Pedometer Accuracy in Lower Limb Amputees: A Pilot Study

To date there have been no studies examining the accuracy of the pedometer on lower limb amputees. PURPOSE: To measure the accuracy of pedometers in lower limb amputees. METHODS: Four participants (Table 1) had their height and weights measured and were then fitted with a Velcro Walk4Life™ pedometer belt (Walk4Life Inc, Plainfield, IL) around the waistline at the hip. They were then fitted with two pedometers: a SW-701 Digiwalker™ (NEW-LIFESTYLES, Inc., Lee\u27s Summit, MO) spring-levered pedometer on the anterior mid-line of the right hip and a New-Lifestyles® NL-800 (NEW-LIFESTYLES, Inc., Lee\u27s Summit, MO) piezoelectric pedometer just laterally to the SW-701. They then engaged in three walking trials, two on the treadmill at a slower and faster tolerable walking speed for three minutes each, and one over ground for 200m at a self-selected pace. At the end of each trial pedometer counts and actual step counts from a hand tally were recorded. Pedometer error was calculated as [((pedometer steps-actual steps)/actual steps) * 100]. RESULTS: Error was highest in the SW during the slowest walking speeds (14.5 % and 14.6% lower than actual counts in two participants) and was lowest in the NL at the higher walking speeds (3.7% and no error in two participants) during the treadmill trials. Ground walking trials produced least error in all subjects (~1.5%). Subject four was not able to walk at speeds above 2. 5 mph and thus walked on the treadmill at 1.0 and 1.5 mph. Participant two was not able to walk on the treadmill at 3 mph and rain kept participant four from performing the ground-walking trial. CONCLUSION: This pilot study suggests the potential of the pedometer in accurately counting steps in lower limb amputees. There is clearly some discrepancy in those who cannot walk at faster speeds, as indicated by subject four. Research is continuing to examine if right or left amputation, above or below knee amputation, and if prosthetic type affects the pedometer accuracy

Implementasi Program Pencegahan dan Pengendalian Infeksi di RS Umum Royal Prima Tahun 2018

Implementasi  program  pencegahan  dan  pengendalian  infeksi  di  RSU Royal Prima sudah berjalan baik. Dukungan manajemen terhadap program pencegahan dan pengendalian infeksi di RSU Royal Prima juga sudah cukup maksimal. Direktur RSU Royal Prima sudah memahami dan melaksanakan  kegiatan manajerial PPI  yaitu  perencanaan,  pengawasan, pembinaan, monitoring dan evaluasi pelaksanaan program dengan baik. Standar Pelayanan Medik (SPM) bahwa tim PPI yang terlatih dilihat sudah sesuai dengan yang ditetapkan sebanyak 75% tim PPI   sudah mengikuti pendidikan dan pelatihan baik dari luar rumah sakit (PERSI dan HIPPI) ataupun dari dalam rumah sakit (In House Training). Struktur  organisasi  komite  PPIRS  Royal  Prima  sudah  sesuai  dengan susunan  yang  di  tetapkan  Depkes  RI,  2008.  Direktur  sebagai  posisi tertinggi dalam struktur organisasi serta sudah ada susunan komite dan tim PPIRS.     Posisi    komite    PPIRS    juga    sudah    melibatkan    seluruh unit/komite/departemen terkait di rumah sakit. Uraian tugas komite dan tim PPI sudah sesuai antara penentu kebijakan dan pelaksana kebijakan. Terbukti dengan terlaksananya tugas komite PPI dan tim PPI dalam melaksanakan evaluasi berkala pada kebijakan dan pelaksanaan kebijakan PPI. Uraian tugas pengawasan oleh IPCN sudah berjalan baik sedangakan tugas pengawasan oleh IPCLN belum optimal akibat banyaknya tugas dan tanggungjawab yang harus dilaksanakan serta tidak adanya insentif atau tunjangan secara khusus yang diberikan kepada IPCLN. Fasilitas yang disediakan di rumah sakit sudah cukup memadai. Informan menyatakan bahwa penyediaan fasilitas bahan dan peralatan sebagai pelaksanaan program PPI di RSU Royal Prima selalu terpenuhi. Laporan kepada direktur untuk menyediakan barang yang dibutuhkan selalu dipenuhi dan disetujui sehingga gudang penyediaan barang akan menyediakan barang yang dibutuhkan. Penyediaan fasilitas penunjang untuk kerja komite dan tim PPI sudah baik dikarenakan terdapatnya ruangan  khusus komite   PPIRS Royal  Prima.  Manajemen  rumah  sakit telah memberikan perhatian terhadap kelengkapan penyediaan fasilitas sebagai upaya pencegahan dan pengendalian infeksi rumah sakitKomitmen individu sudah tampak dari adanya keinginan dan keperdulian seluruh informan untuk terlibat dan peduli dalam implementasi PPI di rumah  sakit  dengan  adanya  arahan  dari  direktur  rumah  sakit

‘Nothing about us, without us’: reflections on the challenges of building Land in Our Hands, a national land network in Myanmar/Burma

The transition from military dictatorship to an electoral regime has opened limited political spaces for social activism in Myanmar. Some have called the unfolding situation a ‘transition to democracy’. But this is far from the reality for some, if not most, of Myanmar’s ‘rural working people’. This paper explores the trajectory of the national land network called Land in Our Hands (LIOH or Doe Myay), which came into formal existence in 2014. This paper attempts to lay out a more comprehensive account of the historical legacies and internal and external pressures that have been shaping LIOH as a movement building initiative, and in relation to three key dimensions: its identity politics; its ideology and class base; and its political work

Penalty-free feasibility boundary convergent multi-objective evolutionary algorithm for the optimization of water distribution systems

This paper presents a new penalty-free multi-objective evolutionary approach (PFMOEA) for the optimization of water distribution systems (WDSs). The proposed approach utilizes pressure dependent analysis (PDA) to develop a multi-objective evolutionary search. PDA is able to simulate both normal and pressure deficient networks and provides the means to accurately and rapidly identify the feasible region of the solution space, effectively locating global or near global optimal solutions along its active constraint boundary. The significant advantage of this method over previous methods is that it eliminates the need for ad-hoc penalty functions, additional “boundary search” parameters, or special constraint handling procedures. Conceptually, the approach is downright straightforward and probably the simplest hitherto. The PFMOEA has been applied to several WDS benchmarks and its performance examined. It is demonstrated that the approach is highly robust and efficient in locating optimal solutions. Superior results in terms of the initial network construction cost and number of hydraulic simulations required were obtained. The improvements are demonstrated through comparisons with previously published solutions from the literature

Population structure and linkage disequilibrium unravelled in tetraploid potato

Association mapping is considered to be an important alternative strategy for the identification of quantitative trait loci (QTL) as compared to traditional QTL mapping. A necessary prerequisite for association analysis to succeed is detailed information regarding hidden population structure and the extent of linkage disequilibrium. A collection of 430 tetraploid potato cultivars, comprising two association panels, has been analysed with 41 AFLP® and 53 SSR primer combinations yielding 3364 AFLP fragments and 653 microsatellite alleles, respectively. Polymorphism information content values and detected number of alleles for the SSRs studied illustrate that commercial potato germplasm seems to be equally diverse as Latin American landrace material. Genome-wide linkage disequilibrium (LD)—reported for the first time for tetraploid potato—was observed up to approximately 5 cM using r2 higher than 0.1 as a criterion for significant LD. Within-group LD, however, stretched on average twice as far when compared to overall LD. A Bayesian approach, a distance-based hierarchical clustering approach as well as principal coordinate analysis were adopted to enquire into population structure. Groups differing in year of market release and market segment (starch, processing industry and fresh consumption) were repeatedly detected. The observation of LD up to 5 cM is promising because the required marker density is not likely to disable the possibilities for association mapping research in tetraploid potato. Population structure appeared to be weak, but strong enough to demand careful modelling of genetic relationships in subsequent marker-trait association analyses. There seems to be a good chance that linkage-based marker-trait associations can be identified at moderate marker densities

Oral abstracts of the 21st International AIDS Conference 18-22 July 2016, Durban, South Africa

The rate at which HIV-1 infected individuals progress to AIDS is highly variable and impacted by T cell immunity. CD8 T cell inhibitory molecules are up-regulated in HIV-1 infection and associate with immune dysfunction. We evaluated participants (n=122) recruited to the SPARTAC randomised clinical trial to determine whether CD8 T cell exhaustion markers PD-1, Lag-3 and Tim-3 were associated with immune activation and disease progression.Expression of PD-1, Tim-3, Lag-3 and CD38 on CD8 T cells from the closest pre-therapy time-point to seroconversion was measured by flow cytometry, and correlated with surrogate markers of HIV-1 disease (HIV-1 plasma viral load (pVL) and CD4 T cell count) and the trial endpoint (time to CD4 count <350 cells/μl or initiation of antiretroviral therapy). To explore the functional significance of these markers, co-expression of Eomes, T-bet and CD39 was assessed.Expression of PD-1 on CD8 and CD38 CD8 T cells correlated with pVL and CD4 count at baseline, and predicted time to the trial endpoint. Lag-3 expression was associated with pVL but not CD4 count. For all exhaustion markers, expression of CD38 on CD8 T cells increased the strength of associations. In Cox models, progression to the trial endpoint was most marked for PD-1/CD38 co-expressing cells, with evidence for a stronger effect within 12 weeks from confirmed diagnosis of PHI. The effect of PD-1 and Lag-3 expression on CD8 T cells retained statistical significance in Cox proportional hazards models including antiretroviral therapy and CD4 count, but not pVL as co-variants.Expression of ‘exhaustion’ or ‘immune checkpoint’ markers in early HIV-1 infection is associated with clinical progression and is impacted by immune activation and the duration of infection. New markers to identify exhausted T cells and novel interventions to reverse exhaustion may inform the development of novel immunotherapeutic approaches