Adult Pattern Research Articles

Effect of Different Eye Movement Training Methods on Postural Oscillations of Older Women

Background and Aims Postural control is one of the most important abilities to maintain body stability and upright posture in the elderly. This study aims to investigate the effect of different patterns of eye movement training on postural oscillations in older women. Methods This is a quasi-experimental study with a pretest-posttest design using a control group. Participants were 72 older women in Mashhad, Iran (Mean±SD age= 68.7±2.4 years, weight= 67.7±4.4 kg, height=163.1±3.2 cm) who were selected purposefully and randomly divided into four groups including three experimental groups (saccade, anti-saccadic, and pursuit training) and one control group. All groups were evaluated under four different conditions of visual stimulus presentation. The training groups performed the training for 4 weeks. A repeated measures analysis of variance was used to analyze the collected data. All analyses were carried out in SPSS software, version 25. Results The results of ANOVA showed that the main effect of time for postural oscillations in the anterior-posterior and mediolateral directions was significant with the effect sizes of 0.57 and 0.492, respectively (P<0.05). This indicates that, regardless of the effect of group, postural oscillations in the experimental groups showed a significant difference over time. The interaction effect of time and group at the anterior-posterior and mediolateral directions was significant with the effect sizes of 0.168 and 0.28, respectively (P=0.010), where there was a significant decrease in the postural oscillations over time in the groups. The saccade training group showed the greatest decrease in the number of postural oscillations at the anterior-posterior and mediolateral directions (P<0.05). Conclusion Eye movement training with different patterns in older adults can reduced postural oscillations in the mediolateral and anterior-posterior directions. Saccade training cause less postural oscillation than anti-saccade and pursuit training in both directions. It is recommended that these training methods be included in the training program of the elderly to reduce their postural oscillation.

The genetic basis of conspicuous coloration in the Guadeloupean anole: Evolution by sexual and ecological selection

AbstractUnderstanding how natural selection acts on the genome and contributes to the process of speciation is a primary aim of the study of evolution. Here we used natural variation in two subspecies of the Guadeloupean anole (Anolis marmoratus ssp.), from the island of Guadeloupe in the Lesser Antilles, to explore the genomic basis of adaptation and speciation in Anolis lizards. These subspecies inhabit distinct ecological environments and display marked differences in adult male color and pattern. We sequenced the complete genomes of 20 anoles, 10 from each subspecies, at 1.4× coverage. We used genome‐wide scans of population differentiation, allele frequency spectrum, and linkage disequilibrium to characterize the genomic architecture within and between the subspecies. While most of the genome was undifferentiated, we observed five large divergent regions. Within these regions we identified blocks, 5 kb pairs in length, enriched for fixed single nucleotide polymorphisms. These blocks encompass 97 genes, two of which are candidate pigmentation genes. One is melanophilin (mlph), which helps transport melanosomes within melanocytes. The other is a cluster of differentiation 36 (cd36), which regulates carotenoid pigment sequestration. We used high‐pressure liquid chromatography to confirm that carotenoid pigments are significantly more abundant in the conspicuous orange‐pigmented skin of male A. m. marmoratus suggesting that cd36 may be regulating pigment deposition in this tissue. We identified for the first time a carotenoid gene that is a potential target of divergent sexual selection and may be contributing to the early stages of speciation in Anolis lizards.

The effect of severe obesity on three-dimensional ground reaction force signals during walking

BackgroundThe gait pattern of adults with class I obesity [30 ≤ body mass index < 35kg/m2] was characterized by altered three-dimensional ground reaction force signals compared to lean adults (18.5 ≤ body mass index < 25 kg/m2). However, results might not be generalizable to adults with severe obesity (class II and III; body mass index ≥ 35 kg/m2). Hence, the purpose of the present study was to investigate the differences in relative ground reaction force signals, i.e., normalized by body weight, between adults with severe obesity and lean adults using functional principal component analysis. MethodsThirteen lean and eighteen sedentary adults with severe obesity performed a 5-min walking trial (1.11 m/s) on an instrumented treadmill. The first five functional principal components of the relative force signals (mediolateral, anterior-posterior, and vertical directions) were obtained using functional principal component analysis. Functional principal component scores were compared between groups using an analysis of covariance with age as covariable. FindingsFunctional principal component analysis reported a statistically significant group effect for first functional principal component score for mediolateral (P = 0.004), and second and fifth functional principal component scores for anterior-posterior (P ≤ 0.02) force signals. Adults with severe obesity displayed a greater mediolateral force during most of the stance but similar magnitudes of the anterior-posterior and vertical forces compared to lean adults. InterpretationTherefore, increasing the obesity level accentuates differences in mediolateral force but promotes no specific changes in anterior-posterior force likely due to chronic loading adaptation.

Examining adults’ behavioral patterns in a sequence of problem solving tasks in technology-rich environments

Computer-based assessment allows for the monitoring of test-takers’ behaviors. Previous research has made efforts to identify their behavioral patterns or investigate potentially influential factors. However, very few studies have examined the changes in behavioral patterns when completing a sequence of tasks. To fill this research gap, we aim to 1) explore different disengaged and engaged behavioral patterns in completing problem-solving tasks, 2) investigate changing behavioral patterns across different tasks, and 3) examine both task and individual characteristics relating to the changing behavioral patterns on all tasks. Data used in this study were drawn from log data of the U.S. Piaac 2012 (N = 660). We first identified two disengaged behaviors (i.e., rapid omit and rapid perfunctory action). Results of cluster analysis also show six types of engaged behaviors (i.e., proficient, exploring, hasty, reflecting, struggling, and passive). Overall, the transition of behavior patterns of adults in the first 8 tasks was relatively stable, while it was more complex in the following 6 tasks. The results of multinomial regression analysis indicate that adults' behaviors in completing problem-solving in technology-rich environments are mostly due to task-related factors, and individual-related factors including age, education attainment, and gender, as well as learning abilities and the use of ICT skills. The findings from this study provide several implications for future vocational training in the context of ICT needs.

Contribution of Frailty to Multimorbidity Patterns and Trajectories: Longitudinal Dynamic Cohort Study of Aging People

Background Multimorbidity and frailty are characteristics of aging that need individualized evaluation, and there is a 2-way causal relationship between them. Thus, considering frailty in analyses of multimorbidity is important for tailoring social and health care to the specific needs of older people. Objective This study aimed to assess how the inclusion of frailty contributes to identifying and characterizing multimorbidity patterns in people aged 65 years or older. Methods Longitudinal data were drawn from electronic health records through the SIDIAP (Sistema d’Informació pel Desenvolupament de la Investigació a l’Atenció Primària) primary care database for the population aged 65 years or older from 2010 to 2019 in Catalonia, Spain. Frailty and multimorbidity were measured annually using validated tools (eFRAGICAP, a cumulative deficit model; and Swedish National Study of Aging and Care in Kungsholmen [SNAC-K], respectively). Two sets of 11 multimorbidity patterns were obtained using fuzzy c-means. Both considered the chronic conditions of the participants. In addition, one set included age, and the other included frailty. Cox models were used to test their associations with death, nursing home admission, and home care need. Trajectories were defined as the evolution of the patterns over the follow-up period. Results The study included 1,456,052 unique participants (mean follow-up of 7.0 years). Most patterns were similar in both sets in terms of the most prevalent conditions. However, the patterns that considered frailty were better for identifying the population whose main conditions imposed limitations on daily life, with a higher prevalence of frail individuals in patterns like chronic ulcers &amp;peripheral vascular. This set also included a dementia-specific pattern and showed a better fit with the risk of nursing home admission and home care need. On the other hand, the risk of death had a better fit with the set of patterns that did not include frailty. The change in patterns when considering frailty also led to a change in trajectories. On average, participants were in 1.8 patterns during their follow-up, while 45.1% (656,778/1,456,052) remained in the same pattern. Conclusions Our results suggest that frailty should be considered in addition to chronic diseases when studying multimorbidity patterns in older adults. Multimorbidity patterns and trajectories can help to identify patients with specific needs. The patterns that considered frailty were better for identifying the risk of certain age-related outcomes, such as nursing home admission or home care need, while those considering age were better for identifying the risk of death. Clinical and social intervention guidelines and resource planning can be tailored based on the prevalence of these patterns and trajectories.

Cortical thickness moderates intraindividual variability in prefrontal cortex activation patterns of older adults during walking.

Increased intraindividual variability (IIV) in behavioral and cognitive performance is a risk factor for adverse outcomes but research concerning hemodynamic signal IIV is limited. Cortical thinning occurs during aging and is associated with cognitive decline. Dual-task walking (DTW) performance in older adults has been related to cognition and neural integrity. We examined the hypothesis that reduced cortical thickness would be associated with greater increases in IIV in prefrontal cortex oxygenated hemoglobin (HbO2) from single tasks to DTW in healthy older adults while adjusting for behavioral performance. Participants were 55 healthy community-dwelling older adults (mean age = 74.84, standard deviation (SD) = 4.97). Structural MRI was used to quantify cortical thickness. Functional near-infrared spectroscopy (fNIRS) was used to assess changes in prefrontal cortex HbO2 during walking. HbO2 IIV was operationalized as the SD of HbO2 observations assessed during the first 30 seconds of each task. Linear mixed models were used to examine the moderation effect of cortical thickness throughout the cortex on HbO2 IIV across task conditions. Analyses revealed that thinner cortex in several regions was associated with greater increases in HbO2 IIV from the single tasks to DTW (ps < .02). Consistent with neural inefficiency, reduced cortical thickness in the PFC and throughout the cerebral cortex was associated with increases in HbO2 IIV from the single tasks to DTW without behavioral benefit. Reduced cortical thickness and greater IIV of prefrontal cortex HbO2 during DTW may be further investigated as risk factors for developing mobility impairments in aging.

Implications of Pediatric Artificial Intelligence Challenges for Artificial Intelligence Education and Curriculum Development

Several radiology artificial intelligence (AI) courses are offered by a variety of institutions and educators. The major radiology societies have developed AI curricula focused on basic AI principles and practices. However, a specific AI curriculum focused on pediatric radiology is needed to offer targeted education material on AI model development and performance evaluation. There are inherent differences between pediatric and adult practice patterns, which may hinder the application of adult AI models in pediatric cohorts. Such differences include the different imaging modality utilization, imaging acquisition parameters, lower radiation doses, the rapid growth of children and changes in their body composition, and the presence of unique pathologies and diseases, which differ in prevalence from adults. Thus, to enhance radiologists’ knowledge of the applications of AI models in pediatric patients, curricula should be structured keeping in mind the unique pediatric setting and its challenges, along with methods to overcome these challenges, and pediatric-specific data governance and ethical considerations. In this report, the authors highlight the salient aspects of pediatric radiology that are necessary for AI education in the pediatric setting, including the challenges for research investigation and clinical implementation.

1437-P: Treatment Pattern and Glycemic Control of Adults with T2DM in Northern China

Aim: To better understand the current treatment pattern and glycemic control status in Chinese adults with T2DM. Methods: A retrospective study was conducted among adult T2DM patients using electronic medical records from 2015 to 2019 in Tianjin, a metropolis in Northern China. Results: From 2015 to 2019, a total of 312,203 patients from 75 hospitals were included, with mean age of 61.9 years old and BMI 26.1 kg/m2. HbA1c decreased from 8.2% to 7.9% with the percentages of HbA1c &amp;lt;7% increased from 28.1% to 33.7% (P&amp;lt;0.001). A growing proportion treated with basal insulin and GLP-1RA ± basal insulin was seen while the proportion of premixed insulin decreased (P&amp;lt;0.001). 44.0% of the subjects were treated with OAD only and the most frequently used OADs were α-glucosidase inhibitor (55.7%) and metformin (47.0%). The percentages of cardiovascular risk factors and macrovascular events including hypertension, dyslipidemia, obesity, cardiovascular disease and stroke were increased each year (P&amp;lt;0.001). During 2015-2019, 27.7% and 40.3% of the population had FPG&amp;lt;7 mmol/L and PPG&amp;lt;10 mmol/L, respectively, while 46.1% of them had both FPG ≥ 7 and PPG ≥10 mmol/L. Conclusion: From 2015 to 2019, an increasing proportion of T2DM population achieved HbA1c target, reflecting the potential optimized treatment concept and regimen. Meanwhile, there is still room to improve the holistic management of T2DM in China for a better patient outcome. Disclosure L.Chen: None. L.Kang: Employee; Sanofi China. M.Li: None. Q.Zhang: None. Y.Fan: None. X.Liu: None. M.Zhang: Employee; Sanofi China. G.Wu: Employee; Sanofi China. M.Wu: Employee; Sanofi China. Q.Huang: Employee; Sanofi China. Y.Han: Employee; Sanofi China. Funding Sanofi

Altered resting-state functional connectivity patterns in late middle-aged and older adults with obstructive sleep apnea.

Obstructive sleep apnea (OSA) is increasingly recognized as a risk factor for cognitive decline, and has been associated with structural brain alterations in regions relevant to memory processes and Alzheimer's disease. However, it is unclear whether OSA is associated with disrupted functional connectivity (FC) patterns between these regions in late middle-aged and older populations. Thus, we characterized the associations between OSA severity and resting-state FC between the default mode network (DMN) and medial temporal lobe (MTL) regions. Second, we explored whether significant FC changes differed depending on cognitive status and were associated with cognitive performance. Ninety-four participants [24 women, 65.7 ± 6.9 years old, 41% with Mild Cognitive Impairment (MCI)] underwent a polysomnography, a comprehensive neuropsychological assessment and a resting-state functional magnetic resonance imaging (MRI). General linear models were conducted between OSA severity markers (i.e., the apnea-hypopnea, oxygen desaturation and microarousal indices) and FC values between DMN and MTL regions using CONN toolbox. Partial correlations were then performed between OSA-related FC patterns and (i) OSA severity markers in subgroups stratified by cognitive status (i.e., cognitively unimpaired versus MCI) and (ii) cognitive scores in the whole sample. All analyzes were controlled for age, sex and education, and considered significant at a p < 0.05 threshold corrected for false discovery rate. In the whole sample, a higher apnea-hypopnea index was significantly associated with lower FC between (i) the medial prefrontal cortex and bilateral hippocampi, and (ii) the left hippocampus and both the posterior cingulate cortex and precuneus. FC patterns were not associated with the oxygen desaturation index, or micro-arousal index. When stratifying the sample according to cognitive status, all associations remained significant in cognitively unimpaired individuals but not in the MCI group. No significant associations were observed between cognition and OSA severity or OSA-related FC patterns. OSA severity was associated with patterns of lower FC in regions relevant to memory processes and Alzheimer's disease. Since no associations were found with cognitive performance, these FC changes could precede detectable cognitive deficits. Whether these FC patterns predict future cognitive decline over the long-term needs to be investigated.

Race/Ethnicity, Attachment, and the Cortisol Awakening Response among Young Sexual Minority Men

Young sexual minority men (YSMM), particularly YSMM of color, are more likely to have dysregulated physiological stress responses compared to heterosexuals. Moreover, the quality of social relationships impacts physiological stress patterns among young adults. One key indicator of social relationships is that of adult attachment, which refers to the types of socioemotional bonds that individuals form with peers, family, and romantic partners. However, the association between adult attachment and physiological stress functioning among diverse samples of YSMM has been underexplored. Thus, the current study sought to bridge this gap in the literature by exploring how race/ethnicity moderates the association between adult attachment and physiological stress patterns among Black versus White YSMM. N = 63 YSMM participated in a 5-day daily diary study in which they completed a baseline survey and provided saliva samples over the 5-day period in order to measure diurnal cortisol. Three-level hierarchical linear modeling was used in order to examine the association between race/ethnicity, adult attachment, and diurnal cortisol over the 5-day period. Results suggest that adult attachment avoidance was associated with the cortisol awakening response (CAR) among YSMM. In addition, race/ethnicity moderated the association between adult attachment avoidance and the CAR such that YSMM who identified as Black had evidence of a more dysregulated physiological stress response as compared to YSMM who identified as White. Future research should focus on further unpacking the drivers of physiological stress patterns among White and Black YSMM.

Trip-Related Fall Risk Prediction Based on Gait Pattern in Healthy Older Adults: A Machine-Learning Approach

Trip perturbations are proposed to be a leading cause of falls in older adults. To prevent trip-falls, trip-related fall risk should be assessed and subsequent task-specific interventions improving recovery skills from forward balance loss should be provided to the individuals at risk of trip-fall. Therefore, this study aimed to develop trip-related fall risk prediction models from one’s regular gait pattern using machine-learning approaches. A total of 298 older adults (≥60 years) who experienced a novel obstacle-induced trip perturbation in the laboratory were included in this study. Their trip outcomes were classified into three classes: no-falls (n = 192), falls with lowering strategy (L-fall, n = 84), and falls with elevating strategy (E-fall, n = 22). A total of 40 gait characteristics, which could potentially affect trip outcomes, were calculated in the regular walking trial before the trip trial. The top 50% of features (n = 20) were selected to train the prediction models using a relief-based feature selection algorithm, and an ensemble classification model was selected and trained with different numbers of features (1–20). A ten-times five-fold stratified method was utilized for cross-validation. Our results suggested that the trained models with different feature numbers showed an overall accuracy between 67% and 89% at the default cutoff and between 70% and 94% at the optimal cutoff. The prediction accuracy roughly increased along with the number of features. Among all the models, the one with 17 features could be considered the best model with the highest AUC of 0.96, and the model with 8 features could be considered the optimal model, which had a comparable AUC of 0.93 and fewer features. This study revealed that gait characteristics in regular walking could accurately predict the trip-related fall risk for healthy older adults, and the developed models could be a helpful assessment tool to identify the individuals at risk of trip-falls.

Continuity of Care in Adults Aging with Cerebral Palsy and Spina Bifida: The Importance of Community Healthcare and Socioeconomic Context.

Continuity of care is considered a key metric of quality healthcare. Yet, continuity of care in adults aging with congenital disability and the factors that contribute to care continuity are largely unknown. Using data from a national private administrative health claims database in the United States (2007-2018). we examined continuity of care in 8596 adults (mean age 48.6 years) with cerebral palsy or spina bifida. Logistic regression models analyzed how proximity to health care facilities, availability of care providers, and community socioeconomic context were associated with more continuous care. We found that adults aging with cerebral palsy or spina bifida saw a variety of different physician specialty types and generally had discontinuous care. Individuals who lived in areas with more hospitals and residential care facilities received more continuous care than those with limited access to these resources. Residence in more affluent areas was associated with receiving more fragmented care. Findings suggest that over and above individual factors, community healthcare resources and socioeconomic context serve as important factors to consider in understanding continuity of care patterns in adults aging with cerebral palsy or spina bifida.

Influence of Aerosol Mask Design on Fugitive Aerosol Concentrations During Nebulization.

Secondhand exposure to fugitive aerosols may cause airway diseases in health providers. We hypothesized that redesigning aerosol masks to be closed-featured would reduce the fugitive aerosol concentrations during nebulization. This study aimed to evaluate the influence of a mask designed for a jet nebulizer on the concentration of fugitive aerosols and delivered doses. An adult intubation manikin was attached to a lung simulator to mimic normal and distressed adult breathing patterns. The jet nebulizer delivered salbutamol as an aerosol tracer. The nebulizer was attached to 3 aerosol face masks: an aerosol mask, a modified non-rebreathing mask (NRM, with no vent holes), and an AerosoLess mask. An aerosol particle sizer measured aerosol concentrations at parallel distances of 0.8 m and 2.2 m and a frontal distance of 1.8 m from the manikin. The drug dose delivered distal to the manikin's airway was collected, eluted, and analyzed using a spectrophotometer at a 276 nm wavelength. With a normal breathing pattern, the trends of aerosol concentrations were higher with an NRM followed by an aerosol mask and AerosoLess mask (P < .001) at 0.8 m; however, the concentrations were higher with an aerosol mask followed by NRM and AerosoLess mask at 1.8 m (P < .001) and 2.2 m (P < .001). With a distressed breathing pattern, the aerosol concentrations were higher with an aerosol mask followed by an NRM and AerosoLess mask at 0.8 m, 1.8 m (P < .001), and 2.2 m (P = .005). The delivered drug dose was significantly higher with AerosoLess mask with a normal breathing pattern and with an aerosol mask with a distressed breathing pattern. Mask design influences fugitive aerosol concentrations in the environment, and a filtered mask reduces the concentration of aerosols at 3 different distances and with 2 breathing patterns.

Sleep assessment in adults with Down syndrome: correlation between functionality and polysomnographic findings.

Sleep disorders have a negative impact on health, being associated with neurocognitive problems, cardiovascular diseases and obesity, influencing children's development and learning. To assess the sleep pattern of people with Down syndrome (DS) and correlate changes with functionality and behavior. A cross-sectional study was conducted to evaluate the sleep pattern in adults with DS > 18 years old. Twenty-two participants were assessed using the Pittsburgh Sleep Quality Index, the Functional Independence Measure and the Strengths and Difficulties Questionnaire, and the 11 who presented indications of disorders by the screening questionnaires were referred to polysomnography. Statistical tests were performed using a significance level of 5%, including sample normality tests and correlation tests (sleep and functionality). Impairment in sleep architecture was found due to an increase in the rate of awakenings in 100% of the participants, a decrease in the number of slow waves, and a high prevalence of sleep disordered breathing (SDB), with higher averages in the Apnea and Hypopnea Index (AHI) in the group. There was a negative correlation between sleep quality and global functionality (p = 0.011) and the motor (p = 0.074), cognitive (p = 0.010), and personal care (p = 0.072) dimensions in the group. Global and hyperactivity behavior changes were related to worse sleep quality (p = 0.072; p = 0.015, respectively). There is an impairment in the sleep quality of adults with DS, with an increase in the rate of awakenings, a decrease in the number of slow waves, and a high prevalence of SDB affecting this population in the functional and behavioral aspects.

The association between sleep restlessness and neuroimaging biomarkers of Alzheimer’s Disease in mid‐life to older adults and patients

AbstractBackgroundRecent research demonstrates a bidirectional relationship between sleep and Alzheimer’s Disease (AD) pathology, with supporting evidence that changes in sleep pattern occurs from the preclinical stage of AD. The cooccurrence of sleep disturbances and amyloid‐beta (Aβ) accumulation suggests the importance of monitoring sleep patterns in adults that are at high‐risk of developing AD later in life. We first investigated whether resting heart rate (RHR) and nocturnal sleep restlessness (NSR) are different in cognitively impaired (CI) and cognitively unimpaired (CU) mid‐life to older adults. We also examined any association of these sleep characteristics with hippocampus volume (HV) and Aβ, as neuroimaging biomarkers of AD, regardless of the cognitive status.Method107 middle to old age (46‐75 years old) adults (age 61.5±6.5, 74 Females, 64 APOE ε4 carriers, and 88 CU) underwent 3T MRI and PET scans as part of the Prospective Imaging Study of Ageing (PISA) study. A ballistocardiograph sleep monitoring device was used to track their RHR and NSR for approximately 5 months after their PET scan. NSR was quantified by total time in bed, total duration and number of bed‐exits, and multi‐episodic sleep. HV was normalised using total intracranial volume, and Aβ load was calculated in Centiloid scale (CL) with Aβ positivity defined as CL&gt;20. Generalised Linear Models were used to examine the relationship between sleep and imaging biomarkers. Age, gender, BMI, APOE, and years of education were used as independent covariates.ResultCIs spent more time in bed (p = 0.002) and had more bed‐exits (p = 0.009) than CUs. However, no significant difference was found on RHR and multi‐episodic sleep between CUs and CIs. Individuals with higher Aβ load, regardless of their cognitive status, had lower RHR (p = 0.04) and more bed‐exits (p = 0.04), and spent more time in bed (p = 0.01). Also, individuals with smaller HV frequently exited the bed during the night (p = 0.03) and spent more time in bed (p = 0.003).ConclusionIndividuals with cognitive impairment experienced higher levels of NSR with frequent bed‐exits and more time in bed. Also, these sleep characteristics were significantly associated with the Centiloid value, Aβ status, and HV, regardless of the cognitive status.

Psychometric Properties of the Turkish Adaptation of the Yale Physical Activity Survey.

This study aimed to examine the convergent validity and test-retest reliability of the Turkish version of the Yale Physical Activity Survey (YPAS-TR). Eighty-one volunteer older adults were included in the study. Test-retest reliability was evaluated using the intraclass correlation coefficient. Correlation coefficients between YPAS-TR and Physical Activity Scale for the Elderly (PASE), Short Form-36, and Short Physical Performance Battery were examined for convergent validity. Acceptable intraclass correlation coefficient values were reached for YPAS-TR energy expenditure, total physical activity time and summary, vigorous, leisurely walking, moving, standing, and sitting indices (intraclass correlation coefficient = .96-.99). There was a moderate correlation between energy expenditure and total physical activity time with PASE (leisure time activities), PASE (household activities), and PASE (total) (r = .478, r = .468, r = .570, r = .406, r = .490, r = .550, respectively, p < .001). Also, a weak correlation was found between summary and leisurely walking index with PASE (household activities), standing index with PASE (leisure time activities), and PASE (total) (r = .285, p = .010; r = .257, p = .021; r = .238, p = .033; r = .283, p = .010; respectively). The results of the study suggest that the YPAS-TR is a valid and reliable measurement tool that can be used to assess the physical activity patterns of Turkish older adults.

P273 Chronic airway infection and resistance pattern in children and adults with cystic fibrosis in Oman. A single centre cross sectional study

To assess the pattern of airway bacterial growth among cystic fibrosis (CF) patients in Oman, and to identify possible risk factors for the hypothesize early Pseudomonas aeruginosa (PA) acquisition among these children.

A critical review on fast-food consumption pattern among South Asian and Southeast Asian young adults

Fast food consumption trend has become very popular worldwide. Globalization has led to rapid rise in the number of fast-food outlets in Asian countries. The present study focuses on reviewing the consumption pattern of fast food among young adults of South Asian and Southeast Asian countries. Here a shift has been witnessed from consumption of traditional homemade food which included healthy nutritious locally available foods toward fast foods and processed foods. An extensive review of existing scientific studies in several South Asian and Southeast Asian countries was carried out to analyse fast food consumption patterns of young adults. Globalization, affluence, busy schedules, increase in number of working female population, mass media, increase in fast food production and delivery outlets are some of the main reasons contributing to increasing fast food consumption trends. Several western fast-food franchises are now well established in developing Asian countries. Dining out culture has increased in the Asian society and is socially acceptable. A rapid nutritional shift in Southeast Asia may be due to increase in food availability and food purchasing power. Consumption of fast-food items is associated with increasing obesity rates among young adults. Such trends are also associated with the increasing prevalence of non-communicable diseases such as indigestion, hypertension, asthma, and other several diseases among South Asian and Southeast Asian adults.

Multidrug Aerosol Delivery During Mechanical Ventilation.

Background: In the critically ill, pulmonary vasodilators are often provided off label to intubated patients using continuous nebulization. If additional aerosol therapies such as bronchodilators or antibiotics are needed, vasodilator therapy may be interrupted. This study assesses aerosol systems designed for simultaneous delivery of two aerosols using continuous nebulization and bolus injection without interruption or circuit disconnection. Methods: One i-AIRE dual-port breath-enhanced jet nebulizer (BEJN) or two Aerogen® Solo vibrating mesh nebulizers (VMNs) were installed on the dry side of the humidifier. VMN were stacked; one for infusion and the second for bolus drug delivery. The BEJN was powered by air at 3.5 L/min, 50 psig. Radiolabeled saline was infused at 5 and 10 mL/h with radiolabeled 3 and 6 mL bolus injections at 30 and 120 minutes, respectively. Two adult breathing patterns (duty cycle 0.13 and 0.34) were tested with an infusion time of 4 hours. Inhaled mass (IM) expressed as % of initial syringe activity (IM%/min) was monitored in real time with a ratemeter. All delivered radioaerosol was collected on a filter at the airway opening. Transients in aerosol delivery were measured by calibrated ratemeter. Results: IM%/h during continuous infusion was linear and predictable, mean ± standard deviation (SD): 2.12 ± 1.45%/h, 2.47 ± 0.863%/h for BEJN and VMN, respectively. BEJN functioned without incident. VMN continuous aerosol delivery stopped spontaneously in 3 of 8 runs (38%); bolus delivery stopped spontaneously in 3 of 16 runs (19%). Tapping restarted VMN function during continuous and bolus delivery runs. Bolus delivery IM% (mean ± SD): 20.90% ± 7.01%, 30.40% ± 11.10% for BEJN and VMN, respectively. Conclusion: Simultaneous continuous and bolus nebulization without circuit disconnection is possible for both jet and mesh technology. Monitoring of VMN devices may be necessary in case of spontaneous interruption of nebulization.

Distinct patterns of adult transport-related physical activity (TRPA) behaviour exist independent of the TRPA behaviours of childhood: the childhood determinants of adult health study

BackgroundTransport-related physical activity (TRPA) is recognised as a potential means of increasing total physical activity participation that may yield substantial health benefits. Public health campaigns focusing on promoting TRPA from a young age aim to develop life-long healthy habits. However, few studies have examined how TRPA changes across the lifecourse and whether childhood TRPA levels influence those observed later in life.MethodsUsing the Australian Childhood Determinants of Adult Health study (baseline, 1985), latent class growth mixture modelling with adjustment for time-varying covariates was performed using four timepoints (ranging from 7 to 49 years) to assess behavioural patterns and retention of TRPA across the lifecourse. As child and adult adjusted TRPA measures could not be harmonised, trajectories of adult TRPA (n = 702) were instead identified, and log-binomial regression analysis was performed to determine whether childhood levels of TRPA (high/medium/low) influenced these trajectories.ResultsTwo stable groups of adult TRPA trajectories were identified: persistently low (n = 520; 74.2%), and increasingly high TRPA (n = 181; 25.8%). There was no significant relationship between childhood TRPA levels and patterns in adulthood (relative risk of high childhood TRPA yielding high adult TRPA trajectory membership = 1.06; 95% confidence interval = 0.95–1.09).ConclusionThis study found childhood TRPA levels were not associated with TRPA patterns in adulthood. These findings suggest that while TRPA in childhood may have health, social, and environmental benefits, it does not appear to impact adult TRPA directly. Therefore, further intervention is required beyond childhood to promote the implementation of healthy TRPA behaviours into adulthood.