A pilot observational study to analyze (in)activity and reasons for sedentary behavior of cognitively impaired geriatric acute inpatients.

BACKGROUND AND OBJECTIVE: Mobility decline and worsening of the cognitive status are all too often the result of acute hospital treatment in older patients. This is particularly pronounced in patients with pre-existing cognitive impairment. This study strived to analyze the routines of geriatric acute care and identify reasons and triggers for sedentary behavior during acute hospitalization of cognitively impaired inpatients. METHODS AND PATIENTS: A sample of 20 moderately cognitively impaired geriatric inpatients (average age 84 years) were recruited on an acute care ward. Information on persons attending the patient, daytime, location, context, patient's activity behavior and difficulty of action were collected by behavioral mapping over a period of 35 1­min timeslots and extrapolated to a period of 525 min. Routines were further analyzed via semi-structured interviews with five healthcare professionals (HCP). RESULTS: Relevant relations between various categorical and ordinal variables, such as patients' activity behavior, persons attending the patient, daytime, location, difficulty of action and contextual factors were found. Extrapolated data showed that patients spent 396.9 min (75%) in their room, 342.0 min (65%) were spent alone and 236.2 min (45%) lying in bed. The time patients spent alone was grossly underestimated by HCP. CONCLUSION: Time spent without company, lacking meaningful activities and continuous bedridden periods due to missing demands to leave the room might have led to time spent inactive and alone. These seem to be strong predictors for sedentariness. Routines of acute care should be reorganized to increase physical activity and thereby reduce sedentary behavior of this patient group.

Direct evidence for linguistic influences in two-digit number processing.

Language-specific differences in number words influence number processing even in nonverbal numerical tasks. For instance, the unit-decade compatibility effect in two-digit number magnitude comparison (compatible number pairs [42_57: 4 < 5 and 2 < 7] are responded to faster than incompatible pairs [47_62: 4 < 6 but 7 > 2]) was shown to be influenced by the inversion of number words (e.g., in German the number word for 42 is zweiundvierzig [literally: two-and-forty]). In two studies, we used articulatory suppression to investigate whether previously observed cross-linguistic differences in two-digit number processing are indeed driven by differences in number word formation. In a two-digit number comparison task, German- and English-speaking participants had to identify the larger of two numbers presented in Arabic digits. In Study 1, participants performed the same task twice, with and without articulatory suppression. In Study 2, the percentage of within-decade filler items (36_39) was manipulated additionally. As expected, in both studies between-groups differences in the compatibility effect disappeared under articulatory suppression irrespective of the percentage of fillers included. Furthermore, paralleling results of previous studies including 33% or less filler items, we found that the compatibility effect was larger in German compared with English speakers in the 20% filler condition. However, this pattern was reversed in the 50% filler condition in both studies. Thus, results provide first direct evidence for influences of verbal number word formation on symbolic number processing. Moreover, these new findings suggest that linguistic influences and those of cognitive control processes associated with characteristics of the stimulus set interact in symbolic number processing. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Elevated tissue sodium deposition in patients with type 2 diabetes on hemodialysis detected by 23Na magnetic resonance imaging.

Long-term elevated blood sugar levels result in tissue matrix compositional changes in patients with diabetes mellitus type 2 (T2DM). We hypothesized that hemodialysis patients with T2DM might accumulate more tissue sodium than control hemodialysis patients. To test this, 23Na magnetic resonance imaging (23Na MRI) was used to estimate sodium in skin and muscle tissue in hemodialysis patients with or without T2DM. Muscle fat content was estimated by 1H MRI and tissue sodium content by 23Na MRI pre- and post-hemodialysis in ten hemodialysis patients with T2DM and in 30 matched control hemodialysis patients. We also assessed body fluid distribution with the Body Composition Monitor. 1H MRI indicated a tendency to higher muscle fat content in hemodialysis patients with T2DM compared to non-diabetic hemodialysis patients. 23Na MRI indicated increased sodium content in muscle and skin tissue of hemodialysis patients with T2DM compared to control hemodialysis patients. Multi-frequency bioimpedance was used to estimate extracellular water (ECW), and excess ECW in T2DM hemodialysis patients correlated with HbA1c levels. Sodium mobilization during hemodialysis lowered muscle sodium content post-dialysis to a greater degree in T2DM hemodialysis patients than in control hemodialysis patients. Thus, our findings provide evidence that increased sodium accumulation occurs in hemodialysis patients with T2DM and that impaired serum glucose metabolism is associated with disturbances in tissue sodium and water content.

Which numbers do you have in mind? Number generation is influenced by reading direction.

In Western participants, small numbers are associated with left and larger numbers with right space. A biological account proposes that brain asymmetries lead to these attentional asymmetries in number space. In contrast, a cultural account proposes that the direction of this association is shaped by reading direction. We explored whether number generation is influenced by reading direction in participants from a left-to-right (UK) and a right-to-left (Arab) reading culture. Participants generated numbers randomly while lying on their left and right side. The mean number generated by participants from a left-to-right reading culture was smaller when they lay on their left than on their right side, and the opposite was found for participants from a right-to-left reading culture. Asymmetries in number space observed in number generation are more compatible with a cultural than biological account.

Safety, immunogenicity and efficacy of a pre-erythrocytic malaria candidate vaccine, ICC-1132 formulated in Seppic ISA 720.

ICC-1132, a recombinant virus-like particle comprising of a modified hepatitis B core protein with a B cell (NANP) and two T cell epitopes of Plasmodium falciparum circumsporozoite protein (CSP), was administered i.m. as a single 50 microg dose in Seppic ISA 720 to 11 volunteers. Local reactogenicity and systemic side effects were acceptable with the predominant finding being mild pain at the injection site. This regimen induced anti-NANP antibodies in 10/11 and modest T cell responses. There was no evidence of protection from experimental challenge with P. falciparum sporozoites. Other formulations and/or multi-dose regimens will be required to enhance the immunogenicity and efficacy of ICC-1132.

Phase I testing of a malaria vaccine composed of hepatitis B virus core particles expressing Plasmodium falciparum circumsporozoite epitopes.

We report the first phase I trial to assess the safety and immunogenicity of a malaria vaccine candidate, ICC-1132 (Malarivax), composed of a modified hepatitis B virus core protein (HBc) containing minimal epitopes of the Plasmodium falciparum circumsporozoite (CS) protein. When expressed in Escherichia coli, the recombinant ICC-1132 protein forms virus-like particles that were found to be highly immunogenic in preclinical studies of mice and monkeys. Twenty healthy adult volunteers received a 20- or a 50-microg dose of alum-adsorbed ICC-1132 administered intramuscularly at 0, 2, and 6 months. The majority of volunteers in the group receiving the 50-microg dose developed antibodies to CS repeats as well as to HBc. Malaria-specific T cells that secreted gamma interferon were also detected after a single immunization with ICC-1132-alum. These studies support ICC-1132 as a promising malaria vaccine candidate for further clinical testing using more-potent adjuvant formulations and confirm the potential of modified HBc virus-like particles as a delivery platform for vaccines against other human pathogens.