29 research outputs found
Prevalence of Frailty in European Emergency Departments (FEED): an international flash mob study
Introduction
Current emergency care systems are not optimized to respond to multiple and complex problems associated with frailty. Services may require reconfiguration to effectively deliver comprehensive frailty care, yet its prevalence and variation are poorly understood. This study primarily determined the prevalence of frailty among older people attending emergency care.
Methods
This cross-sectional study used a flash mob approach to collect observational European emergency care data over a 24-h period (04 July 2023). Sites were identified through the European Task Force for Geriatric Emergency Medicine collaboration and social media. Data were collected for all individuals aged 65 + who attended emergency care, and for all adults aged 18 + at a subset of sites. Variables included demographics, Clinical Frailty Scale (CFS), vital signs, and disposition. European and national frailty prevalence was determined with proportions with each CFS level and with dichotomized CFS 5 + (mild or more severe frailty).
Results
Sixty-two sites in fourteen European countries recruited five thousand seven hundred eighty-five individuals. 40% of 3479 older people had at least mild frailty, with countries ranging from 26 to 51%. They had median age 77 (IQR, 13) years and 53% were female. Across 22 sites observing all adult attenders, older people living with frailty comprised 14%.
Conclusion
40% of older people using European emergency care had CFS 5 + . Frailty prevalence varied widely among European care systems. These differences likely reflected entrance selection and provide windows of opportunity for system configuration and workforce planning
Whole-genome sequencing reveals host factors underlying critical COVID-19
Critical COVID-19 is caused by immune-mediated inflammatory lung injury. Host genetic variation influences the development of illness requiring critical care1 or hospitalization2,3,4 after infection with SARS-CoV-2. The GenOMICC (Genetics of Mortality in Critical Care) study enables the comparison of genomes from individuals who are critically ill with those of population controls to find underlying disease mechanisms. Here we use whole-genome sequencing in 7,491 critically ill individuals compared with 48,400 controls to discover and replicate 23 independent variants that significantly predispose to critical COVID-19. We identify 16 new independent associations, including variants within genes that are involved in interferon signalling (IL10RB and PLSCR1), leucocyte differentiation (BCL11A) and blood-type antigen secretor status (FUT2). Using transcriptome-wide association and colocalization to infer the effect of gene expression on disease severity, we find evidence that implicates multiple genes—including reduced expression of a membrane flippase (ATP11A), and increased expression of a mucin (MUC1)—in critical disease. Mendelian randomization provides evidence in support of causal roles for myeloid cell adhesion molecules (SELE, ICAM5 and CD209) and the coagulation factor F8, all of which are potentially druggable targets. Our results are broadly consistent with a multi-component model of COVID-19 pathophysiology, in which at least two distinct mechanisms can predispose to life-threatening disease: failure to control viral replication; or an enhanced tendency towards pulmonary inflammation and intravascular coagulation. We show that comparison between cases of critical illness and population controls is highly efficient for the detection of therapeutically relevant mechanisms of disease
Associations between the metabolic syndrome and retinal microvascular signs: The atherosclerosis risk in communities study
10.1167/iovs.04-0069Investigative Ophthalmology and Visual Science4592949-2954IOVS
Serum and hair zinc in severely malnourished Bangladeshi children associated with or without acute lower respiratory infection
Combinatorial Optimization in a Cattle Yard: Feed Distribution, Vehicle Scheduling, Lot Sizing, and Dynamic Pen Assignment
Creating Countertrade Opportunities in Financially Distressed Developing Countries: Framework and Nigerian Example
Análise genética da habilidade de permanência em fêmeas da raça Nelore Genetic analysis of stayability among Nelore females
O objetivo deste estudo foi verificar a possibilidade da característica habilidade de permanência (HP) de matrizes ser utilizada como critério de seleção na raça Nelore. A HP foi definida como a probabilidade de uma vaca parir, no rebanho, na idade de seis anos ou depois desta idade, dado que ela teve uma parição em data anterior. Foram analisadas informações de 55.682 animais. Utilizou-se a amostragem de Gibbs para estimar os componentes de variância e um modelo de limiar de máximo a posteriori para predizer os valores genéticos. A análise forneceu estimativa posterior de herdabilidade e desvio-padrão de 0,21 ± 0,00 e tendência genética, média por ano, de 0,14% para HP. A facilidade de mensuração da característica, a estimativa de herdabilidade e a tendência indicam que a utilização desta característica como critério de seleção pode contribuir para o aumento da fertilidade do rebanho.<br>The purpose of this study was to analyse of the stayability trait (STAY) of Nelore cows. Stayability was defined as the probability of calving at a specific age, or after that age, given that the cow calved at least one time prior to that age. The study focused specifically on six year old groups, and the information corresponding to 55,682 animals were analysed. The data were analysed based on an a posteriori maximum threshold model to predict the genetic values, while the Gibbs sample was used to estimate the variance components. The analyses provided heritability estimate and standard deviation of 0.21 ± 0.003 and average genetic tendency a year was of 0.14% for STAY. The estimates indicate that the use of this trait as a criterion for selection may contribute toward increased female fertility