WorldWideScience

Sample records for stroke pump control

  1. The Combination of Micro Diaphragm Pumps and Flow Sensors for Single Stroke Based Liquid Flow Control

    Directory of Open Access Journals (Sweden)

    Christoph Jenke

    2017-04-01

    Full Text Available With the combination of micropumps and flow sensors, highly accurate and secure closed-loop controlled micro dosing systems for liquids are possible. Implementing a single stroke based control mode with piezoelectrically driven micro diaphragm pumps can provide a solution for dosing of volumes down to nanoliters or variable average flow rates in the range of nL/min to μL/min. However, sensor technologies feature a yet undetermined accuracy for measuring highly pulsatile micropump flow. Two miniaturizable in-line sensor types providing electrical readout—differential pressure based flow sensors and thermal calorimetric flow sensors—are evaluated for their suitability of combining them with mircopumps. Single stroke based calibration of the sensors was carried out with a new method, comparing displacement volumes and sensor flow volumes. Limitations of accuracy and performance for single stroke based flow control are described. Results showed that besides particle robustness of sensors, controlling resistive and capacitive damping are key aspects for setting up reproducible and reliable liquid dosing systems. Depending on the required average flow or defined volume, dosing systems with an accuracy of better than 5% for the differential pressure based sensor and better than 6.5% for the thermal calorimeter were achieved.

  2. The Combination of Micro Diaphragm Pumps and Flow Sensors for Single Stroke Based Liquid Flow Control.

    Science.gov (United States)

    Jenke, Christoph; Pallejà Rubio, Jaume; Kibler, Sebastian; Häfner, Johannes; Richter, Martin; Kutter, Christoph

    2017-04-03

    With the combination of micropumps and flow sensors, highly accurate and secure closed-loop controlled micro dosing systems for liquids are possible. Implementing a single stroke based control mode with piezoelectrically driven micro diaphragm pumps can provide a solution for dosing of volumes down to nanoliters or variable average flow rates in the range of nL/min to μL/min. However, sensor technologies feature a yet undetermined accuracy for measuring highly pulsatile micropump flow. Two miniaturizable in-line sensor types providing electrical readout-differential pressure based flow sensors and thermal calorimetric flow sensors-are evaluated for their suitability of combining them with mircopumps. Single stroke based calibration of the sensors was carried out with a new method, comparing displacement volumes and sensor flow volumes. Limitations of accuracy and performance for single stroke based flow control are described. Results showed that besides particle robustness of sensors, controlling resistive and capacitive damping are key aspects for setting up reproducible and reliable liquid dosing systems. Depending on the required average flow or defined volume, dosing systems with an accuracy of better than 5% for the differential pressure based sensor and better than 6.5% for the thermal calorimeter were achieved.

  3. Controlling groundwater pumping online.

    Science.gov (United States)

    Zekri, Slim

    2009-08-01

    Groundwater over-pumping is a major problem in several countries around the globe. Since controlling groundwater pumping through water flow meters is hardly feasible, the surrogate is to control electricity usage. This paper presents a framework to restrict groundwater pumping by implementing an annual individual electricity quota without interfering with the electricity pricing policy. The system could be monitored online through prepaid electricity meters. This provides low transaction costs of individual monitoring of users compared to the prohibitive costs of water flow metering and monitoring. The public groundwater managers' intervention is thus required to determine the water and electricity quota and watch the electricity use online. The proposed framework opens the door to the establishment of formal groundwater markets among users at very low transaction costs. A cost-benefit analysis over a 25-year period is used to evaluate the cost of non-action and compare it to the prepaid electricity quota framework in the Batinah coastal area of Oman. Results show that the damage cost to the community, if no active policy is implemented, amounts to (-$288) million. On the other hand, the implementation of a prepaid electricity quota with an online management system would result in a net present benefit of $199 million.

  4. Method for controlling powertrain pumps

    Science.gov (United States)

    Sime, Karl Andrew; Spohn, Brian L; Demirovic, Besim; Martini, Ryan D; Miller, Jean Marie

    2013-10-22

    A method of controlling a pump supplying a fluid to a transmission includes sensing a requested power and an excess power for a powertrain. The requested power substantially meets the needs of the powertrain, while the excess power is not part of the requested power. The method includes sensing a triggering condition in response to the ability to convert the excess power into heat in the transmission, and determining that an operating temperature of the transmission is below a maximum. The method also includes determining a calibrated baseline and a dissipation command for the pump. The calibrated baseline command is configured to supply the fluid based upon the requested power, and the dissipation command is configured to supply additional fluid and consume the excess power with the pump. The method operates the pump at a combined command, which is equal to the calibrated baseline command plus the dissipation command.

  5. Blood Pressure Control: Stroke and Stroke Prevention

    Directory of Open Access Journals (Sweden)

    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.

  6. D-Zero HVAC Heat Pump Controls

    International Nuclear Information System (INIS)

    Markley, Dan

    2004-01-01

    This engineering note documents the integration of Dzero Heat Pump 1 through Heat Pump 15 into the cryo/gas process control system commonly referred to as the cryo control system. Heat pumps 1 through 15 control the ambient air temperature on the 3rd, 5th, and 6th floor office areas at Dzero. The entire Johnson HVAC control system was replaced with a Siemens control system in 1999 leaving behind the 15 heat pumps with stand-alone Johnson controllers. Now, these 15 heat pump Johnson controllers are being replaced with small stand alone Beckhoff BC9000 controllers. The Beckhoff BC9000 controllers are network able into the existing Intellution control system. The Beckhoff BC9000 controllers use the cryo private Ethernet network and an OPC driver to get data into the Intellution SCADA node databases. The BC9000 is also programmed over this same Ethernet network.

  7. Mechanisms of early and delayed stroke after systematic off-pump coronary artery bypass.

    Science.gov (United States)

    Chen, Jeng-Wei; Lin, Cheng-Hsin; Hsu, Ron-Bin

    2015-10-01

    Stroke is one of the most devastating complications after cardiac surgery. Off-pump coronary artery bypass (OPCAB) has been reported to offer a lower risk of stroke. However, limited information was available on timing and mechanisms of stroke after OPCAB. We sought to assess the incidence, timing, and mechanisms of stroke after OPCAB. A retrospective review of 1010 patients undergoing systematic OPCAB between 2001 and 2012. Stroke was defined as any focal or global neurologic deficits lasting for more than 24 hours. Stroke was classified as early stroke when it occurred less than 24 hours postoperatively, and delayed stroke when it occurred more than 24 hours postoperatively. Stroke mechanisms were classified as embolic or hypoperfusion. In a total of 10 patients (1.0%) 11 episodes of stroke developed after OPCAB. Early stroke occurred in five (0.5%) patients and delayed stroke occurred in six (0.6%) patients. Of five early strokes, the mechanisms were embolic in two (40%) and hypoperfusion in three (60%). Of six delayed strokes, the mechanisms were embolic in five (83%) and unknown in one. Of six delayed strokes, all the patients had diabetes mellitus and acute cardiac events prior to surgery, and five patients had postoperative atrial fibrillation. The incidence of stroke after systematic OPCAB was low. Early and delayed strokes were equally distributed. Stroke mechanisms were predominantly embolic. Early and delayed stroke differed in their mechanisms. Early and delayed stroke should be considered as two separate entities and different preventive strategies should be applied in future intervention. Copyright © 2014. Published by Elsevier B.V.

  8. Reactor feedwater pump control device

    International Nuclear Information System (INIS)

    Nishiyama, Hiroyuki.

    1990-01-01

    An amount of feedwater necessary for ensuring reactor inventory after scram is ensured automatically based on the reactor output before scram of a BWR type reactor. That is, if scram should occur, a feedwater flow rate just before the scram is stored by reactor output signals. Further, the amount of feedwater required after the scram is determined based on the output of the memory. The reactor power after the scram based on a feedwater flow rate and a main steam flow rate is inputted to an integrator, to calculate and output the amount of the feedwater flow rate (1) injected after the scram for the inventory. A coast down flowrate (2) in a case of pump trip is forecast by the output signals. Automatic trip is outputted to all turbine driving feedwater pumps when the sum of (1) and (2) exceeds a necessary and sufficient amount of feedwater required for ensuring inventory. For motor driving feedwater pumps, only a portion, for example, one of the pumps is automatically started while other pumps are stopped their operation, only in this case, to prevent excess water feeding. (I.S.)

  9. Fuzzy multivariable control of domestic heat pumps

    International Nuclear Information System (INIS)

    Underwood, C.P.

    2015-01-01

    Poor control has been identified as one of the reasons why recent field trials of domestic heat pumps in the UK have produced disappointing results. Most of the technology in use today uses a thermostatically-controlled fixed speed compressor with a mechanical expansion device. This article investigates improved control of these heat pumps through the design and evaluation of a new multivariable fuzzy logic control system utilising a variable speed compressor drive with capacity control linked through to evaporator superheat control. A new dynamic thermal model of a domestic heat pump validated using experimental data forms the basis of the work. The proposed control system is evaluated using median and extreme daily heating demand profiles for a typical UK house compared with a basic thermostatically-controlled alternative. Results show good tracking of the heating temperature and superheat control variables, reduced cycling and an improvement in performance averaging 20%. - Highlights: • A new dynamic model of a domestic heat pump is developed and validated. • A new multivariable fuzzy logic heat pump control system is developed/reported. • The fuzzy controller regulates both plant capacity and evaporator superheat degree. • Thermal buffer storage is also considered as well as compressor cycling. • The new controller shows good variable tracking and a reduction in energy of 20%.

  10. 21 CFR 870.4380 - Cardiopulmonary bypass pump speed control.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Cardiopulmonary bypass pump speed control. 870... Cardiopulmonary bypass pump speed control. (a) Identification. A cardiopulmonary bypass pump speed control is a... control the speed of blood pumps used in cardiopulmonary bypass surgery. (b) Classification. Class II...

  11. Off-Pump Coronary Artery Bypass Grafting and Stroke-Exploratory Analysis of the GOPCABE Trial and Methodological Considerations.

    Science.gov (United States)

    Reents, Wilko; Zacher, Michael; Boergermann, Jochen; Kappert, Utz; Hilker, Michael; Färber, Gloria; Albert, Marc; Holzhey, David; Conradi, Lenard; Riess, Friedrich Christian; Veeckman, Philippe; Strauch, Justus T; Diegeler, Anno; Böning, Andreas

    2018-03-22

     Coronary artery bypass grafting (CABG) without cardiopulmonary bypass (off-pump CABG) may reduce severe adverse events including stroke.  In the German Off-Pump Coronary Artery Bypass Grafting in Elderly patients trial, the rate of major adverse cardiovascular events was compared in 2,394 elderly (≥ 75 years) patients undergoing CABG with (on-pump) or without (off-pump) cardiopulmonary bypass. This exploratory post-hoc analysis investigated the impact of surgical aortic manipulation on the rate of stroke.  There was no significant difference in the rate of stroke within 30 days after surgery between both groups (off-pump: 2.2%; on-pump: 2.7%; odds ratio [OR]: 0.83 [0.5-1.38]; p  = 0.47). Within the off-pump group, different degrees of aortic manipulation did not lead to significant different stroke rates (tangential clamping: 2.3%; OR 0.86 [0.46-1.60]; clampless device: 1.8%; OR 0.67 [0.26-1.75]; no aortic manipulation: 2.4%; OR 0.88 [0.37-2.14]). An aggregate analysis including more than 10,000 patients out of the four recent major trials also yielded comparable stroke rates for on- and off-pump CABG (off-pump: 1.4%; on-pump: 1.7%; OR 0.87 [0.64-1.20]).  Within recent prospective randomized multicenter trials off-pump CABG did not result in lower stroke rates. The possible intrinsic benefit of off-pump CABG may be offset by the complexity of the operative therapy as well as the multiple pathomechanisms involved in perioperative stroke. Georg Thieme Verlag KG Stuttgart · New York.

  12. Aggregated Control of Domestic Heat Pumps

    DEFF Research Database (Denmark)

    Nielsen, Kirsten M.; Andersen, Palle; Pedersen, Tom S.

    2013-01-01

    A challenge in Denmark in the near future is to balance the electrical grid due to a large increase in the renewable energy production mainly from wind turbines. In this work an aggregated control system using heat pumps in single family houses to help balancing the grid is investigated. The cont......A challenge in Denmark in the near future is to balance the electrical grid due to a large increase in the renewable energy production mainly from wind turbines. In this work an aggregated control system using heat pumps in single family houses to help balancing the grid is investigated....... The control system is able to adjust the consumptions of the heat pump without affecting the comfort in the houses and uses this ability to shift the total consumption to hours with high wind energy production....

  13. Using Variable Speed Control on Pump Application

    Directory of Open Access Journals (Sweden)

    Dr.Sc. Aida Spahiu

    2012-06-01

    Full Text Available Pumps are one of the most common variable speed drive (VSD system applications and special interest has focused on improving their energy efficiency by using variable speed control instead of throttling or other less efficient flow control methods. Pumps are the single largest user of electricity in industry in the European Union, consuming 160 TWh per annum of electricity and accounting for 79 million tonnes of carbon dioxide (CO2 emissions [1]. Centrifugal pumps are the most likely pump style to provide a favorable return based on energy savings when applied with a variable speed drive. To help illustrate this, are conducted benchmark testing to document various head and flow scenarios and their corresponding effect on energy savings. Paper shows the relationship of static and friction head in the energy efficiency equation and the effect of motor, pump and VSD efficiencies. The received results are good reference points for engineers and managers of water sector in Albania to select the best prospects for maximizing efficiency and energy savings.

  14. Sucker-rod pumping handbook production engineering fundamentals and long-stroke rod pumping

    CERN Document Server

    Takacs, Gabor

    2015-01-01

    Sucker-Rod Pumping Handbook presents the latest information on the most common form of production enhancement in today's oil industry, making up roughly two-thirds of the producing oilwell operations in the world. The book begins with an introduction to the main features of sucker rod pumping and an explanation and comparison of lift methods. It goes on to provide the technical and practical knowledge needed to introduce the new and practicing production engineer and operator to the equipment, technology, and applications required to maintain optimum operating conditions.

  15. Vacuum pumping for controlled thermonuclear reactors

    International Nuclear Information System (INIS)

    Watson, J.S.; Fisher, P.W.

    1976-01-01

    Thermonuclear reactors impose unique vacuum pumping problems involving very high pumping speeds, handling of hazardous materials (tritium), extreme cleanliness requirements, and quantitative recovery of pumped materials. Two principal pumping systems are required for a fusion reactor, a main vacuum system for evacuating the torus and a vacuum system for removing unaccelerated deuterium from neutral beam injectors. The first system must pump hydrogen isotopes and helium while the neutral beam system can operate by pumping only hydrogen isotopes (perhaps only deuterium). The most promising pumping techniques for both systems appear to be cryopumps, but different cryopumping techniques can be considered for each system. The main vacuum system will have to include cryosorption pumps cooled to 4.2 0 K to pump helium, but the unburned deuterium-tritium and other impurities could be pumped with cryocondensation panels (4.2 0 K) or cryosorption panels at higher temperatures. Since pumping speeds will be limited by conductance through the ducts and thermal shields, the pumping performance for both systems will be similar, and other factors such as refrigeration costs are likely to determine the choice. The vacuum pumping system for neutral beam injectors probably will not need to pump helium, and either condensation or higher temperature sorption pumps can be used

  16. Overdose of opioid from patient-controlled analgesia pumps.

    Science.gov (United States)

    Notcutt, W G; Knowles, P; Kaldas, R

    1992-07-01

    Two incidence have occurred in our hospital when a patient-controlled analgesia pump has accidentally delivered the whole contents of the syringe of diamorphine (60 mg) over a period of approximately 1 h. Electrical corruption of the pumps' program has been identified as the probable cause. All pumps of this type have been modified to prevent such occurrences.

  17. Energy Efficient Pump Control for an Offshore Oil Processing System

    DEFF Research Database (Denmark)

    Yang, Zhenyu; Soleiman, Kian; Løhndorf, Bo

    2012-01-01

    The energy efficient control of a pump system for an offshore oil processing system is investigated. The seawater is lifted up by a pump system which consists of three identical centrifugal pumps in parallel, and the lifted seawater is used to cool down the crude oil flowing out of a threephase s...

  18. PLC-Based Pressure Control in Multi-Pump Applications

    Directory of Open Access Journals (Sweden)

    Vodovozov Valery

    2015-12-01

    Full Text Available The paper is devoted to the centrifugal pumps represented the most popular type of pumping equipment used in different areas. The pressure control approach for variable speed driven (VSD parallel connected centrifugal pumps is reported. The goal of the study is optimization of some quality indices, such as efficiency, consumed power, productivity, energy carrier temperature, heat irradiation, etc. One of them – efficiency – has been studied in the paper more carefully. The mathematical model of pumping process is discussed and a vector-matrix description of the multi-pump application is given. The program-based pressure control system is developed which productivity is changed by regulating the number of working pumps. The paper introduces new pressure control algorithms based on the working point estimation intended for programmable logical controllers (PLC. Experiments prove correctness of the offered methodology.

  19. Acceptance for Beneficial Use Pumping Instrumentation and Control Skid N

    International Nuclear Information System (INIS)

    KOCH, M.R.

    2000-01-01

    This is a final Acceptance for Beneficial Use (ABU) for Pumping and Instrumentation Control (PIC) skid ''N''. PIC skid ''N'' is ready for pumping tank U-109. All the testing and documentation has been completed as required on the AE3U checklist. This AE3U covers only the readiness of the PIC skid ''N''. Other U-farm preparations including dilution tank fabrication, portable exhauster readiness, leak detection, valve pit preparation, and the Operation Control Station readiness are not part of this ABU. PIC skid ''N'' is a new skid fabricated and tested at Site Fabrication Services. The skid controls the jet pump and monitors various instruments associated with the pumping operation. This monitoring includes leak detection along the waste transfer route and flammable gases in the pump pit. This Acceptance for Beneficial Use documents that Pumping Instrumentation and Control (PIC) skid ''N'' is ready for field use. This document does not cover the field installation or operational testing

  20. 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

  1. Study of high-pressure cryogenic pumps with different methods of delivery control

    International Nuclear Information System (INIS)

    Braun, V.M.; Brailovskii, Y.L.; Pavlenko, Y.A.; Tsokalo, I.V.

    1986-01-01

    This paper describes new reciprocating pumps with smooth control of delivery in a running pump. Control is effected either by changing the length of the piston stroke or by changing the speed of the driving motor. The individual features of the two methods are described. In the first method (mechanical), delivery is controlled in the range 50 to 100%. A separate actuating mechanism is needed to connect the pump to an automatic control system. This method complicates the driving mechanism and increases the bulk and cost of production. In the second method of controlling the speed of the electric motor, an electric drive fitted with a frequency thyristor is used. AC induction motors series 4A working at current frequencies of 60 HZ are used. By this method, delivery control could be enhanced by 1.3 times. Comparative tests were made on pumps using the above methods of control. The tests demonstrated the possibilities of using the frequency thyristor converters. The complexity and high cost of EKT type drives is largely compensated by the convenience and simplicity of control in a wide range. The mechanical control is advantageous only in low-output units

  2. microcontroller based automatic control for water pumping machine

    African Journals Online (AJOL)

    user

    In this paper a Microcontroller Based Automatic Control for Water Pumping. Machine and Level Indicator (MBACWPMLI) has been designed, constructed and tested. The MBACWPML I uses the reflection of sound (echo) to give the indication of water level in a storage tank and also the automatic control of the water pumping ...

  3. 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.

  4. Liquid metal flow control by DC electromagnetic pumps

    International Nuclear Information System (INIS)

    Borges, Eduardo Madeira; Braz Filho, Francisco Antonio; Guimaraes, Lamartine Nogueira Frutuoso

    2006-01-01

    The cooling system of high-density thermal power requires fluids of high thermal conductivity, such as liquid metals. Electromagnetic pumps can be used to liquid metal fluid flow control in cooling circuits. The operation of electromagnetic pumps used to flow control is based on Lorentz force. This force can be achieved by magnetic field and electric current interaction, controlled by external independent power supplies. This work presents the electromagnetic pump operational principles, the IEAv development scheme and the BEMC-1 simulation code. The theoretical results of BEMC-1 simulation are compared to electromagnetic pump operation experimental data, validating the BEMC-1 code. This code is used to evaluate the DC electromagnetic pump performance applied to Mercury flow control and others liquid metal such as Sodium, Lead and Bismuth, used in nuclear fast reactors. (author)

  5. PLC & DTAM Software Programs for Pumping Instrumentation & Control Skid P

    Energy Technology Data Exchange (ETDEWEB)

    HORNER, T.M.

    2001-07-19

    This document describes the software programs for the programmable logic controller and the datable access module for pumping instrumentation and control skid P. The appendices contains copies of the printouts of these software programs.

  6. Adaptive sliding mode back-stepping pitch angle control of a variable-displacement pump controlled pitch system for wind turbines.

    Science.gov (United States)

    Yin, Xiu-xing; Lin, Yong-gang; Li, Wei; Liu, Hong-wei; Gu, Ya-jing

    2015-09-01

    A variable-displacement pump controlled pitch system is proposed to mitigate generator power and flap-wise load fluctuations for wind turbines. The pitch system mainly consists of a variable-displacement hydraulic pump, a fixed-displacement hydraulic motor and a gear set. The hydraulic motor can be accurately regulated by controlling the pump displacement and fluid flows to change the pitch angle through the gear set. The detailed mathematical representation and dynamic characteristics of the proposed pitch system are thoroughly analyzed. An adaptive sliding mode pump displacement controller and a back-stepping stroke piston controller are designed for the proposed pitch system such that the resulting pitch angle tracks its desired value regardless of external disturbances and uncertainties. The effectiveness and control efficiency of the proposed pitch system and controllers have been verified by using realistic dataset of a 750 kW research wind turbine. Copyright © 2015 ISA. Published by Elsevier Ltd. All rights reserved.

  7. Acceptance for Beneficial Use Pumping Instrumentation and Control Skid ''M''

    International Nuclear Information System (INIS)

    KOCH, M.R.

    2000-01-01

    This document is a Final Acceptance for Beneficial Use (ABU) for the readiness of Pumping Instrumentation and Control (PIC) skid ''M''. All the testing and documentation for PIC skid ''M'' is completed and the skid is ready for use in the field for pumping of tank U-102

  8. Dewatering pump control in underground coal mines

    International Nuclear Information System (INIS)

    Anthony, Kim M.

    2012-01-01

    An underground coal mine roadway dewatering network is a highly variable, constantly changing system. Pumps used in this environment need to achieve a wide range of duties that may change regularly. This article discusses the use of and preferred methods in the context of an Australian underground coal mine with conditions particular to this industry.

  9. Absorption Cycle Heat Pump Model for Control Design

    DEFF Research Database (Denmark)

    Vinther, Kasper; Just Nielsen, Rene; Nielsen, Kirsten Mølgaard

    2015-01-01

    Heat pumps have recently received increasing interest due to green energy initiatives and increasing energy prices. In this paper, a nonlinear dynamic model of a single-effect LiBr-water absorption cycle heat pump is derived for simulation and control design purposes. The model is based...... to operational data and different scenarios are simulated to investigate the operational stability of the heat pump. Finally, this paper provides suggestions and examples of derivation of lower order linear models for control design. © Copyright IEEE - All rights reserved....

  10. Test report - 241-AN-274 Caustic Pump Control Building

    International Nuclear Information System (INIS)

    Paintner, G.P.

    1995-05-01

    This Acceptance Test Report documents the test results of test procedure WHC-SD-WM-ATP-135 'Acceptance Test Procedure for the 241-AN- 274 Caustic Pump Control Building.' The objective of the test was to verify that the 241-AN-274 Caustic Pump Control Building functions properly based on design specifications per applicable H-2-85573 drawings and associated ECN's. The objective of the test was met

  11. Sliding mode controller for a photovoltaic pumping system

    Science.gov (United States)

    ElOugli, A.; Miqoi, S.; Boutouba, M.; Tidhaf, B.

    2017-03-01

    In this paper, a sliding mode control scheme (SMC) for maximum power point tracking controller for a photovoltaic pumping system, is proposed. The main goal is to maximize the flow rate for a water pump, by forcing the photovoltaic system to operate in its MPP, to obtain the maximum power that a PV system can deliver.And this, through the intermediary of a sliding mode controller to track and control the MPP by overcoming the power oscillation around the operating point, which appears in most implemented MPPT techniques. The sliding mode control approach is recognized as one of the efficient and powerful tools for nonlinear systems under uncertainty conditions.The proposed controller with photovoltaic pumping system is designed and simulated using MATLAB/SIMULINK environment. In addition, to evaluate its performances, a classical MPPT algorithm using perturb and observe (P&O) has been used for the same system to compare to our controller. Simulation results are shown.

  12. Influencing factors for early acute cerebrovascular accidents in patients with stroke history following off-pump coronary artery bypass grafting.

    Science.gov (United States)

    Wang, Bin; Jia, Ming; Jia, Shijie; Wan, Jiuhe; Zhou, Xiao; Luo, Zhimin; Zhou, Ye; Zhang, Jianqun

    2014-06-01

    To analyse risk factors for early acute cerebrovascular accidents following off-pump coronary artery bypass grafting (OPCAB) in patients with stroke history, and to propose preventive measures to reduce the incidence of these events. A total of 468 patients with a history of stroke underwent OPCAB surgery in Beijing Anzhen Hospital of China from January 2010 to September 2012. They were retrospectively divided into two groups according to the occurrence of early acute cerebrovascular accidents within 48 hours following OPCAB. Multivariate logistic regression analysis was used to find risk or protective factors for early acute cerebrovascular accidents following the OPCAB. Fifty-two patients (11.1%) suffered from early acute cerebrovascular accidents in 468 patients, including 39 cases of cerebral infarction, two cases of cerebral haemorrhage, 11 cases of transient ischaemic attack (TIA). There were significant differences between the two groups in preoperative left ventricular ejection fraction ≤ 35%, severe bilateral carotid artery stenosis, poorly controlled hypertension, intraoperative application of Enclose® II proximal anastomotic device, postoperative acute myocardial infarction, atrial fibrillation, hypotension, ventilation time > 48h, ICU duration >48h and mortality. Multivariate logistic regression analysis showed that preoperative severe bilateral carotid stenosis (OR=6.378, 95%CI: 2.278-20.987) and preoperative left ventricular ejection fraction ≤ 35% (OR=2.737, 95%CI: 1.267-6.389), postoperative acute myocardial infarction (OR=3.644, 95%CI: 1.928-6.876), postoperative atrial fibrillation (OR=3.104, 95%CI:1.135∼8.016) and postoperative hypotension (OR=4.173, 95%CI: 1.836∼9.701) were independent risk factors for early acute cerebrovascular accidents in patients with a history of stroke following OPCAB procedures, while intraoperative application of Enclose® II proximal anastomotic device was protective factor (OR=0.556, 95%CI: 0.337-0.925). This

  13. Optimizing pain control through the use of implantable pumps

    Directory of Open Access Journals (Sweden)

    Boris Todoroff

    2008-10-01

    Full Text Available Wilfried Ilias1, Boris Todoroff21Dept Anesthesiology, Intensive Care Medicine and Pain Therapy, Academic Teaching Hospital St. John of God, Vienna, Austria; 2Dept. Plastic and Reconstructive Surgery, Hospital of St. Vincent, Vienna, AustriaAbstract: Intrathecal therapy represents an effective and well established treatment of nonmalignant as well as malignant pain. Devices available include mechanical constant flow pumps as well as electronic variable flow pumps with patient-controlled bolus release. The latter provide faster dose finding, individual pain control, and good acceptance by patients. New technologies such as membrane pumps and rechargeable devices are expected to be developed to clinical perfection. The available drugs for intrathecal therapy are listed according to the polyanalgesic consensus on intrathecal therapy. The integration of remote patient-controlled analgesia into electronic implantable devices, and the peptide analgesic ziconotide, have significantly improved intrathecal therapy. Complications include infections, catheter ruptures or disconnections, catheter granulomas, and technical dysfunctions. Further possibilities for optimizing intrathecal therapy include development of new drugs, drug side effects, catheter and pump technologies, and surgical techniques.Keywords: intrathecal therapy, implantable pumps, morphine pumps, intrathecal drugs, intrathecal catheters, intrathecal pain control

  14. Mold Heating and Cooling Pump Package Operator Interface Controls Upgrade

    Energy Technology Data Exchange (ETDEWEB)

    Josh A. Salmond

    2009-08-07

    The modernization of the Mold Heating and Cooling Pump Package Operator Interface (MHC PP OI) consisted of upgrading the antiquated single board computer with a proprietary operating system to off-the-shelf hardware and off-the-shelf software with customizable software options. The pump package is the machine interface between a central heating and cooling system that pumps heat transfer fluid through an injection or compression mold base on a local plastic molding machine. The operator interface provides the intelligent means of controlling this pumping process. Strict temperature control of a mold allows the production of high quality parts with tight tolerances and low residual stresses. The products fabricated are used on multiple programs.

  15. Self-pumping inpurity control systems for INTOR

    International Nuclear Information System (INIS)

    Brooks, J.N.; Mattas, R.F.; Smith, D.L.; Hassanein, A.M.

    1987-01-01

    Two self-pumping systems have been examined for use as the INTOR impurity control system. The systems work by trapping helium in freshly deposited metal surface layers on or near the divertor plate. A slot divertor concept using vanadium or other trapping material appears to be both feasible and mechanically simple, and offers significant advantages in cost, reduced complexity, and helium pumping efficiency for the INTOR design

  16. PUMPS

    Science.gov (United States)

    Thornton, J.D.

    1959-03-24

    A pump is described for conveving liquids, particure it is not advisable he apparatus. The to be submerged in the liquid to be pumped, a conduit extending from the high-velocity nozzle of the injector,and means for applying a pulsating prcesure to the surface of the liquid in the conduit, whereby the surface oscillates between positions in the conduit. During the positive half- cycle of an applied pulse liquid is forced through the high velocity nozzle or jet of the injector and operates in the manner of the well known water injector and pumps liquid from the main intake to the outlet of the injector. During the negative half-cycle of the pulse liquid flows in reverse through the jet but no reverse pumping action takes place.

  17. Analysis of Decentralized Control for Absorption Cycle Heat Pumps

    DEFF Research Database (Denmark)

    Vinther, Kasper; Just Nielsen, Rene; Nielsen, Kirsten Mølgaard

    2015-01-01

    Email Print Request Permissions This paper investigates decentralized control structures for absorption cycle heat pumps and a dynamic nonlinear model of a single-effect LiBr-water absorption system is used as case study. The model has four controllable inputs, which can be used to stabilize...

  18. Design and control of a standalone PV water pumping system

    Directory of Open Access Journals (Sweden)

    Essam E. Aboul Zahab

    2017-09-01

    Full Text Available Water resources are vital for satisfying human needs. However, almost one-fifth of the world’s population – about 1.2 billion people – live in areas where water is physically rare. One quarter of the global population also live in developing countries that face water shortages. This paper presents standalone PV water pumping system. Photovoltaic (PV is the main power source, and lead acid batteries are used as energy storage system, to supply a water pump driven by a BLDC motor. The proposed control strategy consists of three control units. The first unit is to control the speed and hysteresis current controller for BLDC motor. The maximum power point tracking (MPPT is the second control unit, and the battery charging/discharging system is controlled by the third controller. The simulation results show the effectiveness and the good efficiency of the proposed system.

  19. Variable fuzzy control for heat pump operation

    International Nuclear Information System (INIS)

    Cho, Eun Jun; Hwang, Yoon Jei; Ha, Man Yeong; Chang, Se Dong

    2011-01-01

    The aim of this study is to determine the electronic expansion valve (EEV) opening using a fuzzy table when the superheating of a variable capacity air conditioning system is controlled via fuzzy control. Optimum opening of EEV is determined by applying superheat control method, where factors including superheat error and superheat gradient, as well as compressor capacity, indoor temperature, outdoor temperature, and indoor fan rpm, are considered. This control algorithm uses a fuzzy table wherein values are changed to optimal values according to operating conditions, enabling fast and stable control

  20. Impact of insulin pumps on glycaemic control in a pump-naïve paediatric regional population.

    Science.gov (United States)

    de Bock, Martin; Gunn, Alistair Jan; Holt, Jean-Ann; Derraik, José G B; Reed, Peter; Cutfield, Wayne; Mouat, Fran; Hofman, Paul; Jefferies, Craig

    2012-03-01

    To examine the clinical impact of insulin-pump therapy for children with type 1 diabetes mellitus (T1DM) in a regional paediatric service, Auckland, New Zealand. Retrospective analysis of children with T1DM from the Starship paediatric diabetes database who started on insulin-pump therapy from 2002 to 2008 compared with the whole T1DM population and with an equal number of non-pump patients matched by age, sex, ethnicity and duration of diabetes. From 621 subjects with 6680 clinic visits, 75 children were treated with insulin-pump therapy for more than 12 months. Transitioning to insulin-pump treatment was associated with an improvement in HbA1c compared with baseline (-0.3%/year, P pump controls showed a continuing trend to higher HbA1C values (+0.2%/year, P pump start (from 27 (0-223) to 5 (0-0.91) events/100 patient years) with no change in non-pump controls; the rate of diabetic ketoacidosis remained low in both groups. In a pump-naïve regional paediatric population, insulin-pump therapy for T1DM was safe and effective, and associated with sustained improvements in HbA1c and lower risk of hypoglycaemia. © 2011 The Authors. Journal of Paediatrics and Child Health © 2011 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

  1. Metabolic Control with Insulin Pump Therapy: Preliminary Experience

    Directory of Open Access Journals (Sweden)

    Shang-Ren Hsu

    2008-07-01

    Conclusion: Our preliminary experience demonstrated the effectiveness of insulin pump therapy for both type 1 and type 2 diabetic patients. The reduction in their HbA1C values was both statistically and clinically significant. This treatment should be considered for patients poorly controlled by subcutaneous insulin injection therapy.

  2. System control fuzzy neural sewage pumping stations using genetic algorithms

    Directory of Open Access Journals (Sweden)

    Владлен Николаевич Кузнецов

    2015-06-01

    Full Text Available It is considered the system of management of sewage pumping station with regulators based on a neuron network with fuzzy logic. Linguistic rules for the controller based on fuzzy logic, maintaining the level of effluent in the receiving tank within the prescribed limits are developed. The use of genetic algorithms for neuron network training is shown.

  3. Decant pump assembly and controls qualification testing - test report

    Energy Technology Data Exchange (ETDEWEB)

    Staehr, T.W., Westinghouse Hanford

    1996-05-02

    This report summarizes the results of the qualification testing of the supernate decant pump and controls system to be used for in-tank sludge washing in aging waste tank AZ-101. The test was successful and all components are qualified for installation and use in the tank.

  4. Achieving effective glycaemic control using an insulin micro-pump.

    Science.gov (United States)

    Kelly, Peter

    2017-02-02

    For those with type 1 diabetes mellitus (T1DM), a deranged blood glucose level can cause hypo/hyperglycaemic episodes and in the long term contribute to microvascular disease. Such outcomes can effect concordance with insulin management regimens and affect the patient's quality of life. A variety of insulin delivery methods are available, including continuous subcutaneous insulin infusion (CSII) via either a tethered or patch pump. Pumps have the potential to improve delivery, monitoring and adjustment of insulin regimens, thus freeing patient's time and affording more control of their disease. This article reports how a new patch pump, has helped a cohort of patients to improve blood glucose variability levels and thus quality of life.

  5. Pump

    International Nuclear Information System (INIS)

    Mole, C.J.

    1983-01-01

    An electromagnetic pump for circulating liquid -metal coolant through a nuclear reactor wherein opposite walls of a pump duct serve as electrodes to transmit current radially through the liquid-metal in the ducts. A circumferential electric field is supplied to the liquid-metal by a toroidal electromagnet which has core sections interposed between the ducts. The windings of the electromagnet are composed of metal which is superconductive at low temperatures and the electromagnet is maintained at a temperature at which it is superconductive by liquid helium which is fed through the conductors which supply the excitation for the electromagnet. The walls of the ducts joining the electrodes include metal plates insulated from the electrodes backed up by insulators so that they are capable of withstanding the pressure of the liquid-metal. These composite wall structures may also be of thin metal strips of low electrical conductivity backed up by sturdy insulators. (author)

  6. Histamine H2-Blocker and Proton Pump Inhibitor Use and the Risk of Pneumonia in Acute Stroke: A Retrospective Analysis on Susceptible Patients.

    Science.gov (United States)

    Arai, Nobuhiko; Nakamizo, Tomoki; Ihara, Hikaru; Koide, Takashi; Nakamura, Akiyoshi; Tabuse, Masanao; Miyazaki, Hiromichi

    2017-01-01

    Although histamine H2-blockers (H2B) and proton pump inhibitors (PPI) are used commonly to prevent gastrointestinal bleeding in acute stroke, they are implicated in the increased risk of pneumonia in other disease populations. In acute stroke, the presence of distinctive risk factors of pneumonia, including dysphagia and impaired consciousness, makes inclusive analysis vulnerable to confounding. Our aim was to assess whether acid-suppressive drugs increase pneumonia in acute stroke in a population controlled for confounding. We analyzed acute stroke patients admitted to a tertiary care hospital. To minimize confounding, we only included subjects who could not feed orally during 14 days of hospitalization. Exposure was defined as H2B or PPI, given in days; the outcome was development of pneumonia within this period. The incidence was calculated from the total number of pneumonias divided by the sum of person-days at risk. We additionally performed multivariate Poisson regression and propensity score analyses, although the restriction largely eliminated the need for multivariate adjustment. A total of 132 pneumonias occurred in 3582 person-days. The incidence was 3.69%/person-day (95% confidence interval (CI); 3.03-4.37%/day). All subjects had dysphagia. Stroke severity and consciousness disturbances were well-balanced between the groups exposed to H2B, PPI, or none. The relative risk (RR) compared with the unexposed was 1.22 in H2B (95%CI; 0.83-1.81) and 2.07 in PPI (95% CI; 1.13-3.62). The RR of PPI compared with H2B was 1.69 (95%CI; 0.95-2.89). In multivariate regression analysis, the RRs of H2B and PPI were 1.24 (95% CI; 0.85-1.81) and 2.00 (95% CI; 1.12-3.57), respectively; in propensity score analyses they were 1.17 (95% CI; 0.89-1.54) and 2.13 (95% CI; 1.60-2.84). The results of this study suggested that prophylactic acid-suppressive therapy with PPI may have to be avoided in acute stroke patients susceptible to pneumonia.

  7. Application of the DTC control in the photovoltaic pumping system

    International Nuclear Information System (INIS)

    Moulay-Idriss, Chergui; Mohamed, Bourahla

    2013-01-01

    Highlights: ► To improve the efficiency of PV systems, under different temperature and irradiance conditions. ► The MPPT and different control method for the induction motor were applied. ► The DTC in PV pumping system introduced and performance studied. ► The introductions of DTC in PV systems are very promising. ► Optimizing the water pumping system speed response characteristic by DTC. - Abstract: We aim to find a better control and optimization among the different functions of a solar pumping system. The photovoltaic panel can provide a maximum power only for defined output voltage and current. In addition, the operation to get the maximum power depends on the terminals of load, mostly a non-linear load like induction motor. In this work, we propose an intelligent control method for the maximum power point tracking of a photovoltaic system under variable temperature and irradiance conditions. The system was tested without maximum power point tracking, with the use of Scalar-Based control motor, but we cannot maintain the speed optimal. Next, we developed several methods for the control. Finally, we have chosen the Direct Torque Control.

  8. An automatic control of the pumping system for the vacuum chamber of the cyclotron

    International Nuclear Information System (INIS)

    Ikegami, Kumio; Kageyama, Tadashi; Kohno, Isao

    1979-01-01

    The main pumping system of the 160 cm cyclotron is composed of 32'', 14'', and 6'' oil difusion pumps connected in series and rough pumping system which consists of 1500 l/min rotary pump and 300 m 3 /h roots pump with 650 l/min rotary backing pump. Instead of manual operation an automatic control devise of the pumping system was developed and many valves were replaced with pneumatic ones. In the new control system, pumps and valves are operated automatically, according to the indication of pirani detectors, to evacuate the chamber of the cyclotron up to the pressure of 0.7 - 1.0 x 10 -6 Torr, and also to protect the pumping system against vacuum failure by accidental leakage in the chamber. The graphic handling board of the pumping system is installed on the control panel and each switch is provided with a name card showing its function briefly. (author)

  9. Centrifuge pump control: valves or electronic driving?; Controle de bombas centrifugas: valvulas ou acionamento eletronico?

    Energy Technology Data Exchange (ETDEWEB)

    Bortoni, Edson da Costa [UNESP, Guaratingueta (Brazil); Tiago Filho, Geraldo Lucio; Silva, Benedito Claudio da [Escola Federal de Engenharia de Itajuba (EFEI), MG (Brazil)

    1998-10-01

    A methodology to estimate the energy economy potential is presented, resultant of the utilization, in the flow control in pumping systems of variable-speed electronic driving in place of throttling valves. The procedure comprehends the determination and analysis of the pump and installation curves, providing reliable data for a economical feasibility analysis.

  10. Acupuncture intervention in ischemic stroke: a randomized controlled prospective study.

    Science.gov (United States)

    Shen, Peng-Fei; Kong, Li; Ni, Li-Wei; Guo, Hai-Long; Yang, Sha; Zhang, Li-Li; Zhang, Zhi-Long; Guo, Jia-Kui; Xiong, Jie; Zhen, Zhong; Shi, Xue-Min

    2012-01-01

    Stroke is one of the most common causes of death and few pharmacological therapies show benefits in ischemic stroke. In this study, 290 patients aged 40-75 years old with first onset of acute ischemic stroke (more than 24 hours but within 14 days) were treated with standard treatments, and then were randomly allocated into an intervention group (treated with resuscitating acupuncture) and a control group (treated using sham-acupoints). Primary outcome measures included Barthel Index (BI), relapse and death up to six months. For the 290 patients in both groups, one case in the intervention group died, and two cases in the control group died from the disease (p = 0.558). Six patients of the 144 cases in the intervention group had relapse, whereas 34 of 143 patients had relapse in the control group (p two groups, respectively (p two groups for the National Institute of Health Stroke Scale (NIHSS), not at two weeks (7.03 ± 3.201 vs. 8.13 ± 3.634; p = 0.067), but at four weeks (4.15 ± 2.032 vs. 6.35 ± 3.131, p Stroke Scale (CSS) at four weeks showed more improvement in the intervention group than that in the control group (9.40 ± 4.51 vs. 13.09 ± 5.80, p Stroke Specific Quality of Life Scale (SS-QOL) at six months was higher in the intervention group (166.63 ± 45.70) than the control group (143.60 ± 50.24; p < 0.01). The results of this clinical trial showed a clinically relevant decrease of relapse in patients treated with resuscitating acupuncture intervention by the end of six months, compared with needling at the sham-acupoints. The resuscitating acupuncture intervention could also improve self-care ability and quality of life, evaluated with BI, NIHSS, CSS, Oxford Handicap Scale (OHS), and SS-QOL.

  11. Controlled porosity solubility modulated osmotic pump tablets of gliclazide.

    Science.gov (United States)

    Banerjee, Arti; Verma, P R P; Gore, Subhash

    2015-06-01

    A system that can deliver drug at a controlled rate is very important for the treatment of various chronic diseases such as diabetes, asthma, and heart disease. Poorly water-soluble drug with pH-dependent solubility such as gliclazide (GLZ) offers challenges in the controlled-release formulation because of low dissolution rate and poor bioavailability. Solid dispersion (SD) of GLZ consisted of hydroxypropyl cellulose (HPC-SSL) as a polymeric solubilizer was manufactured by hot melt extrusion (HME) technology. Then, controlled porosity osmotic pump (CPOP) tablet of gliclazide was designed to deliver drug in a controlled manner up to 16 h. The developed formulation was optimized for type and level of pore former and coating weight gain. The optimized formulation was found to exhibit zero order kinetics independent of pH and agitation speed but depends on osmotic pressure of dissolution media indicated that mechanism of drug release was osmotic pressure. The in vivo performance prediction of developed formulation using convolution approach revealed that the developed formulation was superior to the existing marketed extended-release formulation in terms of attaining steady state plasma levels and indicated adequate exposure in translating hypoglycemic response. The prototype solubilization method combined with controlled porosity osmotic pump based technique could provide a unique way to increase dissolution rate and bioavailability of many poorly water-soluble, narrow therapeutic index drugs used in diabetes, cardiovascular diseases, etc.

  12. The control of convection by fuelling and pumping in the JET pumped divertor

    Energy Technology Data Exchange (ETDEWEB)

    Harbour, P.J.; Andrew, P.; Campbell, D.; Clement, S.; Davies, S.; Ehrenberg, J.; Erents, S.K.; Gondhalekar, A.; Gadeberg, M.; Gottardi, N.; Von Hellermann, M.; Horton, L.; Loarte, A.; Lowry, C.; Maggi, C.; McCormick, K.; O`Brien, D.; Reichle, R.; Saibene, G.; Simonini, R.; Spence, J.; Stamp, M.; Stork, D.; Taroni, A.; Vlases, G. [Commission of the European Communities, Abingdon (United Kingdom). JET Joint Undertaking

    1994-07-01

    Convection from the scrape-off layer (SOL) to the divertor will control core impurities, if it retains them in a cold, dense, divertor plasma. This implies a high impurity concentration in the divertor, low at its entrance. Particle flux into the divertor entrance can be varied systematically in JET, using the new fuelling and pumping systems. The convection ratio has been estimated for various conditions of operation. Particle convection into the divertor should increase thermal convection, decreasing thermal conduction, and temperature and density gradients along the magnetic field, hence increasing the frictional force and decreasing the thermal force on impurities. Changes in convection in the SOL, caused by gaseous fuelling, have been studied, both experimentally in the JET Mk I divertor and with EDGE2/NIMBUS. 1 ref., 4 figs., 1 tab.

  13. Foot placement control and gait instability among people with stroke.

    Science.gov (United States)

    Dean, Jesse C; Kautz, Steven A

    2015-01-01

    Gait instability is a common problem following stroke, as evidenced by increases in fall risk and fear of falling. However, the mechanism underlying gait instability is currently unclear. We recently found that young, healthy humans use a consistent gait stabilization strategy of actively controlling their mediolateral foot placement based on the concurrent mechanical state of the stance limb. In the present work, we tested whether people with stroke (n = 16) and age-matched controls (n = 19) used this neuromechanical strategy. Specifically, we used multiple linear regressions to test whether (1) swing phase gluteus medius (GM) activity was influenced by the simultaneous state of the stance limb and (2) mediolateral foot placement location was influenced by swing phase GM activity and the mechanical state of the swing limb at the start of the step. We found that both age-matched controls and people with stroke classified as having a low fall risk (Dynamic Gait Index [DGI] score >19) essentially used the stabilization strategy previously described in young controls. In contrast, this strategy was disrupted for people with stroke classified as higher fall risk (DGI foot placement may contribute to poststroke instability.

  14. Incremental Adaptive Fuzzy Control for Sensorless Stroke Control of A Halbach-type Linear Oscillatory Motor

    Science.gov (United States)

    Lei, Meizhen; Wang, Liqiang

    2018-01-01

    The halbach-type linear oscillatory motor (HT-LOM) is multi-variable, highly coupled, nonlinear and uncertain, and difficult to get a satisfied result by conventional PID control. An incremental adaptive fuzzy controller (IAFC) for stroke tracking was presented, which combined the merits of PID control, the fuzzy inference mechanism and the adaptive algorithm. The integral-operation is added to the conventional fuzzy control algorithm. The fuzzy scale factor can be online tuned according to the load force and stroke command. The simulation results indicate that the proposed control scheme can achieve satisfied stroke tracking performance and is robust with respect to parameter variations and external disturbance.

  15. Stroke

    Science.gov (United States)

    ... adjust your treatment as needed. Rehabilitation After a stroke, you may need rehabilitation (rehab) to help you recover. Rehab may include working with speech, physical, and occupational therapists. Language, ... may have trouble communicating after a stroke. You may not be able to find the ...

  16. Skeletal Muscle Pump Drives Control of Cardiovascular and Postural Systems

    Science.gov (United States)

    Verma, Ajay K.; Garg, Amanmeet; Xu, Da; Bruner, Michelle; Fazel-Rezai, Reza; Blaber, Andrew P.; Tavakolian, Kouhyar

    2017-03-01

    The causal interaction between cardio-postural-musculoskeletal systems is critical in maintaining postural stability under orthostatic challenge. The absence or reduction of such interactions could lead to fainting and falls often experienced by elderly individuals. The causal relationship between systolic blood pressure (SBP), calf electromyography (EMG), and resultant center of pressure (COPr) can quantify the behavior of cardio-postural control loop. Convergent cross mapping (CCM) is a non-linear approach to establish causality, thus, expected to decipher nonlinear causal cardio-postural-musculoskeletal interactions. Data were acquired simultaneously from young participants (25 ± 2 years, n = 18) during a 10-minute sit-to-stand test. In the young population, skeletal muscle pump was found to drive blood pressure control (EMG → SBP) as well as control the postural sway (EMG → COPr) through the significantly higher causal drive in the direction towards SBP and COPr. Furthermore, the effect of aging on muscle pump activation associated with blood pressure regulation was explored. Simultaneous EMG and SBP were acquired from elderly group (69 ± 4 years, n = 14). A significant (p = 0.002) decline in EMG → SBP causality was observed in the elderly group, compared to the young group. The results highlight the potential of causality to detect alteration in blood pressure regulation with age, thus, a potential clinical utility towards detection of fall proneness.

  17. Optimal control of hydroelectric facility incorporating pump storage

    International Nuclear Information System (INIS)

    Zhao, Guangzhi; Davison, Matt

    2009-01-01

    We consider a simple model of a pump-assisted hydroelectric facility operating in a market with time-varying but deterministic power prices and constant water inflows. The engineering details of the facility are described by a model containing several parameters. We present an algorithm for optimizing first the energy and then the profit produced by these plants. This algorithm allows us to describe the relationships between control trajectory and time, and between inflow and price. Remarkably, we see that under some reasonable choices of facility parameters and for power prices that are not extremely variable, the optimal profit operation of these facilities is not too different from their optimal energy operation, and the control is less affected by the price as the inflow rate increases. (author)

  18. Community-based case-control study of childhood stroke risk associated with congenital heart disease.

    Science.gov (United States)

    Fox, Christine K; Sidney, Stephen; Fullerton, Heather J

    2015-02-01

    A better understanding of the stroke risk factors in children with congenital heart disease (CHD) could inform stroke prevention strategies. We analyzed pediatric stroke associated with CHD in a large community-based case-control study. From 2.5 million children (aged hemorrhagic strokes and randomly selected age- and facility-matched stroke-free controls (3 per case). We determined exposure to CHD (diagnosed before stroke) and used conditional logistic regression to analyze stroke risk factors. CHD was identified in 15 of 412 cases (4%) versus 7 of 1236 controls (0.6%). Cases of childhood stroke (occurring between ages 29 days to 20 years) with CHD had 19-fold (odds ratio, 19; 95% confidence interval 4.2-83) increased stroke risk compared to controls. History of CHD surgery was associated with >30-fold (odds ratio, 31; confidence interval 4-241) increased risk of stroke in children with CHD when compared with controls. After excluding perioperative strokes, the history of CHD surgery still increased the childhood stroke risk (odds ratio, 13; confidence interval 1.5-114). The majority of children with stroke and CHD were outpatients at the time of stroke, and almost half the cases who underwent cardiac surgery had their stroke >5 years after the most recent procedure. An estimated 7% of ischemic and 2% of hemorrhagic childhood strokes in the population were attributable to CHD. CHD is an important childhood stroke risk factor. Children who undergo CHD surgery remain at elevated risk outside the perioperative period and would benefit from optimized long-term stroke prevention strategies. © 2014 American Heart Association, Inc.

  19. Iterative learning control for electrical stimulation and stroke rehabilitation

    CERN Document Server

    Freeman, Chris T; Burridge, Jane H; Hughes, Ann-Marie; Meadmore, Katie L

    2015-01-01

    Iterative learning control (ILC) has its origins in the control of processes that perform a task repetitively with a view to improving accuracy from trial to trial by using information from previous executions of the task. This brief shows how a classic application of this technique – trajectory following in robots – can be extended to neurological rehabilitation after stroke. Regaining upper limb movement is an important step in a return to independence after stroke, but the prognosis for such recovery has remained poor. Rehabilitation robotics provides the opportunity for repetitive task-oriented movement practice reflecting the importance of such intense practice demonstrated by conventional therapeutic research and motor learning theory. Until now this technique has not allowed feedback from one practice repetition to influence the next, also implicated as an important factor in therapy. The authors demonstrate how ILC can be used to adjust external functional electrical stimulation of patients’ mus...

  20. Microbiota Dysbiosis Controls the Neuroinflammatory Response after Stroke.

    Science.gov (United States)

    Singh, Vikramjeet; Roth, Stefan; Llovera, Gemma; Sadler, Rebecca; Garzetti, Debora; Stecher, Bärbel; Dichgans, Martin; Liesz, Arthur

    2016-07-13

    Acute brain ischemia induces a local neuroinflammatory reaction and alters peripheral immune homeostasis at the same time. Recent evidence has suggested a key role of the gut microbiota in autoimmune diseases by modulating immune homeostasis. Therefore, we investigated the mechanistic link among acute brain ischemia, microbiota alterations, and the immune response after brain injury. Using two distinct models of acute middle cerebral artery occlusion, we show by next-generation sequencing that large stroke lesions cause gut microbiota dysbiosis, which in turn affects stroke outcome via immune-mediated mechanisms. Reduced species diversity and bacterial overgrowth of bacteroidetes were identified as hallmarks of poststroke dysbiosis, which was associated with intestinal barrier dysfunction and reduced intestinal motility as determined by in vivo intestinal bolus tracking. Recolonizing germ-free mice with dysbiotic poststroke microbiota exacerbates lesion volume and functional deficits after experimental stroke compared with the recolonization with a normal control microbiota. In addition, recolonization of mice with a dysbiotic microbiome induces a proinflammatory T-cell polarization in the intestinal immune compartment and in the ischemic brain. Using in vivo cell-tracking studies, we demonstrate the migration of intestinal lymphocytes to the ischemic brain. Therapeutic transplantation of fecal microbiota normalizes brain lesion-induced dysbiosis and improves stroke outcome. These results support a novel mechanism in which the gut microbiome is a target of stroke-induced systemic alterations and an effector with substantial impact on stroke outcome. We have identified a bidirectional communication along the brain-gut microbiota-immune axis and show that the gut microbiota is a central regulator of immune homeostasis. Acute brain lesions induced dysbiosis of the microbiome and, in turn, changes in the gut microbiota affected neuroinflammatory and functional outcome

  1. Centrifugal pump and roller pump in adult cardiac surgery: a meta-analysis of randomized controlled trials.

    Science.gov (United States)

    Saczkowski, Richard; Maklin, Michelle; Mesana, Thierry; Boodhwani, Munir; Ruel, Marc

    2012-08-01

    Centrifugal pump (CP) and roller pump (RP) designs are the dominant main arterial pumps used in cardiopulmonary bypass (CPB). Trials reporting clinical outcome measures comparing CP and RP are controversial. Therefore, a meta-analysis was undertaken to evaluate clinical variables from randomized controlled trials (RCTs). Keyword searches were performed on Medline (1966-2011), EmBase (1980-2011), and CINAHL (1981-2011) for studies comparing RP and CP as the main arterial pump in adult CPB. Pooled fixed-effects estimates for dichotomous and continuous data were calculated as an odds ratio and weighted-mean difference, respectively. The P value was utilized to assess statistical significance (P pump-related malfunction or mishap. The meta-analysis of RCTs comparing CP and RP in adult cardiac surgery suggests no significant difference for hematological variables, postoperative blood loss, transfusions, neurological outcomes, or mortality. © 2012, Copyright the Authors. Artificial Organs © 2012, International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

  2. Variable flow controls of closed system pumps for energy savings in maritime power systems

    DEFF Research Database (Denmark)

    Su, Chun-Lien; Liao, Chi-Hsiang; Chou, Tso-Chu

    2016-01-01

    pumps on marine vessels. The existing problem of traditional control methods for closed system pumps is analyzed and a mathematical model for variable flow controls with the appropriate control settings is derived. The performance of the proposed method is demonstrated and verified through experimental...... and field tests of a practical auxiliary boiler feed water management system on a commercial vessel. It is proved that the proposed method can maintain constant water pressure for closed system pumps and provide an efficient way to measure energy savings and maintenance benefits. The results serve......Pumps are extensively used in maritime industries as marine vessels utilize a wide range of pumps and pumping techniques to transfer and distribute all types of air and fluids. The electrical energy consumed by the various motors accounts for about 70% of a vessel’s total power consumption...

  3. Designing an Electro-Hydraulic Control Module for an Open-Circuit Variable Displacement Pump

    DEFF Research Database (Denmark)

    Pedersen, Henrik Clemmensen; Andersen, Torben Ole; Hansen, Michael Rygaard

    2005-01-01

    , in the form of an electric control signal, under varying working conditions, when having access to engine speed and actual pump pressure. The paper presents a model of both the pump and the control module, along with design considerations on which linear controllers are developed for a worst point......This paper deals with the problem of designing an electric control module for a Sauer-Danfoss Series 45 H-frame open circuit axial piston pump. The purpose of the electric control module is to replace the existing hydro-mechanical (LS) regulator, and enable the pump to follow a reference pressure...... consideration. Based on the initial topology experimental results are presented and a simulation comparison is made with the original hydro-mechanical controlled pump. Based on these results, improvements for a second prototype are presented along with a simulation result for this....

  4. Evidence for coordinate genetic control of Na,K pump density in erythrocytes and lymphocytes

    International Nuclear Information System (INIS)

    DeLuise, M.; Flier, J.S.

    1985-01-01

    The erythrocyte is widely used as a model cell for studies of the Na,K pump in health and disease. However, little is known about the factors that control the number of Na,K pumps expressed on the erythrocytes of a given individual, nor about the extent to which erythrocytes can be used to validly assess the pump density on other cell types. In this report, the authors have compared the interindividual variance of Na,K pump density in erythrocytes of unrelated individuals to that seen with identical twins. Unlike unrelated individuals, in whom pump parameters, i.e., ouabain binding sites, 86 Rb uptake, and cell Na concentration vary widely, identical twin pairs showed no significant intrapair variation for these values. Thus, a role for genetic factors is suggested. In addition, the authors established and validated a method for determining Na,K pump density and pump-mediated 86 Rb uptake in human peripheral lymphocytes. Using this method, they show that whereas Na,K pump density differs markedly between erythrocytes (mean of 285 sites per cell) and lymphocytes (mean 40,600 sites per cell), there is a strong and highly significant correlation (r = 0.79, P less than 0.001) between the pump density in these cell types in any given individual. Taken together, these studies suggest that genetic factors are important determinants of Na,K pump expression, and that pump density appears to be coordinately regulated in two cell types in healthy individuals

  5. Control of Electric Drives in the Best Efficiency Region of Pumping System

    Directory of Open Access Journals (Sweden)

    Bakman Ilja

    2014-10-01

    Full Text Available The paper concentrates on improving the efficiency of the pumping system in which pumps are run by variable speed drives. The method is applicable to system consisting of several centrifugal pumps. Problems arising from running the pumps outside the optimal efficiency region are discussed. Common principles of operation and control of typical boosting pumping station are represented. Methods of regulation of productivity of the system are described. The proposed method is based on prediction of future efficiency of pumps before making adjustments of pumping system productivity. The proposed method is basing on tracking the working point of pump on efficiency graph. Monitoring the location of working point vs. efficiency graph enables to evaluate its current and future distances from the best efficiency point of the pump. Knowing the current number of running pumps it is possible to predict the location of working point after adjustment of productivity of the system. Ability to predict the increase or decrease of efficiency enables to enhance the adjustment of productivity of the system. Methods of graphical analysis of working state of the pumping system are representing topic for future research.

  6. Design Document for Control Dewar and Vacuum Pump Platforms

    International Nuclear Information System (INIS)

    Rucinksi, R.

    1997-01-01

    This engineering note documents the design of the control dewar and vacuum pump platform that is to be installed on the D-Zero detector. It's purpose is twofold. Firstly it is a summary and repository of the final design calculations of the structure. Secondly, it documents that design follows the American Institute of Steel Construction (AISC) manual and applicable OSHA requirements with respect to walking working surfaces. The information contained in the main body of this note is supported by raw calculations included as the appendix. The platform is a truss type frame strucrure constructed primarily of rectangular steel tubing. The upper platform is for support of the control dewar (cryogenic/electrical interface for the solenoid), visible light photon counter (VLPC) cryogenic bayonet can, and infrequently, personnel during the connection and disconnection of the detector to building services. Figure 1 shows a layout of the structure as mounted on the detector and with the installed equipment. The connection of the platform to the detector is not conventional. Two main booms cantilever the structure to a location outside of the detector. The mounting location and support booms allow for the uninhibited motion of the detector components.

  7. Experimental Investigation and Passive Flow Control of a Cavitating Centrifugal Pump

    Directory of Open Access Journals (Sweden)

    Spyridon D. Kyparissis

    2012-01-01

    Full Text Available Passive flow control techniques are used to improve the flow field and efficiency of centrifugal pumps and turbomachines, in general. An important phenomenon that mechanical engineers have to take into account is cavitation. It leads to the decrease of the pump performance and total head. In the present experimental study, a centrifugal pump is investigated in cavitating conditions. A passive flow control is realized using three different blade leading edge angles in order to reduce the cavitation development and enhance the pump performance. The experiments are carried out in a pump test rig specially designed and constructed, along with the impellers. The head drop and total efficiency curves are presented in order to examine the effect of the blade leading edge angle on the cavitation and pump performance. Finally, the vapour distribution along with the blades is illustrated for the tested blade leading edge angles.

  8. Controlling the optical bistability and multistability in a two-level pumped-probe system

    International Nuclear Information System (INIS)

    Mahmoudi, Mohammad; Sahrai, Mostafa; Masoumeh Mousavi, Seyede

    2010-01-01

    We study the behavior of the optical bistability (OB) and multistability (OM) in a two-level pumped-probe atomic system by means of a unidirectional ring cavity. We show that the optical bistability in a two-level atomic system can be controlled by adjusting the intensity of the pump field and the detuning between two fields. We find that applying the pumping field decreases the threshold of the optical bistability.

  9. Elimination of Oscillations in a Central Heating System using Pump Control

    DEFF Research Database (Denmark)

    Andersen, Palle; Pedersen, Tom Søndergaard; Stoustrup, Jakob

    2000-01-01

    In central heating systems with thermostatic valve temperature control it is a well known fact that room temperature oscillations may occur when the heat demand becomes low due to the non-linear behavior of the control loop. This is not only discomforting but it also increases the energy cost...... of heating the room. Using the pump speed as an active part in control is it shown that the room temperature may be stabilized in a wider interval of heat demand. The idea is to control the pump speed in a way that keeps the thermostatic valve within a suitable operating area using an estimate of the valve...... position. The position is estimated from the pump terminals, using the pump flow and the pump differential pressure. The concept is tested on a small central heating test bench. The results show that it is possible to stabilize the room temperature even at part load conditions...

  10. PLC and DTAM Software Programs for Pumping Instrumentation and Control Skid P

    International Nuclear Information System (INIS)

    KOCH, M.R.

    2000-01-01

    This document describe the software programs for the Programmable Logic Controller and the Datable Access Module for Pumping Instrumentation and Control skid ''P''. The Appendices contains copies of the printouts of these software programs

  11. PLC/DTAM Software Programs for Pumping Instrumentation and Control Skid ''L''

    International Nuclear Information System (INIS)

    KOCH, M.R.

    2000-01-01

    This document describes the software programs for the Programmable Logic Controller and the Data Table Access Module for Pumping Instrumentation and Control skid ''L''. The Appendices contains copies of the printouts of these software programs

  12. D0 HVAC System Heat Pump Controller Programming, Networking, and Operating Information

    International Nuclear Information System (INIS)

    Anderson, B.

    1999-01-01

    The purpose of this engineering note is to provide the necessary information to setup, program, and network the Electronic Systems USA Heat Pump Controller with the LON network card and Intellution Fix32 to operate properly within the HVAC system at D-Zero. The heat pump controllers are used for local temperature control of the office environments on the fifth and six floors of D-Zero. Heat pump units 1-6 are located in the ceiling of the sixth floor. Heat pump units 7-12 are found in the fifth floor ceiling. Heat pump unit 13 is in the Southeast corner of the fifth floor. Prior to installation the heat pump controller must be properly prepared to operate correctly in the HVAC system. Each heat pump unit must contain firmware (software) version 1.31 to operate properly on the network. Controllers with version 1.30 will not be able to communicate over the LON network. The manufacturer can only update the firmware version. Before installation a series of heat pump setpoints must be manually set using the Intelligent Stat. Connect the Intelligent Stat via the serial cable or wired connection.

  13. Operating experience with an on-line vibration control system for PWR main coolant pumps

    International Nuclear Information System (INIS)

    Runkel, J.; Stegemann, D.; Vortriede, A.

    1996-01-01

    The main circulation pumps are key components of nuclear power plants with pressurized water reactors, because the availability of the main circulation pumps has a direct influence on the availability and electrical output of the entire plant. The on-line automatic vibration control system ASMAS was developed for early failure detection during the normal operation of the main circulation pumps in order to avoid unexpected outages and to establish the possibility of preventive maintenance of the pumps. This system is permanently and successfully operating in three German 1300 MW el NPP's with PWR and has been successfully tested in a 350 MW el NPP with a PWR. (orig.)

  14. Operating experience with an on-line vibration control system for PWR main coolant pumps

    International Nuclear Information System (INIS)

    Runkel, J.; Stegemann, D.; Vortriede, A.

    1998-01-01

    The main circulation pumps are key components of nuclear power plants with pressurized water reactors (PWRs), because the availability of the main circulation pumps has a direct influence on the availability and electrical output of the entire plant. The on-line automatic vibration control system ASMAS was developed for early failure detection during the normal operation of the main circulation pumps in order to avoid unexpected outages and to establish the possibility of preventive maintenance of the pumps. This system is permanently and successfully operating in three German 1300 MW e1 NPP's with PWR and has been successfully tested in a 350 MW e1 NPP with a PWR. (orig.)

  15. Energy management algorithm for an optimum control of a photovoltaic water pumping system

    International Nuclear Information System (INIS)

    Sallem, Souhir; Chaabene, Maher; Kamoun, M.B.A.

    2009-01-01

    The effectiveness of photovoltaic water pumping systems depends on the adequacy between the generated energy and the volume of pumped water. This paper presents an intelligent algorithm which makes decision on the interconnection modes and instants of photovoltaic installation components: battery, water pump and photovoltaic panel. The decision is made by fuzzy rules on the basis of the Photovoltaic Panel Generation (PVPG) forecast during a considered day, on the load required power, and by considering the battery safety. The algorithm aims to extend operation time of the water pump by controlling a switching unit which links the system components with respect to multi objective management criteria. The algorithm implementation demonstrates that the approach extends the pumping period for more than 5 h a day which gives a mean daily improvement of 97% of the water pumped volume.

  16. Energy management algorithm for an optimum control of a photovoltaic water pumping system

    Energy Technology Data Exchange (ETDEWEB)

    Sallem, Souhir; Chaabene, Maher; Kamoun, M.B.A. [Unite de Commande de Machines et Reseaux de Puissance CMERP-ENIS, Rte Sokra Km 3.5, BP 1173-3038, Sfax 3052 (Tunisia)

    2009-12-15

    The effectiveness of photovoltaic water pumping systems depends on the adequacy between the generated energy and the volume of pumped water. This paper presents an intelligent algorithm which makes decision on the interconnection modes and instants of photovoltaic installation components: battery, water pump and photovoltaic panel. The decision is made by fuzzy rules on the basis of the Photovoltaic Panel Generation (PVPG) forecast during a considered day, on the load required power, and by considering the battery safety. The algorithm aims to extend operation time of the water pump by controlling a switching unit which links the system components with respect to multi objective management criteria. The algorithm implementation demonstrates that the approach extends the pumping period for more than 5 h a day which gives a mean daily improvement of 97% of the water pumped volume. (author)

  17. Earliest Deadline Control of a Group of Heat Pumps with a Single Energy Source

    Directory of Open Access Journals (Sweden)

    Jiří Fink

    2016-07-01

    Full Text Available In this paper, we develop and investigate the optimal control of a group of 104 heat pumps and a central Combined Heat and Power unit (CHP. The heat pumps supply space heating and domestic hot water to households. Each house has a buffer for domestic hot water and a floor heating system for space heating. Electricity for the heat pumps is generated by a central CHP unit, which also provides thermal energy to a district heating system. The paper reviews recent smart grid control approaches for central and distributed levels. An online algorithm is described based on the earliest deadline first theory that can be used on the aggregator level to control the CHP and to give signals to the heat pump controllers if they should start or should wait. The central controller requires only a limited amount of privacy-insensitive information from the heat pump controllers about their deadlines, which the heat pump controllers calculate for themselves by model predictions. In this way, a robust heat pump and CHP control is obtained, which is able to minimize energy demand and results in the desired thermal comfort for the households. The simulations demonstrate fast computation times due to minor computational and communication overheads.

  18. Improving the Efficiency of the Heat Pump Control System of Carbon Dioxide Heat Pump with Several Evaporators and Gas Coolers

    Directory of Open Access Journals (Sweden)

    Sit M.L.

    2016-12-01

    Full Text Available The problem of coordination of the values of the refrigerant flow through the evaporators and gas coolers of the heat pump for the simultaneous production of heat and cold is studied. The compensation of the variations of the total flow through the evaporators is implemented using the variation of the capacity of the compressor and a corresponding change in flow through the auxiliary gas cooler of the heat pump. Control system of this gas cooler is constructed using the invariance principle of the output value (outlet temperature of the heated agent with respect to perturbations on the control channel (the refrigerant flow through the gas cooler. Principle of dual-channel compensation of the disturbance and advancing signal on input of control valve of the refrigerant through the gas cooler is ensured. Due to proposed solution, the intensity of the disturbances on the flow of refrigerant is reduced. Due to proposed technical solution power consumed by the heat pump compressor drive under transients is decreased.

  19. Earliest Deadline Control of a Group of Heat Pumps with a Single Energy Source

    NARCIS (Netherlands)

    Fink, J.; van Leeuwen, Richard Pieter

    2016-01-01

    In this paper, we develop and investigate the optimal control of a group of 104 heat pumps and a central Combined Heat and Power unit (CHP). The heat pumps supply space heating and domestic hot water to households. Each house has a buffer for domestic hot water and a floor heating system for space

  20. Computer-Based Monitoring and Remote Controlling for Oil Well Pumps Using Scada

    Directory of Open Access Journals (Sweden)

    Rudi Tjiptadi

    2011-12-01

    Full Text Available The research aims to change manually the monitoring and controlling of oil well pumps into a computer-based system using SCADA (Supervisory and Data Acquisition system. To design the protection system which consists of controller unit and display system, RTU (Remote Terminal Unit and MTU (Master Terminal Unit are used. The research results in a controller unit which is able to communicate to personal computer using RS-232 C and an alarm system to protect oil pump motors by detecting sensors installed at the pumps

  1. A review: Motor rehabilitation after stroke with control based on human intent.

    Science.gov (United States)

    Li, Min; Xu, Guanghua; Xie, Jun; Chen, Chaoyang

    2018-02-01

    Strokes are a leading cause of acquired disability worldwide, and there is a significant need for novel interventions and further research to facilitate functional motor recovery in stroke patients. This article reviews motor rehabilitation methods for stroke survivors with a focus on rehabilitation controlled by human motor intent. The review begins with the neurodevelopmental principles of motor rehabilitation that provide the neuroscientific basis for intuitively controlled rehabilitation, followed by a review of methods allowing human motor intent detection, biofeedback approaches, and quantitative motor rehabilitation assessment. Challenges for future advances in motor rehabilitation after stroke using intuitively controlled approaches are addressed.

  2. Liquid metal flow control by DC electromagnetic pumps; Controle de vazao de metais liquidos por bombas eletromagneticas de corrente continua

    Energy Technology Data Exchange (ETDEWEB)

    Borges, Eduardo Madeira; Braz Filho, Francisco Antonio; Guimaraes, Lamartine Nogueira Frutuoso [Instituto de Estudos Avancados (IEAv), Sao Jose dos Campos, SP (Brazil)], e-mail: eduardo@ieav.cta.br, e-mail: fbraz@ieav.cta.br, e-mail: guimarae@ieav.cta.br

    2006-07-01

    The cooling system of high-density thermal power requires fluids of high thermal conductivity, such as liquid metals. Electromagnetic pumps can be used to liquid metal fluid flow control in cooling circuits. The operation of electromagnetic pumps used to flow control is based on Lorentz force. This force can be achieved by magnetic field and electric current interaction, controlled by external independent power supplies. This work presents the electromagnetic pump operational principles, the IEAv development scheme and the BEMC-1 simulation code. The theoretical results of BEMC-1 simulation are compared to electromagnetic pump operation experimental data, validating the BEMC-1 code. This code is used to evaluate the DC electromagnetic pump performance applied to Mercury flow control and others liquid metal such as Sodium, Lead and Bismuth, used in nuclear fast reactors. (author)

  3. Acceptance Test Procedure for New Pumping Instrumentation and Control Skid ''V''

    International Nuclear Information System (INIS)

    KOCH, M.R.

    2000-01-01

    This Acceptance Test Procedure (ATP) provides for the inspection and testing of the new Pumping Instrumentation and Control (PIC) skid designated as ''V''. The ATP will be performed after the construction of the PIC skid in the fabrication shop

  4. Acceptance Test Procedure for New Pumping Instrumentation and Control Skid R

    International Nuclear Information System (INIS)

    KOCH, M.R.

    2000-01-01

    This Acceptance Test Procedure (ATP) provides for the inspection and testing of the new Pumping Instrumentation and Control (PIC) skid designed as ''R''. The ATP will be performed after the construction of the PIC skid in the fabrication shop

  5. Acceptance Test Procedure for New Pumping Instrumentation and Control Skid ''P''

    International Nuclear Information System (INIS)

    KOCH, M.R.

    2000-01-01

    This Acceptance Test Procedure (ATP) provides for the inspection and testing of the new Pumping Instrumentation and Control (PIC) skid designed as ''P''. The ATP will be performed after the construction of the PIC skid in the fabrication shop

  6. Acceptance Test Procedure for New Pumping Instrumentation and Control Skid ''U''

    International Nuclear Information System (INIS)

    KOCH, M.R.

    2000-01-01

    This Acceptance Test Procedure (ATP) provides for the inspection and testing of the new Pumping Instrumentation and Control (PIC) skid designed as ''U''. The ATP will be performed after the construction of the PIC skid in the fabrication shop

  7. Acceptance Test Procedure for New Pumping Instrumentation and Control Skid ''T''

    International Nuclear Information System (INIS)

    KOCH, M.R.

    2000-01-01

    This Acceptance Test Procedure (ATP) provides for the inspection and testing of the new Pumping Instrumentation and Control (PIC) skid designated as ''T''. The ATP will be performed after the construction of the PIC skid in the fabrication shop

  8. Acceptance Test Procedure for New Pumping and Instrumentation Control Skid N

    International Nuclear Information System (INIS)

    KOCH, M.R.

    1999-01-01

    This Acceptance Test Procedure (ATP) provides for the inspection and testing of the new Pumping and Instrumentation Control (PIC) skid designed as ''N''. The ATP will be performed after the construction of the PIC skid in the shop

  9. Acceptance Test Procedure for New Pumping Instrumentation and Control Skid T

    International Nuclear Information System (INIS)

    KOCH, M.R.

    2000-01-01

    This Acceptance Test Procedure (ATP) provides for the inspection and testing Of the new Pumping Instrumentation and Control (PIC) skid designed as ''T''. The ATP will be performed after the construction of the PIC skid in the fabrication shop

  10. Acceptance Test Procedure for New Pumping and Instrumentation Control Skid L

    International Nuclear Information System (INIS)

    KOCH, M.R.

    1999-01-01

    This Acceptance Test Procedure (ATP) provides for the inspection and testing of the new Pumping and Instrumentation Control (PIC) skid designed as ''L''. The ATP will be performed after the construction of the PIC skid in the shop

  11. Computer system design description for the spare pump mini-dacs data acquisition and control system

    International Nuclear Information System (INIS)

    Vargo, G.F. Jr.

    1994-01-01

    The attached document outlines the computer software design for the mini data acquisition and control system (DACS), that supports the testing of the spare pump for Tank 241-SY-101, at the maintenance and storage facility (MASF)

  12. Computer system design description for the spare pump mini-dacs data acquisition and control system

    Energy Technology Data Exchange (ETDEWEB)

    Vargo, G.F. Jr.

    1994-09-29

    The attached document outlines the computer software design for the mini data acquisition and control system (DACS), that supports the testing of the spare pump for Tank 241-SY-101, at the maintenance and storage facility (MASF).

  13. Design of ion-pump power supply control software system based on TCP/IP protocol

    International Nuclear Information System (INIS)

    Lin Feiyu; Huang Jijiang; Guo Yuhui; Fang Zheng; Wang Yanyu

    2009-01-01

    This paper discuss a Ion-pump Power Supply control system making use of RS232 series bus and Intranet. The system's hardware VAC800 is composed of MSP430F149 mixed-signal processors produced by TI and UA7000A network model. MSP430F149 has advantages of ultra-low-power and high-integration. The Ion-pump Power Supply control system has the characteristics of strong function, simple structure, high reliability, strong resistance of noise, no peripheral chip, etc. Visual studio 2005 is used to design the system's software. The Ion-pump Power supplier control system can remotely monitor and control Ion-pump Power Suppliers. (authors)

  14. Acceptance Test Procedure for New Pumping Instrumentation and Control Skid V

    International Nuclear Information System (INIS)

    KOCH, M.R.

    2000-01-01

    This Acceptance Test Procedure (ATP) provides for the inspection and testing of the new Pumping Instrumentation and Control. (PIC) skid designed as ''V''. The ATP will be performed after the construction of the PIC skid in the fabrication shop

  15. Acceptance Test Procedure for New Pumping Instrumentation and Control Skid W

    International Nuclear Information System (INIS)

    KOCH, M.R.

    2000-01-01

    This Acceptance Test Procedure (ATP) provides for the inspection and testing of the new Pumping Instrumentation and Control (PIC) skid designed as ''W''. The ATP will be performed after the construction of the PIC skid in the fabrication shop

  16. How Cells Can Control Their Size by Pumping Ions

    Directory of Open Access Journals (Sweden)

    Alan R. Kay

    2017-05-01

    Full Text Available The ability of all cells to set and regulate their size is a fundamental aspect of cellular physiology. It has been known for sometime but not widely so, that size stability in animal cells is dependent upon the operation of the sodium pump, through the so-called pump-leak mechanism (Tosteson and Hoffman, 1960. Impermeant molecules in cells establish an unstable osmotic condition, the Donnan effect, which is counteracted by the operation of the sodium pump, creating an asymmetry in the distribution of Na+ and K+ staving off water inundation. In this paper, which is in part a tutorial, I show how to model quantitatively the ion and water fluxes in a cell that determine the cell volume and membrane potential. The movement of water and ions is constrained by both osmotic and charge balance, and is driven by ion and voltage gradients and active ion transport. Transforming these constraints and forces into a set of coupled differential equations allows us to model how the ion distributions, volume and voltage change with time. I introduce an analytical solution to these equations that clarifies the influence of ion conductances, pump rates and water permeability in this multidimensional system. I show that the number of impermeant ions (x and their average charge have a powerful influence on the distribution of ions and voltage in a cell. Moreover, I demonstrate that in a cell where the operation of active ion transport eliminates an osmotic gradient, the size of the cell is directly proportional to x. In addition, I use graphics to reveal how the physico-chemical constraints and chemical forces interact with one another in apportioning ions inside the cell. The form of model used here is applicable to all membrane systems, including mitochondria and bacteria, and I show how pumps other than the sodium pump can be used to stabilize cells. Cell biologists may think of electrophysiology as the exclusive domain of neuroscience, however the electrical

  17. Advanced control for ground source heat pump systems

    Energy Technology Data Exchange (ETDEWEB)

    Hughes, Patrick [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Gehl, Anthony C. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Liu, Xiaobing [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States)

    2017-09-01

    Ground source heat pumps (GSHP), also known as geothermal heat pumps (GHP), are proven advanced HVAC systems that utilize clean and renewable geothermal energy, as well as the massive thermal storage capacity of the ground, to provide space conditioning and water heating for both residential and commercial buildings. GSHPs have higher energy efficiencies than conventional HVAC systems. It is estimated, if GSHPs achieve a 10% market share in the US, in each year, 0.6 Quad Btu primary energy consumption can be saved and 36 million tons carbon emissions can be avoided (Liu et al. 2017). However, the current market share of GSHPs is less than 1%. The foremost barrier preventing wider adoption of GSHPs is their high installation costs. To enable wider adoption of GSHPs, the costeffectiveness of GSHP applications must be improved.

  18. Optically controlled tunable dispersion compensators based on pumped fiber gratings.

    Science.gov (United States)

    Shu, Xuewen; Sugden, Kate; Bennion, Ian

    2011-08-01

    We demonstrate optically tunable dispersion compensators based on pumping fiber Bragg gratings made in Er/Yb codoped fiber. The tunable dispersion for a chirped grating and also a uniform-period grating was successfully demonstrated in the experiment. The dispersion of the chirped grating was tuned from 900 to 1990 ps/nm and also from -600 to -950 ps/nm in the experiment. © 2011 Optical Society of America

  19. Energy-saving control model of inverter for centrifugal pump systems

    Directory of Open Access Journals (Sweden)

    Yin Luo

    2015-06-01

    Full Text Available The inverter control strategy is the key to pump energy-saving operation and should be established based on the current system configurations and system requirements, which is not the case in practice. As a result, the characteristics of pump system requirements and a combination pump with inverter were studied, and the mathematical models were established. A new model for an optimal inverter control strategy based on the current system configurations and system requirements was then established, and a method combining golden section search and genetic algorithm was formulated to solve this optimal model. This model sets up an optimal inverter control strategy to increase the efficiency of pump operation following a process line near the minimum requirements to improve operation conditions. The implementation difficulty of the control law was also reduced. Finally, the optimized model was applied to an industrial circulating pump system, and the result showed that the model can not only determine the optimal inverter control strategy but also evaluate the current operation situation of the pump configuration and determine the energy-saving potential for the current configuration, which can aid in the subsequent energy-saving reconstruction.

  20. Misery perfusion, blood pressure control, and 5-year stroke risk in symptomatic major cerebral artery disease.

    Science.gov (United States)

    Yamauchi, Hiroshi; Kagawa, Shinya; Kishibe, Yoshihiko; Takahashi, Masaaki; Higashi, Tatsuya

    2015-01-01

    The benefit of strict blood pressure (BP) control in high-risk patients with symptomatic major cerebral artery disease and misery perfusion (MP) is controversial. Our purposes were (1) to determine whether MP is a predictor of a 5-year risk of subsequent stroke and (2) to investigate the relationships among BP during follow-up, MP, and the stroke risk. We studied 130 nondisabled patients with symptomatic major cerebral artery disease. Baseline hemodynamic measurements were obtained from (15)O-gas positron emission tomography, and patients received medical treatment and they were followed for 5 years or until stroke recurrence or death. During 5 years, strokes occurred in 6 of 16 patients with MP and in 15 of 114 without MP (log-rank test; Pstrokes in patients with MP and 4 in those without MP (Pstroke declined markedly after 2 years, and there was only 1 ipsilateral ischemic stroke in a patient without MP. Normal systolic BP (strokes in patients with impaired perfusion (including MP), whereas systolic BP outside the 130 to 149 mm Hg range was associated with an increased risk of all strokes in patients without MP. Patients with MP showed a high-5-year stroke recurrence, but a large part of the 5-year stroke risk disappeared after 2 years. Aggressive BP control may be hazardous in patients with impaired perfusion, including MP. © 2014 American Heart Association, Inc.

  1. Rationale and design of INTERSTROKE: a global case-control study of risk factors for stroke

    DEFF Research Database (Denmark)

    O'Donnell, M; Serpault, Damien Xavier; Diener, C

    2010-01-01

    Stroke is a major global health problem. It is the third leading cause of death and the leading cause of adult disability. INTERHEART, a global case-control study of acute myocardial infarction in 52 countries (29,972 participants), identified nine modifiable risk factors that accounted for >90......-income countries is inadequate, where a very large burden of stroke occurs. Accordingly, a similar epidemiological study is required for stroke, to inform effective population-based strategies to reduce the risk of stroke. Methods: INTERSTROKE is an international, multicenter case-control study. Cases are patients...... years). A questionnaire (cases and controls) is used to acquire information on known and proposed risk factors for stroke. Cardiovascular (e.g. blood pressure) and anthropometric (e.g. waist-to-hip ratio) measurements are obtained at the time of interview. Nonfasting blood samples and random urine...

  2. On the relative contribution of the paretic leg to the control of posture after stroke

    NARCIS (Netherlands)

    Roerdink, Melvyn; Geurts, Alexander C. H.; de Haart, Mirjam; Beek, Peter J.

    2009-01-01

    Reduced postural steadiness and asymmetry of weight bearing are characteristic for posture after stroke. To examine the relative contribution of each leg to postural control in a cohort of 33 stroke patients at 5 stages during 3 months of inpatient rehabilitation, while taking clinical scores of

  3. On the relative contribution of the paretic leg to the control of posture after stroke

    NARCIS (Netherlands)

    Roerdink, M.; Geurts, A.C.; de Haart, M.; Beek, P.J.

    2009-01-01

    Background: Reduced postural steadiness and asymmetry of weight bearing are characteristic for posture after stroke. Objective: To examine the relative contribution of each leg to postural control in a cohort of 33 stroke patients at 5 stages during 3 months of inpatient rehabilitation, while taking

  4. On the relative contribution of the paretic leg to the control of posture after stroke.

    NARCIS (Netherlands)

    Roerdink, M.; Geurts, A.C.H.; Haart, M. de; Beek, P.J.

    2009-01-01

    BACKGROUND: Reduced postural steadiness and asymmetry of weight bearing are characteristic for posture after stroke. OBJECTIVE: To examine the relative contribution of each leg to postural control in a cohort of 33 stroke patients at 5 stages during 3 months of inpatient rehabilitation, while taking

  5. Minimal sensor count approach to fuzzy logic rotary blood pump flow control.

    Science.gov (United States)

    Casas, Fernando; Ahmed, Nisar; Reeves, Andrew

    2007-01-01

    A rotary blood pump fuzzy logic flow controller without flow sensors was developed and tested in vitro. The controller, implemented in LabView, was set to maintain a flow set point in the presence of external pressure disturbances. Flow was estimated as a function of measured pump's delta P and speed, using a steady-state, nonlinear approximation. The fuzzy controller used the pump's flow estimate and delta P as feedback variables. The defuzzified control output manipulated the pump speed. Membership functions included flow error, delta P, and pump speed. Experimental runs in a mock loop (water/glycerin 3.5 cPs, 37 degrees C), using the estimated flow, were compared with those using a Transonic flow meter for nine conditions of flow and delta P (4 to 6 L/min, 150 to 350 mm Hg). Pressure disturbances generated by a servo pinch valve ranged from +/-23 to +/-47 mm Hg. Results indicated that the fuzzy controller ably regulated the flow set point to within +/-10% of the baseline even under large swings in pressure. There was no difference in controller performance between the ultrasonic flow measurement and the estimated flow calculation scenarios. These tests demonstrated that the fuzzy controller is capable of rejecting disturbances and regulating flow to acceptable limits while using a flow estimate.

  6. Controlling Price-Responsive Heat Pumps for Overload Elimination in Distribution Systems

    DEFF Research Database (Denmark)

    Csetvei, Zsuzsa; Østergaard, Jacob; Nyeng, Preben

    2011-01-01

    This paper investigates the possibility of applying electric heat pumps with the control-by-price-concept in order to avoid overload in a local distribution system. The proposed control algorithm is based upon a centrally dispatched real-time market price, reflecting the state of a larger power...... system, and is extended with a local price control for overload elimination on the corresponding feeder. The paper presents the mathematical models of a two-node system with price-responsive heat pumps, the chosen methodology of the central price calculation, and the proposed local feedback control...

  7. Central model predictive control of a group of domestic heat pumps, case study for a small district

    NARCIS (Netherlands)

    van Leeuwen, Richard Pieter; Fink, J.; Smit, Gerardus Johannes Maria; Helfert, Markus; Krempels, Karl-Heinz; Donnellan, Brian; Klein, Cornel

    2015-01-01

    In this paper we investigate optimal control of a group of heat pumps. Each heat pump provides space heating and domestic hot water to a single household. Besides a heat pump, each house has a buffer for domestic hot water and a floor heating system for space heating. The paper describes models and

  8. Integrated real time control of influent pumping station and primary settling tanks at WWTP Eindhoven

    NARCIS (Netherlands)

    van Daal-Rombouts, P.M.M.; de Jonge, J; Langeveld, J.G.; Clemens, F.H.L.R.

    2016-01-01

    This research deals with the design and implementation of an integrated control for the WWTP of Eindhoven. The control influences the operation of the primary settling tanks and influent pumping station to reduce reduce ammonia peaks in the WWTP effluent. The control takes into account the treatment

  9. Use of an implantable pump for controlled subcutaneous insulin delivery in healthy cats.

    Science.gov (United States)

    Zini, E; Padrutt, I; Macha, K; Riederer, A; Pesaresi, M; Lutz, T A; Reusch, C E

    2017-01-01

    The aim of this study was to examine the safety and reliability of a research-grade implantable pump for controlled delivery of insulin glargine in cats. For this purpose, a small telemetrically controlled drug delivery pump with a refillable reservoir was implanted into the subcutaneous tissues of the dorsal neck in 10 clinically healthy cats. The reservoir was filled with insulin glargine, and the pump was programmed to deliver four boluses of 0.25 IU/kg, 2-3 weeks apart. As a control, insulin glargine (0.25 IU/kg) was injected SC. Blood glucose and plasma insulin glargine concentrations were measured before each bolus and SC injection and for 8 h afterward. Cats were monitored for signs of discomfort. Pumps were easily implanted and well tolerated by all cats. The experiment was completed in five of 10 cats. In four, the pump failed because of technical reasons; another cat developed severe hypoglycaemia attributable to insulin leakage. Overall, plasma insulin glargine increased after six of eight (75%) initial boluses and after one of 16 (6%) successive boluses. Glucose decreased after seven of eight (88%) initial boluses and after four of 16 (25%) successive boluses. Only the first bolus significantly increased plasma insulin glargine (P = 0.008) and decreased glucose (P = 0.008). Of 20 SC injections, 10 (50%) increased plasma insulin glargine (P pump did not cause discomfort in cats, but life-threatening hypoglycaemia occurred in one. Frequent device problems suggest that the pump needs improvements. Because successive boluses did not increase plasma insulin glargine, this type of insulin may not be appropriate with the pump. Copyright © 2016 Elsevier Ltd. All rights reserved.

  10. Stroke

    Science.gov (United States)

    ... as independent as possible. It may include physical therapy, occupational therapy, speech therapy, and swallowing therapy. Your doctor will ... Prevention and Wellness Staying Healthy Healthy Living Travel Occupational ... Sex and Sexuality Birth Control Family Health Infants and Toddlers Kids ...

  11. Stroke

    Science.gov (United States)

    ... or reading Dizziness or abnormal feeling of movement (vertigo) Eyesight problems, such as decreased vision, double vision, ... control risk factors, such as high blood pressure, diabetes, and high cholesterol Special procedures or surgery to ...

  12. Optimal control strategies with nonlinear optimization for an Electric Submersible Pump lifted oil field

    Directory of Open Access Journals (Sweden)

    R. Sharma

    2013-04-01

    Full Text Available In an Electric Submersible Pump (ESP lifted oil field, the ESP of each oil well should be operated inside its operating window. The total power consumed by the ESPs in the oil field should be minimized. The speed of the ESPs and the production choke valve opening should be optimally chosen for maximizing the total oil produced from the oil field. At the same time, the capacity of the separator should not be exceeded. In this paper, nonlinear steady state optimization based on Sequential Quadratic Programming (SQP is developed. Two optimal control structures are proposed in this paper. In the first case, the optimal pump speed is controlled by a PI controller by varying the electrical excitation signal to the motors. The optimal fluid flow rate through each oil well is controlled by another PI controller by varying the production choke valve opening. The paper shows that the production choke valve for each oil well has to be always 100% open to maintain the optimal fluid flow rate. In the second case, the production choke valves are considered to be always 100% open as hard constraints. The optimal fluid flow rate through each oil well is controlled by a PI controller by varying the pump speed. It is shown that when the optimal fluid flow rate is tracked by the controller, the speed of each of the pumps is equal to the optimal pump speed calculated by the optimizer. This basically means that we can achieve the optimization objective with the same optimal results as in the first case by using only a single PI controller. The limitations of these two optimal control structures for very low values and for very high values of the separator capacity are discussed. For the feasible range of separator capacities, the optimal locus of the fluid flow rate and the pump speed are shown in this paper.

  13. Dimensional and Structural Control of Silica Aerogel Membranes for Miniaturized Motionless Gas Pumps.

    Science.gov (United States)

    Zhao, Shanyu; Jiang, Bo; Maeder, Thomas; Muralt, Paul; Kim, Nayoung; Matam, Santhosh Kumar; Jeong, Eunho; Han, Yen-Lin; Koebel, Matthias M

    2015-08-26

    With growing public interest in portable electronics such as micro fuel cells, micro gas total analysis systems, and portable medical devices, the need for miniaturized air pumps with minimal electrical power consumption is on the rise. Thus, the development and downsizing of next-generation thermal transpiration gas pumps has been investigated intensively during the last decades. Such a system relies on a mesoporous membrane that generates a thermomolecular pressure gradient under the action of an applied temperature bias. However, the development of highly miniaturized active membrane materials with tailored porosity and optimized pumping performance remains a major challenge. Here we report a systematic study on the manufacturing of aerogel membranes using an optimized, minimal-shrinkage sol-gel process, leading to low thermal conductivity and high air conductance. This combination of properties results in superior performance for miniaturized thermomolecular air pump applications. The engineering of such aerogel membranes, which implies pore structure control and chemical surface modification, requires both chemical processing know-how and a detailed understanding of the influence of the material properties on the spatial flow rate density. Optimal pumping performance was found for devices with integrated membranes with a density of 0.062 g cm(-3) and an average pore size of 142.0 nm. Benchmarking of such low-density hydrophobic active aerogel membranes gave an air flow rate density of 3.85 sccm·cm(-2) at an operating temperature of 400 °C. Such a silica aerogel membrane based system has shown more than 50% higher pumping performance when compared to conventional transpiration pump membrane materials as well as the ability to withstand higher operating temperatures (up to 440 °C). This study highlights new perspectives for the development of miniaturized thermal transpiration air pumps while offering insights into the fundamentals of molecular pumping in

  14. Rationale and design of INTERSTROKE: a global case-control study of risk factors for stroke

    DEFF Research Database (Denmark)

    O'Donnell, M; Serpault, Damien Xavier; Diener, C

    2010-01-01

    Stroke is a major global health problem. It is the third leading cause of death and the leading cause of adult disability. INTERHEART, a global case-control study of acute myocardial infarction in 52 countries (29,972 participants), identified nine modifiable risk factors that accounted for >90......% of population-attributable risk. However, traditional risk factors (e.g. hypertension, cholesterol) appear to exert contrasting risks for stroke compared with coronary heart disease, and the etiology of stroke is far more heterogeneous. In addition, our knowledge of risk factors for stroke in low...... years). A questionnaire (cases and controls) is used to acquire information on known and proposed risk factors for stroke. Cardiovascular (e.g. blood pressure) and anthropometric (e.g. waist-to-hip ratio) measurements are obtained at the time of interview. Nonfasting blood samples and random urine...

  15. A circuit scheme to control current surge for RFID-NVM pumps

    International Nuclear Information System (INIS)

    Li Ming; Kang Jinfeng; Wang Yangyuan; Yang Liwu

    2010-01-01

    This paper presents a new circuit scheme to control the current surge in the boosting phase of an radio frequency idenfication-nonvolative memory pump. By introducing a circuit block consisting of a current reference and a current mirror, the new circuit scheme can keep the period-average current of the pump constantly below the desired level, for example, 2.5 μA. Therefore, it can prevent the rectified supply of the RFID tag IC from collapsing in the boosting phase of the pump. The presented scheme could effectively reduce the voltage drop on the rectified supply from more than 50% to even zero, but could cost less area. Moreover, an analytical expression to calculate the boosting time of a pump in the new scheme is developed. (semiconductor integrated circuits)

  16. Economic COP Optimization of a Heat Pump with Hierarchical Model Predictive Control

    DEFF Research Database (Denmark)

    Tahersima, Fatemeh; Stoustrup, Jakob; Rasmussen, Henrik

    2012-01-01

    A low-temperature heating system is studied in this paper. It consists of hydronic under-floor heating pipes and an air/ground source heat pump. The heat pump in such a setup is conventionally controlled only by feed-forwarding the ambient temperature. Having shown >10% cut-down on electricity bi....... The proposed control strategy is a leap forward towards balanced load control in Smart Grids where individual heat pumps in detached houses contribute to preserve load balance through intelligent electricity pricing policies....... bills by involving feedback control in a previous study, this paper has continued the same line of argument and has investigated effects of a priori knowledge on weather forecast and electricity price profile to alleviate the total electricity cost subject to constraints on resident's thermal comfort...

  17. A randomised controlled trial of roller versus centrifugal cardiopulmonary bypass pumps in patients undergoing pulmonary endarterectomy.

    Science.gov (United States)

    Mlejnsky, F; Klein, A A; Lindner, J; Maruna, P; Kvasnicka, J; Kvasnicka, T; Zima, T; Pecha, O; Lips, M; Rulisek, J; Porizka, M; Kopecky, P; Kunstyr, J

    2015-10-01

    There is some controversy as to whether there is a benefit from the use of a centrifugal pump compared with a roller pump during cardiopulmonary bypass to facilitate cardiac surgery. We compared the two pumps, with the primary aim of determining any difference in the effects on inflammation after pulmonary endarterectomy surgery which required prolonged cardiopulmonary bypass and deep hypothermic circulatory arrest. Between September 2010 and July 2013, 58 elective patients undergoing pulmonary endarterectomy were included in this prospective, randomised, controlled study; 30 patients were randomly allocated to the control group, which used a roller pump, and 28 patients to the treatment group, which used a centrifugal pump. Interleukin-6, procalcitonin, C-reactive protein, thromboelastographic parameters, P-selectin, international normalised ratio, activated prothrombin time, free haemoglobin, haematocrit, red blood cell count, white blood cell count, platelet count and protein S100β were recorded during and after the procedure. We also recorded the length of intensive care unit stay, blood loss and transfusion, neurological outcomes and respiratory and renal failure. There was a significant difference in the primary outcome measure: Interleukin-6 was significantly higher in the roller pump group (587 ± 38 ng · l(-1) vs. 327 ± 37 ng · l(-1); ppump group 48 hours following surgery (0.79 (0.08-25.25) ng · ml(-1) vs. 0.36 (0.02-5.83) ng · ml(-1); pcentrifugal pump during prolonged cardiopulmonary bypass and deep hypothermic circulatory arrest is associated with a reduced inflammatory response compared to the standard roller pump. Larger multi-centre trials in this area of practice are required. © The Author(s) 2014.

  18. Life satisfaction in spouses of stroke survivors and control subjects: A 7-year follow-up of participants in the Sahlgrenska Academy study on ischaemic stroke.

    Science.gov (United States)

    Abzhandadze, Tamar; Forsberg-Wärleby, Gunilla; Holmegaard, Lukas; Redfors, Petra; Jern, Christina; Blomstrand, Christian; Jood, Katarina

    2017-07-07

    To investigate life satisfaction in spouses of middle-aged stroke survivors from the long-term perspective and to identify factors that explain their life satisfaction. Cross-sectional, case-control study. Cohabitant spouses of survivors of ischaemic stroke aged life satisfaction was assessed with the Fugl-Meyer's Life Satisfaction Check-List (LiSAT 11). Stroke-related factors were examined with the National Institutes of Health stroke scale, Mini-Mental State Examination, Barthel Index and modified Rankin Scale. Spouses of stroke survivors had significantly lower satisfaction with general life, leisure, sexual life, partner relationship, family life, and poorer somatic and psychological health than spouses of controls. Caregiving spouses had significantly lower scores on all life domains except vocation and own activities of daily living than non-caregiving spouses. Spouses' satisfaction on different life domains was explained mainly by their age, sex, support given to the partner, and the survivor's level of global disability, to which both physical and cognitive impairments contributed. Seven years after stroke, spouses of stroke survivors reported lower life satisfaction compared with spouses of controls. Life satisfaction in stroke survivors' spouses was associated with spouses' age, sex, giving support, and the stroke survivors' level of global disability.

  19. The relation between serum Vitamin D levels and body antioxidant status in ischemic stroke patients: A case?control study

    OpenAIRE

    Afshari, Laleh; Amani, Reza; Soltani, Farhad; Haghighizadeh, Mohammad Hossein; Afsharmanesh, Mohammad Reza

    2015-01-01

    Background: Stroke is the second cause of death among elderly people. Oxidative stress plays an important role in brain damage after stroke. Currently, Vitamin D has been shown as an antioxidant. The aim of this study was to evaluate the status of Vitamin D, antioxidant enzymes, and the relation between them in ischemic stroke patients. Materials and Methods: This case?control study was carried out on 36 patients with ischemic stroke patients and 36 matched subjects as controls. Intake of fru...

  20. Insulin pump-associated adverse events are common, but not associated with glycemic control, socio-economic status, or pump/infusion set type.

    Science.gov (United States)

    Ross, P; Gray, A R; Milburn, J; Kumarasamy, I M; Wu, F; Farrand, S; Armishaw, J; Wiltshire, E; Rayns, J; Tomlinson, P; Wheeler, B J

    2016-12-01

    While there have been many outcome-focussed studies examining insulin pump therapy, only a few have looked at potential adverse events (AEs), with none examining the relationship between AEs and pump/infusion set type, ethnicity or socio-economic status. In addition, current data on the incidence and characteristics of pump-associated AEs are confined to one paediatric centre. We aimed to describe the incidence, characteristics and potential predictors of insulin pump-associated AEs in New Zealand adults and children with T1DM. We approached adults and families of children with T1DM on insulin pumps in four main New Zealand centres. Participants completed a questionnaire examining pump-related issues they had experienced in the preceding 12 months. Response rate was 64 % with 174 of 270 eligible people participating in the study. 84 % of subjects reported one or more AEs, with an overall AE incidence of 3.42 per person/year (95 % CI 3.14, 3.73). An event serious enough to require a hospital presentation occurred in 9.8 %, all but one reporting high ketones or diabetic ketoacidosis (DKA). Set/site problems were the AE most commonly reported (by 53 % of respondents), followed by cutaneous complications (43 %) and pump malfunction (38 %). Few predictors of AEs (of any type) were found; however, a negative binomial regression model found that a longer duration of pumping (p = 0.018) and age Insulin pump-associated AEs are very common. However, few variables are predictive of them with no relationships seen with glycaemic control, socio-economic status, pump manufacturer or infusion set type. Based on these findings, AEs should be anticipated in both adults and children, with anticipatory patient education and training recommended for their successful and safe use.

  1. RECAST (Remote Ischemic Conditioning After Stroke Trial): A Pilot Randomized Placebo Controlled Phase II Trial in Acute Ischemic Stroke.

    Science.gov (United States)

    England, Timothy J; Hedstrom, Amanda; O'Sullivan, Saoirse; Donnelly, Richard; Barrett, David A; Sarmad, Sarir; Sprigg, Nikola; Bath, Philip M

    2017-05-01

    Repeated episodes of limb ischemia and reperfusion (remote ischemic conditioning [RIC]) may improve outcome after acute stroke. We performed a pilot blinded placebo-controlled trial in patients with acute ischemic stroke, randomized 1:1 to receive 4 cycles of RIC within 24 hours of ictus. The primary outcome was tolerability and feasibility. Secondary outcomes included safety, clinical efficacy (day 90), putative biomarkers (pre- and post-intervention, day 4), and exploratory hemodynamic measures. Twenty-six patients (13 RIC and 13 sham) were recruited 15.8 hours (SD 6.2) post-onset, age 76.2 years (SD 10.5), blood pressure 159/83 mm Hg (SD 25/11), and National Institutes of Health Stroke Scale (NIHSS) score 5 (interquartile range, 3.75-9.25). RIC was well tolerated with 49 out of 52 cycles completed in full. Three patients experienced vascular events in the sham group: 2 ischemic strokes and 2 myocardial infarcts versus none in the RIC group ( P =0.076, log-rank test). Compared with sham, there was a significant decrease in day 90 NIHSS score in the RIC group, median NIHSS score 1 (interquartile range, 0.5-5) versus 3 (interquartile range, 2-9.5; P =0.04); RIC augmented plasma HSP27 (heat shock protein 27; P stroke is well tolerated and appears safe and feasible. RIC may improve neurological outcome, and protective mechanisms may be mediated through HSP27. A larger trial is warranted. URL: http://www.isrctn.com. Unique identifier: ISRCTN86672015. © 2017 American Heart Association, Inc.

  2. The SWITCH study (sensing with insulin pump therapy to control HbA(1c))

    DEFF Research Database (Denmark)

    Conget, Ignacio; Battelino, Tadej; Giménez, Marga

    2011-01-01

    injections. However, there is still a proportion of subjects using continuous subcutaneous insulin infusion in whom goals for metabolic control are far from achieved or benefits of this type of insulin therapy are transient. The SWITCH (Sensing With Insulin pump Therapy to Control HbA(1c) [hemoglobin A1c...

  3. Studies on impurity control and hydrogen pumping with chromium gettering in ISX-B

    International Nuclear Information System (INIS)

    Mioduszewski, P.; Simpkins, J.E.; Edmonds, P.H.; Isler, R.C.; Lazarus, E.A.; Ma, C.H.; Murakami, M.; Wootton, A.J.

    1984-01-01

    Chromium gettering has been proven to be a trouble-free and efficient method of surface pumping in tokamaks. The impurity control capabilities are excellent and comparable to that of titanium. The hydrogen uptake is reduced to monolayer quantities on the surface. The expansion of the operating space is similar to that seen with titanium without the disadvantage of strongly increased hydrogen fluxes. Possible applications of chromium gettering are: impurity control in contemporary tokamaks; surface pumping in short pulse DT-burning devices to minimize tritium inventory, and wall conditioning of future large machines prior to operation

  4. Efficacy and Safety of Individualized Coaching After Stroke: the LAST Study (Life After Stroke): A Pragmatic Randomized Controlled Trial.

    Science.gov (United States)

    Askim, Torunn; Langhammer, Birgitta; Ihle-Hansen, Hege; Gunnes, Mari; Lydersen, Stian; Indredavik, Bent

    2018-02-01

    The evidence for interventions to prevent functional decline in the long term after stroke is lacking. The aim of this trial was to evaluate the efficacy and safety of an 18-month follow-up program of individualized regular coaching on physical activity and exercise. This was a multicentre, pragmatic, single-blinded, randomized controlled trial. Adults (age ≥18 years) with first-ever or recurrent stroke, community dwelling, with modified Rankin Scale Stroke Impact Scale. Other outcomes were adverse events and compliance to the intervention assessed by training diaries and the International Physical Activity Questionnaire. Three hundred and eighty consenting participants were randomly assigned to individualized coaching (n=186) or standard care (n=194). The mean estimated difference on Motor Assessment Scale in favor of control group was -0.70 points (95% confidence interval, -2.80, 1.39), P =0.512. There were no differences between the groups on Barthel index, modified Rankin Scale, or Berg Balance Scale. The frequency of adverse events was low in both groups. Results from International Physical Activity Questionnaire and training diaries showed increased activity levels but low intensity of the exercise in the intervention group. The regular individualized coaching did not improve maintenance of motor function or the secondary outcomes compared with standard care. The intervention should be regarded as safe. Despite the neutral results, the health costs related to the intervention should be investigated. URL: https://www.clinicaltrials.gov. Unique identifier: NCT01467206. © 2017 American Heart Association, Inc.

  5. Sensorless Sinusoidal Drives for Fan and Pump Motors by V/f Control

    Science.gov (United States)

    Kiuchi, Mitsuyuki; Ohnishi, Tokuo

    This paper proposes sensorless sinusoidal driving methods of permanent magnet synchronous motors for fans and pumps by V/f control. The proposed methods are simple methods that control the motor peak current constant by voltage or frequency control, and are characterized by DC link current detection using a single shunt resistor at carrier wave signal bottom timing. As a result of the dumping factor from square torque load characteristics of fan and pump motors, it is possible to control stable starting and stable steady state by V/f control. In general, pressure losses as a result of the fluid pass of fan and pump systems are nearly constant; therefore, the flow rate and motor torque are determined by revolutions. Accordingly, high efficiency driving is possible by setting corresponding currents to q-axis currents (torque currents) at target revolutions. Because of the simple current detection and motor control methods, the proposed methods are optimum for fan and pump motor driving systems of home appliances.

  6. Sodium pumping: pump problems

    International Nuclear Information System (INIS)

    Guer, M.; Guiton, P.

    Information on sodium pumps for LMFBR type reactors is presented concerning ring pump design, pool reactor pump design, secondary pumps, sodium bearings, swivel joints of the oscillating annulus, and thermal shock loads

  7. Effect of acupuncture on insomnia following stroke: study protocol for a randomized controlled trial.

    Science.gov (United States)

    Cao, Yan; Yin, Xuan; Soto-Aguilar, Francisca; Liu, Yiping; Yin, Ping; Wu, Junyi; Zhu, Bochang; Li, Wentao; Lao, Lixing; Xu, Shifen

    2016-11-16

    The incidence, mortality, and prevalence of stroke are high in China. Stroke is commonly associated with insomnia; both insomnia and stroke have been effectively treated with acupuncture for a long time. The aim of this proposed trial is to assess the therapeutic effect of acupuncture on insomnia following stroke. This proposed study is a single-center, single-blinded (patient-assessor-blinded), parallel-group randomized controlled trial. We will randomly assign 60 participants with insomnia following stroke into two groups in a 1:1 ratio. The intervention group will undergo traditional acupuncture that achieves the De-qi sensation, and the control group will receive sham acupuncture without needle insertion. The same acupoints (DU20, DU24, EX-HN3, EX-HN22, HT7, and SP6) will be used in both groups. Treatments will be given to all participants three times a week for the subsequent 4 weeks. The primary outcome will be the Pittsburgh Sleep Quality Index. The secondary outcomes will be: the Insomnia Severity Index; sleep efficacy, sleep awakenings, and total sleep time recorded via actigraphy; the National Institutes of Health Stroke Scale; the Stroke-Specific Quality of Life score; the Hospital Anxiety and Depression Scale. The use of estazolam will be permitted and regulated under certain conditions. Outcomes will be assessed at baseline, 2 weeks after treatment commencement, 4 weeks after treatment commencement, and at the 8-week follow-up. This proposed study will contribute to expanding knowledge about acupuncture treatment for insomnia following stroke. This will be a high-quality randomized controlled trial with strict methodology and few design deficits. It will investigate the effectiveness of acupuncture as an alternative treatment for insomnia following stroke. Chinese Clinical Trial Registry identifier: ChiCTR-IIC-16008382 . Registered on 28 April 2016.

  8. Visual feedback alters force control and functional activity in the visuomotor network after stroke

    Directory of Open Access Journals (Sweden)

    Derek B. Archer

    2018-01-01

    Full Text Available Modulating visual feedback may be a viable option to improve motor function after stroke, but the neurophysiological basis for this improvement is not clear. Visual gain can be manipulated by increasing or decreasing the spatial amplitude of an error signal. Here, we combined a unilateral visually guided grip force task with functional MRI to understand how changes in the gain of visual feedback alter brain activity in the chronic phase after stroke. Analyses focused on brain activation when force was produced by the most impaired hand of the stroke group as compared to the non-dominant hand of the control group. Our experiment produced three novel results. First, gain-related improvements in force control were associated with an increase in activity in many regions within the visuomotor network in both the stroke and control groups. These regions include the extrastriate visual cortex, inferior parietal lobule, ventral premotor cortex, cerebellum, and supplementary motor area. Second, the stroke group showed gain-related increases in activity in additional regions of lobules VI and VIIb of the ipsilateral cerebellum. Third, relative to the control group, the stroke group showed increased activity in the ipsilateral primary motor cortex, and activity in this region did not vary as a function of visual feedback gain. The visuomotor network, cerebellum, and ipsilateral primary motor cortex have each been targeted in rehabilitation interventions after stroke. Our observations provide new insight into the role these regions play in processing visual gain during a precisely controlled visuomotor task in the chronic phase after stroke.

  9. Telomere length and ischaemic stroke in women: a nested case-control study.

    Science.gov (United States)

    Schürks, M; Prescott, J; Dushkes, R; De Vivo, I; Rexrode, K M

    2013-07-01

    Telomere shortening has been implicated in cardiovascular disease (CVD). However, prospective data on the association between relative telomere length (RTL) and ischaemic stroke are scarce and inconclusive. We used a nested case-control design among women participating in the prospective Nurses' Health Study. Participants provided blood samples in 1990 and were followed till 2006. Women with confirmed incident ischaemic stroke were matched to controls by age, smoking, postmenopausal status and postmenopausal hormone use. Quantitative polymerase chain reaction was used to determine RTL in genomic DNA extracted from peripheral blood leukocytes. Conditional logistic regression was used to determine the risk of ischaemic stroke associated with RTL, using RTL quartiles and as dichotomous according to the median. Data on RTL were available from 504 case-control pairs. Results did not suggest an association between RTL and ischaemic stroke. The odds ratio (OR) for ischaemic stroke was 0.82 [95% confidence interval (CI) 0.52-1.32] comparing lowest with the highest RTL quartile and 0.90 (95% CI 0.65-1.24) comparing RTL below the median with RTL above the median. Associations were unchanged after additional adjustment for cardiovascular risk factors. Further analyses suggested an association between RTL and fatal ischaemic stroke (54 case-control pairs; lowest versus highest quartile OR = 1.99, 95%CI 0.26-14.9); however, results were statistically insignificant. In this large nested case-control study among women RTL was not associated with ischaemic stroke. In light of the varying study results in the literature on the association between telomere length and stroke, additional research is warranted. © 2013 The Author(s) European Journal of Neurology © 2013 EFNS.

  10. Adherence to a DASH-Style Diet in Relation to Stroke: A Case-Control Study.

    Science.gov (United States)

    Niknam, Mahdieh; Saadatnia, Mohammad; Shakeri, Forough; Keshteli, Ammar Hassanzadeh; Saneei, Parvane; Esmaillzadeh, Ahmad

    2015-01-01

    Despite the growing body of evidence from Western societies on the association between dietary patterns and stroke, limited data are available in this regard from developing countries. This study was conducted to examine the association between adherence to the Dietary Approaches to Stop Hypertension (DASH) diet and risk of stroke among the Iranian population. This hospital-based case-control study included 194 stroke patients and 194 controls and was conducted at the Alzahra University Hospital, Isfahan, Iran. The cases were stroke patients who were hospitalized in the neurology ward of the Alzahra University Hospital. Controls were randomly selected from among hospitalized patients in the orthopedic or surgical wards of this center. A validated food frequency questionnaire (FFQ) was used to assess the patients' usual dietary intake. We constructed the DASH diet score based on food and nutrients emphasized or minimized in the DASH diet. The prevalence of stroke among those in the top quartile of the DASH diet score was 40%, which was 15% lower than among those in the bottom quartile; this difference was marginally significant (p = 0.10). After controlling for age, sex, and total energy intake, adherence to the DASH diet was inversely associated with the risk of stroke (OR: 0.52; 95% CI: 0.28; 0.98). These associations remained significant even after additionally controlling for physical activity, smoking, hypertension, and diabetes, such that individuals in the highest quartile of the DASH diet score had a 58% lower risk of stroke than those in the lowest category (OR: 0.48; 95% CI: 0.24, 0.96). However, after further adjustment for body mass index (BMI), the association disappeared (OR: 0.62; 95% CI: 0.29, 1.31), indicating an obesity-dependent association. We found an inverse relationship between the DASH-style diet and prevalence of stroke. Prospective studies are needed to confirm this association.

  11. Impact of Spasticity on Balance Control during Quiet Standing in Persons after Stroke

    Science.gov (United States)

    Mochizuki, George; Ismail, Farooq; Boulias, Chris

    2017-01-01

    Background Balance impairments, falls, and spasticity are common after stroke, but the effect of spasticity on balance control after stroke is not well understood. Methods In this cross-sectional study, twenty-seven participants with stroke were divided into two groups, based on ankle plantar flexor spasticity level. Fifteen individuals with high spasticity (Modified Ashworth Scale (MAS) score of ≥2) and 12 individuals with low spasticity (MAS score spasticity group demonstrated greater ML COP velocity, trunk roll velocity, trunk roll velocity frequency amplitude at 3.7 Hz, and trunk roll velocity frequency amplitude at 4.9 Hz, particularly in the eyes closed condition (spasticity by vision interaction). ML COP MPF was greater in the high spasticity group. Conclusion Individuals with high spasticity after stroke demonstrated greater impairment of balance control in the frontal plane, which was exacerbated when vision was removed. PMID:29098109

  12. Neural network-based control of an intelligent solar Stirling pump

    International Nuclear Information System (INIS)

    Tavakolpour-Saleh, A.R.; Jokar, H.

    2016-01-01

    In this paper, an ANN (artificial neural network) control system is applied to a novel solar-powered active LTD (low temperature differential) Stirling pump. First, a mathematical description of the proposed Stirling pump is presented. Then, optimum operating frequencies of the converter corresponding to different operating conditions (i.e. different sink and source temperatures and water heads) are investigated using the proposed mathematical framework. It is found that the proposed complex mathematical scheme has a very slow convergence and thus, is not appropriate for real-time implementation of the model-based controller. Consequently, a NN (neural network) model with a lower complexity is proposed to learn the simulation data obtained from the mathematical model. The designed neural network controller is thus applied to a digital processor to effectively tune the converter frequency so that a maximum output power is acquired. Finally, the performance of the proposed mechatronic system is evaluated experimentally. The experimental results clearly demonstrate the feasibility of pumping water at low temperature difference under variable operating conditions using the proposed intelligent Stirling converter. - Highlights: • A novel intelligent solar-powered active LTD Stirling pump was introduced. • A neural network controller was used to tune the converter speed. • The intelligent converter was able to adapt itself to different operating conditions. • It was possible to excite the water column with its resonance mode. • Experimental results showed the effectiveness of the proposed converter.

  13. Acceptance Test Procedure for New Pumping Instrumentation and Control Skid Q

    International Nuclear Information System (INIS)

    KOCH, M.R.

    2000-01-01

    This Test Plan provides a test method to dedicate the leak detection relays used on the new Pumping Instrumentation and Control (PIC) skids. The new skids are fabricated on-site. The leak detection system is a safety class system per the Authorization Basis

  14. Acceptance Test Procedure for New Pumping Instrumentation and Control Skid ''P''

    International Nuclear Information System (INIS)

    KOCH, M.R.

    2000-01-01

    This Test Plan provides a test method to dedicate the leak detection relays used on the new Pumping Instrumentation and Control (PIC) skids. The new skids are fabricated on-site. The leak detection system is a safety class system per the Authorization Basis

  15. Test Report for Acceptance Test Procedure for Pumping Instrumentation and Control Skid ''P''

    International Nuclear Information System (INIS)

    KOCH, M.R.

    2000-01-01

    This Acceptance Test Report (ATR) provides the test results for the inspection and testing of the new Pumping Instrumentation and Control (PIC) skid designed as ''P''. The ATR summaries the results and provides a copy of the ATP and inspections in the Appendix

  16. Acceptance Test Procedure for New Pumping Instrumentation and Control Skid ''V''

    International Nuclear Information System (INIS)

    KOCH, M.R.

    2000-01-01

    This Acceptance Test Procedure (ATP) verifies proper construction per the design drawings and tests for proper functioning of the Pumping Instrumentation and Control (PIC) skid ''V''. The scope section lists the systems and functions to be checked. This ATP will be performed at the Site Fabrication Services (SFS) shop upon completion of the construction of the PIC skid

  17. Continuous pumping and control of mesoscopic superposition state in a lossy QED cavity

    OpenAIRE

    de Oliveira, M. C.; Moussa, M. H. Y.; Mizrahi, S. S.

    2000-01-01

    Here we consider the continuous pumping of a dissipative QED cavity and derive the time-dependent density operator of the cavity field prepared initially as a superposition of mesoscopic coherent states. The control of the coherence of this superposition is analyzed considering the injection of a beam of two-level Rydberg atoms through the cavity. Our treatment is compared to other approaches.

  18. Test Report for Acceptance Test Procedure for Pumping Instrumentation and Control Skid L

    International Nuclear Information System (INIS)

    KOCH, M.R.

    1999-01-01

    This is a Test Report for Acceptance Test Procedure (ATP) RPP-5055. This test report provides the results of the inspection and testing of the new Pumping Instrumentation and Control (PIC) skid designed as ''L''. The ATP was successfully completed. A copy of the completed ATP is in the Appendix of this document

  19. A predictive model for smart control of a domestic heat pump and thermal storage

    NARCIS (Netherlands)

    van Leeuwen, Richard Pieter; Gebhardt, I.; de Wit, J.B.; Smit, Gerardus Johannes Maria

    The purpose of this paper is to develop and validate a predictive model of a thermal storage which is charged by a heat pump and used for domestic hot water supply. The model is used for smart grid control purposes and requires measurement signals of flow and temperature at the inlet and outlet of

  20. Performance investigation on a multi-unit heat pump for simultaneous temperature and humidity control

    International Nuclear Information System (INIS)

    Fan, Hongming; Shao, Shuangquan; Tian, Changqing

    2014-01-01

    Highlights: • A multi-unit heat pump is proposed for simultaneous temperature and humidity control. • Condensation heat is non, partly or fully recovered for temperature regulation. • Highly integrated heat pump for residential cooling, dehumidification and heating. • High energy saving potential for all-year-round operation in wet and warm regions. - Abstract: A multi-unit heat pump is presented for simultaneous humidity and temperature control to improve the energy efficiency and the thermal comfort. Two parallel connected condensers are employed in the system, locating at the back of the indoor evaporator and the outdoor unit, respectively. The heat pump can operate in four modes, including heating, cooling and dehumidification without and/or with partial or total condensing heat recovery. The experimental investigation shows that the temperature control capacity is from 3.5 kW for cooling to 3.8 kW for heating with the cooling and heating efficiency higher than 3.5 kW kW −1 , and the dehumidification rate is about 2.0 kg h −1 with the efficiency about 2.0 kg h −1 kW −1 . The supply air temperature and humidity can be simultaneously regulated with high accuracy and high efficiency by adjusting the indoor and/or outdoor air volumes. It provides an integrated and effective solution for simultaneous indoor air temperature and humidity control for all-year-round operation in residential buildings

  1. Test Report for Acceptance Test Procedure for Pumping Instrumentation and Control Skid Q

    International Nuclear Information System (INIS)

    KOCH, M.R.

    2000-01-01

    This Acceptance Test Report (ATR) provides the test results for the inspection and testing of the new Pumping Instrumentation and Control (PIC) skid designed as ''Q''. The ATR summaries the results and provides a copy of the ATP and inspections in the Appendix

  2. Test Report for Acceptance Test Procedure for Pumping Instrumentation and Control Skid L

    Energy Technology Data Exchange (ETDEWEB)

    KOCH, M.R.

    1999-11-09

    This is a Test Report for Acceptance Test Procedure (ATP) RPP-5055. This test report provides the results of the inspection and testing of the new Pumping Instrumentation and Control (PIC) skid designed as ''L''. The ATP was successfully completed. A copy of the completed ATP is in the Appendix of this document.

  3. Test Report for Acceptance Test Procedure for Pumping and Instrumentation Control Skid ''K''

    CERN Document Server

    Johns, B R

    1999-01-01

    This is a Test Report for Acceptance Test Procedure (ATP) HNF-4276. This test report provides the results of the inspection and testing of the new Pumping and Instrumentation Control (PIC) skid designed as ''K''. The ATP was successfully completed. A copy of the completed ATP is in the Appendix of this document.

  4. Test Report for Acceptance Test Procedure for Pumping Instrumentation and Control Skid M

    International Nuclear Information System (INIS)

    KOCH, M.R.

    1999-01-01

    This is a Test Report for Acceptance Test Procedure (ATP) RPP-5073. This test report provides the results of the inspection and testing of the new Pumping Instrumentation and Control (PIC) skid designed as ''M''. The ATP was successfully completed. A copy of the completed ATP is in the Appendix of this document

  5. Randomized controlled trial of early rehabilitation after intracerebral hemorrhage stroke: difference in outcomes within 6 months of stroke.

    Science.gov (United States)

    Liu, Ning; Cadilhac, Dominique A; Andrew, Nadine E; Zeng, Lingxia; Li, Zongfang; Li, Jin; Li, Yan; Yu, Xuewen; Mi, Baibing; Li, Zhe; Xu, Honghai; Chen, Yangjing; Wang, Juan; Yao, Wanxia; Li, Kuo; Yan, Feng; Wang, Jue

    2014-12-01

    Mechanisms, acute management, and outcomes for patients who experience intracerebral hemorrhage may differ from patients with ischemic stroke. Studies of very early rehabilitation have been mainly undertaken in patients with ischemic stroke, and it is unknown if benefits apply to those with intracerebral hemorrhage. We hypothesized that early rehabilitation, within 48 hours of stroke, would improve survival and functional outcomes in patients with intracerebral hemorrhage. This was a multicenter, randomized controlled study, with blinded assessment of outcome at 3 and 6 months. Eligible patients were randomized to receive standard care or standard care plus early rehabilitation. Primary outcome includes survival. Secondary outcomes includes health-related quality of life using the 36-item Short Form Questionnaire, function measured with the modified Barthel Index, and anxiety measured with the Zung Self-Rated Anxiety Scale. Two hundred forty-three of 326 patients were randomized (mean age, 59 years; 56% men). At 6 months, patients receiving standard care were more likely to have died (adjusted hazard ratio, 4.44; 95% confidence interval [CI], 1.24-15.87); for morbidity outcomes, a 6-point difference in the Physical Component Summary score of the 36-item Short Form Questionnaire (95% CI, 4.2-8.7), a 7-point difference for the Mental Component Summary score (95% CI, 4.5-9.5), a 13-point difference in Modified Barthel Index scores (95% CI, 6.8-18.3), and a 6-point difference in Self-Rating Anxiety Scale scores (95% CI, 4.4-8.3) was reported in favor of the intervention groups. For the first time, we have shown that commencing rehabilitation within 48 hours of intracerebral hemorrhage improves survival and functional outcomes at 6 months after stroke in hospitalized patients in China. http://www.chictr.org/en. Unique identifier: ChiCTR-TRC-13004039. © 2014 American Heart Association, Inc.

  6. [Incorrect programming of a target controlled infusion pump. Case SENSAR of the trimester].

    Science.gov (United States)

    2014-10-01

    We report the case of a patient who underwent surgical aortic valve replacement. During general anaesthesia maintenance, the patient received a remifentanyl infusion via a target controlled infusion (TCI) system. The infusion pump that was prepared to deliver the infusion showed malfunction at the beginning of the surgery, so it was quickly replaced with a second pump. After a few minutes into the surgery, the patient presented with hypotension refractory to treatment. The remifentanyl syringe also emptied faster than expected. On reviewing the TCI pump, it was found that it was erroneously programmed for propofol instead of remifentanyl, thus the patient had received a very high dose of remifentanyl that was probably the cause of the haemodynamic disturbances. The incident was an error in equipment use, facilitated by hurry, lack of checking of the equipment prior to its use, and the complex and unclear design of the devices' screens. After analysis of this incident, all TCI pumps were reviewed, and all the programs for infrequently used drugs were deleted. Furthermore, 2 pumps were selected for exclusive use in the cardiac surgery theatre, one with propofol-only programming, and the other with remifentanyl-only programming, both clearly marked and situated in fixed places in that theatre. Copyright © 2014 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Published by Elsevier España. All rights reserved.

  7. Auto-control of pumping operations in sewerage systems by rule-based fuzzy neural networks

    Directory of Open Access Journals (Sweden)

    Y.-M. Chiang

    2011-01-01

    Full Text Available Pumping stations play an important role in flood mitigation in metropolitan areas. The existing sewerage systems, however, are facing a great challenge of fast rising peak flow resulting from urbanization and climate change. It is imperative to construct an efficient and accurate operating prediction model for pumping stations to simulate the drainage mechanism for discharging the rainwater in advance. In this study, we propose two rule-based fuzzy neural networks, adaptive neuro-fuzzy inference system (ANFIS and counterpropagation fuzzy neural network for on-line predicting of the number of open and closed pumps of a pivotal pumping station in Taipei city up to a lead time of 20 min. The performance of ANFIS outperforms that of CFNN in terms of model efficiency, accuracy, and correctness. Furthermore, the results not only show the predictive water levels do contribute to the successfully operating pumping stations but also demonstrate the applicability and reliability of ANFIS in automatically controlling the urban sewerage systems.

  8. Beneficial effects of footbaths in controlling spasticity after stroke

    Science.gov (United States)

    Matsumoto, Shuji; Shimodozono, Megumi; Etoh, Seiji; Shimozono, Yurika; Tanaka, Nobuyuki; Kawahira, Kazumi

    2010-07-01

    Footbaths are considered to provide beneficial thermal therapy for post-stroke patients with spasticity, but their anti-spastic effects have not been investigated comprehensively. The present study aimed to evaluate alterations in motor-neuron excitability using F-wave parameters in post-stroke patients with spastic hemiplegia. Subjects’ legs below the knee joint were immersed in water at 41°C and F-wave recordings were made over the abductor hallucis muscle before, immediately after, and 30 min after thermal treatment. Antidromic stimulation was performed on the tibial nerve at the ankle. Measurements included F-wave amplitude, F-wave/M-response ratio, changes in modified Ashworth scale (MAS), body temperature and surface-skin temperature. The mean values of both F-wave parameters were higher on the affected side before footbath treatment. In post-stroke patients, the mean values of F-wave parameters were significantly reduced after footbath treatment ( P spastic effects of footbath treatment were indicated by decreased F-wave parameters, in parallel with decreases in MAS. Body temperature was significantly increased both immediately after, and 30 min following footbath treatment in both groups, which appeared to play an important role in decreased spasticity. Surface-skin temperature increased immediately after footbath treatment in both groups and returned to baseline 30 min later. These findings demonstrate that the use of footbaths is an effective nonpharmacological anti-spastic treatment that might facilitate stroke rehabilitation.

  9. The Sodium-Potassium Pump Controls the Intrinsic Firing of the Cerebellar Purkinje Neuron

    Science.gov (United States)

    Forrest, Michael D.; Wall, Mark J.; Press, Daniel A.; Feng, Jianfeng

    2012-01-01

    In vitro, cerebellar Purkinje cells can intrinsically fire action potentials in a repeating trimodal or bimodal pattern. The trimodal pattern consists of tonic spiking, bursting, and quiescence. The bimodal pattern consists of tonic spiking and quiescence. It is unclear how these firing patterns are generated and what determines which firing pattern is selected. We have constructed a realistic biophysical Purkinje cell model that can replicate these patterns. In this model, Na+/K+ pump activity sets the Purkinje cell's operating mode. From rat cerebellar slices we present Purkinje whole cell recordings in the presence of ouabain, which irreversibly blocks the Na+/K+ pump. The model can replicate these recordings. We propose that Na+/K+ pump activity controls the intrinsic firing mode of cerbellar Purkinje cells. PMID:23284664

  10. Four-Quadrant Facial Function in Dysphagic Patients after Stroke and in Healthy Controls

    OpenAIRE

    Mary Hägg; Lita Tibbling

    2014-01-01

    This study aims to examine any motility disturbance in any quadrant of the face other than the quadrant innervated by the lower facial nerve contralateral to the cortical lesion after stroke. Thirty-one stroke-afflicted patients with subjective dysphagia, consecutively referred to a swallowing centre, were investigated with a facial activity test (FAT) in all four facial quadrants and with a swallowing capacity test (SCT). Fifteen healthy adult participants served as FAT controls. Sixteen pat...

  11. Noninvasive cardiac event monitoring to detect atrial fibrillation after ischemic stroke: a randomized, controlled trial.

    Science.gov (United States)

    Higgins, Peter; MacFarlane, Peter W; Dawson, Jesse; McInnes, Gordon T; Langhorne, Peter; Lees, Kennedy R

    2013-09-01

    Atrial fibrillation (AF) elevates risk of recurrent stroke but is incompletely identified by standard investigation after stroke, though detection rates correlate with monitoring duration. We hypothesized that 7 days of noninvasive cardiac-event monitoring early after stroke would accelerate detection of AF and thus uptake of effective therapy. We performed a pragmatic randomized trial with objective outcome assessment among patients presenting in sinus rhythm with no AF history, within 7 days of ischemic stroke symptom onset. Patients were randomized to standard practice investigations (SP) to detect AF, or SP plus additional monitoring (SP-AM). AM comprised 7 days of noninvasive cardiac-event monitoring reported by an accredited cardiac electrocardiology laboratory. Primary outcome was detection of AF at 14 days. One-hundred patients were enrolled from 2 centers. Within 14 days of stroke, sustained paroxysms of AF were detected in 18% of patients undergoing SP-AM versus 2% undergoing SP (Pstroke enhances detection of paroxysmal AF and early anticoagulation. Extended monitoring should be offered to all eligible patients soon after acute stroke. Guidelines on investigation for AF in stroke patients could be strengthened. http://www.controlled-trials.com/isrctn/. Unique identifier: ISRCTN97412358.

  12. Dietary habits in patients with ischemic stroke: a case-control study.

    Directory of Open Access Journals (Sweden)

    Ana Rodríguez-Campello

    Full Text Available Diet appears to have some role in stroke development. The objective of our study was to describe the dietary habits in patients admitted with acute ischemic stroke and compare selected dietary components with healthy controls. Adherence to healthy diet behaviors was also assessed.A case-control study of consecutive patients with acute ischemic stroke admitted to the Neurology Department of Hospital del Mar from 2007 to 2010. Patients were matched by age and sex with control subjects. A previously validated nutritional survey was administered to patients and controls. Demographic data, vascular risk factors, caloric intake and dietary nutrients were evaluated. Intention to follow a healthy diet was also assessed in both groups.A total of 300 acute ischemic stroke patients and 300 controls with evaluation of dietary habits. No differences were observed in vascular risk factors, except smoking habit, diabetes and ischemic heart disease. Stroke patients reported a higher caloric intake: 2444.8(1736.8-3244.5 vs 2208.7(1753.1-2860.7 Kcal, p = 0.001. After adjusting for energy intake, patients had higher intake of proteins (p<0.001; OR 1.02, total cholesterol (p = 0.001; OR 1.04, and breaded foods (p = 0.001; OR 1.94 and lower consumption of probiotic yogurt (p = 0.002; OR 0.88. Compared to patients, control participants indicated greater intention to eat vegetables (p = 0.002; OR 1.5 and whole foods (p = 0.000; OR 2.4 and reduce their intake of salt (p = 0.002; OR 1.7, fat (p = 0.000; OR 3.7 and sweets (p = 0.004; OR 1.7 than patients.We observed different dietary patterns between stroke patients and controls. Stroke patients have a higher caloric intake and are less concerned about maintaining healthy nutritional habits.

  13. Serum Taurine and Stroke Risk in Women: A Prospective, Nested Case-Control Study.

    Science.gov (United States)

    Wu, Fen; Koenig, Karen L; Zeleniuch-Jacquotte, Anne; Jonas, Saran; Afanasyeva, Yelena; Wójcik, Oktawia P; Costa, Max; Chen, Yu

    2016-01-01

    Taurine (2-aminoethanesulfonic acid), a conditionally essential sulfur-containing amino acid, is mainly obtained from diet in humans. Experimental studies have shown that taurine's main biological actions include bile salt conjugation, blood pressure regulation, anti-oxidation, and anti-inflammation. We conducted a prospective case-control study nested in the New York University Women's Health Study, a cohort study involving 14,274 women enrolled since 1985. Taurine was measured in pre-diagnostic serum samples of 241 stroke cases and 479 matched controls. There was no statistically significant association between serum taurine and stroke risk in the overall study population. The adjusted ORs for stroke were 1.0 (reference), 0.87 (95% CI, 0.59-1.28), and 1.03 (95% CI, 0.69-1.54) in increasing tertiles of taurine (64.3-126.6, 126.7-152.9, and 153.0-308.5 nmol/mL, respectively). A significant inverse association between serum taurine and stroke risk was observed among never smokers, with an adjusted OR of 0.66 (95% CI, 0.37-1.18) and 0.50 (95% CI, 0.26-0.94) for the second and third tertile, respectively (p for trend = 0.01), but not among past or current smokers (p for interaction taurine and stroke risk, although a protective effect was observed in never smokers, which requires further investigation. Taurine, Stroke, Epidemiology, Prospective, Case-control study, NYUWHS.

  14. microcontroller based automatic control for water pumping machine

    African Journals Online (AJOL)

    user

    arduino Integrated Development Environment (IDE) in C programming Language into the microcontroller for control and coordination of the system functions. The height of tank used for this design is 0.30 metres and using equation 1, the different levels are calculated as shown in table 1. Table 1: Water level sensing.

  15. Energy consumption control in centrifugal pumps; Control del consumo energetico en las bombas centrifugas

    Energy Technology Data Exchange (ETDEWEB)

    Soler Manuel, M.A.

    1997-09-01

    Centrifugal pumps are widely used in Spain for driving water or other liquids, but they are not always operated in the most appropriate way. This gives rise to an additional energy cost of approximately 50.000 million pesetas a year. Two examples of inadequate functioning are given-for flows of 10 l/sec at 60 m water leg and 500 l/sec at 200 m water leg- showing the economic savings from small performance improvements. A graph is used to indicate the performance to be expected from a pump, the pump operating areas and their effect on cavitation, axis deflection, etc. A thermodynamic method is presented based on liquid entry and exit pressure and temperature measurements which enables the pump`s performance to be restored following appropriate repairs. (Author)

  16. Effect of B-vitamin supplementation on stroke: a meta-analysis of randomized controlled trials.

    Directory of Open Access Journals (Sweden)

    Chi Zhang

    Full Text Available BACKGROUND: B vitamins have been extensively used to reduce homocysteine levels; however, it remains uncertain whether B vitamins are associated with a reduced risk of stroke. Our aim was to evaluate the effects of B vitamins on stroke. METHODOLOGY AND PRINCIPAL FINDINGS: We systematically searched PubMed, EmBase, and the Cochrane Central Register of Controlled Trials to identify studies for our analysis. Relative risk (RR was used to measure the effect of B-vitamin supplementation on the risk of stroke. The analysis was further stratified based on factors that could affect the treatment effects. Of the 13,124 identified articles, we included 18 trials reporting data on 57,143 individuals and 2,555 stroke events. B-vitamin supplementation was not associated with a significant reduction in the risk of stroke (RR, 0.91, 95%CI: 0.82-1.01, P = 0.075; RD, -0.003, 95%CI: -0.007-0.001, P = 0.134. Subgroup analyses suggested that B-vitamin supplementation might reduce the risk of stroke if included trials had a man/woman ratio of more than 2 or subjects received dose of folic acid less than 1 mg. Furthermore, in a cumulative meta-analysis for stroke, the originally proposed nonsignificant B-vitamin effect was refuted by the evidence accumulated up to 2006. There is a small effect with borderline statistical significance based on data gathered since 2007. CONCLUSIONS/SIGNIFICANCE: Our study indicates that B-vitamin supplementation is not associated with a lower risk of stroke based on relative and absolute measures of association. Subgroup analyses suggested that B-vitamin supplementation can effectively reduce the risk of stroke if included trials had a man/woman ratio of more than 2 or subjects received dose of folic acid less than 1 mg.

  17. Fuzzy Supervisor Approach Design Based-Switching Controller for Pumping Station: Experimental Validation

    Directory of Open Access Journals (Sweden)

    Wael Chakchouk

    2017-01-01

    Full Text Available This paper proposes a discrete-time switching controller strategy for a hydraulic process pumping station. The proposed solution leads to improving control system performances with two tests: combination of Fuzzy-PD and PI controllers and Fuzzy-PID and PI controllers. The proposed design methodology is based on accurate model for pumping station (PS, which is developed in previous works using Fuzzy-C Means (FCM algorithm. The control law design is based on switching control; a fuzzy supervisor manages the switching from one to another and regulates the rate of participation of each order, in order to satisfy various objectives of a stable pumping station like the asymptotic stability of the tracking error. To validate the proposed solution, experimental tests are made and analyzed. Compared to the conventional PI and fuzzy logic (FL approaches, the results show that the switching controller allows exhibiting excellent transient response over a wide range of operating conditions and especially is easier to be implemented in practice.

  18. Comparative Study on Photovoltaic Pumping Systems Driven by Different Motors Optimized with Sliding Mode Control

    Directory of Open Access Journals (Sweden)

    Abdelhak Bouchakour

    2017-06-01

    Full Text Available This study investigates the performance of three different photovoltaic (PV water pumping systems driven by three types of motors, namely a separately excited DC motor (DCM, an asynchronous motor (ASM, and a permanent magnet synchronous motor (PMSM, via a DC/DC buck-boost converter coupled to a centrifugal pump. The purpose of this study is to implement a fast and robust control for this type of a nonlinear system, controlled by sliding mode (SM. This paper presents an SM control technique for controlling a DC/DC buck-boost converter to transfer the maximum power delivered by the PV generator. Each component is studied and analyzed to simulate the global system in MATLAB/SIMULINK. The three systems are then compared to determine the overall effectiveness of the proposed command. The study concludes that the ASM-driven PV system yields highly favorable results and requires less maintenance compared with other systems.

  19. A fuzzy controller for the VASPS (Vertical Annular Separation and Pumping System) subsea separation and pumping system; Um controlador fuzzy para o sistema de separacao e bombeamento submarino - VASP (Vertical Annular Separation and Pumping System)

    Energy Technology Data Exchange (ETDEWEB)

    Teixeira, Alex F.; Mendes, Jose Ricardo P.; Morooka, Celso K. [Universidade Estadual de Campinas, SP (Brazil). Faculdade de Engenharia Mecanica. Dept. de Engenharia de Petroleo; Estevam, Valdir [PETROBRAS, Rio de Janeiro, RJ (Brazil); Guilherme, Ivan R. [UNESP, Rio Claro, SP (Brazil). Inst. de Geociencias e Ciencias Exatas. Dept. de Estatistica, Matematica Aplicada e Computacao; Rigo, Jose Eduardo [Centro Federal de Educacao Tecnologica no Espirito Santo (CEFETES), Vitoria, ES (Brazil)

    2004-07-01

    In this paper the designs of a fuzzy controller for the VASPS (Vertical Annular Separation and Pumping System) liquid level and separation pressure control are presented, as well as a simulation of its work to evaluate the performance of the controller designed. The VASPS is a two-phase subsea separation and pumping system, which is made up of a separation vessel, where the mixture (liquid and gas) enters and suffers the separation process through three levels, the expansion chamber, the helix and the pool. The liquid inside the pool is taken to the platform using a pump that with a choke control the pool liquid level. The pool liquid level control is necessary because if the level exceeds the maximum value allowed, the liquid can invade the space occupied by the helix and hinder the separation process. An the other hand if the level is below the minimum allowed the pump can be damaged. The separation pressure control is important for operational security and efficiency issues, because when we keep the separation pressure near an optimum value we are maximizing its efficiency. With the controller and the simulator, many simulations of the work of system were made to get results that could be used to evaluate if the designed controller solved the problem and if its performance were satisfactory. After, a PID control system was designed to be used as comparison with the results obtained with the fuzzy controller, since the PID is widely used in the industrial environment. (author)

  20. Control of main risk factors after ischaemic stroke across Europe: data from the stroke-specific module of the EUROASPIRE III survey.

    Science.gov (United States)

    Heuschmann, Peter U; Kircher, Julia; Nowe, Tim; Dittrich, Ralf; Reiner, Zeljko; Cifkova, Renata; Malojcic, Branko; Mayer, Otto; Bruthans, Jan; Wloch-Kopec, Dorota; Prugger, Christof; Heidrich, Jan; Keil, Ulrich

    2015-10-01

    Previous cross-sectional surveys in different European countries within the EUROASPIRE programme demonstrated a high prevalence of modifiable risk factors, unhealthy lifestyles and inadequate drug treatment in coronary heart disease patients. Comparable data for ischaemic stroke patients is lacking. A stroke-specific study module was added to the EUROASPIRE III core survey. This cross-sectional multicentre survey included consecutive patients with first-ever ischaemic stroke from four European countries. Data were obtained from medical records, patient interviews and patient examinations within 6-36 months after the stroke event. Control of modifiable risk factors after stroke was evaluated against contemporary European guidelines. A total of 881 patients was recruited. Median age was 66 years, 37.5% were female; average time from the stroke event to interview was 550 days. At the time of the interview, 17.6% of stroke patients smoked cigarettes, 35.5% had a body mass index ≥30 kg/m(2), 62.4% showed elevated blood pressure and 75.7% exhibited elevated LDL cholesterol levels. Antiplatelet drugs or oral anticoagulants were used by 87.2%, antihypertensive medication by 84.4% and statins by 56.8% of stroke patients. Among patients using antihypertensive drugs and lipid-lowering medication at the time of the interview, 34.3% and 34.4%, respectively, achieved target blood pressure and total cholesterol values according to current European guidelines. The EUROASPIRE III stroke-specific module shows that secondary prevention and risk factor control in patients after ischaemic stroke need to be improved in four European centres at the time of the study since about half of patients are not achieving risk factor targets defined in European guidelines. © The European Society of Cardiology 2014.

  1. Comparison of Risk Factor Control in the Year After Discharge for Ischemic Stroke Versus Acute Myocardial Infarction.

    Science.gov (United States)

    Bravata, Dawn M; Daggy, Joanne; Brosch, Jared; Sico, Jason J; Baye, Fitsum; Myers, Laura J; Roumie, Christianne L; Cheng, Eric; Coffing, Jessica; Arling, Greg

    2018-02-01

    The Veterans Health Administration has engaged in quality improvement to improve vascular risk factor control. We sought to examine blood pressure (stroke or acute myocardial infarction (AMI). We identified patients who were hospitalized (fiscal year 2011) with ischemic stroke, AMI, congestive heart failure, transient ischemic attack, or pneumonia/chronic obstructive pulmonary disease. The primary analysis compared risk factor control after incident ischemic stroke versus AMI. Facilities were included if they cared for ≥25 ischemic stroke and ≥25 AMI patients. A generalized linear mixed model including patient- and facility-level covariates compared risk factor control across diagnoses. Forty thousand two hundred thirty patients were hospitalized (n=75 facilities): 2127 with incident ischemic stroke and 4169 with incident AMI. Fewer stroke patients achieved blood pressure control than AMI patients (64%; 95% confidence interval, 0.62-0.67 versus 77%; 95% confidence interval, 0.75-0.78; P stroke patients (odds ratio, 1.39; 95% confidence interval, 1.21-1.51). There were no statistical differences for AMI versus stroke patients in hyperlipidemia ( P =0.534). Among patients with diabetes mellitus, the odds of glycemic control were lower for AMI than ischemic stroke patients (odds ratio, 0.72; 95% confidence interval, 0.54-0.96). Given that hypertension control is a cornerstone of stroke prevention, interventions to improve poststroke hypertension management are needed. © 2017 The Authors.

  2. Energy Savings and Economics of Advanced Control Strategies for Packaged Heat Pumps

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Weimin; Huang, Yunzhi; Katipamula, Srinivas

    2012-10-31

    Pacific Northwest National Laboratory (PNNL), with funding from the U.S. Department of Energy’s (DOE’s) Building Technologies Program (BTP), evaluated a number of control strategies for packaged cooling equipment that can be implemented in an advanced controller, which can be retrofit into existing packaged heat pump units to improve their operational efficiency. This report documents the results of that analysis.

  3. Operational Test Report (OTR) for U-105 Pumping and Instrumentation and Control (PIC) Skid

    Energy Technology Data Exchange (ETDEWEB)

    KOCH, M.R.

    2000-02-28

    Attached is the completed Operation Test Procedure (OTP-200-004, Rev. A-18). OTP includes a print out of the Programmable Logic Controller (PLC) Ladder Diagram. Ladder Diagram was designed for installation in the PLC used to monitor and control pumping activity for Tank Farm 241-U-105. The completed OTP and OTR are referenced in the IS PIC Skid Configuration Drawing (H-2-829998).

  4. Serum cholinesterase activities distinguish between stroke patients and controls and predict 12-month mortality

    DEFF Research Database (Denmark)

    Ben Assayag, Einor; Shenhar-Tsarfaty, Shani; Ofek, Keren

    2010-01-01

    To date there is no diagnostic biomarker for mild stroke, although elevation of inflammatory biomarkers has been reported at early stages. Previous studies implicated acetylcholinesterase (AChE) involvement in stroke, and circulating AChE activity reflects inflammatory response, since acetylcholine...... suppresses inflammation. Therefore, carriers of polymorphisms that modify cholinergic activity should be particularly susceptible to inflammatory damage. Our study sought diagnostic values of AChE and Cholinergic Status (CS, the total capacity for acetylcholine hydrolysis) in suspected stroke patients....... For this purpose, serum cholinesterase activities, butyrylcholinesterase-K genotype and inflammatory biomarkers were determined in 264 ischemic stroke patients and matched controls during the acute phase. AChE activities were lower (P...

  5. Model Predictive Control Algorithms for Pen and Pump Insulin Administration

    DEFF Research Database (Denmark)

    Boiroux, Dimitri

    parameters are personalized using a priori available patient information. We consider an autoregressive integrated moving average with exogenous input (ARIMAX) model. Wesummarize and the results of the overnight clinical studies conducted at Hvidovre Hospital. Based on these results, we propose improvements...... ARMAX model in which we estimate the parameters of the stochastic part using a Recursive Least Square (RLS) method. We test the controller in a virtual clinic of 100 patients. This virtual clinic is based on the Hovorka model. We consider the case where only half of the bolus is administrated...

  6. A pilot study of factors associated with glycaemic control in adults with Type 1 diabetes mellitus on insulin pump therapy.

    Science.gov (United States)

    Wen, W; Frampton, R; Wright, K; Fattore, S; Shadbolt, B; Perampalam, S

    2016-02-01

    To identify the knowledge and management factors associated with glycaemic control among adults with Type 1 diabetes mellitus treated with insulin pump therapy. A cross-sectional study of adults with Type 1 diabetes mellitus on insulin pump therapy for at least 12 months (n = 50, 18-70 years old) was undertaken between December 2013 and May 2014. A new questionnaire was developed to evaluate participants' knowledge and management related to insulin pump therapy, and were correlated with insulin pump data, HbA1c and frequency of hypoglycaemia. Participants who changed their insulin pump settings when indicated had significantly better glycaemic control than those who did not (P = 0.04). Multivariate logistic regression analysis found that better overall insulin pump therapy management was a significant predictor of better glycaemic control (odds ratio 4.45, 95% confidence interval 1.61-12.3; P = 0.004) after adjusting for potential confounders including age, gender, duration of diabetes and insulin pump therapy. However, overall insulin pump therapy knowledge was not a significant predictor of glycaemic control (P = 0.058). There was no significant association between frequency of hypoglycaemia and insulin pump therapy knowledge or management. We identified some key knowledge and management factors associated with glycaemic control in adults with Type 1 diabetes mellitus on insulin pump therapy using a newly designed questionnaire. The pilot study assessed the clinical utility of this evaluation tool, which may facilitate provision of targeted education to insulin pump therapy users to achieve optimal glycaemic control. © 2015 The Authors. Diabetic Medicine © 2015 Diabetes UK.

  7. Stroke rehabilitation evidence and comorbidity: a systematic scoping review of randomized controlled trials.

    Science.gov (United States)

    Nelson, Michelle L A; McKellar, Kaileah A; Yi, Juliana; Kelloway, Linda; Munce, Sarah; Cott, Cheryl; Hall, Ruth; Fortin, Martin; Teasell, Robert; Lyons, Renee

    2017-07-01

    Most strokes occur in the context of other medical diagnoses. Currently, stroke rehabilitation evidence reviews have not synthesized or presented evidence with a focus on comorbidities and correspondingly may not align with current patient population. The purpose of this review was to determine the extent and nature of randomized controlled trial stroke rehabilitation evidence that included patients with multimorbidity. A systematic scoping review was conducted. Electronic databases were searched using a combination of terms related to "stroke" and "rehabilitation." Selection criteria captured inpatient rehabilitation studies. Methods were modified to account for the amount of literature, classified by study design, and randomized controlled trials (RCTs) were abstracted. The database search yielded 10771 unique articles. Screening resulted in 428 included RCTs. Three studies explicitly included patients with a comorbid condition. Fifteen percent of articles did not specify additional conditions that were excluded. Impaired cognition was the most commonly excluded condition. Approximately 37% of articles excluded patients who had experienced a previous stroke. Twenty-four percent excluded patients one or more Charlson Index condition, and 83% excluded patients with at least one other medical condition. This review represents a first attempt to map literature on stroke rehabilitation related to co/multimorbidity and identify gaps in existing research. Existing evidence on stroke rehabilitation often excluded individuals with comorbidities. This is problematic as the evidence that is used to generate clinical guidelines may not match the patient typically seen in practice. The use of alternate research methods are therefore needed for studying the care of individuals with stroke and multimorbidity.

  8. Cerebral and extracerebral vasoreactivity in symptomatic lacunar stroke patients: a case-control study.

    Science.gov (United States)

    Deplanque, Dominique; Lavallee, Philippa C; Labreuche, Julien; Gongora-Rivera, Fernando; Jaramillo, Arturo; Brenner, David; Abboud, Halim; Klein, Isabelle F; Touboul, Pierre-Jean; Vicaut, Eric; Amarenco, Pierre

    2013-08-01

    Whether cerebral artery endothelial dysfunction is a key factor of symptomatic lacunar stroke and cerebral small vessel disease remains unclear. Cerebral and extracerebral vasoreactivity were measured in 81 patients with recent symptomatic lacunar stroke and in 81 control subjects matched for main vascular risk factors. Cerebral vasoreactivity and carotid endothelial-dependent vasodilation were measured after five-minutes of carbon dioxide-induced hypercapnia. Brachial endothelial-dependent vasodilation was assessed after hyperemia induced by deflating a cuff around the forearm previously inflated to 200 mmHg for four-minutes. Carotid and brachial endothelial-independent vasodilation were measured five-minutes after administration of sublingual nitroglycerin 300 μg. Brain magnetic resonance imaging were analyzed in lacunar stroke patients. One-month after stroke onset, patients had more severely impaired cerebral vasoreactivitys than matched controls (mean ± standard deviation, 14·4 ± 12·1% vs. 19·4 ± 17·4%; P = 0·049). Severe alterations of both carotid and brachial endothelial-dependent and at a lesser degree of carotid and brachial endothelial-independent vasodilation were observed in both groups. After adjustment for confounders, subjects with a cerebral vasoreactivity value in the two lower tertiles (≤19·6%) were more likely to have had a symptomatic lacunar stroke (adjusted odds ratio, 3·78; 95% confidence interval, 1·42 to 10·08; P = 0·008). Only alteration of brachial endothelial-independent vasodilation correlated with parenchymal abnormalities, namely microbleeds and leukoaraiosis. While abnormalities in extracerebral vasoreactivity seem related to vascular risk factors, the severity of endothelial dysfunction in cerebral arteries may be determinant in the occurrence of symptomatic lacunar stroke in patients with small vessel disease. © 2012 The Authors. International Journal of Stroke © 2012 World Stroke

  9. Constant speed control of four-stroke micro internal combustion swing engine

    Science.gov (United States)

    Gao, Dedong; Lei, Yong; Zhu, Honghai; Ni, Jun

    2015-09-01

    The increasing demands on safety, emission and fuel consumption require more accurate control models of micro internal combustion swing engine (MICSE). The objective of this paper is to investigate the constant speed control models of four-stroke MICSE. The operation principle of the four-stroke MICSE is presented based on the description of MICSE prototype. A two-level Petri net based hybrid model is proposed to model the four-stroke MICSE engine cycle. The Petri net subsystem at the upper level controls and synchronizes the four Petri net subsystems at the lower level. The continuous sub-models, including breathing dynamics of intake manifold, thermodynamics of the chamber and dynamics of the torque generation, are investigated and integrated with the discrete model in MATLAB Simulink. Through the comparison of experimental data and simulated DC voltage output, it is demonstrated that the hybrid model is valid for the four-stroke MICSE system. A nonlinear model is obtained from the cycle average data via the regression method, and it is linearized around a given nominal equilibrium point for the controller design. The feedback controller of the spark timing and valve duration timing is designed with a sequential loop closing design approach. The simulation of the sequential loop closure control design applied to the hybrid model is implemented in MATLAB. The simulation results show that the system is able to reach its desired operating point within 0.2 s, and the designed controller shows good MICSE engine performance with a constant speed. This paper presents the constant speed control models of four-stroke MICSE and carries out the simulation tests, the models and the simulation results can be used for further study on the precision control of four-stroke MICSE.

  10. A functional tracking task to assess frontal plane motor control in post stroke gait.

    Science.gov (United States)

    Reissman, Megan E; Dhaher, Yasin Y

    2015-07-16

    The ability to execute appropriate medio-lateral foot placements during gait is thought to require active frontal plane control and to be critical in maintaining upright posture during gait. The aggregate frontal plane metrics of step width and step width variability have been assessed for post-stroke populations, but only under normal walking conditions. However, in the case of stroke, limb specific differences in sensory-motor control are likely. Thus, an investigation of limb specific motor control characteristics under tracking task conditions is needed to appropriately characterize frontal plane sensory-motor control post-stroke. Chronic stroke subjects (n=15) and age matched control subjects (n=10) tracked static, bilateral foot placement targets at self-selected walking speeds and completed a free walking trial. Variability and error of tracking performance were analyzed for step width and foot placement. Stroke subjects demonstrated reduced ability to control step width variability and foot placement variability, compared to control subjects. Step width variability and affected limb foot placement variability were sensitive to task complexity, increasing significantly in response to a decrease in step width target size. These results show that stroke mediated changes in the sensory-motor integration processes are manifested as inter-limb differences in frontal plane motor variability during a gait tracking task, with an additional sensitivity to task complexity. Additionally, the proposed step width tracking paradigm presents a clinically reproducible motor control metric that can be used for diagnostic assessment or as a potential outcome for a gait training regimen. Copyright © 2015 Elsevier Ltd. All rights reserved.

  11. AZ-101 Mixer Pump Demonstration Data Acquisition System and Gamma Cart Data Acquisition Control System Software Configuration Management Plan

    International Nuclear Information System (INIS)

    WHITE, D.A.

    1999-01-01

    This Software Configuration Management Plan (SCMP) provides the instructions for change control of the AZ1101 Mixer Pump Demonstration Data Acquisition System (DAS) and the Sludge Mobilization Cart (Gamma Cart) Data Acquisition and Control System (DACS)

  12. Risk factor management in survivors of stroke: a double-blind, cluster-randomized, controlled trial.

    Science.gov (United States)

    Thrift, Amanda G; Srikanth, Velandai K; Nelson, Mark R; Kim, Joosup; Fitzgerald, Sharyn M; Gerraty, Richard P; Bladin, Christopher F; Phan, Thanh G; Cadilhac, Dominique A

    2014-07-01

    Comprehensive community care has the potential to improve risk factor management of patients with stroke or transient ischaemic attack. The primary aim is to determine the effectiveness of an individualized management program on risk factor management for patients discharged from hospital after stroke. Multicentre, cluster-randomized, controlled trial, with clusters by general practice. Participants are randomized to receive intervention or control after a baseline assessment undertaken after discharge from hospital. The general practice they attend is marked as an intervention or control accordingly. All subsequent participants attending those practices are automatically assigned as intervention or control. Baseline and all outcome assessments, including an analysis of risk factors, are undertaken by assessors blinded to patient randomization. Based on the results of blinded assessments, the individualized management program group will receive targeted advice on how to manage their risk factors using a standardized, evidence-based template to communicate 'ideal' management with their general practitioner. In addition, patients randomized to the individualized management program group will receive counselling and education about stroke risk factor management by an intervention study nurse. Individualized management programs will be reviewed at three-months, six-months, 12 months, and 18 months after stroke, at which times they will be modified if appropriate. Stroke risk management will be evaluated using changes in the Framingham cardiovascular risk score. Analysis will be on an intention-to-treat basis using analysis of covariance or generalized linear model to adjust for baseline risk score and other relevant confounding factors. © 2012 The Authors. International Journal of Stroke © 2012 World Stroke Organization.

  13. 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.

  14. The effects of mirror therapy on the gait of subacute stroke patients: a randomized controlled trial.

    Science.gov (United States)

    Ji, Sang Gu; Kim, Myoung Kwon

    2015-04-01

    To investigate the effect of mirror therapy on the gait of patients with subacute stroke. Randomized controlled experimental study. Outpatient rehabilitation hospital. Thirty-four patients with stroke were randomly assigned to two groups: a mirror therapy group (experimental) and a control group. The stroke patients in the experimental group underwent comprehensive rehabilitation therapy and mirror therapy for the lower limbs. The stroke patients in the control group underwent sham therapy and comprehensive rehabilitation therapy. Participants in both groups received therapy five days per week for four weeks. Temporospatial gait characteristics, such as single stance, stance phase, step length, stride, swing phase, velocity, and cadence, were assessed before and after the four weeks therapy period. A significant difference was observed in post-training gains for the single stance (10.32 SD 4.14 vs. 6.54 SD 3.23), step length (8.47 SD 4.12 vs. 4.83 SD 2.14), and stride length (17.03 SD 6.57 vs 10.54 SD 4.34) between the experimental group and the control group (p two groups on stance phase, swing phase, velocity, cadence, and step width (P > 0.05). We conclude that mirror therapy may be beneficial in improving the effects of stroke on gait ability. © The Author(s) 2014.

  15. Transcranial direct current stimulation in post-stroke dysphagia: a systematic review of randomized controlled trials

    Directory of Open Access Journals (Sweden)

    Kavian Ghandehari

    2016-07-01

    Full Text Available Introduction: The aim of this research was to systematically review all the randomized controlled trials that have evaluated the effect of transcranial direct current stimulation (tDCS on post-stroke dysphagia. Methods: Three electronic databases were searched for relevant articles that were uploaded from their inception to March 2015: PubMed, Cochrane Library (Cochrane Central Register of Controlled Trials, and Scopus. All data was that was related to the location of the cerebrovascular accident (CVA, the parameters of tDCS, post-stroke time to commencement of tDCS, the stimulated hemisphere, stimulation dose, any outcome measurements, and follow-up duration were extracted and assessed. Finally, a number of observations were generated through a qualitative synthesis of the extracted data.Result: Three eligible randomized controlled trials were included in the systematic review. All three trials reported that, in comparison to a placebo, tDCS had a statistically significant effect on post-stroke dysphagia.Discussion: The results of our systematic review suggest that tDCS may represent a promising novel treatment for post-stroke dysphagia. However, to date, little is known about the optimal parameters of tDCS for relieving post-stroke dysphagia. Further studies are warranted to refine this promising intervention by exploring the optimal parameters of tDCS.Conclusion: Since brainstem swallowing centers have bilateral cortical innervations, measures that enhance cortical input and sensorimotor control of brainstem swallowing may facilitate recovery from dysphagia.

  16. Ischaemic stroke in HIV-infected patients: a case-control study.

    Science.gov (United States)

    Silva-Pinto, A; Costa, A; Serrão, R; Sarmento, A; Abreu, P

    2017-03-01

    The aim of the study was to provide insights into the contributions of HIV infection stage, antiretroviral therapy (ART) and vascular risk factors to the occurrence of ischaemic stroke in HIV-infected patients. We performed a case-control study of HIV-infected patients followed in our clinic. We compared patients hospitalized between January 2006 and June 2014 with an ischaemic stroke or transient ischaemic attack to age- and gender-matched controls without stroke. Of 2146 patients followed in our clinic, we included 23 cases (20 men and three women; mean age 51.3 years) and 23 controls. Eighty-three per cent of cases had had a stroke and 17% a transient ischaemic attack. According to the Trial of Org 10172 in Acute Stroke Treatment (TOAST) classification, small-vessel occlusion was the most frequent aetiology, followed by large-artery atherosclerosis and cardioembolism. Compared with controls, stroke was statistically significantly associated with diabetes, smoking and low concentrations of high-density lipoprotein (HDL) cholesterol. Illegal drug use, a low CD4 count and a high viral load were also associated with ischaemic cerebral events. There were no statistically significant differences between cases and controls in Centers for Disease Control and Prevention (CDC) HIV stage, CD4 count nadir and HIV infection time-to-event. No statistically significant differences were found concerning ART or treatment compliance. In our single centre study, we found associations of illegal drug use, HIV replication and some traditional vascular risk factors with the occurrence of ischaemic cerebral events. The paradigm of the care of HIV-infected patients is changing. Concomitant diseases in the ageing patient with HIV infection, including cerebrovascular disease, must also be addressed in view of their impacts on morbidity and mortality. Apart from controlling the HIV infection and immunosuppression with ART, vascular risk factors must also be addressed. © 2016 British HIV

  17. A Pressure Control Method for Emulsion Pump Station Based on Elman Neural Network

    Directory of Open Access Journals (Sweden)

    Chao Tan

    2015-01-01

    Full Text Available In order to realize pressure control of emulsion pump station which is key equipment of coal mine in the safety production, the control requirements were analyzed and a pressure control method based on Elman neural network was proposed. The key techniques such as system framework, pressure prediction model, pressure control model, and the flowchart of proposed approach were presented. Finally, a simulation example was carried out and comparison results indicated that the proposed approach was feasible and efficient and outperformed others.

  18. Prophylactic antibiotics after acute stroke for reducing pneumonia in patients with dysphagia (STROKE-INF): a prospective, cluster-randomised, open-label, masked endpoint, controlled clinical trial.

    Science.gov (United States)

    Kalra, Lalit; Irshad, Saddif; Hodsoll, John; Simpson, Matthew; Gulliford, Martin; Smithard, David; Patel, Anita; Rebollo-Mesa, Irene

    2015-11-07

    Post-stroke pneumonia is associated with increased mortality and poor functional outcomes. This study assessed the effectiveness of antibiotic prophylaxis for reducing pneumonia in patients with dysphagia after acute stroke. We did a prospective, multicentre, cluster-randomised, open-label controlled trial with masked endpoint assessment of patients older than 18 years with dysphagia after new stroke recruited from 48 stroke units in the UK, accredited and included in the UK National Stroke Audit. We excluded patients with contraindications to antibiotics, pre-existing dysphagia, or known infections, or who were not expected to survive beyond 14 days. We randomly assigned the units (1:1) by computer to give either prophylactic antibiotics for 7 days plus standard stroke unit care or standard stroke unit care only to patients clustered in the units within 48 h of stroke onset. We did the randomisation with minimisation to stratify for number of admissions and access to specialist care. Patient and staff who did the assessments and analyses were masked to stroke unit allocation. The primary outcome was post-stroke pneumonia in the first 14 days, assessed with both a criteria-based, hierarchical algorithm and by physician diagnosis in the intention-to-treat population. Safety was also analysed by intention to treat. This trial is closed to new participants and is registered with isrctn.com, number ISRCTN37118456. Between April 21, 2008, and May 17, 2014, we randomly assigned 48 stroke units (and 1224 patients clustered within the units) to the two treatment groups: 24 to antibiotics and 24 to standard care alone (control). 11 units and seven patients withdrew after randomisation before 14 days, leaving 1217 patients in 37 units for the intention-to-treat analysis (615 patients in the antibiotics group, 602 in control). Prophylactic antibiotics did not affect the incidence of algorithm-defined post-stroke pneumonia (71 [13%] of 564 patients in antibiotics group vs 52

  19. New innovative glucose-controlled pump enabling glucose control in a pregnant patitient with diabetes

    DEFF Research Database (Denmark)

    Pilemann-Lyberg, Sascha; Solis, Anette Bratt; Mathiesen, Elisabeth R

    2014-01-01

    Abstract Continuous glucose monitoring enables innovative insulin pumps to stop infusion of insulin at selected blood glucose thresholds. We present the first and successful Danish clinical case using this device, a Medtronics Veo insulin pump, in a patient with numerous cases of severe...... hypoglycaemia during earlier pregnancies. During this treatment insulin infusion was frequently stopped and severe hypoglycaemia prevented in the remaining part of pregnancy...

  20. Ischemic Stroke in Young Adults and Preexisting Psychiatric Disorders: A Nationwide Case-Control Study.

    Science.gov (United States)

    Chiu, Yu-Chuan; Bai, Ya-Mei; Su, Tung-Ping; Chen, Tzeng-Ji; Chen, Mu-Hong

    2015-09-01

    Previous studies showed that psychiatric disorders such as major depression, bipolar disorders, and alcohol misuse are associated with an increased risk of ischemic stroke. However, the link between psychiatric disorders and stroke in the young population is rarely investigated. Using the Taiwan National Health Insurance Research Database, 2063 young adults aged between 18 and 45 years with ischemic stroke and 8252 age- and sex-matched controls were enrolled in our study between 1998 and 2011. Participants who had preexisting psychiatric disorders were identified. After adjusting for preexisting physical disorders and demographic data, patients with ischemic stroke had an increased risk of having preexisting psychiatric disorders, including bipolar disorder (odds ratio [OR]: 2.23, 95% confidence interval [CI]: 1.06∼4.67), unipolar depression (OR: 2.15, 95% CI: 1.62∼2.86), anxiety disorders (OR: 2.63, 95% CI: 1.87∼3.69), and alcohol use disorders (OR: 2.86, 95% CI: 1.79∼4.57). Young ischemic stroke (age ≥30 years) was related to the risk of preexisting unipolar depression (OR: 1.49, 95% CI: 1.05∼2.11), anxiety disorders (OR: 1.99, 95% CI: 1.33∼2.97), and alcohol use disorders (OR: 2.54, 95% CI: 1.55∼4.14); very young stroke (age ischemic stroke at age younger than 45 years had a higher risk of having pre-existing bipolar disorder, unipolar depression, anxiety disorders, and alcohol use disorders than those who did not after adjusting for demographic data and stroke-related medical comorbidities.

  1. Evaluation of Manufacturability of Embedded Sensors and Controls with Canned Rotor Pump System

    Energy Technology Data Exchange (ETDEWEB)

    Kisner, Roger A [ORNL; Fugate, David L [ORNL; Melin, Alexander M [ORNL; Holcomb, David Eugene [ORNL; Wilson, Dane F [ORNL; Silva, Pamela C [ORNL; Cruz Molina, Carola [ORNL

    2013-07-01

    This report documents the current status of fabrication and assembly planning for the magnetic bearing, canned rotor pump being used as a demonstration platform for deeply integrating I&C into nuclear power plant components. The report identifies material choices and fabrication sequences for all of the required parts and the issues that need to be either resolved or accommodated during the manufacturing process. Down selection between material options has not yet been performed. Potential suppliers for all of the necessary materials have also been identified. The assembly evaluation begins by logically subdividing the pump into modules, which are themselves decomposed into individual parts. Potential materials and fabrication processes for each part in turn are then evaluated. The evaluation process includes assessment of the environmental compatibility requirements and the tolerances available for the selected fabrication processes. A description of the pump power/control electronics is also provided. The report also includes exploded views of the modules that show the integration of the various parts into modules that are then assembled to form the pump. Emphasis has been placed on thermal environment compatibility and the part dimensional changes during heat-up. No insurmountable fabrication or assembly challenges have been identified.

  2. Parental involvement buffers associations between pump duration and metabolic control among adolescents with type 1 diabetes.

    Science.gov (United States)

    Wiebe, Deborah J; Croom, Andrea; Fortenberry, Katherine T; Butner, Jonathan; Butler, Jorie; Swinyard, Michael T; Lindsay, Rob; Donaldson, David; Foster, Carol; Murray, Mary; Berg, Cynthia A

    2010-11-01

    To examine pump duration associations with adolescents' metabolic control and whether parental involvement moderated this association. This study used a cross-sectional sample of 10- to 14-year-olds with diabetes (N = 252, 53.6% female) and parents' reported parental involvement; HbA1c was obtained from medical records. Half (50.8%) were on an insulin pump (continuous subcutaneous insulin infusion, CSII), with the remainder prescribed multiple daily injections (MDI). Adolescents on CSII displayed better HbA1c than those on MDI. A curvilinear association revealed that participants on CSII for Parental involvement interacted with pump duration to predict HbA1c. Pump duration was associated with poorer HbA1c only when parents were relatively uninvolved. Within the limitations of a cross-sectional design, data suggest that adolescents on CSII have better HbA1c than those on MDI, but may experience a period of deterioration that can be offset by parental involvement.

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

    Science.gov (United States)

    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.

  4. Long-Term Improvements After Multimodal Rehabilitation in Late Phase After Stroke: A Randomized Controlled Trial.

    Science.gov (United States)

    Bunketorp-Käll, Lina; Lundgren-Nilsson, Åsa; Samuelsson, Hans; Pekny, Tulen; Blomvé, Karin; Pekna, Marcela; Pekny, Milos; Blomstrand, Christian; Nilsson, Michael

    2017-07-01

    Treatments that improve function in late phase after stroke are urgently needed. We assessed whether multimodal interventions based on rhythm-and-music therapy or horse-riding therapy could lead to increased perceived recovery and functional improvement in a mixed population of individuals in late phase after stroke. Participants were assigned to rhythm-and-music therapy, horse-riding therapy, or control using concealed randomization, stratified with respect to sex and stroke laterality. Therapy was given twice a week for 12 weeks. The primary outcome was change in participants' perception of stroke recovery as assessed by the Stroke Impact Scale with an intention-to-treat analysis. Secondary objective outcome measures were changes in balance, gait, grip strength, and cognition. Blinded assessments were performed at baseline, postintervention, and at 3- and 6-month follow-up. One hundred twenty-three participants were assigned to rhythm-and-music therapy (n=41), horse-riding therapy (n=41), or control (n=41). Post-intervention, the perception of stroke recovery (mean change from baseline on a scale ranging from 1 to 100) was higher among rhythm-and-music therapy (5.2 [95% confidence interval, 0.79-9.61]) and horse-riding therapy participants (9.8 [95% confidence interval, 6.00-13.66]), compared with controls (-0.5 [-3.20 to 2.28]); P =0.001 (1-way ANOVA). The improvements were sustained in both intervention groups 6 months later, and corresponding gains were observed for the secondary outcomes. Multimodal interventions can improve long-term perception of recovery, as well as balance, gait, grip strength, and working memory in a mixed population of individuals in late phase after stroke. URL: http//www.ClinicalTrials.gov. Unique identifier: NCT01372059. © 2017 American Heart Association, Inc.

  5. PLC and DTAM Software Programs for Pumping Instrumentation and Control Skid N

    International Nuclear Information System (INIS)

    KOCH, M.R.

    2000-01-01

    This document describe the software programs for the Programmable Logic Controller and the Datable Access Module for Pumping Instrumentation and Control skid ''N''. The Appendices contains copies of the printouts of these software programs. This document describes the software programs for the Allen-Bradley SLC 500 programmable logic controller (PLC) and the Allen-Bradley DTAM PLUS operator interface module used on Pumping Instrumentation and Control (PIC) skid ''N''. The software programs for the SLC 500 and DTAM Plus are based on the core programs provided by Allen-Bradley. The PLC and DTAM software programs on skid ''D'' for SX-104 are the baseline programs. These baselines have been tailored for U-farm skids. The skid ''N'' program for U-109 is similar to the skid ''M'' program for U-102. An Acceptance Test Procedure (ATP) and an Operational Test Procedure (OTP) verify that the software programs meet the specific requirements for U-109 pumping. This document represents the final PLC and DTAM programs for PIC skid ''N'' at U-109. These programs were printed out after the performance of the OTP. The OTP acts as the final qualification test for the software programs. Functional requirements and details of the PLC ladder logic are described in this document. The final programs entered into the PLC and DTAM Plus are included as Appendices to this document

  6. A fuzzy logic controller for hormone administration using an implantable pump

    Science.gov (United States)

    Coles, L. Stephen; Wells, George H., Jr.

    1994-01-01

    This paper describes the requirements for a Fuzzy Logic Controller for the physiologic administration of hormones by means of a FDA-approved surgically implantable infusion pump. Results of a LabVIEW computer simulation for the administration of insulin for diabetic adult patients as well as human growth hormone for pediatric patients are presented. A VHS video tape of the simulation in action has been prepared and is available for viewing.

  7. Risks for Heart Disease & Stroke

    Science.gov (United States)

    ... Risks for Heart Disease & Stroke Risks for Heart Disease & Stroke About 1.5 million heart attacks and strokes ... the Centers for Disease Control and Prevention: Heart Disease Stroke High Blood Pressure Cholesterol Salt Video: Know Your ...

  8. Metabolic control after years of completing a clinical trial on sensor-augmented pump therapy.

    Science.gov (United States)

    Quirós, Carmen; Giménez, Marga; Orois, Aida; Conget, Ignacio

    2015-11-01

    Sensor-augmented pump (SAP) therapy has been shown to be effective and safe for improving metabolic control in patients with type 1 diabetes mellitus (T1DM) in a number of trials. Our objective was to assess glycemic control in a group of T1DM patients on insulin pump or SAP therapy after years of participating in the SWITCH (Sensing With Insulin pump Therapy To Control HbA1c) trial and their return to routine medical monitoring. A retrospective, observational study of 20 patients who participated in the SWITCH trial at our hospital from 2008 to 2010. HbA1c values were compared at the start, during (at the end of the periods with/without SAP use - Sensor On/Sensor Off period respectively - of the cross-over design), and 3 years after study completion. HbA1c values of patients who continued SAP therapy (n=6) or only used insulin pump (n=14) were also compared. Twenty patients with T1DM (44.4±9.3 years, 60% women, baseline HbA1c level 8.43±0.55%) were enrolled into the SWITCH study). Three years after study completion, HbA1c level was 7.79±0.77 in patients on pump alone, with no significant change from the value at the end of the Off period of the study (7.85±0.57%; p=0.961). As compared to the end of the On period, HbA1c worsened less in patients who remained on SAP than in those on pump alone (0.18±0.42 vs. 0.55±0.71%; p=0.171), despite the fact that levels were similar at study start (8.41±0.60 vs. 8.47±0.45; p=0.831) and at the end of the On period (7.24±0.48 vs. 7.38±0.61; p=0.566). Frequency of CGM use in patients who continued SAP therapy was high (61.2% of the time in the last 3 months). Our study suggests that the additional benefit of SAP therapy achieved in a clinical trial may persist in the long term in routine clinical care of patients with T1DM. Copyright © 2015 SEEN. Published by Elsevier España, S.L.U. All rights reserved.

  9. Sensor-augmented pump therapy lowers HbA(1c) in suboptimally controlled Type 1 diabetes; a randomized controlled trial

    DEFF Research Database (Denmark)

    Hermanides, J; Nørgaard, K; Bruttomesso, D

    2011-01-01

    To investigate the efficacy of sensor-augmented pump therapy vs. multiple daily injection therapy in patients with suboptimally controlled Type 1 diabetes.......To investigate the efficacy of sensor-augmented pump therapy vs. multiple daily injection therapy in patients with suboptimally controlled Type 1 diabetes....

  10. Clinical evaluation of the use of a multifunctional remotely controlled insulin pump: multicenter observational study.

    Science.gov (United States)

    Boizel, Robert; Pinget, Michel; Lachgar, Karim; Parkin, Christopher G; Grulet, Hervé; Guillon-Metz, Françoise; Weissmann, Joerg

    2014-11-01

    Current insulin pumps now feature advanced functions for calculating insulin dosages, delivering insulin and analyzing data, however, the perceived usefulness of these functions in clinical settings has not been well studied. We assessed the use and patient perceptions of an insulin delivery system (Accu-Chek® Combo, Roche Diagnostics, Mannheim, Germany) that combines an insulin pump and a handheld multifunctional blood glucose meter with integrated remote control functions. This prospective, observational, multicenter study enrolled 74 type 1 diabetes patients within 13 weeks after starting use of the pump system. At 4 to 24 weeks, investigators collected usage data from the latest 14-day period. Seventy-two patients completed the evaluation, aged 39 ± 15 years, diabetes duration 16 ± 13 years, HbA1c 8.3 ± 1.6%. At follow-up, 62 (86.1%) patients used the remote control for ≥50% of all boluses, 20 (27.8%) used the bolus advisor for ≥50% of all boluses, and 42 (58.3%) viewed at least 1 of the e-logbook reports. More than 95% of users appraised the functions as easy-to-use and useful; median scores from VAS (0 = useless to 100 = indispensable) ranged from 72 to 85. A high percentage of study patients used the system's advanced features, especially the remote control feature for bolusing. Overall, patients assessed the functions as useful and easy to use. Results support the implementation of these smart capabilities in further insulin pump developments. © 2014 Diabetes Technology Society.

  11. Risk factors for ischaemic and intracerebral haemorrhagic stroke in 22 countries (the INTERSTROKE study): a case-control study

    DEFF Research Database (Denmark)

    O'Donnell, M.J.; Serpault, Damien Xavier; Xiufeng, Liu

    2010-01-01

    Background The contribution of various risk factors to the burden of stroke worldwide is unknown, particularly in countries of low and middle income. We aimed to establish the association of known and emerging risk factors with stroke and its primary subtypes, assess the contribution of these risk...... factors to the burden of stroke, and explore the differences between risk factors for stroke and myocardial infarction. Methods We undertook a standardised case-control study in 22 countries worldwide between March 1, 2007, and April 23, 2010. Cases were patients with acute first stroke (within 5 days...... of symptoms onset and 72 h of hospital admission). Controls had no history of stroke, and were matched with cases for age and sex. All participants completed a structured questionnaire and a physical examination, and most provided blood and urine samples. We calculated odds ratios (ORs) and population...

  12. Fuzzy sliding mode control for maximum power point tracking of a photovoltaic pumping system

    Directory of Open Access Journals (Sweden)

    Sabah Miqoi

    2017-03-01

    Full Text Available In this paper a new maximum power point tracking method based on fuzzy sliding mode control is proposed, and employed in a PV water pumping system based on a DC-DC boost converter, to produce maximum power from the solar panel hence more speed in the DC motor and more water quantity. This method combines two different tracking techniques sliding mode control and fuzzy logic; our controller is based on sliding mode control, then to give better stability and enhance the power production a fuzzy logic technique was added. System modeling, sliding method definition and the new control method presentation are represented in this paper. The results of the simulation that are compared to both sliding mode controller and perturbation and observation method demonstrate effectiveness and robustness of the proposed controller.

  13. Modeling and dynamic control simulation of unitary gas engine heat pump

    International Nuclear Information System (INIS)

    Zhao Yang; Haibo Zhao; Zheng Fang

    2007-01-01

    Based on the dynamic model of the gas engine heat pump (GEHP) system, an intelligent control simulation is presented to research the dynamic characteristics of the system in the heating operation. The GEHP system simulation model consists of eight models for its components including a natural gas engine, a compressor, a condenser, an expansion valve, an evaporator, a cylinder jacket heat exchanger, an exhaust gas heat exchanger and an auxiliary heater. The intelligent control model is composed of the prediction controller model and the combined controller model. The Runge-Kutta Fehlberg fourth-fifth order algorithms are used to solve the differential equations. The results show that the model is very effective in analyzing the effects of the control system, and the steady state accuracy of the intelligent control scheme is higher than that of the fuzzy controller

  14. A new technique to control brushless motor for blood pump application.

    Science.gov (United States)

    Fonseca, Jeison; Andrade, Aron; Nicolosi, Denys E C; Biscegli, José F; Legendre, Daniel; Bock, Eduardo; Lucchi, Júlio César

    2008-04-01

    This article presents a back-electromotive force (BEMF)-based technique of detection for sensorless brushless direct current motor (BLDCM) drivers. The BLDCM has been chosen as the energy converter in rotary or pulsatile blood pumps that use electrical motors for pumping. However, in order to operate properly, the BLDCM driver needs to know the shaft position. Usually, that information is obtained through a set of Hall sensors assembled close to the rotor and connected to the electronic controller by wires. Sometimes, a large distance between the motor and controller makes the system susceptible to interference on the sensor signal because of winding current switching. Thus, the goal of the sensorless technique presented in this study is to avoid this problem. First, the operation of BLDCM was evaluated on the electronic simulator PSpice. Then, a BEMF detector circuitry was assembled in our laboratories. For the tests, a sensor-dependent system was assembled where the direct comparison between the Hall sensors signals and the detected signals was performed. The obtained results showed that the output sensorless detector signals are very similar to the Hall signals at speeds of more than 2500 rpm. Therefore, the sensorless technique is recommended as a responsible or redundant system to be used in rotary blood pumps.

  15. Controlled X-ray pumping in a wide range of piezo-electric oscillation frequencies

    CERN Document Server

    Navasardyan, M A; Galoyan, K G

    1986-01-01

    In case of Laue diffraction the transmitted X-ray reflection in shown to be effectively controllable in the perfect quartz single crystal when it generates ultrasonic oscillations at the resonance frequency or in its vicinity. The maximum effective amplitude of applied sinusoidal oscillations is equal to 70 V. The pumping degree depends on the voltage amplitude. In this work monochromatic K subalpha sub 1 and K subalpha sub 2 molybdenum lines satisfying the thin crystal condition, mu t<=1, are used (mu is the linear absorption coefficient of the sample for the given wavelength and t is its thickness). The radiation was reflected from different planes such as (1011), (1011), (2022) etc. The complete pumping strongly restricts the structural factor possibilities in estimating the intensity of diffracted X-rays in case of considerable deformations in the bulk of perfect single crystal.

  16. A Polymer Film Dye Laser with Spatially Modulated Emission Controlled by Transversely Distributed Pumping

    Directory of Open Access Journals (Sweden)

    Zurab V. Wardosanidze

    2016-01-01

    Full Text Available Spatial modulation of laser emission controlled by the structure of excitation light field was demonstrated. A dye doped polymer film as an active medium was sandwiched between two laser mirrors forming a laser cell. The pumping was performed by an interference pattern formed with two mutually coherent beams of the second harmonic of a Q-switched Nd:YAG laser (532 nm and located in the plane of the laser cell. The laser emission was observed normally on the plane of the cell. The cross section of the obtained laser emission was modulated in intensity with an interval between maximums depending on the period of the pumping interference pattern. Thus, the emitted light field qualitatively looks like diffraction from an elementary dynamic hologram, that is, a holographic diffraction grating.

  17. Serum Taurine and Stroke Risk in Women: A Prospective, Nested Case-Control Study

    Science.gov (United States)

    Wu, Fen; Koenig, Karen L.; Zeleniuch-Jacquotte, Anne; Jonas, Saran; Afanasyeva, Yelena; Wójcik, Oktawia P.; Costa, Max; Chen, Yu

    2016-01-01

    Background Taurine (2-aminoethanesulfonic acid), a conditionally essential sulfur-containing amino acid, is mainly obtained from diet in humans. Experimental studies have shown that taurine’s main biological actions include bile salt conjugation, blood pressure regulation, anti-oxidation, and anti-inflammation. Methods We conducted a prospective case-control study nested in the New York University Women’s Health Study, a cohort study involving 14,274 women enrolled since 1985. Taurine was measured in pre-diagnostic serum samples of 241 stroke cases and 479 matched controls. Results There was no statistically significant association between serum taurine and stroke risk in the overall study population. The adjusted ORs for stroke were 1.0 (reference), 0.87 (95% CI, 0.59–1.28), and 1.03 (95% CI, 0.69–1.54) in increasing tertiles of taurine (64.3–126.6, 126.7–152.9, and 153.0–308.5 nmol/mL, respectively). A significant inverse association between serum taurine and stroke risk was observed among never smokers, with an adjusted OR of 0.66 (95% CI, 0.37–1.18) and 0.50 (95% CI, 0.26–0.94) for the second and third tertile, respectively (p for trend = 0.01), but not among past or current smokers (p for interaction taurine and stroke risk, although a protective effect was observed in never smokers, which requires further investigation. Taurine, Stroke, Epidemiology, Prospective, Case-control study, NYUWHS. PMID:26866594

  18. Factors associated with glycemic control in adult type 1 diabetes patients treated with insulin pump therapy.

    Science.gov (United States)

    Matejko, Bartłomiej; Skupien, Jan; Mrozińska, Sandra; Grzanka, Małgorzata; Cyganek, Katarzyna; Kiec-Wilk, Beata; Malecki, Maciej T; Klupa, Tomasz

    2015-02-01

    Continuous subcutaneous insulin infusion (CSII) by insulin pump seems to improve glycemia and quality of life as compared to conventional insulin therapy in type 1 diabetes (T1DM). However, while many T1DM subjects achieve excellent glycemic control, some others cannot reach recommended goals. In a retrospective analysis, we searched for factors associated with glycemic control in T1DM patients treated with insulin pump therapy. Data from 192 patients (133 women and 59 men) treated with personal insulin pumps at the Department of Metabolic Diseases, University Hospital, Krakow, Poland were analyzed. Sources of information included medical records, memory read-outs from insulin pumps and data from glucose meters. Univariate, multivariate linear and logistic regression analysis for the association with hemoglobin A1c (HbA1c) level were performed. The mean age of the subjects was 28.9 (±11.2) years, the mean duration of T1DM-14.6 (±7.6) years, mean body mass index-23.5 (±3.1) kg/m2. The mean HbA1c level in the entire study group was 7.4% (57 mmol/mol). In the multivariate linear regression analysis, HbA1c correlated with the mean number of daily blood glucose measurements, number of hypoglycemic episodes per 100 blood glucose measurements, age at the examination, and continuous glucose monitoring system use. Multivariate logistic regression analysis for reaching the therapeutic target of HbA1cpump-treated T1DM subjects.

  19. Simultaneous control of drying temperature and superheat for a closed-loop heat pump dryer

    International Nuclear Information System (INIS)

    Yang, Zhao; Zhu, Zongsheng; Zhao, Feng

    2016-01-01

    Highlights: • In a closed-loop heat pump drying system, the drying process is divided into two processes: heating and cooling. • A simultaneous control strategy is proposed to improve the precision of superheat and drying temperature. • Two distinct fuzzy controllers are employed to achieve more stable drying temperature. • The superheat controller is mainly composed of a PID controller and a conversion emergency controller. • The experimental data show that the simultaneous controller decreases the nonlinearities of superheat and drying temperature. - Abstract: Closed-loop heat pump drying system has its particular characteristics, and in this paper a simultaneous control strategy is proposed to improve the precision of superheat and drying temperature. The stability of drying temperature guarantees the quality of drying material. And on the premise, superheat should be accurate and stable to improve energy usage. Two fuzzy controllers employing different membership functions and control rules are used to achieve more stable drying temperature. The superheat controller is mainly composed of a PID controller and a conversion emergency controller which accelerates the response of electronic expansion valve. The experimental results show that the temperatures at the outlet of indoor and outdoor condensers give smaller fluctuations. The variations of superheat are investigated when the temperature of drying chamber changes from ambient temperature to 25/30 °C, from 25 to 30 °C and from 30 to 25 °C, respectively. All the experimental data confirm that the new controller is applicable to decrease the nonlinearities of superheat and drying temperature.

  20. Control over the Dissociation of Highly Excited Oxygen in Attosecond XUV Pump- IR Probe experiments

    Science.gov (United States)

    Timmers, Henry; Shivaram, Niranjan; Sandhu, Arvinder

    2013-05-01

    We present results on the phase and amplitude control over the photodissociation yield of O2+ in a pump-probe experiment. Using an attosecond pulse train, we create excited state wavepackets along both the B and c state pathways of O2+. We use a two-IR pulse probe to steer the wavepacket. By tuning the excitation spectrum and phase between the two IR pulses, we find we can modulate the dissociated O+ yield with the frequency of IR intensity modulation and control the phase difference between the two dissociation pathways. This work was supported by NSF grant PHY-0955274.

  1. Effects of Ankle Kinesio Taping on Postural Control in Stroke Patients.

    Science.gov (United States)

    Rojhani-Shirazi, Zahra; Amirian, Shiva; Meftahi, Narges

    2015-11-01

    To investigate the effects of kinesio taping on postural control in stroke patients. Forty stroke patients aged 30 to 60 years were randomly divided into an experimental and a control group. In the experimental group, kinesio tape (KT) was applied directly on the skin over the affected ankle in the direction of dorsiflexion and eversion to correct the equinovarus deformity. The tape was kept on the ankle for 1 day. The results were measured with the forward reach test, lateral reach test, Berg Balance Scale (BBS), and timed up and go test. Center of pressure (COP) displacement and velocity were also measured while the patients stood on a force plate. All variables were measured on the first day immediately after taping and 24 hours later in the KT group, and on the first day and also 24 hours later in the control group. There was a statistically significant difference in BBS between the first day and 24 hours later in the KT group (P = .01). The forward reach test and mediolateral displacement of the COP differed significantly after taping in the experimental group compared to the control group (P = .04). Immediately after taping, BBS improved significantly in the KT group (P = .02). The application of KT improved forward reach test results and displacement of the COP in stroke patients. Copyright © 2015 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  2. Effects of circuit training as alternative to usual physiotherapy after stroke: randomised controlled trial

    NARCIS (Netherlands)

    van de Port, I.G.L.; Wevers, L.E.G.; Lindeman, E.; Kwakkel, G.

    2012-01-01

    Objective: To analyse the effect of task oriented circuit training compared with usual physiotherapy in terms of self reported walking competency for patients with stroke discharged from a rehabilitation centre to their own home. Design: Randomised controlled trial with follow-up to 24 weeks.

  3. Arm Motor Control as Predictor for Hypertonia After Stroke : A Prospective Cohort Study

    NARCIS (Netherlands)

    de Jong, Lex D.; Hoonhorst, Maurits H.; Stuive, Ilse; Dijkstra, Pieter U.

    de Jong LD, Hoonhorst MH, Stuive 1, Dijkstra PU. Arm motor control as predictor for hypertonia after stroke: a prospective cohort study. Arch Phys Med Rehabil 2011;92:1411-7. Objectives: To analyze the development of hypertonia in the hemiparetic elbow flexors, and to explore the predictive value of

  4. Rationale and design of INTERSTROKE: a global case-control study of risk factors for stroke

    DEFF Research Database (Denmark)

    O'Donnell, M; Serpault, Damien Xavier; Diener, C

    2010-01-01

    Stroke is a major global health problem. It is the third leading cause of death and the leading cause of adult disability. INTERHEART, a global case-control study of acute myocardial infarction in 52 countries (29,972 participants), identified nine modifiable risk factors that accounted for >90% ...

  5. Capture, learning, and classification of upper extremity movement primitives in healthy controls and stroke patients.

    Science.gov (United States)

    Guerra, Jorge; Uddin, Jasim; Nilsen, Dawn; Mclnerney, James; Fadoo, Ammarah; Omofuma, Isirame B; Hughes, Shatif; Agrawal, Sunil; Allen, Peter; Schambra, Heidi M

    2017-07-01

    There currently exist no practical tools to identify functional movements in the upper extremities (UEs). This absence has limited the precise therapeutic dosing of patients recovering from stroke. In this proof-of-principle study, we aimed to develop an accurate approach for classifying UE functional movement primitives, which comprise functional movements. Data were generated from inertial measurement units (IMUs) placed on upper body segments of older healthy individuals and chronic stroke patients. Subjects performed activities commonly trained during rehabilitation after stroke. Data processing involved the use of a sliding window to obtain statistical descriptors, and resulting features were processed by a Hidden Markov Model (HMM). The likelihoods of the states, resulting from the HMM, were segmented by a second sliding window and their averages were calculated. The final predictions were mapped to human functional movement primitives using a Logistic Regression algorithm. Algorithm performance was assessed with a leave-one-out analysis, which determined its sensitivity, specificity, and positive and negative predictive values for all classified primitives. In healthy control and stroke participants, our approach identified functional movement primitives embedded in training activities with, on average, 80% precision. This approach may support functional movement dosing in stroke rehabilitation.

  6. Follow-up services for stroke survivors after hospital discharge--a randomized control study

    DEFF Research Database (Denmark)

    Andersen, Hanne Elkjaer; Eriksen, Karen; Brown, Anne

    2002-01-01

    OBJECTIVE: To evaluate whether follow-up services for stroke survivors could improve functional outcome and reduce readmission rate. In this paper results of functional outcome are reported. DESIGN: Randomized controlled trial allocating patients to one of three different types of aftercare: (1......) follow-up home visits by a physician, (2) physiotherapist instruction in the patient's home, or (3) standard aftercare. SUBJECTS: Stroke patients with persisting impairment and disability who, after completing inpatient rehabilitation, were discharged to their homes. OUTCOME MEASURES: Six months after...... discharge, functional outcome was assessed with Functional Quality of Movement, Barthel Index, Frenchay Activity Index and Index of Extended Activites of Daily Living. RESULTS: One-hundred and fifty-five stroke patients were included in the study. Fifty-four received follow-up home visits by a physician, 53...

  7. Establishment of a low recycling state with full density control by active pumping of the closed helical divertor at LHD

    Science.gov (United States)

    Motojima, G.; Masuzaki, S.; Tanaka, H.; Morisaki, T.; Sakamoto, R.; Murase, T.; Tsuchibushi, Y.; Kobayashi, M.; Schmitz, O.; Shoji, M.; Tokitani, M.; Yamada, H.; Takeiri, Y.; The LHD Experiment Group

    2018-01-01

    Superior control of particle recycling and hence full governance of plasma density has been established in the Large Helical Device (LHD) using largely enhanced active pumping of the closed helical divertor (CHD). In-vessel cryo-sorption pumping systems inside the CHD in five out of ten inner toroidal divertor sections have been developed and installed step by step in the LHD. The total effective pumping speed obtained was 67  ±  5 m3 s‑1 in hydrogen, which is approximately seven times larger than previously obtained. As a result, a low recycling state was observed with CHD pumping for the first time in LHD featuring excellent density control even under intense pellet fueling conditions. A global particle confinement time (τ p* ) is used for comparison of operation with and without the CHD pumping. The τ p* was evaluated from the density decay after the fueling of hydrogen pellet injection or gas puffing in NBI plasmas. A reliably low base density before the fueling and short τ p* after the fueling were obtained during the CHD pumping, demonstrating for the first time full control of the particle balance with active pumping in the CHD.

  8. Effects of Normobaric Hyperoxia in Severe Acute Stroke: a Randomized Controlled Clinical Trial Study.

    Science.gov (United States)

    Mazdeh, Mehrdokht; Taher, Abbas; Torabian, Saadat; Seifirad, Soroush

    2015-11-01

    Oxygen therapy might increase damaged tissue oxygenation, turn on the aerobic pathway, and save neurons from death and could improve clinical outcome of the patients with stroke and head trauma. Hyperbaric oxygen therapy is accompanied by some unfavorable effects. Results of normobaric oxygen therapy on clinical outcomes of patients with stroke were controversial up till now.  This study was therefore designed to evaluate effects of normobaric hyperoxia on clinical outcomes of patients with severe acute stroke. A total of 52 consecutive patients with stroke who meet the inclusion criteria of the study were entered into this randomized controlled clinical trial. The patients in the case group underwent oxygen therapy with Venturi mask for first 12 hours of admission. The patients were examined for neurologic defects at the time of discharge and after six months using both Barthel and modified Rankin Scale (mRS) neurologic disability scoring systems. There was no significant sex difference between the two groups (P=0.5). There was no statistically significant difference between ischemic-hemorrhagic stroke constitutions of two groups (P=0.2). There were no significant difference in Barthel index scores of both groups at the time of discharge as well as the follow-up examination (P=0.7) According to the mRS scoring system, there was no difference between the patients of both groups at the time of admission (P= 0.8), however after treatment there was a significant difference between mRS scores of the treated group compared to the controls (P=0.04). According to the results of this study, normobaric oxygen therapy in the first 12 hours of accident could improve long time outcome of the patients with either ischemic or hemorrhagic stroke.

  9. Art participation for psychosocial wellbeing during stroke rehabilitation: a feasibility randomised controlled trial.

    Science.gov (United States)

    Morris, Jacqui H; Kelly, Chris; Joice, Sara; Kroll, Thilo; Mead, Gillian; Donnan, Peter; Toma, Madalina; Williams, Brian

    2017-08-30

    To examine the feasibility of undertaking a pragmatic single-blind randomised controlled trial (RCT) of a visual arts participation programme to evaluate effects on survivor wellbeing within stroke rehabilitation. Stroke survivors receiving in-patient rehabilitation were randomised to receive eight art participation sessions (n = 41) or usual care (n = 40). Recruitment, retention, preference for art participation and change in selected outcomes were evaluated at end of intervention outcome assessment and three-month follow-up. Of 315 potentially eligible participants 81 (29%) were recruited. 88% (n = 71) completed outcome and 77% (n = 62) follow-up assessments. Of eight intervention group non-completers, six had no preference for art participation. Outcome completion varied between 97% and 77%. Running groups was difficult because of randomisation timing. Effectiveness cannot be determined from this feasibility study but effects sizes suggested art participation may benefit emotional wellbeing, measured on the positive and negative affect schedule, and self-efficacy for Art (d = 0.24-0.42). Undertaking a RCT of art participation within stroke rehabilitation was feasible. Art participation may enhance self-efficacy and positively influence emotional wellbeing. These should be outcomes in a future definitive trial. A cluster RCT would ensure art groups could be reliably convened. Fewer measures, and better retention strategies are required. Implications for Rehabilitation This feasibility randomised controlled trial (RCT) showed that recruiting and retaining stroke survivors in an RCT of a visual arts participation intervention within stroke rehabilitation was feasible. Preference to participate in art activities may influence recruitment and drop-out rates, and should be addressed and evaluated fully. Art participation as part of rehabilitation may improve some aspects of post-stroke wellbeing, including positive affect and self-efficacy for art

  10. Fast-responsive hydrogel as an injectable pump for rapid on-demand fluidic flow control.

    Science.gov (United States)

    Luo, Rongcong; Dinh, Ngoc-Duy; Chen, Chia-Hung

    2017-05-01

    Chemically synthesized functional hydrogels have been recognized as optimized soft pumps for on-demand fluidic regulation in micro-systems. However, the challenges regarding the slow responses of hydrogels have very much limited their application in effective fluidic flow control. In this study, a heterobifunctional crosslinker (4-hydroxybutyl acrylate)-enabled two-step hydrothermal phase separation process for preparing a highly porous hydrogel with fast response dynamics was investigated for the fabrication of novel microfluidic functional units, such as injectable valves and pumps. The cylinder-shaped hydrogel, with a diameter of 9 cm and a height of 2.5 cm at 25 °C, achieved a size reduction of approximately 70% in less than 30 s after the hydrogels were heated at 40 °C. By incorporating polypyrrole nanoparticles as photothermal transducers, a photo-responsive composite hydrogel was approached and exhibited a remotely triggerable fluidic regulation and pumping ability to generate significant flows, showing on-demand water-in-oil droplet generation by laser switching, whereby the droplet size could be tuned by adjusting the laser intensity and irradiation period with programmable manipulation.

  11. Immediate therapeutic effect of interferential current therapy on spasticity, balance, and gait function in chronic stroke patients: a randomized control trial.

    Science.gov (United States)

    Suh, Hye Rim; Han, Hee Chul; Cho, Hwi-Young

    2014-09-01

    To determine whether a single trial of interferential current therapy (ICT) can immediately alleviate spasticity and improve balance and gait performance in patients with chronic stroke. Randomized, placebo-controlled clinical trial. Inpatient rehabilitation in a local center. A total of 42 adult patients with chronic stroke with plantar flexor spasticity of the lower limb. The ICT group received a single 60-minute ICT stimulation of the gastrocnemius in conjunction with air-pump massage. In the placebo-ICT group, electrodes were placed and air-pump massage performed without electrical stimulation. After a single ICT application, spasticity was measured immediately using the Modified Ashworth Scale (MAS), and balance and functional gait performance were assessed using the following clinical tools: Functional Reach Test (FRT), Berg Balance Scale (BBS), Timed Up and Go Test (TUG), and 10-m Walk Test (10MWT). Gastrocnemius spasticity significantly decreased in the ICT group than in the placebo-ICT group (MAS: ICT vs placebo-ICT: 1.55±0.76 vs 0.40±0.50). The ICT group showed significantly greater improvement in balance and gait abilities than the placebo-ICT group (FRT: 2.62±1.21 vs 0.61±1.34, BBS: 1.75±1.52 vs 0.40±0.88, TUG: 6.07±6.11 vs 1.68±2.39, 10MWT: 7.02±7.02 vs 1.96±3.13). Spasticity correlated significantly with balance and gait abilities (P < 0.05). A single trial of ICT is a useful intervention for immediately improving spasticity, balance, and gait abilities in chronic stroke patients, but not for long-term effects. Further study on the effects of repeated ICT is needed. © The Author(s) 2014.

  12. Dose-Response Relationship Between Thrombin-Activatable Fibrinolysis Inhibitor (TAFI) and Stroke: A Chinese Case-Control Study

    Science.gov (United States)

    Dai, Huixu; Shi, Jingpu; He, Qiao; Sun, Hao

    2017-01-01

    Background Because TAFI (thrombin-activatable fibrinolysis inhibitor) antigen varies widely among different populations, we performed this case-control study to explore the relationship between TAFI levels and stroke in a Chinese population. Material/Methods Our population-based case-control study included 217 stroke patients and 218 healthy controls. The plasma TAFI level was measured by immune turbidimetry. Univariate and multivariate logistic regression analyses were used to analyze the association between different TAFI levels and stroke and its subtypes. Restricted cubic spline (RCS) combined with logistic regression analysis were used to explore the dose-response relationship between TAFI levels and stroke. Results The plasma TAFI levels of cases were much higher than in the control group (p=0.038) and this difference persisted even after adjustment (OR=2.2). In the elderly (aged over 60) and female subgroups, TAFI levels in stroke patients were higher than those in controls, and the results were also noted in ischemic stroke. The dose-response curve showed that, as a whole, with the increase of TAFI levels, the relative risk of stroke first increased and then decreased (p=0.0127). Similarly, in general, with the increase of TAFI levels, the curve showed that the relative risk of ischemic stroke first increased and then decreased (p=0.0110). Conclusions There was a definite correlation between TAFI levels and stroke in this Chinese population, and with the increase of TAFI levels, the relative risk of stroke or ischemic stroke first increased and then decreased. PMID:28890533

  13. Impact of Spasticity on Balance Control during Quiet Standing in Persons after Stroke.

    Science.gov (United States)

    Rahimzadeh Khiabani, Reza; Mochizuki, George; Ismail, Farooq; Boulias, Chris; Phadke, Chetan P; Gage, William H

    2017-01-01

    Balance impairments, falls, and spasticity are common after stroke, but the effect of spasticity on balance control after stroke is not well understood. In this cross-sectional study, twenty-seven participants with stroke were divided into two groups, based on ankle plantar flexor spasticity level. Fifteen individuals with high spasticity (Modified Ashworth Scale (MAS) score of ≥2) and 12 individuals with low spasticity (MAS score Balance control measures included centre of pressure (COP) root mean square (RMS), COP velocity, and COP mean power frequency (MPF) in anterior-posterior and mediolateral (ML) directions. Trunk sway was estimated using a wearable inertial measurement unit to measure trunk angle, trunk velocity, and trunk velocity frequency amplitude in pitch and roll directions. The high spasticity group demonstrated greater ML COP velocity, trunk roll velocity, trunk roll velocity frequency amplitude at 3.7 Hz, and trunk roll velocity frequency amplitude at 4.9 Hz, particularly in the eyes closed condition ( spasticity by vision interaction). ML COP MPF was greater in the high spasticity group. Individuals with high spasticity after stroke demonstrated greater impairment of balance control in the frontal plane, which was exacerbated when vision was removed.

  14. Electrical stimulation and iterative learning control for functional recovery in the upper limb post-stroke.

    Science.gov (United States)

    Meadmore, Katie; Exell, Timothy; Freeman, Christopher; Kutlu, Mustafa; Rogers, Eric; Hughes, Ann-Marie; Hallewell, Emma; Burridge, Jane

    2013-06-01

    Therapies using functional electrical stimulation (FES) in conjunction with practice of everyday tasks have proven effective in facilitating recovery of upper limb function following stroke. The aim of the current study is to develop a multi-channel electrical stimulation system that precisely controls the assistance provided in goal-orientated tasks through use of advanced model-based 'iterative learning control' (ILC) algorithms to facilitate functional motor recovery of the upper limb post-stroke. FES was applied to three muscle groups in the upper limb (the anterior deltoid, triceps and wrist extensors) to assist hemiparetic, chronic stroke participants to perform a series of functional tasks with real objects, including closing a drawer, turning on a light switch and repositioning an object. Position data from the participants' impaired upper limb was collected using a Microsoft Kinect® and was compared to an ideal reference. ILC used data from previous attempts at the task to moderate the FES signals applied to each muscle group on a trial by trial basis to reduce performance error whilst supporting voluntary effort by the participant. The clinical trial is on-going. Preliminary results show improvements in performance accuracy for each muscle group, as well as improvements in clinical outcome measures pre and post 18 training sessions. Thus, the feasibility of applying precisely controlled FES to three muscle groups in the upper limb to facilitate functional reach and grasp movements post stroke has been demonstrated.

  15. Active structural control of a floating wind turbine with a stroke-limited hybrid mass damper

    Science.gov (United States)

    Hu, Yaqi; He, Erming

    2017-12-01

    Floating wind turbines are subjected to more severe structural loads than fixed-bottom wind turbines due to additional degrees of freedom (DOFs) of their floating foundations. It's a promising way of using active structural control method to improve the structural responses of floating wind turbines. This paper investigates an active vibration control strategy for a barge-type floating wind turbine by setting a stroke-limited hybrid mass damper (HMD) in the turbine's nacelle. Firstly, a contact nonlinear modeling method for the floating wind turbine with clearance between the HMD and the stroke limiters is presented based on Euler-Lagrange's equations and an active control model of the whole system is established. The structural parameters are validated for the active control model and an equivalent load coefficient method is presented for identifying the wind and wave disturbances. Then, a state-feedback linear quadratic regulator (LQR) controller is designed to reduce vibration and loads of the wind turbine, and two optimization methods are combined to optimize the weighting coefficients when considering the stroke of the HMD and the active control power consumption as constraints. Finally, the designed controllers are implemented in high fidelity simulations under five typical wind and wave conditions. The results show that active HMD control strategy is shown to be achievable and the designed controllers could further reduce more vibration and loads of the wind turbine under the constraints of stroke limitation and power consumption. "V"-shaped distribution of the TMD suppression effect is inconsistent with the Weibull distribution in practical offshore floating wind farms, and the active HMD control could overcome this shortcoming of the passive TMD.

  16. Dominant modifiable risk factors for stroke in Ghana and Nigeria (SIREN: a case-control study

    Directory of Open Access Journals (Sweden)

    Mayowa O Owolabi, ProfDrMed

    2018-04-01

    Full Text Available Summary: Background: Sub-Saharan Africa has the highest incidence, prevalence, and fatality from stroke globally. Yet, only little information about context-specific risk factors for prioritising interventions to reduce the stroke burden in sub-Saharan Africa is available. We aimed to identify and characterise the effect of the top modifiable risk factors for stroke in sub-Saharan Africa. Methods: The Stroke Investigative Research and Educational Network (SIREN study is a multicentre, case-control study done at 15 sites in Nigeria and Ghana. Cases were adults (aged ≥18 years with stroke confirmed by CT or MRI. Controls were age-matched and gender-matched stroke-free adults (aged ≥18 years recruited from the communities in catchment areas of cases. Comprehensive assessment for vascular, lifestyle, and psychosocial factors was done using standard instruments. We used conditional logistic regression to estimate odds ratios (ORs and population-attributable risks (PARs with 95% CIs. Findings: Between Aug 28, 2014, and June 15, 2017, we enrolled 2118 case-control pairs (1192 [56%] men with mean ages of 59·0 years (SD 13·8 for cases and 57·8 years (13·7 for controls. 1430 (68% had ischaemic stoke, 682 (32% had haemorrhagic stroke, and six (<1% had discrete ischaemic and haemorrhagic lesions. 98·2% (95% CI 97·2–99·0 of adjusted PAR of stroke was associated with 11 potentially modifiable risk factors with ORs and PARs in descending order of PAR of 19·36 (95% CI 12·11–30·93 and 90·8% (95% CI 87·9–93·7 for hypertension, 1·85 (1·44–2·38 and 35·8% (25·3–46·2 for dyslipidaemia, 1·59 (1·19–2·13 and 31·1% (13·3–48·9 for regular meat consumption, 1·48 (1·13–1·94 and 26·5% (12·9–40·2 for elevated waist-to-hip ratio, 2·58 (1·98–3·37 and 22·1% (17·8–26·4 for diabetes, 2·43 (1·81–3·26 and 18·2% (14·1–22·3 for low green leafy vegetable consumption, 1·89 (1·40–2·54 and 11·6% (6·6–16·7

  17. The Control of Welding Deformation of the Three-Section Arm of Placing Boom of HB48B Pump Truck

    Science.gov (United States)

    Wang, Zhi-ling

    2018-02-01

    The concrete pump truck is the construction equipment of conveying concrete with self contained base plate and distributing boom. It integrates the pump transport mechanism of the concrete pump, and the hydraulic roll-folding type distributing boom used to distribute materials, and the supporting mechanism into the automobile chassis, and it is the concrete conveying equipment with high efficient and the functions of driving, pumping, and distributing materials. The placing boom of the concrete pump truck is the main force member in the pump parts with bearing great pressure, and its stress condition is complex. Taking the HB48B placing boom as an example, this paper analyzes and studies the deformation produced by placing boom of pump truck, and then obtains some main factors affecting the welding deformation. Through the riveter “joint” size, we controlled the process parameters, post-welding processing, and other aspects. These measures had some practical significance to prevent, control, and reduce the deformation of welding.

  18. Effects of Twice-Weekly Intense Aerobic Exercise in Early Subacute Stroke: A Randomized Controlled Trial.

    Science.gov (United States)

    Sandberg, Klas; Kleist, Marie; Falk, Lars; Enthoven, Paul

    2016-08-01

    To examine the effects of 12 weeks of twice-weekly intensive aerobic exercise on physical function and quality of life after subacute stroke. Randomized controlled trial. Ambulatory care. Patients (N=56; 28 women) aged ≥50 years who had a mild stroke (98% ischemic) and were discharged to independent living and enrolled 20 days (median) after stroke onset. Sixty minutes of group aerobic exercise, including 2 sets of 8 minutes of exercise with intensity up to exertion level 14 or 15 of 20 on the Borg rating of perceived exertion scale, twice weekly for 12 weeks (n=29). The nonintervention group (n=27) received no organized rehabilitation or scheduled physical exercise. Primary outcome measures included aerobic capacity on the standard ergometer exercise stress test (peak work rate) and walking distance on the 6-minute walk test (6MWT). Secondary outcome measures included maximum walking speed for 10m, balance on the timed Up and Go (TUG) test and single leg stance (SLS), health-related quality of life on the European Quality of Life Scale (EQ-5D), and participation and recovery after stroke on the Stroke Impact Scale (SIS) version 2.0 domains 8 and 9. Participants were evaluated pre- and postintervention. Patient-reported measures were also evaluated at 6-month follow-up. The following improved significantly more in the intervention group (pre- to postintervention): peak work rate (group × time interaction, P=.006), 6MWT (P=.011), maximum walking speed for 10m (PAerobic exercise was associated with improved EQ-5D scores (visual analog scale, P=.008) and perceived recovery (SIS domain 9, P=.002). These patient-reported improvements persisted at 6-month follow-up. Intensive aerobic exercise twice weekly early in subacute mild stroke improved aerobic capacity, walking, balance, health-related quality of life, and patient-reported recovery. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  19. 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.

  20. Development and computational simulation of thermoelectric electromagnetic pumps for controlling the fluid flow in liquid metal cooled space nuclear reactors

    International Nuclear Information System (INIS)

    Borges, E.M.

    1991-01-01

    Thermoelectric Electromagnetic (TEEM) Pumps can be used for controlling the fluid flow in the primary and secondary circuits of liquid metal cooled space nuclear reactor. In order to simulate and to evaluate the pumps performance, in steady-state, the computer program BEMTE has been developed to study the main operational parameters and to determine the system actuation point, for a given reactor operating power. The results for each stage of the program were satisfactory, compared to experimental data. The program shows to be adequate for the design and simulating of direct current electromagnetic pumps. (author)

  1. ExStroke Pilot Trial of the effect of repeated instructions to improve physical activity after ischaemic stroke: a multinational randomised controlled clinical trial

    DEFF Research Database (Denmark)

    Boysen, Gudrun; Krarup, Lars-Henrik; Zeng, Xianrong

    2009-01-01

    training programme before discharge and at five follow-up visits during 24 months. Control patients had follow-up visits with the same frequency but without instructions in physical activity. MAIN OUTCOME MEASURES: Physical activity assessed with the Physical Activity Scale for the Elderly (PASE) at each......OBJECTIVES: To investigate if repeated verbal instructions about physical activity to patients with ischaemic stroke could increase long term physical activity. DESIGN: Multicentre, multinational, randomised clinical trial with masked outcome assessment. SETTING: Stroke units in Denmark, China......, Poland, and Estonia. PARTICIPANTS: 314 patients with ischaemic stroke aged >or=40 years who were able to walk-157 (mean age 69.7 years) randomised to the intervention, 157 (mean age 69.4 years) in the control group. INTERVENTIONS: Patients randomised to the intervention were instructed in a detailed...

  2. Risk of vertebrobasilar stroke and chiropractic care: results of a population-based case-control and case-crossover study.

    Science.gov (United States)

    Cassidy, J David; Boyle, Eleanor; Côté, Pierre; He, Yaohua; Hogg-Johnson, Sheilah; Silver, Frank L; Bondy, Susan J

    2009-02-01

    Population-based, case-control and case-crossover study. To investigate associations between chiropractic visits and vertebrobasilar artery (VBA) stroke and to contrast this with primary care physician (PCP) visits and VBA stroke. Chiropractic care is popular for neck pain and headache, but may increase the risk for VBA dissection and stroke. Neck pain and headache are common symptoms of VBA dissection, which commonly precedes VBA stroke. Cases included eligible incident VBA strokes admitted to Ontario hospitals from April 1, 1993 to March 31, 2002. Four controls were age and gender matched to each case. Case and control exposures to chiropractors and PCPs were determined from health billing records in the year before the stroke date. In the case-crossover analysis, cases acted as their own controls. There were 818 VBA strokes hospitalized in a population of more than 100 million person-years. In those aged VBA stroke in those older than 45 years. Positive associations were found between PCP visits and VBA stroke in all age groups. Practitioner visits billed for headache and neck complaints were highly associated with subsequent VBA stroke. VBA stroke is a very rare event in the population. The increased risks of VBA stroke associated with chiropractic and PCP visits is likely due to patients with headache and neck pain from VBA dissection seeking care before their stroke. We found no evidence of excess risk of VBA stroke associated chiropractic care compared to primary care.

  3. REMOTE CONTROLLING OF AN AGRICULTURAL PUMP SYSTEM BASED ON THE DUAL TONE MULTI-FREQUENCY (DTMF TECHNIQUE

    Directory of Open Access Journals (Sweden)

    BEZA N. GETU

    2015-10-01

    Full Text Available In modern days, as a result of advances in technology, human beings are interested to remotely control different systems and applications. In this work, telephone signalling technique using Dual Tone Multi-Frequency (DTMF signalling, is used to control switching of electrical loads such as agricultural pumps located in remote areas. A DTMF tone command sent from a transmitting fixed or mobile phone terminal will be used to SWITCH ON/OFF the motors used to pump water for agricultural fields. A processing electronic system at the receiving side is designed to interpret the tone commands and sends an appropriate signal to the motor driving circuit to complete the pump switching states. In the design methodology, it is possible to control several water pumps distributed in a certain agricultural site, however, in this work we considered four pumps and the paper presents the complete electronic design and simulation results at the different stages of the design. The electronic design is based on discrete passive and active electronic components and the system is tested and simulated using Multism program. The results of the simulation show that the design is capable of controlling the switching state of the motors. For a certain DTMF command, it is possible to switch ON/OFF a specific motor pump or all of the four motors.

  4. The gender effect in stroke thrombolysis: of CASES, controls, and treatment-effect modification.

    Science.gov (United States)

    Kent, David M; Buchan, Alastair M; Hill, Michael D

    2008-09-30

    Large studies of patients with acute stroke not receiving thrombolytic therapy have repeatedly demonstrated poorer outcomes for women compared to men. An analysis of five pooled randomized controlled trials testing IV recombinant tissue plasminogen activator (rtPA) demonstrated that rtPA benefits women more than men; the usual gender difference, apparent among controls, was totally nullified in the rtPA group. This nullification of the usual gender effect among rtPA-treated patients has not been confirmed. We analyzed baseline characteristics and functional outcomes in men vs women in the Canadian Alteplase for Stroke Effectiveness Study (CASES), a multicenter study that collected outcomes data for patients treated with rtPA in Canada to assess the safety and effectiveness of alteplase for stroke in the context of routine care. Among 1,110 patients, including 615 men and 505 women, a normal or near normal outcome at 90 days was found in 37.1% of men vs 36.0% of women (p = 0.71). This was essentially unchanged after adjusting for differences in baseline characteristics, including age >70, glucose, hypertension, atrial fibrillation, hypercholesterolemia, baseline National Institute of Health Stroke Severity, and baseline Alberta Stroke Program Early CT score (35.2% in men vs 38.2% in women, p = 0.332). Ninety-day mortality was similar between the sexes in both the adjusted and unadjusted analysis. There was no difference in 90-day outcomes in recombinant tissue plasminogen activator (rtPA)-treated men and rtPA-treated women. This is consistent with the pooled analysis of randomized controlled trials, showing greater benefit for thrombolysis in women and nullification of the usual gender difference in outcome.

  5. Interventions for improving modifiable risk factor control in the secondary prevention of stroke.

    Science.gov (United States)

    Lager, Kate E; Mistri, Amit K; Khunti, Kamlesh; Haunton, Victoria J; Sett, Aung K; Wilson, Andrew D

    2014-05-02

    People with stroke or transient ischaemic attack (TIA) are at increased risk of future stroke and other cardiovascular events. Evidence-based strategies for secondary stroke prevention have been established. However, the implementation of prevention strategies could be improved. To assess the effects of stroke service interventions for implementing secondary stroke prevention strategies on modifiable risk factor control, including patient adherence to prescribed medications, and the occurrence of secondary cardiovascular events. We searched the Cochrane Stroke Group Trials Register (April 2013), the Cochrane Effective Practice and Organisation of Care Group Trials Register (April 2013), CENTRAL (The Cochrane Library 2013, issue 3), MEDLINE (1950 to April 2013), EMBASE (1981 to April 2013) and 10 additional databases. We located further studies by searching reference lists of articles and contacting authors of included studies. We included randomised controlled trials (RCTs) that evaluated the effects of organisational or educational and behavioural interventions (compared with usual care) on modifiable risk factor control for secondary stroke prevention. Two review authors selected studies for inclusion and independently extracted data. One review author assessed the risk of bias for the included studies. We sought missing data from trialists. This review included 26 studies involving 8021 participants. Overall the studies were of reasonable quality, but one study was considered at high risk of bias. Fifteen studies evaluated predominantly organisational interventions and 11 studies evaluated educational and behavioural interventions for patients. Results were pooled where appropriate, although some clinical and methodological heterogeneity was present. The estimated effects of organisational interventions were compatible with improvements and no differences in the modifiable risk factors mean systolic blood pressure (mean difference (MD) -2.57 mmHg; 95% confidence

  6. TOPPITS: Trial Of Proton Pump Inhibitors in Throat Symptoms. Study protocol for a randomised controlled trial.

    Science.gov (United States)

    Watson, Gillian; O'Hara, James; Carding, Paul; Lecouturier, Jan; Stocken, Deborah; Fouweather, Tony; Wilson, Janet

    2016-04-01

    Persistent throat symptoms and Extra Oesophageal Reflux (EOR) are among the commonest reasons for attendance at a secondary care throat or voice clinic. There is a growing trend to treat throat symptom patients with proton pump inhibitors (PPIs) to suppress stomach acid, but most controlled studies fail to demonstrate a significant benefit of PPI over placebo. In addition, patient views on PPI use vary widely. A UK multi-centre, randomised, controlled trial for adults with persistent throat symptoms to compare the effectiveness of treatment with the proton pump inhibitor (PPI) lansoprazole versus placebo. The trial includes a six-month internal pilot, during which three sites will recruit 30 participants in total, to assess the practicality of the trial and assess the study procedures and willingness of the patient population to participate. If the pilot is successful, three additional sites will be opened to recruitment, and a further 302 participants recruited across the six main trial sites. Further trial sites may be opened, as necessary. The main trial will continue for a further 18 months. Participants will be followed up for 12 months from randomisation, throughout which both primary and secondary outcome data will be collected. The primary outcome is change in Reflux Symptom Index (RSI) score, the 'area standard' for this type of assessment, after 16 weeks (four months) of treatment. Secondary outcomes are RSI changes at 12 months after randomisation, Quality of Life assessment at four and 12 months, laryngeal mucosal changes, assessments of compliance and side effects, and patient-reported satisfaction. TOPPITS is designed to evaluate the relative effectiveness of treatment with a proton pump inhibitor versus placebo in patients with persistent throat symptoms. This will provide valuable information to clinicians and GPs regarding the treatment and management of care for these patients, on changes in symptoms, and in Quality of Life, over time. ISRCTN

  7. A case-control study on potato consumption and risk of stroke in central Iran.

    Science.gov (United States)

    Khosravi-Boroujeni, Hossein; Saadatnia, Mohammad; Shakeri, Forough; Keshteli, Ammar Hassanzadeh; Esmaillzadeh, Ahmad

    2013-03-01

      Potato, a high- glycemic index (GI) food, is one of the most widely used starchy foods worldwide. Previous studies on the association of dietary intakes with stroke have mostly focused on the dietary GI and there is no information regarding the association between potato consumption and risk of stroke. This case-control study was conducted to evaluate the association between potato consumption and risk of stroke in an Iranian adult population. In this case-control study, 195 patients with stroke, hospitalized in the Neurology Ward of Alzahra University Hospital and 195 controls from other wards of the hospital with convenience non-random sampling method were enrolled. To assess participants' dietary intakes, a validated food frequency questionnaire was used. Information on socioeconomic and demographic variables, physical activity pattern, and smoking were collected by the use of questionnaires. Logistic regression method in different models was applied to explore the associations between potato intake and stroke. First quartile of potato intake was used as a reference in all models. Mantel-Haenszel extension chi-square test was used to assess the overall trend across quartiles of potato consumption. Individuals with stroke were more likely to be male (60% vs. 46%, P < 0.05) and older (68.0 ± 1.0 vs. 61.5 ± 0.8 y, P < 0.001) as compared with controls. They had lower body mass index (BMI) (25.2 ± 0.3 vs. 28.5 ± 1.0 kg/m2, P < 0.05), and were less likely to be obese (11.3% vs. 29.2%, P < 0.001) compared with controls. The mean potato consumption was 31.1 ± 3.4 and 23.4 ± 1.3 g/d for cases and controls, respectively. Participants with the highest potato consumption were younger and more likely to be physically active. High potato consumption was associated with higher intakes of energy, fruits, vegetables, pulses, and grains. After adjustment for age, sex, and total energy intake, we found that individuals with the highest potato consumption were more likely

  8. A cross-sectional observational study comparing foot and ankle characteristics in people with stroke and healthy controls.

    Science.gov (United States)

    Kunkel, Dorit; Potter, Julia; Mamode, Louis

    2017-06-01

    The purpose of this study was to explore and compare foot and ankle characteristics in people with stroke and healthy controls; and between stroke fallers and non-fallers. Participants were recruited from community groups and completed standardized tests assessing sensation, foot posture, foot function, ankle dorsiflexion and first metatarsal phalangeal joint range of motion (1st MPJ ROM), hallux valgus presence and severity. Twenty-three stroke participants (mean age 75.09 ± 7.57 years; 12 fallers) and 16 controls (mean age 73.44 ± 8.35 years) took part. Within the stroke group, reduced 1st MPJ sensation (p = 0.016) and 1st MPJ ROM (p = 0.025) were observed in the affected foot in comparison to the non-affected foot; no other differences were apparent. Pooled data (for both feet) was used to explore between stroke/control (n = 78 feet) and stroke faller/non-faller (n = 46 feet) group differences. In comparison to the control group, stroke participants exhibited reduced sensation of the 1st MPJ (p = 0.020), higher Foot Posture Index scores (indicating greater foot pronation, p = 0.008) and reduced foot function (p = 0.003). Stroke fallers exhibited significantly greater foot pronation in comparison to non-fallers (p = 0.027). Results indicated differences in foot and ankle characteristics post stroke in comparison to healthy controls. These changes may negatively impact functional ability and the ability to preserve balance. Further research is warranted to explore the influence of foot problems on balance ability and falls in people with stroke. Implications for Rehabilitation Foot problems are common post stroke. As foot problems have been linked to increased fall risk among the general population we recommend that it would be beneficial to include foot and ankle assessments or a referral to a podiatrist for people with stroke who report foot problems. Further research is needed to explore if we can improve functional

  9. Development of a Mechatronic Syringe Pump to Control Fluid Flow in a Microfluidic Device Based on Polyimide Film

    Science.gov (United States)

    Sek Tee, Kian; Sharil Saripan, Muhammad; Yap, Hiung Yin; Fhong Soon, Chin

    2017-08-01

    With the advancement in microfluidic technology, fluid flow control for syringe pump is always essential. In this paper, a mechatronic syringe pump will be developed and customized to control the fluid flow in a poly-dimethylsiloxane (PDMS) microfluidic device based on a polyimide laminating film. The syringe pump is designed to drive fluid with flow rates of 100 and 1000 μl/min which intended to drive continuous fluid in a polyimide based microfluidic device. The electronic system consists of an Arduino microcontroller board and a uni-polar stepper motor. In the system, the uni-polar stepper motor was coupled to a linear slider attached to the plunger of a syringe pump. As the motor rotates, the plunger pumps the liquid out of the syringe. The accuracy of the fluid flow rate was determined by adjusting the number of micro-step/revolution to drive the stepper motor to infuse fluid into the microfluidic device. With the precise control of the electronic system, the syringe pump could accurately inject fluid volume at 100 and 1000 μl/min into a microfluidic device.

  10. The effects of visual control whole body vibration exercise on balance and gait function of stroke patients

    OpenAIRE

    Choi, Eon-Tak; Kim, Yong-Nam; Cho, Woon-Soo; Lee, Dong-Kyu

    2016-01-01

    [Purpose] This study aims to verify the effects of visual control whole body vibration exercise on balance and gait function of stroke patients. [Subjects and Methods] A total of 22 stroke patients were randomly assigned to two groups; 11 to the experimental group and 11 to the control group. Both groups received 30 minutes of Neuro-developmental treatment 5 times per week for 4 weeks. The experimental group additionally performed 10 minutes of visual control whole body vibration exercise 5 t...

  11. The Stroke and Carer Optimal Health Program (SCOHP) to enhance psychosocial health: study protocol for a randomized controlled trial.

    Science.gov (United States)

    Brasier, Catherine; Ski, Chantal F; Thompson, David R; Cameron, Jan; O'Brien, Casey L; Lautenschlager, Nicola T; Gonzales, Graeme; Hsueh, Ya-Seng Arthur; Moore, Gaye; Knowles, Simon R; Rossell, Susan L; Haselden, Rachel; Castle, David J

    2016-09-09

    Stroke is a leading cause of disability and distress, and often profoundly affects the quality of life of stroke survivors and their carers. With the support of carers, many stroke survivors are returning to live in the community despite the presence of disability and ongoing challenges. The sudden and catastrophic changes caused by stroke affects the mental, emotional and social health of both stroke survivors and carers. The aim of this study is to evaluate a Stroke and Carer Optimal Health Program (SCOHP) that adopts a person-centred approach and engages collaborative therapy to educate, support and improve the psychosocial health of stroke survivors and their carers. This study is a prospective randomised controlled trial. It will include a total of 168 stroke survivors and carers randomly allocated into an intervention group (SCOHP) or a control group (usual care). Participants randomised to the intervention group will receive nine (8 + 1 booster) sessions guided by a structured workbook. The primary outcome measures for stroke survivors and carers will be health-related quality of life (AQoL-6D and EQ-5D) and self-efficacy (GSE). Secondary outcome measures will include: anxiety and depression (HADS); coping (Brief COPE); work and social adjustment (WSAS); carer strain (MCSI); carer satisfaction (CASI); and treatment evaluation (TEI-SF and CEQ). Process evaluation and a health economic cost analysis will also be conducted. We believe that this is an innovative intervention that engages the stroke survivor and carer and will be significant in improving the psychosocial health, increasing independence and reducing treatment-related costs in this vulnerable patient-carer dyad. In addition, we expect that the intervention will assist carers and stroke survivors to negotiate the complexity of health services across the trajectory of care and provide practical skills to improve self-management. ACTRN12615001046594 . Registered on 7 October 2015.

  12. Muscle Synergies Control during Hand-Reaching Tasks in Multiple Directions Post-stroke

    Directory of Open Access Journals (Sweden)

    Sharon Israely

    2018-02-01

    Full Text Available Purpose: A muscle synergies model was suggested to represent a simplifying motor control mechanism by the brainstem and spinal cord. The aim of the study was to investigate the feasibility of such control mechanisms in the rehabilitation of post-stroke individuals during the execution of hand-reaching movements in multiple directions, compared to non-stroke individuals.Methods: Twelve non-stroke and 13 post-stroke individuals participated in the study. Muscle synergies were extracted from EMG data that was recorded during hand reaching tasks, using the NMF algorithm. The optimal number of synergies was evaluated in both groups using the Variance Accounted For (VAF and the Mean Squared Error (MSE. A cross validation procedure was carried out to define a representative set of synergies. The similarity index and the K-means algorithm were applied to validate the existence of such a set of synergies, but also to compare the modulation properties of synergies for different movement directions between groups. The similarity index and hierarchical cluster analysis were also applied to compare between group synergies.Results: Four synergies were chosen to optimally capture the variances in the EMG data, with mean VAF of 0.917 ± 0.034 and 0.883 ± 0.046 of the data variances, with respective MSE of 0.007 and 0.016, in the control and study groups, respectively. The representative set of synergies was set to be extracted from movement to the center of the reaching space. Two synergies had different muscle activation balance between groups. Seven and 17 clusters partitioned the muscle synergies of the control and study groups. The control group exhibited a gradual change in the activation in the amplitude in the time domain (modulation of synergies, as reflected by the similarity index, whereas the study group exhibited consistently significant differences between all movement directions and the representative set of synergies. The study findings support

  13. The performance of stroke survivors in turning-while-walking while carrying out a concurrent cognitive task compared with controls.

    Directory of Open Access Journals (Sweden)

    Wing-Nga Chan

    Full Text Available Turning-while-walking is one of the commonest causes of falls in stroke survivors. It involves cognitive processing and may be challenging when performed concurrently with a cognitive task. Previous studies of dual-tasking involving turning-while-walking in stroke survivors show that the performance of physical tasks is compromised. However, the design of those studies did not address the response of stroke survivors under dual-tasking condition without specifying the task-preference and its effect on the performance of the cognitive task.First, to compare the performance of single-tasking and dual-tasking in stroke survivors. Second, to compare the performance of stroke survivors with non-stroke controls.Fifty-nine stroke survivors and 45 controls were assessed with an auditory Stroop test, a turning-while-walking test, and a combination of the two single tasks. The outcome of the cognitive task was measured by the reaction time and accuracy of the task. The physical task was evaluated by measuring the turning duration, number of steps to turn, and time to complete the turning-while-walking test.Stroke survivors showed a significantly reduced accuracy in the auditory Stroop test when dual-tasking, but there was no change in the reaction time. Their performance in the turning-while-walking task was similar under both single-tasking and dual-tasking condition. Additionally, stroke survivors demonstrated a significantly longer reaction time and lower accuracy than the controls both when single-tasking and dual-tasking. They took longer to turn, with more steps, and needed more time to complete the turning-while-walking task in both tasking conditions.The results show that stroke survivors with high mobility function performed the auditory Stroop test less accurately while preserving simultaneous turning-while-walking performance. They also demonstrated poorer performance in both single-tasking and dual-tasking as compared with controls.

  14. PLC/DTAM Software Programs for Pumping Instrumentation & Control Skid X

    Energy Technology Data Exchange (ETDEWEB)

    HORNER, T.M.

    2001-07-30

    This document describes the software programs for the Allen-Bradley SLC 500 programmable logic controller (PLC) and the Allen-Bradley DTAM PLUS operator interface module used on Pumping Instrumentation and Control (PIC) skid ''X''. The software programs for the SLC 500 and DTAM Plus are based on the core programs provided by Allen-Bradley. The PLC and DTAM software programs on skid ''D'' for SX-104 are the baseline programs. These baselines will be tailored for each individual BY-farm skid. An Acceptance Test Procedure (ATP) and an Operational Test Procedure (OTP) verify that the software programs meet the specific requirements for BY-105 pumping. This document represents the final PLC and DTAM programs for PIC skid ''X'' at BY-105. These programs were printed out after the performance of the OTP. The OTP acts as the final qualification test for the software programs. Functional requirements and details of the PLC ladder logic are described in this document. The final programs entered into the PLC and DTAM Plus are included as Appendices to this document.

  15. PLC/DTAM Software Programs for Pumping Instrumentation & Control Skid U

    Energy Technology Data Exchange (ETDEWEB)

    HORNER, T.M.

    2001-08-01

    This document describes the software programs for the Allen-Bradley SLC 500 programmable logic controller (PLC) and the Allen-Bradley DTAM PLUS operator interface module used on Pumping Instrumentation and Control (PIC) skid ''U''. The software programs for the SLC 500 and DTAM Plus are based on the core programs provided by Allen-Bradley. The PLC and DTAM software programs on skid ''D'' for SX-104 are the baseline programs. These baselines will be tailored for each individual BY-farm skid. An Acceptance Test Procedure (ATP) and an Operational Test Procedure (OTP) verify that the software programs meet the specific requirements for BY-106 pumping. This document represents the final PLC and DTAM programs for PIC skid ''U'' at BY-106. These programs were printed out after the performance of the OTP. The OTP acts as the final qualification test for the software programs. Functional requirements and details of the PLC ladder logic are described in this document. The final programs entered into the PLC and DTAM Plus are included as Appendices to this document.

  16. A preliminary study on the development of electronic pump system using Arduino controller

    Science.gov (United States)

    Salleh, Mohd Sharil; Miskon, Azizi; Hashim, Fakroul Ridzuan

    2018-02-01

    The implications of treatment using hemodialysis machine and equipment remain speculative. Most studies, case reviews and medical surveys have shown statistics of side effects of hypertension while undergo a treatment using hemodialysis machine. Therefore, a specific action must be taken to prevent the effects of hypertension during treatment especially using hemodialysis machine. In order to reduce this matter in terms of frequency of hypertension while undergo hemodialysis treatment, many approach have been undertaken for improvement. For the beginning, this project reviews the technique of controlling instantaneous blood pressure for normal and hypertension stage and describe the challenges faced by a researcher during experiment to match human stability. The methodology used in this project is to develop one electronics pump system using Arduino controller for transferring liquid (a tap water) from a tank to another tank. The liquid flow rate was measured by using flow sensor where it located at input and output part. This project has decided to focus on flow rate range from 300 mL/min to 900 mL/min. Results shows an efficiency for speed 30 is 97.96%, speed 50 is 100.15%, speed 130 is 99.54% and speed 200 is 99.87%. A range of efficiency for this preliminary study on the development of Electronic Pump System are from 97.96% to 100.15%. In addition, analysis and simulation of the system delivers a better performance efficiency.

  17. Operation and control strategies in pre-series testing of cold circulating pumps for ITER

    International Nuclear Information System (INIS)

    Bhattacharya, R.; Vaghela, H.; Sarkar, B.; Srinivas, M.; Choukekar, K.

    2013-01-01

    Cryo-distribution system of ITER is responsible for the distribution and control of forced-flow supercritical helium for cooling of the superconducting magnets and the cryo-pumps. The requirements of cold circulating pumps (CCP) for mass flow rates and performance are much higher than presently existing and commercially available one used at 4.0 K helium. Design up-scaling with pre-series test of CCP has been proposed including test infrastructure. Operation and control strategies for the test distribution box (TDB) of test infrastructure have been developed and analyzed using steady state and dynamic process simulation to cope with the functional requirements of CCPs. Off-normal scenario with CCP inlet pressure variation is an important concern, dynamic process responses during such scenario have been evaluated to verify the operability of CCP. The paper describes process simulation to cope with the functional requirements of CCPs along with evaluation of off-normal scenario to verify the operability of CCP. (author)

  18. Physiological control of dual rotary pumps as a biventricular assist device using a master/slave approach.

    Science.gov (United States)

    Stevens, Michael C; Wilson, Stephen; Bradley, Andrew; Fraser, John; Timms, Daniel

    2014-09-01

    Dual rotary left ventricular assist devices (LVADs) can provide biventricular mechanical support during heart failure. Coordination of left and right pump speeds is critical not only to avoid ventricular suction and to match cardiac output with demand, but also to ensure balanced systemic and pulmonary circulatory volumes. Physiological control systems for dual LVADs must meet these objectives across a variety of clinical scenarios by automatically adjusting left and right pump speeds to avoid catastrophic physiological consequences. In this study we evaluate a novel master/slave physiological control system for dual LVADs. The master controller is a Starling-like controller, which sets flow rate as a function of end-diastolic ventricular pressure (EDP). The slave controller then maintains a linear relationship between right and left EDPs. Both left/right and right/left master/slave combinations were evaluated by subjecting them to four clinical scenarios (rest, postural change, Valsalva maneuver, and exercise) simulated in a mock circulation loop. The controller's performance was compared to constant-rotational-speed control and two other dual LVAD control systems: dual constant inlet pressure and dual Frank-Starling control. The results showed that the master/slave physiological control system produced fewer suction events than constant-speed control (6 vs. 62 over a 7-min period). Left/right master/slave control had lower risk of pulmonary congestion than the other control systems, as indicated by lower maximum EDPs (15.1 vs. 25.2-28.4 mm Hg). During exercise, master/slave control increased total flow from 5.2 to 10.1 L/min, primarily due to an increase of left and right pump speed. Use of the left pump as the master resulted in fewer suction events and lower EDPs than when the right pump was master. Based on these results, master/slave control using the left pump as the master automatically adjusts pump speed to avoid suction and increases pump flow

  19. [Research on magnetic coupling centrifugal blood pump control based on a self-tuning fuzzy PI algorithm].

    Science.gov (United States)

    Yang, Lei; Yang, Ming; Xu, Zihao; Zhuang, Xiaoqi; Wang, Wei; Zhang, Haibo; Han, Lu; Xu, Liang

    2014-10-01

    The purpose of this paper is to report the research and design of control system of magnetic coupling centrifugal blood pump in our laboratory, and to briefly describe the structure of the magnetic coupling centrifugal blood pump and principles of the body circulation model. The performance of blood pump is not only related to materials and structure, but also depends on the control algorithm. We studied the algorithm about motor current double-loop control for brushless DC motor. In order to make the algorithm adjust parameter change in different situations, we used the self-tuning fuzzy PI control algorithm and gave the details about how to design fuzzy rules. We mainly used Matlab Simulink to simulate the motor control system to test the performance of algorithm, and briefly introduced how to implement these algorithms in hardware system. Finally, by building the platform and conducting experiments, we proved that self-tuning fuzzy PI control algorithm could greatly improve both dynamic and static performance of blood pump and make the motor speed and the blood pump flow stable and adjustable.

  20. Supporting Treatment decision making to Optimise the Prevention of STROKE in Atrial Fibrillation: The STOP STROKE in AF study. Protocol for a cluster randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Gattellari Melina

    2012-07-01

    Full Text Available Abstract Background Suboptimal uptake of anticoagulation for stroke prevention in atrial fibrillation has persisted for over 20 years, despite high-level evidence demonstrating its effectiveness in reducing the risk of fatal and disabling stroke. Methods The STOP STROKE in AF study is a national, cluster randomised controlled trial designed to improve the uptake of anticoagulation in primary care. General practitioners from around Australia enrolling in this ‘distance education’ program are mailed written educational materials, followed by an academic detailing session delivered via telephone by a medical peer, during which participants discuss patient de-identified cases. General practitioners are then randomised to receive written specialist feedback about the patient de-identified cases either before or after completing a three-month posttest audit. Specialist feedback is designed to provide participants with support and confidence to prescribe anticoagulation. The primary outcome is the proportion of patients with atrial fibrillation receiving oral anticoagulation at the time of the posttest audit. Discussion The STOP STROKE in AF study aims to evaluate a feasible intervention via distance education to prevent avoidable stroke due to atrial fibrillation. It provides a systematic test of augmenting academic detailing with expert feedback about patient management. Trial registration Australian Clinical Trials Registry Registration Number: ACTRN12611000076976.

  1. Virtual reality-based training improves community ambulation in individuals with stroke: a randomized controlled trial.

    Science.gov (United States)

    Yang, Yea-Ru; Tsai, Meng-Pin; Chuang, Tien-Yow; Sung, Wen-Hsu; Wang, Ray-Yau

    2008-08-01

    This is a single blind randomized controlled trial to examine the effect of virtual reality-based training on the community ambulation in individuals with stroke. Twenty subjects with stroke were assigned randomly to either the control group (n=9) or the experimental group (n=11). Subjects in the control group received the treadmill training. Subjects in the experimental group underwent the virtual reality-based treadmill training. Walking speed, community walking time, walking ability questionnaire (WAQ), and activities-specific balance confidence (ABC) scale were evaluated. Subjects in the experimental group improved significantly in walking speed, community walking time, and WAQ score at posttraining and 1-month follow-up periods. Their ABC score also significantly increased at posttraining but did not maintain at follow-up period. Regarding the between-group comparisons, the experimental group improved significantly more than control group in walking speed (P=0.03) and community walking time (P=0.04) at posttraining period and in WAQ score (P=0.03) at follow-up period. Our results support the perceived benefits of gait training programs that incorporate virtual reality to augment the community ambulation of individuals with stroke.

  2. Corrosion Control of Central Vehicle Wash Facility Pump Components Using Alternative Alloy Coatings

    Science.gov (United States)

    2016-07-01

    pumps would use bushings coated with an abrasion- and corrosion-resistant coating. Colmonoy,† a...power to the new pump. No power or signal was detected from the switchgear to Unit 2. While the electricians addressed the problem, work was...pumps that incorporate new protective coatings. Areas included impellors, housings, and bush - ings. The old pumps were inspected once, when they were

  3. ExStroke Pilot Trial of the effect of repeated instructions to improve physical activity after ischaemic stroke: a multinational randomised controlled clinical trial

    DEFF Research Database (Denmark)

    Boysen, Gudrun; Krarup, Lars-Henrik; Zeng, Xianrong

    2009-01-01

    training programme before discharge and at five follow-up visits during 24 months. Control patients had follow-up visits with the same frequency but without instructions in physical activity. MAIN OUTCOME MEASURES: Physical activity assessed with the Physical Activity Scale for the Elderly (PASE) at each......OBJECTIVES: To investigate if repeated verbal instructions about physical activity to patients with ischaemic stroke could increase long term physical activity. DESIGN: Multicentre, multinational, randomised clinical trial with masked outcome assessment. SETTING: Stroke units in Denmark, China...... infarction, or falls and fractures. CONCLUSION: Repeated encouragement and verbal instruction in being physically active did not lead to a significant increase in physical activity measured by the PASE score. More intensive strategies seem to be needed to promote physical activity after ischaemic stroke...

  4. Independently variable phase and stroke control for a double acting Stirling engine

    Science.gov (United States)

    Berchowitz, David M.

    1983-01-01

    A phase and stroke control apparatus for the pistons of a Stirling engine includes a ring on the end of each piston rod in which a pair of eccentrics is arranged in series, torque transmitting relationship. The outer eccentric is rotatably mounted in the ring and is rotated by the orbiting ring; the inner eccentric is mounted on an output shaft. The two eccentrics are mounted for rotation together within the ring during normal operation. A device is provided for rotating one eccentric with respect to another to change the effective eccentricity of the pair of eccentrics. A separately controlled phase adjustment is provided to null the phase change introduced by the change in the orientation of the outer eccentric, and also to enable the phase of the pistons to be changed independently of the stroke change.

  5. Functional Exercise and Physical Fitness Post Stroke: The Importance of Exercise Maintenance for Motor Control and Physical Fitness after Stroke

    Directory of Open Access Journals (Sweden)

    Birgitta Langhammer

    2012-01-01

    Full Text Available It is argued that all stroke patients, indifferent of disability, have the same possibility to improve with training. The aim of the study was to follow and register functional improvements in two groups with different functional capacities at baseline for a period of 36 months. Stroke patients were recruited and divided into groups related to their functional status at baseline. During the acute rehabilitation, both groups received functional task-oriented training, followed by regular self- or therapeutic driven training the first year after stroke and varied exercise patterns the following 24 months. The participants were tested on admission, and at three, six, twelve, and thirty-six months after the onset of stroke. Both groups improved functional activity up to six months which then stabilized up to twelve months to decline somewhat at thirty-six months after stroke. Change scores indicate a greater potential for rehabilitation in the MAS ≤35 in relation to group MAS >35 although the functional capacity was higher in the latter. This indicates the importance of maintaining exercise and training for all persons after stroke.

  6. Control strategy and experimental study on a novel defrosting method for air-source heat pump

    International Nuclear Information System (INIS)

    Liang Caihua; Zhang Xiaosong; Li Xiuwei; Chen Zhenqian

    2010-01-01

    A new defrosting method - the sensible heat defrosting method, aiming at shelving the various disadvantages of the conventional reverse cycle defrosting was proposed in this paper. The mechanism and process of this method was analysed. To guarantee the reliability, the self-organizing control algorithm with self-learning function was introduced based on the cardinal fuzzy control algorithm. Moreover, the control strategy was enacted; the corresponding self-organizing fuzzy control system was developed; the Micro Controller Unit (MCU) based control unit was accomplished; and the experimental study was conducted to investigate the sample machine of air-source heat pump system. The results of the experiments showed that the self-organizing control algorithm has good control characteristic and effect. On one hand, the adverse shock from the conventional reverse cycle defrosting to the refrigeration system could be avoided through this proposed method; on the other hand, the 'oil rush' could also be eliminated. Besides, the thermal comfort could be greatly improved since the temperature fluctuation range of the supplied water is narrowed by applying this new method in practice.

  7. Brain-machine interface in chronic stroke rehabilitation: a controlled study.

    Science.gov (United States)

    Ramos-Murguialday, Ander; Broetz, Doris; Rea, Massimiliano; Läer, Leonhard; Yilmaz, Ozge; Brasil, Fabricio L; Liberati, Giulia; Curado, Marco R; Garcia-Cossio, Eliana; Vyziotis, Alexandros; Cho, Woosang; Agostini, Manuel; Soares, Ernesto; Soekadar, Surjo; Caria, Andrea; Cohen, Leonardo G; Birbaumer, Niels

    2013-07-01

    Chronic stroke patients with severe hand weakness respond poorly to rehabilitation efforts. Here, we evaluated efficacy of daily brain-machine interface (BMI) training to increase the hypothesized beneficial effects of physiotherapy alone in patients with severe paresis in a double-blind sham-controlled design proof of concept study. Thirty-two chronic stroke patients with severe hand weakness were randomly assigned to 2 matched groups and participated in 17.8 ± 1.4 days of training rewarding desynchronization of ipsilesional oscillatory sensorimotor rhythms with contingent online movements of hand and arm orthoses (experimental group, n = 16). In the control group (sham group, n = 16), movements of the orthoses occurred randomly. Both groups received identical behavioral physiotherapy immediately following BMI training or the control intervention. Upper limb motor function scores, electromyography from arm and hand muscles, placebo-expectancy effects, and functional magnetic resonance imaging (fMRI) blood oxygenation level-dependent activity were assessed before and after intervention. A significant group × time interaction in upper limb (combined hand and modified arm) Fugl-Meyer assessment (cFMA) motor scores was found. cFMA scores improved more in the experimental than in the control group, presenting a significant improvement of cFMA scores (3.41 ± 0.563-point difference, p = 0.018) reflecting a clinically meaningful change from no activity to some in paretic muscles. cFMA improvements in the experimental group correlated with changes in fMRI laterality index and with paretic hand electromyography activity. Placebo-expectancy scores were comparable for both groups. The addition of BMI training to behaviorally oriented physiotherapy can be used to induce functional improvements in motor function in chronic stroke patients without residual finger movements and may open a new door in stroke neurorehabilitation. Copyright © 2013 American Neurological

  8. Polymorphisms in prothrombotic genes in young stroke patients in Greece: a case-controlled study.

    Science.gov (United States)

    Ranellou, Kyriaki; Paraskeva, Anteia; Kyriazopoulos, Panagiotis; Batistatou, Anna; Evangelou, Aggelos; El-Aly, Mahmoud; Zis, Panagiotis; Tavernarakis, Antonios; Charalabopoulos, Konstantinos

    2015-06-01

    Mechanisms of ischemic stroke in young adults are poorly understood. The aim of the study was to investigate and compare the frequency of common variations in prothrombotic genes between young patients with ischemic stroke and controls. Fifty-one cases of first-ever ischemic stroke and 70 community-based controls aged below 50 years were studied. In both groups, the insertion/deletion 4G/5G variation (-675 4G/5G PAI-1) as well as the single-nucleotide polymorphism-844 G/A of the PAI-1 (-844 G/A PAI-1) gene promoter, factor V Leiden (FVL) G1691Α, the prothrombin variant (allele 20210A, FIIG20210A), factor XIII-A Val34Leu polymorphism (FXIII-AVal34Leu) and C677T methylenotetrahydrofolate reductase (C677T MTHFR) polymorphism have been assessed. The -675 4G/5G PAI-1 allele distribution differed significantly between patients and controls (P = 0.020), but no difference was found regarding the distribution of -844 G/A PAI-1 (P = 0.493), FVL (P = 0.199), FIIG20210A (P = 0.410), FXIII-AVal34leu (P = 0.160) and C677T MTHFR (P = 0.788). A lower frequency of 5G/5G genotype and a higher frequency of the 4G/5G genotype of the PAI -675 4G/5G polymorphism was found in young ischemic stroke patients compared to healthy controls. Further epidemiological studies are needed to investigate the differences between different geographic areas, and prospective cohort studies are needed to investigate the possible protective role of 5G/5G polymorphism.

  9. Modular Ankle Robotics Training in Early Sub-Acute Stroke: A Randomized Controlled Pilot Study

    Science.gov (United States)

    Forrester, Larry W.; Roy, Anindo; Krywonis, Amanda; Kehs, Glenn; Krebs, Hermano Igo; Macko, Richard F.

    2014-01-01

    Background Modular lower extremity (LE) robotics may offer a valuable avenue for restoring neuromotor control after hemiparetic stroke. Prior studies show that visually-guided and visually-evoked practice with an ankle robot (anklebot) improves paretic ankle motor control that translates into improved overground walking. Objective Assess the feasibility and efficacy of daily anklebot training during early sub-acute hospitalization post-stroke. Methods Thirty-four inpatients from a stroke unit were randomly assigned to anklebot (N=18) or passive manual stretching (N=16) treatments. All suffered a first stroke with residual hemiparesis (ankle manual muscle test grade 1/5 to 4/5), and at least trace muscle activation in plantar- or dorsiflexion. Anklebot training employed an “assist-as-needed” approach during > 200 volitional targeted paretic ankle movements, with difficulty adjusted to active range of motion and success rate. Stretching included >200 daily mobilizations in these same ranges. All sessions lasted 1 hour and assessments were not blinded. Results Both groups walked faster at discharge, however the robot group improved more in percent change of temporal symmetry (p=0.032) and also of step length symmetry (p=0.038), with longer nonparetic step lengths in the robot (133%) vs. stretching (31%) groups. Paretic ankle control improved in the robot group, with increased peak (p≤ 0.001) and mean (p≤ 0.01) angular speeds, and increased movement smoothness (p≤ 0.01). There were no adverse events. Conclusion Though limited by small sample size and restricted entry criteria, our findings suggest that modular lower extremity robotics during early sub-acute hospitalization is well tolerated and improves ankle motor control and gait patterning. PMID:24515923

  10. Fluoxetine for motor recovery after acute ischaemic stroke (FLAME): a randomised placebo-controlled trial.

    Science.gov (United States)

    Chollet, François; Tardy, Jean; Albucher, Jean-François; Thalamas, Claire; Berard, Emilie; Lamy, Catherine; Bejot, Yannick; Deltour, Sandrine; Jaillard, Assia; Niclot, Philippe; Guillon, Benoit; Moulin, Thierry; Marque, Philippe; Pariente, Jérémie; Arnaud, Catherine; Loubinoux, Isabelle

    2011-02-01

    Hemiplegia and hemiparesis are the most common deficits caused by stroke. A few small clinical trials suggest that fluoxetine enhances motor recovery but its clinical efficacy is unknown. We therefore aimed to investigate whether fluoxetine would enhance motor recovery if given soon after an ischaemic stroke to patients who have motor deficits. In this double-blind, placebo-controlled trial, patients from nine stroke centres in France who had ischaemic stroke and hemiplegia or hemiparesis, had Fugl-Meyer motor scale (FMMS) scores of 55 or less, and were aged between 18 years and 85 years were eligible for inclusion. Patients were randomly assigned, using a computer random-number generator, in a 1:1 ratio to fluoxetine (20 mg once per day, orally) or placebo for 3 months starting 5-10 days after the onset of stroke. All patients had physiotherapy. The primary outcome measure was the change on the FMMS between day 0 and day 90 after the start of the study drug. Participants, carers, and physicians assessing the outcome were masked to group assignment. Analysis was of all patients for whom data were available (full analysis set). This trial is registered with ClinicalTrials.gov, number NCT00657163. 118 patients were randomly assigned to fluoxetine (n=59) or placebo (n=59), and 113 were included in the analysis (57 in the fluoxetine group and 56 in the placebo group). Two patients died before day 90 and three withdrew from the study. FMMS improvement at day 90 was significantly greater in the fluoxetine group (adjusted mean 34·0 points [95% CI 29·7-38·4]) than in the placebo group (24·3 points [19·9-28·7]; p=0·003). The main adverse events in the fluoxetine and placebo groups were hyponatraemia (two [4%] vs two [4%]), transient digestive disorders including nausea, diarrhoea, and abdominal pain (14 [25%] vs six [11%]), hepatic enzyme disorders (five [9%] vs ten [18%]), psychiatric disorders (three [5%] vs four [7%]), insomnia (19 [33%] vs 20 [36%]), and partial

  11. Insulin Pump Patient Characteristics and Glucose Control in the Hospitalized Setting

    Science.gov (United States)

    Kannan, Subramanian; Satra, Ankita; Calogeras, Ellen; Lock, Patricia

    2014-01-01

    Patients’ knowledge of their insulin pumps and glucose control during hospitalization has not been studied. The aim was to study the determinants of glycemic control in patients using continuous subcutaneous insulin infusion (CSII) in the hospital. Three groups of patients were identified: those who did not need any inpatient education and continued on CSII (gorup A), those who received education then continued on CSII (group B), and those for whom CSII was not appropriate and were treated with multiple daily insulin injections (gorup C). We compared the measures of glycemic control between the 3 groups and analyzed which variables impacted glucose control. There were 50 patients, with 51 hospital admissions, 57% males, mean age 48 ± 13 years, 86% had type 1 diabetes (T1DM). The mean DM duration was 26 ± 14 years, mean duration of CSII use was 8.7 ± 6 years, and mean HbA1c was 7.6 ± 1.4%. The mean duration of hospital stay was 5.6 ± 4.6 days. Mean blood glucose (BG) and frequency of hyperglycemia and hypoglycemic events among the 3 groups adjusted for their duration of hospital stay were not statistically different. None of the patients developed diabetic ketoacidosis while using their pump. Stepwise multivariate analysis revealed knowledge of hypoglycemia correction was the single most important predictor of mean BG (P < .001). Patients who received inpatient education performed similarly to patients who did not need inpatient education. Patients who receive inpatient education on CSII fare similar as patients who did not require inpatient education. PMID:24876608

  12. Effect of ankle-foot orthosis on postural control after stroke: a systematic review.

    Science.gov (United States)

    Guerra Padilla, M; Molina Rueda, F; Alguacil Diego, I M

    2014-09-01

    Stroke is currently the main cause of permanent disability in adults. The impairments are a combination of sensory, motor, cognitive and emotional changes that result in restrictions on the ability to perform basic activities of daily living (BADL). Postural control is affected and causes problems with static and dynamic balance, thus increasing the risk of falls and secondary injuries. The purpose of this review was to compile the literature to date, and assess the impact of ankle-foot orthosis (AFO) on postural control and gait in individuals who have suffered a stroke. The review included randomised and controlled trials that examined the effects of AFO in stroke patients between 18 and 80 years old, with acute or chronic evolution. No search limits on the date of the studies were included, and the search lasted until April 2011. The following databases were used: Pubmed, Trip Database, Cochrane library, Embase, ISI Web Knowledge, CINHAL and PEDro. Intervention succeeded in improving some gait parameters, such as speed and cadence. However it is not clear if there was improvement in the symmetry, postural sway or balance. Because of the limitations of this systematic review, due to the clinical diversity of the studies and the methodological limitations, 0these results should be considered with caution. Copyright © 2011 Sociedad Española de Neurología. Published by Elsevier Espana. All rights reserved.

  13. Abnormal sensory integration affects balance control in hemiparetic patients within the first year after stroke

    Directory of Open Access Journals (Sweden)

    Clarissa B. Oliveira

    2011-01-01

    Full Text Available OBJECTIVE: Impairments in balance can be a consequence of changes in the motor, sensory, and integrative aspects of motor control. Abnormal sensory reweighting, i.e., the ability to select the most appropriate sensory information to achieve postural stability, may contribute to balance impairment. The Sensory Organization Test is a component of Computerized Dynamic Posturography that evaluates the impact of visual, vestibular, and somatosensory inputs, as well as sensory reweighting, under conditions of sensory conflict. The aim of this study is to compare balance control in hemiparetic patients during the first year post-stroke and in age-matched neurologically normal subjects using the Berg Balance Scale and Computerized Dynamic Posturography. METHODS: We compared the Berg Balance Scale and Sensory Organization Test scores in 21 patients with hemiparesis after first-ever ischemic stroke and in 21 age-matched, neurologically normal subjects. An equilibrium score was defined for each Sensory Organization Test condition. RESULTS: Berg Balance Scale scores were significantly lower in the patients than in the neurologically normal subjects. Equilibrium scores were significantly lower in the patients than in the neurologically normal subjects for those Sensory Organization Test conditions that did not provide appropriate somatosensory information and under conditions of sensory conflict. A history of falls was more frequent in patients with lower equilibrium scores. CONCLUSION: During the first year after a stroke, defective sensory reweighting significantly impacts balance control in hemiparetic patients. These results are important for the planning of effective rehabilitation interventions.

  14. Feedback control of biomimetic exotendon device for hand rehabilitation in stroke.

    Science.gov (United States)

    Kim, Dong Hyun; Lee, Sang Wook; Park, Hyung-Soon

    2014-01-01

    Many hand exoskeleton devices have recently been developed for hand rehabilitation of stroke survivors, but most hand exoskeletons focused on implementing joint movement driven by individual actuator located at the finger joints rather than considering function of hand muscle-tendons and their coordination. In order to achieve hand rehabilitation targeted on restoration of specific muscle-tendon functions, a biomimetic hand exotendon device (BiomHED) was introduced recently. This paper introduces a ring-type design of exotendon device for easier donning and the design of a feedback control system for controlling posture of the finger. Technical details of the feedback sensor and controller with preliminary experimental results are presented.

  15. The Effects of Exercise with TENS on Spasticity, Balance, and Gait in Patients with Chronic Stroke: A Randomized Controlled Trial

    OpenAIRE

    Park, Junhyuck; Seo, Dongkwon; Choi, Wonjae; Lee, Seungwon

    2014-01-01

    Background Transcutaneous electrical nerve stimulation (TENS) is a useful modality for pain control. TENS has recently been applied to decrease spasticity. The purpose of this study is to determine whether the addition of TENS to an exercise program reduces spasticity and improves balance and gait in chronic stroke patients. Material/Methods This was a single-blinded, multicenter, randomized controlled trial. Thirty-four ambulatory individuals with chronic stroke participated and were randoml...

  16. Relative contribution of different altered motor unit control to muscle weakness in stroke: a simulation study

    Science.gov (United States)

    Shin, Henry; Suresh, Nina L.; Zev Rymer, William; Hu, Xiaogang

    2018-02-01

    Objective. Chronic muscle weakness impacts the majority of individuals after a stroke. The origins of this hemiparesis is multifaceted, and an altered spinal control of the motor unit (MU) pool can lead to muscle weakness. However, the relative contribution of different MU recruitment and discharge organization is not well understood. In this study, we sought to examine these different effects by utilizing a MU simulation with variations set to mimic the changes of MU control in stroke. Approach. Using a well-established model of the MU pool, this study quantified the changes in force output caused by changes in MU recruitment range and recruitment order, as well as MU firing rate organization at the population level. We additionally expanded the original model to include a fatigue component, which variably decreased the output force with increasing length of contraction. Differences in the force output at both the peak and fatigued time points across different excitation levels were quantified and compared across different sets of MU parameters. Main results. Across the different simulation parameters, we found that the main driving factor of the reduced force output was due to the compressed range of MU recruitment. Recruitment compression caused a decrease in total force across all excitation levels. Additionally, a compression of the range of MU firing rates also demonstrated a decrease in the force output mainly at the higher excitation levels. Lastly, changes to the recruitment order of MUs appeared to minimally impact the force output. Significance. We found that altered control of MUs alone, as simulated in this study, can lead to a substantial reduction in muscle force generation in stroke survivors. These findings may provide valuable insight for both clinicians and researchers in prescribing and developing different types of therapies for the rehabilitation and restoration of lost strength after stroke.

  17. Predicting long-term outcome after acute ischemic stroke: a simple index works in patients from controlled clinical trials.

    Science.gov (United States)

    König, Inke R; Ziegler, Andreas; Bluhmki, Erich; Hacke, Werner; Bath, Philip M W; Sacco, Ralph L; Diener, Hans C; Weimar, Christian

    2008-06-01

    An early and reliable prognosis for recovery in stroke patients is important for initiation of individual treatment and for informing patients and relatives. We recently developed and validated models for predicting survival and functional independence within 3 months after acute stroke, based on age and the National Institutes of Health Stroke Scale score assessed within 6 hours after stroke. Herein we demonstrate the applicability of our models in an independent sample of patients from controlled clinical trials. The prognostic models were used to predict survival and functional recovery in 5419 patients from the Virtual International Stroke Trials Archive (VISTA). Furthermore, we tried to improve the accuracy by adapting intercepts and estimating new model parameters. The original models were able to correctly classify 70.4% (survival) and 72.9% (functional recovery) of patients. Because the prediction was slightly pessimistic for patients in the controlled trials, adapting the intercept improved the accuracy to 74.8% (survival) and 74.0% (functional recovery). Novel estimation of parameters, however, yielded no relevant further improvement. For acute ischemic stroke patients included in controlled trials, our easy-to-apply prognostic models based on age and National Institutes of Health Stroke Scale score correctly predicted survival and functional recovery after 3 months. Furthermore, a simple adaptation helps to adjust for a different prognosis and is recommended if a large data set is available.

  18. Does Perturbation Training Prevent Falls after Discharge from Stroke Rehabilitation? A Prospective Cohort Study with Historical Control.

    Science.gov (United States)

    Mansfield, Avril; Schinkel-Ivy, Alison; Danells, Cynthia J; Aqui, Anthony; Aryan, Raabeae; Biasin, Louis; DePaul, Vincent G; Inness, Elizabeth L

    2017-10-01

    Individuals with stroke fall frequently, and no exercise intervention has been shown to prevent falls post stroke. Perturbation-based balance training (PBT), which involves practicing reactions to instability, shows promise for preventing falls in older adults and individuals with Parkinson's disease. This study aimed to determine if PBT during inpatient stroke rehabilitation can prevent falls after discharge into the community. Individuals with subacute stroke completed PBT as part of routine inpatient rehabilitation (n = 31). Participants reported falls experienced in daily life for up to 6 months post discharge. Fall rates were compared to a matched historical control group (HIS) who did not complete PBT during inpatient rehabilitation. Five of 31 PBT participants, compared to 15 of 31 HIS participants, reported at least 1 fall. PBT participants reported 10 falls (.84 falls per person per year) whereas HIS participants reported 31 falls (2.0 falls per person per year). When controlled for follow-up duration and motor impairment, fall rates were lower in the PBT group than the HIS group (rate ratio: .36 [.15, .79]; P = .016). These findings suggest that PBT is promising for reducing falls post stroke. While this was not a randomized controlled trial, this study may provide sufficient evidence for implementing PBT in stroke rehabilitation practice. Copyright © 2017 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  19. Unilateral versus bilateral robot-assisted rehabilitation on arm-trunk control and functions post stroke: a randomized controlled trial.

    Science.gov (United States)

    Wu, Ching-Yi; Yang, Chieh-Ling; Chen, Ming-de; Lin, Keh-Chung; Wu, Li-Ling

    2013-04-12

    Although the effects of robot-assisted arm training after stroke are promising, the relative effects of unilateral (URT) vs. bilateral (BRT) robot-assisted arm training remain uncertain. This study compared the effects of URT vs. BRT on upper extremity (UE) control, trunk compensation, and function in patients with chronic stroke. This was a single-blinded, randomized controlled trial. The intervention was implemented at 4 hospitals. Fifty-three patients with stroke were randomly assigned to URT, BRT, or control treatment (CT). Each group received UE training for 90 to 105 min/day, 5 days/week, for 4 weeks. The kinematic variables for arm motor control and trunk compensation included normalized movement time, normalized movement units, and the arm-trunk contribution slope in unilateral and bilateral tasks. Motor function and daily function were measured by the Wolf Motor Function Test (WMFT), Motor Activity Log (MAL), and ABILHAND Questionnaire. The BRT and CT groups elicited significantly larger slope values (i.e., less trunk compensation) at the start of bilateral reaching than the URT group. URT led to significantly better effects on WMFT-Time than BRT. Differences in arm control kinematics and performance on the MAL and ABILHAND among the 3 groups were not significant. BRT and URT resulted in differential improvements in specific UE/trunk performance in patients with stroke. BRT elicited larger benefits than URT on reducing compensatory trunk movements at the beginning of reaching. In contrast, URT produced better improvements in UE temporal efficiency. These relative effects on movement kinematics, however, did not translate into differential benefits in daily functions. ClinicalTrials.gov: NCT00917605.

  20. Y chromosome gene expression in the blood of male patients with ischemic stroke compared with male controls.

    Science.gov (United States)

    Tian, Yingfang; Stamova, Boryana; Jickling, Glen C; Xu, Huichun; Liu, Dazhi; Ander, Bradley P; Bushnell, Cheryl; Zhan, Xinhua; Turner, Renee J; Davis, Ryan R; Verro, Piero; Pevec, William C; Hedayati, Nasim; Dawson, David L; Khoury, Jane; Jauch, Edward C; Pancioli, Arthur; Broderick, Joseph P; Sharp, Frank R

    2012-04-01

    Sex is suggested to be an important determinant of ischemic stroke risk factors, etiology, and outcome. However, the basis for this remains unclear. The Y chromosome is unique in males. Genes expressed in males on the Y chromosome that are associated with stroke may be important genetic contributors to the unique features of males with ischemic stroke, which would be helpful for explaining sex differences observed between men and women. We compared Y chromosome gene expression in males with ischemic stroke and male controls. Blood samples were obtained from 40 male patients ≤3, 5, and 24 hours after ischemic stroke and from 41 male controls (July 2003-April 2007). RNA was isolated from blood and was processed using Affymetrix Human U133 Plus 2.0 expression arrays (Affymetrix Inc., Santa Clara, California). Y chromosome genes differentially expressed between male patients with stroke and male control subjects were identified using an ANCOVA adjusted for age and batch. A P 1.2 were considered significant. Seven genes on the Y chromosome were differentially expressed in males with ischemic stroke compared with controls. Five of these genes (VAMP7, CSF2RA, SPRY3, DHRSX, and PLCXD1) are located on pseudoautosomal regions of the human Y chromosome. The other 2 genes (EIF1AY and DDX3Y) are located on the nonrecombining region of the human Y chromosome. The identified genes were associated with immunology, RNA metabolism, vesicle fusion, and angiogenesis. Specific genes on the Y chromosome are differentially expressed in blood after ischemic stroke. These genes provide insight into potential molecular contributors to sex differences in ischemic stroke. Copyright © 2012 Elsevier HS Journals, Inc. All rights reserved.

  1. A Control Method to Balance the Efficiency and Reliability of a Time-Delayed Pump-Valve System

    Directory of Open Access Journals (Sweden)

    Zhounian Lai

    2016-01-01

    Full Text Available The efficiency and reliability of pumps are highly related to their operation conditions. The concept of the optimization pump operation conditions is to adjust the operation point of the pump to obtain higher reliability at the cost of lower system efficiency using a joint regulation of valve and frequency convertor. This paper realizes the control of the fluid conveying system based on the optimization results. The system is a nonlinear Multi-Input Multioutput (MIMO system with time delays. In this paper, the time delays are separated from the system. The delay-free system is linearized using input-output linearization and controlled using a sliding mode method. A modified Smith predictor is used to compensate time delays of the system. The control strategy is validated to be effective on the test bench. The comparison of energy consumption and operation point deviation between conventional speed regulation and the new method is presented.

  2. Influence of Renal Impairment on Outcome for Thrombolysis-Treated Acute Ischemic Stroke: ENCHANTED (Enhanced Control of Hypertension and Thrombolysis Stroke Study) Post Hoc Analysis.

    Science.gov (United States)

    Carr, Susan J; Wang, Xia; Olavarria, Veronica V; Lavados, Pablo M; Rodriguez, Jorge A; Kim, Jong S; Lee, Tsong-Hai; Lindley, Richard I; Pontes-Neto, Octavio M; Ricci, Stefano; Sato, Shoichiro; Sharma, Vijay K; Woodward, Mark; Chalmers, John; Anderson, Craig S; Robinson, Thompson G

    2017-09-01

    Renal dysfunction (RD) is associated with poor prognosis after stroke. We assessed the effects of RD on outcomes and interaction with low- versus standard-dose alteplase in a post hoc subgroup analysis of the ENCHANTED (Enhanced Control of Hypertension and Thrombolysis Stroke Study). A total of 3220 thrombolysis-eligible patients with acute ischemic stroke (mean age, 66.5 years; 37.8% women) were randomly assigned to low-dose (0.6 mg/kg) or standard-dose (0.9 mg/kg) intravenous alteplase within 4.5 hours of symptom onset. Six hundred and fifty-nine (19.8%) patients had moderate-to-severe RD (estimated glomerular filtration rate, 90 mL/min per 1.73 m 2 ), those with severe RD (stroke. There was no significant association with modified Rankin Scale scores 2 to 6 (adjusted odds ratio, 1.03; 95% confidence interval, 0.62-1.70; P =0.81 for trend), modified Rankin Scale 3 to 6 (adjusted odds ratio, 1.20; 95% confidence interval, 0.72-2.01; P =0.44 for trend), or symptomatic intracerebral hemorrhage, or any heterogeneity in comparative treatment effects between low-dose and standard-dose alteplase by RD grades. RD is associated with increased mortality but not disability or symptomatic intracerebral hemorrhage in thrombolysis-eligible and treated acute ischemic stroke patients. Uncertainty persists as to whether low-dose alteplase confers benefits over standard-dose alteplase in acute ischemic stroke patients with RD. URL: http://www.clinicaltrials.gov. Unique identifier: NCT01422616. © 2017 American Heart Association, Inc.

  3. An optimization strategy for the control of small capacity heat pump integrated air-conditioning system

    International Nuclear Information System (INIS)

    Gao, Jiajia; Huang, Gongsheng; Xu, Xinhua

    2016-01-01

    Highlights: • An optimization strategy for a small-scale air-conditioning system is developed. • The optimization strategy aims at optimizing the overall system energy consumption. • The strategy may guarantee the robust control of the space air temperature. • The performance of the optimization strategy was tested on a simulation platform. - Abstract: This paper studies the optimization of a small-scale central air-conditioning system, in which the cooling is provided by a ground source heat pump (GSHP) equipped with an on/off capacity control. The optimization strategy aims to optimize the overall system energy consumption and simultaneously guarantee the robustness of the space air temperature control without violating the allowed GSHP maximum start-ups number per hour specified by customers. The set-point of the chilled water return temperature and the width of the water temperature control band are used as the decision variables for the optimization. The performance of the proposed strategy was tested on a simulation platform. Results show that the optimization strategy can save the energy consumption by 9.59% in a typical spring day and 2.97% in a typical summer day. Meanwhile it is able to enhance the space air temperature control robustness when compared with a basic control strategy without optimization.

  4. Cardiac rehabilitation adapted to transient ischaemic attack and stroke (CRAFTS: a randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Blake Catherine

    2009-02-01

    Full Text Available Abstract Background Coronary Heart Disease and Cerebrovascular Disease share many predisposing, modifiable risk factors (hypertension, abnormal blood lipids and lipoproteins, cigarette smoking, physical inactivity, obesity and diabetes mellitus. Lifestyle interventions and pharmacological therapy are recognised as the cornerstones of secondary prevention. Cochrane review has proven the benefits of programmes incorporating exercise and lifestyle counselling in the cardiac disease population. A Cochrane review highlighted as priority, the need to establish feasibility and efficacy of exercise based interventions for Cerebrovascular Disease. Methods A single blind randomised controlled trial is proposed to examine a primary care cardiac rehabilitation programme for adults post transient ischemic attack (TIA and stroke in effecting a positive change in the primary outcome measures of cardiac risk scores derived from Blood Pressure, lipid profile, smoking and diabetic status and lifestyle factors of habitual smoking, exercise and healthy eating participation. Secondary outcomes of interest include health related quality of life as measured by the Hospital Anxiety and Depression Scale, the Stroke Specific Quality of Life scale and WONCA COOP Functional Health Status charts and cardiovascular fitness as measured by a sub-maximal fitness test. A total of 144 patients, over 18 years of age with confirmed diagnosis of ischaemic stroke or TIA, will be recruited from Dublin community stroke services and two tertiary T.I.A clinics. Exclusion criteria will include oxygen dependence, unstable cardiac conditions, uncontrolled diabetes, major medical conditions, claudication, febrile illness, pregnancy or cognitive impairment. Participants will be block-statified, randomly allocated to one of two groups using a pre-prepared computer generated randomisation schedule. Both groups will receive a two hour education class on risk reduction post stroke. The

  5. 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 ...

  6. Comparing the Comprehensive Stroke Ward Versus Mixed Rehabilitation Ward-The Importance of the Team in the Acute Stroke Care in a Case-Control Study.

    Science.gov (United States)

    Lange, Marcos C; de Araujo, Tiago F S; Ferreira, Luiz F T; Ducci, Renata D P; Novak, Edison M; Germiniani, Francisco M B; Zetola, Viviane F

    2017-04-01

    Ischemic stroke is one of the most frequent causes of death in Brazil. Many measures have been taken to reduce this tragic outcome, and one of those is the implementation of stroke units in hospitals. The aim of the present study is to analyze the in-hospital complications for patients with ischemic stroke admitted in a comprehensive stroke ward (CSW) as compared to patients admitted in a mixed rehabilitation ward (MRW). A retrospective interventional study with historic controls of patients admitted to the Neurology Division between January 2010 and October 2013. Patients admitted between January 2010 and September 2012 were included in the MRW group, and patients admitted from October 2012 until October 2013 were included in the CSW group. Throughout the whole study period, the same team assisted all the patients. Both groups were paired in relation to age and gender. The rate of in-hospital complications, mortality, and independency on discharge were evaluated in both groups. Each group was comprised of 91 patients. There were no statistically significant differences for any of the risk factors analyzed between the 2 groups nor for outcome measures-in-hospital complications, mortality, and independence on discharge. The present study demonstrated that in-hospital complications, independence on discharge, and mortality have similar rates in patients admitted to an MRW compared to patients admitted to a CSW, when the same staff provided them with specialized in-hospital care. Case-control study-Evidence Level 3.

  7. Acupuncture for Spasticity after Stroke: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

    Directory of Open Access Journals (Sweden)

    Sung Min Lim

    2015-01-01

    Full Text Available The aim of this systematic review was to determine how effective acupuncture or electroacupuncture (acupuncture with electrical stimulation is in treating poststroke patients with spasticity. We searched publications in Medline, EMBASE, and the Cochrane Library in English, 19 accredited journals in Korean, and the China Integrated Knowledge Resources Database in Chinese through to July 30, 2013. We included randomized controlled trials (RCTs with no language restrictions that compared the effects of acupuncture or electroacupuncture with usual care or placebo acupuncture. The two investigators assessed the risk of bias and statistical analyses were performed. Three RCTs in English, 1 in Korean, and 1 in Chinese were included. Assessments were performed primarily with the Modified Ashworth Scale (MAS. Meta-analysis showed that acupuncture or electroacupuncture significantly decreased spasticity after stroke. A subgroup analysis showed that acupuncture significantly decreased wrist, knee, and elbow spasticity in poststroke patients. Heterogeneity could be explained by the differences in control, acupoints, and the duration after stroke occurrence. In conclusion, acupuncture could be effective in decreasing spasticity after stroke, but long-term studies are needed to determine the longevity of treatment effects.

  8. Conductive Education as a Method of Stroke Rehabilitation: A Single Blinded Randomised Controlled Feasibility Study

    Directory of Open Access Journals (Sweden)

    Judith Bek

    2016-01-01

    Full Text Available Background. Conductive Education for stroke survivors has shown promise but randomised evidence is unavailable. This study assessed the feasibility of a definitive randomised controlled trial to evaluate efficacy. Methods. Adult stroke survivors were recruited through local community notices. Those completing the baseline assessment were randomised using an online program and group allocation was independent. Intervention group participants received 10 weekly 1.5-hour sessions of Conductive Education at the National Institute of Conductive Education in Birmingham, UK. The control group participants attended two group meetings. The study evaluated the feasibility of recruitment procedures, delivery of the intervention, retention of participants, and appropriateness of outcome measures and data collection methods. Independent assessments included the Barthel Index, the Stroke Impact Scale, the Timed Up and Go test, and the Hospital Anxiety and Depression Scale. Results. Eighty-two patients were enrolled; 77 completed the baseline assessment (46 men, mean age 62.1 yrs. and were randomised. 70 commenced the intervention (n=37 or an equivalent waiting period (n=33. 32/37 completed the 10-week training and 32/33 the waiting period. There were no missing items from completed questionnaires and no adverse events. Discussion. Recruitment, intervention, and assessment methods worked well. Transport issues for intervention and assessment appointments require review. Conclusion. A definitive trial is feasible. This trial is registered with ISRCTN84064492.

  9. MAJOR RISK FACTORS FOR STROKE AND THEIR CONTROL IN PATIENTS LIVING IN A SMALL TOWN OF THE MOSCOW REGION

    Directory of Open Access Journals (Sweden)

    V. V. Kozyaykin

    2015-01-01

    Full Text Available Background: Evaluation of prevalence and degree of control of leading risk factors for stroke among population of various regions of the Russian Federation enables rational planning of preventive activities.Aim: To analyze prevalence of the leading stroke risk factors, to assess efficacy of their control and to determine their impact on outcomes.Materials and methods: We examined and treated 129 patients with primary and repeated cerebral accidents living in a small town of the Moscow region.Results: The most prevalent stroke risk factor was arterial hypertension (94.6%. During 6 months before the stroke, target levels of systolic blood pressure had been achieved in 36/122 patients with arterial hypertension and those of diastolic blood pressure, in 4/122 patients. During the last 2 years preceding the index stroke, 48.8% of patients had hypertensive crises. More than half of the patients (71/122 either had not been taking their antihypertensive medications, or had not taken them regularly. There was a positive correlation between duration of arterial hypertension and degree of stroke-related disability, assessed by NIHSS (r = 0.263, p = 0.003, as well as between duration of arterial hypertension and functional activity index on Rankin scale at manifestation of stroke (r = 0.268, p = 0.003. Other prevalent risk factors were smoking (51.9% of patients, alcohol use (67.44%, diabetes mellitus (23.26%. Hypercholesterolemia that was diagnosed in 102/129 of the stroke patients, did not significantly affect any parameter of stroke severity (p > 0.05. There were weak positive correlations between body mass index and difference in NIHSS scores at admission and at discharge (r = 0.204, p = 0.049, between body mass and difference in NIHSS scores at admission and at discharge (r = 0.227, p = 0.028, as well as between body mass and difference in Rankin scale scores at admission and at discharge (r = 0.247, p = 0.016. Chronic stress situation (depression

  10. Meaningful task-specific training (MTST) for stroke rehabilitation: a randomized controlled trial.

    Science.gov (United States)

    Arya, Kamal Narayan; Verma, Rajesh; Garg, R K; Sharma, V P; Agarwal, Monika; Aggarwal, G G

    2012-01-01

    The upper extremity motor deficit is one of the functional challenges in post stroke patients. The objective of the present study was to evaluate the effectiveness of the meaningful task-specific training (MTST) on the upper extremity motor recovery during the subacute phase after a stroke. This was a randomized, controlled, double-blinded trial in the neurology department of a university hospital and occupational therapy unit of a rehabilitation institute. A convenience sample of 103 people, 4 to 24 weeks (mean, 12.15 weeks) after the stroke, was randomized into 2 groups (MTST, 51; standard training group, 52). Subjects in the Brunnstrom stage of arm recovery of 2 to 5 were included in the study. Ninety-five participants completed the 8-week follow-up. Participants were assigned to receive either the MTST or dose-matched standard training program based on the Brunnstrom stage and Bobath neurodevelopmental technique, 4 to 5 days a week for 4 weeks. Fugl-Meyer assessment (FMA), Action Research Arm Test (ARAT), Graded Wolf Motor Function Test (GWMFT), and Motor Activity Log (MAL) were outcome measures The MTST group showed a positive improvement in the mean scores on the outcome measures at post and follow-up assessments in comparison to the control group. Further, statistically significant differences were observed in changes between the groups at post and follow-up assessment for FMA, ARAT, GWMFT, and MAL. The MTST produced statistically significant and clinically relevant improvements in the upper extremity motor recovery of the patients who had a subacute stroke.

  11. Pharyngeal Electrical Stimulation for Treatment of Dysphagia in Subacute Stroke: A Randomized Controlled Trial.

    Science.gov (United States)

    Bath, Philip M; Scutt, Polly; Love, Jo; Clavé, Pere; Cohen, David; Dziewas, Rainer; Iversen, Helle K; Ledl, Christian; Ragab, Suzanne; Soda, Hassan; Warusevitane, Anushka; Woisard, Virginie; Hamdy, Shaheen

    2016-06-01

    Dysphagia is common after stroke, associated with increased death and dependency, and treatment options are limited. Pharyngeal electric stimulation (PES) is a novel treatment for poststroke dysphagia that has shown promise in 3 pilot randomized controlled trials. We randomly assigned 162 patients with a recent ischemic or hemorrhagic stroke and dysphagia, defined as a penetration aspiration score (PAS) of ≥3 on video fluoroscopy, to PES or sham treatment given on 3 consecutive days. The primary outcome was swallowing safety, assessed using the PAS, at 2 weeks. Secondary outcomes included dysphagia severity, function, quality of life, and serious adverse events at 6 and 12 weeks. In randomized patients, the mean age was 74 years, male 58%, ischemic stroke 89%, and PAS 4.8. The mean treatment current was 14.8 (7.9) mA and duration 9.9 (1.2) minutes per session. On the basis of previous data, 45 patients (58.4%) randomized to PES seemed to receive suboptimal stimulation. The PAS at 2 weeks, adjusted for baseline, did not differ between the randomized groups: PES 3.7 (2.0) versus sham 3.6 (1.9), P=0.60. Similarly, the secondary outcomes did not differ, including clinical swallowing and functional outcome. No serious adverse device-related events occurred. In patients with subacute stroke and dysphagia, PES was safe but did not improve dysphagia. Undertreatment of patients receiving PES may have contributed to the neutral result. URL: http://www.controlled-trials.com. Unique identifier: ISRCTN25681641. © 2016 The Authors.

  12. Automated Software System to Promote Anticoagulation and Reduce Stroke Risk: Cluster-Randomized Controlled Trial.

    Science.gov (United States)

    Holt, Tim A; Dalton, Andrew; Marshall, Tom; Fay, Matthew; Qureshi, Nadeem; Kirkpatrick, Susan; Hislop, Jenny; Lasserson, Daniel; Kearley, Karen; Mollison, Jill; Yu, Ly-Mee; Hobbs, F D Richard; Fitzmaurice, David

    2017-03-01

    Oral anticoagulants (OAC) substantially reduce risk of stroke in atrial fibrillation, but uptake is suboptimal. Electronic health records enable automated identification of people at risk but not receiving treatment. We investigated the effectiveness of a software tool (AURAS-AF [Automated Risk Assessment for Stroke in Atrial Fibrillation]) designed to identify such individuals during routine care through a cluster-randomized trial. Screen reminders appeared each time the electronic health records of an eligible patient was accessed until a decision had been taken over OAC treatment. Where OAC was not started, clinicians were prompted to indicate a reason. Control practices continued usual care. The primary outcome was the proportion of eligible individuals receiving OAC at 6 months. Secondary outcomes included rates of cardiovascular events and reports of adverse effects of the software on clinical decision-making. Forty-seven practices were randomized. The mean proportion-prescribed OAC at 6 months was 66.3% (SD=9.3) in the intervention arm and 63.9% (9.5) in the control arm (adjusted difference 1.21% [95% confidence interval -0.72 to 3.13]). Incidence of recorded transient ischemic attack was higher in the intervention practices (median 10.0 versus 2.3 per 1000 patients with atrial fibrillation; P =0.027), but at 12 months, we found a lower incidence of both all cause stroke ( P =0.06) and hemorrhage ( P =0.054). No adverse effects of the software were reported. No significant change in OAC prescribing occurred. A greater rate of diagnosis of transient ischemic attack (possibly because of improved detection or overdiagnosis) was associated with a reduction (of borderline significance) in stroke and hemorrhage over 12 months. URL: http://www.isrctn.com. Unique Identifier: ISRCTN55722437. © 2017 American Heart Association, Inc.

  13. Phase-Sensitive Control Of Molecular Dissociation Through Attosecond Pump/Strong-Field Mid-IR Probe Spectroscopy

    Science.gov (United States)

    2016-04-15

    AFRL-AFOSR-VA-TR-2016-0166 Phase-Sensitive Control Of Molecular Dissociation Through Attosecond Pump/Strong-Field Mid- IR Probe Spectroscopy Jeffery...Pump/Strong- Field Mid- IR Probe Spectroscopy 5a.  CONTRACT NUMBER 5b.  GRANT NUMBER FA9550-12-1-0080 5c.  PROGRAM ELEMENT NUMBER 61102F 6. AUTHOR(S...sequentially controlling ionization and dissociation steps in the H2+ molecule using tightly synchronized few-fs EUV and few-cycle mid- IR pulses. We

  14. A review on controlled porosity osmotic pump tablets and its evaluation

    Directory of Open Access Journals (Sweden)

    Chinmaya Keshari Sahoo

    2015-12-01

    Full Text Available Conventional drug delivery system provides an immediate release of drug which does not control the release of the drug and does not maintain effective concentration at target site for a longer period of time. Hence to avoid the shortcomings there is development of various controlled drug delivery systems. Among these osmotic drug delivery system (ODDS utilizes the principle of osmotic pressure and delivers drug dose in an optimized manner to maintain drug concentration within the therapeutic window and minimizes toxic effects. ODDS releases drug at a controlled rate that is independent of the pH and thermodynamics of dissolution medium. The release of drug from ODDS follows zero order kinetics. The release of drug from osmotic system depends upon various formulation factors such as solubility, osmotic pressure of the core components, size of the delivery orifice and nature of the rate controlling membrane. Controlled porosity osmotic pump (CPOP contains drug, osmogens, excipients in core and a coating of semipermeable membrane with water soluble additives. In CPOP water soluble additives dissolve after coming in contact with water, resulting in an in situ formation of a microporous membrane. The present study gives an idea about osmosis, CPOP, components of CPOP and its evaluation.

  15. Heat Pump Water Heaters: Controlled Field Research of Impact on Space Conditioning and Demand Response Characteristics

    Energy Technology Data Exchange (ETDEWEB)

    Parker, Graham B.; Widder, Sarah H.; Eklund, Ken; Petersen, Joseph M.; Sullivan, Greg

    2015-10-05

    A new generation of heat pump water heaters (HPWH) has been introduced into the U.S. market that promises to provide significant energy savings for water heating. Many electric utilities are promoting their widespread adoption as a key technology for meeting energy conservation goals and reducing greenhouse gas emissions. There is, however, considerable uncertainty regarding the space conditioning impact of an HPWH installed in a conditioned space. There is also uncertainty regarding the potential for deployment of HPWHs in demand response (DR) programs to help manage and balance peak utility loads in a similar manner as conventional electric resistance water heaters (ERWH). To help answer these uncertainties, controlled experiments have been undertaken over 30 months in a matched pair of unoccupied Lab Homes located on the campus of the Pacific Northwest National Laboratory (PNNL) in Richland, Washington.

  16. Off-pump Versus On-pump Coronary Artery Bypass Surgery: Graft Patency Assessment With Coronary Computed Tomographic Angiography: A Prospective Multicenter Randomized Controlled Pilot Study.

    Science.gov (United States)

    Noiseux, Nicolas; Stevens, Louis-Mathieu; Chartrand-Lefebvre, Carl; Soulez, Gilles; Prieto, Ignacio; Basile, Fadi; Mansour, Samer; Dyub, Adel M; Kieser, Teresa M; Lamy, André

    2017-11-01

    A large multicenter randomized trial (RCT) is needed to assess off-pump coronary artery bypass graft (CABG) patency when performed by skilled surgeons. This prospective multicenter randomized pilot study compares graft patency after on-pump and off-pump techniques and addresses the feasibility of such an RCT. Consecutive patients were prospectively recruited for ≥64-slice computed tomography angiography graft patency assessment 1 year after randomization to off-pump or on-pump CABG. Blinded assessment of graft patency was performed, and the results were categorized as normal, ≥50% stenosis, or occlusion. A multilevel model with random effects on the patient was used to account for correlation of results in patients with multiple grafts. A total of 157 patients (3 centers, 84 off-pump and 73 on-pump patients, 512 grafts, assessability rate 98.4%) were included. Patency index (% nonoccluded grafts) was 89% for the off-pump technique and 95% for the on-pump technique (P=0.09). Patency was similar for arterial and vein grafts (both 92%; P=0.88), as well as between target territories (89% to 94%; P=0.53). In this pilot study, 1-year graft patency results after off-pump and on-pump surgery were similar. This feasibility trial demonstrates that a large multicenter RCT to compare CABG patency after on-pump with that after off-pump techniques is feasible and can be reliably undertaken using computed tomography angiography.

  17. Indications for Insulin Pump Therapy in Type 1 Diabetes and Associations With Glycemic Control.

    Science.gov (United States)

    Jendle, Johan H; Rawshani, Araz; Svensson, Ann-Marie; Avdic, Tarik; Gudbjörnsdóttir, Soffia

    2016-09-01

    Real-world data regarding indications for use of insulin pump remain sparse. We investigated characteristics among individuals with type 1 diabetes (T1D) in relation to indication for use of insulin pump (CSII). Comparison was made with T1D subjects using multiple daily injections (MDI). We included all individuals with T1D who had at least 1 registration in the National Diabetes Register during 2014-2015. Among 46 874 individuals, we excluded 2350 due to missing data. We examined 35 725 on MDI and 8799 on CSII regarding characteristics in relation to insulin delivery method, as well as association between insulin delivery and glycemic control (HbA1c) and presence of albuminuria. Unadjusted mean (SD) HbA1c was 63.84 (15.07) mmol/mol (7.99 [1.38]%) and 63.75 (13.19) mmol/mol (7.99 [1.21]%) in the MDI and CSII group, respectively. MDI and CSII users were on average 48.8 and 41.5 years old, respectively. MDI users were on average 26 years old and CSII users 17 years old at the time of diabetes diagnosis. Overall, a higher proportion of CSII users were females (53.5%). As compared with MDI, use of CSII was associated with up to 7.84 mmol/mol (0.72%) lower HbA1c in a multivariable adjusted model. Use of CSII was, however, not associated with risk of having albuminuria. CSII was used more frequently in younger individuals, early-onset diabetes, and problematic glycemic control. The use of CSII was associated with lower HbA1c among CSII users except from those who started CSII due to high HbA1c. © 2016 Diabetes Technology Society.

  18. Effects of the Bad Ragaz Ring Method on muscle activation of the lower limbs and balance ability in chronic stroke: A randomised controlled trial

    OpenAIRE

    Hyun-Gyu Cha, PT, PhD; Young-Jun Shin, PT, MS; Myoung-Kwon Kim, PT, PhD

    2017-01-01

    Background: Recovery of balance and walking abilities is important for the rehabilitation of stroke patients. Objectives: To evaluate the effects of the Bad Ragaz Ring method on functional recovery in chronic stroke patients. Methods: Twenty-two chronic stroke patients were randomly assigned to two groups: a Bad Ragaz Ring method group (the experimental group) or a control group. Stroke patients in the experimental group underwent Bad Ragaz Ring exercise and comprehensive rehabilitation thera...

  19. Combined Electrical Stimulation and Exercise for Swallow Rehabilitation Post-Stroke: A Pilot Randomized Control Trial

    Science.gov (United States)

    Sproson, Lise; Pownall, Sue; Enderby, Pam; Freeman, Jenny

    2018-01-01

    Background: Dysphagia is common after stroke, affecting up to 50% of patients initially. It can lead to post-stroke pneumonia, which causes 30% of stroke-related deaths, a longer hospital stay and poorer health outcomes. Dysphagia care post-stroke generally focuses on the management of symptoms, via modified oral intake textures and adapted…

  20. Pumping machinery theory and practice

    CERN Document Server

    Badr, Hassan M

    2014-01-01

    Pumping Machinery Theory and Practice comprehensively covers the theoretical foundation and applications of pumping machinery. Key features: Covers characteristics of centrifugal pumps, axial flow pumps and displacement pumpsConsiders pumping machinery performance and operational-type problemsCovers advanced topics in pumping machinery including multiphase flow principles, and two and three-phase flow pumping systemsCovers different methods of flow rate control and relevance to machine efficiency and energy consumptionCovers different methods of flow rate control and relevance to machine effi

  1. Edge plasma control: Particle channeling in Tore Supra pump limiter and ergodic divertor

    International Nuclear Information System (INIS)

    Ghendrih, P.; Samain, A.; Grosman, A.; Capes, H.; Morera, J.P.

    1989-01-01

    Improved pumping efficiency can be achieved on Tore Supra by channeling process for particles, i.e. channeling of neutrals in the throat of pump limiters and channeling of plasma towards neutralizer plates in the ergodic divertor. The plugging length for the pump limiter throat is computed and numerical evidence of plasma flux channeling between the conductor bars of the ergodic divertor is presented. The effect of the Tore Supra ergodic divertor on edge plasma state and edge plasma transport is discussed. (orig.)

  2. Off-pump versus on-pump coronary artery bypass grafting: comparative effectiveness

    Directory of Open Access Journals (Sweden)

    Raja SG

    2015-11-01

    Full Text Available Shahzad G Raja Department of Cardiac Surgery, Harefield Hospital, London, UK Background: Historically, coronary artery bypass grafting (CABG with the use of cardiopulmonary bypass (CPB, referred to as on-pump CABG, has been regarded as the “gold standard”. However, in recent years, it has been increasingly recognized that the systemic inflammatory response associated with using CPB contributes substantially to postoperative organ dysfunction. Intuitively, performance of CABG without CPB, referred to as off-pump CABG, should translate into improved clinical outcomes. Interestingly, no single randomized trial has been able to prove the superiority of off-pump CABG over on-pump CABG for all hard outcomes, and off-pump CABG remains the subject of intense scrutiny as well as controversy. The purpose of the review is to summarize the current best available evidence, comparing the effectiveness of off- and on-pump CABG. Methods: The English language scientific literature was reviewed primarily by searching MEDLINE from January 2010 to December 2014 using PubMed interface to identify meta-analyses and systematic reviews of randomized controlled trials as well as observational studies using propensity score matching, comparing the effectiveness of off- and on-pump CABG. Results: Current best available evidence from meta-analyses and systematic reviews of randomized controlled trials as well as propensity score analyses suggests that off-pump CABG is associated with fewer distal anastomoses, increased repeat revascularization rates, and poor saphenous vein graft patency compared with on-pump CABG. No significant differences were observed for other hard outcomes including mortality, myocardial infarction, and stroke. Conclusion: Off-pump CABG compared to on-pump CABG is associated with similar short-, mid-, and long-term mortality, comparable organ protection, and fewer distal anastomoses. The concerns about the safety and efficacy of off-pump CABG are

  3. Short-term blood pressure variability in acute stroke: post hoc analysis of the controlling hypertension and hypotension immediately post stroke and continue or stop post-stroke antihypertensives collaborative study trials.

    Science.gov (United States)

    Manning, Lisa S; Mistri, Amit K; Potter, John; Rothwell, Peter M; Robinson, Thompson G

    2015-06-01

    Short-term blood pressure variability (BPV) may predict outcome in acute stroke. We undertook a post hoc analysis of data from 2 randomized controlled trials to determine the effect of short-term BPV on 2-week outcome. Controlling Hypertension and Hypotension Immediately Post Stroke (CHHIPS) was a trial of BP-lowering, enrolling 179 acute stroke patients (onset3) at 2 weeks. Seven hundred six (92.5%) and 171 (95.5%) participants were included in the analysis for the COSSACS and CHHIPS data sets, respectively. Adjusted logistic regression analyses revealed no statistically significant associations between any of the included BPV parameters with 2-week death or disability in either study data set: COSSACS, odds ratio SD systolic BP 0.98 (0.78-1.23); CHHIPS, odds ratio SD systolic BP 0.97 (0.90-1.11). When derived from casual cuff BP measures, short-term BPV is not a useful predictor of early (2 weeks) outcome after acute stroke. Differing methodology may account for the discordance with previous studies indicating long-term (casual BPV) and short-term (beat-to-beat BPV) prognostic value. COSSACS was registered on the International Standard Randomised Controlled Trial Register; URL: http://www.isrctn.com. Unique identifier: ISRCTN89712435. CHHIPS was registered on the National Research Register; URL: http://public.ukcrn.org.uk. Unique identifier: N0484128008. © 2015 American Heart Association, Inc.

  4. Comparison between Infusion Pumps: Fentanyl/Ketamine and Fentanyl/Paracetamol in Pain control Following Tight and Leg Surgeries

    Directory of Open Access Journals (Sweden)

    Behnam Mahmoodiyeh

    2016-08-01

    Full Text Available Background: Adjuvants such as ketamine, promethazine and paracetamol could bring up patients satisfaction and control harmful effects of opioids besides lessening their needed doses, as seen by fentanyl/paracetamol and fentanyl/ketamine combination before. The current study headed to compare paracetamol and ketamine in addition to fentanyl applied by infusion pumps in order to pain relief following major surgery.Methods: Through a double blinded randomized clinical trial, patients between18 and 65 with elective surgery for tight or leg fractures with ASA Class 1 and 2 referring to a university hospital in Arak, a town in central region of Iran, were recruited and used infusion pump for their postoperative pain control. The participants were divided into cases and controls regarding using ketamine/fentanyl (KF or paracetamol/fentanyl (PF infusion pumps.Results: The mean pain score was totally 3.87 with higher value in KF (5.06 and lower in PF (4.5 immediately after finishing surgery and getting conscious when started using infusion pump. There was no statistical difference between the groups in this regard. Concerning the side effects of the applied medications, blood pressure and heart rate had no differences comparing the groups.Conclusion: This study showed that paracetamol used in infusion pump can be brilliant in pain control after major surgeries like what done in lower extremities and joint replacement while lessens opioid use. Although paracetamol was more effective than ketamine in the current trial, more qualified studies at bigger size and in other fields of surgery beside orthopedic ones would be useful to support the effects if applicable.Keywords: Infusion pump, Ketamine, Paracetamol, Fentanyl, Postoperative pain

  5. Effect of early trunk control training on balance function of patients with acute stroke

    Directory of Open Access Journals (Sweden)

    Bao-jin LI

    2017-07-01

    Full Text Available Background Trunk is the core part of human body, and plays an important role in maintaining the body balance. Studies show that trunk control training can improve the balance function and mobility ability, and promote motor function and activities of daily living (ADL of stroke patients. This study aims to investigate the effect of early trunk control training on the recovery of balance function of acute stroke patients.  Methods A total of 120 patients with acute ischemic stroke (duration ≤ 14 d were randomly divided into 2 groups: control group [N = 60, 39 males and 21 females; age 23-85 years, mean age (63.43 ± 13.61 years; duration 1-13 d, median duration 4.12 (2.30, 6.09 d] and observation group [N = 60, 40 males and 20 females; age 20-84 years, average age (62.55 ± 13.77 years; duration 1-12 d, median duration 4.19 (2.48, 6.30 d]. Control group was given routine drug treatment plus rehabilitation education and guidance, and observation group was given routine drug treatment, rehabilitation education and guidance plus trunk control training. Fugl-Meyer Assessment Scale-Balance (FMA-Balance and Modified Rivermead Mobility Index (MRMI were used to evaluate the balance function of patients in both groups before training and after 2-week training.  Results All patients finished the rehabilitation training programme without adverse reactions. Compared with before training, the scores of FMA-Balance (P =0.000 and MRMI (P = 0.000 were significantly increased after 2-week training in both groups. Compared to control group, the scores of FMA-Balance (P = 0.002 and MRMI (P = 0.002 were significantly increased after 2-week training in observation group.  Conclusions Early trunk control training can significantly improve the balance function and motor ability of patients with acute stroke. DOI: 10.3969/j.issn.1672-6731.2017.04.005

  6. A Peristaltic Pump Integrated on a 100% Glass Microchip Using Computer Controlled Piezoelectric Actuators

    Directory of Open Access Journals (Sweden)

    Yo Tanaka

    2014-05-01

    Full Text Available Lab-on-a-chip technology is promising for the miniaturization of chemistry, biochemistry, and/or biology researchers looking to exploit the advantages of a microspace. To manipulate fluid on a microchip, on-chip pumps are indispensable. To date, there have been several types of on-chip pumps including pneumatic, electroactive, and magnetically driven. However these pumps introduce polymers, metals, and/or silicon to the microchip, and these materials have several disadvantages, including chemical or physical instability, or an inherent optical detection limit. To overcome/avoid these issues, glass has been one of the most commonly utilized materials for the production of multi-purpose integrated chemical systems. However, glass is very rigid, and it is difficult to incorporate pumps onto glass microchips. This paper reports the use of a very flexible, ultra-thin glass sheet (minimum thickness of a few micrometers to realize a pump installed on an entirely glass-based microchip. The pump is a peristaltic-type, composed of four serial valves sealing a cavity with two penetrate holes using ultra-thin glass sheet. By this pump, an on-chip circulating flow was demonstrated by directly observing fluid flow, visualized via polystyrene tracking particles. The flow rate was proportional to the pumping frequency, with a maximum flow rate of approximately 0.80 μL/min. This on-chip pump could likely be utilized in a wide range of applications which require the stability of a glass microchip.

  7. Acupuncture treatment for ischaemic stroke in young adults: protocol for a randomised, sham-controlled clinical trial.

    Science.gov (United States)

    Chen, Lifang; Fang, Jianqiao; Jin, Xiaoming; Keeler, Crystal Lynn; Gao, Hong; Fang, Zhen; Chen, Qin

    2016-01-06

    Stroke in young adults is not uncommon. Although the overall incidence of stroke has been recently declining, the incidence of stroke in young adults is increasing. Traditional vascular risk factors are the main cause of young ischaemic stroke. Acupuncture has been shown to benefit stroke rehabilitation and ameliorate the risk factors for stroke. The aims of this study were to determine whether acupuncture treatment will be effective in improving the activities of daily living (ADL), motor function and quality of life (QOL) in patients of young ischaemic stroke, and in preventing stroke recurrence by controlling blood pressure, lipids and body weight. In this randomised, sham-controlled, participant-blinded and assessor-blinded clinical trial, 120 patients between 18 and 45 years of age with a recent (within 1 month) ischaemic stroke will be randomised for an 8-week acupuncture or sham acupuncture treatment. The primary outcome will be the Barthel Index for ADL. The secondary outcomes will include the Fugl-Meyer Assessment for motor function; the World Health Organization Quality of Life BREF (WHOQOL-BREF) for QOL; and risk factors that are measured by ambulatory blood pressure, the fasting serum lipid, body mass index and waist circumference. Incidence of adverse events and long-term mortality and recurrence rate during a 10-year and 30-year follow-up will also be investigated. Ethics approval was obtained from the Ethics Committee of The Third Affiliated Hospital of Zhejiang Chinese Medical University. Protocol V.3 was approved in June 2013. The results will be disseminated in a peer-reviewed journal and presented at international congresses. The results will also be disseminated to patients by telephone during follow-up calls enquiring on the patient's post-study health status. ChiCTR-TRC- 13003317; Pre-results. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  8. A neurocognitive approach for recovering upper extremity movement following subacute stroke: a randomized controlled pilot study.

    Science.gov (United States)

    Sallés, Laia; Martín-Casas, Patricia; Gironès, Xavier; Durà, María José; Lafuente, José Vicente; Perfetti, Carlo

    2017-04-01

    [Purpose] This study aims to describe a protocol based on neurocognitive therapeutic exercises and determine its feasibility and usefulness for upper extremity functionality when compared with a conventional protocol. [Subjects and Methods] Eight subacute stroke patients were randomly assigned to a conventional (control group) or neurocognitive (experimental group) treatment protocol. Both lasted 30 minutes, 3 times a week for 10 weeks and assessments were blinded. Outcome measures included: Motor Evaluation Scale for Upper Extremity in Stroke Patients, Motricity Index, Revised Nottingham Sensory Assessment and Kinesthetic and Visual Imagery Questionnaire. Descriptive measures and nonparametric statistical tests were used for analysis. [Results] The results indicate a more favorable clinical progression in the neurocognitive group regarding upper extremity functional capacity with achievement of the minimal detectable change. The functionality results are related with improvements on muscle strength and sensory discrimination (tactile and kinesthetic). [Conclusion] Despite not showing significant group differences between pre and post-treatment, the neurocognitive approach could be a safe and useful strategy for recovering upper extremity movement following stroke, especially regarding affected hands, with better and longer lasting results. Although this work shows this protocol's feasibility with the panel of scales proposed, larger studies are required to demonstrate its effectiveness.

  9. Comparison of Bobath based and movement science based treatment for stroke: a randomised controlled trial.

    Science.gov (United States)

    van Vliet, P M; Lincoln, N B; Foxall, A

    2005-04-01

    Bobath based (BB) and movement science based (MSB) physiotherapy interventions are widely used for patients after stroke. There is little evidence to suggest which is most effective. This single-blind randomised controlled trial evaluated the effect of these treatments on movement abilities and functional independence. A total of 120 patients admitted to a stroke rehabilitation ward were randomised into two treatment groups to receive either BB or MSB treatment. Primary outcome measures were the Rivermead Motor Assessment and the Motor Assessment Scale. Secondary measures assessed functional independence, walking speed, arm function, muscle tone, and sensation. Measures were performed by a blinded assessor at baseline, and then at 1, 3, and 6 months after baseline. Analysis of serial measurements was performed to compare outcomes between the groups by calculating the area under the curve (AUC) and inserting AUC values into Mann-Whitney U tests. Comparison between groups showed no significant difference for any outcome measures. Significance values for the Rivermead Motor Assessment ranged from p = 0.23 to p = 0.97 and for the Motor Assessment Scale from p = 0.29 to p = 0.87. There were no significant differences in movement abilities or functional independence between patients receiving a BB or an MSB intervention. Therefore the study did not show that one approach was more effective than the other in the treatment of stroke patients.

  10. Assessment of the correlations between gait speed in post-stroke patients and the time from stroke onset, the level of motor control in the paretic lower limb, proprioception, visual field impairment and functional independence

    Directory of Open Access Journals (Sweden)

    Drużbicki Mariusz

    2016-09-01

    Full Text Available Introduction: Gait recovery is one of the main objectives in the rehabilitation of post-stroke patients. The study aim was to assess the correlations between gait speed in post-stroke hemiparetic patients and the level of motor control in the paretic lower limb, the time from stroke onset, the subjects’ age as well as the impairment of proprioception and visual field.

  11. A case-control study of medium-term exposure to ambient nitrogen dioxide pollution and hospitalization for stroke.

    Science.gov (United States)

    Johnson, Julie Y M; Rowe, Brian H; Allen, Ryan W; Peters, Paul A; Villeneuve, Paul J

    2013-04-19

    There are several plausible mechanisms whereby either short or long term exposure to pollution can increase the risk of stroke. Over the last decade, several studies have reported associations between short-term (day-to-day) increases in ambient air pollution and stroke. The findings from a smaller number of studies that have looked at long-term exposure to air pollution and stroke have been mixed. Most of these epidemiological studies have assigned exposure to air pollution based on place of residence, but these assignments are typically based on relatively coarse spatial resolutions. To date, few studies have evaluated medium-term exposures (i.e, exposures over the past season or year). To address this research gap, we evaluated associations between highly spatially resolved estimates of ambient nitrogen dioxide (NO2), a marker of traffic pollution, and emergency department visits for stroke in Edmonton, Canada. This was a case-control study with cases defined as those who presented to an Edmonton area hospital emergency department between 2007 and 2009 with an acute ischemic stroke, hemorrhagic stroke, or transient ischemic attack. Controls were patients who presented to the same emergency departments for lacerations, sprains, or strains. A land-use regression model provided estimates of NO2 that were assigned to the place of residence. Logistic regression methods were used to estimate odds ratios for stroke in relation to an increase in the interquartile range of NO2 (5 ppb), adjusted for age, sex, meteorological variables, and neighborhood effects. The study included 4,696 stroke (cases) and 37,723 injury patients (controls). For all strokes combined, there was no association with NO2. Namely, the odds ratio associated with an interquartile increase in NO2 was 1.01 (95% confidence interval {CI}: 0.94-1.08). No associations were evident for any of the stroke subtypes examined. When combined with our earlier work in Edmonton, our findings suggest that day

  12. [Acupuncture treatment programs for post-stroke motor rehabilitation in community hospitals: study protocol of a multicenter, randomized, controlled trial].

    Science.gov (United States)

    Fu, Qin-hui; Pei, Jian; Jia, Qi; Song, Yi; Gu, Yue-hua; You, Xiao-xin

    2012-05-01

    Stroke is responsible for increasingly high rates of mortality and disability worldwide. Approximately two million people suffer from stroke for the first time in China each year. The high incidence (50%) of post-stroke disability brings a heavy burden to patients and their caregivers. Acupuncture has been widely used in the communities for post-stroke rehabilitation in China. The objective of this trial is to apply our acupuncture research achievement to treatment and evaluation of post-stroke hemiplegic patients in community. A multicenter, randomized, controlled trial will be performed in Longhua Hospital and a number of community health service centers in Shanghai. A total of 124 patients (estimated sample size) with post-stroke hemiplegia will be randomly divided into an acupuncture group and a control group. The patients undergoing randomization should be stratified according to National Institutes of Health Stroke Scale score at baseline. Within the acupuncture group, different acupuncture protocols are administered to patients with flaccid paralysis or spastic paralysis based on the Ashworth Scale. Patients in the acupuncture group will also be treated with comprehensive rehabilitation therapy. The control group will be treated with comprehensive rehabilitation therapy only. The primary outcome measures are the Simplified Fugl-Meyer Motor Scale, the Modified Barthel Index, and the Burden of Stroke Scale. Secondary outcome measures are the modified Rankin Scale, the modified Ashworth Scale and the Stroke Scale of Traditional Chinese Medicine. Outcome measures will be performed after 4 and 8 weeks of treatment. The patients will be followed up after 6 months. The results of this study are expected to demonstrate that our standardized acupuncture protocol for treating and evaluating post-stroke hemiplegic patients will improve motor function and lessen the burden of post-stroke patients within the communities. This will provide the evidence to support

  13. Aerobic treadmill plus Bobath walking training improves walking in subacute stroke: a randomized controlled trial.

    Science.gov (United States)

    Eich, H-J; Mach, H; Werner, C; Hesse, S

    2004-09-01

    To evaluate the immediate and long-term effects of aerobic treadmill plus Bobath walking training in subacute stroke survivors compared with Bobath walking training alone. Randomized controlled trial. Rehabilitation unit. Fifty patients, first-time supratentorial stroke, stroke interval less than six weeks, Barthel Index (0-100) from 50 to 80, able to walk a minimum distance of 12 m with either intermittent help or stand-by while walking, cardiovascular stable, minimum 50 W in the bicycle ergometry, randomly allocated to two groups, A and B. Group A 30 min of treadmill training, harness secured and minimally supported according to patients' needs, and 30 min of physiotherapy, every workday for six weeks, speed and inclination of the treadmill were adjusted to achieve a heart rate of HR: (Hrmax-HRrest)*0.6+HRrest; in group B 60 min of daily physiotherapy for six weeks. Primary outcome variables were the absolute improvement of walking velocity (m/s) and capacity (m), secondary were gross motor function including walking ability (score out of 13) and walking quality (score out of 41), blindly assessed before and after the intervention, and at follow-up three months later. Patients tolerated the aerobic training well with no side-effects, significantly greater improvement of walking velocity and capacity both at study end (p =0.001 versus p =0.002) and at follow-up (p Bobath walking training in moderately affected stroke patients was better than Bobath walking training alone with respect to the improvement of walking velocity and capacity. The treatment approach is recommended in patients meeting the inclusion criteria. A multicentre trial should follow to strengthen the evidence.

  14. Integrative medicine for subacute stroke rehabilitation: a study protocol for a multicentre, randomised, controlled trial

    Science.gov (United States)

    Fang, Jianqiao; Chen, Lifang; Chen, Luni; Wang, Chao; Keeler, Crystal Lynn; Ma, Ruijie; Xu, Shouyu; Shen, Laihua; Bao, Yehua; Ji, Conghua

    2014-01-01

    Introduction Many patients with stroke receive integrative medicine in China, which includes the basic treatment of Western medicine and routine rehabilitation, in conjunction with acupuncture and Chinese medicine. The question of whether integrative medicine is efficacious for stroke rehabilitation is still controversial and very little research currently exists on the integrated approach for this condition. Consequently, we will conduct a multicentre, randomised, controlled, assessor-blinded clinical trial to assess the effectiveness of integrative medicine on stroke rehabilitation. Methods and analysis 360 participants recruited from three large Chinese medical hospitals in Zhejiang Province will be randomly divided into the integrative medicine rehabilitation (IMR) group and the conventional rehabilitation (CR) group in a 1:1 ratio. Participants in the IMR group will receive acupuncture and Chinese herbs in addition to basic Western medicine and rehabilitation treatment. The CR group will not receive acupuncture and Chinese herbal medicine. The assessment data will be collected at baseline, 4 and 8 weeks postrandomisation, and then at 12 weeks’ follow-up. The primary outcome is measured by the Modified Barthel Index. The secondary outcomes are the National Institutes of Health Stroke Scale (NIHSS), Fugl-Meyer Assessment, the mini-mental state examination and Montreal Cognitive, Hamilton's Depression Scale and Self-Rating Depression Scale, and the incidence of adverse events. Ethics and dissemination Ethical approval was obtained from ethics committees of three hospitals. The results will be disseminated in a peer-reviewed journal and presented at international congresses. The results will also be disseminated to patients by telephone, during follow-up calls inquiring on patient's post-study health status. Trial registration number Chinese Clinical Trial Register: ChiCTR-TRC-12001972, http://www.chictr.org/en/proj/show.aspx?proj=2561 PMID:25475247

  15. Operational test procedure for pumping and instrumentation control skid SALW-6001B monitor and control system

    International Nuclear Information System (INIS)

    Garcia, M.F.

    1995-11-01

    This OTP shall verify and document that the monitor and control system comprised of PICS SALW-6001B PLC, 242S PLC, Operator Control Station, and communication network is functioning per operational requirements

  16. Performance of Wind Pump Prototype

    African Journals Online (AJOL)

    Mulu

    Keywords: Wind pump, Windmill, Performance testing, Pump efficiency, Pump discharge,. Ethiopia. 1. INTRODUCTION. Energy demand .... Control/safety system. Mechanical control (by hand) .... important when irrigation is an issue. Daily water flow capacity is probably the best overall performance indicator of a wind pump.

  17. Modular ankle robotics training in early subacute stroke: a randomized controlled pilot study.

    Science.gov (United States)

    Forrester, Larry W; Roy, Anindo; Krywonis, Amanda; Kehs, Glenn; Krebs, Hermano Igo; Macko, Richard F

    2014-09-01

    BACKGROUND. Modular lower extremity robotics may offer a valuable avenue for restoring neuromotor control after hemiparetic stroke. Prior studies show that visually guided and visually evoked practice with an ankle robot (anklebot) improves paretic ankle motor control that translates into improved overground walking. To assess the feasibility and efficacy of daily anklebot training during early subacute hospitalization poststroke. Thirty-four inpatients from a stroke unit were randomly assigned to anklebot (n = 18) or passive manual stretching (n = 16) treatments. All suffered a first stroke with residual hemiparesis (ankle manual muscle test grade 1/5 to 4/5), and at least trace muscle activation in plantar- or dorsiflexion. Anklebot training employed an "assist-as-needed" approach during >200 volitional targeted paretic ankle movements, with difficulty adjusted to active range of motion and success rate. Stretching included >200 daily mobilizations in these same ranges. All sessions lasted 1 hour and assessments were not blinded. Both groups walked faster at discharge; however, the robot group improved more in percentage change of temporal symmetry (P = .032) and also of step length symmetry (P = .038), with longer nonparetic step lengths in the robot (133%) versus stretching (31%) groups. Paretic ankle control improved in the robot group, with increased peak (P ≤ .001) and mean (P ≤ .01) angular speeds, and increased movement smoothness (P ≤ .01). There were no adverse events. Though limited by small sample size and restricted entry criteria, our findings suggest that modular lower extremity robotics during early subacute hospitalization is well tolerated and improves ankle motor control and gait patterning. © The Author(s) 2014.

  18. Effect of vitamin C supplementation on stroke recovery: A case-control study

    Directory of Open Access Journals (Sweden)

    Meheroz H Rabadi

    2007-04-01

    Full Text Available Meheroz H Rabadi1, Bruce S Kristal2,31Burke Rehabilitation Hospital, an affiliate of Weill Medical College of Cornell Medical College, White Plains, NY, USA; 2Burke Medical Research Institute, an affiliate of Weill Medical College of Cornell Medical College, White Plains, NY, USA; 3Department of Neuroscience, Cornell University Medical College, White Plains, NY, USABackground and purpose: Epidemiological studies have associated increased dietary intake of antioxidants (vitamin C, E, and β-carotene in preventing and decreasing the extent of ischemic brain injury. The effect of vitamin C supplementation on functional recovery after stroke has not been studied. Method: In this retrospective, case-control study of 23 patients with ischemic stroke taking vitamin C were identified and matched for age, sex, onset to admission, and admission total functional independence measure (TFIM with 23 patients with ischemic stroke not taking Vitamin C supplementation. Vitamin C 1000 mg daily was prescribed on admission to our unit mainly to patients who were undernourished (defined as significant weight loss and/or 90% or less ideal body weight for age and sex and those with pressure sores. The outcome measures were: change in the TFIM, FIM-Cognition (FIM-Cog, and FIM-Motor sub-scores, discharge disposition, and length of stay (LOS.Results: The change in TFIM (20 ± 13 standard deviation [SD] vs. 26 ± 6, p = 0.20, FIM-Cog (3 ± 3 SD vs. 4 ± 5, p = 0.41, FIM-Motor (15 ± 11 SD vs. 20 ± 13, p = 0.21 sub-scores were less in the vitamin C treated group, but these differences did not reach statistical significance. Similarly, no significant differences were found in LOS (21 ± 9 SD vs. 23 ± 9, p = 0.59, and discharge disposition (home/institution (9/10 vs. 13/9, p = 0.60 between the vitamin C and the control groups.Conclusion: This study suggests vitamin C supplementation did not enhance functional recovery in undernourished ischemic stroke patients

  19. Effect of IQoro® training on impaired postural control and oropharyngeal motor function in patients with dysphagia after stroke.

    Science.gov (United States)

    Hägg, Mary; Tibbling, Lita

    2016-07-01

    Conclusion All patients with dysphagia after stroke have impaired postural control. IQoro® screen (IQS) training gives a significant and lasting improvement of postural control running parallel with significant improvement of oropharyngeal motor dysfunction (OPMD). Objectives The present investigation aimed at studying the frequency of impaired postural control in patients with stroke-related dysphagia and if IQS training has any effect on impaired postural control in parallel with effect on OPMD. Method A prospective clinical study was carried out with 26 adult patients with stroke-related dysphagia. The training effect was compared between patients consecutively investigated at two different time periods, the first period with 15 patients included in the study more than half a year after stroke, the second period with 11 patients included within 1 month after stroke. Postural control tests and different oropharyngeal motor tests were performed before and after 3 months of oropharyngeal sensorimotor training with an IQS, and at a late follow-up (median 59 weeks after end of training). Result All patients had impaired postural control at baseline. Significant improvement in postural control and OPMD was observed after the completion of IQS training in both intervention groups. The improvements were still present at the late follow-up.

  20. Intraoperative temperature control using the Thermogard system during off-pump coronary artery bypass grafting.

    Science.gov (United States)

    Allen, Gary S

    2009-01-01

    Normothermia during off-pump coronary bypass (OPCAB) grafting reduces metabolic derangements and contributes to improved clinical outcomes. Thus study examined the feasibility and efficacy of intraoperative temperature control using a novel endovascular heating system during OPCAB. Thirty-eight consecutive patients undergoing OPCAB were prospectively randomized to receive conventional warming (elevated room temperature, warmed intravenous fluids, warming blanket) or the Thermogard system (Alsius Corp, Irvine, CA). The triple-lumen temperature control Icy catheter (Alsius Corp) was inserted percutaneously into the inferior vena cava through common femoral vein. The catheter was removed after all wounds were closed. Temperature measurements (bladder, nasopharyngeal, and blood) were recorded at 5-minute intervals and compared between groups. Patient demographics did not significantly differ between groups. The 17 Thermogard patients warmed at a significantly faster rate than the 21 control patients (0.28 degrees vs 0.11 degrees C/h, p = 0.03). Furthermore, Thermogard patients received more bypass grafts (3.4 +/- 0.6 vs 2.6 +/- 0.9, p temperatures. The Thermogard system compared favorably with conventional methods for warming during OPCAB.

  1. Integration of Variable Speed Pumped Hydro Storage in Automatic Generation Control Systems

    Science.gov (United States)

    Fulgêncio, N.; Moreira, C.; Silva, B.

    2017-04-01

    Pumped storage power (PSP) plants are expected to be an important player in modern electrical power systems when dealing with increasing shares of new renewable energies (NRE) such as solar or wind power. The massive penetration of NRE and consequent replacement of conventional synchronous units will significantly affect the controllability of the system. In order to evaluate the capability of variable speed PSP plants participation in the frequency restoration reserve (FRR) provision, taking into account the expected performance in terms of improved ramp response capability, a comparison with conventional hydro units is presented. In order to address this issue, a three area test network was considered, as well as the corresponding automatic generation control (AGC) systems, being responsible for re-dispatching the generation units to re-establish power interchange between areas as well as the system nominal frequency. The main issue under analysis in this paper is related to the benefits of the fast response of variable speed PSP with respect to its capability of providing fast power balancing in a control area.

  2. AUTOMATIC CONTROL SYSTEM OF THE DIFFERENCE BETWEEN DISCHARGE AND SUCTION PRESSURES OF THE HEAT PUMP STATION COMPRESSOR

    Directory of Open Access Journals (Sweden)

    Sit M.L.

    2009-04-01

    Full Text Available Possibility of realization is shown and the control system of a difference of pressure between an exit and an input of the compressor of the heat pump on carbon dioxide working at variable thermal load, and discharge and suction pressures by means of two control valves connected in series is developed. On an example a flow coefficient calculation procedure of control valves is shown.

  3. Randomized Controlled Trial of Early Versus Delayed Statin Therapy in Patients With Acute Ischemic Stroke: ASSORT Trial (Administration of Statin on Acute Ischemic Stroke Patient).

    Science.gov (United States)

    Yoshimura, Shinichi; Uchida, Kazutaka; Daimon, Takashi; Takashima, Ryuzo; Kimura, Kazuhiro; Morimoto, Takeshi

    2017-11-01

    Several studies suggested that statins during hospitalization were associated with better disability outcomes in patients with acute ischemic stroke, but only 1 small randomized trial is available. We conducted a multicenter, open-label, randomized controlled trial in patients with acute ischemic strokes in 11 hospitals in Japan. Patients with acute ischemic stroke and dyslipidemia randomly received statins within 24 hours after admission in the early group or on the seventh day in the delayed group, in a 1:1 ratio. Statins were administered for 12 weeks. The primary outcome was patient disability assessed by modified Rankin Scale at 90 days. A total of 257 patients were randomized and analyzed (early 131, delayed 126). At 90 days, modified Rankin Scale score distribution did not differ between groups ( P =0.68), and the adjusted common odds ratio of the early statin group was 0.84 (95% confidence interval, 0.53-1.3; P =0.46) compared with the delayed statin group. There were 3 deaths at 90 days (2 in the early group, 1 in the delayed group) because of malignancy. Ischemic stroke recurred in 9 patients (6.9%) in the early group and 5 patients (4.0%) in the delayed group. The safety profile was similar between groups. Our randomized trial involving patients with acute ischemic stroke and dyslipidemia did not show any superiority of early statin therapy within 24 hours of admission compared with delayed statin therapy 7 days after admission to alleviate the degree of disability at 90 days after onset. URL: http://www.clinicaltrials.gov. Unique identifier: NCT02549846. © 2017 American Heart Association, Inc.

  4. Ginkgo biloba extract improved cognitive and neurological functions of acute ischaemic stroke: a randomised controlled trial

    Science.gov (United States)

    Li, Shanshan; Zhang, Xinjiang; Fang, Qi; Zhou, Junshan; Zhang, Meijuan; Wang, Hui; Chen, Yan; Xu, Biyun; Wu, Yanfeng; Qian, Lai

    2017-01-01

    Purpose To evaluate the efficacy and safety of Ginkgo biloba extract (GBE) in acute ischaemic stroke and its impact on the recurrence of vascular events. Methods We conducted a multicentre, prospective, randomised, open label, blinded, controlled clinical trial enrollingpatients with an onset of acute stroke within 7 days from five hospitals in China Jiangsu Province. Participants were assigned to the GBE group (450 mg GBE with 100 mg aspirin daily) or the control group (100 mg aspirin daily) for 6 months. The primary outcome was the decline in the Montreal Cognitive Assessment score at 6 months. Secondary outcomes were other neuropsychological tests of cognitive and neurological function, the the incidence of adverse events and vascular events. Results 348 patients were enrolled: 179 in the GBE group and 169 in the control group. With 18 patients lost to follow-up, the dropout rate was 5.17%. Admission data between two groups were similar, but in the GBE group there was a marked slow down in the decline in the Montreal Cognitive Assessment scores (−2.77±0.21 vs −1.99±0.23, P=0.0116 (30 days); −3.34±0.24 vs −2.48±0.26, P=0.0165 (90 days); −4.00±0.26 vs −2.71±0.26, P=0.0004 (180 days)) compared with controls. The National Institutes of Health Stroke Scale scores at 12 and 30 days, the modified Rankin Scale scores for independent rate at 30, 90 and 180 days, and the Barthel Index scores at 30, 90 and 180 days in the GBE group were significantly improved compared with controls. Improvements were also observedin GBE groups for Mini-Metal State Examination scores of 30, 90 and 180 days, Webster’s digit symbol test scores at 30 days and Executive Dysfunction Index scores at 30 and 180 days. No significant differences were seen in the incidence of adverse events or vascular events. Conclusions We conclude that GBE in combination with aspirin treatment alleviated cognitive and neurological deficits after acute ischaemic stroke without increasing

  5. Pressure management of water distribution systems via the remote real-time control of variable speed pumps

    CSIR Research Space (South Africa)

    Page, Philip R

    2017-08-01

    Full Text Available Low and constant pressure can be maintained throughout a water distribution system by setting the pressure at remote consumer locations and using the pressure to control the speed of a variable speed pump (VSP). The prospect of incorporating...

  6. Analog Fixed Maximum Power Point Control for a PWM Step-downConverter for Water Pumping Installations

    DEFF Research Database (Denmark)

    Beltran, H.; Perez, E.; Chen, Zhe

    2009-01-01

    This paper describes a Fixed Maximum Power Point analog control used in a step-down Pulse Width Modulated power converter. The DC/DC converter drives a DC motor used in small water pumping installations, without any electric storage device. The power supply is provided by PV panels working around...

  7. Installation design of pump motor control systems for supplied of the RSG-GAS secondary raw water cooling system

    International Nuclear Information System (INIS)

    Kiswanto; Teguh Sulistyo; M-Taufik

    2013-01-01

    It has designed already of an installation of the pump motor control system for supplied of raw water to fulfil the RSG-GAS secondary cooling system. The installation design of this plant is used to supply electrical energy from PLN and 3 phase generator to operate the pump motor embedded multilevel type, capacity, Q = 30 m 3 /h; electric power, PN = 4 kW; voltage, 380V/3-/50Hz, and Y connections that can be operated manually or automatically by using the automatic transfer switch. The results obtained recapitulation total load of 4 kW, the magnitude of the nominal current of 9.5 A; kind of safety and capacity are used NFB 16 A, use of this type of cable to the control panel is PLN NYY 6 mm 2 diameter maximum current capacity of 25 A cable and use the control panel to the pump motor cable type NYY 4 mm 2 diameter maximum current capacity of 20 A. The design of the pump motor control system installation is ready to be implemented. (author)

  8. Controlling the heating mode of heat pumps with the TRIANA three step methodology

    NARCIS (Netherlands)

    Toersche, Hermen; Bakker, Vincent; Molderink, Albert; Nykamp, Stefan; Hurink, Johann L.; Smit, Gerardus Johannes Maria

    2012-01-01

    Heat pump based heating systems are increasingly becoming an economic and efficient alternative for domestic gas heating systems. Concentrations of heat pump installations do consume large amounts of electricity, causing significant grid distribution and stability issues when the diversity factor is

  9. 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

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

    Science.gov (United States)

    Dean, Catherine M; Rissel, Chris; Sharkey, Michelle; Sherrington, Catherine; Cumming, Robert G; Barker, Ruth N; Lord, Stephen R; O'Rourke, Sandra D; Kirkham, Catherine

    2009-07-22

    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. 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. 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 found to be effective, has the potential to be implemented within

  11. Self-pumping impurity control by in-situ metal deposition. Summary for tokamak innovations activities workshop

    International Nuclear Information System (INIS)

    Brooks, J.N.; Mattas, R.F.; Smith, D.L.

    1986-01-01

    The self pumping concept uses vanadium, nickel, or certain other materials to selectively trap impinging helium from the plasma, in-situ, on a surface. No vacuum ducts or pumps are used. The trapping materials are added to the surface at an average rate of 3-4 times the α-production rate. Trapping material can be added by injecting pellets or exposing rods, etc. to the edge or scrapeoff plasma where it is ablated, vaporized and transported to the trapping surface. Several self-pumping systems have been examined - a first wall/limiter, self-pumped divertor, slot limiter, and a slot divertor. The first two concepts trap helium on the front surface (i.e., first wall or divertor plate) directly exposed to the edge plasma. The slot systems trap helium on partially hidden surfaces thus minimizing the heat flux on the trapping surfaces and the plasma contamination potential. Although there are clear uncertainties, due to the lack of reactor relevant data, self-pumping impurity control appears promising for improving the tokamak reactor. These improvements are a cost savings, of the order of 125 M$ for a STARFIRE size reactor (approx. 100 M$ in reduced shielding costs and approx. 25 M$ in reduced tritium system costs), a substantial increase in the mass utilization factor, a long (approx. 10 year) limiter or divertor lifetime, a reduction in tritium processing and inventory, and the elimination of several reactor components

  12. Scaling up and controlling beam quality of flowing-gas diode pumped potassium laser with different pumping geometries: 3D CFD modeling

    Science.gov (United States)

    Yacoby, Eyal; Waichman, Karol; Sadot, Oren; Barmashenko, Boris D.; Rosenwaks, Salman

    2017-10-01

    Comprehensive analysis of the performance and beam quality of subsonic flowing-gas K diode-pumped alkali lasers (DPALs) with different pumping geometries, using 3D computational fluid dynamics model, is reported. The model is first applied to a K DPAL with transverse pumping and parameters similar to those of the 1.5 kW K DPAL [Pitz et al, Proc. SPIE 9729, 972902 (2016)] and the calculated results are in satisfactory agreement with the measurements. To study the possibility of scaling up the K DPAL the model is then applied to 100-kW class device with transverse and end pumping geometry. Dependence of the output power on the flow velocity and the pumping geometry is studied. Comparison between end and transverse pumping schemes shows that the output power is almost unaffected by the pumping geometry. However, the spatial intensity distribution of the output laser beam depends on the pumping geometry: it is uniform for the end pumping, whereas for the transverse pumping it is strongly non-uniform at high gas temperature (corresponding to large density of K atoms), becoming more uniform with temperature reduction. The model is applied to evaluation of the beam quality of flowing-gas K DPALs which strongly depends on the refractive index distribution in the gain medium. The beam divergence and the width of the intensity profile in the far field for the end pumping appear to be much smaller than for the transverse pumping. Wave front corrections of the transversely pumped device using cylindrical lens results in substantial reduction of the laser beam divergence and improvement of its quality which becomes comparable with that of the end pumped laser.

  13. Low-Cost Control System Built Upon Consumer-Based Electronics For Supervisory Control Of A Gas-Operated Heat Pump

    Energy Technology Data Exchange (ETDEWEB)

    Wetherington Jr, G Randall [ORNL; Vineyard, Edward Allan [ORNL; Mahderekal, Isaac [ORNL; Abu-Heiba, Ahmad [ORNL

    2017-06-01

    A preliminary evaluation of the performance of a consumer-based control system was conducted by the Oak Ridge National Laboratory (ORNL) and Southwest Gas as part of a cooperative research and development agreement (CRADA) authorized by the Department of Energy (DOE) (Mahderekal et al. (2013). The goal of the research was to evaluate the low-cost approach as a solution for implementing a supervisory control system for a residential gas-operated heat pump. The design incorporated two consumer-based micro-controllers; the Arduino Mega-2650 and the BeagleBone (white). Ten five-ton heat pump systems were designed, fabricated, and operationally tested in the Las Vega NV region. A robust data set was produced that allowed detailed assessment of the reliability and the operational perfromance of the newly developed control system. Experiences gained from the test provided important points of improvement for subsequent evolution of the heat pump technology.

  14. Groundwater-pumping optimization for land-subsidence control in Beijing plain, China

    Science.gov (United States)

    Qin, Huanhuan; Andrews, Charles B.; Tian, Fang; Cao, Guoliang; Luo, Yong; Liu, Jiurong; Zheng, Chunmiao

    2018-01-01

    Beijing, in the North China plain, is one of the few megacities that uses groundwater as its main source of water supply. Groundwater accounts for about two-thirds of the city's water supply, and during the past 50 years the storage depletion from the unconsolidated aquifers underlying the city has been >10.4 billion m3. By 2010, groundwater pumping in the city had resulted in a cumulative subsidence of greater than 100 mm in an area of about 3,900 km2, with a maximum cumulative subsidence of >1,200 mm. This subsidence has caused significant social and economic losses in Beijing, including significant damage to underground utilities. This study was undertaken to evaluate various future pumping scenarios to assist in selecting an optimal pumping scenario to minimize overall subsidence, meet the requirements of the Beijing Land Subsidence Prevention Plan (BLSPP 2013-2020), and be consistent with continued sustainable economic development. A numerical groundwater and land-subsidence model was developed for the aquifer system of the Beijing plain to evaluate land subsidence rates under the possible future pumping scenarios. The optimal pumping scenario consistent with the evaluation constraints is a reduction in groundwater pumping from three major pumping centers by 100, 50 and 20%, respectively, while maintaining an annual pumping rate of 1.9 billion m3. This scenario's land-subsidence rates satisfy the BLSPP 2013-2020 and the pumping scenario is consistent with continued economic development. It is recommended that this pumping scenario be adopted for future land-subsidence management in Beijing.

  15. Real-time Control of sewer pumps by using ControlNEXT to smooth inflow at Waste Water Treatment Plant Garmerwolde

    Science.gov (United States)

    van Heeringen, Klaas-Jan; van Nooijen, Ronald; Kooij, Kees; Postma, Bokke

    2016-04-01

    The Garmerwolde waste water treatment plant (WWTP) in the Groningen area of the Netherlands, receives waste water from a large area. That waste water is collected from many sewer systems and transported to the WWTP through pressurized pipes. The supply of waste water to the WWTP is relatively low and very irregular during dry-weather conditions, resulting in a random pattern of flows. This irregularity is the effect of the local control of the pumps, where the pumps are individually operated as an on/off control based on the water levels in the connected sewer system. The influent may change from zero to high values in a few minutes. The treatment processes at the WWTP are negatively influenced by this irregularity, which ends in high costs for energy and use of chemicals. The ControlNEXT central control system is used to control the 5 largest pump stations, such that the total inflow at the WWTP becomes much smoother. This results in a reduction of operational costs of about 10%. The control algorithm determines whether the actual condition is dry or wet, based on real-time radar precipitation images and the rainfall forecast product HiRLAM. All actual data is also collected and validated, like water levels, pump operations and pump availability. This data management is done using Delft-FEWS. If the situation is identified as "wet", the sewer systems are emptied as far as possible to create maximum storage. If the situation is "dry" (and of course there is a dead band between dry and wet), the pumps are operated such that the total inflow into the WWTP is smoothed. This is done with a Greedy algorithm, developed by Delft University of Technology. The algorithm makes a plan for the next 24 hours (as the daily inflow has a typical daily pattern) and generally stores some water volume in the sewer systems during the day to be able to continue operations during the night. The pumps are controlled with a time step of 5 minutes, where ControlNEXT manages the

  16. Exhaust Recirculation Control for Reduction of NOx from Large Two-Stroke Diesel Engines

    DEFF Research Database (Denmark)

    Nielsen, Kræn Vodder

    the automotive industry, but have only recently been introduced commercially to large two-stroke diesel engines. Recirculation of exhaust gas to the cylinders lowers the oxygen availability and increases the heat capacity during combustion, which in turn leads to less formation of NOx. Experience shows...... for the scavenge oxygen fraction is designed. This observer compensates for a significant delay in the oxygen sensor, and observer errors are proven to converge exponentially. By inverting part of the reduced model and using the parameter observer, a novel scavenge oxygen controller based on nonlinear adaptive...

  17. A randomised controlled trial of a client-centred self-care intervention after stroke

    DEFF Research Database (Denmark)

    Guidetti, Susanne; Ytterberg, Charlotte

    2011-01-01

    services and the caregiver burden. METHOD: An intervention group (IG) received CCSCI and a control group (CG) received ordinary training. Forty individuals with stroke (IG n = 19, CG n = 21) were included. Data were collected at 3, 6 and 12 months using established instruments. RESULTS: After 12 months 24...... people remained in the study (IG = 10, CG = 14). The data collection method was acceptable to most participants. At 12 months there were no differences in ADL, use of services or caregiver's burden. Both groups improved significantly and clinically important improvements were achieved by 80% in the IG...

  18. Identifying continence options after stroke (ICONS): a cluster randomised controlled feasibility trial.

    Science.gov (United States)

    Thomas, Lois H; Watkins, Caroline L; Sutton, Christopher J; Forshaw, Denise; Leathley, Michael J; French, Beverley; Burton, Christopher R; Cheater, Francine; Roe, Brenda; Britt, David; Booth, Joanne; McColl, Elaine

    2014-12-23

    Urinary incontinence (UI) affects half of patients hospitalised after stroke and is often poorly managed. Cochrane systematic reviews have shown some positive impact of conservative interventions (such as bladder training) in reducing UI, but their effectiveness has not been demonstrated with stroke patients. We conducted a cluster randomised controlled feasibility trial of a systematic voiding programme (SVP) for the management of UI after stroke. Stroke services were randomised to receive SVP (n = 4), SVP plus supported implementation (SVP+, n = 4), or usual care (UC, n = 4).Feasibility outcomes were participant recruitment and retention. The main effectiveness outcome was presence or absence of UI at six and 12 weeks post-stroke. Additional effectiveness outcomes included were the effect of the intervention on different types of UI, continence status at discharge, UI severity, functional ability, quality of life, and death. It was possible to recruit patients (413; 164 SVP, 125 SVP+, and 124 UC) and participant retention was acceptable (85% and 88% at six and 12 weeks, respectively). There was no suggestion of a beneficial effect on the main outcome at six (SVP versus UC: odds ratio (OR) 0.94, 95% CI: 0.46 to 1.94; SVP+ versus UC: OR: 0.62, 95% CI: 0.28 to 1.37) or 12 weeks (SVP versus UC: OR: 1.02, 95% CI: 0.54 to 1.93; SVP+ versus UC: OR: 1.06, 95% CI: 0.54 to 2.09).No secondary outcomes showed a strong suggestion of clinically meaningful improvement in SVP and/or SVP+ arms relative to UC at six or 12 weeks. However, at 12 weeks both intervention arms had higher estimated odds of continence than UC for patients with urge incontinence. The trial has met feasibility outcomes of participant recruitment and retention. It was not powered to demonstrate effectiveness, but there is some evidence of a potential reduction in the odds of specific types of incontinence. A full trial should now be considered. ISRCTN Registry, ISRCTN08609907, date of

  19. 21 CFR 880.5725 - Infusion pump.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Infusion pump. 880.5725 Section 880.5725 Food and... Infusion pump. (a) Identification. An infusion pump is a device used in a health care facility to pump fluids into a patient in a controlled manner. The device may use a piston pump, a roller pump, or a...

  20. Pressure Pump Power Control in the Primary Circuit of the Heat Exchange System

    Directory of Open Access Journals (Sweden)

    Shilin Aleksandr

    2017-01-01

    Full Text Available In this paper we consider the problem of speed in hot water systems where highly efficient plate heat exchanger is used. Especially marked the problem which is connected with long transition drive of constant speed exceeding the time of the heat exchanger accumulative tank emptying more than twice. As a regulating element in the heat exchange system there was proposed to use asynchronous electric drive of pressure pump in the primary circuit of the heat exchanger. For correct use of such electric drive we solved the problem of control object mathematical model synthesis, which has non-linear properties, in particular, the transfer coefficient of the circuit can vary in more than 6 times. At the same time there was revealed the dependence of the transfer coefficient on the motor speed, which must be considered in the controller synthesis. In conclusion we suggested the solutions of regulators synthesis tasks with customizable settings for speed and switchable structure between relay λ and PI regulators.

  1. Low socioeconomic status is an independent risk factor for ischemic stroke: a case-control study in North Indian population.

    Science.gov (United States)

    Kumar, Amit; Prasad, Manya; Kathuria, Prachi; Nair, Pallavi; Pandit, Awadh Kishor; Sahu, Jitendra K; Prasad, Kameshwar

    2015-01-01

    Stroke is a multifactorial disease and is influenced by complex environmental interactions. The contribution of various risk factors to the burden of stroke worldwide is not well known, particularly in developing countries. The present case-control study is aimed at exploring the association between a low socioeconomic status and the risk of ischemic stroke among the North Indian population. The study design was a hospital-based, case-control study. Age- and sex-matched controls were included. The demographic characteristics and risk factor variables were documented by means of a personal interview through a standardized case record form. The household asset index for determining the socioeconomic status (HAISS) was used for the assessment of the socioeconomic status of the population. HAISS was validated with the widely used Kuppuswamy scale for measurement of socioeconomic status. The multivariable logistic regression model was used to estimate the odds ratio associated with stroke. In all, 224 ischemic stroke patients and 224 controls were recruited between February 2009 and February 2012. The mean age of cases and controls was 53.47 ± 14 and 52.92 ± 13.4, respectively. The low economic status was independently associated with the risk of ischemic stroke after adjustment for demographic and risk factor variables (OR 2.8; 95% CI 1.2-6.3). Our findings suggest that there is a significant association between a low socioeconomic status and the risk of ischemic stroke risk in North Indian population. Well-designed studies embedded with long-term prospective cohorts are required for confirming the results. © 2015 S. Karger AG, Basel.

  2. Virtual Reality Reflection Therapy Improves Balance and Gait in Patients with Chronic Stroke: Randomized Controlled Trials.

    Science.gov (United States)

    In, Taesung; Lee, Kyeongjin; Song, Changho

    2016-10-28

    BACKGROUND Virtual reality reflection therapy (VRRT) is a technically enhanced version of the mirror therapy concept. The aim of this study was to investigate whether VRRT could improve the postural balance and gait ability of patients with chronic stroke. MATERIAL AND METHODS Twenty-five patients with chronic stroke were randomly allocated into the VRRT group (n=13) and the control group (n=12). The participants in both groups performed a conventional rehabilitation program for 30 minutes. The VRRT group also performed a VRRT program for 30 minutes, five times a week for 4 weeks. The control group performed conventional rehabilitation program and a placebo VRRT program. Outcome measures included Berg Balance Scale (BBS), the Functional Reaching Test (FRT), and the Timed Up and Go (TUG) test (for dynamic balance ability), postural sway (for static balance ability), and 10 meter walking velocity (10 mWV) for gait ability. RESULTS There were statistically significant improvements in the VRRT group compared with the control group for BBS, FRT, TUG, postural sway (mediolateral sway distance with eyes open and eyes closed, anteroposterior and total sway distance with eyes open but not with eyes closed), and 10 mWV (pstroke might be even more beneficial than conventional rehabilitation program alone in improving affected lower limb function. Future studies should investigate the effectiveness of VRRT with optimal patient selection, and duration and intensity of training.

  3. Effects of Community Exercise Therapy on Metabolic, Brain, Physical, and Cognitive Function Following Stroke: A Randomized Controlled Pilot Trial.

    Science.gov (United States)

    Moore, Sarah A; Hallsworth, Kate; Jakovljevic, Djordje G; Blamire, Andrew M; He, Jiabao; Ford, Gary A; Rochester, Lynn; Trenell, Michael I

    2015-08-01

    Exercise therapy could potentially modify metabolic risk factors and brain physiology alongside improving function post stroke. To explore the short-term metabolic, brain, cognitive, and functional effects of exercise following stroke. A total of 40 participants (>50 years, >6 months post stroke, independently mobile) were recruited to a single-blind, parallel, randomized controlled trial of community-based exercise (19 weeks, 3 times/wk, "exercise" group) or stretching ("control" group). Primary outcome measures were glucose control and cerebral blood flow. Secondary outcome measures were cardiorespiratory fitness, blood pressure, lipid profile, body composition, cerebral tissue atrophy and regional brain metabolism, and physical and cognitive function. Exercise did not change glucose control (homeostasis model assessment 1·5 ± 0·8 to 1·5 ± 0·7 vs 1·6 ± 0·8 to 1·7 ± 0·7, P = .97; CI = -0·5 to 0·49). Medial temporal lobe tissue blood flow increased with exercise (38 ± 8 to 42 ± 10 mL/100 g/min; P function, and cognition also improved with exercise. Exercise therapy improves short-term metabolic, brain, physical, and cognitive function, without changes in glucose control following stroke. The long-term impact of exercise on stroke recurrence, cardiovascular health, and disability should now be explored. © The Author(s) 2014.

  4. Comparing the Course of Mental Health Over the First Year After Stroke With Healthy Controls in Colombia, South America.

    Science.gov (United States)

    Sutter, Megan; Olabarrieta Landa, Laiene; Calderón Chagualá, Amilkar; Chacón Peralta, Helmer; Vergara Torres, Gina; Perrin, Paul B; Arango-Lasprilla, Juan Carlos

    2017-01-01

    Stroke is a primary cause of death and disability in upper-middle-income countries such as Colombia. Given the lack of comprehensive rehabilitation for stroke patients in Colombia, there is a need to assess longitudinal mental health problems poststroke in this region. To compare the course of mental health in stroke patients to healthy controls over the first year poststroke in Ibague, Colombia. Cross-sectional study. The Psychological Attention Center of Antonio Nariño University in Ibague, Colombia. Stroke patients (n = 50) and age- and gender-matched healthy controls (n = 50). Patients and controls completed self-report Spanish versions of demographic information, injury-related characteristics, and mental health questionnaires MAIN OUTCOME MEASUREMENTS: Outcomes assessed included mental health (depression, anxiety, and stress) at 3, 6, and 12 months poststroke. Hierarchical linear models suggested that stroke patients had worse depression and anxiety over time than controls (P Colombia. Despite the improvements in anxiety and depression over the first year poststroke, patient anxiety and depression were still worse in comparison to those in healthy controls. The current findings indicate a need for rehabilitation services in Colombia, especially targeting mental health issues. I. Copyright © 2017 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

  5. Randomized, Placebo-Controlled, Double-Blind Pilot Study of D-Cycloserine in Chronic Stroke

    Directory of Open Access Journals (Sweden)

    Andrew J. Butler

    2015-01-01

    Full Text Available Stroke is a leading cause of death and disability in the USA. Up to 60% of patients do not fully recover despite intensive physical therapy treatment. N-Methyl-D-aspartate receptors (NMDA-R have been shown to play a role in synaptic plasticity when activated. D-Cycloserine promotes NMDA receptor function by binding to receptors with unoccupied glycine sites. These receptors are involved in learning and memory. We hypothesized that D-cycloserine, when combined with robotic-assisted physiotherapy (RAP, would result in greater gains compared with placebo + RAP in stroke survivors. Participants (n=14 were randomized to D-cycloserine plus RAP or placebo plus RAP. Functional, cognitive, and quality-of-life measures were used to assess recovery. There was significant improvement in grip strength of the affected hand within both groups from baseline to 3 weeks (95% confidence interval for mean change, 3.95 ± 2.96 to 4.90 ± 3.56 N for D-cycloserine and 5.72 ± 3.98 to 8.44 ± 4.90 N for control. SIS mood domain showed improvement for both groups (95% confidence interval for mean change, 72.6 ± 16.3 to 82.9 ± 10.9 for D-cycloserine and 82.9 ± 13.5 to 90.3 ± 9.9 for control. This preliminary study does not provide evidence that D-cycloserine can provide greater gains in learning compared with placebo for stroke survivors.

  6. Classical and additional antiphospholipid antibodies in blood samples of ischemic stroke patients and healthy controls.

    Science.gov (United States)

    Carmel-Neiderman, Narin-Nard; Tanne, David; Goren, Idan; Rotman-Pikielny, Pnina; Levy, Yair

    2017-04-01

    Classical antiphospholipid antibodies (aPLa) are found in 6-25% of blood samples from stroke patients. The frequency of novel aPLa antibodies in blood samples of CVA patients is not known. Enzyme-linked immunosorbent assays (ELISA) were performed on blood samples from 209 CVA patients (170 samples were obtained during the acute phase and 39 samples were from patients with complete carotid stenosis) and compared to 54 healthy controls. Subjects were tested for the presence of the classical aPL antibodies anticardiolipin (aCL) and anti-beta2-glycoprotein (aβ2gI), in addition to antiphosphatidylethanolamine (aPE), anti-phosphatidylserine (aPS), and Annexin V. All antibodies were tested for both IgM and IgG subclasses. Numeric analysis of the antibody titer levels (μ/ml) revealed a significantly higher subclinical titer by two standard deviations of many aPL autoantibodies among CVA patients (Pv < 0.05). However, according to the kit manufacturer's cutoff value, no positive antibodies were found except a trend toward higher percentage of positive aPS IgG titer in the CVA group compared to controls (6.2 vs. %0; P = 0.077). According to the manufacturer's cutoff, significantly higher levels of positive antibodies were not found among stroke patients. However, the absolute ELISA values of stroke patients were significantly higher. These results suggest that lower cutoff values than those used for APS diagnosis should be used for risk stratification of CVA among healthy individuals.

  7. Feedback control of primary pump using midplane temperature of lower density lock for a PIUS-type reactor

    International Nuclear Information System (INIS)

    Tasaka, Kanji; Haga, Katsuhiro; Tamaki, Masayoshi

    1993-01-01

    A new automatic pump speed control system, using a measurement of the temperature distribution in the lower density lock, is proposed for the PIUS-type reactor. This control system maintains the fluid temperature at the axial center of the lower density lock at the average of the fluid temperatures below and above the lower density lock in order to prevent the poison water from penetrating into the core during normal operation. In a startup test, the effectiveness of this control system to bring the system quickly to the stable state from a very small initial temperature difference between top and bottom of the lower density lock has been confirmed. The effectiveness of the primary pump trip at the limit speed in the control system to shutdown the core power safely in an accident such as a loss-of-feedwater accident with and without the primary loop isolation has also been proved

  8. Impaired nocturnal melatonin in acute phase of ischaemic stroke: cross-sectional matched case-control analysis.

    Science.gov (United States)

    Atanassova, P A; Terzieva, D D; Dimitrov, B D

    2009-07-01

    Quantitative data on melatonin in stroke patients are scarce. A gender- and age-matched cross-sectional case-control study in 33 patients with ischaemic stroke was performed and associations between nocturnal melatonin and other factors (e.g. cortisol) were evaluated. Clinical and laboratory (e.g. melatonin and cortisol) measurements (03.00 h and 08.00 h) with statistical techniques [e.g. multifactorial regressions, receiver operating characteristic (ROC) curve and curvilinear estimations] were used. We identified mean value and 95% confidence interval (CI) (69.70 pg/ml; 95% CI = 53.86-85.54) for control levels of nocturnal melatonin in healthy subjects. The patients with stroke had lower melatonin (48.1 +/- 35.9 pg/ml) and higher cortisol (297.3 +/- 157.8 nmol/l) at 03.00 h (P 0.05). Stroke was the strongest factor of disturbed nocturnal cortisol (P melatonin depended on stroke (P = 0.010) and gender (P = 0.018). At the same time, vice versa, only nocturnal measures were associated with an increased probability of the presence of stroke (accuracy > 75%, Pmodel melatonin with 1.0 pg/ml might be associated with > 2% increase in the probability of the presence of stroke [adjusted odds ratio (OR) = 1.020; 95% CI = 1.002-1.037] was also suggested. The ROC curve (0.67, P = 0.0119) and optimisation techniques indicated that a novel best cut-off melatonin in the view of the presence of stroke (OR = 3.12, P = 0.0463) might exist. The classification performance of such a cut-off might be confirmed by existing nocturnal melatonin and cortisol differences between the sub-groups; potential differences in diurnal melatonin were also suggested. In conclusion, a novel melatonin cut-off of 51.5 pg/ml may be associated with the presence of ischaemic stroke. As a single marker (84% sensitivity, 74% specificity), it is hypothesised that modelling performance was independent of age, gender and cortisol. These new results, including the suggested hypothesis, might be further tested in

  9. Stroke Treatments

    Science.gov (United States)

    ... Month Infographic Stroke Hero F.A.S.T. Quiz Stroke Treatment Stroke used to rank fourth in leading causes of ... type of treatment depends on the type of stroke. Ischemic stroke happens when a clot blocks a ...

  10. ICARUSS, the Integrated Care for the Reduction of Secondary Stroke trial: rationale and design of a randomized controlled trial of a multimodal intervention to prevent recurrent stroke in patients with a recent cerebrovascular event, ACTRN = 12611000264987.

    Science.gov (United States)

    Joubert, J; Davis, S M; Hankey, G J; Levi, C; Olver, J; Gonzales, G; Donnan, G A

    2015-07-01

    The majority of strokes, both ischaemic and haemorrhagic, are attributable to a relatively small number of risk factors which are readily manageable in primary care setting. Implementation of best-practice recommendations for risk factor management is calculated to reduce stroke recurrence by around 80%. However, risk factor management in stroke survivors has generally been poor at primary care level. A model of care that supports long-term effective risk factor management is needed. To determine whether the model of Integrated Care for the Reduction of Recurrent Stroke (ICARUSS) will, through promotion of implementation of best-practice recommendations for risk factor management reduce the combined incidence of stroke, myocardial infarction and vascular death in patients with recent stroke or transient ischaemic attack (TIA) of the brain or eye. A prospective, Australian, multicentre, randomized controlled trial. Academic stroke units in Melbourne, Perth and the John Hunter Hospital, New South Wales. 1000 stroke survivors recruited as from March 2007 with a recent (system (IVRS). Exposure to the ICARUSS model of integrated care or usual care. The composite of stroke, MI or death from any vascular cause, whichever occurs first. Risk factor management in the community, depression, quality of life, disability and dementia. With 1000 patients followed up for a median of one-year, with a recurrence rate of 7-10% per year in patients exposed to usual care, the study will have at least 80% power to detect a significant reduction in primary end-points The ICARUSS study aims to recruit and follow up patients between 2007 and 2013 and demonstrate the effectiveness of exposure to the ICARUSS model in stroke survivors to reduce recurrent stroke or vascular events and promote the implementation of best practice risk factor management at primary care level. © 2015 World Stroke Organization.

  11. Measurement properties of the upright motor control test for adults with stroke: a systematic review.

    Science.gov (United States)

    Gorgon, Edward James R; Lazaro, Rolando T

    2016-01-01

    The Upright Motor Control Test (UMCT) has been used in clinical practice and research to assess functional strength of the hemiparetic lower limb in adults with stroke. It is unclear if evidence is sufficient to warrant its use. The purpose of this systematic review was to synthesize available evidence on the measurement properties of the UMCT for stroke rehabilitation. Electronic databases that indexed biomedical literature were systematically searched from inception until October 2015 (week 4): Embase, PubMed, Web of Science, CINAHL, PEDro, Cochrane Library, Scopus, ScienceDirect, SPORTDiscus, LILACS, DOAJ, and Google Scholar. All studies that had used the UMCT in the time period covered underwent hand searching for any additional study. Observational studies involving adults with stroke that explored any measurement property of the UMCT were included. The COnsensus-based Standards for the selection of health Measurement INstruments was used to assess the methodological quality of included studies. The CanChild Outcome Measures Rating Form was used for extracting data on measurement properties and clinical utility. The search yielded three methodologic studies that addressed criterion-related validity and contruct validity. Two studies of fair methodological quality demonstrated moderate-level evidence that Knee Extension and Knee Flexion subtest scores were predictive of community-level and household-level ambulation. One study of fair methodological quality provided limited-level evidence for the correlation of Knee Extension subtest scores with a laboratory measure of ground reaction forces. No published studies formally assessed reliability, responsiveness, or clinical utility. Limited information on responsiveness and clinical utility dimensions could be inferred from the included studies. The UMCT is a practical assessment tool for voluntary control or functional strength of the hemiparetic lower limb in standing in adults with stroke. Although different

  12. Creative art therapy to enhance rehabilitation for stroke patients: a randomized controlled trial.

    Science.gov (United States)

    Kongkasuwan, Ratcharin; Voraakhom, Kotchakorn; Pisolayabutra, Prim; Maneechai, Pichai; Boonin, Jiraporn; Kuptniratsaikul, Vilai

    2016-10-01

    To examine the efficacy of creative art therapy plus conventional physical therapy, compared with physical therapy only, in increasing cognitive ability, physical functions, psychological status and quality of life of stroke patients. Randomized controlled trial with blinded assessor. An in-patient setting PARTICIPANTS: One hundred and eighteen stroke patients aged ⩾50 years who could communicate verbally. All participants received conventional physical therapy five days per week. An intervention group received additional creative art therapy, twice a week for four weeks, in a rehabilitation ward. Cognitive function, anxiety and depression, physical performance and quality of life were measured with the Abbreviated Mental Test, the Hospital Anxiety and Depression Scale, the modified Barthel Index scale and the pictorial Thai Quality of Life questionnaire, respectively. Mean differences for the intervention group were significantly greater than the control group for depression (-4.5, 95% CI -6.5, -2.5, pcreative art therapy and most reported improved concentration (68.5%), emotion (79.6%), self-confidence (72.2%) and motivation (74.1%). Creative art therapy combined with conventional physical therapy can significantly decrease depression, improve physical functions and increase quality of life compared with physical therapy alone. © The Author(s) 2015.

  13. 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

  14. Preload-based Starling-like control of rotary blood pumps: An in-vitro evaluation.

    Directory of Open Access Journals (Sweden)

    Mahdi Mansouri

    Full Text Available Due to a shortage of donor hearts, rotary left ventricular assist devices (LVADs are used to provide mechanical circulatory support. To address the preload insensitivity of the constant speed controller (CSC used in conventional LVADs, we developed a preload-based Starling-like controller (SLC. The SLC emulates the Starling law of the heart to maintain mean pump flow ([Formula: see text] with respect to mean left ventricular end diastolic pressure (PLVEDm as the feedback signal. The SLC and CSC were compared using a mock circulation loop to assess their capacity to increase cardiac output during mild exercise while avoiding ventricular suction (marked by a negative PLVEDm and maintaining circulatory stability during blood loss and severe reductions in left ventricular contractility (LVC. The root mean squared hemodynamic deviation (RMSHD metric was used to assess the clinical acceptability of each controller based on pre-defined hemodynamic limits. We also compared the in-silico results from our previously published paper with our in-vitro outcomes. In the exercise simulation, the SLC increased [Formula: see text] by 37%, compared to only 17% with the CSC. During blood loss, the SLC maintained a better safety margin against left ventricular suction with PLVEDm of 2.7 mmHg compared to -0.1 mmHg for CSC. A transition to reduced LVC resulted in decreased mean arterial pressure (MAP and [Formula: see text] with CSC, whilst the SLC maintained MAP and [Formula: see text]. The results were associated with a much lower RMSHD value with SLC (70.3% compared to CSC (225.5%, demonstrating improved capacity of the SLC to compensate for the varying cardiac demand during profound circulatory changes. In-vitro and in-silico results demonstrated similar trends to the simulated changes in patient state however the magnitude of hemodynamic changes were different, thus justifying the progression to in-vitro evaluation.

  15. Smoking Cessation Intervention After Ischemic Stroke or Transient Ischemic Attack. A Randomized Controlled Pilot Trial

    DEFF Research Database (Denmark)

    Brunner Frandsen, Nicole; Sørensen, Margit; Hyldahl, Tanja Kirstine

    2012-01-01

    BACKGROUND: Smoking cessation is widely recommended for secondary stroke prevention. However, little is known about the efficacy of smoking cessation intervention after stroke or transient ischemic attack (TIA). METHODS: Ninety-four smokers under age 76, admitted with ischemic stroke or TIA were...... to the results from other studies. Intensive smoking cessation intervention was not superior to short smoking cessation intervention. Thus, other factors than intensity of smoking cessation intervention might influence the smoking cessation rates after stroke or TIA....

  16. Safety and Efficacy of MLC601 in Iranian Patients after Stroke: A Double-Blind, Placebo-Controlled Clinical Trial

    Directory of Open Access Journals (Sweden)

    A. A. Harandi

    2011-01-01

    Full Text Available Objective. To investigate the safety and efficacy of MLC601 (NeuroAid as a traditional Chinese medicine on motor recovery after ischemic stroke. Methods. This study was a double-blind, placebo-controlled clinical trial on 150 patients with a recent (less than 1 month ischemic stroke. All patients were given either MLC601 (100 patients or placebo (50 patients, 4 capsules 3 times a day, as an add-on to standard stroke treatment for 3 months. Results. Sex, age, elapsed time from stroke onset, and risk factors in the treatment group were not significantly different from placebo group at baseline (P>.05. Repeated measures analysis showed that Fugl-Meyer assessment was significantly higher in the treatment group during 12 weeks after stroke (P<.001. Good tolerability to treatment was shown, and adverse events were mild and transient. Conclusion. MLC601 showed better motor recovery than placebo and was safe on top of standard ischemic stroke medications especially in the severe and moderate cases.

  17. Reinforced Feedback in Virtual Environment for Rehabilitation of Upper Extremity Dysfunction after Stroke: Preliminary Data from a Randomized Controlled Trial

    Directory of Open Access Journals (Sweden)

    Paweł Kiper

    2014-01-01

    Full Text Available Objectives. To study whether the reinforced feedback in virtual environment (RFVE is more effective than traditional rehabilitation (TR for the treatment of upper limb motor function after stroke, regardless of stroke etiology (i.e., ischemic, hemorrhagic. Design. Randomized controlled trial. Participants. Forty-four patients affected by stroke. Intervention. The patients were randomized into two groups: RFVE (N=23 and TR (N=21, and stratified according to stroke etiology. The RFVE treatment consisted of multidirectional exercises providing augmented feedback provided by virtual reality, while in the TR treatment the same exercises were provided without augmented feedbacks. Outcome Measures. Fugl-Meyer upper extremity scale (F-M UE, Functional Independence Measure scale (FIM, and kinematics parameters (speed, time, and peak. Results. The F-M UE (P=0.030, FIM (P=0.021, time (P=0.008, and peak (P=0.018, were significantly higher in the RFVE group after treatment, but not speed (P=0.140. The patients affected by hemorrhagic stroke significantly improved FIM (P=0.031, time (P=0.011, and peak (P=0.020 after treatment, whereas the patients affected by ischemic stroke improved significantly only speed (P=0.005 when treated by RFVE. Conclusion. These results indicated that some poststroke patients may benefit from RFVE program for the recovery of upper limb motor function. This trial is registered with NCT01955291.

  18. Long-term use of Proton Pump Inhibitors, Dose-response Relationship, and Associated Risk of Ischemic Stroke and Myocardial Infarction

    DEFF Research Database (Denmark)

    Sehested, Thomas S G; Gerds, Thomas A; Fosbøl, Emil L

    2018-01-01

    Danish individuals with no prior history of MI or stroke, who had an elective upper gastrointestinal endoscopy performed between 1997 and 2012, were identified from nationwide registries. We used multiple Poisson regression to test associations with current PPI use and its dose, and used multiple cause...

  19. Insulin Pumps

    Science.gov (United States)

    ... Size: A A A Listen En Español Insulin Pumps Insulin pumps are small computerized devices that deliver insulin in ... tissue and is taped in place. The insulin pump is not an artificial pancreas (because you still ...

  20. Penis Pump

    Science.gov (United States)

    ... your appointment might be less involved. Choosing a penis pump Some penis pumps are available without a ... it doesn't get caught in the ring. Penis pumps for penis enlargement Many advertisements in magazines ...

  1. The Paracetamol (Acetaminophen) In Stroke (PAIS) trial : a multicentre, randomised, placebo-controlled, phase III trial

    NARCIS (Netherlands)

    den Hertog, Heleen M.; van der Worp, H. Bart; van Gemert, H. Maarten A.; Algra, Ate; Kappelle, L. Jaap; Van Gijn, Jan; Koudstaal, Peter J.; Dippel, Diederik W. J.

    Background High body temperature in the first 12-24 h after stroke onset is associated with poor functional outcome. The Paracetamol (Acetaminophen) In Stroke (PAIS) trial aimed to assess whether early treatment with paracetamol improves functional outcome in patients with acute stroke by reducing

  2. A randomized controlled behavioral intervention trial to improve medication adherence in adult stroke patients with prescription tailored Short Messaging Service (SMS)-SMS4Stroke study.

    Science.gov (United States)

    Kamal, Ayeesha Kamran; Shaikh, Quratulain; Pasha, Omrana; Azam, Iqbal; Islam, Muhammad; Memon, Adeel Ali; Rehman, Hasan; Akram, Masood Ahmed; Affan, Muhammad; Nazir, Sumaira; Aziz, Salman; Jan, Muhammad; Andani, Anita; Muqeet, Abdul; Ahmed, Bilal; Khoja, Shariq

    2015-10-21

    The effectiveness of mobile technology to improve medication adherence via customized Short Messaging Service (SMS) reminders for stroke has not been tested in resource poor areas. We designed a randomized controlled trial to test the effectiveness of SMS on improving medication adherence in stroke survivors in Pakistan. This was a parallel group, assessor-blinded, randomized, controlled, superiority trial. Participants were centrally randomized in fixed block sizes. Adult participants on multiple medications with access to a cell phone and stroke at least 4 weeks from onset (Onset as defined by last seen normal) were eligible. The intervention group, in addition to usual care, received reminder SMS for 2 months that contained a) Personalized, prescription tailored daily medication reminder(s) b) Twice weekly health information SMS. The Health Belief Model and Social Cognitive theory were used to design the language and content of messages. Frontline SMS software was used for SMS delivery. Medication adherence was self-reported and measured on the validated Urdu version of Morisky Medication Adherence Questionnaire. Multiple linear regression was used to model the outcome against intervention and other covariates. Analysis was conducted by intention-to-treat principle. Two hundred participants were enrolled. 38 participants were lost to follow-up. After 2 months, the mean medication score was 7.4 (95 % CI: 7.2-7.6) in the intervention group while 6.7 (95 % CI: 6.4-7.02) in the control group. The adjusted mean difference (Δ) was 0.54 (95 % CI: 0.22-0.85). The mean diastolic blood pressure in the intervention group was 2.6 mmHg (95 % CI; -5.5 to 0.15) lower compared to the usual care group. A short intervention of customized SMS can improve medication adherence and effect stroke risk factors like diastolic blood pressure in stroke survivors with complex medication regimens living in resource poor areas. Clinicaltrials.gov NCT01986023 last accessed at https

  3. Does electrical stimulation reduce spasticity after stroke? A randomized controlled study.

    Science.gov (United States)

    Bakhtiary, Amir H; Fatemy, Elham

    2008-05-01

    To investigate the therapeutic effect of electrical stimulation on plantarflexor spasticity in stroke patients. A randomized controlled clinical trial study. Rehabilitation clinic of Semnan University of Medical Sciences. Forty stroke patients (aged from 42 to 65 years) with ankle plantarflexor spasticity. Fifteen minutes of inhibitory Bobath techniques were applied to one experimental group and a combination of 9 minutes of electrical stimulation on the dorsiflexor muscles and inhibitory Bobath techniques was applied to another group for 20 sessions daily. Passive ankle joint dorsiflexion range of motion, dorsiflexion strength test, plantarflexor muscle tone by Modified Ashworth Scale and soleus muscle H-reflex. The mean change of passive ankle joint dorsiflexion in the combination therapy group was 11.4 (SD 4.79) degrees versus 6.1 (SD 3.09) degrees, which was significantly higher (P = 0.001). The mean change of plantarflexor muscle tonicity measured by the Modified Ashworth Scale in the combination therapy group was -1.6 (SD 0.5) versus -1.1 (SD 0.31) in the Bobath group (P = 0.001). Dorsiflexor muscle strength was also increased significantly (P = 0.04) in the combination therapy group (0.7 +/- 0.37) compared with the Bobath group (0.4 +/- 0.23). However, no significant change in the amplitude of H-reflex was found between combination therapy (-0.41 +/- 0.29) and Bobath (-0.3 +/- 0.28) groups. Therapy combining Bobath inhibitory technique and electrical stimulation may help to reduce spasticity effectively in stroke patients.

  4. Bridges self-management program for people with stroke in the community: A feasibility randomized controlled trial.

    Science.gov (United States)

    McKenna, Suzanne; Jones, Fiona; Glenfield, Pauline; Lennon, Sheila

    2015-07-01

    Enabling self-management behaviors is considered important in order to develop coping strategies and confidence for managing life with a long-term condition. However, there is limited research into stroke-specific self-management interventions. The aim of this randomized controlled trial was to evaluate the feasibility of delivering the Bridges stroke self-management program in addition to usual stroke rehabilitation compared with usual rehabilitation only. Participants recruited from the referrals to a community stroke team were randomly allocated to the Bridges stroke self-management program, receiving either one session of up to one-hour per week over a six-week period in addition to usual stroke rehabilitation, or usual rehabilitation only. Feasibility was measured using a range of methods to determine recruitment and retention; adherence to the program; suitability and variability of outcome measures used; application and fidelity of the program; and acceptability of the program to patients, carers and professionals. Twenty-five people were recruited to the study over a 13-month period. Eight out of the 12 participants in the Bridges stroke self-management program received all six sessions; there was one withdrawal from the study. There were changes in outcomes between the two groups. Participants who received the Bridges stroke self-management program appeared to have a greater change in self-efficacy, functional activity, social integration and quality of life over the six-week intervention period and showed less decline in mood and quality of life at the three-month follow-up. Professionals found the program acceptable to use in practice, and feedback from participants was broadly positive. The findings from this study appear promising, but questions remain regarding the feasibility of delivering the Bridges stroke self-management program in addition to usual rehabilitation. The dose response of receiving the program cannot be ruled out, and the next stage

  5. Randomized controlled trial of a coordinated care intervention to improve risk factor control after stroke or transient ischemic attack in the safety net: Secondary stroke prevention by Uniting Community and Chronic care model teams Early to End Disparities (SUCCEED).

    Science.gov (United States)

    Towfighi, Amytis; Cheng, Eric M; Ayala-Rivera, Monica; McCreath, Heather; Sanossian, Nerses; Dutta, Tara; Mehta, Bijal; Bryg, Robert; Rao, Neal; Song, Shlee; Razmara, Ali; Ramirez, Magaly; Sivers-Teixeira, Theresa; Tran, Jamie; Mojarro-Huang, Elizabeth; Montoya, Ana; Corrales, Marilyn; Martinez, Beatrice; Willis, Phyllis; Macias, Mireya; Ibrahim, Nancy; Wu, Shinyi; Wacksman, Jeremy; Haber, Hilary; Richards, Adam; Barry, Frances; Hill, Valerie; Mittman, Brian; Cunningham, William; Liu, Honghu; Ganz, David A; Factor, Diane; Vickrey, Barbara G

    2017-02-06

    Recurrent strokes are preventable through awareness and control of risk factors such as hypertension, and through lifestyle changes such as healthier diets, greater physical activity, and smoking cessation. However, vascular risk factor control is frequently poor among stroke survivors, particularly among socio-economically disadvantaged blacks, Latinos and other people of color. The Chronic Care Model (CCM) is an effective framework for multi-component interventions aimed at improving care processes and outcomes for individuals with chronic disease. In addition, community health workers (CHWs) have played an integral role in reducing health disparities; however, their effectiveness in reducing vascular risk among stroke survivors remains unknown. Our objectives are to develop, test, and assess the economic value of a CCM-based intervention using an Advanced Practice Clinician (APC)-CHW team to improve risk factor control after stroke in an under-resourced, racially/ethnically diverse population. In this single-blind randomized controlled trial, 516 adults (≥40 years) with an ischemic stroke, transient ischemic attack or intracerebral hemorrhage within the prior 90 days are being enrolled at five sites within the Los Angeles County safety-net setting and randomized 1:1 to intervention vs usual care. Participants are excluded if they do not speak English, Spanish, Cantonese, Mandarin, or Korean or if they are unable to consent. The intervention includes a minimum of three clinic visits in the healthcare setting, three home visits, and Chronic Disease Self-Management Program group workshops in community venues. The primary outcome is blood pressure (BP) control (systolic BP control of other vascular risk factors including lipids and hemoglobin A1c, (3) inflammation (C reactive protein [CRP]), (4) medication adherence, (5) lifestyle factors (smoking, diet, and physical activity), (6) estimated relative reduction in risk for recurrent stroke or myocardial

  6. Methylenetetrahydrofolate reductase gene A1298C polymorphism in pediatric stroke--case-control and family-based study.

    Science.gov (United States)

    Balcerzyk, Anna; Niemiec, Paweł; Kopyta, Ilona; Emich-Widera, Ewa; Pilarska, Ewa; Pienczk-Ręcławowicz, Karolina; Kaciński, Marek; Wendorff, Janusz; Żak, Iwona

    2015-01-01

    Moderate hyperhomocysteinemia is one of the risk factors of pediatric stroke. Methylenetetrahydrofolate reductase (MTHFR) is an important enzyme, which regulates homocysteine metabolism, and some polymorphisms of gene encoding this enzyme are associated with a decreased activity of the enzyme. The aim of the study was to assess an association between the A1298C polymorphism and pediatric stroke. We also evaluated a possible synergistic effect of A1298C and C677T polymorphisms of this gene. The study group consisted of 88 children after ischemic stroke, 142 of their parents and 111 controls. The A1298C polymorphism was genotyped using the restriction fragment length polymorphism method. We used 2 study designs: a case-control model and a family-based association test. The Statistica 7.1 and EpiInfo 6 softwares were used in all analyses. We did not observe any statistically significant differences either in the transmission of the A allele in the family-based test or in the frequency of the A allele in the patients group compared with the controls. We also did not notice any significant additive or synergistic effects between the A1298C and C677T polymorphisms. An analysis of the results obtained in this study and a critical review of previously published studies indicate that the A1298C polymorphism of the MTHFR gene is not related to ischemic stroke in children. Copyright © 2015 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  7. Effectiveness of an Intervention to Improve Risk Factor Knowledge in Patients With Stroke: A Randomized Controlled Trial.

    Science.gov (United States)

    Olaiya, Muideen T; Cadilhac, Dominique A; Kim, Joosup; Ung, David; Nelson, Mark R; Srikanth, Velandai K; Bladin, Christopher F; Gerraty, Richard P; Fitzgerald, Sharyn M; Phan, Thanh; Frayne, Judith; Thrift, Amanda G

    2017-04-01

    Despite the benefit of risk awareness in secondary prevention, survivors of stroke are often unaware of their risk factors. We determined whether a nurse-led intervention improved knowledge of risk factors in people with stroke or transient ischemic attack. Prospective study nested within a randomized controlled trial of risk factor management in survivors of stroke or transient ischemic attack. 3 nurse education visits and specialist review of care plans. unprompted knowledge of risk factors of stroke or transient ischemic attack at 24 months. Effect of intervention on knowledge and factors associated with knowledge were determined using multivariable regression models. Knowledge was assessed in 268 consecutive participants from the main trial, 128 in usual care and 140 in the intervention. Overall, 34% of participants were unable to name any risk factor. In adjusted analyses, the intervention group had better overall knowledge than controls (incidence risk ratio, 1.26; 95% confidence interval, 1.00-1.58). Greater functional ability and polypharmacy were associated with better knowledge and older age and having more comorbidities associated with poorer knowledge. Overall knowledge of risk factors of stroke or transient ischemic attack was better in the intervention group than controls. However, knowledge was generally poor. New and more effective strategies are required, especially in subgroups identified as having poor knowledge. URL: http://www.anzctr.org.au. Unique identifier: ACTRN12608000166370. © 2017 American Heart Association, Inc.

  8. Association of cardiovascular emerging risk factors with acute coronary syndrome and stroke: A case-control study.

    Science.gov (United States)

    Martínez Linares, José Manuel; Guisado Barrilao, Rafael; Ocaña Peinado, Francisco Manuel; Salgado Parreño, Francisco Javier

    2016-12-01

    In this study, we estimated the risk of acute coronary syndrome and stroke associated with several emerging cardiovascular risk factors. This was a case-control study, where an age - and sex-matched acute coronary syndrome group and stroke group were compared with controls. Demographic and clinical data were collected through patient interviews, and blood samples were taken for analysis. In the bivariate analysis, all cardiovascular risk factors analyzed showed as predictors of acute coronary syndrome and stroke, except total cholesterol and smoking. In the multivariate logistic regression model for acute coronary syndrome, hypertension and body mass index, N-terminal section brain natriuretic peptide and pregnancy-associated plasma protein-A were independent predictors. For stroke, the predictors were hypertension, diabetes mellitus, body mass index, and N-terminal section brain natriuretic peptide. Controlling for age, sex, and classical cardiovascular risk factors, N-terminal section brain natriuretic peptide and pregnancy-associated plasma protein-A were independent emerging cardiovascular risk factors for acute coronary syndrome, but pregnancy-associated plasma protein-A was not for stroke. High levels of cardiovascular risk factors in individuals with no episodes of cardiovascular disease requires the implementation of prevention programs, given that at least half of them are modifiable. © 2016 John Wiley & Sons Australia, Ltd.

  9. Na(+)/K(+) pump interacts with the h-current to control bursting activity in central pattern generator neurons of leeches.

    Science.gov (United States)

    Kueh, Daniel; Barnett, William H; Cymbalyuk, Gennady S; Calabrese, Ronald L

    2016-09-02

    The dynamics of different ionic currents shape the bursting activity of neurons and networks that control motor output. Despite being ubiquitous in all animal cells, the contribution of the Na(+)/K(+) pump current to such bursting activity has not been well studied. We used monensin, a Na(+)/H(+) antiporter, to examine the role of the pump on the bursting activity of oscillator heart interneurons in leeches. When we stimulated the pump with monensin, the period of these neurons decreased significantly, an effect that was prevented or reversed when the h-current was blocked by Cs(+). The decreased period could also occur if the pump was inhibited with strophanthidin or K(+)-free saline. Our monensin results were reproduced in model, which explains the pump's contributions to bursting activity based on Na(+) dynamics. Our results indicate that a dynamically oscillating pump current that interacts with the h-current can regulate the bursting activity of neurons and networks.

  10. Metabolic Control of Type 1 Diabetes in Children Treated with Insulin Pump Therapy

    Directory of Open Access Journals (Sweden)

    Sniježana Hasanbegović

    2009-05-01

    Full Text Available In this paper we present study of metabolic control in children suffering from TYPE 1 Diabetes Mellitus (T1DM who use insulin pump (IP therapy, and who were treated at Paediatric Clinic in Sarajevo.In retrospective study we followed all T1DM patients with IP therapy introduced in the period from 1st March 2005 to 1st September 2008.We analyzed their age and sex structure, therapy before IP use, and the metabolic control of T1DM represented with glycosylated haemoglobin (HbA1c value just before and 6 months after IP therapy introducing.The total number of observed patients was 39. There were 24 boys (61,5 % and 15 girls (38,5 % with the age range between 12,3 ± 3,2 years. Most patients were from age group 8-14 years. In the same number of patients 17 (43,6 % diabetes duration was less than 5 years and 5-10 years. Before IP introduction most patient 61,5 % use therapy with insulin analogues. Mean value of HbA1c before IP therapy introduction was 8,57±1,65 % and 6 months after IP therapy introduction HbA1c 7,53 ± 0,81 % (p = 0,0009. There was significant reduction HbA1c values even 6 month after IP therapy introduced.Therapy with IP in children with diabetes was very efficient in achieving therapeutic goal of T1DM treatment (HbA1c<7,0 % what will protect patients from appearance and progression of chronic micro vascular complications on eyes, kidneys and peripheral nerves.

  11. Using LDR as Sensing Element for an External Fuzzy Controller Applied in Photovoltaic Pumping Systems with Variable-Speed Drives

    Science.gov (United States)

    Maranhão, Geraldo Neves De A.; Brito, Alaan Ubaiara; Leal, Anderson Marques; Fonseca, Jéssica Kelly Silva; Macêdo, Wilson Negrão

    2015-01-01

    In the present paper, a fuzzy controller applied to a Variable-Speed Drive (VSD) for use in Photovoltaic Pumping Systems (PVPS) is proposed. The fuzzy logic system (FLS) used is embedded in a microcontroller and corresponds to a proportional-derivative controller. A Light-Dependent Resistor (LDR) is used to measure, approximately, the irradiance incident on the PV array. Experimental tests are executed using an Arduino board. The experimental results show that the fuzzy controller is capable of operating the system continuously throughout the day and controlling the direct current (DC) voltage level in the VSD with a good performance. PMID:26402688

  12. Fever, hyperglycaemia and swallowing dysfunction management in acute stroke: A cluster randomised controlled trial of knowledge transfer

    Directory of Open Access Journals (Sweden)

    Quinn Clare

    2009-03-01

    Full Text Available Abstract Background Hyperglycaemia, fever, and swallowing dysfunction are poorly managed in the admission phase of acute stroke, and patient outcomes are compromised. Use of evidence-based guidelines could improve care but have not been effectively implemented. Our study aims to develop and trial an intervention based on multidisciplinary team-building to improve management of fever, hyperglycaemia, and swallowing dysfunction in patients following acute stroke. Methods and design Metropolitan acute stroke units (ASUs located in New South Wales, Australia will be stratified by service category (A or B and, within strata, by baseline patient recruitment numbers (high or low in this prospective, multicentre, single-blind, cluster randomised controlled trial (CRCT. ASUs then will be randomised independently to either intervention or control groups. ASUs allocated to the intervention group will receive: unit-based workshops to identify local barriers and enablers; a standardised core education program; evidence-based clinical treatment protocols; and ongoing engagement of local staff. Control group ASUs will receive only an abridged version of the National Clinical Guidelines for Acute Stroke Management. The following outcome measures will be collected at 90 days post-hospital admission: patient death, disability (modified Rankin Score; dependency (Barthel Index and Health Status (SF-36. Additional measures include: performance of swallowing screening within 24 hours of admission; glycaemic control and temperature control. Discussion This is a unique study of research transfer in acute stroke. Providing optimal inpatient care during the admission phase is essential if we are to combat the rising incidence of debilitating stroke. Our CRCT will also allow us to test interventions focussed on multidisciplinary ASU teams rather than individual disciplines, an imperative of modern hospital services. Trial Registration Australia New Zealand Clinical Trial

  13. Fever, hyperglycaemia and swallowing dysfunction management in acute stroke: a cluster randomised controlled trial of knowledge transfer.

    Science.gov (United States)

    Middleton, Sandy; Levi, Christopher; Ward, Jeanette; Grimshaw, Jeremy; Griffiths, Rhonda; D'Este, Catherine; Dale, Simeon; Cheung, N Wah; Quinn, Clare; Evans, Malcolm; Cadilhac, Dominique

    2009-03-16

    Hyperglycaemia, fever, and swallowing dysfunction are poorly managed in the admission phase of acute stroke, and patient outcomes are compromised. Use of evidence-based guidelines could improve care but have not been effectively implemented. Our study aims to develop and trial an intervention based on multidisciplinary team-building to improve management of fever, hyperglycaemia, and swallowing dysfunction in patients following acute stroke. Metropolitan acute stroke units (ASUs) located in New South Wales, Australia will be stratified by service category (A or B) and, within strata, by baseline patient recruitment numbers (high or low) in this prospective, multicentre, single-blind, cluster randomised controlled trial (CRCT). ASUs then will be randomised independently to either intervention or control groups. ASUs allocated to the intervention group will receive: unit-based workshops to identify local barriers and enablers; a standardised core education program; evidence-based clinical treatment protocols; and ongoing engagement of local staff. Control group ASUs will receive only an abridged version of the National Clinical Guidelines for Acute Stroke Management. The following outcome measures will be collected at 90 days post-hospital admission: patient death, disability (modified Rankin Score); dependency (Barthel Index) and Health Status (SF-36). Additional measures include: performance of swallowing screening within 24 hours of admission; glycaemic control and temperature control. This is a unique study of research transfer in acute stroke. Providing optimal inpatient care during the admission phase is essential if we are to combat the rising incidence of debilitating stroke. Our CRCT will also allow us to test interventions focussed on multidisciplinary ASU teams rather than individual disciplines, an imperative of modern hospital services. Australia New Zealand Clinical Trial Registry (ANZCTR) No: ACTRN12608000563369.

  14. Music-supported therapy in the rehabilitation of subacute stroke patients: a randomized controlled trial.

    Science.gov (United States)

    Grau-Sánchez, Jennifer; Duarte, Esther; Ramos-Escobar, Neus; Sierpowska, Joanna; Rueda, Nohora; Redón, Susana; Veciana de Las Heras, Misericordia; Pedro, Jordi; Särkämö, Teppo; Rodríguez-Fornells, Antoni

    2018-04-01

    The effect of music-supported therapy (MST) as a tool to restore hemiparesis of the upper extremity after a stroke has not been appropriately contrasted with conventional therapy. The aim of this trial was to test the effectiveness of adding MST to a standard rehabilitation program in subacute stroke patients. A randomized controlled trial was conducted in which patients were randomized to MST or conventional therapy in addition to the rehabilitation program. The intensity and duration of the interventions were equated in both groups. Before and after 4 weeks of treatment, motor and cognitive functions, mood, and quality of life (QoL) of participants were evaluated. A follow-up at 3 months was conducted to examine the retention of motor gains. Both groups significantly improved their motor function, and no differences between groups were found. The only difference between groups was observed in the language domain for QoL. Importantly, an association was encountered between the capacity to experience pleasure from music activities and the motor improvement in the MST group. MST as an add-on treatment showed no superiority to conventional therapies for motor recovery. Importantly, patient's intrinsic motivation to engage in musical activities was associated with better motor improvement. © 2018 New York Academy of Sciences.

  15. Modified constraint-induced therapy in acute stroke: a randomized controlled pilot study.

    Science.gov (United States)

    Page, Stephen J; Levine, Peter; Leonard, Anthony C

    2005-03-01

    To determine modified constraint-induced therapy (mCIT) feasibility and compare its efficacy to traditional rehabilitation (TR) in acute stroke patients exhibiting upper limb hemiparesis. Before-after, multiple baseline, randomized controlled pilot study. Rehabilitation hospital. Ten stroke patients Fugl-Meyer Assessment of Motor Recovery (Fugl-Meyer), Action Research Arm Test (ARA), and Motor Activity Log (MAL). Before intervention, all patients exhibited stable motor deficits and more affected arm nonuse. After intervention, mCIT patients displayed increased affected arm use (+ 2.43 on the MAL amount of use scale), uniformly exhibited increases on the Fugl-Meyer and ARA (mean change scores = + 18.7 and + 21.7, respectively), and were able to again perform valued activities. TR patients exhibited nominal change in affected limb use (+ 0.07 on the MAL amount of use scale) and modest changes on the Fugl-Meyer and ARA (+ 4.4 and + 4.8, respectively). Fugl-Meyer and ARA changes were significant for the mCIT group only (P < 0.01). mCIT is a promising regimen for improving more affected limb use and function in acute cerebrovascular accident. However, larger confirmatory studies need to be performed.

  16. Fluid mechanic phenomena relating to flow control in conduits and pumps

    Science.gov (United States)

    Bayazit, Yilmaz

    first time, thereby contradicting the prior limitation to inertial laminar flow. The Taguchi method was applied to pinpoint the most important among the independent variables with respect to the dimensionless pressure drop, highlighting the importance of the porosity. Control of the liquid flow produced by a pump was analyzed as a problem of fluid-structural interaction.

  17. Fuzzy optimization in hydrodynamic analysis of groundwater control systems: Case study of the pumping station "Bezdan 1", Serbia

    Directory of Open Access Journals (Sweden)

    Bajić Dragoljub

    2014-01-01

    Full Text Available A groundwater control system was designed to lower the water table and allow the pumping station “Bezdan 1” to be built. Based on a hydrodynamic analysis that suggested three alternative solutions, multicriteria optimization was applied to select the best alternative. The fuzzy analytic hierarchy process method was used, based on triangular fuzzy numbers. An assessment of the various factors that influenced the selection of the best alternative, as well as fuzzy optimization calculations, yielded the “weights” of the alternatives and the best alternative was selected for groundwater control at the site of the pumping station “Bezdan 1”. [Projekat Ministarstva nauke Republike Srbije, br. OI-176022, TR-33039 i br. III-43004

  18. Performance Evaluation of HP/ORC (Heat Pump/Organic Rankine Cycle) System with Optimal Control of Sensible Thermal Storage

    DEFF Research Database (Denmark)

    Do Carmo, Carolina Madeira Ramos; Dumont, Olivier; Nielsen, Mads Pagh

    2016-01-01

    come to contribute to the integration of intermittent renewables.This paper describes an innovative concept that consists of the addition of an Organic Rankine Cycle (ORC) to a combined solar system coupled to a ground-source heat pump (HP) in a single-family building. The ORC enables the use of solar...... energy in periods of no thermal energy demand and reverses the heat pump cycle to supply electrical power. A dynamic model based on empirical data of this system is used to determine the annual performance. Furthermore, this work assesses the benefits of different control strategies that address...... of the users. Results show that real load control logic can lessen the adverse effects of cycling in the compressor of the system as well as increase the thermal demand (up to 33%) and the electrical demand (max. 8.4%) covered by renewable energy (solar). However, the extension of these improvements is highly...

  19. Interleukin-1β Accelerates the Onset of Stroke in Stroke-Prone Spontaneously Hypertensive Rats

    Directory of Open Access Journals (Sweden)

    Tsuyoshi Chiba

    2012-01-01

    Full Text Available High blood levels of inflammatory biomarkers and immune cells in stroke lesions have been recognized as results of stroke. However, recent studies have suggested that inflammation occurs prior to stroke onset. In this study, we aimed to clarify the role of inflammation in stroke onset among stroke-prone spontaneously hypertensive rats (SHRSP. At 4 weeks of age (before stroke onset, the plasma level of IL-1β was significantly higher in SHRSP (153.0±49.7 pg/ml than in Wistar Kyoto rats (WKY (7.7±3.4 pg/ml, P<0.001 versus SHRSP or spontaneously hypertensive rats (SHR (28.0±9.1 pg/ml, P<0.001 versus SHRSP (n=6 per strain. Stimulated IL-1β signal was also observed in cerebrovascular endothelial cells of SHRSP. Gene expressions of IL-1β, IL-1 receptors, caspase-1, and downstream genes (MCP-1 and ICAM-1, which associated with immune cell recruitment, were significantly greater in SHRSP than in WKY or SHR, coincident with greater NFκB protein levels in SHRSP compared to WKY or SHR. In addition, continuous administration of IL-1β (2 μg/day using an osmotic pump slightly increased the incidence of stroke in SHR (P=0.046 and significantly accelerated the onset of stroke in SHRSP (P=0.006 compared to each control (n=10 per group. These results suggest that a stimulated IL-1β signal might be a cause of stroke onset when concomitant with severe hypertension.

  20. Dynamic Modeling, Control, and Analysis of a Solar Water Pumping System for Libya

    Directory of Open Access Journals (Sweden)

    Muamer M. Shebani

    2017-01-01

    Full Text Available In recent years, one of the suitable solar photovoltaic (PV applications is a water pumping system. The simplest solar PV pumping system consists of PV array, DC-DC converter, DC motor, and water pump. In this paper, water pumping system sizing for Libya is evaluated based on a daily demand using HOMER software, and dynamic modeling of a solar PV water pumping system using a Permanent Magnet DC (PMDC motor is presented in Matlab/Simulink environment. The system performance with maximum power point tracking (MPPT based on Fractional Open Circuit Voltage (FOCV is evaluated with and without a battery storage system. In some applications, a rated voltage is needed to connect a PMDC motor to a PV array through a DC-DC converter and in other applications the input voltage can vary. The evaluation of the system is based on the performance during a change in solar irradiation. Using Matlab/Simulink, simulation results are assessed to see the efficiency of the system when it is operating at a specific speed or at the MPPT. The results show that an improvement in the system efficiency can be achieved when the PMDC motor is running at a specific speed rather than at the peak PV power point.

  1. Stroke rehabilitation at home before and after discharge reduced disability and improved quality of life: a randomised controlled trial.

    Science.gov (United States)

    Rasmussen, Rune Skovgaard; Østergaard, Ann; Kjær, Pia; Skerris, Anja; Skou, Christina; Christoffersen, Jane; Seest, Line Skou; Poulsen, Mai Bang; Rønholt, Finn; Overgaard, Karsten

    2016-03-01

    To evaluate if home-based rehabilitation of inpatients improved outcome compared to standard care. Interventional, randomised, safety/efficacy open-label trial. University hospital stroke unit in collaboration with three municipalities. Seventy-one eligible stroke patients (41 women) with focal neurological deficits hospitalised in a stroke unit for more than three days and in need of rehabilitation. Thirty-eight patients were randomised to home-based rehabilitation during hospitalization and for up to four weeks after discharge to replace part of usual treatment and rehabilitation services. Thirty-three control patients received treatment and rehabilitation following usual guidelines for the treatment of stroke patients. Ninety days post-stroke the modified Rankin Scale score was the primary endpoint. Other outcome measures were the modified Barthel-100 Index, Motor Assessment Scale, CT-50 Cognitive Test, EuroQol-5D, Body Mass Index and treatment-associated economy. Thirty-one intervention and 30 control patients completed the study. Patients in the intervention group achieved better modified Rankin Scale score (Intervention median = 2, IQR = 2-3; Control median = 3, IQR = 2-4; P=0.04). EuroQol-5D quality of life median scores were improved in intervention patients (Intervention median = 0.77, IQR = 0.66-0.79; Control median = 0.66, IQR = 0.56 - 0.72; P=0.03). The total amount of home-based training in minutes highly correlated with mRS, Barthel, Motor Assessment Scale and EuroQol-5D™ scores (P-values ranging from Prehabilitation reduced disability and increased quality of life. Compared to standard care, home-based stroke rehabilitation was more cost-effective. © The Author(s) 2015.

  2. An assistive control approach for a lower-limb exoskeleton to facilitate recovery of walking following stroke.

    Science.gov (United States)

    Murray, Spencer A; Ha, Kevin H; Hartigan, Clare; Goldfarb, Michael

    2015-05-01

    This paper presents a control approach for a lower-limb exoskeleton intended to facilitate recovery of walking in individuals with lower-extremity hemiparesis after stroke. The authors hypothesize that such recovery is facilitated by allowing the patient rather than the exoskeleton to provide movement coordination. As such, an assistive controller that provides walking assistance without dictating the spatiotemporal nature of joint movement is described here. Following a description of the control laws and finite state structure of the controller, the authors present the results of an experimental implementation and preliminary validation of the control approach, in which the control architecture was implemented on a lower limb exoskeleton, and the exoskeleton implemented in an experimental protocol on three subjects with hemiparesis following stroke. In a series of sessions in which each patient used the exoskeleton, all patients showed substantial single-session improvements in all measured gait outcomes, presumably as a result of using the assistive controller and exoskeleton.

  3. Robot training for hand motor recovery in subacute stroke patients: A randomized controlled trial.

    Science.gov (United States)

    Orihuela-Espina, Felipe; Roldán, Giovana Femat; Sánchez-Villavicencio, Israel; Palafox, Lorena; Leder, Ronald; Sucar, Luis Enrique; Hernández-Franco, Jorge

    2016-01-01

    Evidence of superiority of robot training for the hand over classical therapies in stroke patients remains controversial. During the subacute stage, hand training is likely to be the most useful. To establish whether robot active assisted therapies provides any additional motor recovery for the hand when administered during the subacute stage (robot based therapies for hand recovery will show significant differences at subacute stages. A randomized clinical trial. A between subjects randomized controlled trial was carried out on subacute stroke patients (n = 17) comparing robot active assisted therapy (RT) with a classical occupational therapy (OT). Both groups received 40 sessions ensuring at least 300 repetitions per session. Treatment duration was (mean ± std) 2.18 ± 1.25 months for the control group and 2.44 ± 0.88 months for the study group. The primary outcome was motor dexterity changes assessed with the Fugl-Meyer (FMA) and the Motricity Index (MI). Both groups (OT: n = 8; RT: n = 9) exhibited significant improvements over time (Non-parametric Cliff's delta-within effect sizes: dwOT-FMA = 0.5, dwOT-MI = 0.5, dwRT-FMA = 1, dwRT-MI = 1). Regarding differences between the therapies; the Fugl-Meyer score indicated a significant advantage for the hand training with the robot (FMA hand: WRS: W = 8, p hand prehension for RT with respect to OT but failed to reach significance (MI prehension: W = 17.5, p = 0.080). No harm occurred. Robotic therapies may be useful during the subacute stages of stroke - both endpoints (FM hand and MI prehension) showed the expected trend with bigger effect size for the robotic intervention. Additional benefit of the robotic therapy over the control therapy was only significant when the difference was measured with FM, demanding further investigation with larger samples. Implications of this study are important for decision making during therapy administration and resource allocation. Copyright © 2016 Hanley

  4. Long-term outcome of insulin pump therapy in children with type 1 diabetes assessed in a large population-based case-control study.

    Science.gov (United States)

    Johnson, Stephanie R; Cooper, Matthew N; Jones, Timothy W; Davis, Elizabeth A

    2013-11-01

    We determined the impact of insulin pump therapy on long-term glycaemic control, BMI, rate of severe hypoglycaemia and diabetic ketoacidosis (DKA) in children. Patients on pump therapy at a single paediatric tertiary hospital were matched to patients treated by injections on the basis of age, duration of diabetes and HbA1c at the time of pump start. HbA1c, anthropometric data, episodes of severe hypoglycaemia and rates of hospitalisation for DKA were collected prospectively. A total of 345 patients on pump therapy were matched to controls on injections. The mean age, duration of diabetes at pump start and length of follow-up were 11.4 (± 3.5), 4.1 (± 3.0) and 3.5 (± 2.5) years, respectively. The mean HbA1c reduction in the pump cohort was 0.6% (6.6 mmol/mol). This improved HbA1c remained significant throughout the 7 years of follow-up. Pump therapy reduced severe hypoglycaemia from 14.7 to 7.2 events per 100 patient-years (p pump cohort over the same period from 6.8 to 10.2 events per 100 patient-years. The rate of hospitalisation for DKA was lower in the pump cohort (2.3 vs 4.7 per 100 patient-years, p = 0.003) over the 1,160 patient-years of follow-up. This is the longest and largest study of insulin pump use in children and demonstrates that pump therapy provides a sustained improvement in glycaemic control, and reductions of severe hypoglycaemia and hospitalisation for DKA compared with a matched cohort using injections.

  5. Sensor-augmented pump therapy lowers HbA(1c) in suboptimally controlled Type 1 diabetes; a randomized controlled trial

    NARCIS (Netherlands)

    Hermanides, J.; Nørgaard, K.; Bruttomesso, D.; Mathieu, C.; Frid, A.; Dayan, C. M.; Diem, P.; Fermon, C.; Wentholt, I. M. E.; Hoekstra, J. B. L.; DeVries, J. H.

    2011-01-01

    To investigate the efficacy of sensor-augmented pump therapy vs. multiple daily injection therapy in patients with suboptimally controlled Type 1 diabetes. In this investigator-initiated multi-centre trial (the Eurythmics Trial) in eight outpatient centres in Europe, we randomized 83 patients with

  6. EMG pattern classification to control a hand orthosis for functional grasp assistance after stroke.

    Science.gov (United States)

    Meeker, Cassie; Park, Sangwoo; Bishop, Lauri; Stein, Joel; Ciocarlie, Matei

    2017-07-01

    Wearable orthoses can function both as assistive devices, which allow the user to live independently, and as rehabilitation devices, which allow the user to regain use of an impaired limb. To be fully wearable, such devices must have intuitive controls, and to improve quality of life, the device should enable the user to perform Activities of Daily Living. In this context, we explore the feasibility of using electromyography (EMG) signals to control a wearable exotendon device to enable pick and place tasks. We use an easy to don, commodity forearm EMG band with 8 sensors to create an EMG pattern classification control for an exotendon device. With this control, we are able to detect a user's intent to open, and can thus enable extension and pick and place tasks. In experiments with stroke survivors, we explore the accuracy of this control in both non-functional and functional tasks. Our results support the feasibility of developing wearable devices with intuitive controls which provide a functional context for rehabilitation.

  7. Finite element analysis for structural modification and control resonance of a vertical pump

    Directory of Open Access Journals (Sweden)

    Dalia M. El-Gazzar

    2017-12-01

    Full Text Available The main objective of this research was to evaluate and enhance dynamic performance for a vertical pumping unit. The original electric motor of the pump unit had been replaced by another one different in design and weights. Vibration has been increased greatly after installing the new motor. Consequently, it is necessary to estimate the change in the vibration characteristics owing to the difference in the boundary conditions of the new motor. Measured vibration levels and frequency analysis were dangerous at 1× due to resonance problem. Finite Element Analysis was used to model the motor structure in order to find its natural frequencies and mode shapes. The results confirm that the third natural frequency is very close to 1× operating speed with deviation about 1%. To solve the resonance problem, it was recommended to increase the structure stiffness. The results after modifications confirmed that the overall vibration level decreases by 89%. Keywords: Vibration, Vertical pump, Modal analysis

  8. 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.

  9. Exercise-induced muscle fatigue in the unaffected knee joint and its influence on postural control and lower limb kinematics in stroke patients

    Directory of Open Access Journals (Sweden)

    Sun Wook Park

    2017-01-01

    Full Text Available This study aimed to investigate the effects of exercise-induced muscle fatigue in the unaffected knee joint on postural control and kinematic changes in stroke patients. Forty participants (20 stroke patients, 20 age-matched healthy participants were recruited. To induce fatigue, maximum voluntary isometric contractions were performed in the unaffected knee joint in a Leg Extension Rehab exercise machine using the pneumatic resistance. We measured static and dynamic balance and lower-limb kinematics during gait. Changes in postural control parameters anteroposterior sway speed and total center of pressure distance differed significantly between the stroke and control groups. In addition, changes in gait kinematic parameters knee and ankle angles of initial contact differed significantly between stroke (paretic and non-paretic and control groups. Muscle fatigue in the unaffected knee and ankle impaired postural control and debilitates kinematic movement of ipsilateral and contralateral lower limbs, and may place the fatigued stroke patients at greater risk for falls.

  10. Centrifugal pumps

    CERN Document Server

    Anderson, HH

    1981-01-01

    Centrifugal Pumps describes the whole range of the centrifugal pump (mixed flow and axial flow pumps are dealt with more briefly), with emphasis on the development of the boiler feed pump. Organized into 46 chapters, this book discusses the general hydrodynamic principles, performance, dimensions, type number, flow, and efficiency of centrifugal pumps. This text also explains the pumps performance; entry conditions and cavitation; speed and dimensions for a given duty; and losses. Some chapters further describe centrifugal pump mechanical design, installation, monitoring, and maintenance. The

  11. Receptor kinase-mediated control of primary active proton pumping at the plasma membrane

    DEFF Research Database (Denmark)

    Fuglsang, Anja Thoe; Kristensen, Astrid; Cuin, Tracey A.

    2014-01-01

    Acidification of the cell wall space outside the plasma membrane is required for plant growth and is the result of proton extrusion by the plasma membrane-localized H+-ATPases. Here we show that the major plasma membrane proton pumps in Arabidopsis, AHA1 and AHA2, interact directly in vitro...... heterologous expression system, the introduction of a negative charge at this position caused pump activation. Application of PSY1 to plant seedlings induced rapid in planta phosphorylation at Thr-881, concomitant with an instantaneous increase in proton efflux from roots. The direct interaction between AHA2...

  12. Controlling the light propagation in one-dimensional photonic crystal via incoherent pump and interdot tunneling

    Science.gov (United States)

    Abbasabadi, Majid; Sahrai, Mostafa

    2018-01-01

    We investigated the propagation of an electromagnetic pulse through a one-dimensional photonic crystal doped with quantum-dot (QD) molecules in a defect layer. The QD molecules behave as a three-level quantum system and are driven by a coherent probe laser field and an incoherent pump field. No coherent coupling laser fields were introduced, and the coherence was created by the interdot tunnel effect. Further studied was the effect of tunneling and incoherent pumping on the group velocity of the transmitted and reflected probe pulse.

  13. Effects of Kinesio taping for stroke patients with hemiplegic shoulder pain: A double-blind, randomized, placebo-controlled study.

    Science.gov (United States)

    Huang, Yen-Chang; Chang, Kwang-Hwa; Liou, Tsan-Hon; Cheng, Chau-Wei; Lin, Li-Fong; Huang, Shih-Wei

    2017-03-06

    To investigate the effects of Kinesio taping for stroke patients with hemiplegic shoulder pain. Double-blind, placebo-controlled clinical trial. Twenty-one stroke patients with hemiplegic shoulder pain within 6 months of stroke onset in the rehabilitation ward of a medical university hospital in Taiwan. A 3-week intervention involving a conventional rehabilitation protocol and therapeutic Kinesio taping was conducted with an experimental group of 11 stroke patients. A control group of 10 stroke patients underwent an identical conventional rehabilitation programme and sham Kinesio taping on the hemiplegic shoulder. Numerical rating scale scores, Shoulder Pain and Disability Index, ultrasound findings and pain-free passive range of motion of the affected shoulder, were evaluated before and after the intervention. Mann-Whitney test was used to compare within-group continuous variables before and after the intervention. Wilcoxon signed-rank test was used to analyse the differences and changes in values between study and control groups. There was no statistical difference in demographic variables between the 2 groups. Both groups showed improvement in passive range of motion of the shoulder, (mean numerical rating scale 2.36 (standard deviation (SD) 1.03)), and mean Shoulder Pain and Disability Index (16.64 (SD 2.62)) after the intervention (p pain-free passive ROM, and ultrasound findings for the shoulder after 3 weeks of treatment. Concerning the variables changes, the therapeutic Kinesio taping group showed more improvement in the numerical rating scale (p = 0.008), shoulder flexion (p = 0.008), external rotation (p = 0.006), internal rotation (p = 0.040), and Shoulder Pain and Disability Index (p shoulder pain can experience greater reductions in Shoulder Pain and Disability Index, pain, and improvement in shoulder flexion, external, and internal rotation after 3 weeks of Kinesio taping intervention compared with sham Kinesio taping. Kinesio taping may be an

  14. Thermal analysis of hybrid single-phase, two-phase and heat pump thermal control system (TCS) for future spacecraft

    International Nuclear Information System (INIS)

    Lee, S.H.; Mudawar, I.; Hasan, Mohammad M.

    2016-01-01

    Highlights: • Hybrid Thermal Control System (H-TCS) is proposed for future spacecraft. • Thermodynamic performance of H-TCS is examined for different space missions. • Operational modes including single-phase, two-phase and heat pump are explored. • R134a is deemed most appropriate working fluid. - Abstract: An urgent need presently exists to develop a new class of versatile spacecraft capable of conducting different types of missions and enduring varying gravitational and temperature environments, including Lunar, Martian and Near Earth Object (NEOs). This study concerns the spacecraft's Thermal Control System (TCS), which tackles heat acquisition, especially from crew and avionics, heat transport, and ultimate heat rejection by radiation. The primary goal of the study is to explore the design and thermal performance of a Hybrid Thermal Control System (H-TCS) that would satisfy the diverse thermal requirements of the different space missions. The H-TCS must endure both ‘cold’ and ‘hot’ environments, reduce weight and size, and enhance thermodynamic performance. Four different operational modes are considered: single-phase, two-phase, basic heat pump and heat pump with liquid-side, suction-side heat exchanger. A thermodynamic trade study is conducted for six different working fluids to assess important performance parameters including mass flow rate of the working fluid, maximum pressure, radiator area, compressor/pump work, and coefficient of performance (COP). R134a is determined to be most suitable based on its ability to provide a balanced compromise between reducing flow rate and maintaining low system pressure, and a moderate coefficient of performance (COP); this fluid is also both nontoxic and nonflammable, and features zero ozone depletion potential (ODP) and low global warming potential (GWP). It is shown how specific mission stages dictate which mode of operation is most suitable, and this information is used to size the radiator for

  15. DC electromagnetic pump applied to liquid metal flow control used in fast reactors; Bomba eletromagnetica de corrente continua aplicada ao controle de escoamento de metais liquidos utilizados em reatores rapidos

    Energy Technology Data Exchange (ETDEWEB)

    Borges, Eduardo M.; Braz Filho, Francisco A.; Guimaraes, Lamartine N.F. [Centro Tecnico Aeroespacial (CTA), Sao Jose dos Campos, SP (Brazil). Inst. de Estudos Avancados (IEAv)]. E-mail: Eduardo@ieav.cta.br; fbraz@ieav.cta.br; guimarae@ieav.cta.br

    2005-07-01

    Electromagnetic pumps use Faraday principle to liquid metal flow control, where DC electric current and magnetic field applied produce the Lorentz force on the liquid metal. In this paper the results of the computational simulation are compared to experimental data of Mercury DC electromagnetic pump operation and the BEMC-1 code is used to evaluation of DC electromagnetic pump performance applied to liquid metal flow control as Sodium, Lead and Bismuth, used in fast reactors. (author)

  16. International Space Station Active Thermal Control Sub-System On-Orbit Pump Performance and Reliability Using Liquid Ammonia as a Coolant

    Science.gov (United States)

    Morton, Richard D.; Jurick, Matthew; Roman, Ruben; Adamson, Gary; Bui, Chinh T.; Laliberte, Yvon J.

    2011-01-01

    The International Space Station (ISS) contains two Active Thermal Control Sub-systems (ATCS) that function by using a liquid ammonia cooling system collecting waste heat and rejecting it using radiators. These subsystems consist of a number of heat exchangers, cold plates, radiators, the Pump and Flow Control Subassembly (PFCS), and the Pump Module (PM), all of which are Orbital Replaceable Units (ORU's). The PFCS provides the motive force to circulate the ammonia coolant in the Photovoltaic Thermal Control Subsystem (PVTCS) and has been in operation since December, 2000. The Pump Module (PM) circulates liquid ammonia coolant within the External Active Thermal Control Subsystem (EATCS) cooling the ISS internal coolant (water) loops collecting waste heat and rejecting it through the ISS radiators. These PM loops have been in operation since December, 2006. This paper will discuss the original reliability analysis approach of the PFCS and Pump Module, comparing them against the current operational performance data for the ISS External Thermal Control Loops.

  17. Right cerebral hemisphere specialization for quiet and perturbed body balance control: Evidence from unilateral stroke.

    Science.gov (United States)

    Fernandes, Corina Aparecida; Coelho, Daniel Boari; Martinelli, Alessandra Rezende; Teixeira, Luis Augusto

    2018-02-01

    Our aim in this investigation was to assess the relative importance of each cerebral hemisphere in quiet and perturbed balance, based on uni-hemispheric lesions by stroke. We tested the hypothesis of right cerebral hemisphere specialization for balance control. Groups of damage either to the right (RHD, n=9) or the left (LHD, n=7) cerebral hemisphere were compared across tasks requiring quiet balance or body balance recovery following a mechanical perturbation, comparing them to age-matched nondisabled individuals (controls, n=24). They were evaluated in conditions of full and occluded vision. In Experiment 1, the groups were compared in the task of quiet standing on (A) rigid and (B) malleable surfaces, having as outcome measures center of pressure (CoP) amplitude and velocity sway. In Experiment 2, we evaluated the recovery of body balance following a perturbation inducing forward body oscillation, having as outcome measures CoP displacement, peak hip and ankle rotations and muscular activation of both legs. Results from Experiment 1 showed higher values of CoP sway velocity for RHD in comparison to LHD and controls in the anteroposterior (rigid surface) and mediolateral (malleable surface) directions, while LHD had lower balance stability than the controls only in the mediolateral direction when supported on the rigid surface. In Experiment 2 results showed that RHD led to increased values in comparison to LHD and controls for anteroposterior CoP displacement and velocity, time to CoP direction reversion, hip rotation, and magnitude of muscular activation in the paretic leg, while LHD was found to differ in comparison to controls in magnitude of muscular activation of the paretic leg and amplitude of mediolateral sway only. These results suggest that damage to the right as compared to the left cerebral hemisphere by stroke leads to poorer postural responses both in quiet and perturbed balance. That effect was not altered by manipulation of sensory information

  18. [Post-stroke unilateral spatial neglect treated with acupuncture and rehabilitation: a randomized controlled trial].

    Science.gov (United States)

    Li, Yanli; Xu, Jimin; Liu, Lanqun; Li, Mingyu; Lu, Huying; Chen, Honglei; Li, Huilan; Chen, Zhigang

    2017-09-12

    To observe the impacts on post-stroke unilateral spatial neglect treated with acupuncture for "regaining consciousness, benefiting marrow and opening orifices" and rehabilitation. Forty patients of post-stroke unilateral spatial neglect were randomized into an observation group and a control group, 20 cases in each one. In the observation group, acupuncture was applied to the acupoints for "regaining consciousness, benefiting marrow and opening orifices", named Baihui (GV 20), Sishencong (EX-HN 1), Benshen (GB 13), Shenting (GV 24), and the bilateral yuan -primary points and luo -connecting points of the heart meridian, pericardium meridian and kidney meridian, as well as the acupoints along the affected meridians. Additionally, the rehabilitation was provided. In the control group, acupuncture at the acupoints along the affected meridians and rehabilitation were adopted. The treatment was given once a day, 5 times a week. After 8 weeks of treatment the evaluation was made. the indexes of unilateral spatial neglect such as line bisection test, the score of the mini-mental state examination (MMSE), the score of simple Fugl-Meyer motor function assessment and the modified Barthel indexes were adopted for the assessment of the severity of unilateral spatial neglect, cognitive function, motor function, and the activities of daily living. After treatment, the indexes of unilateral spatial neglect (line bisection test, line cancellation test, clock-drawing test and copying drawing test), MMSE score, the simple Fugl-Meyer motor function assessment and modified Barthel indexes were all improved as compared with those before treatment in the two groups (all P neglect and improves the motor function and the activities of daily living in the patients.

  19. Relationship between postural alignment in sitting by photogrammetry and seated postural control in post-stroke subjects.

    Science.gov (United States)

    Iyengar, Y R; Vijayakumar, K; Abraham, J M; Misri, Z K; Suresh, B V; Unnikrishnan, B

    2014-01-01

    This study was executed to find out correlation between postural alignment in sitting measured through photogrammetry and postural control in sitting following stroke. A cross-sectional study with convenient sampling consisting of 45 subjects with acute and sub-acute stroke. Postural alignment in sitting was measured through photogrammetry and relevant angles were obtained through software MB Ruler (version 5.0). Seated postural control was measured through Function in Sitting Test (FIST). Correlation was obtained using Spearman's Rank Correlation co-efficient in SPSS software (version 17.0). Moderate positive correlation (r = 0.385; p < 0.01) was found between angle of lordosis and angle between acromion, lateral epicondyle and point between radius and ulna. Strong negative correlation (r = -0.435; p < 0.01) was found between cranio-vertebral angle and kyphosis. FIST showed moderate positive correlation (r = 0.3446; p < 0.05) with cranio-vertebral angle and strong positive correlation (r = 0.4336; p < 0.01) with Brunnstrom's stage of recovery in upper extremity. Degree of forward head posture in sitting correlates directly with seated postural control and inversely with degree of kyphosis in sitting post-stroke. Postural control in sitting post-stroke is directly related with Brunnstrom's stage of recovery in affected upper extremity in sitting.

  20. Therapeutic effect of an implantable peroneal nerve stimulator in subjects with chronic stroke and footdrop: A randomized controlled trial

    NARCIS (Netherlands)

    Kottink, Anke I.R.; Kottink, A.I.R.; Hermens, Hermanus J.; Nene, A.V.; Tenniglo, Martinus Johannes Bernardus; Groothuis-Oudshoorn, Catharina Gerarda Maria; IJzerman, Maarten Joost

    Background and Purpose: Footdrop, characterized by a person's inability to raise the foot at the ankle, is a common problem in patients with stroke. A randomized controlled trial was performed to determine the therapeutic effect of using a new implantable, 2-channel peroneal nerve stimulator for 6

  1. Subjecting Acute Ischemic Stroke Patients to Continuous Tube Feeding and an Intensive Computerized Protocol Establishes Tight Glycemic Control

    NARCIS (Netherlands)

    Kruyt, N. D.; Biessels, G. J.; Vriesendorp, T. M.; DeVries, J. H.; Hoekstra, J. B. L.; Elbers, P. W.; Kappelle, L. J.; Portegies, P.; Vermeulen, M.; Roos, Y. B. W. E. M.

    2010-01-01

    Introduction Tight glycemic control (TGC) after ischemic stroke may improve clinical outcome but previous studies failed to establish TGC, principally because of postprandial glucose surges. The aim of the present study was to investigate if safe, effective and feasible TGC can be achieved with

  2. 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 Halliwick-Therapy group (mean (SD) 1.25(0.86)) than in the control group (mean (SD) 0.73 (0.70)) (P Halliwick-Therapy is safe and well tolerated in stroke patients in post-acute rehabilitation and has positive effects upon some aspects of mobility.

  3. Short-term effects of whole-body vibration on postural control in unilateral chronic stroke patients: preliminary evidence.

    NARCIS (Netherlands)

    Nes, I.J.W. van; Geurts, A.C.H.; Hendricks, H.T.; Duysens, J.E.J.

    2004-01-01

    The short-term effects of whole-body vibration as a novel method of somatosensory stimulation on postural control were investigated in 23 chronic stroke patients. While standing on a commercial platform, patients received 30-Hz oscillations at 3 mm of amplitude in the frontal plane. Balance was

  4. Gait training assisted by multi-channel functional electrical stimulation early after stroke: study protocol for a randomized controlled trial.

    Science.gov (United States)

    van Bloemendaal, Maijke; Bus, Sicco A; de Boer, Charlotte E; Nollet, Frans; Geurts, Alexander C H; Beelen, Anita

    2016-10-01

    Many stroke survivors suffer from paresis of lower limb muscles, resulting in compensatory gait patterns characterised by asymmetries in spatial and temporal parameters and reduced walking capacity. Functional electrical stimulation has been used to improve walking capacity, but evidence is mostly limited to the orthotic effects of peroneal functional electrical stimulation in the chronic phase after stroke. The aim of this study is to investigate the therapeutic effects of up to 10 weeks of multi-channel functional electrical stimulation (MFES)-assisted gait training on the restoration of spatiotemporal gait symmetry and walking capacity in subacute stroke patients. In a proof-of-principle study with a randomised controlled design, 40 adult patients with walking deficits who are admitted for inpatient rehabilitation within 31 days since the onset of stroke are randomised to either MFES-assisted gait training or conventional gait training. Gait training is delivered in 30-minute sessions each workday for up to 10 weeks. The step length symmetry ratio is the primary outcome. Blinded assessors conduct outcome assessments at baseline, every 2 weeks during the intervention period, immediately post intervention and at 3-month follow-up. This study aims to provide preliminary evidence for the feasibility and effectiveness of MFES-assisted gait rehabilitation early after stroke. Results will inform the design of a larger multi-centre trial. This trial is registered at the Netherlands Trial Register (number NTR4762 , registered 28 August 2014).

  5. Gingivitis and periodontitis as a risk factor for stroke: A case-control study in the Iranian population.

    Science.gov (United States)

    Hashemipour, Maryam Alsadat; Afshar, Afsaneh Jahanshahi; Borna, Roya; Seddighi, Behnas; Motamedi, Amin

    2013-09-01

    Periodontitis and gingivitis are one of the most infectious diseases in human. Several studies have been carried out on dependence of periodontitis and stroke. The aim of this study was to investigate the gingivitis and periodontitis as a risk factor for stroke in Iranian population. A case-control study was conducted on 100 patients suffering from stroke as case group, and 100 hospitalized patients as control group. The case group included 42 males and 58 females, and in control group there were 44 males and 56 females. Using a University of North Carolina-15 manual probe, the clinical attachment level, the distance between the cemento-enamel junction and the probed base of the periodontal pocket, were recorded by gingival and periodontal indexes. The data were analyzed by multiple logistic regressions, Chi-square test, Fisher's test, t-test, Man Whitney, and SPSS11.5 software program. P > 0.05 was considered as significant. The case group included 42 males and 58 females, and in control group 44 males and 56 females were included. In this investigation, the average of gingival index in men and women of case group was 1.22 ± 0.55 and 1.31 ± 0.55, respectively. This study showed that the average of gingival index in case group was more than control group. Periodontal index in both groups in men was more than women. The moderate and severe periodontitis in case group were more than that of control group (P = 0.003, P = 0.001). The result of this study shows that there is a significant relation between stroke and periodontal index; however, there isn't any significant relation between stroke and gingival index.

  6. The rs10757278 Polymorphism of the 9p21.3 Locus in Children with Arterial Ischemic Stroke: A Family-Based and Case-Control Study.

    Science.gov (United States)

    Niemiec, Pawel; Balcerzyk, Anna; Iwanicki, Tomasz; Emich-Widera, Ewa; Kopyta, Ilona; Nowak, Tomasz; Pilarska, Ewa; Pienczk-Ręcławowicz, Karolina; Kaciński, Marek; Wendorff, Janusz; Gorczynska-Kosiorz, Sylwia; Trautsolt, Wanda; Grzeszczak, Władysław; Zak, Iwona

    2017-12-01

    The association of 9p21.3 locus single nucleotide polymorphisms with arterial ischemic stroke in adults was demonstrated in many studies, but there are no studies in pediatric arterial ischemic stroke patients. We investigated whether the 9p21.3 locus polymorphism, namely rs10757278, is associated with the arterial ischemic stroke risk in children. The study group consisted of 335 individuals: 80 children with arterial ischemic stroke, their biological parents (n = 122), and 133 children (age and sex matched) without any symptoms of arterial ischemic stroke as a control group. The rs10757278 polymorphism was genotyped using the TaqMan® Pre-designed SNP Genotyping Assay (Applied Biosystems). Two different study design models were used: family-based association test (transmission-disequilibrium test) and case-control model. There were no statistically significant differences in the distribution of genotypes and alleles of the rs10757278 polymorphism between groups of children with arterial ischemic stroke and controls. The frequency of both transmitted alleles in transmission-disequilibrium test analysis was identical (50%). The A allele carrier state (AA+AG genotype) was more frequent in arterial ischemic stroke children with hemiparesis than in patients without this symptom (94.5% versus 68.0%, P = .004). There is no evidence to consider the 9p21.3 locus polymorphism as a risk factor for childhood arterial ischemic stroke. Copyright © 2017 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  7. An anthropomorphic transhumeral prosthesis socket developed based on an oscillometric pump and controlled by force-sensitive resistor pressure signals.

    Science.gov (United States)

    Razak, N A Abd; Gholizadeh, H; Hasnan, N; Osman, N A Abu; Fadzil, S S Mohd; Hashim, N A

    2017-02-01

    While considering the importance of the interface between amputees and prosthesis sockets, we study an anthropomorphic prosthesis socket whose size can be dynamically changed according to the requirements of the residual limb. First, we introduce the structure and function of the anthropomorphic prosthesis socket. Second, we study the dynamic model of the prosthesis system and analyze the dynamic characteristics of the prosthesis socket system, the inputs of an oscillometric pump, and the control mechanism of force-sensitive resistor (FSR) pressure signals. Experiments on 10 healthy subjects using the designed system yield an average detection result between 102 and 112 kPa for the FSR pressure sensor and 39 and 41 kPa for the oscillometric pump. Results show the function of the FSR pressure signal in maintaining the contact pressure between the sockets and the residual limb. The potential development of an auto-adjusted socket that uses an oscillometric pump system will provide prosthetic sockets with controllable contact pressure at the residual limb. Moreover, this development is an attractive research area for researchers involved in rehabilitation engineering, prosthetics, and orthotics.

  8. Behaviour and metabolic control in children with Type 1 diabetes mellitus on insulin pump therapy: 2-year follow-up.

    Science.gov (United States)

    Knight, S J; Northam, E A; Cameron, F J; Ambler, G R

    2011-09-01

    This study investigated whether continuous subcutaneous insulin infusion is associated with sustained improvement in behaviour and metabolic control. Children with Type 1 diabetes mellitus (n = 27, 8-18 years old) who had been assessed previously prior to commencing continuous subcutaneous insulin infusion, and 6-8 weeks later, were re-evaluated 2 years after commencing insulin pump therapy. Behaviour was reassessed using the Behavioral Assessment System for Children-2nd edition (BASC-2) and current HbA(1c) levels were recorded. Two years after commencing continuous subcutaneous insulin infusion, parent-reported internalizing and externalizing symptoms were significantly lower than pre-insulin pump therapy commencement levels. Self reports of internalizing and externalizing problems did not differ significantly across the three assessment points. There was no significant difference between pre-insulin pump therapy HbA(1c) and HbA(1c) after 2 years on continuous subcutaneous insulin infusion, despite an initial improvement 6-8 weeks after commencing the therapy. Children with Type 1 diabetes mellitus showed sustained improvements in parent-reported behaviour, but not in self reports of behaviour or in metabolic control 2 years after commencement of continuous subcutaneous insulin infusion. © 2011 The Authors. Diabetic Medicine © 2011 Diabetes UK.

  9. Effects of scapulohumeral rehabilitation protocol on trunk control recovery in patients with subacute stroke: A pilot randomized controlled trial.

    Science.gov (United States)

    Dell'Uomo, Daniela; Morone, Giovanni; Centrella, Antonio; Paolucci, Stefano; Caltagirone, Carlo; Grasso, Maria Grazia; Traballesi, Marco; Iosa, Marco

    2017-01-01

    Despite upper limb rehabilitation is widely investigated in patients with stroke, the effects of scapulohumeral rehabilitation on trunk stabillization are mainly unknown. To test the effects of scapulohumeral rehabilitation protocol on trunk control recovery in patients with subacute stroke. A pilot randomized controlled trial with two groups of 14 patients each one performing 20 minutes per day, 5 days a week, for 6 weeks in add on to standard therapy. Experimental group performed a specific scapulohumeral rehabilitation protocol aiming to improve trunk competencies whereas control group performed conventional arm rehabilitation. Clinical scale tests and accelerometric evaluations were performed pre- and post-treatment. Experimental groups showed better scores at discharge at Trunk impairment Scale (p post-stroke.

  10. Developing a System for Integraded Automatic Control of Mutiple Infusion Pumps : The Multiplex infusion system

    NARCIS (Netherlands)

    Doesburg, Frank

    2013-01-01

    Most errors in ICUs are related to intravenous (IV) therapy. Previous studies suggested that hard to operate infusion pumps and the high cognitive workload for ICU nurses contribute to these errors. Conventional IV therapy requires separate lumens for incompatible IV drugs. This often requires the

  11. Baking-powder driven centripetal pumping controlled by event-triggering of functional liquids

    DEFF Research Database (Denmark)

    Kinahan, David J.; Burger, Robert; Vembadi, Abhishek

    2015-01-01

    This paper reports radially inbound pumping by the event-triggered addition of water to on-board stored baking powder in combination with valving by an immiscible, high-specific weight liquid on a centrifugal microfluidic platform. This technology allows making efficient use of precious real estate...

  12. Clinical application of computerized evaluation and re-education biofeedback prototype for sensorimotor control of the hand in stroke patients

    Directory of Open Access Journals (Sweden)

    Hsu Hsiu-Yun

    2012-05-01

    Full Text Available Abstract Background Hemianaesthesia patients usually exhibit awkward and inefficient finger movements of the affected hands. Conventionally, most interventions emphasize the improvement of motor deficits, but rarely address sensory capability and sensorimotor control following stroke. Thus it is critical for stroke patients with sensory problems to incorporate appropriate strategies for dealing with sensory impairment, into traditional hand function rehabilitation programs. In this study, we used a custom-designed computerized evaluation and re-education biofeedback (CERB prototype to analyze hand grasp performances, and monitor the training effects on hand coordination for stroke patients with sensory disturbance and without motor deficiency. Methods The CERB prototype was constructed to detect momentary pinch force modulation for 14 sub-acute and chronic stroke patients with sensory deficiency and 14 healthy controls. The other ten chronic stroke patients (ranges of stroke period: 6–60 months were recruited to investigate the effects of 4-weeks computerized biofeedback treatments on the hand control ability. The biofeedback procedures provide visual and auditory cues to the participants when the interactive force of hand-to-object exceeded the target latitude in a pinch-up-holding task to trigger optimal motor strategy. Follow-up measurements were conducted one month after training. The hand sensibility, grip forces and results of hand functional tests were recorded and analyzed. Results The affected hands of the 14 predominant sensory stroke patients exhibited statistically significant elevation in the magnitude of peak pinch force (p = 0.033 in pinching and lifting-up tasks, and poor results for hand function tests (p = 0.005 than sound hands did. In addition, the sound hands of patients were less efficient in force modulation (p = 0.009 than the hands of healthy subjects were. Training with the biofeedback system produced

  13. Clinical application of computerized evaluation and re-education biofeedback prototype for sensorimotor control of the hand in stroke patients.

    Science.gov (United States)

    Hsu, Hsiu-Yun; Lin, Cheng-Feng; Su, Fong-Chin; Kuo, Huan-Ting; Chiu, Haw-Yen; Kuo, Li-Chieh

    2012-05-09

    Hemianaesthesia patients usually exhibit awkward and inefficient finger movements of the affected hands. Conventionally, most interventions emphasize the improvement of motor deficits, but rarely address sensory capability and sensorimotor control following stroke. Thus it is critical for stroke patients with sensory problems to incorporate appropriate strategies for dealing with sensory impairment, into traditional hand function rehabilitation programs. In this study, we used a custom-designed computerized evaluation and re-education biofeedback (CERB) prototype to analyze hand grasp performances, and monitor the training effects on hand coordination for stroke patients with sensory disturbance and without motor deficiency. The CERB prototype was constructed to detect momentary pinch force modulation for 14 sub-acute and chronic stroke patients with sensory deficiency and 14 healthy controls. The other ten chronic stroke patients (ranges of stroke period: 6-60 months) were recruited to investigate the effects of 4-weeks computerized biofeedback treatments on the hand control ability. The biofeedback procedures provide visual and auditory cues to the participants when the interactive force of hand-to-object exceeded the target latitude in a pinch-up-holding task to trigger optimal motor strategy. Follow-up measurements were conducted one month after training. The hand sensibility, grip forces and results of hand functional tests were recorded and analyzed. The affected hands of the 14 predominant sensory stroke patients exhibited statistically significant elevation in the magnitude of peak pinch force (p = 0.033) in pinching and lifting-up tasks, and poor results for hand function tests (p = 0.005) than sound hands did. In addition, the sound hands of patients were less efficient in force modulation (p = 0.009) than the hands of healthy subjects were. Training with the biofeedback system produced significant improvements in grip force modulation (p = 0.020) and

  14. Center for stroke disparities solutions community- based care transition interventions: study protocol of a randomized controlled trial.

    Science.gov (United States)

    Feldman, Penny H; McDonald, Margaret V; Trachtenberg, Melissa A; Schoenthaler, Antoinette; Coyne, Noreen; Teresi, Jeanne

    2015-01-27

    Racial and ethnic disparities persist in stroke occurrence, recurrence, morbidity and mortality. Uncontrolled hypertension (HTN) is the most important modifiable risk factor for stroke risk. Home health care organizations care for many patients with uncontrolled HTN and history of stroke; however, recurrent stroke prevention has not been a home care priority. We are conducting a randomized controlled trial (RCT) to compare the effectiveness, relative to usual home care (UHC), of two Community Transitions Interventions (CTIs). The CTIs aim to reduce recurrent stroke risk among post-stroke patients via home-based transitional care focused on better HTN management. This 3-arm trial will randomly assign 495 black and Hispanic post-stroke home care patients with uncontrolled systolic blood pressure (SBP) to one of three arms: UHC, UHC complemented by nurse practitioner-delivered transitional care (UHC + NP) or UHC complemented by an NP plus health coach (UHC + NP + HC). Both intervention arms emphasize: 1) linking patients to continuous, responsive preventive and primary care, 2) increasing patients'/caregivers' ability to manage a culturally and individually tailored BP reduction plan, and 3) facilitating the patient's reintegration into the community after home health care discharge. The primary hypothesis is that both NP-only and NP + HC transitional care will be more effective than UHC alone in achieving a SBP reduction. The primary outcome is change in SPB at 3 and 12 months. The study also will examine cost-effectiveness, quality of life and moderators (for example, race/ethnicity) and mediators (for example, changes in health behaviors) that may affect treatment outcomes. All outcome data are collected by staff blinded to group assignment. This study targets care gaps affecting a particularly vulnerable black/Hispanic population characterized by persistent stroke disparities. It focuses on care transitions, a juncture when patients are

  15. Effectiveness of a Web-Based Health Education Program to Promote Oral Hygiene Care Among Stroke Survivors: Randomized Controlled Trial.

    Science.gov (United States)

    Ab Malik, Normaliza; Mohamad Yatim, Sa'ari; Lam, Otto Lok Tao; Jin, Lijian; McGrath, Colman Patrick Joseph

    2017-03-31

    Oral hygiene care is of key importance among stroke patients to prevent complications that may compromise rehabilitation or potentially give rise to life-threatening infections such as aspiration pneumonia. The aim of this study was to evaluate the effectiveness of a Web-based continuing professional development (CPD) program on "general intention" of the health carers to perform daily mouth cleaning for stroke patients using the theory of planned behavior (TPB). A double-blind cluster randomized controlled trial was conducted among 547 stroke care providers across 10 hospitals in Malaysia. The centers were block randomized to receive either (1) test intervention (a Web-based CPD program on providing oral hygiene care to stroke patients using TPB) or (2) control intervention (a Web-based CPD program not specific to oral hygiene). Domains of TPB: "attitude," "subjective norm" (SN), "perceived behavior control" (PBC), "general intention" (GI), and "knowledge" related to providing oral hygiene care were assessed preintervention and at 1 month and 6 months postintervention. The overall response rate was 68.2% (373/547). At 1 month, between the test and control groups, there was a significant difference in changes in scores of attitude (P=.004) and subjective norm (P=.01), but not in other TPB domains (GI, P=.11; PBC, P=.51; or knowledge, P=.08). At 6 months, there were significant differences in changes in scores of GI (P=.003), attitude (P=.009), SN (Poral hygiene care among stroke carers for their patients. Changing subjective norms and perceived behavioral control are key factors associated with changes in general intention to provide oral hygiene care. National Medical Research Register, Malaysia NMRR-13-1540-18833 (IIR); https://www.nmrr.gov.my/ fwbLoginPage.jsp. ©Normaliza Ab Malik, Sa'ari Mohamad Yatim, Otto Lok Tao Lam, Lijian Jin, Colman Patrick Joseph McGrath. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 31.03.2017.

  16. Communication and Low Mood (CALM): a randomized controlled trial of behavioural therapy for stroke patients with aphasia.

    Science.gov (United States)

    Thomas, Shirley A; Walker, Marion F; Macniven, Jamie A; Haworth, Helen; Lincoln, Nadina B

    2013-05-01

    The aim was to evaluate behavioural therapy as a treatment for low mood in people with aphasia. A randomized controlled trial comparing behavioural therapy plus usual care with a usual care control. Potential participants with aphasia after stroke were screened for the presence of low mood. Those who met the criteria and gave consent were randomly allocated. Participants were recruited from hospital wards, community rehabilitation, speech and language therapy services and stroke groups. Of 511 people with aphasia identified, 105 had low mood and were recruited. Behavioural therapy was offered for up to three months. Outcomes were assessed three and six months after random allocation. Stroke Aphasic Depression Questionnaire, Visual Analog Mood Scales 'sad' item, and Visual Analogue Self-Esteem Scale. Participants were aged 29 to 94 years (mean 67.0, SD 13.5) and 66 (63%) were men. Regression analysis showed that at three months, when baseline values and communication impairment were controlled for, group allocation was a significant predictor of the Stroke Aphasic Depression Questionnaire (P aphasia.

  17. Effects of progressive backward body weight suppoted treadmill training on gait ability in chronic stroke patients: A randomized controlled trial.

    Science.gov (United States)

    Kim, Kyung Hun; Lee, Kyoung Bo; Bae, Young-Hyeon; Fong, Shirley S M; Lee, Suk Min

    2017-10-23

    A stroke patient with hemiplegic gait is generally described as being slow and asymmetric. Body weight-supported treadmill training and backward gait training are recent additions to therapeutic gait trainings that may help improve gait in stroke patient with hemiplegic gait. Therefore, we examined the effect of progressive backward body weight-supported treadmill training on gait in chronic stroke patients with hemiplegic gait. Thirty subjects were divided to the experimental and control groups. The experimental group consisted of 15 patients and underwent progressive backward body weight-supported treadmill training. The control group consisted of 15 patients and underwent general treadmill gait training five times per week, for a total of four weeks. The OptoGait was used to analyze gait kinematics, and the dynamic gait index (DGI) and results of the 6-minute walk test were used as the clinical evaluation indicators. A follow-up test was carried out four weeks later to examine persistence of exercise effects. The experimental group showed statistically significant results in all dependent variables week four compared to the control group. However, until the eighth week, only the dependent variables, of affected step length (ASL), stride length (SL), and DGI differed significantly between the two groups. This study verified that progressive bodyweight-supported treadmill training had a positive influence on the temporospatial characteristics of gait and clinical gait evaluation index in chronic stroke patients.

  18. Effect of Virtual Reality on Postural and Balance Control in Patients with Stroke: A Systematic Literature Review.

    Science.gov (United States)

    Chen, Ling; Lo, Wai Leung Ambrose; Mao, Yu Rong; Ding, Ming Hui; Lin, Qiang; Li, Hai; Zhao, Jiang Li; Xu, Zhi Qin; Bian, Rui Hao; Huang, Dong Feng

    2016-01-01

    Objective . To critically evaluate the studies that were conducted over the past 10 years and to assess the impact of virtual reality on static and dynamic balance control in the stroke population. Method . A systematic review of randomized controlled trials published between January 2006 and December 2015 was conducted. Databases searched were PubMed, Scopus, and Web of Science. Studies must have involved adult patients with stroke during acute, subacute, or chronic phase. All included studies must have assessed the impact of virtual reality programme on either static or dynamic balance ability and compared it with a control group. The Physiotherapy Evidence Database (PEDro) scale was used to assess the methodological quality of the included studies. Results . Nine studies were included in this systematic review. The PEDro scores ranged from 4 to 9 points. All studies, except one, showed significant improvement in static or dynamic balance outcomes group. Conclusions . This review provided moderate evidence to support the fact that virtual reality training is an effective adjunct to standard rehabilitation programme to improve balance for patients with chronic stroke. The effect of VR training in balance recovery is less clear in patients with acute or subacute stroke. Further research is required to investigate the optimum training intensity and frequency to achieve the desired outcome.

  19. Bone marrow stromal cell therapy for ischemic stroke: A meta-analysis of randomized control animal trials.

    Science.gov (United States)

    Wu, Qing; Wang, Yuexiang; Demaerschalk, Bart M; Ghimire, Saruna; Wellik, Kay E; Qu, Wenchun

    2017-04-01

    Background Results of animal studies assessing efficacy of bone marrow stromal cell therapy for ischemic stroke remain inconsistent. Aims The aims are to assess efficacy of bone marrow stromal cell therapy for ischemic stroke in animal studies. Methods Randomized controlled animal trials assessing efficacy of bone marrow stromal cell therapy were eligible. Stroke therapy academic industry round table was used to assess methodologic quality of included studies. Primary outcomes were total infarction volume and modified Neurological Severity Score. Multiple prespecified sensitivity analyses and subgroup analyses were conducted. Random effects models were used for meta-analysis. Results Thirty-three randomized animal trials were included with a total of 796 animals. The median quality score was 6 (interquartile range, 5-7). Bone marrow stromal cell therapy decreased total infarction volume (standardized mean difference, 0.897; 95% confidence interval, 0.553-1.241; P animals treated with bone marrow stromal cell and controls was 2.47 (95% confidence interval, 1.84-3.11; P animal studies. Conclusions Bone marrow stromal cell therapy significantly decreased total infarction volume and increased neural functional recovery in randomized controlled animal models of ischemic stroke.

  20. Upper-limb stroke rehabilitation using electrode-array based functional electrical stimulation with sensing and control innovations.

    Science.gov (United States)

    Kutlu, M; Freeman, C T; Hallewell, E; Hughes, A-M; Laila, D S

    2016-04-01

    Functional electrical stimulation (FES) has shown effectiveness in restoring upper-limb movement post-stroke when applied to assist participants' voluntary intention during repeated, motivating tasks. Recent clinical trials have used advanced controllers that precisely adjust FES to assist functional reach and grasp tasks with FES applied to three muscle groups, showing significant reduction in impairment. The system reported in this paper advances the state-of-the-art by: (1) integrating an FES electrode array on the forearm to assist complex hand and wrist gestures; (2) utilising non-contact depth cameras to accurately record the arm, hand and wrist position in 3D; and (3) employing an interactive touch table to present motivating virtual reality (VR) tasks. The system also uses iterative learning control (ILC), a model-based control strategy which adjusts the applied FES based on the tracking error recorded on previous task attempts. Feasibility of the system has been evaluated in experimental trials with 2 unimpaired participants and clinical trials with 4 hemiparetic, chronic stroke participants. The stroke participants attended 17, 1 hour training sessions in which they performed functional tasks, such as button pressing using the touch table and closing a drawer. Stroke participant results show that the joint angle error norm reduced by an average of 50.3% over 6 attempts at each task when assisted by FES. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  1. Switching sliding mode force tracking control of piezoelectric-hydraulic pump-based friction element actuation systems for automotive transmissions

    Science.gov (United States)

    Kim, Gi-Woo; Wang, K. W.

    2009-08-01

    In this study, a nonlinear sliding-mode controller is designed for force tracking of a piezoelectric-hydraulic pump (PHP)-based actuation system, which is developed to replace the current electro-hydraulic actuation systems for automatic transmission (AT) friction elements, such as band brakes or clutches. By utilizing the PHP, one can eliminate the various hydraulic components (oil pump, regulating valve and control valve) in current ATs and achieve a simpler configuration with more efficient operation. With the derived governing equation of motion of the PHP-based actuation system integrated with the friction element (band brake), a switching control law is synthesized based on the sliding-mode theory. To evaluate the effectiveness of the proposed control law, its force tracking performance for the engagement of a friction element during an AT 1\\to 2 up-shift is examined experimentally. It is shown that one can successfully track the desired force trajectory for AT shift control with small tracking error. This study demonstrates the potential of the PHP as a new controllable actuation system for AT friction elements.

  2. Developing Efficient Coordination Schemes to Control Over-Pumping in the Heihe River Basin, China

    Science.gov (United States)

    Pedrazzini, G.

    2015-12-01

    Many wicked water resources problems are approached in a social planner perspective. This not always matches the real institutional and policy-making context, where, rather, multiple decision-makers (DMs) can act independently, or weakly cooperate, ultimately producing system-wide inefficient trade-offs. The idea in this work is to adopt a more realistic approach, where the multi-DMs nature of the problem is preserved and the uncoordinated DMs are driven, thorough coordination mechanisms, towards a more system-wide efficient solution. An agent-based modelling framework linked to a surface and groundwater model is used to design these coordination mechanisms as constraints to the independent agents (i.e., DMs) behaviour. In the Heihe Basin the ongoing introduction of smart meter IC-card systems on farmers' pumping wells will soon allow monitoring and control of abstractions with the goal of preventing further depletion of the resource. The major interest of policy makers in the region concerns the development of new and the improvement of existing legislation on pricing schemes and/or groundwater quotas. The model outcome where agents act rationally but selfishly is compared to the optimal solution at system-level assuming perfect coordination and cooperation. The optimal solutions with respect to the given utility functions are computed using nonlinear optimization with a rolling out time horizon. The Pareto-Frontier is synthesized through an exhaustive sampling of the weight coefficient space and related to the current and to the historical management of the last 4 decades. The best parameter values for the proposed coordination mechanisms are determined and the alternatives are compared with respect to their efficiency and acceptability. Preliminary results suggest that a regulatory tax on groundwater of about a factor 10 of the current resource fee is required to increase the elasticity of the groundwater demand curve such that reducing consumption becomes

  3. A controlled pilot trial of two commercial video games for rehabilitation of arm function after stroke.

    Science.gov (United States)

    Chen, Mei-Hsiang; Huang, Lan-Ling; Lee, Chang-Franw; Hsieh, Ching-Lin; Lin, Yu-Chao; Liu, Hsiuchih; Chen, Ming-I; Lu, Wen-Shian

    2015-07-01

    To investigate the acceptability and potential efficacy of two commercial video games for improving upper extremity function after stroke in order to inform future sample size and study design. A controlled clinical trial design using sequential allocation into groups. A clinical occupational therapy department. Twenty-four first-stroke patients. Patients were assigned to one of three groups: conventional group, Wii group, and XaviX group. In addition to regular one-hour conventional rehabilitation, each group received an additional half-hour of upper extremity exercises via conventional devices, Wii games, or XaviX games, for eight weeks. The Fugl-Meyer Assessment of motor function, Box and Block Test of Manual Dexterity, Functional Independence Measure, and upper extremity range of motion were used at baseline and postintervention. Also, a questionnaire was used to assess motivation and enjoyment. The effect size of differences in change scores between the Wii and conventional groups ranged from 0.71 (SD 0.59) to 0.28 (SD 0.58), on the Fugl-Meyer Assessment of motor function (d = 0.74) was larger than that between the XaviX and conventional groups, ranged from 0.44 (SD 0.49) to 0.28 (SD 0.58) (d = 0.30). Patient enjoyment was significantly greater in the video game groups (Wii mean 4.25, SD 0.89; XaviX mean 4.38, SD 0.52) than in the conventional group (mean 2.25, SD 0.89, F = 18.55, p video games in rehabilitation. A sample size of 72 patients (24 per group) would be appropriate for a full study. © The Author(s) 2014.

  4. The stroke oxygen pilot study: a randomized controlled trial of the effects of routine oxygen supplementation early after acute stroke--effect on key outcomes at six months.

    Directory of Open Access Journals (Sweden)

    Khalid Ali

    Full Text Available Post-stroke hypoxia is common, and may adversely affect outcome. We have recently shown that oxygen supplementation may improve early neurological recovery. Here, we report the six-month outcomes of this pilot study.Patients with a clinical diagnosis of acute stroke were randomized within 24 h of admission to oxygen supplementation at 2 or 3 L/min for 72 h or to control treatment (room air. Outcomes (see below were assessed by postal questionnaire at 6 months. Analysis was by intention-to-treat, and statistical significance was set at p ≤ 0.05.Out of 301 patients randomized two refused/withdrew consent and 289 (148 in the oxygen and 141 in the control group were included in the analysis: males 44%, 51%; mean (SD age 73 (12, 71 (12; median (IQR National Institutes of Health Stroke Scale score 6 (3, 10, 5 (3, 10 for the two groups respectively. At six months 22 (15% patients in the oxygen group and 20 (14% in the control group had died; mean survival in both groups was 162 days (p = 0.99. Median (IQR scores for the primary outcome, the modified Rankin Scale, were 3 (1, 5 and 3 (1, 4 for the oxygen and control groups respectively. The covariate-adjusted odds ratio was 1.04 (95% CI 0.67, 1.60, indicating that the odds of a lower (i.e. better score were non-significantly higher in the oxygen group (p = 0.86. The mean differences in the ability to perform basic (Barthel Index and extended activities of daily living (NEADL, and quality of life (EuroQol were also non-significant.None of the key outcomes differed at 6 months between the groups. Although not statistically significant and generally of small magnitude, the effects were predominantly in favour of the oxygen group; a larger trial, powered to show differences in longer-term functional outcomes, is now on-going.Controlled-Trials.com ISRCTN12362720; Eudract.ema.europa.eu 2004-001866-41.

  5. Robot Assisted Training for the Upper Limb after Stroke (RATULS): study protocol for a randomised controlled trial.

    Science.gov (United States)

    Rodgers, Helen; Shaw, Lisa; Bosomworth, Helen; Aird, Lydia; Alvarado, Natasha; Andole, Sreeman; Cohen, David L; Dawson, Jesse; Eyre, Janet; Finch, Tracy; Ford, Gary A; Hislop, Jennifer; Hogg, Steven; Howel, Denise; Hughes, Niall; Krebs, Hermano Igo; Price, Christopher; Rochester, Lynn; Stamp, Elaine; Ternent, Laura; Turner, Duncan; Vale, Luke; Warburton, Elizabeth; van Wijck, Frederike; Wilkes, Scott

    2017-07-20

    Loss of arm function is a common and distressing consequence of stroke. We describe the protocol for a pragmatic, multicentre randomised controlled trial to determine whether robot-assisted training improves upper limb function following stroke. Study design: a pragmatic, three-arm, multicentre randomised controlled trial, economic analysis and process evaluation. NHS stroke services. adults with acute or chronic first-ever stroke (1 week to 5 years post stroke) causing moderate to severe upper limb functional limitation. Randomisation groups: 1. Robot-assisted training using the InMotion robotic gym system for 45 min, three times/week for 12 weeks 2. Enhanced upper limb therapy for 45 min, three times/week for 12 weeks 3. Usual NHS care in accordance with local clinical practice Randomisation: individual participant randomisation stratified by centre, time since stroke, and severity of upper limb impairment. upper limb function measured by the Action Research Arm Test (ARAT) at 3 months post randomisation. upper limb impairment (Fugl-Meyer Test), activities of daily living (Barthel ADL Index), quality of life (Stroke Impact Scale, EQ-5D-5L), resource use, cost per quality-adjusted life year and adverse events, at 3 and 6 months. Blinding: outcomes are undertaken by blinded assessors. Economic analysis: micro-costing and economic evaluation of interventions compared to usual NHS care. A within-trial analysis, with an economic model will be used to extrapolate longer-term costs and outcomes. Process evaluation: semi-structured interviews with participants and professionals to seek their views and experiences of the rehabilitation that they have received or provided, and factors affecting the implementation of the trial. allowing for 10% attrition, 720 participants provide 80% power to detect a 15% difference in successful outcome between each of the treatment pairs. Successful outcome definition: baseline ARAT 0-7 must improve by 3 or more points; baseline

  6. Problem-Solving Therapy During Outpatient Stroke Rehabilitation Improves Coping and Health-Related Quality of Life: Randomized Controlled Trial.

    Science.gov (United States)

    Visser, Marieke M; Heijenbrok-Kal, Majanka H; Van't Spijker, Adriaan; Lannoo, Engelien; Busschbach, Jan J V; Ribbers, Gerard M

    2016-01-01

    This study investigated whether problem-solving therapy (PST) is an effective group intervention for improving coping strategy and health-related quality of life (HRQoL) in patients with stroke. In this multicenter randomized controlled trial, the intervention group received PST as add-on to standard outpatient rehabilitation, the control group received outpatient rehabilitation only. Measurements were performed at baseline, directly after the intervention, and 6 and 12 months later. Data were analyzed using linear-mixed models. Primary outcomes were task-oriented coping as measured by the Coping Inventory for Stressful Situations and psychosocial HRQoL as measured by the Stroke-Specific Quality of Life Scale. Secondary outcomes were the EuroQol EQ-5D-5L utility score, emotion-oriented and avoidant coping as measured by the Coping Inventory for Stressful Situations, problem-solving skills as measured by the Social Problem Solving Inventory-Revised, and depression as measured by the Center for Epidemiological Studies Depression Scale. Included were 166 patients with stroke, mean age 53.06 years (SD, 10.19), 53% men, median time poststroke 7.29 months (interquartile range, 4.90-10.61 months). Six months post intervention, the PST group showed significant improvement when compared with the control group in task-oriented coping (P=0.008), but not stroke-specific psychosocial HRQoL. Furthermore, avoidant coping (P=0.039) and the utility value for general HRQoL (P=0.034) improved more in the PST group than in the control after 6 months. PST seems to improve task-oriented coping but not disease-specific psychosocial HRQoL after stroke >6-month follow-up. Furthermore, we found indications that PST may improve generic HRQoL recovery and avoidant coping. URL: http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=2509. Unique identifier: CNTR2509. © 2015 American Heart Association, Inc.

  7. Clinical usefulness of the virtual reality-based postural control training on the gait ability in patients with stroke.

    Science.gov (United States)

    Park, Yu-Hyung; Lee, Chi-Ho; Lee, Byoung-Hee

    2013-01-01

    This study is a single blind randomized controlled trial to determine the effect of virtual reality-based postural control training on the gait ability in patients with chronic stroke. Sixteen subjects were randomly assigned to either experimental group (VR, n= 8) or control group (CPT, n= 8). Subjects in both groups received conventional physical therapy for 60 min per day, five days per week during a period of four weeks. Subjects in the VR group received additional augmented reality-based training for 30 min per day, three days per week during a period of four weeks. The subjects were evaluated one week before and after participating in a four week training and follow-up at one month post-training. Data derived from the gait analyses included spatiotemporal gait parameters, 10 meters walking test (10 mWT). In the gait parameters, subjects in the VR group showed significant improvement, except for cadence at post-training and follow-up within the experimental group. However, no obvious significant improvement was observed within the control group. In between group comparisons, the experimental group (VR group) showed significantly greater improvement only in stride length compared with the control group (Pgait parameters. In conclusion, we demonstrate significant improvement in gait ability in chronic stroke patients who received virtual reality based postural control training. These findings suggest that virtual reality (VR) postural control training using real-time information may be a useful approach for enhancement of gait ability in patients with chronic stroke.

  8. Characteristics of daily life gait in fall and non fall-prone stroke survivors and controls

    NARCIS (Netherlands)

    Mirjam Pijnappels; Sjoerd M. Bruijn; Kimberley M. Schooten; Jaap H. van Dieën; Dr. H.M. Wittink; Michiel Punt

    2016-01-01

    Background: Falls in stroke survivors can lead to serious injuries and medical costs. Fall risk in older adults can be predicted based on gait characteristics measured in daily life. Given the different gait patterns that stroke survivors exhibit it is unclear whether a similar fall-prediction model

  9. Wellpoint pumping system

    Energy Technology Data Exchange (ETDEWEB)

    Gilfillan, W.C.

    1990-04-03

    This patent describes a wellpoint pumping system. It comprises: a frame, a positive displacement rotary pump capable of pumping air, water or a mixture thereof mounted upon the frame, the pump having two rotors with intermeshing lobes mounted for counter rotation upon substantially horizontal and parallel shafts. The pump having an inlet port located blow the rotors opening downwardly and an outlet port located above the rotors opening upwardly, a motor for driving the rotors mounted upon the frame, means for coupling the motor to at least one of the rotor shafts to drive at least one of the rotor shafts, means forming a closed air-tight inlet reservoir in the frame below the pump, an outlet reservoir mounted on the frame at a level above the inlet reservoir, an outlet reservoir mounted on the frame at a level above the inlet reservoir, an exhaust conduit for the outlet reservoir, conduit means; water recirculation means; and an adjustable recirculation control valve.

  10. Number of nursing staff and falls: a case-control study on falls by stroke patients in acute-care settings

    NARCIS (Netherlands)

    Tutuarima, J. A.; de Haan, R. J.; Limburg, M.

    1993-01-01

    Falls occur frequently in patients with a stroke and have serious consequences: discharge delays and hip fractures can result. In order to evaluate the impact of nursing workload on stroke-patient falls, we assessed the patients per nurse ratio in a detailed case-control study carried out in nine

  11. Home-based neurologic music therapy for arm hemiparesis following stroke: results from a pilot, feasibility randomized controlled trial.

    Science.gov (United States)

    Street, Alexander J; Magee, Wendy L; Bateman, Andrew; Parker, Michael; Odell-Miller, Helen; Fachner, Jorg

    2018-01-01

    To assess the feasibility of a randomized controlled trial to evaluate music therapy as a home-based intervention for arm hemiparesis in stroke. A pilot feasibility randomized controlled trial, with cross-over design. Randomization by statistician using computer-generated, random numbers concealed in opaque envelopes. Participants' homes across Cambridgeshire, UK. Eleven people with stroke and arm hemiparesis, 3-60 months post stroke, following discharge from community rehabilitation. Each participant engaged in therapeutic instrumental music performance in 12 individual clinical contacts, twice weekly for six weeks. Feasibility was estimated by recruitment from three community stroke teams over a 12-month period, attrition rates, completion of treatment and successful data collection. Structured interviews were conducted pre and post intervention to establish participant tolerance and preference. Action Research Arm Test and Nine-hole Peg Test data were collected at weeks 1, 6, 9, 15 and 18, pre and post intervention by a blinded assessor. A total of 11 of 14 invited participants were recruited (intervention n = 6, waitlist n = 5). In total, 10 completed treatment and data collection. It cannot be concluded whether a larger trial would be feasible due to unavailable data regarding a number of eligible patients screened. Adherence to treatment, retention and interview responses might suggest that the intervention was motivating for participants. ClinicalTrials.gov identifier NCT 02310438.

  12. Use of cardiopulmonary pump support during coronary artery bypass grafting in the high-risk: a meta-analysis.

    Science.gov (United States)

    Yousif, A; Addison, D; Lakkis, N; Rosengart, T; Virani, S S; Birnbaum, Y; Alam, M

    2017-09-21

    Data from randomized trials evaluating the efficacy of on- versus off-pump coronary artery bypass grafting remain inconclusive, particularly in high-risk populations. The aim of this study is to compare the outcomes associated with on- versus off-pump coronary artery bypass grafting among high-risk patients. We performed a meta-analysis of randomized control trials comparing on- versus off-pump coronary artery bypass grafting, focusing on high-risk populations. Studies focusing on "high-risk" features: European System of Cardiac Operative Risk Evaluation (EuroSCORE) ≥ 5, age > 70 years, preexisting renal insufficiency, history of stroke(s), and the presence of left ventricular dysfunction were included. MEDLINE, Scopus, and Embase were searched for all publications between January 1, 2000 and August 1, 2016, using the following terms: on-pump, off-pump, coronary artery bypass, high-risk, left ventricular dysfunction, elderly, aged, and renal insufficiency. Endpoints included cardiovascular and all-cause mortality, non-fatal myocardial infarction, stroke, need for revascularization, renal failure, and length of hospital stay. Nine studies incorporating 11,374 patients with a mean age of 70 years were selected. There was no statistical difference in cardiovascular mortality, all-cause mortality, non-fatal myocardial infarction, and renal failure between the two groups. There was a decrease in further revascularization at 1 year with on-pump (OR 0.67 (0.50-0.89)). However, there was an increase in length of hospital stay by 2.24 days (p = 0.03) among the on-pump group with no difference in stroke (OR 1.34 (1.00-1.80)). On-pump is associated with a decreased risk of additional revascularization by 1 year. However, this appears to be a cost of longer hospitalization.

  13. Kinematic control of aerodynamic forces on an inclined flapping wing with asymmetric strokes

    International Nuclear Information System (INIS)

    Park, Hyungmin; Choi, Haecheon

    2012-01-01

    In the present study, we conduct an experiment using a one-paired dynamically scaled model of an insect wing, to investigate how asymmetric strokes with different wing kinematic parameters are used to control the aerodynamics of a dragonfly-like inclined flapping wing in still fluid. The kinematic parameters considered are the angles of attack during the mid-downstroke (α md ) and mid-upstroke (α mu ), and the duration (Δτ) and time of initiation (τ p ) of the pitching rotation. The present dragonfly-like inclined flapping wing has the aerodynamic mechanism of unsteady force generation similar to those of other insect wings in a horizontal stroke plane, but the detailed effect of the wing kinematics on the force control is different due to the asymmetric use of the angle of attack during the up- and downstrokes. For example, high α md and low α mu produces larger vertical force with less aerodynamic power, and low α md and high α mu is recommended for horizontal force (thrust) production. The pitching rotation also affects the aerodynamics of a flapping wing, but its dynamic rotational effect is much weaker than the effect from the kinematic change in the angle of attack caused by the pitching rotation. Thus, the influences of the duration and timing of pitching rotation for the present inclined flapping wing are found to be very different from those for a horizontal flapping wing. That is, for the inclined flapping motion, the advanced and delayed rotations produce smaller vertical forces than the symmetric one and the effect of pitching duration is very small. On the other hand, for a specific range of pitching rotation timing, delayed rotation requires less aerodynamic power than the symmetric rotation. As for the horizontal force, delayed rotation with low α md and high α mu is recommended for long-duration flight owing to its high efficiency, and advanced rotation should be employed for hovering flight for nearly zero horizontal force. The present

  14. Kinematic control of aerodynamic forces on an inclined flapping wing with asymmetric strokes.

    Science.gov (United States)

    Park, Hyungmin; Choi, Haecheon

    2012-03-01

    In the present study, we conduct an experiment using a one-paired dynamically scaled model of an insect wing, to investigate how asymmetric strokes with different wing kinematic parameters are used to control the aerodynamics of a dragonfly-like inclined flapping wing in still fluid. The kinematic parameters considered are the angles of attack during the mid-downstroke (α(md)) and mid-upstroke (α(mu)), and the duration (Δτ) and time of initiation (τ(p)) of the pitching rotation. The present dragonfly-like inclined flapping wing has the aerodynamic mechanism of unsteady force generation similar to those of other insect wings in a horizontal stroke plane, but the detailed effect of the wing kinematics on the force control is different due to the asymmetric use of the angle of attack during the up- and downstrokes. For example, high α(md) and low α(mu) produces larger vertical force with less aerodynamic power, and low α(md) and high α(mu) is recommended for horizontal force (thrust) production. The pitching rotation also affects the aerodynamics of a flapping wing, but its dynamic rotational effect is much weaker than the effect from the kinematic change in the angle of attack caused by the pitching rotation. Thus, the influences of the duration and timing of pitching rotation for the present inclined flapping wing are found to be very different from those for a horizontal flapping wing. That is, for the inclined flapping motion, the advanced and delayed rotations produce smaller vertical forces than the symmetric one and the effect of pitching duration is very small. On the other hand, for a specific range of pitching rotation timing, delayed rotation requires less aerodynamic power than the symmetric rotation. As for the horizontal force, delayed rotation with low α(md) and high α(mu) is recommended for long-duration flight owing to its high efficiency, and advanced rotation should be employed for hovering flight for nearly zero horizontal force. The

  15. A Randomized Controlled Trial on Very Early Speech and Language Therapy in Acute Stroke Patients with Aphasia

    Directory of Open Access Journals (Sweden)

    A.C. Laska

    2011-07-01

    Full Text Available Background: Aphasia affects one third of acute stroke patients. There is a considerable spontaneous recovery in aphasia, but impaired communication ability remains a great problem. Communication difficulties are an impediment to rehabilitation. Early treatment of the language deficits leading to increased communication ability would improve rehabilitation. The aim of this study is to elucidate the efficacy of very early speech and language therapy (SLT in acute stroke patients with aphasia. Methods: A prospective, open, randomized, controlled trial was carried out with blinded endpoint evaluation of SLT, starting within 2 days of stroke onset and lasting for 21 days. 123 consecutive patients with acute, first-ever ischemic stroke and aphasia were randomized. The SLT treatment was Language Enrichment Therapy, and the aphasia tests used were the Norsk grunntest for afasi (NGA and the Amsterdam-Nijmegen everyday language test (ANELT, both performed by speech pathologists, blinded for randomization. Results: The primary outcome, as measured by ANELT at day 21, was 1.3 in the actively treated patient group and 1.2 among controls. NGA led to similar results in both groups. Patients with a higher level of education (>12 years improved more on ANELT by day 21 than those with Conclusions: Very early intensive SLT with the Language Enrichment Therapy program over 21 days had no effect on the degree of aphasia in unselected acute aphasic stroke patients. In aphasic patients with more fluency, SLT resulted in a significant improvement as compared to controls. A higher educational level of >12 years was beneficial.

  16. Holter-electrocardiogram-monitoring in patients with acute ischaemic stroke (Find-AFRANDOMISED): an open-label randomised controlled trial.

    Science.gov (United States)

    Wachter, Rolf; Gröschel, Klaus; Gelbrich, Götz; Hamann, Gerhard F; Kermer, Pawel; Liman, Jan; Seegers, Joachim; Wasser, Katrin; Schulte, Anna; Jürries, Falko; Messerschmid, Anna; Behnke, Nico; Gröschel, Sonja; Uphaus, Timo; Grings, Anne; Ibis, Tugba; Klimpe, Sven; Wagner-Heck, Michaela; Arnold, Magdalena; Protsenko, Evgeny; Heuschmann, Peter U; Conen, David; Weber-Krüger, Mark

    2017-04-01

    months, we detected atrial fibrillation in 14% of 200 patients in the enhanced and prolonged monitoring group (27 patients) versus 5% in the control group (nine of 198 patients, absolute difference 9·0%; 95% CI 3·4-14·5, p=0·002; number needed to screen 11). Enhanced and prolonged monitoring initiated early in patients with acute ischaemic stroke aged 60 years or older was better than standard care for the detection of atrial fibrillation. These findings support the consideration of all patients aged 60 years or older with stroke for prolonged monitoring if the detection of atrial fibrillation would result in a change in medical management (eg, initiation of anticoagulation). Boehringer Ingelheim. Copyright © 2017 Elsevier Ltd. All rights reserved.

  17. Therapeutic interventions and success in risk factor control for secondary prevention of stroke.

    Science.gov (United States)

    Alvarez-Sabin, Jose; Quintana, Manuel; Hernandez-Presa, Miguel Angel; Alvarez, Carlos; Chaves, Jose; Ribo, Marc

    2009-01-01

    We sought to evaluate the success rates in achieving preventive therapeutic goals in patients who experienced an ischemic stroke (IS) and compare them with those achieved in patients with coronary artery disease (CAD). This was an observational multicenter case-control study (3 patients with IS and one control subject with CAD) performed in 1444 primary health centers in Spain. Preventive therapeutic objectives according to American Heart Association guidelines were predefined. Demographic data, vascular risk factors, and success/failure in achievement of objectives were recorded and compared between patients with IS and CAD. A total of 5458 patients were included, 4098 (75.1%) had IS and 1360 (24.9%) had CAD. Although more than 90% of patients with hypertension, diabetes, or dyslipidemia were under specific drug regimens, only about 25% achieved the recommended therapeutic objective for each risk factor. Success rate was especially low among patients with IS compared with CAD: hypertension (23.8% v 27.2%; P = .028); dyslipidemia (13.6% v 20.3%; P risk factors under control, compared with 5.6% of those with CAD (P = .006). For all patients, multivariate logistic regression model showed that independent predictors of full risk factor control were: presence of CAD as compared with IS (odds ratio [OR] 2.11; 95% confidence interval [CI] 1.35-3.29; P = .001), older age (OR 1.02; 95% CI 1.00-1.04; P = .028), and having less than 3 risk factors (OR 16.98; 95% CI 9.02-31.97; P risk factor control.

  18. Heat pumps

    CERN Document Server

    Macmichael, DBA

    1988-01-01

    A fully revised and extended account of the design, manufacture and use of heat pumps in both industrial and domestic applications. Topics covered include a detailed description of the various heat pump cycles, the components of a heat pump system - drive, compressor, heat exchangers etc., and the more practical considerations to be taken into account in their selection.

  19. Use of insulin pump therapy in children and adolescents with type 1 diabetes and its impact on metabolic control: comparison of results from three large, transatlantic paediatric registries.

    Science.gov (United States)

    Sherr, Jennifer L; Hermann, Julia M; Campbell, Fiona; Foster, Nicole C; Hofer, Sabine E; Allgrove, Jeremy; Maahs, David M; Kapellen, Thomas M; Holman, Naomi; Tamborlane, William V; Holl, Reinhard W; Beck, Roy W; Warner, Justin T

    2016-01-01

    While the use of insulin pumps in paediatrics has expanded dramatically, there is still considerable variability among countries in the use of pump technology. The present study sought to describe differences in metabolic control and pump use in young people with type 1 diabetes using data collected in three multicentre registries. Data for the years 2011 and 2012 from 54,410 children and adolescents were collected from the Prospective Diabetes Follow-up Registry (DPV; n = 26,198), T1D Exchange (T1DX; n = 13,755) and the National Paediatric Diabetes Audit (NPDA; n = 14,457). The modality of insulin delivery, based on age, sex and ethnic minority status, and the impact of pump use on HbA1c levels were compared. The overall mean HbA1c level was higher in the NPDA (8.9 ± 1.6% [74 ± 17.5 mmol/mol]) than in the DPV (8.0 ± 1.6% [64 ± 17.0 mmol/mol], p pump use was much lower in the NPDA (14%) than in the DPV (41%, p pump use was associated with a lower mean HbA1c (pump: 8.0 ± 1.2% [64 ± 13.3 mmol/mol] vs injection: 8.5 ± 1.7% [69 ± 18.7 mmol/mol], p pump (p pump less often compared with girls (p insulin pump therapy.

  20. [Association Between SNP rs6007897 of CELSR1 and Acute Ischemic Stroke in Western China Han Population: a Case-control Study].

    Science.gov (United States)

    Qin, Feng-qin; Yu, Li-hua; Hu, Wen-ting; Guo, Jian; Chen, Ning; Guo, Jiang; Fang, Jing-huan; He, Li

    2015-07-01

    To investigate the relationship between single nucleotide polymorphism (SNP) rs6007897 of CELSR1 and acute ischemic stroke in Western China Han population. All subjects (759 acute ischemic stroke patients and 786 controls) were genotyped using ligation detection reaction (LDR). We analyzed the differences between SNP rs6007897 genotypes and allele frequencies between two groups. Two genotypes (AA, AG) of rs6007897 were found in both stroke and control group. There was no statistically significance between two groups about genotype and allele frequency. After adjusting for risk factors, we found there was no significant association between rs6007897 and ischemic stroke CP = 0.797, odds ratio (OR) = 0.886, 95% confidence interval (CI) = 0.352-2.227). SNP rs6007897 of CELSR1 was not significantly associated with ischemic stroke in Western China Han population.

  1. Core stabilization exercise with real-time feedback for chronic hemiparetic stroke: a pilot randomized controlled trials.

    Science.gov (United States)

    Chung, Eunjung; Lee, Byoung-Hee; Hwang, Sujin

    2014-01-01

    The purpose of this study was to examine the feasibility of core stabilization exercise with real-time feedback on balance and gait function in patients with chronic hemiparetic stroke. Nineteen stroke subjects were enrolled in this study. The patients were randomly divided into the experimental (n = 10) and control groups (n = 9). Subjects in the experimental group performed core stabilization exercise with real-time feedback training for 30 minutes per day during a period of six weeks. Subjects in the control group performed core stabilization exercise during the same period. This study assessed the kinematic parameters using a portable walkway system, and timed up-and-go test. Gait velocity showed significantly greater improvement in the experimental group (7.3 ± 5.0 sec) than in the control group (-0.7 ± 10.6). Stride length showed significantly greater increase in the experimental group (13.2 ± 7.9 on the affected side and 12.6 ± 8.0 on the less affected side) than the control group (3.5 ± 8.7 on the affected side and 3.4 ± 8.5 on the less affected side). After training, change in results on the timed up and go test was significantly greater in the experimental group than in the control group. Core stabilization exercise using real-time feedback produces greater improvement in gait performance in chronic hemiparetic stroke patients than core stabilization exercise only.

  2. Means-End based Functional Modeling for Intelligent Control: Modeling and Experiments with an Industrial Heat Pump System

    DEFF Research Database (Denmark)

    Saleem, Arshad

    2007-01-01

    The purpose of this paper is to present a Multilevel Flow Model (MFM) of an industrial heat pump system and its use for diagnostic reasoning. MFM is functional modeling language supporting an explicit means-ends intelligent control strategy for large industrial process plants. The model is used...... in several diagnostic experiments analyzing different fault scenarios. The model and results of the experiments are explained and it is shown how MFM based intelligent modeling and automated reasoning can improve the fault diagnosis process significantly....

  3. Migraine as a risk factor for young patients with ischemic stroke: a case-control study.

    Science.gov (United States)

    Abanoz, Yasin; Gülen Abanoz, Yeşim; Gündüz, Ayşegül; Uludüz, Derya; İnce, Birsen; Yavuz, Burcu; Göksan, Baki

    2017-04-01

    Studies have suggested a possible association of migraine and increased risk of ischemic stroke in young adults, particularly in smokers and in women who use oral contraceptive drugs. We aimed to analyze the association between migraine and ischemic stroke in young population in a hospital-based cohort. We included 202 consecutive patients with the diagnosis of ischemic stroke who were between 15 and 50 years and age- and gender-matched 250 volunteers with no history of stroke. All participants were interviewed using a questionnaire for migraine. Localization of ischemic lesion was classified as anterior and posterior circulation according to neuroimaging findings. The cause of ischemic lesion and all risk factors were recorded. Undetermined etiology was the most frequent (43.1%) and the most common determined cause was cardioembolism (22.3%) in young stroke patients. Frequency of migraine was 30.2% among patients with stroke whereas 16.8% of healthy subjects had migraine (p = 0.001). Migraine with aura was significantly more common among patients with stroke compared to healthy subjects (18.3 vs 4.4%; p = 0.000) whereas the frequency of migraine without aura was similar in both groups (11.9 vs 12.4%). Using logistic regression, migraine with aura was shown to be an independent risk factor for ischemic stroke in young population (p = 0.000) and separate analysis for gender demonstrated that it was only a risk factor for women (p = 0.009) but not for men (p = 0.107). Migraine with aura was found to be more common in ischemic stroke in young patients. It was an independent risk factor in women.

  4. Characteristics of daily life gait in fall and non fall-prone stroke survivors and controls.

    Science.gov (United States)

    Punt, Michiel; Bruijn, Sjoerd M; van Schooten, Kimberley S; Pijnappels, Mirjam; van de Port, Ingrid G; Wittink, Harriet; van Dieën, Jaap H

    2016-07-27

    Falls in stroke survivors can lead to serious injuries and medical costs. Fall risk in older adults can be predicted based on gait characteristics measured in daily life. Given the different gait patterns that stroke survivors exhibit it is unclear whether a similar fall-prediction model could be used in this group. Therefore the main purpose of this study was to examine whether fall-prediction models that have been used in older adults can also be used in a population of stroke survivors, or if modifications are needed, either in the cut-off values of such models, or in the gait characteristics of interest. This study investigated gait characteristics by assessing accelerations of the lower back measured during seven consecutive days in 31 non fall-prone stroke survivors, 25 fall-prone stroke survivors, 20 neurologically intact fall-prone older adults and 30 non fall-prone older adults. We created a binary logistic regression model to assess the ability of predicting falls for each gait characteristic. We included health status and the interaction between health status (stroke survivors versus older adults) and gait characteristic in the model. We found four significant interactions between gait characteristics and health status. Furthermore we found another four gait characteristics that had similar predictive capacity in both stroke survivors and older adults. The interactions between gait characteristics and health status indicate that gait characteristics are differently associated with fall history between stroke survivors and older adults. Thus specific models are needed to predict fall risk in stroke survivors.

  5. The effect of additional core stability exercises on improving dynamic sitting balance and trunk control for subacute stroke patients: a randomized controlled trial.

    Science.gov (United States)

    Cabanas-Valdés, Rosa; Bagur-Calafat, Caritat; Girabent-Farrés, Montserrat; Caballero-Gómez, Fernanda Mª; Hernández-Valiño, Montserrat; Urrútia Cuchí, Gerard

    2016-10-01

    To examine the effect of core stability exercises on trunk control, dynamic sitting and standing balance, gait, and activities of daily living in subacute stroke patients. A randomized controlled trial. Inpatient rehabilitation hospital in two centres. Eighty patients (mean of 23.25 (±16.7) days post-stroke) were randomly assigned to an experimental group and a control group. Both groups underwent conventional therapy for five days/week for five weeks and the experimental group performed core stability exercises for 15 min/day. The patients were assessed before and after intervention. The Trunk Impairment Scale (Spanish-Version) and Function in Sitting Test were used to measure the primary outcome of dynamic sitting balance. Secondary outcome measures were standing balance and gait as evaluated via Berg Balance Scale, Tinetti Test, Brunel Balance Assessment, Postural Assessment Scale for Stroke (Spanish-Version), and activities of daily living using Barthel Index. The experimental group showed statistically significant differences for all of the total scale scores (PCore stability exercises in addition to conventional therapy improves trunk control, dynamic sitting balance, standing balance, gait and activities of daily living in subacute post-stroke patients. © The Author(s) 2015.

  6. Characteristics of daily life gait in fall and non fall-prone stroke survivors and controls

    OpenAIRE

    Pijnappels, Mirjam; Bruijn, Sjoerd M.; Schooten, Kimberley M.; Dieën, van, Jaap H.; Wittink, H.M.; Punt, Michiel

    2016-01-01

    Background: Falls in stroke survivors can lead to serious injuries and medical costs. Fall risk in older adults can be predicted based on gait characteristics measured in daily life. Given the different gait patterns that stroke survivors exhibit it is unclear whether a similar fall-prediction model could be used in this group. Therefore the main purpose of this study was to examine whether fall-prediction models that have been used in older adults can also be used in a population of stroke s...

  7. Characteristics of daily life gait in fall and non fall-prone stroke survivors and controls

    OpenAIRE

    Punt, Michiel; Bruijn, Sjoerd M.; van Schooten, Kimberley S.; Pijnappels, Mirjam; van de Port, Ingrid G.; Wittink, Harriet; van Die?n, Jaap H.

    2016-01-01

    Background Falls in stroke survivors can lead to serious injuries and medical costs. Fall risk in older adults can be predicted based on gait characteristics measured in daily life. Given the different gait patterns that stroke survivors exhibit it is unclear whether a similar fall-prediction model could be used in this group. Therefore the main purpose of this study was to examine whether fall-prediction models that have been used in older adults can also be used in a population of stroke su...

  8. Comparison of physio ball and plinth trunk exercises regimens on trunk control and functional balance in patients with acute stroke: a pilot randomized controlled trial.

    Science.gov (United States)

    Karthikbabu, S; Nayak, Akshatha; Vijayakumar, K; Misri, Zk; Suresh, Bv; Ganesan, Sailakshmi; Joshua, Abraham M

    2011-08-01

    To examine the effects of trunk exercises performed using the physio ball as against the plinth, on trunk control and functional balance in patients with acute stroke. An observer-blinded pilot randomized controlled trial. Thirty patients with acute stroke (mean post-stroke duration 12 (95% confidence interval (CI) 2-34) days) who had the first onset of unilateral haemorrhagic or ischaemic lesion and an independent ability to sit for 30 seconds. Inpatient stroke rehabilitation centre. The experimental group performed task-specific trunk exercises on an unstable surface (physio ball) while the control group performed them on a stable surface (plinth). In addition to regular acute physiotherapy, both the groups underwent 1 hour of trunk exercises a day, four days a week for three weeks. Trunk Impairment Scale and Brunel Balance Assessment. The difference between the baseline characteristics of the patients belonging to both groups was not statistically significant. Post-intervention, both the groups improved on trunk control and functional balance but the experimental group improved more significantly than the control group (change scores of between-group comparison for the total Trunk Impairment Scale 3.06 (1.43), dynamic sitting balance 1.47 (1.36) and coordination 1.3 (0.67) subscales of Trunk Impairment Scale; the total Brunel Balance Assessment 1.8 (1.4) and stepping 1.87 (1.6) component of Brunel Balance Assessment). The level of significance was set at P physio ball are more effective than those performed on the plinth in improving both trunk control and functional balance in acute stroke patients, suggesting a task-specific effect and also a carry-over effect.

  9. The effects of Pilates exercise training on static and dynamic balance in chronic stroke patients: a randomized controlled trial

    Science.gov (United States)

    Lim, Hee Sung; Kim, You Lim; Lee, Suk Min

    2016-01-01

    [Purpose] The purpose of this study was to analyze the effects of Pilates exercise on static and dynamic balance in chronic stroke patients. [Subjects and Methods] Nineteen individuals with unilateral chronic hemiparetic stroke (age, 64.7 ± 6.9 years; height, 161.7 ± 7.9 cm; weight, 67.0 ± 11.1 kg) were randomly allocated to either a Pilates exercise group (PG, n=10) or a control group (CG, n=9). The PG attended 24 exercise sessions conducted over an 8-week period (3 sessions/week). Center of pressure (COP) sway and COP velocity were measured one week before and after the exercise program and compared to assess training effects. [Results] Pilates exercise positively affected both static and dynamic balance in patients with chronic stroke. For static balance, COP sway and velocity in the medial-lateral (M-L) and anterior-posterior (A-P) directions were significantly decreased in the PG after training while no significant differences were found in the CG. For dynamic balance, measured during treadmill walking, the PG showed significantly reduced COP sway and velocity in the M-L and A-P directions for both the paretic and non-paretic leg. [Conclusions] The findings provide initial evidence that Pilates exercise can enhance static and dynamic balance in patients with chronic stroke. PMID:27390424

  10. The effects of Pilates exercise training on static and dynamic balance in chronic stroke patients: a randomized controlled trial.

    Science.gov (United States)

    Lim, Hee Sung; Kim, You Lim; Lee, Suk Min

    2016-06-01

    [Purpose] The purpose of this study was to analyze the effects of Pilates exercise on static and dynamic balance in chronic stroke patients. [Subjects and Methods] Nineteen individuals with unilateral chronic hemiparetic stroke (age, 64.7 ± 6.9 years; height, 161.7 ± 7.9 cm; weight, 67.0 ± 11.1 kg) were randomly allocated to either a Pilates exercise group (PG, n=10) or a control group (CG, n=9). The PG attended 24 exercise sessions conducted over an 8-week period (3 sessions/week). Center of pressure (COP) sway and COP velocity were measured one week before and after the exercise program and compared to assess training effects. [Results] Pilates exercise positively affected both static and dynamic balance in patients with chronic stroke. For static balance, COP sway and velocity in the medial-lateral (M-L) and anterior-posterior (A-P) directions were significantly decreased in the PG after training while no significant differences were found in the CG. For dynamic balance, measured during treadmill walking, the PG showed significantly reduced COP sway and velocity in the M-L and A-P directions for both the paretic and non-paretic leg. [Conclusions] The findings provide initial evidence that Pilates exercise can enhance static and dynamic balance in patients with chronic stroke.

  11. Bilateral robotic priming before task-oriented approach in subacute stroke rehabilitation: a pilot randomized controlled trial.

    Science.gov (United States)

    Hsieh, Yu-Wei; Wu, Ching-Yi; Wang, Wei-En; Lin, Keh-Chung; Chang, Ku-Chou; Chen, Chih-Chi; Liu, Chien-Ting

    2017-02-01

    To investigate the treatment effects of bilateral robotic priming combined with the task-oriented approach on motor impairment, disability, daily function, and quality of life in patients with subacute stroke. A randomized controlled trial. Occupational therapy clinics in medical centers. Thirty-one subacute stroke patients were recruited. Participants were randomly assigned to receive bilateral priming combined with the task-oriented approach (i.e., primed group) or to the task-oriented approach alone (i.e., unprimed group) for 90 minutes/day, 5 days/week for 4 weeks. The primed group began with the bilateral priming technique by using a bimanual robot-aided device. Motor impairments were assessed by the Fugal-Meyer Assessment, grip strength, and the Box and Block Test. Disability and daily function were measured by the modified Rankin Scale, the Functional Independence Measure, and actigraphy. Quality of life was examined by the Stroke Impact Scale. The primed and unprimed groups improved significantly on most outcomes over time. The primed group demonstrated significantly better improvement on the Stroke Impact Scale strength subscale ( p = 0.012) and a trend for greater improvement on the modified Rankin Scale ( p = 0.065) than the unprimed group. Bilateral priming combined with the task-oriented approach elicited more improvements in self-reported strength and disability degrees than the task-oriented approach by itself. Further large-scale research with at least 31 participants in each intervention group is suggested to confirm the study findings.

  12. The fluid control mechanism of bionic structural heterogeneous composite materials and its potential application in enhancing pump efficiency

    Directory of Open Access Journals (Sweden)

    Limei Tian

    2015-11-01

    Full Text Available Studies have shown that the structure of dolphin skin controls fluid media dynamically. Gaining inspiration from this phenomenon, a kind of bionic structural heterogeneous composite material was designed. The bionic structural heterogeneous composite material is composed of two materials: a rigid metal base layer with bionic structures and an elastic polymer surface layer with the corresponding mirror structures. The fluid control mechanism of the bionic structural heterogeneous composite material was investigated using a fluid–solid interaction method in ANSYS Workbench. The results indicated that the bionic structural heterogeneous composite material’s fluid control mechanism is its elastic deformation, which is caused by the coupling action between the elastic surface material and the bionic structure. This deformation can decrease the velocity gradient of the fluid boundary layer through changing the fluid–solid actual contact surface and reduce the frictional force. The bionic structural heterogeneous composite material can also absorb some energy through elastic deformation and avoid energy loss. The bionic structural heterogeneous composite material was applied to the impeller of a centrifugal pump in a contrast experiment, increasing the pump efficiency by 5% without changing the hydraulic model of the impeller. The development of this bionic structural heterogeneous composite material will be straightforward from an engineering point of view, and it will have valuable practical applications.

  13. Heat pumps

    CERN Document Server

    Brodowicz, Kazimierz; Wyszynski, M L; Wyszynski

    2013-01-01

    Heat pumps and related technology are in widespread use in industrial processes and installations. This book presents a unified, comprehensive and systematic treatment of the design and operation of both compression and sorption heat pumps. Heat pump thermodynamics, the choice of working fluid and the characteristics of low temperature heat sources and their application to heat pumps are covered in detail.Economic aspects are discussed and the extensive use of the exergy concept in evaluating performance of heat pumps is a unique feature of the book. The thermodynamic and chemical properties o

  14. Association between self-perceived psychological stress and transitory ischaemic attack and minor stroke: A case-control study.

    Science.gov (United States)

    Ramírez-Moreno, J M; Muñoz Vega, P; Espada, S; Bartolomé Alberca, S; Aguirre, J; Peral, D

    2017-12-22

    Stroke has a complex aetiopathogenesis influenced by numerous risk factors. There is growing interest in the study of the pathophysiological changes associated with stress and their potential relationship with cerebrovascular disease. The purpose of this paper is to assess the strength of association between exposure to stress and stroke. We conducted a case-control study (1:1) to compare exposure to stress in a group of patients with a history of a first transient ischaemic attack (TIA) or minor stroke and in a control group. Participants were asked a subjective question about their perception of stress in the previous months and completed the standardised Effort-Reward Imbalance (ERI) questionnaire. Logistic regression models were used for data analysis. The study included data on 50 cases and 50 controls. There were no significant differences in demographic variables and economic, social, and employment status between cases and controls. Fifty percent of the cases reported moderate to severe stress, compared to 30% of controls (OR: 2.33; 95% CI: 1.02-5.30; P=.041). ERI questionnaire results found that greater effort at work (OR: 1.48; 95% CI: 1.19-1.83) and greater commitment is associated with stroke (OR: 1.34; 95% CI: 1.17-1.54), while higher reward constitutes a protective factor against the disease (OR: 0.71; 95% CI: 0.61-0.82). There is a strong association between self-perceived psychological stress and TIA. The imbalance between effort and reward at work is also clearly related to TIA. Copyright © 2017 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.

  15. Effects of Self-esteem, Optimism, and Perceived Control on Depressive Symptoms in Stroke Survivor-Spouse Dyads.

    Science.gov (United States)

    Chung, Misook L; Bakas, Tamilyn; Plue, Laura D; Williams, Linda S

    2016-01-01

    Depressive symptoms are common in stroke survivors and their family caregivers. Given the interdependent relationship between the members of dyads in poststroke management, improving depressive symptoms in dyads may depend on their partner's characteristics. Self-esteem, optimism, and perceived control, all known to be associated with depressive symptoms in an individual, may also contribute to their partner's depressive symptoms. The purpose of this study is to examine actor and partner effects of self-esteem, optimism, and perceived control on depression in stroke survivors and their spousal caregivers. A total of 112 ischemic stroke survivors (78% white, 34% women; mean age, 62.5 ± 12.3 years) and their spouses (mean age, 60.6 ± 12.9 years) completed surveys in which depressive symptoms, self-esteem, optimism, and perceived control were assessed using the Patient Health Questionnaire, the Rosenberg Self-esteem Scale, the Revised Life Orientation Test, and the Sense of Control Scale. Multilevel modeling, actor-partner interdependence model regression was used to determine influences on depressive symptoms within the dyad. Individuals with lower self-esteem, optimism, and perceived control had higher levels of depressive symptoms. Stroke survivors whose spouses had lower levels of self-esteem (B = -0.338, P self-esteem (B = -0.047, P = .036) also had higher levels of depressive symptoms. We found significant partner effects of self-esteem on depression for both members and partner effect of optimism on patient's depressive symptoms. These findings suggest that further research is needed to determine if dyadic interventions may help to improve self-esteem, optimism, and depressive symptoms in both patients and their caregivers.

  16. Efficacy of Insulin Pump Therapy on Diabetes Treatment Satisfaction and Glycemic Control Among Patients with Type 1 Diabetes Mellitus in Saudi Arabia: A Prospective Study

    OpenAIRE

    Al Hayek, Ayman A.; Robert, Asirvatham A.; Al Dawish, Mohamed A.; Braham, Rim B.; Goudeh, Hanouf S.; Al Sabaan, Fahad S.

    2015-01-01

    Introduction The aim of this study was to explore the impact of insulin pump therapy on diabetes treatment satisfaction and glycemic control among patients with type 1 diabetes mellitus (T1DM) in Saudi Arabia. Methods A 6-month, prospective study was conducted among 47 patients (aged 17?24?years) with T1DM who attended the Insulin Pump Clinic at Prince Sultan Military Medical City, Riyadh, Saudi Arabia, between April 2014 and November 2014. The respondents were purposively and conveniently se...

  17. Effectiveness of enhanced communication therapy in the first four months after stroke for aphasia and dysarthria: a randomised controlled trial.

    Science.gov (United States)

    Bowen, Audrey; Hesketh, Anne; Patchick, Emma; Young, Alys; Davies, Linda; Vail, Andy; Long, Andrew F; Watkins, Caroline; Wilkinson, Mo; Pearl, Gill; Ralph, Matthew A Lambon; Tyrrell, Pippa

    2012-07-13

    To assess the effectiveness of enhanced communication therapy in the first four months after stroke compared with an attention control (unstructured social contact). Externally randomised, pragmatic, parallel, superiority trial with blinded outcome assessment. Twelve UK hospital and community stroke services. 170 adults (mean age 70 years) randomised within two weeks of admission to hospital with stroke (December 2006 to January 2010) whom speech and language therapists deemed eligible, and 135 carers. Enhanced, agreed best practice, communication therapy specific to aphasia or dysarthria, offered by speech and language therapists according to participants' needs for up to four months, with continuity from hospital to community. Comparison was with similarly resourced social contact (without communication therapy) from employed visitors. Primary outcome was blinded, functional communicative ability at six months on the Therapy Outcome Measure (TOM) activity subscale. Secondary outcomes (unblinded, six months): participants' perceptions on the Communication Outcomes After Stroke scale (COAST); carers' perceptions of participants from part of the Carer COAST; carers' wellbeing on Carers of Older People in Europe Index and quality of life items from Carer COAST; and serious adverse events. Therapist and visitor contact both had good uptake from service users. An average 22 contacts (intervention or control) over 13 weeks were accepted by users. Impairment focused therapy was the approach most often used by the speech and language therapists. Visitors most often provided general conversation. In total, 81/85 of the intervention group and 72/85 of the control group completed the primary outcome measure. Both groups improved on the TOM activity subscale. The estimated six months group difference was not statistically significant, with 0.25 (95% CI -0.19 to 0.69) points in favour of therapy. Sensitivity analyses that adjusted for chance baseline imbalance further reduced

  18. Effectiveness of enhanced communication therapy in the first four months after stroke for aphasia and dysarthria: a randomised controlled trial

    Science.gov (United States)

    Hesketh, Anne; Patchick, Emma; Young, Alys; Davies, Linda; Vail, Andy; Long, Andrew F; Watkins, Caroline; Wilkinson, Mo; Pearl, Gill; Ralph, Matthew A Lambon; Tyrrell, Pippa

    2012-01-01

    Objective To assess the effectiveness of enhanced communication therapy in the first four months after stroke compared with an attention control (unstructured social contact). Design Externally randomised, pragmatic, parallel, superiority trial with blinded outcome assessment. Setting Twelve UK hospital and community stroke services. Participants 170 adults (mean age 70 years) randomised within two weeks of admission to hospital with stroke (December 2006 to January 2010) whom speech and language therapists deemed eligible, and 135 carers. Interventions Enhanced, agreed best practice, communication therapy specific to aphasia or dysarthria, offered by speech and language therapists according to participants’ needs for up to four months, with continuity from hospital to community. Comparison was with similarly resourced social contact (without communication therapy) from employed visitors. Outcome measures Primary outcome was blinded, functional communicative ability at six months on the Therapy Outcome Measure (TOM) activity subscale. Secondary outcomes (unblinded, six months): participants’ perceptions on the Communication Outcomes After Stroke scale (COAST); carers’ perceptions of participants from part of the Carer COAST; carers’ wellbeing on Carers of Older People in Europe Index and quality of life items from Carer COAST; and serious adverse events. Results Therapist and visitor contact both had good uptake from service users. An average 22 contacts (intervention or control) over 13 weeks were accepted by users. Impairment focused therapy was the approach most often used by the speech and language therapists. Visitors most often provided general conversation. In total, 81/85 of the intervention group and 72/85 of the control group completed the primary outcome measure. Both groups improved on the TOM activity subscale. The estimated six months group difference was not statistically significant, with 0.25 (95% CI –0.19 to 0.69) points in favour of

  19. Feedback control of a primary pump for safe and stable operation of a PIUS-type reactor

    International Nuclear Information System (INIS)

    Tasaka, K.; Imai, S.; Masaoka, H.; Tamaki, M.; Kukita, Y.

    1993-01-01

    A new automatic pump speed control system by using a measurement of the temperature distribution in the lower density lock is proposed for the PIUS-type reactor. This control system maintains the fluid temperature at the axial center of the lower density lock at the average of the fluid temperatures below and above the density lock in order to prevent the poison water from penetrating into the core during normal operation. The effectiveness of this control system was successfully confirmed by a series of experiments such as start-up and power ramping tests for the stable normal operation and a loss-of-feedwater test for the safe shutdown in an accident condition, using a small scale atmospheric pressure test loop which simulated the PIUS principle. (orig.)

  20. Pulsed-diode-pumped, all-solid-state, electro-optically controlled picosecond Nd:YAG lasers

    International Nuclear Information System (INIS)

    Gorbunkov, Mikhail V; Shabalin, Yu V; Konyashkin, A V; Kostryukov, P V; Olenin, A N; Tunkin, V G; Morozov, V B; Rusov, V A; Telegin, L S; Yakovlev, D V

    2005-01-01

    The results of the development of repetitively pulsed, diode-pumped, electro-optically controlled picosecond Nd:YAG lasers of two designs are presented. The first design uses the active-passive mode locking with electro-optical lasing control and semiconductor saturable absorber mirrors (SESAM). This design allows the generation of 15-50-ps pulses with an energy up to 0.5 mJ and a maximum pulse repetition rate of 100 Hz. The laser of the second design generates 30-ps pulses due to combination of positive and negative electro-optical feedback and the control of the electro-optical modulator by the photocurrent of high-speed semiconductor structures. (active media. lasers)

  1. Crystallization Analysis and Control of Ammonia-Based Air Source Absorption Heat Pump in Cold Regions

    Directory of Open Access Journals (Sweden)

    Wei Wu

    2013-01-01

    Full Text Available Energy consumption of heating and domestic hot water is very high and will keep increasing. Air source absorption heat pump (ASAHP was proposed to overcome the problems of low energy efficiency and high air pollution existing in boiler systems, as well as the problem of bad performance under low ambient temperatures for electrical heat pumps. In order to investigate the crystallization possibility of ammonia-salt ASAHP, crystallization margin (evaluated by solution mass concentration at generating temperature ranging from 100 to 150°C, evaporating temperature from −30 to 10°C, and condensing temperature from 30 to 65°C are analyzed. To prevent the NH3–NaSCN solution from crystallizing, ASAHP integrated with pressure booster located between the evaporator and absorber is simulated. Analysis and comparisons show that NH3–NaSCN is easy to crystallize at relatively high generating temperature, low evaporating temperature, and low condensing temperature. But crystallization margin of NH3–LiNO3 can always stay above 5% for most conditions, keeping away from crystallization. Pressure booster can effectively avoid the crystallization problem that will take place in the NH3–NaSCN ASAHP system.

  2. Mechanical thrombectomy after intravenous alteplase versus alteplase alone after stroke (THRACE): a randomised controlled trial.

    Science.gov (United States)

    Bracard, Serge; Ducrocq, Xavier; Mas, Jean Louis; Soudant, Marc; Oppenheim, Catherine; Moulin, Thierry; Guillemin, Francis

    2016-10-01

    Intravenous thrombolysis with alteplase alone cannot reperfuse most large-artery strokes. We aimed to determine whether mechanical thrombectomy in addition to intravenous thrombolysis improves clinical outcome in patients with acute ischaemic stroke. THRACE is a randomised controlled trial done in 26 centres in France. Patients aged 18-80 years with acute ischaemic stroke and proximal cerebral artery occlusion were randomly assigned to receive either intravenous thrombolysis alone (IVT group) or intravenous thrombolysis plus mechanical thrombectomy (IVTMT group). Intravenous thrombolysis (alteplase 0·9 mg/kg [maximum 90 mg], with an initial bolus of 10% of the total dose followed by infusion of the remaining dose over 60 min) had to be started within 4 h and thrombectomy within 5 h of symptom onset. Occlusions had to be confirmed by CT or magnetic resonance angiography. Randomisation was done centrally with a computer-generated sequential minimisation method and was stratified by centre. The primary outcome was the proportion of patients achieving functional independence at 3 months, defined by a score of 0-2 on the modified Rankin scale, assessed in the modified intention-to-treat population (ie, patients lost to follow-up and those with missing data were excluded). Safety outcomes were analysed in the per-protocol population (ie, all patients who did not follow the protocol of their randomisation group precisely were excluded from the analysis). THRACE is registered with ClinicalTrials.gov, NCT01062698. Between June 1, 2010, and Feb 22, 2015, 414 patients were randomly assigned to the IVT group (n=208) or the IVTMT group (n=204). Four patients (two in each group) lost to follow-up and six (four in the IVT group and two in the IVTMT group) with missing data were excluded. 85 (42%) of 202 patients in the IVT group and 106 (53%) of 200 patients in the IVTMT group achieved functional independence at 3 months (odds ratio 1·55, 95% CI 1·05-2·30; p=0·028). The two

  3. [Motor dysfunction in stroke of subacute stage treated with acupuncture: multi-central randomized controlled study].

    Science.gov (United States)

    Chen, Li-Fang; Fang, Jian-Qiao; Wu, Yuan-Yuan; Ma, Rui-Jie; Xu, Shou-Yu; Shen, Lai-Hua; Luo, Kai-Tao; Gao, Feng; Bao, Ye-Hua; Ni, Ke-Feng; Li, Li-Ping

    2014-04-01

    To verify the clinical efficacy of acupuncture on motor dysfunction in ischemic stroke of subacute stage. The multi-central randomized controlled trial was adopted. One hundred and twenty-six cases of ischemic stroke of subacute stage were randomized into an acupuncture group (61 cases) and a conventional treatment group (65 cases). The basic treatment of western internal medicine and rehabilitation training were applied to the patients of the two groups. In the acupuncture group, acupuncture was supplemented at the body points located on the extensor of the upper limbs and the flexor of the lower limbs. In combination, scalp acupuncture was applied to NS5, MS6 and MS6 on the affected side. The treatment was given 5 times a week and totally 8 weeks were required. The follow-up observation lasted for 3 months. The scores in Fugl-Meyer scale and NIHSS scale and Barthel index were compared between the two groups before treatment, in 4 and 8 weeks of treatment and the 3-month follow-up observation after treatment separately. In 4 and 8 weeks of treatment and the follow-up observation, Fugl-Meyer scale score was improved obviously in the patients of the two groups (all PFugl-Meyer scale score in the acupuncture groupwas im proved much apparently as compared with that in the conventional treatment group [68. 0 (43. 0,86. 5) vs 52. 5 (30.3, 77.0), 77.0 (49.5, 89.0) vs 63. 0 (33.0, 84.0), both Pscale score was not reduced apparently in 4 weeks of treatment in the conventional treatment group (P>0.05), the results of NIHSS scale at the other time points were all decreased obviously as compared with those before treatment in the patients of the two groups (all P<0. 01). In 8 weeks of treatment and the follow-up observation, the results in the acupuncture group were reduced much apparently as compared with those in the conventional treatment group [5. 0 (3.0,8.0) vs 7. 0 (3.0,13.8), 4. 0 (1.5,7.0) vs 6.0 (2.0,11.7) ,both P<0. 05]. In 8 weeks of treatment and the follow

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

    OpenAIRE

    M. Schoone; E. Dusseldorp; M. E. van den Akker-van Marle; A. J. Doornebosch; R. Bal; A. Meems; M. P. Oderwald; R. van Balen

    2011-01-01

    The ACRE (ACtive REhabilitation) robotic device is developed to enhance therapeutic treatment of upper limbs after stroke. The aim of this study is to assess effects and costs of ACRE training for frail elderly patients and to establish if ACRE can be a valuable addition to standard therapy in nursing home rehabilitation. The study was designed as randomized controlled trial, one group receiving therapy as usual and the other receiving additional ACRE training. Changes in motor abilities, str...

  5. Art meets science – empowering stroke patients to regain muscular control through creative graphics technology, psycho-physiology and neuroplasticity.

    OpenAIRE

    Thompson, Simon

    2012-01-01

    Treating patients with a cerebrovascular accident or stroke is complicated by severity and site of brain lesion. Muscular control is lost when neural pathways are interrupted or damaged due to embolus, thrombosis or ruptured aneurysm. Return of movement is further hindered by sustained spasticity of muscle groups or inflammation or severance to functionally important neural pathways. Neuro-feedback mechanisms have been explored in the past with some success. A new, improved and innovative met...

  6. Tongue pressure profile training for dysphagia post stroke (TPPT): study protocol for an exploratory randomized controlled trial.

    Science.gov (United States)

    Steele, Catriona M; Bayley, Mark A; Péladeau-Pigeon, Melanie; Stokely, Shauna L

    2013-05-07

    It is estimated that approximately 50% of stroke survivors will experience swallowing difficulty, or dysphagia. The associated sequelae of dysphagia include dehydration, malnutrition, and aspiration pneumonia, all of which have can have serious medical consequences. To improve swallowing safety and efficiency, alternative nutritional intake methods (for example, a feeding tube) or a modified diet texture (such as pureed foods or thickened liquids) may be recommended but these modifications may negatively affect quality of life. An alternative approach to treating dysphagia has emerged over the past few years, targeting stronger lingual muscles through maximal isometric pressure tasks. Although these studies have shown promising results, thin-liquid bolus control continues to be challenging for patients with dysphagia. Previous work investigating lingual pressures when healthy participants swallow has suggested that greater task specificity in lingual exercises may yield improved results with thin liquids. This is a small, exploratory randomized clinical trial being conducted with post-stroke patients 4 to 20 weeks after onset of dysphagia secondary to impaired lingual control. At enrollment, participants are randomly assigned to one of two treatment protocols, either tongue pressure profile training (TPPT) or the control treatment, tongue pressure strength-and-accuracy training (TPSAT). Each treatment protocol consists of 24 sessions of treatment over 8 to 12 weeks with monitoring of tongue pressure as well as a baseline and outcome videofluoroscopic swallowing study. Tongue pressure measures, videofluoroscopic measures, and functional outcome measures will be obtained following training of 60 participants (30 in each condition), to determine whether TPPT yields better outcomes. This study will continue to explore options beyond tube feeding and modified diets for people with neurogenic dysphagia following stroke. Should the novel protocol, TPPT, prove to be more

  7. Robot-assisted reaching exercise promotes arm movement recovery in chronic hemiparetic stroke: a randomized controlled pilot study.

    Science.gov (United States)

    Kahn, Leonard E; Zygman, Michele L; Rymer, W Zev; Reinkensmeyer, David J

    2006-06-21

    Providing active assistance to complete desired arm movements is a common technique in upper extremity rehabilitation after stroke. Such active assistance may improve recovery by affecting somatosensory input, motor planning, spasticity or soft tissue properties, but it is labor intensive and has not been validated in controlled trials. The purpose of this study was to investigate the effects of robotically administered active-assistive exercise and compare those with free reaching voluntary exercise in improving arm movement ability after chronic stroke. Nineteen individuals at least one year post-stroke were randomized into one of two groups. One group performed 24 sessions of active-assistive reaching exercise with a simple robotic device, while a second group performed a task-matched amount of unassisted reaching. The main outcome measures were range and speed of supported arm movement, range, straightness and smoothness of unsupported reaching, and the Rancho Los Amigos Functional Test of Upper Extremity Function. There were significant improvements with training for range of motion and velocity of supported reaching, straightness of unsupported reaching, and functional movement ability. These improvements were not significantly different between the two training groups. The group that performed unassisted reaching exercise improved the smoothness of their reaching movements more than the robot-assisted group. Improvements with both forms of exercise confirmed that repeated, task-related voluntary activation of the damaged motor system is a key stimulus to motor recovery following chronic stroke. Robotically assisting in reaching successfully improved arm movement ability, although it did not provide any detectable, additional value beyond the movement practice that occurred concurrently with it. The inability to detect any additional value of robot-assisted reaching may have been due to this pilot study's limited sample size, the specific diagnoses of the

  8. MIDAS (Modafinil in Debilitating Fatigue After Stroke): A Randomized, Double-Blind, Placebo-Controlled, Cross-Over Trial.

    Science.gov (United States)

    Bivard, Andrew; Lillicrap, Thomas; Krishnamurthy, Venkatesh; Holliday, Elizabeth; Attia, John; Pagram, Heather; Nilsson, Michael; Parsons, Mark; Levi, Christopher R

    2017-05-01

    This study aimed to assess the efficacy of modafinil, a wakefulness-promoting agent in alleviating post-stroke fatigue ≥3 months after stroke. We hypothesized that 200 mg of modafinil daily for 6 weeks would result in reduced symptoms of fatigue compared with placebo. This single-center phase 2 trial used a randomized, double-blind, placebo-controlled, crossover design. The key inclusion criterion was a multidimensional fatigue inventory score of ≥60. Patients were randomized to either modafinil or placebo for 6 weeks of therapy, then after a 1 week washout period swapped treatment arms for a second 6 weeks of therapy. The primary outcome was the multidimensional fatigue inventory; secondary outcomes included the Montreal cognitive assessment, the Depression, Anxiety, and Stress Scale (DASS), and the Stroke-Specific Quality of Life (SSQoL) scale. The multidimensional fatigue inventory is a self-administered questionnaire with a range of 0 to 100. Treatment efficacy was assessed using linear regression by estimating within-person, baseline-adjusted differences in mean outcomes after therapy. This trial was registered with the Australian New Zealand Clinical Trials Registry (ACTRN12615000350527). A total of 232 stroke survivors were screened and 36 were randomized. Participants receiving modafinil reported a significant decrease in fatigue (multidimensional fatigue inventory, -7.38; 95% CI, -21.76 to -2.99; P modafinil therapy during the study period ( P >0.05). Stroke survivors with nonresolving fatigue reported reduced fatigue and improved quality of life after taking 200 mg daily treatment with modafinil. URL: https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=368268. Unique identifier: ACTRN12615000350527. © 2017 The Authors.

  9. Robot-assisted reaching exercise promotes arm movement recovery in chronic hemiparetic stroke: a randomized controlled pilot study

    Directory of Open Access Journals (Sweden)

    Rymer W Zev

    2006-06-01

    Full Text Available Abstract Background and purpose Providing active assistance to complete desired arm movements is a common technique in upper extremity rehabilitation after stroke. Such active assistance may improve recovery by affecting somatosensory input, motor planning, spasticity or soft tissue properties, but it is labor intensive and has not been validated in controlled trials. The purpose of this study was to investigate the effects of robotically administered active-assistive exercise and compare those with free reaching voluntary exercise in improving arm movement ability after chronic stroke. Methods Nineteen individuals at least one year post-stroke were randomized into one of two groups. One group performed 24 sessions of active-assistive reaching exercise with a simple robotic device, while a second group performed a task-matched amount of unassisted reaching. The main outcome measures were range and speed of supported arm movement, range, straightness and smoothness of unsupported reaching, and the Rancho Los Amigos Functional Test of Upper Extremity Function. Results and discussion There were significant improvements with training for range of motion and velocity of supported reaching, straightness of unsupported reaching, and functional movement ability. These improvements were not significantly different between the two training groups. The group that performed unassisted reaching exercise improved the smoothness of their reaching movements more than the robot-assisted group. Conclusion Improvements with both forms of exercise confirmed that repeated, task-related voluntary activation of the damaged motor system is a key stimulus to motor recovery following chronic stroke. Robotically assisting in reaching successfully improved arm movement ability, although it did not provide any detectable, additional value beyond the movement practice that occurred concurrently with it. The inability to detect any additional value of robot-assisted reaching

  10. Bobath Concept versus constraint-induced movement therapy to improve arm functional recovery in stroke patients: a randomized controlled trial.

    Science.gov (United States)

    Huseyinsinoglu, Burcu Ersoz; Ozdincler, Arzu Razak; Krespi, Yakup

    2012-08-01

    To compare the effects of the Bobath Concept and constraint-induced movement therapy on arm functional recovery among stroke patients with a high level of function on the affected side. A single-blinded, randomized controlled trial. Outpatient physiotherapy department of a stroke unit. A total of 24 patients were randomized to constraint-induced movement therapy or Bobath Concept group. The Bobath Concept group was treated for 1 hour whereas the constraint-induced movement therapy group received training for 3 hours per day during 10 consecutive weekdays. Main measures were the Motor Activity Log-28, the Wolf Motor Function Test, the Motor Evaluation Scale for Arm in Stroke Patients and the Functional Independence Measure. The two groups were found to be homogeneous based on demographic variables and baseline measurements. Significant improvements were seen after treatment only in the 'Amount of use' and 'Quality of movement' subscales of the Motor Activity Log-28 in the constraint-induced movement therapy group over the the Bobath Concept group (P = 0.003; P = 0.01 respectively). There were no significant differences in Wolf Motor Function Test 'Functional ability' (P = 0.137) and 'Performance time' (P = 0.922), Motor Evaluation Scale for Arm in Stroke Patients (P = 0.947) and Functional Independence Measure scores (P = 0.259) between the two intervention groups. Constraint-induced movement therapy and the Bobath Concept have similar efficiencies in improving functional ability, speed and quality of movement in the paretic arm among stroke patients with a high level of function. Constraint-induced movement therapy seems to be slightly more efficient than the Bobath Concept in improving the amount and quality of affected arm use.

  11. No specific effect of whole-body vibration training in chronic stroke: a double-blind randomized controlled study.

    Science.gov (United States)

    Brogårdh, Christina; Flansbjer, Ulla-Britt; Lexell, Jan

    2012-02-01

    To evaluate the effects of whole-body vibration (WBV) training in individuals after stroke. A double-blind randomized controlled study with assessments pre- and posttraining. A university hospital rehabilitation department. Participants (N=31; mean age ± SD, 62±7 y; 6-101 mo poststroke) were randomized to an intervention group or a control group. Supervised WBV training (2 sessions/wk for 6wk; 12 repetitions of 40-60s WBV per session). The intervention group trained on a vibrating platform with a conventional amplitude (3.75 mm) and the control group on a "placebo" vibrating platform (0.2mm amplitude); the frequency was 25Hz on both platforms. All participants and examiners were blinded to the amplitudes of the 2 platforms. Primary outcome measures were isokinetic and isometric knee muscle strength (dynamometer). Secondary outcome measures were balance (Berg Balance Scale), muscle tone (Modified Ashworth Scale), gait performance (Timed Up & Go, comfortable gait speed, fast gait speed, and six-minute walk tests), and perceived participation (Stroke Impact Scale). There were no significant differences between the 2 groups after the WBV training. Significant but small improvements (Pnormative variation. Six weeks of WBV training on a vibration platform with conventional amplitude was not more efficient than a placebo vibrating platform. Therefore, the use of WBV training in individuals with chronic stroke and mild to moderate disability is not supported. Copyright © 2012 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  12. Hydrotherapy vs. conventional land-based exercise for improving walking and balance after stroke: a randomized controlled trial.

    Science.gov (United States)

    Zhu, Zhizhong; Cui, Liling; Yin, Miaomiao; Yu, Yang; Zhou, Xiaona; Wang, Hongtu; Yan, Hua

    2016-06-01

    To investigate the effects of hydrotherapy on walking ability and balance in patients with chronic stroke. Single-blind, randomized controlled pilot trial. Outpatient rehabilitation clinic at a tertiary neurological hospital in China. A total of 28 participants with impairments in walking and controlling balance more than six months post-stroke. After baseline evaluations, participants were randomly assigned to a land-based therapy (control group, n = 14) or hydrotherapy (study group, n = 14). Participants underwent individual sessions for four weeks, five days a week, for 45 minutes per session. After four weeks of rehabilitation, all participants were evaluated by a blinded assessor. Functional assessments included the Functional Reach Test, Berg Balance Scale, 2-minute walk test, and Timed Up and Go Test. After four weeks of treatment, the Berg Balance Scale, functional reach test, 2-minute walk test, and the Timed Up and Go Test scores had improved significantly in each group (P hydrotherapy exercise resulted in a large improvement in a small group (n = 14) of individuals with relatively high balance and walking function following a stroke. © The Author(s) 2015.

  13. Evaluation of self-reported ethnicity in a case-control population: the stroke prevention in young women study

    Directory of Open Access Journals (Sweden)

    Wozniak Marcella A

    2009-12-01

    Full Text Available Abstract Background Population-based association studies are used to identify common susceptibility variants for complex genetic traits. These studies are susceptible to confounding from unknown population substructure. Here we apply a model-based clustering approach to our case-control study of stroke among young women to examine if self-reported ethnicity can serve as a proxy for genetic ancestry. Findings A population-based case-control study of stroke among women aged 15-49 identified 361 cases of first ischemic stroke and 401 age-comparable control subjects. Thirty single nucleotide polymorphisms (SNPs throughout the genome unrelated to stroke risk and with established ancestry-based allele frequency differences were genotyped in all participants. The Structure program was used to iteratively evaluate for K = 1 to 5 potential genetic-based subpopulations. Evaluating the population as a whole, the Structure output plateaued at K = 2 clusters. 98% of self-reported Caucasians had an estimated probability ≥50% of belonging to Cluster 1, while 94% of self-reported African-Americans had an estimated probability ≥50% of belonging to Cluster 2. Stratifying the participants by self-reported ethnicity and repeating the analyses revealed the presence of two clusters among Caucasians, suggesting that potential substructure may exist. Conclusions Among our combined sample of African-American and Caucasian participants there is no large unknown subpopulation and self-reported ethnicity can serve as a proxy for genetic ancestry. Ethnicity-specific analyses indicate that population substructure may exist among the Caucasian participants indicating that further studies are warranted.

  14. 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" (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.

  15. Efficacy of a Virtual Reality Commercial Gaming Device in Upper Limb Recovery after Stroke: A Randomized, Controlled Study.

    Science.gov (United States)

    Kong, Keng-He; Loh, Yong-Joo; Thia, Ernest; Chai, Audrey; Ng, Chwee-Yin; Soh, Yan-Ming; Toh, Shirlene; Tjan, Soon-Yin

    2016-10-01

    To compare the efficacy of a virtual reality commercial gaming device, Nintendo wii (NW) with conventional therapy and customary care in facilitating upper limb recovery after stroke. Randomized, controlled, single-blinded study. Tertiary rehabilitation center. 105 subjects admitted to in inpatient rehabilitation program within 6 weeks of stroke onset. Subjects were randomly assigned to one of three groups of upper limb exercises: (1) NW gaming; (2) conventional therapy; (3) control. NW gaming and conventional therapy were provided fourtimes a week for 3 weeks. The main outcome measure was Fugl-Meyer assessment (FMA) of upper limb function. Secondary outcome measures included Action Research Arm Test, Functional Independence Measure, and Stroke Impact Scale. These measures were assessed at baseline, completion of intervention (week 3) and at 4 weeks and 8 weeks after completion of intervention. The primary outcome measure was the change in FMA scores at completion of intervention. The mean age was 57.5±9.8 years, and subjects were enrolled at a mean of 13.7±8.9 days after stroke. The mean baseline FMA score was 16.4±14.2. There was no difference in FMA scores between all 3 groups at the end of intervention, and at 4 and 8 weeks after completion of intervention. Similar findings were also noted for the secondary outcome measures. Twelve sessions of augmented upper limb exercises via NW gaming or conventional therapy over a 3-week period was not effective in enhancing upper limb motor recovery compared to control.

  16. Preventing stroke

    Science.gov (United States)

    ... A.M. Editorial team. Related MedlinePlus Health Topics Hemorrhagic Stroke Ischemic Stroke Stroke Browse the Encyclopedia A.D. ... any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should ...

  17. Stroke Rehabilitation

    Science.gov (United States)

    A stroke can cause lasting brain damage. People who survive a stroke need to relearn skills they lost because of ... them relearn those skills. The effects of a stroke depend on which area of the brain was ...

  18. Differences in blood pressure control and stroke mortality across Spain: the Prevención de Riesgo de Ictus (PREV-ICTUS) study.

    Science.gov (United States)

    Redón, Josep; Cea-Calvo, Luis; Lozano, José V; Martí-Canales, Juan C; Llisterri, José L; Aznar, Jose; González-Esteban, Jorge

    2007-04-01

    The objective was to assess the stroke risk and prevalence of the cardiovascular risk factors and to analyze their relationship with the specific stroke rates of mortality in each of the autonomic communities of Spain. We conducted a multicenter, cross-sectional study of population >60 years old in Spanish primary care centers. In all of the subjects, clinical, biochemical, and electrocardiographic data were obtained, and the 10-year stroke risk was calculated using the Framingham score. Mortality rates of stroke, age and sex adjusted, were obtained for each of the autonomic communities from the Ministry of Health. A total of 7343 subjects (mean age: 71.6 years, 53.4% women, 34.4% obese, and 27.1% diabetic subjects) were analyzed. A total of 73% were already diagnosed with hypertension. Among hypertensive subjects, 29.1% had blood pressure on therapeutic objective, and, of the total population, 35.7% had blood pressure under control. ECG-left ventricular hypertrophy was present in 12.9% of the subjects. The estimated stroke risk was 19.6%. Stroke mortality rates were significantly related to the estimated 10-year stroke risk (r=0.41; P<0.05) in each autonomic community. Poor hypertension control (P=-0.42; P<0.05) and prevalence of ECG-left ventricular hypertrophy (P=0.52; P<0.05) were the main factors related to the stroke mortality rates after controlling by age, sex, obesity, diabetes, and urban setting. Differences in stroke mortality throughout the autonomic communities of Spain were associated with indexes of worse blood pressure handling, low control rates, and high left-ventricular hypertrophy.

  19. Rehabilitation effect of trunk control training under suspension on motor function of stroke patients in sequela period

    Directory of Open Access Journals (Sweden)

    Xiao-hua YAN

    2017-07-01

    Full Text Available Objective To study the effect of two trunk control trainings on motor function recovery of stroke patients in sequela period.  Methods A total of 42 patients were randomly divided into control group (N = 21 and observation group (N = 21. The control group was treated by traditional trunk control training, and the observation group was treated by trunk control training using suspension technology. Both groups all received other conventional rehabilitation treatment. All patients received Trunk Control Test (TCT, Functional Ambulation Category Scale (FAC, Berg Balance Scale (BBS and 10 m Maximum Walking Speed (10 m MWS before and 20 d after treatment.  Results After two courses of treatment, the scores of TCT (P = 0.000, FAC (P = 0.000, BBS (P = 0.000 and 10 m MWS (P = 0.000 were significantly improved in both groups. The scores of TCT (P = 0.000, FAC (P = 0.002, BBS (P = 0.000 and 10 m MWS (P = 0.000 after treatment in observation group were all significantly higher than those in control group.  Conclusions The method of trunk control training under suspension can effectively improve the motor function of stroke patients in sequela period. DOI: 10.3969/j.issn.1672-6731.2017.04.006

  20. Centrifugal pumps

    CERN Document Server

    Gülich, Johann Friedrich

    2014-01-01

    This book gives an unparalleled, up-to-date, in-depth treatment of all kinds of flow phenomena encountered in centrifugal pumps including the complex interactions of fluid flow with vibrations and wear of materials. The scope includes all aspects of hydraulic design, 3D-flow phenomena and partload operation, cavitation, numerical flow calculations, hydraulic forces, pressure pulsations, noise, pump vibrations (notably bearing housing vibration diagnostics and remedies), pipe vibrations, pump characteristics and pump operation, design of intake structures, the effects of highly viscous flows, pumping of gas-liquid mixtures, hydraulic transport of solids, fatigue damage to impellers or diffusers, material selection under the aspects of fatigue, corrosion, erosion-corrosion or hydro-abrasive wear, pump selection, and hydraulic quality criteria. As a novelty, the 3rd ed. brings a fully analytical design method for radial impellers, which eliminates the arbitrary choices inherent to former design procedures. The d...

  1. Clinical Characteristics, Risk Factors, and Outcomes Associated With Neonatal Hemorrhagic Stroke: A Population-Based Case-Control Study.

    Science.gov (United States)

    Cole, Lauran; Dewey, Deborah; Letourneau, Nicole; Kaplan, Bonnie J; Chaput, Kathleen; Gallagher, Clare; Hodge, Jacquie; Floer, Amalia; Kirton, Adam

    2017-03-01

    Hemorrhage into the brain of term newborns often results in major injury and lifelong disability. The clinical epidemiology of neonatal hemorrhagic stroke (NHS) remains undefined, hindering the development of strategies to improve outcomes. To characterize the incidence, types, presentations, associated factors, and outcomes of neonatal hemorrhagic stroke. Population-based, nested case-control study. The Alberta Perinatal Stroke Project, a provincial registry, ascertained NHS cases using exhaustive diagnostic code searching (1992-2010, >2500 medical record reviews). Prospective cases were captured through the Calgary Pediatric Stroke Program (2007-2014). Participants included term neonates with magnetic resonance imaging-confirmed NHS including primary and secondary intracerebral hemorrhage, hemorrhagic transformation of ischemic injury, and presumed perinatal hemorrhagic stroke. Control infants with common data were recruited from a population-based study (4 to 1 ratio). Infants with NHS underwent structured medical record review using data-capture forms and blinded scoring of neuroimaging. Clinical risk factor common data elements were explored using logistic regression. Provincial live births were obtained from Statistics Canada. Outcomes were extrapolated to the Pediatric Stroke Outcome Measure. We identified 86 cases: 51 infants (59%) with NHS, of which 32 (67%) were idiopathic, 30 (35%) were hemorrhagic transformation of primary ischemic injuries (14 with neonatal cerebral sinovenous thrombosis, 11 with hypoxic ischemic encephalopathy, and 5 with neonatal arterial ischemic stroke), and 5 were presumed perinatal hemorrhagic stroke. Sixty-two percent were male. Incidence of pure NHS was 1 in 9500 live births and 1 in 6300 for all forms. Most presented in the first week of life with seizures and encephalopathy. Acute neurosurgical intervention was rare (3 of 86 total cases; 3.5%). Temporal lobe was the most common NHS location (16 of 51 pure NHS cases; 31%). A

  2. Improvement in balance using a virtual reality-based stepping exercise: a randomized controlled trial involving individuals with chronic stroke.

    Science.gov (United States)

    Lloréns, Roberto; Gil-Gómez, José-Antonio; Alcañiz, Mariano; Colomer, Carolina; Noé, Enrique

    2015-03-01

    To study the clinical effectiveness and the usability of a virtual reality-based intervention compared with conventional physical therapy in the balance recovery of individuals with chronic stroke. Randomized controlled trial. Outpatient neurorehabilitation unit. A total of 20 individuals with chronic stroke. The intervention consisted of 20 one-hour sessions, five sessions per week. The experimental group combined 30 minutes with the virtual reality-based intervention with 30 minutes of conventional training. The control group underwent one hour conventional therapy. Balance performance was assessed at the beginning and at the end of the trial using the Berg Balance Scale, the balance and gait subscales of the Tinetti Performance-Oriented Mobility Assessment, the Brunel Balance Assessment, and the 10-m Walking Test. Subjective data of the virtual reality-based intervention were collected from the experimental group, with a feedback questionnaire at the end of the trial. The results revealed a significant group-by-time interaction in the scores of the Berg Balance Scale (p Virtual reality interventions can be an effective resource to enhance the improvement of balance in individuals with chronic stroke. © The Author(s) 2014.

  3. EMG and kinematic analysis of sensorimotor control for patients after stroke using cyclic voluntary movement with visual feedback

    Directory of Open Access Journals (Sweden)

    Song Rong

    2013-02-01

    Full Text Available Abstract Background Clinical scales are often used to evaluate upper-limb deficits. The objective of this study is to investigate the parameters during voluntary arm tracking at different velocities for evaluating motor control performance after stroke. Methods Eight hemiplegic chronic stroke subjects were recruited to perform voluntary movements of elbow flexion and extension by following sinusoidal trajectories from 30 deg to 90 deg at six velocities in the horizontal plane by completing 3, 6, 8, 12, 15, 18 flexion and extension cycles in 36 seconds in a single trial, and the peak velocities ranged from 15.7 to 94.2 deg/s. The actual elbow angle and the target position were displayed as real-time visual feedback. The angular displacement of the arm and electromyographic (EMG signals of biceps and triceps were captured to evaluate the sensorimotor control of the affected and unaffected side. Results The results showed significant differences in the root mean square error (RMSE, response delay (RD and cocontraction index (CI when the affected and unaffected sides were compared during the arm tracking experiment (P Conclusions The method and parameters have potential for clinical use in quantitatively evaluating the sensorimotor deficiencies for patients after stroke about the accuracy of motion, response delay and cocontraction between muscle pairs.

  4. Hydrodynamic Effects on Modeling and Control of a High Temperature Active Magnetic Bearing Pump with a Canned Rotor

    Energy Technology Data Exchange (ETDEWEB)

    Melin, Alexander M [ORNL; Kisner, Roger A [ORNL; Fugate, David L [ORNL; Holcomb, David Eugene [ORNL

    2015-01-01

    Embedding instrumentation and control Embedding instrumentation and control (I\\&C) at the component level in nuclear power plants can improve component performance, lifetime, and resilience by optimizing operation, reducing the constraints on physical design, and providing on-board prognostics and diagnostics. However, the extreme environments that many nuclear power plant components operate in makes embedding instrumentation and control at the component level difficult. Successfully utilizing embedded I\\&C requires developing a deep understanding of the system's dynamics and using that knowledge to overcome material and physical limitations imposed by the environment. In this paper, we will develop a coupled dynamic model of a high temperature (700 $^\\circ$C) canned rotor pump that incorporates rotordynamics, hydrodynamics, and active magnetic bearing dynamics. Then we will compare two control design methods, one that uses a simplified decoupled model of the system and another that utilizes the full coupled system model. It will be seen that utilizing all the available knowledge of the system dynamics in the controller design yield an order of magnitude improvement in the magnitude of the magnetic bearing response to disturbances at the same level of control effort, a large reduction in the settling time of the system, and a smoother control action.

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

    Directory of Open Access Journals (Sweden)

    M. Schoone

    2011-01-01

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

  6. Examining interference of different cognitive tasks on voluntary balance control in aging and stroke.

    Science.gov (United States)

    Bhatt, Tanvi; Subramaniam, Savitha; Varghese, Rini

    2016-09-01

    This study compared the effect of semantic and working memory tasks when each was concurrently performed with a voluntary balance task to evaluate the differences in the resulting cognitive-motor interference (CMI) between healthy aging and aging with stroke. Older stroke survivors (n = 10), older healthy (n = 10) and young adults (n = 10) performed the limits of stability, balance test under single task (ST) and dual task (DT) with two different cognitive tasks, word list generation (WLG) and counting backwards (CB). Cognitive ability was evaluated by recording the number of words and digits counted while sitting (ST) and during balance tasks (DT). The balance and cognitive costs were computed using [(ST-DT)/ST] × 100 for all the variables. Across groups, the balance cost was significantly higher for the older stroke survivors group in the CB condition than older healthy (p aging and stroke impact both semantic and working memory. Stroke-related cognitive deficits may further significantly decrease working memory function.

  7. Experimental Research and Control Strategy of Pumped Storage Units Dispatching in the Taiwan Power System Considering Transmission Line Limits

    Directory of Open Access Journals (Sweden)

    Ming-Tse Kuo

    2013-07-01

    Full Text Available Taiwan’s power system is isolated and not supported by other interconnected systems. Consequently, the system frequency immediately reflects changes in the system loads. Pumped storage units are crucial for controlling power frequency. These units provide main or auxiliary capacities, reducing the allocation of frequency-regulating reserve (FRR and further reducing generation costs in system operations. Taiwan’s Longmen Nuclear Power Plant is set to be converted for commercial operations, which will significantly alter the spinning reserves in the power system. Thus, this study proposes a safe and economic pumped storage unit dispatch strategy. This strategy is used to determine the optimal FRR capacity and 1-min recovery frequency in a generator failure occurrence at the Longmen Power Plant. In addition, this study considered transmission capacity constraints and conducted power flow analysis of the power systems in Northern, Central, and Southern Taiwan. The results indicated that, in the event of a failure at Longmen Power Plant, the proposed strategy can not only recover the system frequency to an acceptable range to prevent underfrequency load-shedding, but can also mitigate transmission line overloading.

  8. Bichromatic coherent random lasing from dye-doped polymer stabilized blue phase liquid crystals controlled by pump light polarization

    Science.gov (United States)

    Wang, Lei; Wang, Meng; Yang, Mingchao; Shi, Li-Jie; Deng, Luogen; Yang, Huai

    2016-09-01

    In this paper, we investigate the bichromatic coherent random lasing actions from the dye-doped polymer stabilized blue phase liquid crystals. Two groups of lasing peaks, of which the full widith at half maximum is about 0.3 nm, are clearly observed. The shorter- and longer-wavelength modes are associated with the excitation of the single laser dye (DCM) monomers and dimers respectively. The experimental results show that the competition between the two groups of the lasing peaks can be controlled by varying the polarization of the pump light. When the polarization of the pump light is rotated from 0° to 90°, the intensity of the shorter-wavelength lasing peak group reduces while the intensity of the longer-wavelength lasing peak group increases. In addition, a red shift of the longer-wavelength modes is also observed and the physical mechanisms behind the red-shift phenomenon are discussed. Project supported by the National Natural Science Foundation of China (Grant Nos. 11474021 and 51333001), the Key Program for International S&T Cooperation Projects of China (Grant No. 2013DFB50340), the Issues of Priority Development Areas of the Research Fund for the Doctoral Program of Higher Education of China (Grant No. 20120001130005), and the Key (Key Grant) Project of Chinese Ministry of Education (Grant No. 313002).

  9. Integrated solar-assisted heat pumps for water heating coupled to gas burners; control criteria for dynamic operation

    International Nuclear Information System (INIS)

    Scarpa, F.; Tagliafico, L.A.; Tagliafico, G.

    2011-01-01

    A direct expansion integrated solar-assisted heat pump (ISAHP) is compared to a traditional flat plate solar panel for low temperature (45 deg. C) water heating applications. The (simulated) comparison is accomplished assuming both the devices are energy supplemented with an auxiliary standard gas burner, to provide the typical heat duty of a four-member family. Literature dynamical models of the systems involved have been used to calculate the main performance figures in a context of actual climatic conditions and typical stochastic user demand. The paper highlights new heat pump control concepts, needed when maximum energy savings are the main goal of the apparatus for given user demand. Simulations confirm the high collector efficiency of the ISAHP when its panel/evaporator works at temperature close to the ambient one. The device, with respect to a flat plate solar water heater, shows a doubled performance, so that it can do the same task just using an unglazed panel with roughly half of the surface.

  10. Home-based intravenous analgesia with elastomeric pump as an outpatient procedure for pain control after anterior cruciate ligament repair.

    Science.gov (United States)

    Villalba, J; Peñalver, J; Torner, P; Serra, M; Planell, J

    To follow up pain in the immediate postoperative period, using an elastomeric pump in anterior cruciate ligament surgery. 309 patients who had undergone anterior cruciate ligament repair with bone-tendon-bone allograft. Pain control was assessed with a visual analogue scale (VAS) during the immediate postoperative period, in the postoperative care unit, in the recovery room, and after the first 24-48-72hours following home discharge. The need for rescue medication, adverse effects observed and emergency visits were also registered. 309 patients were assessed (264 males, 45 females), mean age 33 (range: 18 - 55). Postoperative pain was mild in 44.7% of patients, and 38.5% were pain-free. At discharge, 41.1% of patients reported mild pain and 57% were pain-free. At home, mild to moderate levels of pain were maintained and over 97% of patients presented VAS values ≤ 3. Fewer than 3% had adverse effects, 8.7% had to use analgesic medication at some point. Pruritus occurred in less than 1% of patients receiving intravenous analgesia at home, and fewer than 2% had device-related complications. There is no consensus regarding the postoperative management of anterior cruciate ligament lesions, although most surgeons use multimode anaesthesia and different combinations of analgesics to reduce postoperative pain. The use of an intravenous elastomeric pump as postoperative analgesia for anterior cruciate ligamentoplasty has yielded good results. Copyright © 2017. Publicado por Elsevier España, S.L.U.

  11. Pumping life

    DEFF Research Database (Denmark)

    Sitsel, Oleg; Dach, Ingrid; Hoffmann, Robert Daniel

    2012-01-01

    The name PUMPKIN may suggest a research centre focused on American Halloween traditions or the investigation of the growth of vegetables – however this would be misleading. Researchers at PUMPKIN, short for Centre for Membrane Pumps in Cells and Disease, are in fact interested in a large family...... of membrane proteins: P-type ATPase pumps. This article takes the reader on a tour from Aarhus to Copenhagen, from bacteria to plants and humans, and from ions over protein structures to diseases caused by malfunctioning pump proteins. The magazine Nature once titled work published from PUMPKIN ‘Pumping ions...

  12. Virtual Reality to control active participation in a subacute stroke patient during robot-assisted gait training.

    Science.gov (United States)

    Bergmann, J; Krewer, C; Müller, F; Koenig, A; Riener, R

    2011-01-01

    Virtual Reality (VR) provides a promising medium to enrich robot assisted rehabilitation. VR applications present the opportunity to engage patients in therapy and control participation. The aim of this study was to investigate two strategies to control active participation of a stroke patient focusing on the involvement of the paretic leg in task solution. A subacute stroke patient with a severe hemiparesis performed two experiments on the driven gait orthosis Lokomat. Patient activity was quantified by weighted interaction torques measured in both legs (experiment A) and the paretic leg only (experiment B). The patient was able to successfully implement both the bilateral and unilateral control modality. Both control modes increased the motor output of the paretic leg, however the paretic leg control mode resulted in a much more differentiated regulation of the activity in the leg. Both control modes are appropriate approaches to enhance active participation and increase motor output in the paretic leg. Further research should evaluate the therapeutic benefit of patients with hemiparesis using the unilateral control mode depending on the severity of their impairment. © 2011 IEEE

  13. Clinical usefulness of the virtual reality-based postural control training on the gait ability in patients with stroke

    Science.gov (United States)

    Park, Yu-Hyung; Lee, Chi-ho; Lee, Byoung-Hee

    2013-01-01

    This study is a single blind randomized controlled trial to determine the effect of virtual reality-based postural control training on the gait ability in patients with chronic stroke. Sixteen subjects were randomly assigned to either experimental group (VR, n= 8) or control group (CPT, n= 8). Subjects in both groups received conventional physical therapy for 60 min per day, five days per week during a period of four weeks. Subjects in the VR group received additional augmented reality-based training for 30 min per day, three days per week during a period of four weeks. The subjects were evaluated one week before and after participating in a four week training and follow-up at one month post-training. Data derived from the gait analyses included spatiotemporal gait parameters, 10 meters walking test (10 mWT). In the gait parameters, subjects in the VR group showed significant improvement, except for cadence at post-training and follow-up within the experimental group. However, no obvious significant improvement was observed within the control group. In between group comparisons, the experimental group (VR group) showed significantly greater improvement only in stride length compared with the control group (Pvirtual reality based postural control training. These findings suggest that virtual reality (VR) postural control training using real-time information may be a useful approach for enhancement of gait ability in patients with chronic stroke. PMID:24282810

  14. Functional electrical stimulation mediated by iterative learning control and 3D robotics reduces motor impairment in chronic stroke

    Directory of Open Access Journals (Sweden)

    Meadmore Katie L

    2012-06-01

    Full Text Available Abstract Background Novel stroke rehabilitation techniques that employ electrical stimulation (ES and robotic technologies are effective in reducing upper limb impairments. ES is most effective when it is applied to support the patients’ voluntary effort; however, current systems fail to fully exploit this connection. This study builds on previous work using advanced ES controllers, and aims to investigate the feasibility of Stimulation Assistance through Iterative Learning (SAIL, a novel upper limb stroke rehabilitation system which utilises robotic support, ES, and voluntary effort. Methods Five hemiparetic, chronic stroke participants with impaired upper limb function attended 18, 1 hour intervention sessions. Participants completed virtual reality tracking tasks whereby they moved their impaired arm to follow a slowly moving sphere along a specified trajectory. To do this, the participants’ arm was supported by a robot. ES, mediated by advanced iterative learning control (ILC algorithms, was applied to the triceps and anterior deltoid muscles. Each movement was repeated 6 times and ILC adjusted the amount of stimulation applied on each trial to improve accuracy and maximise voluntary effort. Participants completed clinical assessments (Fugl-Meyer, Action Research Arm Test at baseline and post-intervention, as well as unassisted tracking tasks at the beginning and end of each intervention session. Data were analysed using t-tests and linear regression. Results From baseline to post-intervention, Fugl-Meyer scores improved, assisted and unassisted tracking performance improved, and the amount of ES required to assist tracking reduced. Conclusions The concept of minimising support from ES using ILC algorithms was demonstrated. The positive results are promising with respect to reducing upper limb impairments following stroke, however, a larger study is required to confirm this.

  15. Functional electrical stimulation mediated by iterative learning control and 3D robotics reduces motor impairment in chronic stroke.

    Science.gov (United States)

    Meadmore, Katie L; Hughes, Ann-Marie; Freeman, Chris T; Cai, Zhonglun; Tong, Daisy; Burridge, Jane H; Rogers, Eric

    2012-06-07

    Novel stroke rehabilitation techniques that employ electrical stimulation (ES) and robotic technologies are effective in reducing upper limb impairments. ES is most effective when it is applied to support the patients' voluntary effort; however, current systems fail to fully exploit this connection. This study builds on previous work using advanced ES controllers, and aims to investigate the feasibility of Stimulation Assistance through Iterative Learning (SAIL), a novel upper limb stroke rehabilitation system which utilises robotic support, ES, and voluntary effort. Five hemiparetic, chronic stroke participants with impaired upper limb function attended 18, 1 hour intervention sessions. Participants completed virtual reality tracking tasks whereby they moved their impaired arm to follow a slowly moving sphere along a specified trajectory. To do this, the participants' arm was supported by a robot. ES, mediated by advanced iterative learning control (ILC) algorithms, was applied to the triceps and anterior deltoid muscles. Each movement was repeated 6 times and ILC adjusted the amount of stimulation applied on each trial to improve accuracy and maximise voluntary effort. Participants completed clinical assessments (Fugl-Meyer, Action Research Arm Test) at baseline and post-intervention, as well as unassisted tracking tasks at the beginning and end of each intervention session. Data were analysed using t-tests and linear regression. From baseline to post-intervention, Fugl-Meyer scores improved, assisted and unassisted tracking performance improved, and the amount of ES required to assist tracking reduced. The concept of minimising support from ES using ILC algorithms was demonstrated. The positive results are promising with respect to reducing upper limb impairments following stroke, however, a larger study is required to confirm this.

  16. Effects of Mirror Therapy in Stroke Patients With Complex Regional Pain Syndrome Type 1: A Randomized Controlled Study.

    Science.gov (United States)

    Pervane Vural, Secil; Nakipoglu Yuzer, Guldal Funda; Sezgin Ozcan, Didem; Demir Ozbudak, Sibel; Ozgirgin, Nese

    2016-04-01

    To investigate the effects of mirror therapy on upper limb motor functions, spasticity, and pain intensity in patients with hemiplegia accompanied by complex regional pain syndrome type 1. Randomized controlled trial. Training and research hospital. Adult patients with first-time stroke and simultaneous complex regional pain syndrome type 1 of the upper extremity at the dystrophic stage (N=30). Both groups received a patient-specific conventional stroke rehabilitation program for 4 weeks, 5 d/wk, for 2 to 4 h/d. The mirror therapy group received an additional mirror therapy program for 30 min/d. We evaluated the scores of the Brunnstrom recovery stages of the arm and hand for motor recovery, wrist and hand subsections of the Fugl-Meyer Assessment (FMA) and motor items of the FIM-motor for functional status, Modified Ashworth Scale (MAS) for spasticity, and visual analog scale (VAS) for pain severity. After 4 weeks of rehabilitation, both groups had significant improvements in the FIM-motor and VAS scores compared with baseline scores. However, the scores improved more in the mirror therapy group than the control group (P<.001 and P=.03, respectively). Besides, the patients in the mirror therapy arm showed significant improvement in the Brunnstrom recovery stages and FMA scores (P<.05). No significant difference was found for MAS scores. In patients with stroke and simultaneous complex regional pain syndrome type 1, addition of mirror therapy to a conventional stroke rehabilitation program provides more improvement in motor functions of the upper limb and pain perception than conventional therapy without mirror therapy. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  17. Study to assess the effectiveness of modified constraint-induced movement therapy in stroke subjects: A randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Priyanka Singh

    2013-01-01

    Full Text Available Background and Purpose: The purpose of this study was to assess the effectiveness of modified constraint induced movement therapy (m-CIMT in stroke subjects. Materials and Methods: A total of forty sub-acute stroke subjects were randomly assigned to either a m-CIMT (n = 20 or in a control group (n = 20. The m-CIMT group (14 men, 6 women; mean age = 55.2 years consisted of structured 2 h therapy sessions emphasizing affected arm use, occurring 5 times/week for 2 weeks. A mitt was used to restrain the unaffected arm for 10 h/day for 2 week. The control group (11 men, 9 women; mean age = 56.4 years consisted of conventional rehabilitation for time-matched exercise program. The outcome measures were evaluated at pre- and post-intervention by using the Wolf Motor Function Test (WMFT and Fugl-Meyer assessment (FMA of motor recovery after stroke. Results: After intervention significant effects were observed in m-CIMT group on WMFT (pre-test and post-test score was 28.04 ± 6.58, 13.59 ± 2.86; P =0.003. Similarly on FMA (pre- and post-test score was 31.15 ± 6.37, 55.7 ± 6.4; P = 0.00. Conclusion: There is a significant improvem ent in upper extremity function so it indicates that m-CIMT is effective in improving the motor function of the affected arm in stroke subjects. However, its long-term effect has not proved since there was no follow-up after intervention.

  18. Relationship between Factor V Leiden Gene Variant and Risk of Ischemic Stroke: A Case-Control Study.

    Science.gov (United States)

    Kumar, Amit; Misra, Shubham; Sagar, Ram; Kumar, Pradeep; Yadav, Arun K; Talwar, Pumanshi; Raj, Ritesh; Prasad, Kameshwar

    2017-01-01

    Factor V Leiden is the most common genetic variation among the blood coagulation pathway which leads to prothrombotic state, therefore, is considered an important gene for understating the stroke mechanism. The aim of the present study is to determine the relationship between single nucleotide polymorphism at G1691A position of Factor V gene and risk of ischemic stroke (IS) in North Indian population. In a retrospective case-control study, 250 patients with IS and 250 age- and gender-matched controls were enrolled in the period of October 2012 to September 2014 from in- and out-patient department of Neurology, All India Institute of Medical Sciences, New Delhi, India. Deoxyribonucleic acid for each case and control was isolated from peripheral blood using phenol-chloroform extraction method. Polymerase chain reaction-restriction fragment length polymorphism method was used to determine the polymorphism. Data were analyzed using STATA Software Version 13. The mean age of IS patient was 52.8 ± 12.5 years and in control group was 50.97 ± 12.7 years. Genotypic frequency distributions were in accordance with Hardy-Weinberg equilibrium in both cases and controls. As expected hypertension, diabetes, dyslipidemia, smoking, heavy alcohol intake, family history of stroke, and poor economic status were significantly associated with the risk of IS. Multivariate analysis revealed 5.17 times higher odds for developing the risk of large vessel subtype of IS in patients carrying Factor V Leiden G1691A gene variation as compared to control subjects (OR, 5.17; 95% CI, 1.32-20.3, P = 0.01). The present study suggests that Factor V Leiden G1691A polymorphism may be significantly associated with the risk of large vessel subtype of IS. Large sample size studies using prospective cohort designs are required to corroborate the present findings.

  19. Relationship between Factor V Leiden Gene Variant and Risk of Ischemic Stroke: A Case–Control Study

    Science.gov (United States)

    Kumar, Amit; Misra, Shubham; Sagar, Ram; Kumar, Pradeep; Yadav, Arun K; Talwar, Pumanshi; Raj, Ritesh; Prasad, Kameshwar

    2017-01-01

    Background: Factor V Leiden is the most common genetic variation among the blood coagulation pathway which leads to prothrombotic state, therefore, is considered an important gene for understating the stroke mechanism. Aim: The aim of the present study is to determine the relationship between single nucleotide polymorphism at G1691A position of Factor V gene and risk of ischemic stroke (IS) in North Indian population. Materials and Methods: In a retrospective case–control study, 250 patients with IS and 250 age- and gender-matched controls were enrolled in the period of October 2012 to September 2014 from in- and out-patient department of Neurology, All India Institute of Medical Sciences, New Delhi, India. Deoxyribonucleic acid for each case and control was isolated from peripheral blood using phenol-chloroform extraction method. Polymerase chain reaction-restriction fragment length polymorphism method was used to determine the polymorphism. Data were analyzed using STATA Software Version 13. Results: The mean age of IS patient was 52.8 ± 12.5 years and in control group was 50.97 ± 12.7 years. Genotypic frequency distributions were in accordance with Hardy–Weinberg equilibrium in both cases and controls. As expected hypertension, diabetes, dyslipidemia, smoking, heavy alcohol intake, family history of stroke, and poor economic status were significantly associated with the risk of IS. Multivariate analysis revealed 5.17 times higher odds for developing the risk of large vessel subtype of IS in patients carrying Factor V Leiden G1691A gene variation as compared to control subjects (OR, 5.17; 95% CI, 1.32–20.3, P = 0.01). Conclusion: The present study suggests that Factor V Leiden G1691A polymorphism may be significantly associated with the risk of large vessel subtype of IS. Large sample size studies using prospective cohort designs are required to corroborate the present findings. PMID:28904463

  20. The home stroke rehabilitation and monitoring system trial: a randomized controlled trial

    Science.gov (United States)

    Linder, Susan M.; Rosenfeldt, Anson B.; Reiss, Aimee; Buchanan, Sharon; Sahu, Komal; Bay, Curtis R.; Wolf, Steven L.; Alberts, Jay L.

    2015-01-01

    Rationale Because many individuals post-stroke lack access to the quality and intensity of rehabilitation to improve upper extremity (UE) motor function, a home-based robotic-assisted UE rehabilitation device is being paired with an individualized home exercise program (HEP). Aims/Hypothesis The primary aim of this project is to determine the effectiveness of robotic-assisted home therapy compared to a home exercise program on UE motor recovery and health-related quality of life for stroke survivors in rural and underserved locations. The secondary aim is to explore whether initial degree of motor function of the upper limb may be a factor in predicting the extent to which patients with stroke may be responsive to a home therapy approach. The HEP intervention, when enhanced with robotic-assisted therapy will result in significantly better outcomes in motor function and quality of life. Design A total of 96 participants within six months of a single, unilateral ischemic or hemorrhagic stroke will be recruited in this prospective, single-blind, multi-site randomized clinical trial. Study Outcomes The primary outcome is the change in UE function using the Action Research Arm Test. Secondary outcomes include changes in: UE function (Wolf Motor Function Test), UE impairment (UE portion of the Fugl-Meyer Test), self-reported quality of life (Stroke Impact Scale), and affect (Centers for Epidemiologic Studies Depression Scale). Discussion Similar or greater improvements in UE function using the combined robotic-HEP intervention compared to HEP alone will be interpreted as evidence that supports the introduction of in-home technology to augment the recovery of function post-stroke. PMID:23280269

  1. Numerical study on the selective excitation of Helmholtz-Gauss beams in end-pumped solid-state digital lasers with the control of the laser gain transverse position provided by off-axis end pumping

    Science.gov (United States)

    Tsai, Ko-Fan; Chu, Shu-Chun

    2018-03-01

    This study proposes a complete and unified method for selective excitation of any specified nearly nondiffracting Helmholtz-Gauss (HzG) beam in end-pumped solid-state digital lasers. Four types of the HzG beams: cosine-Gauss beams, Bessel-Gauss beams, Mathieu-Gauss beams, and, in particular, parabolic-Gauss beams are successfully demonstrated to be generated with the proposed methods. To the best of the authors’ knowledge, parabolic-Gauss beams have not yet been directly generated from any kind of laser system. The numerical results of this study show that one can successfully achieve any lasing HzG beams directly from the solid-state digital lasers with only added control of the laser gain transverse position provided by off-axis end pumping. This study also presents a practical digital laser set-up for easily manipulating off-axis pumping in order to achieve the control of the laser gain transverse gain position in digital lasers. The reported results in this study provide advancement of digital lasers in dynamically generating nondiffracting beams. The control of the digital laser cavity gain position creates the possibility of achieving real-time selection of more laser modes in digital lasers, and it is worth further investigation in the future.

  2. Adaptive Hierarchical Control for the Muscle Strength Training of Stroke Survivors in Robot-Aided Upper-Limb Rehabilitation

    Directory of Open Access Journals (Sweden)

    Guozheng Xu

    2012-10-01

    Full Text Available Muscle strength training for stroke patients is of vital importance for helping survivors to progressively restore muscle strength and improve the performance of their activities in daily living (ADL. An adaptive hierarchical therapy control framework which integrates the patient's real biomechanical state estimation with task-performance quantitative evaluation is proposed. Firstly, a high-level progressive resistive supervisory controller is designed to determine the resistive force base for each training session based on the patient's online task-performance evaluation. Then, a low-level adaptive resistive force triggered controller is presented to further regulate the interactive resistive force corresponding to the patient's real-time biomechanical state – characterized by the patient's bio-damping and bio-stiffness in the course of one training session, so that the patient is challenged in a moderate but engaging and motivating way. Finally, a therapeutic robot system using a Barrett WAM™ compliant manipulator is set up. We recruited eighteen inpatient and outpatient stroke participants who were randomly allocated in experimental (robot-aided and control (conventional physical therapy groups and enrolled for sixteen weeks of progressive resistance training. The preliminary results show that the proposed therapy control strategies can enhance the recovery of strength and motor control ability.

  3. Operation control of fluids pumping in curved pipes during annular flow: a numerical evaluation

    Directory of Open Access Journals (Sweden)

    T Andrade

    2016-10-01

    Full Text Available To generate projects which provide significant volume recovery from heavy oils reservoirs and improve existing projects, is important to develop new production and transport technologies, especially in the scenario of offshore fields. The core-flow technique is one of new technologies used in heavy oil transportation. This core-flow pattern is characterized by a water pellicle that is formed close or adjacent to the inner wall of the pipe, functioning as a lubricant. The oil flows in the center of the pipe causing a reduction in longitudinal pressure drop. In this sense, this work presents a numerical study of heavy oil annular flow (core-flow assisted by computational tool ANSYS CFX® Release 12.0. It was used a three-dimensional, transient and isothermal mathematical model considered by the mixture and turbulence - models to address the wate