The capsid protein of Helicoverpa armigera stunt virus (HaSV) a T=4 insect virus was expressed in Spodoptera frugiperda 9 cells using a baculovirus vector. When the insect cells were infected at a high MOl the expressed coat protein assembled into virus-like particles (VLPs) that spontaneously underwent maturation and were morphologically indistinguishable from wild-type HaSV. The VLPs were electron dense when viewed under EM and encapsidated their coat protein mRNA. When Sf9 cells were infected at a low multiplicity of infection (MOl) the expressed capsid protein assembled into procapsids that did not spontaneously undergo maturation. These procapsids underwent autoproteolytic maturation cleavage when they were treated with an acidic buffer. The procapsids were used in the encapsidation of a FITC labelled peptide. The peptide encapsidating VLPs showed an increase in their buoyant density that was not collaborated by an increase in the concentration of the FITC labelled peptide detected when these samples were compared to control samples with similar buoyant densities.

INTRODUCTION: Cerebral Palsy (CP) is the most common disabling motor disorder found during childhood, occurring in 2.1-3.2 of every 1,000 births. Motor functionality of children with CP is commonly compromised and is classified with a gross motor function classification score (GMFCS) and with the gross motor function measure (GMFM). Balance ability has typically been assessed using single leg stance test (SLST) time but more recently, center of pressure excursion (COPE) has shown to be a more valid measurement in populations with altered motor abilities. However, COPE has not been used to test balance in the CP population, yet. This study aimed to determine if relationships were present between COPE measurements, functionality measurement scores (GMCS and GMFM) and reported fall frequency. It was hypothesized that i) larger COPE measurements would be associated with a higher GMFCS level and lower GMFM score, and that ii) COPE measurements would be significantly higher in children with a high reported incidence of fall frequency. METHODS: Gross functionality was measured using a GMFM score and GMFCS level. Balance ability was assessed using COPE measurements on a force plate and SLST time. Fall frequency was determined by a short questionnaire. A Pearson correlation analyzed COPE measurements vs. mean GMFM score. A one-way ANOVA was used to compare COPE measures between GMFMCS levels, with a Bonferroni post-hoc test. Lastly, an independent sample t-test analyzed differences in COPE measurements and SLST time between fall frequency groups. RESULTS: Significantly larger COPE velocities were demonstrated in children who reported a greater number of falls in the past month and were considered high risk for falling (p = 0.02). No relationships were demonstrated between COPE measurements and GMFM score. GMFCS level III participants demonstrated statistically significant lower COPE velocity compared to GMFCS level II participants (p = 0.05). There were no significant differences in SLST between high and low risk fall groups (p = 0.07). DISCUSSION: Children with higher reported fall frequencies demonstrated a 60% increase in COPE velocity, compared to those with little to no falls. Clinical GMFM scores did not demonstrate significant correlations to COPE measurements and may not be an appropriate identifier for falling in children diagnosed with CP. This is the first trial to evaluate COPE measurements and reported fall frequencies in children diagnosed with CP. The use of a force plate to determine COPE velocity during a SLST is useful in identifying children with CP who may be at an elevated risk for experiencing a fall. COPE velocity was able to provide intricate quantitative data regarding fall risk that could not be obtained during a normal SLST.

Purpose of study: To examine change in balance-related fall risk and daily functional abilities in the first 2 postoperative weeks and up to 6 weeks after gynecologic surgery. Materials and methods: Prospective cohort study in gynecologic surgery patients age 65 and older. Balance confidence (Activities-specific Balance Confidence Scale) and functional status (basic and instrumental activities of daily living) were recorded pre-and post-operatively daily for 1 week and twice the second week. Physical performance balance and functional mobility were measured pre-and 1 week post-operatively using the Tinetti Fall Risk Scale, Timed Up and Go, and 6-Minute Walk test. Measures were repeated 6 weeks after surgery. Nonparametric tests for paired data were used comparing scores baseline to post-operative (POD) 7 and to POD 42. Results: Median age was 72 years (range 65-88). Fall risk was elevated during the first 2 post-operative weeks, greatest on the median discharge day, POD 2 (p < 0.01). Balance performance and functional mobility at 1 week were significantly lower than baseline (p < 0.01). Functional abilities declined, including new dependence in medication management at home in 22% of these independent and cognitively intact women. Conclusions: After gynecologic surgery, older women's fall risk is highest on POD 2 and remains elevated from baseline for 2 weeks. Functional limitations in the early home recovery period include the anticipated (bathing, cooking, etc.) and some unanticipated (medication management) ones. This information may help with postoperative discharge planning.

Le vieillissement amoindri de façon régulière les capacités physiques, sensorielles et parfois cognitives des individus. Le vieillissement du corps transforme également l'image offerte à autrui et à soi-même. La perception que la personne âgée a alors d’elle-même est une question qui n’est pas sans conséquence. La perception réaliste de ses capacités physiques semble nécessaire dans la réalisation d’actes moteurs alors que la perception optimiste de soi et de l’environnement semble nécessaire au maintien du moral. Notre objectif est d’étudier de façon relativement globale la perception de soi chez la personne âgée. Pour cela, nous étudions les perceptions qu’ont les personnes âgées a de leurs propres capacités dans la réalisation d’actes moteurs (posturabilité sur pente, enjambement d’obstacle), la perception qu’elles ont d’elles-mêmes par la réalisation de questionnaires d’auto-évaluation, en particulier la perception qu’elles ont de leur âge. Nous examinons également les perceptions qu’elles ont d’autrui, en particulier celles qu’elles ont d’autres personnes âgées. L’objectif est d’étudier les impacts positifs et négatifs sur leur santé des perceptions correctes ou erronées des séniors. Nos deux premières études ont mis en évidence l’existence d’un biais de surestimation de capacités posturales chez les participants âgés, qui pourrait être en lien avec une vision positive d’eux-mêmes. Ensuite nos recherches de sont intéressées à l’existence de cette surestimation des capacités motrices chez les personnes âgées présentant une détérioration cognitive (Maladie d’Alzheimer à un stade débutant). Dans une seconde partie, nos recherches se sont tournées vers l’estimation que les personnes âgées ont d’elles mêmes, en étudiant en particulier l’auto-estimation et l’hétéro-estimation de l’âge. Nos études ont montré que les personnes âgées adoptaient en général une vision optimiste d’elles-mêmes et de leurs capacités motrices ne correspondant pas à la réalité. Cette vision optimiste, bien que permettant de maintenir un bon moral peut être liée à la mise en danger sur le plan moteur. / Elderly steadily diminished physical, sensory and sometimes cognitive individuals abilities. The aging body also converts the image presented to others and to oneself. The perception that the elderly person then herself is a question which is not inconsequential. Realistic perception of physical seems necessary in motor actions while the optimistic perception of self and the environment seems necessary to maintain morale.Our goal is to study a relatively comprehensive self-perception in the elderly. For this, we study the perceptions of older people has their own abilities in performing motor acts (posturability on slope, crossing over an obstacle), their perceptions of themselves by achieving of self-assessment questionnaires, particularly their perceptions of their age. We also examine the perceptions they have of others, especially those that have other seniors. The objective is to study the positive and negative impacts on their health perceptions of older correct or incorrect. Our first two studies showed the existence of a bias of overestimating postural abilities among older participants, which could be related to a positive vision of themselves. Then our research is concerned with the existence of this overestimation of motor skills in older people with cognitive impairment (Alzheimer's disease at a beginning stage). In the second part, our research turned to the estimate that seniors have of themselves, especially in student self-assessment and hetero-age estimation.Our studies showed that older people usually adopted an optimistic view of themselves and their motor skills do not match reality. This optimistic view, although to maintain morale may be related to the endangerment on the motor.

This study assessed falls efficacy and confidence-related changes among participants attending the a Matters of Balance/Volunteer Lay Leader (AMOB/VLL) falls prevention program for older adults, based on their residential location. Data were examined from 431 older Texans enrolled in AMOB/VLL during a two-year period, and assessed at baseline and post-intervention. Results indicate that participants significantly increased falls efficacy, reduced activity interference due to their health, and decreased the number of days limited from usual activity. Regression models show that participants, despite entering the program with lower reported health status, reported greater rates of positive change for falls efficacy and health interference compared with their baseline pre-intervention counterparts. Overall program attendance and attendance at major sessions showed the greatest influence. Findings contribute to the understanding of cognitive restructuring and strengthening variations with falls prevention program outcomes.

The purpose of this study is to investigate the main causes of fall accidents and, to pinpoint the factors that influence the risk of falls in the U.S. construction industry. This study employed the Integrated Management Information System (IMIS) data from the Occupational Safety and Health Administration (OSHA) to examine 9,141 fall accidents, recorded for the period of last 20 years. The results show that specialty trade contractors working on low-budget, residential housing and commercial building projects are more susceptible to fall accidents. In terms of fall height, 85% of the fall accidents occurred on heights less than 30 ft., and most of them are not equipped with a fall protection tool. The main contribution of this study is that it has specifically analyzed fall heights and the current state of usage of fall protection using actual accident data. Since there has been hardly any research done in the last decade to study falls in the U.S. construction industry, by examining the IMIS database; this study also presents updated analysis on fall accidents.

Falls are a leading cause of injury and accidental injury death worldwide. Fall-risk prevention techniques exist but fall-risk identification can be difficult. While clinical assessment tools are the standard for identifying fall risk, wearable-sensors and machine learning could improve outcomes with automated and efficient techniques. Machine learning research has focused on older adults. Since people with lower limb amputations have greater falling and injury risk than the elderly, research is needed to evaluate these approaches with the amputee population. In this thesis, random forest and fully connected feedforward artificial neural network (ANN) machine learning models were developed and optimized for fall-risk identification in amputee populations, using smartphone sensor data (phone at posterior pelvis) from 89 people with various levels of lower-limb amputation who completed a 6-minute walk test (6MWT). The best model was a random forest with 500 trees, using turn data and a feature set selected using correlation-based feature selection (81.3% accuracy, 57.2% sensitivity, 94.9% specificity, 0.59 Matthews correlation coefficient, 0.83 F1 score). After extensive ANN optimization with the best ranked 50 features from an Extra Trees Classifier, the best ANN model achieved 69.7% accuracy, 53.1% sensitivity, 78.9% specificity, 0.33 Matthews correlation coefficient, and 0.62 F1 score. Features from a single smartphone during a 6MWT can be used with random forest machine learning for fall-risk classification in lower limb amputees. Model performance was similarly effective or better than the Timed Up and Go and Four Square Step Test. This model could be used clinically to identify fall-risk individuals during a 6MWT, thereby finding people who were not intended for fall screening. Since model specificity was very high, the risk of accidentally misclassifying people who are a no fall-risk individual is quite low, and few people would incorrectly be entered into fall mitigation programs based on the test outcomes.

京都大学 / 0048 / 新制・課程博士 / 博士(人間健康科学) / 甲第21704号 / 人健博第70号 / 新制||人健||5(附属図書館) / 京都大学大学院医学研究科人間健康科学系専攻 / (主査)教授 青山 朋樹, 教授 黒木 裕士, 教授 松田 秀一 / 学位規則第4条第1項該当 / Doctor of Human Health Sciences / Kyoto University / DFAM

Background: Healthcare workers are ranked among one of the top occupations for musculoskeletal disorder (MSD) injuries that affect the muscles, the bones, the nervous system and due to repetitive motion tasks (Centers for Disease Control and Prevention, 2017). Numerous high-risk patient handling tasks such as lifting, transferring, ambulating and repositioning of patients cause injuries that can be prevented when evidence-based solutions are used for safe patient handling and mobility (SPHM) tasks. Purpose: The purpose of this quality improvement project was to evaluate the knowledge and attitudes of orthopedic nurses regarding the use of SPHM algorithms as the standard of care when transferring patients. Theoretical Framework. Lewin’s Theory of Change Methods. A quasi-experimental pretest-post-test design was utilized in this evidenced-based practice project. Results. Descriptive statistics that evaluated pre and post questionnaires of the orthopedic nurses noted nurses displayed behavioral and attitudinal intent to use the SPHM algorithms as the standard of care to improve patient outcomes by decreasing falls. Although the behavioral beliefs and attitudes reflected acknowledgement of SPHM skills and knowledge, nursing did not improve in their documentation of SPH fall risk as two separate tools were required on each patient. Conclusions: SPHM evidenced-based standards do guide staff to critically examine how to safely transfer and mobilize a patient. Patient fall rates did decrease during educational sessions, prompting the need for on-going education of all staff on the unit that transfers patients. The findings from this quality project may encourage future practice approaches to use of the safe patient handling (SPH) fall risk assessment tool for all patients to prevent patient falls.

abstract: There are many inconsistencies in the literature regarding how to estimate the Lyapunov Exponent (LyE) for gait. In the last decade, many papers have been published using Lyapunov Exponents to determine differences between young healthy and elderly adults and healthy and frail older adults. However, the differences in methodologies of data collection, input parameters, and algorithms used for the LyE calculation has led to conflicting numerical values for the literature to build upon. Without a unified methodology for calculating the LyE, researchers can only look at the trends found in studies. For instance, LyE is generally lower for young adults compared to elderly adults, but these values cannot be correlated across studies to create a classifier for individuals that are healthy or at-risk of falling. These issues could potentially be solved by standardizing the process of computing the LyE. This dissertation examined several hurdles that must be overcome to create a standardized method of calculating the LyE for gait data when collected with an accelerometer. In each of the following investigations, both the Rosenstein et al. and Wolf et al. algorithms as well as three normalization methods were applied in order to understand the extent at which these factors affect the LyE. First, the a priori parameters of time delay and embedding dimension which are required for phase space reconstruction were investigated. This study found that the time delay can be standardized to a value of 10 and that an embedding dimension of 5 or 7 should be used for the Rosenstein and Wolf algorithm respectively. Next, the effect of data length on the LyE was examined using 30 to 1300 strides of gait data. This analysis found that comparisons across papers are only possible when similar amounts of data are used but comparing across normalization methods is not recommended. And finally, the reliability and minimum required number of strides for each of the 6 algorithm-normalization method combinations in both young healthy and elderly adults was evaluated. This research found that the Rosenstein algorithm was more reliable and required fewer strides for the calculation of the LyE for an accelerometer. / Dissertation/Thesis / Appendix A / Doctoral Dissertation Biomedical Engineering 2019