Adaptive-mutation compact genetic algorithm for dynamic environments

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Human-Centered Design Components in Spiral Model to Improve Mobility of Older Adults

As humans grow older, their cognitive needs change more frequently due to distal and proximal life events. Designers and developers need to come up with better designs that integrate older users’ needs in a short period of time with more interaction with the users. Therefore, the positioning of human end users in the center of the design itself is not the key to the success of design artifacts while designing applications for older adults to use a smartphone as a promising tool for journey planner while using public transportation. This study analyzed the use of human-centered design (HCD) components, the spiral model, and the design for failure (DfF) approach to improve the interactions between older users and designers/developers in gathering usability needs in the concept stage and during the development of the app with short iterative cycles. To illustrate the importance of the applied approach, a case study with particular focus on older adults is presented.The results presented in this study are based on “Assistant” project funded by AAL JP, co-funded by the European Union. The authors would like to thank Dr. Stefan Carmien, my colleague in Assistant, for mentoring and for reading and making comments in the earlier versions of this chapter; participating research institutes; funding agencies; and companies from Finland, Spain, Austria, France, and the United Kingdom for their active support throughout the project

Robot deployment in long-term care: a case study of a mobile robot in physical therapy

Background. Healthcare systems in industrialised countries are challenged to provide care for a growing number of older adults. Information technology holds the promise of facilitating this process by providing support for care staff, and improving wellbeing of older adults through a variety of support systems. Goal. Little is known about the challenges that arise from the deployment of technology in care settings; yet, the integration of technology into care is one of the core determinants of successful support. In this paper, we discuss challenges and opportunities associated with technology integration in care using the example of a mobile robot to support physical therapy among older adults with cognitive impairment in the European project STRANDS. Results and discussion. We report on technical challenges along with perspectives of physical therapists, and provide an overview of lessons learned which we hope will help inform the work of researchers and practitioners wishing to integrate robotic aids in the caregiving process

The effectiveness and cost-effectiveness of strength and balance Exergames to reduce falls risk for people aged 55 years and older in UK assisted living facilities: A multi-centre, cluster randomised controlled trial

Background: Falls are the leading cause of fatal and non-fatal unintentional injuries in older people. The use of Exergames (active, gamified video-based exercises) is a possible innovative, community-based approach. This study aimed to determine the effectiveness of a tailored OTAGO/FaME based strength and balance Exergame programme for improving balance, maintaining function and reducing falls risk in older people. Methods: A two-arm cluster randomised controlled trial recruiting adults aged 55 years and older living in 18 assisted-living (sheltered housing) facilities (clusters) in the UK. Standard care (physiotherapy advice and leaflet) was compared to a tailored 12-week strength and balance Exergame programme, supported by physiotherapists or trained assistants. Complete-case analysis (intention to treat) was used to compare Berg Balance Scale (BBS) at baseline and at 12 weeks. Secondary outcomes included: fear of falling, mobility, falls risk, pain, mood, fatigue, cognition, healthcare utilisation and health-related quality of life; self-reported physical activity and falls. Results: Eighteen clusters were randomised (9 to each arm) with 56 participants allocated to the intervention and 50 to the control (78% female, mean age 78 years). Fourteen participants withdrew over the 12 weeks (both arms), mainly for ill health. There was an adjusted mean improvement in balance (BBS) of 6.2 (95% CI 2.4 to 10.0), reduced fear of falling (p=0.007) and pain (p=0.02) in Exergame group. Mean attendance at sessions was 69% (mean exercising time of 33 minutes/week). 24% of control group and 20% of Exergame group fell over trial period. The change in falls rates significantly favoured the intervention (incident rate ratio 0.31 (95% CI 0.16 to 0.62, p=0.001)). The point estimate of the incremental cost effectiveness ratio (ICER) was £15,209.80 per QALY. Using 10,000 bootstrap replications, at the lower bound of the NICE threshold of £20,000 per QALY, there was a 61% probability of Exergames being cost-effective, rising to 73% at the upper bound of £30,000 per QALY. Conclusions: Exergames, as delivered in this trial, improve balance, pain and fear of falling and are a cost-effective fall prevention strategy in assisted living facilities for people aged 55 years or older

Bioactivity guided fractionation of Icacina trichantha Oliv. (Icacinaceae) tuber for antimalarial activity against Plasmodium berghei infected mice and GC-MS profile of bioactive fraction

902-912Aqueous methanol extract of the tuber of Icacina trichantha was prepared using cold maceration and dried in vacuo at 40°C. The extract was purified using solvent-solvent partitioning with n-hexane, dichloromethane, ethyl acetate, n-butanol. n-Hexane fraction was purified using Vacuum Liquid Chromatography, eluting with a gradient of dichloromethane in methanol (9:1, 7:3, 5:5, 0:10, each 500 mL) to obtain four sub-fractions. Acute toxicity study was done using Lorke’s method while in vivo anti-malarial study was carried out using suppressive model. Phytochemical analysis was carried out using standard procedure and most active sub-fraction was subjected to gas chromatography-mass spectroscopy. The extract at doses of 100, 200 and 400 mg/kg caused a significant (p<0.001) increase in percentage suppression of Plasmodium: 91.54 %, 94.48 % and 94.58% respectively. Phytochemical analysis of the extract revealed the presence of alkaloids, tannins, flavonoids saponin, glycoside, terpenoids, phenols, steroids, carbohydrates, reducing sugars. The GC-MS analysis showed the presence of eighteen compounds, the most abundant compound includes 9- octadecenoic acid (Z)-, methyl ester (oleic acid, 15.30%), 9, 12-octadecadienoic acid (Z, Z), methyl ester (linoleic acid, 14.34%). These findings suggest scientific evidence in support to the use of I. trichantha tuber for the management of malaria

Hospital Stroke Volume and Case-Fatality Revisited

Background: A few studies have found an inverse association between hospital patient volume and case-fatality among stroke patients. However, the different stroke categorizations used in these Studies might have influenced the findings. Furthermore, the relevance of the association observed remains questionable given that the relatively small magnitude may not support volume-based referral policies. We re-examined this association in a large nationwide Study, paying attention to the influence of volume categorizations. Methods: Applying multilevel logistic regression, we re-examined the relationship between hospital stroke volume and 7-day case-fatality using admissions data obtained from Statistics Netherlands on 73,077 stroke patients for the years 2000 to 2004. Different cut-offs were used to categorize hospitals in volume groups. We also examined the implications of a volume based referral strategy. Results: Stroke patients in high-volume hospitals had decreased risk of dying within 7 days of admission even when different hospital categorizations are applied. For instance, the odds ratio was 0.45 (95% CI 0.20-0.99) in high-volume (>200 case-volume) versus low-volume ( 250 case-volume) versus low-volume ( 200 case-volume hospital. A nontransfer policy aimed at reducing mortality by 10% in all those hospitals would save 1260 patients. Conclusion: Stroke patients in low-volume versus high-volume hospitals have higher odds of dying. This finding may not lend itself to a substantial volume-based referral strateg

Antimicrobial and Antioxidant Activities of Secondary Metabolites of an Endophytic fungus of Azadirachta indica

Background: Recent upsurge in the mortality rate and long hospital stays as a result of antimicrobial resistance caused by multi-drug resistant bacteria is a huge burden to public health sector. Intensive search for more effective and newer agents to deal with these problems. Endophytes are a novel source of potentially useful medicinal compounds. Aim: The study aimed at evaluating the antimicrobial and antioxidant activities of an endophytic fungus isolated from Azadirachta indica against multi drug resistant bacteria species. Method: Endophytic fungus was isolated from fresh leaves of Azadirachta indica. The fungus was fermented in rice medium, and the secondary metabolites were extracted. The antimicrobial activity of the extract against laboratory strains of Staphylococcus aureus, Escherichia coli, Klebsiella pneumonia and Bacillus subtilis, Candida albicans, Aspergillus niger) was determined. The fungal extract was also evaluated for antioxidant activity using the DPPH assay method. Using GC-FID analysis, some constituents of the fungal extracted were identified.&nbsp;Result: At 1 and 0.5 mg/mL, the fungal extract demonstrated antibacterial activity against Klebsiella pneumoniae but no activity against the other test microbes. However, the fungal extract of A. indica showed excellent antioxidant activity due to possession of bioactive secondary metabolites. Conclusion: The result of GC-FID showed the presence of Rutin, Lunamarin, Anthocyanin, Catechin, Naringenin, Flavan 3 ol, Sapogernin, Tannin, Spartein, Naringin, Flavonones, Steroids, Kaemferol, Cyanogenic glycoside, Phytate, Epicatechin, Reseveratol, Cardic glycoside and Epihedrine at different concentrations. This study reveals the dynamic potentials of the endophytic fungus of A. indica as the bedrock of naturally occurring bioactive agent.&nbsp; Keywords: Azadirachta indica, endophytes, GC-FID, secondary metabolites, medicinal plants, phytochemicals

Effects of hospital delivery during off-hours on perinatal outcome in several subgroups: a retrospective cohort study

Contains fulltext : 107710.pdf (publisher's version ) (Open Access)ABSTRACT: BACKGROUND: Studies have demonstrated a higher risk of adverse outcomes among infants born or admitted during off-hours, as compared to office hours, leading to questions about quality of care provide during off-hours (weekend, evening or night). We aim to determine the relationship between off-hours delivery and adverse perinatal outcomes for subgroups of hospital births. METHODS: This retrospective cohort study was based on data from the Netherlands Perinatal Registry, a countrywide registry that covers 99% of all hospital births in the Netherlands. Data of 449,714 infants, born at 28 completed weeks or later, in the period 2003 through 2007 were used. Infants with a high a priori risk of morbidity or mortality were excluded. Outcome measures were intrapartum and early neonatal mortality, a low Apgar score (5 minute score of 0-6), and a composite adverse perinatal outcome measure (mortality, low Apgar score, severe birth trauma, admission to a neonatal intensive care unit). RESULTS: Evening and night-time deliveries that involved induction or augmentation of labour, or an emergency caesarean section, were associated with an increased risk of an adverse perinatal outcome when compared to similar daytime deliveries. Weekend deliveries were not associated with an increased risk when compared to weekday deliveries. It was estimated that each year, between 126 and 141 cases with an adverse perinatal outcomes could be attributed to this evening and night effect. Of these, 21 (15-16%) are intrapartum or early neonatal death. Among the 3100 infants in the study population who experience an adverse outcome each year, death accounted for only 5% (165) of these outcomes. CONCLUSION: This study shows that for infants whose mothers require obstetric interventions during labour and delivery, birth in the evening or at night, are at an increased risk of an adverse perinatal outcomes