Interventions for fall prevention in community-dwelling older persons

Falls in individuals over the age of 65 is a pervasive problem resulting in significant health and economic burden in our country. Thus, effective fall prevention strategies are an important public health measure, especially in an age group that is growing rapidly. Research has shown a multifactorial approach to fall prevention addressing environmental hazards, strength and balance, medications, and medical comorbidities to be most effective. Despite there being strong evidence to support this, many individuals are unaware of the factors that put them at risk and ways to mitigate them. An educational pamphlet containing evidence-based strategies to reduce fall risk was produced for distribution within the New Milford primary care clinic in New Milford, CT.https://scholarworks.uvm.edu/fmclerk/1511/thumbnail.jp

Novel Device for Measuring Lung Function using Oscillometry

The forced oscillation technique (FOT) is a non-invasive means of measuring lung mechanics. Broad-band oscillations in flow are delivered to the lungs while the resultant pressure oscillations are recorded. These signals are processed to yield the input impedance of the respiratory system (Zrs), which encapsulates the mechanical properties of the lung over the frequency range spanned by the oscillations. Clinically, can be used to assess pulmonary pathologies such as asthma and COPD. Standard methods of performing FOT are limited to the non-ambulatory clinical setting. Production of a light-weight device that operates without an external power source would allow real-time measurements of in a wide variety of more natural settings. Breath-driven oscillators, such as the Smith’s Medical Acapella and D R Burton vPEP, are currently used clinically to help cystic fibrosis patients clear mucus from their lungs by generating pressure oscillations that travel into the airways. We hypothesized that these oscillations could be used to determine . We performed FOT on healthy individuals without history of lung disease using a calibrated piston oscillator (Flexivent) to determine reference between 1 and 20 Hz. We then measured airway pressure and flow using the same sensors but with the oscillations produced by the Acapella and vPEP during tidal breathing. Respiratory resistance (Rrs), elastance (Ers) and Inertance (Irs) were determined by fitting the single-compartment model of the respiratory system to the time-domain signals from all three measurement devices. Correlation coefficients, Bland-Altman plots, and coefficients of variation were used to compare the results obtained with the three devices. We found bias values of 0.633857 [0.214382378, 1.053331908] cmH2O.s.L-1, 0.041333 [-0.38432604, 0.46699271] cmH2O.s.L-1 for comparing the Flexivent against the Acapella and vPEP, respectively. Coefficients of variation of 9.003%, 9.855%, and 9.643% were obtained for the Flexivent, Acapella, and vPEP, respectively. These results demonstrate that breath-driven oscillators are promising alternatives to conventional powered oscillators for the measurement of

Preservation of glaciochemical time-series in snow and ice from the Penny Ice Cap, Baffin Island

A detailed investigation of major ion concentrations of snow and ice in the summit region of Penny Ice Cap (PIC) was performed to determine the effects of summer melt on the glaciochemical time-series. While ion migration due to meltwater percolation makes it difficult to confidently count annual layers in the glaciochemical profiles, time-series of these parameters do show good structure and a strong one year spectral component, suggesting that annual to biannual signals are preserved in PIC glaciochemical records

Pan-active imidazolopiperazine antimalarials target the Plasmodium falciparum intracellular secretory pathway.

A promising new compound class for treating human malaria is the imidazolopiperazines (IZP) class. IZP compounds KAF156 (Ganaplacide) and GNF179 are effective against Plasmodium symptomatic asexual blood-stage infections, and are able to prevent transmission and block infection in animal models. But despite the identification of resistance mechanisms in P. falciparum, the mode of action of IZPs remains unknown. To investigate, we here combine in vitro evolution and genome analysis in Saccharomyces cerevisiae with molecular, metabolomic, and chemogenomic methods in P. falciparum. Our findings reveal that IZP-resistant S. cerevisiae clones carry mutations in genes involved in Endoplasmic Reticulum (ER)-based lipid homeostasis and autophagy. In Plasmodium, IZPs inhibit protein trafficking, block the establishment of new permeation pathways, and cause ER expansion. Our data highlight a mechanism for blocking parasite development that is distinct from those of standard compounds used to treat malaria, and demonstrate the potential of IZPs for studying ER-dependent protein processing

Health-related quality of life in KEYNOTE-010 : a phase II/III study of pembrolizumab versus docetaxel in patients with previously treated advanced, programmed death ligand 1-expressing NSCLC

Introduction: In the phase II/III KEYNOTE-010 study (ClinicalTrials.gov, NCT01905657), pembrolizumab significantly prolonged overall survival over docetaxel in patients with previously treated, programmed death ligand 1-expressing (tumor proportion score >= 1%), advanced NSCLC. Health-related quality of life (HRQoL) results are reported here. Methods: Patients were randomized 1:1:1 to pembrolizumab 2 or 10 mg/kg every 3 weeks or docetaxel 75 mg/m(2) every 3 weeks. HRQoL was assessed using European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire (QLC) Core 30 (C30), EORTC QLQ-Lung Cancer 13 (LC13), and EuroQoL-5D. Key analyses included mean baseline-to-week-12 change in global health status (GHS)/quality of life (QoL) score, functioning and symptom domains, and time to deterioration in a QLQ-LC13 composite endpoint of cough, dyspnea, and chest pain. Results: Patient reported outcomes compliance was high across all three instruments. Pembrolizumab was associated with better QLQ-C30 GHS/QoL scores from baseline to 12 weeks than docetaxel, regardless of pembrolizumab dose or tumor proportion score status (not significant). Compared with docetaxel, fewer pembrolizumab-treated patients had "deteriorated" status and more had "improved" status in GHS/QoL. Nominally significant improvement was reported in many EORTC symptom domains with pembrolizumab, and nominally significant worsening was reported with docetaxel. Significant prolongation in true time to deterioration for the QLQ-LC13 composite endpoint emerged for pembrolizumab 10 mg/kg compared to docetaxel (nominal two-sided p = 0.03), but not for the 2-mg/kg dose. Conclusions: These findings suggest that HRQoL and symptoms are maintained or improved to a greater degree with pembrolizumab than with docetaxel in this NSCLC patient population. (C) 2019 International Association for the Study of Lung Cancer. Published by Elsevier Inc. All rights reserved.

Six simple guidelines for introducing new genera of fungi

We formulate five guidelines for introducing new genera, plus one recommendation how to publish the results of scientific research. We recommend that reviewers and editors adhere to these guidelines. We propose that the underlying research is solid, and that the results and the final solutions are properly discussed. The six criteria are: (1) all genera that are recognized should be monophyletic; (2) the coverage of the phylogenetic tree should be wide in number of species, geographic coverage, and type species of the genera under study; (3) the branching of the phylogenetic trees has to have sufficient statistical support; (4) different options for the translation of the phylogenetic tree into a formal classification should be discussed and the final decision justified; (5) the phylogenetic evidence should be based on more than one gene; and (6) all supporting evidence and background information should be included in the publication in which the new taxa are proposed, and this publication should be peer-reviewed

Phase transitions and critical behavior of black branes in canonical ensemble

We study the thermodynamics and phase structure of asymptotically flat non-dilatonic as well as dilatonic black branes in a cavity in arbitrary dimensions ($D$). We consider the canonical ensemble and so the charge inside the cavity and the temperature at the wall are fixed. We analyze the stability of the black brane equilibrium states and derive the phase structures. For the zero charge case we find an analog of Hawking-Page phase transition for these black branes in arbitrary dimensions. When the charge is non-zero, we find that below a critical value of the charge, the phase diagram has a line of first-order phase transition in a certain range of temperatures which ends up at a second order phase transition point (critical point) as the charge attains the critical value. We calculate the critical exponents at that critical point. Although our discussion is mainly concerned with the non-dilatonic branes, we show how it easily carries over to the dilatonic branes as well.Comment: 37 pages, 6 figures, the validity of using the effective action discussed, references adde

How Americans Feel About Terrorism And Security: Two Years After 9/11

Understanding attitudes, concerns and reactions of individuals and families is critical to emergency planning efforts on all levels. In order to have effective implementation of a disaster plan, people need to be confident in (a) the reliability of information from official sources, (b) the capacity of government to perform effectively in a crisis and (c) the capability of response systems, particularly the health systems and first responders. Absence of confidence in response systems or leadership may undermine the best of crisis plans, leading to unnecessary panic and potential excess loss of life. In August 2003, The National Center for Disaster Preparedness at Columbia University's Mailman School of Public Health, in collaboration with The Children's Health Fund, commissioned the Marist Institute for Public Opinion to conduct a survey of adults nearly two years after the multiple terrorist attacks on New York, Washington, D.C. and Pennsylvania. The survey included both a national and a New York City representative sample of households contacted by telephone. Questions covered a wide range of issues including people's concern about potential new additional acts of terrorism in the U.S., the government's ability to protect citizens, and the health system's capacity to respond. Throughout, specific questions were asked of a subset of parents of children from four to eighteen years of age. To the extent possible, specific questions were replicated from four previous surveys commissioned by The Children's Health Fund since September 11, 2001 to identify trends in public attitudes and perceptions