Wulffshea3358

Unilateral aural stimulation has been shown to cause massive cortical reorganization in brain with congenital deafness, particularly during the sensitive period of brain development. However, it is unclear which side of stimulation provides most advantages for auditory development. The left hemisphere dominance of speech and linguistic processing in normal hearing adult brain has led to the assumption of functional and developmental advantages of right over left implantation, but existing evidence is controversial. To test this assumption and provide evidence for clinical choice, we examined 34 prelingually deaf children with unilateral cochlear implants using near-infrared spectroscopy. While controlling for age of implantation, residual hearing, and dominant hand, cortical processing of speech showed neither developmental progress nor influence of implantation side weeks to months after implant activation. In sharp contrast, for nonspeech (music signal vs. noise) processing, left implantation showed functional advantages over right implantation that were not yet discernable using clinical, questionnaire-based outcome measures. These findings support the notion that the right hemisphere develops earlier and is better preserved from adverse environmental influences than its left counterpart. This study thus provides, to our knowledge, the first evidence for differential influences of left and right auditory peripheral stimulation on early cortical development of the human brain.

It is unclear whether frailty index (FI) change captures mortality risk better than and independently of the current FI level, i.e. whether a regular FI assessment among older adults provides additional insights for mortality risk stratification or not.

We used data from the LASA 75-PLUS-study, which monitored health among 508 older adults (75+) between 2016 and 2019 every 9months. Joint models for longitudinal and time-to-event data were used to assess the impact of both current FI and within-person FI change during the last year on mortality risk.

Twenty percent of the participants died during 4.5years of follow-up. Adding within-person FI change to the current FI model improved model fit and it showed that FI increases during the last year were associated with an increase in mortality risk. Consequently, the effect of the current FI decreased considerably and became statistically non-significant.

The rate of FI change was more important than the current FI level for short-term mortality prediction among the oldest old, which highlights the benefits of regular frailty assessments.

The rate of FI change was more important than the current FI level for short-term mortality prediction among the oldest old, which highlights the benefits of regular frailty assessments.Nocturia and chronic insomnia disorder are common conditions that frequently coexist in older adults. Existing medication treatments for each condition have risks, particularly in older adults. While treatment guidelines recommend starting with behavioural therapy for each condition, no existing program simultaneously addresses nocturia and insomnia. Existing behavioural interventions for nocturia or insomnia contain concordant and discordant components. An expert panel (including geriatricians with sleep or nocturia research expertise, sleep psychologists and a behavioural psychologist) was convened to combine and reconcile elements of behavioural treatment for each condition. Concordant treatment recommendations involve using situational self-management strategies such as urge suppression or techniques to influence homeostatic drive for sleep. Fluid modification such as avoiding alcohol and evening caffeine and regular self-monitoring through a daily diary is also appropriate for both conditions. The expert panel resolved discordant recommendations by eliminating overnight completion of voiding diaries (which can interfere with sleep) and discouraging routine overnight voiding (a stimulus control strategy). The final product is an integrated cognitive behavioural treatment that is delivered by advanced practice providers weekly over 5 weeks. This integrated program addresses the common scenario of coexisting nocturia and chronic insomnia disorder.

The provision of appropriate nutritional care in care homes is a priority for health services in England. There is limited evidence demonstrating the role of dietitians within older people care homes. This study explores the experiences of dietitians working with care homes for older people in England.

A qualitative study using semi-structured face-to-face or telephone interviews was conducted. Criterion and snowball purposive sampling recruited six dietitian participants. Interviews were audio recorded and transcribed verbatim. A reflexive diary was completed, and data analyses followed interpretative phenomenological analyses. Constant comparison, code-recode audits, independent coding by a supervisor, supervisory support and peer review were used to promote rigour.

Two key themes and three subthemes were identified Theme 1 is collaboration with multidisciplinary team (MDT) professionals and its two subthemes are as follows using support strategies (pathway/standards implementation, training/education nutrition and the need for dietitians to share outcome data to improve the limited evidence-base. There is a need to agree a defined dietetic service provision to care homes in England.

Functional decline (FD) is a common and serious problem among hospitalised older adults.

This systematic review and meta-analysis aims to identify patient-related risk factors for in-hospital FD in older adults.

Previous reviews on this topic (1970-2007) and the databases PubMed, Embase, and CINAHL (January 2007-December 2020) were searched. Reference lists of included articles were screened. Studies investigating patient-related risk factors for FD from (pre)admission to discharge in older adults admitted to an acute geriatric or internal medical unit were included. Study quality was assessed using the modified Newcastle-Ottawa Scale. Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were estimated using random-effects models. The quality of evidence was assessed using GRADE.

Twenty-nine studies met the inclusion criteria. Statistically significant risk factors were living in a nursing home (OR, 2.42; 95% CI, 1.29-4.52), impairment in instrumental activities of daily living (OR, 2.08; 95% CI, 1.51-2.86), history of falls (OR, 1.71; 95% CI, 1.00-2.92), cognitive impairment (OR, 1.83; 95% CI, 1.56-2.14), dementia (OR, 1.71; 95% CI, 1.23-2.38), delirium (OR, 2.34; 95% CI, 1.88-2.93), (risk of) malnutrition (OR, 1.76; 95% CI, 1.03-3.03), hypoalbuminemia (OR, 1.79; 95% CI, 1.36-2.36), comorbidity (OR, 1.09; 95% CI, 1.03-1.16), and the presence of pressure ulcers (OR, 3.33; 95% CI, 1.82-6.09). The narrative synthesis suggested prehospital FD, needing assistance with walking, and low body mass index as additional risk factors.

Several patient-related risk factors for in-hospital FD were identified that can be used at hospital admission to identify older patients at risk of FD.

Several patient-related risk factors for in-hospital FD were identified that can be used at hospital admission to identify older patients at risk of FD.Veterinary diagnostic laboratories derive thousands of nucleotide sequences from clinical samples of swine pathogens such as porcine reproductive and respiratory syndrome virus (PRRSV), Senecavirus A and swine enteric coronaviruses. In addition, next generation sequencing has resulted in the rapid production of full-length genomes. Presently, sequence data are released to diagnostic clients but are not publicly available as data may be associated with sensitive information. However, these data can be used for field-relevant vaccines; determining where and when pathogens are spreading; have relevance to research in molecular and comparative virology; and are a component in pandemic preparedness efforts. We have developed a centralized sequence database that integrates private clinical data using PRRSV data as an exemplar, alongside publicly available genomic information. We implemented the Tripal toolkit, a collection of Drupal modules that are used to manage, visualize and disseminate biological data stored within the Chado database schema. read more New sequences sourced from diagnostic laboratories contain genomic information; date of collection; collection location; and a unique identifier. Users can download annotated genomic sequences using a customized search interface that incorporates data mined from published literature; search for similar sequences using BLAST-based tools; and explore annotated reference genomes. Additionally, custom annotation pipelines have determined species, the location of open reading frames and nonstructural proteins and the occurrence of putative frame shifts. Eighteen swine pathogens have been curated. The database provides researchers access to sequences discovered by veterinary diagnosticians, allowing for epidemiological and comparative virology studies. The result will be a better understanding on the emergence of novel swine viruses and how these novel strains are disseminated in the USA and abroad. Database URLhttps//swinepathogendb.org.

There are conflicting results regarding endogenous estrogen exposure and risk of incident non-tuberculous mycobacterial pulmonary disease (NTM-PD). In addition, the impact of hormone replacement therapy (HRT) on risk of NTM-PD is lacking. This study aimed to evaluate the impacts of endogenous estrogen exposure and HRT on risk of NTM-PD in postmenopausal women.

This population-based cohort study consisted of 1,400,095 postmenopausal women without previous NTM-PD who participated in the 2009 national health screening exam in South Korea. The cohort was followed until the date of incident NTM-PD, death, or December 2018. We evaluated whether lifetime endogenous estrogen exposure and HRT were associated with incident NTM-PD. Endogenous estrogen exposure was evaluated using age at menarche, age at menopause, and reproductive period (duration between age at menarche and age at menopause).

During a median of 8.4 (interquartile range, 8.2-8.7) years of follow-up, 0.1% of participants (1,818/1,400,095) developed NTM-PD, with an incidence rate of 0.15/1000 person-years. Multivariable Cox regression analyses showed no significant relationship between endogenous estrogen exposure (age at menarche, age at menopause, and reproductive period) and risk of NTM-PD. In contrast, duration of HRT showed a significant dose-response relationship with incident NTM-PD even after adjustment of demographics and reproductive factors (adjusted hazard ratio [95% confidence interval]; 1.30 [1.12-1.51] in HRT for < 2 years, 1.28 [1.03-1.59] in 2-5 years, and 1.65 [1.33-2.05] in ≥ 5 years).

While there was no significant association with endogenous estrogen exposure, HRT was monotonically associated with increased risk of NTM-PD in postmenopausal women.

While there was no significant association with endogenous estrogen exposure, HRT was monotonically associated with increased risk of NTM-PD in postmenopausal women.