Gait and Balance in Alzheimer\u27s Disease: A Retrospective Analysis Across Varying Levels of Cognitive Impairment

Background: It was once thought that Alzheimer’s disease (AD) affected mostly cognition with minor motor impairment; however, it is becoming apparent that motor impairment may also be a prominent feature. Determining the extent of motor impairments throughout the continuum of cognitive impairment is critical in developing timely interventions for this population. Purpose/Hypothesis: The aim of this study was to gain a greater understanding of motor impairment in AD by exploring the relationships among gait, balance, and falls. Specifically, we explored the association of fall history to measures of cognition and performance-based balance measures in individuals with AD. We hypothesized that falls would increase as balance impairments became more severe. Additionally, we mapped the trajectory of gait and balance function along the continuum of cognitive impairment in individuals with AD. We hypothesized that balance and gait would be worse for those in the lower quartiles of cognitive function compared to those in the upper quartiles. Lastly, we sought to determine if fall history worsened as cognition declined. We hypothesized that falls history would be worse in lower quartiles of cognitive impairment compared to upper quartiles of cognitive impairment. Subjects: Retrospective data of 419 patients with brain health conditions and an initial evaluation for physical therapy at the Cleveland Clinic Lou Ruvo Center for Brain Health were extracted from electronic records. Of those 419, 155 were diagnosed by a neurologist with AD (age=77.4 ± 9.5; 69 males, 86 females) and were subsequently analyzed for this study. Materials/Methods: Patients were stratified into cognitive quartiles using scores from the Montreal Cognitive Assessment (MoCA): 0-9 (very severe cognitive impairment), 10-14 (severe cognitive impairment), 15-20 (Moderate to severe impairment), 21-30 (mild to moderate impairment). These cognitive function quartiles were then compared across the following measures: fall history (falls in last year, falls in the last 30 days, and fall injuries in the last year), 5 times Sit To Stand (5STS), Timed Up and Go (TUG), TUG cognitive (TUGcog), Preferred Gait Speed (PGS), Fast Gait Speed (FGS), 6 Minute Walk Test (6MWT), and Mini Balance Evaluation Systems Test (MBT). Results: For our first aim, there were no statistically significant differences between fallers and non-fallers for cognition, age, and measures of gait and balance (ps≥.068), except non-fallers walked farther on the 6MWT (p=.030). There were no statistically significant differences for recent (last 30 days) fallers and non-fallers across the same measures (ps≥.082). Fallers who had experienced an injury as a result of a fall in the last year performed more poorly on the 6MWT (p=.034) and MBT SOT (p=.008); all other comparisons were not statistically significant (ps≥.085). For our second aim, there were no statistically significant differences among the four cognitive quartiles for 5STS (p=.456), TUG (p=.060), FGS (p=.181), 6MWT (p=.468), MBT (p=.321); however, there were for TUGcog (p=.046) and PGS (p=.033). The mild to moderate impairment quartile was significantly faster than the severe quartile (p=.006) for the TUGcog. For PGS, the mild to moderate was significantly faster than the very severe quartile (p=.039) and the moderate to severe was significantly faster than the severe and the very severe quartiles (severe, p=.036; and, very severe, p=.016). For our third aim, there were no statistically significant differences in the proportions of fallers (p=.636), recent fallers (p=.868), and injured fallers (p=.565) across the four cognitive quartiles. Discussion: Despite impairments recognized in our study compared to normative data, patients in the study with a fall history were not significantly worse across most measures of gait and balance, except fallers had poorer walking endurance as measured in the 6MWT. Additionally, the proportion of fallers did not increase as severity of cognitive impairment increased, although walking impairment as measured with PGS and TUGcog, especially with cognitive demand, is more prominent in those with more severe cognitive impairment. Conclusions: Balance and gait dysfunction were prominent at all levels of cognitive impairment in our study of patients with AD and appears to become more prominent at the most severe cognitive impairment levels. These progressive deficits represent potentially mitigable motor impairment features of AD that warrant physical therapy

Cosmic web alignments with the shape, angular momentum and peculiar velocities of dark matter haloes

We study the alignment of dark matter haloes with the cosmic web characterized by the tidal and velocity shear fields. We focus on the alignment of their shape, angular momentum and peculiar velocities. We use a cosmological N-body simulation that allows to study dark matter halos spanning almost five orders of magnitude in mass ($10^{9}$-$10^{14}$) $h^{-1}$$M_{\odot}$ and spatial scales of $(0.5$-$1.0)$ $h^{-1}$ Mpc to define the cosmic web. We find that the halo shape presents the strongest alignment along the smallest tidal eigenvector, e.g. along filaments and walls, with a signal that gets stronger as the halo mass increases. In the case of the velocity shear field only massive halos $>10^{12}$ $h^{-1}$$M_{\odot}$ tend to have their shapes aligned along the largest tidal eigenvector; that is, perpendicular to filaments and walls. For the angular momentum we find alignment signals only for halos more massive than $10^{12}$ $h^{-1}$$M_{\odot}$ both in the tidal and velocity shear webs where the preferences are for it to be parallel to the middle eigenvector; perpendicular to filaments and parallel to walls. Finally, the peculiar velocities show a strong alignment along the smallest tidal eigenvector for all halo masses; halos move along filaments and walls. In the velocity shear the same alignment is present but weaker and only for haloes less massive than $10^{12}$ $h^{-1}$$M_{\odot}$. Our results clearly show that the two different algorithms we used to define the cosmic web describe different physical aspects of non-linear collapse and should be used in a complementary way to understand the effect of the cosmic web on galaxy evolution.Comment: 14 pages, 5 figures, MNRAS accepte

Feasibility study of technical and financial creation of small business fans in industrial processes

Mediante el análisis del método descriptivo, la investigación de estudios históricos y una encuesta; se desarrolló la metodología de evaluación de proyectos para el estudio de pre factibilidad técnica y financiera, con el propósito de crear una empresa de ventiladores especializada en la extracción localizada en procesos industriales. En el desarrollar el proyecto, se utilizó la norma técnica colombiana, NTC 5183 sobre ventilación y la calidad aceptable de aire generado en espacios interiores. Se entrevistó al gerente de proyectos de una firma de Ventilación Industrial, quien con su experiencia mencionó criterios de viabilidad del proyecto en lo que respecta a los procesos industriales involucrados y la posible definición de clientes; estos criterios se tuvieron en cuenta en el proyecto. Además, se analizó el comportamiento de la competencia del sector de ventilación y los potenciales clientes de empresas pertenecientes a los sectores textil, litográfico, metalmecánico y químico. Con esta información se definió el horizonte financiero y los aspectos técnicos indispensables en el proyecto. En la investigación se realizó una muestra de veintisiete (27) empresas definidas como competencia potencial, de las cuales solo cuatro (4) se dedican a la ventilación localizada, el resto se especializa en aire acondicionado y ventilación mecánica. Los resultados obtenidos permitieron inferir que el proyecto es viable y que el mercado en los sectores textil, litográfico, metalmecánico y químico, no ha sido explorado en su totalidad, quedando la posibilidad de atender las necesidades de estos posibles clientes.By descriptive analysis method for Historical Studies Research and Survey his project evaluation methodology for the study of pre technical and financial feasibility, in order to create a company specialized in the extraction fans localized extraction in industrial processes. To develop the project, the Colombian technical standard NTC 5183 based on ventilation and acceptable quality of indoor air generated is used. Was interviewed the project manager of a business industrial ventilation, who with his experience mentioned project feasibility criteria regarding one industrial processes involved and the possible definition of customers; they were considered project criteria. Also, the behavior of ventilation competition sector and prospects of costumers in the textile, lithographic, metallurgical and chemical sectors analyzed. With this information the financial horizon and the essential technical aspects of the project was defined This was done investigation a sample of twenty (27) business defined potential competition, of which only four (4) are engaged exhaust ventilation, the rest specializes in air conditioning and mechanical ventilation. The results allowed us to infer that the project is viability and that the market in the textile, lithographic, metallurgical and chemical industries, has not been fully explored, leaving the possibility of addressing the needs of these potential customers

Feasibility study of technical and financial creation of small business fans in industrial processes

Mediante el análisis del método descriptivo, la investigación de estudios históricos y una encuesta; se desarrolló la metodología de evaluación de proyectos para el estudio de pre factibilidad técnica y financiera, con el propósito de crear una empresa de ventiladores especializada en la extracción localizada en procesos industriales. En el desarrollar el proyecto, se utilizó la norma técnica colombiana, NTC 5183 sobre ventilación y la calidad aceptable de aire generado en espacios interiores. Se entrevistó al gerente de proyectos de una firma de Ventilación Industrial, quien con su experiencia mencionó criterios de viabilidad del proyecto en lo que respecta a los procesos industriales involucrados y la posible definición de clientes; estos criterios se tuvieron en cuenta en el proyecto. Además, se analizó el comportamiento de la competencia del sector de ventilación y los potenciales clientes de empresas pertenecientes a los sectores textil, litográfico, metalmecánico y químico. Con esta información se definió el horizonte financiero y los aspectos técnicos indispensables en el proyecto. En la investigación se realizó una muestra de veintisiete (27) empresas definidas como competencia potencial, de las cuales solo cuatro (4) se dedican a la ventilación localizada, el resto se especializa en aire acondicionado y ventilación mecánica. Los resultados obtenidos permitieron inferir que el proyecto es viable y que el mercado en los sectores textil, litográfico, metalmecánico y químico, no ha sido explorado en su totalidad, quedando la posibilidad de atender las necesidades de estos posibles clientes.By descriptive analysis method for Historical Studies Research and Survey his project evaluation methodology for the study of pre technical and financial feasibility, in order to create a company specialized in the extraction fans localized extraction in industrial processes. To develop the project, the Colombian technical standard NTC 5183 based on ventilation and acceptable quality of indoor air generated is used. Was interviewed the project manager of a business industrial ventilation, who with his experience mentioned project feasibility criteria regarding one industrial processes involved and the possible definition of customers; they were considered project criteria. Also, the behavior of ventilation competition sector and prospects of costumers in the textile, lithographic, metallurgical and chemical sectors analyzed. With this information the financial horizon and the essential technical aspects of the project was defined This was done investigation a sample of twenty (27) business defined potential competition, of which only four (4) are engaged exhaust ventilation, the rest specializes in air conditioning and mechanical ventilation. The results allowed us to infer that the project is viability and that the market in the textile, lithographic, metallurgical and chemical industries, has not been fully explored, leaving the possibility of addressing the needs of these potential customers

Holographic model for heavy vector meson masses

The experimentally observed spectra of heavy vector meson radial excitations show a dependence on two different energy parameters. One is associated with the quark mass and the other with the binding energy levels of the quark anti-quark pair. The first is present in the large mass of the first state while the other corresponds to the small mass splittings between radial excitations. In this article we show how to reproduce such a behavior with reasonable precision using a holographic model. In the dual picture, the large energy scale shows up from a bulk mass and the small scale comes from the position of anti-de Sitter (AdS) space where field correlators are calculated. The model determines the masses of four observed S-wave states of charmonium and six S-wave states of bottomonium with , 6.1 % rms error. In consistency with the physical picture, the large energy parameter is flavor dependent, while the small parameter, associated with quark anti-quark interaction is the same for charmonium and bottomonium states.Comment: In V5 we just added some clarifying explanations about the model. 5 tables, no figure. Version published in Europhysics Letter

Holographic Picture of Heavy Vector Meson Melting

The fraction of heavy vector mesons produced in a heavy ion collision, as compared to a proton proton collision, serves as an important indication of the formation of a thermal medium, the quark gluon plasma. This sort of analysis strongly depends on understanding the thermal effects of a medium like the plasma on the states of heavy mesons. In particular, it is crucial to know the temperature ranges where they undergo a thermal dissociation, or melting. AdS/QCD models are know to provide an important tool for the calculation of hadronic masses, but in general are not consistent with the observation that decay constants of heavy vector mesons decrease with excitation level. It has recently been shown that this problem can be overcome using a soft wall background and introducing an extra energy parameter, through the calculation of correlation functions at a finite position of anti-de Sitter space. This approach leads to the evaluation of masses and decay constants of S wave quarkonium states with just one flavor dependent and one flavor independent parameters. Here we extend this more realistic model to finite temperatures and analyse the thermal behavior of the states $1S, 2S$ and $3S$ of bottomonium and charmonium. The corresponding spectral function exhibits a consistent picture for the melting of the states where, for each flavor, the higher excitations melt at lower temperatures. We estimate for these six states, the energy ranges in which the heavy vector mesons undergo a transition from a well defined peak in the spectral function to complete melting in the thermal medium. A very clear distinction between the heavy flavors emerges, with bottomonium state $\Upsilon (1S)$ surviving deconfinemet transition at temperatures much larger than the critical deconfinement temperature of the medium.Comment: 20 pages, 7 figure

Decay constants in soft wall AdS/QCD revisited

Phenomenological AdS/QCD models, like hard wall and soft wall, provide hadronic mass spectra in reasonable consistency with experimental and (or) lattice results. These simple models are inspired in the AdS/CFT correspondence and assume that gauge/ gravity duality holds in a scenario where conformal invariance is broken through the introduction of an energy scale. Another important property of hadrons: the decay constant, can also be obtained from these models. However, a consistent formulation of an AdS/QCD model that reproduces the observed behavior of decay constants of vector meson excited states is still lacking. In particular: for radially excited states of heavy vector mesons, the experimental data lead to decay constants that decrease with the radial excitation level. We show here that a modified framework of soft wall AdS/QCD involving an additional dimensionfull parameter, associated with an ultraviolet energy scale, provides decay constants decreasing with radial excitation level. In this version of the soft wall model the two point function of gauge theory operators is calculated at a finite position of the anti-de Sitter space radial coordinate.Comment: Shorter (letter) version. Results unchanged. More references included. We now explain that the large UV scale of the model is associated with the non-hadronic decay of the heavy vector meson into light leptons. Version Published in Phys. Lets.

Stochastic angular momentum slews and flips and their effect on discs in galaxy formation models

The angular momentum of galactic discs in semi-analytic models of galaxy formation is usually updated in time as material is accreted to the disc by adopting a constant dimensionless spin parameter and little attention is paid to the effects of accretion with misaligned angular momenta. These effects are the subject of this paper, where we adopt a Monte-Carlo simulation for the changes in the direction of the angular momentum of a galaxy disc as it accretes matter based on accurate measurements from dark-matter haloes in the Millennium II simulation. In our semi-analytic model implementation, the flips seen the dark matter haloes are assumed to be the same for the cold baryons; however, we also assume that in the latter the flip also entails a difficulty for the disc to increase its angular momentum which causes the disc to become smaller relative to a no-flip case. This makes star formation to occur faster, specially in low mass galaxies at all redshifts allowing galaxies to reach higher stellar masses faster. We adopt a new condition for the triggering of starbursts during mergers. As these produce the largest flips it is natural to adopt the disc instability criterion to evaluate the triggering of bursts in mergers instead of one based on mass ratios as in the original model. The new implementation reduces the average lifetimes of discs by a factor of 2, while still allowing old ages for the present-day discs of large spiral galaxies. It also provides a faster decline of star formation in massive galaxies and a better fit to the bright end of the luminosity function at z = 0.Comment: 15 pages, 12 figures, MNRAS in pres

Galactic conformity measured in semi-analytic models

We study the correlation between the specific star formation rate of central galaxies and neighbour galaxies, also known as 'galactic conformity', out to 20 Mpc/h using three semi-analytic models (SAMs, one from L-GALAXIES and other two from GALFORM). The aim is to establish whether SAMs are able to show galactic conformity using different models and selection criteria. In all the models, when the selection of primary galaxies is based on an isolation criterion in real space, the mean fraction of quenched galaxies around quenched primary galaxies is higher than that around star-forming primary galaxies of the same stellar mass. The overall signal of conformity decreases when we remove satellites selected as primary galaxies, but the effect is much stronger in GALFORM models compared with the L-GALAXIES model. We find this difference is partially explained by the fact that in GALFORM once a galaxy becomes a satellite remains as such, whereas satellites can become centrals at a later time in L-GALAXIES. The signal of conformity decreases down to 60% in the L-GALAXIES model after removing central galaxies that were ejected from their host halo in the past. Galactic conformity is also influenced by primary galaxies at fixed stellar mass that reside in dark matter haloes of different masses. Finally, we explore a proxy of conformity between distinct haloes. In this case the conformity is weak beyond ~ 3 Mpc/h (<3% in L-GALAXIES, <1-2% in GALFORM models). Therefore, it seems difficult that conformity is directly related with a long-range effect.Comment: 15 pages, 7 figures. Accepted for publication in MNRA

Estudio de caso proyecto de fortalecimiento de capacidades asociativas por medio de Negocios Inclusivos desarrollado en El Carmen de Bolívar por parte de la Fundación Crecer en Paz

81 páginasEl presente estudio de case se concentra en el proyecto de fortalecimiento de capacidades asociativas por medio de Negocios Inclusivos desarrollado par la Fundación Crecer en Paz, creada par iniciativa del Grupo Argos. Este proyecto tiene lugar en el municipio de El Carmen de Bolívar, departamento de Bolívar, Colombia, en la región de Montes de María que entre marzo de 2014 y julio de 2016, desarrollo cultivos frutales de mango, frijol, ajonjolí, proyectos apícolas, arboles maderables y proyectos ganaderos, todos con comercialización asegurada, con una vinculación de 407 familias pertenecientes a la Base de la Pirámide algunas sin tierras propias. La investigación, de corte cualitativo, permitió identificar, que los Negocios Inclusivos impulsados en zonas de posconflicto, pueden aportar a la construcción de paz y mantener un vínculo de mutuo beneficio, mientras exista la suma de acciones por parte de los actores clave presentes en el territorio: campesinos, empresas privadas, organizaciones de la sociedad civil e instituciones estatales, liderados por una organización articuladora, esta construcción se ve representada en transformaciones en las formas de relacionamiento social, en la capacidad de trabajar asociativamente, y en la búsqueda de un desarrollo socio-económico come modelo de negocio.This study case document, systematize and value the experience in the light of theories on Corporate Social Responsibility and peace building. The investigation, a qualitative one, allowed to identify, among others, that inclusive business driven in post conflict areas, can contribute to peace building and to keep a mutual benefit agreement, meanwhile it exists the communion of actions from several key actors in the territory: farmers, private companies, civil society organizations and government institutions, led by a coordinator organism, in this case the Crecer en Paz Foundation. This communion of actions might be seen in networking transformations, in the ability of team working and in the seeking of social-economic development as a business model. Throughout the study case it was observed that inclusive business does not guarantee necessarily success or profitability. In fact, external factors such as climatic changes (El Nino and La Nina phenomena) can represent a risk to both the allied company and the producers, resulting in a business relationship with sharing of losses. Nevertheless, these business relationships end in a good scenario to contribute to the strengthen o reconstruction of social weave and thus offer other benefits that far exceed the merely economic.Magíster en Responsabilidad Social y SostenibilidadMaestrí