Physiotherapy interventions for people with dementia and a hip fracture-a scoping review of the literature.

BACKGROUND: People with dementia are 2.7 times more likely to suffer a hip fracture than those without and their management is estimated to cost £0.92 billion per year. Yet there has been little focus on the effectiveness of interventions for this population. OBJECTIVE: The aim of this scoping review was to summarise the current available evidence for physiotherapy interventions for people with dementia who fracture their hip as well as to identify gaps in the literature that may require further research. DATA SOURCES: A systematic search of the following databases was undertaken-TRIP, CINAHL, Amed, Embase, PEDro, PsycINFO, Cochrane Library, Open Grey, Ethos, ISRCTN, Proquest, PROSPERO and UK Clinical Trials Gateway. STUDY SELECTION: Articles were included if they described an intervention which is considered within the scope of a physiotherapist and targeted those with both a hip fracture and dementia. SYNTHESIS METHODS: A narrative summary was then undertaken to describe the current state of the literature. RESULTS: Twenty six studies were included, of which thirteen were observational, six RCTs, two qualitative, two surveys and three systematic reviews. Only nine studies focused explicitly on physiotherapy interventions. CONCLUSION: The findings of this scoping review suggest there is limited evidence to guide physiotherapists in the management of people with dementia who fracture their hip. No evidence was found about perceptions or experiences of patients in this group or of the physiotherapists involved in their care. Further research is needed to develop and evaluate physiotherapy interventions for people with dementia who fracture their hip

Global Retinoblastoma Presentation and Analysis by National Income Level

Importance: Early diagnosis of retinoblastoma, the most common intraocular cancer, can save both a child's life and vision. However, anecdotal evidence suggests that many children across the world are diagnosed late. To our knowledge, the clinical presentation of retinoblastoma has never been assessed on a global scale. Objectives: To report the retinoblastoma stage at diagnosis in patients across the world during a single year, to investigate associations between clinical variables and national income level, and to investigate risk factors for advanced disease at diagnosis. Design, Setting, and Participants: A total of 278 retinoblastoma treatment centers were recruited from June 2017 through December 2018 to participate in a cross-sectional analysis of treatment-naive patients with retinoblastoma who were diagnosed in 2017. Main Outcomes and Measures: Age at presentation, proportion of familial history of retinoblastoma, and tumor stage and metastasis. Results: The cohort included 4351 new patients from 153 countries; the median age at diagnosis was 30.5 (interquartile range, 18.3-45.9) months, and 1976 patients (45.4) were female. Most patients (n = 3685 84.7%) were from low-and middle-income countries (LMICs). Globally, the most common indication for referral was leukocoria (n = 2638 62.8%), followed by strabismus (n = 429 10.2%) and proptosis (n = 309 7.4%). Patients from high-income countries (HICs) were diagnosed at a median age of 14.1 months, with 656 of 666 (98.5%) patients having intraocular retinoblastoma and 2 (0.3%) having metastasis. Patients from low-income countries were diagnosed at a median age of 30.5 months, with 256 of 521 (49.1%) having extraocular retinoblastoma and 94 of 498 (18.9%) having metastasis. Lower national income level was associated with older presentation age, higher proportion of locally advanced disease and distant metastasis, and smaller proportion of familial history of retinoblastoma. Advanced disease at diagnosis was more common in LMICs even after adjusting for age (odds ratio for low-income countries vs upper-middle-income countries and HICs, 17.92 95% CI, 12.94-24.80, and for lower-middle-income countries vs upper-middle-income countries and HICs, 5.74 95% CI, 4.30-7.68). Conclusions and Relevance: This study is estimated to have included more than half of all new retinoblastoma cases worldwide in 2017. Children from LMICs, where the main global retinoblastoma burden lies, presented at an older age with more advanced disease and demonstrated a smaller proportion of familial history of retinoblastoma, likely because many do not reach a childbearing age. Given that retinoblastoma is curable, these data are concerning and mandate intervention at national and international levels. Further studies are needed to investigate factors, other than age at presentation, that may be associated with advanced disease in LMICs. © 2020 American Medical Association. All rights reserved

Optimal Output Vector Feedback Control Strategy for Wind Power Systems

This article presents the design of optimal output feedback controllers to enhance the dynamic performance of wind turbine generator supplying an infinite bus through transmission line. Efforts have been made to propose optimal regulators based on feedback of output state variables, which are easily accessible and available for the measurement. The designed optimal output feedback controllers are implemented in the wake of step disturbance in the system. The system dynamic responses and pattern of closed loop system eigenvalues for various system states are obtained with the designed optimal regulators to investigate the system dynamic performance. The investigations of the results obtained reveal that the reduction in system states used for feedback has resulted in degradation of system dynamic performance. However, for a particular set of output variables used as feedback; five states are used for feedback for an eighth order original system. The system dynamic performance is the same as offered by optimal controllers based on full state vector feedback control strategy.http://www.tandfonline.com/loi/uemp202016-06-30hb2016Electrical, Electronic and Computer Engineerin

Detailed spectroscopy in 249^{249}Fm

Excited states in 249Fm were populated via the alpha decay of 253No and the subsequent decay was observed with the GABRIELA detection system installed at the focal plane of the VASSILISSA recoil separator. The energies, spins, and parities of these states could be established through combined alpha, gamma, and conversion-electron spectroscopy. The first members of the ground-state rotational band were identified. Their excitation energies as well as the observation of a cross-over E2 transition confirm the assignment of 7/2+[624] for the ground state of 249Fm. Two excited states were also observed and their decay properties suggest that they correspond to the particle excitation 9/2-[734] and hole excitation 5/2+[622]. The analysis suggests that the 279-keV transition de-exciting the 9/2- state has anomalous E1 conversion coefficients

High-K,t1/2=1.4(1) ms, isomeric state in Lr255

An isomeric state in Lr255 with a half-life of t1/2=1.4(1) ms and Ex>720-keV has been observed for the first time using the GABRIELA setup at the focal plane of the VASSILISSA separator. Based on its K-forbiddeness, the configuration of the state is most probably formed by coupling the valence proton to a two quasiparticle neutron excitation. Possible three quasiparticle configurations are discussed. © 2008 The American Physical Society.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Gamma and electron spectroscopy of heavy nuclei at FLNR JINR

Detailed spectroscopic information of excited nuclear states in deformed transfermium nuclei is scarce. Most of the information available today has been obtained from investigations of fine structure α decay. Although α decay gives access to hindrance factors and lifetimes which are strongly correlated to shell/subshell closures and the presence of isomers, only the combined use of γ and conversion electron spectroscopy allows the precise determination of excitation energy, spin and parity of nuclear levels. In particular, the study of odd isotopes gives crucial information on the single particle states available at and around the Fermi surface. In the following, the preliminary results of decay studies using α - γ and α - beta coincidences at the focal plane of the VASSILISSA recoil separator are presented. © 2007 American Institute of Physics.SCOPUS: cp.pinfo:eu-repo/semantics/publishe

Isomeric states in 253No

Isomeric states in 253No have been investigated by conversion electron and γ -ray spectroscopy with the GABRIELA detection system. The 31μs isomer reported more than 30 years ago is found to decay to the ground state of 253No by the emission of a 167keV M2 transition. The spin and parity of this low-lying isomeric state are established to be 5/2 + .The presence of another longer-lived isomeric state is also discussed. © Società Italiana di Fisica and Springer-Verlag 2007.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Spectroscopy of heavy elements at Dubna

In 2004, the GABRIELA (Gamma Alpha Beta Recoil Investigation with the Electromagnetic Analyzer VASSILISSA) collaboration started a twofold scientific program at the FLNR (Dubna) laboratory: (a) the systematic study of the behaviour of single particle states within isotopic and isotonic chains with Z = 100-104 as N varies from 152 to 162 and (b) the study of isotopes for which very little spectroscopic information is known. After discussing the Physics motivations and the experimental setup, some new results concerning the structure of 249Fm and 253No nuclei, and some preliminary results on the decay of 217Pa decay are presented.SCOPUS: cp.pinfo:eu-repo/semantics/publishe