Assessment of Physical Activity of Hospitalised Older Adults: A Systematic Review

BACKGROUND

The assessment of physical activity levels of hospitalised older people requires accurate and reliable measures. Physical activities that older people in hospital commonly engage in include exercises and walking. Measurement of physical activity levels of older inpatients is essential to evaluate the impact of interventions to improve physical activity levels and to determine associations between physical activity in hospital and other health-related outcome measures.

OBJECTIVE

To determine which measures are used to measure physical activity of older people in hospital, and to describe their properties and applications.

METHOD

A systematic review of four databases: Medline, Embase, CINAHL and AMED was conducted for papers published from 1996 to 2016. Inclusion criteria were participants aged ≥ 65 years and studies which included measures of physical activity in the acute medical inpatient setting. Studies which specifically assessed the activity levels of surgical patients or patients with neurological conditions such as stroke or brain injury were excluded. All study designs were included in the review.

RESULTS

18 studies were included from 127 articles selected for full review. 15 studies used objective measures to measure the physical activity of older inpatients: 11 studies used accelerometers and four used direct systematic observations. Seven accelerometers were identified including the StepWatch Activity Monitor, activPAL, GENEActiv, Kenz Lifecorder EX, Actiwatch-L, Tractivity and AugmenTech Inc. Pittsburgh accelerometer. Three studies used a subjective measure (interviews with nurses and patients) to classify patients into low, intermediate and high mobility groups. The StepWatch Activity Monitor was reported to be most accurate at step-counting in patients with slow gait speed or altered gait. The activPAL was reported to be highly accurate at classifying postures.

CONCLUSION

Physical activity levels of older inpatients can be measured using accelerometers. The accuracy of the accelerometers varies between devices and population-specific validation studies are needed to determine their suitability in measuring physical activity levels of hospitalised older people. Subjective measures are less accurate but can be a practical way of measuring physical activity in a larger group of patients.

Homozygous nonsense mutation in SCHIP1/IQCJ-SCHIP1 causes a neurodevelopmental brain malformation syndrome

We report a consanguineous Arab family with 3 affected siblings who display a disorder of global developmental delay, learning difficulties, facial dysmorphism, hearing impairments, and cataract. The clinical phenotype was associated with characteristic brain magnetic resonance imaging (MRI) features of axonal guidance defects involving anterior commissure agenesis as well as scattered areas of polymicrogyria-cobblestone complex. Whole genome sequencing revealed a novel nonsense mutation (159609921C>T) that segregated in the family consistent in an autosomal recessive pattern. This mutation located in the C-terminal region shared by the Schwanomin-Interacting Protein1 (SCHIP1) isoforms including the IQCJ-SCHIP1. The in vitro expression of SCHIP1 and IQCJ-SCHIP1 truncated mutant isoforms (NM_001197109.1; p.R209* and NM_001197114.1; p.R501*, respectively) were markedly reduced as compared to their full-length versions suggesting protein stability/folding impairment. The pathogenic nature of this mutation is supported by a previously reported mouse knockout of Schip1 isoforms, which phenocopied the human axon guidance abnormality. This is the first report of a SCHIP1/IQCJ-SCHIP1 point mutation in humans associated with a neurological-developmental phenotype.

Lipoprotein apheresis influences monocyte subpopulations

BACKGROUND

Monocytes can be differentiated into subpopulations depending on their expression profile of CD14 and CD16. CD16-positive monocytes are associated with coronary artery disease. Up to now, no data exist about the effect of lipoprotein apheresis (LA) on the distribution of monocyte subpopulations.

METHODS

80 patients who underwent LA at the University Hospital Dresden were included in the study. 8 out of the 80 LA patients received LA for the first time at the time point of blood analysis. Six different methods of LA were used (H.E.L.P. n = 8; Liposorber D n = 10; LF n = 14; DALI n = 17; MONET n = 11; Therasorb^® LDL n = 12). Blood samples were taken immediately before and after LA and analyzed for CD14 and CD16 expression on monocytes. A total of 42 patients with cardiovascular risk factors but no indication for LA served as control group.

RESULTS

The composition of monocyte-population was analyzed in regard to the 3 subpopulations. After LA, an increase in classical monocytes (CD14⁺⁺CD16^-) (93.3% vs. 93.9%, p < 0.01) and a decrease in non-classical monocytes (CD14⁺CD16⁺) (1.5% vs 1.0%; p < 0.001) were observed. LA did not change the amount of intermediate monocytes (CD14⁺⁺CD16⁺) (5.3% vs. 5.1%). Two methods (MONET and Therasorb^® LDL) did not influence the distribution of monocyte subpopulations. Interestingly, patients with LDL-C above 2.5 mmol/l prior LA showed increased amounts of intermediate monocytes.

CONCLUSION

The distribution of monocyte populations is influenced by LA but depends on the distinct method of LA. Influences of LA were mainly observed in the content of classical and non-classical monocytes, whereas the intermediate monocyte population remained unaltered by LA.

Osteoradionecrosis in Subaxial Cervical Spine - a Rare and Devastating Complication: A Case Report

Osteoradionecrosis, a rare complication of radiation therapy, is a slow progression disease which affects the surrounding structures of spinal components. It essentially weakens the soft tissue and bony configuration and can cause nerve impingement or cord compression. We describe a patient who underwent radiotherapy for thyroid cancer and presented with cervical kyphosis with anterolisthesis of C3/C4 and C4/C5 some 32 years later. We explore the role of anterior and posterior fusion, as well as hyperbaric oxygen therapy in promoting healing.

Correspondence between the electronic structure and phase separation in a K-doped FeSe system

Phase separated potassium intercalated FeSe thin films have been synthesized by pulsed laser deposition. The coexistence of FeSe phase and 245 phase was investigated both by x-ray photoemission spectroscopy (XPS) and x-ray diffraction. The volume ratio of these two phases is sensitive to temperatures and amount of extra potassium dosing. The XPS and ultraviolet photoelectron spectroscopy results indicated that these two phases shows the different hybridization strength between adjacent Fe layer and Se layer. We infer that the layered electronic structure is the necessary condition of superconductivity in potassium-doped FeSe system, and the phase separation is driven by competition between quasi-2D and 3D bonding mode within FeSe layer. Similar competition may also be able to interpret the phase seperation in K _x Fe_2-y Se₂ bulk single crystal.

Intrinsically patterned two-dimensional materials for selective adsorption of molecules and nanoclusters

Two-dimensional (2D) materials have been studied extensively as monolayers, vertical or lateral heterostructures. To achieve functionalization, monolayers are often patterned using soft lithography and selectively decorated with molecules. Here we demonstrate the growth of a family of 2D materials that are intrinsically patterned. We demonstrate that a monolayer of PtSe₂ can be grown on a Pt substrate in the form of a triangular pattern of alternating 1T and 1H phases. Moreover, we show that, in a monolayer of CuSe grown on a Cu substrate, strain relaxation leads to periodic patterns of triangular nanopores with uniform size. Adsorption of different species at preferred pattern sites is also achieved, demonstrating that these materials can serve as templates for selective self-assembly of molecules or nanoclusters, as well as for the functionalization of the same substrate with two different species.

Prevalence of Hepatitis B surface antigen among biomedical students of African descent in Usmanu Danfodiyo University, Sokoto, Nigeria

BACKGROUND

Hepatitis B (HB) is a serious global public health problem that put health professionals particularly at risk.

OBJECTIVE

The aim of this study was to investigate the prevalence of Hepatitis B surface antigen (HBsAg) among Biomedical Students of African descent attending Usmanu Danfodiyo University Sokoto in North-Western Nigeria.

METHODS

The Onsite HBsAg (CTK Biotech, USA) was used to detect the presence of hepatitis B surface antigen.

RESULTS

We tested 186 consecutively-recruited students consisting of 147 males and 39 females aged 18-35 years (mean age 26 ± 2.0 years). Of the 186 students tested, 25 (13.4%) were positive for HBsAg. The prevalence of HBsAg was significantly higher among students in the 21-25 years age group. Hepatitis B vaccination uptake among students was 7%. Majority of subjects were single 173(93.1%) compared to married 13 (6.9%). Ethnic distribution of the subjects indicated that 104(55.9%) were Hausa compared to Yoruba 32 (17.2%), other ethnic groups 21(11.3%), Fulani 20(10.8%) and Igbo 9(4.8%).

CONCLUSIONS

This study indicates a high prevalence of hepatitis B virus infection among Biomedical students in Sokoto, North Western, Nigeria. Finding from this study is enough justification for the implementation of a policy to routinely test students entering into the biomedical professions for Hepatitis B virus infection. There is the need to provide hepatitis B vaccination universally to all those who are found negative prior to commencement of their biomedical training. There is also need to educate students entering biomedical professions and healthcare workers on the modes of transmission and prevention, importance of being compliant with protective vaccination as well as the need to observe universal precaution and infection control guidelines during their training and future professional practice.

A highly sensitive flexible SnS thin film photodetector in the ultraviolet to near infrared prepared by chemical bath deposition

A novel flexible broad band UV-vis-NIR SnS photodetector with high photosensitivity and fast response time for scientific and industrial applications.

Evaluation and classification of right ventricular wall motion abnormalities in healthy subjects by 3-tesla cardiovascular magnetic resonance imaging

BACKGROUND

Right ventricular (RV) shape and function serves as an indicator in several types of heart disease such as arrhythmogenic right ventricular dysplasia (ARVD). However, there is no in-depth knowledge of RV motion, even in healthy subjects. The aim of our study was to provide a quantitative analysis of normal variations in RV wall motion in healthy subjects by cardiac magnetic resonance imaging (CMRI).

MATERIAL AND METHODS

The study population consisted of 65 consecutive patients referred for the evaluation of cardiac function by 3 Tesla CMR. Balanced steady-state free-precession images were obtained and areas of disordered RV wall motion were evaluated and classified based on a standardised segmental model for the right ventricle.

RESULTS

In 59 patients (90.8 %) wall motion abnormalities (WMA) of the right ventricle were evident. WMA were predominately detected in the apicolateral segments (72 %) compared with mediolateral (24 %, P < 0.001) and inferolateral segments (4 %, P < 0.001). Dyskinesia was the most frequent wall motion disorder (62.4 %), followed by hypokinesia (20.8 %) and bulging (16.8 %). The mean WMA diameter in the transverse plane (6.4 ± 1.9 mm) was significantly shorter compared with the diameter in the horizontal long-axis (8.1 ± 3.6 mm, P = 0.002) and short-axis plane (10.7 ± 4.6 mm).

CONCLUSION

WMA of the right ventricle are common. Therefore, one should be aware that these nonpathological wall motion disorders can easily be mistaken for a pathological regional wall motion contraction, particularly in ARVD where to date, clear wall motion criteria are lacking.