Increasing frailty is associated with higher prevalence and reduced recognition of delirium in older hospitalised inpatients: results of a multi-centre study

Purpose: Delirium is a neuropsychiatric disorder delineated by an acute change in cognition, attention, and consciousness. It is common, particularly in older adults, but poorly recognised. Frailty is the accumulation of deficits conferring an increased risk of adverse outcomes. We set out to determine how severity of frailty, as measured using the CFS, affected delirium rates, and recognition in hospitalised older people in the United Kingdom. Methods: Adults over 65 years were included in an observational multi-centre audit across UK hospitals, two prospective rounds, and one retrospective note review. Clinical Frailty Scale (CFS), delirium status, and 30-day outcomes were recorded. Results: The overall prevalence of delirium was 16.3% (483). Patients with delirium were more frail than patients without delirium (median CFS 6 vs 4). The risk of delirium was greater with increasing frailty [OR 2.9 (1.8–4.6) in CFS 4 vs 1–3; OR 12.4 (6.2–24.5) in CFS 8 vs 1–3]. Higher CFS was associated with reduced recognition of delirium (OR of 0.7 (0.3–1.9) in CFS 4 compared to 0.2 (0.1–0.7) in CFS 8). These risks were both independent of age and dementia. Conclusion: We have demonstrated an incremental increase in risk of delirium with increasing frailty. This has important clinical implications, suggesting that frailty may provide a more nuanced measure of vulnerability to delirium and poor outcomes. However, the most frail patients are least likely to have their delirium diagnosed and there is a significant lack of research into the underlying pathophysiology of both of these common geriatric syndromes

Improving Nutrient Uptake, Growth, Yield and Protein Content in Chickpea by the Co-Addition of Phosphorus Fertilizers, Organic Manures, and Bacillus sp. MN-54

The main purpose of this study was to examine the impact of different phosphorus (P) fertilizers and organic manures alone and in combination with Bacillus sp. MN-54 on growth, yield, nutrient uptake, chlorophyll (SPAD value) and crude proteins content of chickpea. The simple manure (SM), processed manure (PM), single super phosphate (SSP), and rock phosphate (RP) were applied individually and in different combinations to the soil in pots, and the chickpea seeds treated with Bacillus sp. MN-54 were sown in the selective pots. Results showed that individual use of SM, PM, SSP, RP, and strain MN-54 significantly increased (P ≤ 0.05) the nutrient uptake, growth, yield, and protein content of chickpea as compared to control treatments. While the combined use of SM or PM, SSP or RP, and MN-54 further enhanced this effect. Among different treatments, combined use of RP, PM and MN-54 proved the most effective treatment showing increase of 37.5 and 42.6% in shoot and root lengths, 43.4 and 38.3% in fresh and dry shoot weights, 36.1 and 36.5% in fresh and dry root weights, 45.8% in no. of pods, 43.6% in nodules counts, 16.0% in 100-grain weight and 31–36% nutrient uptake over control treatments. Our findings suggest that the co-addition of organic manures and P fertilizers along with plant growth promoting bacteria (i.e., Bacillus sp. MN-54) not only increases the growth and yield but also improves nodulation, nutrient uptake, and crude proteins content in chickpea

Improving Nutrient Uptake, Growth, Yield and Protein Content in Chickpea by the Co-Addition of Phosphorus Fertilizers, Organic Manures, and <i>Bacillus</i> sp. MN-54

The main purpose of this study was to examine the impact of different phosphorus (P) fertilizers and organic manures alone and in combination with Bacillus sp. MN-54 on growth, yield, nutrient uptake, chlorophyll (SPAD value) and crude proteins content of chickpea. The simple manure (SM), processed manure (PM), single super phosphate (SSP), and rock phosphate (RP) were applied individually and in different combinations to the soil in pots, and the chickpea seeds treated with Bacillus sp. MN-54 were sown in the selective pots. Results showed that individual use of SM, PM, SSP, RP, and strain MN-54 significantly increased (P ≤ 0.05) the nutrient uptake, growth, yield, and protein content of chickpea as compared to control treatments. While the combined use of SM or PM, SSP or RP, and MN-54 further enhanced this effect. Among different treatments, combined use of RP, PM and MN-54 proved the most effective treatment showing increase of 37.5 and 42.6% in shoot and root lengths, 43.4 and 38.3% in fresh and dry shoot weights, 36.1 and 36.5% in fresh and dry root weights, 45.8% in no. of pods, 43.6% in nodules counts, 16.0% in 100-grain weight and 31–36% nutrient uptake over control treatments. Our findings suggest that the co-addition of organic manures and P fertilizers along with plant growth promoting bacteria (i.e., Bacillus sp. MN-54) not only increases the growth and yield but also improves nodulation, nutrient uptake, and crude proteins content in chickpea