Impact of the HOP-UP-PT program on older adults at risk to fall: a randomized controlled trial

BACKGROUND: Reduced falls and fall risks have been observed among older adults referred to the HOP-UP-PT (Home-based Older Persons Upstreaming Prevention-Physical Therapy) program. The purpose of this study was to describe outcomes of HOP-UP-PT program participants and then to compare these outcomes to non-participants. METHODS: Six Michigan senior centers referred adults ≥65 years who were at-risk for functional decline or falls. 144 participants (n = 72 per group) were randomized to either the experimental group (EG) or the control group (CG). Physical therapists (PTs) delivered physical, environmental, and health interventions to the EG over nine encounters (six in-person, three telerehabilitation) spanning seven months. The CG participants were told to continue their usual physical activity routines during the same time frame. Baseline and re-assessments were conducted at 0-, 3-, and 7-months in both groups. Descriptions and comparisons from each assessment encounter were analyzed. RESULTS: Participants ages were: EG = 76.6 (7.0) years and CG = 77.2 (8.2). Baseline measures were not significantly different apart from the Short Physical Performance Battery (SPPB) which favored the EG (P = 0.02). While no significant differences were identified in the survey outcomes or home environment assessments, significant differences in favor of the EG were identified in common fall risk indicators including the Timed Up and Go (P = 0.04), Four Test Balance Scale (P = 0.01), and the modified SPPB (P = 0.02) at the 3-month assessment visit. However, these differences were not sustained at the 7-month assessment as, notably, both groups demonstrated positive improvements in the Four Test Balance Score and SPPB. For individuals at a moderate/high fall risk at baseline, 47.8% of CG reported falling at seven months; whereas, only 6.3% of EG participants meeting the same criteria reported a fall after HOP-UP-PT participation. CONCLUSIONS: A prevention-focused multimodal program provided by PTs in older adults\u27 homes proved beneficial and those with the highest fall risk demonstrated a significant decrease in falls. A collaboration between PTs and community senior centers resulted in upstreaming care delivery that may reduce both the financial and personal burdens associated with falls in an older adult population. TRIAL REGISTRATION: This study was retrospective registered at Clinical Trials.gov , TRN: NCT04814459 on 24/03/2021

Epithelial Na \u3csup\u3e+\u3c/sup\u3e sodium channels in magnocellular cells of the rat supraoptic and paraventricular nuclei

The epithelial Na + channels (ENaCs) are present in kidney and contribute to Na + and water homeostasis. All three ENaC subunits (α, β, and γ) were demonstrated in the cardiovascular regulatory centers of the rat brain, including the magnocellular neurons (MNCs) in the supraoptic nucleus (SON) and the paraventricular nucleus (PVN). However, the functional significance of ENaCs in vasopressin (VP) and oxytocin (OT) synthesizing MNCs is completely unknown. In this study, we show with immunocytochemical double-labeling that the α-ENaC is colocalized with either VP or OT in MNCs in the SON and PVN. In addition, parvocellular neurons in the dorsal, ventrolateral, and posterior subregions of the PVN (not immunoreactive to VP or OT) are also immunoreactive for α-ENaC. In contrast, immunoreactivity to β- and γ-ENaC is colocalized with VP alone within the MNCs. Furthermore, immunoreactivity for a known target for ENaC expression, the mineralcorticoid receptor (MR), is colocalized with both VP and OT in MNCs. Using single-cell RT-PCR, we detected mRNA for all three ENaC subunits and MR in cDNA libraries derived from single MNCs. In whole cell voltage clamp recordings, application of the ENaC blocker benzamil reversibly reduced a steady-state inward current and decreased cell membrane conductance approximately twofold. Finally, benzamil caused membrane hyperpolarization in a majority of VP and about one-half of OT neurons in both spontaneously firing and quiet cells. These results strongly suggest the presence of functional ENaCs that may affect the firing patterns of MNCs, which ultimately control the secretion of VP and OT. © 2012 the American Physiological Society

HOPS 383: An Outbursting Class 0 Protostar in Orion

We report the dramatic mid-infrared brightening between 2004 and 2006 of HOPS 383, a deeply embedded protostar adjacent to NGC 1977 in Orion. By 2008, the source became a factor of 35 brighter at 24 microns with a brightness increase also apparent at 4.5 microns. The outburst is also detected in the submillimeter by comparing APEX/SABOCA to SCUBA data, and a scattered-light nebula appeared in NEWFIRM K_s imaging. The post-outburst spectral energy distribution indicates a Class 0 source with a dense envelope and a luminosity between 6 and 14 L_sun. Post-outburst time-series mid- and far-infrared photometry shows no long-term fading and variability at the 18% level between 2009 and 2012. HOPS 383 is the first outbursting Class 0 object discovered, pointing to the importance of episodic accretion at early stages in the star formation process. Its dramatic rise and lack of fading over a six-year period hint that it may be similar to FU Ori outbursts, although the luminosity appears to be significantly smaller than the canonical luminosities of such objects.Comment: Accepted by ApJ Letters, 6 pages, 4 figures; v2 has an updated email address for the lead autho

The Herschel Orion Protostar Survey: Far-Infrared Photometry and Colors of Protostars and Their Variations across Orion A and B

The degree to which the properties of protostars are affected by environment remains an open question. To investigate this, we look at the Orion A and B molecular clouds, home to most of the protostars within 500 pc. At ~400 pc, Orion is close enough to distinguish individual protostars across a range of environments in terms of both the stellar and gas projected densities. As part of the Herschel Orion Protostar Survey (HOPS), we used the Photodetector Array Camera and Spectrometer (PACS) to map 108 partially overlapping square fields with edge lengths of 5 arcmin or 8 arcmin and measure the 70 micron and 160 micron flux densities of 338 protostars within them. In this paper we examine how these flux densities and their ratio depend on evolutionary state and environment within the Orion complex. We show that Class 0 protostars occupy a region of the 70 micron flux density versus 160 micron to 70 micron flux density ratio diagram that is distinct from their more evolved counterparts. We then present evidence that the Integral-Shaped Filament (ISF) and Orion B contain protostars with more massive envelopes than those in the more sparsely populated LDN 1641 region. This can be interpreted as evidence for increasing star formation rates in the ISF and Orion B or as a tendency for more massive envelopes to be inherited from denser birth environments. We also provide technical details about the map-making and photometric procedures used in the HOPS program.Comment: Accepted by Ap

The Herschel Orion Protostar Survey: Far-infrared Photometry and Colors of Protostars and Their Variations across Orion A and B

The degree to which the properties of protostars are affected by environment remains an open question. To investigate this, we look at the Orion A and B molecular clouds, home to most of the protostars within 500 pc. At ~400 pc, Orion is close enough to distinguish individual protostars across a range of environments in terms of both the stellar and gas projected densities. As part of the Herschel Orion Protostar Survey (HOPS), we used the Photodetector Array Camera and Spectrometer to map 108 partially overlapping square fields with edge lengths of 5' or 8' and measure the 70 and 160 μm flux densities of 338 protostars within them. In this paper we examine how these flux densities and their ratio depend on evolutionary state and environment within the Orion complex. We show that Class 0 protostars occupy a region of the 70 μm flux density versus 160 μm/70 μm flux density ratio diagram that is distinct from their more evolved counterparts. We then present evidence that the Integral-Shaped Filament (ISF) and Orion B contain protostars with more massive inner envelopes than those in the more sparsely populated LDN 1641 region. This can be interpreted as evidence for increasing star formation rates in the ISF and Orion B or as a tendency for more massive inner envelopes to be inherited from denser birth environments. We also provide technical details about the mapmaking and photometric procedures used in the HOPS program

A Herschel and APEX Census of the Reddest Sources in Orion: Searching for the Youngest Protostars

We perform a census of the reddest, and potentially youngest, protostars in the Orion molecular clouds using data obtained with the PACS instrument on board the Herschel Space Observatory and the LABOCA and SABOCA instruments on APEX as part of the Herschel Orion Protostar Survey (HOPS). A total of 55 new protostar candidates are detected at 70 μm and 160 μm that are either too faint (m_(24) > 7 mag) to be reliably classified as protostars or undetected in the Spitzer/MIPS 24 μm band. We find that the 11 reddest protostar candidates with log λF_λ70/λF_λ24 > 1.65 are free of contamination and can thus be reliably explained as protostars. The remaining 44 sources have less extreme 70/24 colors, fainter 70 μm fluxes, and higher levels of contamination. Taking the previously known sample of Spitzer protostars and the new sample together, we find 18 sources that have log λF_λ70/λF_λ24 > 1.65; we name these sources "PACS Bright Red sources," or PBRs. Our analysis reveals that the PBR sample is composed of Class 0 like sources characterized by very red spectral energy distributions (SEDs; T_(bol) 0.6%). Modified blackbody fits to the SEDs provide lower limits to the envelope masses of 0.2-2 M_☉ and luminosities of 0.7-10 L_☉. Based on these properties, and a comparison of the SEDs with radiative transfer models of protostars, we conclude that the PBRs are most likely extreme Class 0 objects distinguished by higher than typical envelope densities and hence, high mass infall rates

Impact of Cigarette Smoking Status on Pain Intensity Among Veterans With and Without Hepatitis C

Objective: Chronic pain is a significant problem in patients living with hepatitis C virus (HCV). Tobacco smoking is an independent risk factor for high pain intensity among veterans. This study aims to examine the independent associations with smoking and HCV on pain intensity, as well as the interaction of smoking and HCV on the association with pain intensity. Design/Particpants: Cross-sectional analysis of a cohort study of veterans of Operations Enduring Freedom/Iraqi Freedom/New Dawn (OEF/OIF/OND) who had at least one visit to a Veterans Health Administration (VHA) primary care clinic between 2001 and 2014. Methods: HCV was identified using ICD-9 codes from electronic medical records (EMRs). Pain intensity, reported on a 0-10 numeric rating scale, was categorized as none/mild (0-3) and moderate/severe (4-10). Results: Among 654,841 OEF/OIF/OND veterans (median age [interquartile range] = 26 [23-36] years), 2,942 (0.4%) were diagnosed with HCV. Overall, moderate/severe pain intensity was reported in 36% of veterans, and 37% were current smokers. The adjusted odds of reporting moderate/severe pain intensity were 1.23 times higher (95% confidence interval [CI] = 1.14-1.33) for those with HCV and 1.26 times higher (95% CI = 1.25-1.28) for current smokers. In the interaction model, there was a significant Smoking Status x HCV interaction (P = 0.03). Among veterans with HCV, smoking had a significantly larger association with moderate/severe pain (adjusted odds ratio [OR] = 1.50, P \u3c 0.001) than among veterans without HCV (adjusted OR = 1.26, P \u3c 0.001). Conclusions: We found that current smoking is more strongly linked to pain intensity among veterans with HCV. Further investigations are needed to explore the impact of smoking status on pain and to promote smoking cessation and pain management in veterans with HCV

Dietary Arginine Regulates Severity of Experimental Colitis and Affects the Colonic Microbiome

There is great interest in safe and effective alternative therapies that could benefit patients with inflammatory bowel diseases (IBD). L-arginine (Arg) is a semi-essential amino acid with a variety of physiological effects. In this context, our aim was to investigate the role of dietary Arg in experimental colitis. We used two models of colitis in C57BL/6 mice, the dextran sulfate sodium (DSS) model of injury and repair, and Citrobacter rodentium infection. Animals were given diets containing (1) no Arg (Arg0), 6.4 g/kg (ArgNL), or 24.6 g/kg Arg (ArgHIGH); or (2) the amino acids downstream of Arg: 28 g/kg L-ornithine (OrnHIGH) or 72 g/kg L-proline (ProHIGH). Mice with DSS colitis receiving the ArgHIGH diet had increased levels of Arg, Orn, and Pro in the colon and improved body weight loss, colon length shortening, and histological injury compared to ArgNL and Arg0 diets. Histology was improved in the ArgNL vs. Arg0 group. OrnHIGH or ProHIGH diets did not provide protection. Reduction in colitis with ArgHIGH diet also occurred in C. rodentium-infected mice. Diversity of the intestinal microbiota was significantly enhanced in mice on the ArgHIGH diet compared to the ArgNL or Arg0 diets, with increased abundance of Bacteroidetes and decreased Verrucomicrobia. In conclusion, dietary supplementation of Arg is protective in colitis models. This may occur by restoring overall microbial diversity and Bacteroidetes prevalence. Our data provide a rationale for Arg as an adjunctive therapy in IBD