A COMPARSION OF METHODS TO EXAMINE DOUBLE AND SINGLE LEG DROP JUMP PERFORMANCE

The purpose of this study was to compare the use of both a force platform and Optojump photocell system (Microgate, Bolzano, Italy) to examine double leg and single leg drop jumps. Thirteen physically active individuals performed 5 double leg drop jumps and 5 single leg drop jumps from a height of 0.3 m. Ground contact time (CT), flight height (FH) and reactive strength index (RSI) were calculated concurrently for both jump types. Despite intraclass correlation coefficients for all variables being very close to 1, a significant systematic difference was consistently observed between both devices with the Optojump system overestimating CT and underestimating both FH and RSI for both jump types. Both devices demonstrated excellent test- retest reliability with all ICCs for CT, FH and RSI above 0.940

A nationwide survey of confidence and knowledge of assessment and management oral conditions amongst a sample of physicians, United Kingdom

Objective: This study aimed to assess current confidence and knowledge of oral conditions amongst a sample of UK physicians and doctors in training programmes using a web-based survey. Results: 131 survey responses were analysed for doctors from FY1 to consultant grade working within medical specialties. 36.6% and 35.9% of those surveyed expressed that they felt confident diagnosing and managing oral conditions respectively. The median knowledge score was 60%; 65.6% correctly identified the image that demonstrated a squamous cell carcinoma. 91.6% reported that they felt they needed additional training in the diagnosis and management of oral conditions. Neither confidence nor knowledge were affected by grade, specialty, or region of practice

Increasing frailty is associated with higher prevalence and reduced recognition of delirium in older hospitalised inpatients: results of a multi-centre study

Purpose: Delirium is a neuropsychiatric disorder delineated by an acute change in cognition, attention, and consciousness. It is common, particularly in older adults, but poorly recognised. Frailty is the accumulation of deficits conferring an increased risk of adverse outcomes. We set out to determine how severity of frailty, as measured using the CFS, affected delirium rates, and recognition in hospitalised older people in the United Kingdom. Methods: Adults over 65 years were included in an observational multi-centre audit across UK hospitals, two prospective rounds, and one retrospective note review. Clinical Frailty Scale (CFS), delirium status, and 30-day outcomes were recorded. Results: The overall prevalence of delirium was 16.3% (483). Patients with delirium were more frail than patients without delirium (median CFS 6 vs 4). The risk of delirium was greater with increasing frailty [OR 2.9 (1.8–4.6) in CFS 4 vs 1–3; OR 12.4 (6.2–24.5) in CFS 8 vs 1–3]. Higher CFS was associated with reduced recognition of delirium (OR of 0.7 (0.3–1.9) in CFS 4 compared to 0.2 (0.1–0.7) in CFS 8). These risks were both independent of age and dementia. Conclusion: We have demonstrated an incremental increase in risk of delirium with increasing frailty. This has important clinical implications, suggesting that frailty may provide a more nuanced measure of vulnerability to delirium and poor outcomes. However, the most frail patients are least likely to have their delirium diagnosed and there is a significant lack of research into the underlying pathophysiology of both of these common geriatric syndromes

Autism-spectrum traits in neurotypicals predict the embodiment of manipulation knowledge about object concepts: Evidence from eyetracking

Sensorimotor-based theories of cognition predict that even subtle developmental motor differences, such as those characterizing autism spectrum disorder (ASD), impact how we represent the meaning of manipulable objects (e.g., faucet). Here, we test 85 neurotypical participants, who varied widely on the Adult Autism Spectrum Quotient (AQ), a measure intended to capture variability in ASD characteristics in the general adult population (participant scores were all below the clinical threshold for autism). Participants completed a visual world eyetracking task designed to assess the activation of conceptual representations of manipulable objects. Participants heard words referring to manually manipulable objects (e.g., faucet) while we recorded their eye movements to arrays of four objects: the named object, a related object typically manipulated similarly (e.g., jar), and two unrelated objects. Consistent with prior work, we observed more looks to the related object than to the unrelated ones (i.e., a manipulation-relatedness effect). This effect likely reflects the overlapping conceptual representations of objects sharing manipulation characteristics (e.g., faucet and jar), due to embodied sensorimotor properties being part of their representations. Critically, we observed—among typically developed young adults—that as AQ scores increased, manipulation-relatedness effects decreased. In contrast, in a visual control condition, in which a target object was paired with related objects of a similar shape (e.g., snake and rope), relatedness effects increased with AQ scores. The results show that AQ scores can predict variation in how object-concept representations are activated for typically developed individuals. More speculatively, they are consistent with the hypothesis that in individuals with ASD, differences in object-concept representations emerge at least in part via differences in sensorimotor experience

Impact of Tumour Epithelial Subtype on Circulating microRNAs in Breast Cancer Patients

While a range of miRNAs have been shown to be dysregulated in the circulation of patients with breast cancer, little is known about the relationship between circulating levels and tumour characteristics. The aim of this study was to analyse alterations in circulating miRNA expression during tumour progression in a murine model of breast cancer, and to detemine the clinical relevance of identified miRNAs at both tissue and circulating level in patient samples. Athymic nude mice received a subcutaneous or mammary fat pad injection of MDA-MB-231 cells. Blood sampling was performed at weeks 1, 3 and 6 following tumour induction, and microRNA extracted. MicroRNA microArray analysis was performed comparing samples harvested at week 1 to those collected at week 6 from the same animals. Significantly altered miRNAs were validated across all murine samples by RQ-PCR (n = 45). Three miRNAs of interest were then quantified in the circulation(n = 166) and tissue (n = 100) of breast cancer patients and healthy control individuals. MicroArray-based analysis of murine blood samples revealed levels of 77 circulating microRNAs to be changed during disease progression, with 44 demonstrating changes >2-fold. Validation across all samples revealed miR-138 to be significantly elevated in the circulation of animals during disease development, with miR-191 and miR-106a levels significantly decreased. Analysis of patient tissue and blood samples revealed miR-138 to be significantly up-regulated in the circulation of patients with breast cancer, with no change observed in the tissue setting. While not significantly changed overall in breast cancer patients compared to controls, circulating miR-106a and miR-191 were significantly decreased in patients with basal breast cancer. In tissue, both miRNAs were significantly elevated in breast cancer compared to normal breast tissue. The data demonstrates an impact of tumour epithelial subtype on circulating levels of miRNAs, and highlights divergent miRNA profiles between tissue and blood samples from breast cancer patients

Retrospective delirium ascertainment from case notes: a retrospective cohort study

Objectives This study sets out to ascertain if recognition of delirium impacts on patient outcomes. Design Retrospective cohort study. Setting Unscheduled admissions to acute care trust/secondary care UK hospitals. Participants Six hundred and fifty-six older adults aged ≥65 years admitted on 14 September 2018. Measurements Delirium was ascertained retrospectively from case notes using medical notes. Documented delirium was classified as recognised delirium and retrospectively ascertained delirium was classified as unrecognised delirium. Primary and secondary outcome measures Primary outcome measure: inpatient mortality. Secondary outcome measures: length of stay, discharge destination. Results Delirium was present in 21.1% (132/626) of patients at any point during admission. The presence of delirium was associated with increased mortality (HR 2.65, CI 1.40 to 5.01). Recognition of delirium did not significantly impact on outcomes. Conclusions Delirium is associated with adverse outcomes in hospitalised older adults. However, there is insufficient evidence that recognition of delirium affects outcomes. However, delirium recognition presents an opportunity to discuss a person’s overall prognosis and discuss this with the patient and their family. Further research is needed to assess the pathophysiology of delirium to enable development of targeted interventions towards improved outcomes in patients with delirium