Search

Blood clots form in a lower limb due to a prolonged period of inactivity. They can be prevented by improving the deep vein circulation through ankle exercises. However, existing automatic exercise assisting devices are expensive and bulky. In this study, we designed a novel wearable deep vein thrombosis prevention device using thin McKibben muscles. The device has no rigid structure; it is composed almost entirely of soft materials, is extremely lightweight, and occupies little space around the leg. Ankle exercises, including dorsiflexion-plantarflexion, inversion-eversion, and abductionadduction, can be performed in all directions using the proposed device. On evaluating the range of motion with this device, it is found that it can achieve 90% of the maximum range of motion for all directions of ankle exercises. From the preliminary clinical evaluation, the popliteal vein velocity in the lower limbs, measured using an ultrasonic flow meter, increased after the device assisted ankle exercises. The results indicate that the proposed device can effectively improve blood circulation.

Summary Background As a vital issue in geriatric research, risk factors for falls were concluded to be multifactorial, and prevention has been mostly aimed at decreasing situational and environmental risks that cause and aggravate fall-related injuries, particularly within the institutions. While knowledge is limited about older patients' intrinsic determinants, the purpose of this study was to explore elderly Taiwanese's intrinsic risk factors associated with severe fall-related injuries. Methods Between April 2011 and December 2013, medical records related to in-ward elderly patients' falls were retrieved from two teaching hospitals in the northern Taiwan area. A total of 244 elderly hospitalized patients' fall-related assessments were reviewed from the national hospital safety reporting system. Chi-square statistics and odds ratio calculations were performed to ascertain significant associations between risk factors and the severity of after-fall injuries. Results Major risk factors resulting in fall-related injuries were found to be intrinsic and not situational or environment-related. Vertigo and weakness of the legs were both significant physical and behavioral determinants, and elderly cancer patients staying in oncological wards were more likely to have severe injuries after incidents of falls, compared with those in medical and surgical wards. Female gender was not discovered as a significant factor to affect the severity of falls. Conclusion Elderly Taiwanese inpatients with existing intrinsic conditions of cancer, vertigo, and lower leg weakness were at high risk of falling, resulting in severe injuries. Additional research including controlled trials is necessary to further identify treatable, causal intrinsic risk factors for this elderly group.

Purpose: Due to the ethical concern around involuntary treatment, this study sought to investigate if youth participants in wilderness therapy who were transported to the program experienced different rates of change than those not transported. Methods: Multilevel modeling techniques were used to investigate rates of change for youth between transported and nontransported youth over 5 points until 6 months postdischarge. In addition, repeated measures analyses of variance investigated parent reports of change over time across transport status, gender, and diagnosis. Results: The findings showed no differences between transported and nontransported youth in changes over time. Overall, all youth improved significantly with changes maintained postdischarge regardless of transport status. Discussion: This study shows that transporting youth to treatment does not appear to interfere with the treatment outcome; however, more research is needed to understand clients’ perception of the transport process.

This paper investigates the dynamics of a 3-link gymnastic robot using both a simulation and an experiment to identify the dominant parameters required for a desired front-flip motion. The objectives of this study are as follows: (1) construct a mathematical model of the gymnast robot and verify the theoretical results via simulation for a 3-link gymnast robot, (2) design a 3-link mechanism and perform experiments under different conditions, and (3) compare the results of both the simulation and the experiment, and analyze the relation between the parameters and the corresponding locomotion. To achieve these objective, first, a theoretical model of a 3-link gymnastic robot is proposed. Then, simulation results are provided to verify the model. Next, a 3-link robot mechanism is designed and fabricated, and experiments are conducted to demonstrate the dynamics behavior observed in the simulation results. This paper provides the ideal initial condition to perform any desired front-flip locomotion. It is found that the initial angle of the 3-link mechanism is the parameter that mainly influences the front-flip performance.

Background: Totally implantable port systems are generally recommended for prolonged central venous access in diverse settings, but their risk of complications remains unclear for patients with advanced cancer. Aim: The aim of this study was to assess the risk of port system failure in patients with advanced cancer. Design: We conducted a retrospective cohort study in a comprehensive cancer centre. Setting/participants: A detailed chart review was conducted among 566 patients with 573 ports inserted during January–June, 2009 (average 345.3 catheter-days). Cox regression analysis was applied to evaluate factors during insertion and early maintenance that could lead to premature removal of the port systems due to infection or occlusion. Results: Port system-related infection was significantly associated with receiving palliative care immediately after implantation (hazard ratio, HR = 7.3, 95% confidence interval, 95% CI = 1.2–46.0), after adjusting for probable confounders. Primary cancer site also impacted the occurrence of device-related infection. Receiving oncologic/palliative care (HR = 3.0, P = 0.064), advanced cancer stage (HR = 6.5, P = 0.077) and body surface area above 1.71 m2 (HR = 3.4, P = 0.029) increased the risk of port system occlusion. Conclusions: Our study indicates that totally implantable port systems yield a higher risk of complications in terminally ill patients. Further investigation should be carefully conducted to compare outcomes of various central venous access devices in patients with advanced cancer and to develop preventive strategies against catheter failure.