Natural history of falls in an incident cohort of Parkinson’s disease: early evolution, risk and protective features

The natural history of falls in early Parkinson’s disease (PD) is poorly understood despite the profound effect of falls on outcome. The primary aim of this study was to describe the natural history of falls, and characterise fallers over 54 months in 99 newly diagnosed people with PD. Seventy-nine (79.7%) participants fell over 54 months and 20 (20.3%) remained falls-naïve. Twenty six (26.2%) reported retrospective falls at baseline. Gait outcomes, disease severity and self-efficacy significantly discriminated across groups. Subjective cognitive complaints emerged as the only significant cognitive predictor. Without exception, outcomes were better for non-fallers compared with fallers at any time point. Between group differences for 54 month fallers and non-fallers were influenced by the inclusion of retrospective fallers and showed a broader range of discriminant characteristics, notably stance time variability and balance self-efficacy. Single fallers (n = 7) were significantly younger than recurrent fallers (n = 58) by almost 15 years (P = 0.013). Baseline performance in early PD discriminates fallers over 54 months, thereby identifying those at risk of falls. Clinical profiles for established and emergent fallers are to some extent distinct. These results reiterate the need for timely interventions to improve postural control and gait

Natural history of falls in an incident cohort of Parkinson’s disease: early evolution, risk and protective features

The natural history of falls in early Parkinson’s disease (PD) is poorly understood despite the profound effect of falls on outcome. The primary aim of this study was to describe the natural history of falls, and characterise fallers over 54 months in 99 newly diagnosed people with PD. Seventy-nine (79.7%) participants fell over 54 months and 20 (20.3%) remained falls-naïve. Twenty six (26.2%) reported retrospective falls at baseline. Gait outcomes, disease severity and self-efficacy significantly discriminated across groups. Subjective cognitive complaints emerged as the only significant cognitive predictor. Without exception, outcomes were better for non-fallers compared with fallers at any time point. Between group differences for 54 month fallers and non-fallers were influenced by the inclusion of retrospective fallers and showed a broader range of discriminant characteristics, notably stance time variability and balance self-efficacy. Single fallers (n = 7) were significantly younger than recurrent fallers (n = 58) by almost 15 years (P = 0.013). Baseline performance in early PD discriminates fallers over 54 months, thereby identifying those at risk of falls. Clinical profiles for established and emergent fallers are to some extent distinct. These results reiterate the need for timely interventions to improve postural control and gait

Establishing a robust two-step cloning strategy for the generation of cell lines with a high probability of monoclonality

A regulatory requirement for the production of therapeutic proteins from mammalian cells is that the production cell line is clonal, that is, derived from a single progenitor cell. It is therefore standard procedure to include at least one cloning step during the development of a recombinant cell line for therapeutic protein production. Numerous techniques can be employed for cloning cell lines, but regardless of the cloning method used there should be appropriate evidence to support that the method is fit for purpose. A point highlighted by the increasing interest from regulatory bodies regarding the cloning method used and the probability of monoclonality (P(monoclonality)) achieved during cell line development (CLD). FUJIFILM Diosynth Biotechnologies have thoroughly considered the cloning approach used during CLD: A two-step cloning strategy employed which combines the ClonePix™ as a cloning and screening tool followed by a second cloning step using the industrially accepted method of limiting dilution cloning will be discussed. A collaboration with statisticians led to the development of a method to estimate the resulting P(monoclonality) of cell lines generated using the ClonePix™ and experimental data to support this statistical method was generated, thereby ensuring that the ClonePix™ cloning step is robust. We will highlight the challenges of using the ClonePix™ for a single round of cloning and the advantages of combining it with a second cloning step. We will demonstrate how we achieve a minimum probability of monoclonality of ≥99.78% and typically achieve a P(monoclonality) of 99.9% using a two-step cloning strategy

Engaging Families and the Community in Schools

This module is designed to lead a collaborative group of educators through the process of designing and implementing an event or activity to increase the levels of family and community engagement in schools. The module presents current research supporting family and community involvement in schools. Learners are prepared to recognize potential barriers to increasing family and community involvement and methods to overcome those barriers. Visit professional learning module.https://digitalcommons.gardner-webb.edu/improve/1011/thumbnail.jp

Teaching JavaScript with Vue.js

In this paper we provide details of the enhancements made to a front-end web design and development course. The Computer Information Systems (CIS) course successfully teaches HTML, CSS, and JavaScript with supporting libraries. A practical experiential project provides foundational concepts and provides web design front end developer knowledge and most in-demand skills. Our focus in this paper is on advanced JavaScript – specifically frameworks, libraries and packages. In particular we demonstrate the flexibility, versatility and power of Vue.js in this paper. Topics covered include the Vue instance, expressions, directives, attribute binding, conditionals and loops, event handling and methods, and class and style binding. The paper describes a pedagogically well-defined application which continuously builds upon these topicsAccepted manuscrip

Giving in Illinois 2016

Illinois is home to over 5,200 grantmaking foundations spanning all types—independent or family, corporate, community, and operating—sizes, and issue areas. The community includes many foundations that only give locally or within the state, as well as those that fund nationally and even internationally. The following analysis provides an overview of the scale and composition of the Illinois foundation community and an examination of how Illinois foundations have fared relative to U.S. foundations in general over the past decade

A phase II, multicentre, UK study of vinorelbine in advanced breast cancer.

Clinical Trial, Phase IIMulticenter StudyFull text is available as a scanned copy of the original print versionThirty-four evaluable patients were treated with vinorelbine, a novel, semisynthetic vinca alkaloid, as first-line chemotherapy for advanced breast cancer. They received vinorelbine 25 mg m-2 i.v. given weekly for a maximum of 16 cycles. Two patients achieved a complete remission and 15 a partial remission, giving a response rate of 17/34 (50%; 95% CI of 34-66%); median response duration was 5.8 months. The median progression-free interval was 4.4 months and median survival 9.9 months. Treatment was generally well tolerated. Fatigue was the most common side-effect. The main reason for dose adjustments was myelosuppression; 68% of patients had WHO grade 3 or 4 neutropenia and there was one death attributed to neutropenic sepsis. Nausea/vomiting and neuropathy were mild and alopecia was uncommon. This study confirms vinorelbine as a highly active, well-tolerated agent in advanced breast cancer worthy of evaluation in combination chemotherapy regimens

HumMod: A Modeling Environment for the Simulation of Integrative Human Physiology

Mathematical models and simulations are important tools in discovering key causal relationships governing physiological processes. Simulations guide and improve outcomes of medical interventions involving complex physiology. We developed HumMod, a Windows-based model of integrative human physiology. HumMod consists of 5000 variables describing cardiovascular, respiratory, renal, neural, endocrine, skeletal muscle, and metabolic physiology. The model is constructed from empirical data obtained from peer-reviewed physiological literature. All model details, including variables, parameters, and quantitative relationships, are described in Extensible Markup Language (XML) files. The executable (HumMod.exe) parses the XML and displays the results of the physiological simulations. The XML description of physiology in HumMod's modeling environment allows investigators to add detailed descriptions of human physiology to test new concepts. Additional or revised XML content is parsed and incorporated into the model. The model accurately predicts both qualitative and quantitative changes in clinical and experimental responses. The model is useful in understanding proposed physiological mechanisms and physiological interactions that are not evident, allowing one to observe higher level emergent properties of the complex physiological systems. HumMod has many uses, for instance, analysis of renal control of blood pressure, central role of the liver in creating and maintaining insulin resistance, and mechanisms causing orthostatic hypotension in astronauts. Users simulate different physiological and pathophysiological situations by interactively altering numerical parameters and viewing time-dependent responses. HumMod provides a modeling environment to understand the complex interactions of integrative physiology. HumMod can be downloaded at http://hummod.or

Creating Talk & Texts: Taking the Classroom into the Community

This project report highlights a partnership among Communication & Rhetoric university members and staff and students from El Centro del Quinto Sol which is a community recreation center. We describe the context and background of our project, workshops that employ Theatre of the Oppressed (TO) techniques, and provide some reflections and pictures documenting this joint learning experience

An outline framework for the efficient onward-sharing of linked Longitudinal Population Study and NHS Digital records.

Background Longitudinal Population Studies (LPS) typically operate as data resources for global bona-fide research, and therefore routinely share data to inform new research investigations. Current data sharing agreements between LPS and NHS Digital generally do not permit the onward-sharing of linked health records beyond the LPS’s host institution or provide mechanisms to dynamically add new research hypotheses. Aim To develop a framework of standardised onward-sharing models which control for risk and legal requirements and fit the context of different LPS. Approach The CLOSER longitudinal consortium and NHS Digital held consultation meetings with 13 UK longitudinal studies, consortia studies and infrastructure providers to identify requirements and potential solutions. Results Five onward-sharing models were identified. Two rely on the principle that anonymised data can be shared in a light-touch regulatory framework, and that this principle extends to ‘effectively anonymised’ data processed in line with the Information Commissioner’s Office (ICO) anonymisation code of practice. Three methods utilise differing permutations of contractual agreements in order to control for risk and enforce NHS Digital’s legal obligations. Establishing and maintaining these contractual arrangements will involve close working arrangements between the LPS and NHS Digital and further work is needed to clarify requirements for international data sharing. All models rely on the use of socio-technical controls used by LPS and infrastructure providers operating ‘Data Safe Haven’ approaches. Secure research facilities offered by national infrastructure providers – such as UK Secure eResearch Platform and UK Data Service – provide powerful risk control tools. Conclusion The identified models provide varied and flexible options for the onward-sharing of linked LPS and NHS Digital data. Greater clarity is needed in order to share effectively anonymised data and to share data internationally. There are opportunities for the LPS community to facilitate elements of these processes through partnership approaches