Increasing frailty is associated with higher prevalence and reduced recognition of delirium in older hospitalised inpatients: results of a multi-centre study

Purpose: Delirium is a neuropsychiatric disorder delineated by an acute change in cognition, attention, and consciousness. It is common, particularly in older adults, but poorly recognised. Frailty is the accumulation of deficits conferring an increased risk of adverse outcomes. We set out to determine how severity of frailty, as measured using the CFS, affected delirium rates, and recognition in hospitalised older people in the United Kingdom. Methods: Adults over 65 years were included in an observational multi-centre audit across UK hospitals, two prospective rounds, and one retrospective note review. Clinical Frailty Scale (CFS), delirium status, and 30-day outcomes were recorded. Results: The overall prevalence of delirium was 16.3% (483). Patients with delirium were more frail than patients without delirium (median CFS 6 vs 4). The risk of delirium was greater with increasing frailty [OR 2.9 (1.8–4.6) in CFS 4 vs 1–3; OR 12.4 (6.2–24.5) in CFS 8 vs 1–3]. Higher CFS was associated with reduced recognition of delirium (OR of 0.7 (0.3–1.9) in CFS 4 compared to 0.2 (0.1–0.7) in CFS 8). These risks were both independent of age and dementia. Conclusion: We have demonstrated an incremental increase in risk of delirium with increasing frailty. This has important clinical implications, suggesting that frailty may provide a more nuanced measure of vulnerability to delirium and poor outcomes. However, the most frail patients are least likely to have their delirium diagnosed and there is a significant lack of research into the underlying pathophysiology of both of these common geriatric syndromes

Efficacy of secondary closure technique after surgical removal of impacted lower third molars

The purpose of this study was to evaluate and compare the postoperative healing, using primary versus secondary closure techniques after impacted mandibular third molar removal. The study consisted of 86 patients, under 40 years of age were divided into two groups as Group A and Group B in the randomized fashion. In Group A, closure was done by primary intention and in Group B, by secondary closure. A comparison between both groups was done with a follow-up period of 6 h to 6 days with regards to postoperative pain and swelling. The swelling in group I was greater than that in group II, with a statistically significant difference (P < 0.05). The pain was worse in group I than in group II; a difference that also was statistically significant (P < 0.05). The study showed that the patients in the secondary closure group had a significantly lesser amount of pain and swelling postoperatively than the primary closure group

Prevalence of juxta-apical radiolucency and its association to inferior alveolar nerve injury during removal of impacted mandibular third molars

This study aimed to investigate the prevalence of juxta-apical radiolucency (JAR)- a well-defined area of radiolucency that is apical or lateral to the roots of the lower third molar. , and assessing its association to injury of the inferior alveolar nerve (IAN) during surgical removal of lower third molars. We evaluated 1250 panoramic radiographs and 1960 third molars for the presence of JAR.  The patients were assessed based on the presence or absence of JAR. These were further classified according to the impacted third molar’s angulation in relation to the adjacent second molar. The radiographic relationship of the mandibular canal and third molar was also noted. JAR was identified in 88 patients (4.4%). Out of the 88, 28 (31.8%) were males and 60 (68.1%) were females, which was statistically significant (P<0.02). There also was an association with teeth that were mesioangularly impacted which was not statistically significant. Radiographic signs of proximity to the mandibular canal were present in 48 (54.5%) of JAR cases. One (1.13%) of them reported with inferior alveolar nerve injury after the surgical procedure postoperatively. JAR was prevalent in 4.4% patients.&nbsp

Efficacy of Secondary Closure Technique After Surgical Removal of Impacted Lower Third Molars

The purpose of this study was to evaluate and compare the postoperative healing, using primary versus secondary closure techniques after impacted mandibular third molar removal. The study consisted of 86 patients, under 40 years of age were divided into two groups as Group A and Group B in the randomized Fashion. In Group A, closure was done by primary intention and in Group B, by secondary closure. A comparison between both groups was done with a follow-up period of 6 h to 6 days with regards to postoperative pain and swelling. The swelling in group I was greater than that in group II, with a statistically significant difference (P < 0.05). The pain was worse in group I than in group II; a difference that also was statistically significant (P < 0.05). The study showed that the patients in the secondary closure group had a significantly lesser amount of pain and swelling postoperatively than the primary closure group

Effectiveness of clonidine as a preanesthetic drug on intra operative blood loss in oral and maxillofacial surgery: A systematic review

Controlled hypotension during a surgical procedure is a way to decrease blood pressure and subsequently to improve the field of operation. Clonidine is an antihypertensive drug which acts through facilitation of Alph-2 post-synaptic receptors and in addition to its antihypertensive, anti-anxiety and analgesic effects, its beneficial effects in reducing the bleeding during. Correction of maxillomandibular discrepancies may necessitate performing osteotomy on both the jaws in several cases. Bimaxillary orthognathic surgery and rhinoplasty are procedures associated with significant blood making proper hemostasis essential for a surgical field that is free of excessive blood, reduced postoperative swelling, and appropriate surgical results. The aim of this systematic review is to assess the effectiveness of Clonidine as a pre-anesthetic drug on intraoperative blood loss in maxillofacial surgery. The Databases of PubMed, Cochrane and Google scholar were searched for the related topics along with a complimentary manual search of all oral surgery journals till January 2021. Articles were selected based on the inclusion criteria, which included all RCTs. From this study it is concluded that clonidine premedication is effective in reducing intraoperative blood loss as well as providing hemodynamic stability in patients undergoing different maxillofacial surgeries

Erratum to “Substantially enhanced photoelectrochemical performance of TiO2 nanorods/CdS nanocrystals heterojunction photoanode decorated with MoS2 nanosheets” [Appl. Catal. B 259 (2019) 118102]

The publisher regrets that the article has been published without proof-reading. Please find the correct version of the graphical abstract, Fig. 7, Table 2 and acknowledgement. The publisher would like to apologise for any inconvenience caused. [Figure presented] [Figure presented] Fig. 7 Schematic diagram illustrating the charge transport mechanism in TiO2/CdS/MoS2photoanode. Table 2. The PEC performance of different TiO2/chalcogenide based systems in the presence of Na2S and Na2SO3in electrolyte at 0.5 V vs. RHE under one sun illumination. [Table presented] © 2019 Elsevier B.V

Substantially enhanced photoelectrochemical performance of TiO2 nanorods/CdS nanocrystals heterojunction photoanode decorated with MoS2 nanosheets

Two-dimensional (2D) MoS2 nanosheets (NSs) modified 1D TiO2 nanorods/0D CdS nanocrystals (NCs) heterojunction has been fabricated by all solution process as a potential anode for photoelectrochemical (PEC) water splitting applications. This heterojunction photoanode shows high photocurrent density of 3.25 mA/cm2 at 0.9 V vs. RHE (0 V vs. Ag/AgCl) compared to the pristine TiO2/CdS photoanode. The influence of MoS2 NSs on PEC performance of TiO2/CdS/MoS2 heterojunction has been systematically investigated. We demonstrate that MoS2 NSs transfer holes from CdS and facilitate further charge separation in TiO2/CdS. Time resolved photoluminescence measurement reveals increase in photoluminescence lifetime due to the presence of MoS2 NSs in TiO2/CdS/MoS2 resulting in enhanced PEC activity. This work suggests that 1D TiO2/0D CdS/2D MoS2 heterojunction prototype is an interesting system where MoS2 NSs can be utilized to improve charge separation in photoanodes. This study would pave the way towards designing new heterojunction functional materials for efficient PEC applications

Nanostructured Na 2 Ti 9 O 19 for Hybrid Sodium-Ion Capacitors with Excellent Rate Capability

Herein, we report a new Na-insertion electrode material, Na2Ti9O19, as a potential candidate for Na-ion hybrid capacitors. We study the structural properties of nanostructured Na2Ti9O19, synthesized by a hydrothermal technique, upon electrochemical cycling vs Na. Average and local structures of Na2Ti9O19 are elucidated from neutron Rietveld refinement and pair distribution function (PDF), respectively, to investigate the initial discharge and charge events. Rietveld refinement reveals electrochemical cycling of Na2Ti9O19 is driven by single-phase solid solution reaction during (de)sodiation without any major structural deterioration, keeping the average structure intact. Unit cell volume and lattice evolution on discharge process is inherently related to TiO6 distortion and Na ion perturbations, while the PDF reveals the deviation in the local structure after sodiation. Raman spectroscopy and X-ray photoelectron spectroscopy studies further corroborate the average and local structural behavior derived from neutron diffraction measurements. Also, Na2Ti9O19 shows excellent Na-ion kinetics with a capacitve nature of 86% at 1.0 mV s–1, indicating that the material is a good anode candidate for a sodium-ion hybrid capacitor. A full cell hybrid Na-ion capacitor is fabricated by using Na2Ti9O19 as anode and activated porous carbon as cathode, which exhibits excellent electrochemical properties, with a maximum energy density of 54 Wh kg–1 and a maximum power density of 5 kW kg–1. Both structural insights and electrochemical investigation suggest that Na2Ti9O19 is a promising negative electrode for sodium-ion batteries and hybrid capacitors

Photoluminescence tuning of Na_1−xK_xNdW₂O₈ (0.0 ≤ x ≤ 0.7) nanoparticles: synthesis, crystal structure and Raman study

A series of Na_1−xK_xNdW₂O₈ (0.0 ≤ x ≤ 0.7) nanoparticles have been synthesized by an efficient glycothermal technique for the first time. SEM measurements confirmed the particle size ranges from 30–200 nm with ellipsoidal shaped morphology. Combined X-ray and neutron diffraction and Raman spectroscopy techniques were utilized in order to investigate the influence of K⁺ ion substitution in NaNdW₂O₈. K⁺ ion substitution in the crystal lattice introduced a change in the Nd–O bond length and the Nd–O–W bond angle of NaNdW₂O₈. The photoluminescence intensity increased up to the threshold composition x = 0.4. K⁺ ion substitution resulted in blue shifted emission of NaNdW₂O₈. Size mismatch, the Nd–O–W angle and local disorder contributed to the observed difference in luminescence properties. Also, the chromaticity diagram for this blue emitting phosphor showed the possibility of tuning the emission by incorporation of K

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