Frailty and the impacts of the COVID-19 pandemic on community-living middle-aged and older adults:an analysis of data from the Canadian Longitudinal Study on Aging (CLSA)

BACKGROUND: frailty imparts a higher risk for hospitalisation, mortality and morbidity due to COVID-19 infection, but the broader impacts of the pandemic and associated public health measures on community-living people with frailty are less known. METHODS: we used cross-sectional data from 23,974 Canadian Longitudinal Study on Aging participants who completed a COVID-19 interview (Sept-Dec 2020). Participants were included regardless of whether they had COVID-19 or not. They were asked about health, resource, relationship and health care access impacts experienced during the pandemic. Unadjusted and adjusted prevalence of impacts was estimated by frailty index quartile. We further examined if the relationship with frailty was modified by sex, age or household income. RESULTS: community-living adults (50-90 years) with greater pre-pandemic frailty reported more negative impacts during the first year of the pandemic. The frailty gradient was not explained by socio-demographic or health behaviour factors. The largest absolute difference in adjusted prevalence between the most and least frail quartiles was 15.1% (challenges accessing healthcare), 13.3% (being ill) and 7.4% (increased verbal/physical conflict). The association between frailty and healthcare access differed by age where the youngest age group tended to experience the most challenges, especially for those categorised as most frail. CONCLUSION: although frailty has been endorsed as a tool to inform estimates of COVID-19 risk, our data suggest it may have a broader role in primary care and public health by identifying people who may benefit from interventions to reduce health and social impacts of COVID-19 and future pandemics.</p

A Deterioration in Hearing is Associated With Functional and Cognitive Impairments, Difficulty With Communication and Greater Health Instability

Objectives: To examine the relationship between hearing deterioration and several health-related outcomes among home care clients in Ontario. Design: Longitudinal analysis was completed for clients with at least two comprehensive assessments. Hearing status, based on a single item, ranged from zero (no impairment) to three (highly impaired). Hearing deterioration was defined as at least a 1-point decline between subsequent assessments. Results: Seven percent experienced a 1-point deterioration in hearing and roughly 1% had a 2/3-point decline. After adjusting for other covariates, increasing age (odds ratio = 1.94; 95% confidence intervals [CIs] = [1.45, 2.61]) and a diagnosis of Alzheimer\u27s disease (1.37; CI = [1.04, 1.80]) and other dementias (1.32; CI = [1.07, 1.63]) increased the risk of a 2/3-point deterioration. Conclusion: These findings can assist home care professionals and policy makers in creating and refining interventions to meet the needs of older adults with hearing difficulties

Niobium tungsten oxides for high-rate lithium-ion energy storage.

The maximum power output and minimum charging time of a lithium-ion battery depend on both ionic and electronic transport. Ionic diffusion within the electrochemically active particles generally represents a fundamental limitation to the rate at which a battery can be charged and discharged. To compensate for the relatively slow solid-state ionic diffusion and to enable high power and rapid charging, the active particles are frequently reduced to nanometre dimensions, to the detriment of volumetric packing density, cost, stability and sustainability. As an alternative to nanoscaling, here we show that two complex niobium tungsten oxides-Nb16W5O55 and Nb18W16O93, which adopt crystallographic shear and bronze-like structures, respectively-can intercalate large quantities of lithium at high rates, even when the sizes of the niobium tungsten oxide particles are of the order of micrometres. Measurements of lithium-ion diffusion coefficients in both structures reveal room-temperature values that are several orders of magnitude higher than those in typical electrode materials such as Li4Ti5O12 and LiMn2O4. Multielectron redox, buffered volume expansion, topologically frustrated niobium/tungsten polyhedral arrangements and rapid solid-state lithium transport lead to extremely high volumetric capacities and rate performance. Unconventional materials and mechanisms that enable lithiation of micrometre-sized particles in minutes have implications for high-power applications, fast-charging devices, all-solid-state energy storage systems, electrode design and material discovery.K.J.G. gratefully acknowledges support from The Winston Churchill Foundation of the United States, the Herchel Smith Scholarship, and the Science and Technology Facilities Council Futures Early Career Award. K.J.G and C.P.G thank the EPSRC via the LIBATT grant (EP/P003532/1). L.E.M. was funded by the European Union’s Horizon 2020 – European Union research and innovation program under the Marie Skłodowska–Curie grant agreement No. 750294. We thank Dr. Ieuan Seymour, University of Cambridge, and Prof. Bruce Dunn, University of California, Los Angeles, for fruitful discussions. We thank Drs. Jeremy Skepper and Heather Greer, University of Cambridge, for assistance with the electron microscopy and Dr. Maxim Avdeev, Bragg Institute, for his bond valence sum mapping program. We thank Dr. Olaf Borkiewicz, Advanced Photon Source, Argonne National Laboratory and Alisha Kasam, University of Cambridge for diffraction data reduction scripts. We thank Diamond Light Source for access to beamline B18 (SP14956, SP16387, SP17913) that contributed to the results presented here. This research used resources of the Advanced Photon Source, a U.S. Department of Energy (DOE) Office of Science User Facility operated for the DOE Office of Science by Argonne National Laboratory under Contract No. DE- AC02-06CH11357

Synthesis of polymeric bismuth chlorido hydroxamato complexes; X-ray crystal structure and antibacterial activity of a novel Bi(lll) salicylhydroxamato complex

Reaction of salicylhydroxamic acid (Sha) and 2-aminophenyl hydroxamic acid (2-NH2-pha) with BiCl3 affords the corresponding novel polymeric bismuth chlorido hydroxamato complexes; [BiCl2(-Sha-1H)]∞ and [BiCl3(--Pha-1H)]∞ respectively. The X-ray crystal structure of the THF-solvated polymeric bismuth chlorido salicylhydroxamato complex, [BiCl2(-Sha-1H)(THF)]∞ was solved, confirming the polymeric structure of this class of compounds and the (O,μ-O’)-bidentate bridging coordination mode of the hydroxamato ligand. The antibacterial activity of the THF-free polymeric bismuth chlorido salicylhydroxamato complex, [BiCl2(-Sha-1H)]∞, was investigated against a broad panel of bacteria, further highlighting the antibacterial properties of Bi-based compounds against Gram-positive and Gram-negative pathogenic and environmental strains of bacteria

Evaluation of serum cytokines in cats with and without degenerative joint disease and associated pain

Degenerative joint disease is common in cats, with signs of pain frequently found on orthopedic examination and radiographs often showing evidence of disease. However, understanding of the pathophysiology of degenerative joint disease and associated pain remains limited. Several cytokines have been identified as having a role in pain in humans, but this has not been investigated in cats. The present study was performed to use a multiplex platform to evaluate the concentration of 19 cytokines and chemokines in serum samples obtained from cats with and without degenerative joint disease and associated pain. Samples from a total of 186 cats were analyzed, with cats representing a range of severity on radiographic and orthopedic evaluations and categorized by degenerative joint disease scores and pain scores. Results showed that cats with higher radiographic degenerative joint disease scores have higher serum concentrations of IL-4 and IL-8, while cats with higher orthopedic exam pain scores have higher concentrations of IL-8, IL-2, and TNF-α increased concentration of IL-8 in degenerative joint disease and pain may be confounded by the association with age. Discriminant analysis was unable to identify one or more cytokines that distinguish between groups of cats classified based on degenerative joint disease score category or pain score category. Finally, cluster analysis driven by analyte concentrations show separation of groups of cats, but features defining the groups remain unknown. Further studies are warranted to investigate any changes in cytokine concentrations in response to analgesic therapies, and further evaluate the elevations in cytokine concentrations found here, particularly focused on studies of local cytokines present in synovial fluid

An Exploration of Methods to Resolve Inconsistent Self-Reporting of Chronic Conditions and Impact on Multimorbidity in the Canadian Longitudinal Study on Aging

OBJECTIVES: To quantify inconsistent self-reporting of chronic conditions between the baseline (2011-2015) and first follow-up surveys (2015-2018) in the Canadian Longitudinal Study on Aging (CLSA), and to explore methods to resolve inconsistent responses and impact on multimorbidity.METHODS: Community-dwelling adults aged 45-85 years in the baseline and first follow-up surveys were included ( n = 45,184). At each survey, participants self-reported whether they ever had a physician diagnosis of 35 chronic conditions. Identifiable inconsistent responses were enumerated. RESULTS: 32-40% of participants had at least one inconsistent response across all conditions. Illness-related information (e.g., taking medication) resolved most inconsistent responses (&gt;93%) while computer-assisted software asking participants to confirm their inconsistent disease status resolved ≤53%. Using these adjudication methods, multimorbidity prevalence at follow-up increased by ≤1.6% compared to the prevalence without resolving inconsistent responses.DISCUSSION: Inconsistent self-reporting of chronic conditions is common but may not substantially affect multimorbidity prevalence. Future research should validate methods to resolve inconsistencies.</p

Rapid Orthotics for Cure Kenya: Mechanical Design and Modeling of 3D Printed Sockets

Rapid Orthotics for Cure Kenya (ROCK) works with CURE, a non-profit orthopedic workshop in Kjabe, Kenya, to implement a 3D printing system for manufacturing custom prosthetics and orthotics. The goal is to reduce the production time and cost for the current transtibial sockets being manufactured in the orthotic clinic to give the patients a way to integrate into society and reduce stigma from their communities. The team has developed a transtibial socket for below-the-knee amputees produced by a 3D printing system that converts a scan of the residual limb to a model that takes a third of the time to print versus the current manufacturing method. The current focus of the team is to develop a rigorous testing procedure adhering to the requirements set by the ISO 10328 Standard, an internationally recognized testing method. In order to ensure the safety of the sockets, tests must be run demonstrating that the product can withstand the different forces experienced during the gait cycle. Due to the complex geometry of the applied forces outlined in the ISO 10328, the team has designed a novel testing rig that interfaces with the MTS machine at Messiah University to apply the necessary forces according to the geometry outlined in the standard. Additionally, computer-based simulations are being developed in SolidWorks, a 3D modeling software, to determine how the components will behave under certain loading conditions. This is done to ensure accordance with the 10328 Standard and will be critical in the future for developing necessary cyclic tests.https://mosaic.messiah.edu/engr2021/1013/thumbnail.jp

Effectiveness of a Community Program for Older Adults with Type 2 Diabetes and Multimorbidity: A Pragmatic Randomized Controlled Trial

Background Type II diabetes mellitus (T2DM) affects upwards of 25% of Canadian older adults and is associated with high comorbidity and burden. Studies show that lifestyle factors and self-management are associated with improved health outcomes, but many studies lack rigour or exclude older adults, particularly those with multimorbidity. More evidence is needed on the effectiveness of community-based self-management programs in older adults with T2DM and multimorbidity. The study purpose is to evaluate the effect of a community-based intervention versus usual care on physical functioning, mental health, depressive symptoms, anxiety, self-efficacy, self-management, and healthcare costs in older adults with T2DM and 2 or more comorbidities. Methods Community-living older adults with T2DM and two or more chronic conditions were recruited from three Primary Care Networks (PCNs) in Alberta, Canada. Participants were randomly allocated to the intervention or control group in this pragmatic randomized controlled trial comparing the intervention to usual care. The intervention involved up to three in-home visits, a monthly group wellness program, monthly case conferencing, and care coordination. The primary outcome was physical functioning. Secondary outcomes included mental functioning, anxiety, depressive symptoms, self-efficacy, self-management, and the cost of healthcare service use. Intention-to-treat analysis was performed using ANCOVA modeling. Results Of 132 enrolled participants (70-Intervention, 62-Control), 42% were 75 years or older, 55% were female, and over 75% had at least six chronic conditions (in addition to T2DM). No significant group differences were seen for the baseline to six-month change in physical functioning (mean difference: -0.74; 95% CI: − 3.22, 1.74; p-value: 0.56), mental functioning (mean difference: 1.24; 95% CI: − 1.12, 3.60; p-value: 0.30), or other secondary outcomes.. Conclusion No significant group differences were seen for the primary outcome, physical functioning (PCS). Program implementation, baseline differences between study arms and chronic disease management services that are part of usual care may have contributed to the modest study results. Fruitful areas for future research include capturing clinical outcome measures and exploring the impact of varying the type and intensity of key intervention components such as exercise and diet