Browsing by Subject "Trajectory"

Now showing 1 - 3 of 3
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    Identification, Quantification, and Characterization of Nursing Home Resident Pain Trajectories
    (2022-05) Cole, Connie Sue; Hickman, Susan; Blackburn, Justin; Carpenter, Janet S.; Chen, Chen X.
    Pain prevalence in nursing home (NH) residents is high. Studies report up to 85.0% of NH residents experience pain and up to 58.0% experience persistent pain. Pain in NH residents can lead to decreased happiness, quality of life, and life satisfaction. Traditionally, pain has been studied in relation to specific comorbid conditions or pain subtypes (nociceptive, neuropathic) with little consideration for the dynamic (temporal) nature of pain. Current pain subtypes are clinically linked to recommended pain treatments and provide insight into underlying mechanisms. However, current pain subtypes are limited by their focus on pain origin, do not include severity or duration of the pain experience, and do not illustrate how the course or trajectory of pain changes over time. Understanding the trajectory of pain experience can provide opportunities to alter the course of pain experience, improve residents’ quality of life and prevent adverse outcomes. This dissertation provides the first evidence of four distinct pain trajectories among NH residents including persistent pain which was associated with several resident characteristics and clinically relevant diagnosis. Using residents’ characteristics associated with persistent pain, such as a history of fracture or contracture, may improve care planning based on early identification or risk stratification and can improve mitigation of persistent pain. To identify and characterize pain trajectories in NH residents, the following activities were completed (1) systematic review of the literature related to prevalence of pain and associated factors in NH residents, (2) cross-sectional analysis of secondary data to examine prevalence of pain, persistent pain, and factors associated with pain in NH residents, and (3) a longitudinal retrospective analysis of secondary data using group-based trajectory modeling to identify, quantify, and characterize NH pain trajectories. The findings from this study highlight the prevalence and complexity of pain in NH residents.
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    Robustness Improvement of Computationally Efficient Cooperative Fuzzy Model Predictive-Integral Sliding Mode Control of Nonlinear Systems
    (IEEE, 2021) Farbood, Mohsen; Veysi, Mohammad; Shasadeghi, Mokhtar; Izadian, Afshin; Niknam, Taher; Aghaei, Jamshid; Engineering Technology, Purdue School of Engineering and Technology
    This paper introduces a systematic and comprehensive method to design a constrained fuzzy model predictive control (MPC) cooperated with integral sliding mode control (ISMC) based on the Takagi-Sugeno (T-S) fuzzy model for uncertain continuous-time nonlinear systems subject to external disturbances. The proposed controller benefits from the robustness, optimality, and practical constraints considerations. The robustness against the uncertainties and matched external disturbances is achieved by the proposed ISMC without iterative calculation for obtaining the robust invariant set. The MPC schemes are designed separately based on the both quadratic and non-quadratic Lyapunov functions. By the proposed MPC, the states of the system reach the desired values in the optimal, constrained, and robust manner against the unmatched external disturbances. New linear matrix inequalities (LMIs) conditions are proposed to design both the proposed MPC schemes. Also, the practical constraints on the control signals are guaranteed in the design procedure based on the invariant ellipsoid set. To evaluate the effectiveness of the suggested strategy, some simulation and experimental tests were run.
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    Trajectories of antenatal depression and adverse pregnancy outcomes
    (Elsevier, 2022) Miller, Emily S.; Saade, George R.; Simhan, Hyagriv N.; Monk, Catherine; Haas, David M.; Silver, Robert M.; Mercer, Brian M.; Parry, Samuel; Wing, Deborah A.; Reddy, Uma M.; Grobman, William A.; Obstetrics and Gynecology, School of Medicine
    Background: Antenatal depression affects approximately 1 of 7 pregnancies, with an increasing prevalence across gestation. Data regarding the associations between antenatal depression and adverse pregnancy outcomes yielded conflicting results. However, previous studies evaluated the cross-sectional prevalence of depression at various time points and not the depressive symptom trajectory across gestation. Objective: This study aimed to identify whether the trajectory of antenatal depressive symptoms is associated with different risks of adverse pregnancy outcomes. Study design: This was a secondary analysis of a large multisite prospective cohort of nulliparous women across the United States. The Edinburgh Postpartum Depression Scale was administered at 2 study visits: between 6 and 14 weeks' gestation and between 22 and 30 weeks' gestation. The Edinburgh Postpartum Depression Scale score trajectories were categorized as improved, stable, or worsened based on whether the scores changed by at least 1 standard deviation between the 2 visits. The frequencies of adverse pregnancy outcomes (hypertensive disorders of pregnancy, abruption, cesarean delivery, preterm birth [ie, <37 weeks' gestation], small for gestational age neonates, neonatal intensive care unit admission, and maternal readmission) were compared with depression trajectories across gestation in bivariable and multivariable analyses. Secondary analyses evaluated the frequencies of spontaneous and medically indicated preterm births and frequencies of spontaneous and medically indicated preterm births before 35, 32, and 28 weeks' gestation. Results: Of the 8784 women who completed the 2 antenatal Edinburgh Postpartum Depression Scale screens, 1141 (13.0%) had improved, 6663 (75.9%) had stable, and 980 (11.2%) had worsened depressive symptom trajectories across gestation. Compared with women with improved or stable depressive symptoms, those with worsened symptoms were more likely to experience preterm birth (8.3% vs 7.4% vs 9.9%, respectively; P=.018). After controlling for potential confounders, worsened depressive symptoms remained associated with more frequent preterm birth (adjusted odds ratio, 1.68; 95% confidence interval, 1.10-2.57). Conclusion: Women with depression symptoms that worsen as pregnancy progresses have increased odds of preterm birth. Future research is warranted to optimize and implement effective prevention, screening, and treatment protocols for antenatal depressive symptoms as a strategy to prevent preterm birth.