Patterns, Predictors, and Outcomes of Falls Trajectories in Older Adults: The MOBILIZE Boston Study with 5 Years of Follow-Up

Background: Falls may occur as unpredictable events or in patterns indicative of potentially modifiable risks and predictive of adverse outcomes. Knowing the patterns, risks, and outcomes of falls trajectories may help clinicians plan appropriate preventive measures. We hypothesized that clinically distinct trajectories of falls progression, baseline predictors and their coincident clinical outcomes could be identified. Methods: We studied 765 community-dwelling participants in the MOBILIZE Boston Study, who were aged 70 and older and followed prospectively for falls over 5 years. Baseline demographic and clinical data were collected by questionnaire and a comprehensive clinic examination. Falls, injuries, and hospitalizations were recorded prospectively on daily calendars. Group-Based Trajectory Modeling (GBTM) was used to identify trajectories. Results: We identified 4 distinct trajectories: No Falls (30.1%), Cluster Falls (46.1%), Increasing Falls (5.8%) and Chronic Recurring Falls (18.0%). Predictors of Cluster Falls were faster gait speed (OR 1.69 (95CI, 1.50–2.56)) and fall in the past year (OR 3.52 (95CI, 2.16–6.34)). Predictors of Increasing Falls were Diabetes Mellitus (OR 4.3 (95CI, 1.4–13.3)) and Cognitive Impairment (OR 2.82 (95CI, 1.34–5.82)). Predictors of Chronic Recurring Falls were multi-morbidity (OR 2.24 (95CI, 1.60–3.16)) and fall in the past year (OR 3.82 (95CI, 2.34–6.23)). Symptoms of depression were predictive of all falls trajectories. In the Chronic Recurring Falls trajectory group the incidence rate of Hospital visits was 121 (95% CI 63–169) per 1,000 person-years; Injurious falls 172 (95% CI 111–237) per 1,000 person-years and Fractures 41 (95% CI 9–78) per 1,000 person-years. Conclusions: Falls may occur in clusters over discrete intervals in time, or as chronically increasing or recurring events that have a relatively greater risk of adverse outcomes. Patients with multiple falls, multimorbidity, and depressive symptoms should be targeted for preventive measures

Oscillatory and Asymptotic Behavior of Nonlinear Functional Dynamic Equations of Third Order

The purpose of this work is to derive sufficient conditions for the oscillation of all solutions of the third-order functional dynamic equation p2ξφγ2p1ξφγ1yΔξΔΔ+pξφβygξ=0, on a time scale T. In addition, we present some Hille-type conditions for generalized third-order dynamic equations that improve and extend significant contributions reported in the literature without imposing time-scale restrictions. An example is given to demonstrate the essential results. © 2022 Taher S. Hassan et al

Traumatismes de L’Abdomen et du Périnée par Encornements de Bœufs au Centre Hospitalier Régional de Dapaong, Togo

Background: This paper focuses on describing the epidemilogical, lesional, and therapeutic aspects of abdomen and perineum bull horn trauma at Regional Hospital of Dapaong. Methodology: It is a descriptive retrospective study, which includes patientstreated for abdomen and perineum bullhorn trauma, in the surgery department of Regional Hospital of Dapaong from January 2016 to December 2018 (3 years). Results: 34 patients were treated for abdominal and perineal bullhorn injuries. They comprised of 31 men and 3 women, with an average age of 18.47 ± 16.14 years old (extremes: 6 and 70 years old). They were mainly less than 15 years old and were herd guards. The lesion report noted 9 cases of abdominal blunt trauma, 22 cases of abdominal wounds including 19 cases of penetrating wounds, and 3 cases of perineal wounds including 1 case of associated rectal lesion. Visceral lesions were varied and often associated. The care was mainly surgical. The short term evolution was marked by a local infection in 8 cases (23.5%). The prognosis was good in all cases. Conclusion: Bullhorn trauma is a frequent cause of abdomen and perineum injuries at Regional Hospital of Dapaong. The outcome after adequate care is often favourable. Objectifs: Décrire les aspects épidémiologiques, lésionnels et thérapeutiques destraumatismes de l’abdomen et du périnée par encornements de bœufs au Centre Hospitalier Régional de Dapaong. Méthodologie : Etude rétrospective descriptive incluant les dossiers des blessés de l’abdomen et du périnée par encornements de bœufs, pris en charge dans le service de chirurgie du CHR Dapaong, de Janvier 2016 à Décembre 2018 (3 ans). Résultats : Trente-quatre patients ont été pris en charge pour lésions traumatiques de l’abdomen et du périnée par coups de cornes de bœufs. Il s’agissait de 31 hommes et 3 femmes d’âge moyen de 18,47 ± 16,14 ans (extrêmes : 6 ans et 70 ans). La majorité des victimes avait moins de 15 ans, et était des gardes troupeaux. Le bilan lésionnel au niveau abdominal notait 9 cas de contusion et 22 cas de plaies dont 19 cas de plaies pénétrantes. Les lésions viscérales étaient variées et souvent associées. Au niveau périnéal, on notait 3 cas de plaies dont un cas de lésion rectale associée. La prise en charge était chirurgicale dans la majorité des cas. L’évolution à court terme était marquée par une infection locale dans 8 cas (23,5%). Le pronostic était bon dans tous les cas. Conclusion : Les encornements de bœufs constituent une cause fréquente de traumatismes de l’abdomen et du périnée au CHR Dapaong. L’évolution après prise en charge adéquate est souvent favorable

Multicomponent intervention to prevent mobility disability in frail older adults: randomised controlled trial (SPRINTT project)

Objective: To determine whether a multicomponent intervention based on physical activity with technological support and nutritional counselling prevents mobility disability in older adults with physical frailty and sarcopenia. Design: Evaluator blinded, randomised controlled trial. Setting: 16 clinical sites across 11 European countries, January 2016 to 31 October 2019. Participants: 1519 community dwelling men and women aged 70 years or older with physical frailty and sarcopenia, operationalised as the co-occurrence of low functional status, defined as a short physical performance battery (SPPB) score of 3 to 9, low appendicular lean mass, and ability to independently walk 400 m. 760 participants were randomised to a multicomponent intervention and 759 received education on healthy ageing (controls). Interventions: The multicomponent intervention comprised moderate intensity physical activity twice weekly at a centre and up to four times weekly at home. Actimetry data were used to tailor the intervention. Participants also received personalised nutritional counselling. Control participants received education on healthy ageing once a month. Interventions and follow-up lasted for up to 36 months. Main outcome measures: The primary outcome was mobility disability (inability to independently walk 400 m in <15 minutes). Persistent mobility disability (inability to walk 400 m on two consecutive occasions) and changes from baseline to 24 and 36 months in physical performance, muscle strength, and appendicular lean mass were analysed as pre-planned secondary outcomes. Primary comparisons were conducted in participants with baseline SPPB scores of 3-7 (n=1205). Those with SPPB scores of 8 or 9 (n=314) were analysed separately for exploratory purposes. Results: Mean age of the 1519 participants (1088 women) was 78.9 (standard deviation 5.8) years. The average follow-up was 26.4 (SD 9.5) months. Among participants with SPPB scores of 3-7, mobility disability occurred in 283/605 (46.8%) assigned to the multicomponent intervention and 316/600 (52.7%) controls (hazard ratio 0.78, 95% confidence interval 0.67 to 0.92; P=0.005). Persistent mobility disability occurred in 127/605 (21.0%) participants assigned to the multicomponent intervention and 150/600 (25.0%) controls (0.79, 0.62 to 1.01; P=0.06). The between group difference in SPPB score was 0.8 points (95% confidence interval 0.5 to 1.1 points; P<0.001) and 1.0 point (95% confidence interval 0.5 to 1.6 points; P<0.001) in favour of the multicomponent intervention at 24 and 36 months, respectively. The decline in handgrip strength at 24 months was smaller in women assigned to the multicomponent intervention than to control (0.9 kg, 95% confidence interval 0.1 to 1.6 kg; P=0.028). Women in the multicomponent intervention arm lost 0.24 kg and 0.49 kg less appendicular lean mass than controls at 24 months (95% confidence interval 0.10 to 0.39 kg; P<0.001) and 36 months (0.26 to 0.73 kg; P<0.001), respectively. Serious adverse events occurred in 237/605 (39.2%) participants assigned to the multicomponent intervention and 216/600 (36.0%) controls (risk ratio 1.09, 95% confidence interval 0.94 to 1.26). In participants with SPPB scores of 8 or 9, mobility disability occurred in 46/155 (29.7%) in the multicomponent intervention and 38/159 (23.9%) controls (hazard ratio 1.25, 95% confidence interval 0.79 to 1.95; P=0.34). Conclusions: A multicomponent intervention was associated with a reduction in the incidence of mobility disability in older adults with physical frailty and sarcopenia and SPPB scores of 3-7. Physical frailty and sarcopenia may be targeted to preserve mobility in vulnerable older people

Use of Biomarkers in the Evaluation and Treatment of Hypertensive Patients

The current definition of hypertension is based on blood pressure values, and blood pressure also drives treatment decisions, is the most important treatment monitoring tool and helps estimating risk of hypertension related organ damage. In an era of precision medicine additional biomarkers are needed in the diagnosis and management of patients with hypertension. In this review we outline the areas in which functional, imaging and circulating biomarkers could help in a more individualised definition of hypertension and associated risk. We will cover biomarkers for diagnosis; of pathophysiology and prediction of hypertension; response to treatment, organ damage; and to monitor treatment. A clear focus is on the vasculature, the heart and the kidneys, whereas we see a need to further develop biomarkers of cerebral function in order to diagnose cognition deficits and monitor changes in cognition in the future to support addressing the growing burden of hypertension associated vascular dementia

Etude de l'impact de la domotique et des systèmes de téléassistance sur les chutes à domicile des personnes âgées en perte d'autonomie

LIMOGES-BU Médecine pharmacie (870852108) / SudocSudocFranceF

Efficacy of Home-based Technology (HBTec) for Preventing Falls in Older Adults.

International audienc

Removing attitude-related variations in the line-of-sight for kinematic GPS positioning

ISI Document Delivery No.: 785FG Times Cited: 1 Cited Reference Count: 18 Cited References: ANDERSEN OB, 2009, GEOD PLAN EARTH M BU BLEWITT G, 1989, J GEOPHYS RES-SOLID, V94, P10187, DOI 10.1029/JB094iB08p10187 Bock H, 2009, J GEODESY, V83, P1083, DOI 10.1007/s00190-009-0326-1 Bouin MN, 2009, J GEODESY, V83, P1203, DOI 10.1007/s00190-009-0338-x Chen G., 1998, THESIS MIT CAMBRIDGE Dai Z, 2009, GPS SOLUT, V13, P241, DOI 10.1007/s10291-008-0108-x Ge M, 2008, J GEODESY, V82, P389, DOI 10.1007/s00190-007-0187-4 King M, 2000, EARTH PLANETS SPACE, V52, P1043 King M, 2003, J GEODESY, V77, P15, DOI 10.1007/s00190-002-0308-z Georgiadou Y., 1988, Manuscripta Geodaetica, V13 Kouba J., 2009, GUIDE USING INT GNSS LAURICHESS D, 2007, P 20 INT TECH M SAT MELACHROINOS S, 2004, THESIS OBSERVATOIRE Melachroinos S.A., 2009, OC SEA SURF SCI TEAM Melachroinos SA, 2008, J GEODESY, V82, P357, DOI 10.1007/s00190-007-0185-6 PROVOST, 2010, EXPEDITION RES VESSE Schmid R, 2005, GPS SOLUT, V9, P283, DOI 10.1007/s10291-005-0134-x Wu J. T., 1993, Manuscripta Geodaetica, V18 Melachroinos, Stavros A. Tchalla, Mayaba Biancale, Richard Menard, Yves 1 SPRINGER HEIDELBERG HEIDELBERG GPS SOLUTWe are presenting a method for removing attitude-related variations (ATTRVs) in dynamic 1 Hz GPS positioning. The ATTRVs are separated into vertical and horizontal components. These result from the translational and rotational motions of the vehicle, which is a marine research vessel in our case. We have developed new observation equations that use corrected pseudoranges and carrier phases to account for ATTRVs. In the present contribution, we are only focusing on the vertical signals. These modeled ATTRVs are included as corrections in the line-of-sight (LoS) to each GPS satellite in the RINEX data sets using a new software called RNXATTCOR. Precise IGS sp3-orbits are used as inputs together with precise lever arm coordinates of the onboard GPS antennas, observations from the marine inertial navigation system and a priori 3D position of the vessel. The corrected RINEX data sets are then processed using kinematic processing or sequential processing in Precise Point Positioning (PPP) mode. The reduction of the standard deviation from a running mean in the final processed GPS time series is about 95%. The current method is being proposed for marine geodesy science applications such as along-track calibration/validation of altimetry products, and also for applications related to offshore kinematic high precision GPS positioning such as drilling, offshore platforms stability, marine pipeline positioning, earthquake monitoring and tsunami detection

Fully Immersive Virtual Reality Using 360° Videos to Manage Well-Being in Older Adults: A Scoping Review

Objective: The development of negative behavioral and psychosocial factors (depression, anxiety, apathy, etc) is associated with poor well-being, which can contribute to health issues in ageing, especially in the context of COVID-19. Despite its relative novelty, fully immersive virtual reality (VR) interventions through 360 immersive videos are becoming more accessible and flexible and constitute an emerging method to potentially enhance well-being. The aim of this scoping review is to assess the effectiveness of 360 interventions on well-being in older adults with or without cognitive impairment, as well as cybersickness and attitudes toward this technology. Design: Scoping review. Setting and Participants: Older adults with or without cognitive impairment. Methods: The PRISMA-SR guideline was followed. Four databases were used, and we selected articles published until April 2022. We have analyzed the effect of 360° videos on the well-being of older adults with respect to the study design, the population, the contents, the duration of intervention, and the outcomes. Results: A total of 2262 articles were screened, of which 10 articles were finally included in this review. Most of them are pilot studies and used mixed methods including scales and interviews. The material and content of VR are diversified. Many behavioral and psychological outcomes were assessed, including anxiety, apathy, loneliness, depression, social engagement, quality of life, and emotions. The results were positive or mixed, according to the outcomes. We recorded few adverse events, and the interviews show contrasting results concerning the participants’ feelings (ie, degree of immersion, familiarity with technology, and VR content). Conclusions and Implications: The use of VR 360° videos seems feasible in community-dwelling older adults or residential aged care facilities, as they are safe and provide enjoyment. It constitutes an emerging and promising therapeutic tool to manage psychosocial disorders. This review provides key considerations for the design and implementation of interventions using VR 360° video in clinical practice

Pathologies et Risques Infectieux, diagnostic d’une méningo encéphalite hépétique suite à une hyperthermie persistante.

National audienc