The decline in activities of daily living at discharge (DADLD) index : stratifying patients at lower and higher risk

Background: Decreased ability to perform Activities of Daily Living (ADLs) during hospitalisation has negative consequences for patients and health service delivery. Objective: To develop an Index to stratify patients at lower and higher risk of a significant decline in ability to perform ADLs at discharge. Design: Prospective two cohort study comprising a derivation (n=389; mean age 82.3 years; SD� 7.1) and a validation cohort (n=153; mean age 81.5 years; SD� 6.1). Patients and setting: General medical patients aged = 70 years admitted to three university-affiliated acute care hospitals in Brisbane, Australia. Measurement and main results: The short ADL Scale was used to identify a significant decline in ability to perform ADLs from premorbid to discharge. In the derivation cohort, 77 patients (19.8%) experienced a significant decline. Four significant factors were identified for patients independent at baseline: 'requiring moderate assistance to being totally dependent on others with bathing'; 'difficulty understanding others (frequently or all the time)'; 'requiring moderate assistance to being totally dependent on others with performing housework'; a 'history of experiencing at least one fall in the previous 90 days prior to hospital admission' in addition to 'independent at baseline', which was protective against decline at discharge. 'Difficulty understanding others (frequently or all the time)' and 'requiring moderate assistance to being totally dependent on others with performing housework' were also predictors for patients dependent in ADLs at baseline. Sensitivity, specificity, Positive Predictive Value (PPV), and Negative Predictive Value (NPV) of the DADLD dichotomised risk scores were: 83.1% (95% CI 72.8; 90.7); 60.5% (95% CI 54.8; 65.9); 34.2% (95% CI 27.5; 41.5); 93.5% (95% CI 89.2; 96.5). In the validation cohort, 47 patients (30.7%) experienced a significant decline. Sensitivity, specificity, PPV and NPV of the DADLD were: 78.7% (95% CI 64.3; 89.3); 69.8% (95% CI 60.1, 78.3); 53.6% (95% CI 41.2; 65.7); 88.1% (95% CI 79.2; 94.1). Conclusions: The DADLD Index is a useful tool for identifying patients at higher risk of decline in ability to perform ADLs at discharge.

Primary Microcephaly Gene MCPH1 Shows Signatures of Tumor Suppressors and Is Regulated by miR-27a in Oral Squamous Cell Carcinoma

Mutations in the MCPH1 (microcephalin 1) gene, located at chromosome 8p23.1, result in two autosomal recessive disorders: primary microcephaly and premature chromosome condensation syndrome. MCPH1 has also been shown to be downregulated in breast, prostate and ovarian cancers, and mutated in 1/10 breast and 5/41 endometrial tumors, suggesting that it could also function as a tumor suppressor (TS) gene. To test the possibility of MCPH1 as a TS gene, we first performed LOH study in a panel of 81 matched normal oral tissues and oral squamous cell carcinoma (OSCC) samples, and observed that 14/71 (19.72%) informative samples showed LOH, a hallmark of TS genes. Three protein truncating mutations were identified in 1/15 OSCC samples and 2/5 cancer cell lines. MCPH1 was downregulated at both the transcript and protein levels in 21/41 (51.22%) and 19/25 (76%) OSCC samples respectively. A low level of MCPH1 promoter methylation was also observed in 4/40 (10%) tumor samples. We further observed that overexpression of MCPH1 decreased cellular proliferation, anchorage-independent growth in soft agar, cell invasion and tumor size in nude mice, indicating its tumor suppressive function. Using bioinformatic approaches and luciferase assay, we showed that the 3'-UTR of MCPH1 harbors two non-overlapping functional seed regions for miR-27a which negatively regulated its level. The expression level of miR-27a negatively correlated with the MCPH1 protein level in OSCC. Our study indicates for the first time that, in addition to its role in brain development, MCPH1 also functions as a tumor suppressor gene and is regulated by miR-27a.

A critical review on in situ reduction of graphene oxide during preparation of conducting polymeric nanocomposites

Graphene oxide (GO), prepared by chemical oxidation of graphite, serves as a building block for developing polymeric nanocomposites. However, their application in electrical conductivity is limited by the fact that the oxygen sites on GO trap electrons and impede charge transport. Conducting nanocomposites can be developed by reducing GO. Various strategies have been adopted to either reduce GO ex situ, before the composite preparation, or in situ during the development of the nanocomposites. The current state of research on in situ reduction of GO during the preparation of conducting polymeric nanocomposites is discussed in this review. The mechanism and the efficiency of reduction is discussed with respect to various strategies employed during the preparation of the nanocomposite, the type of polymer used, and the processing conditions employed, etc. Its overall effect on the electrical conductivity of the nanocomposites is also discussed and the future outlook in this area is presented.

Porous membranes designed from bi-phasic polymeric blends containing silver decorated reduced graphene oxide synthesized via a facile one-pot approach

In this work, porous membranes were designed by selectively etching the PEO phase, by water, from a melt-mixed PE/PEO blend. The pure water flux and the resistance across the membrane were systematically evaluated by employing an indigenously developed cross flow membrane setup. Both the phase morphology and the cross sectional morphology of the membranes was assessed by scanning electron microscopy and an attempt was made to correlate the observed morphology with the membrane performance. In order to design antibacterial membranes for water purification, partially reduced graphene oxide (rGO), silver nanoparticles (Ag) and silver nanoparticles decorated with rGO (rGO-Ag) were synthesized and incorporated directly into the blends during melt mixing. The loss of viability of bacterial cells was determined by the colony counting method using E. coli as a model bacterium. SEM images display that the direct contact with the rGO-Ag nanoparticles disrupts the cell membrane. In addition, the rGO-Ag nanoparticles exhibited a synergistic effect with respect to bacterial cell viability in comparison to both rGO and Ag nanoparticles. The possible mechanism associated with the antibacterial activity in the membranes was discussed. This study opens new avenues in designing antibacterial membranes for water purification.

A Surlyn/magnesium oxide nanocomposite as an effective water vapor barrier for organic device encapsulation

A reactive polymer nanocomposite system was proposed as an effective water vapor barrier material for organic device encapsulation. Nanosized magnesium oxide (MgO) was synthesized by the solution combustion technique using two different fuels, lactose and alanine. The purity and crystallite size of MgO were determined from X-ray diffraction studies. The surface areas and porosity measurements were used to determine the water adsorption capacities of MgO. Nanocomposites with various concentrations (wt% = 0.25, 0.5, 1 and 2.5) of MgO were prepared using Surlyn as the base polymer. The permeation rate of moisture through the fabricated films was calculated using calcium degradation test and these rates were further used to calculate the diffusivities. Accelerated aging experiments were conducted to study the performance of organic photovoltaic devices encapsulated with synthesized films under accelerated weathering conditions. The performance of the barrier materials with synthesized MgO was also compared to that obtained with commercial MgO. The films containing MgO obtained from lactose exhibited better barrier properties compared to other films made with commercial MgO and MgO synthesized using alanine as well as other nanocomposites reported in the literature.

Evaluación de diferentes niveles de rastrojo, métodos y densidades de siembra, en el cultivo del maiz (Zea mays L.) variedad NB-6

El presente estudio se estableció en terrenos del Centro Experimental La Compañía, ubicado en el municipio de San Marcos departamento de Carazo a una altura de 480 msnm a 11”51 latitud norte y 86”11 latitud Oeste, durante la época de primera que comprende desde el mes de Junio hasta el mes de octubre de 1996, con precipitaciones promedios de 1 400 mm anuales y temperaturas promedio de 24 grados Celcius (INETER, 1996). Esto con el objetivo de evaluar la sembradora combinada PROMECH con el arado egipcio en dos densidades de siembra (50 mil y 65 mil plantas por hectárea), y tres niveles de rastrojo (0.3 y 5 toneladas por hectárea), en el cultivo de maíz (Zea mays, L.) variedad NB-6, se utilizó un diseño de Bloques completamente al azar (BCA), en tres repeticiones. De los resultados obtenidos se observó que el mayor número de plántulas emergió en los tratamientos donde se trabajó con 5 t/ha de rastrojo, con el uso de la Sembradora Combinada y con densidad poblacional de 65 000 plantas /ha con un promedio de 64 291 plantas /ha, el mayor diámetro del tallo se encontró en los tratamientos donde se trabajó con niveles de 3 t/ha de rastrojo, utilizando la sembradora combinada y con densidad poblacional de 50 000 plantas /ha, con un promedio de 2,88 cm de diámetro, el menor número de plantas acamadas se encontró en los tratamientos donde se aplicó 3 t/ha de rastrojo, la sembradora Combinada y densidad poblacional de 50 000 plantas/ha, con un promedio de 2 519 plantas acamadas por hectárea, el mayor número de mazorcas cosechadas se obtuvo con la aplicación de 3 t/ha de rastrojo, utilizando la sembradora combinada y con densidad poblacional de 65 000 plantas /ha, con un promedio de 58 772 mazorcas/ha; la mayor cantidad de biomasa seca (5 41 t/ha), se obtuvo en los tratamientos con aplicación de 3 t/ha de rastrojo, usando la sembradora combinada y con densidad poblacional de 65 000 plantas/ha, el mayor rendimiento (1 439.6 kg/ha) se obtuvo en la tratamientos donde se aplicó la interacción 3 t/ha de rastrojo, usando la sembradora combinada y con densidad poblacional de 50 000 plantas/ha

Nuclear reactions leading to energy levels of Ar37 and K37

In view of recent interest in the Cl³⁷ (ʋ solar’^e-)Ar³⁷ reaction cross section, information on some aspects of mass 37 nuclei has been obtained using the K³⁹ (d, ∝) Ar³⁷ and Cl³⁵ (He³, p) Ar³⁷ reactions. Ar³⁷ levels have been found at 0, 1.41, 1.62, 2.22, 2.50, 2.80, 3.17, 3.27, 3.53, 3.61, 3.71, (3.75), (3.90), 3.94, 4.02, (4.21), 4.28, 4.32, 4.40, 4.45, 4.58, 4.63, 4.74, 4.89, 4.98, 5.05, 5.10, 5.13, 5.21, 5.35, 5.41, 5.44, 5.54, 5.58, 5.67, 5.77, and 5.85 MeV (the underlined values correspond to previously tabulated levels). The nuclear temperature calculated from the Ar³⁷ level density is 1.4 MeV. Angular distributions of the lowest six levels with the K³⁹ (d, ∝) Ar³⁷ reaction at E_d = 10 MeV indicate a dominant direct interaction mechanism and the inapplicability of the 2I + 1 rule of the statistical model. Comparison of the spectra obtained with the K³⁹ (d, ∝) Ar³⁷ and Cl³⁵ (He³, p) Ar³⁷ reactions leads to the suggestion that the 5.13-MeV level is the T = 3/2 Cl³⁷ ground state analog. The ground state Q-value of the Ca⁴⁰ (p, ∝) K³⁷ reaction has been measured: -5179 ± 9 keV. This value implies a K³⁷ mass excess of -24804 ± 10 keV. Description of a NMR magnetometer and a sixteen-detector array used in conjunction with a 61-cm double-focusing magnetic spectrometer are included in appendices.

SIHSUS como fonte para o estudo de morbi-mortalidade por medicamentos no Estado do Rio de Janeiro

A despeito de suas limitações, os dados do SIHSUS são os mais sistemáticos e abrangentes sobre as Reações Adversas e Intoxicações a medicamentos que provocam hospitalização. Eles demonstram a importância das ações de educação e investigação de casos do Programa Nacional de Farmacovigilância para possibilitar o diagnóstico mais acurado e superação do quadro atual de ocorrência desses agravos, além da possibilidade de o SIH/SUS ser utilizado sistematicamente como fonte de dados na detecção e análise dos problemas relacionados a medicamentos. No período de 1999 a 2007, foram emitidas 6.670.609 AIH (tipo 1), entre as quais 3.611 foram classificadas como internações devidas a RAM e 4.675 como Intoxicações, correspondendo, respectivamente, às taxas médias de 5,41 casos por 104 AIH e 7,2 casos por 104 AIH. Ocorreram 137 óbitos (3,79% das AIH) por RAM e 207 (4,43% das AIH) por Intoxicações na população internada. Tanto as RAM como as Intoxicações tiveram menor chance de levar ao óbito quando comparados às outras causas. Uma característica da distribuição dos RAM foi concentrar 62% das AIH nas faixas etárias de 20 a 59 anos de idade (grupo adulto). Nas Intoxicações merece destaque a elevada proporção de AIH na faixa etária de 0-4 anos (14,29%). As AIH registradas com causas básicas relacionados a RAM foram principalmente de pacientes do sexo masculino, já as Intoxicações foram principalmente de pacientes do sexo feminino. Em ambos tipos de agravos estes pacientes foram internados em hospitais que não faziam parte da Rede de Hospitais Sentinelas do Programa Nacional de Farmacovigilância. No entanto, a probabilidade destes hospitais registrarem as AIH com códigos CID-10 referentes às RAM é maior, o que ocorre provavelmente por estarem mais capacitados em diagnosticar este tipo de agravo. Porém este fato não foi observado para as Intoxicações. Os fármacos que causaram os agravos estudados são psicoativos. Este estudo apresentou algumas evidências sobre a distribuição da morbi-mortalidade provocada por medicamentos entre pacientes internados em hospitais conveniados ao SUS no período de 1999-2007, baseadas nas informações das AIH, que podem ser úteis ao Programa de Farmacovigilância no Estado do Rio de Janeiro.

杜泊羊冷冻胚胎移植的影响因素

下载PDF阅读器为进一步提高杜泊羊的冻胚移植成功率,于春秋两季同期处理湖羊和小尾寒羊受体共997只(次),同期发情782只(次),发情率达78.4%,其中湖羊春秋两季平均发情率为84.6%,显著高于小尾寒羊(73.9%)(P＜0.01),秋季两品种平均发情率83.3%,显著高于春季75.8%(P＜0.01);对431只发情受体羊进行移植,总妊娠率为58.5%(252/431),产羔率为58.0%(250/431).其中湖羊为受体的春秋两季平均妊娠率62.5%,高于小尾寒羊(54.7%);秋季两品种的平均妊娠率为64.8%,显著高于春季(52.5%).囊胚移植后的平均妊娠率为61.5%,显著高于桑椹胚(41.5%),其中A级囊胚为67.4%,显著高于B级囊胚(P＜0.05)和所有桑椹胚(P＜0.01);B级囊胚显著高于B级桑椹胚(P＜0.05),B级囊胚与A级桑椹胚间及A、B级桑椹胚间均无显著差异;C级囊胚和桑椹胚均未见妊娠.此外,受体羊卵巢黄体发育状况及移植技术熟练程度对妊娠率也有显著影响.

印刷线路板废弃物的热解与动力学实验研究

分别应用管式炉反应器和热重分析手段对印刷线路板废弃物的热解行为和热解动力学进行了实验研究。在管式炉中，研究不同的热解温度：700～950℃，对产物分布和气体成分分布的影响。实验结果表明：PCB热解气体的主要成分是H2和CO2，气体的热值较低，仅为2.09～5.41MJ/m^3，PCB不适合以气体产物为目标的能源利用方式。应用Friedman方法对PCB的热解动力学进行了研究，求得PCB的热解动力学参数分别是：表观活化能190.92kJ/mol，反应级数5.97，指前因子lnA47.14min^-1。

黄土丘陵区退耕前后典型流域农业生态经济系统能值分析

应用能值分析理论和方法,从资源的投入和产出结构角度对黄土丘陵区退耕还林草政策实施前后纸坊沟流域农业生态经济系统的资源利用、环境压力、能值指标变化及生态经济效益进行比较研究。结果表明:退耕前,该流域农业生态经济系统农产品总产出能值为7.53E+18 sej,退耕后减小了1.50E+17 sej,单位面积农产品生产力由退耕前的5.38E+15 sej/hm2上升到退耕后的1.68E+16 sej/hm2,畜产品的产出能值有所下降。退耕后系统生产优势度指数由退耕前的0.60上升到0.72,系统稳定性指数由退耕前的0.51增加到退耕后的0.53,退耕后流域人口承载力较退耕前大。退耕前后该流域能值投入率及环境负荷几乎无变化,净能值产出率由0.11增加到0.29,退耕前流域人均能值用量为5.16×1015 sej,退耕后增加到5.41×1015 sej,系统可持续发展指数由退耕前的2.55上升到退耕之后的6.69。退耕后,能值-货币比为2.21×1012 sej/＄,与退耕前相比变化不大。为了使该流域的农业生态系统更加持续稳定的发展,需进一步调整农业结构,优化资源投入配置,提高资源生产效率,减小环境负荷,逐步走向系统可持...

准连续5kW叠层激光二极管列阵

报导了5kW GaAs/AlGaAs叠层激光二极管列阵的制作过程和测试结果。通过金属有机物化学气相沉积方法实现分别限制单量子阱结构。1cm激光条的填充密度是70%。采用80个激光条叠层封装，激光条间距是0.5mm，功率密度达1.25kW/cm~2，峰值波长是809.0nm，谱线宽度是4.8nm。