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Purpose
The most commonly used mobility assessments for screening risk of falls among older adults are rating scales such as the Tinetti performance oriented mobility assessment (POMA). However, its correlation with falls is not always predictable and disadvantages of the scale include difficulty to assess many of the items on a 3-point scale and poor specificity. The purpose of this study was to describe the ability of the new Aachen Mobility and Balance Index (AMBI) to discriminate between subjects with a fall history and subjects without such events in comparison to the Tinetti POMA Scale.
Methods
For this prospective cohort study, 24 participants in the study group and 10 in the control group were selected from a population of patients in our hospital who had met the stringent inclusion criteria. Both groups completed the Tinetti POMA Scale (gait and balance component) and the AMBI (tandem stance, tandem walk, ten-meter-walk-test, sit-to-stand with five repetitions, 360° turns, timed-up-and-go-test and measurement of the dominant hand grip strength). A history of falls and hospitalization in the past year were evaluated retrospectively. The relationships among the mobility tests were examined with Bland–Altmananalysis. Receiver-operated characteristics curves, sensitivity and specificity were calculated.
Results
The study showed a strong negative correlation between the AMBI (17 points max., highest fall risk) and Tinetti POMA Scale (28 points max., lowest fall risk; r = −0.78, p < 0.001) with an excellent discrimination between community-dwelling older people and a younger control group. However, there were no differences in any of the mobility and balance measurements between participants with and without a fall history with equal characteristics in test comparison (AMBI vs. Tinetti POMA Scale: AUC 0.570 vs. 0.598; p = 0.762). The Tinetti POMA Scale (cut-off <20 points) showed a sensitivity of 0.45 and a specificity of 0.69, the AMBI a sensitivity of 0.64 and a specificity of 0.46 (cut-off >5 points).
Conclusion
The AMBI comprises mobility and balance tasks with increasing difficulty as well as a measurement of the dominant hand-grip strength. Its ability to identify fallers was comparable to the Tinetti POMA Scale. However, both measurement sets showed shortcomings in discrimination between fallers and non-fallers based on a self-reported retrospective falls-status.
An amperometric biosensor using a substrate recycling principle was realized for the detection of low adrenaline concentrations (1 nM) by measurements in phosphate buffer and Ringer’s solution at pH 6.5 and pH 7.4, respectively. In proof-of-concept experiments, a Boolean logic-gate principle has been applied to develop a digital adrenaline biosensor based on an enzyme AND logic gate. The obtained results demonstrate that the developed digital biosensor is capable for a rapid qualitative determination of the presence/absence of adrenaline in a YES/NO statement. Such digital biosensor could be used in clinical diagnostics for the control of a correct insertion of a catheter in the adrenal veins during adrenal venous-sampling procedure.
Es werden Effizienzbegriffe zum Vergleich von statistischen Tests basierend auf verschiedenen statistischen Experimenten eingeführt. Dabei handelt es sich um die schon aus dem Vergleich von statistischen Tests in je demselben Modell bekannten asymptotischen relativen Effizienzen wie die Hodges-Lehmann-Effizienz, die Bahadur-Effizienz und die Pitman-Effizienz sowie um Kriterien basierend auf Volumina von Konfidenzbereichen. Effizienzaussagen werden unter anderem für Likelihood-Quotienten-Tests und Waldsche Tests im Rahmen eines allgemeinen multivariaten parametrischen Modells erhalten. Statistische Tests zur Prüfung von Hypothesen über die relative Wirksamkeit zweier Experimente werden vorgeschlagen. Auf der Grundlage der erhaltenen Ergebnisse erfolgt ein Vergleich der Wirksamkeit von korrespondierenden Verfahren bei verbundener Stichprobenerhebung und unabhängiger Stichprobenerhebung. Die Rolle der Kovarianzmatrix bei verbundener Stichprobenerhebung wird insbesondere unter der Annahme, dass die zugrunde liegenden Verteilungen durch k-parametrische Exponentialfamilien modellierbar sind, herausgearbeitet. Verbindungen zu Effizienzbegriffen bei Punkt- und Konfidenzbereichsschätzverfahren werden aufgezeigt. Ausführlichere Untersuchungen betreffen die korrespondierenden Hotellingschen T²-Tests im multivariaten Normalverteilungsfall, die klassischen Homogenitatstests bei k × k-Kontingenztafeln und die Wilcoxon Tests in nichtparametrischen Lagealternativmodellen
Visualization of the recovery process of defects in a cultured cell layer by chemical imaging sensor
(2016)
The chemical imaging sensor is a field-effect sensor which is able to visualize both the distribution of ions (in LAPS mode) and the distribution of impedance (in SPIM mode) in the sample. In this study, a novel cell assay is proposed, in which the chemical imaging sensor operated in SPIM mode is applied to monitor the recovery of defects in a cell layer brought into proximity of the sensing surface. A reduced impedance at a defect formed artificially in a cell layer was successfully visualized in a photocurrent image. The cell layer was cultured over two weeks, during which the temporal change of the photocurrent distribution corresponding to the recovery of the defect was observed.