Prevention of hip fractures in older adults residing in long-term care facilities with a hip airbag: a retrospective pilot study.

BACKGROUND: Hip and pelvic fractures do commonly occur among older adults. This pilot study aimed to evaluate the effect of introduction of the WOLK hip airbag on the incidence of hip fractures. METHODS: A retrospective study was performed among 969 participants residing within 11 long-term care facilities for older patients, belonging to one large healthcare organization in The Netherlands. The intervention concerned application of 45 WOLK hip-airbags, distributed among selected residents of the long-term care facilities. Inclusion criteria; physically active participants with a pelvic circumference between 90-125 cm able to wear the hip airbag. Exclusion criteria; participants who continuously removed the hip airbag themselves or participants who depended on a wheelchair for mobility. Main outcome measures were the occurrence of falls and hip, pelvic and other fractures. RESULTS: The incidence of hip and pelvic fractures declined from 3.3/100 person years to 1.8/100 person years during the study for an Incidence Rate Ratio (IRR) of 0.55 (95% confidence interval (95%CI) 0.34-0.87) in the entire study population. The incidence of other fractures did not decline during the study period (IRR 0.72;95%CI 0.37-1.40). The incidence of falls declined to some extent during the study (IRR 0.88; 95%CI 0.83-0.93). CONCLUSIONS: After introduction of the WOLK hip airbag a reduction of the incidence of hip and pelvic fractures by almost half was observed in older patients residing in long-term care facilities, even though only 45 hip airbags were distributed among the 969 residents. As selection bias cannot be ruled out in this study, the results of this pilot study warrant replication by a future clinical trial to determine true effectiveness of this intervention.

Light-dark rhythms during incubation of broiler chicken embryos and their effects on embryonic and post hatch leg bone development.

There are indications that lighting schedules applied during incubation can affect leg health at hatching and during rearing. The current experiment studied effects of lighting schedule: continuous light (24L), 12 hours of light, followed by 12 hours of darkness (12L:12D), or continuous darkness (24D) throughout incubation of broiler chicken eggs on the development and strength of leg bones, and the role of selected hormones in bone development. In the tibiatarsus and femur, growth and ossification during incubation and size and microstructure at day (D)0, D21, and D35 post hatching were measured. Plasma melatonin, growth hormone, and IGF-I were determined perinatally. Incidence of tibial dyschondroplasia, a leg pathology resulting from poor ossification at the bone's epiphyseal plates, was determined at slaughter on D35. 24L resulted in lower embryonic ossification at embryonic day (E)13 and E14, and lower femur length, and lower tibiatarsus weight, length, cortical area, second moment of area around the minor axis, and mean cortical thickness at hatching on D0 compared to 12L:12D especially. Results were long term, with lower femur weight and tibiatarsus length, cortical and medullary area of the tibiatarsus, and second moment of area around the minor axis, and a higher incidence of tibial dyschondroplasia for 24L. Growth hormone at D0 was higher for 24D than for 12L:12D, with 24L intermediate, but plasma melatonin and IGF-I did not differ between treatments, and the role of plasma melatonin, IGF-I, and growth hormone in this process was therefore not clear. To conclude, in the current experiment, 24L during incubation of chicken eggs had a detrimental effect on embryonic leg bone development and later life leg bone strength compared to 24D and 12L:12D, while the light-dark rhythm of 12L:12D may have a stimulating effect on leg health.

Effects of maternal dietary nitrate supplementation during the perinatal period on piglet survival, body weight, and litter uniformity.

The objective of this study was to evaluate effects of different dosages of dietary nitrate supplementation to sows from d 108 of gestation until d 5 of lactation on reproductive performance of sows and piglet performance from birth until weaning. Dietary nitrate supplementation leads to nitric oxide (NO) formation that can potentially increase blood flow to the fetuses (by the vasodilative effect of NO), leading to a decrease in the loss of potential viable piglets in the form of stillbirth and preweaning mortality. Three hundred and five gilts and sows were allocated to one of six diets from d 108 of gestation until d 5 of lactation, containing 0.00% (Control), 0.03%, 0.06%, 0.09%, 0.12%, or 0.15% of dietary nitrate. The source of nitrate used was calcium nitrate double salt. Calcium levels were kept the same among diets by using limestone. Gilts and sows were weighed and backfat was measured at arrival to the farrowing room (d 108 of gestation) and at weaning (d 27 of age). Data included number of piglets born alive, born dead, and weaned, as well as individual piglet weights at d 0, 72 h of age and weaning. Preweaning mortality was determined throughout lactation. Body weight d 0 (P = 0.04) as well as BW at 72 h of age (P < 0.01) increased linearly with increasing dosages of nitrate in the maternal diet. Litter uniformity (SD) at birth was not affected by maternal nitrate supplementation level (P > 0.10), but tended to be higher at 72 h of age in the control treatment than in all nitrate-supplemented treatments (P = 0.07), and SD decreased linearly (increased uniformity) at weaning with increasing dosages of nitrate (P = 0.05). BW at weaning (P > 0.05) and average daily gain of piglets during lactation (P > 0.05) were not affected by maternal nitrate supplementation. A tendency for a quadratic effect (P = 0.10) of the dosage of maternal dietary nitrate was found on preweaning mortality of piglets with the lowest level of mortality found at 0.09% to 0.12% of maternal nitrate supplementation. We conclude that the use of nitrate in the maternal diet of sows during the perinatal period might stimulate preweaning piglet vitality. Exact mode of action and optimal dose of nitrate still need to be elucidated.

Retro-Diels-Alder Reaction in Aqueous Solution: Toward a Better Understanding of Organic Reactivity in Water.

The retro-Diels-Alder (RDA) reaction of anthracenedione 1a proceeds considerably faster in aqueous solutions than in organic solvents. Addition of organic solvents to water retards the reaction, whereas glucose induces a modest acceleration. SDS micelles induce a considerable retardation, but even at high concentrations of surfactant (complete micelle-substrate binding), the cycloreversion is not fully inhibited. Correlation with data for solvatochromic indicators strongly suggest that the origin of the water-induced acceleration involves primarily enhanced hydrogen bonding of water to the activated complex for the RDA reaction of 1a. Activation parameters support this view. A comparison of the present results with previous kinetic data for bimolecular and intramolecular Diels-Alder reactions provides insights into the contributions of hydrogen-bond and hydrophobic interactions to the aqueous accelerations of the latter two types of reactions.

Solvent Effects on a Diels-Alder Reaction Involving a Cationic Diene: Consequences of the Absence of Hydrogen-Bond Interactions for Accelerations in Aqueous Media.

In order to study the influence of hydrogen-bond interactions on the accelerations of Diels-Alder reactions in water and highly aqueous mixed solvent systems, second-order rate constants for the Diels-Alder reaction of acridizinium bromide (1a) with cyclopentadiene (CP) have been measured in aqueous media and organic solvents. Only modest rate accelerations were found in water-rich media. This is attributed to the absence of hydrogen-bonding groups in the reactants. Comparison with cycloadditions of CP with 9-carbomethoxyacridizinium bromide (1b), acrylonitrile (3), and methyl vinyl ketone (4), which do contain hydrogen-bond acceptors, reveals substantially larger aqueous accelerations. These results demonstrate that hydrogen bonding is a major factor in aqueous accelerations. Also rate constants for the cycloaddition of CP to 1a in surfactant solutions were determined. Micellar catalysis is observed in SDS solutions, due to binding of both the diene and the dienophile to the anionic micellar surface.