Absorption rate of subcutaneously infused fluid in ill multimorbid older patients

BACKGROUND: Subcutaneous (SC) hydration is a valuable method for treating dehydration in the very old patients. Data are absent on the absorption rate, and the availability of SC infused fluid in the circulation in this group of patients where SC hydration is particularly relevant. METHODS: We performed an explorative study on ill very old (range 78–84 years old) geriatric patients with comorbidities who received an SC infusion of 235 ml isotonic saline containing a technetium-99m pertechnetate tracer. The activity over the infusion site was measured using a gamma detector to assess the absorption rate from the SC space. The activity was measured initially every 5 minutes, with intervals extended gradually to 15 minutes. Activity in blood samples and the thyroid gland was measured to determine the rate of availability in the circulation. RESULTS: Six patients were included. The mean age was 81 years (SD 2.1), the number of comorbidities was 4.6 (SD 1.3), and the Tilburg frailty indicator was 3.8 (SD 2.4). When the infusion was completed after 60 minutes, 53% (95% CI 50–56%) of the infused fluid was absorbed from the SC space, with 88% (95% CI 86–90%) absorbed one hour later. The absorption rate from the SC space right after the completion of the infusion was 127 ml/h (95% CI 90–164 ml/h). The appearance of the fluid into the blood and the thyroid gland verified the transfer from SC to circulation. CONCLUSION: This first explorative study of absorption of SC infused fluid in the very old found an acceptable amount of fluid absorbed from the SC space into the circulation one hour after infusion had ended. Results are uniform but should be interpreted cautiously due to the low sample size. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT04536324

Reliability and agreement of a novel portable laser height metre

BACKGROUND:Human height is a simple measure with great applicability. Usually, stadiometers are used to measure height accurately. However, these may be impractical to transport and expensive. Therefore, we developed a portable and low-cost laser height metre (LHM). OBJECTIVE:We aimed to (1) determine intrarater and interrater reliability of our LHM and compare it to a wall-fixed stadiometer, (2) examine its agreement with the same stadiometer, and (3) determine the minimum number of recordings needed to obtain an accurate and reliable height measurement using the LHM. METHODS:We recruited 32 participants (18+ years)-both men and women. Two raters performed assessments on the same day blinded to each other and their reference standard measurements. We calculated intraclass correlation coefficient (ICC), coefficient of variation (CV), standard error of measurement (SEM), and Bland-Altman plots with limits of agreement (LOA). RESULTS:For both the LHM and stadiometer, we found ICC values of 0.99-1.00 (95% CI: 0.997-1.000) for both intrarater and interrater reliability. Regarding LHM intrarater reliability, SEM, CV, and LOA were 0.34 cm, 0.16%, and -1.07 to 0.73 cm, respectively. In terms of LHM interrater reliability, SEM, CV, and LOA were 0.27 cm, 0.12%, and -0.32 to 0.84 cm, respectively. As to agreement with stadiometers using one measurement, the mean difference was -0.14 cm and LOA ranged from -0.81 to 0.77 cm. CONCLUSION:A portable and low-cost LHM, for measuring body height once, showed an excellent reproducibility within and between raters along with an acceptable agreement with a stadiometer thereby representing a suitable alternative

Effects of treadmill slip and trip perturbation-based balance training on falls in community-dwelling older adults (STABILITY): study protocol for a randomised controlled trial

INTRODUCTION: Falls among older adults are most frequently caused by slips and trips and can have devastating consequences. Perturbation-based balance training (PBT) have recently shown promising fall preventive effects after even small training dosages. However, the fall preventive effects of PBT delivered on a treadmill are still unknown. Therefore, this parallel-group randomised controlled trial aims to quantify the effects of a four-session treadmill-PBT training intervention on falls compared with treadmill walking among community-dwelling older adults aged 65 years or more. METHODS AND ANALYSIS: 140 community-dwelling older adults will be recruited and randomised into either the treadmill-PBT or the treadmill walking group. Each group will undergo three initial training sessions within a week and an additional ‘booster’ session after 26 weeks. Participants in the treadmill-PBT group will receive 40 slip and/or trip perturbations induced by accurately timed treadmill belt accelerations at each training session. The primary outcome of interest is daily life fall rates collected using fall calendars for a follow-up period of 52 weeks. Secondary outcomes include physical, cognitive and social–psychological fall-related risk factors and will be collected at the pre-training and post-training test and the 26-week and 52-week follow-up tests. All outcomes will be analysed using the intention-to-treat approach by an external statistician. A Poisson’s regressions with bootstrapping, to account for overdispersion, will be used to compare group differences in fall rates. ETHICS AND DISSEMINATION: The study protocol has been approved by the North Denmark Region Committee on Health Research Ethics (N-20200089). The results will be disseminated in peer-reviewed journals and at international conferences. TRIAL REGISTRATION NUMBER: NCT04733222

Large expert-curated database for benchmarking document similarity detection in biomedical literature search

Document recommendation systems for locating relevant literature have mostly relied on methods developed a decade ago. This is largely due to the lack of a large offline gold-standard benchmark of relevant documents that cover a variety of research fields such that newly developed literature search techniques can be compared, improved and translated into practice. To overcome this bottleneck, we have established the RElevant LIterature SearcH consortium consisting of more than 1500 scientists from 84 countries, who have collectively annotated the relevance of over 180 000 PubMed-listed articles with regard to their respective seed (input) article/s. The majority of annotations were contributed by highly experienced, original authors of the seed articles. The collected data cover 76% of all unique PubMed Medical Subject Headings descriptors. No systematic biases were observed across different experience levels, research fields or time spent on annotations. More importantly, annotations of the same document pairs contributed by different scientists were highly concordant. We further show that the three representative baseline methods used to generate recommended articles for evaluation (Okapi Best Matching 25, Term Frequency-Inverse Document Frequency and PubMed Related Articles) had similar overall performances. Additionally, we found that these methods each tend to produce distinct collections of recommended articles, suggesting that a hybrid method may be required to completely capture all relevant articles. The established database server located at https://relishdb.ict.griffith.edu.au is freely available for the downloading of annotation data and the blind testing of new methods. We expect that this benchmark will be useful for stimulating the development of new powerful techniques for title and title/abstract-based search engines for relevant articles in biomedical research.Peer reviewe

Averting biodiversity collapse in tropical forest protected areas

The rapid disruption of tropical forests probably imperils global biodiversity more than any other contemporary phenomenon¹⁻³. With deforestation advancing quickly, protected areas are increasingly becoming final refuges for threatened species and natural ecosystem processes. However, many protected areas in the tropics are themselves vulnerable to human encroachment and other environmental stresses⁴⁻⁹. As pressures mount, it is vital to know whether existing reserves can sustain their biodiversity. A critical constraint in addressing this question has been that data describing a broad array of biodiversity groups have been unavailable for a sufficiently large and representative sample of reserves. Here we present a uniquely comprehensive data set on changes over the past 20 to 30 years in 31 functional groups of species and 21 potential drivers of environmental change, for 60 protected areas stratified across the world’s major tropical regions. Our analysis reveals great variation in reserve ‘health’: about half of all reserves have been effective or performed passably, but the rest are experiencing an erosion of biodiversity that is often alarmingly widespread taxonomically and functionally. Habitat disruption, hunting and forest-product exploitation were the strongest predictors of declining reserve health. Crucially, environmental changes immediately outside reserves seemed nearly as important as those inside in determining their ecological fate, with changes inside reserves strongly mirroring those occurring around them. These findings suggest that tropical protected areas are often intimately linked ecologically to their surrounding habitats, and that a failure to stem broad-scale loss and degradation of such habitats could sharply increase the likelihood of serious biodiversity declines.Keywords: Ecology, Environmental scienc

Effect of incubation temperature on eggs and larvae of lumpsucker (Cyclopterus lumpus L.)

In this study the aim was to investigate how incubation temperature effected lumpsucker eggs and larvae; by comparing early cell symmetry, egg/embryo development, mortality, hatching success and early larvae size weight and histomorphology. Two batches of eggs were incubated at 3 temperature regimes; 1- Ambient seawater 4-6°C (cold), 2-Ambient seawater for 10 days then gradually increased to 10°C (gradient), 3- constant 10°C seawater (warm). Early cell symmetry, development and hatching time was similar with regard to day degrees between all temperature groups, although faster (in days) with warmer temperature. The eggs incubated in cold water had the highest egg mortality and lowest hatching success. The warm group had lowest egg mortality while the gradient group had highest hatching success. The gradient group also had the most synchronized hatching; most of the eggs hatched during the first day. The warm and cold group both had a hatching peak 3 days post first hatching. The larvae mortality was highest in the warm group and lowest in the gradient group. The cold group had the longest, heaviest and thickest larvae followed by the gradient and warm group respectively. Newly hatched larvae from the warm group had most body deformities. Larvae from all groups kept fed at 10°C for two weeks showed a difference in body size; larvae from the cold regime being largest. No difference between groups were found in mortality or body deformeties. Studies of organ and tissue histomorphology of hatched and two week old larvae did not reveal differences between the temperature groups. This study demonstrated that incubation temperature will effect: mortality, hatching success and early larvae conditions of lumpsucker. A gradual rise in incubation temperature at an early embryo stage seemed to be most beneficia