Recent Trends in Hospitalization for Acute Myocardial Infarction in Beijing: Increasing Overall Burden and a Transition From ST-Segment Elevation to Non-ST-Segment Elevation Myocardial Infarction in a Population-Based Study

Comparable data on trends of hospitalization rates for ST-segment elevation myocardial infarction (STEMI) and non-STEMI (NSTEMI) remain unavailable in representative Asian populations.To examine the temporal trends of hospitalization for acute myocardial infarction (AMI) and its subtypes in Beijing.Patients hospitalized for AMI in Beijing from January 1, 2007 to December 31, 2012 were identified from the validated Hospital Discharge Information System. Trends in hospitalization rates, in-hospital mortality, length of stay (LOS), and hospitalization costs were analyzed by regression models for total AMI and for STEMI and NSTEMI separately. In total, 77,943 patients were admitted for AMI in Beijing during the 6 years, among whom 67.5% were males and 62.4% had STEMI. During the period, the rate of AMI hospitalization per 100,000 population increased by 31.2% (from 55.8 to 73.3 per 100,000 population) after age standardization, with a slight decrease in STEMI but a 3-fold increase in NSTEMI. The ratio of STEMI to NSTEMI decreased dramatically from 6.5:1.0 to 1.3:1.0. The age-standardized in-hospital mortality decreased from 11.2% to 8.6%, with a significant decreasing trend evident for STEMI in males and females (P < 0.001) and for NSTEMI in males (P = 0.02). The rate of percutaneous coronary intervention increased from 28.7% to 55.6% among STEMI patients. The total cost for AMI hospitalization increased by 56.8% after adjusting for inflation, although the LOS decreased by 1 day.The hospitalization burden for AMI has been increasing in Beijing with a transition from STEMI to NSTEMI. Diverse temporal trends in AMI subtypes from the unselected "real-world" data in Beijing may help to guide the management of AMI in China and other developing countries

Compliance adaptation of an intrinsically soft ankle rehabilitation robot driven by pneumatic muscles

Pneumatic muscles (PMs)-driven robots become more and more popular in medical and rehabilitation field as the actuators are intrinsically complaint and thus are safer for patients than traditional rigid robots. This paper proposes a new compliance adaptation method of a soft ankle rehabilitation robot that is driven by four pneumatic muscles enabling three rotational movement degrees of freedom (DoFs). The stiffness of a PM is dominated by the nominal pressure. It is possible to control the robot joint compliance independently of the robot movement in task space. The controller is designed in joint space to regulate the compliance property of the soft robot by tuning the stiffness of each active link. Experiments in actual environment were conducted to verify the control scheme and results show that the robot compliance can be adjusted when provided changing nominal pressures and the robot assistance output can be regulated, which provides a feasible solution to implement the patient-cooperative training strategy

Robust iterative feedback tuning control of a compliant rehabilitation robot for repetitive ankle training

Robot-assisted rehabilitation offers benefits, such as repetitive, intensive, and task-specific training, as compared to traditional manual manipulation performed by physiotherapists. In this paper, a robust iterative feedback tuning (IFT) technique for repetitive training control of a compliant parallel ankle rehabilitation robot is presented. The robot employs four parallel intrinsically compliant pneumatic muscle actuators that mimic skeletal muscles for ankle's motion training. A multiple degrees-of-freedom normalized IFT technique is proposed to increase the controller robustness by obtaining an optimal value for the weighting factor and offering a method with learning capacity to achieve an optimum of the controller parameters. Experiments with human participants were conducted to investigate the robustness as well as to validate the performance of the proposed IFT technique. Results show that the normalized IFT scheme will achieve a better and better tracking performance during the robot repetitive control and provides more robustness to the system by adapting to various situations in robotic rehabilitation

Recent development of mechanisms and control strategies for robot-assisted lower limb rehabilitation

Robot-assisted rehabilitation and therapy has become more and more frequently used to help the elderly, disabled patients or movement disorders to perform exercise and training. The field of robot-assisted lower limb rehabilitation has rapidly evolved in the last decade. This article presents a review on the most recent progress (from year 2001 to 2014) of mechanisms, training modes and control strategies for lower limb rehabilitation robots. Special attention is paid to the adaptive robot control methods considering hybrid data fusion and patient evaluation in robot-assisted passive and active lower limb rehabilitation. The characteristics and clinical outcomes of different training modes and control algorithms in recent studies are analysed and summarized. Research gaps and future directions are also highlighted in this paper to improve the outcome of robot-assisted rehabilitation

A MUSIC-based method for SSVEP signal processing

The research on brain computer interfaces (BCIs) has become a hotspot in recent years because it offers benefit to disabled people to communicate with the outside world. Steady state visual evoked potential (SSVEP)-based BCIs are more widely used because of higher signal to noise ratio and greater information transfer rate compared with other BCI techniques. In this paper, a multiple signal classification based method was proposed for multi-dimensional SSVEP feature extraction. 2-second data epochs from four electrodes achieved excellent accuracy rates including idle state detection. In some asynchronous mode experiments, the recognition accuracy reached up to 100 %. The experimental results showed that the proposed method attained good frequency resolution. In most situations, the recognition accuracy was higher than canonical correlation analysis, which is a typical method for multi-channel SSVEP signal processing. Also, a virtual keyboard was successfully controlled by different subjects in an unshielded environment, which proved the feasibility of the proposed method for multi-dimensional SSVEP signal processing in practical applications

Coupling Disturbance Compensated MIMO Control of Parallel Ankle Rehabilitation Robot Actuated by Pneumatic Muscles

To solve the poor compliance and safety problems in current rehabilitation robots, a novel two-degrees-offreedom (2-DOF) soft ankle rehabilitation robot driven by pneumatic muscles (PMs) is presented, taking advantages of the PM’s inherent compliance and the parallel structure’s high stiffness and payload capacity. However, the PM’s nonlinear, time-varying and hysteresis characteristics, and the coupling interference from parallel structure, as well as the unpredicted disturbance caused by arbitrary human behavior all raise difficulties in achieving high-precision control of the robot. In this paper, a multi-input-multi-output disturbance compensated sliding mode controller (MIMO-DCSMC) is proposed to tackle these problems. The proposed control method can tackle the un-modeled uncertainties and the coupling interference existed in multiple PMs’ synchronous movement, even with the subject’s participation. Experiment results on a healthy subject confirmed that the PMs-actuated ankle rehabilitation robot controlled by the proposed MIMO-DCSMC is able to assist patients to perform high-accuracy rehabilitation tasks by tracking the desired trajectory in a compliant manner

Pre-selectable integer quantum conductance of electrochemically fabricated silver point contacts

The controlled fabrication of well-ordered atomic-scale metallic contacts is of great interest: it is expected that the experimentally observed high percentage of point contacts with a conductance at non-integer multiples of the conductance quantum G_0 = 2e^2/h in simple metals is correlated to defects resulting from the fabrication process. Here we demonstrate a combined electrochemical deposition and annealing method which allows the controlled fabrication of point contacts with pre-selectable integer quantum conductance. The resulting conductance measurements on silver point contacts are compared with tight-binding-like conductance calculations of modeled idealized junction geometries between two silver crystals with a predefined number of contact atoms