Nutritional status and nutritional treatment are related to outcomes and mortality in older adults with hip fracture

Malnutrition is very prevalent in geriatric patients with hip fracture. Nevertheless, its importance is not fully recognized. The objective of this paper is to review the impact of malnutrition and of nutritional treatment upon outcomes and mortality in older people with hip fracture. We searched the PubMed database for studies evaluating nutritional aspects in people aged 70 years and over with hip fracture. The total number of studies included in the review was 44, which analyzed 26,281 subjects (73.5% women, 83.6 ± 7.2 years old). Older people with hip fracture presented an inadequate nutrient intake for their requirements, which caused deterioration in their already compromised nutritional status. The prevalence of malnutrition was approximately 18.7% using the Mini-Nutritional Assessment (MNA) (large or short form) as a diagnostic tool, but the prevalence was greater (45.7%) if different criteria were used (such as Body Mass Index (BMI), weight loss, or albumin concentration). Low scores in anthropometric indices were associated with a higher prevalence of complications during hospitalization and with a worse functional recovery. Despite improvements in the treatment of geriatric patients with hip fracture, mortality was still unacceptably high (30% within 1 year and up to 40% within 3 years). Malnutrition was associated with an increase in mortality. Nutritional intervention was cost effective and was associated with an improvement in nutritional status and a greater functional recovery. To conclude, in older people, the prevention of malnutrition and an early nutritional intervention can improve recovery following a hip fracture

Tracing out the Northern Tidal Stream of the Sagittarius Dwarf Spheoridal Galaxy

The main aim of this paper is to report two new detections of tidal debris in the northern stream of the Sagittarius dwarf galaxy located at 45 arcdeg and 55 arcdeg from the center of galaxy. Our observational approach is based on deep color-magnitude diagrams, that provides accurate distances, surface brightness and the properties of stellar population of the studied region of this tidal stream. The derived distances for these tidal debris wraps are 45 kpc and 54 kpc respectively.We also confirm these detections with numerical simulations of the Sagittarius dwarf plus the Milky Way. The model reproduces the present position and velocity of the Sagittarius main body and presents a long tidal stream formed by tidal interaction with the Milky Way potential. This model is also in good agreement with the available observations of the Sagittarius tidal stream. We also present a method for estimating the shape of the Milky Way halo potential using numerical simulations. From our simulations we obtain an oblateness of the Milky Way dark halo potential of 0.85, using the current database of distances and radial velocities of the Sagittarius tidal stream. The color-magnitude diagram of the apocenter of Sagittarius shows that this region of the stream shares the complex star formation history observed in the main body of the galaxy. We present the first evidence for a gradient in the stellar population along the stream, possibly correlated with its different pericenter passages. (abridged)Comment: 43 pages (including 15 figures; for high resolution color figures, please contact [email protected]). Submitted to Ap

Errors on the inverse problem solution for a noisy spherical gravitational wave antenna

A single spherical antenna is capable of measuring the direction and polarization of a gravitational wave. It is possible to solve the inverse problem using only linear algebra even in the presence of noise. The simplicity of this solution enables one to explore the error on the solution using standard techniques. In this paper we derive the error on the direction and polarization measurements of a gravitational wave. We show that the solid angle error and the uncertainty on the wave amplitude are direction independent. We also discuss the possibility of determining the polarization amplitudes with isotropic sensitivity for any given gravitational wave source.Comment: 13 pages, 4 figures, LaTeX2e, IOP style, submitted to CQ

Voltage Stability Analysis of Grid-Connected Wind Farms with FACTS: Static and Dynamic Analysis

Recently, analysis of some major blackouts and failures of power system shows that voltage instability problem has been one of the main reasons of these disturbances and networks collapse. In this paper, a systematic approach to voltage stability analysis using various techniques for the IEEE 14-bus case study, is presented. Static analysis is used to analyze the voltage stability of the system under study, whilst the dynamic analysis is used to evaluate the performance of compensators. The static techniques used are Power Flow, V–P curve analysis, and Q–V modal analysis. In this study, Flexible Alternating Current Transmission system (FACTS) devices- namely, Static Synchronous Compensators (STATCOMs) and Static Var Compensators (SVCs) - are used as reactive power compensators, taking into account maintaining the violated voltage magnitudes of the weak buses within the acceptable limits defined in ANSI C84.1. Simulation results validate that both the STATCOMs and the SVCs can be effectively used to enhance the static voltage stability and increasing network loadability margin. Additionally, based on the dynamic analysis results, it has been shown that STATCOMs have superior performance, in dynamic voltage stability enhancement, compared to SVCs

Enfermedad de pompe: presentación de un caso

Presentamos el caso de una niña de 6 meses de ascendencia china con enfermedad de Pompe diagnosticada a partir de una miocardiopatía hipertrófica biventricular e hipotonía global. En esta enfermedad el acúmulo de glucógeno lisosomal principalmente en el corazón y músculo esquelético ocasiona la mayoría de la sintomatología clínica. En esta paciente la hipotonía generalizada, macroglosia, debilidad en el llanto y la confirmación ecocardiográfica de una miocardiopatía hipertrófica biventricular fueron el punto inicial para la sospecha clínica de la enfermedad que, junto a la elevación de enzimas musculares y hepáticas, condujo al estudio de alfa-glucosidasa ácida (AGA) que confirmó el diagnóstico. Desde 2006 existe terapia de reemplazo enzimático que permite mejorar la sobrevida y la calidad de vida si el diagnóstico se realiza precozmente.We are presenting the case of a 7 month old infant with infantile Pompe disease, who was the first case treated by enzyme replacement therapy (ERT) at our Hospital.The patient was of chinese ancestry and was suspected to have the disease after finding biventricular hypertrophic myocardiopathy and muscle weakness and hypotonia. Other relevant features were macroglosia and increase in CK level as well as the results of the electrophysiology studies. In view of the new possibility of ERT, educational efforts must be done in order to perform early diagnosis before signs of severe cardiorespiratory failure develops, and to improve survival and quality of life of patients with this condition

Response of Growing Dairy Bulls to Dietary Tannin in Rations with Varying Energy Levels

This study was conducted to determine the effect of dietary tannin on growth performance, rumen fluid characteristics, and apparent total-tract digestibility in growing Holstein-Friesian x Sahiwal bulls fed low and high energy rations. Eighteen growing bulls with initial body weight (BW) of 162.8±12.7 kg at 15±0.80 months were used in an unbalanced randomized complete block design set-up in a 2x2 factorial arrangement. The experimental animals were blocked by their respective BW. Animals were fed with concentrates containing metabolizable energy (ME) at 2.47 and 2.72 Mcal/kg without or with 20g/kg tannin in dry matter basis. At the final week of the trial, rumen fluid and fecal samples were collected for the rumen fluid characteristics and apparent total-tract digestibility analyses. No differences (p>0.05) were observed between the growth performance, rumen gas production, volatile fatty acids as well as organic matter, crude protein, and energy digestibility. High energy concentrates had higher (p<0.05) dry matter and neutral detergent fiber digestibility than low energy concentrates. Low energy concentrates without tannin had cheaper (p<0.001) total feed cost but feed cost per kilogram BW gain was similar (p>0.05) across treatments. Feed savings costs of US$ 17.58 per animal were attained in feeding low energy concentrates without tannin. Therefore, feeding concentrates containing 2.47 Mcal/kg ME without additional tannin can still be fed economically to growing cattle without any adverse effect on growth, ruminal fermentation characteristics, and apparent total-tract digestibility

Thyroid-Associated Orbitopathy and Biomarkers: Where We Are and What We Can Hope for the Future.

Thyroid-associated orbitopathy (TAO) is the most common autoimmune disease of the orbit. It occurs more often in patients presenting with hyperthyroidism, characteristic of Graves' disease, but may be associated with hypothyroidism or euthyroidism. The diagnosis of TAO is based on clinical orbital features, radiological criteria, and the potential association with thyroid disease. To date, there is no specific marker of the orbital disease, making the early diagnosis difficult, especially if the orbital involvement precedes the thyroid dysfunction. The goal of this review is to present the disease and combine the available data in the literature concerning investigation of TAO biomarkers. Despite the progress done in the understanding of TAO disease, some important pieces are still missing. Typically, for the future, major efforts have to be done in the discovery of new biomarkers, validation of the suspected candidates on multicenter cohorts with standardized methodologies, and establishment of their clinical performances on the specific clinical application fields in order to improve not only the management of the TAO patients but also the therapeutic options and follow-up

Critical Thinking Activities and the Enhancement of Ethical Awareness: An application of a ‘Rhetoric of Disruption’ to the undergraduate general education classroom

This article explores how critical thinking activities and assignments can function to enhance students’ ethical awareness and sense of civic responsibility. Employing Levinas’s Othercentered theory of ethics, Burke’s notion of ‘the paradox of substance’, and Murray’s concept of ‘a rhetoric of disruption’, this article explores the nature of critical thinking activities designed to have students question their (often taken-for-granted) moral assumptions and interrogate their (often unexamined) moral identities. This article argues that such critical thinking activities can trigger a metacognitive destabilization of subjectivity, understood as a dialectical prerequisite (along with exposure to otherness) for increased ethical awareness. This theoretical model is illustrated through a discussion of three sample classroom activities designed to destabilize moral assumptions and identity, thereby clearing the way for a heightened acknowledgment of otherness. In so doing, this article provides an alternative (and dialectically inverted) strategy for addressing one of the central goals of many General Education curricula: the development of ethical awareness and civic responsibility. Rather than introducing students to alternative perspectives and divergent cultures with the expectation that heightened moral awareness will follow, this article suggests classroom activities and course assignments aimed at disrupting moral subjectivity and creating an opening in which otherness can be more fully acknowledged and the diversity of our world more fully appreciated