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The origin of malnutrition in older age is multifactorial and risk factors may vary according to health and living situation. The present study aimed to identify setting-specific risk profiles of malnutrition in older adults and to investigate the association of the number of individual risk factors with malnutrition.
Data of four cross-sectional studies were harmonized and uniformly analysed. Malnutrition was defined as BMI < 20 kg/m2 and/or weight loss of >3 kg in the previous 3–6 months. Associations between factors of six domains (demographics, health, mental function, physical function, dietary intake-related problems, dietary behaviour), the number of individual risk factors and malnutrition were analysed using logistic regression.
Community (CD), geriatric day hospital (GDH), home care (HC), nursing home (NH).
CD older adults (n 1073), GDH patients (n 180), HC receivers (n 335) and NH residents (n 197), all ≥65 years.
Malnutrition prevalence was lower in CD (11 %) than in the other settings (16–19 %). In the CD sample, poor appetite, difficulties with eating, respiratory and gastrointestinal diseases were associated with malnutrition; in GDH patients, poor appetite and respiratory diseases; in HC receivers, younger age, poor appetite and nausea; and in NH residents, older age and mobility limitations. In all settings the likelihood of malnutrition increased with the number of potential individual risk factors.
The study indicates a varying relevance of certain risk factors of malnutrition in different settings. However, the relationship of the number of individual risk factors with malnutrition in all settings implies comprehensive approaches to identify persons at risk of malnutrition early.
Resource utilisation for infants with single ventricle CHD remains high without well-studied ways to decrease economic burden. Same-day discharge following cardiac catheterisation has been shown to be safe and effective in children with CHD, but those with single ventricle physiology are commonly excluded. The purpose of this study was to investigate the economic implications of planned same-day discharge following cardiac catheterisation versus universal overnight hospital admission in infants with single ventricle CHD.
Methods and Results:
A probabilistic decision-tree analysis with sensitivity analyses was performed. All included patients were categorised into four possible outcomes; discharge, readmission following discharge (within 48 hours), observation and prolonged hospitalisation. Baseline probabilities of each node of the tree were then combined with the cost data to evaluate the comparative dominance of one decision (immediately discharge) versus the other decision (routinely admit). Patients discharged on the same day as the procedure accrued the lowest attributed hospital cost ($5469), while patients readmitted to the hospital had the highest attributed cost ($11,851). Currently, no other studies have assessed the cost of hospitalisation following cardiac catheterisation in this population. Thus, we allowed for a wide range of cost variation, but same-day discharge dominated the decision outcome with a lower economic burden.
Same-day discharge following routine cardiac catheterisation in patients with single ventricle physiology is less costly compared to universal overnight admission. This demonstrates an important cost-limiting step in a complex population of patients who have high resource utilisation.
Cadillo is an invasive species in Florida pastures and natural areas. Despite its invasiveness, relatively few studies have evaluated cadillo management. Thus, the objective of this research was to determine effective POST herbicides for cadillo control in Florida. Greenhouse and field studies were conducted at the Range Cattle Research and Education Center near Ona, FL, in 2015 and 2016. In the greenhouse study, triclopyr-ester, aminopyralid, metsulfuron, 2,4-D amine, aminopyralid+metsulfuron, aminocyclopyrachlor+metsulfuron, and imazapyr+aminocyclopyrachlor+metsulfuron provided ≥80% control of cadillo 28 d after treatment (DAT). Aminocyclopyrachlor at 17 and 35 g ha–1 were the only treatments with <80% control, with 70% and 75% control, respectively. Similar results were reflected in cadillo dry biomass reduction. The herbicide treatments used in the field study were triclopyr-ester, aminopyralid, 2,4-D amine, aminocyclopyrachlor, and triclopyr+fluroxypyr. Most treatments provided excellent control in the field (≥90% control) 30 DAT, and by 60 DAT all treatments provided 100% control. Results from these studies suggest that cadillo is susceptible to many of the common POST herbicides utilized in pastures and natural areas in Florida.
We aimed to investigate the incidence and causes of readmission of infants with single-ventricle and shunt-dependent biventricular CHD following routine, outpatient cardiac catheterisation.
Cardiac catheterisation is commonly performed in patients with single-ventricle and shunt-dependent biventricular CHD for haemodynamic assessment and surgical planning. Best practices for post-procedural care in this population are unknown, and substantial variation exists between centres. Outpatient catheterisation reduces parental anxiety and decreases cost. Our institutional strategy is to discharge patients following a 4- to 6-hour post-procedure observation period.
Retrospective cohort study using the Society of Thoracic Surgeons Database identified patients <1 year of age with pre-stage II single-ventricle CHD or shunt-dependent biventricular CHD who underwent cardiac catheterisation between 2007 and 2015. Readmission was defined as admission to the hospital within 48 hours after discharge after catheterisation.
A total of 92 patients were included in the analysis. Among them, 62 patients (67%) were discharged after a 4- to 6-hour observation period with only 3% readmission, 18 patients (20%) stayed for a 23-hour observation period, and 12 patients (13%) were admitted for >23 hours. There were no differences in baseline characteristics between discharged and admitted patients. Patients who underwent intervention were more likely to be admitted. Patients with hypoplastic left heart syndrome did not have major adverse events or readmissions. No intra- or peri-procedural deaths occurred.
Outpatient cardiac catheterisation may be a safe option for infants with single-ventricle and shunt-dependent biventricular CHD, with low readmission rates and minimal morbidity.
Posthodiplostomum minimum utilizes a three-host life cycle with multiple developmental stages. The metacercarial stage, commonly known as ‘white grub’, infects the visceral organs of many freshwater fishes and was historically considered a host generalist due to its limited morphological variation among a wide range of hosts. In this study, infection data and molecular techniques were used to evaluate the host and tissue specificity of Posthodiplostomum metacercariae in centrarchid fishes. Eleven centrarchid species from three genera were collected from the Illinois portion of the Ohio River drainage and necropsied. Posthodiplostomum infection levels differed significantly by host age, host genera and infection locality. Three Posthodiplostomum spp. were identified by DNA sequencing, two of which were relatively common within centrarchid hosts. Both common species were host specialists at the genus level, with one species restricted to Micropterus hosts and the other preferentially infecting Lepomis. Host specificity is likely dictated by physiological compatibility and deviations from Lepomis host specificity may be related to host hybridization. Posthodiplostomum species also differed in their utilization of host tissues. Neither common species displayed strong genetic structure over the scale of this study, likely due to their utilization of bird definitive hosts.
Bipolar disorder (BD) is associated with adverse childhood experiences (ACE), which worsen the lifetime course of illness, and with signs of widespread disruption of white matter (WM) integrity in adult life. ACE are associated with changes in WM microstructure in healthy humans.
We tested the effects of ACE on diffusion-tensor imaging (DTI) measures of WM integrity in 80 in-patients affected by a major depressive episode in the course of BD. We used whole-brain tract-based spatial statistics in the WM skeleton with threshold-free cluster enhancement of DTI measures of WM microstructure: axial, radial and mean diffusivity, and fractional anisotropy.
ACE hastened the onset of illness. We observed an inverse correlation between the severity of ACE and DTI measures of axial diffusivity in several WM fibre tracts contributing to the functional integrity of the brain and including the corona radiata, thalamic radiations, corpus callosum, cingulum bundle, superior longitudinal fasciculus, inferior fronto-occipital fasciculus and uncinate fasciculus.
Axial diffusivity reflects the integrity of axons and myelin sheaths, and correlates with functional connectivity and with higher-order abilities such as reasoning and experience of emotions. In patients with BD axial diffusivity is increased by lithium treatment. ACE might contribute to BD pathophysiology by hampering structural connectivity in critical cortico-limbic networks.
We present an overview of the latest results from the PdBI Arcsecond Whirlpool Survey (PAWS, PI: E. Schinnerer), which has mapped CO(1-0) emission in the nearby grand-design spiral galaxy M51 at 40pc resolution. Our data are sensitive to GMCs above 105 M⊙, allowing the construction of the largest GMC catalog to date – containing over 1500 objects – using the CPROPS algorithm (Rosolowsky & Leroy 2006). In the inner disk of M51, the properties of the CO emission show significant variation that can be linked to the dynamical environment in which the molecular gas is located. We find that dynamically distinct regions host clouds with different properties and exhibit different GMC mass spectra, as well as distinct patterns of star formation. To understand how this sensitivity to environment emerges, we consider the role of pressure on GMC stabilization (including shear and star formation feedback-driven turbulence). We suggest that, in the presence of significant external pressure, streaming motions driven by the spiral arm can act to reduce the surface pressure on clouds. The resulting stabilization impacts the global pattern of star formation and can account for the observed non-monotonic radial dependence of the gas depletion time. Our findings have implications for the observed scatter in the standard GMC relations and extragalactic star formation laws.
Studies conducted in tertiary care hospitals of different European countries and the United States have shown incidence rates of candidemia ranging from 0.17 to 0.76 and 0.28 to 0.96 per 1,000 admissions, respectively. So far, only 1 study has evaluated the incidence rates of candidemia in tertiary care hospitals in Latin American countries.
To evaluate the epidemiology of candidemia in 4 tertiary care hospitals in São Paulo, Brazil.
Multicenter, laboratory-based surveillance of candidemia.
A total of 7,038 episodes of bloodstream infection were identified, and Candida species accounted for 282 cases (4%). The incidence rate of candidemia was 1.66 candidemic episodes per 1,000 hospital admissions. Candida albicans was the most frequently isolated Candida species in all hospitals, but Candida species other than C. albicans accounted for 62% of isolates, including predominantly Candida parapsilosis and Candida tropicalis. Azole resistance was restricted to only 2% of all Candida isolates (1 isolate of Candida glabrata and 4 isolates of Candida rugosa). Candidemia was mostly documented in surgical patients with long durations of hospital stay. The crude mortality rate was 61%, and advanced age and high Acute Physiology and Chronic Health Evaluation II score were both conditions independently associated with risk of death.
We observed in our series a higher incidence rate of candidemia than that reported in European countries and the United States. Advanced age and a high Acute Physiology and Chronic Health Evaluation II score were factors associated with a higher probability of death in candidemic patients. Fluconazole-resistant Candida strains are still a rare finding in our case-based study of candidemia.
The BaR-SPOrt experiment is designed to measure the E-mode
power spectrum of the Cosmic Microwave Background Polarization (CMBP)
in the multipole range 50 < l < 1000.
In the current configuration at 32 GHz
it can explore up to l = 400.
Recent low frequency observations of the target region show that
the synchrotron emission should not contamine the CMBP already at 32 GHz.
A 6-month observation of a 6° × 6° sky area
during the polar night, in ideal
environmental conditions, will allow the Italian-French collaboration
to both measure the E–mode power spectrum with appropriate sensitivity
and perform important tests of the anomalous dust emission.
The BaR-SPOrt 32 GHz instrument, now under test and ready
for operations by Spring 2005, is proposed
for 1–2 years Winter operations at Dome C.
We discuss and test a combined method to efficiently perform ground- and excited-state calculations for relaxed structures using both a quantum first-principles approach and a classical molecular-dynamics scheme. We apply this method to calculate the ground state, the optical properties, and the electronic excitations of Ge nanoparticles embedded in a cubic SiC matrix. Classical molecular dynamics is used to relax the large-supercell system. First-principles quantum techniques are then used to calculate the electronic structure and, in turn, the electronic excitation and optical properties. The proposed procedure is tested with data resulting from a full first-principles scheme. The agreement is quantitatively discussed between the results after the two computational paths with respect to the structure, the optical properties, and the electronic excitations. The combined method is shown to be applicable to embedded nanocrystals in large simulation cells for which the first-principle treatment of the ionic relaxation is presently out of reach, whereas the electronic, optical and excitation properties can already be obtained ab initio. The errors incurred from the relaxed structure are found to be non-negligible but controllable.
This study investigates and compares the deposition of Hf1-xSixO2 films from two suites of metalorganic CVD precursors. The first precursor suite has oxygen coordinated to the Si or Hf center and includes β-diketonate, alcoxide and acetoxy ligands. The second precursor suite has alkylamido ligands, which have nitrogen coordinated to the Hf or Si center. The process space for deposition of silicates was evaluated for controlling the composition of the silicate films while optimizing deposition rates for a manufacturable single-wafer process. The composition of the film, x, is controlled over the entire range by changing the composition of the precursor solution, Si:Si+Hf. The composition of the films, including hafnium, silicon, oxygen, carbon, and nitrogen content were measured by XPS. Both suites of precursors provide routes by which composition can be controlled in fully oxidized films with low carbon and nitrogen content. Film deposition rates are consistent with manufacturing requirements. The interfacial layers that were observed by HRTEM between the film and the substrate were thin (< 10Å) and possibly graded in composition.
Following recent works that report a non linear dependence of the lattice parameter versus composition in some semiconductor alloys the InGaAs/InP system has been investigated. The lattice parameter and the composition of InGaAs/InP lattice matched heterostructures have been independently determined by measuring the high resolution X-ray diffraction profile and the absorption of the X-ray beam diffracted from the InP substrate. In contrast with previous results that stated a linear dependence of the lattice parameter with composition, a 6% larger In content in the InGaAs/InP lattice matched alloy is found. Such result has been confirmed by the analysis of the X-ray fluorescence induced by an electron beam on the layer and on standards made of InAs and GaAs fine ground crystals. The result is in good agreement with the predictions of models based on the elasticity theory applied on a microscopic scale.
We present calculated values of effective masses, bandgap reduction, and Fermi energy of p-doped Si and strained p-doped SiGe layers. The calculations have been made for Ge concentrations in the range 0 to 30% and boron concentration in the range 1018 cm−3 to 3×1020 cm−3. Empirical expressions for the effective masses are given. These expressions and calculated values of the other parameters are convenient for use in computer codes for modeling device processing and performance. To validate the calculated values, we have compared them with the available experimental results. Good agreement between the calculated and the experimental values is found.
A new solid-state embedding approach has been developed which focuses on modelling the surfaces of polar materials. The method is applied to investigate the chemisorption of pre- methanol species on the polar (000-1) surface of zincite (a major phase of zinc oxide having the wurtzite structure). Initial results include the geometries of active sites and adsorbates in different charge states.
The observation of intense luminescence in Si/SiO2 superlattices (SLs) has lead to new theoretical research on silicon-based materials. We have performed first-principles calculations using three Si/SiO2 SL models in order to examine the role of interfaces on the electronic structure and optical properties. The first two models are derived directly from crystalline structures and have simple interfaces. These models have been studied using the full-potential, linearized-augmented-plane-wave method, in the local-density-approximation (LDA). The optical absorption within the interband transition theory (excluding excitonic effects) have been deduced. The Si(001)-SiO2 interface structure is shown to affect the optical behaviour. Following these observations, we have considered a more realistic, fully-relaxed model. The projector-augmented-wave method under the LDA is used to perform the structural relaxation as well as band structure and optical calculations. The role of confinement on the energy gap is studied by inserting additional silicon slabs into the supercell. Direct energy gaps are observed and the energy gap is found to decrease with increasing silicon slab thickness, as observed experimentally. The role of the interface has been considered in more details by studying the contribution to the energy gap of Si atoms having different oxidation patterns; partially oxidized Si atoms at the interface, as well as Si atoms inside the Si layer, are shown to contribute to the transitions at the energy gap.
We present a method to calculate impact ionization and Auger recombination rates within density functional theory and a screened-exchange approach and implement it in the all- electron FLAPW method. We investigate the dependence of the overlap matrix elements as a function of the states involved along the main symmetry lines of the Brillouin zone. Our results for the final impact ionization rates along the main symmetry lines of the Brillouin zone. Our results for the final impact ionization rates along τ — X and τ —L directions for GaAs show a strong anisotropy imposed by energy and momentum conservation and related to the use of a realistic and accurate sX-LDA band structure.