Preventie van valincidenten bij thuiswonende ouderen: een kostenbesparende interventie?

Nationale en internationale cijfers tonen aan dat 1 op 3 thuiswonende 65-plussers en nagenoeg de helft van de 80-plussers minstens eenmaal per jaar valt. Bij ongeveer 40% van hen resulteert dit in een letsel. Ongeveer 10% van de valpartijen bij ouderen leidt tot ernstige letsels, waaronder heupfracturen (1-2%), andere fracturen (3-5%) en letsels van de weke delen en hoofdtrauma (5%)

Bolus residue scale: an easy-to-use and reliable videofluoroscopic analysis tool to score bolus residue in patients with dysphagia

Background. We aimed to validate an easy-to-use videofluoroscopic analysis tool, the bolus residue scale (BRS), for detection and classification of pharyngeal retention in the valleculae, piriform sinuses, and/or the posterior pharyngeal wall. Methods. 50 randomly selected videofluoroscopic images of 10 mL swallows (recorded in 18 dysphagia patients and 8 controls) were analyzed by 4 experts and 6 nonexpert observers. A score from 1 to 6 was assigned according to the number of structures affected by residue. Inter- and intrarater reliabilities were assessed by calculation of intraclass correlation coefficients (ICCs) for expert and nonexpert observers. Sensitivity, specificity, and interrater agreement were analyzed for different BRS levels. Results. Intrarater reproducibility was almost perfect for experts (mean ICC 0.972) and ranged from substantial to almost perfect for nonexperts (mean ICC 0.835). Interjudge agreement of the experts ranged from substantial to almost perfect (mean ICC 0.780), but interrater reliability of nonexperts ranged from substantial to good (mean 0.719). BRS shows for experts a high specificity and sensitivity and for nonexperts a low sensitivity and high specificity. Conclusions. The BRS is a simple, easy-to-carry-out, and accessible rating scale to locate pharyngeal retention on videofluoroscopic images with a good specificity and reproducibility for observers of different expertise levels.Nathalie Rommel, Charlotte Borgers, Dirk Van Beckevoort, Ann Goeleven, Eddy Dejaeger, and Taher I. Omar

Is the metabolic cost of walking higher in people with diabetes?

People with diabetes walk slower and display biomechanical gait alterations compared with controls, but it remains unknown whether the metabolic cost of walking (CoW) is elevated. The aim of this study was to investigate the CoW and the lower limb concentric joint work as a major determinant of the CoW, in patients with diabetes and diabetic peripheral neuropathy (DPN). Thirty-one nondiabetic controls (Ctrl), 22 diabetic patients without peripheral neuropathy (DM), and 14 patients with moderate/severe DPN underwent gait analysis using a motion analysis system and force plates and treadmill walking using a gas analyzer to measure oxygen uptake. The CoW was significantly higher particularly in the DPN group compared with controls and also in the DM group (at selected speeds only) compared with controls, across a range of matched walking speeds. Despite the higher CoW in patients with diabetes, concentric lower limb joint work was significantly lower in DM and DPN groups compared with controls. The higher CoW is likely due to energetic inefficiencies associated with diabetes and DPN reflecting physiological and biomechanical characteristics. The lower concentric joint work in patients with diabetes might be a consequence of kinematic gait alterations and may represent a natural strategy aimed at minimizing the CoW

Once is an Instance, Twice is a Hobby: Multiple Optical and Near-Infrared Changing-Look Events in NGC 5273

NGC 5273 is a known optical and X-ray variable AGN. We analyze new and archival IR, optical, UV, and X-ray data in order to characterize its long-term variability from 2000 to 2022. At least one changing-look event occurred between 2011 and 2014, when the AGN changed from a Type 1.8/1.9 Seyfert to a Type 1. It then faded considerably at all wavelengths, followed by a dramatic but slow increase in UV/optical brightness between 2021 and 2022. We propose that NGC 5273 underwent multiple changing-look events between 2000 and 2022 -- starting as a Type 1.8/1.9, NGC 5273 changes-look to a Type 1 only temporarily in 2002 and again in 2014, reverting back to a Type 1.8/1.9 by 2005 and 2017, respectively. In 2022, it is again a Type 1 Seyfert with optical and NIR broad emission lines. We characterize the changing-look events and their connection to the dynamic accretion and radiative processes in NGC 5273.Comment: 18 pages, 13 figures, 4 tables, submitting to MNRA

Automatische Impedantie Manometrie (AIM): objectieve diagnostiek van oro-faryngale dysfagie

Dit overzichtsartikel wil het klinisch potentieel aantonen van Automatische Impedantie Manometrie (AIM) als nieuwe, nietradiologische techniek voor screening en diagnostiek van faryngale dysfagie, zijnde slikstoornissen in de mond, keelholte en bovenste slokdarm. Deze AIM-techniek maakt gebruik van een katheter met druksensoren en impedantie-elektroden om slikken kwantitatief te beschrijven. Een geïntegreerde – eerder dan afzonderlijke – analyse van de gemeten druk- en impedantiepatronen die ontstaan bij het doorslikken van een voedselbolus, kan een zinvolle aanvulling zijn op de dynamische beeldvormingsonderzoeken die vandaag de dag als gouden standaard worden gezien. Belangrijke voordelen zijn het objectieve karakter van de techniek en de geautomatiseerde berekening van diverse slikparameters. Een globale maat voor de slikfunctie kan worden bekomen (Slik Risico Index, SRI) en houdt verband met (de ernst van) het aspiratierisico van de patiënt en de aanwezigheid van bolusresidu. Zo kan een accurate detectie van aspiratie met een sensitiviteit van 0,88 en specificiteit van 0,96 niet via radiologisch onderzoek bereikt worden. Verschillende slikparameters zijn ook voldoende gevoelig om veranderingen in voedselconsistentie te detecteren en om de effecten van slikmanoeuvres objectief te beschrijven. Recent werd ook aangetoond dat deze AIM-analyse snel en betrouwbaar kan worden uitgevoerd door clinici met variërende ervaring en opleiding. Bovendien worden in verschillende patiëntengroepen andere patronen van afwijkende slikparameters aangetroffen. Of deze observatie aanleiding kan geven tot specifieke slikdiagnoses en dus meer gerichte behandelingen is momenteel onderwerp van onderzoek

Data mining for software engineering and humans in the loop

The field of data mining for software engineering has been growing over the last decade. This field is concerned with the use of data mining to provide useful insights into how to improve software engineering processes and software itself, supporting decision-making. For that, data produced by software engineering processes and products during and after software development are used. Despite promising results, there is frequently a lack of discussion on the role of software engineering practitioners amidst the data mining approaches. This makes adoption of data mining by software engineering practitioners difficult. Moreover, the fact that experts’ knowledge is frequently ignored by data mining approaches, together with the lack of transparency of such approaches, can hinder the acceptability of data mining by software engineering practitioners. To overcome these problems, this position paper provides a discussion of the role of software engineering experts when adopting data mining approaches. It also argues that this role can be extended to increase experts’ involvement in the process of building data mining models. We believe that such extended involvement is not only likely to increase software engineers’ acceptability of the resulting models, but also improve the models themselves. We also provide some recommendations aimed at increasing the success of experts involvement and model acceptability