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Due to the lack of information about the concept of Tons of Steering Pull (TSP) of many escort tugs, and the lack of research works relating the TSP demanded by a tethered vessel with respect to the TSP provided by tugs, the present paper shows an original study with mathematical models on how to solve these problems. What is more, an important percentage of the towing sector always employs Bollard Pull (BP), which is considered the only parameter capable of defining performance, so this paper aims to relate BP with TSP. The present research was carried out based on more than 25 escort tugs of different towing companies. Furthermore, a real case study of different tanker vessels was used for modelling purposes of tethered vessels' TSP. Finally, once the proposed models were obtained, they were compared with International Maritime Organization (IMO) guidelines. The results showed charts with the main independent variables of tugs and vessels in order to be as useful and practical as possible to the shipping industry, mainly to ship owners and tug operators, from a safety point of view. [ABSTRACT FROM AUTHOR]

The abundant homohexameric AAA + ATPase p97 (also known as valosin-containing protein, VCP) is highly conserved from Dictyostelium discoideum to human and a pivotal factor of cellular protein homeostasis as it catalyzes the unfolding of proteins. Owing to its fundamental function in protein quality control pathways, it is regulated by more than 30 cofactors, including the UBXD protein family, whose members all carry an Ubiquitin Regulatory X (UBX) domain that enables binding to p97. One member of this latter protein family is the largely uncharacterized UBX domain containing protein 9 (UBXD9). Here, we analyzed protein-protein interactions of D. discoideum UBXD9 with p97 using a series of N- and C-terminal truncation constructs and probed the UBXD9 interactome in D. discoideum. Pull-down assays revealed that the UBX domain (amino acids 384–466) is necessary and sufficient for p97 interactions and that the N-terminal extension of the UBX domain, which folds into a β0-α–1-α0 lariat structure, is required for the dissociation of p97 hexamers. Functionally, this finding is reflected by strongly reduced ATPase activity of p97 upon addition of full length UBXD9 or UBXD9261–573. Results from Blue Native PAGE as well as structural model prediction suggest that hexamers of UBXD9 or UBXD9261–573 interact with p97 hexamers and disrupt the p97 subunit interactions via insertion of a helical lariat structure, presumably by destabilizing the p97 D1:D1’ intermolecular interface. We thus propose that UBXD9 regulates p97 activity in vivo by shifting the quaternary structure equilibrium from hexamers to monomers. Using three independent approaches, we further identified novel interaction partners of UBXD9, including glutamine synthetase type III as well as several actin-binding proteins. These findings suggest a role of UBXD9 in the organization of the actin cytoskeleton, and are in line with the hypothesized oligomerization-dependent mechanism of p97 regulation.

Physical rehabilitation programs for patients with heart failure (HF) are underdeveloped in our country. In order to establish the correct rehabilitation plan, the first step is to evaluate the patient’s functional capacity. G-Walk is a simple and effective test in assessing functional capacity. The aim of the study is to analyze the correlation between the results obtained in Timed Up and Go (TUG) and walking speed test and the prognosis of patients with heart failure. Material and methods. We prospectively analyzed a group of 44 patients with heart failure class II-III NYHA hospitalized in the Cardiology Department of Elias Hospital between June 17 and July 15, 2019.We evaluated the functional mobility of the patients with heart failure with the G-Walk device that contains a wireless sensor. The G-Walk device represents a gait analysis system, performing – according to a protocol – 2 tests: Walk (patient’s walking speed) and TUG (measures balance and mobility). Results. After analyzing the walking speed, the patients were divided into 2 groups: those with a speed <0.8 m/s and those with a speed> 0.8 m/s. Out of 44 patients, 21 patients had a walking speed < 0.8 m/s and 23 patients had a walking speed > 0.8 m/s. It was seen that patients with lower walking speed (V < 0.8 m/s) versus patients with better walking speed (V > 0.8 m/s) were older, had a lower body weight, a lower blood pressure value, a lower value of the oxygen saturation, a lower value of sodium and a higher blood glucose value. After analyzing the value of the TUG test, patients were divided into 2 groups: patients with a TUG test duration < 15 seconds and patients with a TUG test duration > 15 seconds. Thus, out of 44 patients studied, 19 patients had a TUG value < 15 seconds and 25 patients had a TUG value over 15 seconds. It was observed that patients with a higher TUG value (> 15 seconds) versus patients with normal TUG value (< 15 seconds) were older, had a higher creatinine value and a higher blood glucose value. Conclusions. It has been shown that a low value of walking speed and mobility is associated with increased morbidity and mortality of all causes in elderly patients with cardiovascular disease. The physical rehabilitation of patients with heart failure is very important for improving the quality of life. [ABSTRACT FROM AUTHOR]

La reconstruction mammaire par implant présente des inconvénients à long terme et conduit un nombre croissant de patientes à demander une chirurgie secondaire de correction. Deux stratégies chirurgicales sont possibles : le changement d'implant (associé à des gestes de capsulectomie/capsulotomie et/ou lipofilling) et le retrait d'implant associé à l'apport d'un tissu autologue (lambeau et/ou lipofilling). Entre 2010 et 2018, 54 patientes ont bénéficié d'une chirurgie secondaire de correction d'une première reconstruction mammaire par implant. Les motifs d'insatisfaction de la reconstruction initiale, les interventions réalisées et les complications postopératoires ont été analysés. Le bien-être et la satisfaction des patientes ont été évalués au moyen du questionnaire BREAST-Q. Trente-quatre patientes ont bénéficié d'un changement de prothèse et 20 patientes d'un retrait définitif de leur prothèse associé à l'apport d'un tissu autologue. La présence d'une coque périprothétique, la douleur, l'aspect figé du sein et l'asymétrie mammaire étaient les motifs d'insatisfaction les plus fréquents. Avec un recul moyen de 2,6 ans, les patientes ayant bénéficié d'une conversion autologue étaient globalement plus satisfaites de l'aspect de leurs seins que les patientes ayant conservé un implant mammaire (p < 0,0001). En cas de mauvais résultat esthétique ou fonctionnel d'une reconstruction mammaire par implant, le retrait de la prothèse associé à une reconstruction autologue donne de meilleurs résultats en termes de bien-être et de satisfaction que le changement d'implant. Breast reconstruction with implants has long-term disadvantages and is leading an increasing number of patients to request secondary corrective surgery. Two surgical strategies are possible: implant replacement (associated with capsulectomy/capsulotomy and/or lipofilling procedures) and implant removal associated with the provision of autologous tissue (flap and/or lipofilling). Between 2010 and 2018, 54 patients underwent secondary surgery for correction of a first implant breast reconstruction. The reasons for dissatisfaction with the initial reconstruction, the procedures performed, and postoperative complications were analysed. Patient well-being and satisfaction were evaluated using the BREAST-Q questionnaire. Thirty-four patients benefited from a prosthesis change and 20 patients benefited from a permanent removal of their prosthesis combined with the addition of autologous tissue. The presence of a periprosthetic shell, pain, fixed appearance of the breast and breast asymmetry were the most frequent reasons for dissatisfaction. With a mean follow-up of 2.6 years, autologous conversion patients were generally more satisfied with the appearance of their breasts than patients who retained a breast implant (P < 0.0001). In cases of poor esthetic or functional outcomes of implant-based breast reconstruction, removal of the prosthesis in combination with autologous reconstruction provides better results in terms of well-being and satisfaction than implant replacement. [ABSTRACT FROM AUTHOR]

Copyright of Electronics & Control Systems is the property of National Aviation University and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Electronics & Control Systems is the property of National Aviation University and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: The use of virtual reality (VR) in clinical settings has increased with the introduction of affordable, easy-to-use head-mounted displays (HMDs). However, some have raised concerns about the effects that HMDs have on posture and locomotion, even without the projection of a virtual scene, which may be different across ages.Research Question: How does HMD wear impact the kinematic measures in younger and older adults?Methods: Twelve healthy young and sixteen older adults participated in two testing conditions: 1) TUG with no HMD and 2) TUG with an HMD displaying a scene of the actual environment (TUGHMD). The dependent variables were the pitch, yaw, and roll peak trunk velocities (PTVs) in each TUG component, turning cadence, and the time to complete the TUG and its components - SIT-TO-STAND, TURN, WALK, and STAND-TO-SIT.Results: Wearing the HMD decreased turning cadence and pitch and yaw PTVs in all TUG components, decreased roll PTV in SIT-TO-STAND and TURN, and increased the time taken to complete all TUG components in all participants. Wearing the HMD decreased the pitch PTV in SIT-TO-STAND in older relative to younger adults. Wearing an HMD affected TUG performance in younger and older adults, which should be considered when an HMD is used for VR applications in rehabilitation.Significance: Our findings highlight the importance of considering the physical effect of HMD wear in clinical testing, which may not be present with non-wearable VR technologies. [ABSTRACT FROM AUTHOR]

The Timed Up and Go test (TUG) is commonly used to estimate the fall risk in the elderly. Several ways to improve the predictive accuracy of TUG (cameras, multiple sensors, other clinical tests) have already been proposed. Here, we added a single wearable inertial measurement unit (IMU) to capture the residents’ body center-of-mass kinematics in view of improving TUG’s predictive accuracy. The aim is to find out which kinematic variables and residents’ characteristics are relevant for distinguishing faller from non-faller patients. Data were collected in 73 nursing home residents with the IMU placed on the lower back. Acceleration and angular velocity time series were analyzed during different subtasks of the TUG. Multiple logistic regressions showed that total time required, maximum angular velocity at the first half-turn, gender, and use of a walking aid were the parameters leading to the best predictive abilities of fall risk. The predictive accuracy of the proposed new test, called i + TUG, reached a value of 74.0%, with a specificity of 95.9% and a sensitivity of 29.2%. By adding a single wearable IMU to TUG, an accurate and highly specific test is therefore obtained. This method is quick, easy to perform and inexpensive. We recommend to integrate it into daily clinical practice in nursing homes.

The purpose of the study was to evaluate the effect of a repeated 1-week intensive programme in patients with mid-stage Huntington's disease on stability and quality of life. 12 patients completed two 1-week programmes, separated by a one-year interval. Each programme consisted of a 120-minute intervention in the form of a fitness exercise, procedures targeting static and dynamic postural stability, procedures of respiratory physiotherapy and orofacial region therapy. The patient completed a total of 4 evaluations using the Sit to Stand Test, Timed up and Go Test and completed the quality of life SF-36 questionnaire. Statistically significant changes have been shown in the Sit-and-stand test in both years. Weaker but still significant changes were found in the TUG test only in the first year, while there was improvement in the second intervention year that was not statistically significant. Evaluation of the quality of life suggested a positive influence of physical activity in the dimensions: restriction caused by emotional problems, somatic pain and change of health. Our results suggest that a repeated, intensive one-week intervention can have a positive influence on postural stability and can contribute to the improvement of some quality of life dimensions in patients with mid-stage HD. [ABSTRACT FROM AUTHOR]

The purpose of this study was to evaluate the association between functional mobility performance and executive functions in older adults with the amnestic (aMCI) and nonamnestic (naMCI) type of mild cognitive impairment (MCI), as well as in a control group. A cross-sectional study was conducted among 800 older adults (147 with MCI) who participated in a longitudinal study consisting in an interdisciplinary geriatric assessment and rehabilitation program in Kraków. Motor performance was measured with the Timed Up and Go test (TUG), while standard neuropsychological tests were used to assess different cognitive domains. Analysis of the entire sample showed that almost all cognitive domains and the presence of MCI are associated with functional mobility. Executive functions, letter fluency, and working memory were associated with TUG in the MCI group. The MCI type was not a significant moderator of the relationship between cognitive and motor performance. In group analyses, various cognitive predictors for TUG in the aMCI group, naMCI, and control group were demonstrated. Our results suggest that executive functions and working memory in aMCI and letter fluency in naMCI are independently associated with functional mobility performance. Executive functions are important for gait control in MCI. [ABSTRACT FROM AUTHOR]

Background: Clinical exoskeletal-assisted walking (EAW) programs for individuals with spinal cord injury (SCI) have been established, but many unknown variables remain. These include addressing staffing needs, determining the number of sessions needed to achieve a successful walking velocity milestone for ambulation, distinguishing potential achievement goals according to level of injury, and deciding the number of sessions participants need to perform in order to meet the Food and Drug Administration (FDA) criteria for personal use prescription in the home and community. The primary aim of this study was to determine the number of sessions necessary to achieve adequate EAW skills and velocity milestones, and the percentage of participants able to achieve these skills by 12 sessions and to determine the skill progression over the course of 36 sessions.Methods: A randomized clinical trial (RCT) was conducted across three sites, in persons with chronic (≥6 months) non-ambulatory SCI. Eligible participants were randomized (within site) to either the EAW arm first (Group 1), three times per week for 36 sessions, striving to be completed in 12 weeks or the usual activity arm (UA) first (Group 2), followed by a crossover to the other arm for both groups. The 10-meter walk test seconds (s) (10MWT), 6-min walk test meters (m) (6MWT), and the Timed-Up-and-Go (s) (TUG) were performed at 12, 24, and 36 sessions. To test walking performance in the exoskeletal devices, nominal velocities and distance milestones were chosen prior to study initiation, and were used for the 10MWT (≤ 40s), 6MWT (≥80m), and TUG (≤ 90s). All walking tests were performed with the exoskeletons.Results: A total of 50 participants completed 36 sessions of EAW training. At 12 sessions, 31 (62%), 35 (70%), and 36 (72%) participants achieved the 10MWT, 6MWT, and TUG milestones, respectively. By 36 sessions, 40 (80%), 41 (82%), and 42 (84%) achieved the 10MWT, 6MWT, and TUG criteria, respectively.Conclusions: It is feasible to train chronic non-ambulatory individuals with SCI in performance of EAW sufficiently to achieve reasonable mobility skill outcome milestones.

The calpain-10 (CAPN10) protease is implicated in the translocation of the glucose transporter 4 (GLUT4), which is retained in the Golgi matrix vi a the Tether containing a UBX domain for GLUT4 (TUG) protein. Insulin stimulation induces the proteolytic processing of TUG, which leads to the translocation of GLUT4 to the cell membrane. We tested whether TUG is a CAPN10 substrate. Proteolysis of TUG by calpains was assessed using a cell-free system containing calpain-1 and TUG. In situ proteolysis of TUG by calpains was demonstrated in 3T3-L1 adipocytes in the presence of insulin or calpain inhibitors to modulate calpain activity. Proteolysis of TUG by CAPN10 was confirmed using transient or stable silencing of CAPN10 in 3T3-L1 adipocytes. Calpains proteolyzed the C-terminus of TUG in vitro. In adipocytes, insulin-induced cleavage of TUG was correlated with the activation of calpains. Treatment with calpain inhibitors reduced TUG cleavage, resulting in impaired GLUT4 translocation without altering Akt phosphorylation. Furthermore, CAPN10 but not calpain-1 or calpain-2 colocalized with GLUT4 in the absence of insulin, and their colocalization was reduced after stimulation with insulin. Finally, we demonstrated that CAPN10 knockdown reduced the proteolysis of TUG without altering the phosphorylation of Akt or the expression of the Usp25m protease. Thus, our results provide evidence that the TUG protein is clea ved by CAPN10 to regulate GLUT4 translocation. [ABSTRACT FROM AUTHOR]

The introductory part of the article discusses briefly the basic principles and methods of towing large aircrafts. Then, events that occurred while different large passenger planes were towed are analyzed. Based on the analysis, the main causes of plane damages during towing are indicated. The percentage distribution of individual identified risk factors is determined to show that the main cause is the broadly understood human factor, especially errors of service personnel and the crew. Finally, preventive recommendations were made based on the analysis; they can help avoid such events. The analysis stimulates further research in this field and highlights the necessity to continuously analyze the risk, which should minimize the number of towing-related incidents. [ABSTRACT FROM AUTHOR]

Background: Diminished balance confidence increases the risk of a fall and falls that occur when turning during walking are associated with an eightfold increase in hip fractures compared to when walking in a straight trajectory. Although an effect of aging on turning is revealed, the role of gender during turning is not yet clear.Research Question: How can balance confidence impact turning behavior in younger, middle-aged, and older men and women?Methods: This cross-sectional study included 22 young adults (11 women), 13 middle-aged adults (9 women), and 13 older adults (6 women). Participants ranked their balance confidence using the activities-specific balance confidence (ABC) scale and completed two different turns: Turn1 (around the cone) and Turn2 (turn to sit). Measures obtained for each turn included: turning time, step count, and peak trunk velocities (PTV) in pitch, yaw, and roll.Results: In Turn1, older adults exhibited an increase in turning time and step count relative to younger adults (both p < 0.03). In Turn2, older adults showed an increase in turning time and roll PTV compared to the middle-aged group (both p < 0.02). Lower scores in ABC were significantly correlated with an increase in Turn1 time (p < 0.001) and step count (p = 0.04) in middle-aged and older adults, respectively. Bivariate correlations revealed that women with lower scores on the ABC took more time to complete both turns (both p = 0.01).Significance: Older adults demonstrated longer turning time, more steps, and higher roll PTV while turning that were associated with decreased balance confidence scores. The association between decreased balance confidence and turning kinematics implies a relationship between turning and increased fall risk. These results suggest that testing for fall risk requires tests of activities that are performed outside traditional clinical settings and gait laboratories. [ABSTRACT FROM AUTHOR]

Introduction: Involutional changes that occur in skeletal muscle are a feature that characterizes the aging process. In women, age-related decreases in muscle mass and function of skeletal muscles occur more rapidly with the onset of menopause. Progressive muscle dysfunction has been directly linked with an increased probability of falls, fractures, disability and mortality. Aim of the study: To assess the relationship between the risk of falls and parameters of skeletal muscle assessment in a group of postmenopausal women together with the identification of patients with sarcopenia. Material and methods: This study was carried among 122 women over 60 years of age. Patients had their muscular system tested with the emphasis on the sarcopenia diagnosis using: Total Body Composition, handgrip and physical performance tests. Patients also underwent a questionnaire survey assessing occurrence of falls. Results: The analysis showed an over 2-fold increase (OR 2.4; 95% CI, 1.02-5.56) in risk of falls in a year among subjects with decreased muscle mass. No such correlation was noted with parameters such as falls in the last 12 months and decrease of muscle strength as well as physical performance. Sarcopenia is more likely to be diagnosed with European Working Group on Sarcopenia in Older People (EWGSOP1) criteria than EWGSOP2 (updated in 2018) (18% vs. 4.1% respectively). The increased risk of falls has not been proven in women with sarcopenia. Conclusions: The decrease of muscle mass is significantly correlated with the risk of falls in the last year in postmenopausal women. Impact of sarcopenia on the risk of falls depends on diagnostic criteria. [ABSTRACT FROM AUTHOR]

Background: Stroke patients often experience functional ambulation difficulties and lack ability to walk independently due to the reduction cardiorespiratory fitness so that an understanding of the relationship between fitness levels cardiorespiratory with functional mobility ability is needed, especially for thrombotic infarction stroke patients.. Objectives: This study aims to assess the relationship between cardiorespiratory fitness levels with functional mobility ability in the first three months after thrombotic infarction stroke. Method: Subjects are 38 post trombotic infarction stroke. Functional mobility is measured by the Timed Up and Go test. Subjects were asked to stand up from a chair whose seat is ± 46cm and the height of its back is 65cm, walk as far as 3 m, turn 1800, walk back and sit back. Data were analyzed and performed statistical test using SPSS 17. Results: The study showed the average TUG test was 15.56-7.79 seconds with the longest travel time was 37.38 seconds and the fastest travel time was 8.16 seconds. The average of VO2max was 10.62 ± 2.31mL / kg / min, with the lowest VO2max yield of 5.78mL / kg / min and the highest was 14.54mL / kg / minute. The TUG test had a negative correlation with VO2max the 6 minute walk test result. Conclusion: There is a significant relationship between cardiorespiratory fitness level and functional mobility abilities in post thrombotic infarction stroke patient. [ABSTRACT FROM AUTHOR]

Introduction: We aimed to assess, in patients with Parkinson's disease (PD), the association between obstructive sleep apnea (OSA), progression of motor dysfunction and the effect of OSA treatment.Methods: Data were analysed from a prospective cohort study of idiopathic PD patients from a movement disorders clinic. Patients found to have OSA on polysomnography (apnea-hypopnea index [AHI] ≥15 events/h, OSA+) were offered treatment using continuous positive airway pressure (CPAP). CPAP+ was defined as an average ≥ 2 h/night use at each follow-up. Motor symptoms were assessed using the motor section of the Movement Disorder Society Unified Parkinson's Disease Rating Scale (mUPDRS) and the Timed-Up-And-Go (TUG). Follow-up times were 3, 6 and 12 months. Mixed models were constructed, adjusting for age, sex, body mass index, levodopa equivalent dose and comorbidities.Results: We studied 67 individuals (61.2% male) of mean age 64.7 years (SD = 10.1). Baseline mUPDRS was higher in OSA+ compared to OSA- (24.5 [13.6] vs. 16.2 [7.2], p < 0.001). Motor dysfunction increased at comparable rates in OSA- and OSA+CPAP-. However, in OSA+CPAP+, mUPDRS change was significantly lower compared to OSA- (β = -0.01 vs. 0.61, p = 0.03; p = 0.12 vs. OSA+CPAP- [β = 0.39]) and TUG change was lower compared to OSA+CPAP- (β = -0.01 vs. 0.13, p = 0.002; p = 0.05 vs. OSA- [β = 0.02]).Conclusions: In this PD cohort, OSA was associated with higher baseline mUPDRS. In those with OSA, CPAP use was associated with stabilization of motor function (mUPDRS and TUG) over 12 months. These observations support further research to clarify the role of OSA in PD pathophysiology and motor dysfunction. [ABSTRACT FROM AUTHOR]

Aims: Dual task conditions of the Timed Up-and-Go (TUG) add a cognitive (C-TUG) and a manual (M-TUG) task. The purpose of this study was to determine if balance ability differentially affected performance on the three TUG conditions. Methods: One hundred community-dwelling older adults participated. They performed the sharpened Romberg (SR) eyes open test as a measure of balance and the three TUG conditions. Results: Participants were 71.8 ± 7.8 years old. Across TUG conditions, those who completed the SR had faster TUG times than those who could not. Across groups, TUG times were faster than C-TUG and M-TUG times. Trends indicated that the C-TUG was challenging for those with the poorest balance, with an automaticity index twice that of the other groups and the lack of a correlation between the C-TUG and the TUG. Conclusions: As part of clinical assessment, the C-TUG may provide important information about balance, mobility, and cognition. [ABSTRACT FROM AUTHOR]

Gender plays a role in cognitive performance. Yet the selection of a secondary task, an important paradigm in studies of posture control, has not considered gender as a variable. We explored whether different cognitive tasks differentially influence performance during the Timed Up and Go (TUG) test in men and women. Twenty young adults performed five cognitive tasks while seated and during the TUG test. Men exhibited a slower normalized cadence than women. When seated, women recalled more items than men and men were more accurate in mental calculation task. There were no changes in spatiotemporal measures. We conclude that gender did not play a major role in motor-cognitive interference during dual task TUG test. [ABSTRACT FROM AUTHOR]

Diabetes mellitus is a chronic disease defined as a state of hyperglycaemia in fasting or postprandial states. Patients with type 2 diabetes mellitus (T2DM) often show reduced physical function, including low levels of strength, balance or mobility. In this regard, the timed up and go (TUG) is a widely used physical fitness test in people with T2DM. However, there is a lack of studies evaluating the properties TUG in this population. The present study aimed to evaluate the test-retest reliability of kinetic and kinematic parameters obtained from TUG in the diabetic population with different levels of diabetic neuropathy. A total of 56 patients with T2DM participated in the study. They were divided into three groups according to the vibration threshold: (a) severe neuropathy, (b) moderate neuropathy and (c) normal perception. The TUG was performed using two force platforms to assess kinematic measurements. The results show that both kinetic and kinematic variables had good to excellent reliability. The reliability of TUG was excellent for the whole sample and the groups with non-severe neuropathy. However, it was just good for the group with severe neuropathy. [ABSTRACT FROM AUTHOR]

Due to the lack of information about the concept of Tons of Steering Pull (TSP) of many escort tugs, and the lack of research works relating the TSP demanded by a tethered vessel with respect to the TSP provided by tugs, the present paper shows an original study with mathematical models on how to solve these problems. What is more, an important percentage of the towing sector always employs Bollard Pull (BP), which is considered the only parameter capable of defining performance, so this paper aims to relate BP with TSP. The present research was carried out based on more than 25 escort tugs of different towing companies. Furthermore, a real case study of different tanker vessels was used for modelling purposes of tethered vessels’ TSP. Finally, once the proposed models were obtained, they were compared with International Maritime Organization (IMO) guidelines. The results showed charts with the main independent variables of tugs and vessels in order to be as useful and practical as possible to the shipping industry, mainly to ship owners and tug operators, from a safety point of view.

Phlebopathic diseases are chronic conditions that impact the health status and affect functional capacity. We developed SISTINE 3.0, a wearable system for remote monitoring of patients, and the aim of the study is to evaluate whether it can detect differences between participants with phlebology and healthy ones. Twelve patients and five healthy subjects performed a 3-metres Timed-Up-Go wearing SISTINE 3.0 system. The results support the system's potential to discriminate participants, especially based on the linear walking and turning angular velocity. [ABSTRACT FROM AUTHOR]

Identifying factors that affect mortality requires a robust statistical approach. This study’s objective is to assess an optimal set of variables that are independently associated with the mortality risk of 433 older comorbid adults that have been discharged from the geriatric ward. We used both the stepwise backward variable selection and the iterative Bayesian model averaging (BMA) approaches to the Cox proportional hazards models. Potential predictors of the mortality rate were based on a broad range of clinical data; functional and laboratory tests, including geriatric nutritional risk index (GNRI); lymphocyte count; vitamin D, and the age-weighted Charlson comorbidity index. The results of the multivariable analysis identified seven explanatory variables that are independently associated with the length of survival. The mortality rate was higher in males than in females; it increased with the comorbidity level and C-reactive proteins plasma level but was negatively affected by a person’s mobility, GNRI and lymphocyte count, as well as the vitamin D plasma level.

With approaches for the detection of joint positions in color images such as HRNet and OpenPose being available, consideration of corresponding approaches for depth images is limited even though depth images have several advantages over color images like robustness to light variation or color- and texture invariance. Correspondingly, we introduce High- Resolution Depth Net (HRDepthNet)—a machine learning driven approach to detect human joints (body, head, and upper and lower extremities) in purely depth images. HRDepthNet retrains the original HRNet for depth images. Therefore, a dataset is created holding depth (and RGB) images recorded with subjects conducting the timed up and go test—an established geriatric assessment. The images were manually annotated RGB images. The training and evaluation were conducted with this dataset. For accuracy evaluation, detection of body joints was evaluated via COCO’s evaluation metrics and indicated that the resulting depth image-based model achieved better results than the HRNet trained and applied on corresponding RGB images. An additional evaluation of the position errors showed a median deviation of 1.619 cm (x-axis), 2.342 cm (y-axis) and 2.4 cm (z-axis).

This article covers the suitability to measure gait-parameters via a Laser Range Scanner (LRS) that was placed below a chair during the walking phase of the Timed Up&Go Test in a cohort of 92 older adults (mean age 73.5). The results of our study demonstrated a high concordance of gait measurements using a LRS in comparison to the reference GAITRite walkway. Most of aTUG’s gait parameters demonstrate a strong correlation coefficient with the GAITRite, indicating high measurement accuracy for the spatial gait parameters. Measurements of velocity had a correlation coefficient of 99%, which can be interpreted as an excellent measurement accuracy. Cadence showed a slightly lower correlation coefficient of 96%, which is still an exceptionally good result, while step length demonstrated a correlation coefficient of 98% per leg and stride length with an accuracy of 99% per leg. In addition to confirming the technical validation of the aTUG regarding its ability to measure gait parameters, we compared results from the GAITRite and the aTUG for several parameters (cadence, velocity, and step length) with results from the Berg Balance Scale (BBS) and the Activities-Specific Balance Confidence-(ABC)-Scale assessments. With confidence coefficients for BBS and velocity, cadence and step length ranging from 0.595 to 0.798 and for ABC ranging from 0.395 to 0.541, both scales demonstrated only a medium-sized correlation. Thus, we found an association of better walking ability (represented by the measured gait parameters) with better balance (BBC) and balance confidence (ABC) overall scores via linear regression. This results from the fact that the BBS incorporates both static and dynamic balance measures and thus, only partly reflects functional requirements for walking. For the ABC score, this effect was even more pronounced. As this is to our best knowledge the first evaluation of the association between gait parameters and these balance scores, we will further investigate this phenomenon and aim to integrate further measures into the aTUG to achieve an increased sensitivity for balance ability.

Background: Knee osteoarthritis is the occurrence of osteoarthritis (OA) in the knee joint. Osteoarthritis involves the degradation of joints, including articular cartilage and subchondral bone. Osteoarthritis is the most common disease of joints adults suffer from worldwide. The most common procedures done for the treatment of osteoarthritis of knee is a surgical procedure called Total knee arthroplasty (TKA) or total knee replacement (TKR) which is mostly done in advance cases. It is usually starts from age group of 40 and slowly progresses. The most common age group in which its seen is between 50-60 years. They slowly start losing balance after the TKR. Balance is an important aspect of mobility and physical function. Patients with severe OA who are awaiting total hip arthroplasty (THA) or total knee arthroplasty (TKA) are reported to have a higher incidence of falls compared to the general population. Balance Training Exercises with Conventional Therapy gives much better effect. So, the aim of the study is to check the effectiveness of balance training to improve function in patients in post-operative phase following total knee arthroplasty. Materials and methods: 60 patients were included in the study which was divided into two groups; Group A and Group B, 30 patients in each group. Subjects were randomly selected and assigned to each group. Pre-test measurements of the patient were done with the help of TUG for each group. The Subjects in Group-A were given Conventional Therapy. The Subjects in Group-B were given Balance Training Exercises with Conventional Therapy. Then the Result analysis was done. Results: On comparing Group A and Group B for post-treatment TUG score, results showed a significant difference (p=0.001). The overall study proved that Balance Training Exercises with Conventional Therapy is beneficial in improving functional activities and decreasing the disability level. Conclusion: The analysis obtained indicated that Group B (Balance Training Exercises with Conventional Therapy) showed more significant improvement when compared to Group A (Conventional therapy). [ABSTRACT FROM AUTHOR]

Background: The current guidelines for fall prevention in community-dwelling older adults issued by the American Geriatrics Society and British Geriatrics Society (AGS/BGS) indicate an algorithm for identifying who is at increased risk of falling. The predictive accuracy of this algorithm has never been assessed, nor have the consequences that its introduction in clinical practice would bring about. Aims: To evaluate this risk screening algorithm, estimating its predictive accuracy and its potential impact. Methods: The analyses are based on 438 community-dwelling older adults, participating in the InCHIANTI study. We analysed different tests for gait and balance assessment. We compared the AGS/BGS algorithm with alternative strategies for fall prevention not based on fall risk evaluation. Results: The AGS/BGS screening algorithm (using TUG, cut-off 13.5 s) has a sensitivity for single falls of 35.8% (95% confidence interval 23.2%–52.7%) and a specificity of 84.0% (79.3%–88.4%). It marks 18.0% (13.7%–22.4%) of the older population as at high risk. A policy of targeting people with preventive intervention regardless of their individual risk could be as effective as the policy based on risk screening but at the price of intervening on 17.3% (4.1%–34.0%) more people of the older population. Discussion: This study is the first that validates and estimates the impact of the screening algorithm of these guidelines. Main limitations are related to some modelling assumptions. Conclusions: The AGS/BGS screening algorithm has low sensitivity. Nevertheless, its adoption would bring benefits with respect to policies of preventive interventions that act regardless of individual risk assessment. [ABSTRACT FROM AUTHOR]

The purpose of this study was to evaluate the association between functional mobility and mild cognitive impairment in older adults. A total of 800 older adults were recruited (653 controls and 147 subjects with MCI [88 subjects with aMCI and 59 subjects with naMCI]). Motor performance was measured with the Timed Up and Go test (TUG). The demographic factors associated with MCI were: age (OR = 1.05; 95% CI: 1.01-1.09) and the level of education (OR = 0.73; 95% CI: 0.68-0.79). An independent clinical factor associated with MCI was the TUG (OR = 1.14; 95% CI: 1.03-1.27). In the aMCI group, the relation between the TUG and cognitive status occurred (OR = 1.15; 95% CI: 1.02-1.31), whereas in the naMCI group this relationship was not observed. There is an association between cognitive dysfunction and impaired motor performance in older adults with MCI. [ABSTRACT FROM AUTHOR]

• A new kinetic index (K.I.) is proposed to characterize gait deficits. • K.I. has strong correlation with the Time Up and Go (TUG) test score. • K.I. could classify stroke survivors into different homogeneous subgroups. • Implications of the proposed K.I. on clinical assessment are discussed. This paper proposes a new Kinetic Index (K.I.) to characterize the gait deficits in stroke survivors. The index is derived from the fractal properties of surface electromyography (sEMG) signals. The objectives of proposing this K.I. are (i) to find the correlation between sEMG fractal properties with TUG test; (ii) to classify stroke survivors into different homogeneous subgroups based on K.I., and (iii) to compare the classification results based on published methods. To achieve these objectives, 30 stroke survivors with different levels of gait impairments were recruited to perform TUG. sEMG signals from Tibialis Anterior (TA) and Gastrocnemius Lateral (GL) were acquired in a 5-meter walk test. Sliding window Higuchi fractal dimension algorithm was applied to sEMG of these TA and GL muscles to determine the fractal properties. Hierarchical cluster analysis was used to classify stroke survivors into different subgroups with (i) conventional multiple category of gait parameters (Approach 1), and (ii) single input by using the proposed K.I. value (Approach 2). Besides that, classification based on stroke survivors TUG score was also applied. Results showed that K.I. has strong correlation with the TUG score. A higher value in K.I. associates with higher TUG score. This suggests K.I. could quantify gait deficits and detect risk of fall in this population. The classification results from the Approach 1 were similar to previous published studies. The gait parameters from Approach 2 showed similar gait patterns to Approach 1. Meanwhile, gait results from classification based on TUG score yielded heterogeneous subgroups. These results suggested that K.I. was able to assess gait severity among stroke survivors and was more efficient (it requires a single input parameter only) to classify stroke survivors into homogeneous subgroups. [ABSTRACT FROM AUTHOR]

• Static and dynamic balance and fall risk of toe-in/out gait are observed. • TUG test was also done for functional balance. • Toe-in/out gait affect balance at higher degrees of platform tilt. • TUG scores also show significant effects of toe-out/in gait. Toe-in and toe-out foot positions have not yet been tested for dynamic balance and risk of fall. The aim of this study was to investigate the effects of these two modifications on static and dynamic postural stability and risk of fall through instrumental (Biodex Balance System®) and functional (timed up and go-TUG test) tools. Twenty healthy adults (8 males, 12 females, age: 29 ± 4.10 years, BMI: 21.56 ± 2.36 kg/m2) participated in this study. Static and dynamic (levels 8 and 2) balance with single stance and double stance and dynamic (level 8 and levels 6–2) for risk of fall with double stance were tested with the Biodex Balance System with three self-selected feet positions: straight (13.8°), toe-out (35.6°) and toe-in (−11.9°) for each test condition. Additionally, TUG test was performed with toe-out and toe-in gait. The results of repeated measures ANOVA showed significant differences (p < 0.05) between straight and modified toe angles in balance at dynamic level 2 with both double and single stance conditions. Significant differences (p < 0.001) were also found in TUG scores for the test conditions. Toe-in and toe-out gait modifications have significant effects on balance at higher levels of platform tilt and functional balance. Further investigations with knee osteoarthritis patients and electromyography may provide insight in balancing strategies adopted by the body in toe-out and toe-in gait. [ABSTRACT FROM AUTHOR]

The purpose of this study was to evaluate the association between functional mobility performance and executive functions in older adults with the amnestic (aMCI) and nonamnestic (naMCI) type of mild cognitive impairment (MCI), as well as in a control group. A cross-sectional study was conducted among 800 older adults (147 with MCI) who participated in a longitudinal study consisting in an interdisciplinary geriatric assessment and rehabilitation program in Kraków. Motor performance was measured with the Timed Up and Go test (TUG), while standard neuropsychological tests were used to assess different cognitive domains. Analysis of the entire sample showed that almost all cognitive domains and the presence of MCI are associated with functional mobility. Executive functions, letter fluency, and working memory were associated with TUG in the MCI group. The MCI type was not a significant moderator of the relationship between cognitive and motor performance. In group analyses, various cognitive predictors for TUG in the aMCI group, naMCI, and control group were demonstrated. Our results suggest that executive functions and working memory in aMCI and letter fluency in naMCI are independently associated with functional mobility performance. Executive functions are important for gait control in MCI. [ABSTRACT FROM AUTHOR]

Summary: In this case-control study, we concluded that women with distal radial fractures who were surgically treated showed lower grip strength and dynamic body balancing than those of controls. These results suggest that measurements of grip strength and dynamic body balance may be useful screening tools to assess future fracture risk. Introduction: Patients with distal radial fractures (DRFs) are at risk of future fragility fractures. However, their physical characteristics and tendencies for falls remain unclear. We aimed to compare the physical characteristics of women with and without distal radial fractures. Methods: We included 128 women with a DRF as their first fragility fracture (fracture group) who underwent surgical treatment. Concurrently, 128 age- and sex-matched participants without a history of fragility fractures were selected as controls (control group). The participants underwent assessments of grip strength and the body balancing ability test. Measurements were taken twice in the fracture group, at 2 weeks and 6 months postoperatively, and once in the control group. The body balancing ability test included the Functional Reach Test, Timed Up and Go test (TUG), 2-Step test (2ST), and Timed Uni-pedal Stance test. The participants also completed questionnaires about their health. Results: There were no significant differences (p > 0.05) in patient characteristics between the groups. The fracture group showed lower grip strength across all age groups. In the DRF group, prolonged TUG time was observed at 2 weeks postoperatively in all age groups and at 6 months in participants aged 55–74 years; the 2ST score was significantly lower in participants aged between 65 and 74 years. Conclusions: Women with DRF demonstrated lower grip strength and dynamic body balancing ability. Lower grip strength and dynamic body balancing ability were identified as significant risk factors in women with DRF, suggesting that these may be useful screening tools to assess fracture risk. [ABSTRACT FROM AUTHOR]

Abstract Purpose Gait speed in older patients with cancer is associated with mortality risk. One approach to assess gait speed is with the 'Timed Up and Go' (TUG) test. We utilized machine learning algorithms to automatically predict the results of the TUG tests and its association with survival, using patient-generated responses. Methods A decision tree classifier was trained based on functional status data, obtained from preoperative geriatric assessment, and TUG test performance of older patients with cancer. The functional status data were used as input features to the decision tree, and the actual TUG data was used as ground truth labels. The decision tree was constructed to assign each patient to one of three categories: "TUG < 10 s", "TUG ≥ 10 s", and "uncertain." Results In total, 1901 patients (49% women) with a mean age of 80 years were assessed. The most commonly performed operations were urologic, colorectal, and head and neck. The machine learning algorithm identified three features (cane/walker use, ability to walk outside, and ability to perform housework), in predicting TUG results with the decision tree classifier. The overall accuracy, specificity, and sensitivity of the prediction were 78%, 90%, and 66%, respectively. Furthermore, survival rates in each predicted TUG category differed by approximately 1% from the survival rates obtained by categorizing the patients based on their actual TUG results. Conclusions Machine learning algorithms can accurately predict the gait speed of older patients with cancer, based on their response to questions addressing other aspects of functional status. [ABSTRACT FROM AUTHOR]

Introduction: Co-occurrence of physical and cognitive dysfunctions contribute to functional decline and a gradual loss of independence. Objectives: The purpose of this study was to evaluate the association between global cognitive impairment and physical mobility in older adults with and without mild cognitive impairment (MCI). Material and Methods: A total of 800 older adults were recruited (653 with normal cognitive functioning and 147 participants with MCI). Motor performance was measured with the Timed Up and Go test (TUG) and the 6 Minute Walk Test (6MWT). Cognitive functions were evaluated using Mini-Mental State Examination (MMSE) and Addenbrooke's Cognitive Examination (ACE-III). Results: ACE-III scores were associated with the TUG test performance in older adults (with and without MCI), but not with 6MWT results. The overall score in ACE-III and its subscales, i.e. a) memory and fluency in the MCI group and in the total group, and b) fluency in the control group, were associated with TUG after adjusting for age, sex, body mass index, medication use, depressive symptoms, hypertension, coronary artery disease and diabetes. In the case of the 6MWT test results, only the ACE-III fluency subscale scores and not the overall ACE-III score were associated with them. Conclusions: Global cognitive function, verbal fluency and memory were independently associated with the TUG. ACE-III, being a more extensive testing tool than MMSE, made it possible to show the relationship between global cognition and motor skills. [ABSTRACT FROM AUTHOR]

Previously, studies reported that falls analysis is possible in the elderly, when using wearable sensors. However, these devices cannot be worn daily, as they need to be removed and recharged from time-to-time due to their energy consumption, data transfer, attachment to the body, etc. This study proposes to introduce a radar sensor, an unobtrusive technology, for risk of falling analysis and combine its performance with an instrumented insole. We evaluated our methods on datasets acquired during a Timed Up and Go (TUG) test where a stride length (SL) was computed by the insole using three approaches. Only the SL from the third approach was not statistically significant (p = 0.2083 > 0.05) compared to the one provided by the radar, revealing the importance of a sensor location on human body. While reducing the number of force sensors (FSR), the risk scores using an insole containing three FSRs and y-axis of acceleration were not significantly different (p > 0.05) compared to the combination of a single radar and two FSRs. We concluded that contactless TUG testing is feasible, and by supplementing the instrumented insole to the radar, more precise information could be available for the professionals to make accurate decision.

Comprehensive and repetitive assessments are needed to detect physical changes in an older population to prevent functional decline at the earliest possible stage and to initiate preventive interventions. Established instruments like the Timed “Up & Go” (TUG) Test and the Sit-to-Stand Test (SST) require a trained person (e.g., physiotherapist) to assess physical performance. More often, these tests are only applied to a selected group of persons already functionally impaired and not to those who are at potential risk of functional decline. The article introduces the Unsupervised Screening System (USS) for unsupervised self-assessments by older adults and evaluates its validity for the TUG and SST. The USS included ambient and wearable movement sensors to measure the user’s test performance. Sensor datasets of the USS’s light barriers and Inertial Measurement Units (IMU) were analyzed for 91 users aged 73 to 89 years compared to conventional stopwatch measurement. A significant correlation coefficient of 0.89 for the TUG test and of 0.73 for the SST were confirmed among USS’s light barriers. Correspondingly, for the inertial data-based measures, a high and significant correlation of 0.78 for the TUG test and of 0.87 for SST were also found. The USS was a validated and reliable tool to assess TUG and SST.

Diabetes mellitus is a chronic disease defined as a state of hyperglycaemia in fasting or postprandial states. Patients with type 2 diabetes mellitus (T2DM) often show reduced physical function, including low levels of strength, balance or mobility. In this regard, the timed up and go (TUG) is a widely used physical fitness test in people with T2DM. However, there is a lack of studies evaluating the properties TUG in this population. The present study aimed to evaluate the test-retest reliability of kinetic and kinematic parameters obtained from TUG in the diabetic population with different levels of diabetic neuropathy. A total of 56 patients with T2DM participated in the study. They were divided into three groups according to the vibration threshold: (a) severe neuropathy, (b) moderate neuropathy and (c) normal perception. The TUG was performed using two force platforms to assess kinematic measurements. The results show that both kinetic and kinematic variables had good to excellent reliability. The reliability of TUG was excellent for the whole sample and the groups with non-severe neuropathy. However, it was just good for the group with severe neuropathy.

Sanjak, banner and tug are among the important symbols representing state tradition. They have both material and spiritual functions in Anatolian lodge culture. Sanjak, banner and tug stands out as symbolic figures in dervish narrations and ceremonies. In this line, it is seen that most of the related customs and practices of these are projections of the theoretical and philosophical dimension of the order structure. Sanjak, banner and tug are parts of allegoric language and they have their own unique sūfī symbolism with these semantic possibilities. In addition, these figures add different dimensions to the sūfī ceremonies, tradition and terminology. This article investigates the functions of these figures from the perspective in-depth analysis of the symbolic stories in mystic narratives. Furthermore, functions of these figures in the resolution of symbolic practices in the rituals of the sects were examined since resolution of the allegorical language of sanjak, banner and tug constitutes an important semantic ground for understanding sūfī thought. This research consists of two parts. In the first part, the figures of sanjak, banner and tug were examined in terms of their basic references and their origins. In the second part, these elements were examined in terms of their functions as linguistic tools representing the mentioned elements. This study proposes that that there is an important place in the hierarchy of these figures. It was found that these objects were regarded as elements that systematize knowledge and values.

Background: Falls are a common and complex geriatric syndrome. The fear of falling has negative consequences for older adults. Fall Efficacy Scale-International (FES-I) is one of the questionnaires that assesses fear of falling and its Arabic version has established validity. Aim of the work: To evaluate the validity of the modification on original Arabic FES-I to be suitable for the Egyptian culture. Materials and Methods: 100 geriatric patients participated in this research. All participants were subjected to full medical history taking, application of the modified Arabic Falls Efficacy Scale-International (FES-I), Mini mental state examination, Time Up and go test. Results: The present study group included 100 participants 46 men and 54 women with female predominance, with a mean age of 66 years, the minimum age was 60 years and maximum was 85 years. Most of participants age lies between 60ys & 69ys. Medical history revealed that 67 % of participants had no history of falling and 33% with positive history of falling once or more; also 31 % with history of imbalance and 69 % without history of imbalance. From the participants in our study there were 40% below cut off value of TUG (14 sec) (low risk of falling), and 60% above or equal cut off value of TUG (14 sec) (high risk of falling). Also according to Mini Mental Status Examination (MMSE), 59% with mild cognitive impairment (21 to 26 points) and 41% with normal cognitive function. As regards the categories of modified Arabic FES-I; 16% in low concern category, 22% in moderate concern category, 62% in high concern category. In the current study, the validity and reliability of the modified Arabic FES-I have been proved, there was a statistically significant difference between the two ROC curves in favor of the modified FES-I regarding sensitivity (90.9% compared to 72.7%) and in favor of original FES-I regarding specificity (68.7% compared to 58.2%). Modified Arabic FES-I showed significant positive correlation with age and Time Up and go test, history of falling and history of imbalance and a negative correlation with the MMSE. Conclusion: The validated modified Arabic FES-I can be used in assessment of risk of falling among Egyptian geriatric population. The modified Arabic FES-I is more sensitive than the original Arabic FES-I. [ABSTRACT FROM AUTHOR]

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Summary Introduction Implant-based breast reconstruction has relatively high complication rates. Removal of infected implants and immediate autologous reconstruction is a safe single-stage procedure that preserves the native breast skin envelope. Methods A single-centre, retrospective proof-of-concept review of all salvage procedures performed for acute/chronic infected or exposed implant-based reconstructions by a single surgeon over a 6-year period. Results We present 13 cases of a particularly difficult subgroup of acute/chronic infection/extrusion over a 6-year period. All were successfully salvaged in a single procedure by implant removal and immediate free flap reconstruction with no significant complications. All patients had a change of pocket from subpectoral to subcutaneous and partial capsulectomies. Four patients had unilateral DIEP flaps for unilateral reconstruction, 3 bi-pedicle DIEP flaps for unilateral reconstruction, 2 bilateral TUG flaps for unilateral reconstruction, 3 bilateral DIEP flaps for bilateral reconstruction and 1 unilateral DIEP and implant for unilateral reconstruction. Conclusions These patients are often slim with limited donor sites and pose technical challenges, often requiring double free flap reconstructions. Single-stage implant removal and autologous reconstruction preserves the breast skin envelope to maximise cosmesis in a single procedure. The introduction of healthy, well-vascularised tissue may also help treat the infection. [ABSTRACT FROM AUTHOR]