Balance Measurements Research Articles

Reduced Blood Culture Use in High-Volume Lung Transplant MICU Following a Stewardship Program, Northern California, 2021–2023

Introduction: There is a need to optimize blood culture (BC) utilization among hospitalized adults. A previous study showed an evidence-based BC algorithm improved BC utilization in a medical intensive care unit (MICU) at a large academic center. Our aim is to evaluate the impact of an intervention based on this algorithm on blood culture utilization in the MICU at Stanford Health Care, a referral center known for its high volume of solid organ transplants. Methods: We conducted a before-after study evaluating the impact of a BC diagnostic stewardship program in the MICU at Stanford Health Care, a 20-bed unit with an average of 20% lung transplant patients per day. All patients ≥18 years of age admitted to the unit during the study period were included. We adopted a previously published evidence-based algorithm detailing syndromes with low and high risk for bacteremia, which was referenced during patient rounds. Additionally, education and feedback to providers about BC utilization and indication inappropriateness was performed during leadership meetings every other month. We performed an interrupted time series analysis using historical data 17 months before the implementation of the blood culture stewardship program on April 1, 2022 and 8 months after. We assessed changes on BC utilization adjusted to patient days and crude mortality rate during the same period as a balancing measure. Results: Before the implementation of the program, the median BC utilization was 216 per 1,000 patient days (range 150–250 per 1,000 patient days). Following the introduction of the program, there was a significant decrease in blood culture utilization by 5% (95% CI -10% to -1%, p=.02; Figure 1). Post-intervention, the blood culture stabilized, with no significant increase observed (0.09% increase, 95% CI -0.7% to 1%, p=.81). The mortality rate, prior to the implementation of the program, had shown a significant downward trend of 1.4% over time (95% CI -3% to -0.2%, p=.02). After the intervention, a nonsignificant decrease of 8% was observed (95% CI -44% to 27%, p=.62; Figure 2), followed by a nonsignificant upward trend of 6% (95% CI -1% to 13%, p=.10). Conclusion: We observed a significant reduction in BC utilization after implementing the BC diagnostic stewardship program in a MICU frequented by a high number of lung transplant patients.

Relationship of Arm Length, Foot Length and Dynamic Balance in 9-12 Years Old Children

OBJECTIVE: Dynamic balance (DB) is defined as abilities that are operating during performance of a functional task such as reaching, walking, or running, irrespective of changing support surface (i.e. BOS). Functional Reach Test (FRT), which was developed by Duncan et al. in 1990. FRT is defined as the maximal distance one can reach forward beyond arm’s length while maintaining a fixed Base of Support (BOS) in standing. The outcome measures of dynamic balance (DB) are important elements of examination, which measures correlate with specific age but how anthropometric variables (e.g.: arm length, foot length, height, weight) which might influence balance is still unclear. The influence of arm length, foot length on dynamic balance in children is not well understood. Hence there is a need to investigate the relationship between arm length, foot length on dynamic balance in children. The objective of this study is to investigate the relationship of arm length, foot length on dynamic balance in 9-12 years old children. METHODOLOGY: This descriptive study (correlational study) was conducted among 41 children with typical development of age 9-12 years old (50% male and 50% females). Arm length (males 58.6 + 4.0; females 58.7 + 3.6), foot length (males 20.8 + 1.4; females 20.6 + 1.6). Dynamic balance was assessed using FRT, the participants were asked to reach three times and the scores were recorded. STATISTICAL ANALYSIS: The collected data was summarized using the descriptive statistics such mean +S.D. (standard deviation) to find the relationship between the arm length, foot length with dynamic balance in 9-12-years-old children. Pearson correlation coefficient is used, p value <0.05 was considered as significant. The data was analyzed using Microsoft Excel and SPSS 21. RESULTS: The mean distance reached by the children aged 9-12 years old were (males 22.2 + 5.1; females 22.9 + 6.6). The obtained p value for Pearson correlation coefficient is >0.05 and hence there is between arm length, foot length and dynamic balance in children of 9-12 years old. CONCLUSION: Dynamic balance has correlation with arm length and foot length. Hence it suggests that the arm length and foot length does influence the score of dynamic balance on FRT in children. Keywords: Arm length, foot length, dynamic balance, children, 9-12-year-olds

Insulin Resistance Treatment with Balanced Personalized Nutrition to Improve Insulin Sensitivity for Prediabetes Remission and Diabetes Type 2 Reversal with Reduction of Risks for Related Chronic Disease

Insulin sensitivity, as a key measure of metabolic health and hormonal balance, plays a crucial role in metabolic disease with impaired insulin signaling also described as insulin resistance (Zhao et al., 2023). The problem of insulin resistance as a hormonal imbalance due to a changed metabolism is gaining increasing international attention and can be referred to as new epidemic of the 21st century (Zyoud et al., 2022). Insulin resistance affects an estimated 40% of people aged 18–48. Half of the affected people are not overweight (Parcha et al., 2022).

Direct measurement of the 2D axisymmetric ionization source rate in a helicon plasma for wakefield particle accelerator applications

A direct measurement of the particle balance and derivation of the underlying particle source rate distribution in a helicon plasma developed for wakefield particle accelerators is presented. Parallel and radial ion fluxes are measured using laser induced fluorescence on single ionized argon. We find that the radial contribution to the source rate is an order of magnitude larger than the axial contribution. We also find that the axial source rate profile closely matches the radial density gradient axial profile, thus indicating the importance of the radial density profile for the particle balance. Notably, the peak ion source rate is located off-axis, about halfway between the axis and the vacuum wall on both sides of the axial center.

Analysis of posture and balance impairments in individuals with chronic nonspecific neck pain-an observational study.

Neck pain is one of the most burdensome chronic musculoskeletal problems globally. Impaired proprioception is associated with Chronic Nonspecific neck pain as the structures of the cervical spine are crucial for proprioception and balance. There is a paucity of literature examining objective measures of balance and postural sway in patients with Nonspecific neck pain. This study was observational and consisted of 126 samples (63 cases and 63 controls who were recruited using convenience sampling. The demographics of the samples were collected and the postural and balance impairment was assessed using Biodex Balance SD. Mean, Median, and SD were obtained and the inferential analysis was done using the Whitney U Test and the level of significance was accepted at p < 0.05. The subjects with neck pain showed had a lower static stability index, static sway index, static stability index- forward backward and static sway index lateral scores than the normal counterparts. There are significant differences in the overall static stability index, (p < 0.001). There was a significant difference in static sway index(p = 0.003), and static stability index lateral (p = 0.004). There was no significant difference for static sway index forward and backward (p = 0.550) and lateral sway index (p = 0.711). Subjects with neck pain showed had a lower static stability index, static sway index, static stability index- forward backward and static sway index lateral scores than the normal counterparts and there was a significant difference between the static sway and static stability index in forward and backward directions as well as in lateral direction. These findings may help to assess the specific balance parameters and address the underlying causes of balance issues in patients with neck pain and also provide a comprehensive care to the patients. The trial was registered with CTRI India with registration number: CTRI/2022/07/044222.

Effect of Combined Training With Balance, Strength, and Plyometrics on Physical Performance in Male Sprint Athletes With Intellectual Disabilities.

Individuals with intellectual disabilities often face unique challenges in physical capabilities, making traditional training methods less effective for their specific needs. This study aimed to investigate the effect of combining balance, plyometric, and strength (CBPS) training with sprint training on physical performance in male athletes with intellectual disabilities. Twenty-seven participants were randomly assigned to either a CBPS group or a control group that only maintained their regular sprint training. Participants underwent pre- and posttraining tests, including measures of balance, jumping, agility, and sprinting ability. The results showed that the CBPS group demonstrated significant improvements (p < .05) in one-leg stance, crossover-hop jump, squat jump, countermovement jump, and 10- and 30-m sprint at posttraining compared with pretraining. CBPS training combined with sprinting significantly improves physical performance in male athletes with intellectual disabilities, suggesting implications for tailored training programs to enhance their physical fitness and overall health.

Aquatic Cognitive–Motor Exercise for Cognition, Balance, and Functional Mobility in Older Adults

ABSTRACT Introduction Cognitive declines and mobility challenges in older adults often hinder exercise, leading to a sedentary lifestyle. Addressing both cognitive and physical health is crucial for enhancing overall well-being in older adults. The purpose of this study was to assess the feasibility and effectiveness of aquatic cognitive–motor exercise on cognition, balance, and functional mobility in older adults. Methods This pilot randomized controlled study included 25 participants from two retirement communities who were randomly assigned to a control (n = 12, 81 ± 8 yr old) or aquatic exercise group (n = 13, 83 ± 7 yr old). The aquatic exercise group received 45 min of moderate-intensity cognitive–motor exercise three times per week for 8 wk. The control group received one fall prevention education class. Results The session attendance rate for the aquatic exercise program was 95%. Between-group comparisons showed that 8 wk of aquatic exercise improved various measures of cognition with a medium effect size, as assessed by the Stroop Color and Word Test (∆ 2.8, d = 0.51) and the Trail Making Test part B (∆ −19.2 s, d = −0.59). Gait speeds while walking forward (∆ 0.04 m·s−1, d = 0.43) and counting backward by serial 7s (∆ 0.05 m·s−1, d = 0.43) were improved with a small effect size in the aquatic exercise intervention. This change was recognized as a clinically meaningful improvement in older adults. The aquatic intervention group had a medium to large effect size improvement in speed with the Four Square Step Test (∆ −0.6 s, d = −0.42), Timed Up and Go test (∆ −1.1 s, d = −0.50), and Timed Up and Go cognitive test (∆ −1.0 s, d = −0.56), whereas only negligible to small changes were noted with single-leg balance measures. Conclusions The aquatic cognitive–motor exercise program is feasible and enhanced cognition and functional mobility in older adults.

Six Years of Quality Improvement in Pectus Excavatum Repair: Implementation of Intercostal Nerve Cryoablation and ERAS Protocols for Patients Undergoing Nuss Procedure

BackgroundThe Nuss procedure for pectus excavatum is associated with prolonged hospitalizations due to pain. We evaluated implementation of intercostal nerve cryoablation and enhanced recovery after surgery (ERAS) protocols on outcomes of Nuss procedures performed over six years at a single institution. MethodsThis retrospective cohort study included patients who underwent Nuss procedure from 10/2017 to 09/2023. Patients received epidurals prior to 06/2019, cryoablation from 06/2019 to 07/2021, and ERAS with cryoablation and intraoperative methadone administration after 07/2021. We used multivariable linear regression to evaluate length of stay (LOS), inpatient morphine milligram equivalents (MMEs), and discharge opioids. We assessed the balancing measures of operative time, postoperative pain scores, and complications. ResultsWe identified 62 patients; 15 who received epidurals, 18 cryoablation, and 29 cryoablation with ERAS. Cryoablation was associated with a 62.3% (p < 0.001) decrease in length of stay, an 86.6% (p < 0.001) decrease in inpatient MMEs, and a 72.9% (p < 0.001) decrease in discharge opioids. Cryoablation was additionally associated with 24.5% (p = 0.02) longer operative times and 46.4% (p = 0.04) higher postoperative day one pain scores. Subsequent implementation of an ERAS protocol was associated with a further 82.8% (p = 0.04) decrease in discharge opioids and a 25.0% (p = 0.04) decrease in postoperative day one pain scores. ConclusionsOver six years of quality improvement efforts, we found the implementation of cryoablation and ERAS protocols to be associated with a significant decrease in length of stay and opioid exposures. Protocolized pain management and cryoablation may work synergistically to improve outcomes without compromising patient experience. Level of EvidenceLevel III – Retrospective comparative study.

Altered body balance and plantar pressure distribution in young adults with forward head posture

BackgroundForward head posture (FHP), a common postural issue, affects balance and may be linked to altered muscle activity and cervical spine alignment. This study investigated the impact of FHP on static balance and plantar pressure distribution in adults. We hypothesized that FHP would be associated with poorer balance and altered pressure distribution. MethodsThis case-control study investigated the impact of FHP on static balance and plantar pressure distribution in adults (n = 52). Participants were categorized based on craniovertebral angle (CVA), into FHP (CVA <47°) and control (CVA ≥47°) groups. Static balance was assessed using a NeuroCom® Balance Manager System, evaluating parameters like center of gravity sway and directional control. Plantar pressure distribution was measured with an Emed Pedobarography system during walking, analyzing maximum force, peak pressure, and contact area. ResultsParticipants with FHP showed poorer balance with eyes closed on foam compared to the control group. Additionally, the FHP group exhibited lower total maximum force and altered force distribution in both feet during walking. Correlations suggested that higher CVA degrees were associated with decreased balance and altered plantar pressure distribution. Despite, linear regression analyses revealed no significant predictive relationships between CVA and specific balance measures, it showed significant associations with several plantar pressure distribution parameters, including total maximum force exerted on both feet, maximum force on the forefoot, and peak pressure on the hindfoot. ConclusionThese findings suggest that FHP may influence balance and plantar pressure distribution, with a potentially stronger effect on plantar pressure than balance parameters.

Role of the probiotics in pathologies Metabolics of gut Microbiota

The gut microbiota is the central regulator of human metabolism, it is considered a superorganism, it fulfills functions related to homeostasis and the maintenance of systemic health, contributing to immunity and epithelial integrity, any alteration is related to non-compliance or interruption of some of its functions, for this reason in search of balance, prevention and treatment measures have been implemented, one of them is the use of probiotics, which has been proven to bring beneficial actions towards the health of the host. , such as lactobacillus and bifidobacteria, here we will review the association between gut microbiota, probiotics and the use of probiotics like a treatment of prevention for pathologies of gut microbiota.

Expediting Discharges on the Inpatient Medicine Teaching Services

Introduction: Delayed discharges can adversely affect patient flow throughout the hospital. Late afternoon discharges may lead to high hospital occupancy, admission bottlenecks, ER overcrowding, and disrupted ICU transfers. Discharge by noon (DBN) is key to enhancing hospital capacity, bed utilization, and patient satisfaction and outcomes. Last year, DBN for patients returning home with or without home care services (HHC) was chosen as one of three annual priorities for our hospital medicine division. This was implemented in October 2023 but did not gain momentum among the medical resident teaching services (MTS), paving the way for our QI project. Model for Improvement: Baseline data on the percentage of MTS DBN to home and HHC were available from November 2023 to January 2024. We surveyed our residents/faculty and conducted a root-cause analysis. The main barriers to DBN included a lack of planning and motivation, delayed communication with case management, and prolonged rounding. Aims Statement: Our goal was to increase the median percentage of MTS discharge orders placed by noon to home and HHC from 22% to 35% within 3 months. Measures: Our primary outcome measure was the percentage of MTS DBN to home and HHC. Weekly EMR-generated reports were collected. The outcome measure was then calculated and uploaded weekly on a run chart for analysis. Qualitative process measures included assessing if residents were planning discharges and documenting the number of discharges completed before noon. Changes: Our interventions targeted the lack of planning and motivation. These included introducing the expedited initiative and its importance to residents/faculty through conferences. In addition, a process was created where potential next-day discharges were discussed at afternoon sign-out and a tracking chart of DBN orders was designed for each team room. Tests of Change: Our pre-intervention median percentage of MTS DMB to home and HHC was 22% and improved to 40% post-intervention. While we observed a variation in discharge practice based on the rounding attending, we had notably sustained an upward shift in practice from our baseline when data was plotted on a run chart. We are currently continuing data collection to track sustainability and variability among rounding physicians. Conclusion: We attained an upward shift in the percentage of MTS DBN to home and HHC post-intervention. Although an upward shift has been achieved, we are looking to sustain and further improve it. In future PDSA cycles, we will look at individualizing feedback and optimizing interdisciplinary rounds. We plan on further investigating balancing measures such as bed availability, discharge timing for rehabilitation destinations, and patient and staff satisfaction.

Cautious Gait during Navigational Tasks in People with Hemiparesis: An Observational Study.

Locomotor and balance disorders are major limitations for subjects with hemiparesis. The Timed Up and Go (TUG) test is a complex navigational task involving oriented walking and obstacle circumvention. We hypothesized that subjects with hemiparesis adopt a cautious gait during complex locomotor tasks. The primary aim was to compare spatio-temporal gait parameters, indicators of cautious gait, between the locomotor subtasks of the TUG (Go, Turn, Return) and a Straight-line walk in people with hemiparesis. Our secondary aim was to analyze the relationships between TUG performance and balance measures, compare spatio-temporal gait parameters between fallers and non-fallers, and identify the biomechanical determinants of TUG performance. Biomechanical parameters during the TUG and Straight-line walk were analyzed using a motion capture system. A repeated measures ANOVA and two stepwise ascending multiple regressions (with performance variables and biomechanical variables) were conducted. Gait speed, step length, and % single support phase (SSP) of the 29 participants were reduced during Turn compared to Go and Return and the Straight-line walk, and step width and % double support phase were increased. TUG performance was related to several balance measures. Turn performance (R2 = 63%) and Turn trajectory deviation followed by % SSP on the paretic side and the vertical center of mass velocity during Go (R2 = 71%) determined TUG performance time. People with hemiparesis adopt a cautious gait during complex navigation at the expense of performance.

Heteronymous feedback from quadriceps onto soleus in stroke survivors.

Recent findings suggest increased excitatory heteronymous feedback from quadriceps onto soleus may contribute to abnormal coactivation of knee and ankle extensors after stroke. However, there is lack of consensus on whether persons post-stroke exhibit altered heteronymous reflexes and, when present, the origin of increased excitation (i.e. increased excitation alone and/or decreased inhibition). This study examined heteronymous excitation and inhibition from quadriceps onto soleus in paretic, nonparetic, and age-matched control limbs to determine whether increased excitation was due to excitatory and/or reduced inhibitory reflex circuits. A secondary purpose was to examine whether heteronymous reflex magnitudes were related to clinical measures of lower limb recovery, walking-speed, and dynamic balance. Heteronymous excitation and inhibition from quadriceps onto soleus were examined in fourteen persons post-stroke and fourteen age-matched unimpaired participants. Heteronymous feedback was elicited by femoral nerve and quadriceps muscle stimulation in separate trials while participants tonically activated soleus at 20% max. Fugl-Myer assessment of lower extremity, 10-meter walk test, and Mini-BESTest were assessed in stroke survivors. Heteronymous excitation and inhibition onsets, durations, and magnitudes were not different between paretic, nonparetic or age-matched unimpaired limbs. Quadriceps stimulation elicited excitation that was half the magnitude of femoral nerve stimulation. Femoral nerve elicited paretic limb heteronymous excitation was positively correlated with walking speed but did not reach significance because only a subset of paretic limbs exhibited excitation (n = 8, Spearman r = 0.69, P = 0.058). Heteronymous feedback from quadriceps onto soleus assessed in a seated posture was not impaired in persons post-stroke. Despite being unable to identify whether reduced inhibition contributes to abnormal excitation reported in prior studies, our results indicate quadriceps stimulation may allow a better estimate of heteronymous inhibition in those that exhibit exaggerated excitation. Heteronymous excitation magnitude in the paretic limb was positively correlated with self-selected walking speed suggesting paretic limb excitation at the higher end of a normal range may facilitate walking ability after stroke. Future studies are needed to identify whether heteronymous feedback from Q onto SOL is altered after stroke in upright postures and during motor tasks as a necessary next step to identify mechanisms underlying motor impairment.

Balance, Strength, and Risk of Dementia: Findings From the Health and Retirement Study and the English Longitudinal Study of Ageing.

Slow gait speed has been consistently associated with an increased risk of dementia. This study examined whether measures of balance and lower limb strength are similarly related to the risk of developing dementia. Participants from the Health and Retirement Study (HRS, N = 5658, mean age = 73.23, standard deviation [SD] = 6.22) and the English Longitudinal Study of Ageing (ELSA, N = 3667, mean age = 69.90, SD = 7.02) completed measures of gait speed, semi-tandem balance, chair stand (ELSA only), and cognitive status at baseline. Cognitive status was assessed over up to 15 years. Baseline slower gait speed (hazard ratio [HR]HRS = 1.52, 95% confidence interval [CI] = 1.32-1.75, p < .001; HRELSA = 1.73, 95% CI = 1.37-2.18, p < .001); and balance impairment (HRHRS = 1.58, 95% CI = 1.26-1.96, p < .001; HRELSA = 1.97, 95% CI = 1.24-3.14, p < .01) were related to a higher risk of incident dementia, adjusting for demographic factors. The combination of slower gait and impaired balance was associated with a two-to-three times higher risk of dementia in HRS and ELSA. Worse performance on the chair stand at baseline was associated with a higher risk of dementia in ELSA (HR = 1.56, 95% CI = 1.23-1.99, p < .001). All performance measures remained significant when entered simultaneously and accounted for obesity, diabetes, blood pressure, physical activity, smoking, and depressive symptoms. There was little evidence that age, sex, or APOE ε4 moderated the association. Similar to gait speed, measures of balance and strength are associated with a higher risk of incident dementia. The findings have implications for clinical practice, given that these routinely used geriatric assessment tools are similarly related to dementia risk.

On the maximum value of the stairs2 index

Measures of tree balance play an important role in different research areas such as mathematical phylogenetics or theoretical computer science. The balance of a tree is usually quantified in a single number, called a balance or imbalance index, and several such indices exist in the literature. Here, we focus on the stairs2 balance index for rooted binary trees, which was first introduced in the context of viral phylogenetics but has not been fully analyzed from a mathematical viewpoint yet. While it is known that the caterpillar tree uniquely minimizes the stairs2 index for all leaf numbers and the fully balanced tree uniquely maximizes the stairs2 index for leaf numbers that are powers of two, understanding the maximum value and maximal trees for arbitrary leaf numbers has been an open problem in the literature. In this note, we fill this gap by showing that for all leaf numbers, there is a unique rooted binary tree maximizing the stairs2 index. Additionally, we obtain recursive and closed expressions for the maximum value of the stairs2 index of a rooted binary tree with n leaves.

Efficacy and underlying mechanisms of three-circle post standing qigong on insomnia in college students: a four-arm, double-blind, randomized controlled trial protocol

BackgroundInsomnia is common in college students, but its impact on health and wellbeing is often neglected. Enhancing sleep quality through targeted interventions could improve overall health and reduce the risk of consequent co-morbidities and mental health problems. Qigong exercises have been shown to significantly improve sleep quality and relieve insomnia. Three-circle Post Standing (TCPS) can help integrate body, breath, and mind, a fundamental principle of Qigong that promotes holistic wellbeing. In this clinical trial, we aim to (1) evaluate the feasibility, safety, and therapeutic efficacy of administering TCPS to improve sleep quality and quality of life in college students with insomnia; (2) explore the neurophysiological mechanisms underlying the mind adjustments mediated by TCPS in insomnia; (3) investigate body and breath pathophysiology mediated by TCPS in insomnia; and (4) assess the long-term efficacy of TCPS in terms of sleep quality and quality of life.MethodsThis will be a prospective, parallel, four-arm, double-blind randomized controlled trial to investigate the effects and underlying mechanisms of TCPS on college students with insomnia. One hundred college students meeting diagnostic criteria for insomnia will be randomly assigned to receive either 14 weeks of standardized TCPS training (two weeks of centralized training followed by 12 weeks of supervised training) or sham-control Post Standing training. Efficacy outcomes including sleep quality, quality of life, neurophysiological assessments, plantar pressure, biomechanical balance, and physical measures will be collected at baseline, eight weeks (mid-point of supervised training), and 14 weeks (end of supervised training). Sleep quality and quality of life will also be evaluated during the four- and eight-week follow-up.DiscussionThis trial will be an important milestone in the development of new therapeutic approaches for insomnia and should be easily implementable by college students with insomnia. The neuro- and pathophysiological assessments will provide new insights into the mechanisms underlying TCPS.Clinical trial registrationThis trial has been registered in the China Clinical Trials Registry (registration number: ChiCTR2400080763).

An Exogenous Risk in Fiscal-Financial Sustainability: Dynamic Stochastic General Equilibrium Analysis of Climate Physical Risk and Adaptation Cost

This research aims to explore the fiscal and public finance viability on climate physical risk externalities cost for building social-economic-environmental sustainability. It analyzes climate physical risk impact on the real business cycle to change the macroeconomic output functions, its regressive cyclic impact alters tax revenue income and public expenditure function; This research also analyzes that the climate physical risk escalates social-economic inequality and change fiscal-financial policy functions, illustrates how the climate damage cost and adaptation cost distorts fiscal-finance cyclical and structural equilibrium function. This research uses binary and multinomial logistic regression analysis, dynamic stochastic general equilibrium method (DSGE) and Bayesian estimation model. Based on the climate disaster compensation scenarios, damage cost and adaptation cost, analyzing the increased public expenditure and reduced revenue income, demonstrates how climate physical risk externalities generate binary regression to financial fiscal equilibrium, trigger structural and cyclical public budgetary deficit and fiscal cliff. This research explores counterfactual balancing measures to compensate the fiscal deficit from climate physical risk: effectively allocating resources and conducting the financial fiscal intervention, building greening fiscal financial system for creating climate fiscal space.

Interfacial Behavior of Biodegradable Poly(lactic-co-glycolic acid)-Pluronic F127 Nanoparticles and Its Impact on Pickering Emulsion Stability.

Biodegradable nanoparticle-based emulsions exhibit immense potential in various applications, particularly in the pharmaceutical, cosmetic, and food industries. This study delves into the intricate interfacial behavior of Pluronic F127 modified poly(lactic-co-glycolic acid) (PLGA-F127) nanoparticles, a crucial determinant of their ability to stabilize Pickering emulsions. Employing a combination of Langmuir balance, surface tension, and diffusion coefficient measurements, we investigate the interfacial dynamics of PLGA-F127 nanoparticles under varying temperature and ionic strength conditions. Theoretical calculations are employed to elucidate the underlying mechanisms governing these phenomena. Our findings reveal a profound influence of temperature-dependent Pluronic layer behavior and electrostatic and steric interactions on the interfacial dynamics. Nonlinear changes in surface tension are observed, reflecting the interplay of these factors. Particle aggregation is found to be prevalent at elevated temperatures and ionic strengths, compromising the stability and emulsification efficiency of the formed emulsions. This work provides insights into the rational design of stable and efficient biodegradable nanoparticle-based Pickering emulsions, broadening their potential applications in various fields.

The relationship between single leg balance and proprioception of the knee joint in individuals with non-specific chronic back pain

BackgroundProprioceptive information from the hips, knees, and ankles as well as joint coordination are important for maintaining and controlling balance. Regional receptors in the muscles, joints, skin, and tendons as well as proprioception in the knee joint provide the necessary joint activity and stability. Pain may occur with a decreased sense of balance and proprioception. ObjectiveTo investigate the relationship between single-leg balance and proprioception of the knee joint in individuals with non-specific chronic low back pain. DesignFifty-two individuals with non-specific chronic low back pain, 30 females and 22 males, were included in our study, with a range of 18–50 years (mean age:25.15 ± 8.2 years). MethodPain intensity at rest and activity was assessed using Visual Analogue Scale (VAS), and disability and function were assessed using Oswestry Disability Index (ODI). Single-leg balance measurements were performed using Prokin TecnoBody kinematic balance device. A goniometer was used to evaluate the proprioception of the knee joint. ResultsThere were low-level negative correlations between VAS resting pain intensity and medium-lateral standard deviation value (p = 0.018; r = −0.327) and ellipse area measure (p = 0.039; r = −0.287) from static balance assessments. There were low-level negative correlations between VAS activity pain intensity and medium-lateral standard deviation value (p = 0.039; r = −0.288), ellipse area (p = 0.044; r = −0.281), and perimeter measure (p = 0.043; r = −0.282) from static balance assessments. No correlation was seen between ODI and clinical balance and proprioception assessments (p > 0.05). There was no correlation between clinical balance and proprioception evaluations (p > 0.05). ConclusionAs a result of the study, it was decided that there is a minimal relationship between single-leg balance and knee joint proprioception in people with nonspecific low back pain.

Post-adoption experiences of discrimination moderated by sleep quality are associated with depressive symptoms in previously institutionalized youth over and above deprivation-induced depression risk.

The association of post-adoption experiences of discrimination with depressive symptoms was examined in 93 previously institutionalized (PI) youth (84% transracially adopted). Additionally, we explored whether sleep quality statistically moderated this association. Notably, we examined these associations after covarying a measure of autonomic balance (high/low frequency ratio in heart rate variability) affected by early institutional deprivation and a known risk factor for depression. PI youth exhibited more depressive symptoms and experiences of discrimination than 95 comparison youth (non-adopted, NA) raised in their biological families in the United States. In the final regression model, there was a significant interaction between sleep quality and discrimination, such that at higher levels of sleep quality, the association between discrimination and depression symptoms was non-significant. Despite being cross-sectional, the results suggest that the risk of depression in PI youth involves post-adoption experiences that appear unrelated to the impacts of early deprivation on neurobiological processes associated with depression risk. It may be crucial to examine methods of improving sleep quality and socializing PI youth to cope with discrimination as protection against discrimination and microaggressions.