Trajectories of depressive symptoms after hip fracture

BACKGROUND: Hip fracture is often complicated by depressive symptoms in older adults. We sought to characterize trajectories of depressive symptoms arising after hip fracture and examine their relationship with functional outcomes and walking ability. We also investigated clinical and psychosocial predictors of these trajectories. METHOD: We enrolled 482 inpatients, aged ≥60 years, who were admitted for hip fracture repair at eight St Louis, MO area hospitals between 2008 and 2012. Participants with current depression diagnosis and/or notable cognitive impairment were excluded. Depressive symptoms and functional recovery were assessed with the Montgomery–Asberg Depression Rating Scale and Functional Recovery Score, respectively, for 52 weeks after fracture. Health, cognitive, and psychosocial variables were gathered at baseline. We modeled depressive symptoms using group-based trajectory analysis and subsequently identified correlates of trajectory group membership. RESULTS: Three trajectories emerged according to the course of depressive symptoms, which we termed ‘resilient’, ‘distressed’, and ‘depressed’. The depressed trajectory (10% of participants) experienced a persistently high level of depressive symptoms and a slower time to recover mobility than the other trajectory groups. Stressful life events prior to the fracture, current smoking, higher anxiety, less social support, antidepressant use, past depression, and type of implant predicted membership of the depressed trajectory. CONCLUSIONS: Depressive symptoms arising after hip fracture are associated with poorer functional status. Clinical and psychosocial variables predicted membership of the depression trajectory. Early identification and intervention of patients in a depressive trajectory may improve functional outcomes after hip fracture

Acompa?amientos sensibles

45 p. Recurso Electr?nicoAcompa?amientos sensibles es una exploraci?n que se propone encontrar maneras de cuidar desde el arte pl?stico y visual en el hospital Federico Lleras Acosta en la ciudad de Ibagu?, Tolima y posteriormente en el hospital San Vicente de Paul en Fresno, Tolima. Est? dedicado a pensar c?mo se generan gestos y maneras de acompa?ar en el intento de entender y abrazar a los habitantes del territorio hospitalario brind?ndoles escucha y atenci?n para as? humanizar dicho territorio. Palabras clave: Gesto, habitar, clown hospitalario, acci?n.Sensitive accompaniment is a exploration that aims to find ways of caring from plastic an visual art in the Federico Lleras Acosta hospital in the city of Ibague, Tolima and later in the San Vicente de Paul hospital in Fresno, Tolima. It is dedicated to think about how gestures and ways to come along are generated in the attempt to understand and embrace the inhabitants of the hospital territory, providing them with someone to listen and bring them attention in order to humanize the same territory. Keywords: gesture, inhabit, hospital clown, action

Observational Learning During Simulation-Based Training in Arthroscopy: Is It Useful to Novices?

This is the author accepted manuscript. The final version is available from Elsevier via the DOI in this record.OBJECTIVE: Observing experts constitutes an important and common learning experience for surgical residents before operating under direct guidance. However, studies suggest that exclusively observing experts may induce suboptimal motor learning, and watching errors from non-experts performing simple motor tasks may generate better performance. We investigated whether observational learning is transferrable to arthroscopy learning using virtual reality (VR) simulation. SETTING/DESIGN: In our surgical simulation laboratory, we compared students learning basic skills on a VR arthroscopy simulator after watching an expert video demonstration of VR arthroscopy tasks or a non-expert video demonstration of the same tasks to a Control group without video demonstration. Ninety students in 3 observing groups (expert, non-expert, and Control) subsequently completed the same procedure on a VR arthroscopy simulator. We hypothesized the non-expert-watching group would outperform the expert-watching group, and both groups to outperform the Control group. We examined performance pretest, posttest, and 1 week later. PARTICIPANTS: Participants were recruited from the final year of medical school and the very early first year of surgical residency training programs (orthopaedic surgery, urology, plastic surgery, and general surgery) at Western University (Ontario, Canada). RESULTS: All participants improved their overall performance from pretest to retention (p < 0.001). At initial retention testing, non-expert-watching group outperformed the other groups in camera path length p < 0.05 and time to completion, p < 0.05, and both the expert/non-expert groups surpassed the Control group in camera path length (p < 0.05). CONCLUSION: We suggest that error-observation may contribute to skills improvement in the non-expert-watching group. Allowing novices to observe techniques/errors of other novices may assist internalization of specific movements/skills required for effective motor performances. This study highlights the potential effect of observational learning on surgical skills acquisition and offers preliminary evidence for peer-based practice (combined non-experts and experts) as a complementary surgical motor skills training strategy.This project was supported by a Physicians׳ Services Incorporated (PSI) Foundation, Canada grant. Funds were used to pay for salary and employee benefits (LvE). The PSI Foundation did not play a role in the investigation

Detección de desórdenes de lenguaje de pacientes con enfermedad de Alzheimer usando embebimientos de palabras y características gramaticales

Alzheimer's Disease (AD) is a progressive neurodegenerative disorder that affects the language production and thinking capabilities of patients. The integrity of the brain is destroyed over time by interruptions in the interactions between neuron cells and associated cells required for normal brain functioning. AD comprises deterioration of the communicative skills, which is reflected in deficient speech that usually contains no coherent information, low density of ideas, and poor grammar. Additionally, patients exhibit difficulties to find appropriate words to structure sentences. Multiple ongoing studies aim to detect the disease considering the deterioration of language production in AD patients. Natural Language Processing techniques are employed to detect patterns that can be used to recognize the language impairments of patients. This paper covers advances in pattern recognition with the use of word-embedding and word-frequency features and a new approach with grammar features. We processed transcripts of 98 AD patients and 98 healthy controls in the Pitt Corpus of the Dementia-Bank database. A total of 1200 word-embedding features, 1408 Term Frequency—Inverse Document Frequency features, and 8 grammar features were extracted from the selected transcripts. Three models are proposed based on the separate extraction of such feature sets, and a fourth model is based on an early fusion strategy of the proposed feature sets. All the models were optimized following a Leave-One-Out cross validation strategy. Accuracies of up to 81.7 % were achieved using the early fusion of the three feature sets. Furthermore, we found that, with a small set of grammar features, accuracy values of up to 72.8 % were obtained. The results show that such features are suitable to effectively classify AD patients and healthy controls.La enfermedad de Alzheimer es un desorden neurodegenerativo-progresivo que afecta la producción de lenguaje y las capacidades de pensamiento de los pacientes. La integridad del cerebro es destruida con el paso del tiempo por interrupciones en las interacciones entre neuronas y células, requeridas para su funcionamiento normal. La enfermedad incluye el deterioro de habilidades comunicativas por un habla deficiente, que usualmente contiene información inservible, baja densidad de ideas y habilidades gramaticales. Adicionalmente, los pacientes presentan dificultades para encontrar palabras apropiadas y así estructurar oraciones. Por lo anterior, hay investigaciones en curso que buscan detectar la enfermedad considerando el deterioro de la producción de lenguaje. Así mismo, se están usando técnicas de procesamiento de lenguaje natural para detectar patrones y reconocer las discapacidades del lenguaje de los pacientes. Por su parte, este artículo se enfoca en el uso de características basadas en embebimiento y frecuencia de palabras, además de hacer una nueva aproximación con características gramaticales para clasificar la enfermedad de Alzheimer. Para ello, se consideraron transcripciones de 98 pacientes con Alzheimer y 98 controles sanos del Pitt Corpus incluido en la base de datos Dementia-Bank. Un total de 1200 características de embebimientos de palabras, 1408 características de frecuencia de término inverso vs. frecuencia en documentos, y 8 características gramaticales fueron calculadas. Tres modelos fueron propuestos, basados en la extracción de dichos conjuntos de características por separado y un cuarto modelo fue basado en una estrategia de fusión temprana de los tres conjuntos de características. Los modelos fueron optimizados usando la estrategia de validación cruzada Leave-One-Out. Se alcanzaron tasas de aciertos de hasta 81.7 % usando la fusión temprana de todas las características. Además, se encontró que un pequeño conjunto de características gramaticales logró una tasa de acierto del 72.8 %. Así, los resultados indican que estas características son adecuadas para clasificar de manera efectiva entre pacientes de Alzheimer y controles sanos

Very high rotational frequencies and band termination in 73Br

Rotational bands in 73Br have been investigated up to spins of 65/2 using the EUROBALL III spectrometer. One of the negative-parity bands displays the highest rotational frequency 1.85 MeV reported to date in nuclei with mass number greater than 25. At high frequencies, the experimental dynamic moment of inertia for all bands decrease to very low values, indicating a loss of collectivity. The bands are described in the configuration-dependent cranked Nilsson-Strutinsky model. The calculations indicate that one of the negative-parity bands is observed up to its terminating single-particle state at spin 63/2. This result establishes the first band termination case in the A = 70 mass region.Comment: 6 pages, 6 figures, submitted to Phys. Rev. C as a Rapid Communicatio

DJ-1 contributes to adipogenesis and obesity-induced inflammation

Adipose tissue functions as an endocrine organ, and the development of systemic inflammation in adipose tissue is closely associated with metabolic diseases, such as obesity and insulin resistance. Accordingly, the fine regulation of the inflammatory response caused by obesity has therapeutic potential for the treatment of metabolic syndrome. In this study, we analyzed the role of DJ-1 (PARK7) in adipogenesis and inflammation related to obesity in vitro and in vivo. Many intracellular functions of DJ-1, including oxidative stress regulation, are known. However, the possibility of DJ-1 involvement in metabolic disease is largely unknown. Our results suggest that DJ-1 deficiency results in reduced adipogenesis and the down-regulation of pro-inflammatory cytokines in vitro. Furthermore, DJ-1-deficient mice show a low-level inflammatory response in the high-fat diet-induced obesity model. These results indicate previously unknown functions of DJ-1 in metabolism and therefore suggest that precise regulation of DJ-1 in adipose tissue might have a therapeutic advantage for metabolic disease treatment.open0