Miracle-dz/UniFAR-FTUs huggingface dataset:
Development of a protocol for improving the clinical utility of posturography as a fall-risk screening tool.

BACKGROUND The usefulness of posturography in the clinical screening of older adults for fall risk has been limited by a lack of standardization in testing methodology and data reporting. This study determines which testing condition and postural sway measures best differentiate recurrent fallers and nonrecurrent fallers. METHODS One hundred and fifty older adults were categorized based on their fall status in the past year. Participants performed four quiet-standing tasks, eyes open and eyes closed in both comfortable and narrow stance, for 60 seconds while standing on a force-measuring platform. Traditional and fractal measures were calculated from the center of pressure data. Logistic regression was performed to determine the model for each condition that best discriminated between recurrent fallers and nonrecurrent fallers. RESULTS The eyes closed comfortable stance condition, with its associated model, best differentiated recurrent fallers and nonrecurrent fallers. Medial-lateral sway velocity, anterior-posterior short-term α-scaling exponent, medial-lateral short-term α-scaling exponent, mean frequency, body mass index, and age were included in this model. Sensitivity of the model was 75%, and specificity was 94%. CONCLUSIONS This resulting model demonstrates potential to differentiate recurrent fallers and nonrecurrent fallers in an eyes closed comfortable stance condition. The inclusion of traditional sway parameters, fractal measures, and personal characteristics in this model demonstrates the importance of considering multiple descriptions of postural stability together rather than using only a single measure to establish fall risk.
Cardiovascular Events in Obstructive Sleep Apnea - Can CPAP Therapy SAVE Lives?

Obstructive sleep apnea is a common disorder that has been associated with an increased risk of cardiovascular disease.1 Continuous positive airway pressure (CPAP) is frequently prescribed in patients with obstructive sleep apnea and is effective in reversing hypoxemia and upper airway obstruction. Meta-analyses of randomized trials have shown that CPAP therapy elicits significant reductions in systemic arterial pressure, and the effect is greater with higher adherence.2,3 Observational studies have shown significantly fewer cardiovascular events in patients adherent to CPAP therapy than in those who are not adherent,4,5 but the need for large trials has lingered. The Sleep Apnea .
Gait variability is associated with frailty in community-dwelling older adults.

BACKGROUND The relationship between frailty and gait characteristics other than velocity has received little attention. Gait variability quantifies the automaticity of gait with greater variability usually indicating an irregular and unstable gait. High gait variability reflects the loss of gait regulation and predicts mobility decline and falls, which may reveal systemic vulnerability. Thus, we hypothesize that high gait variability may be associated with frailty phenotype. METHODS Cross-sectional study including 100 community-dwelling women and men 75 years and older. Frailty was defined using validated phenotypic criteria and two additional frailty indexes that omit gait velocity criterion were used to verify associations between frailty and quantitative gait parameters. Gait was assessed under usual and fast pace using an electronic walkway. RESULTS Frailty phenotype was identified in 20% of the participants and at least one component of frailty was present in 75%. Linear regression models were generated to explore the associations between frailty and gait variability. In the univariate regression model, frailty was associated with higher variability for all the gait parameters of interest. After adjustments, stride time variability under fast gait condition was the most prominent parameter consistently associated with frailty. This association remained significant in two additional frailty indexes that omit gait velocity criterion. CONCLUSION Frailty is associated with low performance in several quantitative gait parameters beyond velocity of which the most prominent is high stride time variability. This finding may help to understand the high risk of falls and mobility decline in people with frailty.
Aislamiento de Mycoplasma spp. a partir de pacientes cubanos VIH-positivos con síntomas respiratorios

Introduction: Mycoplasma and Ureaplasma are recognized as etiologic agents of opportunistic infections in HIV-positive patients. The microbiological diagnosis of respiratory infections caused by mycoplasmas is an arduous task. The use of specific selective culture media for these microorganisms is a decisive step in the procedures to be followed. Objective: detect the presence of Mycoplasma spp. as an etiologic agent of respiratory infections in Cuban immunocompromised patients. Methods: 54 sputum samples from HIV-positive patients with respiratory symptoms were analyzed by bacteriological culture in modified SP-4 medium followed by identification of the isolates by biochemical and molecular techniques. Results: growth of Mycoplasma spp. was observed in 16 % (9/54) of the samples. Polymerase chain reaction confirmed that all isolates belonged to the class Mollicutes. However, none could be identified with the sets of primers assayed for each of the species studied. Conclusions: results provide evidence suggestive of the reemergence of Mycoplasma spp. as a pathogen responsible for respiratory manifestations in Cuban HIV-positive patients, which points to the need to take these microorganisms into consideration when indicating microbiological examinations to patients with respiratory manifestations.
Feasibility and safety of peroral endoscopic myotomy for achalasia after failed endoscopic interventions.

With advances in natural orifice transluminal endoscopic surgery, peroral endoscopic myotomy (POEM) has become a novel treatment for esophageal achalasia. In this study, we investigated the feasibility and safety of POEM in patients with achalasia after failed endoscopic interventions. Data on all patients undergoing POEM treatment of achalasia were collected prospectively. We enrolled 61 patients who underwent POEM for achalasia between July 2011 and January 2014. The preoperative intervention group included patients who had undergone botulinum toxin injection or pneumatic balloon dilation before POEM. The preoperative, operative, and short-term outcome data between the groups were compared. Among preoperative intervention group, 22 patients received endoscopic therapy before being referred for operation (18 dilation only, 2 botulinum toxin only, and 2 both treatments). Procedure time in the preoperative intervention group was similar to the nonpreoperative intervention group (60.8 ± 30.9 vs. 62.0 ± 21.0 minutes, P = 0.863). Both groups demonstrated significant improvement in Eckardt scores and manometric outcomes at 1-year follow-up. There were no significant differences in pretreatment and posttreatment D-values of symptom scores and lower esophageal sphincter pressures between groups (6.2 ± 2.2 vs. 6.1 ± 1.8, P = 0.840; 27.9 ± 17.6 vs. 24.9 ± 15.2; P = 0.569). There was also no significant difference in the incidence of intraoperative complications (P = 0.958) and gastroesophageal reflux rate (23.5% vs. 20.0%, P = 0.771) between the two groups. Our study demonstrated that POEM is safe and effective, even for treating achalasia in the setting of failed endoscopic interventions.
Neuromuscular contributions to age-related weakness.

BACKGROUND Declines in skeletal muscle mass and quality are important factors contributing to age-related weakness. Neural activation of agonist and antagonist muscles may also be important contributing factors. METHODS We conducted a review of the scientific literature on older adults to determine (a) methodologies used to quantify activation, (b) the potential role of agonist and antagonist activation on weakness, and (c) some possible neurophysiological mechanisms that may underlie impaired activation. RESULTS The cumulative evidence indicates that agonist activation is impaired in some, but not all, older adults and that this impairment contributes to age-related weakness. It is possible that antagonist coactivation also plays a role in age-related weakness, though a definitive link has not been established. CONCLUSION Future research should focus on improving quantitative measurement and mechanistic understanding of impaired activation with aging.
Microfluidic flow driven by electric fields

Microfluidics or lab on chip technology, has developed itself significantly during the past 25 years. Now it has become a robust tool to manipu- late tiny amounts of fluid or gas for various applications. Microfluidics is the process of transporting, mixing, separating small amounts of fluid in microchannels. Also chemical reactions can be carried out in a well con- trolled way. With this technology major advancements in point-of-care diagnostics, biotechnology, pharmaceuticals, public health and agricul- ture has been achieved. The basic ingredients of microfluidics are mi- crochannels, micropumps to transport small amounts of fluid or droplets, electronics to control the flow and various sensors and detectors for chem- ical analysis. The research described in this thesis deals with flow in mi- crochannels and in small drops. In both cases the flow is controlled by electric fields.
Weight loss and low-intensity exercise for the treatment of metabolic syndrome in obese postmenopausal women.

BACKGROUND The prevalence of the metabolic syndrome (MetSyn) approaches 50% in postmenopausal women. This study examines the efficacy of lifestyle modification for the treatment of MetSyn and its associated risk for cardiovascular disease and diabetes in this population. METHODS This prospective controlled study examines the effects of a 6-month weight loss and low-intensity exercise program (WL+LEX) on body composition (dual-energy X-ray absorptiometry and abdominal computed tomography scans), fasting glucose and lipid levels, cytokines, and blood pressure in postmenopausal women with and without MetSyn. RESULTS WL+LEX reduced body weight (MetSyn: -5% vs non-MetSyn: -7%) and fat mass (-11% vs -15%) and increased VO(2max) (+2% vs +3%) in both MetSyn (N = 35) and non-MetSyn (N = 41) groups. Constituents of MetSyn decreased comparably in both groups. Fifteen (45%) MetSyn participants responded (R) by converting to non-MetSyn, 18 remained MetSyn (NR), and 2 had missing data. Reduction in fat mass (-15% vs -8%, p = .02) was greater in R than NR, but there were no between-group differences in changes in VO(2max), cytokines, or other variables. The decrease in the number of MetSyn criteria was greater in R than in NR (-27 vs -13, p < .0001) due to decreases in blood pressure (p < .01), glucose (p = .02), and with a trend for triglyceride (p = .07). Reductions in fat mass best predicted resolution of MetSyn (p = .04). CONCLUSIONS Women who lose more fat are more likely to lower blood pressure, glucose, and triglyceride levels to resolve MetSyn. Thus, a WL+LEX program effectively treats postmenopausal women with MetSyn.
Gender and life course occupational social class differences in trajectories of functional limitations in midlife: findings from the 1946 British birth cohort.

BACKGROUND Older women and those of lower socioeconomic position (SEP) consistently constitute a larger portion of the disabled population than older men or those of higher SEP, yet no studies have examined when in the life course these differences emerge. METHODS Prevalence of self-reported limitations in the upper body (gripping or reaching) and lower body (walking or stair climbing) at 43 and 53 years were utilized from 1,530 men and 1,518 women from the British 1946 birth cohort. Generalized linear models with a binomial distribution were used to examine the effects of gender, childhood and adult SEP, and the differences in the SEP effects by gender on the prevalence of limitations at age 43 years and changes in prevalence from 43 to 53 years. RESULTS For both genders, the prevalence of upper and lower body limitations were reported at 3%-5% at age 43 years. However, by age 53 years, women's upper body limitations had increased to 28% and lower body limitations to 21%, whereas men's limitations had only increased to 12% and 11%, respectively. Men and women whose father's occupation was manual or whose adult head of household occupation was manual had higher prevalence of both limitations compared with those with non-manual backgrounds. These differences widened with age, especially in women. The effect of adult SEP on the prevalence of limitations was stronger than that of childhood SEP and was partly mediated by educational attainment. CONCLUSION Our findings provide the first evidence that prevention of disability in old age should begin early in midlife, especially for women from manual occupation households.
THE EFFECT OF CAFFEINE INGESTION ON ANAEROBIC PERFORMANCE IN MODERATELY TRAINED ADULTS

Although studies have reported a positive effect of caffeine on aerobic performance, results relating to its effect on anaerobic performance are equivocal. The aim of this study was to examine the impact of caffeine ingestion on anaerobic performance in a group of moderately trained adults. Following ethical approval, 8 males and 6 females (Mean age = 21.8, s = 3.5 years) performed the Wingate anaerobic test on 3 occasions in randomised order, once where no substance was ingested (Control), once where a 5mg kg -1 of caffeine was consumed and once where a placebo was consumed. Results indicated that peak power output and mean power output were significantly greater in both the caffeine and placebo conditions compared to control (Both P = 0.001). Peak blood lactate values were significantly higher in the caffeine condition compared to the control condition (P = 0.04) but not between caffeine and placebo conditions (P<0.05). Rating of Perceived Exertion was higher in the placebo condition compared to the caffeine condition (P = 0.04) and there was no difference in peak heart rate across trials (P<0.05). These results suggest that caffeine ingestion does not enhance anaerobic performance over consumption of a placebo substance.
Screening for Syphilis Infection in Nonpregnant Adults and Adolescents US Preventive Services Task Force Recommendation Statement

T he US Preventive Services Task Force (USPSTF) makes recommendations about the effectiveness of specific preventive care services for patients without obvious related signs or symptoms. It bases its recommendations on the evidence of both the benefits and harms of the service and an assessment of the balance. The USPSTF does not consider the costs of providing a service in this assessment. The USPSTF recognizes that clinical decisions involve more considerations than evidence alone. Clinicians should understand the evidence but individualize decision making to the specific patient or situation. Similarly, the USPSTF notes that policy and coverage decisions involve considerations in addition to the evidence of clinical benefits and harms.
The Benefits and Challenges of One New Zealand Nursing Undergraduate Clinical Education Model: a Case Study

This research project has utilised a case study approach to give ward managers a voice in the literature, by exploring and describing from their perspective the benefits and challenges of one particular nursing undergraduate clinical education model. The Tertiary Education Provider contracts the Health Provider to provide Clinical Nurse Educators (CNEs) to support second and third year undergraduate nursing students during their clinical experiences. The CNEs are seconded from their respective wards to meet the organisation’s contractual obligations. Data were gathered from two ward manager’s using semi-structured interviews. A thematic analysis using the ‘colour coding’ method as described by Roberts and Taylor (1999) was used to analyse the interview data. The findings elucidate the role of the undergraduate CNE, highlighting benefits such as the CNE being supernumerary to ward rosters and having time to teach, not only supervise students. CNEs are student-focused and easily accessible as they are based on site. The CNE was the one person who was ‘there’ for a student as a student’s preceptor can change shift-by-shift and day-by-day. One significant challenge which emerged was the replacement of ward staff, not only of senior nurses who can leave their wards for up to 12 weeks to undertake the CNE role but also that of the student’s preceptor if the student’s preceptor was on annual, sick or study leave. Other challenges such as the inability of ward managers to pre-book casual staff; preceptor work-loads; skill-mix issues and fluctuating fulltime equivalents (FTEs) are also discussed.
NESFATIN-1/NUCLEOBINDIN-2 AND VISFATIN GENES RESPONSES TO 8 WEEKS OF TREADMILL RUNNING WITH OR WITHOUT PISTACHIO ATLANTICA LIQUID EXTRACTION IN FEMALE RAT TISSUE

Resumen en: RAHMATI-AHMADABAD, S. ; GHANBARI-NIAKI, A . ; ZARE-KOOKANDEH, N. ; ANSARI-PIRSARAE, Z. Nesfatin-1/nucleobindin-2 and visfatin genes responses to 8 weeks.
Skeletal muscle mitochondrial energetics are associated with maximal aerobic capacity and walking speed in older adults.

BACKGROUND Lower ambulatory performance with aging may be related to a reduced oxidative capacity within skeletal muscle. This study examined the associations between skeletal muscle mitochondrial capacity and efficiency with walking performance in a group of older adults. METHODS Thirty-seven older adults (mean age 78 years; 21 men and 16 women) completed an aerobic capacity (VO2 peak) test and measurement of preferred walking speed over 400 m. Maximal coupled (State 3; St3) mitochondrial respiration was determined by high-resolution respirometry in saponin-permeabilized myofibers obtained from percutanous biopsies of vastus lateralis (n = 22). Maximal phosphorylation capacity (ATPmax) of vastus lateralis was determined in vivo by (31)P magnetic resonance spectroscopy (n = 30). Quadriceps contractile volume was determined by magnetic resonance imaging. Mitochondrial efficiency (max ATP production/max O2 consumption) was characterized using ATPmax per St3 respiration (ATPmax/St3). RESULTS In vitro St3 respiration was significantly correlated with in vivo ATPmax (r (2) = . 47, p = . 004). Total oxidative capacity of the quadriceps (St3*quadriceps contractile volume) was a determinant of VO2 peak (r (2) = . 33, p = . 006). ATPmax (r (2) = . 158, p = . 03) and VO2 peak (r (2) = . 475, p < . 0001) were correlated with preferred walking speed. Inclusion of both ATPmax/St3 and VO2 peak in a multiple linear regression model improved the prediction of preferred walking speed (r (2) = . 647, p < . 0001), suggesting that mitochondrial efficiency is an important determinant for preferred walking speed. CONCLUSIONS Lower mitochondrial capacity and efficiency were both associated with slower walking speed within a group of older participants with a wide range of function. In addition to aerobic capacity, lower mitochondrial capacity and efficiency likely play roles in slowing gait speed with age.
Assessing the temporal relationship between cognition and gait: slow gait predicts cognitive decline in the Mayo Clinic Study of Aging.

BACKGROUND The association between gait speed and cognition has been reported; however, there is limited knowledge about the temporal associations between gait slowing and cognitive decline among cognitively normal individuals. METHODS The Mayo Clinic Study of Aging is a population-based study of Olmsted County, Minnesota, United States, residents aged 70-89 years. This analysis included 1,478 cognitively normal participants who were evaluated every 15 months with a nurse visit, neurologic evaluation, and neuropsychological testing. The neuropsychological battery used nine tests to compute domain-specific (memory, language, executive function, and visuospatial skills) and global cognitive z-scores. Timed gait speed (m/s) was assessed over 25 feet (7.6 meters) at a usual pace. Using mixed models, we examined baseline gait speed (continuous and in quartiles) as a predictor of cognitive decline and baseline cognition as a predictor of gait speed changes controlling for demographics and medical conditions. RESULTS Cross-sectionally, faster gait speed was associated with better performance in memory, executive function, and global cognition. Both cognitive scores and gait speed declined over time. A faster gait speed at baseline was associated with less cognitive decline across all domain-specific and global scores. These results were slightly attenuated after excluding persons with incident mild cognitive impairment or dementia. By contrast, baseline cognition was not associated with changes in gait speed. CONCLUSIONS Our study suggests that slow gait precedes cognitive decline. Gait speed may be useful as a reliable, easily attainable, and noninvasive risk factor for cognitive decline.
Associations between frailty and serum 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D concentrations in older Australian men: the Concord Health and Ageing in Men Project.

BACKGROUND Poor vitamin D status and frailty are common in older people and associated with adverse health outcomes. The aim of this study was to examine the associations between serum 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D levels and frailty and components of frailty in older Australian men. METHODS Cross-sectional analysis of the Concord Health and Ageing in Men Project, a large epidemiological study conducted in Sydney, Australia, between January 2005 and May 2007. Participants included 1,659 community-dwelling men. Main outcome measurements were frailty (assessed using the Cardiovascular Health Study), frailty criteria comprising five core components: weight loss; reduced muscular strength/weakness; slow walking speed; exhaustion; and low activity level, and the separate components of frailty. Covariates included serum 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D levels measured by radioimmunoassay, age, country of birth, season of blood collection, sun exposure, body mass index, vitamin D supplement use, income, measures of health, parathyroid hormone, estimated glomerular function. RESULTS Frailty was present in 9.2% of the sample. Low serum 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D levels were independently associated with frailty and with four of the five components of frailty (except weight loss). CONCLUSIONS 1,25-dihydroxyvitamin D and 25-hydroxyvitamin D levels were independently associated with frailty in older men. This suggests that there might be a number of different biological mechanisms for how low vitamin D status might contribute to the frailty syndrome. In addition, the possibility that improving vitamin D status may specifically influence the incidence and progression of frailty needs to be explored.