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Abstract Background This study conducted in-depth interviews to explore the factors that influence the adoption of fall detection technology among older adults and their families, providing a valuable evaluation framework for healthcare providers in the field of fall detection, with the ultimate goal of assisting older adults immediately and effectively when falls occur. Methods The method employed a qualitative approach, utilizing semi-structured interviews with 30 older adults and 29 families, focusing on their perspectives and expectations of fall detection technology. Purposive sampling ensured representation from older adults with conditions such as Parkinson's, dementia, and stroke. Results The results reveal key considerations influencing the adoption of fall-detection devices, including health factors, reliance on human care, personal comfort, awareness of market alternatives, attitude towards technology, financial concerns, and expectations for fall detection technology. Conclusions This study identifies seven key factors influencing the adoption of fall detection technology among older adults and their families. The conclusion highlights the need to address these factors to encourage adoption, advocating for user-centered, safe, and affordable technology. This research provides valuable insights for the development of fall detection technology, aiming to enhance the safety of older adults and reduce the caregiving burden.

Abstract Background While the treatment guidelines have been established for pure urothelial carcinoma (pUC), patients with variant type urothelial carcinoma (vUC) face limited effective treatment options. The effectiveness of immune checkpoint inhibitors (ICI) in patients with vUC remains uncertain and necessitates additional research. Method We conducted a retrospective, multicenter study to explore the effectiveness of ICI in patients with pUC or vUC in Taiwan. We evaluated the overall response rate (ORR) through univariate logistic regression analysis and examined the overall survival (OS) and progression-free survival (PFS) using Kaplan-Meier analysis. Additionally, we employed univariate and multivariate Cox proportional hazards models to analyze the data. Result A total of 142 patients (116 pUC, 26 vUC) were included in our final analysis. The ORR was marginally higher in patients with pUC compared to those with vUC (34.5% vs. 23.1%, p = 0.26). Among all patients, 12.9% with pUC achieved a complete response (CR) after ICI treatment, while no vUC cases achieved CR (p = 0.05). There were no significant differences in PFS (median 3.6 months vs. 4.1 months, p = 0.34) or OS (median 16.3 months vs. 11.0 months, p = 0.24) when comparing patients with pUC or vUC. In the subgroup analysis, patients with pUC who underwent first-line ICI treatment exhibited significantly improved OS compared to those with vUC (24.6 months vs. 9.1 months, p = 0.004). Conclusion The use of ICI as monotherapy is a feasible and effective treatment approach for patients with metastatic vUC.

Because imbalanced power will cause the loss of the propulsion motor of the railway vehicle, and the increase in temperature will shorten the service life of the electric vehicle. Not only this but also increase the cost of electricity and maintenance. In the past, the industry only focused on methods to improve power quality such as load capacity, relay setting, and harmonic resolution. Now, the consider of three-phase unbalance rate (TPUR) must be applied. I propose special transformers wiring (STW) to improve the three unbalance rates and provide different transformer wiring methods. According to the IEEE Committee, in the future, power companies will need to install balanced relay stations to improve three-phase unbalance rate. The internal regulations of Taipower must be less than 4.5% (voltage unbalance rate (NPSUR) of 2.5% and motor temperature rise of 12.5%). The derivation of the transformer “three-phase unbalance rate” model is the focus of the railway system. This research is based on the model derivation of different wiring methods to improve the problem caused by the three-phase imbalance and improve the using life of the train. They pointed out that Scott, Le-Blanc, and Modified-Woodbridge, the three wiring methods can be applied to future railway system and reduce the three-phase unbalance rate. They are in line with the IEEE standard ( % P U V ) of less than 2%.

With the development of such technologies as embedded systems, cloud databases and hardware components, detection of cognitive in the elderly can be made more convenient and accurate. This work develops a novel cognitive assessment interactive embedded system, which consists of a micro-controller unit (MCU), organic light-emitting diode (OLED) modules and a client identification circuit. The reliability of the proposed system is demonstrated in visuospatial memory tests. With its combination of OLED modules and pressable components, the elderly can use the system to perform testing under a flashing light source sequence with tactile feedback. To identify the various pattern arrangements in the Corsi block tapping task (CBTT), the client identification circuit in the proposed system is implemented to compute the number of OLED lighting devices on each column of the wooden base. The data that are collected from each subject will be transferred to cloud servers through a smart phone APP via wireless networks to eliminate recording errors by the experimenter. The functionality of the spatial working memory is verified in experiments that involve the proposed OLED, a computerized version of the CBTT, and 24 participants. Experimental results reveal that the difference in memory span between young and elderly groups is significant, F(1, 92) = 214, p

Due to superior robustness characteristic of sliding-mode control techniques, this study proposes a multiple sliding-mode control (MSMC) strategy based on the stator flux oriented vector scheme for speed control of three-phase AC induction motor (IM) drives in the presence of an external disturbance and uncertainties. At first, the dynamic model of a three-phase IM drive is transformed into two-axe orthogonal model (i.e. d and q axes) in the synchronously rotating frame so that vector control can be applied. Then, based on the stator flux oriented scheme (i.e. zero stator flux at q-axis and constant at d-axis), the proposed MSMC causes mechanical angular speed and stator current at q-axis reach toward predefined sliding surfaces. Moreover, stator flux and current at d-axis are respectively indirect and direct controlled such that tracking errors approach toward designed sliding surfaces. The closed-loop stability of the proposed MSMC is proved to possess uniformly ultimately bounded (UUB) performance by Lyapunov stability criteria. Furthermore, the simulation results reveal that the proposed MSMC strategy has a high level of robustness despite addition of an external load and random uncertainties on system parameters. In the meantime, the simulations for comparing the baseline controller (i.e. conventional PI control) are also conducted to verify the superiority of the proposed control scheme.

A compact beam-position monitor was constructed using a linear contact image sensor attached to a plastic scintillator and tested using a 230 MeV proton beam. The results indicate that the beam position can be obtained in real-time, and the beam position with a precision of up to 0.03 mm. The compactness and high precision of the device hold considerable potential for it to be used as a beam-position monitor and offline, daily quality assurance monitor in hadron therapy. • The method can provide a high precision and high resolution beam position for flash irradiation in particle therapy in real-time. • The method using contact image sensor with scintillator does not require a long focal length for camera and it is free of image distortion. • The method can be integrated into medical particle accelerator for feedback control and daily quality assurance.

Abstract The impact of tumor infiltrating lymphocytes (TILs) on survival was confirmed in various cancer types. Our study aims to investigate the prognostic role of TILs on survival in patients with metastatic urothelial carcinoma (mUC) receiving platinum based chemotherapy. Patients who were diagnosed to have pathologically proved mUC between 1997 and 2016 and received palliative chemotherapy with platinum based regimen were recruited into our study. Kaplan-Meier curves and Cox regression analysis were constructed for overall survival (OS). A total of 259 mUC patients were enrolled into our study with median age 63 years and median follow-up visit 13.5 months. Of these patients, 179 (69%) had intense TILs and 80 (31%) had non-intense TILs. The median OS were 15.7 vs. 6.7 months (P =

Abstract We report in this paper a new MRI contrast agent based on magnetic nanodiamonds fabricated by Fe ion implantation. The Fe atoms that are implanted into the nanodiamonds are not in direct contact with the outside world, enabling this new contrast agent to be free from cell toxicity. The image enhancement was shown clearly through T2 weighted images. The concentration dependence of the T2 relaxation time gives a relaxivity value that is about seven times that of the regular non-magnetic nanodiamonds. Cell viability study has also been performed. It was shown that they were nearly free from cytotoxicity independent of the particle concentration used. The imaging capability demonstrated here adds a new dimension to the medical application of nanodiamonds. In the future one will be able to combine this capability of magnetic nanodiamonds with other functions through surface modifications to perform drug delivery, targeted therapy, localized thermal treatment and diagnostic imaging at the same time.

Objective: This study aims to evaluate the operative efficacy and safety of the GreenLight 180-W XPS laser system in comparison to the GreenLight 120-W HPS system used by a single experienced surgeon for the treatment of bladder outlet obstruction caused by an enlarged prostate. Materials and methods: We retrospectively compared the patients undergoing GreenLight 180-W XPS (September 2014–September 2015) and GreenLight 120-W HPS (August 2008–September 2009) for lower urinary tract symptoms secondary to benign prostatic hyperplasia by a single experienced surgeon. The patient baseline characteristics, perioperative parameters, and complications were recorded. Prostate size and prostate-specific antigen were also assessed. Functional parameters, including International Prostate Symptom Score, maximum uroflow rate, postvoid residual, and quality of life score, were analyzed in different follow-up periods. Results: A total of 130 patients (65 in the HPS and 65 in the XPS group) were included in this study. Intraoperative lasing time was significantly shorter in the XPS group, but the postoperative length of catheterization and hospital stay were comparable in both groups. The number of fibers used during vaporization was significantly less, and only one case required two fibers for prostate vaporization in the XPS group (p=0.03). During the follow-up period, there was statistically significant improvement compared with baseline in all functional parameters in each group. However, no significant difference was observed in these parameters between the two groups. The mean percentages of prostate volume reduction were 57% and 41% and those of prostate-specific antigen reduction were 60% and 49%, respectively, in the XPS and HPS groups. Complications were comparable between the two groups. Conclusion: The 180-W XPS system displays a shorter lasing time, less laser fiber use, more volume reduction, and a comparable safety profile in comparison with the 120-W HPS system for the treatment of bladder outlet obstruction caused by an enlarged prostate.

Preserving renal function and controlling oncological outcomes are pertinent when managing renal neoplasms. Cryoablation is the recommended treatment only for clinical T1a stage renal tumour. Here, we compared the outcomes of robot-assisted laparoscopic partial nephrectomy (RaPN) and laparoscopic cryoablation (LCA) in the treatment of patients with localised T1-T2 renal tumours. Overall, 86 patients who received RaPN and 78 patients underwent LCA were included in this study. The intraoperative, postoperative, and oncological outcomes in the LCA group were non-inferior to the RaPN group. Moreover, LCA demonstrated shorter operative time (267.45 ± 104.53 min vs. 138.56 ± 45.28 min, p < 0.001), lower blood loss (300.56 ± 360.73 mL vs. 30.73 ± 50.31 mL, p < 0.001), and slight renal function deterioration because of the reduced invasiveness, without compromising on the oncological outcomes.

This work presents a fall detection system that is worn on the head, where the acceleration and posture are stable such that everyday movement can be identified without disturbing the wearer. Falling movements are recognized by comparing the acceleration and orientation of a wearer’s head using prespecified thresholds. The proposed system consists of a triaxial accelerometer, gyroscope, and magnetometer; as such, a Madgwick’s filter is adopted to improve the accuracy of the estimation of orientation. Moreover, with its integrated Wi-Fi module, the proposed system can notify an emergency contact in a timely manner to provide help for the falling person. Based on experimental results concerning falling movements and activities of daily living, the proposed system achieved a sensitivity of 96.67% in fall detection, with a specificity of 98.27%, and, therefore, is suitable for detecting falling movements in daily life.

Chronic prostatitis/chronic pelvic pain syndrome (CP/ CPPS) has a negative impact on the quality of life, and its etiology still remains unknown. Although many treatment protocols have been evaluated in CP/CPPS, the outcomes have usually been disappointing. Botulinum neurotoxin A (BoNT-A), produced from Clostridium botulinum, has been widely used to lower urinary tract dysfunctions such as detrusor sphincter dyssynergia, refractory overactive bladder, interstitial cystitis/bladder pain syndromes, benign prostatic hyperplasia, and CP/ CPPS in urology. Here, we review the published evidence from animal models to clinical studies for inferring the mechanism of action underlying the therapeutic efficacy of BoNT in CP/CPPS. Animal studies demonstrated that BoNT-A, a potent inhibitor of neuroexocytosis, impacts the release of sensory neurotransmitters and inflammatory mediators. This pharmacological action of BoNT-A showed promise of relieving the pain of CP/CPPS in placebo-controlled and open-label BoNT-A and has the potential to serve as an adjunct treatment for achieving better treatment outcomes in CP/CPPS patients.