± 15.5% at 3 months post rehabilitation. The study showed a statistically significant trend in improvement in mobility related subscales of National Eye Institute Visual Function Questionnaire-NEI VFQ-25 (p=0.003) and the Veteran Affairs Low Vision Visual Function Questionnaire-VA LVFQ-48 (p=0.036) at 3 months post rehabilitation. The NVT intervention resulted in functional improvements in mobility post rehabilitation. The NVT training showed improvement in vision specific quality of life. There is a need for standardised vision therapy intervention, in conjunction with existing rehabilitation services, for patients with stroke and traumatic brain injury.

  15. Perceiving the affordance of string tension for power strokes in badminton: expertise allows effective use of all string tensions.

    Science.gov (United States)

    Zhu, Qin

    2013-01-01

    Affordances mean opportunities for action. These affordances are important for sports performance and relevant to the abilities developed by skilled athletes. In racquet sports such as badminton, different players prefer widely different string tension because it is believed to provide opportunities for effective strokes. The current study examined whether badminton players can perceive the affordance of string tension for power strokes and whether the perception of affordance itself changed as a function of skill level. The results showed that string tension constrained the striking performance of both novice and recreational players, but not of expert players. When perceptual capability was assessed, perceptual mode did not affect perception of the optimal string tension. Skilled players successfully perceived the affordance of string tension, but only experts were concerned about saving energy. Our findings demonstrated that perception of the affordance of string tension in badminton was determined by action abilities. Furthermore, experts could adjust the action to maintain a superior level of performance based on the perception of affordance.

  16. Cryptogenic Stroke

    Directory of Open Access Journals (Sweden)

    Mohammad Saadatnia

    2017-02-01

    Full Text Available Cryptogenic stroke is defined as brain infarction that is not attributable to a source of definite embolism, large artery atherosclerosis, or small artery disease despite a thorough vascular, cardiac, and serologic evaluation. Despite many advances in our understanding of ischemic stroke, cryptogenic strokes remain a diagnostic and therapeutic challenge. The pathophysiology of cryptogenic stroke is likely various. Probable mechanisms include cardiac embolism secondary to occult paroxysmal atrial fibrillation, aortic atheromatous disease or other cardiac sources, paradoxical embolism from atrial septal abnormalities such as patent foramen ovale, hypercoagulable states, and preclinical or subclinical cerebrovascular disease.  Cryptogenic stroke is one-fourth among cerebral infarction, but most of them could be ascribed to embolic stroke. A significant proportion of cryptogenic strokes adhere to embolic infarct topography on brain imaging and improvement in our ability to detect paroxysmal atrial fibrillation in patients with cryptogenic stroke has strengthened the idea that these strokes are embolic in nature. a significant proportion of cryptogenic strokes adhere to embolic infarct topography on brain imaging.embolic stroke of undetermined sources(ESUS was planned for unifying embolic stroke of undetermined source.  The etiologies underlying ESUS included minor-risk potential cardioembolic sources, covert paroxysmal atrial fibrillation, cancer-associated coagulopathy and embolism, arteriogenic emboli, and paroxysmal embolism. Extensive evaluation including transesophageal echocardiography and cardiac monitoring for long time could identify the etiology of these patients. Therefore cryptogenic stroke is a diagnosis of exclusion. Compared with other stroke subtypes, cryptogenic stroke tends to have a better prognosis and lower long-term risk of recurrence.

  17. Use of escitalopram to prevent depression and cognitive impairments in the acute phase of stroke

    Directory of Open Access Journals (Sweden)

    Dina Rustemovna Khasanova

    2013-01-01

    Full Text Available The purpose of the study was to comparatively analyze the rate of post-stroke depression and cognitive impairments in escitalopram (cipralex-treated and untreated (control patients. Emotional and affective cognitive symptoms, neurological deficit, and day-to-day activity were evaluated over time 1, 3, and 6 months after treatment. The results of the study indicated that escitalopram used to prevent depression in the acute phase of stroke provided a good effect. This drug caused a prompter recovery of cognitive impairments and reduced the pace of development of neurodegenerative disorders underlying the post-stroke 2D (depression and dementia syndrome. The study group was recorded to have more favorable functional outcomes of stroke and patient mobility indicators associated with lower disability rates.

  18. Numerical Investigation of the Scavenging Process in Marine Two-Stroke Diesel Engines

    DEFF Research Database (Denmark)

    Andersen, Fredrik Herland; Hult, Johan; Nogenmyr, Karl-Johan

    2013-01-01

    The scavenging process is an integral part of any two-stroke internal combustion engine cycle whether it is spark ignited or compression ignited. The scavenging process is responsible for transporting the burned gases from the previous working stroke out of the combustion chamber to allow...... for the fresh charge or fresh air to enter for the next combustion/working stroke. This implies that the scavenging process is responsible for setting the initial condition for the combustion process, consequently affecting fuel economy, power output and emission of hazardous gases. Two-stroke diesel engines...

  19. Late night activity regarding stroke codes: LuNAR strokes.

    Science.gov (United States)

    Tafreshi, Gilda; Raman, Rema; Ernstrom, Karin; Rapp, Karen; Meyer, Brett C

    2012-08-01

    There is diurnal variation for cardiac arrest and sudden cardiac death. Stroke may show a similar pattern. We assessed whether strokes presenting during a particular time of day or night are more likely of vascular etiology. To compare emergency department stroke codes arriving between 22:00 and 8:00 hours (LuNAR strokes) vs. others (n-LuNAR strokes). The purpose was to determine if late night strokes are more likely to be true strokes or warrant acute tissue plasminogen activator evaluations. We reviewed prospectively collected cases in the University of California, San Diego Stroke Team database gathered over a four-year period. Stroke codes at six emergency departments were classified based on arrival time. Those arriving between 22:00 and 8:00 hours were classified as LuNAR stroke codes, the remainder were classified as 'n-LuNAR'. Patients were further classified as intracerebral hemorrhage, acute ischemic stroke not receiving tissue plasminogen activator, acute ischemic stroke receiving tissue plasminogen activator, transient ischemic attack, and nonstroke. Categorical outcomes were compared using Fisher's Exact test. Continuous outcomes were compared using Wilcoxon's Rank-sum test. A total of 1607 patients were included in our study, of which, 299 (19%) were LuNAR code strokes. The overall median NIHSS was five, higher in the LuNAR group (n-LuNAR 5, LuNAR 7; P=0·022). There was no overall differences in patient diagnoses between LuNAR and n-LuNAR strokes (P=0·169) or diagnosis of acute ischemic stroke receiving tissue plasminogen activator (n-LuNAR 191 (14·6%), LuNAR 42 (14·0%); P=0·86). Mean arrival to computed tomography scan time was longer during LuNAR hours (n-LuNAR 54·9±76·3 min, LuNAR 62·5±87·7 min; P=0·027). There was no significant difference in 90-day mortality (n-LuNAR 15·0%, LuNAR 13·2%; P=0·45). Our stroke center experience showed no difference in diagnosis of acute ischemic stroke between day and night stroke codes. This

  20. Power Dependence of the Electron Mobility Profile in a Hall Thruster

    Science.gov (United States)

    Jorns, Benjamin A.; Hofery, Richard H.; Mikellides, Ioannis G.

    2014-01-01

    The electron mobility profile is estimated in a 4.5 kW commercial Hall thruster as a function of discharge power. Internal measurements of plasma potential and electron temperature are made in the thruster channel with a high-speed translating probe. These measurements are presented for a range of throttling conditions from 150 - 400 V and 0.6 - 4.5 kW. The fluid-based solver, Hall2De, is used in conjunction with these internal plasma parameters to estimate the anomalous collision frequency profile at fixed voltage, 300 V, and three power levels. It is found that the anomalous collision frequency profile does not change significantly upstream of the location of the magnetic field peak but that the extent and magnitude of the anomalous collision frequency downstream of the magnetic peak does change with thruster power. These results are discussed in the context of developing phenomenological models for how the collision frequency profile depends on thruster operating conditions.

  1. Child-Mediated Stroke Communication: findings from Hip Hop Stroke.

    Science.gov (United States)

    Williams, Olajide; DeSorbo, Alexandra; Noble, James; Gerin, William

    2012-01-01

    Low thrombolysis rates for acute ischemic stroke are linked to delays in seeking immediate treatment due to low public stroke awareness. We aimed to assess whether "Child-Mediated Stroke Communication" could improve stroke literacy of parents of children enrolled in a school-based stroke literacy program called Hip Hop Stroke. Parents of children aged 9 to 12 years from 2 public schools in Harlem, New York City, were recruited to participate in stroke literacy questionnaires before and after their child's participation in Hip Hop Stroke, a novel Child-Mediated Stroke Communication intervention delivered in school auditoriums. Parental recall of stroke information communicated through their child was assessed 1-week after the intervention. Fifth and sixth grade students (n=182) were enrolled into Hip Hop Stroke. One hundred two parents were approached in person to participate; 75 opted to participate and 71 completed both the pretest and post-test (74% response rate and 95% retention rate). Parental stroke literacy improved after the program; before the program, 3 parents of 75 (3.9%) were able to identify the 5 cardinal stroke symptoms, distracting symptom (chest pains), and had an urgent action plan (calling 911) compared with 21 of 71 parents (29.6%) postintervention (P<0.001). The FAST mnemonic was known by 2 (2.7%) of participants before the program versus 29 (41%) after program completion (P<0.001). Knowledge of stroke signs and symptoms remains low among residents of this high-risk population. The use of Child-Mediated Stroke Communication suggests that school children aged 9 to 12 years may be effective conduits of critical stroke knowledge to their parents.

  2. Feasibility of ballistic strength training in sub-acute stroke: A randomized, controlled, assessor-blinded pilot study.

    Science.gov (United States)

    Hendrey, Genevieve; Clark, Ross A; Holland, Anne E; Mentiplay, Benjamin F; Davis, Carly; Windfeld-Lund, Cristie; Raymond, Melissa J; Williams, Gavin

    2018-05-30

    To establish the feasibility and effectiveness of a six week ballistic strength training protocol in people with stroke. Randomized, controlled, assessor-blinded study. Sub-acute inpatient rehabilitation. Consecutively admitted inpatients with a primary diagnosis of first ever stroke with lower limb weakness, functional ambulation category score of ≥3, and ability to walk ≥14m were screened for eligibility to recruit 30 participants for randomization. Participants were randomized to standard therapy or ballistic strength training three times per week for six weeks. The primary aim was to evaluate feasibility and outcomes included recruitment rate, participant retention and attrition, feasibility of the exercise protocol, therapist burden and participant safety. Secondary outcomes included measures of mobility, lower limb muscle strength, muscle power and quality of life. Thirty participants (11% of those screened) with mean age of 50 (SD 18) years were randomized. The median number of sessions attended was 15/18 and 17/18 for the ballistic and control groups respectively. Earlier than expected discharge home (n=4) and illness (n=7) were the most common reasons for non-attendance. Participants performed the exercises safely, with no study-related adverse events. There were significant (pballistic group for comfortable gait velocity (mean difference (MD) 0.31m/s, 95% confidence interval CI: 0.08 to 0.52), muscle power, as measured by peak jump height (MD 8cm, 95% CI: 3 to 13) and peak propulsive velocity (MD 64cm/s, 95% CI: 17 to 112). Ballistic training was safe and feasible in select ambulant people with stroke. Similar rates of retention and attrition suggest that ballistic training was acceptable to patients. Secondary outcomes provide promising results that warrant further investigation in a larger trial. Copyright © 2018. Published by Elsevier Inc.

  3. Prediction of Large Vessel Occlusions in Acute Stroke: National Institute of Health Stroke Scale Is Hard to Beat.

    Science.gov (United States)

    Vanacker, Peter; Heldner, Mirjam R; Amiguet, Michael; Faouzi, Mohamed; Cras, Patrick; Ntaios, George; Arnold, Marcel; Mattle, Heinrich P; Gralla, Jan; Fischer, Urs; Michel, Patrik

    2016-06-01

    Endovascular treatment for acute ischemic stroke with a large vessel occlusion was recently shown to be effective. We aimed to develop a score capable of predicting large vessel occlusion eligible for endovascular treatment in the early hospital management. Retrospective, cohort study. Two tertiary, Swiss stroke centers. Consecutive acute ischemic stroke patients (1,645 patients; Acute STroke Registry and Analysis of Lausanne registry), who had CT angiography within 6 and 12 hours of symptom onset, were categorized according to the occlusion site. Demographic and clinical information was used in logistic regression analysis to derive predictors of large vessel occlusion (defined as intracranial carotid, basilar, and M1 segment of middle cerebral artery occlusions). Based on logistic regression coefficients, an integer score was created and validated internally and externally (848 patients; Bernese Stroke Registry). None. Large vessel occlusions were present in 316 patients (21%) in the derivation and 566 (28%) in the external validation cohort. Five predictors added significantly to the score: National Institute of Health Stroke Scale at admission, hemineglect, female sex, atrial fibrillation, and no history of stroke and prestroke handicap (modified Rankin Scale score, < 2). Diagnostic accuracy in internal and external validation cohorts was excellent (area under the receiver operating characteristic curve, 0.84 both). The score performed slightly better than National Institute of Health Stroke Scale alone regarding prediction error (Wilcoxon signed rank test, p < 0.001) and regarding discriminatory power in derivation and pooled cohorts (area under the receiver operating characteristic curve, 0.81 vs 0.80; DeLong test, p = 0.02). Our score accurately predicts the presence of emergent large vessel occlusions, which are eligible for endovascular treatment. However, incorporation of additional demographic and historical information available on hospital arrival

  4. CFD analysis of the scavenging process in marine two-stroke diesel engines

    DEFF Research Database (Denmark)

    Andersen, Fredrik Herland; Hult, Johan; Nogenmyr, Karl-Johan

    2014-01-01

    /charge before the subsequent compression stroke. This implies that the scavenging process is integral to engine performance as it influence the initial condition for the combustion process, thus affecting the fuel economy, power output and emission of hazardous gases. Two-stroke diesel engines for marine...

  5. Sensorimotor enhancement with a mixed reality system for balance and mobility rehabilitation.

    Science.gov (United States)

    Fung, Joyce; Perez, Claire F

    2011-01-01

    We have developed a mixed reality system incorporating virtual reality (VR), surface perturbations and light touch for gait rehabilitation. Haptic touch has emerged as a novel and efficient technique to improve postural control and dynamic stability. Our system combines visual display with the manipulation of physical environments and addition of haptic feedback to enhance balance and mobility post stroke. A research study involving 9 participants with stroke and 9 age-matched healthy individuals show that the haptic cue provided while walking is an effective means of improving gait stability in people post stroke, especially during challenging environmental conditions such as downslope walking.

  6. Level of physical activity in men and women with chronic stroke.

    Science.gov (United States)

    Vahlberg, Birgit; Bring, Annika; Hellström, Karin; Zetterberg, Lena

    2018-04-16

    Community-dwelling stroke survivors generally show low levels of physical activity (PA). An improved understanding of the factors influencing participation in PA after stroke is imperative to improve levels of PA. Furthermore, gender differences in PA have received little attention in stroke research. The objective of this study was to examine gender differences in PA, physical functioning and psychological factors and the association between these factors and PA in men and women 1-3-year post-stroke. A total of 187 community-dwelling individuals with stroke (65-85 years old, 29% women) were included in a secondary analysis based on data from a cross-sectional study. The exclusion criteria were severe cognitive or language dysfunction or dementia. The level of PA was measured by the Physical Activity Scale for the Elderly. Physical function included balance, walking speed and mobility. Psychological factors included depression, health-related quality of life and fall-related self-efficacy. Falls and fear of falling were each measured with a single question. There were no significant differences in PA levels between men and women. In multiple regression analyses, walking speed (p men, and balance (p = 0.038) was associated with PA in women. The results indicate that strategies to increase PA levels 1-3-year post-stroke could be improved by considering gender-specific factors.

  7. The African Mobile Story

    DEFF Research Database (Denmark)

    This book identifies the factors that has enabled the growth of mobile telephony in Africa. The book covers the regulatory factors, the development and usage of mobile application, mobile security and sustainable power source for mobile networks...

  8. Portfolio Purchasing Decision for Mobile Power Equipment of B2C E-Commerce Export Retailer Based on CVaR

    Science.gov (United States)

    Yanchun, Wan; Qiucen, Chen

    2017-11-01

    Purchasing is an important part of export e-commerce of B2C, which plays an important role on risk and cost control in supply management. From the perspective of risk control, the paper construct a CVaR model for portfolio purchase. We select a heavy sales mobile power equipment from a typical B2C e-commerce export retailer as study sample. This study optimizes the purchasing strategy of this type of mobile power equipment. The research has some reference for similar enterprises in purchasing portfolio decision.

  9. After heat distribution of a mobile nuclear power plant

    Science.gov (United States)

    Parker, W. G.; Vanbibber, L. E.; Tang, Y. S.

    1971-01-01

    A computer program was developed to analyze the transient afterheat temperature and pressure response of a mobile gas-cooled reactor power plant following impact. The program considers (in addition to the standard modes of heat transfer) fission product decay and transport, metal-water reactions, core and shield melting and displacement, and pressure and containment vessel stress response. Analyses were performed for eight cases (both deformed and undeformed models) to verify operability of the program options. The results indicated that for a 350 psi (241 n/sq cm) initial internal pressure, the containment vessel can survive over 100,000 seconds following impact before creep rupture occurs. Recommendations were developed as to directions for redesign to extend containment vessel life.

  10. Item hierarchy-based analysis of the Rivermead Mobility Index resulted in improved interpretation and enabled faster scoring in patients undergoing rehabilitation after stroke.

    Science.gov (United States)

    Roorda, Leo D; Green, John R; Houwink, Annemieke; Bagley, Pam J; Smith, Jane; Molenaar, Ivo W; Geurts, Alexander C

    2012-06-01

    To enable improved interpretation of the total score and faster scoring of the Rivermead Mobility Index (RMI) by studying item ordering or hierarchy and formulating start-and-stop rules in patients after stroke. Cohort study. Rehabilitation center in the Netherlands; stroke rehabilitation units and the community in the United Kingdom. Item hierarchy of the RMI was studied in an initial group of patients (n=620; mean age ± SD, 69.2±12.5y; 297 [48%] men; 304 [49%] left hemisphere lesion, and 269 [43%] right hemisphere lesion), and the adequacy of the item hierarchy-based start-and-stop rules was checked in a second group of patients (n=237; mean age ± SD, 60.0±11.3y; 139 [59%] men; 103 [44%] left hemisphere lesion, and 93 [39%] right hemisphere lesion) undergoing rehabilitation after stroke. Not applicable. Mokken scale analysis was used to investigate the fit of the double monotonicity model, indicating hierarchical item ordering. The percentages of patients with a difference between the RMI total score and the scores based on the start-and-stop rules were calculated to check the adequacy of these rules. The RMI had good fit of the double monotonicity model (coefficient H(T)=.87). The interpretation of the total score improved. Item hierarchy-based start-and-stop rules were formulated. The percentages of patients with a difference between the RMI total score and the score based on the recommended start-and-stop rules were 3% and 5%, respectively. Ten of the original 15 items had to be scored after applying the start-and-stop rules. Item hierarchy was established, enabling improved interpretation and faster scoring of the RMI. Copyright © 2012 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  11. Application of autonomous mobile patrol system for nuclear power plants

    International Nuclear Information System (INIS)

    Kanemoto, S.; Hattori, Y.; Ochiai, M.; Tai, I.; Ozaki, O.; Shimada, H.; Okano, H.

    1995-01-01

    The integrity of the components of an operating nuclear power plant (NPP) is usually monitored daily by an operator patrol. Currently, there is a great need to replace such human patrol activities by automated remote monitoring in order to reduce radiation exposure and severe workload. From this perspective, we started an R and D project with the objective of developing an autonomous mobile patrol system for NPPs. The project started in 1991 and is scheduled to be completed in 1996. The main targets of this project are as follows. (1) Development of an autonomous and independent mobile robot, (2) Development of a transportable compact remote sensing system for plant component inspection, (3) Development of a patrol guidance and sensing data evaluation system. The remote sensing system has the capability of detecting video image, sound, temperature and vibration distribution of component surfaces. A laser Doppler vibrometer is newly developed to measure a wide range of vibration distribution remotely. Also, in order to integrate and recognize various kinds of remote sensing data, a 3-dimensional (3D) computer aided design database and 3D graphics technology is extensively used. Operators can interpret the measured image data by mapping their textures onto the 3-dimensional model surface. In this paper, we describe the concept of the entire patrol system and its three main component technologies, that is, mobile robot, remote sensing and inspected data evaluations. (author)

  12. Techno-Economic Evaluation of a Stand-Alone Power System Based on Solar Power/Batteries for Global System for Mobile Communications Base Stations

    Directory of Open Access Journals (Sweden)

    Mohammed H. Alsharif

    2017-03-01

    Full Text Available Energy consumption in cellular networks is receiving significant attention from academia and the industry due to its significant potential economic and ecological influence. Energy efficiency and renewable energy are the main pillars of sustainability and environmental compatibility. Technological advancements and cost reduction for photovoltaics are making cellular base stations (BSs; a key source of energy consumption in cellular networks powered by solar energy sources a long-term promising solution for the mobile cellular network industry. This paper addresses issues of deployment and operation of two solar-powered global system for mobile communications (GSM BSs that are being deployed at present (GSM BS 2/2/2 and GSM BS 4/4/4. The study is based on the characteristics of South Korean solar radiation exposure. The optimum criteria as well as economic and technical feasibility for various BSs are analyzed using a hybrid optimization model for electric renewables. In addition, initial capital, replacement, operations, maintenance, and total net present costs for various solar-powered BSs are discussed. Furthermore, the economic feasibility of the proposed solar system is compared with conventional energy sources in urban and remote areas.

  13. Stroke Treatments

    Science.gov (United States)

    ... Stroke Association.org Professionals for Stroke Association.org Shop for Stroke Association.org Support for Stroke Association. ... works by dissolving the clot and improving blood flow to the part of the brain being deprived ...

  14. Post-stroke depression among stroke survivors attending two ...

    African Journals Online (AJOL)

    Background: The burden of stroke worldwide is increasing rapidly. There is paucity of data on post-stroke depression (PSD) among stroke survivors in Uganda, despite the high prevalence of PSD reported elsewhere. Methods: In a cross-sectional study, we assessed adult participants with confirmed first stroke with a ...

  15. Day-to-Day Market Power and Efficiency in Tradable Mobility Credits

    Directory of Open Access Journals (Sweden)

    Ye Tian

    2015-09-01

    Full Text Available An active transportation and demand management framework focusing on tradable mobility credits (TMC is integrated into an agent-based modeling and simulation (ABMS platform. In this framework, it is conceived that an auction market within which mobility credits can be transferred between buyers and sellers is constructed in general. The idea of ABMS is extensively incorporated to mimic system users’ daily route choices as well as market-related micro-economical decision making process under TMC circumstance. Users are able to form individual propensities towards available bid/ask choices by reinforcement learning principles. The integrated platform offers a brand new insight view of microscopic aspect of the daily operations of credit transfer market, which has hardly been obtained by prior analytical models. Day-to-day traffic dynamics and market dynamics can be captured. Besides, market MOEs, including convergence, stability, efficiency and relative market powers of buyers and sellers under different market policies are investigated.

  16. Anosognosia, neglect and quality of life of right hemisphere stroke survivors.

    Science.gov (United States)

    Dai, C-Y; Liu, W-M; Chen, S-W; Yang, C-A; Tung, Y-C; Chou, L-W; Lin, L-C

    2014-05-01

    Anosognosia and neglect may coexist in stroke patients. Neglect patients often report poor quality of life (QOL), whereas patients suffering from other cognition disorders with poor insight report better QOL. This study investigates the relationship between anosognosia, neglect and QOL amongst stroke survivors. Stroke survivors who met the criteria were used as a sampling pool. Sixty stroke patients were observed in this study, amongst whom 20 patients with anosognosia and neglect (A+N+), 20 patients with neglect but not anosognosia (A-N+) and 20 patients with neither anosognosia nor neglect (A-N-) were selected from the sampling pool based on demographic characteristics matched with the A+N+ group. A questionnaire (SS-QOL) was used to collect the QOL perceived by the stroke survivors. The perceived QOL of the A+N+ group was significantly better than those of the other groups, including the subscales of self-care, mobility, work/productivity, upper extremity, mood, family role and social role. However, the A+N+ group had poor balance level and more fall incidents were reported. The A+N+ group perceived better QOL but had more falls and poorer balance than the other groups. Health providers should work with caregivers aggressively in preventing accidents. © 2014 The Author(s) European Journal of Neurology © 2014 EFNS.

  17. A review of wireless power transfer for electric vehicles: Prospects to enhance sustainable mobility

    International Nuclear Information System (INIS)

    Bi, Zicheng; Kan, Tianze; Mi, Chunting Chris; Zhang, Yiming; Zhao, Zhengming; Keoleian, Gregory A.

    2016-01-01

    Highlights: • Reviewed technology advances and sustainability performance of WPT for EVs. • Identified the technical bottlenecks for improving system performance. • Highlighted system performance of case studies and real-world demonstrations. • Evaluated energy, environmental, economic, and societal impacts of WPT deployment. • Defined WPT challenges and opportunities for enhancing future sustainable mobility. - Abstract: Wireless power transfer (WPT), which transmits power by an electromagnetic field across an intervening space, provides the prospect of new opportunities for electric vehicles (EVs) to enhance sustainable mobility. This review article evaluates WPT technology for EV applications from both technical and sustainability perspectives. The objectives of this review include: (1) to present the state-of-the-art technical progress and research bottlenecks in WPT development and applications in the transportation sector; (2) to characterize the demonstrations of the real-world deployment of WPT EV systems; and (3) to evaluate the sustainable performance and identify challenges and opportunities for improvement. From the technical perspective, progress on coil design, compensation topologies, and power electronics converters and control methods are reviewed with a focus on system performance. From the sustainability perspective, performance is defined in terms of energy, environmental, and economic metrics, and policy drivers and issues of health and safety are also examined.

  18. Biomechanical mechanisms underlying exosuit-induced improvements in walking economy after stroke.

    Science.gov (United States)

    Bae, Jaehyun; Awad, Louis N; Long, Andrew; O'Donnell, Kathleen; Hendron, Katy; Holt, Kenneth G; Ellis, Terry D; Walsh, Conor J

    2018-03-07

    Stroke-induced hemiparetic gait is characteristically asymmetric and metabolically expensive. Weakness and impaired control of the paretic ankle contribute to reduced forward propulsion and ground clearance - walking subtasks critical for safe and efficient locomotion. Targeted gait interventions that improve paretic ankle function after stroke are therefore warranted. We have developed textile-based, soft wearable robots that transmit mechanical power generated by off-board or body-worn actuators to the paretic ankle using Bowden cables (soft exosuits) and have demonstrated the exosuits can overcome deficits in paretic limb forward propulsion and ground clearance, ultimately reducing the metabolic cost of hemiparetic walking. This study elucidates the biomechanical mechanisms underlying exosuit-induced reductions in metabolic power. We evaluated the relationships between exosuit-induced changes in the body center of mass (COM) power generated by each limb, individual joint power and metabolic power. Compared with walking with an exosuit unpowered, exosuit assistance produced more symmetrical COM power generation during the critical period of the step-to-step transition (22.4±6.4% more symmetric). Changes in individual limb COM power were related to changes in paretic ( R 2 =0.83, P= 0.004) and non-paretic ( R 2 = 0.73, P= 0.014) ankle power. Interestingly, despite the exosuit providing direct assistance to only the paretic limb, changes in metabolic power were related to changes in non-paretic limb COM power ( R 2 =0.80, P= 0.007), not paretic limb COM power ( P> 0.05). These findings contribute to a fundamental understanding of how individuals post-stroke interact with an exosuit to reduce the metabolic cost of hemiparetic walking. © 2018. Published by The Company of Biologists Ltd.

  19. Design and simulation of a two- or four-stroke free-piston engine generator for range extender applications

    International Nuclear Information System (INIS)

    Jia, Boru; Smallbone, Andrew; Zuo, Zhengxing; Feng, Huihua; Roskilly, Anthony Paul

    2016-01-01

    Highlights: • A FPE model operated in two thermodynamic cycles is presented. • The engine performance for both gas exchange cycles are described. • Power distribution with different operation parameters are provided. • Advantages and disadvantages for the two thermodynamic cycles are summarised. - Abstract: Free-piston engines (FPEs) are known to have a greater thermal efficiency (40–50%) than an equivalent and more conventional four-stroke reciprocating engines (30–40%). Modern FPEs are proposed for the generation of electric and hydraulic power, with a potential application in hybrid electric vehicles. The numerous FPE configurations considered to date have almost exclusively operated using a two-stroke thermodynamic cycle to improve the thermal efficiency, however it is well known that the application of two-stoke cycles can be limited by noise and exhaust gas emissions constraints. In this article, a numerical model is used to investigate the techno-feasibility of operating Newcastle University’s FPE prototype using a two- or four-stroke thermodynamic cycle. If operated as a four-stroke cycle, the linear generator must be used as both a motor and a generator resulting in a more irregular piston motion compared to corresponding operating in a two-stroke cycle. In four-stroke cycles, almost half the indicated power is consumed in overcoming the pumping losses of the motoring process. Whilst the heat release process is appears to be closer to a constant volume process when operated on two-stroke engine cycle, the peak cylinder pressure and compression ratio proved lower. In addition, a narrower power range is reported for a four-stroke cycle despite a corresponding higher thermal efficiency.

  20. Hemorrhagic versus ischemic stroke: Who can best benefit from blended conventional physiotherapy with robotic-assisted gait therapy?

    Directory of Open Access Journals (Sweden)

    Frédéric Dierick

    Full Text Available Contrary to common belief of clinicians that hemorrhagic stroke survivors have better functional prognoses than ischemic, recent studies show that ischemic survivors could experience similar or even better functional improvements. However, the influence of stroke subtype on gait and posture outcomes following an intervention blending conventional physiotherapy with robotic-assisted gait therapy is missing.This study compared gait and posture outcome measures between ambulatory hemorrhagic patients and ischemic patients, who received a similar 4 weeks' intervention blending a conventional bottom-up physiotherapy approach and an exoskeleton top-down robotic-assisted gait training (RAGT approach with Lokomat.Forty adult hemiparetic stroke inpatient subjects were recruited: 20 hemorrhagic and 20 ischemic, matched by age, gender, side of hemisphere lesion, stroke severity, and locomotor impairments. Functional Ambulation Category, Postural Assessment Scale for Stroke, Tinetti Performance Oriented Mobility Assessment, 6 Minutes Walk Test, Timed Up and Go and 10-Meter Walk Test were performed before and after a 4-week long intervention. Functional gains were calculated for all tests.Hemorrhagic and ischemic subjects showed significant improvements in Functional Ambulation Category (P<0.001 and P = 0.008, respectively, Postural Assessment Scale for Stroke (P<0.001 and P = 0.003, 6 Minutes Walk Test (P = 0.003 and P = 0.015 and 10-Meter Walk Test (P = 0.001 and P = 0.024. Ischemic patients also showed significant improvements in Timed Up and Go. Significantly greater mean Functional Ambulation Category and Tinetti Performance Oriented Mobility Assessment gains were observed for hemorrhagic compared to ischemic, with large (dz = 0.81 and medium (dz = 0.66 effect sizes, respectively.Overall, both groups exhibited quasi similar functional improvements and benefits from the same type, length and frequency of blended conventional physiotherapy and RAGT

  1. Direct observation of the myosin Va recovery stroke that contributes to unidirectional stepping along actin.

    Directory of Open Access Journals (Sweden)

    Katsuyuki Shiroguchi

    2011-04-01

    Full Text Available Myosins are ATP-driven linear molecular motors that work as cellular force generators, transporters, and force sensors. These functions are driven by large-scale nucleotide-dependent conformational changes, termed "strokes"; the "power stroke" is the force-generating swinging of the myosin light chain-binding "neck" domain relative to the motor domain "head" while bound to actin; the "recovery stroke" is the necessary initial motion that primes, or "cocks," myosin while detached from actin. Myosin Va is a processive dimer that steps unidirectionally along actin following a "hand over hand" mechanism in which the trailing head detaches and steps forward ∼72 nm. Despite large rotational Brownian motion of the detached head about a free joint adjoining the two necks, unidirectional stepping is achieved, in part by the power stroke of the attached head that moves the joint forward. However, the power stroke alone cannot fully account for preferential forward site binding since the orientation and angle stability of the detached head, which is determined by the properties of the recovery stroke, dictate actin binding site accessibility. Here, we directly observe the recovery stroke dynamics and fluctuations of myosin Va using a novel, transient caged ATP-controlling system that maintains constant ATP levels through stepwise UV-pulse sequences of varying intensity. We immobilized the neck of monomeric myosin Va on a surface and observed real time motions of bead(s attached site-specifically to the head. ATP induces a transient swing of the neck to the post-recovery stroke conformation, where it remains for ∼40 s, until ATP hydrolysis products are released. Angle distributions indicate that the post-recovery stroke conformation is stabilized by ≥ 5 k(BT of energy. The high kinetic and energetic stability of the post-recovery stroke conformation favors preferential binding of the detached head to a forward site 72 nm away. Thus, the recovery

  2. Safe decommissioning of mobile nuclear power plant

    International Nuclear Information System (INIS)

    Paliukhovich, V.M.

    2002-01-01

    The paper addresses some issues for ensuring radiation safety during the process of decommissioning the 630 kW 'Pamir-630D' mobile nuclear power plant (MNPP). That nuclear power plant consisted of a gas cooled reactor (weight of 76.5t), gas turbine-driven set (76t), two control units (2'20t), and an auxiliary unit (20t). The reactor and turbine-driven set were supposed to be put on transport platforms and carried by tractors. The control and auxiliary units were set on track beds. The 'Pamir-630D' was constructed and tested in an appropriate building. The set-up time was no greater than six hours after all units of the MNPP had reached the site. The 'Pamir-630D' was ready to be moved to another site in 30 hours after the shut down. Service lifetime of 'Pamir-630D' was 10 years: 7 years of storage and 3 years of operation. Operational lifetime was no less than 10000 hours (non-stop operational period was no longer than 2000 hours). Dose rate at the boundary of the restrictive area was no more than 6.5 mR/h at the time of reactor operation and no greater than 300 mR/h on the side surface and 1000 mR/h on the end surface of the biological shielding of the reactor, 24 hours after shut down. (author)

  3. Emerging technologies to power next generation mobile electronic devices using solar energy

    Institute of Scientific and Technical Information of China (English)

    Dewei JIA; Yubo DUAN; Jing LIU

    2009-01-01

    Mobile electronic devices such as MP3, mobile phones, and wearable or implanted medical devices have already or will soon become a necessity in peoples' lives.However, the further development of these devices is restricted not only by the inconvenient charging process of the power module, but also by the soaring prices of fossil fuel and its downstream chain of electricity manipulation.In view of the huge amount of solar energy fueling the world biochemically and thermally, a carry-on electricity harvester embedded in portable devices is emerging as a most noteworthy research area and engineering practice for a cost efficient solution. Such a parasitic problem is intrinsic in the next generation portable devices. This paper is dedicated to presenting an overview of the photovoltaic strategy in the chain as a reference for researchers and practitioners committed to solving the problem.

  4. The impact of early powered mobility on parental stress, negative emotions, and family social interactions.

    Science.gov (United States)

    Tefft, Donita; Guerette, Paula; Furumasu, Jan

    2011-02-01

    Powered mobility has been found to have positive effects on young children with severe physical disabilities, but the impact on the family has been less well documented. We evaluated the impact of early powered mobility on parental stress, negative emotions, perceived social interactions, and parental satisfaction with wheelchair characteristics such as size and durability. The participants were parents of 23 children with disabilities-10 with orthopedic disabilities (average age 30.1 months) and 13 with cerebral palsy (average age 47.0 months). Pretest assessments were completed two times: at initial wheelchair evaluation and at wheelchair delivery. A posttest assessment was completed after each child had used the wheelchair for 4-6 months. Parents reported a lower perceived level of stress at the time of wheelchair delivery, although the magnitude of this effect was fairly small, standardized mean difference (δ) = .27. They also reported an increased satisfaction with their child's social and play skills (δ = .38), ability to go where desired (δ = .86), sleep/wake pattern (δ = .61), and belief that the general public accepts their child (δ = .39) after several months using the wheelchair. Parents reported an increase in interactions within the family at the time of wheelchair delivery (δ = .66). There was no decrease in negative emotions. Parents were satisfied with most factors relating to the wheelchair itself, with areas of concern being wheelchair size and difficulty adjusting the wheelchair. The findings suggest that self-initiated powered mobility for a young child had a positive impact on the family.

  5. The mobilize center: an NIH big data to knowledge center to advance human movement research and improve mobility.

    Science.gov (United States)

    Ku, Joy P; Hicks, Jennifer L; Hastie, Trevor; Leskovec, Jure; Ré, Christopher; Delp, Scott L

    2015-11-01

    Regular physical activity helps prevent heart disease, stroke, diabetes, and other chronic diseases, yet a broad range of conditions impair mobility at great personal and societal cost. Vast amounts of data characterizing human movement are available from research labs, clinics, and millions of smartphones and wearable sensors, but integration and analysis of this large quantity of mobility data are extremely challenging. The authors have established the Mobilize Center (http://mobilize.stanford.edu) to harness these data to improve human mobility and help lay the foundation for using data science methods in biomedicine. The Center is organized around 4 data science research cores: biomechanical modeling, statistical learning, behavioral and social modeling, and integrative modeling. Important biomedical applications, such as osteoarthritis and weight management, will focus the development of new data science methods. By developing these new approaches, sharing data and validated software tools, and training thousands of researchers, the Mobilize Center will transform human movement research. © The Author 2015. Published by Oxford University Press on behalf of the American Medical Informatics Association.

  6. Design of an off-grid hybrid PV/wind power system for remote mobile base station: A case study

    Directory of Open Access Journals (Sweden)

    Mulualem T. Yeshalem

    2017-01-01

    Full Text Available There is a clear challenge to provide reliable cellular mobile service at remote locations where a reliable power supply is not available. So, the existing Mobile towers or Base Transceiver Station (BTSs uses a conventional diesel generator with backup battery banks. This paper presents the solution to utilizing a hybrid of photovoltaic (PV solar and wind power system with a backup battery bank to provide feasibility and reliable electric power for a specific remote mobile base station located at west arise, Oromia. All the necessary modeling, simulation, and techno-economic evaluation are carried out using Hybrid Optimization Model for Electric Renewable (HOMER software. The best optimal system configurations namely PV/Battery and PV/Wind/Battery hybrid systems are compared with the conventional stand-alone diesel generator (DG system. Findings indicated that PV array and battery is the most economically viable option with the total net present cost (NPC of $\\$$57,508 and per unit cost of electricity (COE of $\\$$0.355. Simulation results show that the hybrid energy systems can minimize the power generation cost significantly and can decrease CO2 emissions as compared to the traditional diesel generator only. The sensitivity analysis is also carried out to analysis the effects of probable variation in solar radiation, wind speed, diesel price and average annual energy usage of the system load in the optimal system configurations.

  7. Risk Factors and Stroke Characteristic in Patients with Postoperative Strokes.

    Science.gov (United States)

    Dong, Yi; Cao, Wenjie; Cheng, Xin; Fang, Kun; Zhang, Xiaolong; Gu, Yuxiang; Leng, Bing; Dong, Qiang

    2017-07-01

    Intravenous thrombolysis and intra-arterial thrombectomy are now the standard therapies for patients with acute ischemic stroke. In-house strokes have often been overlooked even at stroke centers and there is no consensus on how they should be managed. Perioperative stroke happens rather frequently but treatment protocol is lacking, In China, the issue of in-house strokes has not been explored. The aim of this study is to explore the current management of in-house stroke and identify the common risk factors associated with perioperative strokes. Altogether, 51,841 patients were admitted to a tertiary hospital in Shanghai and the records of those who had a neurological consult for stroke were reviewed. Their demographics, clinical characteristics, in-hospital complications and operations, and management plans were prospectively studied. Routine laboratory test results and risk factors of these patients were analyzed by multiple logistic regression model. From January 1, 2015, to December 31, 2015, over 1800 patients had neurological consultations. Among these patients, 37 had an in-house stroke and 20 had more severe stroke during the postoperative period. Compared to in-house stroke patients without a procedure or operation, leukocytosis and elevated fasting glucose levels were more common in perioperative strokes. In multiple logistic regression model, perioperative strokes were more likely related to large vessel occlusion. Patients with perioperative strokes had different risk factors and severity from other in-house strokes. For these patients, obtaining a neurological consultation prior to surgery may be appropriate in order to evaluate the risk of perioperative stroke. Copyright © 2017. Published by Elsevier Inc.

  8. Wireless Power System Design for Mobile Robots used in Nuclear Power Plants

    International Nuclear Information System (INIS)

    Choi, S. Y.; Yoo, S. J.; Lee, Kun J.; Rim, C. T.

    2012-01-01

    The robots used in nuclear power plants (NPP) have received much attention in recent years due to the Fukushima nuclear accident, which is considered as one of the worst nuclear disasters. In general, the NPP robots can play important roles in fuel exchange, repair work, radiation monitoring, rescue, and scouting out NPP. Under these conditions, human access to NPP during normal and emergency operations is strictly restricted due to the risks of high level radiation and contamination. However, in practice, robots have not been widely used in NPP because of the following limitations. First, the NPP robots cannot be of multi-purpose use because of their mission complexity and uniqueness. Second, the demand of the NPP robots is low due to the limited number of NPP over the world. Third, the NPP robots developed so far have no enough confidence in spite of the improvement of robot technology. Lastly, the NPP robots cannot carry on their mission continuously due to the limited energy capacity of the battery: mobile robots should stop working every two hours to recharge their batteries and spend least twenty minutes. As the solutions for this 'energy hungry' problem, high capacity batteries, quick battery chargers, power cables, and internal combustion engines were proposed; however, they still have the problems such as limited mission time and range, frequent recharging, or exhausting emission and noise. In this paper, the wireless power transfer systems (WPTS) for NPP robots are proposed. This technology can let NPP robots free from mission time and range limits, and exhausting emission. The requirements for the NPP robots are newly proposed, and two types of WPTS, roaming and railway, are suggested in this paper

  9. Deep learning guided stroke management: a review of clinical applications.

    Science.gov (United States)

    Feng, Rui; Badgeley, Marcus; Mocco, J; Oermann, Eric K

    2018-04-01

    Stroke is a leading cause of long-term disability, and outcome is directly related to timely intervention. Not all patients benefit from rapid intervention, however. Thus a significant amount of attention has been paid to using neuroimaging to assess potential benefit by identifying areas of ischemia that have not yet experienced cellular death. The perfusion-diffusion mismatch, is used as a simple metric for potential benefit with timely intervention, yet penumbral patterns provide an inaccurate predictor of clinical outcome. Machine learning research in the form of deep learning (artificial intelligence) techniques using deep neural networks (DNNs) excel at working with complex inputs. The key areas where deep learning may be imminently applied to stroke management are image segmentation, automated featurization (radiomics), and multimodal prognostication. The application of convolutional neural networks, the family of DNN architectures designed to work with images, to stroke imaging data is a perfect match between a mature deep learning technique and a data type that is naturally suited to benefit from deep learning's strengths. These powerful tools have opened up exciting opportunities for data-driven stroke management for acute intervention and for guiding prognosis. Deep learning techniques are useful for the speed and power of results they can deliver and will become an increasingly standard tool in the modern stroke specialist's arsenal for delivering personalized medicine to patients with ischemic stroke. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  10. 30 CFR 77.906 - Trailing cables supplying power to low-voltage mobile equipment; ground wires and ground check...

    Science.gov (United States)

    2010-07-01

    ... portable or mobile equipment from low-voltage three-phase resistance grounded power systems shall contain... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Trailing cables supplying power to low-voltage... STANDARDS, SURFACE COAL MINES AND SURFACE WORK AREAS OF UNDERGROUND COAL MINES Low- and Medium-Voltage...

  11. Impact of Generator Stroke Length on Energy Production for a Direct Drive Wave Energy Converter

    Directory of Open Access Journals (Sweden)

    Yue Hong

    2016-09-01

    Full Text Available The Lysekil wave energy converter (WEC, developed by the wave energy research group of Uppsala University, has evolved through a variety of mechanical designs since the first prototype was installed in 2006. The hundreds of engineering decisions made throughout the design processes have been based on a combination of theory, know-how from previous experiments, and educated guesses. One key parameter in the design of the WECs linear generator is the stroke length. A long stroke requires a taller WEC with associated economical and mechanical challenges, but a short stroke limits the power production. The 2-m stroke of the current WECs has been an educated guess for the Swedish wave climate, though the consequences of this choice on energy absorption have not been studied. When the WEC technology is considered for international waters, with larger waves and challenges of energy absorption and survivability, the subject of stroke length becomes even more relevant. This paper studies the impact of generator stroke length on energy absorption for three sites off the coasts of Sweden, Chile and Scotland. 2-m, 4-m, and unlimited stroke are considered. Power matrices for the studied WEC prototype are presented for each of the studied stroke lengths. Presented results quantify the losses incurred by a limited stroke. The results indicate that a 2-m stroke length is likely to be a good choice for Sweden, but 4-m is likely to be necessary in more energetic international waters.

  12. Output power distributions of terminals in a 3G mobile communication network.

    Science.gov (United States)

    Persson, Tomas; Törnevik, Christer; Larsson, Lars-Eric; Lovén, Jan

    2012-05-01

    The objective of this study was to examine the distribution of the output power of mobile phones and other terminals connected to a 3G network in Sweden. It is well known that 3G terminals can operate with very low output power, particularly for voice calls. Measurements of terminal output power were conducted in the Swedish TeliaSonera 3G network in November 2008 by recording network statistics. In the analysis, discrimination was made between rural, suburban, urban, and dedicated indoor networks. In addition, information about terminal output power was possible to collect separately for voice and data traffic. Information from six different Radio Network Controllers (RNCs) was collected during at least 1 week. In total, more than 800000 h of voice calls were collected and in addition to that a substantial amount of data traffic. The average terminal output power for 3G voice calls was below 1 mW for any environment including rural, urban, and dedicated indoor networks. This is <1% of the maximum available output power. For data applications the average output power was about 6-8 dB higher than for voice calls. For rural areas the output power was about 2 dB higher, on average, than in urban areas. Copyright © 2011 Wiley Periodicals, Inc.

  13. Ischemic stroke destabilizes circadian rhythms

    Directory of Open Access Journals (Sweden)

    Borjigin Jimo

    2008-10-01

    Full Text Available Abstract Background The central circadian pacemaker is a remarkably robust regulator of daily rhythmic variations of cardiovascular, endocrine, and neural physiology. Environmental lighting conditions are powerful modulators of circadian rhythms, but regulation of circadian rhythms by disease states is less clear. Here, we examine the effect of ischemic stroke on circadian rhythms in rats using high-resolution pineal microdialysis. Methods Rats were housed in LD 12:12 h conditions and monitored by pineal microdialysis to determine baseline melatonin timing profiles. After demonstration that the circadian expression of melatonin was at steady state, rats were subjected to experimental stroke using two-hour intralumenal filament occlusion of the middle cerebral artery. The animals were returned to their cages, and melatonin monitoring was resumed. The timing of onset, offset, and duration of melatonin secretion were calculated before and after stroke to determine changes in circadian rhythms of melatonin secretion. At the end of the monitoring period, brains were analyzed to determine infarct volume. Results Rats demonstrated immediate shifts in melatonin timing after stroke. We observed a broad range of perturbations in melatonin timing in subsequent days, with rats exhibiting onset/offset patterns which included: advance/advance, advance/delay, delay/advance, and delay/delay. Melatonin rhythms displayed prolonged instability several days after stroke, with a majority of rats showing a day-to-day alternation between advance and delay in melatonin onset and duration. Duration of melatonin secretion changed in response to stroke, and this change was strongly determined by the shift in melatonin onset time. There was no correlation between infarct size and the direction or amplitude of melatonin phase shifting. Conclusion This is the first demonstration that stroke induces immediate changes in the timing of pineal melatonin secretion, indicating

  14. Intelligent control system for nuclear power plant mobile robot

    International Nuclear Information System (INIS)

    Koenig, A.; Lecoeur-Taibi, I.; Crochon, E.; Vacherand, F.

    1991-01-01

    In order to fully optimize the efficiency of the perception and navigation components available on a mobile robot, the upper level of a mobile robot control requires intelligence support to unload the work of the teleoperator. This knowledge-based system has to manage a priori data such as the map of the workspace, the mission, the characteristics of sensors and robot, but also, the current environment state and the running mission. It has to issue a plan to drive the sensors to focus on relevant objects or to scan the environment and to select the best algorithms depending on the current situation. The environment workspace is a nuclear power plant building. The teleoperated robot is a mobile wheeled or legged vehicle that moves inside the different floors of the building. There are three types of mission: radio-activity survey, inspection and intervention. To perform these goals the robot must avoid obstacles, pass through doors, possibly climb stairs and recognize valves and pipes. The perception control system has to provide the operator with a synthetic view of the surroundings. It manages background tasks such as obstacle detection and free space map building, and specific tasks such as beacon recognition for odometry relocalization and valve detection for maintenance. To do this, the system solves perception resources conflicts, taking into account the current states of the sensors and the current conditions such as lightness or darkness, cluttered scenes, sensor failure. A perception plan is issued from the mission goals, planned path, relocalization requirements and available perception resources. Basically, the knowledge-based system is implemented on a blackboard architecture which includes two parts: a top-down planning part and a bottom-up perception part. The results of the perception are continuously sent to the operator who can trigger new perception actions. (author)

  15. Feasibility and effectiveness of circuit training in acute stroke rehabilitation.

    Science.gov (United States)

    Rose, Dorian; Paris, Trevor; Crews, Erin; Wu, Samuel S; Sun, Anqi; Behrman, Andrea L; Duncan, Pamela

    2011-02-01

    Task-specificity, repetition and progression are key variables in the acquisition of motor skill however they have not been consistently implemented in post-stroke rehabilitation. To evaluate the effectiveness of a stroke rehabilitation plan of care that incorporated task-specific practice, repetition and progression to facilitate functional gain compared to standard physical therapy for individuals admitted to an inpatient stroke unit. Individuals participated in either a circuit training (CTPT) model (n = 72) or a standard (SPT) model (n = 108) of physical therapy, 5 days/week. Each 60 minute circuit training session, delivered according to severity level, consisted of four functional mobility tasks. Daily exercise logs documented both task repetition and progression. The CTPT model was successfully implemented in an acute rehabilitation setting. The CTPT group showed a significantly greater improved change in gait speed from hospital admission to discharge than the SPT group (0.21 ± 0.25 m/sec vs. 0.13 ± 0.22 m/sec; p = 0.03). The difference between groups occurred primarily among those who were ambulatory upon admission. There were no significant differences between the two cohorts at 90 days post-stroke as measured by the FONE-FIM, SF-36 and living location. Therapy focused on systematically progressed functional tasks can be successfully implemented in an inpatient rehabilitation stroke program. This circuit-training model resulted in greater gains in gait velocity over the course of inpatient rehabilitation compared to the standard model of care. Community-based services following hospital discharge to maintain these gains should be included in the continuum of post-stroke care.

  16. Power saving control for the mobile DVB-H receivers based on H.264/SVC standard

    DEFF Research Database (Denmark)

    Belyaev, Evgeny; Grinko, Vitaly; Ukhanova, Ann

    2009-01-01

    This paper discusses the utilization of scalable extension of H.264/AVC standard in digital video broadcasting for handheld devices. In this area the problem of mobile receiver power consumption is critically important. This paper amplifies the well-known idea of the time-slicing and allows...

  17. 77 FR 28797 - Redundancy of Communications Systems: Backup Power Private Land Mobile Radio Services: Selection...

    Science.gov (United States)

    2012-05-16

    ... FEDERAL COMMUNICATIONS COMMISSION 47 CFR Parts 12 and 90 [DA 11-1838] Redundancy of Communications Systems: Backup Power Private Land Mobile Radio Services: Selection and Assignment of Frequencies, and Transition of the Upper 200 Channels in the 800 MHz Band to EA Licensing AGENCY: Federal Communications...

  18. Home setting after stroke, facilitators and barriers: A systematic literature review.

    Science.gov (United States)

    Marcheschi, Elizabeth; Von Koch, Lena; Pessah-Rasmussen, Hélène; Elf, Marie

    2018-07-01

    This paper seeks to improve the understanding of the interaction between patients with stroke and the physical environment in their home settings. Stroke care is increasingly performed in the patient's home. Therefore, a systematic review was conducted to identify the existing knowledge about facilitators and barriers in the physical environment of home settings for the stroke rehabilitation process. Based upon Arksey and O'Malley's framework, a Boolean search strategy was performed in the databases; CINAHL, Medline, Web of Science and Scopus. Fifteen articles were retained from the literature search conducted between August and November 2016, and two researchers independently assessed their quality based on the Swedish Council on Health Technology Assessment guidelines. The results suggest that despite the healthcare system's ongoing shift towards home-based rehabilitation, the role played by the physical environment of home settings is still considered a side finding. Moreover, the research appears to focus mainly on how this environment supports mobility and activities of daily living, whereas information regarding the psychosocial and emotional processes that mediate the interaction between stroke survivors and their home setting are missing. A lack of information was also found with regard to the influence of different geographic locations on the stroke rehabilitation process. Future investigations are therefore needed to advance the understanding of the role played by the physical environment of home settings in supporting stroke recovery. © 2017 The Authors. Health and Social Care in the Community Published by John Wiley & Sons Ltd.

  19. Flex-Fuel Two-Stroke Snowmobile: Development of a Flex-Fuel, Two-Stroke, Direct-Injection Snowmobile for Use in the Clean Snowmobile Challenge and National Parks

    Science.gov (United States)

    2009-09-01

    The University of Idaho's entry into the 2009 SAE Clean Snowmobile Challenge (CSC) was a semi-direct-injection (SDI) two-stroke powered REV-XP snowmobile modified to use flex fuel. The flex fuel engine produces stock engine power on any blend of etha...

  20. Four-fold increase in direct costs of stroke survivors with spasticity compared with stroke survivors without spasticity: the first year after the event.

    Science.gov (United States)

    Lundström, Erik; Smits, Anja; Borg, Jörgen; Terént, Andreas

    2010-02-01

    The prevalence of spasticity after first-ever stroke is approximately 20%, but there are no health economic studies on costs associated with spasticity after stroke. The objective of our study was to estimate direct costs of stroke with spasticity for patients surviving up to 1 year after the stroke event in comparison to costs of stroke without spasticity. A representative sample of patients with first-ever stroke hospitalized at Uppsala University Hospital was eligible for our cross-sectional survey. All direct costs during 1 year were identified for each patient, including costs for hospitalization (acute and rehabilitation), primary health care, medication, and costs for municipality services. Swedish currency was converted to Purchasing Power Parities US dollar (PPP$). Median age (interquartile range) was 73 years (18), and the proportion of women was 48%. The majority of the direct costs (78%) was associated with hospitalization, whereas 20% was associated with municipality services during 1 year after a first-ever stroke. Only 1% of all direct costs were related to primary health care and 1% to medication. The level of costs for patients with stroke was correlated with the presence of spasticity as measured with the modified Ashworth scale (r(s)=0.524) and with the degree of disability as measured with modified Rankin Scale (r(s)=0.624). The mean (median, interquartile range) direct cost for stroke patients with spasticity was PPP$ 84,195 (72,116, 53,707) compared with PPP$ 21,842 (12,385, 17,484) for patients with stroke without spasticity (Pstroke survivors are 4 times higher than direct costs for patients with stroke without spasticity during the first year after the event.

  1. A Powered Lower Limb Orthosis for Providing Legged Mobility in Paraplegic Individuals

    OpenAIRE

    Quintero, Hugo A.; Farris, Ryan J.; Hartigan, Clare; Clesson, Ismari; Goldfarb, Michael

    2011-01-01

    This paper presents preliminary results on the development of a powered lower limb orthosis intended to provide legged mobility (with the use of a stability aid, such as forearm crutches) to paraplegic individuals. The orthosis contains electric motors at both hip and both knee joints, which in conjunction with ankle-foot orthoses, provides appropriate joint kinematics for legged locomotion. The paper describes the orthosis and the nature of the controller that enables the SCI patient to comm...

  2. Self-efficacy and its influence on recovery of patients with stroke : a systematic review

    NARCIS (Netherlands)

    Korpershoek, Corrie; van der Bijl, Jaap; Hafsteinsdottir, Thora B.

    Aims. To provide an overview of the literature focusing on the influence of self-efficacy and self-efficacy enhancing interventions on mobility, activities of daily living, depression and quality of life of patients with stroke. Background. There is growing evidence for the importance of

  3. Mobile Health Technology for Atrial Fibrillation Management Integrating Decision Support, Education, and Patient Involvement: mAF App Trial.

    Science.gov (United States)

    Guo, Yutao; Chen, Yundai; Lane, Deirdre A; Liu, Lihong; Wang, Yutang; Lip, Gregory Y H

    2017-12-01

    Mobile Health technology for the management of patients with atrial fibrillation is unknown. The simple mobile AF (mAF) App was designed to incorporate clinical decision-support tools (CHA 2 DS 2 -VASc [Congestive heart failure, Hypertension, Age ≥75 years, Diabetes Mellitus, Prior Stroke or TIA, Vascular disease, Age 65-74 years, Sex category], HAS-BLED [Hypertension, Abnormal renal/liver function, Stroke, Bleeding history or predisposition, Labile INR, Elderly, Drugs/alcohol concomitantly], SAMe-TT 2 R 2 [Sex, Age Mobile Health technology in patients with atrial fibrillation, demonstrating that the mAF App, integrating clinical decision support, education, and patient-involvement strategies, significantly improved knowledge, drug adherence, quality of life, and anticoagulation satisfaction. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  4. Early versus delayed rehabilitation treatment in hemiplegic patients with ischemic stroke: proprioceptive or cognitive approach?

    Science.gov (United States)

    Morreale, Manuela; Marchione, Pasquale; Pili, Antonio; Lauta, Antonella; Castiglia, Stefano F; Spallone, Aldo; Pierelli, Francesco; Giacomini, Patrizia

    2016-02-01

    Early/intensive mobilization may improve functional recovery after stroke but it is not clear which kind of "mobilization" is more effective. Proprioceptive neuromuscular facilitation (PNF) and cognitive therapeutic exercise (CTE) are widespread applied in post-stroke rehabilitation but their efficacy and safety have not been systematically investigated. To compare PNF and CTE methods in a two different time setting (early versus standard approach) in order to evaluate different role of time and techniques in functional recovery after acute ischemic stroke. We designed a prospectical multicenter blinded interventional study of early versus standard approach with two different methods by means of both PNF and CTE. A discrete stroke-dedicated area for out-of-thrombolysis patients, connected with two different comprehensive stroke centres in two different catchment areas. Three hundred and forty consecutive stroke patient with first ever sub-cortical ischemic stroke in the mean cerebral artery (MCA) territory and contralateral hemiplegia admitted within 6 and 24 hours from symptoms onset. All patients were randomly assigned by means of a computer generated randomization sequence in blocks of 4 to one to the 4 interventional groups: early versus delayed rehabilitation programs with Kabat's schemes or Perfetti's technique. Patients in both delayed group underwent to a standard protocol in the acute phase. disability at 3-12 months. Disability measures: modified Rankin Score and Barthel Index. Safety outcome: immobility-related adverse events. Six-Minute Walking Test, Motricity Index, Mini-Mental State Examination, Beck Depression Inventory. Disability was not different between groups at 3 months but Barthel Index significantly changed between early versus delayed groups at 12 months (P=0.01). Six-Minute Walking Test (P=0.01) and Motricity Index in both upper (P=0.01) and lower limbs (P=0.001) increased in early versus delayed groups regardless rehabilitation schedule. A

  5. Design and Evaluation of the Kinect-Wheelchair Interface Controlled (KWIC) Smart Wheelchair for Pediatric Powered Mobility Training.

    Science.gov (United States)

    Zondervan, Daniel K; Secoli, Riccardo; Darling, Aurelia Mclaughlin; Farris, John; Furumasu, Jan; Reinkensmeyer, David J

    2015-01-01

    Children with severe disabilities are sometimes unable to access powered mobility training. Thus, we developed the Kinect-Wheelchair Interface Controlled (KWIC) smart wheelchair trainer that converts a manual wheelchair into a powered wheelchair. The KWIC Trainer uses computer vision to create a virtual tether with adaptive shared-control between the wheelchair and a therapist during training. It also includes a mixed-reality video game system. We performed a year-long usability study of the KWIC Trainer at a local clinic, soliciting qualitative and quantitative feedback on the device after extended use. Eight therapists used the KWIC Trainer for over 50 hours with 8 different children. Two of the children obtained their own powered wheelchair as a result of the training. The therapists indicated the device allowed them to provide mobility training for more children than would have been possible with a demo wheelchair, and they found use of the device to be as safe as or safer than conventional training. They viewed the shared control algorithm as counter-productive because it made it difficult for the child to discern when he or she was controlling the chair. They were enthusiastic about the video game integration for increasing motivation and engagement during training. They emphasized the need for additional access methods for controlling the device. The therapists confirmed that the KWIC Trainer is a useful tool for increasing access to powered mobility training and for engaging children during training sessions. However, some improvements would enhance its applicability for routine clinical use.

  6. The Influence of Social Networks on the Development of Recruitment Actions that Favor User Interface Design and Conversions in Mobile Applications Powered by Linked Data

    Directory of Open Access Journals (Sweden)

    Pedro R. Palos-Sanchez

    2018-01-01

    Full Text Available This study analyzes the most important influence factors in the literature, which have the greatest influence on the conversions obtained in a mobile application powered by linked data. With the study of user interface design and a small user survey (n = 101,053, we studied the influence of social networks, advertising, and promotional and recruitment actions in conversions for mobile applications powered by linked data. The analysis of the users’ behavior and their application in the design of the actions to promote and capture constitutes an important part of the current theories of digital marketing. However, this study shows that its results may be contradictory and depend on other factors and circumstances when mobile applications powered by linked data are considered. The predictive value, reached by the developed model, may be useful for professionals and researchers in the field of digital marketing and the user interface design in mobile applications powered by linked data.

  7. Perturbation training to promote safe independent mobility post-stroke: study protocol for a randomized controlled trial

    OpenAIRE

    Mansfield, Avril; Aqui, Anthony; Centen, Andrew; Danells, Cynthia J.; DePaul, Vincent G.; Knorr, Svetlana; Schinkel-Ivy, Alison; Brooks, Dina; Inness, Elizabeth L.; McIlroy, William E.; Mochizuki, George

    2015-01-01

    Background Falls are one of the most common medical complications post-stroke. Physical exercise, particularly exercise that challenges balance, reduces the risk of falls among healthy and frail older adults. However, exercise has not proven effective for preventing falls post-stroke. Falls ultimately occur when an individual fails to recover from a loss of balance. Thus, training to specifically improve reactive balance control could prevent falls. Perturbation training aims to improve react...

  8. The electron mobility and thermoelectric power in InSb at atmospheric and hydrostatic pressures

    International Nuclear Information System (INIS)

    Litwin-Staszewska, E.; Piotrzkowski, R.; Szymanska, W.

    1981-01-01

    First, theoretical calculations of electron mobility and thermoelectric power in n-type InSb are reported at liquid nitrogen and room temperatures. All the scattering mechanisms of importance in InSb are taken into account. The calculations based upon a variational solution of the Boltzmann equation are compared with experimental results over the whole available range of electron concentrations. Good agreement between theoretical and experimental results is obtained using the value of deformation potential constant C = 14.6 eV. Secondly, both, experimental and theoretical investigations are made of mobility in InSb under hydrostatic pressure at 77 K within a wide range of electron concentrations. The smallest electron concentrations obtained by freezing the conduction electrons on the metastable states are of order of 1x10 12 cm -3 . Also for those smallest concentration it is possible to describe theoretically the dependence of mobility on the hydrostatic pressure using the same set of parameters as previously, and assuming some compensation of donors by acceptors. (author)

  9. Effects of Mind-Body Exercises for Mood and Functional Capabilities in Patients with Stroke: An Analytical Review of Randomized Controlled Trials

    Directory of Open Access Journals (Sweden)

    Liye Zou

    2018-04-01

    Full Text Available Objective: The effects of stroke are both physical and mental in nature and may have serious implications on the overall well-being of stroke survivors. This analytical review aims to critically evaluate and statistically synthesize the existing literature regarding the effects of mind-body (MB exercises on mood and functional capabilities in patients with stroke. Methods: A structured literature review was performed in both English (PubMed, PEDro, and Cochrane Library and Chinese (Wanfang and CNKI (Chinese National Knowledge Information Database databases. Sixteen randomized controlled trials were considered eligible for meta-analysis. Based on the random effects model, we used the pooled effect size to determine the magnitude of rehabilitative effect of MB exercise intervention on depression, anxiety, activities of daily living, and functional mobility among stroke survivors. The sum PEDro score ranged from five to nine points (fair-to-good methodological quality, but the absence of concealed allocation and blinded assessors were reported in most studies. Results: The aggregated results showed that MB exercise intervention is associated with significantly improved ADL (Hedges’ g = 1.31, 95% CI 0.85 to 1.77, p < 0.001, I2 = 79.82% and mobility (Hedges’ g = 0.67, 95% CI 0.25 to 1.09, p < 0.001, I2 = 69.65%, and reduced depression (Hedges’ g = −0.76, 95% CI −1.16 to −0.35, p < 0.001, I2 = 74.84%. Conclusions: as add-on treatments, the MB exercises may potentially improve depression, activities of daily living, and mobility of these post-stroke patients. Future studies with more robust methodology will be needed to provide a more definitive conclusion.

  10. Effects of Mind-Body Exercises for Mood and Functional Capabilities in Patients with Stroke: An Analytical Review of Randomized Controlled Trials.

    Science.gov (United States)

    Zou, Liye; Yeung, Albert; Zeng, Nan; Wang, Chaoyi; Sun, Li; Thomas, Garrett Anthony; Wang, Huiru

    2018-04-11

    Objective : The effects of stroke are both physical and mental in nature and may have serious implications on the overall well-being of stroke survivors. This analytical review aims to critically evaluate and statistically synthesize the existing literature regarding the effects of mind-body (MB) exercises on mood and functional capabilities in patients with stroke. Methods : A structured literature review was performed in both English (PubMed, PEDro, and Cochrane Library) and Chinese (Wanfang and CNKI (Chinese National Knowledge Information Database)) databases. Sixteen randomized controlled trials were considered eligible for meta-analysis. Based on the random effects model, we used the pooled effect size to determine the magnitude of rehabilitative effect of MB exercise intervention on depression, anxiety, activities of daily living, and functional mobility among stroke survivors. The sum PEDro score ranged from five to nine points (fair-to-good methodological quality), but the absence of concealed allocation and blinded assessors were reported in most studies. Results : The aggregated results showed that MB exercise intervention is associated with significantly improved ADL (Hedges' g = 1.31, 95% CI 0.85 to 1.77, p < 0.001, I ² = 79.82%) and mobility (Hedges' g = 0.67, 95% CI 0.25 to 1.09, p < 0.001, I ² = 69.65%), and reduced depression (Hedges' g = -0.76, 95% CI -1.16 to -0.35, p < 0.001, I ² = 74.84%). Conclusions : as add-on treatments, the MB exercises may potentially improve depression, activities of daily living, and mobility of these post-stroke patients. Future studies with more robust methodology will be needed to provide a more definitive conclusion.

  11. Mobilities

    DEFF Research Database (Denmark)

    to social networks, personal identities, and our relationship to the built environment. The omnipresence of mobilities within everyday life, high politics, technology, and tourism (to mention but a few) all point to a key insight harnessed by the ‘mobilities turn’. Namely that mobilities is much more than......The world is on the move. This is a widespread understanding by many inhabitants of contemporary society across the Globe. But what does it actually mean? During over one decade the ‘mobilities turn’ within the social sciences have provided a new set of insights into the repercussions of mobilities...... and environmental degradation. The spaces and territories marked by mobilities as well as the sites marked by the bypassing of such are explored. Moreover, the architectural and technological dimensions to infrastructures and sites of mobilities will be included as well as the issues of power, social exclusion...

  12. Knowledge of Stroke Risk Factors among Stroke Survivors in Nigeria

    OpenAIRE

    Grace Vincent-Onabajo; Taritei Moses

    2016-01-01

    Background. Knowledge of stroke risk factors is expected to reduce the incidence of stroke?whether first-ever or recurrent. This study examined knowledge of stroke risk factors and its determinants among stroke survivors. Methods. A cross-sectional survey of consenting stroke survivors at two physiotherapy facilities in Nigeria was carried out. Sociodemographic and clinical data were obtained and knowledge of stroke risk factors (defined as the ability to mention at least one correct risk fac...

  13. Identification of stroke mimics among clinically diagnosed acute strokes.

    Science.gov (United States)

    Tuntiyatorn, Lojana; Saksornchai, Pichaya; Tunlayadechanont, Supoch

    2013-09-01

    Stroke is a clinically syndrome of a sudden onset of neurological deficit in a vascular cause. Stroke mimics is the non-vascular disorders with stroke-like clinical symptoms. It is important to distinguish true stroke from mimics since treatment plan may differ To determine the incidence of the stroke mimics and identify their etiologies. All non-contrast head CT of the patients with clinically diagnosed stroke who immediately received imaging upon arrival at the emergency department of the university hospital were retrospectively reviewed in 12-month period between January 1 and December 31, 2008. Medical records, laboratory results, MRI, and 6-month clinical follow-up records were reviewed for final diagnosis. Seven hundred four patients were included in this study, including 363 (51.5%) men and 341 (48.5%) women with range in age from 24 to 108 years. Amongst those, 417 (59.2%) were ischemic stroke, 80 (11.40%) were hemorrhagic stroke, 186 (26.4%) were stroke-mimics, and 21 (3%) were inconclusive. The etiologies among stroke-mimics were metabolic/intoxication (35, 18.8%), sepsis (28, 15.0%), seizure (21, 11.3%), syncope (20, 10.8%), subdural hemorrhage (14, 7.5%), vertigo (11, 6.0%), brain tumor (10, 5.30%), central nervous system infection (5, 2.7%), others (26, 14.0%), and unspecified (16, 8.6%). Incidence rates and etiologies of the stroke mimics were similar to the western reports. However the frequency of each mimic was not.

  14. Prevention Of Stroke

    Directory of Open Access Journals (Sweden)

    Nagaraja D

    2005-01-01

    Full Text Available Stroke is an important cause for neurological morbidity and mortality. Prevention of ischemic stroke involves identification and prevention of risk factors and optimal use of pharmacotherapy. Risk factors have been classified as modifiable and non-modifiable; control of modifiable factors should prevent stroke occurrence. Stroke prevention has been described at three levels: primary, secondary and tertiary. Prolonged hypertension increases an individual′s risk for developing fatal or nonfatal stroke by three times and its control has been shown to prevent stroke. Diabetes mellitus is an important cause for microangiopathy and predisposes to stroke. Statin trials have shown significant reduction in stroke in those who were treated with statins. Stroke risk can be reduced by avoiding tobacco use, control of obesity and avoiding sedentary life style. Anti platelet medications are effective for secondary prevention of stroke. Educating society regarding modifiable risk factors and optimal use of pharmacotherapy form the cornerstone for the prevention of stroke.

  15. Voluntary muscle activation improves with power training and is associated with changes in gait speed in mobility-limited older adults

    DEFF Research Database (Denmark)

    Hvid, Lars G; Strotmeyer, Elsa S; Skjødt, Mathias

    2016-01-01

    Incomplete voluntary muscle activation may contribute to impaired muscle mechanical function and physical function in older adults. Exercise interventions have been shown to increase voluntary muscle activation, although the evidence is sparse for mobility-limited older adults, particularly...... in association with physical function. This study examined the effects of 12weeks of power training on outcomes of voluntary muscle activation and gait speed in mobility-limited older adults from the Healthy Ageing Network of Competence (HANC) study. We included 37 older men and women with a usual gait speed...... in TG (r=0.67, pactivation is improved in mobility-limited older adults following 12-weeks of progressive power training, and is associated with improved maximal gait speed. Incomplete voluntary muscle activation should be considered one of the key mechanisms...

  16. Stroke risk perception among participants of a stroke awareness campaign

    Science.gov (United States)

    Kraywinkel, Klaus; Heidrich, Jan; Heuschmann, Peter U; Wagner, Markus; Berger, Klaus

    2007-01-01

    Background Subjective risk factor perception is an important component of the motivation to change unhealthy life styles. While prior studies assessed cardiovascular risk factor knowledge, little is known about determinants of the individual perception of stroke risk. Methods Survey by mailed questionnaire among 1483 participants of a prior public stroke campaign in Germany. Participants had been informed about their individual stroke risk based on the Framingham stroke risk score. Stroke risk factor knowledge, perception of lifetime stroke risk and risk factor status were included in the questionnaire, and the determinants of good risk factor knowledge and high stroke risk perception were identified using logistic regression models. Results Overall stroke risk factor knowledge was good with 67–96% of the participants recognizing established risk factors. The two exceptions were diabetes (recognized by 49%) and myocardial infarction (57%). Knowledge of a specific factor was superior among those affected by it. 13% of all participants considered themselves of having a high stroke risk, 55% indicated a moderate risk. All major risk factors contributed significantly to the perception of being at high stroke risk, but the effects of age, sex and education were non-significant. Poor self-rated health was additionally associated with high individual stroke risk perception. Conclusion Stroke risk factor knowledge was high in this study. The self perception of an increased stroke risk was associated with established risk factors as well as low perception of general health. PMID:17371603

  17. Electric Power Substitute Meter Management via Mobile Application

    Directory of Open Access Journals (Sweden)

    Nelson C. Rodelas

    2014-10-01

    Full Text Available EPSMvMA is composed of Digital Sub-Meter connected to different components namely the GSM module, Bluetooth module, Power Analyzer Module, LCD Module, Relay Module and Main Microcontroller module. The connection via Mobile is made possible by the modules mentioned. The software that the proponents will be dealing with in the study is C++ language, which will be used in programming the Main Microcontroller module and Visual Basic Language for the Android Phones. The Bluetooth module can access the Android Phones and connect to the digital sub-meter in a limited distance. The users will be at ease since a code embedded to the microcontroller will make the utility sub-meter produce the desired value of electricity (KWH and wherein the computed Sub-meter reading can be viewed through the LCD. This project is accommodating to those person that is always on the go and prudent.

  18. Mobility Charters and Manifestos

    DEFF Research Database (Denmark)

    Jensen, Ole B.

    2010-01-01

    This paper explore a number of different cases of articulating notions of ‘correct’ mobility behavior and practice by looking into charters, manifestos and codes of mobility regulation. Within such discourses of ‘correct mobility’ more or less subtle expressions of power as well as normative and ...... ‘Highway Code Booklets’ from the 1930’s, 40’s and 50’s, the ‘City Slow Charter’, the ‘New Urbanism Charter’ as attempts to codify and order mobility and mobile practices.......This paper explore a number of different cases of articulating notions of ‘correct’ mobility behavior and practice by looking into charters, manifestos and codes of mobility regulation. Within such discourses of ‘correct mobility’ more or less subtle expressions of power as well as normative...... and ethical positions on mobility prevail. Such ‘imagined correct mobility behavior’ are drawing on larger issues of societal change that need to be brought out in a critical analysis and discussion reflecting the attempts to control, design and orchestrate mobility patterns. The paper therefore argues within...

  19. A comparison of two systems for lunar surface remote and mobile power applications

    International Nuclear Information System (INIS)

    Determan, W.R.; Otting, W.D.; Hunt, M.E.

    1993-01-01

    The free piston Stirling engine (FPSE) is now being developed by Mechanical Technology Incorporated (MTI) and NASA-LeRC for space power applications. Some conceptualizations of an isotope powered FPSE have been proposed. The performance characteristics of the proposed 2.5-kWe Stirling Isotope Power (STIP) system were developed for lunar surface remote and mobile applications. The Stirling system configuration uses a nonredundant power conversion system coupled to an annular heat source assembly (HSA) using an array of sodium heat pipes which transfer energy from the annular general-purpose heat source (GPHS) stack within the HSA to the Stirling heater head. The Stirling engine uses a dual-opposed piston design with heater head coupling. The engine coolers are connected to a single-pumped coolant loop, which rejects the cycle's waste heat to a radiator. Quantitative information, such as mass, area, and efficiency, are reported for the system. The results of a qualitative evaluation of the proposed STIP system against the desirable attributes of a lunar-based isotope power system are presented. Alternate configurations are also presented

  20. Wireless Power System Design for Mobile Robots used in Nuclear Power Plants

    Energy Technology Data Exchange (ETDEWEB)

    Choi, S. Y.; Yoo, S. J.; Lee, Kun J.; Rim, C. T. [Korea Advanced Institute of Science and Technology, Daejeon (Korea, Republic of)

    2012-05-15

    The robots used in nuclear power plants (NPP) have received much attention in recent years due to the Fukushima nuclear accident, which is considered as one of the worst nuclear disasters. In general, the NPP robots can play important roles in fuel exchange, repair work, radiation monitoring, rescue, and scouting out NPP. Under these conditions, human access to NPP during normal and emergency operations is strictly restricted due to the risks of high level radiation and contamination. However, in practice, robots have not been widely used in NPP because of the following limitations. First, the NPP robots cannot be of multi-purpose use because of their mission complexity and uniqueness. Second, the demand of the NPP robots is low due to the limited number of NPP over the world. Third, the NPP robots developed so far have no enough confidence in spite of the improvement of robot technology. Lastly, the NPP robots cannot carry on their mission continuously due to the limited energy capacity of the battery: mobile robots should stop working every two hours to recharge their batteries and spend least twenty minutes. As the solutions for this 'energy hungry' problem, high capacity batteries, quick battery chargers, power cables, and internal combustion engines were proposed; however, they still have the problems such as limited mission time and range, frequent recharging, or exhausting emission and noise. In this paper, the wireless power transfer systems (WPTS) for NPP robots are proposed. This technology can let NPP robots free from mission time and range limits, and exhausting emission. The requirements for the NPP robots are newly proposed, and two types of WPTS, roaming and railway, are suggested in this paper

  1. Study protocol: home-based telehealth stroke care: a randomized trial for veterans

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    McGee-Hernandez Nancy

    2010-06-01

    Full Text Available Abstract Background Stroke is one of the most disabling and costly impairments of adulthood in the United States. Stroke patients clearly benefit from intensive inpatient care, but due to the high cost, there is considerable interest in implementing interventions to reduce hospital lengths of stay. Early discharge rehabilitation programs require coordinated, well-organized home-based rehabilitation, yet lack of sufficient information about the home setting impedes successful rehabilitation. This trial examines a multifaceted telerehabilitation (TR intervention that uses telehealth technology to simultaneously evaluate the home environment, assess the patient's mobility skills, initiate rehabilitative treatment, prescribe exercises tailored for stroke patients and provide periodic goal oriented reassessment, feedback and encouragement. Methods We describe an ongoing Phase II, 2-arm, 3-site randomized controlled trial (RCT that determines primarily the effect of TR on physical function and secondarily the effect on disability, falls-related self-efficacy, and patient satisfaction. Fifty participants with a diagnosis of ischemic or hemorrhagic stroke will be randomly assigned to one of two groups: (a TR; or (b Usual Care. The TR intervention uses a combination of three videotaped visits and five telephone calls, an in-home messaging device, and additional telephonic contact as needed over a 3-month study period, to provide a progressive rehabilitative intervention with a treatment goal of safe functional mobility of the individual within an accessible home environment. Dependent variables will be measured at baseline, 3-, and 6-months and analyzed with a linear mixed-effects model across all time points. Discussion For patients recovering from stroke, the use of TR to provide home assessments and follow-up training in prescribed equipment has the potential to effectively supplement existing home health services, assist transition to home and

  2. Experimental Evaluation of a Method for Turbocharging Four-Stroke, Single Cylinder, Internal Combustion Engines

    Science.gov (United States)

    Buchman, Michael; Winter, Amos

    2015-11-01

    Turbocharging an engine increases specific power, improves fuel economy, reduces emissions, and lowers cost compared to a naturally aspirated engine of the same power output. These advantages make turbocharging commonplace for multi-cylinder engines. Single cylinder engineers are not commonly turbocharged due to the phase lag between the exhaust stroke, which powers the turbocharger, and the intake stroke, when air is pumped into the engine. Our proposed method of turbocharging single cylinder engines is to add an ``air capacitor'' to the intake manifold, an additional volume that acts as a buffer to store compressed air between the exhaust and intake strokes, and smooth out the pressure pulses from the turbocharger. This talk presents experimental results from a single cylinder, turbocharged diesel engine fit with various sized air capacitors. Power output from the engine was measured using a dynamometer made from a generator, with the electrical power dissipated with resistive heating elements. We found that intake air density increases with capacitor size as theoretically predicted, ranging from 40 to 60 percent depending on heat transfer. Our experiment was able to produce 29 percent more power compared to using natural aspiration. These results validated that an air capacitor and turbocharger may be a simple, cost effective means of increasing the power density of single cylinder engines.

  3. Blood Pressure Control: Stroke and Stroke Prevention

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    Hans-Christoph Diener

    2005-03-01

    Full Text Available Hypertension is the most important modifiable risk factor for primary and secondary stroke prevention.All antihypertensive drugs are effective in primary prevention: the risk reduction for stroke is 30—42%. However, not all classes of drugs have the same effects: there is some indication that angiotensin receptor blockers may be superior to other classes of antihypertensive drugs in stroke prevention.Seventy-five percent of patients who present to hospital with acute stroke have elevated blood pressure within the first 24—48 hours. Extremes of systolic blood pressure (SBP increase the risk of death or dependency. The aim of treatment should be to achieve and maintain the SBP in the range 140—160 mmHg. However, fast and drastic blood pressure lowering can have adverse consequences.The PROGRESS trial of secondary prevention with perindopril + indapamide versus placebo + placebo showed a decrease in numbers of stroke recurrences in patients given both active antihypertensive agents, more impressive for cerebral haemorrhage.There were also indications that active treatment might decrease the development of post-stroke dementia.

  4. Hemorrhagic and ischemic strokes compared: stroke severity, mortality, and risk factors.

    Science.gov (United States)

    Andersen, Klaus Kaae; Olsen, Tom Skyhøj; Dehlendorff, Christian; Kammersgaard, Lars Peter

    2009-06-01

    Stroke patients with hemorrhagic (HS) and ischemic strokes were compared with regard to stroke severity, mortality, and cardiovascular risk factors. A registry started in 2001, with the aim of registering all hospitalized stroke patients in Denmark, now holds information for 39,484 patients. The patients underwent an evaluation including stroke severity (Scandinavian Stroke Scale), CT, and cardiovascular risk factors. They were followed-up from admission until death or censoring in 2007. Independent predictors of death were identified by means of a survival model based on 25,123 individuals with a complete data set. Of the patients 3993 (10.1%) had HS. Stroke severity was almost linearly related to the probability of having HS (2% in patients with the mildest stroke and 30% in those with the most severe strokes). Factors favoring ischemic strokes vs HS were diabetes, atrial fibrillation, previous myocardial infarction, previous stroke, and intermittent arterial claudication. Smoking and alcohol consumption favored HS, whereas age, sex, and hypertension did not herald stroke type. Compared with ischemic strokes, HS was associated with an overall higher mortality risk (HR, 1.564; 95% CI, 1.441-1.696). The increased risk was, however, time-dependent; initially, risk was 4-fold, after 1 week it was 2.5-fold, and after 3 weeks it was 1.5-fold. After 3 months stroke type did not correlate to mortality. Strokes are generally more severe in patients with HS. Within the first 3 months after stroke, HS is associated with a considerable increase of mortality, which is specifically associated with the hemorrhagic nature of the lesion.

  5. Stroke Care 2: Stroke rehabilitation

    NARCIS (Netherlands)

    Langhorne, P.; Bernhardt, J.; Kwakkel, G.

    2011-01-01

    Stroke is a common, serious, and disabling global health-care problem, and rehabilitation is a major part of patient care. There is evidence to support rehabilitation in well coordinated multidisciplinary stroke units or through provision of early supported provision of discharge teams. Potentially

  6. Airplane stroke syndrome.

    Science.gov (United States)

    Humaidan, Hani; Yassi, Nawaf; Weir, Louise; Davis, Stephen M; Meretoja, Atte

    2016-07-01

    Only 37 cases of stroke during or soon after long-haul flights have been published to our knowledge. In this retrospective observational study, we searched the Royal Melbourne Hospital prospective stroke database and all discharge summaries from 1 September 2003 to 30 September 2014 for flight-related strokes, defined as patients presenting with stroke within 14days of air travel. We hypothesised that a patent foramen ovale (PFO) is an important, but not the only mechanism, of flight-related stroke. We describe the patient, stroke, and flight characteristics. Over the study period, 131 million passengers arrived at Melbourne airport. Our centre admitted 5727 stroke patients, of whom 42 (0.73%) had flight-related strokes. Flight-related stroke patients were younger (median age 65 versus 73, p<0.001), had similar stroke severity, and received intravenous thrombolysis more often than non-flight-related stroke patients. Seven patients had flight-related intracerebral haemorrhage. The aetiology of the ischaemic strokes was cardioembolic in 14/35 (40%), including seven patients with confirmed PFO, one with atrial septal defect, four with atrial fibrillation, one with endocarditis, and one with aortic arch atheroma. Paradoxical embolism was confirmed in six patients. Stroke related to air travel is a rare occurrence, less than one in a million. Although 20% of patients had a PFO, distribution of stroke aetiologies was diverse and was not limited to PFO and paradoxical embolism. Copyright © 2016 Elsevier Ltd. All rights reserved.

  7. Accuracy and reliability of observational gait analysis data: judgments of push-off in gait after stroke.

    Science.gov (United States)

    McGinley, Jennifer L; Goldie, Patricia A; Greenwood, Kenneth M; Olney, Sandra J

    2003-02-01

    Physical therapists routinely observe gait in clinical practice. The purpose of this study was to determine the accuracy and reliability of observational assessments of push-off in gait after stroke. Eighteen physical therapists and 11 subjects with hemiplegia following a stroke participated in the study. Measurements of ankle power generation were obtained from subjects following stroke using a gait analysis system. Concurrent videotaped gait performances were observed by the physical therapists on 2 occasions. Ankle power generation at push-off was scored as either normal or abnormal using two 11-point rating scales. These observational ratings were correlated with the measurements of peak ankle power generation. A high correlation was obtained between the observational ratings and the measurements of ankle power generation (mean Pearson r=.84). Interobserver reliability was moderately high (mean intraclass correlation coefficient [ICC (2,1)]=.76). Intraobserver reliability also was high, with a mean ICC (2,1) of.89 obtained. Physical therapists were able to make accurate and reliable judgments of push-off in videotaped gait of subjects following stroke using observational assessment. Further research is indicated to explore the accuracy and reliability of data obtained with observational gait analysis as it occurs in clinical practice.

  8. Identification of Barriers to Stroke Awareness and Risk Factor Management Unique to Hispanics

    Directory of Open Access Journals (Sweden)

    Marina Martinez

    2015-12-01

    Full Text Available Barriers to risk factor control may differ by race/ethnicity. The goal of this study was to identify barriers to stroke awareness and risk factor management unique to Hispanics as compared to non-Hispanic whites (NHWs. We performed a prospective study of stroke patients from an academic Stroke Center in Arizona and surveyed members of the general community. Questionnaires included: the Duke Social Support Index (DSSI, the Multidimensional Health Locus of Control (MHLC Scale, a stroke barriers questionnaire, and a Stroke Awareness Test. Of 145 stroke patients surveyed (72 Hispanic; 73 NHW, Hispanics scored lower on the Stroke Awareness Test compared to NHWs (72.5% vs. 79.1%, p = 0.029. Hispanic stroke patients also reported greater barriers related to medical knowledge, medication adherence, and healthcare access (p < 0.05 for all. Hispanics scored higher on the “powerful others” sub-scale (11.3 vs. 10, p < 0.05 of the MHLC. Of 177 members of the general public surveyed, Hispanics had lower stroke awareness compared to NHWs and tended to have lower awareness than Hispanic stroke patients. These results suggest that Hispanic stroke patients perceive less control over their health, experience more healthcare barriers, and demonstrate lower rates of stroke literacy. Interventions for stroke prevention and education in Hispanics should address these racial/ethnic differences in stroke awareness and barriers to risk factor control.

  9. System Architecture and Mobility Management for Mobile Immersive Communications

    Directory of Open Access Journals (Sweden)

    Mehran Dowlatshahi

    2007-01-01

    Full Text Available We propose a system design for delivery of immersive communications to mobile wireless devices based on a distributed proxy model. It is demonstrated that this architecture addresses key technical challenges for the delivery of these services, that is, constraints on link capacity and power consumption in mobile devices. However, additional complexity is introduced with respect to application layer mobility management. The paper proposes three possible methods for updating proxy assignments in response to mobility management and compares the performance of these methods.

  10. Developing a falls prevention program for community-dwelling stroke survivors in Singapore: client and caregiver perspectives.

    Science.gov (United States)

    Xu, Tianma; O'Loughlin, Kate; Clemson, Lindy; Lannin, Natasha A; Dean, Catherine; Koh, Gerald

    2017-12-25

    Drawing on the perspectives of stroke survivors, family members and domestic helpers, this study explores participants' experiences of self-perceived fall risk factors after stroke, common fall prevention strategies used, and challenges to community participation after a fall. Semi-structured interviews were conducted in Singapore with community-dwelling stroke survivors with a previous fall (n = 9), family caregivers (n = 4), and domestic helpers (n = 4) who have cared for a stroke survivor with a previous fall. Purposive sampling was used for recruitment; all interviews were audio-recorded with permission and transcribed. Thematic analysis was conducted using NVivo (v10) software. All participants shared their self-perceived intrinsic and extrinsic fall risk factors and main challenges after a fall. For stroke participants and family caregivers, motivational factors in developing safety strategies after a previous fall(s) include social connectedness, independent living and community participation. For family caregivers and domestic helpers, the stroke survivor's safety is their top priority, however this can also lead to over-protective behavior outside of the rehabilitation process. Reducing the risk of falls in community-dwelling stroke survivors seems to be more important than promoting community participation among caregivers. The study findings highlight that a structured and client-centered fall prevention program targeting stroke survivors and caregivers is needed in Singapore. Implications for rehabilitation Falls after stroke can lead to functional decline in gait and mobility and restricted self-care activities. Community-dwelling stroke survivors develop adaptive safety strategies after a fall and want to be socially connected. However, caregivers see the safety of the stroke survivors as their top priority and demonstrate over-protective behaviors. Fall prevention programs for community-dwelling stroke survivors should target both stroke

  11. Mobile Service Platform: A Middleware for Nomadic Mobile Service Provisioning

    NARCIS (Netherlands)

    van Halteren, Aart; Pawar, P.

    Nowadays mobile devices are characterized by higher processing power, lower costs, multiple network interfaces, ability to support multiple auxiliary devices and connect to the Internet using a wireless network. The applications collecting statistics concerning the mobile user, computational and

  12. Risk Factors for Stroke-associated Pneumonia: A Prospective Cohort Study

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    Alexis Suárez Quesada

    2015-12-01

    Full Text Available Background: stroke-associated pneumonia prolongs hospital stay and is an important risk factor for morbidity and mortality. Objective: to determine risk factors for stroke-associated pneumonia. Methods: a prospective single-cohort study was conducted involving 390 patients aged 16-93 years who met clinical and neuroimaging criteria for acute stroke treated at the Carlos Manuel de Céspedes Hospital from January 2012 through March 2015. Univariate comparison of qualitative variables was performed by using the Kaplan-Meier method. The Cox regression model was applied for multivariate analysis of risk factors for pneumonia. The area under the ROC curve was used to determine the discriminatory power of the model. Results: two hundred thirteen patients (54.6 % with ischemic stroke and 177 (45.4 % with hemorrhagic stroke were studied. Cases of nosocomial pneumonia after acute stroke accounted for 25.4 %. Subjects who developed pneumonia had lower scores on the Glasgow scale and higher scores on the modified Rankin scale. The following risk factors were identified using the Cox regression model: Glasgow coma score (Exp (B: 0.687; 95 % CI 0.630 to 0.750 and stroke subtype (Exp (B: 1.723; 95 % CI 1.137 to 2.610. The area under the ROC curve was 0.88. Conclusions: the risk factors for the development of nosocomial pneumonia after acute stroke found were the level of consciousness and suffering a hemorrhagic stroke. Other influencing variables are chronic obstructive pulmonary disease and heart disease as a comorbid condition.

  13. Streamlining Workflow for Endovascular Mechanical Thrombectomy: Lessons Learned from a Comprehensive Stroke Center.

    Science.gov (United States)

    Wang, Hongjin; Thevathasan, Arthur; Dowling, Richard; Bush, Steven; Mitchell, Peter; Yan, Bernard

    2017-08-01

    Recently, 5 randomized controlled trials confirmed the superiority of endovascular mechanical thrombectomy (EMT) to intravenous thrombolysis in acute ischemic stroke with large-vessel occlusion. The implication is that our health systems would witness an increasing number of patients treated with EMT. However, in-hospital delays, leading to increased time to reperfusion, are associated with poor clinical outcomes. This review outlines the in-hospital workflow of the treatment of acute ischemic stroke at a comprehensive stroke center and the lessons learned in reduction of in-hospital delays. The in-hospital workflow for acute ischemic stroke was described from prehospital notification to femoral arterial puncture in preparation for EMT. Systematic review of literature was also performed with PubMed. The implementation of workflow streamlining could result in reduction of in-hospital time delays for patients who were eligible for EMT. In particular, time-critical measures, including prehospital notification, the transfer of patients from door to computed tomography (CT) room, initiation of intravenous thrombolysis in the CT room, and the mobilization of neurointervention team in parallel with thrombolysis, all contributed to reduction in time delays. We have identified issues resulting in in-hospital time delays and have reported possible solutions to improve workflow efficiencies. We believe that these measures may help stroke centers initiate an EMT service for eligible patients. Copyright © 2017 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  14. Stroke Rehabilitation.

    Science.gov (United States)

    Belagaje, Samir R

    2017-02-01

    Rehabilitation is an important aspect of the continuum of care in stroke. With advances in the acute treatment of stroke, more patients will survive stroke with varying degrees of disability. Research in the past decade has expanded our understanding of the mechanisms underlying stroke recovery and has led to the development of new treatment modalities. This article reviews and summarizes the key concepts related to poststroke recovery. Good data now exist by which one can predict recovery, especially motor recovery, very soon after stroke onset. Recent trials have not demonstrated a clear benefit associated with very early initiation of rehabilitative therapy after stroke in terms of improvement in poststroke outcomes. However, growing evidence suggests that shorter and more frequent sessions of therapy can be safely started in the first 24 to 48 hours after a stroke. The optimal amount or dose of therapy for stroke remains undetermined, as more intensive treatments have not been associated with better outcomes compared to standard intensities of therapy. Poststroke depression adversely affects recovery across a variety of measures and is an important target for therapy. Additionally, the use of selective serotonin reuptake inhibitors (SSRIs) appears to benefit motor recovery through pleiotropic mechanisms beyond their antidepressant effect. Other pharmacologic approaches also appear to have a benefit in stroke rehabilitation. A comprehensive rehabilitation program is essential to optimize poststroke outcomes. Rehabilitation is a process that uses three major principles of recovery: adaptation, restitution, and neuroplasticity. Based on these principles, multiple different approaches, both pharmacologic and nonpharmacologic, exist to enhance rehabilitation. In addition to neurologists, a variety of health care professionals are involved in stroke rehabilitation. Successful rehabilitation involves understanding the natural history of stroke recovery and a

  15. Ethnic differences in ischemic stroke subtypes in young-onset stroke: the Stroke Prevention in Young Adults Study.

    Science.gov (United States)

    Trivedi, Megh M; Ryan, Kathleen A; Cole, John W

    2015-10-29

    Prior studies indicate that young African-Americans (AA) have a greater frequency of ischemic stroke than similarly aged European-Americans (EA). We hypothesized that differences in stroke subtype frequency mediated through sex and differing risk factor profiles may play a role in ethnicity-specific stroke. Utilizing our biracial young-onset stroke population, we explored these relationships. Fifty nine hospitals in the Baltimore-Washington area participated in a population-based study of young-onset stroke in men (218-AA, 291-EA) and women (219-AA, 222-EA) aged 16-49. Data on age, sex, ethnicity and stroke risk factors (hypertension (HTN) and smoking) were gathered through standardized interview. A pair of vascular neurologists adjudicated each case to determine TOAST subtype. Logistic regression analyses evaluating for differences in stroke risk factors by TOAST subtype were performed. Analyses controlling for age and sex demonstrated that AA were more likely to have a lacunar stroke than EA (OR = 1.61; 95% CI = 1.12-2.32; p = 0.011) when utilizing the other TOAST subtypes as the reference group. This effect was mediated by HTN, which increases the risk of lacunar stroke (OR = 2.03; 95% CI = 1.38-2.98; p = 0.0003) and large artery stroke (OR = 1.70; 95% CI = 1.01-2.88; p = 0.048) when controlling for sex, ethnicity, and age. Cases below age 40 were more likely to have a cardioembolic stroke than those above age 40 (OR = 1.62; 95% CI = 1.15-2.27; p = 0.006), controlling for sex and ethnicity. Lastly, current smokers were more likely to have a large artery stroke than non-smokers (OR = 1.79; 95% CI = 1.08-2.98; p = 0.024). Our population-based data demonstrate ethnic differences in ischemic stroke subtypes. These findings may help clarify mechanisms of stroke in young adults which may in part be driven by ethnic-specific differences in early-onset traditional risk factors, thereby indicating differing emphasis on workup and prevention.

  16. Bilateral versus ipsilesional cortico-subcortical activity patterns in stroke show hemispheric dependence.

    Science.gov (United States)

    Vidal, Ana C; Banca, Paula; Pascoal, Augusto G; Cordeiro, Gustavo; Sargento-Freitas, João; Gouveia, Ana; Castelo-Branco, Miguel

    2018-01-01

    Background Understanding of interhemispheric interactions in stroke patients during motor control is an important clinical neuroscience quest that may provide important clues for neurorehabilitation. In stroke patients bilateral overactivation in both hemispheres has been interpreted as a poor prognostic indicator of functional recovery. In contrast, ipsilesional patterns have been linked with better motor outcomes. Aim We investigated the pathophysiology of hemispheric interactions during limb movement without and with contralateral restraint, to mimic the effects of constraint-induced movement therapy. We used neuroimaging to probe brain activity with such a movement-dependent interhemispheric modulation paradigm. Methods We used a functional magnetic resonance imaging block design during which the plegic/paretic upper limb was recruited/mobilized to perform unilateral arm elevation, as a function of presence versus absence of contralateral limb restriction (n = 20, with balanced left/right lesion sites). Results Analysis of 10 right hemispheric stroke participants yielded bilateral sensorimotor cortex activation in all movement phases in contrast with the unilateral dominance seen in the 10 left hemispheric stroke participants. Superimposition of contralateral restriction led to a prominent shift from activation to deactivation response patterns, in particular in cortical and basal ganglia motor areas in right hemispheric stroke. Left hemispheric stroke was, in general, characterized by reduced activation patterns, even in the absence of restriction, which induced additional cortical silencing. Conclusion The observed hemispheric-dependent activation/deactivation shifts is novel and these pathophysiological observations suggest short-term neuroplasticity that may be useful for hemisphere-tailored neurorehabilitation.

  17. Dual-task training effects on motor and cognitive functional abilities in individuals with stroke: a systematic review.

    Science.gov (United States)

    He, Ying; Yang, Lei; Zhou, Jing; Yao, Liqing; Pang, Marco Yiu Chung

    2018-02-01

    This systematic review aimed to examine the effects of dual-task balance and mobility training in people with stroke. An extensive electronic databases literature search was conducted using MEDLINE, PubMed, EBSCO, The Cochrane Library, Web of Science, SCOPUS, and Wiley Online Library. Randomized controlled studies that assessed the effects of dual-task training in stroke patients were included for the review (last search in December 2017). The methodological quality was evaluated using the Cochrane Collaboration recommendation, and level of evidence was determined according to the criteria described by the Oxford Center for Evidence-Based Medicine. About 13 articles involving 457 participants were included in this systematic review. All had substantial risk of bias and thus provided level IIb evidence only. Dual-task mobility training was found to induce more improvement in single-task walking function (standardized effect size = 0.14-2.24), when compared with single-task mobility training. Its effect on dual-task walking function was not consistent. Cognitive-motor balance training was effective in improving single-task balance function (standardized effect size = 0.27-1.82), but its effect on dual-task balance ability was not studied. The beneficial effect of dual-task training on cognitive function was provided by one study only and thus inconclusive. There is some evidence that dual-task training can improve single-task walking and balance function in individuals with stroke. However, any firm recommendation cannot be made due to the weak methodology of the studies reviewed.

  18. Outcome Determinants of Stroke in a Brazilian Primary Stroke Center

    Directory of Open Access Journals (Sweden)

    Gustavo W. Kuster

    2014-01-01

    Full Text Available Background. Stroke mortality in Brazil is one of the highest among Western countries. Nonetheless, stroke outcome determinants are still poorly known in this country. In this study we evaluate outcome determinants of stroke in a primary stroke center in São Paulo, Brazil. Methods. We evaluated demographic, clinical, and outcome data of patients with ischemic stroke (IS, transient ischemic attack (TIA, and intracerebral hemorrhage (ICH admitted at “Hospital Paulistano,” São Paulo, Brazil. In-hospital mortality and functional outcome determinants were assessed. Univariate and binary logistic regression analysis were performed. Results. Three hundred forty-one patients were included in the study, 52.2% being male with 66.8±15.7 years. The stroke type distribution was IS: 59.2%, TIA: 29.6%, and ICH: 11.1%. ICH was associated with greater severity and poorer functional outcome. The determinants of poorer functional outcome were higher NIHSS, lower Glasgow score, and lower oxygen saturation level. The most important mortality determinant was the presence of visual symptoms. Conclusions. The stroke mortality and stroke outcome determinants found in the present study do not remarkably differ from studies carried out in developed countries. Stroke prognosis studies are crucial to better understand the high burden of stroke in Brazil.

  19. Hemorrhagic Cardioembolic Stroke Secondary to a Left Ventricular Thrombus: a Therapeutic Dilemma

    Directory of Open Access Journals (Sweden)

    Khalil Al-Farsi

    2013-01-01

    Full Text Available Cardiogenic embolism is a major cause of stroke and often leads to significant morbidity and mortality. Despite the recent advances in our understanding of the pathophysiology of stroke and its risk factors, diagnosis and therapy; some case scenarios still present a real challenge for the treating physicians. We report a case of a 50 year old male patient presenting with multi-territory cerebral infarctions due to a left ventricular mobile thrombus complicated with hemorrhagic transformation at the time of presentation. Gradual introduction of anticoagulation coupled with a multidisciplinary team approach advocating careful daily clinical assessment of the patient and regular echocardiographic and neuroimaging studies have resulted in a better management and achievement of therapeutic goals.

  20. Analysis of mobile phone design features affecting radiofrequency power absorbed in a human head phantom.

    Science.gov (United States)

    Kuehn, Sven; Kelsh, Michael A; Kuster, Niels; Sheppard, Asher R; Shum, Mona

    2013-09-01

    The US FCC mandates the testing of all mobile phones to demonstrate compliance with the rule requiring that the peak spatial SAR does not exceed the limit of 1.6 W/kg averaged over any 1 g of tissue. These test data, measured in phantoms with mobile phones operating at maximum antenna input power, permitted us to evaluate the variation in SARs across mobile phone design factors such as shape and antenna design, communication technology, and test date (over a 7-year period). Descriptive statistical summaries calculated for 850 MHz and 1900 MHz phones and ANOVA were used to evaluate the influence of the foregoing factors on SARs. Service technology accounted for the greatest variability in compliance test SARs that ranged from AMPS (highest) to CDMA, iDEN, TDMA, and GSM (lowest). However, the dominant factor for SARs during use is the time-averaged antenna input power, which may be much less than the maximum power used in testing. This factor is largely defined by the communication system; e.g., the GSM phone average output can be higher than CDMA by a factor of 100. Phone shape, antenna type, and orientation of a phone were found to be significant but only on the order of up to a factor of 2 (3 dB). The SAR in the tilt position was significantly smaller than for touch. The side of the head did not affect SAR levels significantly. Among the remaining factors, external antennae produced greater SARs than internal ones, and brick and clamshell phones produced greater SARs than slide phones. Assuming phone design and usage patterns do not change significantly over time, we have developed a normalization procedure and formula that permits reliable prediction of the relative SAR between various communication systems. This approach can be applied to improve exposure assessment in epidemiological research. Copyright © 2013 Wiley Periodicals, Inc.

  1. Rehabilitation of Motor Function after Stroke: A Multiple Systematic Review Focused on Techniques to Stimulate Upper Extremity Recovery

    Science.gov (United States)

    Hatem, Samar M.; Saussez, Geoffroy; della Faille, Margaux; Prist, Vincent; Zhang, Xue; Dispa, Delphine; Bleyenheuft, Yannick

    2016-01-01

    Stroke is one of the leading causes for disability worldwide. Motor function deficits due to stroke affect the patients' mobility, their limitation in daily life activities, their participation in society and their odds of returning to professional activities. All of these factors contribute to a low overall quality of life. Rehabilitation training is the most effective way to reduce motor impairments in stroke patients. This multiple systematic review focuses both on standard treatment methods and on innovating rehabilitation techniques used to promote upper extremity motor function in stroke patients. A total number of 5712 publications on stroke rehabilitation was systematically reviewed for relevance and quality with regards to upper extremity motor outcome. This procedure yielded 270 publications corresponding to the inclusion criteria of the systematic review. Recent technology-based interventions in stroke rehabilitation including non-invasive brain stimulation, robot-assisted training, and virtual reality immersion are addressed. Finally, a decisional tree based on evidence from the literature and characteristics of stroke patients is proposed. At present, the stroke rehabilitation field faces the challenge to tailor evidence-based treatment strategies to the needs of the individual stroke patient. Interventions can be combined in order to achieve the maximal motor function recovery for each patient. Though the efficacy of some interventions may be under debate, motor skill learning, and some new technological approaches give promising outcome prognosis in stroke motor rehabilitation. PMID:27679565

  2. Wireless power pad with local power activation for portable devices

    NARCIS (Netherlands)

    Waffenschmidt, E.; Zheglov, V.

    2007-01-01

    Wireless power transfer by magnetic induction offers a simple to use way to recharge mobile devices like e.g. mobile phone, music players or medical sensors. As shown by a previous report and an existing Power Pad demonstrator, wireless inductive power transfer is possible with a good power

  3. Feasibility and Preliminary Efficacy of Visual Cue Training to Improve Adaptability of Walking after Stroke: Multi-Centre, Single-Blind Randomised Control Pilot Trial

    Science.gov (United States)

    Hollands, Kristen L.; Pelton, Trudy A.; Wimperis, Andrew; Whitham, Diane; Tan, Wei; Jowett, Sue; Sackley, Catherine M.; Wing, Alan M.; Tyson, Sarah F.; Mathias, Jonathan; Hensman, Marianne; van Vliet, Paulette M.

    2015-01-01

    Objectives Given the importance of vision in the control of walking and evidence indicating varied practice of walking improves mobility outcomes, this study sought to examine the feasibility and preliminary efficacy of varied walking practice in response to visual cues, for the rehabilitation of walking following stroke. Design This 3 arm parallel, multi-centre, assessor blind, randomised control trial was conducted within outpatient neurorehabilitation services Participants Community dwelling stroke survivors with walking speed adaptability practice using visual cues are feasible and may improve mobility and balance. Future studies should continue a carefully phased approach using identified methods to improve retention. Trial Registration Clinicaltrials.gov NCT01600391 PMID:26445137

  4. Development and implementation of the Ontario Stroke System: the use of evidence

    Directory of Open Access Journals (Sweden)

    Jill I. Cameron

    2007-08-01

    Full Text Available Introduction The Ontario Stroke System was developed to enhance the quality and continuity of stroke care provided across the care continuum. Research Objective To identify the role evidence played in the development and implementation of the Ontario Stroke System. Methods This study employed a qualitative case study design. In-depth interviews were conducted with six members of the Ontario Stroke System provincial steering committee. Nine focus groups were conducted with: Regional Program Managers, Regional Education Coordinators, and seven acute care teams. To supplement these findings interviews were conducted with eight individuals knowledgeable about national and international models of integrated service delivery. Results Our analyses identified six themes. The first four themes highlight the use of evidence to support the process of system development and implementation including: 1 informing system development; 2 mobilizing governmental support; 3 getting the system up and running; and 4 integrating services across the continuum of care. The final two themes describe the foundation required to support this process: 1 human capacity and 2 mechanisms to share evidence. Conclusion This study provides guidance to support the development and implementation of evidence-based models of integrated service delivery.

  5. Atherosclerosis and Stroke

    Science.gov (United States)

    ... Stroke Association.org Professionals for Stroke Association.org Shop for Stroke Association.org Support for Stroke Association. ... endothelium significantly. The artery’s diameter shrinks and blood flow decreases, reducing oxygen supply. How atherosclerotic plaque causes ...

  6. Reliability and Validity of Dual-Task Mobility Assessments in People with Chronic Stroke

    Science.gov (United States)

    Yang, Lei; He, Chengqi; Pang, Marco Yiu Chung

    2016-01-01

    Background The ability to perform a cognitive task while walking simultaneously (dual-tasking) is important in real life. However, the psychometric properties of dual-task walking tests have not been well established in stroke. Objective To assess the test-retest reliability, concurrent and known-groups validity of various dual-task walking tests in people with chronic stroke. Design Observational measurement study with a test-retest design. Methods Eighty-eight individuals with chronic stroke participated. The testing protocol involved four walking tasks (walking forward at self-selected and maximal speed, walking backward at self-selected speed, and crossing over obstacles) performed simultaneously with each of the three attention-demanding tasks (verbal fluency, serial 3 subtractions or carrying a cup of water). For each dual-task condition, the time taken to complete the walking task, the correct response rate (CRR) of the cognitive task, and the dual-task effect (DTE) for the walking time and CRR were calculated. Forty-six of the participants were tested twice within 3–4 days to establish test-retest reliability. Results The walking time in various dual-task assessments demonstrated good to excellent reliability [Intraclass correlation coefficient (ICC2,1) = 0.70–0.93; relative minimal detectable change at 95% confidence level (MDC95%) = 29%-45%]. The reliability of the CRR (ICC2,1 = 0.58–0.81) and the DTE in walking time (ICC2,1 = 0.11–0.80) was more varied. The reliability of the DTE in CRR (ICC2,1 = -0.31–0.40) was poor to fair. The walking time and CRR obtained in various dual-task walking tests were moderately to strongly correlated with those of the dual-task Timed-up-and-Go test, thus demonstrating good concurrent validity. None of the tests could discriminate fallers (those who had sustained at least one fall in the past year) from non-fallers. Limitation The results are generalizable to community-dwelling individuals with chronic stroke only

  7. Mobile Test Capabilities

    Data.gov (United States)

    Federal Laboratory Consortium — The Electrical Power Mobile Test capabilities are utilized to conduct electrical power quality testing on aircraft and helicopters. This capability allows that the...

  8. Hemorrhagic and Ischemic Strokes Compared Stroke Severity, Mortality, and Risk Factors

    DEFF Research Database (Denmark)

    Andersen, Klaus Kaae; Olsen, T. S.; Dehlendorff, Christian

    2009-01-01

    were diabetes, atrial fibrillation, previous myocardial infarction, previous stroke, and intermittent arterial claudication. Smoking and alcohol consumption favored HS, whereas age, sex, and hypertension did not herald stroke type. Compared with ischemic strokes, HS was associated with an overall...... higher mortality risk (HR, 1.564; 95% CI, 1.441-1.696). The increased risk was, however, time-dependent; initially, risk was 4-fold, after 1 week it was 2.5-fold, and after 3 weeks it was 1.5-fold. After 3 months stroke type did not correlate to mortality. Conclusion-Strokes are generally more severe...... based on 25 123 individuals with a complete data set. Results-Of the patients 3993 (10.1%) had HS. Stroke severity was almost linearly related to the probability of having HS (2% in patients with the mildest stroke and 30% in those with the most severe strokes). Factors favoring ischemic strokes vs HS...

  9. Using of virtual reality technology in acute cerebral stroke and their influense on post-stroke affective disorders

    Directory of Open Access Journals (Sweden)

    Maslyuk О.А.

    2014-12-01

    Full Text Available Aim. The study of virtual reality technology in the rehabilitation of patients with cerebral stroke and influence on post stroke affective disorder. Materials and methods. The study included 88 patients with ischemic stroke: 59 men (67% and 29 women (33%. The average age of the patients was 62,05 ± 11,74 years. In the study group included 46 patients, 44 patients in the control group. The groups were matched by age, time from the begin of disease, severity of disease, the severity of motor, affective and cognitive impairments. In addition, in the study group to the program of early rehabilitation to use individual training with virtual reality technology (BTS NIRVANA. The duration of the training was 21 days, 3 times a week for 40 minutes. Results. On the background of rehabilitation in the study group patients had a significant reduced of neurological deficit (p <0,05. Significantly improved neurodynamic and executive cognitive function (p <0,01. In the study group was a statistically significant decrease symptoms of depression on a scale of BDI was 31,7% vs. 20.9% in the control group, anxiety on a scale of HADS was 18,46% (p <0,05 vs. 12,23% (p <0,05 in the control group. Increase motivation and decrease symptoms of apathy in the study group of patients on a scale of AES-C was 13,78% (p <0,05 vs. 1,01 % in the control group. On the background of rehabilitation patients in the study group was no difference between the rates of pathological muscle and mental fatigue. On the background there is rehabilitation of the quality of life due to mobility and activities of daily living. Conclusion. The study showed the positive effect of virtual reality technology for the correction of post-stroke mood disorders.

  10. Stroke etiology and collaterals: atheroembolic strokes have greater collateral recruitment than cardioembolic strokes.

    Science.gov (United States)

    Rebello, L C; Bouslama, M; Haussen, D C; Grossberg, J A; Dehkharghani, S; Anderson, A; Belagaje, S R; Bianchi, N A; Grigoryan, M; Frankel, M R; Nogueira, R G

    2017-06-01

    Chronic hypoperfusion from athero-stenotic lesions is thought to lead to better collateral recruitment compared to cardioembolic strokes. It was sought to compare collateral flow in stroke patients with atrial fibrillation (AF) versus stroke patients with cervical atherosclerotic steno-occlusive disease (CASOD). This was a retrospective review of a prospectively collected endovascular database. Patients with (i) anterior circulation large vessel occlusion stroke, (ii) pre-treatment computed tomography angiography (CTA) and (iii) intracranial embolism from AF or CASOD were included. CTA collateral patterns were evaluated and categorized into two groups: absent/poor collaterals (CTA collateral score 0-1) versus moderate/good collaterals (CTA collateral score 2-4). CT perfusion was also utilized for baseline core volume and evaluation of infarct growth. A total of 122 patients fitted the inclusion criteria, of whom 88 (72%) had AF and 34 (27%) CASOD. Patients with AF were older (P Collateral scores were lower in the AF group (P = 0.01) with patients having poor collaterals in 28% of cases versus 9% in the CASOD group (P = 0.03). Mortality rates (20% vs. 0%; P = 0.02) were higher in the AF patients whilst rates of any parenchymal hemorrhage (6% vs. 26%; P collaterals (odds ratio 4.70; 95% confidence interval 1.17-18.79; P = 0.03). Atheroembolic strokes seem to be associated with better collateral flow compared to cardioembolic strokes. This may in part explain the worse outcomes of AF-related stroke. © 2017 EAN.

  11. Deep Classifiers-Based License Plate Detection, Localization and Recognition on GPU-Powered Mobile Platform

    Directory of Open Access Journals (Sweden)

    Syed Tahir Hussain Rizvi

    2017-10-01

    Full Text Available The realization of a deep neural architecture on a mobile platform is challenging, but can open up a number of possibilities for visual analysis applications. A neural network can be realized on a mobile platform by exploiting the computational power of the embedded GPU and simplifying the flow of a neural architecture trained on the desktop workstation or a GPU server. This paper presents an embedded platform-based Italian license plate detection and recognition system using deep neural classifiers. In this work, trained parameters of a highly precise automatic license plate recognition (ALPR system are imported and used to replicate the same neural classifiers on a Nvidia Shield K1 tablet. A CUDA-based framework is used to realize these neural networks. The flow of the trained architecture is simplified to perform the license plate recognition in real-time. Results show that the tasks of plate and character detection and localization can be performed in real-time on a mobile platform by simplifying the flow of the trained architecture. However, the accuracy of the simplified architecture would be decreased accordingly.

  12. Effects of dual task on turning ability in stroke survivors and older adults.

    Science.gov (United States)

    Hollands, K L; Agnihotri, D; Tyson, S F

    2014-09-01

    Turning is an integral component of independent mobility in which stroke survivors frequently fall. This study sought to measure the effects of competing cognitive demands on the stepping patterns of stroke survivors, compared to healthy age-match adults, during turning as a putative mechanism for falls. Walking and turning (90°) was assessed under single (walking and turning alone) and dual task (subtracting serial 3s while walking and turning) conditions using an electronic, pressure-sensitive walkway. Dependent measures were time to turn, variability in time to turn, step length, step width and single support time during three steps of the turn. Turning ability in single and dual task conditions was compared between stroke survivors (n=17, mean ± SD: 59 ± 113 months post-stroke, 64 ± 10 years of age) and age-matched healthy counterparts (n=15). Both groups took longer, were more variable, tended to widen the second step and, crucially, increased single support time on the inside leg of the turn while turning and distracted. Increased single support time during turning may represent biomechanical mechanism, within stepping patterns of turning under distraction, for increased risk of falls for both stroke survivors and older adults. Crown Copyright © 2014. Published by Elsevier B.V. All rights reserved.

  13. Stroke treatment outcomes in hospitals with and without Stroke Units.

    Science.gov (United States)

    Masjuan, J; Gállego Culleré, J; Ignacio García, E; Mira Solves, J J; Ollero Ortiz, A; Vidal de Francisco, D; López-Mesonero, L; Bestué, M; Albertí, O; Acebrón, F; Navarro Soler, I M

    2017-10-23

    Organisational capacity in terms of resources and care circuits to shorten response times in new stroke cases is key to obtaining positive outcomes. This study compares therapeutic approaches and treatment outcomes between traditional care centres (with stroke teams and no stroke unit) and centres with stroke units. We conducted a prospective, quasi-experimental study (without randomisation of the units analysed) to draw comparisons between 2 centres with stroke units and 4 centres providing traditional care through the neurology department, analysing a selection of agreed indicators for monitoring quality of stroke care. A total of 225 patients participated in the study. In addition, self-administered questionnaires were used to collect patients' evaluations of the service and healthcare received. Centres with stroke units showed shorter response times after symptom onset, both in the time taken to arrive at the centre and in the time elapsed from patient's arrival at the hospital to diagnostic imaging. Hospitals with stroke units had greater capacity to respond through the application of intravenous thrombolysis than centres delivering traditional neurological care. Centres with stroke units showed a better fit to the reference standards for stroke response time, as calculated in the Quick study, than centres providing traditional care through the neurology department. Copyright © 2017 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.

  14. Stroke: advances in medical therapy and acute stroke intervention.

    Science.gov (United States)

    Barrett, Kevin M; Lal, Brajesh K; Meschia, James F

    2015-10-01

    Evidence-based therapeutic options for stroke continue to emerge based on results from well-designed clinical studies. Ischemic stroke far exceeds hemorrhagic stroke in terms of prevalence and incidence, both in the USA and worldwide. The public health effect of reducing death and disability related to ischemic stroke justifies the resources that have been invested in identifying safe and effective treatments. The emergence of novel oral anticoagulants for ischemic stroke prevention in atrial fibrillation has introduced complexity to clinical decision making for patients with this common cardiac arrhythmia. Some accepted ischemic stroke preventative strategies, such as carotid revascularization for asymptomatic carotid stenosis, require reassessment, given advances in risk factor management, antithrombotic therapy, and surgical techniques. Intra-arterial therapy, particularly with stent retrievers after intravenous tissue plasminogen activator, has recently been demonstrated to improve functional outcomes and will require investment in system-based care models to ensure that effective treatments are received by patients in a timely fashion. The purpose of this review is to describe recent advances in medical and surgical approaches to ischemic stroke prevention and acute treatment. Results from recently published clinical trials will be highlighted along with ongoing clinical trials addressing key questions in ischemic stroke management and prevention where equipoise remains.

  15. Self-esteem level and stability, admission functional status, and depressive symptoms in acute inpatient stroke rehabilitation.

    Science.gov (United States)

    Vickery, Chad D; Sepehri, Arash; Evans, Clea C; Jabeen, Linsa N

    2009-11-01

    Explore the relationship of self-esteem level, self-esteem stability, and admission functional status on discharge depressive symptoms in acute stroke rehabilitation. One hundred twenty stroke survivors serially completed a measure of state self-esteem during inpatient rehabilitation and completed a measure of depressive symptoms at discharge. Functional status was rated at admission using the Functional Independence Measure (FIM). Regressions explored main effects and interactions of self-esteem level and stability and admission FIM self-care, mobility, and cognitive functioning on discharge depressive symptoms. After controlling for potential moderating variables, self-esteem level interacted with FIM self-care and cognitive functioning to predict discharge depressive symptoms, such that survivors with lower self-rated self-esteem and poorer functional status indicated higher levels of depressive symptoms. Self-esteem stability interacted with FIM mobility functioning, such that self-esteem instability in the presence of lower mobility functioning at admission was related to higher depressive symptoms at discharge. These results suggest that self-esteem variables may moderate the relationship between functional status and depressive symptoms. Self-esteem level and stability may differentially moderate functional domains, although this conclusion requires further empirical support.

  16. Improvement in the Physical and Psychological Well-Being of Persons with Spinal Cord Injuries by Means of Powered Wheelchairs Driven by Dual Power Wheels and Mobile Technologies

    Directory of Open Access Journals (Sweden)

    Yee-Pien Yang

    2017-10-01

    Full Text Available This study unites researchers from the fields of psychology, occupational therapy, and engineering to improve the holistic physical and psychological well-being of persons with spinal cord injury (SCI by using assistive devices (i.e., wheelchairs and mobile technology (i.e., cell phone and network. These technologies are used to bring persons with SCI through the difficult period of rehabilitation and to return them to their daily life in school or the working environment. First, a SpinoAid Application (APP is developed to motivate persons with SCI to participate in the community after their injury. Second, we integrate mobile technology with a mobility assistive device to design a smart wheelchair, which is innovated by transforming the pushrim of a manually driven wheelchair into a rim motor. After the rim motor is combined with a battery, a brake, and a controller to become a power wheel, two power wheels are installed on both sides of the wheelchair to become a powered wheelchair. Third, a SmartChair APP is developed with the main functions of reminding persons with SCI to perform exercises, recording the physical condition and the wheelchair using status, and building up a social network for information sharing to increase their exercise habit, prevent cumulative injuries or discomfort of the upper extremities, and enhance their health and quality of life.

  17. Walking adaptability after a stroke and its assessment in clinical settings.

    Science.gov (United States)

    Balasubramanian, Chitralakshmi K; Clark, David J; Fox, Emily J

    2014-01-01

    Control of walking has been described by a tripartite model consisting of stepping, equilibrium, and adaptability. This review focuses on walking adaptability, which is defined as the ability to modify walking to meet task goals and environmental demands. Walking adaptability is crucial to safe ambulation in the home and community environments and is often severely compromised after a stroke. Yet quantification of walking adaptability after stroke has received relatively little attention in the clinical setting. The objectives of this review were to examine the conceptual challenges for clinical measurement of walking adaptability and summarize the current state of clinical assessment for walking adaptability. We created nine domains of walking adaptability from dimensions of community mobility to address the conceptual challenges in measurement and reviewed performance-based clinical assessments of walking to determine if the assessments measure walking adaptability in these domains. Our literature review suggests the lack of a comprehensive well-tested clinical assessment tool for measuring walking adaptability. Accordingly, recommendations for the development of a comprehensive clinical assessment of walking adaptability after stroke have been presented. Such a clinical assessment will be essential for gauging recovery of walking adaptability with rehabilitation and for motivating novel strategies to enhance recovery of walking adaptability after stroke.

  18. The experience of living with stroke in low urban and rural socioeconomic areas of South Africa

    Directory of Open Access Journals (Sweden)

    M. Maleka

    2012-12-01

    Full Text Available The effects of stroke on stroke survivors are profound and affecttheir quality of life. The aim of this study was to establish the experience of peopleliving with stroke in low socioeconomic urban and rural areas of South Africa.A qualitative study using semi-structured interviews was used to collect data.Participants were identified from stroke registers and recruited from PHC clinicsin Soweto, Gauteng and Limpopo provinces. Participants had to have had a stroke,be above the age of 18 and had lived in the community six months to a year followingtheir stroke. The researcher or research assistant conducted the interviews ofparticipants who had had strokes as well as their caregivers in the home language of the participants. The interviewswere audio taped, transcribed and translated into English. A thematic content analysis was done.Thirty two participants were interviewed, 13 from Soweto, Gauteng, and 19 from rural Limpopo provinces. Theresults suggest that the sudden, overwhelming transformation as a result of a stroke forms a background for loss ofcommunity mobility, social isolation, role reversal within the family and community, loss of role within the family andcommunity, loss of meaningful activities of daily living, loss of hope and threat to livelihood amongst stroke survivorsliving in low socioeconomic areas of South Africa.An overwhelming picture of despondency was found, with few positive stories told in both settings. The themesidentified from the interviews reflected the experience and issues that a patient with stroke has to deal with in lowsocioeconomic areas of South Africa.

  19. Quantitative data analysis of perceived barriers and motivators to physical activity in stroke survivors.

    Science.gov (United States)

    Nicholson, S L; Greig, C A; Sniehotta, F; Johnston, M; Lewis, S J; McMurdo, M E; Johnston, D; Scopes, J; Mead, G E

    2017-09-01

    Levels of physical activity after stroke are low, despite multiple health benefits. We explored stroke survivors' perceived barriers, motivators, self-efficacy and intention to physical activity. Fifty independently mobile stroke survivors were recruited prior to hospital discharge. Participants rated nine possible motivators and four possible barriers based on the Mutrie Scale, as having 'no influence', 'some influence' or 'a major influence' on physical activity. Participants also rated their self-efficacy and intention to increasing walking. The most common motivator was 'physical activity is good for health' [34 (68%)]. The most common barrier was 'feeling too tired' [24 (48%)]. Intention and self-efficacy were high. Self-efficacy was graded as either 4 or 5 (highly confident) on a five-point scale by [34 (68%)] participants, while 42 (84%) 'strongly agreed' or 'agreed' that they intended to increase their walking. Participants felt capable of increasing physical activity but fatigue was often perceived as a barrier to physical activity. This needs to be considered when encouraging stroke survivors to be more active.

  20. Community re-integration and long-term need in the first five years after stroke: results from a national survey.

    Science.gov (United States)

    Walsh, Mary Elizabeth; Galvin, Rose; Loughnane, Cliona; Macey, Chris; Horgan, N Frances

    2015-01-01

    Acute stroke care continues to improve but the later stroke recovery phase remains less well understood. The aim of this study was to document self-reported need in relation to stroke recovery and community re-integration among community-dwelling persons up to five years post-stroke. A national survey was carried out in Ireland. Participants were recruited through stroke advocacy organisations and health professionals. Existing validated questionnaires were adapted with permission. The final questionnaire assessed respondents' perceptions of their community re-integration and on-going needs. A total of 196 stroke survivors, aged 24-89 years responded. Over 75% of respondents reported experiencing mobility, emotional, fatigue and concentration difficulties post-stroke. Emotional problems and fatigue demonstrated the highest levels of unmet need. Families provided much support with 52% of people needing help with personal care post-stroke. Forty-two per cent of respondents in a relationship felt that it was significantly affected by their stroke. In addition, 60% of respondents reported negative financial change. Only 23% of those <66 years had worked since their stroke, while 60% of drivers returned to driving. Stroke had a personal, social and economic impact. Emotional distress and fatigue were common and satisfaction with the help available for these problems was poor. Implications for Rehabilitation Professionals should recognise that family members provide high levels of support post-stroke while dealing with changes to personal relationships. Emotional, concentration and fatigue problems post-stroke require recognition by health professionals. A greater focus on return-to-work as part of stroke rehabilitation may be of value for patients of working age.

  1. Brain control of volitional ankle tasks in people with chronic stroke and in healthy individuals.

    Science.gov (United States)

    Beaulieu, L D; Massé-Alarie, H; Brouwer, B; Schneider, C

    2014-03-15

    This study explored the relationships between motor cortical control of ankle dorsiflexors and clinical impairments of volitional ankle dorsiflexion in people with chronic stroke. Eighteen persons with stroke and 14 controls were evaluated. Clinical tools were used to assess ankle dorsiflexion amplitude and isometric strength. Transcranial magnetic stimulation (TMS) of the primary motor cortex (M1) tested the functional integrity of cortical circuits controlling the tibialis anterior (TA). All clinical scores and most TMS outcomes were impaired in people with chronic stroke. The lower clinical scores were related to the reduction of the strength of corticospinal projections onto spinal motoneurons. Concurrent TMS and clinical testing in chronic stroke provided original data demonstrating relationships between the integrity of cortical and corticospinal components of TA motor control and volitional ankle tasks. Our study proposes that volitional ankle mobilization in chronic stroke may be explained by the residual abnormal M1 circuits which may be responsive for rehabilitation intervention. This should be confirmed in longitudinal studies with larger samples to determine whether TMS outcomes associated with lower limb muscles are predictive of clinical changes or vice versa. Copyright © 2013 Elsevier B.V. All rights reserved.

  2. A randomized controlled trial on rehabilitation through caregiver-delivered nurse-organized service programs for disabled stroke patients in rural china (the RECOVER trial): design and rationale.

    Science.gov (United States)

    Yan, Lijing L; Chen, Shu; Zhou, Bo; Zhang, Jing; Xie, Bin; Luo, Rong; Wang, Ninghua; Lindley, Richard; Zhang, Yuhong; Zhao, Yi; Li, Xian; Liu, Xiao; Peoples, Nicholas; Bettger, Janet Prvu; Anderson, Craig; Lamb, Sarah E; Wu, Yangfeng; Shi, Jingpu

    2016-10-01

    Stroke is the leading cause of death and disability in rural China. For stroke patients residing in resource-limited rural areas, secondary prevention and rehabilitation are largely unavailable, and where present, are far below evidence-based standards. This study aims to develop and implement a simplified stroke rehabilitation program that utilizes nurses and family caregivers for service delivery, and evaluate its feasibility and effectiveness in rural China. This 2-year randomized controlled trial is being conducted in 2-3 county hospitals located in northwest, northeast, and southwest China. Eligible and consenting stroke inpatients (200 in total) have been recruited and randomized into either a control or intervention group. Nurses in the county hospital are trained by rehabilitation specialists and in turn train the family caregivers in the intervention group. They also provide telephone follow-up care three times post discharge. The recruitment, baseline, intervention, follow-up care, and evaluation are guided by the RECOVER mobile phone app specifically designed for this study. The primary outcome is patients' Barthel Index (activities of daily living: mobility, self-care, and toileting) at 6 months. Process and economic evaluation will also be conducted. The results of our study will generate initial high-quality evidence to improve stroke care in resource-scarce settings. If proven effective, this innovative care delivery model has the potential to improve the health and function of stroke patients, relieve caregiver burden, guide policy-making, and advance translational research in the field of stroke care. © 2016 World Stroke Organization.

  3. Use of the challenge point framework to guide motor learning of stepping reactions for improved balance control in people with stroke: a case series.

    Science.gov (United States)

    Pollock, Courtney L; Boyd, Lara A; Hunt, Michael A; Garland, S Jayne

    2014-04-01

    Stepping reactions are important for walking balance and community-level mobility. Stepping reactions of people with stroke are characterized by slow reaction times, poor coordination of motor responses, and low amplitude of movements, which may contribute to their decreased ability to recover their balance when challenged. An important aspect of rehabilitation of mobility after stroke is optimizing the motor learning associated with retraining effective stepping reactions. The Challenge Point Framework (CPF) is a model that can be used to promote motor learning through manipulation of conditions of practice to modify task difficulty, that is, the interaction of the skill of the learner and the difficulty of the task to be learned. This case series illustrates how the retraining of multidirectional stepping reactions may be informed by the CPF to improve balance function in people with stroke. Four people (53-68 years of age) with chronic stroke (>1 year) and mild to moderate motor recovery received 4 weeks of multidirectional stepping reaction retraining. Important tenets of motor learning were optimized for each person during retraining in accordance with the CPF. Participants demonstrated improved community-level walking balance, as determined with the Community Balance and Mobility Scale. These improvements were evident 1 year later. Aspects of balance-related self-efficacy and movement kinematics also showed improvements during the course of the intervention. The application of CPF motor learning principles in the retraining of stepping reactions to improve community-level walking balance in people with chronic stroke appears to be promising. The CPF provides a plausible theoretical framework for the progression of functional task training in neurorehabilitation.

  4. Innate Immunity and Inflammation Post-Stroke: An α7-Nicotinic Agonist Perspective

    Directory of Open Access Journals (Sweden)

    Silke Neumann

    2015-12-01

    Full Text Available Stroke is one of the leading causes of death and long-term disability, with limited treatment options available. Inflammation contributes to damage tissue in the central nervous system across a broad range of neuropathologies, including Alzheimer’s disease, pain, Schizophrenia, and stroke. While the immune system plays an important role in contributing to brain damage produced by ischemia, the damaged brain, in turn, can exert a powerful immune-suppressive effect that promotes infections and threatens the survival of stroke patients. Recently the cholinergic anti-inflammatory pathway, in particular its modulation using α7-nicotinic acetylcholine receptor (α7-nAChR ligands, has shown potential as a strategy to dampen the inflammatory response and facilitate functional recovery in stroke patients. Here we discuss the current literature on stroke-induced inflammation and the effects of α7-nAChR modulators on innate immune cells.

  5. Acute stroke unit improves stroke management-four years on from INASC.

    Science.gov (United States)

    Shanahan, E; Keenan, R; Cunningham, N; O'Malley, G; O'Connor, M; Lyons, D; Peters, C

    2015-02-01

    The Irish Heart Foundation carried out the Irish National Audit of Stroke Care (INASC) in 2008. Management practices were significantly poorer than those in the UK Sentinel audits. Since then an acute stroke unit has been established in University Hospital Limerick. A stroke database was established. 12 key indicators of stroke management audited by INASC were identified. Results were compared to those in INASC. 89 stroke patients were admitted. 8 of the 12 key indicators scored significantly better than in INASC. 92.5% had a brain scan within 24hrs (INASC-40%, p = strokes received anti-thrombotics (INASC-85%, p = 0.001). 94% had rehab goals agreed by MDT (22% in INASC p = 0.0000). 55% were treated in stroke unit (2% in INASC, p = 0.0000). MDT input improved with regard to physiotherapy (87% vs 43% in INASC, p = Stroke management has significantly improved from 2008, however some deficiencies remain.

  6. Mobile phones and sleep - A review

    Science.gov (United States)

    Supe, Sanjay S.

    2010-01-01

    The increasing use of mobile phones has raised concerns regarding the potential health effects of exposure to the radiofrequency electromagnetic fields. An increasing amount research related to mobile phone use has focussed on the possible effects of mobile phone exposure on human brain activity and function. In particular, the use of sleep research has become a more widely used technique for assessing the possible effects of mobile phones on human health and wellbeing especially in the investigation of potential changes in sleep architecture resulting from mobile phone use. Acute exposure to a mobile phone prior to sleep significantly enhances electroencephalogram spectral power in the sleep spindle frequency range. This mobile phone-induced enhancement in spectral power is largely transitory and does not linger throughout the night. Furthermore, a reduction in rapid eye movement sleep latency following mobile phone exposure was also found, although interestingly, neither this change in rapid eye movement sleep latency or the enhancement in spectral power following mobile phone exposure, led to changes in the overall quality of sleep. In conclusion, a short exposure to the radiofrequency electromagnetic fields emitted by a mobile phone handset immediately prior to sleep is sufficient to induce changes in brain activity in the initial part of sleep. The consequences or functional significance of this effect are currently unknown and it would be premature to draw conclusions about possible health consequences.

  7. Extension of Tissue Plasminogen Activator Treatment Window by Granulocyte-Colony Stimulating Factor in a Thromboembolic Rat Model of Stroke

    Directory of Open Access Journals (Sweden)

    Ike C. dela Peña

    2018-05-01

    Full Text Available When given beyond 4.5 h of stroke onset, tissue plasminogen activator (tPA induces deleterious side effects in the ischemic brain, notably, hemorrhagic transformation (HT. We examined the efficacy of granulocyte-colony stimulating factor (G-CSF in reducing delayed tPA-induced HT, cerebral infarction, and neurological deficits in a thromboembolic (TE stroke model, and whether the effects of G-CSF were sustained for longer periods of recovery. After stroke induction, rats were given intravenous saline (control, tPA (10 mg/kg, or G-CSF (300 μg/kg + tPA 6 h after stroke. We found that G-CSF reduced delayed tPA-associated HT by 47%, decreased infarct volumes by 33%, and improved motor and neurological deficits by 15% and 25%, respectively. It also prevented delayed tPA treatment-induced mortality by 46%. Immunohistochemistry showed 1.5- and 1.8-fold enrichment of the endothelial progenitor cell (EPC markers CD34+ and VEGFR2 in the ischemic cortex and striatum, respectively, and 1.7- and 2.8-fold increases in the expression of the vasculogenesis marker von Willebrand factor (vWF in the ischemic cortex and striatum, respectively, in G-CSF-treated rats compared with tPA-treated animals. Flow cytometry revealed increased mobilization of CD34+ cells in the peripheral blood of rats given G-CSF. These results corroborate the efficacy of G-CSF in enhancing the therapeutic time window of tPA for stroke treatment via EPC mobilization and enhancement of vasculogenesis.

  8. Measuring of vertical stroke Vub vertical stroke in the forthcoming decade

    International Nuclear Information System (INIS)

    Kim, C.S.

    1997-01-01

    I first introduce the importance of measuring V ub precisely. Then, from a theoretician's point of view, I review (a) past history, (b) present trials, and (c) possible future alternatives on measuring vertical stroke V ub vertical stroke and/or vertical stroke V ub /V cb vertical stroke. As of my main topic, I introduce a model-independent method, which predicts Γ(B→X u lν)/Γ(B→X c lν)≡(γ u /γ c ) x vertical stroke V ub /V cb vertical stroke 2 ≅(1.83±0.28) x vertical stroke V ub /V cb vertical stroke 2 and vertical stroke V ub /V cb vertical stroke ≡(γ c /γ u ) 1/2 x [B(B→X u lν)/B(B→ X c lν]) 1/2 ≅(0.74±0.06) x [B(B→X u lν/)B(B→X c lν)] 1/2 , based on the heavy quark effective theory I also explore the possible experimental options to separate B→X u lν from the dominant B→X c lν: the measurement of inclusive hadronic invariant mass distributions, and the 'D-π' (and 'K-π') separation conditions I also clarify the relevant experimental backgrounds. (orig.)

  9. Mobile Assisted Language Learning: Review of the Recent Applications of Emerging Mobile Technologies

    Science.gov (United States)

    Yang, Jaeseok

    2013-01-01

    As mobile computing technologies have been more powerful and inclusive in people's daily life, the issue of mobile assisted language learning (MALL) has also been widely explored in CALL research. Many researches on MALL consider the emerging mobile technologies have considerable potentials for the effective language learning. This review study…

  10. Stroke

    Science.gov (United States)

    ... doctor Preventing falls Stroke - discharge Swallowing problems Images Brain Carotid stenosis, x-ray of the left artery Carotid stenosis, x-ray of the right artery Stroke Brainstem function Cerebellum - function Circle of Willis Left cerebral hemisphere - ...

  11. Stroke prevention in atrial fibrillation: findings from Tuscan FADOI Stroke Registry

    Directory of Open Access Journals (Sweden)

    Luca Masotti

    2014-06-01

    Full Text Available Despite vitamin K antagonists (VKAs are considered the first choice treatment for stroke prevention in atrial fibrillation (AF, literature shows their underuse in this context. Since data about VKAs use prior and after acute stroke lack, the aim of this study was to focus on management of anticoagulation with VKAs in this context. Data were retrieved from Tuscan FADOI Stroke Registry, an online data bank aimed to report on characteristics of stroke patients consecutively admitted in Internal Medicine wards in 2010 and 2011. In this period 819 patients with mean age 76.5±12.3 years were enrolled. Data on etiology were available for 715 of them (88.1%, 87% being ischemic and 13% hemorrhagic strokes. AF was present in 238 patients (33%, 165 (69.3% having a known AF before hospitalization, whereas 73 patients (31.7% received a new diagnosis of AF. A percentage of 89% of strokes in patients with known AF were ischemic and 11% hemorrhagic. A percentage of 86.7% of patients with known AF had a CHADS2 ≥2, but only 28.3% were on VKAs before hospitalization. A percentage of 78.8% of patients treated with VKAs before stroke had an international normalized ratio (INR ≤2.0; 68.7% of patients with VKAs-related hemorrhagic strokes had INR ≤3.0. Combined endpoint mortality or severe disability in patients with ischemic stroke associated with AF was present in 47%, while it was present in 19.30% and 19.20% of atherothrombotic and lacunar strokes, respectively. At hospital discharge, VKAs were prescribed in 25.9% of AF related ischemic stroke patients. AF related strokes are burdened by severe outcome but VKAs are dramatically underused in patients with AF, even in higher risk patients. Efforts to improve anticoagulation in this stroke subtype are warranted.

  12. Acute stroke unit improves stroke management-four years on from INASC.

    LENUS (Irish Health Repository)

    Shanahan, E

    2015-02-01

    The Irish Heart Foundation carried out the Irish National Audit of Stroke Care (INASC) in 2008. Management practices were significantly poorer than those in the UK Sentinel audits. Since then an acute stroke unit has been established in University Hospital Limerick. A stroke database was established. 12 key indicators of stroke management audited by INASC were identified. Results were compared to those in INASC. 89 stroke patients were admitted. 8 of the 12 key indicators scored significantly better than in INASC. 92.5% had a brain scan within 24hrs (INASC-40%, p = < 0.001). 100% of ischaemic strokes received anti-thrombotics (INASC-85%, p = 0.001). 94% had rehab goals agreed by MDT (22% in INASC p = 0.0000). 55% were treated in stroke unit (2% in INASC, p = 0.0000). MDT input improved with regard to physiotherapy (87% vs 43% in INASC, p = < 0.02) and SALT (74% vs 26%, p = < 0.02). Stroke management has significantly improved from 2008, however some deficiencies remain.

  13. Rehabilitation of motor function after stroke: a multiple systematic review focused on techniques to stimulate upper extremity recovery

    Directory of Open Access Journals (Sweden)

    Samar M Hatem

    2016-09-01

    Full Text Available Stroke is one of the leading causes for disability worldwide. Motor function deficits due to stroke affect the patients’ mobility, their limitation in daily life activities, their participation in society and their odds of returning to professional activities. All of these factors contribute to a low overall quality of life. Rehabilitation training is the most effective way to reduce motor impairments in stroke patients. This multiple systematic review focuses both on standard treatment methods and on innovating rehabilitation techniques used to promote upper extremity motor function in stroke patients. A total number of 5712 publications on stroke rehabilitation was systematically reviewed for relevance and quality with regards to upper extremity motor outcome. This procedure yielded 270 publications corresponding to the inclusion criteria of the systematic review. Recent technology-based interventions in stroke rehabilitation including non-invasive brain stimulation, robot-assisted training and virtual reality immersion are addressed. Finally, a decisional tree based on evidence from the literature and characteristics of stroke patients is proposed.At present, the stroke rehabilitation field faces the challenge to tailor evidence-based treatment strategies to the needs of the individual stroke patient. Interventions can be combined in order to achieve the maximal motor function recovery for each patient. Though the efficacy of some interventions may be under debate, motor skill learning and some new technological approaches give promising outcome prognosis in stroke motor rehabilitation.

  14. Stroke scale score and early prediction of outcome after stroke

    International Nuclear Information System (INIS)

    Ahmed, R.; Zuberi, F.Z.; Afsar, S.

    2004-01-01

    Objective: To evaluate the baseline National Institute of Health Stroke Scale (NIHSS) score as a predictor of functional outcome after ischemic stroke. Subjects and Methods: The study included 50 patients who presented to Civil Hospital, Karachi, during the study period with acute stroke and were evaluated with CT scan of brain. Only those patients were enrolled in the study that had acute ischemic stroke. The enrolled subjects were then evaluated for the neurological impairment using National Institute of Health Stroke Scale (NIHSS). The subjects were followed-up and their functional outcome was assessed using Barthel index (BI) on the 7th day of their admission. Results: Of the fifty patients enrolled in the study, 31 (62%) were males and 19 (38%) were females, with age ranging from 45 years to 95 years and a mean age of 59.9 years. Neurological impairment at presentation was assessed by NIHSS. The score ranged between 2 and 28. The functional outcome was evaluated on the 7th day using Barthel index (BI), which ranged from 0 to 80. NIHSS score was found to be a good predictor of functional outcome in patients with ischemic stroke (p<0.001). Other factors like gender, hypertension and heart disease did not affect the functional recovery in such patients. Various factors were found to be significant for early prediction of stroke recovery. The NIHSS score was the strongest predictor of outcome after ischemic stroke. Age at the time of the event was also found to be an important predictor for stroke recovery. Conclusion: The NIHSS score is a good predictor of patient's recovery after stroke. Assessing the patient's neurological impairment at first presentation of ischemic stroke can guide the physician regarding the prognosis and management plan. (author)

  15. Power attenuation characteristics as switch-over criterion in personal satellite mobile communications

    Science.gov (United States)

    Castro, Jonathan P.

    1993-01-01

    A third generation mobile system intends to support communications in all environments (i.e., outdoors, indoors at home or office and when moving). This system will integrate services that are now available in architectures such as cellular, cordless, mobile data networks, paging, including satellite services to rural areas. One way through which service integration will be made possible is by supporting a hierarchical cellular structure based on umbrella cells, macro cells, micro and pico cells. In this type of structure, satellites are part of the giant umbrella cells allowing continuous global coverage, the other cells belong to cities, neighborhoods, and buildings respectively. This does not necessarily imply that network operation of terrestrial and satellite segments interconnect to enable roaming and spectrum sharing. However, the cell concept does imply hand-off between different cell types, which may involve change of frequency. Within this propsective, the present work uses power attenuation characteristics to determine a dynamic criterion that allows smooth transition from space to terrestrial networks. The analysis includes a hybrid channel that combines Rician, Raleigh and Log Normal fading characteristics.

  16. Does use of the recognition of stroke in the emergency room stroke assessment tool enhance stroke recognition by ambulance clinicians?

    Science.gov (United States)

    Fothergill, Rachael T; Williams, Julia; Edwards, Melanie J; Russell, Ian T; Gompertz, Patrick

    2013-11-01

    U.K ambulance services assess patients with suspected stroke using the Face Arm Speech Test (FAST). The Recognition Of Stroke In the Emergency Room (ROSIER) tool has been shown superior to the FAST in identifying strokes in emergency departments but has not previously been tested in the ambulance setting. We investigated whether ROSIER use by ambulance clinicians can improve stroke recognition. Ambulance clinicians used the ROSIER in place of the FAST to assess patients with suspected stroke. As the ROSIER includes all FAST elements, we calculated a FAST score from the ROSIER to enable comparisons between the two tools. Ambulance clinicians' provisional stroke diagnoses using the ROSIER and calculated FAST were compared with stroke consultants' diagnosis. We used stepwise logistic regression to compare the contribution of individual ROSIER and FAST items and patient demographics to the prediction of consultants' diagnoses. Sixty-four percent of strokes and 78% of nonstrokes identified by ambulance clinicians using the ROSIER were subsequently confirmed by a stroke consultant. There was no difference in the proportion of strokes correctly detected by the ROSIER or FAST with both displaying excellent levels of sensitivity. The ROSIER detected marginally more nonstroke cases than the FAST, but both demonstrated poor specificity. Facial weakness, arm weakness, seizure activity, age, and sex predicted consultants' diagnosis of stroke. The ROSIER was not better than the FAST for prehospital recognition of stroke. A revised version of the FAST incorporating assessment of seizure activity may improve stroke identification and decision making by ambulance clinicians.

  17. Autonomy and Housing Accessibility Among Powered Mobility Device Users

    Science.gov (United States)

    Brandt, Åse; Lexell, Eva Månsson; Iwarsson, Susanne

    2015-01-01

    OBJECTIVE. To describe environmental barriers, accessibility problems, and powered mobility device (PMD) users’ autonomy indoors and outdoors; to determine the home environmental barriers that generated the most housing accessibility problems indoors, at entrances, and in the close exterior surroundings; and to examine personal factors and environmental components and their association with indoor and outdoor autonomy. METHOD. This cross-sectional study was based on data collected from a sample of 48 PMD users with a spinal cord injury (SCI) using the Impact of Participation and Autonomy and the Housing Enabler instruments. Descriptive statistics and logistic regression were used. RESULTS. More years living with SCI predicted less restriction in autonomy indoors, whereas more functional limitations and accessibility problems related to entrance doors predicted more restriction in autonomy outdoors. CONCLUSION. To enable optimized PMD use, practitioners must pay attention to the relationship between client autonomy and housing accessibility problems. PMID:26356666

  18. Stroke-induced immunodepression and dysphagia independently predict stroke-associated pneumonia - The PREDICT study.

    Science.gov (United States)

    Hoffmann, Sarah; Harms, Hendrik; Ulm, Lena; Nabavi, Darius G; Mackert, Bruno-Marcel; Schmehl, Ingo; Jungehulsing, Gerhard J; Montaner, Joan; Bustamante, Alejandro; Hermans, Marcella; Hamilton, Frank; Göhler, Jos; Malzahn, Uwe; Malsch, Carolin; Heuschmann, Peter U; Meisel, Christian; Meisel, Andreas

    2017-12-01

    Stroke-associated pneumonia is a frequent complication after stroke associated with poor outcome. Dysphagia is a known risk factor for stroke-associated pneumonia but accumulating evidence suggests that stroke induces an immunodepressive state increasing susceptibility for stroke-associated pneumonia. We aimed to confirm that stroke-induced immunodepression syndrome is associated with stroke-associated pneumonia independently from dysphagia by investigating the predictive properties of monocytic HLA-DR expression as a marker of immunodepression as well as biomarkers for inflammation (interleukin-6) and infection (lipopolysaccharide-binding protein). This was a prospective, multicenter study with 11 study sites in Germany and Spain, including 486 patients with acute ischemic stroke. Daily screening for stroke-associated pneumonia, dysphagia and biomarkers was performed. Frequency of stroke-associated pneumonia was 5.2%. Dysphagia and decreased monocytic HLA-DR were independent predictors for stroke-associated pneumonia in multivariable regression analysis. Proportion of pneumonia ranged between 0.9% in the higher monocytic HLA-DR quartile (≥21,876 mAb/cell) and 8.5% in the lower quartile (≤12,369 mAb/cell). In the presence of dysphagia, proportion of pneumonia increased to 5.9% and 18.8%, respectively. Patients without dysphagia and normal monocytic HLA-DR expression had no stroke-associated pneumonia risk. We demonstrate that dysphagia and stroke-induced immunodepression syndrome are independent risk factors for stroke-associated pneumonia. Screening for immunodepression and dysphagia might be useful for identifying patients at high risk for stroke-associated pneumonia.

  19. Design of Mobile Device Display for Nuclear Power Plant Maintenance Considering the Level of Expertise

    International Nuclear Information System (INIS)

    Kim, In; Seong, Poong Hyun

    2009-01-01

    Maintaining and repairing complex technical facilities such as nuclear power plants requires comprehensive knowledge on a broad range of the system, as well as on operational and safety procedures by the performing maintenance personnel. There exists the need to have access to instruction sheets and parameter tables at the work site. This may not be practicable with printed manuals simply due to their increasing bulk. To cope with this situation, fully mobile wirelessly connected (FMWC) information and communication technologies (ICT) are thought to have high potential for improving field maintenance through increased accessibility and availability of critical information needed in on-site reference or decision making. Among many up-todate technologies, the mobile application to the maintenance support system will be proposed in this paper

  20. Validation of a reduced chemical mechanism coupled to CFD model in a 2-stroke HCCI engine

    NARCIS (Netherlands)

    Izadi Najafabadi, M.; Somers, B.; Nuraini, A.

    2015-01-01

    Homogeneous Charge Compression Ignition (HCCI) combustion technology has demonstrated a profound potential to decrease both emissions and fuel consumption. In this way, the significance of the 2-stroke HCCI engine has been underestimated as it can provide more power stroke in comparison to a

  1. Blood markers of coagulation, fibrinolysis, endothelial dysfunction and inflammation in lacunar stroke versus non-lacunar stroke and non-stroke: systematic review and meta-analysis.

    Science.gov (United States)

    Wiseman, Stewart; Marlborough, Fergal; Doubal, Fergus; Webb, David J; Wardlaw, Joanna

    2014-01-01

    The cause of cerebral small vessel disease is not fully understood, yet it is important, accounting for about 25% of all strokes. It also increases the risk of having another stroke and contributes to about 40% of dementias. Various processes have been implicated, including microatheroma, endothelial dysfunction and inflammation. A previous review investigated endothelial dysfunction in lacunar stroke versus mostly non-stroke controls while another looked at markers of inflammation and endothelial damage in ischaemic stroke in general. We have focused on blood markers between clinically evident lacunar stroke and other subtypes of ischaemic stroke, thereby controlling for stroke in general. We systematically assessed the literature for studies comparing blood markers of coagulation, fibrinolysis, endothelial dysfunction and inflammation in lacunar stroke versus non-stroke controls or other ischaemic stroke subtypes. We assessed the quality of included papers and meta-analysed results. We split the analysis on time of blood draw in relation to the stroke. We identified 1,468 full papers of which 42 were eligible for inclusion, including 4,816 ischaemic strokes, of which 2,196 were lacunar and 2,500 non-stroke controls. Most studies subtyped stroke using TOAST. The definition of lacunar stroke varied between studies. Markers of coagulation/fibrinolysis (tissue plasminogen activator (tPA), plasminogen activator inhibitor (PAI), fibrinogen, D-dimer) were higher in lacunar stroke versus non-stroke although fibrinogen was no different to non-stroke in the acute phase. tPA and PAI were no different between lacunar and non-lacunar stroke. Fibrinogen and D-dimer were significantly lower in lacunar stroke compared to other ischaemic strokes, both acutely and chronically. Markers of endothelial dysfunction (homocysteine, von Willebrand Factor (vWF), E-selectin, P-selectin, intercellular adhesion molecule-1 (ICAM), vascular cellular adhesion molecule-1 (VCAM)) were higher or

  2. Organizational issues in stroke treatment: The Swiss paradigm - Stroke units

    Directory of Open Access Journals (Sweden)

    Georgios K Matis

    2013-01-01

    Full Text Available Stroke represents the leading cause of acquired disability in adults and poses a tremendous socioeconomic burden both on patients and the society. In this sense, prompt diagnosis and urgent treatment are needed in order to radically reduce the devastating consequences of this disease. Herein the authors present the new guidelines recently adopted by the Swiss Stroke Society concerning the establishment of stroke units. Standardized treatment and allocation protocols along with an acute rehabilitation concept seem to be the core of the Swiss stroke management system. Coordinated multidisciplinary care provided by specialized medical, nursing and therapy staff is of utmost importance for achieving a significant dependency and death reduction. It is believed that the implementation of these guidelines in the stroke care system would be beneficial not only for the stroke patients, but also for the health system.

  3. Sensory impairments of the lower limb after stroke: a pooled analysis of individual patient data.

    Science.gov (United States)

    Tyson, Sarah F; Crow, J Lesley; Connell, Louise; Winward, Charlotte; Hillier, Susan

    2013-01-01

    To obtain more generalizable information on the frequency and factors influencing sensory impairment after stroke and their relationship to mobility and function. A pooled analysis of individual data of stroke survivors (N = 459); mean (SD) age = 67.2 (14.8) years, 54% male, mean (SD) time since stroke = 22.33 (63.1) days, 50% left-sided weakness. Where different measurement tools were used, data were recorded. Descriptive statistics described frequency of sensory impairments, kappa coefficients investigated relationships between sensory modalities, binary logistic regression explored the factors influencing sensory impairments, and linear regression assessed the impact of sensory impairments on activity limitations. Most patients' sensation was intact (55%), and individual sensory modalities were highly associated (κ = 0.60, P sensory impairment (P analysis showed sensation of the lower limb is grossly preserved in most stroke survivors but, when present, it affects function. Sensory modalities are highly interrelated; interventions that treat the motor system during functional tasks may be as effective at treating the sensory system as sensory retraining alone.

  4. Urinary tract infection after acute stroke: Impact of indwelling urinary catheterization and assessment of catheter-use practices in French stroke centers.

    Science.gov (United States)

    Net, P; Karnycheff, F; Vasse, M; Bourdain, F; Bonan, B; Lapergue, B

    2018-03-01

    Urinary catheterization and acute urinary retention increase the risk of urinary tract infection (UTI). Our study aimed to investigate the incidence of UTI following acute stroke at our stroke center (SC) and to assess urinary catheter-care practices among French SCs. Stroke patients hospitalized within 24h of stroke onset were prospectively enrolled between May and September 2013. Neurological deficit level was assessed on admission using the US National Institutes of Health Stroke Scale (NIHSS). Patients were followed-up until discharge. Indwelling urinary catheterization (IUC) was the only technique authorized during the study. An electronic survey was also conducted among French SCs to assess their practices regarding urinary catheterization in acute stroke patients. A total of 212 patients were included, with 45 (21.2%) receiving indwelling urinary catheters. The overall estimated incidence of UTI was 14.2%, and 18% among patients receiving IUC. On univariate analysis, IUC was significantly associated with older age, longer hospital stays and higher NIHSS scores. Of the 30 SCs that responded to our survey, 19 (63.3%) declared using IUC when urinary catheterization was needed. The main argument given to justify its use was that it was departmental policy to adopt this technique. Also, 27 participants (90%) stated that conducting a study to assess the impact of urinary catheterization techniques on UTI rates in acute stroke patients would be relevant. Our results are in accord with previously reported data and confirm the high burden of UTI among acute stroke subjects. However, no association was found between IUC and UTI on univariate analysis due to a lack of statistical power. Also, our survey showed high heterogeneity in catheter-use practices among French SCs, but offered no data to help determine the best urinary catheterization technique. Urinary catheterization is common after acute stroke and a well-known risk factor of UTI. However, as high

  5. Aspects correlates with Scandinavian Stroke Scale for predicting early neurological impairment

    Directory of Open Access Journals (Sweden)

    Gustavo José Luvizutto

    2015-05-01

    Full Text Available Objective To investigate the correlation between the Alberta Program Early CT Score (ASPECTS and the Scandinavian Stroke Scale (SSS for the evaluation of neurological impairment in patients with acute stroke. Method 59 patients with a first acute ischemic stroke were evaluated. The ASPECTS were evaluated by 2 neurologists at admission and by another neurologist after 48 hours. The NIHSS and SSS was applied to determinate stroke severity. Correlations and agreements were analysed statistically by Spearman and Kappa tests. Results ASPECTS was correlated with National Institute of Health Stroke Scale (NIHSS at admission (r = -0.52; p < 0.001 and SSS (r = 0.50; p < 0.001. The ASPECTS and SSS items were most correlated with arm (r = 0.52; p < 0.001 and hand (r = 0.49; p < 0.001 motor power, and speech (r = 0.51; p < 0.001. The SSS of 25.5 shows sensitivity (68% and specificity (72% when associated with ASPECTS ≤ 7. Conclusion The SSS can predict worst neurological impairment when associated with lower values of ASPECTS.

  6. Stroke survivors' endorsement of a "stress belief model" of stroke prevention predicts control of risk factors for recurrent stroke.

    Science.gov (United States)

    Phillips, L Alison; Tuhrim, Stanley; Kronish, Ian M; Horowitz, Carol R

    2014-01-01

    Perceptions that stress causes and stress-reduction controls hypertension have been associated with poorer blood pressure (BP) control in hypertension populations. The current study investigated these "stress-model perceptions" in stroke survivors regarding prevention of recurrent stroke and the influence of these perceptions on patients' stroke risk factor control. Stroke and transient ischemic attack survivors (N=600) participated in an in-person interview in which they were asked about their beliefs regarding control of future stroke; BP and cholesterol were measured directly after the interview. Counter to expectations, patients who endorsed a "stress-model" but not a "medication-model" of stroke prevention were in better control of their stroke risk factors (BP and cholesterol) than those who endorsed a medication-model but not a stress-model of stroke prevention (OR for poor control=.54, Wald statistic=6.07, p=.01). This result was not explained by between group differences in patients' reported medication adherence. The results have implications for theory and practice, regarding the role of stress belief models and acute cardiac events, compared to chronic hypertension.

  7. What about self-management post-stroke? Challenges for stroke survivors, spouses and professionals

    NARCIS (Netherlands)

    Satink, A.J.H.

    2016-01-01

    Self-management post-stroke is challenging for many persons after a stroke. In this thesis is explored how stroke survivors, spouses and professionals perceived self-management post-stroke and how the process of self-management post-stroke evolved over time. The following studies are conducted: a

  8. Diabetes mellitus is associated with late-onset post-stroke depression.

    Science.gov (United States)

    Zhang, Yu; He, Ji-Rong; Liang, Huai-Bin; Lu, Wen-Jing; Yang, Guo-Yuan; Liu, Jian-Rong; Zeng, Li-Li

    2017-10-15

    To explore the associated factors of late-onset post-stroke depression (PSD). A total of 251 patients with acute ischemic stroke were recruited. The evaluation of depression was performed 2 weeks after ischemia. 206 patients showing no depression in 2 weeks were followed up. They were divided into late-onset PSD group and non-depressed group by clinical interview with Hamilton depression scale score 3 months after stroke. On the first day following hospitalization, the clinical data including age, gender, educational level and vascular risk factors were recorded. The severity, etiological subtype and location of stroke were evaluated. The inflammatory mediators, glucose and lipid levels were recorded on the day of admission. The association between clinical factors and late-onset PSD was explored by logistic regression analysis. The ROC analysis was performed to evaluate the predicting power of the clinical factors. 187 of 206 patients completed the assessment 3 months after stroke. 19 (10.16%) patients were diagnosed as late onset PSD. Diabetes mellitus was an independent risk factor for late-onset PSD (OR 2.675, p = 0.047). ROC analysis demonstrated that glucose and HbA1C could predict late-onset PSD with specificity of 84.4%. The sample of our study was small. The results should be further confirmed in a larger cohort of patients with acute ischemic stroke. The acute ischemic stroke patients with diabetes mellitus were more tendered to suffer late-onset PSD. Copyright © 2017 Elsevier B.V. All rights reserved.

  9. Measurement-based harmonic current modeling of mobile storage for power quality study in the distribution system

    Directory of Open Access Journals (Sweden)

    Wenge Christoph

    2017-12-01

    Full Text Available Electric vehicles (EVs can be utilized as mobile storages in a power system. The use of battery chargers can cause current harmonics in the supplied AC system. In order to analyze the impact of different EVs with regardto their number and their emission of current harmonics, a generic harmonic current model of EV types was built and implemented in the power system simulation tool PSS®NETOMAC. Based on the measurement data for different types of EVs three standardized harmonic EV models were developed and parametrized. Further, the identified harmonic models are used by the computation of load flow in a modeled, German power distribution system. As a benchmark, a case scenario was studied regarding a high market penetration of EVs in the year 2030 for Germany. The impact of the EV charging on the power distribution system was analyzed and evaluated with valid power quality standards.

  10. Magnetic Particle Imaging for Real-Time Perfusion Imaging in Acute Stroke.

    Science.gov (United States)

    Ludewig, Peter; Gdaniec, Nadine; Sedlacik, Jan; Forkert, Nils D; Szwargulski, Patryk; Graeser, Matthias; Adam, Gerhard; Kaul, Michael G; Krishnan, Kannan M; Ferguson, R Matthew; Khandhar, Amit P; Walczak, Piotr; Fiehler, Jens; Thomalla, Götz; Gerloff, Christian; Knopp, Tobias; Magnus, Tim

    2017-10-24

    The fast and accurate assessment of cerebral perfusion is fundamental for the diagnosis and successful treatment of stroke patients. Magnetic particle imaging (MPI) is a new radiation-free tomographic imaging method with a superior temporal resolution, compared to other conventional imaging methods. In addition, MPI scanners can be built as prehospital mobile devices, which require less complex infrastructure than computed tomography (CT) and magnetic resonance imaging (MRI). With these advantages, MPI could accelerate the stroke diagnosis and treatment, thereby improving outcomes. Our objective was to investigate the capabilities of MPI to detect perfusion deficits in a murine model of ischemic stroke. Cerebral ischemia was induced by inserting of a microfilament in the internal carotid artery in C57BL/6 mice, thereby blocking the blood flow into the medial cerebral artery. After the injection of a contrast agent (superparamagnetic iron oxide nanoparticles) specifically tailored for MPI, cerebral perfusion and vascular anatomy were assessed by the MPI scanner within seconds. To validate and compare our MPI data, we performed perfusion imaging with a small animal MRI scanner. MPI detected the perfusion deficits in the ischemic brain, which were comparable to those with MRI but in real-time. For the first time, we showed that MPI could be used as a diagnostic tool for relevant diseases in vivo, such as an ischemic stroke. Due to its shorter image acquisition times and increased temporal resolution compared to that of MRI or CT, we expect that MPI offers the potential to improve stroke imaging and treatment.

  11. Therapeutic Effects of Mechanical Horseback Riding on Gait and Balance Ability in Stroke Patients

    Science.gov (United States)

    Han, Jun Young; Kim, Shin Kyoung; Chung, Jin Sang; Lee, Hyun-Cheol; Lim, Jae Kuk; Lee, Jiwon; Park, Kawn Yong

    2012-01-01

    Objective To investigate the therapeutic effects of mechanical horseback riding for gait and balance parameters in post-stroke patients. Method This study was a non randomized prospective positive-controlled trial over a 12 week period. From May 2011 to October 2011, 37 stroke patients were recruited from our outpatient clinic and divided into two groups. The control group received the conventional physiotherapy while the intervention group received the conventional physiotherapy along with mechanical horseback riding therapy for 12 weeks. Outcome measurements of gait included the Functional Ambulation Category (FAC) and gait part of the Performance Oriented Mobility Assessment (G-POMA) while those of balance included the Berg Balance Scale (BBS) and the balance part of the Performance Oriented Mobility Assessment (B-POMA). These measurements were taken before and after treatment. Results There were no significant differences in the baseline characteristics and initial values between the two groups. When comparing baseline and 12 weeks post treatment in each group, the intervention group showed significant improvement on BBS (39.9±5.7 → 45.7±4.8, p=0.001) and B-POMA (10.4±2.6 → 12.6±2.1, p=0.001), but significant improvement on gait parameters. When comparing the groups, the dynamic balance category of BBS in post treatment showed significant difference (p=0.02). Conclusion This study suggests that mechanical horseback riding therapy may be an effective treatment tool for enhancing balance in adults with stroke. PMID:23342307

  12. Cyber Security Evaluation of the Wireless Communication for the Mobile Safeguard Systems in Nuclear Power Plants

    International Nuclear Information System (INIS)

    Lee, S.; Kim, Y.S.; Ye, S.H.

    2015-01-01

    This paper introduces cyber security evaluation results and a design of the wireless communication technology to apply to safeguard systems in nuclear power plants. While wireless communication technologies can generally make mobility and efficiency on plant operation, those have seldom been installed on the nuclear I&C systems due to the negative concern of unexpected outcomes that stem from electromagnetic interference and cyber attack. New design of advanced digital safeguard and I&C systems uses computer-based systems for the safeguard and safety functions. On the other hand, those are being exposed to various types of new and existing cyber threats, vulnerabilities and risks which significantly increase the likelihood that those could be compromised. In order to employ the wireless communication technology in safeguard function, licencees assess and manage the potential for adverse effects on safeguard and safety functions so as to provide high assurance that critical functions are properly protected cyber attack. It is expected that the safeguard function, specifically on the area of real-time monitoring, logging, can be enhanced by employing the mobile safeguard devices (: smart phone, laptop, smart pad, etc). In this paper, we deal with the cyber security evaluation, which consists of threat analysis, vulnerability test, establishment of security plan, and design solutions for the wireless communication on the basis of IEEE 802.11(Wi-Fi) protocol. Proposed evaluation and design solution could be a basis for the design of wireless communication and mobile safeguard systems in nuclear power plants. (author)

  13. Interventions for coordination of walking following stroke: systematic review.

    Science.gov (United States)

    Hollands, Kristen L; Pelton, Trudy A; Tyson, Sarah F; Hollands, Mark A; van Vliet, Paulette M

    2012-03-01

    Impairments in gait coordination may be a factor in falls and mobility limitations after stroke. Therefore, rehabilitation targeting gait coordination may be an effective way to improve walking post-stroke. This review sought to examine current treatments that target impairments of gait coordination, the theoretical basis on which they are derived and the effects of such interventions. Few high quality RCTs with a low risk of bias specifically targeting and measuring restoration of coordinated gait were found. Consequently, we took a pragmatic approach to describing and quantifying the available evidence and included non-randomised study designs and limited the influence of heterogeneity in experimental design and control comparators by restricting meta-analyses to pre- and post-test comparisons of experimental interventions only. Results show that physiotherapy interventions significantly improved gait function and coordination. Interventions involving repetitive task-specific practice and/or auditory cueing appeared to be the most promising approaches to restore gait coordination. The fact that overall improvements in gait coordination coincided with increased walking speed lends support to the hypothesis that targeting gait coordination gait may be a way of improving overall walking ability post-stroke. However, establishing the mechanism for improved locomotor control requires a better understanding of the nature of both neuroplasticity and coordination deficits in functional tasks after stroke. Future research requires the measurement of impairment, activity and cortical activation in an effort to establish the mechanism by which functional gains are achieved. Copyright © 2011 Elsevier B.V. All rights reserved.

  14. Mobile agents basic concepts, mobility models, and the tracy toolkit

    CERN Document Server

    Braun, Peter

    2005-01-01

    Mobile agents are software nomads that act as your personal representative, working autonomously through networks. They are able to visit network nodes directly using available computing power and are not limited by platform. This emerging field is now poised to become a cornerstone for new Web-based ubiquitous computing environments. Mobile Agents provides a practical introduction to mobile agent technology and surveys the state of the art in mobile agent research. Students and researchers can use the book as an introduction to the concepts and possibilities of this field and as an overview of ongoing research. Developers can use it to identify the capabilities of the technology to decide if mobile agents are the right solution for them. Practioners can also gain hands-on experience in programming mobile agents through exploration of the source code for a complete mobile agent environment available through the companion website.*Summarizes the state of the art in mobile agent research*Identifies the benefits...

  15. Mobile solar mini power station filled with infrared heliochambers

    International Nuclear Information System (INIS)

    Abdukadirov, M.A.; Akhmedova, N.A.

    2000-01-01

    The work dedicated to development of perspective types of solar energetic devices of in-land application in accordance with conception about advantage of decentralized production of electrical and heat energy for supply of atom customers. It is given constructive particulars and characteristics of developed by authors mobile energy complex, which contents from block photoelectrical of convertor on the base of semiconductor solar elements, transparent in longwaved area out of edge of absorption base band, with power from 100 till 1000 Wt and heliochamber for accumulation of infrared part of solar radiation with wave length λ> 1 mcm. It is shown that, introduction into the system of energy complex the infrared heliochamber, increase the efficiency of equipment generally on the account of increasing the useful application of solar spectrum and extend her functional abilities. It is discussed the advantages of similar energy complex at decision of separate production tasks, including agriculture processing. (Author)

  16. Cost-effectiveness of a structured progressive task-oriented circuit class training programme to enhance walking competency after stroke: The protocol of the FIT-Stroke trial

    Directory of Open Access Journals (Sweden)

    Roelse Hanneke

    2009-08-01

    Full Text Available Abstract Background Most patients who suffer a stroke experience reduced walking competency and health-related quality of life (HRQoL. A key factor in effective stroke rehabilitation is intensive, task-specific training. Recent studies suggest that intensive, patient-tailored training can be organized as a circuit with a series of task-oriented workstations. Primary aim of the FIT-Stroke trial is to evaluate the effects and cost-effectiveness of a structured, progressive task-oriented circuit class training (CCT programme, compared to usual physiotherapeutic care during outpatient rehabilitation in a rehabilitation centre. The task-oriented CCT will be applied in groups of 4 to 6 patients. Outcome will be defined in terms of gait and gait-related ADLs after stroke. The trial will also investigate the generalizability of treatment effects of task-oriented CCT in terms of perceived fatigue, anxiety, depression and perceived HRQoL. Methods/design The multicentre single-blinded randomized trial will include 220 stroke patients discharged to the community from inpatient rehabilitation, who are able to communicate and walk at least 10 m without physical, hands-on assistance. After discharge from inpatient rehabilitation, patients in the experimental group will receive task-oriented CCT two times a week for 12 weeks at the physiotherapy department of the rehabilitation centre. Control group patients will receive usual individual, face-to-face, physiotherapy. Costs will be evaluated by having each patient keep a cost diary for the first 24 weeks after randomisation. Primary outcomes are the mobility part of the Stroke Impact Scale (SIS-3.0 and the EuroQol. Secondary outcomes are the other domains of SIS-3.0, lower limb muscle strength, walking endurance, gait speed, balance, confidence not to fall, instrumental ADL, fatigue, anxiety, depression and HRQoL. Discussion Based on assumptions about the effect of intensity of practice and specificity of

  17. [Cyclic movement training versus conventional physiotherapy for rehabilitation of hemiparetic gait after stroke: a pilot study].

    Science.gov (United States)

    Podubecka, J; Scheer, S; Theilig, S; Wiederer, R; Oberhoffer, R; Nowak, D A

    2011-07-01

    Recovery of impaired motor functions following stroke is commonly incomplete in spite of intensive rehabilitation programmes. At 6 months following a stroke up to 60 % of affected individuals still suffer from permanent motor deficits, in particular hemiparetic gait, that are relevant for daily life. Novel innovative therapeutic strategies are needed to enhance the recovery of impaired gait function following stroke. This pilot study has investigated the effectiveness of conventional physiotherapy in comparison to an apparative cyclic movement training over a period of 4 weeks to improve (i) power during a submaximal cyclic movement training of the lower limbs, (ii) cardiac fitness, (iii) balance and gait ability, and (iv) quality of life in stroke patients. In comparison to physiotherapy apparative cyclic movement training improved power, balance, cardiac fitness and quality of life to a greater extent. However, there was a statistically significant difference between both intervention groups only for balance but not for the other parameters assessed. The present pilot study should inspire future research with larger patient cohorts to allow appropriate judgement on the effectiveness of apparative cyclic movement training in stroke rehabilitation. © Georg Thieme Verlag KG Stuttgart · New York.

  18. Community participation of patients 12 months post-stroke in Johannesburg, South Africa

    Directory of Open Access Journals (Sweden)

    Witness Mudzi

    2013-01-01

    Full Text Available Background: Improvement in health-related quality of life (HRQL is the main goal of rehabilitation. The ability of the stroke-patient to participate in various situations signifies successful rehabilitation. The aim of the study was to establish the extent of communityparticipation and the barriers and facilitators to the participation for stroke patients after their discharge.Method: This study formed part of a larger study focusing on the impact of caregiver education on stroke survivors and their careers. This was a longitudinal study comprising 200 patients with first-time ischaemic stroke. Although the patients were followed up at home at 3 months, 6 months and 12 months post-stroke, this paper focuses on the 12-months follow-up participation results. Patient functional ability was measured by using the Barthel Index (BI and the Rivermead Mobility Index (RMI, whereas participation was measured by using the International Classification of Functioning, Disability and Health (ICF checklist. Descriptive statistics were used to analyse the data.Results: Patients experienced severe to complete difficulty when undertaking single and multiple tasks without help 12-months post-discharge. They struggled with the preparation of meals, household work and interpersonal interactions, and they had difficulties withcommunity life and partaking in recreation and leisure activities. Immediate family and societal attitudes were viewed as facilitators to community participation whereas friends, transportation services and social security services were viewed as barriers to communityparticipation.Conclusion: The patient-ability to socialise and participate in community issues is currently poor. The identified barriers to community participation need to be addressed in order toimprove patient-participation in the community post-stroke.

  19. Hemorrhagic versus ischemic stroke: Who can best benefit from blended conventional physiotherapy with robotic-assisted gait therapy?

    Science.gov (United States)

    Dierick, Frédéric; Dehas, Mélanie; Isambert, Jean-Luc; Injeyan, Soizic; Bouché, Anne-France; Bleyenheuft, Yannick; Portnoy, Sigal

    2017-01-01

    Contrary to common belief of clinicians that hemorrhagic stroke survivors have better functional prognoses than ischemic, recent studies show that ischemic survivors could experience similar or even better functional improvements. However, the influence of stroke subtype on gait and posture outcomes following an intervention blending conventional physiotherapy with robotic-assisted gait therapy is missing. This study compared gait and posture outcome measures between ambulatory hemorrhagic patients and ischemic patients, who received a similar 4 weeks' intervention blending a conventional bottom-up physiotherapy approach and an exoskeleton top-down robotic-assisted gait training (RAGT) approach with Lokomat. Forty adult hemiparetic stroke inpatient subjects were recruited: 20 hemorrhagic and 20 ischemic, matched by age, gender, side of hemisphere lesion, stroke severity, and locomotor impairments. Functional Ambulation Category, Postural Assessment Scale for Stroke, Tinetti Performance Oriented Mobility Assessment, 6 Minutes Walk Test, Timed Up and Go and 10-Meter Walk Test were performed before and after a 4-week long intervention. Functional gains were calculated for all tests. Hemorrhagic and ischemic subjects showed significant improvements in Functional Ambulation Category (Pbenefits from the same type, length and frequency of blended conventional physiotherapy and RAGT protocol. The use of intensive treatment plans blending top-down physiotherapy and bottom-up robotic approaches is promising for post-stroke rehabilitation.

  20. Design and experimental investigations on six-stroke SI engine using acetylene with water injection.

    Science.gov (United States)

    Gupta, Keshav; Suthar, Kishanlal; Jain, Sheetal Kumar; Agarwal, Ghanshyam Das; Nayyar, Ashish

    2018-06-02

    In the present study, a four-stroke cycle gasoline engine is redesigned and converted into a six-stroke cycle engine and experimental study has been conducted using gasoline and acetylene as fuel with water injection at the end of the recompression stroke. Acetylene has been used as an alternative fuel along with gasoline and performance of the six-stroke spark ignition (SI) engine with these two fuels has been studied separately and compared. Brake power and thermal efficiency are found to be 5.18 and 1.55% higher with acetylene as compared to gasoline in the six-stroke engine. However, thermal efficiency is found to be 45% higher with acetylene in the six-stroke engine as compared to four-stroke SI engine. The CO and HC emissions were found to be reduced by 13.33 and 0.67% respectively with acetylene as compared to gasoline due to better combustion of acetylene. The NO x emission was reduced by 5.65% with acetylene due to lower peak temperature by water injection. The experimental results showed better engine performance and emissions with acetylene as fuel in the six-stroke engine.

  1. Measurement of vertical stroke Vub vertical stroke using b hadron semileptonic decay

    International Nuclear Information System (INIS)

    Abbiendi, G.; Aakesson, P.F.

    2001-01-01

    The magnitude of the CKM matrix element vertical stroke V ub vertical stroke is determined by measuring the inclusive charmless semileptonic branching fraction of beauty hadrons at OPAL based on b → X u lν event topology and kinematics. This analysis uses OPAL data collected between 1991 and 1995, which correspond to about four million hadronic Z decays. We measure Br(b → X u lν) to be (1.63 ±0.53 +0.55 -0.62 ) x 10 -3 . The first uncertainty is the statistical error and the second is the systematic error. From this analysis, vertical stroke V ub vertical stroke is determined to be: vertical stroke V ub vertical stroke =(4.00±0.65(stat) +0.67 -0.76 (sys)±0.19(HQE)) x 10 -3 . The last error represents the theoretical uncertainties related to the extraction of vertical stroke V ub vertical stroke from Br(b→X u l ν) using the Heavy Quark Expansion. (orig.)

  2. Active cooling of a mobile phone handset

    International Nuclear Information System (INIS)

    Grimes, Ronan; Walsh, Ed; Walsh, Pat

    2010-01-01

    Power dissipation levels in mobile phones continue to increase due to gaming, higher power applications, and increased functionality associated with the internet. The current cooling methodologies of natural convection and radiation limit the power dissipation within a mobile phone to between 1-2 W depending on size. As power dissipation levels increase, products such as mobile phones will require active cooling to ensure that the devices operate within an acceptable temperature envelop from both user comfort and reliability perspectives. In this paper, we focus on the applied thermal engineering problem of an active cooling solution within a typical mobile phone architecture by implementing a custom centrifugal fan within the mobile phone. Its performance is compared in terms of flow rates and pressure drops, allowable phone heat dissipation and maximum phone surface temperature as this is the user constraint for a variety of simulated PCB architectures in the mobile phone. Perforated plates with varying porosity through different size orifices are used to simulate these architectures. The results show that the power level dissipated by a phone for a constant surface temperature may be increased by ∼50 - 75% depending on pressure drop induced by the internal phone architecture. Hence for successful implementation and efficient utilization of active cooling will require chip layout to be considered at the design stage.

  3. Does national expenditure on research and development influence stroke outcomes?

    Science.gov (United States)

    Kim, Young Dae; Jung, Yo Han; Norrving, Bo; Ovbiagele, Bruce; Saposnik, Gustavo

    2017-10-01

    Background Expenditure on research and development is a macroeconomic indicator representative of national investment. International organizations use this indicator to compare international research and development activities. Aim We investigated whether differences in expenditures on research and development at the country level may influence the incidence of stroke and stroke mortality. Methods We compared stroke metrics with absolute amount of gross domestic expenditure on R&D (GERD) per-capita adjusted for purchasing power parity (aGERD) and relative amount of GERD as percent of gross domestic product (rGERD). Sources included official data from the UNESCO, the World Health Organization, the World Bank, and population-based studies. We used correlation analysis and multivariable linear regression modeling. Results Overall, data on stroke mortality rate and GERD were available from 66 countries for two periods (2002 and 2008). Age-standardized stroke mortality rate was associated with aGERD (r = -0.708 in 2002 and r = -0.730 in 2008) or rGERD (r = -0.545 in 2002 and r = -0.657 in 2008) (all p < 0.001). Multivariable analysis showed a lower aGERD and rGERD were independently and inversely associated with higher stroke mortality (all p < 0.05). The estimated prevalence of hypertension, diabetes, or obesity was higher in countries with lower aGERD. The analysis of 27 population-based studies showed consistent inverse associations between aGERD or rGERD and incident risk of stroke and 30-day case fatality. Conclusions There is higher stroke mortality among countries with lower expenditures in research and development. While this study does not prove causality, it suggests a potential area to focus efforts to improve global stroke outcomes.

  4. Seizure development after stroke.

    Science.gov (United States)

    Misirli, H; Ozge, A; Somay, G; Erdoğan, N; Erkal, H; Erenoğlu, N Y

    2006-12-01

    Although there have been many studies on seizures following stroke, there is still much we do not know about them. In this study, we evaluated the characteristics of seizures in stroke patients. There were 2267 patients with a first-ever stroke, and after excluding 387 patients, 1880 were available for analysis. Of these 1880 patients, we evaluated 200 patients with seizures and 400 patients without seizures. We investigated the seizures according to age, gender, stroke type, the aetiology of ischaemic stroke and the localisation of the lesion. The seizures were classified as early onset and late onset and the seizure type as partial, generalised or secondarily generalised. Seizures occurred in 200 (10.6%) of 1880 strokes. The number of patients with seizures were 138 (10.6%) in ischaemic stroke group and 62 (10.7%) in haemorrhagic stroke group. Patients with ischaemic strokes had 41 embolic (29.7%) and 97 thrombotic (70.3%) origin, and these were not statistically significant in comparison with controls. Cortical involvement for the development of seizures was the most important risk factor (odds ratios = 4.25, p < 0.01). It was concluded that embolic strokes, being younger than 65 years old, and cortical localisation of stroke were important risks for developing seizures.

  5. Clinical Epidemiology Of Stroke

    Directory of Open Access Journals (Sweden)

    Nagaraja D

    2005-01-01

    Full Text Available Stroke is a huge public health problem because of its high morbidity and disability. The epidemiology of stroke is of relevance to construct practical paradigms to tackle this major health issue in the community. Recent data have shown that about 72-86% of strokes are ischemic, 9-18% are due to hemorrhage (intracerebral of subarachnoid and the rest are undefined. The risk factors for stroke are multiple and combined. At present, stroke is no more considered as unavoidable and untreatable. It is an emergency and specialized units and teams improve outcome and lower costs. Death related to stroke is declining in many countries and in both sexes. This decrease in multifactorial. The detection and more effective treatment of hypertension may play an important factor, as well as the improved medical care and improvement in diagnostic procedures. While stroke incidence appears stable and stroke mortality is slowly declining, the absolute magnitude of stroke is likely to grow over the next 30 years. as the population ages, the absolute number of stroke victims and demands on healthcare and other support systems is likely to increase substantially in the future. Keeping this in perspective, this chapter shall focus on the epidemiology of stroke in the world and in Indian, in particular.

  6. Effects of aquatic physiotherapy on the improvement of balance and corporal symmetry in stroke survivors.

    Science.gov (United States)

    Montagna, Jéssica Cristine; Santos, Bárbara C; Battistuzzo, Camila R; Loureiro, Ana Paula C

    2014-01-01

    One of the main problems associate with hemiparesis after stroke is the decrease in balance during static and dynamic postures which can highly affect daily life activities. To assess the effects of aquatic physiotherapy on the balance and quality of life (SS-QoL) of people with pos stroke. Chronic stroke participants received at total 18 individual sessions of aquatic physiotherapy using the principle of Halliwick (2x of 40 minutes per week). The outcomes measured were: Berg Balance scale, Timed up & go test (TUG), Stroke Specific Quality of Life Scale (SS-QoL) and baropodometric analysis. These assessment were performed before and one week after intervention. Fifteen participants were included in this study. The mean age was 58.5 and 54% was male. After intervention, participants had a significant improvement on their static balance measured by Berg Balance scale and TUG. Dynamic balance had a significant trend of improvement in mediolateral domain with eyes closed and during sit-to-stand. The mobility domain of the SS-QoL questionnaire was significant higher after intervention. Our results suggest that aquatic physiotherapy using the method of Halliwick can be a useful tool during stroke rehabilitation to improve balance. However, this improvement may not have significant impact of their quality of life.

  7. Stroke in Commercial Flights.

    Science.gov (United States)

    Álvarez-Velasco, Rodrigo; Masjuan, Jaime; DeFelipe, Alicia; Corral, Iñigo; Estévez-Fraga, Carlos; Crespo, Leticia; Alonso-Cánovas, Araceli

    2016-04-01

    Stroke on board aircraft has been reported in retrospective case series, mainly focusing on economy class stroke syndrome. Data on the actual incidence, pathogenesis, and prognosis of stroke in commercial flights are lacking. A prospective registry was designed to include all consecutive patients referred from an international airport (40 million passengers a year) to our hospital with a diagnosis of ischemic stroke or transient ischemic attack and onset of symptoms during a flight or immediately after landing. Forty-four patients (32 ischemic strokes and 12 transient ischemic attacks) were included over a 76-month period (January 2008 to April 2014). The estimated incidence of stroke was 1 stroke in 35 000 flights. Pathogeneses of stroke or transient ischemic attack were atherothrombotic in 16 (36%), economy class stroke syndrome in 8 (18%), cardioembolic in 7 (16%), arterial dissection in 4 (9%), lacunar stroke in 4 (9%), and undetermined in 5 (12%) patients. Carotid stenosis >70% was found in 12 (27%) of the patients. Overall prognosis was good, and thrombolysis was applied in 44% of the cases. The most common reason for not treating patients who had experienced stroke onset midflight was the delay in reaching the hospital. Only 1 patient with symptom onset during the flight prompted a flight diversion. We found a low incidence of stroke in the setting of air travel. Economy class stroke syndrome and arterial dissection were well represented in our sample. However, the main pathogenesis was atherothrombosis with a high proportion of patients with high carotid stenosis. © 2016 American Heart Association, Inc.

  8. From dictatorship to a reluctant democracy: stroke therapists talking about self-management.

    Science.gov (United States)

    Norris, Meriel; Kilbride, Cherry

    2014-01-01

    Self-management is being increasingly promoted within chronic conditions including stroke. Concerns have been raised regarding professional ownership of some programmes, yet little is known of the professional's experience. This paper aims to present the views of trained therapists about the utility of a specific self-management approach in stroke rehabilitation. Eleven stroke therapists trained in the self-management approach participated in semi-structured interviews. These were audio recorded, transcribed verbatim and analysed thematically. Two overriding themes emerged. The first was the sense that in normal practice therapists act as "benign dictators", committed to help their patients, but most comfortable when they, the professional, are in control. Following the adoption of the self-management approach therapists challenged themselves to empower stroke survivors to take control of their own recovery. However, therapists had to confront many internal and external challenges in this transition of power resulting in the promotion of a somewhat "reluctant democracy". This study illustrates that stroke therapists desire a more participatory approach to rehabilitation. However, obstacles challenged the successful delivery of this goal. If self-management is an appropriate model to develop in post stroke pathways, then serious consideration must be given to how and if these obstacles can be overcome. Stroke therapists perceive that self-management is appropriate for encouraging ownership of rehabilitation post stroke. Numerous obstacles were identified as challenging the implementation of self-management post stroke. These included: professional models, practices and expectations; institutional demands and perceived wishes of stroke survivors. For self-management to be effectively implemented by stroke therapists, these obstacles must be considered and overcome. This should be as part of an integrated therapy service, rather than as an add-on.

  9. Stroke care: Experiences and clinical research in stroke units in Chennai

    Directory of Open Access Journals (Sweden)

    Gobindram Arjundas

    2006-01-01

    Full Text Available Background: S troke is the second commonest cause of death in India with crude overall prevalence rate of 220 per 100,000. With an increasing aging population at risk, the stroke burden in India can be expected to reach epidemic proportions. Materials and Methods: The first protocol-based prospective studies, funded by private agencies was conducted in Madras Institute of Neurology in 1984-86. The results led to establishment of the first stroke unit in Tamil Nadu state, in the institute. The first all-India hospital-based studies in acute stroke was completed as INDIAN COOPERATIVE ACUTE STROKE STUDIES (ICASS I and ICASS II with WHO STEP ONE by members of the Indian Stroke Association between 2000-2005. This has generated very useful data for our country. Results: Mortality in 1984-86 was 40%. Stroke unit in the institute dropped it to 12%. About 10 years later, ICASS studies showed a further fall of mortality to 8%, which is the current international figure in the west. Morbidity pattern showed about half return to their original activities. But about one third are left totally disabled needing prolonged care, for which fiscal, social and rehab provisions have to be done on a national basis. Conclusions: The progress and success of care of Stroke in the last three decades, from treatment in medical and neurology wards to specialized stroke units is presented. The main risk factors are hypertension, diabetes and ischemic heart disease across the country. Hypertension alone or with the other two diseases was present in 72% of cases. Prevention and treatment of these factors will reduce the stroke burden, mortality and morbidity of strokes. The Stroke-team concept can be extended to the smallest hospitals in our country.

  10. Analysis of speed, stroke rate, and stroke distance for world-class breaststroke swimming.

    Science.gov (United States)

    Garland Fritzdorf, Stephen; Hibbs, Angela; Kleshnev, Valery

    2009-02-15

    Speed in aquatic locomotion is determined by stroke distance and stroke rate, but it does not always follow that an increase in stroke rate will lead to an increase in speed. Kleshnev (2006) developed a method to evaluate the relationship between speed and stroke rate during rowing - the effective work per stroke. In this case study, the effective work per stroke was determined for a male world-class 100-m breaststroke swimmer for seven races in major championships and compared between: each of the seven races; each quarter within each race; and the best swims of this case study and seven other world-class swimmers. The effective work per stroke was related to race performance, with the fastest race having the highest effective work per stroke and lowest stroke rate, with slower races having low effectiveness and high stroke rate (R(2) = 0.85). The effective work per stroke was reduced in a race as the swimmer fatigued. The within-race standard deviation of effectiveness was lower in fast swims (R(2) = 0.84). This analysis has identified some characteristics of fast swimming: high effectiveness, optimal stroke rate, and a flat effectiveness profile. Training and racing strategies can now be devised to improve performance by increasing the sensitivity of assessment of strengths and weaknesses in individuals.

  11. Stroke Burden in Rwanda: A Multicenter Study of Stroke Management and Outcome.

    Science.gov (United States)

    Nkusi, Agabe Emmy; Muneza, Severien; Nshuti, Steven; Hakizimana, David; Munyemana, Paulin; Nkeshimana, Menelas; Rudakemwa, Emmanuel; Amendezo, Etienne

    2017-10-01

    Cerebrovascular accidents or stroke constitute the second leading cause of mortality worldwide. Low- and middle-income countries bear most of the stroke burden worldwide. The main objective of this study is to determine the burden of stroke in Rwanda. This was a prospective observational study in 2 parts: 6 months baseline data collection and outcome assessment sessions at 1 year. A total of 96 patients were enrolled in our series. Stroke constituted 2100 per 100,000 population. Of all patients, 55.2% were male and most (60%) were 55 years and older. Of all patients and/or caretakers, 22% were not aware of their previous health status and 53.5% of hypertensive patients were not on treatment by the time of the event. Median presentation delay was 72 hours for patients with ischemic stroke and 24 hours for patients with hemorrhagic stroke. Most patients had hemorrhagic stroke (65% vs. 35%), and more patients with hemorrhagic stroke presented with loss of consciousness (80% vs. 51%). Many patients (62% ischemic group and 44% hemorrhagic group) presented with severe stroke scores, and this was associated with worst outcome (P = 0.004). At 1 year follow-up, 24.7% had no or mild disability, 14.3% were significantly disabled, and 61% had died. Our results show that stroke is a significant public health concern in Rwanda. Risk factor awareness and control are still low and case fatality of stroke is significantly high. The significant delay in presentation to care and presentation with severe stroke are major contributors for the high mortality and severe disability rates. Copyright © 2017 Elsevier Inc. All rights reserved.

  12. The Riks-Stroke story: building a sustainable national register for quality assessment of stroke care.

    Science.gov (United States)

    Asplund, Kjell; Hulter Åsberg, Kerstin; Appelros, Peter; Bjarne, Daniela; Eriksson, Marie; Johansson, Asa; Jonsson, Fredrik; Norrving, Bo; Stegmayr, Birgitta; Terént, Andreas; Wallin, Sari; Wester, Per-Olov

    2011-04-01

    Riks-Stroke, the Swedish Stroke Register, is the world's longest-running national stroke quality register (established in 1994) and includes all 76 hospitals in Sweden admitting acute stroke patients. The development and maintenance of this sustainable national register is described. Riks-Stroke includes information on the quality of care during the acute phase, rehabilitation and secondary prevention of stroke, as well as data on community support. Riks-Stroke is unique among stroke quality registers in that patients are followed during the first year after stroke. The data collected describe processes, and medical and patient-reported outcome measurements. The register embraces most of the dimensions of health-care quality (evidence-based, safe, provided in time, distributed fairly and patient oriented). Annually, approximately 25,000 patients are included. In 2009, approximately 320,000 patients had been accumulated (mean age 76-years). The register is estimated to cover 82% of all stroke patients treated in Swedish hospitals. Among critical issues when building a national stroke quality register, the delicate balance between simplicity and comprehensiveness is emphasised. Future developments include direct transfer of data from digital medical records to Riks-Stroke and comprehensive strategies to use the information collected to rapidly implement new evidence-based techniques and to eliminate outdated methods in stroke care. It is possible to establish a sustainable quality register for stroke at the national level covering all hospitals admitting acute stroke patients. Riks-Stroke is fulfilling its main goals to support continuous quality improvement of Swedish stroke services and serve as an instrument for following up national stroke guidelines. © 2010 The Authors. International Journal of Stroke © 2010 World Stroke Organization.

  13. Mobile application as a business strategy

    OpenAIRE

    Dordonne, Rudy

    2013-01-01

    The mobile phone market has gone through a revolution with the increase of power of the devices and the popularization of smartphones. Similarly to the change operated into the IT business more than two decades ago, the mobile phone market switched from hardware oriented to software oriented. The redistribution of powers over the market has generated new opportunities and mobile applications have become a major stake for the market's actors. The purpose of this research is to assess the va...

  14. Mobile Service Platform: A Middleware for Nomadic Mobile Service Provisioning

    NARCIS (Netherlands)

    van Halteren, Aart; Pawar, P.

    Ongoing miniaturization and power efficiency of mobile devices have led to widespread availability of devices that have an increasing amount of processing power and storage, and that support multiple wireless network interfaces connecting to various auxiliary devices and to the Internet. It is now

  15. Hip Hop Stroke: Study Protocol for a Randomized Controlled Trial to Address Stroke Literacy.

    Science.gov (United States)

    Williams, Olajide; Leighton-Herrmann, Ellyn; DeSorbo, Alexandra; Hecht, Mindy; Hedmann, Monique; Huq, Saima; Gerin, William; Chinchilli, Vernon; Ogedegbe, Gbenga; Noble, James

    2015-10-01

    Stroke is the fifth leading cause of death and the leading cause of serious long-term adult disability in the US. Acute stroke treatments with intravenous thrombolysis and endovascular therapy are proven to reduce disability, however a critical limitation on their effectiveness is the narrow time window for administration, which is 4.5 hours and 6 hours respectively from the onset of symptoms. Our overarching goal is to reduce pre-hospital delays to acute stroke treatments in economically disadvantaged minority communities where the greatest delays exist, using Hip Hop Stroke. Hip Hop Stroke (HHS) is a school-based, child-mediated, culturally-tailored stroke communication multimedia intervention developed using validated models of behavior change and designed to improve stroke literacy (knowledge of stroke symptoms, the urgent need to call 911, and prevention measures) of 4 th , 5 th and 6 th grade students and their parents residing in poor urban communities. Children in the intervention arm will receive the HHS intervention, while those in the attentional control arm will receive standardized nutrition education based on the USDA's MyPyramid program. Children will be trained and motivated to share stroke information with their parents or other adult caregiver. Both children and parents will complete a stroke knowledge assessment at baseline, immediately following the program, and at 3-months post-program. The primary outcome is the effect of the child mediation on parental stroke literacy. Stroke literate children, a captive audience in school systems, may represent a viable channel for spreading stroke information into households of poor urban communities where mass media stroke campaigns have shown the lowest penetration. These children may also call 911 when witnessing a stroke in their homes or communities. The HHS program may highlight the potential role of children in the chain of stroke recovery as a strategy for reducing prehospital delays to acute stroke

  16. Prevalence of stroke symptoms among stroke-free residents: first national data from Lebanon.

    Science.gov (United States)

    Farah, Rita; Zeidan, Rouba Karen; Chahine, Mirna N; Asmar, Roland; Chahine, Ramez; Salameh, Pascale; Hosseini, Hassan

    2015-10-01

    Stroke symptoms are common among people without a history of stroke or transient ischemic attack. Reported stroke symptoms may represent stroke episodes that failed to reach the threshold for clinical diagnosis. This study aimed to assess in the Lebanese population the prevalence of self-reported stroke symptoms in a stroke- and transient ischemic attack-free population, and the association of these symptoms with major risk factors for stroke. We carried out a cross-sectional study using a multistage cluster sample across Lebanon. We interviewed residents aged 40 years and more. Stroke symptoms were assessed using the Questionnaire for Verifying Stroke-Free Status. We included 1515 individuals (mean age was 57·2 ± 12·4 years, 783 women, 51·7%). Among 1460 participants stroke- and transient ischemic attack-free, 175 had experienced at least one stroke symptom (12·1%, 95% CI 9·9%-14·3%). Arterial hypertension (adjOR 4·37, 95% CI 2·68-7·12), history of heart disease (adjOR 3·34, 95% CI 2·00-5·56), current waterpipe smoking (adjOR 3·88, 95% CI 2·33-6·48), current and former cigarette smoking (adjOR 1·84, 95% CI 1·18-2·87 and adjOR 2·01, 95% CI 1·13-3·5, respectively), psychological distress (adjOR 1·04, 95% CI 1·02-1·05), the Mediterranean diet score (adjOR 0·87, 95% CI 0·76-0·99), and regular physical activity (adjOR 0·45, 95% CI 0·26-0·77) were independently associated with stroke symptoms. This is the first study conducted in the Middle East, assessing self-reported stroke symptoms among stroke-free residents. Our study showed that almost one in eight residents without a history of stroke or transient ischemic attack has had stroke symptoms. Major vascular risk factors are associated with these symptoms, thus allowing for prevention strategies. © 2015 World Stroke Organization.

  17. Effects of indirect lightning strokes on lossy power distribution lines in the presence of nonlinear loads

    International Nuclear Information System (INIS)

    Rahimian, M. S.; Sadeghi, S. H. H.; Moini, R.

    2003-01-01

    Cloud-to-ground lightning strokes can include dangerous overvoltage on power distribution overhead lines. In this paper, a new algorithm is propagated within a distribution network including nonlinear apparatus. The coupling between the lightning channel and the overhead line is based on an antenna theory model and employs the method of moment for solving the governing electric field integral equation. The computed induced overvoltage is then used in the electromagnetic transient program to analyze its propagation within the distribution network. In this regard, the accuracy of the new coupling method is demonstrated by comparing the calculated induced over voltages using the new method and those obtained using the conventional methods. Simulation results are presented to show how the induced overvoltage is penetrated in a typical distribution network, consisting of overhead lines and underground cables, a distribution transformer protected by surge arresters and a three-phase resistive load

  18. Self-Reported Stroke Risk Stratification: Reasons for Geographic and Racial Differences in Stroke Study.

    Science.gov (United States)

    Howard, George; McClure, Leslie A; Moy, Claudia S; Howard, Virginia J; Judd, Suzanne E; Yuan, Ya; Long, D Leann; Muntner, Paul; Safford, Monika M; Kleindorfer, Dawn O

    2017-07-01

    The standard for stroke risk stratification is the Framingham Stroke Risk Function (FSRF), an equation requiring an examination for blood pressure assessment, venipuncture for glucose assessment, and ECG to determine atrial fibrillation and heart disease. We assess a self-reported stroke risk function (SRSRF) to stratify stroke risk in comparison to the FSRF. Participants from the REGARDS study (Reasons for Geographic and Racial Differences in Stroke) were evaluated at baseline and followed for incident stroke. The FSRF was calculated using directly assessed stroke risk factors. The SRSRF was calculated from 13 self-reported questions to exclude those with prevalent stroke and assess stroke risk. Proportional hazards analysis was used to assess incident stroke risk using the FSRF and SRSRF. Over an average 8.2-year follow-up, 939 of 23 983 participants had a stroke. The FSRF and SRSRF produced highly correlated risk scores ( r Spearman =0.852; 95% confidence interval, 0.849-0.856); however, the SRSRF had higher discrimination of stroke risk than the FSRF (c SRSRF =0.7266; 95% confidence interval, 0.7076-0.7457; c FSRF =0.7075; 95% confidence interval, 0.6877-0.7273; P =0.0038). The 10-year stroke risk in the highest decile of predicted risk was 11.1% for the FSRF and 13.4% for the SRSRF. A simple self-reported questionnaire can be used to identify those at high risk for stroke better than the gold standard FSRF. This instrument can be used clinically to easily identify individuals at high risk for stroke and also scientifically to identify a subpopulation enriched for stroke risk. © 2017 American Heart Association, Inc.

  19. Effect of a provincial system of stroke care delivery on stroke care and outcomes

    Science.gov (United States)

    Kapral, Moira K.; Fang, Jiming; Silver, Frank L.; Hall, Ruth; Stamplecoski, Melissa; O’Callaghan, Christina; Tu, Jack V.

    2013-01-01

    Background: Systems of stroke care delivery have been promoted as a means of improving the quality of stroke care, but little is known about their effectiveness. We assessed the effect of the Ontario Stroke System, a province-wide strategy of regionalized stroke care delivery, on stroke care and outcomes in Ontario, Canada. Methods: We used population-based provincial administrative databases to identify all emergency department visits and hospital admissions for acute stroke and transient ischemic attack from Jan. 1, 2001, to Dec. 31, 2010. Using piecewise regression analyses, we assessed the effect of the full implementation of the Ontario Stroke System in 2005 on the proportion of patients who received care at stroke centres, and on rates of discharge to long-term care facilities and 30-day mortality after stroke. Results: We included 243 287 visits by patients with acute stroke or transient ischemic attack. The full implementation of the Ontario Stroke System in 2005 was associated with an increase in rates of care at stroke centres (before implementation: 40.0%; after implementation: 46.5%), decreased rates of discharge to long-term care facilities (before implementation: 16.9%; after implementation: 14.8%) and decreased 30-day mortality for hemorrhagic (before implementation: 38.3%; after implementation: 34.4%) and ischemic stroke (before implementation: 16.3%; after implementation: 15.7%). The system’s implementation was also associated with marked increases in the proportion of patients who received neuroimaging, thrombolytic therapy, care in a stroke unit and antithrombotic therapy. Interpretation: The implementation of an organized system of stroke care delivery was associated with improved processes of care and outcomes after stroke. PMID:23713072

  20. White matter changes in stroke patients. Relationship with stroke subtype and outcome

    DEFF Research Database (Denmark)

    Leys, D; Englund, E; Del Ser, T

    1999-01-01

    or white matter lesions or leukoencephalopathy or leukoaraiosis' and 'stroke or cerebral infarct or cerebral hemorrhage or cerebrovascular disease or transient ischemic attack (TIA)'. WMC, as defined radiologically, are present in up to 44% of patients with stroke or TIA and in 50% of patients...... of death or dependency, recurrent stroke of any type, cerebral bleeding under anticoagulation, myocardial infarction, and poststroke dementia. WMC in stroke patients are often associated with small-vessel disease and lead to a higher risk of death, and poor cardiac and neurological outcome. However......White matter changes (WMC), detected by imaging techniques, are frequent in stroke patients. The aim of the study was to determine how WMC relate to stroke subtypes and to stroke outcome. We made a systematic Medline search for articles appearing with two of the following key words: either 'WMC...

  1. The multilevel four-stroke swap engine and its environment

    Science.gov (United States)

    Uzdin, Raam; Kosloff, Ronnie

    2014-09-01

    A multilevel four-stroke engine where the thermalization strokes are generated by unitary collisions with thermal bath particles is analyzed. Our model is solvable even when the engine operates far from thermal equilibrium and in the strong system-bath coupling. Necessary operation conditions for the heat machine to perform as an engine or a refrigerator are derived. We relate the work and efficiency of the device to local and non-local statistical properties of the baths (purity, index of coincidence, etc) and put upper bounds on these quantities. Finally, in the ultra-hot regime, we analytically optimize the work and find a striking similarity to results obtained for efficiency at maximal power of classical engines. The complete swap limit of our results holds for any four-stroke quantum Otto engine that is coupled to the baths for periods that are significantly longer than the thermal relaxation time.

  2. The multilevel four-stroke swap engine and its environment

    International Nuclear Information System (INIS)

    Uzdin, Raam; Kosloff, Ronnie

    2014-01-01

    A multilevel four-stroke engine where the thermalization strokes are generated by unitary collisions with thermal bath particles is analyzed. Our model is solvable even when the engine operates far from thermal equilibrium and in the strong system–bath coupling. Necessary operation conditions for the heat machine to perform as an engine or a refrigerator are derived. We relate the work and efficiency of the device to local and non-local statistical properties of the baths (purity, index of coincidence, etc) and put upper bounds on these quantities. Finally, in the ultra-hot regime, we analytically optimize the work and find a striking similarity to results obtained for efficiency at maximal power of classical engines. The complete swap limit of our results holds for any four-stroke quantum Otto engine that is coupled to the baths for periods that are significantly longer than the thermal relaxation time. (paper)

  3. Knowledge of stroke among stroke patients and their relatives in Northwest India.

    Science.gov (United States)

    Pandian, Jeyaraj Durai; Kalra, Guneet; Jaison, Ashish; Deepak, Sukhbinder Singh; Shamsher, Shivali; Singh, Yashpal; Abraham, George

    2006-06-01

    The knowledge of warning symptoms and risk factors for stroke has not been studied among patients with stroke in developing countries. We aimed to assess the knowledge of stroke among patients with stroke and their relatives. Prospective tertiary referral hospital-based study in Northwest India. Trained nurses and medical interns interviewed patients with stroke and transient ischemic attack and their relatives about their knowledge of stroke symptoms and risk factors. Univariable and multivariable logistic regression were used. Of the 147 subjects interviewed, 102 (69%) were patients and 45 (31%) were relatives. There were 99 (67%) men and 48 (33%) women and the mean age was 59.7+/-14.1 years. Sixty-two percent of respondents recognized paralysis of one side as a warning symptom and 54% recognized hypertension as a risk factor for stroke. In the multivariable logistic regression analysis, higher education was associated with the knowledge of correct organ involvement in stroke (OR 2.6, CI 1.1- 6.1, P =0.02), whereas younger age (OR 2.7, CI 1.1-7.0, P =0.04) and higher education (OR 4.1, CI 1.5-10.9, P =0.005) correlated with a better knowledge regarding warning symptoms of stroke. In this study cohort, in general, there is lack of awareness of major warning symptoms, risk factors, organ involvement and self-recognition of stroke. However younger age and education status were associated with better knowledge. There is an urgent need for awareness programs about stroke in this study cohort.

  4. The Influence of Social Networks on the Development of Recruitment Actions that Favor User Interface Design and Conversions in Mobile Applications Powered by Linked Data

    OpenAIRE

    Palos-Sanchez, Pedro R.; Saura, Jose Ramon; Debasa, Felipe

    2018-01-01

    This study analyzes the most important influence factors in the literature, which have the greatest influence on the conversions obtained in a mobile application powered by linked data. With the study of user interface design and a small user survey (n = 101,053), we studied the influence of social networks, advertising, and promotional and recruitment actions in conversions for mobile applications powered by linked data. The analysis of the users’ behavior and their application in the design...

  5. A novel and simple test of gait adaptability predicts gold standard measures of functional mobility in stroke survivors.

    Science.gov (United States)

    Hollands, K L; Pelton, T A; van der Veen, S; Alharbi, S; Hollands, M A

    2016-01-01

    Although there is evidence that stroke survivors have reduced gait adaptability, the underlying mechanisms and the relationship to functional recovery are largely unknown. We explored the relationships between walking adaptability and clinical measures of balance, motor recovery and functional ability in stroke survivors. Stroke survivors (n=42) stepped to targets, on a 6m walkway, placed to elicit step lengthening, shortening and narrowing on paretic and non-paretic sides. The number of targets missed during six walks and target stepping speed was recorded. Fugl-Meyer (FM), Berg Balance Scale (BBS), self-selected walking speed (SWWS) and single support (SS) and step length (SL) symmetry (using GaitRite when not walking to targets) were also assessed. Stepwise multiple-linear regression was used to model the relationships between: total targets missed, number missed with paretic and non-paretic legs, target stepping speed, and each clinical measure. Regression revealed a significant model for each outcome variable that included only one independent variable. Targets missed by the paretic limb, was a significant predictor of FM (F(1,40)=6.54, p=0.014,). Speed of target stepping was a significant predictor of each of BBS (F(1,40)=26.36, padaptability is a clinically meaningful target for measurement and treatment of functionally adaptive walking ability in stroke survivors. Copyright © 2015 Elsevier B.V. All rights reserved.

  6. Exhaust emissions of low level blend alcohol fuels from two-stroke and four-stroke marine engines

    Science.gov (United States)

    Sevik, James M., Jr.

    The U.S. Renewable Fuel Standard mandates that by 2022, 36 billion gallons of renewable fuels must be produced on a yearly basis. Ethanol production is capped at 15 billion gallons, meaning 21 billion gallons must come from different alternative fuel sources. A viable alternative to reach the remainder of this mandate is iso-butanol. Unlike ethanol, iso-butanol does not phase separate when mixed with water, meaning it can be transported using traditional pipeline methods. Iso-butanol also has a lower oxygen content by mass, meaning it can displace more petroleum while maintaining the same oxygen concentration in the fuel blend. This research focused on studying the effects of low level alcohol fuels on marine engine emissions to assess the possibility of using iso-butanol as a replacement for ethanol. Three marine engines were used in this study, representing a wide range of what is currently in service in the United States. Two four-stroke engine and one two-stroke engine powered boats were tested in the tributaries of the Chesapeake Bay, near Annapolis, Maryland over the course of two rounds of weeklong testing in May and September. The engines were tested using a standard test cycle and emissions were sampled using constant volume sampling techniques. Specific emissions for two-stroke and four-stroke engines were compared to the baseline indolene tests. Because of the nature of the field testing, limited engine parameters were recorded. Therefore, the engine parameters analyzed aside from emissions were the operating relative air-to-fuel ratio and engine speed. Emissions trends from the baseline test to each alcohol fuel for the four-stroke engines were consistent, when analyzing a single round of testing. The same trends were not consistent when comparing separate rounds because of uncontrolled weather conditions and because the four-stroke engines operate without fuel control feedback during full load conditions. Emissions trends from the baseline test to each

  7. Burden of stroke in Bangladesh.

    Science.gov (United States)

    Islam, Md Nazmul; Moniruzzaman, Mohammed; Khalil, Md Ibrahim; Basri, Rehana; Alam, Mohammad Khursheed; Loo, Keat Wei; Gan, Siew Hua

    2013-04-01

    Stroke is the third leading cause of death in Bangladesh. The World Health Organization ranks Bangladesh's mortality rate due to stroke as number 84 in the world. The reported prevalence of stroke in Bangladesh is 0.3%, although no data on stroke incidence have been recorded. Hospital-based studies conducted in past decades have indicated that hypertension is the main cause of ischaemic and haemorrhagic stroke in Bangladesh. The high number of disability-adjusted life-years lost due to stroke (485 per 10,000 people) show that stroke severely impacts Bangladesh's economy. Although two non-governmental organizations, BRAC and the Centre for the Rehabilitation of the Paralysed, are actively involved in primary stroke prevention strategies, the Bangladeshi government needs to emphasize healthcare development to cope with the increasing population density and to reduce stroke occurrence. © 2012 The Authors. International Journal of Stroke © 2012 World Stroke Organization.

  8. Pre-stroke use of beta-blockers does not affect ischaemic stroke severity and outcome

    NARCIS (Netherlands)

    De Raedt, S.; Haentjens, P.; De Smedt, A.; Brouns, R.; Uyttenboogaart, Maarten; Luijckx, G. J.; De Keyser, J.

    Background and purpose: It is unclear whether pre-stroke beta-blockers use may influence stroke outcome. This study evaluates the independent effect of pre-stroke use of beta-blockers on ischaemic stroke severity and 3 months functional outcome. Methods: Pre-stroke use of beta-blockers was

  9. Post-stroke disposition from a geriatric-rehabilitative stroke care area: an Italian experience

    Directory of Open Access Journals (Sweden)

    Marco Masina

    2014-02-01

    Full Text Available A large number of stroke patients cannot be discharged at home. Studies on post stroke disposition have low validity outside the country in which they are carried out because healthcare systems offer different rehabilitative and long-term facilities. Moreover absolute selection criteria for admission to rehabilitation are not available yet. Few studies on post-stroke disposition from Italian stroke units are available. Authors evaluated data of a 18-month period from a geriatric managed stroke care area where comprehensive multi-professional assessment and discharge planning are routinely carried out. Only patients discharged with diagnosis related to acute stroke were considered. Baseline characteristics, clinical, neurological and functional conditions according to the structured multidimensional assessment were prospectively collected in the stroke unit registry. Univariate and multinomial logistic regression were performed to identify independent variables associated with three discharge settings: home, rehabilitation and skilled long-term ward. Out of 188 patients evaluated, 56.4% were discharged home, 18.6% to rehabilitation and 25.0% to long-term ward. Data showed an efficient disposition to intermediate settings with a shorter length of stay compared to other international studies. Factors associated with post-stroke disposition were age, dysphagia, neurological impairment on admission (NIH-SS≥6, after stroke functional status (mRankin≥3, poor pre-stroke functional level (mRankin≥3 and hemorrhagic stroke. Dysphagia, severe neurological impairment and post-stroke disability were associated with discharge to rehabilitation and long term ward. These two settings differed in age and pre-stroke functional condition. Patients discharged to long-term wards were about 10 years older than those admitted to rehabilitative ward. Only 5% of patients discharged to rehabilitation had a pre-stroke mRankin score ≥3. Disposition to a skilled

  10. Using Brain Oscillations and Corticospinal Excitability to Understand and Predict Post-Stroke Motor Function

    Directory of Open Access Journals (Sweden)

    Aurore Thibaut

    2017-05-01

    Full Text Available What determines motor recovery in stroke is still unknown and finding markers that could predict and improve stroke recovery is a challenge. In this study, we aimed at understanding the neural mechanisms of motor function recovery after stroke using neurophysiological markers by means of cortical excitability (transcranial magnetic stimulation—TMS and brain oscillations (electroencephalography—EEG. In this cross-sectional study, 55 subjects with chronic stroke (62 ± 14 yo, 17 women, 32 ± 42 months post-stroke were recruited in two sites. We analyzed TMS measures (i.e., motor threshold—MT—of the affected and unaffected sides and EEG variables (i.e., power spectrum in different frequency bands and different brain regions of the affected and unaffected hemispheres and their correlation with motor impairment as measured by Fugl-Meyer. Multiple univariate and multivariate linear regression analyses were performed to identify the predictors of good motor function. A significant interaction effect of MT in the affected hemisphere and power in beta bandwidth over the central region for both affected and unaffected hemispheres was found. We identified that motor function positively correlates with beta rhythm over the central region of the unaffected hemisphere, while it negatively correlates with beta rhythm in the affected hemisphere. Our results suggest that cortical activity in the affected and unaffected hemisphere measured by EEG provides new insights on the association between high-frequency rhythms and motor impairment, highlighting the role of an excess of beta in the affected central cortical region in poor motor function in stroke recovery.

  11. Sequential Multiple Assignment Randomized Trials: An Opportunity for Improved Design of Stroke Reperfusion Trials.

    Science.gov (United States)

    Meurer, William J; Seewald, Nicholas J; Kidwell, Kelley

    2017-04-01

    Modern clinical trials in stroke reperfusion fall into 2 categories: alternative systemic pharmacological regimens to alteplase and "rescue" endovascular approaches using targeted thrombectomy devices and/or medications delivered directly for persistently occluded vessels. Clinical trials in stroke have not evaluated how initial pharmacological thrombolytic management might influence subsequent rescue strategy. A sequential multiple assignment randomized trial (SMART) is a novel trial design that can test these dynamic treatment regimens and lead to treatment guidelines that more closely mimic practice. To characterize a SMART design in comparison to traditional approaches for stroke reperfusion trials. We conducted a numerical simulation study that evaluated the performance of contrasting acute stroke clinical trial designs of both initial reperfusion and rescue therapy. We compare a SMART design where the same patients are followed through initial reperfusion and rescue therapy within 1 trial to a standard phase III design comparing 2 reperfusion treatments and a separate phase II futility design of rescue therapy in terms of sample size, power, and ability to address particular research questions. Traditional trial designs can be well powered and have optimal design characteristics for independent treatment effects. When treatments, such as the reperfusion and rescue therapies, may interact, commonly used designs fail to detect this. A SMART design, with similar sample size to standard designs, can detect treatment interactions. The use of SMART designs to investigate effective and realistic dynamic treatment regimens is a promising way to accelerate the discovery of new, effective treatments for stroke. Copyright © 2017 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  12. Effect of pre-stroke use of ACE inhibitors on ischemic stroke severity

    Directory of Open Access Journals (Sweden)

    Caplan Louis

    2005-06-01

    Full Text Available Abstract Background Recent trials suggest that angiotensin-converting enzyme inhibitors (ACEI are effective in prevention of ischemic stroke, as measured by reduced stroke incidence. We aimed to compare stroke severity between stroke patients who were taking ACEI before their stroke onset and those who were not, to examine the effects of pretreatment with ACEI on ischemic stroke severity. Methods We retrospectively studied 126 consecutive patients presenting within 24 hours of ischemic stroke onset, as confirmed by diffusion-weighted magnetic resonance imaging (DWI. We calculated the NIHSS score at presentation, as the primary measure of clinical stroke severity, and categorized stroke severity as mild (NIHSS [less than or equal to] 7, moderate (NIHSS 8–13 or severe (NIHSS [greater than or equal to] 14. We analyzed demographic data, risk-factor profile, blood pressure (BP and medications on admissions, and determined stroke mechanism according to TOAST criteria. We also measured the volumes of admission diffusion- and perfusion-weighted (DWI /PWI magnetic resonance imaging lesions, as a secondary measure of ischemic tissue volume. We compared these variables among patients on ACEI and those who were not. Results Thirty- three patients (26% were on ACE-inhibitors. The overall median baseline NIHSS score was 5.5 (range 2–21 among ACEI-treated patients vs. 9 (range 1–36 in non-ACEI patients (p = 0.036. Patients on ACEI prior to their stroke had more mild and less severe strokes, and smaller DWI and PWI lesion volumes compared to non-ACEI treated patients. However, none of these differences were significant. Predictably, a higher percentage of patients on ACEI had a history of heart failure (p = 0.03. Age, time-to-imaging or neurological evaluation, risk-factor profile, concomitant therapy with lipid lowering, other antihypertensives or antithrombotic agents, or admission BP were comparable between the two groups. Conclusion Our results

  13. Measurement of the CKM matrix element vertical stroke Vts vertical stroke 2

    International Nuclear Information System (INIS)

    Unverdorben, Christopher Gerhard

    2015-03-01

    This is the first direct measurement of the CKM matrix element vertical stroke V ts vertical stroke, using data collected by the ATLAS detector in 2012 at √(s)= 8 TeV pp-collisions with a total integrated luminosity of 20.3 fb -1 . The analysis is based on 112 171 reconstructed t anti t candidate events in the lepton+jets channel, having a purity of 90.0 %. 183 t anti t→W + W - b anti s decays are expected (charge conjugation implied), which are available for the extraction of the CKM matrix element vertical stroke V ts vertical stroke 2 . To identify these rare decays, several observables are examined, such as the properties of jets, tracks and of b-quark identification algorithms. Furthermore, the s-quark hadrons K 0 s are considered, reconstructed by a kinematic fit. The best observables are combined in a multivariate analysis, called ''boosted decision trees''. The responses from Monte Carlo simulations are used as templates for a fit to data events yielding a significance value of 0.7σ for t→s+W decays. An upper limit of vertical stroke V ts vertical stroke 2 <1.74 % at 95 % confidence level is set, including all systematic and statistical uncertainties. So this analysis, using a direct measurement of the CKM matrix element vertical stroke V ts vertical stroke 2 , provides the best direct limit on vertical stroke V ts vertical stroke 2 up to now.

  14. The effect of static scanning and mobility training on mobility in people with hemianopia after stroke: A randomized controlled trial comparing standardized versus non-standardized treatment protocols

    Science.gov (United States)

    2011-01-01

    Background Visual loss following stroke impacts significantly on activities of daily living and is an independent risk factor for becoming dependent. Routinely, allied health clinicians provide training for visual field loss, mainly with eye movement based therapy. The effectiveness of the compensatory approach to rehabilitation remains inconclusive largely due to difficulty in validating functional outcome with the varied type and dosage of therapy received by an individual patient. This study aims to determine which treatment is more effective, a standardized approach or individualized therapy in patients with homonymous hemianopia post stroke. Methods/Design This study is a double-blind randomized controlled, multicenter trial. A standardised scanning rehabilitation program (Neuro Vision Technology (NVT) program) of 7 weeks at 3 times per week, is compared to individualized therapy recommended by clinicians. Discussion The results of the trial will provide information that could potentially inform the allocation of resources in visual rehabilitation post stroke. Trial Registration Australia and New Zealand Clinical Trials Register (ANZCTR): ACTRN12610000494033 PMID:21767413

  15. The effect of static scanning and mobility training on mobility in people with hemianopia after stroke: A randomized controlled trial comparing standardized versus non-standardized treatment protocols

    Directory of Open Access Journals (Sweden)

    George Stacey

    2011-07-01

    Full Text Available Abstract Background Visual loss following stroke impacts significantly on activities of daily living and is an independent risk factor for becoming dependent. Routinely, allied health clinicians provide training for visual field loss, mainly with eye movement based therapy. The effectiveness of the compensatory approach to rehabilitation remains inconclusive largely due to difficulty in validating functional outcome with the varied type and dosage of therapy received by an individual patient. This study aims to determine which treatment is more effective, a standardized approach or individualized therapy in patients with homonymous hemianopia post stroke. Methods/Design This study is a double-blind randomized controlled, multicenter trial. A standardised scanning rehabilitation program (Neuro Vision Technology (NVT program of 7 weeks at 3 times per week, is compared to individualized therapy recommended by clinicians. Discussion The results of the trial will provide information that could potentially inform the allocation of resources in visual rehabilitation post stroke. Trial Registration Australia and New Zealand Clinical Trials Register (ANZCTR: ACTRN12610000494033

  16. Does feedback on daily activity level from a Smart watch during inpatient stroke rehabilitation increase physical activity levels? Study protocol for a randomized controlled trial.

    Science.gov (United States)

    Dong, Yun; Steins, Dax; Sun, Shanbin; Li, Fei; Amor, James D; James, Christopher J; Xia, Zhidao; Dawes, Helen; Izadi, Hooshang; Cao, Yi; Wade, Derick T

    2018-03-09

    Practicing activities improves recovery after stroke, but many people in hospital do little activity. Feedback on activity using an accelerometer is a potential method to increase activity in hospital inpatients. This study's goal is to investigate the effect of feedback, enabled by a Smart watch, on daily physical activity levels during inpatient stroke rehabilitation and the short-term effects on simple functional activities, primarily mobility. A randomized controlled trial will be undertaken within the stroke rehabilitation wards of the Second Affiliated hospital of Anhui University of Traditional Chinese Medicine, Hefei, China. The study participants will be stroke survivors who meet inclusion criteria for the study, primarily: able to participate, no more than 4 months after stroke and walking independently before stroke. Participants will all receive standard local rehabilitation and will be randomly assigned either to receive regular feedback about activity levels, relative to a daily goal tailored by the smart watch over five time periods throughout a working day, or to no feedback, but still wearing the Smart watch. The intervention will last up to 3 weeks, ending sooner if discharged. The data to be collected in all participants include measures of daily activity (Smart watch measure); mobility (Rivermead Mobility Index and 10-metre walking time); independence in personal care (Barthel Activities of Daily Living (ADL) Index); overall activities (the World Health Organization (WHO) Disability Assessment Scale, 12-item version); and quality of life (the Euro-Qol 5L5D). Data will be collected by assessors blinded to allocation of the intervention at baseline, 3 weeks or at discharge (whichever is the sooner); and a reduced data set will be collected at 12 weeks by telephone interview. The primary outcome will be change in daily accelerometer activity scores. Secondary outcomes are compliance and adherence to wearing the watch, and changes in mobility

  17. Relationship between QT Interval Dispersion in acute stroke and stroke prognosis: A Systematic Review

    Science.gov (United States)

    Lederman, Yitzchok S.; Balucani, Clotilde; Lazar, Jason; Steinberg, Leah; Gugger, James; Levine, Steven R.

    2014-01-01

    Background QT dispersion (QTd) has been proposed as an indirect ECG measure of heterogeneity of ventricular repolarization. The predictive value of QTd in acute stroke remains controversial. We aimed to clarify the relationship between QTd and acute stroke and stroke prognosis. Methods A systematic review of the literature was performed using pre-specified medical subjects heading (MeSH) terms, Boolean logic and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Eligible studies (a) included ischemic or hemorrhagic stroke and (b) provided QTd measurements. Results Two independent reviewers identified 553 publications. Sixteen articles were included in the final analysis. There were a total of 888 stroke patients: 59% ischemic and 41% hemorrhagic. There was considerable heterogeneity in study design, stroke subtypes, ECG assessment-time, control groups and comparison groups. Nine studies reported a significant association between acute stroke and baseline QTd. Two studies reported that QTd increases are specifically related to hemorrhagic strokes, involvement of the insular cortex, right-side lesions, larger strokes, and increases in 3, 4-dihydroxyphenylethylene glycol in hemorrhagic stroke. Three studies reported QTd to be an independent predictor of stroke mortality. One study each reported increases in QTd in stroke patients who developed ventricular arrhythmias and cardiorespiratory compromise. Conclusions There are few well-designed studies and considerable variability in study design in addressing the significance of QTd in acute stroke. Available data suggest that stroke is likely to be associated with increased QTd. While some evidence suggests a possible prognostic role of QTd in stroke, larger and well-designed studies need to confirm these findings. PMID:25282188

  18. Leukocytosis in acute stroke

    DEFF Research Database (Denmark)

    Kammersgaard, L P; Jørgensen, H S; Nakayama, H

    1999-01-01

    Leukocytosis is a common finding in the acute phase of stroke. A detrimental effect of leukocytosis on stroke outcome has been suggested, and trials aiming at reducing the leukocyte response in acute stroke are currently being conducted. However, the influence of leukocytosis on stroke outcome has...

  19. Hydrodynamic interactions in metachronal paddling: effects of varying stroke kinematics

    Science.gov (United States)

    Samaee, Milad; Kasoju, Vishwa; Lai, Hong Kuan; Santhanakrishnan, Arvind

    2017-11-01

    Crustaceans such as shrimp and krill use a drag-based technique for propulsion, in which multiple pairs of limbs are paddled rhythmically from the tail to the head. Each limb is phase-shifted in time relative to its neighbor. Most studies of this type of metachronal swimming have focused on the jet formed in the animal's wake. However, synergistic hydrodynamic interactions between adjacent limbs in metachrony have received minimal attention. We used a dynamically scaled robotic model to experimentally investigate how variations in stroke kinematics impact inter-paddle hydrodynamic interactions and thrust generation. Physical models of limbs were fitted to the robot and paddled with two different motion profiles (MPs)-1) MP1: metachronal power stroke (PS) and metachronal recovery stroke (RS); and 2) MP2: metachronal PS and synchronous RS. Stroke frequency and amplitude were maintained constant across both MPs. Our results show that MP2 produced faster jets in the thrust-generating direction as compared to MP1. The necessity for a pause in MP2 after completion of PS by the paddles leading the motion, prior to executing the synchronous RS, aided in further downstream flow propagation. The effect of using asymmetric stroke kinematics on thrust generated will be discussed.

  20. Driving After a Stroke

    Science.gov (United States)

    ... 23,2015 Can I drive after a stroke? Driving is often a major concern after someone has a stroke. It’s not unusual for stroke survivors to want to drive. Being able to get around after a stroke is important. Safety behind the wheel is even more important after ...

  1. Relation between intracranial artery calcifications and aortic atherosclerosis in ischemic stroke patients.

    Science.gov (United States)

    Bugnicourt, Jean-Marc; Chillon, Jean-Marc; Tribouilloy, Christophe; Canaple, Sandrine; Lamy, Chantal; Massy, Ziad A; Godefroy, Olivier

    2010-08-01

    We previously demonstrated a strong relation between carotid atherosclerosis (defined as carotid artery stenosis > or =50%) and intracranial artery calcification (IAC) in ischemic stroke patients. The purpose of this study was to evaluate the relation between aortic atherosclerosis and IAC. Four hundred fifty-four patients with ischemic stroke were included. Complex aortic plaques (CAP) were assessed by transesophageal echocardiography (TEE) and defined as plaques > or =4 mm thick or with mobile components in the proximal aorta. IAC were assessed in the seven major cerebral arteries and a semiquantitative score system was applied, ranging from 0 (no calcification) to 7. Forty-two patients (9.3%) had CAP. Patients with CAP were older compared with patients without CAP (73.6 vs. 63.6 years, p vs. 1.8; p stroke or TIA (OR 3.3; 95%CI 1.5-7.0; p = 0.002), carotid artery stenosis > or =50% (OR 3.7; 95%CI 1.7-8.0; p = 0.001), chronic kidney disease (OR 3.8; 95%CI 1.9-7.8; p stroke patients, the absence of IAC strongly points to the lack of CAP. However, these results warrant confirmation in prospective studies before concluding the non-utility of the use of TEE to exclude CAP as a potential source of cerebral embolism in patients without IAC.

  2. Factors influencing pre-stroke and post-stroke quality of life among stroke survivors in a lower middle-income country.

    Science.gov (United States)

    Mahesh, P K B; Gunathunga, M W; Jayasinghe, S; Arnold, S M; Liyanage, S N

    2018-02-01

    Quality of life (QOL) reflects the individual's perception of the position within living contexts. This study was done to describe pre- and post-stroke QOLs of stroke survivors. A prospective longitudinal study was done among stroke survivors admitted to 13 hospitals in the western province of Sri Lanka. The calculated sample size was 260. The pre-stroke and post-discharge one-month QOL was gathered using short form-36 (SF-36) QOL tool. SF-36 includes questions on eight domains: general health, physical functioning, pain, role limitation due to physical problems, social functioning, vitality, role limitations due to emotional problems, and mental health. Univariate analysis was followed by determining the independent risk factors through multivariate analysis. The response rate was 81%. The disability was measured by the modified Rankin scale which ranges from 0 (no symptoms) to 6 (fatal outcome). The median (IQR) disability score was 4 (3 to 5). The post-discharge QOL scores were significantly lower than pre-stroke values (p role limitation-physical domains), female gender (for physical functioning and pain domains), lower health infrastructure (for general health, vitality, and mental health domains), lower education (for pain domain), higher disability (for general health, physical functioning, vitality, social functioning, and mental health domains), and hypercholesterolemia (for role limitation-emotional domain). Stroke survivors have not regained their pre-stroke QOL at 1 month following the hospital discharge irrespective of income level and pre-stroke QOL. Higher pre- and post-stroke QOLs are associated with better statuses of social determinants of health.

  3. Risk of Stroke in Migraineurs Using Triptans. Associations with Age, Sex, Stroke Severity and Subtype

    DEFF Research Database (Denmark)

    Albieri, Vanna; Olsen, Tom Skyhøj; Andersen, Klaus Kaae

    2016-01-01

    for a first stroke were identified in the Danish Registries. Information on stroke severity/subtype and cardiovascular risk factors was available for stroke patients. FINDINGS: Of the 49,711 patients hospitalized for a first stroke, 1084 were migraineurs using triptans. Adjusting for age, sex, income......, and educational level, risk for stroke was higher among migraineurs in respect to all strokes (RR 1.07; CI 1.01-1.14) and ischemic strokes (RR 1.07; CI 1.00-1.14). Risk for hemorrhagic stroke was increased but only in women (RR 1.41; CI 1.11-1.79). Risk was for mild strokes (RR 1.31; CI 1.16-1.48) while risk...

  4. Mobile Collocated Interactions

    DEFF Research Database (Denmark)

    Lucero, Andrés; Clawson, James; Lyons, Kent

    2015-01-01

    Mobile devices such as smartphones and tablets were originally conceived and have traditionally been utilized for individual use. Research on mobile collocated interactions has been looking at situations in which collocated users engage in collaborative activities using their mobile devices, thus...... going from personal/individual toward shared/multiuser experiences and interactions. However, computers are getting smaller, more powerful, and closer to our bodies. Therefore, mobile collocated interactions research, which originally looked at smartphones and tablets, will inevitably include ever......-smaller computers, ones that can be worn on our wrists or other parts of the body. The focus of this workshop is to bring together a community of researchers, designers and practitioners to explore the potential of extending mobile collocated interactions to the use of wearable devices....

  5. Hyponatremia in stroke

    Directory of Open Access Journals (Sweden)

    Sheikh Saleem

    2014-01-01

    Full Text Available Introduction: Hyponatremia is a common electrolyte disorder encountered in patients of neurological disorders which is usually either due to inappropriate secretion of Antidiuretic hormone (SIADH or cerebral salt wasting syndrome (CSWS. We conducted this study in a tertiary care hospital to determine the incidence and etiology of hyponatremia in patients of stroke admitted in the hospital. Materials and Methods: It was a prospective study done over a period of two years that included established cases of stroke diagnosed on the basis of clinical history, examination and neuroimaging. 1000 stoke patients were evaluated for hyponatremia (serum sodium <130 meq/l. The data was analysed using Chi-square test using SPSS (Statistical package for social science software. Results: Out of 1000 patients, 353 patients had hyponatremia. Out of this 353 patients, 238 (67% had SIADH and 115 (33% had CSWS. SIADH was seen in 83 patients who had ischemic stroke and 155 patients of hemorrhagic stroke. CSWS was found in 38 patients with ischemic stroke and 77 patients with hemorrhagic stroke. Statistical analysis revealed that hyponatremia significantly affects the outcome of stroke especially when it is due to CSWS rather than SIADH. Conclusion: Incidence of hyponatremia in our study population was 35%. In patients of hyponatremia 67% were having SIADH and 33% were having CSWS. Overall hyponatremia affected the outcome of stroke especially when caused by CSWS. Therefore close monitoring of serum sodium must be done in all patients who are admitted with stroke and efforts must be made to determine the cause of hyponatremia, in order to properly manage such patients thereby decreasing the mortality rate.

  6. Experiences of using information and communication technology within the first year after stroke – a grounded theory study

    DEFF Research Database (Denmark)

    Marwaa, Mille Nabsen; Ytterberg, Charlotte; Guidetti, Susanne

    2017-01-01

    of the interviews with the participants: 1) Using the mobile phone to feel safe, 2) Staying connected with others, 3) Recreating everyday life, 4) A tool for managing everyday life, and 5) Overcoming obstacles for using ICT. From these categories one core category emerged: The drive to integrate ICT in everyday...... life after stroke. Conclusions: People with stroke had a strong drive to integrate ICT in order to manage and bring meaning to their everyday lives, although sometimes they needed support and adaptations. It is not only possible but also necessary to start using ICT in rehabilitation in order...

  7. Prediabetes is associated with post-stroke cognitive impairment in ischaemic stroke patients.

    Science.gov (United States)

    Wang, Qiongzhang; Zhao, Kai; Cai, Yan; Tu, Xinjie; Liu, Yuntao; He, Jincai

    2018-05-15

    Diabetes mellitus is associated with post-stroke cognitive impairment. To the best of our knowledge, no study has explored the relationship between prediabetes and post-stroke cognitive impairment. The purpose of this study is to explore the association between prediabetes and cognitive impairment in ischaemic stroke patients at 1 month. Two hundred one acute ischaemic stroke patients were consecutively recruited within the first 24 h after admission and were followed up for 1 month. Patients were divided into a diabetes mellitus group, prediabetes group and non-diabetes mellitus group by fasting glucose levels, 2-h postprandial blood glucose levels and glycosylated haemoglobin levels at admission. Cognitive function was evaluated by the Mini-Mental State Examination at 1 month after stroke. The prediabetes group had a higher risk of post-stroke cognitive impairment than the non-diabetes group (35.7% vs. 18.1%, χ 2  = 4.252, P = .039). In logistical analyses, prediabetes was associated with post-stroke cognitive impairment after adjusting for potential confounding factors (odds ratio 3.062, 95% confidence interval 1.130-8.299, P = .028). Our findings show that prediabetes is associated with post-stroke cognitive impairment and may predict its development at 1 month post-stroke. Copyright © 2018 Elsevier B.V. All rights reserved.

  8. Burden of Stroke in Qatar.

    Science.gov (United States)

    Ibrahim, Faisal; Deleu, Dirk; Akhtar, Naveed; Al-Yazeedi, Wafa; Mesraoua, Boulenouar; Kamran, Sadaat; Shuaib, Ashfaq

    2015-12-01

    Qatar is located on the northeastern coast of the Arabian Peninsula. The total population is over 2.1 million with around 15% being Qatari citizens. Hamad General Hospital (HGH) is the only tertiary referral governmental hospital in Qatar which admits acute (thrombolysis-eligible) stroke patients. To provide an overview of the burden of stroke in Qatar. Data from literature databases, online sources and our stroke registry were collated to identify information on the burden of stroke in Qatar. Overall, over 80% of all stroke patients in Qatar are admitted in HGH. In 2010, the age-standardized incidence for first-ever ischemic stroke was 51.88/100,000 person-years. To date our stroke registry reveals that 79% of all stroke patients are male and almost 50% of stroke patients are 50 years or less. Hypertension, diabetes and dyslipidemia are the main predisposing factors for stroke, with ischemic stroke being more common (87%) than hemorrhagic stroke (13%). Despite the lack of a stroke unit, 9% of ischemic stroke patients are being thrombolyzed. However the presence of a stroke ward allows swift turnover of patients with a length of stay of less than 5 days before discharge or, if required, transfer to the fully-equipped hospital-based rehabilitation service. Several community awareness programs are ongoing, in addition to several research programs funded by the Qatar National Research Fund and Hamad Medical Corporation. In a country where over 15% of the population suffers from diabetes there is continuous need for national community-based awareness campaigns, prevention and educational programs particularly targeting patients and health care workers. Copyright © 2015 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  9. Orthostatic intolerance during early mobilization after fast-track hip arthroplasty

    DEFF Research Database (Denmark)

    Jans, O; Bundgaard-Nielsen, M; Solgaard, S

    2012-01-01

    has not been established after THA. This study evaluated the cardiovascular response and tissue oxygenation to mobilization before and after surgery in relation to OI in fast-track THA patients. METHODS: /st>OI and the cardiovascular response to standing were evaluated with a standardized mobilization......BACKGROUND: /st>Early postoperative mobilization is a cornerstone in fast-track total hip arthroplasty (THA), but postoperative orthostatic intolerance (OI) may delay early recovery or lead to fainting, falls, and prosthesis dislocation or fracture. However, the prevalence and pathophysiology of OI...... protocol, before, 6, and 24 h after surgery in 26 patients undergoing THA with spinal anaesthesia and an opioid-sparing analgesic regime. Haemoglobin, fluid balance, and opioid use were recorded. Systolic (SAP) and diastolic (DAP) arterial pressure, heart rate (HR), stroke volume (SV), cardiac output (CO...

  10. Determinan Penyakit Stroke

    Directory of Open Access Journals (Sweden)

    Woro Riyadina

    2013-02-01

    Full Text Available Penyakit stroke merupakan penyebab kematian dan kecacatan kronik yang paling tinggi pada kelompok umur diatas usia 45 tahun terbanyak di Indonesia. Tujuan penelitian ini untuk mengidentifikasi determinan utama yang berhubungan dengan penyakit stroke pada masyarakat di kelurahan Kebon Kalapa Bogor. Analisis lanjut terhadap 1.912 responden subset baseline data penelitian “Studi Kohort Faktor Risiko Penyakit Tidak Menular” Data dikumpulkan dengan metode wawancara pada penduduk tetap di kelurahan Kebon Kalapa, Kecamatan Bogor Tengah, Bogor tahun 2012. Diagnosis stroke berdasarkan anamnesis dan pemeriksaan dokter spesialis syaraf. Variabel independen meliputi karakteristik sosiodemografi, status kesehatan dan perilaku berisiko. Data dianalisis dengan uji regresi logistik ganda. Penyakit stroke ditemukan pada 49 (2,6% orang. Determinan utama stroke meliputi hipertensi (OR = 4,20; IK 95% = 2,20 – 8,03, penyakit jantung koroner (OR = 2,74; IK 95% = 1,51 – 4,99, diabetes melitus (OR = 2,89; IK 95% = 1,47 – 5,64, dan status ekonomi miskin (OR = 1,83 ; IK 95% = 1,03 – 3,33. Pencegahan penyakit stroke dilakukan dengan peningkatan edukasi (kampanye/penyuluhan melalui pengendalian faktor risiko utama yaitu hipertensi dan pencegahan terjadinya penyakit degeneratif lain yaitu penyakit jantung koroner dan diabetes melitus. Stroke disease is the leading cause of death and chronic disabi lity in most over the age of 45 years in Indonesia. The aim of study was to identify the major determinants of stroke disease in Kebon Kalapa community in Bogor. A deep analyze was conducted in 1.912 respondents based on the subset of baseline data “Risk Factors Cohort Study of Non Communicable Diseases.” Data was collected by interviews on Kebon Kalapa community, Bogor in 2012. Stroke diagnosis was determined by anamnesis and neu-rological examination with specialist. Independent variables were sociodemographic characteristics, health status and risk behavior

  11. Acute single channel EEG predictors of cognitive function after stroke.

    Directory of Open Access Journals (Sweden)

    Anna Aminov

    Full Text Available Early and accurate identification of factors that predict post-stroke cognitive outcome is important to set realistic targets for rehabilitation and to guide patients and their families accordingly. However, behavioral measures of cognition are difficult to obtain in the acute phase of recovery due to clinical factors (e.g. fatigue and functional barriers (e.g. language deficits. The aim of the current study was to test whether single channel wireless EEG data obtained acutely following stroke could predict longer-term cognitive function.Resting state Relative Power (RP of delta, theta, alpha, beta, delta/alpha ratio (DAR, and delta/theta ratio (DTR were obtained from a single electrode over FP1 in 24 participants within 72 hours of a first-ever stroke. The Montreal Cognitive Assessment (MoCA was administered at 90-days post-stroke. Correlation and regression analyses were completed to identify relationships between 90-day cognitive function and electrophysiological data, neurological status, and demographic characteristics at admission.Four acute qEEG indices demonstrated moderate to high correlations with 90-day MoCA scores: DTR (r = -0.57, p = 0.01, RP theta (r = 0.50, p = 0.01, RP delta (r = -0.47, p = 0.02, and DAR (r = -0.45, p = 0.03. Acute DTR (b = -0.36, p < 0.05 and stroke severity on admission (b = -0.63, p < 0.01 were the best linear combination of predictors of MoCA scores 90-days post-stroke, accounting for 75% of variance.Data generated by a single pre-frontal electrode support the prognostic value of acute DAR, and identify DTR as a potential marker of post-stroke cognitive outcome. Use of single channel recording in an acute clinical setting may provide an efficient and valid predictor of cognitive function after stroke.

  12. Stroke subtyping for genetic association studies? A comparison of the CCS and TOAST classifications.

    Science.gov (United States)

    Lanfranconi, Silvia; Markus, Hugh S

    2013-12-01

    A reliable and reproducible classification system of stroke subtype is essential for epidemiological and genetic studies. The Causative Classification of Stroke system is an evidence-based computerized algorithm with excellent inter-rater reliability. It has been suggested that, compared to the Trial of ORG 10172 in Acute Stroke Treatment classification, it increases the proportion of cases with defined subtype that may increase power in genetic association studies. We compared Trial of ORG 10172 in Acute Stroke Treatment and Causative Classification of Stroke system classifications in a large cohort of well-phenotyped stroke patients. Six hundred ninety consecutively recruited patients with first-ever ischemic stroke were classified, using review of clinical data and original imaging, according to the Trial of ORG 10172 in Acute Stroke Treatment and Causative Classification of Stroke system classifications. There was excellent agreement subtype assigned by between Trial of ORG 10172 in Acute Stroke Treatment and Causative Classification of Stroke system (kappa = 0·85). The agreement was excellent for the major individual subtypes: large artery atherosclerosis kappa = 0·888, small-artery occlusion kappa = 0·869, cardiac embolism kappa = 0·89, and undetermined category kappa = 0·884. There was only moderate agreement (kappa = 0·41) for the subjects with at least two competing underlying mechanism. Thirty-five (5·8%) patients classified as undetermined by Trial of ORG 10172 in Acute Stroke Treatment were assigned to a definite subtype by Causative Classification of Stroke system. Thirty-two subjects assigned to a definite subtype by Trial of ORG 10172 in Acute Stroke Treatment were classified as undetermined by Causative Classification of Stroke system. There is excellent agreement between classification using Trial of ORG 10172 in Acute Stroke Treatment and Causative Classification of Stroke systems but no evidence that Causative

  13. Strokes Associated With Pregnancy and Puerperium: A Nationwide Study by the Japan Stroke Society.

    Science.gov (United States)

    Yoshida, Kazumichi; Takahashi, Jun C; Takenobu, Yohei; Suzuki, Norihiro; Ogawa, Akira; Miyamoto, Susumu

    2017-02-01

    The incidence and cause of strokes associated with pregnancy and the puerperium are still not fully understood. The aim of this study was to characterize pregnancy-related strokes in Japan using a large-scale survey with current imaging techniques. A retrospective analysis was conducted based on clinical chart reviews in 736 stroke teaching hospitals certified by the Japan Stroke Society between 2012 and 2013, using a web-based questionnaire requesting the detailed clinical course without any personally identifying information. The collection rate of this questionnaire was 70.5%, with 151 pregnancy-associated strokes extracted. Hemorrhagic strokes were observed in 111 cases (73.5%), ischemic strokes in 37 (24.5%), and mixed type in 3 cases (2.0%). The estimated incidence of pregnancy-associated stroke was 10.2 per 100 000 deliveries. Major causes of hemorrhage were aneurysm (19.8%), arteriovenous malformation (17.1%), pregnancy-induced hypertension (11.7%), and HELLP syndrome (hemolysis, elevated liver enzymes, and low platelet count) (8.1%). Preexisting cerebrovascular diseases responsible for hemorrhage were detected in 59 cases (53.1%). Among the ischemic strokes, 28 (75.7%) were arterial and 9 (24.3%) were venous infarctions. The most frequent cause of arterial infarctions was reversible cerebral vasoconstriction syndrome. Hemorrhagic stroke showed much poorer prognosis than ischemic stroke. The incidence of pregnancy-associated stroke in Japan did not seem higher than that in other Asian and Western countries. The proportion of hemorrhagic stroke among Japanese women was much higher than that in white women. Preexisting cerebrovascular diseases and reversible cerebral vasoconstriction syndrome play a key role in hemorrhagic and ischemic stroke, respectively. © 2016 American Heart Association, Inc.

  14. Biomarkers of Atrial Cardiopathy and Atrial Fibrillation Detection on Mobile Outpatient Continuous Telemetry After Embolic Stroke of Undetermined Source.

    Science.gov (United States)

    Sebasigari, Denise; Merkler, Alexander; Guo, Yang; Gialdini, Gino; Kummer, Benjamin; Hemendinger, Morgan; Song, Christopher; Chu, Antony; Cutting, Shawna; Silver, Brian; Elkind, Mitchell S V; Kamel, Hooman; Furie, Karen L; Yaghi, Shadi

    2017-06-01

    Biomarkers of atrial dysfunction or "cardiopathy" are associated with embolic stroke risk. However, it is unclear if this risk is mediated by undiagnosed paroxysmal atrial fibrillation or flutter (AF). We aim to determine whether atrial cardiopathy biomarkers predict AF on continuous heart-rhythm monitoring after embolic stroke of undetermined source (ESUS). This was a single-center retrospective study including all patients with ESUS undergoing 30 days of ambulatory heart-rhythm monitoring to look for AF between January 1, 2013 and December 31, 2015. We reviewed medical records for clinical, radiographic, and cardiac variables. The primary outcome was a new diagnosis of AF detected during heart-rhythm monitoring. The primary predictors were atrial biomarkers: left atrial diameter on echocardiography, P-wave terminal force in electrocardiogram (ECG) lead V1, and P wave - R wave (PR) interval on ECG. A multiple logistic regression model was used to assess the relationship between atrial biomarkers and AF detection. Among 196 eligible patients, 23 (11.7%) were diagnosed with AF. In unadjusted analyses, patients with AF were older (72.4 years versus 61.4 years, P atrial diameter (39.2 mm versus 35.7 mm, P = .03). In a multivariable model, the only predictor of AF was age ≥ 60 years (odds ratio, 3.0; 95% CI, 1.06-8.5; P = .04). Atrial biomarkers were weakly associated with AF after ESUS. This suggests that previously reported associations between these markers and stroke may reflect independent cardiac pathways leading to stroke. Prospective studies are needed to investigate these mechanisms. Copyright © 2017 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  15. Registration of acute stroke

    DEFF Research Database (Denmark)

    Wildenschild, Cathrine; Mehnert, Frank; Thomsen, Reimar Wernich

    2014-01-01

    BACKGROUND: The validity of the registration of patients in stroke-specific registries has seldom been investigated, nor compared with administrative hospital discharge registries. The objective of this study was to examine the validity of the registration of patients in a stroke-specific registry...... (The Danish Stroke Registry [DSR]) and a hospital discharge registry (The Danish National Patient Registry [DNRP]). METHODS: Assuming that all patients with stroke were registered in either the DSR, DNRP or both, we first identified a sample of 75 patients registered with stroke in 2009; 25 patients...... in the DSR, 25 patients in the DNRP, and 25 patients registered in both data sources. Using the medical record as a gold standard, we then estimated the sensitivity and positive predictive value of a stroke diagnosis in the DSR and the DNRP. Secondly, we reviewed 160 medical records for all potential stroke...

  16. Psychometric properties of the NOMO 1.0 tested among adult powered-mobility users

    DEFF Research Database (Denmark)

    Sund, Terje; Brandt, Åse; Anttila, Heidi

    2017-01-01

    (Participation Repertoire). PURPOSE: This study aimed to investigate a range of psychometric properties of the NOMO 1.0 in a sample of adult powered mobility device (PMD) users. METHOD: Data collected from PMD users ( N = 248) in Denmark, Finland, and Norway as part of a larger study were analyzed using state...... scale and six components of the Frequency scale. IMPLICATIONS: The NOMO 1.0 should be used for research purposes and not for clinical practice. Better reliability should be established for the Need for Assistance and Ease/Difficulty scales prior to further psychometric testing to establish the validity...

  17. Body Mass Index and Stroke

    DEFF Research Database (Denmark)

    Andersen, Klaus Kaae; Olsen, Tom Skyhøj

    2013-01-01

    Although obesity is associated with excess mortality and morbidity, mortality is lower in obese than in normal weight stroke patients (the obesity paradox). Studies now indicate that obesity is not associated with increased risk of recurrent stroke in the years after first stroke. We studied...... the association between body mass index (BMI) and stroke patient's risk of having a history of previous stroke (recurrent stroke)....

  18. Stroke code improves intravenous thrombolysis administration in acute ischemic stroke.

    Directory of Open Access Journals (Sweden)

    Chih-Hao Chen

    Full Text Available Timely intravenous (IV thrombolysis for acute ischemic stroke is associated with better clinical outcomes. Acute stroke care implemented with "Stroke Code" (SC may increase IV tissue plasminogen activator (tPA administration. The present study aimed to investigate the impact of SC on thrombolysis.The study period was divided into the "pre-SC era" (January 2006 to July 2010 and "SC era" (August 2010 to July 2013. Demographics, critical times (stroke symptom onset, presentation to the emergency department, neuroimaging, thrombolysis, stroke severity, and clinical outcomes were recorded and compared between the two eras.During the study period, 5957 patients with acute ischemic stroke were admitted; of these, 1301 (21.8% arrived at the emergency department within 3 h of stroke onset and 307 (5.2% received IV-tPA. The number and frequency of IV-tPA treatments for patients with an onset-to-door time of <3 h increased from the pre-SC era (n = 91, 13.9% to the SC era (n = 216, 33.3% (P<0.001. SC also improved the efficiency of IV-tPA administration; the median door-to-needle time decreased (88 to 51 min, P<0.001 and the percentage of door-to-needle times ≤60 min increased (14.3% to 71.3%, P<0.001. The SC era group tended to have more patients with good outcome (modified Rankin Scale ≤2 at discharge (49.5 vs. 39.6%, P = 0.11, with no difference in symptomatic hemorrhage events or in-hospital mortality.The SC protocol increases the percentage of acute ischemic stroke patients receiving IV-tPA and decreases door-to-needle time.

  19. Validation of the Neurological Fatigue Index for stroke (NFI-Stroke

    Directory of Open Access Journals (Sweden)

    Mills Roger J

    2012-05-01

    Full Text Available Abstract Background Fatigue is a common symptom in Stroke. Several self-report scales are available to measure this debilitating symptom but concern has been expressed about their construct validity. Objective To examine the reliability and validity of a recently developed scale for multiple sclerosis (MS fatigue, the Neurological Fatigue Index (NFI-MS, in a sample of stroke patients. Method Six patients with stroke participated in qualitative interviews which were analysed and the themes compared for equivalence to those derived from existing data on MS fatigue. 999 questionnaire packs were sent to those with a stroke within the past four years. Data from the four subscales, and the Summary scale of the NFI-MS were fitted to the Rasch measurement model. Results Themes identified by stroke patients were consistent with those identified by those with MS. 282 questionnaires were returned and respondents had a mean age of 67.3 years; 62% were male, and were on average 17.2 (SD 11.4, range 2–50 months post stroke. The Physical, Cognitive and Summary scales all showed good fit to the model, were unidimensional, and free of differential item functioning by age, sex and time. The sleep scales failed to show adequate fit in their current format. Conclusion Post stroke fatigue appears to be represented by a combination of physical and cognitive components, confirmed by both qualitative and quantitative processes. The NFI-Stroke, comprising a Physical and Cognitive subscale, and a 10-item Summary scale, meets the strictest measurement requirements. Fit to the Rasch model allows conversion of ordinal raw scores to a linear metric.

  20. Quality of stroke care at an Irish Regional General Hospital and Stroke Rehabilitation Unit.

    LENUS (Irish Health Repository)

    Walsh, T

    2012-01-31

    BACKGROUND: Robust international data support the effectiveness of stroke unit (SU) care. Despite this, most stroke care in Ireland are provided outside of this setting. Limited data currently exist on the quality of care provided. AIM: The aim of this study is to examine the quality of care for patients with stroke in two care settings-Regional General Hospital (RGH) and Stroke Rehabilitation Unit (SRU). METHODS: A retrospective analysis of the stroke records of consecutive patients admitted to the SRU between May-November 2002 and April-November 2004 was performed applying the UK National Sentinel Audit of Stroke (NSAS) tool. RESULTS: The results of the study reveal that while SRU processes of care was 74% compliant with standards; compliance with stroke service organisational standards was only 15 and 43% in the RGH and SRU, respectively. CONCLUSION: The quality of stroke care in our area is deficient. Comprehensive reorganisation of stroke services is imperative.

  1. The Second Stroke Audit of Catalonia shows improvements in many, but not all quality indicators.

    Science.gov (United States)

    Abilleira, Sònia; Ribera, Aida; Sánchez, Emília; Tresserras, Ricard; Gallofré, Miquel

    2012-01-01

    Periodic audits allow monitoring of healthcare quality by comparing performances at different time points. Aims To assess quality of in-hospital stroke care in Catalonia in 2007 and compare it with 2005 (post-/preguidelines delivery, respectively). Data on 13 evidence-based performance measures were collected by a retrospective review of medical records of consecutive stroke admissions (January-December 2007) to 47 acute hospitals in Catalonia. Adherence was calculated according to the ratio (patients with documented performance measures' compliance) (valid cases for that measure). Sampling weights were applied to produce estimates of compliance. The proportions of compliance with performance measures in both audits were compared using random-effects logistic regressions, with each performance measure as the dependent variable and audit edition as the explanatory variable to determine whether changes in stroke care quality occurred along time. We analyzed 1767 events distributed among 47 hospitals. In 2007, there was an increase in tissue plasminogen activator administrations (2·8% vs. 5·9%) and stroke unit admissions (16·6% vs. 22·6%) and a reduction in seven-day mortality (9·5% vs. 6·8%). Logistic regression models provided evidence of improved adherences to seven performance measures (screening of dysphagia, management of hyperthermia, baseline computed tomography scan, baseline glycemia, rehabilitation needs, early mobilization, and anticoagulants for atrial fibrillation), but worsening of management of hypertension, dyslipidemia, and antithrombotics at discharge. The remaining three performance measures showed no changes. The Second Stroke Audit showed improvements in most dimensions of care, although unexpectedly a few but relevant performance measures became worse. Therefore, periodic stroke audits are needed to check changes in quality of care over time. © 2011 The Authors. International Journal of Stroke © 2011 World Stroke Organization.

  2. Dizziness in stroke

    Directory of Open Access Journals (Sweden)

    M. V. Zamergrad

    2015-01-01

    Full Text Available Differential diagnosis of new-onset acute vestibular vertigo is chiefly made between vestibular neuronitis and stroke. Dizziness in stroke is usually accompanied by other focal neurological symptoms of brainstem and cerebellar involvement. However, stroke may appear as isolated vestibular vertigo in some cases. An analysis of history data and the results of neurovestibular examination and brain magnetic resonance imaging allows stroke to be diagnosed in patients with acute isolated dizziness. The treatment of patients with stroke-induced dizziness involves a wide range of medications for the reduction of the degree of dizziness and unsteadiness and for the secondary prevention of stroke. Vestibular rehabilitation is an important component of treatment. The paper describes an observation of a patient with poorly controlled hypertension, who developed new-onset acute systemic dizziness. Vestibular neuronitis might be presumed to be a peripheral cause of vestibular disorders, by taking into account the absence of additional obvious neurological symptoms (such as pareses, defective sensation, diplopia, etc. and the nature of nystagmus. However, intention tremor in fingernose and heel-knee tests on the left side, a negative Halmagyi test, and results of Romberg’s test could suggest that stroke was a cause ofdizziness.

  3. Large Animal Stroke Models vs. Rodent Stroke Models, Pros and Cons, and Combination?

    Science.gov (United States)

    Cai, Bin; Wang, Ning

    2016-01-01

    Stroke is a leading cause of serious long-term disability worldwide and the second leading cause of death in many countries. Long-time attempts to salvage dying neurons via various neuroprotective agents have failed in stroke translational research, owing in part to the huge gap between animal stroke models and stroke patients, which also suggests that rodent models have limited predictive value and that alternate large animal models are likely to become important in future translational research. The genetic background, physiological characteristics, behavioral characteristics, and brain structure of large animals, especially nonhuman primates, are analogous to humans, and resemble humans in stroke. Moreover, relatively new regional imaging techniques, measurements of regional cerebral blood flow, and sophisticated physiological monitoring can be more easily performed on the same animal at multiple time points. As a result, we can use large animal stroke models to decrease the gap and promote translation of basic science stroke research. At the same time, we should not neglect the disadvantages of the large animal stroke model such as the significant expense and ethical considerations, which can be overcome by rodent models. Rodents should be selected as stroke models for initial testing and primates or cats are desirable as a second species, which was recommended by the Stroke Therapy Academic Industry Roundtable (STAIR) group in 2009.

  4. Stroke And Substance Abuse

    Directory of Open Access Journals (Sweden)

    A Chitsaz

    2017-02-01

    Full Text Available Introduction: stroke in recreational substance users can be an indirect complication, like endocarditis and cardio embolism in parenteral drug users. With some drug like cocaine, stroke appear to be the result of a direct effect. In young subjects without other risk factors provide persuasive evidence for causality . OPIATES: Heroine is the most abused opiate drug, which is administered by injection, by snorting or by smoking. Stroke affects heroin users by diverse mechanisms,. Injectors are at risk of infections endocarditis, which carries risk for both ischemic and hemorrhagic stroke. Cerebral or subarachnoid hemorrhage usually occurs after rupture of a septic (mycotic aneurysm. Heroine users can are also at risk for hemorrhagic stroke secondary to liver failure with deranged clotting and to heroin nephropathy with uremia or malignant hypertension. In some heroin users the drug it self is directly causal due to vasculitis, hypersensitivity and immunologic changes. Embolization of foreign material to brain due to mixed of heroine with quinine can cause cerebral embolism. AMPHETAMINE AND other psychostimulants: In abuser of amphetamine hemorrhagic stroke can occur, oral, intravenous, nasal, and inhalational routes of administration have been reported. Most were chronic user, but in several patients, stroke followed a first exposure. Some of amphetamine induced intracranial hemorrhages are secondary to acute hypertension, some to cerebral vacuities, and some to a combination of two. Decongestants and diet pills: Phenylpropanolamine (PPA, an amphetamine – like drug, in decongestants and diet pills, induce acute hypertension, sever headache, psychiatric symptoms, seizures and hemorrhagic stroke. Ephedrine and pseudo ephedrine are present in decongestants and bronchodilators and induce headache, tachyarrhythmia, hypertensive emergency, and hemorrhagic and occlusive stroke. Ecstasy, 3,4 Methylenedioxymethamphetamin (MDMA with amphetamine like can

  5. Detecting atheromatous plaques in the aortic arch or supra-aortic arteries for more accurate stroke subtype classification.

    Science.gov (United States)

    Cui, Xiaoyang; Wu, Simiao; Zeng, Quantao; Xiao, Jiahe; Liu, Ming

    2015-02-01

    To investigate the correlations of atheromatous plaques in the aortic arch or supra-aortic arteries with intracranial arterial stenosis and carotid plaques in stroke patients, and to determine whether taking these plaques into account will reduce the proportion of patients in the undetermined etiology group. We prospectively enrolled 308 ischemic stroke patients, whose clinical characteristics and A-S-C-O classifications were compared with analyses of intracranial arteries, carotid arteries, aortic arch, and supra-aortic arteries. 125(40.6%) patients had plaques in the aortic arch or supra-aortic arteries, of which 106 (84.8%) had complex plaques. No correlations were observed between these plaques and carotid plaques ( p = 0.283) or intracranial arterial stenosis ( p = 0.097). After detecting the mobile thrombi in the aortic arch and supra-aortic arteries, the proportion of patients in the atherothrombosis group was increased from 33.8% to 55.5% ( p = 0.00), whereas the proportion of patients in stroke of undetermined etiology group was decreased from 19.2% to 11.0% ( p = 0.00). Examining only the carotid and intracranial arteries may not provide adequate information about large arteries in stroke patients. Therefore, it would be better to include a search for relevant plaques in the aortic arch or supra-aortic arteries in modern stroke workup, for it may lead to more accurate stroke subtype classification and guide secondary prevention.

  6. Bounds on the Cabibbo-Kobayashi-Maskawa matrix elements vertical strokeVtdvertical stroke and vertical strokeVtsvertical stroke from experiments on B0-anti B0 mixings

    International Nuclear Information System (INIS)

    Ali, A.; Eijk, B. van; Have, I. ten

    1987-01-01

    We present a theoretical analysis of the process panti p → μ ± μ ± X, μ ± X', μ + μ - X' due to heavy flavour production and decays, based on perturbative quantum chromodynamics, QCD. We find reasonable agreement for the inclusive rates and distributions between the UA1 measurement and our calculations, with the exception of the dimuon ratio R(±±/+--), which is found typically a factor ≅ 1.8 smaller than the UA1 data. We interpret this excess in terms of B s 0 -anti B s 0 mixing and obtain a lower bound on the mixing probability, ρ s > 0.14. In the standard model this implies a lower bound on the Cabibbo-Kobayashi-Maskawa matrix element vertical strokeV ts vertical stroke given the top quark mass. The lower bound on vertical strokeV ts vertical stroke and the upper bound on vertical strokeV td vertical stroke, obtained from the (upper bound) B d 0 -anti B d 0 mixing probability, ρ d , from e + e - experiments are worked out. (orig.)

  7. Ischemic Stroke

    Science.gov (United States)

    ... Workplace Giving Fundraise Planned Giving Corporate Giving Cause Marketing Join your team, your way! The Stroke Challenge ... Your Technology Guide High Blood Pressure and Stroke Importance of Physical Activity See More Multimedia Las minorías ...

  8. Interprofessional stroke rehabilitation for stroke survivors using home care.

    Science.gov (United States)

    Markle-Reid, Maureen; Orridge, Camille; Weir, Robin; Browne, Gina; Gafni, Amiram; Lewis, Mary; Walsh, Marian; Levy, Charissa; Daub, Stacey; Brien, Heather; Roberts, Jacqueline; Thabane, Lehana

    2011-03-01

    To compare a specialized interprofessional team approach to community-based stroke rehabilitation with usual home care for stroke survivors using home care services. Randomized controlled trial of 101 community-living stroke survivors (stroke) using home care services. Subjects were randomized to intervention (n=52) or control (n=49) groups. The intervention was a 12-month specialized, evidence-based rehabilitation strategy involving an interprofessional team. The primary outcome was change in health-related quality of life and functioning (SF-36) from baseline to 12 months. Secondary outcomes were number of strokes during the 12-month follow-up, and changes in community reintegration (RNLI), perceived social support (PRQ85-Part 2), anxiety and depressive symptoms (Kessler-10), cognitive function (SPMSQ), and costs of use of health services from baseline to 12 months. A total of 82 subjects completed the 12-month follow-up. Compared with the usual care group, stroke survivors in the intervention group showed clinically important (although not statistically significant) greater improvements from baseline in mean SF-36 physical functioning score (5.87, 95% CI -3.98 to 15.7; p=0.24) and social functioning score (9.03, CI-7.50 to 25.6; p=0.28). The groups did not differ for any of the secondary effectiveness outcomes. There was a higher total per-person costs of use of health services in the intervention group compared to usual home care although the difference was not statistically significant (p=0.76). A 12-month specialized, interprofessional team is a feasible and acceptable approach to community-based stroke rehabilitation that produced greater improvements in quality of life compared to usual home care. Clinicaltrials.gov identifier: NCT00463229.

  9. Recurrent Stroke: The Value of the CHA2DS2VASc Score and the Essen Stroke Risk Score in a Nationwide Stroke Cohort.

    Science.gov (United States)

    Andersen, Søren Due; Gorst-Rasmussen, Anders; Lip, Gregory Y H; Bach, Flemming W; Larsen, Torben Bjerregaard

    2015-09-01

    The CHA2DS2VASc score and the Essen Stroke Risk Score are respectively used for risk stratification in patients with atrial fibrillation and in patients with cerebrovascular incidents. We aimed to test the ability of the 2 scores to predict stroke recurrence, death, and cardiovascular events (stroke, transient ischemic attack, myocardial infarction, or arterial thromboembolism) in a nationwide Danish cohort study, among patients with incident ischemic stroke and no atrial fibrillation. We conducted a registry-based study in patients with incident ischemic stroke and no atrial fibrillation. Patients were stratified according to the CHA2DS2VASc score and the Essen Stroke Risk Score and were followed up until stroke recurrence or death. We estimated stratified incidence rates and hazard ratios and calculated the cumulative risks. 42 182 patients with incident ischemic stroke with median age 70.1 years were included. The overall 1-year incidence rates of recurrent stroke, death, and cardiovascular events were 3.6%, 10.5%, and 6.7%, respectively. The incidence rates, the hazard ratios, and the cumulative risk of all outcomes increased with increasing risk scores. C-statistics for both risk scores were around 0.55 for 1-year stroke recurrence and cardiovascular events and correspondingly for death around 0.67 for both scores. In this cohort of non-atrial fibrillation patients with incident ischemic stroke, increasing CHA2DS2VASc score and Essen Stroke Risk Score was associated with increasing risk of recurrent stroke, death, and cardiovascular events. Their discriminatory performance was modest and further refinements are required for clinical application. © 2015 American Heart Association, Inc.

  10. Guidelines for acute ischemic stroke treatment: part II: stroke treatment

    Directory of Open Access Journals (Sweden)

    Sheila Cristina Ouriques Martins

    2012-11-01

    Full Text Available The second part of these Guidelines covers the topics of antiplatelet, anticoagulant, and statin therapy in acute ischemic stroke, reperfusion therapy, and classification of Stroke Centers. Information on the classes and levels of evidence used in this guideline is provided in Part I. A translated version of the Guidelines is available from the Brazilian Stroke Society website (www.sbdcv.com.br.

  11. Free piston variable-stroke linear-alternator generator

    Science.gov (United States)

    Haaland, Carsten M.

    1998-01-01

    A free-piston variable stroke linear-alternator AC power generator for a combustion engine. An alternator mechanism and oscillator system generates AC current. The oscillation system includes two oscillation devices each having a combustion cylinder and a flying turnbuckle. The flying turnbuckle moves in accordance with the oscillation device. The alternator system is a linear alternator coupled between the two oscillation devices by a slotted connecting rod.

  12. Costs of stroke and stroke services: Determinants of patient costs and a comparison of costs of regular care and care organised in stroke services

    Directory of Open Access Journals (Sweden)

    Koopmanschap Marc A

    2003-02-01

    Full Text Available Abstract Background Stroke is a major cause of death and long-term disability in Western societies and constitutes a major claim on health care budgets. Organising stroke care in a stroke service has recently been demonstrated to result in better health effects for patients. This paper discusses patient costs after stroke and compares costs between regular and stroke service care. Methods Costs were calculated within the framework of the evaluation of three experiments with stroke services in the Netherlands. Cost calculations are base on medical consumption data and actual costs. Results 598 patients were consecutively admitted to hospital after stroke. The average total costs of care per patient for the 6 month follow-up are estimated at €16,000. Costs are dominated by institutional and accommodation costs. Patients who die after stroke incur less costs. For patients that survive the acute phase, the most important determinants of costs are disability status and having a partner – as they influence patients' stroke careers. These determinants also interact. The most efficient stroke service experiment was most successful in co-ordinating patient flow from hospital to (nursing home, through capacity planning and efficient discharge procedures. In this region the costs of stroke service care are the same as for regular stroke care. The other experiments suffered from waiting lists for nursing homes and home care, leading to "blocked beds" in hospitals and nursing homes and higher costs of care. Costs of co-ordination are estimated at about 3% of total costs of care. Conclusion This paper demonstrates that by organising care for stroke patients in a stroke service, better health effects can be achieved with the same budget. In addition, it provides insight in need, predisposing and enabling factors that determine costs of care after stroke.

  13. Difficulty Swallowing After Stroke (Dysphagia)

    Science.gov (United States)

    ... Stroke Heroes Among Us Difficulty Swallowing After Stroke (Dysphagia) Updated:Nov 15,2016 Excerpted and adapted from "Swallowing Disorders After a Stroke," Stroke Connection Magazine July/August ...

  14. A Mobile Application Recommendation Framework by Exploiting Personal Preference with Constraints

    Directory of Open Access Journals (Sweden)

    Konglin Zhu

    2017-01-01

    Full Text Available Explosive mobile applications (Apps are proliferating with the popularity of mobile devices (e.g., smartphones, tablets. These Apps are developed to satisfy different function needs of users. Majority of existing App Stores have difficulty in recommending proper Apps for users. Therefore, it is of significance to recommend mobile Apps for users according to personal preference and various constraints of mobile devices (e.g., battery power. In this paper, we propose a mobile App recommendation framework by incorporating different requirements from users. We exploit modern portfolio theory (MPT to combine the popularity of mobile Apps, personal preference, and mobile device constraints for mobile App recommendation. Based on this framework, we discuss the recommendation approaches by constraints of phone power and limited mobile data plan. Extensive evaluations show that the proposed mobile App recommendation framework can well adapt to power and network data plan constraints. It satisfies the user App preference and mobile device constraints.

  15. Patient-Centered Goal Setting in a Hospital-Based Outpatient Stroke Rehabilitation Center.

    Science.gov (United States)

    Rice, Danielle B; McIntyre, Amanda; Mirkowski, Magdalena; Janzen, Shannon; Viana, Ricardo; Britt, Eileen; Teasell, Robert

    2017-09-01

    Goal-setting can have a positive impact on stroke recovery during rehabilitation. Patient participation in goal formulation can ensure that personally relevant goals are set, and can result in greater satisfaction with the rehabilitation experience, along with improved recovery of stroke deficits. This, however, not yet been studied in a stroke outpatient rehabilitation setting. To assess patient satisfaction of meeting self-selected goals during outpatient rehabilitation following a stroke. Retrospective chart review. Stroke patients enrolled in a multidisciplinary outpatient rehabilitation program, who set at least 1 goal during rehabilitation. Patients recovering from a stroke received therapy through the outpatient rehabilitation program between January 2010 and December 2013. Upon admission and discharge from rehabilitation, patients rated their satisfaction with their ability to perform goals that they wanted to achieve. Researchers independently sorted and labeled recurrent themes of goals. Goals were further sorted into International Classification of Functioning, Disability and Health (ICF) categories. To compare the perception of patients' goal satisfaction, repeated-measures analysis of variance was conducted across the 3 ICF goal categorizations. Goal satisfaction scores. A total of 286 patients were included in the analysis. Patient goals concentrated on themes of improving hand function, mobility, and cognition. Goals were also sorted into ICF categories in which impairment-based and activity limitation-based goals were predominant. Compared to activity-based and participation-based goals, patients with impairment-based goals perceived greater satisfaction with meeting their goals at admission and discharge (P rehabilitation program (P stroke rehabilitation setting, patients set heterogeneous goals that were predominantly impairment based. Satisfaction in achieving goals significantly improved after receiving therapy. The type of goals that patients

  16. Nursing care for stroke patients

    DEFF Research Database (Denmark)

    Tulek, Zeliha; Poulsen, Ingrid; Gillis, Katrin

    2018-01-01

    AIMS AND OBJECTIVES: To conduct a survey of the clinical nursing practice in European countries in accordance with the European Stroke Strategies (ESS) 2006, and to examine to what extent the ESS have been implemented in stroke care nursing in Europe. BACKGROUND: Stroke is a leading cause of death...... comprising 61 questions based on the ESS and scientific evidence in nursing practice was distributed to representatives of the European Association of Neuroscience Nurses, who sent the questionnaire to nurses active in stroke care. The questionnaire covered the following areas of stroke care: Organization...... of stroke services, Management of acute stroke and prevention including basic care and nursing, and Secondary prevention. RESULTS: Ninety-two nurses in stroke care in 11 European countries participated in the survey. Within the first 48 hours after stroke onset, 95% monitor patients regularly, 94% start...

  17. Diagnostic accuracy of guys Hospital stroke score (allen score) in acute supratentorial thrombotic/haemorrhagic stroke

    International Nuclear Information System (INIS)

    Zulfiqar, A.; Toori, K. U.; Khan, S. S.; Hamza, M. I. M.; Zaman, S. U.

    2006-01-01

    A consecutive series of 103 patients, 58% male with mean age of 62 year (range 40-75 years), admitted with supratentorial stroke in our teaching hospital were studied. All patients had Computer Tomography scan brain done after clinical evaluation and application of Allen stroke score. Computer Tomography Scan confirmed thrombotic stroke in 55 (53%) patients and haemorrhagic stroke in 48 (47%) patients. Out of the 55 patients with definitive thrombotic stroke on Computer Tomography Scan, Allen stroke score suggested infarction in 67%, haemorrhage in 6% and remained inconclusive in 27% of cases. In 48 patients with definitive haemorrhagic stroke on Computer Tomography Scan, Allen stroke score suggested haemorrhage in 60%, infarction in 11% and remained inconclusive in 29% of cases. The overall accuracy of Allen stroke score was 66%. (author)

  18. 40 CFR 1042.140 - Maximum engine power, displacement, power density, and maximum in-use engine speed.

    Science.gov (United States)

    2010-07-01

    ... cylinders having an internal diameter of 13.0 cm and a 15.5 cm stroke length, the rounded displacement would... 40 Protection of Environment 32 2010-07-01 2010-07-01 false Maximum engine power, displacement... Maximum engine power, displacement, power density, and maximum in-use engine speed. This section describes...

  19. Stroke management: Informal caregivers' burdens and strians of caring for stroke survivors.

    Science.gov (United States)

    Gbiri, Caleb Ademola; Olawale, Olajide Ayinla; Isaac, Sarah Oghenekewe

    2015-04-01

    Stroke survivors live with varied degrees of disabilities and cares are provided largely by the informal caregivers. This study investigated informal caregivers' burden and strains of caring for stroke patients. This study involved 157 (81 males and 76 females) informal caregivers of stroke survivors receiving care in all secondary and tertiary health institutions with physiotherapy services in Lagos State, Nigeria. Information was collected through self-administered questionnaire during clinic-hours. Data was analyzed using Spearman's Rank Correlation Coefficient. The patients' age ranged between 20 and 79 (mean=59.6 ± 14.6 years). Sixty-one had haemorrhagic stroke while 96 had ischaemic stroke. The informal caregivers' age was 39.2 ± 12.8 years (range: 17-36 years). More (60.8%) participants reported moderate objective while 79.2% had mild subjective burdens. The following factors significantly increased (Pfinancial well-beings of the informal caregivers. Caring for stroke survivors put social, emotional, health and financial burdens and strains on the informal caregivers. These burdens and strains increase with duration of stroke, intimacy, smaller number of caregivers and length of daily caregiving. Therefore, informal caregivers should be involved in the rehabilitation plan for stroke patients and their well-being should also be given adequate attention. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  20. D-dimer levels and stroke progression in patients with acute ischemic stroke and atrial fibrillation

    DEFF Research Database (Denmark)

    Krarup, L-H; Sandset, E C; Sandset, P M

    2011-01-01

    Krarup L-H, Sandset EC, Sandset PM, Berge E. D-dimer levels and stroke progression in patients with acute ischemic stroke and atrial fibrillation. Acta Neurol Scand: 2011: 124: 40-44. © 2010 John Wiley & Sons A/S. Background -  Patients with acute ischemic stroke and atrial fibrillation are at in......Krarup L-H, Sandset EC, Sandset PM, Berge E. D-dimer levels and stroke progression in patients with acute ischemic stroke and atrial fibrillation. Acta Neurol Scand: 2011: 124: 40-44. © 2010 John Wiley & Sons A/S. Background -  Patients with acute ischemic stroke and atrial fibrillation.......96), and the combined endpoint of stroke progression, recurrent stroke, and death (D-dimer: 991 ng/ml vs 970 ng/ml, P = 0.91). Multivariable analyses did not alter the results. Conclusion -  D-dimer and other markers of hemostatic activation were not associated with stroke progression, recurrent stroke, or death...

  1. National Trends in Patients Hospitalized for Stroke and Stroke Mortality in France, 2008 to 2014.

    Science.gov (United States)

    Lecoffre, Camille; de Peretti, Christine; Gabet, Amélie; Grimaud, Olivier; Woimant, France; Giroud, Maurice; Béjot, Yannick; Olié, Valérie

    2017-11-01

    Stroke is the leading cause of death in women and the third leading cause in men in France. In young adults (ie, stroke was observed at a local scale between 1985 and 2011. After the implementation of the 2010 to 2014 National Stroke Action Plan, this study investigates national trends in patients hospitalized by stroke subtypes, in-hospital mortality, and stroke mortality between 2008 and 2014. Hospitalization data were extracted from the French national hospital discharge databases and mortality data from the French national medical causes of death database. Time trends were tested using a Poisson regression model. From 2008 to 2014, the age-standardized rates of patients hospitalized for ischemic stroke increased by 14.3% in patients hemorrhagic stroke was stable (+2.0%), irrespective of age and sex. The proportion of patients hospitalized in stroke units substantially increased. In-hospital mortality decreased by 17.1% in patients with ischemic stroke. From 2008 to 2013, stroke mortality decreased, except for women between 45 and 64 years old and for people aged ≥85 years. An increase in cardiovascular risk factors and improved stroke management may explain the increase in the rates of patients hospitalized for ischemic stroke. The decrease observed for in-hospital stroke mortality may be because of recent improvements in acute-phase management. © 2017 American Heart Association, Inc.

  2. Relationship between plasma glutamate levels and post-stroke depression in patients with acute ischemic stroke

    Institute of Scientific and Technical Information of China (English)

    钱方媛

    2014-01-01

    Objective To test the association between the plasma glutamate levels during acute ischemic stroke andpost-stroke depression(PSD)initially.Methods Seventy-four ischemic stroke patients admitted to the hospital within the first day of stroke onset were evaluated at a follow-up of 2 weeks.The Beck Depression Inventory(BDI,21-item)and DSM-Ⅳcriteria was used to diagnose post-stroke depression(PSD)at 2 weeks after stroke.

  3. Functional Stroke Mimics: Incidence and Characteristics at a Primary Stroke Center in the Middle East

    Science.gov (United States)

    Wilkins, Stacy Schantz; Bourke, Paula; Salam, Abdul; Akhtar, Naveed; D'Souza, Atlantic; Kamran, Saadat; Bhutta, Zain; Shuaib, Ashfaq

    2018-01-01

    ABSTRACT Objective Approximately 30% of individuals who initially present with stroke are found to be stroke mimics (SM), with functional/psychological SM (FSM) accounting for up to 6.4% of all stroke presentations. Middle Eastern countries may have higher rates of somatization of emotional distress. The aim of this study was to evaluate the incidence and characteristics of FSM at a large general hospital in the Middle East. Methods All patients presenting with an initial diagnosis of stroke from June 2015 to September 2016 were eligible for this study. Clinical and sociodemographic data were obtained from the hospital's stroke database. All SM and strokes were diagnosed by Joint Commission International–certified stroke program neurologists. SM was defined as any discharge diagnosis (other than acute stroke) for symptoms that prompted initial admission for suspected stroke. FSM were compared with medical stroke mimics (MSM) and strokes (ischemic, hemorrhagic, and transient ischemic attacks). Results A total of 1961 patients were identified; 161 FSM (8.2%), 390 MSM (19.9%), and 1410 strokes (71.9%) (985 ischemic strokes, 196 transient ischemic attacks, 229 intracerebral hemorrhages). Admission with FSM was related to patients' nationality, with the highest frequency in Arabic (15.6%) and African (16.8%) patients. FSM patients were younger, more often female, and had fewer cardiovascular risk factors except for smoking compared with the strokes. FSM patients presented with more left-sided weakness and had more magnetic resonance imagings than the stroke and MSM groups. A total of 9.9% of FSM patients received thrombolysis versus only 0.5% of the MSM and 16.4% of ischemic strokes. Conclusions FSM frequencies varied by nationality, with Arab and African nationals being twice as prevalent. Stress, vulnerable status as expats, sociopolitical instability, and exposure to trauma are proposed as potential factors contributing to FSM. PMID:29394187

  4. Inflammatory Mechanisms Associated with Skeletal Muscle Sequelae after Stroke: Role of Physical Exercise

    Science.gov (United States)

    Coelho Junior, Hélio José; Gambassi, Bruno Bavaresco; Diniz, Tiego Aparecido; Fernandes, Isabela Maia da Cruz; Caperuto, Érico Chagas; Uchida, Marco Carlos; Lira, Fabio Santos

    2016-01-01

    Inflammatory markers are increased systematically and locally (e.g., skeletal muscle) in stroke patients. Besides being associated with cardiovascular risk factors, proinflammatory cytokines seem to play a key role in muscle atrophy by regulating the pathways involved in this condition. As such, they may cause severe decrease in muscle strength and power, as well as impairment in cardiorespiratory fitness. On the other hand, physical exercise (PE) has been widely suggested as a powerful tool for treating stroke patients, since PE is able to regenerate, even if partially, physical and cognitive functions. However, the mechanisms underlying the beneficial effects of physical exercise in poststroke patients remain poorly understood. Thus, in this study we analyze the candidate mechanisms associated with muscle atrophy in stroke patients, as well as the modulatory effect of inflammation in this condition. Later, we suggest the two strongest anti-inflammatory candidate mechanisms, myokines and the cholinergic anti-inflammatory pathway, which may be activated by physical exercise and may contribute to a decrease in proinflammatory markers of poststroke patients. PMID:27647951

  5. Paediatric stroke

    African Journals Online (AJOL)

    2011-04-02

    Apr 2, 2011 ... Organization definition of stroke is 'a clinical syndrome of rapidly developing focal or global ..... In the case of sickle cell disease primary and secondary prevention is by ... stroke and must involve caregivers. Prognosis7,10,17.

  6. Spontaneous ischaemic stroke in dogs

    DEFF Research Database (Denmark)

    Gredal, Hanne Birgit; Skerritt, G. C.; Gideon, P.

    2013-01-01

    Translation of experimental stroke research into the clinical setting is often unsuccessful. Novel approaches are therefore desirable. As humans, pet dogs suffer from spontaneous ischaemic stroke and may hence offer new ways of studying genuine stroke injury mechanisms.......Translation of experimental stroke research into the clinical setting is often unsuccessful. Novel approaches are therefore desirable. As humans, pet dogs suffer from spontaneous ischaemic stroke and may hence offer new ways of studying genuine stroke injury mechanisms....

  7. Hemorrhagic stroke in the Stroke Prevention by Aggressive Reduction in Cholesterol Levels study

    DEFF Research Database (Denmark)

    Goldstein, L.B.; Amarenco, P.; Szarek, M.

    2008-01-01

    BACKGROUND: In the Stroke Prevention by Aggressive Reduction in Cholesterol Levels (SPARCL) study, atorvastatin 80 mg/day reduced the risk of stroke in patients with recent stroke or TIA. Post hoc analysis found this overall benefit included an increase in the numbers of treated patients having......: Of 4,731 patients, 67% had ischemic strokes, 31% TIAs, and 2% hemorrhagic strokes as entry events. In addition to atorvastatin treatment (HR 1.68, 95% CI 1.09 to 2.59, p = 0.02), Cox multivariable regression including baseline variables significant in univariable analyses showed that hemorrhagic stroke...... and treatment. Multivariable analyses also found that having Stage 2 (JNC-7) hypertension at the last study visit before a hemorrhagic stroke increased risk (HR 6.19, 95% CI 1.47 to 26.11, p = 0.01), but there was no effect of most recent LDL-cholesterol level in those treated with atorvastatin. CONCLUSIONS...

  8. Deployment of Mobile Learning Course Materials to Android Powered Mobile Devices

    Science.gov (United States)

    Chao, Lee

    2012-01-01

    The objective of this article is to facilitate mobile teaching and learning by providing an alternative course material deployment method. This article suggests a course material deployment platform for small universities or individual instructors. Different from traditional course material deployment methods, the method discussed deploys course…

  9. Critical stroke rate as a parameter for evaluation in swimming

    Directory of Open Access Journals (Sweden)

    Marcos Franken

    2013-12-01

    Full Text Available The purpose of this study was to investigate the critical stroke rate (CSR compared to the average stroke rate (SR when swimming at the critical speed (CS. Ten competitive swimmers performed five 200 m trials at different velocities relative to their CS (90, 95, 100, 103 and 105% in front crawl. The CSR was significantly higher than the SR at 90% of the CS and lower at 105% of the CS. Stroke length (SL at 103 and 105% of the CS were lower than the SL at 90, 95, and 100% of the CS. The combination of the CS and CSR concepts can be useful for improving both aerobic capacity/power and technique. CS and CSR could be used to reduce the SR and increase the SL, when swimming at the CS pace, or to increase the swimming speed when swimming at the CSR.

  10. CLINICAL REABILITATION OF UPPER LIMB IN CHRONIC STROKE IN PORTUGAL A CROSS SECTIONAL SURVEY

    Directory of Open Access Journals (Sweden)

    Andre Vieira

    2016-02-01

    Full Text Available Background: More than 77% of stroke survivors have upper limb dysfunction. The scientific evidence for interventions in upper limb rehabilitation in stroke has shown variable results. To improve health care treatments in this domain it is needed to know what modalities are actually being used by physiotherapists. Methods: A national web-based survey focused in characterizing the profile of Portuguese physiotherapists working in post-stroke upper limb rehabilitation was conducted in 237 health institutions (n= 462 physiotherapists. The recruitment was conducted from August to December 2014. Analytic and descriptive analysis were used. Results: A total of 179 physiotherapists from 64 different locations from Portugal answered the survey, with a rate of response of 38.7%. The average age of respondents was 29.25±6.4 years old and predominantly finished the graduation or bachelor degree between 2001 and 2010. More than half hadn´t carried out any specialization in neurologic rehabilitation area. The top 5 modalities most used in the rehabilitation of upper limb in acute stroke are Goal Oriented Tasks (93.4% n=141, Motor Learning (89.4% n=135, Passive Mobilization (88.7% n=134, Task Repetition (87.4% n=132 and Bobath/Neurodevelopmental Therapy (86.9% n=131. Conclusions: The main modalities used for physiotherapists in upper limb rehabilitation in acute stroke have sparse levels of evidence. It is important to alert teachers, formers, physiotherapists and students for interventions with supported scientific results.

  11. A determination of the CKM-matrix element ratio vertical stroke Vtsvertical stroke /vertical stroke Vcbvertical stroke from the rare B-decays B →K*+γ and B →Xs + γ

    International Nuclear Information System (INIS)

    Ali, A.; Greub, C.

    1993-05-01

    Implication of the recent CLEO observation of the rare decay mode B→K * +γhaving a combined branching ratio BR(B→K * +γ)=(4.5±1.5±0.9)x10 -5 and an improved upper limit on the inclusive branching ratio BR(B→X s +γ) -4 (95% C.L.) are discussed in the context of the Standard Model (SM). Unsing the unitarity of the CKM-matrix and taking into account QCD radiative corrections in the decay rate and the inclusive photon energy spectrum we obtain an improved upper limit on the inclusive branching ratio BR(B→X s +γ) -4 (95% C.L.). This can be used to constrain possible non-SM contributions to the inclusive branching ratio, giving BR(B→X s +γ)(non-SM) -4 for m t ≥108 GeV. Within the SM, we show that the resulting experimental upper limit can be interpreted as a corresponding limit on the CKM-matrix element ratio yielding vertical stroke V ts vertical stroke /vertical stroke V cb vertical stroke * /X s )≡Γ(B→K * +γ)/Γ(B→X s +γ), based on the inclusive hadronic invariant mass distribution in B→X s +γ. Estimating the K * -contribution from this distribution in the threshold region (m K +m π)≤ m X s ≤0.97 GeV and using experimental measurements from the semileptonic D-decays D→K+π+lν l in the same mass interval, we obtain R(K * /X s )=0.13±0.03. This enables us to put a lower bound on the ratio vertical stroke V ts vertical stroke /vertical stroke V cb vertical stroke from the 95% C.L. lower limit on the branching rato BR(B→K * +γ)>1.6x10 -5 . Combining the exclusive and inclusive decay rates, we determine 0.50≤vertical stroke V ts vertical stroke /vertical stroke V cb vertical stroke ≤1.67 (at 95% C.L.). (orig.). 7 figs

  12. Inter-generational micro-class mobility during and after socialism : The power, education, autonomy, capital, and horizontal (PEACH) model in Hungary

    NARCIS (Netherlands)

    Lippényi, Zoltán; Gerber, Theodore P.

    2016-01-01

    We propose a theoretical model of how occupational mobility operates differently under socialism than under market regimes. Our model specifies four vertical dimensions of occupational resources-power, education, autonomy, and capital-plus a horizontal dimension consisting of linkages among

  13. A hydrodynamically active flipper-stroke in humpback whales.

    Science.gov (United States)

    Segre, Paolo S; Seakamela, S Mduduzi; Meÿer, Michael A; Findlay, Ken P; Goldbogen, Jeremy A

    2017-07-10

    A central paradigm of aquatic locomotion is that cetaceans use fluke strokes to power their swimming while relying on lift and torque generated by the flippers to perform maneuvers such as rolls, pitch changes and turns [1]. Compared to other cetaceans, humpback whales (Megaptera novaeangliae) have disproportionately large flippers with added structural features to aid in hydrodynamic performance [2,3]. Humpbacks use acrobatic lunging maneuvers to attack dense aggregations of krill or small fish, and their large flippers are thought to increase their maneuverability and thus their ability to capture prey. Immediately before opening their mouths, humpbacks will often rapidly move their flippers, and it has been hypothesized that this movement is used to corral prey [4,5] or to generate an upward pitching moment to counteract the torque caused by rapid water engulfment [6]. Here, we demonstrate an additional function for the rapid flipper movement during lunge feeding: the flippers are flapped using a complex, hydrodynamically active stroke to generate lift and increase propulsive thrust. We estimate that humpback flipper-strokes are capable of producing large forward oriented forces, which may be used to enhance lunge feeding performance. This behavior is the first observation of a lift-generating flipper-stroke for propulsion cetaceans and provides an additional function for the uniquely shaped humpback whale flipper. Copyright © 2017 Elsevier Ltd. All rights reserved.

  14. Stroke Laterality Bias in the Management of Acute Ischemic Stroke.

    Science.gov (United States)

    McCluskey, Gavin; Wade, Carrie; McKee, Jacqueline; McCarron, Peter; McVerry, Ferghal; McCarron, Mark O

    2016-11-01

    Little is known of the impact of stroke laterality on the management process and outcome of patients with acute ischemic stroke (AIS). Consecutive patients admitted to a general hospital over 1 year with supratentorial AIS were eligible for inclusion in the study. Baseline characteristics and risk factors, delays in hospital admission, imaging, intrahospital transfer to an acute stoke unit, stroke severity and classification, length of hospital admission, as well as 10-year mortality were measured and compared among right and left hemisphere AIS patients. There were 141 patients (77 men, 64 women; median age 73 [interquartile range 63-79] years), There were 71 patients with left hemisphere AIS and 70 with right hemisphere AIS. Delays to hospital admission from stroke onset to neuroimaging were similar among right and left hemisphere AIS patients. Delay in transfer to an acute stroke unit (ASU) following hospital admission was on average 14 hours more for right hemisphere compared to left hemisphere AIS patients (P = .01). Laterality was not associated with any difference in 10-year survival. Patients with mild and nondominant AIS merit particular attention to minimize their intrahospital transfer time to an ASU. Copyright © 2016 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  15. Association between atherogenic dyslipidemia and recurrent stroke risk in patients with different subtypes of ischemic stroke.

    Science.gov (United States)

    Zhao, Lu; Wang, Ruihao; Song, Bo; Tan, Song; Gao, Yuan; Fang, Hui; Lu, Jie; Xu, Yuming

    2015-07-01

    The association between atherogenic dyslipidemia and stroke recurrence remains unclear, and may be influenced by different subtypes of ischemic stroke. We aimed to investigate whether atherogenic dyslipidemia contributed to stroke recurrence in ischemic stroke patients and in those with certain subtypes of ischemic stroke. We conducted a prospective hospital-based study enrolling patients with acute ischemic stroke. Atherogenic dyslipidemia was defined as high-density lipoprotein cholesterol dyslipidemia and stroke recurrence was analyzed by using multivariable Cox regression model. In the 510 ischemic stroke patients, 64 patients (12·5%) had atherogenic dyslipidemia, and 66 patients (12·9%) experienced stroke recurrence events within 24 months. Kaplan-Meier analysis revealed that stroke recurrence rate was significantly higher in patients with atherogenic dyslipidemia than those without in all the stroke patients (20·3% vs. 11·9%; P = 0·048), and more evident in those of large-artery atherosclerosis subtype (31·0% vs. 14·1%; P = 0·014), but not in the other subtypes. Multivariable Cox regression analysis revealed that atherogenic dyslipidemia was associated with higher stroke recurrence risk among stroke patients of large-artery atherosclerosis subtype (hazard ratio, 2·79; 95% confidence interval, 1·24-6·28), but not significant in all the stroke patients (hazard ratio, 1·69; 95% confidence interval, 0·85-3·37). Atherogenic dyslipidemia is associated with higher risk of stroke recurrence in ischemic stroke patients. Such association might be more pronounced in large-artery atherosclerosis subtype and needs further investigation to establish such relationship. © 2015 World Stroke Organization.

  16. One-year outcome after first-ever stroke according to stroke subtype, severity, risk factors and pre-stroke treatment. A population-based study from Tartu, Estonia.

    Science.gov (United States)

    Vibo, R; Kõrv, J; Roose, M

    2007-04-01

    The aim of the current study was to evaluate the outcome at 1 year following a first-ever stroke based on a population-based registry from 2001 to 2003 in Tartu, Estonia. The outcome of first-ever stroke was assessed in 433 patients by stroke risk factors, demographic data and stroke severity at onset using the Barthel Index (BI) score and the modified Rankin Score (mRS) at seventh day, 6 months and 1 year. Female sex, older age, blood glucose value >10 mmol/l on admission and more severe stroke on admission were the best predictors of dependency 1 year following the first-ever stroke. At 1 year, the percentage of functionally dependent patients was 20% and the survival rate was 56%. The use of antihypertensive/antithrombotic medication prior to stroke did not significantly affect the outcome. The survival rate of stroke patients in Tartu is lower compared with other studied populations. The outcome of stroke was mainly determined by the initial severity of stroke and by elevated blood glucose value on admission. Patients with untreated hypertension had more severe stroke and trend for unfavourable outcome compared with those who were on treatment.

  17. Residential mobility and childhood leukemia.

    Science.gov (United States)

    Amoon, A T; Oksuzyan, S; Crespi, C M; Arah, O A; Cockburn, M; Vergara, X; Kheifets, L

    2018-07-01

    Studies of environmental exposures and childhood leukemia studies do not usually account for residential mobility. Yet, in addition to being a potential risk factor, mobility can induce selection bias, confounding, or measurement error in such studies. Using data collected for California Powerline Study (CAPS), we attempt to disentangle the effect of mobility. We analyzed data from a population-based case-control study of childhood leukemia using cases who were born in California and diagnosed between 1988 and 2008 and birth certificate controls. We used stratified logistic regression, case-only analysis, and propensity-score adjustments to assess predictors of residential mobility between birth and diagnosis, and account for potential confounding due to residential mobility. Children who moved tended to be older, lived in housing other than single-family homes, had younger mothers and fewer siblings, and were of lower socioeconomic status. Odds ratios for leukemia among non-movers living mobility, including dwelling type, increased odds ratios for leukemia to 2.61 (95% CI: 1.76-3.86) for living mobility of childhood leukemia cases varied by several sociodemographic characteristics, but not by the distance to the nearest power line or calculated magnetic fields. Mobility appears to be an unlikely explanation for the associations observed between power lines exposure and childhood leukemia. Copyright © 2018 Elsevier Inc. All rights reserved.

  18. Patent foramen ovale and the risk of ischemic stroke in a multiethnic population.

    Science.gov (United States)

    Di Tullio, Marco R; Sacco, Ralph L; Sciacca, Robert R; Jin, Zhezhen; Homma, Shunichi

    2007-02-20

    We sought to assess the risk of ischemic stroke from a patent foramen ovale (PFO) in the multiethnic prospective cohort of northern Manhattan. Patent foramen ovale has been associated with increased risk of ischemic stroke, mainly in case-control studies. The actual PFO-related stroke risk in the general population is unclear. The presence of PFO was assessed at baseline by using transthoracic 2-dimensional echocardiography with contrast injection in 1,100 stroke-free subjects older than 39 years of age (mean age 68.7 +/- 10.0 years) from the Northern Manhattan Study (NOMAS). The presence of atrial septal aneurysm (ASA) also was recorded. Subjects were followed annually for outcomes. We assessed PFO/ASA-related stroke risk after adjusting for established stroke risk factors. We detected PFO in 164 subjects (14.9%); ASA was present in 27 subjects (2.5%) and associated with PFO in 19 subjects. During a mean follow-up of 79.7 +/- 28.0 months, an ischemic stroke occurred in 68 subjects (6.2%). After adjustment for demographics and risk factors, PFO was not found to be significantly associated with stroke (hazard ratio 1.64, 95% confidence interval [CI] 0.87 to 3.09). The same trend was observed in all age, gender, and race-ethnic subgroups. The coexistence of PFO and ASA did not increase the stroke risk (adjusted hazard ratio 1.25, 95% CI 0.17 to 9.24). Isolated ASA was associated with elevated stroke incidence (2 of 8, or 25%; adjusted hazard ratio 3.66, 95% CI 0.88 to 15.30). Patent foramen ovale, alone or together with ASA, was not associated with an increased stroke risk in this multiethnic cohort. The independent role of ASA needs further assessment in appositely designed and powered studies.

  19. Accelerometry: A feasible method to monitor physical activity during sub-acute rehabilitation of persons with stroke.

    Science.gov (United States)

    Joseph, Conran; Strömbäck, Björn; Hagströmer, Maria; Conradsson, David

    2018-05-08

    To investigate the feasibility of using accelerometers to monitor physical activity in persons with stroke admitted to inpatient rehabilitation. Longitudinal observational study. Persons with stroke admitted to a specialized rehabilitation centre for sub-acute rehabilitation were recruited between August and December 2016. Volume and intensity of physical activity were assessed with accelerometers throughout the rehabilitation period. Indicators of feasibility included processes (recruitment, protocol adherence and participants' experiences) and scientific feasibility, which assessed the accelerometers' ability to detect change in physical activity among stroke survivors who ambulate independently and those who are dependent on a mobility device. Twenty-seven out of 31 eligible individuals took part in this study, with 23 (85%) completing it. In total, 432 days of rehabilitation were monitored and valid physical activity data were obtained for 408 days (94%). There were no indications that the measurement interfered with participants' ability to participate in rehabilitation. Despite the subjects' ambulation status, the number of steps and time spent in moderate-to-vigorous physical activity increased significantly across the first 18 days of rehabilitation, whereas sedentary time was unchanged. This study supports the feasibility of using accelerometers to capture physical activity behaviour in survivors of stroke during inpatient rehabilitation.

  20. Validation of the Neurological Fatigue Index for stroke (NFI-Stroke)

    OpenAIRE

    Mills, Roger J; Pallant, Julie F; Koufali, Maria; Sharma, Anil; Day, Suzanne; Tennant, Alan; Young, Carolyn A

    2012-01-01

    Abstract Background Fatigue is a common symptom in Stroke. Several self-report scales are available to measure this debilitating symptom but concern has been expressed about their construct validity. Objective To examine the reliability and validity of a recently developed scale for multiple sclerosis (MS) fatigue, the Neurological Fatigue Index (NFI-MS), in a sample of stroke patients. Method Six patients with stroke participated in qualitative interviews which were analysed and the themes c...