Comparison of balance assessment modalities in emergency department elders: a pilot cross-sectional observational study

<p>Abstract</p> <p>Background</p> <p>More than one-third of US adults 65 and over fall every year. These falls may cause serious injury including substantial long-term morbidity (due declines in activities of daily living) and death. The emergency department (ED) visit represents an opportunity for identifying high risk elders and potentially instituting falls-related interventions. The unique characteristic of the ED environment and patient population necessitate that risk-assessment modalities be validated in this specific setting. In order to better identify elders at risk of falls, we examined the relationship between patient-provided history of falling and two testing modalities (a balance plate system and the timed up-and-go [TUG] test) in elder emergency department (ED) patients.</p> <p>Methods</p> <p>We conducted a cross-sectional observational study of patients ≥ 60 years old being discharged from the ED. Patient history of falls in the past week, month, 6 months, and year was obtained. Balance plate center of pressure excursion (COP) measurements and TUG testing times were recorded. COP was recorded under four conditions: normal stability eyes open (NSEO) and closed (NSEC), and perturbed stability eyes open and closed. Correlation between TUG and COP scores was measured. Univariate logistic regression was used to identify the relationship between patient-provided falls history and the two testing modalities. Proportions, likelihood ratios, and receiver-operating-characteristic (ROC) curves for prediction of previous falls were reported.</p> <p>Results</p> <p>Fifty-three subjects were enrolled, 11% had fallen in the previous week and 42% in the previous year. There was no correlation between TUG and any balance plate measurements. In logistic regression, neither testing modality was associated with prior history of falls (<it>p </it>> 0.05 for all time periods). Balance plate NSEO and NSEC testing cutoffs could be identified which were 83% sensitive and had a negative likelihood ratio (LR-) of 0.3 for falls in the past week. TUG testing was not useful for falls in the past week, but performed best for more distant falls in the past month, 6 months, or year. TUG cutoffs with sensitivity over 80% and LR(-) of 0.17-0.32 could be identified for these time periods.</p> <p>Conclusion</p> <p>Over 40% of community-dwelling elder ED patients report a fall within the past year. Balance plate and TUG testing were feasibly conducted in an ED setting. There is no relationship between scores on balance plate and TUG testing in these patients. In regression analysis, neither modality was significantly associated with patient provided history of falls. These modalities should not be adopted for screening purposes in elders in the ED setting without validation in future studies or as part of multi-factorial risk assessment.</p

Global report on preterm birth and stillbirth (2 of 7): discovery science

<p>Abstract</p> <p>Background</p> <p>Normal and abnormal processes of pregnancy and childbirth are poorly understood. This second article in a global report explains what is known about the etiologies of preterm births and stillbirths and identifies critical gaps in knowledge. Two important concepts emerge: the continuum of pregnancy, beginning at implantation and ending with uterine involution following birth; and the multifactorial etiologies of preterm birth and stillbirth. Improved tools and data will enable discovery scientists to identify causal pathways and cost-effective interventions.</p> <p>Pregnancy and parturition continuum</p> <p>The biological process of pregnancy and childbirth begins with implantation and, after birth, ends with the return of the uterus to its previous state. The majority of pregnancy is characterized by rapid uterine and fetal growth without contractions. Yet most research has addressed only uterine stimulation (labor) that accounts for <0.5% of pregnancy.</p> <p>Etiologies</p> <p>The etiologies of preterm birth and stillbirth differ by gestational age, genetics, and environmental factors. Approximately 30% of all preterm births are indicated for either maternal or fetal complications, such as maternal illness or fetal growth restriction. Commonly recognized pathways leading to preterm birth occur most often during the gestational ages indicated: (1) inflammation caused by infection (22-32 weeks); (2) decidual hemorrhage caused by uteroplacental thrombosis (early or late preterm birth); (3) stress (32-36 weeks); and (4) uterine overdistention, often caused by multiple fetuses (32-36 weeks). Other contributors include cervical insufficiency, smoking, and systemic infections. Many stillbirths have similar causes and mechanisms. About two-thirds of late fetal deaths occur during the antepartum period; the other third occur during childbirth. Intrapartum asphyxia is a leading cause of stillbirths in low- and middle-income countries.</p> <p>Recommendations</p> <p>Utilizing new systems biology tools, opportunities now exist for researchers to investigate various pathways important to normal and abnormal pregnancies. Improved access to quality data and biological specimens are critical to advancing discovery science. Phenotypes, standardized definitions, and uniform criteria for assessing preterm birth and stillbirth outcomes are other immediate research needs.</p> <p>Conclusion</p> <p>Preterm birth and stillbirth have multifactorial etiologies. More resources must be directed toward accelerating our understanding of these complex processes, and identifying upstream and cost-effective solutions that will improve these pregnancy outcomes.</p

Products of cultured neuroglial cells: II. The production of fibronectin by C6 glioma cells

The possibility of fibronectin production by C6 glioma cells was examined with assays which require protein synthesis. Proteins produced by C6 cells using radiolabeled amino acid precursors were tested for affinity to collagen by binding to immobilized gelatin. The predominant collagen binding protein made by C6 coelectrophoresed with fibronectin synthesized by control fibroblasts and with the larger of the two proteins in unlabeled fibronectin when applied to polyacrylamide gels with sodium dodecyl sulfate (SDS). In addition, C6 produced a larger collagen binding protein of approximately 270,000 molecular weight. Solubilities in urea solutions of the collagen-binding proteins made by C6 cells and fibroblasts were similar. Immunofluorescence showed fibronectin associated with the C6 cell monolayer, but less abundant than the fibronectin associated with fibroblasts. Results provide evidence for the production of fibronectin by the C6 glioma cell line.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/45400/1/11064_2004_Article_BF00964399.pd

Enantiomer Identification In Chiral Mixtures With Broadband Microwave Spectroscopy

In nature and as products of chemical syntheses, chiral molecules often exist in mixtures with other chiral molecules. The analysis of these complex mixtures to identify the components, determine which enantiomers are present, and to measure the enantiomeric excesses (ee) is still one of the challenging but very important tasks of analytical chemistry. These analyses are required at every step of modern drug development, from candidate searches to production and regulation. \begin{wrapfigure}{r}{0pt} \includegraphics[scale=0.35]{menthone_carvone_mixed_down_fids.eps} \end{wrapfigure}We present here a new method of identifying individual enantiomers in mixtures of chiral molecules in the gas phase.\footnote{D. Patterson, M. Schnell, J. M. Doyle, \textit{Nature}. \textbf{497}, 475-477, 2013.}$^{,}$\footnote{V. A. Shubert, D. Schmitz, D. Patterson, J. M. Doyle, M. Schnell, \textit{Ang. Chem. Int. Ed.} \textbf{53}, 1152-1155,2014.} It is based on broadband rotational spectroscopy and employs a sum or difference frequency generation three-wave mixing process that involves a closed cycle of three rotational transitions. The phase of the acquired signal bares the signature of the enantiomer (see figure), as it depends upon the combined quantity, $\mu_{a}\mu_{b}\mu_{c}$, which is of opposite sign between members of an enantiomeric pair. Furthermore, because the signal amplitude is proportional to the ee, this technique allows for both determining which enantiomer is in excess and by how much. The high resolution of our technique allows us to perform molecule specific measurements of mixtures of chiral molecules with $\mu_{a}\mu_{b}\mu_{c} \neq$ 0, even when the molecules are very similar (e.g. conformational isomers). We introduce the technique and present results on the analysis of mixtures of the terpenes, carvone, menthone, and carvomenthenol

On the motivation of prospective students to go to university college of the Siberian State Industrial University

Among school graduates, an increased result in secondary vocational education and a decrease in interest in higher education became noticeable. This article discusses options for obtaining vocational education after graduation, puts forward hypotheses that explain the increased interest in obtaining secondary vocational education, in particular, the problem of increased fear of the unified state exam among applicants and their parents and their desire to «get around» it is studied. The article indicates the increased interest in the system of continuous education in general and in the city of Novokuznetsk in particular. To confirm the hypotheses put forward, a study was conducted in which 167 first-year students of the University College of the Siberian State Industrial University took part. The students were asked about their motives for entering the University College after the 9th grade, and about the reasons for entering the University College of the Siberian State Industrial University specifically. After analyzing the results, it was concluded that the hypotheses put forward were confirmed, and the main reason for the refusal of high school students to continue their studies at school in grades 10–11 in favor of obtaining a secondary vocational education was determined. The article notes that every year the number of those wishing to receive a secondary education at the Siberian State Industrial University will grow, therefore, the number of specialties and places for study should be expanded