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Contains fulltext : 299824.pdf (Publisher’s version ) (Open Access)

Purpose People with physical disabilities often require lifetime support and experience challenges to maintain or (re)define their level of independence. Assistive living technologies (ALT) are promising to increase independent living and execution of activities of daily living (ADL). This paper provides a systematic literature review that aims to analyse the present state of the literature about the impact of ALT on perceived independence of people with a physical disability receiving long-term care. Materials and methods Databases Embase, Medline, and Web of Science were searched for eligible studies from 2010 or later. Results Nine studies were included, of which seven qualitative, one quantitative, and one mixed methods. Quality was generally high. ALT enabled participants to execute ADL. We found six themes for the impact of ALT on perceived independence: feeling enabled, choice and control, feeling secure, time alone, feeling less needy, and participation. Conclusions ALT appears to impact perceived independence in many ways, exceeding merely the executional aspect of independence. Existing research is limited and quite one-sided. More large-scale studies are needed in order to inform care organisations how to implement ALT, especially considering societal developments and challenges impacting long-term care.

Inleiding Mensen met niet-aangeboren hersenletsel (NAH) en een licht verstandelijke beperking (LVB) hebben vaak moeite met dagstructuur. Technologie kan hierbij als ondersteuning worden ingezet. Vanuit de praktijk ontstond de vraag wat in de wetenschappelijke literatuur bekend is over de inzet van technologie ter ondersteuning van dagstructuur bij mensen met NAH en LVB. In deze studie doen we literatuuronderzoek om antwoord te geven op deze vraag. Methode We deden twee zoekacties binnen de wetenschappelijke literatuur, één voor de doelgroep NAH en vervolgens een geüpdatete zoekactie voor de doelgroep NAH en LVB. Resultaten Uit de eerste zoekactie includeerden we 12 artikelen gepubliceerd vanaf 2010 en uit de tweede zoekactie vier reviews die focusten op de doelgroep NAH. We vonden slechts één review die de doelgroep LVB includeerde. Conclusie Uit de gevonden studies blijkt dat de inzet van technologie een positief effect heeft op het behalen van doelen en psychosociale uitkomsten. Vooral draagbare technologie zoals (apps op) smartphones kunnen via prompts en timecues bijdragen aan een betere dagstructuur van mensen met NAH of een LVB. Voor succesvol gebruik op de lange termijn zijn aandacht voor een match in de keuze van technologie en voor training in het gebruik van de technologie noodzakelijk. Over meer recent opkomende technologieën als zorgrobots en smartwatches is nog weinig te vinden.

Hypodiploidy, defined as modal numbers (MNs) 45 or lower, has not been independently investigated in pediatric acute myeloid leukemia (AML) but is a well-described high-risk factor in pediatric acute lymphoblastic leukemia. We aimed to characterize and study the prognostic impact of hypodiploidy in pediatric AML. In this retrospective cohort study, we included children below 18 years of age with de novo AML and a hypodiploid karyotype diagnosed from 2000 to 2015 in 14 childhood AML groups from the International Berlin-Frankfurt-Münster (I-BFM) framework. Exclusion criteria comprised constitutional hypodiploidy, monosomy 7, composite karyotype, and t(8;21) with concurring sex chromosome loss. Hypodiploidy occurred in 81 patients (1.3%) with MNs, 45 (n = 66); 44 (n = 10) and 43 (n = 5). The most frequently lost chromosomes were chromosome 9 and sex chromosomes. Five-year event-free survival (EFS) and overall survival (OS) were 34% and 52%, respectively, for the hypodiploid cohort. Children with MN≤44 (n = 15) had inferior EFS (21%) and OS (33%) compared with children with MN = 45 (n = 66; EFS, 37%; OS, 56%). Adjusted hazard ratios (HRs) were 4.9 (P = .001) and 6.1 (P = .003). Monosomal karyotype or monosomy 9 had particular poor OS (43% and 15%, respectively). Allogeneic stem cell transplantation (SCT) in first complete remission (CR1) (n = 18) did not mitigate the unfavorable outcome of hypodiploidy (adjusted HR for OS was 1.5; P = .42). We identified pediatric hypodiploid AML as a rare subgroup with an inferior prognosis even in the patients treated with SCT in CR1.

Background: 95% Of all metals and alloys are processed using strip rolling, explaining the great number of existing strip rolling optimization models. Yet, an accurate in-situ full-field experimental measurement method of the deformation, velocity and strain fields of the strip in the deformation zone is lacking. Objective: Here, a novel time-Integrated Digital Image Correlation (t-IDIC) framework is proposed and validated that fully exploits the notion of continuous, recurring material motion during strip rolling. Methods: High strain accuracy and robustness against unavoidable light reflections and missing speckles is achieved by simultaneously correlating many (e.g. 200) image pairs in a single optimization step, i.e. each image pair is correlated with the same average global displacement field but is multiplied by a unique velocity corrector to account for differences in material velocity between image pairs. Results: Demonstration on two different strip rolling experiments revealed previously inaccessible subtle changes in the deformation and strain fields due to minor variations in pre-deformation, elastic recovery, and geometrical irregularities. The influence of the work roll force and entry/exit strip tension has been investigated for strip rolling with an industrial pilot mill, which revealed unexpected non-horizontal material feed. This asymmetry was reduced by increasing the entry strip tension and rolling force, resulting in a more symmetric strain distribution, while increased distance between the neutral and entry point was found for a larger rolling force. Conclusions: The proposed t-IDIC method allows for robust and accurate characterization of the strip’s full-field behavior of the deformation zone during rolling, revealing novel insights in the material behavior.