Malnutrition, functional ability and mortality among older people aged ⩾60 years: a 7-year longitudinal study

BACKGROUND/OBJECTIVES: This study aimed to assess the association between risk of malnutrition and 7-year mortality, controlling for functional ability, socio-demographics, lifestyle behavior and diseases, and investigate the interaction between risk of malnutrition and functional ability on the risk of mortality. SUBJECTS/METHODS: A longitudinal study on home-living and special-housing residents aged [greater than or equal to] 60 years was conducted. Of 2312 randomly invited participants, 1402 responded and 1203 provided information on both nutritional status and functional ability. The risk of malnutrition was estimated by the occurrence of at least one anthropometric measure (BMI, MAC and CC) below cut-off in addition to the presence of at least one subjective measure (decreased food intake, weight loss and eating difficulty). RESULTS: At baseline, 8.6% of subjects were at risk of malnutrition and during the 7-year follow-up 34.6% subjects died. The risk of malnutrition was independently associated with 7-year mortality (hazard ratio (HR) 1.84, 95% confidence interval (CI) 1.28-2.65). Additional independent predictors were dementia (HR 2.76, 95% CI 1.85-4.10), activity of daily living (ADL) dependence (HR 2.08, 95% CI 1.62-2.67), heart disease (HR 1.44, 95% CI 1.16-1.78), diabetes (HR 1.41, 95% CI 1.03-1.93) and older age (HR 1.09, 95% CI 1.07-1.10). Moreover, the risk of malnutrition and ADL dependence in combination predicted the poorest survival rate (18.7%, P < 0.001). CONCLUSIONS: The risk of malnutrition significantly increases the risk of mortality in older people. Moreover, risk of malnutrition and ADL dependence together explain a significantly poorer survival rate; however, the importance of this interaction decreased in the multivariable model and risk of malnutrition and ADL dependence independently explained a significant risk of mortality

A framework for IoT-enabled environment aware traffic management

Vehicular traffic has increased across all over the world especially in urban areas due to many reasons including the reduction in the cost of vehicles, degradation of the quality of public transport services and increased wealth of people. The traffic congestion created by these vehicles causes many problems. Increased environment pollution is one of the most serious negative effects of traffic congestion. Noxious gases and fine particles emitted by vehicles affect people in different ways depending on their age and present health conditions. Professionals and policy makers have devised schemes for better managing traffic in congested areas. These schemes suffer from many shortcomings including the inability to adapt to dynamic changes of traffic patterns. With the development of technology, new applications like Google maps help drivers to select less congested routes. But, the identification of the best route takes only the present traffic condition on different road segments presently. In this paper the authors propose a system that helps drivers select routes based on the present and expected environment pollution levels at critical points in a given area

The spectrum of imaging findings in pulmonary hydatid disease and the additive value of T2-weighted magnetic resonance imaging in its diagnosis

Purpose: To describe the spectrum of imaging findings in pulmonary echinococcosis and to study the additive value of T2-weighted magnetic resonance imaging (MRI) in the characterisation of pulmonary hydatid disease. Material and methods: This was a descriptive, prospective study conducted for a period of 3 years from December 2016 to November 2019. Patients suspected of having pulmonary echinococcosis (n = 110) on preliminary chest radiography were examined with chest computed tomography (CT). Among them 41 cases were additionally examined with T2-weighted MRI of thorax. Final diagnosis was based on surgery or histopathology. Results: Of the 110 patients enrolled for the study 15 were lost to attrition, and among the final cohort of 95 patients CT correctly diagnosed 68/84 (80.9%) as hydatid cyst, whereas 16/84 (19.1%) received an erroneous alternate diagnosis on CT. Based on the classical findings of hyperintense pulmonary cystic lesion with T2-weighted hypointense rim or detached internal T2-weighted hypointense membrane, a correct diagnosis of hydatid cyst was possible in 30 patients whereas a correct alternate diagnosis was made in 8 cases. T2-weighted MRI was found to have sensitivity of 96.7%, specificity of 80%, positive predictive value (PPV) of 93.7% and negative predictive value (NPV) of 88.9% with an overall diagnostic accuracy of 92.6%. Using the McNemar test, MRI was found to be diagnostically superior to CT (p = 0.019). Conclusions: Most of the pulmonary hydatid cysts can be diagnosed on CT; however, sometimes the findings may be indeterminate or atypical, leading to a diagnostic dilemma. MRI, owing to its ability to demonstrate hypointense endocyst, can act as a useful adjunct to correctly diagnose hydatid cyst or suggest an alternative diagnosis

Treatment of supra condylar fractures of humerus in children, a SKIMS medical college study

Background: Supracondylar fractures of the humerus account for sixty percent of all fractures around the elbow in children. Delayed presentation of these fractures is very common even in developed countries. The aim of the present study was to evaluate the clinical, radiological and functional results following closed reduction (C/R) and percutaneous pinning of widely displaced supracondylar fractures of humerus. An objective of this study was to study supracondylar fractures of humerus in children in Skims medical College.Methods: A total 86 patients with displaced extension type supracondylar fractures (gartland type III) of humerus were managed by closed reduction and percutaneous fixation at Skims medical college after achieving optimal and satisfactory reduction. There were 52 boys and 28 girls. Average age was 6.69 years (range 2-12).Results: A total 86 patients were successfully treated with C/R and cross pinning. 6 patients were lost to follow-up. 80 patients with a minimum follow-up period of 12 months formed the basis of this study.Conclusions: C/R and pinning is effective method despite delayed presentation. Strict anatomical reduction and stable fixation minimises the risk of developing cubitus varus deformity

A multi-sector multi-region economic growth model of drought and the value of water: A case study in Pakistan

This study integrates ecohydrological vegetation and multi-sector multi-region economic growth models to evaluate the impacts of drought on markets and value the economic value of water. The values of several parameters of the agricultural production function are identified by applying leaf area indices that are simulated by the ecohydrological model, AgriCLVDAS. The three-sector three-region closed-economy model with the agricultural production functions of both irrigable and rainfed farmland as well as the stochastic process of precipitation and availability of river water are formulated to analyze the water rent as well as GDP growth in Pakistan under drought stress. According to the characteristics of the closed-economy model, the crop price is increased during drought periods because of the price hike in water (i.e., an increase in the marginal productivity of water, which is double that in high-water periods in Pakistan). The study further presents a way of investigating water resource management policies by applying comparative dynamics

Near complete aortic transection and its successful repair using a novel cardiopulmonary bypass technique

Abstract The case of a 38-year old female, victim of a road traffic accident who presented with a near complete aortic transection is presented. An emergent repair employing cardiopulmonary bypass was attempted in the operating room. Anticipating a high-risk of compromise to cerebral perfusion from air micro-emboli, the bypass was attempted with an innovative approach involving the successful cannulation of the pulmonary artery and descending aorta. The patient survived and was found to be doing well on subsequent post-operative visits

Parabolic Trough Solar Collector – Design, Construction and Testing

This paper presents the design, construction and investigates an experimental study of a parabolic Trough Solar Collector (PTSC). It is constructed of multi – piece glass mirror to form the parabolic reflector (1.8 m ? 2.8 m) its form were checked with help of a laser and carbon steel rectangular as receiver. Sun tracker has been developed (using two – axis) to track solar PTSC according to the direction of beam propagation of solar radiation. Using synthetic oil as a heat transfer its capability to heat transfer and load high temperature (?400 oc). The storage tank is fabricated with stainless steel of size 50 L. The experimental tests have been carried out in Baghdad climatic conditions (33.3o N, 44.4o E) during selective days of the months October and November. The performance of PTSC is evaluated using outdoor experimental measurements including the useful heat gain, the thermal instantaneous efficiency and the energy gained by the storage tank oil. The storage tank oil temperature is increased from 30oc at 9:30h to 136oc at 13:30h without draw – off oil. The experimental result shows the average thermal efficiency was 42% which is fairly acceptable assessment results of a PTSC locally

MEASURING GROWTH CONDITIONS OF SALAD PLANTS USING SENSORS: A HIGH SCHOOL PROJECT

Geoinformatics (GI) education is widely used as a spatial visualization-interdisciplinary tools for its ability to understand the geographical phenomenon around us in the past and model the future scenario. Its global importance and usage have made the need of disseminating the education with public and school students. The MSc. Students of different backgrounds at Institute for Geoinformatics in the University of Munster were involved in one of such works through the seminar cum project on ‘Transdisciplinary education in Geoinformatics’ through GI@School Lab with the aim of engaging high school students on applying GI knowledge on Agriculture. The grade 12 students were presented with the ongoing GI empowered research projects at first such that the school students developed the project ideas of their interests to use GI on agricultural sectors based on which MSc students developed 4 different projects and Growth Condition (Sensors) is one of them. This project aims to determine the best suited condition for Salad plants growth based on the size of the Salad leaves measured after monitoring the growth of the plants by planting them on 4 plastic boxes filled with same soil type but in different lighting conditions and water conditions to be measured by the concerned sensors to after the 8 weeks of indoor growth. The project execution week took place as the 5-day workshop and feedbacks were taken as questionnaire surveys from the participated students and concerned teachers for the project evaluation. The sensors-collected data could even serve as the ground truth data of a citizen observatory projects for Copernicus in-situ component. The whole project aims at reducing generational gaps between the students by bringing them the opportunity for knowledge co-creation through transdisciplinary projects on agricultural sector using GI technologies