Identification of elderly fallers by muscle strength measures

For efficient prevention of falls among older adults, individuals at a high risk of falling need to be identified. In this study, we searched for muscle strength measures that best identified those individuals who would fall after a gait perturbation and those who recovered their balance. Seventeen healthy older adults performed a range of muscle strength tests. We measured maximum and rate of development of ankle plantar flexion moment, knee extension moment and whole leg push-off force, as well as maximum jump height and hand grip strength. Subsequently, their capacity to regain balance after tripping over an obstacle was determined experimentally. Seven of the participants were classified as fallers based on the tripping outcome. Maximum isometric push-off force in a leg press apparatus was the best measure to identify the fallers, as cross-validation of a discriminant model with this variable resulted in the best classification (86% sensitivity and 90% specificity). Jump height and hand grip strength were strongly correlated to leg press force (r = 0.82 and 0.59, respectively) and can also be used to identify fallers, although with slightly lower specificity. These results indicate that whole leg extension strength is associated with the ability to prevent a fall after a gait perturbation and might be used to identify the elderly at risk of falling

Response to Therapeutic Sleep Deprivation: A Naturalistic Study of Clinical and Genetic Factors and Post-treatment Depressive Symptom Trajectory

Research has shown that therapeutic sleep deprivation (SD) has rapid antidepressant effects in the majority of depressed patients. Investigation of factors preceding and accompanying these effects may facilitate the identification of the underlying biological mechanisms. This exploratory study aimed to examine clinical and genetic factors predicting response to SD and determine the impact of SD on illness course. Mood during SD was also assessed via visual analogue scale. Depressed inpatients (n = 78) and healthy controls (n = 15) underwent ~36 h of SD. Response to SD was defined as a score of ≤ 2 on the Clinical Global Impression Scale for Global Improvement. Depressive symptom trajectories were evaluated for up to a month using self/expert ratings. Impact of genetic burden was calculated using polygenic risk scores for major depressive disorder. In total, 72% of patients responded to SD. Responders and non-responders did not differ in baseline self/expert depression symptom ratings, but mood differed. Response was associated with lower age (p = 0.007) and later age at life-time disease onset (p = 0.003). Higher genetic burden of depression was observed in non-responders than healthy controls. Up to a month post SD, depressive symptoms decreased in both patients groups, but more in responders, in whom effects were sustained. The present findings suggest that re-examining SD with a greater focus on biological mechanisms will lead to better understanding of mechanisms of depression

Hide and seek: Directing top-down attention is not sufficient for accelerating conscious access

At any moment in time, we have a single conscious visual experience representing a minute part of our visual world. As such, the visual input stimulating our retinae is in continuous competition for reaching conscious access. Many complex cognitive operations can only be applied to consciously accessible visual information, thereby raising the question whether humans have the ability to select which parts of their visual input rea- ches consciousness. Top-down attention allows humans to flexibly assign more processing resources to certain parts of our visual input, making it a likely mechanism to volitionally bias conscious access. Here, we investigated whether directing top-down attention to a particular location or feature accelerates conscious access of an initially suppressed visual stimulus at the attended location, or of the attended feature. We instructed participants to attend a spatial location (Experiment 1) or color (Experiment 2) for a speeded discrimination task, using a highly predictive cue. The predictive cues were highly effective in prompting sustained attention towards the cued location or color, as evidenced by faster discrimination of cued relative to uncued targets. We simultaneously measured detection times to interocularly suppressed probes that were either of the cued (i.e., attended) color/location or not, and were visually distinct from the targets used for the discrimination task. Despite our successful manipulation of top-down attention, suppressed probes were not released from suppression faster when they were presented at the attended location, or in the attended color. In contrast, when observers were cued to attend a color for locating targets of an ill-defined shape (inciting a broader attentional template), we did observe faster conscious access of probes in the attended color (Experiment 3). We discuss our findings in light of the specificity of attentional templates, and the inherent limitations that this poses for top-down attentional biases on conscious access

Thermotectonic evolution of an extensional dome : the cenozoic Osogovo-Lisets core complex (Kraishte zone, western Bulgaria)

The Kraishte region of Bulgaria is located at the junction of the Balkanides and Hellenides-Dinarides tectonic belts. Fission-track analysis on both apatites and zircons documents the Cenozoic exhumation of a Precambrian basement bounded by low-angle detachments. Late Eocene - Oligocene extension began prior to 47 Ma and was dominantly in a top-to-the-southwest direction, confirmed by the sense of younging of apatite and zircon ages. This crustal extension controlled the formation of half-graben sedimentary basins on the hanging walls of the detachments. Thermal modelling of these hanging wall units provides evidence for heat transfer across the detachments from a relatively warm rising footwall. From 32 to 29 Ma, pervasive magmatic activity resulted in the emplacement of rhyolitic to dacitic subvolcanic bodies and dykes, along with intrusion of the Osogovo granite. The results give evidence for extension in the southern Balkan older than, and separated from, the Miocene to Quaternary Aegean extension. This might reflect transtension during northeastward extrusion and rotation of continental fragments around the western boundary of Moesia. Eocene - Oligocene extension seems to have been controlled by the distribution of earlier thickening all around the Carpatho-Balkanic orocline, which is reflected by the Cretaceous emplacement of the Morava Nappe in the Kraishte

613 cases of splenic rupture without risk factors or previously diagnosed disease: a systematic review

Background Rupture of the spleen in the absence of trauma or previously diagnosed disease is largely ignored in the emergency literature and is often not documented as such in journals from other fields. We have conducted a systematic review of the literature to highlight the surprisingly frequent occurrence of this phenomenon and to document the diversity of diseases that can present in this fashion. Methods Systematic review of English and French language publications catalogued in Pubmed, Embase and CINAHL between 1950 and 2011. Results We found 613 cases of splenic rupture meeting the criteria above, 327 of which occurred as the presenting complaint of an underlying disease and 112 of which occurred following a medical procedure. Rupture appeared to occur spontaneously in histologically normal (but not necessarily normal size) spleens in 35 cases and after minor trauma in 23 cases. Medications were implicated in 47 cases, a splenic or adjacent anatomical abnormality in 31 cases and pregnancy or its complications in 38 cases. The most common associated diseases were infectious (n = 143), haematologic (n = 84) and non-haematologic neoplasms (n = 48). Amyloidosis (n = 24), internal trauma such as cough or vomiting (n = 17) and rheumatologic diseases (n = 10) are less frequently reported. Colonoscopy (n = 87) was the procedure reported most frequently as a cause of rupture. The anatomic abnormalities associated with rupture include splenic cysts (n = 6), infarction (n = 6) and hamartomata (n = 5). Medications associated with rupture include anticoagulants (n = 21), thrombolytics (n = 13) and recombinant G-CSF (n = 10). Other causes or associations reported very infrequently include other endoscopy, pulmonary, cardiac or abdominal surgery, hysterectomy, peliosis, empyema, remote pancreato-renal transplant, thrombosed splenic vein, hemangiomata, pancreatic pseudocysts, splenic artery aneurysm, cholesterol embolism, splenic granuloma, congenital diaphragmatic hernia, rib exostosis, pancreatitis, Gaucher's disease, Wilson's disease, pheochromocytoma, afibrinogenemia and ruptured ectopic pregnancy. Conclusions Emergency physicians should be attuned to the fact that rupture of the spleen can occur in the absence of major trauma or previously diagnosed splenic disease. The occurrence of such a rupture is likely to be the manifesting complaint of an underlying disease. Furthermore, colonoscopy should be more widely documented as a cause of splenic rupture

Design of thermolabile bacteriophage repressor mutants by comparative molecular modeling

Comparative molecular modeling was performed with repressor protein Rro of the temperate Lactococcus lactis bacteriophage r1t using the known 3D-structures of related repressors in order to obtain thermolabile derivatives of Rro. Rro residues presumed to stabilize a nonhomologous but structurally conserved hydrophobic pocket, which was shown to be important for thermostability of the Escherichia coli bacteriophage lambda repressor Cl, were randomized. Of the derivatives that exhibited various temperature-sensitive phenotypes, one was shown to hold promise for both fundamental and industrial applications that require the controlled production of (heterologous) proteins in L. lactis.</p

Assembling Upstream Engagement: the Case of the Portuguese Deliberative Forum on Nanotechnologies

This article analyzes a deliberative forum on nanotechnologies, organized in Portugal within the scope of the research project DEEPEN—Deepening Ethical Engagement and Participation in Emerging Nanotechnologies. This event included scientists, science communicators and members of the “lay public”, and resulted in a position document which summarizes collective aspirations and concerns related to nano. Drawing upon our previous experience with focus groups on nanotechnologies—characterized by methodological innovations that aimed at suspending epistemological inequalities between participants—this paper delves into the performativity of the deliberative event, exploring some of the tensions and power/knowledge asymmetries generated by the forum. Recognizing that the design of participatory assemblages matters, we reflect on our role as facilitators and explore the difficulties in organizing exercises of upstream engagement with emerging technologies