A perturbation-based balance training program for older adults: study protocol for a randomised controlled trial

<p>Abstract</p> <p>Background</p> <p>Previous research investigating exercise as a means of falls prevention in older adults has shown mixed results. Lack of specificity of the intervention may be an important factor contributing to negative results. Change-in-support (CIS) balance reactions, which involve very rapid stepping or grasping movements of the limbs, play a critical role in preventing falls; hence, a training program that improves ability to execute effective CIS reactions could potentially have a profound effect in reducing risk of falling. This paper describes: 1) the development of a perturbation-based balance training program that targets specific previously-reported age-related impairments in CIS reactions, and 2) a study protocol to evaluate the efficacy of this new training program.</p> <p>Methods/Design</p> <p>The training program involves use of unpredictable, multi-directional moving-platform perturbations to evoke stepping and grasping reactions. Perturbation magnitude is gradually increased over the course of the 6-week program, and concurrent cognitive and movement tasks are included during later sessions. The program was developed in accordance with well-established principles of motor learning, such as individualisation, specificity, overload, adaptation-progression and variability. Specific goals are to reduce the frequency of multiple-step responses, reduce the frequency of collisions between the stepping foot and stance leg, and increase the speed of grasping reactions. A randomised control trial will be performed to evaluate the efficacy of the training program. A total of 30 community-dwelling older adults (age 64–80) with a recent history of instability or falling will be assigned to either the perturbation-based training or a control group (flexibility/relaxation training), using a stratified randomisation that controls for gender, age and baseline stepping/grasping performance. CIS reactions will be tested immediately before and after the six weeks of training, using platform perturbations as well as a distinctly different method of perturbation (waist pulls) in order to evaluate the generalisability of the training effects.</p> <p>Discussion</p> <p>This study will determine whether perturbation-based balance training can help to reverse specific age-related impairments in balance-recovery reactions. These results will help to guide the development of more effective falls prevention programs, which may ultimately lead to reduced health-care costs and enhanced mobility, independence and quality of life.</p

Pathological chemotherapy response score is prognostic in tubo-ovarian high-grade serous carcinoma: A systematic review and meta-analysis of individual patient data

There is a need to develop and validate biomarkers for treatment response and survival in tubo-ovarian high-grade serous carcinoma (HGSC). The chemotherapy response score (CRS) stratifies patients into complete/near-complete (CRS3), partial (CRS2), and no/minimal (CRS1) response after neoadjuvant chemotherapy (NACT). Our aim was to review current evidence to determine whether the CRS is prognostic in women with tubo-ovarian HGSC treated with NACT.This article is freely available via Open Access. Click on the Publisher URL to access the full-text via the publisher's site

Ant brood function as life preservers during floods.

Social organisms can surmount many ecological challenges by working collectively. An impressive example of such collective behavior occurs when ants physically link together into floating 'rafts' to escape from flooded habitat. However, raft formation may represent a social dilemma, with some positions posing greater individual risks than others. Here, we investigate the position and function of different colony members, and the costs and benefits of this functional geometry in rafts of the floodplain-dwelling ant Formica selysi. By causing groups of ants to raft in the laboratory, we observe that workers are distributed throughout the raft, queens are always in the center, and 100% of brood items are placed on the base. Through a series of experiments, we show that workers and brood are extremely resistant to submersion. Both workers and brood exhibit high survival rates after they have rafted, suggesting that occupying the base of the raft is not as costly as expected. The placement of all brood on the base of one cohesive raft confers several benefits: it preserves colony integrity, takes advantage of brood buoyancy, and increases the proportion of workers that immediately recover after rafting

Genetic and biochemical modulation of sialic acid O-acetylation on group B Streptococcus: Phenotypic and functional impact

Group B Streptococcus (GBS) is an important human pathogen and a model system for studying the roles of bacterial glycosylation in host–microbe interactions. Sialic acid (Sia), expressed prominently in the GBS capsular polysaccharide (CPS), mimics mammalian cell surface Sia and can interact with host Sia-binding proteins to subvert immune clearance mechanisms. Our earlier work has shown that GBS partially O-acetylates CPS Sia residues and employs an intracellular O-acetylation/de-O-acetylation cycle to control the final level of this surface Sia modification. Here, we examine the effects of point mutations in the NeuD O-acetyltransferase and NeuA O-acetylesterase on specific glycosylation phenotypes of GBS, pinpointing an isogenic strain pair that differs dramatically in the degree of the O-acetyl modification (80% versus 5%) while still expressing comparable levels of overall sialylation. Using these strains, higher levels of O-acetylation were found to protect GBS CPS Sia against enzymatic removal by microbial sialidases and to impede engagement of human Siglec-9, but not to significantly alter the ability of GBS to restrict complement C3b deposition on its surface. Additional experiments demonstrated that pH-induced migration of the O-acetyl modification from the 7- to 9-carbon position had a substantial impact on GBS–Siglec-9 interactions, with 7-O-acetylation exhibiting the strongest interference. These studies show that both the degree and position of the GBS O-acetyl modification influence Sia-specific interactions relevant to the host–pathogen relationship. We conclude that native GBS likely expresses a phenotype of intermediate Sia O-acetylation to strike a balance between competing selective pressures present in the host environment

Islamic education and colonial secularism: the Amroha experiment of 1895–96

In September 1895, a boldly innovative trial was begun with the teaching of Islam in a British government school in the town of Amroha, near Delhi. This article returns to the Amroha experiment to consider what it reveals about Indian Muslim exchanges with European administrators on the subject of secular colonial education and, more broadly, to bring under scrutiny the historical engagement of Muslim parties with colonial secularism. By the final decade of the nineteenth century, European officials had joined a number of their Muslim subjects in rejecting the imparting of exclusively secular education in schools and colleges under the management of the colonial state. Arguing for the reconciliation of religious and secular instruction, Viqar-ul-Mulk and his contemporaries capitalized upon growing British anxieties about the moral deficiency of Indian students taught in state educational institutions, exposing colonial concerns over the likelihood of inculcating moral improvement in the absence of religious teaching. Challenging the official separation of religion and pedagogy, they raised the possibility of the accommodation of multiple faiths within the modern Indian nation and state. The Amroha experiment served as a precedent for elite Muslim attempts to found an Indian Muslim university in which Islamic instruction would be imparted. Viqar-ul-Mulk’s successful negotiations with the government inspired further efforts for the revitalization of religious education on the part of Muslim leaders concerned about the survival and strengthening of Islam under colonial rule