RESUMEN
Background and Objective: Medication non-adherence is a preventable reason for treatment failure, poor blood pressure control among hypertensive patients and the geriatric population owing to poor physical activity is more vulnerable strata. The objective of this study is to investigate medication adherence and its associated factors among Pakistani geriatric hypertensive patients. Methods: A cross-sectional survey-based study was conducted at the out-patient department of the cardiac center from May 2018 to August 2018. A universal sampling technique was used to approach patients and 262 eligible consented patients were interviewed to collect information about socio-demographics, health, and disease-related characteristics using a structured questionnaire. The Morisky Levine Green test was used for the assessment of medication adherence. The Barthel index and single item literacy screener (SILS) was used to measure performance in activities of daily living and health literacy respectively. Chi-square tests and multivariate binary logistic regression analysis were performed to find factors by using SPSS version 20. Results: Of the total 262 participants, about 38.9% (n = 102) were scored 4 and considered adherent while 61.1% (n = 160) were considered as non-adherent. In logistic regression analysis, self-reported moderate (OR = 3.538, p = 0.009) and good subjective health (OR = 4.249, p = 0.008), adequate health literacy (OR = 3.369, p < 0.001) and independence in performing activities of daily living (OR = 2.968, p = 0.002) were found to be independent predictors of medication adherence among older hypertensive patients. Conclusion: Medication adherence among the older hypertensive population in Pakistan is alarmingly low. This clearly requires patient-centered interventions to overcome barriers and educating them about the importance of adherence.
Asunto(s)
Actividades Cotidianas/clasificación , Alfabetización en Salud/normas , Hipertensión/tratamiento farmacológico , Cumplimiento de la Medicación/estadística & datos numéricos , Anciano , Antihipertensivos/uso terapéutico , Distribución de Chi-Cuadrado , Estudios Transversales , Femenino , Geriatría/métodos , Geriatría/estadística & datos numéricos , Alfabetización en Salud/estadística & datos numéricos , Humanos , Hipertensión/psicología , Modelos Logísticos , Masculino , Cumplimiento de la Medicación/psicología , PakistánRESUMEN
The proposed study is based on a feature and channel selection strategy that uses correlation filters for brain-computer interface (BCI) applications using electroencephalography (EEG)-functional near-infrared spectroscopy (fNIRS) brain imaging modalities. The proposed approach fuses the complementary information of the two modalities to train the classifier. The channels most closely correlated with brain activity are extracted using a correlation-based connectivity matrix for fNIRS and EEG separately. Furthermore, the training vector is formed through the identification and fusion of the statistical features of both modalities (i.e., slope, skewness, maximum, skewness, mean, and kurtosis) The constructed fused feature vector is passed through various filters (including ReliefF, minimum redundancy maximum relevance, chi-square test, analysis of variance, and Kruskal-Wallis filters) to remove redundant information before training. Traditional classifiers such as neural networks, support-vector machines, linear discriminant analysis, and ensembles were used for the purpose of training and testing. A publicly available dataset with motor imagery information was used for validation of the proposed approach. Our findings indicate that the proposed correlation-filter-based channel and feature selection framework significantly enhances the classification accuracy of hybrid EEG-fNIRS. The ReliefF-based filter outperformed other filters with the ensemble classifier with a high accuracy of 94.77 ± 4.26%. The statistical analysis also validated the significance (p < 0.01) of the results. A comparison of the proposed framework with the prior findings was also presented. Our results show that the proposed approach can be used in future EEG-fNIRS-based hybrid BCI applications.
RESUMEN
OBJECTIVES: The physical demands of military service place soldiers at risk of musculoskeletal injuries and are major concerns for military capability. This paper outlines the development new training technologies to prevent and manage these injuries. DESIGN: Narrative review. METHODS: Technologies suitable for integration into next-generation training devices were examined. We considered the capability of technologies to target tissue level mechanics, provide appropriate real-time feedback, and their useability in-the-field. RESULTS: Musculoskeletal tissues' health depends on their functional mechanical environment experienced in military activities, training and rehabilitation. These environments result from the interactions between tissue motion, loading, biology, and morphology. Maintaining health of and/or repairing joint tissues requires targeting the "ideal" in vivo tissue mechanics (i.e., loading and strain), which may be enabled by real-time biofeedback. Recent research has shown that these biofeedback technologies are possible by integrating a patient's personalised digital twin and wireless wearable devices. Personalised digital twins are personalised neuromusculoskeletal rigid body and finite element models that work in real-time by code optimisation and artificial intelligence. Model personalisation is crucial in obtaining physically and physiologically valid predictions. CONCLUSIONS: Recent work has shown that laboratory-quality biomechanical measurements and modelling can be performed outside the laboratory with a small number of wearable sensors or computer vision methods. The next stage is to combine these technologies into well-designed easy to use products.
Asunto(s)
Personal Militar , Enfermedades Musculoesqueléticas , Dispositivos Electrónicos Vestibles , Humanos , Inteligencia Artificial , Enfermedades Musculoesqueléticas/prevención & control , ComputadoresRESUMEN
Synchronization plays a significant role in information transfer and decision-making by neurons and brain neural networks. The development of control strategies for synchronizing a network of chaotic neurons with time delays, different direction-dependent coupling (unidirectional and bidirectional), and noise, particularly under external disturbances, is an essential and very challenging task. Researchers have extensively studied the synchronization mechanism of two coupled time-delayed neurons with bidirectional coupling and without incorporating the effect of noise, but not for time-delayed neural networks. To overcome these limitations, this study investigates the synchronization problem in a network of coupled FitzHugh-Nagumo (FHN) neurons by incorporating time delays, different direction-dependent coupling (unidirectional and bidirectional), noise, and ionic and external disturbances in the mathematical models. More specifically, this study investigates the synchronization of time-delayed unidirectional and bidirectional ring-structured FHN neuronal systems with and without external noise. Different gap junctions and delay parameters are used to incorporate time-delay dynamics in both neuronal networks. We also investigate the influence of the time delays between connected neurons on synchronization conditions. Further, to ensure the synchronization of the time-delayed FHN neuronal networks, different adaptive control laws are proposed for both unidirectional and bidirectional neuronal networks. In addition, necessary and sufficient conditions to achieve synchronization are provided by employing the Lyapunov stability theory. The results of numerical simulations conducted for different-sized multiple networks of time-delayed FHN neurons verify the effectiveness of the proposed adaptive control schemes.