Kumble, Sowmya; Zink, Elizabeth K; Burch, Mackenzie; Deluzio, Sandra; Stevens, Robert D; Bahouth, Mona N
2017-08-01
Recent trials have challenged the notion that very early mobility benefits patients with acute stroke. It is unclear how cerebral autoregulatory impairments, prevalent in this population, could be affected by mobilization. The safety of mobilizing patients who have external ventricular drainage (EVD) devices for cerebrospinal fluid diversion and intracranial pressure (ICP) monitoring is another concern due to risk of device dislodgment and potential elevation in ICP. We report hemodynamic and ICP responses during progressive, device-assisted mobility interventions performed in a critically ill patient with intracerebral hemorrhage (ICH) requiring two EVDs. A 55-year-old man was admitted to the Neuroscience Critical Care Unit with an acute thalamic ICH and complex intraventricular hemorrhage requiring placement of two EVDs. Progressive mobilization was achieved using mobility technology devices. Range of motion exercises were performed initially, progressing to supine cycle ergometry followed by incremental verticalization using a tilt table. Physiological parameters were recorded before and after the interventions. All mobility interventions were completed without any adverse event or clinically detectable change in the patient's neurological state. Physiological parameters including hemodynamic variables and ICP remained within prescribed goals throughout. Progressive, device-assisted early mobilization was feasible and safe in this critically ill patient with hemorrhagic stroke when titrated by an interdisciplinary team of skilled healthcare professionals. Studies are needed to gain insight into the hemodynamic and neurophysiological responses associated with early mobility in acute stroke to identify subsets of patients who are most likely to benefit from this intervention.
Roberson, Audrey R; Starkweather, Angela; Grossman, Catherine; Acevedo, Edmund; Salyer, Jeanne
Muscle strength may be one indicator of readiness to mobilize that can be used to guide decisions regarding early mobility efforts and to progressively advance mobilization. To provide a synthesis of current measures of muscle strength in the assessment of early mobilization in critically ill adult patients who are receiving MV therapy. Research studies conducted between 2000-2015 were identified using PubMed, CINHAL, MEDLINE, and the Cochrane Database of Systematic Reviews databases using the search terms "muscle strength", "intensive care", "mechanical ventilation" and "muscle weakness". Nine articles used manual muscle testing, the Medical Research Council scale and/or hand-held dynamometer to provide objective measures for assessing muscle strength in the critically ill adult patient population. Further research is needed to examine the application of standardized measures of muscle strength for guiding decisions regarding early and progressive advancement of mobility goals in adult ICU patients on MV. Copyright © 2017 Elsevier Inc. All rights reserved.
Early mobilization in the critical care unit: A review of adult and pediatric literature.
Cameron, Saoirse; Ball, Ian; Cepinskas, Gediminas; Choong, Karen; Doherty, Timothy J; Ellis, Christopher G; Martin, Claudio M; Mele, Tina S; Sharpe, Michael; Shoemaker, J Kevin; Fraser, Douglas D
2015-08-01
Early mobilization of critically ill patients is beneficial, suggesting that it should be incorporated into daily clinical practice. Early passive, active, and combined progressive mobilizations can be safely initiated in intensive care units (ICUs). Adult patients receiving early mobilization have fewer ventilator-dependent days, shorter ICU and hospital stays, and better functional outcomes. Pediatric ICU data are limited, but recent studies also suggest that early mobilization is achievable without increasing patient risk. In this review, we provide a current and comprehensive appraisal of ICU mobilization techniques in both adult and pediatric critically ill patients. Contraindications and perceived barriers to early mobilization, including cost and health care provider views, are identified. Methods of overcoming barriers to early mobilization and enhancing sustainability of mobilization programs are discussed. Optimization of patient outcomes will require further studies on mobilization timing and intensity, particularly within specific ICU populations. Copyright © 2015 Elsevier Inc. All rights reserved.
The Social Mobility Index: Further Information
ERIC Educational Resources Information Center
Sutton Trust, 2015
2015-01-01
The "Social Mobility Index" ranks all 533 parliamentary constituencies in England according to five measures of social mobility through education: (1) Performance of disadvantaged pupils in early years test; (2) Performance of disadvantaged pupils in Key Stage 2 tests; (3) Performance of disadvantaged pupils at GCSE; (4) Progress of…
The Relationship between School Mobility and the Acquisition of Early Literacy Skills
ERIC Educational Resources Information Center
Franco, Amy C.
2013-01-01
The relationship between frequent mobility and student achievement is complex. While studies have shown that frequent mobility may have a detrimental effect on student achievement, the suggestion that poverty is an underlying cause for poor academic progress has been proposed (Buerkle & Christenson, 1999; United States GAO Report, 2010). The…
Pupil Mobility, Attainment, and Progress during Key Stage 1: A Study in Cautious Interpretation.
ERIC Educational Resources Information Center
Strand, Steve
2002-01-01
Explores association between pupil mobility and attainment in national end of Key Stage 1 tests for 6000+ pupils in an English urban education authority. Indicates pupil mobility during the early years is associated with significantly lower levels of pupil attainment in reading, writing, and mathematics tests at age seven. (BT)
Bahouth, Mona N; Power, Melinda C; Zink, Elizabeth K; Kozeniewski, Kate; Kumble, Sowmya; Deluzio, Sandra; Urrutia, Victor C; Stevens, Robert D
2018-06-01
To measure the impact of a progressive mobility program on patients admitted to a neurocritical critical care unit (NCCU) with intracerebral hemorrhage (ICH). The early mobilization of critically ill patients with spontaneous ICH is a challenge owing to the potential for neurologic deterioration and hemodynamic lability in the acute phase of injury. Patients admitted to the intensive care unit have been excluded from randomized trials of early mobilization after stroke. An interdisciplinary working group developed a formalized NCCU Mobility Algorithm that allocates patients to incremental passive or active mobilization pathways on the basis of level of consciousness and motor function. In a quasi-experimental consecutive group comparison, patients with ICH admitted to the NCCU were analyzed in two 6-month epochs, before and after rollout of the algorithm. Mobilization and safety endpoints were compared between epochs. NCCU in an urban, academic hospital. Adult patients admitted to the NCCU with primary intracerebral hemorrhage. Progressive mobilization after stroke using a formalized mobility algorithm. Time to first mobilization. The 2 groups of patients with ICH (pre-algorithm rolllout, n=28; post-algorithm rollout, n=29) were similar on baseline characteristics. Patients in the postintervention group were significantly more likely to undergo mobilization within the first 7 days after admission (odds ratio 8.7, 95% confidence interval 2.1, 36.6; P=.003). No neurologic deterioration, hypotension, falls, or line dislodgments were reported in association with mobilization. A nonsignificant difference in mortality was noted before and after rollout of the algorithm (4% vs 24%, respectively, P=.12). The implementation of a progressive mobility algorithm was safe and associated with a higher likelihood of mobilization in the first week after spontaneous ICH. Research is needed to investigate methods and the timing for the first mobilization in critically ill stroke patients. Copyright © 2018 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
Why Do Medial Unicompartmental Knee Arthroplasties Fail Today?
van der List, Jelle P; Zuiderbaan, Hendrik A; Pearle, Andrew D
2016-05-01
Failure rates are higher in medial unicompartmental knee arthroplasty (UKA) than total knee arthroplasty. To improve these failure rates, it is important to understand why medial UKA fail. Because individual studies lack power to show failure modes, a systematic review was performed to assess medial UKA failure modes. Furthermore, we compared cohort studies with registry-based studies, early with midterm and late failures and fixed-bearing with mobile-bearing implants. Databases of PubMed, EMBASE, and Cochrane and annual registries were searched for medial UKA failures. Studies were included when they reported >25 failures or when they reported early (<5 years), midterm (5-10 years), or late failures (>10 years). Thirty-seven cohort studies (4 level II studies and 33 level III studies) and 2 registry-based studies were included. A total of 3967 overall failures, 388 time-dependent failures, and 1305 implant design failures were identified. Aseptic loosening (36%) and osteoarthritis (OA) progression (20%) were the most common failure modes. Aseptic loosening (26%) was most common early failure mode, whereas OA progression was more commonly seen in midterm and late failures (38% and 40%, respectively). Polyethylene wear (12%) and instability (12%) were more common in fixed-bearing implants, whereas pain (14%) and bearing dislocation (11%) were more common in mobile-bearing implants. This level III systematic review identified aseptic loosening and OA progression as the major failure modes. Aseptic loosening was the main failure mode in early years and mobile-bearing implants, whereas OA progression caused most failures in late years and fixed-bearing implants. Copyright © 2016 Elsevier Inc. All rights reserved.
Goodwin, A M
1981-07-03
The Precambrian record is interpreted in terms of an evolutionary progression that moves in the direction of increasing continental stability. An early, highly mobile microplate tectonics phase progressed through a more stable, largely intracratonic, ensialic, mobile belt phase to the modern macroplate tectonics phase that involves large, rigid lithospheric plates. Various phases are characterized by distinctive crustal associations. Three controls-bulk earth heat production, crustal fractionation and cratonization, and atmospheric oxygen accumulation-are viewed as the cumulative cause of the trends and events that characterize the crust at different stages of development, from its inception approximately 4.6 billion years ago to the present.
Progress toward a full scale mobile satellite system for Canada
NASA Astrophysics Data System (ADS)
Roscoe, Orest S.
The MSAT satellite, planned for launch in early 1994, will provide full scale, satellite based, mobile voice and data communication services to Canada. The MSAT system will provide mobile telephone, mobile radio and mobile data services to customers on the move in any part of North America. The Telesat Mobile Inc. (TMI) satellite will be backed up by a similar satellite to be operated by the American Mobile Satellite Corporation (AMSC) in the United States. An early entry mobile data service was inaugurated in the second quarter of 1990 using channels leased from INMARSAT on Marisat or Marecs-B. The baseline TMI system is described, beginning with the MSAT satellite under contract. The network architecture and the control system that are under development to support the mobile services are discussed. Since it is clearly desirable to have a North American system, such that customers may buy a mobile earth terminal (MET) from a number of qualified suppliers and be able to use it either in Canada or the U.S., TMI and AMSC are cooperating closely in the development of the space and ground segments of the system. The time scale for the procurement of all the elements of the systems is discussed.
Drenth, Hans; Zuidema, Sytse U; Krijnen, Wim P; Bautmans, Ivan; van der Schans, Cees; Hobbelen, Hans
2017-09-01
People with Alzheimer's disease (AD) experience, in addition to the progressive loss of cognitive functions, a decline in functional performance such as mobility impairment and disability in activities of daily living (ADL). Functional decline in dementia is mainly linked to the progressive brain pathology. Peripheral biomechanical changes by advanced glycation end-products (AGEs) have been suggested but have yet to be thoroughly studied. A multi-center, longitudinal, one-year follow-up cohort study was conducted in 144 people with early stage AD or mixed Alzheimer's/Vascular dementia. Linear mixed model analyses was used to study associations between AGE-levels (AGE reader) and mobility (Timed Up and Go), and ADL (Groningen Activity Restriction Scale and Barthel index), respectively. A significant association between AGE levels and mobility (β = 3.57, 95%CI: 1.43-5.73) was revealed; however, no significant association between AGE levels and ADL was found. Over a one-year time span, mean AGE levels significantly increased, and mobility and ADL performance decreased. Change in AGE levels was not significantly correlated with change in mobility. This study indicates that high AGE levels could be a contributing factor to impaired mobility but lacks evidence for an association with ADL decline in people with early stage AD or mixed dementia. Future research is necessary on the reduction of functional decline in dementia regarding the effectiveness of interventions such as physical activity programs and dietary advice possibly in combination with pharmacologic strategies targeting AGE accumulation.
A mobility program for an inpatient acute care medical unit.
Wood, Winnie; Tschannen, Dana; Trotsky, Alyssa; Grunawalt, Julie; Adams, Danyell; Chang, Robert; Kendziora, Sandra; Diccion-MacDonald, Stephanie
2014-10-01
For many patients, hospitalization brings prolonged periods of bed rest, which are associated with such adverse health outcomes as increased length of stay, increased risk of falls, functional decline, and extended-care facility placement. Most studies of progressive or early mobility protocols designed to minimize these adverse effects have been geared toward specific patient populations and conducted by multidisciplinary teams in either ICUs or surgical units. Very few mobility programs have been developed for and implemented on acute care medical units. This evidence-based quality improvement project describes how a mobility program, devised for and put to use on a general medical unit in a large Midwestern academic health care system, improved patient outcomes.
Suttanon, Plaiwan; Hill, Keith D; Said, Catherine M; Logiudice, Dina; Lautenschlager, Nicola T; Dodd, Karen J
2012-01-01
This study aimed to identify the magnitude and type of balance and mobility impairments in people with Alzheimer disease by comparing their performance with that of older people without cognitive impairment. Twenty-five community-dwelling people with mild to moderate Alzheimer disease and a comparison group of 25 cognitively intact age- and sex-matched people completed a comprehensive balance and mobility assessment. This included computerized posturography measures of static and dynamic balance under various conditions, clinical balance, and mobility measures, and measures of falls and falls risk. The level of falls risk was higher in people with Alzheimer disease. Standing balance in people with Alzheimer disease was significantly impaired across a range of static and dynamic balance conditions. Activity level, gait, and mobility measures were also impaired, particularly turning and dual tasks. The findings of the study highlight the value of including balance screening as a routine component of early dementia assessment. This would allow for the early detection of balance dysfunction and the introduction of balance retraining before impairments progress to more advanced levels.
Garzon-Serrano, Jaime; Ryan, Cheryl; Waak, Karen; Hirschberg, Ronald; Tully, Susan; Bittner, Edward A; Chipman, Daniel W; Schmidt, Ulrich; Kasotakis, Georgios; Benjamin, John; Zafonte, Ross; Eikermann, Matthias
2011-04-01
To evaluate whether the level of mobilization achieved and the barriers for progressing to the next mobilization level differ between nurses and physical therapists. Prospective, observational study. Twenty-bed surgical intensive care unit (SICU) of the Massachusetts General Hospital. Sixty-three critically ill patients. Physical therapists and nurses performed 179 mobilization therapies with 63 patients. Mobilization was defined as the process of enhancing mobility in the SICU, including bed mobility, edge of bed activities, transfers out of bed to a chair, and gait training; the mobilization level was measured on the SICU optimal mobilization scale, a 5-point (0-4) numerical rating scale. Patients' level of mobilization achieved by physical therapists was significantly higher compared with that achieved by nurses (2.3 ± 1.2 mean ± SD versus 1.2 ± 1.2, respectively P < .0001). Different barriers for mobilization were identified by physical therapists and nurses: hemodynamic instability (26% versus 12%, P = .03) and renal replacement therapy (12% versus 1%, P = .03) were barriers rated higher by nurses, whereas neurologic impairment was rated higher by physical therapists providers (18% versus 38%, P = .002). No mobilization-associated adverse events were observed in this study. This study showed that physical therapists mobilize their critically ill patients to higher levels compared with nurses. Nurse and physical therapists identify different barriers for mobilization. Routine involvement of physical therapists in directing mobilization treatment may promote early mobilization of critically ill patients. Copyright © 2011 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.
Evaluation of Progress, Bilingual Mini-Head Start, November 1973.
ERIC Educational Resources Information Center
McConnell, Beverly
A 5-year experimental project, the Bilingual Mini Head Start program is an early education program for children of migrant farm workers. The program has 2 components: the mobile and the stationary components. In the stationary program, 2 year-round centers are operated in Connell and Moses Lake (Washington). These centers' purpose is to…
Sujkowski, Alyson; Rainier, Shirley; Fink, John K; Wessells, Robert J
2015-01-01
Human PNPLA6 gene encodes Neuropathy Target Esterase protein (NTE). PNPLA6 gene mutations cause hereditary spastic paraplegia (SPG39 HSP), Gordon-Holmes syndrome, Boucher-Neuhäuser syndromes, Laurence-Moon syndrome, and Oliver-McFarlane syndrome. Mutations in the Drosophila NTE homolog swiss cheese (sws) cause early-onset, progressive behavioral defects and neurodegeneration characterized by vacuole formation. We investigated sws5 flies and show for the first time that this allele causes progressive vacuolar formation in the brain and progressive deterioration of negative geotaxis speed and endurance. We demonstrate that inducible, neuron-specific expression of full-length human wildtype NTE reduces vacuole formation and substantially rescues mobility. Indeed, neuron-specific expression of wildtype human NTE is capable of rescuing mobility defects after 10 days of adult life at 29°C, when significant degeneration has already occurred, and significantly extends longevity of mutants at 25°C. These results raise the exciting possibility that late induction of NTE function may reduce or ameliorate neurodegeneration in humans even after symptoms begin. In addition, these results highlight the utility of negative geotaxis endurance as a new assay for longitudinal tracking of degenerative phenotypes in Drosophila.
Mobility challenges and solutions for fibrodysplasia ossificans progressiva.
Levy, C; Berner, T F; Sandhu, P S; McCarty, B; Denniston, N L
1999-10-01
Fibrodysplasia ossificans progressiva (FOP) is a rare genetic disorder characterized by progressive soft tissue ossification. Although signs may be present at birth, the first appearance of ectopic bone typically occurs in early childhood. The primary target is the axial musculature. Eventually ectopic bone also occurs in ligaments, fascia, aponeurosis, tendons, and joint capsules of the appendicular skeleton with a proximal to distal predilection. As the disease advances, mobility becomes restricted, and affected individuals are typically limited to bed or chair by their early 30s. This report describes a 30-year-old woman with advanced FOP. She had a fused spine and a fixed pelvis, with hips and knees locked in flexion and feet in plantarflexion. Her upper limb mobility was similarly restricted. She was not able to stand upright or sit independently. The modification of a commercially available power wheelchair that allowed the patient to maintain her employment as a preschool teacher and custom shoes are described. Creative physiatric intervention is essential to liberate human potential for people with FOP.
A Small Corner of the Iceberg: Changing Trends in Early School Literacy in China
ERIC Educational Resources Information Center
Hua, Congchao
2013-01-01
Literacy practices and sociocultural contexts have greatly defined and influenced each other. The role language plays in mobilizing both revolution and progress is well delineated in Congchao Hua's article comparing language learning curriculum in China over three decades, from the 1970s to the 2000s. The universality of the social and political…
Intramedullary Percutaneous Fixation of Extra-Articular Proximal and Middle Phalanx Fractures.
Jovanovic, Nebojsa; Aldlyami, Ehab; Saraj, Basem; Fm Seidam, Mohamed; Badawi, Hamed; Shaat, Ahmed; Alawadi, Khalid; Dodakundi, Chaitanya
2018-06-01
Multiple methods have been described for treating unstable proximal and middle phalangeal fractures. Irrespective of using an open or closed technique of fixation, stiffness and extensor lag at the proximal/distal interphalangeal joint almost always occur. This issue can be avoided by allowing the patients to mobilize the fingers out of plaster or splint as early as possible from the day of surgery. We describe a technique of intramedullary percutaneous fixation of extra-articular proximal and middle phalanx fractures allowing immediate mobilization of fingers, concurrent stabilization with progressive healing and thus preventing such complications.
Gait and Cognition: A Complementary Approach to Understanding Brain Function and the Risk of Falling
Montero-Odasso, Manuel; Verghese, Joe; Beauchet, Olivier; Hausdorff, Jeffrey M.
2012-01-01
Until recently, clinicians and researchers have performed gait assessments and cognitive assessments separately when evaluating older adults. Increasing evidence from clinical practice, epidemiological studies, and clinical trials shows that gait and cognition are inter-related in older adults. Quantifiable alterations in gait among older adults are associated with falls, dementia, and disability. At the same time, emerging evidence indicates that early disturbances in cognitive processes such as attention, executive function, and working memory are associated with slower gait and gait instability during single and dual-task testing, and that these cognitive disturbances assist in the prediction of future mobility loss, falls, and progression to dementia. This paper reviews the importance of the gait-cognition inter-relationship in aging and presents evidence that gait assessments can provide a window into the understanding of cognitive function and dysfunctions, and fall risk in older people in clinical practice. To this end, the benefits of dual-task gait assessments (e.g., walking while performing an attention-demanding task) as a marker of fall risk are summarized. Further, we also present a potential complementary approach for reducing the risk of falls by improving certain aspects of cognition through both non-pharmacological and pharmacological treatments. Untangling the relationship between early gait disturbances and early cognitive changes may be helpful for identifying older adults at higher risk of experiencing mobility decline, falls and the progression to dementia. PMID:23110433
Hsu, Che-Yu; Lin, Cheng-Han; Jan, Yi-Hua; Su, Chia-Yi; Yao, Yun-Chin; Cheng, Hui-Chuan; Hsu, Tai-I; Wang, Po-Shun; Su, Wen-Pin; Yang, Chih-Jen; Huang, Ming-Shyan; Calkins, Marcus J; Hsiao, Michael; Lu, Pei-Jung
2016-04-15
Non-small cell lung cancer (NSCLC) carries a poor survival rate mainly because of metastasis. However, the molecular mechanisms that govern NSCLC metastasis have not been described. Because huntingtin-interacting protein-1 (HIP1) is known to play a role in tumorigenesis, we tested the involvement of HIP1 in NSCLC progression and metastasis. HIP1 expression was measured in human NSCLC tumors, and correlation with survival outcome was evaluated. Furthermore, we investigated the ability of HIP1 to suppress metastasis. The molecular mechanism by which HIP1 contributes to suppress metastasis was investigated. We used tissue arrays containing samples from 121 patients with NSCLC to analyze HIP1 expression by immunohistochemistry. To investigate the role of HIP1 expression on metastasis, we evaluated cellular mobility, migration, and invasion using lung adenocarcinoma (AdCA) cells with modified HIP1 expression levels. The human disease mouse models with the same cells were applied to evaluate the HIP1 suppressing metastasis and its mechanism in vivo. HIP1 expression in AdCA progression was found to be an early-stage prognostic biomarker, with low expression correlated to poor prognosis. We also found HIP1 to be a metastatic suppressor in AdCA. HIP1 significantly repressed the mobility of lung cancer cells in vitro and in vivo and regulated the epithelial-mesenchymal transition by repressing AKT/glycogen synthase kinase-3β/β-catenin signaling. HIP1 serves as an early-stage prognostic biomarker and a metastatic suppressor. Reduced expression during AdCA progression can relieve HIP1 suppression of Akt-mediated epithelial-mesenchymal transition and thereby lead to development of late metastases and poor prognosis.
Rising Intragenerational Occupational Mobility in the United States, 1969 to 2011
Jarvis, Benjamin F.; Song, Xi
2017-01-01
Despite the theoretical importance of intragenerational mobility and its connection to intergenerational mobility, no study since the 1970s has documented trends in intragenerational occupational mobility. The present article fills this intellectual gap by presenting evidence of an increasing trend in intragenerational mobility in the United States from 1969 to 2011. We decompose the trend using a nested occupational classification scheme that distinguishes between disaggregated micro-classes and progressively more aggregated meso-classes, macro-classes, and manual and nonmanual sectors. Log-linear analysis reveals that mobility increased across the occupational structure at nearly all levels of aggregation, especially after the early 1990s. Controlling for structural changes in occupational distributions modifies, but does not substantially alter, these findings. Trends are qualitatively similar for men and women. We connect increasing mobility to other macro-economic trends dating back to the 1970s, including changing labor force composition, technologies, employment relations, and industrial structures. We reassert the sociological significance of intragenerational mobility and discuss how increasing variability in occupational transitions within careers may counteract or mask trends in intergenerational mobility, across occupations and across more broadly construed social classes. PMID:28966346
[Present situation and prospect of enhanced recovery after surgery in pancreatic surgery].
Feng, Mengyu; Zhang, Taiping; Zhao, Yupei
2017-05-25
Enhanced recovery after surgery is a multimodal perioperative strategy according to the evidence-based medicine and multidisciplinary collaboration, aiming to improve the restoration of functional capacity after surgery by reducing surgical stress, optimal control of pain, early oral diet and early mobilization. Compared with other sub-specialty in general surgery, pancreatic surgery is characterized by complex disease, highly difficult procedure and more postoperative complications. Accordingly, pancreatic surgery shares a slow development in enhanced recovery after surgery. In this review, the feasibility, safety, application progress, prospect and controversy of enhanced recovery after surgery in pancreatic surgery are discussed.
ERIC Educational Resources Information Center
Guernsey, Lisa
2012-01-01
Touch-screen technologies, on-demand multimedia, and mobile devices are prompting a rethinking of education. In a world of increasing fiscal constraints, state leaders are under pressure to capitalize on these new technologies to improve productivity and help students excel. The task is daunting across the education spectrum, but for those in…
Stam, Daniel; Fernandez, Jennifer
2017-07-01
Diffuse axonal injury is a prominent cause of disablement post-traumatic brain injury. Utilization of the rapid expansion of our current scientific knowledge base combined with greater access to neurological and assistive technology as adjuncts to providing sensorimotor experience may yield innovative new approaches to rehabilitation based upon a dynamic model of brain response following injury. A 24-year-old female who sustained a traumatic brain injury, bilateral subdural hemorrhage, subarachnoid hemorrhage and severe diffuse axonal injury secondary to a motor vehicle collision. Evidence-based appraisal of present literature suggests a link between graded intensity of aerobic activity to facilitation of neuro-plastic change and up-regulation of neurotrophins essential to functional recovery post-diffuse axonal injury. Following resolution of paroxysmal autonomic instability with dystonia, aggressive early mobilization techniques were progressed utilizing robotic assistive gait technology in combination with conventional therapy. This approach allowed for arguably greater repetition and cardiovascular demands across a six-month inpatient rehabilitation stay. Outcomes in this case suggest that the use of assistive technology to adjunct higher level and intensity rehabilitation strategies may be a safe and effective means towards reduction of disablement following severe traumatic brain and neurological injury. Implications for Rehabilitation Functional recovery and neuroplasticity following diffuse neurological injury involves a complex process determined by the sensorimotor experience provided by rehabilitation clinicians. This process is in part modulated by intrinsic brain biochemical processes correlated to cardiovascular intensity of the activity provided. It is important that rehabilitation professionals monitor physiological response to higher intensity activities to provide an adaptive versus maladaptive response of central nervous system plasticity with activity. Identification of early mobilization parameters and skill acquisition may assist selection of gait assistive technology adjunct in progressing early optimal physical rehabilitation outcomes in the acute inpatient setting.
Ion mobility spectrometry: A personal view of its development at UCSB
2014-09-15
molecules. As we progressed we realized that new, more accurate algorithms were needed to augment our early projection approximation (PA) for determining...required. The goal was to maintain some of the speed of the projection approximation and retain the accuracy of the trajectory method. Christian...Bleiholder, while a postdoc in my group, did just that by development of the projection superposition approximation (PSA) [31–35]. This new method is 100
[Impact of mobile phone radiation on the quality and DNA methylation of human sperm in vitro].
Wang, Dong; Li, Bo; Liu, Yuan; Ma, Ye-fei; Chen, Shu-qiang; Sun, Hui-jun; Dong, Jie; Ma, Xu-hui; Zhou, Jing; Wang, Xiao-hong
2015-06-01
To investigate the influences of mobile phone radiation on the quality and DNA methylation of human sperm in vitro. According to the fifth edition of the WHO Laboratory Manual for the Examination and Processing of Human Semen, we randomly selected 97 male volunteers with normal semen parameters and divided each semen sample from the subjects into two equal parts, one exposed to mobile phone radiation at 1950 M Hz, SAR3. 0 W/kg for 3 hours while the other left untreated as the control. We obtained routine semen parameters as well as the acrosomal reaction ability, apoptosis and DNA methylation of sperm, and compared them between the two groups. Compared with the control, the radiation group showed significantly decreased progressive sperm motility ([36.64 ± 16.93] vs [27.56 ± 16.92]%, P < 0.01) and sperm viability ([63.72 ± 16.35] vs [54.31 ± 17.35]%, P < 0.01) and increased sperm head defects ([69.92 ± 4.46] vs [71.17 ± 4.89]%, P < 0.05), but no significant differences in sperm acrosomal reaction ([66.20 ± 6.75] vs [64.50 ± 3.47]%, P > 0.05). The early apoptosis rate of sperm cells was remarkably higher in the radiation group ([6.89 ± 9.84]%) than in the control ([4.44 ± 5.89]%) (P < 0.05). However, no statistically significant differences were found between the control and radiation groups in the DNA methylation patterns of the paternal imprinting gene H19 ICR ([0.60 ± 0.02] vs [1.40 ± 0.03]%, P > 0.05) or the maternal imprinting gene KvDMR1 ([0.00 ± 0.00] vs [1.80 ± 0.031%, P > 0.05). Mobile phone radiation reduces the progressive motility and viability of human sperm and increases sperm head defects and early apoptosis of sperm cells.
Fostering learners' interaction with content: A learner-centered mobile device interface
NASA Astrophysics Data System (ADS)
Abdous, M.
2015-12-01
With the ever-increasing omnipresence of mobile devices in student life, leveraging smart devices to foster students' interaction with course content is critical. Following a learner-centered design iterative approach, we designed a mobile interface that may enable learners to access and interact with online course content efficiently and intuitively. Our design process leveraged recent technologies, such as bootstrap, Google's Material Design, HTML5, and JavaScript to design an intuitive, efficient, and portable mobile interface with a variety of built-in features, including context sensitive bookmarking, searching, progress tracking, captioning, and transcript display. The mobile interface also offers students the ability to ask context-related questions and to complete self-checks as they watch audio/video presentations. Our design process involved ongoing iterative feedback from learners, allowing us to refine and tweak the interface to provide learners with a unified experience across platforms and devices. The innovative combination of technologies built around well-structured and well-designed content seems to provide an effective learning experience to mobile learners. Early feedback indicates a high level of satisfaction with the interface's efficiency, intuitiveness, and robustness from both students and faculty.
Clinical outcomes of patient mobility in a neuroscience intensive care unit.
Mulkey, Malissa; Bena, James F; Albert, Nancy M
2014-06-01
Patients treated in a neuroscience intensive care unit (NICU) are often viewed as too sick to tolerate physical activity. In this study, mobility status in NICU was assessed, and factors and outcomes associated with mobility were examined. Using a prospective design, daily mobility status, medical history, demographics, Acute Physiology and Chronic Health Evaluation (APACHE) III score, and clinical outcomes were collected by medical records and database review. Depression, anxiety, and hostility were assessed before NICU discharge. Analyses included comparative statistics and multivariable modeling. In 228 unique patients, median (minimum, maximum) age was 64.0 (20, 95) years, 66.4% were Caucasian, and 53.6% were men. Of 246 admissions, median NICU stay was 4 (1, 61) days; APACHE III score was 56 (16, 145). Turning, range of motion, and head of bed of >30° were uniformly applied (n = 241), but 94 patients (39%) never progressed; 94 (39%) progressed to head of bed of >45° or dangling legs, 29 (12%) progressed to standing or pivoting to chair, and 24 (10%) progressed to walking. Female gender (p = .019), mechanical ventilation (p < .001), higher APACHE score (p = .004), and 30-day mortality (p = .001) were associated with less mobility. In multivariable modeling, greater mobility was associated with longer unit stay (p < .001) and discharge to home (p < .001). Psychological profile characteristics were not associated with mobility level. Nearly 40% of patients never progressed beyond bed movement, and only 10% walked. Although limited mobility progression was not associated with many patient factors, it was associated with poorer clinical outcomes. Implementation and evaluation of a progressive mobility protocol are needed in NICU patients. For more insights from the authors, see Supplemental Digital Content 1, at http://link.lww.com/JNN/A10.
FY2017 Analysis Annual Progress Report
DOE Office of Scientific and Technical Information (OSTI.GOV)
None, None
During fiscal year 2017, the U.S. Department of Energy Vehicle Technologies Office (VTO) funded analysis projects supportive of VTO’s goals to pursue early stage research in vehicle and mobility system technologies to reduce petroleum dependence, increase energy reliability and security, improve transportation affordability, and promote economic growth. VTO analysis projects result in a foundation of data, analytical models, and applied analyses that provide insights into critical transportation energy problems and assist in research investment prioritization and portfolio planning.
A Scalable Distributed Approach to Mobile Robot Vision
NASA Technical Reports Server (NTRS)
Kuipers, Benjamin; Browning, Robert L.; Gribble, William S.
1997-01-01
This paper documents our progress during the first year of work on our original proposal entitled 'A Scalable Distributed Approach to Mobile Robot Vision'. We are pursuing a strategy for real-time visual identification and tracking of complex objects which does not rely on specialized image-processing hardware. In this system perceptual schemas represent objects as a graph of primitive features. Distributed software agents identify and track these features, using variable-geometry image subwindows of limited size. Active control of imaging parameters and selective processing makes simultaneous real-time tracking of many primitive features tractable. Perceptual schemas operate independently from the tracking of primitive features, so that real-time tracking of a set of image features is not hurt by latency in recognition of the object that those features make up. The architecture allows semantically significant features to be tracked with limited expenditure of computational resources, and allows the visual computation to be distributed across a network of processors. Early experiments are described which demonstrate the usefulness of this formulation, followed by a brief overview of our more recent progress (after the first year).
Extra-articular fractures of the digital metacarpals and phalanges of the long fingers.
Le Nen, D
2014-02-01
Metacarpal and phalangeal fractures of the long fingers are the result of trauma occurring under extremely varied circumstances. As a consequence, the clinical presentation varies greatly, with every bone and joint potentially being involved. Each step of their treatment is crucial, although the benign appearance of these injuries can lead to steps being missed: diagnostic phase with clinical examination and radiographs; therapeutic phase where the most suitable treatment is chosen, which combines mobilization of the digital chains as soon as possible and in every patient; follow-up phase with regular monitoring to detect any complications, especially secondary displacement, and verify that good progress is being made during rehabilitation. The goal of any fracture treatment is to preserve or restore the anatomy, with the emphasis here being on the stability and mobility of the digital chains. The potential progression towards serious functional sequelae (pain, instability or stiffness in hand) and the resulting significant socio-economic repercussions must be at the forefront of a surgeon's mind early on during the initial care of any finger or hand trauma. Copyright © 2014. Published by Elsevier SAS.
Changing paradigms in thrombolysis in acute myocardial infarction.
Gotsman, M S; Rozenman, Y; Admon, D; Mosseri, M; Lotan, C; Zahger, D; Weiss, A T
1997-05-23
Acute myocardial infarction occurs when a ruptured coronary artery plaque causes sudden thrombotic occlusion of a coronary artery and cessation of coronary artery blood flow. This paper reviews the underlying coronary pathology in progressive coronary atherosclerosis, mechanisms of plaque rupture and arterial occlusion and the time relationship between coronary occlusion and myocardial necrosis. Reperfusion can be achieved by chemical thrombolysis with different thrombolytic agents. Early lysis is achieved best by prehospital administration, a transtelephonic monitor, a mobile intensive care unit, active general practitioner treatment or by warning the emergency room of impending arrival of a patient. Thrombolytic therapy may be unsuccessful and not achieve Grade III TIMI flow in less than 4 h (or even 2 h) due to inadequate or intermittent perfusion or reocclusion. Adjuvant therapy includes aspirin and platelet receptor antagonists. Bleeding is a constant danger. Direct percutaneous transluminal coronary angioplasty (PTCA) may be as effective or better than chemical thrombolysis. Reperfusion protects the myocardium and salvages viable tissue. It also improves mechanical remodelling of the ventricle. Long-term follow-up has shown that quantum leaps of fresh coronary occlusion causes step-wise progression in patient disability and that further early, prompt reperfusion can salvage myocardium and prevent this inexorable progress of the disease.
[PROtocol-based MObilizaTION on intensive care units : Design of a cluster randomized pilot study].
Nydahl, P; Diers, A; Günther, U; Haastert, B; Hesse, S; Kerschensteiner, C; Klarmann, S; Köpke, S
2017-10-12
Despite convincing evidence for early mobilization of patients on intensive care units (ICU), implementation in practice is limited. Protocols for early mobilization, including in- and exclusion criteria, assessments, safety criteria, and step schemes may increase the rate of implementation and mobilization. Patients (population) on ICUs with a protocol for early mobilization (intervention), compared to patients on ICUs without protocol (control), will be more frequently mobilized (outcome). A multicenter, stepped-wedge, cluster-randomized pilot study is presented. Five ICUs will receive an adapted, interprofessional protocol for early mobilization in randomized order. Before and after implementation, mobilization of ICU patients will be evaluated by randomized monthly one-day point prevalence surveys. Primary outcome is the percentage of patients mobilized out of bed, operationalized as a score of ≥3 on the ICU Mobility Scale. Secondary outcome parameters will be presence and/or length of mechanical ventilation, delirium, stay on ICU and in hospital, barriers to early mobilization, adverse events, and process parameters as identified barriers, used strategies, and adaptions to local conditions. Exploratory evaluation of study feasibility and estimation of effect sizes as the basis for a future explanatory study.
Clark, Diane E; Lowman, John D; Griffin, Russell L; Matthews, Helen M; Reiff, Donald A
2013-02-01
Bed rest and immobility in patients on mechanical ventilation or in an intensive care unit (ICU) have detrimental effects. Studies in medical ICUs show that early mobilization is safe, does not increase costs, and can be associated with decreased ICU and hospital lengths of stay (LOS). The purpose of this study was to assess the effects of an early mobilization protocol on complication rates, ventilator days, and ICU and hospital LOS for patients admitted to a trauma and burn ICU (TBICU). This was a retrospective cohort study of an interdisciplinary quality-improvement program. Pre- and post-early mobility program patient data from the trauma registry for 2,176 patients admitted to the TBICU between May 2008 and April 2010 were compared. No adverse events were reported related to the early mobility program. After adjusting for age and injury severity, there was a decrease in airway, pulmonary, and vascular complications (including pneumonia and deep vein thrombosis) post-early mobility program. Ventilator days and TBICU and hospital lengths of stay were not significantly decreased. Using a historical control group, there was no way to account for other changes in patient care that may have occurred between the 2 periods that could have affected patient outcomes. The dose of physical activity both before and after the early mobility program were not specifically assessed. Early mobilization of patients in a TBICU was safe and effective. Medical, nursing, and physical therapy staff, as well as hospital administrators, have embraced the new culture of early mobilization in the ICU.
Low Cost Inkjet Printed Smart Bandage for Wireless Monitoring of Chronic Wounds
Farooqui, Muhammad Fahad; Shamim, Atif
2016-01-01
Chronic wounds affect millions of patients around the world and their treatment is challenging as the early signs indicating their development are subtle. In addition, a type of chronic wound, known as pressure ulcer, develops in patients with limited mobility. Infection and frequent bleeding are indicators of chronic wound development. In this article, we present an unprecedented low cost continuous wireless monitoring system, realized through inkjet printing on a standard bandage, which can send early warnings for the parameters like irregular bleeding, variations in pH levels and external pressure at wound site. In addition to the early warnings, this smart bandage concept can provide long term wound progression data to the health care providers. The smart bandage comprises a disposable part which has the inkjet printed sensors and a reusable part constituting the wireless electronics. This work is an important step towards futuristic wearable sensors for remote health care applications. PMID:27353200
Low Cost Inkjet Printed Smart Bandage for Wireless Monitoring of Chronic Wounds
NASA Astrophysics Data System (ADS)
Farooqui, Muhammad Fahad; Shamim, Atif
2016-06-01
Chronic wounds affect millions of patients around the world and their treatment is challenging as the early signs indicating their development are subtle. In addition, a type of chronic wound, known as pressure ulcer, develops in patients with limited mobility. Infection and frequent bleeding are indicators of chronic wound development. In this article, we present an unprecedented low cost continuous wireless monitoring system, realized through inkjet printing on a standard bandage, which can send early warnings for the parameters like irregular bleeding, variations in pH levels and external pressure at wound site. In addition to the early warnings, this smart bandage concept can provide long term wound progression data to the health care providers. The smart bandage comprises a disposable part which has the inkjet printed sensors and a reusable part constituting the wireless electronics. This work is an important step towards futuristic wearable sensors for remote health care applications.
Low Cost Inkjet Printed Smart Bandage for Wireless Monitoring of Chronic Wounds.
Farooqui, Muhammad Fahad; Shamim, Atif
2016-06-29
Chronic wounds affect millions of patients around the world and their treatment is challenging as the early signs indicating their development are subtle. In addition, a type of chronic wound, known as pressure ulcer, develops in patients with limited mobility. Infection and frequent bleeding are indicators of chronic wound development. In this article, we present an unprecedented low cost continuous wireless monitoring system, realized through inkjet printing on a standard bandage, which can send early warnings for the parameters like irregular bleeding, variations in pH levels and external pressure at wound site. In addition to the early warnings, this smart bandage concept can provide long term wound progression data to the health care providers. The smart bandage comprises a disposable part which has the inkjet printed sensors and a reusable part constituting the wireless electronics. This work is an important step towards futuristic wearable sensors for remote health care applications.
Koo, Karen K.Y.; Choong, Karen; Cook, Deborah J.; Herridge, Margaret; Newman, Anastasia; Lo, Vincent; Guyatt, Gordon; Priestap, Fran; Campbell, Eileen; Burns, Karen E.A.; Lamontagne, FranÇois; Meade, Maureen O.
2016-01-01
Background: The promotion of early mobilization following critical illness is tempered by national reports of patient and institutional barriers to this approach. We carried out a survey to assess current knowledge, perceptions and practices of Canadian physicians and physiotherapists with respect to acquired weakness and early mobilization in adults in the intensive care unit (ICU). Methods: We conducted a cross-sectional, self-administered postal survey among critical care physicians and physiotherapists in all 46 academic ICUs in Canada in 2011-2012. To identify all physicians and physiotherapists working in the ICUs, we contacted division heads and senior physiotherapists by telephone or email. We designed, tested and administered a questionnaire with the following domains: knowledge of ICU-acquired weakness and early mobilization; personal views of, perceived barriers to and adequacy of technical skills for early mobilization; assessments for initiation of early mobilization and permissible activity levels by patient physiologic characteristics, diagnoses and therapies; staffing issues; and sedation practices. Results: The overall response rate was 71.3% (311/436); it was 64.2% (194/302) among physicians and 87.3% (117/134) among physiotherapists. A total of 214 respondents (68.8%) underestimated the incidence of ICU-acquired weakness in the general medical-surgical ICU population, and 186 (59.8%) stated they had insufficient knowledge or skills to mobilize patients receiving mechanical ventilation. Excessive sedation, medical instability, limited staffing, safety concerns, insufficient guidelines and insufficient equipment were common perceived barriers to early mobilization. Interpretation: Physicians and physiotherapists in the ICU underestimated the incidence of ICU-acquired weakness and felt inadequately trained to mobilize patients receiving mechanical ventilation. We identified multiple modifiable barriers to early mobilization at the institutional, health care provider and patient levels that need to be addressed when designing mobilization programs for critically ill adults. PMID:27730109
[Early mobilization. Competencies, responsibilities, milestones].
Nydahl, P; Dewes, M; Dubb, R; Filipovic, S; Hermes, C; Jüttner, F; Kaltwasser, A; Klarmann, S; Klas, K; Mende, H; Rothaug, O; Schuchhardt, D
2016-03-01
Early mobilization is an evident, interprofessional concept to improve the outcome of intensive care patients. It reduces psychocognitive deficits and delirium and attenuates a general deconditioning, including atrophy of the respiratory pump and skeletal muscles. In this regard the interdisciplinary approach of early mobilization, taking into account different levels of mobilization, appears to be beneficial. The purpose of this study was to explore opinions on collaboration and tasks between different professional groups. During the 25th Bremen Conference on Intensive Medicine and Nursing on 20 February 2015, a questionnaire survey was carried out among the 120 participants of the German Early Mobilization Network meeting. In all, 102 questionnaires were analyzed. Most participants reported on the interdisciplinarity of the approach, but none of the tasks and responsibilities concerning early mobilization can be assigned to a single professional group. The practical implementation of mobilizing orally intubated patients may require two registered nurses as well as a physical therapist. Implementation in daily practice seems to be heterogeneous. There is no consensus regarding collaboration, competencies, and responsibilities with respect to early mobilization of intensive care patients. The approach to date has been characterized by a lack of interprofessional communication, which may lead to an inefficient use of the broad and varied base of knowledge and experienceof the different professions.
Sjöholm, Anna; Skarin, Monica; Linden, Thomas; Bernhardt, Julie
2011-01-01
Introduction: Early mobilization after stroke may be important for a good outcome and it is currently recommended in a range of international guidelines. The evidence base, however, is limited and clear definitions of what constitutes early mobilization are lacking. Aims: To explore stroke care professionals’ opinions about (1) when after stroke, first mobilization should take place, (2) whether early mobilization may affect patients’ final outcome, and (3) what level of evidence they require to be convinced that early mobilization is beneficial. Methods: A nine-item questionnaire was used to interview stroke care professionals during a conference in Sydney, Australia. Results: Among 202 professionals interviewed, 40% were in favor of mobilizing both ischemic and hemorrhagic stroke patients within 24 hours of stroke onset. There was no clear agreement about the optimal time point beyond 24 hours. Most professionals thought that patients’ final motor outcome (76%), cognitive outcome (57%), and risk of depression (75%) depends on being mobilized early. Only 19% required a large randomized controlled trial or a systematic review to be convinced of benefit. Conclusion: The spread in opinion reflects the absence of clear guidelines and knowledge in this important area of stroke recovery and rehabilitation, which suggests further research is required. PMID:22096341
ERIC Educational Resources Information Center
Jones, Ann; Gaved, Mark; Kukulska-Hulme, Agnes; Scanlon, Eileen; Pearson, Charlie; Lameras, Petros; Dunwell, Ian; Jones, Jan
2014-01-01
Although the motivating role of feedback and progress indicators is understood in formal learning, their role in supporting incidental mobile learning is less well understood. In this paper we argue that well-designed feedback and progress indicators (FPIs) offer guidance and structure that may encourage mobile app users to move from fragmented…
Implementing a Mobility Program to Minimize Post-Intensive Care Syndrome.
Hopkins, Ramona O; Mitchell, Lorie; Thomsen, George E; Schafer, Michele; Link, Maggie; Brown, Samuel M
2016-01-01
Immobility in the intensive care unit (ICU) is associated with neuromuscular weakness, post-intensive care syndrome, functional limitations, and high costs. Early mobility-based rehabilitation in the ICU is feasible and safe. Mobility-based rehabilitation varied widely across 5 ICUs in 1 health care system, suggesting a need for continuous training and evaluation to maintain a strong mobility-based rehabilitation program. Early mobility-based rehabilitation shortens ICU and hospital stays, reduces delirium, and increases muscle strength and the ability to ambulate. Long-term effects include increased ability for self-care, faster return to independent functioning, improved physical function, and reduced hospital readmission and death. Factors that influence early mobility-based rehabilitation include having an interdisciplinary team; strong unit leadership; access to physical, occupational, and respiratory therapists; a culture focused on patient safety and quality improvement; a champion of early mobility; and a focus on measuring performance and outcomes.
Parker, Geoff A
2014-08-21
After brief historic overviews of sexual selection and sexual conflict, I argue that pre-ejaculatory sexual selection (the form of sexual selection discussed by Darwin) arose at a late stage in an inevitable succession of transitions flowing from the early evolution of syngamy to the evolution of copulation and sex roles. If certain conditions were met, this "sexual cascade" progressed inevitably, if not, sexual strategy remained fixed at a given stage. Prolonged evolutionary history of intense sperm competition/selection under external fertilization preceded the rise of advanced mobility, which generated pre-ejaculatory sexual selection, followed on land by internal fertilization and reduced sperm competition in the form of postcopulatory sexual selection. I develop a prospective model of the early evolution of mobility, which, as Darwin realized, was the catalyst for pre-ejaculatory sexual selection. Stages in the cascade should be regarded as consequential rather than separate phenomena and, as such, invalidate much current opposition to Darwin-Bateman sex roles. Potential for sexual conflict occurs throughout, greatly increasing later in the cascade, reaching its peak under precopulatory sexual selection when sex roles become highly differentiated. Copyright © 2014 Cold Spring Harbor Laboratory Press; all rights reserved.
Parker, Geoff A.
2014-01-01
After brief historic overviews of sexual selection and sexual conflict, I argue that pre-ejaculatory sexual selection (the form of sexual selection discussed by Darwin) arose at a late stage in an inevitable succession of transitions flowing from the early evolution of syngamy to the evolution of copulation and sex roles. If certain conditions were met, this “sexual cascade” progressed inevitably, if not, sexual strategy remained fixed at a given stage. Prolonged evolutionary history of intense sperm competition/selection under external fertilization preceded the rise of advanced mobility, which generated pre-ejaculatory sexual selection, followed on land by internal fertilization and reduced sperm competition in the form of postcopulatory sexual selection. I develop a prospective model of the early evolution of mobility, which, as Darwin realized, was the catalyst for pre-ejaculatory sexual selection. Stages in the cascade should be regarded as consequential rather than separate phenomena and, as such, invalidate much current opposition to Darwin–Bateman sex roles. Potential for sexual conflict occurs throughout, greatly increasing later in the cascade, reaching its peak under precopulatory sexual selection when sex roles become highly differentiated. PMID:25147177
Need for early diagnosis of mental and mobility changes in Wernicke encephalopathy.
Wijnia, Jan W; Oudman, Erik; Bresser, Esmay L; Gerridzen, Ineke J; van de Wiel, Albert; Beuman, Carla; Mulder, Cornelis L
2014-12-01
Korsakoff syndrome is a chronic form of amnesia resulting from thiamine deficiency. The syndrome can develop from unrecognized or undertreated Wernicke encephalopathy. The intra-individual course of Wernicke-Korsakoff syndrome has not been studied extensively, nor has the temporal progression of gait disturbances and other symptoms of Wernicke encephalopathy. Here we present the detailed history of a patient whose acute symptoms of Wernicke encephalopathy were far from stable. We follow his mobility changes and the shifts in his mental status from global confusion and impaired consciousness to more selective cognitive deficits. His Wernicke encephalopathy was missed and left untreated, being labeled as "probable" Korsakoff syndrome. Patients with a history of self-neglect and alcohol abuse, at risk of or suffering with Wernicke encephalopathy, should receive immediate and adequate vitamin replacement. Self-neglecting alcoholics who are bedridden may have severe illness and probably active Wernicke encephalopathy. In these patients, mobility changes, delirium, or impaired consciousness can be an expression of Wernicke encephalopathy, and should be treated to prevent further damage from the neurologic complications of thiamine deficiency.
Zheng, Katina; Sarti, Aimee; Boles, Sama; Cameron, Saoirse; Carlisi, Robert; Clark, Heather; Khawaji, Adeeb; Awladthani, Saif; Al-Harbi, Samah; Choong, Karen
2018-04-11
To understand patient, family caregiver, and clinician impressions of early mobilization, the perceived barriers and facilitators to its implementation, and the use of in-bed cycling as a method of mobilization. A qualitative study, conducted as part of the Early Exercise in Critically ill Youth and Children, a preliminary Evaluation (wEECYCLE) Pilot randomized controlled trial. McMaster Children's Hospital PICU, Hamilton, ON, Canada. Clinicians (i.e., physicians, nurses, and physiotherapists), family caregivers, and capable patients age greater than or equal to 8 years old who were enrolled in a clinical trial of early mobilization in critically ill children (wEECYCLE). Semistructured, face-to-face interviews using a customized interview guide for clinicians, caregivers, and patients respectively, conducted after exposure to the early mobilization intervention. Thirty-seven participants were interviewed (19 family caregivers, four patients, and 14 clinicians). Family caregivers and clinicians described similar interrelated themes representing barriers to mobilization, namely low prioritization of mobilization by the medical team, safety concerns, the lack of physiotherapy resources, and low patient motivation. Key facilitators were family trust in the healthcare team, team engagement, an a priori belief that physical activity is important, and participation in research. Increased familiarity and specific features such as the virtual reality component and ability to execute passive and or active mobilization helped to engage critically ill children in in-bed cycling. Clinicians, patients, and families were highly supportive of mobilization in critically ill children; however, concerns were identified with respect to how and when to execute this practice. Understanding key stakeholder perspectives enables the development of strategies to facilitate the implementation of early mobilization and in-bed cycling, not just in the context of a clinical trial but also within the culture of practice in a PICU.
Iammarino, Kathryn; Marrie, James; Lowes, Linda P.
2018-01-01
Background Ankle injuries account for up to 40% of all sport related injuries. These injuries can result in weeks to months of missed sport or work. The PRICE (Protection, Rest, Ice, Compression, Elevation) treatment is standard care for most acute ankle sprains. Recently, early mobilization in adults has been shown to decrease time off from sport or work, and the likelihood of developing chronic instability. To date, no research has been performed assessing the effectiveness of early mobilization in pediatric patients (<18 years). Purpose: There were two objectives of this study: (1) to determine if early ankle joint mobilization using elastic band traction is effective and (2) assess the occurrence of adverse events with this technique in the pediatric population. Methods Patients with an acute ankle sprain of <7 days referred to physical therapy were randomly assigned to receive early mobilization or PRICE. Early mobilization was performed using a stretch band ankle traction technique. Both groups received a standardized rehabilitation program. Pain, edema, ankle strength using hand-held dynamometry, and Foot and Ankle Disability Index (FADI) were measured at both initial evaluation and at discharge. The number of days before return to sport and the number of treatment sessions were also variables of interest. Results Forty-one pediatric patients were recruited for participation (mean age 14.6 + 1.9 years). Both treatment groups had clinically significant improvements in pain, edema, strength, and FADI scores. No significant differences in outcomes were noted between treatment groups. Mean number of days for return to sport for the PRICE group was 26.33 + 7.14 and the early mobilization group was 26.63 + 14.82, the difference between groups was not significant (p = 0.607). The number of total visits for the PRICE group of 8.07 + 2.63 and the early mobilization groups of 8.5 + 1.57, was also not statistically significantly different (p = 0.762). There were no reported adverse events with early mobilization. Conclusion Early mobilization appears to be a safe intervention in pediatric patients with an acute ankle sprain. Early mobilization resulted in similar outcomes when compared to traditional PRICE treatment. A high drop-out rate in both treatment groups was a limitation of this randomized trial. Level of evidence 1b PMID:29484236
Iammarino, Kathryn; Marrie, James; Selhorst, Mitchell; Lowes, Linda P
2018-02-01
Ankle injuries account for up to 40% of all sport related injuries. These injuries can result in weeks to months of missed sport or work. The PRICE (Protection, Rest, Ice, Compression, Elevation) treatment is standard care for most acute ankle sprains. Recently, early mobilization in adults has been shown to decrease time off from sport or work, and the likelihood of developing chronic instability. To date, no research has been performed assessing the effectiveness of early mobilization in pediatric patients (<18 years). Purpose: There were two objectives of this study: (1) to determine if early ankle joint mobilization using elastic band traction is effective and (2) assess the occurrence of adverse events with this technique in the pediatric population. Patients with an acute ankle sprain of <7 days referred to physical therapy were randomly assigned to receive early mobilization or PRICE. Early mobilization was performed using a stretch band ankle traction technique. Both groups received a standardized rehabilitation program. Pain, edema, ankle strength using hand-held dynamometry, and Foot and Ankle Disability Index (FADI) were measured at both initial evaluation and at discharge. The number of days before return to sport and the number of treatment sessions were also variables of interest. Forty-one pediatric patients were recruited for participation (mean age 14.6 + 1.9 years). Both treatment groups had clinically significant improvements in pain, edema, strength, and FADI scores. No significant differences in outcomes were noted between treatment groups. Mean number of days for return to sport for the PRICE group was 26.33 + 7.14 and the early mobilization group was 26.63 + 14.82, the difference between groups was not significant ( p = 0.607). The number of total visits for the PRICE group of 8.07 + 2.63 and the early mobilization groups of 8.5 + 1.57, was also not statistically significantly different ( p = 0.762). There were no reported adverse events with early mobilization. Early mobilization appears to be a safe intervention in pediatric patients with an acute ankle sprain. Early mobilization resulted in similar outcomes when compared to traditional PRICE treatment. A high drop-out rate in both treatment groups was a limitation of this randomized trial. 1b.
Gromov, Kirill; Troelsen, Anders; Otte, Kristian Stahl; Ørsnes, Thue; Ladelund, Steen; Husted, Henrik
2015-01-01
Patient education and mobilization restrictions are often used in an attempt to reduce the risk of dislocation following primary THA. To date, there have been no studies investigating the safety of removal of mobilization restrictions following THA performed using a posterolateral approach. In this retrospective non-inferiority study, we investigated the rate of early dislocation following primary THA in an unselected patient cohort before and after removal of postoperative mobilization restrictions. From the Danish National Health Registry, we identified patients with early dislocation in 2 consecutive and unselected cohorts of patients who received primary THA at our institution from 2004 through 2008 (n = 946) and from 2010 through 2014 (n = 1,329). Patients in the first cohort were mobilized with functional restrictions following primary THA whereas patients in the second cohort were allowed unrestricted mobilization. Risk of early dislocation (within 90 days) was compared in the 2 groups and odds ratio (OR)-adjusted for possible confounders-was calculated. Reasons for early dislocation in the 2 groups were identified. When we adjusted for potential confounders, we found no increased risk of early dislocation within 90 days in patients who were mobilized without restrictions. Risk of dislocation within 90 days was lower (3.4% vs 2.8%), risk of dislocation within 30 days was lower (2.1% vs 2.0%), and risk of multiple dislocations (1.8% vs 1.1%) was lower in patients who were mobilized without restrictions, but not statistically significantly so. Increasing age was an independent risk factor for dislocation. Removal of mobilization restrictions from the mobilization protocol following primary THA performed with a posterolateral approach did not lead to an increased risk of dislocation within 90 days.
Talley, Cheryl L; Wonnacott, Robert O; Schuette, Janice K; Jamieson, Jill; Heung, Michael
2013-01-01
Evidence to support improved outcomes with early ambulation is strong in medical literature. Yet, critically ill continuous renal replacement therapy (CRRT) patients remain tethered to their beds by devices delivering supportive therapy. The University of Michigan Adult CRRT Committee identified this deficiency and sought to change it. There was no guidance in the literature to support mobilizing this population; therefore, we reviewed literature from devices with similar technological profiles. Revision of our institutional mobility protocol for the CRRT population included a simple safety acronym, ASK. The acronym addresses appropriate candidacy; secured, appropriate access; and potential device and patient complications as a memorable aid to help nursing staff determine whether their CRRT patients are candidates for early mobility. After implementing our CRRT mobility standard, a preliminary study of 109 CRRT patients and a review of incident reports related to CRRT demonstrated no significant adverse patient events or falls and no access complications related to mobility. This deliberate intervention allows CRRT patients to safely engage in mobility activities to improve this population's outcomes. A simple mobility protocol and safety acronym partnered with strong clinical leadership has permitted the University of Michigan to add CRRT patients to the body of early mobility literature.
O'Keefe, Joan A; Robertson-Dick, Erin; Dunn, Emily J; Li, Yan; Deng, Youping; Fiutko, Amber N; Berry-Kravis, Elizabeth; Hall, Deborah A
2015-12-01
Fragile X-associated tremor/ataxia syndrome (FXTAS) results from a "premutation" size 55-200 CGG repeat expansion in the fragile X mental retardation 1 (FMR1) gene. Core motor features include cerebellar gait ataxia and kinetic tremor, resulting in progressive mobility disability. There are no published studies characterizing balance deficits in FMR1 premutation carriers with and without FXTAS using a battery of quantitative measures to test the sensory integration underlying postural control, automatic postural reflexes, and dynamic postural stability limits. Computerized dynamic posturography (CDP) and two performance-based balance measures were administered in 44 premutation carriers, 21 with FXTAS and 23 without FXTAS, and 42 healthy controls to compare balance and functional mobility between these groups. Relationships between FMR1 molecular variables, age, and sex and CDP scores were explored. FXTAS subjects demonstrated significantly lower scores on the sensory organization test (with greatest reductions in the vestibular control of balance), longer response latencies to balance perturbations, and reduced stability limits compared to controls. Premutation carriers without FXTAS also demonstrated significantly delayed response latencies and disrupted sensory weighting for balance control. Advancing age, male sex, increased CGG repeat size, and reduced X activation of the normal allele in premutation carrier women predicted balance dysfunction. These postural control deficits in carriers with and without FXTAS implicate dysfunctional cerebellar neural networks and may provide valuable outcome markers for tailored rehabilitative interventions. Our findings suggest that CDP may provide sensitive measures for early detection of postural control impairments in at-risk carriers and better characterize balance dysfunction and progression in FXTAS.
The progression of disability among older adults in Mexico.
Díaz-Venegas, Carlos; Reistetter, Timothy A; Wang, Ching-Yi; Wong, Rebeca
2016-10-01
This paper seeks to document the progression of disability in a developing country and to examine gender differences in this process. The data come from the Mexican Health and Aging Study (MHAS), a nationally representative sample of older adults. An ordinal logistic regression (n = 3283) is used to measure the progression of disability that considers: (1) no disability, (2) mobility problems, (3) mobility problems with IADLs limitations, (4) mobility problems with ADLs limitations, (5) combinations of the latter three and (6) death. Approximately 43% of the sample remained in the same level of disability after 2 years. The patterns of progression with two disabilities differ for men and women. Our model reflects the importance of separating ADLs and IADLs in the study of disability progression in Mexico. Varying risk profiles and cultural differences might influence the divergent disability paths followed by each gender. Implications for Rehabilitation The disablement process involving transitions from mobility impairments to IADL and ADL limitations seen in developed countries differs for older adults in Mexico. Cultural differences may influence the progression from non-disabled to becoming disabled in different ways for females in developing countries like Mexico. One-fifth of individuals showed greater function and independence over time, suggesting that the disablement process is reversible. This finding highlights the need to focus on improving mobility, ADL, and IADL skills to facilitate successful aging. Although disability is often conceptualised as a combination of ADL and IADL limitations, gender differences seen in Mexico indicate the need to separate ADL and IADL when developing approaches to prevent or ameliorate disability.
Gorphe, Philippe; Blanchard, Pierre; Temam, Stephane; Janot, François
2015-10-01
Disease relapses occur in up to 40% of cases after radiotherapy (RT) for early-stage glottic laryngeal neoplasms, and the foremost remaining treatment option is salvage total laryngectomy (STL). Our objectives were to review the outcomes of patients treated with salvage surgery after RT for early-stage carcinoma of the glottic larynx and to assess prognostic factors. We retrospectively analyzed 43 patients who underwent surgery. Overall and disease-free survival rates among subgroups were calculated and compared, stratified by preoperative stage, vocal cord mobility and postoperative histopathologic data. Recurrences occurred 22.7 months after the end of RT. Surgery was STL in 33 cases (76.8%). The main prognostic factors associated with survival rates were initial vocal cord mobility, vocal cord mobility at the diagnosis of recurrence, and changes in mobility. Vocal cord mobility is an important clinical criterion in treatment decision making for early-stage glottis carcinoma and remains important during follow-up.
Martínez-Avilés, Marta; Ivorra, Benjamin; Martínez-López, Beatriz; Ramos, Ángel Manuel; Sánchez-Vizcaíno, José Manuel
2017-01-01
Early detection of infectious diseases can substantially reduce the health and economic impacts on livestock production. Here we describe a system for monitoring animal activity based on video and data processing techniques, in order to detect slowdown and weakening due to infection with African swine fever (ASF), one of the most significant threats to the pig industry. The system classifies and quantifies motion-based animal behaviour and daily activity in video sequences, allowing automated and non-intrusive surveillance in real-time. The aim of this system is to evaluate significant changes in animals’ motion after being experimentally infected with ASF virus. Indeed, pig mobility declined progressively and fell significantly below pre-infection levels starting at four days after infection at a confidence level of 95%. Furthermore, daily motion decreased in infected animals by approximately 10% before the detection of the disease by clinical signs. These results show the promise of video processing techniques for real-time early detection of livestock infectious diseases. PMID:28877181
Gait and Functional Mobility Deficits in Fragile X-Associated Tremor/Ataxia Syndrome.
O'Keefe, Joan A; Robertson-Dick, Erin E; Hall, Deborah A; Berry-Kravis, Elizabeth
2016-08-01
Fragile X-associated tremor/ataxia syndrome (FXTAS) results from a "premutation" (PM) size CGG repeat expansion in the fragile X mental retardation 1 (FMR1) gene. Cerebellar gait ataxia is the primary feature in some FXTAS patients causing progressive disability. However, no studies have quantitatively characterized gait and mobility deficits in FXTAS. We performed quantitative gait and mobility analysis in seven FMR1 PM carriers with FXTAS and ataxia, six PM carriers without FXTAS, and 18 age-matched controls. We studied four independent gait domains, trunk range of motion (ROM), and movement transitions using an instrumented Timed Up and Go (i-TUG). We correlated these outcome measures with FMR1 molecular variables and clinical severity scales. PM carriers with FXTAS were globally impaired in every gait performance domain except trunk ROM compared to controls. These included total i-TUG duration, stride velocity, gait cycle time, cadence, double-limb support and swing phase times, turn duration, step time before turn, and turn-to-sit duration, and increased gait variability on several measures. Carriers without FXTAS did not differ from controls on any parameters, but double-limb support time was close to significance. Balance and disability scales correlated with multiple gait and movement transition parameters, while the FXTAS Rating Scale did not. This is the first study to quantitatively examine gait and movement transitions in FXTAS patients. Gait characteristics were consistent with those from previous cohorts with cerebellar ataxia. Sensitive measures like the i-TUG may help determine efficacy of interventions, characterize disease progression, and provide early markers of disease in FXTAS.
Mobile Learning and Early Age Mathematics
ERIC Educational Resources Information Center
Peled, Shir; Schocken, Shimon
2014-01-01
The ability to develop engaging simulations and constructive learning experiences using mobile devices is unprecedented, presenting a disruption in educational practices of historical proportions. In this paper we describe some of the unique virtues that mobile learning hold for early age mathematics education. In particular, we describe how…
[Algorithms for early mobilization in intensive care units].
Nydahl, P; Dubb, R; Filipovic, S; Hermes, C; Jüttner, F; Kaltwasser, A; Klarmann, S; Mende, H; Nessizius, S; Rottensteiner, C
2017-03-01
Immobility of patients in intensive care units (ICU) can lead to long-lasting physical and cognitive decline. During the last few years, bundles for rehabilitation were developed, including early mobilization. The German guideline for positioning therapy and mobilization, in general, recommends the development of ICU-specific protocols. The aim of this narrative review is to provide guidance when developing a best practice protocol in one's own field of work. It is recommended to a) implement early mobilization as part of a bundle, including screening and management of patient's awareness, pain, anxiety, stress, delirium and family's presence, b) develop a traffic-light system of specific in- and exclusion criteria in an interprofessional process, c) use checklists to assess risks and preparation of mobilization, d) use the ICU Mobility Scale for targeting and documentation of mobilization, e) use relative safety criteria for hemodynamic and respiratory changes, and Borg Scale for subjective evaluation, f) document and evaluate systematically mobilization levels, barriers, unwanted safety events and other parameters.
A Behaviour Monitoring System (BMS) for Ambient Assisted Living
Eisa, Samih
2017-01-01
Unusual changes in the regular daily mobility routine of an elderly person at home can be an indicator or early symptom of developing health problems. Sensor technology can be utilised to complement the traditional healthcare systems to gain a more detailed view of the daily mobility of a person at home when performing everyday tasks. We hypothesise that data collected from low-cost sensors such as presence and occupancy sensors can be analysed to provide insights on the daily mobility habits of the elderly living alone at home and to detect routine changes. We validate this hypothesis by designing a system that automatically learns the daily room-to-room transitions and permanence habits in each room at each time of the day and generates alarm notifications when deviations are detected. We present an algorithm to process the sensors’ data streams and compute sensor-driven features that describe the daily mobility routine of the elderly as part of the developed Behaviour Monitoring System (BMS). We are able to achieve low detection delay with confirmation time that is high enough to convey the detection of a set of common abnormal situations. We illustrate and evaluate BMS with synthetic data, generated by a developed data generator that was designed to mimic different user’s mobility profiles at home, and also with a real-life dataset collected from prior research work. Results indicate BMS detects several mobility changes that can be symptoms of common health problems. The proposed system is a useful approach for learning the mobility habits at the home environment, with the potential to detect behaviour changes that occur due to health problems, and therefore, motivating progress toward behaviour monitoring and elder’s care. PMID:28837105
Noninflammatory Joint Contractures Arising from Immobility: Animal Models to Future Treatments
Wong, Kayleigh; Trudel, Guy; Laneuville, Odette
2015-01-01
Joint contractures, defined as the limitation in the passive range of motion of a mobile joint, can be classified as noninflammatory diseases of the musculoskeletal system. The pathophysiology is not well understood; limited information is available on causal factors, progression, the pathophysiology involved, and prediction of response to treatment. The clinical heterogeneity of joint contractures combined with the heterogeneous contribution of joint connective tissues to joint mobility presents challenges to the study of joint contractures. Furthermore, contractures are often a symptom of a wide variety of heterogeneous disorders that are in many cases multifactorial. Extended immobility has been identified as a causal factor and evidence is provided from both experimental and epidemiology studies. Of interest is the involvement of the joint capsule in the pathophysiology of joint contractures and lack of response to remobilization. While molecular pathways involved in the development of joint contractures are being investigated, current treatments focus on physiotherapy, which is ineffective on irreversible contractures. Future treatments may include early diagnosis and prevention. PMID:26247029
ERIC Educational Resources Information Center
Tefft, Donita; Guerette, Paula; Furumasu, Jan
2011-01-01
Powered mobility has been found to have positive effects on young children with severe physical disabilities, but the impact on the family has been less well documented. We evaluated the impact of early powered mobility on parental stress, negative emotions, perceived social interactions, and parental satisfaction with wheelchair characteristics…
Evaluation of a Progressive Mobility Protocol in Postoperative Cardiothoracic Surgical Patients.
Floyd, Shawn; Craig, Sarah W; Topley, Darla; Tullmann, Dorothy
2016-01-01
Cardiothoracic surgical patients are at high risk for complications related to immobility, such as increased intensive care and hospital length of stay, intensive care unit readmission, pressure ulcer development, and deep vein thrombosis/pulmonary embolus. A progressive mobility protocol was started in the thoracic cardiovascular intensive care unit in a rural academic medical center. The purpose of the progressive mobility protocol was to increase mobilization of postoperative patients and decrease complications related to immobility in this unique patient population. A matched-pairs design was used to compare a randomly selected sample of the preintervention group (n = 30) to a matched postintervention group (n = 30). The analysis compared outcomes including intensive care unit and hospital length of stay, intensive care unit readmission occurrence, pressure ulcer prevalence, and deep vein thrombosis/pulmonary embolism prevalence between the 2 groups. Although this comparison does not achieve statistical significance (P < .05) for any of the outcomes measured, it does show clinical significance in a reduction in hospital length of stay, intensive care unit days, in intensive care unit readmission rate, and a decline in pressure ulcer prevalence, which is the overall goal of progressive mobility. This study has implications for nursing, hospital administration, and therapy services with regard to staffing and cost savings related to fewer complications of immobility. Future studies with a larger sample size and other populations are warranted.
Mobile Usability in Educational Contexts: What Have We Learnt?
ERIC Educational Resources Information Center
Kukulska-Hulme, Agnes
2007-01-01
The successful development of mobile learning is dependent on human factors in the use of new mobile and wireless technologies. The majority of mobile learning activity continues to take place on devices that were not designed with educational applications in mind, and usability issues are often reported. The paper reflects on progress in…
Use of optokinetics based OKCSIB protocol in restoring mobility in primary progressive MS.
Chitambira, Benjamin; McConaghy, Ciara
2017-10-04
The case is of a mid-40s patient who developed progressive muscle weakness and loss of mobility over 6 weeks due to primary progressive multiple sclerosis. 2.5 days before admission, she became bed bound with weakness of 1/5 on the Oxford scale. She normally rested for a couple of days after similar periods of worsening symptoms and then got back on her feet although with worse balance. She was treated with optokinetic chart stimulation and sensory interaction for balance (OKCSIB) protocol. Within 2 days of intervention, she was mobile with a delta frame and supervision of one. By the end of a week, she was independently mobile with her delta frame. It is recommended that instead of just practising function, the OKCSIB protocol be used to regain antigravity extensor control loss of which leads to deteriorating function in neurological conditions. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Lu, Kang; Liliang, Po-Chou; Wang, Hao-Kuang; Chen, Jui-Sheng; Chen, Te-Yuan; Huang, Ruyi; Chen, Han-Jung
2016-01-01
Background/objective Internal disk disruption (IDD), an early event of lumbar disk degeneration, is the most common cause of low back pain. Since increased intradiskal pressure (IDP) is associated with symptoms and progression of disk degeneration, unloading a painful disk with an interspinous process device (IPD) is a rational treatment option. The goal of this study was to evaluate the effectiveness of dynamic stabilization with an IPD in the treatment of symptomatic IDD of the lumbar spine. Patients and methods Patients with symptomatic IDD were treated with implantation of an IPD, the device for intervertebral assisted motion (DIAM). Diagnosis of IDD was based on typical MRI finding of posterior annular high-intensity zone and positive provocative test on discography. IDP was analyzed intraoperatively. Axial back and leg pain was evaluated with visual analog scale, functional status with Oswestry Disability Index, and final clinical outcomes with Odom criteria. Data from 34 patients followed up for at least 3 years were collected. Results DIAM implantation significantly reduced IDP (n=11, P<0.0001). All 34 patients reported symptom relief. Thirty-one patients (91%) remained symptom free until the last followups. Three patients (9%) experienced recurrence of pain, of which the causes were unrelated to the IDD or surgery. Disk status at the DIAM-implanted segments remained stable. Segmental flexion/extension mobility was preserved in 27 of 30 patients with preoperative mobility. No proximal or distal adjacent segment degeneration was observed. The final clinical outcomes were excellent/good in 31 and fair/poor in three patients. Conclusion For patients with symptomatic IDD, dynamic stabilization with DIAM provides pain relief and functional improvement. The implantation maintains disk status and prevents progression of disk degeneration, without compromising segmental flexion/extension mobility or causing adjacent segment degeneration. PMID:27826214
Schujmann, Debora Stripari; Lunardi, Adriana Claudia; Fu, Carolina
2018-05-10
Enhanced mobility in the Intensive Care Unit (ICU) could minimize the negative effects of critical illness, such as declines in cognitive, muscular, respiratory, and functional capacity. We aim to compare the functional status at ICU discharge of patients who underwent a progressive mobilization protocol versus patients who received conventional physiotherapy. We also examine the level of physical activity in the ICU, the degree of pulmonary and muscle function, and the length of stay to analyze correlations between these variables. This is a protocol for a randomized controlled trial with blind evaluation. Ninety-six ICU patients will be recruited from a single center and randomly assigned to a control group or an intervention group. To determine the level of protocol activity the patient will receive, the patients' ability to participate actively and their muscle strength will be considered. The protocol consists of five phases, ranging from passive therapies to walking and climbing stairs. The primary outcome will be the functional status at ICU discharge, measured with the Barthel Index and the ICU Mobility Scale (IMS). Measured secondary outcomes will include the level of physical activity, maximal inspiratory and expiratory pressures, forced expiratory volume in 1 second, maximum voluntary ventilation, handgrip strength, surface electromyography of the lower limb muscles, and results of the Timed Up and Go and 2-Minute Walk tests. Evaluations will be made within 2 days of ICU discharge except for the level of activity, which will be evaluated daily. Physiological variables and activity level will be analyzed by chi-square and t tests, according to the intention-to-treat paradigm. Mobility and exercise in the ICU should be undertaken with intensity, quantity, duration, and frequency adjusted according to the patients' status. The results of this study may contribute to new knowledge of early mobility in the ICU, activity level, and varying benefits in critical patients, directing new approaches to physiotherapeutic interventions in these patients. Recruitment will begin in February 2017, and the expected completion date is August 2018. Patients are already being recruited. ClinicalTrials.gov, ID: NCT02889146 . Registered on 3 March 2016.
Rethinking liquid biopsy: Microfluidic assays for mobile tumor cells in human body fluids.
Neoh, Kuang Hong; Hassan, Ayon Ahmed; Chen, Anqi; Sun, Yukun; Liu, Peng; Xu, Kai-Feng; Wong, Alice S T; Han, Ray P S
2018-01-01
Traditionally, liquid biopsy is a blood test involving the harvesting of tumor materials from peripheral blood. Tumor cells from non-blood body fluids have always been clinically available in cytological examinations but limited for use in differential diagnosis due to the low sensitivity of conventional cytopathology. With the recent significant progress in microfluidic and downstream molecular technologies, liquid biopsies have now evolved to include harvesting tumor cells and DNA fragments in all kinds of non-blood body fluids. This expansion into general body fluids presages the notion that liquid biopsy could soon be used in competition, as well as, in complementarity with tissue biopsy. Preliminary research of fluid-harvested tumor materials to spot early-stage tumors, monitor disease progression for metastasis and recurrence, and detect chemoresistance have been reported. To reflect the propagation of tumor cells in non-blood body fluids, we introduced the term Mobile Tumor Cells (MTCs), in lieu of the widely accepted term of circulating tumor cells (CTCs) resident in the bloodstream. Our review starts with a discussion on the clinical significance of MTCs, followed by a presentation of microfluidic techniques for MTC capture and various strategies for their identification. Hopefully, the phenotypic and genomic data acquired from harvested MTCs can be used to guide and improve cancer treatment decisions. Copyright © 2017 Elsevier Ltd. All rights reserved.
Molecular isoforms of high-mobility group box 1 are mechanistic biomarkers for epilepsy
Walker, Lauren Elizabeth; Frigerio, Federica; Ravizza, Teresa; Ricci, Emanuele; Tse, Karen; Jenkins, Rosalind E.; Sills, Graeme John; Jorgensen, Andrea; Porcu, Luca; Alapirtti, Tiina; Peltola, Jukka; Brodie, Martin J.; Park, Brian Kevin; Marson, Anthony Guy; Antoine, Daniel James
2017-01-01
Approximately 30% of epilepsy patients do not respond to antiepileptic drugs, representing an unmet medical need. There is evidence that neuroinflammation plays a pathogenic role in drug-resistant epilepsy. The high-mobility group box 1 (HMGB1)/TLR4 axis is a key initiator of neuroinflammation following epileptogenic injuries, and its activation contributes to seizure generation in animal models. However, further work is required to understand the role of HMGB1 and its isoforms in epileptogenesis and drug resistance. Using a combination of animal models and sera from clinically well-characterized patients, we have demonstrated that there are dynamic changes in HMGB1 isoforms in the brain and blood of animals undergoing epileptogenesis. The pathologic disulfide HMGB1 isoform progressively increased in blood before epilepsy onset and prospectively identified animals that developed the disease. Consistent with animal data, we observed early expression of disulfide HMGB1 in patients with newly diagnosed epilepsy, and its persistence was associated with subsequent seizures. In contrast with patients with well-controlled epilepsy, patients with chronic, drug-refractory epilepsy persistently expressed the acetylated, disulfide HMGB1 isoforms. Moreover, treatment of animals with antiinflammatory drugs during epileptogenesis prevented both disease progression and blood increase in HMGB1 isoforms. Our data suggest that HMGB1 isoforms are mechanistic biomarkers for epileptogenesis and drug-resistant epilepsy in humans, necessitating evaluation in larger-scale prospective studies. PMID:28504645
Poletto, Simone Rosa; Rebello, Letícia Costa; Valença, Maria Júlia Monteiro; Rossato, Daniele; Almeida, Andrea Garcia; Brondani, Rosane; Chaves, Márcia Lorena Fagundes; Nasi, Luiz Antônio; Martins, Sheila Cristina Ouriques
2015-01-01
Background The effect of early mobilization after acute stroke is still unclear, although some studies have suggested improvement in outcomes. We conducted a randomized, single-blind, controlled trial seeking to evaluate the feasibility, safety, and benefit of early mobilization for patients with acute ischemic stroke treated in a public teaching hospital in Southern Brazil. This report presents the feasibility and safety findings for the pilot phase of this trial. Methods The primary outcomes were time to first mobilization, total duration of mobilization, complications during early mobilization, falls within 3 months, mortality within 3 months, and medical complications of immobility. We included adult patients with CT- or MRI-confirmed ischemic stroke within 48 h of symptom onset who were admitted from March to November 2012 to the acute vascular unit or general emergency unit of a large urban emergency department (ED) at the Hospital de Clínicas de Porto Alegre. The severity of the neurological deficit on admission was assessed by the National Institutes of Health Stroke Scale (NIHSS). The NIHSS and modified Rankin Scale (mRS, functional outcome) scores were assessed on day 14 or at discharge as well as at 3 months. Activities of daily living (ADL) were measured with the modified Barthel Index (mBI) at 3 months. Results Thirty-seven patients (mean age 65 years, mean NIHSS score 11) were randomly allocated to an intervention group (IG) or a control group (CG). The IG received earlier (p = 0.001) and more frequent (p < 0.0001) mobilization than the CG. Of the 19 patients in the CG, only 5 (26%) underwent a physical therapy program during hospitalization. No complications (symptomatic hypotension or worsening of neurological symptoms) were observed in association with early mobilization. The rates of complications of immobility (pneumonia, pulmonary embolism, and deep vein thrombosis) and mortality were similar in the two groups. No statistically significant differences in functional independence, disability, or ADL (mBI ≥85) were observed between the groups at the 3-month follow-up. Conclusions This pilot trial conducted at a public hospital in Brazil suggests that early mobilization after acute ischemic stroke is safe and feasible. Despite some challenges and limitations, early mobilization was successfully implemented, even in the setting of a large, complex ED, and without complications. Patients from the IG were mobilized much earlier than controls receiving the standard care provided in most Brazilian hospitals. PMID:26034487
Global status of diabetes prevention and prospects for action: A consensus statement.
Ibrahim, Mahmoud; Tuomilehto, Jaakko; Aschner, Pablo; Beseler, Lucille; Cahn, Avivit; Eckel, Robert H; Fischl, Amy Hess; Guthrie, George; Hill, James O; Kumwenda, Mick; Leslie, R David; Olson, Darin E; Pozzilli, Paolo; Weber, Sandra L; Umpierrez, Guillermo E
2018-05-14
Primary prevention of type 2 diabetes (T2D) should be achievable through the implementation of early and sustainable measures. Several randomized control studies that found success in preventing the progression to T2D in high-risk populations have identified early and intensive intervention based on an individualized prevention model as the key factor for participant benefit. The global prevalence of both overweight and obesity has now been widely recognized as the major epidemic of the 21st century. Obesity is a major risk factor for the progression from normal glucose tolerance to prediabetes and then to T2D. However, not all obese individuals will develop prediabetes or progress to diabetes. Intensive, multicomponent behavioural interventions for overweight and obese adults can lead to weight loss. Diabetes medications, including metformin, GLP-1 agonists, glitazones, and acarbose, can be considered for selected high-risk patients with prediabetes when lifestyle-based programmes are proven unsuccessful. Nutrition education is the cornerstone of a healthy lifestyle. Also, physical activity is an integral part of the prediabetes management plan and one of the main pillars in the prevention of diabetes. Mobile phones, used extensively worldwide, can facilitate communication between health professionals and the general population, and have been shown to be helpful in the prevention of T2D. Universal screening is needed. Noninvasive risk scores should be used in all countries, but they should be locally validated in all ethnic populations focusing on cultural differences around the world. Lifestyle interventions reduce the progression to prediabetes and diabetes. Nevertheless, many questions still need to be answered. Copyright © 2018 John Wiley & Sons, Ltd.
Prespecified dose-response analysis for A Very Early Rehabilitation Trial (AVERT).
Bernhardt, Julie; Churilov, Leonid; Ellery, Fiona; Collier, Janice; Chamberlain, Jan; Langhorne, Peter; Lindley, Richard I; Moodie, Marj; Dewey, Helen; Thrift, Amanda G; Donnan, Geoff
2016-06-07
Our prespecified dose-response analyses of A Very Early Rehabilitation Trial (AVERT) aim to provide practical guidance for clinicians on the timing, frequency, and amount of mobilization following acute stroke. Eligible patients were aged ≥18 years, had confirmed first (or recurrent) stroke, and were admitted to a stroke unit within 24 hours of stroke onset. Patients were randomized to receive very early and frequent mobilization, commencing within 24 hours, or usual care. We used regression analyses and Classification and Regression Trees (CART) to investigate the effect of timing and dose of mobilization on efficacy and safety outcomes, irrespective of assigned treatment group. A total of 2,104 patients were enrolled, of whom 2,083 (99.0%) were followed up at 3 months. We found a consistent pattern of improved odds of favorable outcome in efficacy and safety outcomes with increased daily frequency of out-of-bed sessions (odds ratio [OR] 1.13, 95% confidence interval [CI] 1.09 to 1.18, p < 0.001), keeping time to first mobilization and mobilization amount constant. Increased amount (minutes per day) of mobilization reduced the odds of a good outcome (OR 0.94, 95% CI 0.91 to 0.97, p < 0.001). Session frequency was the most important variable in the CART analysis, after prognostic variables age and baseline stroke severity. These data suggest that shorter, more frequent mobilization early after acute stroke is associated with greater odds of favorable outcome at 3 months when controlling for age and stroke severity. This study provides Class III evidence that shorter, more frequent early mobilization improves the chance of regaining independence after stroke. © 2016 American Academy of Neurology.
Prespecified dose-response analysis for A Very Early Rehabilitation Trial (AVERT)
Churilov, Leonid; Ellery, Fiona; Collier, Janice; Chamberlain, Jan; Langhorne, Peter; Lindley, Richard I.; Moodie, Marj; Dewey, Helen; Thrift, Amanda G.; Donnan, Geoff
2016-01-01
Objective: Our prespecified dose-response analyses of A Very Early Rehabilitation Trial (AVERT) aim to provide practical guidance for clinicians on the timing, frequency, and amount of mobilization following acute stroke. Methods: Eligible patients were aged ≥18 years, had confirmed first (or recurrent) stroke, and were admitted to a stroke unit within 24 hours of stroke onset. Patients were randomized to receive very early and frequent mobilization, commencing within 24 hours, or usual care. We used regression analyses and Classification and Regression Trees (CART) to investigate the effect of timing and dose of mobilization on efficacy and safety outcomes, irrespective of assigned treatment group. Results: A total of 2,104 patients were enrolled, of whom 2,083 (99.0%) were followed up at 3 months. We found a consistent pattern of improved odds of favorable outcome in efficacy and safety outcomes with increased daily frequency of out-of-bed sessions (odds ratio [OR] 1.13, 95% confidence interval [CI] 1.09 to 1.18, p < 0.001), keeping time to first mobilization and mobilization amount constant. Increased amount (minutes per day) of mobilization reduced the odds of a good outcome (OR 0.94, 95% CI 0.91 to 0.97, p < 0.001). Session frequency was the most important variable in the CART analysis, after prognostic variables age and baseline stroke severity. Conclusion: These data suggest that shorter, more frequent mobilization early after acute stroke is associated with greater odds of favorable outcome at 3 months when controlling for age and stroke severity. Classification of evidence: This study provides Class III evidence that shorter, more frequent early mobilization improves the chance of regaining independence after stroke. PMID:26888985
A Community-Engaged Approach to Developing a Mobile Cancer Prevention App: The mCPA Study Protocol.
Smith, Selina Ann; Whitehead, Mary Smith; Sheats, Joyce; Mastromonico, Jeff; Yoo, Wonsuk; Coughlin, Steven Scott
2016-03-02
Rapid growth of mobile technologies has resulted in a proliferation of lifestyle-oriented mobile phone apps. However, most do not have a theoretical framework and few have been developed using a community-based participatory research approach. A community academic team will develop a theory-based, culturally tailored, mobile-enabled, Web-based app-the Mobile Cancer Prevention App (mCPA)-to promote adherence to dietary and physical activity guidelines. The aim of this study is to develop mCPA content with input from breast cancer survivors. Members of SISTAAH (Survivors Involving Supporters to Take Action in Advancing Health) Talk (N=12), treated for Stages I-IIIc breast cancer for less than 1 year, 75 years of age or younger, and English-speaking and writing, will be recruited to participate in the study. To develop the app content, breast cancer survivors will engage with researchers in videotaped and audiotaped sessions, including (1) didactic instructions with goals for, benefits of, and strategies to enhance dietary intake and physical activity, (2) guided discussions for setting individualized goals, monitoring progress, and providing or receiving feedback, (3) experiential nutrition education through cooking demonstrations, and (4) interactive physical activity focused on walking, yoga, and strength training. Qualitative (focus group discussions and key informant interviews) and quantitative (sensory evaluation) methods will be used to evaluate the participatory process and outcomes. Investigators and participants anticipate development of an acceptable (frequency and duration of usage) feasible (structure, ease of use, features), and accessible mobile app available for intervention testing in early 2017. Depending on the availability of research funding, mCPA testing, which will be initiated in Miami, will be extended to Chicago, Houston, Philadelphia, and Los Angeles.
A Community-Engaged Approach to Developing a Mobile Cancer Prevention App: The mCPA Study Protocol
2016-01-01
Background Rapid growth of mobile technologies has resulted in a proliferation of lifestyle-oriented mobile phone apps. However, most do not have a theoretical framework and few have been developed using a community-based participatory research approach. A community academic team will develop a theory-based, culturally tailored, mobile-enabled, Web-based app—the Mobile Cancer Prevention App (mCPA)—to promote adherence to dietary and physical activity guidelines. Objective The aim of this study is to develop mCPA content with input from breast cancer survivors. Methods Members of SISTAAH (Survivors Involving Supporters to Take Action in Advancing Health) Talk (N=12), treated for Stages I-IIIc breast cancer for less than 1 year, 75 years of age or younger, and English-speaking and writing, will be recruited to participate in the study. To develop the app content, breast cancer survivors will engage with researchers in videotaped and audiotaped sessions, including (1) didactic instructions with goals for, benefits of, and strategies to enhance dietary intake and physical activity, (2) guided discussions for setting individualized goals, monitoring progress, and providing or receiving feedback, (3) experiential nutrition education through cooking demonstrations, and (4) interactive physical activity focused on walking, yoga, and strength training. Qualitative (focus group discussions and key informant interviews) and quantitative (sensory evaluation) methods will be used to evaluate the participatory process and outcomes. Results Investigators and participants anticipate development of an acceptable (frequency and duration of usage) feasible (structure, ease of use, features), and accessible mobile app available for intervention testing in early 2017. Conclusions Depending on the availability of research funding, mCPA testing, which will be initiated in Miami, will be extended to Chicago, Houston, Philadelphia, and Los Angeles. PMID:26935995
Experimental study of boron geochemistry: implications for fluid processes in subduction zones
NASA Astrophysics Data System (ADS)
You, C. F.; Spivack, A. J.; Gieskes, J. M.; Rosenbauer, R.; Bischoff, J. L.
1995-06-01
A comprehensive experimental study, utilizing an autoclave hydrothermal apparatus with a 10B isotopic tracer, has been conducted to monitor the geochemical behavior of sediment B during early subduction zone processes. The partition coefficient of exchangeable B ( K D) was determined over a temperature range of 25-350°C, at 800 bars and a water/rock ratio of 3-1.5 w/w. These K D are shown to be a complex function of temperature, pH, and possibly mineralogy. At low temperatures, K D is significantly high at ˜4 in contrast to the value of essentially zero at temperatures higher than ˜100°C. A K D of zero represents no B adsorption, implying efficient mobilization of exchangeable B at shallow depths during sediment subduction. Our experimental results demonstrate high mobilization of bulk B in sediments (both exchangeable and lattice bound) at elevated temperatures (200-350°C), in good agreement with previous observations of B in metasediments indicating progressive depletion during metamorphism. In addition, this study emphasizes the importance of a possible water/rock ratio dependence of B mobilization. In other words, the degree of sedimentary B mobilization in subduction zones strongly depends on the local thermal structure and porosity distribution. In low geothermal gradient areas, large amounts of porewater are expelled before significant B mobilization has occurred, so that some sedimentary B will survive and get into the deeper parts of the subduction zone. Our results imply that efficient mobilization of B from the subducted slab must occur and that arc magmatism recycles most of the remaining subducted B back to surface reservoirs. A reconsideration of the B budget in subduction zones provides critical information with respect to B sources and sinks in the ocean.
ERIC Educational Resources Information Center
Chang, Jui-Hung; Chiu, Po-Sheng; Huang, Yueh-Min
2018-01-01
With the advances in mobile network technology, the use of portable devices and mobile networks for learning is not limited by time and space. Such use, in combination with appropriate learning strategies, can achieve a better effect. Despite the effectiveness of mobile learning, students' learning direction, progress, and achievement may differ.…
Krapf, Daniel; Kaipel, Martin; Majewski, Martin
2012-09-01
Acute Achilles tendon ruptures are common sports injuries; however, treatment remains a clinical challenge. Studies show a superior effect of early mobilization and full weight bearing on tendon healing and clinical outcome; however, few data exist on structural and biomechanical characteristics in the early healing phase. This study investigated the histological and biomechanical characteristics of early mobilization and full weight bearing in an Achilles tendon rupture model. Eighty rats underwent dissection of a hindpaw Achilles tendon; 40 rats were treated conservatively and 40 underwent open repair of the transected Achilles tendon by suturing. Early mobilization and full weight bearing were allowed in both groups. At 1, 2, 4, and 8 weeks after tenotomy, tensile strength, stiffness, thickness, tissue characteristics (histological analysis), and length were determined. Dissected Achilles tendons healed in all animals during full weight-bearing early mobilization. One and 2 weeks after tenotomy, rats in the operative group showed increased tensile strength and stiffness compared with the nonoperative group. Repair-site diameters were increased at 1, 2, and 8 weeks after tenotomy. Tendon length was decreased in the operative group throughout observation, whereas the nonoperative group showed increased structural characteristics on the cellular level and a more homogeneous collagen distribution. Surgical treatment of dissected rat Achilles tendons showed superior biomechanical characteristics within the first 2 weeks. Conservative treatment resulted in superior histological findings but significant lengthening of the tendon in the early healing phase (weeks 1-8). Copyright 2012, SLACK Incorporated.
Epidemiology of HIV-TB in Asia.
Narain, Jai P; Lo, Ying-Ru
2004-10-01
Tuberculosis (TB) has, for centuries, continued to remain a public health problem of enormous importance, particularly in the developing world, taking a heavy toll of those at their prime of life. The emergence of human immunodeficiency virus (HIV infection) and its close association with TB poses an even greater challenge to the health systems in general and TB programmes in particular, in African and Asian countries. HIV is considered to be the most potent risk factor for progression to active TB among those infected both with TB and HIV; as a result, TB is the most common life threatening opportunistic infection associated with HIV, and biggest cause of death among patients with acquired immunodeficiency syndrome (AIDS). In areas hard-hit by HIV, TB is increasing, leading to greater case load, thereby overstretching the already fragile health infrastructure. The deadly relationship between HIV and TB, each potentiating the effect of the other, requires a clearly defined strategy taking into consideration the natural history of the co-infection and its progression to clinical TB (and AIDS). It is clear that the only way to fight this is by bringing the two programmes to join forces and work creatively and innovatively. The strategy should include not only preventing HIV through community-based behavioural interventions and limiting progression to clinical TB through the use of isoniazid preventive therapy, but also early diagnosis and treatment of HIV-associated TB and AIDS using DOTS strategy and combination antiretroviral therapy respectively. The strategy probably would not succeed unless both the programmes are first strengthened before attempting to forge collaboration based on mutual strengths and comparative advantages. In addition, mobilizing national and international response, building partnerships and mobilizing resources will help a great deal in mounting an appropriate and effective response to HIV/TB in the Asian context.
Implications of Mobility Impairment on the Diagnosis and Treatment of Breast Cancer
Park, Elyse R.; Kilbridge, Kerry L.
2011-01-01
Abstract Background Among women with chronic, preexisting mobility impairments, we sought to explore how their mobility difficulties affected the diagnosis and treatment of early-stage breast cancer Methods This is a qualitative analysis of transcripts from in-depth in-person or telephone interviews with 20 English-speaking women who had early-stage breast cancer, were <60 years of age, and had chronic difficulty walking or used wheeled mobility aids at the time of their breast cancer diagnoses Results Nine women were disabled by polio as children or had postpolio syndrome, 3 had cerebral palsy, 3 had spinal cord injury, and 5 had other conditions. Most women reported difficulty obtaining mammograms, primarily because of inaccessible equipment, positioning problems, and difficulties with uncontrollable movements. Many women made decisions about surgical approach and chemotherapy by explicitly considering how various therapies would affect their arms, which are essential to their mobility (they use ambulation aids, self-propel manual wheelchairs, or otherwise rely on their arms for mobility or safety). Managing at home after surgery posed major mobility challenges, especially for women who lived alone. Several women reported feeling they suffered more chemotherapy side effects than do women without mobility problems. Weight gains with endocrine therapy compromised the mobility of several women. Conclusions Increasing numbers of American women are living with mobility disabilities and entering age ranges with increased risks of breast cancer. Mobility impairments can affect women at every point during early-stage breast cancer diagnosis, therapy, and recovery. Clinicians must consider women's mobility functioning in making therapeutic recommendations to women with impaired mobility who develop breast cancer. PMID:21034276
ERIC Educational Resources Information Center
Rawashdeh, Awni; Al-namlah, Lamia
2015-01-01
To examine the impact of the usage of fixed and mobile broadband on the progress of continuing professional education (CPE) from the perspective of chartered accountants in Saudi Arabia, an e-mail survey was conducted. A random sampling of chartered accountants in Saudi Arabia was investigated. This research was aimed to identify any correlation…
Learners on the Move: Mobile Modalities in Development Studies
ERIC Educational Resources Information Center
Beckmann, Elizabeth A.
2010-01-01
Many careers involve mobile lifestyles, yet require specialised postgraduate qualifications for career progression. Mobile technologies offer new opportunities by providing more choice in when, where, and how students learn. Experiences in an Australian postgraduate development studies program illustrate the choices. Three key issues are explored:…
Peixoto, Thatiana C A; Begot, Isis; Bolzan, Douglas W; Machado, Lais; Reis, Michel S; Papa, Valeria; Carvalho, Antonio C C; Arena, Ross; Gomes, Walter J; Guizilini, Solange
2015-03-01
The purpose of this study was to evaluate the influence of an early cardiac rehabilitation (CR) program on health-related quality of life (HRQL) and functional capacity in patients who recently experienced an acute myocardial infarction (AMI). This program was initiated in the inpatient setting and was followed by an unsupervised outpatient intervention. After the same inpatient care plan, low-risk patients who experienced an AMI were randomized into 2 groups: (1) a control group (CG) (n = 43) entailing usual care and (2) an intervention group (IG) (n = 45) entailing outpatient (unsupervised) CR primarily centered on a progressive walking program. Initially, all patients underwent a supervised exercise program with early mobilization beginning 12 hours after an AMI. On hospital discharge, all patients were classified according to cardiovascular risk. Quality of life was evaluated by the MacNew Heart Disease HRQL questionnaire 30 days after discharge. Functional capacity was determined by a 6-minute walk test (6MWT) distance on the day of inpatient discharge as well as 30 days afterward. The HRQL global score was higher in the IG compared with the CG 30 days after discharge (P < 0.001); physical and emotional domain scores were both significantly higher in the IG (P < 0.001). Furthermore, the IG showed a greater 6MWT distance compared with the CG (P < 0.001). A CR program based on early progressive exercises, initiated by supervised inpatient training and followed by an unsupervised outpatient program, improved HRQL and functional capacity in patients at low cardiovascular risk who recently experienced an AMI. Copyright © 2015 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.
Jung, Seok Yun; Choi, Jin Hwa; Kwon, Sang-Mo; Masuda, Haruchika; Asahara, Takayuki; Lee, You-Mie
2012-05-01
Endothelial progenitor cells (EPCs) contribute to the tumor vasculature during tumor progression. Decursin isolated from the herb Angelica gigas is known to possess potent anti-inflammatory activities. Recently, we reported that decursin is a novel candidate for an angiogenesis inhibitor [Jung et al., 2009]. In this study, we investigated whether decursin regulates EPC differentiation and function to inhibit tumor vasculogenesis. We isolated AC133+ cells from human cord blood and decursin significantly decreased the number of EPC colony forming units of human cord blood-derived AC133+ cells that produce functional EPC progenies. Decursin dose-dependently decreased the cell number of EPC committing cells as demonstrated by EPC expansion studies. Decursin inhibited EPC differentiation from progenitor cells into spindle-shaped EPC colonies. Additionally, decursin inhibited proliferation and migration of early EPCs isolated from mouse bone marrow. Furthermore, decursin suppressed expression of angiopoietin-2, angiopoietin receptor Tie-2, Flk-1 (vascular endothelial growth factor receptor-2), and endothelial nitric oxide synthase in mouse BM derived EPCs in a dose-dependent manner. Decursin suppressed tube formation ability of EPCs in collaboration with HUVEC. Decursin (4 mg/kg) inhibited tumor-induced mobilization of circulating EPCs (CD34 + /VEGFR-2+ cells) from bone marrow and early incorporation of Dil-Ac-LDL-labeled or green fluorescent protein (GFP)+ EPCs into neovessels of xenograft Lewis lung carcinoma tumors in wild-type- or bone-marrow-transplanted mice. Accordingly, decursin attenuated EPC-derived endothelial cells in neovessels of Lewis lung carcinoma tumor masses grown in mice. Together, decursin likely affects EPC differentiation and function, thereby inhibiting tumor vasculogenesis in early tumorigenesis. Copyright © 2012 Wiley Periodicals, Inc.
Matthews, Stephen G; Miller, Amy L; Clapp, James; Plötz, Thomas; Kyriazakis, Ilias
2016-11-01
Early detection of health and welfare compromises in commercial piggeries is essential for timely intervention to enhance treatment success, reduce impact on welfare, and promote sustainable pig production. Behavioural changes that precede or accompany subclinical and clinical signs may have diagnostic value. Often referred to as sickness behaviour, this encompasses changes in feeding, drinking, and elimination behaviours, social behaviours, and locomotion and posture. Such subtle changes in behaviour are not easy to quantify and require lengthy observation input by staff, which is impractical on a commercial scale. Automated early-warning systems may provide an alternative by objectively measuring behaviour with sensors to automatically monitor and detect behavioural changes. This paper aims to: (1) review the quantifiable changes in behaviours with potential diagnostic value; (2) subsequently identify available sensors for measuring behaviours; and (3) describe the progress towards automating monitoring and detection, which may allow such behavioural changes to be captured, measured, and interpreted and thus lead to automation in commercial, housed piggeries. Multiple sensor modalities are available for automatic measurement and monitoring of behaviour, which require humans to actively identify behavioural changes. This has been demonstrated for the detection of small deviations in diurnal drinking, deviations in feeding behaviour, monitoring coughs and vocalisation, and monitoring thermal comfort, but not social behaviour. However, current progress is in the early stages of developing fully automated detection systems that do not require humans to identify behavioural changes; e.g., through automated alerts sent to mobile phones. Challenges for achieving automation are multifaceted and trade-offs are considered between health, welfare, and costs, between analysis of individuals and groups, and between generic and compromise-specific behaviours. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.
Diet and mobility in Early Medieval Bavaria: a study of carbon and nitrogen stable isotopes.
Hakenbeck, Susanne; McManus, Ellen; Geisler, Hans; Grupe, Gisela; O'Connell, Tamsin
2010-10-01
This study investigates patterns of mobility in Early Medieval Bavaria through a combined study of diet and associated burial practice. Carbon and nitrogen isotope ratios were analyzed in human bone samples from the Late Roman cemetery of Klettham and from the Early Medieval cemeteries of Altenerding and Straubing-Bajuwarenstrasse. For dietary comparison, samples of faunal bone from one Late Roman and three Early Medieval settlement sites were also analyzed. The results indicate that the average diet was in keeping with a landlocked environment and fairly limited availability of freshwater or marine resources. The diet appears not to have changed significantly from the Late Roman to the Early Medieval period. However, in the population of Altenerding, there were significant differences in the diet of men and women, supporting a hypothesis of greater mobility among women. Furthermore, the isotopic evidence from dietary outliers is supported by "foreign" grave goods and practices, such as artificial skull modification. These results reveal the potential of carbon and nitrogen isotope analysis for questions regarding migration and mobility. © 2010 Wiley-Liss, Inc.
Rocca, A; Pignat, J-M; Berney, L; Jöhr, J; Van de Ville, D; Daniel, R T; Levivier, M; Hirt, L; Luft, A R; Grouzmann, E; Diserens, K
2016-09-13
Patients who experience severe brain injuries are at risk of secondary brain damage, because of delayed vasospasm and edema. Traditionally, many of these patients are kept on prolonged bed rest in order to maintain adequate cerebral blood flow, especially in the case of subarachnoid hemorrhage. On the other hand, prolonged bed rest carries important morbidity. There may be a clinical benefit in early mobilization and our hypothesis is that early gradual mobilization is safe in these patients. The aim of this study was to observe and quantify the changes in sympathetic activity, mainly related to stress, and blood pressure in gradual postural changes by the verticalization robot (Erigo®) and after training by a lower body ergometer (MOTOmed-letto®), after prolonged bed rest of minimum 7 days. Thirty patients with severe neurological injuries were randomized into 3 groups with different protocols of mobilization: Standard, MOTOmed-letto® or Erigo® protocol. We measured plasma catecholamines, metanephrines and blood pressure before, during and after mobilization. Blood pressure does not show any significant difference between the 3 groups. The analysis of the catecholamines suggests a significant increase in catecholamine production during Standard mobilization with physiotherapists and with MOTOmed-letto® and no changes with Erigo®. This preliminary prospective randomized study shows that the mobilization of patients with severe brain injuries by means of Erigo® does not increase the production of catecholamines. It means that Erigo® is a well-tolerated method of mobilization and can be considered a safe system of early mobilization of these patients. Further studies are required to validate our conclusions. The study was registered in the ISRCTN registry with the trial registration number ISRCTN56402432 . Date of registration: 08.03.2016. Retrospectively registered.
Hodgson, Carol; Bellomo, Rinaldo; Berney, Susan; Bailey, Michael; Buhr, Heidi; Denehy, Linda; Harrold, Megan; Higgins, Alisa; Presneill, Jeff; Saxena, Manoj; Skinner, Elizabeth; Young, Paul; Webb, Steven
2015-02-26
The aim of this study was to investigate current mobilization practice, strength at ICU discharge and functional recovery at 6 months among mechanically ventilated ICU patients. This was a prospective, multi-centre, cohort study conducted in twelve ICUs in Australia and New Zealand. Patients were previously functionally independent and expected to be ventilated for >48 hours. We measured mobilization during invasive ventilation, sedation depth using the Richmond Agitation and Sedation Scale (RASS), co-interventions, duration of mechanical ventilation, ICU-acquired weakness (ICUAW) at ICU discharge, mortality at day 90, and 6-month functional recovery including return to work. We studied 192 patients (mean age 58.1 ± 15.8 years; mean Acute Physiology and Chronic Health Evaluation (APACHE) (IQR) II score, 18.0 (14 to 24)). Mortality at day 90 was 26.6% (51/192). Over 1,351 study days, we collected information during 1,288 planned early mobilization episodes in patients on mechanical ventilation for the first 14 days or until extubation (whichever occurred first). We recorded the highest level of early mobilization. Despite the presence of dedicated physical therapy staff, no mobilization occurred in 1,079 (84%) of these episodes. Where mobilization occurred, the maximum levels of mobilization were exercises in bed (N = 94, 7%), standing at the bed side (N = 11, 0.9%) or walking (N = 26, 2%). On day three, all patients who were mobilized were mechanically ventilated via an endotracheal tube (N = 10), whereas by day five 50% of the patients mobilized were mechanically ventilated via a tracheostomy tube (N = 18). Early mobilization of patients receiving mechanical ventilation was uncommon. More than 50% of patients discharged from the ICU had developed ICU-acquired weakness, which was associated with death between ICU discharge and day-90. ClinicalTrials.gov NCT01674608. Registered 14 August 2012.
Empowering Learners with Mobile Open-Access Learning Initiatives
ERIC Educational Resources Information Center
Mills, Michael, Ed.; Wake, Donna, Ed.
2017-01-01
Education has been progressing at a rapid pace ever since educators have been able to harness the power of mobile technology. Open-access learning techniques provide more students with the opportunity to engage in educational opportunities that may have been previously restricted. "Empowering Learners with Mobile Open-Access Learning…
EPA is taking final action to revise the February 26, 2007 mobile source air toxics rule’s requirements that specify which benzene control technologies a refiner may utilize to qualify to generate early benzene credits.
Fu, Huichao; Wang, Jiaxing; Zhang, Wen; Cheng, Tao; Zhang, Xianlong
2017-01-01
Pain management after total knee arthroplasty (TKA) should permit early knee mobilization with minimal pain. Periarticular injection (PAI) with local anaesthetics has been recently discussed as a protocol of pain control. The purpose of this review of the literature was to evaluate the efficacy of PAI in comparison with femoral nerve block (FNB). A literature search was performed in PubMed, EMBASE, the OVID database and the Cochrane Library databases. Risk of bias was assessed using the Cochrane collaboration tool. Outcomes of interest included narcotic consumption, pain score, early mobilization ability, length of stay and adverse effects or events. Research identified 918 articles, of which six with a total of 284 knees, met the inclusion criteria and were eligible for the current study. Conflicting evidence was found in terms of narcotic consumption on the postoperative day 1 and early mobilization ability. Total narcotic consumption, pain score in the first 2 days after surgery, length of stay and adverse effects or events showed no difference between two groups. Lower pain score on the day of surgery was detected after PAI. When compared to continuous FNB, patients in PAI group showed a tendency to achieving better ability of early mobilization. In consideration of its relatively simple practice and its potential in analgesic effects or early mobilization ability, PAI had superiority to FNB in the management of pain control after TKA. Before PAI could be widely used in clinical practice after TKAs, further investigations would be necessary to confirm or refute our observed results and to unify the protocol of PAI. I.
40 CFR 52.473 - Conditional approval.
Code of Federal Regulations, 2010 CFR
2010-07-01
...-progress plan to provide MOBILE6-based mobile source emission budgets and adopted measures sufficient to... threshold to 25 tons per year. (9) Revises Reasonably Available Control Technology (RACT) rules to include...
The influence of direct mobile phone radiation on sperm quality.
Gorpinchenko, Igor; Nikitin, Oleg; Banyra, Oleg; Shulyak, Alexander
2014-01-01
It is impossible to imagine a modern socially-active man who does not use mobile devices and/or computers with Wi-Fi function. The effect of mobile phone radiation on male fertility is the subject of recent interest and investigations. The aim of this study was to investigate the direct in vitro influence of mobile phone radiation on sperm DNA fragmentation and motility parameters in healthy subjects with normozoospermia. 32 healthy men with normal semen parameters were selected for the study. Each sperm sample was divided into two equal portions (A and B). Portions A of all involved men were placed for 5 hours in a thermostat, and portions B were placed into a second thermostat for the same period of time, where a mobile phone in standby/talk mode was placed. After 5 hours of incubation the sperm samples from both thermostats were re-evaluated regarding basic motility parameters. The presence of DNA fragmentation in both A and B portions of each sample was determined each hour using a standard sperm chromatin dispersion test. The number of spermatozoa with progressive movement in the group, influenced by electromagnetic radiation, is statistically lower than the number of spermatozoa with progressive movement in the group under no effect of the mobile phone. The number of non-progressive movement spermatozoa was significantly higher in the group, which was influenced by cell phone radiation. The DNA fragmentation was also significantly higher in this group. A correlation exists between mobile phone radiation exposure, DNA-fragmentation level and decreased sperm motility.
The influence of direct mobile phone radiation on sperm quality
Gorpinchenko, Igor; Nikitin, Oleg; Shulyak, Alexander
2014-01-01
Introduction It is impossible to imagine a modern socially–active man who does not use mobile devices and/or computers with Wi–Fi function. The effect of mobile phone radiation on male fertility is the subject of recent interest and investigations. The aim of this study was to investigate the direct in vitro influence of mobile phone radiation on sperm DNA fragmentation and motility parameters in healthy subjects with normozoospermia. Material and methods 32 healthy men with normal semen parameters were selected for the study. Each sperm sample was divided into two equal portions (A and B). Portions A of all involved men were placed for 5 hours in a thermostat, and portions B were placed into a second thermostat for the same period of time, where a mobile phone in standby/talk mode was placed. After 5 hours of incubation the sperm samples from both thermostats were re–evaluated regarding basic motility parameters. The presence of DNA fragmentation in both A and B portions of each sample was determined each hour using a standard sperm chromatin dispersion test. Results The number of spermatozoa with progressive movement in the group, influenced by electromagnetic radiation, is statistically lower than the number of spermatozoa with progressive movement in the group under no effect of the mobile phone. The number of non–progressive movement spermatozoa was significantly higher in the group, which was influenced by cell phone radiation. The DNA fragmentation was also significantly higher in this group. Conclusions A correlation exists between mobile phone radiation exposure, DNA–fragmentation level and decreased sperm motility. PMID:24982785
ERIC Educational Resources Information Center
Seo, Mijung; Choi, Eunsil
2018-01-01
The aim of this study was to identify the classes of trajectory in mobile phone dependency using growth mixture modeling among Korean early adolescents from elementary school to the middle school transition. The effects of negative parenting on determining the classes were also examined. The participants were 2,378 early adolescents in the Korean…
Does Using Mobile Device Applications Lead to Learning?
ERIC Educational Resources Information Center
Vogel, Doug; Kennedy, David; Kwok, Ron Chi-Wai
2009-01-01
Assessing the impact on learning of the use of mobile devices and associated applications is a complex challenge. This article reports on progress to date in a longitudinal study using a design research approach with three cohorts of 800 students each. Results are encouraging in terms of learning enhancement through select mobile application by a…
Exploring Students' Progression in an Inquiry Science Curriculum Enabled by Mobile Learning
ERIC Educational Resources Information Center
Looi, Chee-Kit; Sun, Daner; Xie, Wenting
2015-01-01
The research literature reports on designs of ubiquitous and seamless learning environments enabled by the integration of mobile technology into learning. However, the lack of good pedagogical designs that provide for sustainability and the inadequate investigation of learning outcomes remain major gaps in the current studies on mobile learning.…
Making the case for mobile cognition: EEG and sports performance.
Park, Joanne L; Fairweather, Malcolm M; Donaldson, David I
2015-05-01
In the high stakes world of International sport even the smallest change in performance can make the difference between success and failure, leading sports professionals to become increasingly interested in the potential benefits of neuroimaging. Here we describe evidence from EEG studies that either identify neural signals associated with expertise in sport, or employ neurofeedback to improve performance. Evidence for the validity of neurofeedback as a technique for enhancing sports performance remains limited. By contrast, progress in characterizing the neural correlates of sporting behavior is clear: frequency domain studies link expert performance to changes in alpha rhythms, whilst time-domain studies link expertise in response evaluation and motor output with modulations of P300 effects and readiness potentials. Despite early promise, however, findings have had relatively little impact for sports professionals, at least in part because there has been a mismatch between lab tasks and real sporting activity. After selectively reviewing existing findings and outlining limitations, we highlight developments in mobile EEG technology that offer new opportunities for sports neuroscience. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.
Guerra, Mark L; Singh, Parminder J; Taylor, Nicholas F
2015-09-01
To systematically review the effect of early mobilization after hip or knee joint replacement surgery on length of stay in an acute hospital. Randomized controlled trials were selected from electronic databases based on inclusion criterion requiring an experimental group mobilizing (sitting out of bed/walking) earlier than a comparison group post joint replacement surgery of the hip or knee in an acute hospital. Clinically homogeneous data were analyzed with meta-analysis. Five randomized controlled trials (totaling 622 participants) were included for review. A meta-analysis of 5 trials found a reduced length of stay of 1.8 days (95% confidence interval 1.1 to 2.6) in favor of the experimental group. In 4 of the 5 trials the experimental group first sat out of bed within 24 hours post operatively. In 4 of the 5 trials the experimental group first walked within 48 hours post operatively. Individual trials reported benefits in range of motion, muscle strength and health-related quality of life in favor of the experimental group. There were no differences in discharge destinations, incidence of negative outcomes or adverse events attributable to early mobilization when compared to the comparison groups. Early mobilization post hip or knee joint replacement surgery can result in a reduced length of stay of about 1.8 days. Trials that reported these positive results showed that early mobilization can be achieved within 24 hours of operation. This positive gain was achieved without an increase in negative outcomes. © The Author(s) 2014.
Mobile robotics application in the nuclear industry
DOE Office of Scientific and Technical Information (OSTI.GOV)
Jones, S.L.; White, J.R.
1995-03-01
Mobile robots have been developed to perform hazardous operations in place of human workers. Applications include nuclear plant inspection/maintenance, decontamination and decommissioning police/military explosive ordinance disposal (EOD), hostage/terrorist negotiations and fire fighting. Nuclear facilities have proven that robotic applications can be cost-effective solutions to reducing personnel exposure and plant downtime. The first applications of mobile robots in the nuclear industry began in the early 1980`s, with the first vehicles being one of a kind machines or adaptations of commercial EOD robots. These activities included efforts by numerous commercial companies, the U.S. Nuclear Regulatory Commission, EPRI, and several national laboratories. Somemore » of these efforts were driven by the recovery and cleanup activities at TMI which demonstrated the potential and need for a remote means of performing surveillance and maintenance tasks in nuclear plants. The use of these machines is now becoming commonplace in nuclear facilities throughout the world. The hardware maturity and the confidence of the users has progressed to the point where the applications of mobile robots is not longer considered a novelty. These machines are being used in applications where the result is to help achieve more aggressive goals for personnel radiation exposure and plant availability, perform tasks more efficiently, and allow plant operators to retrieve information from areas previously considered inaccessible. Typical examples include surveillance in high radiation areas (during operation and outage activities), radiation surveys, waste handling, and decontamination evolutions. This paper will discuss this evolution including specific applications experiences, examples of currently available technology, and the benefits derived from the use of mobile robotic vehicles in commercial nuclear power facilities.« less
Sobrinho, Alvaro; da Silva, Leandro Dias; Perkusich, Angelo; Pinheiro, Maria Eliete; Cunha, Paulo
2018-01-12
The chronic kidney disease (CKD) is a worldwide critical problem, especially in developing countries. CKD patients usually begin their treatment in advanced stages, which requires dialysis and kidney transplantation, and consequently, affects mortality rates. This issue is faced by a mobile health (mHealth) application (app) that aims to assist the early diagnosis and self-monitoring of the disease progression. A user-centered design (UCD) approach involving health professionals (nurse and nephrologists) and target users guided the development process of the app between 2012 and 2016. In-depth interviews and prototyping were conducted along with healthcare professionals throughout the requirements elicitation process. Elicited requirements were translated into a native mHealth app targeting the Android platform. Afterward, the Cohen's Kappa coefficient statistics was applied to evaluate the agreement between the app and three nephrologists who analyzed test results collected from 60 medical records. Finally, eight users tested the app and were interviewed about usability and user perceptions. A mHealth app was designed to assist the CKD early diagnosis and self-monitoring considering quality attributes such as safety, effectiveness, and usability. A global Kappa value of 0.7119 showed a substantial degree of agreement between the app and three nephrologists. Results of face-to-face interviews with target users indicated a good user satisfaction. However, the task of CKD self-monitoring proved difficult because most of the users did not fully understand the meaning of specific biomarkers (e.g., creatinine). The UCD approach provided mechanisms to develop the app based on the real needs of users. Even with no perfect Kappa degree of agreement, results are satisfactory because it aims to refer patients to nephrologists in early stages, where they may confirm the CKD diagnosis.
Mobile Multicast in Hierarchical Proxy Mobile IPV6
NASA Astrophysics Data System (ADS)
Hafizah Mohd Aman, Azana; Hashim, Aisha Hassan A.; Mustafa, Amin; Abdullah, Khaizuran
2013-12-01
Mobile Internet Protocol Version 6 (MIPv6) environments have been developing very rapidly. Many challenges arise with the fast progress of MIPv6 technologies and its environment. Therefore the importance of improving the existing architecture and operations increases. One of the many challenges which need to be addressed is the need for performance improvement to support mobile multicast. Numerous approaches have been proposed to improve mobile multicast performance. This includes Context Transfer Protocol (CXTP), Hierarchical Mobile IPv6 (HMIPv6), Fast Mobile IPv6 (FMIPv6) and Proxy Mobile IPv6 (PMIPv6). This document describes multicast context transfer in hierarchical proxy mobile IPv6 (H-PMIPv6) to provide better multicasting performance in PMIPv6 domain.
Zampieri, Cris; Salarian, Arash; Carlson-Kuhta, Patricia; Aminian, Kamiar; Nutt, John G.; Horak, Fay B.
2011-01-01
The Timed Up and Go (TUG) test has been used to assess balance and mobility in Parkinson’s Disease (PD). However, it is not known if this test is sensitive to subtle abnormalities present in early stages of the disease, when balance and gait problems are not clinically evident but may be detected with instrumented analysis of movement. We hypothesize that postural transitions and arm swing during gait will be the most sensitive characteristics of the TUG for early PD. In the present study, we instrumented the TUG test (iTUG) using portable inertial sensors, and extended the walking distance from 3 meters (traditional TUG) to 7 meters. Twelve subjects with early-to-moderate, untreated PD and 12 healthy individuals participated. Our findings show that although the stopwatch measure of TUG duration did not detect abnormalities in early-to-mid stage PD, the peak arm swing velocity on the more affected side, average turning velocity, cadence and peak trunk rotation velocity were significantly slower. These iTUG parameters were also correlated with the UPDRS Motor Scale. Thus, the iTUG test is sensitive to untreated PD and could potentially detect progression of PD and response to symptomatic and disease-modifying treatments. PMID:19726406
The Economic and Clinical Impact of Sustained Use of a Progressive Mobility Program in a Neuro-ICU.
Hester, Jeannette M; Guin, Peggy R; Danek, Gale D; Thomas, Jaime R; Titsworth, William L; Reed, Richard K; Vasilopoulos, Terrie; Fahy, Brenda G
2017-06-01
To investigate a progressive mobility program in a neurocritical care population with the hypothesis that the benefits and outcomes of the program (e.g., decreased length of stay) would have a significant positive economic impact. Retrospective analysis of economic and clinical outcome data before, immediately following, and 2 years after implementation of the Progressive Upright Mobility Protocol Plus program (UF Health Shands Hospital, Gainesville, FL) involving a series of planned movements in a sequential manner with an additional six levels of rehabilitation in the neuro-ICU at UF Health Shands Hospital. Thirty-bed neuro-ICU in an academic medical center. Adult neurologic and neurosurgical patients: 1,118 patients in the pre period, 731 patients in the post period, and 796 patients in the sustained period. Implementation of Progressive Upright Mobility Protocol Plus. ICU length of stay decreased from 6.5 to 5.8 days in the immediate post period and 5.9 days in the sustained period (F(2,2641) = 3.1; p = 0.045). Hospital length of stay was reduced from 11.3 ± 14.1 days to 8.6 ± 8.8 post days and 8.8 ± 9.3 days sustained (F(2,2641) = 13.0; p < 0.001). The impact of the study intervention on ICU length of stay (p = 0.031) and hospital length of stay (p < 0.001) remained after adjustment for age, sex, diagnoses, sedation, and ventilation. Hospital-acquired infections were reduced by 50%. Average total cost per patient after adjusting for inflation was significantly reduced by 16% (post period) and 11% (sustained period) when compared with preintervention (F(2,2641) = 3.1; p = 0.045). Overall, these differences translated to an approximately $12.0 million reduction in direct costs from February 2011 through the end of 2013. An ongoing progressive mobility program in the neurocritical care population has clinical and financial benefits associated with its implementation and should be considered.
Keep on Movin'? Research Mobility's Meanings for Italian Early-Stage Researchers
ERIC Educational Resources Information Center
Carrozza, Chiara; Minucci, Sara
2014-01-01
Research mobility is a core notion for the European Research Area (ERA), and a wide body of literature has focused on the factors facilitating and hindering researchers' mobility. The European discourse tends to promote mobility as a value, but to what extent is it perceived as such by researchers? What role does mobility play in career…
Hsu, Chun L; Best, John R; Wang, Shirley; Voss, Michelle W; Hsiung, Robin G Y; Munkacsy, Michelle; Cheung, Winnie; Handy, Todd C; Liu-Ambrose, Teresa
2017-01-01
Impaired mobility is a major concern for older adults and has significant consequences. While the widely accepted belief is that improved physical function underlies the effectiveness of targeted exercise training in improving mobility and reducing falls, recent evidence suggests cognitive and neural benefits gained through exercise may also play an important role in promoting mobility. However, the underlying neural mechanisms of this relationship are currently unclear. Thus, we hypothesize that 6 months of progressive aerobic exercise training would alter frontoparietal network (FPN) connectivity during a motor task among older adults with mild subcortical ischemic vascular cognitive impairment (SIVCI)-and exercise-induced changes in FPN connectivity would correlate with changes in mobility. We focused on the FPN as it is involved in top-down attentional control as well as motor planning and motor execution. Participants were randomized either to usual-care (CON), which included monthly educational materials about VCI and healthy diet; or thrice-weekly aerobic training (AT), which was walking outdoors with progressive intensity. Functional magnetic resonance imaging was acquired at baseline and trial completion, where the participants were instructed to perform bilateral finger tapping task. At trial completion, compared with AT, CON showed significantly increased FPN connectivity strength during right finger tapping ( p < 0.05). Across the participants, reduced FPN connectivity was associated with greater cardiovascular capacity ( p = 0.05). In the AT group, reduced FPN connectivity was significantly associated with improved mobility performance, as measured by the Timed-Up-and-Go test ( r = 0.67, p = 0.02). These results suggest progressive AT may improve mobility in older adults with SIVCI via maintaining intra-network connectivity of the FPN.
Teachers and Students Poised to Use Mobile Phones in the Classroom
ERIC Educational Resources Information Center
O'Bannon, B. W.; Waters, S.; Lubke, J.; Cady, J.; Rearden, K.
2017-01-01
This study examined the perceptions of 15 teachers and 103 middle school students at a progressive private school located in Mumbai, India to determine their support for the use of mobile phones in the classroom, their perceptions of the mobile phone features that are beneficial for school-related work, and the instructional benefits and barriers…
Mobile Devices and Mobile Learning: Shifting the Mindset of Teachers and Learners
ERIC Educational Resources Information Center
Smith, Philippa K.; Grant, Lynn; Conway, Clare; Narayan, Vickel
2016-01-01
Incorporating new media technologies that enable mobile learning to be part of educational practice poses challenges to those used to teaching in a traditional classroom environment. In this article three lecturers and a learning advisor from a New Zealand university reflect on their experiences in the progressive redesign of a Bachelor of Arts…
Pupil Mobility, Attainment and Progress in Primary School
ERIC Educational Resources Information Center
Strand, Steve; Demie, Feyisa
2006-01-01
This article presents an analysis of the association between pupil mobility and educational attainment in the 2002 national end of Key Stage 2 (KS2) tests for 11-year-old pupils in an inner London education authority. The results show that pupil mobility is strongly associated with low attainment in the end of key stage tests. However, the…
ERIC Educational Resources Information Center
Hung, Pi-Hsia; Hwang, Gwo-Jen; Lin, Yu-Fen; Wu, Tsung-Hsun; Su, I-Hsiang
2013-01-01
Mobile learning has been recommended for motivating students on field trips; nevertheless, owing to the complexity and the richness of the learning resources from both the real-world and the digital-world environments, information overload remains one of the major concerns. Most mobile learning designs provide feedback only for multiple choice…
Mobility one week after a hip fracture - can it be predicted?
Fitzgerald, Michelle; Blake, Catherine; Askin, David; Quinlan, John; Coughlan, Tara; Cunningham, Caitriona
2018-05-01
Better patient outcomes and more efficient healthcare could be achieved by predicting post hip fracture function at an early stage. This study aimed to identify independent predictors of mobility outcome one week post hip fracture surgery. All hip fracture inpatients (n=77) were included in this 6 month prospective observational cohort study. Predictor variables were obtained on the first postoperative day and included premorbid function using the New Mobility Score (NMS). Mobility outcome measures one week postoperatively included the Cumulated Ambulatory Score (CAS). Data were analysed with SPSS using binary multiple logistic regression analysis RESULTS: Patients who fell outdoors (OR 3.848; 95% CI, 1.053-14.061), had no delay to surgery (OR 5.472; 95% CI, 1.073-27.907) and had high pre-fracture function (OR3.366; 95% CI, 1.042-10.879) were predicted to achieve independent mobility (CAS = 6) one week postoperatively. Fall location, time to surgery and baseline function predict independent mobility one week after hip fracture, and can be used for early rehabilitation stratification. The NMS and CAS are recommended as standardised hip fracture clinical measures. Orthogeriatric and physiotherapy service initiatives may improve early functional outcome. Copyright © 2017. Published by Elsevier Ltd.
Mobility and reliability performance measurement.
DOT National Transportation Integrated Search
2013-06-01
This project grew out of the fact that mobility was identified early on as one of the key performance focus areas of NCDOTs : strategic transformation effort. The Transformation Management Team (TMT) established a TMT Mobility Workstream Team : in...
Early Precambrian crustal evolution of south India
NASA Technical Reports Server (NTRS)
Srinivasan, R.
1986-01-01
The Early Precambrian sequence in Karnataka, South India provides evidences for a distinct trend of evolution which differs from trends exhibited in many other Early Precambrian regions of the world. The supracrustal rock associations preserved in greenstone belts and as inclusions in gneisses and granulites suggest the evolution of the terrain from a stable to a mobile regime. The stable regime is represented by (1) layered ultramafic-mafic complexes, (2) orthoquartzite-basalt-rhyodacite-iron formation, and (30 ortho-quartzite-carbonate-Mn-Fe formation. The mobile regime, which can be shown on sedimentological grounds to have succeeded the stable regime, witnessed the accumulation of a greywacke-pillow basalt-dacite-rhyolite-iron formation association. Detrital sediments of the stable zone accumulated dominantly in fluvial environment and the associated volcanics are ubaerial. The volcanics of the stable regime are tholeiites derived from a zirconium and LREE-enriched sources. The greywackes of the mobile regime are turbidities, and the volcanic rocks possess continental margin (island-arc or back-arc) affinity; they show a LREE depleted to slightly LREE-enriched pattern. The evolution from a stable to a mobile regime is in contrast to the trend seen in most other regions of the world, where an early dominantly volcanic association of a mobile regime gives way upward in the sequence to sediments characteristic of a stable regime.
Expanding the Frontiers of Orientation and Mobility for Infants and Toddlers in New Mexico and Utah
ERIC Educational Resources Information Center
Dewald, Hong Phangia; Faris, Cindy; Borg, Karen S.; Maner, Julie; Martinez-Cargo, Loreta; Carter, Mark
2015-01-01
Early intervention services provide very young children, typically aged birth to 3 years, and their families "early and appropriate learning experiences to facilitate the child's learning and development" in their natural environment. Teachers of students with visual impairments and certified orientation and mobility (O&M)…
Fasting: The History, Pathophysiology and Complications
Kerndt, Peter R.; Naughton, James L.; Driscoll, Charles E.; Loxterkamp, David A.
1982-01-01
An appreciation of the physiology of fasting is essential to the understanding of therapeutic dietary interventions and the effect of food deprivation in various diseases. The practice of prolonged fasting for political or religious purposes is increasing, and a physician is likely to encounter such circumstances. Early in fasting weight loss is rapid, averaging 0.9 kg per day during the first week and slowing to 0.3 kg per day by the third week; early rapid weight loss is primarily due to negative sodium balance. Metabolically, early fasting is characterized by a high rate of gluconeogenesis with amino acids as the primary substrates. As fasting continues, progressive ketosis develops due to the mobilization and oxidation of fatty acids. As ketone levels rise they replace glucose as the primary energy source in the central nervous system, thereby decreasing the need for gluconeogenesis and sparing protein catabolism. Several hormonal changes occur during fasting, including a fall in insulin and T3 levels and a rise in glucagon and reverse T3 levels. Most studies of fasting have used obese persons and results may not always apply to lean persons. Medical complications seen in fasting include gout and urate nephrolithiasis, postural hypotension and cardiac arrhythmias. ImagesFigure 4. PMID:6758355
[Progress in research of mobile health intervention].
Huang, Z; Ning, P S; Cheng, P X; Hu, G Q
2016-10-10
With the rapid development of mobile communication technology and the growing popularity of smartphones worldwide, mobile health has become an extension of e-Health and Tele-Health, and is of value in the research and practice of public health. In this paper, we systematically assessed research literature of mobile health' s application on disease prevention and control as well as health promotion. Based on the characteristics of current literature, this paper focused on the application of mobile health in maternal health promotion, chronic disease management, and communicable disease prevention and control to provide reference for the mobile health intervention research in China.
Arthrofibrosis Associated With Total Knee Arthroplasty.
Cheuy, Victor A; Foran, Jared R H; Paxton, Roger J; Bade, Michael J; Zeni, Joseph A; Stevens-Lapsley, Jennifer E
2017-08-01
Arthrofibrosis is a debilitating postoperative complication of total knee arthroplasty (TKA). It is one of the leading causes of hospital readmission and a predominant reason for TKA failure. The prevalence of arthrofibrosis will increase as the annual incidence of TKA in the United States rises into the millions. In a narrative review of the literature, the etiology, economic burden, treatment strategies, and future research directions of arthrofibrosis after TKA are examined. Characterized by excessive proliferation of scar tissue during an impaired wound healing response, arthrofibrotic stiffness causes functional deficits in activities of daily living. Postoperative, supervised physiotherapy remains the first line of defense against the development of arthrofibrosis. Also, adjuncts to traditional physiotherapy such as splinting and augmented soft tissue mobilization can be beneficial. The effectiveness of rehabilitation on functional outcomes depends on the appropriate timing, intensity, and progression of the program, accounting for the patient's ability and level of pain. Invasive treatments such as manipulation under anesthesia, debridement, and revision arthroplasty improve range of motion, but can be traumatic and costly. Future studies investigating novel treatments, early diagnosis, and potential preoperative screening for risk of arthrofibrosis will help target those patients who will need additional attention and tailored rehabilitation to improve TKA outcomes. Arthrofibrosis is a multi-faceted complication of TKA, and is difficult to treat without an early, tailored, comprehensive rehabilitation program. Understanding the risk factors for its development and the benefits and shortcomings of various interventions are essential to best restore mobility and function. Copyright © 2017 Elsevier Inc. All rights reserved.
ERIC Educational Resources Information Center
Bartholomew, Scott R.; Reeve, Edward
2018-01-01
Discussion surrounding the inclusion of mobile devices in K-12 classrooms has escalated since the early 2000s, and the literature base dedicated to mobile devices, mobile-learning, and e-learning has likewise grown. The majority of the research related to mobile devices and their inclusion in educational settings has largely revolved around…
Demonstration of skull bones mobility using optical methods: practical importance in medicine
NASA Astrophysics Data System (ADS)
Zakharov, Alexander V.; Okushko, Vladimir R.; Vturin, Sergey A.; Moseychuk, Vladimir V.; Petrov, Aleksey A.; Suetenkov, Dmitry E.
2014-01-01
Unprompted skull bones mobility not related to breathing, heart beating and other physiological reactions, using installation of original construction with control of physiological parameters by biofeedback hardware-software complex BOS-lab and BOS-pulse appliance (COMSIB, Novosibirsk, Russia) has been confirmed. Teeth eruption occurs through odontiasis canals, emerging from the funiculus. The main driving force for promoting a tooth into odontiasis canal during eruption is the unprompted skull bones mobility. A simple optical installation was made for the visualization of skull bones mobility during the investigation of the median palatine and incisors sutures. Early detection of failures of unprompted skull bones mobility and its normalization can lead to prevention of impact teeth, malocclusion, extrudocclusion and other anomalies and deformations of teeth, teeth rows, TMJ and skull. The skull bones mobility should be considered during the early preventive treatment and therapy of the consequences of injuries and malfunction of the maxillofacial area.
Potential of mobile intraoperative radiotherapy technology.
Goer, Donald A; Musslewhite, Chapple W; Jablons, David M
2003-10-01
Mobile IORT units have the potential to change the way patients who have cancer are treated. The integration of IORT into cancer treatment programs, made possible by the new technologies of mobile linear accelerators that can be used in unshielded operating rooms, makes IORT significantly less time-consuming, less costly, and less risky to administer. It is now practical for IORT to be used in early-stage disease, in addition to advanced disease, and in sites for which patient transportation in the middle of surgery is considered too risky. Preliminary results of trials for early-stage breast and rectal cancer indicate benefits of IORT. Pediatric patients and patients who have lung cancer, previously underserved by IORT therapies, can be offered potential gains when patient transport issues do not limit IORT. Furthermore, because many of these mobile systems require no shielding, it is now practical for mobile units to be shared between hospitals, making this new mobile technology much more widely available.
Smartphone-based multispectral imaging: system development and potential for mobile skin diagnosis.
Kim, Sewoong; Cho, Dongrae; Kim, Jihun; Kim, Manjae; Youn, Sangyeon; Jang, Jae Eun; Je, Minkyu; Lee, Dong Hun; Lee, Boreom; Farkas, Daniel L; Hwang, Jae Youn
2016-12-01
We investigate the potential of mobile smartphone-based multispectral imaging for the quantitative diagnosis and management of skin lesions. Recently, various mobile devices such as a smartphone have emerged as healthcare tools. They have been applied for the early diagnosis of nonmalignant and malignant skin diseases. Particularly, when they are combined with an advanced optical imaging technique such as multispectral imaging and analysis, it would be beneficial for the early diagnosis of such skin diseases and for further quantitative prognosis monitoring after treatment at home. Thus, we demonstrate here the development of a smartphone-based multispectral imaging system with high portability and its potential for mobile skin diagnosis. The results suggest that smartphone-based multispectral imaging and analysis has great potential as a healthcare tool for quantitative mobile skin diagnosis.
Prolonged-release fampridine and walking and balance in MS: randomised controlled MOBILE trial
Hupperts, Raymond; Lycke, Jan; Short, Christine; Gasperini, Claudio; McNeill, Manjit; Medori, Rossella; Tofil-Kaluza, Agata; Hovenden, Maria; Mehta, Lahar R; Elkins, Jacob
2016-01-01
Background: Mobility impairment is a common disability in MS and negatively impacts patients’ lives. Objective: Evaluate the effect of prolonged-release (PR) fampridine (extended-release dalfampridine in the United States) on self-assessed walking disability, dynamic/static balance and safety in patients with MS. Methods: MOBILE was a randomised, double-blind, exploratory, placebo-controlled trial. Patients with progressive/relapsing-remitting MS and Expanded Disability Status Scale score of 4.0–7.0 were treated with PR-fampridine or placebo twice daily for 24 weeks. Efficacy endpoints included change from baseline in the 12-item MS Walking Scale (MSWS-12), Timed Up and Go (TUG) test and Berg Balance Scale (BBS). Results: 132 patients were randomised at 24 sites in six countries. PR-fampridine therapy resulted in greater median improvements from baseline in MSWS-12 score, TUG speed and BBS total score versus placebo over 24 weeks. A higher proportion of patients receiving PR-fampridine versus placebo experienced significant improvements at MSWS-12 improvement thresholds ⩾7 (p = 0.0275), ⩾8 (p = 0.0153) and ⩾9 points (p = 0.0088) and TUG speed thresholds ⩾10% (p = 0.0021) and ⩾15% (p = 0.0262). PR-fampridine was well tolerated. Conclusions: PR-fampridine therapy resulted in early and sustained improvements in broad measures of walking and balance over six months. PMID:25921050
FY2017 Energy Efficient Mobility Systems Annual Progress Report
DOE Office of Scientific and Technical Information (OSTI.GOV)
None
During fiscal year 2017 (FY 2017), the U.S. Department of Energy (DOE) Vehicle Technologies Office (VTO) created the Energy Efficient Mobility Systems (EEMS) Program to understand the range of mobility futures that could result from these disruptive technologies and services, and to create solutions that improve mobility energy productivity, or the value derived from the transportation system per unit of energy consumed. Increases in mobility energy productivity result from improvements in the quality or output of the transportation system, and/or reductions in the energy used for transportation.
Recent progress in high-mobility thin-film transistors based on multilayer 2D materials
NASA Astrophysics Data System (ADS)
Hong, Young Ki; Liu, Na; Yin, Demin; Hong, Seongin; Kim, Dong Hak; Kim, Sunkook; Choi, Woong; Yoon, Youngki
2017-04-01
Two-dimensional (2D) layered semiconductors are emerging as promising candidates for next-generation thin-film electronics because of their high mobility, relatively large bandgap, low-power switching, and the availability of large-area growth methods. Thin-film transistors (TFTs) based on multilayer transition metal dichalcogenides or black phosphorus offer unique opportunities for next-generation electronic and optoelectronic devices. Here, we review recent progress in high-mobility transistors based on multilayer 2D semiconductors. We describe the theoretical background on characterizing methods of TFT performance and material properties, followed by their applications in flexible, transparent, and optoelectronic devices. Finally, we highlight some of the methods used in metal-semiconductor contacts, hybrid structures, heterostructures, and chemical doping to improve device performance.
ERIC Educational Resources Information Center
Welsh, Rachard L.
2005-01-01
This is the final part of the adaptation from my on-stage conversation with Russell Williams at the 1998 International Mobility conference in Atlanta, GA, which attempted to highlight Williams's contributions to the progression of orientation and mobility from the Army's immediate response to the service men and women who lost their sight during…
PARK, JULIE; MYERS, DOWELL
2010-01-01
The new second generation of the post-1965 immigration era is observed as children with their parents in 1980 and again as adults 25 years later. Intergenerational mobility is assessed for both men and women in four major racial/ethnic groups, both in regard to children’s status attainment relative to parents and with regard to the rising societal standards proxied by native-born non-Hispanic whites. A profile of intergenerational mobility is prepared using multiple indicators of status attainment: high school and college completion, upper white-collar occupation, poverty, and homeownership. The immigrant generation cohort method we introduce accounts for four distinct temporal dimensions of immigrant progress, clarifying inconsistencies in the literature and highlighting differences in mobility between racial/ethnic groups and with respect to different outcome measures. The immigrant generation cohort method consistently finds greater intergenerational mobility than suggested by alternative approaches. Our analysis also shows that the intergenerational progress of women is greater than that of men and provides a more complete record of immigrant mobility overall. Findings for individual racial/ethnic groups accord with some expectations in the literature and contradict others. PMID:20608102
Federal Register 2010, 2011, 2012, 2013, 2014
2010-12-29
..., LLC. 20110313 G News Corporation. G Wireless Generation, Inc. G Wireless Generation, Inc. 08-DEC-10.... G Exxon Mobil Corporation. G Mobile Eugene Island Pipeline Company. G Exxon Mobil Pipeline Company. G Mobil Oil Exploration & Producing Southeast Inc. 20110256 G Humana Inc. G Welsh, Carson, Anderson...
The Relationship between External Job Mobility and Salary Attainment across Career Stages
ERIC Educational Resources Information Center
Lam, Simon S. K.; Ng, Thomas W. H.; Feldman, Daniel C.
2012-01-01
The current study examines the relationship between external job mobility and salary for employees in different career stages. Based on career stage and career timetable theories, we predict that external job mobility would generate the greatest salary benefits for early-career employees whereas external job mobility would generate fewer salary…
Hunter, Oluwatobi O; George, Elisabeth L; Ren, Dianxu; Morgan, Douglas; Rosenzweig, Margaret; Klinefelter Tuite, Patricia
2017-06-01
To increase adherence with intensive care unit mobility by developing and implementing a mobility training program that addresses nursing barriers to early mobilisation. An intensive care unit mobility training program was developed, implemented and evaluated with a pre-test, immediate post-test and eight-week post-test. Patient mobility was tracked before and after training. A ten bed cardiac intensive care unit. The training program's efficacy was measured by comparing pre-test, immediate post-test and 8-week post-test scores. Patient mobilisation rates before and after training were compared. Protocol compliance was measured in the post training group. Nursing knowledge increased from pre-test to immediate post-test (p<0.0001) and pre-test to 8-week post-test (p<0.0001). Mean test scores decreased by seven points from immediate post-test (80±12) to 8-week post-test (73±14). Fear significantly decreased from pre-test to immediate post-test (p=0.03), but not from pre-test to 8-week post-test (p=0.06) or immediate post-test to 8-week post-test (p=0.46). Post training patient mobility rates increased although not significantly (p=0.07). Post training protocol compliance was 78%. The project successfully increased adherence with intensive care unit mobility and indicates that a training program could improve adoption of early mobility. Copyright © 2016 Elsevier Ltd. All rights reserved.
High Mobility Group Box 1 Protein as an Auxiliary Biomarker for Dengue Diagnosis
Allonso, Diego; Vázquez, Susana; Guzmán, Maria G.; Mohana-Borges, Ronaldo
2013-01-01
Despite the availability of many methods for rapid and early diagnosis of dengue, there is still a need to develop new approaches that not only combine low cost, specificity, and sensitivity, but also are capable of accurately detecting secondary infection in the early stages of the disease. We report the potential of the high mobility group box 1 protein as an auxiliary biomarker for early dengue diagnosis. We tested a 205-sample serum panel that included negative and positive samples from primary and secondary dengue cases, as well as samples from patients with dengue-like symptoms. We observed that high mobility group box 1 protein was generally detected only in dengue-positive samples for persons with primary and secondary infections. These results highlight the possibility of using this endogenous molecule as an auxiliary biomarker to aid in dengue detection and improve current methods for early diagnosis of dengue. PMID:23269659
ERIC Educational Resources Information Center
Herbers, Janette E.; Cutuli, J. J.; Supkoff, Laura M.; Heistad, David; Chan, Chi-Keung; Hinz, Elizabeth; Masten, Ann S.
2012-01-01
This investigation tested the importance of early academic achievement for later achievement trajectories among 18,011 students grouped by level of socioeconomic risk. Students considered to be at highest risk were those who experienced homelessness or high residential mobility (HHM). HHM students were compared with students eligible for free…
ERIC Educational Resources Information Center
LeBoeuf, Whitney A.; Fantuzzo, John W.
2018-01-01
The primary aim of this study was to assess the relations between concurrent, cumulative, and contextual intradistrict school mobility and early reading achievement. Longitudinal administrative school records were used for an entire cohort of students in a large urban district from first through third grade. Findings indicated that students with a…
Reaching At-Risk Families through Mobile Phones: Successes from the Text4baby Program
ERIC Educational Resources Information Center
Bushar, Jessica; Pirretti, Amy
2017-01-01
Reaching at-risk families with health and development information and connecting them to resources during pregnancy and throughout early infanthood remains a challenge for many health and early learning and development initiatives. This article showcases strategies used by Text4baby--a free mobile health program for pregnant women and mothers--to…
Wang, Hou; Wu, Yan; Yuan, Xingzhong; Zeng, Guangming; Zhou, Jin; Wang, Xin; Chew, Jia Wei
2018-03-01
MXene, an important and increasingly popular category of postgraphene 2D nanomaterials, has been rigorously investigated since early 2011 because of advantages including flexible tunability in element composition, hydrophobicity, metallic nature, unique in-plane anisotropic structure, high charge-carrier mobility, tunable band gap, and favorable optical and mechanical properties. To fully exploit these potentials and further expand beyond the existing boundaries, novel functional nanostructures spanning monolayer, multilayer, nanoparticles, and composites have been developed by means of intercalation, delamination, functionalization, hybridization, among others. Undeniably, the cutting-edge developments and applications of clay-inspired 2D MXene platform as electrochemical electrode or photo-electrocatalyst have conferred superior performance and have made significant impact in the field of energy and advanced catalysis. This review provides an overview of the fundamental properties and synthesis routes of pure MXene, functionalized MXene and their hybrids, highlights the state-of-the-art progresses of MXene-based applications with respect to supercapacitors, batteries, electrocatalysis and photocatalysis, and presents the challenges and prospects in the burgeoning field. © 2018 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.
Development of mobile laboratory for viral haemorrhagic fever detection in Africa.
Weidmann, Manfred; Faye, Ousmane; Faye, Oumar; Abd El Wahed, Ahmed; Patel, Pranav; Batejat, Christophe; Manugerra, Jean Claude; Adjami, Aimee; Niedrig, Matthias; Hufert, Frank T; Sall, Amadou A
2018-06-15
In order to enable local response to viral haemorrhagic fever outbreaks a mobile laboratory transportable on commercial flights was developed. The development progressed from use of mobile real time RT-PCR to mobile Recombinase Polymerase Amplification (RT-RPA). The various stages of the mobile laboratory development are described. A brief overview of its deployments, which culminated in the first on site detection of Ebola virus disease (EVD) in March 2014 and a successful use in a campaign to roll back EVD cases in Conakry in the West-Africa Ebola virus outbreak are described. The developed mobile laboratory successfully enabled local teams to perform rapid viral haemorrhagic fever disgnostics.
Smartphone-based multispectral imaging: system development and potential for mobile skin diagnosis
Kim, Sewoong; Cho, Dongrae; Kim, Jihun; Kim, Manjae; Youn, Sangyeon; Jang, Jae Eun; Je, Minkyu; Lee, Dong Hun; Lee, Boreom; Farkas, Daniel L.; Hwang, Jae Youn
2016-01-01
We investigate the potential of mobile smartphone-based multispectral imaging for the quantitative diagnosis and management of skin lesions. Recently, various mobile devices such as a smartphone have emerged as healthcare tools. They have been applied for the early diagnosis of nonmalignant and malignant skin diseases. Particularly, when they are combined with an advanced optical imaging technique such as multispectral imaging and analysis, it would be beneficial for the early diagnosis of such skin diseases and for further quantitative prognosis monitoring after treatment at home. Thus, we demonstrate here the development of a smartphone-based multispectral imaging system with high portability and its potential for mobile skin diagnosis. The results suggest that smartphone-based multispectral imaging and analysis has great potential as a healthcare tool for quantitative mobile skin diagnosis. PMID:28018743
Efficient Mobility Management Signalling in Network Mobility Supported PMIPV6
Jebaseeli Samuelraj, Ananthi; Jayapal, Sundararajan
2015-01-01
Proxy Mobile IPV6 (PMIPV6) is a network based mobility management protocol which supports node's mobility without the contribution from the respective mobile node. PMIPV6 is initially designed to support individual node mobility and it should be enhanced to support mobile network movement. NEMO-BSP is an existing protocol to support network mobility (NEMO) in PMIPV6 network. Due to the underlying differences in basic protocols, NEMO-BSP cannot be directly applied to PMIPV6 network. Mobility management signaling and data structures used for individual node's mobility should be modified to support group nodes' mobility management efficiently. Though a lot of research work is in progress to implement mobile network movement in PMIPV6, it is not yet standardized and each suffers with different shortcomings. This research work proposes modifications in NEMO-BSP and PMIPV6 to achieve NEMO support in PMIPV6. It mainly concentrates on optimizing the number and size of mobility signaling exchanged while mobile network or mobile network node changes its access point. PMID:26366431
Efficient Mobility Management Signalling in Network Mobility Supported PMIPV6.
Samuelraj, Ananthi Jebaseeli; Jayapal, Sundararajan
2015-01-01
Proxy Mobile IPV6 (PMIPV6) is a network based mobility management protocol which supports node's mobility without the contribution from the respective mobile node. PMIPV6 is initially designed to support individual node mobility and it should be enhanced to support mobile network movement. NEMO-BSP is an existing protocol to support network mobility (NEMO) in PMIPV6 network. Due to the underlying differences in basic protocols, NEMO-BSP cannot be directly applied to PMIPV6 network. Mobility management signaling and data structures used for individual node's mobility should be modified to support group nodes' mobility management efficiently. Though a lot of research work is in progress to implement mobile network movement in PMIPV6, it is not yet standardized and each suffers with different shortcomings. This research work proposes modifications in NEMO-BSP and PMIPV6 to achieve NEMO support in PMIPV6. It mainly concentrates on optimizing the number and size of mobility signaling exchanged while mobile network or mobile network node changes its access point.
NASA Technical Reports Server (NTRS)
Kovalenko, Y. A.
1983-01-01
A 120 day limited mobility experiment with young male rats and its results, including retarded growth and degenerative changes in the cardiac muscle, are described. A 120 day strict bedrest experiment with 10 human volunteers and its results are described and discussed. Early subjective complaints, subsequent adaptation and eventual progressive changes in excitability and reactivity, reduction in functional capability of the cerebral cortex, and disturbances in water-salt, protein and fat metabolism, including development of precursors of atherosclerosis, as well as poor results of the orthostatic test after 4 months, are presented. These results are explained as applied to sedentary workers and recommendations are given for such persons to exercise in the morning, at work and in the evening in order to prevent hypokinesis and its physical, mental and physiological effects.
Dune mobility and aridity at the desert margin of northern China at a time of peak monsoon strength
Mason, J.A.; Lu, H.; Zhou, Y.; Miao, X.; Swinehart, J.B.; Liu, Z.; Goble, R.J.; Yi, S.
2009-01-01
Wind-blown sands were mobile at many sites along the desert margin in northern China during the early Holocene (11.5-8 ka ago), based on extensive new numerical dating. This mobility implies low effective moisture at the desert margin, in contrast to growing evidence for greater than modern monsoon precipitation at the same time in central and southern China. Dry conditions in the early Holocene at the desert margin can be explained through a dynamic link between enhanced diabatic heating in the core region of the strengthened monsoon and increased subsidence in drylands to the north, combined with high evapotranspiration rates due to high summer temperatures. After 8 ka ago, as the monsoon weakened and lower temperatures reduced evapotranspiration, eolian sands were stabilized by vegetation. Aridity and dune mobility at the desert margin and a strengthened monsoon can both be explained as responses to high summer insolation in the early Holocene. ?? 2009 Geological Society of America.
Muhs, D.R.; Holliday, V.T.
1995-01-01
Dune fields are found in several areas of the Great Plains, and though mostly stabilised today, the accounts of early explorers show that they were more mobile in the last century. Using an index of dune mobility and tree ring data, it is found that these periods of mobility were related to temperature-induced drought, the high temperatures increasing evapotranspiration. Explorers also record that rivers upwind of these dune fields had shallow braided channels in the 19th century, and these would have supplied further aeolian sand. It is concluded that these dunes are extremely susceptible to climate change and that it may not need global warming to increase their mobility again. -K.Clayton
40 CFR 52.2450 - Conditional approval.
Code of Federal Regulations, 2010 CFR
2010-07-01
... reasonably available control technology (RACT) for the Manufacturing Center located in Richmond, Virginia is...) Revises the 1999-2005 portion of the severe area rate-of-progress plan to provide MOBILE6-based mobile...) Revises Reasonably Available Control Technology (RACT) rules to include the lower major source...
A GIS-BASED MODAL MODEL OF AUTOMOBILE EXHAUST EMISSIONS
The report presents progress toward the development of a computer tool called MEASURE, the Mobile Emission Assessment System for Urban and Regional Evaluation. The tool works toward a goal of providing researchers and planners with a way to assess new mobile emission mitigation s...
A Learning Progression for Elementary Students' Functional Thinking
ERIC Educational Resources Information Center
Stephens, Ana C.; Fonger, Nicole; Strachota, Susanne; Isler, Isil; Blanton, Maria; Knuth, Eric; Murphy Gardiner, Angela
2017-01-01
In this article we advance characterizations of and supports for elementary students' progress in generalizing and representing functional relationships as part of a comprehensive approach to early algebra. Our learning progressions approach to early algebra research involves the coordination of a curricular framework and progression, an…
Longitudinal patient-reported mobility assessment in fibrodysplasia ossificans progressiva (FOP).
Kaplan, Frederick S; Al Mukaddam, Mona; Pignolo, Robert J
2018-04-01
Fibrodysplasia ossificans progressiva (FOP) is a rare, disabling genetic disorder characterized by episodic soft tissue swelling (flare-ups) that leads to progressive heterotopic ossification and restricted joint mobility. Here we present the first longitudinal patient-reported mobility assessment (PRMA) in FOP based on a simple evaluation tool. At initial presentation and follow-up (1-11year span; median: 6 year span), 64 patients (36 females; 28 males) with classic FOP completed a questionnaire designed to rapidly assess mobility at 15 sites (three axial; six upper limb, and six lower limb). In order to validate this instrument, twenty-one of 64 patients (33%) underwent a cumulative analogue joint involvement scale (CAJIS) evaluation by two physicians within six months of their second self-assessment. We found that: 1) mobility changes were episodic and regional, occurring first in the neck and trunk, followed by the upper limbs and finally the lower limbs; 2) interval improvements in mobility did occur, most notably in the lower limbs (18%), and less so in the upper limbs (12%) and trunk (3%), and 3) patient-reported mobility assessments correlate highly (R 2 =0.81) with physician-reported CAJIS evaluations. This is the first longitudinal PRMA in FOP and provides a simple and valid tool that can be used in the design and evaluation of clinical trials in this progressively disabling disease. Copyright © 2017 Elsevier Inc. All rights reserved.
Valkering, Kars P; Aufwerber, Susanna; Ranuccio, Francesco; Lunini, Enricomaria; Edman, Gunnar; Ackermann, Paul W
2017-06-01
Functional weight-bearing mobilization may improve repair of Achilles tendon rupture (ATR), but the underlying mechanisms and outcome were unknown. We hypothesized that functional weight-bearing mobilization by means of increased metabolism could improve both early and long-term healing. In this prospective randomized controlled trial, patients with acute ATR were randomized to either direct post-operative functional weight-bearing mobilization (n = 27) in an orthosis or to non-weight-bearing (n = 29) plaster cast immobilization. During the first two post-operative weeks, 15°-30° of plantar flexion was allowed and encouraged in the functional weight-bearing mobilization group. At 2 weeks, patients in the non-weight-bearing cast immobilization group received a stiff orthosis, while the functional weight-bearing mobilization group continued with increased range of motion. At 6 weeks, all patients discontinued immobilization. At 2 weeks, healing metabolites and markers of procollagen type I (PINP) and III (PIIINP) were examined using microdialysis. At 6 and 12 months, functional outcome using heel-rise test was assessed. Healing tendons of both groups exhibited increased levels of metabolites glutamate, lactate, pyruvate, and of PIIINP (all p < 0.05). Patients in functional weight-bearing mobilization group demonstrated significantly higher concentrations of glutamate compared to the non-weight-bearing cast immobilization group (p = 0.045).The upregulated glutamate levels were significantly correlated with the concentrations of PINP (r = 0.5, p = 0.002) as well as with improved functional outcome at 6 months (r = 0.4; p = 0.014). Heel-rise tests at 6 and 12 months did not display any differences between the two groups. Functional weight-bearing mobilization enhanced the early healing response of ATR. In addition, early ankle range of motion was improved without the risk of Achilles tendon elongation and without altering long-term functional outcome. The relationship between functional weight-bearing mobilization-induced upregulation of glutamate and enhanced healing suggests novel opportunities to optimize post-operative rehabilitation.
Straudi, Sofia; Manfredini, Fabio; Lamberti, Nicola; Zamboni, Paolo; Bernardi, Francesco; Marchetti, Giovanna; Pinton, Paolo; Bonora, Massimo; Secchiero, Paola; Tisato, Veronica; Volpato, Stefano; Basaglia, Nino
2017-02-27
Gait and mobility impairments affect the quality of life (QoL) of patients with progressive multiple sclerosis (MS). Robot-assisted gait training (RAGT) is an effective rehabilitative treatment but evidence of its superiority compared to other options is lacking. Furthermore, the response to rehabilitation is multidimensional, person-specific and possibly involves functional reorganization processes. The aims of this study are: (1) to test the effectiveness on gait speed, mobility, balance, fatigue and QoL of RAGT compared to conventional therapy (CT) in progressive MS and (2) to explore changes of clinical and circulating biomarkers of neural plasticity. This will be a parallel-group, randomized controlled trial design with the assessor blinded to the group allocation of participants. Ninety-eight (49 per arm) progressive MS patients (EDSS scale 6-7) will be randomly assigned to receive twelve 2-h training sessions over a 4-week period (three sessions/week) of either: (1) RAGT intervention on a robotic-driven gait orthosis (Lokomat, Hocoma, Switzerland). The training parameters (torque of the knee and hip drives, treadmill speed, body weight support) are set during the first session and progressively adjusted during training progression or (2) individual conventional physiotherapy focusing on over-ground walking training performed with the habitual walking device. The same assessors will perform outcome measurements at four time points: baseline (before the first intervention session); intermediate (after six training sessions); end of treatment (after the completion of 12 sessions); and follow-up (after 3 months from the end of the training program). The primary outcome is gait speed, assessed by the Timed 25-Foot Walk Test. We will also assess walking endurance, balance, depression, fatigue and QoL as well as instrumental laboratory markers (muscle metabolism, cerebral venous hemodynamics, cortical activation) and circulating laboratory markers (rare circulating cell populations pro and anti-inflammatory cytokines/chemokines, growth factors, neurotrophic factors, coagulation factors, other plasma proteins suggested by transcriptomic analysis and metabolic parameters). The RAGT training is expected to improve mobility compared to the active control intervention in progressive MS. Unique to this study is the analysis of various potential markers of plasticity in relation with clinical outcomes. ClinicalTrials.gov, identifier: NCT02421731 . Registered on 19 January 2015 (retrospectively registered).
Gorim, Linda; Asch, Folkard
2017-05-24
Seed coating is a technology to improve germination and homogenize stand establishment. Although coating often results in lower germination rates, seeds that do germinate grow more vigorously and show strongly reduced respiratory losses during reserve mobilization. We hypothesize that the higher mobilization efficiency is due to a shift in the enzymatic cleavage of sucrose from invertase to sucrose synthase in the embryonic tissue caused by a reduced oxygen availability induced by oversaturation with water caused by the coating during early germination. We investigated the effect of coating on barley, rye, and wheat seed imbibition during the first 30 h after seeds were placed in moisture. We profiled oxygen in the embryos and measured sucrose and acid invertase levels as imbibition progressed. We found that seeds within coatings absorbed significantly more moisture than uncoated seeds. Coating resulted in near anoxic oxygen concentrations in the developing embryonic tissues in all three species. In barley, sucrose was not cleaved via the invertase pathway, despite the fact that invertase activity in coated seeds was increased. In rye and wheat, invertase activities were significantly lower in embryos from coated seeds without significantly changing the sugar composition.
Gorim, Linda; Asch, Folkard
2017-01-01
Seed coating is a technology to improve germination and homogenize stand establishment. Although coating often results in lower germination rates, seeds that do germinate grow more vigorously and show strongly reduced respiratory losses during reserve mobilization. We hypothesize that the higher mobilization efficiency is due to a shift in the enzymatic cleavage of sucrose from invertase to sucrose synthase in the embryonic tissue caused by a reduced oxygen availability induced by oversaturation with water caused by the coating during early germination. We investigated the effect of coating on barley, rye, and wheat seed imbibition during the first 30 h after seeds were placed in moisture. We profiled oxygen in the embryos and measured sucrose and acid invertase levels as imbibition progressed. We found that seeds within coatings absorbed significantly more moisture than uncoated seeds. Coating resulted in near anoxic oxygen concentrations in the developing embryonic tissues in all three species. In barley, sucrose was not cleaved via the invertase pathway, despite the fact that invertase activity in coated seeds was increased. In rye and wheat, invertase activities were significantly lower in embryos from coated seeds without significantly changing the sugar composition. PMID:28538658
Civil Society, Political Mobilization, and the Impact of HIV Scale-up on Health Systems in Brazil
Parker, Richard G.
2011-01-01
This article examines the role of civil society in shaping HIV and AIDS policies and programs in Brazil. It focuses on the historical context of the re-democratization of Brazilian society during the 1980s, when the initial response to the epidemic took shape, and emphasizes the role of social movements linked to the progressive Catholic Church, the sanitary reform movement in public health, and the emerging gay rights movement in the early response to the epidemic in Brazil. It highlights the broad-based civil society coalition that took shape over the course of the 1990s, and the political alliances that were built up shortly after the 1996 International AIDS Conference in Vancouver, Canada, in order to pass legislation guaranteeing the right to antiretroviral treatment access. It emphasizes the continued importance of civil society organizations – in particular, AIDS-related NGOS – and leading AIDS activists in exerting continued pressure in order to guarantee the sustainability of treatment access, and the impact that action focused on HIV and AIDS has had on the Brazilian public health system more broadly, particularly through strengthening health infrastructures and providing a model for health-related social mobilization more broadly. PMID:19858939
Corcoran, John R; Herbsman, Jodi M; Bushnik, Tamara; Van Lew, Steve; Stolfi, Angela; Parkin, Kate; McKenzie, Alison; Hall, Geoffrey W; Joseph, Waveney; Whiteson, Jonathan; Flanagan, Steven R
2017-02-01
Most early mobility studies focus on patients on mechanical ventilation and the role of physical and occupational therapy. This Performance Improvement Project (PIP) project examined early mobility and increased intensity of therapy services on patients in the intensive care unit (ICU) with and without mechanical ventilation. In addition, speech-language pathology rehabilitation was added to the early mobilization program. We sought to assess the efficacy of early mobilization of patients with and without mechanical ventilation in the ICU on length of stay (LOS) and patient outcomes and to determine the financial viability of the program. PIP. Prospective data collection in 2014 (PIP) compared with a historical patient population in 2012 (pre-PIP). Medical and surgical ICUs of a Level 2 trauma hospital. There were 160 patients in the PIP and 123 in the pre-PIP. Interprofessional training to improve collaboration and increase intensity of rehabilitation therapy services in the medical and surgical intensive care units for medically appropriate patients. Demographics; intensity of service; ICU and hospital LOS; medications; pain; discharge disposition; functional mobility; and average cost per day were examined. Rehabilitation therapy services increased from 2012 to 2014 by approximately 60 minutes per patient. The average ICU LOS decreased by almost 20% from 4.6 days (pre-PIP) to 3.7 days (PIP) (P = .05). A decrease of over 40% was observed in the floor bed average LOS from 6.0 days (pre-PIP) to 3.4 days (PIP) (P < .01). An increased percentage of PIP patients, 40.5%, were discharged home without services compared with 18.2% in the pre-PIP phase (P < .01). Average cost per day in the ICU and floor bed decreased in the PIP group, resulting in an annualized net cost savings of $1.5 million. The results of the PIP indicate that enhanced rehabilitation services in the ICU is clinically feasible, results in improved patient outcomes, and is fiscally sound. Most early mobility studies focus on patients on mechanical ventilation. The results of this PIP project demonstrate that there are significant benefits to early mobility and increased intensity of therapy services on ICU patients with and without mechanical ventilation. Benefits include reduced hospitalization LOS, decreased health care costs, and decreased need for postacute care services. III. Copyright © 2017 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.
Scuderi, Giles R; Hedden, David R; Maltry, John A; Traina, Steven M; Sheinkop, Mitchell B; Hartzband, Mark A
2012-03-01
Between May 2001 and June 2004, 388 total knee arthroplasty cases were enrolled in a prospective, randomized, multicenter investigational device exemption trial. Patients received either the investigational high-flexion mobile-bearing knee or a fixed-bearing control. At 2 to 4 years of follow-up, results in 293 patients with degenerative joint disease were compared using Knee Society Assessment and Function scores, radiographic results, complications analysis, and survival estimates. The mobile-bearing and fixed-bearing groups demonstrated similar, significant improvement over preoperative assessments in Knee Scores, maximum flexion, and range of motion. One mobile-bearing arthroplasty required revision. Radiographic results were unremarkable, and implant-related complications were rare in both groups. At this early follow-up, the investigational high-flexion mobile-bearing knee and its fixed-bearing counterpart demonstrated comparable, effective performance. Copyright © 2012 Elsevier Inc. All rights reserved.
A Learning Progressions Approach to Early Algebra Research and Practice
ERIC Educational Resources Information Center
Fonger, Nicole L.; Stephens, Ana; Blanton, Maria; Knuth, Eric
2015-01-01
We detail a learning progressions approach to early algebra research and how existing work around learning progressions and trajectories in mathematics and science education has informed our development of a four-component theoretical framework consisting of: a curricular progression of learning goals across big algebraic ideas; an instructional…
Circumventing the Glass Ceiling: Women Executives in American State Governments.
ERIC Educational Resources Information Center
Bullard, Angela M.; Wright, Deil S.
1993-01-01
Data from 1984 (n=489) and 1988 (n=658) surveys show that female executives in state government have progressed in top positions in certain types of agencies, but much progress has occurred by avoiding, not breaking, the glass ceiling. Most notable male-female differences are in party affiliation, age, interagency mobility, career progress, and…
Demirci, Jill; Caplan, Erin; Murray, Nora; Cohen, Susan
Our objective was to describe the early breastfeeding experience of primiparous women. Healthy, primiparous women intending to exclusively breastfeed downloaded a commercial infant feeding mobile application (app) during their postpartum hospitalization. Women free-texted breastfeeding thoughts and experiences through 8 weeks postpartum in the app's diary. Diary content was qualitatively coded. Thirty-five participants completed diaries and were included in analyses. The overarching theme was Seeking sustainability and validation. Mothers felt overwhelmed, anxious, and frustrated with the intensity and unpredictability of breastfeeding and inconsistent professional breastfeeding support. The ability to exclusively breastfeed was seen as a bellwether of maternal competence. Breastfeeding progress was primarily measured through external feedback (e.g., weight checks) and managed through strict adherence to provider feeding plans. As breastfeeding problems and intensity abated, women exhibited optimism and assumed greater independence in feeding decisions. The primiparous breastfeeding experience is fraught with internally imposed and externally reinforced pressure to produce and persevere despite inadequate breastfeeding support infrastructure. Copyright © 2017 National Association of Pediatric Nurse Practitioners. Published by Elsevier Inc. All rights reserved.
Tumurov, D A; Sanadze, A G
To investigate the pattern of decrement in the muscles of patients with myasthenia gravis (MG) and Lambert-Eaton myasthenic syndrome (LEMS). Twenty-seven patients with MG and 39 patients with LEMS were studied using low frequency repetitive nerve stimulation (3/ sec). The decrease of safety factor of neuromuscular transmission was equal in both groups. At the same time, a significant difference in the decrease of pattern of the amplitude compound of muscle action potential (CMAP) was found. In LEMS, by contrast with MG, another sequence of amplitude variability of CMAP from the second stimulus to the first and from the fifth stimulus to the fourth was noted. In LEMS patients, progressive decrement, manifesting by increasing ratios of late A9/A1 to early A4/A1 was found, whereas the MG patients showed retrogressive decrement expressed by the reduction in decrement ratio (from late to early). These differences reflect the mechanisms and status of acetylcholine mobilization and release from the axon terminal.
Lunar rover navigation concepts
NASA Astrophysics Data System (ADS)
Burke, James D.
1993-01-01
With regard to the navigation of mobile lunar vehicles on the surface, candidate techniques are reviewed and progress of simulations and experiments made up to now are described. Progress that can be made through precursor investigations on Earth is considered. In the early seventies the problem was examined in a series of relevant tests made in the California desert. Meanwhile, Apollo rovers made short exploratory sorties and robotic Lunokhods traveled over modest distances on the Moon. In these early missions some of the required methods were demonstrated. The navigation problem for a lunar traverse can be viewed in three parts: to determine the starting point with enough accuracy to enable the desired mission; to determine the event sequence required to reach the site of each traverse objective; and to redetermine actual positions enroute. The navigator's first tool is a map made from overhead imagery. The Moon was almost completely photographed at moderate resolution by spacecraft launched in the sixties, but that data set provides imprecise topographic and selenodetic information. Therefore, more advanced orbital missions are now proposed as part of a resumed lunar exploration program. With the mapping coverage expected from such orbiters, it will be possible to use a combination of visual landmark navigation and external radio and optical references (Earth and Sun) to achieve accurate surface navigation almost everywhere on the near side of the Moon. On the far side and in permanently dark polar areas, there are interesting exploration targets where additional techniques will have to be used.
ERIC Educational Resources Information Center
Guth, Jessica
2008-01-01
This paper, based on extensive empirical work with Polish and Bulgarian scientists in Germany and the UK, examines the impact of the EU enlargement including the free movement of persons provisions on the mobility of scientists from Eastern to Western Europe. It focuses on early career researchers and particularly PhD candidates and begins by…
Progress in utilization of a mobile laboratory for making storm electricity measurements
NASA Technical Reports Server (NTRS)
Rust, W. David
1988-01-01
A mobile atmospheric science laboratory has been used to intercept and track storms on the Great Plains region of the U.S., with the intention of combining the data obtained with those from Doppler and conventional radars, NASA U-2 aircraft overflights, balloon soundings, and fixed-base storm electricity measurements. The mobile lab has proven to be valuable in the gathering of ground truth verifications for the two commercially operated lightning ground-strike locating systems. Data acquisition has recently been expanded by means of mobile ballooning before and during storms.
Konig, Alexandra; Satt, Aharon; Sorin, Alex; Hoory, Ran; Derreumaux, Alexandre; David, Renaud; Robert, Phillippe H
2018-01-01
Various types of dementia and Mild Cognitive Impairment (MCI) are manifested as irregularities in human speech and language, which have proven to be strong predictors for the disease presence and progress ion. Therefore, automatic speech analytics provided by a mobile application may be a useful tool in providing additional indicators for assessment and detection of early stage dementia and MCI. 165 participants (subjects with subjective cognitive impairment (SCI), MCI patients, Alzheimer's disease (AD) and mixed dementia (MD) patients) were recorded with a mobile application while performing several short vocal cognitive tasks during a regular consultation. These tasks included verbal fluency, picture description, counting down and a free speech task. The voice recordings were processed in two steps: in the first step, vocal markers were extracted using speech signal processing techniques; in the second, the vocal markers were tested to assess their 'power' to distinguish between SCI, MCI, AD and MD. The second step included training automatic classifiers for detecting MCI and AD, based on machine learning methods, and testing the detection accuracy. The fluency and free speech tasks obtain the highest accuracy rates of classifying AD vs. MD vs. MCI vs. SCI. Using the data, we demonstrated classification accuracy as follows: SCI vs. AD = 92% accuracy; SCI vs. MD = 92% accuracy; SCI vs. MCI = 86% accuracy and MCI vs. AD = 86%. Our results indicate the potential value of vocal analytics and the use of a mobile application for accurate automatic differentiation between SCI, MCI and AD. This tool can provide the clinician with meaningful information for assessment and monitoring of people with MCI and AD based on a non-invasive, simple and low-cost method. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.
Symptomatic unilateral vocal fold paralysis following cardiothoracic surgery.
Puccinelli, Cassandra; Modzeski, Mara C; Orbelo, Diana; Ekbom, Dale C
Unilateral vocal fold paralysis (UVFP) is a complication associated with cardiothoracic procedures that presents clinically as dysphonia and/or dysphagia with or without aspiration. The literature lacks both data on recovery of mobility and consensus on best management. Herein, our goals are to 1) Identify cardiothoracic procedures associated with symptomatic UVFP at our institution; 2) Review timing and nature of laryngology diagnosis and management; 3) Report spontaneous recovery rate of vocal fold mobility. Retrospective case series at single tertiary referral center between 2002 and 2015. 141 patients were included who underwent laryngology interventions (micronized acellular dermis injection laryngoplasty and/or type 1 thyroplasty) to treat symptomatic UVFP diagnosed subsequent to cardiothoracic surgery. Pulmonary procedures were most often associated with UVFP (n=50/141; 35.5%). 87.2% had left-sided paralysis (n=123/141). Median time to diagnosis was 42days (x¯=114±348). Over time, UVFP was diagnosed progressively earlier after cardiothoracic surgery. 63.4% of patients (n=95/141) underwent injection laryngoplasty as their initial intervention with median time from diagnosis to injection of 11days (x¯=29.6±54). 41.1% (n=58/141) ultimately underwent type 1 thyroplasty at a median of 232.5days (x¯=367±510.2) after cardiothoracic surgery. 10.2% (n=9/88) of those with adequate follow-up recovered full vocal fold mobility. Many cardiothoracic procedures are associated with symptomatic UVFP, predominantly left-sided. Our data showed poor recovery of vocal fold mobility relative to other studies. Early diagnosis and potential surgical medialization is important in the care of these patients. Copyright © 2017 Elsevier Inc. All rights reserved.
[Driving and dementia : An issue for general practice?!
Leve, Verena; Ilse, Katharina; Ufert, Marie; Wilm, Stefan; Pentzek, Michael
2017-05-01
With most forms of dementia, the risk of road traffic accidents increases with disease progression. Addressing the issue of fitness to drive at an early stage can help to reduce driving-related risks and simultaneously preserve mobility. General practitioners (GPs) are central contact persons for dementia patients and their relatives in medical and psychosocial matters, and also play a key role in addressing the issue of driving safety. Identification of relevant aspects of managing fitness to drive in dementia, as well as of support requirements for German general practice. Seven focus groups with dementia patients, family caregivers and GPs were conducted in order to define the different requirements for counselling in the general practice setting. The transcribed discussions were analysed by a multiprofessional research team using content analysis. For people with dementia, declining mobility and driving cessation is related to a loss of autonomy. Addressing fitness to drive in dementia is thus a subject of conflict and uncertainty for both family caregivers and GPs. The difficulties include the assessment of fitness to drive in the general practice setting, concerns about compromising the patient-physician relationship by raising the issue of driving fitness, as well as uncertainties about the GP's own role. GPs consider the involvement of caregivers to be important to successfully address the topic of driving safety and organise alternative transport. Support is required in the form of criteria defining the time point at which fitness to drive should be assessed, information on compensation possibilities and mobility alternatives. Resource-oriented and patient-centred development of management strategies for limited mobility is needed in general practice. Finding the correct balance between documentation, adequately informing the patient and establishing patient-centred strategies represents a challenge.
Effect of acarbose to delay progression of carotid intima-media thickness in early diabetes.
Patel, Y R; Kirkman, M S; Considine, R V; Hannon, T S; Mather, K J
2013-10-01
The anti-diabetic agent acarbose reduces postprandial glucose excursions. We have evaluated the effect of randomized treatment with acarbose on the progression of carotid intima-media thickness (IMT) in early diabetes. The Early Diabetes Intervention Program was a randomized trial of acarbose versus placebo in 219 participants with early diabetes characterized by glucose values over 11.1 mmol/L 2 h after a 75 g oral glucose load and a mean HbA1c of 6.3%. IMT was measured at baseline and yearly. Follow-up was discontinued if participants progressed to the study glucose endpoints; IMT readings were available for a median of 2 years, with 72 subjects followed for 5 years. Progressive increases in IMT were seen in both treatment groups, but progression was reduced in participants randomized to acarbose (p = 0.047). In age, sex and smoking-adjusted analyses, IMT progression was associated with greater fasting and oral glucose tolerance test-excursion glucose, fasting insulin, cholesterol and glycated low-density lipoprotein concentrations. IMT progression was reduced with study-related changes in weight, insulin and non-esterified fatty acids; these features were more strongly associated with reduced IMT progression than acarbose treatment. Despite strong associations of baseline glycemia with IMT progression, study-related changes in glucose were not important determinants of IMT progression. Acarbose can delay progression of carotid intima-media thickness in early diabetes defined by an oral glucose tolerance test. Glucose, weight, insulin and lipids contributed to risk of progression but reductions in glycemia were not major determinants of reduced rate of IMT progression. Vascular benefits of acarbose may be independent of its glycemic effects. Copyright © 2013 John Wiley & Sons, Ltd.
Progress on field study with precision mobile drip irrigation technologly
USDA-ARS?s Scientific Manuscript database
Precision mobile drip irrigation (PMDI) is a technology that was developed in the 1970s that converts drop hoses on moving irrigation systems to dripline. Although this technology was developed more than 40 years ago, it was not widely implemented and few studies reported on its performance. Recentl...
Investigation of Using Analytics in Promoting Mobile Learning Support
ERIC Educational Resources Information Center
Visali, Videhi; Swami, Niraj
2013-01-01
Learning analytics can promote pedagogically informed use of learner data, which can steer the progress of technology mediated learning across several learning contexts. This paper presents the application of analytics to a mobile learning solution and demonstrates how a pedagogical sense was inferred from the data. Further, this inference was…
Measuring the post-adoption customer perception of mobile banking services.
Yu, Tai-Kuei; Fang, Kwoting
2009-02-01
With liberalization and internalization in the financial market and progress in information technology, banks face dual competitive pressures to provide service quality and administrative efficiency. That these recent developments are fueled by technology might misleadingly suggest that the adoption of mobile banking is largely based on technological criteria. The purpose of this study is to establish a better measurement model for postadoption user perception of mobile banking services. Based on 458 valid responses of mobile banking users, the results show that the instrument, consisting of 21 items and 6 factors, is a reliable, valid, and useful measurement for assessing the postadoption perception of mobile banking.
Balance and gait of adults with very mild Alzheimer disease.
Gras, Laura Z; Kanaan, Saddam F; McDowd, Joan M; Colgrove, Yvonne M; Burns, Jeffrey; Pohl, Patricia S
2015-01-01
Studies have shown that adults with Alzheimer disease (AD) have gait and balance deficits; however, the focus has been on those with mild to severe disease. The purpose of this study was to determine whether balance and gait deficits are present in those with very mild AD. Thirteen adults (72.9±4.7 years old) with very mild AD and 13 age-matched (72.6±4.6 years old) and sex-matched (10 males and 3 females) participants in a control group without AD performed balance and gait tests. All participants were living in the community and independent in community ambulation. Participants with very mild AD had shorter times in tandem stance with eyes open (P<0.001) and with eyes closed (P=0.007) compared with participants in the control group. Those with AD also took longer to complete the Timed "Up & Go" Test (P<0.001). Gait deficits were found for those with AD as demonstrated by slower velocities in the 10-m walk at a comfortable pace (P=0.029) and on an instrumented walkway (P<0.001). Stance times were longer for those with AD (P<0.001) and step length was shorter (P=0.001). There were no group differences in the 10-m walk at a fast pace. The gait velocity of participants in the control group was faster on the instrumented walkway than in the 10-m walk at a comfortable pace (P=0.031). In contrast, the gait velocity of those with AD was significantly slower on the instrumented walkway than in the 10-m walk at a comfortable pace (P=0.024). Balance and gait deficits may be present in those in the very early stages of AD. Novel surfaces may affect gait speed in those with very mild AD. Identifying mobility deficits early in the progression of AD may provide an opportunity for early physical therapy intervention, thus promoting continued functional independence. Adults in the very early stages of AD may show signs of balance and gait deficits. Recognition of these problems early with subsequent physical therapy may slow the progression of further balance and gait dysfunction.
Hao, Yoshiteru; Numata, Kazushi; Ishii, Tomohiro; Fukuda, Hiroyuki; Maeda, Shin; Nakano, Masayuki; Tanaka, Katsuaki
2017-05-07
To evaluate whether pathologically early hepatocellular carcinoma (HCC) exhibited local tumor progression after radiofrequency ablation (RFA) less often than typical HCC. Fifty pathologically early HCCs [tumor diameter (mm): mean, 15.8; range, 10-23; follow-up days after RFA: median, 1213; range, 216-2137] and 187 typical HCCs [tumor diameter (mm): mean, 15.6; range, 6-30; follow-up days after RFA: median, 1116; range, 190-2328] were enrolled in this retrospective study. The presence of stromal invasion (namely, tumor cell invasion into the intratumoral portal tracts) was considered to be the most important pathologic finding for the diagnosis of early HCCs. Typical HCC was defined as the presence of a hyper-vascular lesion accompanied by delayed washout using contrast-enhanced computed tomography or contrast-enhanced magnetic resonance imaging. Follow-up examinations were performed at 3-mo intervals to monitor for signs of local tumor progression. The local tumor progression rates of pathologically early HCCs and typical HCCs were then determined using the Kaplan-Meier method. During the follow-up period for the 50 pathologically early HCCs, 49 (98%) of the nodules did not exhibit local tumor progression. However, 1 nodule (2%) was associated with a local tumor progression found 636 d after RFA. For the 187 typical HCCs, 46 (24.6%) of the nodules exhibited local recurrence after RFA. The follow-up period until the local tumor progression of typical HCC was a median of 605 d, ranging from 181 to 1741 d. Among the cases with typical HCCs, local tumor progression had occurred in 7.0% (7/187), 16.0% (30/187), 21.9% (41/187) and 24.6% (46/187) of the cases at 1, 2, 3 and 4 years, respectively. Pathologically early HCC was statistically associated with a lower rate of local tumor progression, compared with typical HCC, when evaluated using a log-rank test ( P = 0.002). The rate of local tumor progression for pathologically early HCCs after RFA was significantly lower than that for typical HCCs.
Hao, Yoshiteru; Numata, Kazushi; Ishii, Tomohiro; Fukuda, Hiroyuki; Maeda, Shin; Nakano, Masayuki; Tanaka, Katsuaki
2017-01-01
AIM To evaluate whether pathologically early hepatocellular carcinoma (HCC) exhibited local tumor progression after radiofrequency ablation (RFA) less often than typical HCC. METHODS Fifty pathologically early HCCs [tumor diameter (mm): mean, 15.8; range, 10-23; follow-up days after RFA: median, 1213; range, 216-2137] and 187 typical HCCs [tumor diameter (mm): mean, 15.6; range, 6-30; follow-up days after RFA: median, 1116; range, 190-2328] were enrolled in this retrospective study. The presence of stromal invasion (namely, tumor cell invasion into the intratumoral portal tracts) was considered to be the most important pathologic finding for the diagnosis of early HCCs. Typical HCC was defined as the presence of a hyper-vascular lesion accompanied by delayed washout using contrast-enhanced computed tomography or contrast-enhanced magnetic resonance imaging. Follow-up examinations were performed at 3-mo intervals to monitor for signs of local tumor progression. The local tumor progression rates of pathologically early HCCs and typical HCCs were then determined using the Kaplan-Meier method. RESULTS During the follow-up period for the 50 pathologically early HCCs, 49 (98%) of the nodules did not exhibit local tumor progression. However, 1 nodule (2%) was associated with a local tumor progression found 636 d after RFA. For the 187 typical HCCs, 46 (24.6%) of the nodules exhibited local recurrence after RFA. The follow-up period until the local tumor progression of typical HCC was a median of 605 d, ranging from 181 to 1741 d. Among the cases with typical HCCs, local tumor progression had occurred in 7.0% (7/187), 16.0% (30/187), 21.9% (41/187) and 24.6% (46/187) of the cases at 1, 2, 3 and 4 years, respectively. Pathologically early HCC was statistically associated with a lower rate of local tumor progression, compared with typical HCC, when evaluated using a log-rank test (P = 0.002). CONCLUSION The rate of local tumor progression for pathologically early HCCs after RFA was significantly lower than that for typical HCCs. PMID:28533668
Low Frequency of Early Complications With Dual-mobility Acetabular Cups in Cementless Primary THA.
Chughtai, Morad; Mistry, Jaydev B; Diedrich, Aloise M; Jauregui, Julio J; Elmallah, Randa K; Bonutti, Peter M; Harwin, Steven F; Malkani, Arthur L; Kolisek, Frank R; Mont, Michael A
2016-10-01
Dislocation complicates 1% to 5% of primary total hip arthroplasties (THAs). As a result, some surgeons consider dual-mobility articulations, which are usually used in the revision setting to decrease the likelihood of dislocation, as an option for primary THA. However, few studies have evaluated their use in this setting. (1) What is the cup survivorship when the dual-mobility articulation is used in the setting of primary THA? (2) What are the clinical outcomes with this approach? (3) What are the radiographic outcomes? (4) What are the complications of dual-mobility articulations in primary THA? Between 2011 and 2013, the five participating surgeons performed 495 cementless primary THAs. During that time, one of the five surgeons used dual-mobility articulations for all THAs, and the other four used it whenever the acetabular cup size was 52 mm or greater to enable a 28-mm head. Of the 495 patients, 453 (92%) were performed using this device. Smaller patients were treated with a standard THA. Of the 453 patients, a total of 43 patients (10%) were lost to followup before the 2-year minimum. The resulting 410 patients who were included in the analysis (164 men, 246 women) had a mean age of 64 years (SD, 12 years). The mean followup was 3 years (SD, 0.7 years). We performed Kaplan-Meier analyses to assess survivorship to aseptic failure and all-cause acetabular component survivorship. Clinical outcomes were evaluated using the Harris hip score (HHS); radiographs were assessed for cup migration, progressive radiolucencies, and positional changes of the components; and any surgery-related complications were recorded. The survivorship to aseptic failure and all-cause acetabular component survivorship was 99.8% (failures, n = 1) (95% confidence interval [CI], 4.517-4.547) and 99.3% (failures, aseptic, n = 1; septic, n = 2) (95% CI, 4.494-4.543); one hip had trunnion notching caused by impingement of a malpositioned cup, which was treated with revision of the cup and stem; and two patients had periprosthetic infections that were treated with two-stage revisions. There were no dislocations. Patients had a mean HHS of 94 (SD, 6) at final followup. On radiographic evaluation, no progressive radiolucencies or positional changes of the components were identified. Surgical complications included one traumatic avulsion of the abductors, one traumatic avulsion of the greater trochanter, which was repaired without revision of any of the components, and one loose femoral stem, which required revision of the femoral component only. Dual-mobility cups in primary THA yield seemingly comparable survivorship and complications to conventional THA bearings at short-term followup. Because serious complications have occasionally been reported with the use of these bearings, larger, longer term, comparative-and ideally, randomized-trials will be needed to establish the superiority of one approach over the other. Until or unless such studies show the superiority of dual-mobility designs for primary THA, we recommend that in the setting of uncomplicated primary THA, dual-mobility articulations be used only in centers that track their results carefully or in research protocols. Level IV, therapeutic study.
Effects of Acarbose to Delay Progression of Carotid Intima-Media Thickness in Early Diabetes
Patel, YR; Kirkman, MS; Considine, RV; Hannon, TS; Mather, KJ
2014-01-01
Background The antidiabetic agent acarbose reduces postprandial glucose excursions. We have evaluated the effect of randomized treatment with acarbose on the progression of carotid intima-media thickness (IMT) in early diabetes. Methods The Early Diabetes Intervention Program (EDIP) was a randomized trial of acarbose versus placebo, in 219 participants with early diabetes characterized by glucose values over 11.1 mmol/L 2 hours after a 75g oral glucose load, and mean HbA1c 6.3%. IMT was measured at baseline and yearly. Follow-up was discontinued if participants progressed to the study glucose endpoints; IMT readings were available for a median of 2 years, with 72 subjects followed for 5 years. Results Progressive increases in IMT were seen in both treatment groups, but this was reduced in participants randomized to acarbose (p=0.047). In age, sex and smoking-adjusted analyses IMT progression was associated with greater fasting and OGTT-excursion glucose, fasting insulin, cholesterol, and glycated LDL concentrations. IMT progression was reduced with study-related changes in weight, insulin, and nonesterified fatty acids; these features were more strongly associated with reduced IMT progression than acarbose treatment. Despite strong associations of baseline glycemia with IMT progression, study-related changes in glucose were not important determinants of IMT progression. Conclusions Acarbose can delay progression of carotid intima-media thickness in early diabetes defined by an oral glucose tolerance test. Glucose, weight, insulin and lipids contributed to risk of progression but reductions in glycemia were not major determinants of reduced rate of IMT progression. Vascular benefits of acarbose may be independent of its glycemic effects. PMID:23908125
A Mobile Early Stimulation Program to Support Children with Developmental Delays in Brazil.
Dias, Raquel da Luz; Silva, Kátia Cristina Correa Guimarães; Lima, Marcela Raquel de Oliveira; Alves, João Guilherme Bezerra; Abidi, Syed Sibte Raza
2018-01-01
Developmental delay is a deviation development from the normative milestones during the childhood and it may be caused by neurological disorders. Early stimulation is a standardized and simple technique to treat developmental delays in children (aged 0-3 years), allowing them to reach the best development possible and to mitigate neuropsychomotor sequelae. However, the outcomes of the treatment depending on the involvement of the family, to continue the activities at home on a daily basis. To empower and educate parents of children with neurodevelopmental delays to administer standardized early stimulation programs at home, we developed a mobile early stimulation program that provides timely and evidence-based clinical decision support to health professionals and a personalized guidance to parents about how to administer early stimulation to their child at home.
NOAA, federal partners design 'early warning system' for freshwater
expertise, technology and data to create a mobile app to help water quality managers make important developed by the four partner agencies to a format that the public can use through a mobile devices and web social media channels. NOAA Mobile | Protecting Your Privacy | FOIA | Information Quality | Disclaimer
ERIC Educational Resources Information Center
LeBoeuf, Whitney A.
2013-01-01
A number of studies have identified school mobility as one form of school disengagement that is disproportionately harmful for young children enrolled in large urban districts. However, there is substantial variation in these findings, with some studies actually evidencing positive associations between school mobility and academic outcomes (Mehana…
Mobile Creches: Pioneering Early Childhood Care and Development in India
ERIC Educational Resources Information Center
Young Children, 2007
2007-01-01
Mobile Creche ("creche" means "day nursery") was founded on one woman's determination to change life for India's most vulnerable children. Within its first decade, Mobile Creches' network of child care centers spread from construction sites to urban slums and from the capital city of Delhi to the commercial and cultural centers…
Background and Employability of Mobile vs. Non-Mobile Students
ERIC Educational Resources Information Center
Wiers-Jenssen, Jannecke
2011-01-01
In this paper, a comparison is made of the background and the early career of graduates with higher education from abroad to graduates with all domestic degrees, based on a survey among Norwegian graduates. Results show that those who have studied abroad constitute a selected group regarding social origin and mobility capital (exposure to…
Patel, Yash R.; Kirkman, M. Sue; Considine, Robert V; Hannon, Tamara S; Mather, Kieren J
2017-01-01
Background Retinopathy is increasingly recognized in prediabetic populations, and may herald increased risk of metabolic worsening. The Early Diabetes Intervention Program (EDIP) evaluated worsening of glycemia in screen-detected Type 2 diabetes, following participants for up to 5 years. Here we have evaluated whether the presence of retinopathy at the time of detection of diabetes was associated with accelerated progression of glycemia. Methods We prospectively studied 194 participants from EDIP with available baseline retinal photographs. Retinopathy was determined at baseline using 7-field fundus photography and defined as an Early Treatment of Diabetic Retinopathy Study Scale grading score of ≥20. Results At baseline, 12% of participants had classical retinal lesions indicating retinopathy. In univariate Cox proportional hazard analysis, the presence of retinopathy at baseline was associated with a doubled risk of progression of fasting plasma glucose (HR 2.02; 95% CI 1.05–3.89). The retinopathy effect was robust to individual adjustment for age and glucose, the most potent determinants of progression in EDIP. Conclusion Retinopathy was associated with increased risk of progression of fasting plasma glucose among adults with screen-detected, early diabetes. Early detection of retinopathy may help individualize more aggressive therapy to prevent progressive metabolic worsening in early diabetes. PMID:28003103
National quality improvement policies and strategies in European healthcare systems.
Spencer, E; Walshe, K
2009-02-01
This survey provides an overview of the development of policies and strategies for quality improvement in European healthcare systems, by mapping quality improvement policies and strategies, progress in their implementation, and early indications of their impact. A survey of quality improvement policies and strategies in healthcare systems of the European Union was conducted in 2005 for the first phase of the Methods of Assessing Response to Quality Improvement Strategies (MARQuIS) project. The survey, completed by 68 key experts in quality improvement from 24 European Union member states, represents their views and accounts of quality improvement policies and strategies in their healthcare systems. There are substantial international and intra-national variations in the development of healthcare quality improvement. Legal requirements for quality improvement strategies are an important driver of progress, along with the activities of national governments and professional associations and societies. Patient and service user organisations appear to have less influence on quality improvement. Wide variation in voluntary and mandatory coverage of quality improvement policies and strategies across sectors can potentially lead to varying levels of progress in implementation. Many healthcare organisations lack basic infrastructure for quality improvement. Some convergence can be observed in policies on quality improvement in healthcare. Nevertheless, the growth of patient mobility across borders, along with the implications of free market provisions for the organisation and funding of healthcare systems in European Union member states, require policies for cooperation and learning transfer.
Bonouvrié, Laura; Becher, Jules; Soudant, Dan; Buizer, Annemieke; van Ouwerkerk, Willem; Vles, Georges; Vermeulen, R Jeroen
2016-07-01
Intrathecal baclofen (ITB) treatment is applied in patients with spastic cerebral palsy (SCP), dystonic cerebral palsy (DCP) and progressive neurological disease (PND). Our aim was to investigate whether ITB treatment has a different effect on activities of daily life (ADL) in these groups. A retrospective and cross-sectional survey was conducted using a questionnaire to assess the qualitative effect of ITB (Likert scale) on different domains of functioning (mobility, personal care, communication, comfort) and satisfaction with the results. Groups were compared using non-parametric statistics. Questionnaires were completed for 68 patients (39 SCP, 13 DCP, 16 PND). Satisfaction scores were relatively high in all groups (7-8) and the positive effect on personal care and communication was similar in all groups. The PND group had the shortest follow-up and scored significantly less favourably for the effect on mobility and comfort. This is the first study to show that ITB treatment has similar effects on personal care and communication in stable and progressive neurological disease. The decrease in mobility in the PND group is likely due to the progressive nature of the disease. The different effect on comfort between groups is mainly due to the smaller effect on startles in the PND group. Copyright © 2016 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.
Evolution of the Archean Mohorovičić discontinuity from a synaccretionary 4.5 Ga protocrust
NASA Astrophysics Data System (ADS)
Hamilton, Warren B.
2013-12-01
This review evaluates and rejects the currently dominant dogmas of geodynamics and geochemistry, which are based on 1950s-1970s assumptions of a slowly differentiating Earth. Evidence is presented for evolution of mantle, crust, and early Moho that began with fractionation of most crustal components, synchronously with planetary accretion, into mafic protocrust by ~ 4.5 Ga. We know little about Hadean crustal geology (> 3.9 Ga) except that felsic rocks were then forming, but analogy with Venus, and dating from the Moon, indicate great shallow disruption by large and small impact structures, including huge fractionated impact-melt constructs, throughout that era. The mantle sample and Archean (< 3.9 Ga) crustal geology integrate well. The shallow mantle was extremely depleted by early removal of thick mafic protocrust, which was the primary source of the tonalite, trondhjemite, and granodiorite (TTG) that dominate preserved Archean crust to its base, and of the thick mafic volcanic rocks erupted on that crust. Lower TTG crust, kept mobile by its high radioactivity and by insulating upper crust, rose diapirically into the upper crust as dense volcanic rocks sagged synformally. The mobile lower crust simultaneously flowed laterally to maintain subhorizontal base and surface, and dragged overlying brittler granite-and-greenstone upper crust. Petrologically required garnet-rich residual protocrust incrementally delaminated, sank through low-density high-mantle magnesian dunite, and progressively re-enriched upper mantle, mostly metasomatically. Archean and earliest Proterozoic craton stabilization and development of final Mohos followed regionally complete early delamination of residual protocrust, variously between ~ 2.9 and 2.2 Ga. Where some protocrust remained, Proterozoic basins, filled thickly by sedimentary and volcanic rocks, developed on Archean crust, beneath which delamination of later residual protocrust continued top-down enrichment of upper mantle. That reenrichment enabled modern-style plate tectonics after ~ 600 Ma, with a transition regime beginning ~ 850 Ma.
Framework for Understanding Balance Dysfunction in Parkinson’s Disease
Schoneburg, Bernadette; Mancini, Martina; Horak, Fay; Nutt, John G.
2013-01-01
People with Parkinson’s disease (PD) suffer from progressive impairment in their mobility. Locomotor and balance dysfunction that impairs mobility in PD is an important cause of physical and psychosocial disability. The recognition and evaluation of balance dysfunction by the clinician is an essential component of managing PD. In this review, we describe a framework for understanding balance dysfunction in PD to help clinicians recognize patients that are at risk for falling and impaired mobility. PMID:23925954
A Cardiac Early Warning System with Multi Channel SCG and ECG Monitoring for Mobile Health
Sahoo, Prasan Kumar; Thakkar, Hiren Kumar; Lee, Ming-Yih
2017-01-01
Use of information and communication technology such as smart phone, smart watch, smart glass and portable health monitoring devices for healthcare services has made Mobile Health (mHealth) an emerging research area. Coronary Heart Disease (CHD) is considered as a leading cause of death world wide and an increasing number of people die prematurely due to CHD. Under such circumstances, there is a growing demand for a reliable cardiac monitoring system to catch the intermittent abnormalities and detect critical cardiac behaviors which lead to sudden death. Use of mobile devices to collect Electrocardiography (ECG), Seismocardiography (SCG) data and efficient analysis of those data can monitor a patient’s cardiac activities for early warning. This paper presents a novel cardiac data acquisition method and combined analysis of Electrocardiography (ECG) and multi channel Seismocardiography (SCG) data. An early warning system is implemented to monitor the cardiac activities of a person and accuracy assessment of the early warning system is conducted for the ECG data only. The assessment shows 88% accuracy and effectiveness of our proposed analysis, which implies the viability and applicability of the proposed early warning system. PMID:28353681
A Cardiac Early Warning System with Multi Channel SCG and ECG Monitoring for Mobile Health.
Sahoo, Prasan Kumar; Thakkar, Hiren Kumar; Lee, Ming-Yih
2017-03-29
Use of information and communication technology such as smart phone, smart watch, smart glass and portable health monitoring devices for healthcare services has made Mobile Health (mHealth) an emerging research area. Coronary Heart Disease (CHD) is considered as a leading cause of death world wide and an increasing number of people die prematurely due to CHD. Under such circumstances, there is a growing demand for a reliable cardiac monitoring system to catch the intermittent abnormalities and detect critical cardiac behaviors which lead to sudden death. Use of mobile devices to collect Electrocardiography (ECG), Seismocardiography (SCG) data and efficient analysis of those data can monitor a patient's cardiac activities for early warning. This paper presents a novel cardiac data acquisition method and combined analysis of Electrocardiography (ECG) and multi channel Seismocardiography (SCG) data. An early warning system is implemented to monitor the cardiac activities of a person and accuracy assessment of the early warning system is conducted for the ECG data only. The assessment shows 88% accuracy and effectiveness of our proposed analysis, which implies the viability and applicability of the proposed early warning system.
Connecting Research on Retinitis Pigmentosa to the Practice of Orientation and Mobility.
ERIC Educational Resources Information Center
Geruschat, Duane R.; Turano, Kathleen A.
2002-01-01
Retinitis pigmentosa (RP) causes restriction of the visual field, progressive vision loss, and night blindness. This article presents an overview of the most common problems in orientation and mobility (O&M) for individuals with RP, appropriate interventions, vision science discoveries related to RP, and the impact of RP on functional visual…
ERIC Educational Resources Information Center
Johnson, James Nathaniel
2013-01-01
Ubiquitous computing is a near reality in both the private and public arena. Business and personal spaces are seeing a proliferation of mobile computing devices and pervasive computing technologies. This phenomenon is creating a unique set of challenges for organizational IT professionals, specifically in the numerous spillover effects of having…
Mobile Technology in Hospital Schools: What Are Hospital Teachers' Professional Learning Needs?
ERIC Educational Resources Information Center
McCarthy, Aidan; Maor, Dorit; McConney, Andrew
2017-01-01
The aim of this study was to identify hospital teachers' professional learning needs to enable effective use of mobile technology in hospital schools. Hospitalized students cannot attend their regular schools and as a result their educational progress and development can suffer. In an attempt to address this, hospital schools provide learning…
ERIC Educational Resources Information Center
Cabielles-Hernandez, David; Pérez-Pérez, Juan-Ramón; Paule-Ruiz, MPuerto; Fernández-Fernández, Samuel
2017-01-01
New possibilities offered by mobile devices for special education students have led to the design of skill acquisition software applications. Advances in mobile technologies development have made progress possible in helping teachers with autistic students modelling and evaluation. "Chain of Words" theoretical basis is the autism…
Constantinescu, Gabriela; Loewen, Irene; King, Ben; Brodt, Chris; Hodgetts, William
2017-01-01
Background Adherence to swallowing rehabilitation exercises is important to develop and maintain functional improvement, yet more than half of head and neck cancer (HNC) patients report having difficulty adhering to prescribed regimens. Health apps with game elements have been used in other health domains to motivate and engage patients. Understanding the factors that impact adherence may allow for more effective gamified solutions. Objective The aim of our study was to (1) identify self-reported factors that influence adherence to conventional home therapy without a mobile device in HNC patients and (2) identify appealing biofeedback designs that could be used in a health app. Methods A total of 10 (4 females) HNC patients (mean=60.1 years) with experience completing home-based rehabilitation programs were recruited. Thematic analysis of semi-structured interviews was used to answer the first objective. Convergent interviews were used to obtain reactions to biofeedback designs. Results Facilitators and barriers of adherence to home therapy were described through 6 themes: patient perceptions on outcomes and progress, clinical appointments, cancer treatment, rehabilitation program, personal factors, and connection. App visuals that provide feedback on performance during swallowing exercises should offer an immediate representation of effort relative to a goal. Simple, intuitive graphics were preferred over complex, abstract ones. Continued engagement with the app could be facilitated by tracking progress and by using visuals that build structures with each use. Conclusions This is a detailed documentation of the initial steps in designing a health app for a specific patient group. Results revealed the importance of patient engagement in early stages of app development. PMID:28582245
Fatigue and pain limit independent mobility and physiotherapy after hip fracture surgery.
Münter, Kristine H; Clemmesen, Christopher G; Foss, Nicolai B; Palm, Henrik; Kristensen, Morten T
2018-07-01
The patient's ability to complete their planned physiotherapy session after hip fracture surgery has been proposed as an independent predictor for achieving basic mobility independency upon hospital discharge. However, knowledge of factors limiting mobility is sparse. We therefore examined patient reported factors limiting ability to complete planned physiotherapy sessions as well as limitations for not achieving independency in basic mobility early after hip fracture surgery. A total of 204 consecutive patients with a hip fracture (mean (SD) age of 80 (9.9) years, 47 patients were admitted from a nursing home) were treated in accordance with a multimodal program. The Cumulated Ambulation Score was used to evaluate the patient's independency in three basic mobility activities: getting in and out of bed, sit-to-stand-to-sit from a chair and indoor walking. Pre-defined limitations; pain, motor blockade, dizziness, fatigue, nausea, acute cognitive dysfunction and "other limitations", for not achieving a full Cumulated Ambulation Score or inability to complete planned physiotherapy sessions were noted by the physiotherapist on each of the three first postoperative days. This period was chosen, because of its importance on how well the patients had regained their pre-fracture functional level. Fatigue and hip fracture-related pain were the most frequent reasons for patients not achieving an independent basic mobility level (> 85%) or not fully completing their planned physiotherapy (> 42%) on all three days. At hospital discharge (median day 10), only 54% of the patients had regained their pre-fracture basic mobility level. Based on the patient's perception, fatigue and pain are the most frequent limitations in not achieving independent basic mobility and not completing physiotherapy after hip fracture surgery. This raises questions whether multimodal peri-operative programs can be further optimized to enhance the early recovery of these frail patients. Implications for rehabilitation Early postoperative mobilization is essential for patients undergoing hip fracture surgery to regain the pre-fracture functional level, in not only the short but also in the long term. The most frequent reasons for not achieving an independent Cumulated Ambulation Score or completing physiotherapy, early after hip fracture surgery, are fatigue, pain, and the habitual cognitive status of patients. Knowledge concerning postoperative fatigue is important for rehabilitation professionals and should contribute as an essential factor when planning physiotherapy.
Early Detection of Progressive Adolescent Idiopathic Scoliosis: A Severity Index.
Skalli, Wafa; Vergari, Claudio; Ebermeyer, Eric; Courtois, Isabelle; Drevelle, Xavier; Kohler, Remi; Abelin-Genevois, Kariman; Dubousset, Jean
2017-06-01
Early detection of progressive adolescent idiopathic scoliosis (AIS) was assessed based on 3D quantification of the deformity. Based on 3D quantitative description of scoliosis curves, the aim is to assess a specific phenotype that could be an early detectable severity index for progressive AIS. Early detection of progressive scoliosis is important for adapted treatment to limit progression. However, progression risk assessment is mainly based on the follow up, waiting for signs of rapid progression that generally occur during the growth peak. Sixty-five mild scoliosis (16 boys, 49 girls, Cobb Angle between 10 and 20°) with a Risser between 0 and 2 were followed from their first examination until a decision was made by the clinician, either considering the spine as stable at the end of growth (26 patients) or planning to brace because of progression (39 patients). Calibrated biplanar x-rays were performed and 3D reconstructions of the spine allowed calculating six local parameters related to main curve deformity. For progressive curve 3D phenotype assessment, data were compared with those previously assessed for 30 severe scoliosis (Cobb Angle > 35°), 17 scoliosis before brace (Cobb Angle > 29°) and 53 spines of nonscoliosis subjects. A predictive discriminant analysis was performed to assess similarity of mild scoliosis curves either to those of scoliosis or nonscoliosis spines, yielding a severity index (S-index). S-index value at first examination was compared with clinical outcome. At the first exam, 53 out of 65 predictions (82%) were in agreement with actual clinical outcome. Approximately, 89% of the curves that were predicted as progressive proved accurate. Although still requiring large scale validation, results are promising for early detection of progressive curves. 2.
Mobile Transcripts and Intercellular Communication in Plants.
Saplaoura, E; Kragler, F
2016-01-01
Phloem serves as a highway for mobile signals in plants. Apart from sugars and hormones, proteins and RNAs are transported via the phloem and contribute to the intercellular communication coordinating growth and development. Different classes of RNAs have been found mobile and in the phloem exudate such as viral RNAs, small interfering RNAs (siRNAs), microRNAs, transfer RNAs, and messenger RNAs (mRNAs). Their transport is considered to be mediated via ribonucleoprotein complexes formed between phloem RNA-binding proteins and mobile RNA molecules. Recent advances in the analysis of the mobile transcriptome indicate that thousands of transcripts move along the plant axis. Although potential RNA mobility motifs were identified, research is still in progress on the factors triggering siRNA and mRNA mobility. In this review, we discuss the approaches used to identify putative mobile mRNAs, the transport mechanism, and the significance of mRNA trafficking. © 2016 Elsevier Inc. All rights reserved.
ERIC Educational Resources Information Center
Greenwood, Charles R.; Walker, Dale; Buzhardt, Jay
2010-01-01
The Early Communication Indicator (ECI) is a measure relevant to intervention decision making and progress monitoring for infants and toddlers. With increasing recognition of the importance of quality early childhood education and intervention for all children, measurement plays an important role in documenting children's progress and outcomes of…
Interworking evolution of mobile satellite and terrestrial networks
NASA Technical Reports Server (NTRS)
Matyas, R.; Kelleher, P.; Moller, P.; Jones, T.
1993-01-01
There is considerable interest among mobile satellite service providers in interworking with terrestrial networks to provide a universal global network. With such interworking, subscribers may be provided a common set of services such as those planned for the Public Switched Telephone Network (PSTN), the Integrated Services Digital Network (ISDN), and future Intelligent Networks (IN's). This paper first reviews issues in satellite interworking. Next the status and interworking plans of terrestrial mobile communications service providers are examined with early examples of mobile satellite interworking including a discussion of the anticipated evolution towards full interworking between mobile satellite and both fixed and mobile terrestrial networks.
Federal Register 2010, 2011, 2012, 2013, 2014
2012-11-20
... Corporation. 20121393 G South Mississippi Electric Power Association; Batesville, Generation Holdings, LLC... Pharmaceuticals Corp.; Bruce Kovner. 20130078 G Exxon Mobil Corporation; Denbury Resources Inc.; Exxon Mobil...
Teachers' Perception of Mobile Edutainment for Special Needs Learners: The Malaysian Case
ERIC Educational Resources Information Center
Mohd Yusof, Anuar; Daniel, Esther Gnanamalar Sarojini; Low, Wah Yun; Ab. Aziz, Kamarulzaman
2014-01-01
Study of Malaysian adoption of mobile learning (m-learning) is still in the early stages. However, there are numerous researchers in the country exploring the potential and application of m-learning in the Malaysian education system, including special education. A key question is whether teachers are prepared to incorporate mobile technology as…
Career Mobility of High-Flying Women Academics: A Study at Selected Universities in Malaysia
ERIC Educational Resources Information Center
Ismail, Maimunah; Rasdi, Roziah Mohd
2006-01-01
This study aims to investigate the relationship between past experience and the career mobility of 31 high-flying female academics from eight established Malaysian universities. Based on data gathered from in-depth interviews, it is discerned that the respondents' career mobility at the "exploration" stage is influenced by early exposure…
ERIC Educational Resources Information Center
Coley, Rebekah Levine; Kull, Melissa
2016-01-01
Residential mobility has received notable attention in the literature, yet there remains limited consensus on how and when mobility is associated with detriments to children's development. Drawing on a nationally representative sample of 19,162 children in the Early Childhood Longitudinal Study followed from kindergarten through eighth grade, this…
The Positive Effects of Early Powered Mobility on Children's Psychosocial and Play Skills
ERIC Educational Resources Information Center
Guerette, Paula; Furumasu, Jan; Tefft, Donita
2013-01-01
Powered mobility can have an important cognitive and psychosocial impact on young children who are unable to move independently. Twenty-three children with physical disabilities between the ages of 18 months and 6 years participated in this study. Data evaluating social skills, frequency of mobility play activities, frequency of interaction with…
Age-Related Change in Mobility: Perspectives From Life Course Epidemiology and Geroscience
Cooper, Rachel; Shardell, Michelle; Simonsick, Eleanor M.; Schrack, Jennifer A.; Kuh, Diana
2016-01-01
Mobility is the most studied and most relevant physical ability affecting quality of life with strong prognostic value for disability and survival. Natural selection has built the “engine” of mobility with great robustness, redundancy, and functional reserve. Efficient patterns of mobility can be acquired during development even by children affected by severe impairments. Analogously, age-associated impairments in mobility-related physiological systems are compensated and overt limitations of mobility only occur when the severity can no longer be compensated. Mobility loss in older persons usually results from multiple impairments in the central nervous system, muscles, joints, and energetic and sensory physiological systems. Early preclinical changes in these physiological systems that precede mobility loss have been poorly studied. Peak performance, rate of decline, compensatory behaviors, or subclinical deterioration of physiological resources may cumulatively influence both timing of mobility loss and chances of recovery, but their role as risk factors has not been adequately characterized. Understanding the natural history of these early changes and intervening on them would likely be the most effective strategy to reduce the burden of disability in the population. For example, young women with low bone peak mass could be counseled to start strength resistance exercise to reduce their high risk of developing osteoporosis and fracture later in life. Expanding this approach to other physiological domains requires collecting and interpreting data from life course epidemiological studies, establishing normative measures of mobility, physical function, and physical activity, and connecting them with life course trajectories of the mobility-relevant physiological domains. PMID:26975983
Qi, Xiaoyang; Flick, Matthew J.; Frederick, Malinda; Chu, Zhengtao; Mason, Rachel; DeLay, Monica; Thornton, Sherry
2012-01-01
Rheumatoid arthritis is a chronic inflammatory disease affecting approximately 1% of the population and is characterized by cartilage and bone destruction ultimately leading to loss of joint function. Early detection and intervention of disease provides the best hope for successful treatment and preservation of joint mobility and function. Reliable and non-invasive techniques that accurately measure arthritic disease onset and progression are lacking. We recently developed a novel agent, SapC-DOPS, which is composed of the membrane-associated lysosomal protein saposin C (SapC) incorporated into 1,2-dioleoyl-sn-glycero-3-phospho-L-serine (DOPS) lipid nanovesicles. SapC-DOPS has a high fusogenic affinity for phosphatidylserine-enriched microdomains on surfaces of target cell membranes. Incorporation of a far-red fluorophore, CellVue Maroon (CVM), into the nanovesicles allows for in vivo non-invasive visualization of the agent in targeted tissue. Given that phosphatidylserine is present only on the inner leaflet of healthy plasma membranes but is “flipped” to the outer leaflet upon cell damage, we hypothesized that SapC-DOPS would target tissue damage associated with inflammatory arthritis due to local surface-exposure of phosphatidylserine. Optical imaging with SapC-DOPS-CVM in two distinct models of arthritis, serum-transfer arthritis (e.g., K/BxN) and collagen-induced arthritis (CIA) revealed robust SapC-DOPS-CVM specific localization to arthritic paws and joints in live animals. Importantly, intensity of localized fluorescent signal correlated with macroscopic arthritic disease severity and increased with disease progression. Flow cytometry of cells extracted from arthritic joints demonstrated that SapC-DOPS-CVM localized to an average of 7–8% of total joint cells and primarily to CD11b+Gr-1+ cells. Results from the current studies strongly support the application of SapC-DOPS-CVM for advanced clinical and research applications including: detecting early arthritis onset, assessing disease progression real-time in live subjects, and providing novel information regarding cell types that may mediate arthritis progression within joints. PMID:22470501
Domestic mobile satellite systems in North America
NASA Technical Reports Server (NTRS)
Wachira, Muya
1990-01-01
Telest Mobile Inc. (TMI) and the American Mobile Satellite Corporation (AMSC) are authorized to provide mobile satellite services (MSS) in Canada and the United States respectively. They are developing compatible systems and are undertaking joint specification and procurement of spacecraft and ground segment with the aim of operational systems by late 1993. Early entry (phase 1) mobile data services are offered in 1990 using space segment capacity leased from Inmarsat. Here, an overview is given of these domestic MSS with an emphasis on the TMI component of the MSAT systen.
A New Method of Viewing Attachment Document of eMail on Various Mobile Devices
NASA Astrophysics Data System (ADS)
Ko, Heeae; Seo, Changwoo; Lim, Yonghwan
As the computing power of the mobile devices is improving rapidly, many kinds of web services are also available in mobile devices just as Email service. Mobile Mail Service began early, but this service is mostly limited in some specified mobile devices such as Smart Phone. That is a limitation that users have to purchase specified phone to be benefited from Mobile Mail Service. In this paper, it uses DIDL (digital item declaration language) markup type defined in MPEG-21 and MobileGate Server, and solved this problem. DIDL could be converted to other markup types which are displayed by mobile devices. By transforming PC Web Mail contents including attachment document to DIDL markup through MobileGate Server, the Mobile Mail Service could be available for all kinds of mobile devices.
Teachers' Attitudes toward the Usage of Mobile Devices in EFL Classroom
ERIC Educational Resources Information Center
Dogan, Ali; Akbarov, Azamat
2016-01-01
Nowadays, technology is developing in a geometrically progressive manner. Its usage in different social areas is an imperative, rather than a choice. As expected, digital devices are applicable in the educational context, as well. Hence, the scope of the present study is to examine attitudes toward mobile learning among English teachers. For this…
English-Language Learning at Their Fingertips: How Can Teachers Use Tablets to Teach EFL Children?
ERIC Educational Resources Information Center
Alhinty, Mona
2015-01-01
The emergence of multi-touch screen tablets has increased the opportunities for mobile learning, as the unique capabilities and affordances of these devices give them an educational advantage over other mobile technologies. Tablets are progressively finding their way into classrooms and transforming modes of learning and teaching. However,…
Mathvision: A Mobile Video Application for Math Teacher Noticing of Learning Progressions
ERIC Educational Resources Information Center
Lewis, Stephen T.; Chao, Theodore; Battista, Michael
2017-01-01
We report on the development and evaluation of MathVision, a mobile-application designed to develop Virtual Professional Learning Communities through asynchronous discussion about 2nd, 3rd, 4th, and 5th grade students' mathematical thinking. MathVision allows teachers to upload videos of problems solving sessions using Cognition Based Assessment…
Parental Perception of Mobile Device Usage in Children and Social Competency
ERIC Educational Resources Information Center
Topper, Christin
2017-01-01
Parents in the 21st century are concerned with the ubiquity of mobile devices and their effects on the progression of social development. A review of the literature indicated that although digital interaction has become more prominent, limited empirical data existed on whether children who spend more time interacting in the digital realm would…
Early Restoration Public Meeting, Alabama | NOAA Gulf Spill Restoration
Public Meeting, Alabama Date: January 23, 2012 Location: Mobile, Alabama Description: The Deepwater public meeting starting at 7:00 p.m. Address: Battle House Marriott Hotel 26 North Royal Street Mobile
NASA Technical Reports Server (NTRS)
Williams, K. B.; Kunze, M. E.; Todd, P. W.
1985-01-01
Four major cell types were identified by phase microscopy in early passage human embryonic kidney cell cultures. They are small and large epithelioid, domed, and fenestrated cells. Fibroblasts are also present in some explants. The percent of each cell type changes with passage number as any given culture grows. As a general rule, the fraction of small epithelioid cells increases, while the fraction of fenestrated cells, always small, decreases further. When fibroblasts are present, they always increase in percentage of the total cell population. Electrophoretic separation of early passage cells showed that the domed cells have the highest electrophoretic mobility, fibroblasts have an intermediate high mobility, small epithelioid cells have a low mobility, broadly distributed, and fenestrated cells have the lowest mobility. All cell types were broadly distributed among electrophoretic subfractions, which were never pure but only enriched with respect to a given cell type.
Parisien, Rachel B; Gillanders, Kirstie; Hennessy, Erin K; Herterich, Lisa; Saunders, Kendra; Lati, Jamil; Dos Santos, Stephanie; Hassall, Alison; O'Brien, Kelly K
2016-05-31
The aim of this study was to conduct a preliminary investigation into parents' experiences of physical therapy and early mobility (EM) for their children in a pediatric critical care unit (PCCU). We conducted a series of four qualitative case studies using in-depth semi-structured face-to-face interviews. We recruited parents of children who had undergone surgery and received at least one EM physical therapy intervention while intubated. We conducted a thematic analysis of transcribed interviews to illuminate the factors that influenced EM experiences. Four parents participated in the study. We developed an overview of Parental Experiences with Physical Therapy and Early Mobility in a PCCU, which includes four themes that parents believed influenced their experiences: (1) environmental factors; (2) awareness of physical therapist and health care professional (HCP) roles; (3) communication among parents and HCPs; and (4) parental participation in their child's EM, within the overarching parental experiences in the PCCU. This study affords a preliminary understanding of parents' experiences with physical therapy and EM in a PCCU setting. Results provide an important foundation for future research on mobility in the context of pediatric critical care research and practice.
Bajrami, Besnik; Zhu, Haiyan; Zhang, Yu C.
2016-01-01
Cytokine-induced neutrophil mobilization from the bone marrow to circulation is a critical event in acute inflammation, but how it is accurately controlled remains poorly understood. In this study, we report that CXCR2 ligands are responsible for rapid neutrophil mobilization during early-stage acute inflammation. Nevertheless, although serum CXCR2 ligand concentrations increased during inflammation, neutrophil mobilization slowed after an initial acute fast phase, suggesting a suppression of neutrophil response to CXCR2 ligands after the acute phase. We demonstrate that granulocyte colony-stimulating factor (G-CSF), usually considered a prototypical neutrophil-mobilizing cytokine, was expressed later in the acute inflammatory response and unexpectedly impeded CXCR2-induced neutrophil mobilization by negatively regulating CXCR2-mediated intracellular signaling. Blocking G-CSF in vivo paradoxically elevated peripheral blood neutrophil counts in mice injected intraperitoneally with Escherichia coli and sequestered large numbers of neutrophils in the lungs, leading to sterile pulmonary inflammation. In a lipopolysaccharide-induced acute lung injury model, the homeostatic imbalance caused by G-CSF blockade enhanced neutrophil accumulation, edema, and inflammation in the lungs and ultimately led to significant lung damage. Thus, physiologically produced G-CSF not only acts as a neutrophil mobilizer at the relatively late stage of acute inflammation, but also prevents exaggerated neutrophil mobilization and the associated inflammation-induced tissue damage during early-phase infection and inflammation. PMID:27551153
NASA Astrophysics Data System (ADS)
Foley, Bradford J.; Rizo, Hanika
2017-10-01
The style of tectonics on the Hadean and Archean Earth, particularly whether plate tectonics was in operation or not, is debated. One important, albeit indirect, constraint on early Earth tectonics comes from observations of early-formed geochemical heterogeneities: 142Nd and 182W anomalies recorded in Hadean to Phanerozoic rocks from different localities indicate that chemically heterogeneous reservoirs, formed during the first ∼500 Myrs of Earth's history, survived their remixing into the mantle for over 1 Gyrs. Such a long mixing time is difficult to explain because hotter mantle temperatures, expected for the early Earth, act to lower mantle viscosity and increase convective vigor. Previous studies found that mobile lid convection typically erases heterogeneity within ∼100 Myrs under such conditions, leading to the hypothesis that stagnant lid convection on the early Earth was responsible for the observed long mixing times. However, using two-dimensional Cartesian convection models that include grainsize evolution, we find that mobile lid convection can preserve heterogeneity at high mantle temperature conditions for much longer than previously thought, because higher mantle temperatures lead to larger grainsizes in the lithosphere. These larger grainsizes result in stronger plate boundaries that act to slow down surface and interior convective motions, in competition with the direct effect temperature has on mantle viscosity. Our models indicate that mobile lid convection can preserve heterogeneity for ≈0.4-1 Gyrs at early Earth mantle temperatures when the initial heterogeneity has the same viscosity as the background mantle, and ≈1-4 Gyrs when the heterogeneity is ten times more viscous than the background mantle. Thus, stagnant lid convection is not required to explain long-term survival of early formed geochemical heterogeneities, though these heterogeneities having an elevated viscosity compared to the surrounding mantle may be essential for their preservation.
Experimental Investigations on the Pull-Out Behavior of Tire Strips Reinforced Sands.
Li, Li-Hua; Chen, Yan-Jun; Ferreira, Pedro Miguel Vaz; Liu, Yong; Xiao, Heng-Lin
2017-06-27
Waste tires have excellent mechanical performance and have been used as reinforcing material in geotechnical engineering; however, their interface properties are poorly understood. To further our knowledge, this paper examines the pull-out characteristics of waste tire strips in a compacted sand, together with uniaxial and biaxial geogrids also tested under the same conditions. The analysis of the results shows that the interlocking effect and pull-out resistance between the tire strip and the sand is very strong and significantly higher than that of the geogrids. In the early stages of the pull-out test, the resistance is mainly provided by the front portion of the embedded tire strips, as the pull-out test continues, more and more of the areas towards the end of the tire strips are mobilized, showing a progressive failure mechanism. The deformations are proportional to the frictional resistance between the tire-sand interface, and increase as the normal stresses increase. Tire strips of different wear intensities were tested and presented different pull-out resistances; however, the pull-out resistance mobilization patterns were generally similar. The pull-out resistance values obtained show that rubber reinforcement can provide much higher pull-out forces than the geogrid reinforcements tested here, showing that waste tires are an excellent alternative as a reinforcing system, regardless of the environmental advantages.
ERIC Educational Resources Information Center
Uy-Tioco, Cecilia S.
2013-01-01
The mobile phone has arguably become the most ubiquitous information communication technology (ICT) in the world, including in the developing world. Introduced in the Philippines in the early 1990s, mobile phone penetration is expected to reach 100 percent in 2013, an interesting phenomenon since a third of the country lives below the poverty…
ERIC Educational Resources Information Center
Grigg, Jeffrey
2015-01-01
The United States is a mobile society, and many children are caught up in currents of residential and school mobility. According to the Early Childhood Longitudinal Study, 31% of eighth grade students in 2007 had changed schools three or more times since the beginning of kindergarten. Mobile students offer potential insight into the influences of…
The Conditions of Movement: A Discussion of Academic Mobility between Two Early Career Scholars
ERIC Educational Resources Information Center
Gopaul, Bryan; Pifer, Meghan J.
2016-01-01
Academic mobility is an increasingly crucial topic to the current and future dynamics of doctoral study and the professoriate. Much of the research has focused on US, UK and European contexts. This research explores academic mobility and the manifold issues that arise between the jurisdictions of Canada and the US, in ways that parallel and…
Murphy, Siobhan; Conway, Col; McGrath, Niamh B; O'Leary, Breda; O'Sullivan, Mary P; O'Sullivan, Dawn
2011-12-01
To determine whether the provision of an information booklet on mobilisation improves early mobility postsurgical repair of hip fracture. Hip fracture among older people can have long-lasting consequences with the majority of patients failing to achieve their prefracture functional status. Early postoperative mobility may have a positive effect on long-term recovery. The importance of providing postoperative information on mobility has been highlighted. It is suggested that patients remain passive in their recovery when they do not understand the importance of mobilisation. The study used a pretest-post-test design of two treatments and a usual care control group. Eighty-three adults postsurgical repair of hip fracture, aged 65 years and older, were recruited to the study. Participants were assigned to one of three groups, a usual care group, treatment group 1 (T(1)) usual care plus basic information booklet or treatment group 2 (T(2)) usual care plus detailed information booklet. Data collection three days postsurgery and prior to discharge included the Mini-Mental State Examination, a Demographic Questionnaire, the Elderly Mobility Scale and a Numerical Pain Scale. Greatest improvements in Elderly Mobility Scale scores occurred in T(1), with least changes observed in T(2). Changes did not reach significance level (p=0·105). The results of the study suggest that the provision of basic information is preferable and highlights a deficiency of education in usual care. Hip fracture patients should be provided with an educational booklet containing basic information on mobility to promote optimal recovery. © 2011 Blackwell Publishing Ltd.
Adeolu, Augustine Abiodun; Rabiu, Taopheeq Bamidele; Adeleye, Amos Olufemi
2012-10-01
The traditional care of patients with subacute/chronic subdural haematoma (S/CSDH) often involves delayed mobilization after burr-hole drainage. It is thought that delayed mobilization aids brain re-expansion thereby reducing the risk of recurrence. However, there is paucity of information regarding its efficacy and safety over early mobilization. We evaluated the efficacy and complications of each type of mobilization following burr-hole drainage of S/CSDH. This was a prospective study from October 2004 and September 2010. A total of 50 patients who had burr-hole drainage of S/CSDH were sequentially allocated to either early (day 2) or late (day 7) mobilization (EM or LM) groups (25 patients in each group). Wound related complications, recurrence of haematoma, complications of prolonged bed rest and Glasgow Outcome Score (GOS) at discharge were studied in the two groups. Patients who could not obey commands to mobilize in the early post-operative period were excluded. There were 43 (86%) males and 7 (14%) females. The mean age was 57 years (range: 27-90 years). Fourteen (28%) of the patients were elderly (age > 65 years). Two complications, wound infection in a 76-year old man in the LM group and tension pneumocephalus requiring re-opening burr-hole drainage in a 55-year old man in the EM group were recorded. There was no recurrence or problem associated with prolonged bed rest in the two groups. Five (10%) patients had moderate disability (GOS 4) at discharge (1 EM, 4 LM) while the others (90%) had good recovery (GOS 5) (24 EM, 21 LM). These differences were not statistically significant (p-value: 0.349). It appears that both EM and LM are equally beneficial in the post-operative care of patients following burr-hole drainage of S/CSDH. There is no significant complication referable to the specific type of mobilization. The authors, therefore, advocate EM of patients to reduce the length of hospital stay.
Daily Physical Activity Patterns During the Early Stage of Alzheimer's Disease.
Varma, Vijay R; Watts, Amber
2017-01-01
Alzheimer's disease (AD) is a neurodegenerative disease that results in severe disability. Very few studies have explored changes in daily physical activity patterns during early stages of AD when components of physical function and mobility may be preserved. Our study explored differences in daily physical activity profiles, independent of the effects of non-cognitive factors including physical function and age, among individuals with mild AD compared to controls. Patients with mild AD and controls (n = 92) recruited from the University of Kansas Alzheimer's Disease Center Registry, wore the Actigraph GT3X+ for seven days, and provided objective physical function (VO2 max) and mobility data. Using multivariate linear regression, we explored whether individuals with mild AD had different daily average and diurnal physical activity patterns compared to controls independent of non-cognitive factors that may affect physical activity, including physical function and mobility. We found that mild AD was associated with less moderate-intensity physical activity (p < 0.05), lower peak activity (p < 0.01), and lower physical activity complexity (p < 0.05) particularly during the morning. Mild AD was not associated with greater sedentary activity or less lower-intensity physical activity across the day after adjusting for non-cognitive covariates. These findings suggest that factors independent of physical capacity and mobility may drive declines in moderate-intensity physical activity, and not lower-intensity or sedentary activity, during the early stage of AD. This underscores the importance of a better mechanistic understanding of how cognitive decline and AD pathology impact physical activity. Findings emphasize the potential value of designing and testing time-of-day specific physical activity interventions targeting individuals in the early stages of AD, prior to significant declines in mobility and physical function.
The New Homelessness Revisited
Lee, Barrett A.; Tyler, Kimberly A.; Wright, James D.
2014-01-01
The ‘new homelessness’ has drawn sustained attention from scholars over the past three decades. Definitional inconsistencies and data limitations rendered early work during this period largely speculative in nature. Thanks to conceptual, theoretical, and methodological progress, however, the research literature now provides a fuller understanding of homelessness. Contributions by sociologists and other social scientists since the mid-1990s differentiate among types of homelessness, provide credible demographic estimates, and show how being homeless affects a person's life chances and coping strategies. Agreement also exists about the main macro- and micro-level causes of homelessness. Active lines of inquiry examine public, media, and governmental responses to the problem as well as homeless people's efforts to mobilize on their own behalf. Despite the obstacles faced when studying a stigmatized population marked by high turnover and weak anchors to place, recent investigations have significantly influenced homelessness policy. A greater emphasis on prevention should further strengthen the research-policy nexus. PMID:24910495
DOE Office of Scientific and Technical Information (OSTI.GOV)
Tecza, J.
1998-06-01
'Safe and efficient clean up of hazardous and radioactive waste sites throughout the DOE complex will require extensive use of robots. This research effort focuses on developing Monitoring and Diagnostic (M and D) methods for robots that will provide early detection, isolation, and tracking of impending faults before they result in serious failure. The utility and effectiveness of applying M and D methods to hydraulic robots has never been proven. The present research program is utilizing seeded faults in a laboratory test rig that is representative of an existing hydraulically-powered remediation robot. This report summarizes activity conducted in the firstmore » 9 months of the project. The research team has analyzed the Rosie Mobile Worksystem as a representative hydraulic robot, developed a test rig for implanted fault testing, developed a test plan and agenda, and established methods for acquiring and analyzing the test data.'« less
Echo-Planar Imaging: Magnetic Resonance Imaging in a Fraction of a Second
NASA Astrophysics Data System (ADS)
Stehling, Michael K.; Turner, Robert; Mansfield, Peter
1991-10-01
Progress has recently been made in implementing magnetic resonance imaging (MRI) techniques that can be used to obtain images in a fraction of a second rather than in minutes. Echo-planar imaging (EPI) uses only one nuclear spin excitation per image and lends itself to a variety of critical medical and scientific applications. Among these are evaluation of cardiac function in real time, mapping of water diffusion and temperature in tissue, mapping of organ blood pool and perfusion, functional imaging of the central nervous system, depiction of blood and cerebrospinal fluid flow dynamics, and movie imaging of the mobile fetus in utero. Through shortened patient examination times, higher patient throughput, and lower cost per MRI examination, EPI may become a powerful tool for early diagnosis of some common and potentially treatable diseases such as ischemic heart disease, stroke, and cancer.
Recent advances in multidisciplinary critical care.
Blot, Stijn; Afonso, Elsa; Labeau, Sonia
2015-01-01
The intensive care unit is a work environment where superior dedication is crucial for optimizing patients' outcomes. As this demanding commitment is multidisciplinary in nature, it requires special qualities of health care workers and organizations. Thus research in the field covers a broad spectrum of activities necessary to deliver cutting-edge care. However, given the numerous research articles and education activities available, it is difficult for modern critical care clinicians to keep up with the latest progress and innovation in the field. This article broadly summarizes new developments in multidisciplinary intensive care. It provides elementary information about advanced insights in the field via brief descriptions of selected articles grouped by specific topics. Issues considered include care for heart patients, mechanical ventilation, delirium, nutrition, pressure ulcers, early mobility, infection prevention, transplantation and organ donation, care for caregivers, and family matters. ©2015 American Association of Critical-Care Nurses.
Poppe, L.J.; Poag, C.W.
1993-01-01
The Exxon 975-1, Conoco 145-1, and Mobil 312-1 hydrocarbon exploratory wells and the Continental Offshore Stratigraphic Test (COST) G-1 and G-2 wells were drilled in the southeastern part of the Georges Bank Basin. We used drill cuttings and logs from these wells to describe and correlate the dominant lithostratigraphic units and to document lateral changes in the depositional environments. The strata penetrated by the Exxon 975-1 and COST G-1 wells are much more terrestrial than at the seaward (downdip) COST G-2, Conoco 145-1, and Mobil 312-1 wellsites. Oldest rocks penetrated by the exploratory wells represent a Middle Jurassic carbonate-evaporite sequence that correlates to the Iroquois Formation. The Iroquois records nonmarine to marginal-marine sabkha, tidal-flat, and restricted lagoonal paleoenvironments in the Exxon 975-1 and COST G-1 wells, but progressively changes to inner neritic, littoral, and lagoonal paleoenvironments at the Mobil 312-1 wellsite. The nonmarine deltaic siliciclastics of the overlying Mohican Formation, Misaine Shale, and Mic Mac-Mohawk Formations are thicker and the marine carbonates of the Scatarie and Bacarro Limestones are usually thinner in the Jurassic strata of the Exxon 975-1 and COST G-1 wells than at the other wellsites. Similarly, lower delta-plain and delta-front facies of the Early Cretaceous Missisuaga and Logan Canyon Formations at the Exxon 975-1 and COST G-1 wellsites reflect a greater terrestrial influence than the laterally-equivalent shallow marine to delta-front facies present at the downdip wellsites. ?? 1993.
Visualized macrophage dynamics and significance of S100A8 in obese fat
Sekimoto, Ryohei; Fukuda, Shiro; Maeda, Norikazu; Tsushima, Yu; Matsuda, Keisuke; Mori, Takuya; Nakatsuji, Hideaki; Nishizawa, Hitoshi; Kishida, Ken; Kikuta, Junichi; Maijima, Yumiko; Funahashi, Tohru; Ishii, Masaru; Shimomura, Iichiro
2015-01-01
Chronic low-grade inflammation of adipose tissue plays a crucial role in the pathophysiology of obesity. Immunohistological microscopic analysis in obese fat tissue has demonstrated the infiltration of several immune cells such as macrophages, but dynamics of immune cells have not been fully elucidated and clarified. Here, by using intravital multiphoton imaging technique, to our knowledge for the first time, we analyzed and visualized the inflammatory processes in adipose tissue under high-fat and high-sucrose (HF/HS) diet with lysozyme M-EGFP transgenic (LysMEGFP) mice whose EGFP was specifically expressed in the myelomonocytic lineage. Mobility of LysMEGFP-positive macrophages was shown to be activated just 5 d after HF/HS diet, when the distinct hypertrophy of adipocytes and the accumulation of macrophages still have not become prominent. Significant increase of S100A8 was detected in mature adipocyte fraction just 5 d after HF/HS diet. Recombinant S100A8 protein stimulated chemotactic migration in vitro and in vivo, as well as induced proinflammatory molecules, both macrophages and adipocytes, such as TNF-α and chemokine (C-C motif) ligand 2. Finally, an antibody against S100A8 efficiently suppressed the HF/HS diet-induced initial inflammatory change, i.e., increased mobilization of adipose LysMEGFP-positive macrophages, and ameliorated HF/HS diet-induced insulin resistance. In conclusion, time-lapse intravital multiphoton imaging of adipose tissues identified the very early event exhibiting increased mobility of macrophages, which may be triggered by increased expression of adipose S100A8 and results in progression of chronic inflammation in situ. PMID:25848057
Stover, Jessica T; Shaw, J Ryan; Kuchibhatla, Maragatha; Horwitz, Mitchell E; Engemann, Ashley M
2017-08-01
The addition of plerixafor to high-dose colony-stimulating growth factor has been shown to improve stem cell mobilization rates in autologous transplant patients with multiple myeloma and non-Hodgkin lymphoma. This study evaluates the change in administration time of plerixafor to determine if cell mobilization rates are similar between the US Food and Drug Administration-approved administration time of 11 hours before apheresis and an earlier administration time of 16 hours before apheresis. Medical records of patients age ≥ 18 years undergoing autologous stem cell transplantation requiring the use of plerixafor after at least 4 days of granulocyte colony-stimulating factor therapy to complete stem cell mobilization from January 1, 2010 through September 30, 2014 were retrospectively reviewed. The primary outcome was CD34 + cell mobilization success rates when plerixafor was administered 11 ± 2 hours (standard administration group) compared with 16 ± 2 hours before cell apheresis (early administration group), as defined as collection of ≥2 × 10 6 CD34 + cells/kg. Secondary outcomes included the number of plerixafor therapy days required to collect a total of ≥2 × 10 6 CD34 + cells/kg, the number of apheresis cycles required to achieve ≥2 × 10 6 CD34 + cells/kg, the median CD34 + cells/kg collected in each apheresis session, and the rates of reported adverse events that occurred in the standard administration time group compared with the early administration time group. Of the 197 patients included, 114 patients received plerixafor 11 ± 2 hours before apheresis and 83 patients received plerixafor 16 hours ± 2 hours before apheresis. Ninety-four percent of patients in the early administration group achieved successful stem cell mobilization compared with 81.6% in the standard administration group (P = .0111). The median number of plerixafor days to reach the collection goal of ≥2 × 10 6 CD34 + cells/kg was 1 day for each group (P = .323), and the median number of apheresis days to reach the collection goal was 2 days for the standard administration group compared with 1 day for the early administration group (P = .0156). Most adverse events were similar between the 2 groups except for fever, which occurred in 4.8% of the patients in the early administration group and none of the patients in the standard administration group. This study demonstrates plerixafor effectively mobilizes peripheral blood stem cells when given at an early administration time of 16 hours before apheresis compared with standard administration of 11 hours before apheresis. However, further prospective studies could strengthen these results. Copyright © 2017 The American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved.
Modeling neck mobility in fossil turtles.
Werneburg, Ingmar; Hinz, Juliane K; Gumpenberger, Michaela; Volpato, Virginie; Natchev, Nikolay; Joyce, Walter G
2015-05-01
Turtles have the unparalleled ability to retract their heads and necks within their shell but little is known about the evolution of this trait. Extensive analysis of neck mobility in turtles using radiographs, CT scans, and morphometry reveals that basal turtles possessed less mobility in the neck relative to their extant relatives, although the anatomical prerequisites for modern mobility were already established. Many extant turtles are able to achieve hypermobility by dislocating the central articulations, which raises cautions about reconstructing the mobility of fossil vertebrates. A 3D-model of the Late Triassic turtle Proganochelys quenstedti reveals that this early stem turtle was able to retract its head by tucking it sideways below the shell. The simple ventrolateral bend seen in this stem turtle, however, contrasts with the complex double-bend of extant turtles. The initial evolution of neck retraction therefore occurred in a near-synchrony with the origin of the turtle shell as a place to hide the unprotected neck. In this early, simplified retraction mode, the conical osteoderms on the neck provided further protection. © 2014 Wiley Periodicals, Inc.
Early-onset Alzheimer's Disease Phenotypes: Neuropsychology and Neural Networks
2017-05-11
Alzheimer Disease, Early Onset; Alzheimer Disease; Alzheimer Disease, Late Onset; Dementia, Alzheimer Type; Logopenic Progressive Aphasia; Primary Progressive Aphasia; Visuospatial/Perceptual Abilities; Posterior Cortical Atrophy; Executive Dysfunction; Corticobasal Degeneration; Ideomotor Apraxia
ERIC Educational Resources Information Center
Engdahl, Lora
2009-01-01
In the Baltimore region, a successful housing mobility program is providing families living in very disadvantaged inner city communities with a new home and a chance for a new life. Minority voucher holders in the federal Housing Choice Voucher Program (formerly titled Section 8) have often been limited to living in "voucher submarkets"…
ERIC Educational Resources Information Center
Wilson, Alistair; Hunter, Katie; Spohrer, Konstanze; Bruner, Richard; Beasley, Anna
2014-01-01
Alan Milburn, the Chair of the Government's Social Mobility and Child Poverty Commission recently highlighted the role of education in progressing social mobility in Scotland; "In my view it's a grave social injustice that only one in forty pupils from Scotland's most deprived households…got three As in their Highers in 2011, compared to one…
ERIC Educational Resources Information Center
Welsh, Richard L.
2005-01-01
Russell C. Williams was a key figure in the progression of orientation and mobility from the Army's immediate response to the servicemen and women who lost their sight during World War II to a recognized profession delivering individualized instruction to visually impaired people throughout the world. Blinded in combat while serving in the U.S.…
ERIC Educational Resources Information Center
Bárcena, Elena; Read, Timothy; Underwood, Joshua; Obari, Hiroyuki; Cojocnean, Diana; Koyama, Toshiko; Pareja-Lora, Antonio; Calle, Cristina; Pomposo, Lourdes; Talaván, Noa; Ávila-Cabrera, José; Ibañez, Ana; Vermeulen, Anna; Jordano, María; Arús-Hita, Jorge; Rodríguez, Pilar; Castrillo, María Dolores; Kétyi, Andras; Selwood, Jaime; Gaved, Mark; Kukulska-Hulme, Agnes
2015-01-01
In this paper, experiences from different research groups illustrate the state-of-the-art of Mobile Assisted Language Learning (henceforth, MALL) in formal and non-formal education. These research samples represent recent and on-going progress made in the field of MALL at an international level and offer encouragement for practitioners who are…
PD_Manager: an mHealth platform for Parkinson's disease patient management.
Tsiouris, Kostas M; Gatsios, Dimitrios; Rigas, George; Miljkovic, Dragana; Koroušić Seljak, Barbara; Bohanec, Marko; Arredondo, Maria T; Antonini, Angelo; Konitsiotis, Spyros; Koutsouris, Dimitrios D; Fotiadis, Dimitrios I
2017-06-01
PD_Manager is a mobile health platform designed to cover most of the aspects regarding the management of Parkinson's disease (PD) in a holistic approach. Patients are unobtrusively monitored using commercial wrist and insole sensors paired with a smartphone, to automatically estimate the severity of most of the PD motor symptoms. Besides motor symptoms monitoring, the patient's mobile application also provides various non-motor self-evaluation tests for assessing cognition, mood and nutrition to motivate them in becoming more active in managing their disease. All data from the mobile application and the sensors is transferred to a cloud infrastructure to allow easy access for clinicians and further processing. Clinicians can access this information using a separate mobile application that is specifically designed for their respective needs to provide faster and more accurate assessment of PD symptoms that facilitate patient evaluation. Machine learning techniques are used to estimate symptoms and disease progression trends to further enhance the provided information. The platform is also complemented with a decision support system (DSS) that notifies clinicians for the detection of new symptoms or the worsening of existing ones. As patient's symptoms are progressing, the DSS can also provide specific suggestions regarding appropriate medication changes.
PD_Manager: an mHealth platform for Parkinson's disease patient management
Gatsios, Dimitrios; Rigas, George; Miljkovic, Dragana; Koroušić Seljak, Barbara; Bohanec, Marko; Arredondo, Maria T.; Antonini, Angelo; Konitsiotis, Spyros; Koutsouris, Dimitrios D.
2017-01-01
PD_Manager is a mobile health platform designed to cover most of the aspects regarding the management of Parkinson's disease (PD) in a holistic approach. Patients are unobtrusively monitored using commercial wrist and insole sensors paired with a smartphone, to automatically estimate the severity of most of the PD motor symptoms. Besides motor symptoms monitoring, the patient's mobile application also provides various non-motor self-evaluation tests for assessing cognition, mood and nutrition to motivate them in becoming more active in managing their disease. All data from the mobile application and the sensors is transferred to a cloud infrastructure to allow easy access for clinicians and further processing. Clinicians can access this information using a separate mobile application that is specifically designed for their respective needs to provide faster and more accurate assessment of PD symptoms that facilitate patient evaluation. Machine learning techniques are used to estimate symptoms and disease progression trends to further enhance the provided information. The platform is also complemented with a decision support system (DSS) that notifies clinicians for the detection of new symptoms or the worsening of existing ones. As patient's symptoms are progressing, the DSS can also provide specific suggestions regarding appropriate medication changes. PMID:28706727
Motor, cognitive, and functional declines contribute to a single progressive factor in early HD.
Schobel, Scott A; Palermo, Giuseppe; Auinger, Peggy; Long, Jeffrey D; Ma, Shiyang; Khwaja, Omar S; Trundell, Dylan; Cudkowicz, Merit; Hersch, Steven; Sampaio, Cristina; Dorsey, E Ray; Leavitt, Blair R; Kieburtz, Karl D; Sevigny, Jeffrey J; Langbehn, Douglas R; Tabrizi, Sarah J
2017-12-12
To identify an improved measure of clinical progression in early Huntington disease (HD) using data from prospective observational cohort studies and placebo group data from randomized double-blind clinical trials. We studied Unified Huntington Disease Rating Scale (UHDRS) and non-UHDRS clinical measures and brain measures of progressive atrophy in 1,668 individuals with early HD followed up prospectively for up to 30 to 36 months of longitudinal clinical follow-up. The results demonstrated that a composite measure of motor, cognitive, and global functional decline best characterized clinical progression and was most strongly associated with brain measures of progressive corticostriatal atrophy. Use of a composite motor, cognitive, and global functional clinical outcome measure in HD provides an improved measure of clinical progression more related to measures of progressive brain atrophy and provides an opportunity for enhanced clinical trial efficiency relative to currently used individual motor, cognitive, and functional outcome measures. © 2017 American Academy of Neurology.
Levis, Angelo G; Minicuci, Nadia; Ricci, Paolo; Gennaro, Valerio; Garbisa, Spiridione
2011-06-17
Whether or not there is a relationship between use of mobile phones (analogue and digital cellulars, and cordless) and head tumour risk (brain tumours, acoustic neuromas, and salivary gland tumours) is still a matter of debate; progress requires a critical analysis of the methodological elements necessary for an impartial evaluation of contradictory studies. A close examination of the protocols and results from all case-control and cohort studies, pooled- and meta-analyses on head tumour risk for mobile phone users was carried out, and for each study the elements necessary for evaluating its reliability were identified. In addition, new meta-analyses of the literature data were undertaken. These were limited to subjects with mobile phone latency time compatible with the progression of the examined tumours, and with analysis of the laterality of head tumour localisation corresponding to the habitual laterality of mobile phone use. Blind protocols, free from errors, bias, and financial conditioning factors, give positive results that reveal a cause-effect relationship between long-term mobile phone use or latency and statistically significant increase of ipsilateral head tumour risk, with biological plausibility. Non-blind protocols, which instead are affected by errors, bias, and financial conditioning factors, give negative results with systematic underestimate of such risk. However, also in these studies a statistically significant increase in risk of ipsilateral head tumours is quite common after more than 10 years of mobile phone use or latency. The meta-analyses, our included, examining only data on ipsilateral tumours in subjects using mobile phones since or for at least 10 years, show large and statistically significant increases in risk of ipsilateral brain gliomas and acoustic neuromas. Our analysis of the literature studies and of the results from meta-analyses of the significant data alone shows an almost doubling of the risk of head tumours induced by long-term mobile phone use or latency.
2011-01-01
Background Whether or not there is a relationship between use of mobile phones (analogue and digital cellulars, and cordless) and head tumour risk (brain tumours, acoustic neuromas, and salivary gland tumours) is still a matter of debate; progress requires a critical analysis of the methodological elements necessary for an impartial evaluation of contradictory studies. Methods A close examination of the protocols and results from all case-control and cohort studies, pooled- and meta-analyses on head tumour risk for mobile phone users was carried out, and for each study the elements necessary for evaluating its reliability were identified. In addition, new meta-analyses of the literature data were undertaken. These were limited to subjects with mobile phone latency time compatible with the progression of the examined tumours, and with analysis of the laterality of head tumour localisation corresponding to the habitual laterality of mobile phone use. Results Blind protocols, free from errors, bias, and financial conditioning factors, give positive results that reveal a cause-effect relationship between long-term mobile phone use or latency and statistically significant increase of ipsilateral head tumour risk, with biological plausibility. Non-blind protocols, which instead are affected by errors, bias, and financial conditioning factors, give negative results with systematic underestimate of such risk. However, also in these studies a statistically significant increase in risk of ipsilateral head tumours is quite common after more than 10 years of mobile phone use or latency. The meta-analyses, our included, examining only data on ipsilateral tumours in subjects using mobile phones since or for at least 10 years, show large and statistically significant increases in risk of ipsilateral brain gliomas and acoustic neuromas. Conclusions Our analysis of the literature studies and of the results from meta-analyses of the significant data alone shows an almost doubling of the risk of head tumours induced by long-term mobile phone use or latency. PMID:21679472
Family Adjustment to Geographic Mobility: Military Families on the Move
1981-08-11
military are the related topics of father absence and transcultural experiences. MOBILITY AND ITS EFFECTS ON CHILDREN Children in military families...c-ild experi- ences added stress due to geographic mobility, transcultural experi- ences, transient father absences, and early retirement of the...family, and that short-term crisis therapy was the ideal psychotherapeutic modality for treatment of military children. CONCLUSION In summary, there are
Greater Portland intelligent transportation systems (ITS) early deployment plan
DOT National Transportation Integrated Search
1998-03-01
The Greater Portland Intelligent Transportation Systems Early Deployment Plan is a strategic vision of how smart technology can be applied to help improve mobility in Maines largest metropolitan area.
Low Earth Orbit satellite/terrestrial mobile service compatibility
NASA Technical Reports Server (NTRS)
Sheriff, Ray E.; Gardiner, John G.
1993-01-01
Currently the geostationary type of satellite is the only one used to provide commercial mobile-satellite communication services. Low earth orbit (LEO) satellite systems are now being proposed as a future alternative. By the implementation of LEO satellite systems, predicted at between 5 and 8 years time, mobile space/terrestrial technology will have progressed to the third generation stage of development. This paper considers the system issues that will need to be addressed when developing a dual mode terminal, enabling access to both terrestrial and LEO satellite systems.
Field, Kathryn M; Phal, Pramit M; Fitt, Greg; Goh, Christine; Nowak, Anna K; Rosenthal, Mark A; Simes, John; Barnes, Elizabeth H; Sawkins, Kate; Cher, Lawrence M; Hovey, Elizabeth J; Wheeler, Helen
2017-09-15
Bevacizumab has been associated with prolonged progression-free survival for patients with recurrent glioblastoma; however, not all derive a benefit. An early indicator of efficacy or futility may allow early discontinuation for nonresponders. This study prospectively assessed the role of early magnetic resonance imaging (eMRI) and its correlation with subsequent routine magnetic resonance imaging (MRI) results and survival. Patients were part of a randomized phase 2 clinical trial (CABARET) comparing bevacizumab with bevacizumab plus carboplatin for recurrent glioblastoma. eMRI was conducted after 4 weeks in the trial (after 2 treatments with bevacizumab [10 mg/kg every 2 weeks]). The results were compared with the results of the subsequent 8-week MRI standard. For 119 of 122 patients, eMRI was available, and 111 had subsequent MRI for comparison. Thirty-six (30%) had an early radiological response, and 17 (14%) had progressive disease. The concordance between eMRI and 8-week MRI was moderate (κ = 0.56), with most providing the same result (n = 79 [71%]). There was strong evidence that progression-free survival and overall survival were predicted by the eMRI response (both P values < .001). The median survival was 8.6 months for an eMRI response, 6.6 months for stable disease, and 3.7 months for progressive disease; the hazard ratio (progressive disease vs stable disease) was 3.4 (95% confidence interval, 1.9-6.0). Landmark analyses showed that eMRI progression was a strong predictor of mortality independent of other potential baseline predictors. In this study, early progression on MRI appears to be a robust marker of a poor prognosis for patients on bevacizumab. Cancer 2017;123:3576-82. © 2017 American Cancer Society. © 2017 American Cancer Society.
Progressive friction mobilization and enhanced Janssen's screening in confined granular rafts
NASA Astrophysics Data System (ADS)
Saavedra V., Oscar; Elettro, Hervé; Melo, Francisco
2018-04-01
Confined two-dimensional assemblies of floating particles, known as granular rafts, are prone to develop a highly nonlinear response under compression. Here we investigate the transition to the friction-dominated jammed state and map the gradual development of the internal stress profile with flexible pressure sensors distributed along the raft surface. Surprisingly, we observe that the surface stress screening builds up much more slowly than previously thought and that the typical screening distance later dramatically decreases. We explain this behavior in terms of progressive friction mobilization, where the full amplitude of the frictional forces is only reached after a macroscopic local displacement. At further stages of compression, rafts of large length-to-width aspect ratio experience much stronger screenings than the full mobilization limit described by the Janssen's model. We solve this paradox using a simple mathematical analysis and show that such enhanced screening can be attributed to a localized compaction front, essentially shielding the far field from compressive stresses.
Advanced Networks in Motion Mobile Sensorweb
NASA Technical Reports Server (NTRS)
Ivancic, William D.; Stewart, David H.
2011-01-01
Advanced mobile networking technology applicable to mobile sensor platforms was developed, deployed and demonstrated. A two-tier sensorweb design was developed. The first tier utilized mobile network technology to provide mobility. The second tier, which sits above the first tier, utilizes 6LowPAN (Internet Protocol version 6 Low Power Wireless Personal Area Networks) sensors. The entire network was IPv6 enabled. Successful mobile sensorweb system field tests took place in late August and early September of 2009. The entire network utilized IPv6 and was monitored and controlled using a remote Web browser via IPv6 technology. This paper describes the mobile networking and 6LowPAN sensorweb design, implementation, deployment and testing as well as wireless systems and network monitoring software developed to support testing and validation.
Weber, C; Hametner, C; Tuchscherer, A; Losand, B; Kanitz, E; Otten, W; Sauerwein, H; Bruckmaier, R M; Becker, F; Kanitz, W; Hammon, H M
2013-09-01
Insufficient feed intake during early lactation results in elevated body fat mobilization to meet energy demands for milk production. Hepatic energy metabolism is involved by increasing endogenous glucose production and hepatic glucose output for milk synthesis and by adaptation of postcalving fuel oxidation. Given that cows differ in their degree of fat mobilization around parturition, indicated by variable total liver fat concentration (LFC), the study investigated the influence of peripartum fat mobilization on hepatic gene expression involved in gluconeogenesis, fatty acid oxidation, ketogenesis, and cholesterol synthesis, as well as transcriptional factors referring to energy metabolism. German Holstein cows were grouped according to mean total LFC on d 1, 14, and 28 after parturition as low [<200mg of total fat/g of dry matter (DM); n=10], medium (200-300 mg of total fat/g of DM; n=10), and high (>300 mg of total fat/g of DM; n=7), indicating fat mobilization during early lactation. Cows were fed total mixed rations ad libitum and held under equal conditions. Liver biopsies were taken at d 56 and 15 before and d 1, 14, 28, and 49 after parturition to measure mRNA abundances of pyruvate carboxylase (PC); phosphoenolpyruvate carboxykinase; glucose-6-phosphatase; propionyl-coenzyme A (CoA) carboxylase α; carnitine palmitoyl-transferase 1A (CPT1A); acyl-CoA synthetase, long chain 1 (ASCL1); acyl-CoA dehydrogenase, very long chain; 3-hydroxy-3-methylglutaryl-CoA synthase 1 and 2; sterol regulatory element-binding factor 1; and peroxisome proliferator-activated factor α. Total LFC postpartum differed greatly among cows, and the mRNA abundance of most enzymes and transcription factors changed with time during the experimental period. Abundance of PC mRNA increased at parturition to a greater extent in high- and medium-LFC groups than in the low-LFC group. Significant LFC × time interactions for ACSL1 and CPT1A during the experimental period indicated variable gene expression depending on LFC after parturition. Correlations between hepatic gene expression and performance data and plasma concentrations of metabolites and hormones showed time-specific relations during the transition period. Elevated body fat mobilization during early lactation affected gene expression involved in gluconeogenesis to a greater extent than gene expression involved in lipid metabolism, indicating the dependence of hepatic glucose metabolism on hepatic lipid status and fat mobilization during early lactation. Copyright © 2013 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.
Balas, Michele C; Burke, William J; Gannon, David; Cohen, Marlene Z; Colburn, Lois; Bevil, Catherine; Franz, Doug; Olsen, Keith M; Ely, E Wesley; Vasilevskis, Eduard E
2013-09-01
The awakening and breathing coordination, delirium monitoring/management, and early exercise/mobility bundle is an evidence-based interprofessional multicomponent strategy for minimizing sedative exposure, reducing duration of mechanical ventilation, and managing ICU-acquired delirium and weakness. The purpose of this study was to identify facilitators and barriers to awakening and breathing coordination, delirium monitoring/management, and early exercise/mobility bundle adoption and to evaluate the extent to which bundle implementation was effective, sustainable, and conducive to dissemination. Prospective, before-after, mixed-methods study. Five adult ICUs, one step-down unit, and a special care unit located in a 624-bed academic medical center : Interprofessional ICU team members at participating institution. In collaboration with the participating institution, we developed, implemented, and refined an awakening and breathing coordination, delirium monitoring/management, and early exercise/mobility bundle policy. Over the course of an 18-month period, all ICU team members were offered the opportunity to participate in numerous multimodal educational efforts. Three focus group sessions, three online surveys, and one educational evaluation were administered in an attempt to identify facilitators and barriers to bundle adoption. Factors believed to facilitate bundle implementation included: 1) the performance of daily, interdisciplinary, rounds; 2) engagement of key implementation leaders; 3) sustained and diverse educational efforts; and 4) the bundle's quality and strength. Barriers identified included: 1) intervention-related issues (e.g., timing of trials, fear of adverse events), 2) communication and care coordination challenges, 3) knowledge deficits, 4) workload concerns, and 5) documentation burden. Despite these challenges, participants believed implementation ultimately benefited patients, improved interdisciplinary communication, and empowered nurses and other ICU team members. In this study of the implementation of the awakening and breathing coordination, delirium monitoring/management, and early exercise/mobility bundle in a tertiary care setting, clear factors were identified that both advanced and impeded adoption of this complex intervention that requires interprofessional education, coordination, and cooperation. Focusing on these factors preemptively should enable a more effective and lasting implementation of the bundle and better care for critically ill patients. Lessons learned from this study will also help healthcare providers optimize implementation of the recent ICU pain, agitation, and delirium guidelines, which has many similarities but also some important differences as compared with the awakening and breathing coordination, delirium monitoring/management, and early exercise/mobility bundle.
de Masson, Adele; O'Malley, John T; Elco, Christopher P; Garcia, Sarah S; Divito, Sherrie J; Lowry, Elizabeth L; Tawa, Marianne; Fisher, David C; Devlin, Phillip M; Teague, Jessica E; Leboeuf, Nicole R; Kirsch, Ilan R; Robins, Harlan; Clark, Rachael A; Kupper, Thomas S
2018-05-09
Mycosis fungoides (MF), the most common cutaneous T cell lymphoma (CTCL) is a malignancy of skin-tropic memory T cells. Most MF cases present as early stage (stage I A/B, limited to the skin), and these patients typically have a chronic, indolent clinical course. However, a small subset of early-stage cases develop progressive and fatal disease. Because outcomes can be so different, early identification of this high-risk population is an urgent unmet clinical need. We evaluated the use of next-generation high-throughput DNA sequencing of the T cell receptor β gene ( TCRB ) in lesional skin biopsies to predict progression and survival in a discovery cohort of 208 patients with CTCL (177 with MF) from a 15-year longitudinal observational clinical study. We compared these data to the results in an independent validation cohort of 101 CTCL patients (87 with MF). The tumor clone frequency (TCF) in lesional skin, measured by high-throughput sequencing of the TCRB gene, was an independent prognostic factor of both progression-free and overall survival in patients with CTCL and MF in particular. In early-stage patients, a TCF of >25% in the skin was a stronger predictor of progression than any other established prognostic factor (stage IB versus IA, presence of plaques, high blood lactate dehydrogenase concentration, large-cell transformation, or age). The TCF therefore may accurately predict disease progression in early-stage MF. Early identification of patients at high risk for progression could help identify candidates who may benefit from allogeneic hematopoietic stem cell transplantation before their disease becomes treatment-refractory. Copyright © 2018 The Authors, some rights reserved; exclusive licensee American Association for the Advancement of Science. No claim to original U.S. Government Works.
ERIC Educational Resources Information Center
Greenwood, Charles R.; Carta, Judith J.; Walker, Dale; Hughes, Kere; Weathers, Mary
2006-01-01
Early interventionists are accountable for the progress of children receiving their services. Technically adequate measures of the progress of individual children are needed. While the Early Communication Indicator (ECI) for infants and toddlers is one such measure, data to support its use are limited to a single research report. In this…
Beyond Subprime Learning: Accelerating Progress in Early Education. Policy Brief
ERIC Educational Resources Information Center
Bornfreund, Laura; McCann, Clare; Williams, Conor; Guernsey, Lisa
2014-01-01
Earlier this year, in "Subprime Learning: Early Education in America since the Great Recession," the current state of early education in the U.S. was surveyed by examining progress over the last five years . It was found that while the public, political, and research consensus is stronger than ever, the field remains in dire need of…
Development of the multiple sclerosis (MS) early mobility impairment questionnaire (EMIQ).
Ziemssen, Tjalf; Phillips, Glenn; Shah, Ruchit; Mathias, Adam; Foley, Catherine; Coon, Cheryl; Sen, Rohini; Lee, Andrew; Agarwal, Sonalee
2016-10-01
The Early Mobility Impairment Questionnaire (EMIQ) was developed to facilitate early identification of mobility impairments in multiple sclerosis (MS) patients. We describe the initial development of the EMIQ with a focus on the psychometric evaluation of the questionnaire using classical and item response theory methods. The initial 20-item EMIQ was constructed by clinical specialists and qualitatively tested among people with MS and physicians via cognitive interviews. Data from an observational study was used to make additional updates to the instrument based on exploratory factor analysis (EFA) and item response theory (IRT) analysis, and psychometric analyses were performed to evaluate the reliability and validity of the final instrument's scores and screening properties (i.e., sensitivity and specificity). Based on qualitative interview analyses, a revised 15-item EMIQ was included in the observational study. EFA, IRT and item-to-item correlation analyses revealed redundant items which were removed leading to the final nine-item EMIQ. The nine-item EMIQ performed well with respect to: test-retest reliability (ICC = 0.858); internal consistency (α = 0.893); convergent validity; and known-groups methods for construct validity. A cut-point of 41 on the 0-to-100 scale resulted in sufficient sensitivity and specificity statistics for viably identifying patients with mobility impairment. The EMIQ is a content valid and psychometrically sound instrument for capturing MS patients' experience with mobility impairments in a clinical practice setting. Additional research is suggested to further confirm the EMIQ's screening properties over time.
Day-of-Surgery Mobilization Reduces the Length of Stay After Elective Hip Arthroplasty.
Okamoto, Taro; Ridley, Ryan J; Edmondston, Stephen J; Visser, Mariet; Headford, Julie; Yates, Piers J
2016-10-01
To determine the effect of mobilization on the day of surgery on the readiness for discharge and length of stay after elective total hip arthroplasty (THA). We devised a randomized control trial with concealed allocation and intention-to-treat analysis. Overall, 126 patients who underwent THA and met the criteria for mobilization on the day of surgery were randomly allocated into 2 groups; the intervention group was mobilized on the day of surgery, n = 58 and the control group was mobilized on the day after surgery, n = 68. Apart from timing of mobilization, both groups received the same postoperative management. The primary outcome measures were length of hospital stay and time to readiness for discharge. The early mobilization group was ready for discharge 63 hours (standard deviation [SD] = 15 hours) after surgery, compared to 70 hours (SD = 18 hours) for the control group (P = .03, 95% CI, 0.7-12.8). There was no significant difference in hospital stay in the early mobilization group (77 hours [SD = 30 hours]), compared to the control group (87 hours [SD = 35 hours]; P = .11, 95% CI, -2.1 to 21.6). Despite this at any point in time after the surgery, the intervention group was 1.8 times (P = .003, 95% CI, = 1.2-2.7) more likely to have been discharged. Mobilization on the day of THA surgery significantly increases the probability of discharge at any singular point in time compared with mobilization on the day after surgery and decreases the time to readiness for discharge. Crown Copyright © 2016. Published by Elsevier Inc. All rights reserved.
The state of ergonomics for mobile computing technology.
Dennerlein, Jack T
2015-01-01
Because mobile computing technologies, such as notebook computers, smart mobile phones, and tablet computers afford users many different configurations through their intended mobility, there is concern about their effects on musculoskeletal pain and a need for usage recommendations. Therefore the main goal of this paper to determine which best practices surrounding the use of mobile computing devices can be gleaned from current field and laboratory studies of mobile computing devices. An expert review was completed. Field studies have documented various user configurations, which often include non-neutral postures, that users adopt when using mobile technology, along with some evidence suggesting that longer duration of use is associated with more discomfort. It is therefore prudent for users to take advantage of their mobility and not get stuck in any given posture for too long. The use of accessories such as appropriate cases or riser stands, as well as external keyboards and pointing devices, can also improve postures and comfort. Overall, the state of ergonomics for mobile technology is a work in progress and there are more research questions to be addressed.
Epinette, Jean-Alain; Harwin, Steven F; Rowan, Fiachra E; Tracol, Philippe; Mont, Michael A; Chughtai, Morad; Westrich, Geoffrey H
2017-03-01
To evaluate early performance of contemporary dual mobility acetabular systems with second generation annealed highly cross-linked polyethylene for primary hip arthroplasty of patients under 55 years of age. A prospective observational five years study across five centers in Europe and the USA of 321 patients with a mean age of 48.1 years was performed. Patients were assessed for causes of revision, hip instability, intra-prosthetic dissociation, Harris hip score and radiological signs of osteolysis. There were no dislocations and no intra-prosthetic dissociations. Kaplan Meier analysis demonstrated 97.51% survivorship for all cause revision and 99.68% survivorship for acetabular component revision at five years. Mean Harris hip score was 93.6. Two acetabular shells were revised for neck-rim implant impingement without dislocation and ten femoral stems were revised for causes unrelated to dual mobility implants. Contemporary highly cross-linked polyethylene dual mobility systems demonstrate excellent early clinical, radiological, and survivorship results in a cohort of patients that demand high performance from their implants. It is envisaged that DM and second generation annealed HXLPE may reduce THA instability and wear, the two most common causes of THA revision in hip arthroplasty.
Annual Technical Progress Report for Emergency School Assistance Program, Title 45, 1970-71.
ERIC Educational Resources Information Center
Lindsey, Randall B.
This paper presents a technical progress report of two programs conducted with funds provided under the Emergency School Assistance Program. One, the Mobile Learning Unit, said to have been designed to measure changes in fourth and fifth grade students' self-concept in a reorganized desegregated school environment, focuses on whether a positive…
Balance and gait of adults with very mild Alzheimer’s disease
Gras, LZ; Kanaan, SF; McDowd, JM; Colgrove, YM; Burns, J; Pohl, PS
2015-01-01
Background and Purpose Studies have shown that adults with Alzheimer’s disease (AD) have gait and balance deficits, however the focus has been on those with mild to severe disease. The purpose of this study was to determine if balance and gait deficits are present in those with very mild AD. Methods Thirteen adults (72.9 ± 4.7 years old) with very mild AD and thirteen age (72.6 ± 4.6 years old) and gender-matched (10 males, 3 females) participants in a control group without AD performed balance and gait tests. All participants were living in the community and independent in community ambulation. Results Participants with very mild AD had shorter times in the sharpened Romberg tests with eyes open (p<0.001) and with eyes closed (p=0.007) compared to participants in the control group. Those with AD also took longer to complete the Timed “Up & Go” Test (TUG), (p< 0.001). Gait deficits were found for those with AD as demonstrated by slower velocities in the 10-meter walk at a comfortable pace (p=0.029) and on an instrumented walkway (p<0.001). Stance times were longer for those with AD (p<0.001) and step length was shorter (p=0.001). There were no group differences in the 10-meter walk at a fast pace. The gait velocity of participants in the control group was faster on the instrumented walkway than in the 10-meter walk at a comfortable pace (p=0.031). In contrast, the gait velocity of those with AD was significantly slower on the instrumented walkway than in the 10-meter walk at a comfortable pace, (p=0.024). Discussion Balance and gait deficits may be present in those in the very early stages of AD. Novel surfaces may affect gait speed in those with very mild AD. Identifying mobility deficits early in the progression of AD may provide an opportunity for early physical therapy intervention, thus promoting continued functional independence. Conclusions Adults in the very early stages of AD may show signs of balance and gait deficits. Recognition of these problems early with subsequent physical therapy may slow the progression of further balance and gait dysfunction. PMID:24755691
Lobley, Grace; Worrall, Sandra; Powell, Richard; Kimani, Peter K; Banerjee, Prithwish; Barker, Thomas
2018-01-01
Introduction Current guidelines recommend abstinence from supervised cardiac rehabilitation (CR) exercise training for 6 weeks post-sternotomy. This practice is not based on empirical evidence, thus imposing potentially unnecessary activity restrictions. Delayed participation in CR exercise training promotes muscle atrophy, reduces cardiovascular fitness and prolongs recovery. Limited data suggest no detrimental effect of beginning CR exercise training as early as 2 weeks post-surgery, but randomised controlled trials are yet to confirm this. The purpose of this trial is to compare CR exercise training commenced early (2 weeks post-surgery) with current usual care (6 weeks post-surgery) with a view to informing future CR guidelines for patients recovering from sternotomy. Methods and analysis In this assessor-blind randomised controlled trial, 140 cardiac surgery patients, recovering from sternotomy, will be assigned to 8 weeks of twice-weekly supervised CR exercise training commencing at either 2 weeks (early CR) or 6 weeks (usual care CR) post-surgery. Usual care exercise training will adhere to current UK recommendations. Participants in the early CR group will undertake a highly individualised 2–3 week programme of functional mobility, strength and cardiovascular exercise before progressing to a usual care CR programme. Outcomes will be assessed at baseline (inpatient), pre-CR (2 or 6 weeks post-surgery), post-CR (10 or 14 weeks post-surgery) and 12 months. The primary outcome will be change in 6 min walk distance. Secondary outcomes will include measures of functional fitness, quality of life and cost-effectiveness. Ethics and dissemination Recruitment commenced on July 2017 and will complete by December 2019. Results will be disseminated via national governing bodies, scientific meetings and peer-reviewed journals. Trial registration number NCT03223558; Pre-results. PMID:29574443
Tanović, Edina
2009-01-01
Arteriosclerosis is a disease effecting large elastic, elastic muscular and large muscular arteries. The primary pathological changes are found inside the arteries. Salient feature is atherosclerotic plaque. The main purpose of this paper is to determine whether early kinesitherapy with verticalization and mobilization can give better rehabilitation results with patients after lower extremities operation, in comparison to patients which were not mobilized early in this stage. In this paper we have analyzed two groups of 40 patients that were operatively treated for circulation obstruction to lower extremities. The first, tested group was treated with early kinesiotherapy with early verticalization and mobilization. The second, controlled group was treated with kinesitherapy in bed. All the patients were analyzed according to their gender, age, primary diagnosis, postoperative complications, as well as capabilities for everyday activities. For the evaluation of the everyday life activities we used the Barthel index at hospital admission and discharge. Both groups of patients were equable in gender and age. The most common age group within the tested groups was between 61-70 for males and 51-60 for woman.The most common type of obstruction in both groups was occlusion of femoral artery. The complications which occurred among the tested patients were thrombosis, ileus and contracture in 7.5% of cases, while 85% of patients did not have any complications. Within the controlled group, decubitus occurred in 7.5% of cases, as well as gangrene and ileus. Ulcus occurred in 5% of patients, thrombosis in 10%, and contracture in 4% of cases. 40% of patients in this group were without complications. Based on the results stated above we can conclude that early kinesitherapy with verticalization and mobilization of patients in postoperative phase after the treatment of lower extremities obstruction, have shown much better results in comparison to the patients which were only treated with kinesitherapy in bed. This method of treatment should be included as protocol treatment for all patients after surgical treatment of lower extremities obstruction.
Autonomous Learning in Mobile Cognitive Machines
2017-11-25
2016). [18] Liu, Wei, et al. "Ssd: Single shot multibox detector." European conference on computer vision. Springer, Cham, 2016. [19] Vinyals, Oriol...the brain being evolved to support its mobility has been raised. In fact, as the project progressed, the researchers discovered that if one of the...deductive, relies on rule-based programming, and can solve complex problems, however, faces difficulties in learning and adaptability. The latter
In-Use and Emerging Disruptive Technology Trends
2015-03-31
blog/establishing-zero-trust- infrastructure / (accessed No- vember 7, 2014) Mobile Thin Client End Points In the early days of computing, the...companies are using their network infrastructure to break into the mobile broadband market. For example, Ca- blevision recently began providing a Wi-Fi...smartphones and mobile devic- es will be used within the Pentagon. A building-wide cellular infrastructure is not the an- swer to retrieving and sending
Hurtado, Rafael G.; Floría, Luis Mario
2016-01-01
We analyse the urban mobility in the cities of Medellín and Manizales (Colombia). Each city is represented by six mobility networks, each one encoding the origin-destination trips performed by a subset of the population corresponding to a particular socio-economic status. The nodes of each network are the different urban locations whereas links account for the existence of a trip between two different areas of the city. We study the main structural properties of these mobility networks by focusing on their spatio-temporal patterns. Our goal is to relate these patterns with the partition into six socio-economic compartments of these two societies. Our results show that spatial and temporal patterns vary across these socio-economic groups. In particular, the two datasets show that as wealth increases the early-morning activity is delayed, the midday peak becomes smoother and the spatial distribution of trips becomes more localized. PMID:27853531
New insights into the early steps of oil body mobilization during pollen germination
Castro, Antonio Jesús
2013-01-01
In some plants, pollen grains accumulate storage lipids that serve as energy supply during germination. Here, three enzymes involved in early steps of oil body mobilization in the male gametophyte were functionally characterized for the first time. The effect of extracellular sugars on pollen performance and oil body dynamics was also analysed. Olive pollen oil bodies showed phospholipase A, lipase, and lipoxygenase activities on their surface. Enzyme activity levels increased during germination with a maximum after 3h. Removal of extracellular sugars from the germination medium did not affect pollen performance but increased enzyme activity rates and sped up oil body mobilization. Inhibitors seriously hampered pollen germination and pollen tube growth, leading to a characteristic accumulation of oil bodies in the germinative aperture. It can be concluded that storage lipids are sufficient for proper olive pollen germination. A lipase and a lipoxygenase are likely involved in oil body mobilization. Extracellular sugars may modulate their function, while a phospholipase A may promote their access to the storage lipids. PMID:23132905
Mobility (Parkinson's Disease)
... risk of complications and have better quality of life. Learn More Research Research We Fund Parkinson's Outcomes Project Grant Opportunities Science News & Progress Patient Engagement Research Our research has ...
RESIF national datacentre : new features and forthcoming evolutions
NASA Astrophysics Data System (ADS)
Pequegnat, C.; Volcke, P.; le Tanou, J.; Wolyniec, D.; Lecointre, A.; Guéguen, P.
2013-12-01
RESIF is a nationwide french project aimed at building an high quality system to observe and understand the inner earth. The goal is to create a network throughout mainland France comprising 750 seismometers and geodetic measurement instruments, 250 of which will be mobile, to enable the observation network to be focussed on specific investigation subjects and geographic locations. The RESIF data distribution centre, which is a part of the global project, is operated by the Université Joseph Fourier (Grenoble, France) and is being implemented for two years. Data from french broadband permanent network, strong motion permanent network, and mobile seismological antenna are freely accessible as realtime streams and continuous validated data, along with instrumental metadata, delivered using widely known formats and requests tools. New features of the datacentre are : - new modern distribution tools : two FDSN WEBservices has been implemented and deliver data and metadata. - new data and datasets : the number of permanent stations rose by over 40 % percent in one year and the RESIF archive now includes past data (down to 1995) and data from new networks. Moreover, data from mobile experiments prior to 2011 is progressively released, and data from new mobile experiments in the Alps and in the Pyrenean mountains is progressively integrated. - new infrastructures : (1) the RESIF databank is about to be connected to the grid storage of the University High Performance Computing (HPC) centre. As a scientific use case of this datacenter facility, a focus is made on intensive exploitation of combined data from permanent and mobile networks (2) the RESIF databank will be progressively hosted on a new shared storage facility operated by the Université Joseph Fourier. This infrastructure offers high availability data storage (both in blocks and files modes) as well as backup and long term archival capabilities, and will be fully operational at the beginning of 2014.
Camp, Pat G; Reid, W Darlene; Chung, Frank; Kirkham, Ashley; Brooks, Dina; Goodridge, Donna; Marciniuk, Darcy D; Hoens, Alison M
2015-10-01
Exercise is recommended for people with an acute exacerbation of chronic obstructive pulmonary disease (AECOPD), yet there is little information to guide safe and effective mobilization and exercise for these patients. The purpose of this study was to develop a clinical decision-making tool to guide health care professionals in the assessment, prescription, monitoring, and progression of mobilization and therapeutic exercise for patients with AECOPD. A 3-round interdisciplinary Delphi panel identified and selected items based on a preselected consensus of 80%. These items were summarized in a paper-based tool titled Mobilization in Acute Exacerbations of Chronic Obstructive Pulmonary Disease (AECOPD-Mob). Focus groups and questionnaires were subsequently used to conduct a sensibility evaluation of the tool. Nine researchers, 13 clinicians, and 7 individuals with COPD identified and approved 110 parameters for safe and effective exercise in AECOPD. These parameters were grouped into 5 categories: (1) "What to Assess Prior to Mobilization," (2) "When to Consider Not Mobilizing or to Discontinue Mobilization," (3) "What to Monitor During Mobilization for Patient Safety," (4) "How to Progress Mobilization to Enhance Effectiveness," and (5) "What to Confirm Prior to Discharge." The tool was evaluated in 4 focus groups of 18 health care professionals, 90% of whom reported the tool was easy to use, was concise, and would guide a health care professional who is new to the acute care setting and working with patients with AECOPD. The tool was developed based on published evidence and expert opinion, so the applicability of the items to patients in all settings cannot be guaranteed. The Delphi panel consisted of health care professionals from Canada, so items may not be generalizable to other jurisdictions. The AECOPD-Mob provides practical and concise information on safe and effective exercise for the AECOPD population for use by the new graduate or novice acute care practitioner. © 2015 American Physical Therapy Association.
NASA Astrophysics Data System (ADS)
Bilek, Marcela M. M.
2014-08-01
Despite major research efforts in the field of biomaterials, rejection, severe immune responses, scar tissue and poor integration continue to seriously limit the performance of today's implantable biomedical devices. Implantable biomaterials that interact with their host via an interfacial layer of active biomolecules to direct a desired cellular response to the implant would represent a major and much sought after improvement. Another, perhaps equally revolutionary, development that is on the biomedical horizon is the introduction of cost-effective microarrays for fast, highly multiplexed screening for biomarkers on cell membranes and in a variety of analyte solutions. Both of these advances will rely on effective methods of functionalizing surfaces with bioactive molecules. After a brief introduction to other methods currently available, this review will describe recently developed approaches that use energetic ions extracted from plasma to facilitate simple, one-step covalent surface immobilization of bioactive molecules. A kinetic theory model of the immobilization process by reactions with long-lived, mobile, surface-embedded radicals will be presented. The roles of surface chemistry and microstructure of the ion treated layer will be discussed. Early progress on applications of this technology to create diagnostic microarrays and to engineer bioactive surfaces for implantable biomedical devices will be reviewed.
[Chronically ill and unemployed? A review on vocational status in multiple sclerosis].
Kern, S; Kühn, M; Ziemssen, T
2013-02-01
Multiple sclerosis (MS) is one of the most common neurological disorders in young adults. It is characterised by a chronic progressive course with far reaching implications on the patient's private and professional life. Based on the current literature, employment status is analysed in relation to disease-specific, therapeutic, psychosocial, and socioeconomic factors. A special emphasis is placed on the vocational status of MS patients in Germany. According national and international studies, around 40 % of all MS patients are currently unemployed. Main reasons for early retirement are disease-specific factors such as impaired mobility, disability in the upper extremities, fatigue, and cognitive impairment. According to the German Multiple Sclerosis Registry (GMSR), these symptoms are still insufficiently treated. In patients with minor motoric impairment (EDSS ≤ 3.0), depressive symptoms seem to have a major impact on employment status. Disease progression, older age at diagnosis, and hard physical work are negative predictors in terms of employment situation. The lack of flexible working hours, the inability to have flexible resting times at work, a lack of understanding from colleagues and employers as well as the personal attitude were main non-disease-specific reasons for early retirement. The current knowledge on the vocational status in MS is mainly based on international studies (e. g., Scandinavia, England, USA, Australia, MSIF Survey). For Germany, only the GMSR supports significant information on the employment status of MS patients. According to the GMSR, ataxia, fatigue and cognitive dysfunction are still insufficiently treated - a situation that is at least partly due to insufficient treatment options. Comprehensive studies that focus on a broad range of possible influencing factors on vocational status of German MS patients are currently lacking. © Georg Thieme Verlag KG Stuttgart · New York.
Effects of strawberry supplementation on mobility and cognition in older adults
USDA-ARS?s Scientific Manuscript database
During aging, functional changes in the central and peripheral nervous system can alter mobility and cognition - in some cases leading to early cognitive decline, disability, or injurious falls among older adults. Previously, we have shown that two months of dietary supplementation with berry fruit...
Haseba, Sumihito; Sakakima, Harutoshi; Nakao, Syuhei; Ohira, Misaki; Yanagi, Shigefumi; Imoto, Yutaka; Yoshida, Akira; Shimodozono, Megumi
2018-07-01
We analysed the gross motor recovery of infants and toddlers with cyanotic and acyanotic congenital heart disease (CHD) who received early postoperative physical therapy to see whether there was any difference in the duration to recovery. This study retrospectively evaluated the influence of early physical therapy on postoperative gross motor outcomes of patients with CHD. The gross motor ability of patients with cyanotic (n = 25, average age: 376.4 days) and acyanotic (n = 26, average age: 164.5 days) CHD was evaluated using our newly developed nine-grade mobility assessment scale. Physical therapy was started at an average of five days after surgery, during which each patient's gross motor ability was significantly decreased compared with the preoperative level. Patients (who received early postoperative physical therapy) with cyanotic (88.0%) and acyanotic CHD (96.2%) showed improved preoperative mobility grades by the time of hospital discharge. However, patients with cyanotic CHD had a significantly prolonged recovery period compared to those with acyanotic CHD (p < .01). The postoperative recovery period to preoperative mobility grade was significantly correlated with pre-, intra-, and postoperative factors. Our findings suggested that infants with cyanotic CHD are likely at a greater risk of gross motor delays, the recovery of which might differ between infants with cyanotic and acyanotic CHD after cardiac surgery. Early postoperative physical therapy promotes gross motor recovery. Implications of Rehabilitation Infants and toddlers with cyanotic congenital heart disease are likely at greater risk of gross motor delays and have a prolonged recovery period of gross motor ability compared to those with acyanotic congenital heart disease. Early postoperative physical therapy for patients with congenital heart disease after cardiac surgery promoted gross motor recovery. The postoperative recovery period to preoperative mobility grade was affected by pre-, intra-, and postoperative factors. Rehabilitation experts should consider the risk of gross motor delays of patients with congenital heart disease after cardiac surgery and the early postoperative physical therapy to promote their gross motor recovery.
Sutcliffe, Catherine G; Thuma, Philip E; van Dijk, Janneke H; Sinywimaanzi, Kathy; Mweetwa, Sydney; Hamahuwa, Mutinta; Moss, William J
2017-03-08
Early infant diagnosis of HIV infection is challenging in rural sub-Saharan Africa as blood samples are sent to central laboratories for HIV DNA testing, leading to delays in diagnosis and treatment initiation. Simple technologies to rapidly deliver results to clinics and notify mothers of test results would decrease many of these delays. The feasibility of using mobile phones to contact mothers was evaluated. In addition, the first two years of implementation of a national short message service (SMS) reporting system to deliver test results from the laboratory to the clinic were evaluated. The study was conducted in Macha, Zambia from 2013 to 2015 among mothers of HIV-exposed infants. Mothers were interviewed about mobile phone use and willingness to be contacted directly or through their rural health center. Mothers were contacted according to their preferred method of communication when test results were available. Mothers of positive infants were asked to return to the clinic as soon as possible. Dates of sample collection, delivery of test results to the clinic and notification of mothers were documented in addition to test results. Four hundred nineteen mothers and infants were enrolled. Only 30% of mothers had ever used a mobile phone. 96% of mobile phone owners were reached by study staff and 98% of mothers without mobile phones were contacted through their rural health center. Turnaround times for mothers of positive infants were approximately 2 weeks shorter than for mothers of negative infants. Delivery of test results by the national SMS system improved from 2013 to 2014, with increases in the availability of texted results (38 vs. 91%) and arrival of the texted result prior to the hardcopy report (27 vs. 83%). Texted results arriving at the clinic before the hardcopy were received a median of 19 days earlier. Four discrepancies between texted and hardcopy results were identified out of 340 tests. Mobile phone and text messaging technology has the potential to improve early infant diagnosis but challenges to widespread implementation need to be addressed, including low mobile phone ownership, use and coverage in rural areas.
Reducing School Mobility: A Randomized Trial of a Relationship-Building Intervention
Fiel, Jeremy E.; Haskins, Anna R.; López Turley, Ruth N.
2013-01-01
Student turnover has many negative consequences for students and schools, and the high mobility rates of disadvantaged students may exacerbate inequality. Scholars have advised schools to reduce mobility by building and improving relationships with and among families, but such efforts are rarely tested rigorously. A cluster-randomized field experiment in 52 predominantly Hispanic elementary schools in San Antonio, TX, and Phoenix, AZ, tested whether student mobility in early elementary school was reduced through Families and Schools Together (FAST), an intervention that builds social capital among families, children, and schools. FAST failed to reduce mobility overall but substantially reduced the mobility of Black students, who were especially likely to change schools. Improved relationships among families help explain this finding. PMID:25346541
NeuroMind: Past, present, and future.
Kubben, Pieter L
2017-01-01
This narrative report describes the underlying rationale and technical developments of NeuroMind, a mobile clinical decision support system for neurosurgery. From the perspective of a neurosurgeon - (app) developer it explains how technical progress has shaped the world's "most rated and highest rated" neurosurgical mobile application, with particular attention for operating system diversity on mobile hardware, cookbook medicine, regulatory affairs (in particular regarding software as a medical device), and new developments in the field of clinical data science, machine learning, and predictive analytics. Finally, the concept of "computational neurosurgery" is introduced as a vehicle to reach new horizons in neurosurgery.
NeuroMind: Past, present, and future
Kubben, Pieter L.
2017-01-01
This narrative report describes the underlying rationale and technical developments of NeuroMind, a mobile clinical decision support system for neurosurgery. From the perspective of a neurosurgeon – (app) developer it explains how technical progress has shaped the world's “most rated and highest rated” neurosurgical mobile application, with particular attention for operating system diversity on mobile hardware, cookbook medicine, regulatory affairs (in particular regarding software as a medical device), and new developments in the field of clinical data science, machine learning, and predictive analytics. Finally, the concept of “computational neurosurgery” is introduced as a vehicle to reach new horizons in neurosurgery. PMID:28966822
Mobile Health Advances in Physical Activity, Fitness, and Atrial Fibrillation: Moving Hearts.
McConnell, Michael V; Turakhia, Mintu P; Harrington, Robert A; King, Abby C; Ashley, Euan A
2018-06-12
The growing recognition that "health" takes place outside of the hospital and clinic, plus recent advances in mobile and wearable devices, have propelled the field of mobile health (mHealth). Cardiovascular disease and prevention are major opportunities for mHealth, as mobile devices can monitor key physiological signals (e.g., physical activity, heart rate and rhythm) for promoting healthy behaviors, detecting disease, and aid in ongoing care. In this review, the authors provide an update on cardiovascular mHealth by highlighting recent progress and challenges with mobile and wearable devices for assessing and promoting physical activity and fitness, and for monitoring heart rate and rhythm for the detection and management of atrial fibrillation. Copyright © 2018 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
Comparison of Alignment Correction Angles Between Fixed-Bearing and Mobile-Bearing UKA.
Inoue, Atsuo; Arai, Yuji; Nakagawa, Shuji; Inoue, Hiroaki; Yamazoe, Shoichi; Kubo, Toshikazu
2016-01-01
Good outcomes have been reported with both fixed-bearing and mobile-bearing unicompartmental knee arthroplasty (UKA). However, overcorrected alignment could induce the progression of arthritis on the non-arthroplasty side. Changes of limb alignment after UKA with both types of bearings (fixed bearing: 24 knees, mobile bearing: 28 knees) were investigated. The mean difference between the preoperative standing femoral-tibial angle (FTA) and postoperative standing FTA was significantly larger in mobile bearing UKA group. In fixed-bearing UKA, there must be some laxity in MCL tension so that a 2-mm tension gauge can be inserted. In mobile-bearing UKA, appropriate MCL tension is needed to prevent bearing dislocation. This difference in MCL tension may have caused the difference in the correction angle between the groups. Copyright © 2016 Elsevier Inc. All rights reserved.
Navarro-Pujalte, Esther; Gacto-Sánchez, Mariano; Montilla-Herrador, Joaquina; Escolar-Reina, Pilar; Ángeles Franco-Sierra, María; Medina-Mirapeix, Francesc
2018-01-12
Prospective longitudinal study. To examine the sensitivity of the Mobility Activities Measure for lower extremities and to compare it to the sensitivity of the Physical Functioning Scale (PF-10) and the Patient-Specific Functional Scale (PSFS) at week 4 and week 8 post-hospitalization in outpatient rehabilitation settings. Mobility Activities Measure is a set of short mobility measures to track outpatient rehabilitation progress: its scales have shown good properties but its sensitivity to change has not been reported. Patients with musculoskeletal conditions were recruited at admission in three outpatient rehabilitation settings in Spain. Data were collected at admission, week 4 and week 8 from an initial sample of 236 patients (mean age ± SD = 36.7 ± 11.1). Mobility Activities Measure scales for lower extremity; PF-10; and PSFS. All the Mobility Activities Measure scales were sensitive to both positive and negative changes (the Standardized Response Means (SRMs) ranged between 1.05 and 1.53 at week 4, and between 0.63 and 1.47 at week 8). The summary measure encompassing the three Mobility Activities Measure scales detected a higher proportion of participants who had improved beyond the minimal detectable change (MDC) than detected by the PSFS and the PF-10 both at week 4 (86.64% vs. 69.81% and 42.23%, respectively) and week 8 (71.14% vs. 55.65% and 60.81%, respectively). The three Mobility Activities Measure scales assessing the lower extremity can be used across outpatient rehabilitation settings to provide consistent and sensitive measures of changes in patients' mobility. Implications for rehabilitation All the scales of the Mobility Activities Measure for the lower extremity were sensitive to both positive and negative change across the follow-up periods. Overall, the summary measure encompassing the three Mobility Activities Measure scales for the lower extremity appeared more sensitive to positive changes than the Physical Functioning Scale, especially during the first four weeks of treatment. The summary measure also detected a higher percentage of participants with positive change that exceeded the minimal detectable change than the Patient-Specific Functional Scale and the Physical Functioning Scale at the first follow-up period. By demonstrating their consistency and sensitivity to change, the three Mobility Activities Measures scales can now be considered in order to track patients' functional progress. Mobility Activities Measure can be therefore used in patients with musculoskeletal conditions across outpatient rehabilitation settings to provide estimates of change in mobility activities focusing on the lower extremity.
Creating an Ofsted Story: The Role of Early Years Assessment Data in Schools' Narratives of Progress
ERIC Educational Resources Information Center
Bradbury, Alice; Roberts-Holmes, Guy
2017-01-01
This paper explores the growing importance of measures of progress in judgements of schools' effectiveness in England, with a focus on the role of the early years (settings for children aged 2-5) in providing data for these measures. Qualitative data from a research project involving three diverse school-based and pre-compulsory early years…
ERIC Educational Resources Information Center
Hampton, David D.; Lembke, Erica S.
2016-01-01
The purpose of this study was to examine 4 early writing measures used to monitor the early writing progress of 1st-grade students. We administered the measures to 23 1st-grade students biweekly for a total of 16 weeks. We obtained 3-min samples and conducted analyses for each 1-min increment. We scored samples using 2 different methods: correct…
ERIC Educational Resources Information Center
Van Ryzin, Mark J.; Dishion, Thomas J.
2014-01-01
Background: Early substance use co-occurs with youths' self-organization into deviant peer groups in which substance use is central to social interaction. We hypothesized that the social dynamics of deviant peer groups amplify the risk of progressing from early use to later dependence, and that this influence occurs over and above escalations…
Teixeira, Maria Glória; Paixão, Enny S; Costa, Maria da Conceição N; Cunha, Rivaldo V; Pamplona, Luciano; Dias, Juarez P; Figueiredo, Camila A; Figueiredo, Maria Aparecida A; Blanton, Ronald; Morato, Vanessa; Barreto, Maurício L; Rodrigues, Laura C
2015-05-01
Currently, knowledge does not allow early prediction of which cases of dengue fever (DF) will progress to dengue hemorrhagic fever (DHF), to allow early intervention to prevent progression or to limit severity. The objective of this study is to investigate the hypothesis that some specific comorbidities increase the likelihood of a DF case progressing to DHF. A concurrent case-control study, conducted during dengue epidemics, from 2009 to 2012. Cases were patients with dengue fever that progressed to DHF, and controls were patients of dengue fever who did not progress to DHF. Logistic regression was used to estimate the association between DHF and comorbidities. There were 490 cases of DHF and 1,316 controls. Among adults, progression to DHF was associated with self-reported hypertension (OR = 1.6; 95% CI 1.1-2.1) and skin allergy (OR = 1.8; 95% CI 1.1-3.2) with DHF after adjusting for ethnicity and socio-economic variables. There was no statistically significant association between any chronic disease and progression to DHF in those younger than 15 years. Physicians attending patients with dengue fever should keep those with hypertension or skin allergies in health units to monitor progression for early intervention. This would reduce mortality by dengue.
Early Childhood Investment Zones: A Learning Approach for Authentic Community Partnership
ERIC Educational Resources Information Center
Vermilya, Lois; Kerwin, Dorothy
2017-01-01
Many professionals in the early childhood field are inspired by community-driven initiatives that hold great promise for transforming outcomes for the youngest children and their families. However, most collective impact efforts are mobilized in large urban areas, where early childhood professionals and civic leaders take the lead. New Mexico has…
Early Childhood Teachers' Perceptions of the Educational Needs of Military Dependent Children
ERIC Educational Resources Information Center
Stites, Michele Lee
2012-01-01
Military dependent children remain a largely unexplored subject, particularly in early childhood education. In an effort to fill the gap in the current literature, this research study focuses on how early childhood teachers perceive the educational needs of military dependent children. Previous research in the areas of geographic mobility,…
How Early Childhood Teachers Perceive the Educational Needs of Military Dependent Children
ERIC Educational Resources Information Center
Stites, Michele L.
2016-01-01
Military dependent children remain a largely unexplored subject, particularly in early childhood education. In an effort to fill the gap in the current literature, this research study focuses on how early childhood teachers perceive the educational needs of military dependent children. Previous research in the areas of geographic mobility,…
Mobile Technologies in Schools: The Student Voice
ERIC Educational Resources Information Center
Hodge, Emma-Leigh; Robertson, Neville; Sargisson, Rebecca J.
2017-01-01
Intermediate and high school students spend a large amount of time using mobile devices (Lauricella, Cingel, Blackwell, Wartella, & Conway, 2014), and such devices are increasingly being integrated into our school system. We conducted a series of student-led focus groups, with this early adolescent cohort, in order to better understand their…
Joint Communications Support Element: The Voice Heard Round the World
2013-01-01
Initial Entry Package ( IEP ), Early Entry Package (EEP), and Joint Mobil- ity Package provide secure and nonsecure voice, video, and data to small mobile...teams operating worldwide. The IEP and EEP can be rapidly scaled to meet force surge require- ments from small dismounted teams up to an advance
Pittaccio, Simone; Garavaglia, Lorenzo; Molteni, Erika; Guanziroli, Eleonora; Zappasodi, Filippo; Beretta, Elena; Strazzer, Sandra; Molteni, Franco; Villa, Elena; Passaretti, Francesca
2013-01-01
Lower limb rehabilitation is a fundamental part of post-acute care in neurological disease. Early commencement of active workout is often prevented by paresis, thus physical treatment may be delayed until patients regain some voluntary command of their muscles. Passive mobilization of the affected joints is mostly delivered in order to safeguard tissue properties and shun circulatory problems. The present paper investigates the potential role of early passive motion in stimulating cortical areas of the brain devoted to the control of the lower limb. An electro-mechanical mobilizer for the ankle joint (Toe-Up!) was implemented utilizing specially-designed shape-memory-alloy-based actuators. This device was constructed to be usable by bedridden subjects. Besides, the slowness and gentleness of the imparted motion, make it suitable for patients in a very early stage of their recovery. The mobilizer underwent technical checks to confirm reliability and passed the required safety tests for electric biomedical devices. Four healthy volunteers took part in the pre-clinical phase of the study. The protocol consisted in measuring of brain activity by EEG and NIRS in four different conditions: rest, active dorsiflexion of the ankle, passive mobilization of the ankle, and assisted motion of the same joint. The acquired data were processed to obtain maps of cortical activation, which were then compared. The measurements collected so far show that there is a similar pattern of activity between active and passive/assisted particularly in the contralateral premotor areas. This result, albeit based on very few observations, might suggest that passive motion provides somatosensory afferences that are processed in a similar manner as for voluntary control. Should this evidence be confirmed by further trials on healthy individuals and neurological patients, it could form a basis for a clinical use of early passive exercise in supporting central functional recovery.
Wettstein, Markus; Wahl, Hans-Werner; Shoval, Noam; Auslander, Gail; Oswald, Frank; Heinik, Jeremia
2015-12-01
Heterogeneity in older adults' mobility and its correlates have rarely been investigated based on objective mobility data and in samples including cognitively impaired individuals. We analyzed mobility profiles within a cognitively heterogeneous sample of N = 257 older adults from Israel and Germany based on GPS tracking technology. Participants were aged between 59 and 91 years (M = 72.9; SD = 6.4) and were either cognitively healthy (CH, n = 146), mildly cognitively impaired (MCI, n = 76), or diagnosed with an early-stage dementia of the Alzheimer's type (DAT, n = 35). Based on cluster analysis, we identified three mobility types ("Mobility restricted," "Outdoor oriented," "Walkers"), which could be predicted based on socio-demographic indicators, activity, health, and cognitive impairment status using discriminant analysis. Particularly demented individuals and persons with worse health exhibited restrictions in mobility. Our findings contribute to a better understanding of heterogeneity in mobility in old age. © The Author(s) 2013.
Miller, Wayne L.; Borgeson, Daniel D.; Grantham, J. Aaron; Luchner, Andreas; Redfield, Margaret M.; Burnett, John C.
2015-01-01
Aims Aldosterone activation is central to the sodium-fluid retention that marks the progression of heart failure (HF). The actions of dietary sodium restriction, a mainstay in HF management, on cardiorenal and neuroendocrine adaptations during the progression of HF are poorly understood. The study aim was to assess the role of dietary sodium during the progression of experimental HF. Methods and Results Experimental HF was produced in a canine model by rapid right ventricular pacing which evolves from early mild HF to overt, severe HF. Dogs were fed one of three diets: 1) high sodium [250 mEq (5.8 grams) per day, n=6]; 2) standard sodium [58 mEq (1.3 grams) per day, n=6]; and 3) sodium restriction [11 mEq (0.25 grams) per day, n=6]. During the 38 day study hemodynamics, renal function, renin activity (PRA), and aldosterone were measured. Changes in hemodynamics at 38 days were similar in all three groups, as were changes in renal function. Aldosterone activation was demonstrated in all three groups, however, dietary sodium restriction, in contrast to high sodium, resulted in early (10 days) activation of PRA and aldosterone. High sodium demonstrated significant suppression of aldosterone activation over the course of HF progression. Conclusions Excessive dietary sodium restriction particularly in early stage HF results in early aldosterone activation, while normal and excess sodium intake are associated with delayed or suppressed activation. These findings warrant evaluation in humans to determine if dietary sodium manipulation, particularly during early stage HF, may have a significant impact on neuroendocrine disease progression. PMID:25823360
Experimental Investigations on the Pull-Out Behavior of Tire Strips Reinforced Sands
Li, Li-Hua; Chen, Yan-Jun; Ferreira, Pedro Miguel Vaz; Liu, Yong; Xiao, Heng-Lin
2017-01-01
Waste tires have excellent mechanical performance and have been used as reinforcing material in geotechnical engineering; however, their interface properties are poorly understood. To further our knowledge, this paper examines the pull-out characteristics of waste tire strips in a compacted sand, together with uniaxial and biaxial geogrids also tested under the same conditions. The analysis of the results shows that the interlocking effect and pull-out resistance between the tire strip and the sand is very strong and significantly higher than that of the geogrids. In the early stages of the pull-out test, the resistance is mainly provided by the front portion of the embedded tire strips, as the pull-out test continues, more and more of the areas towards the end of the tire strips are mobilized, showing a progressive failure mechanism. The deformations are proportional to the frictional resistance between the tire-sand interface, and increase as the normal stresses increase. Tire strips of different wear intensities were tested and presented different pull-out resistances; however, the pull-out resistance mobilization patterns were generally similar. The pull-out resistance values obtained show that rubber reinforcement can provide much higher pull-out forces than the geogrid reinforcements tested here, showing that waste tires are an excellent alternative as a reinforcing system, regardless of the environmental advantages. PMID:28773069
Varma, Rohit; Foong, Athena W.P.; Lai, Mei-Ying; Choudhury, Farzana; Klein, Ronald; Azen, Stanley P.
2011-01-01
Purpose To estimate 4-year incidence and progression of early and advanced age-related macular degeneration (AMD). Design Population-based cohort study. Methods A comprehensive ophthalmologic examination including stereoscopic fundus photography was performed on adult Latinos at baseline and follow-up. Photographs were graded using a modified Wisconsin Age-Related Maculopathy Grading System. For estimations of incidence and progression of AMD, the Age Related Eye Disease Study Scale was used. Main outcome measures are incidence and progression of early AMD (drusen type, drusen size, and retinal pigmentary abnormalities) and advanced AMD (exudative AMD and geographic atrophy). Results 4,658/6100 (76%) completed the follow-up examination. The 4-year incidence of early AMD was 7.5% (95%CI:6.6,8.4) and advanced AMD was 0.2% (95%CI:0.1,0.4). Progression of any AMD occurred in 9.3% (95%CI:8.4,10.3) of at-risk participants. Incidence and progression increased with age. Incidence of early AMD in the second eye (10.8%) was higher than incidence in the first eye (6.9%). Baseline presence of soft indistinct large drusen≥250μm in diameter was more likely to predict the 4-year incidence of pigmentary abnormalities, geographic atrophy, and exudative AMD than smaller or hard or soft distinct drusen. Conclusions Age-specific incidence and progression of AMD in Latinos are lower than in non-Hispanic whites. While incident early AMD is more often unilateral, the risk of its development in the second is higher than in the first eye. Older persons and those with soft indistinct large drusen had a higher risk of developing advanced AMD compared to those who were younger and did not have soft indistinct large drusen. PMID:20399926
Unusual course of infective endocarditis: acute renal failure progressing to chronic renal failure.
Sevinc, Alper; Davutoglu, Vedat; Barutcu, Irfan; Kocoglu, M Esra
2006-04-01
Infective endocarditis is an infection of the endocardium that usually involves the valves and adjacent structures. The classical fever of unknown origin presentation represents a minority of infective endocarditis. The presented case was a 21-yearold young lady presenting with acute renal failure and fever to the emergency room. Cardiac auscultation revealed a soft S1 and 4/6 apical holosystolic murmur extended to axilla. Echocardiography showed mobile fresh vegetation under the mitral posterior leaflet. She was diagnosed as having infective endocarditis. Hemodialysis was started with antimicrobial therapy. However, because of the presence of severe mitral regurgitation with left ventricle dilatation and large mobile vegetation, mitral prosthetic mechanical valve replacement was performed. Although treated with antibiotics combined with surgery, renal functions were deteriorated and progressed to chronic renal failure.
Mobile satellite business networks: A part of the European mobile system
NASA Technical Reports Server (NTRS)
deMateo, M. L.; Jongejans, A.; Loisy, C.; VanHimbeeck, C.; Marchal, J. P.; Borella, A.; Sartori, M.
1995-01-01
The European Space Agency (ESA) is presently procuring an L-band payload EMS, to be embarked on the ITALSAT-2 satellite due for launch in early 1996, in order to promote a regional European mobile system. One of the Land Mobile Communication systems supported by EMS is the MSBN (Mobile Satellite Business Network) voice and data system which will offer the services of a business network on a seamless European coverage. This paper will first recall the characteristics of the MSBN system, which is based on quasi-synchronized CDMA (Code Division Multiple Access) techniques in both directions, and then describe the CDMA receivers implementation. Main validation test results will also be reported confirming predicted performances.
New perspectives for Secondary School: The Case of Brazil
NASA Astrophysics Data System (ADS)
Gomes, Candido Alberto
1999-01-01
Despite its importance in relation to social mobility, secondary education is characterised by an unequal distribution of knowledge among different groups of students, and a hierarchy in which some types of knowledge are valued more than others. In comparing secondary education in different countries, two main systems are apparent: "sponsored mobility" and "competitive mobility". In the former, students are divided into different groups according to ability at an early stage in their schooling. In the latter, the selection process is postponed until the final phase. Brazil, in its recent history, has moved from sponsored mobility to competitive mobility. The author explores some of the lessons during this process and examines their implications for the future.
Muhr, Jan; Messier, Christian; Delagrange, Sylvain; Trumbore, Susan; Xu, Xiaomei; Hartmann, Henrik
2016-03-01
While trees store substantial amounts of nonstructural carbon (NSC) for later use, storage regulation and mobilization of stored NSC in long-lived organisms like trees are still not well understood. At two different sites with sugar maple (Acer saccharum), we investigated ascending sap (sugar concentration, δ(13) C, Δ(14) C) as the mobilized component of stored stem NSC during early springtime. Using the bomb-spike radiocarbon approach we were able to estimate the average time elapsed since the mobilized carbon (C) was originally fixed from the atmosphere and to infer the turnover time of stem storage. Sites differed in concentration dynamics and overall δ(13) C, indicating different growing conditions. The absence of temporal trends for δ(13) C and Δ(14) C indicated sugar mobilization from a well-mixed pool with average Δ(14) C consistent with a mean turnover time (TT) of three to five years for this pool, with only minor differences between the sites. Sugar maple trees hence appear well buffered against single or even several years of negative plant C balance from environmental stress such as drought or repeated defoliation by insects. Manipulative investigations (e.g. starvation via girdling) combined with Δ(14) C measurements of this mobilized storage pool will provide further new insights into tree storage regulation and functioning. © 2015 The Authors. New Phytologist © 2015 New Phytologist Trust.
Dascalu, A M; Cherecheanu, A P; Stana, D; Voinea, L; Ciuluvica, R; Savlovschi, C; Serban, D
2014-01-01
to investigate the sensitivity and specificity of the stereometric parameters change analysis vs. Topographic Change Analysis in early detection of glaucoma progression. 81 patients with POAG were monitored for 4 years (GAT monthly, SAP at every 6 months, optic disc photographs and HRT3 yearly). The exclusion criteria were other optic disc or retinal pathology; topographic standard deviation (TSD>30; inter-test variation of reference height>25 μm. The criterion for structural progression was the following: at least 20 adjacent super-pixels with a clinically significant decrease in height (>5%). 16 patients of the total 81 presented structural progression on TCA. The most useful stereometric parameters for the early detection of glaucoma progression were the following: Rim Area change (sensitivity 100%, specificity 74.2% for a "cut-off " value of -0.05), C/D Area change (sensitivity 85.7%, specificity 71.5% for a "cut off " value of 0.02), C/D linear change (sensitivity 85.7%, specificity 71.5% for a "cut-off " value of 0.02), Rim Volume change (sensitivity 71.4%, specificity 88.8% for a "cut-off " value of -0.04). RNFL Thickness change (<0) was highly sensitive (82%), but less specific for glaucoma progression (45,2%). Changes of the other stereometric parameters have a limited diagnostic value for the early detection of glaucoma progression. TCA is a valuable tool for the assessment of the structural progression in glaucoma patients and its inter-test variability is low. On long-term, the quantitative analysis according to stereometric parameters change is also very important. The most relevant parameters to detect progression are RA, C/D Area, Linear C/D and RV.
Lin, Feng-Cheng; Chuang, Yun-Shiuan; Hsieh, Hui-Min; Lee, Tzu-Chi; Chiu, Kuei-Fen; Liu, Ching-Kuan; Wu, Ming-Tsang
2015-11-01
The protective effect of statin on Alzheimer disease (AD) is still controversial, probably due to the debate about when to start the use of statin and the lack of any large-scale randomized evidence that actually supports the hypothesis. The purpose of this study was to examine the protective effect of early statin use on mild-to-moderate AD in the total Taiwanese population.This was a total population-based case-control study, using the total population of Taiwanese citizens seen in general medical practice; therefore, the findings can be applied to the general population. The study patients were those with newly diagnosed dementia (ICD-9 290.x) and prescribed any acetylcholinesterase inhibitors (AChEI) from the Taiwan National Health Insurance dataset in 1997 to 2008. The newly diagnosed eligible mild-to-moderate AD patients were traced from the dates of their index dates, which was defined as the first day to receive any AChEI treatment, back to 1 year (exposure period) to categorize them into AD with early statin use and without early statin use. Early statin use was defined as patients using statin before AChEI treatment. Alzheimer disease patients with early statin use were those receiving any statin treatment during the exposure period. Then, we used propensity-score-matched strategy to match these 2 groups as 1:1. The matched study patients were followed-up from their index dates. The primary outcome was the discontinuation of AChEI treatment, indicating AD progression.There were 719 mild-to-moderate AD-paired patients with early statin use and without early statin use for analyses. Alzheimer disease progression was statistically lower in AD patients with early statin use than those without (P = 0.00054). After adjusting for other covariates, mild-to-moderate AD patients with early stain use exhibited a 0.85-risk (95% CI = 0.76-0.95, P = 0.0066) to have AD progression than those without.Early statin use was significantly associated with a reduction in AD progression in mild-to-moderate AD patients. The future randomized trial studies can confirm our findings.
NASA's Support to Flood Response
NASA Astrophysics Data System (ADS)
Green, D. S.; Murray, J. J.; Stough, T.
2016-12-01
The extent of flood and inundation, the impacts on people and infrastructure, and generally the situational awareness on all scales for decision making are areas where NASA is mobilizing scientific results, advanced sensing and technologies, experts and partnerships to support response. NASA has targeted mature application science and ready technology for flood and inundation monitoring and assessment. This includes supporting timely data management and product dissemination with users and partners. Requirements are captured in the form of science-area questions, while solutions measure readiness for use by considering standard tools and approaches that make information more accessible, interoperable, understandable and reliable. The program collaborates with capacity building and areas of education and outreach needed to create and leverage non-traditional partnerships in transdisciplinary areas including socio-economic practice, preparedness and resilience assessment, early warning and forecast response, and emergency management, relief and recovery. The program outcomes also seek alignment with and support to global and community priorities related to water resources and food security. This presentation will examine the achievements of individual projects and the challenges and opportunities of more comprehensive and collaborative teams behind NASA's response to global flooding. Examples from recent event mobilization will be reviewed including to the serious of domestic floods across the south and Midwest United States throughout 2015 and 2016. Progress on the combined use of optical, microwave and SAR remote sensing measurements, topographic and geodetic data and mapping, data sharing practices will be reviewed. Other response case studies will examine global flood events monitored, characterized and supported in various boundary regions and nations. Achievements and future plans will be described for capabilities including global flood modeling, near real time flood water mapping and damage mapping, observatories, missions and tools to assess surface water variability. Progress being made to establish a comprehensive global flood science team and coordinated response system will be highlighted.
Mboumba Bouassa, R S; Prazuck, T; Lethu, T; Meye, J F; Bélec, L
2017-02-01
Highly oncogenic human papillomavirus (HPV) infections are responsible for 7.7 % of cancers in developing countries, mainly cervical cancer. The incidence of this emerging cancer is steadily increasing in sub-Saharan Africa, with more than 75,000 new cases and close to 50,000 deaths a year, a toll further increased by HIV infection. According to the World Health Organization, cervical cancer will kill more than 443,000 women per year worldwide by 2030, nearly 90 % of them in sub-Saharan Africa. This increase in cervical cancer incidence in Africa is now counteracting the progress made by African women in reducing maternal mortality and increasing longevity. Nevertheless, cervical cancer is a potentially preventable noncommunicable disease that can be averted or halted by primary (vaccination), secondary (early diagnosis of situations at risk), and tertiary (early diagnosis of proven cases of cervical neoplasia) prevention. The close links between HIV and HPV justify linking cervical cancer prevention, screening, and management programs with AIDS programs as part of the "90-90-90" initiative of the UNAIDS, both nationally and regionally. Innovative strategies based on effective, rapid, inexpensive, and mobile screening tools, including at best molecular biology as well as vaccination and awareness programs, should be rapidly implemented and evaluated in sub-Saharan Africa.
Project Fire Model: Summary Progress Report, Period November 1, 1958 to April 30, 1960
W.L. Fons; H.D. Bruce; W.Y. Pong; S.S. Richards
1960-01-01
This report summarizes progress from November 1, 1958, to April 30, 1960, in a study conducted by the Pacific Southwest Forest and Range Experiment Station of the Forest Service in cooperation with the Office of Civil and Defense Mobilization. Called PROJECT FIRE MODEL for convenience, the project sought to develop and study a laboratory-scale fire which would...
ERIC Educational Resources Information Center
Ewell, Peter T.; Schild, Paula R.; Paulson, Karen
A major problem in measuring student success in postsecondary education is the difficulty in tracking students' progress as they transfer from one institution to another. National studies have shown that more than half of students attend more than one institution in their pursuit of a bachelor's degree. This study examined existing state-level…
Liu, Ting-Yun; Dei, Pei-Han; Kuo, Sung-Hsin; Lin, Chung-Wu
2010-06-01
Gastric mucosa-associated lymphoid tissue lymphoma (MALToma) usually presents at an early stage involving only the stomach and/or regional lymph nodes. Although a sequential transformation from low-grade gastric MALToma (GM) to high-grade GM to secondary diffuse large B-cell lymphoma (DLBCL) is commonly assumed, documented cases of transformation are rare. We aim to determine the frequency of transformation. We identified 55 early low-grade GMs, 18 early high-grade GMs, and 13 advanced GMs at the National Taiwan University Hospital from 1995 to 2005. The median follow-up time was 59 months. We found that only one early low-grade GM and two early high-grade GMs transformed into secondary DLBCLs and progressed outside the stomach and regional lymph nodes. Significantly, we identified 13 low-grade GMs that were refractory to Helicobacter eradication therapy or relapsed after initial response. All 13 cases had been followed-up for at least 3 years without development of secondary DLBCLs. The frequency of transformation for early low-grade GM was less than 2% (1/55). Although two lymphoma-unrelated mortalities were identified, none of the 55 patients with early-low grade GMs died of the disease. Compared with chronic lymphocytic leukemia, which has a 16% transformation rate and a median transformation time of 24 months, we conclude that early low-grade GM rarely transforms into secondary DLBCL or progresses beyond the stomach. Without transformation or progression, patients with early low-grade GM rarely die of the disease and should be treated conservatively. Copyright (c) 2010 Formosan Medical Association & Elsevier. Published by Elsevier B.V. All rights reserved.
Contributions of mobile technologies to addiction research.
Swendsen, Joel
2016-06-01
Mobile technologies are revolutionizing the field of mental health, and particular progress has been made in their application to addiction research and treatment. The use of smartphones and other mobile devices has been shown to be feasible with individuals addicted to any of a wide range of substances, with few biases being observed concerning the repeated monitoring of daily life experiences, craving, or substance use. From a methodological point of view, the use of mobile technologies overcomes longstanding limitations of traditional clinical research protocols, including the more accurate assessment of temporal relationships among variables, as well as the reduction in both contextual constraints and discipline-specific methodological isolation. The present article presents a conceptual review of these advances while using illustrations of research applications that are capable of overcoming specific methodological barriers. Finally, a brief review of both the benefits and risks of mobile technology use for the treatment of patients will be addressed.
A review of privacy and usability issues in mobile health systems: Role of external factors.
Katusiime, Jane; Pinkwart, Niels
2017-10-01
The increased penetration of mobile devices has created opportunities in the health sector and led to emerging of mobile health systems. As much as the mobile health systems have registered tremendous progress, they have been faced with privacy and usability issues. Due to the sensitivity of health information, there is an ethical need to equip mobile health systems with adequate privacy measures. However, these systems should also be useable by the intended users. Even though many researchers are working on solutions, the issues still persist. External factors such as cultural differences have also contributed to the issues, yet they have been under researched. In this article, we conduct a systematic literature review of 22 articles, categorize and present privacy and usability issues and possible solutions. We then discuss the relevance and implications of external factors to the findings on privacy and usability. We end with recommendations to address these external factors.
Catching up? The educational mobility of migrants’ and natives’ children in Europe
Oberdabernig, Doris; Schneebaum, Alyssa
2017-01-01
ABSTRACT Migrants into European countries are often less educated than European natives. We analyse whether migrants’ children are more or less likely than natives’ children to achieve upward educational mobility across generations, and study differences in the factors, which contribute to differences in mobility for the two groups. We find that migrants’ descendants are more often upwardly mobile (and less often downwardly mobile) than their native peers in the majority of countries studied, and show that the main factor contributing to these patterns is the education level of parents. Although a lower parental education means that their children are less likely to access the same amount of human, social and financial capital as children of more highly educated parents, migrants’ descendants over the last two generations were able to make significant progress in reducing education gaps with natives. PMID:28620245
Contributions of mobile technologies to addiction research
Swendsen, Joel
2016-01-01
Mobile technologies are revolutionizing the field of mental health, and particular progress has been made in their application to addiction research and treatment. The use of smartphones and other mobile devices has been shown to be feasible with individuals addicted to any of a wide range of substances, with few biases being observed concerning the repeated monitoring of daily life experiences, craving, or substance use. From a methodological point of view, the use of mobile technologies overcomes longstanding limitations of traditional clinical research protocols, including the more accurate assessment of temporal relationships among variables, as well as the reduction in both contextual constraints and discipline-specific methodological isolation. The present article presents a conceptual review of these advances while using illustrations of research applications that are capable of overcoming specific methodological barriers. Finally, a brief review of both the benefits and risks of mobile technology use for the treatment of patients will be addressed. PMID:27489461
Lamarche, Kimberley; Park, Caroline; Fraser, Shawn; Rich, Mariann; MacKenzie, Susan
2016-01-01
The use of mobile devices by nurse practitioners (NPs) to meet an evolving technological landscape is expanding rapidly. A longitudinal study of the ways NP students "normalize" the use of mobile devices in clinical education was completed. This study used researcher-designed survey tools, including sociodemographic questions, and the numerical picture was augmented and interpreted in light of the textual data in the form of selected interviews. Data indicate that mobile technology is normalized in the social realm but still developing in the clinical realm. Progress is hindered by non-modelling by faculty, inconsistent healthcare policy and lack of understanding of the affordances available through this technology. Overall, mobile technology is utilized and normalized in practice; this in turn has influenced their ability to prepare students for practice. Data presented can assist educators and clinicians alike in developing a more fulsome understanding on how to appropriately incorporate mobile technology into education and practice.
What Do Mobiles Speak in Algeria? Evidence from SMS Language
ERIC Educational Resources Information Center
Mostari, Hind Amel
2009-01-01
When Algeria opened its markets to foreign investment starting from the early 2000s, a technological boom occurred, including the expansion of mobile phone use. New technologies have had a considerable impact on the Algerian diglossic situation, in recent decades, and have contributed in the democratisation of the local dialects, which are being…
School Mobility during Childhood Predicts Psychotic Symptoms in Late Adolescence
ERIC Educational Resources Information Center
Winsper, Catherine; Wolke, Dieter; Bryson, Alex; Thompson, Andrew; Singh, Swaran P.
2016-01-01
Background: Recently, school mobility was identified as a risk factor for psychotic symptoms in early adolescence. The extent to which this risk continues into late adolescence and the trajectories via which this risk manifests remain unexplored. Methods: Psychotic symptoms in 4,720 adolescents aged 18 were ascertained by trained psychologists…
ERIC Educational Resources Information Center
Schnepp, Jerry; Rogers, Christian
2017-01-01
Aim/Purpose: To examine the early perceptions (acceptability) and usability of EASEL (Education through Application-Supported Experiential Learning), a mobile platform that delivers reflection prompts and content before, during, and after an experiential learning activity. Background: Experiential learning is an active learning approach in which…
Vocational Education's Role in Impacting on Adult Unemployment and Job Mobility.
ERIC Educational Resources Information Center
Reid, Charles L., III
In order to impact on unemployment of adults and to increase job mobility, the following needs must be met: an increased number of adequate delivery systems; improved teacher education and guidance and counseling programs; early exposure to career development with equal, if not greater, emphasis placed on vocational education; identification of…
Miller, Wayne L; Borgeson, Daniel D; Grantham, J Aaron; Luchner, Andreas; Redfield, Margaret M; Burnett, John C
2015-02-01
Aldosterone activation is central to the sodium–fluid retention that marks the progression of heart failure (HF). The actions of dietary sodium restriction, a mainstay in HF management, on cardiorenal and neuroendocrine adaptations during the progression of HF are poorly understood. The study aim was to assess the role of dietary sodium during the progression of experimental HF. Experimental HF was produced in a canine model by rapid right ventricular pacing which evolves from early mild HF to overt, severe HF. Dogs were fed one of three diets: (i) high sodium [250 mEq (5.8 g) per day, n =6]; (ii) standard sodium [58 mEq (1.3 g) per day, n =6]; and (iii) sodium restriction [11 mEq (0.25 g) per day, n =6]. During the 38-day study, haemodynamics, renal function, plasma renin activity (PRA), and aldosterone were measured. Changes in haemodynamics at 38 days were similar in all three groups, as were changes in renal function. Aldosterone activation was demonstrated in all three groups; however, dietary sodium restriction, in contrast to high sodium, resulted in early (10 days) activation of PRA and aldosterone. High sodium demonstrated significant suppression of aldosterone activation over the course of HF progression. Excessive dietary sodium restriction particularly in early stage HF results in early aldosterone activation, while normal and excess sodium intake are associated with delayed or suppressed activation. These findings warrant evaluation in humans to determine if dietary sodium manipulation, particularly during early stage HF, may have a significant impact on neuroendocrine disease progression.
Mamme, Mesfin Haile; Köhn, Christoph; Deconinck, Johan; Ustarroz, Jon
2018-04-19
Fundamental understanding of the early stages of electrodeposition at the nanoscale is key to address the challenges in a wide range of applications. Despite having been studied for decades, a comprehensive understanding of the whole process is still out of reach. In this work, we introduce a novel modelling approach that couples a finite element method (FEM) with a random walk algorithm, to study the early stages of nanocluster formation, aggregation and growth, during electrochemical deposition. This approach takes into account not only electrochemical kinetics and transport of active species, but also the surface diffusion and aggregation of adatoms and small nanoclusters. The simulation results reveal that the relative surface mobility of the nanoclusters compared to that of the adatoms plays a crucial role in the early growth stages. The number of clusters, their size and their size dispersion are influenced more significantly by nanocluster mobility than by the applied overpotential itself. Increasing the overpotential results in shorter induction times and leads to aggregation prevalence at shorter times. A higher mobility results in longer induction times, a delayed transition from nucleation to aggregation prevalence, and as a consequence, a larger surface coverage of smaller clusters with a smaller size dispersion. As a consequence, it is shown that a classical first-order nucleation kinetics equation cannot describe the evolution of the number of clusters with time, N(t), in potentiostatic electrodeposition. Instead, a more accurate representation of N(t) is provided. We show that an evaluation of N(t), which neglects the effect of nanocluster mobility and aggregation, can induce errors of several orders of magnitude in the determination of nucleation rate constants. These findings are extremely important towards evaluating the elementary electrodeposition processes, considering not only adatoms, but also nanoclusters as building blocks.
McWilliams, David; Weblin, Jonathan; Atkins, Gemma; Bion, Julian; Williams, Jenny; Elliott, Catherine; Whitehouse, Tony; Snelson, Catherine
2015-02-01
Prolonged periods of mechanical ventilation are associated with significant physical and psychosocial adverse effects. Despite increasing evidence supporting early rehabilitation strategies, uptake and delivery of such interventions in Europe have been variable. The objective of this study was to evaluate the impact of an early and enhanced rehabilitation program for mechanically ventilated patients in a large tertiary referral, mixed-population intensive care unit (ICU). A new supportive rehabilitation team was created within the ICU in April 2012, with a focus on promoting early and enhanced rehabilitation for patients at high risk for prolonged ICU and hospital stays. Baseline data on all patients invasively ventilated for at least 5 days in the previous 12 months (n = 290) were compared with all patients ventilated for at least 5 days in the 12 months after the introduction of the rehabilitation team (n = 292). The main outcome measures were mobility level at ICU discharge (assessed via the Manchester Mobility Score), mean ICU, and post-ICU length of stay (LOS), ventilator days, and in-hospital mortality. The introduction of the ICU rehabilitation team was associated with a significant increase in mobility at ICU discharge, and this was associated with a significant reduction in ICU LOS (16.9 vs 14.4 days, P = .007), ventilator days (11.7 vs 9.3 days, P < .05), total hospital LOS (35.3 vs 30.1 days, P < .001), and in-hospital mortality (39% vs 28%, P < .05). A quality improvement strategy to promote early and enhanced rehabilitation within this European ICU improved levels of mobility at critical care discharge, and this was associated with reduced ICU and hospital LOS and reduced days of mechanical ventilation. Copyright © 2014 The Authors. Published by Elsevier Inc. All rights reserved.
Ke, Chih-Kun; Lin, Zheng-Hua
2015-09-01
The progress of information and communication technologies (ICT) has promoted the development of healthcare which has enabled the exchange of resources and services between organizations. Organizations want to integrate mobile devices into their hospital information systems (HIS) due to the convenience to employees who are then able to perform specific healthcare processes from any location. The collection and merage of healthcare data from discrete mobile devices are worth exploring possible ways for further use, especially in remote districts without public data network (PDN) to connect the HIS. In this study, we propose an optimal mobile service which automatically synchronizes the telecare file resources among discrete mobile devices. The proposed service enforces some technical methods. The role-based access control model defines the telecare file resources accessing mechanism; the symmetric data encryption method protects telecare file resources transmitted over a mobile peer-to-peer network. The multi-criteria decision analysis method, ELECTRE (Elimination Et Choice Translating Reality), evaluates multiple criteria of the candidates' mobile devices to determine a ranking order. This optimizes the synchronization of telecare file resources among discrete mobile devices. A prototype system is implemented to examine the proposed mobile service. The results of the experiment show that the proposed mobile service can automatically and effectively synchronize telecare file resources among discrete mobile devices. The contribution of this experiment is to provide an optimal mobile service that enhances the security of telecare file resource synchronization and strengthens an organization's mobility.
King, Laurie A; Horak, Fay B
2009-01-01
This article introduces a new framework for therapists to develop an exercise program to delay mobility disability in people with Parkinson disease (PD). Mobility, or the ability to efficiently navigate and function in a variety of environments, requires balance, agility, and flexibility, all of which are affected by PD. This article summarizes recent research identifying how constraints on mobility specific to PD, such as rigidity, bradykinesia, freezing, poor sensory integration, inflexible program selection, and impaired cognitive processing, limit mobility in people with PD. Based on these constraints, a conceptual framework for exercises to maintain and improve mobility is presented. An example of a constraint-focused agility exercise program, incorporating movement principles from tai chi, kayaking, boxing, lunges, agility training, and Pilates exercises, is presented. This new constraint-focused agility exercise program is based on a strong scientific framework and includes progressive levels of sensorimotor, resistance, and coordination challenges that can be customized for each patient while maintaining fidelity. Principles for improving mobility presented here can be incorporated into an ongoing or long-term exercise program for people with PD. PMID:19228832
King, Laurie A; Horak, Fay B
2009-04-01
This article introduces a new framework for therapists to develop an exercise program to delay mobility disability in people with Parkinson disease (PD). Mobility, or the ability to efficiently navigate and function in a variety of environments, requires balance, agility, and flexibility, all of which are affected by PD. This article summarizes recent research identifying how constraints on mobility specific to PD, such as rigidity, bradykinesia, freezing, poor sensory integration, inflexible program selection, and impaired cognitive processing, limit mobility in people with PD. Based on these constraints, a conceptual framework for exercises to maintain and improve mobility is presented. An example of a constraint-focused agility exercise program, incorporating movement principles from tai chi, kayaking, boxing, lunges, agility training, and Pilates exercises, is presented. This new constraint-focused agility exercise program is based on a strong scientific framework and includes progressive levels of sensorimotor, resistance, and coordination challenges that can be customized for each patient while maintaining fidelity. Principles for improving mobility presented here can be incorporated into an ongoing or long-term exercise program for people with PD.
25th anniversary article: key points for high-mobility organic field-effect transistors.
Dong, Huanli; Fu, Xiaolong; Liu, Jie; Wang, Zongrui; Hu, Wenping
2013-11-20
Remarkable progress has been made in developing high performance organic field-effect transistors (OFETs) and the mobility of OFETs has been approaching the values of polycrystalline silicon, meeting the requirements of various electronic applications from electronic papers to integrated circuits. In this review, the key points for development of high mobility OFETs are highlighted from aspects of molecular engineering, process engineering and interface engineering. The importance of other factors, such as impurities and testing conditions is also addressed. Finally, the current challenges in this field for practical applications of OFETs are further discussed. © 2013 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.
NASA Technical Reports Server (NTRS)
Kunze, M. E.
1985-01-01
A systematic investigation was undertaken to characterize population shifts that occur in cultured human embryonic kidney cells as a function of passage number in vitro after original explantation. This approach to cell population shift analysis follows the suggestion of Mehreshi, Klein and Revesz that perturbed cell populations can be characterized by electrophoretic mobility distributions if they contain subpopulations with different electrophoretic mobilities. It was shown that this is the case with early passage cultured human embryo cells.
Future mobile access for open-data platforms and the BBC-DaaS system
NASA Astrophysics Data System (ADS)
Edlich, Stefan; Singh, Sonam; Pfennigstorf, Ingo
2013-03-01
In this paper, we develop an open data platform on multimedia devices to act as marketplace of data for information seekers and data providers. We explore the important aspects of Data-as-a-Service (DaaS) service in the cloud with a mobile access point. The basis of the DaaS service is to act as a marketplace for information, utilizing new technologies and recent new scalable polyglot architectures based on NoSql databases. Whereas Open-Data platforms are beginning to be widely accepted, its mobile use is not. We compare similar products, their approach and a possible mobile usage. We discuss several approaches to address the mobile access as a native app, html5 and a mobile first approach together with the several frontend presentation techniques. Big data visualization itself is in the early days and we explore some possibilities to get big data / open data accessed by mobile users.
Early mobilization: Why, what for and how?
Miranda Rocha, A R; Martinez, B P; Maldaner da Silva, V Z; Forgiarini Junior, L A
2017-10-01
Early mobilization strategies in the intensive care unit may result in the prevention and reduction of polyneuromyopathy in the critical patient, improved quality of life, shortened ICU and hospital stay, and lesser mortality during hospitalization. However, it is well known that factors such as the protocol used, the population included in the studies, the timing of the strategy, the severity of the patients and different barriers directly influence the outcomes. This study examines the main protocols described in the literature and their associated results. The main techniques used were kinesitherapy, transfer and locomotion training, as well as neuromuscular electrical stimulation and cycle ergometry. Although two trials and a meta-analysis found no positive results with mobilization, programs that focus on specific populations, such as patients with weakness due to immobility and with preserved neuromuscular excitability can derive more positive effects from such treatment. Copyright © 2016 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.
Chemical studies of H chondrites. I - Mobile trace elements and gas retention ages
NASA Technical Reports Server (NTRS)
Lingner, David W.; Huston, Ted J.; Hutson, Melinda; Lipschutz, Michael E.
1987-01-01
Trends for 16 trace elements (Ag, As, Au, Bi, Cd, Co, Cs, Ga, In, K, Rb, Sb, Se, Te, Tl, and Zn), chosen to span a broad geochemical and thermal response range, in 44 H4-6 chondrites, differ widely from those in L4-6 chondrites. In particular, H chondrites classified as heavily shocked petrologically do not necessarily exhibit Ar-40 loss and vice versa. The clear-cut causal relationship between siderophile and mobile element loss with increasing late shock seen in L chondrites is not generally evident in the H group. H chondrite parent material experienced an early high temperature genetic episode that mobilized a substantial proportion of these trace elements so that later thermal episodes resulted in more subtle, collateral fractionations. Mildly shocked L chondrites escaped this early high temperature event, indicating that the two most numerous meteorite groups differ fundamentally in genetic history.
Schotanus, M G M; Pilot, P; Kaptein, B L; Draijer, W F; Tilman, P B J; Vos, R; Kort, N P
2017-09-01
A concern that arises with any new prosthesis is whether it will achieve satisfactory long-term implant stability. The gold standard of assessing the quality of fixation in a new or relatively new implant is to undertake a randomized controlled trial using radiostereometric analysis. It was hypothesized that both mobile-bearing total knee arthroplasty and fixed-bearing total knee arthroplasty have comparable migration patterns at 2-year follow-up. This study investigated two types of cemented total knee arthroplasty, the mobile- or fixed-bearing variant from the same family with use of radiostereometric analysis. This prospective, patient-blinded, randomized, controlled trial was designed to investigate early migration of the tibia component after two years of follow-up with use of radiostereometric analysis. A total of 50 patients were randomized to receive a mobile- or fixed-bearing TKA from the same family. Patients were evaluated during 2-year follow-up, including radiostereometric analysis, physical and clinical examination and patient reported outcome measures (PROMs). At two-year follow-up, the mean (±SD) maximum total point motion (MTPM) in the fixed-bearing group was 0.82 (±1.16) versus 0.92 mm (±0.64) in the mobile-bearing group (p = n.s) with the largest migration seen during the first 6 weeks (0.45 ± 0.32 vs. 0.54 ± 0.30). The clinical outcome and PROMs significantly improved within each group, not between both groups. Measuring early micromotion is useful for predicting clinical loosening that can lead to revision. The results of this study demonstrate that early migration of the mobile-bearing is similar to that of the fixed-bearing component at two years and was mainly seen in the first weeks after implantation. Randomized, single-blind, controlled trial, Level I.
SINEs of progress: Mobile element applications to molecular ecology.
Ray, David A
2007-01-01
Mobile elements represent a unique and under-utilized set of tools for molecular ecologists. They are essentially homoplasy-free characters with the ability to be genotyped in a simple and efficient manner. Interpretation of the data generated using mobile elements can be simple compared to other genetic markers. They exist in a wide variety of taxa and are useful over a wide selection of temporal ranges within those taxa. Furthermore, their mode of evolution instills them with another advantage over other types of multilocus genotype data: the ability to determine loci applicable to a range of time spans in the history of a taxon. In this review, I discuss the application of mobile element markers, especially short interspersed elements (SINEs), to phylogenetic and population data, with an emphasis on potential applications to molecular ecology.
Ultrahigh-mobility graphene devices from chemical vapor deposition on reusable copper
Banszerus, Luca; Schmitz, Michael; Engels, Stephan; Dauber, Jan; Oellers, Martin; Haupt, Federica; Watanabe, Kenji; Taniguchi, Takashi; Beschoten, Bernd; Stampfer, Christoph
2015-01-01
Graphene research has prospered impressively in the past few years, and promising applications such as high-frequency transistors, magnetic field sensors, and flexible optoelectronics are just waiting for a scalable and cost-efficient fabrication technology to produce high-mobility graphene. Although significant progress has been made in chemical vapor deposition (CVD) and epitaxial growth of graphene, the carrier mobility obtained with these techniques is still significantly lower than what is achieved using exfoliated graphene. We show that the quality of CVD-grown graphene depends critically on the used transfer process, and we report on an advanced transfer technique that allows both reusing the copper substrate of the CVD growth and making devices with mobilities as high as 350,000 cm2 V–1 s–1, thus rivaling exfoliated graphene. PMID:26601221
Wilson, George; Maume, David
2014-07-01
Within the context of the "particularistic mobility thesis" we examine racial differences in the incidence, and determinants of, as well as timing to, mobility into management across the critical early career years at a refined level, namely, when groups share similar white collar and blue collar jobs. Findings from a Panel Study of Income Dynamics sample of men support theory and indicate that from both job levels a racial hierarchy exists: African Americans have the lowest rate of mobility, reach management through a route that is relatively formal and structured by a traditional range of stratification-based causal factors and take longest to reach management. Whites, in contrast, have the highest mobility rate, reach management through a relatively informal path that is less structured by traditional stratification-based factors, and reach management the quickest, and, across all three issues Latinos occupy an intermediate ground between African Americans and Latinos. Further, as predicted by theory, racial differences, particularly, relative to whites, are greater among those tracked from blue collar jobs than white collar jobs. Discussed are implications of the findings for understanding racial disadvantage in the American labor market across the work-career and on an inter-generational basis. Copyright © 2014 Elsevier Inc. All rights reserved.
Doiron, Katherine A; Hoffmann, Tammy C; Beller, Elaine M
2018-03-27
Survivors of critical illness often experience a multitude of problems that begin in the intensive care unit (ICU) or present and continue after discharge. These can include muscle weakness, cognitive impairments, psychological difficulties, reduced physical function such as in activities of daily living (ADLs), and decreased quality of life. Early interventions such as mobilizations or active exercise, or both, may diminish the impact of the sequelae of critical illness. To assess the effects of early intervention (mobilization or active exercise), commenced in the ICU, provided to critically ill adults either during or after the mechanical ventilation period, compared with delayed exercise or usual care, on improving physical function or performance, muscle strength and health-related quality of life. We searched CENTRAL, MEDLINE, Embase and CINAHL. We searched conference proceedings, reference lists of retrieved articles, databases of trial registries and contacted experts in the field on 31 August 2017. We did not impose restrictions on language or location of publications. We included all randomized controlled trials (RCTs) or quasi-RCTs that compared early intervention (mobilization or active exercise, or both), delivered in the ICU, with delayed exercise or usual care delivered to critically ill adults either during or after the mechanical ventilation period in the ICU. Two researchers independently screened titles and abstracts and assessed full-text articles against the inclusion criteria of this review. We resolved any disagreement through discussion with a third review author as required. We presented data descriptively using mean differences or medians, risk ratios and 95% confidence intervals. A meta-analysis was not possible due to the heterogeneity of the included studies. We assessed the quality of evidence with GRADE. We included four RCTs (a total of 690 participants), in this review. Participants were adults who were mechanically ventilated in a general, medical or surgical ICU, with mean or median age in the studies ranging from 56 to 62 years. Admitting diagnoses in three of the four studies were indicative of critical illness, while participants in the fourth study had undergone cardiac surgery. Three studies included range-of-motion exercises, bed mobility activities, transfers and ambulation. The fourth study involved only upper limb exercises. Included studies were at high risk of performance bias, as they were not blinded to participants and personnel, and two of four did not blind outcome assessors. Three of four studies reported only on those participants who completed the study, with high rates of dropout. The description of intervention type, dose, intensity and frequency in the standard care control group was poor in two of four studies.Three studies (a total of 454 participants) reported at least one measure of physical function. One study (104 participants) reported low-quality evidence of beneficial effects in the intervention group on return to independent functional status at hospital discharge (59% versus 35%, risk ratio (RR) 1.71, 95% confidence interval (CI) 1.11 to 2.64); the absolute effect is that 246 more people (95% CI 38 to 567) per 1000 would attain independent functional status when provided with early mobilization. The effects on physical functioning are uncertain for a range measures: Barthel Index scores (early mobilization: median 75 control: versus 55, low quality evidence), number of ADLs achieved at ICU (median of 3 versus 0, low quality evidence) or at hospital discharge (median of 6 versus 4, low quality evidence). The effects of early mobilization on physical function measured at ICU discharge are uncertain, as measured by the Acute Care Index of Function (ACIF) (early mobilization mean: 61.1 versus control: 55, mean difference (MD) 6.10, 95% CI -11.85 to 24.05, low quality evidence) and the Physical Function ICU Test (PFIT) score (5.6 versus 5.4, MD 0.20, 95% CI -0.98 to 1.38, low quality evidence). There is low quality evidence that early mobilization may have little or no effect on physical function measured by the Short Physical Performance Battery score at ICU discharge from one study of 184 participants (mean 1.6 in the intervention group versus 1.9 in usual care, MD -0.30, 95% CI -1.10 to 0.50), or at hospital discharge (MD 0, 95% CI -1.00 to 0.90). The fourth study, which examined postoperative cardiac surgery patients did not measure physical function as an outcome.Adverse effects were reported across the four studies but we could not combine the data. Our certainty in the risk of adverse events with either mobilization strategy is low due to the low rate of events. One study reported that in the intervention group one out of 49 participants (2%) experienced oxygen desaturation less than 80% and one of 49 (2%) had accidental dislodgement of the radial catheter. This study also found cessation of therapy due to participant instability occurred in 19 of 498 (4%) of the intervention sessions. In another study five of 101 (5%) participants in the intervention group and five of 109 (4.6%) participants in the control group had postoperative pulmonary complications deemed to be unrelated to intervention. A third study found one of 150 participants in the intervention group had an episode of asymptomatic bradycardia, but completed the exercise session. The fourth study reported no adverse events. There is insufficient evidence on the effect of early mobilization of critically ill people in the ICU on physical function or performance, adverse events, muscle strength and health-related quality of life at this time. The four studies awaiting classification, and the three ongoing studies may alter the conclusions of the review once these results are available. We assessed that there is currently low-quality evidence for the effect of early mobilization of critically ill adults in the ICU due to small sample sizes, lack of blinding of participants and personnel, variation in the interventions and outcomes used to measure their effect and inadequate descriptions of the interventions delivered as usual care in the studies included in this Cochrane Review.
Morandi, Alessandro; Piva, Simone; Ely, E Wesley; Myatra, Sheila Nainan; Salluh, Jorge I F; Amare, Dawit; Azoulay, Elie; Bellelli, Giuseppe; Csomos, Akos; Fan, Eddy; Fagoni, Nazzareno; Girard, Timothy D; Heras La Calle, Gabriel; Inoue, Shigeaki; Lim, Chae-Man; Kaps, Rafael; Kotfis, Katarzyna; Koh, Younsuck; Misango, David; Pandharipande, Pratik P; Permpikul, Chairat; Cheng Tan, Cheng; Wang, Dong-Xin; Sharshar, Tarek; Shehabi, Yahya; Skrobik, Yoanna; Singh, Jeffrey M; Slooter, Arjen; Smith, Martin; Tsuruta, Ryosuke; Latronico, Nicola
2017-11-01
To assess the knowledge and use of the Assessment, prevention, and management of pain; spontaneous awakening and breathing trials; Choice of analgesia and sedation; Delirium assessment; Early mobility and exercise; and Family engagement and empowerment (ABCDEF) bundle to implement the Pain, Agitation, Delirium guidelines. Worldwide online survey. Intensive care. A cross-sectional online survey using the Delphi method was administered to intensivists worldwide, to assess the knowledge and use of all aspects of the ABCDEF bundle. There were 1,521 respondents from 47 countries, 57% had implemented the ABCDEF bundle, with varying degrees of compliance across continents. Most of the respondents (83%) used a scale to evaluate pain. Spontaneous awakening trials and spontaneous breathing trials are performed in 66% and 67% of the responder ICUs, respectively. Sedation scale was used in 89% of ICUs. Delirium monitoring was implemented in 70% of ICUs, but only 42% used a validated delirium tool. Likewise, early mobilization was "prescribed" by most, but 69% had no mobility team and 79% used no formal mobility scale. Only 36% of the respondents assessed ICU-acquired weakness. Family members were actively involved in 67% of ICUs; however, only 33% used dedicated staff to support families and only 35% reported that their unit was open 24 hr/d for family visits. The current implementation of the ABCDEF bundle varies across individual components and regions. We identified specific targets for quality improvement and adoption of the ABCDEF bundle. Our data reflect a significant but incomplete shift toward patient- and family-centered ICU care in accordance with the Pain, Agitation, Delirium guidelines.
NASA Astrophysics Data System (ADS)
Vainshtein, Sergey N.; Duan, Guoyong; Mikhnev, Valeri A.; Zemlyakov, Valery E.; Egorkin, Vladimir I.; Kalyuzhnyy, Nikolay A.; Maleev, Nikolai A.; Näpänkangas, Juha; Sequeiros, Roberto Blanco; Kostamovaara, Juha T.
2018-05-01
Progress in terahertz spectroscopy and imaging is mostly associated with femtosecond laser-driven systems, while solid-state sources, mainly sub-millimetre integrated circuits, are still in an early development phase. As simple and cost-efficient an emitter as a Gunn oscillator could cause a breakthrough in the field, provided its frequency limitations could be overcome. Proposed here is an application of the recently discovered collapsing field domains effect that permits sub-THz oscillations in sub-micron semiconductor layers thanks to nanometer-scale powerfully ionizing domains arising due to negative differential mobility in extreme fields. This shifts the frequency limit by an order of magnitude relative to the conventional Gunn effect. Our first miniature picosecond pulsed sources cover the 100-200 GHz band and promise milliwatts up to ˜500 GHz. Thanks to the method of interferometrically enhanced time-domain imaging proposed here and the low single-shot jitter of ˜1 ps, our simple imaging system provides sufficient time-domain imaging contrast for fresh-tissue terahertz histology.
Slowdown of surface diffusion during early stages of bacterial colonization
NASA Astrophysics Data System (ADS)
Vourc'h, T.; Peerhossaini, H.; Léopoldès, J.; Méjean, A.; Chauvat, F.; Cassier-Chauvat, C.
2018-03-01
We study the surface diffusion of the model cyanobacterium Synechocystis sp. PCC6803 during the incipient stages of cell contact with a glass surface in the dilute regime. We observe a twitching motility with alternating immobile tumble and mobile run periods, resulting in a normal diffusion described by a continuous-time random walk with a coefficient of diffusion D . Surprisingly, D is found to decrease with time down to a plateau. This is observed only when the cyanobacterial cells are able to produce released extracellular polysaccharides, as shown by a comparative study between the wild-type strain and various polysaccharides-depleted mutants. The analysis of the trajectories taken by the bacterial cells shows that the temporal characteristics of their intermittent motion depend on the instantaneous fraction of visited sites during diffusion. This describes quantitatively the time dependence of D , related to the progressive surface coverage by the polysaccharides. The observed slowdown of the surface diffusion may constitute a basic precursor mechanism for microcolony formation and provides clues for controlling biofilm formation.
Novel therapeutic strategies targeting innate immune responses and early inflammation after stroke.
Shichita, Takashi; Ago, Tetsuro; Kamouchi, Masahiro; Kitazono, Takanari; Yoshimura, Akihiko; Ooboshi, Hiroaki
2012-11-01
Post-ischemic inflammation is an essential step in the progression of ischemic stroke. This review focuses on the function of infiltrating immune cells, macrophages, and T cells, in ischemic brain injury. The brain is a sterile organ; however, the activation of Toll-like receptor (TLR) 2 and TLR4 is pivotal in the beginning of post-ischemic inflammation. Some endogenous TLR ligands are released from injured brain cells, including high mobility group box 1 and peroxiredoxin family proteins, and activate the infiltrating macrophages and induce the expression of inflammatory cytokines. Following this step, T cells also infiltrate into the ischemic brain and mediate post-ischemic inflammation in the delayed phase. Various cytokines from helper T cells and γδT cells function as neurotoxic (IL-23/IL-17, IFN-γ) or neuroprotective (IL-10, IL-4) mediators. Novel neuroprotective strategies should therefore be developed through more detailed understanding of this process and the regulation of post-ischemic inflammation. © 2012 The Authors Journal of Neurochemistry © International Society for Neurochemistry.
'Poisonous, filthy, loathsome, damnable stuff': the rhetorical ecology of vaccination concern.
Hausman, Bernice L; Ghebremichael, Mecal; Hayek, Philip; Mack, Erin
2014-12-01
In this article, we analyze newspaper articles and advertisements mentioning vaccination from 1915 to 1922 and refer to historical studies of vaccination practices and attitudes in the early 20th century in order to assess historical continuities and discontinuities in vaccination concern. In the Progressive Era period, there were a number of themes or features that resonated with contemporary issues and circumstances: 1) fears of vaccine contamination; 2) distrust of medical professionals; 3) resistance to compulsory vaccination; and 4) the local nature of vaccination concern. Such observations help scholars and practitioners understand vaccine skepticism as longstanding, locally situated, and linked to the sociocultural contexts in which vaccination occurs and is mandated for particular segments of the population. A rhetorical approach offers a way to understand how discourses are engaged and mobilized for particular purposes in historical contexts. Historically situating vaccine hesitancy and addressing its articulation with a particular rhetorical ecology offers scholars and practitioners a robust understanding of vaccination concerns that can, and should, influence current approaches to vaccination skepticism.
Characteristics of dislocation structure in creep deformed lamellar tial alloy within primary regime
NASA Astrophysics Data System (ADS)
Cho, H. S.; Nam, Soo W.
1999-06-01
In this investigation, dislocations of a lamellar TiAl alloy are analyzed after creeping in the primary range at 800°C/200MPa in order to interpret their mobility It was found that the dislocation density in γ-laths decreased as the creep deformation proceeds within primary creep regime Schmid factor analysis suggests that the creep deformation in the early stage of the primary creep regime is controlled by the gliding of some of the initial dislocations which have a high enough Schmid factor As the creep deformation progressed, those dislocations with high Schmid factors slip preferentially to be annihilated at the α-γ interface For further continuous deformation, dislocation generation is required, and for this, α-phase is transformed to γ-phase in order to generate new dislocations A slow dislocation generation process by phase transformation of α-phase compared with the absorbing rate to sinks is responsible for the decreasing dislocation density as the creep strain increases
Point-of-care rare cell cancer diagnostics.
Issadore, David
2015-01-01
The sparse cells that are shed from tumors into peripheral circulation are an increasingly promising resource for noninvasive monitoring of cancer progression, early diagnosis of disease, and serve as a tool for improving our understanding of cancer metastasis. However, the extremely sparse concentration of circulating tumor cells (CTCs) in blood (~1-100 CTC in 7.5 mL of blood) as well as their heterogeneous biomarker expression has limited their detection using conventional laboratory techniques. To overcome these challenges, we have developed a microfluidic chip-based micro-Hall detector (μHD), which can directly measure single, immunomagnetically tagged cells in whole blood. The μHD can detect individual cells even in the presence of vast numbers of blood cells and unbound reactants, and does not require any washing or purification steps. Furthermore, this cost-effective, single-cell analytical technique is well suited for miniaturization into a mobile platform for low-cost point-of-care use. In this chapter, we describe the methodology used to design, fabricate, and apply these chips to cancer diagnostics.
High-resolution isotopic evidence of specialised cattle herding in the European Neolithic
Doppler, Thomas; Heyd, Volker; Knipper, Corina; Kuhn, Thomas; Lehmann, Moritz F.; Pike, Alistair W. G.; Schibler, Jörg
2017-01-01
Reconstructing stock herding strategies and land use is key to comprehending past human social organization and economy. We present laser-ablation strontium and carbon isotope data from 25 cattle (Bos taurus) to reconstruct mobility and infer herding management at the Swiss lakeside settlement of Arbon Bleiche 3, occupied for only 15 years (3384–3370 BC). Our results reveal three distinct isotopic patterns that likely reflect different herding strategies: 1) localized cattle herding, 2) seasonal movement, and 3) herding away from the site year-round. Different strategies of herding are not uniformly represented in various areas of the settlement, which indicates specialist modes of cattle management. The pressure on local fodder capacities and the need for alternative herding regimes must have involved diverse access to grazing resources. Consequently, the increasing importance of cattle in the local landscape was likely to have contributed to the progress of socio-economic differentiation in early agricultural societies in Europe. PMID:28746367
Increased gluconeogenesis in hyper-G stressed rats
NASA Technical Reports Server (NTRS)
Daligcon, B. C.; Oyama, J.
1982-01-01
The role of gluconeogenesis in the altered carbohydrate metabolism in rats exposed to hyper-G stress is investigated. The blood levels of the substrates and hormones involved in gluconeogenesis were determined in rats exposed to 3.1 G for various time periods (0.25 to 24 hr). It is found that hyper-G stressed rats showed an immediate increase in plasma glucose at the onset of centrifugation which persisted throughout all the exposure periods. A substantial part of the initial rise in blood glucose is attributed to an increased rate of gluconeogenesis. An increase in liver glycogen deposition was observed in centrifuged rats as early as 0.50 hr exposure time, with progressively larger amounts accumulated as the exposure time was extended to 24 hr. It is concluded that the increase in gluconeogenic activity of hyper-G stressed rats is due to an increase in the mobilization of gluconeogenic substrates from perpheral tissues to the liver as a result of increases in circulating catecholamines and glucagon.
Systems Biology and Biomechanical Model of Heart Failure
Louridas, George E; Lourida, Katerina G
2012-01-01
Heart failure is seen as a complex disease caused by a combination of a mechanical disorder, cardiac remodeling and neurohormonal activation. To define heart failure the systems biology approach integrates genes and molecules, interprets the relationship of the molecular networks with modular functional units, and explains the interaction between mechanical dysfunction and cardiac remodeling. The biomechanical model of heart failure explains satisfactorily the progression of myocardial dysfunction and the development of clinical phenotypes. The earliest mechanical changes and stresses applied in myocardial cells and/or myocardial loss or dysfunction activate left ventricular cavity remodeling and other neurohormonal regulatory mechanisms such as early release of natriuretic peptides followed by SAS and RAAS mobilization. Eventually the neurohormonal activation and the left ventricular remodeling process are leading to clinical deterioration of heart failure towards a multi-organic damage. It is hypothesized that approaching heart failure with the methodology of systems biology we promote the elucidation of its complex pathophysiology and most probably we can invent new therapeutic strategies. PMID:22935019
Olson, Christine M
2016-07-17
e- and m-Health communication technologies are now common approaches to improving population health. The efficacy of behavioral nutrition interventions using e-health technologies to decrease fat intake and increase fruit and vegetable intake was demonstrated in studies conducted from 2005 to 2009, with approximately 75% of trials showing positive effects. By 2010, an increasing number of behavioral nutrition interventions were focusing on body weight. The early emphasis on interventions that were highly computer tailored shifted to personalized electronic interventions that included weight and behavioral self-monitoring as key features. More diverse target audiences began to participate, and mobile components were added to interventions. Little progress has been made on using objective measures rather than self-reported measures of dietary behavior. A challenge for nutritionists is to link with the private sector in the design, use, and evaluation of the many electronic devices that are now available in the marketplace for nutrition monitoring and behavioral change.
NASA Astrophysics Data System (ADS)
Giunta, G.; Nigro, F.
1999-12-01
The Peloritani thrust belt belongs to the southern sector of the Calabrian Arc and is formed by a set of south-verging tectonic units, including crystalline basement and sedimentary cover (from the top: Aspromonte U.; Mela U.; Mandanici U.; Fondachelli U.; Longi-Taormina U.), piled up starting from Late Oligocene. At least two main terrigenous clastic formations lie with complicated relationships on top of the previous units: the Frazzanò Fm (Oligocene) and the Stilo-Capo d'Orlando Fm (Late Oligocene?-Early Miocene), as syn-to-post-tectonic deposits. These clastic deposits have different characteristics, in space and time, representing or flysch-like sequences involved in several thrust events (Frazzanò Fm) or molassic-like sequences (Stilo-Capo d'Orlando Fm), which unconformably overlie the tectonic units. In the present paper we describe a kinematic model of the progressive foreland migration of the Peloritani thrust belt, starting from Oligocene, carrying piggy-back basins and incorporating foredeep deposits, recognised in the Frazzanò-Stilo-Capo d'Orlando terrigenous successions. In general, the facies and structural observations on the overall Oligo-Miocene clastic sequences, outcropping in the Western Peloritani Mts, indicate: (a) the distal character of the Frazzanò Fm; (b) a complex group of terrigenous facies of the Stilo-Capo d'Orlando Fm, with lateral-to-vertical organisation, characterised by a distal-to-proximal-to-distal facies trend; (c) facies analogies of the basal portions of the Stilo-Capo d'Orlando Fm with the Frazzanò Fm; (d) the involvement of the Frazzanò Fm in lowermost and more external thrusting, and of the basal (Late Oligocene?) distal Stilo-Capo d'Orlando facies in the higher and inner thrusting during the early stages of deformation; (e) the involvement of the proximal Stilo-Capo d'Orlando facies in the tectonic edifice during the Early Miocene deformation; (f) the generally unconformable stratigraphical contacts of the higher proximal-to-distal (Early Miocene) Stilo-Capo d'Orlando facies on the constructing mobile belt; and (g) the presence of various thrust-faults, distinguished in a sequential order. The collected data allow us to hypothesise that the Oligo-Miocene tectono-sedimentary history was characterised by a foredeep with a deforming internal flank, probably lying in onlap on the constructing tectonic edifice (Frazzanò-lower Stilo-Capo d'Orlando Fms), and then deformed and covered by a piggy-back like sequence (middle-upper Stilo-Capo d'Orlando Fm), which was subsequently also deformed. The tectono-sedimentary evolution of the Peloritani belt has been probably developed through a progressive migration towards the foreland of a foredeep-compressional front couple and the chain body. The thrust stack progressively incorporates terrigenous foredeep deposits and in turn carried piggy-back basins.
The prevalence and usage of mobile health applications among mental health patients in Saudi Arabia.
Atallah, Nora; Khalifa, Mohamed; El Metwally, Ashraf; Househ, Mowafa
2018-03-01
Mobile health (mHealth) applications provide new methods of engagement with patients and can help patients manage their mental health condition. The main objective of this study is to explore the prevalence of the use of mobile health applications for mental health patients in Saudi Arabia. A total of 376 participants with depression and/or anxiety completed an online survey distributed by social networks which asked questions relating to mobile phone ownership, uses of health applications, and utilization patterns to track mental health related issues. Approximately, 46% of the participants reported running one or two healthcare related applications on their mobile phones. In all age groups, 64% of the participants used their mobile phones to access information related to their own health. Also, 64% of the participants expressed interest in using their own mobile phones to track and follow the progression of their depression and/or anxiety. Developing mobile health applications for Saudi mental health patients is needed since it can offer opportunities for patients, researchers, caregivers, and legislators to work together to improve the state of mental health care in Saudi Arabia. Copyright © 2017 Elsevier B.V. All rights reserved.
Helmhout, Pieter H; Witjes, Marloes; Nijhuis-VAN DER Sanden, Ria W; Bron, Carel; van Aalst, Michiel; Staal, J Bart
2017-04-01
It is assumed that low back pain patients who use pain-avoiding immobilizing strategies may benefit from specific back flexion and extension exercises aimed at reducing sagittal lumbar hypomobility. The aim of this study was to test this potential working mechanism in chronic low back pain patients undergoing lumbar extensor strengthening training. A single-group prospective cohort design was used in this study. Patients with persistent low back complaints for at least 2 years were recruited at a specialized physical therapy clinics center. They participated in a progressive 11-week lumbar extensor strength training program, once a week. At baseline, sagittal lumbar mobility in flexion and extension was measured with a computer-assisted inclinometer. Self-rated pain intensity was measured using a visual analogue scale, back-specific functional status was assessed with the Quebec Back Pain Disability Scale and the Patient Specific Complains questionnaire. Statistically significant improvements were found in pain (28% decrease) and functional disability (23% to 36% decrease). Most progress was seen in the first 5 treatment weeks. Lumbar mobility in flexion showed non-significant increases over time (+12%). Pre-post treatment changes in flexion and extension mobility did not contribute significantly to the models. The retained factors together explained 15% to 48% of the variation in outcome. Specific lumbar strengthening showed clinically relevant improvements in pain and disability in patients with persistent chronic low back pain. These improvements did not necessarily relate to improvements in lumbar mobility. Parameters representing other domains of adaptations to exercise may be needed to evaluate the effects of back pain management.
Rocha, Natalia G.; Sales, Allan R. K.; Penedo, Leticia A.; Pereira, Felipe S.; Silva, Mayra S.; Miranda, Renan L.; Silva, Jemima F. R.; Silva, Bruno M.; Santos, Aline A.; Nobrega, Antonio C. L.
2015-01-01
Increased levels of adhesion molecules or metalloproteinases (MMPs) may indicate endothelial dysfunction. Exercise mobilizes circulating angiogenic cells (CACs) from bone marrow in healthy subjects, improving vascular function. However, it is unclear whether this mechanism is preserved in the early stages of metabolic syndrome (early MetS). We aimed to evaluate the acute effects of exercise on adhesion molecules, angiogenic factors, MMPs, and CACs in early MetS. Fifteen subjects with early MetS and nine healthy controls underwent an exercise session and a nonexercise session, randomly. Adhesion molecules, angiogenic factors, CACs, and MMPs were evaluated before and after exercise or nonexercise sessions. At baseline, levels of sE-selectin, sICAM-1, and MMP-9 were higher in early MetS than in controls (P ≤ 0.03). After exercise, sE-selectin, sICAM-1, and MMP-9 levels were still higher in early MetS (P < 0.05). Subjects with early MetS presented less CACs (P = 0.02) and higher MMP-9 activity (P ≤ 0.04), while healthy controls presented higher MMP-2 activity after exercise. There was no difference between moments in nonexercise session (P > 0.05). In conclusion, subjects with early MetS already presented impaired endothelial function at rest along with a decrease in CACs and an increase in MMP-9 activity in response to exercise. PMID:26557715
Rocha, Natalia G; Sales, Allan R K; Penedo, Leticia A; Pereira, Felipe S; Silva, Mayra S; Miranda, Renan L; Silva, Jemima F R; Silva, Bruno M; Santos, Aline A; Nobrega, Antonio C L
2015-01-01
Increased levels of adhesion molecules or metalloproteinases (MMPs) may indicate endothelial dysfunction. Exercise mobilizes circulating angiogenic cells (CACs) from bone marrow in healthy subjects, improving vascular function. However, it is unclear whether this mechanism is preserved in the early stages of metabolic syndrome (early MetS). We aimed to evaluate the acute effects of exercise on adhesion molecules, angiogenic factors, MMPs, and CACs in early MetS. Fifteen subjects with early MetS and nine healthy controls underwent an exercise session and a nonexercise session, randomly. Adhesion molecules, angiogenic factors, CACs, and MMPs were evaluated before and after exercise or nonexercise sessions. At baseline, levels of sE-selectin, sICAM-1, and MMP-9 were higher in early MetS than in controls (P ≤ 0.03). After exercise, sE-selectin, sICAM-1, and MMP-9 levels were still higher in early MetS (P < 0.05). Subjects with early MetS presented less CACs (P = 0.02) and higher MMP-9 activity (P ≤ 0.04), while healthy controls presented higher MMP-2 activity after exercise. There was no difference between moments in nonexercise session (P > 0.05). In conclusion, subjects with early MetS already presented impaired endothelial function at rest along with a decrease in CACs and an increase in MMP-9 activity in response to exercise.
Tools of Engagement: Status Report on Technology in Early Childhood Education
ERIC Educational Resources Information Center
Simon, Fran; Donohue, Chip
2011-01-01
In recent years, a tidal wave of mobile digital devices and applications (apps) has found its way into the daily lives of early childhood professionals everywhere. It is safe to say that the speed at which new digital devices and apps get into people's hands will not slow down. This article presents a status report on technology in early childhood…
Advanced mobile satellite communications using COMETS satellite in MM-wave and Ka-band
NASA Technical Reports Server (NTRS)
Ohmori, Shingo; Isobe, Shunkichi; Takeuchi, Makoto; Naito, Hideyuki
1993-01-01
Early in the 21st century, the demand for personal communications using mobile, hand-held, and VSAT terminals will rapidly increase. In a future system, many different types of services should be provided with one-hop connection. The Communications Research Laboratory (CRL) has studied a future advanced mobile satellite communications system using millimeter wave and Ka band. In 1990, CRL started the Communications and Broadcasting Engineering Test Satellite (COMETS) project. The satellite has been developed in conjunction with NASDA and will be launched in 1997. This paper describes the COMETS payload configuration and the experimental system for the advanced mobile communications mission.
[Risk factors in the living environment of early spontaneous abortion pregnant women].
Liu, Xin-yan; Bian, Xu-ming; Han, Jing-xiu; Cao, Zhao-jin; Fan, Guang-sheng; Zhang, Chao; Zhang, Wen-li; Zhang, Shu-zhen; Sun, Xiao-guang
2007-10-01
To study the relationship between early spontaneous abortion and living environment, and explore the risk factors of spontaneous abortion. We conducted analysis based on the interview of 200 spontaneous abortion cases and the matched control (age +/- 2 years) by using multifactor Logistic regression analysis. The proportions of watching TV > or =10 hours/week, operating computer > or =45 hours/week, using copycat, microwave oven and mobile phone, electromagnetism equipment near the dwell or work place, e. g. switch room < or =50 m and launching tower < or =500 m in the cases are significantly higher than those in the controls in single factor analysis (all P < 0.05). After adjusted the effect of other risk factors by multifactor analysis, using microwave oven and mobile phone, contacting abnormal smell of fitment material > or =3 months, having emotional stress during the first term of pregnancy and spontaneous abortion history were significantly associated with risk of spontaneous abortion. The odds ratios of these risk factors were 2.23 and 4.63, respectively. Using microwave oven and mobile phone, contacting abnormal smell of fitment material > or =3 months, having emotional stress during the first term of pregnancy, and spontaneous abortion history are risk factors of early spontaneous abortion.
ERIC Educational Resources Information Center
Nager, Nancy, Ed.; Shapiro, Edna K., Ed.
This book reviews the history of the developmental-interactive approach, a formulation rooted in developmental psychology and educational practice, progressively informing educational thinking since the early 20th century. The book describes and analyzes key assumptions and assesses the compatibility of new theoretical approaches, focuses on…
Program Monitoring Practices for Teachers of the Deaf and Hard of Hearing in Early Intervention
ERIC Educational Resources Information Center
Thomas, Anne E.; Marvin, Christine A.
2016-01-01
Program monitoring is an important and necessary assessment practice within the field of early childhood deaf education. Effective program monitoring requires a focus on both the consistent implementation of intervention strategies (fidelity) and the assessment of children's ongoing progress in response to interventions (progress monitoring).…
Shuttle Risk Progression by Flight
NASA Technical Reports Server (NTRS)
Hamlin, Teri; Kahn, Joe; Thigpen, Eric; Zhu, Tony; Lo, Yohon
2011-01-01
Understanding the early mission risk and progression of risk as a vehicle gains insights through flight is important: . a) To the Shuttle Program to understand the impact of re-designs and operational changes on risk. . b) To new programs to understand reliability growth and first flight risk. . Estimation of Shuttle Risk Progression by flight: . a) Uses Shuttle Probabilistic Risk Assessment (SPRA) and current knowledge to calculate early vehicle risk. . b) Shows impact of major Shuttle upgrades. . c) Can be used to understand first flight risk for new programs.
Apollo 14 crewmembers sealed inside a Mobile Quarantine Facility
NASA Technical Reports Server (NTRS)
1971-01-01
Separated by aluminum and glass of their Mobile Quarantine Facility (MQF), the Apollo 14 crewmen visit with their families and friends upon arriving at Ellington Air Force Base in the early morning hours of February 12, 1971. Looking through the MQF window are Astronats Alan B Shepard Jr. (left); Stuart A Roosa (right); and Edgar D. Mitchell.
Mobiles for Literacy in Developing Countries: An Effectiveness Framework
ERIC Educational Resources Information Center
Wagner, Daniel A.; Castillo, Nathan M.; Murphy, Katie M.; Crofton, Molly; Zahra, Fatima Tuz
2014-01-01
In recent years, the advent of low-cost digital and mobile devices has led to a strong expansion of social interventions, including those that try to improve student learning and literacy outcomes. Many of these are focused on improving reading in low-income countries, and particularly among the most disadvantaged. Some of these early efforts have…
ERIC Educational Resources Information Center
Presser, Ashley Lewis; Busey, Amy
2016-01-01
This research brief describes the value of using mobile technologies in and out of elementary mathematics classrooms, and investigates the view that teachers may not be getting the guidance they need to best leverage those technologies. The authors explore three areas of concern: How can teachers use technology in developmentally appropriate ways…
Regulatory T-lymphocytes mediate amyotrophic lateral sclerosis progression and survival
Henkel, Jenny S; Beers, David R; Wen, Shixiang; Rivera, Andreana L; Toennis, Karen M; Appel, Joan E; Zhao, Weihua; Moore, Dan H; Powell, Suzanne Z; Appel, Stanley H
2013-01-01
In amyotrophic lateral sclerosis (ALS) mice, regulatory T-lymphocytes (Tregs) are neuroprotective, slowing disease progression. To address whether Tregs and FoxP3, a transcription factor required for Treg function, similarly influence progression rates of ALS patients, T-lymphocytes from patients were assessed by flow cytometry. Both numbers of Tregs and their FoxP3 protein expressions were reduced in rapidly progressing ALS patients and inversely correlated with progression rates. The mRNA levels of FoxP3, TGF-β, IL4 and Gata3, a Th2 transcription factor, were reduced in rapidly progressing patients and inversely correlated with progression rates. Both FoxP3 and Gata3 were accurate indicators of progression rates. No differences in IL10, Tbx21, a Th1 transcription factor or IFN-γ expression were found between slow and rapidly progressing patients. A 3.5-year prospective study with a second larger cohort revealed that early reduced FoxP3 levels were indicative of progression rates at collection and predictive of future rapid progression and attenuated survival. Collectively, these data suggest that Tregs and Th2 lymphocytes influence disease progression rates. Importantly, early reduced FoxP3 levels could be used to identify rapidly progressing patients. PMID:23143995
Tang, Qingping; Tan, Lihong; Li, Baojun; Huang, Xiaosong; Ouyang, Chunhong; Zhan, Hailan; Pu, Qinqin; Wu, Lixiang
2014-01-01
The commonly used therapeutic approach, the contemporary Bobath approach (CBA), is not sufficient to restore independent locomotion for individuals with severe motor deficit (SMD) after stroke. Therefore, we propose that the early sitting, standing, and walking in conjunction with the CBA (ECBA) be used to treat individuals with SMD after stroke. To investigate whether ECBA may enhance mobility and balance in subjects with SMD after stroke. Thirty-three men and 15 women, aged 60 to 74 years, with SMD after stroke were recruited for the study. CBA or ECBA was performed with the subjects 5 times per week in 50-minute sessions for 8 weeks. The Stroke Rehabilitation Assessment of Movement (STREAM) and the Berg Balance Scale were implemented before treatment and at 4 and 8 weeks after treatment, respectively. The STREAM scores indicated that ECBA was more efficient than the CBA intervention for lower extremity mobility, F(1, 46) = 24.0, P < .001, and basic mobility, F(1, 46) = 102.6, P < .001. Overall STREAM scores were higher in the ECBA group, F(1, 46) =24.1, P < .001, after 8 weeks of therapy. Balance scores of the ECBA subjects were higher than those of the CBA subjects after 8 weeks of therapy, F(1, 46) = 73.1, P < .001. However, there was no difference in upper extremity mobility between the 2 groups. ECBA is a valuable intervention to improve lower extremity mobility, basic mobility, and balance ability for individuals with SMD after stroke.
Stuiver, Martijn M; ten Tusscher, Marieke R; Agasi-Idenburg, Carla S; Lucas, Cees; Aaronson, Neil K; Bossuyt, Patrick M M
2015-02-13
Breast cancer-related lymphoedema can be a debilitating long-term sequela of breast cancer treatment. Several studies have investigated the effectiveness of different treatment strategies to reduce the risk of breast cancer-related lymphoedema. To assess the effects of conservative (non-surgical and non-pharmacological) interventions for preventing clinically-detectable upper-limb lymphoedema after breast cancer treatment. We searched the Cochrane Breast Cancer Group's (CBCG) Specialised Register, CENTRAL, MEDLINE, EMBASE, CINAHL, PEDro, PsycINFO, and the World Health Organization (WHO) International Clinical Trials Registry Platform in May 2013. Reference lists of included trials and other systematic reviews were searched. Randomised controlled trials that reported lymphoedema as the primary outcome and compared any conservative intervention to either no intervention or to another conservative intervention. Three authors independently assessed the risk of bias and extracted data. Outcome measures included lymphoedema, infection, range of motion of the shoulder, pain, psychosocial morbidity, level of functioning in activities of daily life (ADL), and health-related quality of life (HRQoL). Where possible, meta-analyses were performed. Risk ratio (RRs) or hazard ratio (HRs) were reported for dichotomous outcomes or lymphoedema incidence, and mean differences (MDs) for range of motion and patient-reported outcomes. Ten trials involving 1205 participants were included. The duration of patient follow-up ranged from 2 days to 2 years after the intervention. Overall, the quality of the evidence generated by these trials was low, due to risk of bias in the included trials and inconsistency in the results. Manual lymph drainageIn total, four studies used manual lymph drainage (MLD) in combination with usual care or other interventions. In one study, lymphoedema incidence was lower in patients receiving MLD and usual care (consisting of standard education or exercise, or both) compared to usual care alone. A second study reported no difference in lymphoedema incidence when MLD was combined with physiotherapy and education compared to physiotherapy alone. Two other studies combining MLD with compression and scar massage or exercise observed a reduction in lymphoedema incidence compared to education only, although this was not significant in one of the studies. Two out of the four studies reported on shoulder mobility where MLD combined with exercise gave better shoulder mobility for lateral arm movement (shoulder abduction) and forward flexion in the first weeks after breast cancer surgery, compared to education only (mean difference for abduction 22°; 95% confidence interval (CI) 14 to 30; mean difference for forward flexion 14°; 95% CI 7 to 22). Two of the studies on MLD reported on pain, with inconsistent results. Results on HRQoL in two studies on MLD were also contradictory. Exercise: early versus delayed start of shoulder mobilising exercisesThree studies examined early versus late start of postoperative shoulder exercises. The pooled relative risk of lymphoedema after an early start of exercises was 1.69 (95% CI 0.94 to 3.01, 3 studies, 378 participants). Shoulder forward flexion was better at one and six months follow-up for participants who started early with mobilisation exercises compared to a delayed start (two studies), but no meta-analysis could be performed due to statistical heterogeneity. There was no difference in shoulder mobility or self-reported shoulder disability at 12 months follow-up (one study). One study evaluated HRQoL and reported difference at one year follow-up (mean difference 1.6 points, 95% CI -2.14 to 5.34, on the Trial Outcome Index of the FACT-B). Two studies collected data on wound drainage volumes and only one study reported higher wound drainage volumes in the early exercise group. Exercise: resistance trainingTwo studies compared progressive resistance training to restricted activity. Resistance training after breast cancer treatment did not increase the risk of developing lymphoedema (RR 0.58; 95% CI 0.30 to 1.13, two studies, 358 participants) provided that symptoms are monitored and treated immediately if they occur. One out of the two studies measured pain where participants in the resistance training group reported pain more often at three months and six months compared to the control group. One study reported HRQoL and found no significant difference between the groups. Patient education, monitoring and early interventionOne study investigated the effects of a comprehensive outpatient follow-up programme, consisting of patient education, exercise, monitoring of lymphoedema symptoms and early intervention for lymphoedema, compared to education alone. Lymphoedema incidence was lower in the comprehensive outpatient follow-up programme (at any time point) compared to education alone (65 people). Participants in the outpatient follow-up programme had a significantly faster recovery of shoulder abduction compared to the education alone group. Based on the current available evidence, we cannot draw firm conclusions about the effectiveness of interventions containing MLD. The evidence does not indicate a higher risk of lymphoedema when starting shoulder-mobilising exercises early after surgery compared to a delayed start (i.e. seven days after surgery). Shoulder mobility (that is, lateral arm movements and forward flexion) is better in the short term when starting shoulder exercises earlier compared to later. The evidence suggests that progressive resistance exercise therapy does not increase the risk of developing lymphoedema, provided that symptoms are closely monitored and adequately treated if they occur.Given the degree of heterogeneity encountered, limited precision, and the risk of bias across the included studies, the results of this review should be interpreted with caution.
Stefanics, G; Thuróczy, G; Kellényi, L; Hernádi, I
2008-11-19
We investigated the potential effects of 20 min irradiation from a new generation Universal Mobile Telecommunication System (UMTS) 3G mobile phone on human event related potentials (ERPs) in an auditory oddball paradigm. In a double-blind task design, subjects were exposed to either genuine or sham irradiation in two separate sessions. Before and after irradiation subjects were presented with a random series of 50 ms tone burst (frequent standards: 1 kHz, P=0.8, rare deviants: 1.5 kHz, P=0.2) at a mean repetition rate of 1500 ms while electroencephalogram (EEG) was recorded. The subjects' task was to silently count the appearance of targets. The amplitude and latency of the N100, N200, P200 and P300 components for targets and standards were analyzed in 29 subjects. We found no significant effects of electromagnetic field (EMF) irradiation on the amplitude and latency of the above ERP components. In order to study possible effects of EMF on attentional processes, we applied a wavelet-based time-frequency method to analyze the early gamma component of brain responses to auditory stimuli. We found that the early evoked gamma activity was insensitive to UMTS RF exposition. Our results support the notion, that a single 20 min irradiation from new generation 3G mobile phones does not induce measurable changes in latency or amplitude of ERP components or in oscillatory gamma-band activity in an auditory oddball paradigm.
Shiroyama, Takayuki; Suzuki, Hidekazu; Tamiya, Motohiro; Tamiya, Akihiro; Tanaka, Ayako; Okamoto, Norio; Nakahama, Kenji; Taniguchi, Yoshihiko; Isa, Shun-Ichi; Inoue, Takako; Imamura, Fumio; Atagi, Shinji; Hirashima, Tomonori
2018-01-01
Programmed death-ligand 1 (PD-L1) expression status is inadequate for indicating nivolumab in patients with non-small cell lung cancer (NSCLC). Because the baseline advanced lung cancer inflammation index (ALI) is reportedly associated with patient outcomes, we investigated whether the pretreatment ALI is prognostic in NSCLC patients treated with nivolumab. We retrospectively reviewed the medical records of all patients treated with nivolumab for advanced NSCLC between December 2015 and May 2016 at three Japanese institutes. Multivariate logistic regression and Cox proportional hazards models were used to assess the impact of the pretreatment ALI (and other inflammation-related parameters) on progression-free survival (PFS) and early progression (i.e., within 8 weeks after starting nivolumab). A total of 201 patients were analyzed; their median age was 68 years (range, 27-87 years), 67% were men, and 24% had an Eastern Cooperative Oncology Group (ECOG) performance status of 2 or higher. An ECOG performance status ≥2, serum albumin <3.7 g/dL, neutrophil-to-lymphocyte ratio ≥4, and ALI <18 were significantly associated with poor PFS and early progression on univariate analysis. Multivariate analyses revealed that pretreatment ALI <18 was independently associated with inferior PFS (median, 1.4 vs. 3.7 months, P < 0.001) and a higher likelihood of early progression (odds ratio, 2.76; 95% confidence interval 1.44-5.34; P = 0.002). The pretreatment ALI was found to be a significant independent predictor of early progression in patients with advanced NSCLC receiving nivolumab, and may help identify patients likely to benefit from continued nivolumab treatment in routine clinical practice. © 2017 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Woolbright, Benjamin L.; Antoine, Daniel J.; Jenkins, Rosalind E.
Cholestasis is a pathological common component of numerous liver diseases that results in hepatotoxicity, inflammation, and cirrhosis when untreated. While the predominant hypothesis in cholestatic liver injury remains hepatocyte apoptosis due to direct toxicity of hydrophobic bile acid exposure, recent work suggests that the injury occurs through inflammatory necrosis. In order to resolve this controversy, we used novel plasma biomarkers to assess the mechanisms of cell death during early cholestatic liver injury. C57Bl/6 mice underwent bile duct ligation (BDL) for 6–72 h, or sham operation. Another group of mice were given D-galactosamine and endotoxin as a positive control for apoptosismore » and inflammatory necrosis. Plasma levels of full length cytokeratin-18 (FL-K18), microRNA-122 (miR-122) and high mobility group box-1 protein (HMGB1) increased progressively after BDL with peak levels observed after 48 h. These results indicate extensive cell necrosis after BDL, which is supported by the time course of plasma alanine aminotransferase activities and histology. In contrast, plasma caspase-3 activity, cleaved caspase-3 protein and caspase-cleaved cytokeratin-18 fragments (cK18) were not elevated at any time during BDL suggesting the absence of apoptosis. In contrast, all plasma biomarkers of necrosis and apoptosis were elevated 6 h after Gal/End treatment. In addition, acetylated HMGB1, a marker for macrophage and monocyte activation, was increased as early as 12 h but mainly at 48–72 h. However, progressive neutrophil accumulation in the area of necrosis started at 6 h after BDL. In conclusion, these data indicate that early cholestatic liver injury in mice is an inflammatory event, and occurs through necrosis with little evidence for apoptosis. - Highlights: • The mechanism of cell death during cholestasis remains a controversial topic. • Plasma biomarkers offer new insight into cell death after bile duct ligation. • Cytokeratin-18, microRNA-122 and HMGB1 levels implicate necrosis. • Acetylated HMGB1 levels rise late after BDL confirming inflammation. • BDL-induced liver injury involves mainly inflammation and necrosis but no apoptosis.« less
Mobile work: Ergonomics in a rapidly changing work environment.
Honan, Meg
2015-01-01
Places of work have been completely transformed by innovations in mobile work tools and ever-present access to internet data. This article characterizes use patterns and provides preliminary considerations for productive and comfortable use of common mobile devices. Two surveys described trends in mobile work. In the first, ergonomics professionals who oversee programs reported common mobile devices, their users and what data is accessed. The second, an end user survey, explored common activities performed on mobile devices, duration of use and locations where mobile work is common. The survey results provide a baseline data point for the status of mobile work in early 2014. Research indicates that additional risks have been introduced to the neck, thumbs and hands when using mobile devices. Possible trends regarding device use and work locations emerge. Intervention studies provide some direction for the practitioner. Practical strategies are outlined to reduce exposure intensity and duration. Contemporary mobile work presents tremendous change and opportunity for ergonomists and researchers to keep pace with fitting the changing models of work to the person. Continued research is needed on current mobile device use patterns to better understand ergonomic risk exposure in this rapidly changing realm.
Acharya, Sunil; Xu, Jia; Wang, Xiao; Jain, Shalini; Wang, Hai; Zhang, Qingling; Chang, Chia-Chi; Bower, Joseph; Arun, Banu; Seewaldt, Victoria; Yu, Dihua
2016-01-01
Tamoxifen and aromatase inhibitors (AIs) have shown efficacy in prevention of estrogen receptor-positive (ER+) breast cancer; however, there exists no proven prevention strategy for estrogen receptor-negative (ER-) breast cancer. Up to 40% of ER- breast cancers have human epidermal growth factor receptor 2 overexpression (HER2+), suggesting HER2 signaling might be a good target for chemoprevention for certain ER- breast cancers. Here, we tested the feasibility of the HER2-targeting agent lapatinib in prevention and/or early intervention of an ER-/HER2+ early-stage breast disease model. We found that lapatinib treatment forestalled the progression of atypical ductal hyperplasia (ADH)-like acini to ductal carcinoma in situ (DCIS)-like acini in ER-/HER2+ human mammary epithelial cells (HMECs) in 3D culture. Mechanistically, we found that inhibition of HER2/Akt signaling by lapatinib led to downregulation of GLUT4 and a reduced glucose uptake in HER2-overexpressing cells, resulting in decreased proliferation and increased apoptosis of these cells in 3D culture. Additionally, our data suggest that HER2-driven glycolytic metabolic dysregulation in ER-/HER2+ HMECs might promote early-stage breast disease progression, which can be reversed by lapatinib treatment. Furthermore, low-dose lapatinib treatment, starting at the early stages of mammary grand transformation in the MMTV-neu* mouse model, significantly delayed mammary tumor initiation and progression, extended tumor-free survival, which corresponded to effective inhibition of HER2/Akt signaling and downregulation of GLUT4 in vivo. Taken together, our results indicate that lapatinib, through its inhibition of key signaling pathways and tumor-promoting metabolic events, is a promising agent for the prevention/early intervention of ER-/HER2+ breast cancer progression. PMID:27293993
Effect of disease stage on progression of hydroxychloroquine retinopathy.
Marmor, Michael F; Hu, Julia
2014-09-01
Hydroxychloroquine sulfate retinopathy can progress after the drug is stopped. It is not clear how this relates to the stage of retinopathy or whether early screening with modern imaging technology can prevent progression and visual loss. To determine the relationship between progression of retinopathy and the severity of disease using objective data from optical coherence tomography and assess the value of early screening for the toxic effects of hydroxychloroquine. Clinical findings in patients with hydroxychloroquine retinopathy were monitored with repeated anatomical and functional examinations for 13 to 40 months after the drug was stopped in a referral practice in a university medical center. Eleven patients participated, with the severity of toxic effects categorized as early (patchy parafoveal damage shown on field or objective testing), moderate (a 50%-100% parafoveal ring of optical coherence tomography thinning but intact retinal pigment epithelium), and severe (visible bull's-eye damage). Visual acuity, white 10-2 visual field pattern density plots, fundus autofluorescence, spectral-density optical coherence tomography cross sections, thickness (from cube diagrams), and ellipsoid zone length. Visual acuity and visual fields showed no consistent change. Fundus autofluorescence showed little or no change except in severe cases in which the bull's-eye damage expanded progressively. Optical coherence tomography cross sections showed little visible change in early and moderate cases but progressive foveal thinning (approximately 7 μm/y) and loss of ellipsoid zone (in the range of 100 μm/y) in severe cases, which was confirmed by quantitative measurements. The measurements also showed some foveal thinning (approximately 4 μm/y) and deepening of parafoveal loss in moderate cases, but the breadth of the ellipsoid zone remained constant in both early and moderate cases. A few cases showed a suggestion of ellipsoid zone improvement. Patients with hydroxychloroquine retinopathy involving the retinal pigment epithelium demonstrated progressive damage on optical coherence tomography for at least 3 years after the drug was discontinued, including loss of foveal thickness and cone structure. Cases recognized before retinal pigment epithelium damage retained foveal architecture with little retinal thinning. Early recognition of hydroxychloroquine toxic effects before any fundus changes are visible, using visual fields and optical coherence tomography (along with fundus autofluorescence and multifocal electroretinography as indicated), will greatly minimize late progression and the risk of visual loss.
Klymiuk, Nikolai; Blutke, Andreas; Graf, Alexander; Krause, Sabine; Burkhardt, Katinka; Wuensch, Annegret; Krebs, Stefan; Kessler, Barbara; Zakhartchenko, Valeri; Kurome, Mayuko; Kemter, Elisabeth; Nagashima, Hiroshi; Schoser, Benedikt; Herbach, Nadja; Blum, Helmut; Wanke, Rüdiger; Aartsma-Rus, Annemieke; Thirion, Christian; Lochmüller, Hanns; Walter, Maggie C; Wolf, Eckhard
2013-11-01
Duchenne muscular dystrophy (DMD) is caused by mutations in the X-linked dystrophin (DMD) gene. The absence of dystrophin protein leads to progressive muscle weakness and wasting, disability and death. To establish a tailored large animal model of DMD, we deleted DMD exon 52 in male pig cells by gene targeting and generated offspring by nuclear transfer. DMD pigs exhibit absence of dystrophin in skeletal muscles, increased serum creatine kinase levels, progressive dystrophic changes of skeletal muscles, impaired mobility, muscle weakness and a maximum life span of 3 months due to respiratory impairment. Unlike human DMD patients, some DMD pigs die shortly after birth. To address the accelerated development of muscular dystrophy in DMD pigs when compared with human patients, we performed a genome-wide transcriptome study of biceps femoris muscle specimens from 2-day-old and 3-month-old DMD and age-matched wild-type pigs. The transcriptome changes in 3-month-old DMD pigs were in good concordance with gene expression profiles in human DMD, reflecting the processes of degeneration, regeneration, inflammation, fibrosis and impaired metabolic activity. In contrast, the transcriptome profile of 2-day-old DMD pigs showed similarities with transcriptome changes induced by acute exercise muscle injury. Our studies provide new insights into early changes associated with dystrophin deficiency in a clinically severe animal model of DMD.
da Silva, Marcos Barragan; Almeida, Miriam de Abreu; Panato, Bruna Paulsen; Siqueira, Ana Paula de Oliveira; da Silva, Mariana Palma; Reisderfer, Letícia
2015-01-01
to evaluate the clinical applicability of outcomes, according to the Nursing Outcomes Classification (NOC) in the evolution of orthopedic patients with Impaired Physical Mobility longitudinal study conducted in 2012 in a university hospital, with 21 patients undergoing Total Hip Arthroplasty, evaluated daily by pairs of trained data collectors. Data were collected using an instrument containing five Nursing Outcomes, 16 clinical indicators and a five point Likert scale, and statistically analyzed. The outcomes Body Positioning: self-initiated, Mobility, Knowledge: prescribed activity, and Fall Prevention Behavior presented significant increases in mean scores when comparing the first and final evaluations (p<0.001) and (p=0.035). the use of the NOC outcomes makes it possible to demonstrate the clinical progression of orthopedic patients with Impaired Physical Mobility, as well as its applicability in this context.
The Evolution of the Advanced Attack Helicopter
1975-06-06
p. 18. C. V. Glines (LTC, USA), "De Bothezat’s Flying Octopus ," Airman, Vol VI, No. I (January, 1962), 43. 29Ross, p. 58. 20 in his own right, being...AIR MOBILE OPIRATIONS, A Report for the Blue Ribbon Defense Panel by COL Jay D. Vanderpool, USA, Ret. (February 1970), 29. F. IY 70A Observation...not produce significant quantitative progress. -Attack Helicopters The Key to Army Air Mobile Operations, A Report for the Blue Ribbon Defense Panel by
ERIC Educational Resources Information Center
Hampton, David D.; Lembke, Erica S.; Lee, Young-Sun; Pappas, Sandra; Chiong, Cynthia; Ginsburg, Herbert P.
2012-01-01
The purpose of this study was to examine six early numeracy measures used to monitor the mathematics progress of kindergarten and first-grade students. Seventy-one kindergarten students and 75 first-grade students were administered the measures each week. Delayed-alternate form reliability was adequate for instructional decision making on some…
Early Childhood Education in Pakistan--Progress and Challenges
ERIC Educational Resources Information Center
Shami, Pervez A.
2009-01-01
This paper is on Early Childhood Education (ECE)--a goal of Education For All (EFA), assesses the progress of Pakistan's efforts and strategies mainly during post Dakar period 2001-02 to 2005-06 and the major challenges being encountered. The information includes analysis of National Educational Data on ECE in the light of policies and plans, EFA…
Multiple scales in metapopulations of public goods producers
NASA Astrophysics Data System (ADS)
Bauer, Marianne; Frey, Erwin
2018-04-01
Multiple scales in metapopulations can give rise to paradoxical behavior: in a conceptual model for a public goods game, the species associated with a fitness cost due to the public good production can be stabilized in the well-mixed limit due to the mere existence of these scales. The scales in this model involve a length scale corresponding to separate patches, coupled by mobility, and separate time scales for reproduction and interaction with a local environment. Contrary to the well-mixed high mobility limit, we find that for low mobilities, the interaction rate progressively stabilizes this species due to stochastic effects, and that the formation of spatial patterns is not crucial for this stabilization.
NASA Astrophysics Data System (ADS)
Le, Minh Tuan; Nguyen, Congdu; Yoon, Dae-Il; Jung, Eun Ku; Kim, Hae-Kwang
2007-12-01
In this paper, we introduce a graphics to Scalable Vector Graphics (SVG) adaptation framework with a mechanism of vector graphics transmission to overcome the shortcoming of real-time representation and interaction experiences of 3D graphics application running on mobile devices. We therefore develop an interactive 3D visualization system based on the proposed framework for rapidly representing a 3D scene on mobile devices without having to download it from the server. Our system scenario is composed of a client viewer and a graphic to SVG adaptation server. The client viewer offers the user to access to the same 3D contents with different devices according to consumer interactions.
Career mobility: equipping nurses for health care beyond the year 2000.
Doswell, W M
1996-01-01
Nurses are faced with uncertain employment in today's rapidly changing work place. The key to survival in this environment is to provide innovative, cost-effective, yet outcome-oriented methods of patient care delivery. Professional nurses and nursing students should make career mobility their watchword. Career mobility defines a planned trajectory which is flexible, role-expandable, and capable of adjusting to the sudden changes in direction which arise as nurses progress through their professional career. Nursing students must carefully examine the educational program they chose, and, once graduated, should use an innovative approach to the health care job market, with emphasis on professional nursing careers outside the traditional employment roles.
Active and reactive behaviour in human mobility: the influence of attraction points on pedestrians
NASA Astrophysics Data System (ADS)
Gutiérrez-Roig, M.; Sagarra, O.; Oltra, A.; Palmer, J. R. B.; Bartumeus, F.; Díaz-Guilera, A.; Perelló, J.
2016-07-01
Human mobility is becoming an accessible field of study, thanks to the progress and availability of tracking technologies as a common feature of smart phones. We describe an example of a scalable experiment exploiting these circumstances at a public, outdoor fair in Barcelona (Spain). Participants were tracked while wandering through an open space with activity stands attracting their attention. We develop a general modelling framework based on Langevin dynamics, which allows us to test the influence of two distinct types of ingredients on mobility: reactive or context-dependent factors, modelled by means of a force field generated by attraction points in a given spatial configuration and active or inherent factors, modelled from intrinsic movement patterns of the subjects. The additive and constructive framework model accounts for some observed features. Starting with the simplest model (purely random walkers) as a reference, we progressively introduce different ingredients such as persistence, memory and perceptual landscape, aiming to untangle active and reactive contributions and quantify their respective relevance. The proposed approach may help in anticipating the spatial distribution of citizens in alternative scenarios and in improving the design of public events based on a facts-based approach.
Active and reactive behaviour in human mobility: the influence of attraction points on pedestrians
Sagarra, O.; Oltra, A.; Palmer, J. R. B.; Bartumeus, F.; Díaz-Guilera, A.; Perelló, J.
2016-01-01
Human mobility is becoming an accessible field of study, thanks to the progress and availability of tracking technologies as a common feature of smart phones. We describe an example of a scalable experiment exploiting these circumstances at a public, outdoor fair in Barcelona (Spain). Participants were tracked while wandering through an open space with activity stands attracting their attention. We develop a general modelling framework based on Langevin dynamics, which allows us to test the influence of two distinct types of ingredients on mobility: reactive or context-dependent factors, modelled by means of a force field generated by attraction points in a given spatial configuration and active or inherent factors, modelled from intrinsic movement patterns of the subjects. The additive and constructive framework model accounts for some observed features. Starting with the simplest model (purely random walkers) as a reference, we progressively introduce different ingredients such as persistence, memory and perceptual landscape, aiming to untangle active and reactive contributions and quantify their respective relevance. The proposed approach may help in anticipating the spatial distribution of citizens in alternative scenarios and in improving the design of public events based on a facts-based approach. PMID:27493774
Exploring the read-write genome: mobile DNA and mammalian adaptation.
Shapiro, James A
2017-02-01
The read-write genome idea predicts that mobile DNA elements will act in evolution to generate adaptive changes in organismal DNA. This prediction was examined in the context of mammalian adaptations involving regulatory non-coding RNAs, viviparous reproduction, early embryonic and stem cell development, the nervous system, and innate immunity. The evidence shows that mobile elements have played specific and sometimes major roles in mammalian adaptive evolution by generating regulatory sites in the DNA and providing interaction motifs in non-coding RNA. Endogenous retroviruses and retrotransposons have been the predominant mobile elements in mammalian adaptive evolution, with the notable exception of bats, where DNA transposons are the major agents of RW genome inscriptions. A few examples of independent but convergent exaptation of mobile DNA elements for similar regulatory rewiring functions are noted.
Can we predict failure in couple therapy early enough to enhance outcome?
Pepping, Christopher A; Halford, W Kim; Doss, Brian D
2015-02-01
Feedback to therapists based on systematic monitoring of individual therapy progress reliably enhances therapy outcome. An implicit assumption of therapy progress feedback is that clients unlikely to benefit from therapy can be detected early enough in the course of therapy for corrective action to be taken. To explore the possibility of using feedback of therapy progress to enhance couple therapy outcome, the current study tested whether weekly therapy progress could detect off-track clients early in couple therapy. In an effectiveness trial of couple therapy, 136 couples were monitored weekly on relationship satisfaction and an expert derived algorithm was used to attempt to predict eventual therapy outcome. As expected, the algorithm detected a significant proportion of couples who did not benefit from couple therapy at Session 3, but prediction was substantially improved at Session 4 so that eventual outcome was accurately predicted for 70% of couples, with little improvement of prediction thereafter. More sophisticated algorithms might enhance prediction accuracy, and a trial of the effects of therapy progress feedback on couple therapy outcome is needed. Copyright © 2015 Elsevier Ltd. All rights reserved.
Deiber, Marie-Pierre; Ibañez, Vicente; Missonnier, Pascal; Herrmann, François; Fazio-Costa, Lara; Gold, Gabriel; Giannakopoulos, Panteleimon
2009-09-01
The electroencephalography (EEG) theta frequency band reacts to memory and selective attention paradigms. Global theta oscillatory activity includes a posterior phase-locked component related to stimulus processing and a frontal-induced component modulated by directed attention. To investigate the presence of early deficits in the directed attention-related network in elderly individuals with mild cognitive impairment (MCI), time-frequency analysis at baseline was used to assess global and induced theta oscillatory activity (4-6Hz) during n-back working memory tasks in 29 individuals with MCI and 24 elderly controls (EC). At 1-year follow-up, 13 MCI patients were still stable and 16 had progressed. Baseline task performance was similar in stable and progressive MCI cases. Induced theta activity at baseline was significantly reduced in progressive MCI as compared to EC and stable MCI in all n-back tasks, which were similar in terms of directed attention requirements. While performance is maintained, the decrease of induced theta activity suggests early deficits in the directed-attention network in progressive MCI, whereas this network is functionally preserved in stable MCI.
Robonaut 2 - Preparing for Intra-Vehicular Mobility on the International Space Station
NASA Technical Reports Server (NTRS)
Badger, Julia; Diftler, Myron; Hulse, Aaron; Taylor, Ross
2013-01-01
Robonaut 2 (R2) has been undergoing experimental trials on board the International Space Station (ISS) for more than a year. This upper-body anthropomorphic robotic system shown in Figure 1 has been making steady progress after completing its initial checkout. R2 demonstrated free space motion, physically interacted with its human crew mates, manipulated interfaces on its task board and has even used its first tool. This steady growth in capability will lead R2 to its next watershed milestone. Developers are currently testing prototype robotic climbing appendages and a battery backpack in preparation of sending flight versions of both subsystems to the ISS in late 2013. Upon integration of its new components, R2 will be able to go mobile inside the space station with a twofold agenda. First, R2 will learn to maneuver in microgravity in the best possible laboratory for such a task. Second, it will start providing early payback to the ISS program by helping with intra-vehicular (IVA) maintenance tasks. The experience gained inside the ISS will be invaluable in reducing risk when R2 moves to its next stage and is deployed as an extra-vehicular (EVA) tool. Even on its current fixed base stanchion, R2 has already shown its capability of performing several maintenance tasks on the ISS. It has measured the air flow through one of the stations vents and provided previously unavailable real time flow data to ground operators. R2 has cleaned its first handrail, exciting some crew members that perhaps Saturday morning housekeeping on the station may someday become a task they can hand off to their robotic colleague. Other tasks, including using radio frequency identification (RFID) tools for inventory tasks or vacuuming air filters, have also been suggested and will be explored. Once mobile, R2 will take on these tasks and more to free up crew time for more important science and exploration pursuits. In addition to task exploration, research and testing is happening on orbit to prepare for R2 mobility operations. The current vision system in R2 s head is being used to identify and localize IVA handrails throughout the US Lab and ground control software is being updated and integrated in advance of supporting mobility operations.
Modified Ride-on Toy Cars for Early Power Mobility: A Technical Report
Huang, Hsiang-han; Galloway, James C
2012-01-01
Background and Purpose Children with significantly decreased mobility have limited opportunities to explore their physical and social environment. A variety of assistive technologies are available to increase mobility, however no single device provides the level of functional mobility that typically developing children enjoy. The purpose of this technical report is to formally introduce a new power mobility option - the modified ride-on toy car. Key Points This report will provide a) an overview of toy car features, b) examples of basic electrical and mechanical modifications and c) a brief clinical case. Clinical Implications With creative use and customized modifications, toy cars function as a “general learning environment” for use in the clinic, home and school. As such, we anticipate that these cars will become a multi-use clinical tool to address not only mobility goals but also goals involving body function and structure such as posture and movement impairments. PMID:22466382
Modified ride-on toy cars for early power mobility: a technical report.
Huang, Hsiang-Han; Galloway, James C
2012-01-01
Children with significantly decreased mobility have limited opportunities to explore their physical and social environment. A variety of assistive technologies are available to increase mobility; however, no single device provides the level of functional mobility that children developing typically enjoy. The purpose of this technical report is to formally introduce a new power mobility option--the modified ride-on toy car. This report will provide (a) an overview of toy car features, (b) examples of basic electrical and mechanical modifications, and (c) a brief clinical case. With creative use and customized modifications, toy cars can function as a "general learning environment" for use in the clinic, home, and school. As such, we anticipate that these cars will become a multiuse clinical tool to address not only mobility goals but also goals involving body function and structure such as posture and movement impairments.
Collins, James W; Mariani, Allison; Rankin, Kristin
2018-03-01
Background The relationship between African-American women's upward economic mobility and small for gestational age (weight for gestational < 10th percentile, SGA) rates is incompletely understood. Objective To ascertain the extent to which African-American women's upward economic mobility from early-life impoverishment is coupled with reduced SGA rates. Methods Stratified and multilevel logistic regression analyses were completed on the Illinois transgenerational dataset of African-American infants (1989-1991) and their Chicago-born mothers (1956-1976) with linked U.S. census income information. Results Impoverished-born (defined as lowest quartile of neighborhood income distribution) African-American women (n = 4891) who remained impoverished by the time of delivery had a SGA rate of 19.7%. Individuals who achieved low (n = 5827), modest (n = 2254), or high (n = 732) upward economic mobility by adulthood had lower SGA rates of 17.2, 14.8, and 13.7%, respectively; RR = 0.9 (0.8-0.9), 0.8 (0.7-0.8), and 0.7 (0.6-0.8), respectively. In adjusted (controlling for traditional individual-level risk factors) multilevel regression models, there was a decreasing linear trend in SGA rates with increasing levels of upward economic mobility; the adjusted RR of SGA birth for impoverished-born African-American women who experienced low, modest, of high (compared to no) upward mobility equaled 0.95 (0.91, 0.99), 0.90 (0.83, 0.98), and 0.86 (0.75, 0.98), respectively, p < 0.05. Conclusions African-American women's upward economic mobility from early-life residence in poor urban communities is associated with lower SGA rates independent of adulthood risk status.
Ko, Young-Bong; Gujarathi, Manan Ramesh
2015-01-01
The purpose of this systematic review is to collate results of studies comparing fixed and mobile bearing unicompartmental knee arthroplasty (UKA), focusing on complications and timing for reoperations. Out of 723 results derived from PubMed, EMBASE and Cochrane database search engines on bearings in arthroplasty, 10 studies comparing clinical results of fixed bearings to mobile bearings in UKA were found eligible for analysis. The reoperation rate was calculated using a novel method such as reoperations per hundred component years, and the causes of specific reoperations were investigated. The overall reoperation rate per hundred component years was similar between the mobile bearings (1.392) and fixed bearings (1.377); however, mobile bearings were more susceptible to reoperations in cases with aseptic loosening (0.393>0.255), progression of arthritis (0.428>0.357) and implant dislocation (0.286>0). The overall incidence of complications is similar for fixed and mobile bearing designs in UKA. The discussion on complications presented above may assist surgeons in their choice of bearing design. PMID:26389066
ERIC Educational Resources Information Center
Pellerin, Martine
2014-01-01
This article examines how the use of mobile technologies (iPods and tablets) in language classrooms contributes to redesigning task-based approaches for young language learners. The article is based on a collaborative action research (CAR) project in Early French Immersion classrooms in the province of Alberta, Canada. The data collection included…
ERIC Educational Resources Information Center
Hargis, Jace; Cavanaugh, Cathy; Kamali, Tayeb; Soto, Melissa
2014-01-01
This article presents faculty perceptions of the first month of iPad deployment in a national college system and a case study describing the integration of mobile learning devices in one college, interpreted within the framework of a SWOT analysis. We include a brief history of the implementation; description of the three-tier structure of…
ERIC Educational Resources Information Center
Horta, Hugo
2013-01-01
This paper analyzes the impact of academic inbreeding in relation to academic research, and proposes a new conceptual framework for its analysis. We find that mobility (or lack of) at the early research career stage is decisive in influencing academic behaviors and scientific productivity. Less mobile academics have more inward oriented…
ERIC Educational Resources Information Center
Goldhaber, Dan; Gross, Betheny; Player, Daniel
2009-01-01
Most studies that have fueled alarm over the attrition and mobility rates of teachers have relied on proxy indicators of teacher quality, even though these proxies correlate only weakly with student performance. This paper examines the attrition and mobility of early-career teachers of varying quality using value-added measures of teacher…
ERIC Educational Resources Information Center
Lindberg, Matti E.
2009-01-01
This article addresses the question of how great are higher education students' incentives to change study programs or institutions to improve one's personal employability in the course of the higher education-to-work transition process. The posed question is addressed at a system level. Students' mobility between programs and institutions is…
Contemporary Mobilization of Legacy Pb Stores by DOM in a Boreal Peatland.
Jeremiason, Jeff D; Baumann, Erin I; Sebestyen, Stephen D; Agather, Alison M; Seelen, Emily A; Carlson-Stehlin, Benjamin J; Funke, Meghan M; Cotner, James B
2018-03-20
We examined how different landscape areas in a catchment containing a northern ombrotrophic peatland and upland mineral soils responded to dramatic decreases in atmospheric deposition of lead (Pb). Pb concentrations in the outflow stream from the peatland measured from 2009-2015 indicated continued mobilization and export of Pb derived from historic inputs to the bog. In contrast, Pb concentrations in surface peat and runoff from upland mineral soils have declined in response to reductions in atmospheric deposition. Relative to the early 1980s, Pb concentrations in the streamflow decreased only ∼50%, while Pb in surface peat and upland subsurface runoff decreased by more than 90%. Water level fluctuations in the slow-accumulating peat have allowed dissolved organic matter (DOM) to continue mobilizing Pb deposited in the peatland decades earlier. Strong correlations between dissolved organic carbon (DOC) and Pb concentrations in outflow from the peatland and in bog porewaters demonstrate Pb mobility related to DOM production. Peat stores of Pb in 2016 were less than or equal to those reported in the early 1980s despite the dry mass inventory increasing by 60-80%. Much of the loss in Pb stored in peat can be accounted for by stream runoff from the peatland.
Training of Personnel for Programmes in Early Childhood Care and Education in India.
ERIC Educational Resources Information Center
Muralidharan, Rajalakshmi
1992-01-01
Describes the early childhood components of India's National Policy on Education (1986), focusing particularly on the training of grassroots level personnel or Anganwadi workers, preschool teachers, creche workers, middle-level personnel, and project officers. Reviews training innovations, including mobile creches, home-based programs,…
Chen, Chao-Ying; Harrison, Tondi; Heathcock, Jill
2015-08-01
The purpose of this study was to examine learning, short-term memory and general development including cognitive, motor, and language domains in infants with Complex Congenital Heart Defects (CCDH). Ten infants with CCHD (4 males, 6 females) and 14 infants with typical development (TD) were examined at 3 months of age. The mobile paradigm, where an infant's leg is tethered to an overhead mobile, was used to evaluate learning and short-term memory. The Bayley Scales of Infant Development 3rd edition (Bayley-III) was used to evaluate general development in cognitive, motor, and language domains. Infants with CCHD and infants with TD both showed learning with significant increase in kicking rate (p<0.001) across periods of the mobile paradigm, but only infants with TD demonstrated short-term memory (p=0.017) in the mobile paradigm. There were no differences on cognitive, motor, and language development between infants with CCHD and infants with TD on the Bayley-III. Early assessment is necessary to guide targeted treatment in infants with CCHD. One-time assessment may fail to detect potential cognitive impairments during early infancy in infants with CCHD. Supportive intervention programs for infants with CCHD that focuses on enhancing short-term memory are recommended. Copyright © 2015 Elsevier Inc. All rights reserved.
Mobile Phones in Research and Treatment: Ethical Guidelines and Future Directions
Liddle, Jacki; Hall, Wayne; Chenery, Helen
2015-01-01
Mobile phones and other remote monitoring devices, collectively referred to as "mHealth," promise to transform the treatment of a range of conditions, including movement disorders, such as Parkinson’s disease. In this viewpoint paper, we use Parkinson’s disease as an example, although most considerations discussed below are valid for a wide variety of conditions. The ability to easily collect vast arrays of personal data over long periods will give clinicians and researchers unique insights into disease treatment and progression. These capabilities also pose new ethical challenges that health care professionals will need to manage if this promise is to be realized with minimal risk of harm. These challenges include privacy protection when anonymity is not always possible, minimization of third-party uses of mHealth data, informing patients of complex risks when obtaining consent, managing data in ways that maximize benefit while minimizing the potential for disclosure to third parties, careful communication of clinically relevant information gleaned via mHealth technologies, and rigorous evaluation and regulation of mHealth products before widespread use. Given the complex array of symptoms and differences in comfort and literacy with technology, it is likely that these solutions will need to be individualized. It is therefore critical that developers of mHealth apps engage with patients throughout the development process to ensure that the technology meets their needs. These challenges will be best met through early and ongoing engagement with patients and other relevant stakeholders. PMID:26474545
The Mobile story: data-driven community efforts to raise graduation rates.
Newell, Jeremiah; Akers, Carolyn
2010-01-01
Through sustained community organizing and strategic partnerships, the Mobile (Alabama) County Public School System is improving achievement and creating beat-the-odds schools that set and achieve high academic expectations despite the challenges of poverty and racial disparity. The authors chart how Mobile's Research Alliance for Multiple Pathways, funded through the U.S. Department of Labor's Multiple Pathways Blueprint Initiative, is identifying gaps in services throughout the community, analyzing the data about dropouts, benchmarking other communities, studying best practices, and mobilizing the community to expect and demand higher graduation rates. These activities are resulting in early identification of off-track students and coordination of school- and community-based reforms.
Lateral unicompartmental knee replacement: fixed or mobile bearing?
Forster, M C; Bauze, A J; Keene, G C R
2007-09-01
Between May 2001 and May 2003, 233 consecutive Preservation unicompartmental knee replacements (UKR) were performed. Of these, 30 were lateral UKRs (13%) performed in 12 men and 16 women (2 bilateral cases) with a mean age of 67 years (range 36-93 years). A metal-backed mobile bearing tibial component was used in 13 knees and an all-polyethylene fixed bearing tibial component in 17 knees. The patients were reviewed prospectively at 1 and 2 years. The 2 year results show no difference in range of motion or function between the mobile and fixed bearing versions of the Preservation knee when used on the lateral side. There were three early revisions, all in the mobile bearing group.
Factors associated with educational mobility in mid-age Australian women.
Tooth, Leigh R; Mishra, Gita D
2017-02-01
The educational mobility of mid-age women is rarely studied. We analysed the baseline socio-economic position (SEP) and health factors associated with obtaining further education in 4117 mid-age Australian women between 1996 and 2010 (aged 45-50 at baseline, 62-67 at follow-up) from a population-based study. Women either unemployed or working part-time at baseline had higher odds of a stable low and middle education over time (ORs ranging from 1.61 to 3.86) versus educational mobility. Apart from obesity, characteristics that may signal an unhealthy lifestyle in early mid-life were not useful indicators of women's future educational mobility. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.
Terrain Perception for DEMO III
NASA Technical Reports Server (NTRS)
Manduchi, R.; Bellutta, P.; Matthies, L.; Owens, K.; Rankin, A.
2000-01-01
The Demo III program has as its primary focus the development of autonomous mobility for a small rugged cross country vehicle. In this paper we report recent progress on both stereo-based obstacle detection and terrain cover color-based classification.
Reconfigurable robots for all terrain exploration
NASA Technical Reports Server (NTRS)
Schenker, P. S.; Pirjanian, P.; Balaram, B.; Ali, K. S.; Trebi-Ollennu, A.; Huntsberger, T. L.; Aghazarian, H.; Kennedy, B. A.; Baumgartner, E. T.; Iagnemma, K.;
2001-01-01
While significant recent progress has been made in development of mobile robots for planetary suface exploration,there remain major challenges. These include increased autonomy of operation, traverse of challenging terrain, and fault-tolerance under long, unattended periods of use.
47 CFR 22.313 - Station identification.
Code of Federal Regulations, 2014 CFR
2014-10-01
... Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES PUBLIC MOBILE SERVICES... delayed to avoid interrupting the continuity of any public communication in progress, provided that station identification is transmitted at the conclusion of that public communication. (c) Station...
47 CFR 22.313 - Station identification.
Code of Federal Regulations, 2012 CFR
2012-10-01
... Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES PUBLIC MOBILE SERVICES... delayed to avoid interrupting the continuity of any public communication in progress, provided that station identification is transmitted at the conclusion of that public communication. (c) Station...
47 CFR 22.313 - Station identification.
Code of Federal Regulations, 2010 CFR
2010-10-01
... Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES PUBLIC MOBILE SERVICES... delayed to avoid interrupting the continuity of any public communication in progress, provided that station identification is transmitted at the conclusion of that public communication. (c) Station...
47 CFR 22.313 - Station identification.
Code of Federal Regulations, 2013 CFR
2013-10-01
... Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES PUBLIC MOBILE SERVICES... delayed to avoid interrupting the continuity of any public communication in progress, provided that station identification is transmitted at the conclusion of that public communication. (c) Station...
47 CFR 22.313 - Station identification.
Code of Federal Regulations, 2011 CFR
2011-10-01
... Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES PUBLIC MOBILE SERVICES... delayed to avoid interrupting the continuity of any public communication in progress, provided that station identification is transmitted at the conclusion of that public communication. (c) Station...
System services and architecture of the TMI satellite mobile data system
NASA Technical Reports Server (NTRS)
Gokhale, D.; Agarwal, A.; Guibord, A.
1993-01-01
The North American Mobile Satellite Service (MSS) system being developed by AMSC/TMI and scheduled to go into service in early 1995 will include the provision for real time packet switched services (mobile data service - MDS) and circuit switched services (mobile telephony service - MTS). These services will utilize geostationary satellites which provide access to mobile terminals (MT's) through L-band beams. The MDS system utilizes a star topology with a centralized data hub (DH) and will support a large number of mobile terminals. The DH, which accesses the satellite via a single Ku band beam, is responsible for satellite resource management, for providing mobile users with access to public and private data networks, and for comprehensive network management of the system. This paper describes the various MDS services available for the users, the ground segment elements involved in the provisioning of these services, and a summary description of the channel types, protocol architecture, and network management capabilities provided within the system.
Low-temperature magnetotransport in Si/SiGe heterostructures on 300 mm Si wafers
NASA Astrophysics Data System (ADS)
Scappucci, Giordano; Yeoh, L.; Sabbagh, D.; Sammak, A.; Boter, J.; Droulers, G.; Kalhor, N.; Brousse, D.; Veldhorst, M.; Vandersypen, L. M. K.; Thomas, N.; Roberts, J.; Pillarisetty, R.; Amin, P.; George, H. C.; Singh, K. J.; Clarke, J. S.
Undoped Si/SiGe heterostructures are a promising material stack for the development of spin qubits in silicon. To deploy a qubit into high volume manufacturing in a quantum computer requires stringent control over substrate uniformity and quality. Electron mobility and valley splitting are two key electrical metrics of substrate quality relevant for qubits. Here we present low-temperature magnetotransport measurements of strained Si quantum wells with mobilities in excess of 100000 cm2/Vs fabricated on 300 mm wafers within the framework of advanced semiconductor manufacturing. These results are benchmarked against the results obtained in Si quantum wells deposited on 100 mm Si wafers in an academic research environment. To ensure rapid progress in quantum wells quality we have implemented fast feedback loops from materials growth, to heterostructure FET fabrication, and low temperature characterisation. On this topic we will present recent progress in developing a cryogenic platform for high-throughput magnetotransport measurements.
Artificial intelligence and deep learning - Radiology's next frontier?
Mayo, Ray Cody; Leung, Jessica
Tracing the use of computers in the radiology department from administrative functions through image acquisition, storage, and reporting, to early attempts at improved diagnosis, we begin to imagine possible new frontiers for their use in exam interpretation. Given their initially slow but ultimately substantial progress in the noninterpretive areas, we are left desiring and even expecting more in the interpretation realm. New technological advances may provide the next wave of progress and radiologists should be early adopters. Several potential applications are discussed and hopefully will serve to inspire future progress. Published by Elsevier Inc.
Mussini, Cristina; Johnson, Margaret; d'Arminio Monforte, Antonella; Antinori, Andrea; Gill, M. John; Sighinolfi, Laura; Uberti-Foppa, Caterina; Borghi, Vanni; Sabin, Caroline
2011-01-01
Objectives We analyzed clinical progression among persons diagnosed with HIV at the time of an AIDS-defining event, and assessed the impact on outcome of timing of combined antiretroviral treatment (cART). Methods Retrospective, European and Canadian multicohort study.. Patients were diagnosed with HIV from 1997–2004 and had clinical AIDS from 30 days before to 14 days after diagnosis. Clinical progression (new AIDS event, death) was described using Kaplan-Meier analysis stratifying by type of AIDS event. Factors associated with progression were identified with multivariable Cox regression. Progression rates were compared between those starting early (<30 days after AIDS event) or deferred (30–270 days after AIDS event) cART. Results The median (interquartile range) CD4 count and viral load (VL) at diagnosis of the 584 patients were 42 (16, 119) cells/µL and 5.2 (4.5, 5.7) log10 copies/mL. Clinical progression was observed in 165 (28.3%) patients. Older age, a higher VL at diagnosis, and a diagnosis of non-Hodgkin lymphoma (NHL) (vs. other AIDS events) were independently associated with disease progression. Of 366 patients with an opportunistic infection, 178 (48.6%) received early cART. There was no significant difference in clinical progression between those initiating cART early and those deferring treatment (adjusted hazard ratio 1.32 [95% confidence interval 0.87, 2.00], p = 0.20). Conclusions Older patients and patients with high VL or NHL at diagnosis had a worse outcome. Our data suggest that earlier initiation of cART may be beneficial among HIV-infected patients diagnosed with clinical AIDS in our setting. PMID:22043301
Genetic Insights in Barrett’s Esophagus and Esophageal Adenocarcinoma
Reid, Brian J.; Paulson, Thomas G.; Li, Xiaohong
2015-01-01
Beginning in the 1980s, an alarming rise in the incidence of esophageal adenocarcinoma (EA) led to screening of patients with reflux to detect Barrett’s esophagus (BE) and surveillance of BE to detect early EA. This strategy, based on linear progression disease models, resulted in selective detection of BE that does not progress to EA over a lifetime (overdiagnosis) and missed BE that rapidly progresses to EA (underdiagnosis). Here we review the historical thought processes that resulted in this undesired outcome and the transformation in our understanding of genetic and evolutionary principles governing neoplastic progression that has come from application of modern genomic technologies to cancers and their precursors. This new synthesis provides improved strategies for prevention and early detection of EA by addressing the environmental and mutational processes that can determine “windows of opportunity” in time to detect rapidly progressing BE and distinguish it from slowly or non-progressing BE. PMID:26208895
ERIC Educational Resources Information Center
Tuck, Kathy D.
An evaluation was conducted to examine the structure and design of the Continuous Progress Report (CPR), an observation scale used to measure students' early developmental skills in the District of Columbia public schools. Item construction and the relative consistency of measurement constructs in the CPR were the specific focus of the evaluation.…
ERIC Educational Resources Information Center
Abdelfattah, Marwa
2015-01-01
This study aims to uncover how a particular imported philosophy of early childhood education, Reggio Emilia, is implemented in the context of one public and one private preschool in San Francisco. The philosophy of Reggio Emilia is believed to be progressive and to be developmentally appropriate for children in early childhood. The study involved…
Miyazaki, Kazunori; Masamoto, Kazuto; Morimoto, Nobutoshi; Kurata, Tomoko; Mimoto, Takahumi; Obata, Takayuki; Kanno, Iwao; Abe, Koji
2012-03-01
The exact mechanism of selective motor neuron death in amyotrophic lateral sclerosis (ALS) remains still unclear. In the present study, we performed in vivo capillary imaging, directly measured spinal blood flow (SBF) and glucose metabolism, and analyzed whether if a possible flow-metabolism coupling is disturbed in motor neuron degeneration of ALS model mice. In vivo capillary imaging showed progressive decrease of capillary diameter, capillary density, and red blood cell speed during the disease course. Spinal blood flow was progressively decreased in the anterior gray matter (GM) from presymptomatic stage to 0.80-fold of wild-type (WT) mice, 0.61 at early-symptomatic, and 0.49 at end stage of the disease. Local spinal glucose utilization (LSGU) was transiently increased to 1.19-fold in anterior GM at presymptomatic stage, which in turn progressively decreased to 0.84 and 0.60 at early-symptomatic and end stage of the disease. The LSGU/SBF ratio representing flow-metabolism uncoupling (FMU) preceded the sequential pathological changes in the spinal cord of ALS mice and was preferentially found in the affected region of ALS. The present study suggests that this early and progressive FMU could profoundly involve in the whole disease process as a vascular factor of ALS pathology, and could also be a potential target for therapeutic intervention of ALS.
Starkey, Leighann; Revenson, Tracey A
2015-04-01
Many studies link childhood socioeconomic status (SES) to body mass index (BMI), but few account for the impact of socioeconomic mobility throughout the lifespan. This study aims to investigate the impact of socioeconomic mobility on changes in BMI in childhood. Analyses tested whether [1] socioeconomic status influences BMI, [2] changes in socioeconomic status impact changes in BMI, and [3] timing of socioeconomic status mobility impacts BMI. Secondary data spanning birth to age 9 were analyzed. SES and BMI were investigated with gender, birth weight, maternal race/ethnicity, and maternal nativity as covariates. Autoregressive structural equation modeling and latent growth modeling were used. Socioeconomic status in the first year of life predicted body mass index. Child covariates were consistently associated with body mass index. Rate of change in socioeconomic status did not predict change in body mass index. The findings suggest that early socioeconomic status may most influence body mass in later childhood.
mHealth Education Applications Along the Cancer Continuum.
Davis, Sharon Watkins; Oakley-Girvan, Ingrid
2015-06-01
The majority of adults worldwide own a mobile phone, including those in under-resourced communities. Mobile health (mhealth) education technologies present a promising mechanism for improving cancer prevention, treatment, and follow-up. The purpose of this study was to summarize the literature related to mobile phone (mhealth) applications for patient education specific to cancer and identify current recommendations from randomized studies. In particular, we were interested in identifying mobile phone applications along the cancer continuum, from cancer prevention to survivorship. The authors identified 28 articles reporting on mobile applications for patients related to cancer. Articles were identified in all categories along the cancer continuum, including health professional involvement in application development. Of these, six involved direct patient education, and eight focused on improving patient/professional communication and patient self-management. However, only six of the studies were randomized interventions. The potential for mobile applications to help overcome the "health care gap" has not yet been realized in the studies from the USA that were reviewed for this paper. However, early recommendations are emerging that support the use of mHealth communications to change behaviors for cancer prevention, early detection, and symptom management and improved patient-provider communication. Recommendations include short messages, use of multiple modalities as patient characteristics dictate comfort with mHealth communication, and the inclusion of patients and health professionals to develop and test applications. Tailoring mHealth to particular cultures, languages, and ethnic groups may also represent a unique possibility to provide accessible information and education at minimal cost for under-resourced communities and individuals.
Technology-Based Early Warning Systems for Bipolar Disorder: A Conceptual Framework
Torous, John; Thompson, Wesley
2016-01-01
Recognition and timely action around “warning signs” of illness exacerbation is central to the self-management of bipolar disorder. Due to its heterogeneity and fluctuating course, passive and active mobile technologies have been increasingly evaluated as adjunctive or standalone tools to predict and prevent risk of worsening of course in bipolar disorder. As predictive analytics approaches to big data from mobile health (mHealth) applications and ancillary sensors advance, it is likely that early warning systems will increasingly become available to patients. Such systems could reduce the amount of time spent experiencing symptoms and diminish the immense disability experienced by people with bipolar disorder. However, in addition to the challenges in validating such systems, we argue that early warning systems may not be without harms. Probabilistic warnings may be delivered to individuals who may not be able to interpret the warning, have limited information about what behaviors to change, or are unprepared to or cannot feasibly act due to time or logistic constraints. We propose five essential elements for early warning systems and provide a conceptual framework for designing, incorporating stakeholder input, and validating early warning systems for bipolar disorder with a focus on pragmatic considerations. PMID:27604265
Taylor, Melissa; Billiot, Fanny; Marty, Virginie; Rouffiac, Valérie; Cohen, Patrick; Tournay, Elodie; Opolon, Paule; Louache, Fawzia; Vassal, Gilles; Laplace-Builhé, Corinne; Vielh, Philippe; Soria, Jean-Charles; Farace, Françoise
2012-05-01
The prevailing concept is that immediate mobilization of bone marrow-derived circulating endothelial progenitor cells (CEP) is a key mechanism mediating tumor resistance to vascular-disrupting agents (VDA). Here, we show that administration of VDA to tumor-bearing mice induces 2 distinct peaks in CEPs: an early, unspecific CEP efflux followed by a late yet more dramatic tumor-specific CEP burst that infiltrates tumors and is recruited to vessels. Combination with antiangiogenic drugs could not disrupt the early peak but completely abrogated the late VDA-induced CEP burst, blunted bone marrow-derived cell recruitment to tumors, and resulted in striking antitumor efficacy, indicating that the late CEP burst might be crucial to tumor recovery after VDA therapy. CEP and circulating endothelial cell kinetics in VDA-treated patients with cancer were remarkably consistent with our preclinical data. These findings expand the current understanding of vasculogenic "rebounds" that may be targeted to improve VDA-based strategies. Our findings suggest that resistance to VDA therapy may be strongly mediated by late, rather than early, tumor-specific recruitment of CEPs, the suppression of which resulted in increased VDA-mediated antitumor efficacy. VDA-based therapy might thus be significantly enhanced by combination strategies targeting late CEP mobilization. © 2012 AACR
VanDevanter, Donald R; Kahle, Jennifer S; O'Sullivan, Amy K; Sikirica, Slaven; Hodgkins, Paul S
2016-03-01
Studies have described illness associated with cystic fibrosis (CF) early in life, but there is no comprehensive accounting of the prevalence and ages of disease manifestation and progression described in individual studies. We searched for peer-reviewed English-language studies of the health of children ≤6years old with CF (published 1990-2014). Structural abnormalities and dysfunction of the digestive and respiratory systems were summarized across relevant studies by system and age group. Primary studies (125 total) from 22 countries described abnormalities, dysfunction, and disease progression in infancy and early childhood. Improved health was consistently observed in association with diagnosis via newborn screening compared with cohorts diagnosed later by symptomatic presentation. The peer-reviewed literature is remarkably consistent: CF-associated growth impairment and airway abnormalities are reported at birth, and disease progression is reported in infancy and throughout childhood. Earlier access to routine CF management is associated with improved subsequent health status. Copyright © 2015 The Authors. Published by Elsevier B.V. All rights reserved.
Gene Discovery in Bladder Cancer Progression using cDNA Microarrays
Sanchez-Carbayo, Marta; Socci, Nicholas D.; Lozano, Juan Jose; Li, Wentian; Charytonowicz, Elizabeth; Belbin, Thomas J.; Prystowsky, Michael B.; Ortiz, Angel R.; Childs, Geoffrey; Cordon-Cardo, Carlos
2003-01-01
To identify gene expression changes along progression of bladder cancer, we compared the expression profiles of early-stage and advanced bladder tumors using cDNA microarrays containing 17,842 known genes and expressed sequence tags. The application of bootstrapping techniques to hierarchical clustering segregated early-stage and invasive transitional carcinomas into two main clusters. Multidimensional analysis confirmed these clusters and more importantly, it separated carcinoma in situ from papillary superficial lesions and subgroups within early-stage and invasive tumors displaying different overall survival. Additionally, it recognized early-stage tumors showing gene profiles similar to invasive disease. Different techniques including standard t-test, single-gene logistic regression, and support vector machine algorithms were applied to identify relevant genes involved in bladder cancer progression. Cytokeratin 20, neuropilin-2, p21, and p33ING1 were selected among the top ranked molecular targets differentially expressed and validated by immunohistochemistry using tissue microarrays (n = 173). Their expression patterns were significantly associated with pathological stage, tumor grade, and altered retinoblastoma (RB) expression. Moreover, p33ING1 expression levels were significantly associated with overall survival. Analysis of the annotation of the most significant genes revealed the relevance of critical genes and pathways during bladder cancer progression, including the overexpression of oncogenic genes such as DEK in superficial tumors or immune response genes such as Cd86 antigen in invasive disease. Gene profiling successfully classified bladder tumors based on their progression and clinical outcome. The present study has identified molecular biomarkers of potential clinical significance and critical molecular targets associated with bladder cancer progression. PMID:12875971
Developing the Medication Reminder Mobile Application "Seeb".
Saghaeiannejad-Isfahani, Sakineh; Ehteshami, Asghar; Savari, Ebtesam; Samimi, Ali
2017-06-01
Today, the structure of comprehensive health care emphasizes self-care more than therapy. Medication therapy is a strong instrument for therapy received through the health setting, especially in medication area. Error in medication administration has produced different problems and they cost billions of dollars every year. Regarding mobile phone extensions, we developed a local medication reminder mobile application called "Seeb" as a suitable solution for decreasing medication errors for Iranians. We conducted a mixed methods study in three Phases: 1) Comparative study of existing mobile applications; 2) developed its object-oriented model; 3) Developed the initial version of "Seeb" that was approved for production. This application was designed for the appropriate medication administration including time and dosages through: recording patient and medication data; scheduling patients' medication; and reporting medication administration on progress. "Seeb" has been designed in compliance with Iranian health information technologists and pharmacists requirements. It is expected to reduce medication error and improve patient adherence to medical prescriptions.
Yoon, T; Shin, D-M; Kim, S; Lee, S; Lee, T G; Kim, K
2017-04-01
We investigated the temperature-dependent locomotion of Caenorhabditis elegans by using the mobile phone-based microscope. We developed the customized imaging system with mini incubator and smartphone to effectively control the thermal stimulation for precisely observing the temperature-dependent locomotory behaviours of C. elegans. Using the mobile phone-based microscope, we successfully followed the long-term progress of specimens of C. elegans in real time as they hatched and explored their temperature-dependent locomotory behaviour. We are convinced that the mobile phone-based microscope is a useful device for real time and long-term observations of biological samples during incubation, and can make it possible to carry out live observations via wireless communications regardless of location. In addition, this microscope has the potential for widespread use owing to its low cost and compact design. © 2017 The Authors Journal of Microscopy © 2017 Royal Microscopical Society.
da Silva, Marcos Barragan; Almeida, Miriam de Abreu; Panato, Bruna Paulsen; Siqueira, Ana Paula de Oliveira; da Silva, Mariana Palma; Reisderfer, Letícia
2015-01-01
AIM: to evaluate the clinical applicability of outcomes, according to the Nursing Outcomes Classification (NOC) in the evolution of orthopedic patients with Impaired Physical Mobility METHOD: longitudinal study conducted in 2012 in a university hospital, with 21 patients undergoing Total Hip Arthroplasty, evaluated daily by pairs of trained data collectors. Data were collected using an instrument containing five Nursing Outcomes, 16 clinical indicators and a five point Likert scale, and statistically analyzed. RESULTS: The outcomes Body Positioning: self-initiated, Mobility, Knowledge: prescribed activity, and Fall Prevention Behavior presented significant increases in mean scores when comparing the first and final evaluations (p<0.001) and (p=0.035). CONCLUSION: the use of the NOC outcomes makes it possible to demonstrate the clinical progression of orthopedic patients with Impaired Physical Mobility, as well as its applicability in this context. PMID:25806631
The Digital Divide: A Global View
NASA Astrophysics Data System (ADS)
Ntoko, Alexander
2011-04-01
Huge progress was made in bridging the digital divide in first decade of 21^st century. This was largely due to the explosive growth of mobile, which saw numbers rise from under 500 million to over five billion mobile cellular subscriptions in just ten years. With household mobile penetration rates of over 50% even in rural areas of developing countries, we have achieved the dream of bringing all the world's people within reach of communications technology. We must now, however, replicate the mobile miracle for the Internet, and especially broadband, if we are to avoid creating a new broadband breach to replace the digital divide. Three things need to happen for this to be achieved: firstly, broadband needs to be brought to the top of the development agenda; secondly, broadband needs to become much more affordable and thirdly, security needs to be part of the strategy.
Quantifying functional mobility progress for chronic disease management.
Boyle, Justin; Karunanithi, Mohan; Wark, Tim; Chan, Wilbur; Colavitti, Christine
2006-01-01
A method for quantifying improvements in functional mobility is presented based on patient-worn accelerometer devices. For patients with cardiovascular, respiratory, or other chronic disease, increasing the amount of functional mobility is a large component of rehabilitation programs. We have conducted an observational trial on the use of accelerometers for quantifying mobility improvements in a small group of chronic disease patients (n=15, 48 - 86 yrs). Cognitive impairments precluded complex instrumentation of patients, and movement data was obtained from a single 2-axis accelerometer device worn at the hip. In our trial, movement data collected from accelerometer devices was classified into Lying vs Sitting/Standing vs Walking/Activity movements. This classification enabled the amount of walking to be quantified and graphically presented to clinicians and carers for feedback on exercise efficacy. Presenting long term trends in this data to patients also provides valuable feedback for self managed care and assisting with compliance.
Mobile health: assessing the barriers.
Terry, Nicolas P
2015-05-01
Mobile health (mHealth) combines the decentralization of health care with patient centeredness. Mature mHealth applications (apps) and services could provide actionable information, coaching, or alerts at a fraction of the cost of conventional health care. Different categories of apps attract diverse safety and privacy regulation. It is too early to tell whether these apps can overcome questions about their use cases, business models, and regulation.
Pardanaud, Luc; Eichmann, Anne
2006-07-01
Using quail-chick parabiosis and QH1 monoclonal antibody analysis, we have identified circulating endothelial cells and/or progenitors in the embryo. These cells were already present early in ontogeny, before the third embryonic day. Under normal conditions, they integrated into most tissues but remained scarce. When experimental angiogenic responses were induced by wounding or grafts onto the chorioallantoic membrane, circulating endothelial cells were rapidly mobilized and selectively integrated sites of neoangiogenesis. Their mobilization was not dependent on the presence of the bone marrow as it was effective before its differentiation. Surprisingly, mobilization was not effective during sprouting angiogenesis following VEGF treatment of chorioallantoic membrane. Thus, embryonic circulating endothelial cells were efficiently mobilized during the establishment of an initial vascular supply to ischemic tissues following wounding or grafting, but were not involved during classical sprouting angiogenesis.
Human mobility in an emerging epidemic: a key aspect for response planning
NASA Astrophysics Data System (ADS)
Poletto, Chiara; Bajardi, Paolo; Colizza, Vittoria; Ramasco, Jose J.; Tizzoni, Michele; Vespignani, Alessandro
2010-03-01
Human mobility and interactions represent key ingredients in the spreading dynamics of an infectious disease. The flows of traveling people form a network characterized by complex features, such as strong topological and traffic heterogeneities, that unfolds at different temporal and spatial scales, from short ranges to the global scale. Computational models can be developed that integrate detailed network structures based on demographic and mobility data, in order to simulate the spatial evolution of an epidemic. Focusing on the recent A(H1N1) influenza pandemic as a paradigmatic example, these approaches allow the assessment of the interplay between individual mobility and epidemic dynamics, quantifying the effects of travel restrictions in delaying the epidemic spread and the role of mobility as an additional source of information for the understanding of the early outbreak.
Moore, Julia E; Mascarenhas, Alekhya; Marquez, Christine; Almaawiy, Ummukulthum; Chan, Wai-Hin; D'Souza, Jennifer; Liu, Barbara; Straus, Sharon E
2014-10-30
As evidence-informed implementation interventions spread, they need to be tailored to address the unique needs of each setting, and this process should be well documented to facilitate replication. To facilitate the spread of the Mobilization of Vulnerable Elders in Ontario (MOVE ON) intervention, the aim of the current study is to develop a mapping guide that links identified barriers and intervention activities to behaviour change theory. Focus groups were conducted with front line health-care professionals to identify perceived barriers to implementation of an early mobilization intervention targeted to hospitalized older adults. Participating units then used or adapted intervention activities from an existing menu or developed new activities to facilitate early mobilization. A thematic analysis was performed on the focus group data, emphasizing concepts related to barriers to behaviour change. A behaviour change theory, the 'capability, opportunity, motivation-behaviour (COM-B) system', was used as a taxonomy to map the identified barriers to their root causes. We also mapped the behaviour constructs and intervention activities to overcome these. A total of 46 focus groups were conducted across 26 hospital inpatient units in Ontario, Canada, with 261 participants. The barriers were conceptualized at three levels: health-care provider (HCP), patient, and unit. Commonly mentioned barriers were time constraints and workload (HCP), patient clinical acuity and their perceived 'sick role' (patient), and lack of proper equipment and human resources (unit level). Thirty intervention activities to facilitate early mobilization of older adults were implemented across hospitals; examples of unit-developed intervention activities include the 'mobility clock' communication tool and the use of staff champions. A mapping guide was created with barriers and intervention activities matched though the lens of the COM-B system. We used a systematic approach to develop a guide, which maps barriers, intervention activities, and behaviour change constructs in order to tailor an implementation intervention to the local context. This approach allows implementers to identify potential strategies to overcome local-level barriers and to document adaptations.
[Intra-prosthetic dislocation of the Bousquet dual mobility socket].
Lecuire, F; Benareau, I; Rubini, J; Basso, M
2004-05-01
The Bousquet system is a dual mobility head-polyethylene polyethylene-metal cup socket. The polyethylene insert retaining the femoral head moves in the noncemented metal cup, increasing both mobility and stability. Between 1989 and 1997, seven cases of intra-prosthetic dislocation (six patients) were observed. The femoral head escaped from the polyethylene insert due to wear. On the average, this complication occurred ten Years after implantation. Risk of dislocation was high in six of the seven hips. All patients had a large sized stem screwed into the femoral neck. There was a characteristic radiological aspect with loss of the concentric head metal cup configuration. The head was applied against the upper wall of the metal cup. Surgical replacement was undertaken early in six patients by simply changing the insert without modifying the other stable components. Outcome remained good at three to eight Years. One patient underwent late surgery. The insert and the cup were replaced with a classical implant. Functional outcome was good but recurrent dislocation occurred. At mid-term, intra-prosthetic dislocation of dual mobility sockets appears to be exceptional. Dislocation results from polyethylene wear leading to failure of the insert to retain the prosthetic head. Wear is favored by direct phenomena (direct contact between neck and insert which can occur early if there is a small difference in the head and neck diameters) or indirect phenomena (factors limiting polyethylene metal-cup mobility). Surgical treatment is necessary. If undertaken early, replacement with a modular head and insert can be sufficient if the prosthesis has not loosened but the metal cup may have to be replaced in the event of metal-metal contact between the head and the cup. Prosthesis loosening, wear of the metal cup, or an identified cause of dislocation imply replacing the failing implants. Implantation of the dual mobility system is particularly interesting for patients with a high risk of dislocation or a chronically unstable hip prosthesis. Careful technique is required to reduce or retard the risk of intra-prosthetic dislocation. Intra-prosthetic dislocation of a dual mobility socket is an exceptional complication at mid-term. Surgical treatment is required but may be limited to simple insert replacement. Systematic use of this type of implant in young subjects must be carefully examined, but for us, the risk of dislocation does not outweigh the advantages of this original concept of dual mobility. This type of socket remains an useful preventive technique for high-risk hips or for curative treatment of recurrent dislocation.
Kay, Neil E; Hamblin, Terry J; Jelinek, Diane F; Dewald, Gordon W; Byrd, John C; Farag, Sherif; Lucas, Margaret; Lin, Thomas
2002-01-01
This update of early stage B-cell chronic lymphocytic leukemia (B-CLL) embraces current information on the diagnosis, biology, and intervention required to more fully develop algorithms for management of this disease. Emphasis on early stage is based on the rapid advancement in our understanding of the disease parameters and our increasing ability to predict for a given early stage patient whether there is a need for more aggressive management. In Section I, Dr. Terry Hamblin addresses the nature of the disease, accurate diagnostic procedures, evidence for an early "preclinical" phase, the use of newer prognostic features to distinguish who will be likely to progress or not, and whether it is best to watch or treat early stage disease. In Section II, Dr. Neil Kay and colleagues address the biologic aspects of the disease and how they may relate to disease progression. Review of the newer insights into gene expression, recurring genetic defects, role of cytokines/autocrine pathways, and the interaction of the CLL B cell with the microenvironment are emphasized. The relationship of these events to both trigger disease progression and as opportunities for future therapeutic intervention even in early stage disease is also considered. In Section III, Dr. John Byrd and colleagues review the historical and now current approaches to management of the previously untreated progressive B-CLL patient. They discuss what decision tree could be used in the initial decision to treat a given patient. The use of single agents versus newer combination approaches such as chemoimmunotherapy are discussed here. In addition, the place of marrow transplant and some of the newer antibodies available for treatment of B-CLL are considered. Finally, a challenge to utilize our growing knowledge of the biology of B-CLL in the early stage B-CLL is proffered.
Imported fire ants in the southeast
David F. Williams
1998-01-01
Two species of imported fire ants were introduced into the U.S. at Mobile, Alabama. The black imported fire ant, Solenopsis richteri Forel, was introduced around the early 1900's while the red imported fire ant, Solenopsis invicta Buren entered in the late 1930' or early 1940's. The red imported fire ant is the most...
Koirala, Nikesh; Han, Myung -Geun; Brahlek, Matthew; ...
2015-11-19
Material defects remain as the main bottleneck to the progress of topological insulators (TIs). In particular, efforts to achieve thin TI samples with dominant surface transport have always led to increased defects and degraded mobilities, thus making it difficult to probe the quantum regime of the topological surface states. Here, by utilizing a novel buffer layer scheme composed of an In 2Se 3/(Bi 0.5In 0.5) 2Se 3 heterostructure, we introduce a quantum generation of Bi 2Se 3 films with an order of magnitude enhanced mobilities than before. Furthermore, this scheme has led to the first observation of the quantum Hallmore » effect in Bi 2Se 3.« less
Increasing Racial Isolation and Test Score Gaps in Mathematics: A 30-Year Perspective
ERIC Educational Resources Information Center
Berends, Mark; Penaloza, Roberto V.
2010-01-01
Background/Context: Although there has been progress in closing the test score gaps among student groups over past decades, that progress has stalled. Many researchers have speculated why the test score gaps closed between the early 1970s and the early 1990s, but only a few have been able to empirically study how changes in school factors and…
Choo, Seryung; Kim, Ju Young; Jung, Se Young; Kim, Sarah; Kim, Jeong Eun; Han, Jong Soo; Kim, Sohye; Kim, Jeong Hyun; Kim, Jeehye; Kim, Yongseok; Kim, Dongouk; Steinhubl, Steve
2016-03-31
Although complications of obesity are well acknowledged and managed by clinicians, management of obesity itself is often difficult, which leads to its underdiagnosis and undertreatment in hospital settings. However, tools that could improve the management of obesity, including self-monitoring, engagement with a social network, and open channels of communication between the patient and doctor, are limited in a clinic-based setting. The objective of our study was to evaluate the usability and acceptability of a newly developed mobile app linked with an accelerometer and its early effects on patient-doctor relationships. From September 2013 to February 2014, we developed a mobile app linked with an accelerometer as a supportive tool for a clinic-based weight loss program. The app used information from electronic health records and delivered tailored educational material. Personal goal setting, as well as monitoring of weight changes and physical activity combined with feedback, are key features of the app. We also incorporated an interactive message board for patients and doctors. During the period of March 2014 to May 2014, we tested our mobile app for 1 month in participants in a hospital clinic setting. We assessed the app's usability and acceptability, as well as the patient-doctor relationship, via questionnaires and analysis of app usage data. We recruited 30 individuals (18 male and 12 female) for the study. The median number of log-ins per day was 1.21, with the most frequently requested item being setting goals, followed by track physical activities and view personal health status. Scales of the depth of the patient-doctor relationship decreased from 27.6 (SD 4.8) to 25.1 (SD 4.5) by a Wilcoxon signed rank test (P=.02). A mobile phone app linked with an accelerometer for a clinic-based weight loss program is useful and acceptable for weight management but exhibited less favorable early effects on patient-doctor relationships.
Predictors of early neurological deterioration after ischaemic stroke: a case-control study.
Barber, Mark; Wright, Fiona; Stott, David J; Langhorne, Peter
2004-01-01
Early neurological deterioration after ischaemic stroke (stroke in progression) is reported to be common and associated with poor outcome or death. The causes of progressing stroke are, however, uncertain. To determine whether prior drug treatment (with anticoagulant or antiplatelet agents) or early adverse physiological features (pyrexia, hypoxia, dehydration or hyperglycaemia) are associated with progressing ischaemic stroke. The study used a case-control design. From a database of 873 consecutive acute stroke admissions, 196 cases of progressing ischaemic stroke (defined by point deterioration in components of the Scandinavian Stroke Scale or death over the first 72 h after hospital admission) were matched to 196 controls on the basis of age and stroke type. Univariate and conditional logistic regression techniques were used to explore predictors of progressing stroke. Cases and controls were well matched for baseline stroke severity. Warfarin use prior to admission was associated with a reduced risk of progressing stroke [odds ratio (OR) 0.10, p = 0.005]. Prior antiplatelet use was not related. A previous history of diabetes (OR 2.11, p = 0.039) and elevated systolic blood pressure on admission (OR 1.01 for each 1 mm Hg rise, p = 0.017) predicted progressing stroke. Although there were no differences in time to presentation or to brain imaging, a visible causative lesion on CT scanning was more common in the progressing stroke group (OR 2.30, p = 0.022). We found no evidence that adverse physiological features were associated with progressing stroke. Outcomes were worse in the progressing stroke group with 70% being dead or dependent by 30 days compared to 55% in the control group (p = 0.002). Prior warfarin use may be protective against progressing ischaemic stroke. A previous history of diabetes along with elevated admission systolic blood pressure predict deterioration. We found no evidence for an association between adverse physiological features and progressing stroke. Copyright 2004 S. Karger AG, Basel
Uskalova, D V; Igolkina, Yu V; Sarapultseva, E I
2016-08-01
Morphofunctional disorders in unicellular aquatic protozoa - Spirostomum ambiguum infusorians after 30-, 60-, and 360-min exposure in electromagnetic field at a radiation frequency of 1 GHz and energy flow density of 50 μW/cm(2) were analyzed by intravital computer morphometry. Significant disorders in morphometric values correlated with low mobility of the protozoa. The results suggested the use of intravital computer morphometry on the protozoa for early diagnosis of radiation-induced effects of the mobile communication electromagnetic field, for example, low mobility of spermatozoa.
Shaw, L J; Shipley, J; Newell, E L; Harris, N; Clinch, J G; Lovell, C R
2013-07-01
Localized scleroderma is a rare but potentially disfiguring and disabling condition. Systemic treatment should be started early in those with active disease in key functional and cosmetic sites, but disease activity is difficult to determine clinically. Superficial blood flow has been shown to correlate with disease activity in localized scleroderma. To examine whether superficial blood flow measured by laser Doppler imaging (LDI) has the potential to predict disease progression and therefore select patients for early systemic treatment. A group of 20 individuals had clinical assessment and scanning LDI blood-flow measurements of 32 affected body sites. After a mean follow-up of 8.7 months their clinical outcome was compared with the results of the initial LDI assessment. Eleven out of 15 patients with an assessment of active LDI had progressed clinically, and 16 out of the 17 scans with inactive LDI assessment had not progressed, giving a positive predictive value of 73% and a negative predictive value of 94%. We believe that LDI can be a useful tool in predicting disease progression in localized scleroderma, and it may help clinicians to decide which patients to treat early. © 2013 The Authors BJD © 2013 British Association of Dermatologists.
Canadian development and commercialization of a North American mobile satellite service
NASA Technical Reports Server (NTRS)
Athanassiadis, Demetre
1990-01-01
Canada recognized early the value of mobile satellite communications, originally through the planning of a military system and subsequently through the development of the Canadian Mobile Satellite (MSAT) systems. Acting on behalf of the government, the Department of Communications (DOC) defined and carried out a complete plan for the implementation of Mobile Satellite Services (MSS). Based on an extensive dialogue between government, industry, and users and encompassing all technical, economic regulatory, and institutional aspects, this plan resulted in the completion by 1986 of a comprehensive business plan and a decision for commercial MSS delivery. The Canadian lead for a commercial system was quickly followed by others, and in particular the U.S., giving rise to the concept of North American MSS.
Meaning of living with severe chronic obstructive lung disease: a qualitative study
Marx, Gabriella; Nasse, Maximilian; Stanze, Henrikje; Boakye, Sonja Owusu; Nauck, Friedemann; Schneider, Nils
2016-01-01
Objectives To explore what it means for patients to live with chronic obstructive pulmonary disease (COPD) as an incurable and constantly progressing disease. Design Qualitative longitudinal study using narrative and semistructured interviews. This paper presents findings of the initial interviews. Analysis using grounded theory. Setting Lung care clinics and community care in Lower Saxony, Germany. Participants 17 patients with advanced-stage COPD (Global Initiative for Chronic Obstructive Lung Disease (GOLD) III/IV). Findings Analysis shows that these patients have difficulties accepting their life situation and feel at the mercy of the disease, which could be identified as a core-experienced phenomenon. Over a long period of time, patients have only a vague feeling of being ill, caused by uncertain knowledge, slow progress and doubtful attribution of clinical symptoms of the disease (causal conditions). As an action strategy, patients try to maintain daily routines for as long as possible after diagnosis. Both effective standard and rescue medication, which helps to reduce breathlessness and other symptoms, and the feeling of being faced with one's own responsibility (intervening conditions) support this strategy, whereby patients' own responsibility is too painful to acknowledge. As a consequence, patients try to deny the threat to life for a long period of time. Frequently, they need to experience facing their own limits, often in the form of an acute crisis, to realise their health situation. The experience of the illness is contextualised by a continuous increase in limited mobility and social isolation. Conclusion In order to help patients to improve disease awareness, to accept their life situation and to improve their reduced quality of life, patients may benefit from the early integration of palliative care (PC), considering its multiprofessional patient-centred and team-centred approach. Psychological support and volunteer work, which are relevant aspects of PC, should be appropriate to address psychosocial needs. More research is needed to evaluate how patients could benefit from early PC. PMID:27932338
NASA Technical Reports Server (NTRS)
Parsons-Wingerter, Patricia
2010-01-01
When analyzed by VESsel GENeration Analysis (VESGEN) software, vascular patterns provide useful integrative read-outs of complex, interacting molecular signaling pathways. Using VESGEN, we recently discovered and published our innovative, surprising findings that angiogenesis oscillated with vascular dropout throughout progression of diabetic retinopathy, a blinding vascular disease. Our findings provide a potential paradigm shift in the current prevailing view on progression and treatment of this disease, and a new early-stage window of regenerative therapeutic opportunities. The findings also suggest that angiogenesis may oscillate with vascular disease in a homeostatic-like manner during early stages of other inflammatory progressive diseases such as cancer and coronary vascular disease.
47 CFR 90.403 - General operating requirements.
Code of Federal Regulations, 2010 CFR
2010-10-01
... communications in progress and such other measures as may be necessary to minimize the potential for causing... 90.403 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES PRIVATE LAND MOBILE RADIO SERVICES Operating Requirements § 90.403 General operating requirements...
Holló, Gábor
2017-07-01
To present a case of early primary open-angle glaucoma in which retinal nerve fiber layer thickness (RNFLT), ganglion cell complex (GCC), and visual field progression were accompanied with significant progression of peripapillary angioflow vessel density (PAFD) measured with optical coherence tomographic angiography. A 68-year-old female patient who was under topical intraocular pressure (IOP) lowering medication for 20 years for ocular hypertension of the right and preperimetric primary open-angle glaucoma of the left eye (with reproducible inferotemporal and superotemporal neuroretinal rim and RNFL loss) was prospectively imaged with the AngioVue OCT for RNFLT, GCC thickness, and PAFD, and investigated with the Octopus Normal G2 visual field test on the same days at 6-month intervals for 18 months, while the IOP of the left eye escaped from control. IOP of the left eye fluctuated between 14 and 30 mm Hg in the study period. RNFLT, GCC thickness, and peripapillary PAFD all decreased significantly (linear regression analysis, P=0.030, 0.040, and 0.020, respectively), and a significant 2.1 dB/y progression was seen for a superior visual field cluster. The RNFLT, peripapillary PAFD, and visual field of the right eye remained normal and unchanged. In our case IOP elevation, glaucomatous visual field conversion, and structural progression were accompanied with significant progressive decrease of peripapillary PAFD. The simultaneous thinning of RNFLT and GCC and decrease of peripapillary PAFD suggest that PAFD may potentially be an additional indicator of early progression in primary open-angle glaucoma.
Moradian, Seyed Tayeb; Najafloo, Mohammad; Mahmoudi, Hosein; Ghiasi, Mohammad Saeid
2017-09-01
Atelectasis and pleural effusion are common after coronary artery bypass graft surgery (CABG). Longer stay in the bed is one of the most important contributing factors in pulmonary complications. Some studies confirm the benefits of early mobilization (EM) in critically ill patients, but the efficacy of EM on pulmonary complications after CABG is not clear. This study was designed to examine the effect of EM on the incidence of atelectasis and pleural effusion in patients undergoing CABG. In a single-blinded randomized clinical trial, 100 patients who were undergoing coronary artery bypass graft surgery were randomly assigned into two groups each consisted of 50 patients. Patients in the experimental group were enrolled in a mobilization protocol consisting of the mobilization from the bed in the first 3 days after surgery in the morning and evening. Patients in the control group were mobilized from bed in third postoperation day, according to the hospital routine. Arterial blood gases, pleural effusion, and atelectasis were compared between groups. Atelectasis and pleural effusion was reduced in experimental group. The partial pressure of oxygen in arterial blood in third postoperative day and the percentage of arterial oxygen saturation in the fourth postoperative day were higher in the intervention group (P value < .05). EM from bed could be an effective intervention in reducing atelectasis and pleural effusion in patients undergoing CABG. Copyright © 2017 Society for Vascular Nursing, Inc. Published by Elsevier Inc. All rights reserved.
Mobile health apps in Sweden: what do physicians recommend?
Zhang, Yiping; Koch, Sabine
2015-01-01
Currently over 50,000 mobile health apps are available worldwide. In general, they are considered as innovations potentially delivering benefits to patients. Physicians are considered as potential channels to disseminate these innovations to patients. However, physicians' behavior in this regard has not been studied. To capture physicians' attitudes towards recommending health apps to patients and to describe factors influencing physicians' behavior, taking the specifics of an early adopter country, Sweden, into account. Diffusion of Innovation theory, the Health App Maturity Model and the Six Hurdles Model were used to construct a web-based survey that was answered by 44 Swedish physicians. Survey results were followed up with 2 individual interviews. Descriptive statistics were used for quantitative data analysis and recursive abstraction for qualitative data analysis. Only a small group of physicians currently recommend mobile health apps to their patients. However, most physicians have a positive attitude and perceive improvement of patients' self-management ability as main benefit of health apps. Main perceived weaknesses include the lack of evidence-based content and lack of multi-language support. Regulation of health apps under the Medical Device Directive is asked for to assure quality and patient safety. Innovators and early adopters play an important role in the diffusion of mobile health apps. Interpersonal communication is seen as the most effective way for physicians gaining information and also motivates them to recommend mobile health apps to their patients. Physicians' knowledge about certified websites to ensure quality is however low.
Hormonal regulation of lipid metabolism in developing coho salmon, Oncorhynchus kisutch
DOE Office of Scientific and Technical Information (OSTI.GOV)
Sheridan, M.A.
1985-01-01
Lipid metabolism in juvenile coho salmon is characterized, and adaptive changes in lipid mobilization are described in relation to development and hormonal influences. The rates of lipogenesis and lipolysis were determined in selected tissues of juvenile salmon during the period of seawater preadaptive development (smoltification). Neutral lipid (sterol) and fatty acid synthesis in the liver and mesenteric fat was measured by tritium incorporation. Fatty acid synthesis in the liver and mesenteric fat decreased by 88% and 81%, respectively, between late February (parr) and early June (smolt). To assess the role of hormones in smoltification-associated lipid depletion, growth hormone, prolactin, thyroxinmore » and cortisol were administered in vivo early in development (parr) to determine if any of these factors could initiate the metabolic responses normally seen later in development (smolt). Growth hormone stimulated lipid mobilization from coho salmon parr. Prolactin strongly stimulated lipid mobilization in coho parr. Thyroxin and cortisol also stimulated lipid mobilization for coho salmon parr. The direct effect of hormones was studied by in vitro pH-stat incubation of liver slices. These data suggest that norepinephrine stimulates fatty acid release via ..beta..-adrenergic pathways. Somatostatin and its partial analogue from the fish caudal neurosecretory system, urotensin II, also affect lipid mobilization. These results establish the presence of hormone-sensitive lipase in salmon liver and suggest that the regulation of lipid metabolism in salmon involves both long-acting and short-acting hormonal agents.« less
Genetic disorders with heterotopic ossificans
Sankar, Ruthiramurthy; Gowrishankar, Kalpana; Viswanathan, Saraswati
2015-01-01
Fibrodysplasia ossificans progressiva (FOP) and progressive ossific heteroplasia (POH) are rare genetic disorders characterized by heterotopic bone formation leading to progressive loss of mobility and function. We report three cases of these rare disorders (two cases of FOP and one case of POH), which were clinically diagnosed and underwent genetic analysis. The aim of this report is to highlight the clinical features and the differences between these two conditions. We would also like to emphasize on the morbidity that can arise from unnecessary invasive investigations for diagnostic purposes. PMID:26015640
Barr, Margo; Ferguson, Raymond; van Ritten, Jason; Hughes, Phil; Steel, David
2015-01-01
Although it was estimated that 20% of the population in Australia were mobile-only phone users in 2010, the inclusion of mobile numbers into computer-assisted telephone interviews (CATI) behavioural risk factor surveys did not occur until 2012. Three papers have been published describing the methods, weighting strategy and the impact in detail of including mobile numbers into the NSW Population Health Survey (NSWPHS). This paper identifies the important components of those papers and summarises them for a broader audience. In the 2012 NSWPHS, 15,214 (15,149 with weights) interviews were completed (64% landline frame; 36% mobile frame). Response, cooperation and contact rates were 37%, 65% and 69% respectively. The inclusion of mobile phone numbers resulted in a sample that was closer to the NSW population profile and impacted on the time series of estimates for alcohol drinking, recommended fruit consumption, current smoking, and overweight or obesity. The papers found that including mobile phone numbers into NSWPHS did not impact negatively on response rates or data collection, but it did cost more and affect the time series for some behavioural risk factors, in that it corrected the estimates that had been produced from a sample frame that was progressively getting less representative of the population.
Change in physical mobility over 10 years in post-polio syndrome.
Bickerstaffe, A; Beelen, A; Nollet, F
2015-03-01
Post-polio syndrome is characterised by progressive muscle weakness and other symptoms which can limit physical mobility. We assessed the rate of decline in mobility over 10 years in relation to strength decline; and investigated potential predictors for the rate of decline of walking capacity, a measure of mobility, in 48 patients with post-polio syndrome and proven quadriceps dysfunction at baseline. Average walking capacity and self-reported physical mobility declined over 10 years, by 6 and 14%, respectively. Concomitantly people lost an average of 15% of isometric quadriceps strength. Significantly more people used walking aids offering greater support at follow-up. Notably, there was much individual variation, with 18% of participants losing a substantial amount of walking capacity (27% decline) and concomitant self-reported physical mobility (38% decline). Loss of quadriceps strength only explained a small proportion of the variance of the decline in walking capacity (R = 11%) and the rate of decline could not be predicted from baseline values for strength, walking capacity, self-reported physical mobility or basic demographics. The individual variability, yet lack of predictive factors, underscores the need for personally tailored care based on actual functional decline in patients with post-polio syndrome. Copyright © 2014. Published by Elsevier B.V.
Rail Outloading Capability Study, Defense General Supply Center Richmond, Virginia,
1978-08-01
COFC) cars) are more cost- effective than the standard types and should be used if available. ( e. For mobilization moves, when time is more critical...and switching functions. b. Coordinate mobilization activities with the Seaboard Coast Line, as early as practicable, for ordering 194 railcars per day...obtained during the field study and other pertinent information relating to installation activities at that time. Problems incurred during implementation of
ERIC Educational Resources Information Center
Law, Gloria C.; Neihart, Maureen; Dutt, Anuradha
2018-01-01
Communication intervention in early life can significantly impact long-term outcomes for young children with autism. Parents can be vital resources in the midst of the current manpower shortage. "Map4speech" is a new mobile application developed for parents of children with autism spectrum disorder. It is specially designed to provide…
Mangone, C A
Alzheimer's disease (AD) is a degenerative dementia that may disclose different cognitive, behavioral, psychiatric and functional symptoms since onset. These distinct cognitive profiles support the conception of clinical heterogeneity and account for AD's highly variable rate of progression. In spite of strict diagnostic criteria NINCS ADRDA's and DSM IV the clinical certainty is only about 85%. Mayeux define 4 subtypes: a). Benign: mild cognitive and functional impairment without focal signs and late onset behavioral signs, slow progression; b). Myoclonic: usually of presenile onset with severe cognitive deterioration, mutism and early onset myoclonus; c). Extrapyramidal: early onset akineto rigid signs with severe cognitive, behavioral and psychiatric involvement; d). Typical: gradual and progressive cognitive, behavioral and functional impairment. The differentiation of these subtypes will allow us to define discrete patterns of progression, to define prognostic subgroups, and to homogenize them for clinical research and drug trials. We examined 1000 charts of probable AD patients from the Santojanni Center. We found 42% extrapyramidal, 35% typical, 15% benign and 8% myoclonic. The early onset of parkinsonism and myoclonus predict a rapidly evolving cognitive impairment and a more severe rate of progression with psychiatric disorders and dependency in activities of daily living. (DADL) Patients with low level of education, low cognitive performance at entry as well as those with rapid rate of cognitive deterioration had a faster rate of progression to DADL. Delusions, low level of education, extrapyramidal signs and motor hyperactivity but not hallucinations, and anosognosia were the best non cognitive predictors of DADL.
A polycomb-mediated epigenetic field defect precedes invasive cervical carcinoma
Wijetunga, Neil Ari; Ben-Dayan, Miriam; Tozour, Jessica; Burk, Robert D.; Schlecht, Nicolas F.; Einstein, Mark H.; Greally, John M.
2016-01-01
Human papillomavirus (HPV)-associated cervical carcinoma is preceded by stages of cervical intra-epithelial neoplasia (CIN) that can variably progress to malignancy. Understanding the different molecular processes involved in the progression of pre-malignant CIN is critical to the development of improved predictive and interventional capabilities. We tested the role of regulators of transcription in both the development and the progression of HPV-associated CIN, performing the most comprehensive genomic survey to date of DNA methylation in HPV-associated cervical neoplasia, testing ~2 million loci throughout the human genome in biopsies from 78 HPV+ women, identifying changes starting in early CIN and maintained through carcinogenesis. We identified loci at which DNA methylation is consistently altered, beginning early in the course of neoplastic disease and progressing with disease advancement. While the loss of DNA methylation occurs mostly at intergenic regions, acquisition of DNA methylation is at sites involved in transcriptional regulation, with strong enrichment for targets of polycomb repression. Using an independent cohort from The Cancer Genome Atlas, we validated the loci with increased DNA methylation and found that these regulatory changes were associated with locally decreased gene expression. Secondary validation using immunohistochemistry showed that the progression of neoplasia was associated with increasing polycomb protein expression specifically in the cervical epithelium. We find that perturbations of genomic regulatory processes occur early and persist in cervical carcinoma. The results indicate a polycomb-mediated epigenetic field defect in cervical neoplasia that may represent a target for early, topical interventions using polycomb inhibitors. PMID:27557505
A polycomb-mediated epigenetic field defect precedes invasive cervical carcinoma.
Wijetunga, Neil Ari; Ben-Dayan, Miriam; Tozour, Jessica; Burk, Robert D; Schlecht, Nicolas F; Einstein, Mark H; Greally, John M
2016-09-20
Human papillomavirus (HPV)-associated cervical carcinoma is preceded by stages of cervical intra-epithelial neoplasia (CIN) that can variably progress to malignancy. Understanding the different molecular processes involved in the progression of pre-malignant CIN is critical to the development of improved predictive and interventional capabilities. We tested the role of regulators of transcription in both the development and the progression of HPV-associated CIN, performing the most comprehensive genomic survey to date of DNA methylation in HPV-associated cervical neoplasia, testing ~2 million loci throughout the human genome in biopsies from 78 HPV+ women, identifying changes starting in early CIN and maintained through carcinogenesis. We identified loci at which DNA methylation is consistently altered, beginning early in the course of neoplastic disease and progressing with disease advancement. While the loss of DNA methylation occurs mostly at intergenic regions, acquisition of DNA methylation is at sites involved in transcriptional regulation, with strong enrichment for targets of polycomb repression. Using an independent cohort from The Cancer Genome Atlas, we validated the loci with increased DNA methylation and found that these regulatory changes were associated with locally decreased gene expression. Secondary validation using immunohistochemistry showed that the progression of neoplasia was associated with increasing polycomb protein expression specifically in the cervical epithelium. We find that perturbations of genomic regulatory processes occur early and persist in cervical carcinoma. The results indicate a polycomb-mediated epigenetic field defect in cervical neoplasia that may represent a target for early, topical interventions using polycomb inhibitors.
Public Use of Mobile Medical Applications: A Case Study on Cloud-Based Medical Service of Taiwan.
Lu, Chen-Luan; Yan, Yu-Hua
2016-01-01
The use of smart mobile devices has been getting increasingly popular. The focus of this study is an attempt to explore the development of mobile medical App by medical centers and regional hospitals of Taiwan and the function of the App for comparison. The results show indicated that many hospitals developed Apps for the public for mobile medical service, of which 26 medical centers (100%) and 72 regional hospitals (84.7%) availed appointment making service via Apps. The result indicated variance at significant level (p < 0.01). There are 23 medical centers (88.5%) and 74 regional hospitals (87.1%) availed Apps for checking service progress. The result indicated insignificant variance level (p > 0.01). We can see that mobile medical service is gradually emerging as a vital issue. Yet, this is a new domain in medical service. With the mushrooming of medical applications in smart mobile devices, the medical service system is expected to be installed in these devices to enhance interactive mode of operation and inquiry services, such as medication and inquiries into physical examination results. By then, people can learn the status of their health with this system.
Unsupervised user similarity mining in GSM sensor networks.
Shad, Shafqat Ali; Chen, Enhong
2013-01-01
Mobility data has attracted the researchers for the past few years because of its rich context and spatiotemporal nature, where this information can be used for potential applications like early warning system, route prediction, traffic management, advertisement, social networking, and community finding. All the mentioned applications are based on mobility profile building and user trend analysis, where mobility profile building is done through significant places extraction, user's actual movement prediction, and context awareness. However, significant places extraction and user's actual movement prediction for mobility profile building are a trivial task. In this paper, we present the user similarity mining-based methodology through user mobility profile building by using the semantic tagging information provided by user and basic GSM network architecture properties based on unsupervised clustering approach. As the mobility information is in low-level raw form, our proposed methodology successfully converts it to a high-level meaningful information by using the cell-Id location information rather than previously used location capturing methods like GPS, Infrared, and Wifi for profile mining and user similarity mining.
Automatic control of a mobile Viking lander on the surface of Mars
NASA Technical Reports Server (NTRS)
Moore, J.; Scofield, W.; Tobey, W.
1976-01-01
A mobile lander system is being considered for use in a possible follow-on mission to the Viking '75 landings on Mars. A mobile Viking lander, which could be launched as early as the 1979 opportunity, would be capable of traversing 100 m to 1 km per day on a commanded heading while sensing hazards and performing avoidance maneuvers. The degree of autonomous control, and consequently the daily traverse range, is still under study. The mobility concept requires the addition of: (1) track-laying or wheel units in place of the Viking Lander footpads, (2) a set of hazard and navigation sensors, and (3) a mobility control computer capability. The technology required to develop these three subsystems is available today. The principal objective of current design studies, as described in this paper, is to define a mobile lander system that will demonstrate high reliability and fail-safe hazard avoidance while achieving range- and terrain-handling capabilities which satisfy the Mars exploration science requirements.
Enhanced Predictive Handover for Fast Proxy Mobile IPv6
NASA Astrophysics Data System (ADS)
Jeon, Seil; Kang, Namhi; Kim, Younghan
Proxy Mobile IPv6 (PMIPv6) has been proposed in order to overcome the limitations of host-based mobility management in IPv6 networks. However, packet losses during doing handover are still a problem. To solve this issue, several schemes have been developed, and can be classified into two approaches: predictive and reactive handover. Both approaches commonly use bi-directional tunnel between mobile access gateways (MAGs). In predictive schemes especially, mobility support for a mobile node (MN) is triggered by simplified link signal strength. Thereafter, the MN sends handover notification to its serving MAG, and is then able to initiate packet forwarding. Therefore, if the MN moves toward an unexpected MAG that does not have any pre-established tunnel with the serving MAG, it may lead to packet losses. In this paper, we define this problem as Early Packet Forwarding (EPF). As a solution, we propose an enhanced PMIPv6 scheme using two-phase tunnel control based on the IEEE 802.21 Media Independent Handover (MIH).
Mobile Life - Innovation in the Wild
NASA Astrophysics Data System (ADS)
Höök, Kristina
After a decade of work in our research labs on mobile and ubiquitous technology, often formed by the early visions of ubiquitous computing, with the urge to move interaction from the desktop out into the wild, these technologies have now moved out into the world - into the wild. We are in the middle of a second IT-revolution, caused by the spread of mobile and ubiquitous services, in combination with a broad consumer-oriented market pull. The first ITrevolution, the introduction and deployment of Internet and the World Wide Web during the 1990’s, had a major impact on all parts of our society. As mobile, ubiquitous technology now becomes wide-spread, the design and evaluation of mobile services - i.e. information technology that can be accessed and used in virtually any setting - represents an important business arena for the IT- and telecom industry. Together we have to look for a sustainable web of work, leisure and ubiquitous technology we can call the mobile life.
Wearable motion sensors to continuously measure real-world physical activities.
Dobkin, Bruce H
2013-12-01
Rehabilitation for sensorimotor impairments aims to improve daily activities, walking, exercise, and motor skills. Monitoring of practice and measuring outcomes, however, is usually restricted to laboratory-based procedures and self-reports. Mobile health devices may reverse these confounders of daily care and research trials. Wearable, wireless motion sensor data, analyzed by activity pattern-recognition algorithms, can describe the type, quantity, and quality of mobility-related activities in the community. Data transmission from the sensors to a cell phone and the Internet enable continuous monitoring. Remote access to laboratory quality data about walking speed, duration and distance, gait asymmetry and smoothness of movements, as well as cycling, exercise, and skills practice, opens new opportunities to engage patients in progressive, personalized therapies with feedback about the performance. Clinical trial designs will be able to include remote verification of the integrity of complex physical interventions and compliance with practice, as well as capture repeated, ecologically sound, ratio scale outcome measures. Given the progressively falling cost of miniaturized wearable gyroscopes, accelerometers, and other physiologic sensors, as well as inexpensive data transmission, sensing systems may become as ubiquitous as cell phones for healthcare. Neurorehabilitation can develop these mobile health platforms for daily care and clinical trials to improve exercise and fitness, skills learning, and physical functioning.
Rapidly progressive idiopathic lenticular astigmatism.
Tint, Naing L; Jayaswal, Rakesh; Masood, Imran; Maharajan, V Senthil
2007-02-01
A myopic 43-year-old woman with early nuclear sclerotic cataract developed more than 11.0 diopters (D) of astigmatism over a 6-month period. This was found to be lenticular in origin. Phacoemulsification with intraocular lens implantation was performed, resulting in residual astigmatism of 0.75 D. To our knowledge, this is the first case of rapidly progressive lenticular astigmatism in an otherwise healthy eye with early nuclear sclerotic cataract.
ERIC Educational Resources Information Center
Meeus, Wim; Van De Schoot, Rens; Keijsers, Loes; Schwartz, Seth J.; Branje, Susan
2010-01-01
This study examined identity development in a 5-wave study of 923 early-to-middle and 390 middle-to-late adolescents thereby covering the ages of 12-20. Systematic evidence for identity progression was found: The number of diffusions, moratoriums, and searching moratoriums (a newly obtained status) decreased, whereas the representation of the…
Tsuda, Takeshi; Fitzgerald, Kristi; Scavena, Mena; Gidding, Samuel; Cox, Mary O; Marks, Harold; Flanigan, Kevin M; Moore, Steven A
2015-03-01
We report a family in which two male siblings with Becker muscular dystrophy (BMD) developed severe dilated cardiomyopathy (DCM) and progressive heart failure (HF) at age 11 years; one died at age 14 years while awaiting heart transplant and the other underwent left ventricular assist device implantation at the same age. Genetic analysis of one sibling showed a novel frameshift mutation in exon 27 of Duchenne muscular dystrophy (DMD) gene (c.3779_3785delCTTTGGAinsGG), in which seven base pairs are deleted and two are inserted. Although this predicts an amino-acid substitution and premature termination (p.Thr1260Argfs*8), muscle biopsy dystrophin immunostaining instead indicates that the mutation is more likely to alter splicing. Despite relatively preserved skeletal muscular performance, both the siblings developed progressive HF secondary to early-onset DCM. In addition, their 7-year-old nephew with delayed gross motor development, mild proximal muscle weakness and markedly elevated serum creatine kinase level (>13 000 IU l(-1)) at 16 months was recently demonstrated to have the familial DMD mutation. Here, we report a novel genotype of BMD with early-onset DCM and progressive lethal HF during early adolescence.
Earthquake Early Warning Beta Users: Java, Modeling, and Mobile Apps
NASA Astrophysics Data System (ADS)
Strauss, J. A.; Vinci, M.; Steele, W. P.; Allen, R. M.; Hellweg, M.
2014-12-01
Earthquake Early Warning (EEW) is a system that can provide a few to tens of seconds warning prior to ground shaking at a user's location. The goal and purpose of such a system is to reduce, or minimize, the damage, costs, and casualties resulting from an earthquake. A demonstration earthquake early warning system (ShakeAlert) is undergoing testing in the United States by the UC Berkeley Seismological Laboratory, Caltech, ETH Zurich, University of Washington, the USGS, and beta users in California and the Pacific Northwest. The beta users receive earthquake information very rapidly in real-time and are providing feedback on their experiences of performance and potential uses within their organization. Beta user interactions allow the ShakeAlert team to discern: which alert delivery options are most effective, what changes would make the UserDisplay more useful in a pre-disaster situation, and most importantly, what actions users plan to take for various scenarios. Actions could include: personal safety approaches, such as drop cover, and hold on; automated processes and procedures, such as opening elevator or fire stations doors; or situational awareness. Users are beginning to determine which policy and technological changes may need to be enacted, and funding requirements to implement their automated controls. The use of models and mobile apps are beginning to augment the basic Java desktop applet. Modeling allows beta users to test their early warning responses against various scenarios without having to wait for a real event. Mobile apps are also changing the possible response landscape, providing other avenues for people to receive information. All of these combine to improve business continuity and resiliency.
Development of robotic mobility for infants: rationale and outcomes.
Larin, Hélène M; Dennis, Carole W; Stansfield, Sharon
2012-09-01
To assess the feasibility of a robotic mobility device for infants using alternative control interfaces aimed at promoting early self-initiated mobility, and to assess the effects of a training protocol and robot experience. Observational and pre-post quantitative case studies. Standardised, research laboratory and day-care centres with toys and individuals familiar to infants. Children with and without disabilities, aged 5 months to 3 years. In each study, infants were seated over a Pioneer™ 3-DX mobile robot. Some infants controlled the directional movement of the robot by weight shifting their body on a Nintendo® Wii™ Balance Board (the WeeBot), while others used a modified joystick. Infants participated in five sessions over 2 to 5 weeks. Sessions consisted of administering a 10-minute training protocol preceded and followed by 2 to 3 minutes of free play. One child with motor impairment used a button switch array and a different experimental design. From the videotaped free-play periods, goal-directed behaviours were coded and time in motion was measured. In the training period, a scoring system was developed to measure the infants' driving performance. Preliminary outcomes indicate that infants without disabilities, aged 5 to 10 months, demonstrated significant improvement in driving performance and goal-directed movement using the WeeBot. Infants who used the joystick were less successful on all measures. Results for infants with disabilities using the WeeBot were mixed. Mobile robots offer promise to enhance the development of early self-mobility. Novel types of interfaces, such as the WeeBot, warrant further investigation. Copyright © 2012 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.
Özkurt, Zübeyde Nur; Sucak, Gülsan Türköz; Akı, Şahika Zeynep; Yağcı, Münci; Haznedar, Rauf
2017-03-16
We hypothesized the levels of free light chains obtained before and after autologous stem cell transplantation can be useful in predicting transplantation outcome. We analyzed 70 multiple myeloma patients. Abnormal free light chain ratios before stem cell transplantation were found to be associated early progression, although without any impact on overall survival. At day +30, the normalization of levels of involved free light chain related with early progression. According to these results almost one-third reduction of free light chain levels can predict favorable prognosis after autologous stem cell transplantation.
Morlock, Robert; Goodwin, Bridgett; Gomez Rey, Gabriel; Eaddy, Michael
2013-05-01
Two previous retrospective database analyses compared early combination therapy with an α-blocker (AB) and 5-α reductase inhibitor (5-ARI) to delayed combination therapy and found that patients receiving the delayed combination therapy were more likely to have clinical progression, acute urinary retention (AUR), and surgery. Although these studies indicate the clinical benefits of early treatment, both studies failed to take into account important baseline clinical measures, such as prostate-specific antigen (PSA) values. This study was designed to compare clinical and cost differences in men with benign prostatic hyperplasia (BPH) who initiated early versus delayed combination therapy with a 5-ARI + an AB, factoring in baseline PSA values. This retrospective claims data analysis assessed data from >14 million US men with linked medical data, pharmacy data, laboratory results, and enrollment information from January 1, 2000, to December 31, 2009. Men aged 50 or older and treated for BPH with a 5-ARI + an AB were identified. Patients were required to be eligible for services at least 6 months before and 12 months after the index medication date. Patients were assigned to 1 of 2 treatment groups based on therapy (early or delayed) and 3 cohorts based on availability of PSA laboratory values (patients with a PSA value, patients with a PSA value >1.5 and <10, and all patients). Using a logistic model, the likelihood of clinical progression (defined as the occurrence of AUR or prostate surgery) during the 12 months after the date of first prescription fill was compared between BPH patients receiving early versus delayed combination therapy. BPH-related medical costs (excluding pharmacy costs) were assessed using generalized linear models. Among the 13,551 patients identified for study inclusion, the highest risks for clinical progression, AUR, and prostate-related surgery were consistently demonstrated in patients with a PSA >1.5 and <10. Across all 3 cohorts, the delayed combination-treatment group was more likely to have clinical progression, AUR, and prostate-related surgeries versus the early combination-treatment group. The incremental difference in BPH-related costs between the delayed and early combination-treatment groups was $190 per patient overall; the greatest incremental difference ($397) was observed in patients with PSA >1.5 and <10. The results suggest that early initiation of combination therapy with 5-ARI + an AB, compared with delayed initiation, can reduce the risks for clinical progression, AUR, and prostate-related surgeries, as well as BPH-related medical costs, in patients with BPH. Copyright © 2013 Elsevier HS Journals, Inc. All rights reserved.
Pomeraniec, I Jonathan; Kano, Hideyuki; Xu, Zhiyuan; Nguyen, Brandon; Siddiqui, Zaid A; Silva, Danilo; Sharma, Mayur; Radwan, Hesham; Cohen, Jonathan A; Dallapiazza, Robert F; Iorio-Morin, Christian; Wolf, Amparo; Jane, John A; Grills, Inga S; Mathieu, David; Kondziolka, Douglas; Lee, Cheng-Chia; Wu, Chih-Chun; Cifarelli, Christopher P; Chytka, Tomas; Barnett, Gene H; Lunsford, L Dade; Sheehan, Jason P
2017-10-27
OBJECTIVE Gamma Knife radiosurgery (GKRS) is frequently used to treat residual or recurrent nonfunctioning pituitary macroadenomas. There is no consensus as to whether GKRS should be used early after surgery or if radiosurgery should be withheld until there is evidence of imaging-defined progression of tumor. Given the high incidence of adenoma progression after subtotal resection over time, the present study intended to evaluate the effect of timing of radiosurgery on outcome. METHODS This is a multicenter retrospective review of patients with nonfunctioning pituitary macroadenomas who underwent transsphenoidal surgery followed by GKRS from 1987 to 2015 at 9 institutions affiliated with the International Gamma Knife Research Foundation. Patients were matched by adenoma and radiosurgical parameters and stratified based on the interval between last resection and radiosurgery. Operative results, imaging data, and clinical outcomes were compared across groups following early (≤ 6 months after resection) or late (> 6 months after resection) radiosurgery. RESULTS After matching, 222 patients met the authors' study criteria (from an initial collection of 496 patients) and were grouped based on early (n = 111) or late (n = 111) GKRS following transsphenoidal surgery. There was a greater risk of tumor progression after GKRS (p = 0.013) and residual tumor (p = 0.038) in the late radiosurgical group over a median imaging follow-up period of 68.5 months. No significant difference in the occurrence of post-GKRS endocrinopathy was observed (p = 0.68). Thirty percent of patients without endocrinopathy in the early cohort developed new endocrinopathies during the follow-up period versus 27% in the late cohort (p = 0.84). Fourteen percent of the patients in the early group and 25% of the patients in the late group experienced the resolution of endocrine dysfunction after original presentation (p = 0.32). CONCLUSIONS In this study, early GKRS was associated with a lower risk of radiological progression of subtotally resected nonfunctioning pituitary macroadenomas compared with expectant management followed by late radiosurgery. Delaying radiosurgery may increase patient risk for long-term adenoma progression. The timing of radiosurgery does not appear to significantly affect the rate of delayed endocrinopathy.
iPads: Improving Numeracy Learning in the Early Years
ERIC Educational Resources Information Center
Spencer, Peta
2013-01-01
The concept of mobile technologies is now an emergency theme in educational research, yet the playing of these edutainment applications and their impact on early childhood learning needs to be fully explored. This study highlights current research and explores how iPads improve student learning. It also examines how the introduction of iPads,…
Here's What We Have to Say! Podcasting in the Early Childhood Classroom
ERIC Educational Resources Information Center
Berson, Ilene R.
2009-01-01
A podcast is an audio file published to the Internet for playback on mobile devices and personal computers; the meaning of the term has expanded to include video files, or "enhanced podcasts" as well. Many students are already engaged with digital technologies when they first step into early childhood classrooms. Children as young as…
The effect of increased mobility on morbidity in the neurointensive care unit.
Titsworth, W Lee; Hester, Jeannette; Correia, Tom; Reed, Richard; Guin, Peggy; Archibald, Lennox; Layon, A Joseph; Mocco, J
2012-06-01
The detrimental effects of immobility on intensive care unit (ICU) patients are well established. Limited studies involving medical ICUs have demonstrated the safety and benefit of mobility protocols. Currently no study has investigated the role of increased mobility in the neurointensive care unit population. This study was a single-institution prospective intervention trial to investigate the effectiveness of increased mobility among neurointensive care unit patients. All patients admitted to the neurointensive care unit of a tertiary care center over a 16-month period (April 2010 through July 2011) were evaluated. The study consisted of a 10-month (8025 patient days) preintervention observation period followed by a 6-month (4455 patient days) postintervention period. The intervention was a comprehensive mobility initiative utilizing the Progressive Upright Mobility Protocol (PUMP) Plus. Implementation of the PUMP Plus increased mobility among neurointensive care unit patients by 300% (p < 0.0001). Initiation of this protocol also correlated with a reduction in neurointensive care unit length of stay (LOS; p < 0.004), hospital LOS (p < 0.004), hospital-acquired infections (p < 0.05), and ventilator-associated pneumonias (p < 0.001), and decreased the number of patient days in restraints (p < 0.05). Additionally, increased mobility did not lead to increases in adverse events as measured by falls or inadvertent line disconnections. Among neurointensive care unit patients, increased mobility can be achieved quickly and safely with associated reductions in LOS and hospital-acquired infections using the PUMP Plus program.
Early detection: the impact of genomics.
van Lanschot, M C J; Bosch, L J W; de Wit, M; Carvalho, B; Meijer, G A
2017-08-01
The field of genomics has shifted our view on disease development by providing insights in the molecular and functional processes encoded in the genome. In the case of cancer, many alterations in the DNA accumulate that enable tumor growth or even metastatic dissemination. Identification of molecular signatures that define different stages of progression towards cancer can enable early tumor detection. In this review, the impact of genomics will be addressed using early detection of colorectal cancer (CRC) as an example. Increased understanding of the adenoma-to-carcinoma progression has led to the discovery of several diagnostic biomarkers. This combined with technical advancements, has facilitated the development of molecular tests for non-invasive early CRC detection in stool and blood samples. Even though several tests have already made it to clinical practice, sensitivity and specificity for the detection of precancerous lesions still need improvement. Besides the diagnostic qualities, also the accuracy of the intermediate endpoint is an important issue on how the effectiveness of a novel test is perceived. Here, progression biomarkers may provide a more precise measure than the currently used morphologically based features. Similar developments in biomarker use for early detection have taken place in other cancer types.
MICROBIAL MOBILIZATION OF ARSENIC FROM SEDIMENTS OF THE ABERJONA WATERSHED. (R823222)
The perspectives, information and conclusions conveyed in research project abstracts, progress reports, final reports, journal abstracts and journal publications convey the viewpoints of the principal investigator and may not represent the views and policies of ORD and EPA. Concl...
DOT National Transportation Integrated Search
2009-02-12
Research, development, and technology (RD&T) activities are vital to meeting the Department of Transportation's (DOT) priorities, such as increasing safety, enhancing mobility, and supporting the nation's economic growth. In fiscal year 2008, the dep...
Preemptive mechanical ventilation can block progressive acute lung injury.
Sadowitz, Benjamin; Jain, Sumeet; Kollisch-Singule, Michaela; Satalin, Joshua; Andrews, Penny; Habashi, Nader; Gatto, Louis A; Nieman, Gary
2016-02-04
Mortality from acute respiratory distress syndrome (ARDS) remains unacceptable, approaching 45% in certain high-risk patient populations. Treating fulminant ARDS is currently relegated to supportive care measures only. Thus, the best treatment for ARDS may lie with preventing this syndrome from ever occurring. Clinical studies were examined to determine why ARDS has remained resistant to treatment over the past several decades. In addition, both basic science and clinical studies were examined to determine the impact that early, protective mechanical ventilation may have on preventing the development of ARDS in at-risk patients. Fulminant ARDS is highly resistant to both pharmacologic treatment and methods of mechanical ventilation. However, ARDS is a progressive disease with an early treatment window that can be exploited. In particular, protective mechanical ventilation initiated before the onset of lung injury can prevent the progression to ARDS. Airway pressure release ventilation (APRV) is a novel mechanical ventilation strategy for delivering a protective breath that has been shown to block progressive acute lung injury (ALI) and prevent ALI from progressing to ARDS. ARDS mortality currently remains as high as 45% in some studies. As ARDS is a progressive disease, the key to treatment lies with preventing the disease from ever occurring while it remains subclinical. Early protective mechanical ventilation with APRV appears to offer substantial benefit in this regard and may be the prophylactic treatment of choice for preventing ARDS.
Preemptive mechanical ventilation can block progressive acute lung injury
Sadowitz, Benjamin; Jain, Sumeet; Kollisch-Singule, Michaela; Satalin, Joshua; Andrews, Penny; Habashi, Nader; Gatto, Louis A; Nieman, Gary
2016-01-01
Mortality from acute respiratory distress syndrome (ARDS) remains unacceptable, approaching 45% in certain high-risk patient populations. Treating fulminant ARDS is currently relegated to supportive care measures only. Thus, the best treatment for ARDS may lie with preventing this syndrome from ever occurring. Clinical studies were examined to determine why ARDS has remained resistant to treatment over the past several decades. In addition, both basic science and clinical studies were examined to determine the impact that early, protective mechanical ventilation may have on preventing the development of ARDS in at-risk patients. Fulminant ARDS is highly resistant to both pharmacologic treatment and methods of mechanical ventilation. However, ARDS is a progressive disease with an early treatment window that can be exploited. In particular, protective mechanical ventilation initiated before the onset of lung injury can prevent the progression to ARDS. Airway pressure release ventilation (APRV) is a novel mechanical ventilation strategy for delivering a protective breath that has been shown to block progressive acute lung injury (ALI) and prevent ALI from progressing to ARDS. ARDS mortality currently remains as high as 45% in some studies. As ARDS is a progressive disease, the key to treatment lies with preventing the disease from ever occurring while it remains subclinical. Early protective mechanical ventilation with APRV appears to offer substantial benefit in this regard and may be the prophylactic treatment of choice for preventing ARDS. PMID:26855896
Bioinspired Intelligent Algorithm and Its Applications for Mobile Robot Control: A Survey.
Ni, Jianjun; Wu, Liuying; Fan, Xinnan; Yang, Simon X
2016-01-01
Bioinspired intelligent algorithm (BIA) is a kind of intelligent computing method, which is with a more lifelike biological working mechanism than other types. BIAs have made significant progress in both understanding of the neuroscience and biological systems and applying to various fields. Mobile robot control is one of the main application fields of BIAs which has attracted more and more attention, because mobile robots can be used widely and general artificial intelligent algorithms meet a development bottleneck in this field, such as complex computing and the dependence on high-precision sensors. This paper presents a survey of recent research in BIAs, which focuses on the research in the realization of various BIAs based on different working mechanisms and the applications for mobile robot control, to help in understanding BIAs comprehensively and clearly. The survey has four primary parts: a classification of BIAs from the biomimetic mechanism, a summary of several typical BIAs from different levels, an overview of current applications of BIAs in mobile robot control, and a description of some possible future directions for research.
Bioinspired Intelligent Algorithm and Its Applications for Mobile Robot Control: A Survey
Ni, Jianjun; Wu, Liuying; Fan, Xinnan; Yang, Simon X.
2016-01-01
Bioinspired intelligent algorithm (BIA) is a kind of intelligent computing method, which is with a more lifelike biological working mechanism than other types. BIAs have made significant progress in both understanding of the neuroscience and biological systems and applying to various fields. Mobile robot control is one of the main application fields of BIAs which has attracted more and more attention, because mobile robots can be used widely and general artificial intelligent algorithms meet a development bottleneck in this field, such as complex computing and the dependence on high-precision sensors. This paper presents a survey of recent research in BIAs, which focuses on the research in the realization of various BIAs based on different working mechanisms and the applications for mobile robot control, to help in understanding BIAs comprehensively and clearly. The survey has four primary parts: a classification of BIAs from the biomimetic mechanism, a summary of several typical BIAs from different levels, an overview of current applications of BIAs in mobile robot control, and a description of some possible future directions for research. PMID:26819582
Hornby, T George; Holleran, Carey L; Leddy, Abigail L; Hennessy, Patrick; Leech, Kristan A; Connolly, Mark; Moore, Jennifer L; Straube, Donald; Lovell, Linda; Roth, Elliot
2015-01-01
Optimal physical therapy strategies to maximize locomotor function in patients early poststroke are not well established. Emerging data indicate that substantial amounts of task-specific stepping practice may improve locomotor function, although stepping practice provided during inpatient rehabilitation is limited (<300 steps/session). The purpose of this investigation was to determine the feasibility of providing focused stepping training to patients early poststroke and its potential association with walking and other mobility outcomes. Daily stepping was recorded on 201 patients <6 months poststroke (80% < 1 month) during inpatient rehabilitation following implementation of a focused training program to maximize stepping practice during clinical physical therapy sessions. Primary outcomes included distance and physical assistance required during a 6-minute walk test (6MWT) and balance using the Berg Balance Scale (BBS). Retrospective data analysis included multiple regression techniques to evaluate the contributions of demographics, training activities, and baseline motor function to primary outcomes at discharge. Median stepping activity recorded from patients was 1516 steps/d, which is 5 to 6 times greater than that typically observed. The number of steps per day was positively correlated with both discharge 6MWT and BBS and improvements from baseline (changes; r = 0.40-0.87), independently contributing 10% to 31% of the total variance. Stepping activity also predicted level of assistance at discharge and discharge location (home vs other facility). Providing focused, repeated stepping training was feasible early poststroke during inpatient rehabilitation and was related to mobility outcomes. Further research is required to evaluate the effectiveness of these training strategies on short- or long-term mobility outcomes as compared with conventional interventions. © The Author(s) 2015.
ERIC Educational Resources Information Center
Shores, Elizabeth F., Ed.
2006-01-01
When Hurricanes Katrina and Rita struck the Gulf Coast of the United States in August and September 2005, it was arguably the worst calamity to strike the region in history. Less well known than the loss in life or property from these storms are the effects on early care and education. Those who work with or on behalf of young children found in…
Sternberg, Cora N; Castellano, Daniel; Daugaard, Gedske; Géczi, Lajos; Hotte, Sebastien J; Mainwaring, Paul N; Saad, Fred; Souza, Ciro; Tay, Miah H; Garrido, José M Tello; Galli, Luca; Londhe, Anil; De Porre, Peter; Goon, Betty; Lee, Emma; McGowan, Tracy; Naini, Vahid; Todd, Mary B; Molina, Arturo; George, Daniel J
2014-10-01
In the final analysis of the phase 3 COU-AA-301 study, abiraterone acetate plus prednisone significantly prolonged overall survival compared with prednisone alone in patients with metastatic castration-resistant prostate cancer progressing after chemotherapy. Here, we present the final analysis of an early-access protocol trial that was initiated after completion of COU-AA-301 to enable worldwide preapproval access to abiraterone acetate in patients with metastatic castration-resistant prostate cancer progressing after chemotherapy. We did a multicentre, open-label, early-access protocol trial in 23 countries. We enrolled patients who had metastatic castration-resistant prostate cancer progressing after taxane chemotherapy. Participants received oral doses of abiraterone acetate (1000 mg daily) and prednisone (5 mg twice a day) in 28-day cycles until disease progression, development of sustained side-effects, or abiraterone acetate becoming available in the respective country. The primary outcome was the number of adverse events arising during study treatment and within 30 days of discontinuation. Efficacy measures (time to prostate-specific antigen [PSA] progression and time to clinical progression) were gathered to guide treatment decisions. We included in our analysis all patients who received at least one dose of abiraterone acetate. This study is registered with ClinicalTrials.gov, number NCT01217697. Between Nov 17, 2010, and Sept 30, 2013, 2314 patients were enrolled into the early-access protocol trial. Median follow-up was 5·7 months (IQR 3·5-10·6). 952 (41%) patients had a grade 3 or 4 treatment-related adverse event, and grade 3 or 4 serious adverse events were recorded in 585 (25%) people. The most common grade 3 and 4 adverse events were hepatotoxicity (188 [8%]), hypertension (99 [4%]), cardiac disorders (52 [2%]), osteoporosis (31 [1%]), hypokalaemia (28 [1%]), and fluid retention or oedema (23 [1%]). 172 (7%) patients discontinued the study because of adverse events (64 [3%] were drug-related), as assessed by the investigator, and 171 (7%) people died. The funder assessed causes of death, which were due to disease progression (85 [4%]), an unrelated adverse experience (72 [3%]), and unknown reasons (14 [1%]). Of the 86 deaths not attributable to disease progression, 18 (<1%) were caused by a drug-related adverse event, as assessed by the investigator. Median time to PSA progression was 8·5 months (95% CI 8·3-9·7) and median time to clinical progression was 12·7 months (11·8-13·8). No new safety signals or unexpected adverse events were found in this early-access protocol trial to assess abiraterone acetate for patients with metastatic castration-resistant prostate cancer who progressed after chemotherapy. Future work is needed to ascertain the most effective regimen of abiraterone acetate to optimise patients' outcomes. Janssen Research & Development. Copyright © 2014 Elsevier Ltd. All rights reserved.
‘Poisonous, Filthy, Loathsome, Damnable Stuff’: The Rhetorical Ecology of Vaccination Concern
Hausman, Bernice L.; Ghebremichael, Mecal; Hayek, Philip; Mack, Erin
2014-01-01
In this article, we analyze newspaper articles and advertisements mentioning vaccination from 1915 to 1922 and refer to historical studies of vaccination practices and attitudes in the early 20th century in order to assess historical continuities and discontinuities in vaccination concern. In the Progressive Era period, there were a number of themes or features that resonated with contemporary issues and circumstances: 1) fears of vaccine contamination; 2) distrust of medical professionals; 3) resistance to compulsory vaccination; and 4) the local nature of vaccination concern. Such observations help scholars and practitioners understand vaccine skepticism as longstanding, locally situated, and linked to the sociocultural contexts in which vaccination occurs and is mandated for particular segments of the population. A rhetorical approach offers a way to understand how discourses are engaged and mobilized for particular purposes in historical contexts. Historically situating vaccine hesitancy and addressing its articulation with a particular rhetorical ecology offers scholars and practitioners a robust understanding of vaccination concerns that can, and should, influence current approaches to vaccination skepticism. PMID:25506275
2007-09-26
KENNEDY SPACE CENTER, FLA. -- A worker monitors the progress of the retraction of the mobile service tower, or gantry, from the Delta II rocket on Launch Pad 17B at Cape Canaveral Air Force Station. Starting with a boost from this higher thrust version of the Delta II rocket, the Dawn spacecraft will study the asteroid Vesta and dwarf planet Ceres, celestial bodies believed to have accreted early in the history of the solar system. To carry out its scientific mission during its nearly decade-long mission, Dawn will carry a visible camera, a visible and infrared mapping spectrometer, and a gamma ray and neutron spectrometer, whose data will be used in combination to characterize these bodies. In addition to the three instruments, radiometric and optical navigation data will provide data relating to the gravity field, and thus, bulk properties and internal structure of the two bodies. Data returned from the Dawn spacecraft could provide opportunities for significant breakthroughs in our knowledge of how the solar system formed. Launch is targeted for Sept. 27 during a window that extends from 7:20 to 7:49 a.m. EDT. Photo credit: NASA/Kim Shiflett
Applications of aerospace technology in biology and medicine
NASA Technical Reports Server (NTRS)
Bass, B.; Beall, H. C.; Brown, J. N., Jr.; Clingman, W. H.; Eakes, R. E.; Kizakevich, P. N.; Mccartney, M.; Rouse, D. J.
1982-01-01
Utilization of National Aeronautics and Space Administration (NASA) technology in medicine is discussed. The objective is best obtained by stimulation of the introduction of new or improved commercially available medical products incorporating aerospace technology. A bipolar donor/recipient model of medical technology transfer is presented to provide a basis for the team's methodology. That methodology is designed to: (1) identify medical problems and NASA technology that, in combination, constitute opportunities for successful medical products; (2) obtain the early participation of industry in the transfer process; and (3) obtain acceptance by the medical community of new medical products based on NASA technology. Two commercial transfers were completed: the Stowaway, a lightweight wheelchair that provides mobility for the disabled and elderly in the cabin of commercial aircraft, and Micromed, a portable medication infusion pump for the reliable, continuous infusion of medications such as heparin or insulin. The marketing and manufacturing factors critical to the commercialization of the lightweight walker incorporating composite materials were studied. Progress was made in the development and commercialization of each of the 18 currently active projects.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Miller, Mark Alan
This report documents progress on DOE Grant# DE-FG02-08ER64531 funded by the Department of Energy’s Atmospheric Systems Research (ASR) program covering the period between its inception in 2008 and its conclusion in 2014. The Atmospheric Radiation Measurement (ARM) Program’s Mobile Facility #1 (AMF#1) is a collection of state-of-the art atmospheric sensing systems including remote and in situ instrumentation designed to characterize the atmospheric column above and in the immediate vicinity of the deployment location. The grant discussed in this report funded the activities of the AMF#1 Site Scientist Team. Broad responsibilities of this team included examining new deployment sites and recommendingmore » instrument deployment configurations; data quality control during the early stages of deployments and for certain instruments through the course of the deployment; scientific outreach in the host country or location (particularly international deployments); scientific research oriented toward basic questions about cloud physics and radiation transfer in the deployment region; and training of Ph.D. students to conduct future research relevant to the Atmospheric Systems Research (ASR) program.« less
Kounatidis, Ilias; Chtarbanova, Stanislava; Cao, Yang; Hayne, Margaret; Jayanth, Dhruv; Ganetzky, Barry; Ligoxygakis, Petros
2017-04-25
During aging, innate immunity progresses to a chronically active state. However, what distinguishes those that "age well" from those developing age-related neurological conditions is unclear. We used Drosophila to explore the cost of immunity in the aging brain. We show that mutations in intracellular negative regulators of the IMD/NF-κB pathway predisposed flies to toxic levels of antimicrobial peptides, resulting in early locomotor defects, extensive neurodegeneration, and reduced lifespan. These phenotypes were rescued when immunity was suppressed in glia. In healthy flies, suppressing immunity in glial cells resulted in increased adipokinetic hormonal signaling with high nutrient levels in later life and an extension of active lifespan. Thus, when levels of IMD/NF-κB deviate from normal, two mechanisms are at play: lower levels derepress an immune-endocrine axis, which mobilizes nutrients, leading to lifespan extension, whereas higher levels increase antimicrobial peptides, causing neurodegeneration. Immunity in the fly brain is therefore a key lifespan determinant. Copyright © 2017 The Author(s). Published by Elsevier Inc. All rights reserved.
[Per os early nutrition for colorectal pathology susceptible of laparoscopy-assisted surgery].
Fernández de Bustos, A; Creus Costas, G; Pujol Gebelli, J; Virgili Casas, N; Pita Mercé, A M
2006-01-01
Current less invasive surgical techniques, the use of new analgesic and anesthetic drugs, and early mobilization ("multimodal surgical strategies") reduce the occurrence of post-surgery paralytic ileus and vomiting, making possible early nutrition by the digestive route. With these premises, a nutrition protocol was designed for its implementation in colorectal pathology susceptible of laparoscopy-assisted surgery. to assess the efficacy of this protocol that comprises 3 phases. Phase I: home preparation with 7 days duration; low-residues and insoluble fiber diet, supplemented with 400 mL of hyperproteic polymeric formula with no lactose or fiber, bowel cleansing 2 days prior to surgery and hydration with water, sugared infusions, and vegetable broth. Phase II: immediate post-surgical period with watery diet for 3 days with polymeric diet with no fiber. Phase III: semi-solid diet with no residues, nutritional formula and progressive reintroduction of food intake in four stages of varying duration according to surgery and digestive tolerance. prospective study performed at our hospital with patients from our influence area, from February 2003 to May 2004, including 25 patients, 19 men and 6 women, with mean age of 63.3 years (range = 33-79) and mean body mass index of 26.25 kg/m2 (range = 20.84-31.3), all of them suffering from colorectal pathology susceptible of laparoscopy-assisted surgery, and to which the study protocol was applied. Fourteen left hemicolectomies, 5 right hemicolectomies, 4 low anterior resections with protective colostomy, and subtotal colectomies and lateral ileostomy were done. Final diagnoses were: 3 diverticular diseases; 3 adenomas; 7 rectosigmoidal neoplasms; and 12 large bowel neoplasms in other locations. The pathology study confirmed: pT3N0 (n = 7), pT3N1 (n = 3), pT3N2 (n = 1), and pT3N1M1 (n = 1), pT1N0 (n = 4), pT1N1 (n = 2), pTis (n = 1). Twelve patients were started on adjuvant therapy of which 3 had received an initial treatment with QT or RT. Intestinal cleansing was poorly effective in 3 patients diagnosed with sub-occlusive neoplasm. Feeding was started within 24 hours in 13 patients, within 48 h in 7 patients, and at day 5 in one patient because of paralytic ileus. Hospital discharge was within the 3d-5th day in 60% of the patient, between 6th-10th day in 28%, and in 12% it occurred more than 20 days later due to complications. Progressive regimens were well tolerated by all patients, with no occurrence of diarrhea syndrome, the number of defecations varying from 2 to 4 and with a soft-normal consistency. In ponderal evolution, it is remarkable disease-related weight loss greater than 5% in 8 patients. By the end of the progressive diet, 5 patients had weight loss greater than 10% (4 for adjuvant therapy, 1 for depressive syndrome because of carrying a stoma). These patients were monitored 3 months later and they had recovered their regular weight. Early nutrition in colorectal surgery is possible. Following a progressive feeding regimen allows for a better digestive tolerance as well as a good physical and functional recovery of the patient.
Progress and challenges of the rural cooperative medical scheme in China
Xu, Ke
2014-01-01
Abstract Problem During China’s transition to a market economy in the 1980s and 1990s, the rural population faced substantial barriers to accessing health care and encountered heavier financial burdens than urban residents in paying for necessary health services. Approach In 2003, China started to implement a rural cooperative medical scheme (RCMS), mainly through government subsidies. The scheme operates at the county level and offers a modest benefit package. Local setting In spite of rapid economic growth since the early 1980s, income disparities in China have increased, particularly between rural and urban populations. In response, the government has put greater emphasis on social development, including health system development. Examples are the prioritization of improved access to health services and the reduction of the burden of payment for necessary services. Relevant changes After 10 years of implementation, the RCMS now provides coverage to the entire rural population and has substantially improved access to health care. Yet despite a drop in out-of-pocket payments as a proportion of total health expenditure, paying for necessary services continues to cause financial hardship for many rural residents. Lessons learnt In its first decade, the RCMS made progress through political mobilization, government subsidies, the readiness of the health-care delivery system, and the availability of a monitoring and evaluation system. Further improving the RCMS will require a focus on cost containment, quality improvement and making the scheme portable. PMID:24940019
Age-related testosterone decline in a Brazilian cohort of healthy military men.
Nardozza Júnior, Archimedes; Szelbracikowski, Sergio dos Santos; Nardi, Aguinaldo Cesar; Almeida, Jose Carlos de
2011-01-01
Androgen decline in the aging man has become a topic of increasing clinical relevance worldwide, as the reduction in testosterone levels has been reported to be accompanied by loss of muscle mass, accumulation of central adiposity, impaired mobility and increase risk of bone fractures. Although well-established in studies conducted in developed countries, progressive decline in serum testosterone levels with age has been poorly investigated in Brazil. To determine the pattern of blood testosterone concentrations decline with age in a cohort of Brazilian healthy military men. We retrospectively reviewed data on serum testosterone measurements of healthy individuals that had undergone a routine check-up at the Military Biology Institute. Blood samples were obtained early in the morning, and total testosterone concentration was determined using a commercial chemoluminescent immunoassay. Mean values were analyzed in five age groups: ≤ 40, 41 to 50, 51 to 60, 61 to 70, and > 70 years. Mean total testosterone levels. 1,623 subjects were included in the analysis; mean age was 57 years (24 to 87), and mean testosterone level was 575.5 ng/dL (25.0 to 1308.0 ng/dL). The evaluation of age-related changes in total testosterone levels revealed a progressive reduction in serum levels of this hormone with increasing age. Testosterone levels below 300 ng/dL were reported in 321 participants, a prevalence of nearly 20% in the study population. In agreement with other findings, a reduction of total testosterone levels with age was reported for healthy Brazilian men.
Is Intelligence in Early Adulthood Associated With Midlife Physical Performance Among Danish Males?
Meincke, Rikke Hodal; Osler, Merete; Mortensen, Erik Lykke; Hansen, Åse Marie
2016-04-01
Insights into the causes of variances in physical performance are important to prevent mobility limitations in old age. We examined associations between intelligence in early adulthood and midlife physical performance. Data from the Copenhagen Aging and Midlife Biobank were analyzed using linear regression. In total, 2,848 male cohort members had intelligence scores from conscription and physical performance measures from midlife. In adjusted models, a 1 SD increase in intelligence resulted in 1.10 more chair-rises (p < .001), a 1.03 cm higher jump (p < .001), a 3.69% smaller balance area (p < .001), a 0.71 kg increase in handgrip strength (p < .001), and a 5.03 N increase in back force (p < .001). Results for flexibility and abdominal force were not significant. Public health interventions should focus on addressing people with different cognitive abilities and bear in mind that prevention of mobility limitations might need to start early in life. © The Author(s) 2015.
Capacity building in the health sector to improve care for child nutrition and development.
Yousafzai, Aisha K; Rasheed, Muneera A; Daelmans, Bernadette; Manji, Sheila; Arnold, Caroline; Lingam, Raghu; Muskin, Joshua; Lucas, Jane E
2014-01-01
The effectiveness of interventions promoting healthy child growth and development depends upon the capacity of the health system to deliver a high-quality intervention. However, few health workers are trained in providing integrated early child-development services. Building capacity entails not only training the frontline worker, but also mobilizing knowledge and support to promote early child development across the health system. In this paper, we present the paradigm shift required to build effective partnerships between health workers and families in order to support children's health, growth, and development, the practical skills frontline health workers require to promote optimal caregiving, and the need for knowledge mobilization across multiple institutional levels to support frontline health workers. We present case studies illustrating challenges and success stories around capacity development. There is a need to galvanize increased commitment and resources to building capacity in health systems to deliver early child-development services. © 2014 New York Academy of Sciences.
Cook, Shane E; Palmer, Louis C; Shuler, Franklin D
2015-01-01
Primary care physicians occupy a vital position to impact many devastating conditions, especially those dependent upon early diagnosis, such as skin cancer. Skin cancer is the most common cancer in the United States and despite improvements in skin cancer therapy, patients with a delay in diagnosis and advanced disease continue to have a grave prognosis. Due to a variety of barriers, advanced stages of skin cancer are more prominent in rural populations. In order to improve early diagnosis four things are paramount: increased patient participation in prevention methods, establishment of screening guidelines, increased diagnostic accuracy of malignant lesions, and easier access to dermatologists. Recent expansion in smartphone mobile application technology offers simple ways for rural practitioners to address these problems. More than 100,000 health related applications are currently available, with over 200 covering dermatology. This review will evaluate the newest and most useful of those applications offered to enhance the prevention and early diagnosis of skin cancer, particularly in the rural population.
Effect of viewing distance on 3D fatigue caused by viewing mobile 3D content
NASA Astrophysics Data System (ADS)
Mun, Sungchul; Lee, Dong-Su; Park, Min-Chul; Yano, Sumio
2013-05-01
With an advent of autostereoscopic display technique and increased needs for smart phones, there has been a significant growth in mobile TV markets. The rapid growth in technical, economical, and social aspects has encouraged 3D TV manufacturers to apply 3D rendering technology to mobile devices so that people have more opportunities to come into contact with many 3D content anytime and anywhere. Even if the mobile 3D technology leads to the current market growth, there is an important thing to consider for consistent development and growth in the display market. To put it briefly, human factors linked to mobile 3D viewing should be taken into consideration before developing mobile 3D technology. Many studies have investigated whether mobile 3D viewing causes undesirable biomedical effects such as motion sickness and visual fatigue, but few have examined main factors adversely affecting human health. Viewing distance is considered one of the main factors to establish optimized viewing environments from a viewer's point of view. Thus, in an effort to determine human-friendly viewing environments, this study aims to investigate the effect of viewing distance on human visual system when exposing to mobile 3D environments. Recording and analyzing brainwaves before and after watching mobile 3D content, we explore how viewing distance affects viewing experience from physiological and psychological perspectives. Results obtained in this study are expected to provide viewing guidelines for viewers, help ensure viewers against undesirable 3D effects, and lead to make gradual progress towards a human-friendly mobile 3D viewing.
Danilovich, Margaret K; Diaz, Laura; Saberbein, Gustavo; Healey, William E; Huber, Gail; Corcos, Daniel M
2017-01-01
We describe a community-engaged approach with Medicaid home and community-based services (HCBS), home care aide (HCA), client, and physical therapist stakeholders to develop a mobile application (app) exercise intervention through focus groups and interviews. Participants desired a short exercise program with modification capabilities, goal setting, and mechanisms to track progress. Concerns regarding participation were training needs and feasibility within usual care services. Technological preferences were for simple, easy-to-use, and engaging content. The app was piloted with HCA-client dyads (n = 5) to refine the intervention and evaluate content. Engaging stakeholders in intervention development provides valuable user-feedback on both desired exercise program contents and mobile technology preferences for HCBS recipients.
Orion Service Module Umbilical (OSMU) Lift & Preparation for Ins
2017-03-13
Crane specialists monitor the progress as the bracket for the Orion Service Module Umbilical (OSMU) is lifted up for installation on the mobile launcher tower at NASA's Kennedy Space Center in Florida. The mobile launcher tower will be equipped with a number of lines, called umbilicals, that will connect to the Space Launch System rocket and Orion spacecraft for Exploration Mission-1 (EM-1). The OSMU will be located high on the mobile launcher tower and, prior to launch, will transfer liquid coolant for the electronics and air for the Environmental Control System to the Orion service module that houses these critical systems to support the spacecraft. EM-1 is scheduled to launch in 2018. The Ground Systems Development and Operations Program is overseeing installation of the umbilicals.
Orion Service Module Umbilical (OSMU) Lift & Preparation for Ins
2017-03-13
Crane specialists monitor the progress as the bracket for the Orion Service Module Umbilical (OSMU) is lifted high up for installation on the mobile launcher tower at NASA's Kennedy Space Center in Florida. The mobile launcher tower will be equipped with a number of lines, called umbilicals, that will connect to the Space Launch System rocket and Orion spacecraft for Exploration Mission-1 (EM-1). The OSMU will be located high on the mobile launcher tower and, prior to launch, will transfer liquid coolant for the electronics and air for the Environmental Control System to the Orion service module that houses these critical systems to support the spacecraft. EM-1 is scheduled to launch in 2018. The Ground Systems Development and Operations Program is overseeing installation of the umbilicals.
Chatterji, Pinka; Brandon, Peter; Markowitz, Sara
2016-07-01
We examine the effects of the 2010 Patient Protection and Affordable Care Act's (ACA) prohibition of preexisting conditions exclusions for children on job mobility among parents. We use a difference-in-difference approach, comparing pre-post policy changes in job mobility among privately-insured parents of children with chronic health conditions vs. privately-insured parents of healthy children. Data come from the 2004 and 2008 Survey of Income and Program Participation (SIPP). Among married fathers, the policy change is associated with about a 0.7 percentage point, or 35 percent increase, in the likelihood of leaving an employer voluntarily. We find no evidence that the policy change affected job mobility among married and unmarried mothers. Copyright © 2016 Elsevier B.V. All rights reserved.
ICU team composition and its association with ABCDE implementation in a quality collaborative.
Costa, Deena Kelly; Valley, Thomas S; Miller, Melissa A; Manojlovich, Milisa; Watson, Sam R; McLellan, Phyllis; Pope, Corine; Hyzy, Robert C; Iwashyna, Theodore J
2018-04-01
Awakening, Breathing Coordination, Delirium, and Early Mobility bundle (ABCDE) should involve an interprofessional team, yet no studies describe what team composition supports implementation. We administered a survey at MHA Keystone Center ICU 2015 workshop. We measured team composition by the frequency of nurse, respiratory therapist, physician, physical therapist, nurse practitioner/physician assistant or nursing assistant involvement in 1) spontaneous awakening trials (SATs), 2) spontaneous breathing trials, 3) delirium and 4) early mobility. We assessed ABCDE implementation using a 5-point Likert ("routine part of every patient's care" - "no plans to implement"). We used ordinal logistic regression to examine team composition and ABCDE implementation, adjusting for confounders and clustering. From 293 surveys (75% response rate), we found that frequent nurse [OR 6.1 (1.1-34.9)] and physician involvement [OR 4.2 (1.3-13.4)] in SATs, nurse [OR 4.7 (1.6-13.4)] and nursing assistant's involvement [OR 3.9 (1.2-13.5)] in delirium and nurse [OR 2.8 (1.2-6.7)], physician [OR (3.6 (1.2-10.3)], and nursing assistants' involvement [OR 2.3 (1.1-4.8)] in early mobility were significantly associated with higher odds of routine ABCDE implementation. ABCDE implementation was associated with frequent involvement of team members, suggesting a need for role articulation and coordination. Copyright © 2017 Elsevier Inc. All rights reserved.
Preoperative Gabapentin Decreases Anxiety and Improves Early Functional Recovery From Knee Surgery
Ménigaux, Christophe; Adam, Frédéric; Guignard, Bruno; Sessler, Daniel I.; Chauvin, Marcel
2005-01-01
Gabapentin has antihyperalgesic and anxiolytic properties. We thus tested the hypothesis that premedication with gabapentin would decrease preoperative anxiety and improve postoperative analgesia and early postoperative knee mobilization in patients undergoing arthroscopic anterior cruciate ligament repair under general anesthesia. Forty patients were randomly assigned to receive 1200 mg oral gabapentin or placebo 1-2 h before surgery; anesthesia was standardized. Patients received morphine, 0.1 mg/kg, 30 min before the end of surgery and postoperatively via a patient-controlled pump. Pain scores and morphine consumption were recorded over 48 hours. Degrees of active and passive knee flexion and extension were recorded during physiotherapy on days 1 and 2. Preoperative anxiety scores were less in the Gabapentin than Control group (visual analog [VAS] score of 28 ± 16 mm versus 66 ± 15 mm; P < 0.001). The Gabapentin group required less morphine than the Control group (29 ± 22 mg versus 69 ± 40 mg; P < 0.001). VAS pain scores at rest and after mobilization were significantly reduced in the Gabapentin group. First and maximal passive and active knee flexions at 24 and 48 hours were significantly more extensive in the Gabapentin than in the Control group. In conclusion, premedication with 1200 mg gabapentin improved preoperative anxiolysis, postoperative analgesia, and early knee mobilization after arthroscopic anterior cruciate ligament repair. PMID:15845693
Muraro, Ana Paula; Souza, Rita Adriana Gomes de; Rodrigues, Paulo Rogério Melo; Ferreira, Márcia Gonçalves; Sichieri, Rosely
2017-01-01
To assess the effect of socioeconomic position (SEP) in childhood and social mobility on linear growth through adolescence in a population-based cohort. Children born in Cuiabá-MT, central-western Brazil, were evaluated during 1994 - 1999. They were first assessed during 1999 - 2000 (0 - 5 years) and again during 2009 - 2011 (10 - 17 years), and their height-for-age was evaluated during these two periods.Awealth index was used to classify the SEP of each child's family as low, medium, or high. Social mobility was categorized as upward mobility or no upward mobility. Linear mixed models were used. We evaluated 1,716 children (71.4% of baseline) after 10 years, and 60.6% of the families showed upward mobility, with a higher percentage among the lowest economic classes. A higher height-for-age was also observed among those from families with a high SEP both in childhood (low SEP= -0.35 z-score; high SEP= 0.15 z-score, p < 0.01) and adolescence (low SEP= -0.01 z-score; high SEP= 0.45 z-score, p < 0.01), whereas upward mobility did not affect their linear growth. Expressive social mobility was observed, but SEP in childhood and social mobility did not greatly influence linear growth through childhood in this central-western Brazilian cohort.
Matussek, J; Dingeldey, E; Wagner, F; Rezai, G; Nahr, K
2014-07-01
Vertical posture of the growing child requires minute central nervous control mechanisms in order to maintain symmetry of the torso in its various activities. Scoliosis describes a constant deviation in the frontal, transverse and sagittal planes from the dynamic symmetry of the trunk. Early intervention with effective bracing, physiotherapy and sports can reverse curve progression during growth spurts, once these are identified in screening. Modern braces have a derotating and reducing effect (mirror effect) on asymmetric body volumes, thus influencing the growing torso and restoring lasting symmetry. Recent data support the use of braces to reverse progressing scoliosis.
Social mobility and health in the Turin longitudinal study.
Cardano, Mario; Costa, Giuseppe; Demaria, Moreno
2004-04-01
One of the most controversial explanations of class inequalities in health is the health selection hypothesis or drift hypothesis which suggests there is a casual link between the health status of individuals and their chances of social mobility, both inter- and intra-generational. This study tests this hypothesis, and tries to answer three related questions: (a) to what extent does health status influence the chances of intra-generational mobility of individuals? (b) what is the impact on health inequalities of the various kinds of social mobility (both mobility in the labour market and exit from employment)-do they increase or reduce inequalities? (c) to what extent does health-related intra-generational social mobility contribute to the production of health inequalities? The data analysed in this paper were drawn from the records of the Turin Longitudinal Study, which was set up to monitor health inequality of the Turin population by combining census data, population registry records and medical records. Occupational mobility was observed during the decade 1981-1991. To evaluate the impact of the various processes of social mobility on health inequalities, mortality was observed over the period 1991-1999. The study population consists of men and women aged 25-49 at the beginning of mortality follow-up (1991), and registered as resident in Turin at both the 1981 and the 1991 censuses (N = 127,384). Health status was determined by observing hospital admission. For the purpose of the study healthy individuals were those with no hospital admissions during the period 1984-1986, while those admitted were classed as unhealthy. Social mobility in the labour market was measured via an interval data index of upward and downward movements on a scale of social desirability of occupations, designed for the Italian labour force via an empirical study carried out by de Lillo and Schizzerotto (La valutazione sociale delle occupazioni. Una scala di stratificazione occupazionale per l'Italia contemporanea, Il Mulino, Bologna, 1985). Movement out of the labour market was described by a discrete variable with four conditions: employed, unemployed, early retired and women returning from work to the housewife status. The relationship between health status and occupational mobility was analysed via analysis of variance and multinomial logistic regression. Health inequalities were measured by the ratio of standardised mortality rates in the unskilled working class and the upper middle class. The study found a weak relationship between health status and occupational mobility chances. Decidedly stronger was the impact on occupational mobility of gender, education and "ethnicity" (being born in the South of Italy). The relationship between occupational mobility and health takes two different forms. Occupational mobility in the labour market decreases health inequalities; occupational mobility out of the labour market (early retirement, unemployment, housewife return) widens them. The maximum contribution health-related intra-generational social mobility can make towards health inequalities was estimated at about 13% for men.
Effects of deep brain stimulation on rest tremor progression in early stage Parkinson disease.
Hacker, Mallory L; DeLong, Mahlon R; Turchan, Maxim; Heusinkveld, Lauren E; Ostrem, Jill L; Molinari, Anna L; Currie, Amanda D; Konrad, Peter E; Davis, Thomas L; Phibbs, Fenna T; Hedera, Peter; Cannard, Kevin R; Drye, Lea T; Sternberg, Alice L; Shade, David M; Tonascia, James; Charles, David
2018-06-29
To evaluate whether the progression of individual motor features was influenced by early deep brain stimulation (DBS), a post hoc analysis of Unified Parkinson's Disease Rating Scale-III (UPDRS-III) score (after a 7-day washout) was conducted from the 2-year DBS in early Parkinson disease (PD) pilot trial dataset. The prospective pilot trial enrolled patients with PD aged 50-75 years, treated with PD medications for 6 months-4 years, and no history of dyskinesia or other motor fluctuations, who were randomized to receive optimal drug therapy (ODT) or DBS plus ODT (DBS + ODT). At baseline and 6, 12, 18, and 24 months, all patients stopped all PD therapy for 1 week (medication and stimulation, if applicable). UPDRS-III "off" item scores were compared between the ODT and DBS + ODT groups (n = 28); items with significant between-group differences were analyzed further. UPDRS-III "off" rest tremor score change from baseline to 24 months was worse in patients receiving ODT vs DBS + ODT ( p = 0.002). Rest tremor slopes from baseline to 24 months favored DBS + ODT both "off" and "on" therapy ( p < 0.001, p = 0.003, respectively). More ODT patients developed new rest tremor in previously unaffected limbs than those receiving DBS + ODT ( p = 0.001). These results suggest the possibility that DBS in early PD may slow rest tremor progression. Future investigation in a larger cohort is needed, and these findings will be tested in the Food and Drug Administration-approved, phase III, pivotal, multicenter clinical trial evaluating DBS in early PD. This study provides Class II evidence that for patients with early PD, DBS may slow the progression of rest tremor. © 2018 American Academy of Neurology.
Diabetic photographic eye screening using a mobile unit in Tayside, Scotland.
Ellingford, A
1992-07-01
Early detection and hospital referral of patients with diabetic changes (retinopathy) is essential if laser photocoagulation is to be effective. The British Diabetic Association (BDA) have therefore funded several diabetic mobile eye screening units and donated them to areas throughout the country, the aim being to screen patients for diabetic retinopathy in those areas. This article describes the use and findings of such a unit in the Tayside area.
Payne, Hannah E; Lister, Cameron; West, Joshua H; Bernhardt, Jay M
2015-02-26
Several thousand mobile phone apps are available to download to mobile phones for health and fitness. Mobile phones may provide a unique means of administering health interventions to populations. The purpose of this systematic review was to systematically search and describe the literature on mobile apps used in health behavior interventions, describe the behavioral features and focus of health apps, and to evaluate the potential of apps to disseminate health behavior interventions. We conducted a review of the literature in September 2014 using key search terms in several relevant scientific journal databases. Only English articles pertaining to health interventions using mobile phone apps were included in the final sample. The 24 studies identified for this review were primarily feasibility and pilot studies of mobile apps with small sample sizes. All studies were informed by behavioral theories or strategies, with self-monitoring as the most common construct. Acceptability of mobile phone apps was high among mobile phone users. The lack of large sample studies using mobile phone apps may signal a need for additional studies on the potential use of mobile apps to assist individuals in changing their health behaviors. Of these studies, there is early evidence that apps are well received by users. Based on available research, mobile apps may be considered a feasible and acceptable means of administering health interventions, but a greater number of studies and more rigorous research and evaluations are needed to determine efficacy and establish evidence for best practices.
Douglas, Joanne T
2014-06-01
Primary progressive aphasia (PPA) is a young-onset neurodegenerative disorder characterized by declining language ability. The nonfluent/agrammatic variant of PPA (PPA-G) has the core features of agrammatism in language production and effortful, halting speech. As with other frontotemporal spectrum disorders, there is currently no cure for PPA, nor is it possible to slow the course of progression. The primary goal of treatment is therefore palliative in nature. However, there is a paucity of published information about strategies to make meaningful improvements to the quality of life of people with PPA, particularly in the early stages of the disease where any benefit could most be appreciated by the affected person. This report describes a range of strategies and adaptations designed to improve the quality of life of a person with early-stage PPA-G, based on my experience under the care of a multidisciplinary medical team. © The Author(s) 2014.
Picková, Tereza; Matěj, Radoslav; Bezdicek, Ondrej; Keller, Jiří; van der Zee, Julie; Van Broeckhoven, Christine; Cséfalvay, Zsolt; Rusina, Robert
2017-03-01
We report a 44-year-old woman, with a family history of early-onset dementia, presenting with primary progressive aphasia. This clinically variable syndrome has multiple underlying pathologies, and correlations between clinical manifestations and postmortem neuropathologic findings are controversial. Our patient suffered worsening language impairment with major word-finding difficulties but preserved comprehension. She also developed episodic memory impairment. Her condition progressed to dementia with behavioral changes. Magnetic resonance imaging showed early left perisylvian and bitemporal atrophy. The patient died shortly afterward from colon cancer. Neuropathologic examination revealed advanced early-onset Alzheimer and Lewy body disease, plus a clinically nonrelevant metastasis of her colon cancer in her left parietal lobe. Genetic examination revealed a p.Glu184Asp mutation in the presenilin1 gene. Our findings confirm the importance of a thorough appreciation for the clinical and neuropathologic correlations in patients with atypical neurodegenerative dementias.
Population mobility and trypanosomiasis in Africa*
Prothero, R. Mansell
1963-01-01
Population mobility has long been established as a feature of life in Africa south of the Sahara. Even though it appears to be a factor in the spread of sleeping-sickness there do not seem to have been serious epidemics until the latter part of the nineteenth century and the early decades of the twentieth century. Various types of population movement of the present day and their possible relevance to trypanosomiasis are discussed. Density of population and settlement patterns are also important. Some of the changes in these which are relevant to trypanosomiasis are outlined and the need for more detailed information on these and on population mobility is emphasized. PMID:13986384
Early agriculture and crop transmission among Bronze Age mobile pastoralists of Central Eurasia
Spengler, Robert; Frachetti, Michael; Doumani, Paula; Rouse, Lynne; Cerasetti, Barbara; Bullion, Elissa; Mar'yashev, Alexei
2014-01-01
Archaeological research in Central Eurasia is exposing unprecedented scales of trans-regional interaction and technology transfer between East Asia and southwest Asia deep into the prehistoric past. This article presents a new archaeobotanical analysis from pastoralist campsites in the mountain and desert regions of Central Eurasia that documents the oldest known evidence for domesticated grains and farming among seasonally mobile herders. Carbonized grains from the sites of Tasbas and Begash illustrate the first transmission of southwest Asian and East Asian domesticated grains into the mountains of Inner Asia in the early third millennium BC. By the middle second millennium BC, seasonal camps in the mountains and deserts illustrate that Eurasian herders incorporated the cultivation of millet, wheat, barley and legumes into their subsistence strategy. These findings push back the chronology for domesticated plant use among Central Eurasian pastoralists by approximately 2000 years. Given the geography, chronology and seed morphology of these data, we argue that mobile pastoralists were key agents in the spread of crop repertoires and the transformation of agricultural economies across Asia from the third to the second millennium BC. PMID:24695428
Early agriculture and crop transmission among Bronze Age mobile pastoralists of Central Eurasia.
Spengler, Robert; Frachetti, Michael; Doumani, Paula; Rouse, Lynne; Cerasetti, Barbara; Bullion, Elissa; Mar'yashev, Alexei
2014-05-22
Archaeological research in Central Eurasia is exposing unprecedented scales of trans-regional interaction and technology transfer between East Asia and southwest Asia deep into the prehistoric past. This article presents a new archaeobotanical analysis from pastoralist campsites in the mountain and desert regions of Central Eurasia that documents the oldest known evidence for domesticated grains and farming among seasonally mobile herders. Carbonized grains from the sites of Tasbas and Begash illustrate the first transmission of southwest Asian and East Asian domesticated grains into the mountains of Inner Asia in the early third millennium BC. By the middle second millennium BC, seasonal camps in the mountains and deserts illustrate that Eurasian herders incorporated the cultivation of millet, wheat, barley and legumes into their subsistence strategy. These findings push back the chronology for domesticated plant use among Central Eurasian pastoralists by approximately 2000 years. Given the geography, chronology and seed morphology of these data, we argue that mobile pastoralists were key agents in the spread of crop repertoires and the transformation of agricultural economies across Asia from the third to the second millennium BC.
Financial sustainability planning for immunization services in Cambodia.
Soeung, Sann Chan; Grundy, John; Maynard, Jim; Brooks, Alan; Boreland, Marian; Sarak, Duong; Jenkinson, Karl; Biggs, Beverley-Ann
2006-07-01
The expanded programme of immunization was established in Cambodia in 1986. In 2002, 67% of eligible children were immunized, despite significant health sector and macro-economic financial constraints. A financial sustainability planning process for immunization was introduced in 2002, in order to mobilize national and international resources in support of the achievement of child health objectives. The aim of this paper is to outline this process, describe its early impact as an advocacy tool and recommend additional strategies for mobilizing additional resources for health. The methods of financial sustainability planning are described, including the advocacy strategies that were applied. Analysis of financial sustainability planning results indicates rising programme costs associated with new vaccine introduction and new technologies. Despite this, the national programme has demonstrated important early successes in using financial sustainability planning to advocate for increased mobilization of national and international sources of funding for immunization. The national immunization programme nevertheless faces formidable system and financial challenges in the coming years associated with rising costs, potentially diminishing sources of international assistance, and the developing role of sub-national authorities in programme management and financing.
Early Detection | Cancer Trends Progress Report
The Cancer Trends Progress Report, first issued in 2001, summarizes our nation's advances against cancer in relation to Healthy People targets set forth by the Department of Health and Human Services.
Interleukin-6 as an early marker for fat embolism
Yoga, R; Theis, JC; Walton, M; Sutherland, W
2009-01-01
Background Fat Embolism is a complication of long bone fractures, intramedullary fixation and joint arthroplasty. It may progress to fat embolism syndrome, which is rare but involves significant morbidity and can occasionally be fatal. Fat Embolism can be detected at the time of embolization by transoesophageal echocardiography or atrial blood sampling. Later, a combination of clinical signs and symptoms will point towards fat embolism but there is no specific test to confirm the diagnosis. We investigated serum Interleukin-6 (IL-6) as a possible early marker for fat embolism. Methods An animal study was conducted to simulate a hip replacement in 31 adult male Sprague Dawley rats. The procedure was performed under general anesthesia and the animals divided into 3 groups: control, uncemented and cemented. Following surgery and recovery from anaesthesia, the rats allowed to freely mobilize in their cages. Blood was taken before surgery and at 6 hours, 12 hours and 24 hours to measure serum IL-6 levels. The rats were euthanized at 24 hours and lungs removed and stained for fat. The amount of fat seen was then correlated with serum IL-6 levels. Results No rats in the control group had fat emboli. Numerous fat emboli were seen in both the uncemented and cemented implant groups. The interleukin levels were raised in all groups reaching a peak at 12 hours after surgery reaching 100 pg/ml in the control group and around 250 pg/ml in the uncemented and cemented implant groups. The IL-6 levels in the control group were significantly lower than any of the implant groups at 12 and 24 hours. At these time points, the serum IL-6 correlated with the amount of fat seen on lung histology. Conclusion Serum IL-6 is a possible early marker of fat embolism. PMID:19523233