Iatrogenic disease in the elderly: risk factors, consequences, and prevention

The epidemiology of iatrogenic disease in the elderly has not been extensively reported. Risk factors of iatrogenic disease in the elderly are drug-induced iatrogenic disease, multiple chronic diseases, multiple physicians, hospitalization, and medical or surgical procedures. Iatrogenic disease can have a great psychomotor impact and important social consequences. To identify patients at high risk is the first step in prevention as most of the iatrogenic diseases are preventable. Interventions that can prevent iatrogenic complications include specific interventions, the use of a geriatric interdisciplinary team, pharmacist consultation and acute care for the elderly units

Ca\u3csup\u3e2+\u3c/sup\u3e, Astrocyte Activation and Calcineurin/NFAT Signaling in Age-Related Neurodegenerative Diseases

Mounting evidence supports a fundamental role for Ca2+ dysregulation in astrocyte activation. Though the activated astrocyte phenotype is complex, cell-type targeting approaches have revealed a number of detrimental roles of activated astrocytes involving neuroinflammation, release of synaptotoxic factors and loss of glutamate regulation. Work from our lab and others has suggested that the Ca2+/calmodulin dependent protein phosphatase, calcineurin (CN), provides a critical link between Ca2+ dysregulation and the activated astrocyte phenotype. A proteolyzed, hyperactivated form of CN appears at high levels in activated astrocytes in both human tissue and rodent tissue around regions of amyloid and vascular pathology. Similar upregulation of the CN-dependent transcription factor nuclear factor of activated T cells (NFAT4) also appears in activated astrocytes in mouse models of Alzheimer’s disease (ADs) and traumatic brain injury (TBI). Major consequences of hyperactivated CN/NFAT4 signaling in astrocytes are neuroinflammation, synapse dysfunction and glutamate dysregulation/excitotoxicity, which will be covered in this review article

Numerical Heat Transfer Investigation in a Solar Receiver Heat Exchanger Channel with Punched Elliptical-Winglet Vortex Generators

Thermal performance in a solar receiver heat exchanger (SRX) channel with punched elliptical-winglet vortex generator (P-EW) mounted on the absorber plate is numerically examined for Reynolds number (Re) ranging from 4000 to 24,000. In the present simulation, the P-EW characteristics included three ratios of winglet pitches (PR = 2.0, 1.5 and 1.0) including four sizes of the perforated-holes (nondimensional hole diameter, dR= 0.0, 0.25, 0.417 and 0.583) at one value of the attack angle (a =30°) and relative height (BR= 0.48). The computation reveals that employing P-EW generally yields considerably large friction factor (f) and Nusselt number (Nu) than the flat-plate channel alone. The use of smaller hole size causes the rise in Nu and f. It is noticeable that counter-spinning vortices pairs generated by the multiple P-EW can induce the impinging flow onto the absorber plate together with the air jet coming out of the hole, leading to the rise in the heat transfer rate greater than the smooth flat-plate channel. The highest thermal performance of about 1.9 was seen for the one with PR = 1.5 and dR = 0.417

ENGINEERING INSURANCE

Engineering insurance is one of the most general and effective methods of project risk management in Western countries with a perfect insurance system. It covers damage to plant, machinery, and other engineering equipment such as boilers, computers, cranes, and lifts. Professional liability insurance, a type of engineering insurance, covers errors and omissions in the services provided by businesses. General liability insurance helps cover bodily injury claims, property damage, and reputational harm, among other risks. Engineering project insurance strategy simulation models can be used to analyze and optimize insurance strategies for projects. Cash flow modeling is an important aspect of insurance business, and efficient methodologies have been proposed to address this

Turbulent Heat Transfer and Pressure Loss in a Square-Duct Heat Exchanger with Inclined-Baffle Inserts

Thermal and friction loss characteristics in a square-duct heat exchanger fitted with inclined-baffles are experimentally examined. Air as the test fluid enters the test duct having a uniform surface heat-flux. The baffles are placed repeatedly on both sides of a rectangular centre-cleared tape/frame before diagonally inserting the baffled frame into the test duct to produce longitudinal vortex flows through the test section. Effects of five different relative baffle height or flow blockage ratios (b/H = BR = 0.1, 0.2, 0.3, 0.4 and 0.5) on heat transfer, pressure loss and thermal performance in the square duct are investigated for Reynolds number ranging from 4100 to 25,600. The relative baffle pitch or pitch ratio (P/H = PR) and baffle attack angle (a) are fixed at 3.0 and 30°, respectively. The experimental results reveal that the heat transfer and pressure drop in the form of respective Nusselt number (Nu) and friction factor (f) from using the baffle tend to increase with the rise of Reynolds number (Re) and BR. The maximum enhancement in Nu and f has been found to be 4.61 and 63.67 times above the smooth duct, respectively. The thermal enhancement factor (h) is maximum at BR = 0.3

Evolution of mirror-image pain in temporomandibular joint osteoarthritis mouse model

Mirror-image pain is a kind of pain that occurs on the contralateral side, but its pathogenesis remains unclear.  Objective: To develop an osteoarthritis mouse model for investigating mirror-image pain through observing nocifensive behaviors, histological changes, and nociceptive activity at days 3, 7, 14, 21, and 28 after the chemical induction of unilateral temporomandibular joint (TMJ) osteoarthritis. Methodology: We randomly divided 6-week-old mice into sham and complete Freund adjuvant groups. To induce nocifensive behaviors, we applied 0.04 g of von Frey filament, 10 psi of air puff, and cold acetone on both sides of whisker pads at different days. The histology of TMJ on both sides was observed by hematoxylin/eosin staining and microcomputed tomography scanning. Furthermore, the nociceptive activity was evaluated using the phosphorylated cyclic AMP response element binding protein (pCREB) and a microglia marker at different days in the trigeminal subnucleus caudalis. Results: Nocifensive behaviors against mechanical and temperature stimuli on the contralateral side became stronger than the baseline on day 28, in agreement with the elevation of the pCREB and the microglia marker in the trigeminal subnucleus caudalis. Thus, hypernociception on the contralateral side occurred at day 28. Conclusions: Clearly, the TMJ model with unilateral osteoarthritis exhibited mirror-image pain. Therefore, this model is useful in investigating the pathogenesis of pain and in developing treatments

Untargeted Metabolomics Analysis using LC-MSQTOF for Metabolite Profile Comparison between Patients with Myofascial Pain of Upper Trapezius Muscle versus Controls

Objective: This study aims to identify different biomarkers of Myofascial pain syndrome (MPS) using untargeted metabolomics screening. Materials and Methods: In a case-control study, serum samples from MPS patients (n = 19) and healthy controls (n = 10) were analyzed using reverse-phase liquid chromatography and mass spectrometry quadrupole time-of-flight (MS-QTOF). The resulted raw data was processed with Progenesis QI data analysis software. The HMBD database was used to identify the metabolites based on their fold change (>1.2), variable importance plot (>1) with P < 0.05. MetaboAnalyst 5.0 was used to generate metabolic network analysis for all identified metabolites. Results: The MPS group reported significantly higher pain on visual analog scale when compared with control while most of the other routine blood chemical profiles were not different. Twenty-seven metabolites were analyzed and identified with untargeted metabolomics analysis which could distinguish MPS patients from healthy controls. Inosine and chenodeoxycholic acid were abundant in the MPS group, whereas the others were low. Metabolites were divided into three categories: lipids, nucleotides, and organic compounds. Possible MPS metabolites included lysoSM (sphingomyelin), lysoPC (lysophosphatidylcholine), lysoPE (lysophosphatidylethanolamine), triglyceride, and inosine. Conclusion: These metabolite profiles, including glycerophospholipids mechanism and purine metabolism, indicate that the inflammatory process might be related to the mechanisms of MPS. A larger sample size, a different trigger point location, and modifications in therapy afterward should all be further explored

Ca2+, Astrocyte Activation and Calcineurin/NFAT Signaling in Age-Related Neurodegenerative Diseases

Mounting evidence supports a fundamental role for Ca2+ dysregulation in astrocyte activation. Though the activated astrocyte phenotype is complex, cell-type targeting approaches have revealed a number of detrimental roles of activated astrocytes involving neuroinflammation, release of synaptotoxic factors and loss of glutamate regulation. Work from our lab and others has suggested that the Ca2+/calmodulin dependent protein phosphatase, calcineurin (CN), provides a critical link between Ca2+ dysregulation and the activated astrocyte phenotype. A proteolyzed, hyperactivated form of CN appears at high levels in activated astrocytes in both human tissue and rodent tissue around regions of amyloid and vascular pathology. Similar upregulation of the CN-dependent transcription factor nuclear factor of activated T cells (NFAT4) also appears in activated astrocytes in mouse models of Alzheimer’s disease (ADs) and traumatic brain injury (TBI). Major consequences of hyperactivated CN/NFAT4 signaling in astrocytes are neuroinflammation, synapse dysfunction and glutamate dysregulation/excitotoxicity, which will be covered in this review article