bluuebunny/crossref_metadata_2025_split huggingface dataset:
82 Effects of Whole Body Vibration Training using Side-Alternating Vibration Platform with Tilt Table in Hospitalized Older Adults with Sarcopenia : A Randomized Controlled Pilot Study
Authors: Seo Kyoung-Ho , Sin Deoksu , Ju Eun Pyo , Lim Jae-Young 
Published: December 2019

Abstract

Background and Aims
Sarcopenia is defined as the loss of skeletal muscle mass and strength with increased age. Increased activity following whole body vibration (WBV) has been reported in patients with chronic illness, but few studies reported the effect of WBV on the physical function of patients with acute illness. This study aimed to investigate the effects of WBV training using vibration platform with tilt table on muscle mass and physical performance in adults with sarcopenia.

Methods
Inclusion criteria were as follow : 1) age more than 70 years old 2) unable to independently ambulate due to long term hospitalized care 3) patient who was diagnosed as sarcopenia. Participants were randomly allocated into WBV group using side-alternating vibration platform with tilt table vs. conventional physical therapy. In WBV group, subjects lied down on tilt table at 60 degree with bare foot. Then, subjects stood on the platform board which could vibrate. Initial evaluation included muscle power, muscle mass, hand grip force, balance test using Leonardo mechanography, Berg balance scale (BBS), timed get up & go (TUG) test, gait speed and activities of daily living (ADL). Muscle power was evaluated using manual muscle test (MMT). In balance test using mechanography, as a center of path parameters, standard ellipse area (SEA), path length (PL) were evaluated. After 2 weeks, 2nd evaluation was conducted.

Results
A total of 15 were enrolled. There were no significant differences between two groups in demographic characteristics. At initial assessment, there were no significant differences in both groups except for SEA. After intervention, WBV group showed improvements in muscle mass, SEA, BBS, TUG, gait speed, ADL. However, there were no statistically significant differences in all outcomes at 2nd evaluation.

Conclusion
WBV training may improve muscle mass, ability of ambulation and ADL in hospitalized older adults with sarcopenia.
86 Developing the Adapted Lifestyle - Integrated Functional Exercise Programme in Thai Context (TLIFE) to Prevent Falls among Older Adults in Thailand: A Mixed Methods Study
Authors: Ounjaichon Sasiporn , Todd Chris , Stanmore Emma , Boulton Elisabeth 
Published: December 2019

Abstract

Introduction
Falls are the leading cause of injuries in older Thai adults. There is a need to develop a fall prevention exercise programme to encourage participation and adherence. The adapted Lifestyle-integrated Functional Exercise (aLiFE) programme may be suitable by integrating exercise into daily routines as opposed to attending an exercise class. This study aimed to explore the acceptability and feasibility of the aLiFE programme in Thai context (TLiFE) among older Thai adults.

Methods
Based on the findings of a prior qualitative study, a feasibility randomised controlled trial (RCT) of TLiFE was conducted among community-dwelling older adults, comparing the TLiFE intervention group with a usual care control group. Outcome measures were analysed at baseline, 3 months, and after 6 months of the intervention.

Results
We recruited a total of 72 older adults into the RCT, randomised to TLiFE (n=36) and control (n=36). The retention rate at 6 months was 91.7%. Attendance in the intervention group (3 home visits and 4 follow-up calls) was 82.9%. There were no differences in fall incidence between the groups. The acceptability survey reveals TLiFE is easy to perform in daily life, safe, and useful. No adverse events were reported.

Conclusion
The TLiFE programme appears to be acceptable and feasible to deliver to community-dwelling older Thai adults. This feasibility study was not powered to detect a difference between groups. A further fully powered definitive randomised controlled trial of TLiFE is needed to evaluate long-term outcomes and cost-effectiveness before it is integrated within the healthcare system in Thailand.
87 Epidemiology Study of Elderly Patients with Acute Myeloid Leukaemia at a Haematological Tertiary Referral Centre
Authors: Yeak Raymond D K , Yap Yee Yee , Tan Sen Mui , Ong Tee Chuan , Tan Jerome T C , Sathar Jameela 
Published: December 2019

Abstract

Introduction
Acute Myeloid Leukemia (AML) is a rare disease with a high incidence in the elderly. Our aim is to report the incidence of elderly patients with AML at a haematological tertiary referral centre.

Method
We have collected data from 2007 till 2017 from the main Malaysian haematological tertiary referral centre involving all the 1225 AML patients. Out of those, 182 elderly patients aged 65 and above with AML were examined. The patients had at least 2 years follow-up.

Results
The elderly represented 14.9% of the 1225 patients who presented with acute myeloid leukemia to the centre. There were 182 elderly patients with AML which were subdivided to the unspecified AML of 154 patients, 1 patient with M1, 4 patients with M2, 6 patients with M3, 5 patients with M4, 8 patients with M5, 2 patients with M6 and 2 patients with M7. There were 109 males and 73 females. The majority of the patients were Chinese (n=85) representing 46.7% of the patients, followed by the Malay (n=76), Indian (n=19) and lastly others (n=2). The average age at diagnosis was 71 years. There were 136 deaths and the mortality rate was 74.7%. The average age of the patients who had passed away (n=136) was 71.4 years. The average age of the patients who are still living (n=42) was 76.5 years.

Conclusion
The incidence of elderly AML is increasing. The younger patients with AML are known to have better survival rate in comparison to the elderly. More research is needed to explore the reasons for the higher mortality in the elderly and the ways to improve the outcome of this elderly population as our lifespan increases and Malaysia heads towards an ageing nation.
88 Prospective Association of Obesity and Falls among Malaysian Community-Dwelling Older Adults
Authors: Kioh Sheng Hui , Mat Sumaiyah , Myint Phyo , Kamaruzzaman Shahrul B , Tan Maw Pin 
Published: December 2019

Abstract

Background
Cross-sectional studies linking the association between obesity and falls are limited and their results are somewhat conflicting. The inconsistent evidence between obesity and falls could be explained by the utilization of different measures of obesity including BMI, WC, waist hip ratio (WHR) and percentage body fat (%BF) in different studies.

Aims
To examine the prospective association between various measures of obesity and falls among community-dwelling older adults.

Methods
We utilized data from the wave 1 and wave 2 of the Malaysian Elder’s Longitudinal Research Study (MELoR). Basic demographic characteristics, medical history, lifestyle factors and falls history in preceding 12 months was recorded by computer assisted questionnaire in participant’s home while anthropometric measurements, body composition assessments and physical performance were collected at the hospital during a hospital check-up at baseline. The main exposure variables were increased body mass index (BMI), waist circumference (WC), waist hip ratio (WHR) and percentage body fat (%BF) and the main outcome was self-report falls in the preceding 12 months at time of follow-up.

Results
Among 746 participants at baseline and follow-up (mean age 68.9 ± 7.3 years, old, 56.7% women), 150(20.1%) individuals had ≥1 time of fall at follow-up. No differences in mean age and proportion of men and women among fallers and non-fallers. However, fallers were found to have higher WHR, lower percentage muscle mass and performed poorer in physical performance (p-value&lt;0.01). Of the four obesity indicators, higher WHR at baseline was associated with increased risk of fall 12 months later even after adjustment for all potential confounders (aOR= 2.01; 95%CI= 1.26-3.18).

Conclusions
In conclusion, our findings suggest that WHR is the measure of adiposity most likely to differentiate fallers from non-fallers prospectively. Future studies should evaluate the mechanisms underlying the increased risk of falls associated with increased WHR.
93 An Epidemiological Study of Falls Presentations in the Elderly in a Regional Hospital
Authors: Bhattacharya Joyita , Craswell Alison , Grimley Rohan 
Published: December 2019

Abstract

Aims
To identify the characteristics and outcomes for older people who present to a regional hospital Emergency Department (ED) with a fall and to determine factors associated with admission and representation.

Methods
In this retrospective cohort study, data for patients with falls (&gt;= 65 years) who presented to the ED was collected from 01/06/2014-30/11/2014 and 01/06/2015-30/11/2015
Falls episodes were reviewed for: Place and time of fall; polypharmacy and medication subtypes; comorbidity count; cognitive impairment; ED assessments; Major injury; Representations and readmissions within 90 days and review by Geriatric Emergency Department Intervention (GEDI) nurse. Characteristics of persons admitted and discharged after a fall was compared. Characteristics associated with representation and admissions were reviewed with a logistic regression analysis.

Results
Episodes of older people with falls presenting to the ED (n=280) had high prevalence of complex multimorbidity (82.8%) and polypharmacy (66.4%), more so in episodes resulting in admission and representation. Most falls occurred indoors, presented to the ED during daytime and arrived by ambulance. 50% of episodes resulted in admission. Investigations in the ED regardless of need for discharge or admission showed only 4% having postural blood pressures recorded, 22% had a physiotherapy review and 31% had a GEDI nurse review. Though 86% of falls episodes had a primary ED diagnoses recorded as falls-related injury, two thirds of admitted episodes did not have a diagnosis of major injury. There were 80 representations. Polypharmacy and prior ED presentations were associated with representation. Comorbidity, previous falls and major injury were associated with admission.

Conclusions
Older adults who present to the ED after a fall were complex and had high rates of admission and representation. The focus of clinical assessments was on injuries. This profile enables building future interventions that address risk factors and falls prevention.
94 Association between Dual-Task Timed “UP and GO” Test and Occurrence of Falls According to Age Group (Young-Older or Old-Older Adults): A Longitudinal Observation Study
Authors: Asai Tsuyoshi , Oshima Kensuke , Fukumoto Yoshihiro , Misu Shogo 
Published: December 2019

Abstract

Aim
To elucidate the association between the occurrence of falls and timed “up and go” (TUG) test score in a dual-task condition among community-dwelling older adults by age group.

Methods
This longitudinal observation study included 987 community-dwelling older adults at baseline. A TUG test (single-TUG) and a TUG test while counting aloud backward from 100 (dual-TUG) were conducted at baseline. The dual-task cost (DTC) value was computed from these results. Data on fall history were obtained using a self-administered questionnaire at the 1-year follow-up. At follow-up, 322 participants had dropped out and six participants had missing data for falls. The final analysis included 658 individuals (follow-up rate: 658/987, 67%) divided into a young-older adult group (aged 60–74 years) and an old-older adult group (aged 75 years or older). Associations between the occurrence of falls and TUG-related values were analyzed by age group using multivariate logistic regression models.

Results
For old-older adults, there were significant associations between the occurrence of falls and DTC value (odds ratio [OR] 0.981, 95% confidence interval [CI]: 0.963–0.999, p = 0.040) and single-TUG score (OR 1.129, 95% CI: 1.006–1.268, p = 0.039). However, no significant associations were observed for young-older adults.

Conclusions
Slower single-TUG test score and lower DTC value are associated with the occurrence of falls among old-older adults but not among young-older adults. Dual task assessment is useful for predicting falls in TUG fall assessment for old-older adults.
96 Kuala Lumpur Hospital Fall Preventive Measures, for a Better Tommorow
Authors: Menon Denesh , Mit Elizabeth Chong Gar , Mosa Nor Hayaniza Awang , Toor Amarneet Kaur 
Published: December 2019

Abstract

Introduction
Hospital Kuala Lumpur is the largest tertiary hospital under the MoH. Inpatient falls is a setback in every health institution with ramifications to the patient’s well-being and the health organization image.

Methodology
This is a retrospective, cross-sectional and descriptive report conducted from January 2014 till December 2018. Data collected from submitted IR forms.

Results
942 cases of falls were reported last 5 years with an exponential increase from 63 cases in 2014 to 386 cases in 2018. 81% (758) falls involved medical-based divisions, 17% (163) falls involved surgical based division and 2.2% (21) falls involved allied health. 59% (556) involving male patient and 41% (386) involving female patients. Prevailing age groups are from 61 to 70 y.o with 28.2% (266) falls. Highest number of falls is observed during night shift 40.6% (382) falls. 58.3% (549) patients escaped with no injuries, however, 3.5% (33) falls sustained severe injuries requiring prolonged stay and treatment.

Discussion
Highest falls were reported at Department of Internal Medicine 60% (564) falls, followed by Department of Orthopaedics 8.8% (83) and 2.6% (24) falls reported at Department of Rehabilitative Medicine in the last 5 years. The embodiment of FIT team was inevitable with the increase in falls at HKL whereby they assume the responsibility in designing fall prevention and awareness program in HKL. The FIT Team represents a multi-disciplinary team consisting of doctors, nurses, and allied health supports. The FIT team has conducted multiple sessions of “Training of Trainers” empowering health staff in improving patient safety. Quality Management team educates health staff on accurate reporting using the IR form and conducts regular audits at wards, concerning patient safety. The collaboration of this both entities have created an immense awareness in regards to patient safety, hence spike in numbers of notification. Thus, patient safety is the epitome and cornerstone of all health institution.
98 Falls among Hospitalized Patients in Hospital Sungai Buloh
Authors: Nordin Nordiana , Osman Linda , Liew Chiat Fong , Sa'at Nadiah , Shariff Siti Mallissa Mohd , Asmungin Hasliza 
Published: December 2019

Abstract

Introduction
There is very minimal data documented on inpatient falls and characteristics in Malaysia. In 2017, Falls Incident Report Form (HSB-MED-FORM-017 Pin.1/18) is made mandatory to be filled up in Hospital Sungai Buloh (HSB), following each incident of falls in order to get a better and concrete data on the characteristic of falls.

Objectives
To capture data on incidence of inpatient falls in HSB in the year 2018.

Method
This is a prospective, observational study of all in-patient falls in the 783 bedded hospitals in the year 2018. Data were collected, documented and subsequently analyzed via SPSS Ver 23.

Result
The falls rate is 0.89 per 1000 bed days. There are a total of 123 fallers (including Paediatrics). 37/113 (33%) were above 65 years old, and 82 were males. 43 (38%) fell on night shift.
84 (74%) fell in the 4 bedded area. 60% of the fallers were in the high risk group of Morse fall score (MFS), of which 49/71(69%) fell at bedside (p&lt;0.007). 25/64 (39%) with high MFS fell despite bed railing was up (p&lt;0.05). There was no association between age group and location of falls. 32/33 (97%) of those attempting to get out of bed, also fell at bedside (p&lt;0.001).
Majority fallers [31(27.2%)] were on anti-hypertensives. 23.9% were on 2 or more high risk falls drugs. There was no association between medications with age or MFS. 59/113 (52.2%) had no injuries, 18% sustained lacerations. 1 case sustained an intracranial bleed and succumbed.

Conclusion
Accidental fall is a common problem in adults. In this study, the majority of fallers are in the younger age group. We confirmed a higher incidence of falls in those classified in the high risk category. These possibly explains the correct usage of MFS in all admissions, hence an effective falls prevention and education programme.
Ectopic expression of the sesame MYB transcription factor SiMYB305 promotes root growth and modulates ABA-mediated tolerance to drought and salt stresses in Arabidopsis
Authors: Dossa Komivi , Mmadi Marie A , Zhou Rong , Liu Aili , Yang Yuanxiao , Diouf Diaga , You Jun , Zhang Xiurong 
Published: December 2019

Abstract
An increasing number of candidate genes related to abiotic stress tolerance are being discovered and proposed to improve the existing cultivars of the high oil-bearing crop sesame (Sesamum indicum L.). However, the in planta functional validation of these genes is remarkably lacking. In this study, we cloned a novel sesame R2-R3 MYB gene SiMYB75 which is strongly induced by drought, sodium chloride (NaCl), abscisic acid (ABA) and mannitol. SiMYB75 is expressed in various sesame tissues, especially in root and its protein is predicted to be located in the nucleus. Ectopic over-expression of SiMYB75 in Arabidopsis notably promoted root growth and improved plant tolerance to drought, NaCl and mannitol treatments. Furthermore, SiMYB75 over-expressing lines accumulated higher content of ABA than wild-type plants under stresses and also increased sensitivity to ABA. Physiological analyses revealed that SiMYB75 confers abiotic stress tolerance by promoting stomatal closure to reduce water loss; inducing a strong reactive oxygen species scavenging activity to alleviate cell damage and apoptosis; and also, up-regulating the expression levels of various stress-marker genes in the ABA-dependent pathways. Our data suggested that SiMYB75 positively modulates drought, salt and osmotic stresses responses through ABA-mediated pathways. Thus, SiMYB75 could be a promising candidate gene for the improvement of abiotic stress tolerance in crop species including sesame.
Giving away home field advantage: the misguided attack on confidentiality in international commercial arbitration
Authors: Foden Timothy , Repousis Odysseas G 
Published: December 2019

Abstract
An acclaimed feature of international arbitration is confidentiality. Almost universally, handbooks on international arbitration celebrate confidentiality as a characteristic of arbitration, often when contrasting arbitration with litigation or when discussing the four key selling points of arbitration, namely, speed, cost, confidentiality, and enforceability. Yet, owing to the backlash against investment treaty arbitration, critics have started to suggest that confidentiality in commercial arbitration is a bad thing. But confidentiality is of fundamental importance when it comes to commercial arbitration and the criticism levied at commercial arbitration by reference to transparency considerations in investment arbitration is misplaced. Setting out from this premise, this article first identifies those reasons or perceived shortcomings of confidentiality that according to critics justify a presumption in favour of transparency and publication. Secondly, this article shows that for the most part, the ongoing vilification of confidentiality is the outcome of a worrying trend that risks sacrificing the interests of clients on the altar of a ‘one size fits all’ approach to transparency. This is a false premise and a reminder that attempts to ‘reform’ can have the opposite effect, especially when reformists overlook the needs of the users and the specificities of commercial arbitration.
Fast closed testing for exchangeable local tests
Authors: Dobriban E 
Published: December 2019

SummaryMultiple hypothesis testing problems arise naturally in science. This note introduces a new fast closed testing method for multiple testing which controls the familywise error rate. Controlling the familywise error rate is state-of-the-art in many important application areas and is preferred over false discovery rate control for many reasons, including that it leads to stronger reproducibility. The closure principle rejects an individual hypothesis if all global nulls of subsets containing it are rejected using some test statistics. It takes exponential time in the worst case. When the tests are symmetric and monotone, the proposed method is an exact algorithm for computing the closure, is quadratic in the number of tests, and is linear in the number of discoveries. Our framework generalizes most examples of closed testing, such as Holm’s method and the Bonferroni method. As a special case of the method, we propose the Simes and higher criticism fusion test, which is powerful both for detecting a few strong signals and for detecting many moderate signals.
Cellular Immunity to Predict the Risk of Cytomegalovirus Infection in Kidney Transplantation: A Prospective, Interventional, Multicenter Clinical Trial
Authors: Jarque Marta , Crespo Elena , Melilli Edoardo , Gutiérrez Alex , Moreso Francesc , Guirado Lluís , Revuelta Ignacio , Montero Nuria , Torras Joan , Riera Lluís , Meneghini Maria , Taco Omar , Manonelles Anna , Paul Javier , Seron Daniel , Facundo Carme , Cruzado Josep M , Gil Vernet Salvador , Grinyó Josep M , Bestard Oriol 
Published: December 2019

Abstract

Background
Improving cytomegalovirus (CMV) immune-risk stratification in kidney transplantation is highly needed to establish guided preventive strategies.

Methods
This prospective, interventional, multicenter clinical trial assessed the value of monitoring pretransplant CMV-specific cell-mediated immunity (CMI) using an interferon-γ release assay to predict CMV infection in kidney transplantation. One hundred sixty donor/recipient CMV-seropositive (D+/R+) patients, stratified by their baseline CMV (immediate-early protein 1)–specific CMI risk, were randomized to receive either preemptive or 3-month antiviral prophylaxis. Also, 15-day posttransplant CMI risk stratification and CMI specific to the 65 kDa phosphoprotein (pp65) CMV antigen were investigated. Immunosuppression consisted of basiliximab, tacrolimus, mycophenolate mofetil, and corticosteroids in 80% of patients, whereas 20% received thymoglobulin induction therapy.

Results
Patients at high risk for CMV based on pretransplant CMI developed significantly higher CMV infection rates than those deemed to be at low risk with both preemptive (73.3% vs 44.4%; odds ratio [OR], 3.44 [95% confidence interval {CI}, 1.30–9.08]) and prophylaxis (33.3% vs 4.1%; OR, 11.75 [95% CI, 2.31–59.71]) approaches. The predictive capacity for CMV-specific CMI was only found in basiliximab-treated patients for both preemptive and prophylaxis therapy. Fifteen-day CMI risk stratification better predicted CMV infection (81.3% vs 9.1%; OR, 43.33 [95% CI, 7.89–237.96]).

Conclusions
Pretransplant CMV-specific CMI identifies D+/R+ kidney recipients at high risk of developing CMV infection if not receiving T-cell–depleting antibodies. Monitoring CMV-specific CMI soon after transplantation further defines the CMV infection prediction risk. Monitoring CMV-specific CMI may guide decision making regarding the type of CMV preventive strategy in kidney transplantation.

Clinical Trials Registration
NCT02550639.