From fall-risk assessment to fall detection: inertial sensors in the clinical routine and daily life

Falls are caused by complex interaction between multiple risk factors which may be modified by age, disease and environment. A variety of methods and tools for fall risk assessment have been proposed, but none of which is universally accepted. Existing tools are generally not capable of providing a quantitative predictive assessment of fall risk. The need for objective, cost-effective and clinically applicable methods would enable quantitative assessment of fall risk on a subject-specific basis. Tracking objectively falls risk could provide timely feedback about the effectiveness of administered interventions enabling intervention strategies to be modified or changed if found to be ineffective. Moreover, some of the fundamental factors leading to falls and what actually happens during a fall remain unclear. Objectively documented and measured falls are needed to improve knowledge of fall in order to develop more effective prevention strategies and prolong independent living. In the last decade, several research groups have developed sensor-based automatic or semi-automatic fall risk assessment tools using wearable inertial sensors. This approach may also serve to detect falls. At the moment, i) several fall-risk assessment studies based on inertial sensors, even if promising, lack of a biomechanical model-based approach which could provide accurate and more detailed measurements of interests (e.g., joint moments, forces) and ii) the number of published real-world fall data of older people in a real-world environment is minimal since most authors have used simulations with healthy volunteers as a surrogate for real-world falls. With these limitations in mind, this thesis aims i) to suggest a novel method for the kinematics and dynamics evaluation of functional motor tasks, often used in clinics for the fall-risk evaluation, through a body sensor network and a biomechanical approach and ii) to define the guidelines for a fall detection algorithm based on a real-world fall database availability.

Assessment of Daily Life Mobility Levels using Wearable Inertial Sensors and Minimun Measured Input Models

Tracking activities during daily life and assessing movement parameters is essential for complementing the information gathered in confined environments such as clinical and physical activity laboratories for the assessment of mobility. Inertial measurement units (IMUs) are used as to monitor the motion of human movement for prolonged periods of time and without space limitations. The focus in this study was to provide a robust, low-cost and an unobtrusive solution for evaluating human motion using a single IMU. First part of the study focused on monitoring and classification of the daily life activities. A simple method that analyses the variations in signal was developed to distinguish two types of activity intervals: active and inactive. Neural classifier was used to classify active intervals; the angle with respect to gravity was used to classify inactive intervals. Second part of the study focused on extraction of gait parameters using a single inertial measurement unit (IMU) attached to the pelvis. Two complementary methods were proposed for gait parameters estimation. First method was a wavelet based method developed for the estimation of gait events. Second method was developed for estimating step and stride length during level walking using the estimations of the previous method. A special integration algorithm was extended to operate on each gait cycle using a specially designed Kalman filter. The developed methods were also applied on various scenarios. Activity monitoring method was used in a PRIN’07 project to assess the mobility levels of individuals living in a urban area. The same method was applied on volleyball players to analyze the fitness levels of them by monitoring their daily life activities. The methods proposed in these studies provided a simple, unobtrusive and low-cost solution for monitoring and assessing activities outside of controlled environments.

Assessment of marine litter in the Western Adriatic Sea and its impact on marine biota

Due to its environmental, safety, health and socio-economic impacts, marine litter has been recognized as a 21st century global challenge, so that it has been included in Descriptor 10 of the EU MSFD. For its morphological features and anthropogenic pressures, the Adriatic Sea is very sensitive to the accumulation of debris, but data are inconsistent and fragmented. This thesis, in the framework of DeFishGear project, intents to assess marine litter on beaches and on seafloor in the Western Adriatic sea, and test if debris ingestion by fish occurs. Three beaches were sampled during two surveys in 2015. Benthic litter monitoring was carried out in the FAO GSA17 during fall 2014, using a rapido trawl. Litter ingestion was investigated through gut contents analysis of 260 fish belonging to 8 commercial species collected in Western Gulf of Venice. Average litter density on beaches was 1.5 items/m2 during spring, and decreased to 0.8 items/m2 in summer. Litter composition was heterogeneous and varied among sites, even if no significant differences were found. Most of debris consisted of plastic sheets, fragments, polystyrene pieces, mussels nets and cottons bud sticks, showing that sources are many and include aquaculture, land-based activities and local users of beaches. Average density of benthic litter was 913 items/Km2 (82 Kg/Km2). Plastic dominated in terms of numbers and weight, and consisted mainly of bags, sheets and mussel nets. The highest density was found close to the coast, and sources driving the major differences in litter distribution were mussel farms and shipping lanes. Litter ingestion occurred in 47% of examined fish, mainly consisting of fibers. Among species, S. pilchardus swallowed almost all debris categories. Findinds may provide a baseline to set the necessary measures to manage and minimize marine litter in the Western Adriatic region and to protect aquatic life from plastic pollution, even accounting the possible implications on human health.

The Savannah hypotheses: origin, reception and impact on paleoanthropology

The reconstruction of the human past is a complex task characterized by a high level of interdisciplinarity. How do scientists from different fields reach consensus on crucial aspects of paleoanthropological research? The present paper explores this question through an historical analysis of the origin, development, and reception of the savannah hypotheses (SHs). We show that this model neglected to investigate crucial biological aspects which appeared to be irrelevant in scenarios depicting early hominins evolving in arid or semi-arid open plains. For instance, the exploitation of aquatic food resources and other aspects of hominin interaction with water were largely ignored in classical paleoanthropology. These topics became central to alternative ideas on human evolution known as aquatic hypotheses. Since the aquatic model is commonly regarded as highly controversial, its rejection led to a stigmatization of the whole spectrum of topics around water use in non-human hominoids and hominins. We argue that this bias represents a serious hindrance to a comprehensive reconstruction of the human past. Progress in this field depends on clear differentiation between hypotheses proposed to contextualize early hominin evolution in specific environmental settings and research topics which demand the investigation of all relevant facets of early hominins' interaction with complex landscapes.

Xenobiotic metabolomics: major impact on the metabolome

Xenobiotics are encountered by humans on a daily basis and include drugs, environmental pollutants, cosmetics, and even components of the diet. These chemicals undergo metabolism and detoxication to produce numerous metabolites, some of which have the potential to cause unintended effects such as toxicity. They can also block the action of enzymes or receptors used for endogenous metabolism or affect the efficacy and/or bioavailability of a coadministered drug. Therefore, it is essential to determine the full metabolic effects that these chemicals have on the body. Metabolomics, the comprehensive analysis of small molecules in a biofluid, can reveal biologically relevant perturbations that result from xenobiotic exposure. This review discusses the impact that genetic, environmental, and gut microflora variation has on the metabolome, and how these variables may interact, positively and negatively, with xenobiotic metabolism.

John Calvin's Impact on Church and Society, 1509-2009. Essays for the 500th birthday of Calvin

A tribute to the monumental influence of John Calvin in the 500 years since his birth. / What legacies, still enduring today, have John Calvin and Calvinism given to the church and society in Europe and North America? An international group of scholars tackles that question in this volume honoring Calvin's 500th birthday. These chapters together provide a comprehensive and accessible introduction to Calvin's life and thought, the history of the Reformation in Switzerland and worldwide, and his continuing relevance for ecclesial, social, and political questions today. / Contributors: Philip Benedict, James D. Bratt, Emidio Campi, Wulfert de Greef, Christopher Elwood, Eva-Maria Faber, Eric Fuchs, Ulrich H. J. Krtner, Christian Link, Christian Moser, Andrew Pettegree, Christoph Strohm, Mario Turchetti./ The essays in this book fit beautifully together to provide a solid, complete work that gives precise insight into the many different facets of Calvin and Calvinism. The high-level research found here clearly shows the great impact that Calvin has had on both church and society. It is a great pleasure to see Calvin here anew. Eberhard Busch / University of Gttingen / That John Calvin made a deep and lasting impact on many aspects of history is common knowledge but the character of the man and the nature of his influence are perhaps as controversial as any that can be named. It is thus a challenge to examine even a fraction of the many ways that Calvins life and thought have contributed to the shaping of later ages in both church and society. This volume offers essays on key points from an appropriately international group of authors appreciative but critical, drawing on a rich range of recent scholarship, presented in a pleasing and accessible form. It is a fine place for the new reader of Calvin to get a glimpse of his impact, while offering a fresh summary of some significant issues for more advanced students of the Reformer. Elsie Anne McKee / Princeton Theological Seminary / Hirzel and Sallmann have succeeded in gathering essays by an illustrious circle of experts both historians and theologians on important areas of Calvins thought and impact. Ranging from an insignificant city at the edge of the Swiss Confederation in the 1530s to the Accra Confession of 2004, these essays will serve to correct popular misconceptions. A fine introduction for a broader readership that wants more than mere armchair theology. Peter Opitz / University of Zurich

Patients with oral tumors. Part 2: Quality of life after treatment with resection prostheses. Resection prosthetics: evaluation of quality of life

In the present study, the oral health-related quality of life of 18 patients (13 men and 5 women) was evaluated using validated questionnaires as proposed by the European Organization of Research and Treatment of Cancer (EORTC). The patients belonged to a cohort of 48 patients, whose prosthetic treatment was performed during the years 2004-2007. In the course of tumor resection, 12 patients underwent graft surgery and 14 patients radiotherapy. One patient required a nasal epithesis since resection of the nose became necessary. Five patients underwent a full block resection of the mandible, and tumor resection in 3 patients resulted in a large oronasal communication. Prosthetic rehabilitation was performed in all patients, and the follow-up period with regular care covered a minimum of 3 years. Eleven patients received dental implants for better support and retention of the prostheses. In spite of compromised oral conditions, functional restrictions, and some difficulties with the prostheses, the answers to the questionnaire were quite positive. The majority judged their general health as good or even excellent. The subjective perception of the patients may contradict the objective view by the dentist. In fact, the individual patient's history and experience provide a better understanding of the impact of oral tumors on daily life. The overall assessment identified 4 items that were perceived as major problems by all patients: swallowing solid food, dry mouth, limited mouth opening, and appearance. Prosthetic rehabilitation has only a limited influence on such problems.

Assessing the Influence of Brain-based Instructional Methods and Its Impact on Systemic Change for Learning Communities

Background: As scholars who prepare future school leaders to be innovative instructional leaders for their learning communities, we are on the verge of a curriculum design revolution. The application of brain research findings promotes educational reform efforts to systemically change the way in which children experience school. However, most educators, school leaders, board members, and policy makers are ill prepared to reconsider the implications for assessment, pedagogy, school climate, daily schedules, and use of technology. This qualitative study asked future school leaders to reconsider how school leadership preparedness programs prepared them to become instructional leaders for the 21st century. The findings from this study will enhance the field of school leadership, challenging the current emphasis placed on standardized testing, traditional school calendars, assessments, monocultural instructional methods, and meeting the needs of diverse learning communities. [See PDF for complete abstract]

Investigating short- and long-term transfer effects of a Taiji beginner course in participants’ daily life

OBJECTIVE: In recent years research investigating various health benefits of Taiji practice has markedly increased. Despite this growing scientific interest, essential questions such as to what extent a Taiji course may exert noticeable effects in participants’ everyday life, what these effects are, and how and where potential transfer effects occur, have hardly been considered. The aim of our study was to explore transfer effects from a Taiji course into participants’ daily lives. METHODS: We conducted a longitudinal observational study in 45 healthy participants at the end of their three-month Taiji beginner course (tp1) and at two months (tp2) as well as one year after course completion (tp3). Participants were asked to report their Taiji practice behavior at all time points, as well as to rate and describe perceived transfer effects of Taiji course contents on their daily life at tp1 and tp3. RESULTS: Transfer effects were reported by 91.1% of all respondents after course completion (tp1) and persisted in 73.3% at the one-year follow-up assessment (tp3), counting “increase of self-efficacy”, “improvement of stress management”, and “increase of body awareness” as the most frequently mentioned effects. Transfer effects predominantly occurred in participants’ work and social environments, as well as during everyday activities in public areas. While selfreliant Taiji practice frequency significantly decreased from 82.2% at tp1 to 55.6% at tp3 (P < 0.001), the magnitude of self-reported transfer effects did not (P = 0.35). As explorative analyses revealed, regular Taiji course attendance was highly correlated with stronger transfer effects at tp1 (r = 0.51; P < 0.001) and tp3 (r = 0.35; P = 0.020). Participants reporting high self-reliant Taiji practice frequency at tp2 were likely to maintain a regular practice routine at tp3 (r = 0.42; P < 0.004), whereas self-reliant practice frequency and transfer effects at tp1 were positively correlated with self-reliant practice frequency at tp3 on a trend level (r < 0.27; P > 0.08). CONCLUSION: Our data underline the importance of regular course participation for pronounced and long lasting transfer effects into participants’ everyday life. We discuss that several context and process-related aspects of a Taiji intervention are potentially relevant factors for enhancement of transfer effect.

Marital split-up and widowhood in old age: Differential impact on psychological and social well-being

Marital split-up and spousal loss are among the most stressful critical life events. Numerous studies have documented their detrimental effects on well-being, yet the large individual differences in psychological adaptation are still not well understood. Whereas in old age bereavement is normative and can be anticipated, divorce is an “off-time” transition for this age group. In contrast to bereavement which has been amply studied, research on later life divorce is still missing despite the increasing relevance of the topic due to the significant increase of divorces in older age. Based on a modified and extended view of Amato’s divorce-stress-adjustment model (2000), the aim of this contribution is to explore the differential impact of marital split-up and widowhood in older age on psychological (life satisfaction) and social well-being (social loneliness), and the adaptation to these critical life events. Our analyses are based on data gathered in a questionnaire study, which is part of the Swiss National Centre of Competence in Research LIVES. In a first step we compared three groups of individuals aged 60 to 75 years: a sample of 251 persons with a marital split-up (127 women; 123 men), a sample of 270 widowed persons (170 women; 100 men), and a group of 221 continuously married people (110 women; 111 men), which served as control group. In a second step, we investigated the role of socio-demographic variables, intrapersonal and interpersonal resources and variables of the context of loss as predictors for the psychological adaptation to a marital break-up and loss in old age. First results by ANCOVA indicate significant differences with regard to life satisfaction among the three groups, with divorced persons with the lowest scores, followed by the bereaved ones, and the married controls with the highest. Regarding social loneliness, divorced individuals report higher social loneliness than the bereaved group and the married controls (no significant difference between widowed and the married). In both loss groups, financial and intrapersonal resources, as well as the emotional valence of the loss are the most important predictors for the psychological and social adaptation. However, happiness in the past relationship is an important resource regarding the indicators for adaptation for the widowers, but not for individuals with a marital dissolution.

Life-span development of self-esteem and its effects on important life outcomes

We examined the life-span development of self-esteem and tested whether self-esteem influences the development of important life outcomes, including relationship satisfaction, job satisfaction, occupational status, salary, positive and negative affect, depression, and physical health. Data came from the Longitudinal Study of Generations. Analyses were based on 5 assessments across a 12-year period of a sample of 1,824 individuals ages 16 to 97 years. First, growth curve analyses indicated that self-esteem increases from adolescence to middle adulthood, reaches a peak at about age 50 years, and then decreases in old age. Second, cross-lagged regression analyses indicated that self-esteem is best modeled as a cause rather than a consequence of life outcomes. Third, growth curve analyses, with self-esteem as a time-varying covariate, suggested that self-esteem has medium-sized effects on life-span trajectories of affect and depression, small to medium-sized effects on trajectories of relationship and job satisfaction, a very small effect on the trajectory of health, and no effect on the trajectory of occupational status. These findings replicated across 4 generations of participants— children, parents, grandparents, and their great-grandparents. Together, the results suggest that self-esteem has a significant prospective impact on real-world life experiences and that high and low self-esteem are not mere epiphenomena of success and failure in important life domains.

Associations of self-compassion and global self-esteem with positive and negative affect and stress reactivity in daily life: Findings from a smart phone study

The present study examined trait self-compassion and trait self-esteem in relation to positive (PA) and negative affect (NA), as well as their associations with stress reactivity in daily life. One hundred and one subjects completed questionnaires on perceived stress and affect twice a day for 14 consecutive days on smart phones. Results indicated that self-compassion and global self-esteem were positively related to PA and negatively to NA. After controlling for self-esteem, self-compassion remained significantly associated with PA and NA, whereas self-esteem was no longer associated with PA and NA after controlling for self-compassion. Furthermore, results indicated that self-compassion buffered the effect of stress on NA, whereas this was not the case for global self-esteem. Neither self-compassion nor self-esteem moderated the relation of stress on PA in separate models. The results of the present study add to the growing literature regarding beneficial relations of self-compassion and psychological well-being and further emphasize the distinction of self-compassion and global self-esteem.

Development of an Elevated Temperature Loop Heat Pipe for Space Applications and Investigation of Non Condensable Gas Impact on its Performance

Un caloducto en bucle cerrado o Loop Heat Pipe (LHP) es un dispositivo de transferencia de calor cuyo principio de operación se basa en la evaporación/condensación de un fluido de trabajo, que es bombeado a través de un circuito cerrado gracias a fuerzas de capilaridad. Gracias a su flexibilidad, su baja masa y su mínimo (incluso nulo) consumo de potencia, su principal aplicación ha sido identificada como parte del subsistema de control térmico de vehículos espaciales. En el presente trabajo se ha desarrollado un LHP capaz de funcionar eficientemente a temperaturas de hasta 125 oC, siguiendo la actual tendencia de los equipos a bordo de satélites de incrementar su temperatura de operación. En la selección del diseño optimo para dicho LHP, la compatibilidad entre materiales y fluido de trabajo se identificó como uno de los puntos clave. Para seleccionar la mejor combinación, se llevó a cabo una exhaustiva revisión del estado del arte, además de un estudio especifico que incluía el desarrollo de un banco de ensayos de compatibilidad. Como conclusión, la combinación seleccionada como la candidata idónea para ser integrada en el LHP capaz de operar hasta 125 oC fue un evaporador de acero inoxidable, líneas de titanio y amoniaco como fluido de trabajo. En esa línea se diseñó y fabricó un prototipo para ensayos y se desarrolló un modelo de simulación con EcosimPro para evaluar sus prestaciones. Se concluyó que el diseño era adecuado para el rango de operación definido. La incompatibilidad entre el fluido de trabajo y los materiales del LHP está ligada a la generación de gases no condensables. Para un estudio más detallado de los efectos de dichos gases en el funcionamiento del LHP se analizó su comportamiento con diferentes cantidades de nitrógeno inyectadas en su cámara de compensación, simulando un gas no condensable formado en el interior del dispositivo. El estudio se basó en el análisis de las temperaturas medidas experimentalmente a distintos niveles de potencia y temperatura de sumidero o fuente fría. Adicionalmente, dichos resultados se compararon con las predicciones obtenidas por medio del modelo en EcosimPro. Las principales conclusiones obtenidas fueron dos. La primera indica que una cantidad de gas no condensable más de dos veces mayor que la cantidad generada al final de la vida de un satélite típico de telecomunicaciones (15 años) tiene efectos casi despreciables en el funcionamiento del LHP. La segunda es que el principal efecto del gas no condensable es una disminución de la conductancia térmica, especialmente a bajas potencias y temperaturas de sumidero. El efecto es más significativo cuanto mayor es la cantidad de gas añadida. Asimismo, durante la campaña de ensayos se observó un fenómeno no esperado para grandes cantidades de gas no condensable. Dicho fenómeno consiste en un comportamiento oscilatorio, detectado tanto en los ensayos como en la simulación. Este efecto es susceptible de una investigación más profunda y los resultados obtenidos pueden constituir la base para dicha tarea. ABSTRACT Loop Heat Pipes (LHPs) are heat transfer devices whose operating principle is based on the evaporation/condensation of a working fluid, and which use capillary pumping forces to ensure the fluid circulation. Thanks to their flexibility, low mass and minimum (even null) power consumption, their main application has been identified as part of the thermal control subsystem in spacecraft. In the present work, an LHP able to operate efficiently up to 125 oC has been developed, which is in line with the current tendency of satellite on-board equipment to increase their operating temperatures. In selecting the optimal LHP design for the elevated temperature application, the compatibility between the materials and working fluid has been identified as one of the main drivers. An extensive literature review and a dedicated trade-off were performed, in order to select the optimal combination of fluids and materials for the LHP. The trade-off included the development of a dedicated compatibility test stand. In conclusion, the combination of stainless steel evaporator, titanium piping and ammonia as working fluid was selected as the best candidate to operate up to 125 oC. An LHP prototype was designed and manufactured and a simulation model in EcosimPro was developed to evaluate its performance. The first conclusion was that the defined LHP was suitable for the defined operational range. Incompatibility between the working fluid and LHP materials is linked to Non Condensable Gas (NCG) generation. Therefore, the behaviour of the LHP developed with different amounts of nitrogen injected in its compensation chamber to simulate NCG generation, was analyzed. The LHP performance was studied by analysis of the test results at different temperatures and power levels. The test results were also compared to simulations in EcosimPro. Two additional conclusions can be drawn: (i) the effects of an amount of more than two times the expected NCG at the end of life of a typical telecommunications satellite (15 years) is almost negligible on the LHP operation, and (ii) the main effect of the NCG is a decrease in the LHP thermal conductance, especially at low temperatures and low power levels. This decrease is more significant with the progressive addition of NCG. An unexpected phenomenon was observed in the LHP operation with large NCG amounts. Namely, an oscillatory behaviour, which was observed both in the tests and the simulation. This effect provides the basis for further studies concerning oscillations in LHPs.

Therapeutic drug monitoring of cefepime with micellar electrokinetic capillary chromatography: Assay improvement, quality assurance, and impact on patient drug levels

The improvement and performance of a micellar electrokinetic capillary chromatography assay for cefepime in human serum and plasma with a 50 μm id fused-silica capillary elongated from 40 to 60 cm is reported. Sample preparation with dodecylsulfate protein precipitation at pH 4.5, the pH 9.1 separation medium and the applied voltage were as reported previously[16]. The change resulted in a significant lower current, higher resolution and increased detection time intervals. The performance of the assay with multi-level internal calibration was assessed with calibration and control samples. Quality assurance data of a two year period assessed under the new conditions demonstrated the robustness of the assay. In serum samples of patients who received both cefepime and sulfamethoxazole, cefepime could not be detected due to the inseparability of the two compounds. The presence of an interference can be recognized by an increased peak width (width > 0.2 min), the appearance of a shoulder or an unresolved double peak. The patient data gathered during a three year period reveal that introduction of therapeutic drug monitoring led to a 50% reduction of the median drug level. The data suggest that therapeutic drug monitoring can help to minimize the risk of major adverse reactions and to increase drug safety on an individual basis. This article is protected by copyright. All rights reserved.