Application of the (fr)AGILE scale in the evaluation of multidimensional frailty in elderly inpatients from internal medicine wards: a cross-sectional observational study

BackgroundWith the rapid growth of an aging global population and proportion, the prevalence of frailty is constantly increasing. Therefore, finding a frailty assessment tool suitable for clinical application by physicians has become the primary link in the comprehensive management of frailty in elderly patients. This study used the (fr)AGILE scale to investigate the frailty status of elderly patients from internal medicine wards and identified relevant factors that affect the severity of frailty.MethodIn this study, 408 elderly inpatients in internal medicine departments of Qilu Hospital of Shandong University from May 2021 to August 2022 were enrolled as research subjects, and a cross-sectional observational study was conducted. Researchers evaluated the frailty based on the (fr)AGILE scale score. The general condition, past medical history, physical examination, laboratory examination, nutrition control score, intervention and treatment measures and other elderly patient information was collected. Logistic regression analysis was used to analyze the relevant factors that affect the severity of frailty and hospitalization costs.ResultsAccording to the (fr)AGILE scale score, the elderly patients were divided into groups to determine whether they were frail and the severity of the frailty. Among them, 164 patients were in the prefrailty stage, which accounted for 40.2%. There were 188 cases of mild frailty that accounted for 46.1%, and 56 cases of moderate to severe frailty that accounted for 13.7%. Decreased grip strength, elevated white blood cell levels, and low sodium and potassium are independent risk factors affecting the severity of frailty. As the severity of frailty increases, the proportion of sodium, potassium, albumin supplementation as well as anti-infection gradually increases.ConclusionFrailty is a common elderly syndrome with a high incidence among elderly patients in internal medicine departments. The main manifestations of frailty vary with different severity levels. Inflammation, anemia, and poor nutritional status can lead to an increase in the severity of frailty as well as blood hypercoagulability, myocardial damage, and additional supportive interventions. This ultimately leads to prolonged hospitalization and increased hospitalization costs

Status of serum vitamin B₁₂ and folate in patients with inflammatory bowel disease in China

Background/Aims: Inflammatory bowel disease (IBD) primarily involves the intestinal tract and can affect vitamin absorption. This study was designed to assess the prevalence of vitamin B₁₂ and folate deficiencies in patients with IBD, and to identify the risk factors associated with abnormal serum vitamin B₁₂ and folate levels.Methods: We evaluated the medical records of 195 patients with Crohn's disease (CD) and 62 patients with ulcerative colitis (UC), and selected 118 healthy subjects for the control group.Results: There were more CD patients with vitamin B₁₂ deficiency than UC patients (14.9% vs. 3.2%, P=0.014) and controls (14.9% vs. 4.2%, P=0.003). The prevalence of folate deficiency was higher in CD patients than in controls (13.3% vs. 3.4%, P=0.004). There were no significant differences in the serum vitamin B₁₂ and folate statuses of the UC and control groups. Patients with prior ileal or ileocolic resection showed a higher prevalence of abnormal vitamin B₁₂ levels than those without prior resection (n=6/16, n=23/179; P=0.018). A disease duration within 5 years was a risk factor of abnormal folate levels in CD patients.Conclusions: This study showed that vitamin B₁₂ and folate deficiencies were more common in patients with CD than in UC patients and controls. Prior ileal or ileocolonic resection was a risk factor of serum vitamin B₁₂ abnormalities, and a disease duration within 5 years was a risk factor of low serum folate levels in CD patients

Process optimization of A356 aluminum alloy wheel hub fabricated by low-pressure die casting with simulation and experimental coupling methods

The aluminum alloy wheel hub is mainly produced by low-pressure die casting process (LPDC), in which casting quality is closely related to the process parameters. In this paper, the LPDC process of the A356 alloy wheel hub was numerically simulated by ProCAST software, and the forming quality of the wheel hub under different cooling processes has been studied. The result indicated that the liquid aluminum exhibited different solidification characteristics under three cooling processes of 300 L/h for 150 s, 400 L/h for 140 s and 500 L/h for 130 s. A sequential solidification state was obtained under the condition of 400 L/h for 140 s. By comparing the tensile properties of the rim under different cooling processes, it was found that the wheel hub casted under 400 L/h for 140 s had higher tensile strength and elongation, which were 178.9 MPa and 6.6%, respectively. The reduction of casting defects, microstructure refinement, and uniform distribution of eutectic Si particles in the wheel hub are the main reasons for the improvement of mechanical properties