The pale evidence for treatment of iron-deficiency anaemia in older people

Funding The authors have received funding to carry out a pilot RCT on management of IDA in older people from the Chief Scientist Office, Scotland.Peer reviewedPostprin

Prognostic value of troponins in acute coronary syndrome depends upon patient age

Peer reviewedPostprin

Discriminant Analysis with Spatial Weights for Urban Land Cover Classification

Classifying urban area images is challenging because of the heterogeneous nature of the urban landscape resulting in mixed pixels and classes with highly variable spectral ranges. Approaches using ancillary data, such as knowledge based or expert systems, have shown to improve the classification accuracy in urban areas. Appropriate ancillary data, however, may not always be available. The goal of this study is to compare the results of the discriminant analysis statistical technique with discriminant analysis with spatial weights to classify urban land cover. Discriminant analysis is a statistical technique used to predict group membership for a target based on the linear combination of independent variables. Strict per pixel statistical analysis however does not consider the spatial dependencies among neighbouring pixels. Our study shows that approaches using ancillary data continue to outperform strict spectral classifiers but that using a spatial weight improved the results. Furthermore, results show that when the discriminant analysis technique works well then the spatially weighted approach performs better. However, when the discriminant analysis performs poorly, those poor results are magnified in the spatially weighted approach in the same study area. The study shows that for dominant classes, adding spatial weights improves the classification accuracy.

Process analysis and optimization of biodiesel production from vegetable oils

The dwindling resources of fossil fuels coupled with the steady increase in energy consumption have spurred research interest in alternative and renewable energy sources. Biodiesel is one of the most promising alternatives for fossil fuels. It can be made from various renewable sources, including recycled oil, and can be utilized in lieu of petroleum-based diesel. To foster market competitiveness for biodiesel, it is necessary to develop cost-effective and technically sound processing schemes, to identify related key design criteria, and optimize performance. The overall goal of this work was to design and optimize biodiesel (Fatty Acid Methyl Ester “FAME”) production from vegetable oil. To achieve this goal, several interconnected research activities were undertaken. First, a base-case flow sheet was developed for the process. The performance of this flow sheet along with the key design and operating criteria were identified by conducting computer-aided simulation using ASPEN Plus. Various scenarios were simulated to provide sufficient understanding and insights. Also, different thermodynamic databases were used for different sections of the process to account for the various characteristics of the streams throughout the process. Next, mass and energy integration studies were performed to reduce the consumption of material and energy utilities, improve environmental impact, and enhance profitability. Finally, capital cost estimation was carried out using the ICARUS Process Evaluator computer-aided tools linked to the results of the ASPEN simulation. The operating cost of the process was estimated using the key information on process operation such as raw materials, utilities, and labor. A profitability analysis was carried out by examining the ROI (Return of Investment) and PP (Payback Period). It was determined that the single most important economic factor is the cost of soybean oil, which accounted for more than 90% of the total annualized cost. Consequently, a sensitivity analysis was performed to examine the effect of soybean oil cost on profitability. It was determined that both ROI and PP quickly deteriorate as the cost of soybean oil increases

Protocol for a scoping review on information needs and information-seeking behaviour of people with dementia and their non-professional caregivers

Background: Dementia is a debilitating disease that can lead to major changes in a patient’s behaviour and function. It is important to educate both dementia patients and their non-professional caregivers about the disease. Yet, currently available sources do not seem to be effective for patients and caregivers, who report a need for more information and guidance. A systematic identification of the patients’ and caregivers’ needs for information and information seeking behaviour is needed to create information resources that are relevant and beneficial to the target population. Objective: This is a protocol for a scoping review aimed at gathering knowledge on the information needs and information seeking behaviour of dementia patients and their non- professional caregivers. Our aim is also to provide recommendations for development of future dementia information resources. Methods: The study will commence in November 2018. Both quantitative and qualitative studies on the information needs of dementia patients or caregivers will be examined using Arksey and O’Malley’s methodological framework for scoping studies. A comprehensive literature search will be conducted in electronic databases and grey literature sources. We will also screen reference lists of included studies and related systematic reviews for additional eligible studies. Two authors will perform screening of citations for eligibility, and independently extract data from the included studies in parallel. Any discrepancies will be resolved through discussion. The findings will be presented through a narrative synthesis and reported in line with PRISMA reporting guidelines. Ethics and dissemination: In this review, all included data will originate from published literature. Ethics approval is therefore not a requirement. We will present our findings at relevant conferences and will submit them for publication in peer-reviewed journals. Strengths and limitations of this study • In this scoping review, we will perform a comprehensive search of electronic databases and grey literature sources to identify up-to-date evidence on information needs and information seeking behaviour of dementia patients and their informal caregivers. • We will seek to identify evidence on information needs and information seeking behaviour of both dementia patients and their caregivers. • As this is a scoping review, a formal quality and risk of bias assessment of the included literature will not be performed. • This review will only include studies published in English

The Genetic Architecture of Noise-Induced Hearing Loss: Evidence for a Gene-by-Environment Interaction.

The discovery of environmentally specific genetic effects is crucial to the understanding of complex traits, such as susceptibility to noise-induced hearing loss (NIHL). We describe the first genome-wide association study (GWAS) for NIHL in a large and well-characterized population of inbred mouse strains, known as the Hybrid Mouse Diversity Panel (HMDP). We recorded auditory brainstem response (ABR) thresholds both pre and post 2-hr exposure to 10-kHz octave band noise at 108 dB sound pressure level in 5-6-wk-old female mice from the HMDP (4-5 mice/strain). From the observation that NIHL susceptibility varied among the strains, we performed a GWAS with correction for population structure and mapped a locus on chromosome 6 that was statistically significantly associated with two adjacent frequencies. We then used a "genetical genomics" approach that included the analysis of cochlear eQTLs to identify candidate genes within the GWAS QTL. In order to validate the gene-by-environment interaction, we compared the effects of the postnoise exposure locus with that from the same unexposed strains. The most significant SNP at chromosome 6 (rs37517079) was associated with noise susceptibility, but was not significant at the same frequencies in our unexposed study. These findings demonstrate that the genetic architecture of NIHL is distinct from that of unexposed hearing levels and provide strong evidence for gene-by-environment interactions in NIHL

Preoperative Kidney Function linked to mortality and readmission outcomes at Day 90 and 30 in Older Emergency Surgical Patients

Grants were received from British Geriatric Society and The Renal Association to support Louis EvansPeer reviewedPublisher PD

The influence of early research experience in medical school on the decision to intercalate and future career in clinical academia : A questionnaire study

Funding for the study was made available from University academic development funds.Peer reviewedPublisher PD

Hyponatremia : Special Considerations in Older Patients

Acknowledgments Roy L. Soiza is funded by an NRS Career Research Fellowship.Peer reviewedPublisher PD

Acute hypertriglyceridemia induces platelet hyperactivity that is not attenuated by insulin in polycystic ovary syndrome.

Atherothrombosis is associated with platelet hyperactivity. Hypertriglyceridemia and insulin resistance (IR) are features of polycystic ovary syndrome (PCOS). The effect of induced hypertriglyceridemia on IR and platelet function was examined in young women with PCOS. Following overnight fasting, 13 PCOS and 12 healthy women were infused with saline or 20% intralipid for 5 hours on separate days. Insulin sensitivity was measured using a hyperinsulinemic euglycaemic clamp in the final 2 hours of each infusion. Platelet responses to adenosine diphosphate (ADP) and prostacyclin (PGI2) were measured by flow cytometric analysis of platelet fibrinogen binding and P-selectin expression using whole blood taken during each infusion (at 2 hours) and at the end of each clamp. Lipid infusion increased triglycerides and reduced insulin sensitivity in both controls (median, interquartile range ) (5.25 [3.3, 6.48] versus 2.60 [0.88, 3.88] mg kg(-1) min(-1), P<0.001) and PCOS (3.15 [2.94, 3.85] versus 1.06 [0.72, 1.43] mg kg(-1) min(-1), P<0.001). Platelet activation by ADP was enhanced and ability to suppress platelet activation by PGI2 diminished during lipid infusion in both groups when compared to saline. Importantly, insulin infusion decreased lipid-induced platelet hyperactivity by decreasing their response to 1 μmol/L ADP (78.7% [67.9, 82.3] versus 62.8% [51.8, 73.3], P=0.02) and increasing sensitivity to 0.01 μmol/L PGI2 (67.6% [39.5, 83.8] versus 40.9% [23.8, 60.9], P=0.01) in controls, but not in PCOS. Acute hypertriglyceridemia induced IR, and increased platelet activation in both groups that was not reversed by insulin in PCOS subjects compared to controls. This suggests that platelet hyperactivity induced by acute hypertriglyceridemia and IR could contribute athero-thrombotic risk. www.isrctn.org. Unique Identifier: ISRCTN42448814