Simulation and control of multipurpose wheelchair for disabled/elderly mobility

© 2016 IOS Press and the author(s). This paper presents investigations into the development of modelling and control strategies for a multipurpose wheelchair as mobile transporter for elderly and disabled people. The research is aimed at helping people with physical weakness/disabilities in their upper and lower extremities to move independently without human intervention. A novel reconfiguration which allows multi-task operations in the same wheelchair system with improved design is modelled in Visual Nastran 4D (VN4D) software. A modular fuzzy logic control mechanism with integrated phases is introduced for the overall operations and two-wheeled stabilization of the wheelchair. It is shown that the proposed modular fuzzy control approach is able to ensure system stability while performing multipurpose tasks such as manoeuvrability on flat surfaces, stairs climbing (ascending and descending), standing in the upright position on two wheels and transformation back to standard four wheels with up to 50% less initial torque in comparison to previous designs

Serum Procalcitonin (PCT) - Is there a Role as an Early Biomarker in Infected Diabetic Foot Ulcer (IDFU) Patients?

Introduction: Infected diabetic foot ulcers may lead to serious complications if not recognised in the early stage. Diagnosis of infection is particularly challenging at that stage; thus, a sensitive inflammatory biomarker may be helpful. We aimed to evaluate the role of procalcitonin (PCT) as an early biomarker for infected diabetic foot ulcers (IDFU). Materials and method: This cross-sectional study was conducted at Klinik Rawatan Keluarga (KRK), Orthopedic clinic and wards in Hospital Universiti Sains Malaysia (USM) from May 2020 to December 2020. A total of 264 participants were recruited and divided into three groups: 50 diabetic patients with no ulcers (control), 107 patients with non-infected diabetic foot ulcers (NIDFU), and 107 patients with infected diabetic foot ulcers (IDFU). The level of PCT was taken for all patients. Total white count (TWC) and C- reactive protein (CRP) were taken only for IDFU patients. Diagnosis of infection was based on the Infectious Disease Society of America-International Working Group of Diabetic Foot (IDSA-IMWGDF), and the severity of infection was graded according to the Wagner Classification. Results: The level of PCT was higher in IDFU than in NIDFU and diabetic patient, with a median (IQR) of 0.355 (0.63) ng/mL, 0.077 (0.15) ng/mL and 0.028 (0.02) ng/mL, respectively. PCT and CRP showed moderate positive correlations in IDFU patients (p<0.001). The sensitivity and specificity were 63.6% and 83.2%, respectively, at the best cut-off at 0.25 ng/mL. Conclusion: PCT is a valuable biomarker for the diagnosis of infection; however, it adds little value in the early diagnosis of IDFU in view of its low sensitivity

Metabonomic fingerprints of fasting plasma and spot urine reveal human pre-diabetic metabolic traits

Impaired glucose tolerance (IGT) which precedes overt type 2 diabetes (T2DM) for decades is associated with multiple metabolic alterations in insulin sensitive tissues. In an UPLC-qTOF-mass spectrometry-driven non-targeted metabonomics approach we investigated plasma as well as spot urine of 51 non-diabetic, overnight fasted individuals aiming to separate subjects with IGT from controls thereby identify pathways affected by the pre-diabetic metabolic state. We could clearly demonstrate that normal glucose tolerant (NGT) and IGT subjects clustered in two distinct groups independent of the investigated metabonome. These findings reflect considerable differences in individual metabolite fingerprints, both in plasma and urine. Pre-diabetes associated alterations in fatty acid-, tryptophan-, uric acid-, bile acid-, and lysophosphatidylcholine-metabolism, as well as the TCA cycle were identified. Of note, individuals with IGT also showed decreased levels of gut flora-associated metabolites namely hippuric acid, methylxanthine, methyluric acid, and 3-hydroxyhippuric acid. The findings of our non-targeted UPLC-qTOF-MS metabonomics analysis in plasma and spot urine of individuals with IGT vs NGT offers novel insights into the metabolic alterations occurring in the long, asymptomatic period preceding the manifestation of T2DM thereby giving prospects for new intervention targets

Trace elements in glucometabolic disorders: an update

Many trace elements, among which metals, are indispensable for proper functioning of a myriad of biochemical reactions, more particularly as enzyme cofactors. This is particularly true for the vast set of processes involved in regulation of glucose homeostasis, being it in glucose metabolism itself or in hormonal control, especially insulin. The role and importance of trace elements such as chromium, zinc, selenium, lithium and vanadium are much less evident and subjected to chronic debate. This review updates our actual knowledge concerning these five trace elements. A careful survey of the literature shows that while theoretical postulates from some key roles of these elements had led to real hopes for therapy of insulin resistance and diabetes, the limited experience based on available data indicates that beneficial effects and use of most of them are subjected to caution, given the narrow window between safe and unsafe doses. Clear therapeutic benefit in these pathologies is presently doubtful but some data indicate that these metals may have a clinical interest in patients presenting deficiencies in individual metal levels. The same holds true for an association of some trace elements such as chromium or zinc with oral antidiabetics. However, this area is essentially unexplored in adequate clinical trials, which are worth being performed

Sit-to-Stand and Stand-to-Sit Control Mechanisms of Two-Wheeled Wheelchair.

This paper presents a mechanism for standing and sitting transformation of a wheelchair using a two-wheeled inverted pendulum concept with reduced torque requirement, in simulation studies. The motivation of this work is to design a compact standing mechanism to help an elderly/disabled person with functional limitation in lower extremities to maneuver in small and confined spaces and enable them to perform standard daily life routines independently. The wheelchair system at the upright standing position is tested with different travel distances, and the challenge is to control both sit-to-stand and stand-to-sit operations in a stable manner using flexible-joint humanoid. An additional spring/damping element is incorporated at each wheel to provide a comfortable ride for the user especially during stand-to-sit transformation task. A PD-fuzzy control with modular structure is implemented, and the performance of the system is observed through visual nastran 4d (vn4d) visualization software and simulation in matlab. The stand-to-sit performance tests have shown more than 38% reduction in tilt and back seat angles fluctuation in linear travel motion using a suspension system, while the initial tilt torque needed is 50% less than the amount required in previous designs

Control of a stair climbing wheelchair

This paper presents investigations into the control of a stair climbing wheelchair particularly for indoor usage. A virtual wheelchair model is developed using Visual Nastran software and linked with Matlab/Simulink for control purposes. The goals are to have a simple, compact and stable stairs climbing wheelchair in order to complete the ascending and descending tasks. The challenges are to ensure the wheelchair seat always stay at the upright position and to control both the front and rear wheel motors while climbing. PID control is used to provide appropriate torque to both front and rear wheels as well as at to the wheelchair seat during climbing. Results show that the wheelchair movement can be controlled smoothly and the seat maintained at the desired position with the adapted approach