Frailty is independently associated with increased hospitalisation days in patients on the liver transplant waitlist

AIM: To investigate the impact of physical frailty on risk of hospitalisation in cirrhotic patients on the liver transplant waitlist. METHODS: Cirrhotics listed for liver transplantation at a single centre underwent frailty assessments using the Fried Frailty Index, consisting of grip strength, gait speed, exhaustion, weight loss, and physical activity. Clinical and biochemical data including MELD score as collected at the time of assessment. The primary outcome was number of hospitalised days per year; secondary outcomes included incidence of infection. Univariable and multivariable analysis was performed using negative binomial regression to associate baseline parameters including frailty with clinical outcomes and estimated incidence rate ratios (IRR). RESULTS: Of 587 cirrhotics, 64% were male, median age (interquartile range) was 60 (53-64) years and MELD score was 15 (12-18). Median Fried Frailty Index was 2 (1-3); 31.6% were classified as frail (fried frailty ≥ 3). During 12 mo of follow-up, 43% required at least 1 hospitalisation; 38% of which involved major infection. 107/184 (58%) frail and 142/399 (36%) non-frail patients were hospitalised at least once (P < 0.001). In univariable analysis, Fried Frailty Index was associated with total hospitalisation days per year (IRR = 1.51, 95%CI: 1.28-1.77; P ≤ 0.001), which remained significant on multivariable analysis after adjustment for MELD, albumin, and gender (IRR for frailty of 1.21, 95%CI: 1.02-1.44; P = 0.03). Incidence of infection was not influenced by frailty. CONCLUSION: In cirrhotics on the liver transplant waitlist, physical frailty is a significant predictor of hospitalisation and total hospitalised days per year, independent of liver disease severity

Examining Teacher Experiences: A Qualitative Study on Inclusion in the Elementary Classroom

This qualitative study utilized a semi-structured interview approach to better understand the experiences of general education teachers (n = 8) with the inclusion of special education students in the general education classroom. By gaining information about the experiences that general education teachers have with supports and services for, as well as communication about, inclusion, the study results provide additional information about experiences in order to inform the supports teachers receive to better educate students with and without disabilities. Each semi-structured interview was transcribed and coded for themes. Seven key themes emerged from findings: Acceptance, Time in General Education Classroom, Supports and Strategies, Special Education Teacher Role, Collaboration and Communication, Dangerous, Destructive, Disruptive Behaviors, and Other Barriers. Literature names the frequent barrier to inclusion being negative attitudes of general education teachers, special education teachers, and parents; that was not the case in the findings of this research, which found the large barrier described by all participants to be experiences with dangerous, destructive, disruptive behavior. Along with the large barrier described as a result of student behavior, teachers detailed experiences with a lack of human supports because of student behavioral support needs. Research findings include that despite teachers having supports and services in place for the education and inclusion of special education students in the general education classroom, such things didn’t appear to be enough to combat the significant barrier that arose from dangerous, destructive, disruptive behavior. Behavior affected the presence, participation, and achievement of special education students. Additionally, participants detailed the rippling effects that dangerous, destructive, disruptive behavior had on inclusion, as well as the learning of other students in the classroom and often across the school. Of importance is for leaders and districts to be cognizant and focused on providing supports to school staff when programming and providing supports for students with significant behavioral needs. Adequate staffing is a must. Candid, supportive Individualized Education Program (IEP) conversations around least restrictive environment are critical

COAL PARTICLE FLOW PATTERNS FOR O2 ENRICHED, LOW NOx BURNERS

Over the past year, the hot flow studies have focused on the validation of a novel 2M near-flame combustion furnace. The 2M furnace was specifically designed to investigate burner aerodynamics and flame stability phenomena. Key accomplishments include completion of coal & oxygen mass balance calculations and derivation of emission conversion equations, upgrade of furnace equipment and flame safety systems, shakedown testing and partial completion of a parametric flame stability study. These activities are described in detail below along with a description of the 2M furnace and support systems

The Effects of a Plyometric Training Program on Jump Performance in Collegiate Figure Skaters: A Pilot Study

International Journal of Exercise Science 9(2): 175-186, 2016. Plyometric training has been implemented to increase jump height in a variety of sports, but its effects have not been researched in figure skating. The purpose of this study was to determine the effects of a plyometric training program on on-ice and off-ice jump performance. Six collegiate figure skaters (19.8±1.2 years; 164.7±4.9 cm; 60.3±11.6 kg) completed a six-week sport-specific plyometric training program, consisting of low to moderate intensity plyometric exercises, while eight collegiate figure skaters (21.1±3.9 years; 162.6±6.0 cm; 60.4±6.1 kg) served as the control group. Significant increases were found for vertical jump height, standing long jump distance, (F = 31.0, p \u3c 0.001), and flight time (F = 11.6, p = 0.007). No significant differences were found for self-reported jump evaluation (p = 0.101). Six weeks of plyometric training improved both on-ice and off-ice jump performance in collegiate figure skaters, while short-term skating training alone resulted in decreases. These results indicate that figure skaters could participate in off-ice plyometric training

Can climate models capture the structure of extratropical cyclones?

Composites of wind speeds, equivalent potential temperature, mean sea level pressure, vertical velocity, and relative humidity have been produced for the 100 most intense extratropical cyclones in the Northern Hemisphere winter for the 40-yr ECMWF Re-Analysis (ERA-40) and the high resolution global environment model (HiGEM). Features of conceptual models of cyclone structure—the warm conveyor belt, cold conveyor belt, and dry intrusion—have been identified in the composites from ERA-40 and compared to HiGEM. Such features can be identified in the composite fields despite the smoothing that occurs in the compositing process. The surface features and the three-dimensional structure of the cyclones in HiGEM compare very well with those from ERA-40. The warm conveyor belt is identified in the temperature and wind fields as a mass of warm air undergoing moist isentropic uplift and is very similar in ERA-40 and HiGEM. The rate of ascent is lower in HiGEM, associated with a shallower slope of the moist isentropes in the warm sector. There are also differences in the relative humidity fields in the warm conveyor belt. In ERA-40, the high values of relative humidity are strongly associated with the moist isentropic uplift, whereas in HiGEM these are not so strongly associated. The cold conveyor belt is identified as rearward flowing air that undercuts the warm conveyor belt and produces a low-level jet, and is very similar in HiGEM and ERA-40. The dry intrusion is identified in the 500-hPa vertical velocity and relative humidity. The structure of the dry intrusion compares well between HiGEM and ERA-40 but the descent is weaker in HiGEM because of weaker along-isentrope flow behind the composite cyclone. HiGEM’s ability to represent the key features of extratropical cyclone structure can give confidence in future predictions from this model

Demonstration of a switchable damping system to allow low-noise operation of high-Q low-mass suspension systems

Low mass suspension systems with high-Q pendulum stages are used to enable quantum radiation pressure noise limited experiments. Utilising multiple pendulum stages with vertical blade springs and materials with high quality factors provides attenuation of seismic and thermal noise, however damping of these high-Q pendulum systems in multiple degrees of freedom is essential for practical implementation. Viscous damping such as eddy-current damping can be employed but introduces displacement noise from force noise due to thermal fluctuations in the damping system. In this paper we demonstrate a passive damping system with adjustable damping strength as a solution for this problem that can be used for low mass suspension systems without adding additional displacement noise in science mode. We show a reduction of the damping factor by a factor of 8 on a test suspension and provide a general optimisation for this system.Comment: 5 pages, 5 figure

Success stories and emerging themes in conservation physiology

The potential benefits of physiology for conservation are well established and include greater specificity of management techniques, determination of cause–effect relationships, increased sensitivity of health and disturbance monitoring and greater capacity for predicting future change. While descriptions of the specific avenues in which conservation and physiology can be integrated are readily available and important to the continuing expansion of the discipline of ‘conservation physiology’, to date there has been no assessment of how the field has specifically contributed to conservation success. However, the goal of conservation physiology is to foster conservation solutions and it is therefore important to assess whether physiological approaches contribute to downstream conservation outcomes and management decisions. Here, we present eight areas of conservation concern, ranging from chemical contamination to invasive species to ecotourism, where physiological approaches have led to beneficial changes in human behaviour, management or policy. We also discuss the shared characteristics of these successes, identifying emerging themes in the discipline. Specifically, we conclude that conservation physiology: (i) goes beyond documenting change to provide solutions; (ii) offers a diversity of physiological metrics beyond glucocorticoids (stress hormones); (iii) includes approaches that are transferable among species, locations and times; (iv) simultaneously allows for human use and benefits to wildlife; and (v) is characterized by successes that can be difficult to find in the primary literature. Overall, we submit that the field of conservation physiology has a strong foundation of achievements characterized by a diversity of conservation issues, taxa, physiological traits, ecosystem types and spatial scales. We hope that these concrete successes will encourage the continued evolution and use of physiological tools within conservation-based research and management plans."This work was supported by the Society for Integrative and Comparative Biology; the University of Windsor, Ontario, Canada; Dalhousie University, Nova Scotia, Canada; and the Canadian Society of Zoologists. C.L.M. was supported by a Natural Sciences and Engineering Research Council of Canada PGS-D (427552). S.J.C. and O.P.L. are supported by the Canada Research Chairs program. E.J.C. was supported by a grant from the National Science Foundation (BCS-1134687). K.R.H. was supported by grants from the National Science Foundation’s MacroSystems Biology program (award no. 1340856) and the US Department of Agriculture (NRI 2015-67013-23138). J.R.R. was supported by grants from the National Science Foundation (EF-1241889), National Institutes of Health (R01GM109499, R01TW010286), US Department of Agriculture (NRI 2006-01370, 2009-35102-0543) and US Environmental Protection Agency (CAREER 83518801)."https://academic.oup.com/conphys/article/4/1/cov057/295129

Success stories and emerging themes in conservation physiology

The potential benefits of physiology for conservation are well established and include greater specificity of management techniques, determination of cause-effect relationships, increased sensitivity of health and disturbance monitoring and greater capacity for predicting future change. While descriptions of the specific avenues in which conservation and physiology can be integrated are readily available and important to the continuing expansion of the discipline of \u27conservation physiology\u27, to date there has been no assessment of how the field has specifically contributed to conservation success. However, the goal of conservation physiology is to foster conservation solutions and it is therefore important to assess whether physiological approaches contribute to downstream conservation outcomes and management decisions. Here, we present eight areas of conservation concern, ranging from chemical contamination to invasive species to ecotourism, where physiological approaches have led to beneficial changes in human behaviour, management or policy. We also discuss the shared characteristics of these successes, identifying emerging themes in the discipline. Specifically, we conclude that conservation physiology: (i) goes beyond documenting change to provide solutions; (ii) offers a diversity of physiological metrics beyond glucocorticoids (stress hormones); (iii) includes approaches that are transferable among species, locations and times; (iv) simultaneously allows for human use and benefits to wildlife; and (v) is characterized by successes that can be difficult to find in the primary literature. Overall, we submit that the field of conservation physiology has a strong foundation of achievements characterized by a diversity of conservation issues, taxa, physiological traits, ecosystem types and spatial scales. We hope that these concrete successes will encourage the continued evolution and use of physiological tools within conservation-based research and management plans

Interdisciplinary Perspectives on Sun Safety and Skin Cancer Risk: achieving consensus

Overexposure to the sun is associated with an increased risk of melanoma and nonmelanoma skin cancer, but indications of improvements in sun protection behavior are poor. Attempts to identify emerging themes in skin cancer control have largely been driven by groups of experts from a single field. In December 2016, 19 experts from various disciplines convened for Interdisciplinary Perspectives on Skin Cancer, a 2-day meeting hosted by the National Academy of Sciences. The group discussed knowledge gaps, perspectives on sun exposure, implications for skin cancer risk and other health outcomes, and new directions. Five themes emerged from the discussion: (1) The definition of risk must be expanded, and categories for skin physiology must be refined to incorporate population diversities. (2) Risky sun exposure often co-occurs with other health-related behaviors. (3) Messages must be nuanced to target at-risk populations. (4) Persons at risk for tanning disorder must be recognized and treated. (5) Sun safety interventions must be scalable. Efficient use of technologies will be required to sharpen messages to specific populations and to integrate them within multilevel interventions. Further interdisciplinary research should address these emerging themes to build effective and sustainable approaches to large-scale behavior change

Trace Analysis of Surfactants in Corexit Oil Dispersant Formulations and Seawater

After the April 2010 explosion on the Deepwater Horizon oil rig, and subsequent release of millions of barrels of oil, two Corexit oil dispersant formulations were used in unprecedented quantities both on the surface and sub-surface of the Gulf of Mexico. Although the dispersant formulations contain four classes of surfactants, current studies to date focus on the anionic surfactant, bis-(2-ethylhexyl) sulfosuccinate (DOSS). Factors affecting the integrity of environmental and laboratory samples for Corexit analysis have not been systematically investigated. For this reason, a quantitative analytical method was developed for the detection of all four classes of surfactants, as well as the hydrolysis products of DOSS, the enantiomeric mixture of α- and β-ethylhexyl sulfosuccinate (α-/β-EHSS). The analytical method was then used to evaluate which practices for sample collection, storage, and analysis resulted in high quality data. Large volume, direct injection of seawater followed by liquid chromatography tandem mass spectrometry (LC-MS/MS) minimized analytical artifacts, analysis time, and both chemical and solid waste. Concentrations of DOSS in the seawater samples ranged from 71–13,000 ng/L, while the nonionic surfactants including Span 80, Tween 80, Tween 85 were detected infrequently (26% of samples) at concentrations from 840–9100 ng/L. The enantiomers α-/β-EHSS were detected in seawater, at concentrations from 200–1,900 ng/L, and in both Corexit dispersant formulations, indicating α-/β-EHSS were applied to the oil spill and may be not unambiguous indicator of DOSS degradation. Best practices are provided to ensure sample integrity and data quality for environmental monitoring studies and laboratory that require the detection and quantification of Corexit-based surfactants in seawater