Prediction of foot clearance parameters as a precursor to forecasting the risk of tripping and falling

Tripping and falling is a serious health problem for older citizens due to the high medical costs incurred and the high mortality rates precipitated mostly by hip fractures that do not heal well. Current falls prevention technology encompasses a broad range of interventions; both passive (e.g., safer environments, hip protectors) and active (e.g., sensor-based fall detectors) which attempt to reduce the effects of tripping and falling. However the majority of these interventions minimizes the impact of falls and do not directly reduce the risk of falling. This paper investigates the prediction of gait parameters related to foot-to-ground clearance height during the leg swing phase which have been physically associated with tripping and falling risk in the elderly. The objective is to predict parameters of foot trajectory several walking cycles in advance so that anticipated low foot clearance could be addressed early with more volitional countermeasures, e.g., slowing down or stopping. In this primer study, foot kinematics was recorded with a highly accurate motion capture system for 10 healthy adults (25-32 years) and 11 older adults (65-82 years) with a history of falls who each performed treadmill walking for at least 10 min. Vertical foot displacement during the swing phase has three characteristic inflection points and we used these peak values and their normalized time as the target prediction values. These target variables were paired with features extracted from the corresponding foot acceleration signal (obtained through double differentiation). A generalized regression neural network (GRNN) was used to independently predict the gait variables over a prediction horizon (number of gait cycles ahead) of 1-10 gait cycles. It was found that the GRNN attained 0.32-1.10 cm prediction errors in the peak variables and 2-8% errors in the prediction of normalized peak times, with slightly better accuracies in the healthy group compared to elderly fallers. Prediction accuracy decreased linearly (best fit) at a slow rate with increasing prediction horizon ranging from 0.03 to 0.11 cm per step for peak displacement variables and 0.34 × 10(-3) - 1.81 × 10(-3)% per step for normalized peak time variables. Further time series analysis of the target gait variable revealed high autocorrelations in the faller group indicating the presence of cyclic patterns in elderly walking strategies compared to almost random walking patterns in the healthy group. The results are promising because the technique can be extended to portable sensor-based devices which measure foot accelerations to predict the onset of risky foot clearance, thus leading to a more effective falls prevention technology.     

Motivational reserve: motivation-related occupational abilities and risk of mild cognitive impairment and Alzheimer disease

Midlife motivational abilities, that is, skills to initiate and persevere in the implementation of goals, have been related to mental and physical health, but their association with risk of mild cognitive impairment (MCI) and Alzheimer's disease (AD) has not yet been directly investigated. This relation was examined with data from the German Study on Ageing, Cognition, and Dementia in Primary Care Patients (AgeCoDe). A total of 3,327 nondemented participants (50.3% of a randomly selected sample) aged 75-89 years were recruited in primary care and followed up twice (after 1.5 and 3 years). Motivation-related occupational abilities were estimated on the basis of the main occupation (assessed at follow-up II) using the Occupational Information Network (O* NET) database, which provides detailed information on worker characteristics and abilities. Cox proportional hazards models were used to evaluate the relative risk of developing MCI and AD in relation to motivation-related occupational abilities, adjusting for various covariates. Over the 3 years of follow-up, 15.2% participants developed MCI and 3.0% developed AD. In a fully adjusted model, motivation-related occupational abilities were found to be associated with a reduced risk of MCI (HR: 0.77; 95% CI: 0.64-0.92). Motivation-related occupational abilities were associated with reduced risk of AD in ApoE ε4 carriers (HR: 0.48; CI: 0.25-0.91), but not in noncarriers (HR: 0.99; CI: 0.65-1.53). These results suggest that midlife motivational abilities are associated with reduced risk of MCI in general and with reduced risk of AD in ApoE ε4 carriers. Revealing the mechanisms underlying this association may inform novel prevention strategies for decelerating cognitive decline in old age.     

Careful what you wish for: the primary role of malicious Envy in Predicting Moral Disengagement

Motivation and Emotion - Envy has been positively associated with both moral disengagement and organizational unethical decision-making. Nevertheless, extant research suffers from a number of...     

Classification and differentiation of bladder and bowel related anxieties: A socio-cognitive exploration

Current Psychology - The current study aimed to explore the validity of a single, self-report measure for bladder and bowel anxieties (Bladder and Bowel Anxiety Grouping Item; BABAGI), using two...     

Philosophy of medicine in 2021

Theoretical Medicine and Bioethics -     

An empirically derived scoring system for intermale aggression in mice

Scoring systems used to assess intermale aggression have been characterized by arbitrary scales and wide variability in the behaviors selected for measurement. The use of such different systems severely limits the ability of investigators to make meaningful comparisons among studies and indicates that there is a need for a common, statistically derived evaluative system for intermale aggression. We measured the frequency and duration of five major components of agonistic behavior exhibited by intact males toward olfactory bulbectomized stimulus males and then analyzed the data using a number of univariate and multivariate procedures. The results were used to generate two statistically based scoring systems, one a short-form index and the other a composite index for more detailed studies of aggression. It is hoped that these statistically derived systems will be adopted by other investigators to increase methodological congruence in the field.     

Interpretation of Baladeva and Yamunā at Harivaṃśa 83

International Journal of Hindu Studies - In Harivaṃśa chapter 83, Kṛṣṇa’s brother Baladeva changes the course of the river Yamunā, using his plough. This...     

Elevation and reduction of plasma tryptophan and their effects on aggression and perceptual sensitivity in normal males

Data from experimental animals suggest that 5-hydroxytryptamine (5HT) may have an inhibitory effect on aggression, while clinical studies have found a correlation between pathological aggression and low brain 5HT. To investigate this relationship further we used amino acid mixtures designed to raise or lower the levels of the 5HT precursor, tryptophan. Normal male subjects were given tryptophan-depleted, balanced, or tryptophan-supplemented ammo acid mixtures and tested for aggression 5 hours later. The balanced amino acid mixture served as a control for the tryptophan depletion and supplementation. Testing for aggression was done using the Buss paradigm in which subjects deliver electric shocks to a (nonexistent) partner in response to stimulus tones. Duration and intensity of shock delivered were the measures of aggression, while responsivity to the stimulus tones was the measure of perceptual sensitivity. Neither tryptophan supplementation nor tryptophan depletion had any effect on these measures of aggression or perceptual sensitivity. We conclude that raising or lowering the synthesis of brain 5HT through alterations in tryptophan availability does not influence aggression in normal males as measured by the Buss task.