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Introduction: Mobility is an evidence-based non-pharmacologic strategy shown to reduce delirium and functional decline among older patients in the acute care setting. Activity trackers have been used in previous studies to objectively measure mobility in older hospitalized patients. This study aims to compare the feasibility and validate the accuracy of three accelerometer-based activity trackers (Fitbit Zip, Fitbit Charge HR and StepWatch). This is the first step in a program of research to objectively measure as a potential marker of delirium risk. Methods: This is a prospective study of patients 65 years of age and older during their ED visit. We excluded those with critical illness, unable to communicate or provide consent; and any ambulatory impediments. Consenting participants wore the trackers for up to 8 hour, and completed a 6-meter walk test while a research assistant manually counted their steps. Our primary feasibility measure was the proportion of eligible patient for which we were able to recover the tracker and recorded their steps. The primary validation endpoint was the concordance between steps recorded by the tracker compared to a gold standard manual step count over a fixed distance. Sample size was based on the desired precision of the final estimate of feasibility. Intraclass correlation coefficient (ICC) was calculated to assess agreements between devices and manual count. We will report proportions with exact binomial 95% confidence intervals (CI) for feasibility and validity endpoints. Results: 41 participants were enrolled in this study. Mean age was 74.6 years (+/- 5.76) and 59% were females. The total subjects that wore the Fitbit Zip, Fitbit Charge HR and StepWatch during study participation was, 40/41 (97.5%, CI 0.87–0.99), 33/34 (97%, CI 0.84–0.99) and 31/32 (96.8%, CI 0.83–0.99), respectively. Total subjects with completed data extracted from the Fitbit Zip, Fitbit Charge HR and StepWatch was, 38/41 subjects (92.6%, CI 0.80–0.98), 34 (100%, CI 0.89–1.00), and 32 (100%, CI 0.89–1.00), respectively. All devices were recovered after use (100%, 95%CI 0.91–100). Conclusion: Our results suggest: 1) the use of gait-tracking devices in the ED is feasible, 2) consumer and research-grade devices showed good validity against the gold standard, and 3) the use of small, inexpensive, consumer-grade trackers to objectively measure mobility of older adults in the ED.
The objectives of this study were: to assess the efficiency of high hydrostatic pressure or ultra-high pressure homogenization against Mycobacterium smegmatis in milk and to discuss whether M. smegmatis can be considered a suitable surrogate for other Mycobacterium spp. in high pressure inactivation trials using milk. Three strains of this specie (CECT 3017, 3020 and 3032) were independently inoculated into both skimmed (0.2% fat) and whole milk (3.4% fat) at an approximate load of 6.5 Log CFU/ml and submitted to HHP treatments at 300, 400 or 500 MPa for 10 m at 6°C and 20°C. Evolution of the surviving cells of the inoculated strains was evaluated analysing milk immediately after the treatments and after 5 and 8 d of storage at 6°C. HHP treatments at 300 MPa were seldom efficient at inactivating M. smegmatis strains, but lethality increased with pressure applied in all cases. Generation of sub-lethal injured cells was observed only after 400 MPa treatments since inactivation at 500 MPa was shown to be complete. Significant differences were not observed due to either temperature of treatment or fat content of milk, except for strain CECT3032, which was shown to be the most sensitive to HHP treatments. Milk inoculated with strain CECT3017 was submitted to ultra-high pressure homogenization (UHPH) treatments at 200, 300 and 400 MPa. Maximum reductions were obtained after 300 and 400 MPa treatments, although less than 3.50 Log CFU/ml were inactivated. UHPH did not cause significant number of injured cells. The usefulness of this species as a marker for pressure-based processing seems limited since it showed greater sensitivity than some pathogenic species including other Mycobacteria reported in previous studies.
Introduction: Delirium is a common complication among older people who need care in the emergency department (ED). Mobility is an evidence-based non-pharmacologic strategy shown to reduce delirium and functional decline among older patients in the acute care setting. However, previous research has shown that compliance with mobility is important to achieve this decreased incidence of delirium. Gait tracking devices have been used in previous studies to accurately measure steps, engagement and intensity of physical activity in older hospitalized patients.The objectives of this study are to compare the feasibility and validate the accuracy of three accelerometer-based gait tracking devices. This is the first step in a program of research to objectively measure mobility among older ED patients as a potential marker of delirium risk. Methods: This is a prospective, observational study of patients 65 years of age and older during their ED visit. We excluded those with critical illness, unable to communicate or provide consent (language barrier, aphasia); and those with any ambulatory impediments. Consenting participants wear the gait trackers for the duration of their stay or for a minimum of 8 hour, and ambulate as normally as they would in their home. Devices were retrieved when the patient was admitted, discharged or, after 8 hours and the steps count was then recorded from an online interface. Our primary feasibility measure is the proportion of eligible patient for which we are be able to recover the tracker and record their steps. The primary validation endpoint will be the concordance between steps recorded by the gait tracking device compared to a gold standard manual step count over a fixed distance. We will report proportions with exact binomial 95% confidence intervals (CI) for feasibility and validity endpoints. Results: Preliminary data from an initial pilot phase includes 7 participants who wore a gait tracking device during their ED visit. Mean age was 79.7 years (+/−5.76) and 57% were females. Devices were worn by participants and recovered by research staff in all 7 cases (100%, 95% CI: 59 – 100). Data from online interface has been collected from 6 participants (85%, 95%CI: 42 – 99). Mean step count by observer was 86.17 +/− 4 (95% CI 82.2 – 90.2) and 70.3 +/− 4 (95%CI 66-74.3) by gait tracker. Conclusion: Our preliminary data suggests that use of gait-tracking devices in the ED is feasible.
The Dark Energy Survey is undertaking an observational programme imaging 1/4 of the southern hemisphere sky with unprecedented photometric accuracy. In the process of observing millions of faint stars and galaxies to constrain the parameters of the dark energy equation of state, the Dark Energy Survey will obtain pre-discovery images of the regions surrounding an estimated 100 gamma-ray bursts over 5 yr. Once gamma-ray bursts are detected by, e.g., the Swift satellite, the DES data will be extremely useful for follow-up observations by the transient astronomy community. We describe a recently-commissioned suite of software that listens continuously for automated notices of gamma-ray burst activity, collates information from archival DES data, and disseminates relevant data products back to the community in near-real-time. Of particular importance are the opportunities that non-public DES data provide for relative photometry of the optical counterparts of gamma-ray bursts, as well as for identifying key characteristics (e.g., photometric redshifts) of potential gamma-ray burst host galaxies. We provide the functional details of the DESAlert software, and its data products, and we show sample results from the application of DESAlert to numerous previously detected gamma-ray bursts, including the possible identification of several heretofore unknown gamma-ray burst hosts.
A number of recent reports emphasize the risk of zoonotic diseases and the high degree of prevalence of asymptomatic animals infected with Leptospira interrogans. This report sought to assess the prevalence of antibodies to certain serovars of L. interrogans, and to describe the association between seropositivity and risk factors associated with within-flock transmission in a mountainous region of Mexico. Overall seroprevalence to L. interrogans was 54·5% (95% confidence interval 48·3–60·7); the most frequent serovar was Icterohaemorrhagiae. The accumulation of placentas and fetuses at a site close to lambing paddocks can play a significant role as a risk factor for within-flock transmission of L. interrogans in transhumant farming systems in the municipality of Xalatlaco. The high prevalence of L. interrogans antibodies supports the hypothesis that natural foci of this zoonosis are present in sheep flocks in this area. These findings emphasize the need for planning and implementation of control programmes for ovine leptospirosis in Mexico and elsewhere.
This work shows a cost effective process to prepare carbon-carbon nanostructured composites using mechanical milling (MM) and a new manufacturing method based on rapid induction sintering. Here we use commercially and cost effective amorphous sources of carbon. The nature of the raw carbon is characterized by means of XRD and Raman, and after MM and sintering we observe a clear evolution of the phases of carbon in situ into more complex structures, including but not limited to graphene, graphitic carbon, and nanodiamond. The raw soot transforms in situ into graphitic particles after 1 hour of MM. Further milling (10 hours) induces the formation of nano-diamond particles. Milling times between 1 and 10 h are ideal to prepare intermediate phases between graphene and nanodiamond. In other words MM is capable of inducing the formation of nearly amorphous carbon soot into complex structures that are ideal for structural composite materials. The sintering process is a novel method involving a “pressureless” process and rapid induction heating. Furthermore, the carbon nanostructures that are produced during milling serve as seeds to grow larger particles that can easily reach micrometric sizes. This process achieved high densification as that proposed in commercial methods such as Spark Plasma Sintering.