Robotic structures based on variable stiffness enable high-performance and flexible motion systems that are inherently safe and thus allow safe Human-Robot Collaboration. This letter presents the ...design of a robotic structure based on variable stiffness. A robotic manipulator is developed using three variable stiff segments based on particle jamming with a backbone architecture and two tendons for an underactuated motion control of the whole structure. By switching the structural stiffness, the manipulator is able to perform complex planar motion with only one pair of tendons, reducing the number of actuators required. A kinematic modeling approach for the calculation of the forward kinematics of this soft continuum structure is presented, and the validation on the real system is explained. The kinematic simulation is performed with a multibody simulation model (MBS) using rigid body elements in combination with rotational springs. The validation of the model is carried out with visual measurements of the real system using defined target shapes. Simulation and experimental results are discussed and compared also with a common constant curvature model. The developed MBS-model demonstrates a promising modeling approach with a position error lower 3% for the calculation of the presented manipulator under gravity.
The Shared Socioeconomic Pathways (SSPs) were developed without explicit assumptions for the future of the water sector; therefore, projections of future water demands based on the SSPs often lack a ...treatment of water technology assumptions that is consistent with the SSP storylines. This study has developed a set of qualitative and quantitative assumptions for future water sector technological advancements in the agricultural, electricity, manufacturing, and municipal sectors within the SSPs and then applied the resulting scenarios to an integrated assessment model to permit analysis of future water demand in a water‐constrained world. These scenarios are then compared to another set that excludes the adoption of water‐efficient technologies. Water demand impacts of individual SSP assumption categories are analyzed to determine scenario‐by‐scenario changes. By 2100, global annual water demands range from 3,560 to 6,600 km3. The results show that (1) technological change in the water sector can act to reduce water demand in a water limited world by up to 32% in 2100 in the SSP scenarios, (2) the most sustainable scenario produces end‐of‐century water withdrawals lower than 2010 values, (3) low‐income regions will likely be one of the largest drivers of future water demands and exhibit the greatest sensitivity to highly‐efficient water technologies, and (4) nonwater sector SSP assumptions have significant and differing impacts on demands across SSP scenarios that act to alter global water demands.
Key Points
Shared Socioeconomic Pathway qualitative and quantitative model assumptions are expanded to include the water sector
Future global water demand for all five SSP scenarios is analyzed with and without technological advancements in the water sector
Where water supplies are constrained, global water demand reductions of up to 32% are possible in SSP scenarios by 2100
. Wilhelm‐Leen ER, Hall YN, deBoer IH, Chertow GM. (Stanford University School of Medicine; University of Washington; Stanford University School of Medicine, Palo Alto, CA, USA). Vitamin D ...deficiency and frailty in older Americans. J Intern Med 2010; 268: 171–180.
Objective. To explore the relation between 25‐hydroxyvitamin D deficiency and frailty. Frailty is a multidimensional phenotype that describes declining physical function and a vulnerability to adverse outcomes in the setting of physical stress such as illness or hospitalization. Low serum concentrations of 25‐hydroxyvitamin D are known to be associated with multiple chronic diseases such as cardiovascular disease and diabetes, in addition to all cause mortality.
Design. Using data from the Third National Health and Nutrition Survey (NHANES III), we evaluated the association between low serum 25‐hydroxyvitamin D concentration and frailty, defined according to a set of criteria derived from a definition previously described and validated.
Subjects. Nationally representative survey of noninstitutionalized US residents collected between 1988 and 1994.
Results. 25‐Hydroxyvitamin D deficiency, defined as a serum concentration <15 ng mL−1, was associated with a 3.7‐fold increase in the odds of frailty amongst whites and a fourfold increase in the odds of frailty amongst non‐whites. This association persisted after sensitivity analyses adjusting for season of the year and latitude of residence, intended to reduce misclassification of persons as 25‐hydroxyvitamin D deficient or insufficient.
Conclusion. Low serum 25‐hydroxyvitamin D concentrations are associated with frailty amongst older adults.
Abstract Background Frailty is common in the elderly and in persons with chronic diseases. Few studies have examined the association of frailty with chronic kidney disease. Methods We used data from ...the Third National Health and Nutrition Examination Survey to estimate the prevalence of frailty among persons with chronic kidney disease. We created a definition of frailty based on established validated criteria, modified to accommodate available data. We used logistic regression to determine whether and to what degree stages of chronic kidney disease were associated with frailty. We also examined factors that might mediate the association between frailty and chronic kidney disease. Results The overall prevalence of frailty was 2.8%. However, among persons with moderate to severe chronic kidney disease (estimated glomerular filtration rate < 45 mL/min/1.73 m2 ), 20.9% were frail. The odds of frailty were significantly increased among all stages of chronic kidney disease, even after adjustment for the residual effects of age, sex, race, and prevalent chronic diseases. The odds of frailty associated with chronic kidney disease were only marginally attenuated with additional adjustment for sarcopenia, anemia, acidosis, inflammation, vitamin D deficiency, hypertension, and cardiovascular disease. Frailty and chronic kidney disease were independently associated with mortality. Conclusion Frailty is significantly associated with all stages of chronic kidney disease and particularly with moderate to severe chronic kidney disease. Potential mechanisms underlying the chronic kidney disease and frailty connection remain elusive.
Aim
Lead migration is a common cause of loss of efficacy in sacral nerve modulation. Our aim was to systematically study the migration pattern of tined leads in sacral nerve modulation. Our ...hypothesis was that tined leads may promote forward migration because of their configuration.
Method
Consecutive patients treated with sacral nerve modulation with a tined lead electrode, who had experienced loss of efficacy and had radiographs both at baseline and after loss of efficacy between 2005 and 2016 were eligible for inclusion.
Results
Twenty-five patients out of 70 with loss of efficacy were studied. Lead migration was measured as percent electrode movement in relation to sacral cortex at lateral projection. All had some degree of lead migration, ranging from 35% backward to 74% forward migration. Sixteen (64%) had forward migration while nine (36%) had backward migration. In seven patients (28%), loss of efficacy was associated with an episode of perceived mechanical strain on the electrode. Fifty percent (4/8) who associated their loss of efficacy with an adverse event had forward migration of the electrode.
Conclusions
Forward lead migration with concomitant loss of efficacy seems to be a common event in patients with tined leads, hence supporting our hypothesis. The retrospective design and that some of the patients with loss of efficacy could not be included because of incomplete data, which is a limitation to the study. Further studies are needed to confirm to what extent the direction and magnitude of the migration relate to loss of efficacy.
Trial registration
People have a stake in conservation and environmental management both for their own interests and the sake of the environment itself. Environmental decision-making has changed somewhat in recent ...decades to account for unintentional impacts on human wellbeing. The involvement of stakeholders in environmental projects has been recognised as critical for ensuring their success and equally for the syntheses of evidence of what works, where, and for whom, providing key benefits and challenges. As a result of increased interest in systematic reviews of complex management issues, there is a need for guidance in best practices for stakeholder engagement. Here, we propose a framework for stakeholder engagement in systematic reviews/systematic maps, highlighting recommendations and advice that are critical for effective, efficient and meaningful engagement of stakeholders. The discussion herein aims to provide a toolbox of stakeholder engagement activities, whilst also recommending approaches from stakeholder engagement research that may prove to be particularly useful for systematic reviews and systematic maps.
Metabolic syndrome is characterized by central obesity, insulin resistance, elevated blood pressure, and dyslipidemia. Metabolic syndrome is a significant risk factor for several common cancers ...(e.g., liver, colorectal, breast, pancreas). Pharmacologic treatments used for the components of the metabolic syndrome appear to be insufficient to control cancer development in subjects with metabolic syndrome. Murine models showed that cancer has the slowest progression when there is no food consumption during the daily activity phase. Intermittent fasting from dawn to sunset is a form of fasting practiced during human activity hours. To test the anticancer effect of intermittent fasting from dawn to sunset in metabolic syndrome, we conducted a pilot study in 14 subjects with metabolic syndrome who fasted (no eating or drinking) from dawn to sunset for more than 14 h daily for four consecutive weeks. We collected serum samples before 4-week intermittent fasting, at the end of 4th week during 4-week intermittent fasting and 1 week after 4-week intermittent fasting. We performed serum proteomic analysis using nano ultra-high performance liquid chromatography-tandem mass spectrometry. We found a significant fold increase in the levels of several tumor suppressor and DNA repair gene protein products (GP)s at the end of 4th week during 4-week intermittent fasting (CALU, INTS6, KIT, CROCC, PIGR), and 1 week after 4-week intermittent fasting (CALU, CALR, IGFBP4, SEMA4B) compared with the levels before 4-week intermittent fasting. We also found a significant reduction in the levels of tumor promoter GPs at the end of 4th week during 4-week intermittent fasting (POLK, CD109, CAMP, NIFK, SRGN), and 1 week after 4-week intermittent fasting (CAMP, PLAC1) compared with the levels before 4-week intermittent fasting. Fasting from dawn to sunset for four weeks also induced an anti-diabetes proteome response by upregulating the key regulatory proteins of insulin signaling at the end of 4th week during 4-week intermittent fasting (VPS8, POLRMT, IGFBP-5) and 1 week after 4-week intermittent fasting (PRKCSH), and an anti-aging proteome response by upregulating H2B histone proteins 1 week after 4-week intermittent fasting. Subjects had a significant reduction in body mass index, waist circumference, and improvement in blood pressure that co-occurred with the anticancer, anti-diabetes, and anti-aging serum proteome response. These findings suggest that intermittent fasting from dawn to sunset actively modulates the respective genes and can be an adjunct treatment in metabolic syndrome. Further studies are needed to test the intermittent fasting from dawn to sunset in the prevention and treatment of metabolic syndrome-induced cancers.
We investigated the response of wurzite GaN thin films to energetic ion irradiation. Both swift heavy ions (92 MeV Xe23+, 23 MeV I6+) and highly charged ions (100 keV Xe40+) were used. After ...irradiation, the samples were investigated using atomic force microscopy, grazing incidence small angle x-ray scattering, Rutherford backscattering spectroscopy in channelling orientation and time of flight elastic recoil detection analysis. Only grazing incidence swift heavy ion irradiation induced changes on the surface of the GaN, when the appearance of nanoholes is accompanied by a notable loss of nitrogen. The results are discussed in the framework of the thermal spike model.
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