Validating a methodology to measure frailty syndromes at hospital level utilising administrative data.

BACKGROUND: Identifying older people with clinical frailty, reliably and at scale, is a research priority. We measured frailty in older people using a novel methodology coding frailty syndromes on routinely collected administrative data, developed on a national English secondary care population, and explored its performance of predicting inpatient mortality and long length of stay at a single acute hospital. METHODOLOGY: We included patient spells from Secondary User Service (SUS) data for those ≥65 years with attendance to the emergency department or admission to West Middlesex University Hospital between 01 July 2016 to 01 July 2017. We created eight groups of frailty syndromes using diagnostic coding groups. We used descriptive statistics and logistic regression to explore performance of diagnostic coding groups for the above outcomes. RESULTS: We included 17,199 patient episodes in the analysis. There was at least one frailty syndrome present in 7,004 (40.7%) patient episodes. The resultant model had moderate discrimination for inpatient mortality (area under the receiver operating characteristic curve (AUC) 0.74; 95% confidence interval (CI) 0.72-0.76) and upper quartile length of stay (AUC 0.731; 95% CI 0.722-0.741). There was good negative predictive value for inpatient mortality (98.1%). CONCLUSIONS: Coded frailty syndromes significantly predict outcomes. Model diagnostics suggest the model could be used for screening of elderly patients to optimise their care

Lipid droplet detection by the cavity perturbation method

There are currently no point-of-care diagnosis strategies available to indicate the presence of neoplasmic growth. This research aims to develop a novel diagnostic strategy based on detecting TAG accumulation in cells. This element of the research is a preliminary experiment to prove the concept of detecting TAG lipid droplets in YEPD media. It was found that a change in mono-unsaturated concentration can be detected by the frequency shift in a resonant cavity. The dielectric constant of TAG vegetable oils was calculated at 2.34-2.39. It was also found that concentrations of lipid droplet can be differentiated up to 5% (v/v)

The ‘Volatile’ World of Vapor Intrusion: Understanding Vapor Intrusion Regulation and the Potential for Litigation

This article provides a conceptual overview of vapor intrusion, identifies available guidance for assessment of the vapor intrusion pathway, and examines the potential for government enforcement actions, citizen suits, and tort suits involving vapor intrusion

Holocene record of Tuggerah Lake estuary development on the Australian east coast: sedimentary responses to sea-level fluctuations and climate variability

We investigated the Holocene palaeo-environmental record of the Tuggerah Lake barrier estuary on the south-east coast of Australia to determine the influence of local, regional and global environmental changes on estuary development. Using multi-proxy approaches, we identified significant down-core variation in sediment cores relating to sea-level rise and regional climate change. Following erosion of the antecedent land surface during the post-glacial marine transgression, sediment began to accumulate at the more seaward location at ~8500. years before present, some 1500. years prior to barrier emplacement and ~4000. years earlier than at the landward site. The delay in sediment accumulation at the landward site was a consequence of exposure to wave action prior to barrier emplacement, and due to high river flows of the mid-Holocene post-barrier emplacement. As a consequence of the mid-Holocene reduction in river flows, coupled with a moderate decline in sea-level, the lake experienced major changes in conditions at ~4000. years before present. The entrance channel connecting the lake with the ocean became periodically constricted, producing cyclic alternation between intervals of fluvial- and marine-dominated conditions. Overall, this study provides a detailed, multi-proxy investigation of the physical evolution of Tuggerah Lake with causative environmental processes that have influenced development of the estuary

Do ENSO and coastal development enhance coastal burial of terrestrial carbon?

Carbon cycling on the east coast of Australia has the potential to be strongly affected by El Niño-Southern Oscillation (ENSO) intensification and coastal development (industrialization and urbanization). We performed paleoreconstructions of estuarine sediments from a seagrass-dominated estuary on the east coast of Australia (Tuggerah Lake, New South Wales) to test the hypothesis that millennial-scale ENSO intensification and European settlement in Australia have increased the transfer of organic carbon from land into coastal waters. Our data show that carbon accumulation rates within coastal sediments increased significantly during periods of maximum millennial-scale ENSO intensity ("super-ENSO") and coastal development. We suggest that ENSO and coastal development destabilize and liberate terrestrial soil carbon, which, during rainfall events (e.g., La Niña), washes into estuaries and becomes trapped and buried by coastal vegetation (seagrass in this case). Indeed, periods of high carbon burial were generally characterized as having rapid sedimentation rates, higher content of fine-grained sediments, and increased content of wood and charcoal fragments. These results, though preliminary, suggest that coastal development and ENSO intensificationboth of which are predicted to increase over the coming centurycan enhance capture and burial of terrestrial carbon by coastal ecosystems. These findings have important relevance for current efforts to build an understanding of terrestrial- marine carbon connectivity into global carbon budgets

Heuristics for Broader Assessment of Effectiveness and Usability in Technology-Mediated Technical Communication

Purpose: To offer additional tools for the assessment of effectiveness and usability in technology-mediated communication based in established heuristics. Method: An interdisciplinary group of researchers at Rensselaer Polytechnic Institute selected five disparate examples of technology-mediated communication, formally evaluated each using contemporary heuristics, and then engaged in an iterative design process to arrive at an expanded toolkit for in depth analyses. Results: A set of heuristics and operationalized metrics for the deeper analysis of a broader scope of contemporary technology-mediated communication. Conclusions: The continual evolution of communication, including the emergence of new, interactive media, provides a challenging opportunity to identify effective approaches and techniques. There are benefits to a renewed focus on relationships between people and between people and information, and we offer additional criteria and metrics to supplement established means of heuristic analysis

Pengaruh Harga Terhadap Peningkatan Penjualan Produk Semen Tiga Roda Pada PT. Robcaga Beo Kabupaten Kepulauan Talaud

The development in business world these days is market by the competition between the business company is getting fierce. Especially in managing the company business unit. It is shown by the appearance of a company that offer a good quality product with a compete price on the market. To handle the fierce competition on the market then one from so many effort that the company do is by apply the strategic price. Which on the way of applying that strategi the company try to set a price that can be compete in the market so the increase sale of the product become maximum. With right price and controlled will result the domino effect to a company to build long term relationship with costumer so it can increase the sales volume. This research is a descriptive quantitative research by using the correlation approach and simple regression. To see relation between variable and to measure the impact to the variable itself. So the purpose of this research is to know how far the price effect and to the increase of PT. ROBCAGA in Talaud. According to the sesult of the research, can be shown as following: price has a correlation and significant determination effort to the increase sale of PT. ROBCAGA Talaud. According to the data analysis, coefficient value moment r = 0,685. That show there is a positive relation, and can be categorize as high and strong, also price coefficient determination to the increase sale is by 46,5% and 53,5% by the rest of it depends on the unknown factors that not been analyze in this research

Be outraged: there are alternatives

Pushed to extremes, austerity is bad economics, bad arithmetic, and ignores the lessons of history. We, an international group of economists and social scientists, are outraged at the narrow range of austerity policies which are bringing so many people around the world to their knees, especially in Europe. Austerity and cutbacks are reducing growth and worsening poverty. In our professional opinions, there are alternatives – for Britain, Europe and all countries that currently imagine that government cutbacks are the only way out of debt. The low-growth, no-growth trap means that the share of debt in GNP falls ever more slowly, if at all. It may even rise – as it has in some countries