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In an increasingly aging world, the effort to automate tasks associated with the care of elderly dependent individuals becomes more and more relevant if quality care provision at sustainable costs is desired. One of the tasks susceptible to automation in this field is the automatic detection of falls. The research effort undertaken to develop automatic fall detection systems has been quite substantial and has resulted in reliable fall detection systems. However, individuals who could benefit from these systems only consider their use in certain scenarios. Among them, a relevant scenario is the one associated to semi-supervised patients during the night who wake up and get out of bed, usually disoriented, feeling an urgent need to go to the toilet. Under these circumstances, usually, the person is not supervised, and a fall could go unnoticed until the next morning, delaying the arrival of urgently needed assistance. In this scenario, associated with nighttime rest, the patient prioritizes comfort, and in this situation, body-worn sensors typical of wearable systems are not a good option. Environmental systems, particularly visual-based ones with cameras deployed in the patient’s environment, could be the ideal option for this scenario. However, it is necessary to work with far-infrared (FIR) images in the low-light conditions of this environment. This work develops and implements, for the first time, a fall detection system that works with FIR imagery. The system integrates the output of a human pose estimation neural network with a detection methodology which uses the relative movement of the body’s most important joints in order to determine whether a fall has taken place. The pose estimation neural networks used represent the most relevant architectures in this field and have been trained using the first large public labeled FIR dataset. Thus, we have developed the first vision-based fall detection system working on FIR imagery able to operate in conditions of absolute darkness whose performance indexes are equivalent to the ones of equivalent systems working on conventional RGB images.

Hardfacing is commonly used in parts recovery and in obtaining surfaces with improved properties. Within this field, it is important to analyze the effect of alloying elements on the properties of the deposited layers. One of the critical parameters affecting alloying performances in SMAW is improper arc length. This article examines the effect of the addition of niobium in different quantities (0, 2, 4, 6, and 8% by weight) to the electrode coating in Fe-Cr-C shielded metal arc welding (SMAW), with short and long arc lengths, on the operational process efficiency, dilution, arc energy, microstructure, and microhardness of the deposited layers. A decrease in operational process efficiency and dilution was found with increases in niobium content. On the other hand, it was found that adding niobium leads to a refinement in chromium carbide sizes, directly affecting the hardness of the obtained deposits. There is a direct relationship between the arc energy, with both short and long arc lengths, leading to a tendency to decrease the dilution in the obtained hardfacing.

In past years, Parallel Sequence Spread Spectrum (PSSS) has attracted significant attention as a modulation technique for wireless communication systems targeting data rates of 100 Gb/s and beyond. PSSS allows designing high-speed baseband processors, which can be partially implemented in the analog domain. It uses multiple analog-to-digital converters (ADCs) to sample the received baseband signal in parallel, significantly relaxing the sampling rate and ADC complexity. However, due to the sidelobe effects of bipolar $m$ -sequences, PSSS shows lower performance than standard digital modulation schemes. This paper proposes real-valued PSSS spreading sequences with attenuated autocorrelation sidelobes. Such sequences show excellent bit error rate (BER) performance. Moreover, our sequences do not have length restrictions of 2m – 1, like in the case of $m$ -sequences, and reduce the chip area required to implement PSSS transceiver. The proposed sequences also reduce the peak-to-average power ratio (PAPR) of PSSS.

The COVID-19 pandemic has had severe consequences on the global economy, mainly due to indiscriminate geographical lockdowns. Moreover, the digital tracking tools developed to survey the spread of the virus have generated serious privacy concerns. In this paper, we present an algorithm that adaptively groups individuals according to their social contacts and their risk level of severe illness from COVID-19, instead of geographical criteria. The algorithm is fully distributed and therefore, individuals do not know any information about the group they belong to. Thus, we present a distributed clustering algorithm for adaptive pandemic control.

BackgroundEssential tremor (ET) is associated with physical and cognitive impairments, as well as embarrassment, avoidance of social settings, and related difficulties that negatively impact the lives of patients. In similar disease contexts, burden on friends and relatives acting as caregivers has been noted and has well-documented implications. There has been no study examining caregiver burden related to ET.MethodsData were gathered from 55 ET participants enrolled in a clinical study and their caregivers. The Zarit Burden Interview was used to assess caregiver burden. To assess clinical features that may be associated with burden, we collected several variables including the Montreal Cognitive Assessment, self-reported tremor disability, a videotaped neurological examination, questionnaires assessing ET participants’ suffering, caregivers’ perceptions of that suffering, and both caregiver and ET participant depressive symptoms. Spearman’s correlations were performed between caregiver burden and clinical features, and we created a multivariate linear regression model predicting caregiver burden.ResultsMany ET caregivers provide little to no care and experience little to no burden. However, some caregivers (11%) provide over 25 h of care/week, and 13% experience high levels of burden. Caregivers most commonly provided assistance with writing and cooking. Increased burden was associated with the ET participants’ decreased cognition, more caregiving tasks, more hours/week of caregiving activities, a longer duration of care, more ET participant falls/year, more medications taken by the ET participant, and more depressive symptoms in both the ET participant and the caregiver (all p

Background: Essential tremor (ET) patients regularly inquire about their prognosis. Therefore, physicians have cause to review available medical literature for meaningful answers. Longitudinal studies are ideally suited to provide a glimpse into the evolution of tremor. Despite its high prevalence, there are surprisingly few longitudinal clinical studies of ET. Furthermore, none of them provided data from the patients’ perspective. Understanding the patient vantage point is valuable as it is the starting point of personalized medicine. Given the progressive nature of ET, we hypothesized that many patients will experience an increase in symptom severity over time. However, due to a lack of clinical data, the exact nature of this progression is unclear. For example, whether patients experience a worsening at each time interval is simply not known. In this longitudinal study, we assessed whether ET patients felt that their symptoms had worsened between each follow-up evaluation and try to identify specific clinical characteristics associated with this experience.Methods: A cohort of 164 ET cases enrolled in a prospective, longitudinal research study. After a baseline in-person assessment, they received regular telephone evaluations for up to 5.25 years, beginning in 2009. During each follow-up evaluation, cases answered the question, has your ET worsened since our last call? Results: Two-thirds (104 63.4%) of ET cases reported worsening at one-half or more of their follow-up evaluations. Furthermore, one-in-four cases (44 26.8%) reported worsening at every follow-up evaluation. Self-reported worsening was not associated with any of the baseline clinical variables assessed, including age, gender, tremor duration, age at tremor onset, or total tremor score. Conclusions: Little has been written from the patient perspective on progression of ET. When followed longitudinally at regular intervals, a majority of ET cases we studied reported worsening one-half or more of the time; furthermore, one-in-four reported worsening at each and every assessment, indicating that they felt they were inexorably getting worse and worse with time. That there is so much self-reported worsening in ET argues against the notion that this is a static and benign condition. It suggests that patients experience it as a condition that worsens regularly and consistently.

Knowing the human immunodeficiency virus (HIV) status of persons infected with Mycobacterium tuberculosis is important for individual treatment and preventing transmission. This evaluation analyzed surveillance data and surveyed health care providers who care for patients with HIV and tuberculosis (TB) to understand the factors contributing to suboptimal levels of Connecticut patients with TB having a known HIV status. During 2008 to 2010, 208 (76.2%) of 273 patients had a known HIV status; 12 (5.8%) were HIV-positive. Patients who were more likely to have a known HIV status were younger (40.5 vs 54.6 years, P < .001) or received care in a TB clinic (risk ratio, 1.26; 95% confidence interval, 1.12-1.42). Among 77 providers, 48 (62.3%) completed the survey, 42 (87.5%) reported routinely offering HIV testing to patients with TB, and 26 (54.2%) reported routinely offering HIV testing to patients with latent TB infection (LTBI). We conclude that interventions for improving HIV testing should focus on non-TB clinic providers and patients with LTBI.

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IntroductionCognitive impairment and dementia are part of a continuum that progressively leads to functional impairment and dependency. Dementia is a paradigmatic example of chronic and complex psychogeriatric diseases, requiring a comprehensive assessment. The authors underline the importance of implementing a formal assessment of needs (whether met or unmet) as an essential element of comprehensive assessment. The aim of this paper is to empirically validate this model of approach towards dementia, the needs assessment, demonstrating the relationship between needs and functionality/dependency in people with cognitive impairment/dementia in the community.Material and methodsCommunity-based, cross-sectional, descriptive epidemiological study based on the reanalysis of data from a two-phase community epidemiological study conducted in Santiago de Compostela, Spain, of 800 people over 65 years of age. The present study reanalyzes a subsample of 368 people, including those with dementia/cognitive impairment. The comprehensive assessment of the sample included sociodemographic variables, the presence of chronic diseases, health self-perception, assessment of affective, cognitive and functional state, as well as the needs assessment. The main instruments used were the MMSE, the Geriatric Depression Scale (GDS), the Barthel and Katz Indices, the Lawton Scale, and, for the needs assessment, the Camberwell Assessment of Need for the Elderly (CANE). For the clinical diagnosis of dementia, the ICD-10 criteria were followed. Statistical analysis: A study of the association between variables was carried out through hypothesis testing and a multivariate study was performed using regression models to analyze the relationship between the different variables defining disability/dependency, other health conditions and sociodemographic variables and the MMSE score as an expression of the cognitive impairment/dementia continuum.ResultsPeople with cognitive impairment/dementia had a higher number of needs compared to the healthy population. The severity of cognitive impairment is a significant predictor of dependency in Basic Activities of Daily Living (BADL) and is also a predictor of a greater number of needs (both met and unmet).DiscussionThe present study provides empirical evidence of the importance of implementing scales to assess the needs of people with cognitive impairment, as part of the process of comprehensive biopsychosocial assessment and person-centered care for dementia.