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

Machine Learning-Based Dynamic Attribute Selection Technique for DDoS Attack Classification in IoT Networks

The exponential growth of the Internet of Things (IoT) has led to the rapid expansion of interconnected systems, which has also increased the vulnerability of IoT devices to security threats such as distributed denial-of-service (DDoS) attacks. In this paper, we propose a machine learning pipeline that specifically addresses the issue of DDoS attack detection in IoT networks. Our approach comprises of (i) a processing module to prepare the data for further analysis, (ii) a dynamic attribute selection module that selects the most adaptive and productive features and reduces the training time, and (iii) a classification module to detect DDoS attacks. We evaluate the effectiveness of our approach using the CICI-IDS-2018 dataset and five powerful yet simple machine learning classifiers—Decision Tree (DT), Gaussian Naive Bayes, Logistic Regression (LR), K-Nearest Neighbor (KNN), and Random Forest (RF). Our results demonstrate that DT outperforms its counterparts and achieves up to 99.98% accuracy in just 0.18 s of CPU time. Our approach is simple, lightweight, and accurate for detecting DDoS attacks in IoT networks

Protein Profiling of Indegnous Common Bean Through SDS-PAGE

This activity was aimed to investigate the proteomic diversity of common bean landraces collected fromthe different ecological zones of Malakand division, KP, Pakistan. The genetic diversity was assessedthrough seed storage protein profile using SDS-PAGE of 117 landraces collected from differentecological zones of Malakand division, KP, Pakistan. The protein summaries were confirmed via SDSPAGE. The electrophoregram produced ten bands ranging from 180 to 10 kDa with Molecular WeightMarker. The electrophoregram exhibited two zones RI and RII. The R-I, contained six bands ranging insize from 180 to 34kDa and RII is comprised of 4 bands ranging in size from 33 to 10kDa.The averageGenetic Index for R-I was 17%, while for R-II, it was 27%. Among all bands, B-4 and B-5 was found tohave the greatest genetic diversity (90.59% and 88.88%, respectively). The dendrogram based on R-Iand R-II zones sorted all the landmarks into 13 and 10 clusters respectively, showed high level of GDwithin 117 landraces. High degree of Variation in protein band profile and multiple clustering validate thatin future Pakistani bean landraces will provide an abundant chance for obtaining genetically strong andstable genotype with high valued production to breeders.&nbsp;</p

Alleviation of Cadmium Adverse Effects by Improving Nutrients Uptake in Bitter Gourd through Cadmium Tolerant Rhizobacteria

Cadmium is acute toxicity inducing heavy metal that significantly decreases the yield of crops. Due to high water solubility, it reaches the plant tissue and disturbs the uptake of macronutrients. Low uptake of nutrients in the presence of cadmium is a well-documented fact due to its antagonistic relationship with those nutrients, i.e., potassium. Furthermore, cadmium stressed plant produced a higher amount of endogenous stress ethylene, which induced negative effects on yield. However, inoculation of 1-amino cyclopropane-1-carboxylate deaminase (ACCD), producing plant growth promoting rhizobacteria (PGPR), can catabolize this stress ethylene and immobilized heavy metals to mitigate cadmium adverse effects. We conducted a study to examine the influence of ACCD PGPR on nutrients uptake and yield of bitter gourd under cadmium toxicity. Cadmium tolerant PGPRs, i.e., Stenotrophomonas maltophilia and Agrobacterium fabrum were inoculated solely and in combination with recommended nitrogen, phosphorus, and potassium fertilizers (RNPKF) applied under different concentration of soil cadmium (2 and 5 mg kg&minus;1 soil). Results showed that A. fabrum with RNPKF showed significant positive response towards an increase in the number of bitter gourds per plant (34% and 68%), fruit length (19% and 29%), bitter gourd yield (26.5% and 21.1%), N (48% and 56%), and K (72% and 55%) concentration from the control at different concentrations of soil cadmium (2 and 5 mg kg&minus;1 soil), respectively. In conclusion, we suggest that A. fabrum with RNPKF can more efficaciously enhance N, K, and yield of bitter gourd under cadmium toxicity

Carvedilol vs. esophageal variceal band ligation in the primary prophylaxis of variceal hemorrhage: a multicentre randomized controlled trial.

Background & Aims: Esophageal variceal bleed is a major problem in patients with cirrhosis. Endoscopic variceal ligation (EVL) has been shown to be equal to or better than propranolol in preventing first bleed. Carvedilol is a non-selective b blocker with alpha-1 adrenergic blocker activity. Hemodynamic studies have shown carvedilol to be more effective than propranolol at reducing portal pressure. We compared efficacy of carvedilol with EVL for primary prophylaxis of esophageal variceal bleed. Methods: Cirrhotic patients with esophageal varices were randomized to carvedilol 12.5 mg daily or EVL at three university hospitals of Pakistan. End points were esophageal variceal bleeding, death or liver transplant. Results: Two hundred and nine patients were evaluated. Eighty two and eighty six patients were randomized in carvedilol and EVL arms respectively. Mean age was 48 ± 12.2 years; 122 (72.7%) were males; 89.9% had viral cirrhosis; mean Child-Pugh score was 7.3 ± 1.6 and mean follow up was 13.3 ± 12.1 months (range 1–50 months). Both EVL and carvedilol groups had comparable variceal bleeding rates (8.5% vs. 6.9%), bleed related mortality (4.6% vs. 4.9%) and overall mortality (12.8% vs. 19.5%) respectively. Adverse events in carvedilol group were hypotension (n = 2), requiring cessation of therapy, while transient nausea (n = 18) and dyspnea (n = 30) resolved spontaneously. In the EVL arm, post banding ulcer bleed (n = 1) and chest pain (n = 17), were termed as serious adverse events while transient dysphagia (n = 58) resolved without treatment

Antioxidant and anti-inflammatory potentials of aerial and floral parts of Neurada procumbens extracts: In vitro and in vivo studies

Neurada procumbens (Neuradaceae) is an importent plant of the Cholistan desert and is traditionally been used for the treatment and control of diabetes, fever, inflammations and jaundice. The aim of the current project is to investigate the bioactive compounds, free radical scavenging capacity and the anti-inflammatory potential of Neurada procumbens separately for its aerial and floral parts in six different extracts. The phytochemical profile (total bioactive contents, HPLC polyphenolic quantification), anti-oxidant (DPPH and FRAP assays), anti-inflammatory (HRBC stabilization) activities of the Aqu, MetOH, n-But, EtAc, n-Hex, and DCM extracts from the aerial and floral parts of Neurada procumbens were quantified. Based on the current results, the aerial and floral parts of N. procumbens extracts have found to contain a significant amount of active metabolites including polyphenolic compounds such as 2,3 di MeO benzoic acid, p-coumaric acid, chlorogenic acid, quercetin dihydrate and t-ferrulic acid. The total phenolic and total flavonoid contents of the plant were found to range from 28.13 to 78.9 GAE mg/g of plant and 17.23 to 68.23 RE mg/g of plant, respectively. DCM and n-But extracts of floral part exhibited comparatively higher antioxidant potential in DPPH (IC50 < 100 μg/ml) and FRAP (IC50 < 55 μg/ml) assays compared to aerial part. The dichloromethane floral extract demonstrated impressive anti-inflammatory activity in the hemolytic red blood cell lysis assay, with 83 % protection of HRBC lysis at an IC50 of 469.6 µg/ml (p < 0.01). In vivo, a 300 mg/kg body weight of DCM floral extract reduced carrageenan-induced paw oedema by 8.51 ± 0.35 mm to 7.65 ± 0.38 mm, a highly significant difference (p < 0.001).The toxicity studies revealed that the floral-DCM dose extract was found to be safe up to 2000 mg/kg BW, while its lethal dose (LD50) was found to be 4472.13 mg/kg BW in rats. Due to quite low toxicity effects, the floral part of the plant could be recommended as a safe pharmacological agent for various therapeutic applications

Impact of acidified carbon on maize growth, yield and grains nutrients concentration under normal irrigation and osmotic stress

Osmotic stress is a major hurdle to the optimization of maize productivity. Limited availability of what the decrease the maize productivity due to alteration in metabolic activities. It also decreases the uptake of essential nutrients in the plants which resulted in limited photosynthetic activities. Such conditions resulted in poor plant growth and productivity. To overcome this critical issue, most scientists suggest incorporating organic amendments in the soil. These days incorporation of acidified carbon (AC) is becoming popular for the alleviation of abiotic stresses in crops. It can not only improve soil physicochemical properties but also increases the bioavailability of nutrients to plants. That's why the current study was conducted to explore the best application rate of AC for maize under osmotic stress. There were application rates of AC i.e., 0, 0.75, and 1.50% applied under 70, 50, and 30% field capacity (FC). Results showed that shoot (47.14 and 82.60%) and root length (32.19 and 69.76%), shoot fresh (102.40 and 135.22%) and dry weight (77.19 and 121.51%), root fresh (82.82 and 104.42%) and dry weight (59.17 and 80.30%) were significantly enhanced in maize by application of 0.75 and 1.50% AC under 30% FC. A significant decrease in the electrolyte leakage also validated the effectiveness of 0.75 and 1.50% AC for alleviation of osmotic stress in maize. In conclusion, 0.75 and 1.50% AC are effective in the improvement of maize growth and yield attributes in maize. More investigations are suggested at the field level to declare 1.50% AC as the best treatment for alleviation of osmotic stress