Post-hoc analysis showed that patients with longer TMT-A time (≥23 s) tended to have longer P3a latency than those with shorter TMT-A time. Conclusions. Decreased psychomotor speed predicted poor clinical outcomes. Because TMT-A time can be performed at the bedside in a relatively short time, this might be a useful neuropsychological biomarker to predict or monitor clinical outcomes. Furthermore, passive oddball P3a may be useful in patients with more severe disease who are unable to perform the TMT task.Background Presentations to the emergency department (ED) by patients with end-of-life (EOL) conditions for their acute care needs are common. Objectives The objective of this study was to identify and describe the ED management across presentations to the ED for EOL conditions. Design Prospective observational cohort study. Settings/Subjects Emergency physicians in two Canadian ED's were asked to identify presentations by adult patients with EOL conditions using a modified screening tool. Measurements Patient characteristics and ED management for each presentation were collected through chart review by trained research assistants. Descriptive analyses were conducted as appropriate and bivariate comparisons of dichotomous and continuous variables were completed using χ2 tests and using t test or Wilcoxon rank-sum test, respectively. Results Physicians identified 663 ED presentations for EOL conditions, with advanced cancer (41%), dementia (23%), and chronic obstructive pulmonary disease (16%) being the most common EOL conditions. The majority of presentations involved consultations (77%), hospitalization (65%), and numerous investigations (97%), including blood work (97%) and imaging (92%). The majority of patients with EOL conditions had a history of ED visits (68%). Using a modified screening tool, 78% of presentations involved patients with unmet palliative care needs, but only 1% of presentations involved a palliative consultation or admission to a palliative care unit. Conclusion Presentations to the ED for EOL conditions involve significant ED resources; however, only a handful of patients are referred to palliative services. Patients with EOL conditions are appropriate targets for palliative services and community support outside the ED.Soft pneumatic actuators (SPAs) are extensively investigated due to their simple control strategies for producing sophisticated motions. However, the motions or operations of homogeneous SPAs show obvious limitations in some varying curvature interaction scenarios because of the profile mismatch of homogeneous SPAs and specific interacted objects.  https://www.selleckchem.com/products/gsk8612.html  Herein, a stiffness preprogrammable soft pneumatic actuator (SPSPA) is proposed by discretely presetting gradient geometrical or materials distributions. Through finite element analysis and experimental validation, a mathematical model of behavior prediction of SPSPA was built to relate the geometrical parameters/materials with its morphing behaviors, making it possible to reversely obtain designed parameters. This design strategy enables conformal and efficient interaction in some curvature varying scenarios. Specifically, higher effective contact area, perimeter utilization ratio, and conformal ability can be obtained while interacting with those inhomogeneous curvature objects, for example, more than 434.7% improvement in contact area rates and 12.5% enhancement in perimeter utilization ratios toward a typical equilateral triangle object. Further, a serial of SPSPAs that have conformal grasping/interactive capability, better contact sensing behaviors were demonstrated. For example, an SPSPA and an SPSP robot were demonstrated, which showed better kinetic, kinematic characterizations and sensing capability compared with the homogeneous one while coming across varying curvature objects. Moreover, underactuated finger rehabilitation SPSPAs were demonstrated with customized profiles and coupled joint motion. This customized scheme can be potentially used in those specific-purposed, single, and repetitive application scenarios where varying curvature, conformal and efficient interaction are needed.
  An anteroposterior (AP) radiograph of the elbow in 45° of flexion has been suggested to increase the diagnostic accuracy of capitellum osteochondritis dissecans (OCD).
 
  To assess the diagnostic performance, inter- and intraobserver reliability, and confidence level for identifying capitellum OCD using plain radiographs (AP, lateral, and 45° flexion AP).
 
  Cohort study (Diagnosis); Level of evidence, 3.
 
  This was a retrospective study of pediatric and adolescent patients with capitellum OCD and a control group. Six independent clinicians who were blinded to the official radiologists' reports reviewed images on 2 separate occasions, 1 week apart. A 5-point Likert scale was used to assess the clinicians' level of confidence. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy were calculated for individual and combinations of radiographic views. Inter- and intraobserver reliability was determined using Cohen kappa (κ) coefficients.
 
  A total of 28 elbows (to almost perfect (κ = 0.45 to 0.93).
 
  The 45° flexion AP view can detect capitellum OCD with excellent accuracy, a high level of confidence, and substantial interobserver agreement. When added to standard AP and lateral radiographs, the 45° flexion AP view aids in the identification of capitellum OCD.
 The 45° flexion AP view can detect capitellum OCD with excellent accuracy, a high level of confidence, and substantial interobserver agreement. When added to standard AP and lateral radiographs, the 45° flexion AP view aids in the identification of capitellum OCD.Background The association between sarcopenia and protein intake has been well studied. However, limited data are available on the association between sarcopenia and protein intake in people with nonalcoholic fatty liver disease (NAFLD). This study aimed to investigate the association between protein intake and sarcopenia among elderly participants with NAFLD using the Korea National Health and Nutrition Examination Survey (KNHANES). Methods Data of 4179 participants (1576 men and 2603 women, age ≥60 years) who participated in the KNHANES during 2008-2011 were obtained. Sarcopenia was defined as appendicular skeletal muscle mass/wt (%) of 1 standard deviation below the gender-specific mean for healthy adults and NAFLD as liver fat score using the fatty liver prediction models. According to their daily protein intake, participants were grouped into the high protein intake group (>1.2 g/kg/day), middle protein intake group (0.8-1.2 g/kg/day), and low protein intake group ( less then 0.8 g/kg/day). Generalized linear models and logistic regression models were used.