Comprehension of pictograms for pain quality and pain affect in adults with Down syndrome

Background Adults with Down syndrome (DS) are at risk for age-related painful physical conditions, but also for under-reporting pain. Pictograms may facilitate self-report of pain, because they seem suitable for the global visual processing in DS and for iconic representation of abstract concepts. Method Participants (N = 39, M age = 41.2) assigned pain qualities to pictograms, rated pain affect levels in facial scales (pictograms vs. drawn faces), and performed cognitive tests. Results Recognition of all intended pain qualities was above chance level. Pain affect levels of both facial scales were ordered equally well. Both facial scales were preferred equally we

Cognitive functioning and psychiatric symptoms in parkinson’s disease

Parkinson’s disease (PD) is characterized by motor symptoms as well as non-motor symptoms, such as (but not limited to) cognitive impairment and psychiatric symptoms. Deep brain stimulation (DBS) is one of the treatment options for patients experiencing medication related motor response fluctuations. The Netherlands SubThalamic And Pallidal Study (NSTAPS), a randomized controlled trial, was initiated to compare the two main DBS targets: the globus pallidus internal segment (GPi) and the subthalamic nucleus (STN). In this thesis, we report that STN DBS showed more improvement in off-drug phase motor symptoms and disability than GPi DBS up to 5 years after surgery. In addition, cognitive, psychiatric, and psychosocial outcomes indicated no clinically significant differences between GPi and STN DBS. Both groups showed subtle cognitive decline after surgery for most tests. Preoperative mild cognitive impairment (PD-MCI) proved not to be a contraindication for DBS per se. These results indicate that the STN is, in general, the preferred target. Future studies should investigate whether rare individual cases with significant cognitive decline after DBS can be predicted before surgery. The International Parkinson and Movement Disorder Society has proposed PD-MCI criteria to aid in uniform assessment. In this thesis, we evaluated the prognostic validity of level I (based on an abbreviated neuropsychological assessment) PD-MCI criteria for development of PD dementia (PDD). We found that level I PD-MCI is related to the hazard of PDD with lower performance on neuropsychological assessment increasing this hazard. More insight into the course of PD-MCI is needed for information sharing with patients and caregivers and for investigating potential treatment interventions

Distributed collision avoidance for autonomous vehicles: World automata representation

The automatic control of interacting autonomous vehicles (AVs) is one of the problems that engineers are currently trying to solve. The present paper deals with the design of local control laws governing the movement and collision avoidance of such groups of AVs, enforcing the safeness of the operations as well as task completions. This problem is inspired by the automation of a container terminal where each AV executes tasks assigned by a supervisor. A task involves moving an AV from an assigned origin to an assigned destination by a given deadline. The constraints imposed by the bounded workspace (a long and narrow quay in the container terminal example), the deadlines assigned to each task, and the uncertainty in the detection and communication make the problem difficult to solve in a centralized way. Therefore a distributed control approach is preferred with a local control agent in each AV adjusting its trajectory, so that its task is completed without collisions. By applying a fixed set of priority rules the computational complexity for each agent is reduced compared to the centralized case. Whenever an AV detects a possible conflict, i.e. the estimated position of another AV within the detection range, it must adjust its own speed and trajectory in order to avoid a future collision, reducing the number of cases where a supervisor has to intervene in order to resolve conflicts that degenerate in dead-locks. The modelling and validation of the system is performed by using the world automata theory

Randomized Delayed-Start Trial of Levodopa in Parkinson's Disease

Contains fulltext : 201287.pdf (publisher's version ) (Open Access

GPi vs STN deep brain stimulation for Parkinson disease Three-year follow-up

Neurological Motor Disorder