Prevalence and risk factors of sarcopenia among adults living in nursing homes

Objectives: Sarcopenia is a progressive loss of skeletal muscle and muscle function, with significant healthand disability consequences for older adults. We aimed to evaluate the prevalence and risk factors ofsarcopenia among older residential aged care adults using the European Working Group on Sarcopeniain Older People (EWGSOP) criteria.Study design: A cross-sectional study design that assessed older people (n = 102, mean age 84.5 ± 8.2 years)residing in 11 long-term nursing homes in Australia.Main outcome measurements: Sarcopenia was diagnosed from assessments of skeletal mass index bybioelectrical impedance analysis, muscle strength by handheld dynamometer, and physical performanceby the 2.4 m habitual walking speed test. Secondary variables where collected to inform a risk factoranalysis.Results: Forty one (40.2%) participants were diagnosed as sarcopenic, 38 (95%) of whom were categorizedas having severe sarcopenia. Univariate logistic regression found that body mass index (BMI) (Oddsratio (OR) = 0.86; 95% confidence interval (CI) 0.78–0.94), low physical performance (OR = 0.83; 95% CI0.69–1.00), nutritional status (OR = 0.19; 95% CI 0.05–0.68) and sitting time (OR = 1.18; 95% CI 1.00–1.39)were predictive of sarcopenia. With multivariate logistic regression, only low BMI (OR = 0.80; 95% CI0.65–0.97) remained predictive.Conclusions: The prevalence of sarcopenia among older residential aged care adults is very high. Inaddition, low BMI is a predictive of sarcopenia

Distribution, Abundance, and Age Structure of Red Snapper (Lutjanus campechanus) Caught on Research Longlines in U.S. Gulf of Mexico

Two pilot surveys were conducted in the northern Gulf of Mexico (Gulf) to determine the feasibility of sampling red snapper (Lutjanus campechanus) populations in offshore waters with bottom longline gear. The first pilot survey off Mississippi-Alabama was conducted in May 1999 and yielded a total of seven snapper from 60 stations. The second pilot survey was off Texas in June 2000 and yielded a total of 76 snapper from 44 stations. The catch per unit effort was 0.12 red snapper/100 hook hr [coefficient of variation (CV) = 0.54] in 1999 and 1.73 red snapper/100 hook hr (CV = 0.21) in 2000. Otoliths were removed from all collected red snapper, and ages were assigned with an average percent error of 3.71%. Red snapper from the 1999 survey ranged from 405 to 873 mm total length (TL) (545 mm TL median) and from 3 to 19 yr (median age 5 yr). The red snapper from Texas ranged in size from 380 to 903 mm TL (755 mm TL median) and ranged in age from 3 to 53 yr (median age 11 yr). Based on the results of the pilot surveys, expanded longline surveys targeting red snapper were conducted in 2001 and 2002; these surveys yielded 86 snapper and 75 snapper, respectively. The 2001 snapper ranged from 427 to 950 mm TL (770 mm TL median) and from 3 to 37 yr (median age 12 yr). The 2002 snapper ranged from 409 to 950 mm TL (815 mm TL median) and from 4 to 44 yr (median age 13 yr). Twelve red snapper were captured in the eastern Gulf (east of the Mississippi River), and their ages ranged from 3 to 19 yr (median age 6 yr). The 232 red snapper that were caught in the western Gulf ranged in age from 3 to 53 yr (median age 12 yr). A difference in catch rates by depth was also noted with most red snapper captures occurring in the 55-92 m depth range

The incidence of deep vein thrombosis detected by routine surveillance ultrasound in neurosurgery patients receiving dual modality prophylaxis.

The optimal method of thromboprophylaxis and the value of screening ultrasonography for detection of deep venous thrombosis (DVT) in neurosurgery patients remains unclear. The goal of this study was to determine the incidence of DVT in neurosurgical patients who, by hospital protocol, receive surveillance ultrasonography of the lower extremities twice weekly, in addition to prophylaxis with unfractionated heparin and external pneumatic compression sleeves. A retrospective review of 7,298 ultrasound studies carried out on 2,593 patients over 4 years at a university neurosurgical hospital was conducted. There was a 7.4% incidence of proximal lower extremity DVT and a 9.7% total incidence including distal DVT. A greater number of distal DVTs were detected with the implementation of whole-leg ultrasonography in the last 2 years of observation. Chart review of 237 patients diagnosed with DVT demonstrated an admitting diagnosis of subarachnoid hemorrhage in nearly half of the patients. The median hospital length of stay for DVT patients was 18 days. Institutional control data demonstrated non-ruptured aneurysm and cerebrovascular anomalies to be the leading reason for admission, followed closely by subarachnoid hemorrhage. The hospital protocol of biweekly screening ultrasound and dual modality prophylaxis for neurosurgery patients resulted in a proximal DVT incidence consistent with that demonstrated by previous studies of standardized dual modality prophylaxis, and higher than that demonstrated in previous studies that employed ultrasound screening protocols

Solubilised bright blue-emitting iridium complexes for solution processed OLEDs

EZ-C acknowledges the University of St Andrews for financial support. IDWS and AKB acknowledge support from EPSRC (EP/J01771X). The authors would like to thank the Engineering and Physical Sciences Research Council for financial support for Adam Henwood: EPSRC DTG Grants: EP/J500549/1; EP/K503162/1; EP/L505097/1.Combining a sterically bulky, electron-deficient 2-(2,4-difluorophenyl)-4-(2,4,6- trimethylphenyl)pyridine (dFMesppy) cyclometalating C^N ligand with an electron rich, highly rigidified 1,1’-(α,α’-o-xylylene)-2,2’-biimidazole (o-xylbiim) N^N ligand gives an iridium complex, [Ir(dFMesppy)2(o-Xylbiim)](PF6), that achieves extraordinarily bright blue emission (ΦPL = 90%; λmax = 459 nm in MeCN) for a cationic iridium complex. This complex is compared with two reference complexes bearing 4,4’-di-tert-butyl-2,2’- bipyridine, and solution-processed organic light emitting diodes (OLEDs) have been fabricated from these materials.Publisher PDFPeer reviewe

The drugs don't sell: DIY heart health and the over-the-counter statin experience

This paper draws on a study of over-the-counter statins to provide a critical account of the figure of the ‘pharmaceutical consumer’ as a key actor in the pharmaceuticalisation literature. A low dose statin, promising to reduce cardiovascular risk, was reclassified to allow sale in pharmacies in the UK in 2004. We analysed professional and policy debates about the new product, promotional and sales information, and interviews with consumers and potential consumers conducted between 2008 and 2011, to consider the different consumer identities invoked by these diverse actors. While policymakers constructed an image of ‘the citizen-consumer’ who would take responsibility for heart health through exercising the choice to purchase a drug that was effectively rationed on the NHS and medical professionals raised concerns about ‘a flawed consumer’ who was likely to misuse the product, both these groups assumed that there would be a market for the drug. By contrast, those who bought the product or potentially fell within its target market might appear as ‘health consumers’, seeking out and paying for different food and lifestyle products and services, including those targeting high cholesterol. However, they were reluctant ‘pharmaceutical consumers’ who either preferred to take medication on the advice of a doctor, or sought to minimize medicine use. In comparison to previous studies, our analysis builds understanding of individual consumers in a market, rather than collective action for access to drugs (or, less commonly, compensation for adverse effects). Where some theories of pharmaceuticalisation have presented consumers as creating pressure for expanding markets, our data suggests that sociologists should be cautious about assuming there will be demand for new pharmaceutical products, especially those aimed at prevention or asymptomatic conditions, even in burgeoning health markets

Rapid desensitization through immunoadsorption during cardiopulmonary bypass. A novel method to facilitate human leukocyte antigen incompatible heart transplantation

Background: Anti-human leukocyte antigen (HLA)-antibody production represents a major barrier to heart transplantation, limiting recipient compatibility with potential donors and increasing the risk of complications with poor waiting-list outcomes. Currently there is no consensus to when desensitization should take place, and through what mechanism, meaning that sensitized patients must wait for a compatible donor for many months, if not years. We aimed to determine if intraoperative immunoadsorption could provide a potential desensitization methodology. Methods: Anti-HLA antibody-containing whole blood was added to a Cardiopulmonary bypass (CPB) circuit set up to mimic a 20 kg patient undergoing heart transplantation. Plasma was separated and diverted to a standalone, secondary immunoadsorption system, with antibody-depleted plasma returned to the CPB circuit. Samples for anti-HLA antibody definition were taken at baseline, when combined with the CPB prime (on bypass), and then every 20 min for the duration of treatment (total 180 min). Results: A reduction in individual allele median fluorescence intensity (MFI) to below clinically relevant levels (4000 was demonstrated. Reduction occurred in all cases within 120 min, demonstrating efficacy in a time period usual for heart transplantation. Flowcytometric crossmatching of suitable pseudo-donor lymphocytes demonstrated a change from T cell and B cell positive channel shifts to negative, demonstrating a reduction in binding capacity. Conclusions: Intraoperative immunoadsorption in an ex vivo setting demonstrates clinically relevant reductions in anti-HLA antibodies within the normal timeframe for heart transplantation. This method represents a potential desensitization technique that could enable sensitized children to accept a donor organ earlier, even in the presence of donor-specific anti-HLA antibodies

Healthcare practitioner views and experiences of patients self-monitoring blood pressure: vignette study

Background Home self-monitoring of blood pressure is widely used in primary care to assist in the diagnosis of hypertension, as well as to improve clinical outcomes and support adherence to medication. The National Institute for Health and Care Excellence (NICE) care pathways for hypertension recommend specific guidelines, although they lack detail on supporting patients to self-monitor. Aim To elicit primary care practitioners’ experiences of managing patients’ home blood pressure self-monitoring, across surgeries located in different socioeconomic areas. Design & setting A qualitative focus group study was conducted with a total of 21 primary care professionals. Method Participants were GPs and practice nurses (PNs), purposively recruited from surgeries in areas of low and high deprivation, according to the English indices of multiple deprivation. Six vignettes were developed featuring data from interviews with people who self-monitor and these were used in five focus groups. Results were thematically analysed. Results Themes derived in the thematic analysis largely reflected topics covered by the vignettes. These included: advice on purchase of a device; supporting home monitoring; mitigating patient anxiety experienced as a result of home monitoring; valuing patients’ data; and effect of socioeconomic factors. Conclusion The work provides an account of methods used by primary care practitioners in the management of home blood pressure self-monitoring, where guidance may be lacking and primary care practitioners act on their own judgement. Findings complement recent policy documentation, which recognises the need to adopt new ways of working to empower patients (for example, additional support from healthcare assistants), but lacks detail on how this should be done

Molecular phylogenetics reveals a new species of Prostanthera from tropical Queensland with links to more southerly taxa

Prostanthera eungella B.J.Conn & K.M.Proft (Lamiaceae) is described as a new species from the South Kennedy botanical region of northern Queensland. Concatenated nuclear (ETS) and chloroplast (trnH–psbA) sequence data for 38 species of Prostanthera were analysed using maximum-likelihood and Bayesian-inference methods. These combined data recovered P. eungella as part of a polytomy that included P. galbraithiae, P. howelliae¸ and a P. tallowa + P. lasianthos clade. A detailed description, photograph of holotype specimen, and distribution map of P. eungella are provided

Conjugated, rigidified bibenzimidazole ancillary ligands for enhanced photoluminescence quantum yields of orange/red-emitting iridium(III) complexes

EZ-C acknowledges the University of St Andrews for financial support. We thank Umicore AG for the gift of materials. We would like to thank the Engineering and Physical Sciences Research Council for financial support for E.Z-C. (EP/M02105X/1) and for the studentship of A.H. (EP/J500549/1, EP/K503162/1, EP/L505097/1). We thank the EPSRC UK National Mass Spectrometry Facility at Swansea University for analytical services. We also would like to thank EaStCHEM and the School of Chemistry for supporting the computing facilities maintained by Dr. H. Früchtl.A series of six novel [Ir(C^N)2(N^N)](PF6) complexes (C^N is one of two cyclometalating ligands: 2-phenyl-4-(2,4,6-trimethylphenyl)pyridine, MesppyH, or 2- (napthalen-1-yl)-4-(2,4,6-trimethylphenyl)pyridine, MesnpyH; N^N denotes one of four neutral diamine ligands: 4,4’-di-tert-butyl-2,2’-bipyridine, dtbubpy, 1H,1’H-2,2’- bibenzimiazole, H2bibenz, 1,1’-(α,α’-o-xylylene)-2,2’-bibenzimidazole, o-Xylbibenz or 2,2’- biquinoline, biq) were synthesised and their structural, electrochemical and photophysical properties comprehensively characterised. The more conjugated MesnpyH ligands confer a red-shift in the emission compared to MesppyH but maintain high photoluminescence quantum yields due to the steric bulk of the mesityl groups. The H2bibenz and o-Xylbibenz ligands are shown to be electronically indistinct to dtbubpy but give complexes with higher quantum yields than analogous complexes bearing dtbubpy. In particular, the rigidity of the o-Xylbibenz ligand, combined with the steric bulk of the MesnpyH C^N ligands, give a red-emitting complex 4 (λPL = 586, 623 nm) with a very high photoluminescence quantum yield (ΦPL = 44%) for an emitter in that regime of the visible spectrum. These results suggest that employing these ligands is a viable strategy for designing more efficient orange-red emitters for use in a variety of photophysical applications.PostprintPeer reviewe