Associations of Gait Disorders and Recurrent Falls in Older People: A Prospective Population-Based Study

<b><i>Background:</i></b> Recurrent falls represent a major source of serious adverse health outcomes in the general older population. Gait impairment has been linked to recurrent falls, but there are only limited long-term data on this association. <b><i>Objectives:</i></b> The objective of the study was to investigate the association of gait disorders (GDs) and gait tests with future falls in an existing longitudinal population-based cohort. <b><i>Method:</i></b> The study was performed in participants of the Bruneck Study cohort 2010 aged 60–97 years, with prospective 5-year follow-up. At baseline, participants underwent a clinical gait assessment (to determine neurological and non-neurological GDs according to an established classification) and were also evaluated by quantitative and semiquantitative gait tests (Hauser Index, Tinetti balance and gait test, and gait speed). Logistic regression analysis adjusted for age and sex was used to determine the relationship of baseline variables with incident recurrent falls at 5-year follow-up. <b><i>Results:</i></b> Of 328 included participants, 22 (6.7%) reported recurrent falls at follow-up. Baseline presence of GDs was associated with recurrent falls at follow-up (odds ratio [OR] 4.2; 95% confidence interval [CI] 1.6–11.1; <i>p</i> = 0.004), and this effect was largely driven by neurological GDs (OR 5.5; 95% CI 1.7–17.4; <i>p</i> = 0.004). All 3 simple gait tests were predictive for incident falls (Hauser Index, <i>p</i> = 0.002; Tinetti test, <i>p</i> = 0.006; and gait speed, <i>p</i> &#x3c; 0.001). <b><i>Conclusions:</i></b> Clinical assessment of GDs and gait tests both had independent significant predictive value for recurrent falls over a 5-year follow-up period. This highlights the potential of such assessments for early fall risk screening and timely implementation of fall-preventive measures.

Asymptomatic Covid-19: a major source of infection at the onset of an Omicron storm

This is the first time since the pandemic began with isolated cases in the early fall of 2019 in the city of Wuhan (CCP-China) that health authorities have completely lost control of the pandemic’s development without having any tool to counteract this evolving event. Sars-CoV-2 Omicron is unstoppable.

Apparent Seasonal Bias in Delta Outflow Estimates as Revealed in the Historical Salinity Record of the San Francisco Estuary: Implications for Delta Net Channel Depletion Estimates

Accurate estimates of freshwater flow to the San Francisco Estuary are important in successfully regulating this water body, in protecting its beneficial uses, and in accurately modeling its hydrodynamic and water-quality transport regime. For regulatory purposes, freshwater flow to the estuary is not directly measured; rather, it is estimated from a daily balance of upstream Delta inflows, exports, and in-Delta water use termed the net Delta outflow index (NDOI). Field research in the 1960s indicated that NDOI estimates are biased low in summer–fall and biased high in winter–spring as a result of conflating Delta island evapotranspiration estimates with the sum of ungauged hydrologic interactions between channels and islands referred to as net channel depletions. In this work, we employed a 50-year observed salinity record along with gauged tidal flows and an ensemble of five empirical flow-salinity (X2) models to test whether a seasonal bias in Delta outflow estimates could be inferred. We accomplished this objective by conducting statistical analyses and evaluating whether model skill could be improved through seasonal NDOI flow adjustments. Assuming that model residuals are associated with channel depletion uncertainty, our findings corroborate the 1960s research and suggest that channel depletions are biased low in winter months (i.e., NDOI is biased high) and biased high in late summer and early fall months (i.e., NDOI is biased low). The magnitude of seasonal bias, which can reach 1,000 cfs, is a small percentage of typical winter outflow but represents a significant percentage of typical summer outflow. Our findings were derived from five independently developed models, and are consistent with the physical understanding of water exchanges on the islands. This work provides motivation for improved characterization of these exchanges to improve Delta outflow estimates, particularly during drought periods when water supplies are scarce and must be carefully managed.

Effects of a Furrow-Bed Seeding System on Stand Establishment, Soil Bacterial Diversity, and the Yield and Quality of Alfalfa Grown in Saline Soils

Purpose: To compare the performance of alfalfa crops and soil properties between a furrow-bed seeding system (FU) and a flat-bed seeding system (FL) in saline soil. Methods: Alfalfa seeds were sown in early fall, 2019, in saline sandy loam soil using FU and FL systems. The soil temperature, moisture, root-zone salinity, bacterial diversity, seedling emergence number in 2019 and soil nutrient contents, alfalfa production characteristics in 2020 were determined for plants in FU and FL treatments.Results: Compared with FL, FU resulted in increased soil moisture content and seedling emergence, and reduced relative abundance of Actinobacteria and Choroflexi in soil at the seedling stage, but it did not affect root-zone salinity. In April 2020, the soil salinity was lower, and the soil available phosphorus, potassium, nitrogen, and soil organic matter contents were higher, in FU than in FL. Compared with FL, FU resulted in increased yield (by 37.5%), protein content (by 3.6%), and potassium concentration (by 33.2%,), and decreased ash content (by 7.7%) and sodium concentration (by 19.0%) in alfalfa plants. The increased yield was positively correlated with seedling emergence, soil available potassium, total nitrogen, and organic matter contents, and shoot potassium content; and negatively correlated with shoot sodium content. The relative abundance of Actinobacteria was negatively correlated with alfalfa ash, calcium, and sodium concentrations, and positively correlated with shoot potassium content. Overall, FU increased alfalfa quality and alleviated salt stress.Conclusions: Furrow-bed seeding in early fall can enhance the yield and quality of alfalfa cultivated in saline soils.

Machine Learning Based IoT Geriatric Fall Intelligent System in Pandemic (Preprint)

UNSTRUCTURED In the current pandemic, there is lack of medical care takers and physicians in hospitals and health centers. The patients other than COVID infected are also affected by this scenario. Besides, the hospitals are also not admitting the old age peoples, and they are scared to approach hospitals even for their basic health checkups. But, they have to be cared and monitored to avoid the risk factors like fall incidence which may cause fatal injury. In such a case, this paper focuses on the cloud based IoT gadget for early fall incidence prediction. It is machine learning based fall incidence prediction system for the old age patients. The approaches such as Logistic Regression, Naive Bayes, Stochastic Gradient Descent, Decision Tree, Random Forest, Support Vector Machines, K-Nearest Neighbor and ensemble learning boosting techniques, i.e., XGBoost are used for fall incidence prediction. The proposed approach is first tested on the benchmark activity sensor data with different features for training purpose. The real-time vital signs like heart rate, blood pressure are recorded and stored in cloud and the machine learning approaches are applied to it. Then tested on the real-time sensor data like heart rate and blood pressure data of geriatric patients to predict early fall.

The COVID States Project #66: September 2021 update on executive approval

The COVID States Project survey regularly asks people in all 50 states about their approval of their governors and the President. Since our last report on executive approval, which examined trends through March 2021, the pandemic has notably evolved, with huge surges of cases and deaths associated with the Delta variant throughout the summer and early fall. Most states reacted to the dip in coronavirus infections and increase in vaccinations in late spring and early summer by lifting indoor mask mandates, only to struggle to adapt as cases surged again in the late summer and early fall 2021. Some of these states were responding to CDC guidance, which announced in May that fully vaccinated people no longer needed to wear masks indoors or outdoors, only to reverse that guidance a few months later and recommend masks indoors for Americans living in areas of high transmission regardless of vaccination status. Other states rebuffed the guidance of public health agencies by, for instance, banning mask mandates in schools, businesses, and other public places. These policy decisions received wide criticism1 particularly as COVID-19 cases, hospitalizations, and deaths surged in those states with the loosest pandemic restrictions.September 2021 has also seen important political developments with respect to national policy around COVID-19. On September 9, President Biden issued an executive order requiring all federal employees and government contractors to be vaccinated. The President also announced that the U.S. Department of Labor would require all businesses with more than 100 employees to require vaccination or weekly testing and provide paid time off for employees to get vaccinated. On September 22, the FDA authorized booster shots for those vaccinated with the Pfizer/BioNTech vaccine for certain populations, including the elderly and those at higher risk of catching the disease due to their professions.In this report, we examine the approval of governors and the President for their handling of the pandemic -- and for the president's overall approval -- over time across the U.S. to assess how the public reacted to the policy decisions and developments surrounding the pandemic as well as state and federal governmental responses.

Season of birth is associated with multiple sclerosis and disease severity

Background The latitude gradient in multiple sclerosis incidence indicates that low sun exposure and therefore vitamin D deficiency is associated with multiple sclerosis risk. Objective Investigation of the effect of month of birth, which influences postnatal vitamin D levels, on multiple sclerosis risk and severity in Sweden. Methods Patients and population-based controls were included from three nationwide cohorts. Differences in month of birth between cases and controls were analyzed using logistic regression and examined for effect modification by calendar year and geographic region at birth. Results Males had a reduced risk of multiple sclerosis if born in the winter and increased risk if born in the early fall. Individuals born before 1960 had an increased risk if born in summer or fall. Being born in late summer and early fall was associated with more severe disease. Conclusions We identified a birth cohort effect on the association between the month of birth and multiple sclerosis, with a more significant effects for births before 1960. This coincides with a period of lower breastfeeding rates, recommended intake of vitamin D, and sun exposure, resulting in a lower vitamin D exposure during the fall/winter season for infants born in the summer.