Frailty as a predictor of disabilities among community-dwelling older people: a systematic review and meta-analysis

BACKGROUND: Frailty has been shown to be associated with disability in the previous studies. However, it is not clear how consistently or to how much degree frailty is actually associated with the future disability risks. METHODS: A systematic review of the literature was conducted using Embase, MEDLINE, CINAHL, PsycINFO, and the Cochrane Library for any prospective studies published from 2010 to September 2015 examining associations between baseline frailty status and subsequent risk of developing or worsening disabilities among community-dwelling older people. A meta-analysis was performed to synthesize pooled estimates. RESULTS: Of 7012 studies identified through the systematic review, 20 studies were included in the meta-analysis. Twelve studies examined activities of daily living (ADL) disability risks, two studies examined instrumental activities of daily living (IADL) disability risks, and six studies examined both ADL and IADL disability risks. Overall, frail older people were more likely to develop or worsen disabilities in ADL (12 studies, pooled OR = 2.76, 95% CI = 2.23-3.44, p < 0.00001; 5 studies, pooled HR = 2.23, 95% CI = 1.42-3.49, p < 0.00001) and IADL (6 studies, pooled OR = 3.62, 95% CI = 2.32-5.64, p < 0.00001; 2 studies, pooled HR = 4.24, 95% CI = 0.85-21.28, p = 0.08). Prefrailty was also associated with incident or worsening disability risks to a lesser degree in most pooled analyses. High heterogeneity observed among 12 studies with OR of ADL disability risks for frailty was explored using subgroup analyses, which suggested methodological quality and mean age of the cohort were the possible causes. CONCLUSION: This systematic review meta-analysis quantitatively showed that frail older people are at higher risks of disabilities. These results are important for all related parties given population aging worldwide. Interventions for frailty are important to prevent disability and preserve physical functions, autonomy, and quality of life. Implications for Rehabilitation Although frailty has been shown to be associated with disability and considered as a precursor of disability, it is not clear how consistently or to how much degree frailty is actually associated with the future disability risks. This systematic review and meta-analysis quantitatively shows frailty is a significant predictor of incident and worsening ADL and IADL disabilities. It is a pressing priority to develop interventions for frailty to prevent disability and preserve older people's physical functions, autonomy, and quality of life

Influence of pure-dephasing by phonons on exciton-photon interfaces: Quantum microscopic theory

We have developed a full quantum microscopic theory to analyze the time evolution of transversal and longitudinal components of an exciton-single photon system coupled to bulk acoustic phonons. These components are subjected to two decay processes. One is radiative relaxation and the other is pure-dephasing due to exciton-phonon interaction. The former results in a decay with an exponent linear to time, while the latter causes a faster initial decay than the radiative decay. We analyzed the dependence of the components on the duration of the input one-photon pulse, temperature, and radiative relaxation rates. Such a quantitative analysis is important for the developments of atom-photon interfaces which enable coherent transfer of quantum information between photons and atomic systems. We found that, for a GaAs spherical quantum dot in which the exciton interacts with bulk phonons, the maximal probability of the excited state can be increased up to 75 %. This probability can be considered as the efficiency for quantum information transfer from photon to exciton.Comment: 9pages, 5figure

Frailty as a predictor of hospitalisation among community-dwelling older people: a systematic review and meta-analysis

BACKGROUND: Owing to detrimental hazards and substantial healthcare burden and costs, hospitalisation of older people has become a major focus. Frailty has increasingly been recognised as an important predictor of hospitalisation. This study aims to identify studies on physical frailty as a predictor of hospitalisation risks and to pool the risk estimates among community-dwelling older people. METHODS: A systematic literature search was performed in August 2015 using five databases: EMBASE, MEDLINE, CINAHL, PsycINFO and the Cochrane Library for prospective studies examining physical frailty as a predictor of hospitalisation published in 2000 or later. OR and HR were combined to synthesise pooled effect measures using fixed-effects models. The included studies were assessed for heterogeneity, methodological quality and publication bias. Subgroup analysis and meta-regression analysis were conducted to examine study characteristics in relation to the hospitalisation risks. RESULTS: Of the 4620 studies identified by the systematic review, 13 studies with average follow-up period of 3.1 years were selected. Frailty and prefrailty were significantly associated with higher hospitalisation risks among 10 studies with OR (pooled OR=1.90, 95% CI 1.74-2.07, p<0.00001; pooled OR=1.26, 95% CI 1.18-1.33, p<0.00001, respectively) and 3 studies with HR (pooled HR=1.30, 95% CI 1.12-1.52, p=0.0007; pooled HR=1.13, 95% CI 1.04-1.24, p=0.005, respectively). Heterogeneity was low to moderate. No publication bias was detected. The studies with older populations and unadjusted outcome measures were associated with higher hospitalisation risks in the subgroup analysis. CONCLUSIONS: This systematic review and meta-analysis demonstrated physical frailty is a significant predictor of hospitalisation among community-dwelling older people. Hospitalisation can potentially be reduced by treating or preventing frailty

Hydrothermal Ethanol Flames in Co-Flow Jets

Results on the autoignition and stabilization of ethanol hydrothermal flames in a Supercritical Water Oxidation (SCWO) reactor operating at constant pressure are reported. The flames are observed as luminous reaction zones occurring in supercritical water; i.e., water at conditions above its critical point (approximately 22 MPa and 374 C). A co-flow injector is used to inject fuel (inner flow), comprising an aqueous solution ranging from 20%-v to 50%-v ethanol, and air (annular flow) into a reactor filled with supercritical water at approximately 24.3 MPa and 425 C. Results show hydrothermal flames are autoignited and form diffusion flames which exhibit laminar and/or turbulent features depending upon flow conditions. Two orthogonal camera views are used; one providing a backlit shadowgraphic image of the co-flow jet and the other providing color images of the flame. In addition, spectroscopic measurements of flame emissions in the UV and visible spectrum are discussed

Neutrino mass effects on vector and tensor CMB anisotropies in the presence of a primordial magnetic field

If a primordial magnetic field (PMF) is present during photon decoupling and afterward, a finite neutrino mass can affect all modes of the CMB. In this work, we expand on earlier studies of the scalar mode effects by constructing the vector and tensor mode equations in the presence of massive neutrinos and a PMF. We compute the power spectrum of the various modes in an illustrative example and find that the neutrino mass can significantly affect the vector and tensor modes when a PMF exists, while the effects are negligible for no PMF. The most prominent result of the present analysis is the behavior of the EE component of the tensor mode at low multipoles. For massive neutrinos the EE mode can become comparable to the observed primary anisotropy. Therefore, if and when the EE mode power spectrum is measured at low multipoles the possibility exists to place a strong constraint on the sum of the neutrino masses.Comment: 11 pages, 8 figure

Interaction Effects in Conductivity of Si Inversion Layers at Intermediate Temperatures

We compare the temperature dependence of resistivity \rho(T) of Si MOSFETs with the recent theory by Zala et al. This comparison does not involve any fitting parameters: the effective mass m* and g*-factor for mobile electrons have been found independently. An anomalous increase of \rho with temperature, which has been considered a signature of the "metallic" state, can be described quantitatively by the interaction effects in the ballistic regime. The in-plane magnetoresistance \rho(B) is qualitatively consistent with the theory; however, the lack of quantitative agreement indicates that the magnetoresistance is more susceptible to the sample-specific effects than \rho(T).Comment: 4 pages, 5 figures. References update

Screenings and Vertex Operators of Quantum Superalgebra Uq(sl^(N∣1))U_q(\hat{{sl}}(N|1))

We construct the screening currents of the quantum superalgebra $U_q(\hat{sl}(N|1))$ for an arbitrary level $k \neq -N+1$. We show that these screening currents commute with the superalgebra modulo total difference. We propose bosonizations of the vertex operators by using the screening currents. We check that these vertex operators are the intertwiners among the Fock-Wakimoto representation and the typical representation for rank $N \leq 4$.Comment: 32 pages, LaTe

Free Field Realization of Quantum Affine Superalgebra Uq(sl^(N∣1))U_q(\hat{{sl}}(N|1))

We construct a free field realization of the quantum affine superalgebra $U_q(\hat{sl}(N|1))$ for an arbitrary level $k \in {\mathbb C}$.Comment: LaTEX 19 page