Does additional weekend and holiday physiotherapy benefit geriatric patients with hip fracture? — A case-historical control study

Objective:To evaluate the new service model of additional weekend and holiday physiotherapy (PT) by comparing functional outcomes and hospital length of stay between a group of geriatric patients with hip fracture receiving daily PT training and a group of geriatric patients with hip fracture receiving weekdays PT training.Methods:A retrospective case-historical control chart review was conducted and a total of 355 patients were identified. Between-group comparisons were done on functional outcomes including Modified Functional Ambulation Classification (MFAC), Elderly Mobility Scale (EMS), Modified Barthel Index (MBI) and process outcome in terms of length of stay (LOS) in hospitals.Results:With similar characteristics, patients who received weekend and holiday PT training had a significant higher percentage of MFAC Category III and a significant lower percentage of MFAC Category II (p=0.015) and significant higher MBI scores (mean±standard deviation, median; Study group: 47.4±19.6 points, 51 points; Control group: 43.0±20.0 points, 43 points; p=0.042) upon admission to rehabilitation hospital. A similar trend in EMS scores (Study group: 8.2±5.5 points, 7 points; Control group: 8.4±6.1 points, 6 points; p=0.998) and MBI scores (Study group: 63.0±23.4 points, 68 points; Control group: 61.2±26.1 points, 64 points; p=0.743) were observed upon discharge from the rehabilitation hospital. The average LOS in acute hospitals remained static (Study group: 7.7±3.9 days, 7 days; Control group: 7.4±5.0 days, 6 days; p=0.192). The average LOS in rehabilitation hospital (Study group: 20.0±5.5 days, 20 days; Control group: 24.3±9.9 days, 23 days; p<0.001) and total in-patient LOS (Study group: 26.7±6.4 days, 26 days; Control group: 30.7±11.2 days, 28 days; p<0.001) were significantly reduced. A higher percentage of days having PT training during hospitalization in rehabilitation hospital was shown with the implementation of new service (Study group: 89.1%; Control group: 65.9%, p<0.001).Conclusion:Additional weekend and holiday PT training in post-operative acute and rehabilitation hospitalization benefits geriatric patients with hip fracture in terms of improved training efficiency, where hospital LOS was shortened with more PT sessions, without any significant impacts on functional outcome.     

Play and theory of mind in early childhood: a Hong Kong perspective

The study seeks to understand the relation between preschool children's mode of participation and negotiation strategies during play and their theory of mind (ToM) development in the Hong Kong context. Forty-two 5-year-old children were recruited. Their emotional and cognitive ToMs were assessed along with expressive language ability. Children's play was observed twice in naturalistic and laboratory settings. Parents completed a questionnaire on their child's emotional and cognitive ToM development, including demographic information and social economic status indexes. The results showed that 5-year-old Hong Kong children mostly engaged in associative and cooperative play and employed two-way, reciprocal strategies in their play. Parent report of emotional ToM predicted children's play strategy in both naturalistic and laboratory settings. Child measure of cognitive ToM predicted their play strategy in the laboratory setting. The study advocates more play time in kindergarten in order to foster an empathetic generation.     

Enantioselective hydrogenation of alpha-aminomethylacrylates containing a free NH group for the synthesis of beta-amino acid derivatives

We describe highly enantioselective synthesis of beta-amino acid derivatives (1a-c) using asymmetric hydrogenation of alpha-aminomethylacrylates (2a-c), which contain a free basic N H group, as the key step. The alpha-aminomethylacrylates (2a-c) were prepared using the Baylis-Hillman reaction of an appropriate aldehyde with methyl acrylate followed by acetylation of the resulting allylic alcohols (4a-b) and S(N)2'-type amination of the allylic acetates (3a-b).     

Enhancement of the immunogenicity of an alphavirus replicon-based DNA vaccine against classical swine fever by electroporation and coinjection with a plasmid expressing porcine interleukin 2

Alphavirus replicon-based DNA vaccines have emerged as a promising approach to generation of antigen-specific immune responses. However, due to their low immunogenicity, there is a need for other approaches to enhance the vaccine potency. In this study, electroporation (EP) and a plasmid expressing porcine interleukin 2 (IL-2) were used to improve the immunogenicity of an alphavirus replicon-based DNA vaccine pSFV1CS-E2 against classical swine fever (CSF). Pigs were immunized with pSFV1CS-E2 alone or together with IL-2 by EP or by simple intramuscular injection. The results showed that EP combined with IL-2 resulted in marked enhancement of E2-specific antibody responses. Moreover, CSFV-specific lymphocyte proliferation, IFN-γ and IL-4 responses were increased significantly in the pSFV1CS-E2+IL-2/EP group. Pigs immunized with pSFV1CS-E2 plus IL-2 by EP were completely protected from lethal challenge, which is comparable to the sterilizing immunity and full protection offered by the live attenuated vaccine C-strain and in contrast with the incomplete protection conferred by pSFV1CS-E2 without or with IL-2 or EP alone, as demonstrated by the presence of pathological changes or/and viral loads. We conclude that EP in combination with IL-2 can significantly improve the immunogenicity of the plasmid DNA vaccine.