Pattern of morbidity among elders attending general practice: health needs assessment of geriatric patients in Oman

The main purpose of this study was to identify specific problems and pattern of morbidities that is common in the elderly. A cross sectional study surveying the health status and needs of targeted population was conducted in selected primary health care (PHC) outpatient settings. All consenting individuals aged 60 years and above who visited the selected PHC clinics were interviewed. Information was collected using face-to-face interviews based on a structured, pre-tested questionnaire. A total of 185 people were evaluated in this study. About 75% of participants were age 60-70 years. Overall, male predominance was noted with 137 (74.1%) males and among all participant’s 80% were married. The mean BMI was 26.47±4.98 kg/m2 and mean waist circumference was 90.16±12.97 cm. The prevalence of smoking, DM, HTN, dyslipidaemia and history of IHD among participants were 7.6%, 37.8%, 49.7%, 27.6% and 8.1%, respectively and males showed a significantly higher prevalence than females in smoking and HTN (p<0.05). Hypertension was common comorbid ailment with 29.2% of stage I and 19.5% of stage II hypertension among 60-70 age groups. The majority of the participants were taking shower; using toilet, feeding and get dressed independently, 88.6%, 87.6%, 87% and 87.6% respectively. These findings provide important information on high prevalence of overweight, hypertension, diabetes, smoking and dyslipidaemia among elders. The other common morbidities were impaired vision, walking difficulty, and hearing problems. The activity of daily living (bathing dressing toileting feeding) is preserved in most of older people

Thermal-aware resource allocation in earliest deadline first using fluid scheduling

Thermal issues in microprocessors have become a major design constraint because of their adverse effects on the reliability, performance and cost of the system. This article proposes an improvement in earliest deadline first, a uni-processor scheduling algorithm, without compromising its optimality in order to reduce the thermal peaks and variations. This is done by introducing a factor of fairness to earliest deadline first algorithm, which introduces idle intervals during execution and allows uniform distribution of workload over the time. The technique notably lowers the number of context switches when compare with the previous thermal-aware scheduling algorithm based on the same amount of fairness. Although, the algorithm is proposed for uni-processor environment, it is also applicable to partitioned scheduling in multi-processor environment, which primarily converts the multi-processor scheduling problem to a set of uni-processor scheduling problem and thereafter uses a uni-processor scheduling technique for scheduling. The simulation results show that the proposed approach reduces up to 5% of the temperature peaks and variations in a uni-processor environment while reduces up to 7% and 6% of the temperature spatial gradient and the average temperature in multi-processor environment, respectively

Novel Molecular classification of colorectal cancer and correlation with survival

Colorectal cancer (CRC) is one of the most common cancers worldwide. This study was designed to evaluate biological patterns, explore molecular classification and correlate with survival outcome in treatment naïve CRC patients. Methods Over 11 years consecutive series of 435 CRC patients were operated on as primary surgical therapy. A total of 201 CRC patients were included, whose complete set of clinical information was available, and their good quality tumour blocks were retrieved. Immunohistochemistry was used for tumour analysis, and partitional clustering was performed using R software for cluster analysis. Results The median age was 43 (range 10-85) years; adenocarcinoma was the most commonly seen histological type. The great majority had positive CK20, CEA, E-Cadherin, Ki67, CDX2, and p53 expression. There were four distinct molecular classes found, whereas Ki67, CDX2, and p53 play 3 the main role in partitioning. Younger age negatively impacted survival; overall and diseasespecific survival was 26 months only with 50 months’ longest survival. Conclusion Colorectal cancer is a biologically heterogeneous disease with at least four distinct molecular patterns, where cell proliferation and gene repair mechanisms appear to play the key role

Effects of a high-dose 24-h infusion of tranexamic acid on death and thromboembolic events in patients with acute gastrointestinal bleeding (HALT-IT): an international randomised, double-blind, placebo-controlled trial

Background: Tranexamic acid reduces surgical bleeding and reduces death due to bleeding in patients with trauma. Meta-analyses of small trials show that tranexamic acid might decrease deaths from gastrointestinal bleeding. We aimed to assess the effects of tranexamic acid in patients with gastrointestinal bleeding. Methods: We did an international, multicentre, randomised, placebo-controlled trial in 164 hospitals in 15 countries. Patients were enrolled if the responsible clinician was uncertain whether to use tranexamic acid, were aged above the minimum age considered an adult in their country (either aged 16 years and older or aged 18 years and older), and had significant (defined as at risk of bleeding to death) upper or lower gastrointestinal bleeding. Patients were randomly assigned by selection of a numbered treatment pack from a box containing eight packs that were identical apart from the pack number. Patients received either a loading dose of 1 g tranexamic acid, which was added to 100 mL infusion bag of 0·9% sodium chloride and infused by slow intravenous injection over 10 min, followed by a maintenance dose of 3 g tranexamic acid added to 1 L of any isotonic intravenous solution and infused at 125 mg/h for 24 h, or placebo (sodium chloride 0·9%). Patients, caregivers, and those assessing outcomes were masked to allocation. The primary outcome was death due to bleeding within 5 days of randomisation; analysis excluded patients who received neither dose of the allocated treatment and those for whom outcome data on death were unavailable. This trial was registered with Current Controlled Trials, ISRCTN11225767, and ClinicalTrials.gov, NCT01658124. Findings: Between July 4, 2013, and June 21, 2019, we randomly allocated 12 009 patients to receive tranexamic acid (5994, 49·9%) or matching placebo (6015, 50·1%), of whom 11 952 (99·5%) received the first dose of the allocated treatment. Death due to bleeding within 5 days of randomisation occurred in 222 (4%) of 5956 patients in the tranexamic acid group and in 226 (4%) of 5981 patients in the placebo group (risk ratio [RR] 0·99, 95% CI 0·82–1·18). Arterial thromboembolic events (myocardial infarction or stroke) were similar in the tranexamic acid group and placebo group (42 [0·7%] of 5952 vs 46 [0·8%] of 5977; 0·92; 0·60 to 1·39). Venous thromboembolic events (deep vein thrombosis or pulmonary embolism) were higher in tranexamic acid group than in the placebo group (48 [0·8%] of 5952 vs 26 [0·4%] of 5977; RR 1·85; 95% CI 1·15 to 2·98). Interpretation: We found that tranexamic acid did not reduce death from gastrointestinal bleeding. On the basis of our results, tranexamic acid should not be used for the treatment of gastrointestinal bleeding outside the context of a randomised trial

A filter-based feature selection approach in multilabel classification

Multi-label classification is a fast-growing field of machine learning. Recent developments have shown several applications, including social media, healthcare, bio-molecular analysis, scene, and music classification associated with the multilabel classification. In classification problems, multiple labels (multilabel or more than one class label) are assigned to an unseen record instead of a single-label class assignment. Feature selection is a preprocessing phase used to identify the most relevant features that could improve the accuracy of the multilabel classifiers. The focus of this study is the feature selection method in multilabel classification. The study used a feature selection filter method involving the Fisher score, analysis of variance test, mutual information, Chi-Square, and ensembles of these statistical methods. An extensive range of machine learning algorithms is applied in the modelling phase of a multilabel classification model that includes binary relevance, classifier chain, label powerset, binary relevance KNN, multi-label twin support vector machine, multi-label KNN. Besides, label space partitioning and majority voting of ensemble methods are used and Random Forest is the base learner. The experiments are carried out over five different multilabel benchmarking datasets. The evaluation of the classification model is measured using accuracy, precision, recall, F1 score, and hamming loss. The study demonstrated that the filter methods (i.e. mutual information) having top weighted $80\%$ to $20\%$ features provided significant outcomes

Comparison of Carbonyls and BTEX Emissions from a Light Duty Vehicle Fuelled with Gasoline and Ethanol-Gasoline Blend, and Operated without 3-Way Catalytic Converter

This paper presents the comparison of unregulated emissions such as carbonyls and BTEX (Benzene, Toluene, Ethyl Benzene, and Xylenes) species emanated from a light duty SI (Spark Ignition) vehicle E-0 (fuelled on gasoline) and E-10 (ethanol-gasoline blend). Meanwhile, the ozone forming potential of these pollutants based on their ozone SR (Specific Reactivity) has also been addressed in this study. The experiments were performed on transient as well as steady-state modes in accordance with the standard protocols recommended for light duty vehicle emissions. Carbonyls and BTEX were analyzed by HPLC (High Performance Liquid Chromatography) with UV detector and GC/MS (Gas Chromatography/Mass Spectroscopy), respectively. Formaldehyde and acetaldehyde were the predominant components of the carbonyls for E-0 and E-10, respectively. During transient mode, formaldehyde, acrolein + acetone, and tolualdehyde pollutants were decreased but, acetaldehyde emissions increased with E-10 as compared to E-0. The BTEX emissions were also decreased with E-10, relative to E-0. During the steady-state modes, formaldehyde, acrolein + acetone and propionaldehyde were lower, aromatic aldehydes were absent, but acetaldehyde pollutants were higher with E-10 compared to E-0. The BTEX emissions were decreased at medium and higher speed modes however, increased at lower speed mode with E-10 as compared to E-0. Total BTEX emissions were maximal at lower speed mode but, least at medium speed mode for both the fuels. SR of the pollutants was higher over transient cycle of operation, compared with steady-state mode. Relative to E-0, E-10 displayed lower SR during both transient as well as steady-state mode

A missense mutation in ASRGL1 is involved in causing autosomal recessive retinal degeneration.

Inherited retinal dystrophies are a group of genetically heterogeneous conditions with broad phenotypic heterogeneity. We analyzed a large five-generation pedigree with early-onset recessive retinal degeneration to identify the causative mutation. Linkage analysis and homozygosity mapping combined with exome sequencing were carried out to map the disease locus and identify the p.G178R mutation in the asparaginase like-1 gene (ASRGL1), segregating with the retinal dystrophy phenotype in the study pedigree. ASRGL1 encodes an enzyme that catalyzes the hydrolysis of L-asparagine and isoaspartyl-peptides. Studies on the ASRGL1 expressed in Escherichia coli and transiently transfected mammalian cells indicated that the p.G178R mutation impairs the autocatalytic processing of this enzyme resulting in the loss of functional ASRGL1 and leaving the inactive precursor protein as a destabilized and aggregation-prone protein. A zebrafish model overexpressing the mutant hASRGL1 developed retinal abnormalities and loss of cone photoreceptors. Our studies suggest that the p.G178R mutation in ASRGL1 leads to photoreceptor degeneration resulting in progressive vision loss