Predictors of future falls in Parkinson disease

Background: Falls are a major health and injury problem for people with Parkinson disease (PD). Despite the severe consequences of falls, a major unresolved issue is the identification of factors that predict the risk of falls in individual patients with PD. The primary aim of this study was to prospectively determine an optimal combination of functional and disease-specific tests to predict falls in individuals with PD. ----- ----- Methods: A total of 101 people with early-stage PD undertook a battery of neurologic and functional tests in their optimally medicated state. The tests included Tinetti, Berg, Timed Up and Go, Functional Reach, and the Physiological Profile Assessment of Falls Risk; the latter assessment includes physiologic tests of visual function, proprioception, strength, cutaneous sensitivity, reaction time, and postural sway. Falls were recorded prospectively over 6 months. ----- ----- Results: Forty-eight percent of participants reported a fall and 24% more than 1 fall. In the multivariate model, a combination of the Unified Parkinson's Disease Rating Scale (UPDRS) total score, total freezing of gait score, occurrence of symptomatic postural orthostasis, Tinetti total score, and extent of postural sway in the anterior-posterior direction produced the best sensitivity (78%) and specificity (84%) for predicting falls. From the UPDRS items, only the rapid alternating task category was an independent predictor of falls. Reduced peripheral sensation and knee extension strength in fallers contributed to increased postural instability. ----- ----- Conclusions: Falls are a significant problem in optimally medicated early-stage PD. A combination of both disease-specific and balance- and mobility-related measures can accurately predict falls in individuals with PD.

Depression among Chinese stroke survivors six months after discharge from a rehabilitation hospital

Aim and objective: The primary aim was to examine the prevalence of poststroke depression in Chinese stroke survivors six months after discharge from a rehabilitation hospital. A second aim was to determine whether six-month poststroke depression was associated with psychological, social and physical outcomes and demographic variables.---------- Background: There has been increasing recognition of the influence of depression on poststroke recovery. While some previous studies report associations between depression and social, psychological, physical and clinical outcomes, few studies had sufficient sample sizes for regression analysis thereby limiting the clinical applicability of their findings. ---------- Design: A cross-sectional design was used.---------- Method: Data were collected from 124 male and 86 female stroke survivors (mean age 71Æ7, SD 10Æ2 years). The Geriatric Depression Scale was used to measure depression, the State Self-esteem Scale to measure state self-esteem, the London Handicap Scale to measure participation restriction, the Social Support Questionnaire to measure satisfaction with social support and the Modified Barthel Index to measure functional ability. Results. Forty-two survivors (20Æ5%) reported mild and 33 (16Æ1%) reported severe depression. The presence of depression was associated with low levels of state self-esteem, social support satisfaction and functional ability. Logistic regression analysis revealed that these variables were statistically significant in predicting the probability of having depression (p < 0Æ05). ---------- Conclusions: Analyses in the present study revealed distinct patterns of correlates of depression, and the results were in agreement with prior studies that depression has a consistent positive ssociation with physical disability, living arrangements and social support and no significant association with the different types of brain lesion. Relevance to clinical practice. There is a need, routinely, to assess stroke survivors for depression and, where necessary, to intervene with the aim of enhancing psychological and social well-being.

Sustainable urban and regional infrastructure development : technologies, applications and management

Sustainable Urban and Regional Infrastructure Development: Technologies, Applications and Management, bridges the gap in the current literature by addressing the overall problems present in society's major infrastructures, and the technologies that may be applied to overcome these problems. It focuses on ways in which energy intensive but 'invisible' (to the general public) facilities can become green or greener. The studies presented re lessons to be learnt from our neighbors and from our own backyard, and provide an excellent general overview of the issues facing us all.

Preface : sustainable urban and regional infrastructure development : technologies, applications and management

The concept of ‘sustainability’ has been pushed to the forefront of policy-making and politics as the world wakes up to the impacts of climate change and the effects of the modern urban lifestyle. Climate change has emerged to be one of the biggest challenges faced by our planet today, threatening both built and natural systems with long term consequences which may be irreversible. While there is a vast literature in the market on sustainable cities and urban development, there is currently none that bring together the vital issues of urban and regional development, and the planning, management and implementation of sustainable infrastructure. Large scale infrastructure plays an important part in modern society by not only promoting economic growth, but also by acting as a key indicator for it. More importantly, it supplies municipal/local amenity and services: water, electricity, social and communication facilities, waste removal, transport of people and goods, as well as numerous other services. For the most part, infrastructure has been built by teams lead by engineers who are more concerned about functionality than the concept of sustainability. However, it has been widely stated that current practices and lifestyle cannot continue if we are to leave a healthy living planet to not only the next generation, but also to the generations beyond. Therefore, in order to be sustainable, there are drastic measures that need to be taken. Current single purpose and design infrastructures that are open looped are not sustainable; they are too resource intensive, consume too much energy and support the consumption of natural resources at a rate that will exhaust their supply. Because of this, it is vital that modern society, policy-makers, developers, engineers and planners become pioneers in introducing and incorporating sustainable features into urban and regional infrastructure.

Rapid displacement of dengue virus type 1 by type 4, Pacific region, 2007-2009

Since 2000-2001, dengue virus type 1 has circulated in the Pacific region. However, in 2007, type 4 reemerged and has almost completely displaced the strains of type 1. If only 1 serotype circulates at any time and is replaced approximately every 5 years, DENV-3 may reappear in 2012.

A subtropical urban community : medium to high density residential typologies - case study 4

On the case study site, using these strategies, the site density achieved was approximately 180 dwellings per hectare. According to ASK consulting engineers‟ acoustic report (in Ecolateral‟s report) the design gives solid consideration to the environmental noise issues associated with the site. The subject structure not only provides significant shielding of transport corridor noise to the suburb, it also minimises the potential for adverse impact on residential amenity within the building itself...

Tangible programming elements for young children

Tangible programming elements offer the dynamic and programmable properties of a computer without the complexity introduced by the keyboard, mouse and screen. This paper explores the extent to which programming skills are used by children during interactions with a set of tangible programming elements: the Electronic Blocks. An evaluation of the Electronic Blocks indicates that children become heavily engaged with the blocks, and learn simple programming with a minimum of adult support.

Overcoming the organ donation dilemma

A book review of: Jason T. Siegel and Eusebio M. Alvaro Understanding organ donation: Applied behavioral science perspectives. Wiley-Blackwell, 2010, 392 pp. US$124.95 (hbk); ISBN 978-1-4051-9213-2

Thermal stability of the soil minerals destinezite and diadochite Fe3+2(PO4)(SO4)(OH)·6H2O - implications for soils in bush fires

Thermogravimetry combined with evolved gas mass spectrometry has been used to ascertain the stability of the soil minerals destinezite and diadochite. These two minerals are identical except for their morphology. Diadochite is amorphous whereas destinezite is crystalline. Both minerals are found in soils. It is important to understand the stability of these minerals because soils are subject to bush fires especially in Australia. The thermal analysis patterns of the two minerals are similar but not identical. Subtle differences are observed in the DTG patterns. For destinezite, two DTG peaks are observed at 129 and 182°C attributed to the loss of hydration water, whereas only a broad peak with maximum at 84°C is observed for diadochite. Higher temperature mass losses at 685°C for destinezite and 655°C for diadochite, based upon the ion current curves, are due to sulphate decomposition. This research has shown that at low temperatures the minerals are stable but at high temperatures, as might be experienced in a bush fire, the minerals decompose.

The spermostatic and microbicidal actions of quinones and malemides : towards a dual-purpose contraceptive agent

There is an urgent need to develop safe, effective, dual-purpose contraceptive agents that combine the prevention of pregnancy with protection against sexually transmitted diseases. Here we report the identification of a group of compounds that on contact with human spermatozoa induce a state of “spermostasis,” characterized by the extremely rapid inhibition of sperm movement without compromising cell viability. These spermostatic agents were more active and significantly less toxic than the reagent in current clinical use, nonoxynol 9, giving therapeutic indices (ratio of spermostatic to cytotoxic activity) that were orders of magnitude greater than this traditional spermicide. Although certain compounds could trigger reactive oxygen species generation by spermatozoa, this activity was not correlated with spermostasis. Rather, the latter was associated with alkylation of two major sperm tail proteins that were identified as A Kinase-Anchoring Proteins (AKAP3 and AKAP4) by mass spectrometry. As a consequence of disrupted AKAP function, the abilities of cAMP to drive protein kinase A-dependent activities in the sperm tail, such as the activation of SRC and the consequent stimulation of tyrosine phosphorylation, were suppressed. Furthermore, analysis of microbicidal activity using Chlamydia muridarum revealed powerful inhibitory effects at the same low micromolar doses that suppressed sperm movement. In this case, the microbicidal action was associated with alkylation of Major Outer Membrane Protein (MOMP), a major chlamydial membrane protein. Taken together, these results have identified for the first time a novel set of cellular targets and chemical principles capable of providing simultaneous defense against both fertility and the spread of sexually transmitted disease.

Whole-proteome phylogeny of large dsDNA viruses and parvoviruses through a composition vector method related to dynamical language model

Background The vast sequence divergence among different virus groups has presented a great challenge to alignment-based analysis of virus phylogeny. Due to the problems caused by the uncertainty in alignment, existing tools for phylogenetic analysis based on multiple alignment could not be directly applied to the whole-genome comparison and phylogenomic studies of viruses. There has been a growing interest in alignment-free methods for phylogenetic analysis using complete genome data. Among the alignment-free methods, a dynamical language (DL) method proposed by our group has successfully been applied to the phylogenetic analysis of bacteria and chloroplast genomes. Results In this paper, the DL method is used to analyze the whole-proteome phylogeny of 124 large dsDNA viruses and 30 parvoviruses, two data sets with large difference in genome size. The trees from our analyses are in good agreement to the latest classification of large dsDNA viruses and parvoviruses by the International Committee on Taxonomy of Viruses (ICTV). Conclusions The present method provides a new way for recovering the phylogeny of large dsDNA viruses and parvoviruses, and also some insights on the affiliation of a number of unclassified viruses. In comparison, some alignment-free methods such as the CV Tree method can be used for recovering the phylogeny of large dsDNA viruses, but they are not suitable for resolving the phylogeny of parvoviruses with a much smaller genome size.