The Effectiveness of the Stepping On Program for Reducing the Incidence of Falls in the Elderly

Background: One in three adults greater than 65 years of age have had an accidental fall in their lifetime. In 2012, accidental falls cost the U.S. healthcare system $30.1 billion dollars. Strength, balance, and coordination deficits contribute to an individual experiencing a fall. Studies have shown that community based-exercise programs for older adults can improve strength, balance, and coordination and reduce the risk of falls. Objective: The purpose of this study was to discover whether participant balance and confidence improved following the completion of the Stepping On program. Also, the study evaluated the effectiveness of Stepping On in reducing fall risk by determining whether balance tests including: Five Time Sit-to-Stand (FTSS), Four-Stage Balance Test (FSBT), Timed Up and Go (TUG), and Gait Speed via GAITRite, identify individuals at risk of falling and if the tests could be effectively administered in community fall prevention programs. Methods: Ten participants were recruited from two Stepping On programs being offered in the local area. Baseline questionnaires were collected from participants at the Week 2 and Week 7 sessions. Balance assessments (FTSS, FSBT, TUG, and Gait Speed) were performed at Week 2 and Week 7 to determine fall risk of the participants. The Falls Efficacy Scale International (FES-I) and Falls Behavior Scale (FaB) were also completed at Week 2, Week 7, and a 3 month recheck to determine participants\u27 confidence and perceived fall risk. Results: T- tests were performed comparing balance test scores from Week 2 to Week 7. There was a significant improvement in times on the TUG (p=0.015). A significant decrease was also found in the total number of tests that identified a participant\u27s fall risk from Week 2 to Week 7 (p=0.034). All the participants subjectively reported balance and confidence improvement following the program. Conclusion: Significance was found with improved times on the TUG from Week 2 to Week 7, demonstrating a decrease of participants\u27 fall risk. These findings suggest that the TUG can be used as a quick balance screening tool to help identify objective benefits from community-based fall prevention programs. The TUG could be an effective addition to fall prevention programs to help participants understand their perceived risk and strategize ways to help prevent falls

Coronavirus disease 2019 vaccine response in pregnant and lactating women: a cohort study

BACKGROUND: Pregnant and lactating women were excluded from initial coronavirus disease 2019 vaccine trials; thus, data to guide vaccine decision making are lacking. OBJECTIVE: This study aimed to evaluate the immunogenicity and reactogenicity of coronavirus disease 2019 messenger RNA vaccination in pregnant and lactating women compared with: (1) nonpregnant controls and (2) natural coronavirus disease 2019 infection in pregnancy. STUDY DESIGN: A total of 131 reproductive-age vaccine recipients (84 pregnant, 31 lactating, and 16 nonpregnant women) were enrolled in a prospective cohort study at 2 academic medical centers. Titers of severe acute respiratory syndrome coronavirus 2 spike and receptor-binding domain immunoglobulin G, immunoglobulin A, and immunoglobulin M were quantified in participant sera (n=131) and breastmilk (n=31) at baseline, at the second vaccine dose, at 2 to 6 weeks after the second vaccine, and at delivery by Luminex. Umbilical cord sera (n=10) titers were assessed at delivery. Titers were compared with those of pregnant women 4 to 12 weeks from the natural infection (n=37) by enzyme-linked immunosorbent assay. A pseudovirus neutralization assay was used to quantify neutralizing antibody titers for the subset of women who delivered during the study period. Postvaccination symptoms were assessed via questionnaire. Kruskal-Wallis tests and a mixed-effects model, with correction for multiple comparisons, were used to assess differences among groups. RESULTS: Vaccine-induced antibody titers were equivalent in pregnant and lactating compared with nonpregnant women (pregnant, median, 5.59; interquartile range, 4.68–5.89; lactating, median, 5.74; interquartile range, 5.06–6.22; nonpregnant, median, 5.62; interquartile range, 4.77–5.98, P=.24). All titers were significantly higher than those induced by severe acute respiratory syndrome coronavirus 2 infection during pregnancy (P<.0001). Vaccine-generated antibodies were present in all umbilical cord blood and breastmilk samples. Neutralizing antibody titers were lower in umbilical cord than maternal sera, although this finding did not achieve statistical significance (maternal sera, median, 104.7; interquartile range, 61.2–188.2; cord sera, median, 52.3; interquartile range, 11.7–69.6; P=.05). The second vaccine dose (boost dose) increased severe acute respiratory syndrome coronavirus 2–specific immunoglobulin G, but not immunoglobulin A, in maternal blood and breastmilk. No differences were noted in reactogenicity across the groups. CONCLUSION: Coronavirus disease 2019 messenger RNA vaccines generated robust humoral immunity in pregnant and lactating women, with immunogenicity and reactogenicity similar to that observed in nonpregnant women. Vaccine-induced immune responses were statistically significantly greater than the response to natural infection. Immune transfer to neonates occurred via placenta and breastmilk

Compromised SARS-CoV-2-specific placental antibody transfer

SARS-CoV-2 infection causes more severe disease in pregnant women compared to age-matched non-pregnant women. Whether maternal infection causes changes in the transfer of immunity to infants remains unclear. Maternal infections have previously been associated with compromised placental antibody transfer, but the mechanism underlying this compromised transfer is not established. Here, we used systems serology to characterize the Fc profile of influenza-, pertussis-, and SARS-CoV-2-specific antibodies transferred across the placenta. Influenza- and pertussis-specific antibodies were actively transferred. However, SARS-CoV-2-specific antibody transfer was significantly reduced compared to influenza- and pertussis-specific antibodies, and cord titers and functional activity were lower than in maternal plasma. This effect was only observed in third-trimester infection. SARS-CoV-2-specific transfer was linked to altered SARS-CoV-2-antibody glycosylation profiles and was partially rescued by infection-induced increases in IgG and increased FCGR3A placental expression. These results point to unexpected compensatory mechanisms to boost immunity in neonates, providing insights for maternal vaccine design.NIH (Grants 3R37AI080289-11S1, R01AI146785, U19AI42790-01, U19AI135995-02, U19AI42790-01, 1U01CA260476 – 01, CIVIC5N93019C00052)Bill and Melinda Gates Foundation (Awards OPP1146996 and INV- 001650

Determination of cyclodextrin formation constants using dynamic coupled-column liquid chromatography

Dynamic coupled-column liquid chromatography is used to determine both aqueous solubilities and cyclodextrin inclusion complex formation constants for a series of polynuclear aromatic hydrocarbons (PAHs). This method Is based on the increase In solubility afforded by cyclodextrlns upon complexation. Formation constant (Kf) values are determined by using α-, β-, and γ-cyclodextrlns at various temperatures. The relative precision of the calculated Kf values is best for cyclodextrin/PAH complexes with large formation constants. The calculated solubilities are comparable to literature values, and in most cases, formation constant data are reproducible within 10%. The resulting Kf values confirm that the formation of Inclusion complexes is based on the relative sizes of host and guest molecules. © 1989, American Chemical Society. All rights reserved

Youth, Technology, and HIV: Recent Advances and Future Directions

Technology, including mobile technologies and social media, offers powerful tools to reach, engage, and retain youth and young adults in HIV prevention and care interventions both in the United States and globally. In this report we focus on HIV, technology, and youth, presenting a synthesis of recently published (Jan 2014-May 2015) observational and experimental studies relevant for understanding and intervening on HIV risk, prevention and care. We present findings from a selection of the 66 relevant citations identified, highlighting studies that demonstrate a novel approach to technology interventions among youth in regard to content, delivery, target population or public health impact. We discuss current trends globally and in the US in how youth are using technology, as well as emergent research issues in this field – including the need for new theories for developing technology-based HIV interventions and new metrics of engagement, exposure, and evaluation