Highly challenging balance program reduces fall rate in Parkinson disease

Published in final edited form as: J Neurol Phys Ther. 2016 January ; 40(1): 24–30. doi:10.1097/NPT.0000000000000111BACKGROUND AND PURPOSE: There is a paucity of effective treatment options to reduce falls in Parkinson disease (PD). Although a variety of rehabilitative approaches have been shown to improve balance, evidence of a reduction in falls has been mixed. Prior balance trials suggest that programs with highly challenging exercises had superior outcomes. We investigated the effects of a theory-driven, progressive, highly challenging group exercise program on fall rate, balance, and fear of falling. METHODS: Twenty-three subjects with PD participated in this randomized cross-over trial. Subjects were randomly allocated to 3 months of active balance exercises or usual care followed by the reverse. During the active condition, subjects participated in a progressive, highly challenging group exercise program twice weekly for 90 minutes. Outcomes included a change in fall rate over the 3-month active period and differences in balance (Mini-Balance Evaluation Systems Test [Mini-BESTest]), and fear of falling (Falls Efficacy Scale-International [FES-I]) between active and usual care conditions. RESULTS: The effect of time on falls was significant (regression coefficient = -0.015 per day, P < 0.001). The estimated rate ratio comparing incidence rates at time points 1 month apart was 0.632 (95% confidence interval, 0.524-0.763). Thus, there was an estimated 37% decline in fall rate per month (95% confidence interval, 24%-48%). Improvements were also observed on the Mini-BESTest (P = 0.037) and FES-I (P = 0.059). DISCUSSION AND CONCLUSIONS: The results of this study show that a theory-based, highly challenging, and progressive exercise program was effective in reducing falls, improving balance, and reducing fear of falling in PD.Video abstract available for more insights from the authors (see Supplemental Digital Content 1, http://links.lww.com/JNPT/A120). TRIAL REGISTRATION: ClinicalTrials.gov NCT02302144.This study was funded by the Boston Claude D. Pepper Older Americans Independence Center (NIH 5P30AG031679). Additional support was provided by the American Parkinson Disease Association (ADPA); ADPAMA Chapter. (NIH 5P30AG031679 - Boston Claude D. Pepper Older Americans Independence Center; American Parkinson Disease Association (ADPA); ADPAMA Chapter

Implications for high speed research: The relationship between sonic boom signature distortion and atmospheric turbulence

In this study there were two primary tasks. The first was to develop an algorithm for quantifying the distortion in a sonic boom. Such an algorithm should be somewhat automatic, with minimal human intervention. Once the algorithm was developed, it was used to test the hypothesis that the cause of a sonic boom distortion was due to atmospheric turbulence. This hypothesis testing was the second task. Using readily available sonic boom data, we statistically tested whether there was a correlation between the sonic boom distortion and the distance a boom traveled through atmospheric turbulence

El otro como espejo : historias de africanos en Bogotá

Comunicador (a) SocialPregrad

Initial Results from the Variable Intensity Sonic Boom Propagation Database

An extensive sonic boom propagation database with low- to normal-intensity booms (overpressures of 0.08 lbf/sq ft to 2.20 lbf/sq ft) was collected for propagation code validation, and initial results and flight research techniques are presented. Several arrays of microphones were used, including a 10 m tall tower to measure shock wave directionality and the effect of height above ground on acoustic level. A sailplane was employed to measure sonic booms above and within the atmospheric turbulent boundary layer, and the sailplane was positioned to intercept the shock waves between the supersonic airplane and the ground sensors. Sailplane and ground-level sonic boom recordings were used to generate atmospheric turbulence filter functions showing excellent agreement with ground measurements. The sonic boom prediction software PCBoom4 was employed as a preflight planning tool using preflight weather data. The measured data of shock wave directionality, arrival time, and overpressure gave excellent agreement with the PCBoom4-calculated results using the measured aircraft and atmospheric data as inputs. C-weighted acoustic levels generally decreased with increasing height above the ground. A-weighted and perceived levels usually were at a minimum for a height where the elevated microphone pressure rise time history was the straightest, which is a result of incident and ground-reflected shock waves interacting

What do all the numbers mean? Making sure we have all the pieces of the puzzle

As large-scale geophysical surveys increase, data collected using differing techniques mean that documenting and archiving this resource is increasingly significant. With technological advances in geophysical instrumentation, especially the integrationofGPS and multisensor platforms, large landscape surveys are increasingly practical and increasingly data-rich. Whilst only a few years ago only one dataset would have been collected at a site, multiple datasets are frequently collected in one “..

The antlions of Cyprus: review and new reports (Neuroptera: Myrmeleontidae)

The antlions (Myrmeleontidae) of Cyprus have been poorly studied and only 13 species were known from this biogeographically interesting island. In light of new field research, we provide an updated checklist to the Cypriot antlions, including seven species reported for the first time from the island. Of these, the findings of the Middle Eastern species Distoleon laticollis and Cueta kasyi are particularly noteworthy. The Cypriot antlion fauna appears dominated by widespread Mediterranean elements, with relatively few Middle Eastern and endemic species

Microbial biopesticides for integrated crop management : an assessment of environmental and regulatory sustainability

Herbivorous insects and mites, plant diseases and weeds are major impediments to the production of food crops and are increasingly difficult to control with conventional chemicals. This paper focuses on microbial control agents with an emphasis on augmentation. There are marked differences in the availability of products in different countries which can be explained in terms of differences in their regulatory systems. Regulatory failure arises from the application of an inappropriate synthetic pesticides model. An understanding of regulatory innovation is necessary to overcome these problems. Two attempts at remedying regulatory failure in the UK and the Netherlands are assessed. Scientific advances can feed directly into the regulatory process and foster regulatory innovation

Trends in Europe storm surge extremes match the rate of sea-level rise

Coastal communities across the world are already feeling the disastrous impacts of climate change through variations in extreme sea levels1. These variations reflect the combined effect of sea-level rise and changes in storm surge activity. Understanding the relative importance of these two factors in altering the likelihood of extreme events is crucial to the success of coastal adaptation measures. Existing analyses of tide gauge records2,3,4,5,6,7,8,9,10 agree that sea-level rise has been a considerable driver of trends in sea-level extremes since at least 1960. However, the contribution from changes in storminess remains unclear, owing to the difficulty of inferring this contribution from sparse data and the consequent inconclusive results that have accumulated in the literature11,12. Here we analyse tide gauge observations using spatial Bayesian methods13 to show that, contrary to current thought, trends in surge extremes and sea-level rise both made comparable contributions to the overall change in extreme sea levels in Europe since 1960 . We determine that the trend pattern of surge extremes reflects the contributions from a dominant north–south dipole associated with internal climate variability and a single-sign positive pattern related to anthropogenic forcing. Our results demonstrate that both external and internal influences can considerably affect the likelihood of surge extremes over periods as long as 60 years, suggesting that the current coastal planning practice of assuming stationary surge extremes1,14 might be inadequate

A new species in the tree genus Polyceratocarpus (Annonaceae) from the Udzungwa Mountains of Tanzania

Polyceratocarpus askhambryan-iringae, an endemic tree species of Annonaceae from the Udzungwa Mountains of Tanzania, is described and illustrated. The new species is identified as a member of the genus Polyceratocarpus by the combination of staminate and bisexual flowers, axillary inflorescences, subequal outer and inner petals, and multi-seeded monocarps with pitted seeds. From Polyceratocarpus scheffleri, with which it has previously been confused, it differs in the longer pedicels, smaller and thinner petals, shorter bracts, and by generally smaller, less curved monocarps that have a clear stipe and usually have fewer seeds. Because Polyceratocarpus askhambryan-iringae has a restricted extent of occurrence, area of occupancy, and ongoing degradation of its forest habitat, we recommend classification of it as Endangered (EN) on the IUCN Red List

Divergent functions and distinct localization of the Notch ligands DLL1 and DLL3 in vivo

The Notch ligands Dll1 and Dll3 are coexpressed in the presomitic mesoderm of mouse embryos. Despite their coexpression, mutations in Dll1 and Dll3 cause strikingly different defects. To determine if there is any functional equivalence, we replaced Dll1 with Dll3 in mice. Dll3 does not compensate for Dll1; DLL1 activates Notch in Drosophila wing discs, but DLL3 does not. We do not observe evidence for antagonism between DLL1 and DLL3, or repression of Notch activity in mice or Drosophila. In vitro analyses show that differences in various domains of DLL1 and DLL3 individually contribute to their biochemical nonequivalence. In contrast to endogenous DLL1 located on the surface of presomitic mesoderm cells, we find endogenous DLL3 predominantly in the Golgi apparatus. Our data demonstrate distinct in vivo functions for DLL1 and DLL3. They suggest that DLL3 does not antagonize DLL1 in the presomitic mesoderm and warrant further analyses of potential physiological functions of DLL3 in the Golgi network