Impact of 10-Week Evidence-Based Falls Prevention Program on Outcomes Related to Falls Risk in Community-Dwelling Older Adults.

This quasi-experimental study evaluated the impact of a 10-week evidence-based falls prevention program (Bingocize®) on self-reported fear of falling, general health, physical activity, social isolation, and avoidance behavior, in community-dwelling older adults in Virginia. Participants > 60 years of age (n= 481) attended BingocizeR group sessions twice per week for 10 weeks. The program combined conventional bingo with periodic strength, balance, flexibility exercises, and fall prevention education. Pre and post assessments gauged participants' self-perception of fear of falling, general health, physical activity, social isolation, and avoidance behavior. 481 participants attended at least 80% of the sessions. Following the intervention, paired sample t-tests revealed statistically significant improvements (p <.05) in fear of falling, physical activity, social isolation, avoidance behavior, and yet there was no notable change in self-reported general health. The 10-week BingocizeR program appears to improve physical activity, social isolation, avoidance behavior, and fear of falling. Self-reported general health did not significantly change.

Facilitators and Barriers to Attendance in a Nursing Home Exercise Program.

Women and residents in Certified Nursing Homes (CNHs) with higher star ratings had better attendance in exercise and social engagement programming (ie, Bingocize) than men and residents in CNHs with lower ratings. OBJECTIVE: The purpose of the current study was to determine whether resident factors and nursing home star ratings influenced attendance in Bingocize, a therapeutic exercise program that incorporates opportunities for social engagement in nursing homes. DESIGN: This is a descriptive study of data collected across multiple nursing homes over 17 months. SETTING AND PARTICIPANTS: Data were collected from residents in 25 certified nursing homes in the mid-southern United States. METHODS: The program consisted of two 45-60-minute sessions each week. Bingocize attendance was recoded as number of sessions attended each month from September 2017 to February 2019 in 25 nursing homes. The impact of gender, age, cognitive functioning, and Nursing Home Star Ratings on adherence to the program based on percentage of Bingocize sessions attended was analyzed. RESULTS: A total of 1165 residents of certified nursing homes were recruited and participated in Bingocize; 55% of participants attended Bingocize infrequently or had poor attendance, 21% of the participants had average attendance, and 24% had good attendance. The association between gender and level of attendance was significant (P = .045). The star rating of the nursing home also affected attendance. As star level of the nursing home increased, the percentage of good attendance increased (P < .001): 19.12% (1 star), 20.69% (2 stars), 23.57% (3 stars), 33.76% (4 stars), and 36.63% (5 stars). Neither age nor cognitive functioning [based on Brief Interview of Mental Status (BIMS)] had a significant impact on attendance. CONCLUSIONS AND IMPLICATIONS: We examined adherence to an exercise program called Bingocize based on percentage of sessions attended in 25 nursing homes. Women and residents in nursing homes with higher star ratings were reported to have better attendance in Bingocize than men or residents in nursing homes with lower ratings, respectively. Residents of all ages and cognitive ability can successfully participate in the Bingocize program.

COVID-19 Biomarkers in research: Extension of the OncoMX cancer biomarker data model to capture biomarker data from other diseases.

Scientists, medical researchers, and health care workers have mobilized worldwide in response to the outbreak of COVID-19, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2; SCoV2). Preliminary data have captured a wide range of host responses, symptoms, and lingering problems post-recovery within the human population. These variable clinical manifestations suggest differences in influential factors, such as innate and adaptive host immunity, existing or underlying health conditions, co-morbidities, genetics, and other factors. As COVID-19-related data continue to accumulate from disparate groups, the heterogeneous nature of these datasets poses challenges for efficient extrapolation of meaningful observations, hindering translation of information into clinical applications. Attempts to utilize, analyze, or combine biomarker datasets from multiple sources have shown to be inefficient and complicated, without a unifying resource. As such, there is an urgent need within the research community for the rapid development of an integrated and harmonized COVID-19 Biomarker Knowledgebase. By leveraging data collection and integration methods, backed by a robust data model developed to capture cancer biomarker data we have rapidly crowdsourced the collection and harmonization of COVID-19 biomarkers. Our resource currently has 138 unique biomarkers. We found multiple instances of the same biomarker substance being suggested as multiple biomarker types during our extensive cross-validation and manual curation. As a result, our Knowledgebase currently has 265 biomarker type combinations. Every biomarker entry is made comprehensive by bringing in together ancillary data from multiple sources such as biomarker accessions (canonical UniProtKB accession, PubChem Compound ID, Cell Ontology ID, Protein Ontology ID, NCI Thesaurus Code, and Disease Ontology ID), BEST biomarker category, and specimen type (Uberon Anatomy Ontology) unified with ontology standards. Our preliminary observations show distinct trends in the collated biomarkers. Most biomarkers are related to the immune system (SAA,TNF-∝, and IP-10) or coagulopathies (D-dimer, antithrombin, and VWF) and a few have already been established as cancer biomarkers (ACE2, IL-6, IL-4 and IL-2). These trends align with proposed hypotheses of clinical manifestations compounding the complexity of COVID-19 pathobiology. We explore these trends as we put forth a COVID-19 biomarker resource that will help researchers and diagnosticians alike. All biomarker data are freely available from https://data.oncomx.org/covid19 .

Students report more positive attitudes toward older adults following an interprofessional service-learning course.

The aim of this study was to assess undergraduate students' perceptions of older adults over the semester in an interprofessional service-learning course that implemented a health promotion program called Bingocize® at community facilities for older adults. Students were surveyed at the beginning of the semester, at midterm, and at the conclusion of the course. Quantitative and qualitative data were collected to assess the students' perceptions and experiences. Results suggest that a course on aging that includes interprofessional service-learning in geriatric settings is associated with a significant increase in positive perceptions of the older adult population. Further research, however, is warranted to validate the findings.

Effects of a Game-Centered Health Promotion Program on Fall Risk, Health Knowledge, and Quality of Life in Community-Dwelling Older Adults.

Quality of life (QOL) is an important aspect of overall well-being in older adults and can be improved with increased physical activity. One in four older adults experiences a fall each year, making it necessary to focus public health interventions towards decreasing fall risk and improving QOL in older adults. The purpose of this study was to determine the effects of the health promotion program, Bingocize®, on QOL and fall risk in community-dwelling older adults (n = 36; mean age 73.63 ± 6.97). Participants were clustered and randomly assigned to (a) experimental (n = 19; participating in Bingocize® program, or (b) control (n = 17; only played normal bingo). Each group completed a 12-week intervention that consisted of two 45-60 minute sessions per week. There were no significant interactions for any of the variables, with the exception of positive affect (PA) (F (1,34) = 5.66, p = 0.02, η p 2 = 0.15 , power = 0.64) and handgrip strength (F (1,34) = 8.31, p = 0.007, η p 2 = 0.196 , power = 0.80). There was also a significant main effect for time for health knowledge. Participating in the Bingocize® health promotion program can produce a meaningful and detectable change in handgrip strength and PA in community-dwelling older adults.

Transcriptome patterns in hidradenitis suppurativa: support for the role of antimicrobial peptides and interferon pathways in disease pathogenesis.

BACKGROUND: Hidradenitis suppurativa (HS) is a recurrent inflammatory disease of the apocrine sweat glands. Immune dysregulation probably contributes to the pathogenesis of HS. AIM: To harness mRNA expression arrays to investigate the transcriptome profile in HS compared with control skin. METHODS: Illumina® HumanHT-12 v4 Expression BeadChips were used to measure mRNA expression in skin samples from HS (n = 10) and abdominoplasty (n = 11) skin specimens. Differentially expressed genes were detected by fitting genewise linear models to the normalized expression data and then modelling using the web-based software Ingenuity® Pathway Analysis. RESULTS: The antimicrobial peptide Dermcidin and the cytokine regulator interleukin (IL)-37 were both significantly downregulated in the HS specimens (Dermcidin expression log ratio -3.93, expression P = 0.04; IL-37 expression log ratio -3.29, expression P < 0.001). Pathway analysis revealed the interferon-signalling pathway, leucocyte extravasation pathway, T helper 1 and 2 pathways and nuclear factor of activated T cells as the top-five upregulated pathways in the HS samples. CONCLUSION: Evaluation of transcriptome patterns in HS compared with normal skin demonstrated downregulation of the antimicrobial peptide Dermcidin and the innate immune regulator IL-37, as well as upregulation of interferon pathways and pathways of leucocyte activation.

Assessing the Impact of a Game-Centered Mobile App on Community-Dwelling Older Adults' Health Activation.

BACKGROUND: Older adults experience normative age-graded declines in physical and cognitive performance and many must manage one or more chronic conditions. Exercise programs can help to improve both their physical health and their knowledge, skill, and confidence in managing aspects of their own healthcare, yet a significant barrier is motivating them to adhere to such programs. The purpose of this investigation was to evaluate the impact of a game-centered mobile app (Bingocize®) on older adults' knowledge, skill, and confidence for managing aspects of their healthcare. METHODS: Community-dwelling older adults (N=84) with mobility and not engaged in any structured exercise program were recruited from rural community senior centers in Kentucky and Tennessee. Participants were randomly assigned to (a) a version that included health education, or (b) health education and an exercise component. Participants used the app in a group setting for 10 weeks, twice per week, for one hour. The Patient Activation Measure (PAM-10) was used to assess group changes in knowledge, skill, and confidence for managing aspects of their healthcare. The design was a two (Group: Exercise + Health Education vs. Health Education-only) x two (Time: Pre- vs. Post-intervention) and an analyses of variance, with significance p<.05, was used to detect within and between group differences. RESULTS: PAM-10 values significantly increased from pre- to post-intervention for both groups, as did knowledge of the health topics (all p < 0.05). Attendance was >93% in both groups. CONCLUSIONS: Bingocize® engendered high attendance and improved health activation of older adults; however, additional research is needed to examine whether changes in activation result in long-term changes in health behaviour. The Bingocize® mobile app is an enjoyable and effective way to increase health activation in community-dwelling older adults.

Efficacy of Bingocize®: A Game-Centered Mobile Application to Improve Physical and Cognitive Performance in Older Adults.

OBJECTIVE: A significant barrier to improving the health and well-being of older adults is that they often do not adhere to health-promoting programs. The present study examined whether Bingocize®, a game-centered mobile app that can combine bingo with healthy activities such as exercise and/or health topic education, could (1) engender high rates of adherence among sedentary community-dwelling older adults, and (2) potentially improve aspects of physical and cognitive performance. MATERIALS AND METHODS: Participants used the app for ∼1 hour, twice per week, for 10 weeks. Each using a tablet, they played the game in small social groups and were randomly assigned to either an Experimental (Bingo + Health Education + Exercise) or Control (Bingo + Health Education) group. Pre- and Postintervention assessments of (1) functional performance, (2) fluid cognition, and (3) knowledge of two health topics (osteoarthritis and fall risks) were administered. RESULTS: Adherence was high in both groups (>93% attendance), suggesting the app was popular and engaging. Two (Experimental/Control) × Two (Pre/Post) interactions were found for two domains of functional performance (Arm Curls, a measure of upper body strength; and Chair Stands, a measure of lower body strength) and one domain of cognition (updating, a component of executive functioning), such that the Experimental group improved more relative to the Control group. Both groups improved their knowledge of the health topics covered (all P < 0.05). CONCLUSION: Our findings suggest that the fun and interactive nature of Bingocize® engenders high levels of adherence to a health-promoting program in a difficult to serve population, serving as a conduit to potentially improve multiple aspects of quality of life for older adults.

A qualitative study exploring the views, attitudes and beliefs of patients and health professionals towards exercise intervention for people who are surgically treated for lung cancer.

Surgical removal remains the best curative option for patients diagnosed with early-stage lung cancer. However, it is also associated with significant morbidity and reduced quality of life. Interventions to improve patient outcomes are required. This study aimed to explore the views, attitudes and beliefs of key stakeholders on exercise intervention for people who are surgically treated for lung cancer to inform the development of future interventions. Focus groups and individual interviews were carried out at two Scottish sites. The study was guided by the Health Action Process Approach behaviour change model. A total of 23 (12 patients and 11 health professionals) participated in the study. The data analysis resulted in three main themes: attitudes and beliefs, external factors and intervention design. The results highlighted certain key elements that should be included in an exercise intervention, such as the need for supervised sessions, an element of individualisation and the perceived social benefits of exercising with others. This study emphasises the importance of including key stakeholders in the development of complex interventions such as exercise and provides important information for the development of future exercise intervention trials for people who are surgically treated for lung cancer.

Students' Perceptions of an Applied Research Experience in an Undergraduate Exercise Science Course.

Applied research experiences can provide numerous benefits to undergraduate students, however few studies have assessed the perceptions of Exercise Science (EXS) students to an applied research experience. The purpose of this study was two-fold: 1) to describe the rationale and implementation of an applied research experience into an EXS curriculum and 2) to evaluate EXS undergraduate students' perceptions of an applied research experience. An EXS measurement course was chosen for implementation of an applied research experience. The applied research experience required groups of students to design, implement, and evaluate a student-led research project. Fourteen questions were constructed, tailored to EXS undergraduate students, to assess students' perceptions of the experience. Qualitative analysis was used for all applicable data, with repeated trends noted; quantitative data were collapsed to determine frequencies. There was an overall positive student perception of the experience and 85.7% of students agreed an applied research experience should be continued. 84.7% of students perceived the experience as educationally enriching, while 92.8% reported the experience was academically challenging. This experience allowed students to develop comprehensive solutions to problems that arose throughout the semester; while facilitating communication, collaboration, and problem solving. Students believed research experiences were beneficial, but could be time consuming when paired with other responsibilities. Results suggest an applied research experience has the potential to help further the development of EXS undergraduate students. Understanding student perceptions of an applied research experience may prove useful to faculty interested in engaging students in the research process.

Older Adults' Functional Performance and Health Knowledge After a Combination Exercise, Health Education, and Bingo Game.

Combining exercise, health education, and the game of bingo may help older adults remain independent. The objective was to determine whether a 10-week health promotion program (Bingocize®) improves functional performance and health knowledge in older adults. Participants were assigned to experimental (n = 13) or control (n = 14) groups. The intervention was administered twice per week at two independent living facilities. Pre and postfunctional performance and health knowledge were measured. Mixed between-within subject ANOVA was used to detect differences between groups (p < .05). Improvements were found in all dependent variables except lower body flexibility, systolic blood pressure, and health knowledge. Adherence was 97.31% ± 2.59%. Bingocize® has the potential to help older adults remain independent by improving functional performance. Statistical improvements in health knowledge were not found, but future researchers may explore modifying the health education component or using a different measure of health knowledge to detect changes.

Phylogeography's past, present, and future: 10 years after Avise, 2000.

Approximately 20 years ago, Avise and colleagues proposed the integration of phylogenetics and population genetics for investigating the connection between micro- and macroevolutionary phenomena. The new field was termed phylogeography. Since the naming of the field, the statistical rigor of phylogeography has increased, in large part due to concurrent advances in coalescent theory which enabled model-based parameter estimation and hypothesis testing. The next phase will involve phylogeography increasingly becoming the integrative and comparative multi-taxon endeavor that it was originally conceived to be. This exciting convergence will likely involve combining spatially-explicit multiple taxon coalescent models, genomic studies of natural selection, ecological niche modeling, studies of ecological speciation, community assembly and functional trait evolution. This ambitious synthesis will allow us to determine the causal links between geography, climate change, ecological interactions and the evolution and composition of taxa across whole communities and assemblages. Although such integration presents analytical and computational challenges that will only be intensified by the growth of genomic data in non-model taxa, the rapid development of "likelihood-free" approximate Bayesian methods should permit parameter estimation and hypotheses testing using complex evolutionary demographic models and genomic phylogeographic data. We first review the conceptual beginnings of phylogeography and its accomplishments and then illustrate how it evolved into a statistically rigorous enterprise with the concurrent rise of coalescent theory. Subsequently, we discuss ways in which model-based phylogeography can interface with various subfields to become one of the most integrative fields in all of ecology and evolutionary biology.

Conservation assessment of southern South American freshwater ecoregions on the basis of the distribution and genetic diversity of crabs from the genus Aegla.

We assessed the conservation priority of 18 freshwater ecoregions in southern South America on the basis of Aegla (genus of freshwater crabs) genetic diversity and distribution. Geographical distributions for 66 Aegla species were taken from the literature and plotted against ecoregions and main river basins of southern South America. Species richness and number of threatened and endemic species were calculated for each area. To assess taxonomic and phylogenetic diversity, we generated a molecular phylogeny based on DNA sequences for one nuclear (28S) and 4 mitochondrial (12S, 16S, COI, and COII) genes. All species richness and phylogenetic methods agreed, to a large extent, in their rankings of the importance of conservation areas, as indicated by the Spearman's rank correlation coefficient (p < 0.01); nonetheless, some of the lowest correlations were observed between taxonomic and phylogenetic diversity indices. The 5 ecoregions of the Laguna dos Patos Basin (Eastern Brazil), Central Chile, South Brazilian Coast, Chilean Lakes, and Subtropical Potamic Axis (northern Argentina and southern Uruguay and Paraguay) had the highest biodiversity scores. Conservation of these regions will preserve the largest number of species and the greatest amount of genetic diversity within the South American freshwater Aegla fauna. Biodiversity across rivers and within areas was heterogeneously distributed in the ecoregions of Upper Paraná, Ribeira do Iguape, Upper Uruguay, and South Brazilian Coast (i.e., one river showed significantly more biodiversity than any other river from the same ecoregion), but homogeneously distributed in the other ecoregions. Hence, conservation plans in the former regions will potentially require less effort than plans in the latter regions.

Economic and environmental feasibility of a perennial cow dairy farm.

More efficient and economical production systems are needed to improve the sustainability of dairy farms. One concept to consider is using perennial cows. Perennial cows are those that maintain a relatively high milk production for >or=2 yr without going through the typical dry period followed by calving. Farm records show that some cows have produced over 20 kg/d after 4 yr of continuous lactation. A farm simulation model was used to evaluate the long-term performance, environmental impact, and economics of a conceptual perennial cow production system on a typical dairy farm in Pennsylvania. Compared with a traditional 100-cow farm with replacement heifers produced on the farm, a perennial herd of 100 cows and purchased replacements provided environmental benefit but sustained a substantial economic loss. However, increasing the perennial herd to 128 cows better utilized the feed produced on the farm. Compared with the traditional 100-cow farm, use of the perennial 128-cow herd reduced supplemental protein and mineral feed purchases by 38%, increased annual milk sales by 21%, reduced nitrogen losses by 17%, maintained a phosphorus balance, and increased annual net return to farm management by 3200 dollars. A traditional 120-cow dairy farm with purchased replacements also used a similar amount of farm-produced feed. Compared with this option, the farm with 128 perennial cows reduced protein and mineral feed purchases by 36%, maintained similar annual milk sales, increased manure production by 7%, reduced N losses by 10%, and increased annual net return by 12,700 dollars. The economic feasibility of the perennial-cow dairy farm was very sensitive to the milk production maintained by the perennial herd and market prices for milk and perennial replacement animals. The analysis was relatively insensitive to the assumed useful life of perennial cows as long as they could be maintained in the herd for at least 3 yr. Thus, a perennial cow production system can improve the economic and environmental sustainability of a traditional dairy farm if a similar level in annual milk production per cow can be maintained.

A modified bootscan algorithm for automated identification of recombinant sequences and recombination breakpoints.

We have developed a modified BOOTSCAN algorithm that may be used to screen nucleotide sequence alignments for evidence of recombination without prior identification of nonrecombinant reference sequences. The algorithm is fast and includes a Bonferroni corrected statistical test of recombination to circumvent the multiple testing problems encountered when using the BOOTSCAN method to explore alignments for evidence of recombination. Using both simulated and real datasets we demonstrate that the modified algorithm is more powerful than other phylogenetic recombination detection methods and performs almost as well as one of the best substitution distribution recombination detection methods.

Phylogeography and speciation of colour morphs in the colonial ascidian Pseudodistoma crucigaster.

Variation in pigmentation is common in marine invertebrates, although few studies have shown the existence of genetic differentiation of chromatic forms in these organisms. We studied the genetic structure of a colonial ascidian with populations of different colour morphs in the northwestern Mediterranean. A fragment of the c oxidase subunit 1 (COI) mitochondrial gene was sequenced in seven populations of Pseudodistoma crucigaster belonging to three different colour morphs (orange, yellow and grey). Maximum likelihood analyses showed two well-supported clades separating the orange morph from the yellow-grey morphotypes. Genetic divergence between these clades was 2.12%, and gamma(ST) values between populations of the two clades were high (average 0.936), pointing to genetic isolation. Nested clade and coalescence analyses suggest that a past fragmentation event may explain the phylogeographical origin of these two clades. Non-neutral mtDNA evolution is observed in our data when comparing the two clades, showing a significant excess of nonsynonymous polymorphism within the yellow-grey morphotype using the McDonald-Kreitman test, which is interpreted as further support of reproductive isolation. We conclude that the two clades might represent separate species. We compare the population genetic differentiation found with that estimated for other colonial and solitary ascidian species, and relate it to larval dispersal capabilities and other life-history traits.

Beam-halo measurements in high-current proton beams.

We present results from an experimental study of the beam halo in a high-current 6.7-MeV proton beam propagating through a 52-quadrupole periodic-focusing channel. The gradients of the first four quadrupoles were independently adjusted to match or mismatch the injected beam. Emittances and beamwidths were obtained from measured profiles for comparisons with maximum emittance-growth predictions of a free-energy model and maximum halo-amplitude predictions of a particle-core model. The experimental results support both models and the present theoretical picture of halo formation.

Evaluation of methods for detecting recombination from DNA sequences: computer simulations.

Recombination is a key evolutionary process that shapes the architecture of genomes and the genetic structure of populations. Although many statistical methods are available for the detection of recombination from DNA sequences, their absolute and relative performance is still unknown. Here we evaluated the performance of 14 different recombination detection algorithms. We used the coalescent with recombination to simulate DNA sequences with different levels of recombination, genetic diversity, and rate variation among sites. Recombination detection methods were applied to these data sets, and whether they detected or not recombination was recorded. Different recombination methods showed distinct performance depending on the amount of recombination, genetic diversity, and rate variation among sites. The model of nucleotide substitution under which the data were generated did not seem to have a significant effect. Most methods increase power with more sequence divergence. In general, recombination detection methods seem to capture the presence of recombination, but they are not very powerful. Methods that use substitution patterns or incompatibility among sites were more powerful than methods based on phylogenetic incongruence. Most methods do not seem to infer more false positives than expected by chance. Especially depending on the amount of diversity in the data, different methods could be used to attain maximum power while minimizing false positives. Results shown here will provide some guidance in the selection of the most appropriate method/s for the analysis of the particular data at hand.

Effects of risperidone on aberrant behavior of persons with developmental disabilities: I. A double-blind crossover study using multiple measures.

The efficacy of the atypical antipsychotic risperidone was evaluated in the treatment of aberrant behavior (e.g., aggression, self-injury) in 20 individuals with developmental disabilities. A double-blind, crossover design was used to compare risperidone with placebo in a 22-week trial with a 6-month follow-up phase. Based on a 50% reduction in mean Aberrant Behavior Checklist--Community total scores, 50% of the participants were identified as responders. Naturalistic observations of a subset of five individuals showed that for 4 out of 5 participants, risperidone was effective in reducing aberrant behavior. Side effects included weight gain (84% of participants) and sedation (40% of participants). The advantages of conducting a comprehensive analysis of the effects of medication on aberrant behavior are discussed.