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This paper addresses the issue of LED short-circuit fault detection in signaling and lighting systems in the automotive industry. The conventional diagnostic method commonly implemented in newer vehicles relies on measuring the voltage drop across different LED branches and comparing it with threshold values indicating faults caused by open circuits or LED short circuits. With this algorithm, detecting cases of a few LEDs short-circuited within a branch, particularly a single malfunctioning LED, is particularly challenging. In this work, two easily implementable algorithms are proposed to address this issue within the vehicle's control unit. One is based on a mathematical prediction model, while the other utilizes a neural network. The results obtained offer a 100% LED short-circuit fault detection rate in the majority of analyzed cases, representing a significant improvement over the conventional method, even in scenarios involving a single malfunctioning LED within a branch. Additionally, the neural network-based model can accurately predict the number of failed LEDs.
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The aim of this current work is to identify three different gears of cross-country skiing utilizing embedded inertial measurement units and a suitable deep learning model. The cross-country style studied was the skating style during the uphill, which involved three different gears: symmetric gear pushing with poles on both sides (G3) and two asymmetric gears pushing with poles on the right side (G2R) or to the left side (G2L). To monitor the technique, inertial measurement units (IMUs) were affixed to the skis, recording acceleration and Euler angle data during the uphill tests performed by two experienced skiers using the gears under study. The initiation and termination points of the tests were controlled via Bluetooth by a smartphone using a custom application developed with Android Studio. Data were collected on the smartphone and stored on the SD memory cards included in each IMU. Convolutional neural networks combined with long short-term memory were utilized to classify and extract spatio-temporal features. The performance of the model in cross-user evaluations demonstrated an overall accuracy of 90%, and it achieved an accuracy of 98% in the cross-scene evaluations for individual users. These results indicate a promising performance of the developed system in distinguishing between different ski gears within skating styles, providing a valuable tool to enhance ski training and analysis.
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Aprendizaje Profundo , Esquí , Teléfono Inteligente , Esquí/fisiología , Humanos , Redes Neurales de la Computación , Patinación/fisiología , AceleraciónRESUMEN
BACKGROUND: Cross-sectionally, older age and obesity are associated with increased coronavirus disease-2019 (COVID-19) risk. We assessed the longitudinal associations of baseline and changes in adiposity parameters with COVID-19 incidence in older adults at high cardiovascular risk. METHODS: This analysis included 6874 men and women (aged 55-75 years) with overweight/obesity and metabolic syndrome in the PREDIMED-Plus lifestyle intervention trial for cardiovascular risk reduction. Body weight, body-mass-index (BMI), waist circumference, waist-to-height ratio (WHtR), and a body shape index (ABSI) were measured at baseline and annual follow-up visits. COVID-19 was ascertained by an independent Event Committee until 31 December 2021. Cox regression models were fitted to evaluate the risk of COVID-19 incidence based on baseline adiposity parameters measured 5-6 years before the pandemic and their changes at the visit prior to censoring. RESULTS: At the time of censoring, 653 incident COVID-19 cases occurred. Higher baseline body weight, BMI, waist circumference, and WHtR were associated with increased COVID-19 risk. During the follow-up, every unit increase in body weight (HRadj (95%CI): 1.01 (1.00, 1.03)) and BMI (HRadj: 1.04 (1.003, 1.08)) was associated with increased COVID-19 risk. CONCLUSIONS: In older adults with overweight/obesity, clinically significant weight loss may protect against COVID-19. TRIAL REGISTRATION: This study is registered at the International Standard Randomized Controlled Trial (ISRCT; http://www.isrctn.com/ISRCTN89898870 ).
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COVID-19 , Síndrome Metabólico , Anciano , Femenino , Humanos , Masculino , Adiposidad , Índice de Masa Corporal , Peso Corporal , COVID-19/epidemiología , COVID-19/complicaciones , Síndrome Metabólico/epidemiología , Síndrome Metabólico/complicaciones , Obesidad/complicaciones , Obesidad/epidemiología , Obesidad/metabolismo , Sobrepeso/complicaciones , Sobrepeso/epidemiología , Factores de Riesgo , Circunferencia de la Cintura , Persona de Mediana EdadRESUMEN
BACKGROUND: Chronic hypophosphatemia can result from a variety of acquired disorders, such as malnutrition, intestinal malabsorption, hyperparathyroidism, vitamin D deficiency, excess alcohol intake, some drugs, or organ transplantation. Genetic disorders can be a cause of persistent hypophosphatemia, although they are less recognized. We aimed to better understand the prevalence of genetic hypophosphatemia in the population. METHODS: By combining retrospective and prospective strategies, we searched the laboratory database of 815,828 phosphorus analyses and included patients 17-55 years old with low serum phosphorus. We reviewed the charts of 1287 outpatients with at least 1 phosphorus result ≤2.2 mg/dL. After ruling out clear secondary causes, 109 patients underwent further clinical and analytical studies. Among them, we confirmed hypophosphatemia in 39 patients. After excluding other evident secondary causes, such as primary hyperparathyroidism and vitamin D deficiency, we performed a molecular analysis in 42 patients by sequencing the exonic and flanking intronic regions of a panel of genes related to rickets or hypophosphatemia (CLCN5, CYP27B1, dentin matrix acidic phosphoprotein 1, ENPP1, FAM20C, FGFR1, FGF23, GNAS, PHEX, SLC34A3, and VDR). RESULTS: We identified 14 index patients with hypophosphatemia and variants in genes related to phosphate metabolism. The phenotype of most patients was mild, but two patients with X-linked hypophosphatemia (XLH) due to novel PHEX mutations had marked skeletal abnormalities. CONCLUSION: Genetic causes should be considered in children, but also in adult patients with hypophosphatemia of unknown origin. Our data are consistent with the conception that XLH is the most common cause of genetic hypophosphatemia with an overt musculoskeletal phenotype.
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Raquitismo Hipofosfatémico Familiar , Hipofosfatemia , Humanos , Estudios Prospectivos , Estudios Retrospectivos , Hipofosfatemia/genética , Hipofosfatemia/complicaciones , Raquitismo Hipofosfatémico Familiar/complicaciones , Raquitismo Hipofosfatémico Familiar/genética , Raquitismo Hipofosfatémico Familiar/metabolismo , Fósforo , Factores de Crecimiento de FibroblastosRESUMEN
The study of the immune response in thyroid autoimmunity has been mostly focused on the autoantibodies and lymphocytes, but there are indications that intrinsic features of thyroid tissue cells may play a role in disrupting tolerance that needs further investigation. The overexpression of HLA and adhesion molecules by thyroid follicular cells (TFC) and our recent demonstration that PD-L1 is also moderately expressed by TFCs in autoimmune thyroid indicates that TFCs they may activate but also inhibit the autoimmune response. Intriguingly, we have recently found that in vitro cultured TFCs are able to suppress the proliferation of autologous lymphocyte T in a contact-dependent manner which is independent of the PD-1/PD-L1 signaling pathway. To get a more comprehensive picture of TFC activating and inhibitory molecules/pathways driving the autoimmune response in the thyroid glands, preparations of TFCs and stromal cells from five Graves' disease (GD) and four control thyroid glands were compared by scRNA-seq. The results confirmed the previously described interferon type I and type II signatures in GD TFCs and showed unequivocally that they express the full array of genes that intervene in the processing and presentation of endogenous and exogeneous antigens. GD TFCs lack however expression of costimulatory molecules CD80 and CD86 required for priming T cells. A moderate overexpression of CD40 by TFCs was confirmed. GD Fibroblasts showed widespread upregulation of cytokine genes. The results from this first single transcriptomic profiling of TFC and thyroid stromal cells provides a more granular view of the events occurring in GD. The new data point at an important contribution of stromal cells and prompt a major re-interpretation of the role of MHC over-expression by TFC, from deleterious to protective. Most importantly this re-interpretation could also apply to other tissues, like pancreatic beta cells, where MHC over-expression has been detected in diabetic pancreas.
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Autoinmunidad , Enfermedad de Graves , Humanos , Antígeno B7-H1/genética , Transcriptoma , Enfermedad de Graves/genética , Moléculas de Adhesión Celular/genéticaRESUMEN
The world of elite sports has always been characterized by intense competition, where victories are often determined by minimal differences. This means that every little detail in the preparation of top-level athletes is crucial to their performance at the highest level. One of the most significant aspects to monitor is the jumping capacity, as it enables the measurement of performance, progression, and helps prevent injuries. Herein, we present the development of a system capable of measuring the flight time and height reached by the user, reporting the results through a smartphone using an Android ad-hoc application, which handles all the data processing. The system consists of an affordable and portable circuit based on an accelerometer. It communicates with the smartphone via UART using a Bluetooth module, and its battery provides approximately 9 h of autonomy, making it suitable for outdoor operations. To evaluate the system's precision, we conducted performance tests (counter-movement jumps) with seven subjects. The results confirmed the system's potential for monitoring high-level sports training sessions, as the average deviation obtained was only 2.1% (~0.01 s) in the analysis of flight time and 4.6% (~0.01 m) in jump height.
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Rendimiento Atlético , Deportes , Humanos , Movimiento , Teléfono Inteligente , Fenómenos BiomecánicosRESUMEN
The histopathological growth patterns (HGPs) of liver metastases of colorectal cancer and of several other tumor types predict outcome of patients in multiple studies. The HGPs of liver metastases have a prognostic but also a predictive value with one of the growth patterns, the replacement growth pattern, related to resistance to systemic treatment. Given that the HGP can only be assessed in a reliable manner when a surgical resection of the metastasis has been performed, this biomarker cannot be exploited to the full. For example, HGPs can at this moment, not be used to decide whether patients with liver metastatic breast or colorectal cancer will benefit or not from locoregional treatment, such as surgery or radiotherapy, and from peri-operative systemic treatment. In this review we highlight studies that suggest that the HGPs of liver metastases can be identified by medical imaging. Although still to be confirmed by a prospective multicenter approach, some studies indeed achieve a high accuracy in predicting the HGPs by applying radiomic algorithms on CT- or MR-images of liver metastases. This is an important step towards a treatment planning of patients with liver metastatic cancer that takes into account the biology and the progression kinetics of the metastases.
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Neoplasias de la Mama/patología , Neoplasias Colorrectales/patología , Neoplasias Hepáticas/secundario , Imagen Multimodal/métodos , Animales , Neoplasias de la Mama/diagnóstico por imagen , Neoplasias Colorrectales/diagnóstico por imagen , Femenino , Humanos , Neoplasias Hepáticas/diagnóstico por imagenRESUMEN
We describe a non-imported malaria case reported in January 2022 in Campo de Gibraltar and the investigations by local public health authorities to identify the transmission mechanism and subsequent measures to prevent local transmission. Vector transmission, parenteral transmission, airport malaria, and imported malaria were ruled out. No clear mechanism of transmission was identified. The most probable cause was a hospital-acquired infection since the case was admitted to hospital at the same time as a case of imported Plasmodium falciparum malaria.
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Malaria Falciparum , Malaria , Humanos , España/epidemiología , Gibraltar , Viaje , Malaria/diagnóstico , Malaria/epidemiología , Malaria Falciparum/diagnóstico , Malaria Falciparum/epidemiologíaRESUMEN
In this work, we present a ballistocardiographic (BCG) system for the determination of heart and breath rates and activity of a user lying in bed. Our primary goal was to simplify the analog and digital processing usually required in these kinds of systems while retaining high performance. A novel sensing approach is proposed consisting of a white LED facing a digital light detector. This detector provides precise measurements of the variations of the light intensity of the incident light due to the vibrations of the bed produced by the subject's breathing, heartbeat, or activity. Four small springs, acting as a bandpass filter, connect the boards where the LED and the detector are mounted. Owing to the mechanical bandpass filtering caused by the compressed springs, the proposed system generates a BCG signal that reflects the main frequencies of the heartbeat, breathing, and movement of the lying subject. Without requiring any analog signal processing, this device continuously transmits the measurements to a microcontroller through a two-wire communication protocol, where they are processed to provide an estimation of the parameters of interest in configurable time intervals. The final information of interest is wirelessly sent to the user's smartphone by means of a Bluetooth connection. For evaluation purposes, the proposed system has been compared with typical BCG systems showing excellent performance for different subject positions. Moreover, applied postprocessing methods have shown good behavior for information separation from a single-channel signal. Therefore, the determination of the heart rate, breathing rate, and activity of the patient is achieved through a highly simplified signal processing without any need for analog signal conditioning.
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Balistocardiografía , Humanos , Balistocardiografía/métodos , Frecuencia Cardíaca/fisiología , Procesamiento de Señales Asistido por Computador , SueñoRESUMEN
Na2 Ti3 O7 (NTO) is considered a promising anode material for Na-ion batteries due to its layered structure with an open framework and low and safe average operating voltage of 0.3â V vs. Na+ /Na. However, its poor electronic conductivity needs to be addressed to make this material attractive for practical applications among other anode choices. Here, we report a safe, controllable and affordable method using urea that significantly improves the rate performance of NTO by producing surface defects such as oxygen vacancies and hydroxyl groups, and the secondary phase Na2 Ti6 O13 . The enhanced electrochemical performance agrees with the higher Na+ ion diffusion coefficient, higher charge carrier density and reduced bandgap observed in these samples, without the need of nanosizing and/or complex synthetic strategies. A comprehensive study using a combination of diffraction, microscopic, spectroscopic and electrochemical techniques supported by computational studies based on DFT calculations, was carried out to understand the effects of this treatment on the surface, chemistry and electronic and charge storage properties of NTO. This study underscores the benefits of using urea as a strategy for enhancing the charge storage properties of NTO and thus, unfolding the potential of this material in practical energy storage applications.
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PURPOSE OF REVIEW: This article will review current guidelines regarding surgical protocols for elective and nonelective surgeries during the severe acute respiratory syndrome coronavirus 2 pandemic. RECENT FINDINGS: Perioperative management for surgical patients should be modified to promote the safety and wellbeing of patients and caregivers amidst the COVID-19 pandemic. COVID-19 testing should be performed preoperatively with subsequent preprocedure quarantine. Nonemergent or nonlife-threatening surgery should be postponed for COVID-19 positive patients. The consensus of surgical societies is to use a laparoscopic surgical approach for COVID-19 positive patients when appropriate and to avoid port venting at the end of procedures. For COVID-19 positive patients requiring an emergent procedure, the use of personal protective equipment is strongly recommended. SUMMARY: After over a year of the COVID-19 pandemic, effective protocols and precautions have been established to decrease the morbidity and mortality of patients undergoing surgery and to promote the safety of healthcare personnel. Continued investigations are necessary as cases of new, possibly more virulent, strains of the virus arise.
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COVID-19/prevención & control , Transmisión de Enfermedad Infecciosa/prevención & control , Procedimientos Quirúrgicos Ginecológicos/normas , Procedimientos Quirúrgicos Mínimamente Invasivos/normas , Atención Perioperativa/normas , Guías de Práctica Clínica como Asunto , Femenino , Humanos , Laparoscopía , Equipo de Protección Personal , SARS-CoV-2RESUMEN
AIM: To know, in the population over 70, independent for walking, the prevalence of the concern to fall according to the short version of the Short Falls Efficacy Scale-International (FES-I) questionnaire, in old people living in the community and their associated factors. DESIGN: Cross-sectional study. LOCATION: Centro de Salud El Greco, Getafe, Madrid, Spain. PARTICIPANTS: 189 patients ≥70years with a Barthel ≥60, independent for walking (walk 45minutes without help or with a cane). The study was offered to a total of 328 people, of these accepted 217 and rejected 111. MAIN MEASUREMENTS: The dependent variable, fear of falling (FOF), was evaluated by means of the short FES-I questionnaire, considering as a cut-off point for the positive screening of the MC a score ≥11. As independent variables we considered: Barthel index, Downton scale, the Short Physical Performance Battery (SPPB) fragility test, falls in the last year, injuries associated with falls, time since the last fall, sensory deficit, use of gait devices, comorbidity and pharmacological treatment. RESULTS: The prevalence of FOF was 42.9% (95%CI: 35.5-50.2). The factors associated with FOF in the final multivariate analysis were: female sex, living alone, high risk of falls, presence of frailty (SPPB≤9), use of hypotensive drugs, and injuries associated with previous falls. CONCLUSIONS: The prevalence of FOF in older people is high. Primary Care professionals should systematize the screening of this health problem, prioritizing especially in people who present the following risk factors: being a woman, living alone, having a low score on the SPPB (as an indicator of frailty) or presenting a high risk of falls.
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Miedo , Vida Independiente , Anciano , Estudios Transversales , Femenino , Humanos , Prevalencia , Factores de RiesgoRESUMEN
MXenes are a recently discovered class of two-dimensional materials that have shown great potential as electrodes in electrochemical energy storage devices. Despite their promise in this area, MXenes can still suffer limitations in the form of restricted ion accessibility between the closely spaced multistacked MXene layers causing low capacities and poor cycle life. Pillaring, where a secondary species is inserted between layers, has been used to increase interlayer spacings in clays with great success but has had limited application in MXenes. We report a new amine-assisted pillaring methodology that successfully intercalates silica-based pillars between Ti3C2 layers. Using this technique, the interlayer spacing can be controlled with the choice of amine and calcination temperature, up to a maximum of 3.2 nm, the largest interlayer spacing reported for an MXene. Another effect of the pillaring is a dramatic increase in surface area, achieving BET surface areas of 235 m2 g-1, a sixty-fold increase over the unpillared material and the highest reported for MXenes using an intercalation-based method. The intercalation mechanism was revealed by different characterization techniques, allowing the surface chemistry to be optimized for the pillaring process. The porous MXene was tested for Na-ion battery applications and showed superior capacity, rate capability and remarkable stability compared with those of the nonpillared materials, retaining 98.5% capacity between the 50th and 100th cycles. These results demonstrate the applicability and promise of pillaring techniques applied to MXenes providing a new approach to optimizing their properties for a range of applications, including energy storage, conversion, catalysis, and gas separations.
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BACKGROUND: Primary cutaneous follicular center-cell lymphoma (PCFCL) is one of the most common types of cutaneous B-cell lymphoma. Differences in immunohistochemical expression of BCL2 and CD10 antigens along with the presence of t(14:18) translocation in neoplastic cells have been postulated as relevant clues in differentiating PCFCL from cutaneous lesions secondary to a systemic follicular lymphoma (SCFL). The aim of this study is to evaluate the significance and usefulness of these parameters in a large series of patients. METHODS: Patients with PCFCL and SCFL diagnosed at three university hospitals in Barcelona, from 2000 to 2015 were reviewed. Clinical, histopathological, immunophenotypical, genetic, and outcome parameters were analyzed. RESULTS: Eighty-one cases (59 PCFCL and 22 SCFL) were included. There were no significant differences between PCFCL and SCFL cases regarding clinical presentation, site of involvement, or predominant type of skin lesions. Most patients in both groups showed positivity for BCL2 and CD10, but strong expression of BCL2 and CD10 was associated with SCFL cases. Although more frequent in SCFL, a small proportion of PCFCL cases also showed the t(14:18) on FISH analysis. CONCLUSION: The intensity of BCL2 expression was found to be the single most valuable clue in differentiating PCFCL from SCFL cases on histopathological grounds.
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Biomarcadores de Tumor/análisis , Linfoma Folicular/diagnóstico , Neoplasias Cutáneas/diagnóstico , Adulto , Anciano , Anciano de 80 o más Años , Cromosomas Humanos Par 14/genética , Cromosomas Humanos Par 18/genética , Diagnóstico Diferencial , Femenino , Humanos , Masculino , Persona de Mediana Edad , Neprilisina/análisis , Neprilisina/biosíntesis , Proteínas Proto-Oncogénicas c-bcl-2/análisis , Proteínas Proto-Oncogénicas c-bcl-2/biosíntesis , Translocación Genética/genética , Adulto JovenRESUMEN
In Andalusia, Spain, West Nile virus (WNV) surveillance takes place from April to November, during the active vector period. Within this area seroconversion to this virus was evidenced in wild birds in 2004, affecting horses and two humans for the first time in 2010. Since 2010, the virus has been isolated every year in horses, and national and regional surveillance plans have been updated with the epidemiological changes found. WNV is spreading rapidly throughout southern Europe and has caused outbreaks in humans. Here we describe the second WNV outbreak in humans in Andalusia, with three confirmed cases, which occurred between August and September 2016, and the measures carried out to control it. Surveillance during the transmission season is essential to monitor and ensure prompt identification of any outbreaks.
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Culex/virología , Brotes de Enfermedades , Insectos Vectores/virología , Vigilancia de la Población/métodos , Fiebre del Nilo Occidental/epidemiología , Fiebre del Nilo Occidental/transmisión , Virus del Nilo Occidental/aislamiento & purificación , Anciano , Animales , Anticuerpos Antivirales/sangre , Aves/virología , Brotes de Enfermedades/veterinaria , Ensayo de Inmunoadsorción Enzimática/veterinaria , Femenino , Enfermedades de los Caballos/epidemiología , Enfermedades de los Caballos/virología , Caballos/virología , Humanos , Inmunoglobulina G/sangre , Inmunoglobulina M/sangre , Masculino , Persona de Mediana Edad , Mosquitos Vectores , España/epidemiología , Fiebre del Nilo Occidental/veterinaria , Fiebre del Nilo Occidental/virología , Virus del Nilo Occidental/genética , Virus del Nilo Occidental/inmunologíaRESUMEN
Conventional intercalation cathodes for lithium batteries store charge in redox reactions associated with the transition metal cations, e.g., Mn(3+/4+) in LiMn2O4, and this limits the energy storage of Li-ion batteries. Compounds such as Li[Li0.2Ni0.2Mn0.6]O2 exhibit a capacity to store charge in excess of the transition metal redox reactions. The additional capacity occurs at and above 4.5 V versus Li(+)/Li. The capacity at 4.5 V is dominated by oxidation of the O(2-) anions accounting for â¼0.43 e(-)/formula unit, with an additional 0.06 e(-)/formula unit being associated with O loss from the lattice. In contrast, the capacity above 4.5 V is mainly O loss, â¼0.08 e(-)/formula. The O redox reaction involves the formation of localized hole states on O during charge, which are located on O coordinated by (Mn(4+)/Li(+)). The results have been obtained by combining operando electrochemical mass spec on (18)O labeled Li[Li0.2Ni0.2Mn0.6]O2 with XANES, soft X-ray spectroscopy, resonant inelastic X-ray spectroscopy, and Raman spectroscopy. Finally the general features of O redox are described with discussion about the role of comparatively ionic (less covalent) 3d metal-oxygen interaction on anion redox in lithium rich cathode materials.
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BACKGROUND: The FRAX® tool estimates the risk of a fragility fracture among the population and many countries have been evaluating its performance among their populations since its creation in 2007. The purpose of this study is to update the first FRIDEX cohort analysis comparing FRAX with the bone mineral density (BMD) model, and its predictive abilities. METHODS: The discriminatory ability of the FRAX was assessed using the 'area under curve' of the receiver operating characteristic (AUC-ROC). Predictive ability was assessed by comparing estimated risk fractures with incidence fractures after a 10-year follow up period. RESULTS: One thousand three hundred eight women ≥ 40 and ≤ 90 years followed up during a 10-year period. The AUC for major osteoporotic fractures using FRAX without DXA was 0.686 (95 % CI 0.630-0.742) and using FN T-score of DXA 0.714 (95 % CI 0.661-0.767). Using only the traditional parameters of DXA (FN T-score), the AUC was 0.706 (95 % CI 0.652-0.760). The AUC for hip osteoporotic fracture was 0.883 (95 % CI 0.827-0.938), 0.857 (95 % CI 0.773-0.941), and 0.814 (95 % CI 0.712-0.916) respectively. For major osteoporotic fractures, the overall predictive value using the ratio Observed fractures/Expected fractures calculated with FRAX without T-score of DXA was 2.29 and for hip fractures 2.28 and with the inclusion of the T-score 2.01 and 1.83 respectively. However, for hip fracture in women < 65 years was 1.53 and 1.24 respectively. CONCLUSIONS: The FRAX tool has been found to show a good discriminatory capacity for detecting women at high risk of fragility fracture, and is better for hip fracture than major fracture. The test of sensibility shows that it is, at least, not inferior than when using BMD model alone. The predictive capacity of FRAX tool needs some adjustment. This capacity is better for hip fracture prediction and better for women < 65 years. Further studies in Catalonia and other regions of Spain are needed to fine tune the FRAX tool's predictive capability.
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Densidad Ósea , Toma de Decisiones Clínicas/métodos , Cuello Femoral/fisiopatología , Fracturas de Cadera/epidemiología , Fracturas Osteoporóticas/epidemiología , Absorciometría de Fotón , Anciano , Algoritmos , Área Bajo la Curva , Femenino , Cuello Femoral/diagnóstico por imagen , Estudios de Seguimiento , Humanos , Incidencia , Persona de Mediana Edad , Valor Predictivo de las Pruebas , Curva ROC , Medición de Riesgo/métodos , Factores de Riesgo , España/epidemiologíaRESUMEN
OBJECTIVE: Apathy is one of the most frequent symptoms of dementia, still needing better measurement methods. The objective of this study was to validate a new scale for apathy in institutionalized persons with dementia (APADEM-NH). METHODS: The scale includes 26 items distributed in three dimensions: Deficit of Thinking and Self-Generated behaviors (DT): 13 items, Emotional Blunting (EB): 7 items, and Cognitive Inertia (CI): 6 items. The sample included 100 institutionalized patients (90% female) with probable Alzheimer disease (AD) (57%), possible AD (13%), AD + cerebral vascular disease (17%), Lewy body dementia (11%), and Parkinson associated to dementia (2%), covering all stages of dementia severity according to the Global Deterioration Scale and Clinical Dementia Rating. Additional assessments were the Apathy Inventory, Neuropsychiatric Inventory, Cornell Scale for Depression, and the tested scale. Re-test and inter-rater reliability were carried out in 50 patients. RESULTS: All subscales lacked relevant floor and ceiling effects (<15%). Internal consistency for each dimension was (Cronbach's α): DT = 0.88, EB = 0.83, CI = 0.88; item-total correlations were >0.40; and item homogeneity 0.36-0.51. Test-retest reliability for the items was kW = 0.48-0.92; for the subscales, intraclass correlation coefficient (ICC) = 0.80-0.88; and for the total score, ICC = 0.90. Inter-rater reliability reached kW values of 0.84-1.00; subscales ICC, 0.97-0.99, and total score ICC, 0.99. Standard error of measurement for total score was 6.41 and internal validity ranged from rS = 0.69-0.80. CONCLUSIONS: APADEM-NH proved to be feasible, reliable, and valid for apathy assessment in institutionalized patients suffering mild to severe dementia, discerning well between apathy and depression.
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Apatía , Demencia/diagnóstico , Demencia/psicología , Institucionalización , Escalas de Valoración Psiquiátrica , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , PsicometríaRESUMEN
In this work, an Android application for measurement of nitrite concentration and pH determination in combination with a low-cost paper-based microfluidic device is presented. The application uses seven sensing areas, containing the corresponding immobilized reagents, to produce selective color changes when a sample solution is placed in the sampling area. Under controlled conditions of light, using the flash of the smartphone as a light source, the image captured with the built-in camera is processed using a customized algorithm for multidetection of the colored sensing areas. The developed image-processing allows reducing the influence of the light source and the positioning of the microfluidic device in the picture. Then, the H (hue) and S (saturation) coordinates of the HSV color space are extracted and related to pH and nitrite concentration, respectively. A complete characterization of the sensing elements has been carried out as well as a full description of the image analysis for detection. The results show good use of a mobile phone as an analytical instrument. For the pH, the resolution obtained is 0.04 units of pH, 0.09 of accuracy, and a mean squared error of 0.167. With regard to nitrite, 0.51% at 4.0 mg L(-1) of resolution and 0.52 mg L(-1) as the limit of detection was achieved.