102,681 research outputs found
Lower Tinetti scores can support an early diagnosis of spatial Neglect in post-stroke patients
Full text linkBACKGROUND: Neglect represents a severe complication of stroke, which impairs patients' daily activities. An early diagnosis of neglect is fundamental for management decisions. AIM: The aim of this study is to evaluate the usefulness of the Tinetti Test as an outcome of spatial neglect in post-stroke patients. DESIGN: Observational retrospective data analysis. SETTING: Rehabilitation Hospital. POPULATION: Cohort of post-stroke adults admitted in our Rehabilitation Unit. METHODS: One hundred and sixty stroke patients were evaluated between the 1st of January 2015 and the 31st of December 2016 at our Department. Eighty-nine inpatients matched the inclusion criteria. Their scores of the Tinetti Test for balance condition and gait function were compared with Bells Test and line bisection task for spatial neglect. Global independence activity was also assessed using Barthel Index and global cognitive functioning by means of the Mini-Mental State Examination. RESULTS: Twenty-two patients between the 89 patients included in this study were affected by spatial neglect at admission. A high statistical significant correlation was observed between lower Tinetti scores and neglect presence (mean Tinetti Score: 2.36 neglect; 7.82 non-neglect; P<0.001). CONCLUSIONS: The Tinetti Test is a well-established assessment scale to measure balance ability and gait function in post-stroke patients. Results from this study suggest that Tinetti Test may be considered as an early ecological screening tool for the diagnosis of neglect in poststroke patients. CLINICAL REHABILITATION IMPACT: The alternative use of the Tinetti Test for the diagnosis of spatial neglect
The interrater reliability of the Tinetti Performance-Oriented Mobility Assessment
Full text linkBackground and Purpose. The purpose of this study was to determine the interrater reliab ility of the Tinetti Performance-Oriented Mobility Assessment (POMA) on geriatric subjec.ts by experienced registered physical therapists. The Tinetti POMA is an assessment tool used to predict risk of falls among the geriatric population. Subjects. Elderly subjects: Twenty elderly resident volunteers from the board and care facility at the Jewish Home for the Aging were videotaped . Observing physical therapist subjects: Five registered physical therapist volunteers who possessed experience using the Tinetti POMA observed the videotapes. Methods. Elderly subjects who met the inclusion criteria for this study were videotaped performing the component tasks of the Tinetti POMA. Observing physical therapists viewed and scored each resident using the Tin.etti POMA scale. Scores were then totaled and entered onto a Microsoft Excel spreadsheet for data analysis. Results. Kappa coefficients were calculated for individual balance and gait tasks . The results revealed significant reliability among 11 of the 20 tasks. Of the 11 reliable tasks, 8 were from the gait subsection , while only 3 were from the balance subsection. Reliability of the observing physical therapists ability to determine the level of risk of falling was also calculated using kappa coefficients. Results of the kappa calculations revealed less than substantial rel ia bility (k=0.509) . Conclusion and Discussion. The Tinetti POMA has less than substantial interrater reliability for determining an elderly person 's level of fall risk.California State University, Northridge. Department of Health Sciences.Includes bibliographical references (leaves 39-43
Near-IR Transmission Spectrum of HAT-P-32b using HST/WFC3
No full textWe report here the analysis of the near-infrared transit spectrum of the hot Jupiter HAT-P-32b, which was recorded with the Wide Field Camera 3 (WFC3) on board the Hubble Space Telescope. HAT-P-32b is one of the most inflated exoplanets discovered, making it an excellent candidate for transit spectroscopic measurements. To obtain the transit spectrum, we have adopted different analysis methods, both parametric and non-parametric (Independent Component Analysis, ICA), and compared the results. The final spectra are all consistent within 0.5σ. The uncertainties obtained with ICA are larger than those obtained with the parametric method by a factor of ∼1.6-1.8. This difference is the trade-off for higher objectivity due to the lack of any assumption about the instrument systematics compared to the parametric approach. The ICA error bars are therefore worst-case estimates. To interpret the spectrum of HAT-P-32b we used -REx, our fully Bayesian spectral retrieval code. As for other hot Jupiters, the results are consistent with the presence of water vapor (log H2O -3.45 1.83-1.65), clouds (top pressure between 5.16 and 1.73 bar). Spectroscopic data over a broader wavelength range are needed to de-correlate the mixing ratio of water vapor from clouds and identify other possible molecular species in the atmosphere of HAT-P-32b
Accelerometric-based Features as Surrogate of Tinetti test
Full text linkINTRODUCTION
Risk of falling is estimated by visual inspection of patient’s movements using clinical scales, e.g., Tinetti test, Berg Balance Scale, Timed Up & Go etc. However, a continuous evaluation of such risk requires both subject hospitalization and expert clinical personnel. We believe that continuous automatic monitoring of the fall risk would provide rapid intervention as well as a reduction of the health care system costs. The main goal of this study is then to determine whether features extracted from low cost accelerometric signals can predict the physician assessments during a Tinetti test.
METHODS
Thirty-seven subjects were enrolled at the rehabilitation and medical research center INRCA (Istituto Nazionale Riposo e Cura Anziani), Casatenovo, Italy. Subjects using breathing supports, walkers and crutches were excluded from the study. All participants signed the informed consent. The median population age at time of the test was 75 (IQR = 81 - 70) years. 3D-axis accelerometric signals were collected using a wearable device (±8g, 12 bits, sampling rate 50 Hz, Geneactiv, Activinsights Limited, UK) positioned at the chest using an elastic band. Each subject underwent a Tinetti test divided in 8 motor tasks [2]. The Tinetti score was assigned by an expert physician and used as gold standard. For the present study only 4 items of the full test were considered (two for balance and two for gait): 1) Rise from the chair (score 0=unable, 1=able with arms, 2=able); 2) Immediate standing balance (score 0=unsteady, 1=steady with supports, 2=steady); 3) Step symmetry (score 0=asymmetric, 1=symmetric); and 4) Step continuity (score 0=discontinuous, 1=continuous). Features were extracted from the accelerometric signals. Sit to Stand Time and Balance after Standing (standard deviation of the vector magnitude within 5s after standing) were computed for the balance part. Step Symmetry and Step Regularity were determined on the vertical axis during walking phase as in [1]. ROC analysis was used to test features’ power in classifying the score assigned to each item by the physician. The area under the ROC curve (AUC) was computed for each combination of scores.
RESULTS
Proportion and age of people with high risk of falling (Tinetti score ≤ 18) were not statistically different to those with low risk (0.46 vs 0.54; median age 76 vs 74; p > 0.05). Male proportion was higher than that of female (0.78 vs 0.22; p 0.79) while Sit to Stand Time, Balance after Standing and Step Symmetry were sufficiently predictive (AUC > 0.60). Table 1. Area under the ROC curve for each feature. AUC was computed only when the number of
subjects for each score was at least 5 (NS=number of subjects < 5).
Test Item Feature Score 0 vs 1 0 vs 2 1 vs 2
1) Rise from the chair Sit to Stand Time NS NS 0.68
2) Immediate standing balance Balance after Standing NS 0.64 NS
3) Step symmetry Step Symmetry 0.60 - -
4) Step continuity Step Regularity 0.79 - -
DISCUSSION
Accelerometric-based features can provide useful information on the body movements as well as correctly classify the physician’s item assessments.
REFERENCES
[1] Moe-Nilssen R, Helbostad JL. J Biomech 2004; 37:121–126
[2] Rivolta MW, et al. EMBC 2015; 6935-6938
A New Look at Spitzer Primary Transit Observations of the Exoplanet HD 189733b
Full text linkBlind source separation techniques are used to reanalyze two exoplanetary transit light curves of the exoplanet HD 189733b recorded with the IR camera IRAC on board the Spitzer Space Telescope at 3.6 μm during the "cold" era. These observations, together with observations at other IR wavelengths, are crucial to characterize the atmosphere of the planet HD 189733b. Previous analyses of the same data sets reported discrepant results, hence the necessity of the reanalyses. The method we used here is based on the Independent Component Analysis (ICA) statistical technique, which ensures a high degree of objectivity. The use of ICA to detrend single photometric observations in a self-consistent way is novel in the literature. The advantage of our reanalyses over previous work is that we do not have to make any assumptions on the structure of the unknown instrumental systematics. Such "admission of ignorance" may result in larger error bars than reported in the literature, up to a factor 1.6. This is a worthwhile tradeoff for much higher objectivity, necessary for trustworthy claims. Our main results are (1) improved and robust values of orbital and stellar parameters, (2) new measurements of the transit depths at 3.6 μm, (3) consistency between the parameters estimated from the two observations, (4) repeatability of the measurement within the photometric level of ~2 × 10-4 in the IR, and (5) no evidence of stellar variability at the same photometric level within one year
Evaluation of the Tinetti score and fall risk assessment via accelerometry-based movement analysis
No full textGait and balance disorders are among the main predisposing factors of falls in elderly. Clinical scales are widely employed to assess the risk of falling, but they require trained personnel. We investigate the use of objective measures obtained from a wearable accelerometer to evaluate the fall risk, determined by the Tinetti clinical scale. Seventy-nine patients and eleven volunteers were enrolled in two rehabilitation centers and underwent a full Tinetti test, while wearing a triaxial accelerometer at the chest. Tinetti scores were assessed by expert physicians and those subjects with a score ≤18 were considered at high risk. First, we analyzed 21 accelerometer features by means of statistical tests and correlation analysis. Second, one regression and one classification problem were designed and solved using a linear model (LM) and an artificial neural network (ANN) to predict the Tinetti outcome. Pearson's correlation between the Tinetti score and a subset of 9 features (mainly related with standing and walking) was 0.71. The misclassification error of high risk patient was 0.21 and 0.11, for LM and ANN, respectively. The work might foster the development of a new generation of applications meant to monitor the time evolution of the fall risk using low cost devices at home
Molecular detectability in exoplanetary emission spectra
No full textAbstractOf the many recently discovered worlds orbiting distant stars, very little is yet known of their chemical composition. With the arrival of new transit spectroscopy and direct imaging facilities, the question of molecular detectability as a function of signal-to-noise (SNR), spectral resolving power and type of planets has become critical. In this paper, we study the detectability of key molecules in the atmospheres of a range of planet types, and report on the minimum detectable abundances at fixed spectral resolving power and SNR. The planet types considered—hot Jupiters, hot super-Earths, warm Neptunes, temperate Jupiters and temperate super-Earths—cover most of the exoplanets characterisable today or in the near future. We focus on key atmospheric molecules, such as CH4, CO, CO2, NH3, H2O, C2H2, C2H6, HCN, H2S and PH3. We use two methods to assess the detectability of these molecules: a simple measurement of the deviation of the signal from the continuum, and an estimate of the level of confidence of a detection through the use of the likelihood ratio test over the whole spectrum (from 1 to 16μm). We find that for most planetary cases, SNR=5 at resolution R=300 (λ<5μm) and R=30 (λ>5μm) is enough to detect the very strongest spectral features for the most abundant molecules, whereas an SNR comprised between 10 and 20 can reveal most molecules with abundances 10−6 or lower, often at multiple wavelengths. We test the robustness of our results by exploring sensitivity to parameters such as vertical thermal profile, mean molecular weight of the atmosphere and relative water abundances. We find that our main conclusions remain valid except for the most extreme cases. Our analysis shows that the detectability of key molecules in the atmospheres of a variety of exoplanet cases is within realistic reach, even with low SNR and spectral resolving power
The ARIEL mission reference sample
Full text linkThe ARIEL (Atmospheric Remote-sensing Exoplanet Large-survey) mission concept is one of the three M4 mission candidates selected by the European Space Agency (ESA) for a Phase A study, competing for a launch in 2026. ARIEL has been designed to study the physical and chemical properties of a large and diverse sample of exoplanets and, through those, understand how planets form and evolve in our galaxy. Here we describe the assumptions made to estimate an optimal sample of exoplanets – including already known exoplanets and expected ones yet to be discovered – observable by ARIEL and define a realistic mission scenario. To achieve the mission objectives, the sample should include gaseous and rocky planets with a range of temperatures around stars of different spectral type and metallicity. The current ARIEL design enables the observation of ∼1000 planets, covering a broad range of planetary and stellar parameters, during its four year mission lifetime. This nominal list of planets is expected to evolve over the years depending on the new exoplanet discoveries
Tinetti mobility test is related to muscle mass and strength in non-institutionalized elderly people
No full textElderly people are characterized by a high prevalence of falls and sarcopenia. However, the relationship among Tinetti mobility test (TMT) score, a powerful tool to detect elderly people at risk of falls, and sarcopenia is still not thoroughly investigated. Thus, to determine the relationship between TMT score and muscle mass and strength, 337 elderly participants (mean age 77.1 ± 6.9 years) admitted to comprehensive geriatric assessment were enrolled. TMT score, muscle mass by bioimpedentiometer, and muscle strength by grip strength were evaluated. Muscle mass progressively decreased as TMT score decreased (from 15.3 ± 3.7 to 8.8 ± 1.8 kg/m
2
;
p
for trend <0.001). Similarly, muscle strength decreased progressively as Tinetti score decreased (from 34.7 ± 8.0 to 23.7 ± 8.7 kg;
p
for trend 0.001). Linear regression analysis demonstrated that TMT score is linearly related with muscle mass (
y
= 4.5
x
+ 0.4,
r
= 0.61;
p
< 0.01) and strength (
y
= 14.0
x
+ 0.8,
r
= 0.53;
p
< 0.01). Multivariate analysis confirms the strong relationship between the TMT score and muscle mass (
r
= 0.48,
p
= 0.024) and strength (
r
= 0.39,
p
= 0.046). The present study indicates that TMT score is significantly related to muscle mass and strength in non-institutionalized elderly participants. This evidence suggests that TMT score, together with evaluation of muscle mass and strength, may identify sarcopenic elderly participants at high risk of falls
Observability of temperate exoplanets with Ariel
No full textWhile the Ariel mission is primarily designed for the study of warm and hot objects, with an equilibrium temperature above 500 K, in this paper we want to explore a larger sample of possible colder targets. We thus investigate the detectability with Ariel of “temperate” exoplanets (with an equilibrium temperature of 400 K). We first consider the case of hydrogen-rich exoplanets (from Jupiters to sub-Neptunes) and we calculate their infrared transmission spectrum for several classes of stars. We consider the Tier 2 mode of Ariel, for which the resolving power (R = 50 for λ < 4 μm and R = 15 for λ > 4 μm) is sufficient to get information about the chemical composition of the objects. Results show that temperate Jupiters and sub-Neptunes around all types of stars from G2 to M8, with revolution periods of a few tens of days and transit durations of a few hours, could be observed with Ariel, up to distances of about 50 pc for Jupiters and 25 pc for sub-Neptunes. In the case of temperate super-Earths, we estimate that they will not be observable in the Ariel Tier 2 mode. In a study of currently available target candidates, we find one sub-Neptune (TOI-178 g) as possibly observable in Ariel’s Tier 2. This on-going study is a follow-up of “Transit spectroscopy of temperate Jupiters with ARIEL: A feasibility study” (Encrenaz et al., Exp. Astr. 46:31–44, 2018)
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