Diagnostic accuracy of calculated serum osmolarity to predict dehydration in older people: adding value to pathology lab reports

Objectives: To assess which osmolarity equation best predicts directly measured serum/plasma osmolality and whether its use could add value to routine blood test results through screening for dehydration in older people. Design: Diagnostic accuracy study Participants: Older people (≥65 years) in 5 cohorts: Dietary Strategies for Healthy Ageing in Europe (NU-AGE, living in the community), Dehydration Recognition In our Elders (DRIE, living in residential care), Fortes (admitted to acute medical care), Sjöstrand (emergency room) or Pfortmueller cohorts (hospitalised with liver cirrhosis). Reference standard for hydration status: Directly measured serum/plasma osmolality: current dehydration (serum osmolality >300mOsm/kg), impending/current dehydration (≥295mOsm/kg). Index tests: 39 osmolarity equations calculated using serum indices from the same blood draw as directly measured osmolality. Results: Across five cohorts 595 older people were included, of whom 19% were dehydrated (directly measured osmolality >300mOsm/kg). Of 39 osmolarity equations, five showed reasonable agreement with directly measured osmolality and three had good predictive accuracy in subgroups with diabetes and poor renal function. Two equations were characterized by narrower limits of agreement, low levels of differential bias and good diagnostic accuracy in ROC plots (areas under the curve >0.8). The best equation was osmolarity =1.86 × (Na+ + K+) + 1.15 × glucose + urea + 14 (all measured in mmol/L). It appeared useful in people aged ≥65 years with and without diabetes, poor renal function, dehydration, in men and women, with a range of ages, health, cognitive and functional status. Conclusions: Some commonly used osmolarity equations work poorly, and should not be used. Given costs and prevalence of dehydration in older people we suggest use of the best formula by pathology laboratories using a cutpoint of 295mOsm/L (sensitivity 85%, specificity 59%), to report dehydration risk opportunistically when serum glucose, urea and electrolytes are measured for other reasons in older adults

Contraception Use among African American and Caucasian College Students

Honorable Mention at the 2013 Denman Undergraduate Research ForumUnintended pregnancies, totaling nearly 3 million each year in the U.S., are associated with increased health risks for both the mother and baby. Former research has shown women of racial minorities are at disproportionally higher risks for unintended pregnancy as a result of less effective contraceptive behaviors. This study aimed to explore the differences in contraceptive behaviors amongst racial subgroups. The purpose of this secondary analysis was to analyze women’s contraceptive choices and determine if there are differences between those of African American and Caucasian women. Women (N = 196; 32% African American) ages 18 – 30 years were recruited for the parent study from a large Midwestern university through internet newsletters. Interested women contacted the PI (second author) who explained the purposes of the study. Those interested were given a secure, on-line link in which to complete informed consent and fill out the study questionnaires. For this analysis a survey using closed- and open-ended questions asking about contraceptive practices was implemented. Data were analyzed with descriptive statistics and chi-square tests. Findings indicated oral contraceptives, condoms, the morning after pill, and withdrawal were the most used by women as contraceptive methods. Additionally, the study revealed oral contraceptives use was significantly more likely by Caucasian women. Although there was not a significant relationship in this sample, results showed African American women reported using the NuvaRing® or no method more than Caucasian women. This information identifies disparities within contraceptive use and helps guide research and practice in discerning underlying mechanisms in contraceptive behaviors.No embargoAcademic Major: Nursin

The OSIRIS-Rex Asteroid Sample Return: Mission Operations Design

The OSIRIS-REx mission employs a methodical, phased approach to ensure success in meeting the missions science requirements. OSIRIS-REx launches in September 2016, with a backup launch period occurring one year later. Sampling occurs in 2019. The departure burn from Bennu occurs in March 2021. On September 24, 2023, the SRC lands at the Utah Test and Training Range (UTTR). Stardust heritage procedures are followed to transport the SRC to Johnson Space Center, where the samples are removed and delivered to the OSIRIS-REx curation facility. After a six-month preliminary examination period the mission will produce a catalog of the returned sample, allowing the worldwide community to request samples for detailed analysis.Traveling and returning a sample from an Asteroid that has not been explored before requires unique operations consideration. The Design Reference Mission (DRM) ties together space craft, instrument and operations scenarios. The project implemented lessons learned from other small body missions: APLNEAR, JPLDAWN and ESARosetta. The key lesson learned was expected the unexpected and implement planning tools early in the lifecycle. In preparation to PDR, the project changed the asteroid arrival date, to arrive one year earlier and provided additional time margin. STK is used for Mission Design and STKScheduler for instrument coverage analysis

Hot and hypoxic environments inhibit simulated soccer performance and exacerbate performance decrements when combined.

The effects of heat and/or hypoxia have been well-documented in match-play data. However, large match-to-match variation for key physical performance measures makes environmental inferences difficult to ascertain from soccer match-play. Therefore, the present study aims to investigate the hot (HOT), hypoxic (HYP) and hot-hypoxic (HH) mediated-decrements during a non-motorised treadmill based soccer-specific simulation. Twelve male University soccer players completed three familiarisation sessions and four randomised crossover experimental trials of the intermittent Soccer Performance Test (iSPT) in normoxic-temperate (CON: 18oC 50% rH), HOT (30oC; 50% rH), HYP (1,000m; 18oC 50% rH) and HH (1,000m; 30oC; 50% rH). Physical performance and its performance decrements, body temperatures (rectal, skin and estimated muscle temperature), heart rate (HR), arterial blood oxygen saturation (SaO2), perceived exertion, thermal sensation (TS), body mass changes, blood lactate and plasma volume were all measured. Performance decrements were similar in HOT and HYP [Total Distance (-4%), High-speed distance (~-8%) and variable run distance (~-12%) covered] and exacerbated in HH [total distance (-9%), high-speed distance (-15%) and variable run distance (-15%)] compared to CON. Peak sprint speed, was 4% greater in HOT compared with CON and HYP and 7% greater in HH. Sprint distance covered was unchanged (p > 0.05) in HOT and HYP and only decreased in HH (-8%) compared with CON. Body mass (-2%), temperatures (+2-5%) and TS (+18%) were altered in HOT. Furthermore, SaO2 (-8%) and HR (+3%) were changed in HYP. Similar changes in body mass and temperatures, HR, TS and SaO2 were evident in HH to HOT and HYP, however, blood lactate (p < 0.001) and plasma volume (p < 0.001) were only significantly altered in HH. Perceived exertion was elevated (p < 0.05) by 7% in all conditions compared with CON. Regression analysis identified that absolute TS and absolute rise in skin and estimated muscle temperature (r = 0.82, r = 0.84 r = 0.82, respectively; p <0.05) predicted the hot-mediated-decrements in HOT. The hot, hypoxic and hot-hypoxic environments impaired physical performance during iSPT. Future interventions should address the increases in TS and body temperatures, to attenuate these decrements on soccer performance

Effect of permissive dehydration on induction and decay of heat acclimation, and temperate exercise performance

Purpose: It has been suggested that dehydration is an independent stimulus for heat 32 acclimation (HA), possibly through influencing fluid-regulation mechanisms and increasing 33 plasma volume (PV) expansion. There is also some evidence that HA may be ergogenic in 34 temperate conditions and that this may be linked to PV expansion. We investigated: i) the 35 influence of dehydration on the time-course of acquisition and decay of HA; ii) whether 36 dehydration augmented any ergogenic benefits in temperate conditions, particularly those related to PV expansion. Methods: Eight males (VO2max: 56.9(7.2) mL·kg-1 ·min-1 37 ) undertook 38 two HA programmes (balanced cross-over design), once drinking to maintain euhydration 39 (HAEu) and once with restricted fluid-intake (HADe). Days 1, 6, 11 and 18 were 60 min exercise- 40 heat stress tests (HST [40°C; 50%RH]), days 2-5 and 7-10 were 90 min, isothermal-strain 41 (Tre~38.5°C), exercise-heat sessions. Performance parameters (VO2max, lactate threshold, 42 efficiency, peak power output [PPO]) were determined pre and post HA by graded exercise test 43 (22°C; 55 %RH). Results: During isothermal-strain sessions hypohydration was achieved in 44 HADe and euhydration maintained in HAEu (average body mass loss -2.71(0.82)% vs. - 45 0.56(0.73)%, P<0.001), but aldosterone concentration, power output and cardiovascular strain 46 were unaffected by dehydration. HA was evident on day 6 (reduced end-exercise Tre [- 0.30°C(0.27)] and exercise heart rate [-12(15) beats.min-1 47 ], increased PV [+7.2(6.4)%] and sweat-loss [+0.25(0.22) L.hr-1 48 ], P<0.05) with some further adaptations on day 11 (further reduced end-exercise Tre [-0.25(0.19)°C] and exercise heart rate [-3(9) beats.min-1 49 ], P<0.05). 50 These adaptations were not notably affected by dehydration and were generally maintained 7- 51 days post HA. Performance parameters were unchanged, apart from increased PPO (+16(20) 52 W, irrespective of condition). Conclusions: When thermal-strain is matched, permissive 53 dehydration which induces a mild, transient, hypohydration does not affect the acquisition and 54 decay of HA, or endurance performance parameters. Irrespective of hydration, trained 55 individuals require >5 days to optimise HA

Water-loss (intracellular) dehydration assessed using urinary tests, how well do they work? Diagnostic accuracy in older people

Background: Water-loss dehydration (hypertonic, hyperosmotic or intra-cellular dehydration) is due to insufficient fluid intake and distinct from hypovolemia due to excess fluid losses. It is associated with poor health outcomes such as disability and mortality in older people. Urine specific gravity (USG), color and urine osmolality have been widely advocated for screening for dehydration in older adults. Objective: To assess the diagnostic accuracy of urinary measures to screen for water-loss dehydration in older people.Design: This was a diagnostic accuracy study of people aged ≥65years taking part in the Dehydration Recognition In our Elders (DRIE, living in long-term care) or Dietary Strategies for Healthy Ageing in Europe (NU-AGE, living in the community) studies. The reference standard was serum osmolality, index tests included USG, urine color, osmolality, cloudiness, additional dipstick measures, ability to provide a urine sample, and volume of a random urine sample. Minimum useful diagnostic accuracy was set at sensitivity and specificity ≥70% or receiver operating characteristics plot area under the curve ≥0.70. Results: DRIE participants (67% women, mean age 86 years, n=162) had more limited cognitive and functional abilities than NU-AGE participants (64% women, mean age 70 years, n=151). 19% of DRIE and 22% of NU-AGE participants were dehydrated (serum osmolality >300mOsm/kg). Neither USG nor any other potential urinary tests were usefully diagnostic for water-loss dehydration. Conclusions: Although USG, urine color and urinary osmolality have been widely advocated for screening for dehydration in older adults, we show in the largest study to date that their diagnostic accuracy is too low to be useful and these measures should not be used to indicate hydration status in older people (either alone or as part of a wider tranche of tests). There is a need to develop simple, inexpensive and non-invasive tools for the assessment of dehydration in older people

The Stardust – a successful encounter with the remarkable comet Wild 2

On January 2, 2004 the Stardust spacecraft completed a close flyby of comet Wild2 (P81). Flying at a relative speed of 6.1 km/s within 237km of the 5 km nucleus, the spacecraft took 72 close-in images, measured the flux of impacting particles and did TOF mass spectrometry